急性脑血栓性栓塞的核素显像诊断与疗效判断

目的 评价核素显像对急性肺血栓性栓塞的诊断与疗效评价的价值。方法对１０例临床确诊或可疑为肺栓塞的患者进行核素肺灌注、肺通气、肺血栓灶以及双下肢深静脉显像，４例与肺动脉造影或电子束ＣＴ结果对照。８例患者溶栓后复查肺灌注显像，２例患者昨查肺血栓灶显像，结果 肺灌注显像＋下肢深静脉显像对急性肺栓塞诊断的阳性率为１００％，与Ｘ线检查结果基本一致，溶栓后复查提示肺血流均有明显改善乃至恢复正常。结论 核素显像     

99Tcm-聚合白蛋白肺灌注显像对肺栓塞溶栓疗效的评价

目的 探讨99Tcm-聚合白蛋白(99Tcm-MAA)肺灌注显像评价肺栓塞溶栓治疗的价值.方法 对54例急性肺栓塞的患者进行回顾性分析,所有患者均由99Tcm-MAA肺灌注显像结合X线胸片检查确诊,并于溶栓治疗1周后复查肺灌注显像,部分病例于治疗3个月后再次复查.结果 54例急性肺栓塞患者溶拴治疗前99Tcm-MAA肺灌注显像共观察到347个受损肺段,X线胸片均无相应肺段或亚肺段异常.溶栓治疗后1周复查肺灌注显像,164个受损肺段(47.3%)恢复正常;3个月后再次复查,199个受损肺段(57.4%)恢复正常(χ2=10.68,P<0.05).结论 99Tcm-MAA肺灌注显像是一种无创的诊断方法,对肺栓塞溶栓治疗效果的评估有重要价值.     

急性肺血栓性栓塞的核素显像诊断与疗效判断(附10例报告)

目的评价核素显像对急性肺血栓性栓塞的诊断与疗效评价的价值。方法对１０例临床确诊或可疑为肺栓塞的患者进行核素肺灌注、肺通气、肺血栓灶以及双下肢深静脉显像，４例与肺动脉造影或电子束ＣＴ结果对照。８例患者溶栓后复查肺灌注显像，２例患者复查肺血栓灶显像。结果肺灌注显像＋下肢深静脉显像对急性肺栓塞诊断的阳性率为１００％，与Ｘ线检查结果基本一致，溶栓后复查提示肺血流均有明显改善乃至恢复正常。结论核素显像对诊断急性肺栓塞以及判断疗效是一种准确、可靠的无创性手段。     

肺灌注显像Meyer评分在肺栓塞疗效评价中的应用

目的 探讨肺灌注显像Meyer评分在肺栓塞患者疗效评价中的临床价值。方法 接受抗凝或溶栓治疗的30例肺栓塞患者,均在治疗前1~2 d内完成肺灌注/通气显像,治疗后1~2周内复查肺灌注显像,治疗前后的灌注图像不分先后随机编号,由2名核医学专业医师对图像进行定性分析,然后对治疗前后灌注图像进行Meyer评分半定量分析。结果 30例肺栓塞患者经临床治疗后,其中15例局部血流灌注有明显改善,8例轻度改善,5例未见有变化,2例有恶化。其中,23例血流灌注有改善者治疗前为0.45±0.14,治疗后为0.22±0.11,治疗前后分值的变化有统计学差异(t=11.627,P<0.05);7例无改善患者治疗前为0.23±0.15,治疗后为0.23±0.17,治疗前后分值的变化无统计学差异(t=0.143,P>0.05);但两组改善率间比较有统计学差异(t=2.410,P<0.05)。结论 Meyer评分能很好的评价治疗前后肺部血流灌注变化的情况,对肺栓塞患者的疗效评价具有一定的临床价值。     

^99Tcm-聚合白蛋白肺灌注显像对肺栓塞溶栓疗效的评价

目的 探讨^99Tcm-聚合白蛋白（^99Tcm-MAA）肺灌注显像评价肺栓塞溶栓治疗的价值。方法对54例急性肺栓塞的患者进行回顾性分析,所有患者均由^99Tcm-MAA肺灌注显像结合X线胸片检查确诊,并于溶栓治疗1周后复查肺灌注显像,部分病例于治疗3个月后再次复查。结果54例急性肺栓塞患者溶拴治疗前^99Tcm-MAA肺灌注显像共观察到347个受损肺段,X线胸片均无相应肺段或亚肺段异常。溶栓治疗后1周复查肺灌注显像,164个受损肺段（47．3％）恢复正常;3个月后再次复查,199个受损肺段（57．4％）恢复正常（χ^2=10．68,P〈0．05）。结论^99Tcm-MAA肺灌注显像是一种无创的诊断方法,对肺栓塞溶栓治疗效果的评估有重要价值。     

肺通气/灌注显像对肺栓塞疗效的评价

目的 探讨肺通气／灌注（V／Q）显像在观察肺栓塞（PE）溶栓和抗凝治疗效果中的价值。方法 对65例抗凝和溶栓治疗的PE患者，治疗前后分别给予^99Tc^m气体37-74MBq和^99Tc^m-聚合白蛋白（MAA）148—185MBq后行8个体位V／Q显像；并在治疗后不同时间多次重复V／Q显像。结 果44例PE患者296个受损肺段，单纯抗凝治疗1年半内，V／Q显像显示106个肺段恢复正常（35．8％），69个受损肺段改善（23．3％），121个肺段无改善（40．9％）。21例PE患者165个受损肺段，溶栓结合抗凝治疗后V／Q显像示有85个肺段恢复正常（51．5％），有29个肺段改善（17．6％），有51个肺段无改善（30．9％）。其中在PE发病7d内治疗效果最佳，单纯抗凝治疗7d与14d疗效之间比较及溶栓结合抗凝治疗7d与14d疗效之间比较，差异均有统计学意义（χ^2=8．79和56．31，P〈0．05和〈0．01）。结论 V／Q显像能较好地评价PE抗凝和溶栓治疗效果。     

肺灌注/通气显像与肺动脉造影诊断肺栓塞的对比分析

目的：评价肺灌注／通气显像诊断肿栓塞的价值。方法：回顾性分析45例疑肺栓塞患者的肺核素显像结果，并与肺动脉造影检查对照。结果：肺动脉造影诊断为肺栓塞的患者26例，有180个肺动脉支为充盈缺损，其肺灌注显像示167个节段呈完全肺段性或亚肺段缺损，符合率为92．7％。肺动脉造影显示为86个肺动脉支为部分充盈缺损，肺灌注显像有63个肺段或亚肺段缺损，符合率为73．2％（P＜0．01）。肺核素显像对肺栓塞诊断的灵敏度为92．3％，特异性为84．2％，阳性预测值和阴性预测值均为88．9％。26例肺动脉造影诊断为肺栓塞的患者，有23例行肺通气显像，通气／灌注均不匹配。结论：肺灌注／通气显像对肺栓塞诊断具有重要的临床价值。     

核素显像在肺栓塞诊断及预后评价的价值(附65例分析)

目的：讨论核素显像在肺栓塞（PE）诊断及预后评价的价值。方法：收集2002年1月-2004年6月经核素显像诊断并结合临床确诊的PE患者65例，其中42例患者在治疗后2周、3个月通过肺灌注显像进行复查，用以评价PE的治疗效果。结果：核素肺显像对PE的诊断准确率为93．8％，双下肢深静脉显像对于深静脉血栓的诊断准确率达88．7％，肺灌注显像复查示治疗后2周受累肺段消退率为44．2％，3个月受累肺段消退率为72．8％。结论：核素显像无创、简便、费用低、可重复进行，是PE诊断及预后评价的首选方法。     

肺通气/灌注显像诊断不典型亚肺段肺栓塞

目的评价核索肺通气／灌注（V／Q）显像对不典型亚肺段肺栓塞（PE）的诊断价值。方法患者141例，男58例，女83例，年龄（65．67±11．29）岁，其中下肢静脉病变史者14例，糖尿病、高脂血症史者45例，63例近期内行有创性诊断和治疗，另19例均无上述病史或诊疗史。所有患者行常规盼^99Tc^m-MAA和^99Tc^m气体显像后进行1—24个月的抗凝治疗，于治疗后再行肺灌注显像。将抗凝治疗前后肺灌注显像进行对比分析，根据肺内放射性分布的变化判断治疗效果，再结合临床资料及其他影像检查综合判断不典型PE的诊断。结果141例患者肺灌注显像均显示某个肺野内不呈肺段或亚肺段分布的片状或小斑片状放射性分布稀疏区。肺通气显像示肺野内放射性分布基本均匀，未见放射性分布稀疏区。治疗后118例肺灌注显像显示双肺内放射性分布不同程度的增多或均匀。按肺野内放射性分布改善情况标准评价：抗凝治疗后恢复正常35例，显效49例，有效34例。总有效率为83．69％（118／141）。另23例肺内放射性分布无明显变化，视为无效。结论V／Q显像是诊断不典型亚肺段PE的首选方法。     

核素肺灌注显像对急性肺栓塞诊断的临床价值

目的评价放射性核素肺灌注显像在诊断急性肺动脉栓塞中的价值。方法对临床怀疑有急性肺动脉栓塞的25例患者进行了放射性核素肺灌注显像,同时行双下肢深静脉显像。结果25例患者中有23例出现不同程度的多发肺段血流灌注异常,其中41个肺段出现放射性缺损区,84个肺段出现放射性稀疏区。25例患者6例双下肢深静脉血栓形成。结论放射性核素肺灌注显像是诊断急性肺动脉栓塞的一种无创伤性的有效的检查方法。     

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.