Tei指数评价儿童三尖瓣下移畸形手术前后心功能的变化

目的:评价Tei指数估测儿童三尖瓣下移畸形手术前后心功能变化的价值。方法:38例接受三尖瓣下移畸形手术治疗的患儿,分别于手术前后应用超声心动图测量左、右心室Tei指数。另选取80名正常儿童作为对照组。结果:正常组左、右心室Tei指数分别为0.30±0.08、0.26±0.08,三尖瓣下移畸形患儿术前左、右心室Tei指数分别为0.46±0.09、0.50±0.11,均高于正常组(P<0.05),术后患者左、右心室Tei指数分别为0.36±0.06、0.33±0.06,明显降低,但尚未恢复至正常组水平(P<0.05)。结论:三尖瓣下移畸形患者术前存在心功能不全,手术可以得到改善;Tei指数可以较准确评价三尖瓣下移畸形患者的心功能变化。     

Tei指数评价川崎病患儿心脏功能的临床意义

目的：应用Tei指数评价川崎病（ kawasaki disease ,KD）患儿心脏功能,探讨其临床意义。方法超声心动图测量KD急性期和恢复期患儿62例的左室射血分数（ EF）、左室短轴缩短率（ FS）、二尖瓣口舒张期血流E/A比值、肺静脉血流S/D比值、左右心室等容收缩期（ICT）、等容舒张期（IRT）、射血时间（ET）和计算左、右心室Tei指数,并与80例年龄、性别匹配的健康儿童作比较。结果 KD急性期左心室Tei指数较健康儿童明显增高（0．43±0．07 vs 0．37±0．06,P＜0．01）,恢复期组左心室Tei指数减低,接近健康儿童（0．40±0．09 vs 0．37±0．06）,差异无统计学意义;KD急性期右心室Tei指数增加,与健康对照组相比差异有统计学意义（0．31±0．06 vs 0．25±0．05,P＜0．01）,恢复期组右心室Tei指数减低,逐渐接近正常（0．30±0．08 vs 0．25±0．05）,差异无统计学意义。结论 KD急性期患儿存在心脏整体功能异常,Tei指数能准确、敏感地评价患儿心脏整体功能。     

Tei指数评价正常胎儿和心力衰竭胎儿心功能的应用价值

目的:探讨Tei指数在评价正常胎儿和心力衰竭胎儿心脏功能中的应用价值。方法:测量400例正常胎儿(20~25周、26~30周、31~35周、36~40周各100例)左、右心室Tei指数,分析孕周、心率对此指数的影响。测量8例心力衰竭胎儿和与其孕龄匹配的30例正常胎儿左、右心室Tei指数,分析两者之间有无显著性差异。结果:400例正常胎儿左心室Tei指数为0.319±0.0104,右心室Tei指数为0.328±0.105,两者之间具有相关性(r=0.766,P<0.001);不同孕龄胎儿之间的Tei指数差异均无显著性意义(P>0.05)。胎儿左、右心室Tei指数与心率无明显相关(P>0.05)。8例心力衰竭胎儿左室Tei指数为0.556±0.141,右室Tei指数为0.819±0.280,比正常胎儿左、右心室Tei指数显著升高,差异有显著性意义(P<0.01)。结论:Tei指数是一种简单可靠的定量综合评价心脏收缩和舒张功能的指标。     

Tei指数评价高血压病患者左心室功能的临床研究

目的：探讨Tei指数评价高血压病患者左心室功能的临床价值。方法：选择高血压病80例,其中非左室肥厚组（Ⅰ组）47例、左室肥厚组（Ⅱ组）33例,以及正常对照组65例。常规行超声心动图检查,测量二尖瓣口血流频谱舒张早期和舒张晚期血流峰值之比（E/A）、左室射血分数（EF）及Tei指数。结果：高血压病Ⅰ、Ⅱ组EF值均在正常范围,与对照组比较无显著差异（P〉0.05）,但E/A值均较对照组减小（P〈0.05）;高血压病Ⅰ、Ⅱ组Tei指数分别为0.49±0.15和0.56±0.10,较正常对照组的0.32±0.08显著增高（P〈0.05）,并且Ⅱ组Tei指数较Ⅰ组有增大趋势。结论：Tei指数能反映高血压病患者左心功能下降情况,具有较好的临床应用价值。     

多普勒Tei指数评价高血压右室功能

目的:探讨多普勒Tei指数评价高血压患者右室功能的价值。材料和方法:受试者分为高血压左室肥厚组(A组)、无左室肥厚组(B组)和正常对照组(C组),每组30例。应用多普勒超声测量三尖瓣及肺动脉瓣血流频谱,计算右室Tei指数,二尖瓣口舒张晚期A峰和早期血流E峰峰值之比(A/E)及左室射血分数(EF)。结果:三组间的EF无差异(P>0.05)。A/E比值分别为1.484±0.221、1.269±0.143、0.893±0.289,呈A组>B组>C组(P<0.01);Tei指数分别为0.596±0.158、0.486±0.104、0.280±0.066,呈A组>B组>C组(P<0.01)。结论:多普勒Tei指数可以综合评价高血压患者的右室功能,但不能单独评价收缩功能或舒张功能。     

定量组织速度成像技术及组织追踪成像技术评价妊娠期高血压疾病患者心功能

目的:采用定量组织速度成像技术(quantitative tissue velocity imaging,QTVI)及组织追踪成像技术(tissue tracking imaging,TTI)超声心动图评价妊娠期高血压疾病(hypertensive disorders complicating pregnancy,HDCP)患者心功能。方法:测量30例HDCP患者(HDCP组)和50例健康孕妇(对照组),在心尖四腔心切面,用QTVI及TTI测量左右心室心肌运动的收缩期峰值速度、Tei指数、收缩期峰值位移。结果:HDCP组与对照组的EF值分别为(61.00±2.35)%、(62.00±3.82)%,差异无统计学意义。HDCP组与对照组左心室心肌运动的收缩期峰值速度分别为(7.37±1.82)cm/s、(8.13±1.64)cm/s,右心室收缩期心肌运动峰值速度分别为(6.90±0.52)cm/s、(7.80±0.38)cm/s,左心室收缩期峰值位移分别为(10.43±1.35)mm、(11.95±1.95)mm,右心室收缩期峰值位移分别为(7.20+1.18)mm、(8.60±1.89)mm,左心室Tei指数分别为0.59±0.06、0.46±0.07,右心室Tei指数分别为0.62±0.09、0.47±0.08,2组间比较,差异均有统计学意义(P0.05)。结论:QTVI及TTI超声心动图可定量评价HDCP患者心功能改变。     

Tei指数对不同程度冠状动脉病变患者右心功能的评价

目的:探讨Tei指数检测不同程度冠状动脉病变患者右心功能变化的临床应用价值。方法:采用组织多普勒显像技术对30例正常对照组、30例冠状动脉造影阴性组(狭窄<50%)、30例轻度冠状动脉狭窄组(狭窄50%～74%),30例中度冠状动脉病变组(75%～94%)进行三尖瓣环右室室间隔及游离壁Tei指数测定。结果:冠状动脉造影阴性组Tei指数与正常对照组比较不存在显著差异,轻度冠状动脉狭窄组及中度冠状动脉狭窄组Tei指数显著高于正常对照组(P<0.05)。结论:冠状动脉病变患者右心功能亦受损,Tei指数能用于评价右心功能受损情况。     

组织应变成像技术对儿童主动脉缩窄左心功能的评价

目的:探讨组织应变成像技术在评价儿童主动脉缩窄患者手术治疗前后左心功能的临床应用价值.方法:24例主动脉缩窄患儿于手术前后接受常规超声及组织多普勒检测,获取二尖瓣血流E/A值、左室短轴缩短率(FS)、射血分数(EF)及左室心肌的收缩期及舒张早期峰值应变和应变率.结果:①患儿手术前后E/A值、FS及EF无明显差异(P＞0.05);②患儿收缩期峰值应变术前高于术后但无明显差异(P＞0.05).③患儿术后收缩期峰值应变率略低于术前(P＞0.05),舒张早期应变率峰值高于术前(P＜0.02).结论:应变及应变率可以敏感检测主动脉缩窄儿童术后左心功能的改善.     

Tei指数评价水肿胎儿心室功能的定量研究

目的探讨Tei指数评价水肿胎儿心室功能的可行性。方法应用多普勒超声心动图测量17名孕龄在20～39周的水肿胎儿及55名孕龄在28～40周正常对照胎儿左、右心室多普勒时间间期,获得左、右心室Tei指数,比较水肿胎儿组与正常对照组Tei指数有无差异性。结果水肿胎儿组左、右心室Tei指数与正常对照组有差异性（P〈0．01）。结论Tei指数能简便、敏感地评估胎儿心脏整体收缩、舒张功能。     

二尖瓣病变合并三尖瓣轻度关闭不全患者二尖瓣置换术后三尖瓣返流加重的超声特点和临床意义

目的:探讨二尖瓣病变合并三尖瓣轻度关闭不全(TR)患者在二尖瓣置换术后三尖瓣关闭不全加重的超声特点,为临床手术方式的制订提供依据.方法:回顾性分析130例二尖瓣病变合并三尖瓣轻度关闭不全患者二尖瓣置换术前及术后的临床和超声资料,术后随访时间为1～6年,平均(3.51±1.82)年.超声检查测量每例患者术前的左心室射血分数(LEVF)、右心房、右心室、左心房和左心室内径、肺动脉收缩期压力、三尖瓣瓣环直径和三尖瓣返流面积、以及术后三尖瓣返流面积,并相应的分为正常组和异常组,采用卡方检验分析上述指标与术后三尖瓣返流的关系.结果:超声检查显示在二尖瓣置换术后130例患者的二尖瓣功能均良好,但33例患者的三尖辩返流量较术前明显增加,其中术前有左心功能下降者25例,右房增大27例,右室增大26例,左房增大15例,左室增大27例,肺动脉压增高27例,三尖瓣环扩大28例.卡方检验显示术前左心室内径与术后三尖辩返流加重无显著相关性(P＞0.05),而其它指标与术后三尖瓣返流加重的相关性均有统计学意义(P＜0.05).结论:术前左心功能下降、右心室、右心房和左心房增大、肺动脉收缩期压力升高、三尖瓣瓣环增大可能是二尖瓣病变合并三尖瓣轻度关闭不全患者在二尖瓣置换术后出现三尖瓣返流加重的危险因素,术中有必要积极处理.     

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.