Objective:To realize the development of processize, dynamic and normalizing of quality control for medical equipment, and increase the rate of submittal for inspection and work efficiency of medical equipment.Methods: Through data management of informationization platform to count the time, quantity and qualified rate of quality control for medical equipment, and to automatically reminded the number of equipment that was submitted to inspect, and to enhance the rate of submittal for inspection.Results: Through the real-time inquiry function of the operation and maintenance system, the work efficiency was enhanced, and the transformation from static state to dynamic state of the process ofcycle quality control for medical equipment was achieved, and the management for detection data of quality control for medical equipment was improved.Conclusion:Through the application of operation and maintenance system, the work efficiency of cycle quality control of medical equipment can be enhanced, and the informationization management of medical equipment can be achieved, and this system is appropriate for the management of medical equipment in all kinds of hospital.

Objective:To explore the importance of preventive maintenance (PM) of the medical equipment operation and maintenance management system in hospital quality control module. Methods:By introducing the quality control module of maintenance management system into medical equipment operation, the test data was analysed and medical equipment PM plan was developed. Results:Medical equipment PM plan can effectively reduce the failure rate of equipment, thus guaranteeing the normal operation of the equipment. Conclusion:The application of hospital medical equipment operation and quality control module of maintenance management system, can make more accurate statistics for failure cycle and failure rate of hospital equipment, implement the new PM plan, effectively reduce the failure rate and operation cost of hospital equipment, and improve equipment utilization.

Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy (3D-CRT) combined with gemcitabine chemotherapy for locally advanced non-small cell lung cancer (NSCLC). Methods From January 2006 to December 2007, 90 cases with advanced NSCLC were divided into two groups, treatment group of 45 patients were tre.ated with 3D-CRT and gemcitabine, control group of 45 patients were treated with gemcitabine and conventional radiotherapy. Chemotherapy consisted of intravenously gemeitabine 350 mg/m2 on day 1, 8, 15, 22, 29, 36. Radioactive source was used with X ray of 6 MV or 15 MV. Irradiatial target area were lung site and mediastinal node. Results The complete remission (CR)and remission rate(RR) in centrol group were 5 cases (11.1%) and 28 cases(62.2%), but in treatment group were 13 cases (28.9%) and 38 cases (84.4%), respectively. The difference of response rate in two groups was significant(P < 0.05). The rate of acute radiation-induced pneumonifis and esophagitis in control group (28.9%, 35.6%)were higher than those in treatment group (11.1%, 17.8%), there were significant difference between two groups (P < 0.05). Conclusions Concurrent application of gemcitabine and 3D-CRT can improve the RR for locally advanced NSCLC, and the acute toxicity are lower than those of gemcitabine and conventional radiotherapy. The clinical study is needed, but the late effect shoud be followed.

Activity of IL-1 produced by peripheral blood monocytes stimulated with lipopolysaccharide in vitro was detected from 17 acute cases, 14 chronic cases and 19 advanced cases of schistosomiasis japonica. It was found that the level of IL-1 was significantly increased and positively related to the body tempereture in the group with acute schistosomiasis. The activity of IL-1 was statistically reduced in the chronic and advanced groups, especially in the latter. After inhibiting the synthesis of prostaglandin with indomethacin, the level of IL-1 was significantly increased in three groups of patients, but no apparent change in the normal contro group. The results indicate that IL-1 may play an important role in inducing the inflammatory reaction in patients with acute schistosomiasis japonica and in the immunoregulation in the chronic stage. The changes of IL-1 activity in patients with schistosomiasis japonica may be closely related to prostaglandin.

Objective:To quantitatively measure the spatial relationship between the temporomandibular joint (TMJ) and surface landmarks such as the tragus and lateral canthus using cone-beam CT (CBCT), as to provide guidance for accurate positioning of CBCT scanning of the TMJ.Methods:DICOM format data from 112 patients (35 males and 77 females with 224 TMJs) were included in this study. The patients were between 12 and 66 years old, with a mean age of (25.6± 9.8) years and they underwent initial visits at the Department of Stomatology, General Hospital of Chinese PLA. CBCT images were imported into Mimics Medical 21.0 software for three-dimensional reconstruction. The distance between selected surface landmarks and corresponding projection points on the same side of the TMJ were measured in both the sagittal and coronal planes. In the frontal view, the distance from the lateral canthus to the perpendicular line passing through the center of the condyle (d x). In the lateral view, the vertical distance from the horizontal line through the rear edge convex of tragus to the roof of glenoid fossa (d y1); the vertical distance from the horizontal line through the rear edge convex of tragus to sigmoid notch (d y2); the distance from the tragus to the perpendicular line through the center of the condyle (d z). The results were compared between different genders and age groups (adolescent group aged 12 to 18 years, 33 cases; adult group aged>18 years, 79 cases). To verify the reliability and stability of the body surface landmarks obtained in this study, a comparison was made between the use of scout view positioning and the auxiliary positioning method that utilizes body surface landmarks to capture the mandibular condyle in a small field of view CBCT of the TMJ (scout view group, 25 cases; surface landmark-assisted positioning group, with 25 cases aged 12-18 years and 25 cases older than 18 years, totaling 50 cases), with regard to the deviation distance from the central point of the field of view to the central point of the mandibular condyle. Results:A total of 112 patients with 224 TMJs were included in this study. In the frontal view, d x was (8.59±3.13) mm, with no significant difference between the left and right sides, between males and females ( P>0.05). Notably, the d x in the adolescent group [(7.43±3.02) mm] was significantly smaller than that in the adult group [(9.07±3.06) mm] ( t=-3.68, P<0.001). In the lateral view, d y1 was (14.80±3.90) mm, showing no significant difference between the left and right sides, males and females, or different age groups( P>0.05). Similarly, d y2 was (6.82±3.95) mm, with no significant differences between the left and right sides or between males and females( P>0.05). However, the d y2 in the adolescent group [(5.88±4.13) mm] was significantly smaller than that in the adult group [(7.22±3.83) mm] ( t=-2.33, P=0.021). Regarding d z, the measurement was (11.73±3.16) mm, with no significant difference between the left and right sides, between males and females ( P>0.05). Meanwhile, the d z in the adolescent group[(10.92± 2.74) mm] was also significantly smaller than that in the adult group [(12.07±3.27) mm] ( t=-2.52, P=0.012). The verification results showed that both positioning methods could fully display the TMJ. The eccentricity in the scout view group [(8.84±3.79) mm ]was slightly greater than that in the body surface landmark-assisted positioning group[ (6.50±2.88) mm], and the difference between the two groups was statistically significant ( t=4.20, P=0.032). Conclusions:The TMJ can be accurately positioned using stable surface landmarks such as the tragus and lateral canthus for reference.

Objective:To observe and compare the radiographs of spiral CT and cone-beam CT (CBCT) in the imaging of temporomandibular joint osteoarthrosis (TMJOA) and to explore the difference between CBCT and spiral CT in detection accuracy so as to provide references for clinical diagnosis and treatment.Methods:A total of 52 patients with TMJOA diagnosed in the Department of Oral and Maxillofacial Surgery, General Hospital of Chinese PLA, from January 2018 to December 2019 were selected. There were 10 males and 42 females, with an average age of 38.6 years (21-70 years). All patients underwent spiral CT and CBCT examinations. Two oral radiologists and two oral and maxillofacial surgeons measured and evaluated the joint spaces and condylar bone lesions of each side of temporomandibular joint. According to the presence or absence of osteoarthrosis, the patients were divided into osteoarthrosis group (92 sides) and non osteoarthrosis group (12 sides). The mean size of joint spaces and the detection rate of lesions were compared between the two groups. SPSS 20.0 was used to analyze the data.Results:There was no significant difference between the measurements of joint space size and joint position in the spiral CT group and the CBCT group ( P>0.05). The mean size of the anterior space and the ratio of the posterior condyle in the osteoarthrosis side were larger than that in the normal side. The linear percentage index was smaller in the osteoarthrosis side than that in the normal side indicating that the position of the posterior condyle in the osteoarthrosis side was deviated. However, the difference was not statistically significant ( P>0.05). Both spiral CT and CBCT showed good consistency in displaying condylar osteopathy. The most common types of condylar osteopathy was surface defect. The detection rates of defects by spiral CT were surface erosion (85.6%, 89/104), articular surface flattening and shortening (82.7%, 86/104), subcortical sclerosis (40.4%, 42/104), osteophyte (40.4%, 42/104) and subcortical cyst (11.5%, 12/104) respectively. The detection rates of defects by CBCT were surface erosion (88.5%, 92/104), articular surface flattening and shortening (86.5%, 90/104), subcortical sclerosis (35.6%, 37/104), osteophyte (41.3%, 43/104) and subcortical cyst (11.5%, 12/104). There was no statistical difference between the two groups ( P>0.05), respectively. Conclusions:Both spiral CT and CBCT showed good accuracies in displaying the osteopathy of TMJOA and the sizes of the joint spaces measured by spiral CT and CBCT were basically the same. Both spiral CT and CBCT could be used as a routine diagnostic method for TMJOA.

Objective: To analyze the clinical characteristics, treatment and prognosis of primary gastric lymphomas (PGL). Methods: A retrospective study was conducted in 124 cases of PGL from July 2009 to January 2016 in our hospital, and the clinical records, pathological and immunohistochemical features were analyzed. The relationship between different factors at diagnosis and prognosis were studied. Results: 124 cases of PGL included 93 diffuse large B cell lymphoma (DLBCL) patients, 25 mucosa associated lymphoid tissue (MALT) lymphoma cases, 1 mantle cell lymphoma, 4 peripheral T-cell lymphoma-not otherwise specified, and 1 extra-nodal NK/T-cell lymphoma-nasal type. Of the 93 primary gastric DLBCL (PG-DLBCL) patients, the germinal center B cell-like (GCB) DLBCL were 45 cases, non-GCB DLBCL were 48 cases. 10 cases (10.8%) of 93 PG-DLBCL were transformed from gastric MALT, and 7 cases (7.5%) have bone marrow involvement. Evidence of Helicobacter pylori infection was detected in 21 cases (51.2%) of 41 DLBCL patients and in 10 cases (43.5%) of 23 MALT patients. Univariate analysis revealed that clinical stages (P=0.002) , B symptoms (P=0.001) , international prognostic index (IPI) score (P<0.001) , anemia (P<0.001) , low level of serum albumin level (P=0.001) , high level of lactate dehydrogenase (LDH) (P<0.001) , high β2-microglobulin (P=0.003) , chemotherapy uncombined with rituximab (P=0.006) were factors affecting progression-free survival (PFS). Multivariate Cox regression analysis indicated that clinical stages (HR=5.113, 95% CI 1.087-24.048, P=0.039) and LDH (HR=5.111, 95%CI 1.651-15.827, P=0.005) were independent poor prognosis factors affecting PFS. In the non-GCB group, the PFS was significantly extended (P=0.013) , the OS has no statistical significance (P=0.764). The PFS was significantly shortened in MALT transformed to DLBCL compared with MALT lymphoma patients (P=0.016) , but have no statistical significance compared with DLBCL patients (P=0.373). Conclusions The types of DLBCL and MALT are more common in PGL. PG-DLBCL is a highly heterogeneous malignant tumor, and advanced clinical stages and high LDH value are associated with poor outcome.

Objective: To evaluate the prognostic value of lymphocyte-to-monocyte ratio (LMR) in angioimmunoblastic T cell lymphoma (AITL). Methods: Data of 64 patients diagnosed as AITL at the First Affiliated Hospital of Nanjing Medical University between June 2009 and July 2017, were analyzed retrospectively. Receiver Operator Characteristic (ROC) curve was used to calculate the cutoff value of LMR to divide this cohort of patients into high and low LMR groups. Characteristics between groups were compared by Pearson Chi-square or Fisher exact tests. Kaplan-Meier method and Cox regression were performed to probe prognostic factors associated with progression-free survival (PFS) and overall survival (OS). Results: A total of 64 cases [39 cases male and 25 ones female with the median age of 63 (29-89) years old] were enrolled. The cutoff value of LMR was 3.07. Patients with low LMR showed inferior PFS (9 months vs 13 months, P=0.044) and OS (16 months vs not reached, P=0.014), respectively than those without low LMR during a median follow-up of 33 months (5 to 103 months). Multivariate analysis showed that low LMR was an independent prognostic factor associated with poor outcomes (HR=0.48, 95% CI 0.26-0.92 for PFS, P=0.027; HR=0.38, 95% CI 0.18-0.82 for OS, P=0.013, respectively). Subgroup analysis showed that patients with low LMR and under the situation of high score of Prognostic Index for peripheral T-cell lymphoma, Unspecified (PIT) (2-4) had shorter PFS and OS (P=0.013 and P=0.031, respectively). But in low score of PIT (0-1) group, low LMR seemed to play almost no effects on PFS and OS (P=0.949 and P=0.238, respectively). Conclusions The disease risk status of patients could be initially assessed according to PIT score and LMR level. Low LMR was demonstrated to be able to predict poor outcome in AITL.

OBJECTIVE: To analyze the correlation between the mutational status of immunoglobulin heavy chain variable (IGHV) gene with the prognosis of patients with Waldenström macroglobulinemia (WM). METHODS: Immunoglobulin heavy chain gene (IGH) clonotypic sequence analysis was carried out to assess the mutational status of IGHV in the blood and/or bone marrow samples from 44 WM patients. The usage characteristics of IGHV-IGHD-IGHJ gene was explored. RESULTS: The most common IGHV subgroup was IGHV3, which was similar to the data from the Institute of Hematology of Chinese Academy of Medical Science. IGHV3-23 (20.45% vs. 15.44%) and IGHV3-74 (11.36% vs. 7.35%) were the main fragments used, which was followed by IGHV4 gene family (15.91% vs. 24.26%). However, no significant correlation was found between the IGHV4 usage and the prognosis of the patients. Should 98% be taken as the cut-off value for the IGHV mutation status, only 5 patients had no IGHV variant, and there was no correlation with the prognosis. Based on the X-tile analysis, 92.6% was re-selected as the cut-off value for the IGHV variant status in such patients. LDH was increased in 26 patients (59.1%) without IGHV variant (P < 0.05), whilst progression-free survival (P < 0.05) and overall survival (P < 0.05) were significantly shorter compared with those with IGHV variants. CONCLUSION The usage characteristics of IGHV-IGHD-IGHJ in our patients was similar to reported by the Institute of Hematology of Chinese Academy of Medical Science, albeit that no correlation was found between the IGHV4 usage and the prognosis of the patients. Furthermore, 98% may not be appropriate for distinguishing the IGHV variant status in WM patients.
Humans ; Immunoglobulin Heavy Chains/genetics* ; Multigene Family ; Mutation ; Waldenstrom Macroglobulinemia/genetics*

Objective:To investigate the clinical symptoms and cone-beam CT (CBCT) imaging characteristics of temporomandibular joint osteoarthritis (TMJOA) with chewing side preference (CSP).Methods:One hundred patients with TMJOA diagnosed in the Department of Stomatology, General Hospital of the Chinese PLA from January 2018 to December 2020 were enrolled, including 32 males and 68 females, with an median age of 27.5 years (16-71 years). According to the habit of CSP, 100 cases were divided into 71 cases of TMJOA with CSP group and 29 cases of TMJOA without CSP group. The clinical symptoms were observed, including pain, TMJ sounds, limited mouth opening as well as the radiograph imaging changes of condylar bone. When analyzing the radiograph imaging changes of condylar, the cases with bilateral TMJ symptoms were excluded and the remaining cases were divided into symptomatic sides and asymptomatic sides with CSP or without CSP according to the symptoms of the chief complaint. SPSS 25.0 was used to analyze the statistical data. Age data did not conform to normal distribution so that median and quartile spacing were used for description, and Mann-Whitney U test was used for nonparametric test. Qualitative data such as gender, clinical symptoms and condylar lesion types were described by composition ratio and chi-square test was performed. Results:There was no statistical significance in age and gender of TMJOA patients in the group with or without CSP ( P>0.05). The incidence of pain in CSP group [83.1% (59/71)] was marginally higher than that in non-CSP group [65.5% (19/29)] but without statistical difference (χ2 =3.71, P=0.054). There was also no significant difference in TMJ sounds and limitation of mandibular movement between the two groups (χ2 =0.11, P=0.742; χ2 =0.48, P=0.489). Among all of joints, the most common types of TMJOA were articular flattening and shortening and erosion. CBCT showed that erosion [65.0% (130/200)], flattening and shortening [73.0% (146/200)], subcortical sclerosis [42.0% (84/200)], osteophyte [30.5% (61/200)] and subcortical cystic [15.5% (31/200)]. According to the different groups of chief complaint sides, intra-group comparisons show that the proportion of erosion in symptomatic sides of CSP group [80.0% (40/50)] was significantly higher than that in asymptomatic sides of CSP group [50.0% (25/50)] (χ2=9.89, P=0.002). Inter-group comparisons show that the proportion of condyle flattening and shortening in symptomatic sides of CSP group [84.0% (42/50)] was significantly higher than that in bilateral joint of non-CSP group (8/15) (χ2=8.81, P=0.032). There was no significant difference in the proportion of subcortical sclerosis, osteophyte and subcortical cystic between the group with or without CSP ( P>0.05). Conclusions:TMJOA patients with CSP may be more prone to clinical symptoms of pain and CBCT imaging changes of condyle erosion as well as flattening and shortening. CSP may be a promoting factor for the development of TMJOA.