Objective To understand the individual dose monitoring of occupational external exposure for radiation workers in Wuhan City and analyze the dose change trend, and to provide a scientific basis for radiation protection management of radiation workers. Methods The data on the monitoring results of occupational external exposure of radiation workers in Wuhan City from 2017 to 2021 were collected through the National Personal Dose Registration System, and the individual dose levels of different years, different occupational categories, and different levels of hospitals were analyzed. Results A total of 9 134 radiation workers were investigated, with an average annual effective dose per capita of 0.20 mSv/a. The overall personal annual effective dose from 2017 to 2021 showed a decreasing trend (P<0.001). The per capita annual effective dose in medical applications was higher than that in industrial applications (0.22 mSv vs 0.14 mSv; P<0.001). Among medical applications, diagnostic radiologists had the highest average annual effective dose (0.27 mSv), and among industrial applications, industrial irradiators had the highest average annual effective dose (0.29 mSv). The proportion of personnel with personal annual effective doses exceeding 1 mSv was higher in interventional radiology and industrial nondestructive testing (4.90% and 1.90%). The annual effective dose per capita in Class I and unrated hospitals was higher (0.35 mSv). Conclusion The average annual effective dose of radiation workers in Wuhan City has decreased year by year and has not exceeded the national standard limit (20 mSv). Radiation protection management still needs to focus on personnel with personal annual effective doses exceeding 1mSv in interventional radiology and industrial nondestructive testing, and supervision over primary healthcare institutions and industrial radiation should be strengthened.

Objective To analyze the eye lens equivalent dose levels of doctors during interventional cardiology procedures and identify related influential factors. Methods Twenty interventional specialists were selected from a cardiovascular specialty hospital. The cumulative equivalent doses to their eye lens during operations were monitored, and equipment-related parameters (fluoroscopy time, dose area product value [DAP], and entrance skin dose[ESD]), operation types, and operators’ positions were recorded. Results The annual equivalent doses to the eye lens of seven doctors exceeded 20 mSv. There was a linear correlation between the weekly number of operations and the equivalent dose to the eye lens (R² = 0.457, P = 0.001). The mean eye lens equivalent dose per operation was 17.1 μSv, showing linear correlations with fluoroscopy time, DAP values, and ESD values (R² = 0.427, 0.206, and 0.237, respectively, P < 0.05). The fluoroscopy time, DAP value, ESD value, and eye lens equivalent dose during percutaneous coronary intervention (PCI) were significantly higher than those during coronary angiography (t = −3.226, −3.108, −3.061, and −2.667, respectively, P < 0.03). Conclusion The annual equivalent doses to the eye lens are relatively high in interventional radiologists, some of whom may have values higher than the latest dose limit (20 mSv) suggested by the International Commission on Radiological Protection. Attention should be paid to operators performing PCI, and the workload optimization is necessary in practical operations to avoid unnecessary fluoroscopy time and reduce the eye lens doses of the operators.

Objective:To attain comprehensive insight into the diagnostic X-ray equipment and examination frequency in radiological diagnosis and treatment institutions in Wuhan, with the purpose of assisting the health administration department in formulating medical exposure protection strategies and efficiently allocating radiological diagnosis and treatment resources.Methods:Using the census method, questionnaires on the basic information on diagnostic X-ray equipment and the annual number of examinations filled out in 2022 by the 1 030 radiological diagnosis and treatment institutions (excluding military and armed police hospitals) were collected through the Wuhan Prevention and Treatment Information Management Platform for Occupational Diseases. To obtain the data on number and frequency of diagnostic X-ray examinations, the different types of diagnostic X-ray examinations were divided by the total number of permanent residents by the end of 2021 in Wuhan.Results:In Wuhan, 1 030 radiological diagnosis and treatment institutions had 7 062 radiation workers and 2 540 diagnostic X-ray units of various types. 37.76% of units and 75.01% of radiation workers were concentrated in tertiary hospitals. The number of diagnostic X-ray units per million population was 186.10, with the top two being 48.65 DR machines per million population and 31.21 intraoral dental machines per million population. The total number of diagnostic X-ray examinations was 11 884 582, with plain radiographs and computed tomography (CT) examinations accounting for 43.61% and 43.59% of the total, respectively. The annual frequency of examinations was 379.75 and 379.52 per 1 000 population, respectively. Radiodiagnosis and treatment resources were higher in central urban areas than that in remote urban areas.Conclusions:The development of diagnostic X-ray equipment in Wuhan was experiencing rapid growth, with potential for further expansion, and the frequency has not yet recovered to the level before the COVID-19 pandemic. The allocation of radiodiagnosis and treatment resources between central urban areas and remote urban areas needs to be coordinated and the management of medical radiation protection should be continuously strengthened, so as to promote the sustainable development of inter-regional radiodiagnosis and treatment, and ensure the health and safety of examinaed patients and indivuduals.

Objective:To evaluate endoscopic retrograde appendicitis therapy in treatment of children with acute uncomplicated appendicitis.Methods:Sixty children patients were admitted at the Affiliated Hospital of Zhengzhou University from Oct 2019 to Jun 2021 and were divided into ERAT group ( n=30) and LA group ( n=30). Results:All operations were successfully performed . ERAT children started oral feeding earlier [(6.8±2.0) h vs. (12.3±2.0) h, t=-10.636, P<0.001], postoperative hospital stay was shorter [(3.2±1.3) d vs. (5.0±1.3) d, t=-5.360, P<0.001]. After 14 months follow up, the recurrence rate in the ERAT group was 6%. The complication rate of LA was 10%. Conclusion:ERAT is a safe and effective therapy in treating children with acute uncomplicated appendicitis with low,acceptable recurrence rate.

From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.

Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Objective To investigate the effect of 6-week high-intensity interval training(HIIT) on the body composition and the autophagy activation in skeletal muscle of C57BL/6 mice,and explore the underlying role of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)α2 in this process.Methods Thirty-six 4-week old male mice with the genotype AMPKα2+/+(n=12),AMPKα2+/-(n=12) and AMPKα2-/-(n=12),were randomly divided into a control(n=6) and an HIIT group(n=6) respectively.The mice from the HIIT group exercised on a motor-driven rodent treadmill for 5 days a week,lasting 6 weeks.The procedure of HIIT included the intensity of 85％ VO2max(20m/min) for 2 min/day and 50％ VO2max(8m/min) for 1 min/day with 12 cycles alternately.The body weight,body mass index(BMI),total body water and fat mass were measured and analyzed after the 6-week exercise.The protein expression of AMPKα2,pAMPK-Thr172,LC3Ⅱ/Ⅰ,Beclin1 and p62 in the skeletal muscle tissue were detected using Western blotting.Results Before exercise,there was no significant difference between the mice of the same genotype in the body weight.However,a significant decrease was observed in the body weight of all the HIIT mice,and BMI of the AMPKα2+/+ and AMPKα2+/-mice undergoing HIIT.There were no significant differences in the total body water between the control and HIIT groups of the same genotype after the intervention.There was significant decrease in the body fat mass in the HIIT group of AMPKα2+/+ and AMPKα2+/-mice after the intervention,while the decrease was not significant in the HIIT AMPKα2-/-mice.The protein expression of pAMPK-Thr172,LC3Ⅱ/Ⅰ and Beclin1 increased significantly,and that of p62 decreased significantly in the skeletal muscle of the AMPK+/+ and AMPK+/-mice after HIIT intervention,but not the AMPK-/-mice.Conclusion HIIT can improve health indicators(i.e,body weight,BMI and fat mass) and enhance autophagy activation in the skeletal muscle through increasing the phosphorylation of AMPKot2.

Objective To analyze high risk factors for poor prognosis in the refractory neonatal respiratory distress syndrome(NRDS).Methods A retrospective analysis was conducted at NICU in the Affiliated Hospital of Xuzhou Medical university.The newborns with NRDS,chest radiograph for grades 3 and 4,who required mechanical ventilation and pulmonary surfactant(PS)therapy were recruited from January 2014 to December 2015.According to treatment rusults,they were divided into death group(21 cases)and survival group(25 cases).Data regarding antenatal corticosteroid administration,maternal high risk factors,the basic situation of neonatal in the perinatal period,surfactant applications,the blood routine,albumin,lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),blood coagulation function with the first 24 hours after birth were collected and analyzed.Results The frequency of using PS in the death group and the survival group was(2±0.9)times and(1.5±0.6)times,the difference between the two groups was statistically significant(t=2.131,P=0.039).Dangerous placenta previa in death group was 19％(4/21),in the survival group was 0％(0/25),the two groups had statistical differences(x2=5.215,P=0.022).CK in death group was(541.5±399.1)U/L,in the survival group was(345.4±173.3)U/L,the difference between of the two groups was statistically significant(t=2.224,P=0.031).Prothrombin time(PT)in the death group was(23.2±6.3)s,in the survival group was(18.5±3.6)s,there was a significant difference between the two groups(t=3.008,P=0.039).Maternal risk factors of premature rupture of the survival group(38.9％)was higher than that of death group(5.0％),the two groups was statistically significant(x2=4.29,P=0.038).The application of prenatal hormone NRDS newborns were more likely to survive,there was statistical difference between two groups(x2=5.197,P=0.023).Multivariate Logistic analysis showed that PT was an independent risk factor for poor prognosis of NRDS.Conclusion PT is an independent risk factor for poor prognosis of neonatal respiratory distress syndrome.