C臂引导下髓核造影指导臭氧消融治疗腰椎间盘突出症的应用价值

目的:观察C臂引导下椎间盘髓核造影对指导臭氧髓核氧化治疗腰椎间盘突出症中臭氧注射量及注射方式的临床应用价值。方法:52例腰椎间盘突出症患者在C臂监视引导下,穿刺成功后行椎间盘髓核造影。根据纤维环是否破裂,破裂部位、形态,以及突出相应平面后纵韧带是否破裂等,确定椎间盘突出类型,并决定注射方式及注射量。所有患者介入术后均随访3～12个月。结果:依据椎间盘髓核造影结果,将椎间盘突出的情况分成纤维环未破裂型、纤维环破裂型及后纵韧带破裂型。依据上述分组次序,臭氧的注射量依次增加5ml,而注射时间依次递减约1～2min。术后随访结果表明,其显效率、有效率、无效率分别为73.08%,17.31%,9.61%,总有效率(显效和有效)为90.39%。结论:利用C臂引导髓核造影技术指导臭氧消融治疗腰椎间盘突出症的臭氧注射量及注射方式,有更好的针对性,对减轻患者术中痛苦、提高疗效有重要指导意义。     

胶原酶单独注射和与髓核切吸术合用治疗腰椎间盘突出症疗效比较

目的　比较胶原酶单独注射和与髓核切吸术合用治疗腰椎间盘突出症疗效。方法　 15 0例腰椎间盘突出症病人分为四组分别按腰椎间盘内、外注射胶原酶法及分别将椎间盘内、外注射胶原酶法与髓核切吸术合用进行治疗。结果　椎间盘内、外注射胶原酶法与髓核切吸术合用两组有效率分别为 94%及 93 %高于单独椎间盘内、外注射胶原酶两组有效率 90 %及 88%。结论　胶原酶溶解髓核与切吸髓核合用治疗腰椎间盘突出症能更快速、有效的降低椎间盘内压力 ,疗效更高。     

髓核及侧隐窝注射臭氧治疗腰椎间盘突出症

目的 探讨经皮穿刺髓核及侧隐窝注射臭氧治疗腰椎间盘突出症的临床疗效.方法 88例经CT或MRI证实为腰椎间盘突出症患者进行髓核及侧隐窝注射奥氧作为研究组,并以74例腰椎间盘突出症仅作髓核注射臭氧患者作为对照组.结果 髓核及侧隐窝联合注射对腰椎间盘突出症的患者症状缓解更快、临床疗效持续更长,随访6个月研究组临床疗效达84.1%;对照组为64.9%.统计学分析显示术后1、2和6个月研究组有效率均高于对照组(X2=4.09,P=0.043;X2=4.62,P=0.032;X2=4.38,P=0.036),差异具有统计学意义.结论 髓核内及侧隐窝联合注射臭氧比单一髓核内注射臭氧更加有效.     

经皮医用臭氧盘内注射治疗腰椎间盘突出的应用

目的分析医用臭氧治疗腰椎间盘突出症的临床疗效及适应证。方法采用经皮腰椎间盘内注射浓度为35~45ug/ml的医用臭氧10~20ml1次。结果臭氧注射治疗腰椎间盘突出症60例,66个椎间盘,总有效率为96.67%。优良率76%,椎间盘突出小于椎管矢状径30%组疗效优于膨出组及>30%组。结论医用臭氧治疗腰椎间盘突出症方法简单,疗效确切,适应范围广。目前尚未发现并发症。     

等离子射频结合臭氧注射治疗颈椎间盘突出症的临床应用

目的探讨等离子刀装置射频消融结合椎间盘内臭氧注射治疗颈椎间盘突出症的操作方法及其疗效。资料与方法对46例颈椎间盘突出症患者采用盘内射频消融结合盘内臭氧注射的方法进行治疗和评价。椎间盘穿刺后,先经穿刺针管行低剂量髓核消融,然后经穿刺针管向髓核内注入60μg/ml的臭氧4～8ml。术后1天、1周和3个月分别进行疗效评价。结果联合治疗的中长期有效率为97.8%～100%,优良率达93.5%,部分患者术后有轻微反应,无明显并发症。结论等离子射频结合盘内臭氧注射,利用低温消融和臭氧溶核的不同作用,直接靠近颈椎间盘突出部位进行治疗,综合疗效较高,是治疗颈椎间盘突出症的有效方法。     

臭氧结合胶原酶治疗腰椎间盘突出症的临床应用

目的研究臭氧髓核氧化术结合胶原酶溶解术治疗腰椎间盘突出症的临床疗效。方法对183例腰椎间盘突出症患者进行臭氧结合胶原酶盘内、外注射治疗。术后随访6~12个月,按照Macnab评定标准进行疗效评定。结果183例患者,优144例,良18例,可16例,差5例;优良率为88.5%,有效率为97.3%;本组患者无1例并发症出现。结论臭氧髓核氧化术结合胶原酶溶解术治疗腰椎间盘突出症集合了两者的优点,因此疗效更好,同时安全、费用低,是腰椎间盘突出症首选的微创治疗方法。     

经皮臭氧靶点注射治疗重度腰椎间盘突出症疗效分析

目的评估CT介导下后入路经椎管及硬膜囊椎间盘内医用臭氧注射治疗重度腰椎间盘突出症的疗效及优势。方法 36例重度腰椎间盘突出症患者于CT介导下从背部棘突旁开约1～2 cm后入路经椎管及硬膜囊穿刺到达椎间盘内,臭氧注射于椎间盘、突出髓核及患侧硬膜外间隙神经根周围。椎间盘及突出髓核内医用臭氧浓度为40～50μg/ml,神经根旁医用臭氧浓度为30μg/ml。结果 36例患者均治疗成功。术前平均下肢根性痛视觉模拟评分(VAS)为(8.34±1.62)分,Oswestry功能障碍指数(ODI)评分平均为(61.75±12.44)分;术后6个月随访VAS评分平均为(3.97±0.53)分,ODI评分平均为(38.28±7.76)分;术前及术后VAS及ODI评分差异均有统计学意义(P值均<0.001)。按照ODI评分区段分布,5例达到优,21例达到良,7例可,3例差,总优良率达72.2%。15例共注射臭氧2次,13例(86.7%)取得优良疗效。全部患者均未见严重并发症。结论 CT介导下后入路经椎管及硬膜囊腰椎间盘内医用臭氧注射治疗重度腰椎间盘突出症安全、注射准确、疗效好,可作为备选方法,根据实际情况选择应用。     

臭氧联合胶原酶注射与单纯臭氧治疗腰椎间盘突出症的疗效观察

目的 观察臭氧联合胶原酶注射治疗腰椎间盘突出症(LDH)与单纯臭氧治疗椎间盘突出症的不同疗效.方法 在DSA导向下,正侧位透视后准确定位,采用9号穿刺针经皮穿刺向椎间盘内单纯注射臭氧或先后注射臭氧及胶原酶治疗76例腰椎间盘突出患者.结果 治疗后1、3和6个月进行随访.1个月后随访,臭氧联合胶原晦注射治疗组(A组,38例...     

CT引导下经皮穿刺盘内注射臭氧联合神经根阻滞治疗腰椎间盘突出症

目的：探讨CT引导下经皮穿刺椎间盘内注射臭氧联合神经根阻滞治疗腰椎间盘突出症的临床应用。方法：对125例148个椎间盘在CT引导下经皮穿刺达病变的椎间盘,缓慢注射浓度为60μg/ml臭氧气体15~20 ml;退针至神经根附近,缓慢注射浓度为40μg/ml臭氧气体5~10 ml,再注入利多卡因、曲安奈德、注射用腺苷钴胺和维生素B1混合液3~5 ml。结果：对患者进行随访,疗效分为优、良、中和差,本组优良率达91%。结论：CT引导下经皮穿刺盘内注射臭氧联合神经根阻滞治疗腰椎间盘突出症是一种有效、安全的微创方法。     

臭氧髓核氧化术治疗腰椎间盘突出200例临床分析

目的探讨臭氧髓核氧化术治疗腰椎间盘突出症的临床价值。方法在C臂适时透视下，经皮穿刺向病变椎间盘内注入浓度为60％的臭氧10～15ml，臭氧注射完后拔出穿刺针，局部按压3分钟左右。结果本组200例病员，78％的疗效好，14％的疗效良，6％的疗效可，2％的疗效差。结论臭氧髓核氧化术操作简单、安全，疗效显著。     

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.