基于关节坐标系的肌肉骨骼间附着点坐标转换方法

目的运动状态下对人体骨肌系统进行运动学及动力学分析时,应避免对人体造成伤害。本研究通过尸体切片、CT或者MRI图像重建等方法构建静态骨肌模型,并将其应用于活体进行分析。方法采用尸体切片数据重建下肢的三维骨肌模型,并对此骨肌模型及活体下肢建立统一规则的关节坐标系,详细描述人体骨肌系统模型和活体上相关肌肉骨骼间附着点空间坐标值转换。结果对研究对象膝关节屈曲运动中股二头肌短头力臂及长度进行计算和分析。结论该方法对提高人体运动学和动力学仿真及肌肉力预测具有重要意义。     

面向鲤鱼机器人控脑技术的磁共振坐标转换方法研究及应用

为解决鲤鱼脑组织坐标准确定位问题,本文提出一种将鲤鱼脑组织磁共振成像坐标转换为应用脑立体定位仪进行电极植入所需坐标的方法。本研究应用3.0T磁共振成像仪对鲤鱼颅脑成像,自主建立颅脑三维立体定位坐标系、颅骨表面辅助三维坐标系和脑组织内部辅助三维坐标系,经两次坐标转换,将脑电极植入位点磁共振图像坐标转换到三维立体定位坐标系中以引导电极植入。实验分A、B两组,A组为磁共振成像仪结合脑立体定位仪组,B组为脑图谱结合脑立体定位仪组,每组鲤鱼20尾(n=20),分别应用两种方法将电极植入小脑运动区。进行鲤鱼机器人水下实验检验,结果表明A组和B组植入电极准确度分别为90%和60%,A组成功率明显高于B组(P <0.05)。故本文的新方法能够准确定位鲤鱼脑组织的坐标。     

眶上神经、血管主干的坐标定位

目的:为临床上手术去除眉间皱纹时防止眶上神经、血管的损伤提供解剖学依据.方法:逐层解剖防腐固定的尸体头部标本,建立相关坐标体系,得出眶上神经内侧支、眶上神经外侧支、眶上动脉主干的体表定位坐标参数,制作出走行范围轨迹.结果:以经过两侧眉弓最高点的水平线为X轴,以经过前正中线的垂直线为Y轴,建立坐标体系,得出在额部左侧面(坐标轴右侧)由(25.14±1.24,10) mm、(25.14±1.24,-10)mm、(28.16±1.23,10) mm、(28.16±1.23,-10)mm4点连线所围成的矩形区域以及在额部右侧面(坐标轴左侧)由(-24.31±2.67,10)mm、(-24.31±2.67,-7.5)mm、(-26.98±1.27,10)mm、(-26.98±1.27,-7.5)mm4点连线所围成的矩形区域为最容易损伤眶上神经、眶上动脉主干的“危险区”.结论:在额眉部有易损伤眶上神经、血管的危险区,临床上在进行额眉部手术时,应尽量保护此区域,尽量减小对眶上神经、眶上动脉的损伤.     

Length of the third stage of labor at term pregnancies is shorter if placenta is located at fundus: prospective study

AIM: To investigate how the location of the placenta at term pregnancies affects the duration of the third stage of labor and to discuss the possible mechanisms affecting the duration of the third stage. We believe that this is the first prospective study comparing the duration of the third stage of labor according to placental location. METHODS: The placental implantation was determined as anterior (n = 78), posterior (n = 59), or fundal (n = 64) by ultrasound, in 201 women with singleton pregnancies. After delivery of the newborn, oxytocin infusion was routinely given. Duration of the third stage of labor was compared by anova. P < 0.05 was determined as significant. RESULTS: The duration of the third stage of labor was 10.36 +/- 5.94 min, 10.44 +/- 5.35 min, and 8.12 +/- 4.25 min with placentas located anteriorly, posteriorly, and fundal, respectively. The length of the third stage was significantly shorter in the fundal placenta group. CONCLUSION: In this study, the length of the third stage of labor was approximately 2 min shorter with placentas located at the fundus compared to the other two groups. The mechanism responsible for shorter duration may be the bipolar separation of fundal placentas in contrast to usual unipolar down-up separation of anterior or posterior placentas. Another contributing factor may be the use of oxytocin infusion for the management of the third stage, however this should be investigated by further studies by using real time ultrasonography.     

腰椎关节突关节的应用解剖与在微创术中的定位价值

目的　通过解剖标本和影像资料测量腰椎关节突关节及毗邻结构的相关数据,探讨关节突关节作为腰椎微创术中重要解剖定位标志的可行性。 方法　收集新鲜成年人体腰椎标本10具20侧,共计80个节段。腰椎X线影像资料50例,200个节段。以关节突关节最高点(Highest point of lumbar zygapophysial joint, HP)作为测量中心,从微创手术应用解剖的角度,分别观测HP与手术相关结构的距离和角度。 结果　HP至腰神经距离随椎间隙向下,数值逐渐增大,而角度趋于变小;HP至邻近椎间盘的距离,向下逐渐增大;HP和相邻椎间盘中平面垂直距离为0.8~1.5 mm,HP垂直高度位于椎间盘厚度范围内。 结论　腰椎关节突关节具备位置稳定、显露简单、容易辨认、对应关系易于掌握、准确性高的特点。是理想的解剖标志。在临床腰椎后路微创手术中可发挥一定的解剖定位作用。     

基于双靶X线球管的双束X射线的金标成像实时跟踪可行性

目的:探究新型双靶X线球管的最优靶间距并建立一种基于此球管的双束X射线的金标记成像实时跟踪算法,实现实时CBCT图像引导放疗。方法:将植入金标记的模体置于医科达Synergy加速器治疗床的床面上,利用该加速器配置的CBCT获取金标记的kV-X射线零度投影图像。在同一机架角,平移模体在床面上的位置,使其处于间距为2~12 mm的等差对称位置,分别得到金标记的两次kV-X射线零度投影图像。然后从叠加的金标投影图像中提取模体两个位置处的金标记的2D投影位置。将相应的2D金标投影位置反向投影至模拟的双靶靶点位置。利用两条投影线相交的几何原理,重建出金标记在模体中的3D坐标,实现靶区内金标记位置的跟踪。结果:模体位于床面上间距在2~12 mm的对称位置时,对应于靶间距为2~12 mm的双靶X线球管的双束平行X射线。当模体位置相距7 mm及以下时,无法成功从叠加投影图像中检测出金标记的2D投影坐标,无法重建金标记的3D位置;仅当模体位于8 mm及以上的对称位置时,金标记2D投影坐标才得以检测到,检测精度为（±0.176、±0.140） mm,此时重建3D坐标的检测精度平均可以达到（±0.242、±0.392、±1.036） mm。结论:当双靶的靶间距大于等于8 mm时,根据金标记投影图像能较精确地重建出金标记的3D坐标。     

三维适形放射治疗位置与剂量精度的验证

目的:验证三维适形放射治疗位置与剂量精度.方法:采用胶片法和电离室法,对所使用的治疗计划系统和加速器距离精度、靶中心位置精度及等中心吸收剂量进行实测验证.结果:治疗计划系统所显示图像的距离精度＜1%,靶中心位置精度＜2mm,等中心吸收剂量精度＜1%.结论:所验证的三维适形放疗位置与剂量精度符合临床要求,验证方法可行.     

一例45,XX,-13/46,XX,r(13)/46,XX,r(13;13)/47,XX,2r(13)(p13q32.3)患者及其表型定位研究

目的　通过对 1例 13号环状染色体综合征患者的染色体分析、表型定位研究和相关文献复习比较 ,探索染色体区带与表型的关系。方法　应用染色体G带、C带、N带、高分辨显带技术、表型定位和文献复习比较分析方法 ,对 1例 13号环状染色体综合征患者进行了研究。结果　患儿双亲核型正常 ,患儿核型为 45 ,XX ,-13 /4 6,XX ,r( 13 ) /4 6,XX ,r( 13 ;13 ) /4 7,XX ,2r( 13 ) ( p13q3 2 .3 ) ;典型的 13号环状染色体综合征与 13q3 4的缺失相关 ;13号环状染色体综合征患者的手足、肾脏、骨骼、外生殖器异常及心脏杂音与 13 q3 2 q3 2 .2片段的缺失有关 ,缩颌与 13q3 2 .3 q3 3片段的缺失相关 ,肛门闭锁与 13 q2 2 q3 2的缺失相关 ,无脑畸形与 13 q13 q2 2片段的缺失相关。 结论　新的环状染色体断裂重接点在 13 p13和 13q3 2 .3 ;13号环状染色体综合征患者临床特征的差异与染色体区带缺失部位的不同密切相关。     

单方向X射线成像定位算法的比较

目的:通过单射野方向的X射线成像来实时定位肿瘤靶区三维位置,不仅能够提高治疗精度,减少成像装置,而且能降低对病人曝光的额外剂量。但是由于射线束方向的运动信息缺失,如何保证高精度是定位算法需解决的一个关键问题。方法:本研究针对4种典型的实时定位算法,使用模拟的呼吸运动轨迹来比较它们的定位效果。这四种定位算法分别是α分布图法、两种基于高斯概率密度分布的算法和贝叶斯概率密度分布法。结果:在连续15分次的模拟结果中,α分布图法的99百分位数(99thpercentile)与最大误差绝大多数大于1 cm,高斯概率密度法1的95thpercentile、99thpercentile与最大误差均大于1 cm,高斯概率密度分布法2的最大误差项中出现了3 cm~4 cm的异常值,只有贝叶斯概率密度分布法的结果均较为稳定,在模型参数P<1的情况下,均方根误差、95thpercentile、99thpercentile和最大误差分别为1.8 mm~2 mm、3.4 mm~4.3 mm、4.2 mm~6 mm和4.8 mm~6.5 mm。结论:相较于前3种算法,贝叶斯概率密度分布法总体上能够对模拟的呼吸运动引起的靶区运动实现更加精确和稳定的实时定位。     

The relationship between trochlear dysplasia and medial patellofemoral ligament rupture location after patellar dislocation: An MRI evaluation

The medial patellofemoral ligament (MPFL) and the native trochlear geometry represent two of the most critical components of patellofemoral stability. We sought to define the relationship between trochlear dysplasia and MPFL rupture location in patients with documented patellar dislocations. We hypothesized that patients with lower grades of trochlear dysplasia would have patellar based MPFL ruptures, while patients with higher grade dysplasia would have femoral-sided ruptures.We reviewed post-injury MRIs of 59 patients with documented patella dislocation. Information gathered included: type of trochlear dysplasia in the axial plane MRI, location of MPFL rupture, patellar height ratio, tibial tuberosity to trochlear groove distance (TTTG), number of dislocations prior to MRI, and time between the latest patella dislocation and the MRI.Statistical calculations utilized the Chi-Square-Test.We classified 11 cases as a dysplasia type A, 35 as a type B, 11 as a type C, and 2 cases as a trochlear dysplasia type D. In 7 patients (12%) the MPFL rupture was patella based, in 18 patients (31%) intra-ligamentous, in 33 cases (56%) femoral sided and in one case no MPFL could be identified.In contrast to our original hypothesis, the type of trochlear dysplasia does not appear to be related to the rupture location of the MPFL after patellar dislocation. According to our results, it is not possible to presume the location of the MPFL rupture based on assessment of the trochlear morphology. Therefore, a MRI is mandatory for final indication of any surgery.