原发性气管肿瘤及肿瘤样病变的X线与CT诊断

目的：评价Ｘ线和ＣＴ检查对原发性气管肿瘤及肿瘤样病变的诊断价值。方法：２２例气管原发性病变均经病理证实。１０例良性，１２例恶性。组织学诊断包括：鳞癌６例，未分化癌３例，腺样囊性癌２例，浆细胞瘤１例，纤维组织细胞瘤１例，神经纤维瘤１例，乳头状瘤１例，良性混合瘤１例，软骨瘤１例，类癌２例，气管内迷走甲状腺１例，结核１例，淀粉样变性１例。结果：Ｘ线和ＣＴ所见分为五种类型：（１）管壁增厚伴腔内高低不平隆起；（２）管腔内局限性不光滑结节；（３）环形狭窄；（４）腔内光滑结节；（５）隆突病变。结论：Ｘ线检查对确定气管病变的部位、范围非常有用。ＣＴ可提供病变的详细特点。气管病变的定性诊断中许多因素需要考虑     

肺硬化性血管瘤的CT诊断(附11例报告)

目的：探讨ＣＴ对肺硬化性血管瘤的诊断及检查方法。方法：ＣＴ检查、经手术及穿刺病理证实的肺硬化性血管瘤（ＳＨＬ）１１例,男３例,女８例,年龄１５～６４岁,平均３８岁。结果：ＳＨＬ表现为胸膜下区或肺实质内孤立性肿块,边界清晰、边缘光滑、密度均匀、偶见钙化,增强扫描时呈均匀性或混杂密度强化,周围肺纹理无异常改变,无胸膜肥厚及凹陷征象,肺门、纵隔淋巴结无肿大。结论：ＣＴ检查可提示ＳＨＬ的诊断,病理穿刺活检可明确诊断。     

外生型肝癌的CT诊断(附7例分析)

目的：提高对外生型肝癌的认识和诊断。方法：回顾性分析７例（男５例，女２例，年龄３６～６６岁）经手术、病理或临床证实的外生型肝癌的ＣＴ表现。结果：根据肝内有无肿块将其分为单纯型（６例）和混合型（１例）。５例肿瘤突出于肝外有蒂与肝相连，２例肿瘤紧邻肝表面。病灶呈低密度，不均匀强化，其病理改变与肝内原发性肝癌一致。结论：外生型肝癌的诊断主要依据肿瘤有蒂与肝脏相连或紧邻肝表面，肿瘤相应的ＣＴ表现。血管造影及血ＡＦＰ检查对诊断有重要参考价值     

肺错构瘤的影像诊断

目的：探讨肺错构瘤的影像诊断问题。方法：回顾性分析经手术病理证实的２６例肺错构瘤，所有病人均有Ｘ线平片，１１例体层及６例ＣＴ检查。并同４５例结核球和９８例周围性肺癌进行对照研究。结果：肺错构瘤的主要Ｘ线征象：中央型３例为叶支气管内或肺门区肿物，周围型２３例均为圆形或椭圆形肿块，病灶平均直径２．２ｃｍ，多数边缘光整，３５％病灶有钙化，以斑点状或环状多见。本病与结核球、肺癌在病灶的大小、边缘及密度等均有不同之处。本病ＣＴ表现病灶内常可显示钙化和脂肪。结论：传统Ｘ线对周围性错构瘤的诊断及其与结核球、周围性肺癌的鉴别很有帮助。ＣＴ检查可补充平片、体层之不足，可显示病灶内钙化或／和脂肪特征。     

肾母细胞瘤的 CT 表现及其病理基础(附21例分析)

目的：探讨肾母细胞瘤的ＣＴ表现及其病理基础。方法：分析２１例病理证实的肾母细胞瘤的ＣＴ表现及病理联系。结果：２０例（９５．２％）单侧发病，１２例（５７．１％）瘤体呈圆形或类圆形，直经平均约１０ｃｍ，平扫ＣＴ值１８～４５ＨＵ，内可见斑状更低密度区，病理基础为出血、坏死及瘤性脂肪；１２例（５７．１％）边缘较清，为肿瘤压迫周围正常肾组织所致，增强尤著：１６例（７６．１％）瘤体占据肾实质大部；５例（２３．８％）可见斑点状或孤形钙化。结论：幼儿单侧或双侧肾实质较大低密度肿块内含更低密度区或钙化应首先考虑肾母细胞瘤。     

周围型肺癌的 CT 表现

目的：为了进一步认识周围型小肺癌的ＣＴ表现。方法：本组病例采用东芝６００ＨＱＣＴ机，对直径≤３ｃｍ的３２例周围型小肺癌作ＣＴ平扫和增强扫描，并作ＣＴ表现分析与病理进行对照。结果：认为周围型小肺癌主要有四种ＣＴ表现：１、小肿瘤结节边缘呈深分叶状，系肿瘤多核发病所致；２、肿瘤结节内空气支气管征；３、肿瘤结节外侧兔耳征；４、肿瘤结节与肺门血管连接。结论：以上任何一种表现对周围型小肺癌的诊断都具有很高的参考价值。     

先天性弓形体病的脑部CT表现（附42例分析）

目的：提高对先天性弓形体病在脑部表现的认识和诊断。材料和方法：笔者分析了４２例经弓形体抗体的血清学ＩＦＡ法检测证实的先天性弓形体病的脑部ＣＴ表现。结果：本病的ＣＴ诊断要点为（１）脑内钙化灶为特征性表现，呈点状或弧线状，多见于基底节区，也可见于室管膜下及额叶和顶叶内；（２）侧脑室旁或灰白质交界处有小片状低密度区，病灶周围在增强后可有不规则强化；（３）阻塞性脑积水；（４）常合并大脑发育不全或神经系统畸形。结论：ＣＴ是诊断本病的主要影像学检查手段，ＣＴ诊断应与弓形体抗体的检测相结合。     

肺炎性结节CT征象分析

目的：探讨肺炎性结节的ＣＴ诊断和鉴别。方法：１９例常规胸部ＣＴ和高分辨率ＣＴ（ＨＲＣＴ）扫描，炎性假瘤１５例手术病理证实，４例球形肺炎随访１～２月明显缩小或吸收。另按ＣＴ序号收集同期病理证实≤３ｃｍ周围型肺癌３０例，结核球１５例与之鉴别。结果：１７／１９肺炎性结节居上叶后段或下叶背段、基底段肺周边紧贴胸膜；形态多样１４／１９，类圆形５／１９；轮廓模糊不规则和长条索１８／１９；空气支气管征５／１９，空洞４／１９，密度均匀１０／１９；１５／１９周围有较明显点片絮状炎症表现，１６／１９不同程度胸膜增厚。结论：大多数肺炎性结节的ＣＴ表现与周围型肺癌、结核球者是不同的。     

膝关节半月板损伤的 CT 诊断

本文报告１８７例（２２３侧）膝关节半月板ＣＴ诊断，其中５１例（５７侧膝关节）有手术对照。我们认为正确的ＣＴ扫描技术和对膝关节正常横断面解剖的熟悉是半月板损伤ＣＴ诊断的关键。半月板撕裂的直接ＣＴ表现有：（１）半月板内裂隙痕；（２）边界不清的局限性密度减低；（３）半月板体积膨大，边缘毛糙；（４）撕裂的半月板碎片移位；（５）内侧半月板中部与内侧副韧带分离。间接表现有：（１）周围软组织肿胀；（２）滑膜增厚；（３）关节囊内积液。本组手术病人中有５例假阳性，２例假阴性，本文对其原因作了分析。     

胃淋巴瘤的CT诊断

目的：探讨胃淋巴瘤的ＣＴ表现及其诊断价值。材料和方法：回顾性分析１１例经手术或活检病理证实的胃非何杰金淋巴瘤的临床和ＣＴ检查资料。结果：１１例胃淋巴瘤中原发性６例、继发性３例,初诊时即属ＩＶ期者２例,病变的ＣＴ表现可分为三种类型：胃壁弥漫增厚型８例（７２．７％）,节段增厚型２例（１８．２％）,肿块型１例（９．１％）;平均厚度约３．１ｃｍ（１．６ｃｍ－６．０ｃｍ）。病灶边界清晰光整,增强后病灶呈轻度强化,病灶内表面胃粘膜呈明显线样强化,均无周围浸润。结论：胃淋巴瘤的ＣＴ表现有一定的特征,有助于诊断。     

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.