浅谈LIS与实验仪器的双向控制的研究与实现

针对目前医院临床实验室（检验科）的效率低下、操作误差等诸多问题，通过应用标本传送系统和自动控制技术，实现实验仪器与LIS系统之间的双向控制，实现夹验室的自动化。本文介绍了LIS与实验仪器的双向控制的设计目标、工作原理、特色与创新，重点讨论了实现双向控制的条件、方法、步骤及重点解决的关键技术问题。     

基于小波分析的红外乳腺图像去噪与增强的实验研究

将小波的多分辨率分析技术运用到红外乳腺图像的降噪增强处理以改善图像质量.运用不同的阈值量化策略实现图像降噪.再引入增益因子,采用基于小波变换的增强算法突出肿块阴影.通过实验将直接增强和去噪后再增强的图像进行对比可以得到清晰度更高的图像.经处理后的乳腺图像,为临床提供了更细致明确的信息,有助于提高诊断水平.     

拉米夫定与单磷酸阿糖腺苷联合应用抗-HBV的体外实验研究

目的　体外观察拉米夫定 (3TC)与单磷酸阿糖腺苷 (Ara AMP)联合应用的抗 HBV作用。方法　以 2 2 15细胞为靶细胞 ,实验共进行 8d。采用放射免疫法及斑点杂交测定单用 3TC、Ara AMP及联合应用后对培养上清液HBsAg、HBeAg及细胞内HBVDNA的抑制作用。结果　Ara AMP浓度为40 0 0 μg ml时 ,对HBsAg、HBeAg的抑制作用分别为 45 48%和 41 46 %。 3TC在所取浓度范围内虽然对HBsAg和HBeAg也有一定的抑制作用 ,但抑制作用较弱。Ara AMP 5 0 0 μg ml与 3TC 1 2 5和 5 0 0μg ml联合应用 ,对HBsAg的抑制率分别可达 19 92 %和 17 32 %。其HBsAg含量与单用相同浓度的3TC相比 ,差异有显著意义 (P <0 0 5 ) ,但与单用相同浓度的Ara AMP相比 ,差异无显著意义 (P <0 0 5 )。联合用药对HBeAg无明显抑制作用。 3TC 5 0 0 μg ml与Ara AMP 12 5和 5 0 0 μg ml联合应用 ,对HBVDNA抑制率可达 45 90 %和 5 0 36 %。HBVDNA含量与阴性对照组及单用相同浓度的 3TC、Ara AMP组相比 ,差异有显著意义 (P <0 0 5 )。结论　 3TC与Ara AMP联合应用对HBVDNA的抑制作用明显增强     

HSV-TK/GCV系统治疗小鼠乳腺癌的实验研究

我们从体内外两方面研究单纯疱疹病毒胸苷激酶基因联合前药ＧＣＶ系统（ＨＳＶＴＫ／ＧＣＶ）对小鼠乳腺癌的作用,并初步探讨引起细胞死亡的机理。一、材料与方法１－细胞培养和实验动物：小鼠乳腺癌细胞系４Ｔ１（密执安州大学Ｄｒ．Ｍｉｌｌｅｒ惠赠）,常规培养在Ｄｕｌｂａｃｃｏ’ｓＭｏｄｉｆｉｅｄＥａｇｌｅ（ＤＭＥ,美国Ｂｉｏｆｌｕｉｄ公司）培养液内,添加１０％胎牛血清,青、链霉素,谷胺酰胺（Ｂｉｏｆｌｕｉｄ公司）。６～８周雌性Ｂａｌｂ／Ｃ小鼠用于实验。２－逆病毒载体及基因转导：ＳＴＫ逆病毒载体来自ＬＮＬ６载…     

乙型肝炎血清HA、PCⅢ、C—IV的检测与临床关系的探讨

肝纤维化是肝硬化发展的早期阶段,具有可逆性.方便、快速检查方法,对早期诊断、治疗有重要意义.本文检测128例乙肝患者血清透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)水平及部分肝病理活检,确定探讨其对肝纤维化程度的临床价值.现报告如下:     

基于ARM的多通信方式的监护仪设计与实现

设计一种基于ARM的具有多种通信方式的多参数监护仪.以ARM9芯片S3C2440为控制核心,设计了生理信号采集电路、人机交互电路和通信接口电路,实现了心电、呼吸、血压、脉搏、体温和血氧饱和度的监测,并通过WiFi、GPRS和DM9000的接口设计,实现不同环境和条件下的有线和无线通信功能.软件采用Linux+QT平台编写,实现监护参数的分析处理、结果显示、记录和远程通信功能.对30位受试者,采用本监护仪和国产监护仪进行生理参数测量和比较.结果表明,本监护仪的测量验证的平均准确率为92.2％,可满足临床生理参数监护的使用要求,而且多种通信方式方便建立局域网和Internet网络连接,为远程医疗和家庭医疗提供条件.     

基于ASTM的检验仪器双向通信控制的研究与实现

在医院检验信息系统(LIS)中,计算机与检验仪器的双向通信是一个关键环节.本文主要针对检验仪器与计算机的通信中所存在的数据传输方式和数据格式不同的现状,提出了基于ASTM的四层结构通信模式,解决了LIS系统中检验仪器与计算机通信的局限性和兼容性的问题.     

人体通信中发送端接触阻抗的实验研究

本研究着眼于电流耦合型人体通信方式,抽象并简化人体前臂的发送端等效电路模型。通过施加交变方波电流激励,测量使用不同尺寸电极时的模型参数,并比较不同频率下接收端的信号衰减率。结果表明人体前臂的信号衰减率随接触阻抗的增大而增大。在小腿处的测量也得到类似的结果。所以,在人体通信过程中应尽可能减小发送端“电极一皮肤”的接触阻抗,可提高通信质量。     

Nogo—A免疫抗体治疗大鼠脊髓损伤的实验研究

Ｎｏｇｏ是近年来被发现的 (Ｓｃｈｗａｂ ,1998年 )一种由中枢神经系统胶质细胞产生 ,抑制轴突生长锥再生的蛋白质。目前Ｎｏｇｏ的基因已被成功地克隆 ,其表达蛋白有Ｎｏｇｏ Ａ、Ｎｏｇｏ Ｂ和Ｎｏｇｏ Ｃ 3种形式。Ｎｏｇｏ Ａ(ＮＩ2 5 0 )的分子量为 2 5 0ｋＤ ,由6 6个氨基酸组成。本研究试图采用Ｎｏｇｏ Ａ的抗体ＩＮ 1阻断Ｎｏｇｏ Ａ抑制蛋白形成 ,为再生的轴突生长锥清除障碍 ,达到治疗脊髓损伤的目的。用 5 6只成年Ｗｉｓｔａｒ大鼠 ,麻醉后在背部Ｔ1 0 处打开椎板 ,暴露脊髓 ,对脊髓背侧半 (锥体束 )行脊髓钳夹损伤术 30ｓ。随…     

ADμC812与MAX6955之间的I2C总线通信实现

文章概括介绍了循环式混合气辅助呼吸装置中央微处理器ADμC812与LED显示控制器件MAX6955之间I2C总线通信的硬件电路、串行接口的数据传输时序、控制串行接口的特殊功能寄存器等设计,并给出了基于汇编语言的相关软件模块.测试结果表明:系统的硬件、软件设计很好地实现了信号的可靠、稳定传输.     

医院红外精准测温系统的设计与研究

新冠疫情中体温筛查已成为医院必不可少的第一道防线。目前的红外终端测温偏离大概0.5 ℃,性能也不稳定,同时数据不能共享。本研究通过改良红外精准测温终端,使测温偏离0.2 ℃,通过结合5G等移动通讯手段,传输到云端服务器,并且与医院信息平台进行对接,可实现数据的共建共享和可追溯。这样不仅有效避免了发热患者的漏检和错检,而且可以结合患者诊疗卡进行大数据筛查,实现对患者体温的实时监控。【关键词】医院;红外线;测温系统;通讯模块     

基于红外热成像的膝关节骨性关节炎早期筛查临床研究

目的 为评估骨性关节炎早期疼痛症状的热表现,并探索红外热成像识别早期关节异常的适用性,本文发展出一种用于膝关节骨性关节炎的红外热成像筛查方法.方法 本研究在中国康复研究中心开展,共招募膝关节测试对象177例并采集其双膝关节红外热图像.基于大量临床红外热图数据,通过总结正常与异常膝关节间温度分布与特征差异,实现一种以髌骨为中心的膝关节热诊断方法.结果 此方法的初步诊断准确率达91.6％(P＜0.05),识别异常关节热分布的灵敏度为93.5％.结论 此方法对于膝关节早期异常的发现有良好的筛查效果,且适合推广于大规模关节筛查与体检中.     

The psychophysiology of medical communication. Linking two worlds of research

Objective

Medical communication is goal oriented behavior. As such, it can be modeled as a chain of decisions, resulting from cognitive and emotional processes each potentially associated with psychophysiological reactions. Psychophysiological may be helpful to detect small changes in affect or arousal in the course of a consultation that would be difficult to detect by other evaluations of the process, like self-reports.The question is how psychophysiological communication research should be modeled for unraveling in more detail the cognitive, emotional and interpersonal processes which underlie physician and patient behavior.

Methods

In the world of medical communication research the six-function model of medical communication reveals a number of fundamental perceptual, cognitive and emotional processes which may evoke psychophysiological responses. The world of psychophysiological research encompasses domains of perception, mental imagery, anticipation and action which all have close connections with fundamental tasks in communication.

Conclusion

This paper discusses ten methodological issues in linking continuous psychophysiological data to verbal and nonverbal events in a medical consultation observed with the Verona coding system.

Practice implications

When linking the two worlds of research, the methodological challenges discussed need to be solved to obtain a valid and reliable application of psychophysiological measures in medical communication research.     

Factors associated with patient reports of positive physician relational communication

Objective

To evaluate the patient, physician, and visit-related factors associated with patient ratings of positive physician relational communication.

Methods

Pre- and post-visit surveys were conducted with 485 patients attending a routine periodic health exam with one of 64 participating physicians. The audio-recorded visits were coded for elements of patient–physician communication including assertive responses, partnership building, question asking, supportive talk, and expressions of concern.

Results

Patient reports of positive physician relational communication were associated with patient perceptions of how well the physician understood the patient's health care preferences and values, a patient–physician interaction outside of the exam room, and physician-prompted patient expressions of concern.

Conclusion

In addition to a patient's perception of their relationship with their physician going into the visit, relatively simple acts like extending the interaction beyond the exam room and ensuring that patients feel invited to express concerns they may have during the visit may influence patient perceptions of physician relational communication.

Practice implications

This study offers preliminary support for the idea that relational communication and its associated benefits may be fostered through simple physician-driven acts such as interacting with patients outside of the exam room and encouraging patients to express concerns within the visit.     

Visualizing risks in cancer communication: A systematic review of computer-supported visual aids

ObjectiveHealth websites are becoming important sources for cancer information. Lay users, patients and carers seek support for critical decisions, but they are prone to common biases when quantitative information is presented. Graphical representations of risk data can facilitate comprehension, and interactive visualizations are popular. This review summarizes the evidence on computer-supported graphs that present risk data and their effects on various measures.MethodsThe systematic literature search was conducted in several databases, including MEDLINE, EMBASE and CINAHL. Only studies with a controlled design were included. Relevant publications were carefully selected and critically appraised by two reviewers.ResultsThirteen studies were included. Ten studies evaluated static graphs and three dynamic formats. Most decision scenarios were hypothetical. Static graphs could improve accuracy, comprehension, and behavioural intention. But the results were heterogeneous and inconsistent among the studies. Dynamic formats were not superior or even impaired performance compared to static formats.ConclusionsStatic graphs show promising but inconsistent results, while research on dynamic visualizations is scarce and must be interpreted cautiously due to methodical limitations.Practice implicationsWell-designed and context-specific static graphs can support web-based cancer risk communication in particular populations. The application of dynamic formats cannot be recommended and needs further research.     

The health literacy demands of electronic personal health records (e-PHRs): An integrative review to inform future inclusive research

Objective

To integrate the findings of research on electronic personal health records (e-PHRs) for an understanding of their health literacy demands on both patients and providers.

Delivery of telephone-based supportive care to people with cancer: An analysis of cancer helpline operator and cancer nurse communication

ObjectivesTelephone-based supportive care presents a potentially highly accessible means of addressing unmet supportive care needs for people with cancer. Identification of behaviours that facilitate communication is essential for development of training for telephone-based supportive care. The aim of this study was to describe communication behaviours within supportive care telephone calls in two contexts (1) a telephone outreach intervention and (2) cancer helpline calls, to identify potential areas for further training.Methods50 recorded calls were analysed using two standardised coding systems: the RIAS and Verona-CoDES-C.ResultsMean call length was 21 min (304 utterances) for nurse-outreach calls and 23 min (355 utterances) for helpline calls. Closed questioning, verbal attentiveness and giving information/counselling were the most common communication behaviours identified. Emotional cues were most commonly responded to through non-explicit back-channelling, exploration of content or provision of reassurance or advice.ConclusionsThis study confirmed the need to address the manner in which questions are framed to maximise patient disclosure. Responding to patent emotional cues was highlighted as an area for future training focus.Practice implicationsCommunication skills training that addresses each of these tasks is likely to improve the effectiveness of telephone-based delivery of supportive care.     

Generation of dynamic random-element stereograms in real time with a system based on a personal computer

A new system capable of generating static and dynamic random-element stereograms is designed and implemented. The stereogram is composed of a rectangle that can be varied in size, element density, orientation, and horizontal and vertical disparties, and can be swept at several velocities. The system is based on an inexpensive personal computer (Amiga 500), designed to work as a slave system under the control of a host computer (e.g. any personal computer). A colour monitor or two black and white monitors are suitable display devices to view the stereograms. This system is used to perform psycophysical experiments in humans and neurophysiological experiments in behaving monkeys, with the purpose of studying depth perception and binocular vision.     

The functions of adequate communication in the neonatal care unit: A systematic review and meta-synthesis of qualitative research

ObjectiveTo assess the main functions of parent-provider communication in the neonatal (intensive) care unit (NICU) and determine what adequate communication entails according to both parents and health professionals.MethodsA systematic review and meta-synthesis of qualitative research. PubMed, Ebsco/PsycINFO, Wiley/Cochrane Library, Ebsco/CINAHL, Clarivate Analytics/Web of Science Core Collection, and Elsevier/Scopus were searched in October-November 2019 for records on interpersonal communication between parents and providers in neonatal care. Title/abstract screening and full-text analysis were conducted by multiple, independent coders. Data from included articles were analyzed using deductive and inductive thematic analysis.Results43 records were included. Thematic analysis of data resulted in the development of the NICU Communication Framework, including four functions of communication (1. building/maintaining relationships, 2. exchanging information, 3. (sharing) decision-making, 4. enabling parent self-management) and five factors that contribute to adequate communication across these functions (topic, aims, location, route, design) and, thereby, to tailored parent-provider communication.ConclusionThe NICU Communication Framework fits with the goals of Family Integrated Care to encourage parent participation in infants’ care. This framework forms a first step towards the conceptualization of (adequate) communication in NICU settings.Practice implicationsFindings can be used to improve NICU communication in practice, in particular through the mnemonic TAILORED.     

Delivery of telephone-based supportive care to people with cancer: An analysis of cancer helpline operator and cancer nurse communication

Objectives

Telephone-based supportive care presents a potentially highly accessible means of addressing unmet supportive care needs for people with cancer. Identification of behaviours that facilitate communication is essential for development of training for telephone-based supportive care. The aim of this study was to describe communication behaviours within supportive care telephone calls in two contexts (1) a telephone outreach intervention and (2) cancer helpline calls, to identify potential areas for further training.

Methods

50 recorded calls were analysed using two standardised coding systems: the RIAS and Verona-CoDES-C.

Results

Mean call length was 21 min (304 utterances) for nurse-outreach calls and 23 min (355 utterances) for helpline calls. Closed questioning, verbal attentiveness and giving information/counselling were the most common communication behaviours identified. Emotional cues were most commonly responded to through non-explicit back-channelling, exploration of content or provision of reassurance or advice.

Conclusions

This study confirmed the need to address the manner in which questions are framed to maximise patient disclosure. Responding to patent emotional cues was highlighted as an area for future training focus.

Practice implications

Communication skills training that addresses each of these tasks is likely to improve the effectiveness of telephone-based delivery of supportive care.