ObjectiveTo investigate effectiveness and safety of right vertical infra-axillary thoracotomy (RVIAT) in surgical repair for intra-cardiac anomalies combined with patent ductus arteriosus (PDA).MethodsWe retrospectively analyzed the clinical data of 34 patients who underwent intra-cardiac correction of congenital heart defects and PDA ligation simultaneously via RVIAT in our hospital from August 2014 to August 2019. There were 25 males and 9 females with an age range of 0.5-6.1 years.ResultsThe length of incision was 3.0 (3.0, 3.5) cm. The operation time lasted 110.0 (90.0, 121.0) min. The cardiopulmonary bypass time was 45.5 (38.8, 63.5) min and the aortic cross-clamp time was 22.5 (14.8, 34.8) min. The bleeding volume was 20.0 (13.8, 20.0) mL. ICU stay time was 17.0 (5.5, 22.3) h, post-operative mechanical ventilation time was 4.0 (2.0, 6.0) h, total in-hospital cost was 46 (39, 51) thousand yuan. There was no mortality or reoperation during perioperative and follow-up period. Within the median follow-up of 636.0 days, 1 patient had minimal residual ventricular septal defect shunt while no new-onset scoliosis, funnel chest or pectus carinatum was detected. No bilateral mammary developmental asymmetry was observed in the female patients during the follow-up period. All the patients’ parents or guardians were satisfied with the right vertical infra-axillary aesthetic skin incision.ConclusionThe minimally invasive repair for intra-cardiac heart defects combined with PDA via RVIAT is a safe and effective method with minimal invasiveness and excellent cosmesis.
The emergence of new-generation artificial intelligence technology has brought numerous innovations to the healthcare field, including telemedicine and intelligent care. However, the artificial intelligent medical device sector still faces significant challenges, such as data privacy protection and algorithm reliability. This study, based on invention patent analysis, revealed the technological innovation trends in the field of artificial intelligent medical devices from aspects such as patent application time trends, hot topics, regional distribution, and innovation players. The results showed that global invention patent applications had remained active, with technological innovations primarily focused on medical image processing, physiological signal processing, surgical robots, brain-computer interfaces, and intelligent physiological parameter monitoring technologies. The United States and China led the world in the number of invention patent applications. Major international medical device giants, such as Philips, Siemens, General Electric, and Medtronic, were at the forefront of global technological innovation, with significant advantages in patent application volumes and international market presence. Chinese universities and research institutes, such as Zhejiang University, Tianjin University, and the Shenzhen Institute of Advanced Technology, had demonstrated notable technological innovation, with a relatively high number of patent applications. However, their overseas market expansion remained limited. This study provides a comprehensive overview of the technological innovation trends in the artificial intelligent medical device field and offers valuable information support for industry development from an informatics perspective.
Our team proposed and constructed an Expert-knowledge and Data-driven Comprehensive Evaluation Model of Chinese Patent Medicine (EDCEM-CPM) using the machine learning algorithm. This model could improve the system of the comprehensive evaluation of the Chinese patent medicine in technology and provide measurement tools for Chinese patent medicine according to its characteristics. The model evaluates the multi-dimensional value of Chinese patent medicine by data pre-treatment, clustering algorithms, and data training steps, such as automatic learning weighting. This evaluation model is already in practice. In this paper, we introduced the establishment of the model with the calculation process for reference.
ObjectiveTo explore the method and feasibility of establishing patent ductus arteriosus (PDA) model in Bama miniature pig by using autologous jugular vein, and to provide a large animal model for the development of PDA occluder and the study of pulmonary hypertension associated with congenital heart disease. MethodsFive male Bama miniature pigs weighing about 45 kg were selected to gain the PDA model of the autogenous jugular vein, which was fixed by glutaraldehyde and anastomosed between the ascending aorta and the main pulmonary artery. The patency of PDA was confirmed by echocardiography and angiocardiography immediately and one week after the operation. Two animals were selected to undergo transcatheter closure of PDA via femoral vein 1 week after the operation, and the rest were euthanized to obtain PDA and lung tissue for pathological examination. ResultsThe PDA model was successfully established in all five animals with a success rate of 100.0%. Immediately and 1 week after the operation, echocardiography and angiography showed that PDA blood flow was unobstructed, and hematoxylin-eosin staining showed that PDA endothelialization was good. One week after the operation, two animals were successfully treated with transcatheter femoral vein occlusion. The pathological examination of lung tissue showed thickening of the intima and muscular layer of pulmonary arterioles, thickening of pulmonary interstitium and infiltration of neutrophils. ConclusionIt is safe and feasible to establish a large animal model of PDA by using autogenous jugular vein anastomosis between the ascending aorta and the main pulmonary artery. The model can be used for the development of PDA interventional occlusive devices and the pathophysiological study of congenital heart disease-related pulmonary hypertension.
This case was a 58-year-old female patient with patent ductus arteriosus (PDA) and severe aortic stenosis. Upon admission, she had severe heart failure and severe edema of both lower extremities unable to lie flat. After cardiac function adjustment and under general anesthesia, she underwent a one-stop operation of PDA occlusion and transcarotid transcatheter aortic valve replacement due to the severe aortic arch stenosis which brought high risk in transfemoral artery approach. Her symptoms improved significantly, and she was discharged only 6 days after operation. At the follow-up 3 months after operation, the aortic valve transvalvular pressure gradient improved significantly, the ductus arteriosus murmur disappeared, and the patient recovered well.
The preferred reporting items for comprehensive evaluation of Chinese patent medicine (PRICE-CPM) were developed, and comprised six domains, 21 items and 72 sub-items. The EQUATOR collaboration network for the formulation and revision of reporting specifications was referred to and the final report list items were established by adopting the literature analysis method, the expert committee discussion and the Delphi method, and considering the characteristics of CPM evaluation.
The preferred reporting items for comprehensive evaluation of Chinese patent medicine (PRICE-CPM) regulate the specific requirements of forming integrity, clear, and transparent reports from title to conclusion. It contains six domains with twenty-one items and seventy-two sub-items and is important to promote the integrity, scientificity, transparency, and applicability of relevant reports. Additionally, it indicates that comprehensive evaluation results reports of post-marketing Chinese patent medicine should refer to PRICE-CPM. Therefore, this article provides a detailed interpretation of the report list and references for future users.
A comprehensive evaluation system of Chinese patent medicine (CPM) is considered as a critical tool to measure the value of CPM. The "guideline for multi-dimensional and multi-criteria comprehensive evaluation for Chinese patent medicine" (abbreviated as guideline) has been released, proposing a comprehensive evaluation system of CPM (1st) comprising six aspects: safety, effectiveness, economy, applicability, scientificity and standardization. This paper elaborated the development method and explained the evaluation dimensions and criteria, so as to help the researchers understand and use the comprehensive evaluation system in the future when evaluating CPM.
The number of clinical practice guidelines for traditional Chinese patent medicine has been increasing recently. However, the quality of guidelines was still low compared to international guidelines. Considering the characteristics of traditional Chinese patent medicine, we suggested the following items should be taken into account when developing traditional Chinese patent medicine guidelines: ensuring the standardized guidelines of traditional Chinese patent medicine research problem is scientific based on reliable evidence; identifying the common questions according to these research problems; understanding the strength of evidence and how to recommend correctly; inviting some experts in other fields to take part in the development of guidelines; paying more attention on the changes of disease burden and the impact of new methods and technologies when developing the guideline; paying more attention to the non-consensus opinions and evidence supporting these opinions; insisting on quality is the priority, while speed is secondary.
Comprehensive evaluation research of Chinese patent medicine (CPM) is performed to demonstrate the comprehensive value of CPM from multiple dimensions and to clarify the clinical value and positioning, so as to provide references for decision-making in health or drug policies. Therefore, to standardize and promote comprehensive evaluation studies on CPM, the current guideline introduced the specific requirements on the applicable subject, basic principles, and major evaluation content, thereby providing guidance for researchers in the future.