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.

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.

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.

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.

During sepsis, circulating leukocytes are in a hyper inflammatory state, and with the progress of the inflammation, immune cells may become tolerated. Glycolysis and pentose phosphate pathway are up-regulated but oxidative phosphorylation is suppressed in hyper inflammatory cells, whereas during immune tolerance, glycolysis is often down-regulated. In this review, we will summarize the changes of cellular metabolic pathways in monocytes and macrophages during sepsis. We also review how the metabolism of glucose, amino acids, and fatty acids affect the function of monocytes and macrophages in sepsis. Current literature indicated that metabolism plays a significant role in regulating the functions of immune cells in sepsis, which might be a potential therapy for sepsis and deserved further research.

Objective To evaluate our short term results in endovascular treatment of symptomatic vertebral arteral stenosis with stents. Methods Balloon expanded stents were utilized to pass across the vertebral arterial stenosis, and then the balloons were inflated for the deployment of stents, outcoming with restoration of the stenosis to normal size. Results Forty five patients presented with posterior circulation ischemic symptoms and refractory to medical therapy were undertaken with endovascular stenting, showing technically successful in forty three of them. The mean degrees of preoperative and postoperative stenosis were 75.7% and 10.3%, respectively. Follow up data showed disappearence of clinical symptoms in 35 patients, chinical implovement and stabilization in 2. There were no intimal dissection and distal embolization. Short term follow up angiogram revealed no restenosis and intimal hyperplasia. Conclusions Endovascular stenting may be a favorable alternative for the treatment of vertebral arterial stenosis, but long term follow up is necessary.

[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.

[Objective]To investigate the possibility of percutaneous minimally invasive technique in treating patients with type C1 pelvic fracture injured in the earthquake.[Method]Thirteen patients with Type C1 pelvic fracture determined by Tile Classification received reduction with external fixation frame for pelvic anterior ring and with cannulated lag screw for pelvic posterior ring fixation guided under C-arm X-ray.[Result]The cannulated lag screw was successfully implanted percutaneously guided under C-arm X-ray,and post-operation X-ray showed satisfactory reduction.[Conclusion]It is an optimum choice for treating C1 pelvic fracture with external fixation frame combined with cannulated lag screw percutaneously implanted under C-arm X-ray.