医院船医疗队虚拟手术训练平台的设计与应用研究

受各种客观条件限制,海上医疗队不能开展大量跨学科专业的、针对海上特殊环境条件下的手术操作训练。为了解决上述问题,采用集成力反馈交互设备、图形工作站、三维立体显示等硬件设备,研发相关虚拟手术仿真系统软件,设计和建立了软硬件结合,可模拟不同海况环境条件,人机交互的虚拟手术训练平台。通过该系统的应用,提高了海战救治技能训练的针对性、有效性,从而更有利于提高海上医疗救治能力。     

医疗救护艇医疗队陆上模拟训练分析

1 模拟训练的目的 （1）作为对接训练的预备性训练：预备性训练可有效地完成对接训练的准备工作,包括人员抽组、思想动员、体能训练、物资筹措、计划制定及海上环境模拟训练等,尤其是理论准备,可缩短对接训练时间,提高对接训练有效率。（2）作为对接训练的补充训练：依托医疗救护艇平台的对接训练,与完成近岸和海峡内海上伤员医疗救护任务有一定差距,对于医疗队员救治能力的形成有一定的局限性。通过医院平时医疗救治平台,进行有针对性的医疗救治能力训练,     

美军卫勤模拟仿真发展与启示

目的探讨美军卫勤模拟仿真的发展现状及对我军的启示。方法采用情报调研、文献计量、知识图谱等方法,分析美军卫勤模拟仿真的基本概念、体系框架、科研分布和重点领域。结果美军卫勤模拟仿真发展较为成熟,其全球影响力正逐渐扩大;美国空军和海军是从事卫勤模拟仿真研究最为重要的机构,与英国和加拿大军队也有一定的合作;美军卫勤模拟仿真研究的重点领域包括卫勤指挥模拟仿真和医疗救治模拟训练。结论我军应借鉴美军卫勤模拟仿真的成功经验,构建标准化平台,加强与地方高水平科研机构合作,围绕目前亟需解决的卫勤保障问题开展研究。     

电子计算机在海军卫勤中的应用

本文概要地介绍了电子计算机在海军卫勤中的应用情况：国外主要用于卫勤信息处理，流行病预测，战伤救治系统，急腹症等辅助诊断，舰艇“人－机－环境”综合鉴定系统，作战卫勤保护模拟等，国内已取得的成果有《海上袭击战卫勤保障预案》软件（已获军队进步三等奖，《海上医疗后送计算机模拟系统》的研究等，并为管理、数学和训练所用。     

医院船不同运动姿态条件下外科手术技术筛选研究

目的 研究医院船不同运动姿态条件与适宜采用的外科手术、手术时间及手术成功率的关系.方法 通过文献调研、专家咨询和多组交叉对照WILLIAMS设计建立实验动物模型的方法,以陆基、六自由度模拟舱和920型医院船手术室为实验平台,制订医院船动物手术实验能力综合评分指标体系.结果 明确了船体不同的运动姿态条件下实施外科手术的影响因素,筛选出了适宜采用的外科手术技术种类,得出了船体不同运动姿态条件下外科手术技术总体成功概率及其时间负荷.结论 本研究明确的适于采用的外科手术及其成功概率和时间负荷,为海上外科手术救治提供了客观依据.     

苦练精练医护兵锐意创新谋打赢

近年来，我院着眼军事斗争准备，不断提高卫生营卫勤保障能力，在按纲施训的基础上，按照实战要求和野战医疗救护任务，狠抓军事训练工作。除坚持常规“三基”训练外，还分科目、集中时间进行强化训练，模拟海上、山地、空中动态训练平板、多功能救护担架、训练伤救治仪和卫星定位搜寻伤病员系统等贴近实战的救护平台，使卫勤保障能力明显提高。     

海上伤病员在医院船上的救护研究总结

随着国家海洋战略与海军战略转型的不断深入,海上多样化军事行动日益频繁,对海上医疗救护提出了更高要求。本研究从海上救护特点与需求出发,在调研资料、典型病案、方案预案、文件案例等资料基础上,运用管理科学、动物实验、统计分析、模型构建等方法,构建对医院船方案制定、技术筛选和救治效率形成实际支撑的“三个技术支撑与一个优化工具”,并形成工作手册、卫勤手册、任务手册等指导性文本,在历次重大任务中得到应用,取得了良好的社会与经济效益。     

医疗救护艇卫勤训练器材的设计

1设计必要性 1．1使命任务的要求 医疗救护艇是海上医疗救治的重要阶梯之一;医疗救护艇医疗队是一种机动卫勤力量。战时,医疗救护艇可对海上伤员进行紧急救治,并将伤病员后送到卫生运输船、医院船或岸基医院;平时,可对从事海上训练、作业、值勤的舰船以及海岛部队进行巡回医疗或紧急医疗支援,完成危重伤病员的救护和后送任务。军队的使命任务对医疗救护艇医疗队的卫勤训练工作提出了新的更高的要求。     

边疆国家级医疗救援队急救训练模式浅析简

结合国家级医疗救援队肩负使命与新疆特殊地理、人文环境，总结边疆国家级医疗救援队急救训练模式。包括医疗救援队的迅速组织、强化团队协作、熟悉抢救预案、按计划体能训练及模拟不同灾害环境下的批量伤病员急救处置运送训练，从而提高医疗救援队应急救治能力。     

医院船上展开胸腔外科的几点建议

866医院船的使命任务是:①担负战时海上伤病员医疗后送任务;②担负大型作战平台、重大战备训练、海上应急突发情况处置等卫勤支援任务;③担负海上医疗救护训练、为沿海和岛礁部队巡诊等任务及参加国际维和、人道主义救助、重大灾难应急救援和撤侨护侨等非战争军事行动.基于医院船的使命任务,外伤的救治和其他应急突发情况的救治为其医疗活动的最主要内容,而胸腔外科急诊的救治在其中占有相当大比重.例如在本次"和谐使命一2010"任务期间,收到的第1例外科急诊即为胸腔外科急诊救治范畴的自发性气胸,因此,在医院船上设立胸腔外科专业,配备胸腔外科专业人员,准备胸腔外科专用医疗仪器和器械不仅是重要的,而且是必要的.     

低温水面环境模拟设备研制

目的：模拟载人飞船上升段应急返回在海上溅落,航天员处于水上漂浮状态时的海面环境。方法：根据热负荷计算对试验室内环境温度和模拟容器内水溶液温度分别进行控制,从结构上为满足较高的水温均匀度要求对水循环管路进行增加线汇流和层流效应的设计。结果：经测试试验证明系统较高的控温精度及均匀度等性能保证了医学研究和评价试验数据的可靠性和有效性。设备投入使用后,在“抗浸防寒服使用效果医学评价”试验中其优良性能得到进一步验证。结论：设备的成功研制为“神舟”飞船的装船服装的医学评价定型提供了必备的试验条件,为低温水上漂浮状态人体生理研究及相关产品的医学评估提供了良好的模拟试验环境,可应用于航空航天领域。     

Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees

PurposeSimulation has been used as an educational and assessment tool in several fields, generally involving training of physical skills. To date, simulation has found limited application in teaching and assessment of skills related to image perception and interpretation. The goal of this pilot study was to evaluate the feasibility of simulation as a tool for teaching and assessment of skills related to perception of nodules on chest radiography.MethodsThis study received an exemption from the institutional review board. Subjects consisted of nonradiology health care trainees. Subjects underwent training and assessment of pulmonary nodule identification skills on chest radiographs at simulated radiology workstations. Subject performance was quantified by changes in area under the localization receiver operating characteristic curve. At the conclusion of the study, all subjects were given a questionnaire with five questions comparing learning at a simulated workstation with training using conventional materials. Statistical significance for questionnaire responses was tested using the Wilcoxon signed rank test.ResultsSubjects demonstrated statistically significant improvement in nodule identification after training at a simulated radiology workstation (change in area under the curve, 0.1079; P = .015). Subjects indicated that training on simulated radiology workstations was preferable to conventional training methods for all questions; P values for all questions were less than .01.ConclusionsSimulation may be a useful tool for teaching and assessment of skills related to medical image perception and interpretation. Further study is needed to determine which skills and trainee populations may be most amenable to training and assessment using simulation.     

Simulation and experimental study of respiratory motion effect on image quality of single photon emission computed tomography (SPECT)

The effect of respiratory motion on the image quality of single photon emission computed tomography (SPECT) was investigated by computer simulation and experimentation. In the computer simulation, the phantom was assumed to be cylindrical with a uniform background and a spherical cold or hot spot. To simulate respiratory motion, a cyclic linear motion parallel to the axis of rotation of a gamma camere was assumed. The contrast in the transaxial images was calculated for various respiratory amplitudes and its dependence on lesion size and object contrast was investigated. In the experiments, a moving phantom was used to simulate respiratory motion. The simulation and the experimenal results were in good agreement within the range of statistical error. The effect on the lesion detectability was investigated using receiver operating characteristics (ROC) analysis, and a method for correcting respiratory motion was devised.     

An integrated environment for plastic surgery support: building virtual patients, simulating interventions, and supporting intraoperative decisions.

In the last decade a number of environments for Computer Supported Plastic Surgery have been presented. Nevertheless, an overall approach for training and intraoperative support is still missing or has not been widely exploited yet. We developed a fully integrated system which allows surgical simulation, planning, and support for computer-guided plastic surgery procedures starting from image acquisition to final intraoperative assistance. The system also provides the user with a radiological workstation able to analyse patient medical images and case studies, with advanced bidimensional and three dimensional image processing functionalities. We intend to demonstrate that such a platform can be built at an affordable cost. The radiological workstation is capable of supporting radiologists and surgeons in real patient case studies and the simulation workstation may be adopted by plastic surgeons in teaching and training of complex surgical planning. Moreover, results of simulation can be used in the operating room with a relatively high benefit in terms of improved accuracy, reduction of surgical risks, and decrease in training costs.     

Simulation and experimental study of respiratory motion effect on image quality of single photon emission computed tomography (SPECT)

The effect of respiratory motion on the image quality of single photon emission computed tomography (SPECT) was investigated by computer simulation and experimentation. In the computer simulation, the phantom was assumed to be cylindrical with a uniform background and a spherical cold or hot spot. To simulate respiratory motion, a cyclic linear motion parallel to the axis of rotation of a gamma camera was assumed. The contrast in the transaxial images was calculated for various respiratory amplitudes and its dependence on lesion size and object contrast was investigated. In the experiments, a moving phantom was used to simulate respiratory motion. The simulation and the experimental results were in good agreement within the range of statistical error. The effect on the lesion detectability was investigated using receiver operating characteristics (ROC) analysis, and a method for correcting respiratory motion was devised.     

Virtual MRI: a PC-based simulation of a clinical MR scanner

RATIONALE AND OBJECTIVE: The aim of this project was to simulate the features and functions of a clinical or real-world MR scanner on a personal computer by means of a computer program. The users should be able to change all relevant settings of the virtual scanner and adapt them to the expected pathology. MATERIALS AND METHODS: The algorithms of the simulation are based on parameter images of the three physical basic properties T1, T2, and proton density. From this, the synthetic images are calculated pixel by pixel on the basis of the well-known formulas of the pulse sequences chosen and modified by the user. The graphical user interface is oriented to a real-world MR scanner. The software is programmed in pure Java and is freely available under the GPL license. RESULTS: Besides spin echo pulse sequence, 6 other pulse sequence classes are implemented. Parameters like repetition time and echo time can be adjusted. The choice of parameters like matrix size, slice-thickness, and number of acquisitions has an impact on the signal-to-noise ratio of the images. In a first step, the simulation calculates the signal intensity in k-space. Wraparound and motion artifacts are simulated by modifying the data of k-space. In a last step, a 2D-Fourier transform of k-space data is performed. As the image calculation takes only a few seconds, an interactive manner of working is possible. CONCLUSION: The simulation has been used in the education of medical students and interns for more than 1 year and has gained widespread acceptance.     

“三防”医学救援队组织指挥模拟训练系统设计

目的将＂三防＂医学救援组织指挥训练过程进行计算机管理,实现＂三防＂医学救援训练任务的模拟化。方法运用系统分析、层次分析、专家咨询与统计分析等方法,对＂三防＂医学救援队工作流程和信息流程进行分析与研究。结果以先进的模拟仿真技术为支撑的训练系统,能够较好完成不同背景条件下的＂三防＂医学救援训练任务。结论 ＂三防＂医学救援队组织指挥模拟训练系统的开发,能够满足＂三防＂医学救援队组织指挥模拟训练的实际需要,提高＂三防＂医学救援队指挥员宏观规划、临场应变等综合组织指挥能力。     

动态成像技术及其在精确放疗中的应用

放射治疗的发展与现代医学影像技术密不可分,CT成像的空间分辨力和时间分辨力的提高使得动态CT日益成为临床应用的有效手段。在放疗模拟定位的应用中,采用呼吸门控技术得到呼吸周期中不同相位的三维图像,可掌握肿瘤目标随呼吸的运动变化规律,从而建立精确的数学模型,对改进治疗计划具有重要意义。此外,在直线加速器上嵌入两正交的X射线成像系统,以实时跟踪肿瘤目标的位置,也是四维放疗研究的一个方向。     

航天前、中、后空间运动病研究

空间运动病的发生一直是困扰着载人航天的重要医学问题。由于空间运动病是人体对空间特殊环境的一种适应，涉及面较广，也使空间运动病的研究不同于空间中心肺系统的研究。采用主观观察及定性实验方法和手段更多一些，定量的观察方法由于刺激手段受到空间特殊环境的限制，样本量较少，很难将问题精确定位。本文综述了苏美科学家在空间中关于前庭功能和空间运动病的观察和实验结果，以期对我国的载人航天提供一些参考，有利于我们采取有效的对抗措施，保证空间任务的完成。