二乙基二硫代氨基甲酸钠驱镍作用的实验研究

本文用大鼠研究了带-SH基的二乙基二硫代氨基甲酸钠(Dithiocarb,简称Na-DDC或称铜试剂)和不带-SH基的新螯合剂(H-73-10)的驱镍作用。结果表明,Na-DDC对羰基镍(Ni(CO)_4〕的驱镍作用明显优于H-73-10;与此相反,H-73-10对硝酸镍〔Ni(NO_3)_2〕染毒大鼠的驱镍作用却明显优于Na-DDC。     

Vertebral plate regeneration induced by radiation-sterilized allogeneic bone sheets in sheep

Objective： To evaluate the effects and mechanism of radiation-sterilized allogeneic bone sheets in inducing vertebral plate regeneration after laminectomy in sheep. Methods ： Twelve adult male sheep （ aged 1.5 years and weighing 27 kg on average ） provided by China Institute for Radiation Protection underwent L3-4 and L4-5 laminectomy. Then they were randomly divided into two groups： Group A （n =6） and Group B （n =6）. The operated sites of L4-5 in Group A and L3-4 in Group B were covered by ＂ H-shaped＂ freeze-drying and radiationsterilized allogeneic bone sheets （ the experimental segments）, while the operated sites of L3-4 in Group A and L4-5 in Group B were uncovered as the self controls （ the control segments ）. The regeneration process of the vertebral plate and the adhesion degree of the dura were observed at 4,8,12,16,20 and 24 weeks after operation. X- ray and CT scan were performed in both segments of 1.34 and L4-5 at 4 and 24 weeks after operation. Results： In the experimental segments, the bone sheets were located in the anatomical site of vertebral plate, and no lumbar spinal stenosis or compression of the dura was observed. The bone sheets were absorbed gradually and fused well with the regenerated vertebral plate. While in the control segments, the regeneration of vertebral plate was not completed yet, the scar was inserted into the spinal canal, compressing the dura and the spinal cord, and the epidural area almost disappeared. Compared with the control segments, the dura adhesion degree in the experimental regenerated segments was much milder （ P 〈 0. 01 ）, the internal volume of the vertebral canal had no obvious change and the shape of the dura sack remained well without obvious compression. Conclusions： Freeze-drying and radiation-sterlilized allogeneic bone sheets are ideal materials for extradural laminoplasty due to their good biocompatibility, biomechanical characteristics and osteogenic ability. They can effectively reduce formation of post-laminectomy scars, prevent recurrence of post-lamlnectomy spinal stenosis, and induce regeneration of vertebral plates.     

同种异体骨板覆盖预防椎板切除术后硬膜外粘连临床应用

目的探讨同种异体骨板覆盖在预防椎板切除术后硬膜外粘连方面的疗效。方法对58例腰椎间盘突出或腰椎管狭窄患者,行全椎板切除,“H”形同种异体冻干辐照骨板覆盖。观察临床症状及CT、MR I表现。结果术后随访6个月~2.5年,CT、MR I椎管扩大,骨板无倾斜、移位,脊髓无压迫,无排异反应;术后椎管内容物形态良好,骨板两侧已与相邻接触骨组织融合,密度相等。结论同种异体冻干辐照骨板具有良好的生物相容性、生物力学性能和诱导成骨作用,是一种良好的硬膜外覆盖材料,能有效阻止硬膜外粘连,防止椎管术后再狭窄,可用于节段性椎管覆盖成型术。     

病因概率在砷致职业性肺癌诊断和赔偿中的应用

本文利用辐射致癌病因概率(PC)原理提出制定砷致职业性肺癌诊断标准的原则,方法和有关参数。用与暴露等级相联系的工龄代表既往累积暴露量,根据国内职业癌调查中得到的危险系数计算砷致肺癌的相对危险增加和PC%。砷致职业性肺癌的诊断界限可取PC≥50%,这时其所伴有的赔偿误差将不超过50%(偏宽)和20%(偏严)。     

同种异体冻干辐照骨板覆盖预防椎板切除术后硬膜外粘连再狭窄：影像学评价

背景：同种异体冻干辐照骨是一种较理想的骨缺损填充修复生物材料，是否可应用于预防椎板切除术后硬膜粘连。 目的：观察同种异体骨板覆盖预防椎板切除术后硬膜外粘连再狭窄的作用。 设计：病例随访调查。 单位：华中科技大学同济医学院附属协和医院骨科；中国辐射防护研究院山西省医用组织库。 对象：选择2003-03／2005—06于华中科技大学同济医学院附属协和医院骨科收治的58例节段性腰椎管狭窄患者，男34例，女24例，年龄30-78岁。单纯腰椎管狭窄25例，合并腰椎间盘突出33例L4-5，36例，L5，S，22例，所有患者年龄，性别，健康情况等无统计学差异。 方法：对58例腰椎间盘突出或腰椎管狭窄患者行节段性全椎板切除，“H”形同种异体冻干辐照骨板覆盖。按照中华骨科学会腰椎手术疗效随访标准评价患者术后临床症状改善情况，并观察植入骨板吸收状况及CT、MRI表现。主要观察指标：所有患者术后临床症状改善情况；腰椎管CT及MRI观察骨板吸收情况。 结果：纳入58例患者全部进入结果分析。术后半年随访21例，按照中华骨科学会腰椎手术疗效随访标准，其中优17例，良4例。术后1年随访23例，CT、MRI显示椎管明显扩大，骨板无倾斜、移位，脊髓无压迫；术后1．5年随访14例，CT显示椎管内容物形态良好，骨板两侧已与相邻接触骨组织融合，密度相等，无排异反应。 结论：同种异体冻干辐照骨板是一种良好的硬膜外覆盖材料，术后1．5年病例影象学提示未发生硬膜外粘连，防止了椎管术后的再狭窄，可用于节段性椎板覆盖成型术。     

氡与矿工肺癌研究进展

矿井高氡及子体环境可引起矿工肺癌的高发。本文回顾了氡致矿工肺癌的人群流行病学资料和动物实验资料,阐述了潜伏期、氡子体累积暴露量等问题,探讨了吸烟及其他因素与矿工肺癌的关系。     

战后德国铀矿工肺癌的历史与现状

总结了1998年10月应德国联邦辐射防护局(BfS)主席Kaul教授邀请考察Wismut铀矿工肺癌时收集的资料。首先介绍战后苏联如何在早年Schneeberg矿山的基础上集中数十万人在非常恶劣的条件下采铀,接受很高剂量的氡子体照射。接着介绍了矿工的氡子体累积暴露量、井下粉尘浓度和砷的暴露水平。德国有关部门对既往矿工进行过大量的临床医学检查、病理学检查和流行病学调查,迄今共登记肺癌9000例,矽肺15000例,由于工作量太大,系统的流行病学总结仍在进行之中。     

辨证论治和机体反应性问题

辨证论治和“辨病论治”辩证论治是中医诊断学和治疗学的基本原则。以证为对象进行治疗,反映了中医在诊断和治疗学体系上的特点;现代医学则是以病(病源)为对象进行治疗的,也可以说是“辨病论治”。中西医在诊断和治疗学体系上存在着重要的差别。诊断和治疗学体系上的这种差别决定于人们对疾病发生发展过程中所持有的不同见解。