Smart library is an advanced stage in the development of library and service is the key content in aca-demic library.The service model of smart library was described from the angle of information service, cloud service and Library 3 .0 with the connotation of smart library and the service function of academic library as the starting points.in an attemp to provide reference for academic libraries to establisht their target of smart library construction.

The social reputation-based incentive mechanisms in preventing the free riding behaviors were put for-ward according to the analysis of personal digital library and P2P technology. Since the reputation value of personal digital library was calculated according to the maximum flow algorithm, personal digital library must increase its reputation value by sharing the resources when it is going to obtain the necessary resources it wants.

Objective:To investigate the effects of E.coli lipopolysaccharide(LPS) stimulus on the synthesis of TLR4 protein and its mRNA expression in human dental pulp cells(HDPCs), and to explore the roles of TLR4 on the activation of HDPCs induced by LPS. Methods:The expressions of TLR4 mRNA and the synthesis of TLR4 protein in HDPCs induced by LPS were detected by real-time fluorescence quantitative RT-PCR(FQ RT-PCR) and immunofluorescence technique.IL-1? concentrations in the supernatant of cultured HDPCs pretreated with TLR4 antibody were assayed with ELISA. Results: The expressions of TLR4 could not be detected in normal HDPCs.After being stimulated with 1?10-4 g/L LPS for 6,12 or 24 h, immunostaining showed that TLR4 was expressed in cytomembrane and cytoplasm of HDPCs,while in nucleus the expressions were negative. FQ RT-PCR showed their expressions significantly increased after being stimulated with LPS (P

Objective To study the optimal dose of esmolol for maintaining cardiovascular stability in patients with hypertension during tracheal extubation. Methods In post-anestheisa care unit, hypertensive patients after general anesthesia meeting the extubation criteria were included. Patients were divided into 2 groups according the age: group Ⅰ (>65 years old for the elderly hypertensive, 21 cases), and groupⅡ(≤65 years old for the non-elderly hypertensive, 22 cases). All the patients received esmolol bolus before sputum suction and tube extraction, and the tracheal extubation were extubated 2 minutes after esmolol bolus. The systolic blood pressure, diastolic blood pressure and heart rate were was recorded before tracheal extubation, 2 min after esmolol bolus, at the time of sputum suction extubation, 1 min after tracheal extubation, 3 min after tracheal extubation and 5 min after tracheal extubation. Esmolol dose was determined by the up and down method. Initial dose was 0.5 mg/kg, in accordance with the arithmetic dose (0.2 mg/kg) increasing or decreasing progressively. In negative results (the systolic blood pressure at extubation or 5 min after extubation ≥ 20% of the base, or the systolic blood pressure at sputum suction extubation>180 mmHg, 1 mmHg=0.133 kPa) esmolol dose increased progressively, and in positive results (the systolic blood pressure at extubation or 5 min after extubation<20%of the base) esmolol dose decreased progressively. When the crosspoint (from positive to negative result) reached 6, the study was terminated. Results The median effective doses of esmolol for maintaining cardiovascular stability in groupⅠand groupⅡwere (0.6 ± 0.1) and (0.8 ± 0.1) mg/kg. Conclusions Esmolol can maintain cardiovascular stability in patients with hypertension during tracheal extubation. Median effective dose decreases in older hypertensive patients.

Objective To investigate the efficacy of centrally fixed eyeball for assessment of the depth of anesthesia in premature infants undergoing outpatient fundus examination. Methods Fifty eight premature infants undergoing examination of fundus of eyes were enrolled in this study. Their gestational age (from the first day of last menstruation period to birth) + after birth age (from birth to the day when examination of fundus of eyes was performed) = 44-64 weeks. The patients were randomly divided into 2 groups: Ⅰ group body movement (group M, n = 27) and Ⅱ group centrally fixed eyeball (group E, n = 31). Anesthesia was induced and maintained with isoflurane inhalation. The patients were breathing spontaneously. The eyelids were kept open with speculum after induction of anesthesia. The EC50 of sevoflurane concentration which could inhibit body movement or make eyeballs centrally fixed was determined by up-and-down sequential experiment. The initial isoflurane concentration was 3% in both groups. Each time the isoflurane concentration was increased/decreased by 0.5 %. 95 % confidence interval (CI) was calculated. The lowest SpO2, respiratory rate and coughing during maintenance of anesthesia were recorded. Results The EC50 of sevoflurane (95% CI) was 2.9% (2.2%-3.6%) in group M and 3.4%(2.6%-4.6%) in group E. Examination was successfully completed in all patients. No respiratory depression and coughing occurred during examination and no vomiting and coughing were observed during feeding at 1 h after recovery from anesthesia. No body movement occurred in 15 patients whose eyeballs were centrally fixed in group E. Conclusion Centrally fixed eyeball can be used as sign of appropriate depth of anesthesia for fundus examination in premature infants.

Objective To investigate the effect of dexmedetomidine on minimal induced dose of propofol and cardiovascular responses to tracheal intubation.Methods A double-blind randomized controlled trial was conducted.Sixty patients who underwent elective laparoscopic surgery were randomly divided into the dexmedetomidine group (treatment group) and control group.Patients in treatment group were given dexmedetomidine at dose of 0.1 μg/kg · min for 10 min before anesthesia induction,and then infused with 0.4 μg/kg · h until the end.Sodium chloride injection was infused at the same rate in control group.After 10 minutes from the start of dexmedetomidine or sodium chloride injection,propofol was infused by 0.4 mg/kg · min.The dosage of propofol used was recorded when eyelash reflex disappearing,and BIS value in 40 to 60.Propofol was infusion at the same rate,and laryngoscope was incubated at 2 minutes after fentanyl and rocuronium were given.The alertness/sedation (OAA/S scores),mean arterial pressure (MAP),heart rate,pluse oxygen saturation (SpO2) and BIS values were recorded at baseline (before dexmedetomidine or sodium chloride injection infusion),5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion,at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 min after intubation.Results OAA/S scores and BIS values in the treatment group were significantly lower than that of control group at 5 minutes and 10 minutes after the dexmedetomidine or sodium chloride injection infusion(P ＜0.05).MAP in treatment group was higher than that of control group at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 minutes after intubation (P ＜0.05).Heart rate in treatment group was lower than that of control group at 5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion and before the endotracheal intubation(P ＜ 0.05).There was no significant difference in terms of SpO2 between two groups (P ＞ 0.05).When patients consciousness disappeared and BIS values were in 40-60,the minimum induced dose of propofol was (88.00 ± 25.91) mg in treatment group and (117.33 ± 25.45) mg in control group.The dosage of propofol treatment group was obviously less than control group (t =4.423,P ＜ 0.05).Conclusion Dexmedetomidine reduces the minimum induced dose of propofol while maintaining more stable hemodynamic changes during anesthesia induction.However,there has no obvious inhibition effect on cardiovascular response to tracheal intubation.

Objective To summarize the lung HRCT findings of lung Langerhans cell histiocytosis (LCH) in children. Methods A total of 54 children with lung LCH pathologically proved in our institute from September 2006 to December 2014 were retrospectively reviewed. Patients were subdivided into two subgroups, diffuse type (n=29) and localized type (n=25). In addition, 32 children with LCH but without pulmonary infiltration were selected as control group. HRCT findings of 54 LCH with lung involvement were reviewed and analyzed for distribution pattern. The age of onset, illness duration and pulmonary function were compared between the lung LCH group and the control group. The differences of HRCT findings in LCH patients between diffuse type and localized type were compared with χ2 test. The differences on the onset age, illness duration and pulmonary function between the LCH group with lung involvement and control group were compared with non-parametric test(Mann-Whitney U Test). The differences of pulmonary function between the LCH group with lung involvement and control group were compared with Fisher exact probability test. Results The signs of pulmonary LCH on HRCT included lobular hyperinflation (n=26), interlobular septa thickening (n=11), cystic lesions (n=11), ground?glass opacity (n=10), nodules (n=9), and centrilobular nodules (n=6). The signs presented in 21, 8, 7, 9, 4 and 6 cases in diffuse type group respectively and 5, 3, 4, 1, 5, 0 in localized type group. Among them, lobular hyperinflation, ground?glass opacity and centrilobular nodules were more prevalent in the diffuse group. The difference was statistically significant (χ2=14.77,2.01,0.55,4.84,0.06 and 3.91, P<0.05). The onset age of LCH group with lung involvement was younger than the other (Z=-2.40, P<0.05). However, there was no statistically significant difference in the illness duration (Z=-1.46, P>0.05) and pulmonary function between two groups (P>0.05). Conclusions Lobular hyperinflation, ground glass opacity and centrilobular nodules are the most common manifestations in LCH patients with lung involvement and the distribution is mostly diffuse. Nodules, cystic lesions and interlobular septa thickening may exist. Several signs may coexist simultaneously. Younger children with LCH are more vulnerable to lung involvement.

Objective To compare the efficiency and safety of dezocine and morphine combined with flurbiprofen for gynecologic postoperative analgesia.Methods Ninty patients for elective hysterectomy,ASA (American Society of Anesthesiologists) Ⅰ - Ⅱ,were randomly divided into three groups,given postoperative intravenous analgesic pump:dezocine 50 mg + flurbiprofen 100 mg( Group D) ;morphine 50 mg + flurbiprofen 100 mg ( Group M) ;dezocine 25 mg + morphine 25 mg + flurbiprofen 100 mg ( Group DM ).Anesthesia were induced by midazolam,etomidate,fentanyl and cisatracurium,maintained with propofol and remifentanil.At 15 -30 min before the end of surgery,flurbiprofen 50 mg was given,if pain was not relieved statsifically,morphine 5mg/per time was given additionally.VAS Pain relief scores,Ramsay sedation Score,usage of morphine and side effects such as nausea,vomiting and itch of skin were recorded at 4,8,24,48 h after surgery.Results At 4,8,24 and 48 h after surgery,VAS score at sedation was ( 2.27 ± 0.64 ),( 2.17 ± 0.65 ),( 1.97 ± 0.67 ),and ( 1.60 ± 0.56) in Group D,and ( 2.50 ± 0.63 ),( 2.40 ± 0.62),( 2.20 ± 0.61 ) and ( 1.87 ± 0.57 ) in Group DM at sedation,which were all significantly low than those of ( 3.10 ± 0.76),( 3.00 ± 0.74 ),( 2.80 ± 0.71 )and (2.40 ±0.72)in Group M.At 4,8,24 and 48 h after surgery,VAS score at active was (3.10 ±0.76),(2.97 ±0.76),(2.70 ±0.84) and (2.17 ±0.70)in Group D,(3.43 ±0.63),(3.30 ±0.65),(3.03 ±0.76)and (2.43 ± 0.68 )in Group DM,which were all significantly lower than those of (4.13 ± 0.94),(3.93 ±1.05),(3.60 ± 1.05 ) and ( 3.03 ± 0.96 ) in Group M ( Ps ＜ 0.05).And the VAS scores of Group DM was significantly higher than those of Group D.Sedation score at 48 h after surgery in group D was better than that in Group M ( x2 =4.812,P ＜ 0.05 ),The side effects at 48 h after surgery was 26.7％ in Group D,46.7％ in Group DM and 80％ in Group M,and there significant difference among these 3 groups (P ＜ 0.05 ).Conclusion Compared to Morphine and or Morphine combined with Dezocine,Dezocine 50 mg + flumazenil 100 mg group is better to release the postoperative pain,and withless adverse effects.

Objective To explore the effects of lifestyle intervention on index of early artery diseases in nondiabetic patients with metabolic syndrome (MS). Methods Eighty-seven nondiabetic patients with MS were randomly assigned to the intervention group ( n =47) and the control group ( n =40).The patients in the intervention group received health education,diet control,regular physical exercises,and unhealthy habit correction; however,the control group did not receive any intervention.All the patients were followed up for 9 months.Body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-C ),low-density lipoprotein cholesterol ( LDL-C ),fasting blood glucose (FBG),HbAlc,fasting insulin (FINS),HOMA-IR,high sensitivity C-reactive protein (hs-CRP),carotid intima-media thickness (IMT),brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index(ABI) were measured at baseline and at 9 months.ResultsAfter 6 or 9 months' intervention,BMI,WC,SBP,TG,HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were improved (all P ＜ 0.05). HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were further improved at 9 months when compared to 6 months ( all P ＜ 0.05 ). In comparison with the control group,BMI,WC,HDL-C,FPG,HbA1 c,FINS,HOMA-IR and hs-CRP were significantly improved in the intervention group at 9 months ( all P ＜ 0.05 ).After 6 or 9 months' intervention,baPWV and ABI were significantly changed ( both P ＜ 0.05 ) in the intervention group although IMT of the carotid did not changed (P ＞0.05). BaPWV and ABI were significantly changed in the intervention group when compared with those in the control group at 9 months ( both P ＜ 0.05).The abnormal rate of baPWV in the intervention group at 9 months was 44.68％. BaPWV and ABI were associated with hs-CRP and HOMA-IR.ConclusionsIn nondiabetic MS patients, health management could significantly improve insulin resistance,modify metabolic disorders,and prevent the development of atherosclerosis.

This paper introduces the program and process of integrative group guidance for asthma patients,as well as relative assistant psychological theories,aiming to provide necessary references for improving the psychological interventions in clinical practice for asthmatics under the guidance of modern medical mode.