Effects of manipulator operation task and troubleshooting task on blood pressure indexes of oceanauts / 中华劳动卫生职业病杂志

Objective: To explore the characteristics and rules of blood pressure changes in oceanauts during simulated operation of manipulator and troubleshooting tasks with different difficulty. Methods: In July 2020, 8 deep-sea manned submersible oceanauts, 6 males and 2 females, were selected as objects. In the 1∶1 model of Jiaolong deep-sea manned submersible, the oceanauts performed manipulator operation tasks and troubleshooting tasks with different difficulties, measured the continuous blood pressure of the oceanauts, filled in the NASA Task Load Index (NASA-TLX scale) after the completion of a single mission, and the changes of systolic pressure (SBP), diastolic pressure (DBP), mean arterial pressure (MAP) and mental workload were analyzed. Results: In a single task, the SBP, DBP and MAP of the oceanauts increased first and then decreased. The blood pressure values at the third minute were significantly lower than those at the first minute (P<0.01), and those at the fifth minute were significantly higher than those at the third minute (P<0.01). When performing the same task, compared with the quiet state, SBP, DBP and MAP increased when the oceanauts performed low difficulty, high difficulty, high difficulty+2-back manipulator operation task and troubleshooting task (P<0.05). When the task difficulty was the same, the SBP and MAP of oceanauts performing manipulator operation tasks were higher than those of oceanauts performing troubleshooting tasks (P<0.05). Compared with low difficulty tasks, the scores of NASA-TLX scale for oceanauts performing high difficulty manipulator operationtasks were significantly higher (P<0.05). Compared with the low difficulty task and high difficulty task, the scale score of the high difficulty+2-back troubleshooting task was significantly higher (P<0.05). When the task difficulty was the same, the scale scores of low difficulty and high difficulty manipulator operation tasks were significantly higher than those of troubleshooting tasks (P<0.05). SBP, DBP, MAP of No. 1, No. 3, No. 4, No. 5, and No. 7 oceanauts (all of whom had 6 years of diving) were positively correlated with NASA-TLX scale scores (r>0.8, P<0.05) . Conclusion: In the process of manned deep-sea diving, when the oceanauts perform manipulator operation tasks and troubleshooting tasks, with the increase of task difficulty, the mental load of oceanauts increases, and the blood pressure index increases significantly in a short time. At the same time, improving the proficiency of operation can reduce the variation range of blood pressure indexes. Blood pressure can be used as an effective reference to evaluate the difficulty of operation and guide scientific training.

Development and application of a moxibustion instrument with multi-jointed manipulator / 中国针灸

In view of the limitations of the existing moxibustion instruments, i.e. possible accidental injury when using moxibustion instruments, the negative effects of products from moxibustion instruments on treatment efficacy and health of medical staff and patients, a moxibustion instrument with multi-jointed manipulator is designed. This moxibustion instrument could accurately control the temperature, maintain a safe moxibustion distance, automatically process the burning ashes of moxa and selectively handle moxa smoke. The experimental results shows that this instrument could maintain the constant temperature of target acupoint, reduce the risk of empyrosis, and reasonably deal with the products of moxibustion. The purification rate of moxa smoke is 44.9%, which not only ensures the therapeutic effect of moxa smoke, but also reduces the negative effects of high-concentration moxa smoke on the health of medical staff and patients.

Spinal Kinetic Control Based on a 6-DOF Robotic Manipulator / 医用生物力学

Objective To design and implement a control algorithm in a 6 degree of freedom (DOF) robotic manipulator, so as to simulate the spinal motion and provide stable and efficient testing plan for biomechanical tests on spinal implants. Methods The recognition method of stiffness matrix for L2-5 spinal system was firstly studied for decoupling purpose. Secondly, the direct force control system under each axial motion was established by combining the 6-axis manipulator control system with the incremental proportion integration differentiation (PID) control algorithm. By using the 6-axis direct force control system, pure moment of 7.5 N·m was applied in the direction of main motion axis to simulate flexion-extension (FE), lateral bending (LB) and axial rotation (AR) motion of L2-5 spinal segment. Results The range of motion (ROM) of L2-5 segment in FE, LB and AR direction was 23.01°,27.92°,9.81°, respectively. A 7.5 N·m pure moment could be achieved in the main motion axis, while maintaining zero force/moment in the unconstrained axis with root mean square (RMS) errors being less than 3 N and 0.1 N·m, respectively. Conclusions The proposed algorithm of direct force control using PID controller with predetermined stiffness decoupling matrix was capable of applying pure moment to the spine under FE, LB, AR motion. The research findings have a relatively high value of engineering application for various biomechanical testing of lumbar vertebrae.

Spinal Kinetic Control Based on a 6-DOF Robotic Manipulator / 医用生物力学

Objective To design and implement a control algorithm in a 6 degree of freedom (DOF) robotic manipulator, so as to simulate the spinal motion and provide stable and efficient testing plan for biomechanical tests on spinal implants. Methods The recognition method of stiffness matrix for L2-5 spinal system was firstly studied for decoupling purpose. Secondly, the direct force control system under each axial motion was established by combining the 6-axis manipulator control system with the incremental proportion integration differentiation (PID) control algorithm. By using the 6-axis direct force control system, pure moment of 7.5 N·m was applied in the direction of main motion axis to simulate flexion-extension (FE), lateral bending (LB) and axial rotation (AR) motion of L2-5 spinal segment. Results The range of motion (ROM) of L2-5 segment in FE, LB and AR direction was 23.01°,27.92°,9.81°, respectively. A 7.5 N·m pure moment could be achieved in the main motion axis, while maintaining zero force/moment in the unconstrained axis with root mean square (RMS) errors being less than 3 N and 0.1 N·m, respectively. Conclusions The proposed algorithm of direct force control using PID controller with predetermined stiffness decoupling matrix was capable of applying pure moment to the spine under FE, LB, AR motion. The research findings have a relatively high value of engineering application for various biomechanical testing of lumbar vertebrae.

Manipulador uterino "KD" como nuevo dispositivo para la histerectomía totalmente laparoscópica / Uterine manipulator "KD" as a new device for the fully laparoscopic hysterectomy

Introducción: Uno de los factores que han influido para lograr una mayor aceptación de la histerectomía totalmente laparoscópica es la introducción de dispositivos que permiten mejorar la movilización del útero durante la cirugía. Objetivo: Evaluar el manipulador uterino KD de producción nacional en la histerectomía totalmente laparoscópica. Método: Estudio prospectivo longitudinal en una serie inicial en humanos. El univero estuvo conformado por las pacientes con patologías uterinas tributarias de tratamiento quirúrgico. La muestra la constituyeron 50 pacientes que cumplieron los criterios de inclusión. Las variables en estudio fueron: realización de la histerectomía, efectos adversos del sistema rígido en el manipulador diseñado, del sistema neumo oclusor, indicación de la operación, peso del útero, sangramiento intraoperatorio, índice de masa corporal, tiempo quirúrgico, morbilidad intraoperatoria y posoperatoria. El análisis estadístico fue realizado por una especialista en Bioestadísticas, mediante el programa estadístico IBM-SPSS versión 21 para Windows en español. Como medidas de resumen, las frecuencias absolutas, frecuencias relativas tales como el porcentaje, la media y el rango, así como la asociación de Spearman. Resultados: Solo existió un efecto adverso con el manipulador uterino: la perforación de un útero de 55 g. El mioma uterino fue la principal indicación de la histerectomía, el tiempo quirúrgico; así como el sangrado intraoperatorio, estuvieron acordes con otros resultados. Existió una correlación entre peso del útero, sangrado y tiempo quirúrgico. Conclusiones: La histerectomía totalmente laparoscópica con el uso del manipulador uterino diseñado se realizó en la totalidad de las pacientes con resultados aceptables(AU)

Introduction: One of the factors that have influenced for achieving greater acceptance of the fully laparoscopic hysterectomy is the introduction of devices that allow to improve the mobilization of the uterus during surgery. Objective: To assess the uterine manipulator KD of domestic production, in the totally laparoscopic hysterectomy. Method: Longitudinal prospective study in an initial series in humans. The total sample was made up by patients with uterine pathologies and who were candidates for surgical treatment. The sample consisted of 50 patients who met the inclusion criteria. The variables under study were hysterectomy, adverse effects of the rigid system on the designed manipulator, pneumo-occlusion system, indication of the operation, uterine weight, intraoperative bleeding, body mass index, surgical time, intraoperative and postoperative morbidity. The statistical analysis was carried out by a specialist in Biostatistics, using the statistical program IBM-SPSS version 21 for Windows in Spanish. As summary measures, we used absolute frequencies, relative frequencies such as the percentage, the mean and the range, as well as the Spearman association. Results: There was only an adverse effect with the uterine manipulator, which was the perforation of a 55-gr uterus. The uterine myoma was the main indication for hysterectomy; the surgical time, as well as intraoperative bleeding, were consistent with other results. There was a correlation between uterine weight, bleeding and surgical time. Conclusions: The fully laparoscopic hysterectomy with the use of the designed uterine manipulator was performed in all of the patients and with acceptable results(AU)

Condições higienicossanitárias de creches públicas em município no sul de Minas Gerais, Brasil / Hygienic sanitary conditions of public day care centers in a municipality in the south of Minas Gerais, Brazil

A maioria das cozinhas de escolas públicas brasileiras não possui estrutura adequada para a manipulação higiênica dos alimentos, desde a recepção da matéria-prima, até a sua distribuição. Deste modo objetivou-se avaliar as condições higienicossanitárias de cozinhas de cinco creches públicas de uma cidade no sul de Minas Gerais, no mês de novembro de 2014. Aplicou-se um checklist de observação direta abrangendo a higiene pessoal, a higiene do ambiente e área física, a higiene, manipulação e armazenamento dos alimentos e o local e a segurança no trabalho. Observou-se que 100% das creches estavam com alguma inadequação, oferecendo assim riscos de contaminação à alimentação produzida pelas instituições.

Grasp torque control based on experiential learning and haptic feedback / 医疗卫生装备

Objective To propose a grasp torque control based on experimental learning and haptic feedback to facilitate the manipulator in dexterous manipulation.Methods An experience database was built firstly,and then the object was recognized by tactile feedback in the grasp task.If the object had been experitentially grasped,the torque was output based on the database.In case a new object was grasped,the optimal output torque was calculated by iterative learning.Results The experiment showed that the robot hand could find the experiential output torque quickly when encountering the object in database and calculate the torque by iterative learning to achieve grasp task.Conclusion The experiential database grows up when the robot hand learns more and more experience.It can fast output torque like human in the grasp task.

Análise de coliformes totais e termotolerantes em açougues da região do Vale dos Sinos ­ RS / Analysis of total and fecal coliforms in butcher from Vale dos Sinos region - RS

Para um alimento chegar com segurança à mesa do consumidor, exigem- -se cuidados especiais em relação à contaminação por micro-organismos durante toda produção e comercialização do produto. Diante destes cuidados, o presente trabalho avaliou as condições microbiológicas dos manipuladores de alimentos, bem como, das bancadas e serras de corte de carnes, de açougues da região do Vale dos Sinos-RS, em três períodos do dia. As amostras foram coletadas por meio de swab estéreis que, em seguida, foram imersos em 15mL de água peptonada 0,1%. Para realizar a análise de coliformes totais e termotolerantes foi utilizada a metodologia de número mais provável (MNP). Os três açougues analisados demonstraram condições higienicossanitárias insatisfatórias em algum momento do dia e apenas um dos manipuladores que participou do estudo apresentou coliformes termotolerantes na mão, o que vem a comprometer a qualidade do alimento comercializado.

Complicaciones en 748 histerectomías por laparoscopia utilizando un manipulador uterino con resaltador vaginal / Complications in 748 laparoscopic hysterectomies using an uterine manipulator with vaginal highlighter

Introducción: la histerectomía laparoscópica (HL) requiere utilizar un dispositivo que permite una sección segura de la cúpula vaginal. El autor desarrolló un manipulador uterino con resaltador vaginal (M-R) para este paso. El objetivo de este trabajo es presentar las complicaciones asociadas a la utilización del M-R en diez años de uso. Materiales y métodos: se presenta una cohorte de mujeres sometidas a histerectomía laparoscópica en quienes se utilizó el manipulador uterino con resaltador vaginal (M-R) entre diciembre 7 de 1999 y junio 21 de 2011. El criterio de inclusión fue indicación de histerectomía por patología benigna. Se excluyeron aquellas con indicación de histerectomía vaginal, sospecha de adherencias intraabdominales o úteros excesivamente grandes. Se evaluó la edad, la paridad, el antecedente de cesáreas o laparotomías previas, el tiempo quirúrgico, el peso de la pieza quirúrgica, las complicaciones intra o posoperatorias y la evolución durante un seguimiento mínimo de 30 días posteriores a la cirugía. Resultados: en el periodo de observación se operaron 854 pacientes. En 106 pacientes el seguimiento posoperatorio fue menor a un mes. Los datos presentados corresponden a 748 pacientes. La edad promedio de las pacientes fue de 44 años (± 6,6). Las principales indicaciones de HL fueron miomatosis y adenomiosis uterina. Tiempo quirúrgico promedio: 90 min (± 17,7). Peso uterino promedio: 205 g (± 88,3). Se presentaron complicaciones en 41 pacientes (5,6%), de las cuales seis (0,8%) fueron complicaciones mayores: tres lesiones vesicales (0,4%), una lesión ureteral (0,13%), una paciente (0,13%) requirió laparoscopia operatoria por sangrado posquirúrgico, y una paciente (0,13%) laparotomía exploratoria por dolor abdominal. La tasa de conversión a laparotomía fue de 2%.Conclusión: con el uso del M-R se presentaron tasas de complicaciones similares a las reportadas por otros autores.

Introduction: Laparoscopic hysterectomy (LH) involves using a device which permits safe section of the vaginal dome. The present author has developed an uterine manipulator with vaginal highlighter (UM-VH) for this step. The present work has been aimed at presenting complications associated with using the UM-VH which have arisen during 10 years’ use.Materials and methods: This study involved a cohort of women undergoing laparoscopic hysterectomy using a UM-VH between December 7th 1999 and June 21st 2011. Inclusion criteria consisted of an indication of hysterectomy due to benign pathology. Females were excluded who had an indication of vaginal hysterectomy or where there was suspicion of excesively large uterine or intra-abdominal adherences. Age, parity, a background of prior caesarean sections or laparotomy, time spent in surgery, the weight of the surgically-excised piece and intra- or post-operatory complications were evaluated and evolution was followed-up for at least 30 days after surgery. Results: 854 patients were operated on during the observation period. Post-operatory follow-up was less than a month for 106 patients; the data presented here deals with the remaining 748 patients. The patients’ average age was 44 years (± 6.6); uterine myomatosis and adenomyosis were the main indications for LH. Average time spent in surgery was 90 minutes (± 17.7). Average uterine weight was 205 grams (± 88.3). Complications occurred in 41 patients (5.6%), six of which were serious complications (0.8%): three vesical lesions (0.4%), a urethral lesion (0.13%), one (0.13%) patient required operative laparoscopy due to bleeding after surgery and one (0.13%) patient underwent exploratory laparotomy because of abdominal pain. There was a 2% conversion to laparotomy rate.Conclusion: Using UM-VH has led to similar complication rates to those reported by other authors.

Application of cup-shaped womb manipulator auxiliary peritoneoscope in entire womb excision / 中国基层医药

Objective To study the superiority and safety of cup-shaped womb manipulator auxiliary peritoneoscope in entire womb excision. Methods 180 cases with hysterectomy were randomly divided into cup-shaped womb manipulator auxiliary peritoneoscope group(treatment group) and tradition into the abdominal group( control group) ,and the amount of bleeding and postoperative complications,and patient recovery were observed in the two groups. Results Compared with the control group, the quality of life of patients with anal exhaust time, average length of staying, postoperative recovery daily time were significantly improved, and there were statistically significant differences between two groups ( P ＜ 0. 05 ). There was no serious complication in the two groups. Conclusion Cup-shaped womb manipulator auxiliary peritoneoscope hysterectomy was a safe and feasible operation,and could relieve harm and improve patients quality of life.

Development of lumbar kyphosis rectifying manipulator / 医疗卫生装备

Objective To develop manipulator to tow and rectify lumbar kyphosis instead of pressing with hands and heels when trying to cure the lumbar disc herniation.Methods Combining the electronic and mechanical application technology,a reasonable and complete scheme was designed and established.Results The mechanization and automation of the treatment process is realized.The labor of medical staff is reduced and the symptoms of sufferers are relieved.Conclusion Lumbar kyphosis rectifying manipulator provides a new method to cure lumbar kyphosis.It's a perfect lumbar kyphosis rectifying tool with a lot of strong points,such as easy operation,concentrated force,desire effectiveness,high security,etc.It has good application foreground.

Total laparoscopic hysterectomy using YSZ-1 uterine manipulator: A clinical analysis of 78 cases / 中国微创外科杂志

Objective To investigate the clinical value of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy.Methods Total laparoscopic hysterectomy was employed in a total of 78 women by using the LigaSure,ultrasonic scalpel,and the YSZ-1 uterine manipulator.The anterior fornix was opened and the manipulator was placed on the lip of the cervix.Then the uterus was completely removed.Results The operation was completed smoothly in all the 78 patients.The operating time was 45~90 min(mean,63 min),and the intraoperative blood loss was 40~100 ml(mean,65 ml).No urinary tract injuries,vaginal bleeding,or other postoperative complications occurred.The length of postoperative hospital stay was 4~7 d(mean,5.3 d).Follow-up examinations in the 78 patients for 3~6 months(mean,4 months) showed that the vaginal wound normally healed up. Conclusions Use of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy makes the procedure easier and safer.The YSZ-1 uterine manipulator is a useful laparoscopic instrument.