婴幼儿先天性巨结肠的X线诊断

目的：探讨婴幼儿先天性巨结肠的X线诊断要点.方法：收集我院47例经手术及病理证实的先天性巨结肠患儿,分析其腹部立位片及结肠钡剂造影的影像学表现.结果：腹部立位片示低位结肠不全性梗阻35例,肠淤张17例,小肠低住梗阻1例.结肠钡剂造影显示常见型39例,短段型5例,超短段型2例,长段型1例,征象可见痉挛段、移行段及扩张段,其中3例新生儿及超短段型狭窄段显示不明显,3例移行段显示不明显,24 h复查38例有不同程度钡剂残留.结论：凡临床怀疑先天性巨结肠的婴幼儿应尽早行腹部立位片及结肠钡剂造影检查,并随访观察24 h钡剂排空情况,对其早期诊断及治疗有重要意义.     

暂时性食管腔内憩室:一个重要的流动性人为征象

作者报告12例食管造影中,食管腔内有卵圆形及长方形的钡剂聚集,周围绕以薄的透明边缘,非常类似食管腔内憩室。6例见于单对比,6例见于双对比食管造影。复查时,不能再显示食管内窥镜检查及9例手术标本的病理检查均未见食管腔内憩室。作者指出,Cho 氏等曾提出食管的动力紊乱伴第三收缩可在食管内贮留气体、钡剂,与分泌物和     

食管癌肉瘤的X线表现(附5例报告)

目的:探讨食管癌肉瘤的X线表现,提高对该病的认识。方法:回顾性分析5例经手术病理证实的食管癌肉瘤影像资料。5例均行食管钡剂造影和电子纤维胃镜检查,5例均行手术治疗。结果:食管钡剂造影显示病变位于食管中段2例,下段3例。食管腔扩张4例,狭窄1例。管壁柔软4例,僵硬1例。结论:息肉型食管癌肉瘤有一定的X线特征性表现,浸润型食管癌肉瘤缺乏影像学特征。     

食管手术后的X线造影检查(附70例报告)

目的：探讨食管手术后的复查机，对比剂和体位的选择。方法：回顾性总结70例食管手术后X线造影复查的表现和结果。结果：15例术后7－9d内复查，发现吻合口瘘4例；50例术后10－15d复查，吻合口瘘2例，吻合口狭窄2例；5例术后15天－2个月内复查，吻合狭窄2例。此外，还发现其它合并症5例。结论：食管手术后，近期造影复查，应从碘剂开始，尔后过渡到钡剂，并应多体位观察，摄片，以便观察临床疗效，对术后并发症及早发现。     

超声造影对食管胃底静脉重度曲张的定量分析诊断

目的 探讨超声造影在门脉高压性食管胃底静脉重度曲张无创诊断中的应用价值.方法 13例无食管静脉曲张的正常对照者（对照组）及11例胃镜、上消化道造影及临床提示食管胃底静脉重度曲张的患者（病例组）接受超声造影检查,采集食管胃底部位动态造影数据,应用QLAB图像分析软件,获得时间-强度曲线,得到以下定量参数：开始增强时间（AT）、达峰时间（TTP）、达峰强度绝对值（DPI）及曲线上升支斜率（A）.结果 造影后病例组食管胃底管壁厚度达（0.87±0.08）cm,远大于正常组（0.38±0.03）cm（P〈0.05）.病例组开始增强时间（AT）、达峰时间（TTP）分别为（16.76±1.23）s、（32.77±0.06）s,较正常组（15.04±1.48）s、（28.99±1.87）s明显延长（P〈0.05）.病例组的达峰强度绝对值（DPI）、曲线上升支斜率（A）增大,但差异无统计学意义（P〉0.05）.结论 超声造影对食管胃底静脉重度曲张的诊断有独特的优势,有望成为其无创诊断的新方法.     

食管穿孔造影检查:水溶性碘剂与钡剂的比较

食管穿孔是消化道严重而致命的损伤,一般食管穿孔的造影检查都把水溶性碘制剂作为首选的对比剂。但当检查结果为阴性时,是否需用钡剂进一步检查?为明确此问题,研究了67例怀疑食管穿孔的患者,先用水溶性碘剂作食管检查,49例为阳性。18例阴性者,进一步以钡剂(100％wt/vol)作食管检查。结果,其中4例可见钡剂外漏,检查后进行患者随访未见并发症发生。该组资料显示食管穿孔水溶性碘剂造影的漏诊率为22％。     

腹茧症的影像诊断

目的探讨腹茧症的影像特点，提高术前诊断水平。方法回顾性分析经手术病理证实的腹茧症6例，术前均进行立位腹部X线平片和腹部CT检查，4例同时行胃肠道钡剂造影，复习其影像表现。结果6例立位腹部X线平片中3例诊断为肠梗阻。4例胃肠道钡剂造影，均可见小肠交错盘绕成团，呈“菜花”状或“手风琴”状表现。6例CT检查，均可见小肠聚集成团，其周围可见膜样的囊状物将其包裹。结论对患者进行胃肠道造影时观察到“菜花”状征象，或CT检查时观察到小肠聚集成团被一层膜样物包裹，应考虑到腹茧症的可能。     

内镜下食管胃底静脉曲张治疗对肝硬化患者肝脏及脾脏弹性指数的影响

目的 探讨肝硬化患者肝脏及脾脏弹性指数在内镜下食管胃底静脉曲张治疗前后的变化.资料与方法 选取拟行内镜下食管胃底静脉曲张治疗的肝硬化患者85例,其中51例行内镜下食管胃底静脉曲张治疗(治疗组),34例行常规胃镜检查(对照组).治疗前后分别采用实时剪切波弹性成像测定肝脏及脾脏弹性指数并进行分析.结果 治疗组患者治疗后肝脏弹性指数由(22.13±7.98) kPa上升为(29.46±12.49) kPa,脾脏弹性指数由(39.66±9.80) kPa上升为(47.49±10.68) kPa,差异均有统计学意义(t=-6.322、-4.924,P＜0.01).对照组肝脏及脾脏弹性指数治疗前后差异无统计学意义(P＞0.05).结论 肝硬化患者肝脏及脾脏弹性指数经食管胃底静脉曲张治疗后显著上升,可敏感地反映门脉压力改变,具有一定的临床意义.     

体位改变对完全植入式静脉输液港导管头端位置影响北大核心CSCD

目的探讨患者体位改变对完全植入式静脉输液港(TIVAP)导管头端位置的影响。方法超声导引下床边穿刺颈内静脉或锁骨下静脉植入TIVAP。术后摄立位和卧位X线胸片确认导管头端位置,分别测量X线胸片上第一胸椎上缘至导管头端距离。通过两者长度测量差异和固定体表标志判断导管头端位置移动。结果 86例恶性肿瘤患者成功植入TIVAP。有71例体位由立位改变为卧位时TIVAP导管头端向足侧移位,平均移位(12.29±7.48)mm;13例向头侧移位,平均移位(5.00±3.79)mm;2例无变化。TIVAP导管头端位置在立位改变为卧位时有向足侧移位倾向,平均移位(-9.32±9.36)mm,差异有显著统计学意义(P<0.0001);性别、年龄、身高、体重、体质指数与导管头端位置变化程度间差异均无统计学意义(P>0.05)。结论 TIVAP植入后导管头端位置会随患者体位变化发生改变,由立位变为卧位时导管头端易向心房内移动。     

采用DSA设备评价吞咽功能的初步探讨

目的:探讨运用DSA设备作吞咽功能检查的价值。材料和方法:用DSA设备对正常组24例,咽异感症患者32例,做上至颅底、下达第七颈椎平面的正侧位动态采集,了解吞咽状况,并行咽传输时间测定,进行对照研究。结果:正常对照组咽传输时间为1.441±0.302s,咽异感症患者咽传输时间为1.367±0.409s,两组结果相比统计学上无显著差异,但后者较易发生咽部钡剂滞留等改变。结论:DSA机由于采集速度快,不但在心血管检查及介入治疗方面有重要意义,而且在非血管性脏器的动力学检查中也起着一定的作用。由于能完整记录钡剂通过咽部的全过程,故此方法是吞咽功能检查的良好方法之一。     

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.     

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.     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme     

改进的定位技术在胸部肿瘤穿刺活检中的应用

目的：探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法：对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果：采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间（9.5 min）较传统方法（16.8 min）缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义（P〈0.05）。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论：根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。