经皮单球囊与双球囊肺动脉瓣成形术的对比观察

作者对经皮单球囊肺动脉瓣成形术１７例和双球囊扩张４０例的效果进行比较。扩张前两组右室收缩压分别为１１．７６±３．９４ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）与１２．６１±４．３３ｋＰａ；跨瓣压差分别为８．１１±３．６８ｋＰａ与８．４０±４．６１ｋＰａ（Ｐ＞０．０５）。扩张后右室收缩压分别为６．４８±１．６６ｋＰａ与７．０５±３．４４ｋＰａ；跨瓣压差分别为２．０１±１．５１ｋＰａ与２．１５±１．７８ｋＰａ（Ｐ＞０．０５）。上述结果提示单球囊与双球囊扩张的效果相同。     

Nd∶YAG激光治疗血管瘤的体会

资料：９例患者中男性３例,女性６例;年龄２个月至２２岁。其中海绵状血管瘤４例、毛细血管瘤３例、混合性血管瘤２例。瘤体大小为１２ｃｍ×２０ｃｍ～４５ｃｍ×６０ｃｍ。方法：（１）海绵状血管瘤：激光输出功率４０～６０Ｗ。ＨｅＮｅ激光同光路输出。局...     

大鼠感染性脑水肿时NMDA受体的变化

测定百日咳菌液（ＢＰ）所致大鼠感染性脑水肿（ＩＢＥ）对３ＨＭＫ８０１与大脑皮层神经细胞特异结合的影响。从大鼠左颈总动脉注入ＢＰ，制备ＩＢＥ模型。雄性ＳＤ大鼠随机分３组：①对照组（ＮＳ，ｎ＝１１）；②ＩＢＥ组（ＢＰ，ｎ＝１２）；③ＭＫ８０１＋ＢＰ预处理组（ＭＫ８０１，ｎ＝４）。０２ｍｌ／ｋｇ体重生理盐水或ＢＰ注入左颈总动脉作为ＮＳ或ＢＰ组；每天腹腔注射０５ｍｇＭＫ８０１／ｋｇ体重，共２天，然后注入ＢＰ为ＭＫ８０１组。注射ＢＰ２４小时后断头取脑。Ｎ甲基Ｄ天冬氨酸（ＮＭＤＡ）受体与３ＨＭＫ８０１的特异结合用放射配体结合分析法测定，Ｓｃａｔｃｈａｒｄ作图。结果，ＮＳ及ＢＰ组的Ｂｍａｘ分别为０６２３±００８２和０６０６±００８７ｐｍｏｌ／ｍｇ蛋白质（ｔ＝０４８，Ｐ＞００５），Ｋｄ分别为４３１±４２和３０５±３０μｍｏｌ／Ｌ（ｔ＝７８，Ｐ＜００５）。ＭＫ８０１预处理减少ＮＭＤＡ受体的特异结合。表明在此脑水肿模型中ＮＭＤＡ受体总数未发生变化，但亲和力明显增高，其增高能被预先腹腔注入的ＭＫ８０１抑制。     

二尖瓣狭窄并发左房活动血栓溶栓后经皮球囊二尖瓣成形术5例

二尖瓣狭窄并发左房活动血栓溶栓后经皮球囊二尖瓣成形术５例３５１１００莆田解放军第９５医院戴蓉，王明元，张朝阳，茅忠年，吴锦水，郑文华，韩文海中图法分类号Ｒ６５４．２自１９９２年６月至１９９４年１月经多普勒超声心动图检测到风湿性心脏病二尖瓣狭窄（ＭＳ）...     

静脉内注射~（99m）Tc－MAA测定静动脉分流率的研究

采用吸纯氧法及用锝９９ｍ（~（９９ｍ）Ｔｃ）标记的人体大颗粒聚合白蛋白（ＭＡＡ）静脉注射法测定２５名健康人及３０例慢性阻塞性肺病（ＣＯＰＤ）患者的静动脉分流率。吸纯氧法测得健康组及ＣＯＰＤ组Ｑｓ／ＱＴ分别为２．９±２．６％、６．４±４．５％，两者差异显著（Ｐ＜０．０１）。核素法测得健康组ＣＯＰＤ组Ｑｓ／ＱＴ分别为１．２±０．７％、４．６±２．４％，两者差异显著（Ｐ＜０．０１）。吸纯氧法测得ＣＯＰＤ组Ｑｓ／ＱＴ的均值（６．４％）是对照均值（３．９％）的２．２倍，而核素法测得ＣＯＰＤ组的均值（４．６％）是对照组（１．２％）的３．８倍，两者差异显著（Ｐ＜０．０１）。提示：核素法是一种较之吸纯氧法灵敏、可靠、简便的测定Ｑｓ／ＱＴ的方法     

^99mTc—DTPA肾动态显像在小儿肾盂积水中的应用

目的探讨９９ｍＴｃＤＴＰＡ肾动态显像诊断小儿肾盂积水的临床价值。方法常规９９ｍＴｃＤＴＰＡ肾动态显像方法，１５分钟后静脉注射速尿，共检查肾盂积水患儿４５例，其中７例作手术前后比较。定量分析指标包括：肾血流灌注率（ＢＰＲ），高峰摄取率（ＰＵＲ），半排泄时间（Ｔ１／２）。结果①ＢＰＲ随积水程度加重而明显下降，重度积水为１６８％±６８％，中度积水为３５１％±６９％，轻度积水为４０６％±９２％。ＰＵＲ在重度积水时为２１６％±１２９％。②７例患儿中６例术后ＢＰＲ明显升高。术前、术后Ｔ１／２分别为４１３±２０４和２２９±１１９分钟。术后Ｔ１／２明显改善。结论①ＢＰＲ可正确反映肾盂积水和肾功能受损程度，两者呈正相关；②术后肾功能改善情况和速尿介入能正确判断集尿系统有无梗阻存在     

^99mTc—抗人活化血小板嵌合McAb SZ—51Hu对狗动脉血栓放免显像

为了评价９９ｍＴｃ抗人活化血小板嵌合单克隆抗体（ＭｃＡｂ）ＳＺ５１Ｈｕ在血栓放射免疫显像（ＲＩ）中的应用价值，用９９ｍＴｃＳＺ５１Ｈｕ对狗动脉血栓模型进行了ＲＩ，并且与９９ｍＴｃ标记的原亲本鼠源性ＭｃＡｂＳＺ５１显像结果比较。结果表明，注射９９ｍＴｃＳＺ５１Ｈｕ后２～４小时血栓显示清晰。血液半清除时间：９９ｍＴｃＳＺ５１ＨｕＴ１／２α＝０３７±０２４小时，Ｔ１／２β＝８２３±３７０小时；９９ｍＴｃＳＺ５１Ｔ１／２α＝０６０±０１７小时，Ｔ１／２β＝９１７±４４４小时。显像结束后处死动物，离体血栓／血液和血栓／周围肌肉单位质量放射性比值：９９ｍＴｃＳＺ５１Ｈｕ为３３０５±７７８和２１０６８±１９２９７；９９ｍＴｃＳＺ５１为３６３３±５３０和２３４０２±７６９１。两组实验结果差异无显著性（ｔ＝０２７９９～１７３２２，Ｐ＞００５）。９９ｍＴｃＳＺ５１Ｈｕ保留了９９ｍＴｃＳＺ５１所具有的活体内导向定位血栓的能力，用于血栓性疾病的ＲＩＩ及导向治疗有一定的可行性。     

尿道前列腺返流显像及其在慢性前列腺炎的应用

目的探讨尿道前列腺返流显像在前列腺内尿液返流（ＩＰＵＲ）诊断中的价值及ＩＰＵＲ在慢性前列腺炎（ＣＰ）发病中的作用。方法在ＣＰ患者中进行插管法与静脉注射法放射性核素尿道前列腺返流显像（ＵＰＲＩ）,计算尿道前列腺返流比率（ＵＰＲＲ）,评价ＵＰＲＲ与ＣＰ症状评分的关系。结果３２例ＣＰ患者中８７５％（２８例）存在ＩＰＵＲ,其ＵＰＲＲ值为７６±３９,正常对照组为１８±１２,两者间差异有显著性（ｔ＝３２５,Ｐ＜００１）;插管法与静脉注射法ＵＰＲＲ在ＩＰＵＲ诊断中无明显差异（ＵＰＲＲ值分别为５４±２３和５８±２６）。ＣＰ患者ＵＰＲＲ与症状评分及ＩＰＳＳ、Ｑｍａｘ和ＭＵＣＰ有好的相关性,ｒ分别为０８９、－０８７和０９１,Ｐ均＜００１。结论ＩＰＵＲ与ＣＰ发病有关,静脉注射法显像能较好地评价ＩＰＵＲ,并具有无创、简便的优点。     

~(99m)Tc-ECD SPECT断层影像采血法和非采血法定量测定rCBF和CBF的对照研究

目的：应用９９ｍＴｃＥＣＤＳＰＥＣＴ断层影像采血和非采血法定量测定ｒＣＢＦ和ＣＢＦ。材料和方法：正常对照组１５例,疾病组１０例。采血法用动脉化静脉血样求得血中９９ｍＴｃＥＣＤ的浓度;非采血法用头颈平面像求得血中９９ｍＴｃＥＣＤ浓度。结果：正常对照组采血法ｒＣＢＦ２５０±４０～５９１±７６ｍｌ．ｍｉｎ－１·（１００ｇ）－１,ＣＢＦ４３０±３６ｍｌ．ｍｉｎ－１·（１００ｇ）－１;非采血法ｒＣＢＦ２６１±３２～６０３±６８ｍｌ．ｍｉｎ－１·（１００ｇ）－１,ＣＢＦ４３５±４４ｍｌ．ｍｉｎ－１·（１００ｇ）－１。和其他方法测得的正常值很接近。疾病组两法测定的结果基本一致。结论：用９９ｍＴｃ－ＥＣＤＳＰＥＣＴ断层影像测定ｒＣＢＦ和ＣＢＦ是可行的,可作为评价脑血流灌注的定量指标。     

早期帕金森病123I-β-CIT脑SPECT显像研究

目的研究早期帕金森患者纹状体中多巴胺转运体的丢失情况。方法通过７例单侧帕金森患者及７例年龄、性别匹配（年龄±５年）的正常人１２３Ｉ２βｃａｒｂｏｍｅｔｈｏｘｙ３β（４ｉｏｄｏｐｈｅｎｙｌ）ｔｒｏｐａｎｅ（βＣＩＴ）脑ＳＰＥＣＴ显像，计算纹状体与小脑的放射性比值及纹状体中１２３ＩβＣＩＴ摄取的非对称指数，分析患者症状侧及症状对侧纹状体特异性１２３ＩβＣＩＴ的摄取。结果纹状体３小时及１８小时特异性摄取１２３ＩβＣＩＴ正常人为３０±０５和５５±０６；患者症状对侧为２０±０８和３１±０４，症状侧为２３±０４和４０±０５。与正常人比较，患者双侧纹状体的１２３ＩβＣＩＴ特异性摄取明显下降（Ｐ＜００１），症状侧纹状体摄取下降与年龄有关（Ｐ＜００５），症状对侧纹状体摄取下降与年龄无关（Ｐ＞００５）。结论早期帕金森患者双侧纹状体多巴胺转运体有不同程度的丢失，症状对侧丢失更明显     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.