一种滑移式微动振幅测量装置的设计

根据微动滑移振幅具有小位移的特点，设计制作了一种弓形传感装置，该装置能把小幅位移信号转换为电信号，并通过示波器实时显示出来，用这种测试装置来测量滑移式微动振幅具有测试方法简单而测试精度较高的优点。     

人体对预先暴露-1,-0.5,0 Gz之后+Gz时的心血管反应

目的: 评价推拉动作的心血管反应性及推拉效应的发生机制. 方法: 17名健康体检现役歼击机飞行员被分别暴露于9次头高位倾斜(HUT,+1 Gz)→头低位倾斜(HDT,-1 Gz,-0.5 Gz,0 Gz)→HUT,随机顺序. 在下列条件下进行:+90° HUT 2 min,随后转为-90°, -30°, 0° HDT各30 s,随后转为+90° HUT 2 min. 床体旋转速度为45°*s-1. 间隔4 s监测一次血压(收缩压、舒张压和平均动脉压),实时监测心电图. 结果: 在HDT期间,心率和血压较基础HUT明显下降. 随后HUT,心率和血压上升,但与基础HUT比较其速度和幅度变小. -0.5 Gz和0 Gz血压较-1 Gz时明显升高. 结论: 在推拉动作小于+1 Gz时相由于颈动脉窦压力感受器的作用,导致反射性交感神经抑制、副交感神经兴奋,在其后的+Gz时相,这种交感-副交感神经兴奋性转换延迟,导致对其后+Gz的心血管反应性延迟. 这可能是推拉效应的发生机制之一.     

Second-order vestibular neuron morphology of the extra-MLF anterior canal pathway in the cat

Second-order vestibular neurons form the central links of the vestibulo-oculomotor three-neuron arcs that mediate compensatory eye movements. Most of the axons that provide for vertical vestibulo-ocular reflexes ascend in the medial longitudinal fasciculus (MLF) toward target neurons in the oculomotor and trochlear nuclei. We have now determined the morphology of individual excitatory second-order neurons of the anterior semicircular canal system that course outside the MLF to the oculomotor nucleus. The data were obtained by the intracellular horseradish peroxidase method. Cell somata of the extra-MLF anterior canal neurons were located in the superior vestibular nucleus. The main axon ascended through the deep reticular formation beneath the brachium conjunctivum to the rostral extent of the nucleus reticularis tegmenti pontis, where it crossed the midline. The main axon continued its trajectory to the caudal edge of the red nucleus from where it coursed back toward the oculomotor nucleus. Within the oculomotor nucleus, collaterals reached superior rectus and inferior oblique motoneurons. Some axon branches recrossed the midline within the oculomotor nucleus and reached the superior rectus motoneuron subdivision on that side. Since these neurons did not give off a collateral toward the spinal cord, they were classified as being of the vestibulo-oculomotor type and are thought to be involved exclusively in eye movement control. The signal content and spatial tuning characteristics of this anterior canal vestibulo-oculomotor neuron class remain to be determined.     

射野孔径形状控制器对直肠癌快速容积旋转调强放射治疗计划质量、机器传输能力和准确性的影响研究

目的:研究Eclipse15.5治疗计划系统中射野孔径形状控制器(ASC)对直肠癌快速(RapidArc)容积旋转调强放射治疗(VMAT)计划质量、机器传输能力和剂量传输准确性的影响。方法:选取医院收治的20例直肠癌患者,对每个病例生成ASC"off"、ASC"verylow"、ASC"moderate"和ASC"veryhigh"共4组RapidArc对照计划。其中ASC调节等级分别设置为关闭(off)、非常低(verylow)、中等(moderate)和非常高(veryhigh),其他计划参数设置保持一致,使用射野剂量系统(PD)验证剂量传输的准确性。主要评价指标包括剂量体积直方图(DVH)、Paddick适形指数(PCI)、梯度指数(GI)、均质性指数(HI)、剂量率(DoseRate)、机架转速(GantrySpeed)、机器跳数(MUs)、每角度机器跳数(MU/deg)和Gamma通过率,采用单因素方差分析和Kruskal-Wallis秩和检验检测4组ASC计划之间各项统计指标的差异。结果:4组ASC计划间除计划靶区平均剂量(PTV D_med)差异有统计学意义(F=3.243,P=0.027)外,其他DVH、PCI、GI和HI指标差异均无统计学意义。机器传输能力中ASC为very low、moderate和very high的MUs较off分别下降14.4%、20.9%和29.6%。4组计划间DoseRate、MU/deg和MUs差异有统计学意义(x²=16.621,x²=16.007,x²=15.877;P=0.001)。剂量传输准确性中4组计划间3%/3 mm和2%/2 mm的Gamma通过率差异均无统计学意义。结论:计划设计过程中需考虑ASC对各项计划指标的影响,应根据计划的复杂性和临床需要调整ASC的等级。     

千伏级锥形束断层扫描验证胸腹部肿瘤容积旋转调强放射治疗摆位误差的准确度

目的采用千伏级锥形束断层扫描(kV-CBCT)量化分析胸腹部肿瘤容积旋转调强放射治疗(VMAT)摆位误差的准确度。方法选取2017年3月至2019年9月于福建医科大学附属协和医院放疗科行胸腹部VMAT的78例患者作为研究对象,于治疗前行k V-CBCT获取实时摆位3D扫描验证图像,并采用灰度自动配准结合人工核对的方法,与计划定位CT图像进行匹配,获取摆位误差并纠正。结果 78例患者行k V-CBCT纠正胸腹部VMAT摆位误差,在X、Y、Z轴方向,差异均有统计学意义(P<0.05)。结论采用k V-CBCT验证胸腹部VMAT可有效提高摆位误差的准确度。     

旋转床模拟推拉动作对脑循环功能的影响

目的 探讨推拉动作对脑血管循环功能的影响及推拉效应的＋ＧＺ下降机制。方法１０名被试者在旋转床上经受“直立位－倒立位－直立位”Ｒ 模拟推拉动作,采用网谱勒（ＴＣＤ）技术监测分析旋转床模拟推拉脑血流速度及脉动参数的变化。结果 倒立位时出现收缩期流速增加、舒张期流速降低、脉动参数ＰＩ与ＲＩ升高的阻力增高型频谱,随后直立位时,这些变化更加明显且恢复较慢。在实验过程中平均血流速度没有显著变化。结论在推拉动作     

What Can Proton Beam Therapy Achieve for Patients with Pectus Excavatum Requiring Left Breast,Axilla and Internal Mammary Nodal Radiotherapy?

AimsExposure of the heart to radiation increases the risk of ischaemic heart disease, proportionate to the mean heart dose (MHD). Radiotherapy techniques including proton beam therapy (PBT) can reduce MHD. The aims of this study were to quantify the MHD reduction achievable by PBT compared with volumetric modulated arc therapy in breath hold (VMAT-BH) in patients with pectus excavatum (PEx), to identify an anatomical metric from a computed tomography scan that might indicate which patients will achieve the greatest MHD reductions from PBT.Materials and methodsSixteen patients with PEx (Haller Index ≥2.7) were identified from radiotherapy planning computed tomography images. Left breast/chest wall, axilla (I–IV) and internal mammary node (IMN) volumes were delineated. VMAT and PBT plans were prepared, all satisfying target coverage constraints. Signed-rank comparisons of techniques were undertaken for the mean dose to the heart, ipsilateral lung and contralateral breast. Spearman's rho correlations were calculated for anatomical metrics against MHD reduction achieved by PBT.ResultsThe mean MHD for VMAT-BH plans was 4.1 Gy compared with 0.7 Gy for PBT plans. PBT reduced MHD by an average of 3.4 Gy (range 2.8–4.4 Gy) compared with VMAT-BH (P < 0.001). PBT significantly reduced the mean dose to the ipsilateral lung (4.7 Gy, P < 0.001) and contralateral breast (2.7 Gy, P < 0.001). The distance (mm) at the most inferomedial extent of IMN volume (IMN to heart distance) negatively correlated with MHD reduction achieved by PBT (Spearman's rho –0.88 (95% confidence interval –0.96 to –0.67, P < 0.001)).ConclusionFor patients with PEx requiring left-sided breast and IMN radiotherapy, a clinically significant MHD reduction is achievable using PBT, compared with the optimal photon technique (VMAT-BH). This is a patient group in whom PBT could have the greatest benefit.     

Microelectronic neural bridging of toad nerves to restore leg function

The present study used a microelectronic neural bridge comprised of electrode arrays for neural signal detection, functional electrical stimulation, and a microelectronic circuit including signal amplifying, processing, and functional electrical stimulation to bridge two separate nerves, and to restore the lost function of one nerve. The left leg of one spinal toad was subjected to external mechanical stimulation and functional electrical stimulation driving. The function of the left leg of one spinal toad was regenerated to the corresponding leg of another spinal toad using a microelectronic neural bridge. Oscilloscope tracings showed that the electromyographic signals from controlled spinal toads were generated by neural signals that controlled the spinal toad, and there was a delay between signals. This study demonstrates that microelectronic neural bridging can be used to restore neural function between different injured nerves.     

腋前弧形切口结合环皮片周围打包压迫法预防腋臭术后伤口皮肤坏死

目的:探讨腋前弧形切口结合环皮片周围打包压迫法预防腋臭术后皮肤坏死的临床疗效。方法:采用腋前手术切口,术后环手术区域皮片周围打包加压固定。结果:52例患者中,51例伤口无积液,无裂开,愈合良好。1例患者切口皮肤有点状黑痂,经局部换药后3天痊愈。均获随访1~3个月,无异味,伤口开裂,无瘢痕形成,肢体活动无异常。结论:腋前弧形切口结合环皮片周围打包压迫方法是预防腋臭术后伤口皮肤坏死的一种良好方式,值得临床推广应用。