氩激光小梁成形术65例临床观察

目的评价氩激光小梁成形术对青光眼的疗效。方法应用进口氩激光机,对６５例不同类型开角型青光眼患者共７９只患眼进行光凝治疗。选用氩蓝激光,光凝部位选择在小梁网功能和非功能部位交界处。年迈体弱患者９例（１５眼）分二次光凝,每次光凝范围１８０°,光凝５０～６０点;余５６例（６４眼）一次性３６０°光凝９０～１２０点。结果治疗后随访３～３６个月,平均２４个月。眼压：６７眼（８４．８％）稳定在２０．５ｍｍＨｇ以下;１２眼（１５．２％）仍超过２５．８ｍｍＨｇ。视野：６６眼（８３．５％）无明显变化;７眼（８．９％）中心暗点扩大;６眼（７．６％）周边视野缩小。视力：８眼（１０．１％）提高;５眼（６３％）下降;余无明显变化。结论氩激光小梁成形术治疗开角型青光眼效果良好,原发性和继发性开角型青光眼均为激光治疗适应证。     

选择性激光小梁成形术治疗原发性开角型青光眼

目的探讨选择性激光小梁成形术治疗原发性开角型青光跟的疗效。方法原发性开角型青光眼12例13只眼,采用532nm倍频Q-开关Nd：YAG激光治疗仪,以光斑直径400μm,脉冲时间3ns,能量0．6～1．8mJ行半周小梁成形术。观察治疗后眼压,视力,前房反应等。结果10例11只眼3个月眼压平均下降(10．2±4．1)mm Hg,术后第1天和2个月时下降幅度最大。2例2只眼术后第1天眼压仍超过30mmHg而加用降眼压药物。术后视力视野均无变化。结论选择性激光小梁成形术可以有效治疗原发性开角型青光眼。     

选择性激光小梁成形术治疗青光眼的临床观察

目的:观察选择性激光小梁成形术(SLT)治疗青光眼的有效性和安全性。方法:原发性开角型青光眼(POAG)患者56例88只眼,原发性开角型青光眼小梁切除术后高眼压患者26例26只眼,原发性闭角型青光眼(PCAG)小梁切除术后高眼压患者20例20只眼,眼压(25.35±8.55)mmHg,倍频Q开关532     

青光眼阀植入术治疗难治性青光眼

目的：观察Ａｈｍｅｄ．Ｏｐｔｉｍｅｄ青光眼阀植入术治疗难治性青光眼的疗效及并发症。方法：对１５例（１６眼）难治性青光眼行青光眼阀植入术,其中植入Ａｈｍｅｄ阀９例１０眼,植入Ｏｐｔｉｍｅｄ阀６例６眼。结果：术后随访１０－１６月平均１２．６±２．１月。Ａｈｍｅｄ阀：术前眼压５．４３±０．０９ｋｐａ,术后２．５９±０．７５ｋｐａ,Ｏｐｔｉｍｅｄ阀：术前眼压５．５１±０．８７ｋｐａ;术后５．４２±１．３９     

氩激光联合Nd:YAG激光治疗原发性闭角型青光眼

目的探讨氩激光联合Nd：YAG激光治疗原发性闭角型青光眼的效果。方法原发性闭角型青光眼123例152眼，随机分成2组。联合激光组用氩激光及Nd：YAG激光对63例78眼进行虹膜周边切开术；Nd：YAG激光组采用Nd：YAG激光对60例74眼行虹膜周边切开术。结果联合激光组一次虹膜穿孔成功100％，Nd：YAG激光组一次虹膜穿孔成功66．21％。联合激光组术中术后并发症较Nd：YAG激光组明显减少。结论氩激光联合Nd：YAG激光治疗原发性闭角型青光眼安全有效、简单易行、并发症少。     

氩离子／Nd：YAG联合激光虹膜切除术治疗闭角型青光眼的临床观察

为探索激光治疗闭角型青光眼的理想术式，对９８例（１５８只眼）原发性闭角型青光眼患者行联合激光虹膜切除术。先用氩离子激光在患眼虹膜面作一光凝斑，再用ＮｄＹＡＧ激光在此光凝斑上作穿透性击射。虹膜透切成功率为１００．０％，一次透切成功率为９７．５％。所有病例术后随访１年半，无一例发生孔洞闭塞，扩瞳试验均无青光眼发作症状。联合激光虹膜切除术操作简单、安全，可在门诊进行，且疗效确切，是治疗和预防由于瞳孔阻滞引起的急、慢性闭角型青光眼急性发作的理想术式。     

小梁切除术和激光断线在青光眼治疗中的应用

正目的:观察激光断线在青光眼小梁切除术中的应用及在术后眼压控制中的作用。方法:青光眼患者168例,年龄(62.55±10.7)岁,198只眼青光眼包括急性闭角型青光眼98只眼,慢性闭角型青光眼60只眼,开角型青光眼13只眼,继发性青光眼7只眼,残余性青光眼13只眼,新生血管性青光眼4只眼,混合型青光眼3只眼,施行标准的小梁切除术,术前59只眼(29.80%)眼压30 mmHg,要求术毕巩膜瓣切口达到"自然     

青光眼术后并发症的预防及治疗措施

目的：观察三种抗青光眼手术后并发症。方法：显微镜下行巩膜板层下咬切术、小梁切除术及虹膜根切术共656例708眼。结果：发生术后并发症28例30只眼。结论：发生术后浅前房的患者中，男性多于女性，开角型青光眼多于闭角型青光眼，巩膜下咬切术多于小梁切除术，高龄及高血压患者较常见；术后高眼压、散光及前房出血则主要与手术操作有关。     

低能量选择性激光小梁成形术对原发性开角型青光眼的疗效

目的:研究低能量选择性激光小梁成形术对原发性开角型青光眼的疗效。方法:回顾2011年9月至2017年6月,原发性开角型青光眼患者44例88只眼,所有患者使用药物治疗后,行选择性激光小梁成形术,初始能量0.3 m J,治疗后1、3、6、12和24个月随访。结果:44例88只眼治疗后1、3、6、12和24个月,累计成功率分别为70.5%、67.0%、59.1%、44.3%、33.2%,并且治疗后眼压明显低于治疗前(P0.05)。与治疗失败的病例相比,治疗成功的病例较年轻(P0.05)并且治疗前眼压较低。选择性激光小梁成形术之后,65只眼用药与治疗前相同,23只眼减少用药。与治疗前眼压相比,治疗后用药不变的病例眼压明显下降,而治疗后减少用药的病例眼压保持稳定。治疗后减少用药的病例年龄及治疗前眼压均与治疗后用药不变的病例比较,差异具有统计学意义(P0.05)。结论:本研究提示,在2年的随访中,低能量选择性激光小梁成形术对于原发性开角型青光眼安全有效。由于年龄较大以及较高的治疗前眼压可能导致更高的治疗失败风险,正规的眼科体检以及对于原发性开角型青光眼的早期诊断非常重要。     

HAPC患者红细胞2,3—二磷酸甘油酸的变化和红细胞ATP酶的活性

目的：了解红细胞２，３－二磷酸甘油酸、红细胞膜ＡＴＰ酶在高原红细胞增多症（ＨＡＰＣ）的变化及二者关系。方法：ＨＡＰＣ患者２４例，正常对照１９例，分别测定红细胞２，３－二磷酸甘油酸，红细胞膜ＡＴＰ酶（Ｎａ＋－Ｋ＋－ＡＴＰ酶，Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性。结果：ＨＡＰＣ组及对照组红细胞２，３－二磷酸甘油分别为：３．２１ｍｍｏｌ／Ｌ±０．１３ｍｍｏｌ／Ｌ，４．８７ｍｍｏｌ／Ｌ±０．０７ｍｍｏｌ／Ｌ，（Ｐ＜０．０５）；Ｎａ＋－Ｋ＋－ＡＴＰ酶活性分别为：４．１±０．０１３λΒ／μｍｏｌ·ｈ－１·ｇ－１，７．４±０．１９λΒ／μｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性分别为１５．１±１．７０λΒ／μｍｏｌ·ｈ－１·ｇ－１，２５．３±２．３１λΒμｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；相关分析显示：２，３－二磷酸甘油酸与Ｎａ＋－Ｋ＋－ＡＴＰ酶呈正相关（ｒ＋０．４８１７，Ｐ＜０．０１）与Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶呈正相关（ｒ＝０．４７８３，Ｐ＜０．０１）。结论：ＨＡＰＣ患者红细胞２，３－二磷酸甘油酸的减少，红细胞膜ＡＴＰ酶活力降低，反映机体缺氧状况，体细胞代谢异常     

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）