ObjectiveTo analyze the current situation and international research focuses on the study of medical device risk management. MethodsTo retrieve medical device risk management literature information cited from 2002 to 2011 in PubMed such as high-frequency MeSH; analyze current situation and research focuses of medical device risk management by using bibliometrics, bibliographic item co-occurrence matrix builder (BICOMB), and graphical clustering toolkit (gCluto) for quantitative analysis, high-frequency MeSH term papers cluster visualization analysis. ResultsA total of 7 073 published studies were retrieved, basically suggesting a gradually increasing trend of the number of published papers. The top 3 numbers of first authors' papers referred to three countries: the United States, Britain and Germany, while China ranked twelfth. The top 3 numbers of journal articles referred to the United States, Britain and Holland, while China ranked twenty-second. Twenty journals published more than 50 papers, and all these journals were clinical journals. Thirty-three authors published no less than 5 papers, with the maximum of 18 articles. Totally, there were 124 highfrequency MeSHs. The high-frequency MeSHs were classified into 6 categories by using double cluster analysis: kinds 0 to 4 included risk report, risk analysis, risk assessment and methodology of heart valve prosthesis, coronary stents, peripheral vascular stents, implantable defibrillators and other life support device, surgical repair surgical flaps and minimal invasion surgical device such as laparoscopy; kind 5 focused on safety management, risk control, organization and implementation and other related research based on prevention and control of medical device adverse reaction, medical errors, occupation exposure, and equipment failure. ConclusionThe analysis on international literature on medical device risk management basically shows a gradually increasing trend; most studies published in the clinical medicine journals; research focus on risk assessment, safety management and quality improvement in the application such as angioplasty, artificial prosthesis replacement, plastic surgery, minimally invasive surgery and critical care medicine, and radiology diagnosis and treatment; implantable, life-supported invasive and radiological devices as the main research subject; and characteristics include closely combination between medical device risk management and the application of safe and effective, quality improvement systems for clinical diagnosis and treatment.
ObjectiveTo explore the preventive role of maintaining constant pressure of the endotracheal catheter cuff on ventilator-associated pneumonia (VAP). MethodsFrom January to December 2015, 96 patients of type Ⅱ respiratory failure were selected as the trial group who underwent intubation and mechanical ventilation more than 48 hours in the Intensive Care Unit (ICU). We used pressure gauges to measure the endotracheal catheter cuff pressure regularly and maintained a constant pressure in addition to the application of artificial airway cluster management. We recorded the initial pressure value which was estimated by pinching with finger and set initial pressure to 30 cm H2O (1 cm H2O=0.098 kPa). We measured endotracheal catheter cuff pressure and recorded it during different intervals. We reviewed 88 patients with the same disease as the control group who only accepted artificial airway cluster management between January and December 2014. Mechanical ventilation time, VAP occurrence time, ICU admission time, the incidence of VAP were recorded and analyzed for both the two groups of patients. ResultsIn the trial group, the initial pressure of endotracheal catheter cuff which was estimated by pinching with finger showed that only 11.46% of pressure was between 25 and 30 cm H2O and 82.29% of the pressure was higher than 30 cm H2O. We collected endotracheal catheter cuff pressure values during different interval time by using pressure gauges to maintain a constant management. The ratio at the pressure between 25 and 30 cm H2O was respectively 41.32%, 43.75%, 64.20%, 76.54%, 91.13%, and 91.85%. ICU admission time, mechanical ventilation time in patients of the trial group decreased more, compared with the control group, and the differences were statistically significant (t=4.171, P<0.001; t=4.061, P<0.001). The VAP occurrence time in patients of the trial group was later than the control group (t=2.247, P<0.001). ConclusionThe endotracheal catheter cuff pressure estimated by pinching with finger has errors. We recommend using pressure gauges to detect pressure every four hours, which utilizes minimal time to maintain effective pressure. The method of artificial airway of cluster management combined with the pattern of maintaining constant endotracheal catheter cuff pressure can shorten ICU admission time, mechanical ventilation time and delay the occurrence of VAP.
When a clustered coronavirus disease 2019 epidemic occurs, how to prevent and control hospital infection is a challenge faced by each medical institution. Under the normalization situation, building an effective prevention and control system is the premise and foundation for medical institutions to effectively prevent and control infection when dealing with clustered epidemics. According to the principles of control theory, medical institutions should quickly switch to an emergency state, and effectively deal with the external and internal infection risks brought by clustered epidemics by strengthening source control measures, engineering control measures, management control measures and personal protection measures. This article summarizes the experience of handling clustered outbreaks in medical institutions in the prevention and control of coronavirus disease 2019, and aims to provide a reference for medical institutions to take effective prevention and control measures when dealing with clustered outbreaks.
Objective To investigate the hot topics of research on evidence-based medicine in 2002. Method To search MEDLINE for papers on evidence-based medicine published in 2002, identify high-frequency subject headings related to research on evidence-based medicine, and cluster the high-frequency subject headings according to rates they appeared in common papers. Results 545 papers, 1 554 subject headings, 30 high-frequency subject headings on evidence-based medicine, and nine clustering categories of high-frequency subject headings were identified through search. Conclusions Both high-frequency subject headings and their clustering categories suggested that “evidence-based practice guidelines and their innovation”, “evidence-based health research and health policy”, “methodology on systematic reviews and randomized clinical trials”, “method of evidence-based decision making and its application in various subjects”, were the hot topics of evidence-based medicine. They provided useful references for Chinese medical professionals to practice evidence-based medicine.
ObjectiveTo observe the effects of cluster therapy combined with anisodamine, dexamethasone and ambroxol on arterial blood gas, inflammatory cytokines and pulmonary pathological changes by making an early (<48 h) primary blast lung injury model in rats. MethodsEighty Wistar rats were randomly divided into six groups, ie. a control group (n=5), an injury group (n=15), an ambroxol treatment group (n=15), a dexamethasone treatment group, a scopolamine treatment group (n=15), a combination of ambroxol, dexamethasone and anisodamine group (n=15). The treatment groups were injected intraperitoneally with ambroxol 46.7 mg/kg (three times a day) or (and) dexamethasone at 5 mg·kg–1·d–1 or (and) anisodamine at a dose of 3.33 mg/kg (three times a day). The rats in the injury group were injected intraperitoneally with an equal volume of normal saline. Respiratory rate and weight change were observed before and after injury. Five rats were sacrificed at 6 hours, 24 hours and 48 hours after injury in each experimental group. Arterial blood gas analysis, Yelverton pathological score, lung tissue wet/dry weight ratio, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured. The lung histopathology was observed. ResultsAfter lung blast injury, the rats in the injury group showed progressive respiratory acidosis, and hypoxemia increased with the increase of IL-6 and TNF-α in a time-dependent manner. The PaO2 decreased in the groups with ambroxol, dexamethasone and anisodamine alone or in combination with anisodamine, and the contents of serum IL-6 and TNF-α decreased. Pathological edema and inflammatory infiltration of lung tissue were alleviated significantly. ConclusionsAfter treatment with dexamethasone, anisodamine and ambroxol after lung blast injury, blood gas analysis is improved, inflammatory factor level is decreased and lung injury is alleviated, indicating that the three drugs can treat lung detonation injury in rats. The cluster therapy is superior to the single drug therapy.
Objective To set up healthcare device-technology deployment assessment model and procedures through establishing the assessment parameter system between the functions of the clinical technical requirements and devices. Methods The bidirectional assessment parameter system developed by the literature review and Delphi, then combination weighting calculated by the combination weighting method, and the proposals for function deployment performed on the cluster analysis. Results The positive coefficients of twice Delphi were 75.56% and 87.50%, respectively. The effective recovery rates of the questionnaire were higher. The structure of the bidirectional assessment parameter system acquired according to the data mining and review, Delphi and integrated analysis. We calculated the weighting for the required functions and the deployed functions of the ventilator in the ICU, ER and RR. We listed the absolute importance and rank. The proposals for the function deployment of the ventilator which met different needs in fields of the critical care medicine were produced by the cluster analysis, ranking absolute importance and the calibration of weighting based on the investigation for actual function utilized rate. Conclusion It studies healthcare device-technology deployment assessment model by sequential integrated methods and sets up bidirectional assessment parameter system based on clinical technical function requirement, and the result is effective.
Due to the high dimensionality and complexity of the data, the analysis of spatial transcriptome data has been a challenging problem. Meanwhile, cluster analysis is the core issue of the analysis of spatial transcriptome data. In this article, a deep learning approach is proposed based on graph attention networks for clustering analysis of spatial transcriptome data. Our method first enhances the spatial transcriptome data, then uses graph attention networks to extract features from nodes, and finally uses the Leiden algorithm for clustering analysis. Compared with the traditional non-spatial and spatial clustering methods, our method has better performance in data analysis through the clustering evaluation index. The experimental results show that the proposed method can effectively cluster spatial transcriptome data and identify different spatial domains, which provides a new tool for studying spatial transcriptome data.
ObjectiveTo learn the distribution pattern and characteristics of autoimmune pancreatitis research literature, and its worldwide research trend. MethodsPublished data between September 22, 2004 and September 21, 2014 were searched by using the keyword autoimmune pancreatitis in the database of Pubmed. Publication year, journals, authors and research topics were bibliometrically analyzed. The analysis software Bibliographic Item Co-occurrence Matrix Builder was used for cluster analysis on high-frequency keywords. ResultsA total of 1 518 articles on autoimmune pancreatitis were acquired. The amount of published literature rose rapidly in the past 10 years, reaching its peak in the year of 2012. Most of the articles were published by several leading authors in the leading journals. There were 26 keywords with a frequency of more than 30 times, and 4 categories were classified through cluster analysis of these keywords. They were pathology and immunology, imaging, diagnosis and treatment. ConclusionsAttention on autoimmune pancreatitis has been increasing in the recent 10 years. Japanese researchers have been taking the lead. Current research focus is the diagnosis of autoimmune pancreatitis.
Epilepsy is a neurological disease with disordered brain network connectivity. It is important to analyze the brain network mechanism of epileptic seizure from the perspective of directed functional connectivity. In this paper, causal brain networks were constructed for different sub-bands of epileptic electroencephalogram (EEG) signals in interictal, preictal and ictal phases by directional transfer function method, and the information transmission pathway and dynamic change process of brain network under different conditions were analyzed. Finally, the dynamic changes of characteristic attributes of brain networks with different rhythms were analyzed. The results show that the topology of brain network changes from stochastic network to rule network during the three stage and the node connections of the whole brain network show a trend of gradual decline. The number of pathway connections between internal nodes of frontal, temporal and occipital regions increase. There are a lot of hub nodes with information outflow in the lesion region. The global efficiency in ictal stage of α, β and γ waves are significantly higher than in the interictal and the preictal stage. The clustering coefficients in preictal stage are higher than in the ictal stage and the clustering coefficients in ictal stage are higher than in the interictal stage. The clustering coefficients of frontal, temporal and parietal lobes are significantly increased. The results of this study indicate that the topological structure and characteristic properties of epileptic causal brain network can reflect the dynamic process of epileptic seizures. In the future, this study has important research value in the localization of epileptic focus and prediction of epileptic seizure.
ObjectiveTo explore the effect of the cluster intervention in new nurses in the Department of Neurosurgery in occupation training, so as to provide reference for the clinical training of new nurses. MethodsEight nurses who entered the Department of Neurosurgery in January 2013 were set as control group and the 8 new nurses entering in January 2014 as the observation group. The control group was adopted the traditional training methods, while the observation group underwent used extra cluster intervention. The differences in the results of theory, technology, operation and the 360-degree evaluation between the two groups were analyzed at the end of year. ResultsIn the observation group, the median theory examination score was 91.50, median operation assessment grades was 95.00, which were higher than those in the control group (82.00 and 83.00). The average scores of 360-degree evaluation in the observation group were higher than those in the control group with a significant difference (P < 0.01). ConclusionsIntensive intervention should be used for new nurses' training. It helps to improve the training effect and new nurses' ability.