吉林192Ir放射事故患者局部急性放射损伤病理改变

目的观察一例大剂量全身极不均匀照射急性放射损伤患者数处局部病理改变。方法病理常规切片染色，光镜检查。结果吸收剂量右下肢为３７３８Ｇｙ，左手掌为８３０Ｇｙ，于照射后第８天行右下肢、左前臂截肢术。右手、左膝照射剂量相对较小但难以准确估计，红斑、水肿、水疱、溃疡出现相对较晚，于第５５天行右手指、左膝清创植皮术。镜下：右小腿局部皮肤和皮肤附属器官、皮下组织和骨胳肌广泛地坏死和弥漫性出血，但真皮中的立毛肌尚存；左手指、手掌皮肤表皮细胞空泡变性、坏死，并形成大小不一的囊泡，致使表皮与真皮分离，真皮弥漫性出血、中性粒细胞浸润，汗腺上皮细胞变性、坏死，皮下组织内弥漫性出血，少数脂肪细胞坏死。胫骨、腓骨上端和股骨、桡骨、尺骨下端处骨髓腔内造血组织各系细胞均消失。左膝、右手拇指、食指、中指皮肤示急性放射性溃疡。结论大剂量照射导致的急性放射损伤造成大面积、深达肌肉的软组织坏死及骨髓造血细胞消失。     

TiN: A Suitable Coating for Defibrillator Electrodes?

The electrochemical behavior of porous TiN coating for defibrillator electrodes was investigated by in vitro studies. A commercially available Ti patch was compared with a Ti patch coated with a layer of porous TiN. Similarly, the influence of the TiN coating on a Pt/Ir intracardial electrode was tested. Porous TiN coatings were made by reactive sputtering on the plain electrodes. Electrode potential measurements were performed during monophasic anodic and cathodic defibrillator shocks delivering energies between 1 J and 49 J. Porous TiN coating of Pt/Ir coils was found suitable to deliver cathodal pulses, while a plain coil remains recommended for anodic shocks. TiN coating was of benefit for conventional Ti patches. Particularly, in the case of anodic shocks, the TiN layer protected the Ti-mesh from immediate oxidation. However, above 70 anodic shocks of 49 J, the TiN coating underwent oxidation to an oxynitride. An estimated 180 anodic shocks of 10 J could be delivered before TiN oxidation became measurable by increased polarization.     

一例~(192)Ir极不均匀外照射局部极重度放射损伤的临床观察

目的对１例１９２Ｉｒ极不均匀外照射局部极重度放射损伤病人进行临床观察。方法系统观察了病变的临床过程和应用红外线热成像技术测定了损伤部位的温度变化。结果照射后２小时出现肢体麻木、抽搐，最早照后４小时出现红斑、肿胀，５４小时出现水疱，第５天出现坏死和剧痛，最晚出现红斑、肿胀是照射后４１天，４７天出现水疱和糜烂创面。红外线热成像显示：损伤早期温度升高，水疱、坏死区和损伤后期温度降低，温度升高越早，损伤越重，温度改变区域与损伤范围相一致。结论大剂量极不均匀外照射放射损伤的初期反应早，放射病与局部损伤相互加重病情，症状先后不一，轻重不等，致残率高和疼痛剧烈，红外线热成像温度变化可以作为临床诊断的指标之一。     

Anti-idiotypic antibodies specific for HLA in heart and kidney allograft recipients

Chronic rejection is the major threat to both heart and renal allograft survival. We have explored the possibility that some patients with anti-donor HLA antibodies (Ab1) develop specific anti-idiotypic antibodies (Ab2) which suppress the production of Ab1, and subsequently, the progression of chronic rejection. analysis of Ab2 in sera obtained from Ab1 producers showed that 22% of heart and 18% of kidney recipients produced Ab2. The 4- and 5-year actuarial graft survivals in Ab2 producers were 100% and 83%, respectively, compared to 57% in patients who formed Ab1 but not Ab2 (p<0.004). Patients carrying the DR2 alleles, DRB1*1501,*1502 or*1601 were at a lower risk of producing anti-donor HLA antibodies.     

PON1Q192R基因多态性与冠心病患者使用氯吡格雷疗效的关系

目的：探讨不同民族PON1Q192R等位基因变异频率以及PON1Q192R基因多态性与冠心病患者氯吡格雷抵抗（CR）的关联性。方法：纳入新疆医科大学第二附属医院2020年1月至2020年12月使用氯吡格雷且诊断为冠心病的患者127例,患者每日服用氯吡格雷75 mg,5 d后用血栓弹力图测定相关参数,并进行CYP2C19*2、CYP2C19*3、CYP2C19*17和PON1Q192R基因分型检测。结果：不同民族之间PON1Q192R基因突变频率差异具有统计学意义（P <0.05）,患者的血栓弹力图参数结果显示,PON1Q192R基突变并不会显著降低氯吡格雷疗效。结论：PON1Q192R基因突变频率与冠心病患者氯吡格雷反应的相关性还需要进一步研究。     

“Buchler”后装机在临床应用的评估(附宫颈癌135例五年疗效分析)

本文从临床角度对Buchler机的放射源和剂量学上进行初步评估,认为尚有不足之处,另总结1983年10月至1985年3月应用高剂量率Buchler机合并~(60)钴或9 Mev直线加速器对分期为Ⅱ、Ⅲ期的宫颈癌135例进行根治性放射治疗,其五年生存率分别是85.25％(52/61)和68.92％(51/74)全组五年生存率为76.03％(103/135)。     

Combined lesions of cholinergic and serotonergic neurons in the rat brain using 192 IgG-saporin and 5,7-dihydroxytryptamine: neurochemical and behavioural characterization

This study assessed behavioural and neurochemical effects of i.c.v. injections of both the cholinergic toxin 192 IgG-saporin (2 microgram) and the serotonergic toxin 5,7-dihydroxytryptamine (5,7-DHT; 150 microgram) in Long-Evans female rats. Dependent behavioural variables were locomotor activity, forced T-maze alternation, beam walking, Morris water-maze (working and reference memory) and radial-maze performances. After killing by microwave irradiation, the concentrations of acetylcholine, monoamines and 5-hydroxyindoleacetic acid (5-HIAA) were measured in the hippocampus, frontoparietal cortex and striatum. 192 IgG-saporin reduced the concentration of acetylcholine by approximately 40% in the frontoparietal cortex and hippocampus, but had no effect in the striatum. 5,7-DHT lesions reduced the concentration of serotonin by 60% in the frontoparietal cortex and 80% in the hippocampus and striatum. Noradrenaline was unchanged in all structures except the ventral hippocampus where it was slightly increased in rats given 192 IgG-saporin. Cholinergic lesions induced severe motor deficits but had no other effect. Serotonergic lesions produced diurnal and nocturnal hyperactivity but had no other effect. Rats with combined lesions were more active than those with only serotonergic lesions, showed motor dysfunctions similar to those found in rats with cholinergic lesions alone, and exhibited impaired performances in the T-maze alternation test, the water-maze working memory test and the radial-maze. Taken together and although cholinergic lesions were not maximal, these data show that 192 IgG-saporin and 5,7-DHT lesions can be combined to selectively damage cholinergic and serotonergic neurons, and confirm that cholinergic-serotonergic interactions play an important role in some aspects of memory, particularly in spatial working memory.     

192Ir-HDR放疗合并外照射治疗口腔癌报道

目的 探讨早、中期口腔癌应用外照射合并^192Ir—HDR后装放疗的疗效。方法 对16例早、中期口腔癌患者，首先给^60Co或6MV—X加速器外照射，外照总剂量为Dt46～56Gy，23～28次，4～6周。外照结束后1周，给^192Ir—HDR后装组织插植或肿瘤表面贴敷放疗，参考点剂量为Dt18～32Gy,2～5次，3～15天,间隔1～5天。结果 5年生存率为81．3％，无严重的放射后遗症。结论 对早、中期口腔癌，就用外照射合并^192Ir—HDR后装放疗疗效与手术疗效相似，无严重的放射后遗症，且患者能保持外观和正常组织功能，提高了病人生存质量。     

192Ir核素脑瘤间质内照射的动物实验与病理学观察研究

目的观察用１９２Ｉｒ后装机对脑瘤行间质内照射的生物学反应与疗效。材料与方法选用Ｇ４２２皮下荷瘤小鼠模型作照射后肿瘤生长抑制试验及Ｃ６胶质母细胞瘤脑内荷瘤模型作照射后小鼠存活期延长试验，并进行病理学观察。各设２．５Ｇｙ，１０Ｇｙ及对照３个组进行。结果照射后１４天Ｇ４２２皮下肿瘤体积：对照组，２．５Ｇｙ组和１０Ｇｙ组分别为８．３４±１．９８ｃｍ３，５．７３±３．９３ｃｍ３和１．００±１．９ｃｍ３，３组间有显著差异。Ｃ６脑内荷瘤照射后其存活期明显延长，病理学证明照射后瘤组织发生各时相的凋亡与坏死。结论用１９２Ｉｒ行脑胶质瘤间质内照射是治疗脑深部肿瘤的一种可供选择的有效方法     

1例192Ir源致外照射轻度骨髓型急性放射病的临床观察与随访

目的 对2005年哈尔滨"7.13"¹⁹²Ir源放射事故受照者1例进行临床观察与12年的医学随访，探讨外照射轻度骨髓型急性放射病的临床治疗及远后效应。方法 详细采集患者病史，收集临床资料，从血液系统改变、心理健康等方面进行总结，评价治疗效果，观察远后效应。结果 早期治疗后，患者造血系统改变、心理创伤、无力综合征、神经衰弱综合征均有所改善，受照后第10年患者开始出现粒系、红系、巨核细胞系同时减少，受照后第13年被诊断患有分离转换障碍，病程中还伴有心力衰竭、肝功异常、免疫力低下、神经衰弱等疾病。治疗后可缓解症状，但易反复。结论 本例轻度骨髓型急性放射病在临床表现与远后效应上有其独特的疾病特点，并发症较多，为今后此类疾病的临床救治提供了参考。