电子束CT三维重建在髋臼骨折诊断与治疗中的应用

目的　探讨EBCT (电子束CT)三维重建在髋臼骨折诊断和治疗中的作用。方法　 12例髋臼骨折患者均行骨盆平片、EBCT平扫及三维重建检查 ,其中 7例行手术 ,比较以上三种方法的检查及术中情况 ,以显示各自的诊断价值。结果　①骨盆平片只能显示髋臼骨折 ,不能确定骨折类型。②EBCT平扫可以明确骨折类型 ,但需要阅片者有良好的空间思维能力 ,并熟悉髋臼周围的解剖结构。③EBCT三维重建可以得到髋臼骨折最直观、最全面的图象。结论　骨盆平片诊断髋臼骨折是粗浅的 ,对制定治疗方案帮助有限 ;EBCT平扫能显示骨折的详细情况 ,并由此选择合适的治疗方法 ,但要制定具体的手术方案 ,需要临床医生有丰富的阅片经验 ;EBCT三维重建对制定详细的手术计划可提供正确指导 ,是目前最理想的诊断髋臼骨折的方法。     

冠状动脉钙化对有和无高血压者全因病死率的影响

冠状动脉钙化(CAC)已成为对冠状动脉心脏疾病的风险一个重要的预后指标。本研究的目的是评估CAC负担增加对于有和无高血压(HTN)者的影响。研究对象包括没有已知的冠状动脉心脏疾病的无症状44 052连续个体,接受电子束CT(EBT)检查评估亚临床动脉粥样硬化状况。术后随访平均为(5.6±2.6)年(范围1～13年)。队列研究的主要终点是任何原因     

电子束CT检测的冠状动脉钙化诊断冠心病的价值

目的:探讨电子束CT(EBCT)检测确定的冠状动脉钙化(CAC)诊断冠心病的价值。方法:同期行EBCT和ECG检查的临床怀疑或确诊的冠心病患者420例,其中:同期行超声心动图(UCG)检查195例,作选择性冠状动脉造影56例,作3种检查的有38例。结果:CAC率和积分(SC)在ECG、UCG各组中差异均有显著性(P<0.01~<0.001)。CAC、CS在冠脉造影显示的不同狭窄程度与病变支数各组中有显著差异(P<0.05~<0.01)。CAC诊断的敏感性、特异性和准确分别达到79.3％、74.1％、76.8％,均显著高于ECG、UCG组(P<0.05)。结论:EBCT检测的CAC诊断冠心病的准确性等指标高于ECG、UCG法。     

动脉粥样硬化的影像诊断新进展

动脉粥样硬化好发于大动脉和冠状动脉，是高血压和冠心病的发病基础，也是引起缺血性脑血管病的主要病因。颈动脉和主动脉由于管腔较大，其粥样硬化斑块更容易被常规的影像检查手段所发现，而冠状动脉粥样硬化斑块的检测是在近年来血管内超声和电子束CT等新技术的产生后才得以快速发展。作者就超声、CT和核磁共振在诊断动脉粥样硬化的新进展方面作一综述。     

原发性心脏心包恶性肿瘤的影像学评价

目的分析原发性心脏心包恶性肿瘤的影像学特征,评估几种常用的影像学诊断方法的主要优势及局限性.方法搜集1979年1月～2004年3月来手术、病理资料证实的原发性心脏恶性肿瘤29例,除1例急诊手术无X线胸片,其余均行胸片及超声检查,接受电子束CT(EBCT)检查6例,MRI5例.结果X线平片示异常26例,超声心动图(UCG)诊断肿瘤28例,1例因大量心包积液漏诊.MRI和EBCT均检出肿瘤、所见与手术探查一致性好.结论X线胸片适合做常规检查,UCG可做首选初查且对心腔或心包腔内的肿瘤诊断准确率高;因各种恶性肿瘤缺乏特征性表现,EBCT和MRI除提供肿瘤及其与毗邻组织的解剖关系外,组织学定性困难.     

3D打印多孔钛支架微观孔隙结构和力学性能

目的研究3D打印技术制造的钻石分子结构多孔钛支架的微观孔隙结构和力学性能,指导3D打印多孔钛骨科植入物的开发。方法采用选择性激光熔化(selective laser melting,SLM)和电子束熔化(electron beam melting,EBM)两种金属3D打印制造工艺,制造钻石分子结构多孔Ti6Al4V支架。使用光学显微镜和扫描电镜观察其微观孔隙结构,并使用万能材料试验机对这些支架进行压缩测试。结果两种3D打印制造工艺都会存在加工误差,并且在表面存在半熔融金属颗粒。SLM工艺相对误差为20.9%~35.8%。EBM工艺相对误差为-9.1%~46.8%,且制造不出杆件宽度为0.2 mm的支架。SLM工艺制造的支架抗压强度为99.7~192.6 MPa,弹性模量为2.43~4.23 GPa。EBM工艺制造的支架抗压强度为39.5~96.9 MPa,弹性模量为1.44~2.83 GPa。结论 SLM工艺比EBM工艺制造精度高。支架的孔隙率是影响其抗压强度和弹性模量的主要因素,相同工艺的情况下,孔隙率越大,抗压强度越小,弹性模量也越小;相近孔隙率的情况下,SLM工艺比EBM工艺强度高,弹性模量也高。     

乳腺癌全乳腺切除术后胸壁电子束照射的研究

目的 探讨乳腺癌全乳腺切除术后胸壁电子束照射的疗效.方法 回顾分析1999-2007年间全乳腺切除术后进行胸壁6 MeV电子束照射及锁骨上下区淋巴结引流区6～8 MV X线和12～15 MeV电子束混合照射患者280例资料,并与同期胸壁6～8 MV X线切线野照射118例进行比较.结果 随访率为93.2%,随访满5、10年者分别为140、12例.电子束组和X线组的5、10年胸壁复发率分别为6.8%和5.0%、14.8%和10.1%(X2=1.12,P=0.290),5、10年无瘤生存率分别为60.6%和65.5%、47.6%和57.3%(X2=0.97,P=0.325),5、10年总生存率分别为77.5%和79.6%、48.4%和53.3%(X2=0.37,P=0.545),>2级皮肤急性不良反应率分别为10.4%和16.9%(X2=3.34,P=0.090),肺纤维化率分别为28.8%和22.1%(X2=1.27,P=0.300).结论 乳腺癌全乳腺切除术后胸壁电子束照射的肿瘤控制率及不良反应与胸壁切线野照射无差别.

Abstract：

Objective To evaluate the effcacy of electron-beam chest-wall irradiation in patients with breast cancer after mastectomy.Methods From June 1999 to December 2007,280 women with localized breast cancer received postmastectomy radiotherapy using electron beam to chest wall.The effcacy and toxicity of these 280 women was compared with 118 women treated during the same period using tangential field with photon beam.Results The follow-up rate was 93.2%.140 patients had a minimum followed up time of 5 years and 12 patients had a minimum follow up time of 10 years.The 5-year and 10-year chest wall recurrence rates were 6.8%and 5.0%.14.8%and 10.1%for patients irradiated with electron and photon(X2=1.12,P=0.290).The corresponding 5-year and 10-year disease-free survival rates were 60.6%and 65.5%,47.6%and 57.3%(X2=0.97,P=0.325).The 5-year and 10-year overall survival rates were 77.5%and 79.6%,48.4%and 53.3%(X2=0.37,P=0.545).Grade Ⅱ or more acute skin toxicity occurred in 10.4%and 16.9%of patients irradiated with electron and photon(X2=3.34.P=0.090).Pulmonary fibrosis developed in 28.8%and 22.1% of patients irradiated with electron and photon(X2=1.27,P=0.300).Conclusion Electron-beam chest-wall irradiation is as effective as photon-beam irradiation in breast cancer after mustectomy.     

可控微结构电子束熔化成形钛合金支架作为成骨细胞载体修复兔骨缺损的研究

Objective To evaluate effects of titanium alloy scaffolds with controlled internal architecture as an osteoblast carrier on bone response in models of rabbit defects. Methods Electron beam melting process was utilized to fabricate porous titanium alloy scaffolds with fully interconnected and controlled internal pore architecture. After osteoblasts were seeded on the scaffolds and cultured for up to 7 days, the growth of rabbit osteoblasts on the scaffolds was observed by scanning electron microscopy. The experiment was conducted in 4 groups to evaluate the bone formation in vivo: group A (cell/scaffold composite), group B (scaffold only), group C (left empty) and group D (autogenous bone implant) . The scaffolds were transplanted into the rabbit defects after cultured in vitro for 7 days. The animals were sacrificed at 4, 8, and 12 weeks after implantation. Bone formation in the scaffolds was investigated by gross observation, histology and histomorphometry of non-decalcified sections and fluorochrome markers. Results Confluent cell layers could be observed on the scaffold surface and in the internal pores after 7 days of incubation in vitro. New bone growth and revascularization could be observed not only at the margins of the scaffolds, but also inside the central pores of the scaffolds after 12 weeks. New bone formed along the controlled internal channels of the scaffolds. The scaffolds were filled fully with the new bone tissue and blood vessels. More extensive new bone formation was found to originate from the host bone towards the implant in group A than in group B (P ＜0. 05) . Conclusions The controlled scaffolds are well biocompatible enough to accelerate healing of rabbit defects and new bone formation. The controlled honeycomb-like architecture may guide and promote the formation of mineralized tissue.     

可控微结构电子束熔化成形钛合金支架作为成骨细胞载体修复兔骨缺损的研究

目的 探讨可控微结构电子束熔化成形钛合金支架作为成骨细胞载体修复兔骨缺损的可行性.方法 应用电子束熔化成形技术制备支架,将成骨细胞与支架复合培养7 d后,通过扫描电镜观察细胞与材料复合情况.将培养7 d的支架/细胞复合物及单纯支架植入兔体内.72只雄性新西兰白兔均制作骨膜-骨缺损模型后随机分为4组(n=18):A组缺损处植入细胞/支架复合物,B组缺损处植入单纯支架,C组缺损处旷置,D组缺损处置入自体骨.分别在第4、8、12周取材,行大体观察、四环素荧光标记、组织学观察以及新生骨定量分析等评价新骨形成及缺损愈合情况.结果 支架与细胞体外共培养7 d后,支架表面及内部孔隙有大量细胞黏附并与材料牢固结合.第12周,新生骨组织和血管不仅在支架周围有生长,而且沿着支架的管道结构向支架内部生长并逐渐填满支架内部,新生骨组织与支架牢固结合并形成一个相互嵌合的复合体.新生骨定量分析显示:第4周,各组间两两比较,差异均无统计学意义(P＞0.05).第8周,A组分别与B、C组比较,差异均有统计学意义(P＜0.05);D组分别与B、C组比较,差异均有统计学意义(P＜0.05).第12周,组间两两比较,差异均有统计学意义(P＜0.05).结论 可控微结构电子束熔化成形钛合金支架具有良好的生物相容性,能够促进支架内新骨生成及缺损的愈合.     

SterStar系统：电子束辐射技术在医药行业的新应用

讲述SterStar系统在医药产业的应用。由Linac Technologies公司研制的SterStar系统是一种利用了电子束辐射技术的消毒系统,它可以用来对即将进入无菌区的产品的外表面进行消毒以降低微生物污染风险。此系统的优势在于它能够实现产品的大量的、连续的、无菌的转移。