Objective:To establish a medical equipment maintenance model based on the analytic hierarchy process(AHP),and to study its application effect in the management of orthopedic medical equipment in hospitals.Methods:Based on the analytic hierarchy process(AHP),the equipment maintenance model was constructed from the classification of the service life,failure mode,failure consequences and other indicators of orthopedic medical equipment.25 sets of medical equipment in clinical use in the Department of Orthopedics of The Second Affiliated Hospital of the Air Force Medical University from 2019 to 2022 were randomly selected,taking the time as the dividing point,the traditional orthopedic medical equipment management model(referred to as traditional management)was implemented during the equipment use period from 2019 to 2020,and the equipment maintenance model based on AHP was used to manage orthopedic medical equipment(referred to as model management)during the equipment use period from 2021 to 2022.A total of 1,000 equipment usage records were collected,500 for each mode,and the effect of equipment repair and maintenance,the satisfaction score of equipment usage management and the incidence of adverse events were compared under different management modes.Results:The cost-effectiveness of equipment using the model management mode was an average of CNY(34,500.00±4,700.00)per unit per year,which was higher than that of the traditional management mode,the difference was statistically significant(t=8.417,P<0.05),the maintenance costs and operating costs were CNY(15,381.95±13.67)per year and CNY(31,600.00±10,500.00)per year,respectively,which lower than those of the traditional management model,the difference was statistically significant(t=858.675,5.371,P<0.05).The scores of equipment management personnel on equipment performance,timeliness and cleanliness of the equipment using the model management mode,and the patients'satisfaction with convenience,effect and comfort of the equipment(9.65±1.14),(9.74±1.38),(9.53±1.09),(9.58±1.07),(9.62±1.14)and(9.81±1.28),respectively,which were all higher than those of the traditional management mode,the difference was statistically significant(t=5.629,5.687,4.736,8.085,5.330,7.680,P<0.05).The total incidence of adverse events in equipment using model management mode was 4.8%(24/500),which was lower than that of the traditional management mode,the difference was statistically significant(x2=12.515,P<0.05).Conclusion:The application of medical equipment maintenance model based on analytic hierarchy process to the management of orthopedic medical equipment can effectively reduce the equipment maintenance cost,improve the cost-effectiveness of the equipment,and improve the satisfaction of the equipment use management personnel.

OBJECTIVE To investigate t he attitude of endocrinology physicians to clinical conversion and substitution of insulin drugs ，and to provide basis for improving the centralized procurement program of insulin. METHODS The proportion of convertible and substitutable insulin recognized by endocrinology physicians was investigated by questionnaire from 4 dimensions： intergenerational level ，bargaining group level ，common name level and brand/specification level. The subjects were endocrinology physicians in the third grade class A general hospitals in Nanchang. RESULTS A total of 89 questionnaires were successfully distributed，accounting for 80.2％ of the on-the-job endocrinology physicians （111 in total ）in the third grade class A general hospitals in Nanchang. Eighty-nine questionnaires were collected ，one of which was invalid ，and the effective rate was 98.9％. At the intergenerational level ，93.2％ of endocrinology physicians preferred insulin analogues. At the bargaining group level ，the weighted average of the convertible ratio between group 3 and group 4 approved by physicians was 63.9％. At the levels of common name and brand/specification ，the weighted averages of convertible proportion of each group were more than 70％. CONCLUSIONS The method of insulin grouping in Wuhan is reasonable which can complete clinical conversion and substitution of insulin in the group safely. It is suggested to cancel long-acting human insulin group. The weighted average of the proportion of convertible and substitutable drugs in the group is high. It is suggested to increase the agreed purchase volume of insulin and conduct“volume price linked ”negotiations. When the surveyed physicians choose the initial treatment scheme of insulin ，they pay more attention to the factors such as efficacy and safety ，so the replacement of insulin should be based on the clinical efficacy and drug safety.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.

Objective To verify the safety and efficacy of IONTRIS particle therapy system ( IONTRIS) in clinical implementation. Methods Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial:31 males and 4 females with a median age of 69 yrs ( range 39?80) . Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non?metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results Twenty?two patients received carbon ion and 13 had proton irradiation. With a median follow?up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression?free survival rate was 93.8％ (15/16). Among the 19 patients with prostate cancer, biological?recurrence free survival was 100％. Particle therapy was well tolerated in all 35 patients. Twenty?five patients (71.4％) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow?up. Six ( 17.1％) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow?up is needed to observe the late toxicity and long term result.

Objective To verify the safety and efficacy of IONTRIS particle therapy system ( IONTRIS) in clinical implementation. Methods Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial:31 males and 4 females with a median age of 69 yrs ( range 39?80) . Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non?metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results Twenty?two patients received carbon ion and 13 had proton irradiation. With a median follow?up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression?free survival rate was 93.8％ (15/16). Among the 19 patients with prostate cancer, biological?recurrence free survival was 100％. Particle therapy was well tolerated in all 35 patients. Twenty?five patients (71.4％) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow?up. Six ( 17.1％) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow?up is needed to observe the late toxicity and long term result.

Objective To illustrate if the racial coefficient (Rc) be biased by different reference GFR (rGFR) distribution among studies. Methods 1405 white and 321 African American participants in MDRD study and 684 chronic kidney disease(CKD)patients in Chinese eGFR Investigation Study were included.Firstly.the unweighted datasets of white and Chinese were stacked together.rGFR,age and plasma creatinine (Pcr) were log transformed.Linear regression model was constructed using log transformed rGFR as dependent,gender,race and log transformed Pcr and age as independent.Unweighted RC (uRC) for Chinese was calculated.Then.the Chinese CKD distribution of rGFR was weighted to be the same as that in White American.and weighted RC (wRC)for Chinese was calculated.The cases of White.and African-American were stacked together.The cases of African-American were weighted to make the rGFR distribution the same as that in White-American and Chinese population respectively,and RCs for African-American were calculated. Resuits The uRC for Chinese was 1.197(1.180-1.211)and the wRC was 1.130 (1.117-1.143).The two RCs did not overlap with each other.The RCs for African-American were 1.205(1.19-1.219)and 1.233(1.219-1.247)respectively. Conclusions The RCs were influenced by the difference of rGFR distribution.To find out the real RC.an intemational collaborative study iS needed,with the same rGFR measure method.strict control of Pcr measurement,and the same rGFR distribution.