局部动脉内溶栓治疗视网膜中央动脉阻塞26例报告

目的观察局部动脉内溶栓治疗视网膜中央动脉阻塞的疗效,探讨如何提高其治疗效果。方法将微导管插入眼动脉或置于颈动脉内行眼动脉造影,将10万～25万U尿激酶用100ml生理盐水稀释溶解,间断手控推人眼动脉或颈内动脉一眼动脉起始部,行溶栓治疗。结果本组26例患者中,8例术后视力由术前光感或眼前数指恢复至0．1以上,10例有中度增进,8例无明显好转。视力有所恢复的18例中,发病至溶栓时间均在8天以内,视力明显恢复的3例中,2例是在发病3天内溶栓。结论局部动脉内溶栓治疗视网膜中央动脉阻塞有明显疗效,溶栓效果与溶栓时间密切相关,溶栓治疗应尽早开始。     

超选择眼动脉插管局部溶栓治疗视网膜中央动脉阻塞

目的　观察超选择眼动脉插管灌注尿激酶溶栓治疗视网膜中央动脉阻塞的疗效。方法　经股动脉或颈动脉插管 ,应用微导管技术将导管插入眼动脉局部溶栓治疗 12例中央动脉血栓形成致视力障碍患者。结果　治疗后 ,患者视力有不同程度提高 ,获得了比较满意的效果。结论　正确诊断 ,早期应用超选择局部溶栓、扩血管并尽可能应用较大剂量溶栓药物 ,可能比其他治疗方法更为有效     

动脉内联合灌注尿激酶,丹参及肝素的溶栓效果观察

目的：评估经导管动脉内联用尿激酶、丹参及肝素溶栓的临床效果。材料和方法：经股动脉穿刺，将５Ｆ导管插入至血栓近心端，经导管注入尿激酶、丹参、术中术后配合肝素抗凝，然后行血管造影，评估治疗效果，结果：血管通畅者１０例，通而不畅者１例，无效得１例，总有效率为９２％。结论：经导管动脉内联有尿激酶、丹参、配合肝素抗凝治疗外周动脉栓塞是一种有效、安全的治疗方法。     

脑梗死的超早期动脉接触性溶栓不同时间窗的疗效对比

脑梗死有较高的致死率和致残率,其治疗的关键是早期溶栓治疗,因此超早期经动脉接触性溶栓已被大力提倡。本文收集2000-04—2004-07共收治的18例急性脑梗死病人,均采取超早期经动脉接触性溶栓,获得了满意疗效,现报道如下。1材料与方法18例超早期(从发病到溶栓<6 h)脑梗死患者,男12例,女6例,年龄53~68岁,均有肢体偏瘫,舌面瘫,失语及意识障碍。采用Seld inger法股动脉穿刺插管,先行全脑血管造影,发现梗塞血管后用微导管做超选择性插管,经微导管推注尿激酶进行溶栓,尿激酶用法和用量:50万u溶于150 m l生理盐水15 m in推完,20 m in后造影复查,若…     

动脉内溶栓治疗急性脑梗塞

目的：探讨急性动脉闭塞性脑梗塞经动脉内溶栓治疗的安全性和疗效。材料和方法：36例患者均采用经皮股动脉穿刺插管行全脑血管造影后将导管选择性插管至患侧颈内动脉内，后经造影导管送入微导管至梗塞部位注入尿激酶溶栓。结果：36例患者DSA造影33例（92％），梗塞部位明确其溶栓后1小时及24小时再通28例（75％），症状和体征完全恢复34例（94％），明显好转1例，无明显变化1例（3％）。结论：动脉内溶栓治疗急性缺血灶脑梗塞是一种安全有效的治疗方法，具有重要的临床应用价值和意义。其最佳治疗时间应控制在梗塞发生后6小时以内。     

下肢深静脉血栓的经动脉溶栓治疗

目的：探讨经动脉保留导管溶栓治疗下肢深静脉血栓的应用价值。方法：40例下肢深静脉血栓患者经健侧股动脉穿刺插管至患侧髂股动脉内，并保留导管3－7d，经导管注入肝素3000－5000IU及尿激酶25万－100万IU稀释液50－200ml，每日1次。另40例经足背静脉注入同样的药物。共植入下腔静脉滤器31例，髂股静脉支架植入术10例。结果：80例患肢肿胀、疼痛均于溶栓治疗后1－3d内开始消退、减轻。31例滤器均未发生移位变形，下腔静脉通畅，10例支架无阻塞。结论：经动脉保留导管溶栓治疗下肢深静脉血栓形成，安全有效。     

尿激酶溶栓治疗内瘘血栓形成

目的 探讨外周和经皮穿刺股动脉导管注入尿激酶对动静脉内瘘血栓形成的治疗效果。方法 对16内瘘血栓形成的病人分别进行了外周溶栓和股动脉插管溶栓治疗。方法是12例病人于内瘘的动脉端穿刺后输注尿激酶，4例病人在DSA下经动脉插管至血栓部位，灌注尿激酶，尿激酶用量为75～100万U，外周溶栓输注时间为3～4h，导管溶栓时间为45～60min。结果 12例外周溶栓病人再通6例，外周溶栓成功率为50％，6例失败，其中4例进行了插管溶栓，3例成功，1例失败，成功率为75％，再通后的内瘘次日可行血液透析，并随访了6～44月，情况良好。结论尿激酶局部输注治疗内瘘血栓形成是安全有效的，可以作为首选的治疗措施。     

慢性周围动脉闭塞的选择性动脉内溶栓治疗

目的 :探讨慢性周围动脉闭塞的选择性动脉内溶栓治疗价值。方法 :36例慢性周围动脉闭塞中 ,男 19例 ,女17例。年龄 38～ 6 9岁 ,平均 4 8.5± 6 .8岁。右下肢 11例 ,左下肢 16例 ,左上肢 6例 ,右上肢 3例。按治疗方式分为 3组 ,常规动脉内导管药物溶栓者 16例 (A组 ) ,改良动脉内导管药物溶栓者 12例 (B组 ) ,超声溶栓结合导管内药物溶栓者 8例(C组 )。溶栓后球囊成形者 13例 ,同时行内支架植入者 4例。结果 :36例慢性周围动脉闭塞均溶栓成功 ,无 1例产生并发症。A、B、C三组的平均溶栓时间分别为 18.4± 5 .8h ,9.6± 3.2h和 8.5± 2 .8h ,C组的溶栓时间明显短于A、B组 (P <0 .0 5 )。A、B、C三组的平均尿激酶量分别为 10 6 .8± 38.5万u ,112 .5± 2 5 .6万u和 4 5 .6± 12 .5万u ,C组的平均尿激酶用量明显少于A、B组 (P <0 .0 5 )。结论 :选择性动脉内溶栓治疗是慢性周围动脉闭塞的安全有效的治疗方法。     

超选择性动脉溶栓治疗急性脑梗塞

目的：探讨急诊超选择性动脉溶栓治疗急性脑梗塞的价值和安全性。方法：对12例急性脑梗塞患者经股动脉插管，超选择至闭塞血管后，注入尿激酶行溶栓治疗。结果：颈内动脉闭塞4例，大脑中动脉闭塞8例。完全开通10例，2例部分开通。术后一周复查CT均未见大面积梗塞灶。1例发生术后脑出血。结论：早期超选择动脉溶栓是治疗急性脑梗塞最有效的方法之一。     

人造动静脉内瘘血栓后介入治疗的疗效分析

目的:探讨经肱动脉顺行介入置管溶栓在开通血液透析造瘘管阻塞中的疗效价值。材料和方法:经患侧肱动脉顺行插管,先行导丝、导管松解、碎裂血栓,再行造瘘管置管溶栓,术中团注10万U尿激酶,再以微泵2万U/h维持溶栓,狭窄处行球囊成形术,并分析不同时期血栓介入开通的疗效。结果:23例经介入置管溶栓及球囊成形后22例开通,开通率达95.6%,血栓形成时间<48h者21例,24h内溶通21例(100%),尿激酶用量在(22～70)万U;血栓形成时间>48h者2例,1例部分溶通,以球囊扩张后开通,1例溶栓超过48h后出现肌间血肿,放弃溶栓。结论:经肱动脉介入顺行碎栓、溶栓在维持血透管通畅方面安全、有效、简便而且微创。尤其在血栓形成时间<48h中疗效肯定。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

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.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

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).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.