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【Objective:】 To understand the current status and related impacts of medical risk perception and treatment decision-making in preoperative patients with malignant tumors. 【Methods:】 The 350 malignant tumor patients who were hospitalized for surgical treatment in two tertiary hospitals in Liaoning Province were selected. The general information questionnaire, medical risk perception questionnaire, and participation in treatment decision-making questionnaire were used as survey tools. SPSS26.0 software, data statistical methods such as the Kappa test and multiple linear regression were used to analyze valid data. 【Results:】 Among the 350 subjects, the mean scores of the actual level of participation in treatment decision-making and attitude towards participation in treatment decision-making were(1.75±0.50) and(1.56±0.52), respectively, and the consistency between them was poor(Kappa=0.134, P<0.001). The total score of medical risk perception in preoperative patients with malignant tumors was(57.13±16.2). The results of multiple linear regression analysis showed that the actual degree of patient participation in treatment decision-making was influenced by the experience of surgical treatment(β=-1.744, P<0.05), economic risk in medical risk perception(β=0.478, P<0.05), and time risk (β=0.478, P<0.05). Economic risk in medical risk perception(β=0.043, P<0.05), time risk (β=0.646, P<0.05), and psychological risk(β=-0.329, P<0.05) were the influencing factors of patients’ attitude towards participating in treatment decision-making. 【Conclusion:】 Medical professionals should pay more attention to the influence of medical risk perception of malignant tumor patients on treatment decision-making. Malignant tumor patients should fully exercise their right to choose treatment plans independently, and jointly improve the actual level and attitude of the group when participating in treatment decision-making.
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ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.
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Objective To investigate the effects of protein active composition of Scorpio on apoptosis of L1210 tumor cells for the purpose of establishing the quality evaluation method of biological effect of Scorpio. Methods L1210 cells were examined by trypan blue exclusion. The proliferation of cells was determined by improved MTT assay. Flow cytometry was performed to analyze cell apoptosis with propidium iodide (PI). Results When the concentration of protein active composition of Scorpio exceeded or equaled 37 mg/ml, the coefficient correlation of the growth inhibiting curve of L1210 cells was 0.9357, and IC50 was 175 mg/ml. The excellence time was 0 to 48 hours. When the concentration of protein active composition of Scorpio exceeded or equaled 9.25 mg/ml, the apoptosis ratio of L1210 cells was raised significantly.Conclusion The protein active composition of Scorpio might promote the apoptosis and restrain the proliferation of L1210 cells. The value of anti-tumor biological effect of the protein active composition of Scorpio was 9.25 ～ 175 mg/ml. This value may be one of the indexes for quality evaluation of biological effect of Scorpio.
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[Objective]To establish digitized visible model of the wrist joint.[Method]Coronal sect ional images of a series of 0.2 man-thick cryosecfions of wrist joint specimens were obtained.After registration and segmentation,the three-dimensional computerized reconstruction of the carpal bone and arch-ligament and its adjacent structures were performed on PC.[Result]For reconstructed Successfully 3D the structures model of wrist joint its adjacent 28 structures.This model can be displayed with single structure and its adjacent structures for wrist joint and can be displayed with several structures in different color and hyalinize.And it can be displayed from any direct ion.Moreover all structures can be measured through angle or line from any direction.[Conclusion]Three-dimensional reconstruction model of the wrist joint demonstrate the relation of anatomy between the carpal bone and ligament by poly-point of view and is meaningful for operations of the wrist joints.
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BACKGROUND: Percutaneous laser disk decompression(PLDD) is a new interventional therapy of lumbar disk herniation recently. Posterior lateral route is often employed. Puncture route was investigated by the application of anatomic methods previously. However, there are relative fewer reports regarding the observation of the route of lumbar nerve root in intervertebral plane and triangle working area from thin section anatomy and CT section anatomy.OBJECTIVE: To clarify the intervertebral route and its adjacent relationship of lumbar nerve root on thin section and CT section to provide a anatomic gist for puncture route in PLDD.DESIGN: An observational study based on corpus and normal individual.SETTING: Department of radiology of a military medical university of Chinese PLA affiliated hospital and the department of anatomy of a military medical university of Chinese PLA.PARTICIPANTS: The collection of the first Chinese visible human was completed in the Department of Anatomy(laboratory of computer medicine) the Faculty of Medicine, Third Military Medical University of Chinese PLA in October 2002. Totally 53 subjects without confirmed vertebral and intervertebral disc diseases and other diseases of the adjacent organs received CT examination and measurement in the Department of Radiology of the Third Military Medical University of Chinese PLA Affiliated Southwest Hospital between january and March 2000.INTERVENTIONS: The intervertebral route of lumbar nerve root in the first Chinese visible human was observed descriptively. The route, morphology, size, adjacent structure, and the distance between puncture line and lumbar nerve in 53 normal individuals were observed and measured by CT.MAIN OUTCOME MEASURES: To describe the intervertebral route of lumbar nerve root in the first CVH and normal individual, to measure the intervertebral length and width of lumbar nerve, and the distance between puncture line and lumbar nerve.RESULTS: The first Chinese visible human lumbar has 48 layers of intervertebral space with a thickness of each layer of 1.0 mm. The route and adjacent structure of lumbar nerve displayed in each section were clear. CT image clearly showed the intervertebral route, size and adjacent structure of lumbar nerve root.CONCLUSION: The first Chinese visible human lumbar nerve root intervertebral route is a continuous and intact thin section specimen. The intervertebral route and morphology of lumbar root nerve have great alterations. The relationship between puncture route and its adjacent lumbar nerve root, anterior articular process, ilium wing and vessels is very close.
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Objective To establish more detailed dataset of Chinese visible human male. Methods After undergoing macroscopical, CT and MRI examinations to exclude organic lesion, a young aged, middle sized male cadaver was selected as the subject. First, morphological measurement and vascular perfusion were performed. Second, after embedding with 5% gelatin, the cadaver was put in ice house and frozen to -30 ℃ for 1 week. Third, TK 6350 numerical control milling machine (milling accuracy of 0.001 mm) was used to shave off slices of the body layer by layer from head to foot at -25 ℃ in low temperature laboratory. Fourth, the successive cross sections were photographed with high resolution digital camera and scanned into an animation computer. Thus, data acquisition from cadaver model was completed to obtain structural dataset of the human body. Results The selected sample was a 21 year old, 1 820 mm in height, 66 kg in weight male died due to non organic disease. CT with 1.0 mm slice thickness for the head and neck and 2.0 mm for the rest of the body was performed. MRI with 1.5 mm slice thickness for the head and neck and 3.0 mm for the rest of the body was also performed. A total of 18 398 serial cross sections with the thickness of 0.1 mm of each section were obtained. The digital photographs were sampled at a resolution of 10 989 056 (4 064?2 704) pixels. The data file of each section occupies 62.9 MB. The complete data files occupy 1 157.23 GB. The research results are issued simultaneously on the Internet (http://www.chinese visiblehuman.Conclusion ① Review of the related literatures reveals that the thinnest thickness of the reported cross section of the visible human dataset is 0.2 mm(the thickness of the sections of the skull base of the first case of Chinese visible human reported by our research group is 0.1 mm.), and the slices consist of several thousands of serial cross sections with several millions of pixels. The data files occupy several tens of GB or more than 100 GB. However, the thickness of the cross sections of the whole body of the dataset achieved in our research is 0.1 mm. The total slices consist of 18 398 serial cross sections with the photographic resolution of 11 million pixels and the total data file reaches 1 157.23 GB. The three indexes mentioned above are elevated by 1 log unit. ② We have solved the key technical problems in data acquisition of visible human such as super thin serial cross sectioning, enormous quantity of data storing and display of tiny blood vessels.
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Objective To achieve computer visualization of the first Chinese visible male and female Methods After acquisition of the dataset of the first Chinese visible male and female (2 518 cross sections were obtained from the visible male, the complete data files take up 90 468 GBs; while 3 640 cross sections from the female, the complete data files take up 131 04 GBs ), we processed 2 D images in an SGI Workstation and on P4 computer respectively Then, image registration was performed through reserved scaling point Reconstruction was achieved by two approaches: volume rendering reconstruction and surface rendering reconstruction Results We visualized the whole body and special parts of Chinese visible male and female on an SGI Workstation and a personal computer respectively Furthermore, by optimizing 3 D reconstruction and data processing technique, interactive 3 D visualization of the dataset was achieved Conclusions ①The dataset of the first Chinese visible male and female proves to be eligible for 3 D visualization research ②The platform setup of interactive 3 D visualization of Chinese visible male and female dataset provides foundation for digital human anatomy and virtual surgery ③The models of human organs and parts built through data segmentation, classification, registration and drawing lay basis for rendering complex structures of the whole human body delicately
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Objective Building the digitized anatomical model of human cerebrum for providing platform for exact simulation of cerebrum on the computerized and functional study of cerebrum.Methods Visible human technique was used to collect human cerebrum data.The main structures of cerebrum were reconstructed and visualized on personal computer by using the software for tridimensional reconstruction exploited by our research group and the VR software provided by the Chinese University of Hong Kong.Results A three-dimensional digitized anatomical model of human cerebrum based on the midpoint of the intercommissural line was established.Each element of the model was associated with a nametag.According to initial transverse sectional images,we can display sagittal,coronal,and other directional sections of cerebrum by computerized 3D reconstruction;and the reconstructed cerebral structures can be measured in 3D space.Conclusion Each voxel of the model is assigned a nametag and the model has tridemensional coordinate system on the midpoint of intercommissural line,often used in clinic,which made the model be used for visualization in surgical planning,for model driven segmentation and for the teaching of neuroanatomy.
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Objective To build the dataset of Chinese visible human female. Methods After undergoing macroscopical, CT and MRI examinations to exclude organic lesions, a young female cadaver of medium height was selected as the subject. After morphological measurement and vascular perfusion, the cadaver was embedded with 5% gelatin and cryopreserved in a -30 ℃ icehouse for 1 week. A digital milling machine TK 6350 (milling accuracy of 0.001 mm) was used to shave off slices of the body layer by layer from head to foot in a laboratory at -25 ℃. The successive cross sections were photographed with a high definition digital camera, and the pictures were put into a computer to establish a dataset of human body. By utilizing the image dataset derived from the successive cross sections, 3D reconstruction and stereodisplay of human structure were finished with a SGI Workstation which was equipped with an independently self developed software package for 3D reconstruction. Results The selected specimen, a 22 year old female native of Chongqing, was 1 620 mm in height, 54 kg in weight and died of non organic disease. CT scans were made in every 1.0 mm for head and neck and every 2.0 mm for rest parts, and the thickness for MRI scans was 1.5 mm for head and 3.0 mm for rest parts. For serial cross sections, the thickness was 0.25 mm for head and 0.5 mm for rest parts. Thus, a total of 3640 slices were obtained, and the photo for every slice was saved as a 36 MB file in a resolution of 6 291 456 pixels (3 072?2 048). Finally, the complete data files reached to 131.04 GB. Conclusion ① This is the first formally reported case of Chinese visible human female, suggesting that China becomes the second country owning visible human female dataset of her population. We set up a website for the purpose of exchanging ideas and information on this subject. So, the results are issued simultaneously on the Internet (http://www.chinesevisiblehuman.com).② According to US Visible Human Project(VHP), the data of the 3 junctional parts of their female cadaver were absent because the body was cut into 4 segments. Taking the age of 59 year old into account, the visible human female's body was not exactly perfect. The sections of 0.33 mm in thickness were saved to pictures at a resolution of 2 490 368 pixels (2 048?1 216). While, the first Chinese visible human female reported here is a young female without organic disease or lesion. No sectional datum is lost for being acquired from successive sections of the whole body. The resolution of cross sectional image reaches to 6 291 456 pixels (3 072?2 048).
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Objective To provide anatomic proof for the localization in neck operation and clinical diagnosis of infection and tumor infiltration. Methods A total of 15 cadaver heads and necks were sectioned on transverse plan with cryosection. The layers and characteristics of the deep cervical fascia were observed. Results The deep cervical fascia was divided into four layers with the fasciae of the infrahyoid muscles being a single layer. The deep layer of the deep cervical fascia was subdivided into alar fascia and prevertebral fascia. The carotid sheath was composed of all the layers of the deep cervical fascia. Conclusion The model figure of the deep cervical fascia is obtained.