These hard technologies make healthcare more precise

Guangming Pictures/Visual ChinaGuangming Pictures/Visual ChinaGuangming Pictures/Visual ChinaHealth Frontiers The world's first full body 5.0T magnetic resonance imaging of the human body has been released, and China is the first to achieve ultra-high field high-resolution full body clinical universal imaging; The first domestic extracorporeal membrane oxygenation system (ECMO) was registered and certified, which filled the long-term gap in China at one fell swoop, and solved the "urgent need" of treating COVID-19 severe patients; The world's first MRI guided non-invasive ultrasound radiation deep Cranial nerves control instrument has been successfully developed, making ultrasound hand in hand with brain science, providing a new technology and means for the treatment of complex functional brain diseases In recent years, from following and running to leading, from assembling components to mastering core technologies, China's independent innovation ability in science and technology has continued to improve

Guangming Pictures/Visual China

Guangming Pictures/Visual China

Guangming Pictures/Visual China

Health Frontiers

The world's first full body 5.0T magnetic resonance imaging of the human body has been released, and China is the first to achieve ultra-high field high-resolution full body clinical universal imaging; The first domestic extracorporeal membrane oxygenation system (ECMO) was registered and certified, which filled the long-term gap in China at one fell swoop, and solved the "urgent need" of treating COVID-19 severe patients; The world's first MRI guided non-invasive ultrasound radiation deep Cranial nerves control instrument has been successfully developed, making ultrasound hand in hand with brain science, providing a new technology and means for the treatment of complex functional brain diseases

In recent years, from following and running to leading, from assembling components to mastering core technologies, China's independent innovation ability in science and technology has continued to improve. High end medical equipment with fully independent intellectual property rights has constantly emerged, breaking through key core technologies and breaking foreign monopolies.

1. Make Chinese people's own high-end magnetic resonance equipment

Back just 10 years ago, the domestic high-end medical imaging equipment market in China was monopolized by overseas international medical equipment giants. Due to China's lack of core technology and technological constraints, domestic magnetic resonance equipment was mainly distributed in the mid to low end market, and high-end 3.0T magnetic resonance equipment was 100% dependent on imports. "recalled Li Ye, Deputy Director and Researcher of the Medical Engineering Institute of Shenzhen Advanced Hospital of the Chinese Academy of Sciences, Ten years ago, he joined the Shenzhen Advanced Technology Research Institute of the Chinese Academy of Sciences with the intention of working with the team here to independently develop high-end magnetic resonance equipment for the Chinese people.

According to Li Ye's recollection, more than a decade ago, even for mid range magnetic resonance imaging devices like 1.5T, the market share of domestic products was very low. High end medical imaging equipment has long relied on imports, with high prices for equipment imports and high costs for patients to undergo relevant examinations. China is a populous country, and it is difficult to imagine that 1.4 billion people rely on imported equipment from abroad for medical treatment. Whether from an economic or clinical diagnostic perspective, people have always been looking forward to high-performance domestically produced equipment. "Li Ye introduced that magnetic resonance signals are a type of electromagnetic wave, Magnetic resonance equipment is a very powerful imaging tool for clinical medical diagnosis. Its advantage is that it can perform high contrast multi-parameter imaging of various parts of the body without ionizing radiation, which is another imaging technology revolution after CT. Magnetic resonance greater than 3.0T is called ultra-high field magnetic resonance. The higher the magnetic resonance field strength, the higher the image resolution, and the more refined the medical imaging examination. Of course, it also poses greater technical challenges to the equipment.

Starting from scratch, the challenges are predictable. At that time, multinational giants had occupied the high-end medical imaging equipment market for decades, and their accumulated technology "Moat" was unattainable. In order to break through the core technology as soon as possible, the team worked tirelessly day and night. When asked about the hardships of the research and development process, Li Ye said there was nothing particularly worth mentioning. Anyway, "It is common to do experiments until one or two o'clock in the morning. If an experiment fails, summarize the experience and start over. If it succeeds, continue to move forward, knowing in his heart that he will definitely succeed in the end

Ten years have passed, and things have been done like this. In November 2021, the team of Shenzhen Advanced Academy of Chinese Academy of Sciences, in cooperation with Lianying Medical, etc., completed the project of "independent development and industrialization of high field magnetic resonance Medical imaging equipment", which won the first prize of the "National Science and Technology Progress Award", and achieved a major breakthrough in the independent innovation of China's high-end medical equipment. In August last year, the internationally pioneered United Film 5.0T ultra-high field human whole body magnetic resonance imaging system was approved for national medical device registration. This is the world's first human whole body 5.0T high-resolution magnetic resonance imaging clinical universal device, among which we have achieved scientific problem-solving, breakthrough core technology, and international leadership.

Liang Dong, Director and Researcher of the Medical Engineering Institute of Shenzhen Advanced Hospital, has been focusing on the development of fast imaging technology in magnetic resonance systems for a long time. He introduced that the 3.0T magnetic resonance equipment has two important characteristics: firstly, all core components are self-developed, without the use of any imported components, breaking through the "bottleneck" problem; The second is the rapid imaging technology that combines software and hardware. If you have undergone medical imaging examinations in a hospital, you will find that magnetic resonance imaging takes much longer than CT examination. It takes about 20 to 30 minutes to perform one examination, and a single device can only examine 20 to 30 patients per day. Due to the large number of patients, it is common to wait for three to four weeks to make an appointment for a magnetic resonance imaging examination, "Liang Dong said. To avoid delaying treatment, It is very necessary to develop high-end magnetic resonance equipment that can be rapidly imaged and produced abroad.

What does fast imaging mean? Simply put, the previous device used to take photos, but now we can use this device to shoot movies, "Liang Dong explained Because the imaging speed is fast enough, doctors can see more things that they couldn't see before during the examination. Moreover, the examination time for each patient has been shortened, so that one device can complete the examination volume of the previous two devices. Taking stroke examination of the cerebral vascular wall as an example, this is an examination that requires particularly high resolution and long imaging time. Previously, it took about fifteen minutes to perform this examination, but now it is set using 5.0T magnetic resonance imaging Preparing for submillimeter high-resolution examination only takes about three and a half minutes. The implementation of such excellent fast and high-resolution imaging relies on the invention and system support of a new system of magnetic resonance imaging technology behind it Liang Dong said.

As one of the first users of 5.0T ultra-high field MRI in the world, Wang Yining, the Chief physician of the Department of Radiology of Peking Union Medical College Hospital, told the reporter that he once received a 44 year old female case of sudden limb weakness. From the 5.0T skull image, we can see cerebral hemorrhage and cerebral ischemia. What is the reason? Through 5.0T vascular imaging, it was found that the middle cerebral artery presented a dual lumen structure. We considered that she had an arterial dissection, so we performed a gold standard angiography and found that there was indeed an arterial dissection with torn intima. This patient had also undergone a 3.0T examination before, but due to insufficient resolution, no issues with cerebral blood vessels were found. Therefore, 5.0T high-resolution vascular imaging can help us identify the cause and diagnose and treat earlier Wang Yining said.

When the reporter and his team visited the Lianying 5.0T magnetic resonance equipment at Shenzhen Advanced Hospital, researchers were anesthetizing a monkey and pushing it into the equipment. This is an experiment related to image guided neural regulation, exploring the greater value of this high-end magnetic resonance equipment in the field of neural regulation therapy.

2. Improve the cure rate and reduce the burden on patients

Shenzhen Advanced Academy of Chinese Academy of Sciences can be called the "national team" for the innovative development of high-end medical equipment. In its Medical imaging laboratory, rows of control lights on a high-end instrument flicker alternately. The controlled sound field formed by ultrasonic waves emitted by more than 10000 probes is like the "The hand of God" passing through the skull of experimental animals, reaching deep into the brain, accurately "touching" some neurons, producing tiny deformation of only a few microns, which is keenly captured by the magnetic resonance instrument.

This is a deep brain stimulation and neural regulation instrument based on ultrasound radiation force developed by Zheng Hairong, Vice President of Shenzhen Advanced Institute of Chinese Academy of Sciences. This instrument allows ultrasound to 'hold hands' with neurons and use ultrasound to manipulate neuronal activity, effectively regulating the deep brain in a non-invasive and precise manner. This is of great help for the precise diagnosis and treatment of brain diseases such as Parkinson's disease, Alzheimer's disease, depression, epilepsy, etc. Zheng Hairong introduced that the device has now entered the clinical trial and industrialization stage.

Ultrasound is a kind of Mechanical wave. In medicine, it uses the wave scattering of ultrasound in human tissues to image, that is, familiar B-ultrasound and color ultrasound. Decades ago, scientists observed that ultrasound can cause small particles in the sound field to move. Based on the research of acoustic tweezers theory and acoustic radiation technology, Zheng Hairong's team not only allows ultrasound to "hold hands" in brain science, but also develops ultrasound elastic imaging equipment to assist in accurate clinical diagnosis and early diagnosis.

"Our traditional B ultrasound color ultrasound uses the wave effect of ultrasound to see the changes in the organizational structure, but in the early stage of many diseases, its organizational structure may not change significantly, but there are some changes in the hardness and softness, such as liver fibrosis and cirrhosis, which have a high incidence of incidence rate, and breast cancer, which has a high incidence of incidence rate." Zheng Hairong gave an example to judge whether breast cancer is benign or malignant, On general B-ultrasound, its shape appears to be a tumor, but its main distinction is between soft and hard. Previously, doctors generally relied on puncture biopsy to distinguish. Now that non-invasive ultrasound elastic imaging equipment is available, doctors can use the mechanical effects of ultrasound to observe the degree of softness and hardness of human tissue, and achieve non-invasive quantitative measurement of biomechanical parameters of human tissue. "Generally speaking, doctors can use this device to more accurately and conveniently judge whether early breast cancer is benign or malignant," Zheng Hairong concluded.

Liang Dong introduced that currently, in addition to structural imaging devices such as ultrasound, magnetic resonance imaging, and CT, molecular imaging devices are also assisting clinical practice in precise diagnosis and treatment, especially in early diagnosis.

"At present, the imaging resolution of structural imaging equipment such as magnetic resonance and CT is getting higher and higher, and doctors can use these equipment to find small lesions that could not be seen before. However, from the perspective of early diagnosis, many diseases may not have structural lesions at the early stage, and doctors can not make a clear diagnosis even if they see it carefully. Many diseases will have metabolic and functional changes in tissues and organs at the early stage, such as Alzheimer's disease, a Degenerative disease In fact, the metabolic activity of nerve cells has changed in patients long before brain atrophy. Therefore, molecular imaging devices that measure changes in functional metabolism are particularly important in early diagnosis Introduction by Yang Yongfeng, a researcher at the Institute of Medical Engineering, Shenzhen Advanced Hospital, Chinese Academy of Sciences.

For early diagnosis, Yang Yongfeng introduced the first high-definition magnetic resonance compatible human brain PET functional imaging device in China that he led the research and development. What is the imaging principle of PET devices? We first inject drugs labeled with radioactive nuclides into the human body, such as glucose drugs. After injection, the drugs will metabolize in the body. Because cancer cells are generally more active and metabolize more sugar, the drugs we inject will gather here and decay through radiation. At this time, we can use PET detectors to measure the location and quantity of radioactive drug decay, and then know this Does the individual have cancer, location, severity, and metastasis Yang Yongfeng introduced that PET equipment has obvious advantages in the early diagnosis of many diseases, For example, for Alzheimer's disease, existing studies have found that PET devices combined with appropriate drugs can diagnose the disease 15 years before its symptoms appear. For many diseases, if early diagnosis can be made, doctors can intervene in advance, and patients do not have to delay to the late stage of the disease and spend high medical costs to treat. This can not only reduce the pain and burden of patients, but also delay the development and improvement of the disease The cure rate of the disease Yang Yongfeng said.

3. How to Develop High end Medical Devices in the Future

Speaking of his experience in developing medical imaging equipment in recent years, Zheng Hairong summarized that he should carry out strong goal oriented organized research, break the innovation silos between disciplines, and build a collaborative innovation platform for industry, university, research, and medicine.

We have close cooperation with medical equipment companies and clinical hospitals. Based on the disciplinary characteristics of this field of instrument research and development, we have also opened up corresponding 'special zones' for researchers, allowing most technical personnel to only calmly consider scientific research difficulties without worrying about applying for research projects or writing papers. For example, as long as effective breakthroughs are made in technology and core technologies are mastered, promotion and recognition can be obtained, without the need to pass research projects or papers And hats. Under such a mechanism, many of our scientific researchers will set their hearts to cooperate with enterprises for permanent residency. Scientists and engineers have achieved a 'seamless connection', and together with the engineering team, they have worked together to solve technical problems, achieving true integration of production and research and collaborative innovation Introduction by Zheng Hairong.

Good medical equipment is made and used, "Zheng Hairong firmly believes in this. "Therefore, the research and development team of high-end medical equipment should avoid talking on paper, write the research results on the motherland, aim at the national needs, grasp the clinical pain points, and research and develop medical equipment with clinical value; after the transformation of scientific and technological achievements, it should also connect with the hospital in a timely manner, and make further technical improvement and iterative refinement through clinical feedback."

In Zheng Hairong's view, the goal for the development of future high-end medical equipment is clear. The goal of medical equipment research is to serve people's health, and the future direction of scientific research is to diagnose and treat more accurately. "Zheng Hairong said that to achieve this goal, the medical research and development team must first focus on the field of classic diagnostic and treatment equipment, It has developed "advanced equipment that is urgently needed clinically and has significant support for medical security, such as multimodal high-resolution medical imaging equipment, functional imaging equipment and large-scale Proton therapy equipment for tumor treatment."

In terms of tumor treatment research, Professor Xu Yingxin, the former deputy director of the General surgery Research Institute of the 301 Hospital and a distinguished expert of national health products, said that the reason why tumor treatment is a comprehensive Sex therapy and very complicated is that there are limitations in existing treatment methods. For example, CAR-T has achieved good efficacy in treating B-cell derived tumors, but it also kills normal B lymphocytes, often requiring stem cell transplantation

At present, we are strengthening the basic and clinical application research of stem cells and immune cells. In the future, we will combine surgery, immune cell therapy, and stem cell transplantation technologies to develop different treatment plans based on the specific conditions of different patients, "said Xu Yingxin.

"In addition, new and revolutionary technologies that cannot see the whole picture at present should also be actively deployed. Artificial intelligence, nanotechnology, High-temperature superconductivity, Quantum technology in the forefront of physics, etc., these cutting-edge technologies may have more cross fields with medicine in the future, breeding new instrument technology changes. For example, there are weak quantum signals found in tumors at present, and magnetic resonance equipment signals are derived from quantum effects, but now Can we develop micro magnetic resonance and extremely weak quantum magnetic resonance imaging diagnostic equipment in the future by utilizing its macroscopic quantum signal? That may be a new tool for detecting tumors and brain diseases. I think these are all development directions worth paying attention to for high-end medical devices in the future. In short, as long as it is the demand for scientific discovery and clinical precise diagnosis and treatment, it is worth us to deeply cultivate. I think this is also the dream of the medical instrument development team Zheng Hairong sighed.

(Reporter Zou Xiaojing from this newspaper)

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