Objective To discuss the ways to train qualified clinical engineers,and thereby to enhance the teamwork of clinical engineers.Methods The problems in training the clinical engineer were pointed out in training mode,knowledge reserve,innovation and etc,and some countermeasures were put forward accordingly.Results The countermeasures were proposed from the aspects of basic theoretical system,continuing education system,self-adaptive working mode,enhanced communication and etc.Conclusion The clinical engineer needs to utilize their own advantages to elevate their personal qualities and raise their profiles so as to meet the requirements of social and technological development.

Objective To investigate the value of Xueshuangtong combined with radiofrequency thermocoagulation in the treatment of lumbar degenerative lumbar pain.MethodsFrom January 1, 2014 to December 30, 2015, 60 patients with lumbar degenerative low back pain admitted in Jiashan Traditional Chinese Medicine Hospital.All of them were randomly divided into observation group and control group, and each with 30 cases.All patients received radiofrequency thermocoagulation, while the observation group received Xueshuantong for further treatment.All of the patients were assessed by the international Pain Association recommended the use of visual analogue scale (VAS) and McGill pain questionnaire (SF-MPQ) and CRP when treatment before starting and after 1, 3, 7, 14, 30 and 90d of the treatment.ResultsThere were no significant differences between the two groups in VAS, SF-MPQ and CRP before treatment (P<0.05).However, when compared with the control group, patients in the observation group got significantly lower levels of VAS at 1, 3, 7 and 14d after the operation;significantly lower levels of SF-MPQ at 1, 3, 7, 14 and 30d after the operation;and significantly lower levels of CRP at 14, 30 and 90d after the operation (P<0.05).And we found no serious complications occurred in the two groups.ConclusionThe Xueshuantong combined with radiofrequency thermocoagulation treatment of lumbar facet joint is a safe, effective and inexpensive for the low back pain which caused by lumbar degeneration.

[Objective]To analyze the causes of perioperative periprothetic fracture with hip arthroplasty and discuss the prevention and treatment of the fracture.[Method]18 of 640 THR cases occurred femoral fracture from July 1995 to August 2006,11 with intraoperative fracture and 7 with postoperative fracture,12 were and 6 female,the mean age 68 years(range:51 to 79 years).According to AAOS'standard,18 cases were divided into 6 types:1 of I type,6 of II type,4 of III type,4 of IVa type,2 of IVb type,1 of V type and 2 of VI type.10 of 11 cases of intraoprative fracture were operated immediately with internal fixation,and one of II type was treated with conservative method.4 of 7 cases of postoperative fracture were operated with open reduction and internal fixation in two weeks,2 cases with loosen stem were operated by revision hip,and one of V type was treated with conservative method because of other disease.[Result]The mean followed up perioid were 15.2 months(rang:6 to 42 months),15 fractures united,2 delayed united and 1 dead after 8 months postoperatively.The average scores were 80 according to Harris'standard(range:67 to 92).[Conclusion]Violence、abnormal of femur cannal、osteoprosis and bigger prothesis are the main causes of intraoperatively peri-prothetic femur fracture after THA,and loosening、 osteoperosis and outside injury are the main causes of postoperatively periprothetic femoral fracture,different treatment should be used according to the different types.

[Objective]To study the reason of loosening prothesis by observing the interface membranes harvested during the hip revision operation.[Method]Thirty eight specimens of interface membranes around the loosening prothesis were harvested from thirty eight patients who underwent the revision of total hip replacement.All the specimens were underwent outer observation,light and scanning electronic microscopic observation.[Result]All the gap of the loosening prothesis were filled with interface membranes with different thickness.A large number of the foreign pelletand bone pieces were found under scanning electronic microscope.[Conclusion]Interface membranes growed and filled in the gap between the loosening prothesis and bone(or bone cement).The wear debris stimulated the interface membrane to release bone resorption factors which caused the prothesis loosening,and the more loosening,the more large gap appeared,and the more resorption factors released from the interface membranes due to the debris stimulating,which formed vicious circle.Cutting the link of the circle could decrease the loosening rates.

Objective To explore how the different intervention measures affect the outcome of central venous catheter-related thrombosis (CRT) in children. Methods A retrospective analysis was carried out to collect the clinical data of patients with CRT from the nursing management system of the Children′s Hospital Affiliated to Zhejiang University School of Medicine which reported by each nursing unit from January 1,2015 to December 31,2015. Results Totally 108 cases were included (72 boys and 36 girls), median age of 24.5 months (ranged from 1 month to 14 years old). Nearly 42.59% (46/108) patients suffered from neurological diseases. Nearly 55.56%(60/108) CRT was detected in the first week after catheterization. Once CRT conformed, there were four kinds clinical intervention options applied. Intervention 1: thrombolytic therapy with urokinase combined anticoagulation with nadroparin calcium. Intervention 2: anticoagulant therapy only. Intervention 3: thrombolytic therapy alone. Intervention 4: no medications. The differences of effective between the four kinds of intervention were statistically significant (χ2=13.380, P=0.004). The single-factor regression analysis was done to each relevant factor. Finally the multivariate regression analysis showed four factors had impacts upon the results. The factors were as follows:gender (OR=10.400, 95%CI 1.879-57.563, P=0.007);interval (OR=1.107, 95%CI 1.035-1.184, P = 0.003), size of thrombus(OR = 1.562,95%CI 1.033-2.362,P=0.035; Intervention 2 (OR =11.757, 95% CI 2.254- 61.327, P = 0.003), intervention 4 (OR = 35.397, 95% CI 3.493-358.760, P =0.003). Conclusions The earlier and small size thrombus is more soluble. Thrombolytic therapy or combined anticoagulation is more effective. It is recommended that if no contraindications presents, thrombolytic combined with anticoagulant therapy should start early standardized treatment.

Objective To test the performance of field blood transportation vehicle from the aspects of heat preservation,refrigeration and oil consumption.Methods Two vehicles without power supply were stowed with maximum load,one with red cell suspension,and the other with frozen plasma.With the environmental temperature higher than 35 ℃ or lower than 25 ℃,related time lengths were detected respectively.Results The holding time of the vehicles was from 1.5 h to 7 h,refrigerating time was from 15 min to 138 min,and a full tank of gasoline was exhausted around 5～7 hours.Conclusion During line-haul,field blood transportation vehicle has to be equipped with additional cooling agents,in case the refrigeration equipment out of work for the reason of gasoline exhaustion.

Objective To investigate the electrophysiological and morphological properties of the single ventral neuron in the medial geniculate body (MGBv) in rats. Methods The basic electrophysiological properties and action potentials at different levels of membrane potentials were recorded by whole cell patch clamp technique. Morphological properties of ventral neurons in the medial geniculate body were studied by biocytin staining. Results Nissl and biocytin stainings indicated that MGBv neurons were composed of oval shaped cell bodies, and the dendritic branches were tufted. In current clamp recordings, the resting membrane potential was (-54.92?10.85) mV, the input resistance (945.67?507.80) M?, the membrane capacitance (5.37?1.98) pF, and the time constant (2 109 87 ?2 496 01) ?s. Action potentials under different current inputs were various. Spontaneous discharge could be recorded by voltage clamp and current clamp. Conclusion MGBv dendritic trees are fairly dense with bushy tufted neurons and variety of action potentials under different current inputs in ventral neurons of the medial geniculate body. Spontaneous activities recorded by current clamp are similar to the action potential, which may be the spontaneous action potential due to the exceeding of membrane potential over liminal value.

Objective To develop a portable integral dental unit in the ship to fulfill medical service during canvoy operation.Methods The unit developed was modified based on WD6232-E dental unit,and comprised of a chair and accessories.An earth box and a seat box were under the chair,and a base was at one side of it.The accessories included a level bar,emesis basin,cold light and etc.The digital unit was modified,which involved in a miniature digital dental X-ray machine and a micro computer.Results The dental unit developed could fulfill dental auxiliary diagnosis and treatment similar to them in garrison hospital.Conclusion The unit gains advantages in portability and easy operation and adapts itself to dental service during expedition,and thus is worthy promoting practically.

Objective To assess the clinical efficacy and safety of proton pump inhibitors (PPI)for preventing recurrence of non-steroidal anti-inflammatory drugs (NSAIDs)-indueed upper gastrointestinal ulcers using meta-analysis. Methods Mono- or multicenter randomized controlled clinical trials related to NSAIDs-indueed ulcers were retrieved from database of China Biological Medicine and Medline from 1966 to 2007. The data were analyzed by RevMan 4. 2 software using random or fixed effects model. Results Ten randomized controlled trials including 3361 patients were included, The recta-analysis revealed that PPI treatment significantly reduced the recurrent rate of NSAIDs-associated ulcers (8. 7%) in comparison with controls (17. 2%, P = 0. 03). Those who received esomeprazole (4. 4%) or lansoprazole (18. 0%) had a low recurrence of peptic ulcers compared with controls (14.7% or 28.7%, P value= 0.01 or 0.05). But there was no significant differencebetween omeprazole and controls (P= 0. 16). The recurrence of NSAIDs-associated ulcers in patients treated with esomeprazole 20 mg or 40 mg and tansoprazole 15 mg were 4.4%, 4.3% and 19.7 % respectively. The stratify analysis showed that PPI therapy could effectively reduce recurrentce of non-selective NSAIDs-induced ulcer (P= 0. 009), but failed to selective cyclooxygenase (COX)-2 inhibitor induced ulcer. No severe adverse reactions were found in PPI groups. Conclusion PPI is effective and safe in prevention of NSAIDs-related ulcers without discontinuation of NSAIDs.

Objective To study the clinical efficacy of computer-assisted stereotactic brain transplantation of human retinal pigment epithelium (hRPE) cells into the patients with Parkinson disease (PD). Methods Under the guidance of computed X-ray tomography and magnetic resonance imaging image mergence, 4 × 106 hRPE cells were transplanted into the putamen and ventriculus laterlis of 17 cases of PD by stereotactic surgery. The transplantation sites were contralateral to the side of main symptoms and signs. The curative efficacy were observed at the 7th day, 1st month, and 3rd month after the transplantation. Results The contralateral symptoms were ameliorated continuously after the transplantation. Three months after the surgery, the total effective rate of cell transplantation was 88. 2 %, and 82. 4 % of the cases got significant improvement. The cases that got ipsilateral improvement soon after the surgery gave a total effective rate as high as 88. 2 % at the 3rd month during follow-up period, and 64. 7% among these cases improved significantly. Only a minority of cases had transient dizziness and hemiparesis, but the duration was short. Conclusion The therapy, computer-assisted stereotactic transplantation of hRPE ceils in the treatment of PD, is safe and efficient.