基于Hausdorff距离的CARTO电解剖图与CT曲面配准

我们提出一种全自动、高精度的CARTO电解剖图(EAM)与CT曲面的配准算法。算法首先以基于主轴的方法粗配准EAM与CT曲面,然后再以基于Hausdorff距离的方法进一步实现EAM与CT曲面精配准。实验结果表明,相对Carto-Merge配准软件以及随机配准算法,基于Hausdorff距离的配准算法能获得更稳定且更精确的EAM与CT曲面配准效果,同时算法完全自动,基于Hausdorff距离的EAM与CT曲面配准算法能很好地满足房颤消融手术的临床应用需求。     

Principal axes based registration for CARTO electroanatomic map and CT surface

目的 为房颤消融提供全自动、高精度的心脏CARTO 电解剖图(electroanatomic map,EAM)与CT曲面配准算法.方法 遍历两图48种主轴对应关系,选择使得两图平均距离最小的一种,作为最终的配准结果.结果 相对临床常用的Carto-Merge影像整合软件,以及现有的随机算法,主轴配准无需任何人工操作,计算简单快速,配准精度高.结论 基于主轴的EAM与CT曲面配准算法能很好地满足临床房颤消融手术的需求.     

基于主轴的CARTO电解剖图与CT曲面配准

目的 为房颤消融提供全自动、高精度的心脏CARTO 电解剖图（electroanatomic map,EAM）与CT曲面配准算法.方法 遍历两图48种主轴对应关系,选择使得两图平均距离最小的一种,作为最终的配准结果.结果 相对临床常用的Carto-Merge影像整合软件,以及现有的随机算法,主轴配准无需任何人工操作,计算简单快速,配准精度高.结论 基于主轴的EAM与CT曲面配准算法能很好地满足临床房颤消融手术的需求.     

基于弹性模型的CT与CARTO电解剖图像的配准算法

提出一种全自动、高精度的CARTO电解剖图与CT曲面配准算法。该算法采用了由粗到精的配准策略。粗配准部分分两步:首先采用刚体变换模型以及迭代最近点法,初次配准EAM与CT曲面;然后选择仿射变换模型,再次配准EAM与CT曲面。在粗配准的基础上,以基于B样条的自由形变模型进一步精确配准EAM与CT曲面。实验结果表明,相对临床常用的Carto-Merge配准软件,基于弹性模型的配准算法获得了远高于前者的EAM与CT曲面配准精度,配准效果稳定;同时算法完全自动,不需要任何手工介入。     

标测点对基于主轴的CARTO电解剖图与CT曲面配准算法的影响

我们分析了标测点对基于主轴的CARTO电解剖图(EAM)与CT曲面配准算法的影响。在模拟的实验数据上,我们以实验的方法分别探讨标测点形变、标测点数量、标测点分布与主轴配准结果的关系。实验结果表明:主轴配准对标测点刚性形变完全鲁棒,同时也不受标测点数量的影响,但是标测点集的分布与配准精度显著相关。相对非均匀分布的点集,均匀分布的标测点集能获得更为稳定和高精度的配准结果,而且均匀分布的标测点能更好地还原真实心腔内表面。此结论对临床医生实施房颤消融手术有着重要的指导意义。     

CARTO XP系统中CARTO电解剖图的数据提取

利用CARTO XP系统指导心房颤动消融手术是当今临床研究的热点,手术消融的最终效果取决于心脏CT图像与CARTO XP系统生成的电解剖图的配准精度.然而,由于CARTO XP系统图像文件为专属的dicm格式,现有的DICOM浏览器只能读取三维CARTO电解剖图在某一体位的二维截图,相关研究非常少,数据格式的不兼容严重阻碍了心脏CT与CARTO电解剖图的算法研究.本文在详细阐述CARTO电解剖图像格式的基础上,给出用MATLAB提取相应数据信息的具体方法,然后根据标测点位置信息重建出心腔内壁关键点的三维点图.本方法避免了使用仿真软件绘制CARTO电解剖图形带来的主观性差异,为后续的配准算法研究提供了很好的实际数据支持.     

基于球形标记的多模态医学体配准

本文提出在医学多模态数据集（尤其是MRI和CT）中基于球形人造标记的体配准过程，此过程是半自动或是全自动完成的，半自动方法要求数据集中标出球形标记的近似点位置，再自动进行配准，全自动方法不需要用户的任何交互操作，即所有配准子任务（球体的分割，寻找两组球体的对应关系，最后把第一套球体映射成第二套球体的几何变换的计算）能由计算机自动执行，在全自动配准中，积聚器算法和迭代最近点算法的结合证明是一种有效的和鲁棒性好的点匹配方法。     

基于球形标记的多模态医学体配准

本文提出在医学多模态数据集 (尤其是 MRI和 CT)中基于球形人造标记的体配准过程。此过程或是半自动或是全自动完成的。半自动方法要求数据集中标出球形标记的近似点位置 ,再自动进行配准。全自动方法不需要用户的任何交互操作 ,即所有配准子任务 (球体的分割、寻找两组球体的对应关系、最后把第一套球体映射成第二套球体的几何变换的计算 )能由计算机自动执行。在全自动配准中 ,积聚器算法和迭代最近点算法的结合证明是一种有效的和鲁棒性好的点匹配方法     

手术导航中空间坐标系配准与注册研究

目的手术导航精度对手术的效果有着至关重要的影响,笔者研究了影响导航精度的因素,包括标志点的选取方法和注册算法。标志点的选取影响配准中两个空间相同目标点的选取,而注册算法影响利用这两组点进行空间配准的精度。方法首先分别阐述了在注册过程中基于点匹配和基于点云的迭代最近点(ICP)匹配点选取方法和注册算法,随后对它们的特点与原理进行分析,比较了其优缺点。提出一种基于点匹配的系统注册方法结合四元数坐标系配准方法,并通过实验验证该方法在将手术空间和图像空间配准时符合手术导航精度要求。同时,分析了这种系统注册方法将来存在的问题和研究方向。结果利用光学导航仪追踪注册模具上的反光球,得到模具内乒乓球的球心坐标,而后在CT图像中获取乒乓球的球心坐标,在Visual Studio中验证两组点的配准,实验结果表明误差在科学可接受范围内。结论这种新的系统注册模具可以用于手术导航注册,结合四元数法精度是符合手术导航精度的。     

精确锥形束CT和扇形束CT三维变形配准

自适应放疗可根据患者解剖和/或生理的变化对放疗计划进行修正。与加速器集成的锥形束CT成像装置是最普遍的在线影像获取设备。但是,由于锥形束CT固有的电子散射,重建影像的电子密度不准确,使得通常采用的基于密度的配准算法配准计划扇形束CT和在线获取的锥形束CT影像时,会产生较大的配准误差。我们通过建模图像变形配准问题为一个求解梯度距离能量泛函的极值问题,然后通过变分法和Gauss-Seidel方法获得一种新型的基于梯度信息的变形配准算法的迭代公式。该方法在迭代过程中同时考虑梯度信息的吻合和变形场的连续性,产生准确光滑的变形场。此算法迭代公式的局部特性,使其便于并行实施。通过OpenCL编程将此算法在图形处理器(GPU)上并行实施,大大缩短了配准时间。利用配准结果结合flood filling和cubic matching算法,可以快速地完成在线器官映射。算法临床数据配准结果表明,本文提出的基于梯度场的配准算法与基于密度的算法相比可以更准确地配准临床锥形束CT和扇形束CT影像。由于配准可以在很短的时间内完成,配准结果可用于在线器官映射和在线重新计划优化。     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

Beta-endorphin and drug-induced reward and reinforcement

Although drugs of abuse have different acute mechanisms of action, their brain pathways of reward exhibit common functional effects upon both acute and chronic administration. Long known for its analgesic effect, the opioid beta-endorphin is now shown to induce euphoria, and to have rewarding and reinforcing properties. In this review, we will summarize the present neurobiological and behavioral evidences that support involvement of beta-endorphin in drug-induced reward and reinforcement. Currently, evidence supports a prominent role for beta-endorphin in the reward pathways of cocaine and alcohol. The existing information indicating the importance of beta-endorphin neurotransmission in mediating the reward pathways of nicotine and THC, is thus far circumstantial. The studies described herein employed diverse techniques, such as biochemical measurements of beta-endorphin in various brain sites and plasma, and behavioral measurements, conducted following elimination (via administration of anti-beta-endorphin antibodies or using mutant mice) or augmentation (by intracerebral administration) of beta-endorphin. We suggest that the reward pathways for different addictive drugs converge to a common pathway in which beta-endorphin is a modulating element. beta-Endorphin is involved also with distress. However, reviewing the data collected so far implies a discrete role, beyond that of a stress response, for beta-endorphin in mediating the substance of abuse reward pathway. This may occur via interacting with the mesolimbic dopaminergic system and also by its interesting effects on learning and memory. The functional meaning of beta-endorphin in the process of drug-seeking behavior is discussed.     

PTEN与信号转导及肿瘤

ＴＥＮ[1] (ｐｈｏｓｐｈａｔａｓｅａｎｄｔｅｎｓｉｎｈｏｍｏｌｏｇｙｄｅｌｅｔｅｄｏｎｃｈｒｏｍｏｓｏｍｅｔｅｎ)又名ＭＭＡＣ1 [2 ] (ｍｕｔａｔｅｄｉｎｍｕｔｉｐｌｙａｄａｎｃｅｄｃａｎｃｅｒ 1 )和ＴＥＰ1 [3 ] (ＴＧＦ -βｒｅｇｕｌａｔｅｄａｎｄｅｐｉｔｈｅｌｉａｌｃｅｌｌ -ｒｉｃｈｅｄｐｈｏｓｐｈａｔａｓｅ 1 ) (以下均称为ＰＴＥＮ) ,是 1 997年由 3个研究小组先后发现的一个具有双特异磷酸酶活性的抑癌基因。ＰＴＥＮ基因异常广泛存在于人类多种恶性肿瘤 ,如恶性神经胶质瘤、前列腺癌、子宫内膜癌、黑色素瘤等…     

Tobacco and alcohol and the risk of head and neck cancer

Summary We carried out two case-control studies on the relative risk of head and neck cancer in association with tobacco and alcohol consumption. The first study carried out at the ENT Department of the University hospitals of Heidelberg and Giessen (FRG) comprised 200 male patients with squamous cell cancer of the head and neck and 800 control subjects matched for sex, age, and residential area (1:4 matching design). Of the tumour patients, 4.5% had never smoked, in contrast to 29.5% of the control group. The average tobacco and alcohol consumption of the patients was approximately twice as high as in the control subjects. The highest alcohol and tobacco consumption was observed in patients suffering from oropharyngeal cancer. Tobacco and alcohol increased the risk of head and neck cancer in a dose-dependent fashion and acted as independent risk factors. In heavy smokers (> 60 pack-years) a relative risk of 23.4 (alcohol adjusted) was calculated. Combined alcohol and tobacco consumption showed a synergistic effect. The risk ratio increased more in a multiplicative than in an additive manner. Oral and laryngeal cancer were associated with the highest tobacco-associated risk values. The highest ethanol-associated risk values were associated with oropharyngeal and laryngeal cancer. The second study was carried out at the ENT Department of the University of Heidelberg on 164 males with squamous cell carcinoma of the larynx and 656 control subjects matched for sex, age and residential area (1:4 matching design). Of the cases, 4.2% had never smoked, compared with 28.5% of the control subjects. The risk of laryngeal cancer by tobacco consumption was dose dependent, reaching a maximum value of 9.1 (adjusted for alcohol) for a consumption of more than 50 tobacco-years (TY). The relative risk of laryngeal cancer associated with alcohol intake was also dose dependent, reaching a value of 9.0 (adjusted for tobacco) for a mean daily consumption of more than 75 g alcohol. An analysis of subsite specific risks showed that heavy smokers (> 50 TY) carried a nearly ten times higher risk of supraglottic cancer than of glottic cancer. The risk of supraglottic cancer from alcohol consumption was also higher than that of glottic cancer.     

Postinfectious immunodeficiency and autoimmunity: pathogenic and clinical values and implications

Autoimmunity is still a mystery of clinical immunology and medicine as a whole. The etiology and pathogenesis of autoimmune disorders remain unclear and, thus, are assessed as a balance between hereditary predisposition, triggering factors and the appearance of autoantibodies and/or self-reactive T cells. Among the immunological armamentarium, molecular mimicry, based on self-reactive T- and B-cell activation by cross-reactive epitopes of infectious agents, is of special value. Hypotheses regarding the possible involvement of molecular mimicry in the development of postinfectious autoimmunity are currently very intriguing. They provide new approaches for identifying etiological agents that are associated with postinfectious autoimmunity, paired microbial- and tissue-linked epitopes targeted for autoimmune reaction determination, postinfectious autoimmunity pathogenesis recognition and specific prevention, and therapy for autoimmune disorder development.     

类赖氨酰氧化酶2与肿瘤转移和发生

类赖氨酰氧化酶2(lysyl oxidase-like 2,LOXL2)是赖氨酰氧化酶(lysyl oxidase,LOX)基因家族的成员之一,其表达产物能促进胶原沉积.LOXL2的过表达能促进纤维化,并与肿瘤侵袭、转移及不良预后有关.目前大部分学者认为LOXL2是一种转移促进基因,也有实验支持其是一种肿瘤抑制基因.研究发现LOXL2可以通过激活Snail/Ecadherin通路或Src/FAK通路促进转移.LOXL2有望作为肿瘤生物标志物,用于预后判断,成为一个新的治疗靶点.     

Muscle strength and serum testosterone,cortisol and SHBG concentrations in middle-aged and elderly men and women

Forty healthy males (M) and females (F) divided into two different age groups i.e. M50 years (range 44–57; n= 9), F50 years (range 43–54; n= 9), M70 years (range 64–73; n= 11) and F70 years (range 63–73; n= 11) volunteered as subjects for examination of muscle cross-sectional area (CSA) and maximal voluntary isometric force production characteristics of the leg extensor muscles and serum androgen and sex hormone binding globulin (SHBG) concentrations. The CSA in the male groups was greatly larger (P < 0.01) than in the female groups and both elderly groups demonstrated slightly (n.s.) smaller values in the CSA than the two middle-aged groups. Maximal force of 2854 ± 452 N in M50 was greater (P < 0.05) than that of 2627 ± 752 N recorded for F50 as well as the force of 2787 ± 843 in M70 was greater (P < 0.001) than that of 1849 ± 295 recorded for F70. The force between F50 and F70 differed significantly (P < 0.05) from each other. The maximal rate of force production in M50 was greater (P < 0.01) than in F50 as well as in M70 greater (P < 0.001) than in F70. Both middle-aged groups demonstrated greater (P < 0.05) values than the respective elderly groups of the same sex. The individual values in the CSA correlated with the values in maximal force both in the middle-aged subjects (r= 0.66; P < 0.01) and in the elderly subjects (r= 0.69; P < 0.01). The mean concentration of serum testosterone in M50 was slightly (n.s.) greater than in M70 and in F50 significantly (P < 0.05) greater than in F70. Serum SHBG levels were lower in the males (P < 0.01) than in the females and serum testosterone/SHBG ratio in M70 and in F70 were lower (P < 0.05) than in M50 and in F50, respectively. In the females significant positive correlations were observed between the individual values in serum testosterone concentration and the values both in the CSA (r= 0.46; P < 0.05) and in maximal force (r= 0.62; P < 0.01) as well as between serum testosterone/SHBG ratio and both the CSA (r= 0.55; P < 0.05) and maximal force (r= 0.68; P < 0.01). The present results imply that the decreasing basal level of blood testosterone over the years in aging people, especially in females, may lead to decreasing anabolic effects on muscles thus having an association with age-related declines in the maximal voluntary neuromuscular performance capacity in aging people.