儿童肾积水诊断的临床思维辅助导向系统研究

目的:针对儿童肾积水诊断过程复杂,不同医疗机构的设备和医生技术经验不尽相同的问题,研发儿童肾积水诊断临床思维导向方案,实现智能化与高效化诊断.方法:纳入多类先天性肾积水诊断知识,并基于工作流和知识图谱关键节点推理技术给出将这些知识计算机临床思维化的方法,建立辅助导向系统,实现智能导诊.结果 与结论:形成儿童肾积水临床思...     

工作流程梳理在门诊药房应用的体会

目的总结门诊药房工作流程梳理及应用体会。方法从建立和应用的角度,介绍工作流程制订的方法和使用的意义。结果建立工作流程可避免传统带教弊端,提高工作效率,减少工作差错,便于药房统一管理。结论合理的工作流程是高质高效完成各项工作的有力保障。     

Head-and-Neck MRI-only radiotherapy treatment planning: From acquisition in treatment position to pseudo-CT generation

PurposeIn context of head-and-neck radiotherapy, this study aims to compare MR image quality according to diagnostic (DIAG) and radiotherapy (RT) setups; and to optimise an MRI-protocol (including 3D T₁ and T₂-weighted sequences) for dose-planning (based on pseudo-CT generation).Materials and methodsTo compare DIAG and RT setups, signal-to-noise-ratio (SNR) and percentage-image-uniformity (PIU) were computed on T₁ images of phantoms and volunteers. Influence of the sample conductivity on SNR was quantified using homemade phantoms. To obtain reliable T₁ and T₂ images for RT-planning, an experimental design was performed on volunteers by using SNR, contrast-to-noise-ratio (CNR) and mean-opinion-score (MOS). Further, pseudo-CTs were generated from 8 patients T₂ images with a state-of-art deep-learning method. These pseudo-CTs were evaluated by mean-absolute-error (MAE) and mean-error (ME).ResultsSNR was higher for DIAG-setup compared to RT-setup (SNR-ratio = 1.3). A clear influence of the conductivity on SNR was observed. PIU was higher for DIAG-setup (38.8%) compared to RT-setup (33.5%). Regarding the protocol optimisation, SNR, CNR, and MOS were 20.6, 6.16, and 3.91 for the optimal T₁ sequence. For the optimal T₂ sequence, SNR, CNR and MOS were 25.6, 44.46 and 4.0. In the whole head-and-neck area, the mean MAE and ME of the pseudo-CTs were 82.8 and -3.9 HU.ConclusionWe quantified the image quality decrease induces by using an RT-setup for head-and-neck radiotherapy. To compensate this decrease, an MRI protocol was optimised by using an experimental design. This protocol of 15 minutes provides accurate images which could be used for MRI-dose-planning in clinical practice.     

Improved X-Ray Safety,Quality Control,and Resource Management in Medical Imaging Using QATrack+

Introduction/BackgroundManagement of a quality assurance program in diagnostic imaging involves a variety of machine types, multiple vendors, and a large number of frontline staff who have different specializations. Standardizing tests across multiple platforms in the face of vendor recommendations, regulatory requirements, and professional practice protocols can present challenges to maintain a robust and coherent quality assurance program. The current work presents a unique application of an existing tool that can be used to manage a comprehensive quality assurance program in a diagnostic imaging department.Materials and MethodsQATrack+ is an open source, quality assurance platform originally developed for and currently widely used in radiation therapy departments. The use of QATrack+ for quality assurance program management within a large diagnostic imaging department is a novel use of this tool.Results and DiscussionQATrack+ was successfully implemented in a large, multisite diagnostic imaging department. The progression toward a single platform for the quality assurance program has addressed issues of end of life with previous software packages and has improved the standardization of testing across the institution. The configuration of the software has enabled frontline staff to be directly engaged in the quality control (QC) program, improving the efficiency of resource allocation for QC and promoting a strong safety culture and commitment to quality. Trending tools within QATrack+ allow for simplified review of tests and enable the early identification of potential failures.ConclusionOriginally developed for radiation therapy programs, QATrack+ is well suited to applications within diagnostic imaging. It is versatile and is easily adapted to the individual needs of a department for activities ranging from quality control testing, scheduling, test review, and data trending. It simplifies the standardization of quality control practices across platforms, thereby facilitating training and promoting involvement in the quality assurance program by all staff.     

Application of 1H NMR-based metabolomics for discrimination of different parts and development of a new processing workflow for Cistanche deserticola

Cistanche deserticola (CD) is one of the two authoritative source plants of Cistanches Herba, a well-known medicinal plant. Herein, ¹H NMR spectroscopy was employed to characterize the chemical profile and to distinguish the different parts, as well as to propose a new processing workflow for CD. Signal assignment was achieved by multiple one and two dimensional NMR spectroscopic techniques in combination with available databases and authentic compounds. The upper parts of the plant were distinguished from the lower parts by combining ¹H NMR spectroscopic dataset with multivariate statistical analysis. A new processing method that hyphenated steaming with freeze-drying, was demonstrated to be superior to either steaming coupled with oven-drying or direct freeze-drying via holistic ¹H NMR-based metabolomic characterization. Phenylethanoid glycosides, mainly echinacoside and acteoside, were screened out and confirmed as the chemical markers responsible for exhibiting the superiority of the new processing workflow, whereas serial primary metabolites, especially carbohydrates and tricarboxylic acid cycle metabolites, were found as the primary molecules governing the discrimination between the upper and lower parts of the plant. Collectively, ¹H NMR spectroscopy was demonstrated as a versatile analytical tool to characterize the chemical profile and to guide the in-depth exploitation of CD by providing comprehensive qualitative and quantitative information.     

成人重症患者深静脉血栓医护一体快速筛查流程的构建

目的 探讨适合我国成人重症患者深静脉血栓快速筛查的流程,为血栓预防护理提供参考。方法 应用循证护理方法,针对成人重症患者深静脉血栓筛查流程提出问题,进行系统检索、证据提取等,形成成人重症患者深静脉血栓医护一体筛查的证据;通过2轮焦点小组访谈确定成人重症患者深静脉血栓医护一体快速筛查流程。结果 形成的成人重症患者深静脉血栓医护一体快速筛查流程包括风险评估、超声筛查、深静脉血栓预防、管理与质控4个步骤。结论 本研究构建的成人重症患者深静脉血栓医护一体快速筛查流程,可用于成人重症患者深静脉血栓风险筛查。