目的:基于蒙特卡罗仿真模拟方法,研究方舱机房环境下的CT检查患者剂量.方法:采用蒙特卡罗方法和MCNP程序模拟联影uCT530机型,模拟头部模体和体部模体的CT剂量指数(CTDI)测量.对比分析CT扫描中相同管电压、管电流和准直宽度条件下模拟获取的常规机房CTDI值与产品技术手册中CTDI值的差异性;并分别对相同扫描条件下的常规机房与方舱机房的头部模体和体部模体的CTDI值进行对比分析.结果:常规机房内体部模体和头部模体的CTDI值模拟结果与产品技术手册中相应CTDI值比较,差异均无统计学意义(t=-1.39,t=-2.814;P＞0.01).常规机房与方舱机房之间,准直宽度分别为11 mm和22 mm条件下体部模体和头部模体CTDI值模拟结果比较,差异均无统计学意义(t体部模体=3.909,t=9.54;t头部模体=3.796,t=3.958;P＞0.01).结论:基于蒙特卡罗仿真模拟方法用于方舱CT检查患者剂量研究结果可靠.尽管方舱CT机房的面积和最小单边长度均小于常规机房的标准要求,但其不会显著增加CT检查患者的辐射剂量.

目的 探讨正电子发射型磁共振成像(Positron Emission Tomography/Magnetic Resonance Imaging,PET/MR)设备的人机接口协同性,探讨该类设备在临床中的可用性评价方法.方法 采用层次分析法构建可用性评价体系,设立专家组并计算专家权威系数,以德尔菲法设计可用性调查问卷,以操作设备的技师和医生为调查对象,收集全国范围内联影PET/MR设备的问卷打分表.结果 共收集79份调查问卷,涉及医院18家.其中生理信号门控单元接口可用性评价评分最低,PET无源质控可用性评价评分最高;副高级、高级职称人员对指标评分略高于中级及以下人员;人员的不同操作时长对各项接口的评分具有相同趋势,使用时长在3个月内的操作者评分明显低于另外两组,差异均有统计学意义(P<0.05);不同操作时长人员对6个特定评价参数评分差异均有统计学意义(P<0.05).结论 基于层次分析法建立的可用性评价体系能够用于PET/MR设备临床可用性评价,基于德尔菲法形成的可用性调查问卷为探讨PET/MR设备可用性评价方法提供参考.

目的:构建高值耗材监测系统,实现医院高值耗材的信息化和精细化管理,保障高值耗材合理、有效和安全使用,降低医院运营成本.方法:分析现阶段医院高值耗材管控现状,基于客户机与服务器(C/S)和浏览器与服务器(B/S)结构,采用C#和Java开发语言、Windows server 2012 R2服务器和Oracle数据库构建高值耗材监测系统,从请领、采购、入库、出库、计费及报表统计各环节入手,重塑流程优化财务报表,完善耗材管理机制.结果:高值耗材监测系统运用内外交互平台降低耗材成本,加强内部控制对耗材合理计费,制定多维度报表联合监管耗材,使耗材管理模式由粗放式向精细化转变,实现医用耗材全程可追溯,为医院耗材成本管控、内部控制和各部门联合监管提供数据支持.结论:高值耗材监测系统可为医院提供信息化数据支撑,使耗材管控从监管部门到财务部门各项业务和模块的数据融会贯通,形成完整的耗材精细化管控模式,推进医院高质量发展.

Based on2015 Top Ten Technology Hazards published by Emergency Care Research Institute (ECRI), this paper expounds the potential risks existing in the use of medical equipment in the following year from the perspective of medical equipment safety and provides some targeted scientiifc management methods. This paper also provides reference comments for the establishment and improvement of medical equipment risk assessment as well as quality control and scientiifc management, which can effectively promote the harmonious development of the hospital and improve the overall efifciency.

Objective:To offer guarantee for clinical operation through Quality Control(QC) of medical equipments.Methods:QC is introduced into the full life circle of medical equipments and enforced in the process of equipment argumentation,acquisition,acceptance,application,maintenance,preventative maintenance,measurement and abandonment.Results:Under the efficient quality control,the failure rate has been reduced during the equipment usage.The security,accuracy and validity of the clinical examination are guaranteed.Conclusion:QC in the full life circle of medical equipments provides safe and effective examination/treatment for patients,as well as effectively reduces the risk of adverse events.

Objective:To decrease the radiation for computed tomography examination and to improve the safety of patients is an important direction of the development of CT technique. Methods:We demonstrated the principles, merits and drawback and their potentialities of each kind of new low-dose CT technique. Results:With the new developed low-dose CT technique, patients’ dose could be reduced by 86% without losing clinical information. Conclusion:Despite of some limitation, new developed low-dose CT techniques can decrease patients’ dose dramatically and make more widely and deeply clinical needs possible.

Objective To find out the utilization and satisfaction to community health service(CHS) among the residents in six urban districts of Beijing and to propose suggestions for carrying out community health service.Methods Systematic random sampling method was aplied to select urban residents for an investigation on community health service utilization and satisfaction.Stata 10.0 was used in statistical analysis.Results Of all residents surveyed 76.84 percent chose community health service when they had minor illenss.The main causes of the residents coming to the community health institutions were to obtain treatment(35.04%),to procure medicine(19.97%) or to get diagnosis(16.26%).The overal satisfaction rate of the residents to community health service was 90.07 percent.The satisfaction rates for the residents to accessebility,attitude,communication and waiting time of the community health service were 94.44%,92.12%,89.68%,and 89.08%,respectively.But the satisfaction rates were only 55.99% and 69.67% for the residents to institutional facileties and drug price.Satisfaction rate was significantly correlated with age of residents(χ2 = 10.62,P = 0.014),income level(χ2 =18.46,P 0.01) and types of medical payment of the residents(χ2 = 11.32,P = 0.010).Conclusion The utilization rate and satisfaction rate for community health service are high among residents in Beijing.

The application,new progress and development trend of monitoring technology for medical treatment are presented in this paper.