胎肝血管的三维可视化建模及意义

目的　探讨胎肝血管三维模型的分割方法及其意义。 方法　采用分色和密度差金属造影剂对1例38周新鲜引产正常胎肝进行灌注并铸型,红色环氧树脂填充剂灌注腹主动脉（造影剂为氧化铅）,蓝色环氧树脂填充剂灌注下腔静脉、静脉导管、肝左静脉及肝右静脉外侧支（造影剂为二氧化钛）,紫色环氧树脂填充剂灌注肝中静脉（造影剂为氧化锌）,绿色环氧树脂填充剂灌注肝右静脉内侧支（造影剂为氧化铅）。然后行128层螺旋CT薄层扫描和Mimics软件重建胎肝三维模型。 结果 构建胎肝血管三维模型形态逼真、立体感强。调整mimics阈值间距由大逐步变小,可以有效分割出肝中静脉、肝静脉系及肝固有动脉等血管,能清晰地显示肝内多血管走行及分布情况。 结论　不同密度金属造影剂灌注分割胎肝内多血管方法简便可行,能够为研究者对胎肝血管发生发展及其移植术的研究提供理想技术支持。     

胎儿全身动脉系统数字化三维模型的构建及意义

目的　探讨胎儿全身动脉系统数字化三维模型的构建方法及其意义。 方法　采用“环氧树脂-氧化铅”填充剂对1例33周新鲜引产正常胎儿标本行全身动脉灌注并铸型,然后行64层螺旋CT薄层扫描采集二维图像数据,利用Mimics重建胎儿全身动脉系统数字化三维模型。 结果　基于CT原始数据,利用 Mimics 15.0软件成功构建出胎儿全身动脉系统数字化三维模型。重建得到的模型立体感强,三维效果逼真,与胎儿全身动脉血管铸型一致性高,可以清晰再现胎儿动脉主干及其分支的形态结构,且可进行任意缩放、任意角度旋转观察。 结论　胎儿全身动脉系统数字化三维模型的构建能够全面展示胎儿全身的各级动脉,为胎儿血管的后续研究提供了良好的支撑平台;该模型还可为宫内手术及宫内输血等提供解剖支持。     

Mimics软件三维重建全骨盆几何模型模拟骨盆肿瘤切除假体置换

背景:CT扫描所得DICOM数据在Mimics软件中的运用是目前国际上公认的计算机辅助手术的"金标准"。目地:探索一条可行的计算机辅助手术途径。方法:将骨盆肿瘤病例CT扫描图像数据导入Mimics10.01软件,三维重建包含髂血管的全骨盆几何模型,并按Enneking and Dunhan提出的标准分型,该病例为TypeⅡ型。利用mimics软件的三维重建全骨盆几何模型的各项数据进行术前测量,设计肿瘤切除范围,并进行模拟肿瘤切除假体置换。结果与结论:利用mimics软件重建的全骨盆三维几何模型可准确反映骨盆的三维立体结构和预测肿瘤的大小,并可进行任意旋转观察,精确测量出相关的各项指标。为定制假体提供有意义的参考数据,有效实现了骨盆肿瘤广泛切除特制假体置换术的模拟。结果提示Mimics软件重建的包含髂血管的全骨盆几何模型可立体直观显示骨盆内部解剖结构并明确肿瘤分型。Mimics可以为术前设计和手术模拟提供快捷、便利、精确、可重复运用的模型。     

基于CT增强连续扫描数据的颅面部血管三维重建数字化模型

背景:通过三维重建技术,可以对人体的任何一个部位进行可视化观察,但国内外基于个人PC的颅面部血管三维重建研究报道尚少。目的:探讨基于CT增强扫描数据重建颅面部血管三维数字化模型的方法及其应用价值。方法:选择1例经CT增强连续扫描检查的健康志愿者数据集,以DICOM格式导入Mimics10.01软件,运用阈值选取技术、手动编辑技术、三维区域增长技术对颅面部血管进行三维重建。结果与结论:获得了颅面部血管的三维数字化模型。该模型可以进行任意缩放和任意角度旋转,可显示不同结构间的毗邻关系和空间构象,并可进行三维的距离、角度测量。提示在PC上应用Mimics软件可以方便快捷地建立颅面部血管的三维数字化模型,为人体解剖学教学、临床神经外科、口腔颌面外科和影像诊断学提供了形态学参考,并为后期的虚拟手术奠定了基础。     

解剖教学中肝内管道可视化的应用

目的探讨利用医学图像三维处理技术将肝内多管道CT扫描数据应用于医学影像专业的解剖教学。方法采用羧甲基纤维素／氧化铅（CMC／LO）填充剂和自凝牙托材料分别对肝内管道进行灌注。运用多层螺旋CT进行薄层扫描获取二维数据资料,利用Mimics10．01软件对肝内多套管道进行可视化重建,并将其应用于解剖教学。结果肝内虚拟管道系统的重建图像显影均匀．层次分明．边缘光滑。能分别对肝门静脉和肝静脉进行任意方位的旋转,并充分显示出立体的解剖结构。结论通过重建获得的高质量肝内多管道三维影像,能够便于医学生从多角度、多层次进行观察和分析．加深对肝内管道结构的理解和认识。     

胎儿冠状动脉数字化三维模型构建及意义

目的探讨胎儿冠状动脉数字化三维模型的构建方法及其意义。方法选取1例36周新鲜引产正常胎儿标本,在升主动脉根部上方切口插管灌注"环氧树脂-二氧化钛"填充剂并铸型后,行64层螺旋CT薄层扫描采集二维图像数据集,利用Mimics18.0软件构建胎儿冠状动脉数字化三维模型。对比分析同一胎儿冠状动脉标本的数字化三维模型与血管铸型的形态结构特点。结果基于CT原始数据,利用Mimics 18.0软件成功构建出胎儿冠状动脉数字化三维模型。重建得到的模型清晰逼真、立体感强,与胎儿冠状动脉1~3级铸型结构一致性高,且可在三维空间任意缩放、平移、任意角度旋转。结论血管灌注铸型结合三维重建方法观察现实和虚拟胎儿冠状动脉的三维状态,最大限度为宫内先心手术和影像解剖学教学提供一个仿真平台和实践工具。     

小型猪冠状动脉的三维建模与3D打印研究

目的探讨小型猪冠状动脉三维模型的构建方法及其3D打印模型的意义。方法选取1例新鲜正常离体小型猪心脏,灌注"环氧树脂-氧化铅"填充剂并铸型后,行128层螺旋CT薄层扫描采集二维图像数据集,利用Mimics 19. 0软件构建小型猪冠状动脉数字化三维模型,3D打印机打印其实体模型。结果基于CT原始数据,利用Mimics 19. 0软件成功构建出小型猪冠状动脉三维模型。重建模型清晰逼真、立体感强,可在三维空间任意缩放、平移及任意角度旋转,且可通过调整阈值范围分割显示左、右冠状动脉及其分支走行分布。结论血管三维重建技术和3D打印技术可以直观显示虚拟和现实小型猪冠状动脉的三维状态,可有效地辅助当前数字化、精准化医疗的发展方向,可为先心手术和影像解剖学教学提供一个仿真平台和实践工具。     

颌面部血管的三维可视化

目的:探讨人体颌面部血管数字化的方法,对颌面部血管进行三维可视化研究.方法: 选人体新鲜头颈部标本,未经灌注及灌注后,通过CT连续扫描获得数据集,运用Mimics软件对颌面部血管进行三维重建,并对相关结构进行解剖学观察.结果: 该数字化可视模型可以多色彩、透明或任意组合显示,可任意旋转和切割,并从任意角度和方式进行观察...     

基于CT增强扫描三维重建的股动脉插管个性化设计

目的　探讨基于CT增强扫描数据重建股动脉插管区血管的三维数字化模型的方法及其应用。 方法　采用1例股动脉插管失败病例,经CT增强连续扫描,获得数据集,以Dicom格式导入Mimics10.01软件,运用阈值选取技术、手动分割技术、三维动态区域增长技术、布尔运算技术对股动脉插管区进行三维重建。 结果　按照组织层次获得了股动脉插管区皮肤、血管、髋骨的三维数字化模型,该三维模型可以进行任意缩放旋转,可显示结构间的毗邻关系和空间构象,可在三维空间进行距离、角度的测量,由此找到了股动脉插管导丝误入腹壁下动脉的原因。 结论　提示在个人PC上用Mimics软件可以较为快捷地建立三维数字可视化模型,为临床介入治疗和影像诊断提供了形态学参考及个性化考量。     

颌面部骨性结构及其周围血管的快速重建

目的　利用三维重建软件进行颌面部骨性结构与血管快速重建探讨其对口腔颌面外科临床的指导意义。 方法　对2例志愿者和2名颌面部骨折患者行多层螺旋CT 头颅血管造影扫描, 层厚0.6 mm, 将Dicom格式数据导入Mimics 10.01和3D-Doctor4.0,对颌面部骨性结构及其周围血管进行快速重建三维模型。 结果　重建的三维模型能清楚显示颌面部骨性结构及其周围血管的详尽立体解剖形态, 所得重建图像逼真, 可观察任意剖面并且多角度变换,显示其空间位置关系和定量测量分析。重建过程简单,无须专业三维重建人员进行操作,且结果可以导入CAD软件,进行快速成模。 结论 利用三维软件进行颌面骨性结构及其周围血管快速重建能为颌面部的手术设计与实施, 提供了快速可靠的形态学依据。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.