医院医疗器械维修中存在的问题及维修管理对策研究

近几年来,随着科学技术的发展和医院规模的扩大,社会对医疗技术要求不断提高,因此,高端医疗器械和新型医疗设备需求加大,医疗器械管理与维修也需跟进。医疗器械的正常使用在医疗工作中有着举足轻重的作用,可提高医疗人员的工作效率,提升临床诊治的水平,但其在改善医疗条件的同时也存在一系列的问题,若无法保质和及时维修医疗器械,对正常医疗设备的使用具有严重影响,延误患者的就诊与治疗。目前医院医疗器械维修中存在的维修人员整体素质偏低、管理机制不健全、维修技术落后、医疗器械维修人员不足、缺乏积极性及再学习的机会、医疗器械缺乏定期保养和管理等实际问题,导致医疗器械维修效率低,本文就以上问题展开讨论,旨在为医院维修管理的制定提供参考。     

浅谈设备维修人员的应急能力

先进的医疗仪器是现代化医院的重要组成部分,及时做好医疗仪器的维修工作是充分发挥医疗仪器作用的保证。医疗仪器维修质量的高低,直接影响到仪器完好率和使用率,也是医院医疗工作正常运转的保证。随着中国现代化建设不断发展,一些县级医院医疗设备不断增添和更新,各种高、精、尖技术进口设备应用到临床,伴随而来的维修人员队伍也越来越大。这些年来实践证明,维修人员在对支持临床医疗工作中起着重要的作用,但由于维修技术队伍素质差,技术水平低,难以适应换代产品的技术进展。目前医疗设备进入以电脑芯片控制为重要模式的大规模集成电路时代,而我们的维修人员多数仍停留在晶体管时代,个别的处于电工水平,从技术发展阶段来看,已落后一个时代,不能发挥应有的作用。从全局来看,在新技术日新月异的今天,我们设备维修人员面临如何提高技术素质的迫切任务。因此现在完全有必要提出加强“应急能力”的训练。     

当代医院大型医疗设备维修存在问题与对策探析

目的:探讨医院大型医疗设备在维修过程中所暴露的问题,并提出相应的解决对策。方法:选取我院2012年4月至2013年4月间采购及正常使用的大型医疗设备60台,通过观察和探讨设备维修中的问题,提出对应的问题解决方案。结果:大型医疗设备在维修过程中面临资金匮乏、技术陈旧等突出问题,要通过制度完善、人才培养、技术改造及定期维修等方面加以努力解决。结论:大型医疗设备尽管存在的问题较多,但均是可控的,医院要积极重视设备维修中的问题,确保使用安全、可靠。     

基于设备劣化预防的可靠性维修模式探讨

本文通过对设备维修管理的探索,形成适合企业设备特点的可靠性维修模式,把设备保养体系、点检管理、设备状态检测、寿命周期管理、故障缺陷管理及设备信息化分析应用等流程进行有效集成,实施主动维修、预测维修和预防维修,取得了良好效果。     

影像设备电路板测试与故障诊断之系统实现

大型医学影像设备是医院中的贵重设备,其中不少进口设备的维护修理的技术难度较高,医院每年花费在医学影像设备上的维护修理费是非常之大。本文从建立国内的维修力量着眼,研讨医学影像设备维修方法。     

大型进口工程设备维修探讨

进口大型工程设备使用率和寿命很大程度上取决于维修质量的好坏。文章分析了我国进口大型设备仪器使用维修现状,有针对性地提出了一些维修办法,并立足国产化技术,对维修备件的国产化进行了有益的实践。     

数字减影血管造影设备的维护与维修

数字减影血管造影设备是大型医学影像仪器,在临床诊断及治疗发挥着重要的作用。因此,及时的维护和规范的保养是降低设备故障,减少维修成本,提高工作效率的关键。本文对我院数字减影血管造影设备的保养工作展开回顾,分析临床工作中常见的设备故障,并总结实用的维护、保养方法,为有效利用设备资源提供参考。     

高频高压发生器逆变电路的控制方法

高频高压发生器是X线设备的核心部件之一。根据西班牙SEDECAL、美国QUANTUM、日本SHIMADZU与加拿大CPI四大公司生产的高频高压发生器的高压主回路逆变电路,结合高频高压发生器主电路的结构,分析了串联谐振逆变电路的各种控制方式及特点。它将为该类设备的维修、维护提供相应的技术指导。     

心电监护仪故障维修及养护

心电监护设备是现代医学必不可缺的仪器设备,是科技在医疗实践中的具体应用,是每个医院必须具备的硬件设施,尤其是相关科室的重症监护室更是不能缺少心电监护仪的。正确地维修及有效的养护能延长使用寿命,提高临床对心电监护仪的使用效率。本文旨在对现代心电监护仪的故障维修及心电监护仪的养护综述如下。     

长沙市八方科学仪器有限公司

长沙市八方科学仪器有限公司创立于2006年,公司主要从事各类进口、国产分析检测仪器设备、生物制药、医疗、环保、教学、生命科学、机械、科研等仪器的销售,并提供技术咨询、用户培训、维修和进出口代理等业务。     

Trends in forest condition,threats and conservation action as derived from participatory monitoring in coastal Kenya

The coastal forests of Kenya are conservation priorities hosting high levels of biodiversity. Monitoring of biodiversity in these forests is therefore necessary to understand and reverse negative trends in good time. Using the Important Bird Area (IBA) monitoring framework, a participatory approach, state (habitat condition), pressure (threats) and response (conservation action) indicators of twelve coastal Kenya forest IBAs were assessed from 2004 to 2011. Trends for these indicators were assessed at six sites for which sufficient data existed: Arabuko‐Sokoke, Dakatcha Woodlands, Gede Ruins, Lower Tana River, Shimba Hills and Taita Hills, and baselines were described for remaining six. Changes were always small, but state deteriorated in Gede, Lower Tana and Shimba Hills, remained the same (unfavourable) in Arabuko‐Sokoke and Dakatcha, and improved in Taita Hills. Pressure reduced in Arabuko‐Sokoke, Dakatcha and Taita Hills, deteriorated in Lower Tana and Shimba Hills and remained the same (medium) in Gede. Response improved in Dakatcha, remained the same (medium) in Shimba Hills, and deteriorated in the rest. As there was an apparent overall deterioration in the forests assessed, improved management of the protected sites and increased conservation action through community engagement around protected areas and within the nonprotected IBAs are recommended.     

Extracellular pressure stimulates colon cancer cell proliferation via a mechanism requiring PKC and tyrosine kinase signals

Pressure in colonic tumours may increase during constipation, obstruction or peri-operatively. Pressure enhances colonocyte adhesion by a c-Src- and actin-cytoskeleton-dependent PKC-independent pathway. We hypothesized that pressure activates mitogenic signals. METHODS: Malignant colonocytes on a collagen I matrix were subjected to 15 mmHg pressure. ERK, p38, c-Src and Akt phosphorylation and PKCalpha redistribution were assessed by western blot after 30 min and PKC activation by ELISA. Cells were counted after 24 h and after inhibition of each signal, tyrosine phosphorylation or actin depolymerization. RESULTS: Pressure time-dependently increased SW620 and HCT-116 cell counts on collagen or fibronectin (P < 0.01). Pressure increased the SW620 S-phase fraction from 28 +/- 1 to 47 +/- 1% (P = 0.0002). Pressure activated p38, ERK, and c-Src (P < 0.05 each) but not Akt/PKB. Pressure decreased cytosolic PKC activity, and translocated PKCalpha to a membrane fraction. Blockade of p38, ERK, c-Src or PI-3-K or actin depolymerization did not inhibit pressure-stimulated proliferation. However, global tyrosine kinase blockade (genistein) and PKC blockade (calphostin C) negated pressure-induced proliferation. CONCLUSIONS: Extracellular pressure stimulates cell proliferation and activates several signals. However, the mitogenic effect of pressure requires only tyrosine kinase and PKCalpha activation. Pressure may modulate colon cancer growth and implantation by two distinct pathways, one stimulating proliferation and the other promoting adhesion.     

食用菌调味品造粒工艺研究

应用压力成型法、搅拌法和沸腾法对食用菌调味品进行造粒,并对制成的颗粒的成型率、颗粒外观、粒度分布、吸湿性和流动性等有关指标进行评价和比较。结果表明,造粒后颗粒成型率达到90%以上,临界相对湿度达到53%以上,比粉状原料防潮性能更强。压力成型法所制颗粒的成型率、吸湿性和流动性均为最好,在3种造粒方法中最适于食用菌调味品的造粒生产。     

2009年雅安市食源性病原菌监测分析

目的了解雅安市食品中污染的食源性疾病中的重要致病菌,积累监测数据。方法按照《全国食源性致病菌监测2009年度工作手册》,检测10大类食品中的大肠菌群、沙门菌、金黄色葡萄球菌、单核增生李斯特菌、大肠菌群O157和副溶血性弧菌。结果果汁、凉拌蔬菜和蔬菜沙拉大肠菌群的检出率为60%、100%和100%;生畜肉、生食水产品和皮蛋中沙门菌的检出率为10%、20%和3.3%;未检出金黄色葡萄球菌、单核增生李斯特菌、大肠埃希菌O157和副溶血性弧菌。结论通过对食源性疾病的基础监测,加强食品安全,为雅安市防治食源性疾病提供科学依据。     

鸡生化基因位点检测方法的建立及在SPF鸡群中的应用

目的建立鸡生化标记检测方法,用于SPF鸡群的遗传学检测。方法参照国家标准《实验动物近交系小鼠、大鼠生化标记检测方法》,应用乙酸纤维素板,建立SPF鸡生化标记位点的检测方法。结果共有7种同工酶可以用于鸡的生化检测,其中血红蛋白-β链(Hbb)的检测组织为溶血素,转铁蛋白酶(Trf)的检测组织为肺脏,碳酸酐酶-2(Car2)的检测组织为肝脏或溶血素,异柠檬酸脱氢酶-1(Idh1)、苹果酸酶-1(Mod1)、碱性磷酸酶-1(Akp1)检测组织为肾脏,酯酶-1(Es1)检测组织为血清。结论建立了鸡生化标记检测方法,并对BWEL-SPF鸡群和Line-22鸡群进行了分析,发现都存在多态性。     

植物体内水分长距离运输的生理生态学机制

植物体内长距离水分运输是植物生理生态学研究中的一个重要问题,长期为植物生理学家和生理生态学家所关注。木质部探针技术的问世,掀起了近年来植物生理学界最为激烈的一场争论。提出了已经有100多年,风行40年的内聚力-张力(Cohesion-Tension, C-T)学说受到质疑。随后维护派和质疑派围绕木质部探针技术、压力室技术(C-T理论的主要支撑实验技术)的可靠性展开辩论。进一步从物理学原理和各种实验上就C-T理论的3个支柱(木质部导管或管胞中巨大的张力、沿树高的压力梯度、连续水柱)进行争论。这场争论似暂告一段落,C-T理论没有被推翻,但仍留有问题期待以后的研究。     

Adaptation of the "Dynamic Method" for measuring the specific respiration rate in oxygen transfer systems through diffusion membrane

Monitoring the specific respiration rate (Q(O2)) is a valuable tool to evaluate cell growth and physiology. However, for low Q(O2) values the accuracy may depend on the measurement methodology, as it is the case in animal cell culture. The widely used "Dynamic Method" imposes serious difficulties concerning oxygen transfer cancellation, especially through membrane oxygenation. This paper presents an improved procedure to this method, through an automated control of the gas inlet composition that can minimize the residual oxygen transfer driving force during the Q(O2) measurement phase. The improved technique was applied to animal cell cultivation, particularly three recombinant S2 (Drosophila melanogaster) insect cell lines grown in a membrane aeration bioreactor. The average measurements of the proposed method reached 98% of stationary liquid phase balance method, taken as a reference, compared to 21% when the traditional method was used. Furthermore, this methodology does not require knowledge of the volumetric transfer coefficient k(L)a, which may vary during growth.     

Three-dimensional computational model of left heart diastolic function with fluid-structure interaction

Aided by advancements in computer speed and modeling techniques, computational modeling of cardiac function has continued to develop over the past twenty years. The goal of the current study was to develop a computational model that provides blood-tissue interaction under physiologic flow conditions, and apply it to a thin-walled model of the left heart. To accomplish this goal, the Immersed Boundary Method was used to study the interaction of the tissue and blood in response to fluid forces and changes in tissue pathophysiology. The fluid mass and momentum conservation equations were solved using Patankar's Semi-Implicit Method for Pressure Linked Equations (SIMPLE). A left heart model was developed to examine diastolic function, and consisted of the left ventricle, left atrium, and pulmonary flow. The input functions for the model included the pulmonary driving pressure and time-dependent relationship for changes in chamber tissue properties during the simulation. The results obtained from the left heart model were compared to clinically observed diastolic flow conditions for validation. The inflow velocities through the mitral valve corresponded with clinical values (E-wave = 74.4 cm/s, A-wave = 43 cm/s, and E/A = 1.73). The pressure traces for the atrium and ventricle, and the appearance of the ventricular flow fields throughout filling, agreed with those observed in the heart. In addition, the atrial flow fields could be observed in this model and showed the conduit and pump functions that current theory suggests. The ability to examine atrial function in the present model is something not described previously in computational simulations of cardiac function.     

Differential Release of Dopamine by Nitric Oxide in Subregions of Rat Caudate Putamen Slices

Abstract: Fast cyclic voltammetry was used to measure NO and dopamine (DA) simultaneously in rat caudate putamen (CPu) slices. Analysis of electrochemical signals obtained from mixtures of DA and NO showed that subtraction of either the DA or the NO component revealed the contribution of the other component. Application of such data manipulation to signals obtained in CPu slices indicated that DA and NO components contributed to electrochemical signals. Following electrical stimulation (>1 s), site-dependent NO-like signals were observed. Pressure ejection of NMDA yielded a biphasic electrochemical signal. The first phase (lasting 10–20 s) had electrochemical characteristics of DA and was observed only during the first application of NMDA. The second phase developed more slowly, was of longer duration (1–3 min), and had electrochemical characteristics of a mixture of DA and NO. Generation of the NO-like signal by NMDA was antagonised by l - N -monomethylarginine. Pressure ejection of NO into CPu slices caused dose- and site-dependent DA release. More DA was released in the dorsolateral than in the dorsomedial CPu. Pressure ejection of DA did not generate NO. It is concluded that electrically stimulated DA release is not mediated by prior release of NO.