透明质酸钠在输卵管介入再通术后预防复发性粘连的临床应用

目的 评价透明质酸钠在输卵管介入再通术后预防复发性粘连的临床价值.方法 将169例输卵管阻塞性不孕症患者随机分为对照组(60例)和观察组(109例),前者行输卵管介入再通术后常规使用松解液(庆大霉素8万u、地塞米松10 mg、α-糜蛋白酶5 g的水溶液40 ml)治疗,后者则在此基础上加用透明质酸钠预防复发性粘连.观察2组术后输卵管再通、复发性粘连发生情况及受孕情况.结果 观察组109例子宫输卵管造影显示输卵管阻塞210条,术后缺如8条,介入再通202条,再通成功率为96.2%(202/210);对照组60例经子宫输卵管造影显示输卵管阻塞108条,介入再通103条,再通成功率为95.4%(103/108),2组比较无显著性差异(P＞0.05).观察组介入再通术后3个月粘连复发率及12个月内受孕率分别为3.7%和57.8%,对照组分别为26.7%和25.0%,2组比较有显著性差异(P＜0.05).结论 透明质酸钠能有效预防输卵管介入再通术后复发性粘连的发生,具有很好的临床应用价值.     

输卵管再通术联合中医治疗输卵管阻塞性不孕

目的　评价介入性输卵管再通术与中医药联合应用在治疗输卵管阻塞性不孕症方面的临床疗效。方法　对 38例输卵管阻塞性不孕病人的 76条输卵管,在DSA监视下,用Cook公司FTC-900输卵管再通系列器材进行输卵管阻塞再通术,手术前、后均辅以中医药侧穹隆封闭、灌肠治疗。结果　76条阻塞的输卵管中有 71条获得疏通,有效率为 93. 4%;术后随访半年, 38例不孕病人中有 25人受孕,受孕率为 67. 3%; 13例未受孕者中,有 8例出现输卵管的再阻塞。结论　输卵管再通术与中医药联合应用,简便安全,输卵管疏通率、术后受孕率均高于单纯行输卵管再通术或中医药治疗的病例,值得推广应用。     

中西医结合治疗输卵管阻塞疗效观察

目的：观察抗生素加中药和理疗提高输卵管复通率及预防复通后再阻塞的疗效.方法：以抗生素＋中药灌肠、外敷＋理疗治疗输卵管阻塞98例为观察组;以采用常规方法治疗103例为对照组.对两组复通率、再阻塞率、受孕率及异位妊娠率等进行比较.结果：观察组复通率79.9%,重复粘连率17.7%,受孕率46.1%,无异位妊娠;对照组复通率55.7%,重复粘连率37.4%,受孕率33.8%,异位妊娠率4.6%.两组比较,差异显著（P＜0.05）.结论：抗生素＋中药灌肠、外敷＋理疗治疗输卵管阻塞,可明显提高输卵管复通率,以及预防复通后再阻塞.     

介入性输卵管再通术及碘化油应用初步研究

目的　探讨介入性输卵管再通术在治疗输卵管阻塞性不孕症的临床效果及碘化油的应用价值。方法　观察组 2 1例 42条输卵管阻塞。对照组 16例 3 2条输卵管阻塞 ,对照组仅行介入性输卵管再通术 ,观察组在再通术成功后向输卵管内注入超液态碘化油丁胺卡那霉素乳剂。所有病例 6个月后复查。结果　观察组与对照组的再通率、术后受孕率分别为 81.0 %、81.3 %;2 8.6%、2 5 %。术后再通输卵管粘连复发率观察组 5 .88%、对照组 2 6.9%,比较两者差异具有显著性意义 (x2 =6.3 6,Ρ <0 .0 5 )。结论　介入性输卵管再通术是治疗输卵管阻塞性不孕的一项有效方法 ,碘化油应用可明显降低再通术后输卵管粘连复发率     

输卵管再通术联合腹腔镜治疗输卵管性不孕症

目的:探讨梗阻输卵管治疗的有效途径及复通输卵管受孕的影响因素.方法:输卵管造影确诊的近段梗阻患者306例,利用输卵管再通装置先行输卵管再通术(FTR),对输卵管近段再通后显示远段积水粘连的68例,再施行腹腔镜伞端造口术.结果:306例近段输卵管梗阻经FTR治疗,除7例再通失败外,完全再通231例;近段再通后显示远段积水的68例接受腹腔镜伞端造口术.术后1～2个月造影复查输卵管通畅率为92.26%(465/504);追踪随访48个月受孕率为36.93%(113/306).结论:FTR联合腹腔镜治疗输卵管梗阻性不孕症疗效显著,两者通过优势互补有效地提高了输卵管的再通成功率,但经腹腔镜造口术复通的患者受孕率较低.     

用自制器械行选择性输卵管造影和再通术

报告用自制器械行子宫输卵管选择性造影及再通术45例,插管成功率95.5%。近端输卵管阻塞再通率80%。随访结果:15例患者正常受孕,受孕率33.3%,其中继发不孕症受孕率50%,原发不孕症受孕率17.4%。近端阻塞再通术后受孕率54.5%,远端积水或阻塞患者受孕率15%。显示选择性输卵管造影及再通术是治疗女性不孕症的有效方法;本手术最佳适应证为继发不孕、近端输卵管阻塞患者;自制器械价廉、安全。     

输卵管再通术与电视腹腔镜联合治疗输卵管阻塞所致不孕症的临床分析

目的 分析输卵管再通术与电视腹腔镜联合治疗输卵管(多段)阻塞所致不孕症的临床应用价值.方法 经输卵管造影或/和选择性输卵管造影选择单侧或双侧输卵管伞端粘连合并同侧输卵管其它段阻塞患者67例作为研究对象,一般选择输卵管再通术后2～3 d行电视腹腔镜对伞端粘连分离,必要时行输卵管成形、造口术.准确统计输卵管再通率、联合再通率、妊娠率以及宫外孕、输卵管再次阻塞并发症的发生率. 结果本组67例127条输卵管阻塞均成功实施输卵管再通术与电视腹腔镜联合治疗微创手术,其中,单纯输卵管再通率(前三段)97.6%(124/127),再通术与电视腹腔镜联合治疗再通率为96.0%(122/127),术后1年内妊娠率为58.2%(39/67),宫外孕发生率4.5%(3/67).术后1年未受孕患者28例,其中27例患者再次行普通输卵管造影,10例输卵管各段通畅,占14.9%(10/67);17例输卵管再次阻塞,再次阻塞率25.4%(17/67),其中伞端粘连积水13例,占19.4%(13/67),输卵管其它各段阻塞4例,占6.0%(4/67).另外1例因确诊生殖道结核而放弃该治疗.结论 输卵管再通术与电视腹腔镜联合治疗对输卵管阻塞所致不孕症的治疗是一种有效治疗手段.     

介入性输卵管再通术结合中医治疗输卵管阻塞性不孕症的临床研究

目的探讨介入性输卵管再通术结合中医治疗输卵管阻塞性不孕症的临床应用价值.材料和方法对200例337条输卵管阻塞性不孕症患者,在电视透视下,用改进的导管、导丝进行输卵管再通术,其中120例再通术后行口服中药、中药灌肠及热敷治疗.结果337条阻塞输卵管中,再通276条,再通率为81.9%.2个月后子宫输卵管造影显示,单纯再通术的127条再通后的输卵管,68条再通良好,有效率为53.5%;配合中药治疗组的149条经再通后的输卵管,保持通畅良好112条,有效率为75.2%.术后随访1年,单纯再通术组受孕率为33.8%(27/80),配合中药治疗组的受孕率为56.7%(68/120).结论输卵管再通术结合中医治疗不孕症,方法简单安全,再通的有效率、受孕率均高于单纯输卵管再通术.     

输卵管阻塞的影像学分析及其中西医结合介入治疗

目的:通过输卵管造影探讨和论证输卵管阻塞狭窄的原因及其中西医结合介入治疗的临床效果。方法:对109例均行子宫输卵管造影,进行影像学及临床治疗效果分析,其中105例行再通术,并联合应用中西药内服外用。结果:插管成功率96.3％,原发性不孕21例,继发性不孕88例,再通成功率73.3％,术后受孕率29.5％,术后粘连复发率26.7％。结论:输卵管造影术是一种诊断明确、操作简便的影像学检查方法,对不孕不育的原因及疗效评定能提供确切依据。中西医结合介入再通术方法成功率高、效果显著,是目前较理想的治疗方法。     

选择性输卵管造影与再通术器械的改进及临床应用

目的：探讨选择性输卵管造影与再通术治疗输卵管阻塞的临床价值，验证改进后再通器械的可行性。方法：对６０例１１６条输卵管阻塞引起不孕症患者在透视下，用改进后器械行选择性输卵管造影及再通术。结果：其中近端输卵管再通率９３．８％；总有效率８１．８％；受孕率３１．７％；未发生严重并发症。结论：选择性输卵管造影对病变的诊断效果高于传统的子宫碘油造影，用改进后同轴导管行选择性输卵管造影与再通术方法简便易行，安全可靠，成本低廉     

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.