After the characteristics of intelligent service and smart library were described, the construction of intel-ligent service platform in smart library was elaborated from its logical and physical frameworks, and the problems that may be encountered in the construction of intelligent service platform in smart library were pointed out.

Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.

Objective To study the effect of the serum levels of 25-hydroxyvitamin D3 [25-(OH)D3] and total IgE (TIgE) in pathogenesis of the children bronchial asthma.Methods Twenty-two children with bronchial asthma (bronchial asthma group) and 20 healthy children (control group) were selected.The serum levels of 25-(OH)D3 and TIgE in the children of 2 groups were detected.Results The level of serum 25-(OH)D3 in bronchial asthma group was significantly lower than that in control group [(23.64 ± 3.89)μ g/L vs.(35.82 ± 4.37) μ g/L],there was statistical difference (P ＜ 0.05).The level of serum TIgE in bronchial asthma group was significantly higher than that in control group [(208.62 ± 32.59) kU/L vs.(73.84 ± 18.86) kU/L],there was statistical difference (P ＜ 0.05).There was negative correlation between the level of serum 25-(OH)D3 and TIgE in bronchial asthma group (r =-0.832,P ＜ 0.01),but there was no correlation between the level of serum 25-(OH)D3 and TIgE in control group (r =-0.038,P ＞0.05).Conclusions The lack of 25-(OH)D3 may be associated with allergy and childhood bronchial asthma.By monitor the levels of 25-(OH)D3 and TIgE may assess condition of childhood bronchial asthma.

Objective To develop novel disposable liquid filling device as well as its function and clinical value. Methods The experimental group adopted disposable liquid filling device,while the control group used injector simply.The result underwent comparison analysis,including time cost for liquid preparation,pollution of medical sollution by bacteria and particles and spattering of medical sol-lution. Results Disposable liquid filling device shortened time cost for liquid preparation,reduced pollution of medical sollution by bacteria and particles and prevented spattering of medical sellution. Condusions Disposable liquid filling device possesses many characteristics such as simple structure,low cost, easy operation,high efficiency,reduction of medical sollution pollution and prevention of spattering.It is worthy of clinical application.

Objective To investigate measures of preventing asphyxia neonatorum in order to reduce the rate of asphyxia neonatorum.Methods Clinical datas on a total of 78 cases of critical asphyxia neonatorum from the year 2003～2004 in Longgang Central Hospital were collected and analyzed.Related high risk factors and effective precaution measures of reducing the rate of asphyxia neonatorum were studied.Results The rate of asphyxia neonatorum from January 2003 to December 2004 was 4.22%,of which it was 1.70% of critical asphyxia neonatorum and 8% of treated deaths.The first seven related factors to critical asphyxia neonatorum of this group were:fetal distress(47%),premature delivery(49%),umbilical factors-torsion,prolapse,shortening(32%),breech presentation(26%),high risk PIH(14%),monstrosity(6%),placental abruption and placenta praevia(6%).Conclusion Effective measures of reducing critical asphyxia neonatorum are to strengthen the monitoring of pregnant women and their antenatal care so as to find and treat PIH early and correct breech presentation in time,try to reduce premature delivery,find early and properly treat fetal distress and oafs and prohibit illegal accouchement.

Objective To compare the treatment outcomes between minimally invasive perventricular device occlusion (MIPDO) and right subaxillary incision surgical repair(RSISR) on perimembranous ventricular septal defect(PmVSD) in children less than 15 kilograms.Methods From January,2010 to January,2013,a total of 530 infants(age ＜ 3 years,weigh ＜ 15 kg) with PmVSD enrolled and they were divided into two groups according to different treatment methods at random.Group 1 (265 cases) was arranged perventricular device closure with modified occluders through a lower partial median sternotomy under transesophageal echocardiography (TEE) guidance;group 2 (265 cases) was arranged surgical repair on cardiopulmonary bypass(CPB) through a right subaxillary small incision.A prospective randomized controlled study was performed between two groups on success rate,operation time,volume of blood loss and transfusion,length of intubation and ICU stay,complications,expenses and follow-up results etc.Results All patients in two groups obtained effective treatment with no death or serious life-threatening complications.Group 1:255 cases (96.23％) underwent successfully MIPDO.The remainder 10 cases (3.77％) who failed in attempt were successfully converted to conventional open heart operation by extending the original incision.Different arrhythmias arose in 30 cases(11.76％),including incomplete left bundle branch block(ILBB) in 3 cases(1.18％),complete right bundle branch block(CRBB) in 3 cases(1.18％),incomplete right bundle branch block(IRBB) in 16 cases(6.27％),Ⅰ° atrioventricular block(Ⅰ°AVB) in 8 cases(3.14％);trivial residual shunt(RS) in 18 cases(7.06％);newly arose trivial tricuspid regurgitation(TR) in 29 cases(11.37％).Group 2:All the patients(100％) underwent successful surgical repair through right subaxillary incision.Different arrhythmias occurred in 116 cases (43.77％),including transient complete atrioventricular block(CAVB) and ILBB in 2 cases respective(0.75％),junctional ectopic tachycardia(JET) in 1 cases(0.38％),CRBB in 61 cases(23.02％),IRBB in 52 cases(19.62％);trivial RS in 16 cases (6.04％);newly arose trivial TR in 11 cases(4.15％);heart dysfunction in 17 patients(6.42％).All patients were followed up for more than 12 months,and there were no newly happened or aggravated valve regurgitation or late onset CAVB in two groups.The final treatment effects are similar in both groups.But group 1 was significantly superior to group 2 in the aspects of operation time,volume of blood loss and consumption,length of intubation and ICU stay,hospitalizations and costs(all P ＜ 0.05).The incidence of TR is higher in group 1 (P ＜ 0.05),and that of right bundle branch block was higher in group 2 (P ＜ 0.05).The incision is longer in group 2,but in a less exposed location.CPB is not needed in group 1,but anticoagulant drug is required for 3-6 months.Conclusion Both RSISR and MIPDO are effective treatment methods of PmVSD.Though having some limitations,MIPDO which characterized by simple procedure,minimal invasion,quick recovery,saving of medical resources could not only minimize the surgical trauma to patients,but also ensure the safety of operation to the maximum extent.However,the patient selection is vital.For selected patients,especially those of moderate PmVSDs with obvious clinical symptoms but no cardiac valve regurgitation,it is an ideal approach.

Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.

Objective To evaluate the use of laparoscopic operation in gynecological acute disease. Methods 56 cases of gynecological acute disease patients were treated with different laparoscopic operation according to pathogenetic condition. Results All were exelcymosised urinary canal, liquid diet, out-of-bed actived 6h post operation, ambulation 10h later,no infective fever,postoperative hospital stay 3～5d[mean (3.3?1.1d)] and incisal opening healing well. Conclusion Laparoscope is an effective and safe operation in gynecological acute disease.

Objective To explore the appropriate frequency of ventilator tube replacement by researching the influence of different ventilator circuit change frequency on ventilator-associated pneumonia (VAP).Methods A prospective randomized sampling study was conducted.The patients undergoing invasive mechanical ventilation over or equal to 3 days admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were enrolled.The patients were divided into 3,7 and 10 days group according to the frequency of ventilator tube replacement.Bacteriology of ventilator tube and the incidence of VAP were compared among the groups.Results Ninety-eight patients were enrolled,mainly with the artificial airway of endotracheal intubation or tracheotomy,with 56 male and 42 female,aging 8 to 86 years with mean of (51.97 ± 17.56) years.There were no statistical differences in gender,age,Glasgow coma scale (GCS) score,cough function and application of glucocorticoid,enteral nutrition,atomization and sedative therapy among three groups,indicating that the risk factors among three groups were consistent.The bacteria detection rates of extension tube,breathe out tube,breathe in tube,and hydrops collection cup were 36.7％,36.7％,33.3％,and 33.3％ respectively in 3 days group,and they were 73.0％,67.6％,62.2％,and 62.2％ in 7 days group respectively,and were all 90.3％ in 10 days group.It was showed that the bacteria detection rate in different pipe parts was almost the same with the same change frequency,and the rate was higher with the longer usage of ventilator tube (x2 values were 20.599,19.879,21.975,21.975,all P =0.000).The longer of the tube used time,the higher incidence of VAP.The incidence of VAP in 3,7,10 days groups were 26.7％,59.5％ and 77.4％,respectively,but there was statistically significant difference among all groups (x2 =30.486,P ＜ 0.001).Based on the value of 3 days group,the incidence of VAP in the 7 days group was 15.950 folds of 3 days group,and the incidence of VAP in the 10 days group was 18.333 folds of the 3 days group (both P ＜ 0.001).Conclusion This study suggests that the longer of pipeline using time,the more serious degree of bacterial contamination of pipeline,the higher incidence of VAP.

Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.