两种方法制备不同颗粒度度^188Re-硫化铼混悬液的生物分布研究

目的了解两种方法制备的不同粒径^188Re-硫化铼混悬液在生物体内各主要脏器的分布，以选择合适粒径范围的混悬液进行关节腔注射。方法采用超声和涡旋两种分散方法制备粒径大小区分明显的^188Re-硫化铼混悬液。36只正常兔分2组，膝关节腔分别注射不同粒径的^188Re-硫化铼混悬液，在10、30min和5、24h各处死3或6只实验兔，取脏器称重并测放射性计数。结果涡旋法所制混悬液注射10min时在肺、肝、脾等组织中的摄取[每克组织百分注射剂量率（％ID／g）分别为0．004、0．003、0．002％ID／g]明显低于超声法所得混悬液（放射性摄取分别为0．05、0．04、0．10％ID／g）：其他脏器中的放射性摄取较少，减少了对非靶组织的辐射损伤。^188Re-硫化铼在血中清除快，10min即达峰值，并很快降低；主要经肾脏排泄。结论涡旋法所制^188Re-硫化铼混悬液非靶组织摄取明显低于超声法所得混悬液，且其质量可控、制备简捷，在关节滑膜切除方面可能有更大的应用前景。     

两种方法制备不同颗粒度188 Re-硫化铼混悬液的生物分布研究

目的了解两种方法制备的不同粒径188Re-硫化铼混悬液在生物体内各主要脏器的分布,以选择合适粒径范围的混悬液进行关节腔注射.方法采用超声和涡旋两种分散方法制备粒径大小区分明显的188Re-硫化铼混悬液.36只正常兔分2组,膝关节腔分别注射不同粒径的188Re-硫化铼混悬液,在10、30 min和5、24h各处死3或6只实验兔,取脏器称重并测放射性计数.结果涡旋法所制混悬液注射10 min时在肺、肝、脾等组织中的摄取[每克组织百分注射剂量率(%ID/g)分别为0.004、0.003、0.002%ID/g]明显低于超声法所得混悬液(放射性摄取分别为0.05、0.04、0.10%ID/g);其他脏器中的放射性摄取较少,减少了对非靶组织的辐射损伤.188Re-硫化铼在血中清除快,10 min即达峰值,并很快降低;主要经肾脏排泄.结论涡旋法所制188Re-硫化铼混悬液非靶组织摄取明显低于超声法所得混悬液,且其质量可控、制备简捷,在关节滑膜切除方面可能有更大的应用前景.     

胶体铼及其应用

胶体铼按所标核素的不同分为^188Re标记的胶体铼和其他核素标记的胶体铼。在放射性关节滑膜切除术中，用^188Re标记的硫化胶体铼是一种有效的治疗手段，对于荷瘤(如黑色素瘤、肝癌等)小鼠也有一定的治疗效果。淋巴显像中^99Tc^m标记的胶体铼是前哨淋巴结显像中常用的一种显像剂。     

153Sm-HA用于关节滑膜切除的实验研究

目的 探讨^153Sm-柠檬酸．羟基磷灰石(HA)对抗原诱导关节炎动物模型兔关节滑膜切除的价值。方法 30只新西兰大白兔随机分为正常对照组(A组)，抗原诱导关节炎^153Sm-HA未治疗组(B组)及治疗组(C、D组)，用核素显像方法检测其关节腔内注射^153Sm-HA后关节内滞留率及生物学分布，并进行组织病理学观察。结果 A组与C组注射^153Sm-HA后3、6d关节腔内滞留率分别为97．7％、93．5％和98．4％、95．1％；A组和C组3和6d关节外漏出率分别为0．17、0．31％ID／g和0．065、0．0912％：ID／g。组织病理学检查示治疗组较未治疗组滑膜炎症明显好转。结论 ^153Sm-HA滑膜切除术漏出率低，在关节内能均匀分布，与炎性滑膜组织亲和力强，安全性高，可有效治疗慢性滑膜性关节炎。     

血友病关节病变的X线、CT和MR影像比较分析

目的 比较观察血友病患者关节病变的X线、CT和MR影像显示差异。方法 选取14例血友病患者41个症状关节的X线、CT和MR影像。每个关节的3种影像学检查均在1d内完成。各关节病变程度均行X线分级[将关节病变严重者（5级）除外]。影像观察分别选用软组织肿胀或关节积液、骨质疏松、骨骺增大、关节侵蚀、关节面下囊肿、关节间隙狭窄、骨髓水肿、关节内出血、滑膜增厚及髁间窝增大和前、后十字韧带病变（仅用于膝关节MRI评估）等征象进行X线、CT和MR影像比较分析。结果 14例血友病患者41个症状关节X线分级中0级5个，1级7个，2级6个，3级8个，4级15个。软组织肿胀或关节积液X线显示有33个关节，CT和MRI均为34个；骨侵蚀病变MRI检出34个关节，Cr33个关节，X线20个关节。关节面下囊肿MRI显示21个关节，CT显示18个关节，X线显示9个关节。χ^2值检验表明MRI和CT分别与X线比较差异均有统计学意义（P值均〈0．05），MRI与CT比较差异无统计学意义（P〉0．05），但MRI检出骨侵蚀和关节面下囊肿病灶数均多于CT和X线；MRI显示骨髓水肿者14个关节，关节内出血者34个关节，滑膜增厚者27个关节。结论 在显示血友病关节炎病变方面，MR／优于CT和传统X线检查，可作为血友病关节炎患者的首选影像学方法。     

MRI在膝关节早期类风湿性关节炎中的诊断价值

目的：探讨MRI在膝关节早期类风湿性关节炎中的诊断价值。方法：回顾性分析了10例临床拟诊为类风湿性关节炎。X线平片检查未见确切异常而行MRI检查的患者资料。结果：12个膝关节中滑膜增厚及血管翳形成12例；关节软骨破坏10例；骨髓水肿6例；骨侵蚀5例；关节积液7例。结论：MRI能反映膝关节类风湿性关节炎早期病理变化。为临床早期诊断、治疗提供依据，并可辅助临床选择适当的治疗方法。     

血友病性关节病的MRI分析

目的:探讨血友病性关节病的MRI表现及临床价值.方法:回顾性分析11例22个膝关节血友病性关节病患者的MRI表现.结果:22个膝关节均有积血,表现为关节腔、骨骼和/或软组织血肿,早期血肿在T1WI为等信号、T2WI呈高信号;中期血肿在T1WI呈略高信号或混杂信号,T2WI呈高信号或混杂信号;晚期血肿在T1WI和T2WI均表现为混杂信号,血肿逐渐被吸收.病变早期关节结构基本保持正常,中晚期关节结构均有损害,表现为关节软骨、骨皮质破坏吸收,关节间隙狭窄,骨端或骨骺增大变形.早中期滑膜、关节囊、肌肉及韧带肿胀,而晚期则萎缩、退变.结论:MRI能准确显示血友病性关节病的病理改变,对疾病分期、指导临床治疗及同位素放射治疗效果评价具有重要意义.     

188Re-硫化铼滑膜切除术实验研究

关节腔内注射β射线的放射性药物治疗滑膜炎有别于外科手术的滑膜切除方法［１］。本研究通过制备１８８Ｒｅ硫化铼混悬液,研究其体外和动物体内的生物学特点,为临床应用提供依据。材料与方法一、材料１８８Ｗ溶液：美国橡树岭国家实验室提供。１８８Ｗ／１８８Ｒｅ发...     

关节镜微创清理术治疗膝关节骨性关节炎

目的探讨关节镜下微创清理术对膝关节骨性关节炎（OA）的治疗效果。方法对54例膝关节骨性关节炎患者进行关节镜下选择性、有限化微创清理术。手术内容包括刨削或射频汽化增生的炎性滑膜组织和前交叉韧带（Anterior Cross Ligment）磨损、游离体取出、软骨打磨成形、增生髁间棘切除、部分骨赘切除、半月板部分切除、髁间窝成形。结果随诊45例。平均18个月（6-24月），大多数患者临床症状明显缓解，关节功能改善。结论关节镜微创清理术可有效缓解OA症状，改善关节功能，提高生活质量。     

膝关节滑膜囊肿的影像学诊断

目的 探讨膝关节滑膜囊肿的CT、MRI表现及诊断价值.资料与方法 回顾性分析经手术和病理证实的24例膝关节滑膜囊肿患者的CT(10例)、MRI(24例)资料并记录、分析各种征象.结果 囊液呈均匀密度(信号)及明显长T1、长T2信号,无强化.囊壁呈均匀薄膜状中等密度(信号),中度强化.关节囊滑膜疝9例,位于半膜肌与腓肠肌内侧头之间,呈"水滴"状或类圆形,前方以"鸟嘴"状狭颈通关节腔.腓肠-半膜肌滑囊积液9例,亦位于半膜肌与腓肠肌内侧头之间,呈圆形、卵圆形或"葫芦"形,4例与关节腔交通.胫侧副韧带囊肿3例,位于胫侧副韧带走行区,呈卵圆形均质囊性肿物.鹅足腱囊肿3例,位于缝匠肌、股薄肌及半腱肌的联合腱止点与胫骨内侧副韧带之间,呈前后向的扁圆形囊性肿物.手术见各囊肿的位置、形态、大小与关节腔交通情况均与术前CT、MRI结果吻合.合并退变性骨关节炎13例,滑膜骨软骨瘤病3例,慢性膝关节滑膜炎5例,类风湿性关节炎1例,关节软骨损伤10例,半月板损伤11例,半月板退变7例,韧带损伤8例.MRI显示合并的关节内病变与手术结果基本吻合.结论 CT、MRI对膝关节滑膜囊肿均可做出正确诊断,但MRI优于CT,能同时发现关节内病变,可指导临床制定合理手术方案.     

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.