The construction of open course for information literacy education in the era of ubiquitous network was described according to the COOC self learning platform that we developed with information retrieval course construc-tion as its standards.

OBJECTIVE:To study the implementation of Prescription Management Method (PMM) in our hospital and to promote rational drug use. METHODS: A total of 71 000 prescriptions were collected from Sept. 2006 to Dec. 2007 (before implementation) and from May to Dec. in 2007 (after implementation) for a statistical analysis and evaluation of the irrational prescriptions. RESULTS: The non-conformity rate of prescriptions was on the higher side before PMM implementation, accounting for 7.76% versus 3.38% after implementation (P

Objective To evaluate the value of CT scan in diagnosis of the splenic lesions.Methods A retrospective analysis was made on the CT scans of 33 patients with surgically and pathologically proven splenic lesions,which included plain CT scan(n=33),biphasic contrast-enhanced CT scan(n=28)and contrast delay scanning(n=6).Results In 33 cases,non-neoplastic lesions were 6 cases,including tuberculosis(n=2),hematomas(n=3)and inflammatory pseudotumor associated with a cavernous hemangioma(n=1).Benign tumors were 13 cases,including cysts(n=5),hemangiomas(n=4),lymphanioma(n=1)and lymph-hemangiomas(n=3).Malignant tumors were 14 cases,including malignant lymphoma(n=8),metastases(n=4),malignant myofibroblastoma and hemangioendothelial sarcoma(n=1,respectively).Conclusion CT is of significant value in diagnosis of splenic lesions.

Total parathyroidectomy (PTX) can be used to treat secondary hyperparathyroidism (SHPT)in uremic patients,relieving the patient's osteolytic destruction.Complete resection of bilateral parathyroid glands is key to successful operation.Recently,2 patients successfully received surgical treatment,in which carbon nanoparticles suspension injection were used.With the help of carbon nanoparticles suspension injection,all of the 4 hyperplastic parathyroid glands were found successfully.The parathyroid hormone(PTH) was significantly decreased after operations and the clinical symptoms were relieved simultaneously.We conclude that the use of carbon nanoparticles suspension injection is helpful for total parathyroidectomy operation in uremic patients with SHPT,which can protect the normal thyroid and recurrent laryngeal nerve.

Objective To summarize and describe clinical features and treatment outcome of syphilitic scleritis.Methods A retrospective study was conducted in patients diagnosed as syphilitic scleritis from 2011 to 2016 in our hospital.Clinical characteristics and prognosis were evaluated.Results Seven patients (7 eyes) were diagnosed as syphilitic scleritis by clinical and serological examinations.All patients were unaware that they had syphilis infection before visit.The ocular manifestation was the only clinical fmdings in three patients.Both treponema pallidum particle agglutination and rapid plasma regain were positive.Meanwhile,the scleritis infection was excluded,tests for human immunodeficiency virus (HIV) were negative.Syphilitic scleritis was unilateral in all patients,and the duration was from one week to two years.Initial symptoms were varied in degree of ocular redness,pain and visual impairment.Two patients presented with anterior episcleritis,nodular anterior scleritis was found in three patients,one patient showed diffuse anterior scleritis,and one patient presented with diffuse episcleritis combined with acute syphilitic posterior placoid chorioretinitis.All patients were treated with penicillin G,and inflammation resolved quickly after treatment.Conelusion Syphilitic scleritis is rare and ease to be misdiagnosed,various types of anterior scleritis is the main manifestation.Syphilitic serologic test should be performed for the suspected cases.The prognosis is well with anti-syphilis therapy.

Acquired syphilis uveitis,due to lack of the characteristic features,presents with various types.The most common type is posterior uveitis and panuveitis,including chorioretinitis,retinal vasculitis,optic nerve retinitis.The diagnosis and assessment of response to treatment depends mainly on the serological diagnostic tests,including nontreponemal and treponemal test.Acquired syphilis uveitis often presents with manifestations similar to various types of uveitis,especially to autoimmune uveitis and other infectious uveitis,so differential diagnosis is important.The gold standard treatment for active syphilitic uveitis is penicillin G,or doxycycline if patient is allergy to penicillin.Clinically misdiagnosis and delayed treatment may result in irreversible visual impairment and severe systemic and eye complications.However such timely treatment always has a good prognosis.

Objective To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness (CMT),other macular complications,and intraocular pressure (IOP).Results Twenty-seven patients (36 eyes) were analyzed.At the 1 st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9％),BCVA increased from (0.66 ±0.36) LogMAR at baseline to (0.40 ±0.31) LogMAR (P ＜0.001),and CMT decreased from (469.0 ± 99.1) μm at baseline to (368.7 ± 85.9) μm (P ＜ 0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8％),no significant difference was found in CMT(323.9 ±60.0) μm or BCVA(0.37 ±0.32)LogMAR compared with the 1 st month after treatment (P ＞ 0.05),significant difference was found in CMT(P ＜0.001) or BCVA(P ＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4％),BCVA(0.32 ± 0.28)LogMAR was significant difference compared with that before the start of treatment(P ＜ 0.05),at the 1st month(P ＜ 0.05),at the 3rd month (P ＜ 0.05).CMT (294.2 ± 81.2) μm was significant difference compared with that before the start of treatment(P ＜0.001),at the 1st month(P ＜0.001),however,no significant difference was compared with that at the 3rd month (P ＞ 0.05).At the 6th month or more after treatment,11 eyes (30.6％) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT(185.0 ± 114.2) μm and the improvement of BCVA (0.29 ± 0.21) LogMAR was found (r =0.322,P=0.052),while the improvement of BCVA(0.29 ± 0.21)LogMAR was negatively associated with the duration of CME(8.4 ±9.8)months(r =-0.395,P =0.015).Conclusion Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME,is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.

Objective To explore the feasibility and value of laparoscopic-assisted surgery(LAS) for colorectal cancer.Methods The clinical data of 51 cases of LAS for colorectal cancer were reviewed retrospectively.Of them,3 cases were converted to open operation,and in 48 cases LAS for colorectal cancer was completed.Among them,9 cases underwent right hemicolectomy,8 cases left hemicolectomy,14 cases sigmoid resection,9 cases rectal anterior resection,and 6 cases Miles operation.Results No intra-operative deaths occurred. The average operation time was 195(150-320)min with 120(40-300)mL average blood loss.The average number of lymph nodes excised was 8(2-26).The time of bowel function recovery was 20-72h after operation.The average hospital stay after operation was 8(7-10)d.No major intra-operative blood loss nor postoperative complications were observed.The follow-up time was from 3-54months for 45(88.2%) patients.Two cases with Ducke′s C rectal cancer died,one died of liver metastasis 17 months after operation,and the another died of diffuse peritoneal metastasis 19 months after operation.There was no trocar port tumor metastasis and no local tumor recurrence at the small abdominal incision.Conclusions LAS of colorectal cancer is technically feasible and has advantages such as less surgical trauma,less bleeding and quick recovery.It is a mini-invasive,safe and efficient treatment for colorectal cancer.

Objective To explore the effect of SFI in radiation-induced mice brain injury after 20 Gy cranial radiation.Methods The mice were divided into three groups:(1) control group,(2) RT-only group:the whole brain was irradiated with a dose of 20 Gy,(3) RT and SFI group:SFI at 20 ml/kg/d from 4 weeks after 20 Gy cranial radiation theraty(CRT).Results Morris water maze test showed that the latency of the irradiated group was longer than control group and SFI improved the cognitive function of mice (t =6.34,6.70,P ＜0.05).The expression of TNF-α reached to the highest level at 3 h after irradiation,and then it decreased but got the second higher level again at 4 weeks after irradiation.The expression of IL-1 β reached to the highest level at 72 h after irradiation and decreased until 4 weeks after irradiation.SFI decreased both expressions of TNF-α (t =11.34,9.70,6.07,P ＜ 0.05) and IL-1 β (t =12.27,5.70,7.52,P ＜ 0.05).Immune florescence staining showed that SFI reduced the number of activated microglia (t =12.35,8.64,7.82,P ＜ 0.05)and inhibited the translocation of p65 of microglia after irradiation.Conclusions Findings suggest that SFI may decrease microglial activation and suppress the expression of TNF-α and IL-1β by inhibiting the translocation of NF-κB p65 and then attenuate irradiation-induced brain injury.

Objective To observe the effect of continuous positive airway pressure ventilation on hypersensitive C reaction protein (hsCRP) and 8-isoprostane in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A total of 78 OSAHS patients were enrolled and monitored by polysomnography (PSG) in January to March,2013.Another 40 healthy persons were chosen as controls during the same time.According to apnea hypopnea index(AHI) and oxygen saturation,the patients were divided into mild,moderate and severe groups.Blood and urinary 8-isoprostane and hsCRP levels were detected before and after monitoring.After continuous positive airway pressure treatment for three months,blood and urinary 8-isoprostane and hsCRP were also detected in three groups.Results (1) In OSAHS patients,blood 8-isoprostane levels before and after sleep monitoring were (273.80 ± 55.83)ng/L and (337.18 ± 56.28) ng/L urinary 8-isoprostane (35.65 ± 7.08) ng/L and (48.30 ± 14.17) ng/L,hsCRP (7.63 ± 6.10) μg/L and (9.68 ± 8.55) μg/L,respectively.Each parameter reached a significant difference before and after sleep(P ＜ 0.05).(2) The levels of blood CRP and urinary 8-isoprostane in the control group before sleep were (4.56 ± 2.43) μg/L,(264.14 ± 33.61) ng/L,(32.77 ± 9.61) ng/L,after sleep were (4.33 ± 2.08) μg/L,(284.27 ± 47.51) ng/L,(31.13 ± 8.24) ng/L.All the levels were less than those of OSAHS group (P ＜ 0.05).(3) The levels of blood 8-isoprostane in mild,moderate and severe groups after monitoring were (308.16 ± 53.48) ng/L,(327.36 ± 59.05) ng/L,(340.39 ± 55.31) ng/Lrespectively,and urinary 8-isoprostane were (35.23 ± 11.28) ng/L,(38.30 ± 10.89) ng/L,(44.57 ±12.69) ng/L,hsCRP were (5.63 ± 4.26) μg/L,(6.96 ± 4.43) μg/L,(8.92 ± 7.84) μg/L.None of these three parameters showed significant difference between the three groups (P ＞ 0.05).However,compared with the control group,blood and urine 8-isoprostane and hsCRP levels of any groups had significant differences(all P values ＜ 0.05).(3) There was no significant difference in the levels of hsCRP and 8-isoprostane after sleep between the three groups in OSAHS (P ＞ 0.05).(4) Urinary 8-isoprostane level after PSG was positively correlated with hsCRP (r =0.498,P ＜0.01).Either 8-isoprostane or hsCRP level was correlated with AHI (r =0.479,r =0.550;P ＜ 0.01).8-isoprostane and hsCRP levels were positively correlated with time of blood hemoglobin oxygen saturation below 90％ (r =0.413,r =0.502;P ＜ 0.01).(5) After continuous positive airway pressure treatment,the levels of 8-isoprostane and hsCRP both in blood or urine were decreased in the three groups of OSAHS patients (P ＜ 0.05).Conclusions Long term intermittent hypoxia in patients with OSAHS results in enhanced oxidative stress reaction and over-generated inflammatory mediators.There is a positive correlation between oxidative stress and inflammatory mediators,which promotes each other,leading to the organ dysfunction induced by hypoxia.