Objective:To build a data-driven operation and maintenance management model for large-scale medical imaging equipment,and to analyze its application value in medical equipment management.Methods:The data-driven operation and maintenance management mode of large-scale medical imaging equipment was composed of operation and maintenance management mode architecture,equipment health status monitoring management platform architecture,historical data fault diagnosis model architecture and operation and maintenance management.16 medical imaging equipment in clinical use in Chengdu Public Health Clinical Medical Center from January 2020 to February 2022 were selected,and the traditional medical imaging equipment operation and maintenance management mode(referred to as traditional mode)and data-driven large-scale medical imaging equipment operation and maintenance management mode(referred to as data-driven mode)were adopted respectively for management according to different management modes.The imaging effect of equipment image,the frequency of equipment failure,the cost effectiveness of equipment and the satisfaction score of equipment management personnel were compared between the two management modes.Results:The scores of accuracy of diagnosis results,accuracy of patient information,image position qualification rate,image clarity,image pass rate,image quality rate and total image imaging score of the data-driven model were(9.78±1.25)points,(9.88±1.11)points,(9.54±1.08)points,(9.66±1.27)points and(9.83±1.43)points,(9.86±1.63)points and(58.55±1.44)points,respectively,which were higher than those in the traditional mode,the difference was statistically significant(t=4.958,5.268,6.522,4.327,9.765,3.923,21.474,P<0.05).The self-repair and human-made failures occurred 22 times and 10 times respectively in the data-driven model,which were lower than those of the traditional model,and 24 times of long-term use faults,which was higher than that of the traditional model,the difference was statistically significant(x2=4.363,4.294,18.692,P<0.05).The satisfaction scores of radiologists,equipment maintenance personnel,imaging technicians and patients with the data-driven mode were(94.52±6.15)points,(91.19±5.35)points,(89.27±4.93)points and(92.24±5.51)points,respectively,which were higher than those of the traditional mode,the difference was statistically significant(t=6.504,5.534,6.821,9.556,P<0.05).Conclusion:The operation and maintenance management mode based on data driven of large medical imaging equipment can improve the imaging quality of imaging equipment,reduce the incidence of failure,reduce equipment maintenance and maintenance costs,and improve user satisfaction.

Objective:To construct a comprehensive evaluation model of equipment operation efficiency,and to explore its application value in process management of large medical equipment.Methods:Based on the driving-pressure-state-impact-response(DPSIR)model,22 evaluation indicators of the operation efficiency of large medical equipment were selected,and the importance of the indicators was evaluated by the composite weight evaluation method.According to the comprehensive evaluation results of the operation efficiency,the management countermeasures for optimal allocation of large medical equipment,the improvement of management processes,the technical support and the improvement of efficiency were formulated.The 61 large medical equipment in clinical use in Public Health Clinical Medical Center of Chengdu from 2019 to 2022 was selected,and the traditional demonstration mode was adopted for process management for 57 devices from 2019 to 2020,the 60 devices(including 56 in the traditional demonstration mode and 4 new ones)from 2021 to 2022 adopted comprehensive evaluation mode for process management.The comprehensive evaluation index,the increase in operating benefit and the recognition of equipment use were compared between the two management modes of large medical equipment.Results:The operation benefit closeness and comprehensive coordination index of large medical equipment managed by comprehensive evaluation mode were(0.91±0.03)and(0.89±0.05),respectively,which were higher than those of the traditional demonstration mode,and the obstacle factor was(0.30±0.09),which was lower than that of the traditional demonstration mode,the difference was statistically significant(t=3.387,3.539,2.912,P<0.05).The increases of the cost-effectiveness,service benefit and development benefit of large medical equipment managed by comprehensive evaluation mode were(2.72±0.97)%,(3.16±0.97)%and(3.90±1.26)%,which were higher than those of traditional demonstration mode,the difference was statistically significant(t=3.428,4.130,4.135,P<0.05).The average scores of the recognition of users for the basic allocation,operation quality,service effect and management level of large medical equipment managed by comprehensive evaluation mode were(90.93±4.26)points,(92.14±4.32)points,(89.75±3.93)points and(92.67±2.94)points,respectively,which were higher than those of the traditional demonstration mode,the difference was statistically significant(t=4.042,5.294,4.438,6.142,P<0.05).Conclusion:The comprehensive evaluation model can improve the process management quality of large medical equipment,improve the operation efficiency of large medical equipment,and improve the recognition of the use of the use of large medical equipment.

Objective To investigate the clinical features and the possible pathogenesis of rhythmic movement disorder (RMD) by analyzing 2 patients with RMD and reviewing the literature. Methods By using overnight polysomnogram (PSG) and sleeping video monitoring, the movement patterns, sleep architecture, and sleep quality of 2 patients who met the RMD diagnostic criteria were examined. Results Two male patients were 15-years old. The onset age of patient 1 was 3-years old, and patient 2 was 10-years old. All abnormal movements occurred in sleep, which presented with repetitive, stereotyping and rhythmical movements. Multiple patterns of abnormal sleeping movement were observed in 2 patients: head hypsokinesis, thoracic and waist hyperextension, and pendular movement of bilateral upper extremities. In the sitting position, the patient exhibited kneeling position, and fore-and-aft or lateral rhythmical swing of the upper body accompanied with head-banging. In the prone position, the patient behaved head backward hyperextension, and horizontal and fluctuating pendular movement of the body, which was just like the auto-erotic situation. In the lateral sleep position, the patient supported their head by using the right hand accompanied with fore-and-aft pendular movement of the head and the upper body. These symptoms mentioned above emerged immediately when the patient fell asleep, and continuously existed in all sleep period including non-rapid eye movement and rapid eye movement. All of the symptoms disappeared once the patient woke. The abnormal movement frequency was 0.1-2.0 Hz. In addition, the sleep architecture and quality were severely influenced by RMD in patient 2. Clonazepam might markedly ameliorate the symptoms and sleep quality. Conclusions Multiple abnormal movement patterns may exist in the RMD patients, and these abnormal movements could last during the whole sleep period. PSG and sleeping video monitoring should be undertaken for the suspected RMD patients, which are very useful for the definite diagnosis of RMD.

Objective To investigate the clinical features of restless legs syndrome(RLS),its possible pathogenesis.and the effects of benserazide on the patients with RLS.Methods Twenty-three patients who met the primary diagnostic criteria of RLS were retrospectively analyzed.Results Twenty-three middle-aged or elderly patients aged 56 years in average had an average onset age of 52 years.Insomnia and daytime sleepiness were mostly common complains for these patients.Based on the diagnostic criteria of International RLS study group(IRLSSG),the average IRLSSG score was 25,and 16 cases(69%)of the patients were severe(21-30).Polysomnographic examination showed that 18 cases(78%)had periodic limb movement.in which the PLM index of 11 cases(61%)patients Was moderate(25-49).PLM-arousal index of all patients was increased.that of 16 cases(67%)patients being moderate.After treatment by levodopa/benserazide 100/25 mg at bedtime each night for 4 weeks,most of patients'subjective symptoms improved markedly.and the IRLSSG score Was obviously decreased.with an average score of 13,and 5 patients became completely normal.Among patients with periodic legs movement.the PLM index became normal in 5 patients and became mild in others.In addition.the PLM-arousal index in all patients Was markedly decreased.with that of 11 patients becoming normal.The sleep latency of 19 patients became normal.On the other hand,6 patients(26%)had transient headache,nausea,and lethargy.Conclusions Patients with discomfortable feeling of lower extremity which is mitigated after movement.and legs movement during sleep should be check up as early as possible.Benserazide may be considered as an effeetive medication for patients with RLS.

BACKGROUND: Much has been studied on the neuroprotective effect of repetitive transcranial magnetic stimulation.OBJECTIVE: To observe the effects of repetitive transcranial magnetic stimulation on the morphology and vitality of rat hippocampus neurons in vitro in order to verify its protective effect on neurons.DESIGN: A completely randomized controlled experiment with animals as subjects.SETTING: Institute of neuroscience of a military medical university of Chinese PLA.MATERIALS: The experiment was conducted at the Institute of Neuroscience, Fourth Military Medical University of Chinese PLA, from April to June 2004. Primary cultured hippocampus neurons of neonatal SD rats were used in the experiment. The cells were randomly assigned to control group,repetitive transcranial magnetic stimulation group, H2O2 group and repetitive transcranial magnetic stimulation-H2O2 group, each group having 10 wells.METHODS: Hippocampus neurons of the rats were cultured by common culture method. Repetitive transcranial magnetic stimulation group and repetitive transcranial magnetic stimulation-H2O2 group were treated with 1 Hz 100 mT repetitive magnetic stimulation for 1 000 times 48 hours after being seeded, whereas the control group and H2O2 group were left untreated. H2O2group and repetitive transcranial magnetic stimulation-H2O2 group were incubated with 100 μmol/L H2O2 56 hours after being seeded. Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was observed under an inverted phase contrast microscope. Cell vitality was assayed with 3-(4, 5)-dimethythioazol-2-yl-2, 5-diphenyl-tetrazoliumbromide method (MTT).MAIN OUTCOME MEASURES: The morphology and viability of the neurons in repetitive transcranial magnetic stimulation group and control group.RESULTS: Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was observed under an inverted phase contrast microscope. Cells clustered and had good refractive power. The cell body was satiated and took round, fusiform or conical shape. Processes were obvious(mostly 20-30 μm) and formed intensive neural network. The two groups did not differ significantly in morphological alteration. MTT metabolic rate: It was higher in repetitive transcranial magnetic stimulation group[ ( 104.43 ± 2.76) % ] than in control group[ (100. 00 ± 3.20) % ] ( F = 1. 344, P ＜ 0.05); it was higher in repetitive transcranial magnetic stimulation-H2O2 group[ (52.61 ± 2.64) % ] than in H2O2 group[ (46. 28 ± 2.04) % ] ( F = 1. 675, P ＜ 0.05).CONCLUSION: After repetitive transcranial magnetic stimulation, the morphology of hippocampus neurons cultured in vitro does not change obviously, but cell vitality and ability of anti-oxidation are increased remarkably, which does not cause obvious harm to the cultured cells and may have some neuroprotective effects.

Objective To summarize the experience of microsurgical repair of soft tissue defects in 136 cases with firearm wound,to probe into repairing defect methods in different parts and to improve repairing results Methods According to the location,area of soft tissue defects or special needs,dorsalis pedis flap,latissimus dorsi flap,thoracoumbilical flap,forearm flap,lateral leg flap,tensor fascia lata flap or compound tissue flap were used to repair 136 cases with soft tissue defects in the firearm wound Results All 136 cases with soft tissue defects were repaired successfully Conclusions Microsurgical technique is a good method to repair soft tissue defects and reconstruct function in the firearm wound

0.05).Conclusions The serum concentration of C_3 rises and the titer of AChRAb decreases in MG patients after treatment with glucocorticoid. There is no correlation between C_3 concentration and titer of AChRAb. The complement possibly cooperates with AChRAb in pathogenesis of MG.

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) on the expression of glial fibrillary acidic protein (GFAP) and OX-42 in hippocampus and dentate gyrus in rats.Methods The rats were treated with 1 Hz, 100 mT TMS 10 min once a day for 14 days, and then the expression of GFAP and OX-42 in hippocampus and dentate gyrus were investigated by ABC technique of immunohistochemistry.Results Compared with the control group, there were no significant difference in the expression of GFAP and OX-42 between the two groups.Conclusion rTMS using our parameters does not cause brain injury in rats.

Objective To study the expressions of S100B and glial fibrillary acidic protein(GFAP) in the central nervous system of Sprague-Dawley rats during postnatal development. Methods Twenty-four male SD rats were divided equally into four groups according to different postnatal times:7-day group,14-day group,21-day group and adult group.Immunohistochemistry was used to investigate the expressions of S100B protein and GFAP in the brain and the spinal cord. Results The amount and density of S100B positive astrocytes decreased significantly in frontal cortex,hippocampus,striatum,substantia nigra and spinal cord during postnatal development.It seemed that the second through the third week after birth was a critical period for these changes.The amount and density of GFAP positive AST increased gradually in the brain,but it was the opposite in the spinal cord.Double-labeled immunofluorescence of S100B and GFAP in hippocampus CA1 area showed that S100B positive stains were evenly distributed in the pyramidal,polymorphic and molecular layers from the seventh till the twenty first day after birth,but apparently decreased in each layer especially in the molecular layer in adult hippocampus while the immunoreactivities of GFAP increased.The proportion of double labeled cells also increased with the aging and more of them were found in the pyramidal and polymorphic layers.Conclusion Different patterns of the expressions of S100B and GFAP exist during postnatal development.It may reflect the different roles of these proteins on the glial cell development.And it may also indicate that the expressions of S100B and GFAP are regulated by different mechanisms during the course of development,which reflects the differentiation of subpopulations of astrocytes during ontogenesis.

Objective To investigate expression of Fos protein in rat brains following restraint stress. Methods The experimental rats were restrained in a small plastic tub for,1,3 and 6 hours,and were sacrificed at 30 min after removing restraint.Immunohistochemical ABC method was used to observe distribution of Fos protein-like immunoreactive(-LI)products in rats brain.Results Fos-LI neurons appeared in (1)Frontal brain:the cingulum,cortex(especially in third and fifth layer),lateral septal nucleus,central amygdaloid nucleus.(2)Diencephalon:the thalamic paraventricular nucleus,lateral geniculate body and medial genicular body,hypothalamic paraventricular nucleus,supraoptic nucleus,periventricular area of third ventricle,arcuate nucleus.(3)Brain stem:the superficial layer of superior colliculus,periaqueductal gray,cortical area of inferior colliculus,lateral parabrachial nucleus,locus coeruleus,A5 area,cochlear nuclei,medullary viceral zone in medulla oblongata.The expression of Fos-LI neurons peaked in rats restrained for 1h,at 3h,then began to decrease,at 6h,significantly decreased. Conclusion Fos-LI neurons appeared in many areas of brain induced with restraint stress.The number of Fos-LI neurons decreased following restraint time.