Objective:To enhance the functional safety of medical electrical equipment and reduce the risk to patient when using the medical electrical equipment.Methods: Theory and rationale introduction of functional safety and provide application cases.Results: Introduce the definition and application scope of functional safety standards IEC 61508, the determination of safety integrity level of functional safety in the Medical Electrical equipment, and the design structure and development, meanwhile show some application examples.Conclusion: Provide suggestions for the manufactures for safety design that introduce functional safety standards IEC 61508 to the development process of Medical Electrical equipment will help enhance the safety level of Medical Electrical equipment and reduce the unacceptable risk’s probability to patient.

Valproate (VPA) has long been used for the treatment of bipolar mood disorder. VPA is effective in control of mania and depression. Recent studies have demonstrated that VPA has profound neuroprotective effects in against various apoptotic stimuli. Moreover, VPA can promote neurogenesis, neuronal proliferation and differentiation. Although intensive research has been dedicated to VPA′s neuroprotection, the molecular mechanisms by which VPA protects neurons are still not fully understood. In this paper, recent progresses in the study of VPA′s neuroprotection and underlying mechanism are reviewed.

Objective To discuss the value of three-dimensional (3D) transrectal ultrasound (3DTRUS)in diagnosing prostatic diseases.In this study ,73 patients were examed.Methods 73 patients underwent three-dimensional reconstruction of prostatic ultrasonic echo were performe.At sametime we did 2DTRUS in these 73 patients.We compare these two groups` ultrasonic echo characteristics.Results 3DTRUS can provide more detailed three-dimensional makeup of prostatic lesions when compared with 2DTRUS.Overall informative value 3DTRUS in detection of prostatic lesions was 94.5%,2DTRUS is 83.6%.3DTRUS produced a significantly higher detection rate (P

Objective To investigate the application of hysterosalpingography (HSG)with iopromide in diagnosing female infer-tility.Methods 549 infertile women had performed HSG with iopromide,and X-ray images were analyzed retrospectively.Results Prevalence of uterine hypoplasia in primary infertility was higher in the minority than in the ethnic Han.Tubal obstruction was more common than hydrosalpinx and severe fimbria adhension.92.3% of the infertile women had pelvic inflammation disease.The dose of iopromide could be increased in need.Conclusion Prevalence of uterine hypoplasia is different as ethnic difference.Obstruction is the most common factor in tubal infertility.It is safe to use iopromide in HSG.

Objective To study the effect of liquid extracts from leaves of Canarium pimela Leenh on myo-cardial ischemia-reperfusion injury in rats. Methods The langendorff isolated perfused heart system was applied in this study. Ligating of the left descending anterior for 35 min,followed with 100 min or 50 min reperfusing to set up the cardiac ischemia-reperfusion injury model (I/R). After perfusing the effective pharmacological extracts of leaves of Canarium pimela Leenh(CPL)to the isolated heart,we monitored the cardiac parameters of left ventricu-lar systolic pressure(LVSP),left ventricular end-diastolic pressure(LVEDP)and left ventricular maximal rise/fall of left ventricular pressure(±dp/dtmax)in the following assays with or without 10 min CPL pretreatment. 1. the cardiac parameters,2. the cardiac parameters in 35 min ischemia,followed with 10 min or 50 min reperfusion,3. the incidence of ventricular fibrillation or ventricular tachycardia after 10 min reperfusion,4. the activity of creatine kinase(CK)and lactate dehydrogenase(LDH)in the coronary effluent after 10 min reperfusion,5. pathological analysis in the I/R,CPL and VER group after reperfusion. Results CPL pretreatment improved functions of normal left heart. Furthermore,it significantly reduced LVEDP and +dp/dtmax,the incidence of ventricular fibrillation or ventricular tachycardia,as well as the activities of CK and LDH in coronary effluent induced by ischemia-reperfusion compared with the I/R model. Moreover,CPL pretreatment markedly alleivated the pathological changes of ischemia-reperfusion. Conclusions The liquid extracts of leaves of Canarium pimela Leenh can effectively relieve the myocardial ischemia-reperfusion injury in rats.

Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

Objective To determine the occurrence rate of liver toxicity and related risk factors after receiving highly active an-tiretroviral-therapy(HAART)by the non-nucleoside reverse transcriptase inhibittor.Methods To observe the changes of liver func-tion indexes before and after antiviral therapy in 102 patients receiving HAART,the incidence rates of the liver toxicity were com-pared between nevirapine(NVP)and efavirenz(EFV)and the risk factors of liver toxicity after treatment were analyzed.Results A-mong 102 patients,73 cases accepted the treatment of NVP,the incidence rate of hepatotoxicity was 35.6%,29 cases accepted the treatment of EFV,the incidence rate of hepatotoxicity was 13.8%,the hepatotoxicity incidence rate had statistically significant difference between the two treatment methods(χ2 =4.761,P =0.029).Co-infected by hepatitis C virus(HCV)and baseline ALT el-evation were the independent risk factors of hepatotoxicity occurrence(P <0.05).Conclusion The patients receiving the treatment of NVP are more likely to have hepatotoxicity than the patients receiving the treatment of EFV.Co-infected by HCV and baseline ALT elevation are the independent risk factors of hepatotoxicity occurrence.

Objective To summarize the laboratory, pathologic and imaging characteristics of patients with autoimmune pancreatitis (AIP) retrospectively for early diagnosis and treatment. Methods Eleven AIP patients were selected in our hospital from 2007 to 2009. Laboratory parameters including complete blood count, tumor markers, hemodiastase and autoantibodies were tested. Abdominal ultrasonography and computerized tomography (CT) scanning were also performed. Results Five patients had elevated hemodiastase and liver enzymes, four patients had hyperbilirubinemia and three patients had hyperglobulinemia. Increased serum CA199 levels (mean 78.4 U/ml) were found in six patients. All of the 11 patients had enlarged pancreas on imaging. Four cases were treated with three months of drug therapy. After the treatment, the pancreas volumereturned to normal size, pancreatic duct and bile duct became normal in size. Seven cases received surgical operation. Pathology examination showed fibrous tissue and folliculus lymphaticus formation in the pancreas,with a large number of lymphocytes and plasma cells infiltration. Two of seven cases were diagnosed with Sj(o)gren's syndrome and rheumatoid arthritis after being followed-up for six to twelve months post-operation.Their symptoms relieved after corticosteroid and immunosuppressive therapy. Conclusion AIP is a special type of chronic pancreatitiswith characteristic laboratory, imaging and histological features. Glucocorticoid and immunosuppressive agents therapy are effective for AIP.

Objective To analyze the prognostic factors and causes of death of patients with systemic lupus erythematosus (SLE).Methods A database with 319 patients were developed.They were newly diagnosed SLE in the Department of Rheumatology and Immunology,Affiliated Drum Tower Hospital of Nanjing University Medical School from 1999 to 2009.Normal distribution of measurement data was presented using mean±standard deviation.The skewed distribution of data was described by median(interquartile range).Using the rate or proportions,the character of classification data was also stated.Survival rate of SLE patients over time was studied by the Kaplan-Meier method,and prognostic factors were analyzed by COX proportional hazards model.Results The 5 year and 10-year survival rates was 96.2%, 88.7%, respectively Prognostic factors affecting survival included duration from onset to diagnosis, anemia, white blood cells in urine, low serum albumin,low C4 level,abnormal ECG and ultrasound echocardiography, pulmonary arterial hypertension (PAH) and systemic lupus erythematosus disease activity index (SLEDAI). However, PAH,duration from onset to diagnosis, low serum albumin were the independent poor prognostic factors and the relative risk and 95% confidence interval were 2.419 (1.052-5.564), 1.162 (1.043-1.294), 0.924 (0.873-0.978), respectively. Renal failure, pulmonary hypertension and infection were the main causes of death,followed by multiple organ failure and lupus encephalopathy. Conclusion PAH, duration from onset to diagnosis, low serum albumin are the important factors predicting poor prognosis. Early diagnosis, timely treatment of SLE organ damages and preventing complications are the key factors to improve the prognosis of patients with SLE.

BACKGROUND:Bone marrow stem cells are defined by their multi-potential ability, and can be differentiated into intrinsic cells in the kidney.
OBJECTIVE:To study the effects of mobilizing autologous bone marrow stem cells by granulocyte colony-stimulating factor plus stem cellfactor on cellapoptosis and proliferation of rats with renal ischemia-reperfusion injury.
METHODS:Total y 160 male Sprague-Dawley rats were randomly divided into four groups:control group, model group, cytokine treatment group, cytokine control group. Rat models of unilateral renal ischemia-reperfusion injury were established in the model and cytokine treatment groups. Rats in the cytokine treatment group and cytokine control group received subcutaneous injection of granulocyte colony-stimulating factor (50μg/kg) and stem cellfactor (200μg/kg), once a day, for 5 continuous days. Rats in the model and control groups had no treatment. Apoptotic cells were detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling method, and the expression of CD34-positive cells, Caspase-3, Bcl-2, proliferating cellnuclear antigen in the kidney were measured using immunohistochemistry staining.
RESULTS AND CONCLUSION:The number of CD34-positive cells in renal tissue of the cytokine treatment group was significantly higher than that of the control group and model group (P<0.05). The apoptotic index and expression of Capase-3 in the model group and cytokine treatment group were higher than those in the control group and cytokine control group (P<0.05). The apoptotic index and expression of Capase-3 in the cytokine treatment group were lower than that in the model group (P<0.05). The expression of Bcl-2 in the model group and cytokine treatment group was higher than that in the control group and cytokine control group (P<0.05). The expression of Bcl-2 in the cytokine treatment group was higher than that in the model group (P<0.05);however, as time went on, Bcl-2 expression was obviously decreased. Proliferating cellnuclear antigen expressed both in the model group and in the cytokine treatment group. Additional y, the proliferative index reached peak at 24 days in the model group, and then decreased gradual y;while in the cytokine treatment group, it reached the peak at 10 days, maintained a high level until the 17th day, and then decreased gradual y. Mobilization of autologous bone marrow stem cells by combination of granulocyte colony-stimulating factor and stem cellfactor can increase proliferation and decrease apoptosis of renal tubular epithelial cells after renal ischemia-reperfusion injury, and thus, promote the recovery from renal tubular injury.