Objective:To construct a reliability management model of medical equipment in the department of respiratory and critical care medicine,and to explore its application effect in the management of medical equipment in the department of respiratory and critical care medicine.Methods:Taking the reliability of equipment management content and management methods as evaluation indexes,standardized procedures of equipment use,cleaning and emergency management were formed,and a reliability management model for medical equipment in the department of respiratory and critical care medicine was constructed.A total of 63 medical devices in clinical use in the Department of Respiratory and Critical Care Medicine of Beijing Anzhen Hospital,Capital Medical University from January 2022 to January 2023 were selected.According to different management modes,conventional management mode(32 devices)and reliability management mode(31 devices)were adopted respectively.The equipment management index score,equipment goal achievement degree and equipment management defect rate,and the equipment management recognition scores of the engineers,equipment operation technicians and doctors of equipment use management were compared between the two management modes.Results:The average recognition scores of the engineers,operating technicians and doctors for the use of equipment of the reliability management model were(90.66±5.25)points,(91.54±4.14)points and(92.17±5.17)points,respectively,which were higher than those of the conventional management model,the difference was statistically significant(t=14.249,13.773,12.267,P<0.05).The average scores of equipment resource allocation,information technology,technical support and management performance indicators of the reliability management mode were(90.25±4.12)points,(92.45±3.26)points,(91.47±2.78)points and(90.25±3.11)points,respectively,which were higher than those of conventional management mode,the difference was statistically significant(t=12.122,18.379,15.581,14.141,P<0.05).The average scores of equipment use standardization,cleaning completion and emergency management timeliness of reliability management mode were(92.36±3.25)points,(90.69±3.69)points and(91.87±3.01)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=14.953,15.030,14.401,P<0.05).The number of equipment damaged,repaired and factory repair of the reliability management mode was 1,1 and 2,respectively,and the defect rates were 3.22%,3.22%and 6.45%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(x2=8.581,9.908,8.782,P<0.05).Conclusion:The application of reliability-based medical equipment management model to the medical equipment management of respiratory and critical care medicine can improve the quality of equipment management and operation,reduce the failure rate of equipment,and improve the service level of equipment.

Objective To investigate the role of the Janus tyrosine kinase (JAK)- signal transducer and activators of transcription (STAT) signaling pathway in thrombosis formation after splenectomy in cirrhotic patients with portal hypertension. Methods A total of 198 liver cirrhosis patients with portal hypertension who underwent splenectomy and devascularization were recruited from March 2018 to April 2020 and then divided into thrombosis ( n =41) and non-thrombosis groups ( n =157) according to whether portal vein thrombosis occurred 3 months after surgery. mRNA levels of JAK2 and STAT3 in peripheral blood mononuclear cells (PBMCs) were assessed. Comparison of continuous data between groups was performed using t test, while comparison of categorial data between group was performed using chi square test. Clinicopathological data from patients were collected and analyzed for the potential risk factors of portal vein thrombosis by using univariate and multivariate Logistic regression analyses. The prediction values of JAK2 and STAT3 mRNA for portal vein thrombosis were evaluated by area under the receiver operating curve ( AUC ). Results The diameter of portal vein, the diameter of portal vein, the velocity difference of portal vein and the volume of spleen in the thrombus group were significantly higher than those in the non-thrombus group ( t =4.718, 3.945, 8.671, and 2.006 respectively; P < 0.05).The relative mRNA levels of JAK2 and STAT3 in PBMCs of the two groups were significantly increased after surgery ( t =12.933, 15.442, 14.386, 10.896; P < 0.05), and their levels were also much higher in the thrombosis group than in the non-thrombosis group of patients ( P < 0.05). Multivariate Logistic regression analytic data showed that the portal vein diameter, the velocity difference of portal vein and mRNA level of JAK2 and STAT3 were all predictors for thrombosis in these patients ( P < 0.05). The AUC of JAK2 and STAT3 mRNAs was 0.850 and 0.787, respectively in diagnosis of thrombosis in these patients. Conclusion The JAK / STAT signaling was activated in the process of thrombosis after splenectomy in cirrhotic patients with portal hypertension, which may be one of the important mechanisms of postoperative portal vein thrombosis, and may become a potential target for the prevention and treatment of postoperative portal vein thrombosis.