血清α－L－岩藻糖苷酶对原发性肝癌诊断价值的研究

本文报道了４７５例血清α－Ｌ－岩藻糖苷酶（ＡＦＵ）检测结果，其中５３例原发性肝癌（ＰＨＣ）病人的血清ＡＦＵ活性（３２３．４±１１２．５ｎｋａｔ／Ｌ）显著高于健康组（１０８．５±３５．９ｎｋａｔ／Ｌ）和其它各疾病组。以ＡＦＵ≥２１６ｎｋａｔ／Ｌ（健康组的＋３ｓ）为阳性界值，对ＰＨＣ的诊断敏感性和特异性分别达８４．９％和８９．４％，诊断效率达８８．８％；对ＡＦＰ（－）的ＰＨＣ病人的阳性率为８４．２％；与ＡＦＰ联合检测对ＰＨＣ总的阳性率达９４．３％。表明：血清ＡＦＵ的检测对ＰＨＣ的诊断和疗效是一项十分有用的观察指标。     

血清α—L—岩藻糖苷酶对原发性肝癌诊断价值的研究

本文报道了４７５例血清ａ－Ｌ－岩藻糖苷酶检测结果，其５３例原发性肝癌疾病组。以ＡＦＵ≥２１６ｎｋａｔ／Ｌ为阳性界值，对ＰＨＣ的诊断敏感性和特异性分别达８４．９％和８９．４％，诊断效率达８８．８％；对ＡＦＰ（－）的ＰＨＣ病人的阳性率为８４．２％；与ＡＦＰ联合检测对ＰＨＣ总的阳性率达９４．３％。表明：血清ＡＦＵ的检测对ＰＨＣ的诊断和疗效是一项十分有用的观察指标。     

聚合酶链反应法与荧光免疫法检测沙眼衣原体的比较研究

为了评价聚合酶链反应法（ＰＣＲ）对泌尿生殖道标本中沙眼衣原体的检测结果，每份临床标本进行了ＰＣＲ法和荧光免疫法（ＤＦＡ）平行检测比较。检测临床标本９３例，ＰＣＲ法阳性率为２５．８％，ＤＦＡ法的阳性率为１７．２％（Ｐ＞０．０５）。结果说明ＰＣＲ是一高度特异和敏感的检测方法。     

促血管生成素-2在恶性肿瘤诊断中的价值分析

目的：探讨促血管生成素-2（Ang-2）在恶性肿瘤诊断中的应用价值。方法：对恶性肿瘤（观察组）136例与健康对照组46例,采用单克隆抗体透射比浊法检测血清中的Ang-2。采用ELISA法检测肝癌13例血清中的AFP和直肠癌10例血清中的CEA,并分别与Ang-2比较其阳性率。结果：观察组与对照组Ang-2的阳性率分别为28．7％和52．2％,两组比较,差异显著（P〈0．05）。直肠癌患者血清Ang-2与CEA的阳性率均为50．0％;肝癌患者血清Ang-2与AFP的阳性率分别为46．2％和92．3％,AFP的阳性检出率显著高于Ang-2（P〈0．05）。结论：Ang-2在恶性肿瘤中的检出率低,其临床应用价值有待进一步研究。     

肾损伤分子-1联合尿β2-微球蛋白在早期高血压肾病中的诊断价值

目的分析肾损伤分子-1（KIM-1）联合尿β2-微球蛋白（β2-MG）在早期高血压肾病中的诊断价值。方法测定40例早期高血压肾病患者、40例高血压无肾病患者和40例肾功能及血压均正常健康体检者尿KIM-1和尿β2-MG水平,以及血肌酐（Scr）值,并进行比较。结果高血压肾病组尿KIM-1和尿β2-MG水平和高血压无肾病组的比较差异有统计学意义（P〈0．05）,高血压无肾病组与对照组比较差异无统计学意义（P〉0．05）,三组患者血肌酐值比较差异无统计学意义（P〉0．05）,高血压肾损伤组中,尿KIM—1的阳性率（60．0％）,尿β2-MG的阳性率（62．5％）,两者联合的阳性率为（92．5％）。结论随机尿KIM－1和尿β2-MG可以作为高血压肾病筛查指标,联合检测尿KIM-1和尿β2-MG能够提高早期高血压肾病检测率。     

医护人员HBV,HCV感染的血清流行病学研究

对北京解放军总医院２６１名经常接触病人血液的医护人员ＨＢＶ、ＨＣＶ感染的血清流行病学进行了调查，并同河北省固安县某农村自然人群作了比较。结果表明，医护人员ＨＢｓＡｇ、ＨＢＶＭ和抗ＨＣＶ阳性率分别为３．１％（８／２６１）、４５．６％（１１９／２６１）和０．８％（２／２６１），ＨＢＶ总感染率高于农村自然人群（２９．４％），而抗ＨＣＶ阳性率同我国普通人群相似（低于１％）。说明北京医护人员感染肝炎的职业威     

介入治疗对耐药基因在原发性肺癌表达的影响

目的 探讨介入治疗对耐药基因在原发性肺癌表达的影响。方法 通过支气管镜和手术获得未行化疗和进行过介入治疗的肺癌标本共118例。小细胞癌（SCLC）26例，非小细胞癌（NSCLC）92例（鳞癌48例，腺癌44例）；其中，非化疗组50例；单纯行支气管动脉灌注化疗药物的非栓塞组28例；应用碘油抗癌药乳剂栓塞支气管动脉的栓塞组40例。运用免疫组织化学两步法检测各组标本中的鼠抗人P－糖蛋白（PgP)和谷胱甘肽硫转移酶－π（GST－π）的阳性率。结果 非化疗组的PgP与GST－π的阳性率分别为32．0％与34．0％，非栓塞组分别为75．0％与78．6％；栓塞组则分别为50．0％与52．5％。非化疗组与非栓塞组的PgP与GST－π阳性率差异均有非常显著性意义（P＜0．01）。非化疗组与栓塞组的PgP与GST－π阳性率差异均无显著性意义（P＞0．05）。在NSCLC中分化程度高的I级癌细胞的耐药基因的表达高于分化程度低的Ⅱ、Ⅲ级癌细胞（P值均＜0．01）。结论 检测癌组织中的PgP与GST－π对肺癌化疗的个体化方案制定有重要的指导意义，支气管动脉灌注化疗可使肺癌多药耐药性的阳性表达率增高，碘油抗癌药乳剂栓塞支气管动脉对癌细胞耐药性产生的诱导性较小。     

飞行员眩晕患者颈动脉及椎动脉的彩色多普勒超声研究

目的应用彩色多普勒超声对颈、椎动脉血流量的检测，评价颈、椎动脉缺血与眩晕的关系。方法使用彩色多普勒超声对１０２例飞行员眩晕患者进行颈、椎动脉的血流动力学检测，并与１００例健康飞行员测值对照。测定参数包括：血管内径（Ｄ）、峰值血流速度（ＰＦＶ）、脉动指数（ＰＩ）、阻力指数（ＲＩ）、加速度／减速度比值（Ａ／Ｄ）和血流量（ＶＦ）。结果颈动脉异常９例（８．８％），椎动脉异常５２例（５１．０％）。飞行员眩晕患者与正常飞行员相比，同侧颈动脉血流动力学相差不显著（Ｐ＞０．０５）；同侧椎动脉血流动力学相差显著（Ｐ＜０．０５～０．０１）。结论对于因颅外段椎动脉暂时性缺血引起的眩晕，彩色多普勒超声不失为简便、直观、实时和准确的诊断方法。     

门电路心肌显像傅立叶分析评价左心功能

用９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）对２０例患者及６例健康志愿者进行门控心肌显像和傅立叶分析，同时进行平衡法核素心室显像．将２０例患者的左室心肌分为１０６个节段，两种显像（门控心肌和心血池）振幅之间有９１个节段相符（８５．８％），所测得的左室射血分数（ＬＶＥＦ）平均值分别为４２．３％±１０．４％和４４．０％±１５．９％（Ｐ＞０，０５）；６例正常人两种显像振幅完全相符，ＬＶＥＦ平均值分别为５８．８％±１０．２％和６４．０％±１１．０％（Ｐ＞０．０５）；正常人与患者间用相同方法所测得的ＬＶＥＦ间有显著差异（Ｐ＜０．０１）．所有２６例受检者两种方法所测得的ＬＶＥＦ值之间有良好的相关性（ｒ＝０．９４，Ｐ＜０．００１）本研究结果表明，９９ｍＴｃ－ＭＩＢＩ门控心肌显像可同时获得心肌血流灌注和左心功能的信息．     

骶髂关节正斜位片在强直性脊柱炎（Ⅱ级以上）X线诊断中的应用价值

目的：评价骶髂关节正斜位片在强直性脊柱炎（Ⅱ级以上）X线诊断中的价值。资料和方法：根据目前常用强直性脊柱炎的纽约诊断标准，对临床上已确诊的120例强直性脊柱炎患者骶髂关节正斜位片与CT片进行对照分析。结果：X线组（60例）：阳性者49例，阴性者11例，阳性率为81．7％；CT组（60例）：阳性者55例，阴性者5例，阳性率为91．7％。结论：虽然对于强直性脊柱炎的诊断，X线组阳性率81．7％低于CT组阳性率91．7％，但二者的结果经统计学分析无显著性差异，故笔者认为X线检查中的骶髂关节正斜位片对于强直性脊柱炎（Ⅱ级以上）诊断可以达到与CT检查基本相同的阳性率。     

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.