Objective:To construct a refined management model based on the Interrupt Time Series(ITS)algorithm model for medical consumables,so as to provide a scientific basis for hospitals in implementing refined management for medical consumables.Methods:The supply,inventory and usage data of medical consumables were collected,and the ITS algorithm was used to analyze the prediction for the usage of medical consumables,and the influence of policy intervention.The outliers and key influencing factors of the full-cycle data of medical consumables were mined,and management countermeasures were formulated from three aspects:early warning for dynamic inventory,feedback of policy effect,and abnormal rectification handling.A total of 10,614 medical consumables that were routinely used at Taizhou People's Hospital from January 2023 to December 2024 were selected.The empirical management method was adopted to manage 4,924 medical consumables during the period from January to December 2023,and the refined management method was adopted to manage 5,690 medical consumables during the period from January to December 2024.The utilization rate of medical consumables,the quality of management decisions and the performance of clinical services of the two management methods were compared.Results:The average inventory turnover rate and usage rate of medical consumables of the refined management method were respectively(91.11±3.02)%and(91.19±2.75)%,which were higher than those of the empirical management method.The proportion of average inventory cost,and loss rate of overstock of the refined management method were respectively(2.53±0.57)%and(2.84±0.44)%,which were lower than those of the empirical management method,and the differences were all statistically significant(t=4.698,5.976,4.518,8.496,P<0.05).The average accuracy rate of prediction,detection rate of abnormity,and the mean of timely handling rate of the refined management method for medical consumables were all higher than those of the empirical management method,and the differences were statistically significant(t=6.423,8.587,6.102,P<0.05).The satisfaction of doctors,nurses,warehouse managers and purchasing managers who used and managed medical consumables for the clinical service performance of adopting the refined management method was higher than that of adopting the empirical management method,and the differences were statistically significant(x2=7.416,12.793,4.267,4.667,P<0.05).Conclusion:The application of the refined management model based on the ITS algorithm model for medical consumables can enhance the predictive ability for the demand of medical staffs for medical consumables,and reduce the pressure for inventory,and management costs of medical consumables,and accurately detect abnormal problems in the use of medical consumables,and improve the level of clinical services.

Objective:To construct a refined management model based on the Interrupt Time Series(ITS)algorithm model for medical consumables,so as to provide a scientific basis for hospitals in implementing refined management for medical consumables.Methods:The supply,inventory and usage data of medical consumables were collected,and the ITS algorithm was used to analyze the prediction for the usage of medical consumables,and the influence of policy intervention.The outliers and key influencing factors of the full-cycle data of medical consumables were mined,and management countermeasures were formulated from three aspects:early warning for dynamic inventory,feedback of policy effect,and abnormal rectification handling.A total of 10,614 medical consumables that were routinely used at Taizhou People's Hospital from January 2023 to December 2024 were selected.The empirical management method was adopted to manage 4,924 medical consumables during the period from January to December 2023,and the refined management method was adopted to manage 5,690 medical consumables during the period from January to December 2024.The utilization rate of medical consumables,the quality of management decisions and the performance of clinical services of the two management methods were compared.Results:The average inventory turnover rate and usage rate of medical consumables of the refined management method were respectively(91.11±3.02)%and(91.19±2.75)%,which were higher than those of the empirical management method.The proportion of average inventory cost,and loss rate of overstock of the refined management method were respectively(2.53±0.57)%and(2.84±0.44)%,which were lower than those of the empirical management method,and the differences were all statistically significant(t=4.698,5.976,4.518,8.496,P<0.05).The average accuracy rate of prediction,detection rate of abnormity,and the mean of timely handling rate of the refined management method for medical consumables were all higher than those of the empirical management method,and the differences were statistically significant(t=6.423,8.587,6.102,P<0.05).The satisfaction of doctors,nurses,warehouse managers and purchasing managers who used and managed medical consumables for the clinical service performance of adopting the refined management method was higher than that of adopting the empirical management method,and the differences were statistically significant(x2=7.416,12.793,4.267,4.667,P<0.05).Conclusion:The application of the refined management model based on the ITS algorithm model for medical consumables can enhance the predictive ability for the demand of medical staffs for medical consumables,and reduce the pressure for inventory,and management costs of medical consumables,and accurately detect abnormal problems in the use of medical consumables,and improve the level of clinical services.

Objective:To construct a clinical benefit evaluation model of medical equipment based on the combination weighting of game theory with cloud model,so as to improve the clinical service capability and operational quality of medical equipment. Methods:The game theory,combination weighting and cloud model were used to scientifically empower and comprehensively evaluate 13 clinical benefit evaluation indexes from 3 dimensions:direct input,direct output. and indirect benefits of medical equipment,and to develop corresponding equipment management strategies.. 47 large medical equipment in clinical use at Taizhou People's Hospital from 2022 to 2023 were selected,and the large medical equipment used in 2022 was subjected to subjective evaluation management. The equipment used in 2023 adopts a medical device clinical benefit evaluation model (referred to as model evaluation management) of game theory combination weighting and cloud model to carry out clinical benefit evaluation and management of the equipment. The clinical benefit,operation quality and management level of the two management methods were compared. Results:The effective management rate of medical equipment using the model evaluation management method was 63.83％(30/47),which was higher than that using the subjective evaluation management method,and the difference was statistically significant (x2=5.158,P<0.05). The average clinical risk rate,failure rate and detection failure rate of medical equipment using the model evaluation management method were (10.59±3.09)‰,(7.27±3.53)‰ and (12.06±2.43)‰,respectively,all of which were lower than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=3.783,2.748,3.928,P<0.05). The assessment scores of medical equipment use managers on the ability of equipment use,maintenance,repair and planning using the model evaluation management method were (93.38±3.73) points,(94.05±3.14) points,(92.61±3.44) points and (94.88±2.50) points,respectively,which were higher than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=2.718,3.036,3.039,3.929,P<0.05). Conclusion:The application of the clinical benefit evaluation model of medical equipment,which based on the game theory combination weighting and cloud model,can accurately evaluate the clinical benefit level of medical equipment,and improve the operation quality of the equipment,and enhance the management level of equipment.

Objective:To construct a clinical benefit evaluation model of medical equipment based on the combination weighting of game theory with cloud model,so as to improve the clinical service capability and operational quality of medical equipment. Methods:The game theory,combination weighting and cloud model were used to scientifically empower and comprehensively evaluate 13 clinical benefit evaluation indexes from 3 dimensions:direct input,direct output. and indirect benefits of medical equipment,and to develop corresponding equipment management strategies.. 47 large medical equipment in clinical use at Taizhou People's Hospital from 2022 to 2023 were selected,and the large medical equipment used in 2022 was subjected to subjective evaluation management. The equipment used in 2023 adopts a medical device clinical benefit evaluation model (referred to as model evaluation management) of game theory combination weighting and cloud model to carry out clinical benefit evaluation and management of the equipment. The clinical benefit,operation quality and management level of the two management methods were compared. Results:The effective management rate of medical equipment using the model evaluation management method was 63.83％(30/47),which was higher than that using the subjective evaluation management method,and the difference was statistically significant (x2=5.158,P<0.05). The average clinical risk rate,failure rate and detection failure rate of medical equipment using the model evaluation management method were (10.59±3.09)‰,(7.27±3.53)‰ and (12.06±2.43)‰,respectively,all of which were lower than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=3.783,2.748,3.928,P<0.05). The assessment scores of medical equipment use managers on the ability of equipment use,maintenance,repair and planning using the model evaluation management method were (93.38±3.73) points,(94.05±3.14) points,(92.61±3.44) points and (94.88±2.50) points,respectively,which were higher than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=2.718,3.036,3.039,3.929,P<0.05). Conclusion:The application of the clinical benefit evaluation model of medical equipment,which based on the game theory combination weighting and cloud model,can accurately evaluate the clinical benefit level of medical equipment,and improve the operation quality of the equipment,and enhance the management level of equipment.

Objective:By sorting out the occurrence of the risk outcomes of scientific research project in the hospital, conducting root-cause analysis, the risk management theory, process and methodologies are introduced into the management system of hospital scientific research projects to reduce the occurrence of risk outcome of scientific research projects.Methods:Through literature review and the reflection of daily scientific research management practice, the risk characteristics of clinical scientific research projects were systematically summarized, comparative analysis were conducted to explore the effectiveness before and after the introduction of risk management, and the practical experiences of scientific research project risk management were summarized.Results:There are mainly six types of internal and external risks in hospital scientific research projects, which lead to project termination, project modifications, project delays, assessment index adjustments, budget adjustments and other risk issues. By establishing scientific research project risk management environment, standardizing risk management procedures, as well as establishing risk-monitoring and early warning information system, the introduction of risk management system enables more effective control of scientific research project risks in hospitals.Conclusions:The application of risk management in the management of scientific research projects in hospitals has showed positive impact. The risk management of scientific research projects in hospitals has certain practical value and feasibility. The exploration of risk management theories and methods should be continued to promote the high-quality development of hospital scientific research project management.

Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.

Objective:To detect the expression of microRNA-218 (miR-218) in human acute lymphocyte leukemia (ALL) T lymphocytes ( CCRF-CEM) ,explore its effects on the biological features of CCRF-CEM cells and the expression of its target gene c-kit, so as to provide new insights for leukemia treatment.Methods: Using the quantitative real-time polymerase chain reaction ( qRT-PCR) ,we detected the expression of miR-218 in the normal peripheral blood T lymphocytes and CCRF-CEM cells.Forty-eight hours after the miR-218 mimic was transfected into the CCRF-CEM cells,the expression of miR-218 in the CCRF-CEM cells was detected by qRT-PCR.The effect of miR-218 on the CCRF-CEM cell viability was detected using MTT.The effect of miR-218 on the proliferation and apoptosis of CCRF-CEM cell was analyzed using flow cytometry.c-kit gene was identified to be a target gene of miR-218 by luciferase reporter enzyme system,and the effect of miR-218 on the expression of KIT protein in cells were determined using Western blot.Results:As shown by qRT-PCR,compared with that in the normal peripheral blood T lymphocytes,the expressions of miR-218 in ALL T lymphocytes cell lines were significantly decreased ( P<0.01 ) .Compared with the control group, the expression of miR-218 increase significantly in CCRF-CEM cells transfected with miR-218 mimic for 48 hours ( P<0.01).MTT showed that the cell viability decreased significantly after the over-expression of miR-218 in the CCRF-CEM cells ( P<0.05 ) .Flow cytometry showed that the S-phase fraction significantly declined after the over-expression of miR-218 ( P<0.01 ) , and meanwhile the apoptosis of cells also significantly increased (P<0.01).Luciferase reporter gene assay showed that,compared with the control group,the relative luciferase activity significantly declined in the miR-218 mimic transfection group (P<0.01).Compared with the control group,the expression of KIT protein in the CCRF-CEM cells transfected with miR-218 mimic for 48 hours significantly decreased ( P<0.01).Conclusion:The expression of miR-218 decreases in ALL T lymphocytes cell lines.MiR-218 can negatively regulate the expression of KIT protein,inhibit the proliferation and increase the apoptosis of CCRF-CEM cells.Treatment based on the enhanced expression of miR-218 may be a promising strategy for leukemia.

Background and objectivehTe prognosis for patients with lung cancer and brain metastases remains poor, with approximately 6 months of survival, despite active measures atfer treatment. In this study, we determined and ana-lyzed clinical parameters that affect the survival of patients with lung cancer and brain metastases to provide clinical guidance. MethodsLung cancer cases with brain metastases were retrospectively collected during 2002 and 2008 from Shanghai Chest Hospital, Shanghai Jiao Tong University.Kaplan-Meier method andCox regression were performed for univariate and multi-variate analyses, respectively, to explore independent predictors inlfuencing the survival of patients with lung cancer and brain metastases.Results Age, Eastern Cooperative Oncology Group performance status (ECOG PS), metastasis interval, number of metastasis, treatment method, treatment period, symptoms of brain metastases, extracranial metastasis, and brain metastasis order were factors that affect the survival of patients with brain metastases as conifrmed through theKaplan-Meiermethod. Treatment periods and extracranial metastasis were independent survival predictors in patients with lung cancer and brain me-tastasis as indicated byCox proportional hazard model.ConclusionTreatment periods and extracranial metastasis were inde-pendent predictors of survival of patients with lung cancer and brain metastasis. Treatment periods and extracranial metastasis were independent predictors of survival of patients with lung cancer and brain metastasis.

Background and purpose:The effective rate of ifrst-line chemotherapy for advanced lung cancer is 30%-40%. The purpose of this study was to evaluate the efifcacy and adverse effects of pemetrexed combined with carboplatin or cisplatin in the treatment of patients with advanced non-squamous non-small cell lung cancer (NSCLC). Methods:One hundrend and twenty-one patients with advanced non-squamous NSCLC were enrolled in this study and all of these patients had been conifrmed with pathology or cytology. Among the 121 cases, 60 cases were male and 61 were female, the median age was 59 years, adnenocarcinoma in 113 patients and large cell carcinoma in 8 patients. Combination regimen: patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 or cisplatin 70 mg/m2 on day 1 by intravenous infusion, administrated every 3 weeks for 2 to 6 cycles. All patients who received 2 or more cycles could be evaluated. Disease control rate (DCR) was the primary end point; secondary end points included progression-free survival (PFS), 1-year survival rate and safety.Results:There was 1 case with complete response (CR), 44 cases achieved partial response (PR), 50 had stable disease (SD) and 26 cases had progressive disease (PD) in the overall cases. ORR and DCR were 37.2% (45/121) and 78.5% (95/121), respectively. The median PFS time was 5.2 months and 1-year survival rate was 59.0%. In pemetrexed combined with carboplatin group, the ORR and DCRwere 38.3% (23/60) and 78.3% (47/60), respectively; The median PFS was 5.1 months (95%CI: 3.8-6.4 month) and 1-year survival rate was 55.2%. The patients treated with pemetrexed plus cisplatin, the ORR and DCR were 36.1% (22/61) and 78.7% (48/61), respectively. Median PFS was 6.2 months (95%CI: 4.3-8.1 month) and 1-year survival rate was 62.5%. There were no statistical differences between carboplatin/pemetrexed and cisplatin/pemetrexed for both ORR, DCR, PFS and 1-year survival rate (P>0.05). The major adverse effects were leukopenia, neutropenia, fatigue and gastrointestinal reaction.Conclusion:Pemetrexed plus platinum chemotherapy could be considered as the ifrst-line treatment option for advanced non-squamous NSCLC patients. Pemetrexed combined with carboplatin/ cisplatin regimen has efifcacy with mild toxicity and better tolerability.

10.3969/j.issn.1007-3969.2013.05.002