The structure and common faults of Philips iU22 and iE33 ultrasound diagnostic equipment were introduced,the fault phenomena,causes and maintenance ideas in the daily work of this series of ultrasonic equipment were analyzed.The equipment was repaired after the failure occurred by analyzing the fault causes,replacing the corresponding components or reinstalling the system software etc.,so as to etc.,so as to provide a reference for the daily maintenance work of medical engineers.

ObjectiveTo determine the influence of COVID-19 prevention and control on the epidemic characteristics and dynamics of notifiable infectious diseases in the first quarters， Zhejiang Province， and to explore more effective countermeasures against infectious diseases. MethodsDescriptive epidemiology was conducted to determine the change in notifiable infectious diseases during the prevention and control of COVID-19 in Zhejiang Province by retrieving the data of notifiable infectious diseases from 2017 to 2022 in the Chinese information system for disease control and prevention. Cumulative reported new cases of notifiable infectious diseases in the first quarters of 2017‒2019 were compared with that of 2020‒2022. ResultsA total of 546 753 cases of notifiable infectious diseases were newly reported in the first quarters of 2017‒2019， with an average incidence of 321.92/10⁵. In contrast， a total of 509 908 cases of notifiable infectious diseases were newly reported in the first quarters of 2020‒2022， during which the COVID-19 epidemic occurred， with an average incidence of 270.39/10⁵. The incidence in 2020‒2022 significantly declined by 51.53/10⁵， compared with that in 2017‒2019 （χ²=8 072.06， P<0.001）. In the first quarters of 2020‒2022， the average incidence of zoonotic diseases and vector-borne diseases decreased by more than 50%. In addition， the incidence of respiratory， enteric， blood-borne， and sexually transmitted diseases declined to certain degree. ConclusionThe decline in the newly reported cases of non-COVID-19 notifiable infectious diseases in the first quarters of 2020‒2022 indicates that the countermeasures against COVID-19 epidemic， such as multi-disease co-prevention， multi-sectoral collaboration， societal mobilization and personal hygiene and protection， may also decrease the incidence of multiple infectious diseases. It suggests the countermeasures are effective， which would provide evidence for routine prevention and control of infectious diseases in future.

Corona virus disease 2019 （COVID-19） has led to more than 500 million cases， including 6.19 million deaths. Mutated strains of SARS-CoV-2 （alpha， beta， gamma， delta and omicron） have successively emerged. Currently the omicron variant is gradually replacing the delta variant， driving a surge of cases in most countries including China， posing a great challenge to the prevention and treatment of COVID-19. In the face of the severe pandemic situation， a large number of non-medical volunteers are fighting on the front lines of the war against the pandemic and are vulnerable to exposure due to lack of professional knowledge. This paper introduces the routine skills training of volunteers and emergency response， aiming to provide behavioral guidance for non-medical volunteers in designated isolation facilities.

COVID-19 has emerged around the world since December 2019 and rapidly evolves as a major global public health challenge. SARS-CoV-2 is a positive single-stranded RNA virus with a relatively high natural mutation rate. The emergence of SARS-CoV-2 variants is generally considered as the outcome of a “mutation-selection-adaption” process. The enzyme APOBECs that is activated in the inflammatory microenvironment may facilitate viral mutagenesis. Currently， the major SARS-CoV-2 variants that impose public health significance are B.1.1.7， B.1.351， P.1， B.1.6.7.2， B.1.1.529 and so on， with probably increasing transmissibility， decreasing reactivity to the neutralizing antibodies， immune escape， and enhancing disease severity and mortality. Consequently， it warrants up-to-date countermeasures against evolving SARS-CoV-2， including tracing viral mutagenesis， developing vaccines against major variants， and enhancing social distancing.

Objective:To evaluate the clinical value of high-definition intelligent endoscopy (iSCAN) combined with stroboscopy in identifying vocal cord leukoplakia.Methods:Seventy-nine patients with vocal cord leukoplakia who underwent CO 2 laser laryngeal microsurgery and diagnosed by histopathology were recruited between October 2020 to August 2021. The morphological features, microvascular morphology and mucosal waves were observed by stroboscope; SPSS 20.0 software was used for statistical analysis. Results:There were 79 patients with a total of 119 lesions (56 on left and 63 on right).Pathological examination showed that 51 sides of the vocal cords were malignant lesions (severe dysplasia, carcinoma in situ and invasive carcinoma), and 68 sides were benign lesions.Under stroboscopy, 69 sides of mucosal wave were normal or slightly decreased, and 50 sides were severely decreased or disappeared.The decrease degree of mucosal wave was positively correlated with malignant lesions ( ρ=0.687, P<0.001).Under iSCAN endoscopy, there was a positive correlation between the morphological changes of microvessels at the lesion site (vertical) and the malignant lesion ( ρ=0.687, P<0.001).Univariate analysis showed that lesion size, thickness, uneven color, granular elevation, peripheral erythema and asymmetry were positively correlated with malignant lesions ( ρ=0.530, 0.401, 0.538, 0.315, 0.497, 0.281, P<0.05).Logistic regression analysis showed that the risk of pathological malignancy with large lesions was 5.437 times higher than those of small lesions, the vertical vascular changes under iSCAN were 8.711 times higher than that of normal vascular morphology, and the severe reduction or disappearance of mucosal waves was 9.12 times higher than that of normal or mild reduction of mucosal waves. Conclusion:ISCAN can be combined with staphyloscopy to comprehensively observe and evaluate the changes of vocal cord morphology, submucosal microvessels and mucosal wave of vocal cord in patients with vocal cord leukoplosis, thus improving the ability to distinguish benign and malignant lesions.

Objective To evaluate the value of capsule endoscopy (CE)in diagnosis,management and prognosis of crohn's disease(CD).Methods Four diagnosed CD patients and 22 patients with suspected CD underwent CE.The lesion location and drug therapy were analysed prospectively.Follow-up of one year was conducted to evaluate the disease and the effectiveness of therapy.Results There was an increase in detection rate of small bowel involvement,namely,from 57.7％ to 80.8％,and a decrease in symptomatic treatment and an increase in medication of hormone and immune inhibitors.After the follow-up of 12 months,12 suspected CD patients were confirmed,and 2 patients were excluded.Variance analysis of CRP,CDAI,IBDQ and LS were conducted by repeated measures (P ＜ 0.05) and that meant the therapy was effective.Conclusion CE is useful for diagnosis,treatment and prognosis of CD.

Objective To analyse and compare the effects and safety of early use (in emergency room, intravenous loading followed by infusion) with bolus injection during primary PCI of tirofiban, on post-procedural TIMI flow and 30d clinical outcomes. Methods Seven hundred and seven patients with acute STEMI treated by primary PCI in Ruijin hospital were retrospectively and enrolled screened. Among them, 86 patients with single bolus intra-coronary injection of tirofiban (25 μg/kg) during the procedure were served as observation group. Baseline, angiographic, PCI features and rate of major adverse cardiac events (MACE) at 30 d follow-up were compared with those received early intravenous infusion of tirofiban (10ug/kg bolus followed by 0.15μg/(kg·min) intravenous infusion)(control group, n=239). Results Compared with control group, patients in observation group were older[(63.8±11.4) vs. (57.9±8.8), P=0.01], had higher prevalence of hypertension (58.6%vs. 51.0%, P=0.005), multivessel disease (57.0%vs. 34.3%, P<0.001), and female in gender (40.7%vs. 25.1%, P=0.006). Post-procedural TIMI flow in culprit vessel and TMP grade were comparable between the two groups (P=0.66 and P=0.48, respectively). Reduction in TIMI minimal bleeding events were found in the observation group (2.3%vs. 9.6%, P=0.03). MACE free survival rate at 30d clinical follow-up was similar between the two groups (P=0.48). Conclusions Single bolus intra-coronary injection of tirofiban exerts similar effects in post-procedural TIMI flow, TMP grade in culprit vessel and 30d clinical outcomes compared with early use in emergency room with intra-venous loading and infusion, nevertheless, intra-coronary injection resulted in significantly reduced TIMI minimal bleeding events. Prospective, randomized clinical study is mandatory to prove our current results.

Pang Zanxiang was a famous ophthalmologist of Chinese medicine. Based on his family experience and combined with his clinical practice, he has written the book Clinical practice of ophthalmology in traditional Chinese medicine. In the book, the theory of stagnation of Qi and blood leading to disease was put forward, and radix stellariae was used most frequently in treating eye disease. From literature interview, we found that pang’s experience of radix stellariae in treating eye disease was its function of replenishing vital essence to improve eyesight.

Objective To investigate the effect of epidermal growth factor receptor 2 (ErbB2) expression on invasion ofglioma cells and its possible mechanism.Methods Glioma TJ905 cells were cultured in vitro; and ErbB2 shRNA and overexpression vectors were constructed and transfected into Glioma T J905 cells to down-regulate and up-regulate the ErbB2 expression levels; empty vector plasmid was also transfected into the TJ905 cells as control group.Invasive ability changes of T J905 cells were measured by Transwell assay,and the expression levels of matrix metalloprotease (MMP)-2 and MMP-9 were identified by Western blotting.Results As compared with the ErbB2,MMP-2 and MMP-9 protein expression levels in the control group (62.34±5.72,62.34±5.72 and 69.76±6.25),those in the ErbB2 shRNA group were significantly decreased (34.82±4.91,58.73±4.48 and 52.32±5.23),while those in the ErbB2 overexpression group were significantly increased (69.76±6.25,87.34±7.96 and 94.39±6.12),with significant differences (P＜0.05).The mean cells crossing Matrigel in the ErbB2 shRNA group (28.5 cells/field) were obviously decreased,and those in the ErbB2 overexpression group were increased (82 cells/field) as compared with those in the control group (70 cells/field),with significant differences (P＜0.05).Conclusion ErbB2 expression can affect the invasiveness ofglioma cells,which might be related to the expression changes of MMP-2 and MMP-9.

Objective To explore the risk factors in disease progression and the significance of vascular endothelial growth factor ( VEGF ) and vascular intercellular adhesion molecule-1 ( VCAM-1 ) in hand foot and mouth disease ( HFMD) combined with encephalitis .Methods Altogether 92 subjects with HFMD were enrolled in the study and were divided into four groups , including group A ( ordinary group with no complication ) , group B ( severe group with complication ) , group C ( critical group with complication ) , group D ( recovery group with complication ) .Concentrations of VEGF and VCAM-1 in serum and cerebro-spinal fluid were detected by double antibody sandwich ELISA method .Multiple factors logistic regression analysis was performed to analyze main risk factors in disease progression for two combinations , one for ordi-nary group and severe group , the other for severe group and critical group .The results were analyzed by SPSS16.0 statistical software.Results The concentration of VEGF and VCAM-1 in serum and cerebrospi-nal fluid had statistically significant differences among the four groups , but there was no significant difference between group A and group D , and between group B and group C .In addition , the statistically significant factors for prediction of disease progression were duration of fever , limb shaking, cerebrospinal fluid WBC , cerebrospinal fluid protein and EV 71 IgM between ordinary group and severe group , and cerebrospinal fluid WBC, respiratory rate and heart rate between severe group and critical group .The multiple factors logistic regression analysis revealed that limb shaking , cerebrospinal fluid protein , VEGF and VCAM-1 in serum were the main risk factors for disease progression from ordinary to severe (P=0.071, 0.019, 0.020, 0.025 and OR=147.629, 26.572, 5.958, 6.345).And increased heart rate indicated the progression from se-vere to critical with P value of 0.001 and OR value of 2.69.Conclusion (1) Compared with group A, VEGF and VCAM-1 in serum and cerebrospinal fluid were highly expressed in patients with HFMD combined with encephalitis .Therefore , VEGF and VCAM-1 could be used as diagnostic criteria for auxiliary diagnosis of encephalitis in patients with HFMD and reflect the severity and prognosis to a certain extent .( 2 ) Risk factors like limb shaking , cerebrospinal fluid protein , VEGF and VCAM-1 in serum would be helpful to early diagnosis of severe patients .Increased heart rate would be a significant factor for identification of patients with critical disease , according to which a timely treatment would be provided to prevent from worse .