6Gyγ射线照射对小鼠Th17细胞含量和血清IL-17A含量的影响

目的：观察6 Gyγ射线照射对Th17细胞含量及其细胞因子的影响,探讨辐射免疫损伤机制.方法：60只C57BL/6雄性小鼠随机分为照射组和对照组,每组30只.照射组小鼠接受6 Gy γ射线一次性全身照射,对照组未进行照射.于照射后1、3、7、14和28 d取小鼠脾脏制备细胞匀浆,采用流式细胞术检测脾脏Th17细胞比例的改变;应用ELISA方法检测照射后6 h及1、3、7、14、28 d血清IL-17a含量变化.结果：6 Gy γ射线照射后1 d,小鼠脾脏Th17细胞比例即出现显著增加,至照后28 d仍显著高于对照组（P〈0.05或P〈0.01）,但照射后各时间点血清中IL-17a水平与对照组比较差异均无显著性（P〉0.05）.结论：6 Gy γ射线全身照射引起小鼠Th17细胞比例明显升高,表明Th17细胞在辐射所致免疫功能损伤和炎症反应中具有重要作用.     

辐射对成骨细胞系MC3T3-E1细胞增殖和功能基因表达的影响

目的为了深入了解辐射对成骨细胞的影响,探讨成骨细胞系MC3T3-E1细胞受到辐射后的功能变化。方法将MC3T3-E1细胞体外培养,诱导成骨前体细胞和成骨细胞,经137Csγ射线照射后,用MTT法分析细胞的存活率,用实时定量PCR方法分析ALP、Run X2和M-CSF基因的mRNA表达。结果 MTT实验表明,随照射剂量增加,正常MC3T3-E1细胞生长率明显下降,而经过诱导分化的MC3T3-E1细胞生长率变化越来越不明显。实时定量PCR实验结果表明,经过137Csγ射线照射后,MC3T3-E1细胞的ALP,Run X2和M-CSF基因的mRNA表达出现明显的降低;经过诱导分化为成骨前体细胞的,ALP,Run X2和M-CSF基因的mRNA表达与相应的正常组相比没有明显的规律变化;经过诱导进一步分化成为成骨细胞的,ALP和Run X2表达下降,M-CSF表达呈现升高趋势。结论辐射抑制早期成骨细胞的增殖、发育和分化。随着成骨细胞的分化,辐射对成骨细胞的增殖和生长发育影响减小,但是对成骨细胞发挥调节破骨细胞功能的作用并没有减少。     

重离子与X射线辐射人肝癌细胞后细胞凋亡及STAT-3基因表达的研究

目的 探讨重离子辐射对人肝癌细胞系SMMC-7721细胞增殖及细胞凋亡的影响,以及STAT-3基因表达的变化.方法 采用克隆存活及流式细胞技术,探讨体外培养的人肝癌细胞系SMMC-7721经X射线及重离子辐射后,细胞周期及细胞凋亡的变化,并采用RT-PCR法及Western blotting法检测肝癌细胞系SMMC-7721 STAT-3基因的表达.结果 人肝癌细胞系SMMC-7721经不同剂量重离子辐射后,随辐射剂量增加,细胞存活率(SF)明显降低(分别t=0.89、0.76、0.41、0.23,均P＜0.05).流式细胞仪检测显示细胞周期G2/M期阻滞增强,重离子较X射线作用更明显(分别t=1.31、8.26,P＜0.05),重离子辐射较X射线对细胞凋亡率影响更大(x2=48.46,P＜0.01).Western blotting和RT-PCR法均显示随着辐射剂量的增加STAT-3基因的表达逐渐增强.结论 重离子较X射线可更明显地诱导癌细胞凋亡,降低细胞存活率,人肝癌细胞系SMMC-7721经X射线及重离子辐射后,细胞凋亡与STAT-3基因的表达相关.     

骨性关节炎与骨质疏松症相关性研究

目的 通过对骨性关节炎(OA)和骨质疏松症(OP)的影响因素的观察,探讨这两种疾病是否存在相关性.方法 流行病学研究194名城市妇女,年龄从36岁至75岁,平均年龄52±12岁.获得基本资料.临床X线检查颈椎、腰椎、双膝、双手关节.按Kellgren标准诊断OA.骨密度检查按国际标准确定骨质疏松;并根据X线、骨密度检查结果将符合研究标准的被研究人分为四组:正常人组、OA组、OP组、OA+OP组.以四组分组为标准,分别在流行病学资料水平、骨密度值水平、雌激素进行组间比较,分析OA与OP之间相关性.结果 在流行病学水平,OA、OP有共同的影响因素:年龄、接受过高等教育、全身性疾病、运动、体重指数.在骨密度水平,骨密度值降低加重了OA的程度,OA随OP的加重而加重,OA和OP是相关的.雌激素,OA组雌激素含量与正常人组的一致,OP组雌激素含量明显降低.结论 OA和OP这两种疾病相互促进、发展,具有正相关的相关性.     

高能X射线放射性皮肤损伤动物模型的建立

高能X射线照射是治疗鼻咽癌及其他肿瘤的重要手段,应用过程中常引起皮肤损伤,严重者出现经久不愈的溃疡、深部组织变性、瘢痕化乃至癌变,严重影响患者生存质量[1-2].为此,笔者采用直线加速器发射的高能X射线照射大鼠局部皮肤组织,观察照射后局部皮肤组织损伤程度,以寻找建立放射性皮肤损伤动物模型的最佳方案,并为进一步研究提供可靠的动物模型.     

人工智能在骨质疏松症中应用的研究进展

骨质疏松症(osteoporosis, OP)是一种与增龄相关的骨骼疾患,其起病隐匿,呈渐进性发展,患者初期无明显的临床表现,但随着病情的进展,骨量不断流失及骨组织微结构破坏,进而出现骨痛、脊柱变形,甚至出现骨质疏松性骨折(osteoporotic fracture, OPF)等严重并发症。双能X线吸收法是目前临床诊断OP的金标准,但由于其诊断的准确度受到体重、腰椎退行性改变及主动脉壁钙化等因素的影响,存在假阴性诊断的可能。近年来,人工智能(artificial intelligence, AI)在医学领域快速发展,目前AI已广泛应用于OP的研究中,其在OP筛查、诊断及预测领域的研究已成为一个新的热点。该文从AI应用于OP的早期筛查、医学影像学表现、临床诊疗资料及OPF风险预测等4个方面,阐述AI在OP诊疗过程中的应用现状及优势,为OP的精准诊疗提供新方向。     

X线在经皮肾取石术应用中对医务人员的影响

目的分析经皮肾碎石取石术中X线定位时X线对医务人员的影响,为更好的防治X射线的损伤提供依据。方法回顾2002年至2006年4年间的X线引导经皮肾手术383例的检测资料,分析X线对手术人员的健康影响。结果X线对手术人员的健康方面有显著影响,手术者个人射线照射实时剂量为0．76±0．90mGy／例,定期剂量（3个月）为7．78±7．35mSv。随访追踪2位手术人员出现辐射损害。结论经皮肾手术中x线对医务人员大部分是安全的,但是X线暴露对身体是有危害的,不管是身体或心理都有很大的影响,应当采取有效措施来减少或防止这一损害。     

介入诊疗工作人员的综合防护评价

目的评价综合防护方法在介入诊疗中对工作人员的防护效果及其应用价值。方法在174例介入诊疗中分别采用床下铅橡胶帘,床边悬挂可活动式铅玻璃防护屏,医用铅防护服,铅防护围脖,铅防护眼镜及距离等对工作人员进行X射线辐射综合防护,利用RAD-60S个人报警剂量仪监测防护前后的X射线辐射剂量,并进行统计学分析。结果综合防护方法可明显减少X射线辐射剂量,有显著性防护意义。结论综合防护方法在介入诊疗中可有效减少X射线辐射剂量,保护工作人员的身体健康。     

简论X射线控制装置

X射线自伦琴发现以来,在医疗界临床诊断领域的应用已有一百余年的历史,而对X射线的控制方式随着应用科学技术的发展自上世纪九十年代以来也得到了迅速的发展.由早先的电子管、晶体管控制,到现在的系统计算机控制,由原来的工频50Hz控制装置发展到如今的逆变高频控制装置,这一发展使得在X射线控制精度和射线质量上有了大大的提高.就目前市场上的X射线控制装置而言,它们有其各自的特点.……     

姜黄素对受X线辐射损伤雄性大鼠睾丸组织保护作用的研究

目的探讨姜黄素（CUR）对大鼠睾丸受X线辐射损伤的保护作用。方法选取雄性SD大鼠60只,体重160～180g,随机分为4组。B组（单纯辐射组）、C组（辐射＋溶剂对照组）及D组（辐射＋CUR组）大鼠进行剂量为2.0Gy X射线一次性全身照射,对照组（A组）不进行照射。C组大鼠于辐射开始1h后给予腹腔注射二甲基亚砜;D组于辐射开始1h后给予腹腔注射姜黄素溶液。照射1周后将所有大鼠处死。采用TUNEL法检测生殖细胞凋亡;检测睾丸组织中超氧化物歧化酶（SOD）、谷胱甘肽过氧化酶（GSHPx）活性及丙二醛（MDA）含量。结果 B组及C组SOD和GSHPx活性明显降低,MDA含量明显升高,与对照组相比,差异有统计学意义（P〈0.01）。而CUR能有效升高SOD和GSHPx活性并降低MDA含量（P〈0.01）。B组及C组睾丸脏器系数明显低于正常对照组,差异有统计学意义（P〈0.01）。CUR能有效增加睾丸脏器系数（P〈0.01）。B组及C组凋亡指数明显高于A组（P〈0.01）,而CUR可以使凋亡指数显著下降（P〈0.01）。结论本实验为CUR作为治疗睾丸辐射损伤的有效物质提供了组织学及生化依据,为临床预防和治疗睾丸辐射损伤提供了理论依据。     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.