Objective To compare the safety and efficacy of flexible terminal suction ureteral access sheath(FTS-UAS)and negative pressure ureteral access sheath(NPUAS)in flexible ureteroscopic lithotripsy with holmium laser in treatment of renal calculi less than 2 cm in diameter.Methods A total of 68 patients(largest diameter of stone＜2 cm)with renal calculi treated in Yangjiang Hospital Affiliated to Guangdong Medical University during Nov.2022 and Aug.2023 were divided into FTS-UAS group(n=34)and NPUAS group(n=34)according to different surgical methods.The perioperative parameters and stone-free rate(SFR)were compared between the two groups.Results The average SFR on the first day after operation was significantly higher in the FTS-UAS group than in the NPUAS group[85.3％(29/34)vs.61.8％(21/34),P=0.028].The operation time was significantly lower in the FTS-UAS group than in the NPUAS group[(65.85±13.16)min vs.(75.59±20.21)min,P=0.022].For lower calyceal renal calculi,the SFR was significantly higher in the FTS-UAS group than in the NPUAS group[82.4％(14/17)vs.43.8％(7/16),P=0.032].One month after operation,the SFR was higher in the FTS-UAS group than in the NPUAS group[94.1％(32/34)vs.85.3％(29/34),P=0.452].There were no significant differences in hemoglobin reduction,serum creatinine level,postoperative complications,hospital stay and hospitalization costs between the two groups(P＞0.05).Conclusion FTS-UAS in flexible ureteroscopic lithotripsy can shorten the operation time and improve stone-clearance rate,which is safe,effective,and worthy of clinical promotion.

BACKGROUND: Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit (ICU). One of the reasons for this is the substandard drug trough concentration. We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin. METHODS: This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having, or confirmed to have, gram-positive cocci infection and treated with vancomycin. One group of the patients was administered a loading dose of vancomycin (loading group) and compared with the group that did not receive a loading dose (control group). The baseline characteristics, vancomycin serum concentrations, and clinical outcomes were collected and analyzed. RESULTS: Fifty-five patients were finally included, of which 29 received a loading dose of vancomycin. The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group (10.3 ± 6.1 mg/L vs. 5.7 ± 4.4 mg/L, P = 0.002). The results for both groups were similar before the fifth dose (12.4 ± 7.3 mg/L vs. 10.3 ± 6.3 mg/L in the loading and the control groups, respectively; P = 0.251). The 28-day mortality was lower for the loading group than for the control group (6.7% vs. 34.6% in the loading and control groups, respectively; P = 0.026). No significant differences were observed in serum creatinine (Cr) concentrations of the two groups. CONCLUSION: With the loading dose of vancomycin, the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury. TRIAL REGISTRATION https://www.chictr.org.cn; ChiCTR2000035369.
Anti-Bacterial Agents/therapeutic use* ; Creatinine ; Humans ; Intensive Care Units ; Retrospective Studies ; Vancomycin

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

OBJECTIVEEstablish a regional cloud account of hospital medical equipment based on dynamic two-dimensional code link.

METHODSEstablish a medical equipment data platform based on B/S architecture. Combined with mobile internet means such as WeChat and try the industrial 4.0 designed intelligent boxes.

RESULTSThe problem of no interface transmission and integration of the regional medical equipment account information is solved. It dynamically collects equipment data, operation cost and efficiency. The real-time operation data is visualized.

CONCLUSIONSThe dynamic management platform of regional medical equipment helps to standardize the management of large medical equipment and improve the utilization ratio of medical equipment. The platform provides basis of management decisions and equipment allocation for relevant departments.

This study based on the technology evolution theory, S-curve and bibliometrics, verified product evolution was accompanied by the evolution and transition of a number of sub technologies. It judged MRI was in the stage of underdevelopment and a new round of technology was being developed. It was found that the value of MRI equipment in scientific research or clinical application in foreign countries was higher than that in China by comparing the literatures at home and abroad. And there was a gap between China and the world scientific center in the independent R&D capability. The study verified the applicability of the technical evolution theory and the evaluation empirical laws in the medical devices evaluation, and explored the operability of the assessment tools. This paper not only provided a reference for equipment configuration, but also showed the gaps of key technologies in home and abroad and provided a reference for upgrading China's independent innovation and industrial technology.
China ; Industry ; Magnetic Resonance Imaging ; instrumentation ; Technology ; trends

Multiple myeloma (MM) is an incurable plasma cell neoplasm with an incidence of 100 patients per year in Singapore. Major advances have been made in the diagnosis, risk stratification and treatment of MM in the recent past. The reclassification of a subset of patients with smouldering MM, based on high-risk biomarkers, and the development of the revised international staging system are among the key new developments in diagnosis and staging. The use of novel agent-based treatment has resulted in significant improvements in the survival and quality of life of many patients with MM. Determining the optimal use of proteasome inhibitors, immunomodulators and, more recently, monoclonal antibodies is an area of ongoing investigation. In this guideline, we aim to provide an overview of the management of MM, incorporating the latest developments in diagnosis and treatment.
Aged ; Antibodies, Monoclonal ; chemistry ; Biomarkers, Tumor ; Female ; Humans ; Male ; Medical Oncology ; standards ; Middle Aged ; Multiple Myeloma ; diagnosis ; therapy ; Practice Guidelines as Topic ; Proteasome Endopeptidase Complex ; Quality of Life ; Risk ; Singapore ; Societies, Medical ; Stem Cell Transplantation ; Transplantation Conditioning

Objective:To investigate the efficacy and toxicity of oxaliplatin reintroduction combined with raltitrexed as second-line che-motherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients. Methods:The 48 evaluable pa-tients with advanced colorectal cancer following disease progression prior to the first-line chemotherapy were treated with oxaliplatin and raltitrexed (raltitrexed 3 mg/m2 ivgtt d1, oxaliplatin 100-130 mg/m2 ivgtt d1, q21d). All 48 patients were divided into two groups:Group A, non-oxaliplatin-based regimens as the first-line chemotherapy, 20 cases;Group B, oxaliplatin-based regimens as the first-line chemotherapy, 28 cases. Each group was evaluated every two cycles. Results:The response rates (RR) of Groups A and B were 30.0%(6/20) and 32.1%(9/28), the disease control rates (DCR) were 80.0%(16/20) and 75.0%(21/28), the median progression free survival time (mPFS) was 6.5 and 7.0 months, and the median overall survival time (mOS) was 10 and 13 months, respectively. No statistical sig-nificance was observed between the two groups in their RR, CR, mPFS, and mOS (P=0.264, 0.514, 0.713, 0.788), respectively. The most common adverse effects observed wereⅠ-Ⅱgrades of bone marrow suppression, aminotransferase abnormality, and digestive toxici-ties. The incidence of neurotoxicity (Ⅰ-Ⅱgrades) between the two groups was similar. Conclusion:Instead of irinotecan combined with raltitrexed, oxaliplatin reintroduction combined with raltitrexed for second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients is feasible.

The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature ; Disinfection ; instrumentation ; Hydrogen Peroxide ; chemistry ; Plasma Gases ; chemistry

Objective To analyse the presence of human papillomavirus and mouse mammary tumor virus in breast cancer,and expected to provide a possible target for gene therapy of breast cancer.Methods PCR and nested PCR assay were used to detect the HPV L1,HPV16E6,HPV16E7,HPV18E6,HPV18E7 and the enevelop gene of MMTV,while sequence analysis was performed in 76 paraffin embedded tissues of breast cancer.Results The percentage of HPV L1,HPV18 E6,HPV18 E7 and the enevelop gene of MMTV was repectively 9.21％,6.58％,9.21％ and 30.26％,while no HPV16 E6 and HPV16E7 was found in 76 paraffin embedded tissues of breast cancer.Conclusions HPV18 and the enevelop gene of MMTV was existed in breast cancer,there was low connection between HPV and breast cancer,but there may be some correlation between MMTV and breast cancer.This research offers a possible target for gene therapy of breast cancer.