大剂量~(60)Co γ射线照射恒河猴造血系统指标的早期变化

目的观察大剂量60 Coγ射线照射恒河猴后造血系统相关指标的早期改变,为急性放射病(ARS)早期造血因子治疗提供实验依据。方法 33只雄性成年恒河猴随机分为对照组和不同照射剂量的照射组,照射组动物用60 Coγ射线4、8和12Gy一次全身照射建立ARS恒河猴模型。XE-2100全自动血细胞分析仪检测照射前和照射后3、6、9、12、24、48、80h血常规指标,照射后6、48和80h麻醉处死动物,取胸骨观察病理组织学变化。结果 4、8Gy 2个剂量照射后3h外周血白细胞均低于照射前检测值,照射后6h白细胞均升高,9h检测值最高,分别达136.04%和221.38%(以照射前检测值为100.00%,下同),12h后开始明显下降。而12Gy照射后白细胞持续升高,9h达到最大值,之后下降,均显示出明显的"暂时性回升"峰。照射后中性粒细胞数先升高,9h达高峰之后又快速下降;照射后外周血淋巴细胞数急剧下降,3h检测值仅为照射前的12.02%~25.04%。照射后胸骨骨髓有核细胞数目急剧减少,照射剂量越大,残存造血细胞数越少。结论骨髓型ARS早期外周血白细胞和中性粒细胞数"暂时性回升"的时间节点可视为造血因子治疗的最佳给药时机。     

元参组方对粒系造血祖细胞的增殖作用

目的研究中药方剂对急性骨髓型放射病的治疗效果和对造血系统的作用及其作用机理。方法选用元参等11种中药组成元参组方,小鼠一次皮下注射后,观察不同时间外周血细胞、胸腺重量、骨髓有核细胞、粒系造血祖细胞、胸腺细胞与骨髓细胞混合培养后粒系造血祖细胞的变化。结果元参组方早期加速粒细胞的成熟和释放,第6天约为注射前的1．5倍。给药8d后,试验组胸腺重量、骨髓有核细胞、脾指数分别为（85．9±5．6）mg、（8．9±1．3）×10^6／每根股骨、1．42,对照组胸腺重量、骨髓有核细胞、脾指数分别为（74．2±6．2）mg、（6．8±0．5）×10^6／每根股骨、1．0,试验组明显高于对照组。试验组小鼠胸腺细胞与对照组小鼠骨髓细胞按20：1混合培养,骨髓CFU-G约为加入未注射元参组方的小鼠胸腺细胞的1．5倍。未注射元参组方则未见有放大作用。结论元参组方对外周血白细胞、骨髓有核细胞、胸腺重量和粒系造血祖细胞有明显的升高作用,激活胸腺细胞对粒系造血祖细胞的增殖有明显的放大作用。这种放大作用通过元参组方激活胸腺细胞实现。     

造血生长因子在医源性急性放射病的临床应用

目的 探讨造血生长因子对使用全身照射(TBI)进行干细胞移植预处理患者造血重建的影响,进而起到模拟事故性急性放射病,了解细胞因子在急性放射病患者救治中的作用。方法对1990-2012年75例预处理含TBI的造血干细胞移植患者及其供者的造血生长因子应用、植入情况、不良反应发生等进行回顾性分析,了解细胞因子在造血功能重建、造血干细胞动员中的作用以及不良反应。结果 造血干细胞移植患者除1例因预处理不良反应死亡外,其他患者全部恢复造血功能重建。应用rhG-CSF组粒细胞植入的中位时间自体移植为10 d、异基因移植为12 d。自体移植患者应用rhIL-11组与未应用rhIL-11组血小板植入的时间分别为(11.67±1.53)、(13.70±6.27) d。所有TBI患者中口腔溃疡发生率为48%,腹泻发生率为44%。造血重建过程中细胞因子不良反应不明显,动员过程中半数出现轻度不良反应。结论 细胞因子在TBI后造血功能重建以及移植时的造血干细胞动员中起关键作用。     

用正交设计优选炔雌醇治疗犬急性放射病的用药条件

通过正交设计选出了炔雌醇治疗300拉德照射犬的最鲁用药条件。经用117条犬的实验证明,积后6小时肌肉注射1.25毫克/公斤的疗效最好,可使照射犬的活存率由对照组的14.0%上升为68.4%(P<0.01)。照后8～24小时内口服或肌注0.5～2.5毫克/公斤也有不同程度的疗效。口腮约剂量要大些(1.25～2.5毫克/公斤),给药时间不迟于照后24小时;矾汪时剂量宜小(0.5～1.25毫克/公斤),在48小时内有效。讨论了在抗放药物研究中应用正交设计构可能性聂其优点。     

氨磷汀对小鼠肠型急性放射病的防护作用及其机制

 目的 研究氨磷汀(amifostine, WR2721)对小鼠肠型急性放射病的防护作用及其机制。方法 建立小鼠肠型急性放射病模型。C57BL/6J小鼠随机分为对照组和WR2721给药组,接受15 Gy ⁶⁰Co-γ全身照射,照后移植健康小鼠骨髓细胞,观察小鼠受照后30 d的存活率和平均生存时间,以及用隐窝细胞微克隆实验,研究照后3.5 d隐窝细胞数量及小肠黏膜情况。结果 对照组小鼠均在10 d内死亡,WR2721给药组存活率提高到80%;对照组和WR2721给药组平均隐窝数分别为(6.1±0.7)个、(28.0±1.1)个,差异有统计学意义(P<0.0001);对照组和WR2721给药组绒毛高度分别为(51.48±2.04)μm、(73.29±3.24)μm,差异有统计学意义(P<0.0001)。结论 WR2721对肠型急性放射病小鼠有保护作用,通过提高隐窝干细胞增殖活性,促进黏膜的恢复,提高小鼠的存活率。     

山东济宁60Co辐射事故受照人员的生物剂量估算

外周血淋巴细胞的染色体畸变是反映电离辐射损伤的良好指标。它不仅能反映辐射损伤和评价远后效应，而且可以估算事故条件下人员所受照的剂量，国内外已经有多例实际应用的报道，都取得了相当满意的结果。笔者对山东济宁“10．21”^60Co辐射事故两名受照者进行了染色体畸变分析，对病例B进行了生物剂量的估算，估算的生物剂量与临床诊断相一致（B被诊断为极重度骨髓型放射病）。病例A培养到73h，标本仍未见分裂象，难以给出剂量估算结果。报道如下。     

Studies on mechanism of treatment of granulocyte colony-stimulating factor,recombinant human interleukin-11 and recombinant human interleukin-2 on hematopoietic injuries induced by 4.5 Gy γ-rays irradiation in beagles

Objective To investigate the mechanism of treatment of granulocyte colony-stimulating factor(rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2 (rhIL-2)on hematopoietic injuries induced by 4.5 Gy60 Coγ-ray irradiation in beagles,and to provide experimental evidence for the clinical treatment of extremely severe myeloid acute radiation sickness (ARS).Methods Sixteen beagle dogs were given 4.5 Gy60 Co γ-ray total body irradiation(TBI),then randomly assigned into irradiation control group,supportive care group or cytokines+supportive care (abbreviated as cytokines)group.In addition to supportive care,rhG-CSF,rhlL-11 and rhIL-2 were administered subcutaneously to treat dogs in cytokines group.The percentage of CD34+cells,cell cycle and apoptosis of nucleated cells in peripheral blood were examined by Flow cytometry.Results After 4.5 Gy 60 Co γ-ray irradiation,the CD34+cells in peripheral blood declined obviously(61.3%and 52.1% of baseline for irradiation control and supportive care group separately).The cell proportion of nucleated cells in Go/G1 phase was increased notably(99.27% and 99.49% respectively).The rate of apoptosis(26.93% and 21.29% separately)and necrosis(3.27% and 4.14%,respectively)of nucleated cells were elevated significantly when compared with values before irradiation(P<0.05) 1 d post irradiation.When beagles were treated with cytokines and supportive care,the CD34+cells in peripheral blood were markedly increased(135.6% of baseline).The effect of G0/G1 phase blockage of nucleated cells became more serious(99.71%).The rate of apoptosis(5.66%)and necrosis(1.60%)of nucleated cells were significantly lower than that of irradiation control and supportive care groups 1 d after exposure.Conclusions Cytokines maybe mobilize CD34+cells in bone marrow to peripheral blood,indce cell cycle block at G0/G1 phase and reduce apoptosis,and eventually cure hematopoieticinjuries induced by irradiation.     

192Ir源辐射事故致亚急性放射病一例报告

2002年7月华南地区某单位发生利用^192Ir源故意伤人事故，致使70余人受到不同剂量的照射，现将1例主要受害者的临床观察情况报道如下。     

造血干细胞移植中预先全身照射对全身及造血系统的影响及并发症治疗

Objective To explore the effects of total body irradiation (TBI) combined with high-dose chemotherapy as conditioning regimen on the whole body and hematopoietic system of patients undergoing hematopoietic stem cell transplantation,and to sum up the clinical experiences in diagnosis and treatment of acute radiation syndrome.Methods A total of 64 patients underwent TBI and high-dose chemotherapy and then received hematopoietic stem cell transplantation.The hematologic changes and clinical toxicity after TBI were observed and the characteristics of bone marrow reconstitution analyzed.Results The transplantation related mortality was 3.12%.Follow-up was carried out post transplantation for 9-72 months (the median follow-up time was 26 months).1,3,5-year overall survival rates were (95.8 ± 3.3)%,(89.8 ± 4.7)% and (81.7 ± 6.9)%,respectively.All patients suffered fromhematologic toxicity.The white blood cells and platelets were obviously decreased.The minimum total number of white blood cells was (0.18 ± 0.13) × 109/L,and the minimum platelet was (14.48 ±8.85) × 109/ L.In addition,gastrointestinal reactions,infection,liver damage,bleeding and other adverse reactions occurred to some extent.Conclusions TBI combined with high-dose chemotherapy as conditioning regimen followed by hematopoietic stem cell transplantation might be effective for treatment of malignant hematological diseases.The clinic conditions after TBI and high-dose chemotherapy could simulate the clinical course of acute accidental radiation syndrome and provide the clinical experience for acute radiation syndrome.     

钝顶螺旋藻对小鼠急性放射病的防护作用

随着和平利用原子能事业的不断发展,各种射线被广泛应用于生产、科研和医疗保健中,使人类受辐射损伤的可能性也在增多。螺旋藻(ＳＰ)作为一种食品已被证实有多种保健功能,而对其抗辐射作用也成为近几年的研究热点,本研究拟以钝顶螺旋藻(ＳＳＰ)为受试物,对小鼠急性放射病的防护作用进行研究。1　材料和方法11　材料受试物　ＳＳＰ,胶囊包装,每粒含量为350ｍｇ/粒,推荐剂量为每人每日12粒,受试物由某生物工程有限公司提供。动物:昆明种雌性小鼠,共80只,体重18～22ｇ。由军事医科学院实验动物中心提供。12　试验方法　80只小鼠检疫两天后取尾…