The defects in management and application of medical equipment and apparatus are analyzed. According to different conditions, countermeasures are put forward. Operators should know the operation requirements and using characteristics and equipment keepers should tighten up the management. The application detail of the medical equipment is the basis of medical security.

Objective To investigate the expression of breast cancer specific gene 1( BCSG1) in breast cancer tissues and its clinical significance.Methods The expression of BCSG1in 51cases of breast cancer tissues and 35 cases of adjacent tissues was determined by fluorescence quantitative polymerase chain reaction (FQ-PCR) and immunohistochenistry.Results FQ-PCR showed the expression level of BCSG1mRNA in breast cancer and adjacent tissues was 1.072 ± 0.178 and 0.324± 0.135 respectively.Immunohistochemistry showed the expression rate of BCSG1protein in breast cancer and adjacent tissues was 74.5％ (38/51) and 14.3％ (5/35).The expression of BCSG1mRNA and protein was dramatically increased in breast cancer tissues compared with that in normal background breast tissues (P ＜ 0.05).BCSG1mRNA and protein expression was significantly different in patients with lymph node metastasis and higher Nottingham prognostic index (P ＜ 0.05 ),and there was no significant difference with the pathological type of breast cancer,or status of ER,PR,and c-erbB2 ( P ＞ 0.05 ).Conclusions BCSG1is highly expressed in breast cancer tissues,which is closely related to the development and clinical prognosis of breast cancer.BCSG1is very likely to play an important role in the pathogenesis of breast cancer.

Objective To study the effect and prognosis of multiple channels percutaneous renal ureteral calculi removal in the treatment of patients with complex renal calculi.Methods One hundred and forty-four cases patients with complex renal calculi accepted treatment in Dongda Hospital of Shanxian County from June 2012 to March 2015 for research.According to the random number table method,the patients were divided into the observation group and the control group,72 cases in each group.The single channel type was used in the control group,while multi-channel type operation was use in the observation group.Indicators related to the operation,stones clearance rate,changes in the degree of hydronephrosis,and the major complications after treatment of the two groups were compared.Results The operation time of the observation group was (104.82 ±8.54) min,significantly longer than that of the control group ((90.23 ±7.68) min),but the duration of hospital stay,fistulation tube indwelling time and the residual stone surface area were (6.84±1.25) d,(5.23±2.16) d and (223.16± 113.49) mm2 respectively,significantly less than that of the control group ((8.33±2.13) d,(6.74 ± 2.19) d and (429.54 ± 107.88) mm2 respectively),the differences were statistically significant(P =0.000).The stone removal rate of the observation group was 86.11％ (62/72),significantly higher than that of the control group(72.22％ (52/72)),the difference was statistically significant (P =0.040).There was no significant difference in terms of the total stone clearance rate and the degree of kidney water after treatment between the two groups (P＞0.05).The total complication rate of the observation group was 11.11％(8/72),of the control group was 9.72％ (7/72),and the difference was not statistically significant(P ＞0.05).Conclusion The efficacy of multi-channel operation for complex renal calculi is better,safe and feasible,but should reduce the number of channels as much as possible,so as to reduce the damage to patients effectively.

Objective To explore the role of ureteroacopy for acute upper urinary tract obstructive anuria.Methods Clinical data of 37 cases with acute upper urinary tract obstructive anuria were analyzed.Results Among 37 cases,34 cases were successfully performed ureteroseopy or ureteroseopic lithotripsy with double-J sent incubation (successful rate was 91.9%).Renal function were recovery in 32 cases.4 Cases returned to 180μmol/L,1 case need hemodialysis periodically.Conclusion Ureteroscopy could rapidly remove the obstruction and protect renal function in management of acute upper urinary tract obstruction anuria,which was contributed to the diagnosis.It was safe,effective and the preferred method.

ObjectiveTo evaluate nipple-areola complex sparing modified radical mastectomy for breast cancer.MethodsClinical data of 159 breast cancer cases undergoing NAC sparing modified radical mastectomy from Jan 1998 to Dec 2009 were retrospectively analyzed.ResultsNAC sparing modified radical mastectomy was successfully carried out in 141 out of the 159 cases ( 88.68％ ).In 14 cases (8. 81％ ) the original operative protocol was changed to modified radical mastectomy or radical mastectomy during the operations because NAC ischemia in 4 (2. 52％ )cases, NAC occult involvement or dysplasia in 5 cases (3. 14％ ), Ⅲ level lymph node metastasis was found in 3 cases (1.89％). Postoperative complete nipple necrosis occurred in 4 (2. 52％ ) cases. Other significant postoperative complications included nipple necrosis in 20 cases ( 12. 58％ ), skin flap necrosis and infection in 11 cases ( 6.92％ ), subcutaneous hydrops in 10 cases (6. 29％ ). All patients got follow-up ranging from 15 to 96 months,median follow-up was 51 months. Local region recurrences were observed in 5 cases (3. 14％ ), distant metastasis in 2 cases ( 1.26％ ). There was no recurrence in the region of NAC.ConclusionsNipple-areola complex sparing modified radical mastectomy is oncologically safe by strict preoperative selection criteria and strict operative procedure.

During years of managent practice of postgraduate training,it is found that great attention of leadership is a good foundation,that pre-service training is an essential part,that srtict implementation of the requirements on postgraduate,advisor-responsibility system unified instruction under subject,focusing on process-management of training and exploring actively effective incentive training methods is necessary.

Objective To study the therapeutic effect of adjuvant chemotherapy and radiotherapy after operation in patients with mucoepidermoid carcinoma of parotid gland,and to screen the indicators ralated to the prognosis of tumor.Methods Eighty patients with mucoepidermoid carcinoma of parotid gland in First People′Hospital of Yibin of Sichuan Province from January 2005 to December 2009 were analysed retrospectively in our research.We studied the survival of patients who were treated wtih simple operation(30 cases)or postoperative adjuvant therapy(50 cases).Then we further analyzed the relationships between the prognosis of the patients and some variables (age,gender,smoking,alcohol drinking,lymph node metastasis,distant organ metastasis,treat-ment method,differentiation degree and T grading).Results Kaplan-Meier survival curves showed that patients with postoperative adjuvant therapy had longer PFS and OS than those without adjuvant therapy (94.4 months vs 69.3 months;114.9 months vs 96.7 months),with statistical significance (χ2 =11 .246,P =0.001 ;χ2 =15.803,P =0.001 ).COX univariate analysis showed that gender (χ2 =22.346,P =0.000),smoking (χ2 =7.891 ,P =0.041 ),lymph node metastasis (χ2 =12.371 ,P =0.005),distant organ metastasis (χ2 =9.81 3, P =0.002),treatment method (χ2 =25.261 ,P =0.000),differentiation degree (χ2 =4.361 ,P =0.006)and T grading (χ2 =5.336,P =0.01 4)were related to the PFS of patients.COX multivariate analysis showed that lymph node metastasis (χ2 =11 .003,RR =2.827,95%CI:1 .965-3.851 ,P =0.011 ),distant organ metastasis (χ2 =7.611 ,RR =0.472,95%CI:0.240-0.775,P =0.016),treatment method (χ2 =24.542,RR =5.390, 95%CI:3.585-9.602,P =0.000),degree of differentiation (χ2 =3.221 ,RR =2.1 1 8,95%CI:1 .845-4.719, P =0.009)and T grading (χ2 =4.336,RR =0.804,95%CI:0.681 -0.916,P =0.024)were related to the PFS of patients.COX univariate analysis showed that smoking (χ2 =4.551 ,P =0.008),alcohol drinking (χ2 =11 .742,P =0.048),lymph node metastasis (χ2 =14.886,P =0.009),distant organ metastasis (χ2 =6.71 3, P =0.005),treatment method (χ2 =22.411 ,P =0.000),degree of differentiation (χ2 =8.1 16,P =0.012)and T grading (χ2 =14.443,P =0.035)were related to the OS of patients.COX multivariate analysis showed that lymph node metastasis (χ2 =11 .711 ,RR =2.985,95%CI:1 .521 -3.999,P =0.005),distant organ metastasis (χ2 =5.390,RR =0.400,95%CI:0.201 -0.793,P =0.009),treatment method (χ2 =19.327,RR =5.086, 95%CI:3.241 -8.006,P =0.000),degree of differentiation (χ2 =7.084,RR =2.301 ,95%CI:1 .908-4.503, P =0.001 )and T grading (χ2 =1 3.229,RR =0.561 ,95%CI:0.348-0.867,P =0.040)were related to the OS of patients.Conclusion Adjuvant radiation and chemotherapy can obviously prolong the PFS and OS for the patients with mucoepidermoid carcinoma of parotid gland.Lymph node metastasis,distant organ metastasis,treat-ment method,differentiation degree and T grading can greatly influence the prognosis of patients with mucoepider-moid carcinoma of parotid gland,which can be used as independent prognostic indicators for the patients with mucoepidermoid carcinoma of parotid gland.

BACKGROUND:A large number of clinical trials have found that the number of bone marrow stem cels at the femoral neck and proximal femur in patients with osteonecrosis of the femoral head is significantly reduced, accompanied by decreased activity, which causes a significant decrease in osteogenic capacity that the necrotic bone cannot be effectively repaired after absorption, leading to the colapse of the femoral head. OBJECTIVE:To probe into the early clinical efficacy of autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head. METHODS:Forty-five patients with avascular necrosis of the femoral head (49 hips) were enroled in this study, and underwent autologous peripheral blood mononuclear cel transplantation with porous core decompression. After treatment, pain scores, Harris hip score, scores on the satisfaction of patients were evaluated, as wel as X-ray, CT and MRI examinations. RESULTS AND CONCLUSION:Al the patients received a folow-up visit of 11-14 months, averagely (12.5±0.6) months. During the folow-up, there were no complications and serious adverse reactions. Postoperative pain scores and Harris scores were both improved significantly compared with preoperative ones (P < 0.05). At 12 months after treatment, the excelent satisfaction rate was up to 92%. Patient’s MRI low signal region accounting for a percentage of the volume of the femoral head was decreased from (40.1±7.34)% preoperatively to (20.23±5.4)% at 6 months postoperatively, and there was a significant difference (P < 0.05). These findings indicate that autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head has significantly clinical effects at early stage, which can obviously reduce joint pain, improve and restore hip joint function, and delay progression of disease.

Objective To observe the clinical efficacy of acupuncture at Shixuan (EX-UE11) plus rehabilitation in improving the upper-limb spasticity and hand function after cerebral stroke. Method Sixty patients with upper-limb spasm due to cerebral stroke were randomized into two groups. The observation group was intervened by conventional acupuncture plus needling Shixuan and rehabilitation training, while the control group was by conventional acupuncture plus rehabilitation training. The Modified Ashworth Scale (MAS) and Modified Barthel Index (MBI) were evaluated before and after the intervention. The effects of the two methods in improving the upper-limb spastic intensity, hand function, and activities of daily living after cerebral stroke were evaluated based on the scores before and after the intervention. Result After treatment, the upper-limb spastic intensity and muscle tension decreased in both groups, and there was a significant difference in comparing the MAS score between the two groups (P<0.05); the improvement of MBI in the treatment group was more significant than that in the control group (P<0.05). Conclusion Acupuncture at Shixuan plus rehabilitation can produce a more significant efficacy in treating upper-limb spasm, improving hand function and activities of daily living after cerebral stroke, compared to the conventional acupuncture plus rehabilitation.

Objective To investigate the effects of combined epidural block with inhalation - intravenous general anesthesia (GE) on stress response in thepatients for laparoscopic radical colonectomy. Methods Twenty-eight ASA I-II patients scheduled for laparoscopic radical colonectomy were randomly divided into group GE and inhalation-intravenous general anesthesia group(group G) with 14 cases each. In group GE, epidural blocks were operated before induction, MAP,ECG ,HR,SpO2 and PETCO2 were observed and recorded at such point-time: pre-pneumoperitoneum and 1,2,3 h after pneumoperitoneum. Arterial blood-gas analysis ,noradrenaline(NE) and adrenaline(E) were also measured at the same time; Group G was the same as group GE except for no epidural block and extra fentanyl. Results The level of stress response hormones(NE and E) of post- pneumoperitoneum 1,2,3 h were increased VS those of pre-pneumoperitoneum in both groups, and group G was significant (P