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Luo M.,Shanghai JiaoTong University | Xie H.,Beijing Union Medical College Hospital | Xie L.,Shanghai JiaoTong University | Cai P.,Shanghai JiaoTong University | Gu L.,Shanghai JiaoTong University
Computerized Medical Imaging and Graphics | Year: 2014

A virtual reality (VR) based vascular intervention simulation system is introduced in this paper, which helps trainees develop surgical skills and experience complications in safety remote from patients. The system simulates interventional radiology procedures, in which flexible tipped guidewires are employed to advance diagnostic or therapeutic catheters into vascular anatomy of a patient. A real-time physically-based modeling approach ground on Kirchhoff elastic rod is proposed to simulate complicated behaviors of guidewires and catheters. The slender body of guidewire and catheter is modeled using more efficient special case of naturally straight, isotropic Kirchhoff rods, and the shorter flexible tip composed of straight or angled design is modeled using more complex generalized Kirchhoff rods. The motion equations for guidewire and catheter were derived with continuous elastic energy, followed by a discretization using a linear implicit scheme that guarantees stability and robustness. In addition, we used a fast-projection method to enforce the inextensibility of guidewire and catheter. An adaptive sampling algorithm was also implemented to improve the simulation efficiency without decrease of accuracy. Experimental results revealed that our system is both robust and efficient in a real-time performance. © 2014 Elsevier Ltd. Source


Shen Y.,Shanghai JiaoTong University | Huang X.-J.,Beijing City University | Wang J.-X.,Peking Union Medical College | Jin J.,Zhejiang University | And 11 more authors.
International Journal of Clinical Pharmacology and Therapeutics | Year: 2013

Background: Invasive fungal infection (IFI) is common in neutropenic patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS). Posaconazole is a broad-spectrum triazole antifungal drug with efficacy in prevention of IFI; however, it has not been previously studied as prophylaxis in a Chinese population. Methods: This multicenter, randomized study in China enrolled AML and MDS patients with persistent chemotherapy-induced neutropenia. Prophylaxis with posaconazole or fluconazole was administered for a maximum of 12 weeks, or until patients recovered from neutropenia and achieved complete remission or an IFI occurred. The primary endpoint was incidence of proven, probable, or possible IFI during treatment. Clinical failure rate, all-cause mortality and time to first systemic antifungal treatment were secondary endpoints. Results: Patients were randomized to receive posaconazole (n = 129) or fluconazole (n = 123); 117 patients in each group were included in the statistical analysis. The incidence of proven, probable or possible IFI was 9.4% (11/117) and 22.2% (26/117) in the posaconazole and fluconazole groups, respectively (p = 0.0114). The clinical failure rate was numerically lower in the posaconazole group (37/117 (31.6%; 95%CI: 23.3-40.9)) than in the fluconazole group (49/117 (41.88%; 95% CI: 32.8-51.4)) (p = 0.168). Patients receiving posaconazole had a later onset of first systematic antifungal treatment than those receiving fluconazole (p = 0.0139). The most common important adverse events were liver function abnormalities (11 patients (8.8%) on posaconazole and 6 (5.0%) on fluconazole (p = 0.221)). Conclusions: Posaconazole demonstrates ef-ficacy as prophylaxis against IFI in high-risk neutropenic Chinese patients and is well tolerated during long-term use (ClinicalTrials. gov number, NCT00811928). © 2013 Dustri-Verlag Dr. K. Feistle. Source


Huang X.,Peking University | Wang F.,Peking University | Chen Y.,Peking University | Liu T.,University of Sichuan | And 9 more authors.
Future Microbiology | Year: 2012

Aim: Invasive fungal infections pose a severe health threat to patients. Despite recent advances in drug development, treatment of recurrent fungal infections remains difficult. Posaconazole is a broad-spectrum triazole antifungal drug available for oral administration. Although initial studies have described its use in treating various fungal infections, its efficacy and safety in patients with invasive fungal infections remains to be further confirmed. Materials & Methods: In this study, we performed a multicenter, open-label clinical trial of posaconazole oral suspension in the treatment of 63 patients with invasive fungal infections who were refractory to or intolerant of first-line therapy. Results: Our result showed that 64.4% of patients had a clinical response after posaconazole treatment, with 52.9% showing eradication of the fungal infection. The treatment caused some adverse effects of mild or moderate severity that were of short duration. Conclusion: The results of this trial indicate that posaconazole can be used in invasive fungal infections as an alternative or salvage therapy. © 2012 Future Medicine Ltd. Source


Jing H.,Beijing Union Medical College Hospital | Li F.,Beijing Union Medical College Hospital | Zhong D.,Beijing Union Medical College Hospital | Zhuang H.,Childrens Hospital of Philadelphia
Clinical Nuclear Medicine | Year: 2013

Tumors that cause osteomalacia are generally benign fibroblast growth factor-23 producing mesenchymal tumors which can be detected by octreoscan. A 45-year-old man underwent 99mTc-HYNIC-TOC scan to detect a possible culprit causing osteomalacia. The images showed abnormal activity in the left humerus and in the right foot. The lesion of the right foot was confirmed pathologically as phosphaturic mesenchymal tumor. After surgical removal of the tumor in the right foot, the patient's symptoms were promptly improved. However, the improvement was transient due to the unresected tumor in the left humerus. Copyright © 2013 by Lippincott Williams & Wilkins. Source


Fang Y.,University of Missouri | Fang Y.,Peking University | Fang Y.,Beijing Union Medical College Hospital | Zhao L.,Wannan Medical College | And 5 more authors.
Clinical Laboratory | Year: 2011

Background: Our previous study suggests that decreased P-450 c17α expression correlated with the overproduction of aldosterone in APA and nodular hyperplasia in patients with primary aldosteronism. This study was performed to further investigate if P-450 c11β contributes to the overproduction of aldosterone in APA and nodular hyperplasia tissues Methods: Total RNA and protein were extracted from 7 cases of APA tissue, 3 nodular hyperplasia tissues, 7 normal adrenal glands. P-450 c11β mRNA was examined by dot blot and confirmed by Northern blot analysis and by realtime PCR. Protein expression level of P-450 c11β was also investigated by immunohistochemical staining and confirmed by Western blot. Results: The relative expression level of P-450 c11β mRNA to β-actin in APA, nodular hyperplasia and the normal adrenal gland group are 47±22 %, 55±13 %, 64±16 % respectively by dot blot and are 94±18 %, 101±20 %, 112±62 % respectively by Northern blot. These results are further confirmed by realtime PCR. This result was also supported by the relative protein expression level of P-450 c11β to β-actin, which are 118±15 %, 107±32 %, 108±22 % respectively evaluated by Western blot. There was no significant difference in protein expression level of P-450 c11β among the normal adrenal gland tissues, APA and adrenal nodular hyperplasia tissue, either (P > 0.05). Conclusions: These results suggest that P-450 c11β is not a key contributor to the overproduction of aldosterone in APA and nodular hyperplasia and can not be considered as a potential marker to differentiate between them in patients with primary aldosteronism. Source

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