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 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.

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.

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.

Folic acid supplementation is one of the most important measures to prevent neural tube defects(NTDs)among child-bearing age women.This article reviews the NTDs prevention efficacy of the studies including field intervention trials,population folic acid supplementation and fortification in different countries,and analyzes the efficacy variation and their influencing factors of the related studies.The results of the article may provide references for folic acid supplementation,fortification and its efficacy evaluation in the population.

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 evaluate CT in the diagnosis of small bowel obstruction in children. Methods Thirty one cases with small bowel obstruction manifestations on CT and plain radiograph were analysed. The age ranged from 9 months to 14 years, male 17 cases, female 14 cases. There were 29 acute small bowel obstructions, and 2 chronic obstruction. Seven cases had history of previous abdominal operation. Results Corred diagnosis was made in 19 cases and 29 cases respectively by plain film and CT. The accurate etiologic diagnosis could be made by CT in 18 cases, including small bowell stone 4 cases, intussusception, 5 localized infection and adhesion 6 intraluminal bowel duplication, 1 congenital umbilical hernia, congenital malrotation of the intestine 1 case.Combined with history of abdominal operation the accurate CT etiologic diagnosis increased to 25 cases.There were 4 CT false negative cases and 2 plain film false negative cases. Conclusion The CT is obviously superior to plain radiograph in detecting strangulation and gas in bowel wall,better dilineating the transitional segment of bowel stenosis thereby demonstrating the case of obstruction which is very helpful for clinical management.

Objective To investigate the distribution and the rate of drug sensitivity of dysenteric bacilli in Beijing from 2003 to 2004 so as to guide the choice of antibacterial. Methods This was a retrospective study. 254 shigellae were cultured from stool. The group and serotype were identified with biochemical and serologic tests. Kirby-Bauer method was used to detect the drug sensitivity rate. Results There were 196 strains of Shigellae flexneri and 58 Shigellae sonnei a-mong 254 strains of shigellae. The number of F4 was 106 strains in Shigellae flexneri. SMZ resistance rate was the highest ; fluoroquinolones, the third generation cephalosporins and phosphonomycins had much more sensitivity. The drug sensitivity rate to fluoroquinolones between Shigellae flexneri and Shigellae sonnei was different. Conclusion In 2003 and 2004, Shigellae flexneri is the dominant group in 254 Shigellae in Beijing. F4 is the dominant serotype among Shigellae flexneri. On antibacterial effects,fluoroquinolones is one of the most effective drug, but had a certain resistance rate. If the pathogen is resistant to fluoroquinolones, the third generation cephalosporins or phosphonomycins can be used.

Objective To assess the value of MRI imaging in diagnosis of the medial collateral ligament(MCL) injury of the knee joint.Methods MR findings of 20 cases of clinically suspected MCL injury of the knee joint were retrospectively reviewed and compared with operative findings of the knee joint.Results In 20 cases of MCL injury,there were 2 cases of gradeⅠinjury,9 gradeⅡand 9 grade Ⅲ.Taking the results of operation as standard,the accuracy of diagnosis of grade Ⅱand Ⅲ injury of the MCL was 88.9% and 100% respectively.Conclusion MRI can accurately display the MCL injury of the knee joint,it is important for the preoperative treatment planning.

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.