Objective To evaluate the radiation impact of a self-developed digital miniature CT on the human body and the environment under simulated scanning conditions, and verify its safety and regulatory compliance. Methods Under typical head scanning conditions with the digital miniature CT (70 kV/10 mA), the equivalent doses received at the body surface sites corresponding to the thyroid, breast, stomach, liver, kidney, and gonads of the phantom were measured without protection and with 0.5 mmPb equivalent protection using LiF (Mg, Cu, P) thermoluminescent dosimeters. The ambient dose equivalent rates at the bed level inside the CT room at different directions and distances from the scanning center were measured using a model AT1121 X/γ dosimeter. The equivalent doses of organs on both sides of the phantom and the ambient equivalent dose rates on the left and right sides of the longitudinal axis of the bed in the CT room were compared. The Mann-Whitney test was used at a significance level of P < 0.05. Results During a single scan of the head with the digital miniature CT, the equivalent doses at the body surface sites corresponding to the thyroid, breast, stomach, liver, kidney, and gonads without protection were 1.04, 0.95, 0.55, 0.57, 0.40, and 0.12 mSv, respectively, which were only 0.84% to 8.24% of the doses inside the irradiation field. With 0.5 mm Pb equivalent protection, the equivalent dose of the thyroid decreased from 8.24 mSv to 3.27 mSv with a reduction of 60.3%, and the doses of the other organs were reduced to 1.5-11.5 μSv with the maximum reduction of 14 times. In the longitudinal axis direction of the CT bed, the ambient dose equivalent rate at a distance of 2 m from the scanning center was reduced to 0.066 mSv/h, which was only 9.6% of the ambient equivalent dose rate at a distance of 50 cm from the scanning center. Conclusion The digital miniature CT has advantages in ensuring patient safety, optimizing imaging quality, and promoting technological development, demonstrating promising application potential. However, the radiation protection of personal and CT room should not be ignored.

Objective:To analyze the status of registration of clinical trials of radiopharmaceuticals in China, and to provide reference for the development and clinical application of radiopharmaceuticals.Methods:By searching the clinical trial registration and information disclosure platform of the Center for Drug Evaluation of the National Medical Products Administration (NMPA), the data on clinical trials of radiopharmaceuticals registered from 2014 to 2024 were collected and analyzed for trial design, administered dose, common indications, and geographical distribution.Results:A total of 77 clinical trials were included. The Compound Annual Growth Rate for the number of projects from 2014 to 2024 was 40%. Diagnostic radiopharmaceuticals were predominantly based on 18F and 99Tc m, while therapeutic radiopharmaceuticals primarily utilized 177Lu and 90Y. All indications were concentrated in the field of oncology. Regarding trial design, non-randomized (71.4%), open-label (89.6%), and single-arm (66.2%) trials accounted for the highest proportions. Geographical distribution showed Beijing (29 trials), Shanghai (18 trials), and Jiangsu province (14 trials) as the regions with the highest concentration of clinical trials. Conclusions:Radiopharmaceutical clinical trials in China have shown rapid growth. However, research remains predominantly focused on oncology, with a relatively high proportion of early-stage trials. In order to fully utilize the potentials of radiopharmaceuticals and improve the quality of clinical trials, nuclear medicine researches should broaden therapeutic applications, implement prudently administerd dose in clinical trials, and implement optimized radiation protection procedures across all clinical trial centers.

Objective To explore the relationship the changes of Doppler ultrasound parameters before and after thrombolytic therapy in the patients with acute lower extremity deep venous thrombosis and the prognosis.Methods A total of 100 patients with acute lower extremity deep venous thrombosis from Decem-ber 2022 to December 2024 were enrolled,given the thrombolytic therapy and received Doppler ultrasound ex-amination before and after treatment.The sonographic manifestations of the affected side detected by color Doppler ultrasound before treatment were statistically analyzed,and the changes of Doppler ultrasound param-eters of the affected side[end-diastolic velocity(EDV),peak systolic velocity(PSV),vascular resistance index(RI),vascular diameter at the lesion site]were compared between before and after treatment.According to whether pulmonary embolism occurred after thrombolysis,the patients were divided into the embolization group(n=29)and non-embolization group(m=71).The Doppler ultrasound parameters of the affected side before treatment were compared between the two groups.The binary logistic equation was adopted to analyze the related influencing factors of pulmonary embolism occurrence in the patients.The receiver operating char-acteristic(ROC)curve was used to analyze the predictive value of ultrasound parameters on pulmonary em-bolism.Results After thrombolytic therapy for the affected limb with acute lower extremity deep venous thrombosis,EDV,PSV and vascular diameter at the lesion site were decreased significantly,RI was increased significantly(P＜0.05).Before treatment,EDV.PSV,vascular diameter and the proportion of thrombus grade Ⅳ at the lesion site in the embolization group were significantly higher than those in the non-emboliza-tion group,the RI was significantly lower than that in the non-embolization group(P＜0.05).EDV,PSV,RI and the vascular diameter at the lesion site all were related to the occurrence of pulmonary embolism(P＜0.05).The areas under the curves(AUC)of SEDV,PSV,RI and vascular diameter at the lesion site in predic-ting the pulmonary embolism occurrence in the patients with acute lower extremity deep venous thrombosis were 0.690,0.717,0.649 and 0.662 respectively.The AUC of the 4-items combination in diagnosing the poor prognosis of the patients was 0.829,and the combined diagnostic value was higher.Conclusion EDV,PSV,vascular diameter and RI could predict the risk of pulmonary embolism occurrence after thrombolytic therapy in the patients with acute lower extremity deep venous thrombosis.

Objective To construct an evaluation index system for rational drug use management of key monitoring drugs,and to provide references for medical institutions.Methods The preliminary index framework was formed by researching the policies and regulations,management norms,and guiding principles related to key monitoring drugs.Two rounds of Delphi questionnaire survey were conducted with 26 experts to improve and optimize the index system.The weights of the indicators were obtained by constructing the judgment matrix by analytic hierarchy process(AHP).Results The recovery rates of the two rounds of questionnaire were both 100％,and the authority coefficient was 0.87.The key monitoring drug rational use management evaluation index system was finally constructed to include three primary indicators[ex-ante management(0.253 6),in-process management(0.503 1),and ex-post management(0.243 2)],15 secondary indicators[including prescription review(0.302 6),formulate rational drug use norms(0.133 1),supernormal early warning management(0.103 2)],and 62 tertiary indicators[inclu-ding formulate strict prescription review rules(0.152 5),pharmacists prescription intervention strength(0.085 7)and effective-ness management(0.052 5)].and the index judgment matrix passed the consistency test.Conclusion The evaluation index system for the rational drug use management of key monitoring drugs constructed can satisfy the closed loop of the supervision and management process,achieve the prior reminder,monitoring,and post-supervision,and provide references for medical institutions to ensure the refinement and standardization of the management process.

Objective:To analyze the status of registration of clinical trials of radiopharmaceuticals in China, and to provide reference for the development and clinical application of radiopharmaceuticals.Methods:By searching the clinical trial registration and information disclosure platform of the Center for Drug Evaluation of the National Medical Products Administration (NMPA), the data on clinical trials of radiopharmaceuticals registered from 2014 to 2024 were collected and analyzed for trial design, administered dose, common indications, and geographical distribution.Results:A total of 77 clinical trials were included. The Compound Annual Growth Rate for the number of projects from 2014 to 2024 was 40%. Diagnostic radiopharmaceuticals were predominantly based on 18F and 99Tc m, while therapeutic radiopharmaceuticals primarily utilized 177Lu and 90Y. All indications were concentrated in the field of oncology. Regarding trial design, non-randomized (71.4%), open-label (89.6%), and single-arm (66.2%) trials accounted for the highest proportions. Geographical distribution showed Beijing (29 trials), Shanghai (18 trials), and Jiangsu province (14 trials) as the regions with the highest concentration of clinical trials. Conclusions:Radiopharmaceutical clinical trials in China have shown rapid growth. However, research remains predominantly focused on oncology, with a relatively high proportion of early-stage trials. In order to fully utilize the potentials of radiopharmaceuticals and improve the quality of clinical trials, nuclear medicine researches should broaden therapeutic applications, implement prudently administerd dose in clinical trials, and implement optimized radiation protection procedures across all clinical trial centers.

Objective To construct an evaluation index system for rational drug use management of key monitoring drugs,and to provide references for medical institutions.Methods The preliminary index framework was formed by researching the policies and regulations,management norms,and guiding principles related to key monitoring drugs.Two rounds of Delphi questionnaire survey were conducted with 26 experts to improve and optimize the index system.The weights of the indicators were obtained by constructing the judgment matrix by analytic hierarchy process(AHP).Results The recovery rates of the two rounds of questionnaire were both 100％,and the authority coefficient was 0.87.The key monitoring drug rational use management evaluation index system was finally constructed to include three primary indicators[ex-ante management(0.253 6),in-process management(0.503 1),and ex-post management(0.243 2)],15 secondary indicators[including prescription review(0.302 6),formulate rational drug use norms(0.133 1),supernormal early warning management(0.103 2)],and 62 tertiary indicators[inclu-ding formulate strict prescription review rules(0.152 5),pharmacists prescription intervention strength(0.085 7)and effective-ness management(0.052 5)].and the index judgment matrix passed the consistency test.Conclusion The evaluation index system for the rational drug use management of key monitoring drugs constructed can satisfy the closed loop of the supervision and management process,achieve the prior reminder,monitoring,and post-supervision,and provide references for medical institutions to ensure the refinement and standardization of the management process.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

[Objective]To summarize and analyze the educational quality and problems of Traditional Chinese Medicine students in Zhejiang Chinese Medical University,and provide reference for improving the teaching quality and students'clinical knowledge and skills.[Methods]Taking the students of Traditional Chinese Medicine who participated in the step-1 medical licensing examination empirical research in Zhejiang Chinese Medical University from 2018 to 2020 as the research objects,the data was analyzed by variance analysis and χ2 test.[Results]Staged examination scores could reflect students'academic performance,the average passing rate of theoretical examination was 68.64%,and the average passing rate of skill assessment was 95.27%.The average total mastery rate of theoretical examination was 65.06%,including basic medicine(55.57%)and clinical medicine(52.12%),whose comparison with the total mastery rate of theoretical examination was statistically significant(P<0.05).The total mastery rate of skill assessment was 76.57%,and the average mastery rates of stations 3～4(physical examination)were 71.24%and 72.24%,whose comparison with the total mastery rate of skill assessment was statistically significant(P<0.05).It proposed improvement measures and strategies such as establishing exam incentive mechanisms to enhance students'internal motivation in exams,strengthening clinical medicine course training to improve staged examination pass rates of theoretical part,and repeatedly training clinical skills to fill the gaps in skill assessment.[Conclusion]Traditional Chinese medicine universities can improve the clinical knowledge and skills of students by establishing examination incentive mechanisms,strengthening clinical medicine course training and repeating clinical skill training,so as to improve the quality of training for students majoring in Traditional Chinese Medicine.

Objective:To investigate the current situation of medical equipment allocation in 103 tertiary public hospitals,analyze and compare the proportion of medical equipment in different regional hospitals in our country,and provide basis for scientific and reasonable allocation of medical equipment.Methods:A questionnaire was designed by literature research and expert consultation,and an electronic questionnaire was released through the public account of"China Medical Equipment"and the platform of"Good Medical Workers"to analyze the correlation between the number of medical equipment configuration,the proportion of domestic products,the region where the hospital was located and the number of hospital beds.Results:A total of 103 valid questionnaires were collected,involving 103 tertiary public hospitals in East China,North China,Central China,South China,Southwest,Northwest and Northeast China,of which 18%were in North China,37%were in East China and 9%were in South China.In North China,South China and East China,the average number of medical equipment in the tertiary public hospitals in the region was 9785 units per hospital,9245 units per hospital and 8153 units per hospital,and the number of the expensive equipment was relatively small,which had no correlation with the number of beds.There were statistically significant differences between North China and East China in the number of beds,the number of pieces of equipment per 100 beds and the amount of equipment per 100 beds(t=-2.582,2.939,4.653,P＜0.05).The number of life support equipment configuration was significantly positively correlated with the number of beds,and the domestic share,especially the domestic share of life support equipment,increased.Conclusion:The analysis of medical equipment allocation in public hospitals in China can provide data support for hospitals to better adapt to the adjustment of the new expensive medical equipment catalogue,provide reference for the demonstration and promotion of large medical equipment allocation and localization in tertiary hospitals,and provide reference for relevant health management departments.

OBJECTIVE To optimize the rivaroxaban dosing regimen for anticoagulation in patients with different renal function levels.METHODS The administration regimen was determined based on the drug instructions for rivaroxaban and the actual medication situation of the patient.The target concentration range and the subsection interval were established using rivaroxaban blood minimum concentration for patients from Hebei General Hospital and reference range of rivaroxaban laboratory monitoring concentration recommended by International Council for Standardization in Hematology.The probability of different dosing regimens in each target concentration range was investigated with Monte Carlo simulation using Oracle Crystal Ball software(V11.1.2.4).RESULTS A total of 97 patients with non-valvular atrial fibrillation were enrolled and the minimum concentration of rivaroxaban was tested 125 times with a median trough concentration of 32.2 ng/mL;a total of 121 patients with venous thrombosis were enrolled and the minimum concentration was tested 159 times with a median minimum concentration of 31.0 ng/mL.The reference range for steady-state minimum concentration in patients with non-valvular atrial fibrillation was 12-137 and 3-153 ng/mL,while the reference range for steady-state minimum concentration in patients with venous thrombosis was 6-239 and 3-224 ng/mL.Monte Carlo simulation results showed that in patients with non-valvular atrial fibrillation,the optimal rivaroxaban dosing regimen for patients with glomerular filtration rate(eGFR)0-30 mL/min was 5 mg once daily;for patients with eGFR＞30-60 mL/min,the optimal dosing regimen was 10-20 mg once daily or 5 mg twice daily;for patients with eGFR＞60-90 mL/min,the optimal dosing regimen was 15-30 mg once daily or 5-10 mg twice daily;for patients with eGFR＞90-120 mL/min,the optimal dosing regimen was 25-30 mg once daily or 5-15 mg twice daily.For patients with venous thrombosis,it is not recommended to use rivaroxaban more than 5 mg once daily for patients with eGFR 0-30 mL/min;the optimal dosing regimens of rivaroxaban were 5 mg once daily for patients with eGFR＞30-60 mL/min,25-30 mg once daily or 5-15 mg twice daily for patients with eGFR＞60-90 mL/min,10-15 mg twice daily for patients with eGFR＞90-120 mL/min.CONCLUSIONS Rivaroxaban should be selected carefully as the anticoagulants for patients with severe renal function impairment.Rivaroxaban possesses a wide reference range in the minimum concentration and considerable individual variability.The dosage and frequency of rivaroxaban can be personalized through the Monte Carlo simulation method,taking into account patients'renal function.