Currently, as the key raw material of artificial biological heart valve, bovine pericardium is mainly depend on import and has become a “bottleneck” challenge, greatly limiting the development of domestic biological heart valve. Therefore, the localization of bovine pericardium is extremely urgent. In this study, the pericardium of Sichuan yak was compared with that of Australian cattle in terms of fundamental properties and anti-calcification performance. The results demonstrated that the appearance and thickness of yak pericardium were more advantageous than the Australian one. Sichuan yak pericardium and Australian cattle pericardium had comparable performance in shrinkage temperature, mechanical test and anti-calcification test. This study preliminarily verifies the feasibility of substitution of Australian cattle pericardium by Sichuan yak pericardium and promotes the progression of bovine pericardium localization with data support.
Objective To understand the current situation of Chengdu primary health workers’ performance baseline, and to provide decision-making proof and policy recommendations for Chengdu Coordinated and Balanced Urban-rural Development as well as improve primary health workers’ performance in China. Method See the second study in this series. Result The number of the patients of the Chengdu seven Rural Hospitals / Centers showed a trend of slow increase, and all was higher than the national rural hospital average level except the 2 most remote rural hospitals(“Renhe” and “Bailu”). The seven Rural Hospitals / Centers could provide data about the “Six in One” work, and the performance was generally better than that of the world and the national average level , but showed a decreasing trend from the first circle to the third circle in Chengdu. The rate of patients’ satisfaction and very satisfaction for the Rural Hospitals / Centers “Six in One” work reached 65%-80%, but the rate of health workers’ job satisfaction and very satisfaction only reached 9%-46%, and also showed a decreasing trend from the first circle to the third circle. Conclusion The Chengdu primary health workers provide “Six in One” health service with a higher quality than the world and the national average levels. However, the number of the workers is less than enough; the human managerial structure is irrational; the educational and professional levels are low; their treatment and the work environment are poor. The distribution density , the academic qualification and the structure rationality of professional ranks of health personnel show a decreasing trend, and the difficulty of the service is gradually increasing from the first circle to the third circle, which causes the satisfaction rate of the workers’ job to decrease gradually from the first circle to the third circle. Suggestion: ① To make special performance assessment standard for special health institutions or personnel, and to give the continual oriented training chance for current health personnel. ② To integrate the regional health resources; to establish long-term and stable regional bilateral appointment help policy, technical and rational two-way referral system and indicator systems. ③ To take measures to solve the problems affecting the professional promotion and improvement of the grass-root health personnel.
At present, balanced scorecard is widely used in hospital performance management, but because of the difficulty in selecting indicators and the ambiguity of causality, its implementation on the application level is limited. Based on the theory of “competitive advantage” and resource arrangement, this study constructs an improved balanced scorecard index system for discipline performance evaluation from the perspective of improving discipline competitiveness of Ningbo No.2 Hospital. The index system mainly includes the dimensions of discipline quality development, resource allocation efficiency and so on, with the characteristics of “focusing on advantages, accurate positioning” and innovation, and has achieved good results in practical application.
ObjectiveTo understand the nutritional status of vitamin D in some children aged 0-14 in Mianyang during the past 3 years and the changes of vitamin D nutritional status under home protection during the coronavirus disease 2019 (COVID-19) epidemic, so as to provide a theoretical basis for the monitoring and reasonable supplementation of vitamin D in children in this area after the epidemic.MethodsThe clinical data of children aged 0-14 who underwent physical examination in the Children’s Health Department of Mianyang Central Hospital from January to April 2018, from January to April 2019 and from January to April 2020 were analyzed retrospectively. High performance liquid chromatography tandem mass spectrometry was used to detect vitamin D, including vitamin D2, vitamin D3 and 25-hydroxyvitamin D [25(OH)D] in children’s serum. The differences in vitamin D components and 25(OH)D between different genders, different age groups, and different years were analyzed.ResultsA total of 12 348 children were included. The average vitamin D2 was (4.89±6.02) ng/mL, the average vitamin D3 was (22.91±9.29) ng/mL, the average 25(OH)D was (27.81±10.53) ng/mL, and 9 434 cases had sufficient 25(OH)D. The differences in vitamin D2, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2018, vitamin D2 and 25(OH)D in 2019, and vitamin D2 in 2020 between different genders were not statistically significant (P>0.05). There were statistically significant differences in vitamin D3 and 25(OH)D nutritional status in 2019, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2020 between different genders (P<0.05). From 2018 to 2020, vitamin D2 was the highest in infant group (P<0.05), while vitamin D3, 25(OH)D and 25(OH)D nutritional status were the highest in children group (P<0.05); vitamin D2 (χ2=143.106, P<0.001) showed an overall downward trend, vitamin D3 (F=400.178, P<0.001) and 25(OH)D (F=447.384, P<0.001) showed an overall upward trend; 25(OH)D nutritional status (χ2=103.566, P<0.001) was the highest in 2019.ConclusionsThe overall vitamin D nutritional status of children in Mianyang area is acceptable. Under the home protection, the average level of children’s serum 25(OH)D has little change, while the nutritional status of 25(OH)D has decreased significantly. After the outbreak of COVID-19, more attention should be paid to the monitoring and supplementation of vitamin D in school-age female children.
The heart valve prosthesis must have excellent hydrodynamic performance which is usually tested in vitro, not in vivo. This paper comprehensively introduced the principles and methods of hydrodynamic performance in vitro testing, helping clinicians to understand valve performance parameters, evaluate valve applicability, and reduce clinical risk of the valve prosthesis. In vitro testing not only serves as the "gold standard" for valve prosthesis assessment, but also provides detailed data for design and optimization of the prosthesis. ISO 5840 defines the items and methods for valve in vitro testing, which consists of three parts: (1) pulsatile flow testing, which reproduces the pulsating flow of the valve prosthesis after implantation in the human body; (2) steady flow testing, which assesses valve forward flow resistance; (3) durability testing, which evaluates the durability of the valve prosthesis and determines the expected failure mode. In addition, the paper presented the differences between atrioventricular and aortic valve testing, the method of mitral valve testing, the differences between transcatheter and surgical valve testing, and the method of valve flow visualization.
ObjectiveTo systematically review the clinical utilization of robotic bronchoscopes in diagnosis of pulmonary nodules, including MonarchTM and IonTM platforms, and then evaluate the efficacy and safety of the procedure. MethodsPubMed, EMbase, Web of Science and Cochrane Central Register of Controlled Trials databases were searched by computer for literature about the biopsy of pulmonary nodules with robotic bronchoscope from January 2018 to February 14, 2022. The quality of research was evaluated with Newcastle-Ottawa Scale. RevMan 5.4 software was used to conduct the meta-analysis. ResultsFinally, 19 clinical studies with 1 542 patients and 1 697 targeted pulmonary nodules were included, of which 13 studies used the IonTM platform and 6 studies used the MonarchTM platform. The overall diagnostic rate of the two systems was 84.96% (95%CI 62.00%-95.00%), sensitivity for malignancy was 81.79% (95%CI 43.00%-96.00%), the mean maximum diameter of the nodules was 16.22 mm (95%CI 10.98-21.47), the mean procedure time was 61.86 min (95%CI 46.18-77.54) and the rate of complications occurred was 4.76% (95%CI 2.00%-15.00%). There was no statistical difference in the outcomes between the two systems. Conclusion Robotic bronchoscope provides a high efficacy and safety in biopsy of pulmonary nodules, and has a broad application prospect for pulmonary nodules diagnosis.
Stent migration is one of the common complications following transcatheter valve implantation. This study aims to design a “drum-shaped” balloon-expandable aortic valve stent to address this issue and conduct a mechanical analysis. The implantation process of the stent was evaluated using a method that combines numerical simulation and in vitro experiments. Furthermore, the fatigue process of the stent under pulsatile cyclic loading was simulated, and its fatigue performance was assessed using a Goodman diagram. The process of the stent migrating toward the left ventricular side was simulated, and the force-displacement curve of the stent was extracted to evaluate its anti- migration performance. The results showed that all five stent models could be crimped into a 14F sheath and enabled uniform expansion of the native valve leaflets. The stress in each stent was below the ultimate stress, so no fatigue fracture occurred. As the cell height ratio decreased, the contact area fraction between the stent and the aortic root gradually decreased. However, the mean contact force and the maximum anti-migration force first decreased and then increased. Specifically, model S5 had the smallest contact area fraction but the largest mean contact force and maximum anti-migration force, reaching approximately 0.16 MPa and 10.73 N, respectively. The designed stent achieves a “drum-shaped” change after expansion and has good anti-migration performance.
Objective To review the literature written in English on hospital performance research and provide theoretical and practical references for research in the field of hospital performance in China. Methods Literature related to hospital performance published from 1972 to 2022 in the Web of Science Core Collection was retrieved. Microsoft Excel 2021 was used to analyze the annual publication volume of English literature in the field of hospital performance. CiteSpace 6.1.R6 software was used for co-occurrence analysis of countries/regions, institutions and authors, research hotspots and frontiers. Results A total of 1447 articles were ultimately included. The analysis of annual publication volume showed that the overall publication volume in the field of hospital performance was on the rise. The co-occurrence analysis of countries/regions indicated that the United States had the highest output of academic papers (548), followed by the United Kingdom and China (120 and 89 respectively). The most productive institution was Harvard University in the United States, and the most productive scholar was Harlan M. Krumholz from the Yale University School of Medicine in the United States. The most frequently occurring keyword was “care”. The clustering analysis of keywords revealed that the keywords in the field of hospital performance research were clustered into 12 categories. The top 5 keywords with the highest burst intensity included “acute myocardial infarction” “indicator” “US hospital” “predictor” and “administrative data”. Keywords such as “public hospital” “financial performance” “performance measurement” “framework” and “organizational performance” began to emerge in 2020 and had continued to the present. Conclusions The research hotspot in the field of hospital performance has shifted from focusing on individual performance to organizational performance. There is still a lot of room for research in this field in China, and the exploration of hospital performance evaluation and management models may continue to be research hotspots in this field in the future.
The high rotational speed of the axial flow blood pump and flow separation of the centrifugal blood pump are the main causes for blood damage in blood pump. The mixed flow blood pump can effectively alleviate the high rotational speed and the flow separation. Based on this, the purpose of this study is to explore the performance of the mixed blood pump with a closed impeller. A mixed flow blood pump with closed impeller was studied by numerical simulation in this paper. The flow field characteristics and the pressure distribution of this type of blood pump were analyzed. The hydraulic performance of the blood pump and the possible damages to red blood cells were also discussed. At last, pump performance was compared with the mixed flow blood pump with semi-open impeller. The results show that the mixed flow blood pump with close impeller studied in this paper can operate safely and efficiently with a good performance. The pump can reach the pressure head of 100 mmHg at 5 L/min mass flow rate. Flow in the blood pump is uniform and no obvious separation or vortex occurs. Pressure distribution in and on the impeller is uniform and reasonable, which can effectively avoid the thrombosis of blood. The average mean value of hemolysis index is 4.99 × 10−4. The pump has a good biocompatibility. Compared with the mixed flow blood pump with semi-open impeller, the mixed flow blood pump with closed impeller has higher head and efficiency, a smaller mean value of hemolysis index prediction, a better hydraulic performance and the ability to avoid blood damage. The results of this study may provide a basis for the performance evaluation of the closed impeller mixed flow blood pump.
ObjectiveTo establish a method for content determination of ferulic acid in Piwang massage lotion. MethodsHigh performance liquid chromatography was used. The analysis was carried on Diamonsil C18 (150 mm×4.6 mm, 5 μm, Dimma Science and Technology Co. Ltd.) column with mobile phase consisted of methanol-2% acetic acid (32︰68). The column temperature was 30℃. The detection wavelength was 320 nm. ResultsThe responses of ferulic acid liner in range of 4.55-91.00 μg/mL (R2=0.999 9). The average recovery of ferulic acid was 98.78% (relative standard deviation is 2.668%). ConclusionThe method is simple, rapid and good repeatability. It can be used for quality control of Piwang massage lotion