Ibrutinib and atrial fibrillation:An in-depth review of clinical implications and management strategies

Ibrutinib,a targeted therapy for B-cell malignancies,has shown remarkable efficacy in treating various hematologic cancers.However,its clinical use has raised concerns regarding cardiovascular complications,notably atrial fibrillation(AF).This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence,risk factors,mechanistic links,and management strategies.Through an extensive analysis of original research articles,this review elucidates the complex interplay between ibrutinib’s therapeutic benefits and cardiovascular risks.Moreover,it highlights the need for personalized treatment approaches,vigilant monitoring,and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy.The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib’s therapeutic landscape while prioritizing patient well-being.

Introduction of PIC/S Accession Procedure and Suggestions for Establishing a Unified Quality Management System in China

Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.Methods The procedures and steps of joining PIC/S,the evaluation process of PIC/S,and the experience of several countries in joining PIC/S were introduced and analyzed,which could help the relevant personnel in China understand the specific contents.Results and Conclusion According to the requirements of PIC/S,it is necessary to establish a unified GMP quality management system.

基于C/S架构和物联网技术的可移动医疗设备共享调配系统的设计与应用

目的 设计一个可移动医疗设备高效管理与临床科室共享调配相结合的医疗设备共享管理平台,实现可移动医疗设备使用的全过程管理。方法 基于C/S架构,利用物联网技术优化整合现有医疗设备大数据资源,结合医院需求,构建可移动医疗设备共享调配系统,实现医疗设备共享管理、预约借用、统计分析等核心功能。通过比较系统上线前后呼吸机调配次数、平均调配时间、呼吸机使用率、单台呼吸机日均收入4个指标,分析系统应用效果。结果 系统上线后,呼吸机调配次数明显增加、平均调配时间明显降低,呼吸机使用率、单台呼吸机日均收入明显升高,且差异均有统计学意义(P﹤0.05),表明系统对提高呼吸机调配效率与使用效率有促进作用。结论 可移动医疗设备共享调配系统优化了医院设备管理流程,实现了医疗资源的统一调配,有效满足临床紧急抢救时医疗设备调配使用的相关需求,提高了医疗设备周转率以及设备管理人员的工作效率,有助于医院节约人员成本、降低采购费用,为医院管理者制定相关决策提供数据支撑。

基于B/S的高校实验室预约管理系统设计与实现

为了实现实验室管理信息化,更好地为师生服务,文章设计并开发一套高校实验室预约管理系统。该系统是基于B/S结构,采用Vue视图框架、Nginx服务器及MySQL数据库构建而成的;支持专业实验室、教室和会议室的预约管理;入口对接华中科技大学统一身份认证系统,在校师生可直接使用已有的统一身份认证系统账号密码登录系统。用户可通过浏览器完成在线预约、预约查询、预约管理和数据统计等功能。该系统的应用提高了实验室管理的规范性和信息化程度。

基于三层B/S架构的企业信息化管理系统的设计

为解决企业管理系统中存在的数据冗余、不一致、数据同步效率低等问题,文章通过引入三层浏览器/服务器(B/S)架构模式,实现了对企业信息化管理系统的研究。该系统的设计主要包含数据库设计、系统管理、生产管理、统计报表等主要功能模块的设计。系统由浏览器向服务器发送请求,服务器接收请求并处理,然后将结果返回给浏览器。系统采用了MVC设计模式,将数据层、业务层和表示层分离开来,提高了可维护性、可扩展性和可重用性。该系统的应用不仅达到了数据远程共享的目的,还实现了对现骨干数据及报表的查询功能,可充分满足企业的信息化管理需求。

Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment

Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel dis-ease(IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dys-plasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures.

A Qualitative Appraisal of China’s Efforts in Fishing Capacity Management

This paper provides a critical review of some major efforts made by China to manage the fishing capacity of its marine capture fisheries. It begins by reviewing the key concepts and issues closely related to fishing capacity management. Following on this, a brief introduction to China’s marine capture fisheries is offered, especially the trends of its marine landings and marine fishing fleets and the status of fish stocks in waters under its jurisdiction. Next comes the main concern of the paper, i.e., some major actions recently initiated by China to deal with the overcapacity problem confronting it. The paper ends with conclusions and suggestions.

Multidisciplinary and evidence-based management of fistulizing perianal Crohn's disease

Perianal symptoms are common in patients with Crohn's disease and cause considerable morbidity. The etiology of these symptoms include skin tags, ulcers, fissures, abscesses, fistulas or stenoses. Fistula is the most common perianal manifestation. Multiple treatment options exist although very few are evidence-based. The phases of treatment include: drainage of infection, assessment of Crohn's disease status and fistula tracts, medical therapy, and selective operative management. The impact of biological therapy on perianal Crohn's disease is uncertain given that outcomes are conflicting. Operative treatment to eradicate the fistula tract can be attempted once infection has resolved and Crohn's disease activity is controlled. The operative approach should be tailored according to the anatomy of the fistula tract. Definitive treatment is challenging with medical and operative treatment rarely leading to true healing with frequent complications and recurrence. Treatment success must be weighed against the risk of complications, specially anal sphincter injury. A full understanding of the etiology and all potential therapeutic options is critical for success. Multidisciplinary management of fistulizing perianal Crohn's disease is crucial toimprove outcomes.

Management strategies of Barrett's esophagus

Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.

Application of Delayed Surgical Managements in Patients with Stensen＇s Duct Injury

The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.

Pharmacological management of behavioral symptoms associated with dementia

Dementia is a clinical syndrome with features of neurocognitive decline. Subtypes of dementia include Alzheimer's, frontotemporal, Parkinson's, Lewy body disease, and vascular type. Dementia is associated with a variety of neuropsychiatric symptoms that may include agitation, psychosis, depression, and apathy. These symptoms can lead to dangerousness to self or others and are the main source for caregiver burnout. Treatment of these symptoms consists of nonpharmacological and pharmacological interventions. However, there are no Food and Drug Administration-approved medications for the treatment of behavioral and psychological symptoms of dementia. Pharmacological interventions are used off-label. This article reviews the current evidence supporting or negating the use of psychotropic medications along with safety concerns, monitoring, regulations, and recommendations.

Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic:A case report

BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment strategy.CASE SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 d.Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal region.The patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of Urology.After performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed.After surgery,he was transferred to the intensive care unit for further management.CONCLUSION Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.

Evaluation of Clinical Utility of the Personal KinetiGraph^®in the Management

INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in assessment and monitoring of these symptoms, with their clinical utility currently being evaluated in routine clinical care. OBJECTIVE: To evaluate the clinical utility of the Personal KinetiGraph? (PKG?) Movement Recording System in the routine clinical care of persons with PD (PWP). METHODS: Clinically stable, non-demented PWP presented for two routine clinic visits that included: medication review, symptom review, neurological examination including the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III/IV, and completion of a clinical management plan by a movement disorder specialist prior to review of the PKG report. After reviewing the PKG report, the clinician completed a modified clinical management plan taking into consideration the findings of the PKG. This was repeated at a second visit to evaluate various outcome measures following PKG-enhanced management. RESULTS: The PKG improved the assessment of PD symptoms and the response to treatment, while increasing patient activity levels and compliance. Clinical management plans enhanced by PKG led to different recommendations in 29.4% of cases compared with standard of care due to higher rates of bradykinesia, dyskinesia, tremor, and fluctuations identified by PKG. Using the PKG in the clinical management plan led to a change in medications in 75% (21/28) of patients and both a statistically significant difference and a clinically meaningful reduction in MDS-UPDRS III score of 4.8 (p = 0.028). Additionally, positive changes in both the clinician (17/28;61%) and patient-reported (13/24;54%) Global Impression of Improvement were reported. CONCLUSION: The PKG is a valuable tool in augmenting clinical management when utilized along with a clinical assessment.

Quality of Diabetes Annual Management in the Internal Medicine Department in Yalgado Ouédraogo Teaching Hospital, Ouagadougou

Introduction: The periodic management of diabetes improves disease’s prognosis. We aimed to evaluate the quality of diabetes annual management and the effectiveness of its treatment in Ouagadougou. Material and Method: It was a cross-sectional and descriptive study, from retrospective records in the internal medicine department, Yalgado Ouédraogo Teaching Hospital (CHU-YO). Diabetic patient’s (15 years old and more) files that were registered between January, 2012 and December, 2016 have been analyzed. Files containing less than 80% data were excluded. Data relating to the baseline characteristics of the patients, the therapeutic education dispensation, the clinical and paraclinical assessment of the initial and annual visits at the first year of patient’s follow-up have been collected. The 2007 diabetes management standards of the French “Haute Autorité de Santé” as well as the biological standards of the same instance have been used. The quantitative variables were expressed as means and standard deviations and qualitative variables were expressed as absolute and relative frequencies. Results: 317 patients, including 218 women (68.77%) were studied. The mean age of women was 51.67 ± 12.46 years, and that of men 55.71 ± 10.63. Diabetes was type 2 in 302 (95.26%) patients. The mean duration since the diagnosis of diabetes was 2.9 years. The completeness rate of therapeutic education at the annual visit was 10.46%. That of the clinical examinations was at best 38.17% and 44.23% for the measurement of weight and blood pressure;otherwise it was less than 5%. About the paraclinical data, apart from the measurement of the fasting blood glucose which completeness rate was 71.61%, that of the others exams were less than 10%. At the annual visit, the mean value of HbA1C was 7.5%, and the target for HbA1C was achieved in 47.90% patients. Conclusion: The quality of diabetes annual management is unsatisfying. A structural improvement and the adaptation of guidelines are needed.

Logistics Cost Management Models and Their Usability for Purchasing

In many compames, cost management models are abandoned due to their complexity and because of this, the academic literature has experienced a downturn in publications regarding cost management. This paper deepens the understanding regarding the practical usability of cost management models for purchasing decisions, and provides a framework for determining a desired complexity of cost management in different purchasing environments. The complexity is defined along three dimensions identified in literature and the different purchasing environments stem from an adaptation of Kraljic＇s （1983） matrix.

New Attempt for Building Rural Water Environment Management System Based on the Investigation and Analysis of Water Environment in Xianxia Town, Yudu County

Water environment is a part of ecological environment, and conservation of water environment has always been a focus of public attention in China, but water environment management in the vast countryside has been stuck in bottleneck. Based on the fi eld investigation in Xianxia Town, Yudu County, Ganzhou City, Jiangxi Province, this paper explored the current situation of local water environment and the management diffi culties, then introduced the holistic view to integrate the linkage of government, market and society, proposed the universality of the individual case, and the new attempt centering on urban-rural integrated water environment management system with public participation mechanism, management subjects' benefit balance and coordination system, marketing operation mechanism and economic incentive mechanism as the extension.

Design and implementation of the system of students information management based on WEB

This paper mainly design B/S system structure and small information management system that often appear some problems of college student information management, combines the actual situation of students and student instructor management work. In the process of the development of the whole system, the main use of Microsoft.NET technology as a whole system of compiler environment, SQL Server 2000 is used in the design of backstage supporter＇ s database, were developed and designed by Visual Studi02005 tool, in exchange for page dynamically selected by the ASP.NET database and system interface between Webpage generation. This system has high reliability, high security, low input, so that the efficiency of information management students to improve.

A Probe into the Third-party Intervention Mode in Environmental Management

In environmental management,the absence and offside of the government,enterprises carry heavy burden,all these phenomena require a third-party to exercise part of the power instead of the government or the enterprises and also take on part of their responsibility.

基于B/S的信息管理系统设计

本文介绍基于B/S架构的信息管理系统设计过程。重点描述系统的功能模块设计,涵盖登录、用户管理、查询、接口、基本功能、数据安全检测、系统安全以及数据统计分析等模块。对系统进行全面的测试,包括界面测试、功能测试、性能测试和安全性测试。通过本文的设计和实现,该系统有望为信息管理提供高效、安全、稳定的解决方案。

Proximity to corridors benefits bird communities in vegetated interrow vineyards in Mendoza, Argentina

Management under ecological schemes and increasing habitat heterogeneity,are essential for enhancing biodiversity in vineyards.Birds provide several contributions to agriculture,for example pest control,recreation and enhancing human mental health,and have intrinsic value.Birds are also ideal model organisms because they are easy to survey,and species respond differently to agricultural land use at different scales.Vegetated borders of crops are key for many species of birds,and distance to the border have been found to be an important factor in vineyard-dominated agroecosystems.We evaluate if there are differences in the bird assemblage,between the interior compared to borders within vineyards,using a hierarchical community occupancy model.We hypoth-esized that occupancy of birds is greater in environments with greater heterogeneity,which in this study was considered to be contributed by the proximity to vegetated corridors.We expected that vineyard borders close to corridors will have higher bird occupancy than the center of the vineyard.The research was conducted in three vineyards with biodiversity-friendly management practices,in Gualtallary,Mendoza,Argentina.Bird surveys were conducted over three breeding seasons from 2018 to 2020.Occupancy and richness of the bird community was more closely associated with the borders adjacent to the corridors than with the interior of the vineyards,as we initially predicted,although the assemblage of birds did not differ much.More than 75%of the registered species consume exclusively or partially invertebrates.Biodiversity-friendly management and ecological schemes,together with vegetated corridors provide multiple benefits for biodiversity conservation.These ap-proaches not only minimize the use of agrochemicals but also prioritize soil cover with spontaneous vegetation,which supports a diverse community of insectivorous bird species,potentially contributing to pest control.