Objective To track and evaluate the implementation and application of the occupational health standard Radiation shielding requirements for radiotherapy room—Part 4: Radiotherapy room of ²⁵²Cf neutron afterloading (GBZ/T 201.4-2015) by radiation health technical service agencies, medical institutions, health supervision agencies, and radiotherapy facility design units, and to provide a scientific basis for the further revision and implementation of this standard. Methods Following the Guideline for health standards tracking evaluation (WS/T 536-2017) and the project implementation plan, relevant practitioners were randomly selected for a questionnaire survey. The survey primarily focused on their awareness, standard training, application, and revision suggestions of GBZ/T 201.4-2015. The results were summarized and analyzed. Results A total of 168 evaluation questionnaires were collected from relevant practitioners in 28 provinces. Only 31.6% of the respondents reported being “well familiar” or “ familiar” with the standard, 27.4% of the respondents believed that the standard was widely used, and 45.2% of the respondents believed that the standard could meet the needs of their work. Only 14.9% of the respondents had received relevant training on the standard, more than half of the respondents had not applied the standard within the past 10 years, and 45.2% of the respondents believed that the standard "needs to be revised". Conclusion Due to the small number of californium-252 neutron afterloading radiotherapy devices in operation on the market, the overall awareness of the standard is low, suggesting that relevant authorities need to strengthen training and publicity of the standard, and that certain sections of the standard need to be revised or merged.

Objective To explore the clinical value of endoscopic ultrasonography(EUS)combined with serum serine protease inhibitor Kazal 1(SPINK1)and secretory phosphoprotein 1(SPP1)in early diagnosis of esophageal cancer.Methods 276 patients from June 2021 to May 2023 were selected as the study objects.92 cases of esophageal cancer diagnosed by operation and pathology were esophageal cancer group,another 89 patients diagnosed as benign esophageal lesions through tissue biopsy were selected as the benign lesion group,and 95 healthy individuals who underwent physical examinations were collected as the healthy control group,general information such as age and gender of subjects in three groups were collected and organized;using pathological results as the gold standard,the accuracy of EUS in diagnosing esophageal cancer was verified;the expression of serum SPINK1 and SPP1 was compared among the esophageal cancer group,benign lesion group,and healthy control group;the relationship between the expression of serum SPINK1 and SPP1 in esophageal cancer patients and their clinical and pathological characteristics was explored;efficacy of EUS combined with serum SPINK1,SPP1 levels for early diagnosis of esophageal cancer was analyzed using receiver operator characteristic curve(ROC curve).Results Compared with the gold standard,the results of EUS examination showed that 81 cases were diagnosed with esophageal cancer,79 cases were diagnosed with benign lesions,11 cases were missed diagnosed,and 10 cases were misdiagnosed,with an accuracy rate of 88.40%(160/181);Compared with the healthy control group and the benign lesion group,the expression levels of serum SPINK1 and SPP1 in the esophageal cancer group were obviously increased,the expression levels of serum SPINK1 and SPP1 in the benign lesion group were significantly higher than those in the healthy control group,the differences were statistically significant(P<0.05);Serum SPINK1 expression was linked to tumor diameter>2 cm,presence of lymph node metastasis,lymph node positivity,and tissue grading level 3 in patients(P<0.05).Serum SPP1 expression level was related to tumor diameter>2 cm,presence of lymph node metastasis,lymph node positivity,and estrogen receptor positivity of patients(P<0.05);ROC curve showed that the area under the curve(AUC)of EUS,serum SPINK1,SPP1 levels,and their combination in the early diagnosis of esophageal cancer was 0.862,0.834,0.782,and 0.926,respectively,the clinical efficacy of the combination of the three in the early diagnosis of esophageal cancer was superior to that of EUS,serum SPINK1,and SPP1 alone(Z=2.30,Z=3.70,Z=4.23,P=0.022,P=0.000,P=0.000).Conclusion The expression levels of serum SPINK1 and SPP1 in esophageal cancer patients are abnormally up-regulated.The combination of EUS and serum SPINK1 and SPP1 has high clinical value in early diagnosis of esophageal cancer.

Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n = 48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n = 39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P = 0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P = 0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

The diagnostic technology of acute stroke by microwave imaging has the advantages of being non-ionizing, fast, small, and low-cost. Therefore, this technology is expected to become an auxiliary or alternative means to CT and MRI technology. As the signal transmitting and receiving device of the microwave imaging system, the antenna has an important influence on the performance of the imaging system. At present, there are many antennas with different performances used in imaging systems, but there is a lack of clear evaluation criteria for them. In this paper, several typical antennas were introduced, their advantages and disadvantages from the perspective of bandwidth and near-field were analyzed, and the common requirements of imaging systems for antennas and the performance indicators of various types of imaging systems were summarized. Moreover, the development trend of antenna technology for microwave imaging was pointed out to provide a reference for the study of stroke microwave imaging technology.

Objective:To investigate the safety and feasibility of early operation for acute calculous cholecystitis with elevated liver enzymes.Methods:The clinical data concerned about 39 patients with acute calculous cholecystitis complicated with elevated liver enzymes in The First Department of General Surgery, The First Affiliated Hospital of Anhui University of Science and Technology between January 2018 to December 2018 were analyzed retrospectively.There were 14 males and 25 females, the age was(57.59±15.30) years(range 29 to 84 years). All patients were given hepatoprotective therapy and antibiotic therapy, A total of 18 patients received early surgical treatment within 7 days (surgical group), 21 patients who received only hepatoprotective therapy and antibiotic therapy(control group). Observation indicators: (1)Total bilirubin, white blood cells and pancreatin in both groups at admission; (2)Data of liver enzyme indexes (ALT, AST, GGT) of the two groups at admission and 3 days after admission; (3)The length of hospital stay in the two groups, and gallstone-related events after discharge(the incidence of gallstone-related emergency, the rehospitalization rate). Normally distributed measurement data were expressed as mean±standard deviation( ± s), and comparison between groups were analyzed using t test; Non-normal distribution measurement data were represented by M( Q1, Q3), and comparison between groups were analyzed using Mann-Whitney U test. Comparison between groups were analyzed using chi-square test or Fisher method of count data. Results:There was no statistical difference between the two groups in terms of total bilirubin, white blood cells and pancreatin( P>0.05). There was no significant difference in liver enzyme indexes (ALT, AST, GGT) between the two groups when they were admitted to the hospital ( P>0.05) and 3 days later ( P>0.05). Before treatment, ALT、AST、GGT in surgical group were 161.00(83.75, 237.75) U/L, 63.50(49.50, 257.75) U/L, 245.50(66.75, 549.75) μmol/L, ALT, AST, GGT in control group were 187.00(64.00, 335.50) U/L, 104.00(53.50, 355.00) U/L, 299.00(136.50, 455.00) μmol/L, after 3 days antibiotic therapy and hepatoprotective therapy, ALT, AST, GGT in surgical group were 77.50(52.00, 111.00) U/L, 41.50(33.00, 53.75) U/L, 190.50(65.00, 372.00) μmol/L, ALT, AST, GGT in control group were 67.00(23.50, 129.50) U/L, 37.00(26.00, 61.50) U/L, 187.00(90.50, 337.00) μmol/L, levels of the two groups decreased significantly( P<0.05). There was no statistically significant difference in the length of hospital stay between the surgical group and the control group[(12.89±3.41) d vs (11.05±4.57) d, P>0.05]. After 12 months of follow-up, Gallstone-related events after discharge, the incidence of gallstone-related emergency in the surgical group was lower than that in the control group (5.6% vs 33.3%), the rehospitalization rate in the surgical group was significantly lower than that in the control group (5.6% vs 42.9%), there was statistically significant difference between the two groups ( P<0.05). Conclusion:Hepatoprotective therapy and antibiotic therapy and can effectively reduce the liver enzyme indexes of such patients in a short period of time, early surgical treatment after liver enzymes has decreased is a complete and safe option.

We presented an adolescent with recurrent intracranial hemorrhage and skin lesion. The diagnosis was unclear and the treatment was difficult. Through a multidisciplinary effort type Ⅰ interferon disease was suspected and later, an interferon-stimulated gene was further detected. Considering the high morbidity and fatality rate of recurrent intracranial hemorrhage, tofacitinib and hydroxychloroquine were administered. After treatment, the livedo reticularis was significantly regressed. Unfortunately, the intracranial hemorrhage recurred due to a pre-existing cerebral aneurysm, leading to death of the patient. The diagnosis and treatment of this case highlight the importance of multidisciplinary collaboration in the diagnosis and treatment of difficult and rare diseases.

A 15-year-old female was referred to the hospital with intermittent fever, where multiple systemic abnormalities were found, such as splenomegaly, secondary hypersplenism, retinitis pigmentosa, and ectodermal dysplasia. Medical history revealed that she had suffered recurrent respiratory infections, blurred vision at night, and dysplasia of teeth and nail beds since childhood. Then she was suspected to be experiencing ROSAH syndrome, a rare disease newly recognized in recent years, which was finally confirmed by gene sequencing results. During a course of treatment with tumor necrosis factor inhibitors, recurrent fever with elevated inflammatory markers reappeared, and the child developed headaches. To guide the comprehensive treatment and improve the patient's quality of life, the multidisciplinary team in Peking Union Medical College Hospital discussed together and directed the following treatment.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective: To establish a microwave scattering parameter acquisition system to detect cerebral hemorrhage and cerebral ischemia animal models, and to study the non-contact rapid identification methods for the two stroke types. Methods: Rabbits were selected for modeling. Eight rabbits in the cerebral hemorrhage group were injected with autologous blood. Six rabbits in the cerebral ischemia group were treated with bilateral common carotid artery clamping and femoral artery bleeding. The measurement excitation source has a scanning frequency range of 300 kHz to 3 GHz and an intermediate frequency bandwidth of 30 kHz. The signal of the S21 phase was acquired. The collected microwave scattering signals were subjected to mean filtering, principal component analysis dimension reduction, and mean clustering and nearest neighbor analysis to realize the identification of stroke types. Results: The microwave scattering measurement method can reflect the changes of cerebral hemorrhage and cerebral ischemia. The phase of S21 decreases with the increase of blood loss and increases with the increase of ischemic duration. The results of the differential experiment showed that all 14 models were correctly identified. Conclusions The stroke identification system based on microwave scattering measurement can effectively distinguish rabbit cerebral hemorrhage model and ischemic model. This technology is low cost, portable non-invasive, simple operation and fast, which make it be a promising method for identifying pre-hospital stroke types.

Objective To characterize the brain microstructure changes of amyotrophic lateral sclerosis (ALS) patients with various levels of cognitive impairment as measured by diffusion tensor imaging (DTI).Methods A total of 55 ALS patients and 20 healthy controls (HC) were enrolled in the Department of Neurology of Peking Union Medical College Hospital From September 2013 to March 2017,and all participants underwent neuropsychological assessments and DTI scans.According to their cognitive performance,ALS patients were further subclassified into ALS with normal cognition (ALS-Cn,n =27),ALS with cognitive impairment (ALS-Ci,n =17) and ALS-frontotemporal dementia (ALS-FTD,n =11)subgroups.Comparisons of voxel-based and atlas-based fractional anisotropy (FA) and mean diffusivity (MD) data were conducted among the four subgroups.Results In the voxel-based analyses,the FA showed significant differences in cingulate gyms,corpus callosum,brain stem and cerebellum,and MD showed significant differences in bilateral frontal lobe,temporal lobe,cingulate gyms,corpus callosum,and cerebellum among the four subgroups.Besides,when compared to ALS-Ci,ALS-Cn and HC groups in the order,the areas of involvement were larger and differences were more significant in ALS-FTD group.In the atlas-based analyses,the FA and MD of the corticospinal tracts revealed no difference within the patients groups,but decreased FA and increased MD were found compared to HC group.The ALS-IFD patients manifested widespread white matter fiber integrity damage and microstructure impairment in the extramotor areas compared to other three groups.Conclusion The brain white matter structural patterns of ALS patients correlate with their cognitive function,and there is a gradient of alterations across the ALS-Cn,ALS-Ci and ALS-FTD continuum.