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  • 28 August 2018 Volume 27 Issue 4
      
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  • Study on the influence factors of automatic analysis of dicentric chromosomes for biodosimetry
    FENG Junchao, ZHANG Lin, DAI Hong, LIU Yulong, BIAN Huahui, CHEN Weibo, WANG Youyou, MA Ya, LIU Wei
    2018, 27(4): 289-293. https://doi.org/10.13491/j.issn.1004-714x.2018.04.001
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    Objective To study the influences of different experimental conditions on the results of automatic analysis of dicentric chromosomes for biodosimetry. Methods The dose effect curve of "automatic analysis of dicentric chromosomes" fitted by our laboratory to estimate the dose of samples prepared in different conditions after the genetic workstation automatically analyzed the dicentric chromesomes. Results The results of biodosimetry are not affected by the conditions of 50 hours at 20℃ of blood placement before inoculation, different cell suspensions concentration, different degree of dispersion in the metaphases, Wright-Giemsa staining depth, repeated scanning times, sensitivity parameter of genetic workstation and distribution positions of the metaphases on the slide (P>0.05 and have no significant difference). Conclusion Automatic analysis of dicentric chromosomes is not sensitive to the general influence factors in the experiments, and is conducive to the promotion among different laboratories.
  • Personnel dosimetry report on occupational tritium internal exposure of third Qinshan heavy water reactor nuclear power plant
    WANG Kongzhao, WANG Yue, XIAO Wei, LI Houwen, CUI Fengmei, CHEN Weibo, LIU Yulong
    2018, 27(4): 294-298. https://doi.org/10.13491/j.issn.1004-714x.2018.04.002
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    To provide the reference of personnel dosimetry and protection on the tritium internal exposure by studying the tritium internal exposure dosimetry and protection in the heavy water reactor nuclear power plant. Methods The tritium internal exposure dosimetry of Third Qinshan Nuclear Power Plant (hereinafter referred to as TQNPP) in the last 15 years is summarized, the trend of the individual and collective tritium internal exposure dose is analyzed, and the distribution of the collective tritium internal exposure dose among the typical jobs is compared. Results Since 2003, about 1600 workers were monitored every year, and totally about 11 000 urine samples were analyzed and calculated for internal dose. The average annual tritium internal collective dose is 149.62 person·mSv, which takes about 19.07% of the total annual collective dose. Conclusion The results show that the tritium internal exposure dosimetry of TQNPP meets the requirements of the related regulations and standards, all workers and all types of tritium internal exposure are monitored, the monitoring plans are optimized, the individual tritium internal dose is under the national regulatory limit and the station management target, the average annual internal collective dose is lower than other PHWR plants around the world.
  • Research progress on the application of hydrogel in the treatment of radiation injury and radiation protection
    WANG Ruihao, LIU Yulong
    2018, 27(4): 299-301. https://doi.org/10.13491/j.issn.1004-714x.2018.04.003
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    Hydrogel is a kind of polymer with three dimensional network structure which has hydrophilic group and can be swelled by water but not soluble in water. As a new biomedical material, hydrogel has been widely used in wound dressing, drug carrier, tissue scaffold and many other medical fields. In this paper, the application of hydrogel in the treatment of radiation injury and radiation protection is introduced in detail.
  • Research progress on environmental discharge and biological effects of tritium water
    ZHANG Meng, CUI Fengmei, TU Yu, LIU Yulong
    2018, 27(4): 302-305. https://doi.org/10.13491/j.issn.1004-714x.2018.04.004
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    Tritium has been studied for more than 60 years. Its potential health hazards cannot be ignored because it is particularly mobile and circular in the biosphere and can be exchanged with hydrogen atoms in all substances. This review mainly reviews the situation of tritium emission in the environment, and introduces the latest progress in the current estimation of tritium biological effects and tritium absorption dose, which provides some considerations for the in-depth study of tritium toxicity.
  • Preliminary discussion on decision-making ability of operators in nuclear power plants in China
    CUI Ran, LIU Yulong, HOU Yuhan, WANG Ruihao, WANG Min, DU Yun, YAO Zhen
    2018, 27(4): 306-308. https://doi.org/10.13491/j.issn.1004-714x.2018.04.005
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    Objective To study the decision-making ability and correlation analysis of Chinese nuclear power plant operators. Methods Cluster sampling method was applied And 500 control personnel was randomly selected in seven CGNPC group subordinate station plant, "Mental Health and Neurobehavioral Evaluation System of Version2.0" was used to assess the psychosomatic health status, and record the decision-making ability score, analysis the age, seniority, education level, marital status, etc. Results The masked factor (Li) in this study was less than 8 points, indicating that the test results were reliable. Age and seniority can affect the mean of decision-making ability, and the difference between education degree and marital status is not statistically significant. Conclusion China's nuclear power plant operators have good decision-making ability, strong decision-making ability and good self-management ability, but there are differences in age and seniority.
  • Preliminary study on creativity and interpersonal relationship of China nuclear power plant operators
    WANG Min, LIU Yulong, CUI Ran, WANG Ruihao, HOU Yuhan, DU Yun, YAO Zhen
    2018, 27(4): 309-313. https://doi.org/10.13491/j.issn.1004-714x.2018.04.006
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    Objective To explore and analyze the creativity and interpersonal relationship of China nuclear power plant operators, which is a special occupation. And to provide a model in recruiting new staff, training and guiding job, evaluating post adaptation, enhancing psychological intervention, reducing risks in using staff. Methods "Mental Health and Neurobehavioral Evaluation System of Version2.0" was used to assess the psychosomatic health status in 500 operators who were randomly selected from 5 nuclear power plant in our country. Then trying to obtain and discuss the Y2 factor (the personality of strong creativity)and Y3 factor (interpersonal relationship). Results Lie<8, the test result was credible. The strong creativity (>88) accounted for 40%, while The operator requires less than 88.2. The overall interpersonal relationship went well, operators of poor interpersonal relationship (<18) accounted for only 2.8%. 3. According to the analysis results, the operator with worse interpersonal relationship tends to have higher creativity, which couldn't make him qualified for the operator's daily work. However, there is no significant relationship between creativity and working years, and it's the same case to interpersonal relationship. 4. The working environment of a nuclear power plant assimilates the creativity of its operators. While there is a larger difference of interpersonal relationship among mid-age operators. Conclusion Those with lower creativity and excellent interpersonal skills are more suitable for screening the operational positions.
  • A preliminary report on the operational style of operators in China's nuclear power plants
    DU Yun, LIU Yulong, CUI Ran, WANG Min, HOU Yuhan, WANG Ruihao, YAO Zhen
    2018, 27(4): 314-317. https://doi.org/10.13491/j.issn.1004-714x.2018.04.007
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    Objective To explore the influence of age, length of service, educational background and marital status on the psychological factors of handling style of nuclear power plant operators in China, and to provide scientific basis for the safe operation of nuclear power plants. Methods A total of 500 nuclear power plant operators were randomly selected from 7 nuclear power plant operators of China Nuclear Power Plant (CNNU) and Guangzhou Nuclear Power Group (CGN), and the psychological health assessment scale was used to evaluate the mental health of the operators of China Nuclear Power Plant (NPP). Correlation analysis was porformed on the data results. Results The concealment factor (Li) in this study was less than 8 points, suggesting that the analysis of the test results is credible. The average score of the 500 operators in China was 25.1±4.2, most of them were in good condition. Different ages, working years and academic qualifications have different influences on the psychological factors of handling style, but marital status has no obvious influence on them. The working age, age group, higher educational background group had lower score of work style factor, and the independence factor was the most important factor in each factor of service style. Conclusion The working style of most operators of nuclear power plants in China is mature and stable, and their age, length of service and educational background have some influence on it.
  • Medical follow-up and clinical observation of a case exposed to 192Ir source with mild bone marrow from of ARS
    BIAN Xiaolu, HAN Zhenlin, ZHANG Xiaoqiang, YANG Yi
    2018, 27(4): 318-321. https://doi.org/10.13491/j.issn.1004-714x.2018.04.008
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    Objective To investigate the clinical treatment and late effects of mild bone marrow form of acute radiation sickness after 12 years of medical follow-up and clinical observation in a case of "7.13" 192Ir accident in Harbin in 2005. Methods Collect the patient's history, In detail collect the clinical data, summarize the changes of hematopoietic system and mental health, evaluate the therapeutic effect and observe the late effects. Results After early treatment, the changes of hematopoietic system, psychic trauma, asthenic syndrome and neurasthenia syndrome were all improved. After the first 10 years of exposure, the patient began to experience a decrease in granulocytic system, erythrocyte system, and megakaryocytic system. In the 13th year, the patient was diagnosed with dissociative disorder, heart failure, hepatic Insufficiency, low immunity, neurasthenia and so on. Symptoms can be relieved after treatment, but easy to repeat. Conclusion This case of mild bone marrow form of acute radiation sickness has its unique characteristics and complications in clinical manifestations and late effects, which provides a reference for the clinical treatment of these diseases in the future.
  • Five-year analysis of peripheral blood cell count average and chromosomal aberration and micronucleus rate ofperipheral blood lymphocytes of radiation workers in ShanDong Province
    LIU Dongren, ZHANG Lin, LIU Yulong, LIU Wei, MA Ya, NIU Fei, MIN Nan
    2018, 27(4): 322-326. https://doi.org/10.13491/j.issn.1004-714x.2018.04.009
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    Objective To analyze the average number of white blood cells, hemoglobin, and platelet counts in the blood routine of radiation workers in Shandong Province, the occupational health status of radiation workers, to discuss the effect of low-dose ionizing radiation on the health of radiation workers. Methods Use the overall random sampling method to analyze the blood routine, chromosome aberration rate and micronucleus rate of the 12 496 radiation workers, who performed occupational health examination between 2013 and 2017. Results The annual difference between blood routine and chromosomal aberration was significant from 2013 to 2017. The rate of micronucleus shows a gradual decrease trend (χ2=28.000, P<0.05). The difference between blood routine in the Imaging-diagnosis group and the X-ray industrial group was signifigant, and the chromosomal aberration and the rate of micronucleus was higher than that of the other groups. The difference is statistically significant. compared between different types of works. The average of white blood cells and hemoglobin gradually increased as the length of service increases. The average changes in platelets are statistically significant, There was no significant difference in chromosomal aberration between different seniority groups. (χ2=0.209, P<0.05). Conclusion Long-term low-dose radiation exposition may cause a certain radiant injuries. radiotherapy group、interventional group and industrial group are the focus of radiation protection propaganda and supervision.
  • Application of low-dose CT in lung cancer screening
    BI Jinling, SHENG Mao, DING Lu, HUANG Yong
    2018, 27(4): 327-330,335. https://doi.org/10.13491/j.issn.1004-714x.2018.04.010
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    Objective To explore the value of pulmonary nodules in low-dose CT and follow-up standard diagnostic CT for lung cancer screening. Methods A total of 21 subjects who have been screened for lung cancer by low-dose CT and follow-up standard diagnostic CT were randomly selected. Both CT image sets for all subjects were independently evaluated by five specialized physicians. Results There were no significant differences between low-dose CT screening and follow-up standard diagnostic CT for lung cancer screening. The concordance rate for the diagnoses of nodule disease was approximately 82% (P<0.001)for all categories. Agreement of the evaluation of all categories in the final diagnosis exceeded 96% (P<0.001). With low-dose CT, the effective dose ranged from 1.5 to 3.6 mSv, whereas in the follow-up diagnostic CT, the effective dose ranged from 8.7 to 15.2 mSv. Conclusion Low-dose CT can be effectively used as an alternativeto standard-dose CT in order to reduce the radiation dose, in the follow-up of pulmonary nodules.
  • The efficacy and prognosis of intensity-modulated radiotherapy for 110 cases of elderly esophageal cancer
    HUANG Yong, BI Jinling
    2018, 27(4): 331-335. https://doi.org/10.13491/j.issn.1004-714x.2018.04.011
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    Objective To evaluate the efficacy and related prognostic factors of esophageal carcinoma treated with intensity-modulated radiotherapy (IMRT) inelderly Patients. Methods From January 2014 to March 2017, 110 elderly pat-ients (age ≥ 65 years) with esophageal carcinoma treated with IMRT in the Department of Oncology, Second People's Hospital of Hefei, Anhui Province were analyzed retrospectively. Results Median age was 77years among 110 patients. The median survival time was 19.5 months. The 1-, 3- and 5-year survival rates were 67%, 49%, 28% and 9%, respectively. Grade 1, 2 and 3 acute radiation pneumonitis incidence was 5.3%, 0.9%, 0.4%, respectively. Grade l, 2 and 3 acute radiation-induced esophagitis incidence was 36.2%, 48%, 2.1%, respectively. Grade l, 2 and 3 myelosuppression incidence was 29.6%, 13.7%, 2.7%, respectively. Grade l, 2 and 3 radiation-induced digestive reaction incidence was 13.1%、3.4%、0.1%, respectively. No radiation damage of Class IV or above. COX multivariate analysis identified tumor location, Gross tumor volume (GTV)and treatment modality as related prognostic factors for overall survival. Conclusion IMRT is safe and effective in the treatment of elderly patients with esophageal carcinoma.
  • Application of different tube voltage and noise index in CTA of two lower extremities
    TAO Lei, SHENG Mao, LI Ruomei
    2018, 27(4): 336-338,345. https://doi.org/10.13491/j.issn.1004-714x.2018.04.012
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    Objective To study selecting different tube voltage and image noise index to reduce the radiation dose received by patients in CTA of lower extremities without sacrificing the quality of images. Methods According to different body mass index, seventy patients undergoing CTA with lower limbs were divided into control group and observation group. The tube voltages were 100kV and 80kV, and the noise indexes were 15 and 20, respectively. Use the GE Light Speed64 VCT machine with automatic tube current regulation. Calculate the radiation dose to both groups of patients. Statistical data were measured with (x±s) markers and t test was used. P<0.05 was considered statistically significant. Results The dose length product (DLP) and effective dose (ED) in the observation group were 53% lower than those in the control group. There was a statistically significant difference between the two groups (P<0.05). Conclusion According to the BMI value of the patient, reducing the tube voltage and raising the noise index within the appropriate range can effectively reduce the radiation dose to the patient.
  • Average values of bed method placement technology in the application of IMRT of cervical vertebra bone metastases
    ZHANG Yangfan, BI Jingling, HUANG Yong
    2018, 27(4): 339-341. https://doi.org/10.13491/j.issn.1004-714x.2018.04.013
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    Objective Using KV cone beam CT (cone beam CT, CBCT) image boot scanning technology, to investigate the feasibility of average values of bed method placement technology in intensity modulated radiation therapy (IMRT) for cervical vertebra bone metastases. Methods Each patient was given CBCT scan for 30 times and record the value of three directions each time, including left and right (X)、before and rear (Y)and up and down (Z), take the mean of the previous five times x=(x1+x2+…x5)/5, y=(y1+y2+…y5)/5, z=(z1+z2+…z5)/5, as the value of bed positioning and compare with physicist planned bed value x0, y0, z0. to compute the average upset error, which on X axis is Lat5=x5-x0, Y axis is Lng5=y5-y0, Z axis is Vrt5=z5-z0. Consider the mean of the first five setup errors as the system error and consider the standard deviation of the setup errors in all times as the random error to conduct independent t-test. Results Statistical analysis of system error and random error there was no significant difference (P> 0.05), the left and right, front and back, up and down three dimension error is <0.3 cm within the allowable range. Conclusion The application of average values of bed method placement technology in IMRT for cervical vertebra bone metastases is feasible.
  • Application of standardized nursing assessment in radiotherapy injury of head and neck cancer
    ZHOU Jing, CHENG Danping
    2018, 27(4): 342-345. https://doi.org/10.13491/j.issn.1004-714x.2018.04.014
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    Objective To investigate the effect of standardized nursing assessment on toxic and side effects of radiotherapy in head and neck cancer patients. Methods One hundred and forty-four patients with malignant tumor who underwent head and neck radiotherapy in our oncology department from January 2016 to January 2018 were randomly divided into observation group (72 cases) and control group (72 cases). Predictive care based on standardized nursing assessment was applied to patients in the observation group. Routine care was given in the control group. The adverse reactions of radiation injury were compared between the observation group and the control group. Results The incidence of radioactive stomatitis, radioactive dermatitis, difficulty in opening mouth, radioactive esophagitis and radioactive snuff mucositis in the observation group used standardized nursing assessment was lower than that in the control group (P<0.05). Conclusion Giving the corresponding predictive care based on standardized nursing assessment during the radiotherapy can significantly reduced the adverse effect of radiotherapy in patients with head and neck cancer.
  • Report of 120 cases of acute radiation dermatitis prevention and nursing
    NI Shengli, CHEN Xiaomei, SONG Lin
    2018, 27(4): 346-348. https://doi.org/10.13491/j.issn.1004-714x.2018.04.015
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    Objective To explore the clinical effects of 120 cases of acute and subacute radiation dermatitis prevention and nursing. Methods One hundred and twenty patients who received linear accelerator radiotherapy from June 2014 to December 2017 were randomly divided into control group, VitB12 mixture group and Biafin group. The control group received routine care during radiotherapy; VitB12 mixture group used vitamin B12, dexamethasone, and gentamycin during radiotherapy; and Biafin group used biafine during radiotherapy. Results The incidence of grade 2, grade 3, and grade 4 skin lesions was significantly lower in the VitB12 mixture group and the Biafin group than in the control group. Conclusion Prophylactic/Preventive nursing can effectively prevent the occurrence of radiation dermatitis, alleviates the suffering of patients, and improves patient satisfaction and quality of life.
  • Research progress of radiation-induced cardiovascular diseases
    HUANG Yong
    2018, 27(4): 349-353. https://doi.org/10.13491/j.issn.1004-714x.2018.04.016
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    Cancer survival has improved dramatically, but this has also increased the delayed side effects of multimodality therapy. Radiation (RT) to the thoracic malignancies results in unintentional irradiation of the cardiac chambers. RT-induced microvascular ischemia leads to disruption of capillary endothelial framework, and injury to differentiated myocytes results in deposition of collagen and fibrosis. Radiotherapy not only causes heart damage, but also accelerates the occurrence of major coronary events in patients with metabolic syndrome and atherosclerosis. Hence, it becomes pertinent to understand the underlying pathophysiology and clinical manifestations of RT-induced cardiovascular disease to devise optimal preventive and surveillance strategies.
  • Clinical research of intensity modulated radiation therapy in chest primary tumor for oligometastatic patients with non-small cell lung cancer
    JIANG Zonghui, DONG Xiangning, XUE Song, WANG Weifei
    2018, 27(4): 354-356. https://doi.org/10.13491/j.issn.1004-714x.2018.04.017
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    Lung cancer is the leading cause of cancer-related deaths in China and worldwide, non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. Oligometastasis is a transitional stage between the local primary lesion and the extensive distant metastasis, and might possess organ specificity. In recent years many clinical researches have shown that oligometastatic patients with NSCLC often have better biological behavior and better prognosis than patients with extensive lesions. So it is very necessary to find an effective treatment method for improving prognosis. This article is to explore the application of intensity modulated radiation therapy (IMRT) in the treatment of oligometastatic NSCLC.
  • Research and development of individual protection kit for nuclear emergency
    LIU Shufeng, LIU Chengjun, MA Dexun, YIN Aimin, WANG Li, YU Fengqi
    2018, 27(4): 357-359. https://doi.org/10.13491/j.issn.1004-714x.2018.04.018
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    Objective According to the requirement of radiation protection equipment for emergency in nuclear accidents or invents, to develop individual protection kit for combatants. Methods The protection kit for nuclear emergency was equipped on the base of demands for nuclear emergency and supplies situation of battlefield army. The function types and amount of outfit was insured. The effect was verified whether it satisfied the needs of individual emergency. Results It consists of 2 parts, 4 modules and 19 kinds of 59 equipment. It is portable, practical and easy to operate. Its functions included dose monitoring, protection of radioactive contamination, decontamination and first-aid. Conclusion The individual protection kit for nuclear emergency filled the combatants equipment gap of battlefield army, it can improve the protection capability of combatants and the effectiveness and safety of army for nuclear threat.
  • Analysis and countermeasures of common health problems for professional populaion in nuclear power station
    JIANG Dejuan, WANG Mei, JIN Zheng, LIU Chengjun, ZHANG Congjiang, MA Dexun, LIU Shufeng
    2018, 27(4): 360-362. https://doi.org/10.13491/j.issn.1004-714x.2018.04.019
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    Objective The health status of the occupational population in nuclear power plant was analyzed and corresponding countermeasures were adopted to promote their occupational health management. Methods A total of 1 613 professional staff members of a nuclear power station in our hospital for physical examination in 2017 were selected as the observation group. A total of 516 civil servants who had not been exposed to radiation within 5 years of the physical examination in our hospital were selected as the control group. Observations included blood routine (total white blood cells, hemoglobin, platelets), peripheral blood lymphocyte micronucleus rate, and chromosome aberration analysis. Results The abnormal detection rate of blood routine (the total number of white blood cells, hemoglobin, platelets), lymphocyte micronucleus rate, and chromosomal aberrations in observation group were higher than those in the control group, but there was no significant difference between two groups. Conclusion The occupational population of Haiyang Nuclear Power Plant is less affected by radioactive hazards, but it is still necessary to raise the awareness of occupational protection in nuclear power workplaces and take effective preventive measures.
  • Clinical observation of hydrogen-water on the treatment of acute radiation-induced oral mucositis of 110 cases
    XU Changchun, LI Yanfei, LIU Chengjun, LIU Shufeng
    2018, 27(4): 363-365. https://doi.org/10.13491/j.issn.1004-714x.2018.04.020
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    Objective To observe the clinical effects of hydrogen-water on the treatment of acute ratiation-induced oral mucositis. Methods The 110 patients with nasopharyngeal carcinoma were randomiy divided into treatment group and control group. There were 55 cases in the treatment group and 55 cases in the control group. The treatment group was treated with hydrogen-rich water, while the control group was treated with normal saline until the end of radiotherapy. The clinical symptoms and signs of change, acute ratiation oropharyngeal mucosa reaction, swallowing function and the pain degree of oral mucosa were evaluated at the 2、4 and 6 weeks of radiotherapy. Results The acute radiation corop haryngeal mucosa reaction of treatment group at the 4、6 weeks of treatment was significantly more slight than control group (P<0.05). The improvement of swallowing function and the remission of oral mucosa pain in treatment group at the 4, 6 weeks of radiotherapy were better than that in control group (P<0.05). Conclusion Hydrogen-rich water can improve radiation oral mucosa reaction.
  • Early radiation protection of critically wounded in nuclear emergency rescue
    WANG Mei, MA Dexun, JIANG DeJuan, LIU Chengjun, YIN Aimin, LIU Shufeng
    2018, 27(4): 366-368,375. https://doi.org/10.13491/j.issn.1004-714x.2018.04.021
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    Objective To explore radiation prevention methods of critically wounded in nuclear emergency rescue. Methods It was done according to the requirements and relevant technical standards of nuclear or radiation accidents emergency medical rescue, combined with training, exercise. Results The radiation protection methods about wounded and contamination diffusion protection methods about medical care personnel, ambulance, equipments, working area were formulated. Conclusion It can improve protection awareness of rescue workers, reduce radiation damage and contamination diffusion, increase security and scientificity of emergency medical rescue accordingly.
  • Role of mesenchymal stem cell derived extracellular vesicles in radiation injuries
    WANG Li, MA Dexun, XU Changchun, GAO Rui, GAO Chunji, LIU Shufeng
    2018, 27(4): 369-371. https://doi.org/10.13491/j.issn.1004-714x.2018.04.022
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    Mesenchymal stem cell derived extracellular vesicles (MSC-EVs) conserve MSC' bioactivity, while overcome certain safety concerns related to MSC. The phospholipid bilayer of MSC-EVs may protect their contents, such as lipid, protein, DNA, RNA, from degradation by circulatory enzymes. Moreover, large scale MSC-EVs could be obtained through immortalized MSC technique. Thus, MSC-EVs based therapy is a more efficient, convenient, feasible, safer cell free therapy strategy compared with MSC. So far, MSC-EVs present similar function to MSC in the field of regenerative medicine and immunomodulation. Herein, the recent research progress about the role and the involved mechanisms of MSC-EVs in radiation injuries are systematically reviewed.
  • Current situation of nursing for medical emergency rescue in nuclear accident
    LUO Yingying, MA Dexun, LIU Chengjun, YU Zhihua, YIN Aimin, CHEN Jigang, LIU Shufeng
    2018, 27(4): 372-375. https://doi.org/10.13491/j.issn.1004-714x.2018.04.023
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    Nuclear and radiation accident emergency rescue and the characteristics of nursing work and medical emergency rescue nursing status in China were introduced in this paper Meanwhile we discussed its function orientation, construction requirements, puts forward some Suggestions to its development.
  • High-dose-rate brachytherapy plus external beam radiotherapy: A utilized modality for tracheobronchial obstructive granulation hyperplasia induced by self-expandable metallic stents
    SUN Zhiqiang, YU Jingping, WEI Guozhen, YIN Xiaowei, NI Xinchu, WANG jian, NIE Bin, LI Dongqing, NI Xinye, LIU Xi, SONG Xiangyun, SUN Suping
    2018, 27(4): 376-380. https://doi.org/10.13491/j.issn.1004-714x.2018.04.024
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    Objective To study the effect of high-dose-rate brachytherapy plus external beam radiotherapy (HDRB plus EBR) for re-stricture induced by granulation hyperplasia after SEMS (self-expandable metallic stents) implantation for benign tracheobronchial stricture. Methods 4 cases with re-stricture induced by granulation hyperplasia after SEMS implantation for benign tracheobronchial stricture were treated with high-dose-rate brachytherapy plus external beam radiotherapy, and the effect was evaluated according to the clinical symptoms alleviation and bronchoscopy result. Results 3 cases showed obvious dyspnea alleviation, and the granulation decreased obviously. Conclusion This study indicated that HDRB plus EBR might provide an effective therapeutic alternative for obstructive tracheal granulation hyperplasia.
  • Dosimetric study on intensity-modulated radiotherapy with dissimilar position on peripheral normal tissues and organs of cervical cancer
    MIAO Hui, SHI Linxin, BAI Haisheng, SHAO Weixian, YUAN Cheng, LIU Yazhou, SUN Suping, CHEN Honglin, LUO Jujian, HUI Hua, ZHANG Wen
    2018, 27(4): 381-384. https://doi.org/10.13491/j.issn.1004-714x.2018.04.025
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    Objective To analyze the difference of irradiation dose of organs at risk (OAR) between supine position and prone position on intensity-modulated radiotherapy (IMRT) for cervical cancer. Methods Fourteen patients scheduled to receive postoperative radiotherapy for cervical cancer were scanned with supine position and prone position by CT. The CT images were transported to TPS, then the IMRT plans were designed respectively. HI and CI of the planning target volume (PTV) and irradiation dose of OAR were evaluated. To appraise the difference between the techniques, the paired t-test was applied. Results Both groups showed excellent dose coverage to the clinical target volume. There was no significant difference in CI and HI of PTV between the two groups (P=0.211, 0.190). Compared with supine position, patients with prone position had significantly lower V40 and V50 of the small bowel (P<0.05). The V40 of colon and V50 of pelvis were also lower in Prone-IMRT group (P<0.05). The irradiation dose of rectum, bladder, femur head, spine cord and sigmoid were no obviously differences at dissimilar position (P>0.05). Conclusion The application of prone position in IMRT for cervical cancer patients can reduce the dose of small intestine and other organs, thus reducing the occurrence of adverse reactions, and has clinical application value.
  • The observation of 160 cases of cervical carcinoma with 192Ir afterloading intracavitary brachytherapy and external beam intensity-modulated radiation therapy
    ZHANG Wen, SHI Linxin, YUAN Cheng, LIU Yazhou, SUN Suping, MIAO Hui
    2018, 27(4): 385-389. https://doi.org/10.13491/j.issn.1004-714x.2018.04.026
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    Objective To study the efficacy and radiation response of 192Ir high dose rate intracavitary radiotherapy combined with in vitro contrast-enhanced radiotherapy (IMRT) in the treatment of cervical cancer. Methods From January 2011 to December 2016, 160 stage Ⅰ-Ⅳ cervical cancer patients confirmed pathologically were treated with combination of HDR 192Ir after loading intracavitary brachytherapy plus external beam IMRT. A midplane dose of 45-50 Gy IMRT at 1.8-2.0 Gy per fraction to the whole pelvis were given five times a week. Intracavitary brachytherapy was delivered to a total dose of 21-24 Gy at 5-8 Gy per fraction, once a week. Results The 1-and 3-year survival rates were 100% and78.75%. The 3-year survival rate was significantly different from that of stage I and Ⅱ, Ⅲ and IV (100%、80%, 63.89%、16.67%, P<0.05). There was no significant difference between that of stage Ⅱ and Ⅲ (80%、63.89%, P>0.05). There was significant difference from that of pathological stage I and Ⅱ of stage Ⅱ and Ⅲ cervical cancer patients (100%、53.33%, 100%、33.33%, P<0.05). There was no significant difference in the survival rate of patients with pathological stage IV (P>0.05). In patients with stage Ⅱ and Ⅲ, the 3-year survival rate has a significant difference between tumor diameter <4 cm and >4 cm (P<0.05). However, there was no significant difference between tumor diameter <4 cm and >4 cm in stage IV patients. Immediate ractal reaction and late radioproctitis were present in 21.8% and 7%, acute and chronic radiation cystitis in 7.5% and 5%, respectivity. Rectovaginal fistula developed in 0.625%. Conclusion HDR after loading Intracavitary brachytherapy combined with external IMRT is effective and less toxic in the treatment of carcinoma of uterine cervix.
  • Progress of radioactive seed implantation in the treatment of malignant tumors
    LIU Yazhou, YUAN Cheng, SHI Linxin, SHAO Weixian, JIANG Song, WANG Yufeng, BAI Haisheng, MIAO Hui, ZHANG Wen, SUN Suping
    2018, 27(4): 390-394. https://doi.org/10.13491/j.issn.1004-714x.2018.04.027
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    Radioactive seed implantation is a close-distance therapy for malignant tumors and is an important and effective method in the treatment of malignant tumors. The technology has a long history, but has developed rapidly in recent years, forming a complete specification and standards. In this paper, the historical development, status, progress, application status and protection management of radioactive particle implantation technology are reviewed by consulting literature and working practice in our department. The aim is to improve the comprehensive treatment level of malignant tumor and the quality of life of cancer patients.
  • Clinical effect of individualized education on radiotherapy compliance of patients with nasopharyngeal carcinoma
    JIANG Song, LIANG Wanwan, YANG Tingting, LIANG Ximin, WANG Ying, QI Yan, LIU Yazhou
    2018, 27(4): 395-397. https://doi.org/10.13491/j.issn.1004-714x.2018.04.028
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    Objective To observe the effect of individualized health education on the compliance of nasopharyngeal carcinoma patients with radiotherapy. Methods 66 patients with nasopharyngeal carcinoma who underwent radiotherapy from January 2015 to April 2017 were selected. 33 patients in the control group were treated with conventional radiotherapy for nasopharyngeal carcinoma in the ward, 33 patients in the intervention group were treated with individualized education on the basis of nursing in the control group, and 33 patients in the intervention group were divided into two groups by using random digital table method. To improve the compliance of patients with health education. The observation time was 3 months after the beginning and the end of radiotherapy. The compliance of health education and the occurrence of adverse reactions were compared between the control group and the intervention group. Results The compliance of the patients in the individualized education intervention group was significantly higher than that in the control group, the incidence of adverse reactions was lower than that in the control group, and the adverse reaction rate of radiation temporomandibular arthritis was significantly higher than that of the control group. There was significant difference between the two groups (P<0.05), but the oral mucosa in the intervention group was slightly better than that in the control group (P>0.05). Conclusion Individualized education can improve the compliance of nasopharyngeal carcinoma patients with radiotherapy, alleviate the adverse reaction of radiation temporomandibular arthritis, and improve the quality of life after radiotherapy.
  • Observation on the prevention and treatment of radioactive oral mucositis by carrot ice cubes
    TANG Hua, SHI Yunping, GENG Cong, SUN Suping
    2018, 27(4): 398-399. https://doi.org/10.13491/j.issn.1004-714x.2018.04.029
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    Objective To study the protective effect of carrot ice on oral mucosal radiation injury. Methods From August 2016 to November 2017, 40 patients with nasopharyngeal carcinoma were randomly divided into experimental group and control group, 20 patients in each group. The experimental group was treated with carrot ice for half an hour before radiotherapy, half an hour after radiotherapy and one hour before bed. The control group was treated with routine nursing. The radiation injury of oral mucosa in two groups was observed. Results The oral mucositis of group I, Ⅱ, Ⅲ and IV in the experimental group and the control group were 14, 6, 0, 0 and 8, 8, 3 and 1 respectively. the oral mucosa injury in experimental group was significantly lighter than that of control group. Conclusion Carrot ice has protective and therapeutic effect on oral mucosal radiation injury.
  • Observation on the effect of nedaplatin concurrent with radiotherapy and chemotherapy for locally advanced non-small cell lung cancer
    MA Gaolei, WANG Wei, XU Mengjun, SHI Lingyun, CHEN Yuanyuan, WU Xiaojin
    2018, 27(4): 400-402,405. https://doi.org/10.13491/j.issn.1004-714x.2018.04.030
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    Objective To investigate the sensitization effect of concurrent nedaplatin (NDP) chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Sixty-eight patients who had been diagnosed as advanced NSCLC were randomly divided into control and treatment groups. The control group received radiotherapy alone. The treatment group received NDP sensitization and concurrent radiotherapy and chemotherapy. Three groups of radiation therapy used three-dimensional conformal radiotherapy. The treatment effect of the patient was evaluated 4 weeks after the completion of the treatment and the adverse reactions were observed. Results After 4 weeks of treatment, the results of the evaluation of the patient's treatment showed that the effective rate in the control group was 38.2%, the disease control rate was 85.3%, the effective rate in the treatment group was 64.7%, and the disease control rate was 91.2%. The results of the two groups showed that compared with the control group, the treatment group's efficiency and disease control rate were significantly improved, with significant differences (P<0.05). At the same time, the statistical results of the survival rates of the two groups of patients also showed that compared with the control group, the survival rate of the treatment group was significantly improved in one year and two years, the difference was statistically significant (P<0.05). Moreover, the observation of toxic side effects showed that the main adverse reactions were myelosuppression, gastrointestinal reactions and nephrotoxicity. Conclusion The efficacy of NDP concurrent chemoradiation in the treatment of advanced NSCLC is significant, but due to the limited number of cases, the sensitization of NDP to NSCLC remains to be further studied.
  • Efficacy of chemotherapy combined with 3-dimensional conformal radiation therapy on advanced Ⅲ non-small cell lung cancer
    SHI Lingyun, WANG Wei, DONG Haibei, XU Mengjun, WU Xiaojin
    2018, 27(4): 403-405. https://doi.org/10.13491/j.issn.1004-714x.2018.04.031
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    Objective To analyze the application value in stage Ⅲ non-small cell lung cancer by the combination of the 3d chemotherapeutic radiotherapy with synchronous chemotherapy. Methods The study of 160 cases of stage Ⅲ non-small-cell lung cancer in our hospital from January 2013 to December 2016. They were divided into two groups, and 80 patients were treated with synchronous chemotherapy. Eighty patients were given three dimensional chemotherapeutic radiotherapy combined with synchronous chemotherapy, set as the experimental group. To observe the progress of the patient's treatment and to analyze and compare the treatment outcomes and survival rates of two groups. Results The total efficiency of the patients in the experimental group was higher, and the difference in the data of the control group were statistically significant, which confirmed the statistical significance, (P<0.05). The survival rate of the patients in the experimental group was higher, and the difference between the experimental group and the control group was statistically significant, and (P<0.05). The incidence of adverse effects was low in the experimental group, and the difference between the experimental group and the control group was significant, and the significance of the evidence was statistically significant (P<0.05). Conclusion For patients with stage Ⅲ non-small cell lung cancer using three dimensional conformal radiotherapy in combination with synchronous chemotherapy, obvious effect, can effectively improve the therapeutic effect of patients as well as the quality of life.
  • Common psychological problem among nuclear operators and the countermeasures
    WU Zhenqing, LI Min, LIU Yulong
    2018, 27(4): 406-409. https://doi.org/10.13491/j.issn.1004-714x.2018.04.032
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    Objective To understand the common psychological problems of nuclear power plant operators in China and try to propose countermeasures. Methods A database of psychological interviews with 311 operators from 2015 to 2017 was established and analyzed. Results The psychological distress caused by realistic factors such as work and live is the most common, and there are significant differences in the psychological distress caused by realistic factors between groups by region and by year (χ2=10.19, P=0.006 1, χ2=11.25, P=0.003 6). Anxiety (86.61%) and depression (42.52%) were the most common emotional problems. There were statistically significant differences in mood recognition between groups by year (χ2=7.16, P=0.027 9). Intellectualization and emotional isolation are the most common mechanisms of psychological defense. General psychological problems are most common, and there are occasional suspected mental disorders. The psychodynamic hypothesis of the operator's mental distress involves four aspects:self-esteem, harsh superego, intimate relationship or attachment problem, and trauma. Conclusion There is no qualitative difference between the psychological distress of operators and other population groups, but there are characteristics related to their working characteristics. Establishing and improving the mechanism of communication and linkage between clinical psychology and production safety, putting more psychological resources into the workplace for easy access, and continuing to carry out all kinds of psychological science work all might contribute to further strengthen the mental health of nuclear power plant operators.
  • Psychological crisis intervention strategy in nuclear emergency situations
    WU Zhengyan, LI Min, LIU Yulong
    2018, 27(4): 410-412. https://doi.org/10.13491/j.issn.1004-714x.2018.04.033
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    There are special hazards and psychological effects of nuclear radiation accidents. This article combines reports and research on psychological crisis interventions in nuclear emergency situations at home and abroad, and summarizes the experience and strategies that have been widely recognized and validated through actual use in the context of nuclear emergency, from the performance and classification of psychological crisis in the crowd, the key points of early psychological crisis intervention, evaluation and coping strategy of psychological health, special treatment of pregnant women and children, and core of group therapy, which have a high guiding significance for China's nuclear emergency work.
  • Research on radiation distribution rule of a radiation therapy place based on GEANT4 monte carlo progress
    LI Dong, LIU Ping, JI Fang, LI Ling, SHI Yong
    2018, 27(4): 413-416. https://doi.org/10.13491/j.issn.1004-714x.2018.04.034
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    Objective To construct the Monte Carlo physical model of a radiotherapy site and explore the distribution rules of radiation level in this site. Methods According to the actual treatment room parameters, linear accelerator and room model is established in the Monte Carlo program, and draw the accelerator in energy 15 MV and dose rate 400 MU/min. Then we calculate the distribution of the radiation dose level indoor and outdoor for the treatment, considering the neutron nuclear reactions between high energy X-ray and high Z material of accelerator head. Results The dose rate at the center of the accelerator was about 2.6×105 mSv/h, and analysts pointed out that treatment chamber X-ray dose attenuation trend ratio with the square of the distance is inversely proportional to the attenuation trend to slow, and after a transition radiation levels decreased by an order of magnitude. Conclusion The simulation and computation of radiation distribution rule of radiotherapy site based on Monte Carlo Method, has provide new ideas for shielding optimization design in radiotherapy sites.
  • Analysis of the upper segment esophageal setup errors and planning target margin based on CBCT for esophageal radiation with thermoplastic film immobilized
    SHI Yong, YAN Qinying, LI Dong, ZHANG Fen, ZHANG Min, LIU Yanli, CHEN Ying
    2018, 27(4): 417-420. https://doi.org/10.13491/j.issn.1004-714x.2018.04.035
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    Objective To evaluate the setup errors for the upper segment esophageal cancer with cone beam CT (CBCT) in esophageal patients immobilized by thermoplastic film, and to probe the margins from the esophageal clinical target volume (CTV) in 3 directions. Methods A total of 40 patients treated by Varian iXTM Linear accelerator with upper segment esophageal cancer were enrolled. During the treatment, a CBCT was acquired on a daily basis after conventional position and was registered to the planning CT to determine initial inter-fraction error. Then a second CBCT scan was performed to calculate residual inter-fraction error after the couch online correction. After the RT delivery, a final CBCT was acquired to assess intra-fraction motion. Results A total of 956 CBCT images were acquired from 40 patients. After couch online correction, the inter-fractional setup errors in x y z were significantly reduced (Pearson=-0.523, -0.511, -0.562, P<0.05). The setup errors on (left-right), (superior-inferior), (anterior-posterior) translational directions were (0.22±2.94)mm, (1.51±3.22)mm, (-1.89±1.38)mm, and the margins from CTV were recommended as not less than 5.16mm, 5.87mm, 4.52 mm in, and direction, respectively. Conclusion For the upper segment esophageal cancer patients immobilized by thermoplastic film, which recommended to reduce the external boundary of CTV, respectively. The position immobilized method and the positioning workflow should be further improved in order to reduce the influence of breathing movement on setup errors.
  • Effect of radiation therapy on Treg cells in peripheral blood of NSCLC patients
    CHEN Ying, ZHANG Fen, SUN Yiling, SHI Yong, ZHANG Min, WANG Hongjian
    2018, 27(4): 421-424. https://doi.org/10.13491/j.issn.1004-714x.2018.04.036
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    Objective To study the effect of radiation therapy on peripheral blood Treg cells in NSCLC patients. Methods To analyze the changes of CD4+ CD25+ Foxp3+ Treg/CD4+ cells ratio in peripheral blood of 50 NSCLC patients before and after radiation therapy, and their relationship with clinical characteristics. Results The proportion of CD4+ CD25+ Foxp3+ Treg cells in CD4+ T cells was significantly decreased after radiotherapy in NSCLC patients, which was related to tumor diameter, tumor stage and differentiation. Conclusion The level of CD4+ CD25+ Foxp3+ Treg cells significantly changed during NSCLC radiation therapy, which may be an important prognostic indicator of NSCLC.
  • Research on the nursing cooperation effect of dual-source spiral CT angiography in the imaging of lower extremity arteries
    XUE Shouhua, ZHANG Meihua
    2018, 27(4): 425-426. https://doi.org/10.13491/j.issn.1004-714x.2018.04.037
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    Objective To discuss the nursing coordination effect on dual source spiral CT angiography in the process of arterial angiography of lower extremities. Methods Use an effective method that from September 2016 to September 2017, 247 patients who need to do dual source spiral CT angiography of the lower extremities were selected. All patients were randomly divided into two groups, 119 patients in the nursing coordination group and 128 patients in the control group. The compliance and the imaging quality in angiography of the two groups were compared. Results There were 17 cases of poor imaging quality in the control group and the rate of getting high quality imaging was 86.72%. All patients in the nursing coordination group had high quality imaging, which was significantly different with the control group, P< 0.05. Conclusion The nursing cooperation in dual source spiral CT imaging is beneficial to improve patient compliance and image quality, reduce randomness in the process of examination. The nursing coordination in dual source spiral CT angiography has significant application value.