Action Potentials ; Humans ; Models, Neurological

The content related to the quality during life-cycle in operation of medical device includes daily use, repair volume, preventive maintenance, quality control and adverse event monitoring. In view of this, the article aims at discussion on the quality evaluation method of medical devices during their life cycle in operation based on the Analytic Hierarchy Process (AHP). The presented method is proved to be effective by evaluating patient monitors as example. The method presented in can promote and guide the device quality control work, and it can provide valuable inputs to decisions about purchase of new device.
Decision Support Techniques ; Durable Medical Equipment ; standards ; Equipment Design ; Quality Control

This article introduced the method and procedure of measuring the electrical skin resistance(ESR) by the digital electrical skin-resistance meter.And the factors affecting the ESR were discussed in the article.

Aim To study the antipsychotic effects of l-Scoulerine ( l-SLR) . Methods NMDAreceptorantag-onist MK-801 was used to induce the positive and neg-ative symptoms of schizophrenia and cognitive impair-ment in animal models. The effects of l-SLR were eval-uated on schizophrenia induced by MK-801 and on ex-trapyramidal system. Results l-SLR (10,15 mg · kg - 1 , ip) could suppress pre-pulse inhibition damage in rats induced by MK-801 (0. 3 mg·kg - 1 , ip); l-SLR(30 mg·kg - 1 , ip) could inhibit climbing behav-iors in mice induced by apomorphine, which suggested that l-SLR had significant inhibiting effects on the posi-tive symptoms of schizophrenia by MK-801 and apo-morphine. l-SLR could also induce social contact inhi-bition and cognitive impairment induced by MK-801 (0. 2 mg · kg - 1 , ip), which proposed that l-SLR could improve the negative symptoms and cognitive im-pairment by MK-801. Catalepsy in mice could be caused by the treatment dose of haloperidol (0. 8 mg· kg - 1 , ip), not by that of l-SLR(30 mg·kg - 1 , ip). Conclusion I-SLR has significant effects on the posi-tive and negative symptoms of schizophrenia and cogni-tive impairment and, the effect of l-SLR under effective dose on extrapyramidal system is obviously much less than that of haloperidol and l-SPD.

Objective To investigate the effect of remifentanil preconditioning on hypoxia-reoxygenation (H/R) injury to human hepatocytes.Methods Human HL7702 hepatocytes were cultured in vitro and randomly divided into 6 groups (n =16 each):control group (group C),H/R group,preconditioning with low,median and high concentrations of remifentanil groups (groups RP1-3) and normal saline group (group NS).H/R was produced by 8 h exposure of cells to 94％ N2-5％ CO2-1％ O2 in glucose-free DMEM liquid culture medium followed by 4 h reoxygenation.Remifentanil with the final concentrations of 0.5,5.0 and 50.0 ng/ml were added before hypoxia in groups RP1-3 respectively.Normal saline equal to the volume of remifentanil was added before hypoxia,the culture medium was replaced with glucose-free DMEM liquid culture medium 1 b later and H/R was produced in group NS.At 4 h of reoxygenation,the cell viability was measured by MTT,and activities of alanine aminotransferase (ALT),aspartate amino transferase (AST) and lactic dehydrogenase (LDH) in the culture medium and malondialdehyde (MDA) content in the cells were determined.The cell morphology was also examined.Results Compared with group C,the cell viability was significantly decreased,the activities of AST,ALT and LDH in the culture medium and MDA content in the cells were significantly increased in the other groups (P ＜ 0.05).Compared with groups H/R and NS,the cell viability was significantly increased,the activities of AST and LDH in the culture medium and MDA content in the cells were significantly decreased in group RP2 (P ＜ 0.05),and no significant change was found in the parameters mentioned above in groups RP1 and RP3 (P ＞ 0.05).The degree of damage to the hepatocytes was significantly reduced in group H/R compared with group RP2,and comparable in groups H/R,RP1 and RP3.Conclusion Preconditioning with the median concentration of remifentanil (5 ng/ml) can reduce H/ R injury to the human hepatocytes,while the low (0.5 ng/ml) or high (50 ng/ml) concentration of remifentanil has no such effect.

Objective To study the current status of catheter - related thrombosis(CRT)in Chinese children through a retrospective analysis of the inpatients in the Department of Medicine,Beijing Children's Hospital Affiliated to Capital Medical University. Methods The clinical data of the inpatients with CRT from November 2010 to November 2013 were collected retrospectively,and the causes,clinical symptoms,diagnosis,treatment and prognosis were ana-lyzed. Results There were 42 cases of children with CRT in Beijing Children's Hospital Affiliated to Capital Medical University. Among the cases,the male to female ratio was 1. 0:0. 5;the median age of onset was 88(2 - 186)months with ﹤ 1 year old counted for 16. 7%(7 / 42 cases)and 13 - 14 years old counted for 11. 9%(5 / 42 cases);the distri-bution differences between the male and the female age were not significant(P = 0. 826). The median time from cathe-terization to CRT onset was 9(1 - 81)days,0 - 10 days after catheterization was the peak of onset(52. 5% ,21 / 40 ca-ses)followed by 10 - 20 days(35. 0% ,14 / 40 cases). The protopathy was usually hematologic tumor,kidney disease or deep fungal infection. Slightly more cases developed CRT on the right side(57. 1% ,24 / 42 cases)than on the left side (38. 1% ,18 / 42 cases). All cases were diagnosed by using B - ultrasound,of whom 28. 6%(12 / 42 cases)were symp-tom - free. After being diagnosed,7. 1%(3 / 42 cases)were treated with conservative methods such as immobilization of the affected limbs and hot compress;7. 1%(3 / 42 cases)had catheter removed;anticoagulant and/ or thrombolytics after catheter removal used in 33. 3% patients(14 / 42 cases). After 1 week,22 cases were reviewed,of whom 54. 5%(12 / 22 cases)had thrombosis reduced(all with intervention),thrombosis growing in 22. 7% patients(5 / 22 cases), and thrombosis did not change in 22. 7% patients(5 / 22 cases). Three cases needed re - catheterization after catheter removal,and all of 3 cases had CRT recurrences(100% ). Conclusions CRT is more common among infants and senior children. CRT usually develops within 20 days after catheterization. Children with hematologic tumor,kidney disease or deep fungal infection are more likely to have CRT. Routine ultrasound test should be conducted to monitor CRT in catheterized children. Once CRT is diagnosed,patients need to be treated with anticoagulants and/ or thrombo-lytics. Catheter should also be removed if necessary. Recatheterization can result in CRT recurrence.

Objective To summarize the experience of multidisciplinary consultation for prenatal fetal deformity, and to explore the mode suitable for China. Methods The Obstetrics and Gynecology Hospital of Fudan University and Children's Hospital of Fudan University established a joint multidisciplinary consultation center, including obstetrics, pediatrics, pediatric surgery, ultrasound and other departments. A total of 3 378 pregnant women visited the consultation center from July 31, 2003 to August 1, 2013. After consultation, treatment was divided into three classes:pregnancy termination, pregnancy continuation and perinatal treatment. Follow-up was made through correspondence and telephone communication. Retrospective analysis on reasons for consultation, fetal structural abnormalities of the classification system, chronological order of abnormalities, gestational weeks of diagnosis, maternal-related factors, treatment and prognosis was performed. Results (1) Reasons for consultation:Among 3 378 women undertaking prenatal multidisciplinary consultation, 3 243 (96.00%) were due to fetal factors, and 135 (4.00%) were due to maternal factors. (2) Classification of fetal structural abnormalities:Among the 3 243 cases undertaking consultation with fetal factors, fetal abnormality was found in 80.85%(2 622/3 243). The most common were neurological abnormalities(23.19%, 608/2 622), followed by urinary tract malformation (20.25%, 531/2 622) and cardiovascular malformation (15.48%, 406/2 622). These were followed by digestive system malformation, limb deformities and space-occupying lesions. There were 156 cases of multiple malformations. (3) Average gestational weeks for diagnosis of fetal deformity:The 2 622 cases of fetal deformity were diagnosed at a mean (26.7± 2.1) of gestational weeks (21.1–30.4 weeks). Urinary tract malformations were detected at (24.0±0.7) weeks, whereas digestive system malformations were detected at (28.3±2.6) weeks. (4) Induced labor:Induced labor cases accounted for 35.66% (935/2 622), among which, 92 cases were fetal intrauterine death and 843 cases were active choice. The several highest induced labor rates resulted from multiple malformations (75.64%, 118/156), abdominal wall defects (62.22%, 28/45), diaphragmatic hernia (61.54%, 24/39), cleft lip and palate (55.32%, 26/47) and cardiovascular malformations (49.51%, 201/406). For nervous system (27.80%, 169/608), urinary tract (25.80%, 137/531) and digestive system malformations (26.94%, 66/245), induced labor rates were <30%. For abdominal lesions (14.04%, 25/178) and sacrococcygeal teratoma (13.64%, 3/22), induced labor rates were<15%. (5) Continuation of pregnancy in 1 687 cases:Cesarean section was conducted in 1 046(61.94%). Neonatal death occurred in 117(6.94%).(6) Perinatal treatment:Twenty-one cases were treated during pregnancy, including thirteen cases with fetal ascites and hydrothorax treated by drainage, five cases with fetal anemia treated by intrauterine transfusion and three cases with fetal tachycardia treated by digoxin. Ten cases were treated by ex-utero intrapartum treatment. After birth, 297 newborns immediately underwent neonatal surgery. Among these, 259 cases underwent radical surgery, eleven palliative surgery, and sixteen elective surgery after follow-up. Conclusions Prenatal multidisciplinary consultation can make comprehensive multidisciplinary assessment of fetal prognosis and improve the diagnosis and treatment of structural malformations.

Objective To investigate the effect of intramuscular and oral mecobalamin on hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.Methods One hundred and twenty-six patients with vitamin B12 deficiency who fulfilled the inclusion criteria were randomly divided into 3 groups,42 cases in each,including the intramuscular group (to receive mecobalamin therapy intramuscularly),the oral group ( to receive mecobalamin therapy orally) and the control group ( without mecobalamin therapy).The changes of hematologic markers including hemoglobin (Hb,g/L),mean corpuscular volume (MCV,fl),serum levels of vitamin B12 (ng/L),folate and total homocysteine (Hcy,μmol/L),and neurological signs before and after treatment were compared among these groups.Results Baseline characteristics among the three groups were similar.After a 6-month therapy,there were no differences in any markers in control group patients in comparison to baseline;for patients in the intramuscular group,the blood vitamin B12 levels increased from (139.13 ± 31.57)ng/L to (328.10 ± 42.35 )ng/L (P ＜ 0.001 ).Hcy levels decreased from (36.29 ± 16.23 )μmol/L to ( 18.23 ± 9.85 ) μmol/L ( P ＜ 0.001 ).Hb rose from ( 125.34 ± 16.21 ) g/L to ( 132.79 ± 15.98 )g/L (P =0.037).MCV reduced from (92.98 ±5.35)fl to (87.65 ±5.74)fl (P ＜0.001 ) ;For patients in the oral administration group,the blood vitamin B12 levels increased from ( 138.19 ± 29.95) ng/L to (487.79 ±32.21 ) ng/L ( P ＜ 0.001 ).Hcy levels decreased from ( 33.27 ± 11.51 ) μmol/L to ( 17.49 ± 10.13 ) μmol/L( P ＜ 0.001 ).Hb rose from ( 125.89 ± 17.65 ) g/L to ( 133.46 ± 16.26) g/L ( P =0.041 ).MCV reduced from (93.08 ± 5.10 ) fl to ( 89.29 ± 5.37 ) fl ( P =0.001 ).After the 6-month therapy,there were somewhat improvement in MMSE scores of the intramuscular ( 28.24 ± 3.89 vs.27.85 ± 3.56,P =0.633 ) and the oral groups (27.97 ± 3.77 vs.27.34 ± 3.15,P =0.408 ) compared with baseline,but the differences were not significant.The achilles tendon reflex of the intramuscular ( 1.86 ± 0.67 vs.1.56 ± 0.61,P =0.035 ) and the oral groups ( 1.79 ± 0.64 vs.1.43 ± 0.51,P =0.006 ) were enhanced compared with baseline.Foot vibration sensation of the intramuscular ( 1.35 ± 0.37 vs.1.06 ± 0.41,P =0.001 ) and the oral groups ( 1.24 ± 0.52vs.1.01 ± 0.43,P =0.03) were improved compared with baseline.After treatment,the serum VitB12 concentration in the oral group were higher than that of the intramuscular group ( P ＜ 0.001 ).There were no significant differences in other indexes between the two groups.Conclusion Mecobalamin,administered either intramuscularly or orally,may improve the hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.

Objective To carry out health education nursing intervention mode for patients with hemodialy-sis,and to study and analyze the clinical nursing effect.Methods 112 cases of hemodialysis patients were randomlydivided into the observation group and the control group according to random number table,56 cases in each group. The patients of the control group were given conventional nursing model,and the patients of the observation group were given nursing intervention model on the basis of health education.The blood pressure,the internal fistula blockage, indwelling catheter caused by the incidence of infection and blood phosphorus level of compliance rate were compared in the two groups.Results After nursing intervention,diastolic blood pressure(76.17 ±7.02)mmHg and systolic blood pressure (131.17 ±8.77)mmHg of the observation group were significantly better than the control group [(90.91 ±8.44)mmHg,(141.29 ±7.08)mmHg],there were statistically significant differences(t =10.49,13.75, all P <0.05).The incidence rate of fistula obstruction (1.79%)and the catheter infection incidence rate(1.79%) of the observation group were significantly lower than the control group (28.57%,26.79%),there were statistically significant differences(χ2 =8.22,9.17,all P <0.05).The blood phosphorus level standard rate(60.71%)of the observation group was significantly higher than the control group(33.93%),there was statistically significant differ-ence (χ2 =11.45,P <0.05).Conclusion The incidence of complications is significantly decreased after nursing intervention of health education in patients with hemodialysis,and the indexes are improved significantly,and there is no obvious conflict of interest.

Objective To investigate the concentrations of indoor radon (222Rn) and its daughter products as well as indoor thoron (220Rn) in selected houses in Yuhang district and Sanmen county,Zhejiang province,and estimate their annual effective doses to the population.Methods Solid state nuclear track detectors were used in selected dwellings in Yuhang district and Sanmen county,and the detectors were placed in bedrooms or living rooms.Without changing the ventilation habits of residents,These detectors were continuously placed from March to September in 2009.Results Indoor 222 Rn and 220Rn concentrations in low-rise buildings were the highest among all types of houses.The indoor concentration of 222 Rn had no relation with the building age (F = 0.53,P ＞ 0.05),but that of 220 Rn was dependent on the building age (F = 3.56,P ＜ 0.05).Moreover,the investigation demonstrated indoor 220 Rn concentrations in houses with no decoration were higher than in the houses decorated (t = 2.33,P ＜0.05).The average indoor concentrations of 222Rn and 220Rn in Yuhang district were 32.5 Bq/m3 and 314.3 Bq/m3,respectively,and the annual effective doses were 0.88 mSy and 0.42 mSv respectively.The average indoor concentrations of 222Rn and 220Rn in Sanmen county were 26.8 Bq/m3 and 399.5 Bq/m3,and the annual effective doses were 0.72 mSy and 0.53 mSv respectively.Conclusion The concentrations of indoor 222 Rn in some areas of Zhejiang province are at natural background level,and the concentrations of indoor 220Rn in rural areas are relatively higher.The total annual effective dose from 220Rn and its progeny was larger than that from 222Rn and its progeny by 50 percents.