Aim To explore the effect of genetic poly-morphisms of POR on the stable warfarin maintenance doses in Han Chinese patients receiving mechanical heart valve replacement. Methods The association between POR gene polymorphisms and warfarin doses of 185 Han Chinese patients were investigated through ANOVA or t test. SNPs of POR and VKORC1 were de-tected by Sequenom? DNA MassArray genotyping method. CYP2C9*3 was genotyped by polymerase chain reaction-restriction fragment length polymorphism method ( PCR-RFLP ) . Patients ’ clinical characteris-tics, INR value and daily dose were obtained from their medical records. Statistical analysis was performed by SPSS 21. 0 software. Results No mutant carriers of POR rs17148944 , POR rs56256515 and rs72553971 were found in this study. The genotype frequencies of other SNPs were in accordance with Hardy-Weinberg e-quilibrium. In the group of patients with CYP2C9*1*1 , the mutant type carriers ( T carriers ) of POR rs17685 had a significantly higher dose than CC carri-ers(3. 50 ± 1. 07) mg·d-1 vs (3. 14 ± 0. 94) mg· d-1,P =0. 03. Also, in the group of patients with CYP2 C9*1*1 and VKORC1 rs9934438 G allele carri-ers, the mutant type carriers ( T carriers ) of POR rs17685 had a significantly higher dose than CC carri-ers(4. 76 ± 0. 90) mg·d-1 vs (4. 08 ± 1. 03) mg· d-1 ,P=0. 04. No significant difference was found in different genotypes of POR rs2868177 . Conclusion These results illustrate that POR rs17685 T carrier is closely associated with a higher warfarin maintenance dose, suggesting that this SNP is useful for clinical guidance of warfarin.

Objective To study the relationship between viral infection and chronic obstructive pulmonary disease (COPD),and the effect of viral infections on the changes of Th1/Th2 in COPD patients. Methods The se-ra from 81 patients with acute exacerbations of COPD,25 patients with stable COPD and 22 healthy subjects were tested for specific IgM of respiratary syncytial virus(RSV) ,herpes simplex virus type 1 (HSV-1), parainfluenza vi-rus (PIV), adenovirus (ADV) and cytomegalovirus (CMV) by indirect enzyme-linked immunosorbent assay (ELISA). Supernatant INF-γ and IL-4 cultured with PHA were determined. Results The positive rates of IgM in patients with acute exacerbations of COPD compared with those in patients with stable COPD and healthy subjects were significantly different(P <0.001 ). The level of INF-γ, and IL-4 in patients with acute exacerbations of COPD and stable COPD compared with normal control group;the level of INF-γ (242±43) and the of IL-4(42±9) in pa-tients with acute exacerbations of COPD was not significantly different as compared with the level of INF-γ( 198±32) and the level of IL-4(56±11 ) in patients with stable COPD (P<0.05), but the level of INF-γ was increased (90±18)and IL-4 was decreased (141±24) in control group (P<0.05). Compared with those in IgM negative group, the levels of INF-γ were significantly higher and the levels of IL-4 were significantly lowerIL-4 in lgM positive group( P<0.01 ). Conclusion Virus infection is a rather important factor in acute exacerbations of COPD, and COPD is characterized by a predominance of Th1-type response,and there is more significant Th1 response predomi-nance in COPD with virus infection.

Objective To estimate the application frequency of X-ray diagnosis in Fujian province in 2016 based on the examination number survey in sampled hospitals in 9 cities.Methods Using the national unified questionnaire and stratified typical sampling method,a total of 43 hospitals in 9 cities of Fujian province were selected for the survey.The survey information mainly contained the basic situation of sampled hospitals and the number of X-ray diagnostic examinees.The basic situation included the numbers of out-patient and emergency care,in-patient,X-ray diagnostic equipment and radiological staff,and the examinees were further classified by examination types,gender,ages and beam positions.Furthermore,based on the survey result,a prediction model of the application frequency of X-ray diagnosis in Fujian province was established,and the frequency in 2016 was also estimated.Results There were 418 sets of X-ray diagnostic equipment,and 1 230 radiological diagnostic staff in the 43 hospitals.The total number of out-patient,emergency care and in-patient was 30 919 162,and the number of X-ray diagnostic examinations was 4 277 518 in the hospitals in 2016.In 2016,the application frequency of X-ray diagnosis in Fujian province was estimated to be 695 examinations per thousand population.Among them,the frequencies of conventional X-ray photography and CT examinations were 373 and 293 examinations per thousand population,respectively.Conclusions Through this survey,the general situation of X-ray diagnostic application in Fujian province in 2016 was grasped,so as to provide reference data for improving the regulations and standards of radiation health protection and strengthening the supervision and management of the application of X-ray diagnostic equipment in Fujian province.

Objective:To ascertain the basic situation of radiotherapy in Fujian in 2016.Methods:Based on the unified questionnaire, the types and quantity of radiotherapy and its corollary equipment, the number of radiotherapy staff and the work for quality control were surveyed in the radiotherapy units in the whole province, and the data on patients undergoing radiotherapy and other types of patients were collected from 26 hospitals. The total number of radiotherapy patients in the whole province was estimated by the correlation analysis and multiple linear regression analysis.Results:Radiotherapy was performed in a total of 32 hospitals in Fujian province in 2016. Among them, there were 62 sets of radiotherapy equipment, 33 sets of the simulators, 57 sets of treatment planning systems and 762 workers. The total number of 15 156 radiotherapy patients in 26 hospital were available for the survey. Multiple linear regression models showed that the frequency of application of medical electron accelerator was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of electron accelerators ( r=0.311, 0.893, 0.956, P<0.05). Meanwhile, the frequency of aterloading brachytherapy was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of aterloading brachytherapy units ( r=0.307, 0.966, 0.988, P<0.05). The frequency of radiotherapy was 0.54 patients per 1 000 population in Fujian in 2016. The delivered dose calibration of accelerators was performed in all hospitals involved in line with the relevant regulations, but the number of quality control equipment for radiotherapy was insufficient, such as the QA beam checker or well-type ionization chamber. Conclusions:In recent years, the rapid development of radiotherapy has been seen in Fujian province. The radiotherapy management should focus on standardenized and improved quality control and regulation in future.

Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.

Objective:To explore the assessment methodology for internal dose to workers exposed to 131I radionuclide. Methods:Workers were chosen in a 131I radiopharmaceutial manufacturer and a nuclear medicine department in a hospital using 131I to treat hyperthyroidism and thyroid cancer. A portable high purity germanium (HPGe) gamma spectrometer was used to measure the content of 131I in the thyroid for 4 consecutive times in a period of 7 d. The internal dose was estimated combining with the work rotation mode for workers dealing with 131I. Results:When the monitoring month was used as a typical month to estimate the internal dose, the annual committed effective dose was 0.09-1.93 mSv for the production staff engaged in the repackaging of 131I radiopharmaceuticals in the surveyed enterprise, and 0.06-0.58 mSv for the nuclear medicine staff in the surveyed hospital. After adjusting the monitoring result of the current monitoring period based on the rotation mode, the annual committed effective dose was estimated to be 0.06-1.22 mSv for radiopharmaceutical production workers and 0.03-0.15 mSv for nuclear medicine workers, respectively. Conclusions:In the assessment of internal dose to radiation workers exposed to 131I, using a single time measurement result to estimate the annual dose would lead to a larger error. In the case of continuous monitoring, the result of subsequent monitoring periods should be corrected according to the result of previous monitoring periods. In order to accurately estimate the internal dose of workers exposed to 131I, it is necessary to take full account of the 131I exposure pattern, time and frequency and the internal contamination route. For workers who may be exposed to 131I with potential internal dose greater than 1 mSv/year, a 14 day-routine monitoring period was appropriate.

Objective:To ascertain the activity concentration of gross α and β in foods around Fuqing nuclear power plant (NPP) site.Methods:Totally 167 food samples of 25 kinds within 6 categories were collected from the surveillance areas and control areas around Fuqing NPP site. The total radioactivity was analyzed using the food samples. Paired rank sum test was used to determine the influence of the operation of Fuqing NPP on the total radioactivity in foods in surrounding areas. The multiple local rank sum test was used to assess the difference in total radioactivity in different types of foods.Results:The average gross α in poultry meat, vegetables, crops, aquatic products, milk and tea was 0.65, 1.96, 1.41, 3.80, 1.33, 7.67 Bq/kg in surveillance areas and 0.56, 3.24, 2.04, 3.70, 2.24, 9.05 Bq/kg in reference areas, respectively, around Fuqing NPP site. The average gross β (subtracting 40K) in poultry meat, vegetables, crops, aquatic products, milk and tea was 7.0, 10.5, 6.1, 23.5, 24.7, 8.6 Bq/kg in surveillance areas and 7.4, 8.3, 14.5, 22.1, 21.3, 11.0 Bq/kg in reference areas, respectively, around Fuqing NPP site. The Wilcoxon paired rank test showed that there was no significant difference in the gross α and β in foods between surveillance and reference areas around Fuqing NPP site ( P>0.05). The Kruskal-Wallis H test showed that the radioactivity of gross α and β in different foods was statistically significant ( χ2=23.325, 13.918, P<0.05). Conclusions:The increase was not found in total radioactivity in the surrounding foods since the operation of Fuqing NPP in 2015.

Objective:To explore the main risk factors and to assess the risk of thyroid 131I exposure among nuclear medical workers. Methods:From March to October in 2019, cluster sampling was adopted to collect the number of 131I automatic packer and patients treated for thyroid cancer, hyperthyroidism and liven cancer used 131I, the practicing categories, job rotation and 131I operation condition of nuclear medical staff were also investegated in the 21 nuclear medicine hospitals in Fujian Province that carried out 131I nuclide diagnosis and treatment in 2018. 131I aerosol and personnel thyroid 131I were measured in 20 hospitals using 131I for thyroid cancer or hyperthyroidism. The main risk factors leading to thyroid 131I exposure of nuclear medical staff were found and aninternal exposure risk assessment model was established. Results:The detection rate of 131I aerosol and personnel thyroid 131I were 80.0% (16/20) and 25.5% (62/243) in 20 hospitals. The situation of packaging and administration about 131I in the nearly 10 effective half-life, the concentration of 131I aerosol in the nuclear medicine workplace, the number of patients treated with 131I for thyroid cancer or hyperthyroidism were the main risk factors leading to thyroid 131I internal exposure ( OR=5.857, 6.808, 1.983, 1.150, P<0.05) . Conclusion:131I exposure is common among nuclear medical workers, attention should be paid to the protection of internal radiation, strengthen the control of main risk factors, so as to reduce the risk of internal radiation.

Objective:To explore the main risk factors and to assess the risk of thyroid 131I exposure among nuclear medical workers. Methods:From March to October in 2019, cluster sampling was adopted to collect the number of 131I automatic packer and patients treated for thyroid cancer, hyperthyroidism and liven cancer used 131I, the practicing categories, job rotation and 131I operation condition of nuclear medical staff were also investegated in the 21 nuclear medicine hospitals in Fujian Province that carried out 131I nuclide diagnosis and treatment in 2018. 131I aerosol and personnel thyroid 131I were measured in 20 hospitals using 131I for thyroid cancer or hyperthyroidism. The main risk factors leading to thyroid 131I exposure of nuclear medical staff were found and aninternal exposure risk assessment model was established. Results:The detection rate of 131I aerosol and personnel thyroid 131I were 80.0% (16/20) and 25.5% (62/243) in 20 hospitals. The situation of packaging and administration about 131I in the nearly 10 effective half-life, the concentration of 131I aerosol in the nuclear medicine workplace, the number of patients treated with 131I for thyroid cancer or hyperthyroidism were the main risk factors leading to thyroid 131I internal exposure ( OR=5.857, 6.808, 1.983, 1.150, P<0.05) . Conclusion:131I exposure is common among nuclear medical workers, attention should be paid to the protection of internal radiation, strengthen the control of main risk factors, so as to reduce the risk of internal radiation.

Objective To investigate the predictive value of inflammatory cells and clinical features in the prognosis of immune checkpoint inhibitors (ICIs) treating non-small cell lung cancer (NSCLC).Methods The data of 163 cases of stage Ⅲ and Ⅳ NSCLC patients treated with the ICIs in this hospital from January 1,2017 to December 31,2022 were collected.The CT examination was conducted after 6-8 weeks treatment.The pa-tients were divided into the objective remission group[complete remission (CR)+partial remission (PR)]and non-objective remission group[stable disease (SD)+progressed disease (PD)],disease control group (CR+PR+SD) and non-disease control group (PD),persistent clinical benefit group (DCB) and non-DCB group.The differences in clinical features and inflammatory cells indicators were compared among the differ-ent groups.The receiver operating characteristic (ROC) curve was adopted to evaluate the predictive efficiency of the inflammatory cells indicators for DCB.The influencing factors analysis of progression free survival (PFS) time and overall survival (OS) time adopted the Cox regression analysis.Results The lymphocyte count (ALC) in the disease control group was higher than that in the non-disease control group.The neutro-phil to lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR) and mononuclear lymphocyte ratio (MLR) were lower than those in the non-disease control group.The proportions of squamous cell carcinoma,stage Ⅲ,ECOG score 0-1 point,adverse reactions in the DCB group were higher than those in the non-DCB group (P<0.05),the PLT count,NLR,PLR and MLR were lower than those in the non-DCB group (P<0.05). The ROC curve analysis results showed that PLT,NLR,PLR and MLR could serve as the indicators for pre-dicting DCB,the area under of ROC curve (AUC) was 0.633,0.602,0.635 and 0.604 respectively,the opti-mal cut off values were 187×109/L (P=0.004),5.0 (P=0.026),235 (P=0.003) and 0.35 (P=0.024) re-spectively.The multivariate Cox regression analysis showed that non-squamous carcinoma including adenocar-cinoma (HR=1.565,95％CI:1.057-2.316) and other pathologic types (HR=2.285,95％CI:1.326-3.936),ECOG score 2-3 points (HR=2.375,95％CI:1.652-3.415),AMC≥0.65×109/L (HR=1.847,95％CI:1.160-2.938) and PLR≥235 (HR=1.557,95％CI:1.016-2.386) were the independent risk factors for short PFS.The ECOG score 2-3 points (HR=4.615,95％CI:2.882-7.391),AMC≥0.65×109/L (HR=5.161,95％CI:2.984-8.925) and PLR ≥235 (HR=1.732,95％CI:1.059-2.833) were the independent risk fac-tors for short OS (P<0.05),and having adverse reactions (HR=0.472,95％CI:0.294-0.757) was the independ-ent protective factor for short OS (P<0.05).Conclusion Lower PLT,AMC,NLR,MLR and PLR,higher ALC,squamous cell carcinoma,TNM stage Ⅲ,ECOG score 0-1 point and immunotherapy related adverse reactions could prompt that the prognosis is good in ICIs treating advanced NSCLC.PLT,NLR,PLR and MLR could serve as the indicators for predicting DCB.