Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Objective:To reduce the risk of the supply chain stability caused by the complex relationship among hospitals,Supply Processing Distribution(SPD)service providers and suppliers under the background of the integrated management mode of medical materials in public hospitals.Methods:The game relationship among hospitals,SPD service providers and suppliers was systematically discussed by constructing evolutionary game model and system dynamics method.Results:With the efforts of hospital supervision,supplier integrity and SPD service providers,the three parties will reach a stable equilibrium state.Conclusion:It provides some ideas for the collaborative development of hospitals,SPD service providers and suppliers under the SPD supply chain management model.

Opioids are the main treatment drugs for the patients with moderate and severe cancer pain,and methadone is one of opioid drugs. Compared with the other opioids, methadone has the advantages of low cost, high oral bioavailability and better effect on neuropathic pain. However, methadone also shows such disadvantages as prolonged QT interval and large individual variance in pharmacokinetics. Although the safety of methadone has no difference from the other opioids in the treatment of cancer pain,the lack of knowledge and experience still limits its clinical application. This article aimed to summarize the clinical application of methadone in cancer patients,so as to help clinicians understand and apply methadone better.

Objective:To investigate the risk factors of systolic dysfunction early complicated in patients with isolated traumatic brain injury (iTBI) and to evaluate the influence of complicated systolic dysfunction on the prognosis of iTBI patients.Methods:From January 2017 to October 2018, 123 patients with moderate or severe iTBI admitted to Trauma Centre in our hospital were included in the study, and patients with previous cardiovascular diseases were excluded. Left ventricular systolic function was assessed by transthoracic echocardiography within 24 h after admission. The patients were divided into normal systolic function group ( n=100) and systolic dysfunction group ( n=23) according to the results of echocardiography. Data were collected from all patients on admission, including GCS score, systolic blood pressure, heart rate, high-sensitivity cardiac troponin T (hs-cTnT), clinical treatment variables (use of sedative drugs, vasoactive drugs, etc.), craniotomy or not and clinical outcomes (survival or death) during hospitalization. Logistic regression analysis was used to analyze the related factors for iTBI patients complicated with systolic dysfunction, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each index for iTBI patients complicated with cardiac insufficiency. Results:The systolic blood pressure (147.3±23.3) mmHg, the heart rate (96.1±26.3) beats/min and the hs-cTnT level (16.48±8.17) pg/mL in the systolic dysfunction group were higher than those in the normal systolic function group on admission (all P<0.05); and the GCS score in the systolic dysfunction group was lower than that in the normal systolic function group ( P<0.05). Logistic regression analysis showed that the heart rate ( OR=1.129, 95% CI: 1.001-1.516; P=0.038), the GCS score ( OR=0.640, 95% CI: 0.445-0.920; P=0.016) and the hs-cTnT level ( OR=1.054, 95% CI: 1.009-1.101; P=0.002) on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The area under the ROC curve (AUC) of the hs-cTnT levelon admission was the largest (AUC=0.863, P<0.01). The in-hospital mortality of patients in the systolic dysfunction group was higher than that of patients in the normal systolic function group (52.5% vs 22%, P=0.004). Conclusions:The heart rate, the GCS score and the serum hs-cTnT level on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The hs-cTnT level could better predict the occurrence of cardiac systolic dysfuncion, and higher in-hospital mortality was found in iTBI patients complicated with systolic dysfunction. Therefore, early detection and timely intervention may improve the prognosis of these patients.