OBJECTIVE:To study the development of surgical robots at home and abroad in recent years.METHODS:Through a large number of literature review and analysis, the qualification approval and technical function characteristics of domestic and foreign surgical robots from January 2019 to July 2022 were analyzed.RESULTS:The related situations of 39 surgical robots were analyzed and reported, and the shortcomings and future development direction of the current surgical robots were summarized.CONCLUSIONS:The development of surgical robots in China is now in a rapid development stage. At present, surgical robots generally have the disadvantages of high cost, lack of tactile feedback (force feedback), large size, large space occupation and difficult to move. In the future, it will develop towards intelligent, miniaturized, remote, open and low-cost.

本文以合金材料Ti-6％Al-4％V(质量分数)为研究对象,开展了合金磨削性能研究.在Ti-6％Al-4％V表面设计并采用激光加工了5种不同的沟槽织构图案,采用立方氮化硼(CBN)砂轮进行磨削试验,对比了各种图案的表面磨削性能.分析结果表明:磨削力与磨削深度、工件速度均呈正向相关,当磨削深度、工件速度增大时,磨削力也随之增大.不同的沟槽织构显著影响着合金的磨削力、磨削力比、磨削磨损等参数,对表面粗糙度的影响非常小.交叉螺旋沟槽(沟槽深度24μm,沟槽宽度110 μm,沟槽水平夹角30°,沟槽间距310μm)具有最小的磨削力,且无织构表面磨削力均高于5种类型的织构化表面.减小单个磨粒切割厚度的变形量,会使得切割痕迹在工件表面的深度变得更小,且面织构可以有效地改善CBN砂轮的磨损情况,织构沟槽作为工件表面形态时,由于单个磨粒切割厚度的最大变形减小,会使得切割痕迹在工件表面的深度变得更小,改善了Ti-6％Al-4％V合金表面质量.

目的:研究基于混合层次分析法的医疗设备维护策略,保证医疗设备的安全性和可用性,降低医疗设备运行成本.方法:使用层次分析法(AHP)与逼近理想解排序法(TOPSIS)相结合的多准则决策(MCDM)方法以及混合整数线性规划(MILP)模型为每台医疗设备分配适当的维护策略,减少设备停机时间,提高设备利用率,为医院维护部门决策提供解决问题方案.结果:AHP、TOPSIS和MILP模型3种工具可用于基于多准则分析确定医疗设备的危险性,根据不同的维护策略对医疗设备的重要性进行排序,为每台设备选择最佳维护策略,将总维护成本保持在预定预算内.结论:基于混合层次分析法的医疗设备维护策略应用于医院医疗设备管理,能够提高高风险医疗设备的可用性和可靠性,为医疗设备维护管理提供借鉴.

该研究根据新形势下的要求,结合医院实际,针对医院医用高值耗材管理中存在的不足进行分析,探讨新形势下医院医用高值耗材精细化管理的目标和方法.通过研究,对海军军医大学第一附属医院2021年第3季度的相关数据进行统计分析,发现医用高值耗材帐物相符率和帐帐相符率同比、环比均发生增长,耗占比和重点监管止血类产品用量同比、环比均发生明显下降,单次审批平均周期缩短,单次审批多次使用发生率为0,精细化管理水平明显提高.

目的:针对国内医疗器械技术创新不足,产学研医结合不紧密的难点,研究临床工程师如何结合临床工程学的学科特色和自身职业特点在医疗器械技术创新过程发挥作用.方法:通过分析国内医疗器械现状以及医疗器械技术创新的目的、内容、特征、类型思维和方法,研究临床工程师在医疗器械技术创新过程中7个阶段的作用.结果:通过分析研究发现临床工程师在医疗器械创新过程中发挥着重要的桥梁作用,是技术创新需求的发现者、可行性的建议者,设计研发的协作组者、验证注册的讲解者、生产推广的指导者.根据临床工程师所发挥的作用,结合医院实际情况,医院计划建立一套医工结合技术创新工作机制,鼓励临床工程师参与医疗器械技术创新.结论:通过本文研究充分认识和发挥临床工程师在医疗器械技术创新过程中的桥梁作用,加强临床工程师人才队伍培养建设,提高临床工程师参与医疗器械技术创新积极性,有利于产学研医结合紧密结合,提高医疗器械技术创新水平,推动医疗器械行业持续快速发展.

目的 分析恶性肿瘤患者PET-CT检查对环境及相关工作人员的辐射剂量.方法 选取2019年1月至2020年8月在海军军医大学(第二军医大学)第一附属医院虹口院区行PET-CT检查的恶性肿瘤患者62例,检测行PET-CT检查时受检者周围、相关工作人员及工作场所的辐射剂量,包括受检者体表垂直距离1、2、3 m处的当量剂量率,候诊室、PET-CT机房、医师办公室、注射室各监测点的当量剂量率,以及相关工作人员的年有效剂量.结果 与受检者距离1、2、3 m处的当量剂量率分别为(4.40±0.64)、(1.82±0.61)、(0.87±0.35)μSv/h,与受检者距离1 m处的当量剂量率高于2 m和3 m处(P均<0.01);候诊室防护门外表面及注射室通风柜手洞位置、注射台手洞位置、注射台工作人员身位的当量剂量率高于其他监测点,如防护墙外表面、注射室防护门外表面等(P均<0.05);操作技师的辐射年有效剂量为0.82 mSv,高于其他相关工作人员,如候诊人员、辅助操作人员等.结论 与PET-CT受检者距离1 m处的当量剂量率高于更远距离,候诊室防护门外表面及注射室通风柜手洞位置、注射台手洞位置、注射台工作人员身位的当量剂量率高于其他工作场所.

各类高分子材料常被用于微创介入医疗器械以及各类治疗类器械,主要作为诊断辅助工具.目前常用的医用高分子材料包括聚乳酸、聚氨酯、聚四氟乙烯、氟类材料以及聚醚嵌段酰胺共聚物等.根据微创医疗器械的用途差异,选取合适性质和功能的高分子材料,降低医疗成本、辅助医疗保健、疾病治疗,促进微创介入医疗器械的发展.

手术治疗是海上伤病员救治的重要手段,尤其在战时海上伤员救治中手术量大、手术要求高,而手术照明是直接影响手术质量、手术速度和手术效果的重要因素之一. 海上舰船特殊环境对舰船用手术无影灯性能提出了特殊要求;手术舱室层高较低、空间较为狭小,要求舰艇用手术无影灯的体积要小,拆装要方便[1-2]. 同时,在不同海况下展开手术,舰船持续摇晃状态要求手术无影灯固定和移动不能使用现有机械臂式的方式,而是要设计出一种针对性地固定和展开装置,确保手术无影灯不受舰船晃动的影响[3]. 因此,需要研制一款专门用于海上舰船用的无影灯来满足海上舰船手术照明的需求.

设计一种基于Android平台的心电数据采集与传输系统.硬件电路采用主板加心电采集板的模块化设计方式.心电采集板负责心电信号的测量,并把测量结果通过串口提交给主板;主板负责和心电采集板通过串口进行通信,实现心电数据的显示、存储和传输.软件开发采用Eclipse最新版开发工具,用Java语言编制应用软件程序.

目的：加强医院医疗设备的优化管理，防止交叉感染，降低医院感染的发生率。方法规范设备管理，优化工作流程，落实规章制度和具体措施，以实施医疗设备的优化管理，并通过加强对医护人员及患者的院感防控意识普及，优化培训管理方式，积极开展院感防控工作。结果医疗设备资源得到充分利用，确保了医疗设备的最佳使用状态及发挥其最佳功效，从而提高了医疗质量，明显降低了医院感染的发生率。结论医疗设备的优化管理可以有效降低因医疗设备质量、使用不当或管理监测疏忽等引起的医院感染，从而提高医院的整体医疗水平。

Objective To investigate the change features in the physical performance of helicopter aviators who stayed onboard for a prolonged time,to develop schemes of physical performance training directed at shipboard helicopter aviators and finally to analyze and assess the effects of the intervention schemes,through detection of physical performance parameters of the aviators at different stages of deployment.Methods Fiftyeight helicopter aviators from different batches of escort personnel in the Gulf of Aden were selected as our research subjects.Bilateral gripping power,lumboabdominal muscle strength,PWC170,amplitude of variations in body mass index (BMI),fat percentage and weight were measured or tested at different stages of deployment both before and after physical performance training.Changes in physical performance induced by prolonged stay onboard the ship and the effects of training intervention were discussed in detail,through comparisons of self control and parallel control between groups.Results Before enforcement of physical performance training intervention,bilateral gripping power of the aviators detected at d 48 all decreased by 25％ (left:28.6 ± 5.67 ;right:33.55 ± 6.82),then kept at a relatively lower level till day 71 (left:28.88 ± 4.68; right:32.45 ± 5.55).This trend of decrease by about 5-7％ continued all the way till day 92 (left:26.57 ± 6.74,fight:31.63±6.00).Statistical significance could be noted,when the decreased levels were compared with those before they deployed onboard ships (left:39.94 ± 5.76 ; right:43.04 ± 4.75) (P ＜ 0.05).In total,the decrease in physical performance was as high as 33％.When they returned to their organic units,scores of push-ups and sit-ups were obviously decreased (19.15 ± 3.75,19.0 ± 6.6),and statistical significance could be found,when they were compared with those before deployment (24.65 ± 3.3,23.8 ± 5.9) (P ＜ 0.05).Amplitude of variations in body mass and BMI for the shipboard aviators (3.30 ± 3.01,1.08 ± 0.99) was obviously higher,when it was compared with those of the onshore control group(0.55 ±0.55,0.14 ±0.16) (P＜0.01).Following physical performance training intervention,bilateral gripping power at d 48 (left:38.56 ± 6.06,right:42.28 ± 6.50)were decreased by only 5 ～ 7％,then displayed a slow ascending trend.At day 92,no statistical significance could be seen in physical performance (left:42.28 ± 6.50; right:45.44 ± 4.96),when compared with those before they stayed onboard (P ＞ 0.05).When they were compared with those of the onshore control group,no statistical differences could be noted in the indices of lumboabdominal muscle strength,PWC170,BMI and fat percentage for the shipboard aviators both before and after deployment(P ＞ 0.05).Conclusions The physical performance training scheme could produce good effects on the reduction of physical performance in shipboard aviators,during their prolonged deployment at sea.Due to the fact that significant decrease in physical performance occurred at the end of the first month deployment,physical performance training intervention should be started immediately after they came onboard,not later than one month.

针对心电图机在各型舰船上使用时故障频出的实际问题,结合舰船环境特点,分析了此环境下各种干扰源对心电图机故障成因的影响,提出了采取增配电源滤波器、电磁屏蔽以及电路板三防处理等舰用化改进措施,确保了心电图机适应舰船环境的使用要求.

随着海军的战略转型和维护海洋权益任务的日益繁重，海军舰艇远洋航行日趋常态化。现代海战由于高新武器的大量使用，战斗减员具有伤员大批量发生，伤情复杂，休克、多处伤和烧冲复合伤多，减员率、死亡率高的特点。针对战斗减员的特点，海军舰艇加强了舰船医疗功能建设，逐步配备了技术含量高、功能复杂、保养要求高、针对性强的先进医疗设备。一方面这些先进的医疗设备极大地提高了舰艇上伤病诊治能力，另一方面对舰艇军医的能力提出了更高的要求。

<正>随着医疗技术的日益发展,临床诊断对医疗耗材的需求呈现出多品种、大数量的趋势,对医疗耗材的使用管理也提出了更高的要求。866医院船作为遂行卫勤演练和执行各种医疗任务的海上流动医院,在医疗耗材的管理上不同于驻地医院规范化、日常化的管理,具有很大的特殊性。笔者参加了"和谐使命-2010"医疗任务,并参与了医疗耗材使用管理的具体工作,对医院船的医疗耗材使用管理等谈几点看法。

目的提出逆向迭代修正法(IIC)和基于直方图的熵准则函数,消除MRI图像中刚性平移运动伪影.方法利用该熵函数建立的准则,IIC方法通过两个连续的步骤来消除仿真运动伪影:①在所有可能的运动方向上添加逆向相位差;②利用熵判断函数估计出实际的运动方向和位移,从而消除运动伪影.结果为了检验方法的可行性,通过对模板和医学图像的仿真实验,验证了逆向迭代修正法(IIC)和基于直方图的熵准则函数的有效性和精确性.结论 IIC方法能够有效消除MR图像刚性平移运动伪影.

In the process of MR scan, because patient' s motion affects the collected data, the recon-structed image would contain severe motion artifacts. Translation and rotation are the most basic rigid mo-tion,and nearly all of complex rigid motions consist of them. In this paper, a new post-processing method named inverse iterative correction(IIC)is presented based on the principle of generating MRI rigid trans-lational motion artifacts. Through inversely simulating the patient's translational motion, IIC algotithm can be iteratively implemented to correct the damaged phases in K-space signals. According to the criterion of minimum entropy in the imaging field, we can judge if the translational distance of the simulated inverse motion equals that of the patient's actual motion, i.e., being corrected to the original position. The experi-ments show that through inverse iterative correction, the movement artifacts could be modified to a compara-tively ideal state when the entropy is converged to the minimum value of the whole.