Objective:To investigate the doses received by radiation workers from external and internal exposures during the production of 125I seed source, and to provide scientific basis for accurate evaluation of the annual doses of radiation workers. Methods:The production site and radiation workers of a 125I seed source production enterprise were determined as the survey objects. An AT1121 X/γ dosimeter was used to measure the ambient dose equivalent rate on the operation site such as welding and cleaning of the seed source, and the dose received by workers from external exposure was estimated. LiF (Mg, Cu, P) TLD dosimeters were used to measure the external doses to workers in a specific period. The doses obtained by the two method were compared and analyzed. The RG-50 air sampler and TC-30 iodine box were used to collect the workplace air, The activity concentration of 125I in the air was measured by using of the BE5030 high-purity germanium gamma spectrometer to estimate the internal dose to workers. The evaluation of doses was performed in accordance with the national standards GBZ 128-2019 and GBZ 129-2016. Results:The estimated annual dose to the worker′ hands is 24.5 mSv/year. The estimated maximum dose was 2.61 mSv/year. The maximum value of individual dose monitored was 2.42 mSv/year, basically consistent with the measured value on the basis of considering the actual work rotation. The maximum estimate of committed effective dose from internal exposure was 1.55 mSv, by a factor of up to 17 times the estimated external dose at the corresponding post.Conclusions:The radiation dose to the radiation workers’ hands is relatively high in the production of 125I seed source, so the protective measures for hands should be effectively strengthened. Meanwhile, the internal dose to the workers in the production process of 125I seed source should not be negelected. The ventilation of the site should be strengthened, the air flow direction should be planned, and the 125I activity concentration in the air should be regularly monitored.

Pre-admission is a critical initiative to optimize medical service processes and alleviate the challenge of "difficult access to healthcare. "However, there is currently a lack of standardized protocols for pre-admission procedures. This study aims to systematically analyze key nodes and risk factors in pre-admission process design and propose optimization strategies, providing a foundation for policy formulation and hospital practices. By constructing a "forward-reverse" dual-process model of pre-admission and identifying risk points based on stakeholder theory (patients, hospitals, healthcare administration, and insurance), the study reveals that while pre-admission can reduce the average length of stay, improve bed turnover rates, and enhance patient satisfaction, it also presents risks such as cross-period financial settlement, challenges in insurance policy adaptability, demands for information system integration, and the need for defining medical safety boundaries. To optimize the pre-admission process and mitigate these risks, this study explores framework improvements in areas including eligibility criteria, mode selection, cost settlement, transition between pre-admission and inpatient status, and cancellation of pre-admission, offering practical guidance for public hospitals. The authors argue that pre-admission requires tripartite collaboration among hospitals, insurers, and healthcare administrations: hospitals should establish top-level design, continuously refine processes, and implement dynamic risk assessment mechanisms; insurance providers should support cross-period settlement policies; and healthcare administrations should issue guiding policies or standardized protocols. Through multi-department coordination and collaborative efforts, the optimization and innovation of pre-admission processes can be advanced, ultimately delivering more efficient and convenient healthcare experiences for patients.

Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

Objective:To investigate the doses received by radiation workers from external and internal exposures during the production of 125I seed source, and to provide scientific basis for accurate evaluation of the annual doses of radiation workers. Methods:The production site and radiation workers of a 125I seed source production enterprise were determined as the survey objects. An AT1121 X/γ dosimeter was used to measure the ambient dose equivalent rate on the operation site such as welding and cleaning of the seed source, and the dose received by workers from external exposure was estimated. LiF (Mg, Cu, P) TLD dosimeters were used to measure the external doses to workers in a specific period. The doses obtained by the two method were compared and analyzed. The RG-50 air sampler and TC-30 iodine box were used to collect the workplace air, The activity concentration of 125I in the air was measured by using of the BE5030 high-purity germanium gamma spectrometer to estimate the internal dose to workers. The evaluation of doses was performed in accordance with the national standards GBZ 128-2019 and GBZ 129-2016. Results:The estimated annual dose to the worker′ hands is 24.5 mSv/year. The estimated maximum dose was 2.61 mSv/year. The maximum value of individual dose monitored was 2.42 mSv/year, basically consistent with the measured value on the basis of considering the actual work rotation. The maximum estimate of committed effective dose from internal exposure was 1.55 mSv, by a factor of up to 17 times the estimated external dose at the corresponding post.Conclusions:The radiation dose to the radiation workers’ hands is relatively high in the production of 125I seed source, so the protective measures for hands should be effectively strengthened. Meanwhile, the internal dose to the workers in the production process of 125I seed source should not be negelected. The ventilation of the site should be strengthened, the air flow direction should be planned, and the 125I activity concentration in the air should be regularly monitored.

Background ¹³⁷Cs in atmospheric aerosol is the product of past nuclear weapon tests and nuclear accidents. When ¹³⁷Cs is released into the atmosphere, it will deposit in dry land and marine environment, causing pollution of soil surface, water, agricultural products, and animal byproducts, and affecting public health. Objective To identify the variation pattern of ¹³⁷Cs activity concentration in aerosol and its correlation with dust concentration in Beijing area from 2017 to 2020. Methods A total of 958 aerosol samples were collected from November 1, 2017 to June 30, 2020 in Beijing with a high volume air sampler at a sampling flow rate about 600 m³·h⁻¹ and a collection time for each sample about 24 h. The activity concentration of ¹³⁷Cs in the aerosol samples was determined with a low-background high-purity germanium γ spectrometer. The dust concentration was calculated using the difference in the mass of the aerosol filter before and after sampling. The detection rate of ¹³⁷Cs and dust concentration in different seasons were compared. Spearman rank correlation test was used to analyze the correlation between ¹³⁷Cs activity concentration and dust concentration. Results From 2017 to 2020, the ¹³⁷Cs activity concentrations of 33 from 958 aerosol samples in Beijing were above the minimum detectable activityconcentration, the overall detection rate of ¹³⁷Cs was 3.4%, and the activity concentration ranged from 1.86 to 45.53 μBq·m⁻³, with a median value of 4.85 μBq·m⁻³. The detection rate of ¹³⁷Cs was highest in spring, followed by autumn, and lowest in winter and summer (8.4%, 3.0%, 1.1%, and 0.5%, respectively). The dust concentration ranged from 0.03 to 1.55 mg·m⁻³, with an average value of 0.18 mg·m⁻³. There was a statistically significant difference in the dust concentrations in spring, summer, autumn, and winter (F=45.51, P<0.05), and the highest value was 0.24 mg·m⁻³ in spring (P<0.05). The ¹³⁷Cs activity concentration was positively correlated with the dust concentration (P<0.05). Conclusion The ¹³⁷Cs activity concentration in aerosol in Beijing from 2017 to 2020 fluctuates within the range of background level, and its activity concentration is highest in spring, followed autumn, and lowest in summer and winter.

Based on the natures and flavors of herbal medicinals recorded in Shen Nong's Classic of the Materia Medica （《神农本草经》）； Miscellaneous Records of Famous Physicians （《名医别录》）， this study analyzed the characte-ristics of the natures， flavors and combination of medicinals of the two-herb compound formulas in Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）.Finally， 31 compound formulas were included， and it was found that the nature and flavor of the herbs in these two-herb compound formulas are closely related to the functions of the compound formulas， such as the common pairing of the acrid and the sweet herbs to warm yang and transform qi， the acrid and the bitter herbs in pairs to regulate and harmonize cold and heat， the sweet and the bitter in pairs to remove dampness and clear heat， the acrid and the acrid in pairs to arrest vomiting and direct qi downward， and the sour and the sweet in pairs to slow the urgent and relieve pain. Regardless of the deficiency or excess nature of the disease， the corresponding two-herb compound formulas often aim to reinforce healthy qi while eliminating pathogenic factors， with some formulas showcasing a unique correspondence between the disease pattern and the symptoms addressed.

Objective To explore the uranium concentration in surface water and drinking water in Beijing, China and the relationship between uranium concentration and gross α activity concentration. Methods Water samples were collected from 16 districts in Beijing. Uranium concentration and gross α activity concentration were measured with WGJ-III trace uranium analyzer and LB6008 six-channel α/β counter using the ultraviolet fluorescence and thick source methods. Results The uranium concentrations in surface water and drinking water were 1.131 and 1.572 μg/L, respectively. The gross α activity concentrations in surface water and drinking water were 0.059 and 0.074 Bq/L, respectively. There were no significant differences in uranium concentration and gross α activity concentration between surface water and drinking water (P > 0.05). The uranium concentration was positively correlated with the gross α activity concentration, with a correlation coefficient of 0.700 (P < 0.05). The gross α activity concentration was determined by the uranium concentration with a determination coefficient of 48%. The committed effective dose of ²³⁸U in drinking water was between 3.284 × 10⁻⁵ and 1.640 × 10⁻³ mSv, with an average value of 5.400 × 10⁻⁴ mSv. Conclusion The uranium concentration and gross α activity in the surface water and drinking water in Beijing fluctuate and remain in the background range. These values are much lower than the recommended limits of 0.03 mg/L and 0.5 Bq/L stipulated in the GB 5749-2021 Standard for Drinking Water Quality. The annual committed effective dose of ²³⁸U through drinking water ingestion is very small.

Objective To ensure the accuracy of gamma spectrometer in our laboratory for the analysis of radionuclides in samples and to improve the laboratory personnel’s ability to perform analyses of radionuclides. Methods Our laboratory had continuously participated in the national assessments of gamma spectrometry of radionuclides organized by the Chinese Center for Disease Control and Prevention. The samples were measured by a high-purity germanium gamma spectrometer (GEM-MX7080P4). An analysis was performed on the results of the gamma spectrometry assessments from 2014 to 2021. Results Our laboratory had an overall qualified rate of 100% (8/8) and an overall excellent rate of 39% (3/8) in the gamma spectrometry assessments from 2014 to 2021. The distribution ranges of RD, Z, U, and U_rel for 28 measurements involving radionuclides ²⁰⁸Tl, ²²⁸Ac, ²³²Th, ⁴⁰K, ²³⁸U, and ¹³⁷Cs were −11.82% to 5.97%, −0.59 to 0.30, 0.02 to 0.92, and 4.33% to 10.49%, respectively. Conclusion The methods used in our laboratory for gamma spectrometry of radionuclides are accurate and the testing reports issued by our laboratory are reliable.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a Chinese pedigree affected with Alström syndrome. METHODS: A pedigree with 5 members affected with Alström syndrome who had visited the First Affiliated Hospital of Zhengzhou University in February 2021 was selected as the study subject. Clinical data of the pedigree were collected, and peripheral venous blood samples were collected for the extraction of genomic DNA. Genetic testing was carried out for the eldest daughter and third son through whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The eldest daughter (14 years old) and the third son (11 years old) both had congenital nystagmus, amblyopia, growth retardation and type 2 diabetes. WES revealed that both had harbored homozygous c.3538A>T (p.Lys1180*) variant of the ALMS1 gene. Sanger sequencing confirmed that the father, mother, and second daughter were all heterozygous carriers. Based on the Guidelines for Genetic Variation and the Technical Standards for Interpretation and Reporting of Primary Copy Number Variations, the variant was predicted as pathogenic (PVS1+PM2_Supporting+PP4). CONCLUSION The homozygous c.3538A>T (p.Lys1180*) variant of the ALSM1 gene probably underlay the Alström syndrome in this pedigree, which has provided a reference for the clinical treatment.
Adolescent ; Child ; Humans ; Alstrom Syndrome/genetics* ; Diabetes Mellitus, Type 2 ; DNA Copy Number Variations ; East Asian People ; Pedigree ; Male ; Female