Ⅰ-ⅡB期精原细胞瘤术后放疗中不同厚度低熔点挡铅对睾丸剂量防护的研究

目的 评估精原细胞瘤术后放疗中低熔点挡铅厚度及与射野边缘的距离对健侧睾丸受照剂量的影响。方法 选取1例I期精原细胞瘤术后患者的放射治疗计划，利用Synergy医用直线加速器6 MV X射线在SZMC-IV型仿真人体模型上模拟患者照射。采用PTW 0.6 cm^3指型电离室，在距射野边缘不同距离处分别测量无挡铅和有3、5、7、10及15 mm厚度低熔点挡铅屏蔽条件下的吸收剂量，评价不同条件下的剂量防护效果。结果 在上述各挡铅厚度条件下，测量结果的归一化剂量与测量点离射野边界之间的距离呈指数形式衰减。无挡铅时的测量结果相对于靶区处方剂量，由距离射野边缘1 cm处的8.41%降到25 cm处的0.61%。有3、5及7 mm挡铅时，分别由距离射野边缘1 cm处的4.55%、3.98%及3.47%降到25 cm处的0.27%、0.21%及0.17%。有10 mm挡铅时，由距离射野边缘1.5 cm处的2.55%降到25 cm处的0.15%。有15 mm挡铅时，由距离射野边缘2 cm处的1.86%降到25 cm处的0.13%。在处方剂量为26 Gy并且距离射野边缘10 cm或4 cm以上，和处方剂量为36 Gy并且距离射野边缘4 cm以上的条件下，分别采用3、7和15 mm厚度的挡铅屏蔽，能将睾丸的散射剂量降低到0.5 Gy以下。结论 在精原细胞瘤术后常规放疗中，根据不同的处方剂量和照射野范围，采用低熔点铅自制适当厚度的睾丸防护装置，能方便、有效地降低睾丸受照剂量，有利于保护患者的生育能力。

米非司酮配伍小剂量甲基睾丸素治疗子宫内膜增生35例疗效分析

目的对子宫内膜增生患者接受米非司酮联合小剂量甲基睾丸素的临床治疗效果予以评价,为子宫内膜增生的临床治疗提供科学的依据。方法 35例子宫内膜增生患者,患者使用米非司酮进行为期3个月的治疗,然后使用小剂量甲基睾丸素治疗2周。计算治疗后患者的平均子宫内膜厚度,统计本组治疗的整体有效率。结果 35例患者治疗前子宫内膜厚度平均为（8.79±0.97）mm;治疗后其子宫内膜的平均厚度为（4.36±0.37）mm,治疗前后比较差异有统计学意义（P〈0.05）。治疗6个月后,33例患者病情得到了有效的控制,病情痊愈,治疗有效率达94.29%（33/35）。在用药期间,35例患者均出现了停经现象,用药结束后52~73 d逐渐得到了恢复。结论米非司酮伍小剂量甲基睾丸素治疗子宫内膜增生效果显著,可显著提高患者的生活质量水平,因而具有较高的临床应用价值。

米非司酮合并甲基睾丸素治疗围绝经期功血的临床疗效分析

【目的】探讨米非司酮合并小剂量甲基睾丸素治疗围绝经期功能性子宫出血的疗效。【方法】62例功能性子宫出血患者，年龄45～52岁，均经超声检查，诊断性刮宫后，排除子宫肌瘤，子宫内膜恶性病变者。62例患者分为治疗组和对照组两组，每组各31例患者。对照组口服米非司酮50～12．5mg，1次／日，治疗组另配伍甲基睾丸素2．5mg，1次／日，连服3个月；比较治疗前后血清雌激素、孕激素、卵泡刺激素、促黄体生成激素的变化。【结果】所有患者服药期间成闭经状态，血红蛋白均不同程度的升高。治疗组绝经率优于米非司酮组，且两组相比较差异有显著性（P〈O．05）。【结论】米非司酮合并甲基睾丸素治疗围绝经期功能性子宫出血效果较单用米非司酮效果好，且患者不易复发。

加速器治疗肿瘤时睾丸受照剂量的研究

６ＭＶＸ射线是放疗时常用的射线，睾丸是电离辐射敏感器官，从理论上讲受到辐射后就可能发生随机效应。临床医生在医疗照射实践中，往往把靶外器官———睾丸受到的剂量忽略了。靶外器官受辐射产生的远期效应直接影响患者甚至后代的生存质量，这已日渐引起人们的关注［１...

Effects of Sublethal Doses of Chlorfluazuron on Pupal-testis in the Common Cutworm, Spodoptera fitura （F,） （Lepidoptera： Noctuidae）

The effects of sublethal doses （LD10：1.00 ng larval-1; LD30： 3.75 ng larva-1） of chlorfluazuron on number and size of developmental spermatocytes in pupal-testis during spermatogenesis of the common cutworm, Spodoptera litura （F.） are described. Chlorfluazuron was applied topically to newly-ecdysed fifth-instar larvae of S. litura under laboratory conditions. During first day of pupation, spermatids were the highest （3,430 ± 7）, however, elongated spermatocytes with mature sperm were the lowest （292 ± 16） in number in pupal-testis compared with other developing spermatocytes. During last day of pupation, elongated spermatocytes with mature sperm were the highest （3,581 ± 3）, however, spermatogonia were the lowest （86± 4） in number in pupal-testis compared with other developing spermatocytes. The number of spermatogonia, primary and secondary spermatocytes, spermatids and elongated cysts with mature sperm were increased during pupal-developmental days in the controls. However, their numbers were significantly reduced in LD10- and even more significantly reduced in LD30-treated pupal-testis compared with controls. Moreover, eupyrene sperm bundles were not present in pupal-testis. During pupal-developmental days, spermatids were the smallest （4.1 ± 0.9 dm in μm） and secondary spermatocytes were the largest （31.0 ± 1.8 dm in μm） in size compared with other developing spermatocytes. The sizes of the same developing spermatocytes were significantly reduced in LD10-treated and more significantly reduced in LD30-treated pupal-testis of S. litura compared with controls.