Boron neutron capture therapy (BNCT) is a promising cancer treatment modality that combines targeted boron agents and neutron irradiation to selectively destroy tumor cells. In mainland China, the clinical implementation of BNCT has made certain progress, primarily driven by the development of compact neutron source devices. The availability, ease of operation, and cost-effectiveness offered by these compact neutron sources make BNCT more accessible to cancer treatment centers. Two compact neutron sources, one being miniature reactor-based (IHNI-1) and the other one being accelerator-based (NeuPex), have entered the clinical research phase and are planned for medical device registration. Moreover, several accelerator-based neutron source devices employing different technical routes are currently under construction, further expanding the options for BNCT implementation. In addition, the development of compact neutron sources serves as an experimental platform for advancing the development of new boron agents. Several research teams are actively involved in the development of boron agents. Various types of third-generation boron agents have been tested and studied in vitro and in vivo. Compared to other radiotherapy therapies, BNCT in mainland China still faces specific challenges due to its limited clinical trial data and its technical support in a wide range of professional fields. To facilitate the widespread adoption of BNCT, it is crucial to establish relevant technical standards for neutron devices, boron agents, and treatment protocols.

Boron neutron capture therapy(BNCT) is a binary targeted radiation therapy in which neutron does not directly provide tumor dose. The dose produced by the 10B(n, α)7Li capture reaction will be deposited in tumor cells by using targeted 10B agents. Therefore, understanding the biological distribution of 10B agents in the blood, tumor and normal tissue is essential for BNCT. 4-borono-L-phenylalanine(BPA) is the mainly used 10B agent in BNCT clinical trials worldwide. In order to support and facilitate the preparation of BPA-based BNCT clinical trials, information on the structure, physicochemical properties, cellular uptake mechanisms and human biological distribution of BPA are summarized in this paper.

目的:对比研究131I-MIBG显像、18F-FDG PET/CT显像与99Tcm-MDP-WBS多模态显像在嗜铬细胞瘤/副神经节瘤(PCC/PGL)骨转移病灶中的诊断价值.方法:回顾性分析本院收治的PCC/PGL患者共30例,所有患者均伴骨转移且已行以上三种检查(检查的时间间隔为3个月内).以病理、影像学检查及临床随访结果作为骨转移的诊断依据.比较三种检查方法检测PCC/PGL骨转移病灶的灵敏度、特异性、阳性及阴性预测值和准确性.使用SPSS 25.0软件分析,采用McNemar检验比较三种检查方法诊断骨转移的价值.结果:30例PCC/PGL患者共检查出骨异常病灶302处,确诊为骨转移病灶271处.131 I-MIBG显像、18 F-FDG PET/CT显像与99 Tcm-MDP-WBS在诊断PCC/PGL骨转移病灶时的灵敏度、特异性、阳性和阴性预测值及准确性分别是92.00％、96.30％、99.60％、54.17％、92.38％;96.00％、92.59％、99.25％、69.44％、95.70％和88.39％、62.86％、94.78％、41.51％、85.43％.三种检查方法在诊断PCC/PGL骨转移病灶时18 F-FDG PET/CT显像灵敏度最高,131 I-MIBG显像特异性最好.三种检查方法的诊断效能经McNemar检验,差异有统计学意义(P<0.05).结论:131I-MIBG显像可作为PCC/PGL骨转移的首选检查方法并指导后续131I-MIBG治疗,18 F-FDG PET/CT显像和99 Tcm-MDP-WBS可作为可疑病灶131 I-MIBG显像阴性时的有效补充.

A study of the 10B-enriched Boronophenylalanine-fructose complex(10BPA-F) infusion procedure in potential BNCT patients, including three skin melanomas of extremities, was performed. 10B concentration in tumor(T), blood(B), skin(S) were measured to determine tumor/blood(T/B) and skin/blood(S/B) ratios. T/B ratio for three melanoma patients was in the range 1.48-3.82(average 2.56 ± 0.69). S/B ratio was in the range 0.81-1.99(average 1.29 ± 0.35). Results showed that T/B ratio of nodular metastasis melanoma was higher than superficial spreading melanoma. 10B concentration in skin was higher than blood, which was helpful to avoid over-dose in normal skin.

目的 研究胸部CT联合BRAFV600E对放射性碘难治性分化型甲状腺癌(RAIR-DTC)伴肺转移患者的诊断,和肺转移瘤预后因子.方法 118例RAIR-DTC伴有肺结节患者,其中明确诊断为甲状腺癌肺转移55例,甲状腺癌伴良性结节的63例.观察比较联合诊断与单独检测胸部CT、BRAFV600E对RAIR-DTC伴肺转移的诊断价值;观察RAIR-DTC伴肺转移的发病和生存情况;分析影响RAIR-DTC伴肺转移预后的相关因素.结果 联合诊断敏感度为94.5％明显高于其他两种诊断的81.8％和69.1％,差异具有统计学意义(P<0.05).肺转移瘤<1 cm组的4年和8年生存率分别为76.3％、50.8％均高于肺转移瘤≥1 cm组的54.2％、25.4％,差异均具有统计学意义(P<0.05);转移瘤<1 cm组的中位生存期(mOS)为(116±9.8)个月长于转移瘤≥1 cm组的(80.6±6.5)个月,差异具有统计学意义(P<0.05).BRAFV600E、肺结节大小是影响RAIR-DTC伴肺转移患者临床独立预后因素.结论 胸部CT联合BRAFV600E,应用于RAIR-DTC伴肺转移患者,有助于增加诊断效能,为早期肺转移癌提供诊断依据.

目的 了解初级职称护理人员对乙型病毒性肝炎(简称乙肝)认知、态度和行为,为开展乙肝防治培训和健康教育提供参考.方法 2018年5～7月对86名初级职称护理人员进行问卷调查,采用多因素Logistic回归分析乙肝知识影响因素.结果 86名初级职称护理人员乙肝防治知识得分最低6分、最高12分,平均(9.2±2.3)分,知晓率为81.39％;“乙肝疫苗全程接种后3～5年需要接种加强针”“被病毒污染的食物和水”知识点回答正确率均低于70％;行为方面,100.00％的初级职称护理人员用完注射器后全部回套针帽和参加过体检;态度方面,100.00％的初级职称护理人员认为护士有必要接种乙肝疫苗;不同学历、工作年限、乙肝相关知识培训次数的初级职称护理人员乙肝知识知晓率比较,差异均有统计学意义(x2=7.190、6.159、7.403,P＜0.05);Logistic回归分析结果显示:学历、工作年限、乙肝相关知识培训次数是初级职称护理人员乙肝知识知晓率的影响因素(P＜0.05).结论 初级职称护理人员对乙肝知识知晓情况整体处于中等水平,尚不能够满足临床护理工作的需要.亟需加强对初级职称护理人员乙肝相关知识及职业暴露防护的培训.

目的 分析某二级医院住院患者死因构成及特点,了解死因顺位,提高医院管理水平.方法 收集2008—2017年住院病例首页数据,采用ICD-10国际疾病分类,对病案首页中主要诊断编码进行死因分类,对医院10年间39617例住院患者中的430例死亡患者进行统计分析.结果 10年间,住院患者病死率呈先上升后下降趋势.最初两年的死亡率为1.44％,最近两年的死亡率为0.99％.男性病死率为1.49％,女性为0.78％.死亡年龄集中在70～90岁,占总死亡人数的74.88％.死因顺位前3位为恶性肿瘤、循环系统和呼吸系统疾病,占总体死亡患者的85.58％.结论 加强医院管理有有利于降低死亡率.依据死亡患者性别构成及死因构成特点,提示应当加强男性、老年人等重点人群的的健康管理,降低病死率.

The aim of this study was to evaluate the utility of thyroid static imaging with 99mTcO4- for detecting metastatic lesions following surgery in patients with Differentiated Thyroid Cancer (DTC). A total of 420 consecutive post-total thyroidectomy patients with pathologically diagnosed differentiated thyroid cancer underwent thyroid static imaging with 99mTcO4- before 131I treatment to evaluate the size, location, and function of the residual thyroid. They also underwent 131I whole-body scanning (131IWBS), as well as single-photon emission computed tomography/computed tomography fusion imaging (when necessary), for evaluation of the lesions. The detection rates of thyroid static imaging with 99mTcO4- and 131I-WBS (therapeutic dose) were 83.81% and 98.33%, respectively. The sensitivity of 99mTcO4- thyroid static imaging was 85.2%, and the rate of detection with both 99mTcO4- static imaging and 131I-WBS was 85.48%. The use of 99mTcO4- thyroid static imaging identified metastatic lesions in 10 patients; thus, the original planned treatment dose and protocol were adjusted in these patients. Based on our findings, we conclude that thyroid static imaging with 99mTcO4- can be used to evaluate the residual thyroid tissue after thyroid carcinoma resection and can identify metastatic lesions, thereby helping to guide the selection of the 131I treatment dose.

A phase I/II clinical trial for treating malignant melanoma by boron neutron capture therapy (BNCT) was designed to evaluate whether the world’s first in-hospital neutron irradiator (IHNI) was qualified for BNCT. In this clinical trial planning to enroll 30 patients, the first case was treated on August 19, 2014. We present the protocol of this clinical trial, the treating procedure, and the clinical outcome of this first case. Only grade 2 acute radiation injury was observed during the first four weeks after BNCT and the injury healed after treatment. No late radiation injury was found during the 24-month follow-up. Based on positron emission tomography-computed tomography (PET/CT) scan, pathological analysis and gross examination, the patient showed a complete response to BNCT, indicating that BNCT is a potent therapy against malignant melanoma and IHNI has the potential to enable the delivery of BNCT in hospitals.

A prompt gamma neutron activation analysis (PGNAA) system has been recently developed at the 30-kW research reactor In-Hospital Neutron Irradiator (IHNI) in Beijing. Neutrons from the specially designed thermal neutron beam were used. The thermal flux of this beam is 3.08×10(6) cm(-2) s(-1) at a full reactor power of 30 kW. The PGNAA system consists of an n-type high-purity germanium (HPGe) detector of 40% efficiency, a digital spectrometer, and a shielding part. For both the detector shielding part and the neutron beam shielding part, the inner layer is composed of (6)Li2CO3 powder and the outer layer lead. The boron-10 sensitivity of the PGNAA system is approximately 2.5 cps/ppm. Two calibration curves were produced for the 1-10 ppm and 10-50 ppm samples. The measurement results of the control samples were in accordance with the inductively coupled plasma atomic emission spectroscopy (ICP-AES) results.

目的：分析嗜铬细胞瘤的临床特点，提高嗜铬细胞瘤的诊治水平。方法回顾性分析70例嗜铬细胞瘤或副神经节瘤患者的临床资料，包括临床表现、诊断、病理分型、复发转移、手术治疗等。结果70例患者中肾上腺嗜铬细胞瘤46例（65.7%），副神经节瘤24例（34.3%），其中膀胱副神经节瘤4例（5.7%），腹膜后副神经节瘤9例（12.9%），其他副神经节瘤11例（15.7%）。57例患者接受过手术治疗，术后出现复发23例，出现远处器官及淋巴结转移58例。血压升高67例，心悸37例，头痛42例，大汗39例。结论嗜铬细胞瘤常表现以高血压为代表的临床综合征，症状复杂多样，缺乏特异性，恶性嗜铬细胞瘤易出现术后复发及多器官转移。

Objective To evaluate the efficacy and safety of 131I-metaiodobenzylguanidine (131 I-MIBG) in treatment of malignant pheochromocytoma/malignant paraganglioma (MPHEO/MPGL).Methods The clinical data of 96 cases of MPHEO/MPGL (60/36) treated with 131I-MIBG between December 1998 and April 2014 were retrospectively reviewed.Among them,the malignant pheochromocytoma was found in 60 cases and malignant paraganglioma was found in 36 cases.Seventy-eight patients (81.2％)presented initially with hypertension,whereas 18 patients (18.8％) presented adrenal incidentaloma.Before 131I-MIBG treatment,24 h urinary norepinephrine was (409.5± 127.2) nmol,24 h urinary dopamine was (99.3±41.1) nmol,24 h urine adrenaline was (1 409.9±336.0) nmol.Before treatment,the compound iodine solution was given to each one.Then,all patients were given an initial course of 131I-MIBG therapy (5.55,7.40 GBq).Subsequent 131I-MIBG treatment (5.55,7.40 GBq) was undertaken every three to six months.The patients got symptomatic,hormonal or radiological response underwent sbsequent 131I-MIBG therapy (3.70,5.55 GBq) every year.All patients underwent clinical symptoms (headache,palpitate,sweating,hypertension),biochemical (24 h urine catecholamin) and radiological evaluation (CT/MRI) within 6 months to evaluate the efficacy and safety of 131I-MIBG treatment.Results After one to eleven sessions of 131 I-MIBG treatment,in total,266 doses of 131 I-MIBG were administered,average dose was 6.49 GBq.22.9％ of patients demonstrated radiological partial response (≥ 50％ reduction in tumor size) after first or repeated 131 I-MIBG treatment.Eleven cases (11.5％) achieved clinical complete response,41 cases (42.7％) achieved clinical partial response and 23 cases (24.0％) maintained the stable clinic symptoms.After treatment,24 h urinary norepinephrine (164.3±71.6) nmol and dopamine (49.7±24.7) nmol showed significantly decline,compared with those before treatment (P＜ 0.05).While,24 h urinary epinephrine (1 354.7±433.4) nmol had no obvious change (P＞0.05).No life-threatening adverse events were reported,but 2 MPGL patients developed transient leucopenia or thrombocytopenia after four and five times 131 I-MIBG treatment,respectively.Conclusions Treatment with repeated low dose 131I-MIBG is well tolerated and effective in controlling the progression and alleviating the clinical symptoms.The 131I-MIBG therapy is an effective and safe treatment modality for MPHEO/MPGL.

Objective:To summarize the treatment method,clinical effect and side effect of Iodine 131I Metuximab injection for treating moderate and advanced primary hepatocellular carcinoma(HCC)patients with different liver function.Methods:All 79 HCC patients received treatment of infusing Iodine 131I Metuximab injection via hepatic artery.Patients were followed-up monthly for general information,tumor size,imaging changes,alpha-fetoprotein,liver function,peripheral white blood cell value and platelet value.The efficacy and side effects of patients with different liver function classification were evaluated.After the treatment,71 patients were followed-up.1 months,3 months and 6 months without recurrence rates were 100%,76.1% and 28.2% respectively.Of all patients 14 cases died(19.2%),median survival time was 8 months.There was no severe complication associated with therapeutic drug.Conclusion: Iodine 131I Metuximab injection used for the treatment of inoperable HCC patients,especially the patients with better liver function,can obtain good effect and it is an newly effective comprehensive treatment method for HCC.

[Objective] To retrospectively evaluate clinical efficacy and safety of partial splenic embolization(PSE) in treating primary hepatocellular carcinoma with hypersplenism.[Methods] Fifty-five primary hepatic carcinoma patients with liver cirrhosis,portal hypertension and hypersplenism were treated with PSE,the area of embolization was 50%～70%.After one week,2 weeks and a month to re-examination the blood routine,liver function,one month postoperatively for CT scan.Postoperative complications were recorded.[Results] After embolization 1 week,2 weeks and a month as peripheral blood tests,white blood cells,platelets embolization was significantly higher than the former,the red blood cells,hemoglobin had no significant difference.After embolization a month the white blood cells(5.32±1.48)×109 /L,and platelets(105.68±18.18)×109 /L.After one week,liver functions on AST,ALT and TBIL were significantly increased,after two weeks and after a month,they had no significant difference compared with before PSE.No patient suffered from severe complication such as splenic abscess.[Conclusion] PSE is a safe and effective method to treat primary hepatocellular carcinoma with hypersplenism.

Boron neutron capture therapy (BNCT) method was applied to about one thousand clinical patients and achieved good results internationally. In this paper, the principle of BNCT, the development history and international BNCT clinical progress were mainly introduced. The BNCT clinical treatment situation and evaluation in glioblastoma (GBM), malignant melanoma, recurrent head and neck cancer and metastatic liver cancer were discussed in detail.

目的通过监测131I美妥昔单抗注射液使用后五天内131I衰减的简单规律及药物在病灶的浓聚情况,指导临床医生控制患者在放射防护病房住院天数。方法对2009年1月～2010年3月入住我院治疗的24位患者,经股动脉注射131I美妥昔单抗注射液,对用药第一、三、五天患者体内留存药物活度与相关法规规定进行比较。结果第五天患者体内131I活度低于/等于相关法规规定占92%;第一天至第三天衰减60%以上的患者占96%;第三天至第五天衰减50%以下的患者占83%。结论患者用药后五天可离开放射防护病房;患者体内131I的衰减由快渐慢,由开始的以药物半排期为主导过度为以物理半衰期为主导。

目的 探讨体外低氧浓度培养条件对于新西兰大白兔骨髓间充质干细胞(bone marrow mesenchymal stem cells,BM-MSCs)增殖、分泌等特性的影响.方法 将细胞分为低氧浓度培养组及对照组,分别检测其细胞表面标志物表达、分化能力、生长曲线、克隆形成能力,并使用ELISA法检测两组胶质细胞源性神经营养因子(GDNF)分泌量的区别.结果 低氧浓度培养组细胞在表面标志物表达及分化能力上均与对照组无明显区别,而增殖能力及克隆形成能力较对照组明显增强,经ELISA检测,低氧浓度培养条件下的细胞GDNF的分泌量更高.结论 低氧浓度的培养条件有利于BM-MSCs增殖及分泌能力增强,适宜用于BM-MSCs的扩增.

<正>1病例资料患者男,69岁,因腹胀,乏力,纳差3个月余于2009年7月29日入院。患者2009年4月出现腹胀,乏力,纳差。行腹部B超及CT检查示,肝内多发占位,肝硬化,大量腹腔积液,脾大。以原发性肝癌晚期收住院。既往有多年大量饮酒史,近十年来饮白酒500mL/d。无慢