甲状腺癌术后复发的CT表现

目的 分析甲状腺癌术后复发的ＣＴ表现,了解甲状腺术后复发的特点。方法 回顾性分析经手术及病理证实的甲状腺癌主后复发患者４２例,包括乳头状癌２５例,滤泡癌９例,髓样癌６例,透明细胞癌２例。结果 甲状腺床局部复发２３例,其中侵犯颈动脉１０例,气管、食管１７例,喉及下咽２例,９例滤泡癌中８例局部复发,７例肿特明显强化。对侧甲状腺复发１２例,病理类型与原发甲状腺癌一致。颈部淋巴结转移３１例,乳头状癌颈剖淋     

甲状腺髓样癌不同手术方式对预后影响(附46例报告)

目的探讨甲状腺髓样癌(MTC)的不同手术方式的临床效果。方法对手术治疗的46例甲状腺髓样癌患者的临床资料进行回顾性分析,比较不同手术方式的治疗效果。结果首次手术行全甲状腺切除组甲状腺区复发率低于腺叶切除组,更低于肿瘤摘除组(P<0.05)。结论对MTC单侧病灶者,原发灶至少应行侧腺叶+峡部切除,最好行全甲状腺切除;无论N0或N1患者,颈淋巴结治疗均应考虑行同侧颈清扫,可不必行对侧预防性颈清扫。     

继发性甲状腺功能亢进的^99Tc^m—MIBI双时相显像

目的 评价＾９９Ｔｃ＾ｍ－甲氧基异丁基异腈（ＭＩＢＩ）双时相显像法在肾性继发性甲状旁腺功能亢进（ＳＨＰ）患者中的诊断价值。方法 ２０例因慢性肾功能衰竭行血液透析患者,临床诊断与ＳＨＰ,均行双时相法＾９９Ｔｃ＾ｍ－ＭＩＢＩ甲状旁腺显像,运用甲状旁腺／甲状腺（ＰＴ／Ｔ）比值及甲状旁腺指数（ＰＴＩ）观察阳性病灶对ＭＩＢＩ的清除,３例行颈部探查术并作甲状腺自体移植,结果 ８例显像阳性,其中３例手术摘除９枚     

甲状腺锥体叶^99mTc显像的临床价值

目的：探讨甲状腺锥体叶显像的临床价值。材料和方法：常规肘静脉注射９９ｍＴｃＯ－４后３０分钟甲状腺显像,对２６０例甲状腺机能亢进症患者和２４３例非甲亢对照组患者行甲状腺显像,观察甲状腺锥体叶的出现情况。结果：２６０例甲亢患者中７８例锥体叶阳性,２４３例对照组中８例锥体叶阳性,两者差异有显著性（Ｐ＜００１）,锥体叶阳性对甲亢诊断的敏感性为３００％,特异性为９６６％。锥体叶可位于峡部或一叶上方,多呈舌状,放射性分布略低于左右叶,大小不等。甲亢术后原有锥体叶可长大。结论：甲状腺锥体叶显像有助于甲亢的临床诊断。     

046 18F-FDG、131I-Na和201Tl诊断甲状腺癌复发或转移的比较

目的：通过与１３１I和２０１Tl全身显像结果比较，评价１８F－FDG（１８F－氟代脱氧葡萄糖）PET全身扫描诊断分化甲状腺癌的临床意义。方法：３２例因患分化甲状腺癌而作甲状腺全切术患者（男性１０例，女性２２例，３０～７７岁），其中５例为滤泡癌，２７例为乳头状癌。转移或复发的诊断标准：甲状腺免疫球蛋白阳性（＞３ng／mL），细胞学结果阳性，１８F－FDGPET、１３１I显像、２０１Tl显像、CT、声像图、MRI（磁共振显像）、放射照片和骨显像均发现阳性。PET全身扫描，至少禁食５h，注射１８F－FDG１８５MBq６０min后做…     

原发性高血压及肾血管性高血压患者巯甲丙脯酸前后肾动态显像的初步观察

用ＣＳ－７型ｒ动态显像及分析研究１０例肾动脉狭窄（ＲＡＳ），１０例高血压病Ｉ期，２０例高血压病Ⅱ期及１６例Ⅲ期高血压病患者口服巯甲内脯酸（Ｃａｐ，５０ｍｇ）前后肾功能及肾血流灌注显像的变化，同时测定周围静脉血浆肾素。结果发现８例肾动脉狭窄＜９５％的ＲＡＳ患者Ｃａｐ试验均阳性，２例狭窄＞９５％的ＲＡＳ患者基础显像患肾呈低水平延长线型肾图，肾功能明显降低，口服Ｃａｐ后肾功无变化；高血压病Ｉ至Ⅲ期患者Ｃａｐ试验的阳性率分别为０％，５％和２５％，但均为双侧性。Ｃａｐ试验诊断ＲＡＳ的敏感性，特异性，准确性分别为８０％，８９％，８８％；基础显像＋Ｃａｐ试验的敏感性，特异性，准确性分别为１００％，８７％和８８％。１０例ＲＡＳ患者口服Ｃａｐ后周围静脉肾素均明显增高。这些资料表明：Ｃａｐ介入的￣（９９ｍ）Ｔｃ－ＤＴＰＡ肾动态显像对单侧ＲＡＳ具有较高的敏感性和特异性，但肾动脉严重狭窄时，亦可呈阴性结果，双侧性Ｃａｐ试验阳性应考虑重度高血压病。     

开博通肾功能显像对肾血管性高血压介入治疗疗效的预测价值

目的　探讨开博通肾功能显像（ＣＲＳ）对临床确诊为肾血管性高血压（ＲＶＨ） 患者介入治疗疗效的预测价值。方法　对３３ 例肾动脉造影明确肾动脉狭窄，临床确诊ＲＶＨ 的患者介入治疗疗效和ＣＲＳ结果进行对比分析。ＣＲＳ阳性作为预测ＲＶＨ 介入治疗后高血压治愈或有效控制的指标；ＣＲＳ阴性作为预测ＲＶＨ介入治疗后高血压控制无效的指标。结果　３３ 例患者中，ＣＲＳ阳性２６ 例，２４例介入治疗有效，其阳性预测值为９２－３ ％ ；ＣＲＳ阴性７ 例，５ 例介入治疗后无效，其阴性预测值为７１－４％ ；准确性为８７－９ ％ 。结论　ＣＲＳ对ＲＶＨ 患者介入治疗疗效具有较高的预测价值     

131I联合 125I粒子植入治疗甲状腺髓样癌-乳头状癌骨转移一例及其SPECT/CT剂量学的验证

笔者报道了1例经临床治疗的甲状腺髓样癌-乳头状癌骨转移患者,患者的病理类型在文献报道中较为少见。笔者通过对131I联合125I粒子局部植入治疗所取得的疗效进行经验总结,为甲状腺髓样癌骨转移的治疗提供新的参考方法。同时通过SPECT/CT显像对125I粒子植入治疗实体肿瘤进行初步评价,以便找到一种新的、更加精确和简便的剂量学验证方法。     

~(111)In-pentetreotide 生长抑素受体显像对非摄碘甲状腺癌复发的诊断作用

目的：采用１１１　 Ｉｎｐｅｎｔｅｔｒｅｏｔｉｄｅ 生长抑素受体显像（ Ｓ Ｒ Ｓ）对碘扫描阴性的甲状腺滤胞状或乳头状癌患者进行研究,以评价其诊断价值。方法：已行根治术并接受放射性碘治疗的高分化甲状腺癌患者 １６ 例（２３～８４ 岁）,其中 １５ 例甲状 腺球蛋白升高被怀疑癌复发,已有 ４ 例证实为肺转移或纵膈病变。１６ 例中的 ５ 例显像前已停用替代治疗,１１ 例正在接受替代治疗。碘显像均呈阴性。所有患者在静脉注射 １３７～２００ Ｍ Ｂｑ １１１　 Ｉｎｐｅｎｔｅｔｒｅｏｔｉｄｅ后,分别于 １、４ 和 ２４ 小时用低能高分辨准直器的 γ照相机进行显像。图像判定标准：在 ４ 小时和 ２４ 小时图像上如果怀疑病变处核素摄取和对比随时间呈递增或保持不变,视为阳性;如果是一过性摄取或强度和对比随时间逐渐下降,视为非特异摄取。复发诊断标准：当 Ｃ Ｔ 可疑病变处出现阳性摄取,考虑为真阳性;如 Ｃ Ｔ 未提示的部位出现核素摄取,视为假阳性（经病理证实）。结果：１６ 例中,３ 例 Ｓ Ｒ Ｓ阳性（占 １９％ ）,１ 例假阳性（占６％ ）,１２ 例假阴性（占７５％ ）。有５ 例只在２４小时图像中出现纵膈或肺部少量核素摄取。 Ｓ Ｒ Ｓ阳性的患者甲状腺球蛋白水平都升     

^99mTc标记三种抗人肺癌细胞单抗肺放免显像的临床研究

为了解３种特异性抗人肺癌细胞单抗用于人肺癌放射免疫显像的临床价值，采用＾９９ｍＴｃ标记３种ＭｃＡｂ：抗人大细胞肺癌ＭｃＡｂ（２Ｅ３）、抗人肺鳞状细胞癌ＭｃＡｂ（Ｓｍ－１）和抗人肺腺癌细胞ＭｃＡｂ（Ａｍ－７），对５３例患者进行肺ＲⅡ。结果：５３例中真阳性３４例，假阴性１０例。２Ｅ３的诊断灵敏度高于Ｓｍ－１和Ａｍ－７，混合单抗为８７％。     

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.