Antigenicity of the HCV HVR1 Peptide Analyzed by Computer Modeling

It is important to develop the HCV vaccines in China, be cause 11% 14% of patients with acute and choric hepati tis in this country are infected by HCV, and most of themare infected with Ⅱ/1b and Ⅲ/2a[1]. There are evi dences to indicate that a high variable region 1 (HVR1)exists in the terminal of E2 protein and contains some lin ear epitopes of B cells. Anti HCV antibodies can protectthe sensitive cells from infection by HCV[2 4]. We in tended to get some evidences for designing so…     

Technology evaluation in a US hospital: The role of clinical engineering

Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, containment of cost, and an increased access to the healthcare system. Hospitals have been allocating a, significant portion of their resources to procuring and managing capital assets; they are continously faced with demands for new medical equipment and are, asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programmes that need pertinent information and methods for new equipment planning as well as for reduction in the ownership costs of existing equipment. Clinical engineers can identify new medical equipment, review their institution's technological position, develop equipment-selection criteria, supervise installations and monitor postprocurement performance to meet their hospital's programme's objectives. This programme, together with cost accounting analysis, will objectively guide the capital assets decisionmaking process. The result of systematic planning and execution, the programme will assure the lowest life-cycle costs at the best performance. The clinical engineer's skills and expertise are needed to facilitate the adoption of an objective methodology for implementing the programme, thus improving the match between the hospital's needs and budget projections, equipment performance and cost of ownership.     

Cardiorespiratory and thermal effects of wearing gas protective clothing

Summary Six healthy men aged 25 to 37 walked on a treadmill at work levels of 21 and 41% of their for 25 to 30 min wearing gas protective clothing (GPC) consisting of an impermeable suit with a self-contained breathing apparatus (total weight 25 kg) or shorts (control tests, CT) in a temperate environment (t _a 24.3°C ± 1.0°C, rh 30–50%). When the GPC was worn at 21 and 41% , the most prominent increases, compared with the CT, were noted in the heart rate ( ± SE, 120 ± 5 vs 76 ± 3 beats min^–1 and 171 ± 5 vs 103 ± 3 beats min^–1), mean skin temperature (36.1 ± 0.2 vs 31.3° C ± 0.1°C and 36.9 ± 0.3 vs 30.9°C ± 0.4°C) and sweat rate (473 ± 51 vs 70 ± 23 g m^–2 h^–1 and 766 ± 81 vs 135 ± 18 g m^–2 h^–1) indicating a high cardiovascular and thermoregulatory strain, which was not decreased by ventilating the suit with an air flow of 281 min^–1 at 41% . The ventilation, oxygen consumption and production of carbon dioxide increased in relation to the extra weight of the GPC, partly dependent on the dynamic work level. It was concluded that the increase in the physiological load caused by the GPC was so high that the work-rest regimens, workers' level of physical fitness, cardiovascular health and heat tolerance should be considered whenever gas protective clothing is used.     

信息化管理平台用于医疗设备采购管理的意义及实践

目的:研究信息化管理平台用于医疗设备采购管理的意义及实践效果。方法:以2019年3月~2020年3月本院使用常规管理方法采购的31件次医疗设备为对照组,以2020年4月~2021年4月本院使用信息化管理平台采购的35件次医疗设备为实验组。比较两组设备采购时间(统计、挑选、谈判、到货、验收、付款)、采购情况(供应商数量、平均价格)、采购问题总出现率(不符合统计采购量、账单信息不全、设备资质不统一、采购合同有误、到货进度缓慢、验收核对失误、货款支付超时、采购流程混乱)。结果:实验组统计、挑选、谈判、到货、验收、付款时间、平均价格和不符合统计采购量、账单信息不全、设备资质不统一、采购合同有误、到货进度缓慢、验收核对失误、货款支付超时、采购流程混乱问题总出现率均显著低于对照组(P<0.05);实验组供应商数量显著多于对照组(P<0.05)。结论:使用信息化管理平台管理医疗设备采购可有效缩短采购所需时间,降低采购花费金额,且减少采购过程中问题出现率。     

Musculoskeletal injury survivors’ resiliency: A systematic review

BackgroundMusculoskeletal traumas are on the rise in the United States; however, limited studies are available to help trauma providers assess and treat concerns beyond the physical impact. Little is understood about the psychological, social, and spiritual factors that protect patients from adverse effects after a physical trauma or their experiences with each factor afterward.ObjectiveThis systematic review was conducted to investigate and review advancements in research related to risk and resiliency factors experienced by survivors of traumatic musculoskeletal injuries. The use of biopsychosocial-spiritual (BPS–S) framework and resiliency theory guided the analysis.MethodsResearchers reviewed 1003 articles, but only seven met the search criteria. Due to the complexity and uniqueness of traumatic brain injuries, studies on that target population were excluded.ResultsOf the seven articles reviewed, three identified psychological protective factors that protect against negative health outcomes; three identified negative psychological, social, or spiritual outcomes; and none investigated social or spiritual health.ConclusionsThere are significant gaps in the literature surrounding risk and resiliency factors related to the BPS-S health of musculoskeletal injury survivors.     

Particle Filtration Efficiency Testing of Sterilization Wrap Masks

ObjectivesNon-traditional materials are used for mask construction to address personal protective equipment shortages during the coronavirus disease 2019 (COVID-19) pandemic. Reusable masks made from surgical sterilization wrap represent such an innovative approach with social media frequently referring to them as “N95 alternatives.” This material was tested for particle filtration efficiency and breathability to clarify what role they might have in infection prevention and control.MethodsA heavyweight, double layer sterilization wrap was tested when new and after 2, 4, 6, and 10 autoclave sterilizing cycles and compared with an approved N95 respirator and a surgical mask via testing procedures using a sodium chloride aerosol for N95 efficiency testing similar to 42 CFR 84.181. Pressure testing to indicate breathability was also conducted.ResultsThe particle filtration efficiency for the sterilization wrap ranged between 58% to 66%, with similar performance when new and after sterilizing cycles. The N95 respirator and surgical mask performed at 95% and 68% respectively. Pressure drops for the sterilization wrap, N95 and surgical mask were 10.4 mmH₂O, 5.9 mmH₂O, and 5.1 mmH₂O, respectively, well below the National Institute for Occupational Safety and Health limits of 35 mmH₂O during initial inhalation and 25 mmH₂O during initial exhalation.ConclusionsThe sterilization wrap’s particle filtration efficiency is much lower than a N95 respirator, but falls within the range of a surgical mask, with acceptable breathability. Performance testing of non-traditional mask materials is crucial to determine potential protection efficacy and for correcting misinterpretation propagated through popular media.     

医学装备物资溯源管理系统持续评估与改进的效果分析

目的:研究医学装备物资溯源管理系统持续评估与改进的效果。方法:选取医院151名设备使用管理相关人员,按照医学装备管理方法的不同将其分为观察组(74名)和对照组(77名),观察组采用医学装备物资溯源管理系统的管理模式,对照组采用传统设备管理模式。采用自制满意度调查问卷的方法,调查两组对医学装备管理的满意度,对比分析两组对医学装备管理的中长期效果评价、运营绩效和管理满意度。结果:观察组医学装备管理的中期优良率为91.89%,长期优良率为94.59%,明显高于对照组的79.22%和81.82%,差异有统计学意义(x~2=6.495,x~2=7.837;P<0.05);观察组医学装备管理的满意度为95.95%,明显高于对照组的83.12%,差异有统计学意义(x~2=8.784,P<0.05);观察组平均操作时间、无关操作时间和差错流程数均低于对照组,差异有统计学意义(t=16.620,t=31.638,t=15.745;P<0.05)。结论:医学装备物资溯源管理系统对医学装备管理的中长期效果显著,能够缩短管理操作时间、减少差错流程、提高管理水平和保护患者权益,可实现医学装备全生命周期的信息化管理。     

层次分析法在确定医疗设备维护优先级中的应用研究

目的:运用层次分析法(AHP)确定医疗设备维护中的优先级,增加医疗设备的可用性并降低维护成本。方法:采用AHP对医疗设备标准、子标准和等级进行评定获取其关键评分,基于多标准决策方法确定医疗设备维护的优先级,对选定设备进行评估,以准分子激光器和视力计为例,根据其标准权重、子标准权重和强度计算其总评分,确定维护优先级。结果:医疗设备维护的优先顺序由医疗设备评分的评估结果决定,医疗设备风险是医学技术人员在确定医疗设备维护优先级时的最重要标准。准分子激光器和视力计的关键评分权重分别为0.877和0.373,准分子激光器相比视力计在设备维护方面具有更高的优先级。结论:医疗设备维护优先级评估模型能确定医疗设备维护优先级,根据优先级规模规划医疗设备维护方案,以使资源更多地集中于具有高和中关键度的医疗设备。     

从在用医疗设备存在的电气安全风险谈其质量控制

根据四川省医疗器械检测中心从2015年~2019年对四川省内94家医院所使用的245台医疗设备进行抽验的结果,探讨目前在用医疗设备潜在的电气安全风险,并针对这些风险提出如何进行医疗设备质量控制的建议。     

彩超设备的故障维修与维护保养

由于应用十分频繁以及工作人员应用不当等多种原因,医用彩超设备在应用的过程中经常会出现各种各样的故障与风险,对医疗工作的正常开展形成了十分严重影响。文章就医用彩超设备的故障维修以及维护保养做出探究,以望参考。