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1.
在给定工序下, 排序问题的反问题研究目标是对于预先给定的加工任务, 要求确定加工时间或者工件权重的最小调整值, 使得给定的工件排序最优。 本文研究了平行机上单位加工时间的加权总完工时间排序问题的反问题, 即对于给定的加工工序, 在不同范数下, 通过最小限度调整工件的权值, 实现给定加工工序最优, 同时满足调整权值后,目标函数值不超过原来的值。  相似文献   

2.
目的:探讨依托泊苷+甲氨蝶呤+铂类(EMP)化疗方案治疗妊娠滋养细胞肿瘤(GTN)的临床应用价值.方法:采用EMP方案化疗治疗GTN 22例,其中6例接受单纯EMP方案;16例采用EMP方案作为二线化疗,MTX单药作为初始化疗7例(31.8%),FAV方案作为初始化疗8例(36.4%),FAVE方案作为初始化疗4例(18.2%),EMA-CO方案作为初始化疗2例(9.1%),VMP方案作为初始化疗1例(4.5%).1例在化疗基础上辅以手术治疗.结果:全部病人均达到血清学完全缓解,缓解率100%,其中单纯方案缓解率为37.5%;常见的不良反应依次为骨髓抑制、消化系统反应、脱发以及轻微肝肾毒性,差异有统计学意义(P<0.05).1例化疗至第3疗程时出现Ⅳ度中性粒细胞减少,Ⅲ度血小板减少,予以集落刺激因子(G-CSF)及重组人白细胞介素-11治疗后缓解.随访22例,1例化疗疗程结束后2个月意外妊娠,人工流产后随访无异常,其余均正常.结论:EMP方案作为初始方案或是二线方案治疗GTN病人时疗效较满意,值得临床推广.  相似文献   

3.
本文以153例秦皇岛市妇幼保健院口腔科就诊的牙体大面积缺损患者作为研究对象,以调查问卷的形式来调查患者对各种治疗选择的倾向性,运用健康状态效用分析(包括标准博弈法,支付意愿法,喜好排序)评价了患牙五种临床处理措施的效用值。结果表明:标准博弈法得到的效用值核桩冠最低,种植牙最高。支付意愿法得到的效用值可摘局部义齿最低,种植牙最高。喜好排序中,核桩冠治疗是患者最喜爱的治疗方法,而且医疗保险的支付比例对患者选择治疗方法有较大影响。  相似文献   

4.
复合形法迭代的终点和收敛速度往往取决于初始复合形的特性。目前,初始复合形构形多用在可行域内任意选点法和随机方法。显然,对复杂的优化设计问题,任意选点法对初始复合形很难构形,而随机方法对非凸约束面情形很费事。  相似文献   

5.
TOPSIS法是technique for order preference by similarly to ideai solution(逼近于理想的排序方法)的简称,它借助于一个多指标决策问题的理想解和负理想去排序。如其中有一解最靠近理想解,同时又最远离理想解,则这个解应是方案集中最好的解。TOPSIS法是系统工程中有限方案多目标决策分析的一种常用方法,  相似文献   

6.
守门人(gatekeeper)的初始意义是政府、保险公司或付费机构(第三方付费方)为了给居民或参保人支付保险费用时,由家庭医生对居民或参保人的疾病诊治活动及费用进行"把关"。开始的目标就是为了控制费用,是从第三方费用控制的角度来考虑的,后来随着服务理念的发展  相似文献   

7.
守门人(gatekeeper)的初始意义是政府、保险公司或付费机构(第三方付费方)为了给居民或参保人支付保险费用时,由家庭医生对居民或参保人的疾病诊治活动及费用进行把关。开始的目标就是为了控制费用,是从第三方费用控制的角度来考虑的,后来随着服务理念的发展  相似文献   

8.
为危重症患儿在第一时间制定正确、有效的治疗方案,对提高危重症抢救成功率至关重要.本文就儿科危重症时初始抗生素的选择进行探讨.  相似文献   

9.
陈先平 《九江医学》2005,20(2):123-126
图书馆图书排序,就是将已经加工整理的文献按照一定的依据和次序排列的过程。图书排序的方法有多种,比较科学并被多数图书馆采用的是分类排序法,而分类排序的直接依据是索书号。索书号是根据图书的内容在学科体系中所处的位置所生成,其结构由两部分组成:分类号和种次号。分类号是由图书馆图书分类人员根据图书的内容在《中国图书分类法》中所处学科的位置给出相应的类号。  相似文献   

10.
目的探讨用微种植体支抗整体法内收上颌前牙时组牙的复合阻抗中心位置以及牙齿的初始移动规律。方法用多层螺旋CT对干颅进行扫描,经MIMICS8.0,ABAQUS6.5构建微种植体支抗-上颌前牙整体内收力系的三维有限元模型,数值模拟从不同高度平面施以水平向内收载荷,并分别计算上颌中、侧切牙、尖牙的初始位移以及初始旋转角度,从而推算牙齿的阻抗中心位置。结果整体内收力作用下上颌前牙段的阻抗中心高度为距离牙槽嵴顶5.1mm处。在微种植体支抗整体内收上颌前牙力系中,中切牙、侧切牙以及尖牙的旋转中心常数分别为50.26、57.30、132.73mm2。结论运用微种植体支抗技术整体内收上颌前牙时通过改变力的作用点可以有效控制牙齿的整体移动或倾斜移动方式。  相似文献   

11.
目的了解老年癌症患者住院费用构成及影响因素,为控制医疗费用上涨提出建议。方法收集2007-2011年4种常见老年癌症病例1101例,采用描述性分析、单因素分析和多元线性回归分析等方法分析老年癌症患者的住院费用及其影响因素。结果老年癌症患者住院费用逐年上升,影响住院费用的主要因素是住院天数、特级护理、输血情况、抢救情况、手术情况、患者来源、癌症种类、付费方式。结论实施临床路径管理,优化医院内部流程,缩短平均住院日;完善医疗保障制度,实行按病种限价付费,降低医疗费用。  相似文献   

12.
Objective Knowledge of an enterovirus genome sequence is very important in epidemiological investigation to identify transmission patterns and ascertain the extent of an outbreak. The MinION sequencer is increasingly used to sequence various viral pathogens in many clinical situations because of its long reads, portability, real-time accessibility of sequenced data, and very low initial costs. However, information is lacking on MinION sequencing of enterovirus genomes. Methods In this proof-of-concept study using Enterovirus 71 (EV71) and Coxsackievirus A16 (CA16) strains as examples, we established an amplicon-based whole genome sequencing method using MinION. We explored the accuracy, minimum sequencing time, discrimination and high-throughput sequencing ability of MinION, and compared its performance with Sanger sequencing. Results Within the first minute (min) of sequencing, the accuracy of MinION was 98.5% for the single EV71 strain and 94.12%-97.33% for 10 genetically-related CA16 strains. In as little as 14 min, 99% identity was reached for the single EV71 strain, and in 17 min (on average), 99% identity was achieved for 10 CA16 strains in a single run. Conclusion MinION is suitable for whole genome sequencing of enteroviruses with sufficient accuracy and fine discrimination and has the potential as a fast, reliable and convenient method for routine use.  相似文献   

13.
A E Washington  P Katz 《JAMA》1991,266(18):2565-2569
Pelvic inflammatory disease (PID) and its sequelae affect millions of women in the United States at substantial costs. To estimate these total costs annually and to determine payment sources, we analyzed data from local, state, and national sources. Direct costs for PID and PID-associated ectopic pregnancy and infertility were estimated to be $2.7 billion, and indirect costs were estimated to be $1.5 billion, for a total cost of $4.2 billion in 1990. Overall, private insurance covered the largest portion of the direct costs of PID (41%), followed by public payment sources (30%). However, the proportion of payments made by private insurance appears to be decreasing, while that by public payment sources is increasing. In the year 2000, costs associated with PID are projected to approach $10 billion if the current PID incidence persists, with an increasing proportion of this expense burdening public institutions. Prevention of PID is needed both to reduce human suffering and to contain rising costs.  相似文献   

14.
急性心肌梗死患者住院费用构成分析和影响因素研究   总被引:1,自引:0,他引:1  
孙涛 《中国病案》2014,(8):59-61
目的 分析急性心肌梗死患者住院费用构成的特点及费用的影响因素,提出合理控制医疗费用的方法.方法 收集2009年-2013年急性心肌梗死病例718例,采用描述性分析、单因素分析和多元线性回归分析等方法分析急性心肌梗死患者的住院费用及其影响因素.结果 急性心肌梗死住院费用总体呈现下降趋势,影响住院费用的主要因素是住院天数、手术方式、有无手术、医保类型.结论 医疗费用控制总体效果理想.实施临床路径管理、规范诊疗行为、优化诊疗流程、缩短平均住院日等措施均有助于合理控制医疗费用,完善医疗保障制度.  相似文献   

15.
When viewed from the perspective of the policy analyst, observed inequities in the access to health services and the rising costs of physician and hospital care are among the most important issues confronting the American health delivery system. Recognizing that publicly financed health insurance programs result in a more equitable distribution of medical services, this paper focuses on the components of a national health insurance scheme that not only offers a comprehensive range of benefits but also employs prospective payment and a set of financial incentives to control the costs of care provided by physicians, hospitals, and other health facilities. The national health insurance program proposed in this paper is designed to eliminate or reduce unwarranted expenditures on plant and equipment; the responsibility for approving and funding capital acquisitions is also regarded as an integral component of the program.  相似文献   

16.
在新一轮医改政策的驱动下,DRGs(诊断相关分组)作为医疗支付制度改革的重要工具,正在逐步试点和推广。这一变革促使医院内部的管理开始从粗放型向精细化管理转型,临床路径作为医院精细化管理的工具之一,可以在保障医疗质量的同时降低医疗成本。为按“一次住院”为支付单元的DGRs带来了降低医疗成本,提升效益的有效管理工具。根据DRGs支付制度的特点,分析这一支付工具对临床路径的应用带来的积极推动作用,为临床路径的深入应用提供参考依据。  相似文献   

17.
目的:根据实际药品销售情况和医院自身实际情况制定药品采购成本支付算法。方法:通过应支付~DD--1支付算法设计,确定医院药品采购支付计划。结果:形成了一套合理的采购支付算法。结论:采购支付分为应支付和可支付,在实际系统运行过程中,参照应支付情况,根据实际支付能力,合理分配支付金额,形成可支付计划。  相似文献   

18.
目的探讨新疆4个地区HIV感染者个人直接经济投入的差异。方法对新疆乌鲁木齐、哈密、伊犁、喀什4个地区240例HIV感染者家庭收入和医疗费用支付方式进行调查;分析各地区HIV感染者的门诊费用(诊疗费、交通费)、住院费用(住院费、交通费、食宿费、营养费)等存在的差异。结果乌鲁木齐与其他地区相比HIV门诊就诊率和住院率均比较高,且各项直接医疗费用与非直接医疗费用也较其他地区高。结论经济发达地区,交通业较为便利,医疗服务较为齐全,医疗服务投入较多。而经济发展较为缓慢地区,其各种医疗服务较为匮乏,人民获得各种医疗服务较为困难,并且由于个人收入较低,居民受教育程度也较低,HIV感染者各项医疗投入也较低。  相似文献   

19.
本文考虑了一个包含工件生产和工件送货的单机调度问题。目标是寻找所有工件的公共交货期和每个工件的送货时间使得工件所受到惩罚(提前/拖后惩罚,送货费用等)的值最小。完成的工件按照批次进行送货,所有在公共交货期前完工的工件在最优交货期时间一起交付,对批次送货没有量的约束。本文确定了最优公共交货期,并给出了相应的排序。  相似文献   

20.
E Mu?oz  A Laughlin  D M Regan  I Teicher  I B Margolis  L Wise 《JAMA》1985,254(13):1763-1771
The purpose of this study was to assess the financial impact (revenues vs expenses) as measured by hospital charges and costs vs diagnosis-related group (DRG) revenues of prospective payment systems on emergency department-generated admissions for a large teaching hospital under two payment systems: Medicare and an all-payor system. All emergency department admissions were analyzed for the years 1983 (N = 4,273) and 1984 (N = 4,125) under both systems, using standard DRG methodology. Our findings were as follows: (1) With charges as a measure of expense under both payment schemes, all clinical departments had large groups of unprofitable patients: Medicare, $12,895,038; all-payor system, $15,553,893. (2) When costs were computed as the expense measure (using our hospital's cost-to-charge ratio), Medicare patients produced a deficit ($2,363,163); however, under an all-payor system there was a small net profit ($4,267,859). (3) The implementation of federalized DRG reimbursement rates increased our losses for this population from 1983 to 1984. (4) Reductions in outlier reimbursement (10%) and teaching costs (25%) caused our revenues to drop substantially, potentiating our losses. These findings suggest that hospitals with large emergency department admission populations, particularly Medicare patients, may be at a significant financial disadvantage under prospective payment systems.  相似文献   

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