亚急性放射病的临床特点

本文以我国牡丹江事故的临床资料为主要依据, 结合文献对亚急性放射病的临床特点、诊断与鉴别诊断进行了分析讨论。认为该病是人体在较长时间内受电离辐射连续或间断较大剂量外照射所引起的一组全身性疾病。通常起病隐袭, 分期不明显, 不伴无力型神经衰弱综合征, 临床上以造血功能再生障碍为主, 可见全血细胞减少及与之有关均症状, 染色体畸变率增高, 其中稳定性与非稳定性畸变各占一定比例, 可伴微循环。凝血机制障碍及T淋巴细胞功能及生殖功能低下, 一般抗贫血药物治疗无效。临床上主要需与急性。慢性放射病及原发性再生障碍性贫血相鉴别。     

外照射慢性放射病诊断进展

一、背景外照射慢性放射病（简称慢放）,是指机体在较长时间内连续或间断受到超剂量限值外照射作用所发生以造血组织为主,并伴有其他系统改变的一种全身性疾病,是放射病诊断标准中讨论较多的国标之一。本期人的慢性放射病专栏中的各文已从不同侧面做了阐述,本文作者仅...     

外照射慢性放射病的诊断历史回顾

外照射慢性放射病（ｃｈｒｏｎｉｃｒａｄｉａｔｉｏｎｓｉｃｋｎｅｓ,ＣＲＳ）,是指机体在较长时间内连续或间断受到超剂量限值外照射作用所发生的以造血组织为主,并伴有其他系统改变的一种全身性疾病。１慢性放射病的国外情况目前对慢性放射病（简称慢放）存在不同...     

外照射慢性放射病的胸腺肽治疗及追踪观察

目的本文观察１１例慢性放射病的胸腺肽治疗结果及病程转归。方法以临床症状变化、造血系统造血功能、Ｔ淋巴细胞百分率、染色体畸变率变化作为慢放病恢复的综合判断标准进行分析。结果胸腺肽能促使患者的无力型神经衰弱征候群明显好转；能显著提高Ｔ淋巴细胞百分率，进而增强机体免疫力，治愈口腔粘膜溃疡。追踪观察表明，慢放病恢复时间依次为细胞免疫功能（２年），无力型神经衰弱综合症（３．５年），造血组织造血功能（５～８年），染色体畸变率（１０年）。结论按照我们拟定的慢放病恢复综合判断标准，慢放病是一种可以恢复的职业性疾病。胸腺肽有助于慢放病的治疗，且方法简单，值得临床试用     

两例外照射慢性放射病继发缺铁性贫血

两例外照射慢性放射病继发缺铁性贫血杨秀梅姜恩海陈子齐王晓琳本文作者主要结合已确诊的两例慢性放射病继发缺铁性贫血的诊断进行讨论。１临床病例例１，女，４９岁，放射科主管技师，放射工龄２６年。因头昏、乏力、睡眠障碍、白细胞减少２０年，于１９９１年６月２５日...     

忻州60Co源放射事故主要8例受照者临床报告

目的通过对诊断不明病人“芳”的诊断和治疗,探索在放射源不明情况下,如何进行放射病的诊断;探索采用简易隔离和ＧＭ－ＣＳＦ治疗效果;同时回顾性介绍同组其他病人发病经过。方法通过详细询问病史,排除传染病和中毒,在高度怀疑放射病时,经对外周血淋巴细胞染色体畸变分析,确诊急性放射病;复习文献,提出放射源不明、放射病诊断线索。结果经作淋巴细胞染色体畸变分析,估算受照剂量为２．３０（２．０７～２．５０）Ｇｙ,确诊为骨髓型急性（中度）放射病,同时推断家中死亡３例也为放射病。结论如遇到难以解析的皮肤烧伤病变（红斑,水疱）,排除热或化学烧伤后,应考虑放射烧伤,对有恶心,呕吐,脱发,口腔溃疡,外周血细胞减少者,更支持诊断;如家中成员中相继发生上述同类症状者更应高度怀疑,并作相关检查确诊;简易隔离可为一般医院所采用;细胞因子可促进造血功能恢复,缩短病程     

细胞遗传学指标在慢性放射损伤诊断中的意义

用染色体畸变估算全身一次比较均匀的Ｘ、γ射线和中子的过量照射时的生物剂量比较准确 ,对不均匀和局部照射可给出相当于均匀照射的等效剂量当量。淋巴细胞微核也已被用作估算受照射剂量的指标 ,并取得了较为满意的结果。但在慢性放射损伤时 ,染色体畸变和微核的变化特点及其在慢性放射病诊断中的作用 ,是值得探讨和深入研究的问题。在《外照射慢性放射病诊断标准及处理原则》(ＧＢ82 81 87) [1] 中将“外周血淋巴细胞染色体畸变率显著增加和 /或外周血淋巴细胞微核率显著增加” ,作为慢性放射病诊断的参考指标。到目前为止 ,还不能用染色…     

山东济宁60Co辐射事故受照人员的临床救治

目的总结和探索肠型放射病和极重度骨髓型放射病临床诊治经验。方法中国山东济宁^60Co辐射事故中2例病人受到意外照射。综合估算，病例A受照剂量20～25Gy，诊断为“肠型放射病”；病例B受照剂量9～15Gy，诊断为“极重度骨髓型放射病”。经联合预处理，2例分别行单倍体和HLA相合外周血造血干细胞移植。结果2例患者均移植成功，供体完全植活，三系血细胞和骨髓造血重建成功，均无移植排斥和移植物抗宿主病。病例A于照后33d（d33）死于败血症和多脏器功能衰竭，病例B于d75死于心衰为主的多脏器功能衰竭。结论骨髓和外周血染色体及牙齿ESR检查等对超大剂量放射病诊断有重要价值。HLA相合及半相合外周造血干细胞移植救治急性放射病是完全可能和可行的。感染和多脏器功能衰竭仍然是病人的主要死亡原因。应加强对促进辐射损伤修复和多脏器功能衰竭的救治研究。     

T淋巴细胞亚群和淋巴细胞转化率在急性放射病的观察

Ｔ淋巴细胞亚群和淋巴细胞转化率在急性放射病的观察张东华，张瑶珍，李美颖，汪道文，鲜于志群，路武受电离辐射所致的急性放射病病人，淋巴细胞的功能必然受到不同程度的影响，以Ｔ淋巴细胞为中心的免疫网络在机体辐射损伤后的变化日益受到重视。我们观察了４例受６０Ｃ...     

中度急性放射病的诊断

本文报道了40例中、晚期恶性淋巴瘤病人采用⁶⁰Coγ线一次全淋巴区照射6,8Gy的临床表现。若按病人外周血淋巴细胞染色体畸变估算这一剂量, 则相当于一次全身均匀照射条件下血液平均受照剂量分别为2.73～4.30Gy(平均3.55Gy)和3.48～5.58Gy(平均4.25Gy).按红骨髓千细胞法估算等效剂量为1.85～2.37Gy.可以见到中度急性放射病的临床经过, 表现为消化道反应和造血免疫功能受损, 骨髓受到抑制。白细胞, 血小板迅速减少, 淋巴细胞在早期就有质和量的变化。所有这些均是有意义的诊断指标。此外, 唇肌刺激反应、C反应蛋白、皮质醇, 尿中核苷和碱基, 照射前后皆有显着改变。因此利用肿瘤病人进行6～8Gy全淋巴区照射可以作出中度急性放射病的早期诊断。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.