急性DVT股静脉取栓治疗32例

目的总结急性期单侧下肢深静脉血栓形成股静脉取栓的治疗效果及应用Aegisy可回收下腔静脉滤器预防肺动脉栓塞的效果。方法选择32例急性期单侧下肢深静脉血栓形成患者,通过放置Aegisy可回收下腔静脉滤器后,行股静脉切开取栓,于术后12～16d取出滤器。术后维持抗凝治疗1年。结果32例患者滤器成功置入,股静脉取栓顺利;术后30例成功取出滤器,取出滤器中有20例捕捉到血栓。全组治疗过程中无肺动脉栓塞发生,肢体肿胀明显缓解;随访1—8个月,彩色多普勒超声检查未见下肢深静脉血栓复发。结论股静脉取栓是治疗急性期下肢深静脉血栓形成的有效手段,术中放置可回收下腔静脉滤器能有效预防肺动脉栓塞发生,滤器的置入和取出安全、可行。     

Aegisy可回收腔静脉滤器的临床应用与观察

目的探讨hegisy可回收腔静脉滤器预防肺动脉栓塞的临床应用价值。方法对32例急性或亚急性下肢深静脉血栓形成（deep vein thrombosis,DVT）和（或）肺动脉栓塞（pulmonary embolism,PrO的患者经健侧股静脉置入滤器,经用药物或手术治疗,观察有无肺动脉栓塞症状及有无肺动脉栓塞症状加重情况,滤器有无形态及位置变化。结果下腔静脉滤器置入全部成功,下肢深静脉血栓形成患者治疗后效果良好,无症状性肺动脉栓塞发生,置入滤器平均（14．0±2．0）天,取出可回收滤器捕捉血栓24例,占75％。结论可回收下腔静脉滤器预防肺动脉栓塞的疗效确切,具有较高的临床应用价值。     

Günther Tulip可回收式腔静脉滤器在急性下肢深静脉血栓形成介入治疗中的作用

目的 探讨G(u)nther Tulip可同收式腔静脉滤器在下肢深静脉血栓形成介入治疗中的应用效果及操作技术.方法 2007年9月至2008年4月于我院就治的急性下肢深静脉血栓形成患者36例,发病时间1～12 h,发病诱因包括术后及骨折后卧床18例、产后5例、无明显诱因13例;合并肺动脉栓塞12例.症状表现为患肢肿胀(患肢大腿周径比健侧大3～10 cm)、疼痛、皮肤晕青紫色或苍白,皮温升高或正常,合并肺动脉栓塞者表现为呼吸困难、胸痛、咯血等.分别经股静脉或经右颈内静脉置入G(u)nther Tulip可回收式腔静脉滤器后,均行静脉内置管溶栓治疗.术后45～75 d经血管超声及血管造影复查证实下肢静脉及肺动脉内无新鲜或游离血栓后,经右颈内静脉入路行G(u)nther Tulip腔静脉滤器取出术,复查下腔静脉造影.术后给予抗凝、抗炎治疗3～5d.随访4～10个月.结果 共置入G(u)nther Tulip可回收式腔静脉滤器36枚,均一次性释放成功,释放过程平均耗时1.5 min(0.5～5 min),释放过程中滤器弹跳幅度小于2 mm,1例滤器置入时倾斜25°,滤器置入后未出现新发生肺动脉栓塞的临床表现.12例患者于术后45～75d行G(u)nther Tulip腔静脉滤器取出术,均一次性回收成功,同收过程耗时4.4 min(2～15 min),下腔静脉造影复查未见管壁穿孔及破裂征象.其余24例患者未行滤器取出术,随访期间未出现肺动脉栓塞及下腔静脉闭塞的临床表现.结论 G(u)nther Tulip可回收式腔静脉滤器具有释放定位准确、捕获血栓能力较高、可取出时间期限长(溶栓治疗时间窗长)、回收成功率高等优点,在下肢深静脉血栓介入治疗中的临床效果良好,技术操作成功率较高.     

自制可回收下腔静脉滤器预防急性肺栓塞的实验研究

目的 探讨一种新型可回收下腔静脉滤器预防急性肺栓塞的有效性、安全性.方法 12只犬制备成髂股深静脉血栓模型,分为滤器组(实验组)与无滤器组(对照组),每组6只.滤器组在深静脉血栓脱落前于对侧股静脉置入下腔静脉滤器,其后使血栓脱落;对照组直接使血栓脱落即形成肺动脉栓塞.通过血栓脱落前后的肺动脉造影、肺动脉测压以及动脉血氧饱和度测定评价滤器的血栓捕获性能.结果 滤器组均成功捕获脱落的深静脉血栓,无一例发生肺动脉栓塞,8 h后滤器均能成功回收;而对照组在推注血栓后均发生了肺动脉栓塞.结论 自制可回收下腔静脉滤器能有效预防下肢深静脉急性血栓脱落引起的肺动脉栓塞,其置入和回收简便.     

经皮穿刺下腔静脉滤器置入术

目的 评价下腔静脉滤器预防肺动脉血栓栓塞的作用。方法 ２８例下肢深静脉血栓形成患者实施了经皮穿刺下腔静脉小 置入术,２６例置入岛巢式滤器,２例置入Ｓｉｍｏｎ Ｎｉｔｉｎｏｌ滤器。结果 滤器全部置入肾静脉下方的下腔静脉内。２７例随访２￣３４个月,滤器无移位,１５例不伴有肺动脉血栓栓塞者无肺栓塞发生。结论下腔静脉滤器用于预防肺动脉血栓栓寒是一种安全有效的方法。     

下腔静脉可回收滤器置入预防肺栓塞

目的:评价可回收下腔静脉滤器在下肢深静脉血栓患者中预防肺栓塞效果和安全性。方法:34例下肢深静脉血栓患者全部行下腔静脉滤器置入术,其中12例采用永久性Trap Ease Filter(TEF),16例采用可回收性OptEaseTMFilter(TEF),6例采用可回收性Gunther Tulip Filter(GTF)滤器,滤器均置于肾静脉水平以下的下腔静脉中。结果:34例滤器均经股静脉穿刺置入,16例可回收性OptEaseTMFilter中12例2周后经股静脉取出。6例可回收性Gunther Tulip Filter(GTF)滤器两周后经右颈内静脉取出。手术成功率100%。随访30例(随访时间:2~28个月),12例永久滤器病人中有1例出现倾斜,但角度小于15℃,1例下腔静脉血栓形成,术中术后未出现滤器移位,穿破管壁和肺栓塞。结论:可回收性下腔静脉滤器是预防肺栓塞安全、有效的方法之一,且并发症少。     

下腔静脉滤器预防肺栓塞的临床应用

目的：评价置入下腔静脉滤器预防因下肢静脉血栓脱落引起肺栓塞的效果和安全性。材料与方法：１６例下肢深静脉血栓患者置入钛质Ｇｒｅｎｆｉｅｌｄｆｉｌｔｅｒ（ＴＫＧ）１２例,Ｂｉｒｄ’ｓｎｅｓｔｆｉｌｔｅｒ（ＢＮＦ）４例。滤器位于双肾静脉水平以下的腔静脉内。术后分别于１、６、１２个月摄腹部平片复查,观察滤器的位置、形态变化。结果：全部滤器经股静脉穿刺置入,经右股静脉１３例,左股静脉３例,无严重并发症发生。随访发现ＴＫＧ２例向足侧移位,１例向头侧移位,１例跨度增大,腹部ＣＴ,腔静脉造影发现滤器的１只脚穿透腔静脉壁,未出现任何症状;２例发生滤器偏斜,角度小于１５°。ＢＮＦ未见位置改变。无１例发生腔静脉阻塞或复发肺栓塞。结论：置入下腔静脉滤器预防肺栓塞是安全、有效的方法。     

下腔静脉滤器预防肺栓塞及其并发症

目的 探讨下腔静脉滤器置入术(IVCF)预防肺动脉栓塞(PE)的疗效、相关并发症及处理.方法70例下肢深静脉血栓患者,溶(取)栓术前均行下腔静脉滤器置入术:永久性Trap Ease滤器(TEF)20枚,永久性Vena Tech滤器(VTF)31枚,可回收性OptEase~(TM)滤器(OEF)13枚,临时性TempoⅡ滤器8枚;71枚位置在肾静脉开口下方,1枚位置在肾静脉开口上方.结果 术后随访8～72个月.70例中,无一例出现PE,6例出现相关的并发症.结论 下腔静脉滤器置入可以有效预防肺梗死,但应严格掌握适应证.     

腔静脉滤器置入术预防肺动脉栓塞

目的 评价腔静脉滤器置入术预防肺动脉栓塞的临床效果。方法 对13例深静脉血栓溶栓过程中应用腔静脉滤器置入预防肺动脉栓塞的临床结果进行分析。结果 全部13例患者,上腔1例,下腔12例,其中肾静脉开口上方1例,肾静脉开口下方11例,均成功进行了腔静脉滤器置入术,随访6～16个月,无肺梗塞发生,亦无滤器移位、出血等相关并发症。结论 腔静脉滤器置入是预防肺动脉栓塞的有效方法。     

下腔静脉滤器置入后大剂量尿激酶溶栓治疗下肢深静脉血栓形成

目的　探讨下腔静脉滤器置入后大剂量尿激酶溶栓治疗下肢深静脉血栓形成的可行性。方法　 1 3例经造影证实为左下肢深静脉血栓患者 ,先于下腔静脉内放置滤器 ,后在监护下经患者足背静脉加压推注尿激酶进行持续溶栓治疗 ,尿激酶 (UK)用量 90 0万U～ 1 60 0万U。疗效判断标准 :痊愈 :患者无症状 ,下肢造影示深静脉通畅 ;显效 :患者症状明显缓解 ,下肢造影示深静脉回流畅 ,但壁不光滑 ,血管内径 >70 % ;有效 :症状有所缓解 ,造影示血栓残留 ,血管内径 <70 % ;无效 :症状及下肢造影均无改善。结果　 1 3只下腔静脉滤器均展开良好 ,无移位。其中 :痊愈 2例 ,显效 9例 ,有效 2例 ,无效 0例 ,溶栓过程中未出现肺动脉栓塞症状及出血现象。结论　下腔静脉滤器置入后经患肢浅静脉大剂量尿激酶溶栓治疗下肢深静脉血栓形成是安全、有效的     

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.