The objective is to discuss related problems of medical equipment management to modern hospital.Research Contents:the necessity of strengthening management to medical equipment in medical establishment;the goal of purchase management in medical equipment;assets of medical equipment and stream management;monitoring and management in adverse event monitoring of medical apparatus;medical instrument abandonment management.By strengthening integrated management of medical instrument,the purposes can be attained imply scientific decision,reasonable purchase,effective management,supply guarantee,containment of adverse event monitoring,safeguard of medical service security and quality of medical treatment.

Objective To explore the experience of nursing patients with large area bum.Methods Thirty-one hospitalized patients with large area bums in our hospital during January 2012 to July 2013 were set as the control group,where fasting was done within 24 hours at admission and enteral nutrition was done after surviving shock phase.Another 31 patients with large area bums in the hospital during August 2013 to August 2015 were set as observation group,where short peptide enteral nutrition powder was administered within 24 hours at admission,followed by enteral nutrition was done after surviving shock phase.The two groups were compared in terms of nutrition indexes and intestinal complication rate before admission and 4 weeks after treatment.Result After enteral nutrition,the nutrition indexes in the observation group were all better than those the control group (P＜0.05) and the rates of complications on gastric retention and reflux,aspiration were insignificantly different between the two groups (P＞0.05);the rates of complication on abdominral pain and diarrhea were lower those of the control group (all P＜0.05).Conclusion For patients with large area bums,early enteral nutrition can better the nutrition and it is a safe therapy.

Objective To explore in vitro the best time window for using sinusoidal electromagnetic fields to promote the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).Methods BMSCs were isolated and cultured from 4-week-old Sprague-Dawley rats (male and female,80-120g).The BMSCs (from passage 3) were exposed 0,1,4 or 8h/d for 7d,14,or 28d,respectively,to 15Hz sinusoidal electromagnetic fields with a maximum amplitude of lmT.Those exposed 0h/d served as the control.The relative expressions of runt related gene-2 (RUNX2),bone sialoprotein (BSP) and osteopontin (OPN) were determined using real-time,quantitative reverse transcription-polymerase chain reactions (RT-PCRs).The level of RUNX2 protein was determined by Western blotting after 14d.Alizarin red staining was used to compare calcium distribution in each group.Results Obvious promotion of differentiation to osteoblasts was observed after 7 days of exposure to the15 Hz sinusoidal electromagnetic fields,most obviously manifested by an outstanding increase of the early osteogenic index RUNX2 in those exposed 4h/d.After 14 days of intervention,the 1h/d exposure showed to be most effective,especially in inducing the changes of the late osteogenic index OPN.The trends of changes in RUNX2 protein were similar in all groups.After stimulating 1h/d for 14 and 28days,calcium deposition increased to the greatest extent.Conclusions Exposure to sinusoidal electromagnetic fields induces osteogenic differentiation to osteoblasts in rat BMSCs in vitro.There is an apparent window effect.The best results are observed with more days of exposure and shorter exposure time (1h) every day.

Objective To study the value of diffusion weighted imaging (DWI)in Marchiafava-Bignami disease.Methods (1)12 cases of Marchiafava-Bignami disease (MBD)patients with 6 month follow-up and 12 hedthy adults were clone MRI DWI;(2)MR imaging characteristics of 12 patients were observed on the corpus callosum and the other gray-white matters;(3)The ADC values of the central part and marginal area of the corpus callosum and the other gray-white matters were measured,data analysis were carried out completely by random design.Results Hyperintensity on the corpus callosum were showed in 12 patients on DWI,typical“sandwich sign”was seen on the sagittal T2 WI in 1 1 cases,and gray-white matters beside the corpus callosum were involved other in 6 cases;The ADC values of central and marginal area of the corpus callosum and the other gray-white matters had significant differ-ence between the improved clinical symptom group and,unimproved clinical symptom group and the control group (P < 0.05 ). There were no significant differences in the ADC values for the other white matters.Conclusion DWI can be used to reflect the change of MBD.Low ADC values in the corpus callosum and cortex are associated with a poor prognosis.

Objective To explore the protective effects of erythropoietin (EPO) on cardiomyocytes against hypoxia/reoxygenation (HR) injury. Method Isolated and cultured rat eardiomyocytes were subjected to 2-hour hypoxia followed by 1 hour reoxygenation to establish model of HR injury. Cardiomyocytes were randomly divided into 4 groups: sham group, HR group, HR + EPO-treated group (EPO 10 U/ml), and HR + EPO + UO126-treated group (U0126 10?mol/L). The concentration of lactate dehydrogenase (LDH) in culture medium was detected by automatic biochemical analyzer; viability of eardiomyocytes was measured by MTT assay; apoptosis ratio was determined by TUNEL technology and Annexin-V-FITC with flow cytometer (FCM); level of extracellular signal- regulated kinase 1/2 (ERK_(1/2)) and phospho-ERK_(1/2) were measured by Western-blot analysis. Results EPO significantly decreased the leakage of LDH, enhanced activity, reduced apoptosis ratio, and increased level of phospho-ERK_(1/2).However, the effects were blocked by U0126, an inhibitor of MAPK. Conclusions EPO has the protective effects on cardiomyocytes against HR injury possibly via the mechanism of activation of ERK_(1/2) and inhibition of apoptosis.

To study the attachment, proliferation and differentiation of neural stem cells (NSCs) on surface modified PHBHHx films and to establish the theory of PHBHHx application in NSCs-based brain tissue engineering. PHBHHx film was fabricated by a solution-casting method, and the morphology of the film was observed under scanning electron microscopy(SEM). The films were treated by NaOH or lipase, then the surface hydrophilic property was characterized using water contact angle measurement. NSCs were isolated from the cerebral cortex of rat embryos on embryonic day 14.5, and cultured on surface treated PHBHHx films. The morphology of NSCs attached on the film was visualized under SEM, and the survival and differentiation of NSCs were observed through immunocytochemical staining. Compared with the untreated PHBHHx films, the water contact angle of NaOH or lipase treated PHBHHx films decreased dramatically, and the number of NSCs attached significantly increased. NSCs survived well on treated PHBHHx films and differentiated into neurons and glial cells. The amelioration of hydrophilic property of PHBHHx film improved its biocompatibility with NSCs. PHBHHx can serve as a novel CNS tissue engineering biomaterial applied for NSCs transplantation, brain repairing and regeneration.
3-Hydroxybutyric Acid ; chemistry ; Animals ; Caproates ; chemistry ; Cell Adhesion ; physiology ; Cell Differentiation ; drug effects ; Cell Proliferation ; Cells, Cultured ; Cerebral Cortex ; cytology ; Coated Materials, Biocompatible ; chemistry ; Embryonic Stem Cells ; cytology ; Female ; Neural Stem Cells ; cytology ; Rats ; Surface Properties ; Tissue Engineering

The treatment of central nervous system diseases has always been a hot topic,owning to its complexity and existence of blood-brain barrier.In recent years,studies on mesenchymal stem cells-derived exosomes (MSCs-EVS) showed that MSCs-EVS are not only potential therapeutic drugs for central nervous system diseases,but also natural carriers of therapeutic drugs due to their good biocompatibility and ability to cross the blood-brain barrier.This paper reviews the application and underling mechanism of MSCs-EVS in treatment of central nervous system diseases,and looks forward to its applications in central nervous system disease.

Objective:To study the potential effects of intensity modulated radiation therapy (IMRT) on clinical efficacy,oral mucosa reaction and immunological foundation;and to explore the effect of immunological changes on clinical efficacy and oral mucosa reaction in patients with nasopharyngeal carcinoma.Methods:A total of 200 patients with nasopharyngeal carcinoma,who came from First Department of Nasopharyngeal Radiotherapy,the First People's Hospital of Foshan from October 2008 to November 2011,were selected.The patients were treated with nasopharyngeal radiotherapy,and divided into an observation group and a control group (n=100 in each group).The control group underwent common conventional two-dimensional radiotherapy treatment,while the observation group underwent IMRT.The 5-year survival rates and recurrence rates were recorded at follow-up.After the radiotherapy,the oral mucosa in the patients were evaluated by the classification standard of acute radioactive mucositis by American Radiotherapy Oncology Group (RTOG),and the number of T lymphocyte subsets before and after treatment was detected.Results:There were significant difference in non-regional-recurrence survival rate,disease-free survival rate,local recurrence rate between the above 2 groups (all P＜0.05),but no significant difference in the distant metastasis-free survival rate (P＞0.05).The acute oral mucosa reactions of grade 1,2,3,4 in the control group were 8.00％,20.00％,12.00％,7.00％,respectively,and those were 7.00％,22.00％,15.00％,1.00％ respectively.There was no significant difference in the acute response of oral mucosa in grade 1,2 and 3 in the 2 groups (all P＞0.05),but there was significant difference in the grade 4 (P＜0.05).There were significantly difference in CD8+,CD4+/CD8+ and CD4+ T lymphocyte subsets before and after treatment in the above 2 groups (all P＜0.01);there were also significantly difference after treatment between the observation group and the control group (all P＜0.01).Conclusion:In the process of treatment in patients with nasopharyngeal carcinoma,the use of IMRT on the basis of chemotherapy is more effective than the conventional two-dimensional radiotherapy,which can reduce the proportion of grade 4 (severe) acute oral mucosa reaction.It may be related to the protective effect of IMRT on immune function in the patients.

Objective: Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application. Methods: We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side. We taken the patients the second times of lung lavage who were put PS into the right side as returning group, the first times of lung lavage who were not put PS into as on returning group. We observed indi-cators, such as expiratory resistance, respiratory work, lung compliance, airway pressure, PO₂, the pulmonary function recovery time and other indicators, comparing with the changes of pulmonary function before lung la-vage for the first time and at 0、60、90、120 min after the pulmonary surfactant autotransfusion. Results: Com-pared with the no returning group, the expiratory resistance of the returning group decreased significantly at 90 min、120 min after the pulmonary surfactant autotransfusion; the respiratory work and airway pressure of the re-turning group decreased significantly at 60、90、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). Compared with the no returning group, the lung compliance and the PO₂ of the returning group increased significantly at 60 min、90 min、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). The lung function recovery time of returning group was (155.7 ± 35.2) min, the lung function recovery time of no returning group was (183.71±41.81) min, there was statistical-ly significant in the difference between different groups (P<0.05). Compared with the no returning, there were not statistically significant in the difference of the Heart rate、the systolic blood pressure and the diastolic blood pressure about the returning at 60、90、120 min after the pulmonary surfactant autotransfusion.There was no ad-verse reactions such as pulmonary infection, pulmonary infection and so on. Conclusion The pulmonary surfac-tant autotransfusion may reduce expiratory resistance, work of breathing, airway pressure; improve lung compliance, alveolar ventilation function; increase oxygen partial pressure and decrease the surgery recovery time in patients with pneumoconiosis.

OBJECTIVETo observe the clinical characteristics and regular patterns of subacute 1, 2-dichloroethane poisoning patients for providing evidences to it's diagnosis, treatment and prognosis.

METHODS51 cases of subacute 1, 2-dichloroethane poisoning analyzed. They were divided into 3 groups according to their main clinical manifestation: group A mainly with intracranial hypertension (n = 25), group B with limbs tremor (n = 18), group C with mental and behavior disorder (n = 8). All cases' clinical symptoms, cranial computer tomography, cerebrospinal pressure (Group A) were observed, the durations of the onset, deterioration, improvement, recovery and whole course of the disease were compared between groups and in each group.

RESULTSIn all of 51 cases, only the differences between the deterioration duration of cranial CT and symptom was significantly (t = 2.555, P<0.05), which indicate the deterioration of symptom was earlier than radiological change. The symptom deterioration of group C was the fastest than group A and group B (P<0.00). As to the change of symptom duration, group B's improvement, recovery and whole course was the longest comparing with group A and group C (P<0.05). As to the change of cranial CT duration, group B's recovery duration was the shortest and group A's recovery duration was the longest (P<0.01); group B's whole course was also the shortest and group A's whole course was the longest (P<0.05). The clinical course of symptoms, cranial computer tomography, cerebrospinal pressure (Group A) was compared in each group, in group A, the duration of improvement and whole course of the cranial CT and cerebrospinal pressure change was longer than that of the symptom change (P<0.01), this indicated that group A has longer asymptomatic intracranial hypertension and their cranial radiography recover slowly. In group B, their symptoms (3.94 ± 4.31 days) deteriorated is earlier than cranial CT changes (P<0.05), the recovery (92.39 ± 55.04 days) and whole course of symptom was longer than cranial CT change (all P<0.01). In group C, symptom deterioration was earlier than CT deterioration (P< 0.05).

CONCLUSIONThe clinical characteristic of subacute 1, 2- dichloroethane poisoning is central nervous system damage, it differs according to the different stage of course, the regions and severity of pathology lesions.

Cerebrospinal Fluid Pressure ; Disease Progression ; Ethylene Dichlorides ; poisoning ; Humans ; Intracranial Hypertension ; Mental Disorders ; Poisoning ; diagnosis ; pathology ; Prognosis ; Tomography, X-Ray Computed ; Tremor