The paper analyzes the structure and operation status of human resources structure in hospital libraries of Shanxi province from following aspects: educational background, titles, gender, age and other relevant aspects, then discusses how to improve the distri-bution and proposes strategy for enhancing the quality of personnel.

Objective To investigate the effect of alternating shift on general well-being of nurses,and analyze its relationships with related factors. Methods Alternating shift nurses from general hospi-tals above courty-level in Liaocheng city who were engaged in clinical work were selected by duster sam-pling.Questionnnires were sent out and later gathered. The investigation tools included general well-being schedule(GWB) ,marital quality inventory, social support inventory, Eysenck personality questionnaire were used in survey. Results (1)There was difference in the score of general well-being between nurses with different ages and professional titles(P<0.01). (2)There was significant difference between GWB and oth-er factors such as marital quality,EPQ (psychoticism, neuroticism and introversion and extroversion), so-cial support(P<0.01). (3)Multivariable linear regression which took general well-being as dependent vari-able, the variables which entered the equation were neuroticism, family relationship,support utilization,psychoticism, objective support, introversion and extroversion, marriage satisfaction,arrangement of econ-omy. Conclusions (1)The older, the higher of professional tltles,the stronger general well-being of nurses. (2)Sabjective well-being and marital quality, social support, lying defense were positively corre-lated; neuroticism, psychoticism were negatively correlated. (3)Neuroticism, family relationship,support and utilization, psychoticism, objective Support, introversion and extroversion, marriage satisfaction,ar-rangement of economy can affect general well-being,among which neuroticism had great influence.

Objective To understand the guidance significance of sputum smear on the sputum culture by comparing the micro-scopic detection results of sputum smear with the sputum culture results in 227 cases.Methods 227 cases of sputum specimen were collected for observing the character and smear staining by microscopy.These specimens were divided into the class A,B,C and D according to the standards and simultaneously conducted the culture.The relationship between smear and culture was analyzed.Reˉ sults Among 227 cases of sputum specimen,158 cases were qualified and accounted for 69.60%,and 69 cases were unqualified and accounted for 30.40%.Potential pathogens were detected in 128 cases,the positive detection rate was 56.39%,the positive detec-tion rate of qualified sputum specimens was 70.39% and which of unqualified sputum specimens was 28.00%.The coincidence rate of qualified sputum specimen smear results and the culture results was 72.78%.The positive rate of cytophagic bacteria in the qual-ified sputum specimens was 11.72%,in which 14 cases of cytophagic bacteria were the qualified class A sputum specimens with the positive rate of 16.67% and 5 cases of cytophagic bacteria were the class B sputum specimens with the positive rate of 6.76 %. Conclusion The sputum smear microscopic detection can provide the important information for the diagnosis and treatment of re-spiratory infections and the sputum smear has the important guiding significance for sputum culture.

The clinical application of GlucoWatch used in 32 Chinese diabetic patients was evaluated to determine its value in following blood glucose trends and track patterns and to know the compliance of patient. The results confirmed the accuracy of GlucoWatch and showed that it could follow blood glucose trends and track patterns. The skin irritation was mild and most subjects thought that blood glucose monitoring by GlucoWatch could reduce the pain caused by traditional methods.

Objective To observe the glucose profile in type 2 diabetic gastroparesis.Methods 31 patients diagnosed with type 2 diabetes were enrolled into this study for measurement of gastric emptying of solids and continuous glucose monitoring to observe blood glucose 1evels for 72 hours on a balanced diet;the results were compared with 7 subjects with norinal glucose regulation.Results 58.1%of 31 type 2 diabetic patients were found to have delayed gastric emptying of solids.The average glucose level was lower after breakfast[(7.82±1.42)mmol/L vs(9.35±2.28)mmol/L,P<0.01]in the patients with gastroparesis than in those without.Maximal blood glucose level after breakfast[(10.21±2.17)mmol/L vs (12.24±2.82)mmol/L,P<0.01]was lower in the patients with gastroparesis but it reached the peak at a similar time.Two hour AUC was also lower after breakfast in the patients with gastroparesis[(877.62±Post-prandial glucose levelin type 2 diabetic patients with gastroparesis tends to be lower than those without.

Intravoxel incoherent motion (IVIM) can distinguish the molecular diffusion from the pseudo-diffusion of microcircular perfusion to obtain true diffusion coefficient (D),pseudo-diffusion coefficient (D*) and perfusion fraction (f),which are sensitive to detect alterations in cellularity and microcirculation perfusion.IVIM can also evaluate early therapeutic effects,optimize treatment plan,predict prognoses,and provide information for choosing appropriate treatment methods.In this paper,the principle of IVIM and its application in tumor response evaluation were reviewed.

ObjectiveTo summarize the research and manufacturing ideas of precise positioning instrument and its feasibility and safety in the minimally invasive percutaneous nephrolithotripsy.Methods The precise positioning instrument was preliminarily made by integrating ruler with protractor.Fifty cases of kidney stones or upper ureteral stones were recruited in the study.There were 32 males and 18 females with mean age of 47 years (21 -75 years).Of them,6 cases had open surgery history and 31 cases had different degrees of hydronephrosis.The distance from the mid-point of renal pelvis to the plane of the dorsal surface and the distance from the incident point of the mid-point of pelvis on the dorsal surface to spinous process were measured by ruler on the preoperative CT images.According to the measured results,the point,angle,direction and depth of needle were calculated by geometric formula,and then fix position puncture and percutaneous puncture channel expansion were completed by precise positioning instrument and calibrated by Carm X-ray machine.ResultsThe puncture channels were established successfully in all of the 50 cases.Forty-six cases were punctured successfully by just one try,and the success rate of one puncture only was 92.0％.C-arm was used in none of the cases during the channel establishing process.Each patient was Xrayed 1 -3 times,and the average was 1.4 times.Targeting deflection or renal pelvis injury occurred in none of these cases.ConclusionThe application of the homemade precise positioning instrument is a safe and quick method for the establishment of puncture channel during percutaneous nephrolithotripsy,meanwhile the surgeons can reduce the exposure to radiation.

Objective To investigate the effects of intervention with the fluoxetine and the enriched environment on chronic stress induced depression behavior of rats,and the changes of myelin basic protein in hippocampus and prefrontal regions.Methods 50 adult male SD rats were randomly divided into control group,fluoxetine group,model group,enriched environment (EE) group and EE plus fluoxetine group.Fluoxetine group,model group,EE group and EE plus fluoxetine group underwent chronic unpredictable stress stimulus in the first to third week,and fluoxetine group,EE group,EE plus fluoxetine group underwent the intervention with EE and (or) fluoxetine in the fourth to sixth week.The changes of behavior in rats were evaluated by sucrose water consumption,open field test and weight changes.The content of MBP in each subregion of hippocampus and prefrontal regions of rats was measured with immunocytochemical methods.Results At the third weekend,the assessed behaviors of stressed rats decreased significantly compared with control group (P＜0.05);and at the sixth weekend,the behaviors of stressed rats restored after treated with EE and (or) fluoxetine.The content of MBP in the rat hippocampus CA1,DG area and prefrontal area of model group declined clearly compared with control group (mean density of model group orderly:0.199±0.024,0.204±0.021,0.225±0.028;control group orderly:0.279±0.034,0.288±0.043,0.308±0.053,P＜0.05).The content of MBP in the rat of fluoxetine group,EE group and EE plus fluoxetine group increased obviously compared with model group (fluoxetine group orderly:0.259± 0.047,0.266± 0.052,0.284 ± 0.031;EE group orderly:0.257±0.038,0.258±0.042,0.286±0.037;EE plus fluoxetine group orderly:0.271± 0.046,0.279±0.040,0.289±0.041,P＜0.05).Conclusion The depression-like behavior of rats induced by chronic unpredictable stress is associated with the change of the content of MBP in hippocampal CA1,DG area and prefrontal area;and the depression-like behavior and the content of MBP decrease are reversed after the intervention with fluoxetine and EE.

Objective To investigate the effects of D-limonene on the proliferation and ras P21 expression in human bladder carcinoma EJ cell.Methods The cell proliferation was measured by XTT assay.The expression of ras mRNA was detected by real-time PCR,and the expression of its protein product was analyzed by Western Blot.Results The proliferation of EJ cell was inhibited by exposure to 2 mmol/L and 4 mmol/L D-limonene for 48h.The optical density (A) was 0.801±0.016 and 0.148±0.008,respectively.There were significant differences between the experimental groups and the control group (1.2181±0.031,P<0.05).The expressions of ras P21 and its protein product of EJ cell were decreased obviously when exposure to 1 mmol/L of D-limonene for 48h.The expres-sions were significantly different compared with the control group(P<0.05).Conclusions D-limo-nene could inhibit human bladder carcinoma EJ cell proliferation,which is in a dose-dependant man-ner.In a lower dose (<1 mmol/L),D-limonene can decrease the expression of ras mRNA and its protein product.

Objective To investigate the clinical characteristics of neonatal multi-system Langerhans cell histiocytosis.Methods A female neonate with multi-system Langerhans cell histiocytosis in Guangzhou Women and Children's Medical Center in March,2013 was reported and related literature was reviewed.The clinical manifestations,and laboratory test,imaging examination and biopsy results were analyzed.Results The neonate had onset of jaundice and rash,then was found to have hepatomegaly,splenomegaly,lymphadenopathy and abnormal blood test.The lymph node biopsy revealed infiltration of Langerhans cells and eosinophils,which were positive for CDla/S-100 stains.She was diagnosed with multi-system Langerhans cell histiocytosis.Sixty-two cases of neonatal multi-system Langerhans cell histiocytosis were reviewed in the literature,and the most common clinical manifestations included rash,hepatomegaly,respiratory symptoms,imaging changes,abnormal blood test,digestive symptoms and lymphadenopathy.The most frequently involved organs included lung,liver,spleen,bone marrow,bone,gastrointestinal tract,lymph node and mucosa,among which the risky organs (liver,spleen,blood system and lung) accounted for 88.7％(55/62).Conclusions The incidence rate of multi-system Langerhans cell histiocytosis is low in neonates,and it is characterized by multisystem involvement,especially the liver,spleen,blood system,lung and skin.For the neonates diagnosed without intrauterine infections,besides skin biopsy,lymphadenopathy should be dynamically observed and lymph node biopsy should be done earlier so as to establish an early diagnosis.