体外胆石的CT分类和化学成分关系的研究

目的：探讨体外胆石的ＣＴ分类和化学成分的关系。材料和方法：６０例胆石标本进行体外ＣＴ扫描，以红外光谱仪定量分析所有结石的四种主要化学成分。结果：胆石分成５类；胆石的ＣＴ类型与其化学成分及形态特点密切相关；胆石的ＣＴ值与其胆固醇含量成显著负相关（ｒ＝－０．６３），而与碳酸钙的含量成显著正相关（ｒ＝０．６５）；胆固醇和非胆固醇性结石的ＣＴ值有显著差异，以ＣＴ值－５０Ｈｕ为两者的判断界值，其敏感性和特异性分别为９０％及９７．５％。结论：ＣＴ能准确预测胆石的化学性质和形态特点。     

大白鼠肝癌模型乳剂增强CT研究

目的：评价乳状造影剂在肝脏ＣＴ增强扫描的应用效果。方法：给正常大白鼠及肝癌大白鼠注射乳状造影剂后行ＣＴ扫描，并做泛影葡胺增强对比。结果：注射乳状造影剂后，正常肝脏ＣＴ值增加４５ＨＵ肝内肿瘤ＣＴ值仅增加１．２ＨＵ。乳剂增强ＣＴ可检出０．５ｃｍ大小的肿瘤。病理结果显示：乳剂颗粒被肿瘤周围肝组织的Ｋｕｐｆｅｒ细胞和肝细胞吞噬。肿瘤组织中没有乳剂颗粒。结论：乳状造影剂对正常肝脏有明显的增强效果。肝内肿瘤组织不增强，使肝脏和肝内肿瘤对比度增加，使小肝癌的检出率增加。     

国人肾下段下腔静脉测量及分析

目的：探讨正常国人肾下段下腔静脉（ＩＶＣ）ＣＴ测量值，为国产下腔静脉滤器的设计及放置提供依据。材料与方法：对１００例正常国人用ＣＴ机分别测量平静呼吸及Ｖａｌｓａｌｖａ动作后肾下段下腔静脉长轴、短轴两组数据。结果：平静呼吸时ＩＶＣ修正后直径的几何均数为１９．３７ｍｍ（１４．３０～２４．４０ｍｍ），呈偏态分布，与体表面积无直线相关关系。性别和各年龄组间ＩＶＣ修正直径值无显著差异（Ｐ＞０．０５）。Ｖａｌｓａｌｖａ动作后ＩＶＣ修正直径的几何均数为２１．２３ｍｍ（１５．６０～２８．７０ｍｍ）。经ｔ检验，Ｖａｌｓａｌｖａ动作后ＩＶＣ修正直径显著大于平静呼吸时ＩＶＣ的修正直径（Ｐ＜０．０５）。结论：ＣＴ可以直接测量生理状态下ＩＶＣ大小和变化，具有简便和准确的特点。为避免对ＩＶＣ大小估计不足，放置下腔静脉滤器时应以Ｖａｌｓａｌｖａ动作时的修正直径作为参考。     

TIPS术中胆汁漏出：刺激平滑肌细胞增生?

目的经颈内静脉肝内门腔静脉分流术（ＴＩＰＳ）中胆道损伤并胆汁漏出，可能是引起ＴＩＰＳ术后支架内平滑肌细胞（ＳＭＣ）增生和狭窄的重要因素。本研究以离体ＳＭＣ培养和ＴＩＰＳ猪模型实验评价胆汁对ＳＭＣ的作用。材料与方法离体ＳＭＣ培养分为三组：Ⅰ组＝１．０％血清＋１．０％胆汁；Ⅱ组＝１０．０％血清＋１．０％胆汁；Ⅲ组＝１０．０％血清。细胞收获点分别为３、１０、１４天。动物实验组共用４５只猪建立ＴＩＰＳ模型，术后处死时间为１０～１６天。结果此前预试验结果：使用２．５％、５．０％、１０．０％胆汁的培养基，ＳＭＣ在３天内全部死亡。离体细胞培养（１．０％胆汁）实验组（Ⅰ、Ⅱ组）中的脱氧核糖核酸（ＤＮＡ）和总蛋白量明显较对照组（Ⅲ组）少（Ｐ＜０．０５），且随着培养时间的延长其差异增加。动物实验组：２８．８９％的标本证实有胆汁漏出。定量分析示胆汁漏组中的ＳＭＣ增殖量较无胆汁漏组少。组织学检查发现有新生胆管在支架内生长。结论２．５％～１０．０％胆汁杀死ＳＭＣ，１．０％胆汁可抑制ＳＭＣ生长。动物实验示胆汁漏出导致ＳＭＣ增生减少，但血栓形成增加，从而使支架闭塞率增高。     

CT与B超量化诊断脂肪肝的对比研究

ＣＴ诊断脂肪肝是比较可靠的方法。扫描所见肝脏脂肪浸润部位呈低密度影，其密度与浸润脂肪密切相关。肝脏细胞内脂肪含量越高，ＣＴ值越低［１］。应用测量ＣＴ值可以敏感、准确地诊断脂肪肝。Ｂ超诊断脂肪肝是根据肝内脂肪与正常肝脏组织有不同回声声强的原理。以往的研究多局限于图像直观描述，不象ＣＴ可以测值诊断，缺乏量化指标。本研究参照Ｔａｎｉｇｕｃｈｉ等的方法［２］，采用灰阶直方图技术对脂肪肝回声声强进行定量评价，并用同例的ＣＴ值诊断结果作为对照，研究两种方法诊断之符合性，进一步探讨诊断脂肪肝更为简捷、经济、…     

酒精性脂肪肝的CT表现及忌酒后的动态变化

分析３４例酒精性脂肪肝的ＣＴ表现，并对其中１２例进行了忌酒后复查ＣＴ动态观察。结果发现，酒精性脂肪肝在ＣＴ上表现为不同范围、不同程度的无占位性低密度区，这种改变是可逆性的，它可在忌酒后不久明显好转（５／１２例），或完全恢复正常（７１１２例），ＣＴ表现为肝脂肪浸润的低密区ＣＴ值逐渐升高。结合文献报道，对酒精性脂肪肝的发病机制、ＣＴ表现及忌酒后的动态变化进行了讨论。     

骨密度定量CT测量用固体标准件的研究

目的报告一种自制骨矿密度ＣＴ测量固体标准件。方法使用聚乙二醇塑料和骨基质加工成固体标准件，其两部分Ｘ线衰减特性分别相当于水和骨组织，体积为３０．０ｃｍ×９．０ｃｍ×２．５ｃｍ，重量为０．７ｋｇ。对１２个椎骨标本灰化进行标准性测试。结果骨密度定量ＣＴ（ＱＣＴ）测量结果和灰化标本灰重值相比准确性为８．６％，二者间具有非常显著相关性（ｒ＝０．９１，Ｐ＜０．００１），标准件的精确性为１．１％和０．１％。结论本组固体标准件质量可靠，为国内ＱＣＴ骨密度测量提供了一种新的更准确、可靠的工具     

定量CT技术定量诊断脂肪肝的临床应用

目的 探讨定量CT(QCT)技术在定量诊断脂肪肝中的价值.方法 113例弥漫性脂肪肝患者及17例正常肝脏检查者进行腹部CT平扫.经QCT后处理软件(QCT Pro)测量并得出所有患者肝脏的骨密度(BMD)值、校准斜率(Slope)、扫描野校准系数(FUC)值以及肝脏脂肪含量百分比β值.使用SPSS19.0分析轻、中、重度脂肪肝组及正常对照组肝脏CT值平均值、肝脏BMD值平均值、肝脏脂肪含量百分比β值平均值之间的差异及各项指标的相关性.结果 轻、中、重度脂肪肝组及正常对照组肝脏CT值平均值、肝脏BMD值平均值、肝脏脂肪含量百分比β值平均值之间存在显著性差异(P＜0.05).所有患者的肝脏CT值平均值与肝脏BMD值平均值、肝脏CT值平均值与肝脏脂肪含量百分比p值平均值以及肝脏脂肪含量百分比β值平均值与肝/脾CT值比值(L/S)平均值之间具有高度相关性(r=0.976、-0.977、-0.959,P＜0.05).肝脏脂肪含量百分比β值在定量诊断脂肪肝中具有较高的敏感性(0.912)及特异性(0.882).结论 QCT得出的脂肪肝患者肝脏CT值平均值与肝脏BMD值平均值、肝脏CT值平均值与肝脏脂肪含量百分比β值平均值以及肝脏脂肪含量百分比β值平均值与肝/脾CT比值之间具有高度相关性,肝脏脂肪含量百分比β值在定量诊断脂肪肝中具有较高的特异性、敏感性.     

肝动脉栓塞与经肝静脉逆行栓塞联合应用的实验研究

目的：为了使肿瘤及载瘤肝段完全坏死，获得介入性肝段（叶）切除的效果，作者进行了肝动脉栓塞与经肝静脉逆行栓塞（ＴＨＡＥ－ＲＨＶＥ）联合应用的动物实验。材料和方法：８只健康犬进行了ＴＨＡＥ－ＲＨＶＥ，肝动脉栓塞时用带囊导管阻断区域肝静脉后，向相应区域肝动脉注入碘化油，再注入明胶海绵碎片；逆行栓塞肝静脉时，在球囊阻断肝静脉下注入无水酒精－泛影葡胺（１１）混合剂。对照组（单纯肝静脉逆行注入酒精）４只。术后复查肝功能、ＣＴ，定期处死实验动物，行肝脏及肺病理学检查。结果：ＴＨＡＥ－ＲＨＶＥ及对照组技术均成功，实验组与对照组肝功能指标均呈一过性增高。ＣＴ复查显示实验组碘油充填栓塞区肝段及所属门脉分支。实验组术后１周病理检查，栓塞区肝段呈完全性、凝固性坏死，肝静脉、门静脉分支壁厚，其内充满机化血栓，２周时坏死周围有肉芽组织及炎症细胞浸润，４～８周栓塞肝叶明显萎缩，坏死区逐步为纤维组织取代。对照组肝段呈不完全性凝固性坏死，范围较小。结论：ＴＨＡＥ－ＲＨＶＥ方法安全，能获得选择性肝叶（段）切除的效果，可用于单发性巨块型肝癌的治疗。     

耐力训练后大鼠红核细胞线粒体形态计量学研究

对长期游泳耐力训练后大白鼠红核细胞线粒体进行电镜观察及形态定量分析。结果表明，大鼠红核细胞线粒体有明显的形态结构变化：（１）线粒体数目明显增多，嵴致密，基质电子密度增高；（２）线粒体体密度（Ｖｖ）、面密度（Ｓｖ）和数密度（Ｎｖ）３项参数值均增大，与对照组比较均有显著性差异，Ｐ（Ｖｖ）＜０．０１，０．０１＜Ｐ（Ｓｖ）＜０．Ｏ５Ｐ（Ｎｖ）＜０．００１。     

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.