基于网络计算的远程心电实时自动诊断系统设计

目的：解决多个远程心电监测终端实时数据传输问题。方法：通过无线局域网络管理多个心电采集终端。无线局域网通过WCDMA与数据中心服务器联结成广域网。结果：基于网络计算的远程心电实时自动诊断系统实现了心电数据实时采集与监控。结论：该系统切实可行地解决了远程心电监控中大量数据传输的带宽问题。     

一种野战便携式内窥镜视频系统的研制

目的:研制一种野战便携式内窥镜视频系统。方法:将主控制器TMS320DM368、图像传感器MT9P301、LED照明单元、LED显示器、光学接口和Wi-Fi模块一体化设计,集成在一个微型手持主机上。系统通过手持主机按键或无线脚踏开关2种方式进行采集图像;采用1 800 m Ah锂电池供电,通过市电或太阳能进行充电。结果:经过临床测试,研制的便携式内窥镜视频系统可以与相应的医用内窥镜配接,适合于内窥镜检查及手术的实时观察、记录和回放,可通过Wi-Fi实现远程医疗。结论:便携式内窥镜视频系统体积小、性能稳定、操作方便、自我续航能力强,非常适合野战医疗。     

具有无线传输功能的血流参数自动检测装置的设计

目的：设计一款基于指端容积脉搏波的血流参数自动检测装置。方法：利用反射式光电传感器获得人体指端容积脉搏波,采用C8051F020单片机对脉搏波进行自动分析、处理与计算,将得到的各项血流参数通过TC35i型GSM模块远程传输给医生。结果：设计的血流参数检测装置能够实现指端容积脉搏波的采集与计算,并可顺利地通过GSM网络接收与发送短消息。结论：该装置使得血流参数检测变得简单、方便,利用GSM网络的无线传输功能,使检测不受地理位置的限制,特别适用于家庭医疗保健。     

基于ZigBeePRO的低功耗远程医疗监护系统

本文研究并设计了基于ZigBeePRO和3G技术的低功耗远程医疗监护系统,系统由含zigBeePRO节点的便携式远程医疗监测设备、ZigBeePRO-3G网络和远程医疗监护系统平台组成。便携式监测设备实时采集的生命体征数据,如血压、脉搏等,经ZigBeePRO无线传感器网络传输,通过集中器的3G模块发送到远程医疗监护系统平台;远程医疗监护系统平台的数据处理系统对相关数据进行整理,并及时反馈给医务人员进行分析处理。本系统的应用可以使被监护人有更多的自由活动空间,可以使患者在家里或社区得到有效地远程医疗诊断和监护。     

基于蓝牙技术的心电监护模块设计

目的：针对我国远程医疗绝大部分局限在医院和医院之间的现状,探讨如何让远程医疗真正进入家庭,使患者足不出户即可享受到优质的医疗保健服务的问题。方法：设计了基于蓝牙技术的心电监护模块,心电监护终端由基于单片机系统的具有信号采集和简单处理功能的心电采集模块和蓝牙射频模块通过数据线相连构成;心电数据蓝牙传输模块的设计采用C8051F020和蓝牙模块ROK 101 007通过串口写入HCI指令来实现相互通信;采用VC＋＋6.0作为开发工具编写运行于监护中心计算机上的远程监护服务器程序。结果：心电监护模块可实时采集心电数据并通过蓝牙模块接口传输到家用计算机,然后通过宽带网络系统发送到监护中心,从而实现患者和医生之间信息的实时交换。结论：该心电监护模块充分发挥蓝牙技术的无线优势,具有较强的实用性。     

基于STC12LE2052AD控制芯片的内窥镜无线采集系统设计与应用

目的:设计内窥镜无线采集系统,用于内窥镜检查的图像采集。方法:内窥镜无线采集系统的发射端和接收端均采用单片机STC12LE2052AD为主控制芯片,nRF24L01为无线传输模块,采集图像时按下发射模块的按键,霍尔传感器接通后发射模块输出无线信号,接收模块收到信号后三极管接通,通过采集软件功能完成图像的采集,对300例患者分别进行电子胃镜检查(100例)、喉镜检查(100例)和腹腔镜检查(100例),并进行图像采集测试。结果:设计的内窥镜无线采集系统,经临床对患者的电子胃镜、喉镜和腹腔镜检查各100例的图像采集测试,系统能够采集到各内窥镜检查的清晰图像,实现内窥镜无线图像采集时操作简单、故障率低和系统性能稳定,可满足临床科室的使用。结论:内窥镜无线采集系统适用于内窥镜检查的图像采集,提高内窥镜检查系统采集图像的自由度,降低内窥镜采集系统的故障和医疗风险。     

远程医疗发展现状综述

采用文献综述的方法,对国内外公开发表的关于远程医疗的文献和资料进行整理和分析,初步了解国内外远程医疗各个方面的发展、应用以及一些关键技术。研究结果表明,目前远程医疗主要包括远程会诊、远程诊断、远程教学、远程监护和远程医疗车等。应用空间范围除医院、诊所等医疗场所外,还有作战场地、海上医疗、家庭监护等。而远程医疗中应用的一些技术也从单一的电视监控或电话远程诊断逐渐发展为利用移动通讯设备、有线网、无线网络等进行数字、图像、语音的综合传输;监控设备以及各种生命体征监测仪器、无线传感器都向小型化和便携式方向发展,穿戴式生物医疗仪器是目前的研究热点。虚拟网络和灵活组网等是目前远程医疗的显著特征。     

数字化便携式口腔综合医疗系统的研制与应用

目的：为满足野战救治、基层部队和巡回医疗中口腔医疗保健的需要,对数字化便携式多功能口腔医疗系统进行研制。方法：在调查、了解口腔颌面部创伤救治和基层部队、远航舰船与巡回医疗对便携口腔医疗装备多方面需求的基础上,将数字化口腔X线影像、口腔内窥镜和远程图像传输等技术应用到便携式多功能口腔医疗系统的开发中,与有关医疗器械公司合作,从系统组成、技术参数及多功能整合等方面对数字化便携口腔医疗系统进行研制。结果：数字化便携式口腔综合医疗系统研制成功,系统便于携带,操作简单,具备野战急救、基本口腔医疗及远程会诊等多方面的功能。结论：数字化便携式口腔综合医疗系统整合了多种先进口腔诊疗技术,功能较为全面,能满足野战救治和基层部队、远航舰船与巡回医疗中的口腔医疗和保健需求,能有效提高军队口腔卫勤保障水平,拓宽保障范围。     

基于Android智能手机的WIFI电子内窥镜

针对移动医疗需求的发展,提出一种采用Wi Fi通信并基于Android手机平台的便携式电子内窥镜设计方案,可代替传统的内窥镜设备,应用于网络化或远程医疗环境中。本方案在基于RT5350的Easy MIPS硬件上搭建了openwrt软件系统和MJPG-streamer服务器,并通过USB接口实时读入电子内窥镜的视频数据,转换为MJPEG视频流后,通过Wi Fi接口传入Android智能手机,然后在Android手机上编写相应的客户端用户程序,实现了对电子内窥镜的视频采集、图像增强、保存回放、远程传输等功能。实验结果表明内窥镜封装尺寸可小于5mm,图像分辨率640×480,视场角120?,本方案可广泛应用于资源受限的偏远环境及家庭健康领域,实现耳鼻喉等人体器官的内窥成像及医学诊断。     

便携式数字X线机及远程医学图像工作站软件开发

目的:为了能够给那些因地理环境、灾区环境以及战争情况下受限不便就诊的人员提供高质量的医疗健康服务。设计开发一套便携式数字X线机和医学图像工作站系统。方法:主机基于嵌入式Linux操作系统,采用OMAP1510硬件开发平台;医学图像工作站基于Windows操作系统,软件采用VC 6.0开发环境。结果:医学图像工作站从便携式X线机上获取图像,并对图像进行显示和处理。结论:该系统可以获取实时图像,实现远程医疗。     

矩阵式手术直播系统接入远程医学信息网的实现

目的:探讨手术直播教学演示系统进行远程通信的开展和深化应用。方法:通过手术室的摄像机和话筒等设备采集多路视频和声音信号,通过矩阵处理和控制后接入远程医学信息网。结果:能够实现手术实时转播的远程通信。结论:使手术实时转播的范围扩大,提高了远程手术教学的水平。     

Wireless live streaming video of surgical operations: an evaluation of communication quality

We evaluated a mobile video system for surgical teleconsultation. A video streaming server in the operating room transmitted video and audio to a hand-held computer (personal digital assistant [PDA]) over a wireless local area network. Two groups of 20 surgeons (each with 12 qualified surgeons and eight surgeons between the 2nd and the 4th year of training) participated in the tests. For voice transmission, correct understanding of numbers was achieved in 100% of the cases (n = 1000) and 98% of medical terms (n = 400). The quality of the video displayed on the PDA was assessed by the recognition of different operating room scenarios. Only 62% (SD 17) of the structures were identified clearly on the hand-held device (n = 400). The accuracy improved to 78% (SD 15) (n = 400) if the same scenario was observed on a larger (50 cm) video screen (p < 0.001). Accuracy was significantly better if audio conversation was possible. The quality evaluation by the consultants showed that the PDA display size and quality were sufficient for clinical use.     

对发展我国HIS技术市场的调研与思考

为规范我国ＨＩＳ市场的发展提供决策参考,对医院信息系统开发市场及行业发展的整体情况进行调开,综合调查结果显示：全国的ＨＩＳ发展情况基本处在同一水平,整个ＨＩＳ产品正处于更新换代阶段,市场竞争激烈。对此,建议从整体上强调政府宏观指导,利用市场规律,主张强强联合,注重对国有资产设备的调配和充分利用,加强企业内部管理是ＨＩＳ成功的基本保证。     

会话发起协议在远程医疗中的研究与应用

目的:研究会话发起协议(session initiation protocol,SIP)在远程医疗中的应用.方法:以SIP为基础,设计远程医疗系统,构建远程医疗信息服务平台.结果:远程医疗信息服务平台既可满足医生对患者的远程语音视频诊治需求,又可满足其随时填写或者调用患者电子病历的需求.结论:基于SIP协议的远程医疗系统具有较好的应用前景.     

Technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service - an observational study

We evaluated the technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service (EMS) from the user's perspective. The telemedicine system was designed to transmit vital signs data and 12-lead-ECG data, send still pictures and allow voice communication and video transmission from an ambulance. The data were sent to a teleconsultation centre staffed with EMS physicians (tele-EMS physician). The system was used in 157 EMS missions. The applications were used successfully on 80% of missions for real-time vital signs transmission and on 97% for video transmission. The quality of the transmitted still images (n = 64) was: 23% excellent, 50% good, 17% moderate, 9% rather poor and 0% unusable. The quality of the video streaming (n = 36) was: 33% excellent, 56% good, 6% moderate, 6% rather poor and 0% unusable. The tele-EMS physician was able to assist the EMS team in several cases and provided the preliminary information for the hospital in nearly all missions. Use of the telemedical system in EMS is feasible and the quality of the transmitted images and video was satisfactory. However, technical reliability and availability need to be improved prior to routine use.     

Prerecorded telemedicine

In prerecorded telemedicine (also known as asynchronous or store-and-forward), the person sending the information and the person receiving it do not need to do so simultaneously; thus, viewing the information can be done at some later time. Prerecorded telemedicine is therefore not appropriate for emergency consultations. In prerecorded telemedicine systems, the following steps can be distinguished: (1) the acquisition of diagnostic information at the remote site; (2) its storage, which can be at either site, or at both; (3) its delivery to the expert site through an appropriate connection; and (4) its display at the expert site. The types of information transferred include audio, data and text, still images and moving images (i.e. video). An increasingly common way of doing prerecorded telemedicine is by email sent via the Internet. Although there are some problems associated with the Internet, its wide availability and low cost have encouraged its use. Examples where email has been used successfully include teleradiology, telecardiology, teledermatology and telepathology. In some situations prerecorded telemedicine is the only way to provide remote medical services, or the most cost-effective method. Clearly, there are also situations when prerecorded telemedicine is not an appropriate way to deliver health services, for example whenever the sender of the information is not qualified to sample the information acquired or the specialist receiving the information must manipulate it, during acquisition, in some way.     

Performance of a wireless telemedicine system in a hospital accident and emergency department

We developed a mobile, wireless videoconferencing system suitable for use in a hospital accident and emergency (A&E) department. Four consultants, eight junior doctors and 11 nurses working in the A&E department tested the system. Transmission of three types of data (audio, still images and video) was tested. The audio for the breath and heart sounds was judged to have some disturbance. One consultant rated the diagnostic quality as good and one rated it as fair. The quality of the still images was judged to be from fair to excellent. The quality of the video was rated as good. Possible interference between the wireless local-area network and various medical devices in the A&E department were examined, but none was detected. The four consultants who tested the system were very positive in their initial comments. Eight of the 11 nurses remained sceptical about its use. Of a total of 20 patients who answered a survey, 13 were slightly anxious about the use of the system to transmit their data to a distant point. Overall, the performance of the system was satisfactory for use in the A&E role.     

远程医疗系统技术简介

远程医疗是指使用远程通讯技术和计算机多媒体技术提供医学信息服务。本文从通讯、图像、声音、应用软件等方面介绍了基于ATM、IP网络的远程医疗系统的组成。     

Evaluation of two mobile telemedicine systems in the emergency room

Two different prototype mobile telemedicine systems were constructed for use in the emergency room. They could transmit physiological signals as well as video pictures and sound. One device, the mobile emergency bed (MEB), was powered by battery and had a wireless connection to the local-area network (LAN). For the other, the mobile emergency server (MES), a patient monitor, video-camera and microphone were connected by a radio-frequency link to a server. A functional evaluation and a clinical evaluation (by 12 emergency doctors in six emergency centres) were performed on both prototypes. The bandwidth and the video quality of the MEB were better than those of the MES, because of the digital transmission of the wireless LAN. The MES was better for directing patient treatment and teleconsultation; the MEB was better for static patients in the emergency centre. In general, the MES was more suitable for practical emergency telemedicine work.