Objective: Provide the hardware support for the clinical diagnose and treatment and make sure that the medical instruments run safely and efficient by improving the status of medical equipment maintenance. Methods: retrospective analyze of the equipment maintenance of Shanghai pulmonary hospital. Results: 76.9% of the maintenance service is provided by the manufacturer and 23.1% of which is provided by the equipment department of the hospital. Conclusion: Medical equipment is about the life safety of patients, the manufacturer outsourcing service has its incomparable advantage in technology. It ensures the safe and efficient operation of the equipment, so outsourcing maintenance is the inevitable trend of development. But medical equipment has its particularity, it needs a short period of time to be present and service throughout the day, which requires the maintenance engineers have stronger business ability and give full play to the role. The effective combination of internal maintenance and outsourcing maintenance promotes the effect of the cooperation win-win.

Recently,basic and clinical researches have shown that blood glucose variability is an independent risk factor for diabetic complications.Thus,ideal control of blood glucose is not only to reach the HbA1Ctarget,but also to minimize blood glucose variability.Different glycemic parameters could be selectedaccording to different purpose of evaluation,in which the mean amplitude of glucose excursions(MAGE) and the standard deviation of blood glucose (SDBG) could be used as accurate and simple assessment parameters respectively.

Objective To investigate the usage of antiplatelet drugs(APD)therapy in ischemic stroke with a history of intracranial hemorrhage(ICH)and impact of APD therapy in recurrences of the ICH and the ischemic stroke. Methods In a retrospective study, all survivors of ischemic stroke with ICH who visited our hospital previous to this study were followed by clinic visit or by telephone interview and recurrent ICH, ischemic stroke, and APD use were recorded. Kaplan-Meier plot and Logistic regression were used to assess the effect of APD on recurrent ICH and isclemic stroke. Results Recurrent ICH was more common in patients with lobar hemorrhage compared than patients with deep hemorrhage. APD use was more common for prevention of myocardial infarction and atrial fibrillation. APD use did not increase ICH recurrence (OR = 1. 149, 95% CI 0. 376-3.513, P=0.808)and did not shorten duration of ICH recurrence(X2=1.257, P=0.262); however, it did reduce ischemic stroke recurrence(OR=0.410, 95% CI0. 203-0.826, P=0.013)and prolonged duration(X2 =14.315, P=0.001). Conclusion APD use was not associated with ICH recurrence and was beneficial to recurrence ischemic stroke in this observation study.

Combined acupuncture-medication anesthesia refers to an anesthesia method by combining acupuncture and small dose of anesthetics, i.e. acupuncture plus local anesthesia, acupuncture plus epidural anesthesia, acupuncture plus general anesthesia, and so on, used in cardiac, chest, skull, throat, abdominal, and urinary operations. Clinical studies show that the combined acupuncture-medication anesthesia has integrated the advantage of acupuncture in regulating the function of internal organs and the advantage of drugs insedation, thus producing a better protective effect on important organs than dry drug anesthesia during and after operation. This article summarized the latest research progress of the combined acupuncture-medication anesthesia in protecting organs duringthe perioperative period of pneumonectomy, pointed out the research frontiers of the application of this anesthesia method in pneumonectomy, and was of valuable reference for the clinical study in the future.

Doctor-patient trust is the core and foundation of harmonious doctor-patient relationship, because our country is at the stage of social transformation and deepening medical reform, various problems make the doctor-patient relationship unoptimistic, and there appeared crisis of confidence between doctors and patients. This arti-cle analyzes the current situation of doctor -patient trust in our country, based on the clarification of doctor -patient trust. It also comb the researches focused on doctor-patient trust evaluation on the basis of domestic and foreign literature. It is expected to provide a reference to the future evaluation of doctor-patient trust, to improve the level of trust between doctors and patients, and to build a harmonious doctor-patient relationship.

Objective To analyze the condition of Rhodamine 123 staining of human bronchial epithelium in vitro during the wound-repair process induced by fluorouracil(5-FU). Methods The bronchial epithelial cells in normal and 5-FU injurious group were obtained by enzymatic digestion and analyzed by flow cytometry.1.PI staining to identify the percentage of cells in different cell phase;2.Rhodamine 123 staining in live cells was to contrast the percentage of negative cells in two groups. Results 1.Analysis of cell cycle:apoptotic cells in injurious group increased,cells in S+G-2/M phase almost disappeared,majority of the remain live cells of injurious group were in G-0/G-1 phase;with the recover of bronchial epithelium,cells in S+G-2/M phase increased;2.The percentage of Rhodamine 123 negative staining live cells in injurious group was higher than that of normal group,and with the recover of bronchial epithelium,this percentage lowered to nearly normal.Conclusion 5-FU can make the cycling cells apoptosis and reserve quiescent phase cells.Among them there were bronchial stem cells which had the capacity to efflux Rhodamine 123.Just the proliferation and differentiation of these stem cells regenerated bronchial epithelium.Rhodamine 123 staining to sort the remain cells after 5-FU treatment by FACS can be used to enrich and purify bronchial stem cells.

Objective Our aim is to compare the safety and benefits of laparoscopic versus open incision hernia repair.Methods Forty-seven patients in our hospital were analyzed with prospective randomized double-blind study following either laparoscopic or open hernia repair.And others prospective randomized studies(PRS)were analyzed.Results Overall complication rate was similar in both groups(8.5% versus 9.2% in the laparoscopic and open groups respectively),but some early complications in the laparoscopic group maybe require a reoperation.Operating time was similar in the laparoscopic group.There was shorter length of stay and higher expense in the laparoscopic group and there was significant difference in the pain scores and medications,resumption of diet,or activity scores.At 2 weeks,there was no difference in the activity or pain scores,but physical function and physical health scores on the short-form 36(SF36)quality of life assessment forms were little in the laparoscopic group.Regardless of the technique(P=0.158).The result of PRS meta-analyses is that operating time was simila in the laparoscopic group.There was longer length of stay in the Laparoscopic group.And the rate of wound infection is significantly higher in the open groups.Conclusion Unlike other minimally invasive procedures,Laparoscopic hernia repair did not offer an advantage over open hernia repair in all studied parameters except pain,activities and quality of life scores at 2 weeks.It also took similar to perform.The choice of the procedure should be based on surgeon or patient preference.

OBJECTIVE:To investigate the role of clinical pharmacists in pediatric severe infection treatment,and to provide reference for rational drug use in clinic. METHODS:Based on related typical cases,the breakthrough points of clinical pharmacists providing pharmaceutical care in pediatric severe infection treatment plan were introduced. RESULTS:Clinical pharmacists formu-lated multi-drug resistance pathogenic antibacterial plan according to the results of pathogenic microbiological examination,use pharmacokinetics/pharmacodynamics,excluded interference to pediatric anti-infection treatment from ADR,and guideline and eco-nomical factors of patients. CONCLUSIONS:Clinical pharmacists adopt professional knowledge of pharmacy to provide pharmaceu-tical care in pediatric severe infection treatment and play professional assisted role so as to guarantee safe,effective and economical treatment.

With the establishment of bio-psycho-social medical model,the higher requirements are put forward for medical students′ professional qualification,which include solid theoretical foundation,superb clinical skills,profound humanistic knowledge,and noble medical ethics.It is of great significance to cultivate medical students′ professional qualification,since it can help medical students promote their competitiveness in the job market,improve the quality of medical services and build a harmonious relationship between doctors and patients.There are many approaches to train medical students′ professional qualification,including improving medical curriculum construction,deepening teaching reform of clinical practice,strengthening the integration of professional education and humanities education,conducting medical ethics education,and establishing an assessing system for medical students′ professional qualification.

Objective To compare cerebralspinal fluid acetylcholine (ACh) and choline (Ch) in patients with Alzheimer's disease (AD) and vascular dementia (VD), and their correlation with cognitive impairment.Methods First, dementia scales of 22 ADs, 22 VDs and 20 controls were scored using MMSE. Then the concentrations of CSF ACh and Ch in AD and VD were examined using the high-performance liquid chromatography with electrochemical detector (HPLC-ECD). Finally, the scores of MMSE and concentrations of ACh and Ch were compared. Results The ACh concentrations in AD[(10.7?5.1)nmol/L] and VD [(16.8?7.4)nmol/L] were found to be significantly lower than in controls [(34.5?9.0)nmol/L]( P =0.001), and showed a significant positive correlation with MMSE scores. The Ch concentration in AD CSF [(627.6?145.1)nmol/L] was approximately the same as in controls [(716.0?159.4)nmol/L], and showed no correlation with MMSE scores. The Ch concentration in VD CSF [(887.4?187.4)nmol/L] was significantly higher than in AD ( P =0.001) and controls ( P =0.002).Conclusion (1)The depression of ACh is correlated with cognitive impairment, suggesting ACh is an important neurotransmitters for memory. (2) VD may have a similar pathogenesis as AD. (3) The depression of AD ACh concentration and elevation of VD Ch concentration in CSF may be a role in their differentiation. (4) The application of acetylcholinesterase inhibitors is suitable for AD and VD.