目的 利用来自活体的CCTA数据建立不同狭窄程度冠状动脉的精确解剖三维模型,并对该组模型进行有限元流体力学模拟研究,分析血流速度在不同狭窄程度冠脉血管中的变化情况,以及其对动脉粥样硬化的造成的影响.方法 利用临床患者冠脉的CCTA数据建立精确解剖的三维模型,再使用有限元软件建立有限元模型,设置各种边界条件进行模拟分析,最后采用各种直观的图形形式输出结果.结果 血流速度在冠脉狭窄处明显加快,又在狭窄后区域明显减慢并且产生了涡流;这种明显变化的血流速度对动脉斑块会产生较大的影响.结论 (1)利用CCTA数据建立的冠脉三维模型准确、真实.(2)流速对动脉粥样硬化的发生发展扮演着重要的角色,狭窄动脉的流速变化可以加快动脉粥样硬化斑块的生长并影响斑块稳定性.

Objective To use the technology of three-dimensional(3D)reconstruction based on head CT for preoperation planning and postoperative assessment in the nasal inverted papilloma surgery, and to provide reference value for clinical application. Method This study selected a male patient, who was 65 years old with a weight of 70 kg and height of 170 cm, and had no head trauma history, surgery history and family history of brain disease. Head CT scans were performed to exclude organic brain diseases. Informed consent has been signed with the patient. The reverse engineering software Mimics 15.0 was used to create a 3D-reconstruction model, the model components were measured by 3-matic 7.0, and the preoperative planning and follow-up observation for the nasal inverted papilloma operation were designed. Result The 3Dmodels of head skull and sinus were established in accordance with the CT image measurement results; a 3D model of simulated nasal passages and tumors that consistent with the surgical approach was established; the surgical design of complicated nasal tumor and assessment after eradication were further completed. Postoperative tumor measurements showed a maximum diameter of 64.78 mm on the X-axis, 71.21 mm on the Y-axis, 86.46 mm on the Z-axis, and a total volume of 58.88 ml. This was in accord with the preoperative measurement results in shape and size. According to the analysis, the size of the tumor tissue resected during the operation was basically the same as the size of the preoperative 3D-model reconstructed tumor, indicating that the tumor tissue was completely resected by the operation. Conclusion Through the data analyzed by the 3D model, we can design pre-operation planning and complete the operation successfully. It is of great significance to guide the clinical design of individualized surgical approach for sinus tumors.

目的 基于冠状动脉CT造影数据建立不同狭窄程度冠状动脉的有限元模型,并进行流体力学模拟研究,分析管壁切应力(WSS)的变化情况及其在动脉粥样硬化中的关键作用.方法 利用临床患者狭窄冠状动脉的冠状动脉CT造影数据,建立精确解剖的三维模型;再使用有限元软件建立有限元模型,设置各种边界条件进行模拟分析;最后采用各种图形形式输出结果,进行分析研究.结果 冠状动脉狭窄处WSS明显升高,且随着血管狭窄程度的增加而逐渐升高;狭窄后区域WSS减低,与血管狭窄程度呈反比,二者之间存在切应力梯度,且随着血管狭窄程度的增加逐渐增大.结论 WSS的变化会导致粥样斑块的发生发展,在动脉粥样硬化的发病机制中扮演着重要的角色.

The stress distribution and different abduction angles have a close relation to the hip joint.The purpose of this study is to provide biomechanical evidence for the treatment or precaution of hip joint injuries.A three-dimensional model of the hip was established through a series of processing based on the normal human hip joint computed tomograph(CT)image data which were applied to reverse engineering software Mimics14.0in this study.Firstly,a three-dimensional finite element model was generated with meshing and assigned material and then it was imported into the finite element analysis software Ansys13.0.At last the stress at the femoral neck was solved,computed and analyzed in the positive orthostatic position with 7hip abduction angles of the hip joint:0°,5°,10°,15°,20°,25°,and 30°,respectively.The results showed that the stresses of femoral neck and outer region were obviously higher than those of front and rear area of the neck of femur in the upright position or abduction of a different angle.With the increase of abduction angle,femoral neck in front of the regional stress value basically unchanged and rear area decreased,but the more obvious changes occurred in the outer region although the stress of inner and outer area also increased gradually.The hip abduction may cause changes in stress distribution because of the femoral neck stress mostly concentrated in the inner and outer cortex,and therefore it has an important role in guiding for hip surgery injury patients to choose the most reasonable solutions and prevention initiatives.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.

Obj ective :To establish a numerical finite element model of the ventricle system and to analyze the fluid-structure interaction of the cerebrospinal fluid circulation.Methods :The three-dimensional model was established in Mimics 14.0 with the date of a normal subject for brain MR and it was applied to finite element software Ansys 1 3.0 to create the finite element model,and to simulate the fluid-structure interaction of the aqueduct of the midbrain.Results :A three-dimensional finite element model of the mesencephalic aqueduct was established and a series of visualization computation fluid data was obtained. Conclusion:The key findings of the cerebrospinal fluid circulation study are in alignment with physiological conditions,which provides a more accurate simulation technique for future research on the dynamics of the cerebrospinal fluid circulation.

Objective:To investigate the clinical value of traditional Chinese medicine combined acupuncture for treating recurrent trigeminal neuralgia.Methods:120 patients with recurrent trigeminal neuralgia were ran-domly divided into a treatment group and a control group.Patients in the control group received conventional medicine treatment,and patients in the treatment group were added with acupuncture treatment for one week. Rseults:After treatment, the effective rates in the treatment group and the control group were 98.3% and 85.0%and the treatment group had a significantly higher efficiency ( P<0.05) .After treatment, the pain scores, plasma vasoactive intestinal peptide values showed a significantly downward trend .Compared with those before treatment the difference was significant(P<0.05), while the pain scores, plasma vasoactive intestinal peptide values in the treatment group after treatment were lower than those in the control group ( P<0.05 ) . During treatment, the adverse cases of dizziness, drowsiness, dry mouth, nausea, vomiting and constipation were compared between two groups and there was no significant difference (P>0.05).Conclusion:The tradi-tional Chinese medicine combined with acupuncture for treating recurrent trigeminal neuralgia can adjust the va-soactive intestinal peptide and has a better analgesic effect.It is safe and should be widely applied.

目的:建立髋关节三维有限元模型,并验证其有效性,以用于后续的生物力学分析.方法:选取1名志愿者,采集髋部CT数据,导入软件Mimics 14.0软件,建立髋三维几何模型,再经Ansys13.0软件划分网格、赋材质,建立三维有限元模型.在此模型上施加220N髋关节正立位的模拟体重压力,其应力分布与相关文献对照.结果:成功建立了髋关节三维模型和有限元模型,节点数为284 183个、单元数为160 665个.在模拟重力作用下,应力分布与之前的实验结果一致.结论:建立的三维有限元模型其有良好的仿真性,可以用于临床生物力学分析.

随着现代社会人均寿命越来越长,我国逐渐步入老龄化社会,以椎间盘组织退变为基础的颈椎病的患病率也越来越高。已有研究显示,颈椎退行性疾病在60岁以上人群中,发病率超过50%,70岁以后几乎达到100%,中青年群体中由于不良工作和生活习惯发病率已超过10%,以上数据还在逐年攀升。因此,颈椎间盘退变已经成为一个值得医务工作者及科研人员深入研究的问题。随着计算机技术和有限元软件的快速发展,建立具有仿真性、可重复性等优势的椎间盘有限元模型成为研究颈椎领域最受推崇的方法,藉此可以模拟颈椎间盘损伤、退变,优化手术方案,预测手术效果,以及进行人工椎间盘的开发。颈椎椎间盘的有限元研究在基础理论预测和临床应用方面都具有重要的应用价值。

BACKGROUND:To overcome the disadvantages of traditional mechanical analysis of specimens, and establish the finite element model of realistic foot, are the important basements for the finite element mechanical analysis on foot. <br> OBJECTIVE:To establish three-dimensional finite element model of foot and lay the foundation for the finite element analysis of normal foot and foot injury. <br> METHODS:A healthy female volunteer was involved in this study and was detected with spiral CT scanning on the feet. The resulting image was used to reconstruct the three-dimensional model by using Mimics software. Then entity model was generated in Geomagic software. Final y three-dimensional finite element model was established based on the digital main structure in Ansys. RESULTS AND CONCLUSION:The established finite element digital model of human foot included al bone, cartilage and ligament, skin and soft tissue. The three-dimensional finite element model of human foot was established based on CT data and using Mimics, Geomagic, Ansys softwares. The established model had similar size and shape with skeletal mode, and can rotate freely in any angle for a variety of measurement, the foot bones can be arbitrarily split or merge, which is suitable for biomechanical analysis.

BACKGROUND:Recently, studies on three-dimensional reconstruction and biomechanics became more and more. Three-dimensional models of organs were established by modeling software based on image data using computer. Mechanical analysis was conducted using finite element analysis software. After literature retrieval, we found that the principle of three-dimensional reconstruction of human organs is not clear, and the process description is relatively simple. Some is not accorded with the fact. Above studies cannot guide related research. OBJECTIVE:To explore the principle, process, results and further application of three-dimensional reconstruction models of organs, and to provide evidence for future studies. METHODS:We retrieved China National Knowledge Infrastructure for representative literatures about three-dimensional reconstruction of human organs using the computer, and analyzed the principle, process, results and further application of three-dimensional reconstruction models of organs. RESULTS AND CONCLUSION:In combination with established three-dimensional bone models, we explained the principle, process, and application of three-dimensional reconstruction in detail, and laid the theoretical foundation for subsequent biomechanical research. With continuous development of tissue engineering technology, scholars have begun to study the pathogenesis of bone injury from various angles and different aspects so as to better prevent and treat this disease. The related research is stil in its primary stage, and stil needs further investigations.&nbsp

目的:建立髋关节的三维有限元模型,并分析正立位下的生物力学分布特点.方法:选取1名志愿者,以髋部CT扫描图像为数据源,导入软件Mimics 14.0进行三维重建,将所建模型再导入Ansys13.0中,建立有限元模型,计算正立位下髋关节的力学分布特征.结果:成功建立了髋骨、股骨上段的三维几何模型和有限元模型.模拟体质量负荷,获得髋骨股骨的应力分布云图,集中在髋骨的弓状线,髋臼后上方,股骨颈内、外侧.结论:利用Mimics、Ansys建立的髋关节有限元模型仿真性高,可以进行生物力学分析;分析结果可信,对预防、治疗髋关节损伤等具有重要意义.

BACKGROUND:In recent years, increasing research emphasizes the puncture position of the foramen ovale in skul , but most of the positin methods require a higher personal experience of surgeons and lack of individualized quantitative parameters. OBJECTIVE:To establish a visualized digital model of the foramen ovale in skul , explore the reasonable puncture path and puncture depth of percutaneous treatment of foramen ovale puncture for trigeminal neuralgia, and develop the individualized treatment of trigeminal neuralgia. METHODS:Head CT images from healthy adult male volunteers were obtained and were input into three-dimensional reconstruction software MIMICS 10.01, the three-dimensional visualized models of the skul and skin were established. Using the models, the puncture path of the foramen ovale was designed and the preliminary model of the puncture locator was plotted. RESULTS AND CONCLUSION:The three-dimensional visualized digital model of the foramen ovale puncture path was established with CT scan images by using MIMICS software, which provides reliable anatomical data for clinical teaching and lays the groundwork for the simulation of puncture surgery. On the three-dimensional models, the“needle points”,“target points”, and“midpoint”were determined, and the triangle consisted of the three points was regarded as“positioning plane”. Using these parameters, the positioning instrument is characterized by simple structure, convenient operation, high positioning precision and short period of exposure to radiation, it simulates the foramen ovale puncture needle depth and needle direction in a precise and individualized manner.

目的：：本研究旨在利用CT及MRI图像DICOM数据对正常人脊柱腰段主要结构进行三维重建，然后对模型进行网格划分和材料属性设定使其成为有限元模型并验证模型的有效性。方法：选取一健康成年男性志愿者进行CT和MRI扫描采集数据，以DICOM格式存储入可读写光盘。利用Mimics14.0软件依据CT数据重建L1~L5椎骨及骶骨上部的三维模型，依据MRI数据重建L1~L5椎间盘髓核的三维模型。将所建模型导入Geomagic12.0软件中对位组装，并生成椎间盘模型和韧带模型。将所有模型导回Mim-ics14.0中组装并自动划分面网格和体网格。将模型导入Ansys13.0中设定材料属性，重划网格，设置接触关系，对第五腰椎椎体和下关节突关节面进行约束。在Ansys13.0中对模型的L4~L5节段分级加力验证模型有效性。结果：建立了人脊柱腰段的三维模型及有限元模型，包含L1~L5的椎骨、5个椎间盘、骶骨上端、前纵韧带、后纵韧带等重要结构。该模型与脊柱标本相比具有较高相似性且可以进行有限元力学分析。结论：基于CT、MRI图像DICOM数据通过Mimics14.0、Geomagic12.0和Ansys13.0软件可以重建出人体脊柱腰段的椎骨、椎间盘等结构的三维模型和有限元模型。三维模型解剖结构相符度高，有限元模型准确有效，可以用于有限元分析。

BACKGROUND:Recently, scholars al over the world have made numerous studies on three-dimensional visualization model of reconstructing maxil ofacial bone tissue, skin, and muscle in the ordinary PC. However, few studies concerned the three-dimensional visualization model of constructing maxil ofacial bone tissue, skin, muscle and blood vessels. OBJECTIVE:To establish a three-dimensional visualization model of the complete maxil ofacial region using an ordinary PC based on spiral CT, MRI data, and three-dimensional reconstruction software. METHODS:One healthy male adult was chosen as the object in this study. CT and MRI were performed respectively to acquire the DICOM standardized image of the sample. Al CT and MRI images were imported to Mimics to construct three-dimensional visualization models of the bones in the maxil ofacial region, some masseter muscles, trigeminal cistern, internal carotid artery and internal jugular vein. Three-dimensional model of the bones in the maxil ofacial region was chosen as the reference. Models of muscles, blood vessels and trigeminal cistern established by MRI images were imported, and registration in space of three-dimensional model was performed. At last, three-dimensional visualization model of the complete maxil ofacial region was acquired. RESULTS AND CONCLUSION:The integrated three-dimensional models of the bones, muscles, skin, trigeminal cistern and blood vessels in the maxil ofacial region established accurately reflected the complex anatomic structure of maxil ofacial region, provided reliable anatomic data for clinical diagnosis and laid a good foundation for sham operations in the future.

Objective To explore the effect of Cross-link Device ( CLD) in posterior spinal approach by establishing finite element model through simulating spine flexion , extension, lateral bending and rotation after motion.Methods The finite element model of T12 vertebrae with Cobb’ angle of 42 degrees was established to simulate the spine flexion,extension,lateral bending and rotation .There were two groups in the study ,one was CLD group and the other one was NCLD group without cross-link,then burden was loaded on the surface of T 9 centrum in the model of both groups to simulate spine flexion , extension , lateral bending and rotation after motion , and angular displacement was recorded and statistically analyzed .Results With the loading force increasing ,angular displacement of the model in T 10-L2 of both groups was increased gradually , which showed a linear increase basically.However there was no significant difference between CLD group and NCLD group ( P >0.05). Conclusion There is no need to use CLD after the patient is performed pedicle fixation in adjacent two vertebra for semi-vertebrae resection .

目的 分析直接数字化X线摄影(Digital Radiography;DR)在中足(跗跖关节)损伤摄影中的应用价值.方法 对190例使用DR系统行X线检查的患者的足正斜位影像应用组织均衡、窗宽窗位调节、图像切割及局部缩放等功能进行后处理.并随机对其中30例患者进行传统屏-片系统X线摄影.由2名放射科高年资医师、2名高年资技师对所有跗跖关节影像进行分析,评价其对跗跖关节骨折、脱位、足整体及足周围软组织的显示.结果 190例DR足影像中,诊断骨折72例,脱位17例,足位置形态及软组织显示满意的分别为182例和179例;对照组30例DR跗跖关节影像发现骨折13例,脱位3例,传统屏-片系统X线片发现骨折9例,漏诊4例(χ2=9.36,P<0.05),脱位3例,30例DR足整体及软组织显示满意的为29例和28例;传统屏-片系统X线片两者显示满意的分别为10例(χ2=10.73,P<0.05)和9例(χ2=15.65,P<0.05).结论 DR影像比传统屏-片系统X线影像能更好的显示足及周围软组织,提高跗跖关节骨折脱位的检出率.

目的:建立股动脉局部狭窄处的三维有限元模型,并进行流固耦合血液动力学分析.方法:以股动脉CTA为数据源,在MIMICS 14.0中建立三维模型,再导入到有限元软件ANSYS 13.0中进行有限元模型的建立,并模拟流固耦合条件下的流体力学分析.结果:得到了狭窄血管的三维模型及有限元模型,进行有限元计算得出了一系列的可视化计算流体数据.结论:流固耦合研究得出的结论更符合生理实际,是血液流体力学研究的发展方向,可以为教学和临床提供更多帮助.

BACKGROUND: Establishment of a realistic finite element model is the important basis for the finite element mechanics analysis of the spine. The reports on the finite element model of osteoporosis are less. OBJECTIVE: To establish the main composition of the normal lumbar spine and osteoporosis lumbar vertebrae finite element digital model in order to lay the foundation for the finite element analysis of the normal lumbar spine and lumbar vertebrae of osteoporosis patients. METHODS: One healthy male volunteer received the spiral CT scan on the lumbar spine, then the pictures were separated and reconstructed in Mimics, optimized in Geomagic, assigned material and meshed in Ansys, and finally the three-dimensional finite element digital model was established. RESULTS AND CONCLUSION: The three-dimensional finite element digital models were established, including the lumbar spine, the intervertebral disc and the main ligament of normal and osteoporotic lumbar spine. This model was living with appearance, perfect with similarity. It could revolve arbitrary, so that the researchers could observe and collect the three-dimensional information from multiple perspectives, and the main structural and material properties were closed to the actual properties, which is suitable for biomechanical study. The CT data which is software (mimics, were geomagic and Ansys) can used to establish the normal lumbar spine and osteoporosis finite element digital models.

目的 与正常跗跖关节标本断层解剖对比,评价MRI在分析跗跖关节解剖关系的作用.方法 从标本中取6个正常足,采用德国SIEMENS公司1.5T超导型磁共振机,用T1vibe序列和FLASH序列,分别行斜横断面、冠状面和矢状面扫描.随机分成A、B、C 3组,每组2个标本,对标本进行包埋、固定,行斜横断面、冠状面和矢状面铣切,厚度0.5 mm,用相机连续拍照,保存图像.对标本的MR图像及解剖断层图像进行对照观察.结果 MR扫描能够清晰地显示跗跖关节各结构的排列情况,第2、4跖骨基底的内侧缘分别与中间楔骨、骰骨内侧缘形成连续光滑的连线,跗跖关节的背侧缘为连续光滑的连线,Lisfranc韧带明显比跖侧跖跗韧带粗大,背侧跖跗韧带最为薄弱.斜横断面能够清晰地显示Lisfranc韧带长轴以及跖间、跗间韧带,冠状面能够显示Lisfranc韧带断面以及跖间、跗间韧带,矢状面能够显示跖侧、背侧韧带,Lisfranc韧带显示不理想.MR图像能够很好地与断层图像相对应.结论 MR能够可靠地显示跗跖关节各结构的解剖关系,特别是对韧带的显示更具有优越性.