CT引导下双针共轴穿刺法建立兔肺孤立VX2移植瘤模型的实验研究

目的尝试用双针共轴穿刺法进一步提高兔肺孤立VX2移植瘤成瘤率。方法将30只新西兰大白兔随机分为实验组和对照组,每组15只。实验组采用CT引导下双针共轴穿刺VX2瘤块植入法建立兔肺孤立移植瘤模型,对照组采用单针瘤块植入法,以大体标本及病理结果作为金标准。结果实验组兔肺内孤立VX2肿瘤成瘤率为80%,胸膜种植率为20%,平均生存时间为(67.0±7.0)d,对照组兔肺孤立肿瘤结节成瘤率为40%,胸膜种植率为53.3%,平均生存时间(53.3±10.6)d,组间差异有统计学意义(P<0.05)。结论 CT引导下双针共轴穿刺VX2瘤块植入法建立兔肺孤立移植瘤模型,较单针穿刺法明显降低了胸膜种植转移瘤,提高了肺孤立VX2肿瘤成瘤率,且实验兔生存期更长,更适于制作肺癌影像学研究的动物模型。     

MR导引经皮穿刺瘤块种植法构建兔VX2肝癌模型

目的 探讨MR导引下经皮穿刺瘤块种植法制作兔VX2肝癌模型的方法及建模后影像学和组织学评估.方法 32只新西兰大白兔随机分为A、B两组,每组16只.A组在360°全开放式0.4T MR扫描成像系统光学导航仪导引下,采用剑突左侧肋弓下进针,经皮经肝穿刺将VX2瘤组织块种植于兔肝内;B组通过开腹法将瘤组织块种植于肝内.观察两组手术时间、成瘤率、感染率及肿瘤生长特点.结果 A组模型成瘤率为93.7％,手术时间为(18.24±3.24) min,无术后感染发生;B组模型成瘤率为87.5％,手术时间为(25.23±2.16) min,1例发生术后感染.两组间手术时间差异有统计学意义(P＜0.05).肿瘤HE染色镜下观察显示,2周见癌细胞呈巢状分布,癌细胞核大;3周见明显核分裂像,异型显著;4周可见凝固性坏死及炎性细胞浸润.结论 MR导引下经皮穿刺瘤块种植法构建兔VX2肝癌模型,具有导引准确、操作简便、成功率高等特点,可作为兔VX2肝癌模型构建方式之一.     

改良法兔VX2肝移植瘤模型建立及综合治疗的实验研究

目的 探讨DSA设备导引下经皮穿刺瘤组织块接种法制作兔VX2肝移植瘤模型的可行性及对比经导管动脉化疗栓塞(TACE)、经皮微波凝固治疗(PMCT)及TACE+PMCT 3种方法治疗兔VX2肝移植瘤的效果.方法 ①新西兰大白兔50只,DSA设备导引下采用Angiotech SKATER穿刺针经皮穿刺接种瘤组织块于肝脏,14 d后行CT平扫评价肿瘤接种成功率,测量肿瘤体积并随机处死10只实验兔进行病理分析.②取制作成功的肝移植瘤模型30只,随机分为TACE组(A组)、PMCT组(B组)和TACE+PMCT组(C组),每组10只,治疗后第14天对比各组CT测量肿瘤体积、外周血CD3+、CD4+细胞分布、肿瘤组织坏死率.结果 ①DSA设备导引下经皮穿刺瘤组织块接种法制作兔VX2肝移植瘤模型成功率为100%.②治疗后14 d,C组的肿瘤体积为(0.624±0.031)cm3,明显小于A组(0.799±0.057)cm3和B组(0.858±0.112)cm3,P＜0.05;C组外周血CD3+细胞百分数为(66.30±1.36)%,明显高于A组(53.34±2.12)%和B组(60.68±1.06)%,P＜0.05;C组外周血CD4+细胞百分数为(48.19±1.43)%,也明显高于A组 (40.21±1.07)%和B组(44.03±0.08)%,P＜0.05;C组肿瘤组织坏死率明显高于A组和B组(P＜0.05).结论①DSA设备导引下经皮穿刺瘤组织块接种法建立兔VX2肝移植瘤模型具有方法简单、成功率高、动物损伤小等特点.②TACE+PMCT效果优于单纯经导管肝动脉化疗栓塞或微波凝固治疗.     

兔VX2肺癌模型的建立及评价

目的 探讨肺内注入组织块悬液建立兔VX2肺癌模型的方法 ,并与细胞悬液注入法建立的模型进行比较.方法 50只新西兰白兔随机分为组织块悬液组和细胞悬液组,每组25只,分别将VX2肿瘤组织块悬液和细胞悬液注入兔右肺下叶内.利用CT扫描观察肿瘤生长和胸腔内转移情况,同时观察动物的一般情况.结果 两种方法 建立的兔VX2肺癌模型组织学表现与荷瘤种兔相同.组织块悬液组和细胞悬液组的接种成功率分别为100%和48%(P＜0.01),胸壁种植率分别为4%和20%(P＜0.01),从发现肿瘤生长到出现转移征象的时间间隔分别为9.0±1.8天和4.0±2.0天(P＜0.01),动物自然存活时间分别为32.0±3.4天和30.0±6.5天(P＞0.05).结论 采用组织块悬液肺内注入法建立兔VX2肺癌模型方法 简便,接种成功率高,胸壁种植率低,出现转移晚,是建立兔VX2肺癌模型的理想方法 .     

CT引导下兔VX2肝癌模型的制作及综合评估

目的 探讨CT引导下兔VX2肝癌模型的制作及影像学和组织学评估.方法 选择新西兰大白兔29只作为实验动物(前期9只.后期20只).采用CT引导下经皮穿刺瘤组织块种植于兔肝左中央叶.前期从左侧肋缘进针,术后未予抗感染;后期从剑突下最大层面进针,术后抗感染3 d.分别于接种后1、2、3和4周行CT增强扫描及组织学观察.结果 前期实验移植模型成瘤率为88.9%,腹壁种植转移率为62.5%,50%并发胸腔积液.后期实验肝癌移植模型成功率为95%,腹壁种植转移率为10.5%,无并发胸腔积液.CT平扫瘤体为低密度或等密度,均匀强化(2周)或环状强化(3周、4周);静脉期、延迟期呈低密度,但CT值较动脉期无明显下降.组织学上VX2为血管丰富的低分化鳞状细胞癌,2周出现点灶状凝固性坏死,3周出现肝内转移.4周出现大量凝固性坏死.自然生存时间为5～9周,死亡原因主要为广泛肺和腹腔转移伴全身衰竭.结论 CT引导下兔VX2肝癌模型的制作成功率高,并发症发生率低,进行兔VX2肝癌模型介入治疗实验研究宜选择2周为宜.     

兔VX2膀胱癌移植瘤模型实验研究

目的 通过模拟原位膀胱癌发生机制构建兔VX2膀胱癌移植瘤动物模型,研究其生物学特性及影像学表现.方法 采用同轴法穿刺接种VX2细胞株于25只新西兰大白兔膀胱,接种术后14、21、28 d分别作CT平扫及增强扫描,评估肿瘤种植及生长情况.取兔膀胱组织标本作大体解剖学及组织病理学检查,同时观察腹腔淋巴结及肝肺转移情况.结果 22只实验兔建模成功,植瘤成瘤率为88.0％(22/25).植瘤后14、21、28 d瘤体平均长径分别为(1.38±0.20) mm、(2.30±0.08) mm、(3.22±0.24) mm,且瘤体变化差异有显著统计学意义(P＜0.01).VX2移植瘤CT表现为膀胱壁局部不规则增厚或肿块突起,呈均匀强化(14 d)或环型强化(21、28 d),肿瘤腔内呈不同程度充盈缺损.种植瘤大体形态及其影像学特征基本相符,组织病理学表现为血管丰富的低分化鳞状细胞癌,呈浸润性生长,21 d后瘤体中心出现坏死,21、28 d出现肝、肺及腹腔淋巴结转移.结论 本研究成功构建兔VX2膀胱移植瘤模型,基本反映了膀胱癌发生与发展过程,适合CT动态观察及实验研究.     

两种不同方式建立兔小肝癌模型的比较研究

目的通过开腹埋植瘤块及CT引导下经皮穿刺推注肿瘤块方式建立兔VX2小肝癌模型,探讨不同方法建立小肝癌模型的应用价值。方法 24只新西兰大白兔,随机分为实验组和对照组两组,每组各12只。术前先采用耳中央动脉采血方式检测两组实验兔肝功能指标谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TB)水平,其中实验组实验兔采用外科开腹直视下左肝叶埋植瘤块的方法,对照组实验兔采用CT导向下经皮穿刺肝叶推送瘤块的方法建立模型兔。术后7天、14天各组模型兔分别行CT增强扫描及DSA造影观察是否存在腹腔异位种植及实验室检测肝功能(ALT、AST、TB),并于术后14天随机处死每组模型兔各2只进行病理学检测,其余模型兔记录生存周期。结果两组模型兔均检测到肝脏肿瘤生长,成瘤率(100%)两组无明显统计学差异。实验组模型14天CT检测肿瘤最大径及最小径分别为(2.01±0.11)cm,(1.29±0.33)cm与对照组实验兔(5.21±1.23)cm,(3.56±2.36)cm相比具有统计学差异,实验组实验兔7天ALT、AST及TB分别为(38.44±1.40)U/L,(40.67±8.77)U/L,(2.42±0.50)μmol/L较之于对照组实验兔(37.58±1.79)U/L,(39.69±11.40)U/L,(2.06±0.46)μmol/L无明显统计学差异。术后14天实验组模型兔ALT、AST及TB分别为(53.59±8.63)U/L,(61.39±8.50)U/L,(2.52±0.24)μmol/L较之于对照组实验兔(86.53±5.09)U/L,(87.12±3.50)U/L,(3.23±0.23)μmol/L存在统计学差异。实验组模型生存时间为(40.45±3.08)天较之于对照组(30.45±2.98)天,存在统计学差异。结论外科开腹开腹埋植瘤块的方式建立兔VX2肝脏移植瘤模型具有更好的肿瘤形态、生存周期更适用于相关实验研究。     

CT引导下套管针种植法制作兔双灶肝癌模型的评价

目的 探讨CT引导下经皮套管针种植法制作兔双灶肝癌模型的可行性.方法 将30只健康新西兰大耳白兔随机分为2组,种植VX2瘤细胞株.经皮穿刺种植组采用CT引导下经套管针穿刺种植法,开腹组采用传统的开腹种植法,于兔肝左、右叶各种植1处肿瘤,制成双灶肝癌模型.2周后进行MRI扫描,对比两组单、双灶成瘤率、成瘤满意度、肿瘤体积...     

CT引导建立兔肺VX2肿瘤模型的实验研究

目的 建立适合微波消融的兔肺肿瘤模型.方法 新西兰大白兔36只,CT引导下穿刺,将载有VX2肿瘤组织悬液的亲水凝胶接种于右肺内.结果 接种后14～26 d,CT检查证实34只新西兰大白兔肺内有肿瘤生长,其中26只呈单发结节,直径0.5～0.8 cm,兔肺VX2肿瘤模型成功率为72.2%(26/36);另有2只肺内呈多发结节生长,并出现胸腔积液;4只累及纵隔;2只出现胸壁种植转移.接种过程未出现气胸、出血等并发症.结论 本实验建模方法安全、有效,并可在肺内局部形成较大体积的实体瘤,能满足微波消融治疗肺癌的研究需要,因此所建兔肺VX2肿瘤模型是成功的.     

种植性兔VX2肝肿瘤血供的研究

目的探讨种植性兔VX2肝肿瘤生长的自然血供特点。方法VX2瘤株接种于新西兰兔肝左叶,制成模型瘤兔15只,将其按瘤体直径分为3组:A组直径<2.0cm、B组直径2.0～3.0cm、C组直径>3.0cm,分别应用彩色多普勒超声仪检测各组VX2瘤兔的门静脉和肝动脉的血流动力学指标,以及肝动脉血管造影显示瘤体供血情况,分析不同直径大小的瘤体血流分布及构成。结果A组的VX2兔肝肿瘤供血不丰富,肝动脉部分参与供血;B组的VX2兔肝肿瘤瘤内血流丰富,供血以肝动脉为主;C组的VX2兔肝肿瘤中心部出现坏死,瘤周血流丰富,供血以肝动脉为主。C组的VX2兔肿瘤肝动脉最大血流速度(Vmax)(60.3±10.9cm/s)与A组(50.4±12.2cm/s)相比有差异(P<0.01),阻力指数(RI)(0.9±0.12)与A组(0.5±0.02)相比有差异(P<0.01);门静脉平均血流速度(V)及门静脉内径(D)各组差异不大(P>0.05)。结论种植性VX2肝肿瘤主要供血血管为肝动脉,肝动脉最大血流速度和阻力指数随肿块增大明显增加,多普勒流速曲线呈高速高阻型;门静脉平均血流速度及门静脉内径随肿块增大变化不明显。     

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）