Expounding the status of the current domestic medical equipment maintenance management, and puting forward the strategic thinking of medical maintenance for the challenges of equipment maintenance management in the hospital. This discussion can be performed to control the maintenance costs of hospital effectively, increase the income and social benefits of the hospital.
Costs and Cost Analysis ; Equipment and Supplies, Hospital ; Maintenance and Engineering, Hospital ; economics ; Materials Management, Hospital ; economics

Endometrial cancer is one of the malignant tumors of female reproductive system. The prognosis of advanced endometrial cancer is poor. How to improve the overall survival rate and improve the prognosis of patients with advanced endometrial cancer is still one of the clinical problems. In recent years, the research on tumor gene changes is increasing gradually. Epigenetics is the study of genetic changes in gene expression without changing the nucleotide sequence of genes. Epigenetics includes many phenomena, such as DNA methylation, microRNA expression and gene silencing, chromatin remodeling. These changes may be important factors in the occurrence and development of tumors, and may become new therapeutic targets for tumors. With the study on epigenetics of endometrial cancer in the future, new therapeutic targets may be found. Meanwhile, those study may provide new ideas for targeted therapy of endometrial cancer.

ObjectiveTo study the method and effect of individualized education on children with learning disability (LD).Methods30 children during 7-10 year old in a local boarding elementary school were chosen and guided individually as the following: sensory integration dysfunction drill, subtle motion drill, life skills drill, cognitive capability drill, behavior therapy, game therapy, music therapy and parents education. One and a half year later, the index of Sensory Integration Rating Scales and study marks were determined and compared with that of the normal children.ResultsThere is not significant difference between the LD children and the normal ones in the sensory integration of behavior and the learning achievement.ConclusionIndividualized education is a valid approach improving the potentiality of the LD children\'s physiology and psychology.

Objective To evaluate our short term results in endovascular treatment of symptomatic vertebral arteral stenosis with stents. Methods Balloon expanded stents were utilized to pass across the vertebral arterial stenosis, and then the balloons were inflated for the deployment of stents, outcoming with restoration of the stenosis to normal size. Results Forty five patients presented with posterior circulation ischemic symptoms and refractory to medical therapy were undertaken with endovascular stenting, showing technically successful in forty three of them. The mean degrees of preoperative and postoperative stenosis were 75.7% and 10.3%, respectively. Follow up data showed disappearence of clinical symptoms in 35 patients, chinical implovement and stabilization in 2. There were no intimal dissection and distal embolization. Short term follow up angiogram revealed no restenosis and intimal hyperplasia. Conclusions Endovascular stenting may be a favorable alternative for the treatment of vertebral arterial stenosis, but long term follow up is necessary.

With the information section of the 187th Central Hospital of PLA as an example , the paper introduces the application of the PDCA cycle model in the quality management of its information services .As a result, it finds that the service satisfaction degree after the implementation of the PDCA cycle is significantly higher than that before the implementation .It indicates that the management method with the PDCA cycle can optimize the information service process and promote the continuous improvement of information service quality .

Objective: To discuss the clinical and pathological features, diagnostic standards, therapy and prognosis of chest primitive neuroectodermal tumor (PNET) and to improve diagnostic and therapeutic levels. Methods: Clinical data of four cases of PNET were analyzed retrospectively. Of the 3 cases of mediastial PNET, 2 cases with superior vena cava invasion received partial resection surgery and one case received thoracoscopy-guided mediastinal node biopsy. The 4th case with right lung PNET had supraclavicular node biopsy. Results: All of the four cases were diagnosed as PNET by pathologic and imnmohistochemical examination. Two cases did not receive any therapy, one case received systemic chemotherapy, and one case received local radiotherapy. The life span of the 2 cases who did not receive any therapy was 6 and 7 months, respectively. The life span of the patient who received systemic chemotherapy was 12 months. The patient who received local radiotherapy had survived for 4 months till August of 2006. Conclusion: Chest PNET can occur in every age. Lymph node metastasis may happen when the primary lesion is very small. Misdiagnose rate is very high and final diagnosis depended on pathological plus immunohistochemical examination. Because of the higher malignancy, rapid local invasion and distant metastasis, the resection rate of chest PNET is low and the prognosis is poor. So it is necessary to find a more effective method for treatment of PNET.

During sepsis, circulating leukocytes are in a hyper inflammatory state, and with the progress of the inflammation, immune cells may become tolerated. Glycolysis and pentose phosphate pathway are up-regulated but oxidative phosphorylation is suppressed in hyper inflammatory cells, whereas during immune tolerance, glycolysis is often down-regulated. In this review, we will summarize the changes of cellular metabolic pathways in monocytes and macrophages during sepsis. We also review how the metabolism of glucose, amino acids, and fatty acids affect the function of monocytes and macrophages in sepsis. Current literature indicated that metabolism plays a significant role in regulating the functions of immune cells in sepsis, which might be a potential therapy for sepsis and deserved further research.

Objective To explore the work environment of male nurses of psychiatric in Chongqing, as well as the affecting factors. Methods The Professional Practice Environment (PPE) scale was applied to investigate the work environment of 400 male nurses of psychiatric in Chongqing. And the regression analysis was used to analyze the associated factors. Results staff relationships with physicianswas the subscale with the highest score (3.15 ± 0.41) of the PPE of the tested male nurses of psychiatric in Chongqing, whileteamworkwas the subscale with the lowest score (2.05±0.70). Locations and types of hospitals,nurse-patient ratios and education of male nurses were identified to be predictors of work environment (t=- 14.19- 7.63, P<0.01). Conclusions Multiple factors affecting the work environment of male nurses of psychiatric should be considered when nursing managers draw up management strategies.

The metabolic response to stress plays a key role in the adaptive response during critical illness.Multiple mechanisms including the stimulation of the sympathetic nervous system,inflammation,and immune responses were involved.Insulin resistance is one of the main features in metabolic response to stress.Metabolic response to stress was manifested by disorders of energy consumption,such as glucose,lactic acid,lipids,and proteins.The decrease in fat-free body mass and cell mass,relative excess of adipose tissues,and increased extracellular fluid volumes were also involved.Therapeutic interventions,including hormone supplementation,enhanced protein intake,and early mobilization,are considered for prevention and therapy of metabolic response to stress.The review aims to summarize the pathophysiological mechanisms,clinical consequences,and therapeutic implications of metabolic response to stress in critical illness.

Sepsis is a leading cause of death in critically ill patients.The definitions of sepsis and septic shock were introduced in 1991 and last revised in 2001.Since considerable advances had occurred to its pathophysiology and management,an update definitions for sepsis and septic shock were released in February 2016 by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine.This article is to review the development and limitations of previous versions of sepsis definition,and summarize the sepsis 3.0 definition and its clinical diagnosis criteria.These updated definitions and clinical criteria will play vital roles in providing important reference frame for clinical trials,and facilitating early recognition and timely management of patients with sepsis.