After the basic contents of MOOC and flipped classroom were introduced, MOOC-based flipped classroom teaching model for Chinese medical literature information retrieval course was described, its design and implementation were elaborated with CBM Database as an example.

Taking Liaoning University of Traditional Chinese Medicine as an example, a survey of seven-year program students in-formation quality is made.Based on the survey result, it discusses the content, teaching method and approach reform of Traditional Chi-nese medicine literature and information retrieval course for seven-year program students, so as to make better contribution to improving the information literacy of the seven-year program students.

The paper introduces the research significance of Traditional Chinese Medicine ( TCM) literature information retrieval based on cognition analysis, by analyzing cognition of literature information demands of TCM students in different majors of Liaoning University of Traditional Chinese Medicine, it studies from three perspectives:literature information retrieval demand, retrieval thinking and development direction of TCM literature information retrieval system.It also points out that study on thinking and practice of literature information retriev-al based on cognition analysis is the effective approach to enhance information literacy and improve the comprehensive quality.

On the basis of reviewing the significance of retrieval teaching and scientific research integration and the research situation at home and abroad,the paper proposes the undergraduate teaching optimization plan of literature information retrieval of Traditional Chinese Medicine (TCM) teaching integrated with scientific research,points out that the teaching design should focus on the cultivation of scientific research ability,the teaching process advocates the efficient and rich communication form based on the students,and the course assessment should establish multi-dimensional evaluation system.

OBJECTIVE:To determine the resistance of clinically isolated bacteria to meropenem METHODS:The resistance of 150 clinically isolated strains to meropenem and several other antibiotics was detected by K-B method and the drug resistant spectra to E coli were compared between meropenem and imipenem RESULTS:The sensitivity of 130 clinical isolates to meropenem was 100% No cross resistant strains of E coli was found to meropenem and imipenem CONCLUSION:Meropenem is highly sensitive to the clinical isolates,and its antibacterial spectrum is similar to that of imipenem

BACKGROUND:Mesenchymal stem cells are found to have the immunoregulatory activities and a potential application prospect in the treatment of autoimmune diseases.
OBJECTIVE:To explore the mechanism of transplanting mesenchymal stems cells on the treatment of multiple sclerosis.
METHODS:The mouse mesenchymal stems cells were prepared, and injected into the al ogenic and syngenic normal mice, to detect the frequency of CD4+CD25+Foxp3+T cells in the spleen, thymus, and lymph nodes by flow cytometry, and to detect the Foxp3, transforming growth factor-β1, and interleukin-10 mRNA in the spleen, thymus, and lymph nodes by reverse transcription-PCR.
RESULTS AND CONCLUSION:Transplantation of mesenchymal stem cells on normal mice led to a significant up-regulation of CD4+CD25+Foxp3+T cells, Foxp3, transforming growth factor-β1, and interleukin-10 mRNA in the spleen, thymus, and lymph nodes both in the al ogenic and syngenic transplant groups. Transplantation of mesenchymal stem cells may be an available method in the treatment of autoimmune diseases, and CD4+CD25+Foxp3+T cell, Foxp3, transforming growth factor-β1, and interleukin-10 may be involved in this process.

Objective To investigate the effect of Rumo Shengji San on promoting tissue regeneration of skin defect after repair with tissue-engineered skin.Methods The dermal scaffolds were reconstructed by collagen sponge in which human skin fibroblasts were transplanted inside and human keratocytes were transplanted on the surface.The tissue-engineered skin was transplanted into the wound surface of defected skin in naked mice.Rumo Shengji San was applied externally once every other day after transplantation for 2 days.The animals were randomly divided into two groups:external application group and control group,4 mice in each group.The differentiation tissue of the tissue-engineered skin was sampled 9 days after transplantation.The epidermis thickness and dermal capillary proliferation in wound of defected skin were observed with HE staining,and double-labeled immunofluorescence method was used to test dermal laminin(Ln) and typeⅠcollagen protein expression.Results Rumo Sheng Jji San promoted the development of epidermis after transplantation for 9 days.The number of capillaries in dermis was increased,and the expression of Ln and typeⅠcollagen protein was promoted in external application group than that in the control group.Conclusion Rumo Shengji San can promote tissue regeneration of skin defect after repair with tissue-engineered skin.

Objective:To investigate perioperative management of anesthesia for septic shock.Methods:Anesthesia performed on an elderly patient with septic shock who underwent emergency surgery in Beijing Hospital was analyzed and summarized, with a literature review.Results:Etomidate, Ketamine, cis Atracurium and Remifentanil are preferred for anesthesia induction, and Remifentanil and Sevoflurane are the first choices for anesthesia maintenance.Combined application with Dexmedetomidine may improve patients' prognosis.For septic shock patients with new-onset atrial fibrillation, β-blockers are preferred for perioperative anti-arrhythmia.If necessary, propafenone or amiodarone can be used for cardioversion.Perioperative ultrasound evaluation may be used to guide perioperative fluid therapy and vasoactive drug administration for septic shock in the future.Conclusions:Anesthesiologists should place a high value on and have a good command of the main aspects of perioperative management of anesthesia for septic shock.

Objective To investigate the indications and clinical effect of emergency laparoscopic splenectomy for traumatic splenic rupture.Me,ods Clinical data of 30 traumatic splenic rupture patients undergoing emergency laparoscopic splenectomy from Aug 2011 to Mar 2016 in our hospital were analyzed retrospectively.Results.All patients were of simple traumatic spleen rupture without combined injuries.There were 2 cases of grade Ⅱ (6.7％),17 cases of grade Ⅲ (56.7％),10 cases of grade Ⅳ (33.3％),1 case of grade Ⅴ (3.3％).28 cases underwent successful laparoscopic splenectomy and 2 cases were converted to open surgery.22 cases used intraoperative autologous blood transfusion (73.3％),19 cases received blood transfusion (63.3 ％),average perioperative blood loss were (1 791 ± 643) ml,operation time were (135 ± 51) min,postoperative fasting time was (2.7 ± 1.8) d,postoperative hospital stay was (8 ± 5) d.The overall postoperative morbidity rate was 20％ (6/30),including pancreatic leakage in one,pleural effusions in 2,infections in 3.There were no operative mortality and other serious complications.Conclusions Emergency laparoscopic splenectomy is minimally invasive with faster recovery,less complication and shorter hospital stay.

Objective To explore the effects and indications of physical cooling in fever patients after bone fracture surgery.Methods 450 fever patients after bone fracture surgery were selected.They were divided into different groups according to ~e main influencing factors which affected the effect of physical cooling,including the temperature of sponge bathing,the degree of fever,clinical phases of fever.The influence of above factors on physical cooling was observed.Results The temperature for sponge bathing maintaining at 38～40 ℃(the experimental group) achieved better results than that at 32～34 ℃(the control group).Physical cooling at constant peak period of fever had better effect than that during the fervescence period,and the effect of sponge bathing treatment was better in mild fever patients than in high fever patients.Conclusions The single physical hypothermia only fit the patients following bone fracture surgery who had a fever below 38.5 ℃.Patients who had an infectious high fever should receive drug combination.Temperature of sponge bathing maintaining at 38～40 ℃,bathing timing at constant peak period of fever may get best cooling effect.