Abstract: Objective To compare the multiple organ dysfunction score (MODS), the sequential organ failure assessment (SOFA), the acute physiology, age, and chronic health evaluation system Ⅱ(APACHE Ⅱ), the acute physiology, age, and chronic health evaluation system Ⅲ(APACHE Ⅲ) in evaluating risks for patients after cardiac surgery, in order to provide better treatment and prediction of prognosis after cardiac operation. Methods A prospective study was carried out on 1 935 cardiac postoperative patients, including 1 050 males and 885 females, enrolled in cardiac postoperative intensive care unitof Anzhen hospital between October 2007 and April 2008. The age of the patients ranged from 18 to 86 years with the mean age of 53.96 years. The patients underwent the surgery because of various cardiac diseases including coronary heart disease, valve disease, congenital heart disease, aortic aneurysm, pericardial disease, atrial fibrillation, and pulmonary embolism. We used MODS, SOFA, APACHE Ⅱ, and APACHE Ⅲ respectively to calculate the value of the first day after operation, the maximum value during the first three days, the maximum value, and the change of the value between the third day and the first day for every patient, and then we compared the calibration and discrimination of these different systems using HosmerLemeshow goodnessoffit analysis and Receiver Operating Characteristic (ROC) curve. Results There were 47 perioperative deaths because of circulating system failure, respiration failure, kidney failure, liver failure or nervous system diseases. The death rate was 2.43%. In discrimination analysis, the area under the curve (AUC) in ROC of the first day value after operation, the maximum value, the maximum value during the first three days, and the change of value between the third day and the first day for MODS were respectively 0.747, 0.901, 0.892, and 0.786; for SOFA were respectively 0.736, 0.891, 0.880, and 0.798; for APACHE Ⅱ were respectively 0.699, 0.848, 0,827, and 0.562; for APACHE Ⅲ were respectively 0.721, 0.872, 0.869, and 0.587. In calibration analysis, we compared the χ2 value of the first day value, the maximum value, the maximum value during the first 3 days, and the change of value between the third day and the first day of these systems. χ2 value of MODS was 4.712, 5.905, 5.384, and 13.215; χ2 value of SOFA was 8.673, 3.189, 3.111, and 14.225; χ2 value of APACHE Ⅱ was 15.688, 10.132, 8.061, and 42.253; χ2 value of APACHE Ⅲ was 13.608, 11.196, 19.310, and 47.576. AUC value of MODS and SOFA were all larger than those of APACHE Ⅱ and APACHE Ⅲ (Plt;0.05); AUC value of APACHE Ⅱ was smaller than that of APACHE Ⅲ (Plt;0.05). Conclusion MODS, SOFA, APACHE Ⅱ and APACHE Ⅲ are all applicable in evaluating risks for patients after cardiac surgery. However, MODS and SOFA are better than APACHE Ⅱ、APACHE Ⅲ in predicting mortality after cardiac surgery. In cardiac surgery, the complicated APACHE Ⅱ and APACHE Ⅲ systems can be replaced by MODS and SOFA systems which are simpler for use.
In recent years, wearable devices grew up gradually and developed increasingly. Aiming at the problems of skin sensibility and the change of electrode impedance of Ag/AgCl electrode in the process of long-term electrocardiogram (ECG) signal monitoring and acquisition, this paper discussed in detail a new sensor technology–fabric electrode, which is used for ECG signal acquisition. First, the concept and advantages of fabric electrode were introduced, and then the common substrate materials and conductive materials for fabric electrode were discussed and evaluated. Next, we analyzed the advantages and disadvantages from the aspect of textile structure, putting forward the evaluation system of fabric electrode. Finally, the deficiencies of fabric electrode were analyzed, and the development prospects and directions were prospected.
Objective To analyze the scientific research output of West China Hospital of Sichuan University from 2015 to 2020, so as to evaluate the effectiveness of new scientific research management model. Methods From January 2018, a series of management measures were introduced, including improving research incentive policies, integrating and supporting resources, constructing a scientific quantitative research performance evaluation system, and establishing an information-based research service model. The changes of scientific research output before (2015-2017) and after (2018-2020) the implementation of the management measures were analyzed to evaluate the quality and effectiveness of the management model. Results A total of 10141 high-quality research papers were seized and 2311 research projects were approved. After the implementation of the measures, the absolute number of papers published and projects approved increased significantly. In terms of high-quality papers published after the implementation of the measures, the increase rate reached 46.80%, among which the number of interdisciplinary papers increased by 116.05%, the number of reviews increased by 96.13%, the numbers of papers published in Area 2 and Area 1 increased by 114.67% and 75.00%, respectively, and the number of co-author papers increased by over seven times. In terms of scientific research projects approved after the implementation of the measures, the number of projects approved by the National Natural Science Foundation of China (NSFC) increased by 21.03%, and the number of provincial and ministerial projects increased by 110.17%, with the people in charge becoming younger. The number of principal investigators of NSFC increased by 1.67 times. The number of projects managed by intermediate and undetermined professional titles increased by 64.71% and 68.63%, respectively. The number of projects approved by youth and general fund increased by 30.26% and 14.16% respectively. The number of people in charge of provincial and ministerial projects increased by 1.45 times. The number of projects managed by deputy senior and intermediate titles increased by 1.64 times and 1.54 times, respectively. Key research and development projects, key projects, international cooperation projects, and basic application projects saw a significant increase. Conclusions After the implementation of management measures, the number and overall level of research papers have been improved, and the cross-cooperation between clinical and basic research has been gradually started. The number of projects approved increased significantly, and the project leaders tended to be younger. The high-quality cultivation and continuous growth of scientific research talents achieved initial results.
Day surgery is flourishing in public hospitals in China with the advantages of strong planning, short stay and high efficiency. Under the background of “diversification of surgeons, diversification of disease structure and precision of scheduling needs”, higher requirements are put forward for refined scheduling strategies of day surgery. The research of scientific and precise surgical scheduling strategy is of great significance to realize efficient coordination and optimal allocation of day surgical resources. This article reviews the necessity of precise scheduling of day surgery, the current situation of scheduling of day surgery, the key dimensions affecting the scheduling of day surgery, and the evaluation system for precise scheduling of day surgery.
The surgical difficulty of congenital heart disease varies greatly. To ensure the safety of surgery and maximize the benefits of patients, various congenital heart surgery scoring systems have been used to evaluate the risk of different complex congenital cardiac operations. However, the complete correction of cardiac anatomical malformations is a common surgical challenge. Recent studies have shown that the correction is closely related to perioperative mortality and postoperative complications, and a new scoring system for the degree of cardiac anatomical malformations has been proposed. Therefore, this review summarizes the literature and discusses different evaluative methods of congenital heart surgery, aiming to optimize the surgical evaluation system for congenital heart surgery, enhance the quality of surgery and improve the prognosis of patients.