Effects of different tissue loads on high power ultrasonic surgery scalpel

The objective of this study is to investigate the influence of various tissue loads on the working characteristic of the ultrasonic scalpel, including working frequency, input admittance and reflection factor. Ex vivo animal experiments are carried out and relevant discussions of experimental results are provided. Admittance measurement results show that different tissue loads have different effects on a scalpel's working ability. Soft tissue makes the working frequency decrease and bone tissue makes it increase. Radius of admittance circles and reflection factor are also different. Equivalent circuit model is found and with a least-square parameter identification method, input admittance of ultrasonic scalpel with different tissue loads is solved. Results show that admittance circle radius is determined by the value of R1. Changes in L1 and C1 contribute to the shift of working frequency. This study will help decrease the sensitivity of ultrasonic scalpel to loads and greatly increase surgery efficiency.     

Intra-aortic balloon counterpulsation complicated by limb ischaemia: a reflective commentary

Intra‐aortic balloon counterpulsation (IABC) is widely used to support the failing myocardium, particularly in patients with a background of acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). CS is primarily due to left ventricular failure and is the most serious complication of AMI. Using Driscoll’s ‘What?’ reflective model to guide critical thinking, an incident involving a patient who required IABC following AMI is explored. There are various complications associated with IABC, limb ischaemia being very common. Risk factors, which predispose patients to the development of limb ischaemia following intra‐aortic balloon pump insertion, are discussed as are the issues surrounding their care. Nurses are in an ideal position to detect any complications that may occur. They should be familiar with the patient’s medical history, including any risk factors, which could predispose them to the development of limb ischaemia. Consideration of these factors and the adjunctive treatment the patient may require can be used to plan care accordingly. Anecdotal evidence suggests that more patients are requiring haemodynamic support from IABC. Nurses and health care professionals who have the responsibility of caring for these patients need to be adequately trained in order to maintain a high standard of care. However, there appears to be a lack of evidence‐based guidelines determining the optimum frequency of limb observations to assess for limb ischaemia. Further evidence as to the timing of limb observations is required in order that protocols can be written to guide the practice.     

扫医患纠纷案例引发的妇产科伦理学思考

通过对某医惠纠纷案例的分析,探讨其产生的医学根源、社会影响以及由此引发的伦理学思考,并结合目前实际情况提出对策;强化医学伦理道德意识、尊重患者知情同意权。     

新时期加强医学院校师德师风建设的实践与思考

教师是人类灵魂的工程师,高校教师的师德师风建设是决定高等教育水平和质量的重要因素之一.本文以北京大学公共卫生学院的具体实践为例,探讨新时期进一步加强医学院校师德师风建设的内容和方式,以期提供一些参考和借鉴.     

Reflective practice in the teaching of communication skills

Reflective practice is encouraged in medical education in general and in teaching communication skills in particular to develop into a reflective practitioner. However, the term is complex to understand and multidimensional thus challenging to grasp, describe and teach. Furthermore, though used frequently little guidance exists on how to promote reflective ability in teaching communication skills. This paper builds on a keynote address delivered at the International Conference of Communication in Healthcare (ICCH 2019) and is based on the vast literature on reflection and the author’s personal experience as a researcher and educator. It discusses the components of reflective practice as well as exemplifies the importance of reflective practice to student’s capability to learn communication skills.     

Black beans and red kidney beans induce positive postprandial vascular responses in healthy adults: A pilot randomized cross-over study

Background and aimsConsuming pulses (dry beans, dry peas, chickpeas, lentils) over several weeks can improve vascular function and decrease cardiovascular disease risk; however, it is unknown whether pulses can modulate postprandial vascular responses. The objective of this study was to compare different bean varieties (black, navy, pinto, red kidney) and white rice for their acute postprandial effects on vascular and metabolic responses in healthy individuals.Methods and resultsThe study was designed as a single-blinded, randomized crossover trial with a minimum 6 days between consumption of the food articles. Vascular tone (primary endpoint), haemodynamics and serum biochemistry (secondary endpoints) were measured in 8 healthy adults before and at 1, 2, and 6 h after eating ¾ cup of beans or rice. Blood pressure and pulse wave velocity (PWV) were lower at 2 h following red kidney bean and pinto bean consumption compared to rice and navy bean, respectively (p < 0.05). There was greater vasorelaxation 6 h following consumption of darker-coloured beans, as shown by decreased vascular tone: PWV was lower after consuming black bean compared to pinto bean, augmentation pressure was lower after consuming black bean compared to rice and pinto bean, and wave reflection magnitude was lower after consuming red kidney bean and black bean compared to rice, navy bean, and pinto bean (p < 0.05). LDL-cholesterol concentrations were lower 6 h after black bean consumption compared to rice (p < 0.05).ConclusionOverall, red kidney and black beans, the darker-coloured beans, elicited a positive effect on the tensile properties of blood vessels, and this acute response may provide insight for how pulses modify vascular function.     

基于样本熵和血液动力学参数的中医脉象特征分析与识别

本文提取脉搏波的波速和反射因子作为特征参数来表征中医常见脉象的脉搏波传播和反射特性;考虑到脉搏波信号的非线性,本文提取样本熵来表征中医常见脉象的脉搏波的非线性特征。两类特征相结合对中医平、弦、滑脉进行分类识别,得到较好的效果。     

回归"人"本身：大数据在医学研究中应用的反思

大数据作为一种新的思维方式和技术手段在各行业得到了广泛的应用。随着医疗数据的快速电子数字化,基于大数据的医学研究也开展的如火如荼。本文通过研究大数据的内涵、特征以及大数据应用于医学研究过程中存在的问题,分析大数据应用在医学研究中的作用及其局限性,得出大数据在医学研究中的应用策略及价值指向。