^32磷玻璃微球肝动脉栓塞治疗肝癌的临床疗效观察

目的国产32磷玻璃微球（32P－GMS）治疗肝癌疗效观察。方法经度股动脉穿刺，导管选择性插管至肝动脉灌注32P－GMS超液化碘油混悬液，治疗原发性肝癌32例；转移性肝癌14例；随机对照组原发性肝癌18例用肝动脉栓塞化疗。结果治疗后3月观察原发性肝癌32P－GMS治疗组病灶缩小＞50％6例，50％～25％11例，＜25％～10％12例，有效率为90．63％（29／32），对照组18例中14例有效（77．78％），经Ridit分析和X2检验，二组无显著差异。转移性肝癌14例中11例有效。32P－GMS治疗肝癌总有效率86．96％（40／46）。32P－GMS治疗组未出现明显血液毒性。结论32P－GMS肝动脉栓塞是治疗肝癌的有效手段之一。

女性不孕症诊断中三种诊断方法的应用

女性不孕症诊断中三种诊断方法的应用郑力，何士诚南京铁道医学院附院放射科２１０００９郑惠方南京铁道医学院附院妇产科２１０００９子宫输卵管造影术（简称输卵管造影术）是诊断女性不孕症的常用方法之一，腹腔镜和放射介入输卵管造影再通术（简称放射介入法）是近年来...

^(32)P-玻璃微球介入治疗肝细胞肝癌的临床初步应用

采用 Ｓｅｌｄｉｎｇｅｒｓ穿刺法，导管超选择至肝固有动脉以远，灌注^（３２）Ｐ－玻璃微球（^（３２）Ｐ－ＧＭＳ），对７９例肝细胞肝癌（ＨＣＣ）实施了９９次内照射介入治疗。结果表明，Ａ方案半年及１、２、３年生存率分别为１００％、９６．７％、５６．７％和４３．３％；Ｂ方案分别为９７．９％、９１８％、６１．２％和５１．０％。经治后的中位生存时间为５８５天。多因素分析显示：肝功能、肿瘤大小、临床类型及^（３２）Ｐ－ＧＭＳ在瘤体内积聚情况是影响生存率的预后因素。说明^（３２）Ｐ－ＧＭＳ是一种安全、有效的肝癌治疗方法。

经皮椎间盘摘除术治疗腰椎间盘突出症

目的 探讨经皮穿刺椎间盘摘除术（PLD）治疗腰椎间盘突出症的疗效、安全性。方法 10例患者行经皮腰椎间盘切除术，观察临床症状改变，随访3－6个月。结果 总的症状改善率90％，无并发症发生。结论 PLD治疗腰椎间盘突出症安全、有效，值得推广。

家猪肝动脉内给予^(32)磷-玻璃微球的毒性反应研究

目的 评估正常家猪肝动脉内给予３２ 磷玻璃微球（３２ＰＧＭＳ） 后的急性和亚急性毒性反应。方法 １０ 只健康家猪经皮肝动脉内接受人类治疗剂量的３２ＰＧＭＳ（５ 只猪）、惰性３１ＰＧＭＳ（５ 只猪） ；２ 只猪作全程空白对照。术后按第１ 、２、４ 、８ 或１６ 周分期处以安乐死，取不同部位的肝组织进行光镜、电镜检查和超微形态计量分析。结果 给药组１、２ 周肝细胞核异常率（Ｎａｂｎ） 和线粒体变异率（ Ｍｖａｒ） 与其他各组比较差异均有显著性（ Ｐ＜ ０．０１，Ｐ＜ ０ ．００１）；给药组第８ 周与第１６ 周比较Ｎａｂｎ 无统计学意义（ Ｐ＞０ ．２０）。给药后第１、２ 周异常肝细胞多见；第４ 周异常肝细胞减少，血窦内皮破坏明显；第８ 周异常肝细胞少见，血窦内皮修复；第１６ 周肝组织形态学表现正常。结论 ３２ＰＧＭＳ肝动脉给药正常肝组织宏观吸收剂量不超过１９０Ｇｙ 只是引起临床上允许的肝内变化，肝脏组织损伤修复的时间约８ 周以上。

Toxicology of intrahepatic arterial administration of interventional phosphorus-32 glass microspheres to domestic pigs

Objective To evaluate the toxic response to intrahepatic arterial admin istration of radioactive phosphorus32 glass microspheres (32 P GMS) in domestic pigs Methods Through selective catheterization of hepatic artery,32P GMS was infused to 5 healthy domestic pigs in a dosage equivalent to the thera peutic dose for human being, and31PGMS was infused to other 5 healthy domestic pigs Two pigs se rved as the whole course blank controls One pig from each group was surrendere d to euthanasia at week 1, 2, 4, 8 and 16, respectively, and liver biopsies were performed on the rest of pigs at the corresponding time points Liver tissues f r om different sites were taken for light and electron microscopy The ultrastruc t ural histopathological changes were evaluated semiquantitatively Results The accumulative amount of32PGMS in the target tissue attained more th an 90% of the total dose administrated Histologically, abnormal hepatocytes we re easily found at week 1 or 2 At week 4 they were less than at week 1 or 2, a n d endothelium of the sinuses were damaged prominently At week 8 they were scar cely seen, and liver tissue recovered gradually The histological features of l i ver tissue restored to normal at week 16 Semiquantitative analysis of ultrastr u ctural morphology in the experimental group showed no statistical difference ( P >050) between the nuclear abnormality (Nabn) and mitochrondri a l variability (Mvar) at week 1 or 2, but revealed prominent difference ( P <001, P <0001) as compared with those in other groups I n the experimental group the Nabn in tissues showed no significant differe nce ( P >020) between week 8 and week 16 Conclusion 32 PGMS internal irradiation at the dosag e equiva lent to human therapeutic dosage exerts reversible injury to domestic pig liver tissue, and it takes more than 8 weeks for the injured liver tissue to recover