Anesthesia Machine

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  An inhalation anesthesia machine Principle

Mechanical through inhalation anesthesia circuit will anesthetics (agent) into patients with pulmonary form anesthetic gas pressure, the diffusion of blood, right directly in the central nervous system effect, resulting in the effect of general anesthesia.

2, inhalation anesthesia machine type

(1) Air anesthesia machine
         Air anesthesia machines are semi-narcotic plant. Its main chemical cans, ether-conditioning switch, folding bellows and use, the one-way valve breath and bellows components. Light application of the device, the direct use of air and oxygen as a carrier gas, capable of supporting respiration and breathing control to meet the requirements of various operations.
        Its working principle is: the completion of the patients after induction of anesthesia, anesthesia machine and air masks or closed endotracheal tube connected. Getter, anesthetic gas mixture by the suction valve opening into the body; Breath, breath valve opening, while suction valve closed from exhaled gases. When the use of complementary or controlled breathing, may use folding bellows. When inspiratory pressure, breath, pull up to ensure that patients have adequate ventilation. At the same time based on the actual needs, adjust switch ether anesthesia to maintain a stable level.
         This device is the inadequacy of the ether concentration was low, as only the maintenance of anesthesia, and the consumption of large ether, easy pollution.

(2) DC-anesthesia machine
        DC anesthesia machine, a pressurized oxygen, pressure reducer, flowmeter, narcotic drugs evaporator components. As shown in figure 2-1-2. With the proposed regulation could provide oxygen and inhaled anesthetic gas concentration, we must have the other parts of the series can be output to anesthesia.
(3) closed circuit anesthesia machine
         The installations of low-flow anesthesia mixed gases, the gas valve Plaza (Gate) a one-way flow of supply patients. The exhaled breath gas valve into the repeated use of CO2 absorption. Its main structure of oxygen and nitrous oxide from the plant, gas flowmeter, evaporator, CO2 absorption; The one-way valve, respiratory pipeline, Yat gas valve, reservoir airbag components, modern anesthesia machines are equipped with airway pressure ventilation machines, expiratory flow, end-expiratory CO2 concentration, inhalation anesthesia drug concentration, oxygen concentration monitoring device, alarm and hypoxic hypoxia - nitrous oxide automatic protection devices. 2-1-4 is an actual map of narcotic gas road map. This is a closed circuit anesthesia circuit. During anesthesia, the patient-first give a certain amount (usually 3 to 5 minutes) of pure oxygen, and then a narcotic operation.

BEAM LAU

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  Jin-source digital EEG topographic map is set for EEG and brain topographic map, EEG monitoring, which integrates multi-function machines, a 16-T without the monitor EEG, EEG dynamic three-dimensional topographic map and a complete medical record management system capabilities. For further information, please visit: www.jymedical.com.
The function of the equipment is superior to CT in the diagnosis, such as intracranial infections, meningitis, brain abscess, some pediatric disease; The gas poisoning, pesticide poisoning can make the right diagnosis. Epilepsy CT brain concussion and powerless, particularly in the diagnosis of brain areas, such as neurasthenia, spilled, neurological disorders, psychiatric, neurological and general stunting brain trauma and the location, diagnosis, classification and guide treatment for brain and neurological recovery provided an important basis for rehabilitation . Cerebral vascular diagnosis and transcranial Doppler consistency, such as cerebral ischemia, cerebral sclerosis and cerebral dynamic environment, such as insufficiency. This equipment will be able to objectively reaction brain function changes in cerebral vascular disease, cerebrovascular disease is on the early diagnosis, and prognosis of non-invasive evaluation of the screening equipment, CT can make their own judgment. In intracranial space-occupying lesions and CT consistency, such as brain tumors (meningioma tumor, tuberculoma, hemangioma) brain tumors, brain parasitic diseases, cerebral hemorrhage, cerebral thrombosis Cypriots in the diagnosis of diseases such as CT and consistency. The apparatus of lesions diagnosed positive rate than conventional EEG, lesion that intuitive, smart, accurate positioning. Conventional and various intracranial disease caused by the brain injury, brain injury and intracranial infection diagnosis than conventional EEG. Because the CT X-ray irradiation on the fetus, children and pregnant women have certain side effects, and equipment is based on the body’s own bio-electrical diagnosis of disease conditions, without any side effects.

Breast infrared scanner

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  Kam Yuen JY - 2501D infrared scanner primarily for breast screening and found that women in breast diseases, using wavelengths from 0.8 to 6 µ m infrared light through the breast as through special infrared CCD camera images intake, the various breast tissue lesions appear on the screen for doctors all provide an accurate basis for breast diseases, in particular the early detection of breast cancer wisdom, especially suitable for small, medium and large health and the use of health authorities. For further information, please visit: www.jymedical.com.
Breast infrared instrument performance characteristics:

Features:

With Windows2000 OS
A variety of real-time dynamic pseudo-color display, images can be enhanced, magnified, measurement, Image Processing
Breasts can be compared with the screen display
A DVD video
Big-screen high-resolution color display, single interface operation, convenient
Digital image processing, support for DICOM image transmission
Foot Switch freeze Image Acquisition for doctors
No adjustable-infrared light, and lightweight probe, it is simple to use
Set to be directly activated automatically boot the operating system into the breast, not to prevent the occurrence of the phenomenon operation
The software provides a wealth of comprehensive information base infrared for doctors
The system provides a variety of pseudo-color coding directly reflected in the image processing box, there is no need to remember the results of the various pseudo-color, and the formation of various coding contrast clearly. When the district needs to focus on the pseudo-color processing, simply by dragging the mouse image processing and color processing box will be convenient to increase color images, can easily switch
Through simple query method can be done right before the patient inquiries and statistical information to facilitate hospital for examination and assessment procedures at the same time provide images preview
The number of cases of the management model can store up to 1 million images, and one case of arbitrary right call, add, delete
Case management and hospital Statistical Analysis System (facilitate medical research, academic seminars, distribution of benefits, etc.)
Users can print the results of the need to design and maintain, allowing users to have their own style of the print report. Print the report illustrated with photos of the effects of Print
Machines installed Kam Yuen-not to resume the automated system, once unusual circumstances, the system can immediately resume initial state

Capsule endoscopy

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  “Capsule endoscopy” known as “intelligent capsule Gastrointestinal Endoscopy System,” also known as the “Medical wireless endoscope.” Its working principle is: Oral subjects through a built-in camera and signal transmission devices Intelligent capsule, through the gastrointestinal peristalsis in the upper gastrointestinal movement and photographed image, the image in vitro doctors use recording devices and imaging workstations, understanding subjects of the entire digestive tract, thereby making the diagnosis of their condition . A convenient capsule endoscopy examination, no trauma, no wires, no pain, no cross-infection does not affect the normal working of the advantages of expanding the gastrointestinal examination vision to overcome the traditional insertion of the endoscope with the tolerance of difference, not for the frail and elderly in critical condition and defects, as gastrointestinal diseases, particularly intestinal disease diagnostic method of choice by the medical profession as the 21st century revolution and the development of endoscopic direction. A world history of the development of capsule endoscopy

Human pry into their own in the slightest interest in the mysteries of no less than the external environment of curiosity, the history of endoscopy and Western medical history almost as long.

The title of the Father of Medicine Hippocrates described in Greece had a “advice of the rectum.” Since 1806 German Tamara created to light candles for the bladder-rectum, endoscopy with the advancement of technology and human development: from the hard-endoscope, fiber endoscopy, ultrasound and electronic endoscope, the doctor has been able to use these devices more convenient, more clear closely watching the human body and the internal organs.

Over the past 20 years, with the current scientific advances in related technologies, gastroendoscope rapid development of technology, particularly endoscopic interventional treatment technology is more rapid diagnosis and treatment of digestive diseases has become an indispensable technology, to a certain extent, certain digestive diseases replace traditional surgery treatment.

In 1981, the Israeli Defense Ministry mechanical engineer curve listen to a physician chatted endoscopic examination process, he reminds himself familiar with the smart missiles remote camera installations, and the resulting development of a wireless endoscope originally envisioned. Since then, the curve led by the Israeli experts began vigorously wireless endoscope research work, and in the 1990s was the first technology patents. In 2001, Israel’s Given Imaging companies curve patented technologies produced the world’s first pill called a capsule endoscopes, and the first to enter clinical use of this product in the world has aroused tremendous repercussions.

Capsule Endoscopy Endoscopy opened the birth of a new medical technology field, and with gastroscopy and colonoscopy has a good complementary, and is subject to digest history of the development of an important milestone.

After this, many countries in the world have begun the study of micro-capsules clinics digestive system research and development work, and that the diagnosis of gastrointestinal diseases and treatment toward painless, noninvasive direction. In recent years, various intelligent capsule products have appeared, and in the function of their own talent. For example, in the digestive tract can be completed within the targeted delivery “remote control release capsule”; Also in the digestive tract within the sampling capsule; The United States Diagnostics develops products “smart pill” (Smart pill) is dedicated to detecting gastrointestinal internal pressure, pH and other indicators, which For more information, “gastroesophageal reflux disease” and other gastrointestinal motility of disease diagnosis is important; South Korea’s Ministry of Science and Technology Development Organization, “capsule Robot” is in complete control in vitro drug release, image acquisition, biopsy and treatment of a variety of functions, but such a versatile head capsule the former is still in the prototype stage.

2, domestic capsule endoscopy breakthroughs and technical characteristics

In 2001, Chongqing Jinshan technology group, “capsule endoscopy” independent research and development, and in October 2002 the Ministry of Science and Technology international cooperation projects, but also was included in the “863 Program” advanced manufacturing and automation to the field of MEMS major special support. After more than three years of painstaking research, Jinshan Chongqing Technology Group finally completed in early 2004 capsule endoscopy key technology development, came up with a prototype; After a series of animal tests, in June 2004 of the first-generation products stereotypes.

Chongqing Jinshan Technology Group capsule endoscopy was named “OMOM”, in March 2004 from the Chinese SFDA approval, the granting of clinical application. It was the first one, of course, is the world’s second capsule endoscopy for clinical.

OMOM capsule endoscopy is set image processing, information communications, opto-electronics, biomedical technology and multidisciplinary integration of the typical micro-electromechanical systems (MEMS) technology, the smart capsule, image and video recording devices to workstations (computer and image analysis software) is composed of three parts. Doctors can help patients with digestive tract disease diagnosis, diagnosis and treatment of digestive diseases have a very wide range of applications.

OMOM capsule endoscopy is the working principle: with the same medication as intelligent water swallowed capsules, it is with gastrointestinal muscle movement along the rhythm of gastric duodenal → → → jejunum and ileum → colon rectal running in the direction, right through the cavity of continuous video, and digital signal transmission plan as for the patient in vitro with the image recorder to record storage, work time is six to eight hours in the smart capsule obtain eight to 72 hours after will be excreted with faeces. Doctors imaging workstation images recorded by the instrument can record images of the patients throughout the digestive tract, thereby making the diagnosis of disease.

OMOM capsule endoscopy operation is very simple, the entire inspection only obtain capsule, and recorded three intervals of the process. Doctors only in intervals of the process, to take pictures through the right conditions can be accurately judged. OMOM capsule endoscopy in the early research and development, adopted a foreign patents totally different design and technology, and validate the technical feasibility of a number of breakthroughs in key technologies, including: low-power image acquisition and processing system design, close-King aspherical lens design, duplex Multi-channel wireless transmission design and packaging technology and structural strength, consistency and reliability.

OMOM capsule endoscopy is the main innovation point two aspects: First, the wireless transceiver controllable manner. Only foreign product launch function, and image recording devices only passive receivers, the capsule can not be achieved in vitro control; OMOM capsule endoscopy capsule and the Intelligent Image Recorder wireless duplex multichannel approach to communications, with the reception and control functions. Two imports capsule endoscopy is only after the completion of filming in the delivery of workstations out images. While domestic OMOM capsule endoscopy true color image of the real-time monitoring, intelligent doctors capsules facilitate detection process completed work on the Smart Capsule state control, but also established an open port is conducive to the future of the capsule in vitro control.

3, homemade capsule endoscopy in clinical application

Israel GI’s M2A capsule endoscopy since 2002 after entering China, has more than 30 hospitals to introduce the equipment, however, because some features of limitations, particularly high price (in the early patients as a check on the cost of 8,000 yuan to 10,000 yuan around), , the use of quantitative be greatly affected.

Compared with imported capsule endoscopy, capsule endoscopy in OMOM domestic prices substantially lower, a check charges around 3,000 yuan, while technically has its own unique advantages, since OMOM capsule endoscopy, it has its low price, high-tech and quickly occupied the market. Currently in Beijing Friendship Hospital, Beijing Military General Hospital, Shanghai Changhai Hospital, Huaxi Hospital in Chengdu, Guangzhou Nanfang Hospital Xinqiao Hospital in Chongqing and more than 40 major hospitals in clinical use.

Capsule endoscopy in clinical application value has been a troubled hospitals and manufacturers of a problem. They are all from different angles to the orientation of value. The first time, Israel’s position in the whole digestive tract pill checks, but, because of a stomach cavity, and can not be the right time for the period of control, so too random, not as a screening option stomach with endoscopy technology has been very mature, so the difference pill of choice positioning only clear pill for the small bowel examination. Because of the small intestine for 5-7 meters long been known as clinical examination of blind spots.

Domestic OMOM capsule endoscopy in the clinical value of the location, manufacturers take a completely different line of thought. They will OMOM value of capsule endoscopy, located in three aspects: First, check comfortable means to meet the tolerance of poor people and the investigation of high-end crowd investigations; Two means of diagnosis and treatment is integrated with other means of gastrointestinal examination with a view to improve the diagnostic accuracy; The breakthrough means three small intestine, the traditional method can not achieve the true color image of small intestine checks.

The birth of capsule endoscopy, in addition to the small intestine blind spot outside a major breakthrough to make early diagnosis of gastrointestinal disease to fruition. There is a Chinese saying, called “prevention.” However, in clinical To achieve this, but also the need for advanced, safe, comfortable with the medical equipment. While many of the current treatment and screening devices failed to do so painless non-invasive, patients have a psychological fear and exclusion, can lead to many diseases found in the early, so “is a late discovery.” OMOM capsule endoscopy is a new, safe and comfortable means of gastrointestinal examination, it could remove the patient’s fear of the examination, the patients accept, thereby OMOM capsule endoscopy with the early diagnosis of gastrointestinal diseases important value.

OMOM capsule endoscopy Clinical application has shown that, in addition to some patients because of the pain and accept inspections, have more than half of the subjects are medical in nature. That capsule endoscopy examination in the area also has a broader application of space. With the improvement of the quality of life of people, the pursuit of health has become a necessity. If OMOM capsule endoscopy to vigorously promote the use of physical examination can be expected nationals advanced gastrointestinal disease incidence would be greatly reduced.

4, capsule endoscopy future and the need to resolve the issue

As technology continues to evolve, the capsule endoscopy intelligence will continue to increase its function will be further strengthened, in clinical applications will be even more magical.

The future will be the development of capsule endoscopy how? China gastroendoscope director of the Institute of Professor Zhang Qi Prospect capsule endoscopy in the future, its image has been likened to “hand with legs” Intelligent capsule. “Foot” means the capsule can move around freely within the human gut, which means doctors can control the patient through in vitro capsule and running posture to better check; “Hand”, it means that capsule endoscopy in the body to spot drug release, and even some simple surgical treatment to help doctors intestinal resection of the tumors or polyps. To achieve these functions, but also need to address the following questions:

A wireless electricity, solve the energy problem

But in the future capsule “in hand with legs” ideal state, how to solve the energy problems capsule itself, it has become particularly pronounced. Capsule to the future control of in vitro and in vivo treatment, electricity will cost more, the conventional battery, it is already very difficult to maintain. So, how can we guarantee that capsule in the body has sufficient energy to complete tasks, as capsule endoscopy in the future the most important condition for success.

Currently, Jinshan technology technical staff who are trying to abolish batteries, to develop MEMS (micro-electromechanical systems)? ? Permit the use of capsules in the process, to have continuous current to the directives issued by the external completed.

2, precision positioning, ensure effectiveness

At present, capsule endoscopy in the past can not check for a period of five to seven meters from the small intestine to provide a viable inspection program, but along the capsule failed to capture images for accurate positioning. In other words, patients with capsule endoscopy and found lesions, which puzzled doctors for changing the location of lesions, doctors only images of the cases and time capsule to judge his position is far from enough, so the capsule endoscopy can be a quasi-positioning become imperative, the only way , a surgeon can give the precise location of the operation, rather than the previous “discredit exploration.”

3, increase the controllability of the capsule, achieving biopsy, pesticide control and direction

Capsule endoscopy painless, non-invasive, non-wire comfort gastrointestinal endoscopic examination concept is the development of a future direction. Of course, a perfect capsule endoscopy function also needs a very long time, and now the capsule endoscopy beyond its limitations also led to replace the traditional plug-in gastrointestinal endoscopy. Although the domestic OMOM capsule to a certain extent, control the frequency and precision shooting, movement and gesture, the capsule control capsule endoscopy is the real direction of development. Achieving biopsy, pesticide control and direction of development of a capsule endoscopy on the road to overcome the difficulties, so that capsule endoscopy replace traditional gastroendoscope only become a possibility.

Fiberbronchoscope

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  Fiberbronchoscope applicable to do lobe, and subsegmental bronchial lesions observed, biopsy sampling, bacteriological, cytology, with TV system can photography, teaching and vital records. The bronchoscopic biopsy sampling with agencies, can help detect early disease, polyps can be removed and carried out in surgery, bronchial and lung disease, after inspection is a good precision instruments.

Fiberoptic bronchoscopy (bronchoscopy) after the invention has been widely used clinically. Except in the diagnosis of respiratory diseases have achieved great progress, the treatment has been widely used, are summarized below.
The removal of a foreign body
Bronchoscopy is a common PENTAXFB - 15P, FB-15BS (after a bronchoscopy is portable, battery and AC can be used to light) and OlympusBF-type P30 and P40, a 4.8-4.9mm diameter, a smaller diameter adult bronchoscopy in the bronchoscopy, also can be used for more than six months with the children, aged 6 months, the above-Branchofiberoscope difficult inserted through the trachea and the option of using PENTAXFB-nest, and OlympusBF - 3c30-their diameter of 3.5mm and a biopsy Kong, can be used for newborns seized investigation and removal of foreign body. The variety of foreign bodies, metals, plants, animals bones, in the removal, it is necessary to choose a suitable clamp foreign body (such as alligator teeth tongs, forceps rat bite, scratch or with metal spoons Nets pliers, etc.). Severity, especially in children under the age of 7 in the operating room under general anesthesia, and can monitor SaO2. Metal foreign body, such as the nose, bronchial fell, following Asian segmental bronchi, X-ray or a TV guide under extraction. Surgery, operational requirements carefully, quickly, to prevent bleeding, pneumomediastinum, traumatic pneumothorax, cardiac arrest and suffocation. After availability of secondary respiratory and pulmonary infection or bleeding children to observe whether airway patency, as the process of surgery can cause tracheal, bronchial mucosa damaged bleeding, inflammatory exudation and secretions, often by suction and oximetry monitoring to prevent excessive or tracheal secretions vocal edema occur asphyxia.

Two clear respiratory secretions 2.1 respiratory failure patients with chronic respiratory, lung infection control are not as accurate obstructive airway secretions that condition was worsening, with the patient unable to cough, nasal or oral suction not achieve complete removal of secretions purpose, then underwent bronchoscopy to the use of the gas Road suction secretions clean.
2.2 various causes in patients with respiratory failure, endotracheal intubation artificial ventilation, because of the wet enough, airway drying, airway secretions thick drainage airway obstruction due to increased airway resistance, the effects of poor ventilation, then regular bronchoscopy using suction to strengthen gas Road and wetland management.
2.3 lungs after surgery because of bleeding patients, bleeding and airway secretions or contralateral side gather obstructive airway, can cause atelectasis, if not promptly removed airway secretions, can add conditions, a direct threat to the patient’s life, then they should immediately remove bronchoscopy with airway secretions, anti-infection treatment and strengthening management of the airway.

3 bronchoalveolar lavage (BAL) treatment
     3.1 BAL treatment of respiratory failure in domestic BAL has been used in many hospitals for the treatment of respiratory failure, conventional treatment does not work using this method, treatment, conditions can be improved. By lavage fluid usually sterile saline to disinfect the airway without stimulating cortical hormones or antibiotics, each 30 ~ 50ml, injection followed by 13.3 ~ 26.6kPa pressure pumping, repeated several times, alternating left and right sides irrigation, suction, and then injected antibiotics. Through this most hospitals after treatment with BAL PaCO2 decline conscious.
3.2 BAL treatment of pulmonary infections diseases such as severe pulmonary infection of bronchiectasis, suppurative lung disease, pneumonia and bronchial mucosa because of congestion, swelling and pyogenic secretions, bronchial obstruction of drainage, partial systemic medication difficult to achieve an effective drug concentration, are often difficult to control infection with BAL treatment, the traditional methods difficult to treat patients after treatment was satisfactory results majority of cases, serious anti-infection. In antibiotics, according to the bacterial culture sensitivity inspection report, the use of penicillin, Vanguard V, West Yan Li, Yan Fu and tobramycin, adding suitable addition of dexamethasone. BAL treatment frequency of weekly 2 to 3 times be suitable.
3.3 BAL treatment of tuberculosis in sputum domestic scholars have found various types of TB diagnosed tuberculosis activities, which untreated cases and retreatment cases systemic anti-tuberculosis treatment to local BAL treatment (week 1, 4), a month after X-ray absorption significantly to 60% more than oral chemotherapy in the treatment of three months, six months, better efficacy, and sputum negative conversion rate of oral chemotherapy in the treatment of the effect of retreatment cases focus absorption efficiency was significantly higher than that of oral literature in the six months of chemotherapy drugs in patients retreated.
3.4 BAL was on the treatment of bronchial asthma Asthma status over a month, with a host of heparin OK BAL treatment, the effective rate was above 90% normal saline was used to BAL treatment, and achieved certain results. But many scholars believe that patients with asthma status as mucus suppository and the lack of ventilation can cause severe hypoxia, which can drip mucus suppository transbronchial aspiration. Some people think that this law is a certain danger of the treatment to patients conditional choice, usually in the intensive care unit, trained by the doctors to operate.
3.5 BAL treatment atelectasis atelectasis occurred in the middle of the right and left of the tongue, but also in other lobes. The right middle lobe atelectasis caused inflammatory time in less than two months, with BAL treatment can be more effective (including children). For more than two months over only partially effective. After injection to the local pumping antibiotics (such as amikacin 0.2g or 0.75g West Yan Li. Right from the mid-inflammatory atelectasis, in time within two months, the weekly BAL treatment two to three, six to eight times more curable.
3.6 BAL treatment of pneumoconiosis by BAL in whole lung lavage (WLL) to the acute phase of treatment of pneumoconiosis, domestic several hospitals in the treatment of, a very good successful experience.
3.7 BAL treatment of pulmonary alveolar proteinosis as early as 1963 for the first time Ramirez patients with pulmonary alveolar proteinosis with plenty of liquids to WLL, which is carried out under general anesthesia, a large quantity of liquid pumping, so far has not worked out unified standards. The WLL after treatment can improve symptoms.
3.8 BAL treatment of inhalation of radioactive particles and other diseases of the WLL BAL lung removal of radioactive material, in the dog and baboon study, identified WLL scavenging effect.

4 Bronchofiberscope injecting drug treatment tumor
4.1 NPC treatment of nasopharyngeal carcinoma (NPC) recurrence after radiotherapy for patients underwent bronchoscopy used by the top nasopharyngeal lesion recurrence by bronchoscopy to the needle NPC intralesional injection of 5-fluorouracil, weekly injection of 2 to 3 times, injecting a total of six times, two after the top of nasopharyngeal carcinoma lesions completely disappeared. If the new patients with radiation therapy method has been applied, the effect is good.
4.2 for the treatment of central lung cancer surgery not sick, the heart bronchoscopy, in the tumor tissue of 5-Fu, 2 to 3 times a week and plus radiotherapy, can reduce tumor to improve airway obstruction may improve ventilation.
4.3 for the treatment of pulmonary alveolar cell carcinoma cell cancer patients, particularly affects those suffering from lung, in addition to administering chemotherapy, the use of local high-dose 5-fluorouracil or cisplatin (DDP) in the treatment, especially when patients with systemic situation worse, not systemic chemotherapy tolerance of this method can be used treatment. Conventional bronchoscopy, as a number of airway secretions, they can suction, if necessary, using similar methods BAL irrigation pumping, to the side of the bronchial lung cancer drug injection, 2 to 3 times a week (alternately displayed injection), each about systemic injection drug dose chemotherapy dosage of each 1 ~ 2 times after injection of antiemetic agents and sedatives.

Five alternative thoracoscopy with bronchoscopy
By endotracheal tube inserted to the chest incision of the chest wall, a guide. Bronchoscopy along the catheter into the chest, in the scope of the inspection, to see if the spontaneous pneumothorax, the visceral pleura rupture of a small hole, bubble overflow, to the hole injection adhesive or 50% glucose solution, will enable hole bonding. As a result of the visceral pleura and the layer of the fiber cable between adhesion hole to be closed, can be used biopsy forceps or micro-fiber - cream of the fuse can be broken so that the closing hole, played the role of spontaneous pneumothorax. If found in the chest, bleeding, burning electricity hemostasis.

Six of bronchopleural fistula and tracheo-esophageal fistula
Fistula tumor caused Kong and Africa, the following hole about 0.3cm more to “repair” successful. Some people used drugs: 10% silver nitrate, adhesives, high-speed, Czech Republic (Solcoseryl), and fibrin glue.

Seven of the treatment of hemoptysis
It has been used anhydrous ethanol injection site to hemorrhage. Common drugs such as Reptilase (Reptilase) can be injected into the bleeding site, but also injected intravenously, hemostatic effect affirmed. Another high-frequency electric knife can be used to stop bleeding through bronchoscopy, the balloon catheter can also be used to stop bleeding, can be inserted endotracheal intubation bulging balloon played a role in hemostasis.

Eight high-frequency electric knife treatment of tracheobronchial benign and malignant lesions
Right traumatic scars caused bronchial stenosis, postoperative endobronchial growth of granuloma, caused by foreign body granuloma, and the benign tracheobronchial and other benign lesions (such as primary tracheobronchial amyloidosis), airway treatment of primary malignant tumors can.

9 laser treatment of airway obstruction
Now used YAG (yttrium aluminum garnet) laser and Nd - YAG (Neodymium-doped, yttrium aluminum garnet) laser treatment for lung cancer, the treatment can be benign, and granulomatous inflammation.

10 microwave treatment of lung cancer
It was the center of lung cancer symptoms of airway obstruction and unsuitable for surgery or relapse after surgery, use of microwave hyperthermia therapy plus radiation therapy at the same time, enhance the effect, while the airway through bronchoscopy, the Center of lung cancer, for the treatment of benign diseases similar to high-frequency electric knife, cutting the extent of carbonation than the small micro-electric knife.

11 frozen lung cancer treatment
Now more bronchoscopy treatment through metal around the main tracheal or bronchial cancer with radiation therapy in addition, CO2 gas cooling is used, the low temperature probe can be inserted connecting gas right tracheal cancer treatment.

12 tuberculosis treatment of tracheobronchial endometrial
The application of systemic chemotherapy treatment, the local application of the lesion injection (isoniazid), micro-electric knife cutting treatment, and “stent placement” various methods (as the case may be) for treatment.

13 tracheal intubation through a bronchoscopy
Commonly used in the assisted intubation anesthesia, respiratory failure patients on artificial ventilation and bronchial asthma treatment asthma status.

14 Probe tube placement in critically ill patients
Patients commonly used in the confusion, and the larger body of burn patients, many with critical surgical patients can not eat and nutritional supplies to the gastrointestinal tract, the conventional method of insertion tube failures and adopting this law can be effective. This author a law since 1986 from a total of more than 50 cases of patients, all successful.

15 “stent” Application
Stent (Stent) used mainly trachea and bronchial lesions, in the application of the trachea and bronchial stenosis and avoid further narrow, and support an expanded role. Also for various reasons gas wall weak, lose their supportive role in the trachea wilt depression. It was also difficult for the tracheal esophageal fistula repair. Stents are used plastic materials, silica, metal. Metal use more memory nickel-titanium alloy. Using specially designed clamp holders, in the X-ray guidance into the airway lesion location, play a supportive role. To pull out, into ice water, it could be a clamp in vitro, due to local metal stent mucosa, soft tissue irritation, ulcers enable local infection, Local inflammatory granulation tissue growth from the slot through the metal into the cavity can cause Airway obstruction. Germany has now made of metal and silicone stent system, in the shape of a trachea (the posterior wall of the esophagus contact with the site was semicircular, depression go), another left main bronchus and right main branch, intermediate metal stent support of the outside is transparent soft silicone, and are of different models, reducing the Local mucosa oppression and soft tissue stimulation and reduce injury. Some people at home and abroad applied to lung and heart-lung transplant after the narrow airway for the treatment of stent application, in the airway secretions often impeded drainage, local friction, easy form of chronic bacterial infection, can cause erosion vascular hemorrhage, bleeding or even endanger the patient’s life, in-depth study to be resolved .

Electric heart pacemaker

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Electric heart pacemaker
  For the treatment of atrioventricular block and serious dysfunction of the sinoatrial node, a pulse generator. According to a certain frequency electric pulse to stimulate myocardial to have atrial and ventricular contraction and rhythm and excitement.

Digital Subtraction Angiography，DSA

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Digital Subtraction Angiography，DSA is a new X-ray imaging systems, conventional angiography and computer image processing technology of the product. General angiography images of the anatomical structure of a lot of information, such as bone, muscle, blood vessels and gas-bearing lacunar etc., overlapping each other, if only in order to right a structure or organization of the more subtle difficulties.
DSA imaging examination will be the basic principle is not part contrast agent injected and after contrast agent injection angiography X-ray fluorescence images, respectively image intensifier gain, reuse of the high-resolution television camera scanning, image segmentation into many small box made of the matrix formed by the small box in the a pixel is composed of the video image, and increase the number of A / D converters for different numerical figures, respectively, and a digital image storage, processing and input computer and two digital image subtraction, was calculated from the difference between the different signals, and several enhanced by the contrast / Die converted into ordinary analog signal, and the removal of bone, muscle and other soft tissue, leaving only a simple subtraction angiographic images of images displayed through the display.
Through DSA image processing, the image of clarity in interventional surgery safer.

PET emission tomography PET

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PET emission tomography PET, to reflect the genetic disease, molecular, metabolic and functional status of imaging equipment. It is the use of electronic radionuclide marker of glucose metabolism in the human body, as imaging agents, through lesions on imaging agent uptake to reflect changes in its metabolism, thus providing clinical metabolic diseases biological information. In today’s life sciences, medical imaging technology development milestone. CT (Computed Tomography) is familiar to all X-ray imaging technology. The lesions can clearly receive the anatomical structure information, but structural characteristics of the disease alone there are limitations, the nature of some diseases such as malignant and benign tumors, postoperative CT tumor recurrence there are difficult to make accurate judgments. The disease can not accurately reflect the physiological metabolic state. PET-CT is the integration of PET and CT in one instrument, comprising a complete imaging system, known as PET-CT system (integrated PET-CT system), check patients in the rapid whole body scan can also obtain CT images and anatomical images PET metabolic function the two images complement each other, so that doctors in the understanding of metabolic information, get the precise anatomic location, thus making the disease a comprehensive, accurate judgment.

PET using positron emission of some physiological need radionuclide marker compounds or metabolic substrates such as glucose, fatty acids, amino acids, receptor ligands and water, in the introduction, the application of electronic scanning machines acquired in chemical imaging. It can show that the organ or its metabolic activity and organization of receptor function and by the distribution of a wide range of clinical importance, also known as “living in biochemical imaging.” It can be said that the emergence of PET makes medical imaging technology has reached a new level, noninvasive, dynamic and quantitative evaluation of needle biopsy or organs in the physiological state of cells in the disease process and metabolism of physiological and biochemical changes to the molecular level information as possible, it is any other approach is not achievable. Therefore, in developed countries, widely used in clinical PET has become tumors, coronary heart disease and brain disease three major threats to human life and guiding the treatment of diseases of the most effective means. The most commonly used PET imaging agent for the 18F - labeled FDG (18F - FDG fluoride FDG), a glucose analogues.

PET / CT in tumor diseases of

1. Early diagnosis of tumors and benign and malignant identification:

Tumor tissue is one of the important features of rapid growth, metabolism brisk, especially grapes glycolysis rate increase. Therefore, early diagnosis of metabolic imaging cancer is the most sensitive method one. Such single-lung nodules, PET showed obvious active metabolism, suggested that malignant lesions. Without increased metabolic performance, suggesting that the possibility of a benign lesion, surgery will be carefully chosen.

2. Identify various cancer staging and classification:

PET to conduct a general imaging, which is the other imaging equipment can not be achieved. Apart from the original discovery site lesions, but also found body parts of the soft tissues and bone lesions whether transfer of tumor stage very helpful, and provide accurate puncture or biopsy site to help clinicians formulate the best treatment programs.

3. Evaluation of treatment and prognosis judgment:

The treatment of various tumor evaluation and prognosis and guide further treatment.

4. Early identification of tumor recurrence, tumor staging another:

PET can be right for residual or recurrent tumor after early diagnosis, and treatment of fibrosis, necrosis were identified, based on the treatment of lesions after the re-distribution of phases, such as CT and MRI imaging of information-based tools to do this.

5. The primary tumor lesions find:

Through rapid systemic PET / CT scan, for unknown reasons for the primary tumor metastatic lesions.

6. Radiotherapy biological target location:

Radiotherapy help doctors outlining biological target. For example, in lung cancer with atelectasis circumstances, it is very difficult judgment tumor radiotherapy division of the actual border, PET will help determine the metabolic activity of the lesion, radiation therapy (particularly precision radiotherapy) to provide a more reasonable and accurate positioning, reducing the side effects of treatment.

Myocardial viability studies have become a hot topic in recent years, generally agreed that PET imaging of myocardial metabolism, is the judgment of myocardial cells of the most accurate method, known as the “gold standard.” PET imaging can help define and identify myocardial necrosis with reversible myocardial ischemia, the interventional treatment of coronary artery bypass surgery have an important role in guiding, bypass surgery can significantly improve the success rate, while the recovery of cardiac function to predict.

Cerebral metabolic imaging can accurately understand the disease under normal circumstances and the state of nerve cell activity and metabolic changes and different physiological conditions to stimulate thinking and the state of the cerebral cortex metabolism. PET people intuitively understand that the brain metabolic activities and various physiological or pathological changes in metabolism, and the image is reflected in the way.

Specific applications:

1. Epilepsy Location: right brain lesions epilepsy accurate positioning for the Gamma Knife surgery or provide the basis for epilepsy lesions;

2. Brain tumor recurrence and qualitative judgment: benign and malignant brain tumors qualitative malignant glioma border identification, tumor necrosis after treatment with radioactive differential recurrence, tumor biopsy site preferences.

3. Early diagnosis of dementia: Alzheimer’s diagnosis in the early phases, and with other types of dementia such as vascular dementia were identified.

4. Brain receptor Study: Parkinson’s disease brain receptor analysis, disease diagnosis and guiding treatment.

5. Cerebrovascular diseases: PET can capture sensitive to ischemic attack caused by changes in brain metabolism, it can have an ischemic attack (TIA) and the early diagnosis of cerebral infarction and positioning, and efficacy assessment and prognosis.

6. Drug research: a neuropsychiatric drug pharmacology evaluation and guidance medication, forced realistic models of cerebral glucose metabolism in patients with changes in stereotactic surgery for the treatment of the basis of preoperative and postoperative follow-up and efficacy.

PET / CT is a highly sensitive, accurate and noninvasive means of inspection, for many diseases (especially common diseases such as cancer) with early detection, early diagnosis value. PET / CT imaging can be a one-time general, easy to find the existence of systemic risk in a small lesions, early diagnosis will enable subjects to be really early treatment to achieve cure. While PET / CT is particularly suited to judge the existence of the brain or heart early ischemia, hypoxia and metabolic functions of the abnormal changes help guide targeted subjects to take timely and appropriate treatment or to take preventive measures.

Digital Subtraction 650032, DSA

By admin

 is a new X-ray imaging systems, conventional angiography and computer image processing technology of the product. General angiography images of the anatomical structure of a lot of information, such as bone, muscle, blood vessels and gas-bearing lacunar etc., overlapping each other, if only in order to right a structure or organization of the more subtle difficulties.
DSA imaging examination will be the basic principle is not part contrast agent injected and after contrast agent injection angiography X-ray fluorescence images, respectively image intensifier gain, reuse of the high-resolution television camera scanning, image segmentation into many small box made of the matrix formed by the small box in the a pixel is composed of the video image, and increase the number of A / D converters for different numerical figures, respectively, and a digital image storage, processing and input computer and two digital image subtraction, was calculated from the difference between the different signals, and several enhanced by the contrast / Die converted into ordinary analog signal, and the removal of bone, muscle and other soft tissue, leaving only a simple subtraction angiographic images of images displayed through the display.
Through DSA image processing, the image of clarity in interventional surgery safer.

DSA - assisted system dynamic stability

Dynamic Stability Assistant DSA - system dynamic stability auxiliary system, or STC-Tracing Stability Control system backtracking stability control system is a larger engine power output than with the needs of its role is to inhibit or accelerate the traffic generated by the wheels slipping phenomenon, to maintain the tire grip of the appropriate allocation of vehicles to maintain stability.

DSA algorithm
Digital Signature Algorithm (DSA) is Schnorr and ElGamal signature algorithm variants, the United States NIST as DSS (DigitalSignature Standard). Algorithm application of the following parameters:

P: L bits long prime numbers. L is a multiple of 64, range from 512 to 1024;
Q: p - 1 160bits the prime factor;
G: g = h ^ ((p-1) / q) mod p, h meet h <p - 1, h ^ ((p-1) / q) mod p> 1;
X: x <q, x for the private key;
Y: y = g ^ x mod p, (p, q, g, y) for the public key;
H (x): One-Way Hash Functions. DSS use SHA (Secure Hash Algorithm).
P, q, g by a group of users to share, but in practical application, use public modulus may bring some kind of threat. Signed certification and agreement are as follows:

1. P generated random number k, k <q;
2. Calculation of P r = (g ^ k mod p) mod q
S = (k ^ (1) (H (m) + xr)) mod q
Signed results (m, r, s).
3. Verification of w = s ^ (1) mod q
U1 = (H (m) * w) mod q
U2 = (r * w) mod q
V = ((g ^ ^ u2 u1 * y) mod p) mod q
If v = r, that the signature was valid.

DSA is based on the integer domain limited discrete logarithm problem, and the safety of almost compared with RSA. DSA is an important feature of two prime numbers publicly, so that when people use the p and q, even though they may not know the private key, you can confirm whether they are randomly generated, or made hands. RSA algorithm is not made.
Clinical application of DSA
   1. Nervous System: Carotid artery
   2. Circulatory system: bronchial pulmonary angiography coronary arteriography DSA DSA cardiac chest large limbs DSA DSA

Surgery with astral lamp

By admin

Surgery with astral lamp into “hole surgery with astral lamp” and “overall reflection surgery with astral lamp.” With the purification of room for more and more used by the hospital. Laminar impact on the operating room laminar heat and the main factors impeding the control requirements of increases. Old-hole surgery with astral lamp unable to meet the high standards purification operating room technical requirements, the overall reflectance is gradually being replaced by surgery with astral lamp!
0 is the main operating room with astral lamp lighting medical use!
0
0 Shandong Ming-tai (MingTai) ZF700/700 parameters:
0 illumination from a meter LX 120000 120000
4500 ± 400 K color temperature
MM spot diameter of 280 280
Lighting depth ≥ 500 MM
Stall - dimming brightness level without dimming
Principal Deputy lights automatically switch
Power supply voltage 220V 50HZ V. HZ
Power 150 150 W lamp
The minimum installation height MM 2900
W input power 400 400

ZF series with astral lamp operation widely applicable to various lighting needs surgery occasions, the modern operating room is the ideal lighting equipment.
THE closure of the linear lamp design, the operating room fully meet today’s high standards of disinfection and flow requirements.
Using CAD / CAM technology created at all levels of the overall reflectance of optical systems, lighting depth of 600mm; Use color temperature compensation technology to improve color reproduction conditions are more suitable in brain surgery, thoracic surgery and other large complex surgical lighting.
Water bellows lights panels would light a softer, better security.
Microcomputer digital control, brightness with eighth choice, illumination and memory function and wide voltage characteristics of electricity AC180V ~ 250V work within the framework of stability and anti-jamming capability.
Backup lamp with automatic switching function when the main lights burned, vice lights in 1 / 2 seconds with automatic lights. The handle on the main panel, suggested that failure of lights to remind the timely replacement surgery.
Soft Start device installed, effectively extended lamp life, a long life Bubble Lamp, more than 1,000 hours lamp life.
Focusing System sophisticated structure, replacement bulbs, porcelain Block convenient; From dump handle jacket, can be used for high-temperature (less than 140 ° C) sterilization treatment.
Configuration dexterous balance arm suspension system, universal joints six group interaction, mobile lightweight, stable positioning. All 360 ° design. Surgery can meet the different needs of height and angle.
Overhead (floor) power systems, control box is removed from the wall of the installation trouble.
Key components are used brand-smooth and reliable operation, temperature and flame retardant grade material security, in line with the standard requirements of IEC.