温哥华量表在90Sr治疗瘢痕疙瘩中的应用

目的 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,推断治疗效果,合理选择适应症.方法 选取2008年1月至2013年1月在本院皮肤科及外科门诊确诊的瘢痕疙瘩患者105例,按照温哥华瘢痕量表根据色泽、厚度、血管分布、柔软度进行评分,分为两组(A组0～8分,B组9～15分),采用90Sr同位素敷贴治疗,治疗后随访6 ～12个月,进行疗效评价.结果 在131例瘢痕疙瘩患者中,痊愈率48.09％;好转率51.91％;总有效率100％.其中A组剂量30.12±3.15Gy,痊愈率62.69％,不良反应发生率16.42％.B组剂量44.16±5.56Gy,痊愈率32.81％,不良反应发生率48.48％.经spssl6.0统计学软件处理,差异有统计学意义.结论 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,根据量表评分来选择合适患者治疗,是一种简单、有效且较为准确的方法.     

经皮导管动脉化疗栓塞联合碘^125放射粒子植入治疗中晚期原发性肝癌的疗效

【目的】探讨经皮导管动脉化疗栓塞(TACE)联合碘^125放射粒子植入治疗中晚期原发性肝癌患者的临床疗效。【方法】本院收治的100例中晚期原发性肝癌患者根据治疗方法分为联合组55例(TACE联合碘^125放射粒子植入治疗)和TACE组(单纯使用TACE治疗)45例;比较两组患者的疗效、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甲胎蛋白(AFP)、总胆红素(TBIL)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、基质金属蛋白酶9(MMP9)及毒副反应。【结果】联合组患者的完全缓解(CR)+部分缓解(PR)率为65.45%,高于TACE组的46.67%(P<0.05);治疗前两组患者的血清各相关指标水平比较差异无显著性(P>0.05);治疗后,联合组患者的A FP、NGAL、MMP9水平均低于TACE组(P<0.05);联合组的恶心、腹痛发生率显著高于TACE组(P<0.05);联合组的呕吐、腹泻、肝功能损害发生率与TACE组比较差异无显著性(P>0.05);联合组的中位生存时间(14.0个月)长于对照组(9.0个月)(P<0.05)。【结论】TACE联合破^125放射粒子植入治疗中晚期不能手术的肝癌患者较单纯的TACE手术具有更好的疗效,但是可能会增加毒副反应发生率。     

胰腺癌放射性核素内照射治疗现状及进展

胰腺癌是恶性程度高、进展迅速、预后极差的消化系统肿瘤,早期诊断困难,多数患者发现时已属晚期,失去手术治疗的机会,只能采取放化疗等辅助治疗手段来缓解症状及控制疾病。近年来随着放射性核素内照射治疗的不断发展,治疗策略的不断更新,其在胰腺癌的治疗中的作用越来越受到重视,笔者就其在胰腺癌治疗中的进展进行综述。     

改良直接注射法在SPECT显像应用的探讨

目的:探讨改良直接注射法在SPECT显像应用的效果。方法:将100例进行SPECT显像的患者,随机分成两组,用传统直接注射法和改良直接注射法注射99mTc-标记化合物。测量医护人员完成操作时间和注射器内放射性残留量。结果:传统直接注射法残留放射性活度明显高于改良直接注射法(P<0.01),而两者操作时间差异无统计学意义(P>0.05)。结论:改良直接注射法能显著减少注射器内放射性显像剂残留,保证SPECT检查质量。     

化学镀法制备32P放射性支架预防血管成形术后再狭窄的实验研究

目的：评价^32P放射性支架对兔髂动脉狭窄的预防作用。方法：以化学镀法制备^32P放射支架，与普通支架配对后，随机植入兔双侧髂动脉，于术前、术后即刻及术后30d血管造影观察动脉狭窄程度，病理组织学观察内膜面积及管腔内径的变化。结果：术后30d，两种支架植入后的动脉最小腔径（MLD）均较术后即刻显著减小，放射性支架组的MLD显著大于对照组（P＜0．01），而其后期丢失、丢失指数、狭窄程度3项指标则显著小于对照组（P＜0．01）。两种支架植入均使血管内膜增生；放射性支架侧血管管腔面积显著大于对照侧（P＜0．05），而其新生内膜面积显著小于对照侧（P＜0．01）。两种支架植入后对支架边缘部位均无影响。结论：化学镀法制备的新型32P放射性支架安全有效，较低的放射活度即可有效防止支架内狭窄；短球囊扩张支架可能会避免边缘部位狭窄的发生。     

~(125)I放射性粒子植入并外照射治疗NSCLC近期效果

目的 探讨 125I放射性粒子(125I粒子)植入联合外照射治疗非小细胞肺癌的放射剂量、安全性和近期疗效.方法 对经病理学确诊的12例非小细胞肺癌病人(12例均为周围型,腺癌7例,鳞癌5例;6例为初治)应用125I粒子植入联合外照射治疗.术前经三维立体定向125I粒子植入放射治疗计划系统(TPS)制定治疗计划,根据TPS结果计算所需 125I粒子数和布源方法.在CT引导下经皮穿刺组织间植入125I粒子,内照射剂量为90～100 Gy.术后应用TPS进行剂量验证.4周左右复查胸部CT,观察肿瘤退缩情况,并开始给予外照射(6 MV的X线常规放疗)治疗,50～60 Gy/(25～30)次.结果 125I粒子植入术后4周,肺部肿瘤部分退缩者10例,稳定2例,未观察到完全消退者.12例病人接受外放射治疗后随访6～16个月,每3个月左右复查胸部CT,结果肿瘤完全消退者6例,部分退缩6例,长期生存率在随访中.12例病人接受125I粒子植入术中发生少量气胸者1例;术后4例出现咳血痰,给予止咳和止血药物后1～2 d症状消失;粒子局部脱落者1例.外放射治疗后3个月复查胸部CT,发生肺放射性损伤0级者1例,Ⅰ级者6例,Ⅱ级者1例.结论 125I粒子植入联合外照射治疗非小细胞肺癌是一种有效的方法,且肺放射性损伤程度低,值得进一步扩大病例研究.     

Increased risk of primary hypothyroidism in preterm infants

Serum levels of thyroid stimulating hormone, thyroxine, triiodothyronine, free T4, thyroxine-binding globulin, reverse T3, and the TSH secretory areas and peak T3 after intravenous injection of 40 micrograms thyrotropin-releasing hormone were determined weekly from day 5 to 6 to 11 weeks of age in 42 unselected full-term and 61 preterm Belgian infants. The results on day 5 indicated a progressive deficit of thyroid function related to the degree of prematurity. In 92 infants this deficit progressively decreased with age and disappeared at 5 to 7 weeks. However, 11 infants developed biochemical evidence of overt but transient hypothyroidism. Belgian neonates are relatively iodine deficient, and this factor affects the constitution of iodine stores within the thyroid gland: (1) the urinary concentrations of iodine in the 103 infants studied in Belgium were markedly lower than in 30 infants from California; and (2) The iodine concentration of the thyroid gland in preterm infants who died during the 10 first days of life was almost three times lower in Brussels than in Toronto. The results indicate that, in Belgium, the effects of relative iodine deficiency on thyroid function are superimposed on and mask the physiologic state of tertiary hypothyroidism in prematurity.     

超声引导下32P胶体注射治疗甲状腺良性病变的临床研究

目的：探讨超声引导下^32P胶体注射治疗甲状腺腺瘤和腺瘤囊性变的可行性和治疗效果。方法：采用稀释浓度为37－74MBq/1.0-1.5ml和18．5－37MBq/ml的两种注射液,按病变的体积调整剂量,分别对38例甲状腺腺瘤和30例腺瘤囊性变进行超声引导下^32P胶体注射治疗。68例患者术前均经超声检查确诊,同期甲状腺扫描对照,病理穿刺证实。治疗前后均作血清FT3,FT4,TT3,TT4及TSH,血常规检查,其结果进行对比。32例随访6－36个月评价其治疗结果。结果：甲状腺腺瘤治愈率71．1％（27／38）,腺瘤囊性变治愈率86．7％（26／30）。甲状腺腺瘤囊性变的治疗效果优于甲状腺腺瘤。治疗前后血常规、甲状腺激素检查结果对比差异无显著意义。所有病例均未出现明显副反应。结论：超声引导下^32P胶体注射治疗甲状腺腺瘤和腺瘤囊性变疗效显著,方法简便安全,在临床上具有重要的实用价值。     

Radionuclide accumulation in near-shore sediments along the Bulgarian Black Sea coast

The accumulation of radionuclides in Black Sea marine ecosystems was investigated by low level gamma spectrometry. Artificial as well as natural radionuclides were determined in bottom sediments samples from 35 reference locations along the Bulgarian Black Sea coast, evenly distributed from the Rumanian to the Turkish border including the main Black Sea resorts and rivers. The measurement of radionuclides in sea bed sediments was carried out during six consecutive seasons using a HPGe detector. The data obtained show that the nuclide concentrations depend strongly on the sediment nature. Results for sandy sediments are within close range, while those for slime and silt vary to a much greater extent. The radionuclide content in the sandy sediments of the main Black Sea resorts is at the lowest limit of the determined values. Small seasonal changes of radionuclide concentration in sandy sediments were observed while greater variations in slime and silt occur. From the data obtained ¹³⁴Cs/¹³⁷Cs and ¹³⁷Cs_meas/¹³⁷Cs_Chern ratios are calculated to determine the Chernobyl part of the measured ¹³⁷Cs. The activities determined in the sediments for natural radionuclides correspond to those cited in the literature for natural levels, showing no additional anthropogenic contamination. A data base for the nuclide concentration values was created which will enable the modeling of radionuclide transfers by estimation of their concentration variations, accumulation and influence on the marine ecosystems.