超声下空气灌肠整复小儿肠套叠的应用价值

目的探讨超声下空气灌肠整复术治疗小儿肠套叠的临床应用价值。方法回顾分析本院37例超声引导下空气灌肠整复小儿肠套叠的影像学资料。所有患儿均先行立位腹透排除膈下游离气体,再行常规超声检查,明确诊断后,直接在超声实时监视下,采用空气灌肠机对患儿进行空气灌肠,整复压力为6~12k Pa。如套头出现停顿不动,则排气后对相应部位的腹部进行揉按。再继续充气并用超声观察,如发现套头迅速消失且大量气体进入小肠,小肠区内见广泛气体强回声,则提示整复成功。结果本组肠套叠患儿均为回—结肠型,横切面上均表现为典型的"同心圆征",所有患儿均成功整复。其中3例患儿整复后出现回盲瓣处水肿,在声像图上可见环形低回声的水肿带,称为"暗环征"。结论超声下空气灌肠整复小儿肠套叠既方便、快捷,又避免了常规X线透视的辐射损害,有望成为小儿肠套叠的首选治疗方法。     

超声引导下温生理盐水灌肠在小儿肠套叠整复过程中影响因素分析

小儿肠套叠是临床儿科常见的急腹症之一.目前诊断和治疗方法主要有空气、气钡灌肠整复和超声引导下水灌肠整复以及有创的外科手术治疗.近年来浙江省乐清市人民医院在超声引导下,用温生理盐水灌肠并加以手、探头双合诊在诊治小儿肠套叠中效果显著,整复成功率明显提高.现收集2005年～2010年1月乐清市人民医院超声引导下诊断和治疗的213例肠套叠患者资料,分析影响小儿肠套叠整复的因素,以进一步提高小儿肠套叠整复的成功 率.     

提高小儿肠套叠空气灌肠整复成功率及预防并发症的探讨

目的:提高小儿急性肠套叠空气灌肠整复成功率及预防并发症。方法:对268例临床诊断为急性肠套叠患儿进行空气灌肠整复。结果:空气灌肠整复成功252例(94%),其中24例经2次整复成功,2例在术前麻醉后第三次整复成功,失败16例。结论:空气灌肠是诊断与治疗小儿肠套叠的最好方法,不仅能有效地提高整复成功率,还能避免并发症的发生。     

空气灌肠整复小儿肠套叠的体会——附三例空气灌肠整复中肠穿孔病例报告

空气灌肠不仅对小儿肠套叠具有可靠的诊断价值,而且是整复小儿肠套叠的重要方法之一。近年来我们对120例小儿肠套叠应用空气灌肠整复,其整复率达80%以上。我们认为这种方法操作简便,费用     

空气压力灌肠诊断与治疗小儿急性肠套叠（附177例分析）

目的 :提高对小儿急性肠套叠空气压力灌肠适应证和操作要点的认识。材料和方法 :临床诊断为急性肠套叠177例 ,行腹部摄片、空气压力灌肠诊断与整复 ,整复未成功者行外科剖腹探查 ,回顾分析空气压力灌肠的指征和操作要点。结果 :( 1)腹部平片 :出现典型肠梗阻表现 11例 ,未出现者 16 6例 ;( 2 )空气压力灌肠的X线征象 :杯口状软组织块 16 1例 ,无软组织块 16例 ,杯口状软组织块合并钳状、球状、息肉状、分叶状影分别为 31例、19例、6例、11例 ;( 3)整复成功16 1例 ,未成功 16例。结论 :小儿急性肠套叠 ,在适应证范围内 ,应首选空气压力灌肠。     

针灸配合空气灌肠整复小儿肠套叠的研究

目的:探讨针灸配合空气灌肠在整复小儿肠套叠中的价值。方法:取足三里、合谷、天枢、中脘、关元等穴位,毫针直刺,深度0.5-1寸,用泻法,配合空气灌肠治疗小儿肠套叠。结果:32例肠套叠针灸配合空气灌肠复位成功31例,占96.8％。结论:针灸结合空气灌肠提高了肠套叠的整复率,是小儿肠套叠诊断、治疗的首选方法。     

彩色多普勒超声诊断小儿肠套叠的临床价值

目的探讨彩色多普勒超声在诊断小儿肠套叠中的临床应用价值。方法回顾性分析总结经空气灌肠复位或手术证实的36例小儿肠套叠患者的彩色多普勒声像图特征。结果 36例小儿肠套叠,超声检出34例,超声检出率为94.4%。肠套叠超声典型特征性改变为"同心圆征"和"套筒征"。结论小儿肠套叠的彩色多普勒声像图比较特异,对临床诊断小儿肠套叠有重要临床价值,是目前诊断小儿肠套叠的首选方法。     

小儿肠套叠的影像学分析

目的 探讨临床影像学诊断方法在婴幼儿肠套叠的应用价值.方法 对临床50例肠套叠患儿行超声及空气灌肠X射线检查.结果 婴幼儿肠套叠临床表现为腹痛、哭闹、呕吐、果酱样血便和腹部包块等.腹部超声检查显示腹腔内"同心圆征"、"套筒征",空气灌肠X射线检查具有诊断和治疗双重功效.结论 临床可疑为肠套叠者宜先行超声筛查,空气灌肠X射线检查整复效果显著.     

婴幼儿肠套叠灌肠整复的治疗体会

目的：总结空气灌肠整复婴幼儿肠套叠的治疗经验。方法：对21例确诊为肠套叠的婴幼儿进行空气灌肠整复。结果：成功复位20例,1例未成功转手术治疗,整复成功率95.2%。结论：在严格掌握适应征及操作程序,空气灌肠整复是婴幼儿肠套叠理想的治疗方法。     

小儿肠套叠钡灌肠X线表现及在整复中的体会

目的：探讨小儿肠套叠钡剂灌肠X线表现与整复的关系，认为钡剂灌肠与空气灌肠整复同样具有高安全性、高整复率的优点，对未整复成功的病例进行了临床分析。材料与方法：总结了2003年1月至2005年11月，经钡剂灌肠确诊的小儿肠套叠46例，年龄3个月至3岁，以6个月至1岁患儿多发，发病时间8h至4d，主要临床表现：患儿哭闹不安，呕吐，血便，腹部可触及包块；全部病例在灌肠前做了腹透，发现有肠梗阻征象就摄片；用日立XF130型800mA胃肠X线机，容量300ml至400ml带气囊灌肠器，灌肠压7KPa至14KPa（52．5mmHg至105mmHg）进行灌肠。结果：钡剂灌肠X线片上1．梗阻端为“杯口”状改变，本文43例，其中41例整复成功，整复率89．1％；尚有2例，因发病时间长3d至4d，精神差，疑有肠坏死，未整复。2、梗阻端为“分叶”状及“弹簧”状改变，本文分别为1例和2例，整复失败；在整复过程中均无一例肠破裂穿孔。结论：通过对41例整复成功和5例整复失败小儿肠套叠的钡剂灌肠，结合有关资料表明，只要患儿，1、发病时间短48h内，体质好；2．无复杂性套入；3、无合并器质性病变；无论是钡剂灌肠还是空气灌肠均能达到安全性高、整复率高的目的。     

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.     

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.     

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).     

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.