数值模拟鼻甲的切除对鼻腔内气体流场的影响

量化研究鼻腔结构的变化对鼻腔内气体流场分布的影响.通过CT图像对鼻腔结构进行三维重建并用有限元方法对气体流场进行数值分析.对重建的鼻腔模型的一侧,分别去掉部分中鼻甲和部分下鼻甲并用有限元方法再次进行数值分析,将得到的结果与原始模型进行比较.观察气体流场分布的变化,在两侧鼻腔的流量分布均有变化,在去掉部分鼻甲的一侧流场和气压的分布也有所改变.通过数值模拟,我们量化的显示了鼻腔结构的变化对鼻腔内气体流场分布的影响.     

不同运动强度对骨质疏松影响的数值模拟

探讨数值模拟不同运动强度对因废用引起的骨质疏松的影响。依据骨的功能适应性和力学调控系统理论,遵循骨重建的生理过程,建立了一个带有时间历程的描述松质骨骨质疏松过程的计算模型,用C语言编制程序。得到了不同运动负荷对因废用引起的骨质疏松(孔隙率)的影响曲线。结果表明:较大的运动强度可以减缓因废用引起的骨质疏松。这对于运动防治骨质疏松有一定的参考价值。     

Simulation of cardiovascular physiology: the diastolic function(s) of the heart

The cardiovascular system was simulated by using an equivalent electronic circuit. Four sets of simulations were performed. The basic variables investigated were cardiac output and stroke volume. They were studied as functions (i) of right ventricular capacitance and negative intrathoracic pressure; (ii) of left ventricular relaxation and of heart rate; and (iii) of left ventricle failure. It seems that a satisfactory simulation of systolic and diastolic functions of the heart is possible. Presented simulations improve our understanding of the role of the capacitance of both ventricles and of the diastolic relaxation in cardiovascular physiology.     

Simulation study of the Hemopump as a cardiac assist device

A dynamic model was developed for a Hemopump that withdraws blood from the left ventricle and discharges it to the aorta through a miniature axial-flow pump. Incorporation of the Hemopump model in a previously established model for the canine circulatory system enabled the effects of the Hemopump on various haemodynamic variables of the circulatory system to be studied, and the benefit of the Hemopump to the failing heart was investigated. In addition, the influence of the physiological status of the right ventricle on the Hemopump performances was examined, and the synchronous and non-synchronous operations of the Hemopump were compared. Results verified that the Hemopump assists the failing heart by increasing the oxygen supply, while reducing the oxygen consumption of the heart through a reduction in the workload of the left ventricle. These beneficial effects were enhanced when the pump's rotation speed was increased. When pump speed was increased from 17000 to 23000 revolutions min⁻¹, the oxygen supply increased 101%, and the oxygen consumption decreased 60%. However, when the pump rotation speed was too high, the inflow to the pump could be impaired and the pump performance could be negatively affected. Predications from the model were in good agreement with the results previously obtained in animal experiments and in vitro measurements.     

Insulin Minimal Model Indexes and Secretion: Proper Handling of Uncertainty by a Bayesian Approach

The identification of the insulin minimal model (MM) for the estimation of insulin secretion rate (ISR) and physiological indexes (e.g. beta-cell sensitivity) requires the knowledge of C-peptide (CP) kinetics. The four parameters of the two-compartment model of CP kinetics in a given individual can be derived either from an additional bolus experiment or, more frequently, from a population model. However, in both situations, the CP kinetics is uncertain and, in MM identification, it should be treated as such. This paper shows how to handle CP kinetics uncertainty by using a Bayesian methodology. In seven subjects, MM indexes and ISR were estimated together with their confidence intervals, using either the bolus data or the population model to assess CP kinetics. The two main results that arise from the application of the new methodology are: (i) the use of the population model in place of the bolus data to determine CP kinetics does not affect, on average, the point estimates of ISR profile and MM parameters but only the confidence intervals which becomes wider (less than 50%); (ii) in both the bolus and population situation neglecting the uncertainty of CP kinetics, as done in MM literature so far, introduces no bias, on average, on point estimates of MM indexes but only an underestimation of confidence intervals.     

冠状动脉搭桥术中移植管-宿主动脉直径比和缝合角的优化与分析

目的探索怎样的移植管-宿主动脉直径比和缝合角可以最大限度地提高冠状动脉搭桥术的成功率。方法借助ANSYS9.0对冠状动脉搭桥术进行模拟仿真,用响应面方法建立数学模型,利用优化理论寻找最优的移植管-宿主动脉直径比和缝合角,使影响手术成功率的主要因素-壁面切应力梯度最小。结果结果表明冠状动脉搭桥术中,大移植管-宿主动脉直径比和小缝合角的模型具有更好的血流动力特性。结论影响冠状动脉搭桥术成功率的因素很多,在现有条件下借助临床经验指导,选择尽可能大的移植管-宿主动脉直径比和尽可能小的缝合角的做法是可取的。     

CT模拟定位三维适形放射治疗食管癌的临床研究

目的探讨CT模拟定位三维适形放射治疗食管癌的疗效。方法1997年4月～2002年7月,经病理证实的食管鳞状细胞癌87例患者，其中男性56例，女性31例，年龄42～75岁，平均年龄62.5岁，随机分为2组，两组患者一般情况、性别、年龄及病变部位构成经统计学检验无统计学意义，一组为采用CT模拟定位进行三维适形放射治疗，另一组为常规模拟定位放射治疗，两组的剂量都为64～66Gy／32.33次／6.4～6.6周。结果采用Kaplan—Meier法计算生存率，并用Log—Rank检验其差异性。治疗计划各指标分析采用kolmogorowSmirnov法行正态分布检验，继而行t检验，以P〈0.05为差异有统计学意义。CT模拟定位三维适形放射治疗组和常规模拟定位放射治疗组1、2、3、4年生存率分别为70.1％、55.6％、40.4％、36.3％和65.4％、50.6％、30.6％、20.9％（p〉0.05）。但是对Ⅰ～Ⅱ期患者，CT模拟定位三维适形放射治疗组和常规模拟定位放射治疗组的生存率分别为81.2％、75.5％、67.3％、61.5％和80.1％、65.7％、54.9％、29.7％（P〈0，05），局部控制率分别为75.6％、71.7％、65.5％、59.0％和65.4％、50.6％、33.3％、25.6％（P〈0.05）。而对于Ⅲ～Ⅳ期的患者，两组之间的生存率和局部控制率差异无统计学意义。结论CT模拟定位三维适形放射治疗的疗效明显好于常规模拟定位放射治疗组。特别对Ⅰ-Ⅱ期早期食管癌患者两组之间差异有统计学意义，而对晚期患者差异无统计学意义。     

Modeling of stimulation–secretion coupling in a chromaffin cell

We constructed a chromaffin cell model for analysis of stimulation–secretion coupling in computer simulation studies. The model includes mechanisms involved in the excitatory synapse, voltage-dependent Na⁺, K⁺ and Ca²⁺ channels, Ca²⁺-activated K⁺ channels (SK type), buffered Ca²⁺ diffusion, Ca²⁺ extrusion, fluorescent Ca²⁺ indicators and Ca²⁺-triggered exocytosis. Calculations of the modeled mechanisms were carried out using the NEURON simulation environment (Hines and Carnevale, Neural Computation 9:1179–1209, 1997). A set of parameter values was determined so as to fit basic experimental results reported in the literature. The model was also applied to simulate our experimental results obtained from chromaffin cells in the perfused rat adrenal medulla. Observed profiles of Ca²⁺responses induced by electrically stimulating the splanchnic nerve with various frequencies (1–50 Hz) were adequately simulated with minor readjustments of parameter values for Ca²⁺influx and extrusion. Secretory responses measured at the same time as the Ca²⁺responses were also simulated with consideration of a time constant to detect catecholamines in the experiment. Similarly, model simulations reproduced both Ca²⁺responses and secretory responses evoked by elevations of the extracellular K⁺ concentration for different periods. The results suggest that the presented model provides a useful tool for analyzing and predicting quantitative relations in various events occurring in stimulation–secretion coupling in chromaffin cells.     

Das Magengeschwür als energiebilanzproblem: Entwurf eines cellularen automaten zur simulation von verteilungsstörungen der magenwanddurchblutung

Zusammenfassung Ein cellularer Automat, der eine vereinfachte Abschätzung von Verteilungsmustern der Magendurchblutung erlaubt, wird beschrieben. Die auf der Basis des Energiebedarfs der Säuresekretion und der Morphologie der Magenstrombahn simulierbaren Umverteilungsphänomene stimmen in Form und Lage mit dem menschlichen Magengeschwür überein. Sonderfälle der peptischen' Läsion, wie das lineare Geschwür oder die peptische' Stenose der Speiseröhre, sind mit der Theorie des submucösen Steal-Phänomens zu vereinbaren.

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Gastric ulcer as a problem of energy balance: Design of a cellular automaton for simulation of disorders of blood flow distribution to the stomach wall

Summary A cellular automaton is described, which allows a simple simulation of patterns of gastric blood flow distribution. Effects of redistribution, which can be simulated on the basis of the energy requirements of acid secretion and the morphology of the gastric vascular bed, are isomorph to form and site of gastric ulcer in man. Special forms of the peptic lesion as linear ulcers or peptic stenoses of the oesophagus are consistent with the theory of a submucous steal-phenomenon.

Herrn Prof. Dr. Dr. rer. nat. h. c. Friedrich Stelzner zum 65. Geburtstag gewidmet     

A Bayesian Approach for Incorporating the EQ-5D Visual Analog Scale When Estimating the Health-Related Quality of Life

ObjectivesThe EuroQoL 3-level version of EQ-5D and 5-level version of EQ-5D questionnaires are often used to quantify health states. They include ordinal responses across 5 health dimensions (EQ-5D index) and an EQ-visual analog scale (EQ-VAS) overall health rating. We investigated the value of incorporating the EQ-VAS to update health utility estimates using a Bayesian framework.MethodsWe created a joint bivariate normal EQ-VAS and EQ-5D index utility model and compared this to a univariate normal EQ-5D index utility model. We tested these models for 1026 Sri Lankan patients with chronic kidney disease and 94 Australian patients with wounds. We validated our approach by simulating EQ-VAS and EQ-5D index responses and applying our Bayesian model and then comparing the modeled estimates to our observed data.ResultsThe combined model showed a reduction in estimate uncertainty for all respondents. Compared with the EQ-5D index-only model, the mean utility for Sri Lankan respondents dropped from 0.556 (0.534-0.579) to 0.540 (0.521-0.559) in men and increased from 0.489 (0.461-0.518) to 0.528 (0.506-0.550) in women, with reduced credible interval width by 13% and 23%, respectively. The mean utility in Australian respondents moved from 0.715 (0.633-0.800) to 0.716 (0.652-0.782) in men, and 0.652 (0.581-0.723) to 0.652 (0.593-0.711) in women, with reduced credible interval width by 23% and 17%, respectively. The credible interval width for simulated data also narrowed, ranging from 8.3 to 8.5%.ConclusionsIncluding the EQ-VAS through Bayesian methods can add value by reducing requisite sample sizes and decision uncertainty using small amounts of additional data that is often collected but rarely used.