骨髓间充质干细胞防治多脏器衰竭

Objective The patients with lethal irradiation after sucessful hematopoietic stem cells transplan-tation had blood recovery, but did not avoid to died of multiple organ failure(MOF). To overcome the block, the article investigated mechanisms of mesenchymal stem cells (MSCs) protecting lethal radiated mice from multiple organ failure after haploid bone marrow cells transplantation. Method BALB/c mice irradiated with 8Gy60COγ-rays were randomly divided into two groups: MSCs group, infused MSCs labeled with cm-DiI and bone marrow monocytes of CB6F1 mice; Control group, only infused bone marrow monocytes; normal group, mice were infused cm-DiI marked MSCs without irradiation. The distribution of MSCs and the serous densities of Il-2, Il-10 and TNF-α in the recipients were observed after transplantation. Results MSCs collected in the bone marrow and the intes-tine in normal group at 15 d,in MSCs group MSCs enriched the different organs at 3,15 and 30 d. MSCs regulated down the secretion of IL-2 and TNF-α,and up the IL-10 density. Conclusions MSCs protected mice from multiple organ failure through above effects and may be open a new treatment strategy on acute radiation syndrome by stem cells.     

骨髓间充质干细胞防治多脏器衰竭

Objective The patients with lethal irradiation after sucessful hematopoietic stem cells transplan-tation had blood recovery, but did not avoid to died of multiple organ failure(MOF). To overcome the block, the article investigated mechanisms of mesenchymal stem cells (MSCs) protecting lethal radiated mice from multiple organ failure after haploid bone marrow cells transplantation. Method BALB/c mice irradiated with 8Gy60COγ-rays were randomly divided into two groups: MSCs group, infused MSCs labeled with cm-DiI and bone marrow monocytes of CB6F1 mice; Control group, only infused bone marrow monocytes; normal group, mice were infused cm-DiI marked MSCs without irradiation. The distribution of MSCs and the serous densities of Il-2, Il-10 and TNF-α in the recipients were observed after transplantation. Results MSCs collected in the bone marrow and the intes-tine in normal group at 15 d,in MSCs group MSCs enriched the different organs at 3,15 and 30 d. MSCs regulated down the secretion of IL-2 and TNF-α,and up the IL-10 density. Conclusions MSCs protected mice from multiple organ failure through above effects and may be open a new treatment strategy on acute radiation syndrome by stem cells.     

HLA半相合骨髓移植治疗极重度骨髓型急性放射病（附两例报告）

１９９０年６月２５日，上海发生一起钴辐射事故，７人在短时间内受到大剂量、高剂量率、相对均匀的γ线照射。其中两例受照剂量达１１Ｇｙ和１２Ｇｙ，诊断为极重度骨髓型急性放射病。两例在紧急情况下分别于受照后第７天和第１１天进行了ＨＬＡ半相合的骨髓移植（ＢＭＴ）。其中一例５３岁，骨髓完全植活，造血重建，并成功防治了急性移植物抗宿主病，但于照后第９０天死于间质性肺炎。另一例５６岁，于受照后第２５天死于肺部出血和深部真菌感染。作者对事故性放射病骨髓移植的适应证、追加预处理等问题进行了讨论。     

Toll样受体5激动剂CBLB502蛋白的辐射防护作用

目的研究CBLB502蛋白辐射防护作用。方法 HCT116细胞经CBLB502刺激后,Western印迹法检测NF-κB入核,碱性磷酸酶报告基因法检测CBLB502对NF-κB报告基因的激活。150只C57BL/6J小鼠接受8.0 Gy60Coγ射线照射前随机分为PBS,WR2721,CBLB502 0.02、0.05和0.2 mg/kg共5组,观察小鼠受照后30 d存活率和平均生存时间。另外40只小鼠接受6.5 Gy60Coγ射线照射前随机分为PBS、WR2721、CBLB502 0.2 mg/kg组和正常对照组,照射前1 d和照后30 d内检测外周血细胞。结果 CBLB502可明显促进HCT116细胞NF-κB入核（P〈0.01）并呈剂量依赖性激活NF-κB报告基因（r=0.998 3）。CBLB502显著提高8.0 Gy60Coγ射线照射后小鼠的存活率,PBS,WR2721,CBLB502 0.02、0.05和0.2 mg/kg组小鼠照后30 d存活率分别为0、83.3%、13.3%、66.7%和100%;照射后小鼠平均存活时间除0.02 mg/kg给药组与PBS对照相比无差异外,其余各给药组较PBS对照组有显著提高。6.5 Gy60Coγ射线照射后小鼠外周血白细胞、红细胞、血红蛋白和血小板急剧下降,CBLB502 0.2 mg/kg组上述指标降低持续时间较照射对照组明显缩短,开始恢复时间提前,各指标最低值亦明显高于照射对照组。结论 CBLB502蛋白具有体外生物学活性并对急性放射病小鼠有明显的辐射防护作用。     

战时急性放射病并发感染的防治对策

急性放射病是机体受到大剂量射线后发生的全身性疾病。战时主要为核武器侵袭后,人体受到大量γ、Х射线辐射引起。主要临床症状有造血功能障碍、外周血全血细胞减少、出血症候群发生、免疫功能低下、胃肠道症状、性腺功能障碍以及感染等。其中,感染是急性放射病最常见的严重并发症之一,也是造成伤员死亡的重要原因。如何正确认识和有效预防伤员的各种感染,对最大限度减少致死、致残率具有重大意义。     

亚急性放射病2例临床报告

目的报道2名儿童意外受192Ir迁延照射数月的诊治经过。方法 依据临床表现,生物、物理剂量估算及化验检查,综合分析明确诊断。加强对症、支持治疗,全面检查各项相关指标。结果经多单位估算,病例“A”相当于一次受照剂量1．48～2．2Gy,病例“B”相当于一次受照剂量0．66—1．08Gy,均存在稳定性畸变和非稳定性畸变。经过综合治疗后病情平稳。结论 两例均明确诊断为亚急性放射病,各项指标均提示需密切关注其潜在的远后效应。     

rhIL—6促进血小板恢复的优化应用条件的研究

目的：研究不同给药条件对ｒｈＩＬ－６药效的影响，优化给药方式。方法：以γ射线照射６．５Ｇｙ的ＬＡＣＡ小鼠为造血系统损伤模型，分别按不同的给药途径（皮下或腹腔注射）、每日次数（每天１次或分２次给药）、每日剂量（５００μｇ·ｋｇ－１·ｄ－１×４，２５０μｇ·ｋｇ－１·ｄ－１×８）和开始治疗时间（照后３０ｍｉｎ、１２ｈ、２４ｈ和７２ｈ）等给ｒｈＩＬ－６，观察照后第１１、１４、１８和２２天外周血细胞数的变化。结果：发现ｒｈＩＬ－６采用每日２次皮下注射给药时血小板数显著高于对照组，亦高于每日１次皮下注射组和每日２次腹腔注射组；在有效剂量范围内和总给药剂量相同时，降低每日给药剂量相应延长给药时间并不降低ｒｈＩＬ－６的药效；ｒｈＩＬ－６不同开始治疗时间各组血小板（ＰＬＴ）升高幅度依次为照后１２ｈ、３０ｍｉｎ、２４ｈ和７２ｈ，其中２４ｈ前３个给药组血小板数比对照组升高有统计学意义。结论：ｒｈＩＬ－６促血小板生成较佳的条件是在照射后２４ｈ内（最好在照后１２ｈ）给药，每日２次皮下注射；当给药剂量较大时，可采用减少每日剂量，延长给药时间方案，以减少副作用     

日本东海村核转化工厂临界事故：患者B、C的临床综合治疗

1999年9月30日日本茨城县东海村核转化工厂发生了临界事故，事故经过和剂量估算已经在相关文章中进行了详细的介绍。本文主要介绍事故病人B和C的临床综合治疗。     

急性放射病早期临床分类诊断的一种新方法

这一方法是将急性放射病复杂的临床症状和体征归为4类，并引入半定量的方法综合评估。以此推断患整体的损伤程度；通过多次反复评估，判断患主要器官和系统的损伤程度，了解其病程的发展特点和全身状况：评估结果可指导救治计划的制订、治疗措施的选择和预后的判断，也可用于对患病程和治疗过程的回顾性研究。