羟基喜树碱明胶微球肝动脉化疗栓塞治疗肝肿瘤的实验研究

目的：对羟基喜树碱明胶微球（ＯＰＴ－ｍｓ）进行栓塞特性的实验研究。方法：以草犬为实验对象，比较了肝动脉注射常规型ＯＰＴ，空白明胶微球和ＯＰＴ－ｍｓ对大鼠肝癌的作用，并以肝动脉注射生理盐水作对照。结果：发现微球栓塞后血管造影可见末梢动脉有不同程度的减少，３０ｄ复查未见侧支循环形成。ＡＫＰ，ＧＰＴ在肝动脉灌注后３ｄ可达到最大值，７ｄ后明显下降，１４ｄ恢复正常，肝功能指标与微球的剂量呈正相关。病理检查有局限性或小灶性坏死，其程度与范围与剂量的大小有关，其它主要脏器无明显改变。结论：ＯＰＴ－ｍｓ对于肝肿瘤治疗是理想的。     

肝肿瘤经动脉植入式导管药盒系统的灌注和栓塞化疗

目的：探讨介入放射学方法留置导管药盒治疗肝肿瘤的方法和效果。材料与方法：采用Ｓｅｌｄｉｎｇｅｒ技术经左锁骨下动脉穿刺将导管插入肝动脉，然后与植入式药盒连接并埋置于皮下，对３１例原发性和转移性肝肿瘤患者经导管药盒系统进行了多次动脉灌注和栓塞化疗，灌注抗癌药物有ＡＤＭ和ＣＤＤＰ，栓塞采用ＭＭＣ－碘油乳剂。结果：有３０例病人导管超选择置入肝左右动脉、肝固有动脉或肝总动脉，１例导管留置在腹腔动脉。患者术后     

甲氨蝶呤明胶微球经肝动脉灌注后近期毒性的实验研究

通过肝动脉灌注的实验研究旨在了解甲氨蝶呤明胶微球（ＭＴＸ－ｍｓ）的近期毒性作用，为这种新型化疗栓塞剂介入治疗肝癌的临床应用提供实验依据。经大白鼠肝动脉灌注后显示；与对照组和单纯ＭＴＸ化疗组比较，较大剂量的ＭＴｘ－ｍｓ可使动物血中ＡＬＴ和ＡＫＰ值暂时性升高，肝脏发生不同程度的变性坏死；１２天后肝组织坏死区小血管内仍可见大量微球滞留。其它主要脏器（心、脾、肺和肾脏）未发现与微球有关的病理改变。结果提示     

外磁场控制磁性明胶微球肝动脉栓塞的实验研究

本实验随机使用杂种犬１７只。磁性明胶微球（ＭＧ－ｍｓ）粒径１０～３０μｍ。含ｘ－Ｆｅ＿２Ｏ＿３３０％（Ｗ／Ｗ）。血管造影、放射性核素扫描、ＣＴ扫描以及病理组织学检查，均显示出磁性明胶微球通过外磁场导向控制，在肝动脉内具有明显的靶向栓塞作用。栓塞术后，血清ＡＬＴ、ＡＳＴ、ＡＬＰ短时间内升高，２～３天达高峰，尔后下降，于３～４周内恢复到术前水平。末发现不良反应及异位栓塞。     

原油蒸气吸入对大鼠血和肺抗脂质过氧化活性的影响

给大鼠（每组８只）分别吸入原油蒸气１５ｇ／ｍ３×８Ｍ急性染毒１组）、３０ｇ／ｍ３×８ｈ（急性染毒Ⅱ组）和３ｇ／ｍ３×８ｈ／ｄ×３０ｄ（亚急性染毒组），观察其血液和肺ＧＳＨ、ＭＤＡ含量和ＧＳＨ－Ｐｘ活性变化。结果：３个染毒组大鼠血ＧＳＨ含量均明显减少（Ｐ＜０．０１），肺ＧＳＨ－Ｐｘ活性均有所下降，其中两个急性染毒组下降有显著差异性（Ｐ＜０．０１）。急性染毒Ⅱ组大鼠肺ＧＳＨ－Ｐｘ活性仅为对照组的１／３，其肺ＭＤＡ水平轻度增高，而血ＭＤＡ水平显著增高（Ｐ＜０．０５）。本研究结果提示原油蒸气吸入可削弱机体氢自由基清除系统的抗脂质过氧化活性，井引起一定程度的生物膜脂质过氧化损伤。表明抗过氧化活性下降和脂质过氧化损伤反应可能是原油蒸气吸入性肺损伤的机理之一。     

肝癌“双弹头”免疫导向药物的实验研究

以肝细胞癌单克隆抗体ＨＡｂ１８为载体，用葡聚糖作桥的间接交联方法和氯胺Ｔ法，同时将阿霉素（ＡＤＭ）和１３１Ｉ连接到ＨＡｂ１８上，制备出“双弹头”肝癌免疫导向药物１３１Ｉ－ＨＡｂ１８－ＡＤＭ。其免疫结合率为４３．５％。细胞毒实验结果显示，１３１Ｉ－ＨＡｂ１８－ＡＤＭ对靶肿瘤细胞ＳＭＭＣ－７７２１的杀伤效果较单独应用ＡＤＭ相同浓度的ＨＡｂ１８－ＡＤＭ和比放射性相同的１３１Ｉ－ＨＡｂ１８时，有明显的增强。１３１Ｉ－ＨＡｂ１８－ＡＤＭ具有选择性高效杀伤的作用，它集中了化疗与内放射治疗的优点，互相补充，展示了肿瘤导向治疗的良好前景。     

羟基喜树碱明胶微球肝动脉化疗栓塞治疗原发性肝癌

目的：在动物实验的基础上,我们将ＯＰＴ－ｍｓ进行临床研究。材料和方法：选择２６例原发性肝癌采用粒径为１５４μｍ－２００μｍ,用量１５０ｍｇ－４００ｍｇ：如微球加ＭＭＣ（２０ｍｇ）进行肝动脉灌注,平均２．６次。通过观察血清中ＡＦＰ的下降和肿瘤在ＣＴ上最大层面的两相互垂直的最大径的乘积的改变判定其临床效果,可进行了粗略地随访。结果：９３．３％的病人（１４／１５）ＡＦＰ下降在５０％以下。治疗后肿瘤缩小大于５０％者１２例占４６．６％;缩小在２５％－５０％（ＭＲ）７例占２６．９％;缩小（ＰＲ）小于２５％（ＮＣ）５例占２０％;２例增大（ＰＤ）占７．７％。所有治疗的病人临床症状得以好转和生活质量提高,生存期明显延长,全身副作用仅是一过性的。结论：初步临床应用表明：ＯＰＴ－ｍｓ对于ＰＬＣ肝动脉栓塞化疗效果是明显的,是一种良好未梢栓塞剂。     

颈静脉球瘤的DSA表现及术前栓塞治疗

目的：分析颈静脉球瘤的ＤＳＡ表现，评价栓塞治疗的作用。材料和方法：患者５例（男性３例，女性２例）。采用Ｓｅｌｄｉｎｇｅｒ技术，行超选择性动脉插管并造影；栓塞剂采用明胶海绵颗粒和／或真丝线段，分次缓慢注入栓塞材料，栓塞过程中监测肿瘤血管及供血动脉闭塞情况。结果：５例颈静脉球瘤。ＤＳＡ动脉期表现为颈静脉孔、乳突区或后颅凹大片血管团块影，其间血管婉蜒迂曲，颈外动脉之咽升动脉、耳后动脉、枕动脉为主要供血动脉，颈内动脉脑膜垂体干、椎动脉之脑膜支、小脑后、前动脉可参与供血。实质期肿瘤呈湖状、巢状染色。静脉期２例肿瘤较大者见粗大的引流静脉丛向下引流至颈内静脉。栓塞后肿瘤的供血动脉大多被栓塞，肿瘤染色明显减少或消失。栓塞术后７天内行手术，肿瘤完全或大部分切除。结论：ＤＳＡ是显示颈静脉球瘤供血动脉的最佳方法，根据ＤＳＡ表现，可以准确确定肿瘤的位置和侵犯范围。术前栓塞为手术切除提供了良好条件。     

肾血管平滑肌脂肪瘤的DSA特征性表现及介入栓塞治疗

目的：研究肾血管平滑肌脂肪瘤（ＡＭＬ）的ＤＳＡ特征性表现及介入栓塞治疗问题；材料与方法，１５例症状性肾ＡＭＬ，男５例，女１０例，平均年龄４６岁，经Ｂ超和／或ＣＴ诊断正确１０例，误诊５例，全部病例接受ＤＳＡ检查，并用自制的中药白芨粉粒作血管栓塞剂，超选择性动脉栓塞治疗７例，另外８例接受手术治疗；结果１５例均被ＤＳＡ诊断为肾ＡＭＬ。其特征性表现为，动脉期，肿瘤内中小动脉葡萄串联假性动瘤形成（１４例）实     

胸廓内动脉参与肝脏肿瘤供血的影像表现与介入治疗(附6例报告)

观察胸廓内动脉参与肝脏肿瘤供血的影像表现和介入治疗效果。材料与方法４年间发现ＩＴＡ参与肝癌供血６例，经血管造影证实，男性５例，女１例，年龄３６－５２岁，均有超声波与ＣＴ检查资料，３例曾做ＭＲＩ检查。既往均曾行肝动脉化疗栓塞。ＩＴＡ造影用５Ｆ眼镜蛇形导管，对向肿瘤供血的ＩＴＡ分支行栓塞治疗，２例用同轴微导管。     

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）