What Is Clinical Engineering?

Biomedical engineering has been formed and rapidly developed since the 1950s, with the advancement of many disciplines such as electronics, materials science, engineering mechanics, information science, and computer and widely used in the fields of medicine and biology. . Biomedical engineering has become an important condition for the modernization of medicine and biology.

Clinical engineering

Biomedical engineering started in the 1950s, with

Biomedical engineering research has led to the emergence and popularization of a large number of new clinical diagnostic and monitoring technologies and equipment such as X-ray computed tomography (XCT), magnetic resonance imaging (MRI), ultrasound imaging, patient monitoring and biochemical analysis; a wide variety of Laser and electromagnetic treatment devices provide new treatments and surgical methods, and promote the development of home health; artificial pacemakers and artificial heart valves are saving and maintaining the lives of millions of heart patients in the world; artificial kidneys Blood purification technologies have maintained the normal lives of hundreds of thousands of patients with renal failure; artificial lenses, artificial joints, and functional prostheses have been widely used in rehabilitation and functional assistance for the disabled; biomechanical research has deepened serious harm The understanding of human healthy arterial vascular sclerosis and thrombus formation mechanism provides the basis for the prevention and treatment of heart and cerebrovascular diseases and the design of artificial organs such as artificial heart valves and artificial blood vessels; the expanded application of computers and information technology in medicine and clinical practice It is fundamentally changing the face of the hospital. Chinese scientists have also combined modern engineering methods with traditional Chinese medicine, conducted preliminary research on the four objections of traditional Chinese medicine, a traditional Chinese medicine expert system, and traditional Chinese medicine meridians, injecting vitality into the new development of traditional Chinese medicine. The advancement of modern medicine is inseparable from the development of biomedical engineering.

At the same time, biomedical engineering is an important foundation and driving force for the healthcare industry. The medical device and pharmaceutical industries have the most direct connection with the research and application of biomedical engineering. The industry it drives occupies an important position in the national economy. For example, the industry driven by biomedical engineering in the United States amounts to tens of billions of dollars each year. The investment of various countries in biomedical engineering research has increased year by year with the improvement of living standards. This discipline is facing many new topics, and many achievements have excellent industrialization prospects. Therefore, biomedical engineering is called Chaoyang discipline.

This time two models were shown: 12-meter car and 6-meter car. The 12-meter car is a comprehensive medical examination car. There are 7 inspection items on the car, including X-ray examination, B ultrasound, gynecology, height / weight, hearing, vision / fundus, and biochemical examination; the 6-meter car is a purely domestic digital X-ray physical examination car Real-time inspections are open to live audiences. At the same time of the inspection, the collected images can be sent to a remote consultation center through broadband or ADSL, and the results will be sent back by the experts after diagnosis.

This interactive demonstration demonstrates how to dial a phone number through brain waves. Exhibitors provide their own mobile phone number. By watching the numbers on a virtual keyboard, the operator can use the mind to ring the audience's mobile phone without any physical movement.

This research from the Department of Biomedical Engineering of Tsinghua University is called "Brain-Computer Interface" in international academic circles. This technology uses real-time recorded brain waves of the human brain to interpret human simple thoughts to a certain extent and translates them into control commands to control computers, household appliances, and robots. The original idea of the study was to help disabled people who have lost their ability to exercise but have normal brain functions, and let them use such systems to directly control wheelchairs, artificial limbs, and even use computers.

This interactive demonstration demonstrates the use of a PC-based binocular competition test platform to evaluate the speed of brain information processing using the normal visual physiological phenomenon of "binocular competition". In this demonstration, the test results effectively reflected the differences in the rate of competition among subjects of different ages.

Binocular competition is the phenomenon of presenting different images to the observer's eyes, and the observer sees two input images appear alternately. The main function of the test system is to record the process of binocular dominance during the experiment, to give a distribution map of the time period of dominance, and to evaluate the binocular competition by calculating the competition rate and other parameters. The evaluation parameters of binocular competition can reflect the consciousness of the subject or the degree of dementia in Alzheimer's patients; it can also be used as an auxiliary means for the diagnosis and evaluation of diseases such as bipolar disorder (commonly called bipolar disorder). The alternation rate of perceptual experience in binocular competition may reflect a person's soberness.

China completes first human genetic animal organ transplant

China's first transgenic animal organ transplant operation was successfully completed yesterday at Wuhan Tongji Hospital.

In the hospital's laboratory, a macaque monkey who has just completed a heart transplant is beating. Its body is beating China's first pig heart carrying human genes. ECG examination showed that everything was normal.

Researchers say this will likely bring the gospel to humanity. It is understood that the lack of organ donors has been a worldwide problem plagued the organ transplantation community. Animal organs often undergo rejection after being transplanted into humans. If human genes are transferred to animals for transplantation, this rejection may be greatly reduced.

The world's first transgenic technology was successfully transplanted four years ago. Wuhan Tongji Hospital and other units have started this research since 1996, and have completed a series of problems such as the construction and transplantation of transgenes.

Home

Society Introduction

Academic events

Popular science promotion

Continuing Education

Academic journal

Subject development

conference system

Director Blog

You are here: Home / Science Popularization / Science Popularization

New progress in the field of artificial organs in China

Release time: 07-11-15

Text: Large, medium and small print collection

With the development of implant medicine and alternative medicine, artificial organs that replace and partially replace human diseased organs, devices and tissues and auxiliary organ functions have become one of the landmark achievements of medical progress in the twentieth century. In recent years, clinical demand for it has grown rapidly. The US Food and Drug Administration predicts that among the 39 new products in the biomedical engineering industry in the next decade, artificial organ products involving human organs, devices and tissue replacement will account for almost 50%. At present, there are more than 50 varieties of artificial organ products for clinical use. Almost all artificial organs have been replaced, except for the brain and part of the endocrine organs, from the Tian Linggai to the toe bones, from the internal organs to the skin, and from the blood to the facial features. Its output value accounts for about 15% of the global biomedical engineering industry. Due to the limited source of human-derived allogeneic transplants, at the same time, organ transplantation still needs to solve the immune problem, so that even in developed countries such as the United States, using world resources, only less than 20% of patients with organ, device, and tissue defects get Treat promptly. Therefore, artificial organs, including tissue engineering products developed in recent years, are an inevitable trend for future development. After nearly 50 years of hard work, China has made great progress in the field of artificial organs. Except for the brain, research on artificial organs in various system organs of the human body is underway. The latest international artificial organ products have clinical applications in China. A large number of artificial organ products with their own intellectual property rights have been industrialized and applied in clinical practice.

At present, the most effective treatment for patients with end-stage heart failure is still a heart-natural or artificial heart transplant. Due to the lack of donors, donor preservation, immune rejection, and social ethics, natural heart transplantation is difficult to meet clinical needs. The development of Artificial Heart Assistant Device (AHAD) has become a solution to these problems. The main method.

Since 1993, the research team of Anzhen Hospital affiliated to Capital Medical University, Yan Yan, and others have developed the implantable centrifugal, magnetically-coupled axial flow, and spiral type systematically, starting from the research of the electric implantable AHAD, which has been gradually developed in the 1990s. And electromechanical integrated AHAD. In the development process, the impeller design with the same diameter but different number of blades solves the requirement of left and right heart simultaneous assistance. The concept of spiral blades has a significant effect on reducing blood damage. The application of ceramic bearings plays a very important role in extending the life of the blood pump.

The in vitro test results show that the dynamic output of the electromechanical integrated AHAD can fully meet the needs of cardiac assist, and at the same time, the axial flow cardiac assist device can maintain a relatively stable flow output within a wide range of pressure changes, and it has better heat dissipation performance More suitable for assisting heart assist devices. In vivo animal test results prove that the average auxiliary flow of this AHAD> 3L / min meets the auxiliary needs of animals with heart failure. Experimental data on the kinetic output of experimental animals shows that it has obvious auxiliary functions for animals with heart failure. Myocardial oxygen consumption data confirms that it can also gradually restore a failing heart by reducing natural heart work. The results of myocardial tissue light and electron microscopy also confirmed its auxiliary function on cardiac function. The systematic blood compatibility study found that: because of the special blade shape of the spiral AHAD and the small blood contact area, the damage of the blood by the optimized design of the flow field was significantly reduced compared with other blood pumps. The experiment also found that the vertical distance between the helical AHAD pump casing and the helical impeller has a greater impact on the destruction of red blood cells. The research group also used nano-carbon composite coating technology to reduce the adsorption and hemolysis of platelets on the blood pump surface. This research group is making breakthrough progress in developing AHAD with Chinese characteristics and independent intellectual property rights, especially in the development of short and medium-term AHAD.

China's artificial kidney and blood purification technology started in the 1950s. In 1957, Professor Ma Tengyu of the Tianjin Institute of Urology first applied artificial kidney dialysis to the clinic in China, setting a precedent for the clinical treatment of acute kidney failure in China. . After 50 years of hard work. According to the China Diabetes and Renal Transplant Registration Report published by the Chinese Society of Nephrology in 2001, China has 4,967 hemodialysis machines and 41,755 maintenance hemodialysis patients. In recent years, the number of dialysis equipment and dialysis patients has increased at an annual rate of 11%. China's self-made hemodialysis, hemofiltration machines, water treatment systems, and hemodialyzers, filters, plasma separators, and perfusion devices of various membrane materials have come out one after another. An industrial group with annual sales exceeding 100 million yuan has been formed.

In recent years, China has made remarkable achievements in clinical research on blood purification and maintenance hemodialysis. In 1983, Nankai University and Hedong Hospital of Tianjin Medical University covalently fixed DNA antigen and tetrazolium blue on carbonized resin, and developed an immunoadsorption column that adsorbed anti-DNA antibodies and DNA immune complexes. In 1996, Professor Zhang Xun and Professor Hou Fanfan of the Institute of Nephrology of the Southern Hospital of the First Military Medical University successfully immobilized the tumor necrosis factor- (TNF-) monoclonal antibody on a 5M biogel carrier to make specific immunosorbent columns . New Zealand rabbits were injected with a lethal dose of LPS for 1 hour after immunoadsorption. As a result, the 6-hour survival rate was 31.8% in the control group and 70.0% in the treatment group. They also studied the basic theory and clinical application of continuous renal replacement CRRT technology to rescue complicated acute renal failure, and made the survival rate of critical patients with APACHEII score> 29 reach 25% (international level: 22% to 26%). The AN69 membrane dialyzer was connected to the blood circuit of cardiac surgery extracorporeal circulation to adsorb cytokines produced by extracorporeal circulation. As a result, the systemic inflammatory response after extracorporeal circulation was significantly improved, and lung and kidney damage were reduced. They proposed the "in situ modification" theory of the cause of dialysis-related amyloidosis, which was published in Kidney Int and has been included in 8 international classic textbooks. Discovery, cloning, and expression of advanced joint glycation end product (AGE) receptors in human synovial cells, elucidated the receptor pathway caused by amyloid, published in the International Journal of Nephrology (J. Am. Soc. Nephrol) was awarded the "First Prize for Best Paper" by the International Society of Nephrology in 2001.

The above results show that China has approached and reached the international advanced level in the development of blood purification equipment and the improvement of the long-term dialysis patient survival rate and the application of new blood purification technology.

Liver function is extremely complicated. The metabolism of various substances (sugar, protein, fat, etc.), the production and inactivation of certain enzymes, the production and detoxification of coagulation factors cannot be separated from the liver, and it is difficult to completely replace the liver function. Since 1950, scientists around the world have made a lot of efforts on the Artifical Liver Surpport System ALSS. This device removes various harmful substances, supplements necessary substances, improves the internal environment, and temporarily replaces some functions of the failing liver.

Create conditions for liver cell regeneration and liver function recovery, or wait for an opportunity for liver transplantation.

ALSS is divided into three types: non-biological, biological and mixed. The non-biological artificial liver method is widely used in clinical practice and has proven to be effective. It includes plasma exchange (PE), hemoperfusion (BP), hemofiltration (BF), hemodialysis (BD), and continuous hemodialysis. Filtration (CHDF), Molecular Adsorption Recycling System (MARS), Plasma Filtration Dialysis (PDF), Plasma Specific Bilirubin Adsorption (PBA), etc. The above methods can be used alone or in combination according to the condition. When liver failure is accompanied by hepatic encephalopathy, PE and BP can be used; when with renal failure, CHDF is combined with PE or PDF; when with hyperbilirubinemia, PBA and PDF are used; when with water and electrolyte disorders , Choose CHDF combined with PE or MARS. Sometimes more than three methods can be given in combination. Biological artificial liver: refers to an in vitro biological response device constructed based on artificially cultured hepatocytes. Mixed artificial liver: refers to the combination of bioreactor and hemodiafiltration, plasma exchange, hemoperfusion and other devices that are more focused on detoxification to establish extracorporeal circulation. Biological and mixed artificial livers not only have detoxification function, but also have some synthetic and metabolic functions. Clinical application is still in the exploratory stage.

Professor Li Lanjuan, Key Laboratory of Infectious Diseases, Ministry of Health, the First Affiliated Hospital of Zhejiang University School of Medicine, began to study artificial livers in 1986. The earliest application of hemofiltration and perfusion technology to treat 3 patients with acute and subacute severe hepatitis, 2 patients survived, Their clinical experience was reported in the Journal of Clinical Hepatobiliary Disease. Later, using ALSS technology, that is, plasma exchange, hemoperfusion, plasma adsorption, hemofiltration and other methods were selected for single or combined application according to clinical needs, and a relatively complete artificial liver support system was established, including the application of activated carbon-containing perfusion. Device, membrane type plasma component separator, specific bilirubin adsorber, a combination of multiple methods is selected according to the condition. Explore and clarify the indications and contraindications of the treatment, rational use of heparin, protamine, and control of the balance of in and out, adjust pressure, speed, temperature, etc., and solve the problem of easy bleeding and hypotension in the treatment of severe hepatitis artificial liver support system Etc. So far, more than 500 patients with severe hepatitis have been treated with a cure rate of 46.8%, and good clinical results have been achieved. The results won the second prize of the National Science and Technology Progress Award in 1998 and the second prize of China's university science and technology promotion in 2001. . During the tenth five-year period, experimental research on mixed artificial liver was carried out with the support of the National 863 Program. The first domestic immortal liver cell line was established, and a new non-woven bioreactor was prepared. The experimental treatment of the animal model of senile has achieved significant curative effect. Related research reports were published in the American Journal of Artificial Organs. Domestically, Professor Duan Zongping from Beijing You'an Hospital and other units have achieved remarkable results in the research and clinical aspects of artificial liver. Our ALSS research has attracted international attention.

Cataract is the first blinding disease, the main eye disease worldwide, and there are about 20 million cataract patients worldwide. There are about 5 million cataract patients in China. Cataract extraction combined with intraocular lens implantation is currently the best cataract treatment option. The recovery rate is almost 100%, and the vision of more than 60% of patients can reach 0.8 or more. Approximately 5 million patients worldwide have undergone intraocular lens implantation. According to statistics in 2004, the number of intraocular lens implantations in China has exceeded 500,000. At present, artificial crystals made of various materials such as polymethyl methacrylate, silicone gel, and hydroxyethyl methacrylate have been put on the market for clinical application. IOL has become the most important ophthalmic implantation device.

The production of IOL in China has also begun to take shape. Research on IOLs is flourishing. Professor Yuan Jiaqin, a famous ophthalmologist from Tianjin Medical University, and Professor Gu Hanqing, an expert on biomaterials of artificial organs, have been working together for a long time and started research on artificial lenses since 1989. They have successively developed fluorine-heparin surface-modified artificial lenses, titanium surface-modified artificial lenses and similar Diamond surface modified IOL. These crystals have excellent biocompatibility and optical properties. The implantation of rabbit eyes and macaques for up to one year showed that such intraocular lenses can reduce the occurrence of complications such as infection and blue vision in the early stage of implantation. It can also delay and reduce the occurrence of post-traumatic disorders at a later stage. Their doctoral dissertation on surface-modified artificial crystals was rated as one of the nation's 100 outstanding doctoral dissertations. With the support of the National Tenth Five-Year Plan, it has achieved industrialization. They are now working on new products such as surface-modified soft IOLs and injection-type IOLs. Hard work to further improve the quality of life of patients with IOL implantation and reduce the occurrence of complications of implantation.

Artificial joint replacement is considered to be one of the most successful surgical treatment techniques of the twentieth century, giving a large number of patients with severe joint disease the opportunity to reconstruct joint structure and function and relieve pain. At present, more than 1 million artificial joint replacements are performed every year in the world, and more than 90% of them have good results.

At present, the annual number of joint replacement surgery in China accounts for about 5-10% of patients who need to perform such surgery. The main reasons for the need for surgery and difficult access to treatment include economic constraints and the lack of suitable artificial joints. At present, the types of prostheses used in clinical applications are limited, and the problem of "misfit" between the prosthesis and the bone often occurs. This problem is usually solved by "cutting and covering", that is, to increase the degree of joint and bone matching through more bone cutting, but this method increases the difficulty and risk of surgery, and there are still some serious deformities or In normal cases, artificial joints cannot be used. At present, the only way is to "tailor tailor" according to the individual needs of patients, to customize the design and manufacture of artificial joints, but this has significantly increased the cost and price of the prosthesis. Imported custom-made prostheses not only have a long customization time, but also have limited varieties. Their prices far exceed the affordability of most patients in China.

Academician Dai Kerong of the Orthopaedics Department of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Professor Wang Chengzhang of Shanghai Jiaotong University School of Mechanical Engineering cooperated to take the lead in applying new concepts and technologies such as "priority zone customization", "rapid prototyping" and "agile manufacturing" Design and manufacture of computer-aided (CAD / CAM) custom artificial joints. The Chinese bone database was created, which greatly shortened the production cycle and reduced the economic burden on patients. At present, it takes only 3 to 7 days to complete the design and production of personalized artificial joints. The variety has covered the major joints of the body and the pelvis. The cost It is also much lower than similar foreign products. Applicable cases include limb tumor salvage treatment, artificial joint revision, and severe congenital or acquired deformities of bones and joints. Hundreds of cases have been applied in more than ten provinces and cities across the country over the past seven years, and joint and bone functions of various parts have been reconstructed with good results. At present, it has realized industrial production, which has promoted the clinical popularization and application of computer-assisted customized artificial joints, benefiting the majority of patients.

Since the beginning of the 21st century, the research and development of artificial organs in China have been booming and vigorous. The country has listed organ tissue engineering and organ replacement materials as national key development industries. With the support of the state, the development of this field will achieve better attention. achievement.