脉冲式温热灌注对肿瘤血管渗透性的影响

目的探讨60℃生理盐水经脉冲式灌注肝组织及肿瘤组织对其血管渗透性的影响。方法建立30只兔VX2移植性肝癌模型,随机分为3组(37℃盐水组、60℃盐水连续灌注组及60℃生理盐水脉冲式灌注组),每组10只。经股动脉插管至肝动脉进行灌注,灌注液为生理盐水(液量60ml),灌注过程中,测量60℃热灌注组肿瘤组织达43～45℃持续时间,灌注结束前5min,各组经导管推注1%伊文思蓝(EB)2ml/kg,灌注EB后置10min,取出肝脏用生理盐水灌注肝动脉冲洗血管中残留的EB。取小块正常肝组织、瘤组织,称重后,放入1ml甲酰胺液中,置于50℃恒温水浴箱60h,提取液用722型光栅分光光度计测出620nm下的A值,从标准曲线上测出相应的EB含量,以反映该组织毛细血管的渗透性。结果灌注EB10min后,60℃脉冲式灌注组肿瘤组织EB含量(15.21±0.94)μg/100mg,与60℃连续灌注组(10.71±0.84)μg/100mg相比差异有统计学意义(P<0.01),与37℃灌注组(3.42±0.87)μg/100mg相比差异有统计学意义(P<0.01)。60℃脉冲式灌注组正常组织EB含量(8.32±0.86)μg/100mg与60℃连续灌注组(7.59±0.65)μg/100mg相比差异无统计学意义(P>0.05),但与37℃灌注组(2.68±0.73)μg/100mg相比差异有统计学意义(P<0.01)。60℃脉冲式灌注组肿瘤组织(43～45℃)持续时间为(12.3±3.3)min,与60℃连续灌注组的(5.7±2.5)min相比有差异(P<0.01)。结论60℃脉冲式灌注热疗可以增加肿瘤组织的血管渗透性,可能是一种更为有效的介入热疗方法。     

经动脉间歇性热灌注化疗方法的实验研究

目的　研究经动脉间歇性热灌注化疗方法的有效性、安全性。材料与方法　在 30只新西兰大白兔大腿上建立VX2肿瘤模型 ,经股动脉插管 ,DSA证实肿瘤供血动脉后 ,分 3组 (每组 10只 ) ,分别给予常温 10 0ml生理盐水 +阿霉素 (ADM)灌注、6 0℃热盐水 10 0ml+ADM连续灌注、6 0℃热盐水 10 0ml+ADM间歇性灌注。灌注过程中 ,测量两 6 0℃热灌注组肿瘤组织内 4 3℃～ 4 5℃持续时间 ,灌注后即时检测各组肿瘤组织内ADM浓度。结果　ADM浓度 (μg/ml) :6 0℃间歇性灌注组 2 0 .6 2 2± 2 .2 78,6 0℃连续灌注组 14 .0 5 8± 1.973,常温灌注组 13.115± 2 .180。 6 0℃间歇灌注组与 6 0℃连续灌注组比较有显著性差异 (P <0 .0 5 ) ,6 0℃连续灌注组与常温灌注组比较无显著性差异 (P >0 .0 5 ) ;4 3℃～ 4 5℃持续时间 (min) :6 0℃间歇性灌注组 2 0 .0 0 0± 1.5 71,6 0℃连续灌注组 6 .10 0± 0 .6 74 ,6 0℃间歇性灌注组为 6 0℃连续灌注组的 3倍。两 6 0℃组兔的呼吸、心率、体温变化无明显差异。结论　经动脉间歇性热灌注化疗方法是一种有效而安全的介入性热化疗方法     

兔大腿VX2模型在介入性热化疗实验中的应用

目的　探讨兔大腿VX2 模型在介入性热化疗实验中的应用价值。方法　在 2 0只新西兰大白兔一侧大腿上建立VX2 肿瘤模型 ,经股动脉顺行插管 ,DSA证实肿瘤供血动脉后 ,分 2组 (每组 10只 ) ,分别给予 60℃热盐水 10 0ml连续灌注、60℃热盐水10 0ml间歇性灌注。灌注过程中 ,测量两 60℃热灌注组肿瘤组织内 43℃～ 45℃持续时间。结果　 2 0只新西兰大白兔一侧大腿均建立起VX2 肿瘤模型 ,成功率 10 0 % ;插管成功率 10 0 %。 43℃～ 45℃持续时间 (min) :60℃间歇性灌注组 2 0 .0 0 0± 1.5 71,60℃连续灌注组 6.10 0± 0 .674,60℃间歇性灌注组为 60℃连续灌注组的 3倍。结论　在介入性热化疗实验中 ,兔大腿VX2 模型是一个成功率高、操作简便易行的肿瘤模型。     

介入性灌注化疗与热灌注化疗对兔VX2肝癌模型的作用比较研究

目的观察热灌注化疗对兔VX2肝癌模型疗效及安全性。方法新西兰大白兔20只,制备兔肝VX2模型,随机分为对照组(A)和实验组(B),分别A组给于常温(22～25℃)5%葡萄糖100ml+5-Fu(20mg/kg),B组给于60℃5%葡萄糖100ml+5-Fu(20mg/kg),用B超观察处理前后肿瘤大小,抽血查ALT变化。结果A组肿瘤体积由(1627±473)mm3缩小为(1334±641)mm3,B组肿瘤体积由(1682±397)mm3缩小为(1130±559)mm3,两组差别有统计学意义(P<0.05);ALTA组由(755±203)u/L增加为(834±262)u/L,B组由(781±197)u/L增加为(865±237)u/L,组间差异无统计学意义。结论介入性热灌注化疗比常温灌注化疗对兔VX2肝癌模型有更高的抑制作用。     

60℃碘油栓塞对兔肝VX2肿瘤血供的影响

目的 观察60℃碘油栓塞对兔肝VX2肿瘤的血流动力学的影响.方法 30只肝VX2肿瘤兔,随机分为3组,分别采用37℃生理盐水(对照组)、37℃碘油及60℃碘油各1 ml分别经兔肝动脉灌注,多普勒观察处理前后1周肝脏及肿瘤血供情况,肝动脉、门静脉血流动力学变化.结果 60℃碘油栓塞后肝动脉最大血流速度与对照组比明显降低(P<0.01),与37℃碘油组比降低(P<0.05).与对照组比60℃碘油栓塞组肝动脉内径缩小(P<0.01),阻力指数增大(P<0.01),门静脉血流速度及内径均无明显变化(P>0.05).治疗前,所有病灶能量及彩色多普勒均可检测出瘤内及瘤周较丰富血流信号,治疗后显示60℃碘油组瘤内及瘤周血流信号均明显减弱,部分消失.结论 60℃碘油栓塞可更有效地阻断兔肝VX2肿瘤供血.     

介入性灌注热碘油栓塞兔VX_2肝癌的疗效研究

目的评价热碘油对兔VX2肝癌的疗效及安全性。方法将30只载瘤兔,随机分为两组,每组15只。A组为常温30℃碘油灌注,B组为60℃热碘油灌注。经导管由肝动脉分别灌注常温碘油和热碘油,10 d后观察两组肿瘤体积及血清AST水平,观察载瘤兔的存活期。结果 B组肿瘤生长率(0.90±0.18)与A组(1.28±0.27)相比有统计学差异(P<0.05);A组存活期(42.0±2.0)d与B组(32.5±3.0)d相比有统计学差异(P<0.05)。A组血清AST水平与B组相比无统计学差异(P>0.05)。结论 60℃热碘油栓塞兔VX2肝癌可明显降低肿瘤生长率并延长存活期。     

CT灌注成像监测兔肝VX2肿瘤生长

目的:研究使用CT灌注成像(CTPI)参数监测兔肝VX2肿瘤生长的价值。方法:10只新西兰大白兔,开腹手术于肝右叶内注射VX2肿瘤细胞悬液0.1ml。分别在种瘤前、种瘤后第1周、第3周行CT灌注扫描。应用反卷积算法计算肝脏的灌注参数:血流速(BF)、平均通过时间(MTT)、血容量(BV)、表面通透性(PS)、肝动脉分数(HAF)和到达时间(IRFT0)等。比较在肿瘤生长过程中灌注参数的变化。使用单因素方差分析进行统计学处理。结果:10只兔中共9只成功建立VX2种植模型。9只种植成功的兔肝中CT发现病灶9个,种植后第1周时扫描9只兔均可见肿瘤,直径约为(0.5±0.1)cm,第三周时肿瘤直径(2.6±0.6)cm。种瘤前肝实质、种瘤后第1周和第3周时肿瘤区域CTPI灌注参数BF、BV、PS、HAF、MTT、T0分别为(172.11±10.87)ml/(100g·min)、(31.02±3.02)ml/100g、(16.82±4.34)ml/100g·min、0.1224±0.0068、(11.24±1.20)s、(5.15±0.26)s;(128±5.04)ml/(100g·min)、(25.15±0.86)ml/100g、(14.79±5.18)ml/100g·min、0.7780±0.0514、(9.82±0.47)s、(3.43±0.12)s与(237.00±8.83)ml/(100g·min)、(33.11±1.89)ml/100g、(18.78±6.25)ml/100g·min、0.9440±0.0124、(10.12±0.21)s、(1.86±0.05)s。HAF、T0、BF值比较差异有显著性意义(P<0.05),BV、MTT、PS值差异无显著性意义。结论:CTPI参数HAF、T0、BF值可监测肝脏VX2肿瘤生长过程,较好反映了VX2肿瘤的动脉供血为主的本质,有希望在肝癌的检出及监测中发挥作用。     

热碘油栓塞兔肝VX2肿瘤血流动力学的影响

目的 探讨热碘油栓塞兔肝VX2瘤血液动力学的影响.方法 30只载VX2瘤兔,随机分为3组A组37℃生理盐水,B组37℃碘油,C组60℃热碘油,经股动脉穿刺、兔肝动脉插管灌注或栓塞瘤血管床,1周后多普勒超声观察肿瘤血供及肝动脉、门静脉血流动力学变化,检测结果与治疗前相应血管的多普勒参数行比较.结果 与A,B组相比,热碘油灌注栓塞后肝动脉血流速度降低最明显(P＜0.01),阻力指数增大(P＜0.05),门静脉血流速度及内径无明显变化(P＞0.05);治疗后显示热碘油组瘤内及瘤周血流信号均明显减弱,部分消失(P＜0.05).结论 热碘油栓塞可更有效地阻断兔肝VX2肿瘤供血,提高疗效.     

聚N-异丙基丙烯酰胺磁性阿霉素纳米微球抗兔VX2肝肿瘤效果初步研究

目的 观察应用聚N-异丙基丙烯酰胺磁性阿霉素纳米微球(ADM-PNIPAM-Fe3O4)对兔VX2肝肿瘤的动脉化疗栓塞治疗作用.方法 将肝脏已成功接种VX2肿瘤的新西兰大白兔随机分成4组,每组8只.A组为生理盐水对照组,肝动脉灌注生理盐水10 ml;B组为游离阿霉素组,肝动脉注入阿霉素(1 mg/kg);C组为ADM-PNIPAM组,肝动脉注入ADM-PNIPAM 1.5 mg/kg(约相当于阿霉素1 mg/kg);D组为ADM-PNIPAM-Fe3O4并在瘤区外加磁场组,肝动脉注入ADM-PNIPAM-Fe3O4 2 mg/kg(相当于阿霉素1 mg/kg),同时在肿瘤表面加磁场.4组实验动物于介入术前1 d,术后14 d行CT肝脏及肺部扫描,测量肿瘤大小,检查肺部转移灶;术后第15天处死,全部实验动物均取肿瘤组织及肺脏作组织病理学检查,C组及D组取胃、脾、肾器官行病理学检查.结果 术前1 d各组动物肿瘤体积无明显统计学差异.至术后14 d时,A组平均肿瘤体积为(23.87±7.02)cm3;B组为(7.70±1.53)cm3;C组为(4.29±0.25)cm3;D组为(2.05±0.18)cm3.B、C、D 3组平均肿瘤体积均小于同期对照A组,B、C、D 3组之间亦有差异,按术后肿瘤体积从大到小的顺序排列依次为B组＞C组＞D组,以ADM-PNIPAM-Fe3O4并在瘤区外加磁场组最小.肺转移的发生率A、B、C、D组分别为100%、66.7%、37.5%、12.5%,C、D组肺转移率低于对照A组;与B组相比A组转移率无明显统计学差异,但病理学检查B组转移瘤数目比A组少;肿瘤坏死程度为D组＞C组＞B组＞A组.结论 经动脉途径应用ADM-PNIPAM-Fe3O4联合外加磁场治疗对兔VX2肝肿瘤生长有较明显的抑制作用.初步肯定ADM-PNIPAM-Fe3O4是一种有效的介入化疗栓塞制剂.     

肝动脉热灌注对兔肝VX2肿瘤及正常肝组织血管渗透功能的作用

 目的 探讨介入热疗对肝组织及肿瘤组织血管渗透性的影响及意义,为研究介入热疗的生物学效应机制奠定基础.方法 建立可供实验研究的兔VX2移植性肝癌模型30只,随机等分为3组(非灌注组、普通灌注组及热灌注组),在X线监视下,经股动脉插管至肝动脉.进行灌注,灌注液为生理盐水(温度为60℃),液量30 ml,15 min缓慢推注.灌注结束前5 min,经导管推注10/L伊文思蓝(Evans blue,EB)2 ml/kg,非灌注组直接推注EB,灌注EB后置10 min,取出肝脏用生理盐水灌注肝动脉冲洗血管中残留的EB.切取靠近肝门部的小块正常肝组织、瘤组织,称重后,放入1 ml甲酰胺液中,置于50℃恒温水浴箱60 h,提取液用722型光栅分光光度计测出波长620 nm,从标准曲线上测出相应的EB含量,以反映该组织毛细血管的渗透性.结果 肿瘤组织与肝组织的EB含量在3组中均有差别(P＜0.05) ;正常灌注组与非灌注组肝组织的EB含量、肿瘤组织的EB含量无明显差别(P＞0.05) ;热灌注组与非灌注组、正常灌注组肝组织的EB含量、肿瘤组织的EB含量有明显差别(P＜0.05).结论 介入热疗可以增加肝组织及肿瘤组织的血管渗透性.     

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.