In order to have a better understanding of the role of medical library in medical information service during the implementation of Healthy China strategy,the need of health information service of the public and medical scientific researchers in implementation of Healthy China strategy were analyzed by outlining the development history and major targets of Healthy China strategy,and how to meet the requirements of the development of Healthy China for medical library was studies,namely by improving its resources development,service patterns and staff construction according to the present situation of big data development,the challenges medical library is faced in users needs,resources,platform,space,professionals and funds,and the opportunities brought about by the expanding requirements,improving information academic level,advancing new technologies,favorable policies and environments with relevant suggestions put forward.

Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury.Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed.They were divided into two groups according to the T2 signal of cervical cord,63 cases in Group A(incomplete injury group)with no abnormal on T2 ,32 cases in Group B(complete injury group)with high signal on T2 .The other 50 cases with no injury of cervical cord were recruited as control group (Group C). All the cases were performed with MRS and DWI.The N-acetyl aspartic acid(NAA),choline compounds(Cho)and creatine(Cr)as well as the peak area of lactic acid (Lac)on MRS,and apparent diffusion coefficient(ADC)on DTI were measured separately.Mean-while,NAA/Cho,NAA/Cr,Cho/Cr,Lac/Cho and ADC were analyzed.Results On MRS sequence,the values of NAA/Cho and NAA/Cr were lower in Group B (P <0.05)when compared with Group A.The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C.However,the value of Lac/Cho in Group B was higher than it in Group C(P <0.05).When com-pared Group A with Group C,the value of Lac/Cho only increased in the former.However,on DWI,the value of ADC in Group A was(0.79±0.1 7)×10 -3 mm2/s,lower than that of Group C(0.93±0.1 5)×10 -3 mm2/s (P =0.026);the value of ADC in Group B was(1.21±0.20)×10 -3 mm2/s,significantly higher than that of Group C(P =0.01 7).When compared with Group B,the value of ADC in Group A was a lightly lower (P =0.143)with no statistical significance.Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level.DWI has high sensitivity on early diagnosis of cervical cord injury.The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evaluation.

Objective To explore the biological motion perception in Parkinson's disease (PD).Methods 45 individuals with idiopathic PD were compared with 45 matched healthy controls (HCs) using a duration discrimination task.Results The point of subjective equality(PSE) was negative value (-0.27±0.17) for health controls (HCs),and there was significant difference compared with PSE =0 by one sample t test (t=10.96,P＜ 0.01).Compared with HCs,the PSE for PD patients (-0.14±0.30) significantly decreased (t=2.63,P=0.01).When further dividing PD into early stages (stage 1-2) and late stages (stage 3-4),significant difference was found between late-stage PD patients(0.02±0.39)and HCs (t=4.07,P=0.008),but not between early-stage PD patients (-0.24±0.14) and HCs (t=0.84,P=0.405).Conclusion There is biological motion perception disorder in PD patients and it is related to the severity of PD.

Objective:To investigate the prevalence, risk factors and outcomes of diastasis recti abdominis (DRA) in multiparas after the second delivery.Methods:From June 2017 to September 2019, 300 multiparas with an average age of (31.7±4.0) years (26 to 43 years) after the second delivery were recruited at 6 weeks postpartum from two hospitals in Wenzhou. There were 171 multiparas with two natural births,36 multiparas with one natural birth and one caesarean delivery, and 93 multiparas with two caesarean deliveries. The interrectus distance (IRD) was measured with palpation at 6 weeks, 6 months and 12 months after delivery. Data on age, height, weight before pregnancy and delivery, baby′s birth weight, abdominal circumference before pregnancy and delivery, fetus number, delivery mode and occupation type were collected. Strength and endurance of abdominal muscle was assessed using manual muscle testing and curl-ups, low back pain was assessed using Oswestry disability index(ODI), urinary incontinence was assessed with International Consultation on Incontinence guestionnaire-incontinentia urinae (ICIQ-UI) short form (ICIQ-SF), and quality of life was assessed using 36-item short form health survey (SF-36).Results:Prevalence of DRA was 51.7%(155/300), 39.3%(116/295) and 27.7%(80/289) 6 weeks, 6 months and 12 months after delivery, respectively. Logistic regression analysis indicated that age ( OR=1.39, 95 %CI:1.02-1.91, P=0.38), abdominal circumference ratio ( OR=2.31, 95 %CI:1.23-4.33, P=0.01), twins ( OR=11.41, 95 %CI:2.15-60.76, P<0.01), and cesarean section ( OR=1.44, 95 %CI:1.06-1.95, P=0.02) were the risk factors of DRA at 12 months after delivery. At 12 months after delivery, the multiparas with DRA had weaker strength and endurance of abdominal muscle ( Z=-3.62, P<0.01; Z=-8.91, P<0.01), more serious low back pain ( Z=-2.10, P=0.04), and lower quality of life on physical health ( t=-3.34, P<0.01) than the multiparas without DRA. No difference in prevalence and severity of urinary incontinence and quality of life on psychological health was found when comparing multiparas with and without DRA (χ 2=0.66, P=0.42; Z=-1.18, P=0.24; t=0.91, P=0.36). Conclusion:Multipara after the second delivery has great likelihood for DRA.Age, abdominal circumference ratio, twins, and cesarean section are the risk factors of DRA. DRA is related to abdominal muscle dysfunction, low back pain, and quality of life.

Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.

Doxorubicin (Dox) is widely used to the treatment of cancer, however, it could cause damage to gastric mucosa. To investigate the protective effects and related mechanisms of coenzyme Q10 (CoQ10) and vitamin C (VC) on Dox-induced gastric mucosal injury, we presented the survey of the 4 groups of the rats with different conditions. The results showed Dox treatment significantly induced GES-1 apoptosis, but preconditioning in GES-1 cells with VC or CoQ10 significantly inhibited the Dox-induced decrease and other harm effects, including the expression and of IκKβ, IκBα, NF-κB/p65 and tumor necrosis factor (TNF-α) in GES-1 cells. Moreover, high-throughput sequencing results showed Dox treatment increased the number of harmful gut microbes, and CoQ10 and VC treatment inhibited this effect. CoQ10 and VC treatment inhibits Dox-induced gastric mucosal injury by inhibiting the activation of the IkKB/IκBα/NF-κB/p65/TNF-α pathway, promoting anti-inflammatory effects of gastric tissue and regulating the composition of the intestinal flora.

Doxorubicin (Dox) is widely used to the treatment of cancer, however, it could cause damage to gastric mucosa. To investigate the protective effects and related mechanisms of coenzyme Q10 (CoQ10) and vitamin C (VC) on Dox-induced gastric mucosal injury, we presented the survey of the 4 groups of the rats with different conditions. The results showed Dox treatment significantly induced GES-1 apoptosis, but preconditioning in GES-1 cells with VC or CoQ10 significantly inhibited the Dox-induced decrease and other harm effects, including the expression and of IκKβ, IκBα, NF-κB/p65 and tumor necrosis factor (TNF-α) in GES-1 cells. Moreover, high-throughput sequencing results showed Dox treatment increased the number of harmful gut microbes, and CoQ10 and VC treatment inhibited this effect. CoQ10 and VC treatment inhibits Dox-induced gastric mucosal injury by inhibiting the activation of the IkKB/IκBα/NF-κB/p65/TNF-α pathway, promoting anti-inflammatory effects of gastric tissue and regulating the composition of the intestinal flora.

Objective To study the changes of tinnitus after cochlear implantation in post-lingual adault recip-ients and analyze the factors that affect tinnitus.Methods A total of 47 postilingually-deafened adult subjects with tinnitus who underwent cochlear implantation at the Department of Otology,the first affiliated hospital of Zheng-zhou University,from January 2017 to December 2021.The subjects were evaluated using tinnitus handicap invento-ry(THI)and visual analogue scale(VAS)before cochlear implantation and 6 months after cochlear implant surger-y.Results Among 47 subjects who were eligible for this study,the THI scores were 36.94±13.337,14.48± 12.726,respectively,before CI and 6 months after cochlear implantation.The VAS scores were 5.13±1.676 be-fore and 2.34±1.903 after cochlear tmplantation.Statistical analysis showed significant differences in THI and VAS scores before and after cochlear implantation(P＜0.05).A total of 18 patients experienced complete tinnitus suppression,14 patients experienced alleviation of tinnitus,tinnitus remained unchanged in 13 patients,tinnitus worsened in 2 patients,and the overall efficiency was 66.0％(31/47).The tinnitus alleviation rate was signifant higher in the patients with tinnitus history of ≤5 years than the patients with tinnitus history of＞5 years(P＜0.05).There was a statistically significant difference in tinnitus alleviation between the patients with mild tinnitus and the patients with more than mild tinnitus before surgery(P＜0.001).Conclusion Cochlear implantation has an inhibitory effect on tinnitus in adults.Patients with shorter duration of the tinnitus and higher tinnitus handicap are more likely to experience tinnitus improvement after cochlear implantation.

Objective:To observe the effects of applying ultrasound-guided balloon dilatation in the treatment of post-stroke cyclopthyroid achalasia.Methods:Thirty-eight stroke survivors with cyclopneaful achalasia were divided into a control group ( n=19) and an experimental group ( n=19). All had been diagnosed with cycloparyngeal achalasia using videofluoroscopic swallowing study (VFSS). The controls were treated with conventional oral balloon dilatation, while the experimental group underwent ultrasound-guided oral balloon dilatation. The treatment was performed once every 2 days. During the treatment period, the durations and the number of expansions were recorded, and the patient′s comfort and throat pain were evaluated. The Kubota drinking water test (KDWT), standardized swallowing assessment (SSA) scoring and VFSS scoring were compared before and after the 2 weeks of treatment. Results:The average daily duration of expansions in the experimental group was significantly less than in the control group and their number was significantly greater. Comfort and larynx pain were also significantly better in the experimental group. The effective rate in the KDWT was 78.95% in the treatment group, significantly higher than the control group′s 31.58%. Significant differences were also found in the average SSA scores, VFSS pharyngeal phase scores and in the incidence of achalasia between the experimental and control groups.Conclusions:Using ultrasound to guide balloon dilatation can shorten the operation, reduce the throat pain involved and allow for more expansions, greater comfort and thus more effective treatment.

Objective To investigate the effect of ulinastatin on the expression of serum inflammatory mediators in pa tients with acute myocardial infarction (AMI) after thrombolysis. Methods 84 patients with AMIin our hospital from January 2017 to December 2017 were selected and randomly divided into the control group and the experimental group with 42 cases in each group. The control group received recombinant streptokinase intravenous thrombolytic therapy, while the experimental group was given intravenous infusion of ulinastatin in the foundation of thrombolytic therapy. Two groups of patients were extracted venous blood to measure the expression levels of inflammatory mediators including hs-CRP, IL-1, IL-10 and TNF-a before treatment, 24 h and 72 h after treatment. Results 24 h after treatment, the expression levels of hs-CRP, IL-1, IL-10 and TNF-a in the two groups were higher than those before the treatment, and the difference was statistically significant (P＜0. 05). However, the increase in the experimental group was lower than that of the control group (P＜0. 05). 72 h after treatment, the levels of inflammatory mediators in the two groups were significantly lower than those before and 24 h after the treatment(P＜0. 05). The decrease in the experimental group was higher than that of the control group and the difference between the two groups was statistically significant(P＜0. 05). There was no significant difference in the incidence of adverse reactions and adverse cardiovascular events between the two groups during hospitalization after thrombolysisP＞0. 05). Conclusion The use of ulinastatin before and after thrombolytic therapy can effectively inhibit the expression levels of inflammatory mediators and relieve myocardial ischemia reperfusion injury in patients with AMI.