The medical engineering department is an important part in modern hospitals,but the status and functions of medical engineers are ignored,which result in the drain of the experts in this field.This paper analyses the reason and gives the countermeasure.

Objective To investige the risk factors of urosepsis after percutaneous nephrolithotomy (PCNL).Methods We retrospectively analyzed 204 renal calculi or proximally ureter calcui patients,who underwent ultrasound-guided PCNL,from January 2013 to January 2014.Among them,there were 140 men and 64 women,whose mean age was 49 years (range from 29 to 75 years).Eighty-four operations were performed via standard channel and 120 operations were performed via micro channels.Fifty one patients had staghorn stones.Before operation,the urine culture positive rate was 14.7％ (30/204).The creatinine level ranged from 46 to 340 μmol/L [mean (87.9±33.9) μmol/L].Average stone diameter was (2.3±0.8) cm (range 1.0-7.0 cm).Mean operative time was (68.4±26.9) min (range 23-219 min).The chi-square test and a logistic regression model were used to identify key risk factors.Results The operation duration ranged from 23 to 219 min,mean (68.4±26.9) min.Of 204 patients,9 (4.4％) suffered septic shock,including 7 female patients and 2 male patients.Their mean age was (52.6± 15.2) years (20-73 years).Five operations were performed via standard channels and four operations were performed via micro channels.Five patients had staghorn stones.Urine culture positive rate was 77.8％ (7/9).The average stone diameter was (2.5±0.6) cm (range 1.8-3.5 cm).Mean operative time was (86±53) min (range 47-219 min).In univariate analysis,significant associations was observed between female gender (P =0.005),positive urine culture (P＜0.01),staghorn calculi (P =0.035),operative duration＞90 min (P =0.042) and sepsis after PCNL.While in multivariate analysis,female gender (OR=6.001,95％CI=1.190-30.276,P=0.03) and positive urine culture pre-operation (OR=19.647,95％CI=3.918-98.562,P＜0.01) were identified as independent risk factors for post-MPCNL septic shock.Conclusions Female gender and positive urine culture before operation are the key risk factors of urosepsis after percutaneous nephrolithotomy.

0.05) ; Compared with group A and B , contents of brain water and MDA were significantly increased at 3 hours after ACCI (P

Objective Study on the inhibitory effect of gallnut extract extract on MRSA β-lactamase. Methods Determination of inhibitory effect of gallnut extract on MRSA3002 by TTC method. β-lactamase was repeated by freezing and thawing method . Synergistic effect of gallnut extract and gentamicin was detected by TTC. Results The MIC and MBC of MRSA3002 by gallnut extract were 8mg/mL and 32mg/mL.Gallnut extract can reduce strains of β-lactamase activity,the MRSA300224h 1/2MIC after the effect of gallnut extract, beta lactam enzyme activity inhibition compared with the control group there were significant differences (P<0.01),compared with the positive control group, the difference was not significant. Synergistic effect of gallnut extract and gentamicin can significantly reduce the MIC of MRSA3002. Conclusion Gallnut extract can reduce β-lactamase activity recovery sensitivity of drug-resistant bacteria.

ObjectiveTo study the situation of neural invasion in pancreatic cancer and investigate its related clinical factors. Methods The neural invasion in 73 cases of pancreatic cancer patients was retrospective analysed. The correlation between neural invasion and clinicopathological parameters,and survival rate was investigated.Results In 73 cases of pancreatic cancer,neural invasion occurred in 38(52.1％) patients,among whom intra-pancreatic neural invasion rate was 15.8％ (n =6) ; and both intrapancreatic and external pancreatic plexus invasion rate was 84.2％ ( n =32).Neural invasion was not related with gender,age,and pathological type,degree of differentiation,tumor size and lymph node metastasis (P ＞ 0.05 ).But the presence of abdominal pain,vascular invasion,the expression of EGFR and VEGF in tumor tissue was significantly related with neural invasion (P ＜0.01 ).The median survival of patients in neural invasion group was 8 months,which were significantly shorter than that of in patients without neural invasion (13 months,x2 =4.69,P =0.030).Conclusions Neural invasion has a high incidence in pancreatic cancer,and it can cause obvious abdominal pain.And it is related with vascular invasion and the expression of EGFR and VEGF in tumor tissue.Neural invasion is one of the factors affecting the survival rate.

Objective To investigate the effect of zinc oxide oil care on perianal skin ulceration in elderly patients.Methods A total of 90 elderly fecal incontinence patients with perianal skin ulceration were randomized into the observation group(n=48)and the control group(n=42):The former received zinc oxide oil treatment and the latter were treated with mupirocin ointment.Perianal skin injury was evaluated in all the patients and the treatment effect between two groups were statistically analyzed after one week.Result The total effective rate in the observation group(93.8%)was significantly higher than that in the control group(71.4%)(χ2=8.036,P<0.01).Conclusions Management of perianal skin ulceration in bedridden elderly patients with zinc oxide oil may produce better effect.

Iron is an essential nutrient element for human, but has potential toxicity. Under physiological conditions, the processes of iron absorption, transportation, cellular uptake and utilization, storage, release, excretion as well as regulation of iron metabolism maintain the iron homeostasis. However under pathological conditions, the iron metabolism changes and is associated with the pathological states. In order to realize the relationship between the critical illness status and the iron metabolism, we start with an analysis of the basic processes of iron metabolism in human and the toxicity of iron, followed by summary on the alteration of iron metabolism in the settings of pathological conditions, such as inflammation, infection and anemia, which often occur in critical illness. Then, we discuss the relationship between the prognosis and the parameters of iron metabolism. Moreover, we review the current researches on treatments related to iron metabolism, which involve the iron supplementation, iron chelation and agents regulating iron metabolism.

Objective To explore the practice and efficacy of multidisciplinary collaborative management in the prevention and control of multidrug-resistant organism(MDRO)healthcare-associated infection(HAI).Methods MDROs isolated from clinical specimens and MDRO infection in hospitalized patients in April 2012-March 2013(before intervention)and April 2013-March 2014(after intervention)were analyzed retrospectively.Since April 2013,multidisciplinary collaborative management has been implemented,isolation of MDROs and MDRO HAI in hospitalized patients before and after intervention were compared and analyzed.Results 798 and 833 MDRO strains were isolated before and after the intervention respectively,isolation rate of MDROs after intervention was lower than that before intervention(25.71%vs 31.89%,P<0.001).After the implementation of multidisciplinary collaborative management,incidence of MDRO HAI decreased from 0.94%before intervention to 0.63%;hand hygiene compliance rate of health care workers(HCWs)increased from 36.44%before intervention to 53.51%;compliance rate of contact isolation increased from 65.29%before intervention to 90.88%;rational usage rate of antimicrobial agents increased from 64.93%before intervention to 72.53%;specimen detection rate in patients with therapeutic antimicrobial use increased from 41.36%before intervention to 58.72%,differences were all statistically significant(all P<0.001).Conclusion The practice of multidisciplinary collaborative management can effectively implement the prevention and control measures of MDRO HAI,effectively reduce the occurrence of MDRO HAI.

One alkaline protease from Actinomucor elegans AS3.2778 was purified protein. The enzyme was purified using ammonium sulfate precipitation, ion exchange chromatography, hydrophobic chromatography and size exclusion chromatography method, and its properties were also investigated. The molecular weight of this enzyme is 32 kDa with SDS-PAGE method, optimum temperature is 60℃, optimum pH is 8.5 to 10.5, it is stable in the pH range of 6.0 to 9.0 at < 40℃ temperature, and being completely inhibited by the serine protease inhibitor, PMSF, indicated that it belongs to the serine protease family. Specificity test indicated this protease has extensive selectivity to peptide bones, especially to peptide bones composed of Leucine residue.

Objective To observe the impact of different pacing sites in hemodynamic and cardiovascular events after restoration of spontaneous circulation.Methods A total of 76 patients with-in hospital cardiac arrest occurred from November 2010 to January 2014 were confirmed by electrionic device monitoring or electrocardiogram and they received cardiopulmonary resuscitation,and their ages were over 18 years.Patients with end-stage of various disease,malignancy and cardiac arrest due to incurable diseases or debility of physical conditions were excluded.The 76 patients were divided into two groups according to pacing site checked by X-ray fluoroscopy in emergency rescue unit:right ventriclular outflow trace pacing group [n =36,male 26 cases,female 10 cases,age (57.31 ± 16.65) years] and right ventricular apex pacing group [n =40,22 male cases and 18 female cases,age (60.43 ± 15.48) years].All patients' QRS duration were measured by ECG after pacemaker implantition and left ventricular ejection fraction (LVEF),left ventricular short axis reduced rate (FS),heart rate (HR),cardiac index (CI) were tested by bedside echocardiography and non-invasive hemodynamic monitoring was used during the early to middle stage.All the hemodynamic variables and the cardiac events were observed after spontaneous circulation recovery.All the data were analyzed by SPSS version 13.0 statistical software.Results There were no significant differences in age,gender,the primary disease,the time from cardiac arrest to spontaneous circulation restoration and dosage of epinephrine (P ＞ 0.05).In comparison with right ventricular apex pacing group,LVEF,FS,HR,CI were higher in right ventriclular outflow trace pacing group [(0.46 ± 0.04)％ vs.(0.44 ±0.05)％,(0.34±0.05) vs.(0.32±0.04),(0.04±0.46) L/minvs.(3.47±0.46) L/min,(0.46±0.29) L/ (min · m2) vs.(2.46 ±0.26) L/ (min · m2),P ＜ 0.05] and right ventriclular outflow trace pacing group had shorter QRS duration than right ventriclular apex pacing group [(128.25 ± 6.06) ms vs.(151.93 ± 8.99) ms,P ＜ 0.05]; fewer atrial fibrilation event was detected in right ventriclular outflow trace pacing group after restoration of spontaneous circulation than that in right ventricular apex pacing group.But incidences of cardiac failure and thrombus were not different between two groups (P ＞ 0.05).Conclusions The right ventriclular outflow trace pacing resulted in better hemodynamic and fewer atrial fibrilation after restoration of spontaneous circulation.