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 investigate the frequency of autoimmune encephalitis (AE) in limbic encephalitis (LE) syndrome and compare its clinical features with viral encephalitis.Methods Patients diagnosed with LE syndrome who admitted to Huashan Hospital between December 2015 and June 2016 were enrolled and screened for autoantibodies associated with AE (anti-N-methyl-D-aspartate receptor, anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, anti-gamma-amino-butyric acid B-receptor, anti-leucine-rich glioma inactivated 1 and anti-contactin-associated protein-like 2 antibodies) in cerebrospinal fluid (CSF) and serum. Their clinical features and auxiliary examinations were also collected and analyzed retrospectively. Results Fifty-four patients were diagnosed with LE syndrome, including 35 males and 19 females. The age of these patients was (38.98±17.29) (15-75) years. Twenty patients (37.0%) were identified as AE, 17 patients (31.5%) as viral encephalitis. Other cases included three (5.5%) with neurosyphilis, one (1.9%) with glioma and 13 (24.1%) of unknown cause. Young patients(15-29 years old)and patients older than 45 years accounted for 46.0% (17/37) and 37.8% (14/37) of all AE and viral encephalitis cases respectively. Patients with AE had longer disease progression time than patients with viral encephalitis ((22.45±11.62) d vs (6.24±2.95) d, t=6.015, P<0.01).Emergency hospitalization of patients with AE was less frequent than that of patients with viral encephalitis (3/20 vs 12/17, P=0.001). Patients with AE were less common to present with fever at disease onset than patients with viral encephalitis (8/20 vs 15/17, P=0.006). Seizures as the first neurological symptom were less common in AE than in viral encephalitis (2/20 vs 8/17, P=0.023). White blood cell counts in CSF were less frequently elevated in AE than in viral encephalitis (7/17 vs 12/15, P=0.036). The differences of age, gender, disease severity as well as abnormal rates of brain MRI, electroencephalogram and CSF protein were not statistically significant between the two groups. Tumors were discovered in 6 (6/19) patients with AE. Conclusions The frequency of AE in LE syndrome is not low. It is worthwhile to screen for autoantibodies associated with AE in patients diagnosed with LE syndrome. AE and viral encephalitis have their own characteristics, which could offer help in differential diagnosis between them and application of effective treatment.

Objective To study the effects of Xuanbaichengqi decoction on the regulation of inflammatory factors TNF-α and IL-1 β in patients with acute respiratory distress syndrome (ARDS) and its mechanism.Methods 60 patients with ARDS who had been hospitalized from January 2016 to August 2016 were randonly selected and then assigned to a control group (30 patients) and a study group (30 patients).Both groups received routine therapies and mechanical ventilation,and the study group received additional Xuanbaichengqi decoction.Levels of TNF-o,IL-1β and IL-10,and peak inspiratory pressure (PIP),plateau airway pressure (Pplat),PVC,forced vital capacity (FVC),forced expiratory volume in one second (FEV 1),and oxygenation index (PaO2/FiO2) were detected before and after treatment.Results Levels of TNF-α and IL-1βwere significantly lower in the study group than in the control group (P ＜ 0.05).IL-10 level was significantly higher in the study group than in the control group (P ＜ 0.05).And the improvement in PIP and Pplat was also significant in the study group (P ＜ 0.05).Less adverse reactions occurred in the study group.Conclusions Xuanbaichengqi decoction can improve the indexes for respiratory mechanics and pulmonary function in patients on mechanical ventilation and reduce the inflammatory response,having a significant effect.

ObjectiveTo investigate the effect of dexmedetomidine pretreatment on focal cerebral ischemia-reperfusion(I/R) injury in rats.MethodsOne hundred male SD rats weighing 290-310 g were randomly divided into 5 groups(n =20 each):sham operation group(group SH) ; focal cerebral I/R group; focal cerebral I/R + dexmedetomidine 100 μg/kg(group L); focal cerebral I/R+ dexmedetomidine 200 μg/kg (group M) and focal cerebral I/R + dexmedetomidine 400 μg/kg(group H).Focal cerebral I/R was produced by occlusion of middle cerebral artery for 60 min followed by 24 h of reperfusion.Dexmedetomidine 100,200 and 400 μg/kg were injected intraperitoneally 15 min before ischemia in groups L,M and H respectively.While equal volume of normal saline was injected intraperitoneally in group SH.Neurologic function was assessed and scored at 24 h of reperfusion.Then the animals were sacrificed and brains were removed for determination of cerebral infarct volume and microscopic examination.The expression of heat shock protein 70(HSP70) and activity of Na+ -K + -ATPase in ischemic cortex and activity of SOD and concentration of cortisol in plasma were determinationed at 24 h of reperfusion.ResultsCompared with group SH,neurologic deficit scores and plasma concentration of cortisol were significantly increased,activities of SOD and Na+ -K+ -ATPase decreased and expression of HSP70 was up-regulated in groups I/R,L,M and H( P ＜ 0.05).Compared with group I/R,neurologic deficit scores and plasma concentration of cortisol were significantly decreased,activities of SOD and Na+ -K+ -ATPase increased and expression of HSP70 was up-regulated in a dose-dependent manner ( P ＜ 0.05),and the pathological change was reduced in a dose-dependent manner in groups L,M and H.ConclusionDexmedetomidine pretreatment can attenuate focal cerebral I/R injury in a dose-dependent manner through improvement of brain cell energy metabolism and reduction of lipid peroxidation and stress reaction.

Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in esophagus surgery. Methods From 1982 to 2010, patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with unspecific chest pain, 70.4%(74/105) were diagnosed as esophageal origin. Lower esophageal sphincter pressure (LESP) can be continuously maintained by using 360° fundoplication. Only a minority of patients who underwent transabdominal esophagocardiomyotomy and partial posterior fundoplication had acid reflux postoperatively. Incidence rate of achalasia of upper esophageal sphincter (UES) and pharyngeal "shoulder wave" in side-to-side stapled anastomosis is significantly lower than in traditional hand-sewn anastomosis,as well as contractive pressure in anastomosis region and occurrence of swallow discomfortableness. There is a high pressure region at the esophageal entrance in patients with bilateral platysma muscle flap for cervical esophagus defect following removal of hypopharynx cancer. And the pressure of the region is significantly lower than in healthy controls. Basal pyloric pressure and peak pressure of pylorus in phase Ⅲ of the migrating motor complex increased significantly after gastric conduit was made and anastomosed, but decreased appreciably following pyloric digital fracture. Peak pressure, frequency and duration time of isolated pyloric pressure wave ( IPPW ) decreased after pyloric digital fracture significantly. Conclusion Esophageal manometry and 24-hour pH monitoring are important tools for and diagnosing unspecific chest pain and evaluating the outcome of new surgical procedures.

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.

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 .