1.Visualization analysis of study status of measuring the dose of radiotherapy for Flash-RT
Ning WANG ; Shixu ZHANG ; Yixiao GUO ; Juntao RAN
China Medical Equipment 2024;21(5):1-10
Objective:To conduct visualization analysis,induction and summary for the study status,focus and trend in the dose measurement field of flash radiotherapy(Flash-RT)through bibliometric methods on the basis of the Web of Science Collection(WOS),and analyze the technical bottleneck of Flash-RT dose measurement.Methods:In the WOS database,the("FLASH radiotherapy"or"ultra high dose rate"or"FLASH irradiation")and TS=("dosimetric system"or"dosimeters"or"dosimetry")were used as the theme terms,and all relevant literatures about the study of Flash-RT dose measurement that were included in the Core Collection of WOS database were retrieved.The citation analysis function of WOS and Citespace software(Version 6.2)were used to conduct visualization analysis for the publication trends,sources and research focus of the included literature of Flash-RT dose measurement,and to draw corresponding visualization knowledge maps.Results:The literatures were mainly published during January 2015 and November 2023,and a total of 86 papers were included in the analysis by screening,which included 78 articles and 8 reviews.The top three countries in terms of publication volume were respectively the United States(38 papers),France(19 papers)and Italy(19 papers).The research focuses were respectively Cherenkov,radiotherapy,passive dosimeter,conventional radiation,laser particle acceleration,ionization chamber and proton therapy as cluster analysis.Currently,the study of Flash-RT dose measurement mainly focused on the relevant fields included Flash-RT radiation source,dose rate,and the equipment and method of dose measurement.Conclusion:Flash-RT is a new technology with a key breakthrough in the basic field of radiotherapy,and this technique faces many difficulties and challenges in the clinical translation process of this technique.With the continuous development of science and technique,and deepeningaccumulation of related researchclinical big data,the method and procedure of accurate and efficient dose measurement dosimetry methods and procedures will promote and realize the update and iteration of Flash-RT experiment research and device technique,which will successfully realize the clinical the broader application prospects of this technology.
2.Study on the correlations among contrast-enhanced ultrasound parameters,pathological grading and alpha-fetoprotein in patients with liver cancer
Zhihui FAN ; Xia WU ; Wei HUANG ; Jingjing LI
China Medical Equipment 2024;21(5):11-15
Objective:To explore the correlations among contrast-enhanced ultrasound(CEUS)enhancement,time to peak and resolution time,and pathological grading and alpha fetoprotein(AFP)in diagnosing hepatocellular carcinoma(HCC),so as to provide scientific basis for the CEUS application.Methods:A total of 350 HCC patients who admitted to Kailuan General Hospital of Tangshan City,Hebei Province from June 2018 to February 2020 were selected.All patients underwent routine CEUS scanning and AFP detection that was performed by using Roche e411 electrochemiluminescence immunoassay analyzer.Using World Health Organization(WHO)Category Classification and Diagnostic Criteria Series to complete grading for liver cancer.The COX regression analysis was adopted to analyze the correlation between CEUS characteristic parameters and age,AFP,tumor grading,tumor size and gender.Results:The diameter of liver nodules of 304 HCC patients ranged from 9.0 to 146.2 mm,which maximum average diameter was 42.5 mm.The COX analysis indicated that serum AFP level was important influencing factor on CEUS examination results at arterial phase(HR=1.83,P<0.05).The blood supply artery within the tumor appeared positive correlation with serum AFP level,and the tumor size appeared positive correlation with the CEUS enhancement at arterial phase(r=0.231,0.483,P<0.05),and the correlation between CEUS enhancement at arterial phase and tumor size was strongest.Conclusion:The serum AFP level is correlated with the measured results of CEUS enhancement at arterial phase,time to peak and resolution time,which expression level is often influenced by some factors such as serum AFP and tumor size.It can provide reference for subsequent diagnosis and treatment.
3.Comparative study of POCT instruments and Roche electrochemiluminescence instrument in detecting myocardial biomarkers
Wenjuan LIU ; Pan GUO ; Juan DU ; Herui ZHANG ; Yaping WANG ; Hailong WANG ; Jia XU ; Qi LI
China Medical Equipment 2024;21(5):16-19,25
Objective:To compare and analyze the correlation between two kinds of point-of-care testing (POCT) instruments and Roche electrochemiluminescence instrument in detecting myocardial biomarkers,so as to provide reference for the selection of POCT instruments in clinical testing. Methods:A total of twenty patient's samples were selected,which concentration range covered the reportable range of detection results. Two kinds of POCT instruments (named respectively A and B) were used to detect the concentrations of plasma myoglobin (Myo),creatine kinase isoenzyme mass (CK-MB mass),cardiac troponin I(cTnI),and N-terminal fragment of B-type natriuretic peptide (NT-proBNP)/Brain natriuretic peptide (BNP). The results of the electrochemiluminescence instrument were used as reference,and Pearson correlation analysis and Kappa test evaluation were used to evaluate respectively the correlation and consistency of the detected results between the two kinds of POCT instruments and Roche electrochemiluminescence instrument. Results:Our study demonstrated that there were good correlations in the detected results of Myo,CK-MB mass,cTnI,NT-proBNP/BNP between the instrument A and Roche electrochemiluminescence instrument,and between the instrument B and Roche electrochemiluminescence instrument (rinstrumentA=0.994,0.989,0.917,0.996,rinstrumentB=0.928,0.934,0.883,0.977,P<0.05),respectively. In the comparisons about consistencies,the concordance rates between instrument A and electrochemiluminescence instrument were respectively 90%,100%,70% and 100% in detecting Myo,CK-MB,cTnI and NT-proBNP,and the concordance rates between instrument B and electrochemiluminescence instrument were respectively 90%,100%,70% and 100% in detecting them. Both two kinds of POCT instruments had favorable consistencies with Roche electrochemiluminescence instrument (Kappainstrument A=0.798,1.00,0.429,1.00,Kappainstrument B=0.794,0.886,0.429,1.00),respectively. The precisions of both instruments were less than 10%. Conclusion:Both two kinds of POCT instruments can meet the requirements of clinical test,which have favorable correlations with electrochemiluminescence instrument in detecting myocardial biomarkers.
4.Correlation and consistency evaluation between electrochemiluminescence and direct chemiluminescence in detecting 12 tumor markers
Miao MA ; Jie LIU ; Ruimin MA ; Pingyan LI ; Jing LU ; Huiwen XU ; Danwei YU ; Guojun ZHANG
China Medical Equipment 2024;21(5):20-25
Objective:To assess the correlation and consistency of electrochemiluminescence and direct chemiluminescence in detecting 12 tumor markers.Methods:A total of 2426 serum specimens were selected from the physical examination in Beijing Tiantan Hospital,Capital Medical University from March to August 2023.These specimens included 446 cases for alpha fetoprotein(AFP),284 cases for carcinoembryonic antigen(CEA),289 cases for carbohydrate antigen 72-4(CA72-4),87 cases for carbohydrate antigen 19-9(CA19-9),205 cases for carbohydrate antigen 125(CA-125),216 cases for carbohydrate antigen 15-3(CA 15-3),292 cases for total prostate specific antigen(TPSA),292 cases for free prostate specific antigen(FPSA),84 cases for serum cytokeratin 19 fragment(Cyfra21-1),84 cases for neuron specific enolase(NSE),84 cases for squamous cell carcinoma associated antigen(SCC)and 63 cases for pro-gastrin-releasing peptide(PROGrp).The electrochemiluminescence and direct chemiluminescence methods were respectively used to detect the above 12 indexes,and then,the correlation and consistency between the two detection methods were analyzed.Results:The results of Pearson and Spearman correlation analysis showed that there were significantly positive correlations between electrochemiluminescence and direct chemiluminescence methods in detecting 12 tumor indexes(AFP,CEA,CA72-4,CA19-9,CA125,CA15-3,TPSA,FPSA,Cyfra21-1,NSE,SCC and PROGrp)(r=0.971,0.934,0.945,0.975,0.900,0.948,0.994,0.984,0.982,0.828,0.879,0.922,P<0.05),respectively.The total coincidence rates between the two methods were respectively 98.21%,98.24%,98.27%,98.85%,97.07%,99.54%,99.66%,99.32%,92.86%,92.86%,95.24%and 96.83%.There were consistencies between electrochemiluminescence and direct chemiluminescence methods for 10 indexes excepted CA15-3 and NSE that could not calculate Kappa values due to data reasons(Kappa=0.848,0.728,0.930,0.794,0.485,0.887,0.664,0.540,0.477,0.652,P<0.05),respectively.Conclusion:In the detections of electrochemiluminescence and direct chemiluminescence methods for tumor indexes,there are favorable correlations and consistencies between them in detecting AFP,CA72-4,CA19-9 and TPSA,and there are favorable correlations between them in detecting CEA,CA125,FPSA,Cyfra21-1,SCC and PROGrp but the consistencies between them are average in detecting these indexes,and there are favorable correlations between them in detecting CA15-3 and NSE.Clinical detection should pay attention to there may be differences in the results between different detection methods when the detection is conducted in reference laboratory.
5.Evaluation on curative effect of ureteroscopic holmium laser lithotripsy combined with N-trap intercepted basket in treating middle and upper ureteral stones
Rui XU ; Yu WANG ; Zhao TANG ; Songlin GUO
China Medical Equipment 2024;21(5):26-30,41
Objective:To study the clinically curative effect of ureteroscopic holmium laser lithotripsy combined with intercepted basket of capture and extraction device for stone(N-trap)in treating middle and upper ureteral stones.Methods:A total of 112 patients with middle and upper ureteral stone who were diagnosed and treated in the Department of Urology of the Second Affiliated Hospital of Wannan Medical College from September 2020 to September 2022 were prospectively selected as the study subjects,and they were divided into two groups according to the random number table method,with 56 cases in each group.The control group was treated with ureteroscopic holmium laser lithotripsy alone,and the observation group was treated with ureteroscopic holmium laser lithotripsy combined with N-trap intercepted basket for treatment.The related indicators of surgery,the stone removal effect,renal function indicators,postoperative renal mass,postoperative recurrence and postoperative complications between two groups were compared.The scores of the Wisconsin Stone Quality of Life(WISQOL)questionnaire were used to compare and evaluate the postoperative quality of life between the two groups.Results:There were no significant differences in intraoperative operation time and intraoperative blood loss between the two groups(P>0.05),and the postoperative hospitalization time in the observation group was significantly shorter than that in the control group(t=3.464,P<0.05).The success rate of one-time lithotripsy and the clearance rate of stone within 30 d in the observation group were significantly higher than those in the control group,and the upward movement rate of stones of the observation group was significantly lower than that in the control group,and the difference was statistically significant(x2=6.698,7.240,5.489,P<0.05),respectively.The postoperative serum creatinine(Scr),blood urea nitrogen(BUN)and urine microalbumin(UMA)in the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=6.320,8.115,9.231,P<0.05),respectively.The degree of hydronephrosis at 3,6 and 12 months after surgery in the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=3.218,3.345,2.985,P<0.05),respectively.The recurrence rates at 6 and 12 months after surgery in the inspection group were significantly lower than those in the control group,and the differences were statistically significant(x2=5.114,5.783,P<0.05),respectively.The incidence of postoperative complication in the observation group was significantly lower than that in the control group(x2=4.865,P<0.05).The total score of the each dimension of WISQOL scale,and the total score of energy,sleep status,physical symptoms and overall emotion in the observation group were significantly higher than those in the control group,and the differences were statistically significant(t=3.734,3.889,3.903,4.340,4.650,P<0.05),respectively.Conclusion:The curative effect of ureteroscopic holmium laser lithotripsy combined with N-trap intercepted basket is certain,which can effectively improve the clearance rate of stone,and shorten the postoperative hospitalization time,and reduce the incidence of postoperative complications and recurrence rate,and promote the recovery of renal function,and improve the quality of life of patients after surgery.
6.Design and implementation of negative pressure environment in container-type of biological isolation shelter based on air freight conditions
Jiangxia DUAN ; Xue HUANG ; Changlei HOU ; Jincheng GUO ; Hongbing LU ; Dongguang WANG
China Medical Equipment 2024;21(5):31-35
Objective:To research and design a negative pressure environment that can be applied in container type of biological isolation shelter,so as to meet the stable negative pressure environment and dynamic intelligent regulation of pressure difference in the container during multimodal transportation,especially under air freight conditions.Methods:The design specifications and research achievements of pressure differences of negative pressure isolation equipment for infectious diseases at home and abroad were comprehensively analyzed.And then,one kind of power-distributed ventilation system without air duct was designed to achieve.The preseted pressure redundancy,real-time monitoring of sensors and dynamic follow-up of pressure were used to realize stable and intelligent regulation of negative pressure within the container during air freight.Results:After testing,the pressure differences of each region of the"three regions and two channels"included clean region,buffer region,contamination region,medical staff passage and patient passage within container type of biological isolation shelter under the negative pressure environment could meet the preseted requirements.The values of pressure differences at the outside of room of clean region,the toilet of clean region,the toilet of clean region of the second dressing room of the buffer region,the contamination region of the first dressing room of the buffer region,the toilet of contamination region and the outside of the room of contamination region were respectively 34.2,38.8,-8.0,-31.7,-15.1 and-44.6.The conditions of the pressure differences within each region of container,which dynamically met the requirements of Biosafety Level-Ⅲ(BSL-3)laboratory,were tested through the sensors,and intelligent display and control equipment that deployed inside of container.Conclusion:The stable negative pressure environment and intelligent regulation for pressure difference in each region of the container can take container to have more high biosafety characteristics,which can effectively ensure the safe transportation of whole region for patients with severe infectious diseases,and the transport and treatment under air freight condition.
7.Study on peel test of wearable electronic products based on peel force tester with full-angle
Hui ZHEN ; Shaohui QIN ; Bin WU ; Binbin WU ; Chunlei ZHANG ; Yue WANG ; Yizhou QI
China Medical Equipment 2024;21(5):36-41
Objective:To develop adjustable peel force tester with peel angle from 0° to 180°,so as to realize the test for the performance of interface adhesion of wearable electronic products under multi angles.Methods:The rotating platform of angle adjustment component was used to realize free adjustment of peel angle from 0° to 180°.A method of peel test procedure based on the peel force tester with full-angle was established,and the comparative experiment between that and tensile testing machine was conducted.The peel tests of various kinds of wearable electronic products were conducted under peel angle of 45°,90° and 180°.Results:The test results of the peel force tester with full-angle were consistent with those of the tensile testing machine,which function opposed reliability.The peel test results of more than 10 wearable electronic products indicated that the peel force tester with full-angle could effectively determinate the performance of interface adhesion.Conclusion:The peel force tester with full-angle can effectively appear the performance of the interface adhesion of wearable electronic products,which provides basis for establishing the standard of peel test of wearable electronic products.
8.Study of multimodal"one-stop"CT examination in assessing acute ischemic stroke
Chunlin ZHAO ; Na LIU ; Chuanwei BAO ; Qun SHI ; Huaxiu DUAN
China Medical Equipment 2024;21(5):42-46
Objective:To explore the clinical application value of multimodal"one-stop"CT in assessing acute ischemic stroke(AIS).Methods:A total of 98 patients who were diagnosed as AIS and underwent the treatment of intravenous thrombolysis in Department of Neurology of Huainan Chaoyang Hospital from December 2019 to July 2023 were selected.In them,the degree of vascular stenosis of 49 patients was<30%(mild stenosis),and that of 39 patients was 30%~69%(moderate stenosis),and that of 10 patients was 70%~99%(severe stenosis)and 100%occlusion(severe group).All subjects underwent multimodal"one-stop"CT scan,and the changes of perfusion parameters included time to peak(TTP),mean transit time(MTT),cerebral blood flow(rCBF)and cerebral blood volume(rCBV)of them were analyzed.Results:All 98 patients existed stenosis at different locations and degrees,and CT examination showed existed respectively 5 cases of suspicious low density foci in frontal lobe and parietal lobe.Post-processing pseudo-color map showed that all 98 cases had abnormal hypoperfusion.The responsible vessel of 25 cases with occlusion and 20 cases with stenosis was the cerebral middle artery,and that of 3 cases with occlusion and 7 cases with stenosis was posterior artery,and that of 7 cases was internal carotid artery,and that of 3 cases with occlusion and 5 cases with stenosis was basilar artery,and that of 7 cases with occlusion and 18 cases with stenosis was vertebrobasilar artery.In addition,3 cases existed arteriosclerosis.There were significant differences in the average levels of rCBF,rCBV,MTT and TTP among patients with different degrees of stenosis,and the differences were all statistically significant(F=66.689,46.751,3.401,41.565,P<0.05),respectively.The area under curve(AUC)values of the receiver operating characteristic(ROC)curves of rCBF,rCBV,MTT and TTP were all>0.5 in assessing AIS,and the AUC value of the combined examination of above indicators was higher than the AUC value of each single indicator of the above indicators.Conclusion:Brilliance iCT multimodal"one-stop"CT scan can comprehensively understand the vascular morphology and stenosis location of the head and neck,and effectively assess responsible vessels,and provide perfusion parameters of whole brain.This technique can improve the accuracy of diagnosis and treatment decision,which has important impact in improving the efficacy of cerebral stroke.It can provide the basis for the selection of subsequent treatment plan and the prognosis judgment.
9.Diagnostic value of CT combined with TaqMan probe for cardiopulmonary injury of pediatric patient with mycoplasma pneumonia of different clinical features
Ruizhen BAI ; Jiejing DU ; Shan YU ; Jie LI ; Junran SHI
China Medical Equipment 2024;21(5):47-53
Objective:To investigate the diagnostic value of computed tomography(CT)combined with TaqMan probe for cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features.Methods:The medical records of 80 pediatric patients with mycoplasma pneumonia admitted to Shijiazhuang Maternal and Child Health Care Hospital from March 2020 to March 2023 were collected,and they were divided into<1 year old group(29 cases),1-3 years old group(23 cases)and>3 years old group(28 cases).They also were divided into long disease course group(43 cases,the disease course>7 d)and short disease course group(37 cases,the disease course≤7 d).All of pediatric patients underwent CT combined with TaqMan probe method to detect the cardiopulmonary injury,and to analyze the incidences of cardiopulmonary injury in pediatric patients of different age groups and different disease course groups.The CT and TaqMan probe were adopted to detect the pleural effusion,myocardial thickness,cardiothoracic ratio and the expression level of mycoplasma nucleic acid,and receiver operating characteristic(ROC)curves were adopted to analyze the diagnostic value of CT and probe in detecting cardiopulmonary injury of patients with mycoplasma pneumonia.Results:CT imaging showed that typical pulmonary abnormalities were present in patients of 62.5%,with a diagnostic accuracy of 93.75%(75/80),which main findings were pulmonary ground glass nodules(GGO),combined bacterial pneumonia and reticulation.Bronchiectasis was found in a small portion of patients.Bilateral pulmonary involvement was found in patients with pulmonary abnormalities,and the involvement of lower lobe was the most obvious in them.The 38 pediatric patients with clinically suspected incidental pulmonary embolism(PE)received additional CT examination with contrast agent,and the 24 pediatric patients of them were diagnosed as PE,and the diagnostic accuracy was 63.15%(24/38).TaqMan probe method was adopted to detect mycoplasma infection,and a high sensitivity and wide dynamic range detection system was established,which could conduct six times of dilutions for 10-fold between 0.2-0.2×10-5.Preparation was performed in 1 ng/μ l microbial community(MMC)-DNA standards,which had high linear dynamic range of 6 times of log10 dilutions with regression coefficient of R2=1.The detection lower limit was found to be 2×10-15 g/μl DNA.The incidence of cardiopulmonary injury gradually decreased with increasing age of pediatric patients with mycoplasma pneumonia of different ages.The incidences of cardiopulmonary injury in pediatric patients with mycoplasma pneumonia of<1 year old group,1 to 3 years old group and>3 years old group were respectively 93.10%,73.91%and 21.43%,and there were significant differences among the 3 groups(x2=7.660,33.019,P<0.05).The incidence(93.02%)of cardiopulmonary injury of long disease course group was significantly higher than that of short disease course group(27.03%),and the differences were statistically significant(x2=12.070,36.960,P<0.05),respectively.The amount of pleural effusion in the cardiopulmonary injury group was significantly higher than that in the non-cardiopulmonary damage group,and the myocardial thickness of cardiopulmonary injury group was significantly increased at the same time,and the cardiothoracic ratio of cardiopulmonary injury group was also significantly higher than that of non-cardiopulmonary injury group.There was significant difference in the expression level of mycoplasma nucleic acid(t=9.52,3.33,4.22,10.00,P<0.05).ROC curve analysis showed that the AUC value of CT combined with TaqMan probe method was larger than 0.5 in diagnosing cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features,and the AUC value of the combined diagnosis was largest.Conclusion:CT combined with TaqMan probe method has higher diagnostic value for the cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.It should be considered to conduct the diagnosis of cardiopulmonary injury for pediatric patients who persistently exist the clinical symptom of mycoplasma pneumonia.The adaptation of existing TaqMan probe method,and the further expanded dPCR detection combination would improve the microbial diagnostic toolbox,which would provide reliable quantitative data for treatment decisions to cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.
10.Establishment of a nomographic chart model based on CT imaging characteristics and clinical data in predicting the recurrence risk of pleomorphic adenoma of salivary gland
Li LU ; Chengliang LIU ; Chao ZUO ; Shujing YU ; Li ZHANG
China Medical Equipment 2024;21(5):54-58,63
Objective:To explore the establishment of a nomographic chart model based on computed tomography(CT)imaging characteristics and clinical data in predicting the recurrence risk of pleomorphic adenoma(PA)of salivary gland.Methods:Clinical and CT imaging data of 99 PA patients admitted to Cangzhou central hospital from November 2019 to November 2022 were retrospectively analyzed,and they were divided into recurrence group(15 cases)and non-recurrence group(84 cases)according to whether occurred recurrence.The influence factors of PA recurrence were analyzed by univariate analysis and multivariate logistic regression,and the risk prediction model was constructed.The predictive value of the model was analyzed by receiver operating characteristic(ROC)curve.Results:Multivariate Logistic regression analysis showed that the tumor site was at deep lobe,the capsule of tumor was incomplete and the surrounding tissue of tumor existed invasion were respectively independent risk factors for PA recurrence(OR=79.730,67.194,479.801,P<0.05).The area under curve(AUC)of ROC curve of the risk prediction model based on the above three indexes was 0.960,and the sensitivity and specificity were respectively 80.0%and 97.6%,which were higher than each single index in the model.There was no significant difference between this risk predictive model and actual observation value(x2=0.823,P=0.935).Conclusion:The tumor site is deep lobe,the capsule of tumor is incomplete,and the surrounding tissue of tumor exists invasion are independent risk factors of PA recurrence.The risk prediction model based on the above three indexes has higher predictive value for PA recurrence,which can provide theoretical basis for preventing PA recurrence.

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