Expounding the status of the current domestic medical equipment maintenance management, and puting forward the strategic thinking of medical maintenance for the challenges of equipment maintenance management in the hospital. This discussion can be performed to control the maintenance costs of hospital effectively, increase the income and social benefits of the hospital.
Costs and Cost Analysis ; Equipment and Supplies, Hospital ; Maintenance and Engineering, Hospital ; economics ; Materials Management, Hospital ; economics

Endometrial cancer is one of the malignant tumors of female reproductive system. The prognosis of advanced endometrial cancer is poor. How to improve the overall survival rate and improve the prognosis of patients with advanced endometrial cancer is still one of the clinical problems. In recent years, the research on tumor gene changes is increasing gradually. Epigenetics is the study of genetic changes in gene expression without changing the nucleotide sequence of genes. Epigenetics includes many phenomena, such as DNA methylation, microRNA expression and gene silencing, chromatin remodeling. These changes may be important factors in the occurrence and development of tumors, and may become new therapeutic targets for tumors. With the study on epigenetics of endometrial cancer in the future, new therapeutic targets may be found. Meanwhile, those study may provide new ideas for targeted therapy of endometrial cancer.

ObjectiveTo study the method and effect of individualized education on children with learning disability (LD).Methods30 children during 7-10 year old in a local boarding elementary school were chosen and guided individually as the following: sensory integration dysfunction drill, subtle motion drill, life skills drill, cognitive capability drill, behavior therapy, game therapy, music therapy and parents education. One and a half year later, the index of Sensory Integration Rating Scales and study marks were determined and compared with that of the normal children.ResultsThere is not significant difference between the LD children and the normal ones in the sensory integration of behavior and the learning achievement.ConclusionIndividualized education is a valid approach improving the potentiality of the LD children\'s physiology and psychology.

Objective To evaluate the effect of alIoHCT on recurrence and metastasis of HCC after hepatic radical resection. Methods Umbilical cord blood were collected after labor. The efficacy of separa-tion by 6% hydroxyethyl starch (6% HES) and NH4CL lysing solution were examined. Twenty-two SCID mice were randomized into the scheduled transplantation group (n=8), the single transplantation group (n =8) and the normal saline group (n=6). Human nucleated cells (NC)at a amount of 5×107 were transfused through the tail vein into the 2 groups of transplantation. All the mice in the 3 groups received cyclophospha-mide (CTX) as conditioning regimen before tansplantation and Methylprednisolone (MP) for 1 week continu-ously after trasplantation. Hematopoietic and immune recovery, graft versus host disease (GVHD), engraft-ment and survival rate were observed after transplantation. Six weeks after alloHST, the orthotopic tumor model in SCID mice was established by implanting histologically intact tissue under the embrane of liver. Ten days later, the mice received radical resection of lobe bearing tumor. The condition of recurrence and metas-tasis was observed 4 weeks after operation. Results A murine model of umbilical cord blood transplantation using CTX and MP as conditioning regimen could be successfully established in SCID mice. The percentage CD34+ cells of peripheral blood NC in scheduled transplantation group and single transplantation group was 1.66%±0.47% and 0.68% + 0.56%, respectively. There was significant statistical significance (P<0.01). The intrahepatic recurrence rate after operation was 100% in all the 3 groups. However, the recur-rent tumor volume was (367.18±31.86) mm3 , (648.26±155.22) mm3, (811.38±127.36) mm3, re-spectively in the 3 groups. There was marked difference among the 3 groups (P<0.01). The inhibitory rate of group A and B was 54.7% and 20.1%. The incidence of lung metastasis was 14.3 (1/7), 6.7% (4/6) and 100% (5/5), respectively in the 3 groups and there was remarkable difference (P<0.01). The inci-dence of celiac lymph node metastasis was 14.3 (1/7), 33.4% (2/6) and 40% (2/5), respectively in the 3groups and there was no significant difference (P=0.58). Conclusion AlloHSCT is a useful method for de-creasing metastasis and recurrence of liver cancer after radical resection in early stage.

Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in esophagus surgery. Methods From 1982 to 2010, patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with unspecific chest pain, 70.4%(74/105) were diagnosed as esophageal origin. Lower esophageal sphincter pressure (LESP) can be continuously maintained by using 360° fundoplication. Only a minority of patients who underwent transabdominal esophagocardiomyotomy and partial posterior fundoplication had acid reflux postoperatively. Incidence rate of achalasia of upper esophageal sphincter (UES) and pharyngeal "shoulder wave" in side-to-side stapled anastomosis is significantly lower than in traditional hand-sewn anastomosis,as well as contractive pressure in anastomosis region and occurrence of swallow discomfortableness. There is a high pressure region at the esophageal entrance in patients with bilateral platysma muscle flap for cervical esophagus defect following removal of hypopharynx cancer. And the pressure of the region is significantly lower than in healthy controls. Basal pyloric pressure and peak pressure of pylorus in phase Ⅲ of the migrating motor complex increased significantly after gastric conduit was made and anastomosed, but decreased appreciably following pyloric digital fracture. Peak pressure, frequency and duration time of isolated pyloric pressure wave ( IPPW ) decreased after pyloric digital fracture significantly. Conclusion Esophageal manometry and 24-hour pH monitoring are important tools for and diagnosing unspecific chest pain and evaluating the outcome of new surgical procedures.

ObjectiveTo investigate the effect of dexmedetomidine pretreatment on focal cerebral ischemia-reperfusion(I/R) injury in rats.MethodsOne hundred male SD rats weighing 290-310 g were randomly divided into 5 groups(n =20 each):sham operation group(group SH) ; focal cerebral I/R group; focal cerebral I/R + dexmedetomidine 100 μg/kg(group L); focal cerebral I/R+ dexmedetomidine 200 μg/kg (group M) and focal cerebral I/R + dexmedetomidine 400 μg/kg(group H).Focal cerebral I/R was produced by occlusion of middle cerebral artery for 60 min followed by 24 h of reperfusion.Dexmedetomidine 100,200 and 400 μg/kg were injected intraperitoneally 15 min before ischemia in groups L,M and H respectively.While equal volume of normal saline was injected intraperitoneally in group SH.Neurologic function was assessed and scored at 24 h of reperfusion.Then the animals were sacrificed and brains were removed for determination of cerebral infarct volume and microscopic examination.The expression of heat shock protein 70(HSP70) and activity of Na+ -K + -ATPase in ischemic cortex and activity of SOD and concentration of cortisol in plasma were determinationed at 24 h of reperfusion.ResultsCompared with group SH,neurologic deficit scores and plasma concentration of cortisol were significantly increased,activities of SOD and Na+ -K+ -ATPase decreased and expression of HSP70 was up-regulated in groups I/R,L,M and H( P ＜ 0.05).Compared with group I/R,neurologic deficit scores and plasma concentration of cortisol were significantly decreased,activities of SOD and Na+ -K+ -ATPase increased and expression of HSP70 was up-regulated in a dose-dependent manner ( P ＜ 0.05),and the pathological change was reduced in a dose-dependent manner in groups L,M and H.ConclusionDexmedetomidine pretreatment can attenuate focal cerebral I/R injury in a dose-dependent manner through improvement of brain cell energy metabolism and reduction of lipid peroxidation and stress reaction.

Several genetic polymorphisms of the aldosterone synthase gene(CYP11B2),which may influence the plasma aldosterone levels,had been reported to influence the blood glucose levels.In addition to the effects of sodium()(and consequently water) resorption and potassium excretion(),aldosterone could be involved in the development and progression of diabetes and its chronic complications.This paper also discussed the therapeutic significance of aldosterone receptor antagonists on the occcurance of chronic diabetic complications.

Purpose: To study the clinical application of intensity modulation radiation therapy (IMRT) in patients with prostate cancer. Methods: From May 2000 to June 2001, 14 patients with prostate carcinoma were treated . 12 patients underwent orchiectomy before IMRT. All patients were treated by IMRT with PEACOCK-MIMiC system ( CORVUS 3. 0 NOMOS CORPORATION) and VARIAN 6MV-photons. The prescription dose-time- fraction was 2.5 to 3. 0 Gy per fraction, 5 times per week , the total was 25 to 30 fractions, the total IMRT dose was 72 to 77 Gy, 5 to 6 weeks. Results: 3 months after IMRT , PR: 10(71.4%), NC: 4 cases and 6 month after IMRT CR: 6,PR: 8 cases. The overall response( CR + PR) rate were 100% . No Grade Ⅲ ,Ⅳ gastrointestinal ( GI) and genitourinary ( GU) toxicity occurred in any of the patients. Conclusions: IMRT is an effective approach for patients with prostate carcinoma. The dose of 72 to 77 Gy was safe.

UNLABELLED: A female patient of 56 years old had hoarseness that seems worse after talking excessively,which occasionally associated with slightly sore throat and pharyngeal foreign body sensation. The symptoms are not associated with sore throat, fever, night sweats, not drinking cough, breathing and swallowing difficulties, but no cough, bloody sputum. Neck ultrasound can be showed: goiter and real echo uneven thickening, increased blood supply pan; the right thyroid lobe multiple cysts pan. Enhanced CT shows occupying lesions were found out in the right side of the supraglottic larynx gap and the right lobe of the thyroid, nature to be determined. Full thyroid function showed: thyroid microsomal antibodies 278.2 u/ml, the rest of the indicators in the normal range. Other routine preoperative examinations were normal. Immunohistochemistry: CD45(++) CD68(+) CD99(++) EMA(-) CK(-) Sclc(-) TTF-1(--) CgA(-) SY(-) NSE(--) S-100(-) ESA(-). Supported by immunohistochemistry, hyperplasia organizations was diffuse lymphoid tissue. Through expert consultation by superior hospital the pathology showed: Hashimoto's thyroiditis with thyroid papillary carcinoma (lesions of the right thyroid); Lesion on the right side of the throat gene rearrangement results show: B lymphocyte clonal consider mucosa-associated extranodal marginal zone B-cell lymphoma the gene rearrangement that the right side of the throat disease is: B lymphocyte clonal, be considerd mucosa-associated extranodal marginal zone B-cell lymphoma. DIAGNOSIS throat B-cell lymphoma; thyroid papillary carcinoma (right side); Hashimoto's thyroiditis (right side).
Carcinoma ; pathology ; Carcinoma, Papillary ; pathology ; Female ; Hashimoto Disease ; pathology ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone ; genetics ; pathology ; Middle Aged ; Neck ; Neoplasms, Multiple Primary ; pathology ; Pharyngeal Neoplasms ; pathology ; Pharynx ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology

[Objective]To analyze the clinical features of spinal fracture of the injured in Wenchuan Earthquake and to summarize the medical rescue.[Method]The clinical data of 94 injured cases with spinal fracture in the earthquake were collected and analyzed,including the general condition,injury mechanism,associated injuries and the rescue measures.[Result]The incident rate of the male was much higher than that of the female,the incidence of spinal fracture was high in 21~60-years old;the associated injuries were found in 54 cases,taking up 57.4%.The spinal fracture typing showed that 89 cases had flexion-compression fracture and burst fracture,taking up 94.7%.[Conclusion]Earthquakes cause a large amount of the injured with spinal fracture,who are evacuated within a concentrated time,the injuries are severe with many associated injuries.Scientific organization and reasonable division are critical in the immediate medical rescue of the injured in large quantity within the shortest time.