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.

1.5 T Nuclear Magnetic Resonance Imaging System Failure Treatment and Rectification Summary / 中国医疗器械杂志

Quench of magnetic resonance imaging system refers to the process that the superconducting condition inside the magnet is destroyed due to some reason. The large current stored in the coil is quickly converted into heat at the place where the resistance is formed, and a large amount of liquid helium in the magnet is evaporated. If it happens, it will cause huge loss to the user. We introduce the real cases of 1.5 T magnetic resonance imaging system's quench fault, maintenance treatment and management improvement, which can be used for reference by various medical institutions, so as to better strengthen the operation and maintenance management of magnetic resonance imaging system, so as to avoid the occurrence of out of tolerance fault, and do a good job in the guarantee work after the out of tolerance fault.

Management of a bi-caval dual lumen cannula clot obstruction after TEE guided diagnosis: a case report / Conduta em obstrução por coágulo em cânula de duplo lúmen bicaval após diagnóstico guiado por ETE: relato de caso

Abstract Background: Veno-venous extracorporeal membrane oxygenation is an established therapy for patients with refractory acute respiratory distress syndrome (ARDS). One complication related to the use of veno-venous extracorporeal membrane oxygenation is thrombosis despite proper anticoagulation. We report the diagnosis and management of a clot-obstruction in a single site cannula placed through the internal jugular vein, guided by transesophageal echocardiography. Case report: A 39 year-old male developed acute respiratory distress syndrome and hemodynamic instability after an episode of pulmonary aspiration in the ICU. Eight hours after placement of a single site veno-venous extracorporeal membrane oxygenation, suddenly the perfusionist noticed a reduction in flow. TEE showed a thrombus-like mass obstructing the inflow port in SVC and inflow at IVC was intact. After unsuccessful attempts to reposition the cannula, the team decided to insert additional femoral inflow cannula through the IVC. The single site catheter was then pulled out until its tip was positioned in the right atrium and all three ports of the catheter were switched to the infusion ports. After this, flows and oxygenation improved significantly. Unfortunately, despite all of the efforts, the patient died 2 days later. Discussion: The diagnosis of veno-venous extracorporeal membrane oxygenation cannula obstruction is based on reduced inflow rates, hemodynamic instability and poor oxygenation of blood. TEE allows evaluation of the flows inside the cannula and in this case, an obstruction was found. The management presented points to the fact that in a situation of catheter obstruction caused by a clot, there is a feasible alternative to assure minimal interruption of the hemodynamic support offered by the veno-venous extracorporeal membrane oxygenation.

Resumo Justificativa: A oxigenação por membrana extracorpórea veno-venosa é terapia estabelecida para pacientes com a síndrome do desconforto respiratório agudo. Uma complicação relacionada ao uso da oxigenação por membrana extracorpórea veno-venosa é trombose apesar de anti-coagulação adequada. Relatamos o diagnóstico e conduta em obstrução por coágulo em cânula de acesso único inserida pela veia jugular interna, guiada por ecocardiografia transesofageana. Relato de caso: Paciente do sexo masculino de 39 anos desenvolveu síndrome do desconforto respiratório agudo e instabilidade hemodinâmica após episódio de aspiração pulmonar na UTI. Oito horas após a instalação de oxigenação por membrana extracorpórea veno-venosa de acesso único, o perfusionista notou repentina redução no fluxo. A ETE revelou massa semelhante a um trombo obstruindo o portal de fluxo de entrada na VCS e o fluxo de saída na VCI estava intacto. Após tentativas sem sucesso para reposicionar a cânula, a equipe decidiu inserir cânula de entrada de fluxo adicional pela VCI. O catéter de acesso único foi, então, puxado até que sua ponta se posicionasse no átrio direito e todos os três portais do catéter fossem transferidos para os portais de infusão. A seguir, os fluxos e oxigenação melhoraram significativamente. Infelizmente, apesar dos esforços, o paciente foi a óbito 2 dias depois. Discussão: O diagnóstico de obstrução de cânula da oxigenação por membrana extracorpórea veno-venosa se baseia em velocidades reduzidas de entrada de fluxo, instabilidade hemodinâmica e oxigenação pobre do sangue. A ETE permite a avaliação dos fluxos dentro da cânula, e nesse caso foi encontrada obstrução. A técnica apresentada aponta para o fato de que em situação de obstrução de catéter causada por coágulo, existe alternativa factível para garantir interrrupção mínima do suporte hemodinâmico oferecido pela oxigenação por membrana extracorpórea veno-venosa.

Versa HD Volume-modulated Accelerator High Voltage Circuit Fault Maintenance / 中国医疗器械杂志

This paper introduces a fast repair methods of Versa HD volume-modulated accelerator's high voltage circuit fault:the key points test method. To identify five key points:①Enter maintenance mode to check for AFC deviation; ② The magnetron waveform MI and PFN waveform PFN V are detected on the maintenance terminal board; ③ Detect thyratron waveform; ④ Check the supply voltage of thyratron; ⑤ HT PSU 600 V DC test 600 V normal or not. The waveform or voltage is also measured to efficiently narrow the fault range to find out the cause of the fault, quickly remove the fault.

Varian Ⅸ accelerator kV class CBCT image ring-shaped artifact troubleshooting / 中华放射肿瘤学杂志

The hardware and software faults in the image guidance system may cause ring-shaped artifacts,which is more commonly induced by the aging of the hardware.During troubleshooting,the first step should be checking whether there are obvious faults in the basic hardware.Subsequently,OBI background image is collected to confirm the bad point status.If the bad point is not shielded,it can be compensated by updating the image processing bad point.The invoked Pixel Correction Maps are adopted compensate for the bad point and calibrate the image.If it is still unable to repair,replacing the detection board can be considered.Cone-beam CT (CBCT) image guidance system is an important approach to verify the position orientation and positioning accuracy in modem radiotherapy,which effectively guarantees for the safety and accuracy of radiotherapy.We should fully understand its law of aging,maintain the equipment on a regular basis and verify the image quality to ensure the normal operation of the equipment.

The discussion of the methods on troubleshooting of networking malfunction for mindray iPM-9800 central monitoring system / 中国医学装备

Objective:Common troubleshooting methods of networking malfunction for central monitoring system were discussed in order to realize its safe application of networking central monitoring system.Methods: Time calibration server and necessary conditions of network for central monitoring system were discussed and analyzed. In addition, practical troubleshooting and maintenance methods were proposed to solve the networking malfunction between a bedside monitor of Mindray iPM-9800 and its central workstation.Results: Smooth operation of networking central monitoring system could simultaneously obtain physiological parameters of several patients, thus largely improving the efficiency of medical staffs.Conclusion: Safe operation of networking central monitoring system could ensure the accuracy of real-time monitoring information of patients and improve hospital’s management level of network and informatization.

How to develop an in-house real-time quantitative cytomegalovirus polymerase chain reaction: Insights from a cancer centre in Eastern India.

Development of a reliable, cost-effective cytomegalovirus quantitative polymerase chain reaction (QPCR) is a priority for developing countries. Manufactured kits are expensive, and availability can be inconsistent. Development of an in-house QPCR kit that is reliable and quality assured requires significant effort and initial investment. However, the rewards of such an enterprise are manifold and include an in-depth understanding of molecular reactions, and expertise in the development of further low-cost molecular kits. The experience of an oncology centre in Eastern India has been shared. Hopefully, this would provide a brief roadmap for such an initiative. Staff with adequate understanding of molecular processes are essential along with vital infrastructure for molecular research and development.

Research on the common troubles and basic principle of TCL-II injection pump / 中国医学装备

To introduce the basic working principle of TCL - II medical injection pump, the detailed description of the power circuit and motor drive circuit. According to the basic principle of each function, it gave the corresponding circuit diagram for peer reference. Injection pump in the maintenance can use this typical working principle and the typical electronic circuit to realize the common troubleshooting quickly and accurately.

Principle, maintenance and troubleshooting of medical X-ray machine / 中国医学装备

With the development of modern technology,X-ray machine has been widely applied for medical diagnosis.The article simply reported the principle of medical X-ray machine and its maintenance,and also illustrated two troubleshooting cases of Siemens'X-ray machine.

Principle and troubleshooting of pneumatic tube system named Sumetzberger NW160 / 医疗卫生装备

This paper introduces the working principle and structure of a pneumatic tube system named Sumetzberger NW160.Common failures are also discussed.

Quality check of blood-pressure meter and troubleshooting / 医疗卫生装备

This paper expounds the relation between the quality of the blood-pressure meter and the quality of the medical treatment.The good quality of the blood-pressure meter is the basic quality insurance for the medical treatment system.This paper also introduces the method of quality check for the blood-pressure meter and the troubleshooting.