多层螺旋CT盆腔扫描重建图像质量与X射线剂量的关系

目的分析扫描参数的设置与图像质量和吸收剂量之间的关系,选择适合于二维和三维重建较高图像质量和较低吸收剂量的扫描方式。方法使用GE L ightspeed U ltra 16层螺旋CT机,对人体盆腔模型进行扫描。扫描条件:120 kV,管电流分别为250 mA或200 mA,螺距分别为1.375或0.985,层厚分别为5 mm或7.5 mm。评价二维和三维图像质量,在辐射剂量观测栏,观测剂量长度乘积(DLP)的变化。选择其中图像质量较好和DLP相对较低的4种扫描方式对患者进行扫描。结果DLP随管电流的增加、螺距的减小而增大,而二维和三维图像质量也随mA的增加、螺距的减小而提高。二维图像选择250 mA、1.375螺距、7.5 mm层厚,图像噪声低,影像细节能清晰显示,且DLP相对较低;三维图像选择200 mA、0.938螺距、7.5 mm层厚,能够满足诊断需要。结论遵循医疗照射的正当性和防护最优化原则,科学地设置管电流、层厚、螺距等扫描参数,一方面能够保证二维和三维图像质量,另一方面又能减少DLP值,减少X射线辐射对盆腔生殖器官的损伤。     

三维适形放疗同步化疗治疗Ⅲ期和Ⅳ期非小细胞肺癌

目的观察三维适形放疗同步化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的疗效及耐受性。方法将39例Ⅲ、Ⅳ期非小细胞肺癌患者按治疗方法分为两组,三维适形同步放化疗组(同步组)23例,序贯放化疔组(序贯组) 16例。所有患者均行以铂类药物为主的化疗,放疗用6 MV X线,计划剂量为62～68 Gy,常规分割为2 Gy·次~(-1)·d~(-1),5次/周。分别比较两组的近期疗效、生存率、卡氏评分(KPS)变化及骨髓毒性。结果同步组和序贯组病例的完全缓解率、有效率、KPS改善率分别为17．4%(4/23例)比12．5%(2/16例)、73．9%(17/23例)比62．5%(10/16例)、78．3%(18/23例)比75．0%(12/16例),两组比较差异无显著性；两组白细胞减少率分别为91．3%(21/23例)比87．5%(14/16例)；两组放射性食管炎发生率分别为52．2%(12/23例)比50．0%(8/16例),放射性肺炎发生率分别为13．0%(3/23例)比12．5%(2/16例),均为1、2级。结论三维适形放疗同步化疗治疗晚期非小细胞肺癌有优于序贯放化疗的趋势,为绝大部分患者所接受,同步化疗毒性增大不明显。     

中药饮片小包装的剂量和质量管理

中药饮片小包装作为一项新型的配方模式的改革,其优势非常明显。但在实际使用中主要存在剂量和质量上的问题。药房应从剂量和质量管理入手,一方面监督生产企业做好小包装的剂量和质量工作,另一方面加强医院药房对小包装的剂量和质量管理,提高配方质量,更好地发挥中药饮片小包装的优势。     

No Improvement of Adult Height in Non-growth Hormone (GH) Deficient Short Children with GH Treatment

It is still in doubt whether the standard-dose growth hormone (GH) used in Japan (0.5 IU/kg/week, 0.167 mg/kg/week) for growth hormone deficiency is effective for achieving significant adult height improvement in non-growth hormone deficient (non-GHD) short children. We compared the growth of GH-treated non-GHD short children with that of untreated short children to examine the effect of standard-dose GH treatment on non-GHD short children. GH treatment with recombinant human growth hormone (rhGH) was started before the age of 11 yr in 64 boys and 76 girls with non-GHD short stature registered at the Foundation for Growth Science who have now reached their adult height. In 119 untreated boys and 127 untreated girls whose height standard deviation score (SDS) was below –2 SD at the age of 6 yr, height growth was followed until 17 yr. Height SDS was significantly lower before GH treatment in the GH-treated group than at the age of 6 yr in the untreated group, in both sexes. Adult height and adult height SDS were significantly greater in the untreated group than in the GH-treated group, in both sexes, although the change in height SDS did not differ significantly. Height SDS was significantly lower before GH treatment in the GH-treated group than at the age of 6 yr in the untreated group, so 57 boys and 57 girls whose height SDS at the age of 6 yr in the untreated group closely matched the height SDS before GH treatment in the GH-treated group were chosen for comparison. Height SDS did not differ significantly between the GH-treated group before GH treatment and the untreated group at the age of 6 yr, nor were there differences between these subgroups in adult height, adult height SDS, or height SDS change, in either sex. The effect of GH treatment is reported to be dose-dependent and doses over 0.23 mg/kg/week are reported to be necessary to improve adult height in non-GHD short children. Currently, the GH dose is fixed at 0.175 mg/kg/week in Japan, and we expected to find, and indeed concluded, that ordinary GH treatment in Japanese, non-GHD short children does not improve adult height.     

美托洛尔治疗非瓣膜病慢性心力衰竭的耐受性观察

目的探讨β-受体阻滞剂(美托洛尔)在治疗慢性心力衰竭的剂量耐受性及临床疗效。方法对62例心衰患者在常规抗心衰治疗的基础上加用美托洛尔,并逐渐增加剂量至目标剂量,分别于服药前及达目标剂量后由专人监测心率、血压及左室射血分数(LVEF)等变化。结果美托洛尔的平均维持量为(132.27±44.20)mg/d,本组62例患者中达最大目标剂量者14例,18例因血压下降不能加量,21例因心率降低不能加量,9例因心功能下降而未达目标剂量。加用美托洛尔不同剂量后心功能都有不同程度改善,尤其以大剂量组改善显著(P<0.01)。结论不同患者对美托洛尔耐受性不同,加用美托洛尔治疗充血性心衰后所有患者心功能都有不同程度改善,尤以大剂量组改善显著(P<0.01)。     

硝苯地平缓释片单用及与双氢克尿噻小剂量联用治疗高血压疗效分析

目的：比较硝苯地平缓释片（NF）单用及与双氢克尿噻（DHCT）小剂量联用的降压疗效。方法：将轻、中度原发性高血压患者140例．随机分为治疗组（A组）71例和对照组（B组）69例。A组：口服NF、DHCT（小剂量）；B组：单服NF，疗程均为4周。结果：A组总有效率为93．00%，B组总有效率为86．96%，两组比较有显著性差异（P〈0.05）。结论：NF与DHCT小剂量联用治疗轻、中度高血压痛．疗效优于单用NF。     

某焦化厂新建同位素装置放射防护控制效果评价

目的 对某焦化厂新建同位素装置进行放射防护控制效果评价。方法 通过现场监测，按照标准对辐射源安全级别，场所辐射防护区域，工作人员接受的剂量水平进行分析评价。结果 只有一处密封辐射源仪表的安全级别属3级，其余均符合4级标准；1m外工人接受的最大剂量估算值小于国标规定的公众年剂量限值要求。结论 该焦化厂新装同位素装置场所基本符合国家规定。     

阿司匹林对肺癌细胞增殖的影响及机制探讨

目的:研究阿司匹林对肺腺癌细胞A549增殖的影响,并探讨其作用的可能机制。方法:采用噻唑蓝(MTT)法观察阿司匹林对A549细胞增殖的影响;采用免疫细胞化学法观察阿司匹林对A549细胞COX2表达的影响;采用流式细胞仪(FCM)、HE染色和DNA末端原位标记染色技术(TUNEL)观察阿司匹林对A549细胞周期的影响及诱导凋亡的作用。结果:阿司匹林呈剂量、时间依赖方式抑制A549细胞增殖,72h细胞最高抑制率达75.6%;阿司匹林作用后,A549细胞COX2蛋白表达明显降低;FCM显示G0/G1期细胞比例增加,达到(60.2±2.33)%,S期和G2/M期细胞比例分别降低到(32.9±2.88)%和(6.9±0.66)%,TUNEL显示细胞凋亡指数(AI)由(3.67±1.15)%增加到(26.33±2.52)%,呈一定剂量效应关系。光镜下可见典型的细胞凋亡形态学变化。结论:阿司匹林可能通过减少COX2表达,改变细胞周期分布和诱导细胞凋亡,从而抑制肺腺癌细胞A549增殖。     

左旋精氨酸预防大剂量顺铂急性肾毒性的剂量探讨

目的探讨左旋精氨酸预防大剂量顺铂急性肾毒性的最佳剂量。方法选择128例肿瘤病人,随机分为A、B、C3组,3组病人顺铂的剂量及用法相同,均为100mg/m2,分两天(第1、2天)给药。3组病人左旋精氨酸的用量分别为每天5g/m2、10g/m2和15g/m2,于化疗的当天在顺铂后应用,每例病人加与不加精氨酸周期的两周期化疗形成自身对照,每例病人化疗前及化疗后24h均检测尿β2-MG、血尿素氮(BUN)、血肌酐(Cr)及血尿酸,观察3组病人加与不加精氨酸周期化疗前后各观察指标的变化,并比较3组的疗效。结果血BUN、Cr及尿酸无论在加精氨酸周期还是在不加精氨酸周期,化疗前后检测值均无明显变化,该3项指标不宜作为早期急性肾功能损害的检测指标。而A、B、C3组病人化疗后的尿β2-MG值在加与不加精氨酸周期分别为0.9120±0.6618与1.5167±0.7908(P<0.05)、0.5404±0.5810与1.4616±0.8120(P<0.01)及0.4998±0.6210与1.5210±0.7710(P<0.01),均有明显差别,B组的结果差别极其显著,C组的结果差别也极其显著。A、B、C3组的显效率及总有效率分别为40.9%及59.1%、68.2%及90.9%、77.5%及97.5%,经X2检验,A、B两组的显效率及总有效率均差别显著,B、C两组的显效率及总有效率均无显著性差别。结论左旋精氨酸有效预防大剂量顺铂急性肾毒性的最佳剂量为每天10g/m2,增加剂量并不增加疗效。     

Hérida Regina Nunes SALGADO,et al:Microbiological assay for the determination of azithromycin in ophthalmic solutionsMicrobiological assay for the determination of azithromycin in ophthalmic solutions

IntroductionAzithromyciniscommercializedbypharmaciesinBrazilinophthalmicsolutionform. Despitetheproveneffectivenessandsafetyinitstreatment, thisdrug,untilthen, doesnotpossessamethodologyofstandar dizedanalysisforophthalmicsolutionsinofficialcom pendiumsan…