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.
5.Eleven cases of drug-induced arsenic poisoning.
Da-wei LIN ; Yan-jie PENG ; Chen-yun YANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2005;23(3):227-227
Adult
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Aged
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Arsenic Poisoning
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drug therapy
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etiology
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Drugs, Chinese Herbal
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adverse effects
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Female
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Humans
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Male
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Middle Aged
6.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.
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.Postoperative early stress response alleviated by celiac plexus block after partial hepatectomy in rats
Xiaohong WEI ; Lu LIN ; Jun LI ; Jie NIU ; Xiaoyan LIU
Journal of Regional Anatomy and Operative Surgery 2017;26(2):79-82
Objective To investigate the effects of neurolytic celiac plexus block(NCPB) on stress response during the early stage of partial hepatectomy(PH) postoperation in rats.Methods Thirty healthy SPF-grade male Sprague-Dawley rats were randomly divided into control group and NCPB group,and then were constructed the 70% PH model.NCPB group received NCPB with 0.5 % lidocaine before closing abdominal,and control group received the same procedures,but 0.9% physiological saline was injected instead of 0.5 % lidocaine.The serum concentration of CRP,GC,ACTH,NA and AD,and the levels of serum TNF-α and IL-1β were determined at 6 hours,12 hours and 24 hours after PH.The western blot assay was performed to examine the expression of GR in the peripheral blood mononuclear cells (PBMCs).Results The obvious stress response was produced within 24 hours after PH in rats,postoperative serum CRP,GC,ACTH,NA and AD concentrations increased in the different extent,but the NCPB group were significantly lower than those in the control group in the corresponding time point (P <0.01 or P <0.05).The expression levels of GR in PBMCs in the control group were significantly decreased after PH,and markedly lower than those in the NCPB group in the corresponding time point(P < 0.01).The serum TNF-o and IL-1β levels were gradually increased in the control group and NCPB group within 24 hours after PH.But at the respective time points,the levels in the NCPB group were significantly lower than those in control group(P < 0.01 or P < 0.05).Conclusion Intraoperation NCPB can effectively inhibit postoperative stress response at the early stage after PH,and thereby help to reduce the degree of systemic inflammatory response.
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.A meta-analysis of diagnostic value of gene detection for spontaneous bacterial peritonitis
Wei ZHU ; Jing LIN ; Wenfeng YE ; Jie LIU ; Juanjun HUANG
Chinese Journal of Infectious Diseases 2015;(10):621-626
Objective To systematically assess the diagnostic value of gene detection for spontaneous bacterial peritonitis (SBP) .Methods A literature search was performed in the database of PubMed ,Web of Science ,Cochrane Library and China National Knowledge Internet (CNKI) from databases establishing to March 2015 .Relevant studies on diagnostic value of gene detection for SBP were retrieved .Quality assessment of diagnostic accuracy studies (QUADAS ) was applied for the included studies .Meta-analysis was conducted using bivariate random effects model .Summary receiver operator characteristic curves (SROC) was conducted to calculate area under curve (AUC) and was compared using Z test .Results Five studies with 423 specimen involved were included in the meta-analysis .The pooled sensitivity ,specificity ,diagnostic odds ratio (DOR) ,positive likelihood ratio and negative likelihood ratio of gene detection for the diagnosis of SBP were 0 .56 (95% CI:0 .49 -0 .62) ,0 .88 (95% CI:0 .83 -0 .92 ) ,9 .94 (95% C I:1 .76-56 .27 ) ,4 .35 (95% C I:1 .05 -18 .10 ) and 0 .47 (95% C I:0 .25 -0 .88 ) , respectively .The pooled sensitivity was significantly higher than that of bacterial culture (0 .25[95% CI:0 .19-0 .31]) .The AUC of SROC of gene detection was 0 .810 9 ,which was significantly higher than that of bacterial culture (AUC=0 .659 8 ,Z=3 .14 ,P<0 .01) .Subgroup analysis was conducted in patients with polymorphonuclear neutrophils (PMN)≥250 × 106/L in ascites .All the diagnostic indices of gene detection were inferior to those of bacterial culture for SBP ,except for the sensitivity of gene detection for SBP (0 .64[95% CI:0 .53 -0 .74] vs 0 .39[95% CI:0 .29 -0 .51]) .The diagnostic value of quantitative polymerase chain reaction (qPCR) detection for SBP was inferior to that of bacterial culture in all the aspects except for the sensitivity (0 .54 [95% CI:0 .47 -0 .61 ] vs 0 .25 [95% CI:0 .19 -0 .31 ]) . Conclusions Gene detection shows higher sensitivity than bacterial culture .The diagnostic value of gene detection is influenced by diagnostic standards .qPCR also shows high sensitivity for SBP diagnosis ,while the diagnostic value was inferior to bacterial culture .More researches with high quality are required to validate the results of this study .