Impact of radial and femoral access on radiation dose and fluorography time in patients with acute coronary syndrome

BackgroundCurrent guidelines favor radial over femoral access in patients with acute coronary syndromes for safety according to the results of recent trials. However, influence of access site on radiation dose and fluorography time is still unclear.MethodsWe retrospectively analyzed 390 patients who underwent percutaneous coronary intervention for acute coronary syndrome in Kardiocentrum Vysočina. We compared the access site with the number of stents implanted, the average fluorography time in minutes, the average radiation dose and mean effective dose that each patient received in Gy/cm² or mSv respectively.ResultsUse of femoral access resulted in approximately 11% lower radiation dose (p = 0.03). There has been no significant difference between fluorography time and the number of stents implanted in both cohorts.ConclusionWe found that the radiation dose was lower in femorally accessed group. Although radiation dose is not the main concern in patients with acute coronary syndromes, our results suggest that femoral access can be preferred over radial access in certain situations.     

放疗诱导宫颈癌细胞中经典Wnt通路的表达情况及顺铂耐药性研究

目的:研究放疗诱导后的耐放疗宫颈癌Hela、Siha细胞系顺铂耐药情况及经典Wnt通路相关分子在其化疗耐受中的作用。方法:分割剂量多次照射诱导宫颈癌细胞并成功建立耐放疗细胞系,将细胞分为R0组(空白对照)、R1组(分割剂量4GY,照射6次)和R2组(分割剂量6GY,照射4次)。CCK8法进行耐药实验,Real-time PCR及Western blot法检测Wnt/β-catenin通路及耐药分子表达情况。结果:Hela R0、R1、R2顺铂IC50分别为3.86、6.65μmol/L和6.53μmol/L,Siha R0、Siha R1、Siha R2顺铂IC50分别为4.79、7.25μmol/L和7.98μmol/L;与R0组相比,其他两组的IC50显著升高,差异有统计学意义(P0.001)。放疗诱导宫颈癌Hela、Siha细胞中经典Wnt通路分子在基因与蛋白水平受到激活,其下游基因C-Myc、Cyclin D1表达增多,放疗诱导Hela细胞中耐药蛋白ABCB1、ABCG2表达升高,而放疗诱导Siha细胞中上述耐药蛋白变化无统计学差异。结论:经典Wnt通路可能是放疗诱导宫颈癌细胞化疗耐受性获得的重要机制,这为复发性宫颈癌患者提供了潜在治疗靶点。     

Evaluación del impacto de la sintomatología urinaria en la calidad de vida de los pacientes con síndrome de vejiga dolorosa/dolor pélvico crónico y cistitis rádica: estudio EURCIS

ObjectivesTo evaluate the impact of urinary symptoms of Painful Bladder/Pelvic Pain Syndrome and Radiation Cystitis (PBCPPS) on the Quality of Life, and self-esteem of the patient.Material and methodsAn observational, multicenter, epidemiological and cross-sectional study was performed on patients with Painful Bladder/Chronic Pelvic Pain Syndrome and Radiation Cystitis. Data was recorded on severity of urinary symptoms and QoL impairment using the PUF Score. The patients evaluated the QoL deterioration grade through the King's Health Questionnaire (KHQ), and the level of their anxiety and self-esteem with the Goldberg's Anxiety Scale (GAS) and Rosenberg's Self-Esteem Scale (RSES), respectively. Post-hoc comparisons were performed between the results of the KHQ of this study and a sample of patients with urinary incontinence (UI). Results on RSES were analyzed with data from the general population and from patients with erectile dysfunction.ResultsA total of 530 cases, mostly female patients, who had been diagnosed with PBCPPS, were analyzed. High levels of deterioration in QoL were described: KHQ scores were significantly higher when compared with patients with UI (P < .01). Involvement of self-esteem was higher in patients with RC and men, who obtained scores similar to those of patients with erectile dysfunction.ConclusionsPatients with Painful Bladder Syndrome/Chronic Pelvic Pain Syndrome and Radiation Cystitis present high levels of anxiety, and significant reductions in both quality of life and self-esteem. Especially for men, this affectation is similar to that caused by erectile dysfunction.     

Gastrointestinal radiation injury:Symptoms,risk factors and mechanisms

Ionising radiation therapy is a common treatment modality for different types of cancer and its use is expected to increase with advances in screening and early detection of cancer.Radiation injury to the gastrointestinal tract is important factor working against better utility of this important therapeutic modality.Cancer survivors can suffer a wide variety of acute and chronic symptoms following radiotherapy,which significantly reduces their quality of life as well as adding an extra burden to the cost of health care.The accurate diagnosis and treatment of intestinal radiation injury often represents a clinical challenge to practicing physicians in both gastroenterology and oncology.Despite the growing recognition of the problem and some advances in understanding the cellular and molecular mechanisms of radiation injury,relatively little is known about the pathophysiology of gastrointestinal radiation injury or any possible susceptibility factors that could aggravate its severity.The aims of this review are to examine the various clinical manifestations of post-radiation gastrointestinal symptoms,to discuss possible patient and treatment factors implicated in normal gastrointestinal tissue radiosensitivity and to outline different mechanisms of intestinal tissue injury.     

碘 131 治疗期间辐射防护方法的研究进展

〔摘 要〕 同位素治疗手段及医学显像技术在医疗科技中发挥着越来越重要的作用，在这一趋势之下，放射性治疗 药物在临床中效果更加明显，同时其应用也变得越来越广泛。但同时还需要意识到，放射性治疗药物的应用，本质上 对于患者及医护工作人员都会产生一定的影响，也就是辐射影响。碘 131 主要在一些甲状腺疾病的治疗中进行应用， 其具备明显的靶向性治疗优势和价值，并且碘 131 还可以用于标记多种化合物，在临床中的肝、胆、肾等器官疾病的 诊断过程中均有运用，为了碘 131 在治疗中的价值和作用得到全面发挥，就需要注重辐射防护方法的应用。本研究针 对碘 131 治疗期间辐射防护方法的研究进展进行了系统研究和分析，目的在于提升碘 131 治疗效果和辐射防护效果。     

A fatal case of seronegative,late-onset systemic lupus erythematosus presenting with motor sensory axonal polyneuropathy

Abstract

Systemic lupus erythematosus is a multisystemic, autoimmune, inflammatory disorder predominantly affecting young females. Its onset may be abrupt or insidious, presenting with a broad range of clinical and immunological features. We report an unusual case of elderly-onset systemic lupus erythematosus in a woman initially diagnosed with discoid lupus, and subsequently admitted to hospital due to a progressive psycho-motor deficit. Electrophysiological measurements suggested a diagnosis of acute motor sensory axonal neuropathy. Unusual clinical features and negative serology led to diagnostic uncertainty. This case report offers information on the course of the disease through the entire chain of the health care delivery (from primary to tertiary). Despite the efforts of the hospital staff, it was not possible to save the life of the woman.     

2008-2017年广东省职业性放射性疾病诊断情况分析

目的 了解广东省职业性放射性疾病的诊断情况，分析职业接触特点和职业接触关键控制点。方法 对2008-2017年广东省内申请职业性放射性疾病的35个病例进行分析。结果 诊断为职业性放射性疾病的有10例，其中职业性放射性肿瘤8例，诊断时年龄M（P0~P100）为62.5（42~76）岁，放射工龄M（P0~P100）为27.5（5~33）年，病因概率PC值在26.34%~97.98%之间，PC值95%可信限上限均大于50%，75%的病例为井下矿石与矿物处理工作者，职业中同时接触α、β、γ射线。急性放射性皮肤损伤2例，职业中接触X、β射线，2人均为意外受照，且无法估算出两人确切的受照剂量。结论 部分用人单位和放射工作人员的知识、技术水平、防护意识还有待进一步提高，建议加强辐射防护培训，尤其是上岗前培训。