Adopting the comprehensive fuzzy judgment method,multi-attribute decision-making model of maintenance scheme is achieved based on the principle of maximum subordinate,so as to solve the uncertainness and fuzziness affections of RCM logical decision during the decision-making of maintenance method. Finally,the practical maintenance of high voltage generator illustrates that the model is useful in supplying the effective instruction to the optimal maintenance scheme in practice.

OBJECTIVE To investigate the susceptible factors and pathogenic bacteria in severe hepatitis and hepatocirrhosis cases infected by complex bacteria.METHODS We reviewed the severe hepatitis and hepatocirrhosis cases admitted to our hospital during 2004-2007,who infected by complex bacteria,to investigate the risk factors and pathogenic bacteria.RESULTS In 216 cases of severe hepatitis and hepatocirrhosis,27 cases were infected by complex bacteria(12.5%).After testing in 66 strains of bacteria,there were 22 strains of Gram-negative bacteria(33.3%),10 strains of Gram-positive bacteria(15.2%),and 34 strains of fungi(51.5%),most of the cases were at terminal stage,with long-term hospitalization,with different underlying diseases,repeated use of broad-spectrum antibiotic and hormone,and invasive operations.All of the factors might induce the complex bacteria infections.CONCLUSIONS The complex bacteria infections in the severe hepatitis and hepatocirrhosis cases are critical and difficult to cure.The underlying diseases should be treated actively;the detection of pathogenic bacteria and drug sensitive test should be carried out;the strict measurement of disinfection and isolation are strongly suggestedto decrease the rate of infection of bacteria and prevent the hazards.

Objective To evaluate the effect of management by objective implementation in neurology department nurse training.Methods Divided the nursing students into the experimental group and the control group according to their student ID,there were 100cases in each group.Routine training was used in the control group,while the training based-on management by objective was used in the experimental group.Compared the intervention effects between the two groups.Results The scores of theory,skills and the comprehensive performance in the experimental group was significant higher than that of in the control group respectively,P＜0.01.The excellent rate of theory and skills in the experimental group was 57.95％ (2 434/4 200) and 49.74％ (1 691/4 200),which was significant higher than those of in the control group [28.62％ (1 202/3 400) and 21.91％ (745/3 400)],P＜0.01.The intervention measures had increased the theoretical scores 21.011 times,OR=21.011,95％CI 9.752-45.269,increased the skills scores 14.625 times,OR=14.625,95％ CI7.032-30.416,increased the comprehensive performance 23.993 times,OR=23.993,95％CI1.085-51.934.Conclusion The implementation of management by objective on nurse training can improve the trainee's theory and professional knowledge,the nursing skill can be improved also.So the comprehensive training effect is higher than before.

As an important part of the health service security system,military medical equipment has important strategic position in wartime.Under the condition of high technology,the modern warfare has also laid higher requirement to the reliability guarantee of medical equipment.With the modernization development of military equipment,traditional medical equipment maintenance management mode does not meet the requirements of modern military medical equipment and its maintenance.Therefore,based on the reliability guarantee theory,the "Reliability Centered Maintenance(RCM)" management mode for military medical equipment is studied in order to achieve the purpose of improving the equipment reliability and the integrity of combat readiness.

Objective To discuss the surgical outcomes of atrial septal defects(ASD) by closing the ostium secundum via small chest incision.MethodsTotally 41 cases with ASD were treated by occlusion via a small incision(3-4 cm) at the right anterior chest.After cutting the pericardium,the right atrial was sutured with double ring and a special occluding device was inserted to close the ostium.Afterwards,under the guidance of transthoracical or transesophageal echocardiography,the satisfiable position for the occluder was confirmed by repeated testing with the protect string.After that,the right atrial and the occluder were sutured by a needle thread for fixation.ResultsOf the patients,the procedure was successfully completed in 39 cases.The mean operation time was 45 to 95 minutes(mean,60 minutes).The patients were discharged from our hospital in 3 to 6 days.No dislocation of the device or atrial shut was found in 2 to 24 months after the operation.Two patients were converted to open surgery because of failure in the occlusion.ConclusionOcclusion via small chest incision is safe,minimally invasive,and convenient procedure for ASD.

Objective To investigate the effects of pulsed electromagnetic fields (PEMF) on osteogenic differentiation in demineralized bone matrix (DBM)-induced human marrow stromal cells (hMSCs).Methods hMSCs were obtained from iliac crest marrow aspirates of a healthy boy aged 14.Then 1?104 hMSCs per well were plated in 8 24-well tissue culture plates,and 1?105 hMSCs per well in 2 6-well plates after they were expanded until passage 2.Those 24-well plates and 6-well plates were divided into 4 groups,cell control group (C group),cell-material group (CD group),cell-PEMF group (CP group) and cell-material-PEMF group (CDP group).CD group and CDP group were added with one DBM (size of 5 mm?5 mm?3 mm),CP and CDP groups were exposed to the PEMF (frequency of 15 Hz,intensity of 5 Gs),and hMSCs were cultivated in subculture medium with full media exchange in every 3 d.Alkaline phosphatase (ALP) activity and osteocalcin (OC) level were performed at 1,7,14 and 21 d,and alizarin red staining and counting of calcium nodules were performed at 21 d.Results Significant differences in ALP activity and OC level were observed between cell control group and the other 3 groups in 7 d after treatment (P

Objective To assess the human β-defensin-2 ( hBD2 ) gene therapeutic efficacy in a rat urinary tract infection (UTI) model via intravesical liposome-mediated gene transfer.Methods Fifty-six female Wistar rats (class SPF) weighting 1 80 -220 were randomly divided into an experiment group and a control group ( each n =28 ).The animals were administered either 250 μl recombinant pCAGG-hBD2 or control vector pCAGG intravesically.After 48 h,rats in both groups were infected via intravesical inoculation with 200 μl of the bacterial suspension of UTI89 ( 1 × 108 CFU/ml).The rats were sacrificed at 4,24,48,and 72 h post-inoculation.The bladders were aseptically removed and bisected.One half was fixed in neutral buffered formalin for histological analysis.The remaining half-bladders were homogenized and titered for surviving bacteria.The clean-catch urine sample from each rat was collected in sterile before they were killed for bacterial titers determined and WBC counted.Results Numbers of bacterial colony-forming unit in urine and bladders from hBD2 gene treated UTI rats were significantly lower than those from the control vector administered UTI rats at 24,36,and 72 h after infection ( P ＜ 0.05 ).The amount of WBC in urine was significantly less in the defensin group than in the control group.In addition,in vivo expression of hBD2 could reduce mucosa damage,interstitium edema and inflammatory cells infiltration in UTI animals.Conclusions The successful inhibition of UTI progression could be obtained with hBD2 gene therapy.Recombinant beta-defensin-2 could kill UTI89 in vivo and suppress the subsequent infection-induced inflammatory responses.

winter. The dominant species of algae were Microcystis aeruginosa, Anabaena spiroides and Spirulina . The annual average contents of total nitrogen, total phosphorus and chlorophyl-a were 4. 30 mg/ L, 0.09 mg/ L and 0.015 mg/ L respectively, all of which exceeded the related temporary standards in China. Conclusion The source water of Chaohu Lake had been in the state of serious eutrophication.

Objective To explore the toxicity of algae in water of Chaohu Lake and its influence on the quality of drinking water.Methods In1999,the water samples were collected from the sampling location of A point as a discarded water source for Chaohu Water Plant 1.5km far from the lakeside of Chaohu Lake and the sampling location of B point as a water source in use for Chaohu Water Plant 3.0km far from the lakeside of Chaohu Lake.The species and count of algae in these water samples were analyzed.The determination of micro cystin,sanitary indexes of water quality,Ames test,micronucleus test and SCGE test were carried out in the water samples from B point and the finished water from water plants using water source for B point.Re -sults83species of algae belong to8phylum and49genus were found in water samples from A point and B point in Chao hu Lake.The anual averages of algae count in water sample of B point (8205.67?10 4 /L)exceeded16.8%of that of A point water samples(7024.27?10 4 /L).Microcystin was found in12water samples among total16water samples collected from the lake water,two of which revealed excessive content s of microcystin exceeding standard,but it was not found in raw water and finished water samples from five plants in Hefei and Chaohu Lake[except the4th water plant (4th WP )].After transportation and stor-age,the raw water of4th WP of Hefei with lower content s of microcystin revealed higher contents of microcystin exceeding the standard in primary finished water samples of clean-well finished water storage,but it couldnt be found in secondary finished water samples with the processes of coagulation,ch lorination and active carbon-filtration.The total nitrogen and other6indexes of raw water of4th WP exceeded the related standards ruled by GB3838-2002Surface Water Environment Standard Grade V in different degree,but above6water quality indexes could reach the related sanitary standard after water treatment.Ames test and micronucleus test indicated that the raw water of4th WP presented suspectable mutagenicities which couldnt be removed by co-agulation and chlorination.SCEG test also showed that the organic extracts of the raw water of4th WP presented DNA damage effects.Con clusion The water source in use in Chaohu Lake revealed heavier pollution by algae compared with the original discarded water source in Chaohu Lake.Chaohu Lake water and its finished water revealed higher levels of microcystin exceed-ing the standard and the organic extracts from raw water and finished water presented suspectable mutagenicity.