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Assurance of the safety,reliability and effectiveness of in-use medical equipments is key to improving medical risk management and applied quality of medical equipments of a hospital.By means of regular field survey of in-use medical equipments of the hospital,the authors identified key risk exposures in the current equipment quality control system,and took targeted corrective measurements.Data of routine equipment maintenance and that of appraisal were compared and analyzed.Based on such,appraisal points are set dynamically,and a standardized and customized appraisal program is developed for the safety and quality evaluation of medical equipments,featuring comprehensive coverage and operability.Such efforts effectively supplement daily maintenance work and provide data basis for reliability and usability analysis of medical equipments.
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Objective@#To verify the diagnostic value of adenosine deaminase (ADA) for tuberculous pleural effusion. @*Methods@#Forty-three cases with tuberculous pleural effusion and 163 cases with non-tuberculous pleural effusion were consecutively collected. The concentration of ADA in pleural effusion was determined by enzyme kinetics. The receiver operating characteristic (ROC) analysis curve was used to calculate the optimal cut-off value of ADA for diagnosing tuberculous pleural effusion based on the control groups with non-tuberculous pleural effusion. Meanwhile, the specificity and sensitivity of ADA level for diagnosis of tuberculous pleural effusion were compared with previous reports. @*Results@#The concentration of ADA in tuberculous pleural effusion (median 52.5 U/L) was significantly higher than that in non-tuberculous pleural effusion (median 9.8 and 10.6 U/L) (P<0.05). With a cut-off level for ADA of 25 U/L, the diagnostic sensitivity and specificity was 88.0% and 91.0%, respectively. A system review analyzed data from 17 studies with QUADAS score ≥10 points and revealed the cut-off value of ADA to be (28.1±12.8) U/L (range 10.2 to 55.8 U/L) with a sensitivity of 89% (95%CI: 87% to 91%) and a specificity of 89% (95%CI: 88% to 91%). @*Conclusion@#The specificity and sensitivity of ADA for diagnosis of tuberculous pleural effusions should be up to over 85%, while the cut-off value of ADA from different literature reports were diverse.
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To study application value of red cell distribution width (RDW) in prognosis evaluation of pa‐tients with acute myocardial infarction (AMI).Methods : A total of 300 AMI patients of our hospital were selected as AMI group ,another 300 subjects with normal physical examination outcome simultaneously were enrolled as healthy control group.Levels of peripheral cardiac troponin I (cTnI ) ,hsCRP ,homocysteine (Hcy) and RDW in healthy control group and AMI group before and one year after treatment ,and cardiac function indexes in AMI group before and after treatment were observed .Results : Compared with healthy control group before treatment ,there were significant rise in levels of ser‐um cTnI [(0.24 ± 0.03) ng/ml vs.(19.98 ± 2.54) ng/ml] , hsCRP [(1.05 ± 0.18) mg/L vs.(17.85 ± 1.93) mg/L] , Hcy [ (6.75 ± 0.71) μmol/L vs.(29.89 ± 3.27) μmol/L] and RDW [ (10.38 ± 1.07)% vs.(17.95 ± 1.93)%] in AMI group , P=0.001 all.On one year after treatment ,there were 57 patients (19%) with poor prognosis in AMI group . Compared with good prognosis patients before and one year after treatment ,there were significant rise in levels of cTnI , hsCRP ,Hcy ,RDW ,left ventricular end‐systolic volume index (LVESVI) and left ventricular end‐diastolic volume index (LVEDVI) ,and significant reduction in LVEF in poor prognosis patients ,P<0.05 or <0.01 ;Pearson correlation analy‐sis indicated that RDW was significant positively correlated with cTnI ,hsCRP ,Hcy ,LVESVI and LVEDVI ( r=0. 420- 0.498 , P=0.001 all) ,and significant inversely correlated with LVEF ( r= -0.468 , P=0. 001).Conclusion :RDW is correlated with myocardial injury markers ,inflammatory factors and cardiac function ,which contribute to evalu‐ate the prognosis of AMI patients .
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Objective To investigate the significance of carcinoembryonic antigen (CEA),carbohydrate antigen 19-9 (CA19-9),carbohydrate antigen 125 (CA125),neuron specific enolase (NSE),cytokeratin 19 fragment (CYFRA21-1) and squamous cell carcinoma antigen (SCC) for evaluation of first-line chemotherapeutic response and the prognostic value of these markers for prediction of overall survival (OS) in patients with advanced lung cancer.Methods Patients diagnosed with Ⅲ b/Ⅳ stage untreated,primary lung cancer and received first-line chemotherapy in Peking University Cancer Hospital & Institute from June 2013 to December 2014 were enrolled retrospectively into this study.The results of tumor markers before and after two cycles of chemotherapy and the clinical data of 181 eligible patients,including 133 males and 48 females with the average age of 58 years,were collected.The serum levels of six tumor markers were measured by electrochemiluminescence assay.Using RECISTv1.1 as standard,the sensitivity and specificity of tumor markers in classifying PR,SD,PD,were observed.The Kappa agreement test was used to evaluate the correlation between serum tumor markers and CT in evaluating chemotherapy response.The follow-up of OS was derived by telephone.Results The top three positive rates of biomarkers were CEA,CA125 and NSE in adenocarcinoma patients,CYFRA21-1,NSE and SCC in squamous carcinoma patients,NSE,CA125 and CYFRA21-1 in small cell lung cancer patients,respectively.In Kappa agreement test,the changes of serum levels of CEA and CA125,CYFRA21-1 and SCC,NSE were significantly correlated with CT for chemotherapy response evaluation in the mention above three kinds of carcinomas respectively (P < 0.05).The sensitivity of tumor markers predicting PR was more than 90%,but the specificity was only 20%-58.3%,meanwhile,the specificity for SD and PD was high,but the sensitivity was low 0-66.7%).In the prognostic evaluation based on RECISTv1.1,there was no statistical significance for classifying PR,SD and PD in adenocarcinoma patients (median overall survival 17 months vs 22 months vs 14 months,P >0.05),but the OS of PR was longer than SD and PD in squamous and small cell lung carcinoma (median overall survival 28 months vs 22 months vs 4 months,12 months vs 8 months vs 8 months,P < 0.05).Of these six tumor markers,only SCC was of statistical significance for classifying PR,SD and PD in squamous carcinoma (median overall survival 30 months vs 1 1 months vs 4 months,P < 0.05).Conclusions Tumor marker has high sensitivity for predicting PR,but the value of tumor marker predicting SD and PD of advanced lung cancer was limited.The evaluation of patients would be comprehensive by combined use of tumor markers and CT.The changes of SCC after 2 cycles of chemotherapy are predictive of survival in squamous cell carcinoma patients.
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Colorectal Cancer (CRC) is a kind of molecular diversified neoplasm.For nonmetastatic early CRC patients who received surgery based systemic treatment,the 5 years survival rate is as high as 50%-80%.However,only chemotherapy is available for majority of metastatic advanced CRC patients.The effect of chemotherapy is disappointing.Numerous studies have demonstrated that some patients with metastatic advanced CRC can benefit from anti-EGFR and anti-VEGF monoclonal antibodies.Here,we give a brief overview about the clinical research of the detection of KRAS,BRAF,MSI and HER2in guiding treatment with targeted drugs in metastatic advanced CRC
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AIM: To investigate the effects of sodium hydrosulfide ( NaHS ) , a donor of hydrogen sulfide ( H2 S) , on the membrane permeability , intracellular Ca 2+concentration ( [ Ca2+] i ) and the release of IL-1βinduced by a-denosine triphosphate (ATP) in rat microglia, and to explore the effect of H2S on ATP-P2X purinergic signaling pathway and the molecular mechanism of its neuroprotective effect .METHODS: Rat microglia in logarithmic growth phase were used in the study.The [Ca2+]i was detected by Fura-2/AM staining.Fluorescent dye YO-PRO-1 was used to observe the membrane permeability.Interleukin-1β(IL-1β) was measured by rat IL-1βELISA kits.RESULTS:The YO-PRO-1 flu-orescence intensity was obviously elevated by ATP induction in a dose -dependent manner in the rat microglia , but this effect was counteracted by NaHS pretreatment (P<0.05).[Ca2+]i rapidly increased and then decreased slowly , forming a sta-ble platform for a long time when rat microglia were treated with ATP .Ca2+spike activity induced by ATP had no change , but the platform disappeared (P<0.05) after NaHS pretreatment.The ATP and LPS together facilitated the release of IL-1β, but the phenomenon was inhibited by NaHS (P<0.05).CONCLUSION:Hydrogen sulfide may decrease the mem-brane permeability , calcium inflow and IL-1βrelease in rat microglia activated by high dose of ATP .The cytoprotection of hydrogen sulfide may be mediated by purinergic signaling pathway .
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Objective To investigate the safety and efficacy of the conservative laparoscopic operation in treatment of tubal pregnancy by drug water pressure embryo separation. Method 58 cases with tubal pregnancy without rup-ture, the first focus on internal injection of MTX dilution 5 ml to 3 ml, and then to the near corner of the uterus in-jection of 3 ml MTX dilution, and then the line to retain the fallopian tube laparoscopic embryo removal. Results After 2 weeks, the blood β-HCG was monitored, and the average follow-up was 18 months. There was no persistent ectopic pregnancy, the fallopian tube was unobstructed, 22 cases were married of 16 cases (72.73 %) in the in-trauterine pregnancy. Conclusion Separation of ectopic pregnancy and proximal tubal MTX injection method laparo-scopic conservative surgery in the treatment of fallopian tube pregnancy by methotrexate (MTX) dilution water pres-sure, curative effect is exact, retained the fallopian tube of the normal anatomy and physiological function treatment of tubal pregnancy is safe and effective method.
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Objective To detect the prolactin (PRL)analytical performance verification by BECKMAN DxI 800 automated chemiluminescence analyzer.Methods According to the American Society for Clinical Laboratory Standards (NCCLS)doc-uments,selected the patient’s serum and EQA control materials,the precision,accuracy and linearity of the BECKMAN DxI 800 automated chemiluminescence analyzer system in detecting PRL were detected.Results The CV values of intra-and in-ter-precision were less than manufacturer’s declaration,and within the allowable range.The validation results of linear range showed that,a value of 1.0114,r value of 0.9974,both within the requirements of the instrument,and has excellent lineari-ty;the relative bias between the measured results and the EQA control samples at five levels was -1.18%~-7.78%,both within the scope of the EQA measurement.Conclusion The BECKMAN DxI 800 automated chemiluminescence analyzer system in detecting PRL in precision,accuracy,linearity and other performance indicators were within the requirements of the instrument,tomeet the requirements,can be used in clinical testing.
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Acute kidney injury ( AKI) is a clinical syndrome associated with increased morbidity and mortality, and early recognition is critical .In an attempt to engage laypeople and non-experts,the term kidney attack has been introduced to refer to acute kidney injury (AKI),and AKI with functional loss and tubular damage can be diagnosed both with functional criteria ( CRIAKI, creatinine increase AKI ) and damage criteria ( NCRIAKI, non-creatinine increase AKI ) according to the most recent ADQI consensus .This comprehensive definition of Acute Kidney Syndromes may be a major advancement in terms of early referral , prevention of progression and therapeutic strategies for AKI .
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Aim To investigate the protective effects of hydrogen sulfide ( H2 S) on focal cerebral ischemia/reperfusion injury in rats and the possible mechanisms. Methods Male Sprague Dawley rats were divided into three groups randomly: sham-operated group, cerebral ischemia/ reperfusion ( I/R) group and sodium hydro-sulfide ( NaHS ) + I/R group. The left temporary middle cerebral artery occlusion ( MCAO ) model was established by the line-embolism method. After rats were suffered 2h/24h ischemia/reperfusion stress, the mortality rate was evaluated, and the nervous function-al defect degree was evaluated by Longe scoring, the volumes of cerebral infarction was evaluated by 2 ,3 ,5-triphenyltetrazolium chloride ( TTC) staining, and the expression of P2X7 receptor protein in brain tissue was detected by the immunofluorescence method. Results The mortality rate in NaHS + I/R rats ( 29.41%) was obviously lower than those of I/R group ( 42 . 86%) . The nervous defect scores in NaHS + I/R rats were significant lower than those of I/R group ( P <0.05 ) . The volumes of cerebral infarction in NaHS +I/R group (21.88% ±3.53%) were significant lower than those of I/R group ( 36.71% ±3.73%) ( P <0.01 ) . The results of immunofluorescence showed that the positive expression cells of P2X7 receptor protein in cerebral cortex and hippocampal CA1 area of I/R group were significantly higher than those of sham-op-erated group(P<0. 01). However, compared with I/R group, the positive expression cells of P2X7 receptor protein in cerebral cortex and hippocampal CA1 area of NaHS + I/R group were significantly decreased ( P<0. 01). Conclusions H2S exerts the neuroprotective effect on focal cerebral ischemia/reperfusion injury in rats, and the protective mechanism might be associated with down-regulating the expression of P2X7 receptor protein in brain tissue.
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Objective To investigate the correlation between cognitive function and cerebral microbleeds (CMBs) in patients with acute cerebral infarction.Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective.CMBs were counted according to the findings of MRI.The general conditions,CMB site and leukoaraiosis severity of the patients were recorded in detail.The cognitive function of the patients was assessed with the Montreal cognitive assessment scale (MoCA) the next day in the hospital.MoCA assessment follow-up was conducted at 3,6 and 9 months.The changes in cognitive function of the patients with acute cerebral infarction and its relationship with CBMs were analyzed.Results A total of 82 patients with ischemic stroke were enrolled in the study,33 of them had CBMs and 49 had no CBMs.The systolic blood pressure (155.03 ± 19.68 mm Hg vs.142.20 ± 21.22 mm Hg;t =2.762,P =0.007) and the National Institutes of Health Stroke Scale (NIHSS) score (6.21 ±4.57 vs.4.00 ±3.98; t =2.322,P =0.023) in the CBM group were significantly higher than those in the non-CBM group.Multivariate logistic regression analysis showed that the systolic blood pressure level (odds ratio [OR] 1.032,95% confidence interval [CI] 1.008-1.057; P=0.009) and the NIHSS score (OR 1.163,95% CI 1.013-1.311;P=0.014) were the independent predictors of CBMs in patients with acute cerebral infarction.CMBs were closely associated with MoCA scores,and the longer follow-up time,the correlation would stronger.The executive function (rs =0.318,P =0.004),visual space function (rs =0.403,P =0.000) and calculation function (rs =0.362,P=0.001) in patients with CMBs were significantly impaired.The more serious of CMBs,the lower of the scores in above 3 cognitive domains,and the damage would be more serious.Conclusions CMBs are closely associated with cognitive function impairment in patients with acute cerebral infarction.The more serious of CMBs,the more serious of cognitive function impairment will be,and with the extension of time,cognitive function impairment in patients with CMBs will aggravate.
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Cerebral microbleed is a cerebral small vessel disease.The detection rate is 4.5% to 84.9%in different populations.Vascular cognitive impairment is the general name of various cerebrovascular diseases and their risk factors caused varying degrees of cognitive impairments.Studies have shown that cerebral microbleed is closely associated with vascular cognitive impairment.This article reviews the relationship between cerebral microbleed and vascular cognitive impairment in different populations,different degrees and different locations.
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Objective To determine the effect of inhaling rosemary compound essential oil on learning and memory and the expression of choline acetyl transferase (ChAT) in the CA1 region of the hippocampus in rats with vascular dementia (VD).Methods A modified 2-VO method was used to induce permanent brain hypoperfusion,and thus VD,in 60 male SD rats aged 2 months.They were then randomly divided into a normal control group (n =10),a sham-operation group (n =10),a model group (n =10),a rosemary compound essential oil group (n =10) and an edaravone group (n =10).The rosemary compound essential oil group inhaled a compound of the essential oils of rosemary,eugenol and peppermint once a day; the edaravone group was given a daily injection of edaravone injecta.Both the interventions lasted for 65 days.A water maze was used to test their learning and memory abilities.Morphological damage in the CA1 region of the hippocampus and the expression of ChAT were also observed.Results The learning and memory abilities of the model group were significantly weaker compared with the sham-operated group and the normal controls.The rats in the rosemary compound essential oil and edaravone groups were obviously better than those in the model group,but there was no significant difference between rosemary compound essential oil group and the edaravone group.The morphological damage observed in the hippocampus and striatum of the model group was significantly greater,on average,than that observed in the rosemary compound essential oil group and the edaravone group.The average number of ChAT positive units in the CA1 region of the hippocampus was significantly greater in both the rosemary compound essential oil group and the edaravone group compared with the model group,but there was no significant difference between the rosemary compound essential oil group and the edaravone group.Conclusions Inhaling rosemary compound essential oil can improve the learning and memory abilities of rats with VD caused by permanent chronic brain hypoperfusion.It decreases the damage to the neurons of the hippocampus,increases the expression of ChAT,and shows a therapeutic effect on VD,at least in rats.
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Based on specified demands on medical devices maintenance for clinical engineers and Browser/Server architecture technology, a medical device maintenance information platform was developed, which implemented the following modules such as repair, preventive maintenance, accessories management, training, document, system management and regional cooperation. The characteristics of this system were summarized and application in increase of repair efficiency, improvement of preventive maintenance and cost control was introduced. The application of this platform increases medical device maintenance service level.
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Equipamentos e Provisões , Manutenção , Aplicações da Informática Médica , SoftwareRESUMO
Objective To observe the feasibility, safety and efficacy of percutaneous coronary intervention (PCI) for treatment of chronic total occlusions (CTO)by only the guidewire versus by the guidewire dependent on balloon. Methods The 108 patients with CTO confirmed by coronary angiography and treated with PCI from March 2009 to March 2011 were enrolled in this study, including 59 cases with old myocardial infarction, 22 unstable angina cases and 27 stable angina cases. The clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac events (MACEs) during follow-up were retrospectively analyzed between group A (only by the guide wire) and group B (by guide wire dependent on balloon). Results The 88 of 108 patients (81.5%) got successful operations. The success rate of CTO was a little higher in group B than in group A [80.0%(52/65) vs. 83.7%(36/43), P>0.05]. The rate of total complications was more in group A than in group B [10.8%(7/65) vs. 2.3%(1/43), P<0.05]. No death occurred during operation, no MACE occurred after operation in hospital and no patients underwent emergency coronary artery bypass graft (CABG) in the two groups. Conclusions The PCI for treatment of CTO used by the guidewire dependent on balloon shows a safety and effecary.
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Objective To explore the observation and nursing on complications of artificial vessel arteriovenous fistula in hemodialysis patients. Methods The targeted treatment and nursing care were implemented according to different complications in 40 hemodialysis patients with artificial vessel arteriovenous fistula. Results A total of 25 complications happened in 13 patients. All the patients were cured without dysfunctions after targeted treatment and nursing care. Conclusion Detecting and dealing with the symptoms of complications of artificial vessel arteriovenous fistula in time is important to prolong the using time of artificial vessel arteriovenous fistula.
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<p><b>OBJECTIVE</b>The present study aims to study the influences experimental navigation and intensive exercise on immune-neuroendocrine network of the male rats and the effects of PNS to this influence.</p><p><b>METHOD</b>Thirty 6-week Sprague-Dawley male rats (SD rats) were randomly located into three groups: Quiescent control (QC) group, training control (TC) group and Panax notoginseng saponins (PNS) group. Rats from QC group were not given any stimuli, and samples were taken after 7-day intragastric administration of saline. Rats from TC group underwent 10-day run training of increasing load on treadmill and received 7-day intragastric administration of saline. PNS group were subjected to the same procedure of run training as group TC, and received intragastric administration of PNS at the dose of 0.2 g x kg(-1). Blood samples were immediately obtained at the end of the tests to determine the serum levels of corticosterone (Cort), adrenocorticotropic hormone (ACTH), beta-endorphin (beta-EP), Neuropeptide Y (NPY) and interleukin-1beta (IL-1beta), interleukin-6 (IL-6) by RIA. Expressions of Pituitary ACTH, NPY were observed use the immunohistochemistry method and correlation analyses conducted. And the ultrastructural changes of the pituitaries and the adrenal cortex cells were examined by electron microscope meanwhile.</p><p><b>RESULT</b>The serum beta-EP and Cort levels in TC group were significantly increased compared to the QC group; whereas Expression levels of pituitary ACTH, NPY were markedly higher after experimental navigation and intensive exercise. In Group PNS, the plasma Cort, ACTH and NPY levels decreased significantly compared to Group TC. Meanwhile we found expression levels of pituitary ACTH, NPY also lower than group TC. There was no significant difference about the ultrastructure of anterior pituitary and adrenal cortex of QC and PNS group. However, a obvious change of ultrastructure occurred to TC group rats.</p><p><b>CONCLUSION</b>These results suggest that immune-neuroendocrine network function of rats were confused by negative psychological stresses and intensive exercise. PNS therapy may exert regulation effects to the network.</p>
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Animais , Humanos , Masculino , Ratos , Medicamentos de Ervas Chinesas , Exercício Físico , Sistema Imunitário , Metabolismo , Modelos Animais , Sistemas Neurossecretores , Metabolismo , Panax notoginseng , Química , Distribuição Aleatória , Ratos Sprague-Dawley , SaponinasRESUMO
Seeing that the invasive measuring technique has many disadvantages, we have designed a noninvasive technical system for measuring isovolumetric bladder pressure by controlled inflation of a penile cuff. This system is easy-to-use and the measuring result provides quantitative information on isovolumetric bladder pressure during voiding. The doctor can discriminate obstruction from non-obstruction according to the data of measurement and flow rate.
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Humanos , Masculino , Pessoa de Meia-Idade , Pênis , Fisiologia , Pressão , Processamento de Sinais Assistido por Computador , Bexiga Urinária , Obstrução do Colo da Bexiga Urinária , Diagnóstico , Urodinâmica , UrologiaRESUMO
Objective To analyze the economic effects of different rehabilitation patterns for children suffering from cerebral palsy. Methods A total of 153 cerebral palsy patients were divided into a hospital-community-family rehabilitation group(n = 52), a hospital rehabilitation group (n = 50) and a non-intervention control group (n = 51). Those in the first group were provided with a hospital-community-family rehabilitation therapy pattern, those in the sec-ond only hospital rehabilitation and the third no intervention. All the patients were evaluated using the Gross Motor Function Measure-88 (GMFM-88) Scale and the Cost Measure Scale at admission, and at the end of the 3rd and 6th months of treatment. Results There were no significant differences in gross motor function among the three groups at admission. At the end of the 3rd month and the 6th month there were significant differences between the children in the hospital-community-family rehabilitation program and those in the hospital rehabilitation program in terms of gross motor function. Their general percentage, monthly percentage and monthly relative percentage results were all significantly different. But there was no significant difference in the non-interventian control group since admission. Every unit of improvement in gross motor function cost $101.87±97.59, $75.11±45.75 in the hospital-community-family reha-bilitation program and $387.21±54.76, $170.31±123.16 in the hospital rehabilitation program at the end of the 3rd and the 6th month respectively. So the cost of the former was only about 30% of the latter. Conclusion Hospital rehabilitation is suitable for the early rehabilitation of cerebral palsy children. Hospital-community-family rehabilitation is better for long-term rehabilitation of cerebral palsy children, and what is more, it can decrease the rehabilitation ther-apy cost substantially. So a hospital-community-family rehabilitation pattern is more compatible with China's national situation.
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Objective To quantify the level of human sperm protein 17(Sp17)in serum of the healthy and patients with gynecological cancers and to evaluate whether Sp17 is a suitable serum marker for the diagnosis of gynecological cancers.Methods The recombinant human Sp17 was radioiodinated by the chloramine T method.125I-rhSp17 was used to develop a radioimmunoassay to determine Sp17 in serum of the healthy and the patients.Meanwhile,Sp17 levels in serum were compared with the expression of Sp17 in tissues from gynecological cancers.Results The level of serum Sp17 was(15.60?7.66)?g/L in healthy subjects(n=59),which was significantly lower than those in twenty-two patients(64.36?34.44)?g/L.Sera from nine of twenty-two patients(40.9%)were positive for Sp17 by radioimmunoassay assay.Tumor tissues from twelve of twenty-two patients(54.5%)were positive for Sp17 by immunohistochemistry assay.Conclusions Markedly elevated serum levels of Sp17 were found in patients with gynecological cancers.However,there was no significant correlation between serum level of Sp17 and expression of Sp17 in tumor tissues in patients with gynecological cancer.