Objective:To construct a maintenance management system based on Total Productive Maintenance(TPM)theory for large-scale medical equipment,and explore its application effect in the management for large-scale medical equipment.Methods:By building TPM management team,predicting equipment's failures,planning TPM management pathway for equipment,and implementing quality control to construct TPM management system for the large-scale medical equipment.A total of 547 large-scale medical equipment that were used in clinical practice at the First Affiliated Hospital of Harbin Medical University from February 2022 to July 2024 were selected.They were divided into conventional management mode(272 equipment)and TPM management mode(275 equipment)by using random number table method.The TPM management mode conducted management on the basis of TPM management system for large-scale medical equipment.The equipment configuration,operational quality,effectiveness of equipment maintenance,and maintenance quality of the two kinds of management modes were compared.Using a self-made satisfaction questionnaire to evaluate the satisfaction of management personnel who used equipment for the service quality of maintenance management of two management modes for medical equipment.Results:The average configuration rate,utilization rate,and operation rate of equipment that using TPM management mode were(4.81±0.94)%,(97.98±0.67)%,and(89.15±4.78)%,respectively,all which were higher than those that using conventional management mode.However,the average failure rate was(1.72±0.12)%,which was lower than that of using conventional management mode.The differences of the above indicators were statistically significant(t=39.942,80.213,23.188,71.723,P<0.05).The average values of the efficiency of equipment maintenance,the standardization of usage,timeliness of maintenance,and pass rate of quality inspection of TPM management mode were all higher than those of conventional management mode,and the differences were statistically significant(t=36.893,22.913,17.948,21.553,P<0.05).The response time,average repair rate of failure,and delivery cycle of accessories of equipment maintenance of TPM management mode were all lower than those of conventional management mode,while the quality score of maintenance service was higher than that of conventional management mode,and the differences were statistically significant(t=37.332,25.116,53.265,55.988,P<0.05).The satisfactions of management personnel who used equipment for preventive maintenance,preventive repair,usage management,fault repair,quality inspection,and post maintenance of equipment that adopted TPM management mode were all higher than those that adopted conventional management mode,and the differences were statistically significant(t=24.218,21.408,19.706,27.141,38.149,46.434,P<0.05).Conclusion:The maintenance management system based on TPM theory for large-scale medical equipment can effectively improve operation efficiency and maintenance quality of equipment,and reduce equipment's failure rate,and enhance the timeliness of maintenance services for equipment,and increase the satisfaction of management personnel in using equipment.

AIM To study the chemical constituents from Citri reticulatae Pericarpium Viride and their anti-triple negative breast cancer activities in vitro.METHODS The ethanolic extract of Citri reticulatae Pericarpium Viride was isolated and purified by silica gel,polyamide,MCI,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The anti-triple negative breast cancer activities were screened by SRB assay,and their effects on the proliferation of triple negative breast cancer cell lines HCC1806,HCC1937 and MDA-MB-231 in vitro were evaluated.RESULTS Twenty compounds were isolated and identified as nobiletin(1),tangeritin(2),5,4'-dihydroxy-7,8-dimethoxy flavonoid(3),naringenin(4),artemetin(5),5-demethynobiletin(6),3,5,6,7,8,3',4'-pentamethoxy flavonoid(7),5,4'-dihydroxy-3,6,7,8,3'-pentamethoxyflavone(8),xanthomicrol(9),p-hydroxycinnamic acid(10),5,4'-dihydroxy-6,7,8,3'-tetramethoxyflavone(11),pectolinarigenin(12),4'-dihydroxy-5,6,7-tetramethoxyflavone(13),hispidulin(14),4',5,6,7-tetramethoxy-flavone(15),1-methyl-4-(prop-1-en-2-yl)cyclohexane-1,2-diol(16),umbelliferone(17),5-hydroxymethyl furfural(18),hydroquinone(19),1H-indole-3-carbaldehyde(20).Compound 8 showed a significant inhibitory effect with the IC50 value of(5.36±0.24)μmol/L on HCC1806 cells.CONCLUSION Compound 20 is isolated from genus Citrus for the first time,8,12-13,16-17 are isolated from this plant for the first time.Compound 8 show inhibitory effects on the proliferation of HCC1806,HCC1937 and MDA-MB-231 cells in vitro and have the strongest activities.Compounds 3-4,11-12,15,17 and 19 show strong inhibitory effect on HCC1806 cells.Compounds 15,19 also inhibit the proliferation of HCC1937 cells in vitro.

Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

Objective:To construct a maintenance management system based on Total Productive Maintenance(TPM)theory for large-scale medical equipment,and explore its application effect in the management for large-scale medical equipment.Methods:By building TPM management team,predicting equipment's failures,planning TPM management pathway for equipment,and implementing quality control to construct TPM management system for the large-scale medical equipment.A total of 547 large-scale medical equipment that were used in clinical practice at the First Affiliated Hospital of Harbin Medical University from February 2022 to July 2024 were selected.They were divided into conventional management mode(272 equipment)and TPM management mode(275 equipment)by using random number table method.The TPM management mode conducted management on the basis of TPM management system for large-scale medical equipment.The equipment configuration,operational quality,effectiveness of equipment maintenance,and maintenance quality of the two kinds of management modes were compared.Using a self-made satisfaction questionnaire to evaluate the satisfaction of management personnel who used equipment for the service quality of maintenance management of two management modes for medical equipment.Results:The average configuration rate,utilization rate,and operation rate of equipment that using TPM management mode were(4.81±0.94)%,(97.98±0.67)%,and(89.15±4.78)%,respectively,all which were higher than those that using conventional management mode.However,the average failure rate was(1.72±0.12)%,which was lower than that of using conventional management mode.The differences of the above indicators were statistically significant(t=39.942,80.213,23.188,71.723,P<0.05).The average values of the efficiency of equipment maintenance,the standardization of usage,timeliness of maintenance,and pass rate of quality inspection of TPM management mode were all higher than those of conventional management mode,and the differences were statistically significant(t=36.893,22.913,17.948,21.553,P<0.05).The response time,average repair rate of failure,and delivery cycle of accessories of equipment maintenance of TPM management mode were all lower than those of conventional management mode,while the quality score of maintenance service was higher than that of conventional management mode,and the differences were statistically significant(t=37.332,25.116,53.265,55.988,P<0.05).The satisfactions of management personnel who used equipment for preventive maintenance,preventive repair,usage management,fault repair,quality inspection,and post maintenance of equipment that adopted TPM management mode were all higher than those that adopted conventional management mode,and the differences were statistically significant(t=24.218,21.408,19.706,27.141,38.149,46.434,P<0.05).Conclusion:The maintenance management system based on TPM theory for large-scale medical equipment can effectively improve operation efficiency and maintenance quality of equipment,and reduce equipment's failure rate,and enhance the timeliness of maintenance services for equipment,and increase the satisfaction of management personnel in using equipment.

AIM To study the chemical constituents from salt-processed Litchi Semen and their antioxidant activities.METHODS The 85％ethanol extract from salt-processed Litchi Semen was isolated and purified by silica gel,Sephadex LH-20,MCI,ODS and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.DPPH and ABTS+free radical scavenging method were used to evaluate their antioxidant activities.RESULTS Fifteen compounds were isolated and identified as dehydrocostuslactone(1),ananosmoside A(2),funingensin A(3),(2S)-pinocembrin-7-O-(6-O-α-L-rhamnopyranosyl-β-D-glucopyranoside)(4),liquiritienin(5),quercetin(6),rutin(7),isorhamnetin-3-O-β-rutinoside(8),procyanidin A2(9),procyanidin A1(10),ethyl protocatechuate(11),5-hydroxymethylfurfural(12),di(2-ethyl-hexyl)phthalate(13),nicotinamide(14),(10E,15Z)-9,12,13-trihydroxyoctadeca-10,15-dienoic acid(15).Compounds 6-7,9-10 exhibited scavenging activities against DPPH radicals with IC50 values of(12.929±1.232),(14.104±0.946),(10.417±1.736),(6.944±0.030)μmol/L,respectively.Compounds 6-10 exhibited scavenging activities against ABTS+radicals with IC50 values of(21.952±0.577),(25.683±0.625),(22.970±1.336),(20.210±1.435),(18.725±0.324)μmol/L,respectively.CONCLUSION Compounds 1,5,14-15 are isolated from Litchi genus for the first time.Compounds 6-7,9-10 have strong in vitro antioxidant activities.

AIM To study the chemical constituents from salt-processed Litchi Semen and their antioxidant activities.METHODS The 85％ethanol extract from salt-processed Litchi Semen was isolated and purified by silica gel,Sephadex LH-20,MCI,ODS and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.DPPH and ABTS+free radical scavenging method were used to evaluate their antioxidant activities.RESULTS Fifteen compounds were isolated and identified as dehydrocostuslactone(1),ananosmoside A(2),funingensin A(3),(2S)-pinocembrin-7-O-(6-O-α-L-rhamnopyranosyl-β-D-glucopyranoside)(4),liquiritienin(5),quercetin(6),rutin(7),isorhamnetin-3-O-β-rutinoside(8),procyanidin A2(9),procyanidin A1(10),ethyl protocatechuate(11),5-hydroxymethylfurfural(12),di(2-ethyl-hexyl)phthalate(13),nicotinamide(14),(10E,15Z)-9,12,13-trihydroxyoctadeca-10,15-dienoic acid(15).Compounds 6-7,9-10 exhibited scavenging activities against DPPH radicals with IC50 values of(12.929±1.232),(14.104±0.946),(10.417±1.736),(6.944±0.030)μmol/L,respectively.Compounds 6-10 exhibited scavenging activities against ABTS+radicals with IC50 values of(21.952±0.577),(25.683±0.625),(22.970±1.336),(20.210±1.435),(18.725±0.324)μmol/L,respectively.CONCLUSION Compounds 1,5,14-15 are isolated from Litchi genus for the first time.Compounds 6-7,9-10 have strong in vitro antioxidant activities.

AIM To study the chemical constituents from Citri reticulatae Pericarpium Viride and their anti-triple negative breast cancer activities in vitro.METHODS The ethanolic extract of Citri reticulatae Pericarpium Viride was isolated and purified by silica gel,polyamide,MCI,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The anti-triple negative breast cancer activities were screened by SRB assay,and their effects on the proliferation of triple negative breast cancer cell lines HCC1806,HCC1937 and MDA-MB-231 in vitro were evaluated.RESULTS Twenty compounds were isolated and identified as nobiletin(1),tangeritin(2),5,4'-dihydroxy-7,8-dimethoxy flavonoid(3),naringenin(4),artemetin(5),5-demethynobiletin(6),3,5,6,7,8,3',4'-pentamethoxy flavonoid(7),5,4'-dihydroxy-3,6,7,8,3'-pentamethoxyflavone(8),xanthomicrol(9),p-hydroxycinnamic acid(10),5,4'-dihydroxy-6,7,8,3'-tetramethoxyflavone(11),pectolinarigenin(12),4'-dihydroxy-5,6,7-tetramethoxyflavone(13),hispidulin(14),4',5,6,7-tetramethoxy-flavone(15),1-methyl-4-(prop-1-en-2-yl)cyclohexane-1,2-diol(16),umbelliferone(17),5-hydroxymethyl furfural(18),hydroquinone(19),1H-indole-3-carbaldehyde(20).Compound 8 showed a significant inhibitory effect with the IC50 value of(5.36±0.24)μmol/L on HCC1806 cells.CONCLUSION Compound 20 is isolated from genus Citrus for the first time,8,12-13,16-17 are isolated from this plant for the first time.Compound 8 show inhibitory effects on the proliferation of HCC1806,HCC1937 and MDA-MB-231 cells in vitro and have the strongest activities.Compounds 3-4,11-12,15,17 and 19 show strong inhibitory effect on HCC1806 cells.Compounds 15,19 also inhibit the proliferation of HCC1937 cells in vitro.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.