RU2172068C2 - Complex for telemetering of information on urology - Google Patents

Abstract

FIELD: urology, information and diagnostic equipment for military hospitals, centers and medical detachments. SUBSTANCE: complex includes mobile diagnostic station of advanced army medical unit having mobile and portable radio receiving- transmitting stations in the form of modules in its mix which interact with modules of technical facilities for automatization, data transmission, video information and power supply and autonomous life-support system. Ground equipment of technical support is fitted with new territorial computation network with asynchronous mode of transmission of speech, data, video, audio and multimedia information over one channel simultaneously or by network of asynchronoua mode of transmission that includes corporate hospital computation network with ring asynchronous mode of transmission main line united with local computation networks of centers, sections, working groups of hospitals and remote users. EFFECT: enhanced efficiency of medical treatment of traumas and wounds of victims in the field. 4 cl, 2 dwg

Description

 The invention relates to the field of military medicine and can be used as information and diagnostic equipment for military hospitals, centers, special medical units (MOSN), individual medical battalions and medical service brigades of the Armed Forces of the Russian Federation, emergency medicine units of disasters of the Ministry of Health and Emergencies of Russia , as well as in the educational process at the departments of medical universities.

 It is known that the primary source of problems in the operation of classic local area networks (LANs) is laid down in the principles on which these information technologies (IT) are built: media sharing (Ethernet) or media sharing (Token Ring, FDDI). The main disadvantage of such LANs is the low useful network bandwidth due to the active use of broadcast messages that generate significantly intense traffic. Moreover, each segment (hub, bridge, etc.) of a classic LAN structure is the place where traffic jams occur: a segment due to collisions (Fast Ethernet) or an increase in latency (Token Ring, etc.), bridges and routers due to for their limited bandwidth.

 In order to increase the performance of these LANs, the classical structure is transformed into a switched network, in which the number of stations in the segment is reduced to one, and the functions of bridges and routers are assigned to multi-port switches. However, such a network still consists of nodes in which for each incoming packet the question is solved where it should be sent. In addition, since the logical structure of the network actually exactly repeats its physical structure, territorial movements of users are fraught with significant difficulties.

 In contrast to classical IT and LAN based on access sharing, in networks with asynchronous transmission mode (ARP networks), the connection between the information source and the final receiving point is established once before the data stream is transmitted. Therefore, after establishing the route, it is no longer necessary to decide on each node where to send the next piece of data, since the entire stream will go without delay from the source to the receiver, due to which we get the guaranteed transmission speed (today - up to 622 Mbit / s) and asynchronous data stream . The second most important advantage of an ARP network is the assignment of a guaranteed bandwidth for each virtual connection, and this can be done both statically, with the help of a network administrator, or dynamically - depending on the real needs of the data source. In an ARP network, its physical structure may have nothing to do with its logical structure, and the movement of users does not present any problems. The ARP network is equally well suited for both local and territorial computer networks.

 A well-known broadband digital packet-oriented network with service integration (W-ISDN) for simultaneous transmission of audio, video, speech and data, based on the basis of high-speed terrestrial radio channels and fast packet switching using a high-performance switch using fiber optic cable and asynchronous transmission mode ( ARP) of the radio complex, which includes transportation and multiplexing modules as the transmission of several data streams simultaneously on one channel and data switching / 1 /. ATM is a method of combining frames or blocks of pieces of data from a continuous stream of bits. Asynchronous signals do not correspond to a timer, as is the case with synchronous signals, and in them pieces of data are allocated by the start and final bits or their combinations. The word "asynchronous" means that there is no connection between the time of arrival of the cell (portion) of data and the channel allocated to the user. The ATM is focused on transmission with the establishment of a connection — a fixed route between two systems in W-ISDN, called a virtual channel.

 Most serial communications and almost all communications on the LAN are synchronous, while most data transfers to and from the processor, traffic or data transfer through the parallel port and traffic on the PC bus are asynchronous. In ARP, information is transmitted by a stream of packet cells of a fixed size of 53 bytes, including a header with a route of 5 bits and an information field of 48 bytes / 1 /. An ARP network is used to transfer data between LANs. For this, a special switch is installed in each LAN, for example, a banyan type, in which the switching is based on checking the address bits contained in the header of each cell or packet / 2-5 /.

The disadvantages of the ARP network are:
1). Too long setup time of switched virtual circuits, inefficiency of TCP / IP traffic transmission and significant losses during transitions between Ethernet and ATM. Therefore, the use of ARPs as a backbone of a heterogeneous territorial network with a large volume of traffic immediately leads to problems. So, ARP-switches need 0.5 s to establish from scratch one virtual channel of the ATM. In a high-performance LAN of a hospital, this is a very long delay, hundreds of times, as a rule, exceeding the transit time of one packet from the sender to the addressee. Fortunately, the establishment of a virtual channel occurs once during user registration on the network. The virtual channel is usually cached, and therefore, when the user requests it the next time, it is installed much faster (less than 10 ms).

 In a large territorial ARP network, users are constantly asking for new connections through the trunk with various servers. And each time they have to wait an extra half a second. Therefore, they will not want to pay millions of rubles for such an ARP network in which users constantly complain about the delay.

 2). The time required to establish a virtual channel makes bandwidth use inefficient. During channel establishment for 0.5 s or 10 ms, part of the band is not used for caching. It is easy to calculate how much time it takes to establish hundreds and thousands of virtual channels to fill the channel at 155 Mbps.

 3). Problems with TCP / IP traffic and the transition between ATM and Ethernet.

 3.1). ATMs deliver a payload of information whose size in bits is not a power of two; this can lead to discrepancies between the payload size of data cells or minislots and the buffer of the end station. Attempts to resolve this contradiction can result in a TCP / IP session looping between timeouts and retransmissions. As a result, the data file transfer will not take place, and the bandwidth will be used idle.

 3.2). Many Ethernet switches for workgroups come with an interface for 155 Mbps ATMs to connect them to the trunk of an integrated network. However, these switches face serious difficulties in filling up the ATM channel, and the root of the problem is slow access.

The closest technical solution that we adopted as a prototype device is the information system of the US Army Medical Service for transmitting military medical data via satellite radio communications, called Telemedicine (TM) / 6 /. At symposia on the development of military medical informatics, held in the United States and Russia in 1995-1999. under the motto “Data transmission over a communication line removes time and geographical barriers in the provision of medical care”, a number of features of technical support for telemedicine are noted:
the use of satellite communications allows for the implementation of cellular services for TM systems practically anywhere in the world;
the introduction of a LAN can increase the speed of information transfer and reduce the cost of communication channels;
the development of high-resolution video communication systems allows reproducing television images of biological objects at a morphological level;
the emergence of a new generation of high-speed computers and the developed multimedia technology led to a qualitatively new approach to telemedicine information support / 2 - 5 /.

 The prototype complex includes an orbital constellation of geostationary relay satellites located at west and east longitude points and interfaced with ground-based technical support equipment containing a radio communication control and planning center, interconnected central transceiver station and stationary hospital reporting transceiver stations containing satellite channels and terrestrial radio communications, channels of telephone two-wire communication lines in the form of open and behind secure telephone communication, open facsimile communication, secure and open data transmission without limiting the communication range.

 The prototype complex uses time division multiplexing or time division multiple access (CDMA) technology to implement a primary / secondary system without interrogation, which, if necessary, distributes or assigns time slot slots using a primary, reference transceiver station. The latter receives requests from other stations and, depending on the nature of the traffic and channel occupancy, satisfies these requests by assigning them specific frames for subsequent transmission. Every 20 frames, a reference transceiver station assigned to each transponder sends these assignments to secondary stations. Moreover, 10 transponders are installed on one repeater satellite. A detailed implementation of the MDKV technology of the prototype complex is described in the book of J. Black. Computer networks: protocols, standards, interfaces. - "World". - 1990. - S. 147-150, 305-320.

The main disadvantages of the prototype device are:
a) the lack of a mobile medical center for emergency diagnosis of injuries and injuries in the military unit, placed on an ambulance or medical helicopter and equipped with technical means of automation, video information support, data transmission and radio communications;
b) in the subscriber and stationary hospital reporting transceiver stations there are no modules for individual collection of information about injuries and injuries of each wounded, modules for primary and secondary processing of data about injuries and injuries, modules for diagnosis and urgent decisions for each request to the center for primary military medical unit, as well as shapers reverse medical target designation from the center for each wounded;
c) the lack of interconnection of the telemedicine complex with the regional computing ARP network of hospitals of the military district (front), the lack of technical modules of local computer networks of centers, medical departments and working groups of medical specialists of hospitals of advanced and rear bases; lack of network control and graphic workstations, graphic and video servers, color print servers and scanners, as well as portable computer notebooks and wireless mobile network computers with pen input and a limited keyboard for medical consultants.

 d) lack of technology, classification of diagnostics, an all-army registry and a knowledge base of injuries, wounds, and kidney diseases.

 Therefore, the objective of the invention is to increase the effectiveness of the treatment of injuries and injuries of victims in the field and on the battlefield, in particular the organs of their genitourinary systems, by reducing the time of diagnosis and the waiting period for injured people to receive emergency medical care by increasing the efficiency of video teleconferencing, transferring data about injuries from the field lesions to the center for processing, assessing, diagnosing these injuries and issuing feedback consultations and ready-made target designations of the leading specialists of the center for treatment tactics dogo wounded and injured.

 The problem is solved by introducing new elements and their connections into the teleinformatology complex, namely, the stationary equipment of the satellite radio channel of the central and hospital reporting transceiver stations contains an antenna unit connected to the output of the power amplifier with pathogens connected by their inputs to the first output of the main and control television and sound signals, the second output of which is connected to the input of the driver of the control signal, and This video control unit is connected to a tuner demodulator, the output of which is connected to the inputs of the converters, the outputs of which are connected to the antenna unit through low-noise output amplifiers, the second input of which is connected to the output of the control signal driver, and the channel includes a guidance indicator and a control panel, while ground-based technical support equipment contains a territorial computer network with asynchronous transmission mode or an ARP network connected via a radio channel to stationary hospitals transmitting and receiving stations and including a hospital ring ARP bus with a data transfer rate of at least 625 Mbit / s, connected to a module of distributed local area networks of control, medical departments and hospital centers, and the complex itself additionally contains a mobile diagnostic station for advanced military a medical unit, for example, a special-purpose medical unit, located in standard container bodies installed on the base chassis of a car ipa KamAZ-5350 and on the cargo sling medical helicopter Mi-8Mt, and includes in its membership and the movable block radiopriemoperedayuschie portable stations interconnected with the modules of automation hardware, data, video information, and ensure energy supply, as well as an autonomous life support system.

 The MTD automation hardware (TS) module includes automated workstations of users (ARM-P) for the initial assessment, data collection, and preliminary diagnosis of injuries and injuries of the genitourinary system of victims, performed on the basis of personal computers connected to a local computer network using network adapters installed in the expansion slot unprepared for operation in a network of PCs and connected by a coaxial cable to a hub. A LAN includes a file server, client workstations, a map module, a printer, guaranteed power sources, modems for workstations connected to an information archiving unit with a memory capacity of at least 300 MB. Three AWP-Ps, of which two sets are intended for the operating personnel of doctors and one set for technical personnel, are a TS automation module.

 The module of technical means of data transmission includes one workplace of a telecom operator, contains mobile and block-portable equipment of a satellite radio channel.

 The module of technical means of video-information support intended for television surveillance includes one operator’s workstation and contains black-and-white and color television digital cameras connected to radio equipment for transmitting and receiving television (TV) and sound (SV) signals from the site of injury to a mobile station diagnostics, including a radio transmitter and a radio receiver, and transmitting and receiving TV and SV signals connected to the wired equipment from the place of inspection of the wounded to the Ministry of Internal Affairs using a two-wire sim ternary communication line consisting of a transmitter and a receiver.

 The video information support module also contains a fixed-frame television (TNC) shaper for transmission via a two-wire line or a clock channel, a computer with interface nodes, general and application software, and a TV and SV signal shaper for transmission over a satellite radio channel connected to a VCR and color video control unit.

 The module of the distributed local area network of the hospital’s control contains a routing server with asynchronous data, voice, audio and video transmission, interconnected local switched networks of medical centers and hospital departments operating at a speed of 155 Mbit / s and including 155/155 Mbit / s switched hubs, 10/155 Mbit / s network adapters, interconnected local area networks of doctors' working groups connected to stack concentrators, the outputs of which are connected through a modular high-performance a switch to the hospital ring ARP line and the high-speed network hub of the expanded network of the head of the urological center of the hospital connected to the network management workstation, color printer, scanner, high-resolution printer, graphic and video server, graphic workstation, personal computer of the administrator of the ARP network, a portable computer notebook, a personal computer of a remote user. Moreover, each LAN of the working group of doctors of the urological department of the center includes interconnected client computers, a file server of the group leader, wearable computer notebooks connected by a twisted pair cable through network adapters with ports of the common stack hub, as well as wireless mobile network computers with pen input limited to a keyboard and built-in radio station operating at a frequency of 2.4 GHz for communication with a local switched network of a medical department, center or territorial computer ARP network of the hospital. At the same time, the distributed LAN module contains at least 245 ports installed on the stack of five hubs, one of which is connected to the output of the hospital ring ARP line through a modular high-performance switch.

 The radio output of the stationary hospital reporting transceiver station is connected to the input of the module for collecting information about injured victims, the output of which is connected to the input of the data processing module, the output of which is connected to the input of the module for diagnosing injuries of the genitourinary system of the wounded, the output of which is connected to the input of the decision-making module upon request, the output of which is connected to the input of the reverse target designator, the output of which is connected to the input of the hospital reporting radio transmitter modulator th transceiver station.

 In FIG. 1 shows a functional block diagram of a teleinformurology complex. In FIG. 2 shows a functional block diagram of a mobile point for diagnosing injuries and injuries.

The teleinformurology complex includes the following elements:
1 - orbital constellation of geostationary relay-type satellites-relays;
2 - ground equipment technical support;
3 - the center for control and planning of television communications radio communications;
4 - central transceiver station (Ostankino, Moscow);
5 - stationary hospital reporting transceiver station;
6 - channel of satellite radio communication;
6-1 - channel of terrestrial radio communications;
6-2 - two-wire communication line;
6-3 - channel clock frequency;
7 - stationary equipment channel satellite radio;
8 - antenna unit;
9 - power amplifier;
10 - pathogen 70/15;
10-1 - pathogen 70/14;
11 - modulator;
12 - driver control signal;
13 - color video control unit;
14 - demodulator tuner;
15 - converter 13 / 1.2 (or 11 / 1.2);
15-1 - channel-forming equipment of TV, ST, TLF signals;
16 - input amplifier of the radio;
17 - guidance indicator;
18 - control panel;
19 - territorial computer network of the hospital-ARP network;
20 - hospital ring ARP-highway;
21 - module of distributed local area networks of management, medical departments and hospital centers;
22 - mobile diagnostic station MOSN;
23 - mobile reporting transceiver station;
24 - block-portable reportage transceiver station;
25 - module of technical means of automation;
26 - module technical means of data transmission;
27 - module of technical means of video information support;
28 - module of technical means of power supply;
29 - autonomous life support system;
30 - virtual local area network;
31 - user workstation;
32 - personal computer;
33 - client workstation;
34 - network adapter;
35 - expansion slot;
36 - hub;
37 - coaxial cable;
38 - file server;
39 - cartographic module;
40 - printer;
41 - guaranteed power source;
42 - block archiving data;
43 - modem;
44 - black and white television digital camera;
45 - color television camera;
46 - radio equipment for transmitting and receiving TV, ST signals to a mobile diagnostic point (MTD);
46-1 - a radio transmitter; 46-2 - a radio receiver;
47 - wire apparatus for transmitting and receiving TV, SV signals;
47-1 - transmitter; 47-2 - receiver;
48 - shaper television with a fixed frame (TNC);
49 - interface unit;
50 - shaper TV, SV signals for transmission on channel 6 of satellite radio communications;
51 - video recorder;
52 - color video control unit;
53 - wireless network computer;
54 - wearable computer notebook;
55 - routing server;
56 - local switched network;
57 - switched hub at 155 Mbps;
58 - high-speed network adapter;
59 - local area network of the working group;
60 - stack concentrator;
61 - modular high-performance switch;
62 - high-speed network hub of the expanded network of the center of the hospital;
63 - network management workstation;
64 - color printer;
65 - scanner;
66 - high resolution printer;
67 - graphic and video server;
68 - graphic workstation;
69 - personal computer of the administrator of the ARP network;
70 - personal computer of a remote user;
71 - hospital information collection module;
72 - data processing module;
73 - module for the diagnosis of injuries of the genitourinary system;
74 - decision making module upon request;
75 - shaper reverse target designation from the hospital.

The teleinformurology complex works as follows. The work of the complex and the technology for medical video conferences include the preliminary preparation of data on the wounded and the actual process of discussing the tactics of treatment by doctors. They solve the following tasks:
1). Coordination of the time of video conferencing; at the same time, a fixed time is allowed for this ISS and urgent organization of video conferencing for life-threatening situations. In district and main military hospitals, it is optimal to have two systems for scheduled and urgent videoconferencing sessions.

 2). Preparation of information about the wounded man, necessary for the preliminary transfer to the consultant and for discussion during the video conference. The preparation of data on the wounded is carried out according to the requirements (sequence, detail, formats) imposed by the consultant. Fragments of records from a medical history or injury, static medical images and diagrams are sent.

 3). Pre-sending data by e-mail or during the end of the previous video conferencing (when discussing the next group of wounded for planned consultations) gives the consultant time to calmly analyze the information received and prepare for the video conference.

 4). The analysis of the data sent by the consultant involves, in addition to studying the received documents, also preparing explanatory diagrams and images, searching for precedents, calling the wounded person from the database of medical histories and discussing them with the surgeon and the attending physician.

 Modules TS automation 25, data transfer 26 and video information 27 use client workstations 33 based on personal computers 32, supplemented by specialized hardware and software. To exchange information between workstations 33 remote from each other, they are interconnected via analogue telephone two-wire communication lines 6-2 and dedicated digital channels of satellite 6 and terrestrial 6-1 radio communications (to obtain a wide range of dynamic and / or static image of objects).

 In most cases, when a military doctor needs the help of a more experienced specialist of a military hospital regarding the diagnosis and treatment tactics of a wounded man, a teleconference is of great benefit even without the presence of the victim, based only on structural and graphical laboratory analyzes, as well as studying still and moving images. In the first case, these are radiographs, images from a microscope or endoscope, and in the second case, angiokinematography of cardiac catheterization, etc. All necessary data are recorded in digital format and transmitted electronically via communication channels 6, 6-1, 6-2 to the workstation 33 consultants where they are kept in the patient’s started medical history. At a convenient time for himself, the consultant gets acquainted with the materials sent, after which he calls the military doctor who has come for advice from the remote military district, discusses with him insufficiently clear questions and gives all the necessary recommendations, in his opinion. This allows you to save time for teleconferencing participants and quickly determine the tactics of treating a wounded person compared to document delivery.

 The military doctor has at his disposal the data of an objective examination of the wounded: a video recording of ultrasound diagnostics, computer images of smears or tissue sections. He combines all the text, graphics, images, recorded sounds into a message, which he then sends by e-mail or via satellite radio channel 6 to the address of the consultant, whose opinion must be obtained from the center, indicating at the same time when the consultant can contact him. The consultant of the hospital, after conducting research on the materials transferred to him, preparing the diagnosis and conclusion, contacts his arm with the military doctor who has consulted and transmits his message. Using an optional 45-1 video camera in real time, the consultant can transmit graphical information that can help plan a treatment for the wounded. The session is recorded on the VCR 51 in the mobile diagnostic station 22 MOSN, and the resulting recording becomes part of the primary medical record of the wounded (form 100).

 The most difficult, from a technical point of view, task is to conduct teleinformurology sessions in real time. Smears or slices are placed on the stage of a medical microscope and, using a video camera 44 or 45, the image is entered into workstation 33, where it is digitized. To transmit images or ultrasound, input is performed from a scanner 65 or digital video camera 44. At the same time, a video camera 45 is connected to the client workstation 33, which is aimed at a wounded or treating military doctor to organize a video conference. For sound communication, a microphone is connected to the workstation 33, with the help of which voice information is inputted, followed by its digitization. Digital signals are transmitted via satellite 6 and terrestrial 6-1 radio communications using a modem 43 connected to station 33 and providing the necessary exchange protocol. As a result, 4 digital data streams are transmitted from the military link to the center: an image of a medical diagnostic object, a video image of a wounded or attending physician, sound and control signals for remote control of a microscope.

 A more effective technology for teleinformurology is time-division work. During the communication session, the data is transmitted to the consultant, who, having analyzed them, prepares a package of information for sending. At the same time, he can request the additional information he needs about the wounded person both from the mobile diagnostic point 22 and from other specialists of the hospital involved in the analysis. So, he sends X-ray images via LAN 59 of the working group with the necessary comments to his radiologist, and after completing all the work, the urologist prepares the final information with the results of the studies and sends it to the military doctor at the return address. The latter, after studying the materials received, can either decide or prepare new information for more detailed processing at the center.

 The 33 transmitting client workstation is based on a 32 Pentium 166MMX PC with 32 MB of RAM and a 1.6 GB hard drive equipped with video and sound cards. Either a microscope (not shown in FIG. 1) is connected to station 33 with a high-resolution color video camera 45 as a first video input source and a black-and-white digital video camera 44 as a second video input source. The first source is used to enter a video image of smears or tissue sections, the second source is used to organize video communications between doctors or between a consultant physician and a patient. The microphone enters an audio signal. To ensure the input of radiographs and similar images, a scanner 65 is connected to station 33 (not shown in FIG. 2).

 The input of ultrasound images is carried out similarly to the input of signals from the video camera 44, 45 or directly from the digital output of the ultrasound device (the latter is not shown in Fig. 1). To record the results of the consultation and the process of the communication session to the station 33 connect a VCR 51.

 The receiving workstation 33 is intended for receiving images of diagnostic objects with text, graphic and sound comments, as well as for video and audio communication. It has a network card for LAN communication with workstations of other hospital specialists, with whom the consultant can communicate during research. Station 33 is also equipped with a video camera 44 or 45, a microphone, a scanner 65 and a VCR 51.

 For video conferencing, the complex has deployed two systems: one for scheduled conferences; the second for urgent calls. In the mobile diagnostic point 22, there is one system. Consultations are carried out according to an agreed schedule. Preliminary data for consultants is sent by e-mail or at the end of the previous communication session. At the same time, ASC11 files are used for fragments of injuries (injuries), and PCX files are used for video images. Consultant materials are prepared immediately in the form of video conferencing in data sharing mode. To avoid mistakes, discuss all available information about the wounded. Separate video materials demonstrate 3 frames per second at a reduced speed, on a video camera 44 they record video conferencing completely, memorizing fragments of discussions, prepared conclusions, explaining diagrams and figures.

 The teleinformurology complex provides simultaneous transmission of speech, data, video and audio over a single channel using geostationary relay satellites 1, block-portable 23, mobile 24 and stationary (ground) 5 hospital reporting transceiver stations. The latter consists of stationary equipment 7 of the satellite communication channel, including an antenna unit 8 of 37 cm in size, as well as an antenna used in digital television and using constant access to the channel. The equipment 7 is interconnected with the hospital ring ARP-highway 20 connected to the module 21 of the distributed local computer control networks, departments and centers of the hospital. Network adapters 34 modules of technical means of automation 25 mobile diagnostic point 22, local area networks 59 workgroups, local switched networks 56 modules 21 distributed LANs are responsible for the interface of wired communication lines 6-1 and terrestrial radio communication channel 6-1 of doctors of the teleinformurology complex with module 26 of the technical means of data transmission of the mobile diagnostic point 22 and the stationary hospital reporting transceiver station 5 through the central transceiver station 4 and the orbital th grouping of satellite transponders 1. Network adapters 34 simultaneously receive voice signals and digital data at a speed of at least 1.5 Mbit / s. All digital signals are transmitted via satellite radio channel 6 using its stationary equipment 7, which includes a program-oriented control panel 18 that implements the functions of synchronization, assignment of transceiver stations, switching and processing requests for voice, data and video. When processing requests for the use of satellite radio channel 6, the number of voice communication sessions, the number of available data ports and the number of queued requests for establishing connections for data transmission are taken into account. On this basis, assignment of MDKV technology personnel to these requests is carried out. The packet modem 43 of the virtual LAN 30 of the automation hardware module 25 sends a signal at a speed of 48 Mbit / s using a mobile reporting and receiving-transmitting station 23, and the frames have a duration of 15 ms, i.e. Each satellite transponder operates at a speed of at least 48 Mbps.

 Antenna unit 8 is responsible for transmitting and receiving on the links Earth-satellite 1 and satellite 1-Earth. The complex operates at frequencies of 14 and 15 GHz via the Earth-Sputnik radio channel, 11 and 13 GHz via the 1-Earth satellite radio channel. Terrestrial stations 23, 24 of microwave radio communications operate at 4/6 GHz frequencies.

 In the inventive virtual local area network 30, local switched network 56 and local area networks 59 of the working groups of the teleinformurology complex, the MDKV-P technology is applied - multiple access to the environment with a floating time division. This technology reduces losses of upstream packets of information transmitted by personal computers 32, client workstations 33, wireless network computers 53, routing server 55, network management workstation-application server 63, graphic and video server 67, graphic workstation 68, personal computer 70 remote user, and also provides the personal computer 69 administrator of the ARP network 19 with the possibility of operational regulation of the client schedule.

 The essence of MDKV-P technology is that at low loads on the access point, urologist clients working on personal computers 32, 53, 70 and workstations 33, 63, 68 use the usual Etnernet protocol of IEEE 802.3 standard: MDKN / OK - multiple access with carrier control and collision detection. However, if the reference (or basic network management workstation 63) hospital reporting transceiver station 5 notices the excess of the level of lost packets, then the client’s broadcast schedule is transmitted to client PCs 32, 53, 70 and workstations 33, 63, 68 . Moreover, after several iterations, the client timers of PC 32, 53, 70 and stations 33, 63, 68 are synchronized with the necessary accuracy and packet loss is eliminated. If a new station 33, 63, 68 enters LAN 30, 56, 59 and begins to interfere with the others, the synchronization procedure is repeated. Adjustment of the schedule is carried out in the background and does not lead to a delay in data transmission. If the client station 33, 63, 68 has nothing to transmit in the time allotted for it, this time is used to transmit the packet to the reference hospital reporting station 5 or to the base network management workstation 63. This procedure of interaction between the reference 5, base 63 and client 33, 68 stations allows to negate packet loss and unproductive downtime channel 6, 6-1, 6-2. Even with an equal ratio of upstream and downstream traffic, the efficiency of the access point never falls below 85%. The second important advantage of the MDVK-P protocol is the ability to dynamically manage client connections from PC 69 to the administrator of the APR network 19. If some urologist client needs video teleconferencing, then for the duration of the session he is provided with a greater amount of guaranteed connection time, and delays respectively, decrease.

 The knowledge about the classification of injuries and damage to the kidneys, as well as about the morpho-functional changes in the kidneys during the diagnosis of their injuries and injuries, is stored in the memory of the file server 38, data archiving unit 42, video recorder 51 of the mobile diagnostic station 22 and module for diagnosing injuries of 73 organs of the genitourinary system. The knowledge on predicting the dynamics of functional impairment of the kidneys in the post-traumatic or postoperative periods is stored on the drives of the network manager 63 and graphic 67 workstations, as well as in the memory of the decision-making module at the request of 74 local switched network 56. Graphics and video server 67 store data on the classification of injuries and damage kidney injured and injured. The information collection module of 71 hospitals provides telemetric control functions for microscopes located at the remote terminals of the workstation 31 of the mobile diagnostic point 22.

 Immediately after a kidney injury, in a mobile diagnostic point 22, a comprehensive assessment of the blood supply to the wounded kidney is performed by determining blood flow from the main, segmental and parenchymal vessels of the kidney using color duplex scanning ultrasound dopplerometry on an Ultramark-9 apparatus in combination with determining the degree of secretory disturbance and excretory function of a damaged kidney and blood supply to the parenchyma by dynamic nephroscintigraphy with indirect angiography on a gamma camera ipa "Fogamma".

 These devices (not shown in FIGS. 1 and 2) are included in the block 42 for archiving data from the mobile diagnostic point 22 and module 73 for the diagnosis of injuries of the genitourinary system.

 Ultrasonic color duplex scanning assesses the linear and diastolic blood flow velocities, the resistance index for renal, segmental arteries and capillaries of the parenchyma, and the functional state of the kidneys is assessed by the criteria for renal vascularization, time of onset of secretion, half-life of the indicator by the kidneys, glomerular filtration rate in each kidney separately and in total. In this case, the kidney functions that regulate protein, purine and mineral metabolism are estimated by the content of urea, creatinine, uric acid, ionized calcium, phosphorus, magnesium, sodium and chlorine in the blood serum, and the dynamics of changes in secretion and excretion are determined by daily excretion of urea , uric acid, calcium, phosphorus, magnesium, sodium and chlorine. Moreover, the anti-inflammatory effect is determined by changing the degree of leukocyturia and erythrocyturia using a urine analysis according to Nechiporenko, by assessing urine culture and flora, sensitivity to antibiotics, pH-metry within 10-14 days. The immune status and dynamics of the immune system are assessed by the immunogram, and the size of the kidneys, the thickness of the parenchyma and cortical layer, the size of the cholesterol and its tone - using ultrasound examinations of the kidneys.

 Automated processing of the obtained data is carried out on a personal computer 32 and file server 38 of the module 30 of automation equipment with visualization of the kidneys and ureters during the entire examination, construction of renograms from the selected areas of interest. At the same time, treatment tactics are developed, the dynamics of renal function in the post-traumatic or postoperative periods is predicted, and a correct diagnosis of kidney damage is made using the working classification of kidney injuries and video teleconferencing with leading hospital consultants in the field and inpatient settings.

 Diagnosis of kidney injuries in the field is carried out by using modules of technical means of automation 25, data transfer 26, video information support 27, subsequent transceiver and automated processing of urological information using a stationary hospital reporting station 5, hospital ring ARP line 20, local switched network 55, network control workstation 63, interconnected with modules for diagnosing injuries of 73 organs of the genitourinary system, making decisions on request 74 and a reverse target designator from the hospital 75. In this case, the hospital’s urological center uses black-and-white and color television images of kidney injuries from the location of the report — mobile diagnostic point 22, transceiver of open and protected data for the diagnosis of kidney injuries, primary diagnostic data obtained in the field , using the inventive teleinformurology complex using geostationary orbiting satellite transponders 1 of the Luch type, reporting block-portable 24, mobile 23, stations Onary hospital 5 and central transceiver 4 stations.

 The most expensive resource of the wireless territorial computing ARP network 19 of the hospital is a central access point with good wired 6-2 connection with local switched computer networks 56, LANs of workgroups 59 and highly raised phased antenna arrays (without side lobes) spaced around the perimeter of the building roof and directed to strategically important points in the hospital. Up to four independent radio adapters 34 (not shown in Fig. 1) of type RadioEthnernet with MDKV-P drivers are connected to one application server — the network control workstation 63, which gives an increase in throughput by 4-8 times and range up to 5-15 km . An Ethnernet 10 Base T adapter ($ 30) is installed in each PC, twisted pair with a radio broadcasting in the amount of $ 50 for each medical department, a hub is installed in each entrance of the urological center ($ 10 per port) and placed in the head of the urological center in the office of the top floor server wireless access-network control workstation 63 in the amount of 1900 dollars. Then they direct the antenna to the nearest wireless access point, and to increase reliability connect the modem 43. Thus, the cost of creating a LAN with a wireless Internet connection is not more than 2300 + 65xn dollars. If n = 100, then only 88 dollars. Thus, it is cheaper than the cheapest modem 43.

 Wireless computer modems (cards) 43 weighing 90-100 g and the size of a credit card support continuous connection, regardless of the location of their users, who carry pocket wireless network computers 53 or computer notebooks 54 with a software application for bi-directional messaging with at a speed of at least 20 Kbps with unlimited duration from a built-in battery that automatically recharges from the battery of a network computer 53. At the same time, radio modems 43 allow in the field and on the battlefield to receive data when disconnecting from a computer 53 or notepad 54, as they have a memory for storing information of 64 Kbytes and a screen on the LEDs to display data, performing offline functions of a pager. They also report being in the radio zone, receiving a message, switching to standby mode and the status of the power source. Thus, within 1 day, the e-mail that arrives at the wireless network computer 53 is transmitted wirelessly by the complex to the radio modems 43 to the necessary consultants of the hospital, regardless of wherever they are, i.e. mail finds them everywhere.

 The structure of the local switched network 56 additionally introduced a graphic and video server 67 with a urological database for storing video images of diagnostic objects with text, sound and graphic comments. All PC 32 and workstations 33 of the hospital’s distributed LAN are equipped with specialized software based on the Windows NT 5.0 operating system of centralized management of the complex, which supports all the necessary functions for receiving digital video, sound, graphics and text, their transceiver, teleconferencing and the necessary medical research. In video I / O, an information compression algorithm is used to significantly reduce redundancy and data volume. The Windows NT 5.0 operating system uses the composite urological object model to create applications for the diagnosis of kidney injuries and injuries. Its interface allows urology objects to interact with each other and has a dynamic assembly mechanism and application execution control services. The dynamic assembly mechanism allows you to design applications on the fly from many components written in programming languages. This operating system uses modular and object technologies of teleinformational urology.

 The positive effect of the claimed complex teleinformurology is as follows. Combining the capabilities of voice, audio, image and data transmission, the ARP network of the complex allows you to integrate all services in one place. This increases the reliability and controllability of the complex as a whole and reduces the cost of its maintenance. ARP technology also reduces the cost of laying cables and installing new equipment, and most importantly, it allows you to combine all channels of voice, music, data and television images into one channel and use it more efficiently. Supporting various classes of service and providing the necessary data transfer speed on demand makes it easy to build scalable ARP networks and provide the optimal ratio of equipment cost and bandwidth.

 The ARP network of the complex is designed for transmission speeds from 25 to 625 Mbit / s, and in the future - more than 4.8 Gbit / s. It works great in small workgroup environments where all the equipment is designed to work with ARPs. The backbone of the federal computer network requires high performance, such as that of the ATM and its switches. ARP is a low price with high bandwidth and ensuring the quality of integration of services with the highest transmission rate of channels.

 An advantage of the ARP network of the complex is that it is much easier to predict possible delays in the network and switches when using fixed-length packets. As a result, the process of ensuring the required quality of services provided by the ARP network is simplified. At the same time, there is comparative ease of construction of switching equipment and other technical support: all protocols and low-level interfaces are implemented in hardware in microprocessors. Highly predictable protocols can be implemented much more efficiently in ultra-large integrated circuits.

 The ARP network of the complex provides the construction of switches, the capabilities of which far go beyond the limits of today's needs, because the switches of the data cells are parallel, allowing at least two or more cells to be switched simultaneously. Like the frame translation technology (X.25), the ARP network is oriented towards the preliminary establishment of connections. ARP sessions are implemented in virtual communication networks. In virtual networks, because they do not need to use specific physical paths, although as soon as the virtual channel is established, the connection remains unchanged throughout the session.

 The use of automated workstations, coupled and connected to hospital diagnostic equipment, for the analysis of medical images increases the efficiency of the diagnosis of injuries and injuries at the stages of medical evacuation, saves energy, time and money spent on diagnosis, thereby ensuring timely and adequate treatment of the wounded. It allows you to automate the process of analysis and annotation of images, providing the doctor with qualitatively new effective tools for working with images, namely the analysis of the latter in multimedia mode with the simultaneous use of images obtained on various diagnostic equipment, as well as text, graphic, sound, reference and other information allows you to more reasonably and confidently make a diagnosis and treat wounded and sick military personnel.

 The use of digital image processing in the AWP of the LAN complex significantly saves time and money necessary for the final diagnosis and treatment of the wounded. The need for additional examinations is reduced, which means that the radiation dose is reduced, the time of doctors as clinicians and radiologists is more effectively used. In the near future, lower prices for hardware and software for AWP LANs, the emergence of high-quality and inexpensive systems for digitizing analog images, and the wider introduction of modern diagnostic equipment will make available and familiar the use of AWPs and LANs in the practice of not only district hospitals, but also in the work of military X-ray diagnostic departments and complexes.

 Thus, the teleinformurology complex provides network growth by integrating military and hospital urologists into collaborating workstations, managing information workflows, using document management software in computer networks and teamwork applications, and also allows you to transfer, receive and use large files containing voice messages, graphics, video, multimedia and urology data.

Sources of information
1. V. Efimushkin, S. Spesivov. - Broadband digital networks with service integration. - Open systems. - N 2 (16), 1996 .-- S. 39-42.

 2. E.G. Zhilyaev, A.N. Kozlov, I.Yu. Makarova. - The use of computer information technology by medical services of foreign armies // Military. -honey. journal - 1997. - S. 43-49.

 3. M. Boissot, M. Demange, J.-M. Munier. - Introduction to ATM technology. - Per. from English - M., Radio and Communications, 1997. - 128 p.

 4. Yu. Tolkachev. - We join the advanced network technologies: ATM. - Computer week, N 30-31. - 08/11/1998. - S. 49-50.

 5. V. L. Stolyar, E.N. Timin. - The experience of medical video conferencing // Computer technology in medicine. - N 1, 1998 .-- S. 78-86.

 6. Tomich N. Telepresense: changing the focus of medicine // US Medicine. - 1995 .-- vol. 31, N 9-10. - P. 1, 8, 11 (prototype).

Claims (5)

 1. Teleinformurology complex, including the orbital constellation of geostationary relay satellites located at the west and east longitude points, providing information transmission to the Earth and receiving it from the Earth, and interfaced via satellite radio channels with ground-based technical support equipment containing a control and planning center radio television sessions interconnected via satellite channels, or terrestrial microwave radio communications, or two-way telephone channels water communication lines, the central transceiver station and stationary hospital reporting transceiver stations, characterized in that the central and stationary hospital reporting transceiver stations connected to the control center and planning television sessions of radio communication via communication channels, contain stationary equipment of the satellite radio channel, which is connected to antenna systems and power sources of the control center and planning of television sessions, providing transmission and reception information on satellite and terrestrial radio communication channels, and the stationary equipment of the satellite radio channel contains an antenna unit connected to a radio and a radio transmitter, as well as a guidance indicator and a control panel, while ground-based technical support equipment includes a territorial computer network with asynchronous transmission mode, connected in parallel via terrestrial radio channels and a two-wire communication line with stationary hospital reporting transceivers In the 1990s, and through them with the central transceiver station, a hospital ring highway with an asynchronous transmission mode was introduced, having a data transfer rate of at least 625 Mbit / s, which includes hospital reporting transceiver stations, while a hospital ring highway with asynchronous data transmission mode ( GKM-ARP) is connected to the distributed local area network control module of medical departments and hospital centers, and the specified module of local distributed computing The network of medical departments and hospital centers is interconnected with hospital reporting stations using a data collection module and a reverse target designator from the hospital, while a mobile diagnostic station for advanced military medical units has also been introduced, connected to a radio communication control and planning television center and stationary hospital reporting transceiver stations through repeater satellites via satellite and terrestrial radio channels, while the mobile station diagnostics is placed on container bodies mounted on the chassis of the car or on the cargo suspension of a medical helicopter, while the mobile diagnostic station includes an autonomous life support system, reportable mobile and block-portable radio transmitting stations interconnected with the automation hardware module, the data transmission hardware module , a module of technical means of video information support and a module of technical means of energy supply.  2. The complex according to claim 1, characterized in that the automation hardware module is made in the form of a virtual local area network, including three user workstations assembled on the basis of a personal computer and two client workstations using network adapters installed in the expansion slot a computer and a hub connected by coaxial cables to all elements of a virtual local area network, including file services, a cartographic module, a printer, and guaranteed power supply, data archiving unit, and the outputs of client workstations are connected to modems.  3. The complex according to claim 1, characterized in that the module of technical means of video information support contains black-and-white and color television digital cameras connected to radio equipment for transmitting and receiving television and sound signals from the injured person to a mobile diagnostic point, including radio transmitters, a radio receiver connected to the wired equipment for transmitting and receiving these signals over a two-wire symmetric communication line, while the module of technical means of video information support It also contains a television shaper with a fixed frame for transmission over a two-wire line or a clock channel, a personal computer with interfaces, a television and audio shaper for transmission over a satellite radio channel connected to a VCR and a color video control unit, while the technical module the data transmission contains mobile and block-portable equipment of a satellite radio channel, including blocks similar to blocks of a stationary device A channel for satellite radio communications, as well as a wireless network computer and a doctor’s portable computer notebook.  4. The complex according to claim 1, characterized in that the module for the distribution of local area networks (LAN) of the hospital control contains a routing server with asynchronous transmission mode (ARP) of data, speech, audio and video, interconnected local switched networks of medical centers and departments hospitals with hubs and network adapters, interconnected local area networks (LANs) of working groups of doctors connected to stacked hubs, the outputs of which are connected through a modular switch to the hospital ring main line with asynchronous transmission mode and network hub of the expanded network of the head of the urological center of the hospital connected to the network control workstation, color printer, scanner, high-resolution printer, graphic server and video server, graphic workstation, administrator’s personal computer (ARP), wearable a notebook, a personal computer of a remote user, and each LAN of the working group of doctors of the urological department of the center includes an interaction These are client computers, a team leader file server, wearable computer notebooks connected by twisted pair or coaxial cable through network adapters with ports of a common stack hub, as well as wireless mobile network computers with pen input, a limited keyboard and an integrated radio station operating at frequency 2 , 4 GHz for communication with the local switched network of the medical department of the center or the regional computer ARP network of the hospital, while the distributed LAN module contains at least its ports 245 installed in the stack of five hubs, one of which is connected to the output of GCM-through modular ATM switch.  5. The complex according to claim 1, characterized in that the radio receiver output of the hospital hospital reporting transceiver station is connected to the input of the injured injuries information collection module, the output of which is connected to the input of the data processing module, the output of which is connected to the input of the injuries urogenital system injuries diagnostic module the output of which is connected to the input of the decision-making module upon request, the output of which is connected to the input of the reverse target designator, the output of which is connected to the input of the radio transmitter modulator sensor hospital reporting transceiver station.

Images