数字化技术对半侧颜面萎缩修复皮瓣的选择应用

目的 探讨数字化技术在半侧颜面萎缩畸形治疗中皮瓣设计选择的临床应用价值. 方法 半侧颜面萎缩侧患者7例,术前行CT血管成像扫描,应用Mimics 14.3软件对畸形部位进行三维重建,设计修复所需要的骨组织、软组织块.根据供区、受区的血管直径,选择背阔肌皮瓣4例、股前外侧皮瓣3例,采用快速成型打印缺损块,根据设计方案完成手术. 结果 移植7例皮瓣成活,修复半面萎缩外形良好,术后随访3年,皮瓣外观良好,效果确切. 结论 采用数字化技术进行术前模拟设计手术,可前瞻性了解手术效果,能够精确切取皮瓣范围,并可以避免术中血管吻合时受区、供区不匹配现象,保证了皮瓣的成活,具有实用价值.     

基于物质流分析的丹红注射液制药过程质量控制研究

[目的] 通过研究丹红注射液生产过程的中间工序物料化学成分分析数据和紫外光谱分析数据,阐明生产过程中各成分的含量变化与转移规律,辨析关键生产工序和关键质控指标,建立各个工序的质量监测模型以保障丹红注射液质量一致性。[方法] 收集丹红工业生产数据32个批次7个工序中间产品物料,以高效液相色谱法(HPLC)测定9个主要化学成分含量,并同时采集紫外光谱数据。通过分析各化学成分的相对标准偏差,确定各个成分含量的批次间一致性。通过各个化学成分在每个工序中的收率与物料衡算分析,确定各工序对成分变化的影响及相应的变化原因。以主成分得分、Hotelling-T2、DModX等指标,建立并比较了丹红注射液各工序的基于HPLC数据和紫外光谱数据的质量监测模型。[结果] 丹红注射液主要化学成分在各个工序中均具有较好的批次间质量一致性,RSD均在10%以内。物料衡算结果显示丹酚酸A存在化学转化,其他成分以物理转移为主。以HPLC和UV光谱数据建立了丹红注射液各工序的生产监测模型。[结论] 丹红注射液制药过程物质流分析可以明确药效物质的含量变化与转移规律,辨析关键生产工序和关键质控指标,并以此建立质量监测模型。     

全数字化乳腺X线立体定位及切除技术对触诊阴性乳腺病灶的应用

目的：探讨全数字化乳腺X线立体定位及切除技术对触诊阴性乳腺病灶的应用价值。方法对146例乳腺触诊阴性病灶行X线检查确定病灶位置,采用导丝立体定位乳腺病灶,根据定位导丝指引完整切除病灶及定位导丝,切除标本行X线检查,证实预定病灶已完整切除,标本做病理检查,确定病灶的病理类型。结果146例乳腺病灶中乳腺癌21例,占14.38%（21/146）,癌前病变（非典型增生17例,导管内乳头状瘤病6例）共23例,占15.75%（23/146）,良性病变102例,占（69.86%,102/146）。结论立体定位切除活检对触诊阴性乳腺病灶定位准确,可以早期发现乳腺癌及癌前病变,对提高乳腺癌的早期诊断率、提高乳腺癌的二级预防具有一定的临床应用价值。     

胸部创伤诊断中数字化成像技术的价值研究

目的：探讨数字化成像技术在胸部创伤诊断中的应用价值。方法选取该院于2012年8月—2014年8月收治58例含有胸部创伤患者的临床资料,所有患者均给予胸部数字化成像技术检查。结果在58例胸部创伤患者中,肋骨骨折患者29例,气胸或血气胸21例,皮下及纵隔气肿20例,创伤性湿肺16例,肺挫损11例,肺血肿6例,肺不张及肺萎缩4例。结论数字化成像技术能有效明确胸部创伤的部位、程度及性质,能为疾病的临床诊断及治疗提供有效的依据。     

Effect of Display Resolution on Time to Diagnosis with Virtual Pathology Slides in a Systematic Search Task

Performing diagnoses using virtual slides can take pathologists significantly longer than with glass slides, presenting a significant barrier to the use of virtual slides in routine practice. Given the benefits in pathology workflow efficiency and safety that virtual slides promise, it is important to understand reasons for this difference and identify opportunities for improvement. The effect of display resolution on time to diagnosis with virtual slides has not previously been explored. The aim of this study was to assess the effect of display resolution on time to diagnosis with virtual slides. Nine pathologists participated in a counterbalanced crossover study, viewing axillary lymph node slides on a microscope, a 23-in 2.3-megapixel single-screen display and a three-screen 11-megapixel display consisting of three 27-in displays. Time to diagnosis and time to first target were faster on the microscope than on the single and three-screen displays. There was no significant difference between the microscope and the three-screen display in time to first target, while the time taken on the single-screen display was significantly higher than that on the microscope. The results suggest that a digital pathology workstation with an increased number of pixels may make it easier to identify where cancer is located in the initial slide overview, enabling quick location of diagnostically relevant regions of interest. However, when a comprehensive, detailed search of a slide has to be made, increased resolution may not offer any additional benefit.     

Assessment of DICOM Viewers Capable of Loading Patient-specific 3D Models Obtained by Different Segmentation Platforms in the Operating Room

Patient-specific 3D models obtained by the segmentation of volumetric diagnostic images play an increasingly important role in surgical planning. Surgeons use the virtual models reconstructed through segmentation to plan challenging surgeries. Many solutions exist for the different anatomical districts and surgical interventions. The possibility to bring the 3D virtual reconstructions with native radiological images in the operating room is essential for fostering the use of intraoperative planning. To the best of our knowledge, current DICOM viewers are not able to simultaneously connect to the picture archiving and communication system (PACS) and import 3D models generated by external platforms to allow a straight integration in the operating room. A total of 26 DICOM viewers were evaluated: 22 open source and four commercial. Two DICOM viewers can connect to PACS and import segmentations achieved by other applications: Synapse 3D® by Fujifilm and OsiriX by University of Geneva. We developed a software network that converts diffuse visual tool kit (VTK) format 3D model segmentations, obtained by any software platform, to a DICOM format that can be displayed using OsiriX or Synapse 3D. Both OsiriX and Synapse 3D were suitable for our purposes and had comparable performance. Although Synapse 3D loads native images and segmentations faster, the main benefits of OsiriX are its user-friendly loading of elaborated images and it being both free of charge and open source.