全身18F-FDGPET-CT在脑转移瘤诊断中的应用

目的评价全身18F-氟脱氧葡萄糖（18F-fluorodeoxyglucose,18 F-FDG）正电子发射断层扫描（posi—tronemissiontomography,PET）-CT显像在脑转移瘤的诊断及寻找原发灶中的应用价值。方法对全身脑转移瘤及可疑脑转移瘤的212例行PET—CT检查,并回顾性分析其临床资料。结果212例中,肺原发恶性病变158例（74．5％）,其他部位原发恶性肿瘤40例（18．9％）,可疑脑原发病变11例（5．2％）,未发现原发灶的脑转移瘤3例（1．4％）。未明确原发灶的48例中,全身PET-CT显像发现原发灶34例（70．8％）,其中肺恶性病变来源26例（54．2％）、其他部位来源恶性肿瘤8例（16．7％）。单纯胸部薄层CT扫描诊断为肺恶性病变来源者22例（45．8％）;CT性质不明确的孤立性肺结节4例,结合临床及全身PET—CT显像特征均诊断为肺恶性病变。结论全身18F—FDGPET—CT显像有利于发现脑转移瘤的原发灶。脑转移瘤来源于肺恶性病变较多。胸部薄层CT扫描有利于对原发灶的初步诊断。     

18F-FDG PET显像在原发不明转移癌中的诊断价值

目的：探讨18F－脱氧葡萄糖（FDG）PET显像在原发不明转移癌中的诊断价值。方法：23例原发灶不明转移癌患者，进行18F－FDG PET显像，并与临床随访，活组织检查和手术病理结果相对照。结果：23例患者中18F－FDG PET发现可凝原发灶10例，其中8例病理结果证实为原发灶，1例经长期随访证实为原发灶，1例病理结果为阴性，18F－FDG PET对原发灶检出率为39％，18F－FDG PET全身显像共检出淋巴结和远处转移灶16个，CT和（或）MRI只检出9个，13例18F－FDG PET检查未确定原发灶者，随访3个月－1年，死亡4例，9例18F－FDG PET检查确定原发灶者，随访2个月－1年，死亡1例。结论：18F－FDG PET显像对原发灶不明转移癌原发灶的诊断，淋巴结和远处转移的分期，治疗方案的制定以及预后判断均有一定的临床价值。     

18 F-FDG PET/CT显像探测原发肿瘤病灶的临床价值

目的探讨^18F-脱氧葡萄糖(FDG)PET/CT显像寻找原发肿瘤病灶的价值。方法对临床诊断转移瘤患者31例行唧CT显像，将其诊断结果与手术、活组织检查及临床随访结果对照。结果29例患者唧CT显像准确显示其原发灶，分别为结、直肠癌7例，肺癌13例，甲状腺癌3例，子宫恶性肿瘤4例，胰腺癌和鼻咽癌各1例。1例PET/CT检查未能确定其原发灶。另1例临床诊断为肾上腺转移瘤的患者，PET/CT显像为良性肿瘤，经CT动态增强检查及实验室检查证实。结论PET／CT显像对寻找转移瘤原发灶有重要价值。     

18F-FDG PET/CT在不明原发灶肿瘤中的临床应用价值

目的探讨18F-FDG PET/CT全身显像在不明原发灶肿瘤（CUP）诊断中的临床应用价值。方法回顾分析46例于2015年2月至2016年6月在我院行常规检查未能发现肿瘤原发灶而进一步行18F-FDG PET/CT全身显像查找肿瘤原发灶的转移性肿瘤患者的资料。PET/CT图像分析采用视觉及半定量分析方法。通过病理活检和（或）临床综合诊断、临床随访对结果进行评价。结果46例患者中,18F-FDG PET/CT显像找到原发肿瘤33例,均经过病理活检及临床随访证实;13例未发现原发病灶。18F-FDG PET/CT对不明肿瘤原发灶的检出率为71.7%（33/46）,其中阳性患者中淋巴瘤3例、胃癌2例、食管癌4例、卵巢癌3例、肺癌14例、肝癌2例、尿路上皮癌1例、鼻咽癌2例、多发性骨髓瘤1例、降结肠癌1例。转移方式主要有淋巴结转移32例、骨转移20例、肝转移13例、肺转移9例、胸膜腹膜转移5例、肾上腺转移3例、脑转移4例、皮下转移3例、心包膜转移1例。结论18F-FDG PET/CT全身显像对CUP的检出率显著优于一般常规检查,对临床指导治疗有着重要意义。     

18F-FDG PET/CT全身显像在原发灶不明转移癌中的临床应用

目的 探讨18F-脱氧葡萄糖(FDG)PET/CT全身显像在原发灶不明转移癌(CUP)诊断中的临床应用价值.方法 回顾性分析2006年1月至2007年6月2589例18F-FDG PET/CT显像患者中169例CUP患者的显像结果,通过分析病历记录、病理检查结果及临床随访确定最终原发灶诊断结果.结果 169例CUP患者中19例失访,150例有完整资料.70例成功探测到原发灶,总检出率为46.7%(70/150),其中52例得到病理检查证实,18例为临床诊断;肺癌38例,占54.3%,鼻咽癌8例,占11.4%,消化系统肿瘤13例,占18.6%,其他肿瘤11例,占15.7%.3例临床怀疑转移瘤,18F-FDG PET/CT未见明显恶性征象,经随访证实为良性病变.6例PET/CT诊断错误.15例患者没有确诊.56例未探测到原发灶,其中3例在随访过程中得到确诊,分别为鼻咽癌、膀胱癌、食管癌各1例.结论 18F-FDG PET/CT全身显像对诊断CUP具有重要临床价值.     

18F-FDG PET/CT在可疑神经系统副肿瘤综合征中的应用价值

目的 探讨18F-脱氧葡萄糖（FDG）PET/CT显像探测临床可疑神经系统副肿瘤综合征（PNS）患者潜在肿瘤病灶的应用价值.方法 回顾性分析20例可疑PNS患者18F-FDG PET/CT显像资料,对所有患者行随访病理检查或临床最终诊断,并将结果与PET/CT显像和随访结果进行比较.结果 20例中PET/CT显像发现可疑恶性病变或既往肿瘤复发和（或）转移者9例,阴性11例.9例阳性者中3例为假阳性.PET/CT显像对PNS恶性肿瘤检出的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为6/6,78.57%（11/14）,85.00%（17/20）,6/9和100.00%（11/11）.6例真阳性中4例治疗方案得以修正,经抗肿瘤和免疫疗法后神经异常症状得到改善.结论 18F-FDG PET/CT显像在可疑PNS中的应用有积极意义,有助于发现恶性肿瘤,也能对肿瘤分期提供帮助.     

应用全身18F-FDG PET/PET-CT为脑转移瘤患者寻找原发灶

目的 评价全身18F-FDG PET/PET-CT在脑转移瘤寻找原发灶中的诊断价值.方法 对67例以脑转移瘤查找原发灶为主诉的肿瘤患者的18F-FDG PET/PET-CT资料进行回顾性分析.结果 本组67例患者中57例患者的原发灶位置得到了确诊,原发灶的检出率为85.1%;其中原发性肺癌29例,占50.9%;所有肺癌中病理分型为低分化腺癌者共13/29例,占44.8%.除可检出原发灶外,18F-FDG PET/PET-CT全身显像还检出肺转移、淋巴结转移、骨转移、肝转移及其他少见部位的转移灶.与"F-FDG PET-CT相比,单纯的18F-FDG PET图像对肺转移病灶的检出率仅为10.9%.结论 18F-FDG PET/PET-CT的全身扫描有利于发现原发灶及其他转移灶.     

PET/CT与增强CT检测乳腺癌及其腋淋巴结转移的对照研究

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像与螺旋CT增强扫描检测乳腺癌及其腋淋巴结转移的临床价值。方法27例乳腺肿块患者于同日行^18F—FDG PET／CT显像与CT增强扫描。患者俯卧于乳腺专用泡沫垫上接受检查，前者图像由3位核医学科医师采用目测法结合半定量法进行诊断，后者图像由3位影像科医师分析诊断；最后与病理检查结果对照。结果27例患者PET／CT与增强CT均发现31个乳腺肿块，病理检查证实其中21个为乳腺癌，10个为良性病变；发现腋淋巴结91个，共有66个转移（1例有双侧腋淋巴结转移）；PET／CT显像检测乳腺癌原发灶的灵敏度为80．95％，特异性为90％，阳性预测值为94．44％；检测淋巴结转移的灵敏度为89．39％，特异性为88％，阳性预测值为95．16％。增强CT检测乳腺癌原发灶的灵敏度为90．48％，特异性为60％，阳性预测值为82．61％；检测淋巴结转移的灵敏度为86．36％，特异性为52％，阳性预测值为82．61％。^18F—FDG PET／CT和增强CT对腋淋巴结状态的诊断与病理检查结果的列联系数分别为0．64和0．37；两者对乳腺癌及其腋淋巴结转移的诊断特异性差异有显著性（P〈0．05）；对直径〈2cm的病灶，^18F—FDG PET／CT诊断准确性明显高于增强CT（P〈0．05）。结论^18F—FDG PET／CT对诊断乳腺癌及其腋淋巴结转移的特异性均高于增强CT。     

^18F—FDG PET显像与^99Tc^m—MDP全身骨显像诊断肿瘤远处转移的比较

目的 评价^18F-脱氧葡萄糖（FDG）PET肿瘤显像与^99Tc^m-亚甲基二膦酸盐（MDP）全身骨显像对检出骨和远处转移的价值。方法 对16例恶性肿瘤放化疗后的患者进行^18F-FDG PET显像和^99Tc^m-MDP全身骨显像，并对两种结果进行了比较。结果 16例肿瘤患者中^18F-FDG PET显像皆阳性，其中14例患者有远处转移，转移病灶共62处，其中骨转移病灶20处；在全身骨显像中，11例有局限性异常放射性浓聚，其中2例为单一病灶，9例为多发病灶，共检出病灶57处，另5例骨显像正常。结论 ^18F-FDG PET对恶性肿瘤的诊断具有较高的准确性和特异性，但对骨转移灶的诊断价值相对较差；^99Tc^m-MDP显像阴性或单一病灶的可疑转移瘤患者有必要进行^18F－FDG PET检查，以明确诊断其他远处转移灶。     

^18F-FDG PET／CT在胰腺癌诊断中的价值

目的评价^18F-脱氧葡萄糖（FDG）PET／CT鉴别诊断胰腺良恶性病变及检测淋巴结和（或）远处转移的价值。方法回顾性分析上海交通大学医学院附属仁济医院行^18F—FDGPET／CT检查的46例临床疑胰腺肿瘤患者的影像学检查资料和临床资料,其中胰腺癌患者26例,良性病变者20例,比较分析PET和CT的特征。结果当选择最大标准摄取值（SUVmax）=2．95为判断良恶性的界值时,对胰腺癌诊断的灵敏度是88．5％（23／26）,特异性是85．0％（17／20）。^18F—FDGPET／CT显像假阳性3例,假阴性3例。同时发现16例检查前未确定的肝、肺、骨及淋巴结转移患者。根据显像结果,11例患者治疗方案得以修正。结论根据现有资料分析,^18F—FDGPET／CT是鉴别诊断胰腺良恶性病变及检测胰腺癌患者淋巴结和（或）远处转移一种较好的方法。     

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.