Objective:To construct an evaluation index system of internal control medical equipment based on the internal control theory of The Committee of Sponsoring Organizations of the Treadway Commission(COSO)and combined with the current situation of medical equipment internal management in public hospitals,so as to provide reference and suggestions for the evaluation of internal control of medical equipment in public hospitals.Methods:Through literature research and expert consultation,the evaluation index system of internal control of medical equipment was preliminarily determined.Using the Delphi method,15 experts from 1 medical college and 3 tertiary hospitals in Beijing who were engaged in the use and management of medical equipment were selected to conduct two rounds of consultation on the evaluation index system of internal control of medical equipment,and the evaluation indicators were scored and screened.The analytic hierarchy process(AHP)was used to determine the index weights,and the internal control evaluation index system of medical equipment in public hospitals based on COSO was constructed.Results:The coefficient of the two rounds of expert consultation was 100%.The authority degree of consulting experts was 0.867.Finally,the evaluation index system of internal control of medical equipment in tertiary public hospitals was formed,which included 5 first-level indicators,17 second-level indicators and 50 third-level indicators.Conclusion:The evaluation index of internal control of medical equipment in public hospitals based on COSO has high expert enthusiasm,authority and coordination.The evaluation index system includes the unit level and the business level of internal control,with a wide coverage,which makes up for the limitations of traditional internal evaluation of medical equipment,which can make up for the limitations of the internal evaluation of traditional medical equipment,improve the internal control system of medical equipment in public hospitals,and optimize the medical equipment management system.

Objective:To construct an effectiveness evaluation model of internal control of medical equipment in public hospitals based on fuzzy analytic network process(F-ANP),and to improve the level of internal control management of medical equipment in hospitals.Methods:Through literature research and analysis,based on the internal control theory system of The Committee of Sponsoring Organizations of the Treadway Commission(COSO),combined with the characteristics of medical equipment management in public hospitals,the effectiveness evaluation model of internal control of medical equipment in public hospitals was established by F-ANP,which was combining analytic network process(ANP)and fuzzy comprehensive evaluation.An empirical analysis was carried out on the internal control of medical equipment in Beijing Friendship Hospital,Capital Medical University.Results:The index system for model evaluation included 5 first-level indicators of control environment,risk evaluation,control activities,information exchange,and supervision mechanism,17 second-level indicators,and 50 third-level indicators.The model was used to evaluate the effectiveness of internal control of medical equipment in the hospital,its maximum membership value was 0.133 7,and the result was"relatively effective",indicating that the construction and implementation of internal control of medical equipment in the hospital were relatively perfect,while the management of scrapping of medical equipment,cost control and equipment informatization construction still need to be improved.Conclusion:The effectiveness evaluation model of internal control of medical equipment of public hospitals based on F-ANP can provide certain reference value for evaluation of the effectiveness of internal control of medical equipment in public hospitals,which is conducive to standardizing internal control of medical equipment,promoting the fine management of medical equipment and ensuring the safety of medical equipment assets.

Objcetive: To explore the treatment of long segment defect of tibia by using tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap. Methods: From February 2012 to August 2017, The People′s Hospital of Zun Yi City Bo Zhou District treated 16 patients who had long segment defect of tibia.There were 11 males and 5 females, age from 22 to 58 years old, the average age was 42 years old. Iliac flap grafting with tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle was used to treat the defect of long segment of tibia. There were 4 cases with simple tibial defect and 12 cases with skin defect. The longest tibial defect was 5-8 cm. Results: In this study, four patients used iliac flaps with deep circumflex iliac pedicle, the area of flaps ranged from 2.5 cm×5.0 cm to 5.0 cm×10.0 cm, while the area of iliac flaps ranged from 5.0 cm×2.5 cm to 8.0 cm×4.0 cm. Twelve patients used grafting with tensor fascia lata combined with iliac flap, the area of flaps ranged from 5.0 cm×12.0 cm to 12.0 cm×23.0 cm, while the area of iliac flaps ranged from 7.0 cm×2.0 cm to 8.0 cm×4.0 cm. All 16 cases of bone flap were survived, fracture healing, without surgical complications. The average follow-up period was 1.5 years, the flaps had good appearance in 10 cases and was slightly bloated in 6 cases; the ankle had normal motion in 14 cases and had poor dorsal extension in 2 cases. X-ray films showed that the bone flap repaired the bone defects and reached bone healing. Conclusions Vascularized tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap grafts increase local blood supply and accelerate the process of fracture healing.