| AI Hui-sheng,YU Chang-lin,QIAO Jian-hui.Medical management of irradiated patients in a radiation accident in Jining, Shangdong Province[J].Chinese Journal of Radiological Medicine and Protection,2007,27(1):1-5 |
| Medical management of irradiated patients in a radiation accident in Jining, Shangdong Province |
| Received:September 18, 2006 |
| DOI： |
| KeyWords:Intestinal form of acute radiation disease Bone marrow form of acute radiation disease Hemopoietic stem cell transplantation Multi-organ failure |
| FundProject: |
| Author Name | Affiliation | E-mail | | AI Hui-sheng | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | huishengai@163.com | | YU Chang-lin | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | QIAO Jian-hui | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 罗卫东 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 张石 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 郭梅 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 张锡刚 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 王丹红 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 孙琪云 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 牛文凯 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 李光 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 姚波 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 周振山 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 刘素刚 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 何耀忠 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 陈建魁 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 李晓兵 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 陈英 | 北京军事医学科学院放射与辐射医学研究所 | | | 吴可 | 北京军事医学科学院放射与辐射医学研究所 | | | 杨国山 | 北京军事医学科学院放射与辐射医学研究所 | | | 刘英 | 中国疾病预防控制中心辐射防护与核安全医学所 | | | 胡凯勋 | Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | |
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| Abstract:: |
| Objective To summarize the experience of diagnosis and treatment from the extremely severe bone marrow form of acute radiation sickness and intestinal form of acute radiation sickness. Methods A nuclear accident occurred in China on October 21st, 2004. Two individuals were accidentally irradiated by a 60Co source. The two patients were estimated at more than 20-25 Gy and 9-15 Gy of γ-rays exposures, respectively, and were diagnosed as the intestinal form of acute radiation sickness (patient A) and the extremely severe bone marrow form of acute radiation sickness (patient B), respectively. After urgent preparative regimen based on low-dose fludarabine, antilymphocyte globulin and cyclophosphamide, the two patients received HLA-haploidentical (patient A) or HLA-identical (patient B) peripheral blood stem cell transplantation (PBSCT), respectively. Cyclosporin A combined mycophenolate mofetil regimen was used for the prevention of graft-versus-host disease (GVHD). Bone marrow mesenchymal stem cells from donor were injected to bone marrow of patient A additionally. Results Both peripheral blood and bone marrow examinations showed hemopoietic recovery after PBSCT. Neither of the two patients showed obvious clinical signs specific to GVHD. Patient A died of septicemia and multi-organ failure on the 33rd day after exposure, while patient B died of multi-organ failure with predominant heart failure on the 75th day after exposure. Conclusions Chromosome analysis of bone marrow and peripheral blood, and electron spin resonance measurement of tooth enamel play a very important role in diagnosis of the very high dose radiation disease. It is possible and feasible to treat acute radiation sickness using HLA-haploidentical or HLA-identical PBSCT. The death of patients is mainly due to infection and multi-organ failure. |
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