Cloud computing possesses the great, safe and reliable ability to store data, implements the integration and sharing of information resources, and reduces the economic cost.The infringement risks of intellectual property in digital library under cloud computing environment were described , such as infringement risks of intellectual proper-ty due to cloud computing safety , direct and indirect infringement risks of intellectual property of cloud service pro-viders.Measures for how to prevent and control them were put forward in aspects of laws and administrations.

SoLoMo in the mobile Internet time has provided a new way for service marketing in medical library, its meaning and its effect on medical library and how to innovate SoLoMo marketing service model in medical library were thus described in this paper.

Exhaled nitric oxide fraction (FeNO)reflects eosinophilic bronchial inflammation,and has been widely used to assist in the diagnosis of asthma,to monitor the airway inflammation and the responce to treatment effects of asthma in recent years.FeNO as a noninvasive examination,obtains a high degree of cooperation in adults and children over 5 years of age,but there are a lot of problems in children under 5 years of age.At present,there is still a lack of normal values and large sample-sized studies of FeNO in infants and neonates in China.The principle and method,normal reference value,influencing factors,clinical application and so on of exhaled nitric oxide detection are reviewed in this paper.

Objective To observe the clinical efficacy of ear acupuncture combined with mirtazapine in the treatment of insomnia.Methods Sixty-two patients with insomnia diagnosed by CCMD-Ⅲ were randomly divided into two groups,31 patients in each group.The patients in the observation group were treated by ear acupuncture combined with mirtazapine,and the patients in the control group were treated by mirtazapine.The clinical efficacy was evaluated by SDRS after 4 weeks of treatment.Results The SDRS score of the observation group significantly decreased after one week of treatment [(13.40±5.79)points vs.(21.79±6.12)points,t=2.204,P＜0.05].The SDRS score of the control group significantly decreased after one week of treatment [(14.68±5.88)points vs.(22.67±6.06)points,t=2.198,P＜0.05].After 4 weeks of treatment,the clinical efficacy of the observation group was significantly better than that of the control group (z=-2.209,P＜0.05),the SDRS score of the observation group was also significantly better than that of the control group (t=2.163,P＜0.05).Conclusion Ear acupuncture combined with mirtazapine has better effect in the treatment of insomnia patients,it has less side effects and lasting effects.

Objective:Apoptosis inhibitor 6(Api6),also known as AIM(Apoptosis Inhibitor expressed by Macrophage)or SP?(Soluble Protein alpha),is a newly defined member of the group B scavenger receptor cysteine-rich(SRCR)superfamily.Previous studies have suggested its important roles in immune system regulation,but the involvement of Api6 in lipid metabolism is seldomly studied.Methods:The aim of this study was to define the expression pattern of Api6 in lipid loading and inflammatory macrophages.The human monocyte/macrophage lineage THP-1 cells and murine Raw264.7 macrophages were incubated in the presence of 100 ?g/ml oxidized low-density lipoprotein(oxLDL)alone,LDL plus 200 ng/ml lipopolysaccharide(LPS)and LPS alone.Results:Foam cell formation after treatment was evidenced by oil red O staining.Real-time PCR results showed that after LPS or oxLDL treatment,the mRNA levels of Scavenger receptor SRA were increased 6-fold,2.5-fold and 6-fold,44-fold in Raw264.7 cells and THP-1 cellls respectively,but the expression of Api6 in Raw264.7 did not change.The mRNA levels of Api6 increased 2.7-fold after LPS and oxLDL treatment in THP-1 cells.Conclusion:The expression levels of Api6 in these macrophages were highly related to the presence of nuclear receptor liver X receptor(LXR)isoform LXR?.This study revealed that due to the lack of LXR? isoform,the basic expression level of Api6 was low in Raw264.7 macrophages,that makes it an ideal cell line for further study related to pathophysiological function of Api6 in lipid metabolism.

Objective To investigate the relationship between plasma N-terminal pro brain natriuretic peptide(NT-proBNP) level and left ventricular(LV) diastolic dysfunction in hypertensive patients without systolic dysfunction.Methods Forty-four cases of primary hypertensive patients with left ventricular ejection fraction more than 50％ were enrolled,14 cases in normal diastolic function group,30 cases in diastolic dysfunction group(18 cases in delayed relaxation group and 12 cases in pseudo normalization filling group).LV diastolic function was assessed with conventional Doppler by means of mitral inflow and with tissue Doppler echocardiography by means of mitral annulus.The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E' wave velocities (E/E') was used to detect LV filling pressures.Patients were divided into three groups according to E/E' ratios.Plasma concentrations of NT-proBNP were also measured.All related data were statistically analyzed.Results The levels of NT-proBNP were (115.2 ± 78.9)ng/L in LV diastolic dysfunction group,(34.7 ± 17.5) ng/L in normal filling group and (206.6 ± 75.8) ng/L in pseudonormal filling group.The level of NT-proBNP significantly elevated (F =85.263,P =0.000) along with the severity of lefi ventricular diastolic dysfunction.There was significant difference between each of the two groups among the three groups(all P ＜0.01).According to E/E' ratios,the patients were divided into three groups:E/E' ＜10(n =16),10 ＜ E/E ＜ 15(n =18),E/E' ＞ 15(n =10).The level of NT-proBNP were (39.5 ± 20.1) ng/L,(71.2 ± 26.4) ng/L and (203.7 ± 75.2) ng/L respectively in the three groups.The NT-proBNP blood level was positively correlated significantly with E/E' ratio (r =0.80,P ＜ 0.01).The sensitivity was 87％ and the specificity was 100％ for diagnosis of left ventricular filling pressure (E/E' ＞ 15)according to a NT-proBNP value of 119 ng/L.Conclusion Combining of plasma NT-proBNP and Doppler E/E'have potential value for identification of those patients with hypertension to detect early cardiovascular changes,especially LV diastolic dysfunction.

Objective To identify the influence of early postoperative delirium on long-term morbidity ,mortality and quality of life(QoL) .Methods 261 patients admitting to SICU after noncardiac surgery were prospectively included .The clinical data were collected .Delirium was diagnosed clinically by Confusion Assessment Method-Intensive Care Unit(CAM-ICU) .The patients were followed 2 years after the surgery and the quality of life was assessed by three scales .Results The incidence of early PD was 21 .8% .Multivariate logistic regression analysis showed that increasing age ,shorter educational time ,preoperative diabetes melli-tus ,high ASA grades and high APACHE II score on SICU admission were the independent predictors for early PD .The cumulative survival in 24 months was 66 .5% in patients without delirium and 57 .3% in patients with delirium ,there was no statistical differ-ence between two groups(P=0 .187) .Multivariable Cox model showed that male patients ,tumor stage ≥3 and high ASA grades were the independent predictors for postoperative death .The long-term QoL in delirious patients were significant poorer than that in non-delirious patients in mainly four domains :physical function ,role-physical ,social function and cognitive function .Conclusion Early postoperative delirium significantly deteriorate the long-term quality of life in severe patient after noncardiac surgery in mainly four domains :physical function ,role-physical ,social function and cognitive function .

Objective To investigate incidence and severity of retinopathy of prematurity (ROP)screened by RetcamⅢ and the related factors.Comparative case series were designed.Methods A study was performed among infants who required screening by RetcamⅢ in the second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,and carried out between May 2012 and April 2013.A total of 1097 infants met the study criteria,and were divided into group Ⅰ (n =333 from outpatient screening) and group Ⅱ (n =764 from inpatient screening).Variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),gender,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia,intracranial hemorrhage,congenital heart disease,neonatal anemia,neonatal sepsis,necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations by RetcamⅢ were also recorded.Spearman correlation analysis was used to identify the variables most significantly associated with ROP.Results There were 98 infants of ROP in group Ⅱ (total 764,12.8％).There was a significant association of ROP with variables (P ＜0.05),including BW,GA,and NOB.There was a significant association of ROP with diseases (P ＜ 0.05),including NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD.However,there was no association of ROP with diseases (P ＞ 0.05),including PDA,neonatal hyperbilirubinemia,and congenital heart disease.Conclusions RetcamⅢ can be used to screen retina of infants.ROP is still the most common eye disease in preterm infants.The incidence of ROP was 12.83％ in Wenzhou.Variables,including BW,GA,NOB,NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD,were the most significant factors associated with ROP.

Objective To investigate the effect of transverse incision surgery for epicanthoplasty with double eyelid fold reconstruction. Design Retrospective case series. Participants 103 patients with epicanthus. Method Transverse incision was applied for epicanthoplasty in all patients, and incorporated with double eyelid fold reconstruction. Patients were followed up 3-6 months. Main Outcome Measures Size of lacrimal caruncle, length of palpebral fissure, inner canthic diameter and scarring degree. Results Lacrimal caruncle was revealed 3/4 merous in 21 cases, 2/3 merous in 56 cases, 1/2 merous in 8 cases. Extent of palpebral fissure was 30-31mm in 5 cases, 28-29 mm in 69 cases, 26-27 mm in 11 cases. Inner canthic diameter was 32-33mm in 61 cases, 30-31 mm in 23 cases, 29 mm in 1 case. The scarring was little in 56 cases, obviously in 29 cases. Epicanthus relapsed in 2 cases. 16 cases lost follow-up. Conclusion Transverse incision surgery for epicanthoplasty with double eyelid fold reconstruction has less tissue damage and minimal scarring produced at the medial cantha. It is a simple and reliable surgical approach for correction of epicanthus.

On the anatomy, posterior vitreous cortexneighbors with retina, the relationship of vitreous and retinal is both independent and closely linked. Under pathological condition, changes in the vitreous provides a good environment for occurrence and development of a number of vitreoretinal diseases, which indicates that vitreous plays a crucial role in many vitreoretinal diseases occurrence and growth. Elimination of vitreous change in disease, is an issue of great concern of the ophthalmic industry in recent years. Based on the description of vitreous and vitreoretinal interface structure, changes in the vitreous and retinal adhesion mechanisms and interfaces retinal disease risk factors and the impact on the retinal disease were discussed, And the posterior vitreous detachment impact on the vitreoretinal interface disease, the testing methods and its importance were described in this article.