1.The game analysis for cost management of medical consumable and stakeholder
China Medical Equipment 2017;14(2):112-114,115
Objective:To provide the scientific reference basis in order to establish a perfect cost controlled system for medical consumable. To analyze game factors, such as main resource, the price-off influence and price-off aspiration and so on, from different views, such as medical institutions, patients, manufacturers and other stakeholders and so on, based on game theory and situation of medical consumables management.Methods: To collect the management information of medical consumables cost from a tertiary referral center hospital in Fujian in recent 3 years, and adopt descriptive study to analyze the income situation of medical consumable, medical consumable proportion and medical consumable cost per capita.Results: The medical consumable proportions from 2013-2015 were 14.44%, 16.27% and 18.75%, respectively. Medical consumable cost per patient from 2013-2015 were 3547.95RMB, 4122.3 RMB and 5059.02RMB, respectively. All of these datum contained the drug information.Conclusion: It is obvious that the medical consumable proportions and medical consumable cost per patient were enhancement from 2013 to 2015. The necessity of medical consumable leaded to the direct influence on medical cost. On the other hand, the artificially high price and unreasonable implement of medical consumable are the urgent problems and must be resolved as soon as possible.
2.A discussion of informatization management of reagent used in science and research of hospital based on RCA
China Medical Equipment 2017;14(5):134-137
Objective:To provide scientific references for establishing a whole informatization management system of reagent used in science and research of hospital based on the root cause analysis (RCA). And to find existed problems and analyze main reasons from reagent management, material, time, financial, personnel and other factors through fishbone chart, and to provide relative management measurement of informatization.Methods: The reagent consumptions used in science and research of a tertiary referral center hospital in Fujian province in 2015 year were collected, and then the purchase amount and ratio of them were analyzed.Results: The purchase amount of reagent for science and research of this tertiary referral center hospital in Fujian province was more than 2.55 million RMB in 2015 year, and the ratio of national clinical key special projects was 23.32% and that of provincial clinical key special projects was 6.85%. The two items spent more purchase amount, and the type and ratio of reagent of various department was different depended on their own various developed situation.Conclusion: The informatization management and service mode of reagent used in science and research have very important role in the construction of soft power of hospital. In present, a series of disadvantages existed in various clinical and research department, for example, the use of reagents are scatter, involved professional span is larger and disperse, and accurate trace, dynamic tracking and flexible deploy machines are difficultly achieved. Therefore, how to promote comprehensive informatization management for relative resource, for optimizing structure configuration, for controlling cost and ensuring quality of reagent has became the most important task for informatization management of reagent used in science and research.
6.Influence of different plantar flexion angle on X-ray diagnosis of deltoid ligament injury
Jie YANG ; Youming ZHAO ; Shengwang WEI ; Xiang YANG ; Lin CHEN
Chinese Journal of Trauma 2011;27(10):913-918
Objective To improve the accuracy of X-ray diagnosis of the deltoid ligament injury by evaluating the influence of plantar flexion on the diagnosis.Methods Twenty-four patients with ankle supination-extemal rotation fracture which was distal fibula fracture but no medial malleolus fracture were treated from February 2010 to December 2010.All the patients were taken Mortise radiograph with the ankle in four positions of plantar flexion(0°,15°,30° and 45°)applied with rotational stress and the deltoid ligament injury was identified with MRI.The medical clear space(MCS)and the superior clear space(SCS)on each radiograph were measured.The results were tested by a one-way analysis of variance model(ANOVA),based on the following criteria:(1)the MCS≥ 4 mm and MCS > SCS,or when MCS≥5 mm and MCS >SCS.The MRI examination was taken as the gold standard to compare the influence of X-ray diagnosis of the deltoid ligament injury with different plantar flexions and different standards.Results The average MCS in four positions of plantar flexion(0°,15°,30°,and 45 °)with rotational stress were(4.10 ±0.79)mm,(4.55 ±0.72)mm,(4.99 ±0.56)mm and(5.71 ±0.86)ram,with statistical difference(P <0.05).The average SCS in four positions of plantar flexion(0°,15°,30°,and 45°)were(3.56 ±0.41)mm,(3.50 ±0.43)mm,(3.71 +0.44)mm and(3.93 ±0.51)mm,with no statistical difference in the four groups(P >0.05).With the MSC≥4 mm and MSC > SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 50.0%,66.7%,88.9% and 94.4% respectively.With the MSC≥5 mm and MSC >SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 5.6%,11.1%,38.9% and 77.8% respectively.Condusions Different plantar flexion angle is an important factor for X-ray diagnosis of deltoid ligament injury of the ankle joint.The prevalence of false-positive findings of deltoid injury increases with the increase of plantar flexion.
7.The protective effects of pretreatment with Lipo-PGE1 on fiver injury after hemorrhagic shock and resuscitation in rats
Jie LIN ; Jianying LI ; Lixin WEI ; Yuehong HUANG ; Zhixin CHEN
Chinese Journal of Emergency Medicine 2011;20(5):502-506
Objective To observe the effects and mechanism of pretreatment in rats with prostaglandin E1 on liver after hemorrhagic shock and resuscitation(HSR).Method In total,32 male SD rats were randomly(random number)divided into four groups(n=8):group A(sham group),group B(shock group),group C(HSR group)and group D(Lipo-PGEl+HSR).In group B,rats were sacrificed 90 min after shock,and in group C,rats were anesthetized and then subjected to hemorrhagic shock followed by resuscitation.In group D,rats were pretreated with Lipo-PGEI one hour before HSR.Liver function,NO and ET.1 were measured,and pathological changes of liver tissue in each group were observed,and the expres8ions of iNOS and ET.1 of liver tissue were measured by using immunohistochemistry 6 hours after HSR.Data were analyzed by analysis of variance,and P<0.05 was considered as significantly different in statitistics.Results The levels of liver iNOS and ET-I increased in HSR group compared with shock group [(O.225±0.080)vs.(0.082±0.021)and(0.292±0.047)vs.(0.082±0.035),P<0.05].Pretreatment with Lipo-PGEl markedly reduced the damage of Liver function,and lowered the levels of NO and ET-I.which were consistent with decrease in iNOS and ET-16 hours after HSR[(0.116±0.034)vs.(0.225±0.080)and(0.198±0.041)vs.(0.292±0.047),P<0.05].Conclusions Pretreatment with Lipo-PGEl could reduce liver injury after HSR.The mechanisms might be attributed to inhibiting iNOS and ET-1,regulating the balance of NO/ET-I.
8.Effects on electrical restitution of given esmolol during cardiopulmonary resuscitation in a swine ventricular fibrillation model
Jie WEI ; Jingjun Lü ; Dongdong ZHAO ; Guosheng LIN
Chinese Journal of Emergency Medicine 2010;19(3):257-263
Objective To investigate the effect on electrical restitution of β1-adrenergic receptor antagonist esmolol administered during cardiopulmonary resuscitation in the porcine ventricular fibrillation model. Method Ventricular fibrillation untreated for four minutes was induced by dynamic steady state pacing protocol in 40 healthy male pigs, in which local unipolar electrograms were recorded using one 10-electrode catheter that was sutured to the left ventrieular epicarditan. During CPR, animals were randomized into two groups to receive saline as placebo or esmolol after two standards doses of epinephrine. At postresuscitation 2-hour, six pigs were randomly selected from each group and the second VF induction was performed. Local activation-recovery intervals (ARI) restitutions and the VF inducibility between control group and esmolol group were compared. Western blotting was performed to determine cardiac ryanodine receptor (RyR2) protein expression, and their phosphorylation status. Results No sig-nificant differences were observed at the restoration of spontaneous circulation between two groups. Higher postre-suseitation 2-hour survival rate was observed in the esmolol group. Esmolol significantly flattened ARI restitution slope, lessened regional difference of ARI restitution, decreased the VF inducibility, and alleviated RyR2 hyper-phosphorylation. Conclusions Esmolol given during CPR significantly improved postresuscitation 2-hour survival rate. Its effects on modulating electrical restitution property and intracellular calcium handling make up the most important reasons why β1-blockade significantly reduced the onset and maintenance of VF.
9.Effect of Ginkgo biloba extract on serum DMT1, grp75 and neurological function in patients with Parkinson disease
Fei WEI ; Jie SHUAI ; Lin SHEN ; Zili GONG ; Saiyu CHENG
Chinese Journal of Biochemical Pharmaceutics 2015;(8):72-74
Objective To investigate the effect of Ginkgo biloba extract on serum divalent metal transporter1 ( DMT1 ) , glucose regulated protein 75(grp75) and nerve function in patients with Parkinson disease.Methods 38 cases of patients loith parkinson disease according to different drugs were divided into experimental group and control group, 19 cases in each group.Control group was treated with levodopa and Benserazide tablet, experimental group on the basis of control group, was given Ginkgo biloba extract tablets, treatment for 4 weeks.After treatment, DMT1, grp75 and cognitive function of all patients in substantia nigra were detected.ResuIts Compared with before treatment, two groups of patients with lower DMT1 level (P<0.05), compared with control group, experimental group of patients with lower DMT1 levels (P<0.05).Compared with pre-treatment, two groups of patients grp75 level was higher (P<0.05), compared with control group, experimental group after treatment grp75 level was higher (P<0.05).Compared with before treatment, the two groups of patients with MoCA scores were higher (P<0.05), HAMD scores were lower (P<0.05).Compared with control group, experimental group after treatment MoCA scores were higher (P<0.05), HAMD scores were lower (P<0.05).ConcIusion Ginkgo biloba extract can significantly reduce the level of DMT1 in the substantia nigra of Parkinson patients, increase the level of grp75, and improve the cognitive function.
10.Preliminary Study on Traditional Chinese Medicine Treatment Characteristics of Intestinal Cancer based on Scale-free Network Analysis Method
Liyuan LYU ; Jie LIU ; Wei HOU ; Meiying ZHANG ; Hongsheng LIN
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(6):1252-1255
This article was aimed to study the characteristics of intestinal cancer by traditional Chinese medicine (TCM) based on the scale-free network analysis method. History information of 145 hospitalized cases from 2008 to 2011 was collected from the Oncology Department, Guang A nmen Hospital, in the clinical collection system. The rule of medication in the treatment of intestinal cancer by TCM was explored by scale-free network analysis method from several aspects, such as effects, classification and compatibility relations. The analysis results of 145 intestinal cancer cases showed that strengthening the body resistance was the main treatment principle. Si-Jun-Zi (SJZ) decoc-tion was used with the highest frequency. In the prescription design, qi-supplementing herbs were the most. The heat-clearing, dampness-eliminating, qi-regulating, blood-activating and stasis-removing, food stagnation removing and phlegm-removing herbs were also used frequently. The TCM treatment and syndrome differentiation will be changed due to the treatment and disease stages. It was concluded that scale-free network analysis method is able to relatively show the TCM treatment rule of intestinal cancer quantificationally and intuitively.