肝动脉化疗栓塞治疗原发性肝癌合并门静脉癌栓疗效分析

目的：探讨肝动脉化疗栓塞术治疗原发性肝癌合并门静脉癌栓的疗效。方法：癌栓组为无手术指征的原发性肝癌合并门静脉癌栓患者50例，对照组为原发性肝癌42例，两组患者均行肝动脉化疗栓塞术（TACE）治疗，观察两组患者的疗效、生存率和并发症。结果：对照组和癌栓组近期总有效率分别为50．0％（21／42）和42．0％（21／50），组间比较无显著差异；癌栓组门静脉癌栓消失或缩小〉25％者为44％（22／50），两组治疗后肝癌二期手术切除率分别为38．1％（16／42）和30％（15／50），无显著差异；对照组0．5、1、2年生存率分别为71．4％（30／42）、47．6％（20／42）、31．0％（13／42），中位生存期为15．6个月；癌栓组分别为64．0％（32／50）、40．0%（20／50）、24．0％（12／50），中位生存期为14．2个月，组间差异不显著；两组患者术后并发症发生率无显著差异。结论：肝动脉化疗栓塞术治疗原发性肝癌合并门静脉癌栓具有较好疗效。     

肝动脉化疗、栓塞治疗原发性肝癌的临床研究（附188例分析）

目的：研究原发性肝癌肝动脉化疗、栓塞的疗效及其影响因素。材料与方法：回顾性分析１８８例肝癌肝动脉化疗、栓塞的临床随访资料。结果：总疗效为症状缓解占５９．６％，肿瘤缩小占５５％，ＡＦＰ下降占３７．８％，半年及１、２、３年生存率分别为７５．４％、４６％、２３．５％、１４．７％，平均生存期１２．２月，最长已存活５０月，获二步手术切除１８例，对比分析了７个影响疗效的有关因素。结论：无或轻度肝硬化、早中期、单个肿瘤、直径＜１０ｃｍ、无门脉癌栓或肝动－静脉瘘、行栓塞治疗、治疗次数在３次以上者，其中远期疗效明显优于对应组。克服有关影响因素及综合治疗将会进一步提高肝癌化疗栓塞的疗效     

射频多弹头治疗肝癌的疗效观察

肝癌是我国常见的恶性肿瘤 ,病情进展快 ,预后较差 ,平均生存期仅 3～ 4个月 ,目前治疗肝癌主要方法仍是肿瘤切除 ,但中晚期肝癌往往手术无法切除 ,采用全身化疗、介入、栓塞等方法 ,效果不佳。近年来国内外应用射频技术治疗肝癌 ,造成癌组织坏死 ,被认为是一种安全、有效的方法。我院自 1 999年5月采用用射频多弹头 ( RF)行肝癌原位灭活治疗中晚期肝癌 68例 ,其癌肿直径均大于 5 cm,下面仅就其治疗效果报道如下。1　临床资料1 999年 5月至 2 0 0 2年 3月 ,68例肝癌病人接受射频原位灭活治疗 ,其中男 5 6例 ,女 1 2例。年龄1 3～ 83岁 ,平…     

肝癌合并门脉癌栓的化疗栓塞治疗

１２８例肝癌合并门脉癌栓病人经２次以上插管治疗，Ａ组肝动脉内灌注化疗药物，Ｂ组药物灌注加碘油栓塞，Ｃ组化疗加碘油及明胶海绵粒栓塞。三组１年生存率分别为２５．００％，２８．５２％，４１．７６％，平均生存７．２个月、８．４个月及１０．３个月。Ｃ组疗效最好，１例病人存活达７年，说明、门脉癌栓不应是肝动脉化疗栓塞的禁忌证，对没有严重肝硬化及肝功能损害的门脉癌栓病人均应进行化疗栓塞治疗。     

经肝动脉化疗栓塞治疗原发性肝癌肝静脉与下腔静脉癌栓的疗效观察

目的 研究经肝动脉化疗栓塞(THAE)对原发性肝癌肝静脉及下腔静脉癌栓的治疗作用.方法 对28例影像学检查发现肝静脉下腔静脉癌栓的原发性肝癌患者,行肝动脉血管造影和THAE治疗.结果 25例癌栓血管造影呈条纹征,THAE治疗后平均生存期不足半年.3例癌栓呈结节条状肿瘤染色,其中2例显示瘤栓供血动脉血管,THAE治疗后主瘤灶缩小、癌栓消退,2例二期手术切除,已分别存活151月、30月,1例已带瘤生存50月,3例现生活工作正常.结论 THAE对原发性肝癌患者肝静脉及下腔静脉癌栓呈结节条状者的治疗具有非常积极的作用.     

伴门静脉癌栓肝癌的不同靶区适形放疗临床分析

目的比较原发性肝癌伴门静脉癌栓不同肿瘤靶区三维适形放射治疗联合介入的临床疗效。方法30例原发性肝癌伴门静脉癌栓患者，采用三维适形放射治疗联合肝动脉化疗栓塞（TACE）进行治疗，根据肿瘤靶区分为2组：肿瘤靶区包括肝内原发肿瘤＋静脉癌栓者为A组（15例），肿瘤靶区只包括静脉癌栓而不包括肝原发灶者为B组（15例）。2组病例均于TACE 1～2次后开始放疗。结果A、B两组治疗有效率分别为33．3％和53．3％，1、2年生存率分别为26．7％、6．7％和40．0％、13．3％，两组差异均无统计学意义（P〉0．05）。A组放射反应发生率明显高于B组（P〈0．05）。结论对于晚期肝癌伴门静脉癌栓，特别是肝内多发或大病灶、肝功能差的患者，在联合TACE有效治疗下，对静脉癌栓的局部放射治疗仍能取得较好疗效。     

原发性肝癌合并下腔静脉及右心房癌栓的动脉内化疗栓塞治疗

目的 评价肝动脉化疗栓塞(TACE)治疗原发性肝癌合并下腔静脉及右心房癌栓的可行性.方法 回顾性分析经肝动脉化疗栓塞治疗16例原发性肝癌合并下腔静脉及右心房癌栓的患者.在行氟尿嘧啶、丝裂霉素、吡柔比星动脉灌注化疗后用与吡柔比星、碘油和PVA颗粒(直径300 μm)混合物进行肿瘤供血动脉栓塞治疗.结果 癌栓治疗有效患者11例(占68.7％,11/16),其中位生存期为13.5个月(7.5～26个月).整组的中位生存期为12个月(范围2.6 ～ 26个月).5例癌栓无反应组(癌栓对治疗无反应)的中生存期为3.3个月(2.6～ 12.5个月)(P＜0.01).所有患者无严重栓塞后并发症发生.结论 肝动脉化疗栓塞治疗原发性肝癌合并下腔静脉及右心房癌栓是安全,有效的方法.     

中晚期肝癌根治术后介入放射学治疗的临床研究

报告153例中晚期肝癌根治术后行肝动脉内化疗栓塞的结果。所有患者于根治术后45～90天行介入治疗,两组共计治疗497次,其中单纯肝动脉内化疗灌注399次,化疗栓塞98次,平均每例行3.65次,最多12次。本组资料1、2、3年复发率为20.3％,44.4％,和55.6％,低于文献报告。其生存率1、2、3年分别为70.6％,60.8％,55.6％。本研究表明:外科切除十预防性肝动脉内化疗栓塞,可提高中晚期肝癌的生存率和降低术后复发率,是一种有效可取的术后治疗方法。     

部分脾栓塞在肝癌伴脾亢介入治疗中的应用

目的：对原发性肝癌伴腺功能亢进（脾亢）患者行部分脾栓塞，使其血细胞恢复正常，以便能进一步行肝动脉化疗。方法：对46例不能行手术切除，且血细胞明显低于正常的肝癌伴脾亢的患者行部分脾栓塞，栓塞面积控制在50％－70％，栓塞前后测定血细胞数量，并作方差分析和t检验。结果：脾栓术后24h、48h、72h、1周、2周、4周的血白细胞和血小板均较栓塞前明显升高（P＜0．05或P＜0．01）。结论：部分脾栓塞能治疗脾功能亢进，提高血细胞数量，使肝癌伴脾亢患者的肝动脉化疗能正常进行。     

肾癌伴腔静脉癌栓的介入治疗

目的探讨肾癌尤其是伴有腔静脉癌栓的肾癌患经肾动脉栓塞及经下腔静脉溶栓化疗的意义。方法16例肾癌患全部行肾动脉造影,16例中4例为术前栓塞,12例为治疗性栓塞,其中5例伴下腔静脉癌栓的患除肾动脉栓塞外同时行腔静脉内溶栓化疗。结果下腔静脉造影清晰显示腔静脉内癌栓形成,7例单纯肾动脉姑息性化疗栓塞患术后主要症状均得以改善,生存1年以上占71．4％。5例患行经肾动脉化疗栓塞术及经下腔静脉溶栓化疗。术后1月复查症状无复发。5例中生存6个月以内2例(40．0％),7～13个月3例(60．0％)。结论下腔静脉造影对肾癌腔静脉内癌栓患诊断敏感,肾动脉化疗栓塞并腔静脉溶栓化疗是此类患重要的姑息治疗手段。其长期临床效果有待进一步观察。     

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）