Objective:To discuss the performance management method for large medical equipments in hospitals.Methods:13 large medical equipments in a large hospital were selected as samples and the economic efficiency analysis method and comprehensive evaluation method were aaplied to carry out performance management of medical equipment.Results:11 sets of medical equipment had good economic returns,the remaining 2 sets of equipments had a greater degree of loss due to lack of business and lack of qualification.Conclusion:Performance management of large medical equipments would help change the efficiency management of equipment from extensive to elaborate management.

Objective To compare local infiltration anesthesia with different concentrations of ropivacaine for postoperative analgesia in pediatric patients undergoing tonsillectomy.Methods Sixty ASA physical status Ⅰ patients of both sexes,aged 6-12 yr,weighing 18-41 kg,scheduled for elective tonsillectomy,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group C); 0.2％ ropivacaine group (group R1) ; 0.5 ％ ropivacaine group (group R2).Anesthesia was induced with inhalation of sevoflurane,injection of sufentanil and cisatracurium and maintained with inhalation of sevoflurane and iv infusion of remifentanil.The tonsil was locally infiltrated vith 0.2 ％ and 0.5％ ropivacaine (3-5 ml on each side of the tonsil) before surgery in R1 and R2 groups,respectively.Tonsillectomy was performed under general anesthesia.At 1,3,6,12,and 24 h after surgery,pain was assessed using faces pain scale-revised (FPS-R).Paracetamol 5 mg/kg was used as rescue analgesic when FPS-R scores ≥4.The interval between awake extubation and the first request for analgesic,requirement for postoperative analgesic and development of adverse effects were recorded.Results Compared with group C,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R1 and R2 groups (P ＜ 0.05).Compared with group R1,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R2 group (P ＜ 0.05).There was no significant difference in the incidence of adverse effects between the two groups (P ＞ 0.05).Conclusion The optinum concentration of locally infiltrated ropivacaine is 0.5 ％ for postoperative analgesia in pediatric patients undergoing tonsillectomy.

Aim To investigate the effect of intrauterine injection of rat fetal hepatocytes on homograft rejection reaction. Methods The skin graft from a male LOU/CN rat was transplanted to a female recipient CHN rat of 7 to 9 weeks after parturition, and then survival time of the graft was observed. Simultaneously, homograft rejection reaction was examined by mixture lymphocyte culture. Results As compared with control group, survival time of transplanted skin graft was obviously prolonged. Mixure lymphocyte culture demonstrated that homograft rejection reaction was inhibited markedly. Conclusion Intrauterine injection of rat fetal hepatocytes wuld obviously inhibite homograft rejection reaction, thus prolonging survival time of the graft.

Hyoscyamine 6 beta-hydroxylase (H6H) is the last rate-limiting enzyme directly catalyzing the formation of scopolamine in tropane alkaloids (TAs) biosynthesis pathway. It is the primary target gene in the genetic modification of TAs metabolic pathway. Full-length cDNA and gDNA sequences of a novel H6H gene were cloned from Datura arborea (DaH6H, GenBank accession numbers for cDNA and gDNA are KR006981 and KR006983, respectively). Nucleotide sequence analysis reveals an open reading frame of 1375 bp encoding 347 amino acids in the cDNA of DaH6H, while the gDNA of DaH6H contains four exons and three introns, with the highest similarity to the gDNA of H6H from D. stramonium. DaH6H also exhibited the most identity of 90.5% with DsH6H in amino acids and harbored conserved 2-oxoglutarate binding motif and two iron binding motifs. The expression level of DaH6H was highest in the mature leaf, followed by the secondary root, and with no expression in the primary root based on qPCR analysis. Its expression was inhibited by MeJA. DaH6H was expressed in E. coli and a 39 kD recombinant protein was detected in SDS-PAGE. Comparison of the contents of scopolamine and hyoscyamine in various TAs-producing plants revealed that D. arborea was one of the rare scopolamine predominant plants. Cloning of DaH6H gene will allow more research in the molecular regulatory mechanism of TAs biosynthesis in distinct plants and provide a new candidate gene for scopolamine metabolic engineering.

Objective To investigate the effect of hydrogen-rich saline postconditioning on the expression of vascular endothelial growth factor receptor-1 (VEGFR1) during myocardial ischemiareperfusion (I/R) injury in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H2).Myocardial I/R was induced by 30 min ligation of anterior descending branch of the left coronary artery followed by 2 h reperfusion.In group H2,hydrogen-rich saline 5 ml/kg was injected intravenously at 5 min before reperfusion,while the equal volume of normal saline was given in group I/R.Left ventricular systolic pressure (LVSP),left ventricular enddiastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion and at 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion,and myocardial specimens were obtained for determination of myocardial infarct size,contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (using ELISA),and expression of VEGFR1 (by Western blot).At 120 min of reperfusion,blood samples were collected from the common carotid artery to measure cardiac troponin I (cTnI) concentrations in serum.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased,LVEDP was increased,the myocardial infarct size was enlarged,cTnI concentrations in serum and contents of IL-6 and TNF-α were increased,and the expression of VEGFR1 was down-regulated at 120 min of reperfusion in H2 and I/R groups.Compared with group I/R,LVSP and ± dp/dtmax were significantly increased,LVEDP and myocardial infarct size were decreased,cTnI concentrations in serum and contents of IL-6 and TNF-α were decreased,and the expression of VEGFR1 was up-regulated at 120 min of reperfusion in group H2.Conclusion Hydrogen-rich saline postconditioning can reduce myocardial I/R injury possibly by upregulating myocardial VEGFR1 expression and inhibiting inflammatory responses in the myocardium of rats.

Objective To assess the difference between two-dimensional contrast-enhanced ultrasonography ( 2D-CEUS ) and three-dimensional contrast-enhanced ultrasonography ( 3D-CEUS ) in evaluating hepatic arteries in the liver transplantation. Methods Both 2D-CEUS and 3D-CEUS were used to examine 26 liver transplantation donors and recipients. Fifteen patients who were confirmed by CTA or DSA or MRA were analyzed. The image' s quality and diagnostic levels of 2D-CEUS and 3D-CEUS were compared, and the diagnostic information about anatomic features of hepatic arteries provided by the two methods was evaluated. Results 1) The image' s quality of 2D-CEUS and 3D-CEUS were 3. 62 ± 0. 41, 2. 52 ± 0. 93, respectively. The difference between them was statistically significant ( P <0. 05). 2)When evaluating anatomic features ,2D-CEUS and 3D-CEUS had no significant difference in common hepatic artery (CHA) and proper hepatic artery (PHA). But 3D-CEUS was prior to 2D-CEUS in left hepatic artery (LHA) ,right hepatic artery(RHA) and segmental hepatic artery(SHA) ( P <0. 05). 3)Five hepatic artery complications were discovered by CTA or DSA or MRA in 15 patients. In 4 patients (80%) ,both 2D-CEUS and 3D-CEUS made the affirmative diagnoses in accordance with the results. However, 2D-CEUS made a false positive diagnosis and 3D-CEUS corrected it. Conclusions The 3D-CEUS could provide more diagnostic information,could confirm or correct some diagnosis of 2D-CEUS,but,its image's quality is not as good as 2D-CEUS. Therefore,combining the 3D-CEUS with 2D-CEUS has practical clinical value in liver transplantation.

Objective To compare the performances of baseline ultrasound(BUS),contrast-enhanced ultrasound (CEUS) and spiral computed tomography (CT) in characterizing of portal vein thrombosis (PVT).Methods The capability of differentiation of benign and malignant thrombi by using BUS,CEUS and spiral CT scan were assessed in 43 patients with PVT.Results The diagnostic accuracies of benign and malignant PVT were 100％ with CEUS,60.5％ with BUS and 76.7％ with CT,respectively.There were significant difference between every two groups( P ＜0.05).Conclusions CEUS is superior to BUS and CT in distinguishing benign and malignant PVT,thus it is recommended.

Objective To evaluate the clinical value of three-dimensional contrast-enhanced ultrasonography(3D-CEUS) of hepatic arteries in liver transplant candidates.Methods Twenty-six liver transplantation donors and recipients were examined using two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS.The 3D image's qualities, reconstruction successful rates, and the diagnostic level of hepatic artery complications were estimated. Results Twenty-one hepatic arteries were reconstructed successfully (80.8%).The 3D images showed artery trees continuous, spatial relationship definite, fine and circuitous branches distinct, and the segmental hepatic arteries' origin could be recognized.In 4 of 5 hepatic artery complications,both 2D-CEUS and 3D-CEUS made the correct diagnoses.However,2D-CEUS made a false positive diagnosis and 3D-CEUS retrieved it.Conclusions The 3D-CEUS images of the hepatic arteries are direct and distinct.In evaluating hepatic artery complications, when artery spatial relationship is complicated, the 3D-CEUS could provide more information, and confirm or correct some diagnosis of 2D-CEUS.

Objective To evaluate the usefulness of baseline ultrasound(BUS) and contrast-enhanced ultrasound(CEUS) in diagnosis of portal vein(PV) patency and to explore the indication of CEUS. Methods The diagnostic capability of BUS and CEUS were assessed in 64 cases according to definition of PV on BUS,which was divided into high, moderate and low definition. Results Thirty-five patients with portal vein thrombosis(PVT) and 29 patients with normal portal vein were confirmed. The diagnostic accuracies by using BUS and CEUS were 93.1% and 96.6% with high definition of PV,56.3% and 87.5% with moderate definition,and 68.4% and 89. 5% with low definition, respectively. Conclusions In the case of high definition of PV,the validity of diagnosing of PV patency with BUS may be similar to that with CEUS,thus introduction of CEUS would probably not be necessary. Otherwise CEUS is recommended.

s parameters of CEUS between ITBL group and control groups reflect the characterization of flow perfusion in ITBL, which can provide the objective evidence in the diagnosis of ITBL.