水下超声遥测心率系统的研制

本文介绍了一种用超声进行调制的水下心率遥测系统,可获得80m深度水下作业潜水员的心率。超声调制频率为41.7KHz。现场使用表明,该系统能在湿式和干式两种状态下,实时监测潜水员潜水时的心率变化。     

睡眠呼吸暂停综合征远程监护系统的设计

目的：设计一种无线监护系统,可以使医护人员远程监控患者睡眠呼吸暂停综合征的发生。方法：把信号检测和ZigBee无线网络技术结合起来,由CC2430控制单元将采集到的睡眠呼吸信号以射频方式进行发送和接收,接收到的数据送到PC进行处理和显示,监护终端可以实时监测患者睡眠情况。结果：该系统实现了呼吸信号的无线传输与监护,使患者摆脱了电极连线的束缚,不影响睡眠质量。结论：该系统具有体积小、功耗低的特点,为社区医疗远程监护提供了一种新的思路。     

基于ZigBee的无线传输脉搏检测系统设计

目的：设计了一种基于ZigBee技术的无线传输脉搏检测系统。方法：由CC2430控制单元将脉搏传感器采集到的人体浅表动脉处的搏动信号通过模拟电路的预处理,经数模转换后得到数字信号,再将转换后的数字信号传给控制和显示单元中的信息处理单元．进行处理和显示,同时将数据通过ZigBee无线通讯单元发送到上位机,由上位机存储数据,供医护人员检索和回放。结果：实验表明,此系统能够对人体的脉搏信号进行实时采集,同时可通过ZigBee无线网络进行实时、安全、可靠的通信。结论：该检测系统通过运用ZigBee无线通信技术,可以通过人体随身携带的无线终端采集到脉搏数据．使采集系统具有移动性,因此能广泛适用于健康运动监测、医院移动监测等领域。     

基于移动电话传输信号的心音遥测方法的初步研究

目的:探索心力和心率同时遥测的一种方法。方法:用一心音信号采集装置采集心力和心动周期信号,经一音频电缆传给一只移动电话机,再以无线方式传到另一只移动电话机,最后通过另一条音频电缆传输到计算机。结果:心音信号能通过移动电话机以无线方式传到另一只移动电话机再传到计算机;2只移动电话机之间的无线传输距离为5m,3km和2000km远。结论:心力和心率同时遥测可以通过移动电话机—移动电话机的模式来实现,这种方法具有无创、简便、快速、费用低、可重复采用等特点。     

连续波生物雷达体征检测装置与实验研究

非接触式的生命体征检测技术能够为健康监护提供一种有效辅助手段。该文使用微波雷达技术研制人体生命体征检测装置。根据多普勒原理设计连续波雷达电路实现人体微动信号检测;采用短时傅里叶变换与插值算法实现人体心率和呼吸频率参数提取;引入嵌入式平台实现装置的小型化设计和集成;编制嵌入式信号处理软件实现实时的信号处理、记录和显示。通过利用模拟装置和人体进行实验研究与性能评测,结果表明：检测系统可有效检测单个静止人体目标的生命体征,工作距离范围达90 cm,心率识别率达96%。     

基于移动网络的监护定位系统设计

目的为解决院外监护和院前急救的数据传输问题,设计了一种基于移动网络的监护系统。方法控制单元获取信号采集模块中的生理信息,连同GPS数据一起按照无线传输协议打包后发送到数据传输单元,由数据传输单元通过移动网络实时发送到Internet;在具有实IP的PC机上编写服务器程序接收病人信息实现移动监护功能的同时进行数据转发,连接医院HIS系统。结果通过该装置实现了病人实时监护信息的远程无线传输,把病人的监护空间从院内扩展到了院外的每一个角落。结论该系统运行稳定,费用低廉,具有较高的实际应用价值。     

潜水战士的防寒训练

潜水战士常在江河湖海水下执行任务,由于水下温度一般较低,加上水的导热性比空气大20～50倍,潜水时体表失热量是很大的。据研究,穿着橡胶潜水服的潜水员在5℃水中1小时,可失热242卡。失热量如果超过人体耐受度,必影响潜水员的身体健康,严重的还可酿成潜水事故。 为了防止潜水人员因水下失热过多、受寒而造成意外,除了改进装备,应用现代化的防寒潜水服外,还应重视和加强防寒训练。国外的一项研究表明,经过科学的防寒训练后,潜水员的防寒适应能力和水下作业水平明显提高。     

基于物联网的智能心音检测与分析系统

目的：针对目前人口老龄化程度加快、心脏病患病率增加以及医院看病难等问题,研究一种长期连续监测患者心音变化,实现在家中可以进行心音实时监测与远程诊断的分析系统。方法：综合运用无线传感器、信号处理以及网络传输技术等,设计一个基于物联网的远程心音检测与分析系统。结果：实现了患者心音实时监测、数据实时传输、医生远程诊断等功能。结论：根据医院数据库中长期存储的患者信息和心率指标,医生可及时制定治疗方案,达到提前预防、及时治疗的效果,商业化前景广阔。     

基于蓝牙和智能手机的在体脉搏监测仪

目的:该课题仅仅是利用了脉率这一生理参数作为代表,我们都可以把血氧、心电、心率、呼吸等无创生理参数利用蓝牙传输数据到智能手机上实时显示出来.方法:本设计利用目前已有成熟技术的单片机芯片AT89S52和蓝牙模块HC-06设计基于蓝牙技术与智能手机的脉搏无线监测系统.此项研究将先进的近距离无线传输技术应用于生理参数监护中,使大量数据的传输由有线变为无线、实时、可移动.结果:由病人随身携带可连续记录脉搏信号的便携式采集信号控制器,在采集的数据将同时传输到智能手机上,实现实时监测,若该参数超过或低于预设值,智能手机就会自动报警,监护服务器端就会响应.结论:因此能广泛适用于运动监测、医院移动监测、家庭健康监测等领域,具有重要的临床使用价值.     

水中氨氮现场快速检测与结果远程无线传输

目的 建立简便、实用的现场快速检测水中氨氮的方法,并用检测装置内置的GPRS(分组数据无线传输)模块,利用民用GSM网络,将检测结果远程无线传输到互联网上,进行实时发布,自动更新,实现水质检测数据充分共享,及时监测.方法 用自主研制的SJ2000微型水质理化速测仪,酚盐比色法现场快速测定水样氨氮后,用微型水质理化速测仪内置的GPRS发射接收模块,完成检测结果数据远程传输,发到绑定ASP网页的水质检测数据服务器上,实时在互联网上发布、更新.结果 检测方法相关性显著,精密度和准确度与国标纳氏试剂分光光度法相近.合成水样检测,相对标准偏差为4.4％,相对误差为2.7％.在5～10 min内,可现场完成水中氨氮单个水样检测、互联网结果发布.定量、半定量检测最低质量浓度分别为0.05 mg/L、0.2 mg/L,基本不受pH和常见离子的干扰.在GSM网络信号覆盖区域,数据结果无线发送均无障碍,延迟小.结论 该检测方法简便、快速、实用可靠,适用于野外现场对水中氨氮的快速测定,并实时将检测结果远程发送.为现场获得水质数据,及时快速对水质进行监测,提供了简易有效的技术手段.     

Impact of the Patient-Provider Relationship on the Survival of Foreign Born Outpatients with Tuberculosis

Background Managing tuberculosis in foreign born patients entails a complex interaction between patient and provider. Methods Using a retrospective cohort study and survival analysis, this study evaluates the impact of patient and provider factors on the survival of foreign born outpatients with active tuberculosis. The primary outcome of the study is 1 year all-cause mortality. Results In our cohort, patient-provider language discordance was associated with an increased risk of death [HR: 2.33; 95% CI: 1.39–3.88], while receiving treatment from a tuberculosis experienced physician [HR: 0.41; 95% CI: 0.22–0.77] and treatment in a dedicated tuberculosis clinic [HR: 0.53; 95% CI: 0.29–0.98] was associated with a lower risk of death. Discussion Patient-provider communication and health systems factors played a large role in the survival of our cohort of foreign born tuberculosis outpatients. These findings suggest that language barriers and the provision of care by experienced providers in specialized clinic settings may have important effects on health outcomes.     

高危型人乳头瘤病毒DNA检测在宫颈癌前病变筛查中的价值

目的评价高危型人乳头瘤病毒（HPV）DNA检测在宫颈癌筛查中的应用价值。方法2005—2007年期间,在连云港市第一人民医院进行健康检查的已婚妇女1240例（其中无临床症状1026例,有妇科症状214例）,门诊就诊宫颈异常者534例。进行宫颈癌前病变筛查,采用PCR荧光定量检测高危型HR-HPV.DNA,以病理组织学诊断结果为金标准,应用约登指数比较HPV.DNA和薄层液基细胞技术（LTCT）筛查效果。结果1774例受检者平均年龄（35±10.2）岁,经病理学诊断HPV感染51例（3.24%）,宫颈上皮内瘤变（CIN）Ⅰ级49例,Ⅱ级26例,Ⅲ级17例,浸润癌6例,内膜瘤2例,湿疣26例。以病理学确诊为金标准,HR-HPV.DNA检测CINⅡ、Ⅲ的敏感度95.35%,特异度91.67%,阳性预测值22.16%,阴性预测值99.87%,约登指数0.87;HR-HPV.DNA检测＋LTCT检测敏感度100.0%,特异度100.0%,阳性预测值100.0%,阴性预测值100%,约登指数1.0。HR-HPV.DNA在健康妇女和不同宫颈病变中的阳性率分别是正常（炎症）4.80%（78/1626）、不典型鳞状上皮细胞（ASCUS）50.67%（38/75）、低度鳞状上皮内病变（LSIL）94.44%（34/36）、高度鳞状上皮内病变（HSIL）100%（31/31）、鳞癌100（6/6）。结论HR-HPV.DNA检测在宫颈癌前病变和宫颈癌的筛查中具有敏感度高和阴性预测值高的特点,LTCT与HR-HPV.DNA联合检测可提高筛查的敏感度和阴性预测值。     

非语言交流对膀胱镜检查患者手术应激反应的影响

目的:探讨非语言交流对膀胱镜检查患者手术应激反应的影响。方法:将200例初次行膀胱镜检查患者随机分为观察组和对照组各100例。对照组行膀胱镜检查常规护理,观察组在此基础上使用非语言交流的方法进行护理干预,观察检查前后两组患者焦虑程度、血压、心率的变化。结果:观察组患者焦虑程度、收缩压及心率较对照组有明显改善,且差异有显著性,有统计学意义。结论:使用非语言交流的方法可降低膀胱镜检查患者的应激反应。     

Sexual Dysfunction in Muslim Women Receiving Dialysis: A Qualitative Study

Sexual dysfunction (SD) is common in end stage renal disease (ESRD) patients, affecting their quality of life. Sexuality is not a subject that patient’s, particularly Muslim women, discuss when they require assistance. They need to develop strategies to cope with SD. The qualitative study explored how Muslim women with ESRD cope with SD. A phenomenological approach was adopted and data were collected using semistructured individual interviews. Purposive sampling was used to recruit 20 participants from two southern regional hospitals in Thailand between September and December, 2018. Recruitment continued until data saturation was reached. Data were analysed using Colaizzi’s phenomenological approach. Participants were aged between 30 and 63 years (mean?=?45.25, SD?=?8.50). Ten were receiving haemodialysis (HD) and 10 were receiving continuous ambulatory peritoneal dialysis (CAPD). Five themes were identified: (1) receiving compassion and understanding from their partner, (2) being afraid of sin if not taking responsibility as a wife’s role, (3) denying and ignoring sexuality, (4) being patient to keep their family together and (5) accepting SD associated with God’s will. The findings suggest that understanding Islamic views on SD and how the religion’s beliefs and practices influence SD and the way Muslim women cope with it. Hence, it is critical in opening lines of communication with patients and their partners to help them cope with SD.

     

A conceptual framework of quality of life in chronic kidney disease in Turkey: A patient-focused approach

This study aimed to determine the quality of life of patients with chronic kidney disease who were receiving dialysis treatment. It also aimed to identify the factors affecting the quality of life of these patients. The independent variables analyzed were: patients' sociodemographic characteristics, organizational characteristics, adherence to treatment, patient-physician relationship, and patient activation level. The sample consisted of 328 patients with chronic kidney disease who received services from dialysis units of two university hospitals and two private dialysis centers. Data analysis was performed through multivariate regression. Results showed that receiving treatment from a hospital-based dialysis unit may have a positive effect in patients' quality of life; and patient-physician relationship, patient activity, and adherence to treatment may positively affect quality of life. Thus, planning of health service delivery that focus on improving the quality of life of patients who are more active by allowing them to establish positive relationships with their physicians and to have a better adherence to treatment should be adopted. These findings may provide health managers, health professionals, and individual patients with evidence-based information about treatment management and health service planning processes related to chronic kidney disease.     

Application of Holter electrocardiography to exercise testing for the group examination of school children: comparison between obese and normal children

Application of Holter electrocardiography to an exercise test for heart function is useful in the group examination of school children. The circulatory responses to a step test among obese boys and girls and control were as follows: 1. Four cases of arrhythmia were detected, of whom 2 cases were discovered during exercise. ST-segment depression of 0.1 mV or more during and after exercise was recognized in 29 cases, 27 of the junctional- and 2 of the sagging slope, with a higher percentage in obese girls than in normal girls. 2. Serial ECG records during the procedure, performed for all children with the same single-step test, showed differences in the circulatory responses among the test groups. The load was estimated to be 76-86% of the maximal heart rate predicted by Cummings, with obese and girl groups being higher than other groups. The comparison revealed that the heart rate (HR) responses to exercise done by the boys increased faster than those by the girls at 1 minute after exercise. There were differences between obese and control and between boys and girls in HR at recovery, and also in HR before and 4 minutes after exercise between two sexes, which findings agree with other reports. 3. Concerning anthropometric factors, either the skinfold thickness or the obesity index was related to the HR at the peak of the exercise as well as immediately after it and to the half time. By contrast, the arm muscle diameter was found unrelated to the HR. Using this method, applied these combination of Holter ECG and step test to a group examination, we got ECG data for 254 subjects, 97.5% of which were suitable for analysis. We found this method to be effective for detecting ECG changes and for determining HR responses to exercise. This method is safe, simple, and inexpensive and is applicable to examination not only for school children but also for different population groups, for the estimation of circulatory responses.     

A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study

BACKGROUND: Most large cohort studies have used a food frequency questionnaire (FFQ) for assessing dietary intake. Several biomarker studies, however, have cast doubt on whether the FFQ has sufficient precision to allow detection of moderate but important diet-disease associations. We use data from the Observing Protein and Energy Nutrition (OPEN) study to compare the performance of a FFQ with that of a 24-hour recall (24HR). METHODS: The OPEN study included 484 healthy volunteer participants (261 men, 223 women) from Montgomery County, Maryland, aged 40-69. Each participant was asked to complete a FFQ and 24HR on two occasions 3 months apart, and a doubly labelled water (DLW) assessment and two 24-hour urine collections during the 2 weeks after the first FFQ and 24HR assessment. For both the FFQ and 24HR and for both men and women, we calculated attenuation factors for absolute energy, absolute protein, and protein density. RESULTS: For absolute energy and protein, a single FFQ's attenuation factor is 0.04-0.16. Repeat administrations lead to little improvement (0.08-0.19). Attenuation factors for a single 24HR are 0.10-0.20, but four repeats would yield attenuations of 0.20-0.37. For protein density a single FFQ has an attenuation of 0.3-0.4; for a single 24HR the attenuation factor is 0.15-0.25 but would increase to 0.35-0.50 with four repeats. CONCLUSIONS: Because of severe attenuation, the FFQ cannot be recommended as an instrument for evaluating relations between absolute intake of energy or protein and disease. Although this attenuation is lessened in analyses of energy-adjusted protein, it remains substantial for both FFQ and multiple 24HR. The utility of either of these instruments for detecting important but moderate relative risks (between 1.5 and 2.0), even for energy-adjusted dietary factors, is questionable.     

Increased physiotherapy in sheltered housing in Sweden: a study of structure and process in elderly care

The effect of increasing the level of physiotherapy services in elderly care was studied using an intervention and a control unit. The units had 20 and 2 hours of physiotherapy services per week, respectively. Physiotherapy and occupational therapy records were reviewed before and during the project. Physiotherapists also kept extended documentation over an 11-month period. Data analyses employed the chi-square test and content analysis. There was a significant increase in the number of patients receiving physiotherapy and occupational therapy within both units. No significant differences between the units were found for the number of patients receiving physiotherapy. The number of patients receiving occupational therapy differed significantly between units before as well as during the intervention. Primarily care assistants and auxiliary nurses initiated contact with the physiotherapists mainly for patient-orientated errands. Fifty per cent of the instructions given by the physiotherapist at the 20-hour unit related to movement-orientated activities of daily living. At the 2-hour unit, the majority of instructions (52%) were programme-orientated.     

Subsequent Cancer Risk of Women Receiving Hysterosalpingography: A Nationwide Population-Based Retrospective Cohort Study

The objective of this study was to estimate the subsequent cancer risk of women after receiving hysterosalpingography (HSG) by conducting a nationwide retrospective cohort study. We identified a study cohort of 4,371 patients who had had a HSG examination and a comparison cohort of 17,484 women without HSG examination between 1998 and 2005. Both cohorts were followed up with until the end of 2010 to measure the incidence of cancer. The risk of developing cancer for patients with HSG was assessed using the Cox proportional hazard model. In the multivariate analyses, the HSG cohort did not have a significantly greater risk of cancer (Hazard Ratio [HR] = 1.02, 95% CI = 0.79–1.31) than the non-HSG cohort. The HR was highest for genital cancer (HR = 1.32, 95% CI = 0.77–2.25), followed by urinary system cancer (HR = 1.11, 95% CI = 0.23–5.40), and abdominal cancer not involving the GU system (HR = 1.04, 95% CI = 0.53–2.03), all of which were non-significant elevations. The cancer incidence rates, especially that for urinary system cancer, were increased in the HSG cohort, but the increase in cancer incidence was small and not statistically significant.