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Objective:To explore the application effects of standardized patient (SP) and breast visual palpation simulation system on clinical probation of breast surgery for medical students.Methods:A total of 110 students were randomly divided into experimental group and control group, and each group was further divided into 5 subgroups. In the experimental group, SP scripts of five common diseases in breast surgery department were designed according to the syllabus before probation, and the teachers were trained. During the probation, we first talked about the characteristics of disease diagnosis and treatment, and then the five subgroups collected the history of the disease according to the SP of different diseases mentioned above, and checked the corresponding lesions on the breast visual palpation simulation system. In the physical examination, SP responded to the students' questions. The control group also talked about the above-mentioned five diseases during the probation, and then the five subgroups carried out history collection and physical examination for specific patients in the hospital. Finally, the teaching effects were analyzed through medical record writing, theoretical examination, physical examination and student evaluation. SPSS 26.0 was used for chi-square test (or Fisher exact test) and Mann-Whitney U test. Results:There was no significant difference in the theoretical examination between the two groups. It was demonstrated that the correct rate of experimental group was significantly higher than that of the control group in medical history collection, especially in the main symptoms, incentives, aggravation and remission factors, accompanying and differential symptoms and so on. And the positive results of breast, nipple and axillary lymph node palpation in the experimental group were significantly higher than those in the control group through the physical examination operation of breast visual palpation simulation system. The analysis of students' evaluation showed that the teaching efficiency of the experimental group increased, and the students' satisfaction was improved (satisfaction rate: 92.73% vs. 76.36%).Conclusion:The application of SP and breast visual palpation simulation system in breast surgery probation teaching can not only protect the privacy of clinical patients, but also improve the teaching effects, which can be popularized in the clinical teaching of breast surgery.
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@#AIM: To investigate the application and effect of virtual-reality surgery exercise in minimally invasive cataract surgery training for ophthalmology residents.<p>METHODS:Twenty ophthalmology residents with equal seniority who had completed 3a standardized residency training in the Affiliated Eye Hospital of Nanjing Medical University from 2019 to 2021 were prospectively enrolled. After passing the theoretical examination, residents were randomly divided into virtual surgery exercise(Dry-lab)group(<i>n</i>=10)and real animal surgery exercise(Wet-lab)group(<i>n</i>=10). Dry-lab and Wet-lab group residents performed training using the Eye SI surgical simulator and pig eye respectively. At the end of the training, the overall training effects of the residents in both groups were rated using the Eye SI surgical simulator and the real pig eye operation, and the module training effects of the residents in both groups were rated using the virtual surgical simulator. Furthermore, a questionnaire survey was used to objectively evaluate the two training methods.<p>RESULTS:Residents in Dry-lab group had significantly higher total scores on both operation assessments,simulator assessment and real pig eye operation assessment than Wet-lab group(88.03±1.34 <i>vs</i> 80.35±2.87, 87.50±3.03 <i>vs</i> 77.60±5.62, 88.57±1.89 <i>vs</i> 83.10±3.22, all <i>P</i><0.01). The simulator module assessment results showed that the residents in Dry-lab group scored significantly better than Wet-lab group in terms of scores and completion time on each module(<i>P</i><0.01). The questionnaire results showed that Dry-lab group rated better than Wet-lab group in terms of the novelty of training, the proximity to the real surgical experience, the degree of help to the improvement of microsurgery skills, the confidence to perform real surgery, and the overall satisfaction of surgical training(<i>P</i><0.05). <p>CONCLUSION:Applying virtual-reality surgery exercise to cataract surgery skills training for ophthalmology residents can significantly improve the cataract skills, increase overall training satisfaction, and help residents enhance their confidence, psychological quality, decision-making, and processing ability during real surgery at the initial stage of practice. This provides a new standard and model for establishing a formal and standardized cataract surgery training system for ophthalmology residents.
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The teaching of orthognathic surgery is difficult because it is complex and emphasizes the combination of theory and practice. The traditional teaching method focuses on theoretical teaching, but due to the limitation of conditions, it is difficult for students to master the operation. In this paper, we apply the digital three-dimensional surgical simulation system combined with 3D printing in specialist training of orthognathic surgery. Digital software and 3D printing are applied in the theoretical teaching, surgical operation, summary and reflection to combine practical teaching with theoretical teaching, so as to stimulate the subjective initiative of the students. The results showed that the teaching evaluation of the experimental group [(3.89±0.84) points] was better than that of the control group [(2.91±1.21) points]. The application of digital three-dimensional surgical simulation system combined with 3D printing has achieved satisfactory results.
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In order to explore the adsorption characteristics of proteins on the membrane surface and the effect of protein solution environment on the permeation behavior of berberine, berberine and proteins were used as the research object to prepare simulated solution. Low field NMR, static adsorption experiment and membrane separation experiment were used to study the interaction between the proteins and ceramic membrane or between the proteins and berberine. The static adsorption capacity of proteins, membrane relative flux, rejection rate of proteins, transmittance rate of berberine and the adsorption rate of proteins and berberine were used as the evaluation index. Meanwhile, the membrane resistance distribution, the particle size distribution and the scanning electron microscope (SEM) were determined to investigate the adsorption characteristics of proteins on ceramic membrane and the effect on membrane separation process of berberine. The results showed that the ceramic membrane could adsorb the proteins and the adsorption model was consistent with Langmuir adsorption model. In simulating the membrane separation process, proteins were the main factor to cause membrane fouling. However, when the concentration of proteins was 1 g•L⁻¹, the proteins had no significant effect on membrane separation process of berberine.
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Objective To design and develop a multi-modality medical image fusion and evaluation simulation system to eliminate the deficiencies of the images by different technologies.Methods The system was developed with MATLAB 2014a development platform as well as MATLAB graphical user interface and image processing toolbox.Results Common methods were realized of multi-modality medical images,and the evaluation on seven objective indicators was implemented such as entropy,mutual information,cross entropy,mean,standard deviation and etc.Conclusion The system behaves well in interactivity,practicality and extensibility,and is of great significance for clinical diagnosis as well as teaching medical image processing in specialties of biomedical engineering,medical image technology and etc.[Chinese Medical Equipment
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Objective To design and develop a multi-modality medical image fusion and evaluation simulation system to eliminate the deficiencies of the images by different technologies.Methods The system was developed with MATLAB 2014a development platform as well as MATLAB graphical user interface and image processing toolbox.Results Common methods were realized of multi-modality medical images,and the evaluation on seven objective indicators was implemented such as entropy,mutual information,cross entropy,mean,standard deviation and etc.Conclusion The system behaves well in interactivity,practicality and extensibility,and is of great significance for clinical diagnosis as well as teaching medical image processing in specialties of biomedical engineering,medical image technology and etc.[Chinese Medical Equipment
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The revolution of information war demands fast planning and accurate allocation for naval medical support. The medical support simulation based on digital simulation technology has become a research focus for navies of many countries due to its controllable cost, and it is close to the actual war combat. In this paper we analyzed the key techniques of the American naval medical support simulation system, especially the Tactical Medical Logistics Planning Tool (TML+). Based on the rationale of each module of TML+,we mainly explored the achievements and problems in establishing medical support simulation system for Chinese navy, hoping to provide reference for improving our military health simulation system.
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Objective To explore the application of a three-dimensional simulation system in extended liver resections.Methods A three-dimensional surgical simulation system was used for preoperative assessment and for computer simulation to estimate the resected liver volume,the residual liver volume,and the surgical resection margins.The software virtual liver resection was used to choose the most optimal surgical option.The actual resection,the postoperative liver volume and the actual surgical resection margins were compared.Results 1 patient was diagnosed by ultrasound to develop ascites on post-operative day 2.Another patient was diagnosed by transthoracic ultrasound to have moderate pleural effusion on postoperative day 1.Postoperative liver failure developed in 1 patient.There was no patient who developed bile leakage.The average length of stay was 6 ～ 85 days (average 22 d).There was no recurrence within 1 month after surgery and there was no postoperative deaths.Condusions The three-dimensional surgery simulation system was effective.It gave an accurate evaluation and simulation of the liver surgery.In extended liver resection,it gave good guidance and help.
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Objective: To optimize the pretreatment on the water extract of Chinese materia medica (CMM) before membrane separation. Methods: Using the comprehensive simulation system of four common polymers and index components existed in the water extract of CMM (berberine and geniposide) as the research object, the solution environment was adjusted by different pretreatments. The flux of microfiltration, transmittance of the ingredients, and removal rate of common polymers were selected as indicators to study the effects of different solution environments. Results: It was found that adjusting pH could change the permeation flux obviously, and the removal rate of common polymers was comparatively higher. The transmittance of index components was higher when the pH value and ionic strength were adjusted (adding 0.05 mol/L NaCl). The membrane blocking resistance was the major factor in membrane fouling. Conclusion: Based on the above indicators, the effect of pretreatment is comparatively significant when the ionic strength and pH value are adjusted (pH 6.5 and adding 0.05 mol/L NaCl). It provides a valuable reference for the pretreatment of the water extract of CMM before membrane separation.
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Técnicas cirúrgicas, próteses e dispositivos implantáveis utilizados pela cardiologia estão em constante desenvolvimento. Alguns institutos de pesquisas e universidades desenvolvem simuladores hidrodinâmicos com capacidade de reproduzir os níveis de pressão e vazão do sistema cardiovascular humano, com pistões, válvulas, câmaras de complacência, dispositivos para ajustes e medição de pressão e vazão. Este artigo apresenta o desenvolvimento e a avaliação de um fluxômetro eletromagnético (FE). O custo elevado de um fluxômetro por ultrassom (FUS) pode inviabilizar algumas pesquisas com simuladores; desta forma, uma alternativa com menor custo é apresentada neste trabalho. Baseado na indução eletromagnética para medição de vazão em um fluido iônico, o FE desenvolvido mostrou ser uma solução de baixo custo. O transdutor foi montado em um tubo de plástico com diâmetro interno de 9,5 mm, excitado por um campo magnético de 0,35 T, possui 4 eletrodos que, ligados a um circuito eletrônico, fornecem tensão elétrica proporcional à velocidade do fluido. A equação da tensão induzida, técnicas para calibração, ensaios e resultados são apresentados. Para a realização dos ensaios, foram utilizados um simulador cardiovascular e um FUS como referência. Os dados foram obtidos por hardware e software da National Instruments. Dentre os resultados, destaca-se o baixo desvio padrão de 0,043 L/min do FE para uma vazão de 3,56 L/min. O maior erro porcentual relativo foi de 1,49 ± 1,25%. Em um dos gráficos de vazão do FE observou-se um comportamento não monotônico, confirmado por uma análise da resposta em freqüência, observando-se maior amplitude na segunda, terceira e quarta harmônicas. Os resultados indicaram que o FE pode substituir o FUS em aplicações com simuladores hidrodinâmicos.
Implantable devices, prosthesis and their associated surgical techniques in cardiology are constantly under development. Many research groups have been using hydrodynamic simulators as a tool to assist the development in cardiovascular area, capable to mimic pressure and flow found in human cardiovascular system. They are made with plastic tubes, compliances chambers, valves, moving diaphragms and clamps for pressure and flow adjustments. The high cost of ultrasonic flow meters (UF) may difficult, for some research groups, the development of their own mock systems. This paper presents a simple and low cost electromagnetic flow meter (EF) useful for those cardiovascular simulation systems. EF measures flow of ionic fluids based on electromagnetic induction. A special transducer was assembled directly on a plastic tube with 9.5 mm of inner diameter. The transducer has 4 electrodes and, when excited by a magnetic field of 0.35 tesla, detects electric tension that is proportional to the fluid velocity. In this paper, induced electric potential equation, calibration techniques, performance tests and results are presented. A cardiovascular simulation system was used as test setup with an UF (Transonic Systems Inc.) as comparative flow meter. The signals were acquired by a PCI-6036E card and processed with LabView® 7.1 (National Instruments). The results from EF showed a standard deviation (SD) of 0.043 L/min for a flow of 3.56 L/min. The largest relative error was of 1.49 ± 1.25%. In one flow signal from the EF, the non monotonic behavior suggests a rich harmonic signal, which was confirmed by an analysis in the frequency domain. In vitro performance tests indicated that our EF can substitute the commercial available UF for hydrodynamic simulator application.
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Flow Measurements , Flowmeters , Models, Cardiovascular , Computer Simulation , Risk Measurement Equipment , Diagnostic Techniques, Cardiovascular/instrumentationABSTRACT
Aiming to the fact that the distribution modules of the C3 I simulation system originally developed based on TCP/IP protocol has to be compatible with the present HLA (High Level of Architecture) rules, three methods for implementing the interaction of HLA and TCP/IP subsystems are presented to make the original TCP/IP modules directly used in the HLA-based C3 I system without redevelopment. The three methods are agent method, middleware method and gateway method. Moreover, the implementation of gateway method via VC++ as well as the key technology is discussed.
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Aiming to the fact that the distribution modules of the C3I simulation system originally developed based on TCP/IP protocol has to be compatible with the present HLA (High Level of Architecture) rules, three methods for implementing the interaction of HLA and TCP/IP subsystems are presented to make the original TCP/IP modules directly used in the HLA-based C3I system without redevelopment. The three methods are agent method, middleware method and gateway method. Moreover, the implementation of gateway method via VC++ as well as the key technology is discussed.
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In the light of requirements of medical equipment simulation system, the overall framework of joint control system of medical equipment integrated support in the theater is designed in this paper. Such modules are developed with Delphi as communication module, module for equipment basic information, module for equipment video information and module for medical faculty information. A joint control system suiting integrated support simulation sand table for medical equipment is complteted,which provides a multidimensional informational platform for integrated demonstration of medical equipment.