极重度骨髓型急性放射病犬造血恢复的实验观察

3.27～4.19Gy照射所致的重度骨髓型急性放射病犬,经恰当的综台治疗后可以治活,其造血功能可以恢复。同样,部分5.5～7.0Gy照射所致的极重变骨髓型急性放射病犬,也可治活,其造血功能 仍有恢复的可能性。     

实时医监医保决策支持系统数据管理技术研究

目的 对载人航天飞行任务中航天员生理数据及栽人飞行器数据进行实时接收和管理,为实时处理分析、医监医保提供数据支撑.方法 数据存储软件、数据文件和系统数据库共同组成实时医监医保决策支持系统的数据存储子系统,由数据存储软件接收数据,按照任务需求,将数据进行转换后存入系统数据库,或者创建数据文件及其索引.结果 该系统已经经过...     

影像学文档及数据资料计算机管理系统(VMIS)

目的 :设计一套用于快速处理和管理各种影像学诊断文档信息和数据资料的计算机应用程序。方法 :利用影像学诊断的各种文档信息和数据资料 ,通过建立标准和实用的相关数据库的方法 ,采用 FOX数据库系统设计出适用于快速处理影像学诊断文档信息和数据资料的应用软件。结果 :该软件具有存储容量大、可备份保存、标准信息代码库及数据库等功能 ,适用于 CT或 MRI诊断的预约登记、检查申请和诊断报告的快速查询和检索、疾病分类快速检索和统计、诊断报告快速规范地打印、检查经费及日常管理工作量和综合信息的快速统计等工作。结论 :该软件系统采用全屏幕中文显示工作方式 ,操纵简便 ,信息处理和数据统计快速、准确 ,具有较高的实用价值和推广应用价值。     

Out of the Basement and Into the Classroom: Pathways for Expanding the Role of Radiation Oncologists in Medical Student Education

PurposeTo characterize radiation oncologist involvement in undergraduate medical education at US academic medical centers and to incorporate these findings into practical pathways for greater and broader integration of radiation oncology (RO) into medical curricula.MethodsChairpersons and residency program directors at RO departments directly affiliated with a medical school were asked to describe all the ways in which radiation oncologists in their department are involved in medical student education, excluding their elective clerkship.ResultsOf 75 eligible departments, 49 responded (response rate 65.3%). Twenty departments (40.8%) reported that at least one faculty member participates in a curricular educational session on an oncology-related topic. Twelve (24.5%) of these sessions were focused specifically on RO. Twenty-one departments (42.9%) had faculty involved with organized clinical shadowing or preceptorship programs for first- and second-year medical students. Twelve departments (24.5%) described no involvement in the formal curricula at their local or affiliated medical school. Thirteen departments (44.8%) described participation in a medical school–organized residency fair, and 12 departments (41.4%) sponsor an RO interest group. Reported novel approaches to teaching included development of multidisciplinary clerkships or educational sessions that include RO concepts, guest lectures on RO during a required clerkship, organized extracurricular experiences such as an oncology seminar series, participation in special medical student enrichment programs, and sponsorship or initiation of an RO interest group.ConclusionThe minority of RO departments are involved in formal teaching of the medical student body at large. The approaches described herein should facilitate more robust involvement of radiation oncologists in all areas of undergraduate medical education.     

低压氧舱模拟急性高原缺氧动物模型建立的初探

目的模拟高原低压低氧环境建立小鼠急性缺氧模型,探讨不同缺氧时间对小鼠缺氧损伤程度的影响。方法采用国产低压低氧动物实验舱模拟海拔6000 m高原缺氧环境,观察6 h、12 h、24 h、36 h、2 d、3 d、5 d、7 d不同缺氧时间小鼠组织病理学变化情况,并测定血浆LD、LDH和4种ATP酶的变化规律。结果 LD、LDH、T-AOC和ATP酶随缺氧时间的延长而呈波浪式变化,6 h后可见组织形态发生明显改变,LD显著升高,T-AOC显著下降,12 h后LDH显著升高,ATP酶显著下降,说明在此条件下缺氧6～12 h即可复制出急性高原病动物模型。结论该模型为下一步研究急性高原病发病机制提供了有利条件,在高原病防治研究中具有重要意义。     

尼尔雌醇照前多次给药对骨髓型急性放射病小鼠的防护作用及其机制研究

目的 了解抗放药尼尔雌醇照前不同给药方案对⁶⁰Co γ射线照射所致小鼠骨髓型急性放射病的防护效应的影响,并揭示其促造血恢复机制。方法 采用外周血象分析和存活率实验确定尼尔雌醇较优给药方案,再以骨髓造血干/祖细胞表面标志分析、多系骨髓细胞集落及骨髓HE病理切片等方法,分析尼尔雌醇照前2次间隔给药促进照后骨髓造血恢复的作用机制。结果 尼尔雌醇照前3次间隔给药与2次间隔给药均能提高9.0 Gy照射小鼠存活率至100%,明显优于1次给药(20%, χ²=21.66、21.66,P<0.05)。尼尔雌醇照前3次连续给药与2次间隔给药均能改善6.5 Gy照射小鼠外周血白细胞、中性粒细胞、血小板和红细胞的恢复(F=21.33、100.9、49.34、19.19, P<0.05),且比1次给药效果好(F=17.11、63.38、21.89、14.37, P<0.05)。尼尔雌醇2次间隔给药显著提高6.5 Gy照射后小鼠10 d骨髓造血干、祖细胞数(t=8.58、2.80, P<0.05);显著增强小鼠骨髓造血细胞集落形成能力,与1次给药相比,差异有统计学意义(t=4.29、6.34, P<0.05)。同时,2次间隔给药明显改善照射小鼠骨髓象的重建。结论 与传统的照前单次给药相比,尼尔雌醇照前多次给药可显著提升其对小鼠骨髓型急性放射病的辐射防护效果。考虑到核医学应急救援的实际情况,建议尼尔雌醇照前采用间隔1 d的给药方式,在减少尼尔雌醇给药次数情况下,以获得最佳的抗放效果。     

胎肝细胞移植治疗小儿医疗性重度骨髓型急性放射病两例报告

两例重型B一地中海贫血患儿,经环磷酰胺40mg/kg治疗2天后,分别以6.4,6.6Gyγ线全身均匀照射,发生了医疗性重度骨髓型急性放射病。照后4天内使用胎肝移植(FLT)分别移植了4和8个胎肝的细胞悬液,有核细胞总数为17.7×10⁹与15.9×10⁹,辅以抗感染抗出血等垒身支持治疗。两例患儿胎肝造血干细胞均获得了暂时性植活,没有发生严重的移植物抗宿主病(GVHD).虽然胎肝移植后2～3个月均逐渐恢复了重型β-地中海贫血的自身造血,但却成功地治愈了两例患儿的医疗性重度骨髓型急性放射病。术后至今已分别为21和19个月,一般情况良好。     

急性重症胰腺炎61例非手术综合治疗效果分析

目的观察急性重症胰腺炎（serious acute pancreafitis，SAP）非手术治疗的临床效果。方法回顾分析61例SAP临床资料，患者入院后均采用非手术综合治疗。结果非手术综合治疗61例，治愈49例，治疗率80．32％。住院时间11—23d，平均18d。并发胰腺囊肿4例，好转8倒，死亡3例。结论非手术综合治疗SAP有效，能降低并发症及病死率。     

Multi-Institutional Implementation and Evaluation of a Curriculum for the Medical Student Clerkship in Radiation Oncology

PurposeRadiation oncology curriculum development is challenging because of limited numbers of trainees at any single institution. The goal of this project is to implement and evaluate a standardized medical student clerkship curriculum following the multi-institutional cooperative group research model.MethodsDuring the 2013 academic year, a standardized curriculum was implemented at 11 academic medical centers consisting of three 1-hour lectures and a hands-on radiation treatment planning workshop. After the curriculum, students completed anonymous evaluations using Likert-type scales (1 = “not at all” to 5 = “extremely”) and free responses. Evaluations asked students to rate their comfort, before and after the curriculum, with radiation oncology as a specialty, knowledge of radiotherapy planning methods, and ability to function as a radiation oncology resident. Nonparametric statistical tests were used in the analysis.ResultsEighty-eight students at 11 academic medical centers completed the curriculum de novo, with a 72.7% (64 of 88) survey response rate. Fifty-seven students (89.1%) reported intent to pursue radiation oncology as their specialty. Median (interquartile range) student ratings of the importance of curricular content were as follows: overview, 4 (4-5); radiation biology/physics, 5 (4-5); practical aspects/emergencies, 5 (4-5); and planning workshop, 4 (4-5). Students reported that the curriculum helped them better understand radiation oncology as a specialty (5 [4-5]), increased specialty decision comfort (4 [3-5]), and would help the transition to radiation oncology residency (4 [4-5]). Students rated their specialty decision comfort significantly higher after completing the curriculum (4 [4-5] versus 5 [5-5]; P < .001).ConclusionsA national standardized curriculum was successfully implemented at 11 academic medical centers, providing proof of principle that curriculum development can follow the multi-institutional cooperative group research model.     

甲基强的松龙和强的松治疗儿童肾病综合征伴急性肾衰的疗效比较研究

目的:观察儿童肾病综合征合并急性肾功能衰竭的临床特点,比较甲基强的松龙冲击疗法与足量强的松疗法的效果。方法:以1992年6月至2005年12月我院收治的肾病综合征合并急性肾功能衰竭患儿为研究对象,共61例。其中2002年1月至2005年12月共33例,为治疗组,采用甲基强的松龙冲击治疗;1992年6月至2001年12月共28例,为对照组,采用足量强的松口服治疗。结果:两组疗效及尿蛋白阴转时间无显著性差异(P>0.05),预后基本相同,但甲基强的松龙组的副作用及治疗费用较高。结论:甲基强的松龙冲击治疗原发性肾病综合征合并急性肾功能衰竭与口服足量强的松治疗相比,疗效无显著差别,但医疗费用明显增高,且治疗期间可能出现不良反应,需谨慎使用,其有效性及安全性有待进一步研究加以证实。     

《过量照射人员的医学检查与处理原则》解读

《过量照射人员的医学检查与处理原则》已由卫生部批准并发布实施.该标准是在广泛调研和分析国内外文献、汇总我国历次核事故与辐射事故过量受照人员的资料、结合我国的实际情况,遵循国家现行法令、法规,并广泛征求同行专家意见的基础上制定的.该标准规定了适用范围、过量照射(＜1.0 Gy)人员医学检查的必要项目、处理原则.该标准主要用于核事故与辐射事故受照人员医学检查、处理原则及远后效应医学随访原则.为正确地贯彻执行这一标准,更好地指导过量受照人员医学检查及处理,该文对标准中的相关内容进行解读.     

甲基强的松龙剂量对重症SARS患者疗效和不良反应影响

目的 研究注射用甲基强的松龙的应用剂量对重症SARS患者的疗效和不良反应的影响.方法 根据临床确诊37例使用注射用甲基强的松龙重症SARS患者的用药剂量分为3组,描述性分析各组病例基本病情和不良反应.结果 1 000～4 000mg组治疗效果最好,药品不良反应发生率为30%,0～1 000mg组无药物不良反应发生,〉4 000mg组出现明显的高血糖.结论 在重症SARS患者的治疗中,注射用甲基强的松龙虽有着确切的疗效,但同时也是引起药品不良反应的主要因素,掌握好应用剂量对于重症SARS患者的治疗至关重要.     

重症SARS患者应用甲基强的松龙注射剂时机对疗效和不良反应影响

目的　研究甲基强的松龙注射剂的应用时机 ,对重症SARS患者疗效和不良反应的影响。方法　回顾性分析北京市小汤山医院临床确诊的 37例使用甲基强的松龙注射剂重症SARS患者的病情、用药纪录及药品不良反应发生情况 ,根据用药时机分为 3组 ,描述性分析各组病例基本病情、疗效和不良反应。结果　用药时机 >19d组的治愈率高于其他 2组 ,同时死亡率低于其他 2组 ;用药时机 0～ 9d组药物不良反应发生率为 35 .8% ,大于其他 2组 ,出院血糖高于入院血糖。结论　在重症SARS患者的治疗中 ,甲基强的松龙注射剂有着确切的疗效 ,掌握好应用时机对于重症SARS患者的治疗至关重要。     

MIONS-6000医学图文光盘网络系统的开发与应用

本研究在ＰＣ机中文视窗环境下，采用面向对象的程序设计技术，用Ｃ￣（＋＋）和ＦＯＸＰＲＯ及多媒体应用生成工具混合编程。开发了ＭＩＯＮＳ－６０００医学图文光盘网络系统。该系统可对ＣＴ．ＭＲＩ．Ｘ光影像实行实时海量存储。查询医学文件资料２秒内完成，网络建立方便临床医生随时调用。该系统可制做图文声像并茂的多媒体光盘图书教材，实现计算机多媒体辅助教学，强化视听效果，大大提高教与学的效率。该系统对所存有价值病例统计方便，论文实现图文混编。     

氟伐他汀对急性冠脉综合征血清高敏C-反应蛋白及MMP-9的影响

目的探讨氟伐他汀对急性冠状动脉综合征（ACS）血清高敏C-反应蛋白（hs—cRP）及基质金属蛋白酶-9（MMP-9）水平的影响。方法ACS68例,随机分成氟伐他汀治疗组34例,对照组34例,比较各组患者血清hs—CRP、MMP-9水平的变化。结果治疗4周后,氟伐他汀组血清hs—cfuP、MMP-9水平明显低于对照组（P〈0．05）,两组间血脂变化无统计学差异（P〉0．05）。结论氟伐他汀可降低ACS患者血清hs—cRP、MMP-9水平,抑制炎症反应,稳定粥样硬化斑块。     

Therapy for prevention and treatment of skin ionizing radiation damage: a review

Abstract

Radiologic accidents or terrorist acts involving radioactive material, as well as radiation exposure in medical or industrial procedures are potential sources of risk for human health. All these risks share a common element, exposure to ionizing radiation. The extent of ionizing radiation injury will depend on a number of independent variables such as dose, type of radiation and tissue, etc. As a result of ionizing radiation exposure, biological effects can take place in acute or long-term manner. As in the case of other self-renewing tissues (e.g. hematopoietic system and intestinal epithelium), skin is also extremely sensitive to ionizing radiation. In this way, appropriate management of radiation skin effects might improve the therapeutic benefit of medical radiation therapy, as well as reduce the mortality associated with any radiological incident (e.g. accident or terrorist attack). For this reason, current and potential future treatment approaches for skin radiation injury are reviewed in this work. Unfortunately, there is no sufficient evidence for establishing a standard treatment to prevent or mitigate radiation-induced cutaneous injury. Thus, continued research is necessary to achieve effective therapies to address this important health problem.     

Radioprotective and radiomitigative effects of BP-C2, a novel lignin-derived polyphenolic composition with ammonium molybdate,in two mouse strains exposed to total body irradiation

Purpose: There remains an unmet medical need for radioprotective and mitigative agents. BP-C2 is a novel lignin-derived polyphenolic composition with ammonium molybdate, developed as radioprotector/radiomitigator.

Objectives: The present study evaluated BP-C2 for the mitigation of acute radiation syndrome (ARS).

Methods: A total-body irradiation mouse model (TBI, 4.0–8.0?Gy) was used in the study.

Results: In a 30-day survival study, performed in CBA mice, BP-C2, at a dosage of 81.0?mg/kg, improved survival (dose reduction factor (DRF)?=?1.1) and increased the formation of endogenous spleen colony-forming units (CFU). In C57BL/6 mice, BP-C2, when administered daily for 7 days, starting 24?hours after TBI, also improved survival. In animals irradiated with 5.0?Gy, BP-C2 increased the number of CFUs (6.7?±?5.1) compared to the 5.0?Gy placebo group (2.3?±?2.3, p?=?.0245). The number of surviving intestinal crypts was maintained in the 5.0?Gy BP-C2 group (133.7?±?13.9), in contrast to the 5.0?Gy placebo group (124.2?±?10.5, p?Conclusion: BP-C2 mitigates radiation-induced damage in mid-lethal range of radiation doses. Effects are mediated by enhancement of extramedullar hematopoiesis in the spleen and a protective effect on the intestinal epithelium.     

青年肺癌的误诊分析和放化综合治疗

目的 :探讨青年肺癌误诊原因及合理的治疗方案。方法 :回顾性分析 118例青年肺癌的临床表现 ,误诊原因及放化综合治疗的疗效。结果 :(1)临床表现不典型 ,认识不足及影像检查不全面是误诊的主要原因。(2 )肺结核 ,肺炎等是青年肺癌的主要误诊疾病。 (3)放化综合治疗 1、2、3年的生存率为 5 9% (70 / 118) ,41.5 % (49/ 118) ,2 5 .4% (30 / 118)。结论 :掌握青年肺癌的临床特点 ,多种影像检查结合及影像诊断与临床结合是减少误诊的主要措施 ;放化综合治疗是治疗误诊青年肺癌的合理方案。     

脑型、肠型和骨髓型放射病时中枢神经系统的病理变化

6例核爆炸条件下和7例实验室⁶⁰Coγ线照射脑型放射病死亡狗,观察其脑脊髓16个部位,主要病变是广泛的神经细胞坏死和严重的血循环障碍(充血、淤滞,微血栓、水肿和出血,以泛发性点灶状出血为主),同时神经纤维、传导束.神经胶质细胞也发生严重损伤,病变呈全脑性分布.12例肠型放射病死亡狗中,3例脑脊髓神经细胞发生变性和血循环障碍,其中2例小脑皮质少量(10～13%)颗粒细胞发生坏死。14例骨髓型放射病死亡狗仅5例脑脊髓神经细胞发生变性和血循环障碍,未见坏死病变。