The survey aims at probing into the current development of medical instruments in hospitals and computerized quality control,upgrading the competence of hospital engineering departments and guiding the development of medical clinical engineering.Questionnaire surveys were made to the medical engineering departments of 195 hospitals above secondary hospitals in Zhejiang,totaling 1001 professionals.The results indicate significant differences among hospitals of various scales in terms of deployment of medical engineering Professionals,working conditions,and computerized applications,yet a consistency in academic title promotion and training requirements.In this consideration,it is imperative to build the team,maintain consistency in professional certification of medical engineering professionals,build a regular and systematic examination,promotion and certification system,enhance training in professional knowledge and equipment quality control,as well as promoting information and resources sharing.All these efforts are essential for better quality control and management of medical engineering departments,and promoting computerized management of medical instruments.

Objective To explore the experience of operative cooperation of trans-sternocostal triangle hand-assisted double lung metastatic tumor resection.Method The clinical data of 54 patients undergoing trans-sternocostal triangle hand-assisted double lung metastatic tumor resection were retrospectively analyzed from January 2005 to December 2005.Results The operations were all successful,with blood loss of 10~700 mL,operation time of 40~300 min,averaged(130.3+43.0)mins.One hundred and seventy eight malignant tumor lesions were removed.No serious complications occurred.Conclusion The key points to ensure thesuccessful operation were as follows:preoperation of special equipment,reasonable position,intraoperative strict aseptic operation,fixing of endoscopic incision suturing instrument,and accurate cooperation at all procedures.

Objective To discuss prevention and treatment of the late complications of deteniaceacal-colon continent urinary reservoir. Methods 105 patients who underwent detenia ceacal-colon con-tinent urinary reservoir were followed up for 9 -82 months(mean 40.5 months).Clinical data of these wereretrospectively analyzed. Results Late complications occurred in 25.7%(27/105) of the cases and 9were treated with operations,including difficulty with catheterization in 4 cases(3.8%),3 treated with dila-tion and 1 with efferent limb reconstruction with ileal,urinary pouch stones in 5(4.8%),4 treated with li-thotomy,urinary pouch perfotation in 1 (0.95%),treated with repair,urinary pouch superdistention in 1(0.95%),treated with reduction, single or double lateral hydronephrosis in 8(7.6%),caused by strictureof single or double lateral lower ureters in 4 (2 treated with excision lesion and anastomosis ) and by refluxin 1,1 case suffering from azotemia preoperatively worsened to uraemia treated with regular haemodialysis,hyperchloremia in 7 (6.7%),only 1 needed drugs treatment,repeated urinary infection in 11,amomg them,10 were complicated by the other complications,all treated with sensitive antibiotic. Conclusions Most ofpatients underwent detenia ceacal-colon continent urinary reservoir had good curative effects. Late complica-tions afflicting these patients mostly had immediate or mediate relations with symptomatic urinary infection.Prevention and treatment of symptomatic urinary infection can reduce the occurrence of late complications ofthis operative method,regular and adequant pouch washing and catheterization is efficient to prevention oflate complications of this operative method.

Objective To investigate the effects of S100B on the expressions of dopamine receptors and the synthesis,metabolism of neurotransmitters dopamine,5-hydroxytryptamine which are related to the abnormal motor coordination of Parkinson's disease (PD).Methods The hS100B transgenic mice were established.The mice were divided into S100B transgenic group (TG,n =14),S100B knockout group (KG,n =14) and the non-transgenic control group (CG,n =14).The motor coordination ability of mice was measured by the Rota-rod test.The expressions of dopamine D1 receptor (D1DR),dopamine D2 receptor (D2DR),tyrosine hydroxylase (TH) and phosphorylated TH at Ser19,Ser31,Ser40 in brain tissue were detected by reverse transcription polymerase chain reaction and Western blotting.The levels of Tyr,levodopa,dopamine,homovanillic acid,Trp,5-hydroxytryptamine and 5-hydroxyindoleacetic acid in mesencephalon were measured by high performance liquid chromatography with fluorescence detection.Results Compared with CG,the motor coordination ability of mice (s) showed progressive decline in TG (3 months:4.60±0.30vs4.25±0.21,q =5.194;6 months:4.52±0.31 vs4.07±0.22,q =6.139;9 months:4.43 ± 0.25 vs 3.60 ± 0.18,q =13.484;all P ＜ 0.05),the expressions of D2DR mRNA and protein decreased (1.34 ± 0.13 vs 0.48 ± 0.07,q =21.578;1.05 ± 0.15 vs 0.69 ± 0.10,q =8.063,both P＜0.05) and phosphorylated TH at Serl9 and Ser40 increased (0.95 ±0.10 vs 1.14-0.13,q =4.972;0.94 ± 0.12 vs 1.17 ± 0.14,q=5.382,both P＜ 0.05),the levels of levodopa,dopamine and homovanillic acid were elevated (87.04 ± 11.77 vs 115.28 ± 16.80,q =4.764;56.66 ± 9.87 vs 72.96 ± 11.02,q=3.923;26.58 ± 8.11 vs 38.65 ± 6.67,q=3.981,all P＜ 0.05),the leve1 of 5-hydroxytryptamine was reduced (925.50 ± 74.26 vs 637.87 ± 56.76,q =11.084,P ＜ 0.05),the ratios of homovanillic acid/dopamine and 5-hydroxyindoleacetic acid/5-hydroxytryptamine increased (0.45 ± 0.05 vs 0.54±0.08,q =3.325;0.94±0.07 vs 1.42±0.12,q =12.367,both P＜0.05) in the brain of TG at the age of 9 months old.There was no significant difference of detection indexes between KG and CG.Conclusions S100B plays an important role in the development of PD and the brain-specific S100B transgenic mice can be used to investigate the function of S100B gene on the development of PD.

Objective The study was designed to investigate the serum levels of HE4 in patients with lung cancer,and explore its prognostic value.Methods Blood samples of 106 healthy adults and 191 patients with lung cancer before treatment were measured by means of ELISA for HE4 levels in different stages and pathological types,for analyzing prognostic effect of HE4.Results The serum levels of HE4 in patients with lung cancer (median level 91.63 pmol/L) were significantly higher than control group (median level 56.42 pmol/L) (U =3 081.00,P ＜ 0.05).AUC of serum HE4 was 0.85,with a cut-off value of 82.70 pmol/L (specificity =95.31％,sensitivity =62.32％).HE4 expression was not statistically related to clinical stage and pathological types of lung cancer.The median overall survival (mOS) was 36.87 months in the HE4-low group and 30.43 months in the HE4-high group (P ＜0.05),respectively.HE4 level was an independent prognostic factor for overall survival (HR =2.15,95％ CI 1.49-3.12,P ＜ 0.05).Conclusions The prognosis of patients with high HE4 expression is poor.Therefore,it might be necessary for patients with high level of HE4 to receive more aggressive adjuvant therapy.

Objective To investigate the effect of chymase on the proliferation of rat cardiac fibroblasts (CFs) and the role of transforming growth factor-?1 (TGF-?_1).Methods Cultured CFs of neonatal SD rats were isolated by trypsinization.Cell number and DNA synthesis were evaluated by MTT assay (A_(490) value) and [~3H]-deoxythy- midine [~3H]-TdR incorporation.The mRNA expression of TGF-?_1 in CFs was determined by RT-PCR.Results Chymase increased CFs numbers and [~3H]-TdR incorporation in a dose-dependent manner.The A_(490) value of CFs stimulated by 15,30 and 60 ng/mL chymase was 0.263?0.033,0.348?0.031 and 0.387?0.026,respectively, which were all significantly higher than that of control (0.201?0.019,P

OBJECTIVEThis study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief.

METHODSA total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared.

RESULTSThe postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P < 0.001). The differences among the control group and experimental groups 1 and 2 were not statistically significant (P = 0.871), whereas the differences among experimental group 3 and the other groups were statistically significant (P < 0.001).

CONCLUSIONPostoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

Objective To explore the relationship between the red cell volume distribution width (RDW)in patients with ges-tational diabetes and insulin resistance(IR).Methods A total number of 160 pregnancies performed in Guangzhou Women and Children’s Medical Center from January to October 2016.Matching 80 patients with gestational diabetes (the GDM Group)with 80 healthy pregnancies according to their age,gestational weeks and times.Their inflammatory parameters (hs-CRP,neutrophil-to-lymphocyte ratio,RDW)were respectively examined.HOMA-IR was calculated by testing the level of FBG and FIns.The association of the red cell volume distribution width with insulin resistance was analyzed.Results The level of four inflammatory parameters (hs-CRP,WBC,neutrophil-to-lymphocyte ratio,RDW)were significantly higher than that the control group (t=5.695,5.232,3.337,7.814,all P<0.01).Pearson correlated analysis suggested that RDW had positive correlation with HOMA-IR (r=0.58,P<0.01).Conclusion The RDW level were elevated in the GDM patients and had positive correlation with HOMA-IR,which indicated that IR was associated with inflammation and provided proof to research mechanism of GDM.

Objective To explore the change of red cell volume distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) in the patients with gestational diabetes mellitus (GDM ) .Methods A total number of 160 pregnant women in our center from January to October 2016 were selected as the research subjects .Eighty patients with GDM served as the GDM group and 80 normal pregnant women as the control group .The clinical data at the second trimester (24 to 28 gestational weeks) ,and changes of RDW and NLR were analyzed .Results The age ,gestational weeks ,gestational times and pre-pregnant BMI had no statistical differences between the GDM group and control group (P>0 .05) .There was no statistically significant differences in the hyperten-sion family history and fetal macrosomia incidence between the GDM group and control group .However ,the family history of diabe-tes ,premature rupture of membranes and incidence of premature birth had statistical difference between the two groups (P<0 .05) . The RDW and NLR levels of the GDM group were higher than those of the control group (P<0 .01) .Conclusion GDM has a cer-tain association with inflammation .

Objective To investigate the clinical efficacy of body weight supported treadmill training (BWSTT) for the recovery of walking ability and comprehensive function after thoracolumbar spinal cord injury (SCI).Methods Sixty patients with SCIs in a thoracolumbar segment were assigned to a treatment group or a control group with 30 in each.Both groups received similar conventional rehabilitation training,but the patients in the treatment group were additionally treated with BWSTT (30 to 40 min,once daily,5 d/week,30 days for a course,a total 3 courses).The American Spinal Injury Association lower-extremity motor function assessment (ASIA),a functional comprehensive assessment (FCA),the walking ability assessment from the FCA (WA) and the modified Barthel index (MB1) were used in the assessment of the two groups before and after treatment.Results There were no significant differences in the two groups＇ average ASIA,FCA,WA or MBI results before treatment.After treatment ASIA,FCA,WA and MBI scores had all increased significantly in the treatment group compared with before treatment,and were significantly higher than in the control group.Conclusion As a supplement to conventional rehabilitation,BWSTT can improve walking ability and comprehensive function significantly after thoracolumbar spinal cord injury.