Based on the Kraljic model,this paper established the scoring standard system for medical equipment procurement,and determined the weight coefficients of each evaluation factor by the analytic hierarchy process (AHP),then the procurement classification model of medical equipment was successfully established.It is proved that this model can classify medical equipment effectively,which enables the purchasing personnel to adopt corresponding purchasing strategies according to different classification.This model can be extended to all medical equipment procurement,realizing the delicacy and individualized procurement management of the equipment,which has strong operability and guiding significance.
Equipment and Supplies ; economics ; Models, Theoretical

Objective: To investigate the effects of milrinone on levels of inflammatory factors and liver and renal function after CPB in rheumatic heart disease patients for valve replacement. Methods: From January 2014 to January 2016, 80 patients received valve replacement in the Central Hospital of Chongqing Three Gorges were randomly divided into observation group and control group by block randomization grouping method, with 40 patients in each group.The patients in the observation group were pumped intravenously with milrinone 0.5μg·kg^-1·min^-1 for 72h after surgery, while the patients in the control group were not pumped.The serum levels of IL-6, IL-8, IL-10, TNF-α were detected by ELISA before operation and on 0d, 1d, 3d, 5d after operation, respectively.The levels of ALT, AST, Scr were also detected at the same time.Moreover, the time for operation, extracorporeal circulation, interruption, mechanical ventilation, ICU and hospital were also compared between the two groups. Results: The levels of TNF-α, IL-6, IL-8 and IL-10 increased immediately after operation in both groups[control group: (14.97±5.14)pg/mL, (52.45±10.37)pg/mL, (34.10±8.38)pg/mL, (32.27±8.45)pg/mL; observation group: (16.05±5.71)pg/mL, (54.39±8.56)pg/mL, (33.80±7.69)pg/mL, (31.48±5.94)pg/mL, t=-0.628, -0.644, 0.116, 0.342], and the peak values of TNF-α, IL-6 and IL-8 reached on the first day after operation in both two groups[control group: (52.07±10.18)pg/mL, (96.04±26.45)pg/mL, (91.14±18.28)pg/mL, (48.10±9.78)pg/mL; observation group: (50.37±12.98)pg/mL, (93.66±24.10)pg/mL, (83.16±16.28)pg/mL, (46.68±9.25)pg/mL, t=0.559, 0.295, 1.458, 0.473], and the peak value of IL-10 reached on the 3rd day after operation(t=-3.577), the differences were statistically significant on the 3rd day after operation[control group: (36.03±9.39)pg/mL, (59.56±14.38)pg/mL, (53.91±13.16)pg/mL, (85.55±16.49)pg/mL; observation group: (36.70±4.33)pg/mL, (36.20±3.85)pg/mL, (42.91±7.30)pg/mL, (101.33±10.81)pg/mL, t=-0.289, 7.017, 3.267, -3.577]. The levels of ALT, AST and Scr increased immediately after operation in both groups[control group: (38.51±5.12)U/L, (40.23±5.03)U/L, (62.27±5.02)μmol/L; observation group: (39.20±4.67)U/L, (39.6±4.94)U/L, (73.61±4.04)μmol/L, t=0.114, 0.243, 0.630], there were tatistically significant difference between the two groups on the 5th day after operation[control group: (61.45±5.27)U/L, (54.20±7.0)U/L, (86.45±9.01)μmol/L; observation group: (36.20±3.85)U/L, (34.85±7.12)U/L, (83.7±11.07)μmol/L, t=11.231, 9.224, 5.647], and on the fifth day, the levels of ALT, AST and Scr in the observation group dropped to normal, while only the level of Scr in the control group dropped to normal.There were no statistically significant differences in the time of operation, extracorporeal circulation, interruption, mechanical ventilation between two groups (t=0.267, 0.151, 0.187, 0.773, all P>0.05). However, there were statistically significant differences in the time of ICU and hospital [control group: (54.90±16.84)h, (14.35±3.01)d, observation group: (44.05±7.06)h, (10±1.86)d, t=8.149, 13.042, all P<0.05]. Conclusion Milrinone can obviously improve the inflammatory reaction in surgical trauma tissues caused by IL-6, IL-8, IL-10, TNF-α, and can protect liver, renal tissue from injury, moreover, it can decrease the incidence of postoperative complications and the length of hospital stay.

This paper proposes a clinical alarm management system based on the theory of the closed loop control. The alarm management mechanism can be divided into the expected standard, improving execution rule, rule execution, medical devices with alarm functions, results analysis strategy and the output link. And, we make relevant application and discussion. Results showed that the mechanism can be operable and effective.
Clinical Alarms ; Decision Support Systems, Clinical

Objective: To establish a method to detect the concentrations of dimethyl sulfate in the air of workplace by GC-MS. Methods: DMS in the air of workplace adsorpted by Silicone tube, then desorped by acetone, add 1.0 ml of acetone, shake 1 min, placed after 30 min, the desorption solution qualitative and quantitative determination by gas chromatography-mass. Results: The calibration curves were liner in the range of 0.1-200.0 μg/ml. The within-run and between-run precisions were 2.6%-4.7% and 4.0%-9.0% respectively. The method detection limit is 0.1 μg/ml, the minimum detectable concentration is 0.02 mg/m³ (in terms of sampling 4.5 L) . Add 1 ml of desorption liquid, place 30 min, the average desorption efficiency of more than 90%. Conclusion This method has simple pretreatment, short analysis period, and optimized linear rage and limit of detection, and is suitable for the determination of DMS in workplace air.

The content related to the quality during life-cycle in operation of medical device includes daily use, repair volume, preventive maintenance, quality control and adverse event monitoring. In view of this, the article aims at discussion on the quality evaluation method of medical devices during their life cycle in operation based on the Analytic Hierarchy Process (AHP). The presented method is proved to be effective by evaluating patient monitors as example. The method presented in can promote and guide the device quality control work, and it can provide valuable inputs to decisions about purchase of new device.
Decision Support Techniques ; Durable Medical Equipment ; standards ; Equipment Design ; Quality Control

This paper analyzed current problems and challenges facing hospitals in alarm management both abroad and at home. Based on a survey conducted on alarm management in hospitals, plus an analysis on different kinds of data interfaces and data exchange protocols of the medical equipment used in ICUs, a solution of alarm management is put forwarded which is based on alarm information integration and processing. It aims at improving medical equipment alarm management and reducing relevant adverse events.
Automatic Data Processing ; Clinical Alarms ; Intensive Care Units

Objective To understand the vital signs on admission time and traumatic classification of the inpatients injured in Lushan Earthquake ,and provide a basis evidence for handling major disasters and treating masses of injured patients .Methods The information of patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital was collected by“No .1 Military Medical Project” hospital information system and self-edited “Questionnaire for Hospitalized Patients Injured in 4 .20 Lushan Earthquake” .The data of the vital signs on admission time and traumatic classification of these patients were analyzed by SPSS 16 .0 .Results A total of 65 civilian patients were admitted in this hospital .Among these patients ,there were 30 men (46 .15% )and 35 women(53 .85% );with mean age of(45 .74 ± 20 .96)years old .On admission time ,the abnormal rates of tempera-ture ,pulse ,respiratory rate ,systolic pressure ,diastolic pressure of these patients were 18 .46% ,6 .15% ,21 .54% ,12 .31% and 23 .08% ,respectively .48(73 .85% )patients had closed injury .Traumatic condition:8(12 .31% )patients in mild degree ,17(26 .15% ) patients in moderate degree ,32 patients(49 .23% )patients in severe degree and 8(12 .31% )patients in critical degree .The top 4 traumatic parts were as follows :33(50 .77% )patients got waist(abdomen)division and pelvis(perineum);31(47 .69% )patients got lower limb injuries;18(27 .69% )patients got chest and back injuries and 10(15 .38% )patients got facial injuries .There were 39 skin and soft tissue injuries ,counting for 60 .00% ,and 38 fractures ,counting for 58 .46% .Conclusion The epidemiological characteris-tics of earthquake injuries are founded by analyzing the vital signs on admission time and traumatic classification of the inpatients in-jured in Lushan earthquake ,which suggests attention of the relevant scholars and departments .

This paper analyzed current problems and chalenges facing hospitals in alarm management both abroad and at home. Based on a survey conducted on alarm management in hospitals, plus an analysis on different kinds of data interfaces and data exchange protocols of the medical equipment used in ICUs, a solution of alarm management is put forwarded which is based on alarm information integration and processing. It aims at improving medical equipment alarm management and reducing relevant adverse events.

Objective To develop an overall health risk model and to evaluate its convergent validity and reliability.Methods Health examination results of 230 adults from a public institution were collected by using Chinese Health Risk Appraisal Questionnaire V1.0 (CHRAQ V1.0).An CHRAQ V1.0-based overall health risk model was then developed,which included 34 items.Kolmogorov-Smirnov was used to test normal distribution of the data.Pearson correlation coefficient and Spearman correlation coefficient were used to evaluate parallel validity of the model.Crane Bach coefficient,Spearman-Brown coefficient and test-retest reliability were calculated to evaluated the reliability of the model.Results In this study,212 valid questionnaires (92.17％) were received.The average score of the newly developed overall health risk model was 41.96 ± 9.69,and its kurtosis coefficient and coefficient of skewness were 2.105 and 0.862,respectively.In Kolmogorov-Smirnov,the data were normally distributed (Z =1.073,P =0.199).The correlation coefficient of positive rate of all objective examinations with model scores was 0.774 (P ＜ 0.05).The Cronbach's alpha coefficient,Spearman-Brown coefficient and test-retest reliability of the model were 0.652,0.784 and 0.841,respectively (P ＜ 0.05).Conclusion In this investigation,our newly developed overall health risk model shows good validity and reliability and application prospect in the field of health management.

Human factors engineering is a promising interdisciplinary subject in applied sciences.This study presented the development and research purposes of human factors engineering.Based on case studies,the authors probed into the importance of the engineering in the design,management and procurement of medical equipments,for the purpose of optimizing medical equipment design,manufacturing and procurement.