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Objective:To improve the quality assurance (QA) skills of radiotherapy personnel and medical students and reduce the radiation risk of training by developing a remote training system for QA of medical electronic linear accelerators.Methods:This training system was built based on radiotherapy technology and quality control contents of medical electronic linear accelerators, and a virtual reality interactive software was developed using extended reality (XR) technology Unity 3D. A remote control module of multi-terminal platform was also developed. A multi-perspective evaluation system was adopted and a questionnaire was designed to analyze the application value of this system.Results:The training system reproduced the live environment and physical objects of medical electronic linear accelerator treatment room. It built a multi-terminal virtual simulation training system with radiotherapy technology as well as QA knowledge system. This system could provide 5G remote control of medical electronic linear accelerator for off-site quality control demonstration and guidance. By March 1, 2022, a total number of 133 people had been trained using this system, 76 valid questionnaires had been taken, of which 90.79% (69/76) of the respondents trusted the experimental results shown by the system and 88.16% (67/76) of the respondents considered the training system necessary.Conclusions:The training effect of this system is widely recognized. It fundamentally reduces the training radiation hazard and provides reference for the reform and progress of QA training mode of medical electronic linear accelerators.
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Objective:To investigate the necessity and feasibility of the virtual simulation teaching experiment software of the bronchoscopy intelligent navigation-based fiducial marker implantation technology in the clinical application of radiotherapy.Methods:This study developed a 3D virtual operation and interactive system using the Unity3D engine, tools including 3Dmax and Maya, and the SQL database. The scenes in the system were produced using the currently popular next-generation production process. Targeting the priorities and difficulties in the implantation of fiducial markers, the system developed in this study allowed for simulated demonstration and training based on 12 steps and 10 knowledge points. Internal tests and remote evaluation tests were adopted in this system to obtain the test result of each subject. Then, the application value of the system was analyzed based on the test result.Results:As of May 1, 2022, the system had received 2 409 views and 425 test participants, with an test completion rate of 100% and an experiment pass rate of 96.5%. Moreover, this system won unanimous praise from 167 users, primarily including the students majoring in multilevel medical imaging technology and medical imaging science from the Fujian Medical University, as well as the radiotherapy-related staff of this university.Conclusions:The virtual simulation teaching experiment software of the bronchoscopy intelligent navigation-based fiducial marker implantation technology can be applied to the teaching of students and the training of related professionals.
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Objective:To develop a remote training system for CT simulation positioning of radiotherapy using virtual reality technology, and to explore a new method of medical training.Methods:The 3DMax and Maya were employed to establish the 3D model. The unity3D engine was adopted to develop 3D virtual operation and interaction system. Java spring MVC architecture was utilized as the system background service. MySQL was used as the background database system. The users were assigned into two roles: teacher and student, and the modes were divided into teaching and assessment modes.Results:The function of the system covered the whole process of CT simulation positioning, mainly including modules of patient information management, CT simulation positioning machine cognition, body position fixation technology, CT positioning scanning, and emergency handling, etc. Since it was put into use in 2018, the system has been running stably, with 14 920 pages views and an 86.66% pass rate. Compared with the traditional training, the training efficiency has been significantly improved and has received unanimous recognition.Conclusions:The remote training system can effectively improve the clinical practice ability and humanistic care ability of the trainees, which has good autonomy, sharing, and innovation. At present, the system has been put online and has strong popularization with prospects for broad application.
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Objective:To explore the polymorphism of the uridine diphosphateglucuronosyl transferase 1A1 ( UGT1A1) gene in children of multiple nationalities with etiology-unknown neonatal hyperbilirubinemia in Qiubei County. Methods:Full-term neonates with unknown cause hyperbilirubinemia were collected.They were admitted to neonatal ward of Qiubei People′s Hospital from September 2017 to June 2018.All of them were performed UGT1A1 gene test. Results:A total of 100 neonates were enrolled in this study.Among them, 53 infants were Han, and others were minorities.Ten mutation sites of UGT1A1 gene were found.Five sites were never reported before and 4 sites could be pathogenic mutations.In addition, c.211G>A.was the most common genetic mutation, and 13 cases of homozygote and 32 cases of heterozygote were revealed by exome sequencing.The bilirubin levels of children with homozygote c. 211G>A were higher than those without the variation in this study and the differences were statistically significant ( t=2.621, P=0.008). The incidence of c. 211G>A mutation was similar between Han and minority nationalities.Among new-found mutations, c.1091C>CA heterozygous mutation was found in 19 children and in several nationalities, suggesting that this was a common UGT1A1 gene mutation in Qiubei County.Besides c. 211G>A and c. 1091C>CA were the most common variants.The incidence of c. 211G>A had no significant difference between Han and minority nationalities (χ 2=0.215, P=0.643). Neither had the incidence difference of c. 1091C>CA between Han and minority nationalities (χ 2=0.017, P=0.897). Conclusion:c. 211G>A and c. 1091C>CA mutations , which are distributed in both Han and minority nationalities, are common UGT1A1 mutations in Qiubei County.The distribution rate of c. 211G>A mutation is high in the population.The homozygous variation of c. 211G>A is associated with neonatal hyperbilirubinemia.
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Objective To discuss the necessity and feasibility of application of virtual reality (VR) technology in the teaching course of radiotherapy technology based on the contradictions between the theory and practice of current teaching mode.Methods After in-depth analysis of the characteristics of the existing disciplinary teaching mode,VR technology was introduced to design software,glasses,operating handles and establish a special interactive platform. The teaching courses could be delivered via mobile phone side AR, helmet and AR, touch screen and PC virtual simulation with VR virtual simulation, etc. Six processes of radiotherapy were tested through online courses and offline groups to analyze the feasibility of this technology applied in the training of radiotherapy professionals. Results After the design of software and hardware and the analysis of test results,the online teaching could be utilized to write interactive programs,build virtual experience scenes, create course resource database and construct practical training courses and teaching system. The offline practice test could be applied to the simulation learning of feedback of the whole process, which possessed feasibility and development value. It could be applied to the theory and practice teaching of radiation therapy technology,making the teaching more convenient,vivid and intuitive. Conclusions VR technique combined with radiotherapy technology training can be delivered through online and offline teaching courses of theory and practice by using the plane and virtual simulation technology, which is convenient, quick and highly efficient and deserves widespread application.
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Objective To discuss the effectiveness of heart operation through subaxillary minithoracotomy.Methods Subaxillary minithoracotomy heart operation was carried out in 378 cases between March 1995 and October 2004.The operation was performed under beating heart and without the occlusion of the ascending aorta in 81 cases of atrial septal defect, 32 cases of ventricular septal defect,and 16 cases of other diseases.The operation was completed under low temperature and extracorporeal circulation in other 249 cases.Results The operation was accomplished smoothly in all the cases.The operation time was 167?2.0 min,and the extracorporeal circulation time was 28.1?16.6 min.Postoperatively,1 patient with double-chamber anormaly of the right ventricle was given a tracheotomy because of an acute laryngeal edema,1 patient with tetralogy of Fallot died of low cardiac output syndrome,1 patient had a cerebral embolism,2 patients experienced an incision fat liquefaction,and the remaining patients recovered uneventfully.A follow-up for 2 months ~ 10 years(mean,5.1 years) in 366 patients revealed a full range of physical activities.One case of ventricular septal defect with residual shunt and 1 case of cerebral embolism were fully recovered.Conclusions Subaxillary minithoracotomy open heart operation has advantages of minimal invasion,quick recovery,simplicity of performance,and good cosmetic results.
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<p><b>OBJECTIVE</b>To introduce an operation for fingertip reconstruction.</p><p><b>METHODS</b>The vascularity of the reverse dorsal island flap is augmented by performing an arteriovenous anastomosis between the dorsal vein in the flap and a digital artery at the fingertip. The flap was used in ten patients for reconstruction of their fingertip defects.</p><p><b>RESULTS</b>All the ten flaps survived and the appearance was good.</p><p><b>CONCLUSION</b>The method is easy except for the necessity of performing standard microvascular surgery. The flap is a good option for repairing fingertip defects.</p>
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Adulto , Femenino , Humanos , Masculino , Dedos , Cirugía General , Microcirugia , Métodos , Colgajos QuirúrgicosRESUMEN
Objective To summarize the surgical treatment of heart disease in patients aged 70 years and over. Methods From May 1995 to July 2000, 23 patients aged 70 years and over underwent cardiac operation at our department. Thirteen cases underwent isolated coronary bypass grafting, 5 had isolated valve operations , 3 had combined valve operation and coronary bypass grafting, 1 had excision of left atrial myxomas, 1 had combined pericardiectomy and coronary bypass grafting .Results Postoperative complications occurred in 5 cases (21.7%). The hospital mortality rate was 4.3% (1 case) . All of the 22 cases survived showed improvements in cardiac function and quality of life during a follow up of 1 month to 5 years.Conclusions Cardiac operations can be performed in patient saged 70 yeas and over with a satisfactory outcome,earlier referral and intervention is mandatory to improve results in this patients.