DICOM-RT解析及在精确放射治疗计划系统中的应用

目的:实现CT和DICOM-RT四个放疗对象-RT-Structure、RT-Plan、RT-Image、RT-Dose在治疗计划系统(TPS)中的存储和传输。方法:通过对DICOM-RT四个放疗对象的解析,并对其在治疗计划系统(TPS)中的应用,设计了DICOM-IMPORT和DICOM-EXPORT两个接口。在FDS团队自主研发的精确放射治疗软件系统(ARTS)中调用这两个接口,验证接口导入导出RT-Structure(勾画信息)、RT-Plan(计划信息)、RT-Image(DRR,数字重建放射影像)、RT-Dose(剂量信息)是否正确。结果:通过测试临床病例,ARTS可以成功导入导出两大商用治疗计划系统-飞利浦Pinnacle3和拓能VENUS中获取的DICOM-RT文件。结论:通过对DICOM-RT四个放疗对象的解析,设计的两个接口实现了在精确放射治疗系统计划系统中的应用,及不同TPS数据之间的兼容。     

放射治疗中基于DICOM-RT模型的电子病历信息系统

电子病历(EMR)是医疗机构对门诊、住院患者(或保健对象)临床诊疗、指导干预的数字化医疗服务工作记录,是居民个人在医疗机构历次就诊过程中产生和被记录的完整、详细的临床信息资源。放射治疗EMR中包含文字、图像等信息,因此,比一般的EMR更加复杂。本文提出一种基于DICOM-RT标准的EMR信息系统,通过使用DICOM-RT的七个对象来实现放射治疗中不同系统、设备间的信息交换和共享,方便放射治疗患者治疗数据的管理,提高放射治疗的效率。     

基于3G网络移动监护信息传输定位系统的设计

背景：及时了解疾病状况,对及时诊治具有尤其重要的意义。 目的：为解决院外监护和院前急救的数据传输问题,设计一种基于3G网络的移动监护信息传输定位系统。 方法：通过定位传输模块把插件式监护仪实时采集的患者生理信息,连同患者的位置信息一起发送到3G移动通讯网,在具有实IP的PC机上编写服务器程序接收患者信息实现移动监护功能;通过无线传输协议的制定和软件设计,解决传输过程中丢包、错包问题。 结果与结论：通过该装置实现了患者实时监护信息及位置信息的远程无线传输和显示。该系统运行稳定,费用低廉,具有较高的实际应用价值。     

基于DICOM的多平台放射治疗数据可视化与对比分析

目的:开发一个独立的系统RTViewer对不同商用治疗计划系统的放射治疗数据进行相互验证和对比分析。方法:以放射治疗的质量控制与质量保证为重点,在深入解析DICOM-RT标准的基础上,通过研究主流TPS厂商的底层数据格式,设计DICOM格式放射治疗数据导入、可视化、分析、导出接口,开发RTViewer系统,以实现对不同TPS的放射治疗数据相互验证和对比分析,从而确保放射治疗计划实施的质量。结果:经临床病例验证,RTViewer系统可准确地解析和可视化Eclipse、XIO、Monaco、Pinnacle及Raystation等主流商用TPS获取的DICOM-RT文件。结论:通过对DICOM-RT标准的深入解析,开发的RTViewer实现了对DICOM格式文件的精确解析与可视化,可对比分析不同TPS的放射治疗数据,用于远程肿瘤放射治疗质量控制,对放射治疗计划的质量保证具有重要意义。     

基于Android系统的生理数据蓝牙传输技术

目的：本文建立基于Android智能系统的生理参数移动监护系统,实现生理数据从监测模块向智能手机端传输。方法：在生理参数检测端增加蓝牙传输模块．将检测端采集到的心电等生理数据发送至Android系统智能手机端,智能手机端利用Android蓝牙API开发类,对手机端蓝牙实现打开蓝牙、搜索附近蓝牙设备等基本操作,再利用Socket连接,实现数据传输。同时手机端利用界面编程类,实现心电图界面显示,利用文件操作类实现数据存储和初步的心率计算,最终实现心电等生理参数的接收、显示、心率分析以及传输。结果：Android系统智能手机端接收蓝牙模块发送的心电数据,绘成实时心电图表,绘制在手机屏幕上,并对心电数据进行初步分析,计算得到心率值,显示在手机屏幕顶端,若心率值偏高或偏低,则发出语音报警信息。该系统演示了生理数据的传输过程,实现了蓝牙接口的数据传输控制技术。结论：本文立足于移动医疗监护系统,实现了多生理参数在Android系统中的蓝牙接口传输控制方法,该技术应用前景广泛。     

集成化医院信息系统的设计

随着医院信息技术快速向前发展。2001年中山市人民医院开始研制大规模集成化医院信息系统。重点解决流程再造、系统异构、数据安全、医学影像压缩与传输、虚拟存储、决策支持、医疗数据交换传输标准等技术问题,设计了医院管理信息系统、临床信息系统、医学影像传输与存储系统、检验信息系统和医院办公自动化系统等50多个子系统模块,并进行大规模整合达到高度的无缝集成,实现"一站式服务"。本项目率先在国内引入"医疗集成构架平台"的概念,突破了传统的医院信息系统观念,研究并建立数字化医院工作流分析再造和综合效益分析模型,提升医院整体管理水平。     

植入式人工肛门括约肌系统的实现及动物实验***

背景：研制新型的符合人体生理需求的人工肛门括约肌系统具有十分重要的意义。 目的：设计一种新型植入式人工肛门括约肌系统。 方法：利用无线通讯模块和压力传感器重建排便控制机制,并由经皮能量传输模块供电,采用机电系统模拟人体自然器官的功能,最终实现人体肛门括约肌的控制效果。 结果与结论：设计并实现了一种新型的植入式人工肛门括约肌系统,在重建排便机制和模型的基础上,一定程度上恢复肛门失禁患者的生物反馈控制能力,并带有经皮能量传输模块,为体内系统长期无缆式供电提供可能。该系统实现了植入式动物实验,完成了系统植入可行性和基本功能验证。 关键词：人工肛门括约肌;生物反馈控制;经皮能量传输;植入式动物实验;数字化医学  doi:10.3969/j.issn.1673-8225.2012.13.013     

基于嵌入式AI的癫痫发作监测系统实现

癫痫监测旨在防止患者在癫痫发作期间因失去意识而可能经历的事故。通过分析脑电信号来进行癫痫实时监测,从而为癫痫的诊断、治疗和评估提供相应的参考。本研究设计了一款基于嵌入式AI的癫痫发作监测系统,分为3部分:训练模块、测试模块和报警模块。其中,训练模块使用波恩数据集,采用小波包分解和一维卷积神经网络进行训练,最终模型准确率高达98.3%;测试模块使用脑电波传感器采集信号,通过蓝牙传输,经单片机处理后与训练模型比对;报警模块是将上述结果反馈至微信小程序,如若异常及时报警。该系统基于嵌入式AI,采用可穿戴式癫痫监测报警设备,具有实时监测癫痫发作的功能,能减小患者受到的伤害,保护患者安全。     

人体生理参数采集系统中无线通信模块设计

目的：基于智能终端的移动医疗技术已成为平时医疗健康监护研究的一个热点。相对于传统的医疗设备系统,智能终端的移动医疗技术是一种低生理、心理负荷技术,智能终端的移动医疗系统具有体积小、成本低、功耗小、携带方便等突出特点。为了保证人体生理参数采集系统中采集到的生理参数可靠有效的传输到智能终端,本文设计了生理参数采集系统中数据无线传输模块。方法：该无线通信模块利用蓝牙传输方式,主要包括微处理器外围电路及蓝牙芯片外围电路设计。同时,考虑到性能和数据吞吐率水平以及传输协议执行时的软件开销。所以人体生理信号采集系统中的蓝牙模块的主机控制接口采用的是UART接口。结果：同时为了验证该模块的功能,利用该模块对FLUKE多参数模拟仪MPS450模拟的人体呼吸信号进行了发送传输,并且利用智能终端对发送的数据进行接收。结论：经试验测试表明,整个电路设计合理、工作正常,能准确发送人体生理参数采集系统中采集到的人体生理参数数据。所以该无线通信模块可以满足基于智能终端人体生理参数采集系统的需求。     

一种新型多普勒血流仪的研制

目的 研制一种具有数据采集、存储、传输、显示及声音辅助诊断功能,可以面向社区和家庭应用的便携式多普勒血流仪.方法 基于多普勒测量血流原理,以STM32微处理器为核心,采用定向型正交相位解调法获取多普勒频移信号,通过电源模块、数据采集模块、USB模块、按键模块、数据存储模块、音频处理模块、液晶显示模块、网络收发模块等外围电路,结合PC构成一个完整的血流检测系统.结果 该血流仪能够实现对患者血流数据的采集、处理、存储、传输,可实时显示脉率、诊听血流声音及输出双向血流频移波形和血流速度波形,可用于糖尿病足的诊断.结论 该血流仪使用方便,通过血流声音、血流速度波形、频移波形和脉率等反映血流特征的信息,进行糖尿病足等与血流相关慢性病的早期检测.     

A stochastic model of susceptibility to antibiotic therapy--The effects of cross-resistance and treatment history

OBJECTIVE: Selection of antibiotic therapy is a complicated process, depending on, among others, the effect of cross-resistance between antibiotics. We propose a model, which incorporates information about treatment history in the form of information on the success or failure of the current treatment and which combines this with data on cross-resistance to predict the susceptibility to future antibiotic treatments, thus providing a systematic basis for revision of antibiotic treatment. METHODS AND MATERIAL: The stochastic model was built as a causal probabilistic network (CPN). Data used in the model were based on a bacteriology database including data on patient and episode unique pathogens cultured from a microbiological sample. RESULTS: In this paper, we develop a CPN that can exploit knowledge about cross-resistance between two consecutive treatments, explore the properties of this CPN and consider how the CPN can be integrated into a complete decision support system for selection of antibiotic therapy. CONCLUSION: The model presented may be useful both as a theoretical tool describing cross-resistance between antibiotics and as a part of complete decision support system for selection of antibiotic therapy.     

A language for generating tomographic images of mathematical phantoms

A computer language is presented that can be used to generate image files, as if the images are created with a CT or a MR scanner. The language defines objects in the "scanner's" coordinate system, as sets of quadratic inequalities. Each of these objects, e.g., an ellipsoid or a half-plane or a cylinder, has its own density. Objects can be superimposed and collections of objects are allowed to translate and rotate. The language allows for a concise way of describing complex objects with precisely defined geometries and densities. An implementation of the language can be used for testing, developing, and analyzing diagnostic software, treatment planning systems, etc. A software module that is based on the language can be made available. The utility of the module for acceptance testing of radiation therapy treatment planning systems is described.     

An object-oriented design for automated navigation of semantic networks inside a medical data dictionary

In this paper we present a data dictionary server for the automated navigation of information sources. The underlying knowledge is represented within a medical data dictionary. The mapping between medical terms and information sources is based on a semantic network. The key aspect of implementing the dictionary server is how to represent the semantic network in a way that is easier to navigate and to operate, i.e. how to abstract the semantic network and to represent it in memory for various operations. This paper describes an object-oriented design based on Java that represents the semantic network in terms of a group of objects. A node and its relationships to its neighbors are encapsulated in one object. Based on such a representation model, several operations have been implemented. They comprise the extraction of parts of the semantic network which can be reached from a given node as well as finding all paths between a start node and a predefined destination node. This solution is independent of any given layout of the semantic structure. Therefore the module, called Giessen Data Dictionary Server can act independent of a specific clinical information system. The dictionary server will be used to present clinical information, e.g. treatment guidelines or drug information sources to the clinician in an appropriate working context. The server is invoked from clinical documentation applications which contain an infobutton. Automated navigation will guide the user to all the information relevant to her/his topic, which is currently available inside our closed clinical network.     

多叶光栅控制软件的设计与实现

目的:多叶光栅作为三维适形放射治疗计划和调强放射治疗计划精确快速地实施的重要设备之一,被广泛应用于肿瘤放射治疗。为精确快速地控制多叶光栅,本文对多叶光栅的控制软件进行设计和实现。方法:本文首先概要介绍该软件的整体功能,共包括治疗模块、校验模块、参数模块和串口模块,并重点介绍串口模块和检验模块。串口模块使用串口通信技术,将光栅叶片位置数据和控制数据转换为串口数据并发送到底层电路中,控制多叶光栅,保证多叶光栅控制软件和底层电路的顺畅通信。校验模块根据实际测量的等中心面叶片位置数据,建立等中心面叶片位置数据和叶片实际位置数据转换关系,得到叶片实际运动位置对应的等中心面运动位置,保证叶片在等中心面上的移动精度。结果:本软件已在VC平台下编程实现,参考某厂商多叶光栅产品注册检验报告进行测试。测量结果显示多项指标均小于1.0 mm。结论:本软件能够精确快速的控制多叶光栅,满足临床要求。     

A cardiovascular simulator tailored for training and clinical uses

ObjectiveIn the present work a cardiovascular simulator designed both for clinical and training use is presented.MethodThe core of the simulator is a lumped parameter model of the cardiovascular system provided with several modules for the representation of baroreflex control, blood transfusion, ventricular assist device (VAD) therapy and drug infusion. For the training use, a Pre-Set Disease module permits to select one or more cardiovascular diseases with a different level of severity. For the clinical use a Self-Tuning module was implemented. In this case, the user can insert patient’s specific data and the simulator will automatically tune its parameters to the desired hemodynamic condition.The simulator can be also interfaced with external systems such as the Specialist Decision Support System (SDSS) devoted to address the choice of the appropriate level of VAD support based on the clinical characteristics of each patient.ResultsThe Pre-Set Disease module permits to reproduce a wide range of pre-set cardiovascular diseases involving heart, systemic and pulmonary circulation. In addition, the user can test different therapies as drug infusion, VAD therapy and volume transfusion. The Self-Tuning module was tested on six different hemodynamic conditions, including a VAD patient condition. In all cases the simulator permitted to reproduce the desired hemodynamic condition with an error < 10%.ConclusionsThe cardiovascular simulator could be of value in clinical arena. Clinicians and students can utilize the Pre-Set Diseases module for training and to get an overall knowledge of the pathophysiology of common cardiovascular diseases. The Self-Tuning module is prospected as a useful tool to visualize patient’s status, test different therapies and get more information about specific hemodynamic conditions. In this sense, the simulator, in conjunction with SDSS, constitutes a support to clinical decision – making.     

Using patient data similarities to predict radiation pneumonitis via a self-organizing map

This work investigates the use of the self-organizing map (SOM) technique for predicting lung radiation pneumonitis (RP) risk. SOM is an effective method for projecting and visualizing high-dimensional data in a low-dimensional space (map). By projecting patients with similar data (dose and non-dose factors) onto the same region of the map, commonalities in their outcomes can be visualized and categorized. Once built, the SOM may be used to predict pneumonitis risk by identifying the region of the map that is most similar to a patient's characteristics. Two SOM models were developed from a database of 219 lung cancer patients treated with radiation therapy (34 clinically diagnosed with Grade 2+ pneumonitis). The models were: SOM(all) built from all dose and non-dose factors and, for comparison, SOM(dose) built from dose factors alone. Both models were tested using ten-fold cross validation and Receiver Operating Characteristics (ROC) analysis. Models SOM(all) and SOM(dose) yielded ten-fold cross-validated ROC areas of 0.73 (sensitivity/specificity = 71%/68%) and 0.67 (sensitivity/specificity = 63%/66%), respectively. The significant difference between the cross-validated ROC areas of these two models (p < 0.05) implies that non-dose features add important information toward predicting RP risk. Among the input features selected by model SOM(all), the two with highest impact for increasing RP risk were: (a) higher mean lung dose and (b) chemotherapy prior to radiation therapy. The SOM model developed here may not be extrapolated to treatment techniques outside that used in our database, such as several-field lung intensity modulated radiation therapy or gated radiation therapy.     

Intelligent agents technology applied to tasks scheduling and communications management in a critical care telemonitoring system

This work presents an important part of our telemedicine system for critical care units: a distributed module based on intelligent agents technology that is dedicated to the process management of a network for medical monitoring, including distribution and control of processing tasks and bandwidth management. The system provides the real-time acquisition and analysis of physiological data, the graphical visualisation of these data, and their transmission to a central system charged with the collection and control of all the information concerning the patient, including knowledge-based systems (KBS) for medical reasoning.     

基于VS2010动态血压监测系统的设计

目的：伴随着生活水平的提高、生活节奏的加快、工作压力的增大,高血压疾病呈现出年轻化的趋势,因此近年来便携式、家庭化的动态血压监测系统成为研究热点。本文即阐述一种动态血压监测系统的设计,该系统能实现对患者血压24h的动态监测,且能将监测到的数据在PC机上显示,为高血压疾病的预防、诊断、治疗及治疗效果提供重要参考信息。方法：该系统由全自动充气放气袖带、压力传感器、信号调理电路、AD转换器、单片机控制模块、按键、存储卡、显示器件及PC机监测软件等部分组成。其中,该系统采用MSP430449单片机作为下位机,实现血压的检测、采集、存储及充放气模块电机的控制;PC机作为上位机,采用VS2010实现该系统监测界面的设计,采用Access作为数据库;单片机和PC机之间通过RS232实现数据通信。结果：该系统能实现对血压的动态监测,监测界面可以设置病人信息,设置通信协议,以柱状图、饼图、拟合线、数据报表等形式显示被测试者的测量数据,界面生动形象。结论：该监测系统能够有效的实现对血压的24h动态监测,监测到的数据能够以图表的形式显示,显示界面简洁友好,便于操作,因此该系统既可用于医院病房,亦可用于家庭,通用性较强。