胃癌CT表现及其对手术切除可行性的探讨

目的：探讨胃癌CT表现、诊断价值及CT扫描对胃癌手术切除可行性评估。材料与方法；60例常规CT扫描的胃癌病例，并行手术病理对照，评价手术切除可行性。结果：除3例原胃癌，5例早期胃癌外均有明显胃癌CT征象，胃壁增厚42例，软组织肿块24例，胃周脂肪线改变35例，胃周及远处淋巴结肿大13例，邻近器官及远处器官转移5例，胃壁明显强化28例。结论：胃癌CT扫描能显示内脏及胃壁病变、胃周及邻近器官浸润，远处脏器及淋巴结转移等特征，是胃癌定性诊断、术前分期及术后随访的有效手段，是术前评估的重要方法。     

胃癌螺旋CT术前评估及与手术病理分期对照研究

目的:应用螺旋CT行胃癌术前评估,并将CT分期与手术病理分期进行比较。方法:98例胃癌患者术前行腹部螺旋CT检查,并实施手术分期和病理分期。结果:所有患者行手术治疗,其中16例(16%)无法切除,82例(84%)手术切除。CT扫描中胃壁的厚度和浆膜的累及有相关性(P<0.001)。CT和手术预测病理分期的符合率分别为68%和52%。CT过度分期只有17%。结论:螺旋CT是胃癌患者术前检查的一种有效的方法,可预测胃癌病灶的可切除性,从而避免某些不必要的剖腹手术或使手术方案更加合理。CT过度分期的概率较低,其分期的准确率高于手术。     

进展期胃癌手术切除率的CT分期评价

目的 评价进展期胃癌术前CT分期与手术切除率的相互关系。材料与方法连续性搜集经手术与病理证实的进展期胃癌病例50例,其中25例术前经CT评估,25例术前无CT扫描。将手术及病理结果与CT扫描进行对照。结果25例术前经CT分期评估,手术切除病灶22例(88％),3例未能手术切除(12％)。25例术前无CT扫描评估,手术切除病灶16例(64％)。术前肿瘤CT扫描T分期准确性为96％(24／25)。结论准确的术前CT分期对进展期胃癌的恰当处理是必要的。     

胃癌术前CT分期的价值

目的：评价胃癌术前CT检查的价值。材料和方法：对38例胃癌患者进行术前CT检查分期，预测手术切除的可能性。结果：依据CT术前分期预测38例胃癌患者中，可切除者26例，与手术结果对照，低估1例，高估2例，CT预测准确率为92．1％。CT预测后选择手术者中，切除率92．3％。结论：CT术前分期在确定手术范围、术前判断手术切除可能性方面有重要价值。     

螺旋CT及CD44V6表达分析在胃癌术前分期中的价值

目的探讨CT扫描及CD44V6表达相结合在胃癌术前分期诊断中的意义.方法应用CT增强扫描对48例胃癌进行术前分期;对47例胃切除标本组织进行CD44V6表达分析,与手术及术后病理结果对照;探讨二者在胃癌术前分期中的价值.20例胃良性病变组织检测CD44V6表达作为对照.结果 CT增强扫描对胃癌T分期准确度为74.5%,N分期准确度为64.4%,综合判断CT对于胃癌肿瘤原发灶、淋巴结和转移情况分期法(TNM分期)准确度为77.8%.胃癌组织中CD44V6表达的阳性率为55.6%,明显高于胃良性病变(χ2=11.83,P<0.01).胃癌病理分期Ⅲ、Ⅳ期者其癌组织的CD44V6表达的阳性率明显高于Ⅰ、Ⅱ期(χ2=8.71,P<0.01);伴有淋巴结转移者胃癌组织的CD44V6表达阳性率明显高于淋巴结转移阴性者.结论 CT增强扫描及CD44V6检测都有利于胃癌术前分期的判断,CD44V6的检测弥补了CT对于N分期准确度低的缺点,两者结合有利于提高分期诊断的准确率.     

螺旋CT及E-cad表达在胃癌术前分期中的价值

目的探讨CT扫描及E-cad表达相结合在胃癌术前分期诊断中的意义。方法应用CT增强扫描对66例胃癌进行术前分期;对66例胃切除标本进行E-cad表达分析,与手术及术后病理结果对照,以探讨二者在胃癌术前分期中的价值。结果 CT增强扫描对胃癌T分期准确度为81.8%,N分期准确度为89.4%,综合判断CT对于胃癌肿瘤原发灶、淋巴结和转移情况分期（TNM分期）准确度为80.3%。胃癌组织中E-cad表达阳性率为65.15%。胃癌病理分期Ⅲ、Ⅳ期者其癌组织的E-cad阳性表达率明显高于Ⅰ、Ⅱ期（P〈0.05）;浸润深度为T3、T4胃癌患者其癌组织的E-cad阳性表达率明显高于浸润深度为T1、T2者（P〈0.01）。结论 CT增强扫描及E-cad检测都有利于胃癌术前分期的判断,两者结合有利于提高分期诊断的准确率。     

64排螺旋CT对两种胃癌淋巴结分期的评估

目的评估64排螺旋CT在两种胃癌淋巴结分期中的价值。资料与方法搜集术前作64排螺旋CT检查且经住院手术证实的资料齐全的56例连续性胃癌病例。设定胃周和胃外淋巴结短轴径≥5mm为肿大淋巴结,由两位高年资医师独立对CT图像进行评估,对淋巴结进行计数,并分别按国际抗癌联盟（UICC）分期和日本胃癌规约（GRGCS）分期方法进行分期。评价在不同分期条件下,64排螺旋CT术前对胃癌肿大淋巴结的诊断准确性的差异。结果56例胃癌,手术共清除淋巴结322枚,短轴径≥5mm的淋巴结共计256枚,其中转移为阳性的淋巴结210枚;64排螺旋CT扫描对全部短轴径≥5mm的淋巴结的显示率为94%（240/256）,检测出的阳性淋巴结百分率为95%（200/210）。对于胃壁旁组和血管旁组的肿大淋巴结,CT显示率和准确率较高。N分期的总体准确性,采用GRGCS方法为80%,UICC方法为77%。其中过高分期在GRGCS方法中的发生率为14%（8/56）,在UICC方法中的发生率为9%（5/56）;过低分期在GRGCS方法中的发生率为6%（3/56）,在UICC方法中的发生率为14%（8/56）。两种N分期方法之间差异无统计学意义（P〉0.05）。结论64排螺旋CT能够较为全面和准确地观察胃癌淋巴结的位置、形态和大小,对于N分期的总体准确性较高,采用GRGCS和UICC分期并无差异。     

胃癌在双对比造影、CT扫描表现与手术切除可行性的对照研究

目的 :分析胃癌在双对比造影、CT扫描表现与手术切除根治的可行性。方法 :回顾性分析 38例经双对比造影检查、CT扫描及手术病理证实的胃癌患者资料 ,根据肿瘤的大小、范围、形态及浆膜面是否光滑 ,有无周围淋巴结肿大、周围器官的侵犯及远处淋巴结转移 ,决定是否能行手术切除进行对照。结果 :双对比造影在胃癌定位、定形、定性方面占优势。CT在胃癌的定期方面优势明显 ,对TNM分期准确性较高 ,指导外科手术是否根治方面其它方法无法替代。结论 :胃肠道双对比造影检查与CT扫描相结合 ,对大部分胃癌患者能在术前作出可否手术根治或不宜手术的可能     

MSCT 增强扫描在胃癌术前 TNM 分期中的临床价值

目的：探讨MSCT增强扫描在进展期胃癌的诊断与分期方面的价值。方法对45临床诊断为胃癌的患者进行术前MSCT动态增强扫描,根据结果作出分期诊断,并与手术及病理TNM分期相对照。结果 CT表现为胃壁多层结构破坏,淋巴结及邻近脏器的转移。 MSCT的T、N、M分期准确率分别为77．8％、71．2％和68．6％。结论 MSCT增强扫描术前评估进展期胃癌TNM分期准确性高,对胃癌患者术前评估有较高的临床参考价值。     

MSCT对胃癌转移淋巴结的诊断价值

目的 探讨MSCT对胃癌术前N分期及诊断各组转移淋巴结的准确性.方法 回顾性分析经手术病理证实的91例胃癌患者的病理和CT影像资料,术前均行统一方式低张口服水三期动态增强扫描,采用拟定的联合判断标准,对术前CT影像进行淋巴结N分期及分组,与术后病理对照,分期、分组的准确性采用Kappa一致性检验.结果 MSCT对胃癌N分期总的准确率为86.3%,N0、N1、N2、N3分期准确率为83.5%、89.0%、83.5%、89.0%;敏感性为86.5%、83.3%、50.0%、47.4%;特异性为79.5%、89.4%、89.6%、100.0%.N0与N2、N0与N3敏感性之间差异有统计学意义(P≤0.007).MSCT判断各组检出淋巴结准确率较高的为贲门左侧(No.2)、脾门旁(No.10)、胰头后(No.13)淋巴结,为98.9%;敏感性较高的为No.2、腹腔干旁(No.9)、No.10、No.13组淋巴结,为100%;特异性较高的为No.2、No.10、No.13组淋巴结,为98.9%.结论 MSCT对胃癌术前N分期及各组转移淋巴结的诊断具有较高的准确性,对胃癌术前评估、术中淋巴结清扫具有重要的指导意义.     

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.