Objective:To establish a quantitative evaluation system for medical equipment procurement and to explore its application value in the allocation and management of hospital assets.Methods:Based on theoretical research and on-site evaluation,an evaluation index system was developed from four levels of clinical demand,technical level,procurement process and service capabilities.The quantitative evaluation of the procurement process was conducted by using covariance-analytic hierarchy process(Cov-AHP),and a"6-stage"optimization process of medical equipment procurement was developed.A total of 257 sets of medical equipment purchased by Beijing Shunyi Hospital from August 2019 to July 2023 were selected,and the expert demonstration model(126 units)and the quantitative evaluation model(131 units)were used for medical equipment asset allocation management.The standardization of the medical equipment procurement process,effectiveness of performance objectives and satisfaction of clinical services of medical equipment procurement under different management methods were compared.Results:The standardization degrees of the procurement process of the medical equipment in the quantitative evaluation model in terms of startup,demonstration,implementation,installation and use stages were(98.42±2.83)%,(98.97±2.45)%,(96.24±3.87)%,(96.42±2.54)% and(94.82±5.31)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.741,4.385,6.551,7.620,4.563,P<0.05).The achievement rates of quality index,progress index,social benefit index and cost-benefit index of medical equipment procurement in the quantitative evaluation model were(96.15±4.08)%,(96.41±2.37)%,(92.77±3.89)% and(93.06±4.33)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=4.156,4.562,5.014,4.069,P<0.05).The clinical satisfaction scores of medical equipment users of medical equipment in the quantitative evaluation model for large medical equipment,life support and first aid equipment,laboratory testing equipment,surgical treatment equipment and other medical equipment were(90.24±1.89)points,(93.45±2.64)points,(95.67±3.64)points and(93.82±2.55)points and(97.25±3.89)points,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.678,4.079,2.845,3.628,5.023,P<0.05).Conclusion:The quantitative evaluation system can standardize the procurement process of medical equipment,improve the achievement rate of the performance target of medical equipment procurement,and improve the clinical service level of medical equipment.

Background::The diagnosis of epilepsy in a child often and understandably causes psychological adjustment difficulties in the parents. To help parents of children with epilepsy cope with stress, it is important to understand how parents cope with the sickness of their child. The objective of this study was to assess factors related to the state of anxiety and depression among parents of children with epilepsy.Methods::The present study was a cross-sectional study, and the data were collected through an anonymous, Internet-based survey platform between October 2018 and October 2019 from 250 participants aged 22-65 years. Participants were invited to fill questionnaires include socioeconomic questionnaire, anxiety, depression, and coping strategies scale.Result::Among the parents of children with epilepsy, 48.8% (122/250) had depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score >4) and 46.4% (116/250) had anxiety symptoms (7-item Generalized Anxiety Disorder [GAD-7] score >5). Depression among parents of children with epilepsy was significantly associated with comorbidity (odds ratio [OR] = 0.392, 95% CI = 0.182-0.846), a poor parental relationship (OR = 0.283, 95% CI = 0.130-0.614), positive coping (OR = 0.947, 95% CI = 0.903-0.992), and negative coping (OR = 1.287, 95% CI = 1.179-1.405). Anxiety among parents of children with epilepsy was significantly associated with a poor parental relationship (OR = 0.416, 95% CI = 0.207-0.835) and negative coping (OR = 1.155, 95% CI = 1.087-1.228).Conclusions::The present study indicates the importance of couple support and providing effective coping to make parents of children with epilepsy more resilient in the presence of negative life events, especially for parents of children with comorbidity with cognitive deficiency.

Background::The diagnosis of epilepsy in a child often and understandably causes psychological adjustment difficulties in the parents. To help parents of children with epilepsy cope with stress, it is important to understand how parents cope with the sickness of their child. The objective of this study was to assess factors related to the state of anxiety and depression among parents of children with epilepsy.Methods::The present study was a cross-sectional study, and the data were collected through an anonymous, Internet-based survey platform between October 2018 and October 2019 from 250 participants aged 22-65 years. Participants were invited to fill questionnaires include socioeconomic questionnaire, anxiety, depression, and coping strategies scale.Result::Among the parents of children with epilepsy, 48.8% (122/250) had depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score >4) and 46.4% (116/250) had anxiety symptoms (7-item Generalized Anxiety Disorder [GAD-7] score >5). Depression among parents of children with epilepsy was significantly associated with comorbidity (odds ratio [OR] = 0.392, 95% CI = 0.182-0.846), a poor parental relationship (OR = 0.283, 95% CI = 0.130-0.614), positive coping (OR = 0.947, 95% CI = 0.903-0.992), and negative coping (OR = 1.287, 95% CI = 1.179-1.405). Anxiety among parents of children with epilepsy was significantly associated with a poor parental relationship (OR = 0.416, 95% CI = 0.207-0.835) and negative coping (OR = 1.155, 95% CI = 1.087-1.228).Conclusions::The present study indicates the importance of couple support and providing effective coping to make parents of children with epilepsy more resilient in the presence of negative life events, especially for parents of children with comorbidity with cognitive deficiency.

OBJECTIVE：To study the current status and influencing factors of medication compliance in children with tic disorder（TD），and to provide reference for improving medication compliance in TD children. METHODS：The questionnaire was designed according to the protection motivation theory. The cross-sectional study was adopted to conduct questionnaire survey among TD children in West China Second Hospital of Sichuan University from Jan. 2018 to Dec. 2019. The structural equation model was established according to the theoretical assumptions，and the maximum likelihood method was used to estimate the model；multiple linear regression analysis was carried out for the factors with significant influence in the single factor analysis，and path analysis and intermediary effect test were carried out. RESULTS：A total of 317 patients with TD were included，the mean age was（8.38±2.54）years，and the mean course of disease was（3.19±2.46）years. Average medication compliance scores was （5.70±1.69），among which 15.1％ was low compliance，37.5％ moderate compliance，and 47.3％ high compliance. Multivariate linear regression analysis showed that comorbidities（β＝0.124，SE＝0.167，P＝0.011），education level of the main guardian（β＝ 0.236，SE＝0.110，P＜0.001），quality of life（β＝0.399，SE＝0.112，P＜0.001）and the types of drugs taken（β＝0.166，SE＝ 0.047，P＝0.001）were the factors affecting medication compliance of children with TD. Structural equation model analysis showed that severity（β＝0.295，95％CI：0.103-0.493），external return（β＝0.830，95％CI：0.662-1.002），self-efficacy（β＝0.200，95％CI： 0.057-0.353），susceptibility（β＝0.220，95％CI：0.084-0.352）and quality of life（β＝0.353，95％CI：0.211-0.500）had a direct positive impact on medication compliance. Quality of life mediated between external returns and compliance variables（intermediary effect accounted for 13.9％ of the total effect value）. CONCLUSIONS：Children with TD have low medication compliance. It is recommended that pediatricians in medical institutions at all levels to manage the medication compliance of patients with TD from the severity，susceptibility，external returns and self-efficacy，so as to improve patients and guardians’awareness of the severity and susceptibility of disease and medication non-adherence，weaken external returns and increase self-efficacy，and ultimately improve medication compliance of patients

OBJECTIVE：To compa re the effectiveness and safety of three regimens of tiapride ，clonidine and tiapride combined with clonidine in the treatment of tic disorder （TD）in children. METHODS ：A sequential collection of 312 children with TD from the outpatient department of West China Second Hospital of Sichuan University were conducted during Jan.-Dec. 2019. They were divided into clonidine group ，tiapride group ，tiapride combined with clo nidine group ，with 104 cases in each group. Tiapride group was given Tiapride hydrochloride tablets with initial dose of 50-100 mg per day ，and the dose was gradually increased to 150-500 mg per day according to tolerance and clinical experience. Clonidine group was given Clonidine transdermal patches ，once a week ，with initial dose of 1 mg each week ，maintenance dose of 1-2 mg each week ，once a week. Tiapride combined with clonidine group was given Tiapride hydrochloride tablets （same usage and dosage as tiapride group ）+ Clonidine transdermal patches （same usage and dosage as clonidine group ）. The treatment course of 3 groups was 3 months. After the treatment ，they were followed up every 3 months（the following were expressed as 24，36 and 48 weeks after treatment ）. Yale global tie severity scale （YGTSS）scores of 3 groups were observed before treatment ，after 4，8，12，24，36，48 weeks of treatment，and the occurrence of ADR was recorded at different follow up time points. RESULTS ：Before treatment ，there was no statistical significance in YGTSS scores among 3 groups（P＞0.05）. After 4，8，12，24，36 and 48 weeks of treatment ，YGTSS scores of 3 groups were significantly lower than those before treatment （P＜0.05）. After 4，8 and 12 weeks of treatment ，YGTSS scores of tiapride combined with clonidine group were significantly lower than tiapride group and clonidine group （P＜0.05），while there was no statistical significance between tiapride group and clonidine group （P＞0.05）. At 24 weeks of treatment ，YGTSS score of children in tiopride combined with clonidine group was significantly lower than tiopride group （P＜0.05），but there were no significant differences between tiopride combined with clonidine group and tiopride group ，and between tiopride group and clonidine group （P＞0.05）. After 36 and 48 weeks of treatment ，there was no significant difference in YGTSS scores among 3 groups（P＞0.05）. After 12 weeks of treatment ，the results of P value corrected by Bonferroni method showed that YGTSS score of tiopride combined with clonidine group was significantly lower than those of tiopride group and clonidine group （P＜0.016 7）， while there was no statistical significance in the difference between tiopride group and clonidine group （P＞0.016 7）. There was no statistically significant difference in the total incidence of ADR among 3 groups（P＞0.05）. CONCLUSIONS ：Clonidine，tiapride and tiapride combined with clonidine can significantly improve the tic symptoms of TD children with good safety .

OBJECTIVE： To systematically evaluate the efficacy and safety of Clonidine tansdermal patch for child tic disorders in children， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Medline， Embase， Cochrane library， CNKI， VIP， CBM and Wanfang database， randomized controlled trials （RCTs） about Clonidine tansdermal patch （trial group） versus other therapies （control group， including placebo group， thiopride group， haloperidol group） for child tic disorders were collected from datbase estallishment to July 2018. The literatures met inclusion criteria were summarized. After quality evaluation with Cochrane system evaluation manual 5.1.0， Meta-analysis of reduction rate （amount） of YGTSS， the incidence of ADR and response rate was performed by using Rev Man 5.3 statistical software. Descriptive analysis was performed on indicators of groups that were unable to perform Meta-analysis. RESULTS： A total of 8 RCTs involving 1 320 patients were included. Among them， 2 RCTs involved placebo in control group； 2 RCTs involved thiopride， 3 RCTs involved haloperidol， and 1 RCT involved thiopride and haloperidol. Results of Meta-analysis showed that reduction rate of YGTSS in trial group were significantly higher than haloperidol group [MD＝21.94， 95％CI（21.03， 22.86）， P＜0.001]， but there was no statistical significance compared with thiopride group [MD＝10.66， 95％CI（－15.68， 37.00）， P＝0.43]. The incidence of adverse events （mainly including skin itching， redness， dry mouth， dizziness， decreased blood pressure， abnormal electrocardiogram） in trial group were significantly lower than thiopride group [OR＝0.42， 95％CI（0.22， 0.82）， P＝0.01] and haloperidol group [OR＝0.17， 95％CI（0.09， 0.32）， P＜0.001]， but there was no statistical significance compared with placebo group [OR＝0.61， 95％CI（0.29， 1.29）， P＝0.20]. There was no statistical significance in response rate of trial group compared with thiopride group [OR＝1.29，95％CI（0.38， 4.39）， P＝0.69] and haloperidol group [OR＝1.63， 95％CI（0.89， 2.96）， P＝0.11]. The results of descriptive analysis showed that reduction rate （amount） of YGTSS in trial group was significantly higher than that of placebo group （P＜0.05）， and response rate of trial group was significantly higher than that of placebo group （P＜0.01）. CONCLUSIONS： For child tic disorders in children， Clonidine tansdermal patch is better than placebo and haloperidol in reduction rate （amount） of YGTSS， and is similar to thiopride. Response rate of Clonidine tansdermal patch is better than that of placebo， and is similar to those of thiopride and haloperidol. The safety of Clonidine tansdermal patch is better than those of thiopride and haloperidol， and is similar to that of placebo.

OBJECTIVE:To evaluate the indicators of ADR reporting by medical institutions in China. METHODS:The indicators of ADR reporting by medical institutions in China were presented primarily by 8 pharmacy experts with focus group interview method. System assessment method was used for evidence-based analysis of primary ADR indicators. Delphi method was used to confirm the requirement,calculation formula,definition,evaluation meaning and reference value of ADR indicators. The reliability was assessed. RESULTS:Primary indicators included the rate of ADR reporting,the rate of qualified ADR,constituent ratio of severe and new ADR. A total of 30 literatures were included(15 documents of management standard,15 literature research)in system evaluation,all of which indicated the necessity and requirement of ADR reporting. But the calculation formula, definition and evaluation meaning of ADR indicators were not mentioned. By investigation with Delphi method,the range of reference value was confirmed as follows that the rate of ADR reporting was≥0.01%;the rate of qualified ADR was≥90%;the constituent ratio of severe and new ADR was≥1%. The evaluation result was reliable. CONCLUSIONS:The indicators of ADR reporting and reference lower limit value can urge medical and health institutions to report ADR actively,improve the quality of ADR reporting and strengthen the attention of medical and health institutions to severe and new ADR.

Objective To investigate whether human bone marrow mesenchymal stem cells (hBC-MSCs) have the immune-suppression ability on the proliferation of peripheral blood mononuclear cells (PBMCs) and their pro-inflammatory cytokine production in rats,to explore what kinds of human cytokines are required for the induction of hBM-MSCs to become immune-suppressive,and to observe the effect of intravenous delivery of hBM-MSCs on tumor necrosis factor (TNF)-α transcription and expression in the core infarct areas of rats after cerebral ischemia.Methods The fetal-originated hBC-MSCs and rat PBMCs were extracted;the rat PBMCs were activated by adding 10 μg/mL concanavalin A (ConA).(1) The first experiment was divided into hBM-MSCs+PBMCs group,hBM-MSCs+PBMCs+ConA group,PBMCs group and hBM-MSCs group;CCK-8 assay was employed to detect the proliferation of these cells.(2) The second experiment was divided into hBM-MSCs+PBMCs+ConA group,PBMCs+ConA group;ELISA was used to detect the TNF-α,interferon-γ (IFN-γ) and intedeukin (IL)-10 expressions.(3) The third experiment was divided into hBM-MSCs+PBMCs (IFN-γ+IL-1α) group,hBM-MSCs+PBMCs (IFN-γ+IL-1β) group,hBM-MSCs+PBMCs (IFN-γ+TNF-α) group and hBM-MSCs+PBMCs group;CCK-8 assay was used to detect the proliferation of these cells.(4) Thirty SD rats were randomly divided sham-operated group,control group (giving normal saline after ischemia) and hBM-MSCs group (giving hBM-MSCs after ischemia,n=10);on the third d of ischemia,the TNF-α mRNA and protein expressions at the infarct areas was detected by real time PCR and Western blotting,respectively.Results (1) The optical density (OD) in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the PBMCs group and hBM-MSCs group (P＜0.05);OD in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the hBM-MSCs+PBMCs+ConA group (P＜0.05).(2) The TNF-α,IFN-γand IL-10 levels in the PBMCs+ConA group were (1030±196) pg/mL,(2880±250) pg/mL and (330±45) pg/mL;the TNF-α and IFN-γlevels in hBM-MSCs+PBMCs+ConA group were (160±10) pg/mL and (240±55) pg/mL,which were significantly lower than those in the PBMCs+ConA group (P＜0.05);the IL-10 level in hBM-MSCs+PBMCs+ConA group was (750±110) pg/mL,which was significantly higher than that in the PBMCs+ConA group (P＜0.05).(3) The OD in the hBM-MSCs+PBMCs(IFN-γ+IL-1α)group,hBM-MSCs+PBMCs (IFN-γ+IL-1 β) group and hBM-MSCs+PBMCs (IFN-γ+TNF-α) group was significantly decreased as compared with that in the hBM-MSCs+PBMCs group (P＜0.05).(4) The TNF-α mRNA expression in the sham-operated group,control group and hBM-MSCs group was 0.490±0.128,2.369±0.788 and 1.002±0.408;the TNF-α protein expression in the sham-operated group,control group and hBM-MSCs group was 0.144±0.028,0.314±0.029,0.240±0.029;the TNF-α protein and mRNA expressions in the hBM-MSCs group were significantly decreased as compared with those in the control group (P＜0.05).Conclusions The allogeneic transplantation of hBC-MSCs is competent in suppressing the inflammation of rats in vitro and in vivo.Furthermore,this immune-suppression ability is not innate,but cytokine stimulation dependent.The immune-suppression ability of hBM-MSCs on rat PBMCs are at least partly responsible for the therapeutic effect of hBM-MSCs transplantation into the rat models,such as ischemia stroke.

Objective To investigate the relationship between hepatitis B virus genotype and lamivudine-resistant YMDD mutations and the clinical significance.Methods A total of 150 cases with chronic hepatitis B (CHB) were chosen from the outpatients and inpatients in our hospital.By testing the serum before and after they have taken lamivudine for 12 months,hepatitis B virus (HBV) genotype,HBV DNA quantitation,and YMDD mutation were tested applying polymerase chain reaction (PCR)-reverse dotblot (RDB) hybridization and real-time quantitative PCR.Results Of the 150 patients,81 (54.00％) were HBV subtype B;67 cases (44.67％) were HBV subtype C,and 2 cases (1.33％) were mixtures of HBV B and D.Before taking lamivudine,6 patients were found to have YMDD mutation in their serum,the genotype was HBV subtypes B.After taking lamivudine for 12 months,YMDD mutation was detected in 32 cases,of whom the proportion of HBV subtypes B was 24.69％ (20/81);the proportion of HBV subtype C was 17.91％;the difference was statistically significant (P ＜ 0.05).Conclusion The prevalence of YMDD mutation was associated with hepatitis B virus genotype.

Objective To survey prevalence of human papillomavirus (HPV) and their distribution characteristics in women with and without cervical lesions in Jiaxing,Zhejiang province.Methods The flow-through hybridization technique (HybriMax) was used to detect HPV genotypes in 426 cases of women with cervical lesions and 3134 women with normal cytology.Samples were collected from 4 hospitals in Jinhua,Zhejiang province.HPV infection rate and 26 kinds of genotype detection rate were compared in women with and without cervical lesions.Results HPV prevalences in 426 women with cervical lesions (26.29％) was significantly higher than that of 3134 women without cervical lesions (11.35 ％,P ＜ 0.01).HPV multiple infection rate of in HPV-positive women with cervical lesions (25.89％) was significantly higher than that of HPV-positive women without cervical lesions (4.78％) (P ＜ 0.01).High-risk HPV (HR-HPV) positive rate in cervicitis and cervical intraepithelial neoplasia (CIN) patients were 76.83％and 83.10％,respectively.CIN patients (83.10％) HR-HPV positive rate was higher than that of cervicitis patients (76.83％),but there was no significant difference.The five most common prevalent high-risk HPVs were HPV-16,33,58 and 18,52 in cervicitis patients,and HPV16,52 and 33,58,68 in CIN patients.Conclusion HPV prevalences in women with cervical lesions were higher than those of normal cytology women (P ＜ 0.01).Multiple infection with HPV was associated with cervical lesions.HPV-16,HPV-58,HPV-33 and HPV-52 were the most common prevalent high-risk HPV in HPV-positive women with cervical lesions.