：Objective To analyze theprognostic factors of patients with leukemia treated with single fraction total bodyirradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).MethodsFrom January 2001 to September 2008, 102 patients received HSCT. The differences of thesurvival rate, relapse rate and incidence of interstitial pneumonia (IP) between groupsregarding different genders, ages, pathological types, transplantation methods and TBIparameters were compared and the factors related with the survival rate, relapse rate andincidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days(median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up morethan one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. Inunivariate analysis, the 3-year survival rate was signifcantly different between thegroups with and without relapse before transplantation (20% vs. 55%, χ2 =6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%,χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) andgrade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with andwithout relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), withand without IP (23% vs. 58%, χ2 =8.35, P=0.004).Multivariate analysis showed that grade 3 or more aGVHD was the only statisticallysignificant prognostic factors (χ2 = 12. 74 ,P =0. 000). Thel-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviouslyhigher in the group with relapse before transplantation than that without (47% vs. 16%,χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse beforetransplantation was a significant factor predicting relapse after transplantation (χ2 =9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP wasdifferent between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), withand without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000),allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2=7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acuteparotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P =0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 orhigher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP.Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis isrelated with IP and might be a predictor.
Key words:
Leukemia; Hematopoietic stem cell transplantation; Singlefraction total body irradiation; Interstitial pneumonitis; Acute parotitis
Total body irradiation(TBI) is a pre-treatment in patients with leukemia and other diseases before hematopoietic stem cell transplantation,which is widely accepted as preferred cure for leukemia and other diseases.In this paper,the author with nearly 26 years and about 600 cases of TBI patients treatment experience,introduced the TBI treatment indications and complications,equipment and apparatus,irradiation method and treatment planning,the absorbed dose measurement and calculation of prescribed dose.While the impact of dose rate on radiation pneumonia,total prescribed dose,dose estimates of lung tissue and eye lens,the real-time dose monitoring in treatment process and other relevant contents are also mentioned.The author wants these would be helpful to others.
Purpose:To understand and apply the calculation and process of prescription dose with one-dimensional point dose in radiotherapy.Method:(1)Calculating the dose served to the maximum dose point of intracorporally central field axis,based on the tissue dose,the degree of intracorporal depth and DPP(or called TMP)of reference point in tumour.(2)Correcting the changing of scattered rays caused by the dissimilarity of actual field and reference field.(3)Calibrating the SAD and SSD factor produced by the irradiation of either isocenter or non-nominal SSD.(4)Using wedge-shaped plate calculating the dose of wedge-shaped field.(5)Calculating the prescription dose neared the field axis point.Results:This paper gives the elaborate Calculating result of one-dimensional point dose from the aspect of theory and living example in prescription dose of normal radiation treatment.Conclusion:The calculation of prescription dose of one-dimensional point dose is a shortcut for regular and simply irregular field.It is the theoretical principle of two and three-dimensional point dose calculation that are more complicated.
Objective To study the behavioral and pathological changes of the rats with chronic pcerebrovascular insufficiency (CVI) induced by permanent ligation of bilateral common carotid arteries. Methods Wistar rats (n=110) were divided into CVI group and sham-operation group. The CVI models were produced by permanent ligation of bilateral common carotid arteries. Morris water maze test were done at week 3 and 9 after operation for detecting the visuo-spatial memory impairment. Their pathological changes in brain were primarily studied by HE, Bielschowsky silver stainings, and immunohistochemistry for β-tubulin and GFAP. Results There was no difference in motor function evaluation between 2 groups, but the CVI group displayed significant deficits in locating the hidden platform, and in search strategy in Morris water maze at week 3 (P0.01 vs sham-operation group), and the memory dysfunction became more serious at week 9 (P0.001 vs sham-operation group). The histological examination showed mild to moderate ischemic changes, which included a moderate loss of hippocampal CA1 cells together with increasing GFAP immunoreaction. Some abnormal neurons in the hippocampus and cortex were manifested as dark by HE staining and argyrophilic by modified Bielschowsky silver staining, and these argyrophilic neurons showed such a similar feature as neurofibrillary tangles. Conclusion The CVI rat model made by permanent ligation of bilateral carotid arteries shows significant cognitive impairment and chronic progressing ischemic changes in brain, which indicates that chronic CVI maybe plays a role in the progression of primary neurodegenerative disease.
Acute brain dysfunction is a frequent complication in sepsis patients and is associated with long‑term neurocognitive consequences and increased mortality, yet the underlying mechanism remains unclear. Emerging evidence has suggested that β2‑microglobulin [a component of major histocompatibility complex (MHC) class I molecules] is involved in cognitive dysfunction in various neurological diseases. Therefore, the present study tested the hypothesis that β2‑microglobulin in the brain also mediates sepsis‑induced cognitive impairment. In the present study, wild‑type and antigen processing 1 (Tap1)‑deficient mice (Tap1‑/‑) were subjected to cecal ligation and puncture (CLP). Survival rate, cognitive function, and biochemical analysis were performed at the indicated time points. The data revealed that CLP induced anxiety‑like behavior and impaired hippocampal‑dependent contextual memory in wild‑type mice, which was accompanied by hippocampal microglial activation, increased level of interleukin‑1β, and decreased concentrations of brain derived neurotrophic factor and postsynaptic density protein 95. Notably, it was demonstrated that Tap1‑/‑ mice with reduced cell surface expression of MHC I protected mice from anxiety‑like behavior and impaired hippocampal‑dependent contextual memory and reversed most of these biochemical parameters following sepsis development. In summary, the results of the present study suggest that β2‑microglobulin negatively regulates cognitive impairment in an animal model of sepsis induced by CLP.
Purpose:getting the symmetrical and precise exposure dose to protect concernful organ and to reduce the exposure dose of healthy organ.Method:①This paper introduces the measure of absorbed dosage produced by the medical ionizing radiation of high-energy emanated from Cobalt-60 therapy machine(a kind of medical accelerator) operated in water mould,as well as the dose calibration of medical accelerator.This is based on IAEA TRS277 Report Photon and Electron Beam Absorbed Dose Measurement and JJG589-2001 V.R.of Radiation Source Used in the External Beam Radiotherapy.②Calculating the dose prescription corresponding with the meter of medical accelerator satisfied with the given conditions based on the tissue does used on tumor irradiation determined by doctor.③Thi paper presents the cure level dosimeter related with dose calculations,dose monitor fixed in the head of medical accelerator,as well as the characteristic of radiation field,quality of beam and quality maintenance of output dose.Results:Except the text discourse,there are also some examples of calculation to support the conclusion.Conclusion:The basic guarantee of curing tumour is including the strict and accurate measurement of absorbed dose(including dose calibration of medical accelerator),calculation of prescription dose along with the control and guarantee with the medical accelerator.
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