CT引导下32P胶体介入治疗肺癌

目的 探讨CT引导下^32P胶体瘤体内注射治疗肺癌的可行性及疗效评价。方法 选择晚期周围型肺癌18例，行CT引导下^32P胶体瘤体内注射(1mCi／ml)。随访1月至3年。结果 CT引导下^32P胶体瘤体内注射无副反应。近期治疗有效率约38．9％，远期有效率为44．4％。结论 CT引导下^32P胶体瘤体内注射治疗肺癌是一种安全、可靠、有效的新方法。     

32P-磷酸铬间质给药在荷人胰腺癌裸鼠的体内生物学分布及形态学表现

目的 研究^32P-磷酸铬(^32P胶体)瘤体间质给药治疗BALB／c—nu／nu裸鼠荷人胰腺癌(Pc-3)移植瘤时在体内相应组织中的分布、药代动力学特点及全身毒性反应。方法 51只荷瘤裸鼠，经瘤体给予不同剂量^32P胶体或尾静脉给药，分批处死，动态观察^32P胶体在裸鼠体内放射性分布和组织器官形态学表现，观察体重变化和计数WBC和PLT，测量瘤体表面放射性计数率。结果 ^32P胶体瘤体间质注射后其放射性计数率明显高于其他器官组织，器官组织放射性计数率瘤体给药明显低于尾静脉给药。增体给药有效半减期为13d。形态学检查显示给药后大部分Pc-3细胞被破坏，并出现分化较好的瘤细胞；肝、脾、肺及淋巴结等重要器官组织的辐射损伤为可逆性．未见明显骨髓抑制现象。结论 ^32P胶体瘤体间质给药是治疗胰腺癌安全、简便、有效的核素介入疗法。     

胶体磷[32P]酸铬瘤内注射治疗实体肿瘤实验研究

胶体磷[32P]酸铬肿瘤内注射在临床已有较广泛的应用,尤其用于难治性恶性实体瘤或转移瘤的辅助治疗。其治疗效果确切,不良反应轻,使用安全,但目前治疗剂量及注射方法主要依靠经验。本研究对荷U87实体肿瘤裸鼠瘤内单点和多点注射胶体磷[32P]酸铬,通过观察病理形态学评价其剂量一辐射效应,为临床应用胶体磷[32P]酸铬注射液提供实验依据。     

32P胶体局部给药防治H22移植瘤淋巴道转移的实验研究

目的探讨不同剂量的^32P胶体局部注射对小鼠H22移植瘤和区域淋巴结转移灶的治疗作用。方法应用小鼠H22腹水型肝癌淋巴道转移模型，通过肿瘤组织局部给药，观察^32P胶体在模型小鼠移植瘤、区域淋巴结及全身各器官、组织内的分布。结果^32P胶体局部给药后主要聚集在瘤体注射局部和区域淋巴结内，而在肝、脾、肺等脏器分布的活度较低。区域淋巴结聚集的活度随给药剂量增高而递增。治疗早期瘤体和胭窝淋巴结转移灶呈现局灶性坏死。后期移植瘤和区域淋巴结转移灶的瘤组织呈现出血、坏死。结论^32P胶体瘤体给药可在局部富集，并可经淋巴道转运、聚集于区域淋巴结，对肿瘤组织和邻近的淋巴结转移灶具有明显的杀伤作用。     

CT引导下125Ⅰ粒子植入治疗难治性盆腔恶性肿瘤

目的评价CT引导下^125I粒子组织间植入治疗盆腔难治性恶性肿瘤的临床疗效，探讨粒子植入技术。方法23例盆腔恶性肿瘤，均为术后复发接受化疗和（或）根治量放疗肿瘤仍进展患者，瘤体最大径3.5—7．0cm，平均4．5cm。粒子植入术前1～3d行模拟CT扫描，采用治疗计划系统（TPS）制定粒子植入计划，根据处方剂量求出术中所需^125I粒子的总活度并算出治疗粒子数量。在CT引导下经皮穿刺植入^125I粒子。其中6例患者粒子植入前或后接受髂内动脉灌注化疗。结果单个瘤体内首次植入粒子数为9～75粒，平均27粒。6例接受髂内动脉灌注化疗共14个疗程。粒子植入术后72h～4周，下肢疼痛和（或）肛门、会阴周围疼痛坠胀不适，完全缓解5例，部分缓解11例，有效率69．6％（16／23）。术后随访2～34个月，中位随访21个月，部分缓解（PR）18例；无变化（SD）4例；进展（PD）1例，总有效率78．3％（18／23）。死亡3例，存活20例，最长生存时间34个月。结论CT引导下^125I粒子植入对盆腔难治性恶性肿瘤安全、有效。     

131I-BAC5和CT-BAC5联合应用对鼻咽癌CNE-2细胞微球的作用

目的 观察中华眼镜膜毒素（CT）和131I与抗鼻咽癌（NPC）单克隆抗体BAC5的偶联物，对NPC CNE－2细胞微球的抑制或破坏作用。方法 采用氯胺－T法制备131－I－BAC5，并用异型双功能交联剂（SPDP）偶联CT－BAC5，分别或联合应用于NPC CNE－2细胞微球，观察微球生长的体积变化率和评价其受抑制或受破坏的情况，结果 CT和BAC5的偶联率为32．4％，与对照组比较，CT对微球的生长无明显抑制作用（P＞0．05），CT－BAC5的偶联率为32．4％，与对照组比较，CT对微球的生长无明显抑制作用（P＞0．05），CT－BAC5有明显的抑制作用（P＜0．05），131I－BAC5，131I－BAC5＋CT－BAC5有非常明显的破坏作用（P＜0．01），结论 肿瘤多细胞微球是一种用于体外研究肿瘤治疗效果的理想模型之一，CT－BAC5和131I－BAC5联合免疫导向治疗NPC比单项治疗效果更好。     

放射性125I粒子植入治疗头颈部肿瘤

目的 探讨超声或CT引导下放射性^125I粒子组织间植入治疗头颈部肿瘤的技术可行性和近期疗效。方法 40例头颈部癌和转移癌患者。4例采用全身麻醉，在CT引导下行^125I粒子植入术；36例采用局部麻醉，行超声引导下^125I粒子植入术。粒子针平行排列，间距1～1．5cm，原发肿瘤植入靶体积影像学边界外放lcm，转移瘤植入靶体积为影像学边界。粒子间距1cm。肿瘤周边匹配剂量（matched peripheral dose，MPD）90～145Gy，每颗粒子活度0．40～0．70mCi，每个病灶植入3～84颗粒子。5例患者术后1周加外放疗，每次200cGy，总剂量45～50Gy。术后24h拍头颈正侧位平片或CT，行质量验证。术后24～48h拍胸部x线片了解有无粒子移位或游走。结果 随访3～33月，10例舌癌3例完全缓解，3例部分缓解，3例稳定，1例进展；2例颈部淋巴结转移的患者经粒子治疗后完全缓解，局部控制率为60％，中位生存期11个月，1年和2年生存率分别为87．50％和35％。14例头颈部癌粒子治疗后，局部控制率为76．47％，中位生存期9个月，1年和2年生存率为66．08％和24％。16例头颈部转移癌粒子治疗后，局部控制率95．23％，中位生存期9个月，1年和2年生存率为54．55％和32．73％。没有1例发生严重的皮肤反应。结论 放射性^125I粒子粒子植入治疗头颈部癌疗效确切，尤其是为那些手术后或放疗复发患者提供了一种新的、可行的、安全和微创治疗手段。     

^18F-FDG PET-CT在淋巴瘤分期及疗效评价中的应用研究

目的探讨^18氟-氟代脱氧葡萄糖（^18F-FDG）PET—CT在淋巴瘤分期及疗效评价中的临床应用价值。方法回顾分析28例淋巴瘤患者（HL6例，NHL22例）在治疗前后进行^18F—FDG PET—CT对比检查的结果，并与增强CT及骨髓活检结果进行比较。结果治疗前68处病灶^18F—FDG PET—CT检出67个，检出率为98．5％，其中结内37个全部检出（100％），结外31个检出30个（96．8％）；增强CT则共检出病灶45个（66．2％），其中结内37个检出32个（86．5％），结外31个仅检出13个（41．9％）。6例（21．4％）的分期得到上调并改变了1例（3．6％）的治疗方案。治疗后32处病灶^18F—FDG PET—CT检出29个，检出率为90．6％，其中结内17个检出15个（88．2％），结外15个检出14个（93．3％）；增强CT则共检出病灶18个（56．3％），其中结内17个检出13个（76．5％）．结外15个仅检出5个（33．3％）。治疗后有2例（7．1％）的分期得到上调，8例（28．6％）下调，改变了8例（21．4％）的治疗方案。^18F—FDG PET—CT对淋巴瘤患者治疗前后结内病灶检出率与增强CT相似（P〈0．05），而结外病灶检出率则明显高于增强CT（P〉0．05）。28例中25例^18F—FDG PET—CT与骨髓穿刺结果一致。治疗后^18F—FDG PET—CT对复发的阳性预测值93．8％，阴性预测值为83．3％；增强CT的阳性预测值75％，阴性预测值50％。结论^18F—FDG PET—CT在淋巴瘤分期及疗效评价中具有重要的临床价值．有助于准确分期和残余病变性质的鉴别。     

32P胶体致人胰腺癌Pc-3移植瘤细胞凋亡及其相关基因表达的研究

目的 观察低剂量^3-P胶体瘤体内注射诱导裸鼠人胰腺癌Pc-3移植瘤细胞凋亡的生物学效应、相关基因的表达及其可能的作用机理。方法建立：BALB／c裸鼠人胰腺癌Pc-3移植瘤动物模型，分别向30只荷瘤鼠瘤块中心注射不同剂量(0．37、0．74、1．48、2．96和5．92MBq)的^32P胶体溶液，对照组注射等体积冷胶体。于注射后24h取出瘤块；通过流式细胞仪、透射电镜及免疫组织化学检测等方法，研究肿瘤组织的细胞凋亡率、细胞坏死率、细胞超微结构改变及Apo2．7、Caspase-3、bcl-2、box相关基因的表达。结果 0．74、1．48和2．96MBq组瘤体内注射后电镜下可见典型的细胞凋亡表现，5．92MBq组细胞则以大量坏死为主。辐射诱导凋亡过程中，bcl-2／bax比值下调，Apoa2.7、Caspase-3蛋白表达均明显增加。结论 ^32P胶体瘤体注射可诱导荷瘤裸鼠人胰腺癌Pc-3肿瘤细胞凋亡；Aao2．7、Caspase-3、bcl-2及bax蛋白参与调控辐射诱导细胞凋亡过程。     

32P-胶体灌注治疗慢性上颌窦炎动物模型的实验研究

目的 探讨^32P-胶体灌注治疗慢性上颌窦炎动物模型的作用机制及治疗效果。方法 选择雄性绵羊慢性上颌窦炎动物模型24只，采取上颌窦前外侧壁开窗术，按不同剂量分组将^32P-痰体注入动物模型上颌窦腔内，注药后定期观察窦内细菌变化和黏膜的组织学变化，以体征、细菌培养、病理检查等项指标判定治疗效果。结果 ^32P-胶体灌注治疗后，窦腔内菌种及慢性炎性细胞数量消失或明显减少，纤毛上皮结构基本完好。灌注治疗6个月后，治愈率达到83_3％，各组间比较具有非常显著性差异。结论实验证明了^32P-胶体的抑菌作用和促进慢性炎症消退的作用，并确定了^32P-胶体窦内用药的适宜剂量。放射生物学分布监测显示，对其他重要组织器官无任何影响。     

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.