1.A preliminary study on cerebral vasospasm patients with traumatic subarachnoid hemorrhage
Chuanjian TU ; Jiansheng LIU ; Dagang SONG ; Gang ZHENG ; Haiming LUO
Chinese Journal of Emergency Medicine 2010;19(8):862-864
Objective To analyze the incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage(t-SAH), time windows of CVS as well as the risk factors. Method A total of 98 patients,with t -SAH admitted from June 2007 to December 2008, were enrolled for this prospective study. The hemodynamics of middle cerebral artery (MCA) in these patients was monitored with trancranial Doppler (TCD) daily for 7 days after admission and on the 14th day of hospital stay. The incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage (t-SAH) ,time windows of CVS as well as the risk factors were analyzed. Results Of them, 41 patients (41.8%) had CVS. The flow velocity of MCA in patients with GCS≤ 8 was significantly higher than that in patients with GCS≥9. Classified by t-SAH cumulative blood Hijdra method, 2(4.44%) of 45 patients(45.9%)with scores 6 or less,9 (29.0%)of 31 patients (37.8%) with scores 6~ 13,and 8 (36.4%) of 22 patients (20.0%)with scores 13 or more had CVS. Severe CVS occurred in 13 (35. 1% )of 37 surgical patients (37.8%), and local cerebral infarction occurred in four surgical patients after symptomatic treatment. The flow velocity of the MCA was significantly higher in surgical patients than that in non-surgical patients 3 days after admission. Conclusions The severity of original trauma, bleeding, location of t-SAH and operation are the major risk factors to lead to CVS in patients with t-SAH. Attention should he paid to those risk factors during the treatment of patients with t-SAH.
2.Research on hospital operation efficiency in China based on three-stage data envelopment analysis
Guangliang CHEN ; Chuanjian LUO
Chinese Journal of Hospital Administration 2022;38(11):836-841
Objective:To analyze the operation efficiency of hospitals in 31 provinces in China from 2009 to 2019 based on the three-stage data envelopmeni analysis(DEA) model, for references to improve the operation efficiency of hospitals in China and promote the high-quality development of public hospitals.Methods:The data came from such sources as China health statistics yearbook and China general hospital ranking list of Fudan university.The number of hospitals, health technicians and beds in 31 provinces of China from 2009 to 2019 were used as input indicators, while that of hospital patients, discharged patients, hospitalized patients, reputational scoring of superior specialties and academic scoring of scientific research were used as output indicators.Government health expenditure, per capita GDP, population density and the proportion of tertiary hospitals were used as environmental variables.The three-stage DEA model was used to calculate the hospital operation efficiency and scale reward.Results:The environmental variables affected the operation efficiency of hospitals in China( P<0.05). After removing the impact, the average of comprehensive efficiency, pure technical efficiency and scale efficiency of hospitals in 31 provinces from 2009 to 2019 were 0.703, 0.961 and 0.726, respectively.Among them, the scale benefit of hospitals in 4 provinces remained unchanged, while those in 26 provinces increased progressively and 1 province decreased progressively. Conclusions:Pure technical efficiency could be the main factor to improve the operation efficiency of hospitals in China, while the low scale efficiency will affect the improvement of the operation efficiency of hospitals.The scale efficiency of hospitals in most provinces had great room for improvement.In order to improve the overall hospital operation efficiency in China, the authors suggested to expand hospital scale based on the precondition of quality, promote balanced distribution of high-quality medical resources, and play the positive role of the social, economic and environment variables.
3.Development and preliminary application of the information monitoring system for radiological protection
Xiao LUO ; Mengxue LI ; Chuanjian WANG ; Baojun QIAO ; Yu ZHAO ; Zaiyun ZHU ; Yuan LI ; Jun DENG ; Quanfu SUN
Chinese Journal of Radiological Medicine and Protection 2022;42(7):538-543
Objective:To develop an information system for testing radiological protection that can interface with National Radiation Health Information Platform/Medical Radiation Monitoring Subsystem and to improve the testing efficiency.Methods:Complying with the relevant national regulations and standards, the analysis was carried out of demand investigation and system modeling. An information system for testing radiological protection was established using B/S architecture, comprising three modules such as testing, audit and system management. The users at four levels were set of administrator, inspector, auditor and report issuer.Results:Based on test result, the developed information system has been shown to realize the informatization of the whole process from filling, auditing, issuing, issuing of the testing report to data uploading, with improved testing efficiency.Conclusions:The developed information system for testing radiological protection can improve the testing efficiency, and can be successfully interfaced with the National Radiation Health Information Platform/Medical Radiation Protection Monitoring Subsystem.