目的探讨日本Sysmex公司生产的XN-9000全自动血液细胞分析流水线有核红细胞(nucleated red blood cell,NRBC)计数,与手工方法进行比较,验证仪器计数结果的准确性。方法对60例全自动血液细胞分析流水线检测出NRBC大于1%的患者的血液标本...目的探讨日本Sysmex公司生产的XN-9000全自动血液细胞分析流水线有核红细胞(nucleated red blood cell,NRBC)计数,与手工方法进行比较,验证仪器计数结果的准确性。方法对60例全自动血液细胞分析流水线检测出NRBC大于1%的患者的血液标本,制作血液涂片染色后通过传统的显微镜手工方法镜检,验证仪器结果。结果 60例临床标本的NRBC与显微镜计数的结果比较,所有检测值的可信度分析均在可信范围内;相关性比较中,NRBC(%)在1~10和>10两组的仪器与手工方法的相关系数(r)分别为0.972 1和0.996 2,差异均无统计学意义(P>0.05)。结论无论NRBC值的高低,XN-9000全自动血液细胞分析流水线检测NRBC计数,与手工方法结果比较,均在可信范围内,相关性也较好。仪器检测的NRBC准确可靠,可应用于临床标本的检测。展开更多
In the case of a terrorist attack by a“dirty bomb”,blast injuries,external irradiation and the incorporation of radioactivity are to be expected.Departing from information about the radiological attack scenario with...In the case of a terrorist attack by a“dirty bomb”,blast injuries,external irradiation and the incorporation of radioactivity are to be expected.Departing from information about the radiological attack scenario with cesium-137 in the U.S.National Scenario Planning Guide,we estimated the radiological doses absorbed.Similar calculations were performed for a smaller plume size and a detonation in a subway.For conditions as described in the U.S.scenario,the committed effective dose amounted to a maximum of 848 mSv,even for very unfavorable conditions.Red bone marrow equivalent doses are insufcient to induce acute radiation sickness(ARS).In the case of a smaller plume size,the ARS threshold may be exceeded in some cases.In a subway bombing,doses are much higher and the occurrence of ARS should be expected.The health hazards from a dirty bomb attack will depend on the location and the explosive device.The derived Haddon matrix indicates that preparing for such an event includes education of all the medical staff about radiation effects,the time lines of radiation damages and the treatment priorities.Further determinants of the outcome include rapid evacuation even from difficult locations,the availability of a specific triage tool to rapidly identify victims at risk for ARS,the availability of an antidote stockpile and dedicated hospital beds to treat seriously irradiated victims.展开更多
A wide spectrum of scenarios may lead to radiation incidents and the liberation of radioactive material. In the case of a terrorist attack by a "dirty bomb", there is a risk of mechanical and thermal trauma,...A wide spectrum of scenarios may lead to radiation incidents and the liberation of radioactive material. In the case of a terrorist attack by a "dirty bomb", there is a risk of mechanical and thermal trauma, external irradiation, superficial contamination and incorporation of radioactive material. The first treatment priority must be given to the care of trauma patients with life-threatening injuries, as the health effects of radiation occur with latency. Radionuclide incorporation will lead to a longer-lasting irradiation from inside the body, associated with a higher risk of stochastic radiation effects(e.g., occurrence of tumors) in the long run. It must be expected that victims with potentially incorporated radionuclides will far outnumber trauma patients. The elimination of radionuclides can be enhanced by the administration of decorporation agents such as(Ca) Diethylenetriaminepentaacetic acid(DTPA) or Prussian blue,reducing the radiological burden of the body. There is still no consensus whether decorporation treatment should be started immediately based only on a suspicion of radionuclide incorporation("urgent approach") or if the results of internal dosimetry confirming the necessity of a treatment should be awaited, accepting the delay caused by the measurements and computations("precautionary approach"). As the therapeutic effectiveness may be substantially decreased if treatment initiation is delayed only by several days, depending on the radionuclide, the physicochemical properties of the compounds involved and the route of absorption, we favor an "urgent approach" from a medical point of view. In doubt, it seems justified to treat victims by precaution, as the adverse effects of the medication seem minimal. However, in the case of a high number of victims, an "urgent treatment approach" may require a large number of daily doses of antidotes, and therefore, adequate investments in preparedness and antidote stockpiling are necessary.展开更多
基金Bundeswehr Institute of Radiobiology,Neuherberg Str.1180937 Munich,Germany。
文摘In the case of a terrorist attack by a“dirty bomb”,blast injuries,external irradiation and the incorporation of radioactivity are to be expected.Departing from information about the radiological attack scenario with cesium-137 in the U.S.National Scenario Planning Guide,we estimated the radiological doses absorbed.Similar calculations were performed for a smaller plume size and a detonation in a subway.For conditions as described in the U.S.scenario,the committed effective dose amounted to a maximum of 848 mSv,even for very unfavorable conditions.Red bone marrow equivalent doses are insufcient to induce acute radiation sickness(ARS).In the case of a smaller plume size,the ARS threshold may be exceeded in some cases.In a subway bombing,doses are much higher and the occurrence of ARS should be expected.The health hazards from a dirty bomb attack will depend on the location and the explosive device.The derived Haddon matrix indicates that preparing for such an event includes education of all the medical staff about radiation effects,the time lines of radiation damages and the treatment priorities.Further determinants of the outcome include rapid evacuation even from difficult locations,the availability of a specific triage tool to rapidly identify victims at risk for ARS,the availability of an antidote stockpile and dedicated hospital beds to treat seriously irradiated victims.
文摘A wide spectrum of scenarios may lead to radiation incidents and the liberation of radioactive material. In the case of a terrorist attack by a "dirty bomb", there is a risk of mechanical and thermal trauma, external irradiation, superficial contamination and incorporation of radioactive material. The first treatment priority must be given to the care of trauma patients with life-threatening injuries, as the health effects of radiation occur with latency. Radionuclide incorporation will lead to a longer-lasting irradiation from inside the body, associated with a higher risk of stochastic radiation effects(e.g., occurrence of tumors) in the long run. It must be expected that victims with potentially incorporated radionuclides will far outnumber trauma patients. The elimination of radionuclides can be enhanced by the administration of decorporation agents such as(Ca) Diethylenetriaminepentaacetic acid(DTPA) or Prussian blue,reducing the radiological burden of the body. There is still no consensus whether decorporation treatment should be started immediately based only on a suspicion of radionuclide incorporation("urgent approach") or if the results of internal dosimetry confirming the necessity of a treatment should be awaited, accepting the delay caused by the measurements and computations("precautionary approach"). As the therapeutic effectiveness may be substantially decreased if treatment initiation is delayed only by several days, depending on the radionuclide, the physicochemical properties of the compounds involved and the route of absorption, we favor an "urgent approach" from a medical point of view. In doubt, it seems justified to treat victims by precaution, as the adverse effects of the medication seem minimal. However, in the case of a high number of victims, an "urgent treatment approach" may require a large number of daily doses of antidotes, and therefore, adequate investments in preparedness and antidote stockpiling are necessary.
