经皮穿刺125I粒子植入治疗胃肠道来源肺转移瘤的短期疗效观察

目的评价胃肠道来源肺转移瘤CT导向下125I粒子植入治疗的短期疗效。方法20例胃肠道来源肺转移瘤患者,肺内病灶5个以下,总计病灶数56个,平均每例2.8个病灶,病灶平均直径2.1cm(0.5～3cm)。其中单肺转移13例,双肺7例。原发病灶均有病理诊断,肺转移均经CT或MRI检查后临床诊断。利用计算机三维立体定向治疗计划系统(TPS)计算布源,在CT引导下将125I粒子植入肺转移病灶内。观察治疗后2个月病灶变化。结果20例56个病灶,完全缓解(CR)32个;部分缓解(PR)19个;无变化(NC)5个。总有效率91.1%。2个月内无死亡病例。发生气胸2例,咯血痰2例,胸腔出血1例,均经对症治疗后好转。结论胃肠道来源肺转移瘤,肺内病灶5个以下,最大直径不超过3cm,CT导向下125I粒子植入治疗,创伤小,并发症发生率低,近期效果好。     

CT导引下植入^125I粒子治疗肺部恶性肿瘤

目的:评价CT导引下植入125I粒子治疗肺部恶性肿瘤的短期疗效.材料和方法:54例肺部恶性肿瘤,男38例,女16例.年龄33～80岁,中位年龄62.3岁.中心型肺癌17例(17个病灶)、周围型肺癌23例(23个病灶)和肺转移瘤14例(24个病灶).64个病灶均采用放射性粒子治疗计划系统(TPS)根据肿瘤的大小计算粒子布源,行CT导引下经皮植入125I粒子.术后1～12个月行CT复查.根据国际标准判定疗效.结果:植入125I术后1～2个月全部54例64个病灶中,有效率90.6%.6个月49例58个病灶中,有效率91.4%.12个月15例21个病灶中,有效率85.7%.术中及术后出现气胸9例,经保守观察或常规治疗痊愈;术后复查发现粒子移位3例,无不良反应.结论:CT导引下125I粒子植入近距离放射治疗肺部恶性肿瘤疗效较好.     

CT导引下125I粒子植入治疗外照射后复发的恶性肿瘤

目的 评价外照射后复发的恶性肿瘤行CT导引下瘤体内^125I粒子植入治疗的可行性、安全性及疗效。资料与方法 2001年12月至2004年12月,14例外照射后局部复发的恶性肿瘤行CT导引下瘤体内^125I粒子植入,其中原发肿瘤8例,转移瘤6例（11个病灶）,病灶的平均直径为3．25cm。依据粒子植入术前CT图像应用计算机治疗计划系统制定粒子植入计划,按治疗计划在CT导引下穿刺植入^125I粒子。植入^125I粒子数为9．48粒（中位数为28粒）。植入术后立即CT扫描及术后2～6个月CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效。结果 14例粒子植入均顺利完成,瘤体内粒子分布满意,其中1例植入术后有2粒粒子脱落到体外,未见急性并发症和治疗相关的放射损伤。4例疼痛患者粒子植入术后疼痛均有明显减轻。14例19个病灶粒子植入后完全缓解（CR）5个,部分缓解（PR）9个,无变化（NC）4个,进展（PD）1个,近期总有效率73．7％。结论 对于外照射后复发的恶性肿瘤CT导引下瘤体内^125I粒子植入近距离放射治疗是一种安全、可行的治疗方法,近期肿瘤局部控制率满意,远期疗效有待大组病例进一步观察。     

125I放射性粒子植入联合栓塞化疗治疗肾上腺转移瘤临床应用

目的 探讨CT导引下经皮穿刺植入125I放射性粒子联合介入栓塞化疗治疗肾上腺转移瘤的方法及疗效.方法 对12例肾上腺转移瘤患者,应用介入栓塞化疗,2周后复查CT,采用治疗计划系统(TPS)计算剂量和布粒计划,CT定位下行病灶内125I放射性粒子植入术.植入结束后,再次进行CT扫描观察粒子分布情况及有无并发症,评价粒子分布情况.术后2～6个月定期CT随访.结果 术后2、4、6个月随访,12例有效率分别为58.33 %、81.82 %、80.00 %.结论 CT引导下经皮穿刺125I粒子植入联合介入栓塞化疗治疗肾上腺转移瘤安全,损伤小,并发症轻,近期疗效确切,值得推广和应用.     

CT导引125I粒子植入治疗肝门部胆管癌支架置入后的应用

目的 探讨CT导引经皮穿刺植入125I粒子治疗肝门部胆管癌支架置入术后的可行性、有效性及并发症.方法 17例肝门部胆管癌患者在胆管内支架置入缓解黄疸后,在CT引导下将125I粒子植入胆管癌病灶内.125I粒子活度2.59×107 Bq(0.7mCi),PD110Gy.术前通过放射性粒子治疗计划系统TPS(treatment planning system)布源,在CT导引下采取粒子间隔0.5～1.0cm,后退式平面植入.术后分别于3个月、6个月和12个月观察病人的客观疗效、胆管内支架通畅情况及手术并发症.结果 所有患者未出现严重并发症.17例患者术后3月,CR1例(5.9％),PR11例(64.7％),NC3例(17.6％),PD2例(11.8％).粒子植入术后3个月时未出现再梗阻;12个月存活的患者(10例)1例出现再梗阻.6个月和12个月生存率分别为82.3％和58.9％,中位生存时间为12个月.结论 CT导引经皮穿刺植入125I粒子治疗支架植入术后的肝门部胆管癌疗效确切,明显减少胆管内支架再梗阻的几率,且无明显副作用,值得进一步探讨.     

CT导向下125 I粒子植入治疗肺转移瘤

目的　评价CT导向下12 5I粒子植入治疗肺转移瘤的临床价值。方法　 18例肺转移瘤患者 ,男 10例 ,女 8例 ,年龄 35～ 73岁 ,中位年龄 5 6 2岁 ,其中肝癌肺转移 10例 ,直肠癌肺转移 6例 ,乳腺癌肺转移 2例。 18例病灶数为 6 8个 ,平均每人 3 8个病灶 ,病灶平均直径为 2 5cm。在CT导向下将12 5I粒子植入肺转移瘤灶内 ,采用治疗计划系统 (TPS)计算布源 ;对残留厚度≤ 1 0cm的肿瘤选择平面植入方法 ,采用 18 5～ 2 9 6MBq活度的12 5I粒子相隔 1 0～ 1 5cm平面播植 ,12 5I在 1 7cm内具有杀灭肿瘤的作用。结果　 18例 6 8个病灶 ,完全缓解 (CR) 36个 ;部分缓解 (PR) 17个 ;无变化 (NC) 10个 ;进展 (PD) 5个。总有效率 77 9%。术中肺内有少量渗出 ;2例出现气胸 ,肺压缩均在 30 %以内 ,经保守治疗好转 ;术后 1周痰中带血 15例。 2个月随访过程中发生粒子移位 2例 (肺内 ) ;白细胞下降 2例 ,程度较轻 ,计数均在 3× 10 9/L以上。未见其他严重并发症。结论　放射性粒子植入治疗肺部转移瘤临床疗效好 ,创伤小 ,并发症发生率低     

CT引导下放射性125I粒子植入治疗肾上腺转移瘤的近期疗效观察

目的 评价CT引导下放射性125I粒子植入治疗肾上腺转移瘤的近期疗效及安全性.方法 对2014年8月至2015年4月收治的18例肾上腺转移瘤行CT引导下放射性125I粒子植入治疗的患者进行回顾性分析,术前明确诊断,可评价病灶19处,病灶最大径为4～7 cm,平均(5.55±0.79) cm.应用治疗计划系统(TPS)三维粒子植入制定治疗计划,在CT引导下植入放射性125I粒子,于治疗后6～8周随访观察客观缓解率,按照WHO实体肿瘤评价标准评价病灶.结果 术后6～8周随访,评价病灶完全缓解(CR)5/19,部分缓解(PR)11/19,疾病稳定(SD)3/19,疾病进展(PD)O/19.所有患者术中、术后均未出现严重并发症,如恶性高血压、大出血,肾脏、肺、胰腺等周围脏器损伤等.结论 CT引导下放射性12I粒子植入治疗肾上腺转移瘤是一种安全有效的介入微创治疗手段.     

CT导引下125 I粒子植入在治疗恶性肿瘤中的应用

目的　评价CT导引下瘤体内12 5I粒子植入治疗恶性肿瘤的可行性、安全性及其疗效。方法　 10例 13个病灶行CT导引下瘤体内12 5I粒子植入 ,其中原发肿瘤 4例 ,转移瘤 6例 (9个病灶 )。患者男 4例 ,女 6例 ,年龄 5 4～ 6 2岁 (平均 5 6 .9岁 )。依据粒子植入术前 15d内CT图像应用计算机治疗计划系统制定粒子植入计划 ,按治疗计划在CT导引下穿刺植入12 5I粒子。植入术后立即CT扫描及术后 5～ 10个月CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效。结果　 10例粒子植入均顺利完成 ,粒子分布满意 ,单个瘤体内植入12 5I粒子数为 1～ 4 4粒 (平均 18.6粒 )。未见急性并发症和治疗相关的放射损伤。全部 4例疼痛患者粒子植入术后疼痛均有明显减轻。随诊CT检查示 3个病灶消失 ,8个病灶明显缩小 ,其余 2个病灶大小无明显变化。植入术前及植入术后随诊显示病灶平均大小分别为 3.15和 2 .0 6cm(t =5 .12 7,P <0 .0 0 1)。结论　CT导引下12 5I粒子植入近距离放射治疗对原发及转移性恶性肿瘤是 1种安全、可行、有效的治疗方法在恶性肿瘤的治疗中外照射起着重要作用 ,但由于外照射放疗的准确性较差 ,对周围正常组织损伤明显 ,效果常常不太理想。病灶内放射性粒子植入近距离治疗恶性肿瘤是 1种新的放疗手段 ,其可根     

CT引导下125I粒子植入近距离治疗骨转移瘤(附24例报告)

目的:探讨CT引导下125I粒子植入对骨转移瘤进行近距离放疗的可行性、安全性及其疗效.方法:24例骨转移瘤患者(26个病灶),术前依据CT图像应用计算机治疗计划系统制定粒子植入计划,按治疗计划在CT引导下穿刺植入125I粒子,粒子植入数量6～40颗(中位数16颗).植入术后立即CT扫描及2～8个月CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效.结果:24例患者均成功植入,未见并发症和治疗相关的放射损伤.24h内100%疼痛完全减轻;随诊CT检查示24例的26个病灶中粒子植入后2个病灶消失,18个病灶明显缩小,4个病灶大小无明显变化,只有2个病灶增大.植入术前及植入术后随诊显示病灶平均直径分别为4.39cm和3.14cm(P=0.0059,P＜0.05).结论:CT引导下经皮穿刺125I粒子植入近距离放射治疗骨转移瘤具有微创、安全、高效等优点,可作为骨转移瘤的治疗方法.     

125Ⅰ粒子组织间植入治疗肺恶性肿瘤

目的 评价CT导向下125Ⅰ粒子植入治疗肺恶性肿瘤的临床价值.方法 32例肺恶性肿瘤患者,其中18例为肺癌,共20个病灶;14例为肺转移瘤(原发病9例为肝癌,4例为肠癌,1例为乳腺癌),共28个病灶.病灶平均直径为5.5 cm.采用治疗计划系统(TPS)计算布源,在CT导向下将125Ⅰ粒子植入瘤灶内.结果 32例共48个病灶,完全缓解(CR)25个;部分缓解(PR)15个;无变化(NC)7个;进展(PD)1个,总有效率83.3%.术中肺内有少量渗出;2例出现气胸,肺压缩均在30%以内,经保守治疗好转;术后1周痰中带血15例;术后2周2例出现轻度白细胞下降,白细胞计数(3～4)×109/L;术后2个月的影像学检查发现肺内粒子游走2例;未见其他严重并发症.结论 放射性粒子植入治疗肺恶性肿瘤,近期效果好,是治疗肺恶性肿瘤的简便、安全、有效的方法.     

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.     

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.     

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).     

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.