经阴道三维超声诊断子宫粘膜下肌瘤与肌壁间肌瘤临床分析

目的探讨经阴道三维超声(3D-TVS)在子宫粘膜下肌瘤与子宫肌壁间肌瘤压向宫腔型这两种疾病的鉴别诊断方面所具有的优势。方法将30例行常规妇科超声检查提示宫腔内可疑占位性病变的患者行阴道三维超声检查,并与2D-TVS超声检查结果进行对比分析。结果 3D-TVS与宫腔镜诊断间有差异者1例,占3.3%(1/30);2D-TVS与宫腔镜诊断间有差异者5例,占16.7%(5/30);3D-TVS与病理诊断间有差异者2例,占6.6%(2/30);2D-TVS与3D-TVS诊断正确率比较差异有显著性意义。1例3D-TVS超声误诊为粘膜下肌瘤的宫腔镜结果为肌壁间肌瘤完全压向宫腔,2例3D-TVS超声及宫腔镜误诊为粘膜下肌瘤的病理结果为子宫黏膜下腺肌瘤性息肉。结论经阴道三维超声较经阴道二维超声的临床符合率较有明显提高。     

经阴道彩色多普勒超声诊断子宫内膜病变的临床价值

目的:评价经阴道彩色多普勒超声(TDS)对妇女子宫内膜病变的临床价值。方法:对98例子宫内膜病变患者行阴道彩色多普勒超声检查,分析超声图像与手术病理结果对照。结果:98例患者子宫内膜诊刮病理分类有子宫内膜息肉、粘膜下肌瘤、内膜增生过长和子宫内膜癌,经阴道超声诊断子宫内膜疾病诊断符合率为94.2%。另外,我们也比较了内膜癌与其他宫内膜良性病变的血流显示率及动脉阻力指数RI值有显著差异(P0.5)。结论:经阴道彩色多普勒超声检查患者无痛苦,且内膜结构显示清晰,为诊断子宫内膜疾病的首选方法。     

超声、宫腔镜和腹腔镜诊断纵隔子宫的对比研究

目的 :评价超声、宫腔镜和腹腔镜诊断纵隔子宫的价值。材料和方法 :回顾性分析 92例纵隔子宫的超声、宫腔镜和腹腔镜检查结果 ,所有病例均经手术和病理证实。结果 :经阴道超声的诊断准确率为 96.76% ;宫腔镜检查的诊断准确率为 95 .65 % ,与经阴道超声的结果相似 ;对子宫宽度的观察 ,超声与腹腔镜检查的符合率为 97.4% ,对子宫底外形的观察 ,超声与腹腔镜的符合率为 48%。纵隔子宫中以不全纵隔居多 ( 81/92 ) ;纵隔子宫的外形以扁宽者居多 ( 77/92 )。结论 :经阴道超声检查为纵隔子宫的首选检查方法 ,宫腔镜检查应作为子宫成形术前的必要检查 ,腹腔镜为观察子宫外形的辅助手段。     

经阴道超声宫腔造影对子宫内膜息肉的诊断价值

目的:探讨经阴道超声宫腔造影对子宫内膜息肉的诊断价值。方法:临床疑诊子宫内膜息肉139例患者,行常规阴道超声、经阴道超声宫腔造影及宫腔镜检查,以病理结果为确诊依据,对照不同检查方法的差异。结果:临床疑诊子宫内膜息肉139例患者,最后经病理检查确诊123例。常规阴道超声诊断子宫内膜息肉98例,符合率为79.67%;经阴道超声宫腔造影诊断子宫内膜息肉118例,符合率为95.93%;宫腔镜诊断子宫内膜息肉122例,符合率为99.19%。经阴道超声宫腔造影及宫腔镜诊断符合率明显高于常规阴道超声。3种检查方法与病理诊断结果符合率之间的差异有统计学意义(χ2=34.935,P0.05),进一步两两比较发现,常规阴道超声和经阴道超声宫腔造影诊断符合率之间差异有统计学意义(χ2=15.185,P0.05),而经阴道超声宫腔造影和宫腔镜诊断符合率的差异无统计学意义(χ2=2.733,P0.05)。结论:经阴道超声宫腔造影是诊断子宫内膜息肉的一种无创、安全、简便且准确性高的检查方法,具有很高的诊断价值。     

经阴道彩色多普勒超声宫腔造影诊断宫内病变56例分析

目的探讨经阴道彩色多普勒超声宫腔造影技术诊断宫内病变的价值。方法r对宫腔镜治疗或手术前经阴道彩色多普勒超声宫腔造影诊断的宫内病变患者56例的声像学特点进行分析,并与宫腔镜治疗、手术后的病理结果进行对比。结果宫腔造影诊断子宫粘膜下肌瘤25例、子宫内膜息肉12例、子宫内膜增生过长7例、宫腔粘连9例,诊断符合病例53例,准确率为94．6％。各种不同宫内病变均具有特征性的声像学特点。结论经阴道彩色多普勒超声宫腔造影对宫内病变具有较高的诊断准确性,对大多数病例均可于宫腔镜治疗或手术前做出定性、定位诊断及鉴别诊断,可为临床制定最佳治疗方案提供有价值的诊断信息。     

经阴道超声及宫腔镜对子宫内膜病变的诊断价值

目的：探讨经阴道超声表现与宫腔镜检查对子宫内膜病变的诊断价值。材料和方法：对86例临床疑为子宫内膜病变的患者行阴道超声及宫腔镜检查,并行摘除、活检或刮宫,与病理结果对照分析。结果：病理诊断子宫内膜息肉39例,子宫黏膜下肌瘤9例,子宫内膜增生过长14例,子宫黏膜下肌瘤伴息肉4例,子宫内膜癌4例,正常子宫内膜16例,宫腔镜检查与阴道超声检查对各类子宫内膜病变的诊断准确性相当,两者无统计学差异（P〉0.05）。结论：阴道超声是筛选子宫内膜病变的简便、经济而有效的方法,宫腔镜下活检是可靠的诊断方法,联合检查是目前诊断子宫内膜病变的理想方法。     

经腹与经阴道彩色多普勒超声对妊娠终止后宫腔内异常回声诊断的应用比较

目的探讨经腹与经阴道彩色多普勒超声对妊娠终止后宫腔内异常回声的诊断和鉴别价值,以期为临床诊治提供一定的参考。方法回顾性分析2010年1月~2012年1月间入院诊治的经彩超检查和刮宫术后病理证实的124例妊娠终止后宫腔内异常回声病变的患者资料,分析经腹与经阴道超声诊断符合率以及宫腔内异常声像及临床表现。结果 124例患者不全流产47例、宫内膜增生24例、子宫粘膜下肌瘤15例、子宫内膜息肉21例、慢性子宫内膜炎12例、子宫内膜癌5例,经阴道超声诊断总符合率为90.32%,经腹部超声总符合率为77.42%,两组差异显著(P0.05)。结论经阴道超声对妊娠终止后宫腔内异常回声的诊断与鉴别较经腹部超声更具有临床参考意义。     

经腹部及经阴道超声在子宫黏膜下肌瘤诊断中的应用分析

目的探讨经腹部超声及经阴道超声在子宫黏膜下肌瘤中的诊断价值。方法对76例子宫黏膜下肌瘤(3cm)患者中,分别接受经腹部超声检查和经阴道超声检查,回顾性分析全部患者临床检查结果。结果经腹部超声检出肌瘤直径0.8~3.0cm共54例,诊断符合率为71.05%,误诊率为9.21%,漏诊率为19.74%,经阴道超声检出肌瘤直径0.5~3.0cm共69例,诊断符合率为90.79%,误诊率为3.95%,漏诊率为5.26%,两种诊断方式检出符合率差异具有统计学意义;对子宫黏膜下肌瘤直径0~1cm、1~2cm、2~3cm进行检查,经阴道超声和经腹部超声检查结果无明显差异(P0.05)。结论经腹部超声及经阴道超声两者结合起来,可提高诊断准确率,减少误诊漏诊。     

阴道超声与宫腔镜检查对异常子宫出血的诊断价值

目的观察阴道超声与宫腔镜检查在异常子宫出血患者中的诊断价值。方法对56例异常子宫出血患者分别行阴道超声检查和宫腔镜检查,并将其检查结果分别与患者手术、病理检查结果进行对照比较并进行分析。结果将病理检查结果作为金标准,宫腔镜诊断组诊断符合率为91.07%,其敏感度、特异度、阳性预测值及阴性预测值分别为94.44%、62.50%、94.44%、62.50%,阴道超声诊断符合率为71.43%,阴道超声检查的敏感度、特异度、阳性预测值及阴性预测值分别为87.93%、41.67%、87.93%、33.33%,两组差异有统计学意义(P<0.01)。结论阴道超声与宫腔镜检查对异常子宫出血均有重要的诊断价值,但宫腔镜检查应用于异常子宫出血的诊断,检查时间短,对患者损伤小,而且与手术、病理诊断符合率更高,更利于异常子宫出血的诊断。     

超声造影鉴别子宫肌瘤与子宫腺肌瘤的临床应用价值

目的:探讨超声造影对子宫肌瘤与子宫腺肌瘤鉴别诊断的应用价值。方法:对38例不典型子宫病灶患者行超声造影检查,全部病例均经手术或超声引导穿刺活检证实。结果:本组经病理诊断子宫肌瘤22例,常规超声诊断符合率86.4%,超声造影诊断符合率95.5%;子宫腺肌瘤16例,常规超声诊断符合率81.3%,超声造影诊断符合率93.8%。子宫肌瘤表现为瘤体周边首先灌注呈环状强化,并分支进入瘤体内部,然后内部迅速强化;子宫腺肌瘤则表现为多支、较粗大、短线状增强信号从病灶周边进入内部,继之内部迅速强化。结论:超声造影显示子宫肌瘤与子宫腺肌瘤的血流灌注具有不同的灌注模式和特征,为两者鉴别诊断提供更准确的信息。     

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.