Objective:Through the application of remote diagnosis system in medical equipment operation maintenance analysis, clarify the significance of the remote diagnosis technology.Methods:Combined with the actual case, from the breakdown maintenance, preventive maintenance, online training, and other aspects to explore remote diagnosis technology in the medical equipment application and expand operations.Results:Using the remote diagnosis technology can reduce the failure rate, monitor system operation state and environment parameter, improve the efficiency of management of medical equipment.Conclusion: remote diagnosis technology make full use of the manufacturers of professional and technical resources, early detection equipment problems, provide prospective judgment, ensure the equipment running in the best condition.

Objective:In view of the different kind of equipment to develop proprietary standardization of medical equipment preventive maintenance template, and make a quantitative evaluation of effects.Methods: Set up the experimental group and control group, compare maintenance data and parameters of the quality control.Results: According to the standardization of the preventive maintenance of patient monitor template, maintenance data improved, quality indicators improved significantly.Conclusion: The establishment of the standardization of medical equipment preventive maintenance template, can improve the rate of running machines, security equipment in the best state operation, reduce the equipment failure risk, ensure the safety of the use of the equipment.

Objective To investigate the pathogenesis of hepatorenal syndrome(HRS),especially the role of the vasoconstrictor that and vasodilator that played in the process.Methods The patients were divided into two groups for observation:The patients of chronic hepatitis with HRS were observational group,the patients of chronic hepatitis without hepatorenal syndrome were control group.Immunoenzyme technique was used for detecting the quantity of renin、atrial natruretic polypeptide、nitric oxide and endothelin in blood and ascites of all patients in two groups respectively.Then we compared the data of the two groups.Results Compared with those of the control group,rennin and endothelin in blood and ascites of the observational group increased significantly(P

ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Objective To investigate the clinical effects and related complications of surgical and endovascular treatments of paraclinoid aneurysms. Methods Seventy-two consecutive patients with paraclinoid aneurysm admitted to the Department of Neurosurgery, the First Affiliated Hospital of Soochow University were enrolled retrospectively. They were confirmed by head and neck CT angiography and DSA examination,including 45 females and 27 males. According to the different treatment modalities, 72 patients were divided into endovascular embolization group ( n=38,stent-assisted coil embolization) and microsurgery group (n=34,including aneurysm clipping or intracranial and extracranial vascular bypass plus trapping of aneurysms). The baseline data and aneurysm diameter of both groups were recorded and analyzed. Baseline data included age,sex,cranial nerve injury,Hunt-Hess grade,etc. The new cranial nerve injury,aneurysm recurrence and Glasgow outcome scale ( GOS) scores were compared between the two groups,and the size of recurrent and non-recurrent aneurysms were analyzed. The age, aneurysm diameter,and prognostic score were compared in patients with Hunt-Hess grade Ⅲ-Ⅳ in both groups. Results (1 ) The age of patients in the endovascular embolization group was older than that in the microsurgery group (60 ±10 years vs. 54 ± 10 years,t= -2. 490),the diameter of aneurysms was smaller than that of microsurgery group (5[4,8] mm vs. 9[5,16] mm,Z=3. 026). There were significant differences between the two groups ( all P <0. 05 ) . There were no significant differences in gender, incidence of visual impairment and Hunt-Hess grading between the two groups (all P >0. 05). (2) The patients of both groups were followed up for 6 months. There were no significant differences in GOS score, improvement of postoperative visual acuity,and immediate visual impairment after surgery ( all P>0. 05). The recurrence rate of aneurysms in the endovascular embolization group was higher than that in the microsurgery group. The difference was statistically significant between the two groups (18. 4%[7/38] vs. 2. 9%[1/34], χ2=4. 350,P<0. 05). (3) In the endovascular embolization group, the diameter of aneurysm in recurrent patients was larger than that in non-recurrent patients,and the difference was statistically significant between the two groups (10[8,15] mm vs. 5[3,7] mm,Z = -2. 356, P<0. 05). (4) For aneurysm patients with Hunt-Hess grade Ⅲ-Ⅳ, the GOS score of the endovascular embolization group was lower than that of the microsurgery group,and the difference was statistically significant (4[3,4] vs. 5[4,5],Z= -2. 282,P<0. 05]. Conclusion For paraclinoid aneurysms,the recurrence rate of aneurysms with microsurgical treatment is lower than that of endovascular embolization,and is beneficial to the prognosis of patients with Hunt-Hess grade Ⅲ-Ⅳ.

ObjectiveTo investigate the effect of Wudan pill on the polarization of macrophages in the rat model of endometriosis （EMT） with cold congeal and blood stasis syndrome based on p38 mitogen-activated protein kinases （p38 MAPK）. MethodFemale SD rats with regular motility cycles were selected and randomly divided into sham-operated group， model group， Wudan pill high， medium， and low-dose groups （2.4， 1.2， and 0.6 g⋅kg^-1）， Chinese patent medicine group， and western medicine group by the random number table method. The method of ice water bath + autologous endometrial transplantation was used to establish the rat model of EMT with cold congeal and blood stasis， and the rats were executed after 4 weeks of continuous drug administration to collect materials. Expression levels of serum tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-4， and transforming growth factor-β （TGF-β） were determined by enzyme-linked immunosorbent assay （ELISA） to assess inflammation. The real-time quantitative polymerase chain reaction （Real-time PCR） was performed to determine the inducible nitric oxide synthase （iNOS）， TNF-α， arginase 1 （Arg1）， and human mannose receptor （CD206） transcriptional levels to evaluate macrophage polarization. Western blot （WB） and immunofluorescence （IF） assays were used to determine the protein expression levels of iNOS and Arg1 to corroborate macrophage polarization. WB and Real-time PCR were used to determine the protein expression levels of the p38 MAPK pathway. ResultAs compared with sham-operated group， the levels of serum TNF-α， IL-1β， TGF-β， and IL-4 of rats in the model group were significantly higher （P<0.05）. In the model group， the protein levels of iNOS， TNF-α， p-p38 MAPK， and phosphorylated-extracellular signal-regulated kinase （p-ERK） in endothelial tissues were significantly higher， the mRNA levels of iNOS， TNF-α， MAPK， and ERK were significantly higher， and the mRNA and protein expression levels of Arg1 and CD206 were significantly lower （P<0.05， P<0.01）. The number of iNOS positive cells in endothelial tissues was significantly increased， and the number of Arg1 positive cells in endothelial tissues in the model group was significantly decreased （P<0.05， P<0.01）. As compared with the model group， the expression of TNF-α， IL-1β， TGF-β， and IL-4 in each administration group was reduced to different degrees， which was especially significant in the Wudan pill high and medium-dose groups and the western medicine group （P<0.05）. The protein expression levels of iNOS， TNF-α， p-p38 MAPK， and p-ERK in endometrial tissues of rats in the Wudan pill high and medium-dose groups， the Chinese patent medicine group， and the western medicine group were significantly lower， the mRNA expression levels of iNOS， TNF-α， MAPK， and ERK were significantly lower， and the protein expression levels of Arg1 and CD206 were significantly higher （P<0.05， P<0.01）. The number of iNOS positive cells in endometrial tissues of rats was significantly decreased in the Wudan pill high and medium-dose groups， the Chinese patent medicine group， and the western medicine group， whereas the number of Arg1 positive cells was increased （P<0.05， P<0.01）. The low， medium， and high doses of Wudan pill were dose-dependent， and the efficacy of the Wudan pill high-dose group was similar to that of the western medicine group. ConclusionWudan pill reduces the inflammatory response in rat model of EMT with cold congeal and blood stasis syndrome and decreases expression levels of TNF-α， IL-1β， IL-4， and TGF-β， thereby prompting polarization of macrophages from M1 to M2 type. The mechanism is presumedly related to p38 MAPK signaling pathway.