结肠CT在炎症性肠病诊断中的作用

炎症性肠病病因复杂,目前认为主要与4个方面有关:基因遗传、免疫功能缺陷、屏障功能障碍、微生物菌丛.结肠CT不仅能较为出色地显示结肠黏膜,而且能够显示结肠壁及结肠周围结构,现已广泛应用于结肠肿瘤筛查.目前已有研究显示结肠CT对炎症性肠病的诊断有很好的应用潜力.就炎症性肠病的发病机制、病理改变及其CT表现予以综述.     

结肠CT在炎症性肠病诊断中的作用

炎症性肠病病因复杂,目前认为主要与4个方面有关:基因遗传、免疫功能缺陷、屏障功能障碍、微生物菌丛.结肠CT不仅能较为出色地显示结肠黏膜,而且能够显示结肠壁及结肠周围结构,现已广泛应用于结肠肿瘤筛查.目前已有研究显示结肠CT对炎症性肠病的诊断有很好的应用潜力.就炎症性肠病的发病机制、病理改变及其CT表现予以综述.     

小肠CT成像联合肠系膜血管CTA对炎症性肠病的诊断价值

目的通过分析炎症性肠病的CT小肠造影影像学征象,并与病理及内镜检查相比对,探讨CT小肠造影对炎症性肠病的诊断价值。方法回顾性分析本院2012年8月～2017年2月期间病历资料完整,收治的129例肠道炎症病例,采用飞利浦Brilliance 256层CT扫描仪,所有患者CTE检查完成后采用多平面重组(multi planar reformation,MPR)技术进行图像后处理,结合临床资料、内镜及病理检查结果,探讨CTE对炎症性肠病的诊断价值。结果 129例患者中,炎症性肠病者55例(克罗恩病34例,溃疡性结肠炎21例),普通肠炎32例,结肠息肉或消化道肿瘤10例,内镜及影像学检查均为阴性23例,肠道充盈不佳5例,影像学阴性且未行内镜检查4例。在55例炎症性肠病患者中,CTE检出克罗恩病29例(检出率85. 3%)、溃疡性结肠炎16例(检出率76. 2%)、普通肠炎22例(检出率66. 7%)。CTE检查对于发生于全结肠的溃疡性结肠炎的诊断与内镜检查的诊断符合率为100%。与普通肠炎检查结果相比,CTE检查显示炎症性肠病患者肠壁增厚、肠壁强化、肠系膜淋巴结肿大、肠系膜血管异常表现(P 0. 05)。结论 CTE检查可较好鉴别诊断炎症性肠病患者与普通肠炎,能较好地显示肠壁病变、肠外病变及并发症,对于炎症性肠病具有较大诊断价值。     

炎症性肠病研究新进展

炎症性肠病（IBD）指溃疡性结肠炎（UC）和克罗恩病（CD）,该二种病均以慢性过程、自动复发、病因未明为其特征.西方国家发病率较高,国内发病有上升趋势,为此,中华医学会消化学会于1978（杭州）、1993（太原）和2000（成都）分别召开了炎症性肠病专项研讨会,对其病因、诊断和治疗的规范进行了讨论.     

双能CT在克罗恩病中的研究进展

克罗恩病（CD）是一种慢性、反复发作的炎症性肠病,需要长期监测药物治疗反应。双能CT(DECT)不仅能提供形态学特征,还可生成常规CT影像、虚拟单能谱影像、碘密度图等不同的能谱影像来提供定量特征,实现无创、准确监测。DECT已逐渐应用于CD的诊断与鉴别诊断、活动性及严重程度评估、疗效评估与预后预测等方面。就DECT在CD中的应用进展予以综述。     

Crohn肠病的多层螺旋CT诊断

目的 总结多层螺旋CT(MSCT)在诊断Crohn肠病中的应用价值.方法 观察21例经临床、影像和病理3方面综合诊断为Crohn肠病的MSCT表现,分析其影像学特点.结果 21例均表现为多节段肠壁增厚,其中直、乙状结肠受累2例,系膜缘增厚明显有13节段,肠壁均有不同程度强化.肠壁溃疡3例,瘘管2例,肠内瘘1例,肠梗阻2例,肠旁蜂窝织炎6例,炎性包块或腹腔脓肿6例.肠系膜淋巴结肿大13例,系膜密度增高10例,继发肠间距增宽5例,系膜血管增粗、密集12例,梳子征8例.MIP和MPR技术更有助于全面显示病变.结论 MSCT对Crohn肠病肠壁的病变,肠外并发症及肠系膜、血管、淋巴结异常均有良好显示,并能判断病程,指导临床治疗,不失为一较好的影像检查方法.     

白介素-17在幼年大鼠炎症性肠病中表达及意义

目的探讨白介素-17(IL-17)在炎症性肠病(IBD)幼年大鼠中的表达及其在临床中的意义。方法将16只SD大鼠随机分成DSS模型组和空白对照组2组,每组8只。利用葡聚糖硫酸钠(DSS)诱导大鼠IBD模型,观察其一般状况,计算疾病活动指数(DAI)评分。在第8天处死所有大鼠,取病变结肠病理切片,观察病理改变,并采用免疫组化法检测肠黏膜局部IL-17的表达。结果 DSS模型组DAI评分明显高于空白对照组,病理显示肠道炎症损伤明显,肠黏膜中可见大量炎细胞浸润,腺体结构破坏明显。免疫组化研究显示,DSS模型组肠黏膜中IL-17细胞因子的表达高于空白对照组,差异有统计学意义(P<0.05)。结论炎症性肠病幼年大鼠结肠组织中IL-17水平升高,提示IL-17在儿童炎症性肠病的发生中可能起到重要作用。     

16层螺旋CT诊断肠克罗恩病临床分析(附9例报告)

目的 探讨肠克罗恩病的CT诊断特征.方法 回顾性分析9例经病理或临床证实的肠克罗恩病CT表现.结果 9例肠克罗恩病均表现为节段性分布肠壁肿胀、增厚,肠腔狭窄,增强后肠壁快速强化,周围肠系膜血管扩张.结论 肠克罗恩病具有一定的CT特征,16层螺旋CT扫描能更好的观察肠壁及肠壁外病变,确诊需依赖病理.     

白细胞介素-22在炎症性肠病中的免疫调节作用

为进一步认识白细胞介素-22与炎症性肠病之间的关系。本文综述了白细胞介素-22的结构及其受体、来源和靶点,同时讨论了白细胞介素-22在炎症性肠病的免疫调节作用。     

小肠常见炎症性溃疡性疾患的X线诊断：附35例报告

目的：分析小肠常见炎症性溃疡性疾患的Ｘ线表现。材料与方法：３５例小肠炎症性溃疡性疾患，男２０例，女１５例。其中肠结核１１例，Ｃｒｏｈｎ病１３例，肠Ｂｅｈｃｅｔ病７例，单纯性溃疡和缺血性肠炎各２例。３３例有病理结果，２例经临床治疗证实。结果：病变局限于回肠，肠结核１１例中有９例，Ｃｒｏｈｎ病１３例中有１０例，肠Ｂｅｈｃｅｔ病７例中有５例，单纯性溃疡２例中有１例，２例缺血性肠炎均在回肠。部分病例累及回盲部。３５例均有溃疡，形态表现多种多样，但纵行溃疡和裂隙仅见于Ｃｒｏｈｎ病。大而深的溃疡５例，３例为肠Ｂｅｈｃｅｔ病。浅而不规则溃疡１３例，１０例见于肠结核。横行溃疡２例均见于肠结核。结论：肠溃疡的形态、周围粘膜的变化和肠管变形等Ｘ线特征是各种疾患的诊断依据。强调正确的诊断决定于良好的Ｘ线检查技术和对形态变化的正确解释。     

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）