The change of library space is driven by various factors, such as technology innovation, users demand and the changing competitive environments. The evolution processes of library space were thus clarified by retrie-ving CNKI, namely from computer and IT to Internet and wide application of information and communication tech-nology, from physical space to virtual space, from space function to information commons, learning, pioneering work and social intercourse, which can eventually lead to the intelligent, individual and ubiquitous library space.

Although talus fractures are not common among foot and ankle injuries, their treatment is difficult because of their complications and poor prognosis. They can be treated conservatively or surgically, with a variety of treatment protocols. At present, the main strategy of surgical treatment is to use strong and effective fixation to restore anatomic structure of the talus and preserve blood supply to the talus as much as possible so that deformity can be avoided and early healing be facilitated. This paper reviews the difficulties and current situation, and summarizes principles and the latest progress in clinical treatment of talus fractures, hoping to provide useful references for the treatment.

Objective To provide an approach to research of peroxisome proliferator activated receptor (PPAR) ? 2 function, mouse PPAR? 2 (mPPAR? 2) gene was cloned and its transient expression in eukaryotic cells was carried out. Methods mPPAR? 2 mRNA from epididymis fat pad of Chinese Kunming mice was amplified by RT PCR and subcloned into plasmid pcDNA3 to generate the recombinant plasmid pcDNA3/mPPAR? 2 which was confirmed to contain the amplified target gene segments with fluorescence sequencing. The recombinant plasmid pcDNA3/mPPAR? 2 was used to transfect COS 7 with lipofectamine and the expressing product was detected with immune fluorescence assay and Western blot. Results The sequencing results for amplified target gene showed that the sequence of mPPAR? 2 from epididymis fat pad of Chinese Kunming mice is similar to that of mouse PPAR? 2 in Genbank, only at the site of 383 amino acid where Ser (AGC) substitutes Asn (AAC). pcDNA3/mPPAR? 2 was efficiently expressed in eukaryotic cells in vitro. Conclusion This work is the experimental basis for further researching on PPAR? 2 function.

It is therapeutically effective to apply hemopoietic growth factors to treat hemopoietic irradiation injuries, but for other tissues injuries, hemopoietic growth factors nearly do not work. At the same time, they are only suitable for the patients with severe and lower level acute radiation sickness (ARS). Besides, clinical therapeutic efficacy of marrow transplantation is not optimistic due to difficulties of marrow zygosity and severe complications such as graft versus host disease, radiation interstitial pneumonitis. Mesenchymal stem cells (MSCs) could secret hemopoietic growth factors, rebuild hemopoietic microenvironment and be easily transfected by exogenous gene, which also have low immunogenicity. At present, studies on MSCs application in the treatment of radiation injuries are at the early -stage, but the precise mechanism is not clear. However, the specific characteristics can make up the disadvantage of traditional treatment of acute radiation sickness, and the clinical application is wide.

Thirty seven patients with venous thromboembolic disease in puerperium were admitted to hospital from January 2005 to December 2008; the clinical data of patients were retrospectively analyzed.The average age of patients was (33 ± 6)years (21 -42 years); the average onset time was ( 10 ± 6) d( 1 -50 d) after delivery.Seven patients had vaginal birth and 30 by cesarean section.The risk factors included pregnancy,cesarean section,age,infection,thrombophilia.All were diagnosed by ultrasonography and treated by anticoagulant,antiplatelet and thrombolytic therapy in the acute phase,followed by wearing elastic compressive stockings for more than 2 years.Pulmonary embolism was diagnosed in 8 patients by CT angiography,in 7 of whom inferior vena cava filter was administrated emergently.The patients were followed up for (29 ± 10)months ( 12 -60 months); during the follow-up 3 developed deep vein post-thrombosis syndrome,while others kept in good condition.The results indicate that initial anticoagulant,antiplatelet and thrombolytic therapy followed by elastic compressive stockings administration is effective for venous thromboembolic disease during puerperium.

Objective To explore and evaluate the clinical value of MRI for status of axillary lymph node after neoadju-vant chemotherapy (NAC) in patients with breast cancer. Methods Forty-four patients with 1ocally advanced breast cancer (LABC) were underwent NAC for four cycles. The longest diameter of axillary lymph node (ALN) measured by MRI scan. Val-ue of apparent diffusion coefficient (ADC) and their correlation were compared before NAC and four cycles after NAC. Re-sults of MRI and pathological data for ALN were compared between two groups of patients. Results All patients finished four cycles of NAC. The total response rate (CR+PR) was 72.7% (32/44), and the total non-response rate (SD+PD) was 27.3%(12/44). The longest diameter of ALN was significantly shortened in response group. The longest diameter was (1.37± 1.06) cm before NAC and (0.90±0.76) cm after NAC (P<0.01). The ADC value of the tumor was significantly increased in re-sponse group [(0.91±0.28) ×10-3 mm2/s before NAC and (1.01±0.32)×10-3 mm2/s after NAC, P<0.01)]. There was no signifi-cant correlation between ADC value change (△ADC) and the longest diameter change of ALN (△L, r=0.131, P=0.413). The sensitivity, specificity and Kappa value of ALN evaluation after NAC were 100%, 62.5%and 0.68 measured by MRI. Con-clusion The change of tumor longest diameter reflects the effect of chemotherapy directly. The tumor ADC value of MRI can not be used as an independent indicator of chemotherapy effect of ALN, eventhouth MRI was the sensitive index for eval-uating the status of axillary lymph node after neoadjuvant chemotherapy for breast cancer.

Objective To explore the application of case based learning(CBL)combined with multimedia teaching in the clinical pediatric surgery.Methods 144 five-year program students of Pediatrics in grade 2009 were randomly and evenly divided into the experimental group using CBL with multimedia teaching,and the control group using multimedia teaching mode.After the end of the course the students of the two groups took clinical teaching knowledge test.The evaluation scores were shown by mean ± standard deviation and comparison was made between the two groups with t test.At the same time,teaching satisfaction survey was conducted among the students of the experimental group.Results The usual results,the theoretical scores and total scores of the students in the experimental group were higher than those of the control group students in the operation skills,clinical thinking,and there was statistically significant difference in P＜0.01.(P=0.003,P=0.002,P=0.008,P=0.009,P=0.008).The questionnaire survey shows that compared with traditional multimedia teaching,CBL combined with multimedia teaching can preferably culture students' various abilities and is beneficial to learning.Condusion The use of CBL combined with multimedia teaching can affirmatively improve the clinical teaching effect in the clinical pediatric surgery,and it deserves to be generalized in the future teaching.

Abstract? AlM: To observe the effect of combining partial reduction orthokeratology ( Ortho-K ) and spectacles on slowing myopic progressionin high myopic adolescent.? METHODS: Sixty - nine eyes of 36 high myopic adolescent ( aged 9 ~15 years ) with spherical equivalent refraction ≧-6. 00 diopters ( D) ( spherical component≧-5. 50D) were fitted with custom-made four-zone/five-curve Ortho-K lenses. The target of reduction was to achieve -5. 00D for both eyes. The residual refractive errors after at least one month of Ortho-K wear were corrected with single-vision spectacles for clear vision in the daytime. The unaided visual acuity ( UVA) , refractive error ( RE ) , axial length ( AL ) , and ocular health were assessed before the Ortho-K lens wear, and followed up for 2a after Ortho-K.?RESULTS: ( 1 ) Changes in UVA: The mean UVA was 0. 09±0. 05 at baseline before Ortho-K;the mean UVA was 0. 27 ± 0. 14, 0. 54 ± 0. 18, 0. 78 ± 0. 24, and 0. 81 ± 0. 19, respectively after Ortho-K wear for l night, 1wk, 1, and 3mo. The differences of UVA were significant with baseline (P<0. 05), and became stable 1mo after the treatment. (2) Changes in RE:The mean RE was -6. 82± 0. 71D at baseline before Ortho-K and -6. 86 ± 0. 77D after Ortho-K wear for 1a (P>0. 05 compared to baseline). The mean RE was-7. 11±0. 81D after Ortho-K wear for 2a, and the amount of myopia increased -0. 29 ± 0. 37D compared to baseline (P<0. 05). (3) Changes in AL: The mean AL was 26. 18 ± 0. 57mm at baseline before Ortho-K, and it was not significantly different (P>0. 05) from the AL after Ortho-K wear for 6mo (26. 19±0. 54mm) and for 1a (26. 21± 0. 47mm). The AL was 26. 37±0. 59mm after Ortho-K wear for 2a, and the mean increase was 0. 19 ± 0. 28mm compared to baseline (P<0. 05). (4) Grade 1 corneal staining was observed in some subjects at each visit. However, the staining was improved after lens cleaning, discontinuing lens wear, or applying artificial tears. No other adverse events were reported in all subjects during the 2a study.?CONCLUSlON:Combining partial reduction Ortho-K and spectacles completely slowed myopic progression in high myopic adolescent after receiving the treatment for 1a, and partially reduced myopia progression after 2a of treatment. No severe ocular complications were found throughout the treatment. The combination treatment appeared to be effective and safe, but its long-term effect needs to be further assessed.

AIM: To investigate the protective effects of total of flavone C (TFC) on acute cerebral ischemia in mice and focal cerebral ischemia in rats. METHODS: The occlusion of bilateral common carotid arteries with vagus nerves in mice was used for make the acute cerebral ischemia models. The survival time and the death rate were observed. The permanent occlusion of the proximal of the right middle cerebral artery (MCA) was used for make the focal cerebral ischemia models. The extent of neurological deficits was observed, and the infarct area was measured by NBT staining technique. The activity of LDH and the content of MDA and NO in the ischemic cerebral cortex were determined. RESULTS: TFC of 80 and 40 mg?kg -1 prolonged the survival time and decreased the death rate of mice with acute cerebral ischemia injury. TFC of 60, 30, and 15 mg?kg -1 ameliorated neurologic deficits score and the infarct size of rats with MCAO. CONCLUSION: TFC provides significant protective effects against cerebral ischemia injury.

The course of fundamental operations in surgery is an important part of surgical teaching.It helps students to adapt to surgical practice quickly.During the teaching,there are some ways to improve teaching efficiency and quality,such as to know the new Chinese-English teaching material,the teaching purpose,the training of basic skills and aseptic principles of operation,the examination reform and regular teaching summery.