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.     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…