Objective To discuss the numerial defecography for cases with obstinate constipation.Methods A retrospective study of the data of 60 cases with obstinate constipation,was carried on the radiodiagnosis through the ralative measurement. Results 25 cases with the perineum descending,16 cases with the anterior mucosal prolapse,37 cases with the internal rectal intussusception,12 cases with the external rectal prolapse,47 cases with the rectocele,13 cases with the spastic pelvic floor syndrome,39 cases with the puborectalis muscle hypertrophy,11 cases with the enterocele,12 cases with the sacrum-rectal separate,and 10 cases with the achalasia of anal muscle of internal enlarge. Conclusion It was important that numerial defecography in the diagnosis of obstinate constipation.

The instance reality of medial equipment combined with the center problem of standardization management on medical equipment stock to discuss the questions of how to manage and what about manage.According to correlated management demand and the fact of medical procurement,from the point of view on frame construction flow to the problem of elementary demand on medical equipment procurement,the stock process of medical instrument,the stock process of medical consumable and the management of purchase invoice etc were analyzed.The beneficial research reference can be provided by the daily management jobs of stock and maintenance,the management question of more refinement and general standardization.

The general principles on maintenance and management of technical specification are discussed. Through summarizing many years maintenance experiences of the hospital or medical institutions technical support department, the beneficial mentalities and referential experiences are provided by standardized and effective management on maintenance of medical equipment, according to the medical technology level of medical equipment management department, the economic efficiency, the size of medical equipment, the quality of maintenance technicians, and service ability as well as the management methods of medical equipment material.

A total of 45 patients with indication of vertebroplasty using unilateral approach were detected by CT scanning,2D and 3D reconstruction methods to measure the angle between vertebral pedicle and 1/3 of median horizontal plane,distance from skin needle entry point to spinous process at the horizontal plane as well as the declination angle between vertebral pedicle and sagittal plane.The three-dimensional anterior-posterior perspecitive images of vertebra were reduced to identify the entry point.The measurement results showed significant changes in introversion angle at T4-L5:T4-T8 was 23.75?-25.34?,T9-L1 was 25.74?-26.83?,and L2-L5 was 27.45?-41.57?;but minimal changes in declination angle at sagittal plane,from 19.17? to 25.24?;the open distance adjacent to the spinous process was increased from thoracic vertebra to lumbar vertebra:T4-T8 was 2.56?-2.87?,T9-L1 was 3.05?-3.61?,L2-L5 was 3.89?-8.23?.The best vertebral puncture point reduction was located at 9-11 points of the left,1-3 point of the right.Imaging-based measurements of introversion angle,declination angle,entry point and distance of spinous process at the horizontal plane are important data for percutaneous vertebroplasty.According to pedicle shape features at different stages,included angle,puncture point,path and depth,the vertebroplasty could be performed accurately and safely with reduced damage.Moreover,reliable data are provided for the design of a three-dimensional puncture-oriented device.

Objective The goal of this work is to evaluate the dosimetric characteristics of a new 2D diode array (Mapcheck from Sun Nuclear Corporation,Melbourne,Florida) and assess the role it can play in routine IMRT QA. Methods Fundamental properties of the Mapcheck such as reproducibility and linearity were studied for high-energy photon beams. Clinical performance of the MapCheck for relative and absolute dosimetry was demonstrated with head and neck IMRT plans,and compared with plan dose distribution. Absolute dose measured by Ion chamber and Mapcheck are compared with the one given in TPS. Results The Mapcheck offers the dosimetric characteristics required for performing both relative and absolute dose measurements. Conclusion Mapcheck can provide the verification of absolute dose and relative dose. Its use in the clinic can simplify and reduce the IMRT QA workload.

Objective To study the effect of IFN-αcombined with ATRA in liver cancer therapy in perioperative phase of inter-vention .Methods An animal model of liver cancer CBRH7919 was established by implanting 28 Wistar rats with tumor tissue .The hepatic artery was tied off in one month after formation of tumor .All the rats were randomly divided into the experimental group (14 cases) and the control group(14 cases) .The control group accepted peritoneal injection with normal saline while the experimen-tal group accepted IFN-αcombined with ATRA .10 days later ,all the rats were sacrificed .And the level of expression of VEGF ,bF-GF ,mirovessel density ,and apoptotic index of tumor cells were measured .Results Serum VEGF level ,MVD and apoptotic index of tumor cells of the experimental group were statistically lower than that of the control group [(91 .8 ± 12 .7) pg/mL ,(115 .7 ± 11 .8)/HP ,(12 .29 ± 4 .53)% vs .(67 .4 ± 18 .3)pg/mL ,(65 .3 ± 7 .2)/HP ,(3 .81 ± 1 .52)% ,t=4 .099、13 .642、6 .640 ,P<0 .05)] , results of RT-PCR and immunohistochemistry detection both showed that the levels of expression of VEGF and bFGF of the exper-imental group was lower than that of the control group .Conclusion IFN-αcombined with ATRA in liver cancer therapy in periop-erative phase of intervention could suppress the generation of neoplastic vascular and improve the effect of the intervention .So it is worth promoting .

Objective To investigate the clinical significance of serum level of the diagnosis and treatment of community acquired pneumonia.Methods 42 hospital patients with pneumonia obtained from community were slect-ed as the observation group.According to patient outcome,they were divided into improvement group and aggravated group.Another selection during the same period in hospital for treatment of acute upper respiratory tract infection in patients with 30 cases was the control group.Respectively,in the 1 day,3 days,7 days the results of serum calcitonin angiotensinogen (PCT)and CRP were compared and analyzed.Results In observation group,PCT of first day,third days and seventh days were respectively (1.18 ±0.32)μg/L,(0.78 ±0.12)μg/L and (0.18 ±0.04)μg/L;CRP were respectively (154.15 ±21.58)mg/L,(67.42 ±20.35)mg/L and (15.43 ±7.76)mg/L.In the control group, PCT of first days,third days and seventh days were respectively (0.05 ±0.01 )μg/L,(0.04 ±0.02)μg/L and (0.05 ±0.02)μg/L,while CRP were respectively (9.39 ±2.22)mg/L,(8.83 ±2.91 )mg/L and (7.06 ± 3.03)mg/L.There were significant differences between the two groups (t =6.15,10.85,4.86,58.69,16.79,11.99,all P <0.05).In the aggravated group,PCT levels of first days,third days and seventh days were significantly higher than that of the improved group,the differences were statistically significant (t =17.86,18.21,20.65,all P <0.05). Conclusion As a monitoring marker,PCT showed higher sensibility and specificity than CRP in diagnosis and treat-ment of CAP,and it would be helpful to make early diagnosis and certain the therapeutic schedule to use antibiotics.

Objective Little is known about the influence of congenital heart disease on the phannacodynamies of neuromuscular blocking agents. The aim of this study was to compare the pharmacodynamics of rocuronium in children with cyanotic and acyanotic heart disease. Methods The study was conducted in two parts. In part Ⅰ , 36 children with congenital heart disease scheduled for open heart surgery were allocated into 3 groups (n=12) : acyanotic group; slightly cyanotic group and severely cyanotic group. Neuromuscular blockade was monitored after administration of 0.6 mg ? kg-1 rocuronium. In part Ⅱ , 40 children with congenital heart disease were allocated into acyanotic and cyanotic group ( n = 20). The children in each group were further divided into 4 subgroups of 5 patients according to the dose of rocuronium the children received : 120, 180, 240 and 300 ?g? kg-1 . The dose- response curve for neuromuscular blockade was constructed and ED50 , ED90 and ED95 were calculated. SPSS 8.0 software was used for statistical analysis.Results In part Ⅰ the onset time (the time from injection of rocuronium to 95% depression of neuromuscular transmission) was significantly longer in severely cyanotic group [(2.25 ? 1.27) Min] than in acyanotic group [(1.17 ? 0.15) min] . There was no significant difference in the duration of action and recovery time among the 3 groups. In part Ⅱ the dose-response curve shifted to the right in cyanotic group compared with acyanotic group. ED50, ED90 and ED95 were significantly higher in cyanotic group than in acyanotic group. Conclusion The onset time of rocuronium is prolonged and the sensitivity of the patients to rocuronium is decreased in patients with cyanotic heart disease.

Objective To explore the therapeutic efficacy of a self-made occluder used for bronchoscopic lung volume reduction(BLVR).Methods Two patients with severe chronic obstructive pulmonary disease(COPD)in stable phase were selected for the present study.One or two nitinol occluders were placed,guided by brochoscopy,into the target bronchi of the two patients.Examination of pulmonary functions,chest computed tomography,complications,blood gas analysis,and evaluation of life quality with St George's respiratory questionnaire(SGRQ)were carried out before and 7 months after the bronchoscopic lung volume reduction.Results No dislodging or shifting of all the inserted occluders occurred.Only slight proliferation of granulation tissue was found in mucous membrane around the occluder,and atelectasis was observed at the target sites of lung.Before and 7 months after BLVR,ventilatory capacity(VC)of case 1 rose from 3.08L to 3.57L,and that of case 2 was elevated from 2.19L to 2.58L.Forced vital capacity(FVC)of case 1 was elevated from 2.87L to 3.57L,and that of case 2 from 2.60L to 2.58L.SGRQ showed a remarkable improvement of patients' dyspnea with a decrease of scores from 62 to 26 in case 1 and from 48 to 23 in case 2.No evident changes were found on arterial oxygen blood partial pressure(PaO2)in both patients,and no severe complications such as obstructive pneumonia or pneumothorax occurred yet in either case 1 or case 2.Conclusion The present study has demonstrated that the self-made occluder is convenient for insertion with satisfactory stability and therapeutic efficacy.Application of such occluder is safe with few complications,and may serve the purpose of reducing lung volume and improving lung function.

In terms of technology,modern development of a hospital is increasingly reliant on the update of medical equipment,the fixed assets of which have now taken up 50%～70%of the total,increasing from 20～30% formerly.It is not unusual that a hospital promotes the overall level of technology in one aspect through introducing an advanced equipment.So the revenue brought by the adoption of medical equipment has increased inevitably,and will keep the trend with more momentum.Therefore,it is becoming more and more important to do the maintenance of the equipment well.This article presents the requirements,goal and procedure of enterprise-pattern management of medical equipment in a hospital and makes exploration in the field of hospital modern management concerning medical equipment.