Cost analysis of medical consumables for patients undergoing coronary stent implantation surgery before and after volume procurement in the context of diagnosis related groups payment / 中国医学装备

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.

Consistent analysis of swept-source optical coherence tomography and time-domain optical coherence tomography in measuring the parameters of chamber angle of patients with myopia / 中国医学装备

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.

Research on technological roadmap based on theintegrated development of digestive tract endoscopy and artificial intelligence precision medicine / 中国医学装备

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.

Association between ambient particulate matter exposure and platelet counts in adults: a retrospective cohort study.

Associations between ambient particulate matter exposure and platelet counts are inconsistent in previous studies, and study on the effect of long-term exposure especially in Asian populations is limited. We explored the associations between long-term PM2.5 (particulate matter < 2.5 µm) exposure and platelet counts using a prospective cohort study in Northeast China. We used a logistic regression model to analyze the effects of different PM2.5 increments and platelet count elevation. Mixed linear models were used to analyze the association between PM2.5 concentration and platelet counts. Interaction and sub-group analyses were also conducted. Results showed that every 1 µg/m3 increment of PM2.5 exposure was associated with 0.29% (95%CI: 0.25-0.32%) increase in platelet counts and 10% (95%CI: 8-12%) higher risk of platelet elevation. Effects of long-term PM2.5 exposure on platelet elevation were stronger in male participants, of Han ethnicity, and without diabetes. Long-term PM2.5 exposure would increase platelet counts in adults in Northeast area of China, which might add more evidence to the potential biological mechanisms responsible for the effect of air pollution exposure on cardiovascular disease.

Dietary patterns and associations between air pollution and gestational diabetes mellitus.

The prevalence of gestational diabetes mellitus (GDM) has been increasing worldwide. Dietary patterns and air pollution are closely related to the occurrence of GDM. No previous study has explored the interaction effect of air pollution exposure and dietary patterns on GDM. We explored the interaction effect between main dietary patterns and pre-pregnancy exposure to air pollution on the development of GDM based on a prospective birth cohort in Northeast China. A total of 2244 participants were included in this study. Factor analysis was used to identify dietary patterns. We found that long-term exposure to nitrogen dioxide (NO2) and carbon monoxide (CO) before pregnancy was significantly associated with an increased risk of GDM; the animal foods pattern significantly modified these associations. The sub-group analysis showed that compared with a lower intake in the animal foods pattern (NO2, odds ratio [OR] = 1.07, 95% confidence interval [CI]: 0.84, 1.35; CO, OR = 1.05, 95% CI: 0.81, 1.34), higher intake in the animal foods pattern (NO2, OR = 1.41, 95% CI: 1.09, 1.83; CO, OR = 1.36, 95% CI: 1.05, 1.76) before pregnancy increased the hazardous effects of NO2 and CO on GDM development. The intake of animal blood, animal organs, preserved eggs, and processed meat products in animal food pattern could all aggravate the effect of exposure to air pollution due to NO2 and CO on GDM. Our study demonstrated that there was a significant interaction effect between animal foods pattern and exposure to air pollution on GDM. These results provide further scientific evidence of the associations among air pollution, dietary intake, and GDM, and may help as well as the prevention of GDM.

Association between ambient black carbon concentration and hospital visits of childhood asthma / 国际儿科学杂志

Objective:Exposure to pollutants may induce aggravation of asthma in children through various ways.Ambient black carbon(BC)is a typical pollutant in Northeast China, and there has been no research report on the relationship between atmospheric BC exposure and childhood asthma in Northeast China.This study is to investigate the association between the atmospheric concentration of BC and hospital visits of daily childhood asthma.Methods:During the period of January 1 to August 31 in 2019, 52 653 hospital visits of childhood asthma children were recorded in several hospitals in Shenyang.A time series analysis was conducted to explore the relationship between the atmospheric concentration of BC and hospital visits of daily childhood asthma.Results:During the study period, the total number of children with asthma in outpatient and emergency departments in Shenyang was 52 653, the average concentration of BC was 2.58 mg/m 3.Increased concentrations of BC(2.00~10.03 mg/m 3)( RR=1.17, 95% CI: 1.07~1.28)and NO 2(0~88 μg/m 3)( RR=1.21, 95% CI: 1.06~ 1.39)were significantly associated with elevated number of childhood asthma in outpatient and emergency departments( P< 0.05). The highest cumulative effect of increased pollutants on children′s asthma within 10 days was BC( RR=1.60, 95% CI: 1.23~2.08). Conclusion:There is a positive association between BC concentration and hospital visits of childhood asthma, the accumulative effect of BC on childhood asthma is greater than other pollutants.

A clinical study of 24-hour pumping of continuous feeding in very low birth weight infants / 中华实用儿科临床杂志

Objective:To investigate the effect of 24-hour continuous feeding by pump on gastrointestinal dysfunction and early growth of very low birth weight infants (VLBWI).Methods:Eighty VLBWI fed by tube in the Neonatal Intensive Care Unit (NICU) of Fuyang Women and Children′s Hospital, Anhui Province from January 2017 to June 2019, were retrospectively analyzed.They were randomly divided into the observation group and the control group according to the simple randomization method, 40 cases in each group.The observation group included 23 males and 17 females, with the gestational age of 28 + 2-33 + 5 weeks, and birth weight of 1.04-1.47 kg.The control group included 21 males and 19 females, with the gestational age of 28 + 1-33 + 5 weeks, and birth weight of 1.05 -1.47 kg.On the basis of giving both groups routine treatment, nursing, and non-nutritional sucking, the control group was treated with intermittent tube feeding and infusion of formula milk, while the observation group was microfed 24 h continuously by pump.The general situation, meconium discharge time, frequency of daily defecation, daily milk volume, gastrointestinal dysfunction, increase of body weight after birth, and neonatal behavioral neurological assessment (NBNA) at 40 weeks of gestational age were compared between the two groups.The increase of body mass after birth and the determination of neonatal behavioral neurological assessment (NBNA) in neonatal behavioral nerve at 40 weeks of gestational age were statistically analyzed by χ2 test and t test. Results:(1)There were no significant differences in sex, gestational age, birth weight, head circumference and body length between the 2 groups (all P>0.05). (2) Compared with the control group, the premature infants in the observation group had increased daily milk volume [(12.95±2.34) g/d vs.(10.08±2.08) g/d], shortened meconium discharge time [(3.90±0.84) d vs.(5.02±0.86) d], and higher frequency of daily defecation[(3.85±1.07) times/d vs.(3.00±0.81) times/d], shortened extubation time[(14.75±3.20) d vs.(16.80±3.08) d], shortened time of weight to loss to minimum[(3.38±0.86) d vs.(4.22±0.89) d], faster growth of the daily average body weight[(15.25±2.29) g/(kg·d) vs.(11.55±1.56) g/(kg·d)], shortened average hospitalization time [(35.58±8.29) d vs.(39.42±8.29) d], and faster increase of the head circumference[(35.23±2.40) cm vs.(33.74±1.63) cm]. The differences were statistically significant ( t=5.805, -5.907, 3.981, -2.918, -2.825, 3.890, -2.060, 3.233, all P<0.05). (3)The incidence of vomiting, abdominal distension, hypoglycemia and hyperbilirubinemia in the observation group was significantly lower than that in the control group ( χ2=5.000, 16.050, 5.165, 14.528, all P<0.05). (4) There was no significant difference in necrotizing enterocolitis (NEC) and dyspnea between the two groups ( χ2=1.438, 10.251, all P>0.05). The total scores of behavioral ability, passive muscle tension, active muscle tension, primitive reflex, general evaluation and NBNA in the observation group were higher than those in the control group, the difference was statistically significant ( t=5.026, 3.207, 3.000, 2.421, 3.150, 6.141, all P<0.05). Conclusions:Twenty-four-hour continuous feeding by pump combined with non-nutritious sucking can significantly reduce the occurrence of gastrointestinal dysfunction in VLBWI, promote the development and maturation of gastrointestinal function, improve the nutritional status, accelerate the physical growth, and thus facilitate the development of behavioral nerve.

The impact of prenatal exposure to air pollution on childhood wheezing and asthma: A systematic review.

BACKGROUND AND OBJECTIVES: There has been no clear consensus about whether prenatal exposure to air pollution contributes to the development of wheezing and asthma in children. We conducted a systematic review to analyze the association between exposure to different pollutants during pregnancy and the development of childhood wheezing and asthma. METHODS: We systematically reviewed epidemiological studies published through June 6, 2017 available in the MEDLINE and Web of Science databases. We included studies that examined the association between prenatal exposure to any air pollutants except tobacco smoke and the incidence or prevalence of "wheezing" or "asthma" from birth to 14 years of age. We extracted key characteristics of each included study using a template of predefined data items. We used the Critical Appraisal Skills Programme checklists to assess the validity of each included study. We conducted overall and subgroup meta-analyses for each summary exposure-outcome association. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated by using a random effects model. RESULTS: Eighteen studies met our eligibility criteria. There was notable variability in exposure assessment methods. The overall random effects risk estimates (95% CI) of different pollutants were 1.04 (0.94-1.15) aromatic hydrocarbons (PAH), 1.04 (1.01-1.07) NO2, 1.4 (0.97-2.03) PM2.5 for childhood wheeze and 1.07 (1.01-1.14) NO2, 1 (0.97-1.03) PM2.5, 1.02 (0.98-1.07) SO2, 1.08 (1.05-1.12) PM10 for childhood asthma. Minimal heterogeneity was seen for PAH and SO2, while some heterogeneity was observed for PM10, PM2.5 and NO2. CONCLUSIONS: The overall and subgroup risk estimates from the meta-analyses showed statistically significant associations between prenatal exposures to NO2, SO2, and PM10 and the risk of wheezing and asthma development in childhood. There is insufficient evidence to show an effect of prenatal exposure to BC, CO, and O3 on childhood wheezing and asthma. Further studies are needed to examine the individual compounds' effects.

Development of medical equipment purchase and audit supervision system / 医疗卫生装备

Objective To develop a medical equipment purchase and audit supervision system to promote medical equipment purchase.Methods The system was developed with C/S architecture,Windows XP system and above as the development platform,SQL Server 2005 as the database management system and PowerBuilder 9 as the development tool.There were 5 modules composing the system,including the ones for plan application and management,expert database management,veudor database management,purchase approval as well as audit and supervision.Results The system realized whole-course management of medical equipment purchase and carried out audit supervision based on data analysis,which simplified working flow,increased working efficiency and decreased purchase risks.Conclusion The system promotes the communication between the departments,and contributes to enhancing medical equipment purchase,audit supervision and risk prevention.

Role of medical engineering department in integration of health care, nursing and medical technology departments / 医疗卫生装备

Objective To explore the role of the medical engineering department in integration of the health care,nursing and medical technology departments.Methods The medical engineering department and integration of health care,nursing and medical technology departments were introduced from the aspects of concept,role,characteristic,working mode and etc.Results The medical engineering department contributed to enhancing medical service,medical safety and patient satisfaction,while the role needed strengthening.Conclusion Some measures are put forward to the medical engineering department during integration of health care,nursing and medical technology departments from the aspects of department positioning,examination and assessment,management mode and etc.

Establishment and application of centralized purchase and distribution mode for medical instruments / 医疗卫生装备

Objective To explore the establishment and application of a centralized purchase and distribution mode for medical instruments.Methods The centralized purchase and distribution mode was constructed based on the professional distributor and logistics team,and the application of medical instruments intra-hospital supply,processing and distribution (SPD) system was analyzed in the centralized purchase.Results Centralized purchase and distribution enhanced management efficiency and decreased inventory cost,and SPD system simplified the distribution mode and increased transport efficacy.Conclusion It's pointed out that professional logistics services be introduced to assist hospitals in centralized purchase and distribution.

Research on Electrical Impedance Tomography Technology / 中国医疗器械杂志

This article reviews the principle of electrical impedance tomography imaging and measurement system; focuses on electrical impedance tomography imaging detection system of incentive mode and several typical image reconstruction algorithm of electrical impedance imaging; and objectively compares and effectively evaluates several image reconstruction algorithm.

Research on the methods and application prospects of condition monitoring for medical devices / 中国医学装备

This paper introduces the present situation of condition monitoring of medical devices, states main methods of condition monitoring and puts forward the application strategies in hospitals briefly.

The research and expectation on wearable health monitoring system / 中国医疗器械杂志

Wearable health monitoring systems that use wearable biosensors capturing human motion and physiological parameters, to achieve the wearer's movement and health management needs. Wearable health monitoring system is a noninvasive continuous detection of human physiological information, data wireless transmission and real-time processing capabilities of integrated system, can satisfy physiological condition monitoring under the condition of low physiological and psychological load. This paper first describes the wearable health monitoring system structure and the relevant technology applied to wearable health monitoring system, and focuses on the current research work what we have done associated with wearable monitoring that wearable respiration and ECG acquisition and construction of electric multi-parameter body area network. Finally, the wearable monitoring system for the future development direction is put forward a simple expectation.

Present situation and application control of hospital medical devices / 医疗卫生装备

The necessity to apply medical devices properly was introduced, and the present situation of the application of hospital medical devices were discussed from the aspects of overuse, abuse, operation and supervision. Some countermeasures were put forward to solve the problems in the application of hospital medical devices. It's pointed out that the application of hospital medical devices tends to be standardized with the progress of medical reformation, the attention on medical devices management, the supervision and etc.

Discussion on improving timely rate of medical equipment archives / 中国医学装备

Objective:To improve the medical equipment timely filing rate.Methods: Through the literature reference and practical work experience, based on the research of medical equipment archives management content, problems, solutions.Results: According to the comprehensive analysis of the literature in recent years is introduced and all levels of hospital medical equipment archives management and practice management work experience, summarizes the paper, summarized and further improve the management of medical equipment archives.Conclusion:To improve the timely filing rate, improve the utilization of archives, and find out the existing problems of hospital medical equipment archives management, the medical equipment archives play a major role in the practical work.

Discussion on the Defending Technologies for Military First-aid Equipments of the Army under Complex Electromagnetic Environments / 中国医学物理学杂志

Objective:To discuss the safety capability and defending technologies for military First-aid equipments of the army under complex electromagnetic environment.Methods:This paper analyzed the current status researching of the defending technologies for military First-aid medical equipments of the army,expatiated on the effect mechanism of the high power electromagnetic radiation on the medical equipment,and discussed the defending and reinforcing technologies.Results:The current military First-aid medical equipments of the army are of a sort defending capability,and it will have important significance to strengthen the study on the anti-electromagnetic interference technologies.Conclusion:The defending and reinforcing technologies discussed in this paper could enhance the subsistence capability of the military First-aid equipments under complex electromagnetic environments.

Progress in detection, analysis and application of new techniques to monitoring bowel sounds / 生物医学工程学杂志

The detection and analysis of bowel sounds are of importance to the diagnosis and treatment of gastrointestinal diseases. In this paper are summarized the recent advances in the detection and analysis as well as in the application of new techniques to monitoring bowel sounds. Several methods, including spectrum analysis, adaptive filtering, wavelet transform, principal component analysis, and artificial neutral network are mainly introduced. All of them are promising for feature extraction and automatic classification of bowel sounds.

Research of Independent Component Analysis for Processing Bowel Sounds / 中国医学物理学杂志

Objective: To eliminate the noise merged in bowel sounds and extract the time-domain features of the main signal. Methods: In this paper, the principles of Independent Conponent Analysis (ICA) were investigated; the algorithm of Fast ICA was discussed; the step of ICA was given. Then we processed the bowel sounds with this method, and extracted the time-domain features with normalized average Shannon energy, representative differences were found between the normal and abnormal signals. Results: The noise merged in bowel sounds is eliminated and there are statistical differences between the normal and abnormal bowel sounds. Conclusions: Detection and analysis of bowel sounds has important value in the diagnosis and cure of gastrointestinal diseases, the experimental results show that ICA is an effective method for processing bowel sounds.

Research of Effects and Defense of High-power Microwave Radiation on Military Medical Equipment / 医疗卫生装备

The feature of HPM(high-power microwave) and its effect are briefly introduced.The destroying mechanism of HPM to different electronic medical equipment is described in detail.The reinforcement of HPM and effective measures are discussed.It is crucial to study the effects of high-power microwave radiation on military electronic equipment due to wide application of HPM in future military actions.