BACKGROUND:Based on the integration of virtual reality technology with acupoints, acupuncture can be expressed three-dimensional y.
OBJECTIVE:To explore the structure of points through reconstructing digitalized three-dimensional visualization of Neiguan (PC6) structure based on VOXEL-MAN and Micro-XCT.
METHODS:Muscles and other tissues adjacent with Neiguan (PC6) were segmented and merged based on the VOXEL-MAN system combined with the anatomical knowledge of acupoints;nerves and blood vessels were performed with three-dimensional reconstruction;the needle-inserting animation of Neiguan (PC6) was obtained by running script file. Three-dimensional visualization and virtual needle-inserting researches of Neiguan (PC6) were performed. Nature of the acupoints was detected by the Micro-XCT-200 machine additional y.
RESULTS AND CONCLUSION:The visualization of the anatomical structure of local Neiguan (PC6) was completed, and the localization and expression of Neiguan (PC6) in the digitized virtual human were realized. The Neiguan (PC6) structure was researched with Micro-XCT-200, and showed there was no new tissue. Local three-dimensional reconstruction of the acupoint structure could help to display the anatomical structure of acupoints and simulate the acupuncture process. It could also help to observe the relationship between the needle body and the surrounding tissues during needle-inserting, which supplying a good basis not only for exploring the security of needle-inserting, but also for improving the clinical effect of acupuncture. The research on the structure of acupoint Neiguan (PC6) by Micro-XCT-200 provides further experimental evidence for the hypothesis of three-dimensional acupoint.

Objective To evaluate the effect of digital subtraction angiography and transcatheter embolization for gastrointestinal hemorrhage.Methods Twenty patients with gastrointestinal hemorrhage received celiac arteries,superior mesenteric arteries and inferior mesenteric arteries angiography. Superselective angiography were performed when the arteries were suspicious by clinic or angiogrraphy.Ten patients with definite diagnosis and manifestation of hemorrhagic arteries by angiography were embolized after superseleetive catheterization with gelfoam particles,gelfoam particles and coils,polyvinyl alcohol particles. Results The positive signs were observed in 13 cases.The DSA features including contrast medium accumulation in the gastrointestinal tract outside vascular,aneurysm,tumorous vascularization and staining, artery affect and local vasospasm.The bleedings were stopped immediately in 8 patients.No rebleeding and intestinal ischaemia or necrosis were observed in 30 days.One patient died in the second day after embolization from multiple organ failure.Rebleeding occurred 3 days after embolization in another patient, and was recovered after surgical operation.Conclusion DSA is more effective for the diagnosis of gastrointestinal vascular malformation and tumors complicating acute bleeding.Transcatheter embolization is effective and safe to control the hemorrhage.

OBJECTIVETo observe the anatomic structure of Huantiao (GB 30) visually, to imitate the inserting process of the needle to explore the safty of needle insertion and improve the therapeutic effect of acupuncture in clinic.

METHODSCombined with anatomic structure of acupoint, muscles and other tissues related with Huantiao (GB 30) were interactively segmented in VOXEL-MAN with the computer graphics technology. Nerves and blood vessels were reconstructed by establishing mathematic model, and the needle-inserting animation of Huantiso (GB 30) was obtained by running script file.

RESULTSThe three-dimensional (3-D) visualization of Huantiao (GB 30) on needle-inserting animation was accomplished, the spatial location and expression of Huantiao (GB 30) in the digitized virtual human body were observed, the virtual inserting process was imitated realistically, and the 3-D animation of needle insertion at Huantiao (GB 30) was created.

CONCLUSIONBuilding mathematic model is favorable for expressing the anatomic structure of Huantiao (GB 30) in 3-D space, imitating the process of needle insertion realistically and observing the spatial structure of the point and the around tissues, which can provide a solid foundation for the safety of needle insertion of acupoints and improve therapeutic effect of acupuncture in clinic.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Computer Graphics ; Humans ; Imaging, Three-Dimensional

OBJECTIVETo study on visible display of Meridian on the dummy human body.

METHODSTube model-building method and computer technique were used, and data came from Voxel-Man dummy human body development platform.

RESULTSThe visual effect of re-building Meridian is very good and it can display the different layers of anatomic structures on the Meridian lines.

CONCLUSIONThe visible display of Meridian on the dummy human body is preliminary realized, which provides data carriers for establishing the platform of Meridian study.

Human Body ; Humans ; Meridians

BACKGROUND:The treatment of acute myocardial infarction (AMI) is thought to restore antegrade blood flow in the infarct-related artery (IRA) and minimize ischemic damage to the myocardium as soon as possible. The present study aimed to identify possible clinical predictors for no-reflow in patients with AMI after primary percutaneous coronary intervention (PCI). METHODS:A total of 312 consecutive patients with AMI who had been treated from January 2008 to December 2010 at the Cardiology Department of East Hospital, Tongji University School of Medicine were enrolled in this study. Inclusion criteria were:(i) patients underwent successfully primary PCI within 12 hours after the appearance of symptoms; or (ii) patients with ischemic chest pain for more than 12 hours after a successful primary PCI within 24 hours after appearance of symptoms. Exculsion criteria were:(i) coronary artery spasm; (ii) diameter stenosis of the culprit lesion was ≤50％ and coronary blood flow was normal; (iii) patients with severe left main coronary or multivessel disease, who had to require emergency revascularization. According to thrombolysis in myocardial infarction (TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography findings and surgical data were compared between the two groups. Univariate and multivariate logistic regressions were used to determine the predictors for no-reflow. RESULTS:Fifty-four (17.3％) of the patients developed NR phenomenon after primary PCI. Univariate analysis showed that age, time from onset to reperfusion, systolic blood pressure (SBP) on admission, Killip class of myocardial infarction, intra-aortic balloon pump (IABP) use before primary PCI, TIMI flow grade before primary PCI, type of occlusion, thrombus burden on baseline angiography, target lesion length, reference luminal diameter and method of reperfusion were correlated with no-reflow (P<0.05 for all). Multiple logistic regression analysis identified that age >65 years [OR=1.470, 95％ confidence interval (CI) 1.460–1.490,P=0.007], long time from onset to reperfusion >6 hours (OR=1.270, 95％CI 1.160–1.400,P=0.001), low SBP on admission <100 mmHg (OR=1.910, 95％CI 1.018–3.896,P=0.004), IABP use before PCI (OR= 1.949, 95％CI 1.168–3.253, P=0.011), low (≤1) TIMI flow grade before primary PCI (OR=1.100, 95％CI 1.080–1.250,P<0.001), high thrombus burden (OR=1.600, 95％CI 1.470–2.760,P=0.030), and long target lesion (OR=1.948, 95％CI 1.908–1.990,P=0.019) on angiography were independent predictors of no-reflow. CONCLUSION:The occurrence of no-reflow after primary PCI for acute myocardial infarction can predict clinical, angiographic and procedural features.

Objective To evaluate diagnosis and preoperative management of cases with interrupted aortic arch(IAA)in infancy.Methods Fifty-three infants who were admitted to our hospital from Jan.2001 to Nov.2007 were involved.Clinical data,findings of echocardiogram(Echo),spiral CT,MRI,angiocardiography,preoperative management,surgical repair and postoperative outcome were analyzed retrospectively.Results There were 38 boys and 15 girls,weighted 2.18-10.0(4.32?1.60)kg,aged 1 day to 12(3.05?3.53)months,of which 50.94% were neonates.Symptoms at presentation were 90.57% with tachypnea and 83.02% with difficulty in feeding.Eighty three point zero two percentage cases had different degree of congestive heart failure,37.74% of which were in grade Ⅲ heart function.All cases had weakened femoral pulse.All cases were performed Echo,38 cases of them diagnosed as IAA,6 cases as IAA or severe coarctation of aorta(CoA);they were diagnosed as IAA by CT,and 9 as severe CoA who were diagnosed as IAA via CT or operation.Thirty-three cases were performed CT,of which 15 underwent surgical repair,cardiovascular abnormalities revealed by CT were the same as those in surgical findings.Three cases were taken MRI,and 7 cases were performed angiocardiography.According to the results of Echo,CT,MRI,angiocardiography and surgical findings,35 cases were type A,15 cases were type B and 3 cases were type C.Preoperative treatment included maintaining patent ductus areriosis,management of heart failure and supportive treatment.After proper preoperative management of medication,most cases with congestive heart failure were improved.Twenty-six cases underwent surgical repair,16 survived,10 died du-ring perioperative stage.Main cause of death was severe low cardiac output.Conclusions Value of Echo in diagnosis of IAA is limi-ted.Combination of Echo with CT or MRI is a convenient and safe way to diagnose IAA,it can replace the traditional method of Echo combined with angiocardiography.Proper preoperative management is helpful to patients with IAA to pass to surgical repair,and makes for successful operation.

BACKGROUNDBariatric surgery offers successful resolution of type 2 diabetes mellitus (T2DM). However, recurrence of T2DM has been observed in a number of patients with initial resolution after bariatric surgery. This study aimed to induce reversal of the improvement of diabetes in T2DM rats after duodenal-jejunal bypass (DJB), and identify the effects of weight changes and gut hormones that might be involved.

METHODSDJB surgery was performed in two T2DM rat models (n=20 for each group): non-obese Goto-Kakizaki (GK) rats, and moderately-obese T2DM rats induced by a combination of a high-fat diet (HFD) and low-dose streptozotocin (HS rats). The controls were sham-operated and non-treated rats. All rats were then randomly divided into HFD- and low-fat diet (LFD)-fed groups. Glucose tolerance, insulin tolerance, glucose-stimulated insulin, glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) secretion, food intake and body weight were measured and compared with controls.

RESULTSDJB surgery resulted in a significant improvement in glucose tolerance in both GK and HS rats fed with either HFD or LFD. In contrast to LFD-fed rats, improved glucose tolerance was impaired in GK and HS rats fed with an HFD, accompanied by re-impairment of insulin tolerance and failure in enhancement of insulin secretion. There was no significant difference in food intake and body weight between DJB-operated and control rats, and between HFD- and LFD-fed rats. Glucose-stimulated GLP-1 and PYY levels were significantly increased after DJB surgery; however, they were not significantly different between HFD- and LFD-fed rats.

CONCLUSIONAn HFD reverses the improvement in glucose tolerance induced by DJB surgery in T2DM rats, primarily ascribing to the re-impairment of insulin sensitivity, but does not change body weight, GLP-1 and PYY levels.

Animals ; Blood Glucose ; drug effects ; Diabetes Mellitus, Type 2 ; blood ; chemically induced ; pathology ; surgery ; Diet, High-Fat ; adverse effects ; Gastric Bypass ; Glucose Tolerance Test ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the characteristics of amplitude integrated electroencephalography (aEEG) in preterm infants and changes of maturation with gestational age.

METHODSaEEG monitoring was done within 3 days of age with domestically produced digital aEEG set (CFM3000). Duration of each recording was at least 4 hours. The continuity, sleep-wake cycle, voltage and bandwidth of all aEEG tracing were analyzed.

RESULTSThe percent of continuity background increased from 30% of 28 weeks to 85.7% of 36 weeks (χ(2) = 28.2, P = 0.026); the percent of mature sleep-wake cycle increased from 10% of 28 weeks to 100% of 36 weeks (χ(2) = 192.4, P < 0.01). Low bound voltage increased with gestational age, from (6.8 ± 1.7) µV (28 w) to 9.7 - 10.1 µV (35 - 36 w) (F = 11.4, P < 0.01). Bandwidth of the narrow band decreases gradually with gestational age, from 1.45 cm (28 w) to (0.86 ± 0.24) cm (36 w) (F = 8.731, P < 0.01). The correlation coefficient for continuity, sleep-wake cycle, low bound voltage and bandwidth of narrow band, and total scores were 0.32, 0.81, 0.38, 0.55 and 0.78 respectively (P < 0.05).

CONCLUSIONThe older the gestational age of infants at birth, the more mature the aEEG pattern, manifested as increased continuity and sleep-wake cycle, the higher low bound voltage and more narrowed bandwidth with increased gestational age.

Age Factors ; Electroencephalography ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; physiology ; Male

OBJECTIVETo evaluate the clinical efficacy and toxicity of vinorelbine (N) and epirubicin (E) as the neoadjuvant chemotherapy regimen in the treatment of locally advanced breast cancer (LABC).

METHODSFrom September 2001 to December 2004, 158 patients with LABC were treated with NE chemotherapy before operation. Neoadjuvant chemotherapy containing vinorelbine (N), 25 mg/m(2) (days 1 and 8) and epirubicin (E), 60 mg/m(2) (days 1) was administered every 3 weeks for three cycles before local treatment.

RESULTSResponse in the breast: the clinical objective response was 81.6% [23.4% (37/158) cCR and 58.2% (92/158) PR], 16.5% (26/158) SD and 1.9% (3/158) PD. Pathological complete response was found in 29 cases (18.3%). Eighteen cases (26.5%) who have positive FNA result in the axillary lymphnode before chemotherapy showed negative result in the surgery specimen. The most common toxicities were neutropenia, alopecia and nausea/vomiting. Neutropenia grade 3 - 4 was reported in 111 patients (70.3%) and there was no toxic deaths.

CONCLUSIONSThe combination of vinorelbine and epirubicin is a very active and well-tolerated regimen as neoadjuvant chemotherapy for the LABC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Chemotherapy, Adjuvant ; Drug Administration Schedule ; Epirubicin ; administration & dosage ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Treatment Outcome ; Vinblastine ; administration & dosage ; analogs & derivatives

BACKGROUNDEchocardiography is regarded as a gold standard for measuring hemodynamic values. The ultrasonic cardiac output monitor (USCOM) is a new method for measuring hemodynamics and could provide non-invasive point of care guidance. So far, there are no published USCOM reference values for neonates, nor has USCOM's accuracy been established in this population. We aimed to determine the accuracy and clinical utility of the USCOM in healthy neonates relative to published echocardiographic data, to establish normal hemodynamic parameters that it measures, and to assess the possible role of USCOM as an alternative to echocardiography as a trend monitor.

METHODSRight and left heart hemodynamics of 90 normal neonates were measured during circulatory adaptation over the first three days of life using the USCOM and automated oscillotonometry.

RESULTSHeart rate showed a significant decline from days one to three, from 126 to 120 (P < 0.001). Systolic, diastolic and mean arterial pressures all increased significantly from 66 to 71 mmHg, 33 to 38 mmHg and 44 to 49 mmHg, respectively (P < 0.001 in each case). Right ventricular cardiac index (RV-CI) showed no change with a mean of 5.07 L × min(-1) × m(-2). Left ventricular cardiac index (LV-CI) declined from 3.43 to 3.00 L × min(-1) × m(-2) (P < 0.001). RV-CI exceeded LV-CI on all three days by a mean of 61%. The systemic vascular resistance index (SVRI), based on LV-CI, increased significantly over the three days from 1083 to 1403 dyne × sec × cm(-5) × m(2) (P < 0.001).

CONCLUSIONSNormal neonatal hemodynamic values, as indicated by USCOM, were established. LV-CI measurement showed excellent agreement with published echocardiographic studies. RV-CI was constant and exceeded LV-CI for all three days of this study. It may be falsely high due to flow velocity measurement errors arising from the pulmonary branch arteries, and may represent a limitation of the USCOM method. The progressive rise of arterial pressure and SVRI despite a declining LV-CI may indicate functional closure of the ductus arteriosus, with the greatest change occurring within the first 24 hours. Evidence of closure of the foramen ovale was not observed.

Cardiac Output ; physiology ; Female ; Heart Rate ; physiology ; Hemodynamics ; physiology ; Humans ; Infant, Newborn ; Male ; Monitoring, Physiologic ; instrumentation ; methods ; Ultrasonography ; instrumentation ; methods