72例SARS的胸部X线影像分析

目的 研究严重急性呼吸综合征(SARS)患者X线胸片的改变和影像动态变化。方法对72例SARS的X线表现进行分析，包括X线胸片异常出现的时间、病变最为严重的时间及病变吸收的时间和影像形态。结果胸部X线异常出现的时间多在发病后的4～7d(53例，73．6％)，X线表现最为严重的时间多在发病后的8～14d(54例，75．0％)，多数病变吸收的时间多为发病后的15～21d(37例，51．4％)，病变的主要特点是以双侧或单侧的单发或多发大片状模糊影(58例，80．6％)，最严重时期变化快。部分病人病变呈游走性改变。X线片上病变吸收后1个月内CT证实肺内仍具有病变者占55．0％(11／20例)。结论胸部X线片可反映SARS患者病变的动态变化，但对病变的细微改变显示有限度。     

严重急性呼吸综合征患者的胸部X线分析

目的：分析严重急性呼吸综合征(SARS）患的胸部X线表现及其与临床经过的关系。方法：分析了2003年4月17日至2003年5月20日经临床确诊的74例SARS患的胸部X线表现并与其临床经过进行了对照一大部分病例是CR系列胸片资料结果SARS患的肺部影像表现有索条斑片影、磨玻璃样影、片状影、团块影及弥漫混合影，SARS患肺部病变的分布以两肺中、下部为主(81％)。肺部病变的转归有4种模式：a)在发现病灶后3d～7d内基本吸收占39％；b)病变进展扩大占28％；c)2周以内在吸收过程中有复发占22％；以及d)持续进展在2周以上占11％。结论：SARS患肺部病变的发展有其自身的规律性，病变首次出现时间与病程密切相关，胸部X线表现是其诊断的重要依据。     

50例SARS患者的X线分析

目的 分析总结SARS的X线表现。方法回顾性分析50例确诊为SARS患者的X线表现及其发展过程。结果 (1)SARS的X线主要表现为早期即可出现大小不一、边界模糊的片状阴影，以下肺及肺野外周多见。可单发或多发，可单侧肺受累或双侧同时受累，形态多样，变化迅速。随病情进展，单发病灶多发展为单侧多发或双侧多发病灶。空洞(1例）、结节状病灶(1例)、胸腔积液(2例)及胸膜肥厚粘连(1例)改变少见，未见有钙化灶。X线的进展睛况可分为4种：X线改变严重程度加重，出现1个高峰后，病灶逐渐改善，共32例(占64％)；X线改变波动，共9例(占18％)；X线改变较平稳，共7例(占14％)；X线表现进行性恶化，共2例(4％)。(2)50例SARS患者的肺部X线表现可初步分为三型：实质型36例(占72％)，间质型4例(占8％)，混合型10例(占20％)。(3)转归48例X线胸片有明显吸收，多在接受治疗后6～39d吸收消散(平均为15．9d)，1例治疗期间死亡，1例病危，其X线表现加重。结论 胸部X线检查可以协助临床早期发现SARS，并可了解其进展及转归，为临床诊断及治疗提供重要依据。     

SARS的胸部X线表现及动态观察

目的 研究严重急性呼吸综合征(SARS)患者胸部X线影像及变化规律。方法临床诊断为SARS者46例，每间隔2～4d摄胸片复查，分析全部胸片的影像表现和动态变化。结果 首次胸片正常但不能排除SARS，在拍摄病变初期X线胸片的30例中，4例在发病10d后才发现胸部异常。病变早期胸片表现以单发小片状阴影为主(66．7％，20／30)。动态观察病变的影像变化快，而且病程中严重程度有反复，8例患者肺内病变吸收缓慢。死亡患者肺内有多发弥漫病变及病变逐渐减轻者各3例。结论 胸部X线检查可用于SARS的早期发现及显示病程的变化。但对于早期诊断和判断预后需结合临床及实验室检查。     

SARS的临床X线分析

目的 探讨严重急性呼吸综合征(severe acute respiratory syndrome，SARS)的X线特征。方法 对29例已确诊为SARS患者的临床资料和X线表现进行总结分析。结果 本地区有SARS爆发流行。本组病例均以发热为首发症状。15例(51．7％)病人有咳嗽，多为干咳。10例(34．5％)患者入院前使用抗生素治疗无明显效果。血白细胞计数正常18例(62．1％)、降低11例(37．9％)；血小板计数轻度降低7例(24，1％)；肝功能异常16例(55．2％)，主要表现为血清酶学的改变。肺部体征轻微，与X线胸部阴影显著的表现不相符。其胸部X线表现为：肺纹理增多伴网状阴影7例(24，1％)，磨玻璃状阴影3例(10．4％)，斑片状阴影12例(41．4％)，片状阴影7例(24．1％)。X线改变出现晚、吸收慢。结论 SARS患者的X线表现各异。结合流行病学史、临床表现、实验室检查和影像学检查可明确诊断。     

SARS的胸部X线表现

目的 报道严重急性呼吸综合征(SARS)的胸部X线表现。方法 分析105例SARS的胸部X线表现及特征。所有病人均为2003年1月30日至3月31日期间诊治的病人，并符合中华人民共和国卫生部制定的《传染性非典型肺炎临床诊断标准(试行)》，在住院治疗期间有完整的胸部X线片资料。根据病变早期表现及进展情况，将其分为4型。(1)局限型：由肺内单一局部病灶到病变发展或广泛分布。(2)多发型：早期即见肺内多发片状或(和)结节状病灶。(3)间质-实质型：以肺部间质性炎症为早期主要表现，其后出现明显的肺实质渗出性病变。(4)间质型：以肺间质异常为主要表现。结果 SARS患者的胸部X线表现形式多样，75例表现为肺内渗出性实变病灶，其中局限型57例，多发型18例。25例呈间质性炎症征象，随后出现明显肺内实变。5例主要表现为肺间质性炎症。首次见肺内病变至病变完全吸收的时间为7～46d，平均为19d。结论 SARS的X线表现以肺实质渗出性病变和间质性炎症为主，病变早期发展迅速，肺内实变于首诊后7～10d达高峰，其后大部分病人可完全吸收。绝大多数病人预后良好，目前尚未见有后遗症。     

SARS的早期X线及CT表现

目的 探讨严重急性呼吸综合征(SARS)的早期X线和CT表现。方法 对28例SARS患者的早期X线和CT表现进行分析。患者在发病1—3d内行X线及CT检查。CT检查包括常规螺旋扫描和高分辨率CT(HRCT)。结果 28例中胸部CT检查均有异常所见。X线胸片发现病变者占60．7％(17／28)。影像表现可分为：(1)单发小片状病灶：占82．1％(23／28)。在CT影像上病变分为3种形态：①类圆形磨玻璃样密度病灶20例；②肺小叶形态的磨玻璃样密度病灶2例；③小片状实变影像1例。(2)多发小片状磨玻璃样病灶2例。(3)大片状影像3例。28例患者共发现31个病灶，其分布上叶7个，占22．6％；中叶3个，占9．7％；下叶21个，占67．7％。病灶最大径多为2．0～3．5cm。结论 SARS早期X线和CT主要表现为肺内单发小片状影像。CT显示病变的形态为类圆形磨玻璃样密度病灶最为多见。     

严重急性呼吸综合征胸部并发症的影像学分析

目的 分析严重急性呼吸综合征(SARS)胸部并发症在X线平片和CT上的表现，提高对SARS影像学表现的认识。资料与方法回顾分析182例SARS患者950次X线胸部平片和74次胸部CT检查结果，重点观察肺内空洞性病变、肺间质纤维化、气胸、纵隔气肿、皮下气肿和胸膜病变。结果 根据X线平片和CT所见，在182例患者中，6例(3．3％)出现空洞病变，临床诊断为霉菌感染；l0例(5．5％)出现胸水，8例(4．4％)出现纵隔气肿和皮下气肿，3例(1．6％)出现气胸。另外，在接受胸部CT检查的54例患者中，有17例(31．5％)出现不同程度的肺间质纤维化改变，6例(11．1％)出现胸膜增厚、粘连。结论 全面了解SARS患者胸部并发症的影像学征象有助于SARS的鉴别诊断和指导治疗。     

儿童SARS的胸部X线临床观察

目的　探讨儿童SARS的临床及胸部平片表现特点。方法　回顾 18例按卫生部诊断标准临床诊断为SARS儿童的接触史、主要症状 ,实验室检查结果和胸片表现 ,对照国内外文献进行分析。 18例均有接触史 ,14例为密切接触。主要临床表现为发热、咳嗽、外周血白细胞低 ,其中 5例 <5× 10 9/L ,15例淋巴细胞低。结果　主要胸片X线表现 :( 1) 13例见肺内片状及斑片状实质浸润阴影 ;( 2 ) 3例为类圆形病变 ,边界较清楚 ;( 3 ) 2例磨玻璃样改变 ;( 4 )单侧单发病变多见 ( 10例 ) ,内带较外带略多见 ;( 5)网格状及条点状改变少见 ,未见纵隔、肺门淋巴结肿大及胸腔积液 ;( 6)短时间内病灶变化不如成人快 ,但个别病例病灶呈游走性 ,吸收好转平均 19d。绝大多数病例无后遗改变。结论　儿童SARS的临床表现较成人轻 ,多数有明确接触史 ,X线表现以一侧单发实质浸润病变多见 ,可完全吸收不留后遗症。诊断时需注意与支原体肺炎、腺病毒性肺炎鉴别。     

严重急性呼吸综合征胸部X线和CT诊断

目的 探讨严重急性呼吸综合征(SARS)的X线和CT表现，以提高对本病的认识。资料与方法 回顾性分析我院收治的37例SARS病例，所有患者均摄有胸部X线片，6例行胸部CT平扫。结果 SARS胸部X线表现分为5型，其中局限型7例(19％)，局限扩散型21例(57％)，间质型2例(5％)，间质扩散型5例(14％)，结节-实变型2例(5％)。结论 X线和CT对SARS的诊断具有重要意义。     

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.