儿童良性食管狭窄的介入治疗

目的 评价儿童良性食管狭窄使用球囊扩张及暂时性覆膜可回收支架治疗的疗效.方法 44例(男29例,女15例,平均年龄7岁)儿童良性食管狭窄接受食管球囊扩张治疗,对球囊扩张后临床症状及吞咽评分改善不满意的患儿置放暂时性覆膜可回收支架.结果 44例儿童良性食管狭窄疗效明显,食管穿孔等并发症罕见,术后6～30个月保持临床无症状,吞咽评分由2~3改善为0～1,治疗效果满意.结论 本方法安全简单且实用,可作为儿童良性食管狭窄首选的治疗方法.     

球囊扩张术治疗儿童食管良性狭窄的疗效北大核心CSCD

目的 探讨透视下球囊扩张术治疗不同原因的儿童食管良性狭窄的疗效及安全性。方法 回顾性分析2018年3月至2021年5月天津市儿童医院收治的17例食管良性狭窄患儿的临床资料。患儿中,食管闭锁术后吻合口狭窄组(Ⅰ组)8例,腐蚀性食管狭窄组(Ⅱ组)5例,食道裂孔疝加贲门成形术后贲门狭窄1例,贲门失迟缓症1例,先天性食管狭窄1例。患儿存在吞咽困难,经X线钡餐造影确诊食管狭窄后,在放射线引导下进行食管狭窄的球囊扩张治疗,术后随访6~18个月,观察疗效。结果 17例患儿共进行49次球囊扩张术,每例患儿平均扩张2.88次(1~9次),球囊直径为6~25 mm。Ⅰ组患儿扩张成功7例;Ⅱ组患儿成功扩张4例,其余患儿均扩张成功。术后随访6~18个月,长期有效13例,Ⅰ组长期有效6例,Ⅱ组长期有效4例,余患儿均长期有效。术中术后均无严重并发症出现。结论 透视下食管球囊扩张术治疗不同原因儿童食管良性狭窄安全有效。     

食管上段狭窄球囊扩张及内支架治疗的临床疗效(附47例报告)

目的:探讨食管上段良、恶性狭窄行球囊扩张及内支架治疗的临床疗效。方法:对4 7例食管上段恶性狭窄4 4例,良性狭窄3例行食管球囊扩张及内支架置入,以食管钡餐造影及纤维内窥镜检查随访。结果:4 4例食管上段术后狭窄位于颈段食管2 1例,胸段食管2 3例行球囊扩张并行食管内支架,随访1～38个月,术后生存时间平均7～8个月。3例食管上段化学灼伤良性狭窄,狭窄均位于胸段,随访1～3年,患者进食无异常。结论:食管上段良、恶性狭窄行球囊扩张并内支架置入是治疗食管狭窄的有效方法     

球囊导管扩张术治疗儿童灼伤性食管狭窄

目的　评价儿童烧灼性食管狭窄使用球囊扩张治疗的疗效。方法　分析球囊导管扩张术治疗 18例烧灼性食管狭窄 ,10例食管狭窄为误服硫酸 ,7例食管狭窄为误服烧碱 ,1例食管狭窄为误服以硫酸锌为主的化学物。球囊扩张前均行食管吞钡检查 ,我们分别使用 4mm× 4 0mm～ 16mm× 4 0mm或2 0mm× 4 0mm球囊扩张食管狭窄。结果　 18例儿童烧灼性食管狭窄治愈 16例 ,1例转为手术治疗 ,另 1例因食管闭塞而无法通过球囊导管。术后 6～ 30个月保持临床无症状 ,治疗效果满意。结论　本方法安全简单且实用 ,为儿童烧灼性食管狭窄首选的治疗方法。     

先天性食管闭锁手术后吻合口狭窄的介入治疗

目的 报道13例先天性食管闭锁术后食管吻合口狭窄婴儿使用球囊扩张术治疗。方法 13例患儿均为食管闭锁术后吻合口狭窄,年龄为3～10个月,球囊扩张前均先行食管吞钡检查,显示狭窄段内径仅1～3mm。采用球囊导管分次扩张。所用球囊直径6～12mm。结果 每例经2～3次扩张,13例共进行球囊扩张30次,扩张后疗效明显,保持临床无症状期6～30个月,无食管穿孔并发症。结论 球囊扩张术简单、安全、有效,为婴儿先天性食管闭锁手术后吻合口狭窄的首选疗法。     

婴儿食管吻合口狭窄球囊扩张术

目的：本文报告４例婴儿食管吻合口狭窄使用球囊扩张术治疗。材料和方法：４例女婴均为食物闭锁术后２￣１５个月出现吻合口狭窄，狭窄内径３￣６ｍｍ。采用球囊导管分次扩张，球囊直径６￣１５ｍｍ。结果：４例共进行球囊扩张１２次，保持临床无症状期４￣６个月。无食管穿孔并发症。结论：球囊扩张术简单、安全、有效，为婴儿食物吻合口狭窄的首选治疗方法。     

透视下球囊扩张术治疗婴幼儿食管良性狭窄的临床疗效分析

目的：探讨透视下球囊扩张术治疗婴幼儿食管良性狭窄的临床疗效及安全性。 方法：回顾性分析我院2007年7月至2015年12月收治的53例食管良性狭窄患儿（其中食管腐蚀性狭窄组14例,食管闭锁术后吻合口狭窄组39例）的临床资料,所有患儿经X线钡餐造影确诊后,在影像引导下进行食管狭窄的球囊扩张治疗,比较两组术中的扩张效果。术后随访6~18个月,观察并比较两组疗效。 结果：53例患儿共进行187次球囊扩张术,平均每个患儿扩张3.5次（范围1~11次）,球囊直径范围为6~20 mm。食管腐蚀性狭窄组患儿均需经过两次及以上扩张,扩张成功14例（100%）。食管吻合口狭窄组患儿中,1次扩张成功11例（28.2%）,两次及以上扩张成功28例（71.8%）。两组的扩张次数差异无统计学意义（P>0.05）。术后行X线钡餐造影示食道狭窄段较前显著扩张,造影剂通过顺利,达到治愈标准,扩张成功率为100%。所有患儿术后随访6~18个月,总有效率（79.2%,42/53）,吻合口狭窄组患儿FBD治疗有效率（87.1%,34/39）高于腐蚀性狭窄组（57.1%,8/14）,差异有统计学意义（χ²=3.972,P<0.05）。 结论：透视下球囊扩张术治疗婴幼儿食管良性狭窄临床疗效显著,特别对于食管闭锁术后吻合口狭窄的患儿,安全性好,且易操作,临床应用和推广价值高。     

食管良、恶性狭窄球囊扩张及内支架治疗的随访研究(附156例分析)

目的　评价食管良、恶性狭窄球囊扩张和内支架置入的远期疗效及并发症。方法　 15 6例食管良、恶性狭窄 ,行球囊扩张及置入内支架治疗 ,其中 12例良性狭窄行单纯球囊扩张 ,1例化学灼伤后食管自发性破裂并发纵隔脓肿及脓胸 ,采用可回收式记忆合金覆膜网状支架 ;14 3例恶性狭窄中 ,134例置入了金属内支架 ,9例作了球囊扩张。门诊食管造影或纤维内窥镜检查随访。结果　食管恶性狭窄随访 1～ 48个月 ,6 1例死亡 ,术后生存时间 1～ 33个月 ,平均 8.9个月。支架放置后再次出现吞咽困难 6 3例( 4 7% ) ,因食物及粘液在支架内嵌塞 3例 ,支架两端和支架腔内不规则狭窄 33例 ,狭窄仅局限于支架上端 19例 ,狭窄位于支架两端8例。纤维内窥镜检查发现 ,肿瘤组织 (或肉芽组织 )通过支架“网眼”向腔内和 (或 )两端生长。再次发生吞咽困难的 6 3例 ,均做了球囊扩张或再次内支架置入等治疗。食管良性狭窄随访 5～ 6 1个月 ,仍能进普食。结论　内支架置入术是姑息性治疗食管恶性狭窄的有效方法 ,肿瘤组织和增生的肉芽组织是引起再次狭窄的主要原因 ,带膜支架可有效降低再狭窄率 ,但不能阻止两端的狭窄 ;球囊扩张无效的良性狭窄 ,可放置回收式覆膜支架。     

儿童食管化学性灼伤致疤痕狭窄的介入治疗

目的 探讨儿童食管化学性灼伤致疤痕狭窄的介入球囊扩张治疗的疗效。方法 8例化学性灼伤致食管疤痕患儿在出现临床症状如咽下困难，反流，及呕吐后1-3月内接受了球囊扩张治疗，全部患儿经随访6个月-2年。结果 8例患儿经球囊扩张治疗4-12次。其中7例临床症状明显改善，基本上能进普食，随访6个月-2年无狭窄症状；1例碱性物质灼伤共经12次扩张治疗效果不佳。行外科手术治疗。结论 球囊扩张术治疗儿童食管化学性灼伤致疤痕狭窄是一种安全可靠有效的治疗方法，但食管狭窄严重经多次球囊扩张术无效，需手术治疗。     

食管恶性狭窄内支架治疗和食性狭窄球囊扩张后的随访评价

目的 评价食管恶性狭窄内支架治疗和良性狭窄球囊扩张后的长期随访疗效。方法 ９２例食管狭窄做了内支架或球囊扩张，有较完善的随访资料。５９例恶性食管狭窄均置入了内支架，其中置入支架前后行放射治疗（简称放疗）和（或）化学药物治疗（简称化疗）３７例，占６３％，３３例良性食管狭窄做了单纯球囊扩张治疗。内支架置入类型：国产镍钛记忆合金网孔支架２４例，带膜支架２２例，国产ＧｉａｎｔｕｒｃｏＺ形支架７例。带膜支架     

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.