Objective:To analyze the demands of maintenance management system of medical equipment, and realize the scientization and normalization of plan design for maintenance management system of medical equipment.Methods: On the basis of current status of maintenance management system of medical equipment, the demands of various department during management process were analyzed, and then a systematic maintenance management plan was designed to face to all of medical equipment in hospital.Results: The preponderances of this system were discussed from three aspects: equipment maintenance, equipment archive and equipment benefit.Conclusion: The application of this system can accelerate the progress of maintenance for medical equipment, enhance maintenance awareness of clinical medical staffs for medical equipment, improve the transparency of equipment scrapping and disposal, and provide effective references for demonstration and purchase of medical equipment.

The understanding of the biological behavior of breast cancer has deepened, hence, local treatments for breast cancer have changed from resection to minimally invasive surgery. For patients with early breast cancer, constructing a minimally invasive interven-tion with low systemic toxicity is a problem, especially for cases involving precancerous lesions. Intraductal therapy for breast cancer, which is performed by inserting reagents through breastfeeding openings using suitable carriers, is a promising, accurate, and minimal-ly invasive method for breast cancer prevention and treatment. The combination of intraductal therapy with new therapeutic strate-gies, such as targeted therapy, endocrine therapy, and immunotherapy, might improve the therapeutic effect. Moreover, the mecha-nisms of intraductal therapy for breast cancer incorporate nanotechnology, molecular imaging, and gene sequencing. Intraductal thera-py is based on clinical and pathologic characteristics of Chinese breast cancer patients, and such characteristics must be determined prior to clinical application. This article mainly discusses the research progress of breast intraductal intervention.

This study examined the effect of IL-10 on immunoglobulin-like transcript (ILT4) expression of human monocytic leukemic cell line THP-1, especially the role of the ILT4 promoter activity. ILT4 promoter area was amplified by PCR, and was cloned into the eukaryotic expressing vector pGL3-Basic. The pGL3-ILTP obtained was tested by double endonuclease digestion and sequencing. Then, the recombinant plasmid was transfected into THP-1 cells by using lipofectamine. After culture with IL-10 for 12 h, the mRNA extracted from THP-1 cells was detected by RT-PCR and the protein was detected by FACS. The dual-luciferase reporter assay system was employed to detect the activity of ILT4 promoter with or without IL-10. The results showed that the activity of pGL3-ILTP was significantly increased and was more than ten times that of pGL3-Basic cells. After culture with IL-10 for 12 h, the expression of ILT4 protein and its mean fluorescence intensity (MFI) were increased. Moreover, the mRNA was remarkably higher than that of the control group. Dual-luciferase reporter assay revealed that ILT4 promoter was much more activated after being treated with IL-10. We were led to conclude that pGL3-ILTP containing ILT4 promoter was constructed successfully. The expression of ILT4 could be up-regulated by IL-10 both at the transcriptional and translational level. Furthermore, ILT4 promoter could be much more active after addition of IL-10. This study suggests that IL-10 up-regulates ILT4 expression on monocytes via increasing ILT4 gene promoter activity, which may have implication for inducing transplantation tolerance in clinical practice.

Objective:To observe the outcome of posterior staphyloma (PS) marginal retinal photocoagulation in pars plana vitrectomy (PPV) for high myopia macular hole retinal detachment eyes accompanied with PS.Methods:From January 2017 to June 2019, 49 patients (49 eyes) with high myopia macular hole retinal detachment accompanied with PS who were undergone PPV operation from Tianjin Eye Hospital were included in this study. There were 13 males (13 eyes) and 36 females (36 eyes). All patients underwent best corrected visual acuities (BCVA) and optical coherence tomography examinations. The standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted to minimum resolution angle in logarithmic (logMAR) when recorded. The patients were randomly divided into two groups according to surgical options: conventional PPV with internal limiting membrane (ILM) peeling (group A, 24 eyes), PS marginal retinal photocoagulation in PPV with ILM peeling (group A, 25 eyes). The mean preoperative logMAR BCVA of group A and B were 1.87±0.28 and 1.80±0.37, the difference was not statistically significant ( t=0.604, P=0.551). The patients in the group A received 23G PPV, triamcinolone acetonide staining during the operation, the epiretinal membrane was peeled off, indocyanine green assisted staining, the posterior macular ILM was peeled off, and the peripheral retina was examined in detail during the operation. Areas with retinal degeneration were reinforced by laser photocoagulation, and the subretinal fluid was drained through the macular hole and filled with silicone oil. The eyes of the group B were subjected to retinal photocoagulation for 2 to 3 rows at the edge of the PS in addition to the usual surgical procedures. The average follow-up time was 8.34±3.21 months. Surgical outcome were estimated by the average number of operation, retinal reattachment rate, macular hole closure rate and BCVA. The χ2 test or Fisher exact probability was used to compare the count data. Independent sample t test was used to compare the measurement data. Results:Retinal reattachment was obtained in 17 eyes (70.8%, 17/24) and 24 eyes (96.0%, 24/25) in group A and B after first surgery respectively, the difference was statistically significant ( χ2=3.984, P=0.046). Final retinal reattachment was obtained in all 49 eyes. Final macular hole closure was in 15 eyes (62.5%, 15/24) and 19 eyes (76.0%, 19/25) in group A and B, respectively, the difference was not statistically significant ( χ2=1.051, P=0.305). The mean postoperative logMAR BCVA of group A (1.20±0.47) and B (1.08±0.39) were all improved than preoperative BCVA, the differences were all statistically significant ( t=2.899, 5.327; P=0.001, 0.000), the differences of mean postoperative logMAR BCVA between two groups was not statistically significant ( t=0.675, P=0.506). The mean number of operation of group A (2.63±0.88) was more than group B (2.08±0.28), the difference was statistically significant ( t=3.003, P=0.006). Conclusion:In comparison with conventional PPV, combined PS marginal retinal photocoagulation can improve retinal reattachment rate after first surgery, and reduce the number of reoperations.

Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment. Results:At baseline, compared with the contralateral healthy eye, the FAZ area ( t=-4.091), PERIM ( t=-5.098) and AI ( t=-9.093) of the RVO-ME eye were enlarged, and FD-300 ( t=7.237) and overall SCP and DCP blood flow density ( t=8.735, 9.897) decreased, the difference was statistically significant ( P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased ( t=8.566, 16.739, -6.469, 9.719; P<0.001), the difference was statistically significant. There was no significant change in the blood flow density of FD-300 and overall SCP and DCP, and the difference was not statistically significant ( t=1.017, 1.197, 0.987; P>0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant ( F=21.979, P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment ( r=-0.538, -0.484, -0.879, -0.854; P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment ( r=0.544, P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment ( r=0.604, -0.462, -0.528; P<0.05), it was positively correlated with FAZ area ( r=0.379, P=0.043). Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Objective Inflammation plays a critical role in the presence , development and maintenance of atrial fibrillation ( AF) , but it remains unclear what factors induce inflammation in AF patients , especially in those with valvular heart disease ( VHD) . The aim of this paper was to investigate the role of the shedding of Syndecan -4 in left atrial inflammation in patients with valvular atrial fibrillation. Methods Sixty VHD patients scheduled for valvuloplasty or valve replacement surgery were divided into three groups of equal number:sinus rhythm (SR), paroxysmal atrial fibrillation (PaAF), and persistent atrial fibrillation (PeAF).Another 10 pa-tients with congenital heart disease but no valve damage and atrial fibrillation were included in a control group .Baseline clinical data were recorded and tissues were obtained from the left atrial appendage during operation .The expressions of iNOS , HMGB1, and Syn-decan-4 in the left atrium were detected by Western blot , and the pathological changes of the left atrial tissue observed by HE staining . Results Western blot analysis was performed to detect expression levels of proteins .The iNOS level was significantly higher in pa-tients from the paroxysmal AF group (1.61 ±0.10) and persistent AF group (1.67 ±0.08) than those from sinus group (1.06 ± 0.11) and control group (1.02 ±0.12), as was the protein level of HMGB1 (0.63 ±0.05, 0.95 ±0.10, 0.45 ±0.07 and 0.46 ± 0.06 in paroxysmal AF group, persistent AF group, sinus group and controlgroup respectively ).Inflammatory cell infiltration in-creased, while syndecan 4 was down-regulated in AF groups.All these comparisons were significant (P<0.05). Conclusion The decreased expression of Syndecan-4 and enhanced inflammatory response in the left atrial tissue indicate that the shedding of Synde-can-4 may play a role in the presence and development of inflamma-tion in the left atrium .

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P < 0.05], and shorter catheterization time [SMD = -2.64, 95%CI (-3.92, -1.36), P < 0.05]. There was no significant difference between IPSS [WMD = 0.12, 95%CI (-0.27, 0.51), P > 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

The anti-oxidant stress of the body is mainly mediated by the transcription factor nuclear factor-erythroid 2 related factor 2 (Nrf 2). Nrf 2 can promote cell protective gene expression. Nrf 2 plays an important role in regulating the oxidative stress, the metabolism of toxic substances, the inflammation, the apoptosis, and the physiological functions of cells. Multiple studies have shown that the activation of Nrf 2 alleviates oxidative stress and inflammation, plays an important role in acute lung injury/acute respiratory distress syndrome (ALI/ARDS), and is expected to be potential targets for the prevention and treatment of ALI/ARDS. In this article we review the importance of Nrf 2 and its activation pathway in preventing and treating ALI/ARDS for the aim of understanding its functional mechanism in ALI/ARDS, and providing a reliable reference for the pathogenesis and treatment of ALI/ARDS.

Objective:To investigate Chinese dermatologists′ perceptions of the correlation between diet and psoriasis, and to analyze factors influencing their perceptions.Methods:An exploratory survey study was conducted among Chinese dermatologists via the WeChat and Umer doctor platforms. The questionnaire consisted of 3 sections including career background characteristics (11 items) , dietary suggestions (3 items) and perceptions of effects of diet on psoriasis (19 items) . The results were expressed in frequency, assessed by chi-square test, and variables with significant differences were subjected to binary logistic regression analysis.Results:A total of 3 905 valid questionnaires were received. Among these responders, 91% believed psoriasis could be affected by dietary factors, and most believed certain diets could aggravate the severity of psoriasis; most dermatologists (80.1%) suggested patients avoid some foods or drinks, and the top 5 foods or drinks suggested to be avoided were seafood (2 950, 94.34%) , spicy food (2 599, 83.11%) , wine (2 588, 82.76%) , mutton (1 995, 63.8%) and beef (1 979, 63.29%) . Logistic regression analysis revealed that doctors with a college degree, practitioners of traditional Chinese medicine or integrated traditional Chinese and Western medicine, and those from hospitals of traditional Chinese medicine were more likely to suggest food or drink avoidance (all P < 0.001) ; practitioners of Western medicine ( P < 0.001) and those specializing in psoriasis ( P < 0.001) were more likely to inform that there was no need for food or drink avoidance, while those from municipal or county hospitals were less likely to inform that ( P = 0.025, 0.042, respectively) . Practitioners of traditional Chinese medicine ( P < 0.001) or integrated traditional Chinese and Western medicine ( P = 0.004) were more likely to believe that foods could aggravate the disease condition, while clinicians with working experience of more than 20 years ( P < 0.01) and those with a doctor degree ( P = 0.008) were less likely to think so; doctors with a college degree, and those from traditional Chinese medicine hospitals were more likely to believe that drinks could aggravate the disease condition (both P < 0.05) ; practitioners of traditional Chinese medicine or integrated traditional Chinese and Western medicine, those with intermediate and senior professional titles, those working at psoriasis specialty clinics and those engaged in psoriasis basic research were more likely to believe that foods could relieve the disease condition (all P < 0.05) ; doctors from traditional Chinese medicine hospitals, those with working experience of > 5 years, those with a college degree, and those engaged in psoriasis basic research were more likely to believe that drinks could relieve the condition (all P < 0.05) . Conclusion:A relatively high proportion of Chinese dermatologists had the viewpoints that diets were correlated with the severity of psoriasis and there was a need for food or drink avoidance, and this perception was related to academic degree, practicing category of clinicians, as well as the type and location of the hospital.