浅谈应用红外热成像技术早期诊断糖尿病足的策略

糖尿病足早期症状不明显,待明确诊断时病程多已步入中后期阶段,严重威胁民众健康。红外热成像技术作为一种医用功能性检测技术,能在人体组织发生结构性病变之前,敏感地发现其功能性改变导致的体表温度异常。基于中医学视角,借用计算机辅助诊断系统及属性篇序结构图,可以为糖尿病足红外热图的多角度、多维度解读提供全新思路,突破传统西医解剖学视角难以全面解读热图异常规律的瓶颈,也为红外热成像技术的应用拓宽视野。     

基于红外热成像技术的膝骨性关节炎患者穴位体表温度规律研究＊

目的 观察膝骨性关节炎患者穴位体表温度分布规律。方法 以256例膝骨性关节炎患者和256例健康受试者为观察对象。使用Fotric 226红外热像仪检测患者和健康受试者腧穴的温度值，每名患者每周固定时间检测1次，共检测4次，健康人检测1次，比较患者组与健康受试者组穴位温度值的差异，比较不同时间点不同部位、经脉温度值的差异。结果 膝骨性关节炎患者血海穴、鹤顶穴、梁丘穴、曲泉穴、内膝眼穴、犊鼻穴、委阳穴、阴陵泉穴、膝关穴、阳陵泉穴、大杼穴、悬钟穴、足三里穴、命门穴、腰阳关穴温度值高于健康受试者（P < 0.05）；患者组胃经的4次皮温均较高（P < 0.05），腰背部的4次皮温均较高（P < 0.05）；KOA相关腧穴4次温度值变化趋势不显著（P > 0.05）。结论 膝关节骨性关节炎患者部分腧穴皮温升高；膝骨性关节炎患者的穴位升温现象具有规律性，与经络、部位相关；膝关节骨性关节炎相关穴位升温效应具有稳定性。     

Applications of thermal imaging with infrared thermography in Orthopaedics

BackgroundPathological conditions with ongoing inflammatory processes result in specific heat signatures at the affected body parts; infrared thermography (IRT) detects these changes and can be utilied in screening such conditions. The modern devices are advanced and their non contact, convenient and precise readings can aid in multiple medical sub fields. Orthopaedics as a broad entity has witnessed utilisation of this technology for different indications and the present scoping review was done to assess these established indications and further scope of its utility.Methodology: A Medline search was done on April 26, 2021 with specific keywords for studies of any design in English language discussing the usage of thermography in Orthopaedics. Animal studies, conference abstracts, systematic reviews, e-posters, case reports, book chapters, and studies describing the use of thermography in non-Orthopaedic patients were excluded.ResultsTotal number of hits were 1380. 43 studies including case series and case control studies were included in the review. The subfields or indications described were pain/arthritis, Charcot's foot/neuropathic ulcers, infections associated with diabetic feet and arthroplasties, reflex sympathetic dystrophy, carpal tunnel syndrome, sports medicine, paediatric orthopaedics, spine, ergonomics and compartment syndrome.ConclusionIRT has been described to be effective in orthopaedic conditions with specific heat signatures and this can assess the trend of the ongoing inflammatory process as well as response to a particular treatment. Additionally, it can specifically determine the exact loci of the pathology for targeted interventions.     

Handheld infrared thermometer to evaluate cellulitis: the HI-TEC study

ObjectivesDifferentiating cellulitis from pseudocellulitis is challenging, and misdiagnosis leads to unnecessary antimicrobial use and increased healthcare expenditure. Clinical diagnosis remains the criterion standard and may involve expert consultation. Our objective was to evaluate the usefulness of a handheld infrared thermometer to improve diagnostic certainty in cases of suspected cellulitis.MethodsWe conducted a cross-sectional study from August 2018 to January 2020 at a tertiary-care hospital in Montreal, Canada. We enrolled adult patients with suspected limb cellulitis. Using the infrared thermometer, we compared the average temperature of the affected area with that of the contralateral limb, and we used Youden's method to determine the optimal temperature difference which best differentiated cellulitis from pseudocellulitis as determined by an independent and blinded infectious diseases specialist. We used bootstrapping to estimate 95% confidence intervals for the sensitivity, specificity, and area under the receiver operating curve.ResultsOf 65 patients screened for enrolment, 52 patients were recruited (median age: 64 years, IQR 52–76); 39 of these were diagnosed with cellulitis and 13 were not. The mean temperature difference between affected and unaffected limbs was 2.6°C (95%CI 2.1–3.1°C) for patients with cellulitis and 0.4°C (95%CI –1.2°C to 2.1°C) for patients without (p < 0.001). An average temperature difference between limbs of 0.8°C or more was 95% sensitive (95%CI 74–100%) and 69% specific (95%CI 44–95%) for the diagnosis of cellulitis (c-statistic 0.82).ConclusionsIn this proof-of-concept single-centre study, a handheld infrared thermometer was a useful aid to differentiate cellulitis from pseudocellulitis.     

Nano in nano: Biosynthesized gold and iron nanoclusters cargo neoplastic exosomes for cancer status biomarking

Timely detection is crucial for successful treatment of cancer. The current study describes a new approach that involves utilization of the tumor cell environment for bioimaging with in-situ biosynthesized nanoscale gold and iron probes and subsequent dissemination of Au-Fe nanoclusters from cargo exosomes within the circulatory system. We have isolated the Au-Fe cargo exosomes from the blood of the treated murine models after in situ biosyntheses from their respective pre-ionic solutions (HAuCl₄, FeCl₂), whereas Na₂SeO₃ supplementation added into Au lethal effect. The microarray data of various differentially expressed genes revealed the up-regulated tumor ablation and metal binding genes in SGC-7901 cell lines after treatment with Au-Fe-Se triplet ionic solution. The isolation of Au-Fe nanoclusters cargo exosomes (nano in nano) after secretion from deeply seated tumors may help in early diagnosis and reveal the tumor ablation status during and after the relevant treatment like radio-chemo therapies et al.     

用傅立叶变换红外光谱仪研究复合树脂的双键转化度

为了研究牙科复合树脂的聚合，采用傅立叶变换红外（Ｆｏｕｒｉｅｒｔｒａｎｓｆｏｒｍｉｎｆｒａｒｅｄ，ＦＴＩＲ）光谱仪测定８种牙科复合树脂的双键转化度并比较了压片制样法和薄膜制样法对转化度的影响。结果发现，树脂的双键转化度在４５％～７４％之间；可见光固化树脂的转化度高于化学固化树脂者。在光固化树脂中，混合填料树脂的转化度高于超微填料树脂者，粘接辅助剂的转化度最高。对光固化树脂而言，压片制样法所测得的转化度值高于用薄膜制样法；而在化学固化树脂，用二种制样方法所测得的转化度值相同。本研究结果可供临床应用复合树脂参考。     

锌氧油外涂辅以红外线照射治疗肛周顽固性湿疹疗效观察

将本组湿疹病人分成锌氧油外涂辅以红外线照射治疗组（３２例）和外涂皮炎平对照组（３０例）。结果治疗组治愈２８例，明显高于对照组（１３例）（Ｐ＜０．０１）；治疗组有效率１００％，亦优于对照组（０．０１＜Ｐ＜０．０２５）。治疗组平均治愈天数４．４天，对照组６．２天。     

阴虚体质任脉线上体表温度、循经红外辐射轨迹特征及电针对其的影响

目的:观察自然状态下平和、阴虚体质任脉线上体表温度、循经红外辐射轨迹特征(IRRTM),并探讨电针对其的影响。方法:应用红外热像仪观察17名阴虚体质受试者电针前后任脉体表温度、IRRTM并与平和体质进行比较。结果:在自然状态下:阴虚体质任脉上平均体表温度,膻中穴、下脘穴、气海穴体表均高于平和体质,其中膻中穴具有显著性差异(P<0.05);平和质3个穴位进行比较,膻中穴体表温度显著高于下脘穴与气海穴(P<0.01);阴虚体质3个穴位进行比较,膻中穴体表温度显著高于气海穴(P<0.05);平和体质组IRRTM显示的连续性更好、范围更长;阴虚体质组IRRTM显示范围较宽,与周边组织分界不如平和体质组清晰。电针中脘穴20min:与本组自然状态同穴位比较,平和体质下脘穴体表温度显著升高(P<0.05);阴虚体质下脘穴体表温度显著降低(P<0.05)。电针可诱发平和体质任脉IRRTM轨迹变长,而对已能显示任脉IRRTM轨迹的受试者,电针则可使其变得连续、规整;电针可使部分阴虚体质受试者任脉IRRTM轨迹出现与任脉循经红外辐射轨迹走向相同的低温线,分布在膻中穴周围。结论:阴虚体质任脉上体表温度高,在膻中穴上明显;电针中脘穴能升高平和体质下脘穴体表温度,却降低阴虚体质下脘穴体表温度;表明针刺对不同体质受试者IRRTM能产生不同的影响,IRRTM与人体的能量代谢有密切的关系。     

平乐正骨养血止痛丸联合红外线对老年髋痹病患者功能评分及生活质量的影响

目的:观察养血止痛丸联合红外线对老年髋痹病患者功能评分及生活质量的影响,探讨养血止痛丸联合红外线对髋痹病的作用机制。方法:选择2018年1月-2019年5月期间符合老年髋痹病诊断患者,共56例(64髋),给予养血止痛丸口服联合红外线治疗,4周为一个疗程,共治疗2个疗程,观察治疗前后患者髋关节Harris评分、面部表情疼痛量表(Faces Pain Scale-Revised,FPS-R)评分、分项百分制髋关节评分及生活质量的影响改变。结果:全部完成疗程并随访结束的共52例(58髋),其中临床控制30髋,显效18髋,有效7髋,无效3髋,总有效率为94.83%(55/58),经治疗2个疗程后,髋关节Harris评分、FPS-R评分及分项百分制髋关节评分均有不同程度的改善,差异有统计学意义(P<0.01);生活质量(Medical Outcomes Study Short-Form 36,SF-36)评分有明显提高,差异有统计学意义(P<0.01)。同时,所有患者总不良反应率为5.17%(3/58)。结论:养血止痛丸联合红外线可有效改善老年髋痹症患者髋关节功能评分、提高生活质量评分,治疗效果确切,无明显不良反应,安全有效。