rhEGF防治急性放射性口腔炎的临床疗效观察

目的 观察重组人表皮生长因子（rhEGF）对急性放射性口腔炎的预防和治疗作用。方法 90例接受放射治疗的头颈部恶性肿瘤患者随机分为3组：A组：预防性用药组；B组：治疗性用药组；C组：对照组；每组30例。用药组将rhEGF喷于受照射区的口腔黏膜表面，每天3～4次，对照组仅用多贝氏液漱口，每天3～4次。A组用药与放疗同期进行，B组用药待Ⅰ级放射性口腔炎出现后进行。评价3组放射性口腔炎的发生情况及治疗效果。结果 A组73％（22／30）的患者放射性口腔炎出现在放射剂量≥10Gy后，而C组83％（25／30）出现在〈10Gy时，A组和B组的Ⅲ、Ⅳ级放射性口腔炎发生率均低于C组（P〈0．05）。A、B、C组的治疗有效率分别为96％（29／30）、96％（29／30）和37％（11／30）。用药组与对照组的差异有统计学意义（P〈0．01），用药组放射性口腔炎的愈合时间平均≤7d，对照组≥10d。结论 预防性应用rhEGF可推迟急性放射性口腔炎的发生，预防性或治疗性用药均可降低Ⅲ、Ⅳ级放射性口腔炎的发生率，并能促进放射性口腔炎的愈合，值得临床推广。     

生脉注射液对放射性肺损伤防治作用的临床研究

目的　通过观察生脉注射液对恶性胸部肿瘤患者放疗后放射性肺炎、肺纤维化的临床疗效,探讨生脉注射液对放射性肺损伤的防治作用。方法　130例患者随机分为治疗组和对照组,对照组患者给予根治性放疗,治疗组患者给予根治性放疗加生脉注射液治疗,6 0ml加入5 %葡萄糖注射液2 5 0ml中,iv ,qd ,针对放疗中出现的不良反应给予相同的对症治疗,观察2组患者放射性肺炎和肺纤维化的发生率,以及生活质量评价。结果　治疗组放射性肺炎的发生率(12 .31% )与对照组(2 7.6 9% )相比有显著性差异(P <0 .0 5 ) ,治疗组肺纤维化发生率(33.85 % )与对照组(5 2 .31% )相比有显著性差异(P <0 .0 5 ) ,治疗组患者的生活质量评价明显高于对照组,与对照组相比有显著性差异(P <0 .0 1)。结论　中药制剂生脉注射液可以降低放疗后放射性肺炎及肺纤维化的发生率,对放射性肺损伤具有防治作用。     

6种药物对部队进入海拔5200m急性高原反应预防效果的对比观察

目的 :筛选预防急性高原反应的药物。方法 :进驻海拔 5 2 0 0m哨卡的某部 118名士兵随机分为 6组。将复方红景天、银杏叶片、酪氨酸、复方党参、乙酰唑胺、异叶青兰组列为A、B、C、D、E、F组 ,每组 18～ 2 0人。于进入高原前 4天开始 ,每日早晚各服药 1次 ,到哨卡第 3天停药 ,连服 12d。部队进驻哨卡第 1～ 7天 ,以军用卫生标准GJB10 98- 91《急性高原反应的诊断和处理原则》随访记录受试者每天的急性高原反应症状 ,然后分度评分。分值高者 ,高原反应症状重。结果 :部队进入哨卡第 1天 ,A组症状评分较C、D、E、F组低 ,C组较A、D、E、F组高 (P <0 .0 1或P <0 .0 5 )。第 3天 ,除F组外 ,C组均高于其它 4组 ,B和E组较D组低 (P <0 .0 5或P <0 .0 1)。第 5天 ,A和B组较C组低 ,A组较D组低 (P <0 .0 5或P <0 .0 1)。第 7天 ,B组较A、C和D组低 ,F组较A、C和B组高 (P <0 .0 5或P <0 .0 1)。结论 :银杏叶片预防急性高原反应效果最好 ,乙酰唑胺和复方红景天次之 ,复方党参较异叶青兰好 ,酪氨酸最差     

中药治疗头颈部肿瘤放射性口腔损伤疗效观察

目的 :应用中药治疗头颈部恶性肿瘤放疗中或放疗后并发口腔放射性损伤的临床治疗效果。方法 :1997- 0 1～ 1999- 0 1用沙参麦冬汤治疗头颈部肿瘤因放疗所致口腔损伤者 81例 ,对照组 2 0例。结果 :服药后口腔损伤症状明显改善或消失 ,与对照组相比 ,P <0 .0 1。服药组及对照组治疗后唾液量分别 (4 .2 7± 3.11)ml和 (0 .2 1± 0 .12 )ml,pH分别为 (6 .45± 1.12 )和 (5 .2 9± 0 .2 1) ,两组比较差异有显著意义 ,P <0 .0 1,服药组其CD4+ 增高 ,CD8+ 降低 ,CD4+ /CD8+ 比值升高 ,P <0 .0 5。结论 :沙参麦冬汤对于因放疗导致的放射性口腔损伤有较好的修复作用 ,临床未见有毒性反应。     

复方苦参注射液在食管癌放疗中的临床效果观察

目的观察分析复方苦参注射液在食管癌放疗中应用的疗效及降低急性放疗副反应的情况。方法对我科住院的67例食管癌患者资料进行回顾性分析,病人分为观察组和对照组两组,对照组行单纯放疗,总剂量DT60-66Gy／30-33次／6-7w,2．0Gy／次／d。观察组在放疗的同时,加用复方苦参注射液静脉滴注治疗。结果放疗结束时以食管吞钡X线造影片判断疗效,观察组和对照组的有效率分别为94．3％,81．3％（X^2=1．60,P〉0．05）,差异无统计学意义;观察组生存质量改善率优于对照组（P〈0．01）;观察组放射性食管炎及放射性气管炎发生率低于对照组（P〈0．05）。结论食管癌放疗的同时加用复方苦参注射液治疗,虽不能明显提高疗效,但可以减少急性放疗副反应。改善患者的一般状况。     

鼻咽癌患者放射性口腔黏膜反应护理干预效果分析

目的探讨护理干预对鼻咽癌患者放射性口腔黏膜反应的影响。方法对我科2009年1月至2011年12月收治的120例鼻咽癌患者随机分为观察组与对照组各60例。对照组按护理常规进行对症护理。观察组在放疗前、放疗中、放疗后实施系统的护理干预,观察两组的护理结果。结果对照组患者中有10例因严重口腔黏膜反应放弃治疗。观察组60例患者均顺利完成放疗,放射性口腔炎的发生率和严重程度均明显低于对照组,差异具有显著性(P<0.05)。结论护理干预能有效预防或减轻鼻咽癌患者放疗所致的放射性口腔炎。     

复方茶多酚含漱液防治放射性口腔炎临床观察

放射性口腔炎在头颈部肿瘤的放射治疗中较常见 ,临床上一直无理想方法防治 ,作者用复方茶多酚含漱液防治放射性口腔炎取得较佳效果 ,报道如下。一、资料和方法　 1 临床资料 :2 0 0 0年 10月～ 2 0 0 1年 5月我科 10 0例鼻咽癌放疗病人按住院号单、双分为对照组、治疗组各 5 0人 ,对照组男 31例 ,女 19例 ,平均年龄 47 8岁 ,治疗组男 30例 ,女 2 0例 ,平均年龄 48 1岁 ,两组在年龄、性别上差异无显著性。 2 治疗方法 :放疗一开始 ,治疗组复方茶多酚含漱液每日 3次餐后 10ｍｌ含漱 3ｍｉｎ ,对照组每日0 2 %替硝唑或洗必肽 10ｍｌ,3餐后含…     

基础心功能状况与急性放射性心脏损伤的相关性研究

目的 探讨胸部放疗基础心功能状况对急性放射性心脏损伤的影响,评价急性期内患者心功能的变化。方法 分析109例胸部肿瘤患者放疗后基础心功能状况对急性放射性心脏损伤的影响,并观察放疗前及急性观察期内心功能的变化。结果 全组患者急性放射性心脏损伤发生率为79.8%,患者临床因素及基础心功能各项指标与急性放射性心脏损伤发生均无明显相关(P>0.05)。放射治疗后急性期内出现左室收缩功能减低24例,舒张功能减低15例;瓣膜病变24例,全部为二尖瓣和(或)主动脉瓣改变,其中反流(轻、中度反流)23例、狭窄(轻度)1例,未见三尖瓣和(或)肺动脉瓣反流与狭窄。左房前后径、主动脉流速、E/A值在放疗前、放疗结束、自放疗开始3个月差异有统计学意义(F=8.552、0.017、0.003,P<0.05)。左房前后径、主动脉流速、E/A值放疗结束较放疗前分别下降了9.19%、7.56%、17.5%,自放疗开始3个月较放疗结束分别恢复7.05%、4.14%、7.58%,其中E/A下降和恢复变化幅度最大。结论 临床因素及基础心功能状况与急性放射性心脏损伤发生无明显相关。放疗导致的瓣膜病变以二尖瓣和(或)主动脉瓣轻、中度反流多见,并可引起左室收缩和舒张功能改变。左房前后径、E/A值放疗后首先降低,随着时间延长逐渐改善,但急性期内未能恢复到正常水平。急性观察期内放疗对心脏舒张功能的影响较收缩功能明显。     

吸入一氧化氮防治放射性间质肺炎疗效观察

目的　观察吸入一氧化氮对放射性间质性肺炎的防治效果 ,以期探索防治放射性肺炎的新措施。方法　建立放射性肺纤维化动物模型 ,分别在照前 1d(B和C组 )及照后 1个月 (D和E组 )开始吸入NO ,每种方式均持续治疗 1个月 ,NO吸入浓度为 2 0× 10 - 6 (B和D组 )和 10× 10 - 6 (C和E组 )两个剂量 ,单纯照射组 (A组 )和正常对照组 (F组 )不加任何处理。分别于照射后 1d、1周、1个月、3个月和 6个月取材观察。结果　动物死亡率B组 (10 % )和C组 (5 % )低于其他各组 ;照射后1个月 ,肺重与体重之比B组和C组低于A组 (P <0 0 5 ) ;照后 6个月 ,A组呈现局灶性纤维化 ;B和C组主要在肺叶顶部可见局灶性增生和轻度纤维化病变 ;D和E组可见有较大面积的增生灶 ,主要集中在肺叶顶部。结论　照射前吸入NO明显减轻放射性急性间质肺炎的发生及其病变程度 ,降低动物死亡率 ,延缓和减轻肺纤维化发生的时间和程度 ,而照射后吸入NO此种作用较弱     

大面积脑梗死高热病人早期血清中CORT,SOD,LPO的含量水平及其临床意义

目的观察大面积脑梗死(LCI)高热病人早期血清中皮质醇(CORT)、脂质过氧化物(LPO)、超氧化物歧化酶(SOD)含量变化,探讨CORT,LPO对其预后的影响。方法用放射免疫法、羟胺氧化法、丙二醛法测定31例高热者(A组)高热第2天与30例无高热者(B组)入院第2天血清中CORT,LPO,SOD含量水平,并与30例健康人(C组)作对照。同时对A,B两组生存者预后生活质量进行比较。结果A,B两组较C组CORT,LPO明显升高和SOD降低(P<0.05)。但A组较B组CORT,LDO升高和SOD降低更显著(P<0.05,P<0.01)。A,B两组预后(神经功能缺损程度评分与日常生活能力评分)比较其差异有统计学意义(P<0.05)。结论LCI高热病人早期血清中CORT,LPO,SOD含量水平明显升高,且CORT,LPO参与对LCI神经细胞的进一步损害。     

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.     

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.     

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）