Objective:To construct a maintenance management system based on Total Productive Maintenance(TPM)theory for large-scale medical equipment,and explore its application effect in the management for large-scale medical equipment.Methods:By building TPM management team,predicting equipment's failures,planning TPM management pathway for equipment,and implementing quality control to construct TPM management system for the large-scale medical equipment.A total of 547 large-scale medical equipment that were used in clinical practice at the First Affiliated Hospital of Harbin Medical University from February 2022 to July 2024 were selected.They were divided into conventional management mode(272 equipment)and TPM management mode(275 equipment)by using random number table method.The TPM management mode conducted management on the basis of TPM management system for large-scale medical equipment.The equipment configuration,operational quality,effectiveness of equipment maintenance,and maintenance quality of the two kinds of management modes were compared.Using a self-made satisfaction questionnaire to evaluate the satisfaction of management personnel who used equipment for the service quality of maintenance management of two management modes for medical equipment.Results:The average configuration rate,utilization rate,and operation rate of equipment that using TPM management mode were(4.81±0.94)%,(97.98±0.67)%,and(89.15±4.78)%,respectively,all which were higher than those that using conventional management mode.However,the average failure rate was(1.72±0.12)%,which was lower than that of using conventional management mode.The differences of the above indicators were statistically significant(t=39.942,80.213,23.188,71.723,P<0.05).The average values of the efficiency of equipment maintenance,the standardization of usage,timeliness of maintenance,and pass rate of quality inspection of TPM management mode were all higher than those of conventional management mode,and the differences were statistically significant(t=36.893,22.913,17.948,21.553,P<0.05).The response time,average repair rate of failure,and delivery cycle of accessories of equipment maintenance of TPM management mode were all lower than those of conventional management mode,while the quality score of maintenance service was higher than that of conventional management mode,and the differences were statistically significant(t=37.332,25.116,53.265,55.988,P<0.05).The satisfactions of management personnel who used equipment for preventive maintenance,preventive repair,usage management,fault repair,quality inspection,and post maintenance of equipment that adopted TPM management mode were all higher than those that adopted conventional management mode,and the differences were statistically significant(t=24.218,21.408,19.706,27.141,38.149,46.434,P<0.05).Conclusion:The maintenance management system based on TPM theory for large-scale medical equipment can effectively improve operation efficiency and maintenance quality of equipment,and reduce equipment's failure rate,and enhance the timeliness of maintenance services for equipment,and increase the satisfaction of management personnel in using equipment.

AIM To study the chemical constituents from Citri reticulatae Pericarpium Viride and their anti-triple negative breast cancer activities in vitro.METHODS The ethanolic extract of Citri reticulatae Pericarpium Viride was isolated and purified by silica gel,polyamide,MCI,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The anti-triple negative breast cancer activities were screened by SRB assay,and their effects on the proliferation of triple negative breast cancer cell lines HCC1806,HCC1937 and MDA-MB-231 in vitro were evaluated.RESULTS Twenty compounds were isolated and identified as nobiletin(1),tangeritin(2),5,4'-dihydroxy-7,8-dimethoxy flavonoid(3),naringenin(4),artemetin(5),5-demethynobiletin(6),3,5,6,7,8,3',4'-pentamethoxy flavonoid(7),5,4'-dihydroxy-3,6,7,8,3'-pentamethoxyflavone(8),xanthomicrol(9),p-hydroxycinnamic acid(10),5,4'-dihydroxy-6,7,8,3'-tetramethoxyflavone(11),pectolinarigenin(12),4'-dihydroxy-5,6,7-tetramethoxyflavone(13),hispidulin(14),4',5,6,7-tetramethoxy-flavone(15),1-methyl-4-(prop-1-en-2-yl)cyclohexane-1,2-diol(16),umbelliferone(17),5-hydroxymethyl furfural(18),hydroquinone(19),1H-indole-3-carbaldehyde(20).Compound 8 showed a significant inhibitory effect with the IC50 value of(5.36±0.24)μmol/L on HCC1806 cells.CONCLUSION Compound 20 is isolated from genus Citrus for the first time,8,12-13,16-17 are isolated from this plant for the first time.Compound 8 show inhibitory effects on the proliferation of HCC1806,HCC1937 and MDA-MB-231 cells in vitro and have the strongest activities.Compounds 3-4,11-12,15,17 and 19 show strong inhibitory effect on HCC1806 cells.Compounds 15,19 also inhibit the proliferation of HCC1937 cells in vitro.

Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

Objective:To construct a maintenance management system based on Total Productive Maintenance(TPM)theory for large-scale medical equipment,and explore its application effect in the management for large-scale medical equipment.Methods:By building TPM management team,predicting equipment's failures,planning TPM management pathway for equipment,and implementing quality control to construct TPM management system for the large-scale medical equipment.A total of 547 large-scale medical equipment that were used in clinical practice at the First Affiliated Hospital of Harbin Medical University from February 2022 to July 2024 were selected.They were divided into conventional management mode(272 equipment)and TPM management mode(275 equipment)by using random number table method.The TPM management mode conducted management on the basis of TPM management system for large-scale medical equipment.The equipment configuration,operational quality,effectiveness of equipment maintenance,and maintenance quality of the two kinds of management modes were compared.Using a self-made satisfaction questionnaire to evaluate the satisfaction of management personnel who used equipment for the service quality of maintenance management of two management modes for medical equipment.Results:The average configuration rate,utilization rate,and operation rate of equipment that using TPM management mode were(4.81±0.94)%,(97.98±0.67)%,and(89.15±4.78)%,respectively,all which were higher than those that using conventional management mode.However,the average failure rate was(1.72±0.12)%,which was lower than that of using conventional management mode.The differences of the above indicators were statistically significant(t=39.942,80.213,23.188,71.723,P<0.05).The average values of the efficiency of equipment maintenance,the standardization of usage,timeliness of maintenance,and pass rate of quality inspection of TPM management mode were all higher than those of conventional management mode,and the differences were statistically significant(t=36.893,22.913,17.948,21.553,P<0.05).The response time,average repair rate of failure,and delivery cycle of accessories of equipment maintenance of TPM management mode were all lower than those of conventional management mode,while the quality score of maintenance service was higher than that of conventional management mode,and the differences were statistically significant(t=37.332,25.116,53.265,55.988,P<0.05).The satisfactions of management personnel who used equipment for preventive maintenance,preventive repair,usage management,fault repair,quality inspection,and post maintenance of equipment that adopted TPM management mode were all higher than those that adopted conventional management mode,and the differences were statistically significant(t=24.218,21.408,19.706,27.141,38.149,46.434,P<0.05).Conclusion:The maintenance management system based on TPM theory for large-scale medical equipment can effectively improve operation efficiency and maintenance quality of equipment,and reduce equipment's failure rate,and enhance the timeliness of maintenance services for equipment,and increase the satisfaction of management personnel in using equipment.

AIM To study the chemical constituents from salt-processed Litchi Semen and their antioxidant activities.METHODS The 85％ethanol extract from salt-processed Litchi Semen was isolated and purified by silica gel,Sephadex LH-20,MCI,ODS and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.DPPH and ABTS+free radical scavenging method were used to evaluate their antioxidant activities.RESULTS Fifteen compounds were isolated and identified as dehydrocostuslactone(1),ananosmoside A(2),funingensin A(3),(2S)-pinocembrin-7-O-(6-O-α-L-rhamnopyranosyl-β-D-glucopyranoside)(4),liquiritienin(5),quercetin(6),rutin(7),isorhamnetin-3-O-β-rutinoside(8),procyanidin A2(9),procyanidin A1(10),ethyl protocatechuate(11),5-hydroxymethylfurfural(12),di(2-ethyl-hexyl)phthalate(13),nicotinamide(14),(10E,15Z)-9,12,13-trihydroxyoctadeca-10,15-dienoic acid(15).Compounds 6-7,9-10 exhibited scavenging activities against DPPH radicals with IC50 values of(12.929±1.232),(14.104±0.946),(10.417±1.736),(6.944±0.030)μmol/L,respectively.Compounds 6-10 exhibited scavenging activities against ABTS+radicals with IC50 values of(21.952±0.577),(25.683±0.625),(22.970±1.336),(20.210±1.435),(18.725±0.324)μmol/L,respectively.CONCLUSION Compounds 1,5,14-15 are isolated from Litchi genus for the first time.Compounds 6-7,9-10 have strong in vitro antioxidant activities.

AIM To study the chemical constituents from salt-processed Litchi Semen and their antioxidant activities.METHODS The 85％ethanol extract from salt-processed Litchi Semen was isolated and purified by silica gel,Sephadex LH-20,MCI,ODS and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.DPPH and ABTS+free radical scavenging method were used to evaluate their antioxidant activities.RESULTS Fifteen compounds were isolated and identified as dehydrocostuslactone(1),ananosmoside A(2),funingensin A(3),(2S)-pinocembrin-7-O-(6-O-α-L-rhamnopyranosyl-β-D-glucopyranoside)(4),liquiritienin(5),quercetin(6),rutin(7),isorhamnetin-3-O-β-rutinoside(8),procyanidin A2(9),procyanidin A1(10),ethyl protocatechuate(11),5-hydroxymethylfurfural(12),di(2-ethyl-hexyl)phthalate(13),nicotinamide(14),(10E,15Z)-9,12,13-trihydroxyoctadeca-10,15-dienoic acid(15).Compounds 6-7,9-10 exhibited scavenging activities against DPPH radicals with IC50 values of(12.929±1.232),(14.104±0.946),(10.417±1.736),(6.944±0.030)μmol/L,respectively.Compounds 6-10 exhibited scavenging activities against ABTS+radicals with IC50 values of(21.952±0.577),(25.683±0.625),(22.970±1.336),(20.210±1.435),(18.725±0.324)μmol/L,respectively.CONCLUSION Compounds 1,5,14-15 are isolated from Litchi genus for the first time.Compounds 6-7,9-10 have strong in vitro antioxidant activities.

AIM To study the chemical constituents from Citri reticulatae Pericarpium Viride and their anti-triple negative breast cancer activities in vitro.METHODS The ethanolic extract of Citri reticulatae Pericarpium Viride was isolated and purified by silica gel,polyamide,MCI,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The anti-triple negative breast cancer activities were screened by SRB assay,and their effects on the proliferation of triple negative breast cancer cell lines HCC1806,HCC1937 and MDA-MB-231 in vitro were evaluated.RESULTS Twenty compounds were isolated and identified as nobiletin(1),tangeritin(2),5,4'-dihydroxy-7,8-dimethoxy flavonoid(3),naringenin(4),artemetin(5),5-demethynobiletin(6),3,5,6,7,8,3',4'-pentamethoxy flavonoid(7),5,4'-dihydroxy-3,6,7,8,3'-pentamethoxyflavone(8),xanthomicrol(9),p-hydroxycinnamic acid(10),5,4'-dihydroxy-6,7,8,3'-tetramethoxyflavone(11),pectolinarigenin(12),4'-dihydroxy-5,6,7-tetramethoxyflavone(13),hispidulin(14),4',5,6,7-tetramethoxy-flavone(15),1-methyl-4-(prop-1-en-2-yl)cyclohexane-1,2-diol(16),umbelliferone(17),5-hydroxymethyl furfural(18),hydroquinone(19),1H-indole-3-carbaldehyde(20).Compound 8 showed a significant inhibitory effect with the IC50 value of(5.36±0.24)μmol/L on HCC1806 cells.CONCLUSION Compound 20 is isolated from genus Citrus for the first time,8,12-13,16-17 are isolated from this plant for the first time.Compound 8 show inhibitory effects on the proliferation of HCC1806,HCC1937 and MDA-MB-231 cells in vitro and have the strongest activities.Compounds 3-4,11-12,15,17 and 19 show strong inhibitory effect on HCC1806 cells.Compounds 15,19 also inhibit the proliferation of HCC1937 cells in vitro.

Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

AIM To study the chemical constituents from salt-processed Citri Reticulatae Semen and their antioxidant activities.METHODS The 85% ethanol extract from salt-processed Citri Reticulatae Semen was isolated and purified by silica gel,D101 macroporous resins,MCI,ODS,Sephadex LH-20 and semi-prepative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their antioxidant activities in vitro of the ethanol extract of Citri Reticulatae Semen,salt-processed Citri Reticulatae Semen and all the obtained compounds were evaluated by DPPH and ABTS+assay.RESULTS Sixteen compounds were isolated and identified as limonin(1),obacunone(2),nomilin(3),deacetyl nomilin(4),kaempferol(5),nobiletin(6),diosmetin(7),isosakuranetin(8),hesperetin(9),epicatechin(10),trans-p-menthane-1α,2β,8-triol(11),byakangelicin(12),vanillin(13),p-coumaric acid(14),4-[(1-ethoxy-2-hydroxy)ethyl]phenol(15),catechol(16).Compound 10 showed strong DPPH free radical scavenging activity,with an IC50 value of(0.015±0.001)μmol/mL,and strong ABTS+radical scavenging activity,with an IC50 value of(0.010±0.005)μmol/mL.CONCLUSION Compounds 8,11,15-16 are isolated from genus Citrus for the first time,5,12,14 are obtained from Citri Reticulatae Semen for the first time.Compound 10 shows obvious antioxidant activities.After salt roasting,the antioxidant activity of the ethanol extract of Citri Reticulatae Semen is enhanced.