数字化曲面全景X线系统造影在腮腺非肿瘤类疾病诊断中的应用

目的　本文报告普通X线机腮腺造影与数字化曲面X线机腮腺造影结果及其对比应用。方法　用3种不同的X线机对 3组腮腺非肿瘤类疾病患者进行腮腺造影 ,第 1组患者 10人应用普通 30 0mAX线机 ,第 2组患者 10人应用普通曲面全景X线机 ,第 3组患者 36人应用数字化曲面全景X线系统一套 ,分别行造影检查。结果腮腺造影侧位投照第 2组与第 1组末梢导管及腺泡有显著差异 (P <0 .0 5 ) ,第 3组与第 1组末梢导管及腺泡无显著差异 (P >0 .0 5 ) ,腮腺造影后前位投照第 2组与第 1、3组之间有显著差异 (P <0 .0 5 )。结论　本研究对比了 3种X线投照技术在腮腺非肿瘤性疾病造影诊断中的效果 ,用数字化曲面全景X线系统造影在诊断此类疾病中显示出较好的效果。     

Reduction of gait data variability using curve registration

Timing in peak gait values shifts slightly between gait trials. When averaged, the standard deviation (S.D.) in gait data may increase due to this inter-trial variability unless normalization is carried out beforehand. The objective of this study was to determine how curve registration, an alignment technique, can reduce inter-subject variability in gait data without perturbing the curve characteristics. Twenty young, healthy men participated in this study each providing a single gait trial. Gait was assessed by means of a four-camera high-speed video system synchronized to a force plate. A rigid body three-segment model was used in an inverse dynamic approach to calculate three-dimensional muscle powers at the hip, knee and ankle. Curve registration was applied to each of the 20 gait trials to align the peak powers. The mean registered peak powers increased by an average of 0.10±0.13 W/kg with the highest increases in the sagittal plane at push-off. After performing curve registration, the RMS values decreased by 13.6% and the greatest reduction occurred at the hip and knee, both in the sagittal plane. No important discontinuities were reported in the first and second derivatives of the unregistered and registered curves. Curve registration did not have much effect on the harmonic content. This would be an appropriate technique for application prior to any statistical analysis using able-bodied gait patterns.     

清瘟败毒胶囊的吸湿性研究及数据分析

目的：本实验研究清瘟败毒胶囊及其相应空胶囊的吸湿性，回归分析得到吸湿曲线方程，推测出清瘟败毒胶囊和空胶囊的临界相对湿度（CRH）。方法：测定清瘟败毒胶囊和空胶囊在四种不同相对湿度（RH）下的吸湿量，整理出清瘟败毒胶囊和空胶囊在不同RH下的吸湿曲线以及它们的CRH。结果与结论：清瘟败毒胶囊和空胶囊的CRH分别为66％和65％。     

腹膜后占位性病变的超声造影时间-强度曲线的临床意义

目的:分析腹膜后占位性病变的超声造影时间-强度曲线在形态和参数上有无差异,初步评估其对于鉴别腹膜后良恶性占位性病变的诊断价值。方法:选择腹膜后占位34例(良性12例,恶性22例)进行超声造影获得时间-强度曲线,将曲线下降支分为单相和双相,比较良恶性占位性病变在曲线下降支形态和曲线各参数中有无差异。结果:曲线下降支形态分析,单相组中恶性病变占94.4%,良性病变占5.6%;双相组中恶性病变占31.2%,良性病变占68.8%,差异有显著性(P=0.000 2)。曲线参数分析,良恶性组的上升支斜率(AS)差异具有显著性(P=0.000 1),良恶性组的峰值强度差异亦有显著性(P=0.01)。以AS=0.3为界,AS>0.3组别与AS<0.3组别差异具有显著性(P=0.000 6)。将时间-强度曲线的上升支斜率和下降支形态并联恶性肿瘤的漏诊率为9.19%。结论:超声造影时间-强度曲线对于腹膜后占位性病变的良恶性鉴别诊断具有一定的临床应用价值。     

超声造影成像参数在肝脏良恶性局灶性病变中的诊断价值

目的:探讨超声造影成像参数在肝脏良恶性局灶性病变中的诊断价值.方法:对95例二维超声发现肝脏占位性病变患者(良性51例,恶性44例)行超声造影检查.利用SonoLiver软件得到两组病变的时间-强度曲线,分析两组病灶的血流灌注特点,测得始增时间(AT)、上升时间(RT)、达峰时间(TTP)、峰值强度(IMAX)、上升支斜率、下降支斜率的绝对值,并进行统计学分析.结果:时间-强度曲线示良性组的AT、RT、TTP、IMAX分别为(26.43±5.08)s,(45.58±11.39)s,(54.77±11.30)s,(118.31±37.75)％,恶性组的AT、RT、TTP、IMAX分别为(13.42±3.53)s,(22.05±7.78)s,(25.16±8.85)s,(229.02±68.73)％,良性组的上升支斜率为(2.46±0.80)％/s,下降支斜率绝对值为(0.77±0.28)％/s,恶性组的上升支斜率为(9.39±3.13) ％/s,下降支斜率的绝对值为(2.23±0.82)％/s.良恶性组的AT、RT、TTP、IMAX上升支斜率、下降支斜率绝对值等参数有统计学差异(P＜0.01).结论:利用SonoLiver软件的时间-强度曲线可以对肝脏局灶性病变进行量化分析,在肝脏局灶性病变的定性诊断中有一定的应用价值.     

胸腹腔镜联合食管癌根治术学习曲线分析

目的 探讨胸腹腔镜联合食管癌根治术的学习曲线.方法 回顾性分析2010年4月至2011年12月由同一治疗组医师完成的144例胸腹腔镜联合食管癌根治术.按照手术日期先后顺序分为A、B、C、D4组,每组36例.比较各组患者的手术时间,术中出血量,淋巴结清扫个数,中转开放手术率,并发症率,住院时间及手术频度,分析不同阶段的手术效果.结果 4组患者在年龄、性别、肿瘤侵犯深度,肿瘤位置,中转开放手术率,并发症发生率及手术后住院时间等方面差异均无统计学意义(P＞0.05).A组手术时间为(339.1 ± 56.5)min,显著长于B组(240.7±58.2)min、C组(255.4±45.7) min和D组(269.9 ±45.4) min,P＜0.05.A组的术中失血量为(218.6±142.9)min,显著多于B组(106.4±76.0)min、C组(75.5 ±48.7) min和D组(100.5±91.9) min,P＜0.05.B、C、D三组间差异无统计学意义(P＞0.05).A组清扫淋巴结的个数为(10.6±5.6)个,显著少于B组(15.6±7.7)个、C组(18.3±6.9)个和D组(18.4±8.7)个,(P＜0.05).B、C、D三组间差异无统计学意义(P＞0.05).手术频度由A组的3.9例/月上升到B组的14.4例/月、C组的11.1例/月、D组的10.6例/月,并趋于稳定.结论 胸腹腔镜联合食管癌根治术学习曲线大约为36例.     

孤立性肺结节应用CT动态增强扫描鉴别良恶性的特异性与灵敏度

目的应用CT动态增强扫描鉴别孤立性肺结节良恶性的特异性与灵敏度,并分析三种类型结节的特征参数和动态增强的时间-密度曲线。方法选取2012年6月-2013年6月在我院就诊的孤立性肺结节患者56例,使用多层螺旋CT动态增强扫描,CT诊断结果与穿刺活检或手术病理诊断结果比较,分析该方法的特异性与灵敏度。对病理类型已确诊的孤立性肺结节患者的临床资料进行回顾性分析,探讨恶性结节、良性结节和炎性结节CT动态增强扫描的特征参数和动态增强的时间-密度曲线的区别和联系。结果 CT动态增强扫描对孤立性肺结节诊断的灵敏度为92.31%,特异性为85.00%;恶性结节、良性结节和炎性结节动态增强的时间-密度曲线的走势存在差异;恶性结节和炎性结节的强化峰值(PH)、孤立性肺结节强化峰值和主动脉强化值之比(SPH/PPH)与良性结节比较,P0.05,差异具有统计学意义,恶性结节的PH、SPH/PPH与炎性结节比较,P0.05,差异不具有统计学意义。结论 CT动态增强扫描对孤立性肺结节良恶性鉴别的特异性强、灵敏度高,有利于提高孤立性肺结节的确诊率。CT动态增强扫描的特征参数和动态增强的时间-密度曲线对孤立性肺结节良恶性的鉴别有一定的意义。     

Quantification of coronary arterial stenoses in CTA using fuzzy distance transform

Quantification of coronary arterial stenoses is useful for the diagnosis of several coronary heart diseases. Being noninvasive, economical and informative, computed tomographic angiography (CTA) has become a common modality for monitoring disease status and treatment effects. Here, we present a new method for detecting and quantifying coronary arterial stenosis in CTA using fuzzy distance transform (FDT) approach and a new coherence analysis of observed data for computing expected local diameter. FDT allows computing local depth at each image point in the presence of partial voluming and thus, eliminates the need for binarization, commonly, associated with inclusion of additional errors. In the current method, coronary arterial stenoses are detected and their severities are quantified by analyzing FDT values along the medial axis of an arterial tree obtained by its skeletonization. A new skeletal pruning algorithm has been developed toward improving the quality of medial axes and thereby, enhancing the accuracy of stenosis detection and quantification. Further, we have developed a new method to estimate “expected diameter” along a given arterial branch using a new coherence analysis of observed diameter values along the branch. The overall method is completed in the following steps - (1) fuzzy segmentation of coronary artery in CTA, (2) FDT computation of coronary arteries, (3) medial axis computation, (4) estimation of observed and expected diameters along arteries and (5) detection of stenoses and quantification of arterial blockage. The performance of this method has been quantitatively evaluated on a realistic coronary artery phantom dataset with randomly simulated stenoses and the results have been compared with a binary distance transform based and a conventional binary algorithm. The method has also been applied on a clinical CTA dataset from thirteen heart patients and the results have been compared with an expert's quantitative assessment of stenoses. Results of the phantom experiment indicate that the new method (error: 0.53%) is significantly more accurate as compared to both binary distance transform based (error 2.11%) and conventional binary (error 3.71%) methods. Also, the results of the clinical study indicate that the new FDT-based method (kappa coefficient = 87.9%) is highly in agreement with the expert's assessments and, in this respect, outperforms the other two methods (kappa coefficients = 75.2% and 69.5%).     

Starch digestibility modulation significantly improves glycemic variability in type 2 diabetic subjects: A pilot study

Background and aimsIn type 2 diabetes (T2D) patients, the reduction of glycemic variability and postprandial glucose excursions is essential to limit diabetes complications, beyond HbA1c level. This study aimed at determining whether increasing the content of Slowly Digestible Starch (SDS) in T2D patients’ diet could reduce postprandial hyperglycemia and glycemic variability compared with a conventional low-SDS diet.Methods and resultsFor this randomized cross-over pilot study, 8 subjects with T2D consumed a controlled diet for one week, containing starchy products high or low in SDS. Glycemic variability parameters were evaluated using a Continuous Glucose Monitoring System.Glycemic variability was significantly lower during High-SDS diet compared to Low-SDS diet for MAGE (Mean Amplitude of Glycemic Excursions, p < 0.01), SD (Standard Deviation, p < 0.05), and CV (Coefficient of Variation, p < 0.01). The TIR (Time In Range) [140–180 mg/dL[ was significantly higher during High-SDS diet (p < 0.0001) whereas TIRs ≥180 mg/dL were significantly lower during High-SDS diet. Post-meals tAUC (total Area Under the Curve) were significantly lower during High-SDS diet.ConclusionOne week of High-SDS Diet in T2D patients significantly improves glycemic variability and reduces postprandial glycemic excursions. Modulation of starch digestibility in the diet could be used as a simple nutritional tool in T2D patients to improve daily glycemic control.Registration numberin clinicaltrials.gov: NCT 03289494.