人体胸廓胸外按压的生物力学测试

目的:探讨胸外按压时胸廓受力变形的机制,为胸外按压效果的研究提供生物力学理论依据.方法:选择1例男性新鲜尸体标本,实验前摄片以排除胸廓原有疾病的存在.标本胸部双排螺旋CT扫描后,通过MTS材料试验机,采用0-200N的已知重力,测试垂直加压情况下人体胸廓的位移.结果:在模拟受压的情况下,载荷力由0-200N变化时,随着载荷的增加,胸廓各测量点的位移随之增加;载荷力相同时,不同测量点的位移不同;相同按压点的动态位移小于静态位移.结论:人体胸廓在静态加压与动态加压时的载荷-位移关系的测试,为我们了解人体胸廓在外力作用下的应力特点,以及将胸外按压时下压力度的最化、提高胸外按压的临床效果提供了重要的参考数据.     

有效不间断胸外按压在心肺复苏应用护理体会

目的根据国际最新颁布的《国际心肺复苏指南》中表述的有关心肺复苏护理流程,即CPR。根据对60例患者进行的心肺复苏实例,探讨不间断胸外按压方法对护理的推动作用。方法依据最新版CPR作为指导,在实际的护理过程中,增加连续按压时间,并用于我院60例心跳骤停的患者,将这些患者平均分为观察组和对照组例组,每组30例,总结并统计CPR中每一个步骤,例如：增加连续按压、减少中断按压、患者恢复效果、在24h内患者心肺的复苏率和护理成功率等指标。结果在针对观察组进行新版CPR护理时,与对照组相比,患者的恢复程度和心肺复苏率都有较大提升。结论将护理过程中的中断心肺按压时间降低,配合医护人员的护理,能够较大程度提高心肺复苏率,在临床护理上意义重大。     

基于加速度二次积分的胸外按压深度测量

目的探索一种能够应用于人工和自动胸外按压训练以及急救中实时精确测量按压深度的技术,以改善当前胸外按压无效或者过深的普遍现象。方法本文提出了一种基于加速度二次积分的胸外按压深度测量技术,集成加速度测量模块、压力最值检测模块以及加速度数值积分处理算法,采用基于压力最值检测的加速度二次积分算法,通过对压力最小值与最大值之间采样的加速度数值进行二次积分获取位移。结果通过模拟实施胸外按压实验测试,并与NI公司DAQ采集数据对比分析,上述方法测量误差在5mm内。结论加速度二次积分算法能够有效解决胸外按压深度测量难题,在心肺复苏训练和急救中具有较好的应用价值。     

单纯胸外心脏按压成功抢救心跳呼吸骤停1例

心跳呼吸骤停是指心脏因一过性急性原因突然丧失有效的排血功能而致循环和呼吸停顿的临床死亡状态,是最危重的急症之一,若抢救不及时死亡率极高。2010年5月收治1例心跳呼吸骤停的患者,本例患者因院前得到了及时有效的心脏按压,抢救成功且无任何后遗症,现报告如下。     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救,该机电脑自动控制,当病人心脏骤停时,可自动进行按压抢救,并可呼救。经多年临床应用证明,该机是一种非常有效的抢救设备,在1991年河北省科委、卫生厅和省医药总公司组织的鉴定会上,受到一致的肯定和好评,在国内外居领先水平。该设备准备进一步研究推广,欲合作者可与现代电生理学杂志编辑部联系。     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救,该机电脑自动控制,当病人心脏骤停时,可自动进行按压抢救,并可呼救。经多年临床应用证明,该机是一种非常有效的抢救设备,在1991年河北省科委、     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救,该机电脑自动控制,当病人心脏骤停时,可自动进行按压抢救,并可呼救。经多年临床应用证明,该机是一种非常有效的抢救设备,     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救。经多年临床应用证明,该机是一种非常有效的抢救设备,在1991年河北省科委、卫生厅和省医药总公司组织的鉴定会上,受到一致的肯定和好评,在国内外居领先水平。该设备准备进一步研究推广,欲合作者可与现代电生理学杂志编辑部联系。     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救。经多年临床应用证明,该机是一种非常有效的抢救设备,在1991年河北省科委、卫生厅和省医药总公司组织的鉴定会上,受到一致的肯定和好评,在国内外居领先水平。     

电脑自动控制电动胸外心脏按压机简介

该机是由河北医科大学第四医院、河北省电子技术研究所协作研制的一种新型的心肺脑复苏设备,可广泛应用于各类心脏骤停病人的抢救。经多年临床应用证明,该机是一种非常有效的抢救设备,在1991年河北省科委、卫生厅和省医药总公司组织的鉴定会上,受到一致的肯定和好评,在国内外居领先水平。该设备准备进一步研究推广,欲合作者可与现代电生理学杂志编辑部联系。     

A Technique for Simulating the Effect of Dose Reduction on Image Quality in Digital Chest Radiography

Purpose: The purpose of this study is to provide a pragmatic tool for studying the relationship between dose and image quality in clinical chest images. To achieve this, we developed a technique for simulating the effect of dose reduction on image quality of digital chest images. Materials and Methods: The technique was developed for a digital charge-coupled-device (CCD) chest unit with slot-scan acquisition. Raw pixel values were scaled to a lower dose level, and a random number representing noise to each specific pixel value was added. After adding noise, raw images were post processed in the standard way. Validation was performed by comparing pixel standard deviation, as a measure of noise, in simulated images with images acquired at actual lower doses. To achieve this, a uniform test object and an anthropomorphic phantom were used. Additionally, noise power spectra of simulated and actual images were compared. Also, detectability of simulated lesions was investigated using a model observer. Results: The mean difference in noise values between simulated and real lower-dose phantom images was smaller than 5% for relevant clinical settings. Noise power spectra appeared to be comparable on average but simulated images showed slightly higher noise levels for higher spatial frequencies and slightly lower noise levels for lower spatial frequencies. Comparable detection performance was shown in simulated and actual images with slightly worse detectability for simulated lower dose images. Conclusion: We have developed and validated a method for simulating dose reduction. Our method seems an acceptable pragmatic tool for studying the relationship between dose and image quality.     

腹腔镜手术机器人应用质量与安全评价标准体系研究

腹腔镜手术机器人能提高操作精度,缩短手术用时,患者出血少,恢复速度快。近年来,国产创新手术机器人的研发取得了显著成果,但目前国内外缺乏相关评价标准,增加了临床应用的风险。为科学评价腹腔镜手术机器人的应用质量与安全,急需研究建立质量检测与评价标准。该研究从控制系统、图像质量、机械精度、电气安全4个维度优选评价指标。在控制系统方面选取软件功能检测规范指标;在图像质量方面选取图像质量检测规范指标;在机械精度方面选取机械臂检测规范指标;在电气安全方面选取设备外观检测规范和产品故障预防与维护控制规范两个指标。通过验证试验研究合理可行的检测与评价方法,为腹腔镜手术机器人的应用质量与安全评价提供依据,填补国内外腹腔镜手术机器人相关标准方面的空白。     

人工智能辅助胸部低剂量 CT 在肺部结节良、恶性诊断中的准确率研究

目的? 探讨人工智能辅助胸部低剂量 CT 在肺部结节良、恶性诊断中的应用。方法? 选取 2020 年 3 月至 2021 年 7 月在新乡同盟医院行胸部低剂量 CT 检查患者 83 例,根据阅片方式不同分为人工阅片组和人工智能辅助阅片组,观察两组肺部结节的诊断结果。结果? 人工智能辅助阅片诊断肺部结节的阳性率为 86.75%,高于人工阅片的阳性率 68.67%,差异具有统计学意义（x 2 =6.549,P=0.013）;Kappa 检验两种阅片方式的一致性较弱（Kappa 值 = 0.196）,P ＞ 0.05;人工智能辅助阅片对3～7mm直径肺部结节的检出率为93.44%,明显高于人工阅片的检出率85.25%,差异具有统计学意义（P＜0.05）,而两种阅片方式对 0～3mm、7～20mm 直径肺部结节的检出率差异无统计学意义（P ＞ 0.05）;以病理结果为“金标准”绘制 ROC 曲线,结果显示,人工阅片、人工智能辅助阅片诊断恶性肺部结节的 AUC 分别为 0.742（95%CI：0.514,0.921）、0.830（95%CI：0.701,1.00）,且两种阅片方式的特异度、灵敏度、阳性预测值、阴性预测值差异均无统计学意义（P ＞ 0.05）。结论? 人工智能辅助胸部低剂量 CT 能提高肺部结节良、恶性诊断的准确率,并能提高 3～7mm 直径肺部结节的检出率,但与人工阅片对肺部结节诊断的特异度、灵敏度、阳性预测值、阴性预测值基本一致。     

吻合器作用下小肠组织细胞内外液变化研究

明确胃肠组织在吻合器作用下的内部变化情况是吻合器工程参数优化的前提。改造直线型吻合器,嵌入检测电极;测量猪小肠在吻合器压榨作用下的多频生物阻抗,使用Cole_Y模型对测量结果拟合,模型参数G₀、ΔG表征细胞外液、内液电导;改变垫片厚度,得到不同压榨强度下G₀和ΔG的变化曲线。压榨过程分为两个阶段:第1个阶段,两个参数都迅速下降;第2个阶段,随着压榨强度的增加,G₀始终保持减小趋势,ΔG由轻微波动变为轻微下降;当垫片厚度从0 mm增加至0.52 mm,ΔG和承受压强之间具有显著极相关性的样本数占总样本数的比例从40%上升至100%,而对于G₀,这个比例始终为100%。结果表明:小肠在吻合器作用下,有部分组织被挤压出测量空间,引起参数迅速下降;而后,吻合器持续压榨组织,细胞外液持续排出,细胞内液在不同压榨强度下表现出不同趋势,可能和细胞的受压形变有关。该研究可为吻合器参数优化提供条件。     

Heart rate variability spectra based on non-equidistant sampling: the spectrum of counts and the instantaneous heart rate spectrum

This paper compares two methods to estimate heart rate variability spectra, i.e., the spectrum of counts and the instantaneous heart rate spectrum. Contrary to Fourier techniques based on equidistant sampling of the interbeat intervals, the spectrum of counts and the instantaneous heart rate spectrum are based on non-equidistant sampling: the values are determined at R-wave moments. A consequence of the non-equidistant occurrence of the R-peaks in a heart rate signal is the appearance of the sidebands of the harmonic components of the mean heart rate in the spectra. These sidebands contaminate the signal components in the spectrum. The sideband distortion in the instantaneous heart rate spectrum was found to be smaller than in the spectrum of counts. Simulations using the IPFM-model were made to quantify this difference. On the basis of these simulations, sideband distortion appeared to be dependent on the mean heart rate, the modulation depth and the modulation frequency.     

Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: Approach,results, and success factors

ObjectiveThe article describes the methodological approach to, and results of an evaluation of a comprehensive electronic health record (EHR) in the shake down phase, shortly after its implementation at a regional hospital in Denmark.DesignA formative evaluation based on a mixed-methods case study, designed to be interactive and concurrent was conducted at two hospital departments based on the updated DeLone and McLean framework for evaluating information systems success.MethodsTo ascertain user assessments of the EHR, we distributed a questionnaire two months after implementation to four groups of staff (physicians, nurses, medical secretaries, and physiotherapists; n = 244), and at the same time we conducted thirteen individual, semi-structured interviews with representatives from these four groups. Subsequently, seven follow-up focus group interviews were conducted with the four above-mentioned groups, in order to go deeper into specific user assessments. Simultaneously, focus group interviews with two IT departments and the implementation team were conducted, to gain insight into system provider assessments of the implementation process and the EHR. Before, during, and after implementation, 88 h of ethnographic observation were carried out, to give the researchers an understanding of the daily routine of staff, and their use of health records. Finally, daily system performance data were obtained, to gather factual information on system response and downtime.ResultsOverall, staff had positive experiences with the EHR and its operational reliability, response time, login and support. Performance was acceptable. Medical secretaries found the use of the patient administration module cumbersome, and physicians found the establishment of the overview of professionally relevant data challenging. There were demands for improvements to these and other functionalities, and for the EHR to be integrated with other systems and databases.LimitationsEvaluations immediately following implementation are inherently difficult, but was required because a key role was to inform decision-making upon enrollment at other hospitals and systematically identify barriers in this respect. The strength of the evaluation is the mixed-methods approach. Further, the evaluation was based on assessments from staff in two departments that comprise around 50% of hospital staff. A weakness may be that staff assessment plays a major role in interviews and survey. These though are supplemented by performance data and observation. Also, the evaluation primarily reports upon the dimension ‘user satisfaction’, since use of the EHR is mandatory. Finally, generalizability may be low, since the evaluation was not based on a validated survey. All in all, however, the evaluation proposes an evaluation design in constrained circumstances.ConclusionsDespite inherent limitations, evaluation of a comprehensive EHR shortly after implementation may be necessary, can be conducted, and may inform political decision making. The updated DeLone and McLean framework was constructive in the overall design of the evaluation of the EHR implementation, and allowed the model to be adapted to the health care domain by being methodological flexible. The mixed-methods case study produced valid and reliable results, and was accepted by staff, system providers, and political decision makers. The successful implementation may be attributed to the configurability of the EHR and to factors such as an experienced, competent implementation organization at the hospital, upgraded soft- and hardware, and a high degree of user involvement.