新生儿肺气漏临床X线分析

目的：探讨新生儿肺气漏的临床及X线表现特征。方法：回顾性分析47例新生儿肺气漏的临床及X线表现,包括自发性气漏6例,病理性气漏24例,医源性气漏17例。均摄有卧位正位胸片,14例摄侧位片,7例摄水平侧位片。42例有复查胸片。结果：基础疾病有胎粪吸入综合征（MAS）13例、肺透明膜病（HMD）10例、重度窒息8例,新生儿肺炎6例,宫内感染肺炎2例,湿肺2例。辅助通气中气囊加压4例,持续气道内正压通气（CPAP）7例,呼气末正压通气（PEEP）6例,气管插管过深4例。X线表现为肺间质气肿4例,纵隔积气8例,单纯气胸22例,纵隔积气并发气胸8例,间质气肿伴纵隔积气或气胸各1例,间质气肿＋纵隔积气＋气胸3例。其中内侧气胸4例,前部气胸单侧19例、双侧6例,张力性气胸4例。结论：基础疾病及人工通气/机械通气是新生儿肺气漏的主要原因。因新生儿为仰卧位摄片,气体多聚集在胸腔前部,主要表现为前内部气胸和纵隔积气。水平侧位胸片对诊断有重要价值。     

加用肺泡表面活性物质治疗新生儿肺炎的疗效观察

目的 观察加用肺泡表面活性物质（PS）在治疗新生儿肺炎过程中的疗效。方法 随机选取2005年1月-2007年12月期间我科收治的60例确诊新生儿肺炎患儿,按随机原则分为两组：对照组25例给予常规治疗,治疗组35例在常规治疗基础上加用PS吸入治疗,观察两组治疗效果。结果 加用PS组在改善症状、消除肺部啰音、缩短住院时间和提高治愈率等方面均优于对照组（P〈0.01或0.05）,疗效满意,未发现明显副作用。结论 加用肺泡表面活性物质辅助治疗新生儿肺炎疗效可靠。     

改良气管内给予肺表面活性物质防治早产儿NRDS临床分析

新生儿呼吸窘迫综合征（neonatal respiratory distress syndrome,NRDS）是早产儿主要的发病和死亡原因,主要因为肺表面活性物质（pulmonary surfactant,PS）缺乏所致。针对病因给予外源性PS替代疗法对NRDS的预防和治疗效果已为国内外大多数学者证实。我们自2004年起使用PS（curosurf）预防和治疗早产儿NRDS，并在给药方式上进行了改良．取得了满意效果，现报道如下。     

早期持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征临床观察

目的探讨早期持续气道正压通气(CPAP)联合肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法33例患新生儿呼吸窘迫综合征的早产儿经气管内滴入固尔苏[100mg/(kg.次)],拔管予以NCPAP呼吸支持治疗,观察患儿的临床表现、血气分析及胸片变化情况。结果29例患儿症状、体征均明显好转;治疗后6h患儿的血气较治疗前显著改善,胸片好转。结论CPAP、PS联合应用能有效地治疗新生儿呼吸窘迫综合征。     

X线摄片诊断儿童支原体肺炎的价值分析

目的：总结儿童支原体肺炎的临床表现特点,分析X线摄片诊断儿童支原体肺炎的临床价值。方法回顾性分析2013年1月至2014年1月63例儿童支原体肺炎的临床资料,其中男性36例,女性27例,年龄2个月至1岁5例（8％）,～3岁11例（17％）,3～6岁32例（51％）,7～12岁15例（24％）,平均年龄（5±3）岁。采用美国GE公司计算机X线摄影（CR）行胸部正侧位片,曝光条件根据患儿体厚设定,靶片距100～160 cm,患儿安静时曝光拍摄,尽可能避免再次拍摄和降低射线剂量。总结X线图片质量、临床表现,分析X线摄片的影像学特点。结果126张胸片图像中,一级片120张（95．2％）,二级片5张（4．0％）,三级片1张（0．8％）,废片0张。临床症状主要是咳嗽、发热、咽部发红、喘息、呼吸音粗糙等。63例患儿肺部均存在影像学改变,双侧肺病变23例（37％）,单侧肺40例（63％）,其中右侧肺27例（68％）,左侧肺13例（32％）。 X线表现为间质浸润型阴影35例（56％）、肺泡浸润型阴影19例（30％）、肺门增浓型阴影8例（13％）和混合型阴影2例（3％）。结论儿童支原体肺炎临床表现主要是咳嗽、发热等,X线表现主要是间质浸润型阴影、肺泡浸润型阴影等,确诊应结合临床表现和实验室检查。     

婴幼儿肺气漏的X线与CT表现

目的分析婴幼儿肺气漏的X线与CT表现,提高对该病的认识。资料与方法回顾性分析23例婴幼儿肺气漏的X线与CT表现,包括肺间质积气7例、纵隔积气12例、气胸14例。其中肺间质积气与纵隔积气和/或气胸共存5例,气胸合并纵隔积气5例,纵隔积气并发皮下积气7例。结果肺间质积气表现为自肺门向外放射状分布的条索状、不规则囊状透亮影。纵隔积气表现为上纵隔旁和/或内部纵行条带状、不规则囊状透亮影、"胸腺帆征"、上纵隔透亮度增高。气胸表现为一侧肺野透亮度增高、心脏、纵隔边缘条带状透亮影、下肺野透亮度增高并膈上条带状透亮影。结论X线及CT对多数婴幼儿肺气漏的类型、程度可以做出正确诊断;CT还可以清楚显示多种气漏的并存及扩散途径。     

盐酸氨溴索防治新生儿呼吸窘迫综合症75例疗效观察

<正>新生儿呼吸窘迫综合症是由于肺表面活性物质(PS)的缺乏引起的一种严重疾病,胎龄越小,发生率越高,多见于34周的早产儿,约占早产儿死亡原因的50%-70%[1]。目前外源性PS是防治NRDS的较为公认的疗法,但由于价格昂贵,临床上较难以     

新生儿肺炎的DR影像表现

目的探讨新生儿肺炎的主要临床表现和DR胸部X线平片的影像表现,以及二者之间的特点和相互关系,并提高对该疾病的进一步认识。方法前瞻性分析60例新生儿肺炎的主要临床表现和DR胸部表现。结果本组患儿中支气管肺炎38例（63.3％）,大病灶肺炎3例（5％）,间质性肺炎8例（13.3％）,大叶或节段性肺炎3例（5％）,吸入性肺炎5例（8.3％）,气胸3例（5％）。绝大多数患儿表现为肺纹理增多和肺门阴影模糊。结论通过肺部症状与DR胸片表现之间关系的分析河提高本病诊断率。     

小儿高原性肺水肿合并纵隔积气2例分析

目的：探讨小儿高原性肺水肿合并纵隔积气的X线表现及临床病理特点。方法：对2例小儿高原肺水肿合并纵隔积气在发病时间、诱因、临床表现及胸部X线进行观察分析。结果：2例均表现为弥漫型肺水肿,病变分布对称伴随单侧颈肩部及纵隔旁少量线条状透亮影,复查胸片阴影消失时间快。结论：胸部X线检查对明确诊断具有决定性的意义,它反应了病变发展的程度与阶段,对咳嗽剧烈、呼吸困难的患儿要高度警惕纵隔及皮下气肿的发生。     

新生儿床旁X线胸片的临床应用

目的 评价新生儿床头X线胸片的临床应用价值.方法回顾分析137例共224份新生儿床旁胸片及临床资料,观察其心肺疾病X线表现.结果 224份床旁胸片中212份符合诊断要求,占 94.6 %.其中209份显示有心肺疾病:新生儿感染性肺炎 21例,新生儿湿肺12例,胎粪吸入性肺炎(MAS) 37例,新生儿肺透明膜病(NRDS)23例,急性呼吸窘迫综合征(ARDS)11例,新生儿肺出血4例,新生儿气胸28例,急性肺水肿7例,肺不张4例,先天性心脏病6例及先天性肺发育不良 1 例.单发病例48例,占35%,伴有合并症89例,占65%.其中MAS、NRDS、ARDS、先天性心脏病的合并症多见,共69例,占78%.结合临床资料,床旁胸片对肺炎、湿肺、NRDSⅠ~Ⅱ型、ARDS、MAS、肺不张、肺水肿、中到大量气胸及胸腔积液的初诊的准确率达80%.误诊、漏诊共7例,占5%.肺水肿与ARDS及ARDS与MAS合并NRDS的鉴别存在一定困难,需要结合临床随访复查.结论 床旁胸片能满足新生儿危重病的检查需要.     

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.     

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).     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme     

改进的定位技术在胸部肿瘤穿刺活检中的应用

目的：探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法：对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果：采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间（9.5 min）较传统方法（16.8 min）缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义（P〈0.05）。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论：根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。