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Objective:To investigate the application and effect of the virtual reality (VR) combined with the augmented reality (AR) integrated teaching system in stomatology general medical education of clinical medicine students.Methods:A total of 160 undergraduates from the five-year clinical medicine Batch 2015 of Naval Medical University were randomly divided into VR+AR group and traditional group, with 80 students in each group. A comparative analysis was made on the previous and teaching achievements of the two groups of students, and a questionnaire survey was conducted after the completion of the class. Epidata 3.0 was used to input questionnaire data, and SPSS 23.0 software was used to carry out t test, chi-square test and Fisher precision test. Results:There was no statistical difference in written test scores between the VR+AR group and the traditional group [(52.65±3.76) vs. (51.90±3.46), P=0.516], but the VR+AR group was significantly higher than the traditional group in case analysis scores [(35.85±2.56) vs. (31.40±2.96), P < 0.001] and overall performance [(88.50±4.95) vs. (83.30±4.86), P= 0.002]. The questionnaire survey results showed that the scores of "teaching mode" [(92.30±6.90) vs. (85.20±7.30), P<0.001], "teaching method" [(91.70±5.90) vs. (86.00±6.70), P=0.012] and "teaching improvement" [(90.70± 8.70) vs. (82.30±8.40), P<0.001] in VR + AR group were significantly higher than those in the traditional teaching group. Conclusion:The VR combined with AR integrated teaching system can significantly improve teaching performance and teaching quality, and is convenient for teaching demonstrations and simulation operations in small oral spaces, and is especially suitable for oral general medical education for clinical medicine.
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Objective To investigate the impact of multi-b-value on texture features of DWI in liver cirrhosis.Methods DWI manifestations of liver cirrhosis in 37 patients were analyzed retrospectively,and DWI of 27 healthy volunteers (control group) were enrolled as controls.The b values were set as 0,20,50,100,200,400,800,1 000,1 200 and 1500 s/mm2,respectively.Three ROIs at different levels of every set image were selected,and 37 texture features within these ROIs were extracted.Unstable texture features affected by different b-values were screened with the percent coefficient of variation (％COV),and the fitting degree between the unstable texture features and b values were analyzed with exponential fitting.Results Among 37 texture features,20 (20/37,54.05 ％) were unstable.With the increase of b values,exponential upward trend was found in 10 texture features,exponential downward trend was found in 4 texture features,and the relative trends could not be defined in other 6 unstable texture features.Conclusion The b values of DWI impact the texture features in liver cirrhosis.Correlations exist among some texture features and b values.
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Objective To evaluate the safety and efficacy of induced hypotension and hypotension in carotid endarterectomy (CEA).Methods Data of 1 486 patients who underwent CEA in multicenters from Aug 2012 to Aug 2018 were retrospectively analyzed.After screening,a total of 1 448 patients met the inclusion criteria.Induced hypertension and hypotension was used in all thees patients.Results 87.8％ of the patients were with severe carotid stenosis.The average operative time was (51.8 ± 6.1) min,and the internal carotid artery clamping time was (11.4 ± 3.1) min.After induced hypertension,the stump pressure were higher than that before,of which 1 438 (99.3％) were greater than 50 mmHg.Monitoring of EEG oxygen saturation showed that the value of ipsilateral rSO2 was significantly lower than that of the contralateral [(56％ ± 3％) vs.(64％ ± 4％),P ＜ 0.05] before induced hypertension.After induced hypertension and clamp removal,the value of ipsilateral rSO2 was lower than that of the contralateral,but there was not significant difference (all P ＞ 0.05).Perioperative cerebral infarction occurred in 2 cases,ipsilateral cerebral hemorrhage in 1 case,contralateral cerebral hemorrhage in 1 case and myocardial infarction in 2 cases.Connclusion The technique of induced hypotension and hypotension play a temporary role in brain protection for patients undergoing CEA.This study demonstrated the safety and effectiveness of induced hypertension and hypotension technique.
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Objective To explore the changes of different brain regions of the human beings during completion of spatial working memory tasks under hyperthermia condition with functional magnetic yesonance.Methods Twenty-eight right-handed healthy young male volunteers were divided into control group and hyperthermia group randomly,and working memory task using block design was performed during behavioral test and fMRI scanning on both conditions.Activation intensity and location of different brain areas were compared in control and hyperthermia group.Results The activations of frontal,parietal,occipital and insular lobe were seen in both of the control group and the hyperthermia group.Right lateralization was shown in control group during spatial working memory (Li=0.05 1).While,in hyperthermia group the effect of the right lateralization significantly was enhanced (Li=0.103). Moreover,activation of bilateral middle frontal gyrus and right parietal lobe were significantly enhanced.Conclusion It is found for the first time that the hyperthermia could affect bilateral middle frontal gyrus and right parietal lobe,and enhance the effect of right lateralization in the spatial working memory task.
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OBJECTIVE@#To explore the feasibility of distortion product otoacoustic emission (DPOAE) used for hearing monitoring in the oto-neurosurgery operation.@*METHOD@#Twenty-four rabbits were equally divided into 3 groups: none operation (group A, n = 8); pressing the cerebella after the cerebellopontine angle was exposed (group B, n = 8); Blood flow of internal auditory artery were occlusion for 5 min after the facial-acoustic nerve complex was pressed(group C, n = 8). DPOAE value and histologic were observed.@*RESULT@#In the state of pressing the cerebellar and blood flow of inner hearing artery were occlusion, DPOAE amplitude values changed, part of the frequencies could not be induced, DPOAE amplitude values of induced frequencies descend and nael significant difference (P < 0.05) to preoperation, as well as correspond to histology changes.@*CONCLUSION@#DPOAE could monitor the hearing loss effectively and would be one of ideal monitoring methods in the oto-neurosurgery operation.
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Animals , Rabbits , Disease Models, Animal , Hearing Loss , General Surgery , Hearing Tests , Methods , Neurosurgery , Otoacoustic Emissions, Spontaneous , Otologic Surgical ProceduresABSTRACT
ObjectiveTo investigate the significance of synchronic heart rate variation(HRV) and blood pressure variation(BPV) in the evaluation of coronary artery disease(CAD).MethodsOne hundred and three patients who received coronary artery angiography were divided by the lesion degree into occlusion group (28 cases with more than 1 complete-occlusion coronary artery),non-occlusion group (45 cases with more than 1 coronary artery stenosis ≥50％ but without complete-occlusion) and control group (30 cases without stenosis ≥50％).Occlusion group and non-occlusion group were divided by lesion location into left anterior descending (LAD) lesion (32 cases),left circumflex ( LCF ) lesion (23 cases ) and right coronary artery(RCA) lesion (18 cases).And these two groups were also divided by lesion branch number into 1 lesion branch (23 cases),2 lesion branches (19 cases) and 3 lesion branches(31 cases).The time domain indexes of HRV were detected and calculated by 24 h dynamic blood pressutre and ECG,including standard deviation of normal number of R-R intervals (SDNN),standard deviation of per 5 min average normal R-R intervals(SDANNind),24 h average of standard deviation of per 5 min normal R-R intervals(SDNNind),root mean square of standard deviation of adjacent normal R-R intervals (rMSSD),and percentage of the difference of adjacent normal R-R intervals ＞ 50 ms (PNN50).And indexes of BPV were detected,including daytime systolic pressure standard deviation (dSSD),daytime diastolic pressure standard deviation (dDSD) and nighttime systolic blood pressure standard deviation (nSSD).The correlations between synchronic HRV and BPV and different coronary artery lesions were analyzed.ResultsSDNN,SDANNind significantly decreased and dSSD obviously increased with the aggravation of coronary stenosis,and there was statistical significance[ ( 115 ± 35 ) ms vs.(98 ± 25 ) ms vs.( 78 ± 28 ) ms,( 100 ± 30) ms vs.( 86 ± 23 ) ms vs.( 70 ± 29 )ms,(14 ± 3) mm Hg (1 mm Hg=0.133 kPa) vs.(20±4) mm Hg vs.(28±2) mm Hg](P＜0.05).rMSSD and PNN50 decreased,dDSD and nSSD increased with the aggravation of coronary artery stenosis,but there was no statistical significance (P＞0.05).SDNN and SDANNind in patients with LAD lesion and LCX lesion were significantly lower than those in control group,and dSSD was obviously higher than that in control group (P ＜ 0.01 or ＜ 0.05 ).SDANNind,rMSSD,PNN50,dDSD and nSSD in patients with LAD lesion and LCX lesion had no significant difference compared with those in control group (P ＞ 0.05 ).SDNN,SDANNind,SDNNind,rMSSD,PNN50,dSSD,dDSD and nSSD in patients with RCA lesion had no statistical significance compared with those in control group ( P ＞ 0.05 ).All the indexes of HRV tended to descend and indexes of BPV trended to raise with the increasing number of coronary artery lesion branches.But only the changes of SDNN,SDANNind,SDNNind,rMSSD,PNN50 and dSSD had statistical significance (P ＜ 0.05).Conclusions The more significantly HRV decreases and dSSD increases in patients with coronary artery disease,the more serious the coronary artery stenosis is and the wider the lesions are.The lesions are commonly located in LAD.It has certain guiding value for the evaluation of coronary artery diseases.
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0.05), there were significant statistic differences of any other two TI values (P0.05), there were significant statistic differences of any other two TI values (P0.05 ) , there were significant statistic differences of any other two TI values (P
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AIM: To investigate the effects of angiotensinⅡ receptor type Ⅰ antagonist irbesartan and angiotensin-converting enzyme inhibitor perindopril on the myocardial expression of connexin 43 (CX43), desmin and cardiac troponin T (cTnT) in the pressure overload-induced rat cardiac hypertrophy. METHODS: 40 male adult Sprague-Dawley rats were divided into 5 groups (8 animals for each): sham operation group and other four groups with ventricular hypertrophy caused by banding aortic artery. Drugs were given one week after operation as follows: sham operation group, normal saline (2 mL?kg~-1?d~-1 ig) was given; Operative groups: animals with ventricular hypertrophy were treated with normal saline 2 mL?kg~-1?d~-1 ig; Treatment groups: animals with ventricular hypertrophy were treated with perindopril 2 mg?kg~-1?d~-1 ig, irbesartan 20 mg?kg~-1?d~-1 ig or irbesartan 20 mg?kg~-1?d~-1 ig plus perindopril 2 mg?kg~-1?d~-1 ig, respectively. Left ventricular mass index (LVMI), transverse diameter of myocardial cell (TDM), and myocardial expression of CX43, desmin and cTnT by immunohistochemistry were performed at the end of 8 weeks of drug intervention. RESULTS: LVMI, TDM were remarkably decreased after drug intervention, compared to animals of operative group (P
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Objective: To explore postpartum MRI appearance and diagnostic value of MRI for placental implantation abnormality (PIA). Methods: Postpartum MRI findings of 11 PIA patients (mean age:28?4.5 years; range 23-25) were analyzed retrospectively. All patients underwent hysterectomy because their placentae were not discharged spontaneously, the postpartum hemorrhage added up to 800-4 500 ml and PIA was diagnosed by MRI 2-6 d after delivery. Results:Compared with the signal of the outer layer of the myometrium on the same scanning sequence, the placental signals appeared isointense or slightly hyperintense and the dividing line between the placenta and uterine wall was indistinct on T_1WI. On T_2WI the placental signal intensity was higher than that of the uterine wall. Placenta accreta showed that the placenta was confluent with the uterine wall and the junctional zone continued and the thickness of junctional zone was normal or slightly thinning. Placenta increta showed that the placental tissue invaded the myometrium in the shape of “triangle”, “nodule” or “mushroom”, and the junctional zone became thinner locally or discontinued. On Gadolinium-enhanced T_1WI, the intensity of placental enhancement was higher than that of uterine wall and the placental tissue was confluent with the uterine wall. The surgico-pathologic examination found 7 cases of placenta accrete and 4 cases of placenta increta. MRI diagnosis showed 8 cases of placenta accreta and 3 cases of placenta increta. There was one misdiagnosis by MRI. Conclusion: MRI is an ideal tool for postpartum diagnosis of PIA and can accurately evaluate placental configuration, the extent of placental accreta and the location and deepness of placental invasion.
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AIM: To observe the effects of irbesartan and perindopril on pressure-overload cardiac hypertrophy in rats. METHODS: 40 male adult Sprague Dawley rats were divided into 5 groups. One was sham operation group, other four were aortic banding groups. One week after operation, all rats were gavaged with normal saline, perindopril, irbesartan or combination of perindopril and irbesartan. Morphometric determination, calcineurin (CaN) expression, CaN and sarcoplasmic reticulum (SR) Ca 2+-ATPase activity were performed at the end of 6 weeks of drug intervention. RESULTS: Left ventricular mass index (LVMI), transverse diameter of myocardical cell (TDM), CaN activity were remarkably decreased after drug intervention and this decrease was most remarkable in the combination group. SR Ca 2+-ATPase activity increased after drug intervention, especially in the combination group. CaN expression in myocardium were remarkably decreased after drug intervention. LVMI was positively correlated with TDM and CaN, negatively correlated with SR Ca 2+-ATPase. CONCLUSION: Both irbesartan and perindopril decrease CaN activity, increase SR Ca 2+-ATPase activity and combination of them has synergic effects on regressing of ventricular hypertrophy.