局部残留或复发鼻咽癌的分次立体定向放射治疗

目的　评价分次立体定向放射治疗 (FSRT)对局部残留和复发鼻咽癌的初步疗效。方法　应用FSRT对 30例局部残留 (11例 )或复发 (19例 )鼻咽癌患者分 2个组进行治疗 ,其残留组和复发组中位处方剂量分别为 18Gy和 4 8Gy ,中位分次量分别为 6Gy和 8Gy ,每周 2次。结果　可评价例数共 2 9例 ,FSRT治疗后 3个月残留组的CR和PR各为 6 /11和 3/11,复发组各为 8/18和 8/18。全组病例随诊 3.4～ 37.9个月 (中位值 15个月 ) ,残留组 1和 2年总生存率、无瘤生存率、无局部复发生存率和无远地转移生存率分别为 77.8%和 6 6 .7%、5 6 .8%和 5 6 .8%、88.9%和 88.9%、75 .0 %和75 .0 % ,复发组相应为 6 9.8%和 5 9.8%、5 3.4 %和 4 4 .5 %、76 .6 %和 6 3.8%、70 .5 %和 5 8.7%。残留组和复发组生存患者卡氏评分≥ 90者分别占 8/8和 11/13。结论　FSRT对局部残留或复发鼻咽癌有较好的局部控制效果和较高的安全性 ,区域和远地转移是治疗失败的主要原因。     

鼻咽癌常规外照射改进方案的剂量学研究

目的　应用三维治疗计划系统 ( 3DTPS)对鼻咽癌常规外照射改进方案进行剂量学研究 ,探讨其临床使用价值。方法　选取初治鼻咽癌患者 8例 ,采用 3DTPS设计照射方案。每例患者均设计 2个方案 :( 1)以鼻前面颈野和双侧面颈联合野为主的常规外照射方案 (改进方案 ) ;( 2 )以双侧面颈联合野为主的常规外照射方案 (传统方案 )。每例患者的 2个方案照射剂量相同。采用剂量体积直方图比较各期鼻咽癌以两种方案照射时靶区、脑干、脊髓、腮腺及颞颌关节的受照体积和剂量。结果　( 1)改进方案可满足鼻咽和颈部计划靶体积的剂量要求。 ( 2 )两种方案脊髓受照剂量无差异 ;对 5 %和 10 %体积脑干平均受照剂量 (D5、D10 ) ,T1～T3期患者改进方案高于传统方案 (P <0 .0 5 ) ,T4期患者两种方案无差异。 ( 3)改进方案双侧腮腺和颞颌关节受照剂量、分割剂量和被高剂量覆盖的体积均明显低于传统方案 (P <0 .0 1) ,其他正常组织被较高剂量覆盖的体积亦明显小于传统方案 (P <0 .0 1)。结论　与传统方案比较 ,改进方案靶体积在获得满意的剂量覆盖同时 ,可更好地保护腮腺、颞颌关节等正常组织     

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。     

高聚生配合外照射治疗鼻咽癌的临床研究

目的观察高聚生配合外照射治疗鼻咽癌的疗效.方法160例鼻咽癌随机分入放疗加高聚生组(A组)和单纯放疗组(B组).A组高聚生用法放疗前3～5天开始用1000U,肌注,每天1次,直至放疗结束.B组单纯放射治疗,每天2Gy,每周5次.两组放疗方法、剂量相同.结果放疗后3个月检查A、B两组鼻咽部肿瘤完全消退率分别为88.7%和81.3%(P＞0.05).颈部转移淋巴结完全消退率分别为86.3%和73.6%(P＞0.05).3年生存率A、B组分别为76.3%和66.3%(P＞0.05),5年生存率A、B组分别为65.0%和52.5%(P＞0.05);3年鼻咽部肿瘤控制率A、B组分别为76.3%和68.8%(P＞0.05),5年鼻咽部肿瘤控制率A、B组分别为71.3%和58.8%(P＞0.05);3年颈淋巴结转移灶控制率A、B组分别为72.6%和62.5%(P＞0.05),5年颈淋巴结转移灶控制率A、B组分别为61.6%和48.6%(P＞0.05).5年远处转移发生率A、B组分别为28.8%和42.5%(P＜0.05).A组急性毒副反应与B组相似.结论高聚生配合外照射治疗鼻咽癌无明显提高患者的生存率和局部控制率,但有助于降低远处转移的发生.     

普洱茶营养成分分析和营养学评价

普洱茶（Camellia sinensis Kuntze Varassamica kitamura）原产于我国云南西双版纳地区，因早期集散地在云南普洱县而得名。研究证实，普洱茶具有显的降脂减肥、抗脂质过氧化、抗衰老、防癌等生理功能。本研究分析云南普洱茶的营养成分并对其营养价值进行了评价，为云南普洱茶的深加工利用提供科学依据。     

佤族寄宿制小学生尿碘水平及甲状腺肿患病情况

云南省地处内陆高原,历史上外环境严重缺碘,曾是碘缺乏病重灾区.虽然国家实施全民食盐加碘多年,但是云南省防治碘缺乏病的形势依然严峻,尤其是处于边远山区的少数民族,地理情况复杂,交通不便,加上少数民族饮食习惯,给这些地区的碘缺乏病防治带来了一定的困难[1]. 佤族世代生活在云南省南部、西南部边疆地区,为当地的古老民族之一.云南省临沧地区是佤族的主要聚居地.有调查显示,佤族成年人的身高、体重明显低于全国水平,可能与佤族地区的经济水平、生活习惯、饮食结构等因素相关[2].     

云南野生酸木瓜籽油急性毒性及其脂肪酸含量测定

目的:评价云南野生酸木瓜籽油急性毒性,分析测定其脂肪酸含量,为深入研究提供依据。方法:采用《食品安全性毒理学评价程序和方法》最大耐受量法对受试物进行大鼠、小鼠急性毒性实验;采用气相色谱法测定脂肪酸含量。结果:野生酸木瓜籽油以急性毒性半数致死量(LD50)毒性分级属实际无毒。脂肪酸构成,主要由油酸(65.58%)和亚油酸(23.32%)组成。结论:野生酸木瓜籽油具有一定的开发利用价值。     

蓝孔雀营养液的研制

将蓝孔雀肉破碎、蒸煮后 ,用Alcalase和Flavourzyme分步水解蓝孔雀肉蛋白质 ,再经灭酶、离心、滤材过滤等处理 ,制得风味良好且澄清的蓝孔雀营养液 .