Objective:To evaluate the application effect of management mode based on constraint theory for medical equipment in equipment management of vascular surgery. Methods:Based on five-step method of constraint theory,an operation evaluation system was formulated. An information management mode of medical equipment was constructed to manage quality of medical equipment in department of vascular surgery. A total of 60 sets used medical equipment in the Department of Vascular Surgery at The Second Affiliated Hospital of Xi'an Jiaotong University from 2021 to 2022 were selected. The conventional management mode was adopted to manage these equipment between January to December 2021,while equipment was managed by using medical equipment management mode based on constraint theory (constraint theory management) of the department of vascular surgery from January to December 2022. The quality scores of operation and maintenance of equipment,average incidence rates of risk,configuration effectiveness,and timeliness of equipment management were compared between the two management modes. Results:After constraint theory management was implemented,the average scores of operation and maintenance of equipment,which included success starting-up,operation,routine maintenance and fault repair,were respectively (90.69±8.65),(89.65±4.65),(88.65±5.63),and (90.58±6.01),all of which were higher than those of conventional management mode. The differences of them between two modes were statistically significant (t=13.482,17.867,14.552,14.449,P<0.05). The average incidence rates of the risks of testing equipment,treatment,monitoring equipment and auxiliary equipment of adopting constraint theory mode management were (0.89±0.22)％,(0.84±0.23)％,(0.74±0.32)％ and (0.75±0.32％),all which were lower than those of the conventional management mode,with statistically significant differences (t=9.162,17.745,19.469,15.019,P<0.05). The average utilization rate of equipment and the average amplification of cost benefit of equipment were respectively (88.69±5.54)％ and (50.36±2.69)％ after constraint theory mode was adopted,which were significantly higher than those of conventional management mode,and the average floating rate of using equipment of constraint theory mode was (1.23±0.97)％,which was lower than that of conventional management model,the differences of them between two modes were statistically significant (t=14.174,21.564,11.811,P<0.05). The average times of emergency management for risk events included the safety of power consumption of equipment,safety of diagnosis and treatment,biological safety and radiation safety were respectively (2.36±0.64)h,(3.26±0.78)h,(4.23±1.24)h and (2.26±1.23)h after the constraint theory mode was adopted,all of which were significantly less than those of conventional management mode,and the differences of them between two modes were statistically significant (t=16.704,13.421,9.029,13.971,P<0.05). Conclusion:The application of the management mode based on the constraint theory of medical equipment in department of vascular surgery can improve the quality of operation and maintenance of equipment for safety,and shorten the emergency response time of equipment,and reduce the incidence of equipment risk,and strengthen the effect of configuration for equipment.

Objective:To evaluate the application effect of management mode based on constraint theory for medical equipment in equipment management of vascular surgery. Methods:Based on five-step method of constraint theory,an operation evaluation system was formulated. An information management mode of medical equipment was constructed to manage quality of medical equipment in department of vascular surgery. A total of 60 sets used medical equipment in the Department of Vascular Surgery at The Second Affiliated Hospital of Xi'an Jiaotong University from 2021 to 2022 were selected. The conventional management mode was adopted to manage these equipment between January to December 2021,while equipment was managed by using medical equipment management mode based on constraint theory (constraint theory management) of the department of vascular surgery from January to December 2022. The quality scores of operation and maintenance of equipment,average incidence rates of risk,configuration effectiveness,and timeliness of equipment management were compared between the two management modes. Results:After constraint theory management was implemented,the average scores of operation and maintenance of equipment,which included success starting-up,operation,routine maintenance and fault repair,were respectively (90.69±8.65),(89.65±4.65),(88.65±5.63),and (90.58±6.01),all of which were higher than those of conventional management mode. The differences of them between two modes were statistically significant (t=13.482,17.867,14.552,14.449,P<0.05). The average incidence rates of the risks of testing equipment,treatment,monitoring equipment and auxiliary equipment of adopting constraint theory mode management were (0.89±0.22)％,(0.84±0.23)％,(0.74±0.32)％ and (0.75±0.32％),all which were lower than those of the conventional management mode,with statistically significant differences (t=9.162,17.745,19.469,15.019,P<0.05). The average utilization rate of equipment and the average amplification of cost benefit of equipment were respectively (88.69±5.54)％ and (50.36±2.69)％ after constraint theory mode was adopted,which were significantly higher than those of conventional management mode,and the average floating rate of using equipment of constraint theory mode was (1.23±0.97)％,which was lower than that of conventional management model,the differences of them between two modes were statistically significant (t=14.174,21.564,11.811,P<0.05). The average times of emergency management for risk events included the safety of power consumption of equipment,safety of diagnosis and treatment,biological safety and radiation safety were respectively (2.36±0.64)h,(3.26±0.78)h,(4.23±1.24)h and (2.26±1.23)h after the constraint theory mode was adopted,all of which were significantly less than those of conventional management mode,and the differences of them between two modes were statistically significant (t=16.704,13.421,9.029,13.971,P<0.05). Conclusion:The application of the management mode based on the constraint theory of medical equipment in department of vascular surgery can improve the quality of operation and maintenance of equipment for safety,and shorten the emergency response time of equipment,and reduce the incidence of equipment risk,and strengthen the effect of configuration for equipment.

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids

Objective To study the changes in the immune function of advanced hepatic carcinoma patients after thermochemoembo-lization via hepatic artery. Methods Forty advanced hepatic carcinoma patients were randomized divided into 2 groups. A group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 37℃ 9% sodium chloride solution via hepatic artery, and B group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 60℃ 9% sodium chloride solution via hepatic artery, then all were embolized with some quantity of lipiodol. Flow cytometry (FCM) was used to detect the changes in percentages of T-lymphocyte subsets (CD3<'3, CD4<'+, CD8<'+) and NK cells, and the contents of soluble interleukin-2 receptor (sIL-2R) were detected by double sandwich ELISA before and after therapy. LDH enzyme-release assay was used to detect cytotoxic activity of NK cells. Results Compared with pre-therapy group or A group after therapy, the percentage of CD4<'+ cells of B group after therapy significantly increased (P<0.05), the percentages of CD8<'+ cells and the content of sIL-2R of B group after therapy markedly decreased (P<0.05). The percentages of NK cells and cytotoxic activity NK cells of B group after therapy were significantly higher than those from pre-therapy group or A group (P<0.05). Conclusion Intra-arterial thermochemoembolization may activate and improve cell-mediated immune function with a certain degree.

AIM: To compare the impacts of adriamycin(ADM) intermittent and continuous heat infusion on respiration, heart rate and temperature of the rabbit as well as the concentration of ADM in VX-2 tumor for the verification of the safety and effectiveness of intermittent heat infusion through VX-2 transplanted tumor model in rabbit liver.METHODS: VX-2 tumor models were established respectively in the thighs of 30 New Zealand rabbits. All 30 rabbits were randomly allocated into three groups with 10 rabbits each. After catheterizing into femoral artery, which was demonstrated as the supply artery of tumors by digital subtraction angiography(DSA), animals in three groups were infused with 100 mL saline at normal temperature and ADM, 100 mL saline at 60 ℃ and ADM continuously and 100 mL saline at 60 ℃ and ADM intermittently respectively. During infusion, the 43 ℃ to 45 ℃ lasting time in the tumor tissues of the two 60 ℃ groups was measured. After infusion, the respiration(time/minute), heart rate(beats/minute) and temperature(℃ )of the rabbits in each group as well as the concentrations of ADM in tumor tissue were measured immediately.RESULTS: The concentration of ADM was (7. 1 ± 2.2) mg/L in normal temperature infusion group, (17.2 ± 1.6) mg/L in 60 ℃ continuous infusion group and(16.5 ±3.4) in 60 ℃ intermittent infusion group. There were significant differences among three groups( F = 48.95, P = 0. 000), but there was no significant difference between 60 ℃ intermittent infusion group and 60 ℃ continuous infusion group( P ＞ 0. 05). 43℃ to 45 ℃ lasting time was(22.5 ±1.4) minutes in 60 ℃continuous infusion and (24.3±2.4)minutes in 60 ℃intermittent infusion group( F =4.20, P ＞ 0.05) . There were significant differences among three groups in respiration, heart rate and temperature( F = 14. 58, 33.07, 10.00, P ＜ 0.01), but there was no significant difference in the respiration, heart rate and temperature between 60℃ intermittent infusion and normal temperature infusion group ( P ＞ 0. 05).CONCLUSION: Intermittent thermochemotherapy is a more effective and safe interventional thermochemotherapy method compared with continuous heat infusion.