Objective To evaluate the curative effect and problems of X-ray fluoroscopy guided percutaneous vertebroplasty (PVP) in treating osteoporotic spinal compression fractures. Methods Twenty-four patients (15 females and 8 males) with 44 vertebral compression fractures underwent PVP. They were average 69 years of age (48-83 years). The fracture segment was within T 5-L 3 (20 thoracical vertebrae, 24 lumbar vertebrae). Under the guidance of C-arm fluoroscopy, bone marrow biopsy needle was inserted percutaneously via transpedicular way into the fractured vertebrae. Polymethylmethacrylate (PMMA) was then injected into the fractured vertebrae. Vasual analogue scale (VAS), mobility and analgesic usage were evaluated 2 days before and after PVP and in the follow-up period. Results PVP was successful in 21 cases (40 vertebrae ), but failed in 2 cases (4 vertebrae) due to weak position endurance. The volume of PMMA injected was 1.0-8.0 ml per vertebrae. The average follow-up period was 3.1 months (1-7 months). VAS was sharply decreased from pre-PVP 7.5?1.2 to 2.8?1.0 at day 2 after PVP (P

Objective To study the effect of polysaccharide of Cipangopaludina chinensis on gray human cervix cancer cells(Hela cells) in vitro. Methods Polysaccharide of Cipangopaludina chinensis gray was extracted by water extraction. MTT assay and microscope were used to observe its effect on the growth inhibition of Hela cells at different concentrations of the polysaccharide. Results Polysaccharide of Cipangopaludina chinensis could more significantly inhibit the growth of Hela cells. Conclusion Polysaccharide of Cipangopaludina chinensis could inhibit human cervix cancer cells in vitro

BACKGROUND: Generally, repairing the injuries of sketetal muxcle is to suture the epimysial and exterior muscular nerve. OBJECTIVE: To determine the intramuscular nerve effects on the recovery of lacerated musculus rectus femoris. DESIGN, TIME AND SETTING: The randomized control animal experiment was performed at the Animal Experimental Center, Chongqing Medical University from September 2006 to August 2007. MATERIALS: Twenty New Zealand rabbits weighing 2.0-2.5 kg were used to establish models of right skeletal muscle injury; left side was used as controls. METHODS: Twenty rabbits were randomly divided into two groups. Rabbits in the intact intramuscular nerve group underwent complete muscle laceration with intramuscular nerve intact. Musculus rectus femoris was traversed at 4.0-5.0 mm from nerve entry point. Rabbits in the intramuscular neurotmesis group underwent complete muscle laceration, but intramuscular nerve was cut concomitantly at the same place as above. MAIN OUTCOME MEASURES: 28 weeks after surgery, wet weight and isometric contraction of musculus rectus femoris were detected. Morphological change of musculus rectus femoris was observed by Hematoxylin & Eosin Staining. Fibrous degree was measured by Masson trichrism staining. Myofibrillar type was examined by myosin ATPase staining and tetrazolium staining method of reduced coenzyme Ⅰ to calculate cross-sectional area of muscle fiber. RESULTS: Compared with the controls, wet weight and isometric contraction of musculus rectus femoris reduced in the intramuscular neurotmesis group (P

Objective To evaluate the safety,feasibility,and clinical outcome of anterior percutaneous endoscopic cervical discectomy (PECD).Methods The study involved 28 patients undergone PECD.Visual analogue scale (VAS) and MacNab scale were recorded before operation and at 3 days,1,3,6,12 and 18 months after operation.In addition,MRI examination was conducted at postoperative l month,3 months and 12 months.After data collection,single-factor T test with SAS software was performed.Results Follow-up (range,18-24 months,mean 19 months) was achieved in 25 patients.When compared to the preoperative score,VAS and MacNab scale presented improvement at postoperative 3 days (P ＞ 0.05) and great improvement at postoperative 1,3,6,12,18 and 24 months (P ＜ 0.01).VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3,6,12 and 18 months (P ＜0.05),but the differences were not statistically insignificant at postoperative 3,6,12,and 18 months (P ＞ 0.05).Moreover,VAS and MacNab scale showed significant improvement at postoperative 24 months as compared to those before operation (P ＜0.01) and those at postoperative day 3 (P ＜ 0.01).Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.

ObjectiveTo discuss the feasibility and safety of anterior pedicle screw (APS) fixation in treatment of lower cervical spine injuries.MethodsA total of 10 patients with lower cervical spine injuries were treated with APS fixation.All the patients received preoperative cervical CT scans,and then three-dimensional model was reconstructed by using Mimics software to measure the screw placement parameters (insertion point,screw placement angle,screw length and diameter).All APS fixations were performed through anterior cervical approach,and then centrums antetheca and bilateral outer edges were exposed to distinguish the vertebral end plates.Screw insertion was strictly operated under the fluoroscopic assistance and preoperative screw placement parameters.The postoperative efficacy of APS fixation was evaluated by radiologist and other orthopedist via anteroposterior and lateral radiation,CT scan,three-dimensional model reconstruction and MRI.A follow-up was carried out at 1,3,6 and 12 months after operation.ResultsExcept for one screw for C4 and one for C7,another 24 crews for C3-C7 were successfully inserted.Postoperative CT scan demonstrated four screws breaking the outer vertebral wall.Except for one patient suddenly died from acute myocardial infarction one week after operation,the other nine patients received follow-up.Of three trauma patients,one patient at Grade A did not get improvement but with no aggravation and two achieved improvement for 2-3 grades according to Frankel grade.Among six non-trauma patients,spinal function score by JOA was averagely elevated to 13.4 points,with improvement rate of 60.7％ according to Hirabayashi method.There were no serious complications except for two patients of dysphagia among the patients who were followed up. Conclusions APS fixation is feasible for lower cervical spine injuries.The keys to successful screw insertion are preoperative measurement of individualized screw insertion parameters and appropriate application of intraoperative fluoroscope technique.

OBJECTIVE: Apneagraph can be used to discuss which the best operation scheme is for OSAHS. Effects of uvulopalatopharyngoplasty can be assessed by Apneagraph in obstructive sleep apnea hypopnea syndrome (OSAHS) patients. METHOD: Fifty-six patients with OSAHS received the modified UPPP operation were randomly selected in our hospital. The AG and PSG were applied for diagnosis and evaluation of operation effects. The sleepiness state was assessed by ESS (Epworth sleepiness scale) 6 months after the surgery, compared with the preoperative ESS scores using attest for statistical analysis. We used the SPSS19.0 software to carry our data analysis. RESULT: After 6 months, the evaluation of postoperative efficacy came out to be completely controlled in 42 cases (75%), significantly effective in 14 cases (25%), and uncured in 0 cases. Correlation between the transpalatal obstruction proportion and the AHI reduction percentage was significantly positive (r = 0.667). There were 38 patients with oropharynx obstruction percentage more than 73.35% presented completely controlled in 34 cases (89.47%), significantly effective in 4 cases (10.33%), and uncured in 0 cases. CONCLUSION AG has the dual functions of analyzing sleep-related respiratory disturbance events and determining upper airway obstruction sites. AG application in the postoperative evaluation of modified uppp has significantly objective guide significance. The modified UPPP for treatment of OSAHS can improve the operation effect. Patients with oropharynx obstruction percentage more than 73.5% don't need to receive the operation for treatment of retroglottal region.
Adult ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; physiopathology ; surgery ; Sleep Stages ; Treatment Outcome ; Young Adult

OBJECTIVE: To analyze failure reasons of surgical treatment of obstructive sleep apnea hypopnea syndrome (OSAHS), and explore the methods of reoperation. METHOD: By selecting 27 patients, who accepted surgical treatment for OSAHS and recurred, we analyzed failure reasons and obstructive location by apneagraph, nasopharyngeal 3D-CT, electronic nasopharynlaryngoscope. Among them, 14 patients accepted reoperation, such as uvulopalatopharyngoplasty (UPPP), nasoendoscopic surgery, adenoidectomy, partial glossectomy, tracheotomy were applied matching to differential obstructive location. AHI, lowest SaO2, Epworth sleepiness scale (ESS), complication were recorded after 6 months. RESULT: After 6 months, their AHI decreased from 48.19 +/- 13.11 to 11.32 +/- 4. 42, ESS scores decreased from 12.93 +/- 4.60 to 4.93 +/- 1.44, P<0.05. Two of the 14 patients were cured, while the other 12 were efficient. No complications were observed. CONCLUSION Obstructive location judgement and proper surgical operation are the keys of the treatment. Preoperative AG sleep monitoring, nasopharyngeal 3D CT, electronic nasopharynlaryngoscope examination for determining blocking plane, the decision of surgery which is significant.
Adult ; Female ; Humans ; Male ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Recurrence ; Reoperation ; Sleep Apnea, Obstructive ; prevention & control ; surgery ; Treatment Outcome ; Uvula ; surgery

OBJECTIVE: In order to improve the postoperative effect of modified UPPP, removing the partial pharyngeal muscle in surgery, we investigate the postoperative effect, the characteristics of pharyngeal cavity and the potential complications in OSAHS patients. METHOD: To choose 82 OSAHS patients with obstructive oropharyngeal plane diagnosed by Apneagraphy (AG), Fibre nasopharyngoscope combined with Müller examination and nasopharyngeal 3D-CT, which had completed clinical data inpatients in the anesthesia underwent of the partial pharyngeal muscles in the postoperative, divided into a control group of 26 cases, operating the H-UPPP surgery which did not remove partial pharyngeal muscle; The experimental group of 56 cases did a H-UPPP surgical which removed partial pharyngeal muscle of possible concurrent symptoms such as nasal regurgitation, Eustachian tube dysfunction and other follow-up study in six months after the monthly telephone follow-up or outpatient exams to understand the disease. Patients were evaluated the sleepiness by ESS(Epworth sleepiness scale) in 6 months after the surgery, compared with the preoperative ESS scores, do a t test for statistical analysis. AG can be used to evaluate effects of the UPPP after 6 months. By measuring uvula length (L1), extent from free edge of soft palate to postpharyngeal (L2) and stenosis of nasopharynx width (L3) mean, we investigate the characteristics of pharyngeal cavity using the multiple linear regression to do the hypothesis test and evaluate the association between measuring mean and effect. Using SPSS19.0 software do the preoperative contrast analysis. RESULT: After 6 months in surgery, 56 cases in the experimental group, effect in 50 cases (89.29%), effective in 6 cases (10.71%); ESS score: Preoperative 11.74 +/- 2.48, after the first 6 months 3.84 +/- 2.05. Twenty-six cases in control group,effect in 19 cases (73.08%), effective in 7 cases (26.92%); ESS score: Preoperative 11.91 +/- 2.40, after the first 6 months 6.92 +/- 2.47, t-test P value of less than 0.05 between the experimental group and the control group; There are no ear fullness, hearing loss, increase their own sound which reflect eustachian tube dysfunction and other complications in two groups; The function of pharyngeal cavity could be recovered normal lever after 6 months; After 6 months of the operation, in the experimental group and the control group L1 mean was respectively (5.91 +/- 3.38) mm and (6.20 +/- 3.76) mm (P>0.05); L2 mean was respectively (15.70 +/- 3.29)mm and (15.35 +/- 1.44) mm (P> 0.05); L3 mean was respectively (20.54 +/- 3.33) mm and (16.43 +/- 2.21) mm (P<0.05). Nasal fauces pitch mean was significantly widened. By the multiple linear regression analysis, the postoperative effect has the linear correlation between L2 and 1,3 residual mean with the negative correlation. Due to the standardized coefficient, L3 residual mean has the most influence on the postoperative effect. CONCLUSION Modified UPPP surgery removing the partial pharyngeal muscle is in favor of upgrading the postoperative effect with significantly increasing the width of postoperative nasal pharyngeal isthmus area, then there are not occur the eustachian tube dysfunction, the soft palate function, swallowing and articulation function disabled.
Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Palate, Soft ; surgery ; Pharyngeal Muscles ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult

When applying deep learning algorithms to magnetic resonance (MR) image segmentation, a large number of annotated images are required as data support. However, the specificity of MR images makes it difficult and costly to acquire large amounts of annotated image data. To reduce the dependence of MR image segmentation on a large amount of annotated data, this paper proposes a meta-learning U-shaped network (Meta-UNet) for few-shot MR image segmentation. Meta-UNet can use a small amount of annotated image data to complete the task of MR image segmentation and obtain good segmentation results. Meta-UNet improves U-Net by introducing dilated convolution, which can increase the receptive field of the model to improve the sensitivity to targets of different scales. We introduce the attention mechanism to improve the adaptability of the model to different scales. We introduce the meta-learning mechanism, and employ a composite loss function for well-supervised and effective bootstrapping of model training. We use the proposed Meta-UNet model to train on different segmentation tasks, and then use the trained model to evaluate on a new segmentation task, where the Meta-UNet model achieves high-precision segmentation of target images. Meta-UNet has a certain improvement in mean Dice similarity coefficient (DSC) compared with voxel morph network (VoxelMorph), data augmentation using learned transformations (DataAug) and label transfer network (LT-Net). Experiments show that the proposed method can effectively perform MR image segmentation using a small number of samples. It provides a reliable aid for clinical diagnosis and treatment.
Algorithms ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging

The use of echocardiography ventricle segmentation can obtain ventricular volume parameters, and it is helpful to evaluate cardiac function. However, the ultrasound images have the characteristics of high noise and difficulty in segmentation, bringing huge workload to segment the object region manually. Meanwhile, the automatic segmentation technology cannot guarantee the segmentation accuracy. In order to solve this problem, a novel algorithm framework is proposed to segment the ventricle. Firstly, faster region-based convolutional neural network is used to locate the object to get the region of interest. Secondly, -means is used to pre-segment the image; then a mean shift with adaptive bandwidth of kernel function is proposed to segment the region of interest. Finally, the region growing algorithm is used to get the object region. By this framework, ventricle is obtained automatically without manual localization. Experiments prove that this framework can segment the object accurately, and the algorithm of adaptive mean shift is more stable and accurate than the mean shift with fixed bandwidth on quantitative evaluation. These results show that the method in this paper is helpful for automatic segmentation of left ventricle in echocardiography.