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Objective:To investigate the status of corneal epithelial remodeling and changes in corneal aberration after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and FS-LASIK combined with corneal collagen cross-linking (FS-LASIK Xtra), and to analyze the relationship between corneal epithelial thickness (CET) and corneal aberration.Methods:A cohort study was conducted.A total of 172 patients (172 eyes) who underwent FS-LASIK at Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine were enrolled from June 2021 to February 2022.The 172 eyes were divided into FS-LASIK group (94 eyes) and FS-LASIK Xtra group (78 eyes) according to the surgical procedure, with a total follow-up of 6 months.The cornea was divided into a central 2-mm ring and a ring of 2-5 mm centered on the central cornea.CET at 9 regions in the central 0-5 mm area was measured by OCT before and at 1, 3 and 6 months after surgery, and the corneal higher-order aberration (HOA) was measured by the iTrace visual function analyzer.The main outcomes were the increase in CET (ΔCET), and corneal HOA at 6 months after surgery.The relationship between central corneal ΔCET and corneal aberration was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine (No.2021yh-009). Written informed consent was obtained from each subject.Results:At 1, 3 and 6 months after surgery, the central, superior, superior nasal, nasal, inferior nasal, inferior, inferior temporal, temporal and superior temporal ΔCET were significantly smaller in FS-LASIK Xtra group than in FS-LASIK group (all at P<0.05). In FS-LASIK Xtra group, 6-month postoperative central, superior, superior nasal, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 3- and 6-month postoperative temporal ΔCET were significantly larger than that at 1 month after surgery, and 6-month postoperative superior temporal ΔCET was significantly larger than those at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, 3- and 6-month postoperative central, superior, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 6-month postoperative superior nasal ΔCET was significantly larger than that at 3 months after surgery, and 6-month postoperative nasal, inferior nasal, temporal, superior temporal ΔCET were significantly larger than those at 1 and 3 months after surgery (all at P<0.05). There was no significant difference in vertical trefoil, vertical and horizontal coma changes at different time points after surgery between both groups (vertical trefoil: χ2group=4.27, P=0.118; χ2time=0.01, P>0.05.vertical coma: χ2group=5.74, P=0.057; χ2time=0.08, P=0.957.horizontal coma: χ2group=3.97, P=0.137; χ2time=0.51, P=0.773). The tilted trefoil changes at 1, 3 and 6 months after surgery of FS-LASIK Xtra group were significantly larger than those of FS-LASIK group (all at P<0.05). The 6-month spherical aberration change in FS-LASIK Xtra group was significantly higher than that at 1 month after surgery, and the 6-month spherical aberration change in FS-LASIK group was significantly higher than that at 1 and 3 months after surgery (all at P<0.05). The 6-month total HOA change in FS-LASIK group was significantly lower than that at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, central corneal ΔCET was weakly positively correlated with spherical aberration at 1 and 6 months after surgery ( rs=0.257, P=0.008; rs=0.244, P=0.012), and was weakly positively correlated with total HOA ( rs=0.253, P=0.009; rs=0.279, P=0.004). Conclusions:The postoperative ΔCET after FS-LASIK Xtra is smaller than that after FS-LASIK, but the homogeneity of ΔCET in each region is similar between the two groups.The changes in corneal HOA after surgery are similar in both groups, and there is a certain association between the overall epithelial distribution and corneal aberration.
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Objective To explore the distribution and changes of the upper respiratory tract pressure in the human body under circulatory respiration conditions.Methods An oral-secondary bronchus model was established based on CT images.The pressure distribution at various parts of the model during circulatory respiration and the pressure distribution at the moment of maximum inspiration or expiration were simulated under a respiratory flow of 60 L/min.Results The pressure difference in the upper respiratory tract increased with the respiratory flow.Some positions with special structures,such as pharynx,larynx,trachea,etc.,showed pressure gradient changes,especially between edge of epiglottis to the trachea and upon the bifurcation point of tracheal.Conclusions The air flow motion,including pressure distribution and variation,is related to the anatomy morphological structure of the respiratory tract,and they interactively influence the respiration process.The flow field characteristics of pressure cyclic variation can provide basis for exploring the aerosol deposition and the occurrence and treatment of some respiratory tract diseases.
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Objective@#To evaluate the clinical value of computed tomography (CT)-guided 125I seed implantation in the treatment of patients with spinal and/or paraspinal osteolytic metastatic tumors.@*Methods@#The radiation dose distribution was planned for 27 patients with 35 spinal and paraspinal osteolytic metastatic tumors by a treatment planning system (TPS). CT-guided 125I seed implantation was carried out in the patients, and the quality of treatment was evaluated based on CT-imaging follow-up.@*Results@#All the 27 patients underwent CT-guided 125I seed implantation successfully. 12 to 50 125I seeds were injected into each spinal or paraspinal metastatic tumor, 39.15 on average, and the specific radioactive activity of the particles ranged from 0.60 to 0.80 mCi, 0.73 mCi on average. The minimal percentage of the dose received by 90% of the target volume (D90) of the spinal and paraspinal metastatic tumors ranged from 90 to 165 Gy, 115.03 Gy on average. Among the 27 patients, 21 (77.8%) had partial remission (PR) and 6(22.2%)had stable disease (SD). The Numerical Rating Scale (NRS) scores before implantation and at postoperative 3 and 6 months were 7.81±0.74, 2.04±1.10 and 1.81±0.79, respectively, (P<0.05). The assessment of pain intensity before 125I seed implantation and at 3 postoperative months showed obvious improvements in the patients evaluated according to the American Spinal Injury Association (ASIA) impairment scale: 12 (44.4%) patients with ASIA grade C were changed to grade D, 3 (11.1%) from grade C to grade E, 8 (29.6%) from grade D to grade E, 3 (11.1%) with a stable grade D, and 1 (3.7%)with a stablegrade C. The Karnovsky performance scale (KPS) scores before treatment and at 3 months and 6 months postoperatively were 66.30±6.88, 85.93±9.31 and 87.91±8.56, respectively (P<0.05). Their local control rate (LCR) at 3 months, 6 months and 1 year postoperatively were 100%, 92.6% and 51.9%, respectively, and the overall survival rates(OSR) were 100%, 92.6% and 55.6%, respectively.@*Conclusions@#CT-guided 125I seed implantation can significantly relieve local pain, has advantages of less complications and higher local control rate. Therefore, it is a safe, effective and feasible treatment option for patients with spinal and paraspinal osteolytic metastatic tumors.
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BACKGROUND:Osteosarcoma combined with pathological fracture was often treated by amputation. With clinical application of neoadjuvant chemotherapy and improvement of technology and material of the prosthesis, the limbs of patients with osteosarcoma combined with pathological fracture were reserved. OBJECTIVE:To evaluate the effect of the application of custom-manufactured artificial total knee prosthesis replacement in limb salvage treatment for patients with osteosarcoma combined with pathological fracture. METHODS:A total of 11 patients with pathological fracture with osteosarcoma located in adjacent knee Joint were enrol ed from June 2002 to September 2012. In accordance with individual condition of the patient, limb salvage treatment was designed for knee prosthesis for a tumor. Fol ow-up results were retrospectively analyzed. There were six males (54.5%) and five females (45.5%) and their age ranged from 11 to 50 years old with an average age of 25.4 years old. Onset regions:seven tumors were located in the distal femur and four tumors were in the proximal tibia. Al patients received neoadjuvant chemotherapy, and limb salvage treatment with custom-manufactured artificial knee prosthesis. The fol ow up was performed for 9 to 105 months. RESULTS AND CONCLUSION:In 11 patients after prosthesis replacement, the regional recurrence rates were 18%, lung metastasis rates were 36%. The five-year survival rate was 58%. Four patients developed lung metastases and died in 9 to 24 months postoperatively. During the last fol ow-up, Enneking score of the affected limbs was 11 to 30 points, averagely 23.3 points, with an excellent and good rate of 82%. Results indicated that combined with neoadjuvanet chemotherapy, the application of custom-manufactured artificial total knee prosthesis replacement in the treatment of osteosarcoma located in adjacent knee joint and pathological fracture achieved an ideal outcomes of the limb salvage treatment in the near future. The lone-term effectiveness was expected to be evaluated.
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<p><b>OBJECTIVE</b>To explore the value of percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds in the treatment of metastatic thoracolumbar tumors.</p><p><b>METHODS</b>Based on the CT images before ¹²⁵I seed implantation, a computer-based treatment planning system (TPS) was used to determine the optimal seed distribution. Under CT guidance and local anaesthesia, ¹²⁵I seeds were implanted into 22 osseous metastatic lesions in 18 patients. Based on the CT images after the implantation, quality check was carried out with TPS. DSA (digital subtraction angiography)-guided vertebroplasty was performed under local anaesthesia, and bone cement was injected into the vertebrae through pedicle of vertebral arch.</p><p><b>RESULTS</b>All the 18 patients received percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds. Every vertebra was injected with 2-6 ml bone cement, average 3.5 ml, and was injected with ¹²⁵I seeds 16-34 pills, average 26 pills. At 2-months follow-up, their numerical rating scale (NRS) pain scores were 7.12 ± 1.48 before and 2.26 ± 1.07 after treatment, with a significant difference (P < 0.05).</p><p><b>CONCLUSIONS</b>Percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds is a minimally invasive procedure with small wound and minor complications, and no need of external radiation therapy. It is effective in the alleviation of pain in metastatic thoracolumbar tumor patients, restrains the tumor growth, and improves the quality of life. It is a promising minimally invasive method in the treatment of metastatic thoracolumbar tumors.</p>
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Aged , Female , Humans , Male , Middle Aged , Angiography, Digital Subtraction , Bone Cements , Therapeutic Uses , Brachytherapy , Breast Neoplasms , Pathology , Combined Modality Therapy , Follow-Up Studies , Iodine Radioisotopes , Therapeutic Uses , Lumbar Vertebrae , Lung Neoplasms , Pathology , Pain Measurement , Prostatic Neoplasms , Pathology , Quality of Life , Radiotherapy Planning, Computer-Assisted , Spinal Neoplasms , Therapeutics , Thoracic Vertebrae , Vertebroplasty , MethodsABSTRACT
@#Educational informationization is the focus of education and teaching reform. World University Town provided a very good platform for information and network teaching. This paper, taking the community rehabilitation course as an example, introduced the function ofWorld University Town in course construction and described the concepts, ideas, procedures and application effect.
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The research on cycle change form of the pressure and the wall shear in human upper respiratory tract can strengthen understanding of the characteristics of the airflow in the place and provide us with a scientific basis for analyzing the diffusion, transition and deposition patterns of aerosol there. In our study, we used large eddy simulation to emulate the pressure and wall shear in human upper respiratory tract in conditions of the low intensive respiratory patterns, and discussed the distributing disciplinarian of the pressure and wall shear in mouth-throat model and trachea-triple bifurcation. The results showed that the pressure gradient variation in human upper respiratory tract was mainly fastened from root of epiglottis to trachea. The minimum pressure at the interim of inspiration was a duplication of the interim of expiration, and located on the posterior wall of the glottis. The pressure gradient variation was evident on trachea and its fork. The wall shear changed with the velocity of the air flow, and its direction changed periodically with breath cycle.
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Humans , Biomechanical Phenomena , Bronchi , Physiology , Computer Simulation , Epiglottis , Physiology , Mouth , Physiology , Nose , Physiology , Pharynx , Physiology , Pressure , Pulmonary Ventilation , Physiology , Respiratory Mechanics , Physiology , Respiratory Physiological Phenomena , Respiratory System , Shear Strength , Stress, Mechanical , Trachea , PhysiologyABSTRACT
Three dimensional electrical impedance tomography (3D-EIT) became an important branch of EIT recently. It is important to research imaging and image quality evaluation methods for single targets of different positions and multi-targets in 3D field. Using finite element subdivision method, 3D-EIT field was dispersed into cube unit in the present study for models with single target located in the center of field, middle of field, and near to the edge, respectively. For models with two targets and four targets near to the field edge, Tikhonov-Noser algorithm was adopted in image reconstruction. Imaging error function ER and structure similarity degree function SSIM were introduced to evaluate the reconstructed images. For the models with signal target, with the movement of the target from the center to the edge of the field, the value of ER increased and SSIM decreased, and reconstruction quality decreased. For the models with multi-targets near to the field edge, ER and SSIM increased and decreased respectively with the increase of target number, mage quality also decreased. Tikhonov-Noser algorithm is an effective 3D-EIT algorithm. ER and SSIM are adaptive for the characteristic of 3D-EIT images, and it can quantitatively evaluate the 3D-EIT imaging effect from the two perspective of imaging error and structure quality.
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Algorithms , Electric Impedance , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , TomographyABSTRACT
@#The personnel training mode of school-enterprise cooperation, interaction of study and work is the inevitable trend of senior vocational education reform and development at present. The Changsha Social College cooperates closely with rehabilitation agencies and implements the personnel training mode of the “love to help people with disabilities, interaction of study and work, integration of courses and certificate” for training professionals of rehabilitation therapy, has gained some experience and achievements.
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@#Objective To investigate the effect of the rehabilitative therapy on functional recovery of patients with cervical cord injury.Methods 92 cases with spinal cord injury(SCI),including cervical,thoracic and lumbar cord injury,accepted normal rehabilitation.They were assessed with the Barthel Index and Functional Independence Measure(FIM)before and after treatment.Results After rehabilitation of 60~426 d,the scores of the Barthel Index and FIM were significantly improved(P<0.001)in all the patients,but it was the worst in the cervical cord injured ones,and the best in lumbar ones(P<0.05).Conclusion Rehabilitation can promote the functional recovery of patients with cervical spinal cord injury,but it is not as effective as on the thoracic and lumbar cord injury.