Objective To develop an image analyzing procedure for automatic localization of facial features on infrared images.Methods An unsupervised local and global features extraction method was adopted for the localization of facial features of frontal view face image.First,a threshold was used to segment the image into foreground and background,and the nose was localized by considering the symmetry of the face.Second,Harris operator was adopted to detect interest points in a rectangular area covering all the facial features,and then local maximum of the interest points were detected.And finally,K-means clustering method was used to cluster the points and obtain the facial features localization.Results The experimental result of 100 images demonstrated that the procedure could automatically localize eyes,nose,mouth,and distinguish the feature areas.Conclusion The proposed infrared image analyzing procedure based on Harris operator and K-means clustering can be used to locate facial features on infrared image more rapidly and reliablely.

Objective To extract breathing pattern parameters during sleep and get the varying law of NREM and REM sleep stages. Method A newly designed respiratory inductive plethysmography (RIP) and a polysomnography (PSG) are utilized to record whole-night-sleep data simultaneously. The breathing pattern parameters obtained by RIP are dealt with according to the results of sleep stages and sleep apnea by PSG. Then the rule found out and summarized from the experiment is applied to distinguish REM sleep. Conclusion RC/VT can be used as an effective parameter to differentiate NREM and REM sleep. Using this parameter, the results of RIP totally accord with the results of PSG.

Objective To develop a new type of respiratory inductive plethysmograph to achieve high signal-noise rate(SNR)and low system power cost,and also to eliminate the cross-talk between chest and abdominal band sensors.Method Either of the two bands was powered by a very high power oscillator in a very short time,and these two bands were switched on in turn.The sensor structure of the respiratory inductive plethysmograph was modified so that these two bands could be embeded in a shirt conveniently.Result With these new designs,the cross-talk between these two bands was greatly eliminated and high SNR and low system power cost were achieved.This new wearable respiration monitoring system is easy to use,and can be used for long time and ambulatory monitoring.Conclusion This new system meets the design requirement with excellent performance.With this new wearable respiration monitoring system,non-invasive measurement of ventilation and non-intrusive detection of sleep apnea event can be achieved.

The wearable respiratory inductive plethysmograph(RIP) system is a non-intrusive respiratory monitoring system. Sleep monitoring was performed on 9 human subjects suspected of having sleep apnea hypersomnolence syndrome (SAHS) and 7 healthy volunteers using both the wearable RIP system and the conventional polysomnography(PSG), and the sensitivity and specificity of the wearable RIP system were analyzed by comparison with the PSG results. According to the characteristic of the wearable RIP system in detecting sleep apnea/hypopnea event, the diagnostic criteria of sleep apnea/hypopnea event were put forward. All subjects with SAHS diagnosed by the wearable RIP were confirmed by PSG,the sensitivity and specificity of the wearable RIP system for detecting sleep apnea/hypopnea events were 99.0% and 94.6% respectively. The wearable RIP system can be used reliably in detecting sleep apnea/hypopnea events. This system can be used at home for detecting the sleep apnea/hypopnea events non-intrusively.
Equipment Design ; Humans ; Plethysmography ; instrumentation ; methods ; Polysomnography ; instrumentation ; methods ; Sleep Apnea Syndromes ; diagnosis ; physiopathology

Objective To design the bedside tracheotomy checklist to improve the safety of operation.Methods According to the quality requirements of bedside tracheotomy and perioperative coordination, all the preparatory work and cooperation work in the duration had been summarized and enlist in the ICU bedside tracheotomy checklist. Patients who underwent bedside tracheotomy were enrolled in this study. Sixty-eight patients were evenly and randomly divided into observation group (using ICU bedside tracheotomy checklist) and control group (without the checklist), and each group with 34 cases. Observation and comparison of the two groups were conducted in the passing rate, the operation time and the satisfaction of nursing cooperation. Results The operation time in observation group was (10.94±1.92)min for bedside tracheotomy, while it was (15.00±3.95)min in the control group, and there was statistical significance between two groups (t =-5.383, P<0.01). The qualified rates for operation cooperation were 88.24% in observation group and 35.29% in the control group (χ2=20.176,P<0.01). The doctor's satisfaction was (3.88±0.33) score while nurse's was (3.94±0.24) in observation group, which all were higher than that of control group (t=4.672,5.652;P <0.05). Conclusions The use of ICU bedside tracheotomy checklist after bedside tracheotomy operation tends to make the process standardized, and to ensure the safety of patients, increasing the satisfaction of medical cooperation. It proves its feasibility in clinical practice.

Objective To observe the effect of the continuous low pressure suctioning unite intermittent high pressure suctioning on drainage of subglottic secretions in the patients with artificial airway.Methods Using random number table,a total of 44 patients were evenly and randomly divided into observation group and control group.In the control group,continuous low pressure suctioning was performed to clear away the subglottic secretions.In the observation group,continuous low pressure suctioning combined with intermittent high pressure suctioning were performed.The average daily drainage volume of subglottic secretion,the incidence of early onset VAP (Ventilatorassociated pneumonia),the frequence of cough,the incidence of the airway mucosal damage,the incidence of the clogging of the drainage tube were investigated and compared between two groups.Results The average daily drainage volume of subglottic secretion in the observation group (52.80 ±4.181)ml was significantly more than in the control group (33.00 ± 2.675) ml (t =16.656,P ＜ 0.05).The incidence of early onset VAP in the observation group (10.0％) was significantly less than in the control group (40.0％) (x2 =4.800,P ＜ 0.05).There was no statistical difference in the frequence of cough between the observation group (1.93 ± 1.023) times and the control group (1.75 ± 1.006) times (t =0.771,P ＞ 0.05).There was no statistical difference in the incidence of the mucosal damage of airway between the observation group (15％) and the control group(10％) (x2 =0.229,P ＞0.05).The incidence of the clogging of the drainage tube in the observation group (0.0％) was significantly less than in the control group (20.0％) (x2 =4.444,P ＜0.05).Conclusions Continuous low pressure suctioning combined with intermittent high pressure suctioning can significantly improve the effect of drainage of the subglottic secretions by increasing the drainage volume,reducing the clogging of the drainage tube and the early onset of VAP.

Objective To explore the factors related to the amount of suction under glottis, look for effective nursing counter measures in order to improve the suction effects. Methods A retrospective analysis of the clinical data of 71 patients with subglottic secretion drainage from 1st January 2013 to 1st May 2014 was performed. The secretion viscosity, posture, the endotracheal tube cuff pressure, patients restlessness, suction pressure, and acute physiology and chronic health evaluationⅡscore were set as independent variables. A multiple linear regression analysis was performed to screen factors that may lead to reduction of suction volume of subglottic secretion and nursing counter measures were planned and implemented accordingly. Results Secretion viscosity, supine, endotracheal tube cuff pressure and patient restlessness were the main reasons that influence the amount of suction under glottis(P<0. 05). Multiple linear regression equation:amount of suction of subglottic secretion/2 h(ml) =4. 868 +2. 470 × restlessness-1. 624 × secretion viscosity+0. 874 × endotracheal tube cuff pressure-0. 933 × posture. Conclusions Quantity of suction of subglottic secretion were positively correlated to patients′restlessness, secretion viscosity and endotracheal tube cuff pressure. Subglottic attract amount for the most when take left lateral position. Strengthening the control and intervention of related factors plays a very important role in the care of suction under glottis.

ObjectiveTo construct a quality evaluation index system for continuous aspiration of subglottic secretion(CASS), in order to provide references for clinical objective evaluation of the quality of this technology. MethodsBased on the theory of "structure-process-outcome" model, through literature review, expert meeting, expert consultation and principal component analysis, the quality evaluation index system and the index weights of all indicators for CASS were finally determined by 23 intensive care unit experts from 5 provinces (autonomous regions)and 11 cities through two rounds of consultation. SPSS 18.0 software was used in statistical analysis. ResultsThe effective responsive rate of the questionnaires in the two rounds were 92.0%,87.0%; the expert authority coefficients were 0.887, 0.895; Kendall's idea coordination coefficients were 0.13, 0.09 (P＜ 0.01).The final index system consisted of 3 first-level indicators, 8 second-level indicators, and 23 third-level indicators. ConclusionsThe process of the construction of nursing quality evaluation index system for CASS is scientific, and the contents of index entries are reasonable, which can ensure the effective implementation of the technology.

Objective? Through the popularization of the technique of stabilized pressure suction of the subglottic secretion, to improve the drainage effect of subglottic secretion of intensive care uni(t ICU) patients in this region, and to improve the quality of subglottic secretion management. Methods? The stabilized pressure suction device on continuous aspiration of subglottic secretion was designed and the pressure-stabilized suction technique for subglotted secretion was promoted in 7 hospitals in Zhejiang province from January to December of 2018. The quality of drainage of subglottic secretion before and after the promotion of the stabilized suction technique were compared. In every hospital the included research objects were divided into two groups, and the subglottic secretion stabilized pressure suction devices adopted two suctioning methods of intermittent suction and continuous suction accordingly in the two groups: intermittent suction group(n=161) and continuous suction group(n=160), the incidence of blockage of decompression holes and instability of negative pressure control were compared between the two groups, and the incidences of drainage, cough, blockage of suction tube and mucosal injury during suction were compared. Results? After promotion, the quality of subglotted secretion suctioning in 7 hospitals all improved, among which the dimensions of "suction operation" and "outcome indicator" showed statistically significant difference before and after promotion(P＜0.05). In terms of the performance of stabilized pressure suction device, the blockage rate of decompression holes in continuous suction group (3.13%) was higher than that in intermittent suction group, and the incidence of negative pressure control instability (3.75%) was lower than that in intermittent suction group; in terms of the effect of subglottic drainage, the drainage flow rate of subglottic secretion in continuous suction group was (53.55±5.92) ml/d, and the daily coughing times were (3.01±1.13), both better than the intermittent suction group, the difference was statistically significant (t=12.374,-2.625; P＜ 0.05). Conclusions? Subglottic secretion pressure-stabilized suction device has good performance, and the technology of pressure-stabilized suction can effectively improve drainage effect. The method of continuous suction is recommended in this study, which has a significant effect on improving the drainage quality of subglottic secretion and has a good promotion effect.

To achieve continuously physiological monitoring on hospital inpatients, a ubiquitous and wearable physiological monitoring system SensEcho was developed. The whole system consists of three parts: a wearable physiological monitoring unit, a wireless network and communication unit and a central monitoring system. The wearable physiological monitoring unit is an elastic shirt with respiratory inductive plethysmography sensor and textile electrocardiogram (ECG) electrodes embedded in, to collect physiological signals of ECG, respiration and posture/activity continuously and ubiquitously. The wireless network and communication unit is based on WiFi networking technology to transmit data from each physiological monitoring unit to the central monitoring system. A protocol of multiple data re-transmission and data integrity verification was implemented to reduce packet dropouts during the wireless communication. The central monitoring system displays data collected by the wearable system from each inpatient and monitors the status of each patient. An architecture of data server and algorithm server was established, supporting further data mining and analysis for big medical data. The performance of the whole system was validated. Three kinds of tests were conducted: validation of physiological monitoring algorithms, reliability of the monitoring system on volunteers, and reliability of data transmission. The results show that the whole system can achieve good performance in both physiological monitoring and wireless data transmission. The application of this system in clinical settings has the potential to establish a new model for individualized hospital inpatients monitoring, and provide more precision medicine to the patients with information derived from the continuously collected physiological parameters.