After a description of the development of massive MOOC in domestic biomedicine and its characteris-tics, the major advantages and disadvantages of MOOC were analyzed in aspects of its copyright , guiding role of teachers, course experiments, and independent study of students, the application of MOOC in medical libraries was elaborated with 4 suggestions put forward for the development of MOOC in medical libraries.

Papers on linked data published in foreign countries from 2005 to 2013 were analyzed, showing that the research of linked data in foreign countries is in its introduction period on the subject growth curve, the number of related literatures tends to increase, with a number of classical literatures and core researcher groups formed.At present, the research is focused on the theory, implementation and application of linked data.

Objective To evaluate the clinical effects and safety when adopt smoothing liver and invigorating spleen treatment to cure diarrhea-predominant irritable bowel syndrome (D-IBS) characterized by liver stagnation with spleen deficiency.Methods 71 patients met the inclusion criteria of D-IBS were randomly divided into the treatment group(36 cases)and control group(35 cases),the treatment group used Shugan Jianpi therapy,traditional Chinese medicine Tongxieyao Fang and additive Shenlingbaishu Decoction; the control group taking Lactobacillus Complex Capsules treatment.Two groups of the time of taking medicine for 4 weeks.Observation and analysis of comprehensive effects and D-IBS symptom score before and after treatment.Results There was no statistical significance in the two groups before treatment,symptom total score difference,after the treatment group and the control group of symptom score were (4.83 ± 3.30),(7.00 ± 3.96),with a significant difference between the two groups (t =2.51,P ＜ 0.05) ; the total effective rate of treatment group was 91.67％,which was higher than 68.57 ％ in the control group(x2 =5.98,P ＜ 0.05).Conclusion The adoption of the smoothing liver and invigorating spleen treatment characterized by the use of Tong Xie Yao Fang and additive ShenLingBaiZhu decoction to cure D-IBS patients with liver stagnation and spleen deficiency has a relatively satisfactory clinical curative effect.

Leptin,a peptide encoded by the obese gene,is primarily secreted by adipocytes,which is a critical hormone controlling food intake, body weight, energy expenditure and neuroendocrine function. Leptin can alter the reactivity of the gastrointestinal neuromuscular, thereby to regulate the gastric emptying and bow-el movement. Leptin seems to be a new gut hormone that has a close relationship with the function and dis-ease of gastrointestinal tract. This article reviews the relationship of leptin and gastrointestinal motility.

Objective To evaluate the effect of retroperitoneal laparoscopic ureterolithotomy (RLUL),ureteroscopy(URS),microchannel percutaneous nephrolithotomy (mPCNL) in the treatment of impacted upper ureteral calculi.Methods Clinical data of 105 cases with impacted upper ureteral calculi were retrospectively analyzed.The average residence time of stone in the same position was 8.6 (2-49) months and the average stone surface area were 171 (71-361)mm2 in 41 cases received RLUL treatment.The average residence time of stone in the same position was 9.5 (2-47) months and the average stone surface area were 159 (71-342)mm2 in 29 cases received URS treatment.The average residence time of stone in the same position was 8.9 (2-51) months and the average stone surface area were 165(71-353)mm2 in 35 cases received mPCNL treatment.Results In the RLUL group,surgery was successful in all patients and the stone-free rate was 100％ ;In the URS group,the surgery success rate was 93.1％ and the stone-free rate 1 month later was 92.6％ ;In the mPCNL group,the surgery success rate was 97.1％ and the stone-free rate 1 month later was 97.0％.The operation time in the URS group (mean 65 min,ranged 45-95 min)was longer than that in the RLUL(mean 46 min,ranged 25-70 min) and mPCNL(mean 51 min,ranged 39-80 min)groups (P＜0.05).The hospital stay in the URS group (mean 5.1 days,ranged 4-12 days) was shorter than that in the RLUL(mean 7.9 days,ranged 6-11 days) and mPCNL(mean 8.1 days,ranged 5-18 days)groups (P ＜ 0.05).The operation time and the hospital stay had no significant differences between the RLUL group and mPCNL group (P ＞ 0.05).The surgery success rate,stone-free rate and the serious complications of the three groups had no significant differences (P ＞ 0.05).Conclusion The operation time of URS is shorter,but postoperative recovery is faster than that of RLUL and mPCNL groups.Although the incidence of serious complications has no statistically significant differences among the three treatments,but URS and mPCNL surgery have the potential risk of serious complications.RLUL does not increase the difficulty of operation,has less serious complications,and is a remedy for failure in URS and mPCNL operation.

Integrative medicine is the effective combination of dual diagnosis of Chinese medicine and western medicine.The combination can broaden the scope of clinical diagnosis and combine the local pathological changes with the overall response of the human disease.It can add a more comprehensive understanding of diseases for people.Clinically treated with combination of Chinese medicine and western medicine can achieve the complement of advantages.It is significant.Because the theory system of Chinese medicine compared with western medicine is different and the theory system of combination is not practical and standardized.The methods of clinical diagnosis and treatment are also different.So there are still some problems and deficiencies in the integrative medicine.In this study,through extensive literature research,as well as the clinical investigation in some integrative medicine hospitals and the collection of related clinical data,we compared and analyzed the academic ideas and different features of Chinese medicine and western medicine,analysed the status and the insufficience of current clinical integrative medicine.Finally,we put forward a series of effective strategies and methods for how to combine with integrative medicine in a specific,reasonable and effective way.

AIM:To study the method of determing camphor, menthol, synthetic bornel and the wintergreen oil contents in Shexiang Zhunggu Plaster. METHODS: Gas phase chromatogram was used to determine contents of camphor, menthol, synthetic bornel and the wintergreen oil in Shexiang Zhuanggu Plaster. The chromatogram condition consisted of the capillary vessel column(PEG-20M, 30 m?0.32 mm?0.25 ?m). The temperature programing rose from 100 ?C to 130 ?C by 5 ?C /minute, then 30 ?C /minute to 200 ?C , lasting 2 minutes in the end. The temperature of the entrance of the capillary vessel column: at 220 ?C , temperature of the detector was 240 ?C ; N_2: 5 mL/minute, H_2: 45 mL/minute, Air: 450 mL/minute; sample quantity was 0.2 ?L. RESULTS: Under certain chromatogram condition, there was linear relation among the camphor, menthol, synthetic bornel and the wintergreen oil and the peak area in the scope of 0.027 38 mg/mL-0.438 08 mg/mL, 0.041 15 mg/mL-0.658 4 mg/mL, 0.033 38 mg/mL-0.534 1 mg/mL, 0.042 15 mg/mL-0.674 4 mg/mL, respectively. The average recoveries were 98.37%, 99.76%, 98.80% and 97.61%, respectively. RSD were 1.7%, 1.8%, 0.96% and 1.5%, respectively. CONCLUSION: This experiment provides an accurate and reliable method to control the quality of Shexiang Zhuanggu Plaster.

Using calmodulin dependent cyclic neucleotide phosphodiesterase and dansyl-labeled calmodulin,honokiol's action on calmodulin is studied. It is found that honokiol inhibits the activity of cyclic neucleotide phosphodiesterase induced by stimulus of calmodulin. With the increasing of calmodulin concentration, the IC50 value was increased. In the presence of Ca2+, honokiol reduces the fluorescence intensity of dansyl-calmodulin, and makes the spectrumpeaked red. The results indicate that honokiol can combine with calmodulin in the presence of Ca2+ and antagonise the effect caused by calmodulin's stimulation upon the phosphodiesterase. In addition , honokiol may exert its effect on the basal activity of calmodulin dependent cyclic neucleotide phosphodiesterase.

Objective To explore the clinical value via comparison of umbilical incision and traditional right upper quadrant abdominal transverse incision of congenital hypertrophic pyloric stenosis.Methods According to the digital table,38 children with congenital hypertrophic pyloric stenosis were divided into two groups,the study group (n=19)was given umbilical transverse incision,the control group(n=19)was given right upper quadrant abdominal transverse incision.The effect of the two groups were compared.Results In the study group,the operate time was (20.4 ±1.47)min,incision scar healing time was (5.53 ±0.51)d,which were significantly lower than (24.00 ± 1.36)min and (7.26 ±0.45)d of the control group(t=7.835,11.090,all P<0.05).The length of incision scar [(0.53 ±0.015)cm]was obvious shorter than that of the control group[(2.03 ±0.12)cm](t=54.070,P<0.05). The postoperative eating time[(23.84 ±0.96)h]and hospitalization time[(9.37 ±0.83)d]of the study group had no difference with the control group of[(24.11 ±0.81)h and (9.42 ±0.84)d](t=0.936,0.184,all P>0.05). Followed up for 6-8 months,all children had good growth and development,but abdominal scar was obvious in the control group,and the study group had no obvious scar.Conclusion Umbilical incision for the treatment of congenital hypertrophic pyloric stenosis does not prolong the operation time,and has rapid postoperative recovery and better beau-ty effective than the traditional operation,.It is suitable for primary hospitals with no condition to carry out laparoscop-ic operation.

Objective To observe the effect of omeprazole combined with nursing intervention in the treatment of peptic ulcer disease and evaluate its clinical effect. Methods 83 cases from January 2014 to March 2017 were as the research object, using randomly divided into the control group of 41 patients treated with omeprazole alone, during perioperative treatment give nursing intervention, 42 patients in study group were given omeprazole treatment and nursing intervention, compared two groups of patients with clinical treatment. Results After treatment, the two groups of patients with various indicators of statistical data show that the total efficiency of the study group was 95.24% (40/42), control group was 80.49%(33/42), with statistical significance in two groups the difference (P< 0.05); in addition, compared with before treatment, two groups of patients after treatment, stomach burning sensation, epigastric pain, postprandial protection, belching symptoms and SDS scores, SAS scores were significantly improved, and the improvement in the study group The effect is obviously better than that of control group (P<0.05). Conclusion The treatment of omeprazole combined with nursing intervention in patients with peptic ulcer, can play a satisfactory effect, effectively improve the clinical symptoms of the disease and improve the negative emotions of patients, with clinical application value.