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Objective:To explore the effectiveness of the Shewhart control chart-based assessment and early warning system in prevention of medical device-related pressure injury(MDRPI).Methods:152 critically ill patients admitted to Hebei Central Hospital from January 2020 to December 2021 were selected and divided into a control group and an observation group based on different methods of assessing MDRPI risk,with 76 cases in each group.The control group adopted the Braden scale to assess the risk of MDRPI.The observation group adopted a safety early warning system based on Shewhart control charts to assess the risk of MDRPI in patients.Nursing measures were undertaken according to MDRPI risk grade in both groups.The occurrence of adverse events of MDRPI,nursing safety quality and nursing comprehensive quality were compared between the two groups.Results:The incidence rate of head,neck and face adverse events of MDRPI and the total incidence of adverse events of MDRPI of the patients in the observation group were lower than those in the control group(x2=4.802,5.758,P<0.05).The safety quality and comprehensive quality of nursing of 20 nurses in the observation group were higher than those in the control group(t=6.654,7.172,P<0.05).Conclusion:The application of assessment and early warning system based on Shewhart control chart in clinical nursing management can effectively reduce the incidence of MDRPI adverse events and improve the quality of nursing safety and comprehensive nursing.
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OBJECTIVE:To eval uate the effect of pharmacists intervention on opioid treatment and management in outpatients with cancer pain under multidisciplinary team (MDT)mode. METHODS :Totally 120 outpatients with cancer pain were selected from outpatient department of our hospital from Jan. 2016 to Dec. 2018,and divided into observation group and control group according to random number table method ,with 60 cases in each group. After 1 month follow-up ,patients in the control group were given opioid analgesics and routine intervention according to pain degree ,while patients in the observation group were given same treatment as control group and pharmacist intervention based on MDT. The pain condition ,medication compliance condition , quality of life (QOL)score,the incidence of ADR and satisfaction degree were observed in 2 groups before and after intervention . RESULTS:Follow-up were completed in 2 groups. After intervention ,NRS scores of 2 groups were significantly lower than before intervention;the observation group was significantly lower than the control group ;medication compliance scores and QOL scores of 2 groups were significantly higher than before intervention ,the observation group was significantly higher than the control group at the same time . With the prolongation of treatment time ,the number of patients with mild pain and general medication compliance in 2 groups increased gradually ,and the observation group were significantly higher than the control group at the same time;the number of patients with moderate , severe pain and low medication compliance were significantly decreased gradually , and the observation group was significantly lower than the control group at the same time. The number of patients with good medication compliance in the observation group was significantly higher than that in the same group before intervention and the control group at the same time (P<0.05 or P<0.01). There was no significant difference in the incidence of ADR between 2 groups(P>0.05). The satisfaction of pain control results ,doctors’treatment and pharmacists follow-up in the observation group were significantly higher than control group (P<0.05 or P<0.01). CONCLUSIONS :Under MDT mode ,pharmacists participating in the management of opioid treatment for cancer pain outpatients can effectively relieve the pain ,and improve the medication compliance and quality of life .
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Objective ToevaluatevaluesofADCofDWIinmolecularsubtypeofnonmassenhancedbreastcancerandprovidereference forclinicaltherapeuticplan.Methods Nonmassenhancedbreastcancerincluding46casesofductalcarcinomainsitu(DCIS)and58 casesofinvasiveductalcancer(IDC)wereprovedbyhistopathologyandexperiencedMRIofroutinesequence,DWIanddynamicenhancement.All thepatientsweredividedintobothgroups,DCISgroupandIDCgroup.Accordingtoimmunohistochemicalcharacteristic,molecularsubytpes,Luminal A,LuminalBandnon-Luminalwerefurthergroupedineachgroup.TheADCvaluesoflesionsweremeasuredonADCmapsofb=0s/mm2and b=800s/mm2.TheADCvaluesofnormalbreastgland,DCISandIDC,ofmolecularsubtypeinternaleachgroup,ofsamemolecular subtypebetweengroupswerestatisticallycomparedI.fthedatahadmarkeddifference,ROCcurveofADCvaluesweredrewfortestingtheefficacy diagnosis.Results TheROImeasuredwere104positionsinnormalglands,86inDCISand115inIDCinwhichtheADCwererespectively (1.77±0.27)mm2/s,(1.08±0.14)mm2/sand (0.89±0.15)mm2/sthathadstatisticaldifference.TheADCvaluesofLuminalA, LuminalBandnon-LuminalinDCISwererespectively(11.1±01.5)mm2/s,(1.04±0.13)mm2/sand(1.04±0.13)mm2/sthathadn’tstatistical difference.TheADCvaluesofLuminalA,LuminalBandnon-LuminalinIDCwererespectively(0.95±0.19)mm2/s,(0.87±0.13)mm2/sand (0.84±0.15)mm2/sthathadstatisticaldifference.TheADCvalueshadstatisticaldifferenceinsame molecularsubtypebetween DCISandIDC.InanalysisofROCofIDC,AUCofADCvalueswererespectively0.561,0.632and0.520,theirsensitivity>81%,but specificitywaslower.Conclusion TheADCvaluesofIDCinLuminalA wasmarkedhigherthanLuminalBandADCvaluesofnon-Luminalwaslowest.TheADCvaluesofLuminalA,LuminalBandnon-LuminalinDCISwerehigherthancorrespondingmolecular subtypeofIDCthatmeansADCvaluescouldindicatemolecular subtypeinformationofbreastcancerandprovidereferencefor clinicaltherapeuticplan.
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Objective To observe the effect of Yanshu compound radix sophora injection on the clinical efficacy of patients after interventional embolization for liver cancer rupture and hemorrhage. Methods Sixty-four patients with hepatic cancer rupture and hemorrhage admitted into Department of Hepatobiliary and Pancreatic Surgery in Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology to undergo interventional embolization and hemostasis from January 2013 to December 2017 were retrospectively analyzed. According to whether the Yanshu compound radix sophora injection was used or not after surgery, the patients were divided into two groups: the patients in western medicine routine treatment control group (32 cases) were given blood transfusion, drugs for pain relief, stopping vomiting, liver protection and symptomatic treatment; the patients in Yanshu compound radix sophora injection group (32 cases) were given besides the above western medicine routine treatment, Yanshu compound radix sophora injection 20 mL in 250 mL 0.9% sodium chloride intravenous drip was additionally applied, once a day for consecutive 10 days. The times of postoperative using analgesics, antiemetics and the proportions of occurring myelosuppression, liver function damage tumor re-bleeding, and decrease of alpha-fetoprotein (AFP) level were observed in two groups. Results The times of using analgesics and antiemetics in patients of compound radix sophora injection group were significantly less than those in the routine treatment group [times of using analgesics (times): 3.2±1.2 vs. 7.4±1.3, times of using antiemetics (times): 4.1±1.1 vs. 7.2±1.2, both P < 0.05], the incidences of adverse reactions such as myelosuppression, liver function damage, tumor re-bleeding rate and AFP reduction rate in patients of compound radix sophora injection group were significantly lower than those in the routine treatment group [myelosuppression: 28.1% (9/32) vs. 56.2% (18/32), liver function damage: 9.4% (3/32) vs. 21.9% (7/32), tumor re-bleeding: 3.1% (1/32) vs. 9.4% (3/32), AFP reduction: 21.9% (7 /32) vs. 15.6% (5/32), all P < 0.05]. Conclusion Yanshu compound radix sophora injection combined with interventional embolization for treatment of patients with hepatic cancer rupture and hemorrhage can significantly improve the clinical efficacy, reduce the incidence of adverse reactions and protect liver function.
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Objective To investigate CT,clinical and pathological features of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Methods The clinical,CT and pathological data of 22 patients with pulmonary LELC confirmed by pathology were analyzed retrospectively, including 8 males and 1 4 females whose ages were from 1 8 to 88 years old.Results Among 22 cases,1 2 patients were found by physical examination,2 patients had cough and sputum,7 patients had cough hemoptysis and 1 patient was found by re-examination after breast cancer surgery.On CT,all cases manifested single mass in the lung,and the longer diameters ranged from 1.5 cm to 1 1 cm,in which there were central type tumors in 8 cases and peripheral type tumors in 14 cases.Nineteen masses showed homogeneous density in non-enhanced scan,and the cavity,irregular calcification and small patchy necrosis were seen in each 1 case.After contrast-media injected,masses were mild-moderately or evidently enhanced in 7 cases and 1 5 cases respectively.Eighteen cases had well defined border and unclear border in 4 cases.Vascular encasement were found in 6 central type tumors,8 tumors squeezed peripheral vascular and 8 cases had clear demarcation between tumors and vascular.Nineteen tumors were surgically removed,in which 7 cases appeared metastasis of lymph node.Histopathology showed that the tumor cells had large volumes,unclear boundaries,large nuclei,growing in syncytial nest-like patches.There were abundant lymphocyte and plasma cell infiltration in tumor’s mesenchyma.EBER were done in 1 6 cases and the results were all positive.Conclusion CT feature of pulmonary LELC manifestes that the masses are mostly single,large size, homogeneous density,clearly boundary,shallow lobulated and significantly enhancement.Vascular encasement is the feature of central pulmonary LELC,and peripheral LELC is more likely to occur in the sub-pleural region.Final diagnosis should be combined with clinical and pathological diagnosis.
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Objective To investigate the clinical value of routine MRI and functional imaging modality in the diagnosis of neonatal hypoglycemic encephalopathy.Methods Twelve diagnosed cases of neonatal hypoglycemic encephalopathy were obtained.Routine MRI sequence and DWI and SWI were performed in all cases.The MRI findings of each sequence as well as the sensitivity and the effect of each sequence were analyzed.Results The lesions were mainly located in corpus callosum (1 2 cases)followed by white matter of occipital lobe,frontal lobe and temporal lobe.Bilateral symmetrical distribution was found in 6 cases.The lesions were manifested as dot and flake like shape with different sizes,low signal intensity in T1WI,high in T2WI,bright in DWI and low in ADC maps and low SWI signal lesions.The total number of lesions in each sequence were displayed as follows:31 lesions in DWI,10 lesions in FLAIR,9 lesions in T2WI,6 lesions in T1WI and 5 lesions in SWI.The signal values were 1 898.30±290.46 and 933.71± 450.34 in T2WI and DWI respectively.The signal to noise ratio in T2WI and DWI were 9.28±5.73 and 22.40±15.59 respectively, and the DWI contrast signal ratio was significantly higher than that of T2WI (F=7.48,P=0.012).Conclusion The signal features and distribution of MRI in neonatal hypoglycemic encephalopathy are characteristic.DWI is more sensitive than other sequences in displaying lesions and SWI sequence could detect micro hemorrhagic foci.MRI routine sequence with function imaging is a valuable method for the diagnosis of neonatal hypoglycemic encephalopathy.
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OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.
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PurposeTo evaluate the feasibility and clinical values of CT scan with iterative reconstruction and low radiating dose in craniocerebral trauma.Material and Methods 120 patients suffered from craniocerebral trauma were randomly assigned. All the subjects underwent CT scan using route dose of filtered back projection (FBP) and low dose of iDose (? dose and ? dose), respectively. The quartering were used to subjectively evaluate noise of imaging, skull base artifact, contrast of gyrus-white matter and lesion display in each group. Imaging noise, signal and noise rate (SNR), contrast and noise rate (CNR) of gyrus-white matter and dose length product (DLP) were compared.Results The image quality of both? iDose and ? iDose groups were lower than that of FBP group, but still met the requirement of diagnosis. The image noise of both? iDose and ? iDose groups were higher than that of FBP group (P<0.05). The SNR and CNR of both? iDose and ? iDose groups were lower than those of FBP group (P<0.05). The DLP of both? iDose and ? iDose groups were lower than that of FBP group. There was statistical difference between iDose groups and FBP group (F=2751.46,P<0.05).Conclusion Application of iDose could effectively decrease radiation dose in craniocerebral trauma. Although iDose technique has higher noise level and lower SNR and CNR, the imaging qualities and capability of displaying abnormity meet diagnosis requirement. So that iDose has clinical significance.
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Cell separation technology is an important means for cell sorting and cell-population purification. It is the current international research hot spot in biochemical analysis which has very important applications in many fields such as biology, medicine, agriculture and environment. This review introduces the development status of cell separation using microfluidic chip based on dielectrophoresis. It expounds the working principle of dielectrophoresis and the key factors such as cell size, electrode shape and signals that impacts the dielectrophoresis of cell separation on different types of microfluidic chip. Finally, it forecasts the future development trend of cell separation using microfluidic chip based on dielectrophoresis.
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Objective To analyze the test results of persons with noise -induced hearing loss using disyllabic Mandarin speech test materials (MSTMs) .Methods 57 subjects with noise -induced hearing loss (noise group) were divided into three groups according to the duration of noise exposure :less than 10 years ,between 11 and 20 years and more than 20 years ,and also separated into 2 groups in terms of the degrees of hearing loss (group A :pure tone average thresholds of 0 .5 ,1 ,2 ,and 4 kHz less than or equal to 30 dB HL ,group B:pure tone average threshold of 0 .5 ,1 ,2 ,and 4 kHz greater than 30 dB HL) .66 subjects with normal hearing were in the control group .All the subjects enrolled in this study could speak Mandarin well in their daily life .Nine lists of disyllabic Mandarin speech test materials were utilized to test SRT and P -I function for these groups respectively .Results PTA and SRT in the noise group were much higher than the control group ,the average slope of P -I function was 5 .94% /dB ,and the curve of P-I function moved to the right side .SRT showed obvious changes as the increase of the years of noise exposure and especially in the group which had more than 20 years noise exposure (P<0 .01) . SRT of group B which had more hearing loss were greater than that of group A (P<0 .01) .Conclusion SRTs in the noise group are much higher than the control group with the average slope of P -I functions decreasing and the curve moving to the right side .As the years of noise exposure increase and the degrees of hearing loss become more severe ,SRT rise more apparently .
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Purpose To investigate the effect of sensitivity on image quality and radiation dosage of digital chest radiography. Materials and Methods A total of 300 healthy people undergoing chest X-ray examination were randomly enrolled and divided into two groups according to body weight (150 people with normal weight and 150 overweight), which were further randomly divided into three subgroups (S200 subgroup with low-sensitivity, S400 subgroup with mid-sensitivity, S800 subgroup with high sensitivity, each subgroup contained 50 people). With other parameters unchanged, digital chest photography with different sensitivities was performed to each subgroup (S200, S400 and S800, respectively), and then uploaded the data to PACS and recorded mAs value and dose area product (DAP) value for each time. Then the image quality was assessed by three doctors in terms of mAs value, DAP, image quality score and noise score. Results In all subgroups of normal weight, differences on mAs and DAP were significant (F=1443.191-1829.895, P0.05). In all overweight subgroups, differences in mAs, DAP, image quality score and noise score were significant (F=163.358-290.656, PS400>S800 (F=0.626-3.210, PS400>S800 (F=0.416-1.416, P0.05). In overweight group, there was no difference between subgroups of S200 and S400 (F=0.120-0.145, P>0.05); whilst differences between subgroups of S200 and S800 were significant, the same appeared in subgroups of S400 and S800 (F=1.655-2.360, P<0.05). Conclusion Radiation dose can be effectively controlled by regulating sensitivity with image quality unaffected. It is advisable to choose high-sensitivity photography for patients with normal weight and low or mid-sensitivity photography for overweight patients.
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Objective To lateralize epileptic foci in interictal electroencephalography (EEG) signal by using causal analysis method.Methods On the basis of frequency domain causal analysis,the adapted directed transfer function (ADTF),power spectrum weighted ADTF(psADTF) method was proposed by applying the power spectrum information in defined frequency band with normalized ADTF,to fit the frequency information features of different epileptic wave.EEG signals of two groups of 30 epilepsy patients were analyzed by psADTF.Group Ⅰ included 15 presurgical patients and 104 epilepsy spikes were picked from EEG signals.Group Ⅱ included 15 outpatient patients and 98 epilepsy spikes were picked from EEG signals.Results 96 of 104 spikes of group Ⅰ were lateralized properly by psADTF according to surgery sites,and the accuracy rate was 92%.94 of 98 spikes of group Ⅱ were lateralized properly by psADTF according to three technicians' judgments,with the accuracy rate of 96%.Conclusion Our results proves that the psADTF method over interictal EEG spikes can be a great help to clinical epileptic foci lateralization.
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Flexible print circuit (FPC) technology has been widely applied in variety of electric circuits with high precision due to its advantages, such as low-cost, high specific fabrication ability, and good flexibility, etc. Recently, this technology has also been used in biomedical engineering, especially in the development of microfluidic chip and microelectrode array. The high specific fabrication can help making microelectrode and other micro-structure equipment. And good flexibility allows the micro devices based on FPC technique to be easily packaged with other parts. In addition, it also reduces the damage of microelectrodes to the tissue. In this paper, the application of FPC technology in biomedical engineering is introduced. Moreover, the important parameters of FPC technique and the development trend of prosperous applications is also discussed.
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Ingeniería Biomédica , Métodos , Electricidad , Diseño de Equipo , Dispositivos Laboratorio en un Chip , Microelectrodos , Técnicas Analíticas Microfluídicas , MicrofluídicaRESUMEN
Previously, we found that high doses of genistein show an inhibitory effect on uterine leiomyoma (UtLM) cell proliferation. In this study, using microarray analysis and Ingenuity Pathways Analysis(TM), we identified genes (up- or down-regulated, > or = 1.5 fold, P < or = 0.001), functions and signaling pathways that were altered following treatment with an inhibitory concentration of genistein (50 microg/ml) in UtLM cells. Downregulation of TGF-beta signaling pathway genes, activin A, activin B, Smad3, TGF-beta2 and genes related to cell cycle regulation, with the exception of the upregulation of the CDK inhibitor P15, were identified and validated by real-time RT-PCR studies. Western blot analysis further demonstrated decreased protein expression of activin A and Smad3 in genistein-treated UtLM cells. Moreover, we found that activin A stimulated the growth of UtLM cells, and the inhibitory effect of genistein was partially abrogated in the presence of activin A. Overexpression of activin A and Smad3 were found in tissue samples of leiomyoma compared to matched myometrium, supporting the contribution of activin A and Smad3 in promoting the growth of UtLM cells. Taken together, these results suggest that down-regulation of activin A and Smad3, both members of the TGF-beta pathway, may offer a mechanistic explanation for the inhibitory effect of a high-dose of genistein on UtLM cells, and might be potential therapeutic targets for treatment of clinical cases of uterine leiomyomas.
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Femenino , Humanos , Activinas/genética , Anticarcinógenos/farmacología , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Inhibidor p15 de las Quinasas Dependientes de la Ciclina/genética , Regulación hacia Abajo , Genisteína/farmacología , Leiomioma/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Transducción de Señal/efectos de los fármacos , Proteína smad3/genética , Factor de Crecimiento Transformador beta/genética , Regulación hacia Arriba , Neoplasias Uterinas/metabolismoRESUMEN
How does brain select and adjust the distributed neural activities to achieve its function? To address this problem,researchers introduce Granger causality analysis method to brain functional study,which deals with the estimation of causal influences among multi-variables.First,basic principles of Granger Causality and its improved algorithm structural vector autoregression (SVAR) are introduced.Then several technical problems are reviewed which should be noted when analyzing brain functional signals by Granger Causality Methods.In the end,the application foreground of Granger Causality in epilepsy localization is introduced by taking idiopathic generalized epilepsy as the example.
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The power and signal transmission technology is one of the key technologies in neuroprosthetic research. This paper proposes firstly the related theory of power and signal transmission technology in neuroprosthetic, then summarizes the three key aspects of the power and signal transmission technology in neuroprosthetic. After analyzed the development of the inductive wireless power harvesting technology, the wireless telemetry technology and the wireless power harvesting telemetry technology, the emphasis on research contents will be proposed and discussed, which will help accelerate the further research of prosthetic.
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Humanos , Suministros de Energía Eléctrica , Electrodos Implantados , Prótesis Neurales , Diseño de Prótesis , Procesamiento de Señales Asistido por Computador , Telemetría , Tecnología InalámbricaRESUMEN
Objective To implement visualization and surgical simulation of female pelvis based on virtual reality. Methods The successive cross-section images of pelvic part from a Chinese Visible Human (CVH) dataset were adopted. The important organs in pelvis were segmented initially. Then the VRML-based visualization and Dextrobeam-based virtual surgery simulation were carried out. Results A networked pelvic model and a surgical model were constructed with virtual reality techniques. The organs and structures in pelvis could be displayed clearly and the simulated surgical operations could be performed. Conclusion The application of virtual reality techniques can facilitate the anatomical teaching and surgery design. More significantly, a realistic practice platform will be provided for medical education and training.
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Objective To investigate the variation law of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in patients with cerebral infarction, and to explore the relationship between the changes and the prognosis of cerebral infarct patients. Methods Sixteen patients with cerebral infarction were recruited and divided into 2 groups:good recovery and poor rehabilitation. ADC and FA values were calculated in infarct areas and control areas which were the regions with symmetrical position and the same area as infarct areas. The difference of ADC and FA values in patients at acute and earlier chronic stage between the two areas were analyzed. Results ①At acute stage, ADC values in infarct areas were lower than those in control areas (P0.05), moreover ADC values were higher than that at acute phase (P0.05). Conclusion There are certainly rules in changes of ADC and FA values in patients with cerebral infarction at acute and earlier chronic stage.
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Remote controlled capsule (RCC) has been extensively used in the field of site-specific drug delivery. It is a potent tool to study the regional drug absorption of the gastrointestinal (GI) tract that provides pharmaceutical scientists with significant pharmacokinetics data for oral drug formulation development. In present investigations, a patented novel RCC has been devised based on micro-electronic mechanical system (MEMS) technology. Micro-thrusters were for the first time exploited as drug release actuators of RCCs. As the micro-thruster is ignited by a radio frequency (RF) signal, the thrust force generated by the propellants pushes the piston forward and leads to a rapid and complete expulsion of therapeutic agents from the capsule. The micro-thruster merely consumes 120 mW for ignition and the duration time of drug release is decreased to less than 1 s. The feasibility of the novel RCC was evaluated through animal experiments in beagles using aminophylline as the model drug. The novel RCC developed is a promising alternative for site-specific drug delivery in human GI tract.
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Aminofilina/administración & dosificación , Sistemas de Liberación de Medicamentos , Tracto Gastrointestinal/metabolismo , Sistemas Microelectromecánicos , Robótica , Tecnología Farmacéutica/métodos , Administración Oral , Aminofilina/farmacocinética , Animales , Cápsulas , Perros , Sistemas de Liberación de Medicamentos/instrumentación , Diseño de Equipo , Estudios de Factibilidad , Humanos , Absorción Intestinal , Sistemas Microelectromecánicos/instrumentación , Proyectos Piloto , Robótica/instrumentación , Solubilidad , Tecnología Farmacéutica/instrumentaciónRESUMEN
As an important human body sound signal, heart sound is of great value in the researches on diagnostics of heart diseases. This study sought to explore the methods of transmitting heart sound through the telephone correspondence system for simultaneous telemetering cardiac contractility and heart rate. Heart sounds were transmitted from a phone to another phone with 4 modes, the wirelessly transmitted distance between the two phones being 5 m, 10 km, and 1000 km, respectively. The results of experiments show that telemetering cardiac contractility and heart rate can be realized by the telephone correspondence system. Such methods have the advantages of being noninvasive, inexpensive, rapid and convenient; moreover, they can be used repeatedly and be available for in-home use.