This paper introduces methods to control the cost of maintenance and repair for medical equipments through service team training, service contract control, system establishment and outside service resources, etc..
Cost Control ; Equipment and Supplies ; Maintenance ; economics ; organization & administration

Objective To evaluate the safety,feasibility,and clinical outcome of anterior percutaneous endoscopic cervical discectomy (PECD).Methods The study involved 28 patients undergone PECD.Visual analogue scale (VAS) and MacNab scale were recorded before operation and at 3 days,1,3,6,12 and 18 months after operation.In addition,MRI examination was conducted at postoperative l month,3 months and 12 months.After data collection,single-factor T test with SAS software was performed.Results Follow-up (range,18-24 months,mean 19 months) was achieved in 25 patients.When compared to the preoperative score,VAS and MacNab scale presented improvement at postoperative 3 days (P ＞ 0.05) and great improvement at postoperative 1,3,6,12,18 and 24 months (P ＜ 0.01).VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3,6,12 and 18 months (P ＜0.05),but the differences were not statistically insignificant at postoperative 3,6,12,and 18 months (P ＞ 0.05).Moreover,VAS and MacNab scale showed significant improvement at postoperative 24 months as compared to those before operation (P ＜0.01) and those at postoperative day 3 (P ＜ 0.01).Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.

Objective To compare the heart function and observe the clinical prognosis of dilated cardiomyopathy(DCM) in children treated with combination of prednisone and azathioprine and high dose intravenous immunoglobulin(IVIG).Methods From Jan.1998 to May 2004,20 children who met the diagnostic criteria of DCM were divided into 2 therapeutic groups(groupⅠ,groupⅡ) according to the time of hospitalization.On the basis of traditional congestive heart failure(CHF) therapy,the children in groupⅠwere treated with immunosuppressive therapy(prednisone plus azathioprine) and the children in groupⅡ were treated with high dose IVIG.The course of treatment was 6 months for all children.Heart functions in all children were evaluated and echocardiographic parameters including left auricular diameter(LA),left ventricular end diastolic diameter(LV),left ventricular ejection fraction(LVEF) and cardiac index(CI) were measured before and after therapy,respectively.All children were followed up for 1 year to observe survival rate(%).The findings were analyzed by t test and ?~2 test.Results The percentage of heart function increased from Ⅲ-Ⅳ toⅠ-Ⅱin groupⅠ,which was lower than that in groupⅡ(P

Objective To study the expression of plasma membrane Ca2 + -ATPase isoforms 1 -4 and the splice variants at sites A and C in the neonatal rat vestibular organ.Methods Ten rats at postnatal 2 days (P2 ) were decapitated and their vestibular organs (macula utriculi and macula sacculi)were isolated.The total proteins of the vestibular organs were extracted.The expression of PMCA1-4 splice variants at sites A and C was detected by RT-PCR.Results The splice variants of PMCA1-4 at sites A and C in macula utriculi and macula sacculi of neo-natal rat vestibular organs were PMCA1x/b,PMCA2w/(a,b),PMCA3z/(a,b,c)and PMCA4 (x,z)/b.Conclusion The splice variants at sites A and C among PMCA1,PMCA2,PMCA3 and PMCA4 were different in the vestibu-lar organs of neonatal rats,which could be explained that macula utriculi and macula sacculi had different require-ments of Ca2 + turning for these PMCA isoforms.

Objective To study the expression of plasma membrane Ca2+-ATPase isoforms 1~3 (PMCA 1~3 )in the basilar membrane (BM)of the neonatal rat cochlea by Western blot.The PMCA2 content in single BM of the neonatal rat was also examined.Methods Four rats at postnatal 2 days (P2)and 8 days (P8)were respective-ly decapitated and their BMs were isolated.The total proteins of BMs were extracted.The 20μg total proteins were respectively loaded to the gel.The expression of PMCA1-3 was detected by Western blot.Likewise,3μg total proteins from P2 and P8 rat BM were loaded.The expression of PMCA2 was detected by Western blot.Four rats at P8 were decapitated and their BM was isolated.The 5μg,10μg and 20μg total proteins of P8 rat BM were added to the gel and 100 ng,400 ng and 800 ng bovine serum albumin (BSA)were also loaded as reference.After electro-phoresis,the gel was separated into two parts.One part was used for SYPRO staining and the other part was used for PMCA2 detection by Western blot.Results In the 20μg BM total proteins of P2 and P8 rats,the expression of PMCA1 was weak (0.126±0.024,0.131±0.012,respectively),PMCA2 was strong (4.16±0.528,4.25±0.319, respectively),and PMCA3 was barely expressed (0 ).There was a statistical difference among PMCA1 ,PMCA2 and PMCA3(P<0.05).In the 3μg BM total proteins of P2 and P8 rats,the expression of PMCA2 in P8 (4.571± 0.336)was higher than P2 (3.622±0.285).There was a statistical difference(P<0.05).The PMCA2 content in the BM of a P8 rat was about 2 .5 ng.Conclusion There was a different-level expression of PMCA1~3 in the neonatal rat BM with highest expression of PMCA2 ,which could be explained that cochlear hair cells had different requirements of Ca2+ turning for these PMCA isoforms.

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.
Arsenic ; Ataxia ; Carbon Disulfide ; Carbon Monoxide ; Cerebellar Diseases ; Delivery of Health Care ; Developing Countries ; Dimethylamines ; Disease Outbreaks ; Electrophysiology ; Gases ; Hexanes ; Hydrogen Sulfide ; Manganese ; Metals, Heavy ; Nervous System ; Neuroimaging ; Neurologic Manifestations ; Neuromuscular Junction Diseases ; Neurotoxins ; Occupational Diseases ; Occupational Health ; Organophosphate Poisoning ; Organophosphates ; Parkinsonian Disorders ; Polychlorinated Biphenyls ; Quaternary Ammonium Compounds ; Semiconductors ; Sodium Fluoride ; Solvents ; Taiwan ; Thallium ; Tin ; Toluene ; Urethane

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.
Arsenic ; Ataxia ; Carbon Disulfide ; Carbon Monoxide ; Cerebellar Diseases ; Delivery of Health Care ; Developing Countries ; Dimethylamines ; Disease Outbreaks ; Electrophysiology ; Gases ; Hexanes ; Hydrogen Sulfide ; Manganese ; Metals, Heavy ; Nervous System ; Neuroimaging ; Neurologic Manifestations ; Neuromuscular Junction Diseases ; Neurotoxins ; Occupational Diseases ; Occupational Health ; Organophosphate Poisoning ; Organophosphates ; Parkinsonian Disorders ; Polychlorinated Biphenyls ; Quaternary Ammonium Compounds ; Semiconductors ; Sodium Fluoride ; Solvents ; Taiwan ; Thallium ; Tin ; Toluene ; Urethane

ObjectiveTo discuss the feasibility and safety of anterior pedicle screw (APS) fixation in treatment of lower cervical spine injuries.MethodsA total of 10 patients with lower cervical spine injuries were treated with APS fixation.All the patients received preoperative cervical CT scans,and then three-dimensional model was reconstructed by using Mimics software to measure the screw placement parameters (insertion point,screw placement angle,screw length and diameter).All APS fixations were performed through anterior cervical approach,and then centrums antetheca and bilateral outer edges were exposed to distinguish the vertebral end plates.Screw insertion was strictly operated under the fluoroscopic assistance and preoperative screw placement parameters.The postoperative efficacy of APS fixation was evaluated by radiologist and other orthopedist via anteroposterior and lateral radiation,CT scan,three-dimensional model reconstruction and MRI.A follow-up was carried out at 1,3,6 and 12 months after operation.ResultsExcept for one screw for C4 and one for C7,another 24 crews for C3-C7 were successfully inserted.Postoperative CT scan demonstrated four screws breaking the outer vertebral wall.Except for one patient suddenly died from acute myocardial infarction one week after operation,the other nine patients received follow-up.Of three trauma patients,one patient at Grade A did not get improvement but with no aggravation and two achieved improvement for 2-3 grades according to Frankel grade.Among six non-trauma patients,spinal function score by JOA was averagely elevated to 13.4 points,with improvement rate of 60.7％ according to Hirabayashi method.There were no serious complications except for two patients of dysphagia among the patients who were followed up. Conclusions APS fixation is feasible for lower cervical spine injuries.The keys to successful screw insertion are preoperative measurement of individualized screw insertion parameters and appropriate application of intraoperative fluoroscope technique.

Background There is multi-dimensional order of spatial stereopsis perception in human,however,current stereopsis examination is zero-order of position disparity.A multi-dimensional space perception model is very important for the detection of stereoacuity.Objective This study was to screen the deficit of zero-order,first-order,second-order multi-dimensional spatial stereopsis perception in amblyopia and strabismus children and to explore the association of zero-order,first-order,second-order spatial perception deficit.Methods Multidimensional spacial perception was examined in 79 children aged 4-14 years in Beijing Children' s Hospital.Nineteen normal children,19 children with ametropia amblyopia,12 children with anisometropic amblyopia,18 children with strabismus and 11 children with strabismus combined amblyopia were included this study.The random-dot and line spatial stereopsis perception in zero-order,first-order and second-order were examined with a new system of multidimensional space perception screening.Written informed consent was obtained from each subject or custodian before any ocular examination associated with this study.Results Absence of zero-order,first-order,second-order random-dot channel was found in 24 children (24/79,30.4％),18 children (18/79,22.8％) and 24 children (24/79,30.4％) respectively,with an average percentage of 27.9％.Absence of zero-order,first-order,second-order line channel was examined in 37 children (37/79,46.8％),37 children (37/79,46.8％),32 children (32/79,40.5％),with an average percentage of 44.7％.In the children with a deficiency of the zero-order spatial perception,the children who still remained the first-order or/and second-order spatial perception of random-dot accounted for 41.6％ and that of lines accounted for 43.2％.In children without deficiency of zero-order random-dot or lines spatial space perception,deficiency of first-order and/or second-order spatial perception was in 37.5％ children.Various order spatial perception deficiency was seen in children suffering from amblyopia or strabismus compared with normal group(P ＜ 0.05).Conclusions There exists spatial perception deficiency in children with amblyopia or strabismus.The patients with zero-order spatial perception absence partially remain a first-order or/and second-order spatial perception;while the patients with normal zero-order spatial perception might have first-order or second-order spatial perception deficiency.The multi-dimensional space perception model has a directive role for the training of visual information process and the treatment of spatial perceptual learning in children with amblyopia or strabismus.

OBJECTIVETo summarize the clinical features, diagnosis and treatment of chest trauma.

METHODSA retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011.

RESULTSOut of all cases, 325 were cured, accounting for 96.7%; 11 died, accounting for 3.3%. Among the dead cases, one died of hemorrhagic shock, three of acute respiratory distress syndrome, three of multiple organ failure, and four of severe multiple traumas.

CONCLUSIONS(1) For patients with severe chest trauma, early emergency treatment is crucial to save life. (2) Open thoracic surgery is needed for acute cardiac tamponade, intrapulmonary vascular injuries, progressive intrathoracic bleeding, lung laceration, tracheal breakage, and diaphragmatic injury. In addition, operative timing and method should be well chosen. (3) Pulmonary contusion is one of common complications in chest trauma, for which the combination of strong anti-infection therapy and mechanical ventilation is an effective treatment strategy.