The clinical data of a child with chemical pneumonia caused by kerosene in Hainan Maternal and Children′s Medical Center in June 2019 were retrospectively analyzed.The patient was a 2 years and 1 month old boy with a history of kerosene inhalation and fever.The clinical features included low breath sounds in the left lung and dry and wet rales in both lungs.The white blood cells (WBC) level, C-reactive protein (CRP) level, and erythrocyte se-dimentation rate (ESR) were significantly increased.Chest CT showed inhalation pneumonia.Chest ultrasound suggested medium pleural effusion on the left side.The patient was given antibiotics, nebulization and other treatment.On the 12 th day of the course of the disease, his temperature returned to normal, and breath sounds on the left side were stronger than before.The WBC level, CRP level and ESR were improved according to the re-check results, but pulmonary ventilation was still obstructed mildly to moderately.Fourteen days after hospital discharge, the patient coughed less.Reexamination of chest CT prompted the lesions were further absorbed, but the mild to moderate obstructive lesions were still observed.With the reduction of kerosene use in daily life, kerosene-induced chemical pneumonia is rare, but due to its diverse and complex clinical manifestations and slow absorption of pulmonary inflammation, attention should be paid to its progression into chronic cough.

Objective:To explore the investigation level of individual monitoring for medical radiation workers.Methods:Monitoring and analysis of individual doses to the medical radiation workers in Guangdong province were performed, from 2016 to 2019, by the Individual Dose Monitoring Department of Guangdong Provincial Hospital for Occupational Disease Prevention and Control.Results:The numbers of monitored workers were diagnostic radiology 53 674, dental radiology 2 563, nuclear medicine 5 001, radiotherapy 16 687, interventional radiology 22 272 and others 2 087 from 2016 to 2019, of which the number of individuals with doses in excess of investigation level 1.25 mSv, were 76, 6, 18, 28, 133 and 2 respectively. The non-real doses made up 67.1 %, 100 %, 55.6 %, 82.1 %, 76.7 % and 100 % of their respective totals. Their 99th percentile doses P99 were 0.37, 0.39, 0.67, 0.35, 0.54 and 0.30 mSv, and the average periodic dose equivalent were 0.07, 0.06, 0.11, 0.06, 0.07 and 0.05 mSv respectively, indicating a statistically significant difference existing in the average annual effective dose between groups ( Z=-26.139--2.681, P<0.001). Conclusions:Due to non-reality of doses in excess of investigation levels and high labor cost, it is suggested to currently use 0.40 mSv per 3 months as investigation level for diagnostic radiology, dental radiology, radiotherapy and others, and 0.70 mSv per 3 months as for nuclear medicine and interventional radiology.

Objective:To investigate the performance of W2 plastic scintillator in megavolt photon and electron beams.Methods:The photon and electron beam energy provided by linear accelerator was used to collect data of the W2 scintillator. The parameters include the electrometer reading stability, W2 dose and dose rate linearity, and angular response. And the dose uncertainty of the W2 correction factors was also investigated.Results:The standard deviation of the electrometer reading stability was between 0.03 and 0.47. The linear regression factors of W2 dose were all 1.0; the maximum deviation of the dose rates was 0.61%. The Cerenkov light radiation correction factor(CLR) for 6 and 10 MV were 0.741 and 0.746, respectively, and the CLR for 6, 9, 12 and 15 MeV were 0.750, 0.753, 0.757 and 0.757, respectively. The maximum deviation of dose uncertainty for 15 MeV was 3.15%.Conclusions:The signal obtained by the blue and green channel was no angular dependence, the same as the high-energy electron beam, which verified that the Cerenkov radiation correction factor has good linearity. W2 plastic scintillator can be applied to non-coplanar radiotherapy dosimetry.

Objective To quantify the correlations between Elekta XVI cone beam CT dose and various scanning protocols,providing mathematical models to assess the protocol-dependency of imaging dose during imnage guided radiotherapy.Methods Based on standard protocols and various combinations of kVp and mA on an XVI mounted on an Elekta Versa HD accelerator,the air KERMA was measured at various positions in a standard PTW CTDI body phantom using calibrated PTW 30009 kV chamber and UNIDOS webline electrometer.Weighted CT dose index (CTDIw) was computed thereafter.SigmaPlot 10.0 was used to fit the measurements against mA and/or kVp yielding empirical functions.Results Under standard protocols,the CTDIw of Varian OBI was only 11.23％ (chest) and 9.15％ (pelvis) of Elekta XVI.Using the default and other 4 investigated kVp values,the central and peripheral KERMA were both proportional to mA,and vet the slope value a varied dramatically from 0.479 to 6.679.Major affecting factors included kVp settings,measurement locations,and dosimetric mnetrics,etc.None linear regressions were used to fit kVp against KERMA at various locations and CTDIw (R2 ＞ 0.997).The differences between all coefficients were statistically significant (P ＜ 0.05).The impact of changing both mA and kVp on the dose to phantom center can be described as mGy =(5.917-0.197 ×kVp+0.002 × kVp2-5.063 × 10-6 × kVp3) × mA.Conclusions Imaging dose of Elekta XVI is strongly dependent on scanning paraneters.The proposed mathematical models can be used as efficient and robust indicators of such dependency.

Supervision of teaching is of great significance to the substantive equivalence of "online" and "offline" teaching. Compared with the conventional supervision of offline teaching, supervision of online teaching has its particularity. The School of Medicine of Shanghai Jiao Tong University has formulated the online teaching supervision program, relying on the constantly improving supervision system in long-term practice and based on the quality control concept of OBE (outcomes-based education) which aims to improve the learning effect of students. The supervision program of online teaching includes full coverage of expert supervision, smooth feedback channels for students, prompt communication and solutions by management supervision, etc. And the effect of online teaching supervision on students' learning effect can be tested in practice. The effect of the online teaching has been investigated by the questionnaire survey. The results show that online teaching expert supervision has higher satisfaction and students learning effect is better, which illustrates that the online supervision program has played a positive role in teaching.

Objective To assess the brain development of newborns with cardiac septal defects by MRI.Methods The brain MR images of 150 newborns with cardiac septal defects and 50 normal newborns were analyzed retrospectively.We evaluated the brain development by measuring the four indices of lateral ventricle:anterior horn index (F/F'),body index (D/D'),caudate nucleus index (C/C')and Evans index.Independent samples t test was used to compare the differences between the two groups,and the possible positive diagnostic cut-off points were calculated by using the nonparametric ROC analysis.Results There were no significant differences between the congenital heart disease group and the control group in the two indices:F/F'[(0.301±0.035)vs (0.296±0.031);t=1.035,P>0.05]and Evans index [(0.239±0.052)vs (0.233±0.025);t=0.778,P>0.05].The values of D/D'[(0.261±0.039)vs (0.234±0.032);t=3.873,P<0.05)] and C/C'[(0.138±0.018)vs (0.124±0.015);t=4.479,P<0.05]were significantly higher in the congenital heart disease group than in the control group.In the congenial heart disease group,the area under the ROC curve obtained by D/D'and C/C'were 0.698 and 0.750,respectively.The maximum Yuedeng index corresponding to the D/D'value and the C/C'value were 0.28 and 0.12,respectively. Conclusion The body index(D/D')and the caudate nucleus index(C/C')are sensitive to evaluate the differences of the brain volume between the newborns with cardiac septal defects and the normal newborns.It is helpful to find the abnormal brain volume when the value of D/D'is greater than 0.28 and the value of C/C'is greater than 0.12.

Objective To explore the best percentage of adaptive statistical iterative reconstruction Veo (ASiR-V)in detection of pulmonary nodule by chest ultralow dose CT (ULDCT).Methods 81 patients with pulmonary nodule detected by chest low dose CT (LDCT)underwent a local ULDCT scan at the center of the nodule with a range of 3 cm scan length.LDCT was performed with the mode of the Assist kV (120/100 kV)/Smart mA with noise indices of 14.1 HU and reconstructed with ASiR-V 50% algorithm.ULDCT was acquired at a tube potential of 120 kV and tube current-time product of 2.8 mAs and reconstructed with ASiR-V 50%,70% and 90%algorithms.Subjective and obj ective image qualities,sensitivities of detection and diameter of nodule among all ULDCT images were compared.Results Compared with the radiation dose of LDCT [(0.9 9±0.3 6)mSv],a 90.2% decrease was seen with the ULDCT, for which the calculated mean effective radiation dose was (0.097±0.007)mSv.The noise values of fat and paravertebral muscle for ULDCT reconstructed with ASiR-V 90% were 12.33±1.86 and 14.82±2.6,which were significantly lower than those in the group of ASiR-V 50% (1 9.73±1.98, 21.19±2.46)and the group of ASiR-V 70% (15.79±1.82,17.71±2.50)(P＜0.05).The subjective scores of images reconstructed with ASiR-V 70% (4.13±0.47)were the highest,which were slightly higher than those in 90%groups (4.03±0.38)(P＜0.05).No significant differences for overall sensitivity of nodule detection were observed among the ULDCT reconstructed with ASiR-V 50%(86.42%),ASiR-V 70%(87.04%)and ASiR-V 90% (88.89%)(P＞0.05).The mean nodule diameter measurements were (6.4±2.0)mm,(5.9±2.2)mm,(6.0±2.2)mm and (6.1 ±2.2)mm for LDCT and ULDCT (ASiR-V 50%,70% and 90%),respectively with P＞0.05.Conclusion At extremely low exposure levels,ASiR-V can obviously improve the image qualities of ULDCT,and 90% is the best percentage for lung algorithm reconstruction with a high sensitivity of pulmonary nodule detection.

Objective To explore the effects of meditation relaxation therapy on sleep quality and emotion among breast cancer patients with chemotherapy. Methods From October 2016 to September 2017, we selected 140 breast cancer patients with modified radical mastectomy and chemotherapy by convenience sampling. Patients treated between October 2016 and March 2017 were in control group, while patients treated between April and September 2017 were in observation group, 70 cases in each group. Patients of control group received conventional nursing. On the basis of control group, patients of observation group were treated with meditation relaxation therapy. Finally, patients were evaluated with the Pittsburgh Sleep Quality Index (PSQI), SAS and SDS before and after intervention. Results After intervention, the total score of PSQI, SAS and SDS of patients of observation group was (4.13±2.41), (44.4±5.12) and (39.4±4.93) respectively lower than those of control group (t=-2.138, 3.901, -4.654;P＜0.05). Conclusions Meditation relaxation therapy can improve the sleep quality, anxiety and depression, and it can also promote psychosomatic rehabilitation.

Objective To investigate association of vitamin D receptor (VDR) polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris.Methods A total of 110 patients with psoriasis vulgaris and 183 healthy controls were enrolled into this study,and they were all of Han nationality from Hainan province.Ligase detection reaction (LDR) was conducted to determine the genotypes of VDR gene polymorphisms rs2228570,rs731236,rs1544410 and rs7975232.Single nucleotide polymorphism (SNP)-based association analysis in genotypic and allelic models,and haplotype-based association analysis were then performed.Then,75 patients with psoriasis area and severity index (PASI) scores less than 10 were topically treated with calcipotriol ointment alone.After 6-week treatment,the efficacy of calcipotriol ointment was evaluated,and the correlation between the efficacy and individual genotypes was analyzed.Results The frequency of A allele of rs7975232 in the psoriasis group and control group was 39.09％ and 27.05％ respectively,and the risk of developing psoriasis in rs7975232 A allele carriers was significantly higher than that in non-carriers (OR =1.731,95％ CI:1.213-2.471,P ＜ 0.05).Additionally,the risk of developing psoriasis in individuals with AA genotype (OR =2.404,95％ CI:1.085-5.328,P ＜ 0.05),as well as in individuals with AC genotype (OR =2.143,95％ CI:1.283-3.579,P ＜ 0.05),was significantly higher than that in patients with CC genotype.CTGA haplotype carriers (rs2228570,rs731236,rs1544410,rs7975232,respectively) had significantly higher risk of developing psoriasis compared with non-carriers (OR =1.907,95％ CI:1.132-3.214,P ＜ 0.05).Among 72 patients with mild-to-moderate psoriasis whose PASI scores were less than 10,patients with CC genotype of rs7975232 showed better response to calcipotriol ointment compared with those with AC genotype (OR =3.798,95％ CI:1.061-13.590,P ＜ 0.05) and those with AA genotype (OR =9.667,95％CI:1.556-60.040,P ＜ 0.05).Conclusion VDR polymorphisms are associated with psoriasis susceptibility and clinical response to calcipotriol in patients with psoriasis individuals.

OBJECTIVE To compare the costeffectiveness of two surgical approaches:endoscopic silicone tube intubation(ESTI) and conventional blind silicone tube intubation(CBSTI),in the management of chronic dacryocystitis(CDC).METHODS There were 46 cases of CDC from the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2015.Randomly,22 CDC patients were included in ESTI,24 patients were performed CBSTI.We analyzed both the final success rate,operating time,intraoperative visual analogue scale(VAS) and the rate of post-operative complications,as well as the final therapeutic effect.RESULTS In ESTI group,17 cases were cured,5 cases were improved and 3 cases were invalid.The success rate was 88.00％.Correspondingly for CBSTI group,14 cases were cured,6 eases were improved and 5 cases were invalid,and the success rate was 80.00％.ESTI was better,but there was no significant in success rate between the two groups (x2=0.881,P=0.644).Besides,the operating time and intraoperative VAS score in ESTI group was (10.32±2.30)min and 2.02±0.86,and they were(25.32 ± 4.87)min and 4.11 ± 1.44 in CBSTI group.So ESTI was better than CBSTI(t=-13.918,P=0.000;t=-6.012,P=0.000).ESTI had fewer complications(x2=4.878,P=0.027).CONCLUSION Compared to CBSTI,ESTI is a minimally invasive and highly effective technique for the treatment of CDC.The visualization of nasal endoscopy is the optimization of CBSTI,and this method need to be popularization and application.