ABSTRACT
Objective:To explore the characteristics of the changes in risk score for intensive care unit (ICU) patients during hospitalization by the intelligent calculation method, and to provide evidence for the risk prevention.Methods:In this retrospective study, ICU patients of the Fifth Central Hospital in Tianjin from November 3, 2021 to March 28, 2022 were enrolled and divided into ≥ 14 days group, 10-13 days group, 7-9 days group, and 3-6 days group according to the ICU length of stay. Risk scores assessed by the intelligent calculation method of the ICU patients were collected, including nutritional risk screening 2002 (NRS 2002), Caprini score and Padua score. NRS 2002 score for all patients, Caprini score for surgical patients and Padua score for internal medicine patients were selected. Trends in change of each score were compared between patients admitted to ICU 1, 3, 7 (if necessary), 10 (if necessary), and 14 days (if necessary).Results:A total of 138 patients were involved, including 79 males and 59 females, with an average age of (61.71±18.86) years and an average hospital stay of [6.00 (4.00, 9.25)] days. ① in the group with ICU length of stay ≥ 14 days (21 cases): there was no significant change in the NRS 2002 scores of the patients within 10 days, but the NRS 2002 score was significantly decreased in 14 days as compared with 1 day [3.00 (2.50, 3.50) vs. 4.00 (3.00, 5.00), P < 0.05]; both Caprini and Padua score were increased with prolonged hospital stay and compared with 1 day, the scores at the other time points were significantly increased, especially at 14 days [Caprini score: 5.00 (3.25, 7.00) vs. 2.50 (1.25, 5.50), Padua score: 6.00 (6.00, 7.00) vs. 3.00 (1.00, 3.00), both P < 0.05].② in the group with ICU length of stay from 10-13 days (15 cases): with the prolonged hospital stay, there was no significant change in NRS 2002 score, but both Caprini and Padua score were increased at 3, 7, 10 days, especially at 10 days [Caprini score: 3.00 (2.00, 4.75) vs. 2.00 (0.25, 2.75), Padua score: 5.00 (3.50, 6.00) vs. 2.00 (0.50, 4.00), both P < 0.05].③ in the group with ICU length of stay from 7-9 days (23 cases): compared with 1 day, the NRS 2002 score at 3 days and7 days were decreased, but the Caprini and Padua score were increased, especially at 7 days [NRS 2002 score: 2.00 (1.00, 4.00) vs. 2.00 (2.00, 4.00), Caprini score: 3.00 (2.00, 5.50) vs. 2.00 (0.25, 3.00), Padua score: 5.00 (4.00, 6.00) vs. 2.00 (0, 2.00), all P < 0.05]. ④ in the group with ICU length of stay from 3-6 days (79 cases): compared with 1 day, the NRS 2002 score at 3 days was decreased [NRS 2002 score: 2.00 (1.00, 3.00) vs. 2.00 (1.00, 3.00), P < 0.05], Caprini and Padua score were significantly increased [Caprini score: 3.00 (2.00, 4.00) vs. 2.00 (1.00, 3.00), Padua score: 5.00 (4.00, 5.00) vs. 2.00 (1.00, 3.00), both P < 0.05]. Conclusion:Based on dynamic assessment of intelligent calculation methods, the risk of thrombosis in ICU patients increased with hospital length of stay, and the nutritional risk was generally flat or reducing in different hospitalization periods.
ABSTRACT
OBJECTIV E To investigate the calculation method of drug market share in budget impact analysis （BIA）in order to provide new ideas for BIA research. METHODS In view of the situation that some drugs had multiple indications or the indications in the drug instructions were not clear enough and inconsistent with the indications in the reimbursement catalogue ， starting from the concept of “times per person ”，the parameters such as sample hospital and average treatment time per person for each time were introduced to develop a new market share calculation method. At the same time ，the calculation process was demonstrated by taking the treatment drugs for liver cirrhosis as an example. RESULTS & CONCLUSIONS Taking treatment drugs of liver cirrhosis as an example ，the calculation results of market share showed that the results of the two calculation methods were quite different. The market share calculated on the basis of “the number of people ”was mostly higher than that calculated on the basis of “times per person ”. Compared with the traditional calculation method based on “the number of people ”，the calculation method of market share based on “times per person ”could calculate the market share more accurately ，which could solve the problem that the traditional method didn ’t fully consider that most drugs had multiple indications ，the indications of drug instructions were not clear enough and inconsistent with the reimbursement catalogue ，resulting in inaccurate calculation of market share；at the same time ，this method could also be used to try to solve the problem that the total number of patients could not be obtained from epidemiological data based on the average treatment time per person of each time in the sample hospital. This method can be considered when the indications of the target drug are not clear enough or there are multiple indications ，or when the researchers collect clinical ，epidemiological and medical insurance data to estimate the number of target population ，the prediction results of market capacity do not conform to the theoretical logic or actual situation due to the lack of necessary data ，or when the target disease has the characteristics of repeated attacks and short course of disease.
ABSTRACT
Objective:To explore the accuracy of intelligent calculation (IC) method for risk assessment of hospitalization for patients, aiming to build a more advantageous risk assessment system.Methods:The "Search Engine" program was developed based on hospital information system (HIS) of the Fifth Center Hospital in Tianjin, which automatically captured patient information and generated nutritional risk screening 2002 (NRS 2002) score, Caprini thrombosis risk assessment model and Padua thrombosis risk assessment model for venous thromboembolism (VTE), the CHA 2DS 2-VASc for predicting stroke risk stratification in atrial fibrillation and the HAS-BLED for predicting bleeding risk in anticoagulated patients with atrial fibrillation. A randomized controlled trial was conducted. According to the applicable conditions of each risk assessment, 100 risk scores from "Search Engine" program belonged to each risk assessment were randomly selected, defined as the IC group. Manual scoring with the data of the same case at the same time, defined as the traditional calculation (TC) group, compared the consistency of the scores and the difference in time-consuming between the two groups. Results:The Bland-Altman plots showed that the 95% limits of agreement (95% LoA) of NRS 2002 score, Caprini score, Padua score, CHA 2DS 2-VASc score and HAS-BLED score was -0.46 to 0.41, -0.49 to 0.52, -0.50 to 0.41, -0.67 to 0.60, -0.44 to 0.43, respectively, all P > 0.05. In this study, the Bland-Altman plot showed that 95%, 96%, 97%, 97%, 95% plots fell within the 95% LoA in NRS 2002 score, Caprini score, Padua score, wwCHA 2DS 2-VASc score and HAS-BLED score by the two methods, respectively. The all plots of 95% LoA were within the clinically acceptable range (-0.5 to 0.5 scores). The time-consuming of NRS 2002 score, Caprini score, Padua score, CHA 2DS 2-VASc score and HAS-BLED score in IC group were significantly shorter than those in TC group [0.72 (0.71, 0.73) seconds vs. 361.02 (322.41, 361.02) seconds, 0.72 (0.72, 0.73) seconds vs. 196.68 (179.99, 291.20) seconds, 0.72 (0.72, 0.73) seconds vs. 105.75 (92.32, 114.70) seconds, 0.72 (0.71, 0.72) seconds vs. 72.66 (56.24, 84.20) seconds, 0.72 (0.71, 0.72) seconds vs. 51.30 (38.88, 57.15) seconds, respectively, all P < 0.001]. Conclusion:For the above five risk assessments, the TC method and IC method has good consistency in scores, and the IC method is faster, which has good application prospect for clinical application.
ABSTRACT
OBJECTIVE：To construct a calculation method which can accurately reflect the medical insurance fund expenditure of intervention scheme for cross-year survival patients ，and to provide reference for the research of medical insurance budget impact analysis（BIA）. METHODS ：Based on survival data of cohort model ，taking the patients diagnosed in each cycle in each year as a cohort，the number of per capita survival cycle of cohort patients in each state in the study year was calculated ，i.e. the average survival time ；on this basis ，the total cost of patients in all cohorts in the study year was calculated according to the number of people in each cohort and the per capita cost each cycle in each state. Taking the intervention scheme of a cancer as an example ， the calculation was carried out by the established algorithm ，and the calculation results were compared with the results of several common algorithms ；at the same time ，the application suggestions were put forward for the expansion of the constructed algorithm in special cases. RESULTS & CONCLUSIONS ：Compared with the several common algorithms ，the calculation process of the constructed algorithm is more in line with the process of medical insurance fund expenditure related to drug intervention scheme in the real world ，and it can flexibly adapt to the calculation needs in a variety of special situations. This algorithm can more accurately calculate the medical insurance fund expenditure of a intervention scheme in a specific year ，and to a certain extent solve the problem of inaccurate prediction of medical insurance fund expenditure due to insufficient consideration of cross-year survival patients or simple and rough calculation process. It can provide a more accurate method choice for the research of medical insurance BIA in China.
ABSTRACT
G protein-coupled receptors (GPCR) are a class of receptor superfamily that exist on the surface of cell membrane. With the intensive studies on the GPCR desensitization regulator—β-arrestins, it is found that activated GPCR can not only conduct signal transduction through G protein-dependent pathway, but also mediate via non-G protein-dependent pathway. In addition to mediate endocytosis and desensitization, β-arrestins also initiate a new series of signal transduction events. Therefore, the concept of "biased transduction" was put forward: the receptor activated by a specific ligand could selectively activate a specific signaling pathway, leading the signal to be transmitted downstream along a "preferential" pathway. We call the ligand that binds to the receptor and causes biased activation "biased ligand". It is generally believed that the phenomenon of bias results from different binding modes of ligands and receptors, including multiple receptor conformations, diverse sites that downstream signal proteins bind, and signal proteins’ own conformations, etc. Here we give a brief review focusing on the mechanisms of β-arrestin-biased GPCR signal transduction and the advances in the drug development on β-arrestin biased ligands.
ABSTRACT
Objective To design a calculation method for medical equipment dynamic capability usage rate to provide guidance for capability development and purchasing demonstration during the utilization of large medical equipment.Methods Statistical analysis was executed on the application of all the capabilities of some medical equipment,and the utilization rates were obtained on each capability and dynamic capability respectively.Results The proposed method reflected accurately the application of each capability of the equipment when compared with the conventional way.Conclusion The dynamic calculation method can accurately reflect the capability utilization of a single device,and can be further applied to the evaluation of the capability utilization of all the equipment,which provides guidance for the development of equipment capabilities and procurement.
ABSTRACT
<b>Objective:</b> To explore the data sources used in economic evaluations performed on new drugs, and to propose an improved data infrastructure in Japan.<br><b>Design:</b> A systematic review.<br><b>Methods:</b> We systematically reviewed economic evaluation studies of the new drugs which were launched in Japan between April 2006 and March 2011, and have been priced by the cost calculation method. The “Ichushi” and Pubmed databases were used to find the published articles.<br><b>Results:</b> 198 drugs were priced under cost calculation methods in the last 5 years in Japan. 14 published articles (9 drugs) were found: 5 CUAs and 10 CEAs (including one that was both CUA and CEA). In all studies, several data from different sources were incorporated. Cost data were estimated by using standard treatment protocols and national price lists for drugs and medical services, or obtained from limited number of claims data. Efficacy data were obtained from RCTs or clinical trial data mostly conducted in Japan. In 4 out of the 5 CUAs, utility data were used from other studies conducted on non-Japanese samples. Other data, such as epidemiological data, were adopted from overseas as well as Japanese studies.<br><b>Conclusion:</b> In order to increase quality and efficiency to conduct economic evaluations in Japan, three steps need to be taken in the data environment: increased accessibility to large cost databases such as the national claims database; establish an epidemiological database; and collect and accumulate utility data in Japanese samples.
ABSTRACT
PURPOSE: Dyna-ATC is a unilateral external fixator with angulator, lengthener, and translator, which allows for angular correction and compensation of the secondary displacement during angular correction. The purpose of this study is to introduce surgical technique and calculation methods and to evaluate the clinical outcome of angular deformity correction using Dyna-ATC. MATERIALS AND METHODS: The amounts of secondary displacement were calculated with the distances between axis of correction of angulation, Center of Rotational Angulation, and osteotomy and the amount of angular deformity. The rate of angular correction was determined to distract the corticotomy at 1 mm/day. Clinical and radiographic evaluation was performed on 13 patients who underwent deformity correction using Dyna-ATC. There were 8 proximal tibia vara, 1 tibia valga, 2 varus and 4 valgus deformities on distal femur. One patient underwent pelvic support femoral reconstruction. Concomitant lengthening was combined in all femur cases. Mean age at surgery was 17.5 years (7 to 64). RESULTS: All but one achieved bony healing and normal alignment with the index procedure. Mean mechanical axis deviation improved from 31.9 mm to 3.0 mm. The average amount of angular correction was 11.0degrees on tibiae and 10.0degrees on femora. The average length gain on femora was 6.4 cm, and the healing index averaged to 1.1 mo/cm. One patient underwent quadricepsplasty and one patient had three augmentation surgeries due to poor new bone formation. CONCLUSION: We believe that Dyna-ATC is a useful alternative to bulky ring fixators for selective patients with angular deformity less than 30 degrees in the coronal plane around the knee joint.
Subject(s)
Adolescent , Child , Female , Humans , Male , Middle Aged , Young Adult , Bone Diseases, Developmental/surgery , External Fixators , Femur/abnormalities , Leg Length Inequality/surgery , Lower Extremity Deformities, Congenital/surgery , Osteochondrosis/congenital , Osteogenesis, Distraction/instrumentation , Osteotomy , Tibia/abnormalities , Treatment OutcomeABSTRACT
The subject of modernization of Traditional Chinese Medicine(TCM) has been argued in China for many years.Many good ideas have been suggested by experts and scholars.In this paper,one issue in the modernization of TCM is discussed.The issue is how to introduce some mathematical methods into traditional Chinese medicine.This is a valuable subject to study,because by this way,the computers can be used to analyze the composing methods of TCM prescriptions and to help TCM doctors to select better treating means.A new mathematical method for analyzing the composing methods of TCM prescriptions has been developed,and the methods are still based on TCM theory.By these methods,the TCM prescriptions can be computed or analyzed in digital formations,but the integral conception about human body in TCM is still left intact.In this paper,using the new method,several TCM prescriptions were analyzed,and the analyzed results demonstrate that the methods are efficient and give a good help to understand the composing methods of TCM prescriptions.
ABSTRACT
OBJECTIVE: To compare 3 different calculation methods in the determination of aspirin in the bicomponent (aspirin and salicylic acid) system. METHODS: Different concentrations of mixed standard solution of aspirin and salicylic acid were prepared and scanned under a wavelength ranged from 230nm to 350nm. The absorbabilities of the 2 constituents were recorded at 265nm, 295nm and 320.5nm, and the data were treated with Iso-absorption diplo-wavelength method, proximal multiplying factor coefficient method and SA concentration fractional approximate calculation method. The recoveries of aspirin were calculated. RESULTS:The recoveries of aspirin determined by 3 different methods were (99.11?1.68)%, (98.82?1.17) % and (96.23?4.10)%, respectively. CONCLUSION: The proximal multiplying factor coefficient method is stable with little fluctuation in determination results, which proved to be simple while effective for the determination of sample at a great quantity.