基于CT图像重建腰椎活动节段三维有限元模型及其应用

腰椎节段三维有限元模型既要求在视觉上与实际相似 ,又要求易于网格划分和数学求解。本文基于中国人体腰椎L4 - 5活动节段的系列二维截面CT图像 ,采用轮廓线的描述方式提取平面数据 ,通过将平面数据坐标进行三维化处理 ,获得腰椎节段的三维体数据 ,最后直接利用ANSYS有限元分析软件 ,采用自底向上的建模方式重建腰椎节段的三维有限元模型 ,并利用该模型研究了L4 - 5腰椎间盘的生物力学行为。结果表明 ,该模型具有很好的视觉效果和数学求解能力。     

骨科抗感染预防用药138例的药物经济学分析

目的　观察不同方案对骨科手术后抗感染预防用药的疗效及所发生的经济效果。方法　骨科手术病人 138例 ,类伤口 ,术前无感染指征。随机分为 6组 ,给予不同的治疗方案 ,观察其手术后治疗结果 ,并运用药物经济学的成本 效果分析进行评价。结果　青霉素G Na作骨科抗感染预防用药 ,其C/E值明显小于其他治疗组。结论　 6组方案中 ,青霉素为最佳选择 ,其余依次为氧氟沙星、头孢拉定、头孢噻肟钠、头孢呋辛、头孢三嗪。     

肾炎1号方治疗IgA肾病的临床研究

目的:观察肾炎1号方治疗IgA肾病的疗效。方法:选择经病理诊断确诊为IgA肾病26例,随机分为2组。治疗组14例口服肾炎1号(由旱莲草、小蓟、蒲黄、藕节、生地黄、当归、丹参、生甘草、女贞子、柴胡、黄芩等组成),对照组12例口服西药洛汀新。2组均以6月为1疗程。结果:治疗组完全缓解2例,显效4例,有效6例,无效2例,总有效率为85.7％;对照组完全缓解1例,显效2例,有效2例,无效7例,总有效率为41.7％。2组总有效率比较,差异有显著性意义(P<0.05)。2组治疗前后症状积分值比较,差异有显著性意义(P<0.05)。结论:肾炎1号方治疗IgA肾病有较好的疗效。     

烧烫Ⅱ号方治疗烧烫伤160例临床观察

目的　观察和探讨烧烫Ⅱ号方治疗烧、烫伤的疗效。方法　将 2 42例不同原因所致的不同深度和不同面积的烧、烫、灼伤患者 ,随机分为 2组 ,治疗组 1 60例 ,对照组 82例 ,分别应用烧烫Ⅱ号方和京万红局部涂药 ,每日 2～ 3次 ,全部采用暴露疗法。结果　治疗组总有效率 ( 1 0 0 % )、不同程度烧烫伤平均治愈时间与对照组 (总有效率 69.5 % )比较均有非常显著性差异 (P <0 .0 1 ) ,治疗组疗效明显优于对照组。结论　烧烫Ⅱ号方治疗烧烫伤具有上皮生长速度快、渗出少、感染机会少、止痛效果明显 ,无毒副作用、疗程短、成本低、方法简便、价廉可靠、疗效佳等特点 ,值得临床推广和使用。     

"军字一号"工程升级内容与方法

“军字一号”工程特指军队医院信息系统,该系统从1995年开始开发,到2002年底已经历了8年的时间。由于医院需求的变化和提升．以及信息技术的发展．“军字一号”工程从2002年底开始进行系统升级。论述了“军字一号”工程在升级过程中的指导思想、具体方法和内容,在指导思想上坚持兼容原有系统、循序渐进、有限目标;在方法上首先完善扩充原有系统,其次探索采用新技术逐步升级整个系统;在内容上先升级公共部分内容．再升级、完善各子系统。     

“不出千里,决者至众,不可曲止也”略谈

对于《史记·扁鹊传》中"越人之为方也……不可曲止也"一段,前人多有句读、注译,但各家观点多有挂一漏万之嫌疑,其中"不出千里,决者至众,不可曲止也"一语在注释方面颇有值得商榷之处。经反复推敲语义,并查阅相关文献,指出了此语在文中的原有之义。     

Identification of Orthotropic Elastic Properties of Wood by a Synthetic Image Approach Based on Digital Image Correlation

This work aims to determine the orthotropic linear elastic constitutive parameters of Pinus pinaster Ait. wood from a single uniaxial compressive experimental test, under quasi-static loading conditions, based on two different specimen configurations: (a) on-axis rectangular specimens oriented on the radial-tangential plane, (b) off-axis specimens with a grain angle of about 60° (radial-tangential plane). Using digital image correlation (DIC), full-field displacement and strain maps are obtained and used to identify the four orthotropic elastic parameters using the finite element model updating (FEMU) technique. Based on the FE data, a synthetic image reconstruction approach is proposed by coupling the inverse identification method with synthetically deformed images, which are then processed by DIC and compared with the experimental results. The proposed methodology is first validated by employing a DIC-levelled FEA reference in the identification procedure. The impact of the DIC setting parameters on the identification results is systematically investigated. This influence appears to be stronger when the parameter is less sensitive to the experimental setup used. When using on-axis specimen configuration, three orthotropic parameters of Pinus pinaster (ER, ET and νRT) are correctly identified, while the shear modulus (GRT) is robustly identified when using off-axis specimen configuration.     

骨伤三号方对骨质疏松压缩性骨折模型鼠的影响及部分机制

目的:探讨骨伤三号方对骨质疏松压缩性骨折模型鼠的治疗效果,同时探讨其对OPG/RANKL/核因子-κB信号通路的影响。方法:将30只雌性Sprague Dawley(SD)鼠随机分为2组,空白组(10只)及造模组(20只),20只造模术首先接受双侧卵巢切除术,术后4周再采用剪断L1-5节段椎体前缘以模拟骨质疏松压缩性骨折模型,共有18只大鼠成模,将其随机分为模型组及干预组,每组9只。干预组大鼠找造模成功后接受骨伤三号方灌胃,1次/d。空白组及模型组接受等量生理盐水灌胃,1次/d。各组均干预4周。干预结束后比较各组大鼠生物力学变化,用HE染色法观察各组大鼠骨痂形态结构变化,酶联免疫吸附试验检测各组血清OPG、核因子-κB水平变化;Western Blotting检测骨折组织RANK水平变化。结果:与空白组比较,造模组大鼠弹性模量、最大载荷降低,差异有统计学意义(P<0.05);与模型组比较,干预组弹性模量、最大载荷显著升高,差异有统计学意义(P<0.05)。HE染色显示干预4周后空白组可见成熟骨小梁形成,骨质疏松性骨折组骨痂邻近原骨小梁细小松散,向骨性骨痂转化过程明显延迟;干预组形态介于正常骨折组和骨质疏松性骨折组之间。与空白组比较,模型组及干预组大鼠OPG明显下降,核因子-κB、RANK明显升高,经过中药干预后大鼠OPG水平上调,核因子-κB、RANK表达减少,差异有统计学意义(P<0.05)。结论:骨伤三号方可能通过OPG/RANKL/核因子-κB信号通路加速骨质疏松压缩性骨折的愈合。     

A Cross-Sectional Reproducibility Study of a Standard Camera Sensor Using Artificial Intelligence to Assess Food Items: The FoodIntech Project

Having a system to measure food consumption is important to establish whether individual nutritional needs are being met in order to act quickly and to minimize the risk of undernutrition. Here, we tested a smartphone-based food consumption assessment system named FoodIntech. FoodIntech, which is based on AI using deep neural networks (DNN), automatically recognizes food items and dishes and calculates food leftovers using an image-based approach, i.e., it does not require human intervention to assess food consumption. This method uses one-input and one-output images by means of the detection and synchronization of a QRcode located on the meal tray. The DNN are then used to process the images and implement food detection, segmentation and recognition. Overall, 22,544 situations analyzed from 149 dishes were used to test the reliability of this method. The reliability of the AI results, based on the central intra-class correlation coefficient values, appeared to be excellent for 39% of the dishes (n = 58 dishes) and good for 19% (n = 28). The implementation of this method is an effective way to improve the recognition of dishes and it is possible, with a sufficient number of photos, to extend the capabilities of the tool to new dishes and foods.     

Comparison between the end-diastolic images and the summed images of gated 99mTc-sestamibi SPECT perfusion study in detection of coronary artery disease in women

BACKGROUND: End-diastolic images (EDI) can be easily derived from technetium 99m-sestamibi gated single photon emission computed tomography (SPECT) perfusion study (SGS). This may reduce the effect of myocardial wall thickening during systole and potentially improve the sensitivity of radionuclide perfusion imaging, especially in patients with small hearts. METHODS: This prospective study was conducted in 53 consecutive female patients to compare the diagnostic accuracy of EDI with that of the summed images (SI) of SGS. Fifty-three patients with suspected coronary artery disease (CAD), scheduled for coronary angiography within 2 months, were evaluated with SGS. Treadmill stress testing was used in 28 patients, and dipyridamole injection was used in the remaining 25 patients. A 2-day protocol was used as follows: stress test with 25 to 30 mCi of 99mTc-sestamibi and a rest study performed at least 24 hours later with the same dose. Sixteen frames per cardiac cycle were acquired for both the rest and the stress studies. Three end-diastolic frames were used for EDI, and all the 16 frames were summed for SI. SI and EDI data reconstruction were interpreted by 3 experienced blinded observers (consensus reading) during two distinct reading sessions, one with SI alone and the second with EDI alone. The heart was divided into 17 segments. RESULTS: Coronary angiography showed > or = 50% stenoses in 1 or more major coronary arteries in 38 patients and was normal in 15 patients. The sensitivity was 73.7% (28/38) and 84.2% (32/38), respectively, for SI and EDI. Three of 4 patients with CAD not detected by SI but seen with EDI were considered to have relatively small hearts. The specificity was 86.7% (13/15) and 80.0% (12/15) for SI and EDI, respectively. On a total of 901 segments, 106 ischemic defects were detected by SI and 173 by EDI (P = .001). The segmental agreement between the two techniques was 88.6% (798/901 segments). CONCLUSION: EDI showed more ischemic defects than SI, and there was also a nonsignificant trend toward an improved sensitivity of EDI in comparison to SI in detection of coronary artery disease in women, especially in patients with small hearts. EDI may be a useful adjunct to the standard perfusion imaging with SGS in such a clinical situation.