Objective To explore the key factors which affect maintenance cost of large-scale medical equipment. Methods The basic factors which affect maintenance cost of medical imagining equipment were summarized. The relationships of them are analyzed and then an interpretative structure mode of each factor was set. Additionally, the multiple relationship and controllability between each factor were also analyzed and the judging standard of key factors was set. Results The maintenance policy and mode were the key factors which affect maintenance cost of medical imagining equipment. Conclusion High quality maintenance for equipment condition and scientific optimization of the maintenance policy are necessary to fundamentally reduce the maintenance cost of large-scale medical equipment.

Patient position management is an important work in clinical treatment. In clinic, it is necessary to adjust the corresponding patient's position according to the characteristics of the patient's condition. The appropriate patient's position plays an important role in treating the disease, alleviating the severity of symptoms and preventing the complications in the critical patients. A medical bedside angle measuring device and medical bed was designed. The measuring device was convenient for the clinicians to read the raised angle in time, improving the working efficiency, and the structure was simple and the operation was convenient. The whole device mainly included panel, unfolding device and medical bed with bed angle measuring device on the panel. There was an angle display area, with the range of display angle was 0°to 75°, which was adjusted to the corresponding angle according to the needs of the patient's condition under usage. The angle corresponding to the horizontal measurement line was the angle of elevating the head of the bed. The newly invented medical bedside angle measuring device and the medical bed could help the clinical medical staff know the patient's position at a glance, raising the bed head accurately, and making it convenient to use. It provided a good solution for clinical application and it was worth to popularize.

Chronic?obstructive?pulmonary?disease?(COPD)?is?a?severe?respiratory?disease?characterized?by?airway?obstruction?with?high?mortality?and?rate?of?recurrence.?Rehabilitation?exercise?can?lessen?the?possibility?of?the?progressive?exacerbation?of?the?patient's?condition,?exerting?an?active?role?in?improving?their?lung?function?and?the?quality?of?the?patients'?life.?Therefore,?we?have?designed?a?lung?function?exercise?bottle,?which?is?capable?of?adjusting?the?pressure?according?to?the?patient's?needs.?It?is?easy?to?operate?and?apply?in?practice.?The?exercise?bottle?is?composed?of?three?components,?including?bottle?body,?threaded?round?cap?and?air?blow?pipe.?The?bottle?body?is?formed?in?rectangle?shape,?and?utilized?to?contain?liquid.?The?filling?opening?is?designed?on?the?top?of?the?bottle.?Outside?of?the?filling?opening,?there?is?a?screw?thread?round?cap,?which?can?adjust?the?pressure?according?to?the?patient's?tolerance,?gradually?increasing?the?training?intensity,and?improving?the?training?effect?thereby.?The?blowpipe?can?be?inserted?into?the?bottle?body?and?the?patient?can?blow?the?air?through?the?tube.?Compared?with?the?traditional?rehabilitation?training,?when?the?newly?invented?lung?function?exercise?bottle?has?been?used?for?rehabilitation?exercise,?the?air?pressure?in?the?bottle?can?be?adjusted,?with?the?advantage?of?wider?range?of?application,?lower?cost?and?more?convenient.?It?provides?a?good?solution?for?clinical?and?home-based?rehabilitation?and?is?worth?of?popularizing.

Objective To determine the application value of quantitative detection of DNA in cervical lesion screening.Methods Retrospective analysis of 82 518 cases of cervical lesions was carried out.The sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV) of DNA quantification and ThinPrep cytology test (TCT) for the diagnosis of cervical lesions were compared with the results of biopsy.The accuracy of the two methods was evaluated by applying the receiver operating characteristic curve.Results The sensitivity of DNA quantification,TCT,and combined diagnosis was 77.37％,70.97％,and 90.24％,respectively,and the specificity was 65.59％,70.42％,and 45.06％,respectively.The sensitivity of cell DNA quantitative analysis was higher but the specificity was lower than that of TCT,while the sensitivity of combined diagnosis was the highest.In DNA quantitative analysis of patients with and without atypical squamous cells of undetermined significance (ASCUS),the positive rates of pathology were 42.71％ and 12.5％,respectively.The misdiagnosis rate of cell DNA quantitative analysis for screening cervical adenocarcinoma (39.13％) was higher than that for screening cervical squamous cell carcinoma (15.11％).In a cytologic smear,the misdiagnosis rate of cells ＜ 5 000 (57.83％) was much higher than that of cells ＞ 5 000 (22.63％).However,a combined diagnosis with TCT could reduce the misdiagnosis rate from 20.19％ to 13.38％.Conclusion Cell DNA quantification is more sensitive than TCT,but the specificity of cell DNA analysis is lower than that of TCT,and the screening rate for cervical adenocarcinoma is high.Quantitative DNA analysis combined with TCT can significantly improve the screening sensitivity.

Cardiopulmonary resuscitation (CPR) guidelines emphasize that external chest compressions should be started as soon as possible when CPR is performed in patients with cardiac arrest. Moreover, those guidelines stress on fast and hard compressions to make the chest fully rebound and minimize non-pressing time. Current mechanical recovery device has several problems such as displacement of the pressing position, high price, difficult to move, and easy dislocation of piston. Because of the physical loss of high-intensity unarmed CPR, the depth and frequency of external chest compression will decrease with the extension of CPR time, leading to CPR failure. Besides, there are other problems caused by non-professional staff, such as the deviation of compression position, the inaccuracy of compression depth and the unsatisfactory rebound of the chest wall. Based on the above factors, the medical staff from the intensive care unit of the Eighth Medical Center of the Chinese People's Liberation Army General Hospital designed a portable external chest cardiac compressor based on international CPR guidelines which obtained the National Utility Model Patent of China (ZL 2018 2 1173254.3). The portable external chest cardiac compressor is composed of a positioning sucker, elastic body, mounting shell, and pressing components. Rapid and accurate compression positioning, visible compression depth and full chest rebound can be achieved. This device is mobile, easy to operate, and suitable for a broad crowd and various occasions.

Objective:To establish a risk prediction model for hospital acute heart failure in elderly patients with chronic heart failure (CHF) .Methods:From January 2018 to December 2020, 619 elderly CHF patients admitted to the Cardiovascular Department of Peking University Third Hospital were selected as the research object by convenience sampling. The patients were divided into the occurrence group ( n=55) and the non-occurrence group ( n=564) according to whether the patients had acute heart failure in hospital. Binomial Logistic regression was used to explore the independent risk factors of acute heart failure in elderly CHF patients. The nomogram model was constructed by R software, and its prediction effect was verified. Results:Binomial Logistic regression showed that high heart rate at admission [ OR=1.021, 95% CI (1.003, 1.039) ], history of cerebrovascular disease [ OR=2.253, 95% CI (1.197, 4.240) ], constipation [ OR=10.382, 95% CI (1.376, 78.308) ], arrhythmia [ OR=2.051, 95% CI (1.079, 3.898) , taking aspirin [ OR=2.741, 95% CI (1.447, 5.193) ], intravenous diuretics [ OR=6.326, 95% CI (2.629, 15.220) ]and high level of N-terminal forebrain natriuretic peptide [ OR=3.511, 95% CI (1.890, 6.521) ]were independent risk factors for hospital onset of acute heart failure in elderly patients with CHF, and the use of vasodilator was a protective factor. The nomogram model was validated. The area under the receiver operating characteristic curve ( AUC) of the subject was 0.808 [95% CI (0.753, 0.864) ], the AUC of internal validation was 0.821 [95% CI (0.764, 0.871) ], and the calibration curve was a straight line with a slope close to 1. Conclusions:There are many risk factors of hospital acute heart failure in elderly CHF patients. The prediction model based on risk factors has good discrimination and calibration, and can predict the risk of acute heart failure in elderly CHF patients in hospital.

Chronic obstructive pulmonary disease (COPD) is a severe respiratory disease characterized by airway obstruction with high mortality and rate of recurrence. Rehabilitation exercise can lessen the possibility of the progressive exacerbation of the patient's condition, exerting an active role in improving their lung function and the quality of the patients' life. Therefore, we have designed a lung function exercise bottle, which is capable of adjusting the pressure according to the patient's needs. It is easy to operate and apply in practice. The exercise bottle is composed of three components, including bottle body, threaded round cap and air blow pipe. The bottle body is formed in rectangle shape, and utilized to contain liquid. The filling opening is designed on the top of the bottle. Outside of the filling opening, there is a screw thread round cap, which can adjust the pressure according to the patient's tolerance, gradually increasing the training intensity,and improving the training effect thereby. The blowpipe can be inserted into the bottle body and the patient can blow the air through the tube. Compared with the traditional rehabilitation training, when the newly invented lung function exercise bottle has been used for rehabilitation exercise, the air pressure in the bottle can be adjusted, with the advantage of wider range of application, lower cost and more convenient. It provides a good solution for clinical and home-based rehabilitation and is worth of popularizing.
Equipment Design ; Exercise Therapy/instrumentation* ; Humans ; Lung/physiology* ; Pulmonary Disease, Chronic Obstructive/rehabilitation*

Objective:To assess the association between blood pressure and the risks of diabetes mellitus.Methods:Screening and intervention were conducted from 2015 to 2019 for high-risk subjects of cardiovascular diseases in eight counties of Henan. Information on demographic characteristics, lifestyle behaviors, and anthropometric measurements were obtained via a questionnaire. Fasting blood samples were collected for blood glucose and serum lipids. The R 3.6.3 software was used to analyze the relationship between blood pressure and diabetes mellitus.Results:The detection rate of diabetes mellitus was 23.5% among 120 040 participants aged 35-75 years. The mean fasting blood glucose level was significantly different among normotensive, prehypertensive, and hypertensive patients. Compared to normotensive patients, prehypertension and hypertension had adjusted ORs of 34%( OR=1.34, 95 CI%: 1.30-1.37) and 85%( OR=1.85, 95 CI%: 1.81-1.89). The corresponding ORs were 1.81(1.77-1.85) in controlled and 2.17(2.06-2.28) in uncontrolled patients. A subgroup analysis showed the same trend, where the risk of diabetes increased with blood pressure ( P<0.05). Conclusions:People with elevated BP may increase their risk of diabetes, while the risk declines when BP is under control. Therefore, targeted measures should be taken to reduce the risk.

Objective:To analyze the association between healthy lifestyle and mortality among Henan Province 35-74 years old individuals.Methods:Data from the programme of screening and intervention subjects with high-risk cardiovascular disease 99 133 adults were analyzed in a provincial cohort study of 16 counties. Four healthy lifestyle behaviors were assessed based on a questionnaire survey. Information on mortality endpoints was retrieved from the national death surveillance system. Cox proportional hazards regression models were used to estimate the associations between healthy lifestyles, mortality risk and population attributable fraction (PAF).Results:Out of the adult participants in Henan, 50.6% adhered to a healthy lifestyle, and only 0.1% adhered to 4 healthy lifestyle behaviours. During a mean of 4.5 years, 2 685 all-cause death and 1 283 cardiovascular deaths were documented. The decreased risk of mortality among individuals with non-smoking, moderate drinking, adequate exercise and healthy diet were 0.85 (95% CI: 0.77-0.94), 0.75 (95% CI: 0.63-0.89), 0.73 (95% CI: 0.67-0.79) and 0.86 (95% CI: 0.77-0.96), while the adjusted PAF for all-cause deaths were 5.2% (95% CI: 2.5%-7.9%), 24.0% (95% CI: 10.7%-36.4%), 19.4% (95% CI: 13.8%-24.8%) and 12.3% (95% CI: 3.4%-20.9%), respectively. A combined healthy lifestyle can bring more health benefits. Adherence to 4 healthy lifestyle behaviours could avoid 49.1% of all-cause death. Conclusion:Adherence to a healthy lifestyle can reduce the risk of death, and participants with a healthy lifestyle had a lower mortality risk.

Aim To analyze the influencing factors of adverse cardiovascular events in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),and to establish a nomogram prediction model.Methods A total of 216 elderly patients with acute STEMI who underwent PCI in Jinqiu Hospital of Liaoning Province from February 2021 to January 2023 were selected and divided into occurrence group(n=33)and non-occurrence group(n=183)according to the occurrence of postoperative adverse cardiovascular events.General data,laboratory indicators,imaging information,and postoperative medication data of all patients were collected.Univariate and multivariate Logistic regression analysis were used to explore independent risk factors for adverse cardiovas-cular events.A nomogram prediction model was constructed according to independent risk factors of neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),C-reactive protein/albumin ratio(CAR),C-reactive protein to high density lipoprotein cholesterol ratio(CHR),calibration curve was drawn to verify the nomogram model,and receiv-er operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of the predictive model for column line diagrams.Results The levels of NLR,PLR,CAR,CHR,Gensini score,and platelet aggregation ratio(PAR)were significantly higher in occurrence group than those in non-occurrence group,left ventricular ejection fraction(LVEF)was significantly lower in occurrence group(P＜0.05).Logistic regression analysis showed that Gensini score,LVEF,PAR,NLR,PLR,CAR and CHR were independent risk factors for adverse cardiovascular events after PCI in elderly acute STE-MI patients(P＜0.05).The column-line diagram model for predicting the risk of adverse cardiac events after PCI in eld-erly acute STEMI patients was constructed based on independent risk factors,and the calibration curve of the model was close to the ideal model,and the ROC curve showed that the area under the ROC curve for the prediction of the risk of ad-verse cardiovascular events in the elderly acute STEMI patients was 0.914.Conclusion NLR,PLR,CAR and CHR are independent risk factors for adverse cardiovascular events in elderly acute STEMI patients after PCI,and the nomogram model constructed based on these factors can effectively predict the risk of adverse cardiovascular events in elderly acute STEMI patients after PCI.