Economic image compression of output documentation of the most frequent examinations in nuclear medicine

RATIONALE AND OBJECTIVES: In recent years, picture archiving and communication systems and electronic transfer of radiologic images using the digital imaging and communications in medicine file standard has become more widely employed in diagnostic radiology. It seems to be likely that nuclear medicine will be integrated within such systems. On the other hand, many departments possess older nuclear medicine equipment without digital output facilities. There is an increasing tendency to display and archive evaluated images ("save-screens," printouts) on nondedicated, inexpensive systems using file formats capable of data compression. This was the reason for examining the value of the JPEG format in this pilot study. MATERIALS AND METHODS: Fifty scanned planar bitmap images of the most frequent scintigraphic examinations (thyroid, bone, myocardium, lungs, and kidneys) were compared with JPEG format at different data compressions by two blinded observers. The visualization of details (eg, pathologic findings) is described for all these images as the visual appearance of the images and the storage capacity required. RESULTS: Relevant loss of clinical information did not occur up to compression factors of 0.75. A major decrease of subjective image quality was seen at compression factors >0.90. Compared with bitmap files, the use of these factors reduced the storage capacity required by 98% at a (JPEG-related) compression factor of 0.50, and 99% at a compression factor of 0.90. Compared with the GIF format, a reduction by 4.0-5.7 could be achieved. CONCLUSIONS: Use of the JPEG format can therefore be recommended to save costs of image transfer or archiving of standard planar scans for nuclear medical evaluation.     

4种类型医院感染的经济损失病例对照研究 FREE

目的从卫生经济学角度,分析医院上呼吸道、下呼吸道、泌尿道、手术部位感染所造成的经济损失。方法采用1∶1配对的方法,调查100对患者［发生上述医院感染的患者（病例组）与同期类似住院未发生医院感染的患者（对照组）］的卫生资源消耗并进行比较,对医院感染进行经济学评价。结果病例组住院总费用中位数每例为22 379.01元,对照组为7 611.52元,病例组显著高于对照组（Z=-6.72,P=0.00）;医院感染经济损失因感染部位的不同而异,下呼吸道感染经济损失最大,为21 701.03元,其次为泌尿道感染6 374.52元、手术部位感染5 849.04元、上呼吸道感染3 598.00元;患者住院费用的增加主要是药费、检验费、材料费、治疗费、处置费;病例组中位数每例患者住院时间为24.51 d,对照组为11.00 d,两组间差异有统计学意义（Z=-7.84,P＝0.00）。结论医院感染造成的经济损失较大,经济损失因感染部位的不同而异;同时,由于发生医院感染而延长了患者的住院时间。     

2型糖尿病患者口服降糖药的成本-效果分析

目的比较7种治疗2型糖尿病药物的成本-效果。方法将235例2型糖尿病患者分成7组：马来酸罗格列酮（文迪雅）组29例（A组）;二甲双胍组54例（B组）;格列齐特（达美康）组40例（C组）;格列美脲组28例（D组）;格列喹酮（糖适平）组38例（E组）;阿卡波糖（拜糖平）组25例（F组）;阿卡波糖（卡博平）组21例（G组）,运用药物经济学成本-效果分析方法,对7组口服降糖药进行评价;并且同时做了敏感性分析。结果在2型糖尿病的治疗中,二甲双胍为疗效较好且最经济的方案。结论应选用安全、有效、费用合理的药物治疗2型糖尿病。     

医院医学工程科技术管理规范专题六医院医疗器械账目财务统计管理技术规范探讨

目的：针对医院医疗器械账目财务统计管理的技术规范展开探讨,细化财务管理的规范内容。方法：从技术角度阐述医疗设备、耗材的入、出库统计和设备、器材的维修费用统计等的管理规范。结果：它方便了数据查询、统计、上报和详细了解全院设备、耗材的使用情况及维修情况。结论：它能够使医学工程学科的工作更具有前瞻性、规律性、自主性和确定性。     

Costs of brain disorders in Finland

Objective –  To calculate the costs of brain disorders on the national level.
Methods –  Electronic data bases, national registers and internet data.
Results –  Any brain disorder was estimated to affect a fifth of the Finnish population. The three most common disorders were migraine, anxiety disorder and affective disorder. The total costs of brain disorders constituted 3% of the national gross product, or 45% of all the health-care costs. However, this is likely a conservative estimate, because not all chronic brain disorders and not all costs were included. Of the total costs of brain disorders, 32% were for direct health care, 23% for indirect medical care and 45% for indirect costs. Dementia was the most costly individual brain disorder followed by addiction and affective disorders. Most costly per case were brain tumours and multiple sclerosis.
Conclusion –  Brain disorders constitute a costly part of the population's health costs. Directed preventive measures are needed to counteract the population morbidity and to control the increasing cost pressure in health care.     

Sustainable eutectic mixture-based ultrasound assisted multifaceted valorisation of pineapple waste for bromelain and bioethanol production

A large number of pineapple residues like peels, leaves and stems generated during processing remains underutilized. The current investigation provides one-pot task-specific valorisation of these residues by sequential extraction of bromelain and saccharification of cellulose residue for bioethanol production. Employing natural deep eutectic solvents (NADES) prepared by mixing ammonium salts with imidazole and glycerol has guaranteed sustainable extraction of bromelain. Ultrasound-assisted liquid phase microextraction (UA-LPME) was performed and NADES with moderate density (TBC:I:G/sodium sulphate) was observed to have a higher bromelain yield and purity. Response Surface Methodology-based optimization of UA-LPME was carried out and solid: liquid ratio (25 ml/g), ultrasound time (17.5 min) and ultrasound temperature (45 °C) were observed to be influential variables resulting in an optimal bromelain yield of (87%). Sequential fractionation of the enzyme concentrate with gel filtration chromatography and anion exchange chromatography has resulted in a corresponding purity fold of 89.27. The cellulose-rich residue remaining after bromelain extraction was enzymatically saccharified (Cellic CTec2) for bioethanol production (12.7 g/L). This novel approach guarantees sustainable valorisation of pineapple waste using NADES as a sustainable extraction medium.     

新医改形势下的军队医院卫生经济管理探讨

本文从新医改给军队医院带来的机遇和挑战出发，结合军队医院的发展现状和特点，分析军队医院发展中面临的卫生经济问题，提出加强军队医院卫生经济管理的策略和措施：抓发展方向、抓适度规模、抓人才培养，建立高效的经济管理机构和完善的经济管理机制，将服务向社区卫生服务中心延伸。并就加强军队医院卫生经济管理应注意的问题进行了讨论，以适应新医改的要求，更好的推进医院经济的良性发展。     

医院经济管理指标评价系统的开发与应用

运用卫生经济学成本效益、成本效果、成本效用的理论，研究我军医院经济管理评价体系及运行模式。结合医院不同卫生经济信息点，筛选确立了22项卫生经济评价指标，建立了一套适合不同层次卫生行政人员的指标评价系统，为科室评价医院经济管理水平和经济发展状况提供了一种有效方法。     

山东、河南两省医院主要筹资渠道变化分析

为了解市场经济体制下公立医院筹资渠道的变化情况 ,笔者对山东和河南两省45所医院的筹资情况进行了调查分析。结果表明 :从1987～1999年 ,政府对各级医院的财政补助虽有所增加 ,但与医院总收入相比 ,其所占比例却持续下降 ,分别下降了15%、17 % ,而同期病人付费所占比重分别增加了7%、9% ,药品收入所占比重分别增加了11 %、13% ,即病人付费和药品收入已经成为医院筹资的主渠道。