医用诊断X射线工作者GPA基因突变频率与累积受照 …

目的：探讨ＧＰＡ基因突变频率检测作为累积受照生物剂量计的可行性。方法用改进的ＧＰＡ的基因位点突变检测技术，分析了５５名不同时期开始Ｘ射线工作者和５０名非放射医医务工作者外周血红细胞ＧＰＡ基因突变变异体频率与开始工作时期、工龄和累积受照剂量间的关系。结果医用Ｘ射线工作者的ＧＰＡ基因突变频率明显高于对照；突变率明显增高是发生在１９７０年前开始Ｘ射线工作者，这与肿瘤流行病学调查所见恶性肿瘤危险明显增高发     

个体辐射敏感性对医用X射线工作者GPA基因突变频率的影响

目的　探讨个体辐射敏感性对GPA基因突变频率的影响及其校正方法。方法　利用彗星实验、CB微核 3AB指数实验和多元线性回归统计分析方法 ,检测个体辐射敏感性及其对X射线工作者GPA基因突变频率剂量 效应曲线的影响 ,建立多元线性回归方程。结果　X射线工作者的辐射敏感性存在个体差异 ,个体辐射敏感性是GPA基因突变频率变异的影响因素 ;个体的辐射敏感性较高者 ,GPA基因突变频率较高 ;经个体辐射敏感性校正后GPA基因突变频率与剂量的相关性加强 ,GPAN基因突变频率的多元线性回归曲线方程 :YN=2 4 7× 10 - 6 0 5× 10 - 6 X1 - 99 5× 10 - 6X2 1 7× 10 - 6 X3,总相关系数r=0 6 73(P <0 0 1)。结论　用个体辐射敏感性指标校正个体差异 ,改善了GPA基因突变频率剂量 效应关系 ;多元回归方程估算的累积剂量更接近估算的物理剂量 ;减少了GPA基因突变频率估算累积剂量和预测癌患风险的不确定度。     

放射诊疗工作人员血型糖蛋白A基因突变频率及其相关因素的研究

目的 探讨血型糖蛋白A(GPA)基因突变频率用于辐射危险评价及预测电离辐射诱发肿瘤风险的可行性.方法 采用固定人群分层随机抽样的方法,选取上海市放射诊疗工作人员336例(按工种分为X射线影像诊断组、CT影像诊断组、介人放射学组和放射治疗组),健康对照组 112例;其中,经血型鉴定为MN杂合个体的放射诊疗工作人员为176例,健康对照者为58例.分离、固定、荧光免疫标记外周血红细胞后,应用流式细胞仪,按照BR6-1WI方法,分析GPA基因突变频率;采用胞质分裂阻断微核+3-氨基苯甲酰胺指数实验(CB微核+3AB指数实验),检测DNA损伤修复能力以反映研究对象的个体易感性.结果 放射诊疗工作人员GPA基因突变频率明显高于健康对照组(t=2.29～11.48,P＜0.05),尤其是介入放射学组的GPA NO基因突变频率明显高于X射线影像诊断组(t =2.01,P＜0.05).GPA NO基因突变频率受放射工龄、累积剂量和3AB指数的影响作用明显,而GPA NN基因突变频率仅受放射工龄影响,与累积剂量和3AB指数的相关性不明显.结论 对于职业低剂量电离辐射受照人群,GPA NO基因突变频率可较好地反映电离辐射诱发的DNA损伤效应和个体的辐射易感性,较GPA NN基因突变频率更适宜和敏感.     

TCR基因突变分析技术及其在辐射生物学中的应用

综述了TCR体细胞基因突变检测技术的原理、特点及其在生物剂量学中的应用。研究表明,对于急性受照,TCR基因突变频率与受照剂量有明显的剂量效应关系;但TCR却不适于作为一终生生物剂量计以估算早先受照个体的受照剂量,对于长期慢性小剂量的受照情况,目前尚无明确的结论。     

GPA基因位点突变分析在辐射生物学中的应用潜势

利用单克隆抗体和流式细胞仪检测血型糖蛋白A(glycophorin A)基因位点突变的新方法,为人类体细胞突变的定量分析提供了一个快速、灵敏、可靠的实验体系。对接受过综合化疗或放疗的肿瘤病患者和对40多年前广岛原爆幸存者的研究表明:GPA基因位点突变频率的增高与线性剂量反应相一致。从而提示,GPA基因位点突变分析系统有可能作为对慢性小剂量照射累积的生物剂量计。     

两例钴源事故受照者和体外照射正常人外周血的红细胞GPA变异频率分析

目的 :检测上海“6 .2 5”事故两例中度骨髓放射病病人 8年后血型糖蛋白A(GPA)变异频率和估算物理剂量的相关性 ;同时测定正常人外周血在体外用γ线照射后红细胞GPA的变化。方法 :取正常人和事故患者外周血 ,分离红细胞并固定 ,在和荧光素标记的单抗结合后用流式细胞仪进行GPA分析 ,计算GPA变异频率 ;以两组正常人血样分批体外照射 1,2 ,5,10Gy ,在照射后放置 1,4 ,6d后进行检测。结果 :与正常人相比 ,两事故病例的GPA变异频率较高 ,其中变异频率较高者其估算受照剂量较高 ;体外照射外周血红细胞达 10Gy也未见GPA变化。 结论 :放射病病例变异红细胞频率与估算剂量间成正相关 ;外周血直接受照中度剂量不能导致GPA变化 ,提示GPA突变反映造血干细胞损伤 ,GPA分析法适合放射病远后效应跟踪研究     

BrdU法研究放射性核素内照射诱发HPRT基因突变

目的：研究放射性核素内照射诱发大鼠外周血淋巴细胞HPRT基因突变的剂量效应关系。方法：大鼠尾静脉注入晚期混合裂变产物，5－溴脱氧尿嘧啶（BrdU）法检测不同累积剂量和不同剂量率内照射诱发外周血淋巴细胞HPRT基因突变，并拟合剂量效应关系。结果：随着累积剂量和剂量率的增加，HPRT基因突变频率不断上升，其剂量效应关系符合线性模型，结论：BrdU法是一种快速，简便，较敏感的检测辐射诱发HPRT基因突变的方法，HPRT基因突变可以作为辐射生物剂量计。     

GPA基因突变分析技术及其应用

较系统地介绍了GPA基因突变分析技术的原理、革新、应用及特点。研究表明,GPA可作为一种终生生物剂量计,通过检测个体GPA基因突变频率,估算其长期甚至终生接触有害环境理化因素的水平。通过比较分析个体GPA基因突变及癌症发生情况,简要讨论了该项技术在评估个体受到电离辐射或接触有害理化因素后罹患肿瘤风险方面的应用前景。     

X射线诱发外周血淋巴细胞TCR基因突变研究

目的 用培养法研究X射线诱发的人外周血淋巴细胞TCR 基因突变情况。方法 以不同剂量(0~8 Gy) 的X射线照射新鲜分离的健康成人外周血淋巴细胞, 植物血凝素、白细胞介素2(IL-2)协同刺激培养7 d, 流式细胞术检测TCR基因突变频率(TCR MF),并拟合剂量效应关系。结果 随着照射剂量的增加,TCR基因突变频率随之上升, 最佳拟合曲线为二次多项式模型。结论 TCR 基因突变可作为辐射生物剂量计,用于急性辐射照射生物剂量的估算。     

放射性核素内照射诱发大鼠外周血淋巴细胞HPRT基因突变

目的 用克隆法研究放射性核素内照射诱发的大鼠外周血淋巴细胞HPRT基因突变情况。方法 大鼠尾静脉注入晚期混合裂变产物，克隆法检测不同累积剂量和不同剂量率的内照射诱发的外周血淋巴细胞HPRT基因突变，并拟合剂量效应关系。结果 随着累积剂量和剂量率的增加，HPRT基因突变频率随之上升，其剂量效应关系符合线性平方模型。结论 克隆法是一种较敏感的检测辐射诱发HPRT基因突变的方法，HPRT基因突变可能作为辐射生物剂量计。     

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 role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

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.