肝癌Lp—TAE后并发柏查氏综合征（附4例报告）

本文介绍了肝癌碘油化疗药物肝动脉栓塞术（Ｌｐ—ＴＡＥ）后一少见而又危险的并发症—柏查氏综合征。认为此症的发生主要是肝癌对下腔静脉（ＩＶＣ）的侵犯、压迫和推移导致ＩＶＣ内血栓闭塞。确诊有赖于在肝癌患者Ｌｐ—ＴＡＥ后出现迅速加重的下半身水肿、肝大、腹水和少尿时行ＩＶＣ造影。经导管ＩＶＣ尿激酶灌注血栓溶解术是治疗此并发症的有效方法。     

Cox模型对肝癌预后因素的分析

目的：作者旨在分析原发性肝癌的预后因素，评估不同治疗方法的疗效。材料与方法：应用Ｃｏｘ比例风险模型对经介入治疗的６２１例晚期原发性肝癌进行了回顾性统计分析。根据不同的治疗方法，分为３组：Ａ组，６８例，为单纯动脉内抗癌药物灌注（ＴＡＩ）；Ｂ组，１６８例，碘化油与抗癌药混合化疗栓塞（ＬｐＴＡＣＥ）；Ｃ组，３８５例，ＬｐＴＡＣＥ再加明胶海绵栓塞（ＬｐＧｓＴＡＣＥ）。对三组的生存率作了分析比较。结果：影响肝癌预后最明显的因素是肿瘤大小、门脉内癌栓和治疗方法。６２１例总的生存率１、３、５年分别为６２．２３％、１２．８５％和７．４５％，中位生存期为１６．２３个月。结论：含药碘油和明胶海绵复合性化疗栓塞（ＬｐＧｓＴＡＣＥ）的疗效较ＬｐＴＡＣＥ或单纯ＴＡＩ为好。了解肝癌的预后因素对选择与处理病人是有益的。     

肝癌介入治疗中的完全性充填法

肝癌介入治疗中的完全性充填法罗鹏飞陈晓明经肝动脉碘油化疗栓塞术（Ｌｐ－ＴＡＥ）是目前治疗中晚期肝癌的重要方法，已经收到较好的治疗效果。随着本方法的逐步推广，临床实践中除需完善规范化操作程序以减少并发症外，一个重要的方面是如何提高Ｌｐ－ＴＡＥ的疗效。为...     

暂时阻断肝静脉后行肝动脉化疗栓塞术治疗肝癌的药代动力学研究

目的对照单纯经肝动脉化疗栓塞术（ＴＡＣＥ），研究暂时阻断肝静脉后行肝动脉化疗栓塞术（ＴＡＣＥＴＨＶＯ）治疗原发性肝癌的药代动力学变化。方法为了进行药代动力学研究，随机将病人分为两组，ＴＡＣＥ组和ＴＡＣＥＴＨＶＯ组。采用高效液相色谱仪测定肝静脉和外周静脉血中５氟尿嘧啶（５Ｆｕ）的血药浓度，进行药代动力学分析。结果肝静脉和外周静脉血中５Ｆｕ的曲线下面积比值，ＴＡＣＥＴＨＶＯ组明显大于ＴＡＣＥ组；肝静脉血中５Ｆｕ的峰浓度，ＴＡＣＥＴＨＶＯ组明显高于ＴＡＣＥ组。同组中肝静脉和外周静脉的５Ｆｕ浓度趋向一致时间，ＴＡＣＥＴＨＶＯ组３０分钟，ＴＡＣＥ组为６分钟。结论暂时阻断肝静脉后行肝动脉化疗栓塞术可明显提高肿瘤局部的药物浓度，延长作用时间，加倍提高了抗肿瘤的效果，该法在临床上有很好的应用价值     

不能切除的肝癌动脉内治疗：方法选择和疗效分析

随访了２１３例不能切除的原发性肝癌动脉内治疗的病例。采用以下三种方式：（１）化疗药物灌注（ＨＡＩ组）；（２）碘油抗癌药乳剂栓塞（Ｌｐ－ＴＡＥ组）；（３）碘油乳剂加明胶海绵栓塞（Ｌｐ－ＴＡＥ＋ＧＳ组）。Ｌｐ－ＴＡＥ＋ＧＳ组、Ｌｐ－ＴＡＥ组和ＨＡＩ组，各组１年生存率分别为４２．４％、２７．５％和６．４％（Ｐ＝０．００４７），合并门静脉瘤栓的病例其半年、１年生存率分别为６８．９％和１８．０％。     

不能切除的肝癌动脉内治疗：方法选择和疗效分析

随访了２１３例不能切除的原发性肝癌动脉内治疗的病例。采用以下三种方式：（１）化疗药物灌注（ＨＡＩ组）；（２）碘油抗癌药乳剂栓塞（Ｌｐ－ＴＡＥ组）；（３）碘油乳剂加明胶海绵栓塞（Ｌｐ－ＴＡＥ＋ＧＳ组）。Ｌｐ－ＴＡＥ＋ＧＳ组、Ｌｐ－ＴＡＥ组和ＨＡＩ组，各组１年生存率分别为４２．４％、２７．５％和６．４％（Ｐ＝０．００４７），合并门静脉瘤栓的病例其半年、１年生存率分别为６８．９％和１８．０％。     

肝动脉化疗栓塞结合B超引导下注射无水酒精治疗原发性肝癌的研究

肝动脉化疗栓塞结合Ｂ超引导下注射无水酒精治疗原发性肝癌的研究黎乐群李航曾健林进令原发性肝癌（ＨＣＣ）目前首选的治疗方法仍为手术切除。对因各种原因不能手术切除的病人，经皮肝动脉化疗栓塞术（ＴＡＥ）和Ｂ超引导下肿瘤无水酒精注射术（ＰＥＩ）已被广泛应用。但...     

MRI对评价肝癌Lp-TACE治疗的价值

目的 通过影像－病理对照研究,探讨ＭＲＩ尤其是动态增强ＭＲＩ（Ｄ－ＭＲＩ）在肝癌Ｌｐ－ＴＡＣＥ治疗随诊中的价值以及协助临床确定Ｌｐ－ＴＡＣＥ治疗间隔的可行性。材料与方法 １０例Ｌｐ－ＴＡＣＥ治疗后手术切除的肝癌患者,术前行ＣＴ扫描、ＭＲ平扫及早期动态增强扫描、增强晚期和延迟期扫描。术后肿瘤标本作ＭＲＩ、ＣＴ扫描和软Ｘ线照相（８例）,作影像－病理对照研究。结果 （１）病理表现：１０例均发现残留的肝癌     

肝癌门静脉瘤栓的经肝动脉碘油化疗栓塞

２０例原发性肝癌，门静脉瘤栓位于右支者７例、左支１例、主于４例、主干＋右支８例。经肝动脉碘油化疗栓塞（Ｌｐ－ＴＡＣＥ）后，肝区平片和ＣＴ平扫显示瘤栓内Ｌｐ积聚呈Ａ型者９例、Ｂ型６例和Ｃ型５例。全组瘤栓缩小有效率４０％，平均生存期８．２个月，累积生存率６个月４５％、１年２０％、２年１０％。Ａ型瘤栓缩小有效率７７．８％，平均生存期１２．７个月，累积生存率６个月７７．８％、１年４４．４％和２年２２．２％明显高于Ｂ型和Ｃ型。表明Ｌｐ－ＴＡＣＥ对部分肝癌门静脉瘤栓病人特别是Ｌｐ呈Ａ型积聚者是较有效的方法。     

原发性肝癌患者肝动脉化疗栓塞治疗后T细胞亚群改变及临床意义

目的：了解原发性肝癌患者经肝动脉化疗栓塞术（ＴＡＣＥ）后免疫功能状态。方法：我们应用流式细胞仪检测了１６例原发性肝癌患者ＴＡＣＥ术前后Ｔ细胞表面抗原标志（ＣＤ３、ＣＤ４、ＣＤ８）,并与良性病变患者进行对比分析。结果：原发性肝癌患者术前ＣＤ３＋、ＣＤ４＋、ＣＤ４＋／ＣＤ８＋均低于对照组,ＣＤ８＋高于对照组,ＴＡＣＥ术后ＣＤ８＋降低,ＣＤ３＋、ＣＤ４＋、ＣＤ４＋／ＣＤ８＋均升高。结论：原发性肝癌患者治     

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.