氪离子激光治疗孤立性视网膜大动脉瘤的疗效分析

目的观察多波长氪离子激光治疗孤立性视网膜大动脉瘤的临床疗效。方法瘤体直径200～500μm的孤立性视网膜大动脉瘤的患者32例32只眼。对15例近黄斑区的动脉瘤以波长568nm黄光光凝;对12例屈光间质清晰,离黄斑较远的动脉瘤以波长531 nm绿光光凝;对5例屈光间质浑浊及视网膜大出血的动脉瘤以波长531 nm绿光光凝。观察术后1、3个月患者的视力及动脉瘤的变化。结果 32例患者32只眼激光光凝治疗后1个月28只眼视力均有不同程度的提高;2个月视力增进2行者24只眼;3个月视力提高3行以上者27只眼;6～24个月视力提高5行以上者16只眼,不变者4只眼。光凝后1个月出血吸收者28例。32只眼3个月行眼底彩色照相和FFA复查均见动脉瘤体闭塞。所有患者随访4个月,未发现并发症。结论采用多波长氪离子激光治疗孤立性视网膜大动脉瘤的临床疗效显著。     

532nm激光治疗糖尿病视网膜病变的临床疗效

目的观察532 nm激光治疗糖尿病视网膜病变的临床疗效。方法糖尿病视网膜病变患者152例208只眼,分为重度非增殖性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)104例144只眼,增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)48例64只眼,均采用532 nm倍频Nd∶YAG激光行标准全视网膜激光光凝或超全视网膜激光光凝,对合并黄斑水肿者行局限光凝或格栅光凝。术后6~24个月随访,无灌注区或新生血管未消退者行补充光凝,观察各组最佳矫正视力、眼底血管造影(fundus fluorescein agiography,FFA)及眼底视网膜病变进展变化。结果重度NPDR组视力提高和不变115只眼(占79.9%),PDR组视力提高和不变47只眼(占73.4%),两组比较差异有显著意义(P0.05);眼底视网膜改变,重度NPDR组有效率81.9%,PDR组有效率71.9%,两组比较差异有显著意义(P0.05);39只眼因黄斑水肿行黄斑局限光凝或格栅光凝,24只眼水肿减轻或消退。结论采用激光治疗DR的临床疗效显著,重度NPDR组疗效好于PDR组,选择合适的时机和有效的光凝治疗是稳定视力和延缓眼底病变的关键。     

532nm半导体激光光凝治疗糖尿病视网膜病变

目的 观察532半导体纯绿激光视网膜光凝(RP)治疗糖尿病视网膜病变(DR)的临床效果.方法 应用532 nm半导体纯绿激光对164例324只眼DR患者行RP治疗,观察光凝前后患者视力、眼底及眼底血管造影(FFA)的变化.结果 随访3～20个月,在164例324只眼DR患者中,有效285只眼,总有效率87.9%.239只眼增殖前期糖尿病视网膜病变(PPDR)中有效225只眼,有效率94.1%;95只眼增殖期糖尿病视网膜病变(PDR)中有效60只眼,有效率63.2%.PPDR视力提高或不变221只眼,占92.5%;PDR视力提高或不变66只眼,占69.5%.结论 RP治疗DR是安全有效的方法.PPDR患者行RP治疗对控制和延缓病情发展,稳定患者视力有重要意义,光凝效果优于PDR.合理选择激光参数可以减少视网膜损伤.     

倍频Nd:YAG激光治疗视网膜静脉阻塞的疗效

目的 探讨倍频Nd：YAG激光对视网膜静脉阻塞(RVO)的治疗效果。方法 应用倍频Nd：YAG激光对82例101眼RVO患者行视网膜光凝术。激光波长532nm，功率0.3～0．5W，光斑直径200～500μm，照射时间0．1～0．25s。随访3～18个月，对比分析光凝前后视力及眼底荧光血管造影(FFA)的变化情况。结果 激光治疗后视力提高78眼，占77．23％；无变化者16眼，占15．84％；视力降低者7眼，占6．93％。FFA示激光治疗后有效87眼，其中CRVO患者32眼，有效26眼，有效率81．25％；BRVO69眼，有效61眼，有效率88，41％。结论倍频Nd：YAG激光治疗RVO有显著疗效。     

倍频Nd:YAG激光格栅状光凝治疗弥漫性糖尿病性黄斑水肿

目的评价倍频Nd:YAG激光格栅状光凝治疗弥漫性糖尿病性黄斑水肿的疗效。方法弥漫性2型糖尿病性黄斑水肿患者145例204只眼,以倍频Nd:YAG(532nm)激光行视网膜格栅状光凝治疗,治疗前后行眼底检查、眼底荧光血管造影以及OCT检查,比较检查结果。结果145例204只眼,89例114只眼视力提高,占55.9%(P0.01);66例88只眼黄斑区渗漏基本或大部分吸收,占43.1%(P0.01);65例91只眼黄斑区视网膜水肿基本消退,占44.6%(P0.01)。结论倍频Nd:YAG激光格栅状光凝治疗弥漫性糖尿病性黄斑水肿可显著改善视力、黄斑区渗漏和视网膜水肿。     

倍频532 nm激光治疗糖尿病视网膜病变疗效评价

目的 评价倍频532 nm激光视网膜光凝治疗糖尿病视网膜病变(diabetic retinopathy,DR)的疗效.方法 DR患者58例95只眼,其中DRⅡ期11只眼,Ⅲ期43只眼,Ⅳ期37只眼,Ⅴ期4只眼;非增殖性21只眼,增殖前期33只眼,增殖性41只眼.Ⅱ期和部分Ⅲ期患者行局限性光凝,多数Ⅲ期和增殖性患者行全视网膜光凝.倍频532 nm激光光凝参数:光斑直径200～350μm时间0.2～0.5 s,能量0.2～0.8 w,PRP总光斑900～2600点.随访3～14个月,行视力、眼底和FFA检查.结果 非增殖性(Ⅱ、Ⅲ期)54只眼视力提高或不变(100.0%),增殖性(Ⅳ、Ⅴ期)41只眼视力提高或不变34只眼(82.9%),总有效率为92.6%.增殖前期和增殖性74只眼,存在不同程度的视网膜新生血管和/或无灌注区,治疗后有效率为85.1%.黄斑水肿55只眼,光凝治疗后有明显减轻或消退,但视力提高较难,大部分维持不变.无光凝并发症.结论 倍频532 nm激光治疗DR效果明显且安全,但随病变程度增加疗效降低;提示对DR的激光光凝治疗要把握时机,早期发现,及时治疗.     

532nm激光治疗白内障超声乳化术后糖尿病视网膜病变

目的探讨合并白内障的糖尿病视网膜病变患者行白内障超乳摘除联合人工晶体植入术后行532 nm激光治疗的安全性及临床效果。方法对因合并白内障而难以进行详细眼底检查或激光治疗的糖尿病视网膜病变患者103例120只眼,先行白内障超乳摘除联合人工晶体植入术治疗,术后对有眼底激光治疗指征者及时进行532 nm激光光凝,随访6个月。结果手术经过均较顺利,人工晶体均植入囊袋内,术后检查发现需行激光光凝治疗者共35例38只眼(31.7%),激光治疗后视力提高者12例12只眼(31.6%),保持不变者23例26只眼(68.4%),无视力下降者,经眼底镜检查及FFA检查眼底病变明显好转并保持稳定,无继续进展者。结论对合并白内障的糖尿病视网膜病变患者及时进行白内障超乳摘除联合人工晶体植入术,术后及早进行详细眼底检查,并对发现的病变及时行激光光凝治疗是安全和有效的,能有效地控制糖尿病视网膜病变的进展。     

532nm激光全视网膜光凝治疗糖尿病视网膜病变疗效观察

目的评价532nm激光全视网膜光凝（panretinal photocoagulation,PRP）治疗增殖前期（preproliferative diabetic retinopathy,PPDR）和增殖期糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）的疗效。方法采用532nm激光对125例236只眼PPDR和PDR患者行PRP,比较治疗前后视力、眼底及荧光素眼底血管造影（fundus fluorescein angiography,FFA）变化。结果一次和追加光凝后,PPDR组52只眼视力提高或无变化,占78.8%;14只眼视力下降,占21.2%。PDR组121只眼视力提高或无变化,占71.2%;49只眼视力下降,占28.8%。一次和追加光凝后,PPDR组眼底病变改善63眼,有效率95.5%,有3眼（4.5%）进展为PDR;PDR组改善154眼,有效率90.6%,仍有12眼（7.1%）行玻璃体切割术,4眼（2.3%）因新生血管性青光眼行睫状体冷凝术。结论 532nm激光PRP治疗PPDR和PDR有较好疗效。     

雷珠单抗玻璃体腔注射联合多波长激光治疗视网膜大动脉瘤临床观察

目的:评价多波长激光联合雷珠单抗(Ranibizumab)玻璃体腔注射治疗视网膜大动脉瘤的疗效。方法:回顾性分析2012年10月至2017年10月,经血管造影确诊伴有黄斑水肿的视网膜大动脉瘤(RAM)患者16例16只眼的临床资料,男性7例,女9例,年龄57～75岁。所有患者在行Ranibizumab(0.5 mg)玻璃体腔注射后1～2周内行多波长激光治疗,红光光凝瘤体周围出血区,然后选黄光直接光凝瘤体,并在注射后4、8和12周随访,记录治疗前后最佳矫正视力和中心视网膜厚度的变化。结果:经3～12个月随访,16例患者视力皆有不同程度的提高,初诊视力与注射后4、8、12周最佳矫正视力相比,差异具有统计学意义(P0.05);注射前中央视网膜厚度与注射后4、8和12周相比,差异具有统计学意义(P0.05);治疗后3个月眼底荧光血管造影检查显示动脉瘤均有不同程度的萎缩和变小。结论:研究结果提示,雷珠单抗玻璃体腔注射联合多波长激光治疗伴有黄斑水肿的视网膜大动脉瘤疗效显著,可以降低中央视网膜厚度,提高患者视力。     

532nm激光视网膜局部三点光凝治疗湿性黄斑裂孔临床观察2例的临床病例经验总结

目的:探讨532 nm激光视网膜局部三焦点光凝治疗湿性黄斑裂孔临床效果。方法:湿性黄斑裂孔患者2例,实施的视网膜局部532nm激光三焦点光凝,即裂孔上下及颞侧缘,功率0.2 W,光斑直径200 um,光凝时间0.5 s。对2例患眼中心视力、视野、光学相干断层扫描进行随访观察。结果:2例患眼治疗1个月后随访结果见中心视力稳定,视野缺损轻度扩大,光学相干断层扫描激光光斑显示神经上皮与色素上皮紧密结合,裂孔缘水肿及脱离带消失。结论:视网膜三焦点532 nm激光光凝能稳定湿性黄斑裂孔的形态,防止继发性视网膜脱离的发生。     

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.