Objective To study the characteristics of the procedure of medical equipments purchase.Methods The risk of medical equipment purchase was analyzed.Results Methods of how to avoid this risk was put forward,such as loan in hospital,project management and a series of check and analysis procedures.Conclusion Desirable economic benefit and effective management are achieved.

Objective To express human thyroid peroxidase (hTPO) epitopes gene and apply its products in clinical assay. Methods hTPO epitopes gene was cloned into expression vector pGEX 4T 3 then transformed into E. coli BL21. Expression of hTPO gene was induced by isopropyl ? D thiogalactoside, expressed product (GST hTPO) was purified by affinity chromatography and their immunoactivity was demonstrated. ELISA technique using GST hTPO as antigen was established for determining TPOAb. Serum TPOAb level was determined, and HLA DR antigen, dendritic cells and lymphocytes in the thyroid gland tissue were observed in these same AITD patients.Results GST hTPO acquired from procaryotic expression had high purity and good immunoactivity. The CVs of the ELISA technique established with GST hTPO were between 5.93%～7.59%. A significantly positive correlation was found between the TPOAb levels determined respectively by ELISA and RIA method. Serum TPOAb level and distribution of HLA DR antigen and dendritic cells showed the same ascending tendency following the aggravation of lymphocyte infiltration. Conclusion Product of genetic engineering, GSH hTPO, can be used to establish a clinical assay for TPOAb. The correlation between the level of serum TPOAb and the detriment of thyroid tissue is demonstrated.

OBJECTIVETo examine serum levels of sICAM-1 from normal controls and patients with thyroid diseases (simple goitre, Graves' disease or Hashimoto's thyroiditis) with (125)I-sICAM-1 RIA established in our lab.

METHODSUsing (125)I-sICAM-1 RIA, serum sICAM-1 levels of 400 healthy individuals as the normal group and 1020 patients with simple goitre (SG), Graves' disease (GD) or Hashimoto's thyroiditis (HT) were examined for a comporative chinical study.

RESULTSThe serum level of sICAM-1 (x +/- s) in the normal group was 168.43 +/- 36.23 micro g/L. There was no significant difference between the normal and SG groups (P > 0.05), whereas the serum levels of sICAM-1 in autoimmune thyroid diseases (GD or HT) were higher than those in the normal or SG groups (P < 0.05, respectively). After GD patients received one of three medical treatments, their serum sICAM-1 levels decreased (P < 0.05). After GD patients were treated and their thyroid function decreased to normal, their serum sICAM-1 levels were lower than those in relapsed GD patients (P < 0.05).

CONCLUSIONSsICAM-1 RIA can be used to examine autoimmune thyroid diseases. Serum levels of sICAM-1 can be used as a parameter in diagnosing autoimmune thyroid disease and in evaluating the effects of therapy, drug administration or relapse in GD.

Adult ; Aged ; Female ; Goiter ; blood ; diagnosis ; Graves Disease ; blood ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Middle Aged ; Radioimmunoassay ; Thyroiditis, Autoimmune ; blood ; diagnosis

OBJECTIVETo attempt to produce highly accurate three-dimensional (3D) printed models of aortic aneurysm models aid complicated preoperative planning in endovascular repair procedures.

METHODSFrom October 2012 to May 2014, six patients with complicated aortic aneurysms (one aortic arch aneurysms, one thoracoabdominal aortic aneurysms and four juxtarenal abdominal aortic aneurysms) accepted preoperative contrast-enhanced CT angiography (CTA) scans for procedural planning, 4 male and 2 female, average age 64 years (range 52 to 73 years). All the CTA data were processed with FitMe 3D image processing software to get the modified 3D reconstruction pictures and computer language that can be identified by the 3D printer. With the fused deposition modeling technology, the highly accurate models were got to make preoperative endovascular planning.

RESULTSAll the patients' models were printed before operations. By the guidance of models, the endovascular procedure plans were drawn up. Three patients were performed extracorporeal simulating operations with the models and four patients' endovascular operations were guided by the models during the intraoperative time. The procedure technique success rate was 100%. No serious complications and patients dead during the perioperative period.

CONCLUSIONThe technology of 3D printed highly accurate models of aortic aneurysm models is feasible and can help to make preoperative endovascular planning for improving the safety of complicated procedures.

Aged ; Aortic Aneurysm ; diagnosis ; pathology ; Aortic Aneurysm, Abdominal ; diagnosis ; pathology ; Aortic Aneurysm, Thoracic ; diagnosis ; pathology ; Aortography ; Blood Vessel Prosthesis Implantation ; methods ; Endovascular Procedures ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Preoperative Period ; Software ; Tomography, X-Ray Computed

Objective To evaluate midterm outcomes of thoracic endovascular aortic repair (TEVAR) with in situ fenestration (ISF) to revascularize the aortic arch vessels.Methods From Feb 2012 to Dec 2014,10 patients underwent TEVAR with aortic arch vessels revascularized via ISF.There were 6 patients of thoracic aortic aneurysms (TAA) and 4 of type B aortic dissection (TBAD).Patients were followed for all-cause mortality,endoleak of post-TEVAR,integrity and patency of aortic endograft and branch vessels.Results Totally 11 branch vessels [10 left subclavian arteries (LSA),1 left common carotid artery (LCA)] via ISF were revascularized in 10 patients.Patients were followed-up for 24-55 mouths,mean of 42.80 months.1 TAA patient died in 2 years post-TEVAR unrelated to the operation.All fenestrations remained patent,and there were no endoleaks and no occlusion,compression,or fracture of stents.There were no postoperative strokes and left upper limbs ischemia.1 patient had distal aortic endograft pseudoaneurysms formation in 2 years post-TEVAR and underwent reTEVAR treatment.Conclusion Aortic arch vessels revascularization via ISF in TEVAR is safe and feasible.Midterm outcomes is satisfactory.

Objective:To investigate the value of brainstem auditory evoked potential (BAEPs) combined with cochlear electrogram (ECochG) monitoring in the protection of auditory function during microvascular decompression (MVD) for patients with facial spasm (HFS).Methods:Clinical data of 908 patients with HFS who received MVD treatment in our hospital from January 2018 to December 2020 were retrospectively analyzed. The patients were divided into BAEPs group ( n=309), ECochG group ( n=301) and BAEPs+ECochG group ( n=298) according to the different methods of auditory nerve function monitoring. Waveform extraction rate, mean extraction time, amplitude, latency, intraoperative warning effect of 3 monitoring methods, as well as hearing status immediately after surgery and during follow-up were compared in patents from the 3 groups. Results:(1) The overall waveform extraction rate in ECochG group and BAEPs+ECochG group was significantly higher than that in BAEPs group, and the average waveform extraction time in ECochG group and BAEPs+ECochG group was significantly shorter than that in BAEPs group ( P<0.05). The amplitude of compound action potential (CAP) wave in ECochG group was significantly higher than that of V wave in BAEPs group, and the latency of CAP wave was also significantly earlier than that of V wave ( P< 0.05). (2) A total of 48 patients of the 288 patients in the BAEPs group showed warning signs; a total of 73 of the 292 patients in the ECochG group showed warning signs; and a total of 65 of the 292 patients in the BAEPs+ECochG group showed warning signs. (3) There was significant difference in hearing grading (American Association of Otolaryngology Head and Neck Surgery [AAO-HNS] grading) among the 3 groups immediately after surgery ( H=18.041, P=0.000), and the average rank suggested that the hearing of patients in the BAEPs+ECochG group was superior to the other two groups. All patients were followed up for an average of 15 months (ranged 3-24 months); there was still a significant difference in AAO-HNS grading among the 3 groups ( H=29.625, P=0.000), and the hearing of patients in the BAEPs+ECochG group was still superior to the other two groups. Conclusion:The combined application of ECochG and BAEPs monitoring can reflect the changes of intraoperative hearing impairment comprehensively, accurately and timely, which is of great significance for the protection of auditory function in HFS patients during MVD.

Objective? To develop a nurse-patient communication process for patient with cancer in China based on the American CICARE communication model and to provide standardized and processed guidance for communication between clinical nurses and cancer patients. Methods? Totally 5 clinical nursing experts from a Class Ⅲ Grade A hospital in Beijing were selected by purposive sampling and interviewed using focus group discussion between November and December 2018. Results? The nurse-patient communication process was developed based on the CICARE communication model after two rounds of focus group discussions, whose six steps were polite connection, complete introduction, professional explanation, careful asking, patient response and proper exit, which included role adaptation of nurses, admission evaluation, coordination during hospitalization, case management, care and health education. Conclusions? A nurse-patient communication process for cancer patients in China is developed using nurse-patient communication models from other countries and clinical nursing practice for reference, which provides a reference for nurse-patients communication and lays a foundation for carrying out the optimal nursing service demo projects and refined management.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

Humans ; Endovascular Aneurysm Repair ; Stents ; Blood Vessel Prosthesis ; Aortic Dissection/surgery* ; Endovascular Procedures ; Aortic Aneurysm, Thoracic/surgery* ; Treatment Outcome ; Blood Vessel Prosthesis Implantation ; Retrospective Studies