ObjectiveTo investigate the efficacy of vagus nerve stimulation (VNS) in patients with refractory magnetic resonance imaging (MRI)-negative epilepsy and to evaluate potential clinical predictors. MethodsA retrospective collection of efficacy data was conducted on 24 patients with intractable MRI-negative epilepsy treated with VNS, who were followed up for more than six months, at Beijing Tiantan Hospital and Beijing Fengtai Hospital from January 2016 to September 2023. Patients were divided into two subgroups based on their response to VNS: responders (≥50% reduction in seizure frequency) and non-responders (<50% reduction in seizure frequency). The relationship between preoperative clinical data and VNS efficacy was further analyzed to identify potential predictors of VNS efficacy. ResultsA total of 24 patients were included, with an average age of (14.26±8.39) years old. Seizure frequency was reduced by more than 50% in 37.5% of patients, and 8.3% of patients achieved seizure-free after VNS treatment. Preoperative seizure frequency and interictal epileptiform discharge type were significantly associated with VNS efficacy (P<0.05). Multivariate regression analysis showed that a monthly seizure frequency of less than 100 and focal interictal epileptiform discharges were independent predictors of VNS efficacy (P<0.05). ConclusionVNS is an effective treatment for patients with refractory MRI-negative epilepsy. Lower monthly seizure frequency and focal interictal epileptiform discharges are potential predictors of VNS efficacy. These findings provide important references for clinicians in selecting and evaluating patients for VNS treatment.
The tendons of semitendinosus and biceps femoris were transposed in front of the popliteal vein in a "U" shaped loop with the purpose to impede the venous back-flow. This type of operation was used in 10 cases with the aim to treat incompetence of deep vein of the lower extremity. Following the operation, patients were under clinical observation and undertaken retrograde venographie examination. It was proved that the results after operation were satisfactory with the disapperance of symptoms and subsequent healing of ulcers.
ObjectiveTo evaluate the clinical efficacy and safety of telbivudine (TEV) combined with adefovir dipivoxil (ADV) for chronic hepatitis B (CHB), so as to provide references for clinical practice and research. MethodsWe electronically searched databases including The Cochrane Library (Issue 7, 2013), PubMed, EMbase, Web of Science, CBM, CNKI, VIP, and WanFang Data from inception to August 21st, 2013, for the relevant randomized controlled trials (RCTs). Other sources were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. Then, meta-analysis was performed using RevMan 5.1 software. ResultsA Total of 11 RCTs involving 1 010 patients were included. The trial group were given TEV combined with ADV, while the control group were given TEV alone or ADV alone. The results of metaanalysis showed that, the combined use was superior to TEV alone or ADV alone in improving HBV-DNA negative rates at 12-, 24-, 48-weeks, HBeAg negative rates at 12-, 24-, 48-weeks, and ALT recovery rates at 12-, 24-weeks (P < 0.05). The results of qualitative analysis showed that, the trial group had a lower drug resistance rate, and both were alike in the incidence of adverse reaction. ConclusionCompared with TEV alone or ADV alone, TEV combined with ADV could improve the clinical efficacy of treating CHB which is also fairly safe. Due to the limited quantity and quality of the included studies, the aforementioned conclusion still needs to be further verified by conducting more large-scale and high quality RCTs.
Objective To provide the anatomical basis for the appl ication of the superficial inferior epigastric artery flap. Methods Ten cadavers which were immersed in formal in less than 6 months and were perfused by red latex were used in this study. There were 8 males and 2 females with an average age of 58 years (range, 35-78 years). The origin, course, branch,distribution, diameter, pedicle length, and neighbour of superficial inferior epigastric artery and vein were observed in the 2 sides of inguinal region. Results In these series of 10 cadaver (20 sides) dissections, the superficial inferior epigastric artery was identified in 18 sides, which average cal iber was 1.48 mm with a mean vascular pedicle length of 4.80 cm. In 11 sides, the superficial inferior epigastric artery arose aspart of a common trunk with one or more other vessels; in other 7, it originated from the femoral. There were 4 branch modes of superficial inperior epigastric artery: single trunks (5 sides), double ramification (3 sides), single lateral ramification (7 sides), and single medial ramification (3 sides). The superficial inferior epigastric vein was observed in 20 sides, which average cal iber was 2.33 mm with a mean sides pedicle length of 5.45 cm. In 8 sides, the venous drainage was as an individual vein; in 12 sides, both patterns were observed (a pair of venae comitantes and an individual vein). Conclusion The inferior epigastric artery flap can be appl ied to microsurgical flap transfer, potentially in breast reconstruction, phalloplasty, reconstruction of head, neck and four l imbs defects.
Objective To explore the effectiveness of folded transverse superficial epigastric artery perforator flap in repairing the large penetrating defect after buccal carcinoma resection. Methods Between January 2019 and June 2021, 12 patients with buccal squamous cell carcinoma were treated. There were 6 males and 6 females with an average of 66.9 years (range, 53-79 years). The pathological stage was T3a-T4b, and the preoperative mouth opening was (3.08±0.46) cm. The disease duration ranged from 6 to 24 months, with an average of 15 months. After buccal carcinoma radical resection and neck lymph node dissection, the penetrating defects in size of 8 cm×6 cm to 16 cm×8 cm and in depth of 0.5-1.5 cm were remained. The transverse superficial epigastric artery perforator flap in size of 8 cm×6 cm to 14 cm×8 cm were harvested and folded to repair the penetrating defects. The donor site was sutured directly. Results All 12 skin flaps survived after operation, and the wounds healed by first intention. No internal or external fistula complications occurred. All incisions at the recipient site healed by first intention. All patients were followed up 12-18 months (mean, 14 months). There was no obvious abnormality in the color and texture of the flap, the oral and facial appearances were symmetrical, and there was no obvious swelling in the cheek. At last follow-up, the patient’s mouth opening was (2.89±0.33) cm, which was not significantly different from that before operation (t=1.879, P=0.087). The subjective satisfaction scores of 12 patients were 6-8 points, with an average of 7.3 points. Significant scars remained at the donor site but concealed in location. Conclusion The folded transverse superficial epigastric artery perforator flap can be used as a surgical method for repairing large penetrating defects after the buccal carcinoma resection, with a good recovery of facial appearance and oral function.
ObjectiveTo investigate the influence of 70 kV low-dose CT perfusion technique on brain CT perfusion parameter maps and image quality. MethodsRetrospective analysis of all patients who underwent CT perfusion of brain between October 2013 and February 2014 was carried out. The patients were randomly divided into two groups according to diTherent CT examination dose: group A (80 kV, 200 mAs) and group B (70 kV, 200 mAs). All patients were scanned on a dual-source-CT (Siemens Definition Flash). Fifteen normal subjects without brain diseases in each group were selected to be studied. Region of interest (ROI) with an area of 80 mm2 was placed in the nucleus, putamen, thalamus, periventricular white matter of the frontal lobe and temporo-occipital area, and the parameters in the ROI including cerebral blood flow, cerebral blood volume, mean transit time and time to peak were detected. The carrierto-noise ratio and signal-to-noise ratio of thalamus and periventricular white matter of the frontal lobe were contrasted. The image quality of perfusion was assessed by two senior radiologists using 5 point system for blind assessment (5=best, 1=worst). The measurement of radiation dose was studied through effective dose, volume CT dose index (CTDIVOL) and dose length product (DLP). Statistical analysis was performed by independent sample t test. ResultsThere was no significant difference between group A and group B in brain CT perfusion parameters (P>0.05). There was no significant diTherence in image quality between the two groups in the objective and subjective assessment (P>0.05). In comparison with group A, the measured effective dose, CTDIVOL and DLP for group B decreased by 35%. ConclusionThere was no significant influence on the brain CT perfusion parameters and image quality using 70 kV tube voltage, and radiation dose is decreased obviously.
With high thermal stability, excellent mechanical properties, suitable biocompatibility and radiolucency, polyaryletherketones (PAEKs) have been widely used in biomedical field such as trauma, spinal implants, craniomaxillofacial repair and so on. However, PAEKs are bio-inert in nature and often show weak osteointegration with host bone, limiting their further utilization in biomedical application. Therefore, how to improve the bioactivity and osteointegration of PAEK implants has become the focus in biomedical field. This paper reviews the current research advance and some existed problems in bioactive PAEKs, and outlooks the possible solution.
Pulsed magnetic field gradients generated by gradient coils are widely used in signal location in magnetic resonance imaging (MRI). However, gradient coils can also induce eddy currents in final magnetic field in the nearby conducting structures which lead to distortion and artifact in images, misguiding clinical diagnosis. We tried in our laboratory to measure the magnetic field of gradient-induced eddy current in 1.5 T superconducting magnetic resonance imaging device; and extracted key parameters including amplitude and time constant of exponential terms according to inductance-resistance series mathematical module. These parameters of both self-induced component and crossing component are useful to design digital filters to implement pulse pre-emphasize to reshape the waveform. A measure device that is a basement equipped with phantoms and receiving coils was designed and placed in the isocenter of the magnetic field. By applying testing sequence, contrast experiments were carried out in a superconducting magnet before and after eddy current compensation. Sets of one dimension signal were obtained as raw data to calculate gradient-induced eddy currents. Curve fitting by least squares method was also done to match inductance-resistance series module. The results also illustrated that pulse pre-emphasize measurement with digital filter was correct and effective in reducing eddy current effect. Pre-emphasize waveform was developed based on system function. The usefulness of pre-emphasize measurement in reducing eddy current was confirmed and the improvement was also presented. All these are valuable for reducing artifact in magnetic resonance imaging device.
With the change of medical diagnosis and treatment mode, the quality of medical image directly affects the diagnosis and treatment of the disease for doctors. Therefore, realization of intelligent image quality control by computer will have a greater auxiliary effect on the radiographer’s filming work. In this paper, the research methods and applications of image segmentation model and image classification model in the field of deep learning and traditional image processing algorithm applied to medical image quality evaluation are described. The results demonstrate that deep learning algorithm is more accurate and efficient than the traditional image processing algorithm in the effective training of medical image big data, which explains the broad application prospect of deep learning in the medical field. This paper developed a set of intelligent quality control system for auxiliary filming, and successfully applied it to the Radiology Department of West China Hospital and other city and county hospitals, which effectively verified the feasibility and stability of the quality control system.