The effective and fair allocation model of digital resources was studied by establishing the acquisition performance assessment system and mechanism.The optimal allocation program of digital resources was proposed according to the digital resource performance assessment in Library of Mudanjiang Medical College for the reference of academic library in its scientific allocation of digital resources.

Objective To evaluate the clinical pathology meaning of atypical squamous cell of undetermined significance (ASCUS) in cervical cytology. Methods The clinical data of 2118 cases who underwent cervical liquid thin-prep cell test (TCT) were analyzed retrospectively, ASCUS and squamous epithelium (SIL) were diagnosed according to the classification of the data TBS cytology, the histopathological examination results were tracked. Results The incidence of ASCUS was 3.4% (72/2218), and the ratio for SIL ( 1.2%, 25/2118) was 2.9. In the cellular pathology of ASCUS, there were four aspects, atypical surface cells and atypical hollowed cells in 16 cases (22.2%), atypical atrophy of the squamous epithelial cells in 11 cases (15.3%), atypical mature or immature metaplastic cells 28 cases (38.9%), atypical cells less influence diagnosis 17 cases (23.6%). Tracking the histologic findings in 43 cases with chronic cervicitis 22 cases (51.2%), low level squamous epithelium neoplasia in 12 cases (27.9%), high levels of squamous epithelial change in 8 cases (18.6%), squamous cell carcinoma 1 case(2.3%). Conclusion ASCUS exists within the risk of squamous lesions, management should be strengthened.

BACKGROUND:There is no study about adjacent zygapophyseal joint stress distribution following two level artificial disc replacement (ADR) in China.OBJECTIVE:To explore cervical adjacent zygapophyseal joint stress distribution following two level ADR and anterior cervical discectomy and fusion (ACDF),so as to provide biomechanical reference for clinical application of two level ADR.DESIGN,TIME AND SETTING:In vitro contrast observation and biomechanical detection were performed at the National Key Laboratory of College of Material Science and Engineering,Central South University from January to February 2006.MATERIALS:A total of 11 fresh adult corpse cervical samples with intact cervical disc and ligament and the facet joint capsule ranged from C_3 to T_1 segment.METHODS:A total of 11 intact adult fresh-frozen multi-segmental cervical spine segments were utilized and biomechanically evaluated under the following C_(4～5),C_(5～6) cervical disc conditions:intact spine (intact group),Bryan disc prosthesis implantation (ACDR group) and intervertebral fusion (ACDF group).The testing was performed under axial load (25 N-150 N) on each group.The stress changes of the caudad (C_(5～6),C_(6～7)) zygapophyseal joint was tested.MAIN OUTCOME MEASURES:The pressure of the caudad (C_(5～6),C_(6～7)) zygapophyseal joint.RESULTS:Under axial loading,stress of the caudad (C_(5～6),C_(6～7)) zygapophyseal joint increased with the load and showed no difference between the intact group and ACDR group (P>0.05).Under axial loading,the ACDF group resulted in significant increase of the stress of the caudad (C_(5～6),C_(6～7)) zygapophyseal joint compared with intact group and ACDR group (P<0.05).CONCLUSION:Two level artificial cervical disc replacement can maintain stress in the caudad (C_(5～6),C_(6～7)) zygapophyseal joint,thus reconstruct biomechanical property of cervical spine.Two level cervical discectomy and fusion can increase stress in the caudad (C_(5～6),C_(6～7)) zygapophyseal joint,which may be one of the causes for adjacent cervical spondyiosis postoperatively.

Objective To observe the changes of high mobility group box 1(HMGB1) and nuclear factorκB(NF‐κB) expres‐sion in the hippocampus of rats after cardiopulmonary resuscitation so as to unravel the role of HMGB 1 and NF‐κB in neuroin flam‐mation .Methods Totally 40 Sprague‐Dawley rats were randomly divided into shame‐operated group and recover group [including 2 ,6 ,12 ,24 and 48 h of 5sub‐groups after restoration of spontaneous circulation (ROSC)] .The animals were sacrificed and hippo‐campus were removed at the indicated time .Pathological changes were observed at each time point .The expression of HMGB1 and NF‐κB were determined using RT‐PCR and Western blot respectively .Results There were no histopathological in the hippocampus of rats in shame‐operated group ,brain tissue appeared change of ischemia pathology in recover group ,it was the most severest at ROSC 24 h and still obviously at ROSC 48 h time point .HMGB1 mRNA and NF‐κB mRNA expression in the hippocampus of rats of recover group increased obviously along with the prolongation of time following ROSC and reached its peak at ROSC 24 h(P<0 . 01) ,much higher than that of shame‐operated group ;the HMGB1 level in the hippocampus of rats after recover significantly de‐clined at 2 h after ROSC and increased obviously at 6 ,12 h and reached peak 24 h later ,then decreased 48 h later(P<0 .01) ,there was positive correlation between the expression of HMGB1 and NF‐κB protein .Conclusion HMGB1/NF‐κB signaling pathway may play an important role in the early stages of brain injury after cardiopulmonary resuscitation .Targeted therapies of this path way would be possible to open a new avenue for preventing neuroinflammation after recover .

Objective_To investigate the role of HMGB1 involved in the activation of P38MAPK signal pathway in the hippocampus of rats after cardiopulmonary resuscitation.Methods_Rats were randomly divided into two groups as shame-operated group, CPR group including 2, 6, 12, 24 and 48 h after restoration of spontaneous circulation ( ROSC) (5sub-groups) .The animals were sacrificed and hippocampus were removed at the indicated time.Patholog-ical changes were examined at each time point.Calculated the brain water content by day/wet ration.The HMGB1 mRNA expression was detected by RT-PCR technique.The expressions of HMGB1 and P38MAPK activity were deter-mined using Western blot.Results_There were no histopathological change in the hippocampus of rats in shame-op-erated group, brain tissue appeared change of ischemia pathology in CPR group, it was the most severest at ROSC 24 h.The brain water content, HMGB1 mRNA in rats of CPR group increased obviously along with the prolongation of time following ROSC and reached its peak at ROSC 24 h(P<0.01),much higher than that of shame-operated group, the HMGB1 level in the hippocampus of rats after CPR significantly declined at 2 h after ROSC(P<0.01)and increased obviously at 6, 12 h and reached peak 24 h later(P<0.01), the P38MAPK activity in the hippo-campus of rats after CPR, significantly increased at 2 h after ROSC and reached peak 6 h later(P<0.01), then declined slowly later, much higher than that of shame-operated group.Conclusions_HMGB1 involved in the acti-vation of P38 MAPK signal pathway may play an important role in the early stages of brain injury after CPR.

Objective To investigate the clinical treatment of brucellosis spondylitis (BS) through combination of Mongolian medicine and Western medicine.Methods From December 2010 to June 2015,51 patients which were diagnosed BS at the Department of Brucellosis Hulunbuir People's Hospital were enrolled in this study.After injecting etimicin sulfate and levofloxacin for two weeks,rifampin and doxycycline were administrated orally with Silver pearl pill,Pearl pill and Yunxiang pill (tid) for one treatment cycle which contained three courses of each treatment for 3 weeks.Before and after the treatment,the clinical features and imaging examination results were observed of 2 cases and then followed up for one year.Results Before the treatment,any spinal segment can be affected especially the lumbar spine.Two cases of cervical damage,5 cases of thoracic vertebrae,47 cases of lumbar spine,2 cases of sacral vertebrae,and 39 cases of vertebral abscess were found.After treatment,low back pain symptoms disappeared in 10 cases of the patients.Thirty-nine patients with low back pain symptoms and limited movement.Two patients with low back pain aggravated,MRI examination of the lumbar spine showed lesions increased and abscess formation.The effective rate of Mongolian herbal medicine and Western medicine treatment was 96.1％ (49/51).Conclusion The combined treatment of BS through combination of Mongolia medicine and Western medicine is effective.

Objective To evaluate the intraoperative advantage and postoperative outcomes of threedimensional laparoscopic common bile duct (CBD) choledochoscopic exploration by micro-incision made at the cystic duct-CBD junction (LCBDEM) for gall stones and choledocholithiasis.Methods From January 2014 to December 2015,31 patients were operated under 3D LCBDEM (study group) and 37 patients under 2D LCBDEM (control group).The outcomes of patients in two groups were compared,including total procedure time (TPT),modified procedure time(MPT),suturing time(ST) and the wrong grasping per 100grasps(WG)of the LCBDEM.8 surgeons experienced in 3D LCBDEM were asked to fill in a subjective questionnaire.Results In control group,the TPT,MPT,ST and WG were (148 ± 47) min,(108 ± 42)min,(20 ±3)min and (19 ±4)per 100 grasps,respectively.In study group,the TPT,MPT,ST and WG were (148 ± 46) min,(9 1 ± 25) min,(1 8 ± 3) min and (8 ± 2) per 100 grasps,respectively.There were significant differences in MPT (t =-2.026,P ＜ 0.05),ST (t =-2.239,P ＜ 0.05) and WG (Z=-7.062,P ＜ 0.001).In subjective questionnaire survey,3D laparoscopy has advantages over 2D laparoscopy in visual and operation experience.But 3D laparoscopy made eyes more easily tired and dizzy.31 aparoscopy was inferior to 2D laparoscopy in spinning the camera around to get optimal field of vision.Conclusions 3D LCBDEM shortens procedure time and suturing time,increases operating accuracy and safety by providing high definition stereovision.

Objective To discuss the clinical features of immunocompetent patients with Penicilliosis marneffei.Methods To analyze and summarize the clinical data of 4 immunocompetent patients with Penicilliosis marneffei.Results Clinical manifestation of patients centered on intermittent slight or mild fever,lymphadenectasis,skin eruptions,osteolytic destruction,anaemia,and leukocytosis.The cultural Penicillium marneffei in specimen such as blood,pus showed a higher positive rate.Amphotericin B and itraconazole was available in treatment.Conclusion Immunocompetent people can be infected by Penicillium marneffei,and they appear nonspecific in clinical manifestation after infection.A timely and effective antifungal therapy can improve the prognosis of patients.

Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75％ (38/51),55％ (28/51) and 22％ ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P ＞ 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P ＜ 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.

Objective To investigate bile leakage prevention in laparoscopic common bile duct (CBD) choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction.Methods From August 2007 to February 2015,a total of 147 cases undergoing laparoscopic CBD choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction were included in this study.From August 2007 to November 2012,57 patients were treated with laparoseopic CBD exploration (control group).From November 2012 to February 2015,90 patients were with optimized suture method of CBD (study group).The outcomes of patients in two groups were compared,including procedure time (PT),postoperative hospitalization time (PHT),and postoperative complications.Results In control group,the bile leakage rate was 5.3％,compared to 1.1％ in study group.There were significant differences in postoperative hospitalization time(t =1.98,P =0.0007) and hile leakage rate (x2 =139.5,P =0.04)between the two groups.Conclusions The prophylaxis measurements during operation are important to prevent bile leakage in laparoscopic CBD choledochoscopic exploration through micro-incision approach,including strict indications for micro-incision operation,proper expertise for laparoscopic cholecystectomy and laparoscopic suturing,choledochoscopic exploration,and suturing the whole layer of CBD wall,and carefully checking the suturing spot in case of bile leakage.T-tube placement is recommended while bile leakage is suspected.