RESUMEN

Objective:To investigate the current situation of medical equipment allocation in 103 tertiary public hospitals,analyze and compare the proportion of medical equipment in different regional hospitals in our country,and provide basis for scientific and reasonable allocation of medical equipment.Methods:A questionnaire was designed by literature research and expert consultation,and an electronic questionnaire was released through the public account of"China Medical Equipment"and the platform of"Good Medical Workers"to analyze the correlation between the number of medical equipment configuration,the proportion of domestic products,the region where the hospital was located and the number of hospital beds.Results:A total of 103 valid questionnaires were collected,involving 103 tertiary public hospitals in East China,North China,Central China,South China,Southwest,Northwest and Northeast China,of which 18%were in North China,37%were in East China and 9%were in South China.In North China,South China and East China,the average number of medical equipment in the tertiary public hospitals in the region was 9785 units per hospital,9245 units per hospital and 8153 units per hospital,and the number of the expensive equipment was relatively small,which had no correlation with the number of beds.There were statistically significant differences between North China and East China in the number of beds,the number of pieces of equipment per 100 beds and the amount of equipment per 100 beds(t=-2.582,2.939,4.653,P＜0.05).The number of life support equipment configuration was significantly positively correlated with the number of beds,and the domestic share,especially the domestic share of life support equipment,increased.Conclusion:The analysis of medical equipment allocation in public hospitals in China can provide data support for hospitals to better adapt to the adjustment of the new expensive medical equipment catalogue,provide reference for the demonstration and promotion of large medical equipment allocation and localization in tertiary hospitals,and provide reference for relevant health management departments.

RESUMEN

Objective To investigate the effect of different radiation doses on the accuracy of iodine quantification and CT value of virtual monochromatic image with a muti-spectral CT iodine phantom using second-generation dual-layer detector spectral CT(DLCT).Methods The second-generation DLCT scan abdominal phantom was used,which consisted of six different concentrations of iodine rods at 4,8 and 12 g/L.The scan parameters were set at 100,120 and 140 kVp tube voltages,and six radiation exposure sequences were scanned at each tube voltage:5,10,15,20,25 and 30 mGy.Measure the iodine concentration value and the CT value at the single level of 50,70 and 100 keV,and calculate the absolute error value of iodine concentration and CT value under different radiation exposure.SPSS 22.0 software single factor analysis of variance was used to compare the difference between the io-dine concentration and the absolute error of CT value under different Radiation exposure,and LSD method was used to compare the two groups.Results The absolute error of CT value of 4 g/L iodine rod with 10～30 mGy scanning at 100 keV energy level was significantly higher than that of 12 g/L and 8 g/L(P＜0.05),and the absolute error of iodine concentration measurement of other iodine rods with different concentrations at different Radiation exposure had no statistical difference.Conclusions The second-generation double-layer detector spectral CT has high meas-urement stability for iodine concentration quantification and CT value accuracy under conditions of radiation dose greater than 5 mGy.

RESUMEN

Objective:To explore application value of improving quality of the low dose pancreatic CT images by using deep learning reconstruction (DLR).Methods:From August to December 2020, 68 patients who underwent contrast-enhanced pancreatic CT were prospectively collected in Peking Union Medical College Hospital. All patients were randomly divided into routine dose group (34 patients, with tube voltage of 120 kV) and low dose group (34 patients, with tube voltage of 100 kV). All patients underwent non-contrast, arterial phase, parenchymal phase and delay phase scans. The four-phase images of low dose group were reconstructed by using filtered back projection (FBP), hybrid iterative reconstruction (AIDR) and DLR which were marked with LD-FBP, LD-AIDR and LD-DLR, respectively. The four-phase images of routine dose group were reconstructed by using AIDR algorithm which were marked with RD-AIDR. The CT value, image noise (SD), signal to noise ratio (SNR) and contrast to noise ratio (CNR) of pancreas were measured. The ANOVA test was performed in comparison with objective parameters of different reconstruction algorithms, and LSD test was performed in pairwise comparison. The subjective image scores were obtained and were compared using Kruskal-Wallis test.Results:CT value, SD, SNR and CNR of non-contrast, arterial phase, parenchymal phase and delay phase had significant difference among different reconstruction images of routine dose group and low dose group (all P<0.05). The CT value of LD-FBP, LD-AIDR, and LD-DLR images were significantly higher than those of RD-AIDR images in parenchymal phase and delay phase (all P<0.05). There were statistically significant differences in each pairwise comparison of SD and SNR of four phase images (all P<0.05). There were statistically significant differences of CNR among LD-FBP, LD-DLR and RD-AIDR in four phase images (all P<0.05). The CNR of RD-AIDR was better than that of LD-FBP, and CNR of LD-DLR was better than that of RD-AIDR. DLR algorithm improved the SD, SNR and CNR of four phases of pancreatic images. The improvement of SNR was more significant after contrast enhancement, and the improvement of CNR was more significant in the non-contrast and delay phases. Subjective image scores of different reconstruction images were statistically different in four phase images (all P<0.001). Overall image scores of LD-DLR and RD-AIDR had no significant differences in four phase ( Z value of four phases were 1.00, 2.24, 0.45 and 1.34, respectively; P value of four phases were 0.317, 0.025, 0.655 and 0.180, respectively). Conclusion:The DLR technology can decrease radiation dose of pancreatic CT, improve image quality and satisfy diagnostic requirement. The DLR technology can also reduce image noise, improve the SNR and CNR in low dose contrast-enhanced pancreatic CT.

RESUMEN

OBJECTIVE：To optim ize the ultrafiltration technology of enzymatic hydrolysate from Eucommia ulmoides peel. METHODS：The single factor test was adopted to investigate the effects of molecular weight of ultrafiltration membrane ，liquid temperature，operating pressure ，operating frequency ，membrane filtration time ，liquid concentration and pH on transfer rates of aucubin，geniposide and chlorogenic acid as well as solid removal rate in enzymatic hydrolysate from E. ulmoides peel. Setting the molecular cut off of fixed ultrafiltration membrane of 100 000，liquid concentration of 7 g/L，and pH value of 7，the ultrafiltration technology was optimized by Box-Behnken design response-surface methodology and validated with liquid temperature ，operating pressure，operating frequency and membrane passing time as factors ，using comprehensive scores calculated from transfer rates of aucubin，geniposide and chlorogenic acid as well as solid removal rate as indexes. RESULTS ：The optimal ultrafiltration technology of enzymatic hydrolysate from E. ulmoides peel was as follows as liquid temperature of 35 ℃，operating pressure of 0.5 MPa，operating frequency of 35 Hz and membrane passing time of 42 min. Results of validation tests showed that the comprehensive scores of the transfer rates of aucubin ，geniposide and chlorogenic acid as well as solid removal rate in enzymatic hydrolysate from E. ulmoides peel was 78.06％（RSD＝1.43％，n＝3），and its relative error with the predicted value （77.18％） was 1.14％. CONCLUSIONS ：The optimized ultrafiltration technology is stable and reliable ，and can be used for the ultrafiltration purification of enzymatic hydrolysate from E. ulmoides peel.

RESUMEN

Objective To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy. Methods A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression. Results A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7± 3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01;OR=1.86, P=0.01;OR=1.28, P=0.01;OR=1.98, P=0.01. Conclusion During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

RESUMEN

Objective To explore the clinical value of mDIXON?Quant sequence in the quantitative evaluation of transfusion dependent patients with liver and pancreas iron deposition. Method Prospective collection of 34 transfusion dependent patients from December 2016 to May 2018 in Tianjin First Central Hospital who had not undergone iron chelation therapy was conducted in this study. According to the volume of blood transfusion,the subjects were divided into small amount of blood transfusion group (23 cases with blood transfusion of 2 000 to 5 000 ml within 3 years) and massive blood transfusion group (11 cases with blood transfusion of greater than 5 000 ml within 3 years). All patients underwent MR examinations using a Philips Ingenia 3.0 T MR scanner with multi?echo 3D?fast field echo (FFE) and 3D mDIXON?Quant protocols. For 3D multi?echo FFE images, the R2*(R2*=1/T2*) of liver and pancreas were calculated voxel by voxel. For mDIXON?Quant images,the dR2*(d R2*=1/dT2*),which was different from the R2*with 3D multi?echo FFE,was calculated within liver and pancreas voxel by voxel. Pearson correlation was performed to investigate the relationship between the R2*value and dR2*value of liver and pancreas in each group,and between the R2*(and dR2*) of liver and pancreas with the volume of blood transfusion. A paired ttest was used to compare the values of R2* and dR2* in the same patient. Results For small amount of blood transfusion group: liver and pancreas R2* and dR2* values were significantly correlated with the correlation coefficients of 0.993 and 0.962 respectively. There was no correlation between the value of liver and pancreas and the amount of blood transfusion (P>0.05). There was no significant difference in R2*and dR2*values in liver and pancreas (P>0.05). For massive blood transfusion group:when T2*was smaller than 1.8 ms, the SNR of T2*maps was lower than that of dT2*maps, and the noise seriously affects the T2*measurements. When T2*was greater than 1.8 ms:liver and pancreas R2*and dR2*values were significantly correlated with the correlation coefficients of 0.991 and 0.989 respectively. Liver R2* and dR2* value were correlated with the volume of blood transfusion with the correlation coefficients of 0.527 and 0.639 respectively. Pancreas R2* and dR2* value were correlated with the volume of blood transfusion with the correlation coefficients of 0.590 and 0.602 respectively. There was statistical difference in R2*value of liver and dR2*value in paired t test (P<0.05),but there was no significant difference in R2*value of pancreas and dR2* value of pancreas (P>0.05). Conclusions Both multi?echo 3D FFE and mDIXON?Quant sequences can be applied for the evaluation of organ iron deposition.The mDIXON?quant sequence has advantages in heavy liver and pancreatic iron quantification

RESUMEN

Objective@#To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy.@*Methods@#A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression.@*Results@#A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7±3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01; OR=1.86, P=0.01; OR=1.28, P=0.01; OR=1.98, P=0.01.@*Conclusion@#During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

RESUMEN

A valve-free continuous flow method and instrument were established,with only a multi-channel pump for delivering the sample and reagent,and without any injection or solenoid valves and sample loop for selecting and adding the sample or reagent.Nitrate was reduced to nitrite with Cu-Cd reductant column,and then detected with spectrophotometric detector.The proposed method was suitable for determination of nitrate at normal level in most of estuary and coastal seawaters.With the optimum parameters,the linear range and detection limit were 5-180 μmol/L and 0.27 μmol/L,respectively.The samples of 10 and 80 μmol/L nitrate were continually measured for 11 times,and the relative standard deviations were 1.4％ and 1.3％,respectively.The recovery of real samples at different salinity ranged between 99.4％ and 106.1％.There was no significant difference in the analytical results between the proposed method and the flow injection analysis (FIA).In comparison with FIA,the method and instrument were less cost and easy to operate,and was suitable to be applied in general laboratories and field for continuous monitoring.The method was successfully used to measure the nitrate in seawater samples in Xiamen's Western Harbor and monitor nitrate in Jiulongjiang estuary.

RESUMEN

<p><b>OBJECTIVE</b>To study postoperative anorectal dynamic change in ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection.</p><p><b>METHODS</b>Clinical and follow-up data of 26 ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection in our department from January 2007 to January 2013 were retrospectively analyzed (observation group). Thirty rectal cancer patients undergoing laparoscopic low anterior resection by the same surgical team in the same period from the Medical Record Room were randomly extracted as control group. The observation indexes included preoperative and postoperative anal resting pressure(ARP), anal maximum squeeze pressure (AMSP), rectal maximum tolerable volume (RMTV), rectal anal inhibition reflex (RAIR) and Wexner anal function scores (0 means normal).</p><p><b>RESULTS</b>There were no significant differences in clinical baseline data between the two groups(all P>0.05), except the distance from lower edge of tumor to dentate line [(2.9±0.4) cm in observation group vs. (5.0±0.5) cm in control group, P=0.000]. There were no differences in preoperative anorectal manometry and Wexner anal function score between two groups (all P>0.05). The average follow-up time in observation group and control group was 14.5 months and 14.0 months respectively. Three months after operation, significant differences between observation group and control group (all P=0.000) were as follows: defecation frequency [(6.0±1.5) times/day vs. (2.5±1.0) times/day], Wexner anal function score(5.0±0.9 vs. 2.9±1.2), ARP [(32.0±6.7) mmHg vs. (45.0±8.2) mmHg], AMSP [(90.1±6.9) mmHg vs. (110.0±7.5) mmHg], RMTV [(61.0±7.2) ml vs. (91.1±7.5) ml] and positive rate of RAIR [11.5%(3/26) vs. 66.7%(20/30)]. One year after surgery, there were no significant differences in defecation frequency, Wexner anal function scores, ARP, AMSP and RMTV between the two groups (all P>0.05), however the difference in positive rate of RAIR was still significant[38.5%(10/26) vs. 93.3%(28/30), P=0.000].</p><p><b>CONCLUSION</b>Laparoscopic intersphincteric resection for ultra- low rectal cancer can achieve satisfactory anorectal dynamic effect.</p>

Asunto(s)

RESUMEN

Objective To apply the new type exercise activity and make a guidance,to discuss the application effect of new type exercise activity in nursing of general surgery patients after abdominal surgery.Methods 120 patients with abdominal surgery were divided into the experimental group(58 cases)and the control group (62 cases )according to the mantissa of hospital number.The patients in the control group received routine nursing care.In addition,the patients in the experimental group received systematic new exercise activity.Postoperative rehabilitation progress and complications were compared between two groups.Results The recovery process of the experimental group was faster than the control group,the first time of getting out of bed,anal exsufflation time and wound healing time were shorter than those of the control group.The incidence of complications of the experimental group was lower than the control group.Conclusions The new type exercise activity can speed up the recovery process of general surgery patients after abdominal surgery and reduce the incidence of oostooerative complications.

RESUMEN

Objective To investigate the effect of sufentanil postconditioning on cardiomyocyte apoptosis during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six male Sprague-Dawley rats weighing 250-280 g were randomly divided into 3 groups ( n =12 each):sham operation group (group S),I/R group and sufentanil postconditioning group (group SP).Myocardial I/R was induced by occlusion of the left coronary artery for 30 min followed by 120 min reperfusion.Sufentanil 3.0μg/kg was injected iv at the beginning of reperfusion in group SP.HR and MAP were recorded during I/R.The rats were sacrificed at 120 min of reperfusion and their hearts were removed for determination of infarct size,number of apoptotic cardiomyocytes,and the expression of Bax mRNA and Bcl-2 mRNA,and apoptotic index was caculated.Results There was no significant difference in HR among the 3 groups ( P ＞ 0.05 ).Compared with group S,MAP and Bcl-2 mRNA expression were significantly decreased,apoptotic index and Bax mRNA expression increased in group I/R,and apoptotic index,and the expression of Bax mRNA and Bcl-2 mRNA were increased in group SP (P ＜ 0.05).Compared with group I/R,the infarct size,apoptotic index and Bax mRNA expression were decreased,and Bcl-2 mRNA expression was increased in group SP (P ＜ 0.05).Conclusion Sufentanil postconditioning can attenuate myocardial I/R injury in rats by up-regulating Bcl-2 expression,down-regulating Bax expression and inhibitting cardiomyocyte apoptosis.

RESUMEN

ObjectiveTo investigate the correlation of Skp2,p27kiP1 and p21WAF1 expression with the clinicopathological features of ovarian serous cystadenocarcinomas.Methods Expressions of Skp2 ,p27kiP1 and p21WAF1 were examined by immunohistochemical staining in 124 epithelial ovarian tumors (25 serous cystadenomas, 19 borderline serous cystadenomas, and 80 serous cystadenocarcinomas) Results(1) The expression of Skp2 in serous cystadenocarcinomas (47.5％)was significantly higher than that in borderline serous cystadenomas (0％)and serous cystadenomas (0％)(P ＜ 0.001) .The p27kiP1 expression in serous cystadenocarcinomas (35.0％) was significantly lower than that in borderline serous cystadenomas(73.7％)and serous cystadenomas (80.0％) .The p21WAF1 staining frequency in serous cystadenocarcinomas (38.8％)was significantly lower than in borderline serous cystadenomas (73.7％)and serous cystadenomas (80.0％) .(2) The Skp2 protein expression in serous cystadenocarcinomas was positively correlated with clinicopathological stage,histological differentiation degree and lymph node metastasis of the tumors.The p27kiP1, p21WAF1 protein expression in serous cystadenocarcinomas was reversely correlated with clinicopathological stage and histological differentiation degree of the tumors(Ps ＜ 0.05) .(3) The Skp2 protein expression in serous cystadenocarcinomas was reversely correlated with that of p27kiP1 , p21WAF1.Conclusion The Skp2 protein expression in serous cystadenocarcinomas was increased and positively correlated with the clinicopathological features of ovarian serous cystadenocarcinomas.Skp2 protein expression was reversely correlated with p27kip1 ,p21WAF1.Skp2 protein expression may play an important role in the development and progression of serous cystadenocarcinomas.

RESUMEN

One hundred and eighty patients of shoulder periarthritis were treated by combined traction, acupuncture, physiotherapy, Tuina and functional exercise. After 10 treatments, 133 cases were cured, 36 cases got marked effectiveness, 8 cases got effectiveness, 3 cases had no effectiveness and the total effective rate was 98.3%. Combined therapy can relieve adhesion of soft tissues induced by various causes to achieve the purpose of accelerating recovery.

RESUMEN

This paper analyzes shortcomings and insufficiencies in the moral and political instruction for college students,introduces good examples and novel concepts in the book of "55 Proposals for a Successful College Life",and points out a series of enlightenment for the improvement of the moral and political instruction by extending the function of role models of advanced individuals among college students,adapting multiple forms of instruction,stressing the combination of cross-subjects,and making the instruction content and forms closer to students' realistic conditions by.