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111.
目的:观察甲状腺结节行甲状腺腺叶切除术治疗的临床疗效。方法:资料选取本院2013年2月-2014年2月收治的甲状腺结节患者共96例,随机分为研究组与对照组;研究组48例予甲状腺腺叶切除术治疗,对照组48例予甲状腺次全切术治疗;观察两组患者的手术相关指标、甲状腺激素水平及并发症情况。结果:研究组手术时间(122.18±6.23)min、出血量(73.69±5.47)m L,均显著低于对照组,比较差异明显具统计学意义(P0.05);治疗后研究组患者的甲状腺过氧化物酶(TPO)(65.87±21.06)IU/L、血清促甲状腺激素(TSH)(2.96±7.03)m IU/L,均显著优于对照组,比较差异明显具统计学意义(P0.05);研究组共出现并发症6例(12.50%),显著低于对照组,比较差异明显具统计学意义(P0.05)。结论:甲状腺结节行甲状腺腺叶切除术治疗手术创伤性较小,临床疗效显著,具实际应用价值。 相似文献
112.
《IRBM》2019,40(3):174-182
Background and ObjectivesDental caries is one of the most common painful and infectious oral diseases. Early detection of caries lesion prevents the spreading of infection. Generally, dentists use x-ray images to locate the lesion's position. Dental x-ray images have poor intensity which results difficulties in finding exact affected area at a glance. Due to scarcity of dentists at government hospital, it becomes very difficult for the dentists to treat large number of patients in a short span of time. The objective of this work is to design a system to assist dentists to detect caries lesion quickly and more accurately. Deep learning based method is not suitable for this application because there is not enough training set is available to prepare the pre-trained model properly for deep learning. Traditional handcrafted method is desirable for such situation.MethodsDental x-ray not only contains the image of teeth and bonny structure of the jaws but also the tissues within the gum regions. So normal texture based segmentation is not enough to detect the caries lesion. In x-ray, caries lesion looks like a catchment basin, in which the depth at the center is maximum. Isophote along with geodesic active contour method is suitable to model such property of caries lesion. But prior to that multistage background elimination is essential to locate the suspected caries region. Ramdomness calculation and rescaling of that value on the basis of a small training data set is the first part of this multi stage background elimination process. Initial background elimination is performed on the basis of modified k-means clustering upon the entropy value and gray scale values of the x-ray image. In this clustering technique the number of cluster is determined automatically based on analyzing the distribution of data points. The clustering technique is immune against over clustering. Most of the caries lesion lies within the teeth region. Hence this region is surrounded by teeth region. This property is also checked to detect the suspected caries lesion and eliminate the background.ResultTill now very limited dental x-ray databases with caries lesion is available online. ‘Digital dental periapical x-ray database for caries screening’ dataset is used to test the method. The proposed method achieved overall 94% of accuracy and average computational time is below 4.5 sec.DiscussionThis is an alternate solution to detect ROI when deep learning technique fails due to lack of exhaustive training set. This approach fails to generate correct result if resolution of the x-ray image is very low. Low resolution images make confusion between randomness and noise. In addition to that catchment basin properties are not identified properly. Due to this carries lesion are not properly identified. 相似文献
113.
Joint inflammation, with consequent cartilage damage and pain, typically reduces functionality and affects activities of daily life in a variety of musculoskeletal diseases. Since mechanical loading is an important determinant of the disease process, a possible conservative treatment is the unloading of joints. In principle, a neuromuscular rehabilitation program aimed to promote alternative muscle recruitments could reduce the loads on the lower-limb joints during walking. The extent of joint load reduction one could expect from this approach remains unknown. Furthermore, assuming significant reductions of the load on the affected joint can be achieved, it is unclear whether, and to what extent, the other joints will be overloaded. Using subject-specific musculoskeletal models of four different participants, we computed the muscle recruitment strategies that minimised the hip, knee and ankle contact force, and predicted the contact forces such strategies induced at the other joints. Significant reductions of the peak force and impulse at the knee and hip were obtained, while only a minimal effect was found at the ankle joint. Adversely, the peak force and the impulse in non-targeted joints increased when aiming to minimize the load in an adjacent joint. These results confirm the potential of alternative muscle recruitment strategies to reduce the loading at the knee and the hip, but not at the ankle. Therefore, neuromuscular rehabilitation can be targeted to reduce the loading at affected joints but must be considered carefully in patients with multiple joints affected due to the potential adverse effects in non-targeted joints. 相似文献
114.
During level walking, arm swing plays a key role in improving dynamic stability. In vivo investigations with a telemeterized vertebral body replacement showed that spinal loads can be affected by differences in arm positions during sitting and standing. However, little is known about how arm swing could influence the lumbar spine and hip joint forces and motions during walking. The present study aims to provide better understanding of the contribution of the upper limbs to human gait, investigating ranges of motion and joint reaction forces.A three-dimensional motion analysis was carried out via a motion capturing system on six healthy males and five patients with hip instrumented implant. Each subject performed walking with different arm swing amplitudes (small, normal, and large) and arm positions (bound to the body, and folded across the chest). The motion data were imported in a commercial musculoskeletal analysis software for kinematic and inverse dynamic investigation.The range of motion of the thorax with respect to the pelvis and of the pelvis with respect to the ground in the transversal plane were significantly associated with arm position and swing amplitude during gait. The hip external-internal rotation range of motion statistically varied only for non-dominant limb. Unlike hip joint reaction forces, predicted peak spinal loads at T12-L1 and L5-S1 showed significant differences at approximately the time of contralateral toe off and contralateral heel strike.Therefore, arm position and swing amplitude have a relevant effect on kinematic variables and spinal loads, but not on hip loads during walking. 相似文献
115.
目的:研究尼莫地平联合阿托伐他汀钙对血管性痴呆患者超氧化物歧化酶(Superoxide dismutase,SOD)活性和血脂水平的影响。方法:选择2017年1月～2019年1月我院收治的95例血管性痴呆患者,随机分为两组。对照组口服尼莫地平治疗,每次30 mg,每天3次;观察组在服用尼莫地平的基础上,加服阿托伐他汀钙治疗,每次20 mg,每天1次。比较两组治疗前后的SOD活性和血脂水平。结果:观察组的总有效率高于对照组(P0.05);治疗后,两组的日常生活能力量表(Activity of daily living scale,ADL)和简易精神状态评价量表(Mini-mental state examination,MMSE)评分均升高(P0.05),且观察组的高于对照组(P0.05);治疗后,两组的SOD活性升高(P0.05),且观察组高于对照组(P0.05);治疗后,两组的高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)均明显升高(P0.05),甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)和总胆固醇(Total Cholesterol,TC)均明显降低(P0.05),且上述指标的变化程度观察组优于对照组(P0.05)。结论:尼莫地平联合阿托伐他汀钙能明显提高血管性痴呆患者的SOD活性,改善血脂水平,改善智能认知能力和生活能力。 相似文献
116.
Two main types of endurance runners have been identified: aerial runners (AER), who have a larger flight time, and terrestrial runners (TER), who have a longer ground contact time. The purpose of this study was to assess the neuromuscular characteristics of plantar flexors between AER and TER runners. Twenty-four well-trained runners participated in the experiment. They were classified either in a TER or AER group according to the Volodalen® scale. Plantar flexors’ maximal rate of force development (RFD) and maximal voluntary contraction force (MVC) were assessed. Percutaneous electrical stimulation was delivered to the posterior tibial nerve to evoke maximal M-waves and H-reflexes of the triceps surae muscles. These responses, as well as voluntary activation, muscle potentiation, and V-waves, were recorded by superimposing stimulations to MVCs. RFD was significantly higher in AER than in TER, while MVC remained unchanged. This was accompanied by higher myoelectrical activity recorded in the soleus muscle. While M-waves and other parameters remained unchanged, maximal H-reflex was significantly higher in AER than in TER, still in soleus only. The present study raised the possibility of different plantar flexors’ neuromuscular characteristics according to running profile. These differences seemed to be focused on the soleus rather than on the gastrocnemii. 相似文献
117.