Objective:To explore the process of maintenance management for large medical equipment, and the structure design and core connotation of the maintenance management software of them.Methods: Medical linear accelerator of Precise series of Elekta company was combined to achieve the objective. From the aim of designing normal operation rate to start, the failure mode and effects analysis (FMEA) was operated to analyze the maintenance strategies and maintenance manners which were established on the basis of PDCA(Plan, Do, Check, Action) cycle and the analysis mode of SWOT (Strength, Weakness, Opportunity, Threat), and it could achieve the aim of normal operation rate.Results: Through explored the connotation of maintenance management and the preliminary framework of the software of maintenance management, the detail and process of maintenance management that based on personalized accelerator of process control were established, and the element factors of software of maintenance management of accelerator also was established at the same time.Conclusion: The effective maintenance management of large medical equipment is based on informatization process management of process control, and the element factor of management software need personalized customization. On the other hand, failure mode and degradation mechanism of equipment were the basis for personalized customization, and the creation has practical value.

Objective To observe the clinical efficacy of electrothermal needle apparatus in treating mild hip osteoarthritis.Method Ninety patients were divided into a control group and a treatment group by using the random number table, 45 cases in each group. The treatment group was intervened byelectrothermal needleapparatus; the control group was treated with ordinary electroacupuncture plus TDP radiation. After 15-day treatment, the therapeutic efficacies of the two groups were evaluated by using Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores.Result The VAS and JOA scores were improved inthe two groups after the treatment (P<0.05), and the improvements in the treatment group were more significant than those in the control group after the 15-day treatment (P<0.05).Conclusion Electrothermal needle apparatus can produce a significant therapeutic efficacy in treating mild hip osteoarthritis.

Objective To investigate the correlation between H.pylori strain possessing cagA gene and the formation of gastric lymphoid follicles(GLF),and the effect of H.pylori infection on the occurrence of GLF.Methods Antral biopsy specimens from 655 patients (chronic gastritis:n=479,peptic ulcer:n=176)were used for detection of H.pylori infection and histological analysis. CagA gene was examined in 70 clinical isolates by means of PCR－ amplification. Results The incidence of lymphoid follicles in gastric mucosa is significantly higher(60.14％ ) in patients with H.pylori infection than those without infection(17.06％ ).GLF is easier to be detected in patients with active gastritis than in those with inactive gastritis. There is no significant difference in the presence of GLF among H.pylori associated gastroduodenal diseases,such as chronic gastritis ,gastric ulcer. Moreover, there is also no significant relationship between H.pylori strains possessing cagA gene and GLF. Conclusion The presence of GLF might directly related with H.pylori infection, and can be observed as a constant morpholgical marker of H.pylori related gastroduodenal disease ;The formation of gastric lymphoid follicles is not related to the cytotoxin of cag A gene of H.pylori.

Mango leaves have been widely used in the clinical practice for thousands of years in traditional Chinese medicine.Mangiferin,an effective constituent in the mango leaves,has multiple pharmacological actions involved in some basic pathological processes,such as inflammation,oxidative injury,tumor growth,micro-organism infections,metabolic regulations,and immunological regulations.The pharmacological effects of mangiferin from some published data are reviewed in this article.

This study is to investigate the protective effect of mangiferin on NF-kappaB (P65) and IkappaBalpha expression in peripheral blood mononuclear cell (PBMC) in rats with cigarette smoke induced chronic bronchitis. The rat model with chronic bronchitis was established by cigarette smoke. Real-time fluorescence RT-PCR was executed for evaluating the NF-kappaB (P65) and IKkappaBalpha gene expression in mononuclear cell, and flow cytometry for their protein expression. The serum hs-CRP (high-sensitivity C-reactive proteins) and TNF-alpha (tumor necrosis factor-alpha) were detected by enzyme-linked immunosorbent assay. The histopathological score was obtained from lung tissue HE staining slides of lung tissue. The results showed that mangiferin could markedly suppress the NF-kappaB (P65) mRNA and protein expression in mononuclear cell, while promote the IkappaBalpha mRNA and protein expression. Furthermore, mangiferin could lower serum hs-CRP and TNF-alpha level, and reduce the chronic inflammatory damage of bronchiole. These results suggested that mangiferin could notably ameliorate chronic bronchiole inflammation induced by cigarette smoke, and this protective effect might be linked to the regulation of NF-kappaB (P65) and IkappaBalpha expression in mononuclear cell.

Objective To evaluate the safety and efficacy of nephron sparing surgery for small renal tumor. Methods A total of 43 patients with small renal tumor underwent nephron sparing surgery (NSS). Of the 43 patients, 27 were male and 16 were female, with an average age of 46.0(21-79)years. The mean diameter of the tumors was 3.1 (1.2- 4. 0)cm. Eighteen cases received open NSS, other 25 cases received retroperitoneal laparoscopic NSS. The perioperative data and renal function, postoperative complications and tumor recurrence were evaluated. Results The procedure was successful in all 43 patients, though 2 cases occurred serious bleeding during operation. The average operating time was 158. 0(69- 277) and 150. 0(60-226) min in open NSS and laparoscopic NSS groups. The average warm ischemia time was 23. 2(20-31) and 25.8(23-35) min. The average blood loss was 590.8(120-3000) and 468. 5(50-1600) ml. The average pre-operation creatinine was (65.9±22. 8)and(68.4±25.0)μmol/L. The average creatinine at the end of follow-up was(82. 2±24.1)and(85. 3±25.9)μmol/L. The average hospital stay was 19.2(11-47) and 12.5(10- 16) (P＜0.05). The histological results showed 25 cases of renal cell carcinoma (RCC, Tla) and 18 cases of benign lesions. Sixteen cases(37%)of minor complications were observed. Comparing the open NSS versus laparoscopic NSS group, perirenal hematoma rate was 6 % vs 12 % (P＜0.05), flank numbness rate was 11.1% vs 0(P＜0.05). During the mean 25-60(37. 4±7.2)months follow-up, 1 case with RCC relapsed in 20 months and received radical nephrectomy. 1 case with harmatoma was found a new lesion apart from the original site in 6 months and CT scan confirmed harmatoma, and then received active surveillance. The 3-year recurrence-free survival for all tumors in 2 groups was 94%, 96%, and that for RCC was 100% and 93%, separately. Conclusions Comparing with open NSS, laparoscopic NSS for small renal tumor has a shorter hospital stay and lower flank numbness rate, though has higher perirenal hematoma rate. There was no significant difference in other complications between the 2 groups. No irreversible renal function damage was observed in two groups. The tumor recurrencefree survival and RCC recurrence-free survival were no significant difference between two groups.

OBJECTIVETo investigate mechanism of inhibition on the lipopolysaccharide induced chronic inflammation of mangiferin by the regulation of mitogen-activated protein kinase (MAPK) signaling pathway.

METHODSixty SD rats were randomly divided into normal control, model control, positive drug control (prednisone, 5 mg x kg(-10 x d(-1)) and mangiferin (200, 100, 50 mg x kg(-1) x d(-1)) group. The chronic inflammation models were established by intermittent injection of lipopolysaccharide via the tail vein. The leucocyte count was measured. The levels of serum tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6) and soluble intercellular adhesion molecule 1 (sICAM-1) were detected by enzyme-linked immunosorbent assay (ELISA). The reverse transcription-polymerase chain reaction (RT-PCR) was applied to evaluate the expressions of p38, ERK, JNK gene of leucocyte in MAPK signaling pathway.

RESULTCompared with the model control, not only the leucocyte count and the level of serum TNF-alpha, IL-6, sICAM-1 but also the expressions of ERK, JNK gene of leukocyte were markedly reduced in mangiferin (200 mg x kg(-1) x d(-1)) group (P < 0.05). However, there was no statistics significance for the expression of p38 gene between the model control and the mangiferin (200 mg x kg(-1) x d(-1)) group.

CONCLUSIONAs a possible mechanism, the regulation of mangiferin on the expressions of ERK, JNK gene of leukocyte in MAPK signaling pathway was involved in its great inhibition on the chronic inflammation induced by lipopolysaccharide.

Animals ; Chronic Disease ; Gene Expression ; Inflammation ; chemically induced ; drug therapy ; Intercellular Adhesion Molecule-1 ; blood ; Interleukin-6 ; blood ; Leukocyte Count ; Leukocytes ; metabolism ; Lipopolysaccharides ; toxicity ; MAP Kinase Signaling System ; drug effects ; genetics ; Male ; Mangifera ; chemistry ; Mitogen-Activated Protein Kinases ; genetics ; Models, Animal ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; blood ; Xanthones ; pharmacology ; therapeutic use

The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated. From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA. Peri- and post-operative findings were observed. Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period. All patients received MWA of 1-5 points. The mean operative time was 85 min and the mean blood loss was 65 mL. During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case. Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication. The outcome of middle-term follow-up is satisfactory. Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC). Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC. This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy. The electronic databases were searched. Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib, sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included. Data were pooled to meta-analyze. A total of 7 RCTs with 3451 patients were involved. The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC. Among them, sunitinib had a higher overall response rate (ORR) than IFN (47% versus 12%, P<0.000001). Bevacizumab plus IFN produced a superior PFS [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.76-0.97; P=0.01] and ORR (RR: 2.19; 95% CI: 1.72-2.78; P<0.00001) in patients with mRCC over IFN, but it yielded an increase by 31% in the risk of serious toxic effects (RR: 1.31; 95% CI: 1.20-1.43; P<0.00001) as compared with IFN. The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months). It was concluded that compared with IFN therapy, VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC. However, the risk to benefit ratio of these agents needs to be further evaluated.

OBJECTIVE To investigate the protective effects and mechanism of diterpene ginkgolides meglumine injection (DGMI) against oxidative stress induced by oxygen-glucose deprivation (OGD) in SH-SY5Y cells. METHODS SH-SY5Y cells were divided into five groups: normal control, model control (OGD group) and drug(25 mg · L- 1) administration groups including DGMI group, extract of ginkgo biloba leaves injection group (EGBLI) and lactones ginkgo biloba injection group (LGBI). The cells suffered from oxygen-glucose deprivation (OGD) for 4 h, followed by reoxygenation with drugs for 6 h. Then, cell viabilities were detect using CCK-8 assays, reactive oxygen species (ROS) levels using fluorescence probe DCFH-DA and superoxide dismutase (SOD) activities using WST-1 test. Western blotting was used to detected protein levels of hemeoxygenase-1(HO-1), NAD(P)H, quinone oxidore?ductase l (Nqo1), protein kinase B (Akt), phosphorylated Akt (p-Akt), nuclear factor-E2-related factor2 (Nrf2) and phosphorylated Nrf2 (p-Nrf2). The cells were induced by OGD for 4 h, followed by reoxygen?ation and DGMI for 1 h, combined with different concentrations of PI3K inhibitor (LY294002) (at the final concentration of 12.5, 25 and 50 μmol · L-1) before the protein levels of AKT, p-AKT, Nrf2 and p-Nrf2 were detected by Western blotting. RESULTS SH-SY5Y cells induced by OGD for 4 h resulted in an increase in ROS(P<0.01), but a decrease in cell viabilities(P<0.01), SOD activities(P<0.01), and antioxidant protein levels ( Akt, p-Akt, Nrf2, p-Nrf2, HO-1 and Nqo1) (P<0.01). Compared with OGD group, treatment with reoxygenation and drugs (DGMI,EGBLI and LGBI respectively) for 6 h resulted in a decrease in ROS (P<0.01), but an increase in cell viabilities, SOD activities and antioxidant protein levels of p-Nrf2, HO-1, Nqo1 and p-Akt(P<0.05,P<0.01). DGMI group showed the best efficiently. Moreover, after OGD for 4 h, compared with DGMI group, combining reoxygenation and DGMI with LY294002 for 1 h resulted in a concentration-dependent inhibition of the protein levels of p-AKT and p-Nrf2(P<0.01). CONCLUSION DGMI 25 mg · L-1 can inhibit oxidative stress in SH-SY5Y cells induced by OGD by increasing the activity and expression of Nrf2 through PI3K/Akt pathway, which may be one of the mechanisms by which DGMI protects neurons from stroke.