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Design of a Novel Tendon-Sheath-Driven Upper Limb Exoskeleton for Assisting Surgeon Performing Microlaryngoscopic Surgery 一种新型肌腱鞘驱动的上肢外骨骼的设计,用于辅助外科医生进行喉镜手术
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-11-24 DOI: 10.1115/1.4056319
Zhengyu Wang, Wenjun Song, Sen Qian, Daoming Wang, Zirui Jia, Xiang Yu
Microlaryngoscopic surgery is a type of laryngeal surgery performed by surgeons using microsurgical instruments under the observation of a specially designed laryngoscope. While performing a microlaryngoscopic operation, the surgeons must maintain their arm position for a long time, which can cause arm soreness and affect the accuracy of the operation. In this study, a tendon-sheath-driven upper limb auxiliary exoskeleton (TULAE) is proposed and developed. The flexible cables are compressed by a wave-shaped pressing mechanism to fix the TULAE's rotating joints. The TULAE can assist surgeons in laryngoscopy operations by providing suitable support for their arms to reduce the surgical risks caused by muscle fatigue. The TULAE has 4 degrees of freedom (DOF) on each arm. The shoulder flexion/extension, shoulder abduction/adduction and elbow internal rotation/external rotation can be fixed by the control box. The shoulder internal rotation/ external rotation is a passive DOF obtained using hinges. The TULAE's shoulder, upper arm and forearm links are designed with lengths adjustable to accommodate wearers of different heights and weights. A large-scale but risk-free workspace is analyzed through rigid body kinematics using the spinor method. The control hardware of the TULAE is developed based on the open-source Arduino board. Finally, the experimental results show that this TULAE can significantly reduce the range of wrists shaking and assist surgeons in laryngoscopy surgery.
显微喉镜手术是外科医生在专门设计的喉镜观察下使用显微手术器械进行的一种喉部手术。在进行喉镜手术时,外科医生必须长时间保持手臂姿势,这样会造成手臂酸痛,影响手术的准确性。本研究提出并开发了一种肌腱鞘驱动的上肢辅助外骨骼(TULAE)。柔性电缆被一个波浪形的压紧机构压缩,以固定TULAE的旋转接头。TULAE可以帮助外科医生进行喉镜手术,为他们的手臂提供合适的支撑,以减少因肌肉疲劳引起的手术风险。TULAE的每只手臂上都有4个自由度。肩关节屈伸、外展、内收、肘关节内旋、外旋均可通过控制箱固定。肩部内旋/外旋是利用铰链获得的被动自由度。TULAE的肩部、上臂和前臂连接的长度可调节,以适应不同身高和体重的佩戴者。采用旋量法对大型无风险工作空间进行了刚体运动学分析。TULAE的控制硬件是基于开源的Arduino板开发的。最后,实验结果表明,该TULAE可以明显减小手腕抖动的范围,辅助外科医生进行喉镜手术。
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引用次数: 0
A Portable, Vacuum-Operated, and Purely Mechanical Device for Extracting Feces by Suction to Cure Chronic Anal Fissures 一种便携式、真空操作、纯机械抽吸粪便治疗慢性肛裂的装置
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-11-15 DOI: 10.1115/1.4056251
Riaz Ur Rehman Mohammed, Vedad Bassari, Richard Rasmussen, B. Terry
An anal fissure is a common anorectal problem that affects men and women of all age groups. It develops from an acute phase that presents as a linear or oval tear in the anoderm and may progress to a more complex chronic stage due to poor healing. Routine defecation causes overstretching of the anoderm and deepens the scar, setting up a positive feedback loop that keeps the fissure from healing. Existing treatments can be invasive, expensive, and may induce side effects. Here we present a novel vacuum-operated mechanical device to extract feces via suction. The device is designed to solve the problem of anodermal stretching by assisting in defecation. The device was tested in vitro on a benchtop model of the rectum and in vivo on pigs. In vitro tests showed that the device could hold a vacuum for 12 h with negligible leakage. Further, the device could extract simulated human feces at a flowrate of 32 mL/s. In vivo tests on pigs showed that the device did not cause any trauma to the rectal wall, thus demonstrating its safety. Our results highlight the potential of this novel platform to circumvent the problem of anodermal stretching and improve the healing rate of anal fissures.
肛裂是一种常见的肛门直肠问题,影响所有年龄组的男性和女性。它从急性期发展而来,表现为阳极层的线性或椭圆形撕裂,由于愈合不良,可能发展到更复杂的慢性期。常规排便会导致阳极皮过度拉伸,加深疤痕,形成一个正反馈回路,阻止裂缝愈合。现有的治疗方法可能是侵入性的、昂贵的,并且可能引起副作用。在这里,我们提出了一种新型的真空操作机械装置,通过抽吸提取粪便。该装置旨在通过协助排便来解决阳极拉伸的问题。该装置在直肠台式模型上进行了体外测试,并在猪身上进行了体内测试。体外测试表明,该装置可以保持真空12小时,泄漏量可以忽略不计。此外,该装置可以以32mL/s的流速提取模拟人类粪便。在猪身上进行的体内测试表明,该装置没有对直肠壁造成任何创伤,因此证明了其安全性。我们的研究结果突出了这种新型平台的潜力,可以避免阳极皮肤拉伸的问题,提高肛裂的愈合率。
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引用次数: 0
Application of ANN to Nucleic Acid Analysis: Accurate Discrimination for Untypical Real-Time Fluorescence Curves with High Specificity and Sensitivity 人工神经网络在核酸分析中的应用:高特异性、高灵敏度的非典型实时荧光曲线的精确判别
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-11-08 DOI: 10.1115/1.4056150
Guijun Miao, Xiaodan Jiang, Yunping Tu, Lulu Zhang, Duli Yu, Shizhi Qian, Xianbo Qiu
As a division of polymerase chain reaction (PCR), convective PCR (CPCR) is able to achieve highly efficient thermal cycling based on free thermal convection with pseudo-isothermal heating, which could be beneficial to point-of-care (POC) nucleic acid analysis. Similar to traditional PCR or isothermal amplification, due to a couple of issues, e.g., reagent, primer design, reactor, reaction dynamics, amplification status, temperature and heating condition, and other reasons, in some cases of CPCR tests, untypical real-time fluorescence curves with positive or negative tests will show up. Especially, when parts of the characteristics between untypical low-positive and negative tests are mixed together, it is difficult to discriminate between them using traditional cycle threshold (Ct) value method. To handle this issue which may occur in CPCR, traditional PCR or isothermal amplification, as an example, instead of using complicated mathematical modeling and signal processing strategy, an artificial intelligence (AI) classification method with artificial neural network (ANN) modeling is developed to improve the accuracy of nucleic acid detection. It has been proven that both the detection specificity and sensitivity can be significantly improved even with a simple ANN model. It can be estimated that, the developed method based on AI modeling can be adopted to solve similar problem with PCR, or isothermal amplification methods.
作为聚合酶链式反应(PCR)的一个分支,对流PCR(CPCR)能够在自由热对流和伪等温加热的基础上实现高效的热循环,这可能有利于护理点(POC)核酸分析。与传统的PCR或等温扩增类似,由于一些问题,例如试剂、引物设计、反应器、反应动力学、扩增状态、温度和加热条件以及其他原因,在CPCR测试的某些情况下,会出现阳性或阴性测试的非典型实时荧光曲线。特别是,当非典型低阳性和阴性检测之间的部分特征混合在一起时,使用传统的循环阈值(Ct)值方法很难区分它们。为了解决CPCR、传统PCR或等温扩增中可能出现的这一问题,以提高核酸检测的准确性为例,开发了一种基于人工神经网络建模的人工智能分类方法,而不是使用复杂的数学建模和信号处理策略。已经证明,即使使用简单的ANN模型,也可以显著提高检测的特异性和灵敏度。可以估计,所开发的基于AI建模的方法可以用于解决与PCR或等温扩增方法类似的问题。
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引用次数: 1
Design and Evaluation of Self-Cooling Electrodes for Radiofrequency Intestinal Anastomosis 射频肠吻合自冷电极的设计与评价
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-10-18 DOI: 10.1115/1.4056008
Wanli Yue, Haipo Cui, Chengli Song, Liangyong Tu, Jingcheng Lang, Wenhui Yan, Yingxi Lu
Colorectal cancer is a common malignant tumor in the gastrointestinal tract. Resection of the cancerous site and anastomosis of the residual intestine is the preferred radical treatment for colorectal cancer. In particular, radiofrequency energy anastomosis of the residual intestine is being increasingly used in clinical practice. To improve the quality of anastomosis, reduce the thermal damage of tissue near the anastomosis area, and avoid foreign body residue in this area, we propose a self-cooling eversion-type radiofrequency-energy intestinal anastomosis electrode, which is analyzed through simulations and evaluated experimentally for welding intestinal tissue. For radiofrequency energy power of 160 W, anastomosis time of 13.2 s, and pressure of 154 kPa, the disconnected intestinal tissues can be anastomosed using the proposed electrode. The average burst pressure of the anastomotic orifice is 43.86 mmHg. During welding, the temperature of the normal saline at the outlet is 6.8 °C higher than that at the inlet, indicating that the use of circulating normal saline as the conductive and cooling medium can dissipate part of the heat generated by welding and reduce heat accumulation, thereby reducing thermal damage of biological tissue near the welding area. Overall, the proposed electrode may contribute to the recovery of postoperative intestinal function by enabling a novel strategy for clinical intestinal anastomosis induced by radiofrequency energy.
癌症是一种常见的胃肠道恶性肿瘤。切除癌灶并吻合残余肠是癌症的首选根治性治疗方法。尤其是残余肠的射频能量吻合在临床实践中越来越多地使用。为了提高吻合质量,减少吻合区附近组织的热损伤,避免异物残留在该区域,我们提出了一种自冷却外翻型射频能量肠吻合电极,并对其进行了仿真分析和实验评估,用于焊接肠组织。当射频能量功率为160W,吻合时间为13.2s,压力为154kPa时,可以使用所提出的电极吻合断开的肠组织。吻合口的平均破裂压力为43.86毫米汞柱。在焊接过程中,出口处的生理盐水的温度为6.8°;C高于入口处的温度,表明使用循环生理盐水作为导电和冷却介质可以消散焊接产生的部分热量,减少热量积聚,从而减少焊接区域附近生物组织的热损伤。总的来说,所提出的电极可以通过实现射频能量诱导的临床肠吻合的新策略,有助于术后肠功能的恢复。
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引用次数: 0
Design and Evaluation of a High-Performance, Low-Cost Prosthetic Foot for Developing Countries 一种适用于发展中国家的高性能、低成本假肢足的设计与评价
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-10-13 DOI: 10.1115/1.4055967
W. Johnson, Victor Prost, Pooja Mukul, A. Winter
A novel, high-performance, cosmetic, rugged, appropriately-costed, mass-manufacturable prosthetic foot for use in low-income countries was designed and field tested. This ruggedized foot was created to accommodate the unique economic, environmental, and cultural requirements for users in India. A previous prototype that enabled able-bodied like gait was modified to include a durable cosmetic cover without altering the tuned stiffness of the overall foot. After undergoing mechanical benchtop testing, the foot was distributed to prosthesis users in India to for at least 5 months. Afterwards, participants underwent clinical tests to evaluate walking performance, and additional benchtop testing was performed on the field-tested feet to identify changes in performance. The ruggedized foot endured one million fatigue cycles without failure and demonstrated the desired stiffness properties. Subjects walked significantly faster (0.14 m/s) with the ruggedized foot compared to the Jaipur foot, and the feet showed no visible sign of damage after months of use. Additionally, the field-tested feet showed little difference in stiffness from a set of unused controls. Anecdotal feedback from the participants indicated that the foot improved their speed and/or walking effort, but may benefit from more degrees of freedom about the ankle. The results suggest that the foot fulfills its design requirements; however, further field testing is required with more participants over a longer period to make sure the foot is suitable for use in developing countries.
为低收入国家设计了一种新型、高性能、美观、坚固、成本合理、可大规模生产的假肢足,并进行了现场测试。这种坚固耐用的脚是为了适应印度用户独特的经济、环境和文化要求而设计的。先前的原型,使健全的步态被修改,包括一个耐用的化妆品覆盖,而不改变整个脚的调整刚度。经过机械台式测试后,脚被分发给印度的假体用户至少5个月。之后,参与者进行临床测试以评估步行性能,并对现场测试的脚进行额外的台式测试以确定性能的变化。加固后的脚经受了100万次疲劳循环而没有失效,并显示出所需的刚度特性。与斋浦尔足相比,受试者用加固足行走的速度明显更快(0.14 m/s),并且在使用数月后,足部没有明显的损伤迹象。此外,现场测试的脚与一组未使用的控制脚的刚度几乎没有区别。来自参与者的轶事反馈表明,脚提高了他们的速度和/或行走的努力,但可能受益于踝关节的更多自由度。结果表明,该脚满足设计要求;然而,需要更多的参与者在更长的时间内进行进一步的实地测试,以确保这种脚适合在发展中国家使用。
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引用次数: 0
An Experimental Study of Feasibility of a Mini-Invasive Fixator for Rib Osteosynthesis 微创肋骨骨固定器可行性的实验研究
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-10-05 DOI: 10.1115/1.4055861
L. Puglisi, M. Ceccarelli, V. Ambrogi
Alternatives to the current invasive rib implants are discussed as from the current solutions with their constraints and disadvantages mainly in surgery application and clinical consequences. A novel rib fixator is presented with an experimental validation and characterization for a potential implementation in facilitating osteosynthesis of multifractured ribs. Testing is designed with lab facilities replicating normal breathing and coughing. Results of lab test with a Ribolution rib fixator prototype are discussed from experiences with pig ribs with satisfactory results in behavior and numerical values.
从目前的解决方案出发,讨论了目前有创肋骨植入物的替代方案,主要在手术应用和临床后果方面存在局限性和缺点。一种新型肋骨固定器提出了一个实验验证和表征,以促进多骨折肋骨骨合成的潜在实现。测试是用实验室设备设计的,复制正常的呼吸和咳嗽。从猪肋的实验经验出发,讨论了Ribolution肋固定器原型的实验室试验结果,在性能和数值上都取得了令人满意的结果。
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引用次数: 0
Multi-Manipulator Robotic System for Ultrasound Tomography: Design, Calibration, and Image Results 超声断层扫描的多机械手机器人系统:设计、校准和图像结果
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-09-16 DOI: 10.1115/1.4055655
Xiang Zhang, G. Ely, Bonghun Shin, B. Anthony
In this article, we present the design, validation, and imaging capabilities of a MEchanically Discretized Ultrasound Scanning Apparatus (MEDUSA) that supports flexible development of UST algorithms for complex tissue structures. Ultrasound tomography (UST) in the recent decade has shown promising results in quantitative soft-tissue imaging for clinical breast cancer diagnostics. There is growing interest in applying tomographic techniques to image broader tissue structures that include bone, where imaging is significantly more challenging due to strong impedance mismatches and complex wave propagation within the region. Changes in data acquisition strategy, algorithms, and system design are necessary to enable quantitative imaging of soft-tissue with bone inclusions. The 36 degree of freedom MEDUSA system allows free space positioning of acoustic transducers around an imaging target and enables investigation of imaging strategies not available in other UST systems. We present the mechanical design, parameter calibration, and tomographic imaging results using MEDUSA. Mono/Bi-static imaging and full-waveform inversion (FWI) results on real targets are presented and validates system performance capabilities for broader UST algorithm development for more complex tissue structures
在本文中,我们介绍了一种机电离散化超声扫描设备(MEDUSA)的设计、验证和成像能力,该设备支持复杂组织结构的UST算法的灵活开发。近十年来,超声断层扫描(UST)在用于临床乳腺癌症诊断的定量软组织成像方面显示出有希望的结果。人们对将断层摄影技术应用于包括骨骼在内的更广泛的组织结构成像越来越感兴趣,因为该区域内存在强阻抗失配和复杂的波传播,因此成像更具挑战性。数据采集策略、算法和系统设计的改变对于实现具有骨内含物的软组织的定量成像是必要的。36自由度MEDUSA系统允许在成像目标周围自由空间定位声学换能器,并能够研究其他UST系统中不可用的成像策略。我们介绍了MEDUSA的机械设计、参数校准和断层成像结果。给出了真实目标的单/双静态成像和全波形反演(FWI)结果,并验证了系统在更复杂组织结构的更广泛UST算法开发中的性能
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引用次数: 0
Design, Analysis, and Control of A User-Adaptive 用户自适应的设计、分析和控制
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-09-05 DOI: 10.1115/1.4055521
Yuan Zhou, Lu Liu
This paper presents the design and preliminary evaluation of a user-adaptive ankle foot orthosis (AFO). To begin with, according to the foot dimensions of an able-bodied subject, the structures of the ankle orthotic device are conceived. Then, based on a common two-degree-of-freedom (DOF) foot model, the AFO-human system is set up; its kinematic model and the device's mechanism of user adaptation are analyzed. After that, the layout of a portable orthotic system, as well as a smart insole that detects gait phases, is illustrated. Finally, the orthotic system is tested on the aforementioned subject. Results show that, when assistive torque of the AFO is applied, the foot's plantarflexion magnitude before the swing stage and dorsiflexion magnitude during the swing stage approximately increase by 3 and 4 degrees, respectively. Therefore, the orthosis has the potential to aid propulsion motions and control toe clearance.
本文介绍了一种用户自适应踝足矫形器(AFO)的设计和初步评估。首先,根据身体健全的受试者的足部尺寸,构思了踝关节矫形器的结构。然后,基于常见的两自由度足部模型,建立了AFO人体系统;分析了其运动学模型和设备的用户适应机制。之后,说明了便携式矫形器系统的布局,以及检测步态阶段的智能鞋垫。最后,在上述受试者身上测试矫正系统。结果表明,当施加AFO的辅助力矩时,足部在摆动阶段前的跖屈幅度和摆动阶段的背屈幅度分别约增加3度和4度。因此,矫形器具有帮助推进运动和控制脚趾间隙的潜力。
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引用次数: 0
Research on Movement Intentions of Human's Left and Right Legs Based on EEG Signals 基于脑电图信号的人左右腿运动意图研究
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-09-02 DOI: 10.1115/1.4055435
Fangyan Dong, Liangdan Wu, Yongfei Feng, Dongtai Liang
Active rehabilitation training method can help stroke patients recover better and faster. However, the lower limb rehabilitation robot based on electroencephalogram (EEG) has low recognition accuracy now. A classification method based on EEG signals of motor imagery is proposed to enable patients to accurately control their left and right legs. Firstly, aiming at the unstable characteristics of EEG signals, an experimental protocl of motor imagery was constructed based on multi-joint motion coupling of left and right legs. The signals with time-frequency analysis and ERD/S analysis have proved the reliability and validity of the collected EEG signals. Then, the EEG signals generated by the protocol were preprocessed and Common Space Pattern (CSP) was used to extract their features. Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA) are adapted and their accuracy of classification results are compared. Finally, on the basis of the proposed classifier with excellent performance, the classifier is used in the active control strategy of the lower limb rehabilitation robot, and the experiment verified that the average accuracy of two volunteers in controlling the lower limb rehabilitation robot reached 95.1%. This research provides a good theoretical basis for the realization and application of brain-computer interface in rehabilitation training.
主动康复训练方法可以帮助脑卒中患者更好更快的康复。然而,目前基于脑电图的下肢康复机器人识别准确率较低。提出了一种基于运动意象脑电信号的分类方法,使患者能够准确地控制自己的左腿和右腿。首先,针对脑电信号不稳定的特点,构建了一种基于左右腿多关节运动耦合的运动意象实验方案;对采集到的脑电信号进行时频分析和ERD/S分析,验证了其可靠性和有效性。然后,对该协议生成的脑电信号进行预处理,利用公共空间模式(CSP)提取其特征;采用支持向量机(SVM)和线性判别分析(LDA)对分类结果进行了精度比较。最后,在本文提出的分类器性能优异的基础上,将该分类器应用于下肢康复机器人的主动控制策略中,实验验证了两名志愿者控制下肢康复机器人的平均准确率达到95.1%。本研究为脑机接口在康复训练中的实现和应用提供了良好的理论基础。
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引用次数: 1
On the Design and Testing of an Origami Inspired Nasal Cover: Mitigating Aerosol Risks During Endoscopic Sinus Procedures 折纸启发的鼻罩的设计和测试:降低鼻窦内窥镜手术中的气溶胶风险
IF 0.9 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2022-08-16 DOI: 10.1115/1.4055251
Evan Heatherington, Xiaoyue Zhao, N. Goyal, Z. Ounaies, M. Frecker
Aerosols generated during endoscopic sinus procedures present a concern to the health and safety of healthcare personnel especially with the presence of COVID-19. The purpose of this study is to describe the design and testing of a nasal cover to restrict aerosolized pathogens. The nasal cover was designed to sit overtop the nose with conformal slits for insertion of endoscopic instrumentation. Polydimethylsiloxane (PDMS) was chosen as the nasal mask material and its composition, thickness, and slit geometry were selected using a Taguchi experimental design and survey with clinical collaborators at Penn State Milton S. Hershey Medical Center. The nasal cover was designed using principles of origami engineering to be manufactured flat then folded into its operating state. Form and functionality were evaluated by surgeons, fellows, and residents in the aforementioned survey. Aerosol containment was evaluated by measuring smoke, representative of surgical aerosols, with an optical particle counter. A 25:1 composition PDMS with 3mm thickness and vertical slit geometry was chosen for the nasal cover design. Survey results demonstrated that the origami cover sat well on the nose and did not significantly impact the surgical conditions with single instrumentation. On average, this nasal cover was found to restrict more than 93% of 0.3µm aerosols, and more than 99% of all aerosols larger than 0.5µm in size. Use of a patient worn nasal cover has the potential to drastically reduce the risk to hospital personnel during endonasal surgeries by reducing aerosol generation and potential pathogen spread.
内窥镜鼻窦手术过程中产生的气溶胶对医护人员的健康和安全造成了担忧,尤其是在存在新冠肺炎的情况下。本研究的目的是描述限制雾化病原体的鼻罩的设计和测试。鼻罩被设计为位于鼻子上方,带有用于插入内窥镜仪器的共形狭缝。选择聚二甲基硅氧烷(PDMS)作为鼻面罩材料,并使用田口实验设计和宾夕法尼亚州立大学米尔顿S.好时医疗中心的临床合作者的调查来选择其组成、厚度和狭缝几何形状。鼻罩是根据折纸工程原理设计的,制造成扁平状,然后折叠成工作状态。在上述调查中,外科医生、研究员和住院医师对其形态和功能进行了评估。气溶胶的控制是通过用光学粒子计数器测量烟雾来评估的,烟雾是外科手术气溶胶的代表。选择厚度为3mm、几何形状为垂直狭缝的25:1组成PDMS进行鼻罩设计。调查结果表明,折纸覆盖物可以很好地贴在鼻子上,不会对单一器械的手术条件产生显著影响。平均而言,这种鼻罩可以限制93%以上的0.3µm气溶胶,99%以上的大于0.5µm的气溶胶。使用患者佩戴的鼻罩有可能通过减少气溶胶的产生和潜在的病原体传播,大大降低鼻内手术期间医院工作人员的风险。
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引用次数: 0
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