The goal of this paper is to solve the problems of large volume, slow dynamic response and poor intelligent controllability of traditional gait rehabilitation training equipment by using the characteristic that the shear yield strength of magnetorheological fluid changes with the applied magnetic field strength. Based on the extended Bingham model, the main structural parameters of the magnetorheological fluid damper and its output force were simulated and optimized by using scientific computing software, and the three-dimensional modeling of the damper was carried out after the size was determined. On this basis and according to the design and use requirements of the damper, the finite element analysis software was used for force analysis, strength check and topology optimization of the main force components. Finally, a micro magnetorheological fluid damper suitable for wearable rehabilitation training system was designed, which has reference value for the design of lightweight, portable and intelligent rehabilitation training equipment.
ObjectivesTo develop a real-world-data-based monitoring system for diagnostic large medical equipment, and to use PET/CT as a carrier for validation. MethodsWe used literature survey, site investigation, and two-rounds of modified Delphi methods to develop the indicator system, and used the analytic hierarchy process method to determine the weight of each indicator. We collected real-world PET/CT data from four tertiary hospitals from July to December 2022, and monitored the use of PET/CT in each hospital. ResultsQuestionnaire recovery rates of 2 rounds were 100% and 88%, respectively, the expert authority coefficient was greater than 0.70, and the coordination coefficients of experts in the total index were 0.307 and 0.471 (P<0.001). A three-level indicator system was established to monitor the use of large medical equipment, with three first-level indicators (clinical use, implementation, and other efficiencies), eight second-level indicators, and 15 third-level indicators. Empirical experiment found different hospitals vary in efficiency (of clinical use), staff status, and economic and research efficiency, while remained similar in other indicators. ConclusionWe developed a monitoring system for diagnostic large medical equipment based on real-world data, and used PET/CT as a carrier for validation. These findings provided theoretical and empirical foundations for the management of diagnostic large medical equipment in China.
To reduce the infection risk of 2019-novel coronavirus and to protect medical staffs, “Graded personal protection scheme for preventing medical staffs from 2019-novel coronavirus infection in West China hospital” was formulated according to the guidance and notice issued by the National Health Commission combined with the actual situation of West China Hospital. This scheme could provide reference for preventing such disease for medical staffs.
Objective To provide theoretical basis for the reasonable selection of personal protective equipment by analyzing the willingness of protection and the contamination of severe acute respiratory syndrome coronavirus 2 of medical staff in the designated hospital for treatment of coronavirus disease 2019. Methods The medical staff of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine who entered the contaminated area from May 1 to 31, 2022 were collected as the study subjects. A simple random sampling method was adopted to investigate the willingness of protection of different medical staff leaving the cabin. Contamination of severe acute respiratory syndrome coronavirus2 was detected by fluorescence polymerase chain reaction. Results A total of 70 medical staff were included. There were 61 nurses and 38 in intensive care unit. The survey showed that 47 medical staff chose disposable isolation clothes, 44 medical staff chose protective face screen and 69 medical staff chose double-layer shoe cover/boot cover. A total of 640 specimens were collected. Six positive samples for severe acute respiratory syndrome coronavirus2 nucleic acid test were detected, with a positive rate of 0.94%. All the positive samples were sampled from the sole of a protective clothing. Six positive samples were willing to choose double-layer shoe cover/boot cover. Conclusions The medical staff in designated hospital for treatment of coronavirus disease 2019 tend to take high protection during daily medical activities. However, personal protective equipment is less likely to be contaminated by severe acute respiratory syndrome coronavirus2, and it should be selected rationally to avoid excessive protection.
Foam sclerotherapy is one of the major therapies for varicose veins in lower limbs. It is important to know the influence factor of foam stability which is beneficial to curative effect. The present experiment explored influence of 9 kinds of driving speed on foam stability when using the method of Tessari. Syringes of 5 mL were chosen to do this experiment which was carried out at the liquid gas ratio of 1:4 and the environment temperature of 20℃. A home-made automatic sclerosing foam preparation equipment was used to prepare the foam. A camera recorded the entire process of foam decay. And foam stability indexes which includes drainage time, half-life, foam half-life volume and the drainage rate curve, were analyzed. The results showed that when driving speed ranged from 100 mm/s to 275 mm/s, foam drainage time and the half-life showed a trend of rising. When the driving velocity was greater than 275 mm/s, the foam drainage time and half-life time reduced a little. The largest drainage time and the half-life differences were 340.0% and 118.8% compared to their minimum value. Meanwhile the pressure increased with the increase of driving speed, so that the solubility of carbon dioxide increased and the foam half-life volume decreased with the increase of the driving speed. It can be concluded that when using the method of Tessari to prepare sclerosing foam, driving speed has a significant effect on its stability. With driving speed increasing, foam decay mechanism changes from gas diffusion to liquid drainage as the main function, so the foam stability increased at first and then decreased later. The foam is relatively more stable at the speed of 275 mm/s, which could be considered as the best driving speed.
The deep integration of modern technology and medical development promotes the change of medical and health management environment. As an important part of hospital medical and health decision-making process, the evaluation and access of medical equipment and consumables need scientific evidence-based evaluation system. This paper introduces a new-equipment evaluation model created by the multi-disciplinary evaluation team of West China Hospital of Sichuan University under the guidance of evidence-based ideas and methods. This model is suitable for the Chinese national conditions and easy to operate.
ObjectiveTo strengthen the management of medical equipment and improve the use value of medical equipment by PDCA cycle. MethodsBetween March and June 2014, we introduced PDCA cycle into the management and use of newly-bought equipment.The use of newly-bought arteriosclerosis detector, TCD and ultrasound bone densitometer between March and June 2014 was regarded as the control group (before the implementation of PDCA cycle), and the use of these three kinds of equipment between March and June of 2015(after the implementation of PDCA cycle) was seen as the observation group.By analyzing the status quo through collected information, we drew a fishbone diagram to find out the factors that could influence the use efficiency of medical equipment.Then, corresponding measures were taken for continuous improvement, including adopting revised regulations, training technicians, quantifying work indexes, informatization, changing service mode, and examining and assessing the effect of implementation.Finally, feedback was summarized for the next PDCA cycle. ResultsAfter the implementation of PDCA cycle, the daily check numbers of hospital medical equipment including arteriosclerosis detector, TCD, and ultrasound bone densitometer all improved significantly (P < 0.05).The daily check numbers of those three kinds of equipment after the implementation of PDCA cycle were respectively 48.52±19.72, 32.14±10.14 and 55.59±25.12, while the numbers before were respectively 32.46±20.69, 15.46±10.05 and 29.83±20.20.Moreover, working days, maximum working hours daily, and total working time were also increased after the implementation of PDCA cycle. ConclusionThe application of PDCA cycle can effectively improve the use value of medical equipment, and improve the social benefit and economic benefit.
Objective To understand the current situation of the use and cognition of personal protective equipment (PPE) by healthcare workers in the isolation wards (rooms) during the coronavirus disease 2019 epidemic, and provide data support for the country to further optimize the configuration of PPE and carry out more targeted training and supervision. Methods In March 2020, healthcare workers in isolation wards (rooms) in provinces and cities in the country were investigated by filling in a questionnaire about the use of different levels of PPE. Results A total of 6 859 questionnaires were collected from 29 provinces and cities, containing 5 935 valid questionnaires (86.53%). Among them, there were 448 assisting-Hubei medical team members and 5 487 non-assisting-Hubei healthcare workers. The actual use rate (74.22%) and intended use rate (73.14%) of surgical masks in the cleaning areas were the highest. The actual use rate and intended use rate of working caps in potentially contaminated areas and contaminated areas were higher than 90%. There were various combinations of protective articles, and there were significant differences between actual use and intention (P<0.05). Except for the boot covers (single layer) in the cleaning areas, the working caps, isolation clothing and boot covers (double layer) in the potential pollution areas, and the protective face screens, working caps, three-layer shoe covers and single/double/three-layer boot covers in the pollution areas-splashing operations (P>0.05), the actual utilization rates of protective articles of the assisting-Hubei medical team members were generally higher than those of the non-assisting-Hubei healthcare workers (P<0.05). Conclusions The instructions for the use of PPE in different areas and operations should be further refined, and standardized training should be increased. The phenomenon of non-standard use of protective equipment should be reduced, and a safety barrier should be provided to the healthcare workers.
Objective To survey the present situation of medical equipment configuration of township hospitals in Shuangliu County, to provide baseline data for the next step of discussing the well-off township hospital medical equipment configuration standards. Methods According to the national guidance on device configuration in township hospitals, the questionnaire was made to survey 24 county township medical units (i.e. 3 central township hospitals, 3 community health centers, and 18 general township hospitals). The descriptive and stratified analysis was performed for the survey results. Results The condition of medical equipment configuration in the 3 central hospitals was better than that in the 3 community health centers which was better than that in the 18 general hospitals. The emergency equipment configuration such as defibrillator units, breathing airbags, and tracheotomy package was poor. Annual inspection rate of medical metering equipment was lower than expectation. In 2010, a total of 127 medical measuring equipments from 98.5% of the township hospitals applied annual inspection, among which, only the total annual rate of black and white B ultrasonic and X-ray machine reached above 60%; the rate of blood cells analyzer, ECG monitoring instrument, and biochemical analyzer were between 50% to 60%; and the rate of urine analyzer was the lowest at 4.5%. Conclusion It is the right time to strengthen the first aid equipment configuration in township hospitals and to enhance the annual inspection rate of the medical measuring equipment, so that the safety use and accuracy detecting can be guaranteed.