淋巴水肿上肢体积测量装置的设计及应用

目的 探讨自行设计的淋巴水肿上肢体积测量装置在测量淋巴水肿患者肢体肿胀程度方面的应用效果。 方法 选择2018年7月至2018年12月在我院淋巴水肿专病门诊就诊的患者70例,按照随机数字表法分为观察组(n=35)和对照组(n=35),观察组采用淋巴水肿上肢体积测量装置评估患者治疗前后患侧肢体的肿胀程度,对照组采用传统的软尺测量+不可擦记号笔做标记的方法测量患者治疗前后患侧肢体的周径变化情况。 结果 满意度评价中观察组的满意率明显高于对照组(P＜0.05),护士操作难易度比较中,观察组护士认为操作简单的频率明显高于对照组(P＜0.05)。 结论 自行设计的淋巴水肿上肢体积测量装置可以提高患者的满意度,方便护士操作,值得临床推广。     

基于交叉对比神经网络的心音分类

目的:通过交叉对比神经网络（CCNN）实现心音信号的自动分类，从而对心血管疾病进行早期诊断。方法:实验基于PhysioNet/Cinc 2016心音数据库。训练集和测试集数据来自互斥的健康受试者/病理患者，并以4:1的比例进行划分，输入CCNN。CCNN利用深度卷积神经网络进行特征提取，结合基于信息的相似度度量理论（IBS），对特征向量间的相似性进行度量并分类。结果:实验结果得出灵敏度为0.834 6，特异性为0.962 3，最终大赛综合得分为0.898 5。结论:CCNN使用交叉对比的输入模式扩充数据量，引入信号间的对比信息，同时在神经网络的训练过程中应用统计学思想，使网络具备良好的泛化性，更加适应医学数据量较少的场景，在心音分类中取得较好的结果。     

Characterization of standing balance after incomplete spinal cord injury: Alteration in integration of sensory information in ambulatory individuals

BackgroundUp to one-third of individuals with a recent spinal cord injury (SCI) and most of the individuals with an incomplete lesion are able to regain partial balance and walking ability after the first-year post-injury. However, most individuals experience injurious falls while standing and frequent losses of balance post-rehabilitation, which can result in physical injuries and a fear of falling.Research questionControl of balance during quiet standing depends on the integration of sensory information. Since SCI causes sensory and motor impairments, understanding the underlying mechanisms of how postural control is regulated is of significant importance for targeted and guided rehabilitation post-SCI.MethodsWe characterized the impact of a variety of challenging conditions on the standing balance for eight participants with incomplete SCI with walking ability compared to twelve age-matched able-bodied individuals using a waist-mounted inertial measurement unit (IMU). We compared balance biomarkers derived from IMUs’ readouts under conditions that challenged balance by affecting somatosensory (i.e., standing on hard vs. foam surfaces) and visual (i.e., eyes open vs. closed) inputs. We performed a three-way ANOVA or a Kruskal-Wallis test to characterize changes in postural control post-SCI based on reliance on somatosensory and visual information using balance biomarkers.ResultsWe observed a reduced stability performance, an increased control demand, and a less effective active correction post-SCI in all standing conditions. Due to impaired somatosensory feedback, individuals with incomplete SCI showed a higher and lower reliance on visual and somatosensory information, respectively, for maintaining balance (p < 0.05).SignificanceUsing a single waist-mounted IMU, the proposed method could characterize standing balance in individuals with incomplete SCI compared to able-bodied participants. Having high clinical utility and sufficient resolution with discriminatory ability, our method could be used in the future to objectively evaluate the effectiveness of rehabilitative interventions on the balance performance of individuals with SCI.     

Current Interventional Radiology-Related Benchmarked Clinical Quality Measures Are Less Likely to be “Capped” Than Diagnostic Radiology Clinical Quality Measures

In the merit-based incentive payment system (MIPS), quality measures are considered topped out if national median performance rates are ≥95%. Quality measures worth 10 points can be capped at 7 points if topped out for ≥2 years. This report compares the availability of diagnostic radiology (DR)-related and interventional radiology (IR)-related measures worth 10 points. A total of 196 MIPS clinical quality measures were reviewed on the Center for Medicare and Medicaid Services MIPS website. There are significantly more IR-related measures worth 10 points than DR measures (2/9 DR measures vs 9/12 IR measures; P = .03), demonstrating that clinical IR services can help mixed IR/DR groups maximize their Center for Medicare and Medicaid Services payment adjustment.     

Brilliance型16排螺旋CT的故障分析与维修

针对日常使用中遇到的Brilliance 16排螺旋CT高压系统、机架以及控制器局域网络(CAN)通讯等故障现象进行分析与维修,最终通过更换滤波电容、机架数据采集控制器(DMC)电源以及信号刷等配件得以排除故障。通过对故障准确判断以及合理运用厂家Service模式下的维修工具软件快速解决故障,保障了影像科检查工作的顺利进行,从而提高设备的稳定性。     

A New Asymmetric Directional Microphone Algorithm With Automatic Mode‐Switching Ability for Binaural Hearing Support Devices

For hearing support devices, it is important to minimize the negative effect of ambient noises for speech recognition but also, at the same time, supply natural ambient sounds to the hearing‐impaired person. However, conventional fixed bilateral asymmetric directional microphone (DM) algorithms cannot perform in such a way when the DM‐mode device and a dominant noise (DN) source are placed on the same lateral hemisphere. In this study, a new binaural asymmetric DM algorithm that can overcome the defects of conventional algorithms is proposed. The proposed algorithm can estimate the position of a specific DN in the 90°–270° range and switch directional‐ and omnidirectional‐mode devices automatically if the DM‐mode device and the DN are placed in opposite lateral hemispheres. Computer simulation and KEMAR mannequin recording tests demonstrated that the performance of the conventional algorithm deteriorated when the DM‐mode device and the DN were placed in the opposite hemisphere; in contrast, the performance of the proposed algorithm was consistently maintained regardless of directional variations in the DN. Based on these experimental results, the proposed algorithm may be able to improve speech quality and intelligibility for hearing‐impaired persons who have similar degrees of hearing impairment in both ears.     

沉香中沉香四醇的测量不确定度评估

目的:建立HPLC定量分析沉香药材中沉香四醇含量的测量不确定度的评定方法,找出影响不确定度的因素,为沉香药材质量控制提供科学依据。方法:用HPLC方法测定沉香四醇的含量,并根据《测量不确定度评定与表示》(JJF1059.1-2012)中的规定评估其不确定度,通过统计分析,量化不确定分量,最终确定测量结果的扩展不确定度和置信水平。结果:5批沉香药材中沉香四醇含量测定的不确定度评估结果为(2.80±0.45),(5.13±0.82),(13.86±2.21),(74.86±11.87),(125.71±19.94)g·L~(-1)。发现测量不确定度的主要影响因素有沉香样品的均匀性、称量、配制浓度及高效液相色谱仪性能4个类型,通过严格按照四分法取样沉香样品、确保称量介质保持干燥、正确或规范使用玻璃器皿和精密仪器、可有效减少样品痕量分析的误差。结论:该方法可用于HPLC法测定沉香药材中沉香四醇含量的不确定度分析,方法简便,测量结果不确定度纳入标准制定,有利于标准痕量更加合理,对沉香药材痕量分析方法的建立和质量标准的制定具有重要意义。