经皮左锁骨下动脉导管药盒系统置入术的中远期并发症及处理

目的　探讨经皮左锁骨下动脉导管药盒系统 (PCS)置入术的中远期并发症的原因及处理方法。材料与方法　 2 5 6例胸、腹部和盆腔等部位的晚期恶性肿瘤患者 ,行经皮左锁骨下动脉穿刺PCS置入术。术后隔 3 0～ 40天行经PCS灌注化疗或碘油化疗乳剂栓塞术。随访 2个月～ 3年 ,平均 11.5个月。结果　使用时间为 1～ 3 6个月 ,平均为 10 .5个月。PCS置入术 3 0天后 ,5 3例发生与PCS有关的并发症 ,发生率为 2 0 .7%。主要包括 :除主动脉置管者外 ,留置管移位率为 7.8% ( 16/2 0 5 ) ,靶动脉闭塞占 7.4%( 19/2 5 6)。二者经原途径更换新的留置导管和调整到满意位置 16例 ,拔除PCS 8例 ,其余 11例未作处理。留置导管阻塞占 2 .0 %( 5 /2 5 6) ,经加压注入尿激酶溶液PCS再通 2例。药盒囊腔内积血占 2 .0 % ( 5 /2 5 6) ,经局部穿刺抽吸或切开引流治疗后痊愈。皮肤坏死占 3 .1% ( 8/2 5 6) ,均拔除PCS。结论　经皮左锁骨下动脉PCS置入术的中远期并发症 ,发生率较低 ,大多数经适当处理 ,不影响PCS的正常使用。     

经皮股动脉导管药盒系统植入术的并发症及临床处理

目的探讨经股动脉导管药盒系统植入术(PCS)的并发症原因及处理。方法202例胸、腹、盆腔及四肢恶性肿瘤采用经皮股动脉植入PCS进行化疗和碘油栓塞。分析其相关并发症35例(17．3％)。结果并发症包括6例切口感染及切口延迟愈合(17．1％)，2例穿刺局部延迟出血(5．7％)，3例PCS留置管坠落(8．6％)，1例连接不牢分离(2．9％)，1例渗漏(2．9％)，1例药盒转面(2．9％)，11例PCS堵塞(31．4％，和10例留置导管尖移位(28．6％)。所有并发症经适当处理后无一例死亡和严重后遗症。结论经皮股动脉药盒系统植入术是一种安全有效技术，其相关并发症轻微和易于处理。     

锁骨下动脉经皮导管药盒系统植入法的临床应用

目的:探讨锁骨下动脉经皮完全植入式导管药盒系统(PCS)优缺点及临床应用价值。材料和方法:20列恶性肿瘤患者,经皮锁骨下动脉 PCS 植入术,术后经 PCS 化疗和栓塞。结果:PCS 植入全部成功,并发症发生率14.3%。结论:PCS 介入法是一种安全有效的治疗肿瘤的方法。     

经防反流动脉导管药盒系统灌注化疗治疗盆腔肿瘤的护理

目的 探讨经防反流动脉导管药盒系统(PCS)灌注化疗治疗盆腔肿瘤的护理.方法 17例盆腔恶性肿瘤患者成功植入防反流PCS,并经动脉导管多次灌注化疗,做好植入药盒前后护理,掌握药盒穿刺使用的正确技术,及时处理化疗药物不良反应及并发症,做好患者出院指导及保护药盒的方法.结果 17例经3 ～ 8次灌注化疗,均未发生留置导管堵...     

国产植入式导管药盒系统经皮股动脉植入术治疗恶性肿瘤(附32例报告)

目的研究国产植入式导管药盒系统(PCS)经皮股动脉植入术在恶性肿瘤治疗中的应用。材料与方法全组32例患者,肝癌15例,肺癌6例,食管癌3例,转移性肝癌3例,胃癌2例及盆腔肿瘤3例。均采用国产 PCS,留置管经皮股动脉穿刺 Seldinger 技术留置在肿瘤主要供血动脉内或开口处;药盒则植入穿刺点下方大腿内侧皮下。术后设计合理方案经 PCS 对肿瘤进行区域性治疗。结果全组病例 PCS 植入成功率100%,留置管到位率为93.7%,并发症为12.5%。结论国产 PCS 经皮股动脉植入顺利,质量稳定可靠,价格低,可以替代同类进口产品;经皮股动脉植入PCS 治疗恶性肿瘤,操作简单,创伤小,疗效肯定,是恶性肿瘤区域性治疗的一种新途径。     

肝癌经肝动脉化疗栓塞及门静脉持续灌注化疗的临床研究

目的　将经肝动脉化疗栓塞 (TACE)和经门静脉植入化疗药盒持续灌注化疗药 (VPC) 2种方法结合 ,观察原发性肝癌(HCC)经肝动脉化疗栓塞和经门静脉植入化疗药盒持续灌注化疗药的疗效。方法　对照组 83例中晚期患者 ,用表柔比星 (EPI) 40mg和顺铂 (CDDP) 80mg与碘化油配制成碘油———化疗药物乳化剂 ,经导管向肝癌供血动脉注入 ,后用明胶海绵 (GS)颗粒栓塞该动脉。治疗组 5 9例中晚期HCC患者 ,用上述方法治疗后 ,再经皮下埋置式药盒经门静脉定期灌注化疗药。结果　对照组与治疗组有效率 (完全缓解 部分缓解 )分别为 45 .8%和 61.0 % (P <0 .0 5 ) ,2组治疗后Ⅱ期手术切除率分别为 3 .6%和 11.9% (P <0 .0 5 )。对照组 1年、2年、3年生存率分别为 69.9%、60 .2 %和 2 0 .5 % ;治疗组分别为 96.6%、67.8%和 42 .4% (P <0 .0 5 )。并发症差异无显著性意义。结论　经肝动脉化疗栓塞和经门静脉植入化疗药盒持续灌注化疗药是治疗原发性肝癌的较好方法 ,能提高疗效     

经股浅动脉入路药盒植入术并发症及处理

目的：介绍经股浅动脉入路药盒植入术并发症相应处理方法。材料与方法：６０便,男５３例,女７例,平均年龄４９岁。无栓塞适应症的原发性肝癌３６例,转移性肝癌１４例,其他晚期肿瘤１０便。经经股浅动脉植入药盒。结果：随时间最长１８月,药盒导管移位５例（８．３％）,靶血管闭塞２例（３．３％）,药盒导管闭塞３例（５．５％）。伤口延迟愈合１例（１．６％）。导管移位镁采用介入技术调整导管至腹主词汇经盒导管闭塞溶栓再     

经皮血管内导管药盒系统持续灌注化疗的护理

经皮血管内导管药盒系统植入术(PCS)逐渐成为恶性肿瘤和转移性肿瘤的主要治疗方法之一。PCS术后的长期护理是极为重要的。本文结合我院366例PCS术病例，探讨PCS术后持续灌注化疗护理的重要性。     

国产埋入式药盒介入法植入的临床应用

目的：研究国产埋入式药盒系统（PCS）介入法植入的可能性及安全性。材料和方法：对63例恶性肿瘤，采用国产PCS行经皮血管内植入术，术后经PCS化疗或栓塞。结果：PCS植入全部成功，留置管均位于肿瘤供养动态。并发症有穿刺局部血肿5例（7．9％），切口延迟愈合或开裂4例（6．3％），留置必这阻塞4例（6．3％），留置导管移位1例（1．55），局部感染2例（3．1％）。所有并发症经相应处理后痊愈，无严重后遗症。结论：国产PCS介入法植入是可行的，安全的。     

经皮穿刺左肱动脉入路介入治疗原发性肝癌:兼与股动脉入路比较

目的　总结经皮穿刺左肱动脉入路介入治疗肝癌的初步经验 ,与股动脉入路比较该技术的优缺点。方法　 45 2例患者分为肱动脉组 5 2例和股动脉组 40 0例 ,2组患者均行超选择性肿瘤化疗栓塞。通过比较 2组操作的技术成功率、穿刺口血肿发生率、微导管可控性、患者的舒适程度 ,评价 2种方法的优缺点。结果　股动脉组失败 4例 ,技术成功率 99.0 % ,改用肱动脉入路和锁股下入路成功 ;肱动脉组全部成功 ,技术成功率 10 0 % ,Ρ >0 .0 5 ,无差别。股动脉组 4例 (1% )术后穿刺口形成血肿 ,肱动脉组有 9例 (17.3 % ) ,Ρ <0 .0 5 ,有差别。血肿未予特殊处理均自行吸收。股动脉组 75例使用微导管 ,5例操作困难 ,占 6.7% ;肱动脉组 3 6例使用微导管 ,2例不顺利 ,占 5 .6% ,Ρ >0 .0 5 ,无差别。股动脉组术后卧床 6h以上 ,均诉腰背酸痛 ,2 3例需插导尿管 ;肱动脉组术后不需卧床 ,无腰背痛。结论　经左肱动脉入路介入治疗肝癌 ,提高了患者的舒适和便利 ,是股动脉入路的补充。     

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.