The application of evidence-based medicine in bibliotherapy is defined as evidence-based bibliothera-py.After a description of the connotation, role and significance of bibliotherapy, and foreign and domestic studies on it, the problems in domestic bibliotherapy were pointed out with measures put forward for their solution, and the implementation of bibliotherapy was normalized in view of its methodology.

Objective Through oral vaccination activity on polio,the epidemiological and virological surveillance of acute flaccid paralysis (AFP) case finds its way to develop, so that the realization of eradication on polio may be verified.Method Various kinds of immunization activities such as regular basic immunization, booster vaccination, intensified vaccination and mopping-up operation were adopted among children of the right age in the whole province. Zero case report and active surveillance on AFP were carried out to those population under 15 who had had consultation in medical unit above county level. Each reported case or found case was treated by individual case investigation, follow-up study and sample collection. All the samples were virus-isolated ad identified by RD, Hep-2 and L20B cells. Result Since 1991, an AFP case surveillance system has been built up. Up to the end of 2000, a total of 1,749 AFP cases had been reported in hunan province, from which 1,404 cases samples were collected, and another 218 cases samples of contacts were also collected. A sum of 7 polio wild virus strains was examined out. Since July 1993, no wild strain has been found (isolated). Conclusion Hunan Province has successfully intervened in the circus (spread) of polio wild virus, and hence realized the goal of polio eradication.

Objective To investigate the effects of Huanglong decoction on mRNA and protein expression levels of intestinal epithelial tight junction protein Claudin-1 and Occludin in rat with sepsis. Methods Fifty-five Wistar rats were randomly divided into sham operation group (n=10), model group (n=15), western medicine treatment group (15 rats) and combined traditional Chinese and western medicine group (n=15). In sepsis model group, cecal ligation with puncture (CLP) was reproduced. In the sham operation group, the steps of operation performed were similar to those in the model group, but without CLP. Normal saline 2 mL was given to sham operation group and model group by gavage;meropenem 50 mg was given to the western medicine treatment group by intra-peritoneal injection; in the combined traditional Chinese and western medicine treatment group, besides meropenem 50 mg was injected intra-peritoneally, 2 mL Huanglong decoction (containing raw herbal medicine 0.68 g/mL) was administered by gavage [ingredients of the decoction: rhubarb 15 g (put into water the latest), Glauber salt 10 g, fructus aurantii immaturus 15 g, mangnoliae officinalis 10 g, ginseng 10 g, Angelica sinensis 20 g, Scutellaria baicalensis 15 g, Radix Glycyrrhizae 10 g, concentrated to a decoction 150 mL], in the four groups, the respective drugs or normal saline were given twice a day. After 4 days, the rats were sacrificed, and a partial ileal tissue close to the ileocecal region about 10 cm in length was taken; and mRNA expression levels of Claudin-1 and Occludin were detected by reverse transcription-polymerase chain reaction (RT-PCR), and protein expression levels of Claudin-1 and Occludin were detected by Western Blot. Results Compared with the sham operation group, the expression levels of Claudin-1 and Occludin mRNA [integrated absorbance (IA) ratio] and protein (gray value ratio) were significantly lowered in model group, western medicine group and combined therapy group (Claudin-1 mRNA: 0.327±0.029, 0.387±0.035, 0.420±0.053 vs. 0.561±0.035, Occludin mRNA: 0.364±0.058, 0.422±0.033, 0.442±0.048 vs. 0.616±0.036, Claudin-1 protein: 0.307±0.015, 0.337±0.017, 0.355±0.027 vs. 0.426±0.017, Occludin protein: 0.326±0.028, 0.355±0.017, 0.366±0.025 vs. 0.455±0.018, P<0.05 or P<0.01). Compared with the model group, the expression levels of Claudin-1 and Occludin mRNA and protein in western medicine group and combined therapy group were significantly higher (P < 0.05 or P < 0.01); the up-regulation was more marked in combined therapy group (all P < 0.05). Conclusion The protective effect of Huanglong decoction on intestinal mucosal barrier in rats with sepsis is possibly related to the up-regulation of expression levels of Claudin-1 and Occludin mRNA and protein.

Objective To observe the clinical therapeutic effect of combination of traditional Chinese medicine (TCM) and western medicine for treatment for acute coronary syndrome (ACS). Methods Sixty patients with ACS were randomly divided into 2 groups: the treatment group and the control group. The combined treatment group was treated with conventional therapy (anti-platelet, anticoagulation, therapies for lowering blood-lipids and blood pressure, dilatation of coronary artery and protection of vascular endothelial function) and TCM complex prescription named Suxinkang granules (复方苏欣康颗粒), the control group was treated with conventional therapy and drop pills of salvia miltiorrhiza (复方丹参滴丸). Two weeks of treatment constituted one therapeutic course, and after one therapeutic course, the clinical symptoms, manifestations of electrocardiogram (ECG) and dynamic ECG changes in 24 hours were recorded. Results The total effective rate of combined treatment group was significantly higher than that of the control group90.0%(27/30) vs. 83.3%(25/30), P0.05). Conclusion The TCM complex prescription Suxinkang has a certain curative effect on ACS and it is an effective method in combination of traditional Chinese and western medicine for treatment of ACS.

High frequency key words in papers on MOOC were retrieved from CNKI and Wanfang Data Knowledge Service Platform.A co-words matrix was constructed , which was then transformed into correlation matrix and dis-similarity matrix, respectively.The correlation matrix was analyzed by multidimensional scaling analysis to show the hotspots in domestic MOOC studies on teaching reform, open education, information technology, resource develop-ment, library service innovation and its development trends.

Objective:To observe changes of serum uric acid (UA)level and red cell distribution Width (RDW)in se-nile men With chronic heart failure (CHF),and explore their correlation With cardiac function.Methods:A total of 60 senile male CHF patients Were enrolled,including 28 cases of NYHA cardiac function class Ⅱ and 32 cases of NYHA class Ⅲ-Ⅳ.Another 30 cases With normal cardiac functionWere regarded as normal control group.Levels of UA,RDW and high sensitive C reactive protein (hsCRP)Were measured,and patients received color-coded Doppler echocardiography,change of every index Was compared among patients With different cardiac function class.Results:Compared With normal control group,there Were significant rise in serum levels of UA [(318.2± 54.3)μmol/L vs.(434.7±72.7)μmol/L],RDW [(13.84±0.60)% vs.(15.79±0.74)%]and hsCRP [(2.23 ±0.56)mg/L vs.(6.35±2.34)mg/L]in CHF group,and they significantly rose alongWith cardiac function class aggravated,P <0.01 all;there Were significant decrease in transmitral early diastolic peak floW velocity/transmitral late diastolic peak floWvelocity [E/A,(1.02±0.36)vs.(0.75±0.13)]and left ventricular ejection fraction [LVEF,(59±9)% vs.(49±9)%]in CHF group,and they significantly reduced along With cardiac function aggravated, P <0.01 both;in CHF group;UA,RDW and hsCRPWere negatively correlatedWith E/A and LVEF (r =-0.391~-0.731,P <0.05 all);RDW Was positively correlated With hsCRP (r =0.491,P <0.05).Conclusion: Serum uric acid and red cell distributionWidth are correlated to cardiac function in senile male patients,Which can help to judge the severity of heart failure and guide clinical treatment.

Objective: To explore the correlation among serum prealbumin (PAB) level, red cell distribution width (RDW) and cardiac function in advanced aged male patients with chronic heart failure (CHF). Methods: Research objects included 60 patients with heart failure（28 cases with NYHA class Ⅱ and 32 cases with NYHA class Ⅲ-Ⅳ, heart failure group）and 30 cases with normal cardiac function admitted in the same period（normal control group）. Serum PAB, hemoglobin (Hb) concentration and RDW, red blood cell (RBC) count were measured. Patients all received echocardiography examination. Changes of all indexes were compared among patients with different cardiac function class. Results: ① Compared with normal control group, there was significant decrease in serum PAB level [(252±49) mg/L vs. (185±36) mg/L] and significant increase in RDW [(13.84±0.60) % vs. (15.79±1.33) %] in heart failure group, and compared with class Ⅱ group, there was significant decrease in serum level of PAB and significant increase in RDW in class Ⅲ-Ⅳ group, P<0.01 all; ② Compared with normal control group, there were significant decrease in E/A [(1.02±0.36) vs. (0.75±0.18)] and left ventricular ejection fraction [LVEF, (59±9) % vs. (49±11) %] in heart failure group, and the worse cardiac function was, the lower these two indexes were, P<0.01 all; ③ Pearson linear correlation regression analysis indicated that PAB was positively correlated with E/A and LVEF (r=0.451, P<0.05; r=0.596, P<0.05), and RDW was negatively correlated with E/A and LVEF (r=-0.391, P<0.05; r=-0.574, P<0.05) in heart failure group. Conclusion: Prealbumin and red cell distribution width are closely correlated to cardiac function class in advanced aged male patients. Both of them can indirectly reflect cardiac function in advanced aged patients with chronic heart failure.

To investigate the prevalence and gene types of KPC in Enterobacteriaceae strains isolated from 4 tertiary general hospitals in Hainan area ,a total 43 isolates which were resistant or intermediate to imipenem or ertapenem were collected from sterile sites between August 2012 and June 2013 from 4 tertiary general hospitals in Hainan area .Modified Hodge Tests (M HT ) were performed for KPC phenotype screening .PCR amplification and DNA sequence were performed to analyze the encoding genes of KPC .Results showed that in the 43 isolates ,21 strains were positive in M HT .PCR and DNA sequence analysis confirmed that 3 isolates produced KPC‐2 .It's suggested that there were the Enterobacteriaceae carrying KPC in Hain‐an area .The encoding genes were KPC‐2 .The KPC gene could be horizontally transmitted by plasmid among different groups of bacteria .It is important to control the transmission of these Enterobacteriaceae carrying KPC .

Objective To discuss the effective methods to improve the teaching effect of Basis of Nursing and cultivation of high-quality persons. Methods We randomly divided 87 nursing students into the test group(42 eases) ,which adopt the combination of grouped scene teaching with role-playing teaching and the control group (45 cases),which received routine teaching methods.The effect of the two teaching methods was evaluated by questionnaires. Results The total score and the score of each section of the questionnaires in the test group were higher than those of the control group(P ＜ 0.05 ). Conclusions The combination of scene teaching with role-playing teaching could inspire students' interest,strengthen the role consciousness and improve their comprehensive quality.

ObjectiveTo investigate the relationships between traditional Chinese medicine(TCM) syndrome differentiation and serum cystatin C(Cys-C) and homocysteine(Hcy) in patients with chronic heart failure(CHF). Methods 115 cases with CHF admitted into the Department of Cardiology of the First Affiliated Hospital of Zhejiang Chinese Medical University were selected in the CHF group, and 30 cases who had taken health examination in the same period were chosen in the healthy control group. According to the TCM syndrome differentiation, the CHF cases were subdivided into four groups with different types of syndrome: 30 cases of deficiency of both Qi and Yin syndrome, 30 cases of Qi deficiency syndrome and blood stagnation syndrome, 30 cases of heart and kidney Yang deficiency syndrome and 25 casesof flooding due to Yang deficiency syndrome. The serum levels of Cys-C and Hcy in different groups were tested, and the relationships between TCM syndrome differentiation and serum Cys-C and Hcy were analyzed by using Spearman rank correlation analysis.Results The serum levels of Cys-C and Hcy in the patients with CHF were significantly higher than those in the healthy control group〔Cys-C(mg/L):1.24±0.34 vs. 0.77±0.22, Hcy(μmol/L):18.66±4.57 vs. 11.65±3.21,bothP<0.05〕. Compared with the healthy control group, the serum levels of Cys-C and Hcy in the above four groups of different syndromes had a tendency of gradual elevation in the sequence as follows: deficiency of both Qi and Yin, Qi deficiency and blood stagnation, heart and kidney Yang deficiency and flooding due to Yang deficiencygroups〔Cys-C(mg/L):1.02±0.27,1.09±0.31,1.32±0.22, 1.59±0.25; Hcy(μmol/L): 14.94±2.20, 17.66±3.04, 19.79±3.48, 22.96±5.31〕, and the elevation in levels of flooding due to Yang deficiency group was the most prominent compared with that in other groups(P<0.05). The correlation analyses showed that different types of TCM syndrome in patients with CHF were positively correlated with the levels of Cys-C and Hcy(r1=0.73,r2=0.79,bothP<0.05).ConclusionThe changes of serum Cys-C and Hcy levels are consistent with the evolution of regular pattern of TCM syndrome differentiation in patients with CHF, and these two markers can be regarded as the objective indicators of TCM syndrome differentiation of CHF.