Medical fiber endoscope is one kind of medical device that utilizes fiber technique to realize visual detection for internal organs or cavities.In clinical applications,medical fiber endoscope not only need to complete fiber optic imaging but also need possess the functions of delivering water and air,and operating device.Therefore,its routine management and maintenance for fault is more and more payed attention by the staffs of using medical fiber endoscope in department.The system of delivering water and air is a key structure for some of medical fiber endoscopes,which has higher maintenance matters and frequency of maintaining fault.Based on the above reasons,this research analyzed the working principle of medical fiber endoscopes,and summarized the ideas and methods of repairing common faults through focused on the structural composition of delivering system of water and air of medical fiber endoscopes,so as to improve the management level for this type of medical device.

Medical fiber endoscope is one kind of medical device that utilizes fiber technique to realize visual detection for internal organs or cavities.In clinical applications,medical fiber endoscope not only need to complete fiber optic imaging but also need possess the functions of delivering water and air,and operating device.Therefore,its routine management and maintenance for fault is more and more payed attention by the staffs of using medical fiber endoscope in department.The system of delivering water and air is a key structure for some of medical fiber endoscopes,which has higher maintenance matters and frequency of maintaining fault.Based on the above reasons,this research analyzed the working principle of medical fiber endoscopes,and summarized the ideas and methods of repairing common faults through focused on the structural composition of delivering system of water and air of medical fiber endoscopes,so as to improve the management level for this type of medical device.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective: To analyze the deaths with antiretroviral treatment among adult HIV/AIDS patients in Liangshan Yi Autonomous Prefecture from 2005 to 2015, in order to understand the epidemiological characteristics and to further reduce the mortality rate in Liangshan Prefecture. Methods: The relevant information was collected through the Management Database of Antiretroviral Treatment from the National AIDS Comprehensive Prevention Information System. Results: From 2005 to 2015, a total of 14 219 adult HIV/AIDS patients received antiretroviral treatment and 1 425 death cases were reported during the treatment. The cause of death was mainly AIDS-related diseases (58.9%), and the cumulative mortality rate was 10.02%. Gender, age, the way of infection, duration of antiretroviral therapy, clinical stage when received antiretroviral therapy, and CD₄⁺ T lymphocyte levels were factors for the mortality rate (P<0.001). The mortality increased with older age, higher initiation clinical stage and lower level of CD₄⁺ T lymphocyte. Among the death cases, 82.6% were male, 1 182 (82.9%) were married or cohabited, most aged between 30-39 years old (48.6%). At the initial point of receiving antiretroviral therapy, 49.7% of the cases with CD₄⁺T lymphocytes levels< 200/μl, 61.2% of the deaths cases were>1 000 copies/ml during the last viral load test, and 16.2% of deaths were ≥500/μl in the last CD₄⁺T lymphocyte test; 44.5% of deaths were received antiretroviral treatment within one year. Conclusion Early and timely antiretroviral therapy should be carried out. It is necessary to strengthen the propaganda of antiretroviral therapy and to improve the management quality of follow-up information of antiretroviral therapy case files, and to improve the medication compliance of patients.

OBJECTIVETo investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province.

METHODSA retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System. Cox proportion hazard regression model was used to identify impact factors related survival time.

RESULTSAmong 8 310 ART AIDS patients who initially received ART, their mean age was (34.59 ± 9.10) years old, 65.50% (5 443 cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68 ± 21.69) months. 436 cases died of AIDS related diseases, 28.67% (125 cases) of them died within the first 6 months of treatment. The cumulative survival rate of receiving ART in 1, 2, 3, 4 5 years were 97.11%, 93.41%, 90.61%, 88.81%, 86.02%, respectively. Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR = 1.57, 95% CI: 1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR = 1.64, 95% CI: 1.20-2.24), before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR = 1.53, 95% CI: 1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases (HR = 1.80, 95% CI: 1.39-2.34). The patients with baseline CD4 (+) T lymphocytes cell counts < 50/µl (HR = 9.79, 95% CI: 6.03-15.89), 50-199/µl (HR = 3.26, 95% CI: 2.32-4.59), 200-349/µl (HR = 1.69, 95% CI: 1.22-2.34), were at a higher risk death than those with CD4 (+) T lymphocytes cell counts ≥ 350/µl.

CONCLUSIONAccumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province. AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4 (+) T lymphocyte count have higher risk of death.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-Retroviral Agents ; therapeutic use ; Asian Continental Ancestry Group ; China ; Female ; Humans ; Lymphocyte Count ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Substance Abuse, Intravenous ; Survival Rate ; Tuberculosis ; complications

Chest Pain ; diagnosis ; Goals ; Humans ; Pain Clinics

Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.

Objective To evaluate the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction (STEMI).Methods The 12-lead electrocardiogram was simultaneously recorded with real-time tele-transmission system and a conventional electrocardiograph in 40 STEMI cases.The width and amplitude of each wave,the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test.Results There were no statistical differences in the width and amplitude of P wave,QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs (P ＞0.05).There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude (r =0.912,P =0.000).The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent (Kappa value:0.976).Conclusions Real-time tele-transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

Objective To observe the effect of fleabane injection on serum level of D-dimer, fibrinogen and hypersensitive C-reactive protein in patients with IgA nephropathy and to explore the mechanism of fleabane injection for treating IgA nephropathy. Methods 29 patients with IgA nephropathy were given fleabane injection together with routine treatment. Another group of 28 patients with IgA nephropathy were only treated with routine treatment as con-trol. Determinations of 24 hours urine protein output(24HPQ), serum level of D-dimer(D-D), Fibrinogen(Fib) and hypersensitive C-reactive protein (hsCRP) were carried out pre- and post-study. Results Significant decrease in 24HPQ , serum level of D-D, Fib and hsCRP were observed in both treatment group and control group(P <0. 01 ～0. 05), but more significant in treatment group as compared with control group ( P < 0. 05). Conclusion Flea-bane Injection plus routine treatment could significantly decrease 24HPQ in patients with IgA nephropathy, and this maybe contribute to regulation of D-D, Fib and hsCRP by fleabane injection.