卵巢囊肿超声引导下穿刺介入治疗前后卵巢功能变化研究

目的:探讨超声引导下穿刺介入治疗卵巢囊肿疗效及其对卵巢功能影响。方法 :选取我院2013年10月至2014年10月期间收治71例卵巢囊肿患者为研究对象,采用超声引导下穿刺介入治疗,在治疗前后对患者的血清卵泡刺激素(FSH),雌激素(E2)及孕激素(P)分泌情况进行测定。同时测定卵巢患侧动脉在收缩期的峰值血流速度(Vs),舒张期血流速度(Vd)以及阻力指数(RI)变化。结果 :术后6个月时囊肿治愈率91.5%,有效率98.6%。术后3、6个月时FSH分泌量显著高于治疗前(P<0.05),术后12个月时FSH分泌量与治疗前差异无统计学意义(P>0.05)。E2、P在治疗后分泌量差异无统计学意义。治疗后卵巢动脉收缩期峰值血流(Vs)、舒张期流速显著升高(P<0.05)。阻力指数(RI)较治疗前明显降低(P<0.05)。结论 :超声引导下穿刺介入治疗卵巢囊肿短时间可能导致卵巢功能紊乱,约12个月可恢复正常。     

超声引导下乳腺肿块穿刺活检的临床研究

目的 探讨超声引导穿刺活检(Ultrasound guided-Core Needle Biopsy, US-CNB)在乳腺肿块诊断中的临床价值。方法 回顾性分析2018年1月—2020年1月徐州市中心医院收治的乳腺肿块患者437例共454枚肿块BI-RADS-US分类评估并行US-CNB,将结果与术后病理及随访结果进行比较,评价US-CNB对乳腺肿块的诊断效能及一致性情况。结果 所有肿块均穿刺成功获取病理结果,2例术后出现血肿。454枚乳腺肿块中,恶性肿块93枚,良性肿块361枚;431例女性患者中91枚肿块为恶性,6例男性患者中2枚肿块为恶性。US-CNB诊断中有1枚3类肿块、3枚4A类肿块及1枚4B类肿块与术后病理及随访结果不符。乳腺肿块US-CNB诊断敏感度94.90%,特异度100%,阳性预测值100%,阴性预测值98.61%,BI-RADS分类各指标间差异无统计学意义(P>0.05)。US-CNB诊断准确度为98.90%,κ=0.967(P<0.05),具有良好的一致性。结论 US-CNB诊断乳腺肿块的性质与术后病理及随访结果一致性好,为临床治疗方案的选择及预后...     

超声弹性成像与超声引导下细针穿刺活检对甲状腺结节的诊断价值

目的:比较超声弹性成像与超声引导下细针穿刺活检对甲状腺结节的诊断价值,为甲状腺结节诊断方式的选择提供参考依据。方法:选取我院2014年6月~2015年6月收治均实施超声弹性成像及超声引导下细针穿刺活检的125例甲状腺结节患者,将弹性评分、细针穿刺活检结果与诊断结果进行对照分析,计算两种方案鉴别诊断甲状腺结节的灵敏度、特异性、准确率,比较其临床诊断价值。结果:125例患者共检出甲状腺结节147个,其中良性病变95个,恶性病变52个。所有结节均获得有效超声弹性成像及超声引导下细针穿刺细胞学病理标本,超声弹性成像诊断良性结节43个,恶性结节104个;超声引导下细针穿刺诊断良性结节90个,恶性结节39个,不确定39个;超声引导下细针穿刺诊断甲状腺结节的特异性、准确率均高于超声弹性成像,差异有统计学意义(P<0.05),超声弹性成像与超声引导下细针穿刺活检诊断甲状腺结节的灵敏度比较,差异无统计学意义(P>0.05)。结论:超声弹性成像诊断甲状腺结节的灵敏度较低,超声引导下细针穿刺活检诊断可能出现不确定结果,两种诊断方案均存在一定缺陷,联合应用可优势互补,提高甲状腺结节的早期诊断效能。     

超声引导下微创旋切术用于多发性乳腺良性肿物治疗体会

目的:分析超声引导下微创旋切术治疗多发性乳腺良性肿物的疗效与安全性,总结临床体会。方法:选取河北省第七人民医院2015年11月—2016年6月收治的200例触诊阴性的多发性乳腺良性肿物患者,随机数字表法分为观察组(超声引导下微创旋切术)、对照组(开放手术)各100例。记录两组患者手术前后CRP、PCT变化,手术情况,并发症发生情况,自制量表调查患者满意度,总结微创旋切术的治疗体会。结果:观察组手术时间、术中出血量、住院时间及术后瘢痕直径均小于对照组,差异有统计学意义(P<0.05)。两组患者术后1 d血清CRP、PCT均较术前升高,对照组升高更为明显,差异有统计学意义(P<0.05)。观察组、对照组术后并发症发生率分别为5.00%、7.00%,组间比较差异无统计学意义(P>0.05)。观察组手术切口、术后瘢痕及术后恢复情况满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:与传统开放手术相比,超声引导下微创旋切术在多发性乳腺良性肿物的治疗中具有操作方便、恢复快、创伤小、美观度佳等优势,且对患者血清炎性因子影响更小,值得推荐。     

B超引导下颈内静脉置管在尿毒症血液透析患者中应用

目的 :探讨B超引导下颈内静脉置管在尿毒症血液透析患者中应用。方法 :选择本院2014年5月—2015年12月收治的200例需行颈内静脉置管血液透析的尿毒症患者,随机分为A组(超声引导下,98例)和B组(盲探下,102例)行颈内静脉置管,比较穿刺置管成功率、穿刺时间、患者满意度、并发症以及导管首次透析血流量、尿素氮下降率(URR)、整体尿素氮清除率(Kt/v)。结果 :两组患者一般情况相比差异无统计学意义,具有可比性;A组患者穿刺置管时间明显短于B组,穿刺置管一次成功率、总成功率以及患者满意度明显高于B组,差异有统计学意义,P<0.05;A组患者的总并发症发生率明显低于B组,其中颈动脉损伤、神经损伤、局部血肿的发生率相比差异有统计学意义,P<0.05,血气胸的发生率相比差异无统计学意义;A组患者首次血液透析血流量、URR和Kt/v均高于B组,但两组间比较差异无统计学意义。结论 :超声引导下颈内静脉置管不仅可以缩短穿刺时间、提高穿刺成功率和患者的满意度并且能提高尿毒症血液透析患者的透析效果、降低并发症发生率。     

基于点云三维重建技术的甲状腺超声穿刺三维导航研究

设计了一种基于超声自动扫描机器人的甲状腺点云三维重建系统,并与甲状腺超声截面穿刺机器人系统相融合,实现并验证了一套甲状腺超声穿刺三维导航的软硬件方案.通过甲状腺自动超声扫查机器人获得了１组带有准确空间位姿信息的甲状腺超声图像,并且通过传统图像算法和深度学习方法分割出甲状腺组织的区域.此后通过点云重建和空间重建方案获得了甲状腺模型,并将超声模型与CT扫查模型及机械臂模型进行空间配准和数据融合,依此在软件界面为医生提供了穿刺手术的多视角三维空间信息,在减轻手术医师负担的同时提升了穿刺手术的精准度和成功率.通过实验分析了扫描控制算法和三维重建算法的可行性和稳定性,并验证了该三维导航系统的导航空间精度和响应速度.     

基于电磁跟踪与超声图像的介入机器人穿刺导航方法及实验研究

在超声引导的微创介入手术应用中,仅凭超声图像难以实现对手术针实时、准确的跟踪。利用电磁定位系统结合超声图像实现微创介入机器人的穿刺导航任务。超声图像用于确定局部病变的位置,电磁定位系统用于对手术针进行实时定位和跟踪。为使二者有机结合,提出了一种基于伯恩斯坦多项式的误差补偿方法,对跟踪误差进行补偿;采用N线模型法对超声图像进行标定,并以此为基础完成手术针与图像空间的配准,进而提出了虚拟进针路径的概念,实现了电磁定位数据与图像数据的融合。为验证所提方法的有效性和可行性,对超声系统与电磁定位系统的结合性进行了实验研究;搭建了前列腺微创介入机器人平台,进行了多种角度下的靶向穿刺定位实验。实验结果表明:在使用尼龙作为机器人本体材料、钛合金材质手术针的前提下,所提方法对假体穿刺的平均精密度为1. 14 mm,平均准确度为1. 62 mm,能够满足前列腺介入手术的临床精度要求。     

混凝土超声检测技术的研究与实现

针对混凝土结构无损检测的需要,提出了一种超声激励脉冲产生的方法。由于超声波信号在混凝土中衰减快,为了提高检测系统的探测能力,增强回波信号,提高超声激励脉冲幅值,采用一种高频继电器实现了电磁脉冲源,并通过水和混凝土两种不同介质的无损检测试验验证其可用性。为了实现混凝土结构的高效精细检测,采用波包分解技术对检测数据处理分析,通过合成孔径技术成像,研制了系统样机。不同混凝土结构试块的检测成像试验表明,系统探测深度可达1m,可以较准确成像显示混凝土结构内部嵌入物的位置。     

外压式与内压式软填料密封的理论和试验研究

分析了两种密封结构的侧向压力分布及摩擦功耗，给出了反映其侧向压力变化趋势的压力变化因子和摩擦功比；并以碳素纤维编织填料为试验样品，对其在动态条件下的摩擦功耗和密封性能进行了对比性的试验研究。试验结果表明，内压式软填料密封与外压式软填料密封相比，摩擦功耗小，泄漏量小，工作状态稳定。     

超声引导下胸椎旁神经阻滞与硬膜外阻滞在开胸手术中应用比较

目的:探讨超声引导下胸椎旁神经阻滞与硬膜外阻滞在开胸手术中的应用。方法:选择2015年1月~2016年5月于我院行肺癌根治手术的开胸患者65例,年龄40~75岁,ASA I-Ⅲ级,随机分为A、B两组。A组(n=32)患者在麻醉前于超声引导下行胸椎旁神经阻滞;B组(n=33)患者在麻醉前行硬膜外阻滞。两组患者均于缝皮时开启患者静脉自控镇痛泵静脉镇痛。记录两组患者入室时(T1)、硬膜外或椎旁给药15min后(T2)、诱导插管后(T3)、切皮时(T4)、拔管前(T5)时生命体征(MAP、HR)的变化,并分别于术后6h(T6)、12h(T7)、24h(T8)、48h(T9)进行视觉模拟评分(VAS),分别于T1、T6、T7、T8、T9时采取两组患者外周静脉血5m L检测血浆中炎症因子IL-6、IL-10和TNF-α的浓度变化。结果:两组患者一般情况比较差异无统计学意义,具有可比性;两组患者T1时间点的HR、MAP相比差异无统计学意义,T2-T5时刻B组患者HR、MAP明显低于A组差异有统计学意义,P<0.05;两组患者T6-T9时间点VAS评分相比差异无统计学意义,P>0.05;两组患者T1时间点IL-6、IL-10和TNF-α相比差异无统计学意义,T6-T9时间点两组患者IL-6、IL-10和TNF-α均高于T1水平,差异有统计学意义,P<0.05,组间比较差异无统计学意义。结论:超声引导下胸椎旁神经阻滞与硬膜外阻滞用于开胸手术均能产生良好的镇痛效果,有效减轻炎症反应,但胸椎旁神经阻滞患者术中血流动力学更加平稳,更适合于开胸手术患者。     

Simultaneous in-plane and out-of-plane deformation measurement by speckle multi-recording method

An in-plane and out-of-plane deformation simultaneous measurement method using only two speckle patterns grabbed before and after deformation of an object with rough surfaces using two cameras has been proposed. However, there are some problems concerning the setup of optical system, the aspect ratio of grabbed image data and so on in the conventional method. To solve these problems, the new optical system is proposed by using the multi-recording technology. Though multi-recording technologies have been already employed conveniently in the off-axis digital holography, the technologies have not been used functionally enough in speckle interferometry. In this paper, an in-plane and out-of-plane deformation simultaneous measurement is performed by the proposed method based on multi-recording technology in speckle interferometry. From experimental results, it can be confirmed that the proposed optical system can measure simultaneously in-plane and out-of-plane deformations in high resolution by one camera.     

A novel approach for in-plane/out-of-plane frequency analysis of functionally graded circular/annular plates

An exact closed-form frequency equation is presented for free vibration analysis of circular and annular moderately thick FG plates based on the Mindlin's first-order shear deformation plate theory. The edges of plate may be restrained by different combinations of free, soft simply supported, hard simply supported or clamped boundary conditions. The material properties change continuously through the thickness of the plate, which can vary according to a power-law distribution of the volume fraction of the constituents, whereas Poisson's ratio is set to be constant. The equilibrium equations which govern the dynamic stability of plate and its natural boundary conditions are derived by the Hamilton's principle. Several comparison studies with analytical and numerical techniques reported in literature and the finite element analysis are carried out to establish the high accuracy and superiority of the presented method. Also, these comparisons prove the numerical accuracy of solutions to calculate the in-plane and out-of-plane modes. The influences of the material property, graded index, thickness to outer radius ratios and boundary conditions on the in-plane and out-of-plane frequency parameters are also studied for different functionally graded circular and annular plates.     

Adhesive interface-peeling properties of tapered double cantilever beam bonded with dissimilar material under in-plane and out-of-plane shear conditions

In this study, the lightweight composite materials of carbon fiber-reinforced plastic, aluminum and aluminum foam were applied as three different bonding m     

New anisoparametric 3-node elements for out-of-plane deformable curved beam

Based on numerical reduced minimization theory, new anisoparametric 3-node elements for out-of-plane curved beam are developed. The elements are designed to be free from spurious constraints. In this paper, the effect of the Jacobian upon numerical solution is analyzed and predicted through reduced minimization analysis of anisoparametric 3-node elements with different Jacobian assumption. The prediction is verified by numerical tests for circular and spiral out-of-plane deformable curved beam models. This paper proposes two kinds of 3-node elements with 7-DOF; one element employs 2-point integration for all strains, and the other element uses 3-point integration with a constant Jacobian within element for calculation of shear strain.     

Vibrational energy flow models for out-of-plane waves in finite thin shell

In this paper, an approximate energy flow model for the out-of-plane vibration of a finite thin shell was developed. The derived energy governing equation for the model was expressed in terms of the time- and locally space-averaged far-field wave energy density which can be used as the main equation for the prediction of the out-of-plane structural vibration levels of the energy density and intensity in medium-to-high frequency ranges. The derived model can be applied to the vibration energy problems of a cylindrical shell, spherical shell and doubly-curved shell, whose radius of curvature in each direction is constant, regardless of the position, assuming that the in-plane motion is relatively small. To verify the results of the derived model, wave numbers were obtained using an energy flow analysis and classical analysis, such as the method using Donnell-Mushtari equations. For the case of various types of finite thin shell, the derived energy equations were applied. The results for the spatial distributions and levels of the energy density and intensity were compared with classical displacement solutions, according to the changes in the frequency and internal loss factor of the shell.     

Modeling and design of planar parallel-connection flexible hinges for in- and out-of-plane mechanism applications

The paper studies the planar parallel-connection, small-deformation flexible hinge chains formed of serially-coupled individual segments with variable cross-sections. It introduces the concept of virtual flexible hinge that is quasi-statically equivalent to the actual parallel-hinge configuration. General compliance and stiffness matrices are formulated for the virtual hinge under in-plane and out-of-plane loads by combining the transformed compliances of the individual hinge segments. Two classes are specifically analyzed: one comprises geometrically parallel, straight-axis hinge designs and the other includes concentric, circular-axis hinge configurations. From each class, particular designs with identical and transversely symmetric hinges of right circularly corner-filleted geometry are further investigated. Specifically, the behavior of parallelogram mechanisms with straight-axis hinges and of stage devices with circular-axis hinges is analyzed. Their elastic responses are validated by finite element analysis and their stiffnesses are subsequently studied in terms of offset geometric parameters.     

In-plane and out-of-plane buckling of arches made of FGM

The mechanical buckling of curved beams made of functionally graded materials is studies in this paper. The equilibrium and stability equations of curved beams under mechanical loads are derived. Using proper approximate functions for the displacement components, the stability equations are employed to obtain the related eigenvalues associated with the buckling load of the curved beam. Closed-form solutions are obtained for mechanical buckling of curved beams with doubly symmetric cross section subjected to uniform distributed radial load and pure bending moment. The results are validated with the known data in the literature for beams with isotropic materials.     

Volume-grating digital speckle pattern interferometry for measurement of dynamic out-of-plane displacement fields

Volume-grating digital speckle pattern interferometry used for measuring dynamic out-of-plane displacement fields of a continuously deformed object is proposed in this paper. These continuous out-of-plane displacement fields can be successfully measured by using the method discussed in the paper. A comparison between theoretical and experimental results is presented in the text.     

Exact solutions for the free in-plane vibrations of rectangular plates

All classical boundary conditions including two distinct types of simple support boundary conditions are formulated by using the Rayleigh quotient variational principle for rectangular plates undergoing in-plane free vibrations. The direct separation of variables is employed to obtain the exact solutions for all possible cases. It is shown that the exact solutions of natural frequencies and mode shapes can be obtained when at least two opposite plate edges have either type of the simply-supported conditions, and some of the exact solutions were not available before. The present results agree well with FEM results, which show that the present solutions are correct and the direct separation of variables is practical. The exact solutions can be taken as the benchmarks for the validation of approximate methods.     

A torsional resonance mode AFM for in-plane tip surface interactions

Changing the method of tip/sample interaction leads to contact, tapping and other dynamic imaging modes in atomic force microscopy (AFM) feedback controls. A common characteristic of these feedback controls is that the primary control signals are based on flexural deflection of the cantilever probes, statically or dynamically. We introduce a new AFM mode using the torsional resonance amplitude (or phase) to control the feedback loop and maintain the tip/surface relative position through lateral interaction. The torsional resonance mode (TRmode™) provides complementary information to tapping mode for surface imaging and studies. The nature of tip/surface interaction of the TRmode facilitates phase measurements to resolve the in-plane anisotropy of materials as well as measurements of dynamic friction at nanometer scale. TRmode can image surfaces interleaved with TappingMode™ with the same probe and in the same area. In this way we are able to probe samples dynamically in both vertical and lateral dimensions with high sensitivity to local mechanical and tribological properties. The benefit of TRmode has been proven in studies of water adsorption on HOPG surface steps. TR phase data yields approximately 20 times stronger contrast than tapping phase at step edges, revealing detailed structures that cannot be resolved in tapping mode imaging. The effect of sample rotation relative to the torsional oscillation axis of the cantilever on TR phase contrast has been observed. Tip wear studies of TRmode demonstrated that the interaction forces between tip and sample could be controlled for minimum tip damage by the feedback loop.