支气管动脉栓塞治疗急性大咯血

目的：通过对支气管动脉栓塞治疗急性大咯血的分析,探讨支气管动脉栓塞治疗大咯血的效果及影响因素。方法：21例病人,共栓塞出血动脉34支,其中右支气管动脉18支,左支气管动脉13支,肋间动脉3支：栓塞材料为明胶海绵颗粒。结果：栓塞后,19例病人出血明显减少;2例术后第2天又有大咯血,治疗失败。治疗有效率90．5％（19／21）。结论：支气管动脉栓塞术是急性大咯血的安全、简便、有效的治疗手段。     

支气管动脉栓塞术治疗大咯血的疗效研究

目的：探讨支气管动脉栓塞术治疗急症大咯血的近远期疗效及术后咯血复发、影响该治疗技术疗效的主要原因。方法：对57例大咯血患者行支气管动脉栓塞术治疗。57例中,支气管扩张症20例,肺结核31例,肺癌6例。术后随访3～18个月,观察疗效。结果：即刻止血48例（84．2％）,术后咯血完全停止;7例咯血明显减少,经内科保守治疗2—5天后咯血停止;2例咯血减少不明显,经二次栓塞治疗后咯血停止。2例肺结核患者及1例肺癌患者术后因病情进展,分别于6个月、9个月后再次咯血,经再次栓塞治疗后咯血停止。结论：支气管动脉栓塞术治疗急症大咯血创伤小,止血迅速安全,近远期疗效确切,有效控制原发病可降低咯血复发率。     

支气管动脉栓塞治疗急性大咯血的临床应用

目的评价选择性支气管动脉栓塞对治疗急性大咯血的效果。方法49例大咯血病人包括经临床与放射学证实的肺结核21例，支气管黏膜结核4例，支气管扩张18例，以及晚期肺癌6例，均经选择性支气管动脉栓塞治疗。栓塞治疗后，全部病人经随访6个月至18个月。结果栓塞治疗后12h．49例中的46例(93．9％)被成功地止血，其余3例栓塞后再次咯血，再行栓塞治疗后，咯血停止。在随访6个月至18个月期间，除3例肺癌与1例肺结核偶有痰血外，未发生与栓塞治疗操作相关的严重并发症．结论选择性支气管动脉栓塞是目前治疗急性大咯血的一种较好方法，值得进一步推广应用。     

支气管动脉栓塞术治疗肺咯血疗效分析

目的分析支气管动脉栓塞术治疗肺咯血的临床价值。方法对87例咯血患者(支气管扩张46例、肺结核18例、肺癌15例、支气管动静脉畸形2例、原因不明咯血6例)行选择性支气管动脉或肋间动脉栓塞治疗。其中支气管动脉栓塞78例,肋间动脉栓塞6例,支气管动脉与肋间动脉一同栓塞3例。2例使用同轴微导管行超选择栓塞,使用明胶海绵微粒栓塞85例,使用明胶海绵微粒与聚乙烯醇颗粒联合栓塞2例。全部病例随访12～18个月。结果栓塞后即刻止血58例,咯血量明显减少19例。于栓塞后1周、2周、1个月分别有5例、3例、2例复发。10例复发患者再次行栓塞治疗后未再出现咯血。有效率为89%(77/87)。全部病例无并发症发生。结论支气管动脉栓塞术是治疗肺咯血的一种安全、有效、微创的有效方法。     

支气管动脉栓塞术治疗大咯血26例分析

目的：评价支气管动脉栓塞术治疗大咯血的临床疗效。方法：26例大咯血患者，咯血量300～1200ml／24h，平均420ml／24h，其中肺癌12例，支气管扩张6例，肺结核2例，肺棘球蚴病1例，肺血管畸形5例。采用改良Seldinger方法行选择性支气管动脉栓塞治疗。栓塞材料使用明胶海绵颗粒或PVA，血管粗大者加用明胶海绵条。常规行患侧锁骨下动脉、肋间动脉及对侧支气管动脉造影。以了解有无多支供血，发现供血血管则尽量行超选择插管栓塞治疗。肺癌患者根据不同病理类型行常规化疗灌注。结果：18例一次栓塞成功，3例两次栓塞成功，5例肺癌咯血栓塞后出血量明显减少。栓塞术后即时止血率80．77％，近期复发率7．69％，中远期复发率23．08％。结论：支气管动脉栓塞术治疗大咯血即时止血和近期疗效满意，中远期复发与栓塞材料吸收和原发病有关。     

明胶海绵加丝线微粒栓塞支气管动脉治疗大咯血

目的：观察明胶海绵加丝线微粒栓塞支气管动脉治疗大咯血中的疗效。方法：22例急性大咯血患者，男14例，女8例，支气管扩张症12例，肺结核6例，肺癌并出血4例，均用海绵加丝线粒栓塞。结果：22例患者术后咯血量明显减少，3天后咯血完全停止，1例1周后复发经第二次栓塞止血。所有病例组随访四个月以上均无复发。结论：支气管动脉栓塞控制急性大咯血为有效、安全的微创手术。     

支气管动脉栓塞治疗肺结核并大咯血的疗效观察

目的：探讨支气管动脉栓塞治疗肺结核大咯血中的应用价值。方法：33例肺结核大咯血患者经内科保守治疗无效后行支气管动脉栓塞．栓塞材料为明胶海绵颗粒或聚乙烯醇微粒（PVA），栓塞过程在X线影像监视下完成。结果：33例支气管动脉栓塞治疗后，25例1次栓塞后止血；8例2次栓塞后止血，其中5例行支气管动脉和超选择行胸廓内动脉栓塞止血．1例在第二次栓塞后1周因再次大咯血而死亡。结论：支气管动脉栓塞对肺结核大咯血的治疗是一种安全有效而快捷的手段。     

支气管动脉栓塞治疗肺部大咯血的临床研究

目的：探讨支气管动脉栓塞[BAE]治疗肺部大咯血的临床应用价值。方法：选择20例急性大咯血患者通过选择性支气管动脉造影，用明胶海绵颗粒将出血异常支气管动脉栓塞。结果：1例3天后咯血复发，再次栓塞止血，其余19例一次栓塞成功，在随访6—12个月期间，除1例肺癌与1例肺结核偶有痰血外，未发生与栓塞治疗操作相关的严重并发症。结论：支气管动脉栓塞术是安全有效的大咯血治疗方法，可以作为临床上保守治疗无效后的首选治疗方法。     

高温高压处理后明胶海绵在肺咯血动脉栓塞术中的应用初探

目的：探讨高温高压处理后的明胶海绵作为栓塞剂在动脉栓塞治疗肺咯血中的应用价值。材料和方法：19例行动脉栓塞治疗的肺咯血患者，其中肺结核9例，单纯性支气管扩张7例，肺癌术后继发性支气管扩张1例，肺癌1例，原因不明1例。所有患者在动脉栓塞治疗中均应用高温高压处理后的明胶海绵作为栓塞剂，术后进行疗效随访。结果：所有患者均行出血动脉的双重栓塞术。所有患者均行支气管动脉栓塞术，附加行肋间动脉栓塞术4例，附加行胸廓内动脉栓塞术3例，附加行肩胛下动脉栓塞术1例，附加行心包膈动脉栓塞术1例。19肺咯血患者经动脉栓塞术后随访至今，临床疗效满意，无术后严重并发症。结论：高压高温处理后的明胶海绵作为栓塞剂治疗肺咯血，不仅临床疗效满意而且非常经济，适合目前我国的国情，值得推广。     

无水乙醇栓塞支气管动脉治疗大咯血

目的：探讨支气管动脉栓塞治疗大咯血的材料及方法。方法：分析24例大咯血病人的临床资料，具体操作方法。结果：24例大咯血病人中，支气管动脉明显增粗、扩张、迂曲，行支气管动脉栓塞术后咯血即刻停止，有效率达100％，随访观察12—48个月，平均28个月，22例无复发，占98％，2例因新生肿瘤血管复发，占2％。结论：无水乙醇栓塞支气管动脉治疗大咯血效果好，对原发性肺癌有积极的治疗作用。     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术,观察U50,488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50,488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流,而细胞缺氧后,这一抑制作用减弱;U50,488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱,其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).