肠梗阻的CT诊断价值

目的 :探讨CT检查对肠梗阻的诊断价值。方法 :对 3 6例肠梗阻患者的腹部X线平片和CT表现进行分析。其中 2 4例行手术治疗 ,12例行胃肠减压、抗感染保守治疗。 12例有腹部手术史。结果 :腹部X线平片和CT准确显示梗阻程度的病例分别为 2 0例 ( 5 5 .6% )和 3 4例 ( 94.4% )。CT直接准确诊断梗阻病因 19例 ,包括结肠直肠癌 16例 ,肠系膜囊肿伴绞窄性肠梗阻 1例 ,结肠淋巴瘤合并肠套叠 1例 ,结肠脂肪瘤合并肠套叠 1例。 12例有腹部手术史者中 10例为粘连性肠梗阻 ,2例为麻痹性肠梗阻 ,结合手术史 ,CT诊断无误。结论 :对梗阻病因的判断CT明显优于腹部X线平片 ,CT可显示狭窄移行段的形态 ,有助于判断病因 ,可为临床确定治疗方案提供较可靠的依据。     

肠梗阻的腹部X线平片和CT诊断价值对比

目的探讨肠梗阻腹部X线平片和CT诊断价值差异。方法收治肠梗阻患者共80例腹部X线平片和CT影像学资料,比较两种检查方式用于肠梗阻诊断总符合率。结果 CT用于肠梗阻诊断总符合率显著高于腹部X线平片(P0.05);CT用于肠梗阻患者梗阻部位和梗阻原因诊断符合率均显著高于腹部X线平片(P0.05);CT用于肠梗阻诊断图像清晰度和检查舒适度均显著高于腹部X线平片(P0.05);腹部X线平片用于肠梗阻诊断操作简便度显著高于CT(P0.05)。结论 CT图像清晰度及检查舒适度优于腹部X线平片,但腹部X线平片操作更为简便,且价格低廉。     

儿童小肠机械性梗阻的CT诊断

目的 探讨CT检查对儿童小肠机械性梗阻的诊断价值。方法 分析31例手术确诊为小肠机械性梗阻患者的腹部X线平片与CT表现。年龄9个月至14岁,男17例,女14例。急性小肠梗阻29例,慢性小肠梗阻2例。其中7例有腹部手术史。结果 腹部X线平片与CT准确显示梗阻程度分别为19例和29例。CT准确显示梗阻病因18例,包括小肠石4例,肠套叠5例,腹腔局部感染渗出粘连6例,腔内型肠重复畸形1例,先天性脐疝1例,先天性肠旋转不良1例。本组7例有腹部手术史者全部为粘连性梗阻,结合手术史,CT准确判断病因25例。腹部X线平片与CT假阴性诊断分别为4例和2例。结论 CT对发现肠绞窄和肠壁积气的敏感性较腹平片高。CT显示狭窄移行段的形态有助于判断病因,对梗阻病因的判断CT明显优于腹部X线平片。可为临床确定治疗方案提供比较可靠的依据。     

结肠癌致肠梗阻的CT诊断

目的：探讨结肠癌致机械性肠梗阻的螺旋CT诊断的优越性。材料和方法：搜集64例曾于术前做腹部CT检查并经手术或纤维结肠镜病理证实为结肠癌引起机械性肠梗阻病例，就以下CT及腹部平片表现进行分析：①梗阻近、远侧肠管表现；②梗阻部位改变；③并发症的CT征象。结果：64例肠梗阻中，判断肠梗阻的有无，CT检查诊断64例（100％），X线平片诊断60例（93．7％）；肠梗阻病因的判断，CT诊断64例（100％），平片诊断0例（0％）。全组64例在CT上均见肠腔内软组织肿块影、肠壁增厚和肠腔狭窄，其中4例见缺血性结肠炎。结论：结肠癌引起机械性肠梗阻的CT检查，对诊断梗阻的原因、部位、程度及发病缓急可提供更有价值的资料。     

16层螺旋CT和腹部平片检查在机械性肠梗阻诊断中的价值分析

目的比较16层螺旋CT（16-MSCT）和腹部平片在机械性肠梗阻诊断中的价值。方法 42例患者均经腹部平片及16层螺旋CT扫描检查证实为肠梗阻,比较患者腹部平片及16-MSCT在肠梗阻诊断率、肠梗阻病因检出率及肠梗阻程度判断中的优劣。结果本组42例患者中,16-MSCT肠梗阻诊断率为100%,而腹部平片肠梗阻诊断率为73.81%（P=0.000）;16-MSCT在肠梗阻病因诊断率为92.86%,腹部平片在肠梗阻病因诊断率为11.90%（P=0.000）,且前者能更有效地对梗阻程度进行判定。结论腹部平片在临床上具有操作简便、价格低廉等优点,但16-MSCT在诊断肠梗阻、明确病因、了解梗阻程度等方面均较腹部平片更有优势。     

64层螺旋CT、超声及X线诊断肠梗阻的临床对比分析

目的：探讨64层螺旋CT、B超、腹部x线平片诊断肠梗阻的临床价值。方法：选择2009年10月～2010年10月我院经手术证实为肠梗阻的218例患者为研究对象。其中64层螺旋CT检查135例;B超检查167例;腹部x线平片196例。比较三种方法术前诊断正确性。结果：64层螺旋CT、B超、腹部x线平片对肠梗阻诊断的准确率分别为94．1％、86．8％、72．4％;对肠梗阻部位诊断的准确率分别为80．7％、63．4％和53．5％;对梗阻原因的诊断准确率分别为82．9％、59．2％、34．1％;对绞窄诊断的准确率分别为76．7％、58．1％和27．9％;64层螺旋CT对肠梗阻、梗阻部位和梗阻原因的诊断与B超、x线片相比具有显著性差异（P〈0．01）;B超与x线片相比也具有具有显著性差异（P〈0．01）。结论：64层螺旋CT对肠梗阻诊断具有较高的敏感性,明显优于B超及腹部x线平片检查,对临床及时制定治疗方案有极大的帮助。     

小儿肠梗阻的腹部X线平片和CT诊断价值分析

目的：分析腹部X线平片和CT对小儿肠梗阻的诊断价值，重点探讨小儿绞窄性肠梗阻的CT表现。材料和方法：收集2002年1月-2004年6月复旦大学附属儿科医院手术证实肠梗阻23例，术前24h均拍摄腹部正侧位X线平片，其中14例行腹部CT扫描。结果：23例肠梗阻术前诊断正确率：腹部X线平片为69．6％（16／23）：CT为100％（14／14）。其中，绞窄性肠梗阻术前诊断正确率：腹部X线平片为38．9％（7／18）；CT为90．9％（10／11）。11例绞窄性肠梗阻的主要CT表现包括：小肠壁增厚9例；CT平扫肠壁密度增高7例和“靶征，，2例；CT增强扫描肠壁强化低于正常者6例，3例延迟扫描强化。肠系膜血管增粗水肿5例，4、肠壁积气4例，腹水6例。结论：CT诊断小儿肠梗阻，特别是显示肠绞窄，较腹部X线平片优越。     

螺旋CT在消化道穿孔中的诊断价值

目的：分析CT在消化道穿孔中的诊断价值。方法回顾性分析51例经手术证实的消化道穿孔病例,术前行立位腹部平片检查者41例,腹部CT扫描者51例,比较两种检查方法在消化道穿孔中的诊断价值。结果41例X线片检出游离气体26例,CT检出50例,CT检出率高于普通X线检查（P＜0．05）。CT显示腹内游离气体呈新月状或小气泡影（50例）,胃肠穿孔处周围局限性积液或蜂窝织炎（34例）,阑尾周围脓肿（3例）,肠梗阻（5例）,胃肠壁增厚（25例）,胃肠壁肿块（2例）,胃肠壁缺损（4例）,腹水（30例）。CT对穿孔病因的诊断符合率为68．6％（35/51）,对穿孔部位的诊断符合率为88．2％（45/51）。结论螺旋CT诊断胃肠道穿孔是一种有效的检查方法,且对穿孔部位和病因的诊断也具有重要价值。     

超声在腹部平片阴性肠梗阻中的诊断价值

目的研究超声在腹部X线平片检查阴性的肠梗阻诊断中的价值。方法回顾我院2002～2011年经CT、手术证实为肠梗阻且腹部X平片为阴性而B超检查为阳性的36例患者的临床资料,对诊断结果进行分析。结果36例患者经CT、手术证实梗阻原因中肠套叠18例,肠道肿瘤12例,粘连索带引起内疝3例,粪石梗阻1例,腹腔炎症引起肠梗阻2例。结论超声在肠梗阻诊断中具有一定的意义,可作为腹部X线平片诊断肠梗阻的补充检查。     

多层螺旋CT在诊断肠梗阻的应用研究

目的:探讨多层螺旋CT(MSCT)三维成像技术在肠梗阻诊断及临床上的应用,寻求诊断肠梗阻的新方法.方法:选取疑似肠梗阻患者96例作为研究对象,随机分为观察组和对照组各48例.对照组患者采用X线平片进行诊断,观察组患者采用多层螺旋CT进行扫描诊断,并将诊断结果与手术和病理结果进行比较.结果:MSCT诊断肠梗阻的准确率为95.0％,X线平片诊断准确率为72.5％,MSCT诊断肠梗阻的准确率明显优于X线平片,两种诊断方法比较差异有统计学意义(P＜0.05).结论:MSCT三维成像技术可明确肠梗阻的病因、梗阻部位及患病程度,提高诊断肠梗阻的能力,为临床治疗提供可靠依据.     

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.     

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.     

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).     

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.