After the present situation of two large medical MOOC platforms in China was analyzed, the major effects of MOOC on medical college and university libraries were studied, the forms of domestic and foreign libraries in participating MOOC education were listed, and measures were proposed for the participation of medical college and university libraries in construction of MOOC education framework according to the characteristics of medical subjects.

The freshmen admission education in academic library is characterized by multiple contents and forms with gradual transformation of education position to network in information environment .The cases of freshmen ad-mission education in libraries of Beijing Normal University , Qinghua University , Shanghai Jiaotong University , and Jinan University were analyzed with its new techniques and new models summarized .The future direction of fresh-men admission education was forecasted , including establishment of standard freshmen education concept , use of more new techniques and more innovative methods .

Objective To investigate the expression and significance of bin 1,C-myc in bladder urothelial carcinoma.Methods SP method was used to detect the expression of bin 1,C-myc protein in paraffin specimens from bladder urothelial carcinoma of 84 cases and mucosa of 11 cases,and its relationship with clinical pathological charac-teristics was analyzed.Results The positive expression rate of bin1 in normal bladder tissues was 81.81%,that in bladder urothelial carcinoma was 46.43%,the difference was not significant (χ2 =4.873,P=0.051).No expression of C-myc was observed in normal bladder tissue ,the positive expression rate of C-myc in bladder urothelial carcinoma was 52.38%,the difference was statistically significant (χ2 =10.733,P=0.001).The expression of bin1 in invasive bladder urothelial carcinoma was significantly lower than the non-infiltrating type(χ2 =7.685,P =0.007),with increased histological grade and UICC stage ,the positive rate of bin1 expression decreased (χ2 =15.817,P=0.000;χ2 =11.104,P=0.010).The expression of C-myc had no relationship with the histological classification ,histological grade and UICC stage .Correlation analysis showed that the expression of bin 1 was negatively correlated with histologi-cal classification,histological grade and UICC stage (r=-0.302,P=0.005;r=-0.411,P=0.000;r=-0.302, P=0.005).With the increased expression of bin1,C-myc expression decreased,but the difference was not statistical-ly significant.Conclusion Low expression of bin1 or loss of bin1expression were associated with the progression of bladder urothelial carcinoma , the expression of C-myc was related with bladder urothelial carcinoma lesions .The results suggest that bin1 may be predictive factor for prognosis of urinary bladder urothelial carcinomas ;bin1,C-myc may be viewed as molecular targets for tumor chemotherapy .

Objective To investigate the expression and significance of IDO and c-myc in bladder urothelial carcinoma.Methods IDO mRNA expression from fresh tumor and mucosa specimens from 20 cases were detected by fluorescence quantitative PCR,and SP was used to detect the IDO,c-myc protein in paraffin-embeded specimens from 84 cases and mucosa specimens from 22 cases.Results In bladder urothelial carcinoma,IDO,c-myc protein expression level had no relationship with age and sex.Expression of IDO protein in invasive bladder urothelial carcinoma was significantly higher than that of no-invasive (x2 =5.600,P =0.018).With the increase of the histological grade (x2 =20.268,P =0.000) and UICC stage (x2 =12.075,P =0.007),the positive expression rate of IDO protein was increased.There was not positive expression of c-myc protein in normal bladder tissue,but in bladder urothelial carcinoma,44 cases (52.4 ％) were positive expression (x2 =10.733,P =0.001).The expression of c-myc protein had no relationship with the histological classification,histological grade and UICC stage.In bladder urothelial carcinoma tissue,IDO protein expression level was positively correlated with c-myc protein expression (r =0.205,P =0.047),and was positively correlated with the histological classification,histological grade and UICC stage (r =0.258,P =0.018; r =0.491,P =0.000; r =0.365,P =0.001).Expression of IDO mRNA in bladder urothelial carcinoma (7.696 1±1.745 2) was significantly higher than that in normal bladder tissue (6.397 0±1.205 1)(t =2.367,P =0.023).The average expression level of IDO mRNA in bladder urothelial carcinoma of Ta-T1 stage was 6.803 4±1.567 5,which was significantly lower than that in T2-T4 stage (9.183 8±0.690 3) (t =4.955,P =0.000).The average expression levels of IDO mRNA in grade Ⅰ,Ⅱ,Ⅲ bladder urothelial carcinoma were 7.058 7±1.771 5,7.934 2±1.530 5,9.290 7±0.574 5,respectively,which were increased with the grade increasing (t =2.729,P =0.011).Conclusions The high expression of IDO correlates with bladder urothelial carcinoma progression,and expression of c-myc is irrelevant with bladder urothelial carcinoma progression,but maybe associate with bladder urothelial carcinoma occurrence.IDO may be a predictive factor of prognosis.IDO and c-myc may be therapeutic target in the treatment of bladder urothelial cancer.

Objective To investigate the risk factors of stroke-associated infection (SAI)and their correlation with immunodepression.Methods One hundred fourteen consecutive patients with acute ischemic stroke admitted with 24 hours after symptom onset were enrolled.They were divided into infection (n =45) and non-infection (n =69) groups according to whether they had infection or not within 7 days after admission.Automatic blood analyzer and flow cytometry were used to measure the peripheral blood lymphocyte count and T lymphocyte subsets on the day of admission.Univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for SAI.Results There were statistical significances in vomiting,disturbance of consciousness,dysphagia,indwelling gastric tube,indwelling catheter on admission,and the National Institutes of Health Stroke Scale (NIHSS) score 0-3 days after admission between the infection and non-infection groups.Further more,the numbers of peripheral blood lymphocytes,CD3 + and CD4 + T lymphocytes in the infection group were significantly lower than those in the non-infection group.Multivariate logistic regression analysis showed that dysphagia,the increased NIHSS score 3 days after admission,and the decreased numbers of CD4 + T lymphocytes were the independent risk factors for SAI.Conclusions The T lymphocyte immune function decreased in patients with SAI.It was the result of the combined action of various factors.Targeted prevention and treatment should be taken to reduce the occurrence of SAI.

Objective To probe into the variations of hospital admissions and rate of hospital bed occupancy of medical institutions in the recent ten years in Tianjin, for the purpose of formulating a regional health plan and optimizing regional health resources allocation. Methods The health statistics yearbooks of Tianjin from 1998 to 2008 and the four health service survey data from 1993 to 2008 were analyzed, with the descriptive statistics and ordinal logistic regression of SPSS 16. 0. Results From 1998 to 2008, the amplitude of hospital admissions and rate of hospital bed occupancy in community health service centers (stations) was the lowest, and the occupancy rate of hospital beds in community health service centers and rural hospitals was always lower than that in secondary and above hospitals. The influence factors of options of medical institutions for residents consist of hospital charges, gender,occupation, and regional classification. Conclusion Tianjin needs to strengthen its community health service centers , and improve service capacity of primary care of health organizations.

Objective To investigate the effect of hyperuricemia on early renal damage in patients with type 2 diabetic,and to explore the improvement of albumin-to-creatinine ratio (ACR) after lifestyle intervention to control the level of serum uric acid.Methods One hundred and sixty patients with type 2 diabetic mellitus from our hospital from January 2012 to December 2012 were recruited and divided into the high uric acid group (HUA,60 cases),and the normal uric acid group (NUA,100 cases).Fasting blood glucose (FBG),insulin (FINS),glycosylated hemoglobin (HbA1c),serum lipid levels,morning urine albumin-to-creatinine ratio (ACR) were detected in each group,and body mass index (BMI),insulin resistance index (HOMA-IR) were calculated.The HUA group was intervened by lifestyle for at least 6 months,and related indexes were measured again.Results The FINS,HOMA-IR,ACR and triglyceride(TG) of the patients in the HUA group were higher than that in the NUA group((110.33 ±38.73) pmol/L vs.(72.64 ±21.94) pmol/L,t =2.876; (7.0 ±2.3)vs.(4.6±1.3),t =2.364;13.6(5.1,53.2) mg/mmol vs.6.4(2.9,16.8) mg/mmol,H=3.390;(2.53± 1.45) mmol/L vs.(1.71 ± 1.32) mmol/L,t =2.626 ; P ＜ 0.05).By the Spearman correlation analysis,the level of serum uric acid was positively correlated with FINS,HOMA-IR,ACR,and BMI (r =0.304,0.225,0.248,0.271 respectively; P ＜ 0.05).After adjusting the factor of age,duration,obesity,blood glucose and insulin resistance,the level of serum uric acid was still positively correlated with ACR (r =0.312,P ＜ 0.01).The FINS,UA,HOMA-IR and ACR in group HUA were lower than those before lifestyle intervention ((463.7± 18.6) μmol/L vs.(380.3 ± 9.5) μmol/L,t =3.065 ; (110.33 ± 38.73) pmol/L vs.(83.30 ± 28.21)pmol/L,t =2.532; (7.0 ±2.3) vs.(5.0 ±0.9),t =2.165;13.6(5.1,53.2) mg/mmol vs.8.1(4.9,20.4)mg/mmol,H =2.912 ; P ＜ 0.05).Conclusion The patients with type 2 diabetes complicating hyperuricemia were likely to having abnormal ACR.Controlling the level of serum uric acid by lifestyle intervention may be benefit for delaying the development of early diabetic nephropathy in patients with type 2 diabetes.

Angiotensin-Ⅱ-induced apoptosis was widely involved in the pathogenesis of diabetes mellitus, cardiovascular diseases, etc. The mechanism of angiotensin-Ⅱ-induced apoptosis is complicated, including the receptor (AT1R and AT2R) level regulation, Fas/FasL pathway, and the regulation by p53 family, Bcl-2 family, Caspase family, Ang-(1-7), etc. Mitochondria damage and oxidative damage play important roles in the apoptosis process. This article reviews the previous researches on angiotensin-Ⅱ-induced apoptosis.

OBJECTIVE: To analyze the chemical compositions of the volatile oil in the fruits of Litsea chingpingensis. METHODS: The volatile oil was extracted by wet distillation and its constituents were analyzed by GC-MS. The relative percentage of each constituent was determined by GC area normalization method. RESULTS: A total of 24 chemical compounds were identified, which included ?-Citral (28.32%), ?-Citral (22.28%), Cinene (12.15%), Nerol (4.98%), 1,8-Cineole (4.67%), and 6-Methyl-5-hepten-2-one (4.35%) etc. CONCLUSION: This study serves as a scientific basis for the further development and utilization of Litsea chingpingensis.

In recent years ,lots of studies indicated that inflammation plays an important role in occurrence and de‐velopment of cardiovascular diseases .Neutrophil to lymphocyte ratio (NLR) is a novel inflammatory marker ,the cost of detection is low and it's easy to obtain .NLR is not only related with poor prognosis of stable coronary artery disease and acute coronary syndrome ,but also closely associated with prognosis of acute heart failure .The present article made a review on the correlation between NLR and cardiovascular diseases .