This article outlined the necessity of integrated information literacy education,ex-pounded the connotation of information literacy and integrated education and analyzed the situation of integrated information literacy education in China's medical colleges. In the end,the measures of inte-grated information literacy education were promoted from the following perspectives:improving the level of information literacy of professional teachers,designing the curriculum system of information literacy,integrating with medical professional courses,and establishing a network learning platform with professional education and information literacy education.

Objective To compare the survival and developmental potential of mouse morula, early blastocysts and blastocysts cryopreserved by vitrification. Methods One hundred and forty-two mouse morula, 135 early blastocysts and 148 blastocysts were cryopreserved by 6 mol/L ethylene glycol and 1 mol/L sucrose vitrification solutions. The survival rates and blastocysts hatching rates after thawing were observed. Results The survival rates of morula, early blastocysts and blastocysts groups were 88. 0% ,73. 3% ,and 60. 1% respectively. The blastocyst hatching rates were 73. 9% , 61. 5% ,and 49. 3% respectively. Both the survival rates and blastocyst hatching rates in morula group were higher than those in early blastocysts group (P

Objective To investigate whether pregnant rats exposure to ketamine cause offspring changes in space cognitive abilities and exploration abilities.Methods 3-month Sprague-Dawley female rats ( n =24)were randomly divided into four groups:group N (control group),group K1 (small doses of ketamine group),group K2 ( clinical anesthesia dose of ketamine group),group K3 ( large doses of ketamine group).3-month Sprague-Dawley male rats ( n =4) and female rats were mated at the same cage by the proportion of 2∶ 1.Pregnant mice were treated at tenth day:group N were treated saline with equal-volume to ketamine vein injection; group K1,group K2,group K3 administered vein injection 3,8,20mg/kg of ketamine.Then the 20-day offspring rats'learning and memory were assessed used Open Field Test ( record the time of the offspring in the central case through the number of grid within 2 min ) and Hole Board Test ( Counting the times of offspring stretch into the hole in 5 min) at postnatal days 20.Results In the Open Field Test,the retention time in central check of group N,group K2 and group K3 were (2.45 ± 1.23)s,(6.42 ±2.50)s,(6.41 ±2.19)s.Compared with group N,the retention time in central check of group K2 and group K3 were significantly higher (F=13.42,P＜0.01 ),and group K1 were not significant different ( t =1.33,P＞0.01 ),and the locomotion of group K1,group K2,group K3 were significantly reduced( ( 15.33 ± 6.81 ),( 13.75 ± 5.93 ),( 16.92 ± 6.54 ),F =4.24,P ＜ 0.05 ).In the Hole Board Test,the times of offspring stretch into the hole were not significant different comparing with the control group(F=2.17,P ＞ 0.05 ).Conclusion The dose of ketamine that equivalented clinical anesthesia can affect offspring rats' space cognitive abilities; but the exploring cognitive ability were not significantly influenced.

Leveraging the centralized drug purchase platform of medical institutions in Beijing, the study measured the drug price index (DPI) and the DDD price index from 2005 to 2013, and the outcomes indicate a drop of both the drug price index and the drug price index calculated by DDD.Despite such drops however, drug price drop by itself could not curb the constant rise of drug expenses and medical costs due to changes in the structure and interval of drug administration.

Objective To evaluate sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus.Methods Forty one patients of nonobese Type 2 diabetes mellitus underwent sleeve gastrectomy with ileal interposition and duodenojejunal bypass.Fasting glucose ( FPG ),glycosylated hemoglobin ( HbAlc ),fasting insulin and C-peptide,triglycerides (TG),high density lipoprotein(HDL),low density lipeprotein(LDL) were measured preoperatively and on postoperative first,3rd,6th month.Results Mean postoperative follow-up was 9.6 months (range 6-21 months).95％ patients achieved adequate glycemic control (HbAlc ＜ 7％ ) without antidiabetic medication.Fasting glycemia decreased from ( 9.7 ± 0.4 ) mmol/L to ( 6.2 ± 0.3 ) mmol/L ( P ＜ 0.01 ).Glycosylated hemoglobin decreased from 8.1％ ± 1.4％ to 5.8％ ± 0.6％ ( P ＜ 0.01 ).2-hour postprandial blood glucose decreased from ( 13.6 ± 0.7 ) mmol/L to ( 10.6 ± 0.2 ) mmol/L ( P ＜ 0.01 ).Insulin resistance (Homa-R) decreased from 4.8 ± 1.3 to 1.2 ±0.4 (P ＜0.01 ).Fasting C-peptide increased from ( 3.3 ± 1.7 ) ng/ml to (4.9 ± 0.2 ) ng/ml ( P ＜ 0.01 ).Fasting insulin increased from ( 10.2 + 1.4 ) mlu/L to (15.6±0.7) mlu/L(P＜0.01 ).Triglycerides (TG) decreased from (3.1 ±0.5) mmol/L to (1.9 ±0.4) mmol/L ( P ＜ 0.01 ).High density lipoprotein (HDL) increased from ( 1.2 ±± 0.2 ) mmol/L to ( 1.9 ±0.8 ) mmol/L( P ＜ 0.01 ).Low density lipoprotein (LDL) decreased from (3.5 ± 0.3 ) mmol/L to (2.4 ±0.6) mmol/L (P ＜0.01 ).Hypertension was controlled in 3/7 cases.Microalbuminuria resolved in 78％ patients.Retinopathy was improved in 53％ cases.Conclusions Sleeve gastrectomy with ileal interposition duodenojejunal bypass is effective for treatment of nonobese type 2 diabetes mellitus as showed by 6 month's follow-up.

Objective To evaluate the early effects on insulin resistance following sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Methods From Jun.2010 to Sep.2011,37 cases of type 2 diabetes mellitus patients [23 male,14 female; mean age (45.2 ± 2.4) years,mean BMI (21.7 ± 1.8) kg/m2] underwent sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Fasting plasma glucose(FPG),fasting insulin(FIns),body mass index(BMI),and homeostatic model assessment for insulin resistance (HOMAIR) were detected before surgery and on the 10th,20th,30th,and 60th day after surgery.Results The level of FPG was (6.8 ± 0.7) mmol/L,(7.2 ± 0.6) mmol/L,(6.9 ± 0.3) mmol/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(10.2 ±0.4)mmol/L].The difference had statistical significance (P ＜ 0.05).The level of Fins was (6.3 ± 1.1) mIu/L,(7.1 ± 1.3) mIu/L,and (7.3 ± 1.6) mIu/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(12.6 ± 1.4)mIu/L].The difference had statistical significance (P ＜ 0.05).The level of lnHOMA-IR was 0.7 ± 0.2,0.9 ± 0.5,and 0.8 ±0.4 respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery (1.8 ±0.6).The differenc had statistical significance(P ＜0.05).However,the change of BMI was not obvious between before surgery and on the 10th,20th,and 30th day after surgery.The difference had no statistical significance (P ＞ 0.05).on the 60th day after surgery,the level of FPG,Fins,lnHOMA-IR and BMI was significantly reduced compared with that before surgery.The difference had statistical significantce(P ＜0.05).Conclusion After sleeve gastrectomy with ileal interposition duodenojejunal bypass operation,the early improvement of insulin resistance occurs rapidly and it is iadependent of the loss of BMI.

BACKGROUND:Intravertebral bone graft to rebuild anterior and middle column structure and to recover vertebral morphology has been re-understood, and a suitable bone graft material can promote bone healing and be conducive to rebuild the long-term stability of the spine. OBJECTIVE:To discuss the differences in clinical efficacy of three kinds of bone graft materials through unilateral pedicle to treat thoracolumbar burst fractures. METHODS:Total y 102 thoracolumbar burst fracture patients were randomized into three groups:autologous bone, autologous bone combined with al ogeneic bone and al ogeneic bone were implanted via the unilateral pedicle, respectively, in the three groups. We measured the percentage of height of the anterior edge of vertebral body and Cobb angle by X-Ray before and after bone grafting, and used CT to observe bone graft healing, and used Mimics to measure the defect area of vertebral body at the last fol ow-up. RESULTS AND CONCLUSION:Al the 102 patients were fol owed-up for 24-36 months. The percentage of height of the anterior edge of vertebral body and Cobb angle of three groups were restored after bone grafting (P<0.05), but there was no difference in the percentage of height of the anterior edge of vertebral body of three groups at different time point after bone grafting. The Cobb angle in the al ogeneic bone group was bigger than that in the autologous bone group and autologous bone combined with al ogeneic bone group at 9, 12 and 24 months after bone grafting (P<0.05). The fracture healing rate of the al ogeneic bone group at different time points was lower than that of the autologous bone group and autologous bone combined with al ogeneic bone group (P<0.05), and the area of bone defect was bigger than that in the autologous bone group and autologous bone combined with al ogeneic bone group (P<0.05). These findings indicate that these three bone graft materials can rebuild the vertebral body via the unilateral pedicle to treat thoracolumbar burst fracture, reduce the loss of vertebral height and Cobb angle, and decrease defect area of the vertebral body. The clinical efficacy of autologous bone combined with al ogeneic bone to heal bone graft and reduce bone defect is similar to autologous bone, both of which are better than al ogeneic bone alone.

Objective: To improve the economic and technical indicator’s evaluation system and the essential medicines’ centralized bidding procurement practice in China. Methods:By using the literature analysis, comparative analysis and field survey, we collected and analyzed the implementation plans and regulations for the essential medicines’ centralized bidding procurement in 30 provinces. Results: The quality level classification lacks in preci-sion. The economic and technical indicator’s concentration grade is low, the score and content in each indicator un-reasonably fluctuates in different provinces and these indicators are of low efficiency in bond with their structures for the drug quality evaluation. The quality level indicator lacks in the distinction degree and the government’s unreason-able interference exists in competition. Conclusions and suggestions: The quality levels’ indicator type and number should be simplified. The economic and technical indicators’ function, content, score, weight value and the structure should be normatively and scientifically set to improve the efficiency during the drug quality evaluation and the gov-ernment should strive to play their role in the market.

Objective To analyze the test results of persons with noise -induced hearing loss using disyllabic Mandarin speech test materials (MSTMs) .Methods 57 subjects with noise -induced hearing loss (noise group) were divided into three groups according to the duration of noise exposure :less than 10 years ,between 11 and 20 years and more than 20 years ,and also separated into 2 groups in terms of the degrees of hearing loss (group A :pure tone average thresholds of 0 .5 ,1 ,2 ,and 4 kHz less than or equal to 30 dB HL ,group B:pure tone average threshold of 0 .5 ,1 ,2 ,and 4 kHz greater than 30 dB HL) .66 subjects with normal hearing were in the control group .All the subjects enrolled in this study could speak Mandarin well in their daily life .Nine lists of disyllabic Mandarin speech test materials were utilized to test SRT and P -I function for these groups respectively .Results PTA and SRT in the noise group were much higher than the control group ,the average slope of P -I function was 5 .94% /dB ,and the curve of P-I function moved to the right side .SRT showed obvious changes as the increase of the years of noise exposure and especially in the group which had more than 20 years noise exposure (P<0 .01) . SRT of group B which had more hearing loss were greater than that of group A (P<0 .01) .Conclusion SRTs in the noise group are much higher than the control group with the average slope of P -I functions decreasing and the curve moving to the right side .As the years of noise exposure increase and the degrees of hearing loss become more severe ,SRT rise more apparently .

Objective To investigate the role of prenatal single-dose administration of dexamethasone and ambroxol on the expression of Toll-like receptor 4 (TLR4) of fetal and neonatal rats. Methods Fifty-four pregnant rats were randomly divided into three groups with eighteen rats in each group:rats treated with 0.2 mg/kg dexamethasone (group 1),0.2 mg/kg dexamethasone and 100 mg/kg ambroxol (group 2),or saline(controls) on the 17th day of gestation.The lung tissues of the offsprings were harvest independently on the 19th day of gestation,the postnatal 3 days and 7 days.The expressions of TLR4 in fetal/neonatal rat lungs of each pregnant rat were analyzed by reverse transcription-polymerase chain reaction(RT-PCR),immunohistochemistry stain,and Western blot. ANOVA and two independent samples t-test were applied. Results On the 19th day of pregnancy,TLR4 mRNA expression was up-regulated in lungs of the two treatment groups compared with controls(controls:0.26 ± 0.18,group 1:0.39 ± 0.21,t =5.866,P＜ 0.05 ; control:0.27 ± 0.22,group 2:0.46 ± 0.13,t =9.572,P＜ 0.01 ).TLR4 mRNA expression was up-regulated in group 2 compared with controls on the postnatal 3 days and 7 days(postnatal 3 d:0.59 ± 0.23 and 0.47 ±0.24,t=2.295,P＜0.05;postnatal 7 d:0.52±0.12 and 0.35±0.17,t=4.219,P＜0.05),while no significant difference was found in group 1 compared with the controls(postnatal 3 d:0.45±0.22 and 0.44±0.14,t=0.128,P＞0.05; postnatal 7 d:0.40±0.16 and 0.36 ±0.12,t=1.365,P＞0.05).Results of the immunohistochemistry demonstrated that on the 19th day of pregnancy,the protein expression of TLR4 was significantly increased in the two treatment groups (controls:0.20 ± 0.29,group 1:0.35±0.32,t=7.179,P＜0.05 ;controls:0.20±0.29,group 2:0.39±0.25,t=10.764,P＜0.01).The protein expression of TLR4 was significantly increased in group 2 on the postnatal 3 days and 7 days(postnatal 3 d:0.55±0.32 and 0.37±0.18,t=7.121,P＜0.05;postnatal 7 d:0.41±0.29and 0.25±0.24,t=6.355,P＜0.05),while no notable difference was found between group 1 and the control (postnatal 3 d:0.40±0.21 and 0.37±0.18,t=0.683,P＞0.05 ;postnatal 7 d:0.28±0.31 and 0.25±0.24,t=0.462,P＞0.05).Results of the Western blot demonstrated that on the 19th day of pregnancy,the protein expression of TLR4 was significantly increased in the two treatment groups (controls:0.15 ± 0.12,group 1:0.27± 0.20,t =7.835,P＜0.05; controls:0.16 ± 0.18,group 2:0.34±0.16,t=10.470,P＜0.01).The protein expression of TLR4 was significantly increased in lungs of the combination administration group on the postnatal 3 days and 7 days(postnatal 3 d:group 2:0.37±0.20 and 0.25±0.22,t=6.379,P＜0.05; postnatal 7 d:0.35±0.15 and 0.24±0.13,t=5.152,P＜0.05),while no notable difference could be found between group 1 and the control (postnatal3 d:0.32±0.26 and 0.25±0.16,t=1.167,P＞0.05; postnatal 7 d:0.29±0.19 and 0.24±0.10,t =1.248,P ＞ 0.05 ). Conclusions Prenatal single-dose administration of dexamethasone may up-regulate the expression of TLR4 in the rat fetal lung.The up-regulation of TLR4 might be one of the critical factors for glucocorticoid-induced maturity of fetal lung.Prenatal single-dose administration of dexamethasone and ambroxol may have effects on the regulation of TLR4 not only in fetal rats,but also in neonatal rats.