中国六次核试验辐射对哺乳动物的损伤效应研究

目的 研究中国核试验中不同类型辐射对哺乳动物的近期和远期生物学效应,探讨辐射损伤效应机制。方法 1964-1976年间的6次核试验中,在核爆现场和下风向地区布放狗、恒河猴、大白鼠、小白鼠及家兔等哺乳动物,核爆后受到瞬时γ射线和中子外照射,落下灰γ射线、β射线的外照射,落下灰¹³¹I、¹³³I的内照射(食入及吸入),以及内外复合照射;此外,还有2次、3次重复照射,受照射动物的子代照射。动物回收后进行临床医学、病理学、血液学、生物化学、细胞化学、生殖遗传学、细胞遗传学与辐射剂量学等指标观察测试,前后持续22年。结果 核爆后3、7和12个月,受照0.39 Gy后,狗的外周血淋巴细胞染色体畸变率分别为8.63%、7.25%和7.63%,与对照组比较,差异有统计学意义(P<0.01)。在核爆后6个月,受照0.74 Gy的恒河猴的染色体畸变率为21.00%,高于对照组(P<0.01);核爆后8.5年,恒河猴的染色体畸变率为5.52%,高于对照组(P<0.01)。核爆后52 d,大白鼠受照0.65~4.40 Gy后,生殖率下降为30.8%~69.4%,每胎平均仔数减少,与对照组比较,差异有统计学意义(P<0.01)。狗受照0.75和1.73 Gy后,受照后3~7个月精子数量和存活率降为0,且狗精子畸形率增加,达46.79%,高于对照组(P<0.01);狗的精子和睾丸超微结构出现严重的损伤变化。骨髓造血功能破坏,外周血白细胞、淋巴细胞持续减少,血清菲啶溴红络合物荧光强度(核酸含量测定)升高,达18.9%(P<0.05)。受照2.00 Gy以上的狗,5年后发生良性肿瘤53.3%,恶性肿瘤33.3%,高于对照组(P<0.01)。外照射后,狗的睾丸萎缩发病率升高,眼晶状体白内障发病率升高,内照射后甲状腺萎缩发病率升高。放射性灰尘的污染范围大、危害时间长,狗受到落下灰β射线照射后发生皮肤烧伤,恢复慢,有发生癌变的可能。结论 哺乳动物核辐射损伤比单纯中子、γ射线、X射线等照射损伤严重、伤情复杂;核辐射后造血细胞、生精细胞敏感,损伤严重,损伤程度取决于受照剂量,且与照射后时间有关。放射性落下灰的危害范围大、持续时间长,落下灰β射线能造成皮肤烧伤。即使低剂量核辐射,也会造成不容低估的危险。     

禁食对137Cs γ射线照射诱导小鼠肠道辐射损伤的代谢组学研究

目的 研究禁食对¹³⁷Cs γ射线照射诱导小鼠肠道辐射损伤的干预作用,通过非靶向代谢组学探究小鼠粪便代谢物的变化。方法 将小鼠分为健康对照组、γ射线照射（全身9 Gy或腹部15 Gy）组、禁食（24、48、72 h）+照射（全身9 Gy或腹部15 Gy）组。照射后,计算小鼠的生存率、脾脏指数和胸腺指数。非靶代谢实验测序分为4组,分别为健康对照组、禁食24 h组、腹部局部照射15 Gy组、禁食24 h组+腹部局部照射15 Gy组、每组6只。于照后3.5 d收集各组小鼠的粪便进行非靶向代谢组学检测。结果 9 Gy γ射线全身照射小鼠照射前禁食48和24 h,受照后的中位生存期提高了1和4 d;15 Gy腹部受照小鼠照射前禁食48和24 h的小鼠的存活率分别为16.67%和25%,照射前禁食24 h能够提高受照后3.5 d小鼠的体重（t=2.338,P=0.042）和脾脏指数（t=2.289,P=0.045）。非靶向代谢组学结果显示,禁食24 h和未禁食的受腹部局部照射小鼠粪便样本中有30个差异表达代谢物;代谢通路富集分析表明,类固醇激素生物合成的代谢途径存在着不平衡状态。结论 照射前禁食可以提高肠道辐射损伤小鼠的生存率,改变其肠道代谢产物,提示照射前禁食或短期内饮食营养变化参与调节肠道辐射损。     

硫酸镁抑制经辐射后人脐静脉血管内皮细胞γ-H2AX的表达

目的 探讨不同浓度硫酸镁对照射后人脐静脉血管内皮细胞(human umbilical vein endothelial,HUVEC)存活率及γ-H2AX表达的影响。方法 CCK-8法检测不同浓度的硫酸镁对HUVEC存活率的影响;激光共聚焦显微镜检测4 Gy X射线照射后不同时间HUVEC中γ-H2AX簇集点(foci)的数量;流式细胞术和Western blot检测γ-H2AX蛋白的表达情况。结果 CCK-8法显示,1.25 mg/ml浓度的硫酸镁能提高照射后的细胞存活率(t=-6.34,P<0.05);细胞免疫荧光结果显示,照射后0.5~1 h foci焦点数达到最高值,平均达45个,随着时间的延长foci点数变少,强度减弱,具有时间依赖性,而硫酸镁在照后0.5、1、2、6、12 h均可以明显减少foci的形成(t=12.62、6.36、11.93、5.75、9.43,P<0.05);流式细胞仪检测表明,硫酸镁在照后0.5、1、2 h可以抑制X射线照射后γ-H2AX蛋白表达量的增加(t=6.07、5.32、11.85,P<0.05);Western blot结果与细胞免疫荧光结果一致。结论 硫酸镁可以增加照射后HUVEC的存活率,降低X射线诱导的DNA损伤蛋白γ-H2AX的表达。     

电离辐射致股骨头坏死早期病理特点和机制的研究

目的 观察单次大剂量射线引起大鼠股骨头坏死的早期病理改变,为放射性骨坏死特别是放射性股骨头坏死的早期诊断和防治研究提供依据。方法 ¹³⁷Cs γ射线(30 Gy)体外局部单侧单次照射大鼠股骨头,受照后2、6和12周取双侧股骨头HE染色,光镜观察病理改变;照后2周骨髓间充质干质细胞(bone marrow mesenchymal stem cells ,BMSCs)分离培养,观察BMSCs增殖和集落形成能力;照后12周血管内灌注Microfill造影剂,采用微CT对股骨头毛细血管网进行三维重建和分析。结果 ¹³⁷Cs γ射线局部照射后,受照侧股骨头软骨柱紊乱,骨细胞核皱缩、数量减少、空骨陷窝增多、骨小梁面积减少(P<0.05);受照侧股骨头毛细血管密度由未照侧的12.3%降至6.65%(P<0.05); BMSCs生长缓慢,集落形成率为10%,较对照组(21%)明显下降(P<0.05)。结论 30 Gy单次局部照射后骨组织病理改变主要表现为空骨陷窝增加,照射后6周空骨陷窝率达30%可作为放射性股骨头坏死早期预诊断的指标之一。辐射致股骨头损伤甚至坏死除了射线对骨组织的损伤外,还与射线对骨髓BMSCs和毛细血管的损伤有关。     

12C重离子束对人淋巴细胞增殖、周期和凋亡的影响

目的 探讨¹²C重离子束对人淋巴细胞增殖以及周期、凋亡的影响.方法 ¹²C重离子束照射人淋巴细胞Peng-EBV,吸收剂量分别为0(对照组)、0.5、2.0 Gy.照射后用MTS法检测细胞增殖活力,流式细胞仪检测细胞周期和细胞凋亡.结果 与对照组相比,0.5 Gy照射可以增加细胞增殖活力(t=2.66~14.45, P<0.05),而2.0 Gy照射降低了细胞活力(t=7.65~64.45, P<0.05).受照射细胞的活力存在一个恢复和下降过程,受照后48 h内,细胞数量呈增加趋势,但72 h时细胞数量下降.照射后48 h,两组细胞G₂/M期呈明显上升趋势,高于对照组(t=2.01~99.80,P<0.05),且2.0 Gy组的周期阻滞较0.5 Gy组严重;照射后30 d,细胞周期阻滞恢复到正常水平.照射后12、24、48 h,两照射组与对照组相比,细胞凋亡率差异有统计学意义(t=-3.05~-1.05,P<0.05),在照后24 h最高,48 h明显下降,30 d恢复到对照水平.结论 ¹²C离子束辐射影响人淋巴细胞增殖,诱导人淋巴细胞发生明显的G₂/M期阻滞,并且明显地促进细胞凋亡.     

不同剂量率60Co γ射线照射对人外周血辐射敏感基因表达变化的影响

目的 探讨不同剂量率⁶⁰Co γ射线照射对辐射诱导的基因表达水平改变的影响。方法 ⁶⁰Co γ射线照射3例正常人离体外周血,剂量率分别为0.2、1.0和2.0 Gy/min,照射剂量为0、1、2、4和6 Gy,照射后24 h收集细胞,实时荧光定量（PCR）法对11个基因（CDKN1A、MDM2、PCNA、FDXR、GADD45A、PHPT1、ASTN2、TNFSF4、POLH、GDF-15和PPM1D） mRNA表达水平进行相对定量检测;逐步回归法构建不同剂量率基因组合表达模型。结果 不同剂量率0.2、1和2 Gy/min ⁶⁰Co γ射线照射后,辐射诱导的11个基因的相对表达量随照射剂量增加而升高,具有显著的剂量依赖性（R²=0.744~0.998,P< 0.05）;0.2 Gy/min ⁶⁰Co γ射线照射2 Gy后,CDKN1A、FDXR、PHPT1和TNFSF4基因的表达量明显高于1和2 Gy/min剂量率组,差异具有统计学意义（t=3.73、5.73、2.44、2.77、3.53、2.68、2.43、2.05,P< 0.05）;2 Gy/min ⁶⁰Co γ射线照射6 Gy后,PPM1D基因表达量明显高于其他两个剂量率组（t=3.82、2.54,P< 0.05）;不同剂量率基因组合表达模型由2~3个基因组成,回归方程的R²值为0.951~0.976（P< 0.05）。结论 在0.2~2 Gy/min剂量率范围内,不同剂量率⁶⁰Co γ射线照射可能会影响辐射诱导人外周血基因表达水平的改变。     

胶原蛋白肽对X射线照射小鼠免疫功能的影响

目的 了解胶原蛋白肽（CP）对X射线照射小鼠免疫功能的调节作用。方法 ICR小鼠按体重分层随机分为5组,分别为健康对照组、2 Gy、5 Gy、2 Gy+CP 600 mg·kg^-1·d^-1组（2 Gy CP）和5 Gy+CP 600 mg·kg^-1·d^-1组（5 Gy CP）。6 MV X射线单次全身照射诱导免疫抑制小鼠模型,剂量率为6 Gy/min。2 Gy CP和5 Gy CP组的小鼠连续7 d腹腔注射给予胶原蛋白肽600 mg/kg。测量小鼠体质量、胸腺和脾脏质量,计算胸腺和脾脏指数;检测刀豆蛋白A（ConA）诱导的脾脏T淋巴细胞增殖能力及脾脏T淋巴细胞分泌的白介素-2（IL-2）的水平。结果 与健康对照组相比,X射线照射小鼠的胸腺指数、脾脏指数、脾脏T 淋巴细胞增殖能力及IL-2浓度显著降低（F=76.857、181.870、63.133、8.499,P<0.05）。腹腔注射胶原蛋白肽后,与同等剂量单纯照射小鼠比较,上述指标均有所恢复。结论 腹腔注射胶原蛋白肽能够增强X射线照射小鼠的免疫功能。     

低剂量60Coγ射线诱导人淋巴细胞核质桥适应性反应的研究

目的 以核质桥(NPB)为主要指标,探索低剂量⁶⁰Co γ射线是否能诱导人外周血淋巴细胞的适应性反应及诱导剂量范围。方法 用⁶⁰Co γ射线照射健康成年男子离体外周血,照射剂量分别为0、20、50、75、100、150和200 mGy(吸收剂量率为25 mGy/min),照射后间隔6 h后再给予2 Gy照射(吸收剂量率为1 Gy/min)。采用胞质分裂阻滞法(CBMN)进行细胞培养,观察NPB及微核(MN)的发生情况。结果 0~200 mGy剂量范围内,NPB和MN数目随吸收剂量的增加而增多,并拟合出NPB的线性平方模型y=(1.5×10^-4)x²-(5.67×10^-3)x+0.598 (R²=0.893 8)。提前给予75~100 mGy照射比直接受到2 Gy照射产生的NPB及MN数目均有所减少(U=2.66、2.97、3.96、5.89,P<0.05),在100 mGy照射后NPB减少最多(43.2%)。结论 低剂量⁶⁰Co γ射线可以诱导人外周血淋巴细胞的适应性反应,诱导剂量范围为75~100 mGy。     

不同结构类型双着丝粒体建立的剂量-效应曲线估算剂量可行性研究

目的 探讨基于不同结构类型双着丝粒体（dicentrics,dic）建立的剂量-效应曲线估算生物剂量的可行性。方法 采集两名健康人外周血样品,用0、0.5、1、2、3、4、5和6 Gy ⁶⁰Co γ射线（剂量率为0.27 Gy/min）离体照射人外周血,常规培养、收获和制备染色体标本,镜下分析并记录不同结构类型dic;应用CABAS软件建立dic剂量-效应曲线;并对两验证样本进行剂量估算。结果 不同结构类型dic率均随受照剂量的增加而升高（R²=0.886~0.943,P<0.01）,各剂量点经典型和单端型dic构成比之和约占所有类型dic的92%以上,而近距型dic和双端型dic分别在各照射剂量点的构成比均<4%。不同结构类型dic剂量-效应曲线的R²值均达到0.998;应用4条曲线估算的受照射剂量差异无统计学意义（P>0.05）。经典型dic剂量-效应曲线估算较高剂量时（3.9 Gy）,相对偏差均≤13.08%。结论 基于不同结构类型dic建立的剂量-效应曲线具有估算生物剂量的可行性。     

X射线照射对小鼠辅助性T细胞相关细胞因子的影响

目的 观察不同剂量X射线照射对小鼠辅助性T细胞相关细胞因子的影响。方法 100只BALB/c小鼠用随机数字表法分为4组,包括健康对照组和X射线照射组(分别予2、4和6 Gy 照射),每组25只。于照射前、照射后7、14、21和28 d,对小鼠一般情况进行观察,对外周血进行白细胞计数,用蛋白芯片检测血清中辅助性T细胞相关细胞因子含量,并用ELISA确证细胞因子的浓度变化。结果 照射后,小鼠外周血白细胞14 d降至最低, 同一时间点的下降程度随照射剂量增加而增加 (F=86.267,P<0.05)。芯片法初筛提示,细胞因子IFN-γ、TGF-β、IL-6、IL-17上调,IL-5、IL-23、TNF-α下调。ELISA检测可见,IL-17浓度随辐射剂量增高而明显增高,6 Gy组在7、14和21 d均明显高于对照(t=23.743、21.759和17.662,P<0.05);IFN-γ/IL-4浓度在2和4 Gy照射后无明显变化,6 Gy照射后在7、14、21和28 d均比健康对照组明显增高(t=8.335、9.982、6.990和3.074,P<0.05),呈先升高后降低的变化趋势,14 d达高峰。结论 低于致死剂量的X射线照射可使小鼠血清IFN-γ、TGF-β、IL-6、IL-17细胞因子浓度升高,呈Th1细胞偏移。     

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.     

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).     

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.     

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.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）