Objective:To construct an evaluation indicator system for power system of otolaryngology surgery,so as to provide references for the configuration of surgical power devices of medical institutions.Methods:Literature review and brainstorming were used to analyze existing literature related to surgical power.Combined with expert opinions and clinical demands,an evaluation indicator system was initially proposed.The Delphi method was adopted to determine the evaluation indicators of power system of otolaryngology surgery.The analytic hierarchy process(AHP)method was used to determine the evaluation indicator system of the power system of otolaryngology surgery,which were constructed by weight of each indicator.Results:The evaluation indicator system of power system of otolaryngology surgery included 5 first-level indicators(integrity of medical equipment,products'performance indicators,safety,clinical application effect,and after-sales service guarantee)and 49 second-level indicators under the first-level indicators.In the first-level indicators,equipment's safety had the highest weight(20.48%).In the second-level indicators,the top three of the combined weights were respectively integrity of equipment's main device(7.19%),accessory's integrity(7.03%),and identification's integrity(6.03%).Conclusion:The evaluation index system for otolaryngological surgical power systems clarifies the core dimensions,specific indicators and relative importance of the evaluation,and can be applied to the procurement and selection of surgical power devices in medical institutions,performance testing,clinical effect evaluation and other aspects.

Objective:To explore the accuracy of parameters of anterior segment measurement assessment system and optical biometer in predicting lens in implantable collamer lens(ICL)implantation.Methods:This study retrospectively analyzed the examination data of patients who underwent ICL surgery at the department of ophthalmology,Army Characteristic Medical Center from January 2020 to July 2024.The measured data of the chamber corner parameters,which included anterior chamber depth(ACD),central corneal thickness(CCT),white to white(WTW),flat keratometry(K1)and steep keratometry(K2),of 74 patients(134 eyes)who underwent simultaneous measurements of the IOLMaster 700 optical biometer and the Pentacam HR anterior segment measurement assessment system were selected.The expected spherical equivalent(EXP SPH),expected cylinder(EXP CYL),and expected spherical equivalent(EXP SEQ)were calculated,and the differences,correlations and consistencies of these data were analyzed.Results:There were significant differences in ACD,CCT,WTW,K1 and K2 between the IOLMaster 700 and Pentacam HR in measuring myopic patients(t=12.928,6.202,-37.877,-13.743,-12.007,P<0.001).All measured data showed high correlation(r=0.983,0.984,0.961,0.996,0.994,P<0.001).Bland-Altman consistency test showed that the measured values by 3%-6%were outside the limits of 95%consistency,and the differences among the EXP SPH of two instruments and the postoperative actually measured results of spherical lens(SPH),among the EXP CYL of two instruments and the postoperative actually measured results of cylinder lens(CYL),and among the EXP SEQ of two instruments and the postoperative actual measured results of spherical equivalent(SEQ)were statistically significant(x2=20.927,7.451,25.459,P<0.05).The average differences between Pentacam HR and IOLMaster 700 were respectively(0.024±0.491)D and(0.009±.491)D in predicting SPH,and were respectively(-0.05±0.476)D and(-0.049±0.475)D in predicting CYL,and were respectively(-0.001±0.458)D and(-0.016±0.461)D in predicting SEQ.Conclusion:During selection process of ICL surgery for lens,clinicians can reasonably choose Pentacam HR and IOLMaster 700 to calculate lens according to the actual requirements of the patients.

Objective To investigate the influencing factors of secondary coagulation dysfunction in patients with severe acute pancreatitis(SAP)and establish the prediction model.Methods A total of 298 SAP patients in our hospital from July 2021 to July 2024 were consecutively selected,and those with secondary coagulation dysfunction were included in the observation group,while those without secondary coagulation dysfunction were included in the control group.Multivariate Logistic regression analysis was employed to investigate the risk factors for secondary coagulation dysfunction in patients with SAP and to establish a multivariate joint prediction model.The receiver operating characteristic curve(ROC)and decision curve were used to evaluate the predictive value of the multivariate joint prediction model for secondary coagulation dysfunction in SAP patients.Results The incidence of secondary coagulation dysfunction in SAP patients was 32.21%.The activated partial thromboplastin time(APTT),prothrombin time(PT)and fibrinogen(FIB)were longer in the observation group than those in the control group(P<0.05).Acute physiological and chronic health score Ⅱ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,D-dimer,C-reactive protein and albumin were independent influencing factors of secondary coagulation dysfunction in SAP patients(P<0.05).The regression equation model was established according to the results of multivariate analysis screened variables,logit(P)=-24.747+0.363×APACHEⅡ score+0.952×SOFA score-0.449×albumin+1.768×D-dimer+1.004×C-reactive protein,with a good fit.Regression model predicted that the AUC value of secondary coagulation dysfunction in SAP patients was 0.937.Decision curve analysis results showed that the Logistic regression model could achieve the maximum clinical benefit when the threshold probability was in the range of 0.06 to 0.97.Conclusion A comprehensive assessment of influencing factors can comprehensively evaluate the condition of patients and identify patients at high risk of coagulation disorders at an early stage.

Objective To investigate the influencing factors of secondary coagulation dysfunction in patients with severe acute pancreatitis(SAP)and establish the prediction model.Methods A total of 298 SAP patients in our hospital from July 2021 to July 2024 were consecutively selected,and those with secondary coagulation dysfunction were included in the observation group,while those without secondary coagulation dysfunction were included in the control group.Multivariate Logistic regression analysis was employed to investigate the risk factors for secondary coagulation dysfunction in patients with SAP and to establish a multivariate joint prediction model.The receiver operating characteristic curve(ROC)and decision curve were used to evaluate the predictive value of the multivariate joint prediction model for secondary coagulation dysfunction in SAP patients.Results The incidence of secondary coagulation dysfunction in SAP patients was 32.21%.The activated partial thromboplastin time(APTT),prothrombin time(PT)and fibrinogen(FIB)were longer in the observation group than those in the control group(P<0.05).Acute physiological and chronic health score Ⅱ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,D-dimer,C-reactive protein and albumin were independent influencing factors of secondary coagulation dysfunction in SAP patients(P<0.05).The regression equation model was established according to the results of multivariate analysis screened variables,logit(P)=-24.747+0.363×APACHEⅡ score+0.952×SOFA score-0.449×albumin+1.768×D-dimer+1.004×C-reactive protein,with a good fit.Regression model predicted that the AUC value of secondary coagulation dysfunction in SAP patients was 0.937.Decision curve analysis results showed that the Logistic regression model could achieve the maximum clinical benefit when the threshold probability was in the range of 0.06 to 0.97.Conclusion A comprehensive assessment of influencing factors can comprehensively evaluate the condition of patients and identify patients at high risk of coagulation disorders at an early stage.

Objective:To construct an evaluation indicator system for power system of otolaryngology surgery,so as to provide references for the configuration of surgical power devices of medical institutions.Methods:Literature review and brainstorming were used to analyze existing literature related to surgical power.Combined with expert opinions and clinical demands,an evaluation indicator system was initially proposed.The Delphi method was adopted to determine the evaluation indicators of power system of otolaryngology surgery.The analytic hierarchy process(AHP)method was used to determine the evaluation indicator system of the power system of otolaryngology surgery,which were constructed by weight of each indicator.Results:The evaluation indicator system of power system of otolaryngology surgery included 5 first-level indicators(integrity of medical equipment,products'performance indicators,safety,clinical application effect,and after-sales service guarantee)and 49 second-level indicators under the first-level indicators.In the first-level indicators,equipment's safety had the highest weight(20.48%).In the second-level indicators,the top three of the combined weights were respectively integrity of equipment's main device(7.19%),accessory's integrity(7.03%),and identification's integrity(6.03%).Conclusion:The evaluation index system for otolaryngological surgical power systems clarifies the core dimensions,specific indicators and relative importance of the evaluation,and can be applied to the procurement and selection of surgical power devices in medical institutions,performance testing,clinical effect evaluation and other aspects.

Objective:To explore the accuracy of parameters of anterior segment measurement assessment system and optical biometer in predicting lens in implantable collamer lens(ICL)implantation.Methods:This study retrospectively analyzed the examination data of patients who underwent ICL surgery at the department of ophthalmology,Army Characteristic Medical Center from January 2020 to July 2024.The measured data of the chamber corner parameters,which included anterior chamber depth(ACD),central corneal thickness(CCT),white to white(WTW),flat keratometry(K1)and steep keratometry(K2),of 74 patients(134 eyes)who underwent simultaneous measurements of the IOLMaster 700 optical biometer and the Pentacam HR anterior segment measurement assessment system were selected.The expected spherical equivalent(EXP SPH),expected cylinder(EXP CYL),and expected spherical equivalent(EXP SEQ)were calculated,and the differences,correlations and consistencies of these data were analyzed.Results:There were significant differences in ACD,CCT,WTW,K1 and K2 between the IOLMaster 700 and Pentacam HR in measuring myopic patients(t=12.928,6.202,-37.877,-13.743,-12.007,P<0.001).All measured data showed high correlation(r=0.983,0.984,0.961,0.996,0.994,P<0.001).Bland-Altman consistency test showed that the measured values by 3%-6%were outside the limits of 95%consistency,and the differences among the EXP SPH of two instruments and the postoperative actually measured results of spherical lens(SPH),among the EXP CYL of two instruments and the postoperative actually measured results of cylinder lens(CYL),and among the EXP SEQ of two instruments and the postoperative actual measured results of spherical equivalent(SEQ)were statistically significant(x2=20.927,7.451,25.459,P<0.05).The average differences between Pentacam HR and IOLMaster 700 were respectively(0.024±0.491)D and(0.009±.491)D in predicting SPH,and were respectively(-0.05±0.476)D and(-0.049±0.475)D in predicting CYL,and were respectively(-0.001±0.458)D and(-0.016±0.461)D in predicting SEQ.Conclusion:During selection process of ICL surgery for lens,clinicians can reasonably choose Pentacam HR and IOLMaster 700 to calculate lens according to the actual requirements of the patients.

Objective:To study the changes of patient-related costs and the use of stents and other consumables before and after the centralized procurement of coronary stents.Methods:The inpatient medical insurance settlement case data of 1,973 patients with coronary stent implantation admitted to Daping Hospital of Army Medical University from December 2019 to October 2021 were selected.Among them,the data of 1,317 cases of percutaneous cardiovascular surgery and coronary stent implantation with serious or complications and accompanying disease group were slected according to disease diagnosis related groups(DRG),which were divided into the pre-centralized procurement group(667 cases)and the post-centralized procurement group(650 cases)according to the centralized procurement of coronary stents before and after.The costs of patients'medical consumables with the consumption of patients'medical consumables and the impact of the use of consumables such as coronary stents on the costs of medical consumables were compared.Results:There was no significant statistical difference in the hospitalization days and the average number of stents used in patients undergoing percutaneous cardiovascular procedures and coronary stent implantation with centralized procurement of coronary stents.There was a statistically significant difference in the total diagnosis and treatment cost,medical consumables cost,medicines and consumables cost and medicines cost between the pre-centralized procurement group and the post-centralized procurement group(Z=-22.316,-23.546,-22.917,-5.724,P<0.05).The cost of stents[16 260(13 300,32 272)yuan],the number of catheter guidewire balloon sheaths consumables[5(4,8)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[8 719(5 805,15 372)yuan]in the pre-collection group were collected.There were statistically significant differences in the stent cost[1 059(590,1 770)yuan],the number of catheter guidewire balloon sheaths consumables[8(7,12)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[5 708(3 392,12 871)yuan]between the two groups(Z=-30.452,16.582,-7.670,P<0.05).There was a statistical correlation between the cost of coronary stents and the cost of catheter guidewire balloon sheaths before and after centralized volume procurement on the cost of medical consumables for patients(r=0.903,0.473,0.785,0.953,P<0.05).The correlation coefficient between the cost of coronary stents and the cost of medical consumables for patients in the post-centralized procurement group decreased compared to the pre-centralized procurement group,the correlation coefficient between the cost of catheter guidewire balloon sheath and the cost of medical consumables for patients increased.Conclusion:The centralized procurement of coronary stents has a significant cost control effect on patients in the disease groups,and affects the cost structure of medical consumables.Combined with DRG reform,it can continuously improve the standardization and scientificity of clinical use of medical consumables.

Objective:To investigate the consistency of swept-source optical coherence tomography(SS-OCT)and time-domain optical coherence tomography(TD-OCT)in measuring the parameters of anterior chamber angle.Methods:A total of 46 myopic patients(92 eyes)were retrospectively selected from Department of Ophthalmology of Army Specialty Medical Center from January 2023 to May 2023.Both SS-OCT and TD-OCT were used to measure respectively the parameters of anterior chamber angle of patients.And then,the differences of central anterior chamber depth(ACD),angle opening distance(AOD500,AOD750),scleral spur angle(SSA),trabecular iris area(TISA500,TISA750)between SS-OCT and TD-OCT were compared and analyzed.The Pearson correlation analysis and Bland-Altman test were adopted to analyze and measure the correlation and consistency of the measures.Results:There was significant difference in ACD between the two kinds of scan methods(t=-6.83,P<0.001).Additionally,the differences of the AOD500,AOD750,SSA500,TISA500 and TISA750 of measured data beside of nose were significant(t=-5.16,5.51,-6.51,-4.75,-5.69,P<0.001),respectively.Similarly,the differences of them beside of temple were significant(t=-5.04,-4.8,-6.06,-3.84,-4.02,P<0.001),respectively.There was positive correlation between the two kinds of scan methods(r=0.71-0.92).The Bland-Altman analysis showed that 2.1% to 8.9% of the measured values were outside the consistency limit by 95%.Conclusion:There are differences between SS-OCT and TD-OCT in the measures of the parameters of anterior chamber angle of myopic patients,and the measured results of them appear positive correlation.

Objective:To study the technological roadmap of integrated development of digestive tract endoscopy and artificial intelligence precision medicine,and to provide research directions and feasible technological paths for the"overtaking on a curve"of domestic gastrointestinal endoscopy.Methods:The Delphi method was used to investigate the needs and research directions for the refinement of gastrointestinal endoscopy from the perspective of medical professionals.An analysis of development directions of artificial intelligence precision medical technology based on technical documents on artificial intelligence precision medical technology was conducted.The application scenarios and technology roadmap of early gastric cancer and inflammatory bowel disease patients were designed from four main service directions of precise diagnosis,precise treatment,precise medication,and precise health management of artificial intelligence precision medicine.Results:Two refined application scenarios were designed for precise diagnosis of early gastric cancer and precise health management of inflammatory bowel disease patients,the layout direction and feasible path were planned for the development of the new gastrointestinal endoscopy industry,and a technology roadmap for the development of intelligent gastrointestinal endoscopy industrywas formed.Conclusion:The technology roadmap for the integrated development of gastrointestinal endoscopy with artificial intelligence precision medicine provides a sustainable development path for addressing the patent blockade of foreign gastrointestinal endoscopy companies on domestic products,uneven distribution of medical resources in the field of gastroenterology,and early diagnosis and treatment of digestive system diseases.

Objective:To analyze the results of quality detection of different brands of spectrum therapy apparatuses in complex environment,so as to improve the reliability of that in clinical use and to provide reference for medical institutions in selecting spectrum therapy apparatus that suits to different environments.Methods:A total of 4 different brands of spectrum therapy apparatuses(brand A,B,C,D)were selected,and the environments of cold,hot,wet and heat,and salt fog area were respectively simulated.The detection tests of low temperature storage,high temperature storage,wet and heat storage,and salt fog were conducted on the spectrum therapy apparatuses.According to the national standard"Environmental requirements and test methods for medical electrical equipment"and"Laboratory environmental test methods for military materiel Part 11:salt fog test",the results of quality tests of appearance function and temperature control of the spectrum therapy apparatuses after the test were analyzed.Results:In the test of appearance function,the appearance functions of brand A,brand B and brand C were normal in the tests of low temperature storage,high temperature storage,wet and heat storage,and salt fog,and brand D only showed obvious surface corrosion after salt fog test.In the test of temperature control,the errors of the temperature non-uniformity of the 4 spectral therapy apparatuses were less than 10%after the tests of low temperature storage,high temperature storage,wet and heat storage,and salt fog.The error ranges of brand B and brand D were between-10%and+10%due to the marked values of the surface temperatures of radiation devices of them were known,while those of brand A and C could not be analyzed due to the marked values of them were not known.Conclusion:The analysis on the quality detection of spectrum therapy apparatuses in the complex environment can improve the reliability of that in clinical use,and can choose the suitable brand and model for medical institutions at differently environmental regions,so as to ensure the clinical treatment effect of them.