鼻咽癌调强放疗对腮腺功能的影响

Objective To evaluate the effect of intensity-modulated radiation therapy(IMRT) on parotid function in nasopharyngeal carcinoma(NPC). Methods Eighty-three NPC patients received prima-ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-,2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results Of all the patients,4,31,31 and 17 had stage Ⅰ,Ⅱ,Ⅲ and ⅣA disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95% ,respectively. The 5-year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%,8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D50 were no more than 33 Gy and 29 Gy,respectively. Conclusions IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced in-jury.     

鼻咽癌的影像学诊断及其进展

 鼻咽癌(NPC)是我国南方, 特别是广东地区最常见的恶性肿瘤之一。对其早期诊断, 早期治疗及治疗后随访观察等一直是NPC临床研究的重要课题之一。随着现代影像技术(CT和MRI)的临床广泛应用, 使NPC的临床工作进入一个全新的时期。本文就NPC的各种影像检查方法、诊断价值及进展作一回顾总结并文献复习。     

鼻咽癌调强放疗对腮腺功能的影响

Objective To evaluate the effect of intensity-modulated radiation therapy(IMRT) on parotid function in nasopharyngeal carcinoma(NPC). Methods Eighty-three NPC patients received prima-ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-,2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results Of all the patients,4,31,31 and 17 had stage Ⅰ,Ⅱ,Ⅲ and ⅣA disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95% ,respectively. The 5-year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%,8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D50 were no more than 33 Gy and 29 Gy,respectively. Conclusions IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced in-jury.     

鼻咽癌照射靶体积划定的临床探讨

目的通过分析针对靶体积逐步缩野放疗的临床结果，初步探讨鼻咽癌照射靶体积划定的合理性。方法共81例初治鼻咽癌患者进入研究，按1992年福州分期Ⅰ、Ⅱ、Ⅲ和Ⅳa期分别为4、23、35和19例。43例接受单纯放疗，38例接受放化综合治疗。将照射靶体积划分为鼻咽大体肿瘤体积(GTVnx)、颈部大体肿瘤体积(GTVnd)、临床靶体积1(CTV1)、临床靶体积2(CTV2)，相应计划靶体积分别为PTVnx、PTVnd、PTN1、PTN2。处方剂量PTVnx60-76Gy，PTVnd62-66Gy，PTV160Gy，PTV250—52Gy；按靶体积的剂量要求逐步缩野照射。采用三维治疗计划系统对8例不同期别患者的靶体积受照剂量进行计算，Kaplan—Meier方法计算局部区域无进展生存率、无远地转移生存率和总生存率。结果剂量计算结果显示，各靶体积均获得了所需的剂量覆盖。治疗后鼻咽及颈部肿瘤残留各2例，残留病灶分别位于PTVnx及GIVnd内；鼻咽原发灶及颈部转移灶全消率均为97．5％。中位随访时间15个月，未观察到复发病例；2年局部区域无进展生存率、无远地转移生存率和总生存率分别为100．0％、96．3％、100．0％。结论采用上述靶体积划分方法进行放疗可获得较好局部控制，未观察到靶体积内、外和边缘的复发。但该划分方法的合理性和准确性仍需进一步观察和研究。     

适形调强放射治疗在头颈肿瘤中的临床应用

目的:介绍适形调强放射治疗在头颈肿瘤中临床使用的方法和初步结果。方法:2001年1月至2月我院用适形调强放射治疗头颈肿瘤15例,其中初治鼻咽癌4例,未控或复发鼻咽癌8例,第6颈椎神经鞘瘤,脑膜瘤,肺癌脑转移瘤各1例。照射靶区和敏感器官按ICRU50号文标准勾划。用孔雀系统的CORVUS做逆向治疗计划设计,用MIMiC作共面旋转照射。照射野每5°变换一次,从105°～255°旋转照射。常规外照射+后程IMRT6例,全程IMRT9例。全部病例按常规分割照射,200cGy/次,每周5次。常规外照射剂量20～70Gy。IMRT处方剂量:全程IMRT60～76Gy,后程IMRT30～50Gy。结果:尽管全部病例肿瘤体积的目标剂量是10～76Gy,但最后靶区的平均剂量可达到11.42～78.04Gy。敏感器官照射的平均剂量为,晶体3.26Gy0.30c.c视神经19.13Gy0.90c.c颞颌关节20.55Gy5.54c.c腮腺19.07Gy13.32c.c垂体21.98Gy0.76c.c脑干20.60Gy21.21c.c脊髓19.14Gy9.28c.c。结论:孔雀系统对头颈肿瘤的适形调强放疗能较好地适形照射肿瘤体积和有效地保护邻近敏感器官。     

螺旋CT回顾性分割重建对发现体部微小病灶的价值

在螺旋CT出现之前,非螺旋CT由于不能进行大范围的容积扫描,较难发现并准确诊断胸、腹部的小病灶,特别是1cm以下的微小病灶。当今,随着螺旋CT的出现及推广使用,这一难题得到了较好的解决。但如果对每个有可疑病变的病人都用超薄层（5mm以下层距、层厚）螺旋扫描,由于扫描时间较长,对病人扫描时的呼吸控制要求也较高,这样不仅增加了设备的损耗,也加大了病人对X射线的接受量,因而不可能在临床上广泛应用。而螺旋CT可用多种扫描条件施行容积扫描,而且能在扫描结束后提取容积资料对扫描范围内可疑的部分进行任意间距的回顾性分割重建^[1],这样既能及时地发现扫描范围内的小病灶,又能大大减少设备的损耗和病人再次扫描的机会,同时也能减少X射线对人体的损伤。     

冠心病患者四种常规炎症标志物联合检测对急性心肌梗死的预测价值

[目的]探讨四种常规炎症标志物联合检测与冠心病患者发生急性心肌梗死(AMI)的关系。[方法]采用病例-对照的研究方法,选择2017年8月—2018年2月中日友好医院住院患者,其中稳定型心绞痛(SAP)患者99例,年龄(60.4±10.4)岁;AMI患者96例,年龄(61.9±14.6)岁;收集健康体检者60名为对照组,年龄(58.2±9.5)岁。采用全自动血细胞分析仪和生化分析仪检测炎症标志物,Logistic回归分析炎症标志物与冠心病患者发生AMI的相关性,受试者工作特征(ROC)曲线分析各指标的疾病预测价值。[结果] AMI组空腹血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)、白细胞计数(WBC)、中性粒细胞计数(NEUT)、高敏C反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)水平均明显高于SAP组,血清SOD水平明显低于SAP组,差异均有统计学意义(P<0.05)。在充分调整了协变量后,Logistic回归分析显示SOD与AMI发病呈负相关(OR=0.952,95%CI为0.932～0.973,P<0.001),WBC、NEUT和Hcy与AMI发病呈正相关(...     

新型双膦亚胺中间体的合成

目的合成一种新型的双膦亚胺叶立德中间体(2,2′-双膦亚胺苯甲酸苄酯)。方法以邻氨基苯甲酸为原料,分别经LiA lH4还原、芳香重氮盐重氮化制得邻叠氮基苯甲醇和经芳香重氮盐重氮化、与SOC l2反应制得邻叠氮基苯甲酰氯。两种产物酰化得到双叠氮基苯甲酸苯甲酯,再与三苯基磷发生Staud inger反应,制得双膦亚胺叶立德中间体(2,2′-双膦亚胺苯甲酸苄酯)。结果该方法简单,条件温和,产物稳定,收率达到88%。结论利用该中间体进一步发生双串联aza-wittig反应合成具有生物活性的喹唑啉酮类稠杂环药物,值得进一步探讨。     

《天然药物化学》双语教学的探讨与实践

从专业英语词汇的准备、课堂教学模式的设计、教材的选用、教案的准备、教学语言的组织、课堂教学的进行等6个方面对<天然药物化学>开展双语教学进行了探索和实践.同时指出在高校教育中开展双语教学不是孤立的单门课程,要与相关课程成为一个整体.