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 evaluate the molluscicidal effect of spraying different formulations of niclosamide ethanolamine salt with drones against Oncomelania hupensis in ditches. Methods A semi-dry and semi-wet ditch with O. hupensis snails was selected in the second branch field of Jiangbei Farm, Jiangling County, Hubei Province in May 2023, and divided into 4 experimental areas, named groups A1, A2, B1 and B2. Environmental cleaning was performed in groups A1 and B2, and was not conducted in groups A2 or B2. Then, 50% wettable powder of niclosamide ethanolamine salt was sprayed with drones at an effective dose of 2 g/m² in groups A1 and A2, and 5% niclosamide ethanolamine salt granule was sprayed with drones at an effective dose of 2 g/m² in groups B1 and B2. O. hupensis snails were surveyed using the systematic sampling method 1, 3, 5, 7, 14 days after spraying, and the natural mortality and corrected mortality of O. hupensis snails were calculated. Results The occurrence of frames with living snails, mean density of living snails and natural mortality of snails were 97.50% (117/120), 6.30 snails/0.1 m² and 1.18% (9/765) in the test ditch before spraying, respectively. There were significant differences in the mortality of snails among four groups 1, 3, 5, 7 and 14 days after spraying niclosamide formulations with drones (χ² = 17.230, 51.707, 65.184, 204.050 and 34.435, all P values < 0.01). The overall mortality rates of snails were 94.51% (1 051/1 112), 79.44% (908/1 143), 96.54% (977/1 012) and 88.55% (1 021/1 153) in groups A1, A2, B1 and B2 (χ² = 207.773, P < 0.05), respectively. In addition, there was no significant difference in the overall snail mortality between groups A1 and B1 (P > 0.05), and the snail mortality in groups A1 and B1 were both statistically different from that in groups A2 and B2 (all P values < 0.05). Conclusion Both 50% wettlable powder of niclosamide ethanolamine salt and 5% niclosamide ethanolamine salt granule sprayed with drones are active against O. hupensis snails in ditches, and environmental cleaning may improve the molluscicidal effect.

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.

Objective:To analyze and evaluate the application effect of magnetic navigation-guided nasojejunal tube placement in critically ill patients by literature retrieval.Methods:The Chinese databases of CNKI,Wanfang,VIP and Chinese Biomedical Literature Service System were searched,as well as the literature on randomized controlled trials of magneto-guided nasojejunal tube placement in critically ill patients in foreign language databases of PubMed,CINAHL,Cochrane Library,Web of Science,and Embase,the search period was from January 2000 to September 2023.The literature were screened according to the inclusion and exclusion criteria,and the quality of the literature was evaluated.RevMan 5.4.1 software was used to conduct a meta-analysis of the four outcomes in the literature:success rate of placement,time required for successful placement,time to recovery of vital signs,and patient satisfaction.Results:A total of 7 randomized controlled trials of 7 studies were included,including 4 Chinese studies and 3 English studies,involving 682 patients.The success rate of magnetic navigation-guided nasojejunal tube placement was higher than that of bedside blind nasojejunal tube placement,the difference was statistically significant[OR=4.78,95%CI(2.16～10.58),P<0.0001].The time required for magnetic navigation guided nasojejunal tube placement was less than that of the bedside blind nasojejunal tube placemen,the difference was statistically significant[MD=-12.91,95%CI(-22.93～-2.90,P<0.00001].The time required for recovery of vital signs in patients with magnetic navigation guided nasojejunal tube placement was less than that of the bedside blind nasojejunal tube placemen,the difference was statistically significant[MD=-9.11,95%CI(-12.09～-6.13,P<0.00001].The satisfaction of patients with the magnetic navigation-guided nasojejunal tube placement was higher than that of patients with the bedside blind nasojejunal tube placement,the difference was statistically significant[OR=11.61,95%CI(3.96～34.01),P<0.00001].Conclusion:Compared with bedside blind nasojejunal tube placement,magnetic navigation-guided nasojejunal tube placement can significantly improve the success rate of nasojejunal tube placement in critically ill patients,reduce the time required for successful nasojejunal tube placement,reduce the recovery time of patients'vital signs,and improve patient satisfaction.

Ultrasonic therapy technology is a research hotspot in the field of biomedicine,and the quality control and regulatory requirements for the ultrasonic physiotherapy equipment are also increasing.Based on this,the working principle and structure of ultrasonic physiotherapy equipment were analyzed,and a calibration method of ultrasonic physiotherapy equipment was proposed from the aspects of ultrasonic output power,effective radiation area and acoustic working frequency,etc.,aiming at its main measurement parameters,so as to provide technical reference for its measurement performance evaluation.Two ultrasonic physiotherapy equipment produced by different manufacturers were selected and tested to analyze the calibration results.The results showed that the calibration results were scientific and reasonable,highly operational,and in line with national standards,which can provide technical reference for metrology technical institutions to carry out related work.

A corresponding calibration method was proposed for the key performance parameters of the endoscopic liquid expansion pump,such as the pressure indication error,the flow rate indication error and the flow rate repeatability.4 different brands of endoscopic liquid expansion pumps in clinical use in the hospital were selected for calibration,and the feasibility of the calibration method was evaluated.In the pressure and flow range of the endoscope liquid expansion pump,3 calibration points of high,medium and low were selected,and each flow point was calibrated 3 times.The calibration results showed that the maximum error of pressure indication was 4.3%,the maximum error of flow indication was 9.3%,and the maximum repeatability of flow indication value was 0.8%,all of which met the technical requirements for the maximum allowable error of"Medical Endoscopes.Endoscope Functional Supply Units.Irrigation Pump"(YY/T 0864-2011)and"Calibration Specification for Syringe Pumps and Infusion Pumps"(JJF 1259-2018).The calibration method for endoscopic liquid expansion pump can improve the metrological traceability system of this type of equipment,ensure the accuracy and reliability of equipment values,improve product quality,and ensure medical safety.

Objective:To explore the calibration method of quality detection of spectrum therapy instrument in low pressure environment,so as to ensure its safety and stability in clinical use.Methods:Aimed at the 4 types of vertical spectrum therapy instrument,the calibration of quality test were carried out in normal environment and the simulated low pressure environment for 5 different altitudes that included 1.0,2.5,3.5,4.5 and 5.5 km.The detection of appearance function,unevenness of surface temperature and surface error,as well as the repetition of measurement of spectrum therapy instrument among different low pressure environment were compared.Results:In the low pressure environments of 5 different altitudes,the performance parameters of 3 types of spectrum therapy instruments were better,and the error of temperature unevenness was less than 10％.The performance of one type of spectrum therapy instrument was poor,and the error of temperature unevenness was between 10％and 20％.For the error of surface temperature of radiator,one type of spectrum therapy instrument was＜10％,and one type of that was＞15％,and two types of that cannot be assessed because there was not specific value.In normal environment,each detection indicator of 4 spectrum therapy instruments were normal.In this trial,the repetition of the result of only 1 type of spectrum therapy instrument was relatively larger,which was between 1.5％and 2.4％,and the repetition of other types was smaller.Conclusion:The calibration and detection methods of quality test of spectrum therapy instrument was explored in this article,which can ensure the clinical therapeutic effect,safety and stability.It is helpful to reduce the risk of that in clinical use.

OBJECTIVE: To investigate the effectiveness of tibial transverse transport (TTT) combined with modified neurolysis in treatment of diabetic foot ulcer (DFU) through a prospective randomized controlled study. METHODS: The patients with DFU and diabetic peripheral neuropathy, who were admitted between February 2020 and February 2022, were selected as the research objects, of which 31 cases met the selection criteria and were included in the study. The patients were divided into two groups by random number table method. The 15 patients in the trial group were treated with TTT combined with modified neurolysis, and the 16 patients in the control group received treatment with TTT alone. There was no significant difference in gender, age, duration of DFU, ulcer area, Wagner classification, as well as preoperative foot skin temperature, visual analogue scale (VAS) score, ankle-brachial index (ABI), motor nerve conduction velocity (MNCV) of the common peroneal nerve, MNCV of the tibial nerve, MNCV of the deep peroneal nerve, two-point discrimination (2-PD) of heel, and cross-sectional area (CSA) of the common peroneal nerve between the two groups ( P>0.05). The time for ulcer healing, foot skin temperature, VAS scores, ABI, 2-PD of heel, and CSA of the common peroneal nerve before operation and at 6 and 12 months after operation were recorded and compared between groups. The differences in MNCV of the common peroneal nerve, MNCV of the tibial nerve, and MNCV of the deep peroneal nerve between pre-operation and 12 months after operation were calculated. RESULTS: All patients in both groups were followed up 12-24 months (mean, 13.9 months). The surgical incisions in both groups healed by first intention and no needle tract infections occurred during the bone transport phase. Ulcer wounds in both groups healed successfully, and there was no significant difference in the healing time ( P>0.05). During the follow-up, there was no ulcer recurrences. At 12 months after operation, the MNCV of the common peroneal nerve, the MNCV of the tibial nerve, and the MNCV of the deep peroneal nerve in both groups accelerated when compared to preoperative values ( P<0.05). Furthermore, the trial group exhibited a greater acceleration in MNCV compared to the control group, and the difference was significant ( P<0.05). The foot skin temperature, VAS score, ABI, 2-PD of heel, and CSA of the common peroneal nerve at 6 and 12 months after operation significantly improved when compared with those before operation in both groups ( P<0.05). The 2-PD gradually improved over time, showing significant difference ( P<0.05). The 2-PD of heel and VAS score of the trial group were superior to the control group, and the differences were significant ( P<0.05). There was no significant difference in ABI, foot skin temperature, and CSA of the common peroneal nerve between groups after operation ( P>0.05). CONCLUSION Compared with TTT alone, the TTT combined with modified neurolysis for DFU can simultaneously solve both microcirculatory disorders and nerve compression, improve the quality of nerve function recovery, and enhance the patient's quality of life.
Humans ; Diabetic Foot/surgery* ; Microcirculation ; Prospective Studies ; Quality of Life ; Treatment Outcome ; Diabetes Mellitus