Veins

静脉
  • 文章类型: Journal Article
    硬脑膜动静脉瘘(dAVF)是硬脑膜内动脉和静脉之间的异常连接,涉及硬脑膜窦,桥接静脉,或使者静脉。如果未经治疗,这些病变可导致颅内出血。由于脑干和颅神经附近复杂的静脉解剖结构,后颅窝dAVF的管理具有挑战性。这项研究利用三维(3D)技术与解剖相结合,以了解治疗下幕dAVF的解剖学和显微外科技术。使用五个防腐的头部和一个干燥的头骨精心记录了下鼻室的相关解剖结构。先进的3D技术,包括3D雕刻和结构光扫描,用于构建高分辨率体积模型(VM)。解剖和VM的二维(2D)图像说明了后颅窝的关键解剖标志。幕下DAVF主要累及鼻窦,根据它们的位置分为几组:基础,髓质,和石油。大部分动脉供应来源于颈外动脉,尤其是咽升动脉.随后是来自颈内动脉(ICA)和椎基底动脉系统的脑膜分支。治疗幕下dAVF的手术方法包括乙状结肠后入路和远外侧入路及其修改。我们的研究描述了鼻下隔室的相关血管解剖,重点介绍幕下dAVFs的手术治疗。结合包含的交互式模型,这项研究提高了我们对该区域复杂血管神经解剖学特征的教育能力.当应用于临床环境时,精确的解剖学知识和VM工具可提高手术效果,减少并发症,并最终改善患者护理。
    Dural arteriovenous fistulas (dAVFs) are anomalous connections between arteries and veins within the dura mater, involving dural sinuses, bridging veins, or emissary veins. If untreated, these lesions can result in intracranial hemorrhage. The management of posterior fossa dAVFs is challenging due to the intricate venous anatomy near the brainstem and cranial nerves. This study leverages three-dimensional (3D) technology combined with dissections to understand the anatomy and microsurgical techniques for treating infratentorial dAVFs. Five embalmed heads and one dry skull were used to meticulously document the pertinent anatomy of the infratentorial compartment. Advanced 3D technology, including 3D sculpting and structured light scanning, was employed to construct high-resolution volumetric models (VMs). Two-dimensional (2D) images of dissections and VMs illustrate key anatomical landmarks of the posterior fossa. Infratentorial dAVFs primarily involve sinuses, which are divided into groups based on their location: basal, medullary, and petrosal. Most of the arterial supply originates from the external carotid artery, especially the ascending pharyngeal artery. This is followed by meningeal branches from the internal carotid artery (ICA) and vertebrobasilar system. The surgical approaches to treat infratentorial dAVFs include the retrosigmoid and far lateral approaches and their modifications. Our study describes the relevant vascular anatomy of the infratentorial compartment, focusing on the surgical treatment of infratentorial dAVFs. In conjunction with the included interactive models, this study improves our educational capabilities regarding the intricate vascular neuroanatomical features of this region. When applied to a clinical setting, precise anatomical knowledge and VMs tools enhance surgical outcomes, reduce complications, and ultimately improve patient care.
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  • 文章类型: Journal Article
    三叉神经痛(TN),严重的面部疼痛,常采用微血管减压术(MVD)治疗。虽然MVD对动脉神经血管压迫有效,其在静脉压迫病例中的疗效以及此类病例的术中处理仍存在争议。这篇综述旨在分析MVD期间侵犯静脉的术中管理策略,并评估在单纯静脉压迫的TN病例中这些手术的结果。对报道纯静脉压迫病例的术中静脉处理和MVD手术结果的研究进行了广泛的回顾。共纳入了15项全文研究,共600名患者。值得注意的是,这些患者中有82.33%达到了巴罗神经研究所(BNI)I疼痛评分,随访期从3个月到12年不等。在静脉压迫的情况下,MVD是TN的可行和有效的治疗选择,相当比例的患者经历了实质性的疼痛缓解。
    Trigeminal neuralgia (TN), a severe facial pain condition, is often treated with microvascular decompression (MVD). While MVD is effective for arterial neurovascular compression, its efficacy in cases of venous compression and the intraoperative management of such cases remain areas of debate. This review aimed to analyze the intraoperative management strategies for offending veins during MVD and evaluate the outcomes of these procedures in cases of TN with purely venous compression. An extensive review of studies reporting on the intraoperative handling of veins and the surgical outcomes of MVD in purely venous compression cases was conducted. Fifteen full-text studies were included, encompassing a total of 600 patients. Notably, 82.33% of these patients achieved a Barrow Neurological Institute (BNI) I pain score, with follow-up periods ranging from 3 months to 12 years. MVD is a viable and effective treatment option for TN in cases of venous compression, with a significant proportion of patients experiencing substantial pain relief.
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  • 文章类型: Journal Article
    手指静脉识别方法,作为新兴的生物识别技术,由于其高精度和实时检测功能,在身份验证方面引起了越来越多的关注。然而,随着隐私保护意识的提高,传统的集中式手指静脉识别算法面临隐私和安全问题。联合学习,一种分布式训练方法,在不跨端点共享数据的情况下保护数据隐私,正在逐步推广和应用。然而,它的性能受到数据集之间异质性的严重限制。为了解决这些问题,提出了一种双解耦的手指静脉识别个性化联邦学习框架(DDP-FedFV)。DDP-FedFV方法结合了泛化和个性化。在第一阶段,DDP-FedFV方法实现了涉及模型和特征解耦的双重解耦机制,以优化特征表示并增强全局模型的泛化性。在第二阶段,DDP-FedFV方法实现了个性化的权重聚合方法,联邦个性化重量比降低(FedPWRR),基于数据分布信息优化参数聚合过程,从而增强客户模型的个性化。为了评估DDP-FedFV方法的性能,基于六个公共手指静脉数据集进行了理论分析和实验。实验结果表明,该算法在不增加通信成本和隐私泄露风险的情况下优于集中式训练模型。
    Finger vein recognition methods, as emerging biometric technologies, have attracted increasing attention in identity verification due to their high accuracy and live detection capabilities. However, as privacy protection awareness increases, traditional centralized finger vein recognition algorithms face privacy and security issues. Federated learning, a distributed training method that protects data privacy without sharing data across endpoints, is gradually being promoted and applied. Nevertheless, its performance is severely limited by heterogeneity among datasets. To address these issues, this paper proposes a dual-decoupling personalized federated learning framework for finger vein recognition (DDP-FedFV). The DDP-FedFV method combines generalization and personalization. In the first stage, the DDP-FedFV method implements a dual-decoupling mechanism involving model and feature decoupling to optimize feature representations and enhance the generalizability of the global model. In the second stage, the DDP-FedFV method implements a personalized weight aggregation method, federated personalization weight ratio reduction (FedPWRR), to optimize the parameter aggregation process based on data distribution information, thereby enhancing the personalization of the client models. To evaluate the performance of the DDP-FedFV method, theoretical analyses and experiments were conducted based on six public finger vein datasets. The experimental results indicate that the proposed algorithm outperforms centralized training models without increasing communication costs or privacy leakage risks.
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  • 文章类型: Journal Article
    血管周围空间(PVS)围绕脑血管,在清除大脑中的废物中起着重要作用。他们的解剖结构和功能已经被描述为动脉,但是静脉周围的PVS特征仍然很差。在小鼠体内使用2光子成像,我们确定了动脉和静脉周围PVS的大小,以及它们与蛛网膜下腔的联系.通过大脑池将70kDFITC-葡聚糖注入脑脊液后,标记的PVS在动脉周围很明显,但是静脉显示PVS的标记频率较低。PVS的大小与毛细血管动脉和静脉的血管大小相关,但不是用于穿透血管。脑膜动脉和静脉周围的PVS被薄薄的脑膜层与蛛网膜下腔隔开,这并没有形成示踪剂的屏障。在体内,在血管壁附近观察到FITC-葡聚糖信号,但最低限度的墙本身。验尸后,示踪剂在动脉壁内的位置有明显的变化,延伸到平滑肌层。一起来看,这些发现表明静脉周围的PVS在CSF和脑实质之间的溶质交换中的作用有限。
    The perivascular space (PVS) surrounds cerebral blood vessels and plays an important role in clearing waste products from the brain. Their anatomy and function have been described for arteries, but PVS around veins remain poorly characterized. Using in vivo 2-photon imaging in mice, we determined the size of the PVS around arteries and veins, and their connection with the subarachnoid space. After infusion of 70 kD FITC-dextran into the cerebrospinal fluid via the cisterna magna, labeled PVS were evident around arteries, but veins showed less frequent labeling of the PVS. The size of the PVS correlated with blood vessel size for both pial arteries and veins, but not for penetrating vessels. The PVS around pial arteries and veins was separated from the subarachnoid space by a thin meningeal layer, which did not form a barrier for the tracer. In vivo, FITC-dextran signal was observed adjacent to the vessel wall, but minimally within the wall itself. Post-mortem, there was a significant shift in the tracer\'s location within the arterial wall, extending into the smooth muscle layer. Taken together, these findings suggest that the PVS around veins has a limited role in the exchange of solutes between CSF and brain parenchyma.
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  • 文章类型: Journal Article
    修复部位上的神经包裹物的光化学密封可隔离并优化再生神经微环境。为了促进该技术的临床采用,我们研究了啮齿动物坐骨神经横断和修复模型中的光密封自体组织。对大鼠进行坐骨神经横切,并进行三组修复:标准的显微外科神经修补术(SN)和用交联的人羊膜(xHAM)或自体静脉进行光化学密封。使用足迹分析以四周间隔评估功能恢复。腓肠肌质量保存,组织学,在120天评估和神经的组织形态计量学。用PTB密封的自体静脉治疗的神经在120天改善了功能恢复,尽管组间比较没有显著差异(SN:-58.4+/-10.9;XHAM:-57.9+/-8.7;静脉:-52.4+/-17.1)。各组肌肉质量保存良好,组间无统计学差异(SN:69+/-7%;XHAM:70+/-7%;静脉:70+/-7%)。组织形态计量学在所有修复技术中均显示出良好的轴突再生。这些结果表明,使用光封自体静脉进行的周围神经修复产生的再生至少等同于当前的金标准显微外科手术。自体静脉的使用消除了成本和异物问题,并且在手术期间很容易获得。这项研究说明了一种新的修复方法,该方法可以在严重神经损伤后以最小的创伤恢复正常的神经内膜稳态。
    Photochemical sealing of a nerve wrap over the repair site isolates and optimizes the regenerating nerve microenvironment. To facilitate clinical adoption of the technology, we investigated photosealed autologous tissue in a rodent sciatic nerve transection and repair model. Rats underwent transection of the sciatic nerve with repair performed in three groups: standard microsurgical neurorrhaphy (SN) and photochemical sealing with a crosslinked human amnion (xHAM) or autologous vein. Functional recovery was assessed at four-week intervals using footprint analysis. Gastrocnemius muscle mass preservation, histology, and nerve histomorphometry were evaluated at 120 days. Nerves treated with a PTB-sealed autologous vein improved functional recovery at 120 days although the comparison between groups was not significantly different (SN: -58.4 +/- 10.9; XHAM: -57.9 +/- 8.7; Vein: -52.4 +/- 17.1). Good muscle mass preservation was observed in all groups, with no statistical differences between groups (SN: 69 +/- 7%; XHAM: 70 +/- 7%; Vein: 70 +/- 7%). Histomorphometry showed good axonal regeneration in all repair techniques. These results demonstrate that peripheral nerve repair using photosealed autologous veins produced regeneration at least equivalent to current gold-standard microsurgery. The use of autologous veins removes costs and foreign body concerns and would be readily available during surgery. This study illustrates a new repair method that could restore normal endoneurial homeostasis with minimal trauma following severe nerve injury.
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  • 文章类型: Journal Article
    由于肾上腺静脉解剖结构的变化,在肾上腺静脉采样(AVS)期间,肾上腺静脉的准确插管具有挑战性。本研究旨在探讨国人肾上腺静脉形态特征,提高AVS的成功率。共纳入221名接受AVS的原发性醛固酮增多症(PA)患者。比较按性别划分的亚组的形态,体重指数(BMI),有或没有腺瘤。正确的成功率,左,双侧AVS为98.60%,97.20%,和96.85%,分别。右侧最常见的是三角形图案(39.37%),而左侧为腺样模式(70.14%)。不同患者肾上腺静脉形态的比例不同(χ2=21.335,P<.001),BMI(χ2=10.642P=0.031),右侧有或没有腺瘤(χ2=10.637,P=0.031),而男性,肥胖和腺瘤组显示腺样模式的比例高于三角形模式。如果仅仅依靠计算机断层扫描,9.05%的患者错误地诊断优势侧,14.48%的患者会进行不适当的手术,而25.34%的患者会错过手术机会。总之,左右肾上腺静脉形态最常见的类型是三角形和腺样,分别。性,BMI,腺瘤的存在影响右肾上腺静脉形态。对肾上腺静脉形态的充分了解对于提高AVS的成功率和对PA进行适当的治疗至关重要。
    Accurate cannulation of the adrenal vein is challenging during adrenal venous sampling (AVS) because of the variations in adrenal vein anatomy. This study aimed to investigate the adrenal venous morphology in Chinese and improve the success rate of AVS. A total of 221 participants with primary aldosteronism (PA) who underwent AVS were enrolled. Compare the morphology among subgroups divided according to sex, body mass index (BMI), and with or without adenoma. The success rate of right, left, and bilateral AVS was 98.60%, 97.20%, and 96.85%, respectively. The triangular pattern was the most common (39.37%) on the right side, while the glandlike pattern (70.14%) on the left. The proportion of adrenal venous morphology varies among patients with different sexes (χ2 = 21.335, P < .001), BMI (χ2 = 10.642 P = .031), and with or without adenoma (χ2 = 10.637, P = .031) on the right side, and the male, obese and adenoma group showed a higher proportion of glandlike pattern than triangular pattern. If only dependent on computed tomography, 9.05% of patients incorrectly diagnose the dominant side, 14.48% of patients would have inappropriate surgery meanwhile 25.34% of patients would miss the surgical opportunity. In conclusion, the most common types of right and left adrenal venous morphology were triangular pattern and glandlike pattern, respectively. Sex, BMI, and the presence of adenoma affected right adrenal venous morphology. Adequate knowledge of the adrenal venous morphology is critical for improving the success rate of AVS and making an appropriate treatment for PA.
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  • 文章类型: Journal Article
    两趾树懒(Choloepusdidactylus)的静脉解剖结构仍然知之甚少,由于传统尸体研究的局限性,特别是在活体标本中。本研究旨在使用计算机断层扫描描述Choloepusdidactylus的独特静脉结构,在现场环境中增强我们对这个物种的理解。作为常规临床评估的一部分,对三个活的Choloepusdidactylus进行了CT扫描。使用3D切片器软件(版本5.6.2)重建图像,专注于尾腔静脉解剖。重建证实存在明显的椎内静脉,显示通过腹侧骶骨孔和椎骨孔的复杂静脉连接。这些发现突出了显着的解剖学变化,并挑战了有关物种静脉结构的现有文献。通过采用现代成像技术,这项研究为Choloepusdidactylus的静脉解剖提供了新的见解,证明非侵入性技术在研究活体动物解剖特征方面的价值,从而为进一步的比较和进化研究奠定了基础。
    The venous anatomy of the two-toed sloth (Choloepus didactylus) remains poorly understood, particularly in living specimens due to the limitations of traditional cadaveric studies. This study aims to describe the unique venous structures of Choloepus didactylus using computed tomography, enhancing our understanding of this species in a live setting. Three living Choloepus didactylus underwent CT scans as part of routine clinical assessments. The images were reconstructed using 3D Slicer software (version 5.6.2), focusing on the caudal vena cava anatomy. The reconstructions confirmed the presence of a significant intravertebral vein, showing complex venous connections through the ventral sacral foramen and vertebral foramina. These findings highlight notable anatomical variations and challenge existing literature on the species\' venous architecture. By employing modern imaging technologies, this research provides new insights into the venous anatomy of Choloepus didactylus, demonstrating the value of non-invasive techniques in studying the anatomical features of live animals, thereby offering a foundation for further comparative and evolutionary studies.
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  • 文章类型: Journal Article
    动静脉瘘(AVF)用于血液透析的临床结果仍然不足,因为对AVF成熟和失败的生物学机制仍然知之甚少。在C57BL/6小鼠中进行主动脉瘘创建(AVF组)或假手术(假手术组)。术后第7天采集静脉肢体,提取总RNA进行高通量RNA测序和生物信息学分析。代谢途径中的基因在AVF中显著下调,而没有检测到显著的性别差异。由于AVF组中的基因表达模式是异质的,将AVF组分为“正常”AVF(nAVF)组和“异常值”(OUT)组。nAVF和OUT组的基因表达模式与先前发表的显示静脉适应性重塑的数据一致,而富集分析显示代谢显著上调,与nAVF组相比,OUT组的炎症和凝血功能,提示静脉重构过程中的异质性反映了可能与AVF成熟或衰竭相关的早期基因表达变化.这些过程的早期检测可能是预测瘘管失败和降低患者发病率的转化策略。
    Clinical outcomes of arteriovenous fistulae (AVF) for hemodialysis remain inadequate since biological mechanisms of AVF maturation and failure are still poorly understood. Aortocaval fistula creation (AVF group) or a sham operation (sham group) was performed in C57BL/6 mice. Venous limbs were collected on postoperative day 7 and total RNA was extracted for high throughput RNA sequencing and bioinformatic analysis. Genes in metabolic pathways were significantly downregulated in the AVF, whereas significant sex differences were not detected. Since gene expression patterns among the AVF group were heterogenous, the AVF group was divided into a \'normal\' AVF (nAVF) group and an \'outliers\' (OUT) group. The gene expression patterns of the nAVF and OUT groups were consistent with previously published data showing venous adaptive remodeling, whereas enrichment analyses showed significant upregulation of metabolism, inflammation and coagulation in the OUT group compared to the nAVF group, suggesting the heterogeneity during venous remodeling reflects early gene expression changes that may correlate with AVF maturation or failure. Early detection of these processes may be a translational strategy to predict fistula failure and reduce patient morbidity.
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  • 文章类型: Journal Article
    本研究旨在检查患有胸廓出口综合征(TOS)的高强度运动员的诱发解剖因素和随后的减压后功能结局。
    对2018年至2023年接受TOS手术减压的TOS患者的前瞻性数据库进行了单机构回顾性审查。人口统计,TOS特性,诱发解剖学,操作细节,并检查术后结局.主要结果是术后恢复运动。次要结果包括血管通畅。
    共有13名患者在诊断时从事高需求的运动活动。诊断包括8例(62%)静脉TOS患者,4例(31%)神经源性TOS患者,1例(8%)动脉TOS患者。在3例(23%)患者中观察到混合的血管和神经源性TOS。该队列的平均年龄为30岁。在12例(92%)患者中观察到异常的斜角结构,在4例(27%)患者中发现了异常的骨骼结构;2例(15%)患有颈肋骨和3例(23%)患有锁骨异常的患者。4例(27%)患者报告了同侧上肢创伤。在8位(62%)患者中观察到明显的关节过度活动,中位Beighton评分为6。所有患者均进行了锁骨上颈椎和/或第一肋骨切除术,并进行了斜角切除术。术后1例气胸非手术治疗。10名(77%)患者恢复运动。双重超声检查显示,所有8例静脉TOS患者的锁骨下静脉通畅,动脉TOS患者的血流灌注指数没有下降。
    需要手术干预的患有TOS的运动员肌肉骨骼像差和关节活动过度的发生率很高。锁骨上减压术成功率较高,具有总体良好的功能结局,并且患者恢复术前高强度运动的可能性很高。
    UNASSIGNED: This study aims to examine predisposing anatomic factors and subsequent post-decompression functional outcomes among high-intensity athletes with thoracic outlet syndrome (TOS).
    UNASSIGNED: A single-institution retrospective review was performed on a prospective database of patients with TOS from 2018 to 2023 who had undergone operative decompression for TOS. Demographics, TOS characteristics, predisposing anatomy, operative details, and postoperative outcomes were examined. The primary outcome was postoperative return to sport. Secondary outcomes included vascular patency.
    UNASSIGNED: A total of 13 patients who were engaged in high-demand athletic activity at the time of their diagnosis were included. Diagnoses included 8 (62%) patients with venous TOS, 4 (31%) patients with neurogenic TOS, and 1 (8%) patient with arterial TOS. Mixed vascular and neurogenic TOS was observed in 3 (23%) patients. The mean age of the cohort was 30 years. Abnormal scalene structure was observed in 12 (92%) patients, and abnormal bone structures were noted in 4 (27%) patients; 2 (15%) with cervical ribs and 3 (23%) patients with clavicular abnormalities. Prior ipsilateral upper extremity trauma was reported in 4 (27%) patients. Significant joint hypermobility was observed in 8 (62%) patients with a median Beighton score of 6. Supraclavicular cervical and/or first rib resection with scalenectomy was performed in all patients. One case of postoperative pneumothorax was treated non-operatively. Ten (77%) patients returned to sport. Duplex ultrasonography showed subclavian vein patency in all 8 patients with venous TOS and wide patency with no drop in perfusion indices in the patient with arterial TOS.
    UNASSIGNED: Athletes with TOS who required operative intervention had a high incidence of musculoskeletal aberrations and joint hypermobility. Supraclavicular decompression was associated with a high success rate, with overall good functional outcomes and good likelihood of patients returning to preoperative high-intensity athletics.
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  • 文章类型: Journal Article
    为了解决手指静脉识别的几个常见问题,本研究提出了一种基于小样本的轻量级手指静脉识别算法。首先,为了使处理后的图像能够模拟手指静脉在低温下的一种情况,从而提高算法模型的泛化能力。通过减少VGG-19中卷积层和全连接层的数量,可以给出一个轻量级网络。同时,部分卷积层的激活函数被替换,以保护能够成功更新的网络权值。在那之后,在改进的网络体系结构中引入了多注意力机制,以提高提取重要特征的能力。最后,基于迁移学习的策略被用来减少模型训练阶段的训练时间。老实说,很明显,本文提出的手指静脉识别算法在识别精度上有很好的表现,鲁棒性和速度。实验结果表明,识别准确率达到98.45%左右,与现有的一些算法相比,具有更好的性能。
    To address several common problems of finger vein recognition, a lightweight finger vein recognition algorithm by means of a small sample has been proposed in this study. First of all, a Gabor filter is applied to deal with the images for the purpose of that these processed images can simulate a kind of situation of finger vein at low temperature, such that the generalization ability of the algorithm model can be improved as well. By cutting down the amount of convolutional layers and fully connected layers in VGG-19, a lightweight network can be given. Meanwhile, the activation function of some convolutional layers is replaced to protect the network weight that can be updated successfully. After then, a multi-attention mechanism is introduced to the modified network architecture to result in improving the ability of extracting important features. Finally, a strategy based on transfer learning has been used to reduce the training time in the model training phase. Honestly, it is obvious that the proposed finger vein recognition algorithm has a good performance in recognition accuracy, robustness and speed. The experimental results show that the recognition accuracy can arrive at about 98.45%, which has had better performance in comparison with some existing algorithms.
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