The Department of Nuclear Medicine was founded in 1997: After ten years of development and construction, it is now a comprehensive discipline integrating scientific research and clinical teaching. At present, our department has deputy chief physician 1, attending physician 1, 2 doctors in charge and 2 nurses. At present, the clinical work is as follows:
1, treating hyperthyroidism:
Hyperthyroidism is a common endocrine disease, and the population incidence rate is 1-4%. Conventional drug treatment has a long course of disease, generally taking drugs for 1-2 years, and the recurrence rate after stopping taking drugs is as high as 40-60%; 13 1I was first used in the treatment of hyperthyroidism from 1947. Because of its simplicity, low cost, few side effects and remarkable curative effect, it has been widely used in advanced countries in Europe and America. During the ten years of working in our department, the youngest patient was 6 years old and the oldest was 76 years old. A patient suffering from hyperthyroidism for more than 30 years was cured at one time, which relieved the patient's pain. At present, the patients who come to our hospital are not limited to hyperthyroidism, but many patients with thyroid-related diseases such as goiter, nodular goiter and thyroiditis also come here and get good treatment.
2. Carry out 13 1I thyroid cancer treatment:
Thyroid cancer is the most common tumor in endocrine system, and the population incidence rate is 1-3/65438+ 10,000, accounting for 10% of thyroid nodule surgery, and the incidence rate is increasing year by year. In developed countries in Europe and America, postoperative plus 13 1I is widely used to treat thyroid cancer, which reduces the postoperative recurrence rate, metastasis rate and mortality rate and benefits many patients. Some abandoned patients with extensive metastasis of thyroid cancer were cured. As shown below: the pathological report is papillary thyroid carcinoma, and CT found extensive lung metastasis. After four courses of treatment of 13 1I, the condition was completely relieved and achieved clinical cure.
3. Treatment of malignant pheochromocytoma with 13 1I- MIBG;
Pheochromocytoma is an escalating neuroendocrine tumor, which originated from adrenal medulla. Because it retains the function of adrenal medulla and has the ability to secrete catecholamine, it causes persistent hypertension after paroxysmal, and the condition is dangerous, often complicated with malignant hypertension, such as cardiovascular and cerebrovascular accidents. 13 1I- MIBG can be used for the qualitative and localized diagnosis of pheochromocytoma and for the treatment of malignant pheochromocytoma. It can also achieve satisfactory results in blood pressure control of patients who can't be operated and relapse after operation, and win the opportunity of second operation for some patients. 1984 was first used in clinic in America. 1998 cooperated with Union Medical College Hospital to complete the first diagnosis and treatment of this kind of patients. The patient is a malignant pheochromocytoma with lung metastasis, which was diagnosed by many hospitals and the survival time was only half a year. After repeated chemotherapy and radiotherapy, the tumor volume doubled after half a year. After three courses of treatment, the patient lived for another six years.
4. Application of 90Y-DOTA and somatostatin receptor in neuroendocrine tumors;
Diseases involved: gastrinoma, pheochromocytoma, sympathetic ganglioma, medullary thyroid carcinoma.
5, in line with the line ECT work:
Nuclear medical imaging is an important part of nuclear medical work, which can provide a lot of scientific basis for clinical diagnosis and treatment, and is also a prerequisite for nuclear medical treatment. The coincidence machine ECT purchased by our department in 2005 not only facilitates the treatment of nuclear medicine, but also helps clinical departments to treat cardiovascular and cerebrovascular diseases and tumors.
Teaching work:
Due to the comprehensive advantages of belonging to China Institute of Atomic Energy, in 2007, the Department of Nuclear Medicine of Capital Medical University established a nuclear medicine teaching base in our hospital after many demonstrations. Students can get a comprehensive understanding from the production of nuclear drugs to clinical application, and the unique teaching methods are welcomed by students. Good teaching results have been achieved.
China Nuclear Industry Beijing 40 1 Hospital-boron neutron capture therapy (BNCT)
40 1 Hospital Neutron Irradiator is a nuclear medical equipment developed by Beijing Kaibaite Technology Co., Ltd., a high-tech enterprise in Fangshan District, and built in cooperation with China Institute of Atomic Energy. According to the requirements of boron neutron capture therapy for tumors, the technology is mature, with inherent safety characteristics and no environmental consequences. User-friendly miniature reactors can be built in densely populated areas, and can be improved and developed into hospital neutron irradiators specially used for boron neutron capture therapy, that is, IHNI (Hospital Neutron Irradiator).
Boron neutron capture therapy (BNCT) is to inject a boron-containing compound (10B) into human body and enter the brain through blood circulation. Because the selected boron-containing compounds have affinity with brain tumors, they are only enriched in brain tumors. Due to the blood-brain barrier effect, 10B rarely or even cannot enter normal brain tissue.
When a patient's tumor is irradiated with neutron beam, the reaction of 10B(n, α)7Li produces α particles and 7Li nuclei, which have high energy transmission line density and can kill tumor cells in the range of ≤ 10μ. That is to say, targeted binary characteristics (concentration 10B, energy and intensity of neutron beam) can be used on the cell scale, which is unmatched by any conventional treatment method in principle. Binary (boride, neutron beam) radiotherapy with strong targeting and high energy transmission line density (LET) can be realized on the cell scale. In principle, it is superior to the current surgery, radiotherapy, chemotherapy, immunotherapy and gene therapy for malignant brain tumors. Normal cells and cancer cells are physically distinguished accurately and are harmless to human body. Since 1990s, it is the only effective method to treat glioma. At present, this therapy has become a routine treatment for brain cancer in the world, and it has tried to treat organ tumors such as liver cancer, lung cancer, pancreatic cancer, prostate cancer and breast cancer. After half a century of clinical practice, thermal neutron capture therapy took the lead in establishing an unprecedented 5-year survival rate of 33% in Japan, and has now been listed as a standard technology. The hyperthermic neutron BNCT technique for the treatment of deep brain tumors without craniotomy has gone through extensive clinical trials in the first and second stages, and is moving towards the third stage, that is, the efficacy trial. In a word, "neutron capture therapy" (NCT) is a new field of modern cancer treatment research, with broad prospects.
The three key technologies of BNCT are neutron source and neutron beam, boron (10B) compound drugs and brain dose assessment.
At present, due to the rapid development of computer technology, brain dose assessment technology has matured. Boron compound drugs made decisive achievements in the 1990s, and the third generation drugs were confirmed in animal experiments, which not only had obvious targeting specificity, but also greatly prolonged the retention time in tumors.
At present, there is no special device for BNCT in the world. The reactors that have used BNCT have high power, and most of them are built in remote suburbs or mountainous areas, which is not conducive to the treatment and care of patients. Economy and practicality are the bottlenecks in the popularization of boron neutron capture therapy (BNCT). Therefore, the focus of BNCT's three key technologies is to develop a safe and reliable neutron source device, which can be placed in hospitals and controlled by doctors themselves, and the treatment cost is acceptable.
Seven academicians, including Zhou Yongmao and Wang Zhongcheng, out of professional responsibility and their respective skills in nuclear technology and neurosurgery, followed the international innovative practice at the beginning of this century, and * * * agreed to develop a high-tech nuclear medical device for treating cancer by using the principle of neutron capture therapy (NCT).
According to the experience of nine microreactors and BNCT technology at home and abroad, the hospital neutron irradiator was born. It is an independent innovation project with all independent intellectual property rights in China and authorized by the national invention patent.
It consists of three parts: a miniature reactor as a neutron source, a neutron irradiation beam device and medical facilities for irradiation treatment. The main difference is that in the same size core, high-density UO2 and Zr-4 cladding elements with U5 enrichment of 12.5% are used instead of U-Al alloy and Al cladding elements with U5 enrichment of 90.2%; Two neutron beam holes are led out at the symmetrical sides of the beryllium reflection layer on the reactor side. The optimal combination of thermal neutron beam device and superheated neutron beam device provides neutron beams with different energy and intensity for boron neutron capture therapy, and the inherent safety characteristics have not changed.
40 1 Hospital Neutron Irradiator has the following characteristics.
1.40 1 The neutron source of the hospital neutron irradiator is a reactor with low power (30kW), low radioactive reserves and no environmental consequences. It has passed the evaluation of the National Expert Committee on Nuclear Safety and Environment.
2. Use safer and more reliable nuclear fuel elements. UO2 core and Zr-4 are used as fuel cladding, which are characterized by high melting point, good irradiation stability and strong water corrosion resistance.
3. Strong internal fast negative feedback mechanism improves the inherent safety of the reactor. Hospital neutron irradiators use uranium dioxide as fuel. The fuel contains a lot of U238, which means that the Doppler negative reactivity of U238 is greatly increased.
4. Adding auxiliary control rods as an independent shutdown mechanism will ensure safety.
5. Five physical barriers to prevent radiation leakage.
A, using high density UO2 core.
B, Zr-4 coating and effective welding technology can completely ensure reliable operation within the service life.
C. Fully sealed reactor vessel, which is confirmed by the perfect safe operation records of 7 Slowpoke-2 reactors and 9 MNSR reactors 100 years in the world.
D, large-capacity pool water.
E, architectural design of closed stack hall. The building covers an area of about 477 square meters, with a building area of about 1 145 square meters. It is 4m deep underground and 10m high above the ground, which is equivalent to a nuclear medical equipment similar to a CT machine, and can be accommodated by general large and medium-sized hospitals.
6. Simple, convenient, flexible and economical operation.
The closed-loop control and monitoring system of computer network is established. This paper summarizes the design and operation experience of microreactor for more than 20 years. Through software design, the functions of the control and monitoring system are highly automatic and intelligent, and all reactor parameters can be sampled, recorded and archived in real time. Greatly improve the management level. General medical staff can take up their posts as long as they pass short-term training. Greatly reducing the operation cost. The system has been successfully developed, and has been tested in the micro-reactor in the teaching area of Shenzhen University for 4 years, which proves that its performance is very good.
40 1 Hospital Neutron Irradiator is a reactor with low power, low radioactive reserve and no environmental consequences. Its core facility has a diameter of 24cm, a height of 24cm, a power of 30kw, normal temperature and pressure, and natural circulation. It was evaluated by the International Atomic Energy Agency (IAEA) as "a low-power research reactor with user-friendly and inherent safety characteristics, which can be built in residential units by adopting civil building standards". After the optimization design of reactor core and neutron beam device, its technical indexes and performance fully meet all requirements, which provides a powerful tool for neutron capture research and popularization and cancer treatment. It reflects the international leading level of nuclear technology application in China. At present, the incidence of malignant tumors such as glioma in China is on the rise. According to statistics, the incidence of glioma in China is nearly 65438+ 10,000 every year. Therefore, it is urgent to develop a medical neutron irradiator. This is the world's first dedicated demonstration equipment. Once completed and successfully treated, it will not only make China's large-scale medical equipment occupy a place in the world, benefit mankind, but also have a wide impact. It will also develop into a modern and huge medical rehabilitation industry. Its completion will become another highlight of high-tech projects in Fangshan District.