A reflection on medical treatment of radionuclide-contaminated wounds during medical response to nuclear emergencies / 中国辐射卫生

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

Application of nanoformulations and nanomaterials in the decorporation of radionuclides / 中华放射医学与防护杂志

Internal contamination of radionuclides in the event of nuclear emergencies can lead to serious harm to human health. The research and development of radionuclide chelating agents and the application of new technologies can reduce the internal damage caused by radionuclides. Compared with traditional preparations, the nano-preparations have the advantages of improving drug dissolution, targeting and positioning drug release, and easily passing through biofilm barrier. In recent years, many scholars have used different nano-preparation forms for different decorporation drugs, including nanoparticles, nano-liposomes, nano-emulsions, etc., to conduct related research in order to achieve better clinical application effects. Nanomaterials with excellent properties have the advantages of high efficiency, rapid adsorption and high biocompatibility, etc., and have been used more and more widely in radionuclide decorporation. In this paper, combined with the relevant literatures at home and abroad, the internal contamination of radionuclides is classified according to nuclide-deposited sites of tissues and organs, and the applications of related nanoformulations and nanomaterials in radionuclide decorporation are introduced in order to provide reference for further research.

The toxicological mechanisms and detoxification of depleted uranium exposure

Depleted uranium (DU) has been widely applied in industrial and military activities, and is often obtained from producing fuel for nuclear reactors. DU may be released into the environment, polluting air, soil, and water, and is considered to exert both radiological and chemical toxicity. In humans and animals, DU can induce multiple health effects, such as renal tubular necrosis and bone malignancies. This review summarizes the known information on DU's routes of entry, mechanisms of toxicity, and health effects. In addition, we survey the chelating agents used in ameliorating DU toxicity.

Evaluation of a novel decorporation approach to prevent radioactivity uptake by using acidosis in experimental animals.

With an aim to devise a prophylactic and/or therapeutic approach for preventing internalization of radiothallium (201Tl), and more importantly by implication, its chemical analogue radiocesium (137Cs) during any nuclear emergency, different ex vivo and in vivo animal models were created to determine the role of pH in absorption of 201Tl across jejunum/muscle tissue and whole body retention of 201Tl respectively. Movement of Tl+ under simulated pH conditions proved that pH had direct influence on its absorption. Oral intake of acidified water or parenteral administration of lactic acid was able to reduce the body burden of 201Tl by up to 12 and 50% respectively. The results indicate that acidification of gut, within physiological range may be used as an option for decorporation/inhibition of incorporation of radiothallium and radiocesium, particularly in cases of mass casualty.

The chelator BPCBG decorporates uranium and protects against uranium-induced kidney injury in rats / 中华放射医学与防护杂志

Objective To explore the dose- and time-responses of BPCBG on the decorporation of uranium and its protective effects for uranium-induced kidney injury in rats. Methods Sprague-Dawley (SD) male rats were randomly divided into 4 -7 groups:normal control group,uranium poisoning group,different doses of BPCBG groups and DTPA-CaNa3 group. Rats in chelating agents-treated groups were either injected intramuscularly with 60,120 and 600 μmol/kg of BPCBG or 120 and 600 μmol/kg of DTPA-CaNa3 immediately after intraperitoneal injection of uranyl acetate dihydrate,or injected with 120 μmol/kg of BPCBG 0.5,2 h before or 0,0.5,1 and 2 h after injection of uranium. Uranium poisoning group rats were injected with normal saline after intraperitoneal injection of uranyl acetate dihydrate,and the normal control group rats were merely injected with normal saline. The uranium content in urine,kidney and femurs were detected 24 h after chelator injections by ICP-MS method.After injecting a dose of 500 μg uranyl acetate dihydrate,rats were injected with 600 μmol/kg of BPCBG or 1200 μmol/kg of DTPA-CaNa3. Histopathological changes in the kidney and serum creatinine and urea nitrogen were examined 48 h after chelator administration.Results Prompt injections of BPCBG resulted in 37％ -61％ ( t =2.22,4.43,5.80,P ＜ 0.05 ) increase in 24 h-urinary uranium excretion,and significantly decreased the levels of uranium in kidney and bone by 59％ -69％ (t=3.33,5-59,4-53,P＜0.01) and 14％ -58％ (t =2.15,8.70,9.10,P ＜ 0.05 ) respectively in a dose-dependent manner. BPCRG injection obviously reduced the severity of the uranium-induced histological alterations in the kidney,which was in parallel with the amelioration noted in serum indicators,serum creatinine and urea nitrogen,of uranium nephrotoxicity.Advanced 0.5 h or delayed 0.5 and 1 h administrations of BPCBG were effective in 24 h-urinary uranium excretion ( advanced 0.5 h:t =4.34,delayed 0.5 h:t =3.35,P ＜ 0.05 ),decreasing accumulation of kidney uranium ( t =5.75,7.74,5.87,P ＜ 0.05 ) and accumulation of hone uranium (t =6.43,5.222,2.60,P ＜0.05),but the efficacy decreased with the interval time between uranium and BPCBG injection. Although DTPA-CaNa3 markedly reduced uranium retention in kidney (120,600 μmol/kg,t =2.28,3.35,P ＜ 0.05 ),its efficacy in uranium removal was significantly lower than that of BPCBG,and it had no protective effects against uranium-induced nephrotoxicity.Conclusions BPCBG can effectively decorporate uranium from rats and protect against uranium-induced kidney injury of rats.