Objective: Through the analysis of the current situation of energy consumption and the energy management problems that hospital faced, elaborat the high demands of energy management in hospital effective logistics management, the saving mechanism of Energy Performance Contracting (EPC) is proposed. Methods: The process of introducing EPC to China and related concepts are described, and the main mode and implementation processes as well. Results: To explore the feasibility of the integration in energy-saving reformation and the mode of energy runing management what is the core to EPC, tell people what need to pay attention to in the implementation process, and provide scientific methods for energy management of efficiency operation and sustainable development in hospital. Conclusion:At last, pointing out that saving mechanism of EPC is suitable for hospitals and will bring significant saving benefit.

Objective To observe the effect of Bi-level positive airway pressure(BiPAP) noninvasive ventilation on acute left ventricular failure(LVF). Methods BiPAP group :32 patients with severe LVF from various causes were treated by BiPAP with traditional drugs. Control group:32 patients were treated with traditional drugs alone,and the results were compared with those of BiPAP group. Results Dyspnea was relieved in all patients in BiPAP group,both the respiratory rate and heart rate were slowed,the vital signs were stable,and PaO2 ,SaO2 went up. The total effective rate was 100%, which was only 68. 75% in control group. Conclusion The use of BiPAP noninvasive ventilation therapy is feasible and effective on LVF.

Objective To reveal the transmiting discipline of parameters and define time window for therapy of ischemia penumbra by continuous detection of diffusion tensor imaging(DTI), and evaluate the relations between cortical spinal tracts(CST) and myodynamia by diffusion tensor tract(DTT). Methods 71 patients of cerebral infarction with different timing were imaged with conventional MRI, DWI and DTI, measuring DCavg, FA, RA , 1-VR of different ROI and performing DTT in ten patients. Results DCavg of lesions in different phases were [(0.275?0.022),(0.349?0.019),(0.465?0.023),(0.538?0.035)]?10~ -3mm~2/s, respectively. DCavg value showed tendency of reducing obviously, elevating gradually and false-normalizing (P

Objective To analyze patent applications by the top 20 hospitals in China in published papers and the advantages and disadvantages of patents owned by domestic hospitals so as to predict the development trends of their patents in the future.Methods Using data from China Patent Infonet,an analysis was made of the characteristics and technical features of the patents applied for by hospitals in the period 1985-2004,with a special focus on patent applications by the top 20 hospitals in published papers.Results It was found that in the 20-year period,patent applications by hospitals showed an upward tendency on the whole,with a marked rise in invention patents,a lack of proportion between patent applications and published papers,and a greater proportion of instruments and materials patents. Conclusion Domestic hospitals ought to give more attention to patent applications.

Objective To observe the clinical efficacy of electroacupuncture at different frequencies in treating post-stroke depression. Methods A hundred patients with post-stroke depression were randomized into treatment group 1, treatment group 2, treatment group 3, and a control group, 25 in each group. The treatment groups were intervened by electroacupuncture, while 2 Hz was adopted in treatment group 1, 50 Hz in treatment group 2, and 100 Hz in treatment group 3. The control group was intervened by oral administration of Sertraline Hydrochloride tablets. The Function Independent Measure (FIM) and Hamilton Depression (HAMD) scale were adopted for observation before and after intervention, and the clinical efficacies were compared. Results The FIM and HAMD scores were significantly changed after intervention in the four groups (P<0.05). After treatment, the FIM and HAMD scores in treatment group 1 were significantly different from that in treatment group 2 and 3 (P<0.05). The FIM score in treatment group 1 was significantly different from that in the control group (P<0.05). The total effective rate was 96.0%in treatment group 1, versus 92.0%in treatment group 2, 82.0%in treatment group 3, and 84.0%in the control group. The total effective rate in treatment group 1 was significantly different from that in the control group (P<0.05). Conclusions Electroacupuncture at 2 Hz, 50 Hz, and 100 Hz all can improve the activities of daily living and depression degree in patients with post-stroke depression, while 2 Hz ranks the top in comparing the therapeutic efficacy.

Objective To assess the influence of tube current and tube voltage on the CT attenuation,radiation dose,and image quality.Methods A total of 113 saline solutions with decreasing dilution of contrast medium (370 mg I/ml) was produced.MDCT scan was performed with 15 series of different settings of tube current and tube voltage.CT attenuations with 15 series of different settings were all measured,and influence of tube current and tube voltage on CT attenuations was analyzed.CT dose index (CTDIvol) was recorded.The CT attenuations with different tube voltage and current were compared with one-way ANOVA and Kruskal-Wallis rank sum test.The correlation of CT attenuation with different tube voltage and the influence of tube voltage and current on radiation dose and image quality were tested by correlation analysis.Results Tube current (250,200,150,100,and 50 mA) had no significant effect on CT attenuation (F =0.001,0.008,0.075,P ＞ 0.05),while tube voltage (120,100,and 80 kV) had significant effect (H =17.906,17.906,13.527,20.124,23.563,P ＜ 0.05).The correlation between CT attenuation and tube voltage was determined with equation:CT attenuatio N100 kV =1.561 × CT attenuatio N120kv + 4.0818,CT attenuatio N80kV =1.2131 × CT attenuatio N120kv + 0.9283.The influence of tube voltage on radiation dose and image quality was also analyzed,and equations were also obtained:N120 kV =-5.9771Ln(D120 kV) + 25.412,N100 kV =--10.544Ln (D100 kV) + 36.262,N80 kV =-25.326Ln(D80kv) +62.816.According to the results of relationship among CT attenuation,radiation dose,and image quality,lower tube voltage with higher tube current can reduce the radiation dose.Conclusions Lower tube voltage can reduce the radiation dose.However,CT attenuation was influenced,and correction should be done with the equations.

Objective To evaluate the relationship between calmodulin protein kinase Ⅱ (CaMK Ⅱ) and levosimendan against arrhythmias induced by myocardial ischemia-reperfusion (I/R) in rats in vitro.Methods Thirty male Wistar rats,weighing 250-300 g,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),I/R group and levosimendan group (group L).Their hearts were rapidly excised and perfused in a langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.At 20 min of equilibration,the hearts were perfused with K-H solution for 60 min in group C.The hearts were subjected to 30 min of ischemia followed by 30 min reperfusion with K-H solution in group I/R.The hearts were subjected to 30 min of ischemia followed by 30 min reperfusion with K-H solution containing 300 nmol/L levosimendan in group L.Left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+ dP/dt-dP/dtmax and heart rate (HR) were recorded immediately before ischemia and at 15 and 30 min of reperfusion.Arrhythmia was recorded during reperfusion and scored.Specimens were obtained from the apex of heart at 30 min of reperfusion for determination of the intracellular calcium concentration ([Ca2 +] i).Myocardial specimens were obtained from the left ventricle at 30 min of reperfusion to detect CaMK Ⅱ activity.Results Compared with group C,arrhythmia score,[Ca2+]i and CaMK [Ⅱ activity were significantly increased,and LVDP,+ dP/dtmax,-dP/dtmax and HR were decreased,and LVEDP was increased at 15 and 30 min of reperfusion in group I/R.Compared with group I/R,the number of ventricular premature beat,arrhythmia score,[Ca2+] i and CaMK Ⅱ activity were significantly decreased,and LVDP,+ dP/dtmax,-dP/dtmax and HR were increased,and LVEDP was decreased at 15 and 30 min of reperfusion in group L.Conclusion Inhibition of CaMK Ⅱ activity is involved in the mechanism by which levosimendan decreases the development of arrhythmias induced by myocardial I/R in rats.

Objective To investigate the value of blood oxygenation level dependent (BOLD) MRI in detecting monkey cerebral ischemic penumbra (IP). Methods Six monkeys were used to make reversible middle cerebral artery occlusion (MCAO) model by an interventional microcatheter method. MR DWI, PWI mean transit time (MTT), T_2WI and quantitative T_2 map, T_2~* map were performed at MCAO (0 h) and 1,3,6,12,24,48 h after reperfusion. Reversible transverse relaxation rate (R_2') BOLD imaging was calculated using quantitative T_2 and T_2~* maps. Lesion volume percentage (lesion volume/bilateral hemispheres volume) were measured on 0 h DWI,48 h T_2WI and TTC staining. Ischemic area was subdivided into infracted core (high signal area on both 0 h DWI and 48 h T_2 WI), IP (high signal on 0 h DWI, iso on 48 h T_2 WI) and oligemia (0 h delayed MTT, iso signal on both 0 h DWI and 48 h T_2 WI). Relative R_2' (rR_2') was calculated to get ratio between the lesion and mirror area in contralateral healthyhemisphere. Paired t test and correlation analysis were used for comparison of lesion volume percentage. rR_2' values at each time point were compared by ANOVA. Results Reversible MCAO models were made successfully in 4 of 6 monkeys. Lesion volume porcentage on 48 h T_2 WI was reduced compared to that on Oh DWI [ (8.16±0.55)% vs (11.37±1.41)% ,t=6.472,P<0.05]. There was no significant difference in lesion volume percentage between TTC staining and 48 h T_2 WI[ (8.15±0.62)% vs (8.16±0.55)%, t= 0.150,P>0.05], which showed significant positive correlation (r=0.98, P<0.05). rR_2' values were significant different at each time point, with highest in ohgemia followed by IP and infarcted core (P< 0.05). rR_2' values in infracted core, IP and oligemia were: 0 h(1.129±0.108,1.329±0.081,1.584± 0.103,F=36.19,P<0.05),1 h(0.668±0.082,1.237±0.072,1.435±0.066,F=134.09,P<0.05), 3 h (0.536±0.075,1.453±0.081,1.770±0.141, F=256.30, P<0.05), 6 h (0.259±0.050,2.435± 0.131,2.957±0.177,F=803.25,P<0.05), 12 h(0.385±0.054,2.447±0.148,3.254±0.184,F= 743.74,P<0.05),24 h(0.083±0.026,1.968±0.127,3.101±0.144,F=1236.26,P<0.05),48 h (0.246±0.058,3.694±0.218,4.297±0.322, F=557.02, P<0.05). After reperfusion, rR_2' values in IP and oligemia showed increased trend with time evolution and reflected positive BOLD effect, while the infracted core showed decreased trend, reflecting negative BOLD effect. Conclusion R_2' BOLD can delineate IP from infracted core according to the difference of oxygen metabolic status in ischemic brain tissue.

Objective To verify the pathol ogical basis of high signal intensity on T 1 weighted image after brain ischemia by using the rat model. Methods Fifty-six male Wistar rats, weighing 250 to 300 g, were used for the model of middle cerebral artery occlusion(MCAO). 46 rats model were counted in the results. They were divided into two groups randomly, experimental group (T 1, n =39) and control group (T 0, n =7). Experimental group was further divided into 4 subgroups: 15 minute's MCAO (T 1-a, n =13), 30 minute's MCAO (T 1-b, n =12), 60 minute's MCAO (T 1-c, n =7), and permanent MCAO (T 1-d, n =7). Intraluminal filament technique was used with the method modified by Zea-Longa. Follow-up MRI was applied to observe the time and the position of short T 1 signal. H & E staining and electronic microscope were applied to observe the pathological changes in the position of short T 1 signal. Results In T 0 group ( n = 7), no short T 1 signal was observed in bilateral cerebral hemispheres. In T 1-a subgroup ( n =13), short T 1 signal was observed in 7 rats at the 14 th day. In T 1-b subgroup ( n =12), short T 1 signal was observed in the ischemic side in 8 rats. All of the rats in T 1-c subgroup ( n =7) and T 1-d subgroup ( n =7) were observed to have short T 1 signal. The histological changes of short T 1 signal were hemorrhage, lipid-laden macrophage, denatured protein, and myelinolysis. Earlier short T 1 signal in cortical region was mainly related with hemorrhage, short T 1 signal in the basal ganglia appeared at a later stage, which was induced by lipid-laden macrophages. The occurrence of short T 1 signal was prominently different in the time of MCAO (? 2=29.328, P

Objective To establish a stable implanted model of VX2 rabbit brain tumor, and to evaluate the pathological and imaging features and tumor angiogenesis. Methods Thirty New Zealand white rabbits were implanted with 100 ?l viable VX2 tumor cells (107/ml) through a hole 5 mm to the right of the sagittal suture and 5 mm posterior to the coronal suture bored by a dental drill. MRI was performed every ~2 days after 7 days of implantation to evaluate the growth of the tumor, and perfusion CT studies were performed in different days of tumor growth. After that the animals were sacrificed on days 14, 18, 22, 26, and 30 of tumor implantation. 2% Evans blue (2 ml/kg) was given intravenously in 16 of these animals ~1 hour prior to sacrifice to detect the breakdown of the blood-brain barrier (BBB). The specimens of the rabbit brains were examined pathologically and histologically. VEGF and MVD were evaluated in immunohistochemical examination. Results Of the 22 animals included into the study, the tumor grew in 20 animals, which could be seen clearly on MR imaging. Pathologic examination showed characteristics of squamous carcinoma. VEGF was expressed in all tumors with the mean rate of positive cells of (52.51?19.15)% (19.5%-92.9%). Mean MVD was (51.30?14.42)pice piece/microscope (25-81 pice piece/microscope). Using Pearson′s linear correlation analysis, positive correlation was found between tumor growth time and volume (r=0.791, P=0.000), between MVD and tumor growth time (r=0.875, P=0.000), and between MVD and tumor volume (r=0.901, P=0.000), respectively. Spearman′s rank correlation analysis showed positive correlation between VEGF grade and blue stain of the tumor (r_s=0.594, P=0.015). Conclusion A stable model of VX2 rabbit brain tumor has been established with the method of skull drilling. The method was simple and easy to use, with a high tumor growth rate and remarkable angiogenesis. The model is helpful for the pathological and radiological study of tumor angiogenesis.