The link between micro- and macro-parameters for radiation interactions that take place in living biological systems is described in this paper. Meanwhile recent progress and development in microdosimetry and nanodosimetry are introduced, including the methods to measure and calculate these micro- or nano-parameters. The relationship between radiobiology and physical quantities in microdosimetry and nanodosimetry was presented. Both the current problems on their applications in radiation protection and radiotherapy and the future development direction are proposed.
Objective We searched and reviewed medical evidence to find the guide of treatment for local advanced nasopharyngeal carcinoma. Methods Firstly, we put forward clinical questions. Secondly, we searched medical evidence from Medline (1985-2002), Embase (1984-2000), Cochrane library (2002.1) and ACP. And then we reviewed the results. The key words we used were "nasopharyngeal carcinoma, chemotherapy and radiotherapy randomized" and "meta analysis or randomized control trial". Results Through searching, we got 17 papers including 1 systematic review and 16 randomized control trials, in which there were 8 prospective randomized phase Ⅲ trials. Most of these trials concluded that combination chemo-radiotherapy were better than radiotherapy alone. We think these results were suitable for our patient’treatment decision. Conclusion To treat our patients,we choosed the method of the mutimodality of squeitial neoadjuvant chemotherapy, concurrent chemo-radiotherapy and adjuvant chemotherapy with the drug doses down-adjusted.
【摘要】 目的 探討高原地區橈神經損傷的治療效果，并總結影響療效的因素。 方法 回顧性分析2005年6月-2010年6月收治的橈神經損傷并有完整隨訪資料的54例患者，其中男40例，女14例；年齡8～69歲，平均32.6歲。開放性損傷5例，閉合性損傷49例；左側26例，右側28例。受傷原因:刀傷5例，醫源性損傷（手術牽拉傷、被鋼板擠壓傷）10例，肱骨干骨折合并橈神經損傷39例。神經損傷類型:橈神經完全斷裂12例；大部分斷裂15例；挫傷27例，挫傷長度1.5~4.5 cm。所有患者均有典型的感覺及運動功能障。采用神經吻合修復27 例，神經松解減壓27例。骨折均用鋼板內固定。 結果 所有患者手術均順利，術后切口均I期愈合，無手術相關并發癥發生。54例均獲隨訪16~24個月，平均18個月。骨折于術后8～14個月達臨床愈合。末次隨訪時根據中華醫學會手外科上肢周圍神經功能評定標準，神經吻合的27例中，獲優14例，良8例，差5例；神經松解減壓術治療的27例均獲優。總優良率為91%。 結論 上臂橈神經損傷宜早期手術修復，神經吻合的療效較神經松解減壓術差。【Abstract】 Objective To explore the therapeutic effect on radial nerve injuries in plateau area, and to analyze the influencing factors. Methods The clinical data of 54 patients with radial nerve injuries who were treated between June 2005 and June 2010 were retrospectively analyzed. The patients included 40 males and 14 females and aged 8-69 years (averaged 32.6 years old). Of these 54 patients, 5 were open injuries, 49 were closed injuries; 26 were on the left side, and 28 were on the right sides. Causes of injuries included: 5 direct cut injuries, 10 iatrogenic injuries (including traction injuries and crush injuries by steel plates), and 39 humeral shaft fracture and radial nerve injuries. Types of nerve injuries included: 12 complete radial neurotmesis, 15 partial radial neurotmesis, and 27 radial contusions (with contusion length ranged 1.5-4.5 cm). All patients had radial nerve injuries experienced significant motor dysfunctions. Among these patients, 27 underwent nerve anastomosis, the remaining 27 were treated by nerve decompression; all fractures were treated with internal fixation with steel plates. Results During the average follow-up of 18 months (16-24 months), all 54 patients completely recovered from radial nerve injuries without any complications. The time for fracture healing ranged 8-14 months. According to the evaluation standards for radial nerve functional recovery, developed by the Chinese Medical Association, among the 27 cases treated by nerve anastomosis, 14 were “optimal”, 8 were “fair”, and 5 were “bad”; and all 27 cases treated by nerve decompression were “optimal”. Conclusion It is suggested to have early surgical treatment for the upper arm radical nerve injuries. The nerve decompression had better curative effects than the nerve anastomosis does.
目的探討低位直腸息肉惡變的合理的外科手術方式。方法對我院1997年1月至2001年12月收治的32例低位直腸息肉惡變患者的資料進行回顧性分析。 結果32例中經肛門局部切除20例，經腹前切除低位吻合（Dixon術）8例，經腹會陰聯合切除（Miles’術）4例，其中27例術后給予放、化療。28例獲隨訪1~5年，2例死亡，余均無局部復發。 結論低位直腸息肉惡變手術方式的正確選擇是達到“根除癌腫”、“改善患者生活質量”目的的關鍵，術中冰凍病理檢查是手術方式選擇的重要依據。