Automatic knee meniscus tear detection and orientation classification with Mask-RCNN

Purpose

This work presents our contribution to a data challenge organized by the French Radiology Society during the Journées Francophones de Radiologie in October 2018. This challenge consisted in classifying MR images of the knee with respect to the presence of tears in the knee menisci, on meniscal tear location, and meniscal tear orientation.

战斗机飞行员面部三维形态数字化测量研究

目的 获取我国飞行员面部的三维形态数据与特征.方法 研制了面部空间定位装置,建立了面部定位数字化测量方法,并对154名战斗机飞行员的面部进行了测量.结果 获得了该组飞行员面部65个形态特征点的三维坐标数据.结论 所建立的测量方法实用、有效,能用于大样本飞行员面部三维形态的数字化测量;所获得的结果可用于分析面部三维形态特征,并为供氧面罩等面部防护装具的造型设计提供依据.     

鼻咽癌放疗两种面罩标记法摆位精度的比较

目的分析鼻咽癌放射治疗两种面罩标记法摆位的误差值,以选择出较佳的提高头颈部重复摆位精度的面罩标记方法。方法初治鼻咽癌病人随机分为面罩开窗组和不开窗组,各20例,所有病人分别在首次治疗、治疗第2周未、治疗第4周末和未次治疗时,在加速器下摄验证片,与定位片比较误差大小。结果中心点在X轴上偏离值开窗法为（1．21±0．49）mm,不开窗法为（2．27±1．29）mm,两组差异有统计学意义（t=3．44,P〈0．01）;中心点在Y轴上偏离值开窗法为（1．28±0．43）mm,不开窗法为（2．45±1．48）mm,两组差异有统计学意义（t=3．395,P〈0．01）。结论面罩开窗标记法比面罩不开窗标记法提高了放射治疗重复摆位的精度,具有临床推广价值。     

压力舱不同方式鼻咽部加压预防耳气压性损伤

目的 探讨低压舱内不同方式鼻咽部加压对预防耳鼻气压性损伤的效果.方法 10名健康志愿者,咽鼓管通气阻力<6.0 kPa.低压舱以20 m/s的速率由3500 m模拟海拔高度增压到地面.被试者发生"压耳"感时,经面罩进行全呼吸道加压、封闭声门鼻腔及鼻咽部加压、封闭后鼻孔全鼻腔加压,压力为6.0 kPa,使鼓室内外压力平衡.分别测面罩加压前后鼓室压.结果 志愿者经不同途径对鼻咽部加压都有良好的平衡鼓室压的作用.对面罩加压前后的鼓室压进行比较.差异有统计学意义(P<0.01).结论 当人体的环境气压增加时,经面罩对鼻咽部提供大于咽鼓管通气阻力的压力可以预防耳气压伤的发生.     

面罩氧气雾化吸入治疗的相关因素影响及护理对策

面罩氧气雾化吸入治疗是用氧作为驱动力,用面罩雾化器将药物分散成微小的雾滴或微粒,进入呼吸道及肺内,达到局部治疗及全身治疗的作用,我科收集从2009年10月起雾化吸入治疗的患者200例,发现影响其治疗效果有诸多因素,针对其相关因素有,吸入药液释放的速度,吸入时间,吸入气体湿度,吸入时机,雾化器本身,及病人呼吸道的病理状态,针对这些因素提出了对应的护理对策。     

口含嘴式与面罩式雾化吸入布地奈德混悬液在儿童哮喘治疗的应用比较

目的探讨面罩式与口含嘴式雾化吸入布地奈德混悬液在儿童哮喘治疗中的优劣。方法选择2011年9月--2012年9月在该院儿科就诊的68例哮喘患儿随机分为二组,观察组（n=34）采用面罩式雾化吸入布地奈德混悬液的方式,对照组（n=34）采用口含嘴式雾化吸入方式。观察二组患儿治疗后1、3、6d的呼气高峰流量（最大呼气峰流速）（Peakexpiratoryflowrate,PEFR）PEFR值的变化并比较;治疗后临床疗效、口腔炎的发生率及不同雾化吸入方式的适应率并比较。结果观察组与对照组在治疗后1d、3d、6d的PEFR值（占预计值的百分比）分别为（67．9±5．4）％／（59．6±5．2）％、（72．5±3．5）％／（60．3±5．O）％、（74．3±3．9）％／（73．1±4．5）％,二组1d、3d的PEFR值比较差异有统计学意义（P〈0．05）,6d比较无统计学意义（P〉0．05）;二组在临床疗效上观察组好于对照组,但差异无统计学意义（P〉0．05）;口腔炎发生率及使用适应率观察组好于对照组,差异有统计学意义（P〈0．05）。结论儿童哮喘治疗中面罩式雾化吸入治疗效果优于口含嘴式雾化吸入,并发症少,值得临床推广应用。     

七氟醚面罩吸入麻醉在小儿泪道探通术中的应用

目的观察七氟醚面罩吸人麻醉在小儿泪道探通术中的应用效果。方法选择ASAⅠ-Ⅱ级、年龄3，12个月需行泪道探通术的新生儿泪囊炎患儿40例，随机分为两组：七氟醚组（S组）及氯胺酮组（K组），分别采用面罩吸入七氟醚、肌肉注射氯胺酮进行麻醉诱导及维持。观察记录两组患者麻醉中平均动脉压（MAP）、心率（HR）、呼吸（R）及脉搏血氧饱和度（SpO2）的变化情况，记录意识消失、苏醒及离开麻醉恢复室的时间，观察并随访麻醉中及麻醉后的不良反应。结果S组患者术中MAP轻度下降，HR变化不明显，而K组术中MAP及HR均明显升高；S组意识消失时间、苏醒时间及离开麻醉恢复室的时间明显短于K组；K组诱导期兴奋、术中体动及分泌物增加的病例数明显多于S组。结论七氟醚面罩吸入麻醉可安全用于小儿泪道探通术，具有麻醉诱导迅速、维持平稳、苏醒彻底的优点。     

Application of Minimum Effective Cuff Inflating Volume for Laryngeal Mask Airway and its Impact on Postoperative Pharyngeal Complications

Background:

High intracuff pressure can cause severe pharyngeal complications including sore throat or hoarseness after laryngeal mask airway (LMA) removal postoperatively. Though the application of minimum effective cuff inflating volume is suggested to maintain airway sealing and adequacy of ventilation for patients receiving general anesthesia with LMA at lower level of the intracuff pressure, it is currently not a standard care in most of the anesthetic departments. In this study, the minimum effective cuff inflating volume was determined for classic LMA Well Lead™ (Well Lead Medical Co., Ltd., China) and its impact on postoperative pharyngeal complications was also explored.

Methods:

Patients with American Society of Anesthesiologists physical status (I–III) undergoing the short-duration urological surgery were recruited in this trial. First, the minimum effective cuff inflating volume was determined for size 4 or 5 LMA Well LeadTM in the study 1. Immediately following placement and confirmation of ideal LMA position, the cuff was inflated with 5, 7, 10 ml of air and up to 30 ml at 5 ml increment. The intracuff pressure, oropharyngeal leak pressure (OLP), and inspiratory peak airway pressure under positive pressure ventilation at the corresponding cuff volume as indicated above were recorded. Second, the enrolled patients were randomly allocated into minimum effective cuff inflating volume group (MC) and routine care (RC) group in the study 2. The minimum effective cuff inflating volume was applied and maintained in MC group, whereas the cuff volume was inflated with half of the maximum cuff inflating volume recommended by manufacturer in RC group throughout the surgical procedure and stay in postanesthesia care unit prior to LMA removal. The incidence of pharyngeal complications at 0, 2, 24, and 48 h after removal of LMA and other intra-operative adverse events were also documented.

Results:

The intracuff pressure varied with the cuff inflating volume in a positive linear correlation manner (Y = 11.68X − 42.1, r² = 0.9191) under the range of 5–30 ml for size 4 LMA. In similar with size 4 LMA, the data were also showed the linear relationship between the intracuff pressure and the cuff inflating volume (Y = 7.39X − 10.9, r² = 0.8855) for size 5 LMA. The minimal effective cuff inflating volume for size 4 or 5 LMA was 7–9 ml in combination of considering OLP needed to maintain airway sealing during intermittently positive pressure ventilation. The intracuff pressure in MC group was lower compared with RC group (63.0 ± 3.7 vs. 126.4 ± 24.0 cmH₂O for size 4 LMA; 55.6 ± 2.4 vs. 138.5± 26.8 cmH₂O for size 5 LMA; P < 0.0001). The incidence of pharyngeal adverse events was lower in MC group versus the RC group at 2, 24 h after LMA removal.

Conclusions:

The relationship between the cuff inflating volume and the intracuff pressure for size 4 or 5 LMA Well Lead™ is in a linear correlation manner at the range of 5–30 ml. The minimal cuff inflating volume is adequate for satisfactory airway sealing and consequently associated with lower incidence of postoperative pharyngeal complications for LMA Well Lead.™     

小儿喉罩通气道置人时呼气末七氟烷的最低肺泡有效浓度

目的 探讨全凭七氟烷吸入诱导时小儿喉罩通气道置入所需的呼气末七氟烷最低肺泡有效浓度.方法 全麻下行择期手术患儿27例,ASA Ⅰ或Ⅱ级,年龄3～8岁.吸入8%七氟烷高浓度诱导,睫毛反射消失后调整吸入七氟烷的浓度以达到呼气末浓度的预定值,维持这个预定值10mn后为患儿置人喉罩.置入喉罩即刻以及置入喉罩后的1 min内患儿如果出现咳嗽、肢体运动、下颌松弛困难以致喉罩无法插入,屏气、喉痉挛、低氧血症这其中的任何一项即认为置入喉罩不满意.七氟烷预定浓度根据序贯法确定,初始患儿的呼气末七氟烷浓度为2.0%,若喉罩置入不满意,则下一患儿的七氟烷预定浓度增加0.2%;若喉罩置入满意,则下一患儿的七氟烷预定浓度降低0.2%.结果 患儿满意置入喉罩通气道时的七氟烷MACLMA为(2.01±0.19)%.ED95为2.36%(95%CI 2.15%～4.15%).结论 50%和95%的患儿在呼气末七氟烷浓度分别为2.01%和2.36%时置入喉罩不发生咳嗽、体动及其他气道不良反应.