The connotation and position of learning and examination resources center in library were elaborated. How to perfect the service system for readers was proposed by introducing the IC ideas and model into library con-struction.The characteristic, cooperative, sharing and developmental principles were pointed out, which should be followed in construction of the learning and examination resources center.The new model for learning together and innovative service should be established by integrating the characteristic databases ,constructing communication plat-forms,strengthening librarian literacy,and bringing the functions of library resources,spaces and manpower into full play.

Objective:To study the changes of endothelin-1(ET-1) and malondialdehyde (MDA) in Kawasaki disease (KD) and to probe the relationship between the changes of ET-1, MDA and coronary artery pathological changes. Methods: KD group included 42 patients ( male 25, female 17), with a mean age of (3.25?0.75) years old; control group included 30 normal children (male 19, female 11), with a mean age of (3.58?0.55) years old. Serum contents of ET-1 and MDA were measured by radioimmunology and modified thiabarbituricaid(TBA) method in 2 groups, and the inner diameters of coronary artery and aorta were measured by color echocardiography. KD group was subdivided into dilated-coronary artery group and undilated group for comparison.Results: Serum contents of ET-1 and MDA in KD group were apparently higher than those in control group (-[76.63?18.36-] vs -[41.55?16.68-] pg/ml and -[3.18?0.60-] vs -[1.52?0.24-] ?mol/L,respectively;P

Phospholipase A_2 (PLA_2) inhibitor quinacrine was used to explore protective effect on multiple organ dysfunction (MOD) caused by intestinal ischemia-reperfusion (I/R) in rats. Gut I/R caused the increase of gut PLA_2 activity and induced endotoxemia and bacteriemia. Pretreatment with intravenous quinacrine 10mg?kg~(-1) attenuated bacteria and endotoxin translocation,markedly lowered the levels of thromboxane A_2 and prostacyclin I_2 in blood,and provided protection from the development of vital organs dysfunction. As a result,the survival rate in pretreatment group increased by 25%. The results demonstrate that gut I/R promotes gut barrier failure,then contributes to the development of MOD by allowing bacteria or endotoxin reaching the circulation. PLA_2 and PLA_2-dependent lipid mediators play an important role in the development of gut I/R injury and MOD. Intravenous quinacrine has protection against MOD resulting from gut I/R.

Objective To analyze the effects of dominant hand position on the quality of external chest compression for cardiopulmonary resuscitation (CPR) by the employment of the high-fidelity real-time feedback manikin system.Methods A total of 228 medical students of Wuhan University were enrolled in 2013 after standard CPR training courses.Participants were brought to a simulation scenario in which an adult happened to have heart arrest out of a hospital.Each studeut was asked to do five cycles of conventional CPR.In accordance with the dominant hand and the actual compressing hand position,the students were divided into dominant hand (DH) group and non-dominant hand (NH) group.Comparisons of chest compression rate,chest compression depth and chest recoil between two groups were carried out,respectively.The data were analyzed by the software of SPSS 13.0.Results There was no significant difference in overall chest compression rate between two groups (P ＞ 0.05) while the frequency distributions of chest compression rate showed differences (P ＜0.01),and chest compression rates above 100 cycle per min in DH group were higher than that in NH group (97％ vs.92％,P =0.002).There was significant differences in chest compression depth between two groups (DH 44±8 mm vs.NH 43±8mm,P=0.001).In NH group,the depth in cycle 5 (41 ±8) mm is obviously less than that in cycle 1 (44 ±7) mm,cycle 2 (43 ±7) mm and cycle 3 (43 ±8) mm.Totally,there was no differences in chest recoils between two groups [NH (98 ±8)％ vs.DH (97 ± 10)％,P =0.13],but full chest recoils were seen more in NH group (85％ vs.79％,P ＜ 0.05).Conclusions The dominant hand position can improve the quality of CPR resulted from the higher compression rate,deeper compression depth as well as delayed fatigue.

This retrospective analysis showed that the most frequent pathogen causing bacterial liver abscess was Klebsiella pneumoniae in 138 patients.Compared with the patients without diabetes mellitus,it was found that:( 1 ) the percentage of diabetic patients having typical abdominal pain was lower ( P ＜ 0.05 ) ; ( 2 ) neutrophilic granulocytosis was more marked,but albumin and hemoglobin levels were lower in diabetic patients( P＜0.05 ) ; ( 3 )more diabetic patients were complicated with urinary tract infection and suffered from septicemia( P＜0.05 ) ; (4) the clinical course of treatment in diabetic patients was much more prolonged( P＜0.05 ).

Objective:To assess the effect of combined cognitive rehabilitation training on improving cogni-tive dysfunction in amphetamine-type stimulant dependent patients.Methods:Subjects who met the clinical diagno-sis of ATS dependence by DSM-IV in compulsory isolation detoxification institute were randomly assigned into in-tervention group (n =30 )and control group (n =26 ).Control group received a regular education.Intervention group also received a combined cognitive rehabilitation training besides regular education,including psychological and physical rehabilitation for 24 weeks.The Chinese version of CogState Battery (CSB)was used to assess cogni-tive function at baseline and 24 weeks after the intervention.Results:No significant difference was found on all sub-scales scores of CogState Battery between two groups at baseline.At 24 weeks after the intervention,compared to control group,the intervention group had more improvements in three sub-scale scores,i.e.,One Card LearningTask [(0.06 ±0.12)vs. (-0.03 ±0.14),P<0.05],Two-back Task [(0.12 ±0.15)vs. (0.01 ±0.19),P<0.05]and Continuous Paired Association Learning Task [(-0.46 ±0.35)vs. (-0.15 ±0.49),P<0.05].No difference was found on improvements in the rest 5 sub-scale scores,i.e.,Detection Task,Identification Task,Inter-national Shopping List Task,Groton Maze Learning Task and Social Emotional Cognition Task (P >0.05 ).Conclusion:The combined cognitive rehabilitation training could improve amphetamine-type stimulant dependent patients'visual learning and memory,working memory and spatial working memory,while have no significant im-provement on other cognitive functions.

BACKGROUND: The injury of peripheral nerve may cause electroneurographic changes. However, what is the correlation between electroneurographic changes and the extent of nerve injury?OBJECTIVE: To probe into the changes of evoked electroneurography in early stage after nerve injury for clinical application and reference.DESIGN: Paired t-test in three groups of samples.SETTING: Department of Traumatic Orthopaedics People' s Hospital of Beijing University.MATERIALS:The trial was conducted in the Animal Center of the People's Hospital of Beijing University from August 2003 to December 2003. The subjects were 8 adult New Zealand rabbits of SPF grade(weighing 1.5 kg) and either gender from the Animal Center of Medical College of Beijing University.METHODS:The model of nerve injury was made in the 16 tibial nerves of the 8 rabbits, in which one third or two thirds of each nerve was ligated at the same transverse part. The samples were thus divided into three groups: non-injury (normal) group, 1/3 nerve injury group and 2/3 nerve injury group.MAIN OUTCOME MEASURES: The indices of evoked electroneurography, i. e. motor nerve condution velocity, negative M wave amplitude, negative M wave area, maximal M wave amplitude and maximal M wave area were measured in the three groups. The correlation between the extent of nerve injury and the 5 indices was analyzed.RESULTS: All the 5 indices of the 3 groups were significantly different( P＜ 0.05). The mean values of the 5 indices were 1.00 ±0.0,0.97 ±0.18,1.01 ±0.22;0.98 ±0.16 and 0.98 ±0.19 in normal group, 0.76 ±0.12,0.41 ± 0.24, 0.47 ± 0.30, 0.48 ± 0.27 and 0.50 ± 0.29 in 1/3 nerve injury group, and 0. 62±0. 10, 0. 11 ±0. 11, 0. 11 ±0. 10, 0. 12 ±0. 14 and 0.13± 0. 12 in 2/3 nerve injury group. The coefficient of correlation between the 5 indices and the injury were 0. 902, 0. 938, 0. 936, 0. 907, and 0. 914, respectively.CONCLUSION: In the early stage after peripheral nerve injury, the electroneurographic indices negatively correlate with the extent of nerve injury. The negative M wave amplitude and area are relatively more closely correlated with the extent of injury.

ObjectiveTo evaluate the feasibility and outcome of overnight laparoscopie cholecystectomy (OLC).MethodsThe clinical data of 149 patients with cholecystolithiasis or gallbladder polyps who were admitted to the Tianjin People's Hospital from October 2008 to December 2010 were retrospectively analyzed.All the patients underwent LC in the morning and were discharged 24 hours later.Modified Aldrete scoring was done 4-6hours after LC.Patients were contacted by telephone 3 days after LC and reexamined in the out-patient department 7 days after LC.The hospital cost of patients who underwent OLC or LC was compared using the t test.Results OLC was successfully performed on 149 patients,and the modified Aldrete scores of 130 patients were above 9.The visual analogue scale (VAS) of 118 patients were under 4,and the VAS of 31 patients were above 4.The condition of the 31 patients were closely monitered,and were administered morphine.Of the 149 patieuts,144were discharged 24 hours after operation,and the remaining 5 patients were admitted to general ward because of fever,peritoneal effusion or abdominal pain.The incidence of postoperative complication was 2.0％ (3/149) and the mortality was 0.All the patients were followed up,and none of the patients had an emergency readmission.The duration of incapacity was 5.2 days (range,2-7 days).The mean hospital cost of patients who received OLC was ( 7888 ± 396 ) yuan,which was significantly lower than ( 12121 ± 960) yuan of patients who received LC ( t =38.97,P ＜ 0.05 ).ConclusionOLC is effective and safe,and meets the requirement of health insurance policy.

Objective To explore the value of urinary N-terminal telopeptide of type Ⅰ collagen (uNTX) combined with bone scintigraphy (BS) for the diagnosis of bone metastases.Methods A total of 227 patients suspected of bone metastases by BS were selected from Jan to May of 2012.UNTX was tested for each subject.The threshold of uNTX was chosen as 65 nmol bone collagen equivalents (BCE)/mmol creatinine (Cr) for the diagnosis of bone metastasis.Patients with uNTX greater than 65 nmol BCE/mmol Cr would be diagnosed as having bone metastasis.Other examinations (CT,MRI,PET/CT or bone biopsy) were also performed to confirm the diagnosis.The uNTX values of benign and malignant bone lesions were compared using two-sample t test.The diagnostic efficacy of uNTX combined with BS was evaluated.A ROC curve was analyzed to evaluate the cut-off value of uNTX for the diagnosis of bone metastasis.Results The mean value of uNTX of all 227 patients was (84.30± 13.29) nmol BCE/mmol Cr,which was significantly higher than the upper limit of normal range (t =21.875,P＜0.01).Using 65 nmol BCE/mmol Cr as the threshold,197 cases were diagnosed as with and 30 without bone metastases,in which 188 and 27 were respectively confirmed by other examinations.The mean uNTX was (88.73 ± 8.37) and (60.76± 9.14) nmol BCE/mmol Cr in patients with and without bone metastases,respectively (t =-18.134,P＜0.01).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index of uNTX combined with BS were 98.4％ (188/191),75.0％ (27/36),95.4％ (188/197),90.0％ (27/30),94.7％ (215/227) and 73.4％ respectively.The cut-off value by ROC curve analysis was 78.88 nmol BCE/mmol Cr and the area under the curve was 0.982.Using 78.88 nmol BCE/mmol Cr as threshold,the corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 97.4％(186/191),94.4％(34/36),98.9％(186/188),87.2％(34/39),96.9％(22/227) and 91.8％ respectively.Conclusions Using the cut-off value of 78.88 nmol BCE/mmol Cr,uNTX may have clinical value in helping the differential diagnosis of bone scintigraphy for patients suspected of metastatic bone disease.

Objective To explore the effect of applying the management model of educating diabetics in health knowledge and filinging relevant data .Methods 1 000 patients with type 2 diabetes in hospital were randomly assigned into the experimental group and the control group ,and all of them received health education .In addition ,relevant data were filed in the experimental group ,then the compliance behavior ,general metabolic indicators and occurrences of complications were compared before and after the education in 1 ,3 and 6 months between these two groups .Results The general metabolic indicators in experimental group were better than the control group(P<0 .05);and the compliance behavior of the experimental group patients were improved obviously (P<0 .05);and the cases of the patients with complications from random visit were also obviously lower in the experimental group (P<0 .05) . After 1 month or 6 months ,the two groups of patients′qualities of life were significantly increased ,but the experimental group′was improved more obviously(P<0 .05) .After 6 months ,the degree of satisfaction of the experimental group was 91 .6% (458/500) , the control group′was 68 .2% (341/500) .The satisfaction of experimental group was significantly higher than the control group (P<0 .05) .Conclusion The management model to patients with type 2 diabetes could effectively improve patients′metabolic level and reduces the occurrences of complications and improves the therapeutic effect .