Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

In recent years, there is still an unbridgeable area in the early diagnosis of thyroid carcinoma.Many scholars are committed to the research of molecular markers, and find that RNA markers associated with thyroid carcinoma are microRNAs, human telomerase reverse transcripase, trefail factor 3 and HMGA2 genes.Different genes are closely related to the occurrence, development of different types of thyroid cancers, and some genes may even affect the transfer of thyroid carcinoma.

Objective To understand the effect of standardized training for resident doctors and to improve its evaluation method. Methods A questionnaire survey was made among 89 resident doctors including 46 directors and 46 matrons. Kirkpatrick Model was used to analyze the question-naires in four dimensions including reaction layer,learning layer,behavior layer and achievement layer. Data of reaction layer were analyzed by ANOVA and data of learning layer and behavior layer were compared by paired t-test. Results Reaction layer:the overall satisfaction of the resident doc-tor for training is about 4.09. Learning layer:There were significantly statistical differences in the test scores before and after training(P=0.00). Behavior layer:There were significantly statistical differences in resident doctor’s ability and quality before and after training (P=0.00). Achievement layer:both the complaint rate and the accident rate of the 89 resident doctors were 0 while all of them passed the practicing physician exam. Conclusions Standardized training can improve the quality and ability of resident doctors. Kirkpatrick evaluation model can reflect the effect of the standardized training for resident and is a good tool to analyze the effectiveness of standardized training for resident.

In view of the status of "emphasis on medical treatment,neglecting education,lack of teaching positivity and low teaching management level" in teaching hospital at present,MBO was applied in the incentive mechanism of clinical teachers as a means,which aroused the teachers' positivity effectively,ensured the teaching quality,improved the teaching level of management and achieved significant results. It also made our medical activities,teaching and researching develop harmoniously.