| Objective:1.Using CT imaging to measure preset indicators after three-dimension reconstruction of children’s head and neck,to explore the risk,safe depth and angle of acupuncture in Mongolian children of all age groups and their age-related changes and differences between groups.The first digital and three-dimensional visualization system of acupuncture points in the head and neck of Mongolian medicine children in China was constructed,which can be used for clinical acupuncture training,teaching and acupuncture safety research.Methods:1.According to the applicable age of Mongolian medicine’Barihu’surgery,120 cases of head and neck CT image data of children aged 1 to 5 years old were collected and divided into 4 age groups at the interval of one year,with 30 cases in each group.The skin and bone structure was reconstructed with Mimics 21.0 software,and acupuncture acupoint were marked on the three-dimensional model of skin under the guidance of Mongolian medicine experts.According to the anatomy of the needle path in each direction,the distance and angle indexes were formulated and the data measurement and result verification were completed.The distance index result,namely the dangerous depth of acupuncture,was introduced into the formula of’safe depth=dangerous depth×75%’to calculate the safe depth of acupuncture.The dangerous,safe depth and angle values were converted to obtain the risk degree of acupuncture at three groups of acupuncture acupoint.2.On the basis of the sectional anatomical data sets of preschool boys,Photo Shop 2021 and Digihuman Reconstruction System software were used to complete the three-dimensional digital virtual anatomical model of children and the construction of internal multiple organ tissues;the relevant annotation information database of 27 acupoints such as dinghui acupoint of Mongolian medicine was compiled by Unity database language.The Mongolian gold needles and silver needles were selected to record the acupuncture point teaching video on the3D printed head and neckresin model of children.In Unity3D software,children’s anatomical model,acupuncture acupoint annotation information database and acupuncture operation video were integrated and coded,and a three-dimensional digital children’s Mongolian acupuncture acupoint visualization system integrating simulation acupuncture training,clinical teaching and acupuncture safety research was successfully created.Results:1.All the distance indexes of ZMsagittal plane showed an increasing trend with age,among which ZM-PFM-D,ZM-OAGM-D and ZM-C2SU-D were statistically different between 1～age group and 2～age group and 3～age group and 4～age group（P<0.05,hereinafter referred to as difference）,ZM-C1SU-D and ZM-C1SL-D were different between 1～age group and 2～age group and 4～age group（P<0.05）;The mean values of all distance indexes of ZMhorizontal plane in each age group showed an increasing trend with age.Among them,ZM-LOFMP-D was different between the 4～age group and the other age groups（P<0.05）.ZM-LC1UL-D and ZM-LC1T-D were different between the 1～age group and the other age groups（P<0.05）;There was no obvious age change rule in the angle index of ZM.ZM-PFM-AH was different between the 1～age group and the 2～age group and the 3～age group（P<0.05）,ZM-C2SU-AH was different between 1～age group and other age groups（P<0.05）.The mean values of all the distance indexes of the sagittal plane of the left point of the occipital meeting showed an increasing trend with age.The mean values of ZL-PMF-D,ZL-C1U-D,ZL-C1L-D and ZL-C2U-D in the 1～age group were different from those in the other age groups（P<0.05）,and the mean values of ZL-LOFMP-D in the 1～age group were different from those in the 3～age group and the 4～age group（P<0.05）;Except ZL-C1SU-D and ZR-C1SU-D,the mean values of the other indexes in the horizontal distance index of the left point（ZL）of the pillow meeting（ZL）showed an increasing trend with increasing age and the change range was large.All the indexes were different between the 1～age group and the other age groups（P<0.05）;Except ZL-C1LT-AS and ZR-C1RT-AS,there was no significant age-related change in the mean value of the left occipital point（ZL）angle index,and the lowest value was located in the 1～age group.The mean value of ZL-LOFMP-AH in the 1～age group was different from that in the other age groups（P<0.05）,and ZL-LC2UL-AH was different between the 1～age group and the 2～age group（P<0.05）.The mean values of HM-C6SL-D,HM-C67GM-D and HM-C7T1GM-D in the sagittal plane distance index of Heyizhong（HM）showed an increasing trend with age.HM-C6SL-D and HM-C67GM-D were different between the 4～age group and the 1～age group and the 2～age group（P<0.05）;The mean values of all distance indexes in the horizontal plane of Heyizhong（HM）increased with age.HM-RC7T-D、HM-RC6LL-D and HM-RC7UL-D were different between the 1～age group and the other age groups（P<0.05）;Except for HM-T1SU-AH,the mean values of other indexes in the angle index of Heyizhong（HM）had no significant age-related changes among the age groups.HM-T1SU-AH was different between the 1～age group and the 2～age group and the 3～age group and the 4～age group（P<0.05）.Except for HR-C7LL-D,the mean values of other indexes in the sagittal plane distance index of Heyiyou acupoint had no increasing trend with age.HR-C7UL-D and HR-C7LL-D were different between the 1～age group andt he3～age group and the 4～age group（P<0.05）;Except for HR-C7SL-D,the mean value of the horizontal distance index of Heyiyou（HR）showed an increasing trend with age,and the growth rate was faster between the 1～age group and the 3～age group.The mean values of HR-C7RT-D in the1～age group and the 2～age group were different from those in the 3～age group and the 4～age group,respectively（P<0.05）,and the mean values of HR-RC7LL-Din the 1～age group were different from those in the other age groups（P<0.05）;The mean values of HL-T1UL-AH,HR-T1UL-AH,HL-LC7T-AS and HR-RC7T-AS in the right point（HR）angle index of Heyi showed an increasing trend with age in each age group.The mean value of HR-C6LL-AH was different between the 1～age group and the 2～age group and the 4～age group（P<0.05）,and the HR-RC7T-AS was different between the 1～age group and the 2～age group and the 3～age group and the 4～age group（P<0.05）.There was no overall age change rule in the mean value of all distance indexes on the sagittal plane of XM,and there was no difference in all indexes among all age groups（P>0.05,referred to as no difference）;The mean values of XM-T1LT-D and XM-T1RT-D in the horizontal distance index of Xilazhong（XM）showed an increasing trend with age.The mean value of XM-T1LT-D in the1～age group was different from that in the other age groups（P<0.05）,and the mean value of XM-LT1LL-D in the 1～age group was different from that in the other age groups（P<0.05）;There was no significant age change in XM-T1SU-AH in XMangle index.The mean value of XM-T1SU-AH in 1～age group and 2～age group was different from that in 3～age group and 4～age group（P<0.05）.XM-T2SU-AH in 2～age group was different from that in 3～age group and 4～age group（P<0.05）.The sagittal distance index of Xilazuo（XL）was the most significant difference between the 1～age group and the 2～age group,and the change range was the largest.The 2～age group and the 4～age group were basically the same.XL-T1UL-D,XL-T1LL-D and XL-T2UL-D were different between the 1～agegroup and the 4～age group（P<0.05）;The mean values of XL-T1LT-D,XL-LT1LL-D,XR-T1RT-D and XR-RT1LL-D in the horizontal distance index of Xilazuo（XL）showed an increasing trend with age.The mean values of XL-T1LT-D in the 1～age group and the 2～age group were different from those in the 3～age group and the 4～age group（P<0.05）.The mean values of XL-LT1LL-D in the 1～age group and the 2～age group were different from those in the 3～age group and the 4～age group（P<0.05）;The mean values of XL-LT1UL-AH,XR-RT1UL-AH,XL-T1SL-AS and XR-T1SL-AS in the angle index of XLhad no obvious age change rule.The mean values of XL-LT1UL-AH and XR-RT1UL-AH in each age group were basically the same.The mean values of XL-LT2LL-AH in the 1～age group and the 2～age group were different from those in the 3～age group and the 4～age group（P<0.05）.2.This study completed the three-dimensional reconstruction of dozens of anatomical structures such as head and neck skin,bone structure,cervical spinal cord,blood vessels and nerves,muscles and ligaments in children.Unity3D software was used to integrate the three-dimensional model of children,acupuncture operation video and acupoint annotation library,and a three-dimensional digital Mongolian acupuncture acupoint visualization system for children was successfully constructed.Conclusion:1.Three groups of acupoint distance index mean overall showed a trend of increasing age change increasing trend,including 1～age group to 3～age group interval growth rate is faster,3～age group to 4～age group interval growth rate tends to be gentle,4～age group compared with 1～age group difference is significant,most of the angle index between each age group difference is significant but no obvious age change rule.According to the statistical results,the dangerous depth of acupuncture at most acupoints in the 3～age group and the 4～age group has a large increase compared with the 1～age group and the 2～age group.The dangerous depth of acupuncture in the 1～age group and the 2～age group is basically in the range of 10mm～15mm;the dangerous depth of acupuncture from flat to oblique angle is about 20mm;when the horizontal oblique puncture is 30oand above,the dangerous depth range of acupuncture is 20mm～25mm,and its value changes obviously with the adjustment of acupuncture angle.The acupuncture depth of 3～age group and 4～age group can be increased by about 5mm on the basis of ensuring the safety of operation.2.Based on the real continuous fault ultra-thin data set of preschool boys in China,the first three-dimensional digitization and visualization system of acupuncture points in the head and neck of Mongolian medicine children in China was developed.Compared with the previous acupuncture soft works,it is more suitable for the anatomical morphological development characteristics of Asian children,and has extremely high application value in the fields of Mongolian medicine acupuncture safety research,clinical teaching and acupuncture simulation training. |
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