As a brand new service mode on Internet,crowd sourcing can solve the problems that need high cost and professionals by drawing on the wisdom of tens of thousands of Internet users. Medical college and university libraries should thus strengthen their virtual reference service teams and further improve their virtual reference service level by introducing the crowd sourcing concept,depending on the support of reader association and drawing on the wisdom of readers.

Objective To analyze the clinical application value of the critical value reporting system.Methods The data record-ings of the critical values reported by the clinical laboratory department from Nov.2013 to May.2014 were inquired through the clinical laboratory information management system(LIS).The incidence rate of the critical values,receipt time of the critical values, items and department distribution were analyzed.Results A total of 1856 items of critical value were reported.The occurrence rate of the critical values was 0.31%.The top 5 of critical value numbers according to the item distribution were white blood cells (46.28%),total bilirubin (16.92%),D-dimer (9.81%),hemoglobin(8.51%)and platelets (8.03%).According to the depart-ments distribution,the top 3 departments with maximal reported critical values were the neonatal department (37.12%),followed by the department of gynecological oncology(23.33%)and the obstetrical department (21.17%).Conclusion The critical value reporting system plays an important role in the obstetrics and gynecology hospital.It should be evaluated and analyzed regularly.

As a new interdisciplinary course, the current paper writing course for medical postgraduates exhibits certaln disadvantages. For example, the course does not well target the learners' needs because of the absence of the needs analysis before class;English or biomedical teachers fall to combine English with medicine, thus unable to provide ideal courses. As textbooks are an important means to improve the quality of the course, one way to reform the course is to compile high-quality textbooks by interdisciplinary talents. Meanwhile, the compiling process should be guided by needs analysis as well as the teaching and editing experiences. In addition, the textbooks need to be con-tinuously improved in teaching practice.

The course of medical English fundamental reading carefully chooses reading materials from original English medical textbooks as the course materials, aiming at imparting the skills for reading biomedical English literature, and meeting the reading needs of medical undergraduates. In conducting this course, formative assessment is adopted, the frame of which is the theoretical model developed by Professor Wen Qiufang. There are three key phases in this model: setting up goals, eliciting learning evidence, and providing feedback. Three ways are employed to assess the course (symposium records, reflective journals and quizzes), which confirms that this model of formative assessment has improved the effectiveness of the course.

The perivascular space is formed by the pia mater around the blood vessels and participates in the fluid exchange and waste clearance in the brain. The enlarged perivascular space (EPVS) indicates the disorder of brain clearance mechanism, which is closely related to the occurrence and development of a variety of clinical diseases. In recent years, there are a lot of studies on the pathogenesis and influencing factors of EPVS. This article reviews its anatomy, neuroimaging, pathogenesis, and risk factors.

ObjectiveTo investigate application value of parametric image processing in contrastenhanced ultrasound imaging in diagnosis of ovarian masses. MethodsFifty cases with ovarian masses underwent routine ultrasound and contrast-enhanced ultrasound imaging using a new dedicated parametric image processing software SonoLiver to analyze patterns of vascular formation and blood stream perfusion in the ovarian mass tissues on a digital video recorder in real time, compare their morphological characteristics of time-intensity curve (TIC) and dynamic vascular patterns (DVP) curve, and analyze quantitatively all indicators generated by SonoLiver.ResultsIn ultrasound imaging of the 50 cases, there were 24 cases (86％) displaying mainly blue lowly-enhanced imaging in those with benign masses and 15 cases (68％)displaying mainly red highly-enhanced imaging in those with malignant masses, with statistical significance (P ＜0. 01 ). There was significantly different characteristics of TIC and DVP between patients with benign and malignant masses. In 23 cases with benign masses, their DVP were significantly higher above the baseline than in those with malignant ones ( P = 0. 000), and in 15 cases with malignant lesions, their DVP were much shorter below the baseline than in those with benign ones, with statistical significance (P ＜0.05). The intensity of contrast medium, the time to reach its peak intensity and average transit time were all significantly higher in those with malignant masses than in those with benign ones (all P ＜ 0. 05 ). But, no statistical difference in the time of initial increasing between the two groups was found (P ＞ 0. 05). ConclusionsThere is significant difference in TIC and DVP of ultrasound imaging between benign and malignant masses, which if combined with contrast enhanced ultrasound parametric image processing can provide a more visualized quantitative information of benign and malignant ovarian masses with SonoLiver software.

Objective:To investigate effects of a novel synthetic immunostimulator CH1b containing thiazolidin-4-one on the immunoregulation funotion of iNKT ( invariant nature killer T ) cells in active RA patients in vitro.Methods: Peripheral blood mononuclear cells( PBMCs) isolated from active RA patients were cultured with stimulation of α-Galcer and IL-2 in vitro and iNKT cells were then separated by using magnetic activated cell sorting( MACS) method with iNKT isolation kit.The cells were divided into three groups:control group (IL-2),α-Galcer group (IL-2+α-Galcer),CH1b group(IL-2 +CH1b).The effects of CH1b on the proliferation of iNKT cells in active RA patients were analyzed by using MTT assay.MILLIPLEX MAP Human Cytokine/Chemokine kit was used to evaluate the secretion of IFN-γand IL-4 in iNKT cells culture media.The expressions of IFN-γmRNA and IL-4 mRNA in iNKT cells were analyzed by RT-PCR.Results: Compared with control and α-Galcer group,the proliferation of iNKT cells of CH1b group were significantly higher( P<0.05).Compared with control,the ratio of IFN-γ/IL-4 in iNKT cells culture media in active RA patients of CH1b group were significantly lower (P<0.05).Compared with control,expressions of IFN-γmRNA and IL-4 mRNA were higher inα-Galcer group;compared with control,expressions of IL-4 mRNA were higher in CH1b group,while there were no obvious difference on expressions of IFN-γmRNA.Conclusion:CH1b was found to significantly stimulate the actived iNKT cells in active RA patients proliferation,promote the secretion of IL-4,and increase the ratio of IFN-γ/IL-4,promote the expression of IL-4 mRNA in iNKT cells in active patients.

[ ABSTRACT] AIM:To establish an animal model of rheumatoid arthritis ( RA) in DBA/1 mice induced by im-munodominant mixed peptides derived from glucose-6-phosphate isomerase (GPI).METHODS: The DBA/1 mice were immunized with emulsified mixed peptide fragments of hGPI 325-339+hGPI469-483 or single peptide hGPI325-339 in com-plete Freund′s adjuvant by subcutaneous injection to induce the model of RA .Body weight , ankle joint symptom scores , the pathological change of the ankle joint , the levels of CD4 +T cells in the spleen and peripheral blood , the proportion of iNKT cells in the peripheral blood , and the levels of TNF-αand IL-6 in serum were detected to evaluate and analyze the model.RESULTS:The hind paw of the model mice appeared red swelling on the 8th day, and then aggravated gradually to the limbs.The red swelling reached peak on the 14th day, and then relieved gradually .Inflammation response dominated by lymphocytes and monocytes was observed in the ankle joint .The inflammatory effect of mixed peptides was more obvious than that of the single one (P<0.05).Compared with control group and the mice treated with single peptide , the weight gain was slow, the amount of CD4 +T cells in the peripheral blood and spleen were increased , the proportion of peripheral iNKT cells in the inflammatory peak was decreased (P<0.05), and the serum level of TNF-αwas increased significantly ( P<0.05) in the mice treated with mixed peptide fragments .CONCLUSION: The immunological characteristics of RA model induced by mixed GPI peptides in DBA/1 mice is closer to that in RA patients , especially in the immunopathology of iNKT cells.Therefore, this model can be used as a new tool for studying the mechanism and immunological intervention of RA.

Objective To investigate the gender differences of glucose metabolic network in brains of healthy adults at resting state by 18F-FDG PET.Methods A total of 204 dextromanual,healthy individuals (104 males,average age:(53.45±11.51) years;100 females,average age:(54.11±12.09) years) were enrolled from June 2011 to June 2016 to construct brain metabolic networks.The nodal and global parameters,including clustering coefficient (Cp),characteristic path length (Lp) and betweenness centrality (Cb),were analyzed by graph theory.Permutation test with 1 000 repetitions was used.Results The brain metabolic networks derived from 18F-FDG PET data were with small-world properties in both male group and female group.Compared with Cb in females,Cb in males was significantly reduced in left postcentral gyrus,right angular gyrus and left temporal pole/middle temporal gyrus (permutation test,all P<0.05);and it was increased in left amygdala,left precuneus,right temporal pole/middle temporal gyrus and left inferior temporal gyrus (permutation test,all P<0.05).Comparing with the females,the male group had higher Cp and longer absolute Lp but without significant difference (permutation test,all P>0.05).Conclusions There are gender-related differences of topological structure in whole-brain metabolic networks.Gender should be considered as a covariate while designing experiments,accounting for cerebral metabolic data from normal control and experimental patients as well as making clinical decisions.

Objective To evaluate the application value of bedside lung ultrasound in diagnosis of neonatal severe pneumonia.Methods Bedside lung ultrasound and chest X-ray were performed in 59 the newborn patients admitted to the newborn department for suspected severe pneumonia,from October 2015 to March 2016.According to the characteristics of the chest X-ray,patients were divided into consolidation group (widely spot shadow in double lung and airbronchograms) and the unconsolidation group (enlargement,fuzzy texture in double lung or small patch sample changes) Differences in ultrasonic characteristics were compared between the two groups.Results Ultrasonic image characteristics were pulmonary consolidation with air bronchograms,A-line disappearance,pleural line abnormalities.Among 23 patients with chest X-ray,21 patients were found pulmonary consolidation by lung ultrasound,and all 36 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was no significant difference in the detection rate by lung ultrasound between the two groups (P＞0.05) The pulmonary ultrasound results of 20 cases in the consolidation group showed A-line disappearance,37 cases in the unconsolidation group showed A-line disappearance.There was no statistical significant differences between the two groups (P＞0.05).The pulmonary ultrasound results showed 11 cases in the consolidation group and 15 cases in the unconsolidation group with pleural line abnormalities,there was no statistically significant differences between the two groups (P＞O.05).Conclusions Ultrasound image characteristics of neonatal severe pneumonia include pulmonary consolidation and air bronchograms,A-line disappearance,pleural line abnormalities.Compared lung ultrasound and chest X-ray result,there was no difference between consolidation group and unconsolidation group.Both of the two methods can be used for evaluating the diagnosis of pneumonia.