This paper introduces several novel HPC-based monitoring devices for community medicine. They support net transmission and have superiorities of portability, small size, good mobility, easy use and strong adaptivity.
Blood Pressure Monitoring, Ambulatory ; instrumentation ; Community Health Services ; Computers, Handheld ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Humans ; Monitoring, Physiologic ; instrumentation ; Telemedicine ; instrumentation

The continuous glucose monitoring system (CGMS) has been clinically applied to monitor the dynamic change of the subcutaneous interstitial glucose concentration which is a function of the blood glucose level by glucose sensors. It can track blood glucose levels all day along, and thus provide comprehensive and reliable information about blood glucose dynamics. The clinical application of CGMS enables monitoring of blood glucose fluctuations and the discovery of hidden hyperglycemia and hypoglycemia that are difficult to be detected by traditional methods. As a CGMS needs to work subcutaneously for a long time, a series of factors such as biocompatibility, enzyme inactivation, oxygen deficiency, foreign body reaction, implant size, electrode flexibility, error correction, comfort, device toxicity, electrical safety, et al. should be considered beforehand. The study focused on the difficulties in the technology, and compared the products of Abbott, Medtronic and DexCom, then summarized their cutting-edge. Finally, this study expounded some key technologies in dynamic blood glucose monitoring and therefore can be utilized as a reference for the development of CGMS.
Blood Glucose ; Blood Glucose Self-Monitoring/methods* ; Humans ; Hyperglycemia ; Hypoglycemia ; Monitoring, Ambulatory/methods* ; Monitoring, Physiologic

Telemetering is one of the ideal methods of metering biomedical signal. This paper emphasizes remote medical treatment system and its exploitation, realization and application. It gives an overview of the recent development of biotelemetry. At the same time, it discusses the principle, realization, new development of other biotelemetry methods and further research tendencies on biotelemetry as well.
Biotechnology ; Electrocardiography, Ambulatory ; instrumentation ; Humans ; Internet ; Monitoring, Physiologic ; instrumentation ; Signal Processing, Computer-Assisted ; instrumentation ; Telecommunications ; instrumentation ; Telemedicine ; Telemetry ; instrumentation ; trends

To overcome the problems of current electrocardiogram (ECG) tele-monitoring devices used for daily life, according to information fusion thought and by means of wearable technology, we developed a new type of wearable ECG monitor with the capability of physical activity recognition in this paper. The ECG monitor synchronously detected electrocardiogram signal and body acceleration signal, and recognized the scene information of physical activity, and finally determined the health status of the heart. With the advantages of accuracy for measurement, easy to use, comfort to wear, private feelings and long-term continuous in monitoring, this ECG monitor is quite fit for the heart-health monitoring in daily life.
Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Heart ; physiology ; Humans ; Monitoring, Physiologic ; instrumentation ; Motor Activity ; Signal Processing, Computer-Assisted ; Telemetry ; instrumentation

OBJECTIVENarcolepsy is a sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination and sleep paralysis, with abnormal characteristics of shorter rapid eye movement (REM) sleep latency. The management of the patients is very important. The present study focused on the clinical characteristics, diagnostic methods and long-term prognosis of this particular syndrome.

METHODSThe clinical data of 39 narcoleptic children were analyzed. Sleep EEG monitoring was performed in all patients. Among the 39 cases, 23 were followed up.

RESULTSAll the patients manifested with excessive daytime sleepiness, with disrupted nocturnal sleep occurring in 35 cases. Cataplexy appeared in 36 cases, and sleep paralysis in 9, hypnagogic hallucination in 19, and automatic behavior in 6 cases, respectively. Sleep EEG monitoring demonstrated a short mean sleep latency (< 5 minutes) and two or more sleep onset REM periods (SOREMPs) in 38 cases. Twenty-three of the 39 cases were followed-up. Seventeen cases were followed-up for over one year. The longest follow-up duration was 14 years. Methylphenidate was administered in 10 cases. The excessive daytime sleepiness had been improved in 7 cases (70%). No obvious adverse effects were found. Psychosocial and academic problems appeared in most cases.

CONCLUSIONNarcolepsy is a chronic neurological disorder. A definite diagnosis is established when the symptoms of cataplexy and excessive daytime sleepiness occur in association with the characteristic findings on sleep EEG monitoring. Appropriate drug therapy and psychosocial management are of help for such patients. Stimulant medication is an important component of the overall treatment program. A comprehensive approach is necessary to meet the needs of children with narcolepsy. Family education and emotional support are key elements in the management plan. The overall goal for managing childhood narcolepsy is to assist the child and family in achieving optimal quality of life.

Adolescent ; Child ; Child, Preschool ; Electroencephalography ; Female ; Follow-Up Studies ; Humans ; Male ; Monitoring, Ambulatory ; Monitoring, Physiologic ; Narcolepsy ; drug therapy ; pathology ; Polysomnography

A fetal/maternal multi-parameter monitor is introduced here in the paper. It can monitor the vital signs of a fetus and his/her mother in a same screen synchronously. It is more useful in obstetric clinics. Its other functions include management of patient file, computer-assistant analyses.
Adult ; Automatic Data Processing ; instrumentation ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Female ; Fetal Monitoring ; instrumentation ; Heart Rate, Fetal ; Humans ; Microcomputers ; Monitoring, Ambulatory ; instrumentation ; Pregnancy ; Signal Processing, Computer-Assisted ; Software

OBJECTIVE: Appropriate evaluation of hypertension is important in the patients with a stroke because hypertension is a major cause of a stroke. Blood pressure may be falsely elevated or depressed immediately after a stroke, depending on the severity of neurological deficit, mobility, and physical activity, and the level of consciousness. To overcome this problem, ambulatory blood pressure monitoring (ABPM) has been proposed as a method of obtaining a more accurate clinical assessment. SUBJECTS AND METHODS: The present study was performed in an acute stage of stroke patients to assess the manifestation of 24 hour ambulatory blood pressure, to observe the nocturnal blood pressure fall and to evaluate the relationship of blood pressure degree on admission and nocturnal blood pressure dip. Thirty four patients admitted within 24 hours after onset of acute stroke were involved in this study. 24 Hour blood pressure monitoring device was installed on an independent arm by oscillometric method as soon as brain imaging study was performed. ABPM readings were obtained each 30 minutes during daytime and each 1 hour during nighttime with electrocardiography. Each patients were classified as the presence or absence of hypertension. We examined nocturnal blood pressure dip and mean pressure of 24 hour ambulatory blood pressure. RESULTS: 1)This study demonstrated that comparing daytime with nighttime 24 hour ambulatory blood pressure, 20 of 24 patients (83%) with acute stroke with hypertension, did not show nocturnal blood pressure dip, and there was sustained high nocturnal blood pressure in patients with acute stroke with hypertension. 2)There were significant differences between 24 hour ambulatory mean daytime blood pressure and mean nighttime blood pressure in patients with acute stroke without hypertension, so was lower in nighttime (p<0.05). 3)It is likely that in acute stroke patients with hypertension, patients with higher blood pressure on admission had more abnormality of nocturnal blood pressure dip. CONCLUSION: These results suggest that in patients with acute stroke, 24 hour ABPM is useful method to assess diurnal variation and evaluate hypertension in acute stage of stroke patients, and suggest that patients with acute stroke with hypertension trend to loss of nocturnal blood pressure dip.
Arm ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Consciousness ; Electrocardiography ; Humans ; Hypertension ; Motor Activity ; Neuroimaging ; Reading ; Stroke*

OBJECTIVETo investigate the relationship among circadian blood pressure rhythm, autonomic nervous system and myocardial energy expenditure (MEE) level in patients with primary hypertension.

METHODSA total of 102 hypertensive and 45 normotensive subjects were recruited. According to blood pressure reduction rate at night, the hypertensive patients were divided into non-dipper group (NDH group, n=54) with a reduction rate of <10% and dipper group (DH group, n=48) with a reduction rate of ≥10%. The circadian blood pressure rhythm and heart rate variability were measured with ambulatory blood pressure monitoring and 24-hour electrocardiograph monitoring, respectively, and MEE was measured by Doppler echocardiography to analyze their correlations.

RESULTSSDNN, SDANN, SDNNindex, RMSSD, PNN50, and HF were significantly lower in the hypertensive patients than in the control group (P<0.05); these parameters, except for PNN50, were all significantly lower in NDH group than in DH group (P<0.05). The hypertensive patients had significantly higher MEE than the control group (P<0.05), and MEE was significantly higher in NDH group than in DH group (P<0.05). Bivariate correlation analysis showed significant correlations of MEE with SDANN in the hypertensive patients (P<0.01).

CONCLUSIONPatients with primary hypertension, especially those in NDH group, have impaired autonomic nervous system function. The hypertensive patients in NDH group show a more prominent increase in MEE in relation to sympathetic activation, suggesting the importance of restoring circadian blood pressure rhythm in the treatment of hypertension.

Autonomic Nervous System ; physiology ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Case-Control Studies ; Circadian Rhythm ; Electrocardiography, Ambulatory ; Energy Metabolism ; Essential Hypertension ; Heart ; physiology ; Heart Rate ; Humans ; Hypertension ; physiopathology

BACKGROUND: This study compared the results of 24 hour ambulatory blood pressure monitoring with the clinical blood pressure measurements, and we investigated the relationship of the blood pressure measurement and left ventricular hypertrophy, as determined by routine 12 lead electrocardiography. METHODS: We studied 204 healthy adults with no prior history of heart disease or antihypertensive medication. The clinic blood pressure was measured 3 times and the average was taken. We compared the clinic blood pressure with the daytime blood pressure of the 24 hour ambulatory blood pressure monitoring, and we compared the blood pressure with the sum of the voltage of the S wave on V1 and the R wave on V5. RESULTS: The average of the daytime ambulatory blood pressure of all the patients was 135.33+/-13.73 mmHg for the systolic pressure and 86.55+/-10.14 mmHg for the diastolic pressure. The average of the clinic blood pressure measurement was 140.10+/-17.41 mmHg for the systolic pressure and 88.84+/-10.14 mmHg for the diastolic pressure. The clinic blood pressure averaged higher than the daytime ambulatory blood pressure by 5 mmHg on the systolic pressure and 2 mmHg on the diastolic pressure (p<0.001). The normal ambulatory blood pressure limits were estimated as those that best correlated with 140/90 mmHg at the clinic. The estimated value was 135/87 mmHg for the daytime ambulatory blood pressure (p+/-0.001). The incidence of white coat hypertension was 10.8%. The sum of the voltage on electrocardiography showed a positive linear relationship with all the blood pressure measurements. The daytime systolic blood pressure showed the strongest correlation with the 24 hour ambulatory blood pressure monitoring (r=0.283, p+/-0.001). CONCLUSIONS: We found a linear relation and we analyzed the differences between the clinical and 24 hour ambulatory blood pressure. A daytime ambulatory blood pressure value of 135/87 mmHg was a suitable upper normal limit for the corresponding cutoff value of the clinic blood pressure. Left ventricular hypertrophy showed the strongest relationship with the daytime systolic blood pressure among the results of the 24 hour ambulatory blood pressure monitoring.
Adult ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Electrocardiography* ; Heart Diseases ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Incidence ; White Coat Hypertension

In order to improve the accuracy of blood pressure measurement in wearable devices, this paper presents a method for detecting blood pressure based on multiple parameters of pulse wave. Based on regression analysis between blood pressure and the characteristic parameters of pulse wave, such as the pulse wave transit time (PWTT), cardiac output, coefficient of pulse wave, the average slope of the ascending branch, heart rate, etc. we established a model to calculate blood pressure. For overcoming the application deficiencies caused by measuring ECG in wearable device, such as replacing electrodes and ECG lead sets which are not convenient, we calculated the PWTT with heart sound as reference (PWTT(PCG)). We experimentally verified the detection of blood pressure based on PWTT(PCG) and based on multiple parameters of pulse wave. The experiment results showed that it was feasible to calculate the PWTT from PWTT(PCG). The mean measurement error of the systolic and diastolic blood pressure calculated by the model based on multiple parameters of pulse wave is 1.62 mm Hg and 1.12 mm Hg, increased by 57% and 53% compared to those of the model based on simple parameter. This method has more measurement accuracy.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Cardiac Output ; Electrocardiography ; Heart Rate ; Heart Sounds ; Humans ; Pulse Wave Analysis ; Regression Analysis