鼻咽癌CT灌注成像及其生物学相关性研究

目的研究鼻咽癌CT灌注值与肿瘤微血管密度（MVD）、肿瘤分期的关系，探讨多层螺旋CT灌注成像对鼻咽癌的临床应用价值。方法49例鼻咽部CT灌注检查中，鼻咽癌组30例，鼻咽癌放疗后组14例，正常鼻咽部5例，测量鼻咽癌和鼻咽黏膜位置的血流量（BF）、最大强化指数（PEI）、峰值到达时间（TTP）及血容量（BV）作为灌注指标，其中16例鼻咽癌活检组织行免疫组织化学CD34单抗染色后，Weidner方法计数MVD。各组灌注值比较行方差分析，CT灌注值、肿瘤分期与MVD之间行Spearman等级相关分析。结果49例中1例鼻咽癌灌注检查失败。鼻咽癌组（29例）肿瘤CT灌注值BF为（48．6±16．9）ml·100g^-1·min^-1，PEI为（32．3±7．9）HU，TTP为（17．5±4．9）s，BV为（12．8±4．4）ml·100g^-1；正常对照组（5例）BF、PEI、TTP、BV值分别为（15．9±5．9）ml·100g^-1·min^-1、（12.6±1．3）HU、（22．6±6．9）s、（3．5±0．5）ml·100g^-1；鼻咽癌放疗后组（14例）BF、PEI、TTP、BV值分别为（25．2±7．0）ml·100g^-1·min^-1、（19．8±5．9）HU、（22．6±4．3）s、（6．1±2．4）ml·100g^-1，三组各灌注值差异有统计学意义（P值均〈0．01）；相关分析显示，鼻咽癌组（29例）中TNM分期（其中Ⅰ期3例，Ⅱ期9例，Ⅲ期10例，Ⅳ期7例）与PEI和BV存在相关性（r值分别为0．48和0．50），与BF和TTP无明显相关性（r值分别为0．23和0．22）；16例鼻咽癌MVD为（30．8±12．6）个／高倍镜视野，与其BF（51．4±17．0）ml·100g^-1·min^-1、PEI（33．2±9．6）HU和TTP（16．3±4．1）8存在相关性（r值分别为0．85、0．60和0．78），与BV（13．2±5．6）ml·100g^-1弱相关（r=0．48）。结论鼻咽癌有着特征的CT灌注表现，多层螺旋CT灌注成像的灌注值可以反映鼻咽癌微血管密度特征，PEI和BV值与鼻咽癌的TNM分期存在一定的相关性。     

肺癌的CT灌注成像与脱氧葡萄糖正电子发射计算机体层扫描及肿瘤微血管密度的相关性

目的探讨肺癌的CT灌注参数与微血管密度（MVD）和由脱氧葡萄糖正电子发射计算机体层扫描（FDG-PET）所得的标准摄取值（SUV）的相关性，评价CT灌注成像在反映肺癌肿瘤血管生成方面的价值。方法对50例肺癌患者行CT灌注成像，计算病灶的血流量（BF）、血容量（BV）、平均通过时间（MTT）、表面渗透性（PS）。其中14例行FDG．PET检查，测量病灶的SUV。取50例患者的病理标本作免疫组织化学CD34染色，计数MVD，将CT灌注参数与MVD及SUV进行相关性分析。结果BF、BV、MTT及PS的平均值分别为97．30ml·100g^-1·min^-1，8．86ml·100g^-1，6．75s及34．52ml·100g^-1·min^-1；MVD平均值61．82个／高倍镜；14例患者的SUV平均值5．96。BF与SUV及MVD均呈正相关（r值分别为0．727、0．543，P〈0．05）；MVD与BV及PS亦呈正相关（r值分别为0．375、0．346，P〈0．05）；MVD与SUV呈正相关（r=0．565，P〈0．05）。结论CT灌注参数与MVD及SUV相关，是在体评价肿瘤血管生成的理想方法。     

400 mgI/ml和370 mgI/ml造影剂在脊髓血管CTA中的应用对比

目的：比较400mgI／ml与370mgI／ml非离子碘造影剂在脊髓血管CTA中能否提高脊髓前动脉、大根髓动脉的图像质量。方法：103例患者分为370mgI／ml组（51例）和400mgI／ml组（52例）,行多排CT脊髓血管CTA扫描,图像经颅脑CT算法及小视野二次重建,对比（1）降主动脉起始段CT值;（2）脊髓前动脉（ASA）和大根髓动脉（AA）显示率;（3）AA走行各段对比噪声比（CNR）;（4）ASA和AA图像质量评分。结果：370mgI／ml组和400mgI／ml组降主动脉起始段血管内密度分别为（305．5±23．7）HU和（367．4±19．8）HU,组间有统计学差异（t=2．23,P〈0．05）;370mgI／ml组和400mgI／ml组的ASA和AA的显示率均为100％;370mgI／ml组和400mgI／ml组AA各段的CNR分别为：（1）AA起源血管段（肋间动脉或腰动脉）：24．11±4．43和27．88±5．12,组间有统计学差异（t=3．998,P〈0．05）;（2）椎间孔段：7．23±4．28和7．87±4．72,组间无统计学差异（t=0．316,P〉0．05）;（3）椎管内段：6．08±1．17和6．53±1．52,组间无统计学差异（t=0．894,P〉0．05）;（4）汇入ASA动脉后：9．72±1．91和9．49±2．01,组间无统计学差异（t=0．564,P〉0．05）。ASA和AA的图像质量评分显示370mgI／ml组和400mgI／ml组组间没有统计学差异（Χ^2=0．317,P〉0．05;Χ^2=0．569,P〉0．05）。结论：多排CT脊髓CTA中,使用400mgI／ml非离子碘造影剂与370mgI／ml非离子碘造影剂相比可以增加血管强化,但并不能显著提高ASA和AA图像质量。     

CT灌注成像在腮腺肿瘤鉴别诊断中的临床价值

目的探讨多层螺旋CT灌注成像技术定量评价腮腺良、恶性肿瘤的血液动力学特点及其对腮腺良恶性肿瘤的鉴别诊断价值。方法53例患者共57个病变，其中良性肿瘤35例，恶性肿瘤18例，全部经术后病理证实。术前行CT灌注检查。采用Philips perfusion功能软件包获取组织的时间密度曲线（time density calve，TDC）及CT灌注参数，包括灌注量、增强峰值（PH）、达峰时间（TTP）、血容量（BV）、平均通过时间（MTT）。采用Wilcoxon符号秩和检验进行统计学处理。结果腮腺良性肿瘤的CT灌注参数的中位数及四分位间距[25％CI 75％（Q1，Q2）]分别为：灌注量73．5（18．7，113．3）ml·100g^-1·min^-1、PH 34．5（17．7，53．1）HU、TTP 20．0（13．6，34．4）S、BV 38．5（29．1，63．3）ml·100g^-1、MTT 7．6（4．5，28．7）s。腮腺恶性肿瘤的CT灌注参数分别为：灌注量135．9（101．4，195．2）ml·100g^-1·min^-1，PH 49．1（32．7，59．4）HU，TTP 12．9（11．3，14．6）s，BV 67．5（52．4，109．5）ml·100g^-1，MTT 6．0（5．1，7．6）s。统计结果显示，CT灌注参数BF、BV、TTP的中位数及四分位间距在腮腺良恶性肿瘤之间差异具有统计学意义（P值均〈0．05），而PH、及MTT之间差异无统计学意义（P〉0．05）；腺淋巴瘤、其他良性肿瘤、恶性肿瘤的TDC的差异也有统计学意义（P值均〈0．05）。结论CT灌注扫描技术对腮腺良恶性肿瘤的鉴别诊断具有一定价值。     

兔VX2肿瘤介入治疗前后肿瘤血管生成的多层螺旋CT灌注成像研究

目的 探讨多层螺旋CT（ISCT）灌注成像在定量评价软组织恶性肿瘤介入治疗前后肿瘤血管生成和介入治疗后早期疗效监测中的应用价值。方法 24只成功种植VX2肿瘤的新西兰大白兔，数字表法随机分为介入组和对照组，每组12只，分别于肿瘤种植后第14天、介入治疗后第3天行常规CT平扫和灌注扫描，计算肿瘤组织和正常肌肉组织的血流量（BF）、血容量（BV）、平均通过时间（MTT）和表面通透性（PS）值，分析各参数之间的差异性；并将各灌注参数分别与肿瘤微血管密度（IVD）值和血管内皮生长因子（VEGF）平均吸光度（A）值进行相关性分析。结果 肿瘤种植后第14天，介入组肿瘤BF、BV、MTT、PS值分别为（303．3±69．9）ml·100g^-1·min^-1、（7．02±3．10）ml／100g、（1．99±0．28）s、（65．9±9．4）ml·100g^-1·min^-1，与正常肌肉组织相比[分别为（11．8±5．0）ml·100g^-1·min^-1、（1．04±0．47）ml／100g、（17．92±7．19）s、（13．1±6．4）ml·100g^-1·min^-1]差异有统计学意义（F值分别为4285．82、1867．46、413．04、698．42，P〈0．01）；与对照组肿瘤的各参数值差异无统计学意义（F值分别为2．47、2．03、0．02、0．53，P〉0．05）。介入组肿瘤IVD值和VEGF平均A值分别为（50．1±4．1）个／高倍视野、0．352±0．011，与对照组肿瘤[分别为（50．2±3．7）个／高倍视野、0．352±0．009]差异无统计学意义（F值分别为0．02、0．19，P〉0．05）。介入治疗后第3天（即种植后第18天），介入组肿瘤BF、BY、MTT、PS、MYD值和YEGF平均A值分别为（7．5±24）ml·100g^-1·min^-1、（1．20±0.23）ml／100g、（3．29±0.57）s,（40±1．5）ml·100g^-1·min^-1、（16．0±2．4）个／高倍视野、0．215±0．008，与对照组相比[分别为（390．2±116．3）ml·100g^-1·min^-1、（8．47±2．53）ml／100g、（1．88±0．34）s、（76．9±11．3）ml·100g^-1·min^-1、（84．8±5．6）个／高倍视野、0．366±0．013]差异有统计学意义（F值分别为10166．91、1310．19、272．84、1649．80、1239．72、4168．91，P〈0．01）；与介入治疗前相比，差异也有统计学意义（t值分别为74．53．49．62、-16．82、35．36、50．41、65．64，P〈0．01）。、肿瘤BF、BV、PS值与IVD值和VEGF平均A值呈正相关（r值均〉0．7，P〈0．05）；MTT值与VEGF平均A值呈负相关（r=-0．78，P〈0．05），而与肿瘤IVD值无明显相关性（r=-0．315，P〉0．05）。结论 NSCT灌注成像是一种定量评价肿瘤血管生成、血流灌注及血管通透性改变的功能成像方法，可以无创、准确地对肿瘤介入治疗早期疗效进行定量评价和动态监测。     

多层螺旋CT灌注成像对肾积水肾功能可复性的预测价值

目的 探讨多层螺旋CT（MSCT）灌注成像在肾积水肾功能可复性预测中的价值。方法 建立大白兔单侧输尿管部分梗阻肾积水模型。分为对照组，梗阻2、4及8周组，后3组在解除梗阻后再饲养4周，各组在梗阻解除前、后均行MSCT灌注扫描，测量右肾皮、髓质的血流量（BF）、血容量（BV）值并进行比较。然后处死实验动物制成普通病理切片，观察各组病理改变。结果 （1）MSCT检查显示梗阻2周组在梗阻解除后，其右肾皮质的BF、BV分别为（864±32）ml·100g^-1·min^-1、（19．5±0．9）ml／100g，较梗阻解除前[分别为（630±37）ml·100g^-1·min^-1、（14．0±1．2）ml／100g）]上升，差异有统计学意义（t值分别为-19．37、-12．11，P值均〈0．01）；右肾髓质的BF、BV分别为（182．1±7．5）ml·100g^-1·min^-1、（8．37±0．51）ml／100g，比梗阻解除前[分别为（132．6±3．9）ml·100g^-1·min^-1、（5．13±0．35）ml／100g）]也明显上升，差异有统计学意义（t值分别为-23．52、-11．51，P值均〈0．01）。（2）梗阻4周、8周组在梗阻解除后，其右肾皮质BF[分别为（525±15）、（512±10）ml·100g^-1·min^-1]、BV[分别为（12．8±0．6）、（9．4±1．0）ml／100g]与梗阻解除前[分别为（515±23）、（505±16）ml·100g^-1·min^-1，（12．2±0．8）、（10．3±0．5）ml／100g]相比，差异无统计学意义（P值均〉0．05）。（3）组织学上，梗阻时间短，解除梗阻后的病理变化较轻，梗阻时间长，解除梗阻后的病理变化重。结论 MSCT灌注成像不仅能够提供肾积水形态学的信息，又能提供血流灌注的信息，在肾积水肾功能可复性预测中有一定价值。     

头颈部肿瘤CT灌注成像表现与微血管生成因子表达水平的相关性研究

目的研究头颈部肿瘤CT灌注与肿瘤血管生成因子（VEGF）的相关性。方法对85例共88个（恶性77个，良性11个）头颈部肿瘤术前行CT灌注检查。采用螺旋CT机自带软件绘制感兴趣区（ROI）的时间-密度曲线（TDC）并计算ROI强化峰值（PH）、达峰时间（PT）、平均通过时间（MTT），病灶相对强化峰值（RPH）和灌注量（PF）。其中35例切取与CT灌注靶层面相同的组织切片，行CD34、VEGF抗体免疫组织化学染色，分析肿瘤CT灌注成像表现与微血管密度（MVD）和VEGF表达的相关性。结果（1）头颈部肿瘤CT灌注成像TDC主要有3种类型，77个恶性肿瘤中53个（68．9％）表现为速升速降型；9个淋巴瘤中6个TDC表现为低平型曲线，与68个其他肿瘤中仅有9个为低平型曲线相比差异有统计学意义（P〈0．05）。（2）甲状腺癌呈高灌注，其PF（中位数为82．2ml·min^-1·100g^-1）与淋巴瘤PF（中位数为24．5ml·min^-1·100g^-1）、头颈鳞癌PF（中位数为23．8ml·min^-1·100g^-1）相比差异有统计学意义（P〈0．05）。（3）11个良性肿瘤的MVD均数为（44．7±3．4）条／高倍视野，24个恶性肿瘤的MVD为（49．6±14．8）条／高倍视野，良恶性肿瘤间差异无统计学意义（P〉0．05）；VEGF在恶性肿瘤呈强阳性者15个，弱阳性9个；在良性肿瘤呈强阳性1个，弱阳性10个，VEGF的表达强阳性率在良、恶性肿瘤差异有统计学意义（P〈0．01）。（4）MVD（中位数40．0）与PH（中位数26．9）、RPH（中位数14．5）和PF（中位数46．8）有明显相关性（r值分别为0．35、45．49和0．41），VEGF（中位数4．0）表达与MTT（中位数16．7）呈负相关（r=-0．41）。结论CT灌注成像TDC形态对头颈部肿瘤诊断及鉴别诊断有一定的帮助。MVD、VEGF与CT灌注相关，CT灌注成像可以反映肿瘤微循环情况。     

正常肾和肾细胞癌CT灌注成像及其与微血管密度相关性的研究

目的测量并初步确定正常肾脏皮质CT灌注各参数值范围及肾细胞癌（RCC）各CT灌注参数值变化特点;分析RCC各CT灌注参数值与其微血管密度（MVD）计数的关系。资料与方法对26名肾功能正常的志愿者及30例经手术病理证实的RCC患者行CT灌注扫描,所得数据送入Advanced Workstation4.2工作站,应用perfusion3软件分别测量正常肾脏及肿瘤各CT灌注参数值,包括血流量（BF）值、血容量（BV）值、平均通过时间（MTT）值及毛细血管表面通透性（PS）值;用免疫组织化学过氧化物酶标记的链霉素卵白素法（SP法）检测RCC中MVD的表达（人工计数）;分析RCC实性部分与正常肾脏皮质间各CT灌注参数值差异是否存在统计学意义,分析RCC各CT灌注参数值与其MVD计数的相关性,以上两组数据的采集应用双盲法。结果26名正常人肾脏皮质CT灌注BF值（502.73±99.03）ml·min^-1.100g^-1,BV值（25.35±9.12）ml/100g,MTT值（3.13±0.83）s,PS值（62.15±12.29）ml·min^-1.100g^-1;30例肾癌患者CT灌注BF值、BV值、MTT值及PS值分别为（301.74±250.41）ml·min^-1.100g^-1、（18.17±11.54）ml/100g,（6.62±4.91）s和（21.59±12.75）ml·min^-1.100g^-1,MVD计数为（47.67±30.92）条。RCC与正常肾脏皮质间各CT灌注参数值差异有统计学意义（P〈0.01,tBF=4.904,tBV=3.243,tMTT=-4.376,tPS=14.973）,正常肾脏皮质的BF值、BV值及PS值均高于肾癌实性部分;MTT值则相反。肾癌CT灌注的BF值和BV值与其MVD计数呈正相关,r值分别为0.736和0.632（P〈0.01）;而MTT值与其MVD计数呈负相关,r值为-0.487（P〈0.01）;PS值与其MVD计数无相关性。结论RCC CT灌注参数BF值、BV值和MTT值与MVD计数存在相关性,这些CT灌注参数值在一定程度上可反映活体的肿瘤血管生成状况和恶性程度,有助于临床制定治疗方案,判断疗效及预后。     

盐酸文拉法辛胶囊的人体生物等效性

目的：对盐酸文拉法辛两种胶囊制剂进行生物等效性评价。方法：18名健康受试者分别随机交叉单剂量口服盐酸文拉法辛胶囊50mg后,采用反相高效液相色谱．荧光检测法测定血药浓度。结果：受试制剂和参比制剂的药动学参数Cmax分别为（161．76±70．15）和（143．22±70．14）ng／ml;Tmax分别为（3．00±0．84）和（2．58±0．86）h;AUC0→t。分别为（917．17±500．72）和（834．48±437．99）ng／（h·ml）;AUC0→∞分别为（1115．46±687．85）和（1239．67±861．78）ng／（h·ml）;t1／2分别为（4．51±1．93）和（5．42±3．55）h。受试制剂AUC0→t的90％可信限落在参比制剂80．0％-125．0％范围内。Cmax的90％可信限落在参比制剂70．0％～143．0％范围内,Tmax经Witeoxon非参数秩和检验无显著性差异。结论：受试制剂与参比制剂在人体内生物等效。     

复发性视神经脊髓炎脑扩散张量成像研究

目的利用扩散张量成像（DTI）探讨复发性视神经脊髓炎（RNMO）患者是否存在隐匿性脑组织损伤及其发生机制。方法对16例RNMO患者和16例性别和年龄匹配的正常志愿者脑组织的平均扩散系数（ND）和部分各向异性（FA）进行直方图和感兴趣区（ROI）分析，以P≤0．005为差异有统计学意义。结果与志愿者比较，RNMO患者脑的平均MD升高[脑组织：RNMO患者（0．95±0．02）×10^-3mm^2／s，志愿者（0．91±0．03）×10^-3mm^2，t=3．940，P〈0．001；脑白质：RNMO患者（0．82±0．02）×10^-3mm^2／s，志愿者（0．80±0．02）×10^-3mm^2／s，t=3．117，P=0．004；脑灰质：RNMO患者（1．06±0．04）×10^-3mm^2／s，志愿者（0．88±0．05）×10^-3mm^2／s，t=4．031，P〈0．001]、脑白质的FA直方图峰高抬高[RNMO患者（2．61±0．18）‰，志愿者（2．38±0．18）‰，t=3．627，P=0．001]及脑灰质的MD直方图峰高降低[RNMO患者（7．37±0．89）‰，志愿者（8．91±1．71）‰，t=3．210，P=0．003]和峰位置抬高[RNMO患者（0．83±0．02）×10^-3mm^2／s，志愿者（0．81±0．02）×10^-3mm^2／s，t=4．373，P〈0．001]；与脊髓和视神经有直接联系ROI的平均MD升高[延髓：RNMO患者（1．27±0．11）×10^-3mm^2／s，志愿者（1．11±0．10）×10^-3mm^2／s，t=4．260，P〈0．001；大脑脚：RNMO患者（1．01±0．11）×10^-3mm^2／s，志愿者（0．87±0．05）×10^-3mm^2／s，t=4．391，P〈0．001；内囊：RNMO患者（0．74±0．01）×10^-3mm^2／s，志愿者（0．72±0．01）×10^-3mm^2／s，t=4．683，P〈0．001；视放射：RNMO患者（0．88±0．03）×10^-3mm^2／s，志愿者（0．82±0．03）×10^-3mm^2／s，t=4．619，P〈0．001）、平均FA降低（延髓：RNMO患者0．27±0．01，志愿者0．29±0．03，t=2．996，P=0．005；大脑脚：RNMO患者0．49±0．04，志愿者0．54±0．03，t=4．280，P〈0．001；内囊：RNMO患者0．66±0．02，志愿者0．69±0．02，t=3．953，P〈0．001；视放射：RNMO患者0．53±0．04，志愿者0．59±0．03，t=4．705，P〈0．001）；而与脊髓和视神经无直接联系的胼胝体的平均MD[膝部：RNMO患者（0．76±0．04）×10^-3mm^2／s，志愿者（0．73±0．03）×10^-3mm^2／s；压部：RNMO患者（0．77±0．05）×10^-3mm^2／s，志愿者（0．73±0．04）×10^-3mm^2／s]和FA值（膝部：RNMO患者0．82±0．03，志愿者0．82±0．03；压部：RNMO患者0．83±0．03，志愿者0．83±0．02）差异无统计学意义（P值均〉0．005）。结论RNMO患者存在隐匿性脑组织损伤，这可能与继发于脊髓和视神经病灶的顺行和逆行性变性有关。     

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.