Evaluation of combined three-dimensional computed tomography bronchography and angiography with 3D video thoracoscopic surgery in the clinical practice of thoracic surgery / 中华医学教育探索杂志

Objective:To investigate the effects of 3D video thoracoscopic surgery combined with 3D CTBA (three-dimensional computed tomography bronchography and angiography) method in clinical education practice of the undergraduates.Methods:The study included in 60 undergraduate clinical interns from our hospital, and they were randomly divided into the experimental group ( n=30) and control group ( n=30). The teaching content was diagnosis and surgical treatment of lung cancer. The experimental group applied 3D video thoracoscopic surgery combined with 3D CTBA teaching method. The interns studied the anatomy of lung and diagnosis of lung cancer based on the 3DCTBA and visited the operation of lung cancer under 3D thoracoscopy, which enhanced their knowledge of anatomical structure of lung. The control group applied traditional thoracoscopic surgery for lung cancer. Upon termination of clinic practice, all interns were tested with theoretical and clinical knowledge of lung cancer. A questionnaire survey was conducted among them to access the teaching effect. SPSS 18.0 was used for t test and chi-square test. Results:The scores of theory test were not significantly different between two groups. The scores of anatomic and operational knowledge of lung in the experimental group were significantly higher compared with the control group ( P<0.05). Questionnaire result showed that new teaching method could promote the interest in learning, motivated the desire for thoracic surgery, and improved the comprehension of clinical knowledge. More students approved the new teaching method. Conclusion:The new method, 3D video thoracoscopic surgery combined with 3D CTBA, has beneficial effect on clinical interns, which contributes to inspire the motivation and interest of learning and deepen clinic knowledge, and is a promising teaching method worthy of further exploration and application.

Research on Reliability Index and Realization of Magnetic Resonance (MR) Based on Clinical Use Condition / 中国医疗器械杂志

Combined with the clinical use condition of MR in use in Shanghai Sixth People's Hospital, MR components are divided into scanning type I and scanning type II. At the same time, combined with the main loss force of MR components, the research divides MR components into dynamic components and electric thermal components. In this study, a complete set of MR system reliability indexes and implementation methods are given, including system reliability index determination, system reliability allocation, component reliability index realization, system reliability prediction and system reliability verification. At the same time, this study also gives the methods of reliability prediction and reliability verification, and gives the MTBF calculation method of MR system based on clinical use data statistics.

Research on Reliability Design and Verification of CT Based on Clinical Application Data / 中国医疗器械杂志

Based on the clinical application data of medical X-ray computed tomography (CT) in the Shanghai Sixth People's Hospital, this study transformed it into the product reliability index requirements, and took the mechanical representative component-examination table (hereinafter referred to as "patient table") and the electronic representative component-DCB (data control board) as examples. Based on the relationship between failure characteristics and clinical application data, a complete set of closed-loop implementation methods from reliability index requirements to reliability design and verification are discussed.

Study on PET/CT Service Life Based on Key Components / 中国医疗器械杂志

In this study, through the analysis of the composition of domestic large radioactive medical equipment PET/CT and the characteristics of each subsystem, combing the vulnerable spots, according to the standard requirements of PET/CT for 10 years in its service life, we research the PET/CT service life's effectiveness. Firstly, this study introduces the concept of service life, the relationship between service life and risk analysis, the pivotal system composition of PET/CT, the importance of reliability of each component, the traditional test method to verify its reliability is researched. This study suggests a test procedure and method to prove the reliability of various components of PET/CT equipment during the service life. This method is described in detail, and the specific test process in practical engineering application is discussed, which proves that it is beneficial to ensure the effectiveness of PET/CT during the service life.

Comparison Study between the Second and First Editions of ISO/ TS 10974-Assessment of the Safety of Magnetic Resonance Imaging for Patients with an Active Implantable Medical Device / 中国医疗器械杂志

ISO/TS 10974 is a general international technical specification (TS) which concentrates on the safety assessment of magnetic resonance imaging (MRI) for active implantable medical devices. ISO/TS 10974 Ed.2 was published in 2018 with substantial revision to Ed.1. To provide a guideline for adopting this recently revised TS in practice, this paper summarized the major changes and analyzed the technical improvements in Ed.2. Moreover, we also discussed current and emerging challenges to MRI safety evaluation remaining in Ed.2. The study revealed the consistency between these two editions with respect to classification of potential patient hazards and testing strategies, whereas Ed.2 has many methodological improvements over Ed.1 in testing methods for RF-induced heating, gradient-induced malfunction, and combined field testing, etc. However, it is still necessary to expand the scope of applicability and to adopt latest research findings into this TS to keep pace with the rapid developments in industry, making it a better guidance in the future.

Research on Mathematical Distribution of Failure Time and Engineering Evaluation for Medical Electrical Equipment Based on Operation and Maintenance Data / 中国医疗器械杂志

This study mainly discusses the contents, methods and characteristics of the collection of operation and maintenance data, as well as the establishment and evaluation methods of the distribution model of the failure time of medical electrical equipment. The distribution models of failure time at three levels of medical electrical equipment are established by linear regression method and goodness of fit test:The first is the device level MTBF distribution model, the second is the failure rate distribution model of the failure mode of key components, the third is the calculation model of the influence coefficient of influence factor on the failure mode of key components. This study presents a method of establishing MTBF segment model and implements a calculation model of influence coefficient varying with time.

Study on Electromagnetic Interference Risk of Active Implantable Medical Devices in Multiple Unit Environment / 中国医疗器械杂志

Concerning on the safety risks caused by electromagnetic interference of patients implanted with high-risk active implantable medical devices in the environment of domestic MUs, this study evaluates and focuses on the requirements of electromagnetic compatibility in domestic and international standards for rail transit vehicles, the main mechanism of risks caused by EMI, the actual measurement of environmental data in MUs and the working performance of various active implantables in the compartment. The test results shows that all kinds of active implantable medical device samples works normally in the CRH2A EMU in China, and there is still a large margin between the measured radiation emission in MU and the limit required by the standards.

Simulation Study on Radiated Immunity Test of Active Implantable Medical Device / 中国医疗器械杂志

In the electromagnetic compatibility standards of active implantable medical devices such as ISO 14117,radiated immunity test above 450 MHz frequency is recommended to be carried out in the electromagnetic shielding room.However,different test locations and the shape/size of the shielding room may lead to very different electromagnetic field distribution in the radiation exposure area of the sample,thus affecting the consistency of the test.With the model built by COMSOL software,this paper analyzes the impact of different parameters,such as size of the room and position of torso simulator on the distribution of field intensity,and reaches results about the distribution of field intensity on the torso simulator area under tow sizes of shielding rooms and two typical test positions.The results show that the experimental consistency of the electric field intensity on the surface directly below the center of the antenna is not good enough,which may affect the repeatability of the test.

Exploration of Domestic Medical Electrical Equipment Reliability Promotion Method / 中国医疗器械杂志

The reliability of domestic medical equipment is one of the main factors that restrict the competitiveness of domestic medical devices. It is also an important factor that endangers the safety of patients and a blind spot in safety risk management. By analyzing the core elements of reliability and the situation of domestic medical device industry, this paper sorts out and analyzes the problems existing in the reliability of medical device industry, and puts forward the key points and problems to be solved to improve the reliability of domestic medical equipment products.

Improvement and evaluation of the rat model of myocardial ischemia reperfusion injury / 中国实验动物学报

Objective To improve the preparation method of rat model of acute myocardial ischemia reperfusion injury(MI/RI), to make a comprehensive evaluation and to lay a good model foundation for following MI/RI research. Methods Thirty-six clean grade Wistar rats were randomly divided into 3 groups: normal group without intervention of the left anterior descending coronary artery (LAD), sham operation group with only wearing thread but no ligation of the coronary artery, and ischemia reperfusion group, with ligation of the LAD for 30 min and reperfusion for 120 min. Rats after anesthesia had continuous ECG recording, and tracheostomy for mechanical auxiliary ventilation. Thoracotomy and LAD intervention were carried out on the rats, and then the rat models were comprehensively evaluated by electrocardiography, detection of myocardial enzyme content, determination of the infarct size, and pathological examination of the myocardium. Results The electrocardiogram of the MI/RI group showed obvious ST-T dynamic changes. The level of CK-MB in the MI/RI group was significantly increased at 2 h after surgery. Compared with the sham group, the infarct size of the MI/RI group was significantly increased, with evident degeneration and necrosis of cardiomyocytes and extensive inflammatory cell infiltration in the myocardium. Conclusions The improved modeling method not only reduced the difficulties of operation, but has also successfully established the rat model of MI/RI, providing a good foundation for further MI/RI research.

Research on Field Strength of Radiated Immunity Test for Active Implantable Medical Devices / 中国医疗器械杂志

In order to compare the radiation immunity test level of ISO 14708 series standards and the domestic and international environmental radiation standards and then to ascertain whether the radiated immunity test level has reached the limit of the radiation strength in the relevant radiation environmental standards, this paper calculated the radiation field intensity and power density according to the radiated immunity test of ISO 14708 standards, and compared with the limit of ICNIRP 1998 and GB 8702-2014.

Analysis of the Electromagnetic Compatibility Standard for Active Implantable Medical Devices Using in the Heart / 中国医疗器械杂志

In this paper,standards for active implantable cardiac medical devices are discussed.Potential EMC risks and its correspondent tests settings as well as the design principle of the tests have been analyzed.The problems arises from the difference between domestic and international standards on the limitation of exposure of the general public to electromagnetic fields and the lack of assessment of EMC risk which generated by the the 5th generation mobile communication for the impact on the active implantable devices devices.

Observation on the clinical effect of tongluozhitong capsule combined with carbamazepine on the treatment of trigeminal neuralgia / 中国生化药物杂志

Objective To observe the clinical effect of tongluozhitong capsule combined with carbamazepine on the treatment of trigeminal neuralgia.Methods94 patients with trigeminal neuralgia from January 2012 to May 2014 in Dongyang people's hospital were randomized double-blindly divided into the control group and the observation group, 47 cases in each group.The control group received carbamazepine treatment, and the observation group received tongluozhitong capsule combined with carbamazepine.VAS score, the effect and adverse reaction were recorded and analyzed before treatment, atwo weeks and four weeks after.Recurrence was followed-up a half and one year after treatment.Results①VAS scores in the observation group 2 weeks and 4 weeks after treatment were (3.78±0.44), (2.01±0.23) points separately, which were lower than those in the control group (5.96±0.53), (4.02±0.38) points separately, and the differences were statistically significant (P<0.05).②The total effective rate in the observation group 4 weeks after treatment was 95.74%, which significantly higher than that in the control group 78.72%, and the difference was statistically significant (P<0.05).③ The adverse reactions in the observation group 4 weeks after treatment was 21.28%, 27.66% in the control group, the difference was not significant;④ The recurrence rate in the observation group six months and one year after treatment were 6.38% and 10.64%, which significantly lower than those in the control group 23.40% and 29.79%, and the differences were statistically significant (P<0.05).ConclusionIt can effectively relieve pain, reduce the recurrence rate, and will not increase the adverse reactions which tongluozhitong capsule combined with carbamazepine were used on the treatment of trigeminal neuralgia.It is a safe and effective treatment program.

Facial nerve decompression in treatment of patients with early peripheral traumatic facial paralysis / 局解手术学杂志

Objective To explore the effect of facial nerve decompression via mastoid-epitypanum approach on the treatment of early peripheral traumatic facial paralysis caused by temporal bone fracture.Methods The data of 21 patients with early peripheral traumatic facial paralysis caused by temporal bone fracture in our hospital from October 2011 to June 2016.The facial nerve electrogram and the blink reflex of the injured facial nerve of 21 patients who treated facial nerve decompression via mastoid-epitypanum approach were compared before and after operation.The degree of facial nerve function recovery was evluated by H-B grading method.Results The facial nerve function of all patients had improved in different degrees,85.7% patients recovered to Ⅰ~Ⅱ level.Compared with those before operation,the latency,amplitude and latent period of blink reflex of the ipsilateral facial electroneurography were significantly improved(P<0.05).Conclusion The facial nerve decompression has good effect in the treatment of early peripheral traumatic facial paralysis.

Impact of Lymphocyte Subsets on Chemotherapy Efficacy and Long-term Survival of Patients with Advanced Non-small-cell Lung Cancer / 中国医学科学院学报

Objective To analyze the impact of lymphocyte subsets on chemotherapy efficacy and long-term survival of patients with advanced non-small cell lung cancer(NSCLC).Methods Totally 125 NSCLC patients who had received first-line chemotherapy including paclitaxel and pemetrexed with/without platinum were enrolled in this study.Lymphocytes from peripheral blood were collected before and after two cycles of first-line chemotherapy.Flow cytometry was performed to determine the expressions of 21 fluorescence-labeled lymphocyte subsets.Based on the imaging findings,chemotherapy efficacy was evaluated,and impact of the lymphocyte subsets on progression-free survival(PFS)and overall survival(OS)were analyzed.Results The baseline peripheral lymphocyte subsets showed no significant difference among groups receiving different treatment protocols(all P>0.05).After 2 cycles of chemotherapy,the percentage of CD4CD29lymphocytes was(16.87±5.28)% in progressive disease group,which was significantly lower than those in complete remission+partial remission group [(22.42±7.88)%,P=0.013] and stable disease group [(21.88±6.81)%,P=0.009].The median PFS was 7.07 months and median OS was 23.00 months.Cox multivariable regression analysis showed that the percentages of HLA-DR(HR:1.03,95%CI:1.01-1.05,P<0.001) and CDHLA-DRlymphocytes (HR:1.05,95%CI:1.01-1.08,P<0.001)were positively correlated with OS.Conclusions The rise of CD4CD29T lymphocytes in patients after chemotherapy indicates good chemotherapy efficacy.Higher percentage of HLA-DRand CD3HLA-DRlymphocytes in peripheral blood before chemotherapy predicts favorable prognosis.

Efficacy Comparison of Highly Agglutinative Staphylococcin Injection at High Dose Combined with Oxaliplatin or Cisplatin with Intraperitoneal Perfusion in the Treatment of Malignant Peritoneal Effusion / 中国药师

Objective:To observe the clinical efficacy and side effects of highly agglutinative staphylococcin injection at high dose combined with oxaliplatin or cisplatin with intraperitoneal perfusion in the treatment of malignant peritoneal effusion. Methods:Totally 60 patients with malignant peritoneal effusion were divided into two groups,32 cases in group A,and 28 cases in group B. Group A was treated with staphylococcin at high dose combined with oxaliplatin with intraperitoneal infusion after peritoneal cavity catheter drainage,and group B was treated with staphylococcin at high dose combined with cisplatin with intraperitoneal infusion after peritoneal cavity catheter drainage. All patients underwent the treatment once a week,and continuous four weeks for a courese. The clinical efficacy and adverse drug reactions were compared between the two groups. Results:The complete response rate of group A was 18. 8% ,and the total effective rate was 90. 7% ,which were both significantly higher than those of group B(P 0. 05). Conclusion:Staphylococcin at high dose combined with oxaliplatin with intraperitoneal perfusion is more effective than staphylococcin at high dose combined with cisplatin. Although abdominal pain in group A is obvious,the patients are able to tolerate with it after the symptomatic treatment,therefore,staphylococcin at high dose combined with oxaliplatin with intraperitoneal perfusion can be used as one of effective methods for the treatment of malignant peritoneal effusion.

Comparison of video laryngoscope, direct laryngoscopy and fibreoptic bronchoscope nasal intubation on hemodynamics, inflammatory and stress response / 中国内镜杂志

Objective To analyze the differences of video laryngoscope, direct laryngoscopy and fibreoptic bron﹣choscope nasal intubation on hemodynamics, inflammatory and stress response. Methods 117 patients underwent surgery from November 2013 to March 2015 were chose as research subjects and randomly divided into video laryn﹣goscope group, direct laryngoscopy group, fiberoptic bronchoscope group based on different cannula enrolled way. Then compared the hemodynamics, inflammation, stress level after intubation among the three groups. Results Com﹣pared with the T0, the three groups patients' systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), C-reactive protein (CRP), interleukin -6 (IL-6), tumor necrosis factor (TNF-α), norepinephrine (NE), plasma cortisol (Cor), angiotensinⅡ(ATⅡ) differences had no significant difference (P>0.05);compared with direct laryn﹣goscopy group, video laryngoscope group, fiberoptic bronchoscope group patients' T1, T2, T3 SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ levels were lower; compared with the video laryngoscope group, optical fiber bron﹣choscopy group patients SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ low levels at T1, T2, T3 were lower (P<0.05). Conclusions Fibreoptic bronchoscope nasal intubation has less influence on patients, will not cause severe stress and inflammatory response, it is one of the ideal instrument anesthesia induction intubation.

Application of nasal continuous positive airway pressure preferential ventilation strategy in the treatment of infant severe pneumonia / 中国医师进修杂志

Objective To investigate the value of nasal continuous positive airway pressure (NCPAP) in the treatment of severe pneumonia. Methods The clinical data of 59 severe pneumonia infants who received NCPAP preferential ventilation strategy were retrospectively analyzed. Results After treatment, 50 infants were effective and 9 infants were ineffective. Before treatment, the age, RR, HR between effective group and ineffective group had no significant differences (P>0.05). But the levels of PaCO2, PaO2/FiO2 in ineffective group were significantly higher than those in effective group and the level of PaO2 in ineffective group was significantly lower than that in effective group (P<0.05). In effective group, the levels of PaO2 and PaO2/FiO2 were significantly increased after treatment for 1, 12 and 24 h, and the levels of PaCO2, RR and HR were significantly decreased (P<0.01). Conclusions NCPAP preferential ventilation strategy can reduce the use of invasive mechanical ventilation, improve oxygenation, ease dyspnea and make vital signs stable.

The diagnostic value of MSCT on diagnosis and prognosis evaluation of abdominal aortic aneurysm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in abdominal aortic aneurysm(AAA).Methods 26 patients suspected AAA and admitted to our hospital were studied and checked by MSCT prospectively.The accuracy and features of MSCT were analyzed. Results 26 patients were diagnosed as AAA by MSCT,in which 17 cases were true AAA,and 9 were false AAA.MSCT for true AAA patients showed fusiform dilatation of abdominal aorta bulging to the left,and showed visible thrombus and calcification in aneurysm wall of residual tumor around the cavity when aneurysm ruptured.MSCT of false AAA showed aortic eccentric enlargement lump,which could be outside the boundaries of vascular calcification.25 cases of AAA were surgically confirmed,and the coincidence rate of MSCT and pathology was as high as 96.1% (25/26).Arterial wall calcification was found in all patients,in which 17 cases had mural thrombus.Conclusion MSCT is a safe,effective and non-invasive diagnostic technology for early detection and treatment of AAA, which may help determine patient’s condition and guide the treatment.

Safety of epidural combined with small-dose intravenous anesthesia during total knee arthroplasty in elderly patients with hypertension / 中国组织工程研究

BACKGROUND:Elderly hypertensive patients often associated with organ and tissue ischemia. Al kinds of risks are easy to appear in the process of undergoing arthroplasty. To ensure the smooth operation and to improve the safety of the surgery treatment, it is needed to choose an appropriate mode of anesthesia. OBJECTIVE:To explore the application security of epidural combined with smal dose of intravenous anesthesia in total knee arthroplasty in elderly hypertensive patients. METHODS:A total of 64 elderly hypertensive patients with arthroplasty in the Third Hospital of Hebei Medical University from December 2013 to December 2014 were selected and were divided into control group (32 cases) and observation group (32 cases). They were given total intravenous anesthesia and epidural block combined with smal dose of intravenous anesthesia. Systolic blood pressure, diastolic blood pressure, heart rate, blood oxygen saturation and changes in respiratory rate were detected before anesthesia, after anesthesia induction, 10 minutes after anesthesia, 10 minutes after use of bone cement, and at the end of arthroplasty in both groups. The usage of vasoactive drugs (including ephedrine and dopamine) during arthroplasty and adverse events after arthroplasty were recorded. RESULTS AND CONCLUSION:Compared with pre-anesthesia, systolic blood pressure and diastolic blood pressure were significantly reduced and blood oxygen saturation was increased at 10 minutes after anesthesia and 10 minutes after the application of bone cement in both groups (P<0.05). In the end of arthroplasty, systolic blood pressure, diastolic blood pressure and respiratory rate were significantly higher in the control group than in the observation group (P<0.05). A total of 3 cases in the observation group and 15 cases in the control group used vasoactive drugs (including ephedrine and dopamine), and there was a significant difference in its usage (P<0.05). Moreover, five patients in the control group experienced respiratory insufficiency, which was apparently improved after given the short-term ventilator support. These results confirm that compared with the total intravenous anesthesia, epidural block combined with smal dose of intravenous anesthesia showed a high safety during total knee arthroplasty in elderly hypertensive patients.