第二届国际立体定向放射外科会议情况介绍

第二届国际立体定向放射外科会议于1995年6月14～17日在美国波士顿召开。这次会议共收集论文199篇,其中大会发言124篇,墙报75篇。与会代表500余人,来自美、德、日、瑞典、中国等国。大会设临床和放射物理、生物两大组。各会场交流采用中心发言、代表发言及专题讨论相结合的形式。在大会期间还专设参观墙报时间。大会把1995年度Ｆａｂｒｉｋａｎｔ奖授予两位瑞典学者Ｂａｃｋｌｕｎｄ及Ｌａｒｓｓｏｎ教授。1　动静脉畸形(ＡＶＭ)收入论文34篇。以往以血管造影为确定靶区的基础。目前不少学者认为利用ＭＲＩ、ＭＲＡ可以更准确地勾画靶区,尤…     

葛根素对不稳定型心绞痛患者QT离散度的影响

QT离散度(QTd)可反映心室不同部位心肌细胞除极和复极的时间差异，不稳定型心绞痛患者恶性心律失常的发生与其关系密切。近年来，我们应用葛根素治疗不稳定型心绞痛患者，并观察其治疗前后QTd变化，探讨其作用机制。     

半环槽式外固定器下肢延长术15例报告

1988年以来,我们对各种原因引起的下肢短缩病人,用半环槽式外固定器进行延长术15例,疗效满意。 临床资料 一、一般资料:15例中,男11例,女4例。年龄最小9岁,最大23岁。短缩原因,小儿麻痹后遗症9例,骨折畸形愈合下肢短缩3例,骨髓炎后短缩2例,先天性髋脱位下肢短缩1例。术前短缩3～15厘米,平均4.9厘米。延长部位,胫骨上端骨骺9例,胫骨下端骨骺3例,股骨上1/3 1例,股骨下1/3 2例。     

肺癌掌指骨转移二例报告

肺癌掌指骨转移二例报告郭调良刘明远郝跃峰脊柱、髋、膝关节截骨的理论和手术技术学习班通知《中国脊柱脊髓杂志》编辑部和北京中日友好医院骨科将于１９９８年１０月中旬在北京举办为期一周的“脊柱、髋、膝关节截骨的理论和手术技术”学习班。邀请国内外知名专家授课，...     

乳腺癌放疗应用动态楔形板和物理楔形板对健侧乳腺和肺受量的影响

目的比较乳腺癌放疗中应用动态楔形板和物理楔形板对健侧乳腺和肺受量的影响。方法把实际治疗使用的计划加动态楔形板和物理楔形板分别计算13例患者,得出健侧乳腺(CB)、全肺和患侧肺的剂量分布。CB1和CB2是从内切野边缘算起两个长分别为4、10cm,内侧边界从皮肤表面标记铅丝至皮下3cm处的区域,用来代表健侧乳腺的受量情况。比较CB1和CB2所用指标为平均值,比较肺所用指标为患侧肺平均剂量及双肺V20。所用计划系统为CadPlan治疗计划系统。利用水模、电离室进行实际测量,并对比CadPlan和Eclipse计划系统的计算结果。结果在靶区覆盖率相同情况下,采用30°动态楔形板时,CB1和CB2的剂量百分比分别为1.5%～3.9%和1.1%～2.6%,患侧肺为4.1%～14.7%。采用30°物理楔形板时,CB1和CB2的剂量百分比分别为1.5%～4.4%和1.2%～3.0%,患侧肺为4.4%～15.2%。两种情况下全肺V20基本相同。采用15°动态楔形板时,CB1和CB2的剂量百分比也有所降低,但比30°楔形板时小得多;患侧肺的剂量百分比、全肺V20基本相同。实际测量结果说明采用动态板可以使正常组织受量降低。结论采用动态楔形板减少了健侧乳腺的剂量百分比,肺受量也有所减少或基本相同,从而可能使二次乳腺癌、放射性肺炎及肺纤维化等副作用的发生概率下降。     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

呼气末阻断期间肱动脉峰流速变异度对老年患者术中容量反应性的预测作用

目的:探讨呼气末阻断（end expiratory obstruction, EEO）期间肱动脉峰流速变异度（brachial artery peak velocity variation, ΔVp）对老年患者术中容量反应性的预测作用。方法:选择拟在全身麻醉下行择期胃肠手术的老年患者,ASA分级Ⅰ、Ⅱ级,心功能Ⅰ、Ⅱ级...     

小针刀加通痹止痛汤治疗急性发作期风湿,类风湿性关节炎

小针刀加通痹止痛汤治疗急性发作期风湿、类风湿性关节炎刘明远山东省菏泽地区中医院（２７４０３５）关键词：小针刀／中药／热痹笔者以小针刀结合中药内服治疗风湿和类风湿性关节炎之关节红肿疼痛２１例，效果较好，报告如下。１一般资料本组男７例，女１４例；年龄１８...     

顺行针法治疗肱二头肌长头腱鞘炎57例

2010-07—2012-04,笔者运用顺行针法治疗肱二头肌长头腱鞘炎57例,结果如下。1资料与方法1.1一般资料本组57例,均为我院骨伤科门诊患者,男21例,女36例;年龄32～75岁,平均47.5岁;病程2个月～3年,平均4.5个月;其中左侧25例,右侧32例。1.2诊断标准依据《新编实用骨科学》[1]确诊。1.3治疗方法患者坐位,以0.3 mm×50 mm针灸针于肩关节前上方结节沟上端斜刺进针,此处多有明显压痛,     

长效托宁和氯磷定伍用治疗急性有机磷农药中毒的临床观察

为探讨救治急性有机磷农药中毒 ( AOPP)安全、有效、简便、易行的新方法 ,2 0 0 1年 2月至 2 0 0 2年 1 2月 ,我们选用长效托宁与氯磷定伍用治疗 AOPP,并与阿托品和氯磷定伍用者进行对照。现分析如下。1　资料与方法1 .1　临床资料　本组 1 66例 ,男 5 8例 ,女 1 0 8例 ;平均年龄 39.2岁。中毒药物为 1 60 5 4 3例 ,辛硫磷 2 0例 ,乐果 64例 ,氧化乐果 39例。参照《职业性急性有机磷农药中毒的诊断及处理原则》病情分级[1] ,中毒轻度45例 ,中度 5 7例 ,重度 64例。随机分为治疗组 85例及对照组 81例 ,两组临床资料无明显差异。1 .2　治…