Segmental ureterectomy is less invasive than radical nephroureterectomy and results in nephron preservation and satisfactory tumor control.This study was to determine the feasibility of segmental ureteroileal conduit ...Segmental ureterectomy is less invasive than radical nephroureterectomy and results in nephron preservation and satisfactory tumor control.This study was to determine the feasibility of segmental ureteroileal conduit resection(SUICR) for patients with distal upper urinary tract recurrence of bladder cancer following radical cystectomy.Four patients with high-grade distal upper urinary tract recurrence underwent SUICR 15-108 months after radical cystectomy.The surgical technique details of SUICR,operative results,and follow-up outcomes are reported.The median operation time was 280 min,and estimated blood loss was less than 100 ml One patient suffered from ileus 5 days after surgery and was managed conservatively.Histopathologic evaluation showed high-grade stages pTa-pT1 diseases for these patients,and ureteral margins were all negative.No patient suffered from tumor recurrence,with a median follow-up of 39 months.SUICR preserved the ipsilateral renal unit and conformed to oncological principles during surgery.The oncological outcome was satisfactory for these properly selected patients.This technique provides a valid alternative to nephroureterectomy for patients with imperative indications and high-grade upper urinary tract recurrence of bladder cancer following radical cystectomy.展开更多
The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise ...The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise and lower contrast than helical slice CT, which makes segmentation more challenging and the optimal methods are not yet known. This paper evaluates several methods of segmenting airway geometries (nares, nasal cavities and pharynx) from typical dental quality head and neck CBCT data. The nasal cavity has narrow and intricate passages and is separated from the paranasal sinuses by thin walls, making it is susceptible to either over- or under-segmentation. The upper airway was split into two: the nasal cavity and the pharyngeal region (nasopharynx to larynx). Each part was segmented using global thresholding, multi-step level-set, and region competition methods (the latter using thresholding, clustering and classification initialisation and edge attraction techniques). The segmented 3D surfaces were evaluated against a reference manual segmentation using distance-, overlap- and volume-based metrics. Global thresholding, multi-step level-set, and region competition all gave satisfactory results for the lower part of the airway (nasopharynx to larynx). Edge attraction failed completely. A semi-automatic region-growing segmentation with multi-thresholding (or classification) initialization offered the best quality segmentation. With some minimal manual editing, it resulted in an accurate upper airway model, as judged by the similarity and volumetric indices, while being the least time consuming of the semi-automatic methods, and relying the least on the operator’s expertise.展开更多
Geochemical characteristics of the Upper Permian (P-2) continental marginal arc volcanic rocks are described, which have been found recently around the areas of Xiaodingxi and Zangli on the eastern side of the Yunxian...Geochemical characteristics of the Upper Permian (P-2) continental marginal arc volcanic rocks are described, which have been found recently around the areas of Xiaodingxi and Zangli on the eastern side of the Yunxian|Lincang granite, in terms of rock assemblage, petrochemistry, REE, trace elements, Pb isotopes, geotectonic environment and so on. The volcanic rock assemblage is dominated by basalt-andesite-dacite, with minor trachyte andecite-trachyte; the volcanic rock series is predominated by the calc-alkaline series, with minor tholleiite series and alkaline series rocks; the volcanic rocks are characterized by high Al-2O-3 and low TiO-2, with K-2O contents showing extremely strong polarity; the REE distribution patterns are characterized by LREE enrichment and right-inclined type; trace elements and large cation elements are highly enriched, Ti and Cr are depleted, and P and Nb are partially depleted; the Pb composition is of the Gondwana type; the petrochemical points mostly fall within the field of island-arc volcanic rocks, in consistency with the projection of data points of continental marginal volcanic rocks in the southern segment of the South Lancangjiang Belt and the North Lancangjiang Belt. This continental marginal arc volcanic rock belt, together with the ocean-ridge and ocean-island volcanic rocks and ophiolites in the Changning-Menglian Belt, constitute the ocean-ridge volcanic rock, ophiolite-arc rock-magmatic rock belts which are distributed in pairs, indicating that the Lancangjiang oceanic crust subducted eastwards. This result is of great importance in constraining the evolution of the paleo-Tethys in the Lancangjiang Belt.展开更多
为研究曲线段大直径盾构隧道在上软下硬地层对管片上浮的影响,针对曲线段盾构隧道施工开挖面支护力、管片上浮的施工风险因素进行研究,采用极限平衡法研究开挖面支护力稳定性的影响,对开挖产生的不规则类棱台型土体进行横向竖向受力分析...为研究曲线段大直径盾构隧道在上软下硬地层对管片上浮的影响,针对曲线段盾构隧道施工开挖面支护力、管片上浮的施工风险因素进行研究,采用极限平衡法研究开挖面支护力稳定性的影响,对开挖产生的不规则类棱台型土体进行横向竖向受力分析,建立静力平衡方程,求解开挖面处于极限平衡时的极限支护力.进一步研究开挖面支护力、曲线段大直径盾构隧道在上软下硬地层掘进对管片上浮的影响,并且分析影响管片上浮的地质以及盾构掘进姿态等因素,提出相应盾构管片上浮综合控制措施.结果表明:当破裂角φ_(1)=29.0°,φ_(2)=25.5°时,极限支护力T=128.5 k Pa.应合理控制盾构掘进姿态,保证合理的支护力,防止在上软下硬地层大直径盾构盾尾注浆滞后以及浆液硬化滞后,隧道产生偏离曲线掘进轴线的上下摆动,造成管片上浮;对于上浮比较严重的区域,可以采用双液注浆法,阻止管片上浮;对于已经产生管片上浮的区域,可以采取“上压下放”的方式增加隧道的配重或采用抗拔装置施加外力来抵抗地下水上浮量.展开更多
目的:分析和比较在食管癌放射治疗中胸腹平架和头颈肩架固定装置对患者的体位固定效果。方法:回顾性筛选2020年11月至2021年4月在某院放疗科行放射治疗的41例病变位于胸中段或胸上段的食管癌患者,其中20例采用胸腹平架固定(作为胸腹平架...目的:分析和比较在食管癌放射治疗中胸腹平架和头颈肩架固定装置对患者的体位固定效果。方法:回顾性筛选2020年11月至2021年4月在某院放疗科行放射治疗的41例病变位于胸中段或胸上段的食管癌患者,其中20例采用胸腹平架固定(作为胸腹平架组),21例采用头颈肩架固定(作为头颈肩架组)。比较X(左右)、Y(头脚)、Z(腹背)、RX(矢状面)、RY(横断面)、RZ(冠状面)方向上的整体摆位误差、胸锁关节摆位误差和肩锁关节摆位误差及靶区外放范围。采用SPSS 25.0软件进行统计学分析。结果:在整体摆位误差方面,胸腹平架组在X、RX和RZ方向上显著小于头颈肩架组(0.15 cm vs 0.21 cm,P=0.000;0.66°vs 0.80°,P=0.034;0.52°vs 0.80°,P=0.000),但在Y方向上显著大于头颈肩架组(0.26 cm vs 0.22 cm,P=0.002)。在胸锁关节摆位误差方面,胸腹平架组在X、RY、RZ方向上显著小于头颈肩架组(0.15 cm vs 0.24 cm,P=0.000;0.92°vs 1.19°,P=0.000;0.63°vs 1.00°,P=0.000)。在肩锁关节摆位误差方面,胸腹平架组在RX方向上显著小于头颈肩架组(0.90°vs 1.08°,P=0.019),在Y和RY方向上显著大于头颈肩架组(0.26 cm vs 0.22 cm,P=0.024;0.81°vs 0.62°,P=0.016)。在整体靶区外放方面,胸腹平架组和头颈肩架组在X、Y和Z方向上需要的外放范围分别为0.43、0.66、0.46 cm和0.60、0.58、0.43 cm。结论:对于需要放射治疗的胸中上段食管癌患者,胸腹平架和头颈肩架在不同方向上的固定效果各有优劣,临床上应该根据具体情况选择合适的固定装置。展开更多
基金supported by the foundation of Excellent Academic Leaders of Shanghai(XBR2013076)
文摘Segmental ureterectomy is less invasive than radical nephroureterectomy and results in nephron preservation and satisfactory tumor control.This study was to determine the feasibility of segmental ureteroileal conduit resection(SUICR) for patients with distal upper urinary tract recurrence of bladder cancer following radical cystectomy.Four patients with high-grade distal upper urinary tract recurrence underwent SUICR 15-108 months after radical cystectomy.The surgical technique details of SUICR,operative results,and follow-up outcomes are reported.The median operation time was 280 min,and estimated blood loss was less than 100 ml One patient suffered from ileus 5 days after surgery and was managed conservatively.Histopathologic evaluation showed high-grade stages pTa-pT1 diseases for these patients,and ureteral margins were all negative.No patient suffered from tumor recurrence,with a median follow-up of 39 months.SUICR preserved the ipsilateral renal unit and conformed to oncological principles during surgery.The oncological outcome was satisfactory for these properly selected patients.This technique provides a valid alternative to nephroureterectomy for patients with imperative indications and high-grade upper urinary tract recurrence of bladder cancer following radical cystectomy.
文摘The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise and lower contrast than helical slice CT, which makes segmentation more challenging and the optimal methods are not yet known. This paper evaluates several methods of segmenting airway geometries (nares, nasal cavities and pharynx) from typical dental quality head and neck CBCT data. The nasal cavity has narrow and intricate passages and is separated from the paranasal sinuses by thin walls, making it is susceptible to either over- or under-segmentation. The upper airway was split into two: the nasal cavity and the pharyngeal region (nasopharynx to larynx). Each part was segmented using global thresholding, multi-step level-set, and region competition methods (the latter using thresholding, clustering and classification initialisation and edge attraction techniques). The segmented 3D surfaces were evaluated against a reference manual segmentation using distance-, overlap- and volume-based metrics. Global thresholding, multi-step level-set, and region competition all gave satisfactory results for the lower part of the airway (nasopharynx to larynx). Edge attraction failed completely. A semi-automatic region-growing segmentation with multi-thresholding (or classification) initialization offered the best quality segmentation. With some minimal manual editing, it resulted in an accurate upper airway model, as judged by the similarity and volumetric indices, while being the least time consuming of the semi-automatic methods, and relying the least on the operator’s expertise.
文摘Geochemical characteristics of the Upper Permian (P-2) continental marginal arc volcanic rocks are described, which have been found recently around the areas of Xiaodingxi and Zangli on the eastern side of the Yunxian|Lincang granite, in terms of rock assemblage, petrochemistry, REE, trace elements, Pb isotopes, geotectonic environment and so on. The volcanic rock assemblage is dominated by basalt-andesite-dacite, with minor trachyte andecite-trachyte; the volcanic rock series is predominated by the calc-alkaline series, with minor tholleiite series and alkaline series rocks; the volcanic rocks are characterized by high Al-2O-3 and low TiO-2, with K-2O contents showing extremely strong polarity; the REE distribution patterns are characterized by LREE enrichment and right-inclined type; trace elements and large cation elements are highly enriched, Ti and Cr are depleted, and P and Nb are partially depleted; the Pb composition is of the Gondwana type; the petrochemical points mostly fall within the field of island-arc volcanic rocks, in consistency with the projection of data points of continental marginal volcanic rocks in the southern segment of the South Lancangjiang Belt and the North Lancangjiang Belt. This continental marginal arc volcanic rock belt, together with the ocean-ridge and ocean-island volcanic rocks and ophiolites in the Changning-Menglian Belt, constitute the ocean-ridge volcanic rock, ophiolite-arc rock-magmatic rock belts which are distributed in pairs, indicating that the Lancangjiang oceanic crust subducted eastwards. This result is of great importance in constraining the evolution of the paleo-Tethys in the Lancangjiang Belt.
文摘为研究曲线段大直径盾构隧道在上软下硬地层对管片上浮的影响,针对曲线段盾构隧道施工开挖面支护力、管片上浮的施工风险因素进行研究,采用极限平衡法研究开挖面支护力稳定性的影响,对开挖产生的不规则类棱台型土体进行横向竖向受力分析,建立静力平衡方程,求解开挖面处于极限平衡时的极限支护力.进一步研究开挖面支护力、曲线段大直径盾构隧道在上软下硬地层掘进对管片上浮的影响,并且分析影响管片上浮的地质以及盾构掘进姿态等因素,提出相应盾构管片上浮综合控制措施.结果表明:当破裂角φ_(1)=29.0°,φ_(2)=25.5°时,极限支护力T=128.5 k Pa.应合理控制盾构掘进姿态,保证合理的支护力,防止在上软下硬地层大直径盾构盾尾注浆滞后以及浆液硬化滞后,隧道产生偏离曲线掘进轴线的上下摆动,造成管片上浮;对于上浮比较严重的区域,可以采用双液注浆法,阻止管片上浮;对于已经产生管片上浮的区域,可以采取“上压下放”的方式增加隧道的配重或采用抗拔装置施加外力来抵抗地下水上浮量.
文摘目的:分析和比较在食管癌放射治疗中胸腹平架和头颈肩架固定装置对患者的体位固定效果。方法:回顾性筛选2020年11月至2021年4月在某院放疗科行放射治疗的41例病变位于胸中段或胸上段的食管癌患者,其中20例采用胸腹平架固定(作为胸腹平架组),21例采用头颈肩架固定(作为头颈肩架组)。比较X(左右)、Y(头脚)、Z(腹背)、RX(矢状面)、RY(横断面)、RZ(冠状面)方向上的整体摆位误差、胸锁关节摆位误差和肩锁关节摆位误差及靶区外放范围。采用SPSS 25.0软件进行统计学分析。结果:在整体摆位误差方面,胸腹平架组在X、RX和RZ方向上显著小于头颈肩架组(0.15 cm vs 0.21 cm,P=0.000;0.66°vs 0.80°,P=0.034;0.52°vs 0.80°,P=0.000),但在Y方向上显著大于头颈肩架组(0.26 cm vs 0.22 cm,P=0.002)。在胸锁关节摆位误差方面,胸腹平架组在X、RY、RZ方向上显著小于头颈肩架组(0.15 cm vs 0.24 cm,P=0.000;0.92°vs 1.19°,P=0.000;0.63°vs 1.00°,P=0.000)。在肩锁关节摆位误差方面,胸腹平架组在RX方向上显著小于头颈肩架组(0.90°vs 1.08°,P=0.019),在Y和RY方向上显著大于头颈肩架组(0.26 cm vs 0.22 cm,P=0.024;0.81°vs 0.62°,P=0.016)。在整体靶区外放方面,胸腹平架组和头颈肩架组在X、Y和Z方向上需要的外放范围分别为0.43、0.66、0.46 cm和0.60、0.58、0.43 cm。结论:对于需要放射治疗的胸中上段食管癌患者,胸腹平架和头颈肩架在不同方向上的固定效果各有优劣,临床上应该根据具体情况选择合适的固定装置。
