The 2012 version of international guidelines for management of severe sepsis and septic shock got re-revised on the basis of the 2008 version.For pediatric severe sepsis,the 2012 version enforces initial resuscitation;develops detailed ant-infection measures;stresses isotonic crystalloid fluid resuscitation and the use of albumin,hetastarch is no longer recommended ;reduces the value of early use of dopamine,and clears the use of corticosteroids indications and the use of blood products;mechanical ventilation is recommended to use lung protective ventilation strategy; standardizes sedation and analgesia applications; clears the level of blood glucose control;others include blood purification,nutrition,stress ulcer prevention recommendations.

MircoRNAs (miRNAs) are widely existing inorganisms, non-coding small RNA. MircoR-NAs play important role in cell proliferation, apoptosis, stress resistance and fat metabolism. In vitro studies indicate that miRNAs are important factors in platinum resistance of ovarian cancer cell lines. However, the pathway of platinum resistance of ovarian cancers is complex. Studies find miRNA expression play important roles in the sensitivity of platinum resistance of ovarian cancer cell lines , and can be used as an early alert for platinum resistance. Changing the expression of miRNA even can reverse the platinum resistance . But the regular role of miRNAs in target genes network is still unconfirmed. Thus, more studies about miRNA in vivo and animal tumor models are needed to identify the function of miRNAs in platinum resistance of ovarian cancer.

Objective To assess the ability of the new software SonoAVC to measure follicular volume and to compare these volume calculations with those made by conventional methods. Methods Three-dimensional ultrasound imaging was used to acquire volumetric data from the ovaries of 50 women undergoing controlled ovarian stimulation as part of in-vitro fertilization treatment. SonoAVC was used to automatically measure the volume of follicles and virtual organ computer-aided analysis(VOCAL) was also applied to measure volume, which was used as the standard of volume measurement. And the three perpendicular diameters (xyz diameters) of follicles were manually measured by conventional two-dimensional(2D) ultrasound, which were used to estimate volume using the sphere formula. And the validity of each technique was compared using limits of agreement. Results One hundred and seventy-six follicles were studied. SonoAVC and VOCAL provided highly accurate and repeatable follicular volume measurements in all cases. Volumes estimated from manually derived follicular diameter measurements were less accurate and repeatable. VOCAL took more time in follicular volume of measurement than SonoAVC and conventional 2D displays. Conclusions SonoAVC provides highly accurate, repeatable,and efficient measurements of follicular volume.

Objective To investigate the difference between contrast sensitivity,noise and crowding phenomenon in normal and ametropic amblyopia children. Design Prospective case series. Participants 50 normal children and 50 ametropic amblyopia children. Method Using the noise visual acuity test chart,crowded visual acuity chart and contrast sensitivity visual chart of the visual perception system developed by the National Medical Care Apparatus Engineering Research Center,normal and ametropic amblyopia children were examined in Beijing Tongren Hospital. Main Outcome Measures The number and the constituent ratio of normal and abnormal children in contrast sensitivity,noise and crowding phenomenon. Results The abnormal results of contrast sensitivity in ametropic amblyopia children and normal children were 60 eyes (60%) and 15 eyes (15%) respectively; the abnormal result of noise visual acuity were 62 eyes (62%) and 30 eyes (30%) respectively; the crowded visual acuity were 56 eyes (56%) and 0 eye respectively (all P=0.000). In mild,moderate and severe ametropic amblyopia children,the abnormal results of contrast sensitivity were 32 eyes (51.61%),20 eyes (66.67%) and 8 eyes (100%) respectively (P=0.005),the abnormal results of crowding phenomenon were 30 eyes (48.39%),18 eyes (60%) and 8 eyes (100%) respectively (P=0.010),the abnormal results of noise were 39 eyes (69.90%),18 eyes (60.00%) and 5 eyes (62.5%) respectively (P=0.868). In mild,moderate and severe refractive error children,the abnormal results of contract sensitivity were 33 eyes (70.21%),9 eyes (34.12%) and 17 eyes (62.96%) respectively (P=0.011),the abnormal results of noise were 30 eyes (63.83%),15 eyes (57.69%) and 17 eyes (62.96%) respectively (P=0.868),the abnormal results of crowding phenomenon were 30 eyes (63.83%),11 eyes (42.31%) and 17 eyes (62.96%) respectively (P=0.172). Conclusion Contrast sensitivity,noise and crowding phenomenon in visual perception tests can be used to estimate the impairment of visual perception in amblyopia children.

By using a highly sensitive HRP-TMB method, the present study found parasympathetic preganglionic neurons innervating rat stomach originated from the dorsal motor nucleus of the vagus(DMV), ambiguus nucleus(AM), reticular formation between DMV and AM(RF). rostroventrolateral reticular nucleus (RVL), lateral parvocelluler reticular nucleus (LRP), paraependymal nucloeus of the vagus (PEV), intercalated nucleus(IC) and retroambiguus nucleus(RA). There was a specific representation area of the stomach in the DMV between 0.3-0.6mm rostral to obex, and the different parts of the stomach had topographical organization within this area. The lateral portion of the DMV mainly innervated the forestomach, the medial and medial-middled portion of the DMV predominantly projected to the antrum/pylorus and corpus, respectively. The right and the left DMV did not show difference in innervating the forestomach and antrum/pylorus, but the corpus was mainly innervated by the right DMV. RF only projected to the forestomach and the corpus. RVL and RA only innervated the forestomach. AM, PEV and IC innervated all the three parts. The relationship between the different neuronal types of the DMV and the different parts of the stomach was first discussed in this paper. The forestomach, corpus and antrum/pylorus received their inputs mainly from the large and small neurons, respectively. The dentrites of the DMV contacting CSF were confirmed.

〔Abstract〕 Taking some college and university libraries in China and the United States as investigation objects, based on internet and literature investigation methods, the paper compares the situation of embedded subject service in the US and China from the aspects of embedded in learning environment of students, embedded in teaching environment of teachers, embedded in scientific research environ-ment of users, etc.Then it points out the shortage and gives some suggestions for embedded subject service in Chinese college and univer-sity libraries.

Objective: To establish a method for the determination of ketoconazole and miconazole nitrate in compound ketocon-azole gels. Methods:An HPLC method was developed. A Hypersil BDS C18 column(416 mm × 200 mm,5μm) was used, the mobile phases consisted of 0. 5% ammonium acetate solution-methanol(containing 0. 2% triethanolamine) (20∶80), the flow rate was 1. 0 ml ·min-1 , the detection wavelength was set at 230nm, the column temperature was 30℃ and the injection volume was 20μl. Results:There was a good linear correlation within the range of 5. 1-510. 0 mg·L-1 for ketoconazole (r=0. 999 9) and 50. 0-500. 0 mg·L-1 for miconazole nitrate (r=0. 999 9), the average recovery for ketoconazole and miconazole nitrate was 100. 3%(RSD=0. 38%, n=6) and 99. 9%(RSD=0. 79%, n=6), respectively. Conclusion:The method is simple, rapid, accurate and sensitive, and can pro-vide a method for controlling the quality of compound ketoconazole gels.

Objective To explore the effect of aspirin resistance on cardiovascular events in non-insulin-dependent diabetes melli-tus patients .Methods 496 patients with non-insulin-dependent diabetes mellitus received daily aspirin therapy (100mg/d) 4 weeks were recruited from Jun .2006 to Sept .2010 .Platelet aggregation was measured by light transmission aggregometry .The patients were divided into three groups :aspirin resistance group ,aspirin semi-resistance group and aspirin-sensitive group .The clinical bio-chemistry indications and the adverse cardiovascular events were collected .Results 11 .69% of patients were found to be resistant to aspirin therapy ,and 37 .90% of patients to be aspirin semi-responders .There were 67 .48% female in aspirin resistance group and aspirin semi-responders .The preprandial glucose of group AR and ASR was higher than that of group AS (P<0 .05) .The HbA1C and TG of group AR were higher than those of group AS(P<0 .05) .There was statistically significant difference of the rate of car-diovascular events .Conclusion The measure of platelet aggregation should be taken in the diabetic mellitus patients and pay atten-tion on the dose of aspirin recommended .Particular attention is should also devote to the incidence of adverse cardiovascular events .

Objective To analyze the influence of professional factor on sensory learning style of military medical university undergraduates to put basis for search effective teaching and studying strategies. Methods Taking one military medical university for example, the undergraduates in all specialties were surveyed with VARK 7.0 version on the quantity of tendencies of their sensory learn-ing styles, the distributions and strengths on condition of single style. Results ①There were statistical significances (χ2=134.916,P=0.029) in the types of sensory learning style of students from different specialties. In those with single learning orientation, the percentage was the highest in the Biotechnology Specialty (54.5%) and Nursing Specialty (49.2%), while in those with quadruple ones, the percentage was the highest in the Pharmacy Specialty (37.2%) and Chinese medical science specialty (35.3%). ②There were no statistical significance (χ2=20.372,P=0.119) in the intensity of single learning orienta-tion among different specialties. ③There were no statistical significances (χ2=26.587,P=0.185) in the type distribution of single learning orientation among different specialties. Conclusion The learning style type of sensory learning style of military medical university undergraduates were influenced by professional factors, while single learning style type distribution and the strength were not influenced by professional factors.

Guided by good clinical practice ( GCP) , M hospital cooperated with the Ethics Committee in quali-ty management of clinical trials and took the specific measures including perfecting the institution and standard op-erating procedures, implementing three level quality control institution, strengthening the training of GCP, and closely cooperating with drug and data management of clinical trials, quality control in the clinical trial, ethical re-view and supervision, quality control in the whole process (seamless connection). Seamless connection from the beginning of project acceptance and quality control in the whole process of clinical trials can effectively solve the ex-isting problems in clinical trials and improve the quality of clinical trials.