3D-CE-TOF-SPGR对静脉性颅神经血管压迫综合征的应用

探讨3D-CE-TOF-SPGR序列在诊断静脉性颅神经血管压迫综合征中的临床应用价值。研究对象为我院收治的经手术证实且行磁共振断层血管成像(MRTA)检查的198例中7例静脉性颅神经血管压迫综合征患者,并与微血管减压术(MVD)中所见进行对照,其中原发性三叉神经痛5例、面肌痉挛2例。MRTA包括3D-FIESTA、3D-TOF-SPGR和3D-CE-TOF-SPGR序列,颅神经受压与责任静脉血管3D-FIESTA序列显示1例、3D-TOF-SPGR序列显示1例、3D-CE-TOF-SPGR序列显示6例,独立应用3D-CE-TOF-SPGR序列显示能力最佳(6/7,85.71%)。因此,MRTA成像技术中,3D-CE-TOF-SPGR序列能清楚显示目标颅神经及相应颅神经受压的静脉性责任血管,对指导临床MVD手术具有重要价值。     

经前颅窝底硬膜外入路显微外科手术切除颅底邻近部肿瘤

目的:研究位于颅、面、眶等结构之间侵犯前颅窝底的肿瘤手术入路和手术方法方法:与相关科室合作采用前颅窝底硬膜外入路显微外科手术的方法,成功地为9例病人作肿瘤切除术.其中斜坡脊索瘤2例,筛窦恶性肿瘤4例,筛窦良性肿瘤1例,眶内球后胶质瘤1例,眶尖脑膜瘤1例.结果:肿瘤全切除4例,肿瘤大部切除5例,切口均一期愈合,近期疗效良好.结论:对邻近前颅窝或侵犯前颅窝底的各类肿瘤,经前颅窝底硬膜外入路是一种较为理想的外科手术入路.     

Fine structural dynamics showing functional changes of anterior pituitary cells in the rat

The cell types in the rat anterior pituitary were classified according to the function of hormone produced by each type cells. Depending upon the age and sex of the rat studied, the fine structure of the cell remarkably differs from each other. The name of cell type indicates the name (abbreviation) of hormone produced by each type cell, which is also divided into two or three subtypes according to the ultrastructure or developing stage viz. immature, intermediate and mature types. The immunocytochemistry is a useful method both for light and electron microscopy in order to study the activity of every cell organelles, because it is easy to indicate the localization of hormones in the cell. The anterior pituitary hormones are all proteins or polypeptides fragmented from the former, and making antibodies of these hormones is rather easy. Significance of every cell organelles in the endocrine function was clarified.     

Studying the potential of point detectors in time-resolved dose verification of dynamic radiotherapy

Modern megavoltage x-ray radiotherapy with high spatial and temporal dose gradients puts high demands on the entire delivery system, including not just the linear accelerator and the multi-leaf collimator, but also algorithms used for optimization and dose calculations, and detectors used for quality assurance and dose verification. In this context, traceable in-phantom dosimetry using a well-characterized point detector is often an important supplement to 2D-based quality assurance methods based on radiochromic film or detector arrays. In this study, an in-house developed dosimetry system based on fiber-coupled plastic scintillator detectors was evaluated and compared with a Farmer-type ionization chamber and a small-volume ionization chamber. An important feature of scintillator detectors is that the sensitive volume of the detector can easily be scaled, and five scintillator detectors of different scintillator length were thus employed to quantify volume averaging effects by direct measurement. The dosimetric evaluation comprised several complex-shape static fields as well as simplified dynamic deliveries using RapidArc, a volumetric-modulated arc therapy modality often used at the participating clinic. The static field experiments showed that the smallest scintillator detectors were in the best agreement with dose calculations, while needing the smallest volume averaging corrections. Concerning total dose measured during RapidArc, all detectors agreed with dose calculations within 1.1 ± 0.7% when positioned in regions of high homogenous dose. Larger differences were observed for high dose gradient and organ at risk locations, were differences between measured and calculated dose were as large as 8.0 ± 5.5%. The smallest differences were generally seen for the small-volume ionization chamber and the smallest scintillators. The time-resolved RapidArc dose profiles revealed volume-dependent discrepancies between scintillator and ionization chamber response, which confirmed that correction factors for ionization chambers in high temporal and spatial dose gradients are dominated by the volume averaging effect. The unique scaling of the scintillator volumes indicated how such time-dependent volume averaging corrections could be quantified. The time-resolved measurements further supported the claim that small-volume water equivalent detectors are most likely to accurately detect changes in dose delivery, although exact positioning of detectors remains critical.     

用改进的Dukett''''s手术治疗小儿尿道下裂

通过 5例小儿尿道下裂病例 ,用 Dukett's手术方式治疗 ,并作适当的改进 ,效果良好 .具体措施是 :1.重建舟状窝 ,扩大尿道出口 ,减少排尿阻力 .2 .皮管与尿道斜吻合 ,增大吻合面 ,减少了吻合口狭窄的发生 .     

床旁颅脑超声结合振幅整合脑电图检查在早产儿脑功能发育状态评估中的应用价值

为探讨床旁颅脑超声结合振幅整合脑电图检查对早产儿脑功能发育状态的评估作用,本研究选取2017年6月~2019年4月我院新生儿重症监护病房收治的早产儿100例,根据临床诊断有无脑损伤,将患儿分为脑损伤组(42例)和无脑损伤组(58例),两组患儿均给予床旁颅脑超声和振幅整合脑电图检查,比较其检查结果,活动睡眠期(AS)和安静睡眠期(QS)振幅电压变化,绘制ROC曲线,分析床旁颅脑超声检查、振幅整合脑电图检查,以及联合检查对早产儿脑损伤的诊断效能。结果显示,脑损伤组超声检查异常率、振幅异常检出率均明显高于无脑损伤组(P<0.05);脑损伤组连续性电压、睡眠周期性检出率,以及AS和QS期振幅电压均明显低于无脑损伤组(P<0.05)。ROC曲线分析表明:床旁颅脑超声结合振幅整合脑电图检查对早产儿脑损伤诊断的敏感性、特异性均明显高于单一检查(P<0.05)。床旁颅脑超声检查可反映早产儿脑实质发育情况,振幅整合脑电图检查可反映早产儿脑功能发育情况,两者联合检查对早产儿脑损伤有较好的评估作用。     

超声测量前腹壁脂肪厚度在预测低体质量儿与巨大儿中的应用

本文探究纯净波超声测量胎儿前腹壁脂肪厚度在预测低体质量儿与巨大儿中的应用价值及临床意义。选取104例新生儿作为研究对象,根据新生儿出生体质量分为正常组(n=74)、低体质量儿组(n=12)、巨大儿组(n=18),比较3组孕中晚期胎儿的前腹壁脂肪厚度、出生体质量、出生后新生儿肱三头肌皮褶厚度(SFT)、肩胛下方SFT,分析胎儿前腹壁脂肪厚度与出生后新生儿SFT、出生体质量的关系,评价前腹壁脂肪厚度对低体质量儿、巨大儿的预测价值。结果发现,巨大儿组孕中晚期胎儿前腹壁脂肪厚度、出生体质量、出生后新生儿肱三头肌SFT、肩胛下方SFT均高于正常组、低体质量儿组,正常组上述指标高于低体质量儿组(P<0.05);孕中期、孕晚期胎儿前腹壁脂肪厚度与出生体质量、肱三头肌SFT、肩胛下方SFT呈正相关(P<0.05);孕中、晚期胎儿前腹壁脂肪厚度预测低体质量儿的AUC为0.813、0.898,预测巨大儿的AUC为0.721、0.846。采用纯净波超声测量胎儿前腹壁脂肪厚度,其值与新生儿出生体质量、肱三头肌SFT、肩胛下方SFT密切相关,且在预测低体质量儿、巨大儿的发生方面具有一定价值。     

前交叉韧带及其纤维束对膝关节前错运动的约束作用

本文对人体膝关节中的前交叉韧带及其纤维束在膝关节前错运动中的约束作用与破坏性质进行了实验研究。测定了在膝关节３０°及６０°屈曲时前交叉韧带的约束占关节总约束的百分比，并了解到在分离后的纤维束中，只有前侧带对前错运动起约束作用，在前错至破坏过程中，前侧带比后侧带表现出更高的强度和延展性。     

Change in Collagen Fibril Diameter Distribution of Bovine Anterior Cruciate Ligament upon Injury Can Be Mimicked in a Nanostructured Scaffold

More than 200,000 people are suffering from Anterior Cruciate Ligament (ACL) related injuries each year in the US. There is an unmet clinical demand for improving biological attachment between grafts and the host tissue in addition to providing mechanical support. For biological graft integration, it is important to provide a physiologically feasible environment for the host cells to enable them to perform their duties. However, behavior of cells during ACL healing and the mechanism of ACL healing is not fully understood partly due to the absence of appropriate environment to test cell behavior both in vitro and in vivo. This study aims at (i) investigating the change in fibril diameter of bovine ACL tissue upon injury and (ii) fabricating nanofiber-based scaffolds to represent the morphology and structure of healthy and injured ACL tissues. We hypothesized that distribution and mean diameter of ACL fibrils will be altered upon injury. Findings revealed that the collagen fibril diameter distribution of bovine ACL changed from bimodal to unimodal upon injury with subsequent decrease in mean diameter. Polycaprolactone (PCL) scaffold fiber diameter distribution exhibited similar bimodal and unimodal distribution behavior to qualitatively represent the cases of healthy and injured ACL, respectively. The native ACL tissue demonstrated comparable modulus values only with the aligned bimodal PCL scaffolds. There was significant difference between mechanical properties of aligned bimodal and unaligned unimodal PCL scaffolds. We believe that the results obtained from measurements of diameter of collagen fibrils of native bovine ACL tissue can serve as a benchmark for scaffold design.     

Influence of a skull cranial window on the measurement of haemoglobin concentration in cortical tissue by multi-spectral imaging analysis

The simplified cranial window, which is transparent thinned skull, has been used for the optical imaging of cortical tissue of small animals to measure the concentration change in haemoglobin as an intrinsic signal of brain activation. The multi-spectral images of the cortical tissue of guinea pigs through the skull cranial window were compared with those of the exposed cortex to evaluate the influence of the scattering and absorption properties of the skull on the measurement of the concentration change in haemoglobin. Although skull thickness affects the sensitivity of the optical signal due to a decrease in mean optical path length in the cortical tissue, the influence of the skull cranial window on the wavelength dependence of optical path length can be ignored when the skull thickness is less than approximately 100 mm. Accurate concentration changes in oxygenated and deoxygenated haemoglobins can be calculated from the optical signal measured through a skull cranial window and the wavelength dependence of optical path length for the exposed cortex.