After the digital resources in 8 famous domestic medical academic libraries were investigated, the status quo and characteristics of digital resources development and the use of different social networking tools in these libraries were analyzed, the crowd-sourcing concept was used to guide the users to participate in the development of digital resources using the social networking tools, and a platform for users participating in information organization and integration was constructed by making use of mobile communication/WeChat.

Acute lung injury(ALI) and acute respiratory distress syndrome(ARDS) are common,life-threatening causes of acute respiratory failure that arise from a variety of local and systemic insults.The pathogenesis of ALI/ARDS is complicated and not yet completely interpreted today.The role of altered coagulation and fibrinolysis in the pathogenesis of ALI/ARDS has been investigated.This review will summarize the current understanding of coagulation and fibrinolysis in human ALI/ARDS with emphasis on pathways that could be potential therapeutic targets.These pathways include the tissue factor pathway,the protein C pathway and modulation of fibrinolysis via plasminogen activator inhibitor-1.

Objective In this study,the phenotype heterogeneity of 2 male patients with X-linked Alport syndrome from one family was analyzed and the likely reasons were discussed by reviewing the literature.Methods The clinical data at the time of diagnosis and during 5 years follow-up of 2-male patients with X-linked Alport syndrome from one family were collected.The α5 (Ⅳ) chain expression in the epidermal basement membrane was detected by indirect immunofluorescence method.COL4A5 gene mutations in skin fibroblasts and genomic DNA were detected by using reverse transcription polymerase chain reaction and direct sequencing and PCR sequencing methods from skin fibroblasts and genomic DNA,respectively.Results The diagnostic age of patient Ⅲ 1 was 14 years old.He had only microscopic hematuria,and proteinuria was negative.A negative α5 (Ⅳ) chain staining pattern was detected in his epidermal basement membrane.After 5 years follow-up without drug treatment,he was 19 years old,had persistent microscopic hematuria and normal renal function.The urinary microalbumin was 19.2-31.8 mg/L.The diagnosis age of patient Ⅱ 4 was 29 years old.The hematuria and proteinuria were found at 22 years old.He was treated with tripterygium wilfordii for 1 year.His disease progressed to an end stage of renal disease and he received hemodialysis therapy at 24 years old.He had the renal transplantation surgery at 29 years old,just 2 months before he came to hospital.And his renal function was restored.After 5 years follow-up,his urine examination and renal function were normal.Both patients had a missense mutation c.3650G ＞ A(p.G1217D) in exon 41 in COL4A5 gene.Conclusions The different phenotypes of 2 male patients from one family with X-linked Alport syndrome were reported.The most possible reason for this is somatic mosaic variants in COL4A5 gene based on literature review.Physicians should be alert to phenotype heterogeneity in male X-linked Alport syndrome despite having the same gene mutation.

Objective To discuss the relationship between and value of Leptin with disorder of lipid metabolism in gestational diabetes mellitus. Method Research objects are divided into three groups including GDM group, normal glucose tolerance group (NGT group), normal non-pregnant group. Blood lipid, fasting blood glucose, fasting insulin, serum leptin and placental leptin levels were detected and HOMA-IR was calculated. Result (1) Serum leptin, TC, TG, placental leptin and HOMA-IR in GDM group were higher than those of NGT group and TC, serum leptin and HOMA-IR of NGT group were higher than those of control group. There were statistical significances (P<0.05). (2)Serum leptin levels were positively correlated with BMI, HOMA-IR, TC and TG respectively (r = 0.593, 0.688, 0.722, 0.492 respectively, P < 0.05). Conclusion Leptin may cause lipid metabolism disorders, and together they participate in the pathogenesis of GDM. Maternal serum leptin level is expected to become an observation index of GDM.

Objective To investigate the clinical value of laparoscopic treatment of myoma in the broad uterine ligament.Methods A retrospective comparison was made on clinical data between 26 patients who had received laparoscopic enucleation of myoma in the broad uterine ligament and 12 patients who had received traditional open resection in the same period.Results Both laparoscopic and traditional operations were successfully completed.As compared with open surgery,the laparoscopic surgery had longer operative time(92.5?15.8 min vs 63.0?15.8 min;t=5.350,P=0.000),similar blood loss during operation(99.2?32.9 m1 vs 91.7?30.7 m1; t=0.667,P=0.509),and shorter time of postoperative hospital stay(4.5?0.7 d vs 7.7?0.9 d;t=-11.960,P=0.000),respectively.Conclusions Laparoscopic enucleation of myoma in the broad uterine ligament is safe and effective and offers a rapid postoperative recovery.

Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.

Objective To explore the diagnosis and treatment of Dent’s disease.MethodsThe clinical characteristics, treatment process and disease-causing gene mutation were retrospectively analyzed in 6 pediatric patients with Dent’s disease misdiagnosed of nephritic syndrome from January 2014 to August 2015.ResultsIn these 6 male patients aged 4.5-9.8 years old, the main clinical manifestations were nephropathy-level of proteinuria and transient low serum albumin (26-30 g/L) without obvious edema or high serum cholesterol. In 4 patients who had renal biopsy, 2 cases showed mesangial proliferative glomerulonephritis and other 2 cases showed focal segmental glomerulosclerosis. All of 6 patients were treated with at least one immunosuppressive agent after resistance to full dose of hormone and no changes in proteinuria were observed. After admission, the indexes of early renal damage and urinary protein electrophoresis pointed to low-molecular proteinuria. The ratio of alpha 1 micro albumin (α1-MG) / micro albumin (MA) (the early renal damage index) was?>?1, there was hypercalciuria, and renal function was normal. The B ultrasonography showed renal calciifcation in 2 patients. The ifndings in all the patients were in accord with the clinical diagnosis of Dent’s disease. Further genetic analysis conifrmed the presence ofCLCN5 gene mutation in these 6 patients.ConclusionAs a type of rare inherited renal tubular disorder, Dent’s disease is easily misdiagnosed, to which pediatricians need to pay attention. The early renal damage index, α1-MG/MA?>?1, can be regarded as one of the diagnostic criteria of renal tubular proteinuria.

To review and analyze the pharmacological effect and underlying mechanism of Chinese lobelia. Methods:The references from home and abroad on the pharmacological effect and mechanism of Chinese lobelia in recent years were summarized and analyzed. Results:Chinese lobelia had wide range of pharmacological effects, such as anti-tumor, endothelial cells regulation, an-algesic and anti-inflammatory effect, inhibition against alpha glycosidase enzymes and myocardial ischemia reperfusion et al. Conclu-sion:A large number of effective compositions are in Chinese lobelia and the biological activity is extensive. The mechanism of biologi-cal activity should be further studied in-depth.

OBJECTIVETo evaluate the colorectal cancer incidence among compliers and non-compliers in the population of colorectal cancer screening area, and to provide scientific basis for health economic evaluation of cancer screening.

METHODSBy screening different years build queue, to retrospectively compare the data of colorectal cancer screening from January 1, 2008 to December 31, 2013 and the data of cancer registration, and to analyze the colorectal cancer incidence rates among screening compliers and non-compliers, and to compare the average intervals between the end of screening and clinical cancer diagnosis using SPSS 19 statistical software. Mantel-Haenszel test was performed with a statistical significance level of α = 0.05.

RESULTSThe non-compliance rate was 38.24% among males and 28.49% among females (P < 0.001). The non-compliance rate was highest in the 40-44 and 70-74 years age groups and lowest in the 50-59 years age group. The compliers of the screening were followed up for 476,049 person-years, and there were 51 cases of colorectal cancer, with an incidence rate of 10.71/100,000. The non-compliers of the screening were followed up for 259 183 person-years, and there were 66 cases of colorectal cancer, with an incidence rate of 25.46/100,000, which was 1.38 times higher than that of the compliance group (χ2 = 21.699, P < 0.001). The incidence rate of colorectal cancer among subjects who were positive in initial screening but refused to receive an electronic colonoscopy was as high as 164.40/100,000, and the average delay time was 20.8 ± 16.8 months.

CONCLUSIONSThe colorectal cancer screening adherence among women is better than among men, and that of 50-54 years and 55-59 years age groups is better than in other age groups. The subsequent incidence rate of colorectal cancer in the non-compliance group is significantly higher than that of the compliance population.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Male ; Mass Screening ; statistics & numerical data ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Retrospective Studies ; Sex Factors

Objective To investigate the clinical effect,safety,and value of bronchofibroscopeguided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia.Methods A total of 60 patients with severe pneumonia was randomly divided into two groups with 30 cases in each group.Patients in the control group were treated with conventional anti-infection therapy,while patients in the treatment group were treated with bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics on the basis of conventional therapy.The sputum positive rate,clinical effect,hospital stays,treatment costs,and adverse reactions were compared to analyze its value.Results The total effective rate of treatment group was 93.3％,which was significantly higher than that (60.0％) in the control group (P ＜0.01).The sputum positive rate of treatment group was 80.0％,which was significantly higher than that (43.3％) in the control group (P ＜0.01).The hospital stays and the treatment costs of the treatment group were both significantly less than those in control group (P ＜0.01 orP ＜0.05).No serious complications were found in patients of the treatment group.Conclusions Bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia show exactly clinical effects and significant improvement in dyspnea,which shortens the hospital stays,reduces the treatment costs,and has no seriously adverse reactions.Therefore,it is worthy of clinical promotion and application.