目的 通过Narcotrend指导丙泊酚的靶控浓度来研究帕瑞昔布钠超前镇痛对宫腔手术患者术中和术后镇痛效果的影响。 方法 2012年1月－6月，60例实施宫腔手术的患者随机分为A、B两组，每组30例，A组为术前20 min静脉注射帕瑞昔布钠组，B组为术前20 min静脉注射等量生理盐水组。记录Narcotrend值D1，患者心率稳定时两组的靶控浓度、血压、心率、血氧饱和度（SpO2）及患者术苏醒后10 min镇痛效果视觉模拟评分（VAS）、Riker镇静、躁动评分（SAS）。 结果 A组患者的瑞芬太尼目标靶控浓度小于B组（P＜0.05），两组的丙泊酚靶控浓度差异无统计学意义（P＞0.05）。两组患者血压、心率均小于术前（P＜0.05），SpO2与术前比较差异无统计学意义（P＞0.05）。术后患者VAS评分A组低于B组（P＜0.05），SAS评分B组高于A组（P＜0.05）。 结论 帕瑞昔布钠对Narcotrend值无影响，帕瑞昔布钠能减少宫腔手术患者术中、术后的疼痛及术后的躁动。
The quality of sleep has a great relationship with health and working efficiency. The result of sleep stage classification is an important indicator to measure the quality of sleep, and it is also an important way to diagnose and treat sleep disorders. In this paper, the method of detrended cross-correlation analysis (DCCA) was used to analyze sleep stage classification, sleep electroencephalograph signals, which were extracted from the MIT-BIH Polysomnographic Database randomly. The results showed that the average DCCA exponent of the awake period is smaller than that of the first stage of non-rapid eye movement (NREM) sleeps. It is well concluded that the method of studying the sleep electroencephalograph with this method is of great significance to improve the quality of sleep, to diagnose and to treat sleep disorders.
The present paper is to evaluate the scientific research level and development trends of biomedical engineering in China using metrology analysis on Chinese biomedical engineering scientific literatures. Pubmed is used to search the biomedical engineering publications in recent 5 years which are indexed by Science Citation Index, and the number and cited times of these publications and the impact factor of the journals are analyzed. The results show that comparing with the world, although the number of the publication in China has increased in recent 5 years, there is still much room for improvement. Among Chinese mainland, Hongkong and Taiwan, Chinese mainland maintains the obvious advantage in this subject, but Hongkong has the highest average cited number. Shanghai and Beijing have better research ability than other areas in Chinese mainland.
Optical imaging technology of ocular fundus, including fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and fundus autofluorescence (FAF), is growing at an unprecedented speed and scale and is integrating into the routine clinical management of ocular fundus diseases, such as diagnosis, treatment, and mechanism study. While FFA allow us to observe the retinal and choroidal blood circulation, OCT and FAF are non-invasive, fast and quantifiable measurement; such techniques show even more unique advantages and are favored tools. All these retinal imaging technologies, together with a variety of retinal function assessments, bring us into the era of big data of ocular fundus diseases. All of these developments are the challenges and opportunities for the operator and user of these fundus optics imaging technologies. In order to improve its clinical applications and allocate resources rationally, we need to understand the optical properties of these retinal imaging technologies, and standardize diagnosis behavior. This is a continuous learning process needs to continue to explore.
Choroidal neovascularization (CNV) is the key characteristic of neovascular age-related macular degeneration (nAMD), and the effective therapy is intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents based on clinical and basic research. In the meantime the challenge is how to further improve the inhibiting effect for CNV and visual function of anti-VEGF treatment on nAMD. The new strategy and drug delivery devices for anti-VEGF treatment will optimize the clinical scheme. From bench to bedside, the research on targeted treatment of angiogenesis brings the bloom of nAMD medical therapy.
Using optical imaging equipment with different wavelength and computer technology, fundus optical imaging diagnostic techniques can record fundus reflected light, auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid. Advances in fundus optical image capture technology (including laser, confocal laser, spontaneous auto-fluorescence, multispectral imaging) and storage and analysis technology, promote this field into a high-definition digital imaging era, with features of rapid, non-invasive, wide-angle three-dimensional multi-level integration, dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques. In order to promote clinical and scientific research of ocular fundus diseases, we need to understand the development trend of optical imaging diagnostic technique, interpret the fundus imaging features appropriately, reasonably chose different inspection techniques, establish standardized diagnosis criteria and continue to expand clinical applications.
The hallmark of the recent latest advances in diagnostic fundus imaging technology is combination of complex hierarchical levels and depths, as well as wide-angle imaging, ultra-wide imaging. The clinical application of wide-angle and ultra-wide imaging, not only can reevaluate the role of the peripheral retina, the classification types and treatment modalities of central retinal vein occlusion, and enhance the reliability of diabetic retinopathy screening, improve the classification and therapeutic decision of diabetic retinopathy, and but also can help guide and improve laser photocoagulation. However we must clearly recognize that the dominant role of ophthalmologists in the diagnosis of ocular fundus diseases cannot be replaced by any advanced fundus imaging technology including wide-angle imaging. We emphasize to use the three factors of cognitive performance (technology, knowledge and thinking) to improve the diagnosis of ocular fundus diseases in China.
Sleep apnea syndrome (SAS) is a kind of harmful systemic sleep disorder with high incidence, and the pathological mechanism of it is complicated and the diagnosis and treatment are difficult. Mining the characteristic information of SAS from the single or small physiological signal is a hot topic in the research of sleep disorders in recent years. In our study shown in this paper, the detrended fluctuation analysis (DFA) was used to analyze sleep electroencephalogram (EEG) of SAS patients and normal healthy persons based on the non-stationary and nonlinear characteristics. It was found that in both groups, the scaling exponents increased gradually with the deepening of sleep, and in the rapid eye movement (REM) stage, the scaling exponents decreased. The scaling exponents of SAS group were significantly higher than those of the healthy group. The performance of SAS diagnosis based on scaling exponents was evaluated with receiver operator characteristic (ROC) curve. The optimal threshold value 0.81 for the SAS and normal control were obtained, corresponding to the sensitivity 94.4%, specificity 99.2%, and area under curve (AUC) was 0.994. The results show that DFA scaling exponents have a good discrimination power and accuracy for the SAS, which provide a new theoretical basis for SAS diagnosis.
The multi-fractal de-trended fluctuation analysis was used to estimate the mental stress in the present study. In order to obtain the optimal fractal order of the multi-fractal de-trended fluctuation analysis, we analyzed the relationship between singular index and Hurst index with order. We recorded the electroencephalogram (EEG) of 14 students, compared the relationship between singular index, Hurst index and quality index, ensured the optimal order being [—5, 5] and achieved the estimation of mental stress with the β wave in the EEGs. The result indicated that Hurst index and quality index of the EEGs under mental stress were greater than those of EEGs in the relaxing state. The Hurst index was gradually decreasing with the order increasing and was finally approaching a constant, while the quality index was amplified and variation of amplitude of the singular index was more obvious. We also compared the amplitude and the width of singular spectrum of the EEGs under the two conditions, and results indicated that the characteristics of multi-fractal spectrum of the EEGs under different conditions were different, namely the width of singular spectrum of the EEGs under mental stress was greater than that under relax condition.
There has been ongoing progress in the new technique and equipment in vitreoretinal surgery in recent years, contributing to the improvement of treatment of various vitreoretinal diseases. The application of 3D heads-up display viewing system (3D viewing system) has been one of the most fascinating breakthroughs in vitreoretinal surgery. Unlike the traditional method in which the surgeons have to look through the microscope eyepieces, this system allows them to turn their heads up and operate with their eyes on a high-definition 3D monitor. It provides the surgeons with superior visualization and stereoscopic sensation. And increasing studies have revealed it to be as safe and effective as the traditional microscopic system. Furthermore, the surgeons can keep a heads-up position in a more comfortable posture and lesson the pressure on cervical spine. Meanwhile, 3D viewing system makes it easier for the teaching and learning process among surgeons and assistants. However, there are still potential disadvantages including the latency between surgeon maneuver and visualization on the display, learning curves and cost. We hope that the 3D viewing system will be widely used and become a useful new tool for various vitreoretinal diseases in the near future with rapid development in the technology and constant upgrade of the system.