This article analyses and summarizes the clinical maintenance work of Elekta Precise Linac in five years.Afer the further research on its performances and errors,a better way is found to solve the main problem of clinical electronic linac,i.e.the way to reduce the Stop Rate of Linac in Radiotherapy.

Disaster Medicine ; Earthquakes ; Emergency Medicine ; General Surgery ; Humans ; Relief Work ; Wounds and Injuries ; surgery

Objective To investigate the effects of batroxobin on blood coagulation and fibrinolytic function of patients with sud-den deafness .Methods 87 patients with sudden deafness were enrolled .Their prothrombin time(PT ) ,activated partial thrombo-plastin time(APTT) ,thrombin time(TT) ,fibrinogen(Fib) ,D-dimer and fibrin/fibrinogen degradation products(FDP) were detec-ted before batroxobin treatment and 3 ,6 days after treatment .Results Compared with pre-treatment ,patients after treatment expe-rienced prolonged PT and TT (P<0 .05) ,decreased Fib(P<0 .01) ,increased FDP (P<0 .01) ,and the difference of APTT ,D-di-mer between treatment before and after showed no statistically significant (P>0 .05) .Conclusion PT ,TT ,Fib ,FDP can be applied to monitor the coagulation and fibrinolytic function of patients with sudden deafness treated with batroxobin .

Objective To explore the effects of vecuronium bromide within 24 hours in severe bronchial asthma with acute attack with breathing machine in conventional sedatio.Methods Prospective study,double-blind randomized standard control,where 46 cases of patients of severe bronchial asthma with acute attack transferred to ICU using breathing machine in this year were randomly divided into the vecuronium bromide group (muscle relaxant group) and conventional sedation group (normal group) according to medical record number; Two groups of sample compositions were compared by x test,using two independent samples of t test to compare the effects the treatment and prognosis.Results After mechanical ventilation for 15min and 1-3h in muscle relaxant group,patients' vital signs were statistically analyzed,including respiration; Blood gas analysis parameters were as follows:pH,PaO2,PaCO2,SpO2 of these were improved compared with those in the conventional group (P ＜ 0.05) with statistically significant differences;Compared with the conventional group,in the muscle relaxant group,the retention time in ICU (146.20 ± 17.92) hours,(214.15 ± 22.21) hours,the using time of breathing machine (125.93 ± 16.23) hours,(192.89 ± 22.60) hours,and the dosage of glucocorticoid (2.61 ± 0.17) mg · kg-1 · d-1,(3.55 ± 0.26) mg · kg-1 · d-1,anticholinergic agent(6.25 ±0.51) μg · kg-1 · d-1,(10.64 ±0.75) μg · kg-1 · d-1 and β2 adrenergic receptor agonist (0.06 ±0.01)mg · kg-1 · d-1,(0.15 ±0.04)mg · kg-1 · d-1 were all reduced (all P ＜0.05) with statistically significant differences;The patients were smoothly transferred out of ICU,without the adverse events of mechanical ventilation and cardiovascular diseases.Conclusion The use of vecuronium bromide made the patients with severe bronchial asthma in routine sedation use of breathing machine rapidly correct the clinical symptoms and improve the off-period prognosis.

The importance of course arrangement and standardization construction for the course of hyperbaric oxygenation medicine was expounded in this review.In addition,the measures and experiences on textbook choosing,teaching content assignment,teaching methods designing,assessment means innovation and teaching personnel training were also discussed.The teaching system of the course of hyperbaric oxygenation medicine can be improved and references for thc dcvelopment of clinical hyperbaric oxygenation medicine courses can be provided through these measures.

Aim to explore an assay for the early diagnosis of Toxoplasma infection. Methods Free streptavidin was used to attach a biotinylated DNA to the biotinylated second antibody, through amplication of the DNA label, antigen which bound with antibodies was detected, thus Toxoplasma circulating antigens Immuno-PCR assay was estabished. detecting the CAg in serial dilutions of serum and the dynamic variation of serum CAg of Toxoplasma in experimental infected mice using Immuno-PCR and ELISA parallely to compare the sensitivity Result The detection limit of the immuno-PCR was at about 1/1000 dilution, it was at 1/5 dilution for ELISA. CAg of Toxoplasma could be detected as early as the third day after infection using Immuno - pcr, Wheareas the ELISA on the same samples, revealed no detectable CAg elevations until fifth day after infection. Conclusion In comparison with CAgdetecting by ELISA parallelly performed, this method is more sensitive than ELISA, The detection limit of the immuno-PCR was an 200 fold improvement compared with a conventional ELISA. the positive result could be detected earlier than that of ELISA,It provide scientific basis for early diagnosis of Toxoplasmosis.

Metabolic surgery for obesity and type 2 diabetes mellitus has been received more and more attention in the world.After the development for more than 10 years,metabolic surgery has been widely carried out in China.With the development and progress of the new field of surgery,many related problems have emerged.Besides absorbing foreign experiences,our own practical experience should be also gradually formed according to the patients,condition and the situation of the development of the discipline in China.Therefore,related questions were explored in this article,in order to promote the healthy development of metabolic surgery in China.

Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

In the recent years,the earthquake occured frequently in the whole world which caused the increased incidence of crush syndrome (CS). The four limbs and torso will be bleeding and swelling when they are prounded and crushed from the heavy objects. The necrosis of muscular tissue causes massive production of toxin which leads to a series of symptoms including hypotension ,kidney dysfunction and so on. The serious acute kidney injury (AKI) will be vital. When CS-AKI ,the ascending velocity of urea nitrogen and K+ levels in the blood is quicker than those of general AKI;many kinds of immune cells are activated to engender a great deal of inflammatory mediators;the blood dynamics is often unstable. Therefore, it is advocated that the blood purification treatment should be carried early to eliminate excessive metabolic produces in vivo,to reduce the cardiovascular complication occurrence, and to avoid the irreversible change of the kidney function.

Pancreatic cancer has a strong ability of invasive and metastasis,and the mechanism is still not completely clear.It has been demonstrated that aberrant expression of microRNAs(miRNA) is closely associated with the occurrence,development and metastasis of pancreatic cancer.The reveal of miRNA mechanism related to the metastasis of pancreatic cancer would provide a new approach to the treatment of pancreatic cancer.