Objective:To standardize the process of abandonment management of large medical equipment in hospital, and to achieve the reasonable reuse after large medical equipment were abandoned.Methods: To discuss the conditions, process and reuse assessment when large medical equipments were abandoned, and the concrete operation methods about the abandonment disposition and reused process of large medical equipments.Results:This research has achieved safety and efficient abandonment for large medical equipments under ensuring maximizing benefits of economic efficient.Conclusion: This method reduces the cost of medical device in hospital and create higher social benefits under ensuring maximizing benefits of economic efficiency by standardizing abandonment process and reuse assessment and the safety application for large medical equipment.

Objective To investigate the diagnostic value and clinical significance of phosphorylated signal transducer and activa-tor of transcription 3(pSTAT3)in malignant pleural effusion(MPE)caused by lung adenocarcinoma.Methods 47 pleural effusion samples were collected and detected by using liquid-based cytologic test (LCT).Furthermore,the expression of pSTAT3 was detec-ted by using the method of immunocytochemistry in all of the specimens.Results Among the 47 cases of pleural effusion,40 cases of MPE were caused by lung adenocarcinoma and 7 cases were benign pleural effusion,which were confirmed by clinical manifesta-tion,biopsy and imaging data.The positive expression rate of pSTAT3 was 80.0%(32/40)in MPE caused by lung adenocarcino-ma,significantly higher than benign group(P <0.05).13 cases of MPE caused by lung adenocarcinoma and 7 cases of benign pleural effusion were diagnosed with liquid-based cytologic test alone.The other 27 cases were undetermined and needed to be differentiate between adenocarcinoma and atypical mesothelial cells.However,32 cases of lung adenocarcinoma and 7 cases could be clearly diag-nosed if liquid-based cytologic test was used combined with immunocytochemistry detection of pSTAT3 expression.Only 8 cases were undetermined.Diagnosis of grey area was significantly narrowed.There was significant statistical significance between the two methods(P <0.05).Conclusion High expression of pSTAT3 is related to the MPE caused by lung adenocarcinoma.Detection of pSTAT3 expression can be used as a new method in the diagnosis of MPE caused by lung adenocarcinoma.pSTAT3 may play an important role in the development of the MPE.

While the basic concept of saving life and decreasing disability h as not changed in the management of polytrauma, the timing and strategies of tre atment have been gradually modified. Damage control is one of the new strategies , and its application in orthopedic traumatology is known as damage control orth opedics. Damage control orthopedics involves formalized three stages in the mana gement of fractures of long bones and pelvis. Stage 1 consists of temporary fixa tion of the unstable fractures and hemostasis. Stage 2 comprises resuscitation, warming, oxygen delivery and administration of coagulation factors to the patien t in the intensive care unit. In Stage 3 definitive fixation is done for the fra cture. Indications of damage control orthopedics: for patients with polytrauma w hose conditions are unstable or in extremis the damage control strategy is recom mended. For the borderline patients early total care may be applied, but the sur gery should be performed with great caution. It has to be converted to the damag e control strategy if conditions of the patient deteriorate during the operation . Since damage control orthopedics is an evolving practice, further work is need ed to enhance its effectiveness and to reduce the incidence of ARDS and MOF.

Modern Chinese Orthopaedic traumatology has stemmed from the orthopaed ics of Traditional Chinese Medicine(TMC)and western orthopaedics.On the one hand,with a long history and its unique system of theory and treatment,TMC orthopaedics h as made a great con-tribution to the development of modern Chinese orthopaedic traumatology.On the other hand,the introduction and development of western medicine have dramatically pro moted the development of modern Chinese orthopaedic traumatology.Modern Chinese surgeons of orthopaedic trauma have accomplished numerous successful f irst cases in the world since 1950s an d have thus expanded their professional influence.At pr esent,the Chinese orthopaedic trau ma community has grown much stronger and established its ow n academic associations and journals.More and more de-partments of orthopaedic traumatology have been successively establis hed as an independent en-tity in large and middle-sized hospi tals in China.So far,the Chinese orthopaedic trauma com-munity,on the whole,has reached the international level,but there are q uite a lot to be improved in the aspect of treatment.To end the backwardness,in the future Chinese orthopaedic trauma community should make great efforts in education of orthopedists on comp rehensive knowledge,establishment of formal profession al training system,national standardization of orthopaedic procedures in clinical diagnosis an d treatment,active membership of re lative international aca-demic associations and increasing p rofessional exchanges with international counterparts,as well as in research and development of operative techniques and fixators.All these will be the main strategies and developmental trends in the future for Chinese orthopaed ic traumatology. [

Objective To investigate the related risk factors for stroke among residents aged over 26 years old in communities in Chongqing,to set up a quantitative criteria for determining risk for stroke,and to evaluate and predict the risk of the stroke for individuals.Methods 1 034 cases with 1:2 matched controls were chosen from five communities in Chongqing,which were interviewed with a uniform questionnaire.The risk factors of stroke were analyzed with Logistic regression,collected the odds ratios of risk factors for stroke,and different levels of risk exposure factors be converted into a risk scores by using statistical models.The related risk scores were added to obtain a combined risk score to predict the individual's risk of stoke in the future.Results An individual health risk appraisal model of stroke applicable to individuals of different sex,age,health behavior,disease and family history was established.For men,11 risk factors,including hypertension(5.728),coronary heart disease(5.404),family history of stroke(4.599),and so on,were entered the main effect model;for women,hypertension(5.270),family history of stroke(4.866),hyperlipidemia(4.346),and other eight risk factors entered the main effect model.Conclusion Personal diseases,including hypertension,CHD and hyperlipidemia,etc.,are very important risk factors for stoke.The stroke prevalence can be effectively reduced by changing the unhealthy lifestyle and curing the related individual diseases.The evaluation model of the risk score for stroke based on the main risk factors could be useful in the future health education and community health service on stroke prevention.

Objective To improve the protective strategy of occupational risks for technicians in blood centers so as to ensure their health and safety.Methods The occupational risk factors were analyzed by the 5W1H method,and the corresponding protective measures were introduced.Then,the protective measures were verified dynamically by the PDCA circulation,and were standardized and further spread.The projects with poor effect were replanned and entered the PDCA recycling.Results The system of the 5W1H method combined with PDCA circulation could identify and control various occupational risks,and effectively prevent the occupational detriments.Condusion Combined application of the 5W1H method with PDCA circulation is an effective way to protect the health and safety of technicians in blood centers and an effective mode to improve the management of occupational risks.

Objective To explore the role of miRNA-148a in bladder tumorous development and progression.Methods Ex-pression of miRNA-148a was assessed in 35 bladder carcinoma tissues and 16 non-carcinoma tissues by fluorescence quanti-tative real time PCR,and correlation with clinical features was evaluated.Target genes and transcription factors of miRNA-148a were predicted using bioinformatic analysis,then TF-miRNA-148a-target genes network diagram was built and the tar-get genes was analyzed of gene ontology enrichment and KEGG pathway.Results Expression of miRNA-148a was lower in bladder carcinoma tissues than in non-carcinoma tissues(0.000 8±0.000 2 vs 0.002 1±0.000 5)(t=2.46,P <0.05),but its expression was no statistical significance in different groups of gender,age,pathological classification,clinical stage, lymph node metastasis (P >0.05).268 target genes of miRNA-148a were predicted by three softwares at the same time,60 transcription factors were predicted and the binding sites with combination scroes above 80 was 657.The target genes of miRNA-148a was enriched in many biological processes,such as neuron differentiation,generation of neurons,neuron projec-tion development,cytoplasmic mRNA processing body,cytoplasm(P <0.001).They also participated in p53 signaling path-way,proteoglycans in cancer-homo sapiens,pathways in cancer,prostate cancer,protein processing in endoplasmic reticulum, focal adhesion and so on(P <0.05).According to TF-miRNA-148a-target genes network diagram,miRNA-148a was regula-ted by SP1,ESR1,AP1,MYC and BRCA1,genes of IGF1,P27kip1 ,NCOA1,PTEN,SERPINE1 might be regulated by miR-NA-148a.Conclusion miRNA-148a which was significantly down-regulation in bladder carcinoma tissues may be participate in bladder tumorous development and progression,bioinformatics analysis provides some ideas for further research.

Objective: To investigate the mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on acute myocardial ischemia (AMI). Methods: Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan (PC 6). The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gene expression was detected with reverse transcription polymerase chain reaction(RT-PCR) method. Results: The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group(P＜ 0.05), after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased,there was a significant difference (P＜ 0.05). Conclusion: The mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

Objective To investigate the epidemiology of spinal cord injuries (SCI) in hospital. Methods 423 patients with SCI were reviewed. esults The ratio of male to female was 15.3∶ 1, aged (40±11) years. The coal mine-related staff was the most (61.7%), mainly aused from coal blocks dropping (53.26%). 135 cases (31.91%) injured in cervical vertebra, and 187 cases (44.21%) in lumbar. There were 92 (45.39%) cases were complete injury. The most frequent complication of SCI were urinary tract infection, pressure sore and pulmonary nfection. The factors correlated with the complication were the degree of ASIA Impairment Scale, the period of admitted to hospital after injury, nd the surgery (P<0.05). The expenditure of hospitalization was mainly provided by oneself (73%). Conclusion It is important to improve he occupation prevention, enlarge the coverage of medical insurance, and promote pre-hospital care to prevent SCI.

Objective To discuss how to assess scientifically on the outcome of clinical application with peripheral nerve graft materials. Methods All Pubmed database from 1990 to 2010 were retrieved,and searched the English literatures about the application with peripheral nerve graft materials. The literatures consisted of original clinical research and review excluding animal experiments, repetitive research and irrelevant literatures. The clinical trials data of U.S. was also our target. The information about the safety and effectiveness of peripheral nerve graft materials and related statistical problems were discussed. Results Totally 1578 literatures were identified. Following reading titles and abstracts, we excluded some irrelevant articles. Finally 31 literatures and 2 issue of clinical research from clinical trial data of U.S. were included. After analysis on the literatures, we gained the following results: a remarkable degree of homogeneity among patients can be formed by setting the inclusion and exclusion criteria. For the assessment of proper digital nerve repair, Macknnon- Dellon evaluation is commonly applied, but for the composite nerve, BMRC evaluation is the main method and electromyography can be used as a secondary choice. The safety of peripheral nerve graft materials cannot be evaluated throughout one's life according to the current level of science and technology. It should be evaluated by long-term clinical observation. Randomized clinical trials with random grouping was a gold standard for clinical trials with a good balance and strong comparability. However, non-randomized controlled trials also have an important value. Conclusion It is impossible to make all affected factors homogeneity in a limited timespace conditions of clinical trial. However, we can try our best to keep factors homogeneity to maximum degree by setting the inclusion and exclusion criteria. The scientific assessment of outcome of peripheral nerve repair can be carried out with reasonable and internationally recognized nerve function evaluation methods, strict follow-up time and statistics programme meeting the clinical requirement.