Objective To compare the safety,effectiveness and affordability of robotic-assisted thoracic surgery and video-assisted thoracic surgery in the treatment of malignant pulmonary tumors,and provide ref-erences for the management of selection of different surgical strategies for malignant pulmonary tumors in hospitals and medical insurance departments.Methods The medical records homepages and information sys-tem data of patients with malignant pulmonary tumors who underwent major thoracic surgery in this hospital and discharged from January 1 to December 31,2022 were obtained.The patients were divided into the robotic-assistedthoracic surgery group and video-assisted thoracic surgery group according to the surgical methodolo-gies.After performing propensity score matching (PSM),no statistically significant difference was observed in baseline data between the two groups (117 cases in each group).Then the indicators of safety,effectiveness and affordability were compared between the two groups.Results Concerning the safety,the postoperative in-cision infection rate in the robotic-assisted thoracic surgery group was significantly lower than that in the vide-o-assisted thoracic surgery group (P<0.05),and the amount of intraoperative blood loss and postoperative complication rate were not significantly different between the two groups (P>0.05).Regarding the effective-ness,the average surgical duration in the robotic-assisted thoracic surgery group was appreciably shorter than that in the video-assisted thoracic surgery group (P<0.05),no patient in the two groups was converted to open thoracotomy,and there was no statistically significant difference in the average length of hospital stay and postoperative hospital stay between the two groups (P>0.05).With regard to the affordability,the aver-age inpatient expenditure per case and average daily inpatient expenditure per case in the robotic-assisted tho-racic surgery group were significantly higher than those in the video-assisted thoracic surgery group (P<0.05),and there were disparities in the cost structure between the two procedures.The medical cost,adminis-tration cost and consumables cost in the robotic-assisted thoracic surgery group were significantly higher than those in the video-assisted thoracic surgery group (P<0.05).The cost of medical technology in the robotic-assisted thoracic surgery group was significantly lower than that in the video-assisted thoracic surgery group (P<0.05).Conclusion Physicians should comprehensively consider the clinical efficacy and cost burden of patients when selecting the robotic-assisted thoracic surgery or the video-assisted thoracic surgery,and the monitoring and evaluation of the utilization of clinical robotic-assisted thoracic surgery should be strength-ened.

OBJECTIVE To explore the construction of a new scientific management model for temporary drug purchase，and to provide a reference for hospitals to improve the level of rational drug use. METHODS Guided by clinical diagnosis and treatment needs and patient medication safety， our hospital carried out the whole process management practice of temporarily purchased drugs by optimizing the review process， creating a review team， formulating pre-audit and post follow-up evaluation standards based on comprehensive drug evaluation， and evaluated the practice effect through the number of temporary purchase applications， implementation rate， drug structure optimization and other indicators. RESULTS Since January 2021， our hospital had implemented a new mode of temporary drug purchase management. By December 2022， clinical pharmacists had reviewed 111 temporary drug procurement applications， effectively intercepted 13 irrational drug use applications （11.71%）， reduced the overall implementation rate of temporary drug procurement by 8.36%，and proposed five batches of drug structure optimization suggestions； 24 drugs were successively introduced such as camrelizumab，sorafenib，busulfan. After optimizing the management mode，the number of temporary drug procurement applications decreased by more than half from 133 in 2019 and 138 in 2020 to 66 in 2021 and 45 in 2022. CONCLUSIONS The model is helpful to optimize the hospital drug catalog， strengthen rational drug use，ensure the safety of patients’ drug use， and fully reflects the professional value of clinical pharmacists in hospital pharmacy management and rational drug use.

OBJECTIVE To explor e the effect of clinical pharmacists participatin g in fine management of pharmaceutical affairs among the inpatients in the department of gastroenterology based on diagnosis related groups （DRG）data. METHODS The discharged patients in the gastroenterology department of our hospital were selected as the research objects to compare the changes of DRG indicators and hospitalization related indicators before （from April to December 2019）and after （from April to December 2020 and from April to December 2021） pharmacists participating in fine management of pharmaceutical affairs in the gastroenterology department. The key DRG with the highest number of enrolled cases and DRG cases of the total cost overrun were analyzed to explore the deviation of various costs. The rationality of drug use was evaluated for the cases in each DRG that exceeded the benchmark hospital payment standard by three times ，with the help of prescription doctor ’s advice review. RESULTS In the first year of intervention ，the case combination index value of gastroenterology department was increased ，meanwhile，the cost consumption index ，time consumption index and average hospital stay were decreased significantly （P＜0.01）. In the second year of intervention ，total weight of the cases in gastroenterology department was increased ，while cost consumption index ，time consumption index ，hospitalization cost per time ，drug cost per time and average hospital stay were all decreased significantly ， compared with before intervention （P＜0.01）. Among the top five DRG ，the drug cost per time in the GZ 15，GZ13 and GJ 15 were all decreased significantly in the first year of intervention ；hospitalization cost per time and drug cost per time in the GZ 15，GZ13， GJ15 and GJ 13 were all decreased significantly in the second year of intervention （P＜0.01）；after the intervention of clinical pharmacists in DRG over-expenditure cases ，the over-expenditure rate decreased significantly （P＜0.001）. CONCLUSIONS The fine management of pharmaceutical affairs in our hospital has achieved certain results and promotes the rationality of clinical drug use，and provides a new entry point for the cost control and utilization of medical institutions under the background of 〔2020〕68号） DRG.

OBJECTIVE To investigate the effectiveness of clinical pharmacists’ participation in the refined pharmaceutical management for inpatients of oncology center based on diagnosis related groups （DRG）.　METHODS Patients who entered DRG and stayed in hospital for less than 60 days in oncology center of Daping Hospital， Army Medical University were selected as the research objects to analyze the changes of DRG indicators and related hospitalization indicators before the intervention of clinical pharmacists’ participation in the refined pharmaceutical management （Jan.-Dec. 2019）， the first year after the intervention （Jan.- Dec. 2020）， and the second year after the intervention （Jan.-Dec. 2021）； the key DRG groups were selected from the oncology center according to DRG enrollment and disease diagnosis and treatment methods， and related hospitalization indicators before and after the intervention and rational drug use after intervention were analyzed.　RESULTS Compared with before intervention， in the first and second years after the intervention， the number of DRG groups increased to 157 and 184， and the case mix index increased significantly （P＜0.05）， while costconsumption index， time consumption index， average hospital stay and average hospitalization expense per time were decreased or shortened significantly （P＜0.05）； drug cost per time was increased significantly （P＜0.05）， and there were no low- risk deaths and severe adverse drug reactions. Among the 4 key DRG groups， the average hospital stay in RE19 disease group and RU29 disease group in the first and second year after intervention and those of RU14 disease group in the first year after intervention were significantly lower than before （P＜0.05）； the average hospitalization expense per time of RE19 disease group in the first and second year after intervention and those of RU14 disease group， RV19 disease group and RU29 disease group in the second year after intervention were significantly lower than before （P＜0.05）； drug cost per time of RU14 disease group in the second year after intervention was significantly lower than before， while those of RE19 disease group and RU29 disease group in the first and second year after intervention were significantly higher than before （P＜0.05）. There was some irrational drug use in the DRG disease groups with a significant increase in the drug cost per time after the intervention， such as inappropriate selection of drugs， inappropriate usage and dosage， off-label drug use， etc.　CONCLUSIONS In the context of DRG， after the clinical pharmacists participated in the refined pharmaceutical management， the overall diagnosis and treatment service capacity of oncology center are improved， the efficiency of diagnosis and treatment are improved， and there are no low-risk deaths and severe adverse drug reactions， which promote the management of rational drug use in medical institutions.