经桡动脉途径行下肢动脉造影的可行性研究

目的 评价经桡动脉途径行下肢动脉造影的可行性与安全性，并探讨其技术要点、适应证、禁忌证及主要优点。资料与方法 对90例下肢动脉急慢性缺血的患者采用经桡动脉穿刺插管行下肢动脉造影，统计手术成功率及并发症。结果 90例患者，87例经桡动脉行下肢动脉造影获得成功，成功率为96、7％，余3例改行经肱动脉途径。局部发生轻微血肿2例，术后8例(9、2％)桡动脉搏动微弱，无搏动消失及手部缺血事件发生。结论 经桡动脉途径行下肢动脉造影安全可行，具有成功率高、并发症少、患者舒适、不影响治疗计划等优点，应作为下肢动脉缺血患者造影的首选方法。     

经桡动脉途径在血管内介入诊疗中的应用

目的评价经桡动脉途径进行血管内介入诊疗操作的可行性与安全性,并探讨其技术要点、适应证、禁忌证及主要优点。方法230例患者接受经桡动脉途径血管内介入诊疗265例次,统计手术成功率及并发症。结果265例次操作中260例次取得成功,余5例改行经肱动脉途径,成功率98.1%。局部发生轻微血肿3例,术后8例桡动脉搏动减弱,1例搏动消失,并发症发生率为4.6%。结论经桡动脉途径进行血管内介入诊疗操作安全可行,具有成功率高、并发症少、患者舒适、不影响治疗计划等优点,值得推广应用。     

经桡动脉途径前列腺动脉栓塞术可行性及安全性研究

目的 探讨经桡动脉途径前列腺动脉栓塞术(PAE)治疗前列腺增生的可行性及安全性.方法 回顾性分析18例经左侧或右侧桡动脉行C形臂CT引导下PAE术患者临床资料,观察记录上肢动脉痉挛、损伤和穿刺点出血发生率,术后桡动脉搏动及堵塞情况,手指血供及神经损伤情况,手术成功率,围手术期脑血管并发症发生率,手术时间,射线辐射剂量及临床疗效.结果18例患者中接受经左侧桡动脉、右侧桡动脉途径PAE术分别为14例、4例.16例接受双侧栓塞,2例因前列腺动脉开口扭曲伴狭窄仅完成单侧栓塞.术后1例出现桡动脉搏动减弱,超声提示血流减慢.手术时间96～245 min,患者所受辐射剂量2 435～4 958 mGy,平均(3 342±156) mGy,与同期经股动脉途径PAE术差异无统计学意义(P=0.1167).结论采用经桡动脉途径行PAE术安全、可行.     

肝转移瘤介入治疗的疗效观察

目的：探讨肝脏转移瘤经动脉化疗和栓塞治疗的临床效果。方法：52例各种来源的肝脏转移瘤，采用介入疗法，行选择性肝动脉插管，一次或多次经动脉灌注和栓塞，并视条件积极处理存在的原发病灶。观察病例术后肿瘤变化情况，统计病例的生存时间。结果：有效率为84．6％，半年、一年生存率和中位生存期分别是84．6％、69．2％和9．5月。结论：运用介入疗法即选择性肝动脉化疗和栓塞治疗肝转移瘤效果显著。     

肾透析患者桡动脉-头静脉人工造瘘通道阻塞的溶栓再通术

目的：探讨血液透析患者自体血管瘘道(桡动脉与头静脉侧端吻合)阻塞后用SP微导管的同轴导管技术微创的处理方法。方法：总结5例内瘘闭塞的肾透析患者，行血管造影诊断及介入溶栓治疗。其中4例右侧、1例左侧桡动脉-头静脉人工造瘘堵塞，经皮右股动脉或肱动脉穿刺插管，送入headbunt经左或右锁骨下动脉至人工造瘘的桡动脉阻塞端，再送入SP微导管进行血栓溶栓术及导丝穿刺血栓松解术。全过程2～4h，实际溶栓时间50min～2h。结果：4例患者再通术成功，1例因狭窄而未通，无严重并发症发生。结论：采用SP微导管的同轴导管技术行肾透析惠者的桡动脉-肘正中静脉人工内瘘阻塞的溶栓及血栓松解术简便、安全、有效而且微创。     

输卵管妊娠的介入治疗和护理

研究介入插管治疗输卵管妊娠的方法。方法：通过病史，B超及B—HCG测定，对5例临床确诊妊娠病人在DSA下，将5．0Fcobra导管超选择性行患侧子宫动脉插管，经造影证实后，再注入氨甲蝶呤等药物进行治疗。结果：通过血b—HCG测定及B超判定疗效。本组病例一此插管成功率为91％，治愈率为85％，有效率为94％。不良反应为一过性腹痛，无其他并发症。结论：采用介入放射插管治疗输卵管妊娠简单、安全、有效、且无损伤，术后可保留患侧输卵管功能。     

血性性介入放射诊疗的并发症原因分析

探讨血管性介入术中严重并发症的原因分析，材料与方法：1993年3月－1998年12月对938例患者，进行1142次血管介入性诊断和治疗，结果：术中出现严重并发症12例，发生率以病例数计为1．28％（12例938例），以介入诊治次数计为1．05％（12例／1142次）。其中非离子型造影剂过敏1例，穿刺部位大血肿3例，血管性痉挛3例，动脉剥落1例，血气胸4例。结论：血管性介入诊疗术中可出现一些严重并发症，需引起术者注意，以免造成严重后果。     

肠系膜上动脉供血型肝癌的血管造影分析及介入治疗

目的：研究肠系膜上动脉供血型(即变异肝动脉起源于肠系膜上动脉)肝癌的血管造影表现及插管技术。方法：回顾分析41例肠系膜上动脉供血型肝癌的DSA及介入治疗资料，统计血管解剖变异的发生率，对其起源、走行、分支、分布等解剖学特征及其与血管插管的关系进行描述和分析。结果：350例肝癌中肠系膜上动脉供血型41例(11．9％)，其中副肝右动脉15例(36．5％)，替代肝右动脉16例(39．0％)，肝总动脉8例(19．5％)，腹腔动脉干起源于肠系膜上动脉2例(5％)。31例肠系膜上动脉发出替代或副肝右动脉者，29例(94．0％)腹腔动脉造影表现为肝右动脉细小或缺如，肝右叶出现无血管区。RH导管超选择性插管成功25例(61％)，未成功者改用Cobra、Simmon导管以及结合微导管技术后获得成功。结论：肠系膜上动脉供血型肝癌是一种比较常见的肝动脉变异性供血，熟忿其血管变异的特点对肝动脉化疗栓塞术具有重要的意义。     

胃肠道肿瘤肝转移血管内介入治疗效果分析

目的：探讨多次动脉化疗栓塞术(TACE)治疗胃肠道肿瘤肝转移的效果。方法：43例胃肠道肿瘤肝转移患者行肝动脉化疗栓塞术。均于第三次治疗后2—4个月复查，观察瘤灶反应。结果：本组病例中完全缓解7．0％(3／43)，部分缓解44．2％(19／43)，无变化25．6％(11／43)，进展23．3％(10／43)，有效率51．2％(22／43)。6个月、12个月、2年生存率分别为92．6％、70．4％、14．8％。结论：动脉化疗栓塞法治疗胃肠道肿瘤肝转移有确切疗效，对于乏血供转移灶亦有良好效果。     

肺癌介入治疗并发症的处理和预防

目的：探讨肺癌介入治疗并发症的治疗和预防。方法：188例原发性肺癌患者，男117例，女71例，年龄31～72岁。支气管动脉灌注化疗(BAI)157例，BAI和肺动脉联合灌注化疗(PAI)2例，支气管动脉化疗栓塞(BAE)29例。结果：本组病例共做介入治疗432次，平均每例2．3次。共发生并发症320人次，其中导管操作引起的并发症11人次，对比剂引起的并发症157人次，化疗药物引起的并发症149人次，脊髓损伤1例，胸廓内动脉误栓1例，术后因呼吸衰竭死亡1例。结论：积极防治并发症对提高介入治疗的临床效果有重要的作用。     

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.