重组人粒细胞集落刺激因子对照射小鼠造血功能的影响

为研究重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）对急性放射病的治疗作用，观察了不同剂量的ｒｈＧ－ＣＳＦ对６．５Ｇｙ照射小鼠造血恢复的影响，结果表明，予受照小鼠每日ｒｈＧ－ＣＳＦ１．２５、２．５０及５．００μｇ治疗后，外周血白细胞，红细胞及血小板的恢复明显加快，以５．００μｇ剂量组效果为最佳，照射后１０ｄ骨髓及脾脏ＣＦＵ－ＧＭ，暴增型红系祖细胞集落（ＢＦＵ－Ｅ）及混合型祖细胞集落（ＣＦＵ－Ｍｉｘ）含     

5例医源性急性放射损伤的临床观察

５例医源性急性放射损伤的临床观察张淑兰，贾廷珍，李智华，王良绪，税朝祥，孙玲华为了积累对急性放射病的临床经验，我们利用自体外用血造血干细胞移植（ＡＢＨＣＴ）前大剂量全身照射（ＴＢＩ）预处理这一条件，对５例白血病患者ＴＢＩ前后的临床表现做了较系统的观察...     

医源性急性放射病的临床观察

目的观察医源性急性放射病的临床特点和治疗经验，为事故性放射病的救治提供依据。方法观察１７例经大剂量照射预处理的ＰＢＳＣＴ患者外周血象、体温和症状。结果照后第８～１２天，ＷＢＣ均值＜１×１０９／Ｌ，未用Ｇ－ＣＳＦ者白细胞持续此低值至１３．３天，２９％的患者体温＞３８．５℃，经无菌处理和强有力的抗感染治疗，患者均能平稳渡过骨髓抑制期而不出现典型的急性放射病极期表现。结论回输自体外周血干细胞和应用Ｇ－ＣＳＦ以缩短骨髓重建时间，严格实行全环境保护和及时、联合、足量应用抗生素的原则是ＰＢＳＣＴ患者能够顺利渡过放射病极期，较少合并症的关键     

重组人粒细胞集落刺激因子对6.5Gy不均匀照射狗造…

观察了重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）对屏蔽全骨盆后６．５Ｇｙ＾６０Ｃｏγ射线照射狗的治疗作用。结果表明，ｒｈＧ－ＣＳＦ可使急性放射病狗造血恢复明显提前，恢复速度加快。     

重组人粒细胞集落刺激因子对6.5Gy不均匀照射狗造血影响的研究

观察了重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）对屏蔽全骨盆后６．５Ｇｙ６０Ｃｏγ射线照射狗的治疗作用。结果表明，ｒｈＧ－ＣＳＦ可使急性放射病狗造血恢复明显提前，恢复速度加快。     

rhG─CSF对6．5Gy照射小鼠近期及远期造血恢复作用的影响

为了观察重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）对机体长期造血功能恢复的影响，设计了二次照射小鼠模型，即首次γ线照射后给予不同剂量的ｒｈＧ－ＣＦＳ治疗，待外周血细胞恢复正常后（照后４５ｄ），给予等剂量第二次照射，照后不再接受任何治疗，观察前后两次照射后外周血细胞的恢复和活存率的改变。结果发现首次照射后各治疗组小鼠外周血ＷＢＣ、ＲＢＣ及血小板恢复时间提前，恢复速度加快，ＲＢＣ及血小板谷值升高。第二次照射后尽管各观察组小鼠外周血ＷＢＣ、ＲＢＣ及血小板的恢复均较缓慢，但原ｒｈＧ－ＣＳＦ治疗组小鼠外周血恢复速度仍明显快于对照组，恢复时间也明显提前，其中以２．５及５．０μｇ剂量组效果最佳，１．２５、２．５和５．０μｇ组小鼠３０ｄ活存率分别比对照组提高６％、４０．５％和４４．２％，后两组均明显高于对照组（Ｐ＜０．０５或０．０１）。表明ｒｈＧ－ＣＳＦ不仅能促进受照小鼠近期造血功能的恢复，而且照后早期给药对照射小鼠长期造血功能也有保护作用     

rhG-CSF在一例急性放射病治疗中的应用

ｒｈＧ－ＣＳＦ在一例急性放射病治疗中的应用陈虎王桂林罗庆良胡亮钉江岷秦茂权夏贞彪近１０年来，重组人类造血生长因子（ｒｈＨＧＦ）的基础与临床应用研究不断深入，其中具有代表性的粒－巨噬细胞集落刺激因子（ｒｈＧＭ－ＣＳＦ）、粒系集落刺激因子（ｒｈＧ－ＣＳＦ...     

胎肝基质细胞强化骨髓移植治疗急性放射病

目的为进一步提高骨髓移植效果。方法以昆明种小鼠急性放射病为模型，进行了胎肝基质细胞强化同种异基因骨髓移植，观察了小鼠造血重建、急性移植物抗宿主病（ＧＶＨＤ）及小鼠存活率。结果胎肝基质细胞移植可强化骨髓移植效果，与单纯骨髓移植组比较，于照射后第１１天小鼠外周血白细胞、骨髓有核细胞计数，ＣＦＵ－Ｅ、ＣＦＵ－ＧＭ、ＣＦＵ－Ｆ、ＣＦＵ－Ｓ回升较快，ＣＦＵ－Ｆ已达正常，于照射后第１７天造血得以重建；ＧＶＨＤ较轻，存活率显著提高，达６０％。结论胎肝基质细胞改善了造血微环境，可能既改善了“龛位”，又增加了“龛位”使干细胞更多的植入，促进了造血重建，提高了骨髓移植效果，是一种“种子与土壤”并重的移植新方法。     

一例中度骨髓型急性放射病合并局部极重度放射性损伤病人的临床报告

目的通过对１９９６年１月５日吉林市发生的一起辐射事故病人“文”的救治，对急性放射病合并局部极重度放射性损伤诊断与救治提供新经验。方法通过物理模拟试验、染色体畸变分析、淋巴细胞微核率及局部组织ＥＳＲ的检测，估算全身受照射剂量及局部不同部位受照射剂量，并通过临床症状、造血系统等临床资料综合分析，确定了损伤程度。结果全身受照后吸收剂量（红骨髓干细胞存活计权等效剂量）为２．９±０．３Ｇｙ，右下肢最大吸收剂量达３７３７．８Ｇｙ。照后２小时５０分出现频繁的恶心呕吐。照后第１～２天淋巴细胞计数为０．９～０．４×１０９／Ｌ，为保全生命，于照后第８天行右大腿及左手腕截肢术。白细胞、血小板计数于照后第１７天降至最低值（分别为０．６５×１０９／Ｌ及１９×１０９／Ｌ）。照后４～２３天应用ｒｈＧ－ＣＳＦ，极期仅持续５天便进入恢复期。结论本例为中度骨髓型急性放射病合并局部极重度放射损伤，后者又会加重全身急性放射病的病理改变，在治疗中不能忽视对局部损伤的及时处理，早期应用ｒｈＧ－ＣＳＦ有助于造血功能的恢复，心肌酶的检测有助于局部严重放射损伤的判定。     

人基因工程重组超氧化物歧化酶对小鼠骨髓造血干细胞的辐射防护作用

目的：骨髓造血干细胞（ｈｅｍｏｐｏｉｅｔｉｃｓｔｅｍｃｅｌｌ，ＨＳＣ）损伤所致的造血抑制是急性骨髓型放射病死亡的重要原因之一，本实验旨在观察人基因工程重组超氧化物歧化酶（ｒｈＳＯＤ）对ＨＳＣ有无辐射防护作用以及化学修饰对ｒｈＳＯＤ抗辐射作用的影响。方法：实验用照射小鼠的外源性脾结节（ＣＦＵ－Ｓ）形成法。组间比较用ｔ检验。结果：ｒｈＳＯＤ和ＰＥＧ－ＳＯＤ均能明显提高ＣＦＵ－Ｓ形成数，其中ｒｈＳＯＤ在照射前１小时给药效果好，而ＰＥＧ－ＳＯＤ在照射前２～３小时给药作用更为明显。结论：ｒｈＳＯＤ具有对骨髓造血于细胞的辐射防护作用，化学修饰后ＳＯＤ的血浆半衰期延长而使药物作用持续时间延长。     

Helical tomotherapy for total lymphoid irradiation

Total lymphoid irradiation is employed in the preparative regimens for allogeneic bone marrow and solid organ transplantation, solid organ transplant rejection, and chronic graft-versus-host disease. Linear accelerator-based radiotherapy, typically involving opposed anteroposterior and posteroanterior beams, has been commonly used; however, extended source-to-skin patient setup and/or field matching are required, and all organs within the beam coverage receive the entire prescribed dose. Megavoltage helical tomotherapy represents a technological advance in terms of both treatment delivery and patient positioning. The continuously rotating multileaf collimated fan beam allows highly conformal coverage of complex target geometries, in turn allowing avoidance of radiosensitive adjacent organs. In addition, the megavoltage computed tomographic scans allow potentially more accurate, targetbased setup verification. The present case report describes tomotherapy-based total lymphoid irradiation in an adult patient with late-onset cardiac transplant rejection. Treatment planning allowed dose minimization to the spinal cord, kidneys, intestinal compartment, and lungs. The patient tolerated treatment well without acute adverse effects, and he is now in early follow-up.     

Physical problems of total body irradiation

In the concept of combined treatment of acute leukemias the whole body has to be irradiated as precisely and homogeneously as reasonably achieveable. In fulfillment of these radiobiological requirements, total body irradiation (TBI) means a very special challenge to medical physicists. Very large, uniform high energy photon beams have to be realized and applied. The dose at any relevant reference point has to be determined, regarding all influences of the TBI treatment situation. The dose distribution has to be modified - if necessary - verified and recorded. The lungs - the vital organs at risk in TBI - have to be shielded to tolerable doses. Optimization of TBI demands to understand all physical limitations and to utilize all technical possibilities. These physical problems encountered with TBI dosimetry, treatment planning and treatment performance are discussed.     

Dosimetric problems associated with total body irradiation

Total body irradiation (TBI), which is carried out with high energy photons at large source distances and with large fixed fields, involves special dosimetric requirements. The dose measurements published thus far on anthropomorphic phantoms have shown that deviations from the dose values calculated with "normal" dose functions occur as a result of completely different scatter radiation distributions. The higher the photon energy selected, the more slight these deviations become.     

Modelling hematological parameters after total body irradiation

Abstract

Purpose: The time- and dose-dependent reconstitution of hematopoiesis after radiation exposure is strongly related to the stem cell population and can be used to predict hematological parameters. These parameters allow further insight into the hematopoietic system and might lead to the development of novel stem cell transplantation models.

Materials and methods: CD4-/- C57Bl/6 mice, transgenic for human CD4 and HLA-DR3, were irradiated in a single (3, 6, 8 and 12 Gy) and fractionated (6 × 1 Gy, 6 × 1.5 Gy, 6 × 2 Gy; twice daily) dose regimen. Blood was analyzed weekly for red blood cells (RBC), hemoglobin concentration (Hb), hematocrit (HCT) and white blood cells (WBC). Organ and tissue damage after irradiation were examined by histopathology.

Results: The recovery curves for RBC, Hb, HCT and WBC showed the same velocity (< 1 week) for all radiation doses (3–12 Gy) starting at different, dose-dependent times. The only dose-dependent parameter was defined by the beginning of the recovery process (dose-dependent shift) and higher doses were related to a later recovery of the hematopoietic system. The RBC, Hb and HCT recovery was followed by a saturation curve reaching a final concentration independent of the radiation dose. Histological analysis of the bone marrow in the single dose cohort showed a dose-dependent reduction of the cellularity in the bone marrow cavities. The fractioned radiation dose cohort resulted in a regeneration of all bone marrow cavities.

Conclusion: Specific functions were developed to describe the reconstitution of hematological parameters after total body irradiation.     

Physical treatment planning of total body irradiation

The treatment planning of total body irradiations shows partially other problems than conventional treatments. The data refer to long source-skin-distance and large fields, which are even larger than the patient. In most centres, it is aspired to a homogeneous dose distribution. But its importance is not known, at present. The radiobiology has to yield further answers to a lot of questions. This and the clinical results must help to decide, which technique is the best to eliminate leukemic cells and to avoid side effects as interstitial pneumonia.     

全身电子线照射的剂量测量

介绍在Ｖａｒｉａｎ ＣＬｌｉｎａｃ－１８００直线加速器上，采用改进的双机架角１２野照射技术，以６ＭｅＶ电子线治疗一例皮肤恶性淋巴瘤的剂量测量结果和技术方法处理。应用电离室法、热释光法对射野均匀性，皮肤表面剂量进行测量，患者体表剂量分布均匀。临床治疗表明该方法有效可行。