组间波形相似度及在中医推拿?法 垂直作用力信号分析中的应用

目的 研究表征同类信号不同组间波形相似程度的定量指标,并应用于中医推拿?法垂直作用力信号分析。方法 对两列同类周期信号序列归一化和波形误差分析后,定义表征同类信号不同组间波形相似程度的组间波形相似度。实测著名推拿医师、已学习中医?法一段时间的研究生和?法初学者3组操作者的法垂直作用力信号,计算3组信号的组间波形相似度,分析他们的相似程度。结果 数位推拿医师之间的?法垂直作用力信号组间波形相似度较高,可作为其他?法垂直作用力信号与之比较的模板,研究生和医师之间的相似度次之,初学者与医师之间的相似度最低,三者有显著性差异。结论 本文提出的组间波形相似度可以作为评判中医推拿?法垂直作用力信号不同组间波形相似程度的定量指标,也可应用于其他近周期信号组间波形的相似程度评判。     

人工心瓣脉动流试验中,主动脉根部压力、流量波形重建的实验研究

本文针对目前国内外在人工心瓣体外脉动流试验中,难以直接、准确地检测模拟主动脉根部压力、流量波形的状况,对可能导致的测试结果非客观、可比性问题进行了脉动流实验研究,并依据前文所建立的理论方法,对在现有人工心瓣体外脉动流检测装置上重建可消除测点后移误差的主动脉根部压力、流量波形,进行了流体力学实验模拟研究。     

基于脉搏波的新型血压与血管硬度测量仪的研制

目的：根据脉搏波理论研制出一种新型血压与血管硬度测量仪。方法：利用示波法原理在波形特征法和幅度系数法的基础上提出一种系数差分比值法来间接测量血压的新方法，通过采集肱动脉和桡动脉两处波形，获得了脉搏波传播速度（PWv）、动脉顺应性（C1、C2）和动脉硬化指数（ASI）三个反映受试者动脉弹性的参数指标。结果：通过大量病例分析和临床测试证实了算法的有效性和可靠性，而且此算法已经应用LabVIEW开发成软件并在医院进行临床应用。结论：血压与血管硬度检测仪能判断心血管病患者与正常人的差异性，对我国心血管病方面流行病学的调查、疾病预防、疾病早期发现都具有很大的意义。     

基于小波变换的充气法测量血压的算法研究

目的探索腕部充气测量血压的方法及原理,实现小波变换提取脉搏波以及无创血压的计算,为现有腕式电子血压计提供更精确的算法。方法采用小波变换对采集的袖带脉搏压力混合信号进行去噪处理,并分离脉搏波与袖带压。在此基础上采用差分法与阈值法寻找脉搏波峰值点并修正波形干扰点,再对脉搏波峰值点进行高斯曲线拟合法拟合出平滑包络线,并采用改进的幅度系数法进行收缩压、舒张压的计算,并对30名测试者用本方法与听诊法进行对比测试,观察相关性。结果该方法的测试结果与听诊法对比相关性良好,测量血压速度快,舒适度高。结论基于小波变换的充气法测量血压的算法相比传统方法去噪效果好,脉搏波提取精确度高,血压计算结果符合AAMI标准,但需在软件处理算法中做进一步简化研究。     

动脉压力波形分析在麻醉诱导期的应用

为探索动脉波形分析方法的临床意义，使用波形分离法与储存压力波模型对采集到的25例进行全麻手术的高龄患者的动脉压力波形进行波形分析，在获得[Pf]、[Pb]以及[Pe]、[Pr]等波形形态参数后，将诱导前后的参数变化量与临床生命指标变化量进行相关性分析。在本文的研究群体中，波形分离法与储存压力波模型的参数均与诱导中的血压和心率变化量有相关性，其中△[Pe]与临床指标△PP相关系数最高（r=0.926）。从生理病理学的角度对波形参数的变化进行解读，旨在探索波形分析在诱导期对全麻患者麻醉水平的应用价值，可为动脉压力波形分析及其应用提供新的理论基础和技术方案。     

人工心瓣脉动流模拟试验中,主动脉根部压力、流量波形重建的理论与方法

本文针对目前国内外在人工心瓣体外脉动流试验中难以直接、准确地检测模拟主动脉根部压力、流量波形,从而影响测试结果的客观性、可比性的问题,提出了一种方法,可在现有人工心瓣体外脉动流检测装置上重建主动脉根部假想进口流动已充分发展、未受瓣膜扰动时的压力、流量波形。该方法具有数学处理简便、快速、适应性强、较为准确的特点。     

一种改进的模板匹配算法及其在ECG波形识别中的应用

基于相关系数的模板匹配算法无法区分波形信号f(t)与nf(t),因为模板p(t)与f(t)和nf(t)之间的相关系数相等。本研究提出一种改进的相关性算法,使得模板与信号进行匹配运算后得到的系数c∈[-1,1],并且只有在p(t)=f(t)时c值为1。利用此方法分别对ECG的R波和T波进行识别,可准确地区分R波和T波,并可确定模板波形的检测点。此方法与基于相关系数的模板匹配算法相比具有较好的波形检测特异性,可应用于各个领域的波形识别。     

一种基于几何特征的ECG波形识别算法

目的 ECG自动分析系统由两部分组成:波形识别和智能诊断。在实际应用中,心电波形识别是该系统的关键。波形识别的精确性和可靠性决定了心脏病诊断的可靠性。为提高波形识别的速率及准确度,本文提出一种基于几何特征的ECG波形识别算法。方法首先利用数字滤波算法对信号进行预处理,提高信号的信噪比,然后通过改进的二阶导数计算出数据的几何特征:点的斜率和运动趋势,并在此基础上,结合ECG波形的实际物理特征,利用算法实现T波、P波、QRS波群的起点、终点以及波峰波谷的自动识别。结果统计分析结果表明,本算法能够快速高效地识别ECG波形。同时将该算法与其他当前各种ECG波形识别算法进行对比,该识别算法在识别的精确性与阳性预测值方面具有更好的性能。结论本文提出的基于几何特征的ECG波形识别算法可以进一步提高当前ECG波形识别算法的性能。     

用有创血压验证示波法测量血压的准确性

本文用山羊有创血压作对比研究了示波法无创测量血压的准确性.示波法一般通过袖带放气过程中脉搏波包络线顶点来估计平均压,而用幅度系数算法来估计收缩压和舒张压.虽然示波法能提供较为准确的平均压,但是估计收缩压和舒张压却存在较大误差.用5只山羊进行了试验,以研究幅度系数在不同个体之间的变异性.在用示波法测量山羊血压的同时记录山羊的有创血压.根据放气过程中的袖带内脉搏波包络线和用有创法得到的收缩压和舒张压,计算出每只羊的幅度系数.结果显示5只羊的幅度系数呈现出较大的离散性.究其根源在于,幅度系数法采用的系数是用统计方法得到的,它针对群体而不是个体,是一种经验算法.采用幅度系数算法的示波法血压测量技术不够准确,必须寻找一种新的血压测量方法.     

基于奇异值矩阵分解的腕式示波法血压测量算法

为了减小因手腕部生理结构导致腕式示波法测量中存在的内在干扰,本文提出一种基于奇异值矩阵分解(SVD)的新型曲线拟合算法(SCFA),用于提高测量精度。该方法是通过对腕式示波法测量的波形数据进行SVD,提取出主要特征成分,并对该波形成分应用曲线拟合算法(CFA)计算出血压值。根据对45例样本的测量和数据分析,以听诊法(AM)测量值为参照,基于新算法计算的血压值与测量值之间的相关系数为0.96。对比传统的曲线拟合算法(TCFA)计算值,新算法的结果更为准确。实验结果表明,SCFA能够部分消除腕式示波法血压测量过程中的内在干扰,有效的提高腕式血压测量的准确度。     

A Technical Assessment of Pulse Wave Velocity Algorithms Applied to Non-invasive Arterial Waveforms

Non-invasive assessment of arterial stiffness through pulse wave velocity (PWV) analysis is becoming common clinical practice. However, the effects of measurement noise, temporal resolution and similarity of the two waveforms used for PWV calculation upon accuracy and variability are unknown. We studied these effects upon PWV estimates given by foot-to-foot, least squared difference, and cross-correlation algorithms. We assessed accuracy using numerically generated blood pressure and flow waveforms for which the theoretical PWV was known to compare with the algorithm estimates. We assessed variability using clinical measurements in 28 human subjects. Wave shape similarity was quantified using a cross correlation-coefficient (CC_Coefficient), which decreases with increasing distance between waveform measurements sites. Based on our results, we propose the following criteria to identify the most accurate and least variable algorithm given the noise, resolution and CC_Coefficient of the measured waveforms. (1) Use foot-to-foot when the noise-to-signal ratio ≤10%, and/or temporal resolution ≥100 Hz. Otherwise (2) use a least squares differencing method applied to the systolic upstroke.     

Pressure and volume measurements from the eye for detecting possible arterial obstruction

Detection and evaluation of functionally significant carotid occlusive disease are effectively achieved by noninvasive pressure and/or volume measurements from the eye. Ocular arterial blood pressure is measured by applying either direct compression or suction to evaluate intraocular pressure to the point of arterial collapse. Carotid blood flow is evaluated as it affects ocular volume waveforms, which result from the difference between pulsatile arterial flow and relatively constant venous flow. The relationship between noninvasive measurements from the eyes and carotid blood flow can be predicted using simple models of the cervical-cerebral circulatory system. Proper models verify clinically observed correlations between pressure and volume measurements from the eye and the underlying carotid occlusive disease. Electrical analog circuits provide a method for varying model parameters to simulate abnormalities, producing waveforms with good similarity to waveforms recorded from patients with known vascular or ophthalmic pathology. Further model refinements can be contributed by interested investigators. By using the improved models the strengths and weaknesses of current tests and techniques can then be better defined. Techniques that have been widely used for screening and evaluating potential stroke patients can thereby be modified to give improved functional analysis of these patients.     

锥形血管内血液脉动流的数值模拟

将锥形血管与人体血液的脉动流动联系起来研究发展中的血液流动问题 ,给出了锥形血管的几何模型、血液流动的理论模型、生理边界条件以及计算条件 ;根据人体生理脉动流条件 ,建立了血流平均速度函数 ,并就此对三维锥形血管内的血液脉动流动进行了数值模拟 ,获得心动周期不同时刻的轴向速度、径向速度、断面压力和轴向压力分布曲线。将数值模拟计算结果与实验和分析计算结果进行对照 ,讨论了锥形血管内血液脉动流的特点。     

A numerical investigation on the steady and pulsatile flow characteristics in axi-symmetric abdominal aortic aneurysm models with some experimental evaluation

Steady and pulsatile flow characteristics in rigid abdominal aortic aneurysm (AAA) models were investigated computationally (using Fluent v. 4.3) over a range of Reynolds number (from 200 to 1600) and Womersley number (from 17 to 22). Some comparisons with measurements obtained by particle image velocimetry under the pulsatile flow conditions are also included. A sinusoidal inlet flow waveform 1 + sin omega t with thin inlet boundary layers was used to produce the required pulsatile flow conditions. The bulk features of the mean flow as well as some detailed features, such as wall shear stress distributions, are the foci of the present investigation. Recirculating vortices appeared at different phases of a flow cycle causing significant spatial and temporal variations in wall shear stresses and static pressure distributions. A high level of shear stresses usually appeared at the upstream and downstream ends of the bulge. Effects of pressure rise caused by the increase in cross-sectional area were transmitted into the downstream tube. Further simulation studies were conducted using simulated physiological waveforms under resting and exercise conditions so as to determine the possible implication of vortex dynamics inside the AAA model.     

A numerical investigation on the steady and pulsatile flow characteristics in axi-symmetric abdominal aortic aneurysm models with some experimental evaluation

Steady and pulsatile flow characteristics in rigid abdominal aortic aneurysm (AAA)models were investigated computationally (using Fluent v.4.3) over a range of Reynolds number (from 200 to 1600)and Womersley number (from 17 to 22). Some comparisons with measurements obtained by particle image velocimetry under the pulsatile flow conditions are also included. A sinusoidal inlet flow waveform 1+sin omega t with thin inlet boundary layers was used to produce the required pulsatile flow conditions. The bulk features of the mean flow as well as some detailed features, such as wall shear stress distributions, are the foci of the present investigation. Recirculating vortices appeared at different phases of a flow cycle causing significant spatial and temporal variations in wall shear stresses and static pressure distributions. A high level of shear stresses usually appeared at the upstream and downstream ends of the bulge. Effects of pressure rise caused by the increase in crosssectional area were transmitted into the downstream tube. Further simulation studies were conducted using simulated physiological waveforms under resting and exercise conditions so as to determine the possible implication of vortex dynamics inside the AAA model.     

分岔动脉血管脉动血流的动力学分析

通过分析血管性肺癌介入治疗的特性，建立了分岔动脉血管二维几何模型和动脉血流平均流速脉动流模型。基于SMPLE算法对分岔动脉血管脉动血流的动力学进行了数值模拟，获得用导管注射药液时血液流场的变化情况。结果表明，建立的典型几何模型和血液平均流速脉动流模型可较好地分析临床上观察到的血流动力学现象，能反映分岔动脉血管脉动流的特点。为实施进一步数值模拟提供了可靠的前提，此项研究的计算结果也为优化血管性介入治疗等提供了血流动力学依据。     

Flow pumping system for physiological waveforms

A pulsatile flow pumping system is developed to replicate flow waveforms with reasonable accuracy for experiments simulating physiological blood flows at numerous points in the body. The system divides the task of flow waveform generation between two pumps: a gear pump generates the mean component and a piston pump generates the oscillatory component. The system is driven by two programmable servo controllers. The frequency response of the system is used to characterize its operation. The system has been successfully tested in vascular flow experiments where sinusoidal, carotid, and coronary flow waveforms are replicated.     

基于电磁驱动的体外膜肺氧合搏动式泵血系统

根据电磁学原理建立梯度线圈-永磁体模型,本研究设计了一款新型电磁驱动搏动式血泵,主要包括驱动装置、泵头装置、冷却系统以及体外循环管路等。搏动式血泵运动速率接近正常人体心率,模仿心脏的节律跳动,产生搏动式血流,实现了搏动式泵血。通过搭建实验平台,采集基于电磁驱动的体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)搏动式泵血系统的流量、压力和动脉压力波形等参数。结果表明,基于电磁驱动的ECMO搏动式泵血系统的相关性能基本满足ECMO辅助循环需求,达到了动脉压力波形拟合和搏动灌注的目的,对于体外循环的发展具有重要意义。     

Quantification of pulsatility as a function of vascular input impedance: an in vitro study

The physiological benefits of pulsatility generated by ventricular assist device (VAD) support continue to be heavily debated as application of VAD support has been expanded to include destination and recovery therapies. In this study, the relationship between input impedance (Zart) and vascular pulsatility during continuous flow (CF) or pulsatile flow (PF) VAD support was investigated. Hemodynamic waveforms were recorded at baseline failure and with 50%, 75%, and 100% CF or PF VAD support for nine different Zart test conditions (combination of three different resistance and compliance settings) in a mock circulatory system simulating left ventricular failure. High-fidelity hemodynamic pressure and flow waveforms were recorded to calculate mean arterial pressure (MAP), Zart, energy equivalent pressure (EEP), and surplus hemodynamic energy (SHE) as metrics for quantifying vascular pulsatility. MAP and EEP were elevated with increasing resistance whereas SHE was reduced with increasing compliance. Vascular pulsatility was restored with increasing PF VAD support, but diminished by up to 90% with increasing CF VAD support. The nonpulsatile energy component (MAP) of the pressure waveform is dependent on resistance whereas the pulsatile energy component (SHE) is dependent on compliance. The impact of Zart and vascular pulsatility on patient recovery with VAD support warrants further investigation.     

Unconstrained detection of respiration rhythm and pulse rate with one under-pillow sensor during sleep

A completely non-invasive and unconstrained method is proposed to detect respiration rhythm and pulse rate during sleep. By employing wavelet transformation (WT), waveforms corresponding to the respiration rhythm and pulse rate can be extracted from a pulsatile pressure signal acquired by a pressure sensor under a pillow. The respiration rhythm was obtained by an upward zero-crossing point detection algorithm from the respiration-related waveform reconstructed from the WT 2⁶ scale approximation, and the pulse rate was estimated by a peak point detection algorithm from the pulse-related waveform reconstructed from the WT 2⁴ and 2⁵ scale details. The finger photo-electric plethysmogram (FPP) and nasal thermistor signals were recorded simultaneously as reference signals. The reference pulse rate and respiration rhythm were detected with the peak and upward zero-crossing point detection algorithm. This method was verified using about 24 h of data collected from 13 healthy subjects. The results showed that, compared with the reference data, the average error rates were 3.03% false negative and 1.47% false positive for pulse rate detection in the extracted pulse waveform. Similarly, 4.58% false negative and 3.07% false positive were obtained for respiration rhythm detection in the extracted respiration waveform. This study suggests that the proposed method is suitable, in sleep monitoring, for the diagnosis of sleep apnoea or sudden death syndrome.