Objective:To construct a reliability management model of medical equipment in the department of respiratory and critical care medicine,and to explore its application effect in the management of medical equipment in the department of respiratory and critical care medicine.Methods:Taking the reliability of equipment management content and management methods as evaluation indexes,standardized procedures of equipment use,cleaning and emergency management were formed,and a reliability management model for medical equipment in the department of respiratory and critical care medicine was constructed.A total of 63 medical devices in clinical use in the Department of Respiratory and Critical Care Medicine of Beijing Anzhen Hospital,Capital Medical University from January 2022 to January 2023 were selected.According to different management modes,conventional management mode(32 devices)and reliability management mode(31 devices)were adopted respectively.The equipment management index score,equipment goal achievement degree and equipment management defect rate,and the equipment management recognition scores of the engineers,equipment operation technicians and doctors of equipment use management were compared between the two management modes.Results:The average recognition scores of the engineers,operating technicians and doctors for the use of equipment of the reliability management model were(90.66±5.25)points,(91.54±4.14)points and(92.17±5.17)points,respectively,which were higher than those of the conventional management model,the difference was statistically significant(t=14.249,13.773,12.267,P<0.05).The average scores of equipment resource allocation,information technology,technical support and management performance indicators of the reliability management mode were(90.25±4.12)points,(92.45±3.26)points,(91.47±2.78)points and(90.25±3.11)points,respectively,which were higher than those of conventional management mode,the difference was statistically significant(t=12.122,18.379,15.581,14.141,P<0.05).The average scores of equipment use standardization,cleaning completion and emergency management timeliness of reliability management mode were(92.36±3.25)points,(90.69±3.69)points and(91.87±3.01)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=14.953,15.030,14.401,P<0.05).The number of equipment damaged,repaired and factory repair of the reliability management mode was 1,1 and 2,respectively,and the defect rates were 3.22%,3.22%and 6.45%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(x2=8.581,9.908,8.782,P<0.05).Conclusion:The application of reliability-based medical equipment management model to the medical equipment management of respiratory and critical care medicine can improve the quality of equipment management and operation,reduce the failure rate of equipment,and improve the service level of equipment.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

OBJECTIVES: To investigate the effect of adriamycin (ADM), idelalisib or ADM and their combination on cell proliferation and intracellular concentration of ADM, and to explore the reversal effect of idelalisib on drug resistance to ADM. METHODS: The K562 and K562/ADM cells were respectively treated with ADM and idelalisib at different concentrations. The 50% inhibitory concentration (IC RESULTS: The cell survival rates were significantly decreased in a dose-dependent manner when the cells were treated with different doses of ADM (0.001-10.000 mg/L ). The IC CONCLUSIONS Idelalisib exerts effect on inhibition of the proliferation in myeloid leukemia K562 and K562/ADM cells, which may partially reverse the drug resistance of K562/ADM cells to ADM. The mechanisms for the effect of idelalisib may be related to increasing the accumulation of ADM and inducing the cell apoptosis in the K562 and K562/ADM cells.
ATP Binding Cassette Transporter, Subfamily B, Member 1 ; Cell Proliferation ; Doxorubicin/pharmacology* ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; K562 Cells ; Leukemia, Myeloid ; Purines ; Quinazolinones

Objective The objective of this study was to investigate the abnormal expression of Notch signaling pathway members in pancreatic cancer and its important effect on the development of pancreatic carcinoma. Methods Affymetrix gene expres-sion microarray was used to screen the differentially expressed members of Notch signal pathway in 10 cases of pancreatic carcinoma and its adjacent tissues,and verified by real-time quantitative PCR and Western blotting. The lentivirus expression vector carrying the siRNA fragment of Jagged 2(JAG2)gene was transfected into the pancreatic cancer primary cells to construct the JAG2 gene re-pression-expressing pancreatic cancer cell line. MTT,flow cytometry and Transwell assays were used to analyze cell proliferation, changes of cell cycle and invasive transfer capabilities. Results A total of 512 differentially expressed genes were detected by Affy-metrix gene expression microarray,including 419 up-regulated genes and 93 down-regulated genes. JAG2( up-regulated expres-sion 8. 20 times),NOTCH1(up-regulated expression 3. 74 times),HES1(up-regulated expression 3. 27 times),and NOTCH2(up-regulated expression 3. 16 times)were differentially expressed in Notch signaling pathway. The results of PCR and Western blotting were consistent with those of gene chip. The growth curves of JAG2 gene repressed pancreatic cancer cells and pancreatic cancer pri-mary cells were drawn by the standard OD490 value of d1-d5 by MTT assay. JAG2 gene repressor expression vector could signifi-cantly inhibit the proliferation of pancreatic cancer cells. The cell cycle analysis showed that the apoptosis and the arrested cell cycle at the S phase were significantly increased in pancreatic cancer cells with JAG2 gene repressor expression. The invasive ability was significantly reduced in JAG2 gene repressor expression pancreatic cancer cells(P<0. 05). Conclusion Some members of the Notch signaling pathway are significantly differentially expressed in pancreatic cancer tissues,and repression of this member can affect the growth,cell cycle,invasion and metastasis of pancreatic cancer cells.

The effect of melatonin on juveniles with cardio fibrosis is poorly understood. We investigated whether HDACs participate in the anti-fibrotic processes regulated by melatonin during hypertrophic remodeling. Abdominal aortic constriction (AAC) was employed in juvenile rats resulting in pressure overload-induced ventricular hypertrophy and melatonin was subsequently decreased via continuous light exposure for 5 weeks after surgery. AAC rats displayed an increased cross-sectional area of myocardial fibers and significantly elevated collagen deposition compared to sham-operated rats, as measured by HE and Masson Trichrome staining. Continuous light exposure following surgery exacerbated the increase in the cross-sectional area of myocardial fibers. The expression of HDAC1, HDAC2, HDAC3, HDAC4 and HDAC6 genes were all significantly enhanced in AAC rats with light exposure relative to the other rats. Moreover, the protein level of TNF-α was also upregulated in the AAC light exposure groups when compared with the sham. However, Smad4 protein expression was unchanged in the juveniles' hearts. In contrast, beginning 5 weeks after the operation, the AAC rats were treated with melatonin (10 mg/kg, intraperitoneal injection every evening) or vehicle 4 weeks, and sham rats were given vehicle. The changes in the histological measures of cardio fibrosis and the gene expressions of HDAC1, HDAC2, HDAC3, HDAC4 and HDAC6 were attenuated by melatonin administration. The results reveal that melatonin plays a role in the development of cardio fibrosis and the expression of HDAC1, HDAC2, HDAC3, HDAC4 and HDAC6 in cardiomyocytes.
Animals ; Collagen ; Constriction ; Fibrosis* ; Gene Expression ; Heart ; Histone Deacetylases ; Hypertrophy ; Injections, Intraperitoneal ; Melatonin* ; Myocytes, Cardiac ; Rats* ; Smad4 Protein

Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.

Objective Due to poor effects of sterilization,low efficiency and inconvenience of field emergency transportation for portable exhaust pressure steam sterilizer,we aimed to design and develop a portable pulse vacuum pressure steam sterilizer in order to effectively improve quality and efficiency of sterilization for sterile medical equipment in disaster and emergency medical treatment.Methods From the beginning of February 2013,we focused on the features of small size,light weight,reliable sterilizing effect and fast speed of sterilization,and conducted series of technology researches,and finally developed portable pulse vacuum pressure steam sterilizer which was suitable for individual carrying or air delivery.Results We performed outdoor sterilization tests for portable vacuum pressure steam sterilizer and portable exhaust pressure steam sterilizer under the same condition.Portable pulse vacuum pressure steam sterilizer achieved a 100％ qualification rate,average sterilization cycle was 28.6min per time,sterilization by weight was 48L/h,average water consumption was 0.4L/boiler,average power consumption was 0.7kw/h per time,and sterilization operation index,maneuverability and transportability were significantly better than those of portable exhaust pressure steam sterilizer.Conclusion The developed 4 portable pulse vacuum pressure steam sterilizer have higher cost performance,and have been successfully applied for medical service training and non-war medical treatment activities in our hospital.

An analysis of the opportunities and challenges brought forth to research hospitals in the face of emerging new technologies,described the development direction of such hospitals in terms of strategic planning of precision medicine, breakthrough of mechanism barriers for technology development,andInternet+ service mode innovation.These efforts aim at exploring to build a new type of medical technology service system.

Building a new concept of combat forces is an important initiative in the 12th Five-Year Plan of National Defense Strategies.In the era of biotechnology,global powers have been competing for brain control by means of accelerated development in brain science and the military theory of Innovation to Subdue.Based on elaboration on the concepts and developments of military applications of brain science as well as on analysis of impacts on the mechanism of winning,this paper proposes the operation concepts of pre-settingand bio-orientation,the combat modes of mechanized warfareand idiodynamic warfare,and weapon evolution into intellectualizationand brain-control orientation.This paper presents a practical system design of military applications of brain science:presetting—key technology—weapons′power source-mechanism of winning.The constitution and winning mechanism of the three-stage mode of battle effectiveness are summarized as improving the operation capability—war of super soldiers,changing the main force of operations—war of mechanized legions,altering the principles of operations—war of spiritual consciousness. This paper also suggests the upgradation from damage theoryto control theory,the shift from informatizationtointellectualization,and strategic breakthroughs from independent developmentto collaborative innovation.

Objective To apply the WeChat in family rehabilitation after anterior cruciate ligament (ACL) reconstruction. Methods 126 patients accepted ACL reconstruction using quadrupled semitendinosus and gracilis tendons were divided into observation group (n=69) and control group (n=57). The control group received conventional rehabilitation program, and the observation group joined the WeChat group. They were assessed with knee range of motion (ROM), knee stability test, thigh perimeter, Lysholm score and the International Knee Documentation Committee (IKDC) score 3 and 6 months after operation. Results There was a significant difference between groups in ROM of knee flexion (P<0.05) 3 and 6 months after operation, but not in ROM of knee extension (P>0.05). There was no significant difference in thigh perimeter 3 months after operation, but it was significant 6 months after operation. There was significant difference in Lysholm score and IKDC score (P<0.05), but not in the joint stability (P>0.05). Conclusion Direction of rehabilitation with the WeChat Group can significantly improve the compliance, accelerate the rehabilitation process and reduce complications in patients after ACL reconstruction.