大型医院医用卫生材料的采购与供应管理

本文就医用卫生材料的分类、采购、招标、供应管理提出了自己的一些见解,以期对大型医院在医用卫生材料的采购、供应管理上更科学规范,促进医院医疗工作的发展.     

韶关市第一次医用耗材及检验试剂材料集中招标采购工作实践回顾与分析研究

医疗机构医用耗材集中招标采购是医药卫生体制改革的重要内容,也是纠正卫生部门行业不正之风的重要措施。搞好医疗机构医用耗材集中招标采购,必须统一思想、提高认识,加强对医用耗材集中招标采购具体运作行为的规范、监督,逐步完善政策、健全机制,建立严格有效的医用耗材及试剂材料集中招标采购监督体系,推动医用耗材及试剂材料集中招标采购工作健康、有序地发展。     

韶关市第一次医用耗材及检验试剂材料集中招标采购工作实践回顾与分析研究

医疗机构医用耗材集中招标采购是医药卫生体制改革的重要内容,也是纠正卫生部门行业不正之风的重要措施。搞好医疗机构医用耗材集中招标采购,必须统一思想、提高认识,加强对医用耗材集中招标采购具体运作行为的规范、监督,逐步完善政策、健全机制,建立严格有效的医用耗材及试剂材料集中招标采购监督体系,推动医用耗材及试剂材料集中招标采购工作健康、有序地发展。     

医用耗材招标采购问题初探

论述了医用耗材招标采购的重要意义,分析了医用耗材招标采购的特点及难点,指出实施医用耗材招标采购要抓好思想教育和发动,抓好医用耗材需求的调查分析,抓好产品分类及评标细则的制定,抓好招标后利益的重新调整.     

医用高值耗材对医疗费用产生影响的分析和思考

文章对近三年医用高值耗材使用数量?金额?单价及其增长率进行调查,发现临床高值耗材使用量增幅大,进而分析了医用高值耗材对医疗费用产生的影响,提出政府物价部门定价要科学,卫生行政部门准入要监管,医院内部采购?使用?收费要规范,以促进医用高值耗材的合理使用,控制医疗费用快速增长,降低患者负担和医疗服务成本?     

高值医用耗材管理重要性的探讨

目的 通过规范完善对高值医用耗材的管理操作流程来说明高值医用耗材管理的重要性.方法 高值医用耗材由医院及设备科统一招标、采购,使用方便快捷的微机程序来管理耗材入、出库.使用"零库存"管理和"二级库房"管理.结果 增加高值耗材购置的透明度,降低耗材成本,保证耗材质量,方便了护士对耗材使用情况的把握,有利于医院和科室对耗材的财务核算及材料统计.结论 完整规范的高值医用耗材管理制度能给病人和医院带来良好的社会效益和经济效益.     

医用耗材集中采购模式回顾与探讨

医用耗材的招标采购是一个系统工程,对医用耗材采用集中招标的采购模式,可以保证临床使用到质量优良的医用耗材,控制产品价格的虚高,有利于降低医疗成本,减轻患者负担。在规范医用耗材采购方式和流通渠道的同时,对集中采购的过程也需要不断总结与完善。     

高值医用耗材管理重要性的探讨

目的通过规范完善对高值医用耗材的管理操作流程来说明高值医用耗材管理的重要性。方法高值医用耗材由医院及设备科统一招标、采购，使用方便快捷的微机程序来管理耗材入、出库。使用“零库存”管理和“二级库房”管理。结果增加高值耗材购置的透明度，降低耗材成本．保证耗材质量；方便了护士对耗材使用情况的把握，有利于医院和科室对耗材的财务核算及材料统计。结论完整规范的高值医用耗材管理制度能给病人和医院带来良好的社会效益和经济效益。     

实行医用耗材集中招标采购的体会

近年来,通过实行医用消耗材料集中招标或集中选型议价采购的方法,效果显著、质量可靠、价格优惠、供应及时,是今后各大单位及卫生医疗单位必须采用的办法,已经逐步形成规范化和制度化.通过几年来的实际工作,浅谈几点体会和建议.     

医用卫生材料全程质量控制体系建立初探

目的:随着医用卫生材料用量的逐渐增大,它也越来越成为医疗风险的重要来源之一,如何有效控制这种风险,已成为业界普遍关注的课题.文中就如何加强医用卫生材料应用的安全性有效性进行了初步探讨. 方法:建立医用卫生材料质量控制体系,从多个环节严格控制卫生材料的质量情况,并建立不良耗材事件监测与报告制度. 结果:医用卫生材料的质量得到有效保证,杜绝了因卫生材料质量问题引发的医疗事故. 结论:医用卫生材料质量控制体系的建立有效提高了其应用的安全性.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.