Objective To study the relationship between occupational stress and metal health of radiation workers.Methods Totally 220 radiation workers were investigated by Chinese perceived stress scales questionnaire,Chinese health questionnaire-12,as well as questionnaire related to radiology.Results The stress score of radiation worker with senior title was 18.18 ± 6.12,which was the lowest of all 220 participants.There was positive relationship between stress score and health score (r =0.484).19.1％ of the workers sometimes felt stressed due to the danger of work.Conclusions There are some significantly correlation between occupational stress and metal disorder.More attention should be paid on the occupational stress.Positive measures such as decompression and psychological intervention will be helpful to protect physical and mental health of radiation workers.

Objective To measure the circuit time constants of 4 kinds of radiation survey meters (451P ionization chamber dosimeter,6150AD6 + 6150AD-b dose meter,FH40G + FHZ672E-10 dose meter and AT1123 dose meter) and,to discuss the formula of time response correction and its application.Methods In the condition of continuous exposure of X-ray machine,the ambient dose equivalent rates shown by survey meters were recorded.In order to get the circuits time constant,the least squares fittingmethod was used to fit the data using the time response formula of circuit having a capacitance C and a resistance R in series.Results The relative uncertainty of fitted circuit time constants was higher than 20％ except for 6150AD6 + 6150AD-b dose meter.The relative uncertainty of fitted r was 8％ for 6150AD6 + 6150AD-b dose meter.Conclusions The time required to stabilize the dosimeter readings was 8,5,3 and 2 s,respectively,for the 451P ionization chamber dosimeter,6150AD6 +6150AD-b dose meter,FH40G + FHZ672E-10 dose meter and AT1123 dose meter.The rising trend of their measured values was not fully accordance with the RC circuit time response correction formula.

Objective To use Monte Carlo method to build a shielding calculation model for the proton and heavy ion treatment room,and to provide a reliable calculation method for shielding design.Methods A Monte Carlo-based FLUKA code was adopted to build the shielding calculation model for the proton and heavy ion treatment room,and to simulate the radiation field distribution in the proton and heavy ion treatment room.The calculation model was verified through the radiation detection around the proton and heavy ions treatment room.Results The FLUKA code-based simulation results were consistent with the radiation detection.Conclusions The shielding calculation model based on FLUKA code can simulate the radiation field from proton and heavy ions.Among the secondary particles,secondary neutrons are the dominant component and the main concern of accelerator shielding design.In shielding calculation,the emphasis should be put on both beam intensity and energy.

Objective To investigate the current situation of radiation protection in nuclear medicine diagnosis workplace.Methods The study was performed in 3 hospitals in northeast,north and central of China from February to December in 2013.The γ dose rate instrument was used to detect the workplace ambient dose equivalent rate of medicine preparation,leaching,packing,injection and imaging.Individual effective dose and equivalent dose were evaluated by photoluminescent dosimeter.Results The ambient dose equivalent rate was up to 1.92 mSv/h at repacking place and 1.2 mSv/h at injection place.The ambient dose equivalent rate of patients after injection was 5.36-240 μ,Sv/h.The hand equivalent dose was 0.01-0.02 mGy.Moreover,there were problems of staff route intersection,as well as the patients after injection staying in the public area.Conclusions Radiation workers should pay more attention to individual protection,and improve the operation proficiency to shorten the operation time.Furthermore,in order to protect public from unnecessary irradiation,there should be some changes in staff route and patients administration.

OBJECTIVETo investigate the clinicopathological characteristics of 180 patients with wild type gastrointestinal stromal tumors(GIST).

METHODSThe clinicopathological data of 180 patients with wild type GIST treated in the Peking University Cancer Hospital between October 2001 and September 2013 were analyzed and compared to 513 mutant patients.

RESULTS180 patients were included in this study, and the median age 52.5 years(16-78 years). The percentage of female was significantly higher than that of male among patients under the age of 40. Primary tumor sites mainly included stomach(45.6%) and small intestine(23.9%). The positive expression of CD117, DOG-1, and CD34 were 81.6%, 75.6%, and 74.7%, respectively, which were highest in stamach, secondly in small intestine. The percentage of tumor with length >5 cm was higher in patients under the age of 50 compared to patients more than 50 years, and a significant correlation was found between tumor size and mitosis. Compared to mutant patients, wild type patients had the following features: younger, primary tumor site of stomach, tumor length ≤ 2 cm, and the lower positive expression of CD117 and DOG-1.

CONCLUSIONSThe significant differences in primary tumor sites, tumor size, and the positive expression of CD117/DOG-1 were found between wild type GIST and mutant GIST, which suggested that wild type GIST might be an independent subgroup to be concerned in clinical practice.

Adolescent ; Adult ; Aged ; Female ; Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors ; Humans ; Male ; Middle Aged ; Young Adult

In order to further promote the reform of medical service price and strengthen the macro management of medical service price, the author constructed a calculation method for price adjustment space of medical service. This study was centered on two parameters of the historical base and the growth coefficient, to calculate the total amountof price adjustment. The historical base used the total revenue of medical services in the region from the previous year, and the growth coefficient was measured by two methods, the comprehensive indicator method and the consumer price index (CPI) reference method.Taking Suzhou, a national pilot city, as an example, the historical base in 2022 was 18 754 million yuan. By using the comprehensive indicator method, the annual growth coefficient was calculated to be 2.38%, and adjustment space of medical service price was 446.35 million yuan; According to the CPI reference method, the growth coefficient of Suzhou was 2.10%, and adjustment space of medical service price was 393.83 million yuan.The two methods for calculating the total amount each have their own advantages and disadvantages, and need to be further optimized and improved by drawing on the practical experience of reform in each pilot city.

Objective:To design a set of evaluation index system for the medical service price reform mechanism, so as to provide reference for the evaluation of deepening the medical service price reform mechanism.Methods:On the basis of searching literature of medical service prices reformfrom August 2021 to March 2023, policy logic analysis and expert consultation were used to construct evaluation indexes for the medical service price reform mechanism, set evaluation index thresholds, and assign scores to index thresholds in different grades.Results:The evaluationindex system of medical service price reform mechanism included 5 level-1 indexes, 12 level-2 indexes and 35 level-3 indexes. After scoring, the scores of 5 level-1 indexes were 12, 24, 35, 21, and 8, respectively.Based on the percentile scoring method, the evaluation criteria were categorized into five grades: premium, excellent, good, average and failure.Conclusions:This study constructed a set of evaluation index system for the mechanism of medical service price reform, which had strong scientific and operability. However, due to the fact that medical service price reform in the new era is still in its initial stage, the index system need to be further optimized drawing on the practical experience of reforms in pilot cities.

Peritoneal metastasis is one of the most frequent metastatic patterns of advanced gastric cancer, but the mechanism underlying remains unclear. The 'seed and soil’ theory is now well recognized for peritoneal metastasis of gastric cancer at present. The combination of various cells, extracellular matrix, and ascites components within the abdominal cavity provide a suitable microenvironment for the plantation, infiltra-tion, growth and metastasis of gastric cancer cells. Fully under-standing of peritoneal microenvironment will help to diagnose the peritoneal metastasis of gastric cancer and tumor recurrence, and provide theoretical basis for the development of drugs targeting peritoneal microenvironment. The authors review the main cell formation, ascites and immune microenvironment involved in the formation of the peritoneal microenvironment based on relevant literatures at home and abroad, and investigate the relationship between peritoneal microenvironment and peritoneal metastasis of gastric cancer.

Objective: To evaluate the preliminary efficacy and safety of the 5-fluorouracil/leucovorin, irinotecan, and oxaliplatin (FOLF-OXIRI) and capecitabine, irinotecan, and oxaliplatin (CAPIRINOX) regimens as first-line therapy for unresectable advanced colorectal cancer. Methods: Between January 2013 and November 2018, 73 patients with metastatic colorectal cancer (mCRC) were analyzed. All patients received first-line chemotherapy. Of them, 45 patients were administered FOLFOXIRI, and the remaining 28 patients were ad-ministered CAPIRINOX. The clinical outcomes and safety profiles were evaluated according to the objective response rate (ORR), con-version resection rate, and adverse effects. Results: The ORR, median progression-free survival (mPFS), and R0 resection rate in the FOLFOXIRI group were not statistically different from those in the CAPIRINOX group (60% vs. 57.1%, 7.7 months vs. 9.6 months, 24.4% vs . 17.9% , respectively; P>0.05). No treatment-related deaths occurred. The major adverse events were leukopenia, neutropenia, fa-tigue, nausea, vomiting, diarrhea, alopecia, aspartate aminotransferase/alanine aminotransferase elevation, and neurotoxicity. The to-tal rate of grade 3/4 adverse events in the FOLFOXIRI group was 33.3% (15/45), while the total rate of grade 3/4 adverse events in the CAPIRINOX group was 46.4% (13/28). Toxicities between the two groups were not statistically significant (P=0.263). Conclusions: Both the FOLFOXIRI and CAPIRINOX regimens are effective as first-line treatment for metastatic colorectal cancer. The triple-agent chemo-therapy was associated with good efficacy and tolerable toxicity.

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.