Objective To investigate the current status of quality control of radiological diagnosis and treatment equipment in Shenzhen City, explore the problems in quality control testing of radiological diagnosis and treatment equipment, and provide control strategies. Methods According to the requirements of the Special Monitoring Work Plan for Radiation Health in Shenzhen, quality control tests were carried out on some radiological diagnosis and treatment equipment in Shenzhen according to the test items and methods of the currently valid national standards. Results From 2019 to 2023, a total of 72 medical institutions participated in radiological health monitoring program in Shenzhen, and 839 quality control tests were performed on radiological diagnosis and treatment equipment. The qualified rate was 91.8% in preliminary tests. The qualified rates of radiological diagnosis, radiotherapy, and nuclear medicine equipment were 91.9%, 96.3%, and 62.5%, respectively. The primary unqualified items were response uniformity, flatness of the X-ray irradiation field, and intrinsic spatial linearity. Conclusion The qualified rate in quality control of nuclear medical equipment is relatively low. Medical institutions should strengthen the routine maintenance of radiological diagnosis and treatment equipment. Radiological health technical service institutions should enhance the training of technical personnel to ensure the health and safety of patients and radiation workers.

Objective To analyze the activity concentrations of gross α, gross β, and radionuclides in atmospheric fallout around Daya Bay Nuclear Power Plant from 2019 to 2022, and provide foundational scientific data for the healthy development of nuclear energy. Methods Five monitoring sites were set up at different distances (1.2, 6.9, 12.4, 42.3, and 69.2 km) from Daya Bay Nuclear Island 1. Stainless steel sampling barrels were used to collect atmospheric fallout, with a monitoring cycle of three months. The collected samples were ashed using radiochemical method. Subsequently, the gross α and gross β radioactivity were quantified using a low-background α/β measurement instrument. The remaining ash samples were mixed with water and left to equilibrate for over three weeks before γ-nuclide analysis using a low-background, high-purity germanium γ-spectrometer. Results The gross α activity concentration in atmospheric fallout around Daya Bay Nuclear Power Plant from 2019 to 2022 averaged (25.3 ± 10.6) Bq/m²/season and ranged from 5.8 to 73.4 Bq/m²/season. The gross α activity concentrations in sampling sites #1 to #5 were 5.8-34.4, 11.9-35.2, 14.4-46.4, 7.2-73.4, and 13.1-43.1 Bq/m²/season, respectively. The gross β activity concentration averaged (50.5 ± 23.4) Bq/m²/season and ranged from 13.9 to 139.3 Bq/m²/season. The gross β activity concentrations of sampling sites #1 to #5 were 17.1-107.4, 17.6-87.5, 25.8-102.0, 13.9-139.3, and 23.4-99.2 Bq/m²/season, resprctively. The activity concentrations of ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K, ²¹⁰Pb, and ⁷Be in atmospheric fallout were < lower limit of detection (LLD)-4.2, < LLD-5.8, < LLD-6.3, < LLD-42.1, < LLD-514.0, and 35.7-1761.0 Bq/m²/season, respectively. Gross α and gross β activity concentrations were significantly positively correlated with ²¹⁰Pb activity concentration (r=0.770, α < 0.001; r=0.882, α < 0.001, respectively). Gross β activity concentration showed a significant positive correlation with ⁷Be (r=0.833, α < 0.001). The activity concentrations of ⁵⁴Mn, ⁵⁷Co, ⁵⁸Co, ⁶⁰Co, ⁵⁹Fe, ⁹⁵Zr, ¹⁰³Ru, ¹⁰⁶Ru, ^110mAg, ¹³¹I, ¹³⁴Cs, ¹³⁷ Cs, ¹⁴⁰Ba and ¹⁹²Ir were lower than the LLD of the instrument, and no artificial radionuclides were detected. Conclusion The gross α and gross β radioactive activity concentrations in the atmospheric fallout in the surrounding area of Daya Bay Nuclear Power Plant during 2019-2022 were affected by natural radionuclides ²¹⁰Pb and ⁷Be, and were in the normal fluctuation ranges. No artificial radionuclides were found in the atmospheric fallout, and the Daya Bay Nuclear Power Plant was in a safe and stable state of operation.

Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

Objective To explore the effectiveness of using Excel sheets combined with QR codes for precision naviga-tion and location management of sterile instrument rooms in the operating room.Methods The study focused on the location management of nearly 1,000 sterile instruments in three sterile instrument rooms of our hospital.Instruments from July to Septem-ber 2023 were used as the control group,employing traditional location management methods.Instruments from October to De-cember 2023 were used as the observation group,applying Excel sheets and QR codes for precise navigation and location manage-ment.Results The time taken by new nurses and interns to find and retrieve sterile instruments decreased from(4.61±0.32 min)to(1.41±0.15 min).The accuracy of retrieving sterile instruments increased from 83.33％to 98.33％.The compliance rate for location management of sterile instruments improved from 75％to 100％.Nurse satisfaction increased from 81.67％to 96.67％,with significant differences observed(P＜0.05).Conclusion The application of Excel sheets combined with QR codes for precision navigation and location management of sterile instrument rooms in the operating room effectively reduces re-trieval time for sterile instruments,decreases error rates,optimizes management processes,enhances work efficiency,avoids sur-gical delays,ensures patient safety,minimizes conflicts between medical staff and patients,and increases nurse satisfaction.This approach is worthy of clinical promotion and application.

Objective:To analyze the levels of antibody to measles virus in cord blood of newborns in Ankang city, and provide reference for the development of measles prevention and control measures and strategies.Methods:From January to December, 2023, 1 058 pregnant women from 10 county-level general hospitals in Ankang city were recruited in this study. Neonatal umbilical cord blood samples were collected for detecting IgG antibody against measles with ELISA. SPSS 21.0 software was used to analyze the positive rate of antibody to measles virus and the influencing factors.Results:The overall positive rate of IgG antibody to measles virus was 89.22% (944/1 058), and the geometric mean concentration (GMC) was 570.26 mlU/ml. The positive rates of IgG antibody against measles virus in umbilical cord blood of neonates born to women aged ≤20, 21-25, 26-30, 31-35, and ≥36 years old were 91.07% (51/56), 90.27% (232/257), 89.54% (351/392), 88.12% (230/261), and 86.96% (80/92), respectively (χ 2=1.355, P=0.852). Multivariate logistic regression analysis showed that the positive rate of IgG antibody against measles virus in umbilical cord blood samples was higher in neonates with gestational age ≥37 weeks than in those with gestational age <37 weeks [OR (95%CI): 0.403 (0.262-0.622)]. Besides, the positive rate was also higher in newborns with a birth weight of 3.0-3.5 kg than in those with birth weight <3 kg or ≥3.5 kg [OR (95%CI): 0.868 (0.462-1.629), 1.765(1.087-2.865)]. Conclusions:The positive rate and the GMC of IgG antibody to measles virus in neonatal umbilical cord blood decrease with maternal age. It is recommended that women of childbearing age should receive supplementary immunization with measles-containing vaccine before pregnancy.

Purpose: This retrospective study aimed to re-evaluate the effect of concurrent chemotherapy in patients with locally advanced nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT). Materials and Methods: A total of 498 patients who received neoadjuvant chemotherapy (NCT) combined with concurrent chemoradiotherapy (CCRT) or IMRT were retrospectively reviewed. The distribution of baseline characteristics was balanced using propensity score matching. Additionally, the results of NCT+IMRT and NCT+CCRT were compared using Kaplan-Meier survival analysis, and differences in survival rates were analyzed using the log rank test. Results: There were no significant differences in overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and local progression-free survival (LRFS) between the two groups. Patients were further categorized into risk subgroups based on pretreatment Epstein-Barr virus (EBV) DNA cutoff values using receiver operating characteristic curve analysis. There were no statistically significant differences in OS, PFS, DMFS, and LRFS between patients who received NCT+CCRT and NCT+IMRT in the high-risk group. In the low-risk group, although there were no differences between NCT+CCRT and NCT+IMRT in OS, PFS, and LRFS, patients who received NCT+CCRT had better DMFS than those who received NCT+IMRT. Conclusion Pretreatment EBV DNA level can be used to individualize concurrent chemotherapy for patients with locally advanced NPC. Patients with low pretreatment EBV DNA levels may benefit from concurrent chemotherapy, whereas those with high levels may not. Other treatment modalities need to be explored for high-risk patients to improve their prognosis.

With the rapid changes in people's lifestyles, natural and social environments in recent years, the prevalence of chronic and non-communicable diseases in China and its related risk factors have also had tremendous changes. The epidemiological characteristics of chronic and non-communicable diseases and their risk factors vary throughout the country, and the impact of unique climate, diet and lifestyle in southern China on the incidence and prevalence of chronic and non-communicable chronic diseases remains to be elucidated. Therefore, large-scale cohort study is urgently needed to provide evidence for the etiological research and management of chronic and non-communicable chronic diseases in different areas, and for the national management strategy for major chronic and non-communicable diseases. The prospective cohort study of chronic and non-communicable diseases in general population in southern China was established in December 2017. The study recruited permanent residents aged 35-74 years from both urban and rural areas in Guangdong, Hainan, Fujian Provinces and Guangxi Zhuang Autonomous Region. A big data platform of precision medicine which integrates health information with biological samples for long-term follow up has been established. A baseline database of 116 520 people aged (54.9±12.5) years, including 71 077 women (61.0%), has been established. Collecting questionnaire survey data, physical examination data, and biological samples. This paper briefly introduces the concept, design and progress of the prospective cohort study of chronic and non-communicable diseases in general population in southern China.

Objective:To evaluate the clinical efficacy of transanal total mesorectal excision (taTME) on transanal endoscopic microsurgery (TEM) platform in the treatment of middle and low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 28 patients with middle and low rectal cancer who underwent taTME on TEM platform in the Peking Union Medical College Hospital of Chinese Academy of Medical Science from October 2014 to October 2017 were collected. There were 21 males and 7 females, aged 59 years (51 years, 68 years). Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect post-operative defecation function and survival of patients up to October 2020. Patients underwent physical examination, examination of tumor markers including carcinoembryonic antigen and CA19-9, colonoscopy, rectal magnetic resonance imaging, thoracoabdominal and pelvic enhanced computed tomography (CT) and (or) PET-CT examination during the follow-up. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25,P75) or M (range), and comparison between groups was analyzed using the non parameter Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations: 28 patients underwent successful surgery, without intra-operative conversion to laparotomy. Of 28 patients, 24 cases underwent colorectal anastomosis and 4 cases underwent colon-anal anastomosis. Twenty-six cases underwent primary protective enterostomy and 2 cases didn't undergo primary protective enterostomy. The operation time of 28 patients was (182±37)minutes and the volume of intraoperative blood loss was 40mL(30 mL, 55 mL). One patient with intraoperative presacral hemorrhage received compression hemostasis. Eleven patients had postoperative complications, including 4 cases with anastomotic leakage, 2 cases with alteration of intestinal flora, 2 cases with paralytic ileus, 2 cases with urinary retention, 2 cases with urinary infection, 1 case with prolapse necrosis of small intestinal stoma, 1 case with anal hemorrhage, 1 case with rectovaginal fistula, 1 case with pelvic infection; some patients had multiple complications. Three patients had non-planned reoperation. One case without primary protective enterostomy had anastomotic leakage at postoperative 3 days, and was improved after emergency transversostomy. One case had prolapse necrosis of small intestinal stoma at postoperative 3 days and was improved after emergency enterostomy and reconstruction. One case with anal hemorrhage was stopped hemorrhage under anoscopy. Patients with other complications were cured after conservative treatments. The duration of postoperative hospital stay of 28 patients was 8 days(7 days, 9 days). Results of pathological examination in 28 patients showed 16 cases of moderately differentiated adenocarcinoma, 3 cases of moderately to highly differentiated adenocarcinoma, 5 cases of highly differentiated adenocarcinoma, 1 case of mucinous adenocarcinoma, 3 cases of pathological complete response. TNM staging of 28 patients showed 3 cases in stage T0N0, 4 cases in stage T1N0, 6 cases in stage T2N0, 4 cases in stage T2N1, 7 cases in stage T3N0, 3 cases in stage T3N1, 1 case in stage T4N1. The distance from tumor to distal margin was (2.2±1.7)cm. The surgical specimens of 28 patients showed negative for proximal, distal and circumferential margins. The number of lymph node dissection was 15±7. The complete rate of total mesorectal excision was 100%(28/28). Eleven of 28 patients underwent neoadjuvant therapy and 17 patients didn't receive neoadjuvant therapy. The tumor diameter, distance from tumor to anal margin, operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 2 cm(1 cm, 4 cm), 5 cm(4 cm, 6 cm), (187±25)minutes, 45 mL(38 mL, 53 mL), 8 days(7 days, 12 days) for patients with neoadjuvant therapy, respectively, versus 3 cm(2 cm, 4 cm), 5 cm(4 cm, 6 cm), (177±35)minutes, 40 mL(30 mL, 60 mL), 8 days(7 days, 8 days) for patients without neoadjuvant therapy, showing no significant difference between the two groups ( Z=-1.127, -0.293, t=0.590, Z=-0.790, -0.876, P>0.05). (2) Follow-up: 23 of 28 patients were followed up for (44±14)months. Of the 23 patients,11 cases were classified as grade A of Williams score for defecation function at postoperative 6 months, 8 cases were classified as grade B and 4 cases were classified as grade C. Eighteen of 23 patients with follow-up had disease-free survival, 1 of whom didn't undergo stoma closure due to anastomotic stenosis at postoperative 6 months. Three patients had distant metastasis, including 1 case with parastomal implantation metastasis, 1 case with sacral metastasis, 1 case with pulmonary metastasis. Two patients died, 1 case of whom died of urinary obstruction and 1 case with mucinous adenocarcinoma died at postoperative 24 months. Conclusion:TaTME based on TEM platform is feasible for middle and low rectal cancer, which has the advantages of preserving anus and negative circumferential margin.

Objective:To investigate the influences of minimally invasive hematoma removal assisted by stereotaxis technique and conservative treatment in clinical prognoses of patients with small/medium intracerebral hematoma in the basal ganglia.Methods:Sixty-four patients with spontaneous basal ganglia cerebral hemorrhage, admitted to our hospital from March 2020 to March 2021, were enrolled in our study; these patients were randomly divided into surgical group (accepted minimally invasive hematoma removal assisted by stereotaxis technique, n=33) and conservative treatment group ( n=31). The baseline general data and 6 months follow-up data of patients from the 2 groups were compared. The Glasgow outcome scale (GOS) scores, modified Barthel index (MBI), modified Rankin scale (mRS) scores and complications were compared 7 d, 1 month and 6 months after surgery. Results:There were no significant differences in gender, age, and amount of bleeding between the 2 groups ( P>0.05). On the 7 th d of surgery, there were no significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P>0.05). One month after surgery, there were statistically significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P<0.05); the good prognosis rate in the surgical group was 78.79% (26/33), and that in the conservative treatment group was 25.81%(8/31), with significant difference ( P<0.05). Six months after surgery, there were significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P<0.05); the good prognosis rate in the surgical group was 95.7% (29/33), and that in the conservative treatment group was 32.3% (10/31), with significant difference ( P<0.05). The incidence of complications in the surgical group and conservative treatment group was 6.06% and 29.03%, respectively, with significant difference ( P<0.05). Conclusion:Minimally invasive hematoma removal assisted by stereotaxis technique is more conducive to the repair of nerve function in patients with moderate to small cerebral hemorrhage in the basal ganglia than conservative treatment.

OBJECTIVES: Primary carnitine deficiency (PCD) is a rare fatty acid metabolism disorder that can cause neonatal death. This study aims to analyze carnitine levels and detect SLC22A5 gene in newborns with carnitine deficiency, to provide a basis for early diagnosis of PCD, and to explore the relationship between carnitine in blood and SLC22A5 genotype. METHODS: A total of 40 neonates with low free carnitine (C0<10 μmol/L) in blood were the subjects of the study. SLC22A5 gene was detected by Sanger sequencing to analyze the value of carnitine, the results of gene test and their relationship. RESULTS: A total of 15 variants of SLC22A5 gene were detected, including 11 pathogenic or likely pathogenic variants and 4 variants of uncertain significance. There were 5 new mutations: c.288delG (p.G96fsX33), c.744_745insTCG (p.M258_L259insS), c.752A>G (p.Y251C), c.495 C>A (p.R165E), and c.1298T>C (p.M433T). We found 14 PCD patients including 2 homozygous mutations and 12 heterozygous mutations, 14 with 1 mutation, and 12 with no mutation among 40 children. The C0 concentration of children with SLC22A5 gene homozygous or complex heterozygous mutations was (4.95±1.62) μmol/L in the initial screening, and (3.90±1.33) μmol/L in the second screening. The C0 concentration of children with no mutation was (7.04±2.05) μmol/L in the initial screening, and (8.02±2.87) μmol/L in the second screening. There were significant differences between children with homozygous or compound heterozygous mutations and with no mutation in C0 concentration of the initial and the second screening (both CONCLUSIONS There are 5 new mutations which enriched the mutation spectrum of SLC22A5 gene. C0<5 μmol/L is highly correlated with SLC22A5 gene homozygous or compound heterozygous mutations. Children with truncated mutation may have lower C0 concentration than that with untruncated mutation in the initial screening.
Cardiomyopathies ; Carnitine/deficiency* ; Child ; Humans ; Hyperammonemia/genetics* ; Infant, Newborn ; Muscular Diseases/genetics* ; Mutation ; Solute Carrier Family 22 Member 5/genetics*