Neuroform Atlas支架在宽颈颅内动脉瘤的应用价值

目的探讨颅内宽颈动脉瘤栓塞治疗中Neuroform Atlas支架的临床应用价值。方法回顾性分析52例宽颈动脉瘤患者的临床资料,均在Neuroform Atlas支架的辅助下成功完成介入栓塞手术治疗。采用Raymond Roy分级评估动脉瘤栓塞情况,改良Rankin量表(Modified Rankin Scale,mRS)评分评估患者预后,对术后并发症与动脉瘤复发进行总结结果在52例宽颈动脉瘤患者中,动脉瘤位于大脑中动脉6例,前交通动脉14例,后交通动脉22例,大脑前动脉2例,基底动脉尖2例,椎动脉V4段2例,眼动脉段4例。40例破裂动脉瘤,12例未破裂动脉瘤。术后脑梗死2例,脑梗死合并出血2例,围手术期未见其他明显的介入相关并发症。术后即刻造影显示动脉瘤完全闭塞40例、瘤颈残留6例、瘤体小部分残瘤6例;随访6~12个月,动脉瘤完全闭塞46例,瘤颈残留4例,瘤体小部分残留2例。mRS评分在出院时:0分38例,1分10例,2分2例,3分2例;随访6~12个月,mRS评分0分46例,1分4例,2分2例。结论宽颈动脉瘤患者使用Neuroform Atlas支架辅助弹簧圈栓塞,具有手术成功率高、并发症低等优点,但需进一步跟踪观察其远期效果。

Pan-cancer analysis of RNA 5-methylcytosine reader (ALYREF)

The incre asing interest in RNA modifications has signifcantly advanced epigenomic and epitranscriptomic technologies.This study focuses on the immuno oncological impact of ALYREF in human cancer through a pan-cancer analysis,enhancing understanding of this gene's role in cancer.We observed differential ALYREF expression between tumor and normal samples,correl ating strongly with prognosis in various cancers,particularly kidney renal papillary cell carcinoma(KIRP)and liver hepatocellular carcinoma(LIHC).ALYREF showed a negative correlation with most tumor-infitrating cells in lung squamous cell carcinoma(LUSC)and lymphoid neoplasm difuse large B-cell lymphoma(DLBC),while positive correlations were noted in IIHC,kidney chromophobe(KICH),mesothelioma(MESO),KIRP,pheochromocytoma and paraganglioma(PARD),and glioma(GBMLGG).Aditionally,ALYREF expression was closely associated with tumor heterogeneity,stemness indices,and a high mutation rate in TP53 across these cancers.In conclusion,ALYREF may serve as an oncogenic biomarker in numerous cancers,meriting further research attention.

Relocation of Uppermost Mantle Earthquakes in the Atlas Mountains, Morocco

Upper mantle earthquakes are usually associated with plate boundary tectonics, but rarely occur beneath intracontinental orogenic belts. In the Moroccan Atlas Mountains, earthquakes determined at subcrustal depths are a controversial topic because they are few in number compared to subduction zones and are not related to plate boundary tectonics. A recent increase of broadband stations in Morocco has revealed numerous events below the Atlas belts, thought to occur from the upper mantle. Using additional available stations, these Atlas events were relocated and new epicenter resolutions were acquired following rigorous depth and RMS error criteria. 309 events were reprocessed and epicenter depths obtained were between 31 and 240 km during the last 23 years. Temporal variations of High Atlas events appear to be continually dipping while Anti Atlas events show no temporal variation trends. In addition, a recent strong event M6.8 occurred in September 2023 at the transition crust-uppermost mantle followed by several aftershocks which have been relocated at uppermost mantle depths. These events support delamination model under the High-Middle Atlas which could flow southward beneath the Anti Atlas lithosphere, and explain the large variation observed in lithosphere thickness between the High-Middle Atlas, and the Anti Atlas. Subcrustal events beneath the Atlas may be related to upper mantle earthquakes beneath the neighboring Canary Islands which have experienced recent swarms and eruptions. This possible correlation cannot be excluded since descending and ascending material is necessary for a regional geodynamic balance.

DNA damage response-related immune activation signature predicts the response to immune checkpoint inhibitors: from gastrointestinal cancer analysis to pan-cancer validation

Objective: DNA damage response(DDR) deficiency has emerged as a prominent determinant of tumor immunogenicity. This study aimed to construct a DDR-related immune activation(DRIA) signature and evaluate the predictive accuracy of the DRIA signature for response to immune checkpoint inhibitor(ICI) therapy in gastrointestinal(GI) cancer.Methods: A DRIA signature was established based on two previously reported DNA damage immune response assays. Clinical and gene expression data from two published GI cancer cohorts were used to assess and validate the association between the DRIA score and response to ICI therapy. The predictive accuracy of the DRIA score was validated based on one ICI-treated melanoma and three pan-cancer published cohorts.Results: The DRIA signature includes three genes(CXCL10, IDO1, and IFI44L). In the discovery cancer cohort, DRIA-high patients with gastric cancer achieved a higher response rate to ICI therapy than DRIA-low patients(81.8% vs. 8.8%;P < 0.001), and the predictive accuracy of the DRIA score [area under the receiver operating characteristic curve(AUC) = 0.845] was superior to the predictive accuracy of PD-L1 expression, tumor mutational burden, microsatellite instability, and Epstein–Barr virus status. The validation cohort demonstrated that the DRIA score identified responders with microsatellite-stable colorectal and pancreatic adenocarcinoma who received dual PD-1 and CTLA-4 blockade with radiation therapy. Furthermore, the predictive performance of the DRIA score was shown to be robust through an extended validation in melanoma, urothelial cancer, and pan-cancer.Conclusions: The DRIA signature has superior and robust predictive accuracy for the efficacy of ICI therapy in GI cancer and pancancer, indicating that the DRIA signature may serve as a powerful biomarker for guiding ICI therapy decisions.

The lactylation index predicts the immune microenvironment and prognosis of pan-cancer patients

Background:Protein lactylation is a new way for the“metabolic waste”lactic acid to perform novel functions.Nevertheless,our understanding of the contribution of protein lactylation to both tumor progression and therapeutic interventions remains imited.The construction of a scoring system for lactylation to predict the prognosis of pancancer patients and to evaluate the tumor immune microenvironment(TIME)would improve our understanding of the clinical significance of lactylation.Methods:Consensus clustering analysis of lactylation-related genes was used to cluster 177 pancreatic adenocarcinoma(PAAD)patients.Subsequently,a scoring system was developed using the least absolute shrinkage and selection operator(LASSO)regression.Internal validation and external validation were both conducted to assess and confirm the predictive accuracy of the scoring system.Finally,leucine rich repeat containing 1(LRRC1),a newly discovered lactylation-related gene,was analyzed in PAAD in vitro.Results:Utilizing the profiles of 332 lactylation-related genes,a total of 177 patients with PAAD were segregated into two distinct groups.LacCluster^(high) patients had a poorer prognosis than LacCluster^(low) patients.Through the differential analysis between the LacCluster^(high) and LacCluster^(low) groups,we identified additional genes associated with lactylation.These genes were then integrated to construct the LacCluster-enhanced system,which enabled more accurate prognosis prediction for patients with PAAD.Then,a lactylation index containing three genes(LacI-3)was constructed using LASSO regression.This was done to enhance the usability of the LacCluster-enhanced system in the clinic.Compared to those in the LacI-3^(high) subgroup,patients in the LacI-3^(low) subgroup exhibited increased expression of immune checkpoint-related genes,more immune cell infiltration,lower tumor mutation burdens,and better prognoses,indicating a“hot tumor”phenotype.Moreover,knocking down the expression of LRRC1,the hub gene in the LacI-3 scoring system,inhibited PAAD cell invasion,migration,and proliferation in vitro.Ultimately,the significance of LacI-3 across cancers was confirmed.Conclusion:Our findings strongly imply that protein lactylation may represent a new approach to diagnosing and treating malignant tumors.

Atlas支架“类冰淇淋”技术在伴瘤颈发出重要分支血管的颅内动脉瘤栓塞中的应用

目的探讨Atlas支架“类冰淇淋”技术在伴瘤颈发出重要分支血管的颅内动脉瘤栓塞中应用的可行性和有效性。方法回顾性分析2022年1月至2022年9月采用Atlas支架辅助栓塞治疗的10例伴瘤颈发出重要分支血管的颅内动脉瘤的临床资料。结果10例DSA发现动脉瘤颈处发出重要分支血管,术中采用“类冰淇淋”技术辅助栓塞。术后造影显示支架在位良好,动脉瘤致密栓塞,载瘤动脉血流通畅,分支血管血流通畅,未发生出血或缺血性事件。8例术后6个月DSA复查未见动脉瘤复发,载瘤动脉通畅;2例失访。结论针对伴瘤颈发出重要分支血管的颅内动脉瘤,利用Atlas支架远端开环、精准释放、锚定特性的特性,使支架远端部分置于动脉瘤瘤颈,形成“类冰淇淋”技术,保护重要分支血管,支撑弹簧圈,可增加瘤腔内弹簧圈致密度并保护分支血管。

Neuroform Atlas支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤

目的探讨应用Neuroform Atlas支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的有效性及安全性。方法回顾性分析2022年3月至2023年2月应用Neuroform Atlas支架辅助弹簧圈栓塞治疗的29例颅内宽颈动脉瘤的临床资料。结果29例均为单发动脉瘤,其中9例为破裂动脉瘤,20例为未破裂动脉瘤。术中共置入29枚Neuroform Atlas支架,均成功释放,术中发生操作相关并发症1例。术后即刻DSA显示,改良Raymond分级Ⅰ级25例(86.2%),Ⅱ级1例(3.4%),Ⅲa级3例(10.3%)。术后1例因急性肺栓塞死亡。术后随访3~6个月,28例完成临床随访,mRS评分0分26例,1分1例,3分1例;18例完成影像学随访,改良Raymond分级Ⅰ级15例(83.3%),Ⅱ级1例(5.6%),Ⅲa级例2(11.1%),未发现载瘤动脉狭窄或迟发性血栓事件。结论Neuroform Atlas支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤具有较高的动脉瘤闭塞率和较低的围手术期并发症发生率,安全性和有效性均较好,但其远期疗效仍需进一步随访观察。

Neuroform Atlas支架与Enterprise支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的效果比较

目的探讨Neuroform Atlas支架与Enterprise支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤(IWA)的效果。方法选取IWA患者72例,采用随机数字表法分为A、B组,每组36例。A组采用Neuroform Atlas支架辅助弹簧圈栓塞治疗,B组采用Enterprise支架辅助弹簧圈栓塞治疗。比较两组Raymond分级、脑血流灌注情况、改良Rankin量表(mRS)评分及并发症发生率。结果A组和B组术后即刻Raymond分级Ⅰ级占比分别为75.00%(27/36)、66.67%(24/36),比较差异不显著(P>0.05);两组术后即刻Raymond分级比较,差异不显著(P>0.05);A组术后6个月Raymond分级Ⅰ级占比为83.33%(30/36),高于B组的61.11%(22/36)(P<0.05);A组术后6个月Raymond分级优于B组(P<0.05)。A组和B组术前局部脑血容量(rCBV)、颅内压(ICP)比较,差异不显著(P>0.05);A组和B组术后6个月rCBV均高于术前,ICP均低于术前,且A组术后6个月rCBV(2.18±0.42)ml/100 g高于B组的(1.95±0.33)ml/100 g,ICP(16.24±2.63)mm Hg(1 mm Hg=0.133 kPa)低于B组的(18.52±2.70)mm Hg(P<0.05)。随访6个月,A组mRS评分0~2分占比94.44%高于B组的77.78%(P<0.05)。两组并发症发生率比较,差异不显著(P>0.05)。结论与Enterprise支架相比,Neuroform Atlas支架辅助弹簧圈栓塞治疗IWA的完全闭塞率更高,同时能更好地改善患者脑血流灌注和短期预后,而两种支架的并发症发生率相似。

Systematic analysis of DNA polymerases as therapeutic targets in pan-cancers

Introduction:DNA polymerases are crucial for maintaining genome stability and influencing tumorigenesis.However,the clinical implications of DNA polymerases in tumorigenesis and their potential as anti-cancer therapy targets are not well understood.Methods:We conducted a systematic analysis using TCGA Pan-Cancer Atlas data and Gene Set Cancer Analysis results to examine the expression profiles of 15 DNA polymerases(POLYs)and their clinical correlations.We also evaluated the prognostic value of POLYs by analyzing their expression levels in relation to overall survival time(OS)using Kaplan-Meier survival curves.Additionally,we investigated the correlations between POLY expression and immune cells,DNA damage repair(DDR)pathways,and ubiquitination.Drug sensitivity analysis was performed to assess the relationship between POLY expression and drug response.Results:Our analysis revealed that 14 out of 15 POLYs exhibited significantly distinct expression patterns between tumor and normal samples across most cancer types,except for DNA nucleotidylexotransferase(DNTT).Specifically,POLD1 and POLE showed elevated expression in almost all cancers,while POLQ exhibited high expression levels in all cancer types.Some POLYs showed heightened expression in specific cancer subtypes,while others exhibited low expression.Kaplan-Meier survival curves demonstrated significant prognostic value of POLYs in multiple cancers,including PAAD,KIRC,and ACC.Cox analysis further validated these findings.Alteration patterns of POLYs varied significantly among different cancer types and were associated with poorer survival outcomes.Significant correlations were observed between the expression of POLY members and immune cells,DDR pathways,and ubiquitination.Drug sensitivity analysis indicated an inverse relationship between POLY expression and drug response.Conclusion:Our comprehensive study highlights the significant role of POLYs in cancer development and identifies them as promising prognostic and immunological biomarkers for various cancer types.Additionally,targeting POLYs therapeutically holds promise for tumor immunotherapy.

ICESat-2/ATLAS雷达数据在林业中的应用

ICESat-2/ATLAS作为新一代星载光子计数雷达,较ICESat-1/GLAS在载荷设备、模型算法及测距精度等方面都有了极大的提升。本文介绍了ICESat-2/ATLAS的物理参数、数据产品,并列出了当前ATLAS数据产品去噪分类的各类算法,总结了ICESat-2/ATLAS数据在林业中的应用,包括制作高分辨率的森林高度制图、森林地上生物量的反演、林下地形的反演等,并对比分析了各类研究结果的观测精度及可靠性。最后,对ICESat-2/ATLAS在多源遥感协同不同数据源的应用上进行了展望。本研究能为星载光子计数雷达在林业中的应用提供一定的参考。

A Study of the Comets with Large Perihelion Distances C/2019 L3(ATLAS)and C/2019 O3(Palomar)

This work analyzes the photometric data of the Oort spike comets C/2019 L3(ATLAS)and C/2019 O3(Palomar)obtained between 2016 and 2023 by the ATLAS network and the Belgian Olmen Observatory.The comets Palomar and ATLAS have a typical and unusually high activity level,respectively,based on the Afρparameter corrected to phase angle zero at perihelion.The absolute magnitude of comets ATLAS and Palomar in the o-band is 4.71±0.05 and 4.16±0.02 respectively.The cometary activity of comets ATLAS and Palomar probably began at r>13 au before perihelion and will end at r>14 au after perihelion,which means that they could remain active until the second half of 2026.The nucleus of comet ATLAS has a minimum radius of 7.9 km,and the nucleus of comet Palomar could be a little larger.The c-o colors of the comets ATLAS and Palomar are redder and bluer,respectively,at perihelion than the solar twin YBP 1194.These comets showed a bluish trend in the coma color with decreasing heliocentric distance.Comet Palomar probably had two outbursts after its perihelion,each releasing about 10^(8)kg of dust.The slopes of the photometric profile of the comae of these comets were between 1and 1.5,indicating a steady state during the observation campaign.

Understanding the Activity Performance of Comets 38P/Stephan-Oterma,64P/Swift-Gehrels and C/2017 M4(ATLAS)through Broadband Photometric Observations

In this work,we report observations of three comets:38P/Stephan-Oterma,64P/Swift-Gehrels,and C/2017 M4(ATLAS),conducted with the Nanshan one-meter wide-field telescope in 2018 August and November,and 2019January.We extracted morphological features through image enhancement techniques and calculated the dust activity parameter,Afρ,along with dust mass loss rates and coma color indices using broadband photometric data.Our morphological analysis uncovered a spectrum of dust characteristics among the observed comets,ranging from a significant twisted structure in comet 38P/Stephan-Oterma’s coma to the regular coma envelope surrounding comet 64P/Swift-Gehrels.The Afρvalues varied between 148.8±0.3 cm for 64P/Swift-Gehrels and1118.5±6.2 cm for C/2017 M4(ATLAS)(measured within a reference aperture radius ofρ=6″),indicating a range from moderate to high activity levels.Dust mass loss rates were estimated from 328.1 kg s^(-1)for comet 64P/Swift-Gehrels to 1395.5 kg s^(-1)for comet C/2017 M4(ATLAS).The color indices of comets 38P/Stephan-Oterma and C/2017 M4(ATLAS)closely resemble the average colors of active short-period comets and active longperiod comets,respectively.In contrast,64P/Swift-Gehrels exhibits a significantly bluer hue than typical Jupiter family comets.

《Atlas of Uveitis:Diagnosis and Treatment》一书出版

由杨培增教授独自完成的大型英文葡萄膜炎专著《Atlas of Uveitis:Diagnosis and Treatment》已于2020年12月由Springer出版社和人民卫生出版社联合出版。此书是目前国际上单人完成的最大葡萄膜炎专著,共860页、3000余张患者图片,约合中文170万字。此书分为Overview、Diagnosis of Uveitis、Treatment of Uveitis.Uveitisentities,Scleritis and Episcleritis四大部分,详细介绍了葡萄膜炎类疾病的疾病谱,常见类型的临床特征、进展和致盲规律,疾病诊疗的思想、原则、策略,并使用大量精美图片展现了常见葡萄膜炎类型的表现谱,即从发病到疾病后期,从最细微的异常到最严重的改变,从罕见的表现到典型的特征,展示出葡萄膜炎的全貌和细节,既可使临床医师快速掌握疾病要点,又不至于遗漏细微之处。这也是中国眼科医师首次向国际介绍葡萄膜炎诊疗的中国标准、方案和经验。

The prognostic and immunological impacts of DCX expression:a pan-cancer analysis

Background:Doublecortin(DCX),a microtubule-associated protein,is best known for its critical role in neuronal migration during neural development,where it stabilizes microtubules and guides neurons to their proper positions.Recently,DCX has been implicated in various cancer processes,suggesting it may influence tumor progression and the tumor microenvironment.Emerging evidence indicates that DCX can modulate cell migration,invasion,and interaction with immune cells,making it a potential player in oncogenesis.However,the role of DCX across different cancer types and its potential as a prognostic biomarker remain underexplored,necessitating a comprehensive analysis.Methods:We utilized The Cancer Genome Atlas to extract data on DCX expression in tumor and adjacent normal tissues across diverse cancer types.Differential expression analysis was conducted using differential expression sequencing 2.Survival analysis was performed with Kaplan-Meier estimates and Cox proportional hazards models.Correlations between DCX expression and tumor mutational burden,microsatellite instability,and immune infiltration were examined using Spearman’s correlation.Results:DCX showed variable expression across cancer types,with significant overexpression in certain tumors such as liver and lung cancer and downexpression in others like breast cancer.High DCX expression was correlated with poor prognosis in adrenocortical carcinoma but with better outcomes in low-grade glioma.Additionally,DCX expression was significantly associated with various immune markers and chemokines,suggesting a role in modulating the immune microenvironment.Conclusion:Our findings highlight the complex role of DCX in cancer,underlining its potential as a prognostic marker and its involvement in immune-related pathways.Targeting DCX could represent a novel approach to modulating tumor behavior and enhancing immune response in cancer therapy.

Pan-Cancer dissection of ORAI1:prognostic implications and immune landscapecorrelation

Background:The ORAI1 gene,central to store-operated calcium entry(SOCE),is increasingly recognized for its pivotal role in cancer progression and patient prognosis across a broad spectrum of malignancies.Despite its critical involvement in calcium signaling pathways that are essential for cellular functions such as proliferation,migration,and apoptosis,the comprehensive impacts of ORAI1 within the tumor microenvironment(TME)and its modulation across various cancers have not been fully elucidated.Methods:We conducted a pan-cancer analysis leveraging data from The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)to assess ORAI1 expression.Differential expression analyses were performed,complemented by correlative studies with tumor mutation burden(TMB),microsatellite instability(MSI),immune infiltration,and key biological processes and pathways.Results:Our results demonstrate that ORAI1 is consistently upregulated in a range of cancer types,associated with aggressive tumor characteristics and poor patient outcomes.Significantly,ORAI1 upregulation correlates with increased tumor mutation burden(TMB)and microsatellite instability(MSI),markers of genomic instability that are predictive of response to immunotherapy,underscoring its potential utility in clinical stratification and treatment decision-making.ORAI1's influence extended to the immune landscape,showing associations with immune cell infiltration and both immunosuppressive and immunostimulatory gene sets,thereby affecting the TME and possibly the efficacy of immunotherapeutic interventions.Conclusions:The multifaceted nature of ORAI1's involvement in cancer pathophysiology positions it as a prospective biomarker and therapeutic target.Its expression dynamics and correlative significance with prognostic and immune regulatory elements underscore its potential in guiding therapeutic strategies and improving clinical outcomes.This study lays a foundation for future research,aiming to leverage ORAI1's biological significance in cancer prognosis and therapy optimization.

Deciphering the role of FSCN family genes in cancer:a pan-cancer bioinformatics study

Background:The Fascin(FSCN)family,comprising actin-bundling proteins,plays vital roles in cytoskeletal reorganization and cell migration.FSCN1,FSCN2,and FSCN3 are implicated in cancer progression through cell motility,invasion,and metastasis.However,their specific contributions across different cancer types remain unclear.Methods:We conducted a pan-cancer bioinformatics analysis of FSCN genes using data from The Cancer Genome Atlas.This included differential expression patterns,copy number variations(CNVs),mutations,methylation status,and correlations with tumor mutational burden,microsatellite instability,and immune checkpoint molecule expression.Differential expression was analyzed using DESeq2,while CNV and mutation analyses utilized GISTIC2.0 and MuTect2.Methylation data were assessed using the Illumina Human Methylation 450K BeadChip.Results:FSCN1 and FSCN2 showed significant differential expression in multiple cancers,often correlating with poor prognosis.FSCN3 exhibited less variability but a protective role in certain contexts.CNV analysis indicated frequent gene gains in FSCN genes,correlating with increased expression.FSCN3 had a higher mutation rate,suggesting genetic instability.Methylation analysis showed hypomethylation of FSCN1 and FSCN2 in tumors compared to normal tissues,whereas FSCN3 had minor changes.Significant associations were found between FSCN gene expression and tumor mutational burden,microsatellite instability,and immune checkpoint molecules,suggesting their involvement in tumor immunogenicity and the immune microenvironment.Conclusions:This pan-cancer analysis highlights the multifaceted roles of FSCN genes in cancer biology,emphasizing their potential as biomarkers and therapeutic targets.FSCN1 and FSCN2 are associated with poor prognosis and aggressive phenotypes,while FSCN3 shows protective roles in specific contexts.These findings offer new avenues for cancer diagnosis and treatment,particularly in personalized medicine.Future studies should validate these findings and explore the underlying mechanisms to fully harness the clinical potential of FSCN family proteins in oncology.

Atlas的谢幕

正当全球人工智能的研究和应用如火如荼之时,4月16日,波士顿动力发布了一段约3分钟的视频,宣布研发了十余年的人形机器人Atlas正式退役。在这段告别视频中,Atlas完成了最后一次精彩表演,并回顾了艰辛历程中的种种失败,向人类躹躬致谢,无数观众为之泪目。在过去的十年中,Atlas一直是人形机器人技术领域的标志性产品,它的幽默的舞蹈、谨慎的搬运、灵敏的三级跳、华丽的后空翻、灵活的雪地行走、顽强的抗击打能力,曾经让人们惊艳不已,被视作人形机器人的巅峰之作。

定量评价Atlas模板库病例数目对宫颈癌危及器官自动勾画的影响

目的:探讨基于Atlas实施宫颈癌危及器官自动勾画时图谱库入库病例数的增加对自动勾画结果的影响,以期得到最优图谱库病例数。方法:运用MIM软件建立4组宫颈癌图谱库(入库病例数目分别为30、60、90、120例)。随机选择图谱库外10例宫颈癌患者图像,由一名临床经验丰富的医生进行危及器官(膀胱、直肠和双侧股骨头)的手动勾画,将其定义为参考勾画,并对该10例患者图像进行危及器官自动勾画,勾画匹配数目分别选择为3和9。通过定量评价勾画时间、相似性系数(DSC)、敏感性指数(SI)、包容性指数、质心偏差、Jaccard系数(JAC)、Hausdorff距离(HD),将自动勾画结果与参考勾画进行单因素方差分析,从而探讨不同图谱库病例数对自动勾画结果的影响。结果:勾画匹配数目选择为3时,4组模板中平均自动勾画时间小于手动勾画(1.31/1.33/1.35/1.39min vs 10.25min),匹配数目选9时具有同样的趋势(5.07/5.24/5.14/5.24min vs 10.25min),但各组间没有差异性。匹配数目为3时膀胱SI(P=0.018)、直肠SI(P=0.010)、直肠DSC(P=0.016)、直肠JAC(P=0.013)、直肠HD(P=0.042),以及匹配数目为9时直肠HD(P=0.002)均具有统计学差异,其他参数没有统计学意义。结论:基于Atlas实施危及器官自动勾画能够节省勾画时间,模板数目的增加不会影响勾画效率,30例图谱库勾画时整体结果较差,60例以上的图谱库略有优势,提高膀胱、直肠的勾画准确性,但考虑时间成本,对于宫颈癌的勾画建议采用60例作为临床模板库病例数。

Neuroform Atlas支架辅助弹簧圈栓塞未破裂性颅内宽颈动脉瘤

目的:探讨Neuroform Atlas支架辅助弹簧圈栓塞治疗未破裂性颅内宽颈动脉瘤的安全性和有效性。方法:回顾性分析2020年8月至2021年9月于北京大学第三医院介入血管外科采用Neuroform Atlas支架辅助弹簧圈栓塞治疗的62例未破裂性颅内宽颈动脉瘤患者的临床资料。62例患者共64个颅内动脉瘤,其中25个位于大脑中动脉M1分叉处,16个位于前交通动脉,10个位于颈内动脉C7段,5个位于颈内动脉C6段,4个位于基底动脉顶端,3个位于大脑前动脉A3段,1个位于大脑中动脉M2段。有49个动脉瘤采取单支架辅助栓塞,其余15个采用双支架技术辅助栓塞(“Y”型14个和“X”型1个)。所有患者术后即刻行数字减影血管造影(digital subtraction angiography,DSA),评估动脉瘤的即刻栓塞效果(Raymond评分)和载瘤动脉血流情况。出院后对患者进行临床随访及影像学随访,临床随访为术后3个月采用改良Rankin评分量表(modified Rankin Scale,mRS)评估患者的临床预后;影像学随访为术后6个月复查脑血管DSA评估患者动脉瘤闭塞情况(Raymond评分)和载瘤动脉通畅情况。结果:62例患者手术均获成功,技术成功率为100%。术后即刻DSA显示:57个动脉瘤(89.1%,57/64)完全闭塞(RaymondⅠ级),6个动脉瘤(9.3%,6/64)瘤颈残留(RaymondⅡ级),1个动脉瘤(1.6%,1/64)瘤体残留(RaymondⅢ级)。3例患者(4.8%,3/62)出现围手术期并发症:2例为术中血栓形成,予动脉内替罗非班治疗后血流恢复,1例为术后局限性蛛网膜下腔出血,经保守治疗出院时均无致残性功能障碍。术后3个月时55例患者获临床随访,均预后良好(mRS≤2分),7例患者失访。50例患者(52个动脉瘤)获术后6个月DSA影像随访:RaymondⅠ级45个(86.5%,45/52),RaymondⅡ级4个(7.7%,4/52),RaymondⅢ级3个(5.8%,3/52),12例患者失访。结论:Neuroform Atlas支架辅助弹簧圈栓塞未破裂性颅内宽颈动脉瘤有很高的技术成功率,并具有较低的围手术期并发症发生率和较高的动脉瘤闭塞率,安全性和有效性均较好,但其远期疗效还需进一步随访观察。

Orbscan-II、IOL Master和Atlas角膜地形图测量角膜直径的比较

目的比较IOL Master、Orbscan-II和Atlas角膜地形图三种检查方法测量角膜直径的结果,为临床应用提供参考依据。方法分别应用IOL Master、Orbscan-II和Atlas角膜地形图对63例(126眼)患者进行角膜直径的测量,每种方法重复3次,对比分析测量结果。结果 Orbscan-II、IOL Master与Atlas角膜地形图的角膜直径测量结果分别为(11.50±0.31)mm、(11.95±0.34)mm、(12.08±0.37)mm,组内相关系数分别为0.738、0.735、0.873,变异系数分别为2.70%、2.84%、3.06%,角膜直径测量值两两比较差异均有显著统计学意义(均为P<0.01),相关性分析显示三种方法的测量值均呈显著正相关(均为P<0.01)。三种方法的左右眼测量值间的差异均无统计学意义(均为P>0.05),左右眼测量值间具有显著的相关性(均为P<0.001)。结论 Orbscan-II的测量值要小于IOL Master与Atlas角膜地形图,Atlas角膜地形图的重复性最好。