Objective:This paper makes analysis of problems of emergency equipment existing in clinical application and their causes and puts forward corresponding measure. Methods:Analysis of emergency medical equipment characteristic and the difference between conventional equipment. Find the first aid equipment management problems and reasons existing in the use, and risk assessment. Results:Hospital first aid equipment has the characteristics of more free time, emergency and risks, widely distributed in each department. By the personnel management, periodic inspection, cleaning and disinfection. Risk assessment shall be conducted by experts, the risk value high priority arrangement first aid equipment maintenance, to expect to minimize risk. Conclusion:First aid equipment management is a systematic and important work, to need department, maintenance personnel, equipment manufacturers and so on various aspects to cooperate with each other, to ensure the normal use of equipment.

Objective: To improve the whole-process management of medical devices in purchase, use and maintenance. Methods: In this paper, we clarify the purchase, use and maintenance requirements of large-scaled medical devices including justification, invitation organization, comprehensive estimation, contract signing protocol, advantage analysis, rational control of availability, efficacy measurement and detection, management at different levels, high-efficacy check-up and scrap procedure to adapt the new challenges during the introduction of more and more advanced, complex and high-tech medical devices. Results:The results being analyzed could be used as important evidence for future purchasing of medical equipment, which was important for scientific and reasonable purchasing and utilizing of medical equipment. Conclusion: Strengthen the management to adapt the new challenges during the introduction of more and more advanced, complex and high-tech medical devices.

Objective: To establish the Perfect Systematization and Informatization for the Management of Medical Equipment Archive, so as to ensure the integrity and traceability of each data. Methods: Analysis on Present Situation and the Problems of Medical Equipment Management, Establish Medical Equipment archive Management System from purchasing of medical equipment, Measurement Controls, the Maintenance to Scrap processing the whole-process of medical devices. Results: In this paper, we discussed all kinds of information and archives network information management in the whole-process of medical devices. To clarify the plan, argument, purchase, installation, acceptance, use, quality control, maintenance, transfers and scrap processing, management at different levels. To establish a complete electronic file system is the main direction of medical equipment information management in the future. Conclusion: Realization of the functions on medical equipment archives network information and dynamic management, that can offer necessary for safe treatment,to can also reduce the operation cost of the equipment.

Objective:To investigate the clinical effects and safety of triple therapy based on ipratropium bromide inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary diseases ( AECOPD) . Methods:Totally 150 patients with acute exac-erbation of AECOPD were randomly divided into control group (75 patients) treated with budesonide combined with salbutamol by in-halation, and treatment group (75 patients) treated with ipratropium bromide inhalation additionally. The clinical effects, dyspnea score, pulmonary function index and blood gas analysis index before and after the treatment and the incidence of adverse reactions of the two groups were compared. Results:The clinical effects of the treatment group was significantly better than that of the control group (P<0. 05). The dyspnea score, pulmonary function index in and blood gas analysis index in the two groups after the treatment were significantly better than those before the treatment(P<0. 05), and the improvement of the treatment group was significantly better than that of control group (P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion:Triple therapy including ipratropium bromide inhalation in the treatment of acute exacerbation of AECOPD can ef-fectively alleviate clinical symptoms and signs and improve the lung ventilation function without increased risk of adverse reactions.

Objective To investigate the feasibility and technique of combined endoscopic resection of esophageal carcinoma with VATS. Methods From April 2004 to November 2005, 32 patients with esophageal carcinoma underwent esophagectomy, including 10 cases by routin thoracotomy, 20 cases by 6cm thoracotomy associated with VATS and 2 cases by mediastinoscope and laparoscope. Gastric mobilization was performed with laparoscope in all patients. Results All the gastric mobilizations were successfully performed by laparoscope without blood transfusion. The number of removed celiac lymph nodes by laparoscopic surgery was 5.5?1.9. 20 patients underwent esophagectomy by minithoracotomy associated with VATS successfully, without conversion to open surgery. The number of removed mediastinal lymph nodes was 10.3?2.7. Postoperative complications included arrhythmia (4 patients), bleeding in chest (1 patient) and functional gastric obstruction (1 patient). 2 patients underwent esophagectomy by mediastinoscope and laparoscope successfully, no bleeding and no postoperative complications occurred. All patients were followed up from 1 to 20 months; no postoperative death and tumor recurrence were found. Conclusion Resection of esophageal carcinoma by laparoscope associated with VATS is a safe and feasible technique. The method of esophagectomy by minithoracotomy associated with VATS is wirth encouraged.

Objective To observe the anatomic landmarks in the thoracic cavity under thoracoscope in procedures for scoliosis,so as to facilitate the intraoperative localization and the prevention of complications. Methods During 23 cases of thoracoscopic anterior procedure,anatomic landmarks,including the segmental vessels,azygous vein,intervertebral discs,rib heads and great splanchnic nerve,were observed. Results The segmental vessels of T 6～10 were situated at the center of the vertebral body and their position was relatively constant.The T 7～10 intervertebral discs were a little bit prominent and white-colored,which were easily distinguished.The rib heads corresponding to their vertebral bodies were good landmarks.The great splanchnic nerve crossed over the T 7～9 vertebral bodies arrisways. Conclusions With the assistance of anatomic landmarks,accurate localization of the vertebral body is possible,which is helpful to the prevention of spinal cord injury and the decrease of frequency of radiation exposure.

0.05). No death, pseudoarthrosis, or implantation failure occurred. Conclusions One-row portal pattern is suitable for patients with long-segment deformity and short anteroposterior thoracic diameter, while double-row portal pattern is suitable for patients with short-segment deformity and long anteroposterior thoracic diameter.

Objective To investigate the causes and preventive measures of upper gastrointestinal bleeding in hyperbaric oxygen therapy for patients with severe closed head injury.MethodsThe clinical data of 24 cases of patients with upper gastrointestinal hemorrhage treated by hyperbaric oxygen therapy in the first people's Hospital of Fuyang District Hangzhou from May 2011 to May 2016 were analyzed, the occurrence time and clinical effect of upper gastrointestinal bleeding were analyzed.ResultsAmong the 24 cases of patients, 14 cases were treated for the first time that overt bleeding, including bleeding from the stomach liquid outflow of blood from 2 cases, gastric outflow 2 cases, hemorrhage after cure again received hyperbaric oxygen therapy 3 times again dominant bleeding 2 cases;6 cases hyperbaric oxygen treatment for third, 7, 10 times brown liquid or bloody fluid from the stomach outflow;4 cases hyperbaric oxygen treatment in patients with second and 3 courses of coffee liquid from the outflow tube, which accounted for 58.3%, 25.0%, 16.7% of the total, retrospectively;8 cases were with good recovery, 10 cases moderate disability, 4 cases severe disability, 2 cases vegetative state, 0 case died, the good recovery rate was 33.3%.ConclusionNot correctly grasp the time of hyperbaric oxygen therapy in the treatment of patients with severe closed craniocerebral injury will cause upper gastrointestinal hemorrhage, correct application of H2 receptor binding agent, developing targeted therapy programme can effectively prevent and treat upper gastrointestinal bleeding, so is worthy of the clinical's full attention.

Objective To investigate the brain protective effects of isoflurane preconditioning for local cerebral is-chemia adult rat model by detecting HIF-1α, HO-1 and Bcl-2 expression level. Methods 84 two-month old Spra-gue-Dawley male rats were randomly divided into sham group, ischemia-reperfusion group ( MCAO group) and isoflurance preconditioning group (ISO group). ISO group was exposed to isoflurane for 30 min and then underwent a 90 min middle cerebral arterial occlusion (MCAO), while MCAO group underwent MCAO only. At 24 h after reperfusion all the groups were investigated by modified neurological severity score for neurological deficits, TTC staining for infarct percentage. Cerebral cortices were harvested for HIF-1α, HO-1 and Bcl-2 protein expression level detection at 6 h, 24 h and 72 h after reperfusion using RT-PCR and western blot. Results The mNSS score and infarct percentage in ISO group decreased significantly compared with those of MCAO group at 24 h after reper-fusion(P < 0. 05). Compared with the MCAO group, ISO group had significantly up-regulated protein levels of HIF-1α, HO-1 and Bcl-2 at 6 h and 24 h after reperfusion(P < 0. 05). There was no difference between ISO group and MCAO group for 3 gene expression at 72 h(P > 0. 05). Conclusion Isoflurane preconditioning plays short-term cerebral protective effect through the up regulation of HIF-1α, HO-1 and Bcl-2 gene expression.

Objective To evaluate transsphincteric operation (Mason operation) for rectal tumors.Methods Retrospective study was used to analyze the experience of Mason operation for 150 patients with mid and lower rectal tumors between Aug 1990 to Dee 2008. Results There were villous adenoma in 75 cases,early rectal cancer in 48 and advanced rectal cancer in 9,submucosal carcinoid nodule in 23.Of the 126 rectal tumor patients,120 underwent partial rectectomy,6 underwent segmental rectectomy.Seventeen out of the 21 rectovaginal fistula or rectourethral fistula cases underwent successful one-stage repair.Six patients(4%)developed wound infection.Five patients(3.3%)were complicated with recto-cutaneous fistula.Two patients(4.3%) suffered from local recurrence in 46 followed up early staged rectal carcinoma with a five-year survival rate of 84.5%(39/46).On discharge from hospital no patient suffered from incontinence.Conclusion Mason operation is satisfactory with good exposure and simple access to the rectum,which Was suitable for those lesions that could be locally resected on mid and lower rectum.