子宫输卵管造影对不孕症的诊断价值

子宫输卵管造影(hysterosalpingography,HSG)是了解子宫形态,检查输卵管是否通畅最基本的方法,在不孕症(infertility)的诊断中有重要意义,临床上广泛应用[1].现对我院2001年～2007年165例HSG病例时行分析,旨在探讨HSG对不孕症的诊断价值.     

子宫输卵管造影与子宫腹腔镜检查诊断女性不孕症的对比分析

目的探讨输卵管通液治疗仪子宫输卵管造影(HSG)对女性不孕症的诊断价值。方法 116例经临床与病理证实的女性不孕症患者均经HSG和子宫-腹腔镜(H-LSC)检查。对获自上述两种技术的资料,进行了对比性分析。结果在116例中,H-LSC发现导致不孕的各种病变111例(95.7%),其中检出率较高的几种病变是盆腔炎性粘连(n=87),输卵管炎性阻塞(n=85),子宫肌瘤(n=14),多数患者有两种或以上病变并存;HSG发现导致不孕的各种病变107例(92.2%),HSG对输卵管炎性阻塞的检出(n=106)高于H-LSC,而对盆腔炎性粘连(n=51)和子宫肌瘤(n=2)的检出低于H-LSC。本组HSG诊断女性不孕症的敏感性、特异性、准确性、阳性预测值以及阴性预测值分别为96.4%,80%,56.9%,93.9%以及69.2%。结论 H-LSC和HSG在诊断女性不孕症中各有所长,总体来说,H-LSC优于HSG,但二者不能相互取代而是应优势互补。HSG联合H-LSC检查是目前诊断女性不孕症的最佳方案。     

子宫输卵管造影在女性不孕症中的应用

目的:探讨子宫输卵管造影(HSG)对于女性不孕的诊断价值.方法:收集经临床宫腹腔镜和(或)手术病理证实的219例女性不孕患者,回顾性分析其子宫输卵管造影的X线表现.结果:219例中,宫腔疾患113例(51.60％),包括子宫发育不良及畸形者32例;宫腔粘连26例;宫腔息肉13例;子宫黏膜下及肌壁间肌瘤29例;子宫肌腺症11例;宫颈功能不全2例;输卵管疾患101例(46.12％);生殖系统结核5例(2.28％).结论:子宫输卵管造影是诊断女性不孕的重要检查方法.     

子宫输卵管造影与宫腹腔镜联合探查诊断输卵管通畅性的对比研究

目的探讨高压恒速子宫输卵管造影(hysterosalpingography,HSG)与宫腹腔镜联合检查在诊断输卵管通畅性中的意义。资料与方法回顾性分析36例不孕症患者的HSG资料。均先后行HSG和宫腹腔镜联合探查,间隔时间<1个月。依据诊断标准评价输卵管的通畅性及宫腔、盆腔异常表现。结果 36例共计71支输卵管,HSG通畅30支,阻塞41支,腹腔镜通畅35支,阻塞36支,两者结果一致56支。HSG敏感性为86.1%,特异性为71.4%,阳性似然比3.01,阴性似然比0.19,准确性为78.9%;两组诊断结果比较差异无统计学意义(χ2=0.71,P=0.302),吻合强度差异有统计学意义(k=0.577,P=0.000)。结论 HSG可有效、廉价、快速检查输卵管通畅性,可作为输卵管性不孕检查的首选筛查方法 。     

不孕症宫腹腔镜检查与子宫输卵管造影对照观察

近年来,因女性生殖系统原因导致不孕有增加趋势,而输卵管因素是女性不孕症的重要原因.子宫输卵管造影(HSG)检查是利用碘化油造影剂注入宫腔和输卵管的摄片,显示宫腔和输卵管的形态.除了解输卵管通畅外还能了解宫腔和输卵管的病变.本文通过回顾性分析48例宫腹腔镜手术不孕患者的HSG影像表现,进一步认识HSG的重要性.     

不同三维超声成像模式在宫腔粘连诊断中的应用价值比较

目的探讨经阴道三维超声(transvaginal three-dimensional ultrasonography,3D-TVS)自由解剖(OmniView)成像技术与三维渲染(Render)成像技术在宫腔粘连(IUA)诊断中的临床应用价值。方法选取2017年4月~12月本院收治的临床疑诊为IUA的146例患者,所有患者均行经阴道超声检查并利用Render成像技术及OmniView成像技术进行宫腔成像,以宫腔镜检查结果为金标准,比较两种技术诊断IUA的效率。结果146例患者Render成像技术正确诊断IUA 110例(110/128,85.9%),漏诊18例(18/128,14.1%),无IUA患者中误诊3例(3/18,16.7%)。OmniView成像技术正确诊断IUA 127例(127/128,99.2%),漏诊1例(1/128,0.78%),无IUA患者中误诊2例(2/18,11.1%)。Render成像技术、OmniView成像技术诊断IUA与宫腔镜比较一致性Kappa值分别为0.510、0.903,且计算ROC曲线下面积(AUC)分别为0.846、0.941。在对周围型及混合型IUA诊断方面Render成像技术的敏感度、特异度、阳性预测值、阴性预测值、准确性明显低于OmniView成像技术。结论OmniView成像技术检查诊断IUA具有较好的诊断符合率,且在IUA分型诊断中优于传统的Render成像技术,但在薄型子宫内膜患者IUA检出率较宫腔镜检查仍存在一定的局限性。     

功能性胰岛素瘤DSA、CT表现及与病理对照研究

目的比较功能性胰岛素瘤DSA、CT表现,并与病理对照,以提高诊断水平.材料和方法对23例功能性胰岛素瘤患者行腹部CT平扫、增强扫描和胰腺动脉DSA检查,分析CT、DSA具体表现,并与手术、穿刺病理对照.结果23例患者中手术病理诊断为良性胰岛素瘤22例,共检出肿瘤结节26个,穿刺活检病理诊断为恶性胰岛素瘤1例,肿瘤结节CT和DSA检查与病理的符合率分别为57.7%(15/26)和88.5%(23/26).选择性DSA检查主要表现为肿瘤供血动脉增粗,血管增多和肿瘤染色.结论选择性DSA检查对功能性胰岛素瘤定位诊断率高于CT,同时可提供肿瘤血供情况,对手术治疗有重要参考价值.     

直肠癌CT诊断与分期

目的:评价CT在诊断和直肠癌分期的价值。材料和方法:回顾性分析150例经手术病理证实的直肠癌的CT表现,评价其CT诊断和分期的价值。结果:直肠癌CT的主要表现包括肠壁增厚50例、软组织肿块61例和肠腔狭窄49例;与手术病理对照,CT显示病灶、周围组织侵犯和淋巴结转移的准确性分别为96.7%(145/150)、88.4%(84/95)和51.7%(15/29);CT分期与Dukes分期的总符合率为83.3%。结论:直肠癌的CT诊断和分期与手术病理分期有很好的一致性,CT是直肠癌术前诊断的重要影像检查方法。     

不同宫腔粘连评分标准对宫腔粘连疾病预后的预测作用分析

目的 探讨不同评分标准对宫腔粘连(IUA)手术预后的预测作用.方法 纳入2010年1月-2017年1月南方医科大学珠江医院诊断并治疗的IUA患者,选取其中随访2年的患者100例作为研究对象,分别采用March分类、AFS评分、ESGE评级和中国评分对其进行分级评估,进而比较不同评分标准对IUA术后2年内妊娠率、活产率及有效率的预测作用.结果 ESGE评级对IUA术后活产率和有效率有较好的预测作用,对妊娠率有一定的预测作用,其曲线下面积(AUC)分别为0.722、0.754、0.635;March分类对术后活产率、有效率有一定的预测作用,AUC分别为0.652、0.725,对妊娠率的预测效能不佳;AFS评分、中国分级评分对IUA预后的预测效能不佳.结论 在预测IUA预后方面,ESGE评分优于March分类、AFS评分、中国评分,但仍需大样本研究进一步验证.     

子宫输卵管造影与腹腔镜输卵管检查输卵管性不孕症的临床分析

目的探讨子宫输卵管造影(hysterosaipingography,HSG)与腹腔镜输卵管检查在诊断输卵管性不孕症中的效果。方法对68例输卵管性不孕症患者(136条输卵管)进行子宫输卵管造影与腹腔镜输卵管检查,将两种方法对输卵管通畅性的检查结果进行对比分析。结果腹腔镜下美蓝通染液试验(CLP)结果显示本组68例患者的136条输卵管中输卵管通畅84条,输卵管通而不畅26条,输卵管阻塞26条。以CLP检查结果作为对照进行对比分析发现输卵管造影在输卵管通畅性检查结果方面与CLP比较无明显差异。输卵管造影与腹腔镜输卵管在判断输卵管梗阻部位比较中差异无统计学意义(X~2=0.48,P0.05)。结论 HSG操作便捷、费用低廉,能较好的反映子宫输卵管全貌及梗阻部位,可以作为输卵管性不孕症检查的初筛;腹腔镜检查是诊断输卵管通畅性的"金标准",两者联合是诊断输卵管性不孕症的最佳方法。     

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.