This paper aims to propose a noninvasive radiotherapy patient positioning system based on structured light surface imaging, and evaluate its clinical feasibility. First, structured light sensors were used to obtain the panoramic point clouds during radiotherapy positioning in real time. The fusion of different point clouds and coordinate transformation were realized based on optical calibration and pose estimation, and the body surface was segmented referring to the preset region of interest (ROI). Then, the global-local registration of cross-source point cloud was achieved based on algorithms such as random sample consensus (RANSAC) and iterative closest point (ICP), to calculate 6 degrees of freedom (DoF) positioning deviation and provide guidance for the correction of couch shifts. The evaluation of the system was carried out based on a rigid adult phantom and volunteers' body, which included positioning error, correlation analysis, and receiver operating characteristic (ROC) analysis. Using Cone Beam CT (CBCT) as the gold standard, the maximum translation and rotation errors of this system were (1.5 ± 0.9) mm along Vrt direction (chest) and (0.7 ± 0.3) ° along Pitch direction (head and neck). The Pearson correlation coefficient between results of system outputs and CBCT verification distributed in an interval of [0.80, 0.84]. Results of ROC analysis showed that the translational and rotational AUC values were 0.82 and 0.85, respectively. In the 4D freedom accuracy test on the human body of volunteers, the maximum translation and rotation errors were (2.6 ± 1.1) mm (Vrt direction, chest and abdomen) and (0.8 ± 0.4)° (Rtn direction, chest and abdomen) respectively. In summary, the positioning system based on structured light body surface imaging proposed in this article can ensure positioning accuracy without surface markers and additional doses, and is feasible for clinical application.
Humans ; Patient Positioning/methods* ; Phantoms, Imaging ; Cone-Beam Computed Tomography ; Algorithms ; Radiotherapy, Image-Guided/methods* ; Radiotherapy Planning, Computer-Assisted/methods*

Objective To evaluate the feasibility and effectiveness of enhanced recovery after surgery(ERAS)in minimally invasive surgery for adrenal tumors.Methods A total of 139 patients underwent retroperitoneal laparoscopic adrenalectomy were selected in this study.The maximum tumor diameter was≤6.0 cm.According to the perioperative plan,patients were divided into the ERAS group(n=65)and the conventional group(n=74).The general information(age,gender,tumor location and tumor diameter),surgical indicators(surgical time and surgical blood loss),postoperative rehabilitation indicators(first off-bed ambulation time,first exhaust time,postoperative catheterization time,postoperative drainage tube retention time and postoperative hospitalization time)and incidence of complications were compared between two groups of patients.Results There were no significant differences in gender,age,tumor location,tumor diameter,surgical time and surgical blood loss between the two groups of patients(P＞0.05).In the ERAS group,first off-bed ambulation time,first exhaust time,the indwelling duration of catheters and drainage tubes were shorter than those in the conventional group,and the overall incidence of postoperative complications was lower in the ERAS group than that in the conventional group(P＜0.05).Conclusion The ERAS protocol is safe and feasible for minimally invasive surgery in patients with adrenal tumors with a maximum tumor diameter of≤6.0 cm.

BACKGROUND:The adaptive reconstruction of maxil ofacial muscles would happen when functional orthopedic treatment is done to cure micromaxil ary deformity. The myoblast is the main responder in the process of adaptive reconstruction, and cyclic stretch can induce apoptosis of myoblasts. Caspase-9 is an important factor in the mitochondrial apoptosis pathway.
OBJECTIVE:To investigate the expression of Caspase-9 in different cyclic stretch.
METHODS:Based on myoblasts cultured in vitro-mechanical stimulation model, the rat L6 myoblasts were loaded stretch for 1, 6, 12 and 24 hours through multi-channel cellstress loading system, while the control group received no stretch. The morphological change and growth of myoblasts were observed under inverted phase contrast microscope;the expression of the mRNA and protein of Caspase-9 were detected by RT-PCR and western blot analysis, respectively.
RESULTS AND CONCLUSION:Under inverted phase contrast microscope, the rat L6 myoblasts at cyclic stretch maintained a good growth state and biological characteristics;there was no celldegeneration;and the loss rate was extremely low, which could demonstrate that myoblast in vitro-mechanical stimulation model was established successful y. The results of RT-PCR and western blot analysis showed that, the expression of Caspase-9 mRNA and Cleaved Caspase-9 protein was significantly increased as the loading time prolonged, and the expression of Procaspase-9 protein was significantly decreased as the time. We can conclude that Caspase-9 is involved in the mechanical signal transduction of cyclic stretch.

Objective To investigate the effects of different degrees of neuromuscular blockade (NMB) induced by rocuronium on facial nerve evoked-electromyographic (EEMG) monitoring in patients undergoing resection of acoustic neuroma.Methods Thirty-five ASA Ⅰ or Ⅱ patients of both sexes,aged 20-64 yr,with body mass index ≤30 kg/m2,scheduled for elective resection of acoustic neuroma under general anesthesia,were included in the study.Anesthesia was induced with midazolam,fentanyl and propofol.The patients were mechanically ventilated after tracheal intubation.Facial nerve EEMG monitoring and peripheral NMB monitoring were performed simultaneously during operation.Facial nerve EEMG was monitored using the Epoch XP2000 multichannel electrophysiological nerve monitoring system (Axon Co.,USA),facial nerve was stimulated and evoked potential of orbicularis oculi was recorded during operation.Peripheral NMB degrees were monitored with TOF-Watch SX monitor (Organon Co.Holland).After rocuronium 0.6 mg/kg was injected intravenously,the facial nerve EEMG responses were monitored when the degree of NMB (T1) was at 100％,75％,50％,25％ and 0 of the control height.The amplitude and latency of EEMG were recorded.The amplitude reservation ratio (the ratio of the amplitude of EEMG monitored to the baseline value) was calculated.Linear correlation of the amplitude reservation ratio or latency of EEMG with the degree of NMB was analyzed.Results No EEMG response was elicited when the degree of NMB was 100％ in 6 patients.The lirear regression equation of the interaction between the degree of NMB (X) and the amplitude reservation ratio (Y) was Y =1 - 0.787 X,the coefficient of determination was 0.898 ( P ＜ 0.05) and the correlation coefficient was - 0.947 ( P ＜ 0.05).The correlation coefficient between the latency of EEMG and the degree of NMB was 0.328 ( P ＜ 0.05).Conclusion When the degree of NMB is maintained at 25 ％-50％,facial nerve EEMG can be monitored effectively and body movement can be avoided during resection of acoustic neuroma.