胞磷胆碱钠联合高压氧治疗放射性脑病的临床研究

目的观察胞磷胆碱钠联合高压氧治疗放射性脑病的临床疗效。方法回顾性分析87例因头颈部放射性治疗所致的放射性脑病患者,分为治疗组(n=45)与对照组(n=42)。治疗组疗法为胞磷胆碱钠(0.2 g,每日3次)联合高压氧;对照组单纯应用高压氧治疗。两组患者均常规采用地塞米松、甘露醇等药物支持对症治疗;共行3个疗程。疗效判断依据患者症状改善情况、生活自理情况以及CT或MRI复查病灶改变情况。结果治疗组治愈10例,显效18例,有效11例,有效率为86.7%。对照组治愈8例,显效12例,有效9例,有效率为69.0%,两组有效率比较差异有统计学意义(P<0.05)。结论胞磷胆碱钠联合高压氧治疗放射性脑病可有效增加高压氧治疗放射性脑病的疗效。

皮肤创面无机诱导活性敷料治疗急性放射性皮肤损伤的临床观察

目的:探讨皮肤创面无机诱导活性敷料对3级急性放射性皮肤损伤的临床价值。方法:28例放疗中或放疗后出现3级急性放射性皮肤损伤恶性肿瘤患者,采用随机分组研究观察。观察组用皮肤创面无机诱导活性敷料;对照组外涂龙胆紫。结果:观察组3级急性放射性皮肤损伤愈合效果明显高于对照组(P<0.05)。结论:皮肤创面无机诱导活性敷料对3级急性放射性皮肤损伤的临床价值显著。

Cell cycle and radiosensitivity of progeny of irradiated primary cultured human hepatocarcinoma cells

AIM： To evaluate the change of growth characteristics and radiosensitivity of irradiated primary cultured human hepatocarcinoma cells. METHODS： All tumor tissue samples were obtained from 39 hepatocarcinoma patients with a mean age of 49.6 years （range 22-76 years）. We divided the samples into irradiated group and non-irradiated group and measured their plating efficiency （PE）, population doubling time （PDT）, radiosensitivity index SF2 and cell RESULTS： The PDT of primary culture of hepatocardnoma cells was 91.0±6.6 h, PE was 12.0±1.4%, SF2 was 0.41±0.05%. The PDT of their inadiated progeny was 124.8±5.8 h, PE was 5.0±0.7%, SF2 was 0.65±0.09%. The pdmary cultured human hepatocarcinoma cells showed significant S reduction and G^2 arrest in a dose-dependent manner. The progeny of irradiated primary cultured hepatocarcinoma cells grew more slowly and its radiosensitivity increased. CONCLUSION： The progeny of irradiated primary cultured human hepatocarcinoma cells grows more slowly and its radiosensitivity increases.

Biochemical metabolic changes assessed by ^(31)P magnetic resonance spectroscopy after radiation-induced hepatic injury in rabbits

AIM： To compare the features of biochemical metabolic changes detected by hepatic phosphorus-31 magnetic resonance spectroscopy （^31p MRS） with the liver damage score （LDS） and pathologic changes in rabbits and to investigate the diagnostic value of ^31p MRS in acute hepatic radiation injury. METHODS： A total of 30 rabbits received different radiation doses （ranging 5-20 Gy） to establish acute hepatic injury models. Blood biochemical tests, ^31p MRS and pathological examinations were carried out 24 h after irradiation. The degree of injury was evaluated according to LD5 and pathology. Ten healthy rabbits served as controls. The MR examination was performed on a 1.5 T imager using a 1H/^31P surface coil by the 2D chemical shift imaging technique. The relative quantities of phosphomonoesters （PME）, phosphodiesters （PDE）, inorganic phosphate （Pi） and adenosine triphosphate （ATP） were measured. The data were statistically analyzed. RESULTS： （1） Relative quantification of phosphorus metabolites： （a） ATP： there were significant differences （P 〈 0.05） （LDS-groups：control group vs mild group vs moderate group vs severe group, 1.83±0.33 vs 1.55±0.24 vs 1.27±0.09 vs 0.98±0.18; pathological groups： control group vs mild group vs moderate group vs severe group, 1.83±0.33 vs 1.58±0.25 vs 1.32±0.07 vs 1.02±0.18） of ATP relative quantification among control group, mild injured group, moderate injured group, and severe injured group according to both LDS grading and pathological grading, respectively, and it decreased progressively with the increased degree of injury （r = -0.723, P = 0.000）. （b） PME and Pi; the relative quantification of PME and Pi decreased significantly in the severe injured group, and the difference between the control group and severe injured group was significant （P 〈 0.05） （PME： 1DS- control group vs LDS-severe group, 0.86±0.23 vs 0.58±0.22, P = 0.031; pathological control group vs pathological severe group, 0.86±0.23 vs 0.60±0.21, P = 0.037; Pi： LDS-control group vs LDS-severe group, 0.74±0.18 vs 0.43±0.14, P = 0.013; pathological control group vs pathological severe group, 0.74±0.18 vs 0.43±0.14, P = 0.005） according to LDS grading and pathological grading, respectively. （c） PDE; there were no significant differences among groups according to LDS grading, and no significant differences between the control group and experimental groups according to pathological grading. （2） The ratio of relative quantification of phosphorus metabolites： significant differences （P 〈 0.05） （LDS- moderate group and LDS-severe group vs LDS-control group and LDS-mild group, 1.94±0.50 and 1.96±0.72 vs 1.43±0.31 and 1.40±0.38） were only found in PDE/ATP between the moderate injured group, the severe injured group and the control group, the mild injured group. No significant difference was found in other ratios of relative quantification of phosphorus metabolites.CONCLUSION： ^31p MRS is a useful method to evaluate early acute hepatic radiation injury. The relative quantification of hepatic ATP levels, which can reflect the pathological severity of acute hepatic radiation injury, is correlated with LDS.

Prospect of Functional Salivary Gland Enhancement with Biomedical Strategies for Head and Neck Cancers

Xerostomia is the main complication inflicting head and neck cancer patients treated with radiotherapy.Conventional treatment is not very effective in alleviating this morbidity.Biomedical strategies such as gene transfer and tissue engineering have made substantial progress that will potentially lead to successful new treatment options for this condition.This report reviews the process of radiation damage to the salivary glands and the advances in functional salivary gland enhancement with these two brand-new technologies.

Hepatocyte growth factor gene therapy prevents radiation-induced liver damage

AIM: To transfer human HGF gene into the liver of rats by direct electroporation as a means to prevent radiationinduced liver damage.METHODS: Rat whole liver irradiation model was accomplished by intra-operative approach. HGF plasmid was injected into liver and transferred by electroporation using a pulse generator. Control rats (n = 8) received electrogene therapy (EGT) vehicle plasmid and another 8rats received HGF-EGT 100 μg 48 h before WLIR.Expression of HGF in liver was examined by RT-PCR and ELISA methods. Apoptosis was determined by TUNEL assay. Histopathology was evaluated 10 wk after whole liver irradiation.RESULTS: Marked decrease of apoptotic cells and downregulation of transforming growth factor-beta 1 (TGF-β1)mRNA were observed in the HGF-EGT group 2 d after liver irradiation compared to control animals. Less evidence of radiation-induced liver damage was observed morphologically in liver specimen 10 wk after liver irradiation and longer median survival time was observed from HGF-EGT group (14 wk) compared to control rats (5 wk). (P = 0.031).CONCLUSION: For the first time it has been demonstrated that HGF-EGT would prevent liver from radiation-induced liver damage by preventing apoptosis and down-regulation of TGF-β1.

放射性膀胱炎出血41例治疗体会

目的探讨放射性膀胱炎出血的治疗方案。方法本组41例放射性膀胱炎出血的患者。采用膀胱灌注甲醛，经尿道电凝，高压氧治疗。结果41例患者经过不同的方法出血均得到治愈。结论放射性膀胱炎根据病情特点不同采用膀胱灌注甲醛，经尿道电凝，高压氧治疗可取得满意的效果。

MEBO治疗激光创面78例疗效分析

目的:观察湿润烧伤膏(MEBO)在治疗下肢静脉曲张激光创面的疗效。方法:2005-05/2009-04河北省承德县医院应用湿润烧伤膏治疗78例激光灼伤的皮肤创面,外涂MEBO观察疗效。结果:发现MEBO治疗效果在创面愈合时间、愈合后创面色素改变、瘢痕的发生率有显著优势。结论:MEBO治疗下肢静脉曲张激光创面疗效肯定。

放射性食管癌的研究现状

目的:总结国内外有关放射性食管炎的研究现状。方法:应用PubMed和CHKD期刊全文数据库检索系统,以"放射性食管炎"和"放射性食管损伤"为关键词检索从1999-03-2009-03有关放射性食管炎及食管损伤的文献,共检索到英文文献98篇,中文文献69篇。纳入标准:1)放射性食管炎的临床病理学特点;2)放射性食管炎影响因素的研究进展;3)放射性食管炎防治方法的研究现状。根据该标准,精选80篇,最后纳入分析28篇。结果:临床上有许多因素可预测放射性食管炎的发生,如患者为高龄、采用同步放化疗模式或采用高强度的放疗方式(超分割、加速超分割),受照食管V10～V60、A55、Dmean、Dmax及全周食管剂量较高等。其中食管V20<45%且Dmean<28Gy,>3级放射性食管炎的发生率将<15%;食管V50<30%及V50≥30%时,>2级放射性食管炎的发生率分别为22%及71%,P=0.0009;在同步放化疗中,食管Dmax>58Gy为>3级放射性食管炎独立预测因子(P=0.001),所以在制定放疗计划时,食管的剂量应限制在V20<45%、V50<30%、Dmean<28Gy、Dmax<58Gy,否则不宜给高剂量照射,需修改治疗计划。氨磷汀在动物实验中对放射性食管炎有显著的保护作用,但临床上得出的结论并不一致,有待进一步论证。结论:放射性食管的影响因素研究为临床上制定放化疗计划提供了理论基础,如何用药物预防放射性食管炎是将来的研究方向。