镁合金冠脉支架支撑性能分析及其优化

目的利用有限元法对支架支撑性进行模拟分析,选用Kriging代理模型理论优化支架结构,为支架的临床治疗及设计开发提供更加科学的参考。方法通过惩罚函数法建立接触模型,选用广义变分原理作为数值模拟仿真的理论基础,并以Kriging代理模型理论对支架刚度进行有限元优化,研究周向支撑体数目、支撑体长度和初始直径对支架支撑性能的影响。结果支架的支撑力随着周向支撑体数目和支撑体长度的增加呈现下降的趋势,而随着初始直径的增大呈现上升的趋势;利用Kriging代理模型理论从7款支架中得出:支撑体数目为6个、支撑体长度为1.15 mm、初始直径为1.65 mm是支撑刚度最优支架结构。结论数值分析与体外实验结果吻合较好,误差在5%以内,实验重复性误差率在0.5%以内,验证了有限元分析的有效性和合理性。镁合金支架支撑性能的优化为新型支架设计及开发提供重要参考依据。     

血管支架柔顺性能的仿真模拟及灰色相关性分析

目的利用有限元法与灰色相关性理论的方法,分析并比较支架结构参数对支架植入后与血管同步运动能力的影响。方法选取S型闭环镁合金支架作为研究对象,应用Solid Works软件建立不同材料、周向支撑体数目、支撑体长度及初始直径共9款支架模型;应用Hyper Mesh软件进行支架模型网格的划分;应用ABAQUS软件模拟分析支架植入后与血管同步运动能力;利用灰色相关性理论研究并比较支架结构参数对弯曲刚度影响因子大小。结果材料对支架柔顺性的影响较明显,其中镁合金的柔顺性最好,对应弯曲刚度值为0.958 N·(rad·mm)~(-1);周向支撑体数目为5对应支架的柔顺性最好,其弯曲刚度值为0.853 N·(rad·mm)~(-1);支撑体长度为1.0 mm对应支架的柔顺性最好,其弯曲刚度值为0.829 N·(rad·mm)~(-1);初始直径为1.4 mm对应支架的柔顺性最好,其弯曲刚度值为1.024 N·(rad·mm)~(-1)。结论镁合金支架对应柔顺性最好,其次为不锈钢,钴铬合金支架对应柔顺性较差;柔顺性随着周向支撑体数目、支撑体长度、初始直径的增加而呈减小趋势变化;通过灰色相关性计算可知,材料对应柔顺性的影响最显著,其次为周向支撑体数目、支撑体长度,初始直径对其影响较小;分析支架结构参数对柔顺性的影响,可为支架的设计研发及临床治疗提供更加科学的参考。     

考虑尺寸效应的聚合物血管支架力学性能

目的 研究考虑尺寸效应的聚合物血管支架力学性能,分析支架结构对支架力学性能和支架变形过程中尺寸效应的影响规律,为支架的结构设计提供理论依据。 方法 建立考虑尺寸效应的聚乳酸的 Cosserat 理论模型,并结合有限元法,通过三点弯和平板压获得支架弯曲刚度和径向刚度,进一步分析支架筋厚和筋宽、支撑单元曲率半径和轴向间距对支架径向支撑性能和尺寸效应的影响规律。 结果 聚合物血管支架在弯曲和压缩过程中均存在明显的尺寸效应现象;支架径向刚度与支撑单元曲率半径和轴向间距均呈负相关,与筋厚和筋宽均呈正相关;支撑单元曲率半径、轴向间距以及支架筋厚和筋宽越小,聚合物血管支架压缩过程中的尺寸效应越大。 结论 支架的径向支撑性能主要由结构的刚度决定,并受支架变形过程中尺寸效应的影响;支架几何结构的特征尺寸越小、支架弯扭变形的程度越大,则尺寸效应越明显,对支架径向支撑性能的增幅越大。     

5种支架对颈内动脉瘤血液动力学影响的数值研究

目的 研究不同结构形状以及不同网丝截面的支架用于颈内动脉瘤治疗后对血液动力学及支架柔顺性的影响。方法 针对同一个体模型的颈内动脉瘤,构建5种不同支架介入治疗的模型。这些支架的支撑体网丝截面不同,但支架通透率近似相等。利用有限体积法进行数值仿真,获得其生物力学特性的定量信息。结果 5种模型中,矩形截面网格支架模型动脉瘤腔中平均流动速度的减小幅度最大;圆型截面支架和矩形截面螺旋支架模型中瘤面和瘤颈部分的壁面切应力减小面积较大;网格支架的柔顺性要远好于螺旋支架。结论 矩形截面网格支架对治疗颈内动脉瘤有较好的生物力学影响,这些发现可帮助临床医生在治疗脑动脉瘤时选择合适的支架。     

支架参数对血管壁面剪切应力的影响

目的研究不同支架参数对血管壁面再狭窄的影响,为设计支架形式提供参考和依据。方法根据支柱的螺纹节距、支柱数目、支柱线径、支架突入流域深度、支柱截面形状对支架进行分组,利用三维计算流体动力学(computational fluid dynamics,CFD)模拟方法研究各个参数的不同设置对血管壁面剪切应力分布的影响。结果支架的支柱线径对壁面剪切应力影响最为显著,并且支架参数中节距变短、支柱数目增加、线径变宽、突入流域深度增加会导致壁面低剪切应力区域面积增加;相对于三角形与正方形截面形状,圆形截面支架导致的低剪切应力区域面积更少。结论支架在设计过程中应采用圆形截面,而且应尽可能缩小线径,增长节距,减少支柱数目,减小突入流域深度。     

不同截面和尺寸镁合金支架扩张过程中的应力变化

背景:降解带来的一个重要变化是支架尺寸的减小,从而影响支架的支撑力。由于支架的结构复杂性,导致其应力分布的复杂性。目的:分析不同截面形状和尺寸的镁合金支架在扩张过程中的应力变化。方法:利用有限元法分别计算正方形、八边形、圆形3种筋截面形状的镁合金支架扩张过程中主要受力部位的残余应力,同时计算120,140,160,180μm的4种不同尺寸下该处残余应力的变化情况。结果与结论:正方形、八边形、圆形这3种不同筋截面形状支架扩张后,圆形筋截面形状支架上主要受力部位的应力最大。对3种支架而言,随着筋截面尺寸的减小,该部位的应力减小,提示支架筋截面形状及尺寸均对支架扩张后的残余应力产生影响。     

新型球扩式锥形血管支架的径向支撑力学行为

目的 探求支架锥度和连接筋形式对支架支撑性能的影响规律,为锥形支架的结构设计和临床选择提供重要的科学依据。方法 通过构建新型球囊扩张式锥形血管支架径向支撑性能的非线性有限元模型,采用平面压缩法分析血管支架在不同支架锥度(0°、0.565°、1.13°)和支架连接体结构形式(V、I、C、S、M型)下的支架径向刚度和应力分布规律,研究血管支架结构设计和其径向支撑性能之间的关系。结果 0°、0.565°、1.13°支架径向刚度分别为2.51、1.61、0.85 N/mm, 0.565°、1.13°支架分别比0°支架(圆直支架)下降了35.86%和66.14%;除了C型连接体支架径向刚度为1.48 N/mm外,I、M、S、V型连接体支架的径向刚度相差不大,分别为2.51、2.61、2.41、2.52 N/mm,表明这4种连接体支架在径向抗压缩性能上几乎相同。结论 相比于传统的圆直支架,锥形支架的径向刚度会减小,且随着锥度增加,支架的径向刚度会逐渐降低;在研究的所有支架类型中,除了C型连接体支架的径向刚度较差外,其余连接体形状对支架的径向刚度影响甚微。在不改变支架连接筋形式的情况下,通过降低锥形...     

球囊扩张式冠脉支架生物力学性能研究

研究具有不同连接筋的冠状动脉支架的力学性能,为支架的设计开发以及介入治疗提供更加科学的指导.采用Solid Works建立3种不同连接筋的支架模型(根据连接筋的形状分别称为W-支架、S-支架和L-支架,压握壳以及球囊模型),使用Hypermesh软件完成模型的网格划分,应用ABAQUS软件模拟分析了径向回弹、轴向缩短,扩张不均匀性以及径向支撑刚度和柔顺性,并结合径向均匀加载和“四点弯曲”测量技术的径向支撑刚度和弯曲刚度的测试方法验证了数值模拟的合理性.结果表明:3种支架的各项力学性能都在安全范围内;相对而言,S-支架的支撑强度较大,支撑刚度为3.34 N/mm,容易造成局部血管壁的损伤;L-支架的轴向缩短率较大,为8.25％,不利于支架在血管病变部位的正确定位;S-支架和L-支架的弯曲刚度分别为:17.74 N/rad和18.00 N/rad,它们的柔顺性较差.3种支架的力学性能各有优缺点,其中W-支架的综合力学性能相对较好,这在临床上为选用支架提供良好的参考依据.     

几何参数对Z型覆膜支架柔顺性的影响

目的分析治疗胸主动脉瘤的常用Z型覆膜支架的几何参数对支架柔顺性能的影响及主次顺序。方法通过SolidWorks软件建立波峰数目、波峰高度、丝径及顶端圆角半径4种因素变化的覆膜支架模型,并导入ANSYS有限元软件进行仿真分析,对支架施加弯曲60°的转动变量,根据最大等效应力、节点反力、弯矩3个评价参数分析支架柔顺性。结果支架弯曲后,最大应力集中在弯曲内侧;减小支架丝径、波峰高度与波峰数目,支架的柔顺性增强;增大波峰顶端圆弧半径,支架柔顺性增强;丝径与波峰数目对支架柔顺性的影响强于顶端圆弧半径与波峰高度。结论波峰数目、波峰高度、丝径及顶端圆角半径对覆膜支架柔顺性均有显著影响。研究结果为以后临床支架的选择及优化设计提供理论依据,对减少新发破口等并发症的发生具有积极意义。     

覆膜支架治疗主动脉夹层的有限元分析

目的利用有限元方法模拟覆膜支架植入治疗主动脉夹层的过程,通过观察覆膜支架在血管不同位置处释放对血管壁上的应力分布情况,分析覆膜支架植入后血管出现新发破口的生物力学机制。方法根据主动脉的计算机断层血管造影影像数据,进行图像分割和三维重建,建立具有病人特异性的主动脉夹层的三维几何模型;根据文献数据,给定主动脉夹层壁厚和材料属性;利用CAD软件设计出不同几何参数的覆膜支架环;利用有限元分析软件模拟覆膜支架的释放过程。结果当覆膜支架处于稳定状态时,血管最大Von Mises应力与覆膜支架的释放位置有关;血管壁上的最大Von Mises应力点分布在裸支架及第1节细小镍钛合金环接触处,该作用力的长期存在可能是这个部位出现新发破口的原因。结论覆膜支架的释放位置对主动脉上的最大Von Mises应力分布影响较弱,但对主动脉上的Von Mises应力影响较为明显。研究结果对临床上覆膜支架释放位置的选择具有指导意义。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.