Bidding invitation and procurement of medical equipment is one of the most important works in hospital.It can increase the working efficiency to hold the key taches of medical equipment procurement from 4 aspects including the science of decison-making,the comfirmability of bidding invitation,the right choice of the way of bidding,etc.So some important taches of medical equipment procurement are analyzed and discussed and some points for attention are raised.[Chinese Medical Equipment Journal,2008,29(2):76-77]

Data quality issues of TCM structured data warehouse system is very important.This paper analyzed the data quality issues from the data repository to the data extraction,cleansing,transformation,loading (ETL) into the data warehouse process and established the principle of corresponding control,and researched improving data quality measures to ensure the success of data warehouse and right decision support.

Objective To study the cerebral energy metabolism changes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through hydrogen magnetic resonance spectroscopy examination (1 HMRS ) and its relationship with partial pressure of oxygen / carbon dioxide tension.Methods Totally 13 cases of AECOPD patients and 10 cases of age-matched healthy people underwent HMRS examination.The ratios of n-acetyl-aspartate(NAA)/creatine(Cr),choline (Cho)/Cr,myo-inositol(MI)/Cr of parieto-temporal and occipital areas of brain were detected.Blood gas analysis were also used to detect partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2).Results NAA / Cr of parieto-temporal and occipital areas of brain (1.32±0.12,1.48±0.12) were lower in AECOPD group than those in control group (1.45±0.11,1.58±0.10) (P＜ 0.05),MI/Cr (0.23±0.07,0.30±0.11) were also decreased compared with control group (0.40±0.14,0.46±0.12) (P＜ 0.01),while Cho/Cr of parieto -temporal and occipital areas of brain between the AECOPD group and control group showed no significant difference (P＞0.05).NAA/Cr of parieto temporal and occipital areas of brain were positively correlated with PaO2 (r=0.46 and 0.44),and MI/Cr of these areas of brain were also positively related with PaO2 (r=0.63 and 0.50),but MI / Cr of parieto tempora was negatively correlated with PaCO2 (r =- 0.472). Conclusions Cerebral metabolite changes may occur in AECOPD patients,and this has relationship with hypoxia and carbon dioxide retention.

Objective To evaluate selective retention of the great saphenous vein (GSV) belowknee in the prevention of saphenous nerve injury during varicose veins surgery.Methods From January 2009 to January 2012,280 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups.Patients in the experimental group underwent stripping restricted to the below knee level,patients in control group underwent GSV stripping to the ankle level Patients in the two groups were treated with transilluminated powered phlebectomy,and foam sclerotherapy.Primary end points were postoperative pain,saphenous nerve injury,quality of life and recurrence rate.Results After one month follow-up:5.71％ patients had symptoms of nervous system in the observation group,14.29％ patients had symptoms of nervous system in the control group (P =0.02).After 1 year follow-up,1.47％ patients had symptoms of nervous system in the observation group,7.14％ patients had symptoms of nervous system in the control group (P =0.02).Conclusions Selective retention of great saphenous vein below-knee decreases saphenous nerve injury.

Objective:This paper aims to explore the relationship between the residents’ health and economic de-velopment to provide a scientific basis which will promote the coordinated economy and health development. Methods:Adopting the entropy method, we could calculate the comprehensive health evaluation index. In combining the co-inte-gration and error correction models, we could analyze the long-term and short-term relationships between our country residents’ level of health since 2000 and the national macro-economic development information. The Granger causality test served as a good method used in testing the casual relationships. Results: The health and economic development has a co-integration relationship which is -0. 6216 in the short-term correction. The economic development extent is the Granger cause of residents’ health status. Conclusion:There is not only a long-term equilibrium, but also a short-term relationship between the residents’ health and economic development in our country. The economic growth pro-motes residents’ health status while the promotion of residents’ health to economic growth is not obvious.

Objective To explore the effect of a multimodal electroencephalogram ( EEG) data visualiza-tion system on the motor imagery ability of stroke survivors. Methods Twenty stroke patients were randomly di-vided into an experimental group and a control group, each of 10. Both groups were provided with brain-computer interface-based motor imagery ( MI) training. At the same time, the experimental group was monitored and guided using an online, multimodal EEG data visualization system developed in our department. The classification accuracy ( CA) and event-related desynchronization ( ERD) of the 2 groups′ motor imagery were compared before and after the treatment. Results Before the treatment, no significant differences in the average CA of MI were found be-tween the experiment group (50.92±2.08) and the control group (49.35±4.20)(P>0.05). After the treatment, however, the experimental group′s average CA had increased to (64.52±5.27), significantly higher than that of the control group (51.18±5.02). When the stroke patients imaged affected upper extremity movements, obvious ERD was observed in the α frequency around the bilateral central motor regions of both groups, especially in the experi-mental group, but without significant differences between the two groups. However, no significant changes were found in the ERD of theβwaves of the two groups( P>0.05) . Conclusion The proposed online multimodal elec-troencephalogram data visualization system can help stroke patients imagine movements actively. It is worth sprea-ding in clinical practice.

OBJECTIVETo compare the difference in the efficacy on thoracic facet joint disorder between the combined therapy of electroacupuncture and manual reduction and the simple manual reduction.

METHODSOne hundred and sixty patients were randomized into an electroacupuncture and manual manipulation group (group A) and a simple manual manipulation group (group B), 80 cases in each one. In the group A, Ashi points and three pairs of Jiaji (EX-B 2) bilateral to the painful sites were selected. The perpendicular puncture was used at Ashi points, the oblique puncture was used at Jiaji (EX-B 2) and connected with electric stimulation for 20 min, additionally, the corresponding manual reduction was adopted at the sites of facet joint disorder. In the group B, the simple manual reduction was applied to the affected sites. Acupuncture was given once every day, the manual reduction was applied once every 10 days. The treatment of 10 days made one session. The efficacy was analyzed statistically at the end of two sessions of treatment. Before and after treatment, McGill pain scale was adopted for the value statistical analysis. PRI score, VAS score and PPI score of patients were calculated before and after treatment and compared in the two groups. The efficacy was compared between the two groups.

RESULTSThe curative rate was 56.3% (45/80) in the group A, which was better than 18.8% (15/80) in the group B (P< 0.01). The total effective rate was 95.0% (76/80) in the group A, which was better than 76.3% (61/80) in the group B (P<0.01). The scores of PRI, VAS and PPI after treatment were all improved significantly in the two groups (all P<0.05), in which, the results in the group A were better than those in the group B (PRI: 4.00 +/- 0.97 vs 5.44 +/- 1.16, VAS: 3.29 +/- 0.72 vs 3.87 +/- 0.81, PPI: 1.07 +/- 0.74 vs 1.64 +/- 0.90, all P<0.05).

CONCLUSIONThe combined therapy of electroacupuncture and manual manipulation achieves the superior efficacy on thoracic facet joint disorder as compared with the simple manual manipulation. The combined therapy relieves the symptoms of thoracic facet joint disorder and reduces the severity of disorder.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Thoracic Diseases ; therapy

Objective To evaluate the early clinical efficaoy of hybrid procedure for infants less than six months old with ventricular septal defect and coarctation of aorta.Methods From January 2010 to July 2011,20 patients with ventricular septal defect and coarctation of aorta received hybrid procedure in our center.The body weight was (4.5 ± 1.6) kg ( ranged from 1.9 kg to 6.5 kg) and the age was ( 56 ± 45 ) days ( ranged from 18 days to 6 months).The pressure gradient of the coarctation of the aorta ranged from 30 mm Hg to 56 mm Hg,5 patients of them were diagnosed as hypoplasty of aortic arch.The size of the ventricular septal defect ranged from 8 mm to 16 mm.Results The mortality was zero in all the 20 cases during the surgery,and the mobidity was 20％ (4/20).The complications were pneumonia in 2 cases,infective endocarditis in 1 case and pneumothorax in 1 case.The diameter of coarctation of the aorta ranged from 1.5 mm to 3.4 mm,and the size of the balloon ranged from 4 mm to 12 mm.The pressure gradient of the coarctation of the aorta decreased to 0 to 27 mm Hg.The bypass time ranged from 40 minutes to 87 minutes,and the crossclamp time of the aorta ranged from 20 minutes to 41minutes.The atrial septal defects were repaired and the patent ductuses were ligated during the surgery without leaving the sternum open.The total operation time was (4.0 ± 0.7 ) hours ( ranging from 3.0 hours to 5.2 hours).The mean ventilation time was (2.2 ± 1.4) days and mean ICU stay time was (5 ± 3 ) days.All the patients were followed up for ( 10.0 ± 3.6) months without aneurysm in arch and obstruction in airway.The residual obstructive pressurc gradicnt in the aortic arch ranged from 12 mm Hg to 35 mm Hg and 2 patients received reintervention.One patient received re-balloon dilation and the other received surgery.The cardiac function reached NYHA Ⅰ - Ⅱ in all eases.Conclusion The early outcome of the hybrid procedure (balloon dilation of the coartation of the aorta and surgical repair of ventricular septal defect) for infants with ventricular septal defect and coarctation of aorta was satisfying,which could avoid from circulatory arrest.It is a relatively safe procedure which could be the optional method for one-stage surgical repair.

Objective To evaluate the medium-term outcomes of minimally invasive percutaneous nephrolithotomy in patients with renal function impairment.Methods Data of 811 patients who underwent minimally invasive percutaneous nephrolithotomy between Jan.2009 and Dec.2011 were retrospectively collected.Seventy-eight patients had a preoperative estimated GFR of 30-59 ml/(min · 1.73m2).The minimum follow-up was 1 year.Patients were divided into group 1 (improved or stable disease) and group 2 (worsened disease).Patient age was (42.8 ± 16.3) and (45.3 ± 14.2) separately,with male patients 41 and 7,female patients 25 and 5 respectively.Body mass index were (24.3 ± 4.1) kg/m2 and (25.4 ±5.2) kg/m2,history of open surgery or ESWL were 19 and 4.Mild hydronephrosis were 22 and 4.Staghorn stone were 22 and 5.Multiple access were 13 and 2.Operative time was (78.2 ± 30.4) min and (80.3 ±32.3) min.Stone-free rate 1 month postoperatively were recorded.Multiple regression analysis was used.Results The stone free rate at 1 month postoperatively was 85％ by CT scan.Preoperative eGFR was (38.4±12.8) ml/(min · 1.73m2),and 1 ycar postoperative eGFR was (45.1 ±15.8) ml/(min · 1.73m2)in 78 patients.Renal function had improved in 31％ of patients,but it remained the same or deteriorated in 54％ and 15％,respectively at 1 year follow-up.On multivariate regression analysis,diabetes was associated with the deterioration of renal function.Conclusions At medium-term follow-up,renal function was maintained or improved in 85％ of patients with chronic kidney disease who underwent minimally invasive percutaneous nephrolithotomy.Minimally invasive percutaneous nephrolithotomy could be an effective and safe option for the patients with chronic renal function impairment.Diabetes mellitus was independent predictive factor of renal function impairment.Therefore,patients with diabetes should be followed up carefully.Medical management is needed if necessassry.

Objective To observe vasculogenic mimicry formation difference in human hepatocellular carcinoma cell lines MHCC97-H/L with different metastatic potentials under three-dimensional culture condition,and to study extracellular matrix and adhesion molecules-related mechanism of vasculogenic mimicry.Methods Three-dimensional cell culture system of MHCC97-H/L was established to observe tubelike structures by inverted microscope.Human umbilical vein endothelial cell(HUVEC),human hepatocellular carcinoma cell line Hep3B with non-metastatic potentials and normal human hepatic cell line HL-7702 were taken as control.Gene expression profiles of MHCC97-H and MHCC97-L were detected by Oligo extracellular matrix and adhesion molecules microarray analysis.Two differentially expressed genes were verified with semi-quantitative reverse transcriptionpolymerase chain reaction(RT-PCR)and Western blot.All data were analyzed using two sample t test.Results After a 24-hour three-dimensional culture,the length of tubelike structures was(474 ± 16)mm/cm2 in MHCC97-H,which were significantly longer than(320 ±41)mm/cm2 in MHCC97-L(t =6.119,P ＜0.05).Hep3B and HL-7702 could not form tubelike structures.Compared with MHCC97-L,the expression of 7 genes were up-regulated and the expression of 3 genes were down-regulated among a total of 113 angiogenesis genes in MHCC97-H.Two of the genes with differential expressions including tenascin C and extracellular matrix protein 1 were further validated by RT-PCR and Western blot.Conclusion MHCC97-H has stronger ability to form vasculogenic mimicry than MHCC97-L,and this perhaps correlates with the differential expression of certain extracellular matrix and adhesion molecules-related genes in MHCC97-H.