Establish and implement a pre-prescription system for outpatient based on Six Sigma DMAIC model / 中国临床药理学与治疗学

AIM: The pre-prescription system of outpatient was established and implemented based on six sigma DMAIC model to ensure the safety of drug use and promote rational of drug use. METHODS: The rules database was made scientifically and precisely, according to DMAIC model of Six Sigma-define, measure, analyze, improve and control. The pre-prescription system of our hospital was established and improved, through adopting the prescription review mode of interception and Intervention. And the process management was continued to optimize. RESULTS: The rule-making of pre-trial system for outpatient prescription in our hospital was reasonable, and the rate of clinical approval and acceptance was high. After the system audit, the average rate of doctor's revision was 76.32%, and the average rate of Pharmacist's intervention was 63.23%, the effective rate and qualified rate of pharmacist intervention were 97.23% and 96.87%, respectively. CONCLUSION: Based on Six Sigma DMAIC model, the pre-trial system for outpatient prescription was established and implemented, which improved the level of rational drug use, effectively ensured the safety of drug use, and improved the satisfaction of patients.

Differential diagnosis of pancreatic cancer based on parameter analysis of ultrasonographic features / 中华消化内镜杂志

Objective To extract the texture features of endoscopic ultrasonography (EUS) by digital imaging processing(DIP) and pattern recognition,and then to investigate its value for differential diagnosis between pancreatic cancer and chronic pancreatitis.Methods Two hundred and two patients with pathologicaly confirmed pancreatic malignancy,who underwent EUS from Feb 2005 to Mar 2011,and 104 patients with chronic pancreatitis (including 34 cases of autoimmune pancreatitis),who underwent EUS from May 2002 to Aug 2011,were randomly recruited in this study.The optimal texture features of EUS images in this study were selected by the sequence forward search (SFS) algorithm.With the optimal feature combination,cases were automatically divided into pancreatic cancer and chronic pancreatitis based on the findings of support vector machine (SVM),which were compared with the real results.the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated.Results Nine categories and 105 texture features were extracted based on all EUS images,and 13 features were chosen as optimal combination.Images of 306 cases were randomly divided into training set ( 153 cases,101 cases of cancer,52 cases of chronic pancreatitis) and testing set ( 153 cases,101 cases of cancer,52 cases of chronic pancreatitis).The classifier was trained with the training set and tested with testing set.We proceeded 200 times randomly.the average accuracy,sensitivity,specificity,positive predictive value and negative predictive value were ( 86.08 ± 0.14) ％,(79.47 ± 0.32) ％,( 89.71 ± 0.18 ) ％,( 81.21 ± 0.26 ) ％,( 88.93 ± 0.14 ) ％,respectively.Conclusion Differential diagnosis of pancreatic cancer from chronic pancreatitis by Computer-assisted EUS image analysis,highly accurate,convenient,non-invasive and less costly,is a novel and valuable method of early diagnosis.

The development for real-time sampling and display in epicardial mapping system / 中国医疗器械杂志

In order to realize real-time sampling and display in 128-channeled Epicardial Mapping System whose sampling frequency is 2 kHz per channel, the article introduces a mapping software and preliminarily validates its practicability. The software is designed in MFC, using multiple-thread technology and buffering and pumping values method.

The testing system for OCP of the digital X-ray machine / 中国医疗器械杂志

In this paper, we designed a testing system for operator control panel of a high-voltage and high-frequency X-ray machine, and an online testing software for functional components, in order to help the testing engineers to improve their work efficiency.

A design of electrophysiological stimulator / 中国医疗器械杂志

Electrophysiological stimulator is widely used in study of biological electrical activities. This electrophysiological stimulator is capable of outputting both biphasic and monophasic waveforms with amplitudes within 0V and 30V. The sequence of the biphasic waveforms is alterable and their widths and interval can be respectively arbitrarily modified by the operator. The machine will inform the operator as soon as the charge completes through the indicator and buzzer. The safety of experimental objects is guaranteed by float ground thanks to battery power supply.

The discrimination system of pancreatic endoscopic ultrasonography image based on M-band wavelet transfom / 中华消化内镜杂志

Objective To develop and evaluate the digital discrimination system for pancreatic ultrasound endoscopy images. Methods EUS images of 153 pancreatic cancer and 63 non-cancer cases were selected. According to the multi-fractal feature vectors based on the M-band wavelet transform, we acquired the fractal features with lower dimension with the feature screening algorithm. With the optimal feature combination, cases were classified into pancreatic cancer group and non-pancreatic cancer group automatically.Then the sensitivity, specificity and accuracy of this method were calculated, and compared with those of traditional 9 dimension fractal feature vectors. Results Three kinds of multi-fractal dimensions were introduced to the framework of M-band wavelet transform according to the EUS images to form fractal vectors of 18 dimension. With the selection by sequence forward search (SFS) algorithm, 7 dimension of feature vectors were chosen and were combined with bi-order multi-fractal dimension to a better feature combination. The Bayes, support vector machine (SVM) and ModestAdaBoost classifiers were introduced to evaluate the classification efficiency, resulting in a classification accuracy of 97.98% and short running time of 0. 49 s with lower feature dimension. Conclusion These data suggest the feasibility, accuracy, noninvasiveness and efficacy of classification of EUS images to differentiate pancreatic cancer from normal tissue based on the Mband wavelet transform algorithm. It is a new and valuable research area in diagnosis of pancreatic cancer.

Study on visualization of congenital heart disease by three-dimensional echocardiographic virtual endoscopy / 中华超声影像学杂志

Objective To research the visualization of congenital heart disease by three-dimensional echocardiographic(3DE) virtual endoscopy(VE) system. Methods Datasets.from 10 healthy children and 22 patients with congenital heart disease were collected (10 patients with atrial septal defects, 6 patients with ventricular septal defects and 6 patients with tetralogy of Fallot). 3DE heart models were reconstructed by virtual reality computing techniques and visualization in scientific computing techniques. The VE system was programmed under the C++ 6.0 language condition,the visualization toolkit (VTK) platform was employed to carry out the graphics and visualization utilities. The virtual eye can move along the navigation paths in the heart by manual camera movements. Results The VE can provide special information in aspects of intracardiac anatomy, The visible heart models show precisely complex anatomy structure and spatial relationships. 3DE intracardiac endoscopic imaging can thus be visualized and navigated successfully by the VE system. Conclusions 3DE VE is a new system for the visualization of congenital heart disease.

Computer aided endoscopic ultrasonography in diagnosis of pancreatic cancer / 中华消化内镜杂志

Objective To process the image of endoscopic uhrasonography(EUS)by digital imaging processing(DIP)and pattem recognition,and to evaluate its efficacy in diagnosis of pancreatic adenocarcinoma.Methods Two hundreds and sixteen patients,who underwent EUS between Feb 2005 and Feb 2007,were randomly recruited to the study.The cohort jncluded 153 cases of pancreatic cancer,which were confirmed by cytological findings after fine-needle aspiration,and 63 cases of non-pancreatic cancer(normal pancreas and chronic panereatitis).The texture features of the EUS image were selected and extracted,and cases were automatically divided into cancer and non-cancer based on findings of support vector machine (SVM).Sensitivity,specificity and accuracy of the technique were calculated.Results From each region of interest(ROI),a total of69 texture features vest in 9 sets were extracted,and 25 features with most set interval were taken as initial.The images of 216 cases were divided randomly into training set(108 eases,76 cancer and 32 non cancer)and testing set(108 cases,77 cancer and 31 non cancer).After 50 times of random tests,the average accuracy,sensitivity and specificity of the diagnosis of pancreatic cancer were (97.98±1.237)%,(94.32±0.0354)%,and(99.45±0.0102)%respectively.Conclusion DIP,combined with computer aided EUS imaging,is an accurate and noninvasive technique in diagnosis of pancreatic cancer.which warrants novel and further researches.

Wavelet feature extraction and classification of Doppler ultrasound blood flow signals / 生物医学工程学杂志

The maximum frequency waveforms of Doppler ultrasound blood flow signals were analyzed using a multi-scale wavelet transform. The variation of maxima of wavelet transform modulus under various scales was extracted from the time-scale representation. This novel approach was applied to the analysis of Doppler signals from carotid blood flow. It was found that the shape of this variation from cases with normal cerebral vessels differed from those associated with abnormal cases. The curve was fitted by a polynomial, and its coefficients were put into a back-propagation (BP) neural network to make a classification. The clinical experiments showed that this approach got good performance and could be a new means in the clinical diagnosis of cerebral vascular disease.

Relationship between amount of HBV DNA in serum/liver tissue and hepatitis G virus (HGV) infection in patients with chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the relationship between the amount of HBV DNA in serum/liver tissue and HGV infection in patients with chronic hepatitis B (CH-B) for exploring the effect of HGV infection on hepatitis B virus (HBV) replication of CH-B.</p><p><b>METHODS</b>HGV RNA in serum, HGV nonstructural region 5 (NS5) antigen (HGV Ag) in liver tissue and the amount of HBV DNA in serum, liver tissue were detected for 56 patients with CH-B by reverse transcription-polymerase chain reaction (RT-PCR) assay, peroxidase antiperoxidase (PAP) immunohistochemical method and fluorescence quantitative PCR assay, respectively. Then the relationship between HGV Ag expression in liver tissue and HGV RNA expression in serum was analysed and the amount of HBV DNA in serum and liver tissues from the serum HGV RNA or liver tissue HGV Ag positive patients were compared with those of the serum HGV-RNA or liver tissue HGV Ag negative patients, respectively.</p><p><b>RESULTS</b>Ten (17.9%) and eight (14.3%) patients were positive for serum and liver tissues,respectively.HGV RNA expression in serum was closely related to HGV Ag expression in liver tissues, but there was HGV RNA in serum from some of the liver tissues HGV Ag negative patients ?cases of HGV RNA and HGV Ag positive or negative,HGV RNA positive but HGV Ag negative, HGV RNA negative but HGV Ag positive, respectively: 5,43,5,3,(P<0.01). There was no significant difference in the amount of HBV DNA in serum and liver tissues between HGV RNA or HGV Ag positive and negative patients (P>0.05).</p><p><b>CONCLUSIONS</b>HGV infection may not affect HBV replication. Liver is the site of HGV replication, but HGV probably also replicates in extrahepatic tissues. HGV hepatic pathogenicity is probably mild and further studies are still needed.</p>

Primary Alverolar Bone Sarcoma ( A Report of 4 Cases and Review of the Literature) / 实用放射学杂志

Objective To discuss the clinical and X-ray representations and to improve the knowledge of primary alveolar sarcoma of the bone . Methods The manifestaion of 4 patients with primary alveolar sarcoma of the bone comfirmed by operation and pathology were analyzed retrospectively and relevant literature were reviewed.Results The tumors often located in the long tubular bone and most of them were occurred at the lower limb, The main X-ray features were osteolytic and expansive bone destruction, periosteal reaction was usually absent but soft tissue mass commonly occurred. Pathological characteristics were of typical tumor cell of the aggregating to form solid hest-like or alveolar structure. Conclusion The tumors is rare, this neoplasm is lack of characteristic X-ray features and the finial diagnosis depends on pathology.

Multi-slice Spiral CT Diagnosis of Spondyloschisis / 实用放射学杂志

Objective To study multi-slice spiral CT(MSCT) manifestations of spondyloschisis.Methods 40 patients with spondyloschisis were examined with MSCT scan and 3D reconstruction.Results In the 40 cases,CT scans showed spondyloschisis of the lumbar in L_2(1/40),L_3(1/40),L_4(10/40),L_5 spondyloschisis of the lumbar in L_2(1/40),L_3(1/40),L_4(10/10),L_5(28/40).MSCT displayed:the ring-scission sign(100%),the pseudo-bulging of lumbar intervertebral disc and the elongated sign of spinal canal(95%),and the wavered sign of vertebral body(12.5%).The location,shape of spondyloschisis and the degree of spondylolisthesis were demonstrated by MSCT on multiplanar and 3D.Conclusion The ring-scission sign is the specific sign in diagnosing the spondyloschisis of the lumbar by MSCT.It is of significant value in the detection of spondyloschisis

Clinical and X-ray Analysis of Primary Reticulosarcoma of Bone / 实用放射学杂志

Objective To study the clinical and X-ray findings of primary reticulocytic sarcoma of bone in order to improve its diagnosis and differential diagnosis.Methods X-ray representations of primary reticulocytic sarcoma of bone in 11 cases proved by operations and pathologies in combination with clinical manifestations were analyzed.Results The tumors located in tubular bone were 5 cases(45%),in vertebra,in costa and pelvis were 2 cases respectively.The main X-ray sign was osteolytic lesion.The soft tissue masses were seen in 7 cases and pathologic fracture in 1 case,only 2 cases appeared lightly periosteal reaction.Conclusion When the osteolytic lesions in company with soft tissue mass are showed on X-ray films,but the clinical symptoms of the disease are not as serious as those of other malignant bone tumors,the bone reticulocytic sarcoma should be considered,and the final diagnosis of the disease desponds on pathologic result.

Applied Value of Radiography and Multi-slice Spiral CT in Congenital Scoliosis / 实用放射学杂志

Objective To evaluate the clinical application of multi-slice spiral CT(MSCT) and X-ray plain film in congenital scoliosis.Methods 40 cases with congenital scoliosis were undergone MSCT scan,the imaging data were reconstructed with maximum intensity projection(MIP),multiple planar reconstruction(MPR),surface shaded display(SSD) and surface volume rendering(SVR),the applied value of these various reconstructed images were analysed comparatively with X-ray plain film.Results Based on the preoperative X-ray plain films,the spinal formation failure,segmentation failure and mixed failure of spine were found in 18,15 and 7 cases respecitvely.However MSCT scan showed that 13 cases had formation failure,12 cases had segmentation failure and 15 cases were mixed failure of spine,and in combination with spinal bifida in 6,rib deformity in 8 and bony ridge inside vertebral canal in 4.The relative features of congenital scoliosis could be comprehensively evaluated by SVR images.Conclusion The reformatted images of MSCT is remarkedly superior to conventional X-ray images in judging the classification and area of spinal deformity accurately.

EFFECTS OF HEPATITIS A VIRUS SUPERINFECTION ON PATIENTS WITH CHRONIC HEPATITIS B(CHB) :A COMPARATIVE STUDY / 解放军医学杂志

0 05)before and after 1 year in patients with and without HAV superinfection. The amount of HBV DNA and HBeAg positive rate in serum from HAV infection recovery stage of patients with CHB were higher than those in acute stage( P