肝动脉化疗栓塞治疗肝癌患者的X射线辐射评价

目的　研究经肝动脉化疗栓塞 (THACE)治疗肝癌过程中 ,患者受到的X射线辐射 ,为THACE放射防护提供依据。方法　回顾性分析 82例HCC患者的辐射剂量资料 ,DSA机 (Angiostar Plus)配置穿透电离室型剂量监测系统 (DiamentorK1andDiamentorED) ,在线读取面积剂量乘积DAP(cGy cm2 )和入射表面剂量ESD(mGy) ,采用Monte Carlo转换因子估算有效剂量ED(mSv)。并分析近期 10例THACE患者 ,在提高基值管电压、减低透视脉冲频率和摄影帧数下对辐射剂量的影响。结果　 82例HCC患者透视时间 (35 3± 2 1 1)min ,摄影 (2 34± 10 8)帧 ,DAP为 (2 174 8± 12 4 2 4 )cGy cm2 ,ESD为 (96 4± 6 32 )mGy ,ED为 (34 8± 19 9)mSv。透视对总DAP的贡献 (2 4 0± 12 7) %小于摄影 (75 9± 12 7) % ,透视对ESD值的贡献 (4 9 8± 14 9) % ,与摄影相似 (5 1 6± 14 2 ) %。近期的 10例THACE患者的每分钟透视剂量、每帧摄影剂量及总剂量都比HCC患者明显降低。结论　在THACE过程中患者受到一次性较大剂量X射线照射。适度提高基值管电压、减低透视脉冲频率和缩减摄影帧数 ,可以有效降低患者的辐射剂量     

脑卒中患者吞咽障碍及康复效果影像学研究

目的探讨电视X线透视吞咽功能检查（videofluoroscopic swallowing study,VFSS）在脑卒中患者吞咽功能评估中的应用价值,观察脑卒中后吞咽障碍发生情况,康复前后患者吞咽功能变化.方法脑卒中患者70例及健康成人80名分别作为研究组与对照组均进行VFSS,比较两组误吸等VFSS异常征象的发生情况.对发现误吸患者进行吞咽功能康复训练4周,训练后复查VFSS,比较训练前后吞咽异常的发生情况变化.结果对照组渗透或误吸、口腔滞留、咽腔滞留的发生率为5.0%,13.4%,25.3%.主要为轻度渗透及口咽腔滞留.研究组渗透或误吸、口腔滞留、咽腔滞留发生率为45.0%,46.5%,48.9%,主要为重度渗透或误吸,中重度口咽腔滞留.其中隐匿性误吸为10次（占总误吸的24.4%）.误吸患者康复治疗后渗透或误吸发生率较康复治疗前减少（P＜0.05）.结论脑卒中后吞咽障碍在康复期仍较为常见,可表现为多种影像学异常.VFSS可确切诊断吞咽异常,进行针对性康复训练,使患者吞咽功能提高.     

Anterior eye focusing of peripheral ultraviolet and visible radiation albedo

Concern about short- and long-term ultraviolet radiation (particularly UVB) damage to the eye has led to increased research in this area. Numerous studies have confirmed the pathogenic enhancing roles of reflected ultraviolet (UV) and visible radiation in our environment. There is concern that conventional sunglasses do not protect the eye adequately from reflected rays (albedo), especially on the lateral aspect, from behind and from below. Using eye models and computer ray tracing methods, the pathways of oblique rays incident at the temporal peripheral cornea have been plotted by Maloof, Ho and Coroneo.¹ These rays are refracted and focused and theoretically can result in up to 20 times the concentration of incident irradiance at the nasal anterior chamber angle and nasal equatorial cortex of the crystalline lens. The purpose of this study was to determine the limits of angular subtense of the incident peripheral light which is refracted in this manner in human subjects and to investigate the relation between corneal shape and certain ocular parameters to the limits. A statistically significant positive correlation was found between temporal entrance angle and anterior chamber depth (r = 0.70, P< 0.0006). The entrance angle ranged from 15 degrees to 30 degrees and was located 10 degrees to 45 degrees posterior to the coronal plane. Our results support Maloof and colleagues' predictions for the implication of focused peripheral UV and high intensity visible radiation in the pathogenesis of pterygium and cortical cataract and emphasise the need for lateral eye protection in conditions of high ultraviolet albedo.     

Primary gastrointestinal lymphomas in Turkey: a retrospective analysis of clinical features and results of treatment.

Thirty-three patients with primary gastrointestinal lymphoma (GIL) followed at Ankara University Medical School have been evaluated. The most frequent locations of the disease are the small intestine (48.4%) and the stomach (39.3%). The intermediate and high grade lymphomas constitute 84.8% of the cases. The mean age of the patients with small intestinal lymphoma is 28.7 years and 47.1 years for those with gastric lymphoma. The patients treated with surgery and chemotherapy (S+CT) have a longer survival than those treated with chemotherapy (CT) alone. In conclusion: 1) Small intestinal lymphoma occurs more frequently than gastric lymphoma in our study. 2) The median age of the Turkish patients with primary GIL is approximately 10 years less than those in the Western countries. 3) The therapeutic results of S+CT are superior to those of CT in the early stages of the disease.     

The dynamic distribution of nitric oxide synthase in the small intestine of mice with intestinal radiation sickness

ＴｈｅｄｙｎａｍｉｃｄｉｓｔｒｉｂｕｔｉｏｎｏｆｎｉｔｒｉｃｏｘｉｄｅｓｙｎｔｈａｓｅｉｎｔｈｅｓｍａｌｌｉｎｔｅｓｔｉｎｅｏｆｍｉｃｅｗｉｔｈｉｎｔｅｓｔｉｎａｌｒａｄｉａｔｉｏｎｓｉｃｋｎｅｓｓＷｅｉＬｉｃｈｕｎ（魏丽春）；ＧｕｏＹａｏ（郭鹞）（...     

Localized proton spectroscopy of inoperable brain gliomas. Response to radiation therapy

Within vivo 1H-MRS resonances of several metabolites were simultaneously measured in cerebral gliomas and adjacent normal brain. 15 patients with inoperable brain gliomas all histologically verified were monitored with 1H-MRS and MRI before and after radiotherapy. 11 patients were evaluable. 1H-MRS technique evolved from single volume measurements to one dimensional and two dimensional 1H spectroscopic imaging. In all patients N-acetyl-aspartate signals were decreased in tumour areas compared to the normal brain hemisphere. No recovery was seen after radiotherapy. Choline signals were increased in tumour margins of high grade gliomas and more diffusely in low grade gliomas. In 5 patients the choline resonance decreased after radiotherapy, accompanied by a shrinkage of tumour diameter on MRI. Lactate signals were present in high grade and unspecified astrocytomas and absent in most low grade gliomas. In 3 patients the lactate signal disappeared after radiotherapy. These observations indicate the feasibility of 1H-MRS in monitoring metabolic responses on radiotherapy of brain gliomas.     

硒对辐射所致过氧化脂质含量及谷胱甘肽过氧化物酶活性的影响

以肝、脾组织中过氧化脂质(LPO)含量及谷胱甘肽过氧化物酶(GSHL-Px)活性为指标探讨硒的辐射防护效应。实验结果表明:BALB/C纯系雄性小鼠经3Gy ~(60)Co γ射线照射后3天,肝、脾组织LPO生成量比未照射者均显著增多,而GSH-Px活性却都显著降低;但于照射前连续7天每日经口灌胃亚硒酸钠溶液0.2ml(含硒12.5μg)的实验组动物,肝、脾组织LPO含量均明显少于照射对照组,而GSH-Px活性都显著高于照射对照组,结果提示,通过降低LPO含量和增加GSH-Px活性,硒对小鼠可能有辐射防护作用。     

全身(全淋巴)照射后100例医源性急性放射病的临床分析

在造血干细胞移植治疗肿瘤过程中用全身照射（ＴＢＩ）或全淋巴照射（ＴＬＩ）预处理，研究受照不同剂量患者发生医源性急性放射病严重程度，治疗方法和造血恢复及相关合并症。方法１００例患者（白血病９１例，其他肿瘤９例）接受５００～１０００ｃＧｙＴＢＩ或ＴＬＩ和超大剂量化疗作预处理。结果均发生医源性急性放射病，白细胞降至（０～０．１５）×１０９／Ｌ，骨髓空虚，合并各种感染和出血。经造血干细胞移植，抗感染，应用ＧＭ－ＣＳＦ或Ｇ－ＣＳＦ积极支持治疗及保护隔离措施，９２例造血恢复，８例死于不同感染和出血。结论造血干细胞的移植起主要治疗作用，不同造血因子用于治疗急性放射病，可能是一种有希望的方法     

The effects of alcohol and benzodiazepines on the severity of ski accidents.

Urine samples from 402 victims of ski accidents were analyzed for the presence of benzodiazepines (BZD) and alcohol. Eighty-one (20%) samples were positive for alcohol; BZD were detected in 34 (8.5%) cases. Ten of the samples (2.5%) were found to be positive for both alcohol and BZD. Subjects who were positive for either alcohol or BZD or both were older than the other persons examined. The prevalence of alcohol was significantly higher among male accident victims. BZD intake could be demonstrated to have a significant influence on the severity of injuries. Besides an increased awareness of the need for skier education regarding drug use, heightened attention of medical caregivers is warranted to inform their patients about potential accident hazards in sport activities when BZD are prescribed.