双上肢垫高体位在儿童气道异物CT检查的应用

目的 通过改变CT检查气道异物的儿童双上肢的摆放体位,来明确双上肢和颈胸椎的相对位置关系对图像质量及辐射剂量的影响。方法 前瞻性地分析行气道CT检查的1~48月患儿103例,CT检查时根据双上肢摆放位置按随机数表法将患儿分为A、B、C 3组,A组34例,B组36例,C组33例。A组患儿双上肢上举置于颈椎两侧,B组患儿双上肢置于胸椎两侧,C组患儿双上肢用海绵垫抬高约45°置于胸部两侧。采用荷兰飞利浦128iCT进行数据采集,记录3组患儿的容积CT剂量指数（CTDI_vol）及剂量长度乘积（DLP）并进行对比分析,然后对所得图像质量进行主观及客观评价。结果 颈部图像质量主观评分,B组（4.33±0.72）和C组（4.19±0.63）均优于A组（3.71±0.66）,差异均有统计学意义（Z=-3.19、-2.61,P<0.05）;胸部图像质量主观评分,A组（4.21±0.47）优于B组（3.71±0.39）和C组（3.92±0.42）,C组优于B组,差异均有统计学意义（Z=-1.71、-2.08,P<0.05）;DLP间的差异,B组（57.7±6.8）mGy·cm高于A组（51.6±7.6）mGy·cm和C组（51.3±6.3）mGy·cm,差异有统计学意义（P<0.05）,A组和C组间的差异无统计学意义（P>0.05）。结论 行儿童气道异物CT检查时,将双上肢抬高45°置于胸部两侧,会改善气道CT检查的图像质量,同时降低辐射剂量。     

能谱智能匹配联合双低技术在CT门静脉成像中的可行性研究

目的 探索单能量成像结合自适应统计迭代重建（adaptive statistical iterative reconstruction,ASIR）及自动能谱协议选择（automatic spectral imaging mode selection,ASIS）技术在个体化降低患者门静脉造影辐射剂量、对比剂剂量中的应用价值。方法 回顾性收集华中科技大学同济医学院附属协和医院2017年1月至2017年4月120例临床需进行上腹部增强检查的受检者资料（男80例,女40例）,按扫描方案分为3组,每组各40例。A组采用常规120 kVp扫描,噪声指数（NI）=10,对比剂用量为450 mgI/kg,图像采用50% ASIR重建;B、C两组采用能谱成像模式,NI=10（B组）,NI=13（C组）,对比剂用量均为300 mgI/kg,图像采用60 keV+50% ASIR重建。采用单因素方差分析比较3组图像中门静脉、肝实质的平均CT值及其差值、图像噪声、信噪比（SNR）及对比噪声比（CNR）。由两位高年资放射科医师对3组图像进行主观图像质量评分。记录患者的容积CT剂量指数（CTDI_vol）、剂量长度乘积（DLP）并计算有效剂量（E）。结果 B、C两组对比剂用量较A组降低了约30%。A、B、C组图像的门静脉CT值分别为168.22±17.82、209.06±20.07、211.03±25.60,B、C组与A比较,差异有统计学意义（t=-9.625、-8.680,P<0.05）。A、B、C 3组门静脉与肝实质CT差值分别为60.01±17.01、106.63±25.83、107.72±25.39,B、C组与A组比较,差异有统计学意义（t=-9.536、-9.857,P<0.05）。SNR分别为8.48±1.41、12.64±2.94、10.77±1.94,CNR分别为5.16±1.80、8.13±2.54、7.32±1.84,图像质量评分分别为（3.53±0.68）、（4.75±0.54）和（4.53±0.64）分,B、C组的SNR、CNR和图像质量评分与A组比较,差异有统计学意义（t=-8.082、-6.064、-6.050、-5.308、-8.912、-6.779,P<0.05）。A、B、C组CTDI_vol分别为（12.15±5.02）、（12.34±4.18）、（10.03±3.13）mGy,DLP分别为（348.62±155.99）、（355.56±131.07）、（287.10±92.25）mGy·cm,E分别为（5.23±2.34）、（5.33±1.97）、（4.31±1.38）mSv,相对于A、B两组,C组的CTDI_vol、DLP和E差异均有统计学意义（t=2.274、2.147、2.147、2.812、2.702、2.702,P<0.05）,分别降低了19%。结论 CT门静脉成像时,选择NI=13,60 keV结合50%ASIR重建及ASIS技术可以个体化降低患者的对比剂剂量和辐射剂量,并提供满足诊断要求的图像。     

人工智能图像优化技术在低剂量胸部CT检查中的初步应用研究

目的 探讨人工智能（AI）图像优化技术对低剂量胸部CT平扫图像质量及辐射剂量的影响。方法 前瞻性连续纳入2019年7月至8月于吉林大学第一医院采用NeuViz Prime CT行胸部CT平扫的80例患者,按随机数表法分为A、B两组,每组40例。A组为低剂量组,B组为常规剂量组,分别采用100及120 kV管电压;两组均采用自动管电流技术,参考毫安秒分别为70及140 mAs。根据重建方法的不同,将低剂量组分为A1、A2两个亚组,A1组为低剂量迭代组,采用迭代算法（ClearView 50%）重建图像;A2组为低剂量AI组,采用AI图像优化算法进一步优化A1组图像;B组采用迭代算法（ClearView 50%）重建图像。通过容积CT剂量指数（CTDI_vol）、剂量长度乘积（DLP）和有效辐射剂量（E）的值,比较A、B两组辐射剂量的差异。比较A1、A2及B组感兴趣区的噪声值（SD）、信噪比（SNR）及对比噪声比（CNR）。由两名高年资放射科医生以Likert 5级评分法对3组图像质量进行主观评价。结果 A、B两组患者临床资料的比较差异均无统计学意义。A组与B组相比[（1.48±0.49）mSv vs.（5.30±1.40）mSv],有效辐射剂量降低约72.1%。在图像质量方面,与B组相比,A1组SD较高且SNR及CNR较低（Z_SD=-4.24,Z_SNR=-2.54,t_CNR=-2.27,P<0.05）。经AI优化后,A2组的SD显著低于B组（Z_SD=-28.24,P<0.001）,且SNR及CNR显著高于B组（t_SNR=-26.04,t_CNR=-36.88,P<0.001）;两组图像噪声的主观评分差异无统计学意义,但B组在肺内组织结构显示方面优于A2组（χ²=4.96、7.04,P<0.05）。结论 在辐射剂量降低约72.1%的情况下,经AI优化的低剂量胸部CT图像可达到常规剂量图像质量水平。     

颅脑CT检查患者辐射剂量最优化问题初探

目的 在蒙特-卡罗分析平台基础上,探讨根据头围调节管电流时间积（mAs）在颅脑CT成像的图像质量和敏感器官辐射剂量的应用价值。方法 前瞻性连续选取2017年9月至2018年6月期间吉林大学第一医院门诊或住院患者中的因为不同临床症状被建议行颅脑CT检查的儿童及青少年,共92名。不限定头围尺寸的情况下,采用随机数表法选取22例患者作为常规组,所测头围大小是48.1~59.2 cm。剩余70例患者归入低剂量组,低剂量组根据不同头围尺寸又分为3个亚组：A组,54.1~57.0 cm,22例;B组,51.1~54.0 cm,26例;C组,48.1~51.0 cm,22例。根据头围作为一个指标来指定mAs,因此,常规组和低剂量A、B、C组的管电流（mAs）分别为250、200、150、100 mAs。利用蒙特-卡罗分析平台记录敏感器官（脑实质、眼晶状体及唾液腺）辐射剂量值,并对主观和客观图像质量评分进行评价。采用单因素方差分析比较各组图像质量和辐射剂量的差异。结果 常规组和低剂量A、B、C组脑实质辐射剂量分别为（34.37±3.62）、（25.91±0.99）、（3.18±6.11）和（17.38±3.23）mSv,差异有统计学意义（F=54.51,P<0.05）;眼晶状体辐射剂量分别为（41.54±1.04）、（33.03±0.35）、（26.18±2.72）和（20.88±4.45）mSv,差异有统计学意义（F=189.75,P<0.05）;唾液腺辐射剂量分别为（35.04±4.94）、（25.92±0.99）、（22.93±6.54）和（14.96±2.67）mSv,差异有统计学意义（F=65.74,P<0.05）。常规组和低剂量A、B、C组主观图像质量评分分别为（4.97±0.13）、（4.77±0.49）、（4.67±0.49）和（3.98±0.61）分,差异有统计学意义（F=3.89,P<0.05）,但常规组和A、B组之间差异无统计学意义（P>0.05）。常规组和低剂量A、B、C组灰质信噪比分别为（18.69±3.55）、（16.76±2.87）、（15.05±2.80）和（13.65±2.53）,差异无统计学意义（P>0.05）;白质信噪比分别为（17.46±3.72）、（15.54±2.81）、（13.71±2.43）和（11.77±2.18）,差异亦无统计学意义（P>0.05）。结论 根据儿童和青少年头围尺寸调节mAs可使扫描方案更加个性化,在保证图像质量的前提下降低敏感器官辐射剂量。     

胸部低剂量CT在新型冠状病毒疾病患者出院后复查的应用价值

目的 探讨胸部低剂量CT在新型冠状病毒疾病（COVID-19）患者好转出院后复查应用价值。方法 回顾性分析2020年3月17日至3月25日经武汉大学人民医院治疗出院后的58例COVID-19患者胸部低剂量CT表现,由两名影像医师独立评价CT图像质量,采用5分法进行评分。并计算信噪比（SNR）、背景噪声（SD_air）及辐射剂量。结果 出院前常规剂量组和出院后复查低剂量组图像主观评分观察者1和观察者2分别为4.45±0.22、3.88±0.33（P>0.05）和4.37±0.18、3.91±0.35（P>0.05）;低剂量组的SNR与SD_air分别为4.39±0.95和7.19±2.41,显著低于常规组的5.14±1.06（Z=-5.551,P<0.001）和6.48±1.57（Z=-3.217,P<0.001）,图像质量均能满足临床诊断。低剂量组的CT容积剂量指数（CTDI_vol）、剂量长度乘积（DLP）及有效剂量（E）分别为（2.41±0.09） mGy、（88.03±5.33） mGy·cm和（1.23±0.17） mSv,均显著低于常规组［（10.53±1.03） mGy,（338.74±34.64） mGy·cm,（4.74±0.48） mSv,Z=-6.568、-6.624、-5.976,P<0.001）。结论 COVID-19患者出院后可采用胸部低剂量CT复查。     

“三低”技术联合全模型迭代重建算法在头颈部CT血管成像中的可行性研究

目的探讨80 kV低管电压、低对比剂注射速率和低对比剂用量的“三低”技术,联合全模型迭代重建（IMR）算法在头颈部CT血管成像（CTA）检查的可行性。方法前瞻性连续收集2015年7-11月行头颈部CTA检查的患者60例,采用随机数字表法将其分为A、B两组,每组各30例。A组为常规剂量组,管电压120 kV,滤过反投影（FBP）重建,对比剂注射速率4.5~5.5 ml/s,注射时间10 s;B组为80 kV低管电压组,分别使用FBP和IMR进行图像重建,得到B1和B2两组图像,对比剂注射速率3.5~4.0 ml/s,注射时间10 s。测量并计算A组、B1组、B2组的图像动脉血管CT值、图像噪声、信噪比（SNR）和对比噪声比（CNR）,并由2名放射诊断医师对图像质量按照5分法进行评价。3组图像间动脉血管CT值、图像噪声、SNR和CNR采用单因素方差分析,图像质量主观评价采用Kruskal-Wallis检验,两组检查的容积CT剂量指数（CTDI_vol）和剂量长度乘积（DLP）比较采用两个独立样本t检验。结果 A、B1和B2组3组图像质量主观评分范围分别为3~5分、2~4分和3~5分,B1组有12例患者图像之间评分≤2分,图像无法诊断。A和B1、A和B2、B1和B2图像之间评分差异均有统计学意义（t=4.55、-6.58、-2.03,P<0.05）。B2组与A组的图像客观指标SNR和CNR比较差异无统计学意义（P>0.05）,但B2和A组图像的SNR、CNR均优于B1组,差异均有统计学意义（t=-12.14、13.39、-9.96、9.45,P<0.05）。B组CTDI_vol[（1.7±0.2）mGy]比A组[（8.9±1.0）mGy]减少了80.9%,DLP[（77.9±9.0）mGy·cm]比A组[（415.5±56.7）mGy·cm]减少了81.3%,B组对比剂注射速率[（3.9±0.1）ml/s]比A组[（5.0±0.2）ml/s]减少了22.0%,B组对比剂总量[（39.2±1.9）ml]比A组[（50.3±2.2）ml]减少22.1%,差异有统计学意义（t=39.1、32.2、20.8、20.8,P<0.05）。结论使用80 kV管电压、低对比剂注射速率和用量,并使用IMR算法进行图像重建,进行头颈部CTA扫描是可行的。可以在保证图像质量的基础上,使患者辐射剂量减少81.3%。临床试验注册号中国临床试验注册中心,ChiCTR-BOC-16010060。     

双源CT低电压迭代重建联合分次注射法低辐射泌尿系造影的可行性研究

目的 评估双源CT （DSCT）低电压迭代重建联合分次注射法（SBI）行CT泌尿系造影（CTU）的辐射剂量、图像质量和影像诊断准确率。方法 连续80例临床初诊为泌尿道疾病而准备行CTU检查的患者依据随机数字表法分为对照组和试验组两组。对照组40例采用常规注射,常规电压（120 kV）,滤波反投影法（filtered back-project,FBP）重建,试验组40例采用分次注射法,低电压扫描（80 kV）,正弦迭代重建（sinogram affirmed iterative reconstruction,SAFIRE）,评估两组的有效剂量E、图像质量及影像诊断准确率。结果 共77例患者顺利完成检查和图像评估,其中对照组39例,试验组38例。试验组的平均有效剂量E为（3.93±0.85）mSv,低于对照组的（26.68±4.07）mSv （t=-33.78,P<0.05）。两组图像质量主观评分分别为（4.49±0.79）分和（4.39±1.53）分,差异无统计学意义（P>0.05）。试验组的信噪比（SNR）为127.3±15.9,明显高于对照组的109.6±13.2,差异有统计学意义（t=4.49,P<0.05）,但对比噪声比（CNR）分别为100.84±12.92和108.96±14.42,差异无统计学意义（P>0.05）。两组最终诊断准确率分别为84.62%和81.58%,差异无统计学意义（P>0.05）。结论 双源CT低电压扫描迭代重建联合分次注射法CTU检查可大幅度降低辐射剂量,但图像质量主观评分、CNR值和影像诊断准确率未受明显影响。     

宽体探测器CT低剂量扫描在婴幼儿先天性心脏病中的图像质量及辐射剂量研究

目的 探讨宽体探测器CT低剂量扫描在婴幼儿先天性心脏病检查中的图像质量及辐射剂量。方法 回顾性连续选取本院先天性心脏病患儿100例纳入研究,年龄均<3岁。根据扫描方案不同分为两组：低剂量组50例,男31例,女19例,年龄12 d至32个月,使用宽体探测器CT行低剂量心电门控轴扫;对照组50例,男26例,女24例,年龄19 d至27个月,应用多排CT容积螺旋穿梭技术扫描。分别测量两组图像升主动脉、主肺动脉、左心室、膈肌水平降主动脉及邻近肌肉组织的CT值和图像噪声,并计算信噪比（SNR）及对比噪声比（CNR）。采用双盲法评价心内结构、心外结构及冠状动脉的客观图像质量。记录每位患儿的容积CT剂量指数（CTDI_vol）和剂量长度乘积（DLP）,并计算有效剂量（E）。结果 两组4个解剖区域的CT值、图像噪声、SNR及CNR,差异均无统计学意义（P>0.05）。两组心内结构及心外结构的客观图像质量评分差异无统计学意义（P>0.05）,冠状动脉的图像质量评分低剂量组显著高于对照组（4.10±0.90 vs. 2.88±0.82,Z=-5.818,P<0.05）。低剂量组有效剂量（0.57±0.30）mSv较对照组（2.39±1.15）mSv下降了76%,差异有统计学意义（t=-11.642,P<0.05）。结论 宽体探测器CT低剂量方案扫描婴幼儿先天性心脏病,在不影响图像质量的前提下,有效辐射剂量显著降低。     

自适应统计迭代重建在儿童颞骨低剂量CT扫描中的应用研究

目的 对比宝石高分辨CT及64排容积CT扫描的辐射剂量,评价自适应统计迭代重建技术（ASiR）对儿童颞骨低剂量扫描的价值。方法 将60例因先天性耳聋的患儿按照性别、年龄及就诊顺序分为A组和B组,每组30例。A组采用Discovery HD CT 750行低剂量颞骨CT扫描,预设噪声指数（NI）为12,使用自适应流计迭代重建（ASiR）对原始图像进行后处理重建,ASiR权重值设为40％。B组采用Lightspeed VCT 64进行扫描,NI为8,使用滤波反向投影（FBP）对图像进行重建。分别记录各组CT扫描的最大电流、最小电流及容积CT剂量指数（CTDI_vol）,测量并记录有效剂量及临近颞骨密度相对较均匀的脑组织客观噪声,同时评价和记录图像的主观图像质量。使用SPSS 18.0统计软件对各组数据进行统计学分析。结果 A组的平均管电流和CTDI_vol值分别为（110.40±21.72） mA和（26.43±3.48） mGy,B组分别为（168.56±24.36） mA 和（39.66±4.17） mGy,两组比较差异有统计学意义（t=-9.76、-13.31, P < 0.05）。两组患儿临近颞骨密度相对较均匀的脑组织NI分别为：A组（33.13±2.68）、B组 （33.79±2.93）,两组间差异无统计学意义（P > 0.05）。A、B两组图像主观评分分别为 （4.06±0.03）和（4.05±0.03）;两组比较差异无统计学意义（P > 0.05）。 结论 在获得同样质量图像的前提下,与GE Lightspeed VCT 64的FBP方法相比,GE Discovery HD CT 750采用40％ASiR方法并提高4个单位NI值的扫描方案可有效减低儿童颞骨CT扫描的辐射剂量。     

基于第3代双源CT双低检查技术在肺栓塞成像的临床应用研究

目的 探讨第3代双源CT大螺距70 kV联合超低对比剂用量16 ml在肺栓塞低辐射剂量成像的临床应用价值。方法 将83例临床可疑肺栓塞行CT肺动脉成像患者,按随机数表法,分为两组：常规组,36例,管电压100 kV,螺距1.0,对比剂总量60 ml;双低组,47例,管电压70 kV,螺距2.2,对比剂总量16 ml。记录两组的容积CT剂量指数（CTDI_vol）和剂量长度乘积（DLP）以计算有效剂量（E）,测量各级肺动脉增强CT值、背景噪声及肌肉CT值以计算信噪比（SNR）、对比噪声比（CNR）。两组的总体图像质量和上腔静脉引起的线束硬化伪影均采取3级评分进行主观评价。结果 两组患者之间性别、年龄、身高、体重、体质量指数（BMI）、肺栓塞比例及各级肺动脉增强CT值差异均无统计学意义（P>0.05）。双低组E为（0.76±0.13）mSv,常规组为（1.91±0.54）mSv,两组比较差异有统计学意义（Z=-5.23,P<0.001）。双低组背景噪声高于常规组（Z=-4.99,P<0.001）,且SNR和CNR均低于常规组（Z=-4.56、-4.48,P<0.001）,但两组总体图像质量主观评分差异无统计学意义（P>0.05）,且双低组上腔静脉引起的线束硬化伪影评分（1.34±0.60）低于常规组（2.94±0.23）,两组比较差异有统计学意义（Z=-5.15,P<0.001）。结论 第3代双源CT大螺距70 kV联合16 ml超低对比剂用量,可以显著降低对比剂线束硬化伪影对右肺动脉、右肺上叶动脉的干扰,保证肺栓塞诊断图像质量,并大幅度降低辐射剂量约60%,同时减少73%对比剂总量。     

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.