Objective To study how to fulfill the repair security works of servicing and maintenance of medical equipment when medical corps execute the mission of peacekeeping successfully. Methods The maintenance and support work of medical equipment are fulfilled from several aspects, including the strict selection of maintenance personnel, learning and preparation of equipment and spare parts before going abroad, the completion of peacekeeping mission and the principle of equipment management and how to purchase medical equipment, etc. Results The operation of equipment is ensured under normal condition and the COE verification is passed through successfully. Conclusion The security system of medical equipment management and maintenance in peacekeeping and field operation is groped.

Objective To investigate the characteristics of memory impairment in patients with cereberal cysticercosis and analyze its influence factors. Methods 62 patients with cereberal cysticercosis and S3 normal controls by age, gender, education and occupation using accepted the Clinical Memory Test. Memory score was compared to observe the contrast to patients with cerebral cysticercosis lesions in the left and right groups in different from memory effects. Results There were significant lowering in pointing memory( 12. 29 ±7.41) ,association learning(15.37 ±7.29) ,free picture recall( 11.37 ±7. 35),insignificant figure recognition( 17.72 ±6.27),portrait character association recall(14.28 ± 6.39 ) and memory quotients(71.04 ± 19.48) when that of the normal controls(P<0. 01 ) , pointing memory and free picture recall were the lowest among the five items. There were some significant differences between patients with cerebral cysticercosis in the left and the right of lesion group a-bout different memory contents(P<0.05 ～0.01), and association learning was the lowest in the left lesion group, insignificant figure recognition was the lowest in the right lesion group. Conclusion Cereberal cysticercosis could cause memory impairment. There were some significant differences between the left and the right lesion group about different memory impairment.

Objective To study the changes of cerebral function and pathological morphology before and after the antiparasit-ic treatment with albendazole and praziquantel in patients with cerebral cysticercosis. Methods The data of EEG and neuroimag-ing of 412 patients with cerebral cysticercosis were retrospectively analyzed. Results Before the treatment,the mild abnormali-ty,moderate abnormality,and severe abnormality were observed in 40.53%,45.63% and 13.84% of the patients respectively, which mainly showed the diffuse or focal irregular slow waves,or epileptiform discharges found in the abnormal brain waves. CT/MRI manifestation could be divided into six types,including single sacculus type(23.59%),multiple sacculus type(44.42%), encephalitis type(13.59%),coexistence of macrocyst and sacculus type(4.85%),calcification type(2.18%),and mixed type (11.41%). After 3 courses of the treatment,the normal and improved EEGs were observed in 79.85%and 20.15%,respectively. CT/MRI showed the foci being all absorbed(77.18%),being most absorbed(20.63%),and being no changes(20.18%)which were calcified focus. When cerebral cysticercosis were in acute stage(the single and multiple sacculus type,encephalitis type, and macrocyst and sacculus coexistence type),the therapeutic effect was good;while in the mixed type,the therapeutic effect was relatively poor. If cysticercosis were in the calcification stage,the patients only needed the heteropathy. Conclusions In the pa-tients with cerebral cysticercosis,EEGs show the mild to severe abnormalities,and CT/MRI mainly shows the multiple sacculus type. After the treatment,the abnormal EEGs are gradually recovered and the low density foci can be all absorbed,but some calci-fied focus still exist in some patients.

Objective To evaluate the influence of hematocrit(HCT),vitamin C(Vc)and galactose on three portable blood glucose meters to provide some reference for clinical selection of appropriate blood glucose me-ter.Methods 20 heparin anticoagulant venous blood samples in the clinical laboratory department of Nanfang Hospital were selected for verifying the accuracy of blood glucose meter.2 healthy volunteers were selected for collecting 5 w hole blood samples in interferent test.Referring to the detection results of Roche automatic bio-chemical analyzer,the Nova StatStrip Xpress glucometer,Bayer Contour Plus glucometer and Roche Accu-chek Performa blood glucose meter were performed the accuracy verification.The influence of HCT,Vc and galac-tose on the detection results of above three portable blood glucose meters were evaluated.Results The detec-tion accuracy of Nova StatStrip Xpress and the Roche Accu-Chek glucometers all conformed to the require-ments of ISO15197:2013 standards.The detection accuracy of Bayer Contour Plus glucometer only conformed to the requirements of ISO15197:2003 standards.Under the interference of different levels of HCT,Vc and galactose,the detection results of Nova StatStrip Xpress glucometer conformed to the requirements of ISO15197:2013 standards;w hen detecting low concentration of blood glucose,the Bayer Contour Plus glucom-eter was interfered by 10 mg/dL Vc,and other detection results conformed to the requirements of ISO15197:2003 standards;the anti-interference performance of Roche Accu-chek Performa glucometer conformed to the

This paper reports the diagnosis and therapy of one case of Dipylidium caninum infection in an infant.

Objective:To evaluate the dose-response relationship of alfentanil inhibiting gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy.Methods:Patients of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged ≥60 yr, scheduled for elective painless gastroscopy, were selected. Propofol 1.5 mg/kg combined with alfentanil was given intravenously in all the patients. The dose of alfentanil was determined by the Dixon up-and-down method. The initial dose of alfentanil was set at 5 μg/kg. The dose of alfentanil in the next patient was determined according to the development of gag reflex, and the ratio between the two successive doses was 1.1. The median effective dose (ED 50) and 95% confidence interval of alfentanil-induced inhibition of gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy were calculated using the by up-and-down sequential allocation. Results:The ED 50 (95% confidence interval) of alfentanil-induced inhibition of gag reflex when combined with propofol 1.5 mg/kg was 2.8 (2.4-3.2) μg/kg in elderly patients undergoing painless gastroscopy. Conclusion:When combined with propofol 1.5 mg/kg, the ED 50 of alfentanil inhibiting gag reflex is 2.8 μg/kg in elderly patients undergoing painless gastroscopy.

Objective To introduce the robotic-assisted left hemicolectomy and Soave procedure and its clinical outcome for Hirschsprung's allied disease.Methods From June 2015 to November 2022,19 cases diagnosed with Hirschsprung's allied disease underwent left colectomy and Soave pull-through by using the da Vinci surgical system,and the clinical data of 19 children were summarized and analyzed.A four trocar technique was used.The left colon was firstly mobilized by laparoscopy from splenic flexure of colon to the level of peritoneal reflection,then the rectum was mobilized by Robotic system to the level of dentate line.A circumferential incision was made in the mucosa at 0.5 cm proximal to the dentate line.The upward submucosal dissection was carried out for approximately 1-2 cm.The left colon was pulled through the anal canal and resected.The coloanal anastomosis was fashioned manually 0.5 cm above the dentate line.21 cases underwent conventional laparoscopic-assisted Soave surgery were used as control group.Results All patients were successfully operated.Compared with conventional laparoscopic-assisted Soave surgery,the operation time was significantly prolonged(P＜0.01),the intraoperative blood loss was significantly reduced(P＜0.01),and the overall postoperative complication rate was significantly reduced(11％VS.43％,P＜0.05).There were no serious complications such as major bleeding and death.Conclusion Robotic-assisted left hemicolectomy and Soave procedure are safe and feasible in the treatment of Hirschsprung's allied disease,with few postoperative complications and satisfactory clinical outcome.

Objective: To establish a set of rules for autoverification of blood analysis, in order to provide a way to validate autoverification rules for different analytical systems, which can ensure the accuracy of test results as well as shorten turnaround time (TAT) of test reports. Methods: A total of 34 629 EDTA-K2 anticoagulated blood samples were collected from multicenter cooperative units including the First Hospital of Jinlin University during January 2017 to November 2017. These samples included: 3 478 cases in Autoverification Establishment Group, including 288 cases for Delta check rules; 5 362 cases in Autoverification Validation Group, including 2 494 cases for Delta check; 25 789 cases in Clinical Application Trial Group. All these samples were analyzed for blood routine tests using Sysmex XN series automatic blood analyzers.Blood smears, staining and microscopic examination were done for each sample; then the clinical information, instrument parameters, test results and microscopic results were summarized; screening and determination of autoverification conditions including parameters and cutoff values were done using statistical analysis. The autoverification rules were input into Sysmex Laboman software and undergone stage Ⅰ validation using simulated data, and stage Ⅱ validation for post-analytical samples successively. True negative, false negative, true positive, false positive, autoverification pass rate and passing accuracy were calculated. Autoverification rules were applied to autoverification blood routine results and missed detection rates were validated, and also data of autoverification pass rate and TAT were obtained. Results: (1)The selected autoverification conditions and cutoff values included 43 rules involving WBC, RBC, PLT, Delta check and abnormal characteristics. (2)Validation of 3 190 cases in Autoverification Establishment Group showed the false negative rate was 1.94%(62/3 190)(P<0.001), autoverification pass rate was 76.74%, passing accuracy was 97.47%; Validation of 2 868 cases in Autoverification Validation Group, the false negative rate was 3.38%(97/2 868)(P=0.002), autoverification pass rate was 42.26%, passing accuracy was 92.00%; Validation of Delta check on 288 cases in Autoverification Establishment Group and 2 494 cases in Autoverification Validation Group showed the false negative rates were respectively 1.39% and 2.61%(P<0.001). (3)Three hospitals adopted these rules of autoverification for 25 789 blood routine samples, and found that the average TAT of blood routine test reports were shortened by 24min, 32min and 7min respectively, the rate of samples reported within 30min were elevated by 33%, 53% and 7%. The autoverification pass rates were 72%-74%. Conclusions The application of this set of 43 autoverification rules in blood sample analysis can ensure test quality while shortenTAT and improve work efficiency. It is worth pointing out that for the same analytical systems in this research, validation is necessary before application of this set of rules, and periodic validation is required during application to make necessary adjustment; for different analytical systems, as this research provide a way to establish autoverification rules for blood routine tests.Clinical labs may establish their own suitable autoverification rules on the basis of technological parameters. (Chin J Lab Med, 2018, 41: 601-607)

Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.