难治性小儿遗尿症的激光经络穴位疗法

采用激光经络穴位疗法治疗难治性小儿遗尿症104例，获得近期治愈55例（52．9％）好转45例（43．3％），随访痊愈73例（70．2％）好转28例（269％）。     

经阴道彩色多普勒超声联合血清孕酮对早期先兆流产预后的评价

目的：探讨经阴道二维彩色多普勒超声与血清孕酮联合检测对先兆流产预后判断的价值。方法随机选取孕5—8周早孕患者138例,其中正常宫内早孕（A）组46例,早期先兆流产92例（B）,分别行经阴道彩色多普勒超声检测子宫螺旋动脉、黄体血流的RI、H值及化学发光法检测血清孕酮水平,随访先兆流产者至16周孕,继续妊娠者视为保胎成功归入B1组,反之则归入B2组,比较其各组间的差异并研究各指标单检及联合检测对预后判断的价值。结果：子宫螺旋动脉RI、PI值,黄体血流RI、PI值及血清孕酮值在A、B组间差异有统计学意义（P〈0．05）;其中子宫螺旋动脉m、黄体血流砌及血清孕酮值在B组内（B1与B2组间）差异有统计学意义（P〈0．05）。子宫螺旋动脉RI、黄体血流血及孕酮三者联合检测对先兆流产预后判断的准确性、特异性及阳性预测值分别为85．9％、89．8％、81．3％,较各指标单检及两联检测均高,差异有统计学意义（P〈0．05）。结论：血清孕酮联合彩色多普勒超声检测子宫螺旋动脉RI及黄体血流血能够明显提高先兆流产预后判断的准确性、特异性及阳性预测值,对准确判断先兆流产预后具有重要临床意义。     

间接喉镜下YAG激光治疗慢性咽炎

目的：探讨间接喉镜下YAG激光对慢性咽炎的治疗疗效。方法：对我院2011年1月-12月间行间接喉镜下YAG激光治疗的慢性咽炎120例进行分析,观察治疗后症状、体征变化及并发症的处理效果。结果：经过4至6个月的随访,治愈98例（占82％）,有效15例（占13％）,无效7例（占5％）。结论：YAG激光对于长期药物治疗无效的慢性咽炎总有效率为95％,治疗时间短,费用低,病人痛苦小,是治疗慢性咽炎的一种有效、安全、简便的治疗手段。     

介入超声导入Nd:YAG激光凝固治疗肝癌临床研究

目的：观察介入超声导入Nd：YAG激光热凝固肝癌治疗效果，建立微创技术治疗肝癌的新方法。方法：超声引导经皮穿刺导入Nd：YAG激光光纤，输出功率4～6W，能量释放时间6～8min，对13例肝癌进行热凝固治疗，观察其治疗效果及声像图变化特点。结果：2例肿瘤结节消失，8例肿瘤结节体积缩小。3例肿瘤结节大小无明显变化。结论：介入超声导入Nd：YAG激光治疗肝癌是微创技术治疗肝癌新方法之一。效果肯定，安全可靠。     

宫腔镜对阴道超声发现子宫内膜异常的诊治价值

目的：研究阴道超声发现子宫内膜异常患者的宫腔镜诊治价值。方法：对827例经阴道超声检查发现子宫内膜异常的患者行官腔镜检查,并行诊断性刮宫或宫腔内病变电切,组织物送病检。结果：以病检结果为诊断标准,宫腔镜检查对子宫内膜息肉、子宫粘膜下肌瘤、正常子宫内膜、宫颈管息肉及子宫内膜癌的诊断符合率均明显高于阴道超声检查（P〈0．01）;宫腔镜检查对子宫内膜病变诊断的敏感性和特异性分别是95．23％和86,82％,而阴道超声检查对子宫内膜病变诊断的敏感性和特异性分别是83．99％和41．23％。结论：对阴道超声检查发现子宫内膜异常的患者应常规行宫腔镜检查并取组织活检,才能提高诊断符合率,减少误诊和漏诊。     

二维及三维超声成像在先天性子宫畸形诊断中的应用

目的:分析二维及三维超声成像在先天性子宫畸形诊断中的临床应用。方法:二维超声常规检查时,对可疑有先天性子宫畸形的病例进行经阴道三维超声扫查,并联合二维超声检查结果综合分析。结果:经阴道二维超声成像获得明确子宫畸形诊断的41例,经阴道三维超声成像获得明确子宫畸形诊断的61例,二者联合获得较明确子宫畸形诊断的64例。结论:二维及三维超声成像联合能够得到子宫外形轮廓和子宫腔准确、全面的信息,较准确地诊断先天性子宫畸形,特别是三维超声冠状切面成像在子宫畸形的分类、鉴别诊断及指导临床治疗中,起着非常重要的作用。     

CO_2激光治疗宫颈糜烂720例分析

CO_2激光对宫颈糜烂是简单而有效的一次性治疗方法,治疗后三个月随访720例,治愈654例(90.83%),好转65例(9.03%),无效1例(0.14%),有效率为99.86%,明显优于药物疗法.     

金蒸气激光光敏疗法治疗膀胱癌的临床研究

报道经多种治疗后再生的膀胱癌患者７０例，共３１６个肿瘤，用光纤输出功率２Ｗ，带有球型弥散刀头石英光纤传输的金蒸气激光，通过膀胱镜作肿瘤及全膀胱血卟啉光敏治疗，经６～４６个月的随访，痊愈５４例，占７７．１４％，显效１２例占１７．１４％，好转４例，占５．７％，再生８例，占１１．４３％。     

Starlux晶钻光LuxG对面部雀斑的临床疗效分析

目的：观察Starlux晶钻光LuxG治疗面部雀斑的临床疗效。方法：采用Starlux晶钻光LuxG,根据患者皮肤选择适当的参数,对37例雀斑患者进行治疗。患者每次治疗间隔为4至6周,2至3次治疗结束,随访6个月。结果：治疗的有效率为97．3％（36例）,色素沉着发生率低（2．7％）,1例,术后无瘢痕及色素脱失。结论：Starlux晶钻光LuxG治疗面部雀斑疗效满意,是一种安全无创便捷的治疗方法。     

经直肠前列腺超声造影参数成像预测前列腺癌的临床研究

目的评价经直肠前列腺超声造影参数成像对临床怀疑前列腺癌但超声没有发现明确病灶患者前列腺癌预测的临床应用价值。方法对30名血清PSA升高而灰阶超声没有发现明确病灶的患者在同天先后行经直肠前列腺超声造影及经直肠超声引导下前列腺穿刺活检的操作。造影图像切面选择在前列腺底部、中部及尖部与穿刺部位保持在同一切面,超声造影及穿刺活检由同一名医师承担。采用SonoProstate软件进行参数成像并分析造影参数图像。统计分析参数图像结果与病理结果。结果19例病理证实为前列腺癌的病例中参数成像方法诊断15例,11例病理证实为前列腺增生的病例中参数成像方法诊断9例。前列腺超声造影参数成像与超声引导下前列腺穿刺活检术对前列腺癌的预测无统计学差异(P=0.687)。结论对血清PSA升高但灰阶超声未发现明确前列腺病灶的患者,经直肠前列腺超声造影参数成像有助于提示前列腺癌可疑部位并指导前列腺穿刺活检。     

Accurate localization of optic radiation during neurosurgery in an interventional MRI suite

Accurate localization of the optic radiation is key to improving the surgical outcome for patients undergoing anterior temporal lobe resection for the treatment of refractory focal epilepsy. Current commercial interventional magnetic resonance imaging (MRI) scanners are capable of performing anatomical and diffusion weighted imaging and are used for guidance during various neurosurgical procedures. We present an interventional imaging workflow that can accurately localize the optic radiation during surgery. The workflow is driven by a near real-time multichannel nonrigid image registration algorithm that uses both anatomical and fractional anisotropy pre- and intra-operative images. The proposed workflow is implemented on graphical processing units and we perform a warping of the pre-operatively parcellated optic radiation to the intra-operative space in under 3 min making the proposed algorithm suitable for use under the stringent time constraints of neurosurgical procedures. The method was validated using both a numerical phantom and clinical data using pre- and post-operative images from patients who had undergone surgery for treatment of refractory focal epilepsy and shows strong correlation between the observed post-operative visual field deficit and the predicted damage to the optic radiation. We also validate the algorithm using interventional MRI datasets from a small cohort of patients. This work could be of significant utility in image guided interventions and facilitate effective surgical treatments.     

缩宫素对超声消融治疗子宫腺肌症的量效关系研究

目的：评价不同缩宫素剂量对超声消融子宫腺肌症的影响以及缩宫素在超声消融治疗过程中使用的安全性。方法：129例确诊的子宫腺肌症患者随机分为对照组、缩宫素0．32U／min组、缩宫素0．48U／min组进行超声消融治疗,比较各组间的消融效果及相关不良反应。结果缩宫素0．32U／min组和0．48U／min组分别与对照组相比,病灶体积消融率均明显高于对照组,消融单位体积所需时间和能效因子均明显小于对照组,差异有统计学意义。缩宫素0．32U／min组和0．48U／min组相比较,病灶体积消融率、消融单位体积所需时间和能效因子无显著性差异。三组均无严重不良反应。结论缩宫素能安全有效地降低超声消融子宫腺肌症所需的能量,提高治疗效率,但是增大剂量并不能提高超声消融的效益。     

Dynamic tracking in interventional MRI using wavelet-encodedgradient-echo sequences

This work describes a newly developed magnetic resonance imaging (MRI) data-acquisition strategy which replaces the standard Fourier phase-encoding with the spatially localized coefficients of wavelet-encoding and offers a new technique for image guidance when combined with a dynamic tracking algorithm. By using this new technique, only a specific fraction of the entire raw data set needs to be updated and reconstructed to visualize the movement of an interventional device during an MR guided procedure. The combination of wavelet-encoding and a dynamic tracking algorithm was implemented in two-dimensional and three-dimensional gradient-echo sequences on a 0.2-T open C-arm-shaped MR system (Siemens, Erlangen Germany) and tested in phantom and in vitro experiments. When applying the wavelet-encoding direction parallel to the movement of a straight interventional device, only those spatially localized wavelet-coefficients mainly affected by the interventional device are updated. This led to potential increases of the image frame rate by a factor of up to seven     

基于相位编组的三维直肠超声导引图像中针检测算法研究

本文针对三维直肠超声导引前列腺介入式治疗中,针状手术器械定位难的问题,提出了一种三维超声图像中基于三维相位编组的针检测算法.该算法首先将体素按照梯度相位角进行分组,在得到的分组中用最小二乘拟合方法进行针状物体轴线提取,然后利用轴线体素的灰度统计特性进行端点定位.提出的方法在三维模拟数据、Agar 和鸡肉假体数据,以及三...     

醒脑静注射液对呼吸机相关性肺炎患者免疫因子和临床预后的影响

目的：研究呼吸机相关性肺炎（ventilator assoeiated pneunionia．VAP）病人血清C反应蛋白（C roactive protein,CRP）,白细胞介素-6（interleukin-6．IL-6）．肿瘤坏死因子α（Tumor Necrosis Factor-α TNF-α）的变化及其与机械通气（mechanical ventilation,MV）时间的相互关系,探讨醒脑静注射液对VAP患者的治疗作用及其与临床预后的关系。方法：61例VAP病人随机分为两组。治疗组（基础治疗辅助醒脑静注射液治疗组）,对照组（基础治疗组）,治疗前,治疗后第1、3、5、7天测定血清CRP,IL-6,TNF—α的动态变化。比较治疗前,治疗后第3dX线胸片变化。统计MV时间（h）和脱机成功率：结果;61例VAP病人治疗前血清CRP,IL-6,TNF-α较正常水平均明显升高。治疗组血清CRP在治疗后第7d为（31．31±11．52）mg／L,较对照组（56．09±16．82）mg／L明显下降（P〈0.05）。治疗后第5d血清IL-6为（199．68±37.76）ng/L和TNF-α为（53．60±23．22）ng/L,较对照组IL-6（229．67±30．21）ng／L和TNF-α（6775±1761）ng／L,开始下降（P〈0.05）;治疗后第7dIL-6（161.66±22．49）ng/L和TNF—α（36．88±1706）ng/L,较对照组IL-6（212．37±26．84）ng/L和TNF-α（53．56±15．36）ng/L明显p降（P〈0．05）。治疗组MV时间（85．48±20．89）h,较对照组（100．75±28．70）h缩短（P〈0．05）.治疗组3d后x线胸片改善率为92．86％（26／28）,脱机成功率为92．86%（26／28）,均高于对照组（P〈005）,治疗组,治疗后第7d血清CRP,IL-6和TNF—α与机械通气时间呈正相关,结论;醒脑静注射液在辅助VAP综合治疗中,通过抑制过度的炎症反应,部分恢复机体免疫功能,有助于减弱VAP后继发多脏器功能损害,从而缩短MV时间,改善VAP预后,可以在临床中使用。     

Semiautomatic 3-D image registration as applied to interventional MRI liver cancer treatment

We evaluated semiautomatic, voxel-based registration methods for a new application, the assessment and optimization of interventional magnetic resonance imaging (I-MRI) guided thermal ablation of liver cancer. The abdominal images acquired on a low-field-strength, open I-MRI system contain noise, motion artifacts, and tissue deformation. Dissimilar images can be obtained as a result of different MRI acquisition techniques and/or changes induced by treatments. These features challenge a registration algorithm. We evaluated one manual and four automated methods on clinical images acquired before treatment, immediately following treatment, and during several follow-up studies. Images were T2-weighted, T1-weighted Gd-DTPA enhanced, T1-weighted, and short-inversion-time inversion recovery (STIR). Registration accuracy was estimated from distances between anatomical landmarks. Mutual information gave better results than entropy, correlation, and variance of gray-scale ratio. Preprocessing steps such as masking and an initialization method that used two-dimensional (2-D) registration to obtain initial transformation estimates were crucial. With proper preprocessing, automatic registration was successful with all image pairs having reasonable image quality. A registration accuracy of approximately equal to 3 mm was achieved with both manual and mutual information methods. Despite motion and deformation in the liver, mutual information registration is sufficiently accurate and robust for useful applications in I-MRI thermal ablation therapy.