Objective:To discuss and set up indicator system of medical equipment procurement bidding, propose the evaluation methods which based on Fuzzy synthesis and confirm the most appropriate bidder for improving the management level of hospital in medical equipment purchase. Methods: From the bidder's ability to compete and innovation ability and financial standing and development potential and corporate credibility, five aspects to determine the evaluation index. Establish evaluation index system, the application of fuzzy comprehensive method to analyze the bid scheme offered by the tender.Results: According to the maximum subordinate principle, the evaluation value of the bidder is 0.28, the evaluation value of the B tender is 0.32, the value of the bid quotient is 0.23. Comparison of the comprehensive evaluation of the bid evaluation of the tender score of three, B the highest bid quotient, choose B tender bid.Conclusion:Facing different bidders, in the case of each of the advantages and making program quantification, conducting analysis of fuzzy synthetic method can realize the reasonable choice for medical equipment suppliers.

Objective To evaluate the effect of combination treatment by psychological intervention and a new atypical antipsychotic Paliperidone extended-release tablets(paliperidone ER)on first-episode schizophrenic out-patients.Methods All 62 patients diagnosed as first-episode schizophrenia by DSM-Ⅳ were randomly allocated into,combination treatment group and control group,for a 12-month treatment study.The combination treatment group was treated by paliperidone ER once a day and psychological counseling once a month,while the control group was treated only by paliperidone ER.The efficacy and social function were assessed by Positive and Negative Syndrome Scale(PANSS)and Personal and Social Performance Scale(PSP)individually at baseline,and following 1,3,6,9,12 months.The remission rate was calculated at the end of the 3rd,6th,9th month.The safety and tolerability were assessed using Barnes Akathisia Scale(BARS),extrapyramidal side effects scale(SAS)and involuntary movement scale(AIMS).Results Twenty-seven patients of combination treatment group and seventeen patients of the control group completed the trial with the discontinuation rate 12.9% and 45.2%,respectively.The difference between the above two groups was statistically significant(P＜0.05).The mean total score of PANSS and the PSP of the both groups were significantly improved(P＜0.05)after treatment.PANSS total score reduced more than 30% compared with baseline,and PSP total score increased more than 7.The remission rate of combination treatment group was 74.2%,51.6% and 67.7% at the end of 3rd,6th,and 9th month,which was better than the control group(45.2%,38.7% and 38.7%)(P＜0.05).Both incidence and types of adverse events were almost same between the two groups.The major adverse events were extrapyramidal symptoms,tachycardia,gastrointestinal discomfort and akathisia.Conclusion Paliperidone ER treatment combined with psychological intervention on first-episode schizophrenia out-patients can improve their treatment compliance by reducing the discontinuation rate.And this combination treatment can increase the remission rate and improve social functioning of the patients.

Objective To compare the application values and setup errors between vacuum bag plus body mask and customized alpha cradle duringproton and carbon therapy using Siemens 6D robotic couch in prostate cancer patients.Methods Nineteen patients received vacuum bag plus body mask setup were allocated into the vacuum bag group andl9 patients with alpha cradle were assigned into the alpha cradle group.Orthogonal X-ray portals were performed to verify the treatment position before beam delivery in every fraction.The couch correction between the portal and reference DRR through manual image registration was recorded as setup errors in 6 directions including the lateral,supine-inferior,anterior-posterior,yaws,roll and pitch,respectively.Two-tail t-test was used to analyze the setup error data from each direction between two groups.Results In total,452 and 436 sets of data errors were collected from the vacuum bag and alpha cradle groups.The average setup errors and standard deviation in the vacuum bag and alpha cradle groups in the lateral,supine-inferior,anterior-posterior,yaws,roll and pitch directions were (0.63±0.48) cm vs.(0.33±0.24) cm (P=0.000),(0.40±0.3) cm vs.(0.31±0.25) cm (P=0.000),(0.69±0.61) cm vs.(0.82±0.69) cm (P=0.006),0.65°±0.47°vs 0.32°±0.25°(P=0.000),1.05°±0.95°vs 1.16°±0.94° (P=0.100) and 0.67°±0.56°vs 0.40°±0.36° (P=0.000),respectively.The maximum setup errors were detected in the pitch direction for both groups.Conclusions During the proton and carbon therapy using Siemens 6D robotic couch,two setup methods using vacuum bag plus body mask and customized alpha cradle should be selected according to the individual conditions of patients.A customized foot fixer should be utilized to reduce the uncertainty in the femoral head region.

Objective To evaluate the effect of labor analgesia on maternal and neonatal outcomes. Methods The medical records of mature puerperas with singleton pregnancy from October 2018 to April 2019 at the General Hospital of Ningxia Medical University were retrospectively reviewed. Puerperas were divided into non-labor analgesia group ( NLA) and labor analgesia group ( LA) according to whether or not puerperas received labor analgesia. Maternal and neonatal outcomes were analyzed. Maternal outcomes in-cluded delivery mode, complications, intrapartum hemorrhage and blood loss at 24 h after birth, duration of the second stage of labor and prolongation, episiotomy and length of hospital stay after birth. Neonatal outcomes included Apgar score at 1, 5 and 10 min after birth, cases of Apgar score＜7 at 5 min after birth, and the proportion and reason of transfer to pediatrics unit. Results A total of 839 puerperas were includ-ed, with 551 cases in NLA group and 288 cases in LA group. Compared with NLA group, the second stage of labor was significantly prolonged ( P＜0. 01) , and no significant change was found in the other maternal or neonatal outcomes in LA group ( P＞0. 05) . Conclusion Labor analgesia can prolong the second stage of labor and exerts no effect on the neonatal outcomes.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.