氩氦刀冷冻消融治疗联合肝动脉化疗栓塞术对原发性肝癌生存的影响

目的：观察氩氦刀冷冻消融联合肝动脉化疗栓塞术对原发性肝癌生存的影响。方法：103例中晚期原发性肝癌患者入组;随机分入分入肝动脉化疗栓塞（TACE）组（31例）、氲氦刀冷冻消融组（32例）、TACE联合氩氦刀冷冻消融组（40例）。术后每月复查AFP、T细胞亚群、上腹部CT观察肿瘤坏死情况;随访26个月,观察患者6个月及1年生存率情况。结果：肝动脉化疗栓塞组、氩氦刀冷冻消融组、氩氦刀冷冻消融联合肝动脉化疗栓塞组完全坏死率分别为32．2％、50．0％、50．0％;经统计学检验,P〈0．05,各组之间差异具有统计学意义。1年生存率分别为54．8％、56．2％、75．0％,联合治疗组较单纯TACE组和氩氦刀冷冻消融组明显提高,差异具有统计学意义。结论：TACE联合氩氦刀冷冻消融更有利于改善患者长期生存,不良反应可耐受。     

TACE联合氩氦刀冷冻消融治疗中晚期肝癌的疗效分析

目的探讨TACE联合氩氦刀冷冻消融治疗原发性肝癌(hepatocellular carcinoma,HCC)的临床价值。方法将70例患者通过前瞻随机临床分2组进行研究,观察组行TACE+氩氦刀冷冻消融治疗,对照组单纯行TACE术。随访时间24个月,通过评估治疗前后肿瘤情况、肝功能损害情况、完全缓解率、总有效率及生存时间等方面来比较2种方法的近、远期疗效。结果 TACE联合氩氦刀冷冻消融治疗的完全缓解率及有效率明显高于单纯TACE对照组(P0.05);观察组的肝功能损害低于对照组;TACE联合氩氦刀冷冻消融治疗生存率明显长于单纯TACE对照组(P0.05)。结论TACE联合氩氦刀冷冻消融治疗对治疗中晚期肝癌疗效确切,安全可靠。     

氩氦刀联合肝动脉介入治疗原发性肝癌的免疫效应研究

目的通过比较单纯氩氦刀治疗、单纯肝动脉化疗栓塞治疗（TACE）和氩氦刀联合TACE治疗原发性肝癌前、后的甲胎蛋白（AFP）及T淋巴细胞亚群的变化,探讨氩氦刀联合TACE治疗原发性肝癌的临床价值。方法①将99例原发性肝癌患者随机分为3组,氩氦刀治疗组（A组）、TACE组（B组）和联合组（C组）,3组患者性别、年龄、病理比较差异无统计学意义,有可比性。②通过治疗前、后AFP及外周血T淋巴细胞亚群测定评价。结果3组治疗后与治疗前AFP比较差异均有统计学意义（P〈0．05）;C组与A、B组比较差异有统计学意义（P〈0．05）。3组治疗后T淋巴细胞哑群（Th、Ts及Th／Ts）与治疗前比较差异均有统计学意义（P〈0．01）;C组与A、B组比较差异有统计学意义（P〈0．01）。结论从AFP及T淋巴细胞弧群指标分析,氩氦刀联合TACE治疗组AFP下降和T淋巴细胞亚群变化好于其他单纯治疗组。     

肝动脉化疗栓塞序贯冷循环射频消融治疗原发性肝癌的体会

目的 评价肝动脉化疗栓塞术（TACE）联合冷循环射频消融术（RFA）治疗原发性肝癌的临床价值。方法 65例原发性肝癌分为单纯TACE治疗组31例,TACE联合冷循环射频消融术治疗组（TACE＋RFA组）34例。治疗后通过DSA、CT、超声检查及血清甲胎蛋白（AFP）测定评价。结果 单纯TACE组的肿瘤完全坏死率、复发率、1年生存率分别为16．1％、48．4％、48．4％,TACE＋RFA联合组分别为47．1％、17．7％、79．4％,两组比较有极显著统计学差异（P〈0．01）;单纯TACE组的肿瘤缩小率、AFP下降率分别为22．6％、19．4％,TACE＋RFA联合组分别为32．4％、44．1％,两组比较差异有显著性（P〈0．05）。结论 TACE＋RFA较单纯TACE治疗中晚期肝癌效果好,是治疗中晚期肝癌的一种有效方法,值得提倡。     

经皮氩氦刀冷冻消融治疗原发性肝癌的疗效观察(附300例报告)

目的评价经皮氩氦刀治疗原发性肝癌（HCC）的疗效、安全性及并发症。方法采用氩氦超导手术系统，在B超引导下经皮氩氦刀治疗300例HCC患者，观察其治疗效果及随访情况。结果165例患者的223个瘤体（直径7.2±2.8cm，5.0-15cm）未被彻底毁损，135例的185个瘤体（直径5.6±0.8cm，1.9-7.0cm）被完全毁损，两组肿瘤直径差异显著（P=0.0001）。265例患者随访中位时间为31.2（6-63）个月，彻底毁损组（经氩氦刀治疗后肿瘤被完全毁损）肿瘤原位复发率为16.30（22／135），肝动脉化疗栓塞（TACE）组（经氩氦刀治疗后肿瘤未被完全毁损，再联合TACE治疗）原位复发率为47.1％（41／87），两组肿瘤原位复发率差异显著（P=0.0001）。早期、中期、进展期肝癌（巴塞罗纳肝癌分期标准）术后生存期分别为38.7±3.8、26.5±4.2、16.9±1.4个月。17例（5.7％）发生严重并发症，包括冷休克6例（2.0％）、肝癌破裂出血5例（1.7％）、应激性胃黏膜出血4例（1.3％）、肝功能衰竭2例（0.7％）。术后肝功能多有轻度损害，2周左右恢复至术前的基线水平。结论经皮氩氦刀治疗肝癌是一种较安全有效的方法，肿瘤直径和肿瘤分期是影响疗效的主要因素。     

氩氦刀治疗中晚期肝肿瘤

目的探讨氩氦刀靶向冷冻综合治疗中晚期肝肿瘤的疗效。方法72例中晚期肝肿瘤,采用B超或计算机体层摄影术引导经皮穿刺肝肿瘤氩氦靶向冷冻消融术。共计对117个病灶使用203把氩氦刀2次循环冷冻。结果氩氦超导低温靶向定位对肝肿瘤穿刺准确。冷冻术后有90．3％（65／72）的患者精神状态得到改善,腹部疼痛症状减轻,恢复快。应用18F-氟脱氧葡萄糖扫描显示肿瘤局部放射性浓聚影明显降低。计算机体层摄影术影像上可见肿瘤区域内有空泡样破坏,边界清楚,计算机体层摄影术值较冷冻前低。结论氩氦刀加综合治疗肝癌疗效明确,对正常肝组织损伤少,安全、有效、微创,为已丧失手术机会的晚期肝肿瘤患者开辟了一条新的治疗途径。但应强调的是氩氦刀仅仅是一种局部物理冷冻技术,应该结合化疗、放疗、生物治疗等综合措施。     

TACE联合氩氦刀冷冻消融术治疗原发性肝癌后血小板变化观察

目的 :探讨TACE序贯氩氦刀冷冻消融术治疗中晚期原发性肝细胞癌后血小板的变化规律。方法:47例原发性肝癌患者均先行经典TACE术,术后2~4周内行氩氦冷冻消融术(冷冻时间30 min)。总结术前、术后血小板变化规律。结果:TACE术后1周血小板呈一过性轻度下降。氩氦刀术前与术后1周内血小板呈先迅速下降后快速恢复的过程。结论:肝癌行氩氦刀冷冻肿瘤消融术后导致血小板减少与冷冻时间、冷冻针数量及肝功能损害密切相关。     

氩氦刀冷冻消融联合肝动脉栓塞化疗术治疗中晚期肝癌的疗效分析

目的：评价氩氦刀冷冻消融联合肝动脉栓塞化疗术（TACE）对中晚期原发性肝癌的疗效。方法回顾性分析66例临床或病理确诊原发性肝癌患者的临床资料,根据治疗方式分为TACE组31例,联合组（冷冻消融联合TACE）35例,随访时间5～35个月,通过评估完全缓解率、总有效率及生存时间等方面来比较2种方法的近、远期疗效。结果2组比较,在总有效率、完全缓解率方面,联合组均优于TACE组（P<0.05）,联合组生存期长于TACE组（P=0.038）。在0.5年、1年、2年总体生存率方面,联合组与TACE组相比,差异无统计学意义。结论对于中晚期原发性肝癌,冷冻消融联合TACE 治疗能提高患者近期疗效并延长生存期,但确切效果还有待大样本、多中心随机对照研究证实。     

TACE联合氩氦刀冷冻术治疗巨块型肝细胞癌的临床研究

目的 探讨TACE采用联合氩氦刀冷冻术治疗巨块型肝细胞癌的疗效.方法 收集湖南省肿瘤医院2001年1月-2007年5月采用TACE联合氩氦刀冷冻消融治疗病灶大于5 cm肝细胞癌56例(治疗组),并筛选同期在性别、年龄、病理等无显著差异的单纯TACE治疗的例数相同的病例(对照组).分析比较两组1、2、3年生存率,治疗前后...     

氩氦刀冷冻联合经导管动脉化疗栓塞治疗肝脏转移性肿瘤的疗效分析

目的探索和掌握氩氦刀冷冻治疗联合经导管动脉化疗栓塞（TACE）对肝脏转移性肿瘤的治疗方法和疗效。方法对15例肝转移瘤患者进行氩氦刀治疗,术后7～15d再行TACE治疗,另选15例患者只行TACE治疗,对比治疗效果。结果治疗组有效率达100%,明显高于对照组的47%,且氩氦刀治疗患者无严重的不良反应,恢复快。结论氩氦刀创伤小、疗效好,为肝转移瘤的治疗提供了新方法,结合TACE更能提高疗效。     

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）