Objective To understand the individual radiation dose levels and changes of occupational external exposure among radiation workers in a steel group from 2020 to 2023, and to provide a basis for strengthening radiation protection in the group. Methods According to the Specifications for individual monitoring of occupational external exposure (GBZ 128-2019), individual monitoring was conducted using a thermoluminescent dosimeter, with each monitoring cycle lasting 90 days, totaling four cycles per year. Individual monitoring data of occupational external exposure among radiation workers in the steel group from 2020 to 2023 were collected for statistical analysis. Results A total of 5889 monitoring records were collected from radiation workers across 37 affiliated units of the steel group during the period of 2020-2023. The average annual effective dose was 0.150 mSv, the maximum annual effective dose was 3.84 mSv, and 0.3% monitored workers showed annual effective doses exceeding 1 mSv. The average annual effective dose in 2023 was 0.146 mSv, which was lower than in 2020 but higher than in 2021 and 2022 (Z = −6.657 to 14.129, P < 0.001). The number of monitored workers in industrial and medical sectors accounted for 86.9% and 13.1%, respectively. Their average annual effective doses were 0.152 mSv and 0.140 mSv, respectively, and the difference was statistically significant (Z = −7.969, P < 0.001). In the industrial sector, the average annual effective dose for the monitored workers in industrial radiography was significantly higher than other occupations (Z = −8.094, P < 0.001). There was a significant difference in average annual effective dose among workers of different occupational categories in the medical sector (H = 67.040, P < 0.001). The average annual effective doses were relatively high for diagnostic radiology and nuclear medicine. Additionally, the average annual effective doses for male and female radiation workers were 0.150 mSv and 0.152 mSv, respectively (P > 0.05). Conclusion The average annual effective dose of radiation workers in the steel group was at low levels for four consecutive years, which meet the requirements of the national standard. However, to maintain the individual radiation dose levels of radiation workers as low as reasonably achievable, it remains necessary to strengthen radiation protection management in the steel group.

Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) is the most common subtype of peripheral T-cell lymphoma. The overall incidence rate of this disease is low and the heterogeneity is strong. At present, its diagnosis mainly relies on exclusive diagnosis. Clinically, the first-line treatment of PTCL-NOS mostly refers to CHOP-like chemotherapy regimens for B-cell non-Hodgkin lymphoma, but its efficacy is unsatisfactory, with high recurrence rate and poor long-term survival. The widespread application of new targeted drugs and antibody conjugated drugs, such as chidamide, pralatrexate and brentuximab vedotin have improved the therapeutic effects of patients to some extent. However, the prognosis of relapsed/refractory patients is still not satisfactory. This article reviews the pathological characteristics, immunophenotype, genetic characteristics, clinical features, and treatment progress of PTCL-NOS.

Objective:To establish a TAL gel-clot bacterial endotoxin test for aluminum hydroxide adjuvant.Methods:According to the bacterial endotoxin test in general chapter 1143 of the Chinese Pharmacopoeia 2020,pre-interference test was performed using 3 types of buffer solutions and Ca-Mg additive by orthogonal design.The interference test and sample preparation validation were carried out using different batches of aluminum hydroxide adjuvant from 2 TAL manufacturers.Results:No interference was obtained through pre-interference test.Under the validated conditions,aluminum hydroxide adjuvant combined with phosphate buffered saline and Ca-Mg additive was employed to remove interference in bacteria endotoxin test.Conclusion:The established TAL gel-clot method is applicable to bacterial endotoxin test for aluminum hydroxide adjuvant.

Objective To analyze the factors influencing the levels of occupational exposure in medical radiation workers in China, and to provide a scientific basis for determining the key points of radiation protection in the medical sector. Methods The individual monitoring data on occupational external exposure in medical radiation workers in 2021 were collected from the “National Individual Dose Registry”. The Chi-squared test and logistic regression were used to analyze the factors influencing the levels of occupational exposure in medical radiation workers. Results The Chi-squared test showed that gender, occupational category, medical institution category, region, number of radiation workers per thousand population, and regional per capita GDP were significantly associated with occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv and an annual effective dose limit of 20 mSv (χ² = 21.456−262.329, 7.601−78.650, P < 0.05). The logistic regression analysis further showed that gender, occupational category, region, and number of radiation workers per thousand population were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv (χ² = 14.621−170.857, P < 0.05); gender, occupational category, region, and regional per capita GDP were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 20 mSv (χ² = 5.401−48.709, P < 0.05). Conclusion Male radiation workers in interventional radiology and in central China have high risks of exceeding annual effective doses of 5 and 20 mSv. Moreover, high number of radiation workers per thousand population and regional per capita GDP are associated with low risks. Medical institutions should maintain a sufficient number of radiation workers and strengthen training on radiation protection knowledge for male and interventional radiology workers to enhance their radiation protection awareness. Investigation of the factors contributing to the high occupational exposure in central China should be intensified, and targeted effective measures should be conducted to reduce the occupational exposure in medical radiation workers.

Objective:To analyze the research status of evidence-based nursing practice in China and to discuss research hotspots and development trends.Methods:The evidence summary and evidence-based practice related literature included in CNKI, Wanfang Database, VIP Database and China Biology Medicine disc were retrieved from January 1, 2015 to September 1, 2021. CiteSpace V software was used for visual analysis.Results:A total of 587 related articles were included, and the total number of articles was increasing year by year. Hu Yan from Fudan University, Huang Haiyan from Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology and Ding Yanming from Peking University First Hospital formed the core cooperation team. The core journal with the most publications was the Journal of Nursing Science. The research hotspots were symptomatic nursing, perioperative nursing, functional exercise, vascular access and pipeline nursing, etc. The focus groups were surgical patients, the elderly and critically ill patients. Conclusions:Nursing evidence summary and practice research is in the stage of rapid development. In the future, it is necessary to strengthen interdisciplinary and cross-regional cooperation and exchange between authors and institutions and adopt strategies to promote and maintain the application of evidence in clinical practice.

Objective:To investigate secondary factors, laboratory features, treatment options, and prognosis of pure red cell aplastic anemia (PRCA) .Methods:This was a multicenter retrospective clinical study. Patients aged above 18 years newly diagnosed with PRCA between June 1, 2010, and June 1, 2019, were recruited as the main study object. A comparative analysis of remission rate and overall survival rate was made according to different treatment schemes adopted by patients and different drug reduction rates.Results:A total of 67 patients with PRCA were included in this study and the secondary PRCA group accounted for 44.8% (30/67) . The most common secondary factors were thymoma ( n=10) and T-cell large lymphocytic leukemia (T-LGLL) ( n=6) . The overall response rate of PRCA was 85.7% and the 3-year overall survival rate of PRCA was (74.3±7.5) %. The remission rate of cyclosporine A alone was slightly higher than that of oral glucocorticoid alone or combined with glucocorticoid[90.0% (36/40) vs 75.0% (12/16) , P=0.147]. After patients applied with cyclosporine A treatment reached CR/PR and remained stable for 3-6 months, the dose of cyclosporine A was reduced by 25 mg each time. The cyclosporine A reduction interval of a 25 mg/d reduction in more than 1 month significantly prolonged the median disease-free survival compared with a 25 mg/d reduction in less than 1 month [not reached vs 15 (95% CI 7-23) months, P<0.001]. There were 62.5% (10/16) of patients who responded to the initial or incremental treatment regimen after relapse. Conclusion:PRCA has features of various secondary factors, high overall survival rate, and high remission rate. Treatment with cyclosporine A alone is preferred, and cyclosporine A should be slowly tapered to reduce the risk of later relapse after it takes effect and patients reach a steady state.

Objective? To search and summarize the best evidence of nursing management of procedural pain in pediatric patients so as to provide guidance for clinical nursing staff in the standardized prevention and management of procedural pain. Methods? The Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews, National Guideline Clearinghouse(NGC), the National Institute for Health and Care Excellence(NICE) and Scottish Intercollegiate Guideline Network(SIGN) were searched on computer to collect literature including clinical practice guidelines, evidence summary and systemic reviews about the management of procedural pain among children 3 years old above. Two researchers independently assessed the quality and extracted data and conducted evidence extraction from the articles that met the standard of quality. Results? Totally eleven articles were enrolled including three best practice guidelines, three systematic reviews and five evidence summaries. Conclusions? Cognitive behavioral intervention, topical application of epidermal anesthetics or local cold compress, and combined operation of distraction can effectively reduce the pain and anxiety caused by procedures. The knowledge and skills of procedural pain management should be included in the education and training courses of medical institutions. Evidence should be selected pertinently to participate in the management of procedural pain in the mode of multidisciplinary cooperation.

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.