B超在小儿肠套叠的诊断和治疗中的作用

目的 探讨超声在诊断小儿肠套叠中的价值及对小儿肠套叠的治疗作用.方法 分析我院行超声及X线平片检查并经手术或灌肠确诊的肠套叠患儿87例,以及均行超声及X线检查其他原因的腹痛患儿40例,分别计算B超和X线检查的特异度和灵敏度,分析其报告结果;并采用卡方检验比较超声监视下生理盐水灌肠复位和行X线监视下空气灌肠复的治疗效果.结果 B超检查在灵敏度(96.5%)和特异度(83.3%)方面均高于X线检查(灵敏度73.17%,特异度77.8%);在B超监视下行生理盐水灌肠复位和行X线监视下空气灌肠复位的比较结果显示χ2=0.116,P＞0.05,二者无统计学差异.结论 超声不仅可作为诊断肠套叠的方法,而且可在实时超声图像的监视下进行复位.     

彩色多普勒超声诊断小儿肠套叠的临床价值

目的探讨彩色多普勒超声在诊断小儿肠套叠中的临床应用价值。方法回顾性分析总结经空气灌肠复位或手术证实的36例小儿肠套叠患者的彩色多普勒声像图特征。结果 36例小儿肠套叠,超声检出34例,超声检出率为94.4%。肠套叠超声典型特征性改变为"同心圆征"和"套筒征"。结论小儿肠套叠的彩色多普勒声像图比较特异,对临床诊断小儿肠套叠有重要临床价值,是目前诊断小儿肠套叠的首选方法。     

自制空气灌肠器治疗小儿肠套叠46例疗效分析

目的：探讨自制手控空气灌肠器治疗小儿肠套叠的方法、疗效、注意事项及临床应用价值。方法回顾性分析2011年1月至2013年4月收治的46例小儿肠套叠病例资料。结果 X线透视下行空气灌肠治疗46例,成功43例,失败转手术3例,无死亡病例。结论空气灌肠是治疗小儿肠套叠的一种较好方法,具有复位成功率高、创伤小、复位快、费用低等优点。     

小儿肠套叠空气灌肠复位影响因素探讨

目的 分析空气灌肠治疗小儿肠套叠的各种影响因素。方法 对117例确诊肠套叠的患儿，采用双腔气囊外接压力计或不接压力计，在X线透视下行空气灌肠。结果 117例中，完全复位92例(78％)，复位失败17例(14．5％)，不完全复位8例(6％)。结论 空气灌肠是治疗小儿肠套叠的重要方法，其影响复位成功与否的因素，主要有套入时间、类型、复位方法等。     

空气灌肠诊治小儿肠套叠的临床应用

目的 探讨透视下空气灌肠诊断小儿肠套叠及气压灌肠复位的临床应用价值.方法 对病程＜48h的150例急性肠套叠空气灌肠的诊断、治疗进行回顾性分析.结果 空气灌肠对肠套叠诊断率100％,合理应用气压灌肠使138例成功复位,成功率约92％.结论 空气灌肠为诊治小儿肠套叠起到了重要的作用,具有疗程短、创伤小、成功率高等方面的优势.     

小儿急性肠套叠68例临床分析

目的：为了提高对小儿急性肠套叠的诊治水平。方法：对68例小儿肠套叠进行回顾性分析。其中，男性患儿46例，女性患儿22例。结果：经非手术治疗（空气灌肠复位）48例，手术治疗20例，其中有3例患儿空气灌肠复位失败后手术。全部病例均治愈。结论：（1）肠套叠临床表现不典型者，易误诊。诊断除临床表现外，首选诊断性空气灌肠。（2）根据患儿的病程长短及一般情况而选择不同的治疗方法。     

婴幼儿肠套叠的MSCT诊断

目的总结婴幼儿肠套叠的MSCT表现,并分析其诊断价值。方法回顾分析本院经临床证实的98例婴幼儿肠套叠的MSCT表现。结果 98例经MSCT诊断肠套叠的病例均经临床证实,诊断准确率100%。4例经MSCT诊断有空气灌肠整复禁忌症,均行手术治疗;94例患儿行空气灌肠整复,79例整复成功（整复率84.0%）。结论 MSCT对婴幼儿肠套叠的诊断率准确高,对临床选择肠套叠复位方式具有重要指导意义。     

高频超声结合彩色多普勒超声在小儿肠套叠诊断中的价值

目的探讨高频超声结合彩色多普勒超声在小儿肠套叠诊断中的价值。方法选取我院儿科收治的疑似肠套叠患儿60例,采用高频超声结合彩色多普勒超声进行检测,通过手术或生理盐水灌肠复位确诊后,总结患儿的各项HFU检查指标:1)临床特征方面:分析60例患儿经HFU探测肠套叠的典型影像特征;2)检测准确率方面:分析肠套叠肠管壁的超声血流信号,统计CDFI及CDPI两种显像方法的血供显现情况,同时进行分析对比,并以此为标准。结果高频超声检查均清晰显示"同心圆"及"套筒征",呈"同心圆"有33例,占55.0%;呈"套筒征"有27例,占45.0%。其中,右侧肠套叠54例,占90.0%,左侧肠套叠6例,占10.0%。有51例肠套叠患儿在HFU扫描中CDFI及CDPI血流声像图清晰,表现为条状及棒状血流;其余4例小儿的CDFI及CDPI未发现异常血流信号,无法检测出频谱,说明很可能出现肠管坏死。对这4例患儿实施灌肠或手术均确诊为肠坏死。本组病例中,实施彩超引导下生理盐水灌肠复位55例,5例灌肠复位失败后通过临床手术确诊,检测准确率为100%,无误诊或漏诊。结论小儿肠套叠诊断中应用HFU结合CDFI检测,具有便捷、无创、特异性及准确性的特点,并且CDFI及CDPI还可以观察肠管的血运,可以作为早期肠套叠诊断的首选方式,为临床治疗措施的选择提供依据。     

空气灌肠复位术治疗小儿肠套叠312例临床分析

目的：探讨小儿急性肠套叠空气灌肠复位的疗效及并发症.方法：回顾性分析312例肠套叠患儿经空气灌肠诊疗的临床资料.结果：312例患儿,一次性空气灌肠复位成功281例（98%）,复位成功25例2次（8%）,失败6例（2%）.结论：空气灌肠是诊治小儿肠套叠最有效的方法之一,安全性好,并发症少.     

小儿肠套叠空气灌肠诊疗体会

目的：小儿肠套叠空气灌肠诊疗的体会和应用价值。方法：2000年1月-2005年12月本院对126例临床诊断肠套叠的患儿进行空气灌肠诊断与整复，整复未成功者行外科手术。结果：空气灌肠整复成功112例，整复成功率88．9％，其中14例复位失败后改行手术治疗。结论：小儿急性肠套叠只要符合适应症并无其他并发症；空气灌肠为小儿急性肠套叠首选且经济的治疗方法。     

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.