1.Analysis of the protection of compensation rights for research participants
Aijuan SHENG ; Xiaoqi WANG ; Liyan SUN ; Dongxiang ZHENG ; Fang LIU
Chinese Medical Ethics 2024;37(5):507-513
Life science and medical research involving human beings cannot be separated from the support of research participants.The safety,health,and rights and interests of research participants are the primary considerations in clinical research,and their rights and interests include the right of compensation,privacy protection,health and so on.Protecting the compensation rights of research participants is a necessary responsibility of the research-related departments and personnel.Based on laws and regulations and literature review,and combined with practical experience,this paper made an in-depth discussion on compensation rights.It puts forward the types of compensation(conventional compensation,research-related damage compensation),compensation principles(necessity,timeliness,appropriateness,fairness),compensation elements(method,amount,plan,consent,notification,and reference of compensation),compensation under special circumstances(compensation for participants without or with limited informed consent ability and withdraw from the study midway),protection measures of compensation right(sponsor/contract research organizations,research institutions,research management departments,(main)researchers and research teams,ethics(review)committee).The compensation rights should be implemented to protect research participants.
2.Postoperative management of cardiac and vascular surgery in the period of COVID-19
Shuo CHANG ; Xinyi ZHANG ; Sheng HUANG ; Yuxin FAN ; Xiangbin PAN ; Xiaoqi WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):967-973
Objective To explore the postoperative characteristics and management experience of patients with coronavirus disease 2019 (COVID-19) undergoing cardiac and vascular surgery. Methods From December 7, 2022 to January 5, 2023, the patients with COVID-19 who were admitted to Cardiovascular Hospital Affiliated to Kunming Medical University and underwent cardiac and vascular surgery were selected. The clinical history, surgical information, postoperative recovery process and treatment plan were analyzed retrospectively. Results There were 18 patients in this group, including 11 (61.1%) males and 7 (38.9%) females, with an average age of 58.1±10.9 years. There were 7 patients of hypertension, 5 patients of diabetes, 3 patients of respiratory diseases, and 2 patient of chronic renal insufficiency. There were 5 (27.8%) patients receiving emergency operations and 13 (72.2%) elective operations. All the 18 patients underwent cardiac and vascular surgery in the period of COVID-19, and the time between the last positive nucleic acid test and the surgery was 1.50 (1.00, 6.25) days. There were 8 patients of pulmonary imaging changes, including 3 patients with chest patch shadow, 3 patients with thickened and disordered lung markings, and 2 patients with exudative changes before operation. Antiviral therapy was not adopted in all patients before operation. Three patients were complicated with viral pneumonia after operation, including 2 patients with high risk factors before operation, who developed into severe pneumonia after operation, and underwent tracheotomy. One patient with thrombus recovered after anticoagulation treatment. Another patient of mild pneumonia recovered after antiviral treatment. The other 15 patients recovered well without major complications. There was no operation-related death in the whole group. One patient died after surgery, with a mortality rate of 5.6%. Conclusion Patients with COVID-19 are at high risk of cardiac and vascular surgery, and patients with high-risk factors may rapidly progress to severe pneumonia. Patients with preoperative lung imaging changes or other basic visceral diseases should consider delaying the operation. Early antiviral combined with immunomodulation treatment for emergency surgery patients may help improve the prognosis.
3.Postoperative management of cardiac and vascular surgery in the period of COVID-19
Shuo CHANG ; Xinyi ZHANG ; Sheng HUANG ; Yuxin FAN ; Xiangbin PAN ; Xiaoqi WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):967-973
Objective To explore the postoperative characteristics and management experience of patients with coronavirus disease 2019 (COVID-19) undergoing cardiac and vascular surgery. Methods From December 7, 2022 to January 5, 2023, the patients with COVID-19 who were admitted to Cardiovascular Hospital Affiliated to Kunming Medical University and underwent cardiac and vascular surgery were selected. The clinical history, surgical information, postoperative recovery process and treatment plan were analyzed retrospectively. Results There were 18 patients in this group, including 11 (61.1%) males and 7 (38.9%) females, with an average age of 58.1±10.9 years. There were 7 patients of hypertension, 5 patients of diabetes, 3 patients of respiratory diseases, and 2 patient of chronic renal insufficiency. There were 5 (27.8%) patients receiving emergency operations and 13 (72.2%) elective operations. All the 18 patients underwent cardiac and vascular surgery in the period of COVID-19, and the time between the last positive nucleic acid test and the surgery was 1.50 (1.00, 6.25) days. There were 8 patients of pulmonary imaging changes, including 3 patients with chest patch shadow, 3 patients with thickened and disordered lung markings, and 2 patients with exudative changes before operation. Antiviral therapy was not adopted in all patients before operation. Three patients were complicated with viral pneumonia after operation, including 2 patients with high risk factors before operation, who developed into severe pneumonia after operation, and underwent tracheotomy. One patient with thrombus recovered after anticoagulation treatment. Another patient of mild pneumonia recovered after antiviral treatment. The other 15 patients recovered well without major complications. There was no operation-related death in the whole group. One patient died after surgery, with a mortality rate of 5.6%. Conclusion Patients with COVID-19 are at high risk of cardiac and vascular surgery, and patients with high-risk factors may rapidly progress to severe pneumonia. Patients with preoperative lung imaging changes or other basic visceral diseases should consider delaying the operation. Early antiviral combined with immunomodulation treatment for emergency surgery patients may help improve the prognosis.
4.Implementation status of intracardiac electrocardiogram positioning technology in localizing peripherally inserted central catheter tip position in 199 hospitals
Jing SHI ; Lei WANG ; Xiaoqi WU ; Wei GAO ; Hong SUN ; Yuan SHENG ; Yan WU
Chinese Journal of Modern Nursing 2024;30(4):494-499
Objective:To investigate the implementation status of peripherally inserted central catheter (PICC) tip intracardiac electrocardiogram positioning technology in the hospitals, so as to provide reference for promoting the development of intracardiac electrocardiogram positioning technology.Methods:This study was a cross-sectional survey. Using the convenient sampling method, members of Intravenous Infusion Committee of Chinese Nursing Association selected PICC/ intravenous therapy leaders meeting the inclusion criteria from 5 to 10 hospitals in their work area as the research objects from December 2022 to January 2023. The self-made PICC Tip Intracardiac Electrocardiogram Positioning Technology Implementation Status Questionnaire was used to investigate the PICC/intravenous therapy leaders. A total of 205 questionnaires were distributed in 28 provinces/autonomous regions/municipalities directly under the Central Government, and 199 valid questionnaires were collected, with an effective recovery rate of 97.1%. Results:Among 199 hospitals, 63.3% (126/199) of them successfully implemented PICC tip intracardiac electrocardiogram positioning technology. Among the 126 hospitals that implemented PICC tip intracardiac electrocardiogram positioning technology, only 20 hospitals included it in their charging items. A total of 50.3% (100/199) of hospitals established a unified intracardiac electrocardiogram guided PICC catheterization procedure; 47.7% (95/199) of hospitals organized/participated in training programs on PICC tip intracardiac electrocardiogram positioning technology, and 57.3% (114/199) of hospital PICC/intravenous therapy leaders participated in training programs related to PICC tip intracardiac electrocardiogram positioning technology. In terms of the relevant achievements of 199 research hospitals, 56 papers, seven utility model patents and 28 awards were issued.Conclusions:The application, training and achievement output of PICC tip intracardiac electrocardiogram positioning technology need to be further improved. It is suggested to sink high-quality resources, formulate implementation procedures and evaluation standards, standardize nursing service project management, increase training efforts, and improve scientific research thinking of intravenous therapy nurses, so as to promote the standardization development of new technologies.
5.Training needs of subcutaneous tunnel technique for peripherally inserted central catheter specialist nurses in Shandong Province
Jing SHI ; Cui LIU ; Xiaoqi WU ; Wei GAO ; Yuan SHENG
Chinese Journal of Modern Nursing 2024;30(17):2252-2256
Objective:To explore the training needs of peripherally inserted central catheter (PICC) specialist nurses in Shandong Province for subcutaneous tunnel technique, so as to provide reference for conducting systematic and standardized training.Methods:This study was a cross-sectional survey. From October to December 2022, convenience sampling was used to select 922 PICC specialist nurses in Shandong Province as the research subject. A self-made questionnaire was used to investigate the training needs of PICC specialist nurses for subcutaneous tunnel technique.Results:A total of 922 questionnaires were distributed, and 922 valid questionnaires were collected, with an effective response rate of 100.00%. 22.78% (210/922) of PICC specialist nurses used subcutaneous tunnel technique. In terms of training willingness, 92.08% (849/922) of PICC specialist nurses had a training need for subcutaneous tunnel technique. In terms of training content needs, the total score of PICC specialist nurses for subcutaneous tunnel technique training content needs was (62.26±11.06), and the average score for each item was >4.15, and the highest scoring item was the sharing of special cases in tunnel PICC (4.60±0.77), and the lowest scoring item was PICC maintenance knowledge (4.15±1.15) .Conclusions:The application rate of subcutaneous tunnel technique is low, and PICC specialist nurses have a high training need. Managers should increase training efforts for this technique, improve training content, innovate training models, develop targeted training programs, so as to promote the application and promotion of this technique.
6.Systematic review of thrombosis risk prediction models related to peripherally inserted central catheter in adults
Xiaoqi WU ; Lihong YANG ; Zhijie AN ; Jing SHI ; Yuan SHENG ; Wei GAO
Chinese Journal of Modern Nursing 2024;30(17):2263-2272
Objective:To systematically review thrombosis risk prediction models associated with peripherally inserted central venous catheter (PICC) in adults and provide a basis for the clinical application of these models and the development of subsequent models.Methods:Databases such as CNKI, Wanfang, VIP, PubMed, CINAHL, Web of Science, and Ovid were searched to collect studies on thrombosis risk prediction models related to adult PICC, covering all entries from the inception of the databases until December 31, 2022. Two researchers independently screened the literature, extracted data, and assessed the risk of bias.Results:Nineteen studies were included. D-dimer was the most common predictive factor; only five studies underwent external validation, and six studies evaluated model calibration. All included studies exhibited high risk of bias, primarily due to methodological deficiencies in model development and validation processes; the combined area under the receiver operating characteristic curve for nine models was 0.80 (95% Confidence Interval: 0.75-0.85) .Conclusions:Research on thrombosis risk prediction models related to adult PICC is still in its developmental stage. Most of the known models perform well with comprehensive and easily obtainable predictive factors, yet they exhibit methodological shortcomings. Future research should focus on improving the methodological quality and external validation during model development and validation processes.
7.Colorectal polyp segmentation method based on fusion of transformer and cross-level phase awareness.
Liming LIANG ; Anjun HE ; Chenkun ZHU ; Xiaoqi SHENG
Journal of Biomedical Engineering 2023;40(2):234-243
In order to address the issues of spatial induction bias and lack of effective representation of global contextual information in colon polyp image segmentation, which lead to the loss of edge details and mis-segmentation of lesion areas, a colon polyp segmentation method that combines Transformer and cross-level phase-awareness is proposed. The method started from the perspective of global feature transformation, and used a hierarchical Transformer encoder to extract semantic information and spatial details of lesion areas layer by layer. Secondly, a phase-aware fusion module (PAFM) was designed to capture cross-level interaction information and effectively aggregate multi-scale contextual information. Thirdly, a position oriented functional module (POF) was designed to effectively integrate global and local feature information, fill in semantic gaps, and suppress background noise. Fourthly, a residual axis reverse attention module (RA-IA) was used to improve the network's ability to recognize edge pixels. The proposed method was experimentally tested on public datasets CVC-ClinicDB, Kvasir, CVC-ColonDB, and EITS, with Dice similarity coefficients of 94.04%, 92.04%, 80.78%, and 76.80%, respectively, and mean intersection over union of 89.31%, 86.81%, 73.55%, and 69.10%, respectively. The simulation experimental results show that the proposed method can effectively segment colon polyp images, providing a new window for the diagnosis of colon polyps.
Humans
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Colonic Polyps/diagnostic imaging*
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Computer Simulation
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Electric Power Supplies
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Semantics
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Image Processing, Computer-Assisted
8.Guidelines for Ethical Review Entrustment Contract of Life Science and Medical Research Involving Humans
Aijuan SHENG ; Meixia WANG ; Qiang LIU ; Zhongguang YU ; Hu CHEN ; Hui JIANG ; Jiyin ZHOU ; Xiaoqi WANG ; Haibin YU ; Mingjie ZI ; Yifeng JIANG ; Lei XU ; Tao SHI ; Guizhen SUN ; Dongxiang ZHENG
Chinese Medical Ethics 2023;36(5):492-498
The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.
9.Practice status and development of PICC in China
Xiaoqi WU ; Wei GAO ; Yuan SHENG ; Jing SHI
Chinese Journal of Modern Nursing 2023;29(5):566-572
In recent years, peripherally inserted central catheter (PICC) plays an important role in tumor chemotherapy, parenteral nutrition, long-term intravenous infusion, and is an indispensable lifeline for critically ill patients and cancer patients. This article reviews the application of new tool technology in PICC catheterization, the management of PICC catheter-associated complications, the training status and development prospects of PICC specialist nurses, and discusses the current practice status and research prospects of PICC technology in China, with a view to providing a reference basis for promoting the development of PICC technology in China.
10.Segmentation of retinal vessels by fusing contour information and conditional generative adversarial.
Liming LIANG ; Zhimin LAN ; Xiaoqi SHENG ; Zhaoben XIE ; Wanrong LIU
Journal of Biomedical Engineering 2021;38(2):276-285
The existing retinal vessels segmentation algorithms have various problems that the end of main vessels are easy to break, and the central macula and the optic disc boundary are likely to be mistakenly segmented. To solve the above problems, a novel retinal vessels segmentation algorithm is proposed in this paper. The algorithm merged together vessels contour information and conditional generative adversarial nets. Firstly, non-uniform light removal and principal component analysis were used to process the fundus images. Therefore, it enhanced the contrast between the blood vessels and the background, and obtained the single-scale gray images with rich feature information. Secondly, the dense blocks integrated with the deep separable convolution with offset and squeeze-and-exception (SE) block were applied to the encoder and decoder to alleviate the gradient disappearance or explosion. Simultaneously, the network focused on the feature information of the learning target. Thirdly, the contour loss function was added to improve the identification ability of the blood vessels information and contour information of the network. Finally, experiments were carried out on the DRIVE and STARE datasets respectively. The value of area under the receiver operating characteristic reached 0.982 5 and 0.987 4, respectively, and the accuracy reached 0.967 7 and 0.975 6, respectively. Experimental results show that the algorithm can accurately distinguish contours and blood vessels, and reduce blood vessel rupture. The algorithm has certain application value in the diagnosis of clinical ophthalmic diseases.
Algorithms
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Fundus Oculi
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Optic Disk
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ROC Curve
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Retinal Vessels/diagnostic imaging*

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