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增加清醒下颈动脉手术患者氧供可改善脑氧合

麻醉与镇痛 2009年第6期5卷 16-21页

作者： Mark D. Stoneham Omer Lodi Thearina C. D. John W. Sear 周仁龙(译) 杭燕南(校) Nuffield department of Anaesthetics John Radcliffe Hospital Oxford UK 不详

背景颈动脉内膜剥脱术（CEA）区域麻醉期间，动脉夹闭后，根据语言、思维、对侧运动肌力的改变可发现10％～15％的患者会出现脑缺氧征象。使用100％氧供以逆转这一现象的研究已有报道。我们使用了近红外脑血氧饱和度监测以评估吸入100... 详细信息

背景颈动脉内膜剥脱术（CEA）区域麻醉期间，动脉夹闭后，根据语言、思维、对侧运动肌力的改变可发现10％～15％的患者会出现脑缺氧征象。使用100％氧供以逆转这一现象的研究已有报道。我们使用了近红外脑血氧饱和度监测以评估吸入100％氧是否确能提高颈动脉夹闭期间的局部脑氧舍（rSO2）。方法16例清醒CEA手术患者，开始镇静和实施区域麻醉前放置双侧rSO2电极，通过Venturi面罩给予28％氧吸入，颈动脉夹闭期间维持动脉血压于正常范围或高于正常值10％以内。动脉夹闭后使用紧闭麻醉面罩给予100％氧吸入5分钟，随后去除面罩吸入室内空气，监测对各阶段rSO2数据和动脉血气的影响。结果分析15例患者数据，颈动脉夹闭后同侧rSO2值下降7．4％±5％，与吸入28％氧者相比，吸入100％氧后同侧rSO2升高了6．9％±3．3％（范围1％～12％）（配对t检验，P〈0．001）。血流动力学指标和二氧化碳分压没有改变。结论颈动脉夹闭时，相对于28％的氧，100％氧能有效地提高同侧rSO2值。确切的机制尚不清楚，可能与血氧含量及脑血流增加有关。对于CEA患者，颈动脉夹闭期间给予100％氧供会有益处。

关键词：颈动脉手术脑氧合氧供清醒血氧饱和度监测颈动脉内膜剥脱术血流动力学指标 rSO2

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婴幼儿和儿童的弓状韧带血管压迫综合征

世界核心医学期刊文摘（儿科学分册） 2006年第4期2卷 31-32页

作者： Schweizer P. Berger S. Schweizer M. 余晓梅 department of Pediatric Surgery University of Tü bingen 72076 Tü bingen Germany

Background: Arcuate ligament vascular compression syndrome has not been described previously in the pediatric or pediatric surgical literature. However, it is mentioned in the literature of vascular and general surgery and in journals of radiology and orthopedics. In this review, the intraoperative pathological anatomy and the principles of treatment for 8 children will be presented. Methods: The chart records and the anatomical sketches that were documented by the surgeon immediately after each procedure were analyzed retrospectively. In addition, preoperative courses and long-term follow-up (range, 3- 18 years) were evaluated by a defined program. Results: The diagnosis of celiac artery compression by an arcuate ligament was suspected in children presenting with a history of several years of recurrent acute abdominal pain associated with a typical arterial bruit in the midline of the epigastric region. Conclusions: Other diseases with recurrent abdominal pain and an arterial bruit must be excluded before making the decision for an operative intervention. Duplex ultrasound and angiography are possibly helpful tools to establish the respective diagnosis, but in the patients of the present series, these techniques neither confirmed compression of the celiac axis nor demonstrated decreased perfusion of the superior mesenteric artery. However, as the clinical symptoms clearly announce the disease, these diagnostic measures are not mandatory.

关键词：弓状韧带动脉杂音腹腔轴普外手术干预反复腹痛肠系膜上动脉术前病程整形外科外科医生

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Evaluation of 3-D Printed Immobilisation Shells for Head and Neck IMRT

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Open Journal of radiology 2014年第4期4卷 322-328页

作者： Mark Fisher Christopher Applegate Mohammad Ryalat Stephen Laycock Mark Hulse Daniel Emmens Duncan Bell School of Computing Sciences University of East Anglia Norwich Research Park Norwich UK Faculty of Health and Science University Campus Suffolk Ipswich UK department of Clinical Oncology Ipswich Hospital NHS Trust Ipswich UK

This paper presents the preclinical evaluation of a novel immobilization system for patients undergoing external beam radiation treatment of head and neck tumors. An immobilization mask is manufactured directly from a 3-D model, built using the CT data routinely acquired for treatment planning so there is no need to take plaster of Paris moulds. Research suggests that many patients find the mould room visit distressing and so rapid prototyping could potentially improve the overall patient experience. Evaluation of a computer model of the immobilization system using an anthropomorphic phantom shows that >99% of vertices are within a tolerance of ±0.2 mm. Hausdorff distance was used to analyze CT slices obtained by rescanning the phantom with a printed mask in position. These results show that for >80% of the slices the median “worse-case” tolerance is approximately 4 mm. These measurements suggest that printed masks can achieve similar levels of immobilization to those of systems currently in clinical use.

关键词： Intensity Modulated Radiotherapy Treatment (IMRT) Patient Immobilization System 3-D Printing

Aggregation-enhanced theranostics:AIE sparkles in biomedical field

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聚集体(英文)

聚集体(英文) 2020年第1期1卷 80-106页

作者： Miaomiao Kang Zhijun Zhang Nan Song Meng Li Panpan Sun Xiaohui Chen Dong Wang Ben Zhong Tang Center for AIE Research Shenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhenChina Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province College of Optoelectronic EngineeringShenzhen UniversityShenzhenChina Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction Department of ChemistryThe Hong Kong University of Science and TechnologyKowloonHong KongChina

Theranostics referring to the ingenious integration of diagnostics and therapeutics has garnered tremendous attention in these years as it provides a promising opportunity for modern personalized and precision *** virtue of the good biocompatibility,outstanding fluorescence property,easy processability and functionalization,promoted photosensitizing efficiency,as well as facile construction of multi-modality theranostics,fluorophores with aggregation-induced emission(AIE)characteristics exhibit inexhaustible and vigorous vitality in the field of *** significant breakthroughs and state-of-the-art progression have been witnessed in the past few *** review highlights the tremendous aggregation-enhanced superiorities of AIE luminogens(AIEgens)in disease theranostics mainly involving diagnostic imaging(fluorescence and room temperature phosphorescence),therapeutic intervention(photodynamic therapy),and feasibility in construction of multi-modality theranostics based on the experimental measurements and theoretical ***,the latest and advanced developments of AIEgens in disease theranostics in the aspect of corresponding strategies to design highly effective AIE-active theranostics through triggering aggregation formation are comprehensively ***,a brief conclusion with the discussion of current challenges and future perspectives in this area is further presented.

关键词： aggregation breakthrough summarized

Advances in determining abdominal aortic aneurysm size and growth

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World Journal of radiology 2016年第2期8卷 148-158页

作者： Nikolaos Kontopodis Stella Lioudaki Dimitrios Pantidis George Papadopoulos Efstratios Georgakarakos Christos V Ioannou department of Cardiothoracic and Vascular Surgery University of Crete Medical School department of Vascular Surgery Democritus University of Thrace University Hospital of Alexand- roupolis

Abdominal aortic aneurysm is a common pathology in the aging population of the developed world which carries a significant mortality in excess of 80% in case of rupture. Aneurysmal disease probably represents the only surgical condition in which size is such a critical determinant of the need for intervention and therefore the ability to accurately and reproducibly record aneurysm size and growth over time is of outmost importance. In the same time that imaging techniques may be limited by intra- and inter-observer variability and there may be inconsistencies due to different modalities [ultrasound, computed tomography(CT)], rapid technologic advancement have taken aortic imaging to the next level. Digital imaging, multidetector scanners, thin slice CT and most- importantly the ability to perform 3-dimensional reconstruction and image post-processing have currently become widely available rendering most of the imaging modalities used in the past out of date. The aim of the current article is to report on various imaging methods and current state of the art techniques used to record aneurysm size and growth. Moreover we aim to emphasize on the future research directions and report on techniques which probably will be widely used and incorporated in clinical practice in the near future.

关键词： Abdominal aortic aneurysm Size Growth Maximum diameter Volume Ultrasound Computed tomography

Scatter Radiation Dose Assessment in the radiology department of Cape Coast Teaching Hospital-Ghana

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Open Journal of radiology 2018年第4期8卷 299-306页

作者： J. Owusu-Banahene E. O. Darko D. F. Charles A. Maruf I. Hanan G. Amoako Radiation Protection Institute Ghana Atomic Energy Commission Accra Ghana Graduate School of Nuclear and Allied Sciences University of Ghana Legon Atomic Campus Kwabenya-Accra Ghana department of Physics College of Agriculture and Natural Sciences University of Cape Coast Cape Coast Ghana

During the operation of an X-ray machine, if the radiation protection of X-ray room is insufficient, not only the patient but also clinical staffs as well as public are exposed to high X-ray exposures. In this research work, leakage and scattered radiations were measured from X-ray machine in the radiology department of Cape Coast Teaching hospital in the Cape Coast Municipality of Ghana. The scattered radiation exposures of X-rays in some selected areas within the facility were measured. The X-ray machine was operated for a range of kilo voltage peaks of kVp 77, 70, 63 and 66 with intensities 20, 6.3 and 8.0 mAs, which represents the main technique factors of some body parts such as chest, lumbar spine and extremities during radiographic examinations. The measurements were performed using a RADOS-120 Universal survey meter. The radiation doses rates measured in the various locations in the radiology department of Cape Coast Teaching Hospital of Ghana were in the range of 0.10 μSv/hr to 0.12 μSv/hr. These values were all within the background measurement of 0.10 μSv/hr. Moreover, there were no risks of high radiation doses to patients, staffs and people visiting the X-ray department. The results obtained indicated that within the radiology department of the Hospital, all the selected locations were very safe to patients, occupational workers and the general public which could be attributed to adequate shielding in the facility.

关键词： X-Rays Exposure Dose Scattered and Leakage Radiation

通过3个癌症干预与监测模型网络微模拟,对美国放射影像网络CT结肠成像试验数据的经济评估进行比较

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国际医学放射学杂志 2012年第1期 73-74页

作者： D.J.Vanness A.B.Knudsen I.Lansdorp-Vogelaar C.M.Rutter I.F.Gareen B.A.Herman 管宇 department of Population Health Sciences University of Wisconsin School of Medicine and Public Health610 Walnut StMadisonWI53726

目的评估CT结肠成像对美国50岁、无临床症状的一般人群进行结直肠癌(CRC)筛查的费用效益。材料与方法所有参与美国放射影像网络CT结肠成像试验的对象均签署了知情同意书,且均获得了各地伦理委员会的批准。实

关键词：结肠成像筛查放射影像结肠镜检查 CT 美国美利坚合众国北美洲

将儿童保健纳入21世纪新有效方法:利用计算机化指南提高父母的知识水平

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 45-46页

作者： Sanghavi D.M. 平智广 department of Cardiology Children's Hospit al Boston 300 Longwood Ave. Boston MA 02115 United States Dr.

Background: Despite expert panel recommendations, fewpediatric providers admin ister sufficient anticipatory guidance and educational counseling during well-c hild visits, largely owing to lack of time. Objectives: To design a waiting room educational kiosk that uses interactive, self-guided, computerized tutorials t o give anticipatory guidance to parents at the 6-week and 4-month well-child visits, and assess impact on parent knowledge. The intervention required no addi tional provider time, and automatically printed a summary for the medical record . Setting: A government-funded hospital serving Navajo patients in New Mexico. Methods: After a well-child visit, knowledge regarding issues such as fever man agement, dental care, sleep position, nutrition, and car seat use was tested in a group of parents receiving standard care (control), and a group using the comp uterized tutorials in addition to standard care (intervention). Results: Fifty- two parents in the control group and 49 parents in the intervention group comple ted the knowledge assessment. Ninety-five percent of intervention subjects comp leted the computerized tutorial without clinic staff involvement. Compared with the control group, the intervention group had superior knowledge in all tested a reas. The percentage of correct responses to all questions was higher for the in tervention group in the following categories: car seat use (49%vs 31%, Pintervention g roup identified fever as 100.4°F or higher (86%vs 50%, Pintervention group (P<.001). Conclusion: Computerized antic ipatory g

关键词：儿童保健时间不足睡眠姿势干预组项目测试测试领域婴儿车新墨西哥州咨询指导自动打印

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Safety of direct endoscopic necrosectomy in patients with gastric varices

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World Journal of Gastrointestinal Endoscopy 2016年第10期8卷 402-408页

作者： Andrew C Storm Christopher C Thompson department of Medicine Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital

AIM: To determine the feasibility and safety of transgastric direct endoscopic necrosectomy(DEN) in patients with walled-off necrosis(WON) and gastric varices. METHODS: A single center retrospective study of consecutive DEN for WON was performed from 2012 to 2015. All DEN cases with gastric fundal varices noted on endoscopy, computed tomography(CT) or magnetic resonance imaging(MRI) during the admission for DEN were collected for analysis. In all cases, external urethral sphincter(EUS) with doppler was used to exclude the presence of intervening gastric varices or other vascular structures prior to 19 gauge fine-needle aspiration(FNA) needle access into the cavity. The tract was serially dilated to 20 mm and was entered with an endoscope for DEN. Pigtail stents were placed to facilitate drainage of the cavity. Procedure details were recorded. Comprehensive chart review was performed to evaluate for complications and WON recurrence. RESULTS: Fifteen patients who underwent DEN for WON had gastric varices at the time of their procedure. All patients had an INR 50. Of these patients, 11 had splenic vein thrombosis and 2 had portal vein thrombosis. Two patients had isolated gastric varices, type 1 and the remaining 13 had > 5 mm gastric submucosal varices on imaging by CT, MRI or EUS. No procedures were terminated without completing the DEN for any reason. One patient had self-limited intraprocedural bleeding related to balloon dilation of the tract. Two patients experienced delayed bleeding at 2 and 5 d post-op respectively. One required no therapy or intervention and the other received 1unit transfusion and had an EGD which revealed no active bleeding. Resolution rate of WON was 100%(after up to 2 additional DEN in one patient) and no patients required interventional radiology or surgical interventions. CONCLUSION: In patients with WON and gastric varices, DEN using EUS and doppler guidance may be performed safely. Successful resolution of WON doe

关键词： Necrosectomy Pancreatic necrosis Endoscopy Necrotizing pancreatitis Gastric varices Varices Walled off necrosis Walled-off necrosis Gastrointestinal hemorrhage Endoscopic ultrasound