电影磁共振图像评定运动员心脏形态与功能

本文对瑞典10名耐力运动员(耐力组,长跑7人,游泳3人),10名举重运动员(力量组)及10名健康无训练者(对照组)进行了心脏电影磁共振图像与最大吸氧量的测试。结果表明:1)从左室舒末容量、左室编末容量、心搏量、左室心肌重量、最大吸氧量、最大通气量等指标来看,无论是其绝对实测值,还是其按体表面积或体重校正计算的相对值,耐力组均非常显著地大于其它二组。力量组除了左室心肌重量及左室心肌重量/左室舒末容量比值略有增高外(P<0.05),其余各指标与对照组比较均无显著性差异。2)左室舒末容量、心搏量、左室心肌重量及最大通气量四指标均与最大吸氧量呈高度正相关关系,相关系数依次为0.88,0.85,0.81,0.76,各相关系数均有高度显著性(P<0.001)。3)本文各组的左室心肌重量的电影磁共振图像测定值低于以往多数类似研究对象的超声心动图测定值。文章指出,电影磁共振图像技术是评定左室心肌重量与左室容量十分准确可靠的无创性检查新方法。本文首先报道了运动员心脏电影磁共振部分指标正常测量值。     

心脏超声造影在心尖肥厚型心肌病诊断中的应用

目的探讨心脏超声造影在心尖肥厚型心肌病(AHCM)诊断中的应用价值。方法 AHCM患者30例,正常对照组30例,所有受检者均行心脏超声造影检查,对比两组间超声特征。结果以MRI诊断结果为参照标准,常规超声心动图诊断AHCM的阳性符合率为80. 8%,心脏超声造影的阳性符合率为100%。与正常对照组相比较,AHCM组在左室心尖部心肌厚度、左室心尖部与后壁心肌厚度比值、左室心肌重量、左房容积、E/A差异有统计学意义(P 0. 05); AH-CM组肥厚心肌节段造影平台峰值强度(A)、曲线上升斜率(β)及A×β值与正常对照组左室相应节段测值差异有统计学意义(P 0. 05)。结论心脏超声造影不仅可以提高AHCM的诊断准确性,且能定量评价心肌微循环灌注情况,具有较高的临床应用价值。     

耐力、力量、速度性项目优秀运动员和无训练青年左心形态功能之对比研究

应用超声心动图方法对耐力、力量、速度三组84名优秀运动员及常人对照组的心脏作了对比研究。结果提示:三类运动员心脏结构功能的特点不同;耐力运动员心脏结构功能变化最为明显。     

超声心动图评价大鼠异位移植心脏急性排斥反应的初步实验研究

目的:探讨高频超声心动图评价大鼠颈部异位移植心脏的急性排斥反应的价值。方法:采用高频超声心动图测量17只同种异体移植及6只同系移植心脏测量左室内径、心肌厚度、左室重量和心功能等。6只同系移植大鼠和9只同种异体移植大鼠,分别于移植术后第1、3、5天,采用高频超声对上述指标进行测量,第五天测量完毕后处死并做病理检查。另8只同种异体移植心脏,分别于移植术后第1、3天各测量一次,第3天测量完毕后处死做病理学检查,超声指标与病理结果相对照。结果:①同种异体移植术后,随着移植时间的延长,左室心肌厚度和左室重量逐渐增加,左室内径减小,射血分数无显著性改变;②术后第3天,组织学检查表明已有排斥反应发生,超声检查显示室壁厚度与左室重量明显增加,而常规心脏触诊未能及时发现排斥反应;③随着组织学分级加重显示的排斥,左室心肌厚度与左室重量有显著的增加。结论:室壁厚度和左室重量为超声评价排斥反应发生的敏感、准确指标。高频超声为心脏移植实验研究评价排斥反应提供了一种较为简便可靠的观察方法,为临床上心脏移植的排斥反应的超声评价提供了依据。     

非胰岛素依赖型糖尿病患者左室心肌重量与舒张功能的研究

目的:研究非胰岛素依赖型糖尿病患者左室心肌重量与舒张功能.方法;对78例NIDDM患者及同年龄正常组行彩色多普勒超声心动图.结果:NIDDM组左室舒张功能受损,与此同时左室心肌重量增加,心肌重量增加的敏感性为 88%(69/78),特异性为97%(35/36),准确率为91%(104/114).结论:心肌重量增加与心功能改变密切相关,是NIDDM患者发生心脏损害的危险信号.     

慢性肾功能衰竭患者超声心动图改变临床分析与研究

目的 观察在慢性肾功能衰竭患者中采用超声心动图检查的表现,并分析其价值.方法 选取62例慢性肾功能衰竭患者记为疾病组;另选取健康志愿者60例记为健康组.所有受试者均行超声心动图检查,观察疾病组患者超声心动图表现,并对比疾病组与健康组、疾病组不同分期间的超声心动图检测指标.结果 疾病组患者中超声心动图异常改变者构成比为80.65%;疾病组左房(LA)、左室(LV)、左室后壁厚度(LVPWT)、室间隔(IVS)、左室心肌重量指数(LVMI)指标均显著高于健康组(P<0.05),而二尖瓣口舒张早期血流峰值速度与舒张末期血流峰值速度比值(E/A)、左室射血分数(EF)则显著低于健康组(P<0.05);疾病组不同分期间上述指标比较差异与均有显著性(P<0.05),且病情越严重,上述指标异常幅度越大.结论 慢性肾功能衰竭患者可随着病情加重严重影响心功能,应当对其进行超声心动图监测以了解病情发展和心功能损害程度.     

应用超声心动图评价中国优秀女子足球运动员心脏结构及功能

目的:采用超声心动图评价中国优秀女子足球运动员心脏结构和功能.方法:纳入28名专业女子足球运动员为研究组,年龄25.2±3.4岁,技术等级专业二级以上,运动年限14.2±3.4年;选取28名年龄、体表面积(BSA)相匹配的长期静坐健康女性志愿者为对照组.所有受试者进行超声心动图检查,测量心脏结构和功能的各项指标.结果:...     

超声心动图对左房室瓣球囊扩张术后左室心肌重量及心脏收缩功能变化的评价

目的　应用经胸超声心动图(UCG)评价皮穿刺左房室瓣球囊扩张术对风湿性左房室瓣狭窄患者的左室心肌重量和心脏收缩功能的影响。方法　使用美国Agilent公司生产的PhilipsSonos 5 5 0 0、75 0 0型彩色多普勒超声心动图仪检测4 0例风湿性左房室瓣狭窄患者成功行皮穿刺左房室瓣球囊扩张术后的左室心肌重量、左室收缩功能及左室内径大小的变化,分别于经皮穿刺左房室瓣球囊扩张术术后3d内和手术后3个月接受超声心动图检查。所有研究对象均进行经胸M型、二维及多普勒超声心动图检查,采用二维超声心动图根据面积-长度法测量左室心肌重量,并与体表面积换算成左室心肌重量指数;M型超声心动图测量左室舒张末期径以及根据Teichholz校正公式测量左室射血分数(EF)、左室短轴缩短率(FS)、每搏出量(SV)和心输出量(CO) ;二维及多普勒超声心动图分别按椭圆形面积公式及压差半降时间(pressurehalftime ,PHT)法测量左房室瓣口面积(MVA)。结果　(1)经皮穿刺左房室瓣球囊扩张术后3d全部患者的左室舒张末期径增大(P <0 .0 1) ;射血分数(EF)、左室短轴缩短率(FS)、每搏出量(SV)和心输出量(CO)均明显提高(P <0 .0 0 1) ;同时室间隔厚度、左室后壁厚度、左室心肌重量和左室心肌重量指数也有所改变(P <0 .0 5 ) ;(2 )术后3个月室间     

几种冠状血管病变的超声改变

目的:总结心脏几种冠状血管病变超声心动图改变的特点,诊断或初步诊断心脏冠脉疾病,为临床诊断或选择其它方法检查提供依据.方法:应用彩色多普勒和二维超声心动图对我院115例冠状血管改变进行分析,提出几种冠状血管病变的声像图变化特点.结果:多种冠状血管病变,特别是左右冠状动脉主干及冠状静脉窦病变,超声易于显示并有明显特点.结论:彩色多普勒及二维超声心动图对提示心脏冠状血管病变具有重要的临床应用价值.     

心肌背向散射积分参数评价阿霉素诱导兔心肌病模型

目的:探讨心肌背向散射积分(IBS)参数评价阿霉素诱导兔心肌病模型的应用价值。材料和方法:12只兔(A组)每周静脉注射阿霉素2mg/kg,共8周,同时选10只兔注射同等体积生理盐水作为对照组(B组)。12周后对两组兔心脏进行常规超声参数测量及背向散射积分参数测定。结果:A组心肌IBS%较B照组明显增高(P<0.01),CVIB明显减低(P<0.01),部分失去正常形态。A组常规超声参数左房内径、左室舒张末期内径和左室收缩末期内径明显增大(P<0.01),室间隔厚度、左室后壁厚度明显变薄(P<0.05),左室射血分数、短轴缩短率和E峰明显减低(P<0.01)。结论:心肌背向散射积分参数可有效评价阿霉素诱导兔心肌病模型的建立。     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.