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Comparative Assessment of the Effect of Local Proton Radiation with a Dose of 30 Gy in BALB/c and C57BL/6 Mice 剂量为 30 Gy 的局部质子辐射对 BALB/c 和 C57BL/6 小鼠影响的比较评估
Q4 Medicine Pub Date : 2024-02-01 DOI: 10.33266/1024-6177-2024-69-1-20-27
V.A. Anikina, S.S. Sorokina, A. E. Shemyakov, E. A. Zamyatina, N.R. Popova
Purpose: To evaluate the effect of local proton irradiation at a dose of 30 Gy on Balb/c and C57BL/6 mice in terms of the degree and dynamics of radiation-induced skin damage formation, changes in body weight and peripheral blood elements count. Material and methods: Experiments were performed on non-depilated male mice aged 7‒8 weeks from two strains: Balb/c and C57BL/6 (n=15). Local irradiation of the skin was carried out on the dorsal side of the animals using a scanning proton beam at an extended Bragg peak in the proton therapy complex «Prometheus» of the LPI Physico-technical Centre (Protvino) at a dose of 30 Gy with a proton energy of 87.8 MeV. During the irradiation session, animals were subjected to intraperitoneal anesthesia using a combination of Zoletil 100 (Virbac, France) and Xyla (Interchemie, Netherlands) in a previously determined ratio 1:3 (20‒40 mg/kg). Photographic documentation of radiation-induced skin damage was performed weekly for 70 days. Animals were examined daily for clinical manifestations of radiation-induced skin damage formation according to the RTOG international scale for 21 days following irradiation. The body weight dynamics of mice were evaluated one day before irradiation and then weekly for 70 days. Blood samples were collected from the tail vein by cutting the tip of the tail and analyzed using a DH36 Vet hematology analyzer (Dymind, China) one day before irradiation, one day and three days after irradiation, and weekly thereafter for 70 days. Experimental data were presented as mean ± standard deviation (M ± SD). Results: In this study, the impact of a single local exposure to proton radiation at a dose of 30 Gy on the degree and dynamics of radiation-induced skin damage formation was evaluated. It was demonstrated that Balb/c mice exhibited a higher frequency and degree of radiation-induced skin damage formation compared to the C57BL/6 mice. Analysis of body weight in mice after radiation exposure revealed no significant decrease in either mouse strain. A comparative analysis of the number of platelets, erythrocytes and hemoglobin concentration in both mouse strains did not reveal any changes, while a tendency towards a decrease in the number of leukocytes, lymphocytes, and granulocytes was observed in the irradiated Balb/c mice group compared to the control group. Conversely, in irradiated C57BL/6 mice, the number of lymphocytes was higher compared to control animals. Conclusion: In this study, Balb/c mice exhibited higher radiosensitivity compared to C57BL mice in response to a single local proton irradiation at a dose of 30 Gy.
目的:评估 30 Gy 剂量的局部质子辐照对 Balb/c 和 C57BL/6 小鼠的影响,包括辐射诱导的皮肤损伤形成的程度和动态变化、体重和外周血元素计数的变化。材料和方法实验对象为两个品系的 7-8 周龄未脱毛雄性小鼠:Balb/c和C57BL/6(n=15)。在 LPI 物理技术中心(Protvino)的质子治疗综合设施 "普罗米修斯"(Prometheus)中,使用延伸布拉格峰的扫描质子束对动物背侧皮肤进行局部照射,剂量为 30 Gy,质子能量为 87.8 MeV。在照射过程中,使用 Zoletil 100(Virbac,法国)和 Xyla(Interchemie,荷兰)以事先确定的 1:3 的比例(20-40 毫克/千克)对动物进行腹腔内麻醉。在 70 天内,每周对辐射引起的皮肤损伤进行拍照记录。辐照后 21 天内,根据 RTOG 国际评分标准,每天对动物进行检查,以了解辐射诱导的皮肤损伤形成的临床表现。在辐照前一天评估小鼠的体重动态,然后在 70 天内每周评估一次。在辐照前一天、辐照后一天和三天,以及此后每周的 70 天内,从小鼠尾部静脉采集血液样本,并使用 DH36 Vet 血液分析仪(Dymind,中国)进行分析。实验数据以均数±标准差(M±SD)表示。结果本研究评估了单次局部照射 30 Gy 剂量的质子辐射对辐射诱导的皮肤损伤形成的程度和动态的影响。结果表明,与 C57BL/6 小鼠相比,Balb/c 小鼠出现辐射诱导的皮肤损伤的频率和程度更高。对辐照后小鼠体重的分析表明,两种小鼠的体重都没有明显下降。对两个品系小鼠的血小板数量、红细胞数量和血红蛋白浓度进行的比较分析没有发现任何变化,但与对照组相比,辐照 Balb/c 小鼠组的白细胞、淋巴细胞和粒细胞数量有减少的趋势。相反,与对照组相比,辐照 C57BL/6 小鼠的淋巴细胞数量较高。结论在这项研究中,与 C57BL 小鼠相比,Balb/c 小鼠对 30 Gy 剂量的单次局部质子辐照表现出更高的放射敏感性。
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引用次数: 0
Fluorimetric Evaluation of the Effect of Malic, Succinic and Ascorbic Acids on the Growth Properties of A549 Cells in Culture 用荧光测定法评估苹果酸、琥珀酸和抗坏血酸对培养中的 A549 细胞生长特性的影响
Q4 Medicine Pub Date : 2024-02-01 DOI: 10.33266/1024-6177-2024-69-1-28-32
L.A. Romodin, E. Yashkina, A.A. Moskovskij
Relevance: A number of researchers consider the study of the radioprotective properties of non-toxic or low-toxic natural substances to be a promising direction. A special place among them is occupied by antioxidants and participants in the basic reactions of metabolism. In order to avoid methodological errors when performing these studies, it is necessary to conduct a number of additional experiments. For example, in order to study the properties of various substances on cell cultures using tablet readers, it is first necessary to make sure that these substances do not affect the ability of cells to adsorb to the bottom of the wells of the tablet and do not interfere with cell proliferation. And if such an influence is detected, further experiments with these substances should be planned taking into account the information received. Purpose: To search the effect of ascorbic, malic and succinic acids on the ability of lung adenocarcinoma cells (A549) to adhere in a 96-well plate, followed by the onset of proliferation by fluorescence registration method using Hoechst-33342 fluorophore. Methodology: The experiment was carried out in a 96-well tablet. The working concentration of Hoechst-33342 was 1 μg/ml (1.62 μM). Fluorescence was recorded at a wavelength of 460 nm when the samples were excited by light with a wavelength of 355 nm. In an experiment to study the effect of ascorbate, malate and succinate on cell adhesion and proliferation, 20,000 cells and a solution of one of these substances in a working concentration of 2 mM were introduced into the cells of the tablet. The number of cells in the wells was estimated based on the fluorescence of Hoechst-33342 after a day of incubation. Result: In samples containing 2 mM succinic acid and ascorbic acid, a statistically significant decrease in the intensity of fluorescence was observed compared with a sample that did not contain the drug. This suggests that these compounds negatively affect the growth properties of the A549 culture: they inhibit cell adhesion or slow down their proliferation. Scope of the results and conclusions:The results obtained are necessary for the methodologically correct planning of the most detailed studies on the A549 cell line model using fluorescent methods, including studies on the radioprotective properties of ascorbate, malate and succinate under the influence of rare ionizing and neutron radiation.
相关性:许多研究人员认为,研究无毒或低毒天然物质的防辐射特性是一个很有前途的方向。其中,抗氧化剂和参与新陈代谢基本反应的物质占有特殊地位。为了避免在进行这些研究时出现方法错误,有必要进行一些额外的实验。例如,要使用读片器研究各种物质对细胞培养物的特性,首先必须确保这些物质不会影响细胞吸附到片剂孔底部的能力,也不会干扰细胞增殖。如果检测到有这种影响,则应根据所获信息计划使用这些物质进行进一步实验。目的:研究抗坏血酸、苹果酸和琥珀酸对肺腺癌细胞(A549)在 96 孔板中吸附能力的影响,以及使用 Hoechst-33342 荧光团的荧光登记法对细胞开始增殖的影响。实验方法实验在 96 孔板中进行。Hoechst-33342 的工作浓度为 1 μg/ml (1.62 μM)。当样品被波长为 355 nm 的光激发时,在波长为 460 nm 处记录荧光。在研究抗坏血酸、苹果酸盐和琥珀酸盐对细胞粘附和增殖的影响的实验中,将 20,000 个细胞和工作浓度为 2 mM 的其中一种物质的溶液引入片剂细胞中。培养一天后,根据 Hoechst-33342 的荧光估计孔中细胞的数量。结果在含有 2 mM succinic acid 和 ascorbic acid 的样品中,与不含药物的样品相比,荧光强度出现了统计学意义上的显著下降。这表明这些化合物对 A549 培养物的生长特性产生了负面影响:它们抑制了细胞粘附或减缓了细胞增殖。结果和结论的范围:所获得的结果对于从方法上正确规划使用荧光方法对 A549 细胞系模型进行最详细的研究,包括研究抗坏血酸、苹果酸盐和琥珀酸盐在稀有电离辐射和中子辐射影响下的辐射保护特性非常必要。
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引用次数: 0
The Sublimate Production Cohort of the Siberian Chemical Plant (Dosimetric Characteristics) 西伯利亚化工厂的亚硝酸盐生产群(剂量特性)
Q4 Medicine Pub Date : 2024-02-01 DOI: 10.33266/1024-6177-2024-69-1-73-76
D. Kalinkin, I. Milto, Anas R. Takhauov, Lilia R. Takhauova, Yulia A. Samoilova, G. V. Gorina, Olesya V. Litvinova, R. M. Takhauov
Introduction: Uranium, which is the raw material basis of the nuclear industry, is capable of causing adverse medical and biological consequences for workers who come into contact with its compounds in the course of their professional activities. In order to study this effect and to study in detail the biomedical consequences of the effects of uranium compounds on the body of personnel of nuclear power facilities, it is necessary to form a cohort of persons engaged in work with uranium compounds. One of the key elements of the uranium conversion technology carried out within the framework of sublimation production is the production of raw uranium hexafluoride for subsequent isotopic enrichment. Purpose: To form and characterize a cohort of sublimate production of the personnel of the Siberian Chemical Plant involved in work with uranium compounds in the period 1953–2000. Material and methods: The source of information was the regional medical dosimetric register of Seversk Biophysical Research Center, containing information on all current and former employees of the Siberian Chemical Plant (about 65,000 people) from the moment of the company’s foundation to the present. Results: A cohort of Siberian Chemical Plant workers involved in work with uranium compounds in the period 1953–2000 has been formed and described. The cohort consists of 577 people (475 men and 102 women). Biomedical information and dosimetric information about the employees included in the cohort are included in the created database of the personnel of the Siberian Chemical Plant involved in working with uranium compounds in the period 1953–2000. Conclusion: The formed cohort and database will allow conducting epidemiological studies to assess the morbidity and mortality of personnel due to malignant neoplasms, as well as making scientifically sound conclusions about the role of uranium compounds in the occurrence and mortality due to malignant neoplasms.
导言:铀是核工业的基础原料,它能对在职业活动中接触铀化合物的工人造成不良的医疗和生物后果。为了研究这种影响,并详细研究铀化合物对核电设施工作人员身体造成的生物医学后果,有必要对从事铀化合物工作的人员进行分组。在升华生产框架内进行的铀转化技术的关键要素之一是生产六氟化铀原料,以便随后进行同位素浓缩。目的:建立 1953-2000 年间西伯利亚化工厂参与铀化合物工作的人员升华生产队列并确定其特征。材料和方法信息来源是塞韦尔斯克生物物理研究中心(Seversk Biophysical Research Center)的地区医学剂量登记册,其中包含西伯利亚化工厂自成立至今所有在职和离职员工(约 65,000 人)的信息。研究结果对西伯利亚化工厂 1953-2000 年期间从事铀化合物工作的工人进行了分类和描述。群组共有 577 人(男性 475 人,女性 102 人)。队列中包括的员工的生物医学信息和剂量测定信息已纳入所建立的 1953-2000 年期间西伯利亚化工厂从事铀化合物工作的人员数据库。结论通过建立的队列和数据库,可以开展流行病学研究,评估恶性肿瘤患者的发病率和死亡率,并就铀化合物在恶性肿瘤发病率和死亡率中的作用做出科学合理的结论。
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引用次数: 0
Cryptogenic Organizing Pneumonia (Clinical Case Report, Literature Review) 隐源性组织肺炎(临床病例报告、文献综述)
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-67-72
Zh.V. Sheikh, S. Shvayko, L.G. Leonova, E. Tarachkova, E.I. Bogdanova, E.S. Stepanchenko
Despite the widespread introduction of CT into clinical practice, the diagnosis of cryptogenic organizing pneumonia is still an urgent task of modern radiology. Radiological diagnosticians and clinicians have significant difficulties in diagnosis due to rather low frequency of this disease and nonspecific clinical manifestations. Cryptogenic organizing pneumonia is a disease which sharply worsens the quality of life in case of untimely diagnosis and belongs to the group of idiopathic interstitial pneumonias. The article is devoted to the clinical case of a patient with verified cryptogenic organizing pneumonia. CT of the chest organs, along with clinical data, plays a key role in the accurate diagnosis of organizing pneumonia.
尽管CT广泛应用于临床,但隐源性组织性肺炎的诊断仍然是现代放射学的一项紧迫任务。由于本病发病率较低,临床表现无特异性,放射诊断医师和临床医生在诊断上存在很大困难。隐源性组织性肺炎是一种因诊断不及时而导致生活质量急剧恶化的疾病,属于特发性间质性肺炎。本文报道一例经证实的隐源性组织性肺炎的临床病例。胸部脏器CT结合临床资料对组织性肺炎的准确诊断起关键作用。
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引用次数: 0
Development of Software Tools Based on Clinical Data and Phantom Studies for Mathematical Simulation Modeling to Assess Brain Perfusion and Improve Image Quality During SPECT/CT with 99mTc-GMPAO 开发基于临床数据和模型研究的软件工具,用于在使用 99mTc-GMPAO 进行 SPECT/CT 时进行数学模拟建模,以评估脑灌注情况并提高图像质量
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-106-117
N.V. Denisova, A.V. Nesterova, S.M. Minin, Zh.Zh. Anashbayev, S.E. Krasilnikov, W. Yu. Ussov
Purpose: To develop a software package Virtual examination of brain perfusion by the method of SPECT/CT with 99mTc-HMPAO (Teoxime) and its practical application to study the conditions for achieving the best image quality in clinical studies of patients. Material and methods: The studies were performed using clinical data and the method of computer simulation. Clinical data of single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-hexamethylpropyleneamine oxime (99mTc-Teoxime, produced by DIAMED LLC) of a patient with an ischemic stroke of the right frontal cortex were obtained on a two-detector gamma-camera NM/CT 670 DR GE Discovery (USA) using high-resolution low-energy collimators (LEHR). The measured data were processed using specialized software Q.Brain and Q.Volumetrix MI on a Xeleris 4.0 DR workstation from GE Healthcare (USA) to obtain reconstructed axial tomographic slices. To carry out simulation computer simulation of the procedure of examination of perfusion of GM by the method of SPECT/CT has developed a software package that includes a mathematical Hoffman phantom with the ability to simulate clinical cases of hypoperfusion of different localization and size (Virtual Patient), modeling the collection of “raw” projection data and an image reconstruction program based on the OSEM algorithm (Ordered Subset Expectation Maximization). An important advantage of the mathematical modeling method is the ability to assess the quality of the reconstructed image by calculating the root-mean-square error when compared with a given phantom. In numerical experiments, the dependence of the reconstruction error on the parameters of the OSEM algorithm (on the number of subgroups – subsets, and on the number of iterations) was investigated in order to determine the conditions for achieving the best image quality. A statistical stop criterion was developed and tested. Results: For the first time, a software package was developed and tested that allows us to investigate errors in the reconstruction algorithm, which is a great difficulty when using clinical research methods. A criterion for stopping iterations is proposed when using the OSEM reconstruction algorithm – minimizing the functional deviation of the chi-square function from the target value, while the detector pixels with non-zero values are combined into blocks according to the 2×2 scheme. There is a reliable good correlation between the proposed stop criterion and the minimum of the root-mean-square error of image reconstruction. This makes it possible to introduce this criterion into the clinical practice of using computational tools for reconstructing sections of the SPECT to obtain the best image. The simulation results demonstrated the possibility of reducing the time of data recording, during which the patient must remain motionless, at least twice. Conclusion: The method of computer simulation developed in this work is a practically use
目的:开发99mTc-HMPAO (te肟)SPECT/CT方法脑灌注虚拟检查软件包及其实际应用,研究患者临床研究中获得最佳图像质量的条件。材料和方法:采用临床资料和计算机模拟方法进行研究。采用高分辨率低能准直器(LEHR),在美国通用电气公司(GE Discovery)的双探测器伽马照相机NM/CT 670 DR上获得了1例右侧额叶皮质缺血性卒中患者的单光子发射计算机断层扫描和x射线计算机断层扫描(SPECT/CT)的临床资料。测量数据在GE Healthcare (USA)的Xeleris 4.0 DR工作站上使用专用软件Q.Brain和Q.Volumetrix MI进行处理,以获得重建的轴向断层扫描切片。为了对SPECT/CT方法检查GM灌注过程进行计算机模拟,开发了一个软件包,该软件包包括能够模拟不同位置和大小的临床灌注不足病例的数学霍夫曼模型(Virtual Patient),对“原始”投影数据的收集进行建模,以及基于OSEM算法(有序子集期望最大化)的图像重建程序。数学建模方法的一个重要优点是能够通过计算与给定幻影相比较的均方根误差来评估重建图像的质量。在数值实验中,为了确定获得最佳图像质量的条件,研究了重构误差与OSEM算法参数(子群-子集数量和迭代次数)的依赖关系。开发并测试了统计停止准则。结果:我们首次开发并测试了一个软件包,使我们能够调查重建算法中的错误,这是使用临床研究方法时的一大难点。提出了OSEM重构算法停止迭代的准则——最小化卡方函数与目标值的函数偏差,同时根据2×2方案将非零值的检测器像素组合成块。所提出的停止准则与图像重建的均方根误差最小值之间具有良好的相关性。这使得将这一标准引入临床实践成为可能,使用计算工具重建SPECT切片以获得最佳图像。模拟结果证明了减少数据记录时间的可能性,在此期间,患者必须保持不动,至少两次。结论:本研究开发的计算机模拟方法是一种实用的技术,有助于优化SPECT的使用,以达到患者脑成像的最佳效果。
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引用次数: 0
The Apparent Diffusion Coefficient in the Diagnosis of Metastatic Lesions of Skeletal Bones 诊断骨骼转移性病变的表观扩散系数
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-80-85
S. Prokhorov, N. Kochergina, A. Ryzhkov, A. Krylov, A. Bludov
Aim: To evaluate the possibilities of absolute and relative values of the apparent diffusion coefficient (ADC) in the diagnosis of metastatic lesions of skeletal bones. Material and methods: The study included 12 patients with metastatic bone lesions, before any treatment was applied. The age of the patients ranged from 38 to 73 years, 3 men, 9 women. Among the morphological forms of tumors were presented: cancers of the breast (3), prostate (1) glands, colon (1), lung (2), body (1) and cervix (1) uterus, thyroid (1) and pancreas (2). The detected changes were classified on the basis of Bone scan, SPECT/CT and standard MRI. The ADC values of unchanged bone marrow (n=360), divided by anatomical zones, metastatic foci (n=117), as well as benign changes of various nature (n=19) were analyzed. The ratio of the ADC values of each of the metastatic and benign focal formations to the normal values for each of the localizations was calculated. Results: Unchanged bone marrow, depending on anatomical localization (cervical, thoracic, lumbar spine, pelvic bones, shoulder blades, collarbones, sternum, ribs, proximal humerus and femur bones) from the point of view of ADC, showed statistically significant heterogeneity. Statistical analysis has shown that there is no connection between the groups of ADC indicators in the foci of metastatic lesions, combined depending on the anatomical localization. With a similar comparison, but by belonging to the primary tumor, an even greater intergroup difference was found. ADC values in the foci of metastatic lesions turned out to be dependent on the morphological type of the primary tumor and significantly differ both from metastases of other morphological affiliation and from normal red bone marrow parameters. The use of relative values allowed to increase the specificity from 15 to 19 %. Conclusion: This study showed that knowledge of the range of reference ADC values for unchanged red bone marrow and anomalies of various genesis is important in differential diagnosis. The differentiation of the skeleton into separate anatomical zones probably makes it possible to increase the effectiveness of the isolated application of the technique when it comes to absolute values. The morphological affiliation of metastatic foci is important in the formation of ADC values, rather than the bone marrow microenvironment, which is also supported by the low efficiency of the use of relative values.
目的:探讨表观扩散系数(ADC)绝对值和相对值在骨骼转移性病变诊断中的应用价值。材料和方法:本研究包括12例未进行任何治疗的转移性骨病变患者。年龄38 ~ 73岁,男3例,女9例。肿瘤形态包括:乳腺癌(3例)、前列腺癌(1例)、结肠癌(1例)、肺癌(2例)、体癌(1例)、子宫颈癌(1例)、子宫癌(1例)、甲状腺癌(1例)、胰腺癌(2例)。根据骨扫描、SPECT/CT和标准MRI对检测到的变化进行分类。分析未改变骨髓(n=360)的ADC值,按解剖区、转移灶(n=117)和各种性质的良性改变(n=19)划分。计算每个转移性和良性病灶形成的ADC值与每个定位的正常值的比值。结果:从ADC的角度来看,根据解剖定位(颈椎、胸椎、腰椎、骨盆骨、肩胛骨、锁骨、胸骨、肋骨、肱骨近端和股骨骨),未改变的骨髓表现出统计学上显著的异质性。统计分析表明,在转移病灶的ADC指标组之间没有联系,根据解剖定位而组合。通过类似的比较,但由于属于原发肿瘤,发现了更大的组间差异。转移灶的ADC值取决于原发肿瘤的形态类型,与其他形态相关的转移灶和正常红骨髓参数有显著差异。使用相对值可以将特异性从15%提高到19%。结论:本研究表明,了解未改变的红骨髓和各种来源的异常的参考ADC值范围对鉴别诊断具有重要意义。骨骼分化成独立的解剖区可能使它有可能增加技术的孤立应用的有效性,当它涉及到绝对值。在ADC值的形成中,转移灶的形态学关联比骨髓微环境更重要,这也是相对值使用效率较低的原因之一。
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引用次数: 0
Features of the Systemic Response to Adjuvant Radiation Therapy in Carriers of Polymorphism -308(G/A)TNF in Breast Cancer Patients 乳腺癌患者多态性-308(G/A)TNF携带者对辅助放射治疗的全身反应特征
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-92-98
T. Malivanova, T. Astrelina, I. Kobzeva, V. Nikitina, Y. Suchkova, A.I. Golovkova, A. S. Ostashkin, D. Usupzhanova, V. Brunchukov, A. Rastorgueva, E. I. Dobrovolskaya, A. Kirilchev, M. Sukhova, O.G. Mikhadarkina, N.V. Sokolova, A. Samoilov
Background: Adjuvant radiation therapy (ART), an integral part of locoregional breast cance (BC) therapy, acting not only locally, but also systemically and leads to a shift in homeostasis, which is reflected in routine general clinical tests. Tumor necrosis factor (TNF) is a proinflammatory cytokine, the production of which can be influenced by the single-nucleotide substitution -308(G/A)TNF. The minor allele -308A can be included in the stable inherited haplotype AH8.1 of the HLA gene complex. At the same time, the carriage of the -308A without the AH8.1 haplotype is associated with a poor prognosis in patients with BC. The aim of the study was to evaluate the features of the systemic response to the course of ART in carriers of TNF-associated genotypes with BC. Material and methods: The sample is represented by 147 BC patients who underwent a course of ART (2 Gy in 25 fractions). Clinical and morphological characteristics and data of general clinical blood analysis were obtained from medical histories. Venous blood samples for the study were obtained at the beginning and at the end of the ART course. Alleles -308(G/A)TNF and marker alleles of haplotype AH8.1 (HLA-A×01, HLA-B×08 and HLA-DRB1×03) were determined by allele-specific PCR. sTNF concentrations were determined by the ELISA in 102 blood plasma samples. Results: TNF-associated comparison groups were identified based on genotyping: (1) 114 carriers -308GG of the TNF gene, regardless of the AH8.1 haplotype (77,6 %); (2) 23 carrier -308A(AH8.1pos) had at least one AH8.1 marker allele (15.6 %); (3) 10 carriers -308A(AH8.1neg) did not have any AH8.1 marker allele (6.8 %). In the -308A(AH8.1neg) group the average concentration of sTNF both at the beginning and at the end of ART was significantly higher and, unlike other comparison groups, did not significantly decrease at the end of the ART course. A significant decrease in absolute values was revealed during ART in a number of cases for leukocytes, platelets and lymphocytes, however within the reference values. In the group -308A(AH8.1neg) correlation analysis revealed a high strength of positive connections between sTNF and leukocytes (r=0.71; p=0.027), platelets (r=0.67; p=0.04), neutrophils (r=0.70; p=0.027) only at the end of ART, whereas at the beginning ART these correlations were weak (r≤0.3) and statistically unreliable. For other genetic groups, the revealed correlations were not strong enough. Conclusion: The revealed features of the systemic response to ART for carriers of a prognostically unfavorable genotype -308A(AH8.1neg) – a high concentration of sTNF and a positive correlation with the content of leukocytes (probably due to neutrophils) and platelets – can be considered as targets of individualized therapy.
背景:辅助放射治疗(ART)是局部乳腺癌(BC)治疗的一个组成部分,不仅局部起作用,而且全身起作用,导致体内平衡的改变,这反映在常规的一般临床试验中。肿瘤坏死因子(TNF)是一种促炎细胞因子,其产生可受单核苷酸取代-308(G/ a)TNF的影响。次要等位基因-308A可以包含在HLA基因复合体的稳定遗传单倍型AH8.1中。同时,携带不携带AH8.1单倍型的-308A与BC患者预后不良相关。该研究的目的是评估带有BC的tnf相关基因型携带者对ART治疗过程的全身反应特征。材料和方法:样本为147例接受ART疗程的BC患者(25次2 Gy)。临床和形态学特征及一般临床血液分析资料来源于病史。在ART课程开始和结束时采集静脉血样本进行研究。采用等位基因特异性PCR检测-308(G/A)TNF等位基因和AH8.1单倍型的标记等位基因(HLA-A×01、HLA-B×08和HLA-DRB1×03)。采用ELISA法测定102例血浆中sTNF的浓度。结果:根据基因分型确定TNF相关对照组:(1)114例TNF基因携带者-308GG,与AH8.1单倍型无关(77,6 %);(2) 23例携带者-308A(AH8.1pos)至少有1个AH8.1标记等位基因(15.6%);(3) 10例-308A(AH8.1阴性)携带者(6.8%)未发现AH8.1标记等位基因。在-308A(AH8.1neg)组中,ART治疗开始和结束时sTNF的平均浓度均显著升高,与其他对照组不同,ART治疗结束时sTNF的平均浓度未显著降低。在抗逆转录病毒治疗期间,许多病例的白细胞、血小板和淋巴细胞的绝对值显着下降,但在参考值范围内。在-308A组(AH8.1neg)中,相关分析显示sTNF与白细胞之间存在高强度的正相关(r=0.71;P =0.027),血小板(r=0.67;P =0.04),中性粒细胞(r=0.70;p=0.027)仅在ART结束时,而在ART开始时,这些相关性很弱(r≤0.3)并且在统计上不可靠。对于其他遗传群体,揭示的相关性不够强。结论:预后不良基因型- 308a (AH8.1neg)携带者对ART的全身反应所揭示的特点——sTNF浓度高且与白细胞(可能由中性粒细胞引起)和血小板含量呈正相关,可作为个体化治疗的靶点。
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引用次数: 0
Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation 使用高能射线联合治疗唾液腺癌症患者
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-86-91
O. Gribova, Z. Startseva, E. Choynzonov, V. A. Novikov, A. Ryabova, V. Shtin
The purpose: To evaluate the efficiency of combined treatment of patients with salivary gland cancer using neutron therapy. Material and methods: The study included 130 patients with salivary gland cancer who underwent combined treatment with adjuvant neutron or standard photon radiotherapy. Neutron therapy was performed on a cyclotron U-120. The average energy of fast neutrons was 6.3 MeV. Results: There was observed a significant decrease in the frequency of relapses in the group of patients who received a postoperative course of NT compared with the control group (21.1 % vs. 45 %, p<0.05). The five-year overall survival in the study group was 73.8±9.5 %, in the control group ‒ 43.2±9.4% (p<0.05). The value of five-year relapse-free survival in the study group was 65.6±7.5 %, in the control group ‒ 34.8±9.1 % (p<0.05). Erythema of the skin in the irradiation area (grade I) was the most frequent type of local acute radiation reaction and was observed in 60 % of patients in the study group and in 25 % of patients in the control group. The most frequent late complication in both groups of patients was skin atrophy and subcutaneous fibrosis (grade I on the RTOG/EORTC scale). In the study group, this indicator was 34.4 %, in the control group ‒ 20 % (p>0.05). Conclusion: Thus, the study confirmed the high effectiveness of fast neutron therapy against malignant tumors of the salivary glands. Neutron therapy does not cause serious complications, encourages to increase of patients life expectancy and to decrease the number of relapses after combined treatment in comparison with standard methods of treatment.
目的:评价中子疗法联合治疗涎腺癌的疗效。材料和方法:本研究纳入130例涎腺癌患者,采用辅助中子或标准光子放射治疗联合治疗。中子治疗在U-120回旋加速器上进行。快中子的平均能量为6.3 MeV。结果:与对照组相比,术后接受NT治疗的患者复发频率显著降低(21.1%比45%,p0.05)。结论:本研究证实了快中子治疗唾液腺恶性肿瘤的高疗效。与标准治疗方法相比,中子治疗不会引起严重的并发症,有利于延长患者的预期寿命,减少复发率。
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引用次数: 0
Diabetes Mellitus Incidence and the Risk of its Occurrence in Liquidators of the Chnpp Accident Consequences including Nuclear Industry Workers 包括核工业工人在内的 Chnpp 事故后果清理人员的糖尿病发病率及其发生风险
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-60-66
A. Tukov, I. Shafransky, O. Prokhorova, A.M. Mikhailenko, M. Ziyatdinov
Summary: Investigation purposes Diabetes mellitus (DM) occupies the largest share in the structure of endocrine system diseases, nutritional disorders and metabolic disorders, which is currently one of the important priorities of national health systems. Research on certain groups of the population with their own harmful occupational risk factors is relevant. Analysis of the incidence of diabetes mellitus of the second type - T2DM (ICD 10: E11-E11.9) of liquidators of the consequences of the Chernobyl accident ‒ workers of nuclear industry enterprises for 30 years of observation and assessment of the radiation risk of its occurrence. Material and methods: The study includes data from the Industry register of persons exposed to radiation as a result of the Chernobyl accident over a thirty-year period, having a verified dose of external radiation received during work in the 30 km zone of the Chernobyl nuclear power plant, men – 12663 people, 1327, of whom have data on the dose of occupational irradiation. The Poisson process with an intensity parameter was chosen as a statistical model of morbidity. Results: The incidence of T2DM in liquidators of the consequences of the Chernobyl accident was estimated by age and sex groups. On the basis of the obtained file of individual unstratified data, an analytical likelihood function for the Poisson process was constructed and the value of the excess relative risk (ERR) of T2DM incidence was calculated and the nature of the dose dependence of RR was investigated. A cohort epidemiological study of a group of liquidators in 1986–1990 was carried out. over a thirty-year period, depending on the dose, both received during the liquidation of the consequences of the Chernobyl accident, and during professional work with radioactive substances (RS) and sources of ionizing radiation (IRS). Direct estimates of the radiogenic risk of diabetes mellitus are given. Different values ​​of risk were noted when using doses from different types of radiation. There was no significant increase in the risk of disease per dose unit (ERR / Sv). Conclusion: With the aging of the cohort of liquidators, an increase in the incidence of T2DM was noted in both men and women. The results obtained on the assessment of the radiation risk of T2DM at this stage are taken as preliminary, since the use of radiation risk in the development of radiation safety regulations requires a total dose from all types of exposure (professional, emergency, medical, natural).
摘要:调查目的糖尿病(Diabetes mellitus, DM)在内分泌系统疾病、营养紊乱和代谢紊乱的结构中所占比例最大,是目前国家卫生系统的重要重点之一。对具有自身有害职业风险因素的某些人群进行研究是有意义的。分析切尔诺贝利事故后果清算者——核工业企业工作人员30年来第2型糖尿病- 2型糖尿病(ICD 10: E11-E11.9)的发病率及其发生的辐射风险的观察与评估。材料和方法:这项研究包括来自工业登记册的数据,记录了30年来因切尔诺贝利事故而受到辐射的人,在切尔诺贝利核电站30公里区域内工作期间接受了经核实的外部辐射剂量的男性12663人,其中1327人有职业性辐射剂量的数据。选择带强度参数的泊松过程作为发病率的统计模型。结果:根据年龄和性别分组估算切尔诺贝利事故后果清算者的T2DM发病率。在获得的个体非分层数据文件的基础上,构建泊松过程的似然分析函数,计算T2DM发病的超额相对危险度(ERR)值,并探讨RR的剂量依赖性质。对1986-1990年一组清盘者进行了队列流行病学研究。根据剂量,在清理切尔诺贝利事故后果期间以及在处理放射性物质和电离辐射源的专业工作期间接受的三十年期间。给出了糖尿病放射基因风险的直接估计。在使用不同类型辐射的剂量时,注意到不同的风险值。每剂量单位(ERR / Sv)的疾病风险没有显著增加。结论:随着受试者年龄的增长,T2DM的发病率在男性和女性中都有所增加。在本阶段对2型糖尿病的辐射风险进行评估所获得的结果被认为是初步的,因为在制定辐射安全条例时使用辐射风险需要计算所有类型(专业、紧急、医疗、自然)照射的总剂量。
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引用次数: 0
Modern Possibilities of Imaging Diagnosis Methods in Assessing the Severity of Fatty Hepatosis in Non-Alcoholic Fatty Liver Disease (Clinical Case) 影像诊断方法在评估非酒精性脂肪肝中脂肪肝严重程度中的现代可能性(临床病例)
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-73-79
E.I. Matkevich, A. Bashkov, E.A. Ionova, A.U. Veselkova, V.S. Rudakov, O.V. Parinov, V.V. Kapustin
Purpose: To estimate the potential of imaging methods in the diagnosis of non-alcoholic fatty liver disease (NAFLD) based on the example of a clinical case. Material and methods: A 42 years-old man with suspected of NAFLD, by the clinical and laboratory tests results, underwent a quantitative assessment of fatty hepatosis using radiodiagnosis imaging methods. We used US “liver protocol” with attenuation imaging technique (ATI), shear wave elastography (SWE), shear wave dispersion imaging (SWD), computed tomography (CT) with quantitative and qualitative assessment using the liver-spleen index (CTL-S); MRI with application that provides volumetric whole-liver fat fraction (FF) measurements by proton density (PDFF), on the basis of IDEAL IQ program. The morphological verification of liver biopsy was also performed. Results: All imaging method used in this clinical case showed severe degree of fatty hepathosis, that correlated with biopsy of liver. In repeated studies, on the background of treatment, the quantitative indicators of all imaging methods had a similar dynamics of reduction of the degree of fatty hepatosis. Conclusion: The clinical case of verified acute steatohepatitis shows the possibilities of its diagnostics by means of the radiation modalities. We used US with ATI, SWE и SWD, CT with CTL-S, MRI with FF that demonstrated high diagnostic efficiency for determination fatty hepatosis and the possibility of its quantification. These technologies are suitable for widespread implementation into clinical practice providing good diagnostic accuracy. CT associated with higher doses of radiation is not considered to be the basic method of choice for diagnosing NAFLD, but still may provide a physician with necessary information to determine further treatment strategy.
目的:通过对非酒精性脂肪性肝病(NAFLD)的临床分析,探讨影像学诊断的潜力。材料和方法:一名42岁男性疑似NAFLD,通过临床和实验室检查结果,采用放射诊断成像方法对脂肪肝进行定量评估。我们采用美国“肝脏方案”,结合衰减成像技术(ATI)、横波弹性成像(SWE)、横波色散成像(SWD)、计算机断层扫描(CT),利用肝脾指数(CTL-S)进行定量和定性评估;MRI与应用程序,提供体积全肝脂肪分数(FF)测量的质子密度(PDFF),在IDEAL IQ程序的基础上。同时进行肝活检的形态学验证。结果:本病例所有影像学检查均显示脂肪肝病变严重程度,与肝活检相关。在反复的研究中,在治疗的背景下,所有影像学方法的定量指标都具有相似的降低脂肪肝程度的动态。结论:经证实的急性脂肪性肝炎的临床病例显示了放射诊断的可能性。我们采用US联合ATI, SWE / SWD, CT联合CTL-S, MRI联合FF,对脂肪肝的诊断效率高,并有可能量化脂肪肝。这些技术适合广泛应用于临床实践,提供良好的诊断准确性。CT与高剂量的辐射不被认为是诊断NAFLD的基本方法,但仍然可以为医生提供必要的信息,以确定进一步的治疗策略。
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Medical Radiology and Radiation Safety
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