超声鉴别诊断颈部浅表淋巴结良恶性的临床价值

目的探讨超声在颈部浅表淋巴结良、恶性鉴别与诊断中的临床应用价值。方法对82例颈部浅表淋巴结肿大患者的临床影像学资料进行对比研究。结果本文82例患者经超声检查均发现淋巴结肿大,共测量到92个肿大淋巴结,48例经手术病理确诊,其中良性淋巴结23例,恶性淋巴结25例;另外,34例患者的超声声像图表现不典型,后经超声引导穿刺活检证实,其中良性淋巴结10例,恶性淋巴结24例。良性组最大的淋巴结约为3.19cm×1.88cm,恶性组最大者为5.27cm×2.69cm。良性组和恶性组患者在大小、L/S、边界、淋巴结门、血流类型等声像图表现上存在明显差异,且差异具有统计学意义;另外,CDFI测定恶性组的RI值(0.77±0.21)明显高于良性组(0.58±0.17),且差异具有统计学意义。结论应用高频彩超对于鉴别和诊断颈浅部肿大淋巴结的良恶性病变具有较大的临床价值。     

二维及彩色超声在良恶性腋窝淋巴结肿大鉴别与诊断中的应用价值

目的：探讨二维及彩色超声在良恶性腋窝淋巴结肿大鉴别与诊断中的应用价值。方法选取腋窝淋巴结肿大患者80例为研究对象,其中,腋窝恶性淋巴结肿大40例,腋窝良性淋巴结肿大40例,所有患者均经术后组织病理学、穿刺病理学检查及临床治疗确诊。结果①40例腋窝良性淋巴结肿大中,超声共诊断准确38例,诊断准确率为95．0％。40例腋窝恶性淋巴结肿大中,超声共诊断准确37例,诊断准确率为92．5％;②恶性腋窝淋巴结肿大,淋巴结宽径增大,包膜回声增强不完整,不规则增厚。部分边缘不清晰,中央回声片状增强,部分融合成团,纵横比增大。良性腋窝淋巴结肿大,淋巴结形态规则,边界清晰,包膜完整,增厚均匀。两者比较,恶性腋窝淋巴结肿大皮质偏心性厚度、周围或混合型血流、微小钙化、边界不清、融合成团的比例均显著高于良性腋窝淋巴结肿大,且恶性腋窝淋巴结肿大纵横比显著高于良性腋窝淋巴结肿大,差异均具有统计学意义（ P ＜0．05）。结论超声可显示病变内部及周边回声特点,还可以探测到病变的血液供应及血流动力学特点,对良恶性腋窝性淋巴结肿大诊断及鉴别诊断价值高。     

浅表淋巴结病变二维超声显像及多普勒血流检测的临床研究

目的探讨良、恶性浅表肿大淋巴结声像图及多普勒血流参数变化特征,评价超声诊断技术的临床应用价值。方法98例213枚肿大淋巴结分为良、恶性两组,采用高频探头观察肿大淋巴结的形态、大小、内部回声及血流动力学指标。并结合病理,分析不同病因浅表肿大淋巴结的超声特征。结果恶性淋巴结横径、形态更接近圆形,多融合,其周边型血流明显高于良性淋巴结(P<0.05),良性肿大淋巴结血流分支细少,走行规律,呈低阻力;恶性呈高阻力,为不规则扭曲、紊乱血流。结论超声在浅表肿大淋巴结定性诊断中可为临床提供更多诊断信息,为影像学首选诊断方法。     

甲状腺结节性疾病的高频超声诊断价值

目的 :探讨高频超声对甲状腺结节良恶性的鉴别诊断价值。方法 :回顾性分析我院经手术病理及穿刺活检证实的120例甲状腺结节患者的超声图像,并进行对比,总结超声图像特点。结果 :术前超声诊断甲状腺良性结节82例,恶性结节38例;术后病理证实良性76例,恶性44例。结节形态规则或不规则,30例伴微小钙化,27例伴颈部淋巴结肿大,25例结节内见丰富血流信号。本组良性结节的血流RI≤0.7者68例(89.5%),恶性结节血流RI>0.7者40例(占90.9%)。结论:高频超声对甲状腺结节的良恶性诊断具有较高的敏感性,综合二维及彩色多普勒超声图像特点,可提高诊断准确率。     

儿童肠系膜淋巴结炎的超声诊断及临床价值探讨

目的：探讨超声在肠系膜淋巴结炎诊断中的临床价值.方法：回顾分析我院148例确诊为儿童肠系膜淋巴结炎的声像图特征,观察到肠系膜肿大淋巴结的部位、大小、形态、内部回声、纵横比值（S/L）及彩色多普勒血流信号.结果：148例患儿腹腔内均可见两枚以上不同程度的肿大淋巴结,多分布于脐周及右侧腹;其最大切面长轴径（L）：10～25 mm,短轴径（S）：5～12mm,纵横比值（S/L）＜2,彩色多普勒显示其内可探及血流信号.结论：超声是临床诊断儿童肠系膜淋巴结炎首选检查方法,为肠系膜肿大淋巴结的病因分析及临床诊断提供客观依据.     

彩色多普勒超声定性诊断浅表肿大淋巴结的价值

目的:探讨彩色多普勒超声定性诊断浅表肿大淋巴结的价值.材料和方法:应用彩色多普勒超声观测经病理/临床证实的15例炎性、20例淋巴瘤(9例)或转移癌(11例)患者的浅表淋巴结门髓质部厚度/淋巴结厚度、血流分布及动力学参数,与25例正常受检者相应指标比较.结果:淋巴结门髓质部厚度与淋巴结厚度比值,炎性组>正常组>恶性组;恶性组血流频谱呈高速高阻型,炎性组、正常组呈相对低速低阻型.结论:彩色多普勒超声对浅表淋巴结定性诊断具有较高价值.     

高频超声诊断小儿肠系膜淋巴结炎的临床价值分析

目的 探讨高频超声在诊断小儿肠系膜淋巴结炎中的临床价值.方法 对98例肠系膜淋巴结炎的患儿进行腹部超声检查,观察肠系膜淋巴结的分布、多少、大小、形态及内部回声情况,长径与短径比(L/D)、血流、RI值.结果 98例患儿均有不同程度的肠系膜淋巴结肿大,肿大的淋巴结形态规则,边界清晰,皮髓质界限清晰或欠清晰,淋巴门结构未见破坏.彩色多普勒血流量显像(color Doppler flow imaging,CDFI)显示肿大淋巴结内血流信号丰富,频谱多普勒(PW)探及低速低阻力型动脉频谱,L＞ 1.0cm,D＞0.5cm,L/D值介于2.1～2.8之间,收缩期峰值流速(PSV)介于8～20cm/s之间,阻力指数(RI)介于0.49～0.66之间.结论 高频超声检查便捷,无创伤性,在小儿肠系膜淋巴结炎的诊断中有重要的临床诊断价值.     

超声检查乳腺占位性病变临床分析

目的 探讨超声学检查在乳腺肿块诊断和鉴别诊断中的应用价值.方法 选择我院乳腺外科诊治的单发乳腺肿块患者96例,根据病理学检查结果,观察超声学检查对良恶性乳腺肿块的诊断符合率及良、恶性乳腺肿块的超声声像图特征.结果 彩色多普勒超声共准确诊断91例乳腺肿块,其诊断符合率为94.79％％（91/96）.乳腺癌形态不规则、纵横比≥1的、边缘不清、包膜不完整及周围浸润、内部回声不均、后方回声衰减及腋窝淋巴结肿大的比例均显著高于良性乳腺肿块,差异具有显著性（P＜0.05）..乳腺癌Ⅱ级及Ⅲ级血流的比例均显著高于良性乳腺肿块,其差异均具有显著性（P＜0.05）.恶性乳腺肿块PSV及RI均值分别为（20.1±3.7）cm/s和（0.9±0.2）cm/s,显著高于良性乳腺肿块的（8.8±2.4）cm/s和（0.6士0.1）cm/s,其差异均具有显著性（P＜0.05）.结论 彩色多普勒超声可以清晰显示乳腺肿块的特征,具有很高的应用价值.     

彩色多普勒超声血流阻力指数结合CA125对卵巢肿瘤的诊断价值

目的探讨彩色多普勒超声血流阻力指数(RI)结合肿瘤标志物CA125判断卵巢肿瘤良恶性的价值.资料与方法107例卵巢肿瘤患者采用Finkler 超声评分系统进行评分,经彩色多普勒超声检查测定 RI,同时测定患者血清 CA125判断卵巢肿瘤良恶性,并与术后病理进行对照.结果恶性卵巢肿瘤患者 Finkler 超声评分明显高于良性卵巢肿瘤患者,RI 值低于良性卵巢肿瘤患者,CA125明显高于良性卵巢肿瘤患者(P <0.01、P <0.05).Finkler超声评分、RI 结合 CA125对卵巢肿瘤良恶性诊断的敏感性及特异性分别为94.59%、89.47%,均高于单一检查方法.结论彩色多普勒超声、RI 及肿瘤标志物 CA125联合应用对提高卵巢肿瘤良恶性的诊断有一定临床价值.     

彩色多普勒能量图检测浅表淋巴结内动脉血流的价值

目的 :探讨彩色多普勒能量图检测浅表淋巴结内动脉血流在鉴别良恶性淋巴结病变的价值。方法 :回顾性分析 12 6例浅表淋巴结病变的彩色多普勒能量图及动脉血流频谱。其中良性淋巴结肿大 33例 ;恶性淋巴瘤 18例 ;淋巴结转移性肿大 75例。均经穿刺活检或手术病理证实。结果 :110个 (87.3% )淋巴结内检出动脉血流频谱 ,血流检出率良性病变为 72 .7% (2 4 / 33) ,恶性肿瘤为 92 .5 % (86 / 93)。良性肿大组、恶性淋巴瘤组和淋巴结转移癌组淋巴结内动脉血流PSV分别为 14 .4± 7.3cm/s、2 0 .1± 7.9cm/s和 18.2± 5 .1cm/s,RI测值分别为 0 .6 2± 0 .0 9、0 .73± 0 .19和 0 .74± 0 .16。t检验结果 ,淋巴结内动脉血流速度 (PSV)和阻力指数 (RI) ,良性疾病与恶性淋巴瘤和淋巴结转移癌组间差异具显著性 ,恶性淋巴瘤组和转移癌组间差异无显著性。结论 :淋巴结内动脉血流RI值可作为鉴别淋巴结良恶性的一个重要指标。但是 ,良恶性病变间PSV、RI值存在一定重叠。     

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.     

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.     

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）