应用介入放射技术开展近距离放疗的探讨

对使用介入放射技术开展近距离放疗进行探讨，与普通铱-192后装机比较，评述血管内铱-192后装机的结构特点、安全措施等。     

三种医用射线装置剂量分布及其防护意义

计算机断层X射线机(CT)、远距离钴-60放射治疗机和铱-192内置后装治疗机现已广泛地应用于当今的医疗部门。     

科达KD-HDR82型后装机典型故障分析与检修

后装机一般采用放射源铱-192通入人体腔内的导管对病变部位的表面直接照射的方法,来对肿瘤进行近距离放疗的一种设备。科达公司与中山医科大学肿瘤中心共同研制的KD-HDR82型后装治疗机,具有采用国产铱源,汉字提示操作,独特的放射源传送机构,多重安全防护措施等优点。但是,此类设备普遍存在生产工艺较粗糙,机械传送部位的设计不是十分完善,另外,在安全保护功能上仍然有些欠缺。因此,此型仪器属于故障率较高的设备,下面针对几例典型故障作分析。1故障一假源钢丝在治疗机分度头部位遇阻,随即返回。专控计算机显示,分度头定位出错。分析与检修…     

近距离后装机192Ir源外观活度质量控制

目的探讨192Ir源外观活度测量的必要性。方法回顾性分析福建省肿瘤医院的2台近距离后装机近3年内每次换源后的192Ir源外观活度测量数据,均使用HDR 1000 Plus井型电离室对192Ir源外观活度开展测量,将井型电离室与施源器连接,步进式寻找源在井型电离室最大灵敏位置,依据中华人民共和国卫生行业标准WS 262-2017《后装γ源近距离治疗质量控制检测规范》计算源外观活度相对偏差。结果2台后装机共计12次换源,源外观活度相对偏差都在±3%内,平均偏差为0.56%,超过±2%的为2次。结论192Ir源外观活度的质量控制检测对剂量准确度至关重要,需要严格按照国家标准执行。     

瘢痕疙瘩术后铱-192敷帖治疗的临床疗效观察

73例瘢痕患者均先行手术切除后再给予铱-192敷贴治疗,敷贴治疗于24小时内开始进行,每周2次,共3次,参考点总剂量15GY,结果治愈60例,占82.2%,9例局部复发,4例完全复发.所有病例无并发症.     

瘢痕疙瘩术后铱-192敷帖治疗的临床疗效观察

73例瘢痕患者均先行手术切除后再给予铱-192敷贴治疗．敷贴治疗于24小时内开始进行，每周2次，共3次，参考点总剂量15GY，结果治愈60例，占82．2%，9例局部复发，4例完全复发。所有病例无并发症。     

赣榆县医院放疗科放射防护效果观察

放射治疗已广泛应用于临床,为方便病人的治疗,赣榆县人民医院于1997年度先后引进了钴-60(~(60)Co)治疗机、铱-193(~(193)Ir)后装治疗机,现就其安装调试使用中的防护措施及防护效果作以下分析。 1 基本情况及防护措施 1.1 医用放射性同位素种类、活度 回转式钴-60治疗机一台、活度为700 0居里(2.59 E 14贝可),铱-192后装治疗机一台、活度为10居里(3.7 E 11贝可),模拟定位机一台、容量为     

小型γ射线探伤机防护监测与评价

淄博市近期有一单位购进 1台ＤＬ -ＹＨ -ⅢＡ型γ射线探伤机 ,为了解该机的防护性能特点 ,减少和杜绝放射事故发生 ,我们对其进行了监测与评价 ,现报告如下。1　γ射线探伤机基本情况与技术参数该机由上海茸欣探伤设备附件厂生产。内装放射源铱 -192或硒 - 75均可。整机重量 2 0ｋｇ ,机长 2 6ｃｍ ,直径最大处11 7ｃｍ ;透照范围钢铁为 1～ 10ｃｍ ;容器屏蔽材料为贫化铀 ;额定最大装载量铱 - 192为 3 7× 10 12 Ｂｑ。具有透照焦点小 ,清晰度好 ,灵敏度高 ,工作效率高等特点。2　使用及防护情况①　使用探伤机时 ,首先连接输源导管与探…     

两起γ射线探伤事故的调查报告

1 事故经过 1993年2月23日,某金属结构厂探伤工用γ射线探伤机[射源为铱-192,放射性活度约25.5Ci(9.435×10~(11)Bq)]在探伤间内探伤拍片,探伤机摇柄安放在操作室通往主体探伤间的迷宫内。当操作手按设定的曝光时间结束,将γ源收进探伤机后进入探伤间取片时,其随身携带的个人辐射音响仪(中国辐射防护研究院三辐电子仪器厂生产的FY-Ⅱ型)     

~(192)Ir后装腔内放射治疗卫生防护调查

后装腔内放射治疗机 (以下简称后装机 ) ,是一种近距离肿瘤治疗设备 ,多用于食道、鼻咽、直肠、妇科等肿瘤的治疗 ,所用放射源为192 Ｉｒ。近年随着近距离放射治疗的重新崛起 ,其放射卫生防护和放射治疗质量保证受到放射防护界和放射治疗界的高度重视。为促使该项工作的顺利发展 ,保障人们身体健康 ,我们对192 Ｉｒ后装机的放射防护进行了卫生学调查。1　材料与方法1.1　监测仪器　上海电子仪器厂生产的ＦＤ— 71Ａ型γ闪烁辐射仪和西安 2 6 2厂生产的ＦＪ— 347Ａ型γ、χ巡测仪。上述 2台仪器经国家计量单位校正。1.2　监测方法　按照《放…     

经皮肾镜气压弹道联合超声碎石治疗上尿路感染性结石

目的探讨经皮肾镜治疗输尿管上段结石及肾结石并感染的疗效。方法对肾、输尿上段结石并感染较轻者,经控制感染后I期行经皮肾镜气压弹道联合超声碎石术37例;合并较严重感染者先期行经皮肾造瘘、Ⅱ期经皮肾镜气压弹道联合超声碎石术17例。结果 I期行经皮肾镜气压弹道联合超声碎石术37例中,4例术后出现高热(>39℃),7例术后体温在38℃～39℃,其余26例术后体温<38℃。Ⅱ期经皮肾镜气压弹道联合超声碎石术17例,所有病例Ⅱ期经瘘道碎石取石术后体温均<38℃。结论对于输尿管上段及肾结石并感染患者,经抗炎治疗后复查,血象、体温正常,无腰痛,估计手术时间较短者,选择I期经皮肾镜碎石取石术;否则,选择Ⅱ期经皮肾镜术。     

MRI在临床触诊阳性的乳腺X线非对称性致密影病变诊断中的价值

目的:探讨MRI在临床触诊阳性的乳腺X线非对称性致密影病变中良、恶性疾病的诊断价值。方法;收集2009年3月～2012年3月临床触诊阳性的乳腺X线非对称性致密影病变80例,病变不伴肿块、钙化及结构扭曲,于术后分别与病理对照,观察病灶形态、分布、动态增强、时间-曲线及周围影像改变等显示情况,并统计诊断准确率。所有患者在手术前2周内均进行乳腺X线及MRI检查。结果:肿块型强化22例,非肿块型强化58例;病灶强化均匀14例,强化不均匀66例;其内伴多发脓肿,壁呈均匀或非均匀环形强化34例;患侧乳内异常血管增粗并较对侧丰富28例,皮肤局部或广泛性增厚32例,皮下水肿27例,腋下淋巴结实性增大15例;时间-曲线Ⅰ型36例,Ⅱ型22例,Ⅲ型22例。乳腺良性病变48例,其中乳腺增生症8例,硬化性腺病2例;乳腺炎症37例(慢性炎症23例,肉芽肿性乳腺炎8例,浆细胞性乳腺炎2例,囊肿伴感染4例),纤维腺瘤1例;乳腺癌32例,其中乳腺导管癌23例,乳腺小叶癌5例,乳腺血管肉瘤2例,乳腺导管癌合并乳腺小叶癌2例。结论:对临床触诊阳性的乳腺X线非对称性致密影病变中,乳腺MRI在发现病变及良、恶性疾病定性诊断具有重要价值,特别是乳腺癌的早期诊断。     

Sensory processing and stereotypical and repetitive behaviour in children with autism and intellectual disability

Background: Sensory processing disorders have been linked to stereotypical behaviours in children with intellectual disability (ID) and autism spectrum disorders (ASD) and to anxiety in children with ASD. In earlier phases of this study with the same participants, we found that those with both ASD and ID were more motivated than those with ID alone to engage in stereotypical behaviour to alleviate anxiety. In this phase, we confirmed that children with both ASD and ID and those with ID alone process sensation differently than typically developing children. We asked: Do the sensory processing difficulties of children with ASD and ID differ significantly from those of children with ID alone in a way that would help explain the increased anxiety of the former group? Method: Parents of children with ASD and ID (n = 29; mean age 9.7 years) and with ID alone (n = 23; mean age 9.5 years) completed a Sensory Profile (SP) to provide information about their children's sensory processing abilities. SP quadrant scores for each group were compared with each other and with the published norms of typically developing children. Results: Children with ASD and ID and with ID alone processed sensory information differently than typically developing children (P = 0.0001;d = > 2.00). Children with both ASD and ID were significantly more sensitive (P = 0.007;d = 0.70) and avoidant (P < 0.05;d = 0.47) than the children with ID alone. Conclusion: We conclude that increased sensitivity and the tendency to avoid sensation may help explain anxiety in children with autism.     

腔内技术治疗输尿管狭窄、闭锁443例临床分析

目的探讨腔内泌尿外科技术治疗输尿管狭窄、闭锁的疗效和安全性。方法对443例采用腔内泌尿外科技术治疗的输尿管狭窄、闭锁患者资料进行回顾性分析。结果对443例患者全部采用不同的腔内输尿管腔内技术治疗,其中:输尿管镜下直视扩张218例,导管扩张63例,输尿管球囊扩张15例,采用钬激光或线状电针电凝输尿管炎症性息肉引起的狭窄33例,钬激光内切开25例,线状电刀内切开47例,输尿管镜下直视冷刀切开术35例,输尿管闭锁复通7例。所有病例均一次手术成功,成功率100%。术后有3例输尿管狭窄患者肾积水复发。结论利用腔内技术处理输尿管狭窄疗效好,创伤小,安全性高,费用低。钬激光及线状电切电凝对炎症和息肉引起的狭窄,疗效较好。输尿管镜直视下扩张术结合术,对较轻的输尿管狭窄疗效好;输尿管套管扩张输尿管下段狭窄,效果好。输尿管冷刀切开术对较长段的严重狭窄或闭锁疗效更好。以上腔内技术处理狭窄,术后结合放置双J管引流、慢性扩张效果更好。     

阿昔洛韦联合奥卡西平治疗单纯性疱疹病毒性脑炎伴癫痫患儿的临床效果及对其炎性因子水平的影响

目的探讨阿昔洛韦联合奥卡西平治疗单纯性疱疹病毒性脑炎(HSE)伴癫痫患儿的临床效果及对其炎性因子水平的影响。方法64例HSE伴癫痫患儿随机分为两组各32例,对照组给予阿昔洛韦联合丙戊酸钠治疗,研究组给予阿昔洛韦联合奥卡西平治疗,比较两组的治疗效果及治疗前后的炎性因子水平。结果研究组的治疗总有效率为93.75%,显著高于对照组的71.88%(P<0.05)。治疗后,两组的IL-1β、IL-6、TNF-α水平均较治疗前降低,且研究组的IL-1β、IL-6、TNF-α水平显著低于对照组(P<0.05)。结论阿昔洛韦联合奥卡西平治疗HSE伴癫痫患儿临床效果显著,可有效改善炎性因子水平。     

Life satisfaction in early rheumatoid arthritis: A prospective study

The aim of this study was to describe life satisfaction prospectively in patients with early rheumatoid arthritis (RA) and to investigate its correlation with disease activity. The early RA group was compared with RA patients with longstanding disease and with a reference group. Gender differences were also compared. Patients with early RA, treated by a multidisciplinary team, reported their life satisfaction by completing a questionnaire. Disease activity score, patient global assessment, and pain were scored at onset of disease and after two years. The patients with early RA were less satisfied with life as a whole at disease onset compared with the reference group, as was a cohort of patients with longstanding disease. Patients with early RA also reported low levels of satisfaction with self-care activities, work, and sexual life. The women reported themselves more satisfied than men. After two years, a slight increase in the reported levels of satisfaction could be seen for life as a whole and for five of the eight domains. No correlation was found between disease activity variables and satisfaction with life as a whole. There were, however, positive correlations between disease activity and satisfaction both with partnership and with family life after two years, i.e. the higher disease activity the higher satisfaction with partnership relation and family life. In contrast, patients with greater disease activity were less satisfied with self-care activities. The results of this study indicate that greater effort is needed to assist patients with early RA to cope with problems concerning self-care activities, sexual life, and work.     

三维超声在胎儿半椎体诊断中的应用价值

目的:探讨三维超声(3DUS)在胎儿半椎体诊断中的应用及临床价值。方法:回顾性分析诊断的12例胎儿半椎体病例的产前二维超声(2DUS)及3DUS声像图表现,并与引产后影像学检查及病理结果进行对照。结果:3DUS胎儿半椎体的声像图比2DUS更准确直观;12例中单发4例(33.3%),合并其他系统畸形8例(66.7%),分别是泌尿系统畸形4例,心脏畸形2例,单脐动脉2例,肠道闭锁、肺囊腺瘤样病变、唇腭裂、双足内翻各1例。结论:3DUS对胎儿半椎体及其相关畸形的诊断是较准确的,具有显著的临床价值。     

15 750例新生儿眼底筛查结果分析及随访管理

目的 探讨广角数码视网膜成像系统(RetCam3)在新生儿眼底筛查中的临床价值,并对患儿预后情况进行随访。方法 回顾性分析行RetCam3 眼底筛查的15 750例新生儿的临床病例资料。结果 接受筛查,检出眼底病变5 196例(32.99%),其中视网膜出血(retinal hemorrhage,RH)4 312例(27.38%)、视网膜白点症312例、视网膜色素沉着186例、足月新生儿类早产儿视网膜病变样改变132例、视网膜血管异常64例、早产儿视网膜病变(retinopathy of prematurity,ROP)56例、脉络膜缺损40例、视网膜黄染27例、视神经发育异常17例、玻璃体出血14例、永存原始玻璃体增生症(persistent hyperplastic primary vitreous,PHPV)12 例、视网膜膜前出血10例、黄斑缺损6例、白化病眼底改变4例、牵牛花综合征合并PHPV1例、视网膜母细胞瘤(retinoblastoma,RB)1例、色素失禁症(incontinentia pigmenti,IP)1例、杯/盘比大1例。结论 广角数码视网膜成像系统可及时发现新生儿眼底病,为临床实时、有效的指导和干预提供依据。     

宫腔镜联合腹腔镜诊治先天性子宫畸形的临床应用探讨

目的 探讨官腔镜联合腹腔镜诊治先天性子宫畸形的临床应用价值.方法 回顾性分析53例经宫腔镜联合腹腔镜诊治的先天性子宫畸形患者的临床资料.结果 共诊断子宫中隔39例,包括不全子宫中隔25例,完全子宫中隔14例;残角子宫4例;单角子宫3例;双角子宫2例;双子宫3例;鞍状子宫2例.官腔镜联合腹腔镜手术可同时诊断子宫及腹腔内病变,并且能矫正子宫畸形.超声、子宫输卵管造影、官腔镜检查均有一定的误诊率,而宫腔镜联合腹腔镜的诊断准确率为100.0%.结论 宫腔镜联合腹腔镜是安全、有效的,可作为先天性子宫畸形患者首选的诊治方法.     

宫腔镜联合腹腔镜诊治先天性子宫畸形的临床应用探讨

目的探讨宫腔镜联合腹腔镜诊治先天性子宫畸形的临床应用价值。方法回顾性分析53例经宫腔镜联合腹腔镜诊治的先天性子宫畸形患者的临床资料。结果共诊断子宫中隔39例，包括不全子宫中隔25例，完全子宫中隔14例；残角子宫4例；单角子宫3例；双角子宫2例；双子宫3例；鞍状子宫2例。宫腔镜联合腹腔镜手术可同时诊断子宫及腹腔内病变，并且能矫正子宫畸形。超声、子宫输卵管造影、宫腔镜检查均有一定的误诊率，而宫腔镜联合腹腔镜的诊断准确率为100．0％。结论宫腔镜联合腹腔镜是安全、有效的，可作为先天性子宫畸形患者首选的诊治方法。