There is room for improvement in the clinical department operation of public hospitals. Therefore, through exampling the practice of a public hospital’ s clinical department, to propose the methods in improving the department management.

Objective:To investigate a working program of medical equipment file management. Methods: To analyze the importance, compositions and features of medical equipment files, and propose a life-cycle working program of medical equipment file management. Results:To introduce the approach and experiences of the construction of medical equipment life-cycle file management system in our hospital. Conclusion:The construction of medical equipment life-cycle file management can provide full and accurate basis for asset management, equipment maintenance, and supervising purchasing behavior.

Objective:Based on the laws about medical equipments industry to analyze the basis, key points and methods of medical equipments qualification auditing.Methods: According to the present the qualification documents requirements, medical equipment category were divided into 3 types (categoryⅠ, categoryⅡand categoryⅢ)by risk degree with decreasing order. The qualification and key point of disinfection supplies and each kind of equipment (including in vitro diagnostic reagents) were explained.Results: The main work of medical equipments qualification auditing were confirmed.Conclusion: It is important way to guarantee the safety of clinical diagnosis and treatment through we strengthen the auditing of medical equipments and the qualification documents of suppliers.

Objective To establish the athrmic inouse model of breast cancer in normal position and imitated metastatic breast cancer. Methods Breast cancer cells MDA-MB-231-luc carrying luciferase gene was injected into the athymie mice.The optieal imaging in vivo system was used to observe the establislament of the model. Reseults The breast tumor emerged after we planted the MDA-MB-231-lue cells in the mammary gland fatpads,the volume and photon of the tumor increased during the second weekto the fifth week.After injection by the tail vein,the tumors mainly located in the lungs While after infusion in the left alrtrium.the tumolrs metastate to all over the body. Conclusions We succeeded in the establishment of the athymic mice model of breast cancer.in situ and imitated metastatic breast cancer by iniection into the vena caudalis and the left alttrium.The optical imaging in vivo system could distinctly show the formation of the tumors.

Objective To evaluate immediate breast reconstruction with extended latissimus dorsi flap after mastectomy for patients of breast cancer. Methods One hundred and sixty-two women with breast cancer underwent surgery from Jan, 2000 to Dec, 2007. Masteetomy was carried out including traditional modified mastectomy in 32 cases, skin sparing mastectomy in 51 cases and nipple-areolar sparing mastectomy in 79 cases. Immediate breast reconstruction was performed with latissimus dorsi flap and surrounding fat tissue. Results Operation was successful in 161 cases. The morphology of reconstructed breasts was excellent in 91.93% cases as evaluated by patients themselves. After operation 6 cases had partial nipple necrosis, 5 cases had rhacoma of the chest, but cured conservatively. Eleven cases had seroma on the back, among them 8 cases cured by puncture and drainage. Two cases cured by erasion of the pseudomembrane and 1 case cured by exairesis of the fibrous capsule. Three cases had limited skin necrosis around the incision. One case had necrosis on part of the donor side, cured by reoperation. One case had implant necrosis necessitating removal of the implant. The patients were followed up for 7～90 months, and the 23 cases were free of tumor recurrence before they lost to follow-up. Among those followed-up cases there were bone metastasis in 2 cases, lung metastasis in 1 case and supra clavicular lymph node metastasis in one. No local recurrence was found. Conclusions Immediate breast reconstruction with extended latissimus dorsi flap after masteetomy is safe and effective, especially suitable for small and medium size breasts.

In the course of emerging infectious disease learning,comprehensive methods including comparing the similarity of emerging infectious disease and classical infectious disease,uniting the general introduction and the typical examples explanation,strengthening the multimedia teaching and the case based teaching were adopted to strengthen the effect of teaching.

Purpose　To introduce our experience about the skin-sparing mastectomy and immediate breast reconstruction using transverse rectus abdominis myocutaneous flap(TRAM).　Methods　For early stage breast cancer,we preserved the breast skin,performed the subcutaneous glandular excision and axillary dissection,immediately reconstructed the breast using TRAM flap.　Results　9 patients were treated by skin-sparing mastectomy and immediate TRAM breast reconstruction.The morphology of reconstructed breasts was excellent.　Conclusions　The skin-sparing mastectomy and immediate TRAM breast reconstruction is safe and effective for treating early stage breast cancer.The incision is relative small and more aesthestic.

Objective To construct an oncolytic adenovirus CNHK600-IL24, and to observe the in vivo effects of CNHK600-IL24 in treating breast cancer. Methods The IL-24 gene was cloned into adenovirus shuttle vector SG502-△CR2, and CNHK600-IL24 was obtained by cotransfection of SG502-INSIL24 and pPE3 plasmids and subsequent recombination in 293 cells. Based on the establishment of the athymic mice model of breast cancer in situ and imitated metastatic breast cancer by injection in the vena caudalis and the left artrium, we administered the virus by the tail vein. We used the optical imaging in vivo system to monitor the effects. Results The oncolytic adenovirus CNHK600-IL24 was correctly constructed and confirmed by restriction DNA sequence analysis and PCR. The titer of CNHK600-IL24 reached 1.9 ×1010pfu/ml. Establishing athymic mice model of breast cancer in situ, the volume and photon number of the tumors in the control group was significantly larger than those of the CNHK600-IL24 group( P ＜0. 05). The tumor had conspicuous necrosis after the treatment of CNHK600-IL24. There was noticeable apoptosis of the tumor cells. Immunohistochemistry showed the expression of IL-24 and the Hexon protein in the tumor cells.In athymic mice model of imitated metastatic breast cancer by infusion into the vena caudalis, most of the mice in the control group died before 38 days, the mice of the CNHK600-IL24 group survived significantly longer(P ＜0. 05 ). Using athymic mice model of imitated metastatic breast cancer by infusion in the left artrium, the optical imaging in vivo system showed obvious difference between the control group and the CNHK600-IL24 group. Conclusions The high-titer oncolytic adenovirus CNHK600-IL24 was successfully constructed and purified. The oncolytic adenovirus had obvious antitumor effect on breast cancer.

BACKGROUND: Appropriate direction and angle of traction for the vertebral artery type cervical spondylosis(CSA)make significant effect.Selective angiography is recognized as"gold standard"to diagnose the vascular disease.Although magnetic resonance angiography as a non-invasive examination,there exist shortcomings such as a longer time checking,vulnerable to man-made factors,a certain aggressive feature.OBJECTIVE: Through the use of color Doppler flow imaging(CDFI)and transcranial Doppler sonography(TCD)adding the test of turning neck,to analyze the change of blood current parameter before and after the tractions from different directions and angles.METHODS: 240 cases suffering CSA were selected and divided into groups according to anatomy angle of lesion parts(upper cervical segments,lower cervical segments,mixed type)and traction mode,angel(anteversion sitting position 1°-10°,11°-20°,21°-30° groups,posterior extension sitting position 1°-10°,11°-20°,21°-30° groups,neutral position sitting position group).Local massage served as control group.The indexes of vertebral artery of neck part including inner diameter(D)of narrowest location,peak systolic velocity and average velocity of blood were measured by CDFI adding the test of turning neck.The indexes of left vertebral artery,right vertebral artery and basiiar artery including peak velocity(Vp)of period of contraction and mean velocity(Vm)of blood were measured by TCD adding the test of turning neck.RESULTS AND CONCLUSION: ①We determined vertebral artery type of cervical spondylosis on the base of anatomic site. On the basis of diseased region,we divided cervical syndrome into 3 types.They were superior part(C1-C3),inferior part (C4-C6) and commixture.it offers clinical guidance for traction therapy from spondylous morphous and mechanics.② We determined the gbest angle of traction.The therapeutic efficacy in posterior extension sitting position occupying 11-20～was better in upper hind neck;the therapeutic efficacy in anteversion sitting position occupying 11-20° was better in inferior neck; the therapeutic efficacy in anteversion sitting position occupying 1-10° was better in neutral position sitting position.③ We knew that CDFI and TCD are the convenient,non-invasive,safe and reduplicative methods to guide traction therapy in vertebral artery type of cervical spondylosis.

Objective To observe the therapeutic effect of electronic moxibustion apparatus and stone needle for primary dysmenorrhea disease in 35 cases.Methods 70 patients were randomly divided into the treatment group of 35 cases by random number table ,using electronic moxibustion apparatus and stone needle for treatment;and con-trol group of 35 cases,only using electronic moxibustion apparatus for treatment from 5 days before menstruation ,the treatment was continuous for 5 days,a course including 3 menstruation cycles .The clinical therapeutic effect after one treatment course was observed .Results The curative effects of the two groups were respectively 91.42% and 88.57%(χ2 =0.16,P>0.05);recovery rates of the two groups were respectively 77.14%and 42.85%(χ2 =8.57, P<0.05).The scores of the VAS,CMSS of the treatment group were much lower than those of the control group after treatment (t=2.532,2.137,2.256,P<0.05).Conclusion Electronic moxibustion apparatus and stone needle therapy is an effective method to treat primary dysmenorrhea ,which is a safe and convenient method .