一例~(192)Ir极不均匀外照射局部极重度放射损伤的临床观察

目的对１例１９２Ｉｒ极不均匀外照射局部极重度放射损伤病人进行临床观察。方法系统观察了病变的临床过程和应用红外线热成像技术测定了损伤部位的温度变化。结果照射后２小时出现肢体麻木、抽搐，最早照后４小时出现红斑、肿胀，５４小时出现水疱，第５天出现坏死和剧痛，最晚出现红斑、肿胀是照射后４１天，４７天出现水疱和糜烂创面。红外线热成像显示：损伤早期温度升高，水疱、坏死区和损伤后期温度降低，温度升高越早，损伤越重，温度改变区域与损伤范围相一致。结论大剂量极不均匀外照射放射损伤的初期反应早，放射病与局部损伤相互加重病情，症状先后不一，轻重不等，致残率高和疼痛剧烈，红外线热成像温度变化可以作为临床诊断的指标之一。     

复方卡托普利片中氢氯噻嗪的含量及均匀度测定

用紫外分光度法直接溯定复方卡托普利片中氢氯噻嗪的含量及均匀度。测定波长为272±1nm,平均回收率100.2%,变异系数0.3%,吸收度与氢氯噻嗪的浓度在1～10μg/ml 范围内具有线性关系。     

辐射对豚鼠鼻黏膜组织结构及微血管的影响

目的：探讨辐射对豚鼠鼻黏膜结构及微血管的损伤。方法：选择健康豚鼠84只，随机分为对照组（12只）及照射组（72只）。均在同样条件下喂养。将照射组豚鼠置于直线加速器射线内照射，每周1次，每次照射5Gy，计3周，总剂量15Gy，建立辐射损伤动物模型。分别于照射后0．5、1.0、2．0、3．0、5．0、6．0个月处死动物12只，随机取6只做鼻腔黏膜微血管铸型，另6只做病理检查。对照组在假照射后6个月处死动物，随机各选6只分别做鼻黏膜微血管铸型检查和病理检查。结果：照射组豚鼠的鼻黏膜辐射后早期表现为急性炎症反应，黏膜大量坏死、脱落，电镜下见仅少部分黏膜表面还被覆着正常的纤毛结构。以后黏膜开始修复，至6个月时基本结束，但大部分黏膜失去了正常的纤毛柱状上皮结构特点，部分区域甚至代为组织转化的鳞状上皮；微血管铸型可见，早期改变为毛细血管扩张充血及血管内皮细胞肿胀，以后逐渐出现毛细血管的扭曲变形、闭塞及中断，毛细血管数量大量减少，致血液回流障碍，微静脉萎瘪。后期部分区域出现新生的毛细血管，但结构紊乱，不具备微循环的功能。结论：鼻黏膜的损伤、晚期的鳞状上皮组织转化以及鼻黏膜微循环的破坏是放疗后鼻腔功能障碍的病理学基础。     

Dosage guidelines for the use of vancomycin based on its pharmacokinetics in infants

Summary The purpose of this study was to characterize the pharmacokinetics of vancomycin and to develop optimal dosage guidelines in infants. Thirteen infants between the ages of 13 to 183 days were enrolled. All had been born prematurely, and average gestational age, postconceptional age, and actual body weight were 29.8 weeks, 38.2 weeks, and 2.1 kg respectively. Multiple blood samples were obtained from each patient after 72 h of therapy. Serum inhibitory and bactericidal titres were determined for peak and trough samples.There were good correlations between total body clearance of vancomycin and both postconceptional age (r=0.86) and actual body weight (r=0.87). This information was used to develop vancomycin dosage guidelines in premature infants. The regression line for vancomycin daily dosage requirements vs postconceptional age may be useful for determining initial dosage recommendations.There were also good correlations between vancomycin serum concentrations and serum inhibitory and cidal titres. Peak and trough concentrations in the therapeutic range (peak, 25–35 µg/ml; trough, 5–10 µg/ml) corresponded to titres of 1:8 and 1:2 to 1:8 respectively.Based on these data we suggest the following dosage guidelines for vancomycin: 10 mg/kg 12 hourly for 30–34 weeks postconceptional age and <1.2 kg actual body weight; 10 mg/kg 8 hourly for 30–42 weeks postconceptional age and >1.2 kg actual body weight; 10 mg/kg 6 hourly for >42 weeks postconceptional age and >2.0 kg actual body weight.Thus, doses which are lower than currently recommended are needed for infants born prematurely. Furthermore, the initial dose of vancomycin can easily be determined using an infant's postconceptional age.SML was a Fellow at Children's Hospital at the time of study and is now at Rutgers University, College of Pharmacy, Piscataway, NJ, USA     

Dosage compensation, the origin and the afterlife of sex chromosomes

Over the past 100 years Drosophila has been developed into an outstanding model system for the study of evolutionary processes. A fascinating aspect of evolution is the differentiation of sex chromosomes. Organisms with highly differentiated sex chromosomes, such as the mammalian X and Y, must compensate for the imbalance in gene dosage that this creates. The need to adjust the expression of sex-linked genes is a potent force driving the rise of regulatory mechanisms that act on an entire chromosome. This review will contrast the process of dosage compensation in Drosophila with the divergent strategies adopted by other model organisms. While the machinery of sex chromosome compensation is different in each instance, all share the ability to direct chromatin modifications to an entire chromosome. This review will also explore the idea that chromosome-targeting systems are sometimes adapted for other purposes. This appears the likely source of a chromosome-wide targeting system displayed by the Drosophila fourth chromosome.     

A homozygous MITF mutation leads to familial Waardenburg syndrome type 4

Waardenburg syndrome (WS) is a genetic disorder characterized by hearing loss and pigmentary abnormalities with variable penetrance. Though heterozygous mutations in MITF are a major cause for Waardenburg syndrome type 2 (WS2), homozygous mutations in this gene and the associated phenotype have been rarely characterized. In this study, we identified a novel p.R223H mutation in MITF in a Chinese Han family with variable WS features. Both parents carried a heterozygous p.R223H mutation. They had normal hearing, and premature greying of the hair is their only pigmentary abnormality. In contrast, their two children both carried a homozygous p.R223H mutation and had classic WS features including profound hearing loss, heterochromia irides and marked pigmentary abnormalities in hair and skin. Interestingly, the two affected children also have persistent chronic constipation since the neonatal period, symptoms suggestive of Waardenburg syndrome type 4 (WS4). Our study revealed a likely association between homozygous mutations in MITF and WS4, which implies a dosage effect for the underlying pathogenesis mechanism.     

Charcot-Marie-Tooth phenotype produced by a duplicated PMP22 gene as part of a 17P trisomy-translocation to the X chromosome

The Charcot-Mane-Tooth disease type 1A (CMTlA) phenotype is most often associated with a 1.5 megabase (mb), tandem duplication of chromosome 17 band p12 (17˜12). The prevailing hypothesis is that the demyelinating neuropathy results from a dosage effect of the peripheral myelin protein gene PMP22 which is included within this duplication. We present a patient with clinical and electrophysiological features ofCMTlA in whom an extra PMP22 gene resulted from a rare unbalanced translocation of 17p to the X chromosome. This finding further supports the hypothesis of gene dosage as the basis for CMTlA. More-over, this case highlights the importance of fluorescence in siiu hybridization (FISH) as an alternative molecular technique in the diagnosis of CMTlA.     

诊断X线机辐射剂量的测量

为提高诊断X线机的诊断质量,促进放射防护工作的开展,根据"国际辐射单位和测量委员会"(International Commission on Radiological Units and Measurements,ICRU),"国际放射防护委员会"(International Commission on Radiation Protection,ICRP)关于辐射对人体的损害之划分标准,作者对岛津制作所90年代中期生产的XEB150L-20型500mA X线机按照国家规定的要求及有关标准,分别对辐射空气释动能率,半价层,输入量重复性,输出量线性,高对比分辨率,光野与照射野一致性及X线管的焦点等参数进行了测试。分析了测试的数据与结果,并进行了简要的评价。     

低剂量电离辐射诱导小鼠睾丸生精细胞凋亡及P53基因和蛋白表达

目的:研究低剂量电离辐射对小鼠睾丸生精细胞凋亡及 P53 基因和蛋白表达的影响。方法:应用密度梯度离心法分离不同种类生精细胞, 流式细胞术检测其细胞凋亡, 免疫组化法观察生精细胞P53蛋白表达, 原位杂交法观察其 P53 mRNA水平。结果:0.025-0.2 Gy X射线全身照射后, 生精细胞凋亡具有明显的细胞种类规律性。在较低剂量照射(0.025和0.05 Gy)时, 以精原细胞凋亡为主, 随照射剂量增加(0.075-0.2 Gy)逐渐累及精母细胞, 并且前者凋亡率明显高于后者, 很少累及精子细胞和精子。P53蛋白表达主要见于精原细胞和精母细胞, 并且前者阳性率高于后者, 随照射剂量增加, 其阳性率逐渐升高, 而精子细胞和精子阳性率较低; P53 mRNA表达在较低剂量照射(0.025 Gy)时, 主要以精母细胞和精子细胞为主, 随剂量增加(0.05-0.2 Gy)逐渐累及精原细胞。精原细胞和精母细胞 P53 mRNA表达呈明显的剂量依赖性关系, 但精子细胞表现不明显。结论:低剂量电离辐射可选择性诱导小鼠睾丸生精细胞凋亡, 具有明显的剂量和时程效应关系。提示, 这种选择性诱导凋亡调控机制可能与 P53 基因和蛋白表达相关联。     

Object-based three-dimensional X-ray imaging

A form of three-dimensional X-ray imaging, called Object 3-D, is introduced, where the relevant subject material is represented as discrete ‘objects’. The surface of each such object is derived accurately from the projections of its outline, and of its other discontinuities, in about ten conventional X-ray views, distributed in solid angle. This technique is suitable for many applications, and permits dramatic savings in radiation exposure and in data acquisition and manipulation. It is well matched to user-friendly interactive displays.