The necessity of WeChat public platform-based subject service in medical college and university libraries was analyzed according to its characteristics and problems, followed by an elaboration with the application of We-Chat public platform in common information release, personal information push, reference service, interactive ex-change,information network navigation, educational training, and its management and maintenance, with sugges-tions put forward for improving WeChat public platform-based subject service.

Objective To evaluate the role of spinal extracellular signal-regulated kinase (ERK) signaling pathway in reduction of remifentanil-induced hyperalgesia by electro-acupuncture (EA) at Zusanli in rats with incisional pain.Methods Fifty male adult Sprague-Dawley rats, weighing 250-280 g, in which the intrathecal catheter was successfully placed without complications, were randomly divided into 5 groups (n=10 each) using a random number table: control group (group C), remifentanil + incisional pain group (group RI), EA at acupoint group (group E) , EA at non-acupoint group (group NE), and 1/2 ERK inhibitor U0126 + EA at acupoint group (group UE).Normal saline 0.1 ml · kg-1 · min-1 was infused intravenously for 60 min in group C.In RI, E, NE and UE groups, after the model of incisional pain was established, remifentanil 1.0 μg · kg-1 · min-1 was infused for 60 min, and in addition, EA (intensity 10 mA, frequency 4 Hz) of Zusanli lasting for 60 min was performed at the same time in E and UE groups, and EA was performed at the points 5 mm lateral to the acupoints of Zusanli on the operated side simultaneously in group NE.ERK1/2 inhibitor U0126 5 μg (in 5％ dimethyl sulfoxide 10 μl) was injected intrathecally in group UE, and 5％ dimethyl sulfoxide 10 μl was injected intrathecally in the other groups.The mechanical paw withdrawal threshold (MWT) was measured before remifentanil or normal saline infusion (T1) , and at 2 h, 1, and 2 days after the end of infusion (T2-4).After MWT was measured at T4, the expression of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in spinal cord dorsal horns was measured by Western blot.Results Compared with group C, the MWT was significantly decreased at T2-4 in RI, E, NE and UE groups, and the expression of p-ERK1/2 was up-regulated in RI, E and NE groups (P＜0.05).Compared with group RI, the MWT was significantly increased at T2-4 , and the expression of p-ERK1/2 was down-regulated in E and UE groups (P＜0.05);and no significant change was found in the parameters mentioned above in group NE (P＞0.05).Compared with group E, the MWT was significantly increased at T2-4, and the expression of p-ERK 1/2 was down-regulated in group UE (P＜0.05).Conclusion The mechaism by which EA at Zusanli reduces hyperalgesia induced by remifentanil in rats with incisional pain is related to inhibited activation of ERK signaling pathway in the spinal cord.

Objective To investigate serum alpha 1-acid glycoprotein (AAG)in patients with rheumatoid arthritis (RA)pa-tients with serum drug before and after the treatment,application of evaluation of serum alpha 1-acid glycoproteindetection in RA.Methods 88 cases of newly diagnosed RA patients treated with methotrexate,hydroxychloroquine combined with pyri-dine and the Liu Danhuang administration,in zeroth and June.The patients were taken for determination of serum AAG and rheumatoid factor in the serum of the patients with rate nephelometry (RF)levels,and erythrocyte sedimentation rate (ESR),and record the patients with RA disease the activity index of 28 (DAS28).Results After treatment,RA in the blood of patients with AAG (1 136.30±322.40 mg/L),RF(43.73±4.53 IU/ml),ESR (34.56±9.21 mm/h)and DAS28 (3.10 ±1.0)were significantly decreased (P <0.05 or 0.01),and the AAG,ESR,RF and DAS28 were positively correlated (r=0.19,P =0.02;r=0.24,P =0.0 and r=0.39,P =0.03).Conclusion The serum RA inpatients with AAG changes obvi-ously,had certain curative effect evaluation of RA.

A male patient with hypopharyngeal cancer accepted operation under general anesthesia. Sixth day after surgery in patient with sudden chest pain and obvious difficulty in breathing. Blood oxygen saturation of 90%. The electrocardiogram showed: ST-T change,Tv6 flat;blood gas analysis: pH 7. 491, PCO2 34. 1 mmHg, PO2 54. 7 mmHg; D-Dimer 3. 87 mg/L; white blood cell 17. 50 × 10(9)/L. CTPA showed: right pulmonary artery embolism,pulmonary infection. Another male patient with the right tonsil cancer accepted operation under general anesthesia. Fourth day of patient suddenly appear bosom frowsty and obvious difficulty in breathing. Blood oxygen sat- uration of 88%. Blood gas analysis: pH: 7. 48, PCO2 : 33 mmHg, PO2 : 57 mmHg; D-Dimer: 2. 97 mg/L; white blood cell:11. 80 × 10(9)/L. CTPA showed: the main pulmonary artery and right pulmonary artery branch embolism, pulmonary inflammation. Both were diagnosised as acute pulmonary embolism and recovered well after giving anticoagulant therapy in time.
Anesthesia, General ; Electrocardiography ; Fibrin Fibrinogen Degradation Products ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Male ; Oxygen ; Postoperative Complications ; Pulmonary Embolism

Adrenal Cortex Hormones ; therapeutic use ; Antitubercular Agents ; therapeutic use ; Diagnosis, Differential ; Humans ; Sarcoidosis ; drug therapy ; epidemiology ; microbiology ; pathology ; Tuberculosis ; drug therapy ; epidemiology ; microbiology ; pathology

Objective:To establish a rapid method to detect drug-resistance genotypes of extended spectrum-β-Lactamases (ESBLs) produced by gram negative bacillus using the real -time fluorescence quantitative PCR. Methods: According to clinical common genotypes of ESBLs, SHV, TEM.CTX-M.OXA and their homology, 9 pairs of specific primers were designed including SHV, TEM, CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, OXA-1, OXA-2 and OXA-10. To extract DNA template by boiling assay, and then establish and grade up SYBR GREEN I real-time fluorescence quantitative PCR reaction system, finally definite real-time fluorescence quantitative PCR method. Its precision and range of linearity were tested. With established assay 51 multi- drug resistant ESBLs- E. coli K. pneumoniae were detected and compared with improved three dimensional extract tests. Results: Except OXA-2, 8 genotypes SHV, TEM, CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, OXA-1 and OXA-10 were amplified by quantitative PCR from 39 ESBLs+ and 51 multi-drug resistant ESBLs-E. coli K. pneumoniae and confirmed by sequence testing. The range of linearity was 3×10~3-3×10~8 copies/mL, r =-0.994 7. Repetitive experiments showed that the average coefficient of variation between -runs was 9.6%. Comparing with three dimensional extract test, there was no significant difference (χ2 = 1.125,P> 0.05). Conclusion: Testing drug-resistance genotypes of ESBLs with SYBR GREEN I real-time fluorescence quantitative PCR is a rapid,specific and sensitive method, which is capable of inspecting genotypes of ESBLs from clinical strains.

Objective To explore the early diagnostic marker and mechanism of the injury of in- testinal mucosal barrier induced by intestinal ischemia-reperfusion in rats.Methods Sixty male Wistar rats were randomly divided into six groups:the sham operation group(SO),the ischemia 15 minutes group(A),the ischemia 45 minutes group(B),the ischemia 45 minutes plus reperfusion 2 hours group (C),the ischemia 45 minutes plus reperfusion 6 hours group(D),and the ischemia 45 minutes plus reperfusion 12 hours group(E).Using clamping and then releasing superior mesenteric artery the model of intestinal ischemia-reperfusion in rats was made.The sham operation group only underwent laparotomy. At different time points after ischemia and reperfusion the levels of serum CK,LDH,D-lactate and intes- tinal fatty acid binding protein(IFABP)in each group were examined.The morphological changes of in- testinal tissues were observed with light microscopy.Results Compared with group SO,the level of se- rum IFABP in group A was(374.74?48.85)pg/ml,significantly higher(P＜0.01),but the level of CK,LDH and D-lactate had no significant difference(all P＞0.05).In group B,the level of CK was (1090.40?187.51)u/L,peaking at 45 minutes after ischemia,meanwhile,D-lactate and IFABP levels were significantly increased(P＜0.01,respectively).In group C,D-lactate and IFABP were (2.51?0.19)?g/ml and (1601.42?286.81 )pg/ml,respectively,peaking at 2 hours after reperfusion (P＜0.01).At 6 hours after reperfusion,compared with ischemia 45 minutes,CK level was significantly de- creased(P＜0.01),LDH had no significant difference(P＞0.05),but the levels of D-lactate and IF- ABP were(2.03?0.24)?g/ml and(1443.76?174.52)pg/ml,respectively,all sustained a high lev- el(P＜0.01 ).At 12 hours after reperfusion,D-lactate and IFABP levels were gradually decreased(P＜0.01).At 45 minutes after ischemia the morphological changes of intestinal mucosa could be observed. At 6 hours after reperfusion part of the mucous layer appeared necrotic,some intestinal mucosal cells shed to enteric cavity,and submucous layer had hyperemia and edema obviously.Injury scores of intestinal mucosa were significantly correlated to the serum level of D-lactate and IFABP,correlation coefficients were 0.456,0.612(P＜0.01).Conclusion The monitoring of serum IFABP combined with D-lac- tate is a early,sensitive and specific biochemical marker in the diagnosis of intestinal mucosal barrier in- jury after ischemia-reperfusion.

Objectlve To investigate the effects of sevoflurane or ischemic preconditioning on the expression of extracellular signal-regulated kinase (ERK) and calmodulin (CaM) during lung ischemia-reperfusion (I/R)in rats. Methods Twenty-four male SD rats weighing 270-320 g were randomly divided into 4 groups ( n = 6each): sham operation group (group S), group I/R, ischemic preconditioning group (group IP), and sevoflurane preconditioning group (group SP). In group S, the hilum of the left lung was dissociated after thoracotomy but not occluded. In group I/R, lung I/R was produced by occlusion of the hilum of the left lung for 45 min followed by 120 min of reperfusion. In group IP, the hilum of the left lung was occluded for 5 min and unclamped for 5 min for 2 times before the model was established. In group SP, sevoflurane was inhaled for 30 min at the end-tidal concentration of 2.1% before lung ischemia. All rats were sacrificed at 120 min of reperfusion and the lung tissues were taken for determination of the contents of TNF-α and IL-6 by ELISA and the expression of ERK mRNA and CaM mRNA by RT-PCR. Results Compared with group S, the contents of TNF-α and IL-6 and the expression of ERK mRNA and CaM mRNA were significantly increased in group I/R, IP and SP ( P ＜ 0.05). Compared with group I/R, the contents of TNF-α and IL-6 and the CaM mRNA expression were significantly decreased, while the expression of ERK mRNA was significantly increased in group IP and SP ( P ＜ 0.05). There was no significant difference in the each index metioned above between group IP and SP ( P ＞ 0.05 ). Conclusion Sevoflurane preconditioning and ischemic preconditioning can protect the lung from I/R injury through down-regulating the expression of CaM and up-regulating the expression of ERK.

BACKGROUND:Many scholars have developed a variety of dynamic elastic spine fixator. After biomechanical research, animal experiments and clinical application found that no one elastic spine fixator was general y recognized clinical y. OBJECTIVE:To compare the stress difference between“X”-shaped spine dynamic fixation and traditional pedicle screw fixation. METHODS:Three-dimensional finite element models of“X”-shaped spine dynamic fixation and traditional pedicle screw fixation were established according to adult spine imaging data. Mechanical differences in vertical compression, flexion, extension, lateral bending and rotation were compared between the two groups. RESULTS AND CONCLUSION:The stress at vertical compression was lower than that at flexion, extension, lateral bending and rotation in both groups. The stress at“X”-shaped spine dynamic fixation mainly focused on“X”-shaped connecting rod, but the stress of traditional pedicle screw fixation mainly focused on conjunction of screw-rod. Moreover, the stress of the screw of“X”-shaped spine dynamic fixation was significantly less than that of traditional pedicle screw fixation (P<0.001). These results suggest that“X”-shaped spine dynamic fixation system can share stress of screws and reduce the postoperative stress concentration compared with traditional pedicle screw fixation.

OBJECTIVE To investigate the genotype characteristics of extended-spectrum ?-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae and drug resistance condition in Tianjin.METHODS A total of 218 strains of ESBLs-producing E.coli and K.pneumoniae were isolated from clinic.The drug-resistant CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV,OXA-1,OXA-2 and OXA-10 were tested by SYBR GREEN Ⅰ real-time fluorescent quantitative Polymerase chain reaction(PCR).RESULTS Among 109 strains of ESBLs-producing E.coli,the drug resistance of genotypes CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV and OXA-1 was 32.1%,0.9%,0.9%,33.9%,73.4%,27.5% and 15.6%,respectively.The strains with more than two genes were 66.1%.The positive rate of CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV,OXA-1 and OXA-10 was 49.5%,2.8%,1.8%,22.9%,78.9%,76.1%,33.0% and 0.9%,respectively.The strains with more than two genes were 82.2%.The strains were highly sensitive to imipenem.CONCLUSIONS Most of the genotypes of ESBLs-producing E.coli and K.pneumoniae in Tianjin are SHV,TEM,CTX-M-1 and CTX-M-9.The rate of OXA are increasing,and the drug resistance genes of K.pneumoniae from different hospitals are different.