Objective:To design a programmed evaluation process,and to explore its application effect in the management of medical equipment in emergency department.Methods:The information management platform was constructed based on IntelliJ IDEA and Java language with browser and server(B/S)architecture,a programmed evaluation process was designed to manage medical equipment in the emergency department.From 2021 to 2022,27 medical devices in use in the emergency department of Beijing Friendship Hospital,Capital Medical University were selected,the programmed evaluation process and the post-evaluation process were adopted respectively for management according to the different equipment management methods.A total of 800 equipment operation logs sampled were analyzed under the two management methods.The timeliness of equipment management,management effect and satisfaction scores of related management personnel were compared between the two management methods.Results:The average time consumption of equipment warning timeliness,timeliness of maintenance personnel's arrival and timeliness of proposed treatment methods in the programmed evaluation process management were(0.92±0.21)min,(5.43±1.08)min and(15.63±2.27)min,respectively,which were lower than those in post-evaluation process management method,the difference was statistically significant(t=13.810,16.893,16.554,P＜0.05).The failure rate of 400 logs sampled by the programmed evaluation process management method was 2.75%(11/400),which was lower than that of the post-evaluation process management method,the regular maintenance completion rate was 99.75%(399/400),which was higher than that of the post-evaluation process management method,the difference was statistically significant(x2=18.841,10.778,P＜0.05).The equipment maintenance time and equipment maintenance cost of the programmed evaluation process management were(9.32±1.18)days and CNY(201,600±50,500),respectively,which were lower than those of the post-evaluation process management method,and the difference was statistically significant(t=12.663,37.213,P＜0.05).The satisfaction scores of maintenance engineers,medical staff and patients in equipment use management for the programmed evaluation process management were(97.25±2.44),(98.63±4.57)and(97.16±3.09),respectively,which were higher than the post-evaluation process management method,and the differences were statistically significant(t=21.284,8.206,5.933,P＜0.05).Conclusion:The application of programmed evaluation process to the equipment management of emergency department of the hospital can effectively improve and make up for the loopholes and deficiencies in the conventional equipment management,improve the effect of equipment management,reduce the frequency of equipment failure,and ensure the safe and stable operation of equipment.

Objective:To construct the operation quality management model of ECG monitor based on fuzzy cluster evaluation technology,and to explore its application effect in ECG monitor operating health management.Methods:The quality management of ECG monitor was carried out from two aspects of fault diagnosis and operation health evaluation,and the evaluation index system of hardware structure and system performance was established.The fuzzy clustering algorithm was used to grade the operation health status,and the equipment classification management and early warning maintenance were carried out according to the evaluation results.The ECG monitor equipment in clinical use in the Emergency Department of Beijing Friendship Hospital Capital Medical University from January to December 2022 was selected,12 devices in clinical use from January to June were managed by conventional ECG monitor monitoring and management method(referred to as conventional management),and 13 devices in clinical use from July to December were managed by constructing a health management model for ECG monitors based on fuzzy clustering evaluation technology(referred to as health management).During the study,a total of 440 alarm parameter data were collected by the conventional management method and 480 alarm parameter data by the health management method,the accuracy of the ECG monitor alarm parameters,the satisfaction score of equipment users and the monthly failure rates of the two groups were compared.Results:The accuracy rate of ECG monitor alarm parameter setting using the health management method was 90.21%(433/480),which was higher than that of the conventional management,he difference was statistically significant(x2=8.265,P<0.05).The scores of equipment users on the system quality,service quality,information quality,net benefit,user satisfaction and total satisfaction of ECG monitors using health management methods were(19.47±3.25),(19.55±4.14),(18.92±2.08),(19.34±2.39),(19.82±3.37)and(97.10±3.39),respectively,which were higher than those using conventional management methods,the differences were statistically significant(t=7.358,4.481,2.859,5.304,2.297,29.001,P<0.05).The ECG monitor using the health management method failed 15 times in 6 months,and the failure incidence rate was 3.97%,which was lower than that of the conventional management method(12.71%),the difference was statistically significant(x2=4.672,P<0.05).Conclusion:The application of ECG monitor operation health management model based on fuzzy clustering evaluation technology to the ECG monitor management in the emergency department can effectively improve the correct alarm rate of the ECG monitor,reduce the failure rate of the ECG monitor,and improve the satisfaction of equipment users.

OBJECTIVE： To screen the active component， target and pathway of couplet medicine of “Bupleuri Radix- Atractylodis macrocephalea Rhizoma”， and to comprehensively explore its potential mechanism. METHODS： Based on the method of network pharmacology， main active componets and potential targets of  couplet medicine of “Bupleuri Radix-A. macrocephalea Rhizoma” were retrieved from TCMSP， DRAR-CPI， Genecards and OMIM database. The active component-potential target network and interaction network of potential targets were established by Cytoscape 3.6.0 software. Five potential core targets were screened， and its affinity with active components were validated with molecule docking method. GO classified enrichment analysis and KEGG pathway enrichment analysis of potential targets were carried out to obtain key pathway so as to construct active component-potential target-key pathway network. RESULTS： Totally 17 active components and 47 active component-potential targets were obtained from couplet medicine of “Bupleuri Radix-A. macrocephalea Rhizoma”. Five core targets were obtained， including AKT1， PRKCA， PRKCE， HRas， and PIK3CA. Five signaling pathways were involved， including MAPK pathway， PI3K/AKT pathway， RAS pathway， Estrogen pathway， BMP pathway. CONCLUSIONS： The couplet medicine of “Bupleuri Radix-A. macrocephalea Rhizoma” not only act on multiple targets through multiple components for mammary hyperplasia， but also play a complex network regulation role through the interaction between potential targets.

Objective To evaluate the effects of medical social workers on the service efficiency and patient satisfaction in general practice outpatient service . Methods A randomized controlled intervention study was conducted at general practice department of Shanxi Dayi Hospital in June 2017.Three hundred and thirty patients were randomly selected and assigned into two groups : 159 patients received intervention with medical social work service package ( intervention group ) and 163 patients served as controls.The service package included advising service , counseling service, accompanying service, comfort service, intervention guidance service , etc.The average time per visit and patient satisfaction were compared between two groups and the effectiveness of intervention was evaluated by interview of doctors .Results There were no statistically significant differences in gender , age, occupation and insurance categories between the two groups (P ＞0.05).The average time per visit patients in the intervention and control groups were 18 (15,22) min and 21 (15,25) min, respectively (Z＝2.364, P＝0.018).The highest degree of patient satisfaction in the control group was the attitude of doctors (36/40, 90.0%), and the lowest was in the setting of consulting room (20/40, 50.0%).The highest degree of satisfaction in the intervention group was the "comfortable with doctors" (40/40, 100.0%), followed by the affinity nature of social workers ( 38/40, 95.0%), and the lowest was the environmental satisfaction index ( 32/40, 80.0%).The satisfaction of comfortableness with doctors , clinic environment and consultation process in intervention group [(40/40,100.0%)、(32/40,80.0%)、(37/40,92.5%)] was higher than that in control group [(29/40,72.5%)、(20/40,50.0%)、(30/40,75.0%)] (χ2＝12.754, 7.912, 4.501, P＜0.05).Conclusion Intervention provided by medical social workers can improve the efficiency of general practice outpatient service and improve the satisfaction of patients .

Objective To investigate the possible mechanism of endonuclease G (Endo G)-mediated non-Caspase-dependent apoptotic pathway in brain neuronal apoptosis in chronic fluorosis rats.Methods Sixty Sprague Dawley (SD) rats (half male and half female) were randomly divided into two groups:control group fed with tap water with fluoride content ＜ 0.5 mg/L and fluorine group in which sodium fluoride was added into drinking water with fluoride content of 50.0 mg/L.Both groups were fed with standard food with fluorine content ＜ 0.5 mg/kg.The experiment period was 10 months.At the end of the experiment,all the animals were sacrificed,and brain tissue was taken.Flow cytometry was used to examine apoptosis rate,immune-histochemistry was employed to detect the distribution of Endo G in brain tissue;Western blotting was used to test the protein expression of Endo G.Results Compared to the apoptosis rate of control group [(1.3 ± 0.6)％,(1.9 ± 0.3)％],the apoptosis rate in hippocampus and cortex of rats with chronic fluorosis [(2.6 ± 0.6)％,(3.1-± 0.7)％] was significantly increased (t =3.1,3.4,all P ＜ 0.05).The Endo G positive neurons and their degree of staining in CA1,CA2,CA3 and CA4 of hippocampus,frontal cortex as well as the upper layer of parietal cortex [(11.1 ± 2.2),(10.2 ± 1.9),(9.8 ± 3.1),(9.9 ± 1.6),(10.6 ± 2.9),(8.2 ± 2.4),(11.1 ± 2.8) scores] in rats with chronic fluorosis were significantly higher than those in the control group [(5.8 ± 1.8),(6.7 ± 2.6),(5.2 ± 2.4),(7.2 ± 2.1),(7.7 ± 2.6),(6.1 ± 1.9),(8.1 ± 2.6) scores,t =2.9,2.5,2.4,2.3,2.2,2.5,2.3,P ＜ 0.01 or ＜ 0.05].The protein level of Endo G in the mitochondria of rat brains with chronic fluorosis [(86.4 ± 7.2)％,(83.9 ± 6.8)％] was significantly lower than that of control group [(100.0 ± 6.1)％,(100.0 ± 5.5)％,t =2.6,2.3,all P ＜ 0.05].Meanwhile,the protein level of Endo G in the nucleus of neurons from chronic fluorosis rats [(117.5 ± 6.4)％,(115.2 ± 6.2)％] was significantly higher than that of the control [(100.0 ± 5.2)％,(100.0 ± 5.5)％,t =2.5,2.2,all P ＜ 0.05].Conclusion The high expression of Endo G and nuclear transfer are related to the neuron apoptosis in chronic fluorosis rat,which may be one of the mechanisms of brain injury of the disease.

Objective To investigate the clinical efficacy of buttress plating for patients with posterior pilon fracture.Methods From April 2012 to January 2015,12 patients with posterior pilon fracture of the distal tibia were treated in our hospital.They were 7 men and 5 women,30 to 56 years of age (average,41.2 years).According to the CT classification by Haraguchi et al.,5 cases belonged to type I,3 to type Ⅱ and 4 to type Ⅲ.All the patients underwent open reduction and internal fixation with buttress plate via either a posterolateral approach or a dual posterolateral-posteromedial approach.All the patients were available for follow-up.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS).The radiological evaluation was performed using the osteoarthritis-score (OA-score).Results The patients obtained an average follow-up of 21.2 months (range,from 12 to 30 months).Bone fractures united after an average of 15 weeks (range,from 13 to 19 weeks).The time for full weight walking averaged 16 weeks,ranging from 15 to 23 weeks.The ankle plantar flexion ranged from 36° to 42° (average,40.4°);the ankle dorsal extension ranged from 38° to 44° (average,42.6°).At the final follow-ups,the AOFAS scores ranged from 82 to 97 (average,88.2);the OA-score ranged from 0.6 to 0.8 (average,0.71);the VAS scores during rest,active motion and weight-bearing walking ranged from 0.5 to 0.8 (average,0.66),from 0.6 to 0.9 (average,0.82) and from 1.2 to 1.8 (average,1.41),respectively.No fracture malunion,implant loosening,pain or stiffness of the affected ankle was observed at the final follow-ups.Conclusion Buttress plating for posterior pilon fractures can lead to satisfactory clinical outcomes,because it ensures rigid fixation which in turn enables earlier postoperative mobilization.

Objective To investigate the correlation between fibroblast growth factor receptor 2 (FGFR2) gene polymorphism and endemic fluorosis.Methods In Bijie City,Guizhou Province coal-burning-borne high fluoride areas,148 patients with fluorosis were selected as endemic fluorosis group;in non high fluoride areas of Changshun County of Guizhou Province,134 healthy people were selected as control group.Short tandem repeats (STRs)-PCR was utilized to detected the FGFR2 rs35668561 and D10S14839 microsatellite polymorphisms in endemic fluorosis cases and controls.Results FGFR2 rs35668561 461 bp (22AG)allele frequency of endemic fluorosis group (1.01％) was significantly lower than that of the control group (3.36％,x2 =5.29,P ＜ 0.05).FGFR2 D10S14839 286 bp (9GT),300 bp (16GT),310 bp (21GT) and 314 bp (23GT) allele frequency in the endemic fluorosis group were 14.53％,11.82％,16.89％ and 8.11％,in the control group were 22.01％,6.34％,8.96％ and 16.42％,the difference was statistically significant.Then 300 bp (16GT)and 310 bp (21GT)allele frequency of endemic fluorosis group was significantly higher than that of the control group (x2 =6.82,7.77,all P ＜ 0.05),and 286 bp (9GT),314 bp (23GT) allele frequency of endemic fluorosis group was significantly lower than that of the control group (x2 =5.32,9.16,all P ＜ 0.05).Conclusions FGFR2 rs35668561 and D10S14839 polymorphism are associated with endemic fluorosis.FGFR2 rs35668561 461 bp (22AG) allele may be a protective factor of endemic fluorosis.D10S14839 300 bp (16GT) and 310 bp (21GT) allele may be risk factors of endemic fluorosis,286 bp (9GT) and 314 bp (23GT) allele may be protective factors of endemic fluorosis.

Objective To investigate the geographical distribution of plague host animals in residential areas and the association between plague and its distribution pattern in Yunnan Province.Methods A systematic investigation on fauna and community ecology of rodents was carried out in residential areas of 17 counties(cities) of Yunnan Province,southwestern China with different longitude,latitude and elevation from May 2007 to November 2012.The characteristics of the spatial distribution of flea communities along environmental gradients were analyzed using community structure indexes.Results A total of 390 small mammals were trapped in seventeen counties (cities),and the mammals were classified into 11 species and 7 genus in 4 families.Among all small host mammals,Rattus tanezumi,Rattus nitidus and Rattus norvegicus were dominant species of host animals in residential areas,accounting for 33.85％ (132/390),20.77％ (81/390) and 16.92％ (66/390),respectively.The horizontal distribution of rodents showed that Rattus tanezumi was the widest species in residential areas,which was found at the longitude 98°-105°,followed by Rattus norvegicus,Rattus yunnanensis and Mus musculus.The vertical and latitudinal distributions of rodents were similar in residential areas.Rattus tanezumi was also the widest distributed species,which was observed at the latitude 21°-＜ 28°N and at the altitude 500-＜ 3 500 m; the constituent of Rattus tanezumi showed similar trends of leaning peak curves,first gradually increasing and then decreasing with the increase of latitude and elevation; Rattus tanezumi gradually changed into Rattus nitidus and Apodemus chevrieri,et al.The richness spatial distribution patterns of host animals showed similar trends of leaning peak curves which gradually increased and then decreased with increasing of longitude and latitude; the highest richness was observed at the longitude 98°-＜ 101°E and at the latitude 23°-＜ 28°N.While,the richness spatial d istribution patterns of host animals were relatively poor in the low or the high altitude range.The highest richness was observed at the altitude between 1 000-＜ 1 500 m and 2 000-＜ 2 500 m.Conclusions All spatial patterns of indoor host animals have shown an aggregated spatial distribution in Yunnan Province.Moreover,important environmental factors such as longitude,latitude,and altitude play a substantial role on the distribution patterns of indoor host animals among various focus,therefore directly impact on the modes of prevalence and transmission of plague.

Objective:To investigate the association between polymorphisms of FGFR2 and the susceptibility of breast cancer in Han population in Guizhou province.Methods:Genotyping was performed using PCR-sequence-specific primers(PCR-SSP)in 106 histologically confirmed breast cancer cases and 116 cancer-free controls.Results:The genotype frequencies of rs1219648 TT,TC,and CC were 50%,25.47%.and 24.53% in breast cancer cases and 29.31%,48.28%,and 22.41% in the controls.The gene frequencies of T in breast cancer cases and the controls were 62.74% and 53.45%.respectively.The gene frequencies of C were 37.26% and 46.55%.respectively.The distribution of allele and genotype frequencies of FGFR2 rs1219648 was statistically different between breast cancer cases and the controls(P<0.05).Conclusion:FGFR2 rs1219648 polymorphism influences the susceptibility of breast cancer.TT genotype might serve as a risk factor for breast cancer.

Objective To investigate the risk factors of hyperthermia in early period of an acute cerebral infarction.Methods 299 patients admitted to hospital from January 2003 to December 2004 with a diagnosis of cerebral infartion by CT or MRI,were retrospectively studied.The risks of hyperthermia in the early period for stroke,such as admission conscious level,bulbar palsy,emphysema,atrial fibrillation,multi-cerebral infarction,diabetes mellitus and chronic heart failure were analyzed,Logistic regression analysis was used to determine the factors that were associated with hyperthermia in the early period of stroke.Results 71 patients had fever in early period of an acute cerebral infarction(23.7%).The most common infection was pneumonia(18.4%).The analysis showed that the admission conscious level and atrial fibrillation were the risks of early hyperthermia of an acute cerebral infarction.Conclusion Admission conscious level(subconscious or unconscious/coma) and atrial fibrillation and chronic heart failure are independent risk factors for development of early hyperthermia for acute stroke.