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Risk of Thyroid Diseases Associated with Iodine Deficiency of Liquidators of the Consequences of the Accident at the Chernobyl NPP ‒ Employees of Nuclear Industry Enterprises 切尔诺贝利核电站事故后果清理者-核工业企业雇员与缺碘有关的甲状腺疾病风险
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-65-70
A.R. Tukov, I.L. Shafransky, O.N. Prohorova, A.M. Mikhaylenko, M.N. Ziyatdinov
Purpose: Assessment of thyroid disease risk associated with iodine deficiency, liquidators of the Chernobyl accident consequences, employees of nuclear industry enterprises depending on the doses of different types of exposure. Material and methods: The dose-risk assessment study included 12663 men, 1327 of whom had occupational exposure data. A Poisson’s process with intensity parameter was chosen as a statistical model of morbidity risk. The statistical package of epidemiological data analysis EPICURE was used for the estimation of excess relative risk (ERR) of thyroid diseases related to iodine deficiency. There was conducted a cohort epidemiological study of a group of liquidators who worked in the 30-km zone in 1986‒1990 over a period of more than thirty years depending on the dose received both during liquidation of the Chernobyl accident consequences and during professional work with radioactive substances (RS) and ionizing radiation sources (IRS). Results: As a result of the study direct estimates of radiogenic risk of thyroid diseases associated with iodine deficiency in the liquidators of the Chernobyl accident consequences were obtained for the first time using the data on doses of Chernobyl and the sum of these doses with the doses of occupational exposure. It is shown that the risk of disease per unit dose (ERR/Zv) for dose loads received both at liquidation of Chernobyl accident consequences and for total doses give different results. Conclusion: Assessment of the risk of thyroid diseases associated with iodine deficiency, liquidators of the Chernobyl NPP accident consequences and workers of nuclear industry enterprises, serviced by FMBA health care institutions of Russia using the doses of different types of exposure gives different results. Correct results of assessing the risk of radiation-related diseases can only be given by the register using the total radiation dose (occupational, accidental, medical, natural), as required by the directive documents.
目的:评估与碘缺乏有关的甲状腺疾病风险,切尔诺贝利事故后果清理者,核工业企业雇员,根据不同类型的暴露剂量。材料和方法:剂量风险评估研究纳入12663名男性,其中1327人有职业暴露数据。选择带强度参数的泊松过程作为发病风险的统计模型。流行病学数据分析统计软件包EPICURE用于估计与碘缺乏相关的甲状腺疾病的超额相对风险(ERR)。根据清理切尔诺贝利事故后果期间和处理放射性物质和电离辐射源的专业工作期间所接受的剂量,对1986-1990年在30公里区域工作的一组清理人员进行了一项队列流行病学研究。结果:研究的结果是,利用切尔诺贝利剂量数据以及这些剂量与职业照射剂量的总和,首次获得了切尔诺贝利事故后果清理者中与碘缺乏有关的甲状腺疾病放射成因风险的直接估计。结果表明,清理切尔诺贝利事故后果时和总剂量时所受剂量负荷的每单位剂量疾病风险(ERR/Zv)产生不同的结果。结论:对俄罗斯FMBA医疗机构服务的与碘缺乏相关的甲状腺疾病风险评估、切尔诺贝利核电站事故后果清理者和核工业企业工人使用不同类型的暴露剂量得出不同的结果。根据指令文件的要求,只有使用总辐射剂量(职业辐射、意外辐射、医疗辐射、自然辐射)的登记机构才能给出评估辐射相关疾病风险的正确结果。
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引用次数: 0
Late Effects of γ, n-Irradiation of Mice: Shortening of Telomeres and Tumors Development γ, n辐照小鼠的晚期效应:端粒缩短和肿瘤发展
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-11-18
E.Yu. Moskaleva, O.V. Vysotskaya, E.S. Zhorova, D.A. Shaposhnikova, V.P. Saprykin, I.V. Cheshigin, O.D. Smirnova, A.S. Zhirnik
Purpose: To investigate the telomere length (TL) of bone marrow and thymus cells as a marker of replicative aging late after the prolonged γ, n-irradiation of mice at low and moderate doses and analysis of the appearance of tumors by the end of the experiment − after 14 months. Material and methods: C57Bl/6 and CBA mice were irradiated at doses of 10–500 mGy at the OR-M facility using Pu-Be radionuclide sources at a total absorbed dose rate of neutrons and gamma rays of 2.13 mGy/h, 75 % of which – 1.57 mGy/h – accounted for neutrons with an average energy of 3.5 MeV. Absolute TL in bone marrow and thymus cells was determined using real-time PCR 2 months and 1 year 2 months after irradiation, and the mean TL was calculated. Tumors found during the mice organs examination after autopsy were subjected to histological examination. Results: It was shown that the TL in bone marrow and thymus cells of control CВA mice was 2 times higher than the TL observed in C57Bl/6 mice. Prolonged γ, n-irradiation of C57Bl/6 mice led to a dose-dependent decrease in TL in bone marrow cells 14 months after exposure, which was statistically significant at doses of 100 and 500 mGy. A decreased TL in the thymus was found only at a dose of 500 mGy. During this period, TL in bone marrow cells of CBA mice was reduced in dose-independent manner, starting from as low as 10 mGy, but no statistically significant decrease in TL was found in the thymus. The results obtained indicate the acceleration of replicative senescence of bone marrow cells in mice in the long term period after γ,n-irradiation already at low doses, and in thymus cells only at a dose of 500 mGy. Twenty-four hours after irradiation at doses of 100 and 500 mGy the number of leukocytes in mice of both lines was reduced, which was recovered in C57Bl/6 mice after a week, and in CBA mice – after two weeks. In 14 months after γ, n-irradiation, the appearance of tumors was found in mice of both studied lines: in CBA mice, lung adenocarcinoma at a dose of 50 mGy (in 1 out of 10) and uterine carcinosarcoma at a dose of 500 mGy (in 1 out of 10); in C57Bl/6 mice, keratinizing squamous cell carcinoma of the uterus at a dose of 500 mGy (2 out of 10) was seen in the absence of tumors in control mice. Histological examination of the liver of CBA mice after γ, n-irradiation at a dose of 500 mGy revealed deep dystrophic changes, the causes of which are not clear. Conclusion: The results obtained indicate a high biological hazard of prolonged γ, n-irradiation at doses above 10 mGy, since after irradiation at this dose, an acceleration of replicative senescence of bone marrow cells in the long-term period was found, and the possibility of tumor formation increases after irradiation at a dose of 50 mGy and higher.
目的:研究中、低剂量γ、n照射后小鼠骨髓和胸腺细胞端粒长度(TL)作为增殖衰老的标志,并分析14个月后肿瘤的外观。材料与方法:采用Pu-Be核素源,在OR-M设施对C57Bl/6和CBA小鼠进行10 ~ 500 mGy剂量的辐照,中子和伽马射线的总吸收剂量率为2.13 mGy/h,其中75% (1.57 mGy/h)为平均能量为3.5 MeV的中子。照射后2个月和1年2个月,采用实时荧光定量PCR法测定骨髓和胸腺细胞的绝对TL,并计算平均TL。解剖后对小鼠器官检查中发现的肿瘤进行组织学检查。结果:对照CВA小鼠骨髓和胸腺细胞的TL比C57Bl/6小鼠高2倍。C57Bl/6小鼠长时间γ、n照射14个月后,骨髓细胞TL呈剂量依赖性下降,剂量为100和500 mGy时具有统计学意义。仅在剂量为500mgy时,胸腺中TL降低。在此期间,CBA小鼠骨髓细胞的TL呈剂量无关性降低,从低至10 mGy开始,但胸腺的TL未见统计学意义上的降低。结果表明,低剂量的γ、n照射和仅500 mGy剂量的胸腺细胞在长期内加速了小鼠骨髓细胞的复制衰老。100和500 mGy剂量照射24小时后,两系小鼠白细胞数量均减少,C57Bl/6小鼠一周后恢复,CBA小鼠两周后恢复。在γ, n照射后的14个月,两种研究系的小鼠都出现了肿瘤:在CBA小鼠中,50毫戈瑞剂量的肺腺癌(十分之一)和500毫戈瑞剂量的子宫癌肉瘤(十分之一);在C57Bl/6小鼠中,500 mGy剂量(2 / 10)可在对照组小鼠无肿瘤的情况下观察到子宫角化鳞状细胞癌。500 mGy γ、n辐照后CBA小鼠肝脏组织学检查显示肝脏发生深度营养不良,原因尚不清楚。结论:10 mGy以上长时间γ, n照射具有较高的生物学危害,在此剂量照射后,骨髓细胞在长时间内增殖衰老加速,50 mGy及以上剂量照射后肿瘤形成的可能性增加。
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引用次数: 0
Protective Properties of Compound Aicar in Vivo Exposed to Radiation 复方黄芩对体内辐射防护性能的研究
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-5-10
S.A. Abdullaev, D.V. Saleeva, M.V. Dushenko, N.F. Raeva, А.I. Abdullaeva, G.D. Zasukhina, A.N. Osipov
Purpose: To study the effect of 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) on the survival rate of mice and proportion of polychromatophilic erythrocytes (PCE) in the bone marrow cells with micronuclei (MN), as well as post-irradiation urinary excretion of cell-free nuclear DNA (cf-nDNA) and mitochondrial DNA (cf-mtDNA) in rats. Material and methods: Male Balb/c mice aged 2 months and Fisher-344 male rats aged 3 months were used. To determine the survival rate of mice, X-irradiation was performed at a dose of 8 Gy, and to analysis the proportion of PCE in the bone marrow cells with MN, at a dose of 2 Gy. Rats were X-irradiated at a dose of 5 Gy. AICAR was administered to animals intraperitoneally at a dose of 400 mg/kg. The drug was administered 30 min before and 20 min after irradiation of the animals. The DNA content was measured by real-time PCR. Results: The results of the study showed that the introduction of AICAR causes a statistically significant increase in the survival rate of irradiated animals. The greatest effect was shown in the group of mice treated with AICAR 20 min after their irradiation at a lethal dose. The introduction of AICAR before irradiation reduces the proportion of PCE with MN by 30 %, and after irradiation ‒ by 70 %, in comparison to the control. AICAR promoted enhanced urinary excretion of cf-nDNA and cf-mtDNA fragments in rats after irradiation. Conclusion: The results show that AICAR acts as a radiomitigation effector and promotes active DNA excretion of damaged cell from animal tissues in the post-radiation period.
目的:研究5-氨基咪唑-4-羧基酰胺核糖核苷酸(AICAR)对小鼠存活率、骨髓微核细胞(MN)中多色红细胞(PCE)比例以及辐照后大鼠尿中游离核DNA (cf-nDNA)和线粒体DNA (cf-mtDNA)的影响。材料与方法:2月龄雄性Balb/c小鼠和3月龄雄性Fisher-344大鼠。为了确定小鼠的存活率,x射线照射剂量为8 Gy,并分析骨髓细胞中PCE与MN的比例,剂量为2 Gy。对大鼠进行5gy剂量的x射线照射。AICAR以400 mg/kg的剂量腹腔给药。给药时间分别为动物照射前30 min和照射后20 min。采用实时荧光定量PCR法测定DNA含量。结果:研究结果表明,引入AICAR后,辐照动物的存活率有统计学上的显著提高。在AICAR致死剂量照射20分钟后,AICAR对小鼠的影响最大。与对照组相比,在照射前引入AICAR可将PCE中MN的比例降低30%,照射后降低70%。AICAR促进大鼠在照射后尿中cf-nDNA和cf-mtDNA片段的排泄。结论:AICAR具有辐射抑制作用,可促进动物组织损伤细胞在辐射后的DNA活性排泄。
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引用次数: 0
Ten-Year Results of Complex Treatment of Patients with Primary Local Advanced Breast Cancer 原发性局部晚期乳腺癌综合治疗10年疗效观察
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-71-76
V.V. Velikaya, Zh.A. Startseva, V.E. Goldberg, N.O. Popova
Purpose: To present ten-year results of complex treatment of patients with primary locally advanced breast cancer, depending on the type of ionizing radiation used and chemotherapy regimens. Material and methods: The study included 250 patients with stage T2‒4N0‒3M0 breast cancer, aged 34–69 years (mean age 48.1±5.6 years), who underwent complex treatment (courses of NChT and AChT, hormonal and targeted therapy (according to indications), radical mastectomy and radiation therapy with various types of ionizing radiation) at the Research Institute of Oncology from 2007 to 2020. The mean follow-up period was 10±2.7 years. Main group (n=110) ‒ neutron therapy, comparison group I (n=80) ‒ photon therapy, comparison group II (n=60) ‒ electron therapy. Results: Ten-year relapse-free survival of patients with locally advanced breast cancer (PL BC) after adjuvant neutron therapy on the area of the anterior chest wall was 92.5±3.5 %, after photon therapy ‒ 70.9±5.6 %, after electron therapy ‒ 73.6±7.1 %. There were statistically significant differences between the main group and comparison groups (p<0.05). Overall survival over a ten-year follow-up period in the main group was 87.5±3.8%, in comparison group I ‒ 73.6±8.6 %, in comparison group II ‒ 38.8±10.0 %. Between neutron and electron therapy – p<0.05. In the group with neutron therapy and chemotherapy according to doxorubicin + taxane regimens, ten-year metastatic-free and overall survival was 72.8±10.0 % and 96.7±3.3 %, respectively, compared with neutron therapy and chemotherapy according to FAC/CAF regimens ‒ 44.0±14.7 % and 83.7±6.7 %, respectively (p<0.05). Neutron therapy was well tolerated by all breast cancer patients. Radiation reactions of the skin predominantly I‒II degree. Radiation pneumonitis after neutron therapy ‒ in 6 (5.4 %) out of 110 patients, after photon therapy ‒ in 17 (21.25 %) out of 80 patients with PL BC (p=0.023). Conclusion: Thus, the use of adjuvant neutron therapy in patients with breast cancer T2‒4N0‒3M0 is a safe method and has significantly better results in ten-year relapse-free survival, which makes it possible to increase the effectiveness of complex treatment. In combination with doxorubicin + taxane chemotherapy regimens, neutron therapy increases the 10-year metastatic-free and overall survival rates.
目的:根据所使用的电离辐射类型和化疗方案,介绍原发性局部晚期乳腺癌患者10年来的综合治疗结果。材料与方法:本研究纳入肿瘤研究所2007 - 2020年收治的250例T2-4N0-3M0期乳腺癌患者,年龄34-69岁(平均48.1±5.6岁),均接受了综合治疗(NChT和AChT疗程、激素和靶向治疗(根据适应证)、乳房根治术和各种电离辐射放射治疗)。平均随访时间为10±2.7年。主组(n=110) -中子治疗,比较组(n=80) -光子治疗,比较组(n=60) -电子治疗。结果:局部晚期乳腺癌(PL BC)患者胸壁前区辅助中子治疗后10年无复发生存率为92.5±3.5%,光子治疗后为70.9±5.6%,电子治疗后为73.6±7.1%。主组与对照组比较差异有统计学意义(p < 0.05)。10年随访期间,主组总生存率为87.5±3.8%,对照组为73.6±8.6%,对照组为38.8±10.0%。中子治疗与电子治疗之间- p<0.05。中子治疗组和多柔比星+紫杉烷方案化疗组的10年无转移生存率分别为72.8±10.0%和96.7±3.3%,而中子治疗组和FAC/CAF方案化疗组的10年无转移生存率分别为44.0±14.7%和83.7±6.7% (p < 0.05)。所有乳腺癌患者对中子治疗耐受良好。皮肤的辐射反应以I-II度为主。中子治疗后放射性肺炎- 110例患者中有6例(5.4%),光子治疗后- 80例PL BC患者中有17例(21.25%)(p=0.023)。结论:因此,辅助中子治疗乳腺癌T2-4N0-3M0患者是一种安全的治疗方法,10年无复发生存率明显提高,为提高综合治疗的有效性提供了可能。与阿霉素+紫杉烷化疗方案联合,中子治疗可提高10年无转移生存率和总生存率。
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引用次数: 0
When the Factor of Crystallized Intelligence Can Be a Professionally “Undesirable” Personal Quality of Operators 当结晶智力因素可能成为操作员的职业“不良”个人素质时
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-34-37
A.A. Kosenkov
Purpose: To discuss the case of oppositely directed influences of the indicators of crystallized and fluid intelligence in the decisive rule designed to predict the professional success of the nuclear power plants (NPPs) operators. Material and methods: This paper analyzes the results of psychodiagnostic examinations of operators of main control rooms (MCR) of NPPs that functioned under normal conditions. All individuals were administered the J. Raven’s “Progressive matrices”, the Russian language adaptation of the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire (16PF, form A). A cross-expert review using the ranking method revealed two groups of operators with relatively higher and lower levels of professional success. The method of canonical correlation analysis has been used to obtain the best linear discriminator for predicting the professional success of MCR operators based on indicators of psychodiagnostic tests. Results: Based on the results of the expert assessment, two groups of operators with the highest and lowest professional success were identified. Decisive rule were obtained that make it possible to predict the professional success of operators based on a system of signs (values of the psychodiagnostic tests scales multiplied by coefficients) after the data processing using canonical correlation analysis. Unexpected result was that the high values of 16PF factor «B» turned out to be «undesirable» for the prediction of professional success, that is, these values increased the probability of assigning the operator to the group of the lowest successful specialists. Conclusion: Factor «B» of 16PF was considered as a tool for assessing predominantly crystallized intelligence, and the Raven’s test – for the fluid one. At the same time, there are no methods that allow measuring these indicators in their purest form. Taking this fact into account, the author believes that the true role of factor B in the decisive rule did not reflect the undesirability of advanced crystallized intelligence among MCR operators. It is most likely that its opposition to the «desirable» indicator (the number of correctly solved tasks of the Raven’s test) made it possible to single out the role of fluid intelligence (or some of its lower-level aspects) as a professionally important quality for the particular operator activity.
目的:探讨结晶智力指标和流体智力指标在核电厂操作人员职业成功预测决定性规则中的反向影响情况。材料与方法:对正常运行的核电站主控制室操作人员的心理诊断检查结果进行分析。所有被试均接受了J. Raven的“进步矩阵”、明尼苏达多相人格量表(MMPI)的俄语适应性和16个人格因素问卷(16PF,表格A)。采用排序法进行的跨专家评估显示,两组操作人员的职业成功水平相对较高和较低。运用典型相关分析的方法,以心理诊断测试指标为基础,得到预测MCR操作人员职业成功的最佳线性判别符。结果:根据专家评估结果,确定了专业成功率最高和最低的两组操作人员。在使用典型相关分析对数据进行处理后,获得了基于符号系统(心理诊断测试量表值乘以系数)来预测操作人员专业成功的决定性规则。出乎意料的结果是,16PF因子“B”的高值对于专业成功的预测是“不受欢迎的”,也就是说,这些值增加了将操作员分配到最低成功专家组的可能性。结论:16PF的因子“B”被认为是主要用于评估结晶智力的工具,而Raven测试则用于评估流体智力。同时,没有任何方法能够以最纯粹的形式衡量这些指标。考虑到这一事实,笔者认为,因子B在决定性规则中的真实作用并没有反映出高级结晶情报在MCR操作员中的不受欢迎程度。最有可能的是,它与“理想”指标(正确解决渡鸦测试任务的数量)的对立,使得流体智力(或其一些较低层次的方面)的作用有可能被单独挑出来,作为特定操作员活动的专业重要品质。
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引用次数: 0
Comparative Characteristics of Eeg Frequency Bands and Cerebral Energy Exchange at a Low Level of Psychophysiological Adaptation in Employees of Nuclear Hazardous Enterprises and Productions 核危险企业和生产企业员工低水平心理生理适应时脑电图频带和脑能交换的比较特征
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-50-59
Z.F. Zvereva, F.S. Torubarov, N.P. Vanchakova, S.N. Lukyanova, E.V. Miroshnik, E.A. Denisova
Purpose: Comparative assessment of the functional state and energy processes of the brain in workers of nuclear hazardous enterprises and industries with high and low levels of psychophysiological adaptation (PPA). The parameters of the spectral power of the EEG frequency ranges and cerebral energy exchange at low and high levels of PPA, low and high functional activity (FA) of conditionally isolated structural and functional formations (SFF) characterizing: mental level of functioning − SFF-1, psychophysiological level − SFF-2, physiological − SFF-3 were compared. Material and methods: 311 archived EEG – 159 individuals with a low level of PPA (50.8±4.6; 13 women); 152 EEG individuals with a high level of PPA (48.8±1.5; 12 women). The power of the frequency ranges of the EEG was evaluated by computer analysis using the fast Fourier transform algorithm; cerebral energy exchange using the value of the hemispheric differences in the power of biopotentials of EEG homologous leads. Results: At a low level of PPA, higher activity of cortical structures and higher cerebral energy exchange were revealed. In the SFF the changes manifested themselves in different ways. Increased activity of cortical structures was noted in SFF-1 and SFF-3 (in all areas of the cortex, including temporal, associated with the limbic-reticular complex). In SFF-2, the activity of cortical structures weakened both in the anterior and posterior parts of the cortex, the activity of the temporal zones did not change. Increased cerebral energy exchange was noted in SFF-1 and SFF-2. It was detected in the anterior parts of the cortex, and was not detected in the posterior. In SFF-3, the cerebral energy exchange did not change – neither in the anterior nor posterior parts of the cortex. Conclusion: Various SFF of the brain take part in ensuring brain activity at a low level of PPA, which is reflected in the characteristics of EEG frequency spectra and indicators of cerebral energy exchange of the brain regions concerned. The processes associated with the participation of structural and functional education reflecting the mental level of functioning (SFF-1) are characterized at a low level of PPA by increased activity of the anterior cortex, which is accompanied by increased cerebral energy exchange. The deepening of research in this direction may contribute to the identification of additional compensatory mechanisms of the brain aimed at ensuring the functional activity required for the exercise of professional activity by persons with a low level of PPA.
目的:比较评价核危险企业和高、低心理生理适应水平(PPA)行业工人的脑功能状态和能量过程。比较低、高水平PPA、条件分离结构和功能层(SFF)低、高功能活性(FA)表征的脑电图频率范围谱功率参数和脑能交换:心理功能水平- SFF-1、心理生理水平- SFF-2、生理- SFF-3。材料和方法:311例存档脑电图- 159例低水平PPA(50.8±4.6;13名女性);高PPA EEG个体152例(48.8±1.5);12个女性)。采用快速傅立叶变换算法对脑电信号的频率范围功率进行计算机分析;利用脑电同源导联生物电位的半球差异值进行脑能量交换。结果:PPA水平低时,大鼠皮层结构活动增强,脑能量交换增多。在SFF中,这些变化以不同的方式表现出来。SFF-1和SFF-3(包括颞叶在内的所有与边缘网状复合体相关的皮质区域)的皮层结构活动增加。在SFF-2中,前部和后部皮层结构的活动减弱,颞区活动没有变化。SFF-1和SFF-2脑能量交换增加。它在皮层的前部被检测到,而在后部没有被检测到。在SFF-3中,大脑能量交换没有改变——无论是在皮层的前部还是后部。结论:脑的各种SFF参与了保证低PPA水平下的脑活动,这体现在脑相关区域的脑电图频谱特征和脑能量交换指标上。参与反映心理功能水平(SFF-1)的结构和功能教育相关的过程以低PPA水平为特征,通过增加前皮层的活动,这伴随着大脑能量交换的增加。在这方面的深入研究可能有助于确定大脑的额外代偿机制,旨在确保低PPA水平的人从事专业活动所需的功能活动。
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引用次数: 0
State of Bone Marrow Hematopoiesis in Chronic Radiation Disease Patients, Irradiated with Different Dose Rates 不同剂量率慢性放射病患者骨髓造血状况的研究
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-44-49
I.A. Galstian, A.Yu. Bushmanov, N.A. Metlyaeva, M.V. Konchalovsky, V.Yu. Nugis, F.S. Torubarov, O.V. Shcherbatykh, Z.F. Zvereva, L.A. Yunanova
Purpose: to study the features of the state of the bone marrow according to cytological and histological studies at different periods of the course of CRD, caused by exposure to different dose rates, which developed as a result of professional prolonged exposure in a cohort of former employees of a radiation hazardous enterprise who underwent inpatient examination at the clinic of the A.I. Burnazyan Federal Medical and Biomedical Center in the period up to 1995. Material and methods: the study of the results of cytological and histological studies of the bone marrow was carried out in former workers of the Mayak Production Association who were exposed to long-term industrial exposure with a dose rate of 0.008−0.07 Gy / day (15 people), 0.003−0.007 Gy / day (12 people) and less than 0.001 Gy/day (25 people), during periods of formation, outcomes, immediate and long-term consequences of CRS. At the stage of studying the results of histological examination of the bone marrow, 54 more patients with CRS were added to the third group, irradiated with a dose rate of less than 0.001 Gy / day. Statistical processing of the material was carried out using the IBM SPSS Statistics software package.23 using the Kruskal‒Wallis test and the Mann‒Whitney U-test for independent samples. The results obtained were considered statistically significant at p < 0.05. Results: At a dose rate of 0.008−0.07 Gy / day during the formation period, the myelogram revealed narrowing of the granulocyte and expansion of the red germs, acceleration of maturation of granulocytes with a normal erythrocyte maturation index and leuko-erythroblast ratio. In peripheral blood – agranulocytosis. In the period of outcomes and immediate consequences − narrowing of the granulocytic, expansion of erythrocyte germs, acceleration of maturation of neutrophils with other myelogram parameters within normal limits. In the blood − agranulocytosis, anemic syndrome. In the long term, in the case of restoration of hematopoietic function, narrowing of the granulocytic germ with other myelogram parameters within the reference values. However, with a similar course of CRS in 60 % of patients in periods of outcomes and long-term consequences, the development of myelodysplastic syndrome with transformation into acute leukemia or aplastic anemia is possible. At an irradiation dose rate of 0.003−0.007 Gy / day in the period of CRD formation, the myelogram revealed an expansion of the granulocytic germ, with other indicators within the normal range. In the period of outcomes and immediate consequences, an acceleration of maturation of granulocytes and an increase in the leuko-erythroblastic ratio were found. In the long term, a narrowing of the granulocytic and expansion of the erythrocyte sprouts, a slight acceleration of the maturation of granulocytes were found. Hystological examination: polymorphocellular bone marrow – in 11 out of 25 patients, hypoplasia – in 9 out of 25, signs of hyperplasia – in 5 out of
目的:根据细胞学和组织学研究,在CRD病程的不同时期研究骨髓状态的特征,这是由于暴露于不同剂量率造成的,这是由于在A.I. Burnazyan联邦医疗和生物医学中心的诊所接受了1995年期间的专业长期照射而形成的辐射危险企业的前雇员队列。材料和方法:对在CRS形成、结果、即时和长期后果期间长期暴露于剂量率为0.008 - 0.07 Gy/天(15人)、0.003 - 0.007 Gy/天(12人)和低于0.001 Gy/天(25人)的Mayak生产协会前工人进行骨髓细胞学和组织学研究结果的研究。在研究骨髓组织学检查结果阶段,第三组再增加54例CRS患者,照射剂量率小于0.001 Gy / d。采用IBM SPSS统计软件包对资料进行统计处理。23使用Kruskal-Wallis检验和Mann-Whitney u检验独立样本。获得的结果在p <下被认为具有统计学意义;0.05. 结果:形成期剂量率为0.008 ~ 0.07 Gy / d时,粒细胞变窄,红芽增大,粒细胞成熟加快,红细胞成熟指数和白细胞-红母细胞比值正常。外周血-粒细胞缺乏症。在结果和直接后果期间-粒细胞狭窄,红细胞扩增,中性粒细胞成熟加速,其他骨髓学参数在正常范围内。在血液中-粒细胞缺乏症,贫血综合征。长期来看,在造血功能恢复的情况下,粒细胞变窄,其他骨髓学参数在参考值范围内。然而,在结果期和长期后果期,60%的患者有类似的CRS病程,骨髓增生异常综合征发展为急性白血病或再生障碍性贫血是可能的。在CRD形成期,在0.003 ~ 0.007 Gy /天的照射剂量率下,骨髓示粒细胞增多,其他指标在正常范围内。在结果和直接后果期间,发现粒细胞成熟加速和白细胞-红细胞比例增加。从长期来看,粒细胞变窄,红细胞芽变大,粒细胞成熟稍有加速。生理检查:25例患者中有11例为多形态细胞骨髓,25例患者中有9例发育不全,25例患者中有5例出现增生迹象。长期观察,本组2例患者发生血液病。当辐照功率小于0.001 Gy / day时,在CRD的所有时期,患者的骨髓图中粒细胞和红细胞芽肿值均正常。在CRD形成期间,由于中性粒细胞的加速成熟,粒细胞达到了正常的大小。长期后果期的白细胞/红细胞比率显著高于正常值(分别为5.29和4.5)。生理检查:64例患者骨髓多形态细胞32例,骨髓发育不全22例,骨髓增生7例。结论:CRD的造血组织和外周血的规律性变化可以作为诊断标准,据此可以推测患者所受辐射的剂量率,并在此基础上可以预测由于这种暴露而导致的CRD的结局和长期后果。
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引用次数: 0
Integration of Icrp Oir Models Into the iDose 2 Dosimetry System 将Icrp ir模型集成到idos2剂量测定系统中
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-19-27
V.V. Vostrotin
Introduction: The iDose 2 dosimetry system is a tool for assessing the doses of internal irradiation of workers under the current individual dosimetry control (IDC). In this system, according to a series of measurements of the activity of radionuclides in biological objects (including those not exceeding the detection limit of the measurement technique) and information on contact times and types of compounds, estimates of the committed effective dose equivalent (CEDE) of internal irradiation, as well as their uncertainties, are made based on the Bayesian approach. It is possible to integrate practically any biokinetic models of the behavior of radionuclides in the human body, presented in the form of a system of ordinary differential equations (ODEs) with constant transition coefficients between compartments, into the iDose 2 dosimetry system without changing the source code. Purpose: Integration of new combined biokinetic models for the list of radionuclides: H-3, Sr-90, Cs-137, Pu-238, Pu-239 and Am-241 from Publications 100, 130, 134, 137 and 141 of the ICRP (conventionally called the series Occupational Intakes of Radionuclides (OIR)), for ingestion and inhalation routes of intake with AMAD = 1 and 5 microns. Material and methods: For each variant of the biokinetic model, the functions of retention/removal of radionuclides were found through the eigenvectors and eigenvalues of the matrix describing the ODE system. Results: A total of 65 new biokinetic models and 180 functions of radionuclide retention/removal in the form of a sum of exponents were integrated and quality control was carried out.
iDose 2剂量测量系统是在当前个人剂量控制(IDC)下评估工人内照射剂量的工具。在该系统中,根据对生物物体(包括未超过测量技术检测限度的物体)中放射性核素活度的一系列测量以及接触时间和化合物类型的信息,根据贝叶斯方法估计内部照射的承诺有效剂量当量(CEDE)及其不确定度。实际上,在不改变源代码的情况下,可以将放射性核素在人体内的行为的任何生物动力学模型,以常微分方程(ode)系统的形式呈现,在隔室之间具有恒定的过渡系数,整合到iDose 2剂量测定系统中。目的:整合来自ICRP出版物100、130、134、137和141的放射性核素清单(通常称为放射性核素职业摄入量系列(OIR))的新的组合生物动力学模型,用于AMAD = 1和5微米的摄入和吸入途径。材料和方法:对于生物动力学模型的每个变体,通过描述ODE系统的矩阵的特征向量和特征值找到放射性核素的保留/去除功能。结果:共整合了65个新的生物动力学模型和180个指数和形式的放射性核素保留/去除函数,并进行了质量控制。
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引用次数: 0
Radiation Situation Around Commissioning Mine No. 6 of Pjsc ‘Priargunskiy Mining and Chemical Production Association’ Pjsc“Priargunskiy矿业与化工生产协会”投产6号矿周边辐射情况
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-28-33
N.K. Shandala, I.V. Gushchina, A.V. Titov, I.S. Belskikh, V.А. Seregin, T.A. Doroneva, D.V. Isaev, V.G. Starinskiy, A.A. Shitova
Purpose: Study of the radioecological situation around mine No. 6 of PJSC ‘Priargunsky Industrial Mining and Chemical Association’ named after E.P. Slavskiy" before commissioning. Material and Methods: During the radiation survey, to measure the ambient dose equivalent rate, the pedestrian gamma survey method was used using the portable spectrometric complex MKS-01A ‘Multirad-M’ (Russia) and the dosimeter-radiometer MKS-AT6101s (Belarus). To study the specific activity of radionuclides in the soil, samples were taken in accordance with GOST 17.4.3.01-2017. The activity of gamma-emitting radionuclides was measured on a stationary gamma spectrometer manufactured by Canberra (USA). The activity of 210Po and 210Pb was measured on the radiometric system UMF-2000 (Russia) after their radiochemical extraction from samples. Dose assessment of exposure to biological objects was made using dose coefficients established in ICRP Publication 136, considering recommendations R52.18.820-2015. Results: The results of the study showed that the ambient dose equivalent rate of gamma radiation varied in a wide range from 0.1 to 4.9 µSv/h. The average value in the background areas is 0.14±0.02 µSv/h. The specific activity of natural radionuclides outside the rock dumps, except for 40K, in some areas exceeds the background values up to 10 times. The ecological risk for the considered terrestrial biological objects (grass, shrub, soil worm and mouse-like rodents) does not exceed 10‒2. Conclusion: There are areas on the territory with traces of anthropogenic activity, which led to man-made radiation contamination. The highest levels of ambient dose equivalent of gamma radiation occur near rock dumps. The rest of the territory has local areas with radioactive contamination. Doses of exposure to biological objects don’t have a significant effect on the incidence, reproduction, and life expectancy of terrestrial biological objects.
目的:研究以E.P. Slavskiy命名的PJSC“Priargunsky Industrial Mining and Chemical Association”6号矿投产前的放射性生态状况。材料和方法:在辐射调查中,使用便携式光谱测量仪MKS-01A ' Multirad-M '(俄罗斯)和剂量辐射计MKS-AT6101s(白俄罗斯),采用行人伽马测量法测量环境剂量当量率。为了研究土壤中放射性核素的比活度,按照GOST 17.4.3.01-2017的规定取样。发射放射性核素的活度是在堪培拉(美国)制造的固定式伽马能谱仪上测量的。从样品中提取210Po和210Pb后,在俄罗斯UMF-2000辐射系统上测定了它们的活度。根据ICRP第136号出版物中建立的剂量系数,考虑到R52.18.820-2015建议,对生物物体的暴露进行剂量评估。结果:研究结果表明,伽马辐射的环境剂量当量率在0.1 ~ 4.9µSv/h范围内变化较大。背景区的平均值为0.14±0.02µSv/h。除40K外,在某些地区,岩石堆外天然放射性核素的比活度超过背景值高达10倍。所考虑的陆地生物对象(草、灌木、土壤蠕虫和类鼠啮齿动物)的生态风险不超过10-2。结论:境内存在人为活动痕迹,造成人为辐射污染。相当于伽马辐射的最高水平的环境剂量发生在岩石堆附近。其余地区有局部地区受到放射性污染。接触生物物体的剂量对陆地生物物体的发病率、繁殖和预期寿命没有显著影响。
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引用次数: 0
SPECT/CT with 99mTc-Technetryl in Staging, Planning of External Radiotherapy and Follow-up in Lung Cancer: a Clinical Case and Case – Addressed Review of Literature SPECT/CT与99mtc技术在肺癌分期、外放疗计划和随访中的应用:一个临床病例和个案文献综述
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-96-104
S.M. Minin, Zh.Zh. Anashbayev, E.A. Samoylova, A.A. Zheravin, W.Yu. Ussov, S.E. Krasilnikov, A.M. Cherniavsky
The case of a patient with newly diagnosed peripheral cancer of the right lung, involving the pleura, in whom the local extent of the process initially detected by X-ray CT was significantly extended from the data of the SPECT with 99mTc-technetryl. In particular, with SPECT/CT before the start of radiation therapy (RT), involved lymph nodes were detected both in the lower edge of the root of the right lung, and in paraaortic and paratracheal location. The SPECT/CT with 99mTc-technetryl was carried out with dual-detector gamma-camera GE Discovery NM/CT 670 DR (GE Medical) in a quantitative mode, with calibration and calculation of indexes of standardized uptake values (SUV) and % uptake of the administered activity by the primary tumor and metastatically involved lymph nodes. The values of the volume of tumor tissue were, respectively, for the tumor and the largest proximal metastatically involved lymph node 154.2 cm3 and 12.9 cm3, % of the activity absorbed by the tumor tissue − 0.498 and 0.030 %, and SVP ‒ 2.19 and 2.5.With subsequent external radiation therapy (in total 40 Gy, 2 Gy 5−6 times a week) the irradiation fields were planned in such a way that all affected lymph nodes were within their borders. A control SPECT/CT study carried out immediately after the RT showed a decrease in the volume of tumor tissue in the primary node down to 58 cm3, % of the activity absorbed by the tumor tissue to 0.090 %, and SVP ‒ to 1.15. Reliable imaging of lymph nodes after LT was not observed. After 6.5 months, no evidencies for relapse or continued tumor growth were detected with a control X-ray CT performed on an outpatient visit with contrast enhancement. Thus, SPECT/CT with 99mTc-technetryl in lung cancer is a vital method for clarifying the diagnosis and assessment of the extent of the tumor process, as well as monitoring the patient. A broad inter-center assessment of abilities of the SPECT/CT with 99mTc-technetryl in lung cancer is advisable, especially when planning RT.
1例新诊断的右肺外周癌,累及胸膜,其x线CT最初检测到的局部病变范围与SPECT 99mtc - techtryl的数据相比明显扩大。特别是,在放射治疗(RT)开始前使用SPECT/CT,可以在右肺根的下边缘以及主动脉旁和气管旁位置检测到受累淋巴结。采用GE Discovery NM/CT 670 DR (GE Medical)双探测器伽玛照相机对99mtc - techtryl进行SPECT/CT定量扫描,并对原发肿瘤和转移灶淋巴结的标准化摄取值(SUV)指标和给药活性的摄取%进行校准和计算。肿瘤组织体积为肿瘤和最大近端转移累及淋巴结分别为154.2 cm3和12.9 cm3,肿瘤组织吸收活性%为- 0.498和0.030%,SVP为- 2.19和2.5。在随后的外部放射治疗(总共40 Gy, 2 Gy,每周5 - 6次)中,计划照射场,使所有受影响的淋巴结都在其边界内。放疗后立即进行的对照SPECT/CT研究显示,原发淋巴结肿瘤组织体积减小至58 cm3,肿瘤组织吸收活性%降至0.090%,SVP -降至1.15。没有观察到肝移植后淋巴结的可靠成像。6.5个月后,在门诊进行对比增强的对照x线CT检查时,没有发现复发或肿瘤持续生长的证据。因此,99mtc - techtryl在肺癌中的SPECT/CT是明确诊断和评估肿瘤进程程度以及监测患者的重要方法。采用99mtc技术对SPECT/CT在肺癌诊断中的能力进行广泛的中心间评估是可取的,特别是在计划RT时。
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Medical Radiology and Radiation Safety
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