Objective:To analyze the significance of equipment custodian routine maintenance work and then offer some suggestion of countermeasure.Methods: Twenty four cases of maintenance cassette sterilizer were divided into test group(12 cases), equipment custodian had been trained; control group (12 cases)has not received training. In addition, we analyzed separately the maintenance work with the risk theory and cost-benefit.Results: The total number of failures in the test group was 13, obviously lower than 32 in the control. The risk of all devices under control, the maintenance of the benefits far outweigh the cost.Conclusion:Training equipment custodian, can reduce the incidence of failure, are worthy of promotion.

Objective To explore the correlation of pulmonary heart disease (PHD) with erythrocyte immunity function and serum erythropoietin(EPO)level. Methods Forty-eight patients with PHD were selected as PHD group, while forty people were chosen as control group. The erythrocyte C3b receptor (E-C3bRR), erythrocyte immunity complex (RBC-ICR) and serum EPO content were detected by yeast rosette method and enzyme-linked immunosorbent assay (ELISA),and blood gas indexes were examined by blood gas analyser.Results The E-C3bRR and serum EPO content were lower, while the RBC-ICR was higher in PHD group than in control group(both P< 0. 01). Compared with control group, PCOz and HCO3-levels were higher, but blood oxygen saturation(SaO2) level was lower in the PHD group than in control group(both P<0. 01). There were no differences in pH value and PO2between two groups(both P>0. 05). The E-C3bRR was positively related to serum EPO content (r=0. 623, P<0.01), and HCO3-was positively related to pH value and PCO2(r=0. 219 ,P<0. 05;r=0. 585,P<0. 01) ,whereas PCO2was negatively related to pH value(r=-0. 529,P<0.01),and PO2was positively related to SaO2(r=0. 682,P<0.01)in PHD group. Conclusions There is a correlation between E-C3bRR and serum EPO content in PHD patients.

Objective To investigate the relationship between maintaining concentration and loss of consciousness (LOC) concentration of propofol target controlled infusion (TCI) in patients undergoing heart valve replacement.Methods Thirty patients undergoing elective heart valve replacement were enrolled to receive propofol by ladder plasma TCI for anesthesia induction,8 males and 22 females.The initial plasma concentration (Cp) of propofol was set to 1.0 μg/ml,0.3 μg/ml Cp was increased every 1 min until LOC when the prediction effect-cite concentration (Ce) reached 0.5 μg/ml,then sufentanil 0.8-1.0 μg/kg and rocuronium 0.6-0.9 mg/kg were given for intubation.When BIS reached 50,Cp was decreased to the level of Ce.All the surgeries were performed under hypothermia CPB.MAP,HR,CVP,CO,SV,SVR,BIS,propofol Cp and Ce values were recorded at baseline (T0),LOC (T1),BIS reached 50 (T2),and other time points during operation (T3-T9).The correlation analysis between propofol Ce at LOC and perioperative variables were completed.Results In correlation analysis,there was a significant positive correlation between propofol Ce at LOC and baseline CO,SV (P<0.01),there was a significant negative correlation between propofol Ce at LOC and age (P<0.05),there was a significant positive correlation between propofol Ce at LOC and propofol Ce at T2-T9(P<0.01).Conclusion In patients undergoing valvular replacement,the Ce of propofol at maintenance are related to the concentration of propofol at LOC,which is helpful for adjusting the Ce of propofol at maintenance according to the Ce of propofol at LOC.

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Objective To explore the relationship between glycated albumin ( GA ) in 2 consecutive months and hemoglobin A1c ( HbA1c) in diabetes patients.Methods Totally 100 consecutive patients with main diagnosis of diabetes mellitus were enrolled retrospectively from April 2015 to January 2016 in outpatient clinic of endocrinology of Peking Union Medical College Hospital, who had undertaken GA tests every 4 weeks for 2 successive months and had HbA1c test in the second month.GA was measured with liquid enzymatic method. HbA1c was measured by ion-exchange high performance liquid chromatography.The relationship between HbA1c and GA for the 2 successive months was determined.Results A total of 85 patients were enrolled.The regres-sion equation between HbA1c (y) and average GA (j) for successive 2 months was y=3.187+0.218j (adjusted R2 =0.520, P=0.000), which showed a similar effect as the regression equation for HbA1c and the levels of GA tested for the 2 successive months (adjusted R2 =0.514, P=0.000), and both had more significant regressive effect than the regression equation for HbA1c and single measurement of GA (adjusted R2 =0.392, P=0.000). Conclusions The regressive effect between HbA1c and GA (or the average of GA) in successive 2 months is bet-ter than that with single measurement of GA, hence could better predict HbA1c in clinical practice.

Objective To evaluate and compare the efficacy of holmium laser enucleation of the prostate(HoLEP) and plasmakineticenucleation of the prostate(PKEP) for treating benign prostatic hyperplasia (BPH).Methods A total of 86 cases of BPH were selected from the Shandong Energy Zibo Mining Group Co.Ltd Central Hospital from January 2013 to June 2014.The patients received either HoLEP (40 cases) or PKEP(46 cases) treatment.Clinical data including postvoid residual volume (PVR),international prostate symptom score(IPSS),quality-of-life score(QOL score),maximum urinary flow rate (MFR) were evaluated before and 3 months after operation.Blood loss in operation,operation time,weight of resected prostate tissue,bladder irrigation time,catheterization time and length of hospital stay were also collected from the perioperative period.Results Three months after surgery,PVR,IPSS,QOL and MFR were all significantly improved in both HoLEP and PKEP groups compared with the data before operation (P =0.000),while there was no significant difference between the two groups(P＞0.05).Patients from the HoLEP group showed markedly lower values of bone loss in operation than that of PKEP group((69.5±23.6) ml vs.(87.5±38.0) ml,P=0.011).There were no significant differences in terms of other indexes (P＞ 0.05).Conclusion HoLEP and PKEP have similar efficiency in treating BPH,while HoLEP is suggested superior in regard of bone loss.

Objective: To investigate the hospital employee satisfaction and trustworthiness in the background of the trusteeship mode and to find out the problems after trusteeship.Methods: Minnesota satisfaction questionnaire (MSQ) and the self-made questionnaire were used to conduct the survey.Results: The overall employee satisfaction (3.80±0.86) and trustworthiness (3.95±0.77)were higher.The highest level of trustworthiness concerned the cultural connotation (84.8%) followed by the management concept (82.8%) for overall satisfaction.The lowest level of employee satisfaction concerned income and workload (53.7%), followed by the working conditions and environment (55.3%).The administrative staff satisfaction was higher compared to that of medical staff (p=0.001), which showed significant statistical differences.Conclusions: The hospital has made some achievements after the trusteeship system reform, however, it still needs improvement and further strengthening in many aspects.The hospital must always keep abreast of the demands of workforce and improve the staff satisfaction so as to promote its continuous and sustainable development.

Objective Toexplore the correlation of ApoE gene polymorphism and serum uric acid levels in Ningxia Hui Autonomous Region , China.Methods A case-control study.October 2011 to November 2011, five hundred twenty eight ( 296 male, 232 female ) apparently healthy individuals were studied.Questionnaires and physical examinations were performed by standard operation procedure.Fasting blood was collected for biochemistry testing including serum lipid parameters , uric acid concentration and creatinine levels.The multi-ARMS PCR was applied to determine ApoE genotypes ,and the relation of ApoE genotypes with serum lipid parameters and uric acid levels were analyzed.Non-normal distribution were compared using cause and inspection.Results The common six kinds of ApoE genotype can be detected.The total cholesterol ( TC) ,low density lipoprotein cholesterol ( LDL-C) and uric acid ( UA) levels in different genotype subgroups had statistical differences.The individuals with ε2/3 genotype had a significantly greater reductions in TC and LDL-C levels but increment in uric acid concentration than those withε3/3 and ε3/4 genotype (P<0.05).The effect of ApoE gene polymorphism on uric acid levels still remained significantly after adjustment for age , gender , region and other factors.Conclusion The ApoE polymorphism is associated with serum uric acid levels and individuals with ε2 allele have higher serum uric acid levels.

Objective To study the clinical characteristics of primary hypoparathyroidism in adults.Methods The clinical data of 200 cases with adult-onset primary hypoparathyroidism in Peking Union Medical College Hospital during December 1987 to December 2015 were collected and analyzed retrospectively.Among them, 128 cases were followed up for a median period of 3 years.Results The major manifestations at their first visits were tetany and numbness in the distal extremities (81.5%,163/200 and 62.0%, 124/200).Thirty-two percent of the cases (62 cases) had history of seizures, and 60.9%( 98/161 ) and 74.4% ( 96/129 ) of them were with intracerebral calcifications and cataracts , respectively.Most of subjects(155/200)had more than one year delay in diagnosis.Hypercalciuria occurred in 67.2%( 86/128 ) of the cases during the follow-up.No significant differences in the clinical characteristics and biochemical markers between the hypercalciuria subjects and the non -hypercalciuria subjects.Renal nephrocalcinosis or stones were found in 6.5%( 5/77 ) of the cases , and kidney function decreased in 6.6%(6/91) of the patients.Kidney function was negatively associated with age and duration of disease.Conclusions The predominant manifestations of primary hypoparathyroidism in adults included tetany and numbness in the distal extremities and seizures .It is often misdiagnosed.Calcium supplement combined with vitamin D or its metabolites effectively relieve clinical symptoms and signs.The serum and urinary calcium levels should be monitored frequently to reduce renal complications .

Objective To explore achieving the consistent method of blood lipid examination by comparing the results of 5 dif-ferent blood lipid detection system commonly used in the use of refernce method to assign freach blood serum before and af-ter calibration.Methods Used the indoor quality control total variation (CV%)to evaluate the 5 blood lipid examination system of the imprecision.Referenced the United States Clinical and Laboratory Standardization Institution (CLSI)9A2 EP program,compared with 54 fresh blood serum in 5 commonly used examination system of Total Cholesterol (TC)and Tri-glyceride (TG),and then estimated the bias between the different detection systems and mean value.8 of the samples were determined by the reference method and estimate the bias of different system.The fresh frozen serum samples assigned by reference method were used to evaluate the above examination system,then compare and estimate the bias again with the same 54 fresh serum samples.Compared the variation of 54 samples in different detection system before and after calibra-tion.Results The TG imprecision of 5 examination system were between 3.76%~23.65%,the TC imprecision between 2.19%~23.43%,that mean the results were good,the r value of TG were between 0.996 7~0.999 6 and the TC were 0.956 2~0.996 7.But there were obvious differences between the results of the systems,and the biggest difference were 14.72%~34.21% in TG and 3.11%~14.57% in TC.After use the serum assignment by reference method,the variation of the systems has been significantly decreased.Conclusion Using the reference method to assign the fresh serum of different blood lipid detection system can effectively improve the consistency of the results.