肝细胞癌CT增强特征与bFGF表达和血管生成关系探讨

目的　探讨肝细胞癌 (hepatocellularcarcinoma ,HCC)动脉期CT增强特征与碱性成纤维细胞生长因子 (basicfibroblastgrowthfactor ,bFGF)的表达及微血管生成之间的关系。方法　对 13例经病理证实的且行CT动、静脉双期增强扫描的HCC病灶进行回顾性分析 ,用免疫组化SP法检测肿瘤组织bFGF的表达以及微血管密度 (microvesseldensity ,MVD) ,微血管直径以及第Ⅷ因子相关抗原(FactorⅧrelatedantigen ,FⅧRA)的表达部位 ,将CT的增强特征分别与免疫组化结果进行对照分析。结果　bFGF在HCC组织中的阳性表达率为 84.6% ,平均的MVD和微血管直径分别为 (3 5 .83± 10 .65 ) μm和 (11.85± 7.88) μm ,FⅧRA表达部位Ⅰ、Ⅱ、Ⅲ型病灶分别占病灶总数的 3 0 .77%、2 3 .0 8%和 46.15 %。MVD在bFGF表达的阳性、阴性组具有显著差异 (Ρ <0 .0 5 )。HCC在CT上动脉期显示的强化程度与MVD成正比 (Ρ <0 .0 5 ) ,而强化类型则与bFGF的阳性表达具有一定的关系 (Ρ <0 .0 5 ) ,强化程度和类型与其它因素未见相关性 (Ρ >0 .0 5 )。结论　CT的动脉期强化特征在一定程度上可反映HCC微血管生成以及bFGF的表达情况。     

肝细胞癌螺旋CT表现特征与临床、病理关系的对照研究

目的　探讨肝细胞癌 (hepatocellularcarcinoma ,HCC)螺旋CT(spiralcomputedtomography ,SCT)增强表现特征与HCC多个临床、病理特征之间的关系。方法　对 5 0例 (男 3 9例 ,女 11例 )共 5 4个经手术病理证实且行SCT动、静脉双期增强扫描的HCC病灶进行回顾性分析 ,观察其SCT增强表现特征 ,包括包膜类型、强化类型、侵袭转移性、病灶大小和肝硬化等。记录HCC患者的临床和病理资料 ,如年龄、HBsAg、AFP值、肝硬化、瘤内有无坏死等情况。将SCT表现特征与上述指标进行对照分析。结果　SCT表现特征与HCC的病理表现具有相关性。与SCT显示的包膜类型有关的是病理分级 ,与强化类型有关的是病灶的大小和瘤内有无坏死 ,与SCT显示的侵袭转移性有关的是病灶的大小 ,与SCT显示的病灶大小有关的是AFP值 ,与SCT显示的肝硬化有关的是HBsAg和病灶的大小。结论　SCT各种的表现特征与HCC的某些临床和病理特征关系密切     

肝细胞癌和胆管细胞癌螺旋CT增强表现与VEGF表达及MVD的相关性研究

目的探讨肝细胞癌(HCC)及胆管细胞癌(CCC)螺旋CT(SCT)增强表现特征与它们的血管内皮生长因子(VEGF)蛋白表达水平、微血管密度(MVD)的关系。方法回顾性分析经手术病理证实且术前行SCT增强检查的50例HCC(共54个病灶)和24例CCC(共28个病灶),观察其SCT增强表现类型及二者动脉期增强程度,用免疫组化SP法检测肿瘤VEGF组织的表达水平,用CD34标记微血管染色,进行MVD计数。对二者的SCT增强表现类型与VEGF表达、MVD进行统计学对照分析。结果(1)HCC和CCC肿瘤组织VEGF阳性表达率及MVD方面的差异均具有显著性(2χ=5.50,t=2.03,P<0.05);(2)HCC中动脉期强化类型与VEGF和MVD未显示出相关性(2χ=1.95,t=1.80,P>0.05);CCC中不同延迟强化类型病灶的MVD值差异具有显著性(t=2.09,P<0.05);(3)HCC和CCC病灶动脉期增强程度具有显著性差异(2χ=46.6,P<0.01)。结论HCC和CCC的VEGF蛋白表达率及MVD方面的差异在一定程度上影响了二者SCT图像增强表现情况。     

肝细胞癌SCT表现特征与血管生成及TP和TGF-β1表达的相关性研究

目的探讨肝细胞癌(HCC)螺旋CT(SCT)增强表现特征与TP、TGF-β1及微血管密度(MVD)之间的相关性.方法对47例经手术病理证实且行SCT动、静脉双期增强扫描的HCC病灶进行回顾性分析,观察其SCT表现特征,包括肿瘤大小、包膜、子灶、门静脉癌栓、肝门淋巴结转移和强化类型等.用免疫组织化学方法检测癌组织中TP、TGF-β1和CD34的表达情况.分析评价SCT表现特征与3种因子之间的关系.结果TP及MVD与SCT图像上的高侵袭性、包膜有关(P＜0.05).TGF-β1与高侵袭性有关(P＜0.05).3种因子的表达均与肿瘤大小、强化类型无明显相关性(P＞0.05).结论根据HCC的SCT表现特征可在-定程度上反映HCC微血管生成以及TP、TGF-β1的表达情况.     

肝细胞癌双期螺旋CT表现特征与VEGF、bFGF表达以及临床、病理的关系研究

目的 探讨肝细胞癌(HCC)双期螺旋CT(SCT)增强表现特征与血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)的表达以及临床、病理特征之间的关系。资料与方法 对50例共54个经手术病理证实且行SCT动、静脉双期增强扫描的HCC病灶进行回顾性分析，记录其临床和病理特征，用免疫组织化学SP法检测癌组织中VEGF、bFGF的表达情况，将SCT表现特征与上述指标进行对照分析。结果 HCC中VEGF和bFGF的阳性表达率分别为81.5％(44／54)和75．9％(41／54)。Logistic回归分析表明与SCT显示的包膜类型有关的因素是病理分级；与强化类型有关的因素有病灶的大小和瘤内有无坏死；与SCT显示侵袭转移性有关的因素是病灶的大小；与SCT显示的病灶大小有关的因素有AFP水平、VEGF和病理分级。结论 HCC的SCT表现特征受多种不同因素的共同影响，SCT表现特征可在一定程度上反映VEGF的表达情况。     

非小细胞肺癌肿瘤血管生成与动态增强MRI表现的相关性

目的　探讨非小细胞肺癌的微血管密度 (MVD)及其血管内皮生长因子 (VEGF)与MR动态增强指标间的关系。方法　 3 3例经病理证实的NSCLC ,分析其MR动态增强的最大强化斜率 (Smax)和峰值到达时间 (TTP)。将Smax和TTP分别与肿瘤的病理类型以及免疫组化结果 (MVD、VEGF)进行相互比较。结果　 (1)腺癌的Smax高于鳞癌 ,而TTP则低于鳞癌 ,它们间均有明显的统计学差异(Smax :t=3 .2 2 ,Ρ <0 .0 1和TTP :Z =-2 .795 ,Ρ <0 .0 5 ) ;(2 )腺癌的MVD和VEGF阳性数均高于鳞癌 ,它们之间的差异有统计学意义(MVD :t=6.3 4,P <0 .0 0 1;VEGF :Ρ =0 .0 15 <0 .0 5 )。结论　MR动态增强的Smax和TTP ,可以反映NSCLC的MVD和VEGF表达的高低 ,从而推测其肿瘤血管的生成状况     

肝细胞癌CT表现特征与VEGF、bFGF及凋亡相关蛋白表达的关系

目的　检测肝细胞癌 (hepatocellularcarcinoma ,HCC)组织中血管内皮生长因子 (vascularendothelialgrowthfactor ,VEGF)、碱性成纤维细胞生长因子 (basicfibroblastgrowthfactor ,bFGF)及凋亡相关蛋白的表达与CT表现特征之间的关系。 方法　对 3 8例共 40个经病理证实且行动、静脉双期CT增强扫描的HCC病灶进行分析 ,用免疫组化SP法检测癌组织中VEGF、bFGF以及fas、bax、bcl -2和bcl -xl的表达情况 ,并结合病理分级将CT各个表现特征与免疫组化的结果进行对照分析。结果　VEGF、bFGF、fas、bax、bcl-2和bcl-xl的阳性表达率分别为 77.5 % ( 3 1/ 40 )、75 % ( 3 0 / 40 )、2 0 % ( 8/ 40 )、2 5 % ( 10 / 40 )、2 7.5 % ( 11/ 40 )和5 0 % ( 2 0 / 40 )。VEGF分别与bFGF、bcl -2之间 ,bcl-2与bcl-xl之间 ,以及bax分别与bcl -2、bFGF之间均具有一定的相关性 (Ρ<0 .0 5 )。CT显示的病灶大小与bcl-xl的表达具有一定的关系 (P <0 .0 5 ) ;病灶边缘清晰与否与VEGF的表达和病理分级具有一定的相关性 (Ρ <0 .0 5 ) ;瘤内液化坏死与病理分级有关 (Ρ <0 .0 1) ;强化类型和侵袭转移性则与肿瘤的大小有一定的关系 (Ρ<0 .0 5 )。结论　HCC的某些CT表现特征可在一定程度上反映VEGF和bcl-xl的表达 ,同时还受其它因素     

原发性肝癌肿瘤微血管形态特征研究

目的　探讨原发性肝癌 (HCC)肿瘤微血管形态特征。方法　收集手术切除前做过血管造影且未做栓塞治疗的HCC标本32例 ,男性 2 6例 ,女性 6例 ,年龄 2 8～ 76岁 (5 0 5 6± 10 5 2岁 ) ,肿瘤直径为 2～ 2 3cm(8 0 5± 6 17cm)。对不同大小和不同分化程度的HCC肿瘤微血管进行分型 ,计数肿瘤微血管密度 (MVD) ,测量肿瘤微血管直径、梁索直径和病灶大小 ,并做相关统计学分析。结果　肝癌大小与肿瘤微血管分型、直径和肿瘤梁索直径呈正相关 ,与MVD呈负相关 ,与肿瘤微血管梁索直径比不相关。结论　肝癌肿瘤MVD、形态及分布不均匀 ;肝癌在生长的不同阶段 ,其肿瘤微血管特征是不同的 ,并有一定的发展规律     

肝癌磁共振影像与微血管密度及预后的相关性

目的　对肝细胞癌 (HCC)的MRI表现与组织学微血管密度 (MVD)及术后生存期进行相关性研究。方法　对 47例经MR检查、治疗性肝癌切除术和病理证实的HCC进行回顾性研究。结果　 47例的MVD值与扰相梯度回波 (spoiledgradientrecalledecho ,SPGR)、T1WI的对比增强率 (CER)呈正相关 (rs=0 .740～ 0 775 ,P <0 .0 5 ) ,多元回归分析显示MVD与平均CER关系更密切。以术后生存时间建立的Cox模型显示 ,MVD越高 ,术后生存时间越短。结论　组织学MVD与HCC术后生存时间密切相关 ;HCC的MR影像能够反映其微血管形成程度 ,从而判断病人的预后。     

肝细胞癌和胆管细胞癌螺旋CT增强差异的分子生物学基础

目的 探讨肿瘤血管生成及血管内皮生长因子(VEGF)的表达对肝细胞癌(HCC)和胆管细胞癌(CCC)螺旋CT增强表现特征的影响.资料与方法 对经手术病理证实且术前行CT增强检杳的50例HCC(54个病灶)和24例CCC(28个病灶)患者的资料进行分析.观察其CT增强表现类型及两者动脉期的强化程度;用免疫组织化学SP法检测肿瘤VEGF的表达水平,用CD34标记微血管并进行微血管密度(MVD)计数.将免疫组织化学的结果与两种肿瘤的CT增强表现特征进行对照分析.结果 HCC与CCC肿瘤组织VEGF的阳性表达率差异具有统计学意义(X2=5.50,P＜0.05),HCC和CCC的MVD差异也有统计学意义(t=2.03,P＜0.05);HCC动脉期强化类型与VEGF和MVD未显示出相关性(X2=0.10,t=0.63,P＞0.05),CCC不同延迟强化类型的MVD值的差异具有统计学意义(t=2.09,P＜0.05),HCC和CCC动脉期强化程度差异有统计学意义(x2=46.6,P＜0.01).结论 HCC和CCC组织的VEGF蛋白表达率及MVD值的差异在一定程度上影响了二者CT增强表现.     

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.