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МЕДИЦИНСКАЯ КИБЕРНЕТИКА И МЕЖДИСЦИПЛИНАРНАЯ ПОДГОТОВКА СПЕЦИАЛИСТОВ ДЛЯ МЕДИЦИНЫ 医学控制论与国际准备
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-08-28 DOI: 10.20538/1682-0363-2014-4-5-8
Яков Семенович Пеккер, Тамара Владимировна Новикова
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引用次数: 1
РАЗРАБОТКА ИНФОРМАЦИОННОЙ МОДЕЛИ КЛИНИЧЕСКИХ СЦЕНАРИЕВ НА БАЗЕ ОБУЧАЮЩЕГО СИМУЛЯЦИОННОГО ЦЕНТРА 根据培训模拟中心开发临床场景信息模型
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-08-28 DOI: 10.20538/1682-0363-2014-4-118-122
Иван Владиславович Толмачев, Е. Г. Рипп, Сергей Владимирович Тропин, Евгения Викторовна Карпушкина, Анастасия Сергеевна Цверова
There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center. Objectives: – to analyze the process of scenario conducting; – to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock) with specialist’s help. The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees. By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed. As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones. Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax), pulmonary edema, hypertensive crisis, respiratory distress syndrome of the newborn, meconium aspiration syndrome.
医学教育中存在一个大问题那就是学生没有足够的技能。通常,即使有理论知识,医学研究生也需要通过与病人打交道来提高他们的技能。显然,这对病人来说是一种风险,而且需要很长时间。在医学教育中应用模拟技术可以改变这一现状。使用虚拟模拟器的医学教育可以缩短技能发展的时间,提高培训质量。这项工作的目的是在医学模拟中心开发信息模型和创建紧急状态的临床场景。目标:-分析情景进行的过程;-在专家的帮助下,创建紧急状态(过敏性休克、低血容量休克、阻塞性休克)的临床场景。该方案由主要目的、技能、所需的人体模型、人体模型的准备、为该方案准备医疗设备和仪器、特殊材料的准备、方案说明、操作人员指南、培训人员信息等部分组成。通过对情景实施过程的分析,确定了关键参与者:操作员、助理、培训师、学员。此外,还定义了主要场景阶段。在此基础上,设计了场景传导变型的阶段图。例如,本文中有“阻塞性休克-肺栓塞”的片段。学习技能是认知技能、技术技能和社交技能。结果。本文对临床情景传导进行了分析。建立了基于面向对象分解的信息模型。该模型是场景传导的变型图。制定了紧急状态情景结构。这些情况包括过敏性休克、低血容量性休克、阻塞性休克(肺栓塞、张力性气胸)、肺水肿、高血压危象、新生儿呼吸窘迫综合征、胎便吸入综合征。
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引用次数: 2
Ожирение как фактор риска тромбоэмболии легочной артерии 肥胖是肺动脉血栓栓塞的危险因素
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-03-01 DOI: 10.20538/1682-0363-2014-2-10-13
Оксана Ярославна Васильцева, Ирина Николаевна Ворожцова, Ростислав Сергеевич Карпов
The aim of the study. Based on the data of the Register of new cases of hospital pulmonary embolism (PE) in hospitals in Tomsk (2003–2012), to explore the contribution of obesity to the development of venous thromboembolism. Material and Methods. Study were subjected to medical history and records of autopsies of patients treated in hospitals in Tomsk in 2003–2012, who at patologoanatomic and/or instrumental study revealed pulmonary embolism. The degree of obesity was assessed according to WHO criteria (1997). Statistical processing of the results was carried out using the software package for PC Statistica 8.0 for Windows. To test the normality of the distribution of quantitative traits using the Shapiro–Wilk test and the Kolmogorov–Smirnov with the adjusted Lillieforsa. Check the equality of the population variance was performed using Fisher's exact test and Cochran. Was considered statistically significant level of p < 0.05. The results of the study. In Western Siberia, Tomsk, a register of hospital pulmonary embolism (2003–2012). In the register included 720 patients with in vivo and/or post mortem revealed pulmonary embolism (PE). Analyzed data from medical records and autopsy reports. Revealed statistically significant differences in BMI (p = 0.033) and the presence of obesity (p = 0.002) in patients with pulmonary embolism, holding medical and surgical beds. As of medical, surgical and among patients with thromboembolism, obesity is significantly more common in women than men (p = 0.050 and p = 0.041 respectively). According to the study, obesity grade 1 or 2 alone (at the isolated presence of the patient) is not significantly increased the odds of a massive thromboembolism. However, grade 3 obesity increased the odds of a massive pulmonary embolism by more than 2.7 times (OR = 2.708, CI: 1,461–5,020).
研究的目的。基于2003-2012年托木斯克市医院新发肺栓塞(PE)病例登记册数据,探讨肥胖对静脉血栓栓塞发展的贡献。材料和方法。研究对象是2003-2012年在托木斯克医院接受治疗的患者的病史和尸检记录,这些患者在病理解剖和/或仪器研究中发现肺栓塞。根据世卫组织标准(1997年)对肥胖程度进行了评估。使用PC Statistica 8.0 for Windows软件包对结果进行统计处理。采用Shapiro-Wilk检验和调整后的Lillieforsa的Kolmogorov-Smirnov检验数量性状分布的正态性。使用Fisher精确检验和Cochran检验检验总体方差是否相等。认为p < 0.05有统计学意义。研究的结果。在西西伯利亚,托木斯克,医院肺栓塞登记(2003-2012年)。在登记中包括720例体内和/或死后发现肺栓塞(PE)的患者。分析了医疗记录和尸检报告中的数据发现肺栓塞、内科和外科患者的BMI (p = 0.033)和肥胖(p = 0.002)存在统计学意义上的差异。在内科、外科和血栓栓塞患者中,女性肥胖明显比男性更常见(p = 0.050和p = 0.041分别)。根据这项研究,1级或2级肥胖单独(在患者单独存在的情况下)不会显著增加大块血栓栓塞的几率。然而,3级肥胖使大规模肺栓塞的几率增加了2.7倍以上(OR = 2.708, CI: 1461 - 5020)。
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引用次数: 1
РОЛЬ СООБЩЕСТВА МИКРООРГАНИЗМОВ ДЫХАТЕЛЬНЫХ ПУТЕЙ В ПАТОГЕНЕЗЕ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ 慢性阻塞性肺病病原体病原体社区的作用
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-02-28 DOI: 10.20538/1682-0363-2014-1-153-160
С. В. Федосенко, Людмила Михайловна Огородова, М. А. Карнаушкина, Е. С. Куликов, Иван Анатольевич Деев, Н. А. Кириллова
This review summarizes the results of studies on the composition of microbial communities in the airways of healthy subjects and in patients with chronic obstructive pulmonary disease. Modern technologies of molecular-genetic identification methods of microorganisms allow to perform a deep analysis  of  the  respiratory  microbiom.  It  is  of  considerable  interest  to  determine  the  role  of  the microbiome in the development of human diseases of the bronchopulmonary system, and to understand the impact of the microbes communities as a course of disease and the important factor for the efficacy of current therapy.
本文综述了健康人群和慢性阻塞性肺疾病患者呼吸道微生物群落组成的研究结果。微生物分子遗传鉴定方法的现代技术允许进行呼吸微生物组的深入分析。确定微生物组在人类支气管肺系统疾病发展中的作用,了解微生物群落作为疾病过程的影响以及当前治疗效果的重要因素是相当有意义的。
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引用次数: 3
USING BIOFEEDBACK FOR REHABILITATION OF PATIENTS WITH PARKINSON'S DESEASE 生物反馈在帕金森病患者康复中的应用
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-4-38-42
T. S. Grebysheva, N. Brazovskaya, I. Zhukova, M. Nikitina, O. Izhboldina, N. Zhukova, V. Alifirova, Y. Pekker
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引用次数: 2
ПОЛИМОРФИЗМ ГЕНОВ ИММУНОСУПРЕССОРНЫХ ЦИТОКИНОВ IL-10 И TGF-β ПРИ ТУБЕРКУЛЕЗНОЙ ИНФЕКЦИИ 肺结核感染中免疫抑制细胞因子IL-10和TGFβ基因的多态性
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-5-107-113
Ye. G. Churina, O. I. Urazova, V. V. Novitsky, O. V. Filinyuk
The aim of the work was the study of connection of allelic polymorphism of  IL10  and  TGF В genes with changes in the basal and BCG-induced production of immunosuppressive cytokines IL-10 and TGF-β by mononuclear leukocytes  in vitro  in patients with the first diagnosed pulmonary tuberculosis (TB), depending on the clinical form of the disease. The evaluation of the cytokines production was conducted by measuring its concentration in culture supernatants by ELISA. The allele-specific amplification of specific stretches of the genome was used for the study of polymorphic genes of cytokines. The DNA and supernatants of culture suspensions of blood mononuclear leucocytes in healthy volunteers and patients with TB were the material of the research. It was shown in the research conducted that the basal and BCG-induced over-production of IL-10  in vitro  occurs in patients with TB, regardless of the genotype of the locus of  C-592AIL10  gene. In addition, genotype  AA  of polymorphism of  IL10 gene in patients with infiltrative and disseminated TB is associated with the maximum production of IL-10  in vitro and genotype  CC  – with the minimum production of this cytokine  in vitro . Analysis of the production of TGF-β  in vitro  in patients with TB showed its increase only in case of carriage of allele  T  ( C-509T ) of  TGFB  gene. In patients with disseminated TB and homosygotic genotype  TT  the increase in both basal and BCG-induced production of TGF-β was determined, and in patients with infiltrative TB – only after induction of cells by BCG-antigen. Thus, the over-production of cytokines with inhibiting activity in patients with TB is genetically determined and promotes the formation of suppressive mode of immune-regulation. The increase in the secretion of cytokines IL-10 and TGF-β  in vitro  in patients with TB are associated with carriage of allele  A  and genotype  AA ( C-592A ) of  IL10 gene and allele  T  and genotype  TT  ( C-509T ) of  TGFB  gene.
这项工作的目的是研究IL-10和TGF- В基因等位基因多态性与首次诊断为肺结核(TB)的患者体外单核白细胞基础和bcg诱导的免疫抑制细胞因子IL-10和TGF-β产生的变化之间的联系,这取决于疾病的临床形式。通过ELISA法测定细胞因子在培养上清液中的浓度来评价细胞因子的产生。基因组特异片段的等位基因特异性扩增用于细胞因子多态性基因的研究。以健康志愿者和结核患者血单核白细胞培养悬液的DNA和上清液为研究材料。本研究表明,无论C-592AIL10基因位点的基因型如何,结核患者体外均存在基底和bcg诱导的IL-10过量产生。此外,浸润性和播散性结核患者IL-10基因多态性基因型AA与体外IL-10产量最高相关,基因型CC -与体外IL-10产量最低相关。对TB患者体外TGF-β产生的分析显示,只有携带TGFB基因的等位基因T (C-509T)时,TGF-β的产生才会增加。在弥散性结核和纯合子基因型TT患者中,测定了基础和bcg诱导的TGF-β产量的增加,而在浸润性结核患者中,仅通过bcg抗原诱导细胞后,测定了TGF-β产量的增加。因此,结核患者体内具有抑制活性的细胞因子的过量产生是由遗传决定的,并促进了免疫调节抑制模式的形成。TB患者体外细胞因子IL-10和TGF-β分泌增加与IL10基因等位基因A和基因型AA (C-592A)以及TGFB基因等位基因T和基因型TT (C-509T)的携带有关。
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引用次数: 0
ПРОГРАММНО-АППАРАТНЫЙ КОМПЛЕКС ДЛЯ ОЦЕНКИ ФУНКЦИОНАЛЬНОГО СОСТОЯНИЯ МАТЕРИ И ПЛОДА 评价母子功能的软件硬件综合体
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-4-113-117
Иван Владиславович Толмачёв, Константин Станиславович Бразовский, Анастасия Сергеевна Цверова, В. С. Рипенко
Text abstract Mother’s and fetus’s health are very important in present time. With timely diagnosis perinatal pathology, birth injuries, antenatal stillbirths and newborn perinatal death can be prevented. At the moment in the world there are no complexes which enable monitoring of the fetus without any risk to his health. So the main aim of this work is development of hardware and software system to assess the functional status of the mother and fetus by the analysis of the signals recorded from the abdominal electrodes. Objectives: 1) to formulate the requirements to noninvasive monitoring system and functional state assessment of mother and fetus. 2) to develop algorithms and software for monitoring system and functional state assessment of mother and fetus. 3) to determine fetus functional state at 32–33 week in women with uncomplicated pregnancies and in women with placental insufficiency in the compensation stage and subcompensation. The system concept is based on fetal heart rate recognition and analysis. Fetal heart rate has been extracted from the mixed signals received from abdominal electrodes. This technique is passive for a body so there is no research time limit. Device for simultaneous registration of fetal and maternal electrocardiogram is high sensitive bioamplifier with low level of intrinsic noises, high input resistance and suppression of inphase noises more than 80 DB. Digital processing of a signal is carried out by microcontroller of the registration module and personal computer. Preprocessing is carried out in microcontroller by receiving signals from the analog-to-digital converter on the increased sampling rate, digital filtering, decimation. With the help of the developed complex two-stage study was conducted. At first stage the fetal cardiointervalogram (i.e. fetus heartbeat period and the distribution pattern of these intervals in time) was studied. Second stage was carried out to search additional criteria of fetal functional state assessment with placental insufficiency in the pregnant with hyperandrogenism in the third trimester. As result, it was defined, that parameters of heart rate structure at 32–35 weeks of gestation allows to assess the risk of functional disorders and development of fetus hypoxia with sensitivity Se = 80% and specificity Sp = 73%.
摘要在当今社会,母亲和胎儿的健康非常重要。及时诊断围产期病理,可以预防分娩损伤、产前死产和新生儿围产期死亡。目前,世界上还没有一种综合体能够在不危及胎儿健康的情况下监测胎儿。因此,本研究的主要目的是开发通过分析腹部电极记录的信号来评估母亲和胎儿功能状态的硬件和软件系统。目的:1)制定对无创监护系统及母婴功能状态评估的要求。2)开发母胎监测系统和功能状态评估的算法和软件。3)测定正常妊娠和胎盘功能不全处于代偿期和亚代偿期的32-33周胎儿功能状态。该系统的概念是基于胎儿心率的识别和分析。从腹部电极接收到的混合信号中提取胎儿心率。这种技术对身体来说是被动的,所以没有研究时间限制。胎儿和母亲心电图同时登记装置是高灵敏度生物放大器,具有低水平的固有噪声,高输入电阻,抑制80 DB以上的相位噪声。信号的数字处理由配准模块的单片机和个人计算机共同完成。预处理是在微控制器中通过增加采样率、数字滤波、抽取从模数转换器接收信号来完成的。借助已开发的复杂系统进行了两阶段的研究。第一阶段研究胎儿心脏间期图(即胎儿心跳周期和这些间隔时间的分布模式)。第二阶段是为了寻找在妊娠晚期伴有高雄激素血症的孕妇胎盘功能不全的胎儿功能状态评估的附加标准。因此,定义了妊娠32-35周心率结构参数可以评估功能障碍和胎儿缺氧发展的风险,敏感性Se = 80%,特异性Sp = 73%。
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引用次数: 0
ANALYSIS OF MULTIDIMENSIONAL MEDICAL DATA USING PICTOGRAPHICS «CHERNOFF FACES» 使用象形文字«切尔诺夫面»分析多维医学数据
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-4-89-93
I. A. Osadchaya, O. Berestneva, Ye. V. Nemerov
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引用次数: 4
НАТРИЙ-КАЛИЙ-ХЛОР-КОТРАНСПОРТ В РЕГУЛЯЦИИ МИОГЕННОГО ТОНУСА СОСУДОВ 血管肌张力调节钠钾氯运输
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-6-165-173
Сергей Николаевич Орлов, С. В. Кольцова, Яна Джоновна Анфиногенова, Леонид Владимирович Капилевич, Светлана Валерьевна Гусакова, Л. В. Смаглий, М. Б. Баскаков, Михаил Андреевич Медведев
The article discusses the data on the functioning of Na + ,K + ,2Cl –  cotransport – the carrier providing electroneutral symport of sodium, potassium and chloride, as well as molecular mechanisms of the regulation and physiological significance of this carrier. We analyzed the novel data on involvement of ubiquitous isoform of Na + ,K + ,2Cl – cotransporter (NKCC1) in regulation of vascular smooth muscle contraction, and role of this carrier in the regulation of cell volume and intracellular chloride concentration.
本文讨论了钠、钾、氯离子电中性同调载体Na +、K +、2Cl -共转运的功能及其调控的分子机制和生理意义。我们分析了Na +,K +,2Cl -共转运体(NKCC1)泛在异构体参与血管平滑肌收缩调控的新数据,以及该载体在调节细胞体积和细胞内氯离子浓度中的作用。
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引用次数: 1
Определение и анализ двигательной активности постинсультного пациента по видеопотоку 视频流测定和分析后硫酸盐病人的运动活动
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2014-01-01 DOI: 10.20538/1682-0363-2014-5-36-41
M. Y. Katayev, N. G. Katayeva, S. G. Katayev, M. O. Abramov, V. A. Chistyakova
This article describes an approach to the assessment of motion activity of man in after-stroke period, allowing the doctor to get new information to give a more informed recommendations on rehabilitation treatment than in traditional approaches. Consider description of the hardware-software complex for determination and analysis of motion activity after-stroke patient for the video stream. The article provides a description of the complex, its algorithmic filling and the results of the work on the example of processing of the actual data. The algorithms and technology to significantly accelerate the gait analysis and improve the quality of diagnostics post-stroke patients.
本文描述了一种评估中风后人类运动活动的方法,使医生能够获得新的信息,从而比传统方法更明智地建议康复治疗。考虑对用于确定和分析脑卒中后患者运动活动的软硬件复合体的描述,以用于视频流。文中给出了该复合体的描述、算法的填充以及对实际数据处理实例的工作结果。该算法和技术显著加快了脑卒中后患者的步态分析,提高了诊断质量。
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引用次数: 0
期刊
Byulleten Sibirskoy Meditsiny
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