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Central venous pressure (CVP) reflects the comprehensive condition of effective blood volume, cardiac function and vascular tone. Clinical monitoring of CVP can indirectly understand and evaluate the dynamic changes of blood volume in patients, and provide a reference for patients to venous fluid. At present, the traditional manual measurement method is widely used for measurement, which has some shortcomings such as zero shift, cumbersome operation (requires two health care workers to cooperate). In order to overcome the above problems, the author invented a new fixable CVP measurement tool and obtained the national utility model patent (ZL 2021 2 1451705.7). The tool is mainly composed of a base plate, a movable frame and a measuring department, etc. When used, the base plate is placed into the back of the patient and pressed and fixed, the movable frame is adjusted, the zero point is found, and the measurement data is read from the measuring department. It has the advantages of simple and convenient operation, small measurement error, wide applicability (different body types) and so on, which is suitable for clinical promotion.
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Objective To establish virtual three-dimensional models of interventional devices and individualized surgical area structure in transjugular intrahepatic portosystemic shunt(TIPS)treatment,and to explore the value of virtual models for preoperative simulation in TIPS treatment.Methods Thin slice scan data of 8 patients with supine upper abdomen were obtained,three dimensional structures of bone,liver,portal vein,inferior vena cava and hepatic vein in CT scan area were reconstructed in Mimics software.According to the size of interventional instruments,a virtual RUPS-100 puncture kit and an VIATORR stent were established in 3D MAX software. Computer simulations were performed to evaluate the route from the hepatic vein puncture portal vein using the RUPS-100 puncture kit and VIATORR stent release position.Results ①The establishment of individual three-dimensional model of patients was helpful for doctors to understand the spatial relation of hepatic vein and portal vein.②Through simulation,the puncture parameters of multi angle and multi position are obtained,which was helpful for the doctor to adjust the puncture direction according to the puncture point.③The position of the bare segment of the VIATORR stent in the portal vein was obtained by simulation,which was helpful for evaluating the length of the stent.④The preoperative simulation results included the simulation parameters for each patient puncture into left portal vein,right portal vein and portal vein bifurcation.In the actual operation,we punctured into the portal vein bifurcation in 4 cases,into the right branch in 2 cases and into the left in 2 cases.⑤Preoperative simulations were performed using 8 mm×6 cm×2 cm size VIATORR stent.Howere,the actual operation of the first case was lack of experience,and the stent position was lower,then we released a bare stent at the proximal end of the VIATORR stent.The rest of the cases were the same as the simulation results.Conclusion According to the three-dimensional model of the individual structure of the patient,the preoperative simulations have high fidelity.The simulation results of the parameters of the puncture and the release position of the stent could guide the actual operation more accurately.It is of practical value to improve the success rate of operation and to train residents.
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<p><b>OBJECTIVE</b>Accurate segmentation of lung fields in chest radiographs (CXR) is very useful for automatic analysis of CXR. In this work, we propose to use dense matching of local features and label fusion to automatically segment the lung fields in CXR.</p><p><b>METHODS</b>For an input CXR, the dense Scale Invariant Feature Transform (SIFT) descriptors and raw image patches were extracted as the local features for each pixel. The nearest neighbors of the local features were then quickly searched by dense matching directly from the whole feature dataset of the reference images. The dense matching included three steps: limited random initialization, propagation of nearest neighbor field, and limited random search, with iteration of the last two steps for several times. The label image patches for each pixel were extracted according to the nearest neighbor field and weighted by the matching similarity. Finally, the weighted label patches were rearranged as the label class probability image of the input CXR, from which thresholds were obtained for segmentation of the lung fields.</p><p><b>RESULTS</b>The Jaccard index of the proposed method reached 95.5% on the public JSRT dataset.</p><p><b>CONCLUSION</b>A high accuracy and robustness can be obtained by adopting dense matching of local features and label fusion to segment the lung fields in CXR, and the result is better than that of current segmentation method.</p>
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Humans , Algorithms , Cluster Analysis , Lung , Radiographic Image Interpretation, Computer-Assisted , Radiography, ThoracicABSTRACT
Objective To explore the establishment method of virtual three-dimensional model of the virtual artery and interven-tional devices,and its application value.Methods The virtual models including virtual artery system,catheter,guide wire,stent and coil were established by using the three-dimensional moulding software of 3D Studio MAX R3.The study about interventional preoperative simulation and assistant instruction were run in personal computer.Results ①All the virtual instruments and real in-struments were highly similar shape,the arterial system in the visual display was similar to realistic system.②All arteries branches had own name,could be arbitrarily adjusted curvature,diameter and established the lesion morphology.③The reference value of preoperative simulation results to guide the actual surgery included following aspects:to guide the reasonable shaping of micro-cathe-ter and micro-guide wire tip,to plan the coil and stent deployment location,number and size.④In training and teaching,the preop-erative simulation could assist doctors in learning and remembering the artery branch and establishing the concept of three-dimen-sional space,and enhanceing the intention understanding of surgery.Conclusion The establishment method of virtual model of the virtual artery and interventional devices is reliable.The preoperative simulation results can be used to guide practical operation with relatively high accuracy,and it has an important supporting role for the teaching and training of medical students.
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Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.
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ObjectiveTo study the expression changes of peripheral blood monocyte human leukocyte antigen DR (HLA-DR) in patients with severe craniocerebral injury,and investigate the correlation between HLA-DR expression and infection and prognosis.MethodsNinety patients with craniocerebral injury were selected as experimental group and were divided according to the Glasgow coma scale (GCS) score after hospitalization into experimental group 1 (GCS score 13-15 scores ),experimental group 2 (GCS score 9-12 scores) and experimental group 3 (GCS score 3-8 scores) with 30 patients each,which were moderate,medium,severe craniocerebral injury,respectively.Thirty healthy people were chosen at the same period as control group.The HLA-DR expression of experimental group was detected after 1,3,7 and 14 d of admission by flow cytometry,and the HLA-DR expression of control group was detected on the day they got physical examination.The rates of infection,cure,disability,vegetative state and mortality were counted after 30 d of admission.ResultsThe HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7,14 d of admission were (28.11 ± 2.37),(26.45 ± 1.63),(27.75 ± 1.83),(27.15 ± 2.17) MCF and (29.34 ±2.07),(27.55 ± 1.63),(28.42 ± 1.94),(29.46 ±2.12) MCF,which had no statistical difference compared with that in control group [(29.18 ± 1.91 ) MCF](P＞ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7 d of admission and control group had statistical differences compared with those in experimental group 3 after 1,3,7 d of admission [(18.02 ± 1.78),(16.05 ± 1.97 ),(20.76 ± 1.65) MCF ] (P ＜ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 14 d of admission and control group had no statistical significance compared with that in experimental group 3 after 14 d of admission [ (26.13 ± 2.15) MCF](P＞ 0.05).The infection rates of experimental group 1,experimental group 2 and experimental group 3 were 0,3.6％(1/28),82.8％(24/29),respectively,while the cure rates were 100.0％ (30/30),100.0％ (28/28),10.3％ (3/29),the disability rates were 0,0,41.4％ (12/29),the vegetative state rates were 0,0,20.7％ (6/29),and the mortality were 0,0,27.6％ (8/29).There was no statistical significance in the rates of infection,cure,disability,vegetative state and mortality between experimental group 1 and experimental group 2 (P＞ 0.05 ).While there was statistical differences in the rates of infection,cure,disability,vegetative state and mortality among experimental group 1,experimental group 2 and experimental group 3 (P ＜ 0.05).ConclusionsThe HLA-DR expression changes of patients with moderate and medium craniocerebral injury after 1,3,7,14 d of admission are not significant.The HLA-DR expression of patients with severe craniocerebral injury begins to decline from 1 d after injury,declines obviously at 3 d,increases from 7 d,returns to normal level at 14 d.The decline of HLA-DR expression in patients with severe craniocerebral injury is correlated with the infection,and predicts poor prognosis.
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Objective To explore the methods and curative effect of metallic self-expanding stent in inoperable malignant gas-troduodenal obstruction. Methods The data of 15 cases with gastroduodenal obstruction including 9 cases of carcinoma of head of pancreas and 6 cases of carcinoma of stomach were analyzed retrospectively. The operative procedures of the stent implanted and the tors accepted more radiation dose because the manipulation was under the fluoroscopy in a short distance and with a full field of view. sions, the postoperative eating habit and the development turnover of disease. The main death reasons were tumor transfer and sys-tem exhaustion. Conclusion To pay close attention to the details and main points of operative procedure is the key point to implant stent successfully for malignant gastroduodenal obstruction. The determinative factor to influence the curative effect is the develop-ment turnover of tumor.
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This study is to investigate the effect of curcumin on the induction of glutathione Stransferases (GST) and NADP(H):quinone oxidoreductase (NQO) and explore their possible molecular mechanism. The activity of GST, NQO and cellular reduced glutathione (GSH) content were measured by spectrophotometrical methods. Cellular changes in the distribution of NF-E2 related factor 2 (Nrf2) were detected by Western blotting analysis. Nrf2-AREs (antioxidant-responsive elements) binding activity was examined by electrophoretic mobility shift assay (EMSA). Treatment of HT-29 human colon adenocarcinoma cells with curcumin dramatically induced the activity of GST and NQO at the range of 10-30 μmol·L-1. Curcumin exposure caused a significant increase in cellular GSH content rapidly as early as 3 h. Moreover, curcumin triggered the accumulation of Nrf2 in nucleus, and increased Nrf2 content in ARE complexes. These results demonstrated that induction of GST and NQO activity by curcumin may be mediated by translocation of transcription factor Nrf2 from cytoplasm to nuclear and increased binding activity of Nrf2-ARE complexes.
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Objective To evaluate the dissection and hemostasis effects of harmonic scalpel in laparoscopic surgery. Methods The effect in patients underwent laparoscopic surgery with harmonic scalpel or with high frequency electricity scalpel was compared. Results All the operations were done by laparoscopy.No complications or massive blood loss occurred during and after operation.The average operation time ,blood loss of operation with harmonic scalpel were less than that with high frequency electricity scalpel. Conclusions Harmonic scalpel has precise cutting , controlled coagulation, and less tissue injury,it can increase the safety and microsurgery techinque of laparoscopic surgery.It is a very important equipmeat and useful for laparoscopic surgery .
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Objective To explore the feasibility of endoscopic thyroidectomy without the use of ultrasonic scalpel.Methods Monopolar high frequency electrosurgical unit was used to complete endoscopic thyroidectomy in 6 cases of thyroid benign tumors.Results All the operations were completed successfully.The operation time was 80~200 min(mean,110 min) and the intraoperative blood loss was 25~50 ml(mean,36 ml).The patients got out-of-bed activities and took liquid diets at a mean of 24 hours postoperatively.No complications was found.The drainage tube was removed on 2 days after operation and the patients were discharged from hospital at 3~5 days.Conclusions Use of high frequency electrosurgical unit for endoscopic thyroidectomy is safe and feasible.
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Objective The effects of laparoscopic management of indirect ingunal hernia in adults were studied. Methods 17 patients with indirect inguinal hernia underwent laparoscopic high ligation of hernial sac and 12 patients with indirect inguinal hernia underwent traditional hernial repair between November 2000 to February 2002.The outcomes of two groups were compared retrospectively. Results Comparison between laparoscopic and open group showed that the operating time was (89 9?25 8)min vs(63 5?22 4)min( t =2 8612, P
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Objective To study the possibility and safty of laparoscopic partial cholecystectomy in difficult cholecystectomy. Methods The operative procedures,efficaey and complications of 26 laparoscopic partial cholecystectomy between 1999 and 2001 were reviewed retrospectively.The operative indications were empyema cholecystitis, Mirris syndromeⅠtype,frozen Calot's triangle,shrunken gallbladder. Results operative time was (51?16 5) minutes;The time to recovey activity was (11?4 3) hours;food-intake began (22?8 5) hours after operation; The hospital stay was (4 5?1 5) days;bile leakage after operation was found in 2 cases and recovered after conservative management.Following-up period lasting 6 to 25 months showed no complecations occurred. Conclusions Laparoscopic subtotal cholecystectomy may simplify the operation and decrease the risk in difficult cholecystectomy,and can get the therapeutic result of cholecystomy combined with standard cholecystectomy.
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Objective To study regulatory mechanism of osteopontin (OPN) in rheumatoid arthritis (RA). Methods The expression of OPN in peripheral blood mononuclear cells (PBMC), synovial fluid cells (SFMC) and synovium tissue (ST) and T cell subsets from RA patients were detected by real time PCR. The concentration and relative rate of inflammatory factors in the synovial fluid from RA patients were analyzed by ELISA. Results The mRNA expression of OPN in synovial fluid and tissue was higher than that of PBMC in the same RA patient. The OPN expression was found mainly on CD4+T. The OPN concentration was higher in the synovial fluid than that of in the same patient′s serum. Meanwhile, the concentration of IL-10, IFN-? and TNF-? was higher than that of in the serum from same patient. Also, the concentration of IL-18 and IL-12 were higher than that of normal individual serum. Conclusion OPN may control secretion of inflammatory factors of synovium tissue and synovial fluid and induce the inflammatory response.
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Purpose:To evaluate the accuracy of diagnosing the gastrointestinal vascular malformation and the value of treatment of the hemorrhage of the interventional radiology.Materials and Methods:The superior mesenteric arteriography or/and the inferior mesenteric arteriography or arteriography of coeliac axis were performed by applying Seldinger's techniques in 22 cases with the gastrointestinal bleeding which were suspicous of the gastrointestinal vascular malformation,otherwise were negative or equivocal in di- agnosis by performing with non-interventional study.Results:Focci were detected in 31 arteriographies (22 cases)with the positive gastrointestinal vascular malformation.Operative treatment were performed in 14 of 22 cases,with confimation of the vascular malformation pathologically.Conclusion:The se- lective coeliac arteriography may be a reliably unique method in detection of the gastrointestinal vascular malformation.