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  • Original Articles
    Change in occupational internal dose coefficients for radiation workers
    YANG Baolu, ZHOU Qiang, TUO Fei
    2022, 31(4): 387-391. https://doi.org/10.13491/j.issn.1004-714X.2022.04.001
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    Objective To explore the effect of change in occupational internal dose coefficients on estimation of the internal exposure dose of radiation workers. Methods Forty-one radionuclides were selected as the research objects, and their new and old occupational internal dose coefficients were summarized. The change in internal dose coefficients was analyzed by calculating the ratios of dose coefficients and using the frequency distribution of ratios.Results The occupational internal dose coefficients of the 41 radionuclides analyzed had all changed, with ratios ranging from 0.1 to 4.5, and the maximum difference reaching 10 times (when the ratio was equal to 0.1).Conclusion It is recommended to revise the national standards concerning occupational internal dose coefficients in time and update the occupational internal dose coefficients, so as to better monitor the occupational health of radiation workers.
  • Original Articles
    A sourceless efficiency calibration method based on the coupling of Monte Carlo simulation and analytical calculation
    WU Zhen, SU Pengwen, WANG Yujian, ZHANG Hui, QIU Rui, LI Junli
    2022, 31(4): 392-400. https://doi.org/10.13491/j.issn.1004-714X.2022.04.002
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    Objective To establish a sourceless efficiency calibration method by coupling Monte Carlo simulation with analytical calculation. Methods Monte Carlo simulation was used to calculate the point-to-point detection efficiency of specific detectors to establish a detection efficiency grid. The detection efficiency of point source, disc, cylindrical, beaker, spherical, U-tube and Marlin cup samples was analyzed using numerical integration method after detection efficiency grid interpolation.Results The above coupling method was used for sourceless efficiency calibration. Within the energy range of 0.2–3 MeV, the relative deviation of calibration between coupling method and Monte Carlo simulation was mostly less than 10%, the maximum relative deviation was 18.06%, and the computation time was reduced by at least 86%. The above coupling method was used for sourceless efficiency calibration of an HPGe detector manufactured by ORTEC for point source detection, which was in good agreement with the experimental calibration, and the relative deviations were less than 10%.Conclusion This method can be generalized and used in the sourceless efficiency calibration of HPGe, LaBr3, and NaI detectors.
  • Original Articles
    An exploration of shielding optimization for self-shielded accelerators
    ZHANG Deqin, PAN Yi, DU Xiaohong, LIU Lantao
    2022, 31(4): 401-405,412. https://doi.org/10.13491/j.issn.1004-714X.2022.04.003
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    Objective To analyze the room layout and shielding of three types of self-shielded accelerators, and to provide a basis for optimizing the shielding design of rooms for self-shielded accelerators. Methods We compared the radiation shielding levels (transmitted radiation dose rate outside the primary barrier and scattered radiation dose rate outside the secondary barrier) of three self-shielded accelerator rooms by Monte Carlo simulation and empirical formula calculation. Results According to Monte Carlo simulation and empirical formula calculation, for the Unity MR Linac accelerator, the scatter radiation dose rate outside the secondary barrier was significantly higher (up to five times) than the transmitted primary radiation dose rate outside the primary barrier. The scatter radiation dose rate of the cross section was significantly higher than that of the sagittal section for both Unity MR Linac and TOMO accelerators. Conclusion The differences in the shape, material, and thickness of self-shielding structures complicate the shielding calculation and design for accelerator rooms. The shielding calculation method should be improved to optimize the radiation shielding of novel accelerator rooms.
  • Original Articles
    Discussion of radiation shielding optimization for proton cyclotron therapy system plants
    MENG Qingsen, FU Yaping, WANG Feng, ZHANG Tianjue, DANG Lei
    2022, 31(4): 406-412. https://doi.org/10.13491/j.issn.1004-714X.2022.04.004
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    Objective To explore the radiation shielding optimization plan for a medical proton cyclotron developing and commissioning building at various commissioning stages.Methods According to the maximum source termsat different commissioning stages, we used the empirical formula to estimate the instantaneous dose rate at the point of interest outside the shield of the building, and optimized the building’s shielding ateach commissioning stage.Results When adding 1.0 m mobile concrete shielding blocks (“blocks” below) each to wall 3 and wall 4 at the cyclotron commissioning stage, 1.0 m blocks to wall 4 and 1.25 m blocks to wall 5 at the beam transport line commissioning stage, and 1.0 m blocks to wall 9 and 0.4 m blocks to the ceiling at the simulated treatment room commissioning stage, the dose rates at the points of interest outside the shield could meet the dose rate limit requirements.Conclusion The application of mobile concrete shielding blocks not only meets the shielding requirements, but also has economical and space-saving advantages, conforming to the principle of shielding optimization. This can be an approach to the optimization of radiation shielding for high-energy particle accelerators or similar scientific projects.
  • Original Articles
    Effect of respiratory movement on the dose distribution in the TOMO therapy target area
    CHENG Xianyong, LI Peng, SONG Gang, LU Feng
    2022, 31(4): 413-417. https://doi.org/10.13491/j.issn.1004-714X.2022.04.005
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    Objective To explore the effect of respiratory movement on the dose distribution in the TOMO therapy target area. Methods The motion phantom was used to simulate human respiratory movement. The SNC patient analysis software was used to compare the films of the study group with those of the control group, and the effect of respiratory movement on the dose distribution in the TOMO target area was evaluated by the “pass rate” index. Results Visual observation showed that the distribution of film gray in the head-foot direction (i.e., direction of movement) was significantly different with or without respiratory movement. Film analysis showed that the maximum deviation between the width of the target wrapping curve and the treatment plan value was about 2.4 mm at no respiratory movement and about 27.2 mm at respiratory movement; the penumbra width of the target area was 31 mm (head direction) and 28.5 mm (foot direction) at no respiratory movement and 39.7 mm (head direction) and 37 mm (foot direction) at respiratory movement; the “pass rate” of target dose distribution was only 12.3%. Conclusion Respiratory movement has a great impact on the dose distribution in the TOMO target area in the direction of movement. When making clinical treatment plan, the impact of respiratory movement on the dose distribution in the TOMO target area can not be ignored.
  • Original Articles
    Monitoring and evaluation of radioactivity levels in water sources in Beijing, China, 2012—2021
    LYU Xuya, LI Huiping, MA Xiufeng, LIU Zhuo, SHI Xinyuan, LI Lifan
    2022, 31(4): 418-423. https://doi.org/10.13491/j.issn.1004-714X.2022.04.006
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    Objective To investigate and evaluate the changes in total α and total β radioactivity levels in drinking water in Beijing, China, 2012—2021. Methods The test results of total α and total β radioactivity levels at 14 monitoring sites from 9 groundwater sources and 5 surface water sources in Beijing, 2012—2021 were collected. The radioactivity levels in the two types of water sources were compared. Statistical charts were used to show the monitoring situation at sampling sites in different regions during different periods, and related issues were explored. Results The total α and total β activity concentrations measured at monitoring sites from some water sources in Beijing, 2012—2021, were less than the total α and total β guideline values specified in the Standards for Drinking Water Quality (GB 5749—2006) (total α: 0.5 Bq/L, total β: 1.0 Bq/L). The mean total α activity concentration in the groundwater was significantly higher than that in the surface water. The total α and total β radioactivity levels in the reservoir D in the surface water were slightly higher than those in the other surface water. Conclusion In the past decade from 2012 to 2021, the total α and total β radioactivity levels in some water sources in Beijing were generally in a good condition and fluctuated within the range of environmental background values, without significant changes on the whole.
  • Original Articles
    Natural radioactive level in raw coal of coal mines in some regions of China
    WANG Jiaying, MA Kui, LI Yuwen, CHEN Fei, TONG Linquan, ZHANG Zhen
    2022, 31(4): 424-427,447. https://doi.org/10.13491/j.issn.1004-714X.2022.04.007
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    Objective To understand the activity concentrations of natural radionuclides 40K, 226Ra, 232Th, and 238U in raw coal of coal mines in some regions of China, and to explore the correlation between ore with different activity concentrations and the concentration of radon and its progeny in the workplace. Methods Raw coal samples were collected in twelve coal mines in five provinces, and the activity concentrations of 40K, 226Ra, 232Th, and 238U were measured by a high-purity germanium γ-ray spectrometric system. Results The activity concentrations of four natural radionuclides in the raw coal samples of twelve coal mines were all lower than 1000 Bq/kg, and the activity concentration of 238U in one coal mine was close to 100 Bq/kg. The content of 40K, 226Ra, 232Th, and 238U in different coal mines varied greatly, but 226Ra, 232Th, and 238U were basically at the same level in the same coal mine. Conclusion None of the 12 coal mines belong to radio active mines. One of the coal mines investigated has the activity concentrations of 226Ra, 232Th, and 238U close to the standard limit for restricted-use management mines. It is suggested to study the correlation between the content of 226Ra in raw ore, intermediate products, tailings(slag), or other residues and the concentration of radon and its progeny in mines. Monitoring and protection of radon and its progeny in the decay chain should be strengthened for coal mines with high activity concentrations of natural radionuclides 226Ra, 232Th, and 238U.
  • Original Articles
    An analysis of Yunnan results in national individual dose monitoring ability assessment for external exposure in 2017—2019
    TANG Li, ZHANG Bingxiang, MOU Sheng, FAN Fang
    2022, 31(4): 428-432. https://doi.org/10.13491/j.issn.1004-714X.2022.04.008
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    Objective To analyze and compare the data of Yunnan Center for Disease Control and Preventionin national individual dose monitoring ability assessment for external exposure in 2017—2019 and summarize the assessment experience, and to improve monitoring ability and quality. Methods Ability assessment preparation was carried out according to the requirements of The National Comparison Scheme for Individual Dose Monitoring Ability, and blind samples of individual dosimeters were sent. After the blind samples were measured in the laboratory, the results were judged according to the judgment methods in the Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016) and the requirements of the assessment scheme.Results In 2017, there was a single-group performance of 0.02-0.08 and a comprehensive performance of 0.06, and the results were judged to be qualified. In 2018, there was asingle-group performance of ?0.01 to 0.08 and a comprehensive performance of 0.05, and the results were judged to be excellent. In 2019, there was asingle-group performance of ?0.13 to ?0.04 and a comprehensive performance of 0.08, and the results were judged to be qualified. Conclusion The individual dose monitoring system in our laboratory runs stably, and the monitoring results are accurate and reliable. The quality control measures are effective and feasible.
  • Original Articles
    Analysis and measurement method for carbon-14 in biological samples
    LIU Wenna, DING Hongshen, ZHAO Xinjing
    2022, 31(4): 433-436. https://doi.org/10.13491/j.issn.1004-714X.2022.04.009
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    Objective To optimize the measurement and analysis method for carbon-14 in environmental biological samples, and to provide technical support for the formulation of standard methods for carbon-14 measurement in environmental biological samples. Methods Through the optimization research on the carbon dioxide absorption method, the moisture content and carbon content of biological samples were measured with the moisture meter and the element analyzer according to the simplified personnel operation and the optimized process steps of the method, and intra- and inter-laboratory validation of the method was carried out. Results Under typical conditions, the lower limit of detection of the method reached 3 Bq/kg, and there were a relative standard deviation within laboratories of less than 17% and a relative standard deviation between laboratories of less than 14%, with a relative error of less than 19%. Most of the sample pretreatment was directly completed by the instrument and equipment, which improved the precision and accuracy of the measurement of moisture content and carbon content in samples, and reduced the influence of experiment personnel’s operation differences on the test results. Conclusion The lower limit of detection, precision, and accuracy of the optimized method meet the relevant requirements for the determination of carbon-14 in biological samples.
  • Original Articles
    Radiation doses to subjects in four clinical CT scanning modes and spatial distribution of chest scanning radiation field
    ZHAO Zhixin, WANG Haihua, QIAN Qian, WANG Qiang, YANG Luting, JING Liyan, ZHU Bo, YANG Yong, ZHAI Hezheng
    2022, 31(4): 437-442. https://doi.org/10.13491/j.issn.1004-714X.2022.04.010
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    Objective To explore the absorbed dose to the common tissues of subjects in four clinical CT scanning modes and the spatial distribution of the radiation field in chest scanning, in order to provide a basis for the radiation protection of subjects and the space in the machine room.Methods A thermoluminescence detector (TLD) was used to measure the absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes. The TLD was used to monitor the air kerma at different positions from the CT diagnostic table during chest spiral scanning.Results The absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes were 0.040-64.818 mGy, 0.154-10.155 mGy, 0.028-0.154 mGy, 0.443-17.141 mGy, and 0.093-14.346 mGy, respectively. The maximum air kerma value of the space radiation field during chest scanning was 0.049 mGy, and the farther the distance from the CT tube, the smaller the value.Conclusion The absorbed doses to the common tissues of subjects examined by the four CT scanning modes generally do not exceed the threshold doses. The dose received by the companion of the subject during a single chest CT scan was small. In order to minimize radiation hazards, shielding measures can be taken in CT scanning to reduce the absorbed doses to the tissues of the subject, and the companion of the subject should appropriately increase the distance from the tube and the diagnostic table.
  • Original Articles
    Effect of real-time radiation data on radiation exposure of interventional surgical personnel
    LIU Li, WANG Cunting, ZHANG Liang, ZHANG Xiao, LYU Tianci
    2022, 31(4): 443-447. https://doi.org/10.13491/j.issn.1004-714X.2022.04.011
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    Objective To analyze the radiation exposure of medical personnel, and to provide real-time radiation dose monitoring data for medical personnel in interventional surgeries.Methods A total of 96 person-times who participated in cardiac surgeries in interventional operating rooms from September 2019 to March 2022 were selected as subjects. The subjects were divided into two groups according to the time progress, with 43 person-times in intervention group and 53 person-times in control group. The subjects in the intervention group were provided with radiation dose monitoring data during surgeries, while the subjects in the control group performed surgeries with routine procedures. The average intraoperative radiation dose rates of the two groups were compared.Results The median radiation dose rate was significantly lower in the intervention group than in the control group (88.80 μSv/h vs 188.40 μSv/h, U = 637.000, P = 0.000).Conclusion Providing real-time radiation dose monitoring data for medical personnel in interventional surgeries can effectively reduce their occupational radiation exposure and improve their occupational radiation protection.
  • Original Articles
    Protective effect on subjects receiving lung CT scan
    CHEN Shuyang, SHAYA· Nazihan, WANG Ziheng, ZHAO Jinwen, ZHOU Xu, YANG Xiangshan
    2022, 31(4): 448-450,455. https://doi.org/10.13491/j.issn.1004-714X.2022.04.012
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    Objective To determine the radiation dose of sensitive organs under different protective methods in lung CT scanning environment, and to explore the best protective scheme of corresponding organs. Methods Annealed thermoluminescence dose elements were placed in the stomach, liver, colon, and thyroid gland of a simulated human body model. The dose effect experiment of protective methods included non-protective group, half lead apron group, and full lead apron group. The dose effect experiment of protective thickness included 0.50 mmpb full lead apron group and 0.35 mmpb full lead apron group. The same exposure conditions of lung CT scan were used in the above experiments. Results Compared with the non-protective group, the exposure dose of the stomach, liver, colon, and thyroid gland increased significantly in the half lead apron group (P < 0.05), and the exposure dose of the thyroid gland and colon decreased significantly in the full lead apron group (P < 0.05). There were no significant differences in the exposure dose of the liver, stomach, and colon in the simulated human body model between the 0.35 mmpb full lead apron group and the 0.50 mmpb full lead apron group.Conclusion For lung CT scan, the protective measure of lead apron may not reduce the exposure dose of subjects. The protective thickness of lead apron does not necessarily have a substantial influence on the exposure dose of human body.
  • Original Articles
    Organization and thinking of provincial-level on-sit and off-sit joint exercises for nuclear emergency
    MAO Weixin, CUI Lun, LIN Chen, PENG Chong, GONG Xingjian, CHANG Sheng
    2022, 31(4): 451-455. https://doi.org/10.13491/j.issn.1004-714X.2022.04.013
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    By reviewing the organization and implementation of “Hongsha-2021” Guangxi nuclear emergency joint exercises, this article summarizes the experience in the organization process and puts forward some thoughts and suggestions in order to improve the depth of provincial-level on-site and off-site joint exercises for nuclear emergency at nuclear power plants and further enhance the emergency response capacity of nuclear emergency organizations at all levels.
  • Original Articles
    An investigation of current status of radiotherapy and nuclear medicine in Qingdao, China
    LIU Zhenyou, CHONG Fazhu, ZHANG Xiuyun, LIU Jie, CHE Zijing, FU Qiang
    2022, 31(4): 456-459,476. https://doi.org/10.13491/j.issn.1004-714X.2022.04.014
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    Objective To investigate the application status of radiotherapy and nuclear medicine resources in Qingdao, China, and to provide a data foundation for the development of radiotherapy and nuclear medicine in this city.Methods A questionnaire survey was performed on all medical institutions with radiotherapy and nuclear medicine services across Qingdao. The cut off date for questionnaire data pooling was March 31, 2021.Results A total of 18 hospitals have radiotherapy services in Qingdao, including 12 (66.67%) tertiary hospitals and 6 (33.33%) secondary hospitals. There were 29 pieces of radiotherapy equipment in total, including 24 (82.76%) linear accelerators, 4(13.79%) brachytherapy units, and 1(3.45%) helical tomotherapy unit. Among all patients with radiotherapy in Qingdao, 79.68% were treated in tertiary hospitals. Nuclear medicine departments have been set up in five medical institutions in Qingdao, all in tertiary hospitals. There were five PET-CT scanners, seven SPECT scanners, and two cyclotrons in these nuclear medicine departments. Conclusion Qingdao had a higher radiotherapy equipping rate than the national average level, but with an uneven personnel distribution. Some secondary hospitals were short of medical physicists. The penetration rates of nuclear medicine equipment and personnel should be improved.
  • Original Articles
    Guidance forcase handling of arranging radiation workers who have not undergone an occupational health examination to engage in radiological diagnosis and treatment work
    GAO Zhaolin, ZHAO Jun, YANG Gang
    2022, 31(4): 460-463. https://doi.org/10.13491/j.issn.1004-714X.2022.04.015
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    Through the development of the guidance for case handling of radiological health law enforcement, health supervisors are instructed to accurately grasp the key points of law enforcement and case handling and standardize the process of collecting evidence and law application to ensure the correct implementation of administrative penalty. This article explains the structure and content of the guidance for case handling of radiological health law enforcement by taking the case of arranging radiation workers who have not undergone an occupational health examination to engage in the radiological occupational-disease-inductive operation in medical institutions as an example.
  • Original Articles
    Dose effect of fluence-smoothing on intensity modulated planning after rectal cancer surgery
    LU Liming, LIU Pan, DU Fenglei
    2022, 31(4): 464-470. https://doi.org/10.13491/j.issn.1004-714X.2022.04.016
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    Objective To compare the dosimetric differences of four fluence smoothing (FS) levels of the Monaco system in intensity-modulated radiation therapy (IMRT) after rectal cancer surgery, and to provide a reference for FS selection in clinical practice. Methods A total of 15 postoperative patients with rectal cancer admitted in 2020 were selected. Under the same optimal conditions, FS was set to Off, Low, Medium, and High for IMRT planning. The data were analyzed by SPSS 20.0 software. The dosimetric parameters of planning target volume and organs at risk (OARs), the number of Segments, the number of monitor units (MUs), the estimated total delivery time (ETDT), and the gamma pass rate were compared between the four FS levels. Results The four FS levels resulted in clinically acceptable dosimetric parameters of the planning target volume and OARs, and there was no significant difference in dose distribution between FS levels. From FS-Off to FS-High, number of Segments, number of Mus, and ETDT decreased by 15.2%, 11.8%, and 6.7%, respectively, whereas gamma pass rate increased by 1.6%. Conclusion The IMRT plans at four FS levels can meet the clinical requirements. Considering the planning quality and execution efficiency, FS-High is recommended for postoperative IMRT of patients with rectal cancer.
  • Original Articles
    Influence of normal tissue objective on intensity modulated radiation therapy for rectal cancer based on the Eclipse treatment planning system
    WU Zhe, LIU Ke, MING Zhi, WANG Dong, CAO Junyi
    2022, 31(4): 471-476. https://doi.org/10.13491/j.issn.1004-714X.2022.04.017
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    Objective To analyze the dosimetric effect of the optimization tool, normal tissue objective (NTO), in Eclipse on the intensity modulated radiation therapy (IMRT) for postoperative patients with rectal cancer. Methods Twenty postoperative patients with rectal cancer were randomly selected. Based on the Eclipse treatment planning system, three IMRT plans were formulated for each patient, with manual NTO as the control group, and automatic NTO and no NTO as the other two groups. The dosimetric parameters of the target volume and organs at risk (OAR) and the monitor units (MU) were compared between the automatic NTO and no NTO groups and the control group under the same optimization conditions. Results Compared with the control group, the automatic NTO group showed a worse conformity index (CI) (t = 3.248, P < 0.05), a 0.6% higher Dmean of normal tissues (t = -3.678, P < 0.05), and no significant difference in the dose to OAR and the MU (P > 0.05); the no NTO group showed a worse CI (t = 16.716, P < 0.05), a better homogeneity index (t = 6.594, P < 0.05), a 3.19% higher Dmean of normal tissues (t = -8.560, P < 0.05), no significant difference in the dose to OAR except the small intestine with higher Dmax (P > 0.05), and a 3.95% increase in the MU. Conclusion From the dosimetry results of the target volume and OAR, the plans with manual NTO and automatic NTO, and without NTO can meet clinical needs, but the plan without NTO increases the hot spots outside the target volume and the MU as well as the Dmean of normal tissues. Manual NTO has no obvious advantages over automatic NTO which is recommended for the fixed-field IMRT of rectal cancer.
  • Original Articles
    Application value of CT- based three-dimensional digital navigation technology in interventional microwave ablation of lung cancer
    WANG Feng, SONG Hu, LI Ruidong, DING Ning, ZHANG Kongyuan
    2022, 31(4): 477-481,493. https://doi.org/10.13491/j.issn.1004-714X.2022.04.018
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    Objective To explore the application value of computed tomography (CT)-based three-dimensional digital navigation technology in microwave ablation of lung cancer. Methods A total of 92 patients with lung cancer in our hospital were retrospectively analyzed, and randomized to receive microwave ablation with the three-dimensional digital navigation technology or traditional CT-guided microwave ablation (three-dimensional navigation group and traditional group). The two groups were paired according to tumor location, size (the maximum diameter difference of less than or equal to 2 mm), and microwave ablation conditions, for a total of 46 pairs. The operation time, times of microwave ablation needle puncture, CT dose index, incidence rates of intraoperative complications, and postoperative lesion control were compared between the two groups. Results The operation time [(30.07 ± 6.36) min vs (47.20 ± 9.65) min], times of puncture [(1.72 ± 0.69) times vs (7.13 ± 3.00) times], CT dose index [(11.16 ± 2.20) mGy vs (26.67 ± 8.72) mGy], and incidence of intraoperative complications (10.87% vs 34.78%) in the three-dimensional navigation group were lower than those in the traditional group, and the response rate was higher in the three-dimensional navigation group than in the traditional group (93.48% vs 71.74%) (P < 0.05). Conclusion CT-guided three-dimensional digital navigation technology for microwave ablation of lung cancer makes the operation of interventional puncture more accurate and safe.
  • Original Articles
    MRI-based analysis of predictive factors for nucleus pulposus resorption in patients with lumbar disc herniation treated with three-dimensional balanced chiropractic technique
    BI Shihao, YU Gongchang, LI Ziyuan, ZHANG Bo, CAO Shengnan, SHI Bin
    2022, 31(4): 482-487. https://doi.org/10.13491/j.issn.1004-714X.2022.04.019
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    Objective To observe the effectiveness of the three-dimensional balanced chiropractic technique in the treatment of lumbar disc herniation (LDH) and analyze predictive factors for resorption of the herniated nucleus pulposus based on magnetic resonance imaging (MRI). Methods From June 2015 to June 2021, 95 patients with LDH treated with the three-dimensional balanced chiropractic techniquein our hospital were followed up for clinical and MRI data. They were divided into resorption group and non-resorption group based on the nucleus pulposus resorption rate. Multivariable binary logistic regression analysis was performed to determine the association of 12 factors (sex, age, course of disease, etc.)with nucleus pulposus resorption.Results Thirty-two cases (33.7%)were found at follow-up to have nucleus pulposus resorption (resorption rate≥30%). Resorption was most likely to occur in patients with a disease course of less than a year (P < 0.001), type 3 LDH accoding to the Michigan State University (MSU) classification (P = 0.014), leg numbness (P = 0.006), and a L4/5 or L5/S1 disc herniation (P < 0.001). Conclusion MRI can be used as an important tool to observe nucleus pulposus resorption in LDH. A disease course of less than a year, MSU type 3, leg numbness, a L4/5 or L5/S1 disc herniation are associated with a higher possibility of nucleus pulposus resorption, which can be used as indicators predicting the outcome of patients with LDH treated with the three-dimensional balanced chiropractic technique.
  • Original Articles
    Application value of 18F-FDG PET/CT in the diagnosis of cholangiocarcinoma
    FANG Juanjuan, SONG Dewei, SHAO Yuanwei, YAN Shoumei, ZHOU Jing, JIAO Chunyu, LIU Tingzhou
    2022, 31(4): 488-493. https://doi.org/10.13491/j.issn.1004-714X.2022.04.020
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    Objective To explore the value of 18F-FDG PET/CT in the diagnosis of cholangiocarcinoma. Methods Data were collected from 44 patients with cholangiocarcinoma who underwent PET/CT in Affiliated Cancer Hospital of Shandong First Medical University from September 2017 to October 2020. All patients underwent upper abdominal CT and MRI and whole-body PET/CT. The diagnostic value of three examinations was compared for primary lesions, recurrent lesions, and regional lymph node metastasis of cholangiocarcinoma. Results There were no significant differences in the diagnostic sensitivity of CT, MRI, and PET/CT in the primary lesions and regional lymph node metastasis of cholangiocarcinoma (P > 0.05). There were significant differences in the diagnostic sensitivity of the three examinations for recurrent cholangiocarcinoma lesions (P < 0.05). Conclusion PET/CT has high diagnostic value for recurrent lesions of cholangiocarcinoma, but the three examinations showed no significant differences in the diagnostic sensitivity for primary lesions and regional lymph node metastasis.
  • Original Articles
    Effectiveness of the use of chest wall bolus during adjuvant intensity modulated radiotherapy after modified radical mastectomy
    LIN Zhian, HOU Rurong, SU Duanyu, ZHANG Yingjun, ZHANG Qingluo, PAN Huimin, LU Haijie
    2022, 31(4): 494-497,506. https://doi.org/10.13491/j.issn.1004-714X.2022.04.021
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    Objective To analyze the recurrence of breast cancer without use of chest wall bolus during adjuvant intensity modulated radiotherapy after modified radical mastectomy, so as to investigate the necessity of bolus use. Methods A total of 218 patients undergoing adjuvant intensity modulated radiotherapy after modified radical mastectomy during the period from January 2013 to June 2019 were enrolled as the study subjects. The chest wall bolus was not used during the whole period of radiotherapy after modified radical mastectomy, and the recurrence of breast cancer in the chest wall was analyzed after radiotherapy. Results The post-surgical follow-up through outpatient records, inpatients records, local residents’ health system and telephone was performed until June 31, 2021. The proportion of follow-up was 100%, and the mean follow-up period was 48.9 months. There were three cases with breast cancer recurrence in the chest wall, including one case with recurrence in the chest wall alone and two cases with recurrence in the chest wall and regional lymph nodes, and the overall recurrence of breast cancer was 1.4% in the chest wall. Among the 3 cases with breast cancer recurrence in the chest wall, there were two cases with N3 stage and positive for HER2, and one triple-negative breast cancer case, and all three cases developed distal metastases upon local recurrence. Among 218 study subjects, there were 5 cases with grade Ⅰ radioactive skin reaction, 3 cases with grade Ⅱ radioactive skin reaction, and no grade Ⅲ or Ⅳ radioactive skin reaction occurred. In addition, no grade Ⅲ or Ⅳ acute radioactive injury was seen in the chest wall skin among the 218 study subjects. Conclusion No use of chest wall bolus may be considered during adjuvant intensity modulated radiotherapy after modified radical mastectomy in presence of systemic therapy if tumor invasion into skin is not observed prior to therapy.
  • Original Articles
    Risk factors of corneal endothelial cell injury caused by phacoemulsification
    WANG Jun, GAN Mengxin, HUANG Hua
    2022, 31(4): 498-501. https://doi.org/10.13491/j.issn.1004-714X.2022.04.022
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    Objective To identify the risk factors of corneal endothelial cell injury caused by phacoemulsification, so as to provide the evidence for formulating interventions for prevention of corneal endothelial cell injury among cataract patients. Methods A total 248 eyes from 212 cataract patients that underwent phacoemulsification were selected as study subjects. The associations of subjects’ age, gender, left/right eye, pupillary diameter, grades of lens nucleus hardness, duration of phacoemulsification, total ultrasound energy, total infusion fluid amount with endothelial cell loss were evaluated using univariate analysis, and the independent risk factors for corneal endothelial cell injury caused by phacoemulsification were identified using multiple linear regression analysis. Results The density of endothelial cells was (2282.4 ± 412.16) cells/mm2 prior to phacoemulsification and (1921.77 ± 125.46) cells/mm2 months after phacoemulsification in 239 affected eyes, and the proportion of endothelial hexagonal cells was (54.41 ± 7.22)% prior to phacoemulsification and (45.62 ± 3.58)% months after phacoemulsification (χ2 = 5.43, P < 0.05). The incidence of corneal endothelial cell injury was 15.5% in 239 affected eyes. Univariate analysis showed that advanced age, small pupillary diameter, long duration of phacoemulsification, high grades of lens nucleus hardness and high total ultrasound energy were associated with endothelial cell loss, while gender and surgical eyes (left or right eye) were not associated with endothelial cell loss. Multiple linear regression analysis revealed that high grades of lens nucleus hardness, high total infusion fluid amount, long duration of phacoemulsification and high total ultrasound energy were independent risk factors for endothelial cell loss. Conclusions Lens nucleus hardness, high totalinfusion fluid amount, long duration of phacoemulsification and high total ultrasound energy are independent risk factors for endothelial cell loss caused by phacoemulsification.
  • Original Articles
    Diagnostic value of high-frequency color ultrasound for different types of thyroid nodules during healthy examinations
    QIAN Xiaolan, QIAN Yanjun, SHI Liqun, HU Chengshuang, WU Liangyu
    2022, 31(4): 502-506. https://doi.org/10.13491/j.issn.1004-714X.2022.04.023
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    Objective To evaluate the value of high-frequency color ultrasound for different types of thyroid nodules during healthy examinations. Methods A total of 150 subjects with ultrasound diagnosis of thyroid nodule abnormality were enrolled. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound diagnosis for differentiating benign and malignant thyroid nodules were evaluated with histopathological examinations of surgical thyroid specimens as a gold standard. Results A single thyroid nodule was found in all patients, and histopathological examinations identified 102 benign thyroid nodules and 48 malignant nodules. Microcalcification showed the highest accuracy for prediction of benign and malignant thyroid nodules (98.1%; χ2 = 45.67, P = 0.001), followed by taller than wider shape of thyroid nodule (92.1%; χ2 = 34.06, P = 0.001), central vascularity (82.0%; χ2 = 13.29, P = 0.001), halo (76.0%; χ2 = 6.15, P = 0.008) and hypoechogenicity (70.3%; χ2 = 10.63, P = 0.001). In addition, ultrasound diagnosis showed a 100.0% sensitivity, a 94.1% specificity, a 88.9% positive predictive value, a 100.0% negative predictive value and a 96.0% accuracy for differentiation between benign and malignant thyroid nodules (χ2 = 41.830, P < 0.001). Conclusion High-frequency color ultrasound has a high diagnostic accuracy for differentiating benign and malignant thyroid nodules, and microcalcification and taller than wider shape of thyroid nodule exhibit high values for predicting the malignancy of thyroid nodules.
  • Original Articles
    Analysis of the correlation between MRI features and HER-2 expression inductal carcinoma in situ
    TENG Minmin, SHAO Yuanwei, FANG Juanjuan, ZHANG Liwei, LIU Tingzhou, LI Huafang
    2022, 31(4): 507-511. https://doi.org/10.13491/j.issn.1004-714X.2022.04.024
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    Objective To investigate the correlation between the features of multimodal magnetic resonance imaging (MRI) and the expression of human epidermal growth factor receptor-2 (HER-2) in ductal carcinoma in situ (DCIS). Methods A total of 53 patients with DCIS confirmed by surgery and pathology in Dezhou Second People’s Hospital from September 2018 to June 2021 were analyzed retrospectively. The patients were divided into HER-2 positive group (29 cases) and HER-2 negative group (24 cases). MRI features were compared between the two groups. Results There were significant differences in the internal enhancement characteristics, microvascular sign, and time-intensity curve type between the two groups (P < 0.05). There were no significant differences in lesion morphology, non-mass-like enhancement pattern, and apparent diffusion coefficient value (P > 0.05). The HER-2 positive group showed clumped enhancement (65.5%), type Ⅱ (48.1%) andtype Ⅲ (29.6%) time-intensity curves, and microvascular sign (89.7%). The HER-2 negative group showed clusteredring enhancement (50.0%), type Ⅱ (45.8%) and type I (54.2%) time-intensity curves, and microvascular sign (54.2%). A combination of clumped enhancement, microvascular sign, and type Ⅲ time-intensity curve showed 100% specificity and 100% positive predictive value for the diagnosis of HER-2 positive DCIS. Conclusion Clumped enhancement, microvascular sign, and type Ⅱ or Ⅲ time-intensity curve on MRI can largely reflect the expression of HER-2 in DCIS. The three can be used in combination to improve the diagnostic efficiency of HER-2 positive DCIS.
  • Original Articles
    Clinical significance of Golgi protein 73 in liver cirrhosis and its relationship with radiological parameters
    LI Jiana, WANG Dongxu, HU Yulin, ZHU Hongbin
    2022, 31(4): 512-516. https://doi.org/10.13491/j.issn.1004-714X.2022.04.025
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    Objective To explore the clinical significance of serum Golgi protein 73 (GP73) in liver cirrhosis and its association with radiological parameters. Methods We included 177 patients with liver cirrhosis and 61 patients with chronic hepatitis admitted to The First Hospital of Jilin University from January 2016 to December 2018, with 70 healthy subjects who underwent physical examination during the same period as the control. We compared GP73, alanine transaminase (ALT), aspartate transaminase (AST), albumin (ALB), total bilirubin (TBIL), prothrombin time (PT), and main portal vein diameter between the patients with liver cirrhosis, patients with chronic hepatitis, and healthy subjects. The GP73 level was further compared between liver cirrhosis subgroups by various classification methods. The correlation between GP73 and ALT, AST, ALB, TBIL, PT, and main portal vein diameter was analyzed. Results The GP73 level was significantly higher in the liver cirrhosis group than in the chronic hepatitis group and the healthy control group (P < 0.001). Patients with decompensated cirrhosis had a significantly higher serum GP73 level than those with compensated cirrhosis (P < 0.001). The serum GP73 levels in the Child-Pugh B and C cirrhosis subgroups were significantly higher than that in the Child-Pugh A cirrhosis subgroup (P < 0.05). In the liver cirrhosis group, the GP73 level was positively correlated with AST, ALT, TBIL, PT, and main portal vein diameter, while negatively correlated with ALB. Conclusion Serum GP73 is significantly increased in patients with liver cirrhosis, which is closely related to liver injury indicators. Serum GP73 shows important clinical value for the early diagnosis and prognosis assessment of liver cirrhosis.
    • Review Articles
  • Review Articles
    Research progress on application of virus inactivation by ionizing radiation
    SHI Boxuan, DANG Xuhong, CHENG Jiao, DONG Juancong
    2022, 31(4): 517-523. https://doi.org/10.13491/j.issn.1004-714X.2022.04.026
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    Radiation sterilization is one of the most successful applications of ionizing radiation technologies. This paper reviews research on virus inactivation by ionizing radiation, focusing on its use in virus control for food, blood products, and homologous or heterologous tissue repair materials, inactivated viral vaccine preparation, and high-risk virus-related laboratory sample preparation, and also puts forward some thoughts on the application of ionizing radiation technologies in the prevention and control of coronavirus disease 2019.
  • Review Articles
    Progress on the mechanism of radiation-induced skin injury
    WANG Ping, FAN Li, TIAN Mei
    2022, 31(4): 524-529. https://doi.org/10.13491/j.issn.1004-714X.2022.04.027
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    Skin is the first organ of contact with ionizing radiation. Radiation-induced skin injury is common because the basal cell layer and capillaries of the skin are very sensitive to radiation. Acute radiation-induced skin injury primarily involves cellular alterations and inflammation in the epidermis and dermis, and late skin injury is mainly related to the effect of radiation on blood vessels. Clinical manifestations of radiation-induced skin injury include erythema, dry desquamation, moist desquamation, and ulceration in the skin mucosa, and the severity is related to the type and dose of radiation. Currently, the underlying mechanisms of radiation-induced skin injury are largely unknown, and the gold standard for the treatment of radiation injury has not been established. The known mechanisms of radiation-induced skin injury can be roughly divided into three pathways: oxidative stress injury caused by excessive production of reactive oxygen species, inflammation triggered by transcriptional activation of cytokines, and immune response evoked by bone marrow-derived cells. This paper reviews the three major pathways of mechanisms of radiation-induced skin injury, giving a reference for further mechanism study and preventive treatment of radiation-induced skin injury.