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    Hunderd Years of the Communist Party of China: Striving for Peopele's Health
  • Hunderd Years of the Communist Party of China: Striving for Peopele's Health
    Review of radiation health work in the period of “13th Five-Year Plan” and its development prospects in the period of “14th Five-year Plan”
    CAO Jianbiao, MAO Xu, LIU Qingjie, SU Xu, SUN Quanfu
    2021, 30(6): 659-664. https://doi.org/10.13491/j.issn.1004-714X.2021.06.001
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    As one of the five major branches in the traditional public health in China, significant progress has been made in various aspects of radiation health during the period of “13th Five-Year Plan (2016—2020)”: There is a team of radiation health professionals with a continuously improved system, increasing ability, and cohesion; radiation health laws, regulations, and standards have been further improved; radiation health monitoring and risk assessment have been continuously carried out for ten consecutive years; health preparedness and response to nuclear and radiation emergencies have been continuously strengthened; the aid to Tibet and Xinjiang is solid and effective; in addition, our team had an active part in the prevention and control of COVID-19 pandemic. During the “14th Five-Year Plan (2021—2025)”period, we will continue to promote the construction of technical support institutions for ionizing radiation prevention, further improve radiation health monitoring, and strengthen the capacity and team-building of national radiation health institutions. The construction of the laws, regulations, and standards of radiation health will also be promoted. We will make solid and in-depth health preparedness and medical response to nuclear radiation emergencies, condense important scientific and key technical issues of radiation health in the third decade of the 21st century, carry out in-depth research on radiation health science and technology, and strengthen the training of young talents in radiation health disciplines. Meanwhile, regional and international cooperation will be actively organized and implemented relying on the framework of the WHO Collaborating Centre for Radiation and Health.
  • Hunderd Years of the Communist Party of China: Striving for Peopele's Health
    The Health Program for Poverty Alleviation: Risk surveillance for radioactive contamination of food in Tibet and investigation and analysis of personal radiation dose
    TUO Fei, WANG Kaiyi, ZHOU Qiang, GUO Wen, YANG Baolu, DING Yanqiu, SUN Quanfu
    2021, 30(6): 665-670. https://doi.org/10.13491/j.issn.1004-714X.2021.06.002
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    This article aims to accurately implement “Health Program for Poverty Alleviation” and “Poverty Alleviation”, refine the targeted poverty alleviation mechanism, improve the disease control in poverty-stricken areas, and surveil personal radiation dose and risk for radioactive contamination of food on a national basis. According to the decision-making and arrangement on poverty alleviation of the Communist Party of China Central Committee and the State Council and to implement the basic strategy of taking a targeted approach to poverty alleviation, National Institute for Radiological Protection, China Center for Disease Control and Prevention has carried out the “Health Program for Poverty Alleviation” in Tibet since 2012, focusing on guiding and assisting the surveillance of personal radiation dose in professionals and risk for radioactive contamination of food in Tibet. By April 2021, the work that had been carried out under our assistance includes: free personal radiation dose surveillance for 13 quarters, 2 sessions of training and guidance, and on-site teaching once. The work on the risk surveillance for radioactive contamination of food includes 3 sessions of on-site training and guidance as well as annual radionuclide analysis of 60 food samples in Tibet Autonomous Region for five consecutive years. This work has filled the gap in radiation health surveillance across Tibet, significantly improved the ability of disease control in Tibet Autonomous Region, and is of great significance to the development of radiation health in Tibet and guaranteeing the health of radiation workers.
    • Radiation Health/Original Articles
  • Radiation Health/Original Articles
    Comparative analysis of occupational health status of radiation workers in different medical institutions
    WANG Li, NING Kailu
    2021, 30(6): 671-676. https://doi.org/10.13491/j.issn.1004-714X.2021.06.003
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    Objective To understand the occupational health status of radiation workers of different medical institutions and provide the basis for health management.Methods A comparative analysis of the occupational health examination of 1,630 radiation workers in 14 local medical institutions in Xinjiang, and 260 of them randomly questionnaire surveyed.Results The abnormal rate of ophthalmology and thyroid function among radiation workers was the highest in tertiary hospitals, followed by secondary hospitals, public utilities, private hospitals, first-level hospitals and individual clinics, but the order of blood glucose was reversed (P < 0.05). The abnormal rate of blood pressure, ophthalmology, chest X-ray, color doppler ultrasound, blood routine, kidney function, blood glucose, chromosome detection and urine routine increased with age (P < 0.05). The abnormal rates of blood pressure, color doppler ultrasound, glutamate alanine aminotransferase, kidney function, blood glucose and urine routine in male were higher than that in female, and the rate of thyroid function was lower than that in female(P < 0.05). The differences between hemoglobin and chromosomes, white blood cell and blood glucose, white blood cell and urine were significant. The abnormal rate of ophthalmology, kidney function and thyroid function of the Han nationality was higher than that of minorities, but of the glutamate alanine aminotransferase was lower. There was no difference in the questionnaire survey scores of 260 radiation workers from different medical institutions, cultural levels and working years (P < 0.05).Conclusion The occupational health status of radiation workers in various medical institutions is different, with age, gender and ethnicity, and the occupational health monitoring of radiation workers should be strengthened.
  • Radiation Health/Original Articles
    Preparation technique for the study of chromosome, micronucleus, and transformation rate of peripheral blood lymphocytes
    LING Pan, HE Ling, WANG Xiaofeng, ZHAO Qinhong, ZHAO Yi, CHEN Xiyang
    2021, 30(6): 677-681. https://doi.org/10.13491/j.issn.1004-714X.2021.06.004
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    Objective To explore the preparation technique for improving the quality and efficiency of lymphocyte examination. Methods The peripheral venous blood of a person without radiation exposure was used as the control group, and the blood from the same person irradiated with 60Co γ-ray at a dose rate of 1.002 Gy/min and a dose of 2.8 Gy was used as the experimental group. The lymphocytes were cultured at 37℃ for 48 h, added with colchicine, and cultured for another 20 h. The culture medium was divided into hypotonic and non-hypotonic groups and pre-fixed separately. Then the two groups of culture medium were mixed, purified, sectioned, stained, and observed. The same specimen was used for experiment with the standard method. Results According to the results of improved method and standard method, the chromosome aberration rates of the experimental group were 75.8% and 74.0%, respectively, and those of the control group were 0; the micronucleus cell rates of the experimental group were 7.8‰ and 7.2‰, respectively, and those of the control group were 1.2‰ and 1.4‰, respectively; the lymphocyte transformation rates of the experimental group were 43.6% and 43.2%, respectively, and those of the control group were 65.4% and 66.2%, respectively. Conclusion There are no significant differences between the improved and normal methods in terms of chromosome aberration rate, micronucleus cell rate, and lymphocyte transformation rate of peripheral blood lymphocytes. The improved method can shorten the preparation time, reduce reagent use, and improve the quality of section. Observation can be performed on one slide, which shortens the overall observation time and improves the reporting efficiency.
    • Medical Exposure/Original Articles
  • Medical Exposure/Original Articles
    Investigation and analysis of frequency of radiation diagnosis and treatment in medical and health institutions in Chongqing
    YANG Yunfu, LI Wei, ZHANG Huadong, LUO Hanghang, LIU Ke
    2021, 30(6): 682-686,692. https://doi.org/10.13491/j.issn.1004-714X.2021.06.005
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    Objective To master the frequency of radiological diagnosis and treatment in medical and health institutions in Chongqing in 2019, and to provide basic data for relevant units to carry out radiological diagnosis and treatment supervision and monitoring. Methods Questionnaire method was used to investigate the basic situation of radiological diagnosis and treatment institutions, the frequency of radiological diagnosis and treatment such as X-ray diagnosis, interventional therapy, nuclear medicine diagnosis and treatment, radiotherapy and so on. Results There were 1845 radiological diagnosis and treatment institutions, 3769 radiological diagnosis and treatment equipment and 8647 medical radiological workers. X-ray diagnosis number reached 18430501 person times (frequency of application 594.2 per/1000 population), among which conventional X-ray diagnosis number reached 13007987 (frequency of application 419.4 per/1000 population), CT diagnosis number reached 467244 (frequency of application 148.5 per/1000 population), and other X-ray diagnosis number reached 815270 (frequency of application 26.3per/1000 population). Interventional treatment number reached 71436 person times (frequency of application 2.3 per/1000 population), Nuclear medicine diagnosis number reached 66810 person times (frequency of application 2.15 per/1000 population), Nuclear medicine treatment number reached 4340 cases (frequency of application 0.14 cases/1000 population), Radiation therapy number reached 16249 cases (frequency of application 0.52 cases/1000 population). Conclusion The resource allocation of radiology diagnosis and treatment in Chongqing is not balanced with the development of radiology diagnosis and treatment, it is suggested that relevant departments further optimize the allocation of radiology diagnosis and treatment resources, to improve the development of radiology diagnosis and treatment.
    • Radiation Monitoring/Original Articles
  • Radiation Monitoring/Original Articles
    Analysis of radioactivity level of main seafood in a sea area offshore Beibu Gulf
    ZHAO Xinchun, FENG Lanying, WU Yingyu, LU Xiufang, XIE Ping
    2021, 30(6): 687-692. https://doi.org/10.13491/j.issn.1004-714X.2021.06.006
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    Objective To investigate the radioactivity level of main seafood in the offshore area near the Beibu Gulf.Method High purity germanium (HP-GE) γ spectrometer was used to detect and analyze the collected seafood.Results 226Ra and 40K could be detected in all the 10 samples and the detection ranges were (0.069～4.95) Bq/kg and (34.0～114.9) Bq/kg, respectively. 238U could was detected in four samples, and the detection range was (0.142～0.660) Bq/kg. 137Cs could be detected in seven samples and the detection range was (0.012～0.078) Bq/kg. The detection range of 232Th in the other 9 samples was (0.206～9.81) Bq/kg, except for one sample with abnormal result.Conclusion The radioactivity levels of 238U and 137Cs in seafood in this area were all within the range of the national investigation level. The radioactivity level of 226Ra in two kinds of seafood was higher than that in the national survey. The radioactivity level of 232Th in five kinds of seafood was significantly higher than that in the national survey. The specific activity of 232Th in one sample of balang fish was 23.2 Bq/kg (5.71 mg/kg), which exceeded the national standard limit (3.6 mg/kg). The detection results of natural radionuclides in the seabed sediment and sea water in the sampling area were all within the range of the literature, and the radioactivity levels of artificial radionuclides were all lower than the detection limit of the instrument. The reason for the abnormal radioactivity level of balang fish samples is unknown, and further investigation and long-term monitoring of radioactivity of seafood in this area are needed.
  • Radiation Monitoring/Original Articles
    Analysis of measurement results of γ energy spectrum of a rare earth chloride
    XU Jia'ang, SONG Gang, SU Jing, WANG Xiaoshan, MIN Nan, BI Mingwei, CHEN Yingmin
    2021, 30(6): 693-696,700. https://doi.org/10.13491/j.issn.1004-714X.2021.06.007
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    Objective The measurement results of a rare earth chloride were analyzed to further understand the measurement and analysis of radioactive non-equilibrium samples.Methods The rare earth chloride samples were measured according to China recommendatory national standard of determination of radionuclides in soil by gamma spectrometry (GB/T 11743—2013).Results The rare earth samples were measured three times on April 26, 2019, May 31, 2019, and January 13, 2021, respectively. The activity concentrations of 228Ac in the sample were 3.5×104, 3.5×104 and 2.9×104 Bq·kg−1, respectively. The activity concentrations of 208Tl in the sample were 2.05×103, 2.43×103 and 6.5×103 Bq·kg−1, respectively. The activity concentrations of 227Th in the sample were 7.2×102, 7.7×102 and 7.1×102 Bq·kg−1, respectively. The activity concentrations of 234mPa in the sample were 8.5×102, 7.3×102 and 4.4×102 Bq·kg−1, respectively. The activity concentrations of 214Pb in the sample were 5.5×103, 5.4×103 and 5.6×103 Bq·kg−1, respectively. The activity concentrations of 214Bi in the sample were 6.1×103, 6.0×103 and 6.2×103 Bq·kg-1, respectively. The activity concentrations of 138La at 788.742 keV in the sample were 3.3×101, 2.7×101 and 2.2×101 Bq·kg-1, respectively. The activity concentrations of 138La at 1 435.795 keV in the sample were 5.2×101, 5.2×101 and 5.6×101 Bq·kg−1, respectively.Conclusion The radioactive equilibrium of thorium family and uranium family in the rare earth chloride samples was destroyed. The activity of 227Ac in actinuium-uranium family should be measured 140 days after the completion of the product preparation. When partial radioactivity equilibrium is reached, it is more reliable to choose the γ-ray characteristics peak (1 001.441 keV) of 234mPa to determine the activity of the parent 238U. For the activity measurement of 138La, the γ-ray characteristics peak at 1 435.795 keV should be selected.
  • Radiation Monitoring/Original Articles
    Performance testing and status analysis of nuclear medicine imaging device in Qinghai Province
    MA Lei, MA Qinglu, MA Honghong, SONG Ying, LIU Hui
    2021, 30(6): 697-700. https://doi.org/10.13491/j.issn.1004-714X.2021.06.008
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    Objective To analyze the quality control situation of nuclear medicine equipment in Qinghai Province by testing the performance of SPECT and PET/CT devices.Methods According to WS 523—2019, NEMA NU 2—2007 and GB 17589—2011 standard, the performanc indexes of four SPECTs and one PET/CT were measured in 2019 and 2020.Results For SPECTS, according to the qualified limits requirements of WS 523—2019 Standard, one device with intrinsic spatial linearity is unqualified. For PET/CT, the equipment performance test results in 2020 were better than those in 2019.Conclusion Regular calibration and maintenance are very important for the quality control of nuclear medicine equipment. Strengthening daily quality control can improve equipment performance and clinical application.
  • Radiation Monitoring/Original Articles
    Preliminary application of single and double dosimeter methods for monitoring personal dose of external irradiation in nuclear medicine workers
    DING Yanqiu, ZHAI Hezheng, TAN Zhan, WANG Kaiyi, GAO Pin, HU Aiying, GUO Wen
    2021, 30(6): 701-705. https://doi.org/10.13491/j.issn.1004-714X.2021.06.009
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    Objective To analyze the problems in the application of single and double dosimeter methods for monitoring personal dose of external radiationin nuclear medicine workers. Methods Both questionnaires and on-site personal dose monitoring were used to monitor the personal dose of 52 nuclear medicine workers in 10 hospitals in China according to GBZ 128 for two periods (for 2 months each period).Results Most of the effective doses calculated by the double dosimeter method were lower than the dosein lead clothing. For workers wearing the single dosimeter, the maximum effective dose was 0.11 mSv. The effective doses estimated by the single dosimeter method were generally lower than those estimated by the double dosimeter method. Conclusion The estimation formula of single or double dosimeter for nuclear medicine workers described in GBZ 128—2019(Specifications for individual monitoring of occupational external exposure)needs to be further improved.
  • Radiation Monitoring/Original Articles
    Simulation of mobile cone-beam CT imaging based on the Geant4/GATE platform
    MING Xin, WANG Yongjian, ZHAI Hezheng, YANG Chengwen, MENG Huipeng, YANG Jian, BO Wenzhu
    2021, 30(6): 706-709,719. https://doi.org/10.13491/j.issn.1004-714X.2021.06.010
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    Objective To simulate mobile cone-beam computed tomography (CBCT) imaging based on the Geant4/GATE platform and to explore the optimization method to improve image quality. Methods Mobile CBCT imaging was simulated based on the Geant4/GATE platform of Monte Carlo algorithm to establish the models of X-ray source, flat panel detector, and phantom, and projection data of CBCT were obtained. Three image reconstruction algorithms (FDK, SART, and EM) were used for image reconstruction of the designed digital phantom with the projection data at two X-ray energy levels. Results FDK was the fastest algorithm, SART had high contrast quality, low artifacts, and high image quality; EM had minimum noise but fuzzy boundaries of inserts of different density. With the SART algorithm, the images reconstructed at 70 kV X-ray were scatters, while the images reconstructed at 140 kV X-ray had high quality. Conclusion Simulation of mobile CBCT based on the Geant4/GATE platform can reconstruct 3D images of the digital phantom, which provides a theoretical basis for further research on image quality optimization and quality control of mobile CBCT.
    • Radiation Security/Original Articles
  • Radiation Security/Original Articles
    Radiation protection assessment for 177Lu-Dotatate therapy
    GENG Jianhua, ZHANG Jinming, WANG Xiaotao, CHEN Yingmao
    2021, 30(6): 710-719. https://doi.org/10.13491/j.issn.1004-714X.2021.06.011
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    Objective To comprehensively evaluate the radiation protection of 177Lu-Dotatate therapy, and to provide a reference for standardizing and restraining patient behavior and activities after discharge and establishing relevant standards. Methods The radiation protection of 177Lu-Dotatate therapy started with the infusion of radiopharmaceuticals. The time points of each event in daily activities during and after therapy were listed in a chronological order, as well asthe persons with possible radiation exposure and their contact distance and contact duration in each event. The in vivo pharmacokinetic data in the instructions of 177Lu-Dotatate were used to estimate 177Lu activity in the patient’s body at each time point, and the formula for radiation dose in GBZ 120—2020 was used to estimate the radiation dose of the patient on the persons around him/her. Results 177Lu-Dotatate was administered to the patient at a dose of 7400 MBq when the patient attended the outpatient service or was hospitalized for treatment. The cumulative radiation dose was calculated for the medical staff, the public, colleagues, caregivers, adult family members, and the family members of children aged 3~10 years, and the measures for standardizing and restraining the patient’s behaviors were given when the dose constraint value for related persons in national standard was met. The conditions for realizing the requirement in national standard that pregnant women and family members aged < 3 years should avoid contact was also proposed in this article. Conclusion From the perspective of radiation protection, under the premise of standardizing and restraining the behavior of patients treated with177Lu-Dotatate after discharge, both ambulatory treatment and hospitalization are safe and feasible; if the activities of patients are no restrained after discharge, the radiation dose for family members, the public, and colleagues might exceed the dose limits or constraint values in relevant national standards.
  • Radiation Security/Original Articles
    Radiation protection assessment for interventional therapy with 90Y resin microspheres
    GENG Jianhua, CHEN Yingmao, WANG Xiaotao, LI Xueqin
    2021, 30(6): 720-726. https://doi.org/10.13491/j.issn.1004-714X.2021.06.012
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    Objective To comprehensively evaluate the radiation safety of interventional therapy with yttrium (90Y) resin microspheres, and to provide a reference basis for radiation protection. Methods Using the data from related literature and 90Y resin microsphere drug instructions, the urinary excretion of 90Y and the exposure dose to surrounding personnel during interventional therapy with 3 GBq 90Y resin microspheres were estimated. The radiation safety of interventional therapy with 90Y resin microspheres was also evaluated according to the related Chinese standards and regulations. Results The exposure doses to the medical staff and the wardmates caused by the patient during hospitalization were obtained, which were within the constraint values of professionals and the public; the safety of the patients’ excreta directly discharged into ordinary sewers was also evaluated so that it met the current discharge control value in China. The exposure doses to family members and colleagues after the patients were discharged from the hospital were calculated, which were within the allowed constraint value; the time and distance requirements for avoiding contact with the pregnant women and children under 3 years of age were listed in this study. Conclusion Although 90Y only emits β-ray, continuous X-ray will be emitted in the patient’s body due to bremsstrahlung radiation. The hospitalization treatment project of 90Y resin microspheres in the general ward is feasible in terms of radiation safety. The medical staff who are not radiation workers should pay attention to controlling the number of patients. The post-discharge activities of patients can be unrestricted except for contact with pregnant women and children under 3 years of age.
  • Radiation Security/Original Articles
    Safety evaluation of radiation during223Ra treatment
    SONG Xiaoqing, FAN Yan, YANG Xing, LI Xueqin, GENG Jianhua
    2021, 30(6): 727-731,738. https://doi.org/10.13491/j.issn.1004-714X.2021.06.013
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    Radium [223Ra] dichloride injection (223Ra, Xofigo®) is the first targeted alpha therapy for the treatment of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastases. This article reviews the safety evaluation of radiation during 223Ra treatment, including radiation safety during 223Ra procedures for medical staff, radiation safety after 223Ra injection for patients, and radiation impacts on patients’ family members and the public following 223Ra injection. The effective dose to the hands of medical staff during each injection was approximately 41 μSv, with an effective dose of 219Rn being 3.5 μSv; after 223Ra injection, patients showed the highest absorbed radiation dose in the endosteum and red bone marrow among other tissues, with absorbed alpha doses of 7.5×10-7 Gy/Bq and 7.2×10−8 Gy/Bq, respectively; at the completion of agent injection, the mean radiation dose rates in regions with direct contact with the patients and regions at 1 meter from the patients were less than 2 μSv h−1 MBq−1and 0.02 μSv h−1 MBq−1, respectively. It is not necessary for the patients to stay in the hospital due to radiation after agent injection.
  • Radiation Security/Original Articles
    An assessment of the radiation dose and health effects of the Fukushima nuclear accident in Japan over the past 10 years
    FU Ximing, YUAN Long, SUN Quanfu
    2021, 30(6): 732-738. https://doi.org/10.13491/j.issn.1004-714X.2021.06.014
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    To sketch out and investigate the radiation dose and health effects of the Fukushima nuclear accident on the emergency personnel and the public over the past 10 years, a comprehensive review and an assessment were performed on the latest report of the United Nations Scientific Committee on the Effects of Atomic Radiation and other important research findings, and recent hot issues such as the discharge of tritium-containing wastewater were tracked. The results showed that due to the low dose of public exposure caused by the Fukushima accident, increases in the incidence of leukemia and thyroid cancer were not observed. There have been four rescuers in the accident who were identified with occupational injuries due to leukemia and thyroid cancer. Most foods produced in Fukushima Prefecture and surrounding areas have had a radioactive cesium concentration below the new limit of 100 Bq/kg. In the Fukushima accident, some emergency protective actions were not implemented effectively, which exposed some of the public to radiation that could have been avoided or reduced. At the same time, some excessive protective measures did more harm than good, and caused psychosocial effects. In addition, it is necessary for China to continuously pay attention to and monitor and evaluate the effects of Japan’s nuclear wastewater discharge.
  • Radiation Security/Original Articles
    Investigation on protection status of radiological patients in a county-level city in Shandong province
    NI Tengshan, NI Yan
    2021, 30(6): 739-742. https://doi.org/10.13491/j.issn.1004-714X.2021.06.015
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    Objectives Analyze the protection status of patients in radiological diagnosis and treatment at the grassroots level, provide basis for the regulatory authorities, guide the patients to correctly recognize radiological diagnosis and treatment, and promote the safe and orderly development of radiological diagnosis and treatment.Methods The configuration and use of personal protective equipment, protective facilities and management measures of the patients in 40 radiological diagnosis and treatment units were investigated by means of questionnaire filling and on-site verification. 126 subjects were investigated by sending questionnaires on site, and the survey data were statistically processed.Results According to the requirements of GBZ 130—2020, the radiological diagnosis and treatment units in Rushan City were configured with protective equipment for the patients. The sample survey found that only 37.5% of the patients in the first-level hospitals actually had used protective equipment, and only 62.5% in the third-level hospitals, among which only 10.3% of the patients actively had required protective equipment.Conclusion The radiological protection facilities and supplies in the radiological diagnosis and treatment institutions of Rushan City are basically complete, but there are still problems in the configuration and use of the radiological protection equipment of the subjects. Therefore, publicity and supervision should be strengthened to protect the health and safety of the subjects
    • Radiation Environment/Original Articles
  • Radiation Environment/Original Articles
    A study of environmental surface gamma radiation dose rate in Fangchenggang, Guangxi Zhuang Autonomous Region, China
    CHANG Qing, XU Mingfa, XIANG Huiyun, ZHANG Wei, LIN Chen, HE Yena
    2021, 30(6): 743-747,756. https://doi.org/10.13491/j.issn.1004-714X.2021.06.016
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    Objective To investigate the current situation of environmental radioactivity level in Fangchenggang, Guangxi Zhuang Autonomous Region, China, and to provide a basis for the reasonable formulation of environmental radioactivity monitoring and management plan. Methods Through systematic grid layout, the environmental surface gamma (γ) radiation dose rate was measured in Fangchenggang, and its radioactive characteristics, distribution rules, and influencing factors were systematically investigated. Results The dose rate of environmental γ radiation in this city ranged from 6.7 to 231 nGy/h, with a mean value of about 100 nGy/h. Conclusion The investigation results of environmental radioactivity level in this city are consistent with the investigation results (10.7～239 nGy/h) of Investigation of environmental natural penetrating radiation level in Guangxi Zhuang Autonomous Region(1987—1988), indicating that there is no abnormality in the environmental quality in terms of γ radiation in the whole investigation area.
    • Supervision and Management/Original Articles
  • Supervision and Management/Original Articles
    Exploration on radiation protection management of a tertiary Grade-A hospital in Shanghai
    LI Lishan, YU Jia, ZHANG Jing, JI Hao
    2021, 30(6): 748-751. https://doi.org/10.13491/j.issn.1004-714X.2021.06.017
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    As an important part of hospital diagnosis and treatment, with the rapid development of modern medical technology, a growing number of radiation resources and equipment of radiation diagnosis and treatment are used in clinic, the category of radiological diagnosis and treatment increased, the number of radiation workers growing year by year and the scale continues to expand, and then put forward new challenges to radiation protection management, and the systematicness and integrity of radiological protection management become more and more significant. In order to strengthen the management of radiation protection in hospital, improve work efficiency and ensure the occupational health of radiation workers, combined with the actual work needs, this paper points out the problems existing in the management of radiological protection in hospital from personnel, equipment, place, system and so on and puts forward management measures from many aspects, including the implement system construction, strengthening the department cooperation, enhancing the awareness of personnel protection, increasing the quality control inspection, intensifying disinfection management and information construction and so on, so as to force the close loop of fine management of radiological protection in hospital.
  • Supervision and Management/Original Articles
    Interpretation of Specification for testing of quality control in X-ray computed tomography
    XU Hui, YUE Baorong, WEI Kedao, ZHAO Xipeng
    2021, 30(6): 752-756. https://doi.org/10.13491/j.issn.1004-714X.2021.06.018
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    In order to accurately understand and apply the health standard WS 519—2019 (Specification for testing of quality control in X-ray computed tomography), the background, basis, principles, and main revisions of the standard are introduced, the scope of application and quality control requirements described in the standard are clarified, and CT quality control and test procedures are explained in detail. This standard interpretation can be used to guide institutions to work in a more standard way for the quality control and test of CT machine to better protect the safety and health of CT operators and patients.
    • Diagnosis and Treatment/Original Articles
  • Diagnosis and Treatment/Original Articles
    Application of multi-modal 3D digital navigation combined with PET/CT in pulmonary nodules
    DING Ning, WANG Feng, LI Ruidong, ZHANG Kongyuan, ZHANG Xiaoyi
    2021, 30(6): 757-761. https://doi.org/10.13491/j.issn.1004-714X.2021.06.019
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    Objective To explore the application of three-dimensional digital navigation combined with PET/CT in needle biopsy of pulmonary nodules.Methods A total of 70 patients with comparable chest nodules were enrolled as study subjects; these subjects visited Weifang People’s Hospital from June 2020 to May 2021 and were difficult to diagnose based on clinical manifestations and plain and contrast-enhanced spiral CT scans; meanwhile,the subjects had undergone a PET/CT examination within 1 week. The 70 patients were grouped according to primary non-treatment factors, i.e., the lesions were paired if the pulmonary nodules were of similar sizes (diameter difference < 0.2 cm), with each lesion in a pair numbered 1 and 2, respectively, resulting in a total of 35 pairs; the patients were then randomly divided into multi-modal digital navigation group and traditional operation group. The puncture results of the two groups were recorded, and the two groups were compared for diagnostic accuracy of puncture, first-attempt success rate of puncture, incidence of puncture-related complications, number of punctures, and number of biopsies.Results The multi-modal digital navigation group and the traditional operation group had diagnostic accuracy rates of 97.1% and 80% (P = 0.018), respectively; first-attempt success rates of puncture of 71.4% and 42.8% (P = 0.016), respectively; incidence rates of puncture-related complications of 14.3% and 42.8% (P = 0.008), respectively; numbers of punctures of 1(1,2) and 2(2,3) (P < 0.001), respectively; and numbers of biopsies of 1 (1,2) and 2(1,2) (P = 0.039), respectively; a difference with P < 0.05 was considered significant for all the above indices. Conclusion Multi-modal digital navigation combined with PET/CT is not only very accurate, safe, and reliable, but is also of great significance in clinical application.
  • Diagnosis and Treatment/Original Articles
    Clinical value of diffusely increased bone marrow 18F-FDG uptake in patients with newly diagnosed diffuse large B-cell lymphoma
    LI Xu, CHEN Congxia, LIU Fugeng, CUI Yan, ZHU Hui, YAO Zhiming
    2021, 30(6): 762-766. https://doi.org/10.13491/j.issn.1004-714X.2021.06.020
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    Objective To investigate the clinical value of diffusely increased bone marrow 18F-fluorodeoxyglucose(18F-FDG) uptake in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Methods A retrospective analysis was performed on the clinical data of 114 inpatients who underwent positron emission tomography (PET)/computed tomography examination and were newly diagnosed with DLBCL. All patients underwent bone marrow biopsy. The Chi-square test was used to analyze categorical data, and the t-test or Wilcoxon test was used to analyze continuous data. Results According to the type of bone marrow 18F-FDG uptake, the patients were divided into normal bone marrow group (nPET, 51.8%), only focal group (fPET, 10.5%), only diffuse group (odPET, 28.1%), and focal + diffuse group (f + dPET, 9.6%), with proportions of bone marrow involvement of 0%, 100%, 15.6%, and 100%, respectively, and proportions of stage IV lymphoma of 33.9%, 100%, 59.4%, and 100%, respectively. Compared with the nPET patients, the odPET patients were significantly younger (57 ±17 y vs 70 ±13 y), and had a significantly lower hemoglobin level(108.1 ±23.8 g/dL vs 119.4 ±19.0 g/dL) and significantly higher proportions of stage IV lymphoma and B symptoms (59.4%, 46.9% vs 33.9%, 22.0%, all P < 0.05). There were no significant differences in sex ratio, white blood cell count, frequency of lactate dehydrogenase (LDH) increase, and the proportion of International Prognostic Index (IPI) score > 2. Conclusion Among patients with newly diagnosed DLBCL, patients with diffusely increased bone marrow 18F-FDG uptake are younger than those with normal bone marrow 18F-FDG uptake. They are more prone to bone marrow involvement, stage IV lymphoma, anemia, B symptoms, elevated LDH, and IPI score > 2, which suggest a more serious condition and possibly worse prognosis.
  • Diagnosis and Treatment/Original Articles
    A study of radiation protection optimization for nuclear medicine technologists during 99Tcm-MDP bone imaging
    ZHANG Wenjie, LIU Xiuqin, LIU Fugeng, LI Xu, YAO Zhiming
    2021, 30(6): 767-770. https://doi.org/10.13491/j.issn.1004-714X.2021.06.021
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    Objective To analyze the ambient dose equivalent rate (ADER) of subjects during 99Tcm-MDP bone imaging and to optimize the on-site radiation protection for nuclear medicine technologists. Methods The ADERs at different time points and distances were measured in 33 subjects undergoing wholebody bone imaging after injection of technetium-99m-methylene diphosphonate (99Tcm-MDP); the ADERs were measured in 50 subjects at different body parts (e.g., thoraco-abdominal junction, pelvis, middle femur, and knees) and at different distances after injection of 99Tcm-MDP. Results The ADERs at 3 meters from the subjects 4 hours after injection of 99Tcm-MDP was (59 ±11)% of those 2 hours after injection; the ADERs at 1 to 7 meters from the subjects decreased significantly as the distance increased; 4 hours after injection of 99Tcm-MDP, the ADERs at 3, 5, and 7 meters from the subjects were (18 ±1)%, (7 ±1)%, and (2 ±1)%, respectively, of those at 1 meter (all P < 0.001). The ADERs at 0.1 meter from the subjects’ body surface were highest at the pelvis, followed by the thoraco-abdominal junction, middle femur, and knees, with P values smaller than 0.05. The ADERs at the pelvis decreased (49 ±6)% and (63 ±6)% from the body surface to 0.1 and 0.2 meters from the body surface, respectively. Conclusion The radiation protection measures for technologists during bone imaging can be further optimized as follows: bone imaging can be delayed appropriately until the radiation dose within subjects’ body is further reduced; technologists should keep as much distance as possible from subjects during guiding the subjects while providing them with adequate care; technologists should keep away from the torso of the subjects which bears the heaviest radiation.
  • Diagnosis and Treatment/Original Articles
    Study on efficiency of PET-CT in diagnosis of mediastinal lymph node metastasis of lung cancer and influencing factors
    NI Guanying, WANG Lei, LIU Yang, ZHANG Guojing
    2021, 30(6): 771-775,781. https://doi.org/10.13491/j.issn.1004-714X.2021.06.022
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    Objective To explore the diagnostic efficacy of positron emission tomography-computed tomography (PET-CT) for mediastinal lymph node metastasis of lung cancer, to analyze the factors that affect the diagnostic efficacy and lung cancer lymph node metastasis, and to provide a theoretical reference for clinical practice. Methods The clinical data of 181 patients with lung cancer (476 lymph nodes) confirmed by surgery and pathology who were admitted to our hospital from January 2019 to December 2020 were used for analysis. All patients were diagnosed by PET-CT. We analyzed diagnostic efficiency (sensitivity, specificity, accuracy, and positive/negative predictive value), factors affecting the diagnostic efficiency of PET-CT, and risk factors of mediastinal lymph node metastasis in patients with lung cancer. Results The sensitivity (65.75%, 96/146), specificity (89.39%, 295/330), accuracy rate (82.14%, 391/476), positive predictive value (73.28%, 96/131), and negative predictive value (85.51%, 295/345) of PET-CT in diagnosis of lung cancer lymph node metastasis were slightly different from those of the surgical pathological results (P > 0.05). There were no significant differences in short diameter and SUVmax between true and false positive lymph nodes (P > 0.05), but a significant difference in density was observed between true and false positive lymph nodes (P < 0.05). Logistic regression analysis identified the pathological type of adenocarcinoma, central lung cancer, and low differentiation as the risk factors for mediastinal lymph node metastasis in patients with lung cancer (P < 0.05). Conclusion PET-CT has high sensitivity, high specificity, and high accuracy in the diagnosis of mediastinal lymph node metastasis in lung cancer. The sensitivity of diagnosis is affected by the short diameter and SUVmax of lymph nodes, and the specificity of diagnosis is affected by the density of lymph nodes. Mediastinal lymph node metastasis is mainly associated with pathological type, the location of the lesion, and the degree of differentiation.
  • Diagnosis and Treatment/Original Articles
    Analysis of vagal neuropathy among patients with type 2 diabetes mellitus using ultrasonography
    WANG Qian, XU Lan, XIONG Fan, JIANG Xiao, JIANG Yanmin, YU Lu, LI Yanyu, LIU Lin, HAN Yumeng
    2021, 30(6): 776-781. https://doi.org/10.13491/j.issn.1004-714X.2021.06.023
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    Objective To investigate the vagal neuropathy among patients with type 2 diabetes mellitus (T2DM), so as to provide the evidence for the clinical diagnosis and therapy of diabetic neuropathy.Methods A total of 51 patients with T2DM admitted to the Department of Endocrinology. The Affiliated Wuxi People’s Hospital of Nanjing Medical University during the period from January 2020 through June 2021 and 42 healthy volunteers in the hospital during the same period were enrolled, and the clinical data were reviewed. The autonomic symptoms were evaluated among patients with T2DM using the Survey of Autonomic Symptoms Scale, and the vagus nerve cross-sectional area was measured using ultrasonography. The vagus nerve cross-sectional area was compared between T2DM patients and healthy controls, and the associations of the vagus nerve cross-sectional area with clinical features were evaluated among T2DM patients. Results There were no significant differences between T2DM patients and healthy controls in terms of gender, age, height or proportion of smokers (P > 0.05); however, significant differences were seen between T2DM patients and healthy controls in terms of body weight (t = 4.52, P < 0.01) and body mass index (t = 5.21, P < 0.01). Among the 51 T2DM patients, there were 37 cases developing autonomic symptoms, with 3.7 ±0.9 types (1 to 9 types) of autonomic symptoms seen and 10.5 ±3.2 scores (0 to 25 scores) of overall symptom impact scores evaluated. The mean left and right vagus nerve cross-sectional areas were significantly greater in patients with T2DM than in healthy controls (1.55 ±0.44 vs. 1.37 ±0.37 mm2, t = 2.20, P < 0.05; 1.97 ±0.66 vs. 1.61 ±0.54 mm2, t = 2.87, P < 0.01). Pearson correlation analysis revealed that the vagus nerve cross-sectional area had no statistical associations with age, height, body weight or body mass index among T2DM patients or healthy controls (P > 0.05), and did not correlate with the duration of diabetes, number of autonomic symptoms or SAS overall symptom impact scores (P > 0.05). Conclusion Thickening of vagus nerve is detected in patients with T2DM, and ultrasonography of vagus nerve is effective for early diagnosis of autonomic neuropathy.
  • Diagnosis and Treatment/Original Articles
    Development of a shoulder joint activity program after permanent cardiac pacemaker implantation based on knowledge to action framework
    CAO Wenjun, GU Yijun, GE Sijia, SUN Guozhen
    2021, 30(6): 782-787. https://doi.org/10.13491/j.issn.1004-714X.2021.06.024
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    Objective To development of a shoulder joint activity program in patients after permanent cardiac pacemaker implantation based on knowledge to action framework (KTA), so as to provide insights into the improvements of post-implantation rehabilitation and quality of life. Methods Based on the KTA framework, a knowledge to action group was established for the shoulder joint activity program after permanent cardiac pacemaker implantation. The clinical guidelines, evidences, systematic reviews and reviews were retrieved in national and international electronic databases and publications by professional academic groups, and a preliminary shoulder joint activity program after permanent cardiac pacemaker implantation was proposed. Following two-round expert consultations, the final shoulder joint activity program was produced by the knowledge to action group. Results A total of 9 publications were enrolled in the final analysis. During the two-round expert consultations, the active coefficient of the experts was both 100%, and the authority coefficient, the coefficient of judgment basis and the familiarity coefficient of the experts were 0.81, 0.83 and 0.84, respectively. The final shoulder joint activity program after permanent cardiac pacemaker implantation contained 8 contents, with all levels of evidence being I and all recommended levels of evidence being A. Conclusion The shoulder joint activity program after permanent cardiac pacemaker implantation based on KTA framework is successfully established for the first time, and this program may guide the rehabilitation among patients following permanent cardiac pacemaker implantation.
    • Review Articles
  • Review Articles
    Current research on the relative biological effects and compound effects of neutron
    CHAI Dongjing, DANG Xuhong, ZUO Yahui
    2021, 30(6): 788-793. https://doi.org/10.13491/j.issn.1004-714X.2021.06.025
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    With the development of science and technology, nuclear radiation has been extensively used in industry, military, and medicine, leading to increased radiation exposure. The operation of nuclear reactors and nuclear submarines, tumor radiotherapy, space flight, nuclear explosions, and nuclear leaks all involve exposure to neutron radiation. Neutrons are a form of high linear energy transfer radiation with high ionization density and high energy deposition that can cause serious damage to organisms. Therefore, it is critical to evaluate the effects of neutron radiation damage in radiation exposure events. Relative biological effectiveness (RBE) is a commonly used measure of neutron exposure risk. The value of RBE under specific radiation conditions depends on exposure conditions, such as the energy, dose, and dose rate of neutrons as well as the types of tissues or cells. These parameters are used in this article to discuss the RBE of neutrons. In addition, most of the current radiation exposure fields are mixed fields, so it is also important to fully consider the effects of other components in the mixed field.