After a description of ISO11620:2014 , the international criteria for library performance assessment , how to enforce the construction of military academic libraries was systematically elaborated in terms of improving the quality and use of their resources and infrastructures, and reducing their construction cost.

0 05) between the two procedures in incidence of anastomotic leakage (25 0% vs 10 7%), pulmonary infection rate (31 3% vs 32 1%), incide nce of thoracic cavity infection (0 vs 3 6%), proportion of re-thoracotomy (0 vs 3 6%), incidence of d elayed gastric emptying (3 1% vs 21 4%), postoperative SICU stay (4d?2 3d vs 5d ?3 6d), and peri-operative mortality (3 1% vs 7 1%). The incidence of recurr ent laryngeal nerve injuries (28 1% vs 7 1%, ? 2=4 391,P =0 036) and arr hythmia (43 8 % vs 17 9%, ? 2 =4 627, P =0 031) in the THE Group were significantly higher than those in the TTE Group, while the intra-operative blood loss in the THE Group was signif icantly less than that in the TTE Group ( t = -3 100, P =0 003).ConclusionsVideo- assisted THE is a safe procedure. With the increase of the experience, the incid ence of post- operative complications is subject to further decrease.

Purpose　To investigate whether thoracotomy can induce lung injury in the operative side and the protection by ambroxol in this procedure.　Methods　24 patients with esophageal carcinoma who were performed esophagectomy with anastomosis over the arcus aortae were randomized into 2 groups:an ambroxol group (ambroxol 1 g iv gtt qd×3,preoperatively) and a controlled group without any respiratory medication.General anesthesia by tracheo-cannula combined with continuous epidual anesthesia were used in all the patients.Bilateral broncho-alveolar lavage(BAL) was carried out after intubation preoperatively and before removal of the cannula postoperatively.Total Phospholipid(TPL),Saturated Phosphaytidylcholine(SatPC) and Total protein(TP) in the BALF were measured.The ratio of SatPC/TPL and SatPC/TP represented the activity of PS.　Results　In the controlled group,SatPC/TPL and SatPC/TP of the left lung(operation side) showed significant difference(P<0.05),compared with the right side(non-operation side).In the ambroxol group,no significant difference of such ratio was showed.　Conclusions　Thoracotomy can induce lung injury and bring out the decrease of PS and increase of protein exudation in the operative side.Large dose of ambroxol can promote in synthesize and secretion of PS and protect those changes.

OBJECTIVE:To observe clinical efficacy and safety of Jiedu xiaoyu cream combined with Glucosamine potassium sulfate capsules in the treatment of knee osteoarthritis. METHODS:196 patients with knee osteoarthritis were randomly divided in-to observation group and control group,with 98 cases. Both group were given Glucosamine potassium sulfate capsules 0.5 mg/time, bid;observation group additionally received Jiedu xiaoyu cream for local use,once a week;control group additionally received Di-clofenac diethylamine emulsifiable paste for local use,bid. A treatment course lasted for 2 weeks,and both groups received 3 cours-es of treatment. Clinical efficacy,VAS scores,WOMAC scores and ADR of 2 groups were observed. RESULTS:The total effec-tive rate of observation group was 94.7%,which was significantly higher than that of control group(88.3%),with statistical sig-nificance(P<0.05). Compared with before treatment,VAS and WOMAC scores of 2 groups decreased obviously,with statistical significance(P<0.05);the decrease of observation group was more significant than that of control group,with statistical signifi-cance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Jie-du xiaoyu cream combined with Glucosamine potassium sulfate capsules has good clinical efficacy in the treatment of knee osteoar-thritis,can relieve knee pain and improve the function of activity.

Objective To review the efficacy of bisphosphonates in reducing skeletal events in patients with multiple myeloma. Methods Two hundred and five patients with newly diagnosed MM were enrolled in this retrospective study,with bisphosphonates or not.Skeletal-related events,therapeutic reaction of myeloma bone disease and patient survival were analyzed. Results The occurrence of skeletal-related events (SRE) per patient year (P＜0.01) and the time to first SRE (P＜0.05)were significantly lower in the reatment group than in the untreated group. After 6 cycles of treatment, a significant higher percentage of effective and marked effect patients were observed through X ray in the treatment group (80.0 ％) compared to the untreated group (48.7 ％), P＜0.001. There was no overall significant difference in the level of serum calcium between the two groups (P=0.278). After 6 cycles of treatment, the patients who received bisphosphonates had significant decreases in bone pain and lower ECOG score (ECOG≤2) compared to the untreated group (P＜0.05). Bisphosphonates were tolerated well, and the common adverse reaction including gastrointestinal reaction (3 cases,3.3 ％),fever (lcase,1.1％) and skin rash (2 cases,2.2 ％).There was no significant difference in overall survival between the two treatment groups,(P=0.580).Conclusion Infusions of Bisphosphonates could reduce the occurrence of skeletal- related events (SRE), prolong the time to first SRE and improve the quality of life of patients with multiple myeloma. Bisphosphonates could not prolong survival time of myeloma patients.

Objective To assess the diagnosis value of diffusion- weighted imaging (DWI) in Creutzfeldt-Jakob disease (CJD).Methods 8 cases of sporadic CJD who underwent MRI were reported. 4 cases were definite,3 cases were probable and 1 case was possible. The sensitivity of DWI and conventional MRI were compared. Results T_1WI and T_2WI revealed no abnormal signals except nonspecific diffuse brain atrophy in 4 cases, whereas DWI detected hyperintense abnormalities in all cases. 2 cases showed linear lesions only in the cerebral cortex, and 6 cases showed lesions in both the cerebral cortex and the striatum. The lesions were symmetric in 5 cases, but were asymmetric in the other 3 cases. Although fluid-attenuated inversion recovery (FLAIR) imaging also showed cortical hyperintensity in 1 case, the high signal changes were more evident and extensive on DWI. Conclusions The hyperintense changes in the cerebral cortices and/or striata on DWI are considered characteristic of CJD. DWI is more sensitive than conventional MRI in depicting lesions of CJD and may be an essential tool for the early diagnosis of this disease.

AIM: To observe the effect of piceatannol on the kidney of diabetic nephropathy rats in early stage, and to explore the possible mechanisms.METHODS: The rats were randomly divided into 5 groups: control group, model group, low dose of piceatannol treatment group, medium dose of piceatannol treatment group and high dose of piceatannol treatment group.The rat model of diabetic nephropathy was induced accordingly, and the rats received 20 mg/kg, 40 mg/kg or 60 mg/kg of piceatannol by gavage once a day for 4 weeks.Blood glucose was detected by glucometer.The urea nitrogen and creatinine levels in the serum were measured by urease-glutamate dehydrogenase enzymatic and inosine acid oxidase methods, respectively, and 24 h urinary microalbumin was analyzed by immune transmission turbidimetry test.Moreover, the pathological changes of the kidney tissues were observed under microscope with HE staining.The protein expression of TGF-β1 and Smad 7 and the phosphorylation levels of Smad2 and Smad3 were determined by Western blot.RESULTS: Compared with model group, piceatannol treatment significantly decreased the levels of blood glucose, blood urea nitrogen and urinary microalbumin, but had no effects on serum creatinine.Furthermore, HE staining showed that the increased mesangial cells, matrix hyperplasia and degenerated epithelial cells in model group were markedly inhibited after piceatannol treatment.Additionally, piceatannol treatment also reduced the protein expression of TGF-β1 and Smad 7, and the phosphorylation levels of Smad2 and Smad3.CONCLUSION: Piceatannol attenuates pathological progression in the kidney of diabetic nephropathy rats in early stage, which may be through inhibiting TGF-β/Smad signaling pathway.

Objective To inquire into the location of the relevant gene mutations in the Chinese familial hypokalaemic periodic paralysis, and to specify the correlation between the genotype and the clinical features of this disease. Methods Target-exon PCR and DNA direct sequencing were used to research the mutations in the CACNA1S, SCN4A, and KCNE3 genes of 14 familial hypokalaemic periodic paralysis probands. If a positive member was found, the other members of his (her) family must be inspected with the sequencing method. Results The probands of 3 families showed the known correlating mutations of hypokalaemic periodic paralysis, which were R1239H mutations in the CACNA1S in 1 family and R672H mutations in the SCN4A in the other 2 families. In addition, the differences of the age of onset, the responsibility to the treatment with acetazolamide and penetrance were found between the CACNA1S R1239H and SCN4A R672H mutations. Conclusions SCN4A R672H and CACNA1S R1239H mutations exist in the Chinese familial hypokalaemic periodic paralysis. Differences of the clinical features exist, resulting from these 2 kinds of mutations.

Objective To report two cases of severe pulmonary complication after bortezomib treatment for multiple myeloma. Methods Two cases of severe pulmonary complication after bortezomib treatment patients with relapsed multiple myeloma wereas discussed with review of literature. Results Two relapsed MM patients were treated with bortezomib and thalidomide or dexametbasone. Cough, dyspnea, fever and hypoxia developed after completion of bortezomib. Chest X-ray revealed bilateral pulmonary infiltrates,but infection was not identified with sputum cultures, and broad-spectrum antibiotics were ineffective.Conclusion Severe pulmonary injury was rare complication in patients receiving treatment for multiple myeloma, however, it was a life-threatening disorder. Prophylaxis corticosteroids maybe effective. Although corticosteroids are effective, but the mechanism of lung injury associated with bortezomib is unclear, and further evaluation of this potential toxicity is appropriate.

The clinical practice teaching reform of pediatrics based on TBL combined with medical simulation teaching model was carried out. TBL teaching plan writing under the model of medical simulation teaching was researched. The principles, requirements, contents and procedures of compiling teaching plans were formed. Emphasis should be placed on medical simulation teaching, team cooperation, humanistic quality education and humanistic skills training. The purposes of the reform were to achieve standardized operation skills, improve clinical ability, ensure medical safety, and improve the quality of medical purposes, but still the reform need further improvement in the teaching practice.