Objective To investigate the assembl ing and cl inical appl ication of the video output system util izing teaching sight glass of surgical microscope. Methods Between June 2009 and April 2010, 10 patients with craniocervical junction malformation were treated by the method of transoral-transpharyngeal approach with the microscope and videooutput system under the direct vision. There were 6 males and 4 females with an average age of 32 years (range, 13-52 years). Three cases had the history of injury and 7 cases had no history of definite injury. The disease duration was from 10 months to 12 years (median, 5 years). The main cl inical symptoms were brevicoll is or torticoll is; 2 patients had malformation appearance and 4 patients had occi put-cervical pain. The physical examination showed that all patients had the symptoms that upper cervical cord was damaged; the imaging examination showed that all patients had basilar invagination, atlantoaxial dislocation, and ossification. Before and after operations, the functions of nerve were evaluated by Japanese Orthopaedic Association (JOA) scoring, the improvement rate was calculated to evaluate the efficacy. Results By the video output system assembly, 15.1 mill ion pixels high-definition images could be collected and reached 1 920 × 1 080 pixels video camera, so assistants or medical students could watch the cl inical operation directly. All patients had no neural injury or cerebrospinal fluid leakage during operation. Basilar invagination and atlantoaxial dislocation were corrected. Infection at incision occurred in 1 patient; other incisions healed by first intention without early compl ication. All patients were followed up 6-16 months (mean, 13.5 months). The average JOA score was increased from 10.2 preoperatively to 15.5 at 6 months postoperatively with an improvement rate of 77.9%. At 12 months after operation, bony fusions were achieved. Conclusion The miscroscope and video output system can improve the effectiveness of the original surgical microscope. It makes visual fields much clearer and operations more accuratewith a few compl ications.
The gait acquisition system can be used for gait analysis. The traditional wearable gait acquisition system will lead to large errors in gait parameters due to different wearing positions of sensors. The gait acquisition system based on marker method is expensive and needs to be used by combining with the force measurement system under the guidance of rehabilitation doctors. Due to the complex operation, it is inconvenient for clinical application. In this paper, a gait signal acquisition system that combines foot pressure detection and Azure Kinect system is designed. Fifteen subjects are organized to participate in gait test, and relevant data are collected. The calculation method of gait spatiotemporal parameters and joint angle parameters is proposed, and the consistency analysis and error analysis of the gait parameters of proposed system and camera marking method are carried out. The results show that the parameters obtained by the two systems have good consistency (Pearson correlation coefficient r ≥ 0.9, P < 0.05) and have small error (root mean square error of gait parameters is less than 0.1, root mean square error of joint angle parameters is less than 6). In conclusion, the gait acquisition system and its parameter extraction method proposed in this paper can provide reliable data acquisition results as a theoretical basis for gait feature analysis in clinical medicine.
The growing rate of public health problem for increasing number of people afflicted with poor sleep quality suggests the importance of developing portable sleep electroencephalogram (EEG) monitoring systems. The system could record the overnight EEG signal, classify sleep stages automatically, and grade the sleep quality. We in our laboratory collected the signals in an easy way using a single channel with three electrodes which were placed in frontal position in case of the electrode drop-off during sleep. For a test, either silver disc electrodes or disposable medical electrocardiographic electrodes were used. Sleep EEG recorded by the two types of electrodes was compared to each other so as to find out which type was more suitable. Two algorithms were used for sleep EEG processing, i.e. amplitude-integrated EEG (aEEG) algorithm and sample entropy algorithm. Results showed that both algorithms could perform sleep stage classification and quality evaluation automatically. The present designed system could be used to monitor overnight sleep and provide quantitative evaluation.
Abdominal imaging is one of the important clinical applications of magnetic resonance imagining, but image degradation due to respiratory motion remains a major problem. Retrospective respiratory navigator gating technique is an effective approach to alleviate such degradation but is subject to long scan time and low signal-to-noise ratio (SNR) efficiency. In this study, a modified retrospective navigator gating technique with variable over-sampling ratio acquisition and weighted average reconstruction algorithm is presented. Experiments in phantom and the imaging results of seven volunteers demonstrated that the proposed method provided an enhanced SNR and reduced ghost-to-image ratio compared to the conventional method. The proposed method can also be used to reduce imaging time while maintaining comparable image quality.
The intensive care unit (ICU) is a highly equipment-intensive area with a wide variety of medical devices, and the accuracy and timeliness of medical equipment data collection are highly demanded. The integration of the Internet of Things (IoT) into ICU medical devices is of great significance for enhancing the quality of medical care and nursing, as well as for the advancement of digital and intelligent ICUs. This study focuses on the construction of the IOT for ICU medical devices and proposes innovative solutions, including the overall architecture design, devices connection, data collection, data standardization, platform construction and application implementation. The overall architecture was designed according to the perception layer, network layer, platform layer and application layer; three modes of device connection and data acquisition were proposed; data standardization based on Integrating the Healthcare Enterprise-Patient Care Device (IHE-PCD) was proposed. This study was practically verified in the Chinese People’s Liberation Army General Hospital, a total of 122 devices in four ICU wards were connected to the IoT, storing 21.76 billion data items, with a data volume of 12.5 TB, which solved the problem of difficult systematic medical equipment data collection and data integration in ICUs. The remarkable results achieved proved the feasibility and reliability of this study. The research results of this paper provide a solution reference for the construction of hospital ICU IoT, offer more abundant data for medical big data analysis research, which can support the improvement of ICU medical services and promote the development of ICU to digitalization and intelligence.
In order to investigate the effect of deep brain stimulation on diseases such as epilepsy, we developed a closed-loop electrical stimulation system using LabVIEW virtual instrument environment and NI data acquisition card. The system was used to detect electrical signals of epileptic seizures automatically and to generate electrical stimuli. We designed a novel automatic detection algorithm of epileptic seizures by combining three features of field potentials: the amplitude, slope and coastline index. Experimental results of rat epileptic model in the hippocampal region showed that the system was able to detect epileptic seizures with an accuracy rate 91.3% and false rate 8.0%. Furthermore, the on-line high frequency electrical stimuli showed a suppression effect on seizures. In addition, the system was adaptive and flexible with multiple work modes, such as automatic and manual modes. Moreover, the simple time-domain algorithm of seizure detection guaranteed the real-time feature of the system and provided an easy-to-use equipment for the experiment researches of epilepsy control by electrical stimulation.
目的:探讨蛋白酶体抑制剂——硼替佐米对初治多发性骨髓瘤的疗效及对移植造血干细胞采集的影响。方法:对一例初发的中年男性多发性骨髓瘤患者使用硼替佐米+地塞米松+反应停(VTD)的方案进行化疗,获得缓解后采集外周血造血干细胞。结果:应用以硼替佐米为基础的方案治疗3个疗程后,患者即获得完全缓解;完成4个疗程化疗后成功采集足够数量的外周血造血干细胞;完成6个疗程化疗后,进入维持治疗,至今已完全缓解17个月。治疗过程中除恶心、呕吐外无其他明显不良反应。结论:硼替佐米用于初治多发性骨髓瘤有良好的治疗效果,不良反应少,不影响造血干细胞采集。
Objective To explore the application value of standardized patient (SP)-based teaching method in the teaching of medical history taking for international students. Methods During the autumn semester of 2017, 96 international medical students were randomly divided into two groups, with 48 students in the SP-based teaching group and 48 students in the conventional teaching group. The test scores of medical history taking in English in internal medical practice of the two groups were compared. The teaching feedback from the international students was collected and evaluated by online questionnaire survey. Results The scores of medical history taking examination in internal medical practice of the students using SP-based teaching method were higher than those of the students using conventional teaching method (86.5±9.7 vs.78.2±10.6), and the difference was statistically significant (t=3.983, P<0.001). According to the questionnaire analysis, in terms of whether the current teaching method could enhance learning interest, improve communication ability, promote clinical skills, train clinical thinking, and highlight humanistic care, students with positive views in the SP-based teaching group accounted for 92.86%, 97.62%, 85.71%, 90.48%, and 95.24%, respectively, while students with positive views in the conventional teaching group accounted for 90.00%, 87.50%, 82.50%, 77.50%, and 97.50%, respectively, and the differences were not statistically significant (P>0.05). Conclusions Well-trained SP has a good application value in clinical practice of internal medicine and diagnostics teaching for international students. SP-based teaching method has been accepted and supported by the majority of international medical students who have experienced it.