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.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate our self-designed pre-positioned 3D honeycomb guide device in the internal fixation with percutaneous cannulated screws for femoral neck fractures.Methods:A retrospective study was conducted to analyze the data of 60 patients with femoral neck fracture who had been treated with cannulated screw fixation at Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from June 2019 to June 2022. According to the difference in intraoperative positioning for placement of cannulated screws, the patients were divided into a study group of 30 cases whose placement of cannulated screws was assisted by our self-designed pre-positioned 3D honeycomb guide device, and a control group of 30 cases whose cannulated screws were positioned freehand. In the study group, there were 17 males and 13 females with an age of (44.9±9.2) years, and 2 cases of type Ⅱ, 18 cases of type Ⅲ, and 10 cases of type Ⅳ by the Garden classification. In the control group, there were 11 males and 19 females with an age of (43.5±7.9) years), and 1 case of type Ⅱ, 16 cases of type Ⅲ, and 13 cases of type Ⅳ by the Garden classification. Closed reduction and inverted triangle internal fixation with 3 cannulated screws were conducted for all fractures. The Garden crossline index, operation time, fluoroscopy frequency, needle drillings, fracture healing time, and Harris hip functional score at the last follow-up were compared between the 2 groups. The postoperative imaging indicators in the 2 groups were measured, including screw spacing, distance from screw to neck cortex, screw coverage area, parallel deviation between screws, and deviation from screw to neck axis.Results:There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (14.4±1.9) months after surgery. In the study group, operation time [(33.1±5.5) min], fluoroscopy frequency [(13.7±2.2) times], needle drillings [(3.7±0.6) times], distance from screw to neck cortex [(12.4±2.8) mm], parallel deviation between screws in the anteroposterior view (2.2°±1.1°), parallel deviation between screws in the lateral view (2.4°±1.0°), deviation from screw to neck axis in the anteroposterior view (4.0°±0.9°) and deviation from screw to neck axis in the lateral view (3.2°±0.8°) were all significantly smaller than those in the control group [(46.5±8.6) min, (23.1±5.2) times, (11.0±2.2) times, (19.0±3.3) mm, 6.5°±2.6°, 7.1°±2.9°, 7.7°±2.6°, and 9.2°±3.1°] (all P<0.05). The screw spacing [(45.7±5.8) mm] and screw coverage area [(74.1±10.9) mm 2] in the study group were both significantly larger than those in the control group [(31.3±7.7) mm and (55.5±9.0) mm 2] ( P<0.05). There was no statistically significant difference between the 2 groups in Garden crossline index, fracture healing time, follow-up time, or Harris hip functional score at the last follow-up ( P>0.05). Follow-ups revealed 1 case of bone non-union in the study group and 2 cases of bone non-union and screw withdrawal in the control group, but no such complications as infection, deep vein thrombosis, screw penetration or rupture, or femoral head necrosis in either group. Conclusion:In the internal fixation with percutaneous cannulated screws for the treatment of femoral neck fractures, our self-designed pre-positioned 3D honeycomb guide device can shorten surgical time, significantly reduce fluoroscopy frequency and needle drillings, and effectively improve accuracy of screw placement.

ObjectiveThis study aimed to evaluate the clinical efficacy of Ruyi Zhenbaowan（RYZBW）in the treatment of initial and early knee osteoarthritis （KOA） through a prospective multicenter，randomized，double-blind，and placebo-parallel controlled trial. MethodFrom October 13^th， 2021 to December 25^th， 2021， 240 KOA subjects meeting the acceptance criteria were enrolled in 15 sub-centers including Wangjing Hospital， Chinese Academy of Chinese Medical Sciences， and they were randomly divided into observation group and control group， with 120 cases in each group. The intervention measures for the observation group were RYZBW + health education， and the intervention measures for the control group were RYZBW placebo + health education. The intervention period in both groups was four weeks， and they were followed up for four weeks after the intervention. The primary outcome measure was the total score of Western Ontario and McMaster University Osteoarthritis Index score （WOMAC score）， and the secondary outcome measures were the response rate of visual scale （VAS） pain score， WOMAC sub item scores （joint pain， joint stiffness， and joint function）， quality of life （SF-12） score， and traditional Chinese medicine （TCM） syndrome score. Result（1） Efficacy evaluation. The marginal model results showed that the observation group was better than the control group in improving the WOMAC total score and WOMAC pain score in the treatment of KOA with RYZBW， and the difference was statistically significant （P<0.05）. There was no significant difference between the two groups in improving VAS score response rate， WOMAC function score， WOMAC stiffness score， SF12-PCS （quality of life-physical health） score， SF12-MCS （quality of life-mental health） score， and TCM syndrome score. （2） Subgroup analysis. ① In terms of VAS score response rate， the response rate of the observation group was higher than that of the control group for subjects with baseline VAS score of （4， 5］， and the difference was statistically significant （P<0.05）. ② In terms of TCM syndrome score， for subjects aged ［56， 60］ and ［61， 65］， the decrease in total TCM syndrome score in the observation group was better than that in the control group， and the difference was statistically significant （P<0.05）. ConclusionTibetan medicine RYZBW has good clinical efficacy in improving WOMAC total score， VAS score response rate， WOMAC pain score， WOMAC function score， and TCM syndrome score for patients with initial and early KOA， which can fill the lack of Tibetan medicine RYZBW in the treatment of KOA and make a demonstration study for the inheritance and development of ethnic medicine.

As a new transdermal drug delivery system, microneedles can significantly improve skin permeability, enhance drug transdermal delivery, and demonstrate unique advantages in breaking stratum corneum barrier of skin. This feature enables microneedles to demonstrate enormous potential in delivering biotechnology drugs. The traditional delivery method for biotechnology drugs is mainly injection, which brings problems such as pain and skin redness to patients, leading to poor patient compliance. In addition, the production, transportation, and storage of biotechnology drugs require strict low-temperature conditions to maintain their activity and increase cost output. Microneedles, by contrast, have many benefits, providing new avenues and solutions for biomolecular delivery. Accordingly, this review introduced the microneedle drug delivery system for delivery biotechnology drugs, and summarized the research progress of microneedle systems in biotechnology drugs.

Objective:To explore the use of near-infrared autofluorescence probe (NIRAF-P) and its application in identifying parathyroid glands during surgery.Methods:A total of 68 patients undergoing thyroid surgery at Peking Union Medical College Hospital and Beijing Longfu Hospital between Dec. 2023 and Jun. 2024 were selected. During the operation, the near-infrared parathyroid gland detector was used to identify the parathyroid gland tissue to be tested, and histopathological examination was performed. The positive predictive value and accuracy of the near-infrared parathyroid gland detector were analyzed.Results:A total of 111 parathyroid glands were identified in 68 patients, and the positive predictive value and accuracy of the NIRAF-P were 95.5% and 94.6%, respectively.Conclusions:The NIRAF-P has high accuracy in identifying parathyroid glands. The standardized application of the NIRAF-P can help improve the efficiency of identifying parathyroid glands during surgery.

Objective: To assess the efficacy and safety of combining traditional Chinese medicine (TCM), specifically Chinese herbal medicine (CHM), with Western medicine (WM), compared to WM alone to treat breast cancer endocrine therapy-related osteoporosis (BCET-OP) by meta-analysis. Methods: Thirty-eight randomized controlled trials involving 2170 participants were analyzed. Eight databases were searched for articles published between inception and December 2023. Quality assessment was performed using the Risk of Bias 2 tool. Results: Significant increases were observed in the TCM-WM group in lumbar vertebrae bone mineral density (BMD) (P < .001, mean difference (MD) = 0.07, 95% confidence interval (CI): 0.06 to 0.08), lumbar vertebrae T-score (P = .0005, MD = 0.21, 95%CI: 0.09 to 0.33) and collum femoris BMD (P = .01, MD = 0.10, 95%CI: 0.02 to 0.19). No significant difference was observed between the groups in the collum femoris T-score and estradiol levels. Bone gla-protein levels were significantly increased in the TCM-WM group (P = .0002, MD = 0.52, 95%CI: 0.25 to 0.79). Beta-CrossLaps decreased significantly in the TCM-WM group (P = .0008, MD = −0.10, 95%CI: −0.16 to −0.04). No significant difference was observed between the TCM-WM and WM groups in alkaline phosphatase, in procollagen type I N-terminal propeptide, and in the Kupperman index. The visual analog score (VAS) was decreased in the TCM-WM group compared to the WM group (P < .001, MD = −1.40, 95%CI: −1.94 to −0.87). No significant difference in adverse events was observed between the two groups. Conclusion Combining CHM with WM in patients with BCET-OP significantly improved BMD, T-score, and certain bone turnover markers and reduced the VAS score, indicating potential benefits for bone health and related pain. Adverse event analysis revealed no differences between the groups, supporting the feasibility of the combination therapy. However, further research, particularly in diverse populations, is required.

Objective:In order to improve the staff's ability to deal with public health emergencies, a third-class hospital in Beijing has made efforts to improve the emergency response ability of all staff members to achieve zero infection, and to carry out vocational training and assessment of all staff.Methods:The instructional system design (ISD) model system is used to design the training course. The online learning, electronic examination paper assessment and on-site training of people in the hospital were analyzed by Excel and SPSS 22.0.Results:After training, the average scores of trainees increased from 84 points to 100 points, and the average answering time was shortened from 308 s to 179 s. There were differences in the assessment scores before and after training for personnel with different professional titles, and there were differences in the assessment scores before and after training for personnel between different departments.Conclusion:In case of public health emergency, it is necessary to train and assess the whole staff. The application of ISD model is helpful to make training plan quickly. The application of online learning assessment is the first effective way of emergency training.

The Health-Related Quality of Life (HRQoL) pertains to patients' subjective contentment concerning their physical, psychological, and social well-being throughout disease treatments. Predominantly employed HRQoL metrics in spinal metastases comprise the 36-item Short-Form Health Survey (SF-36), EuroQoL Five Dimensions Questionnaire (EQ-5D), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and the Functional Assessment of Cancer Therapy-General (FACT-G). In clinical applications, due to their broad application and diverse disease types, combined with the lack of specificity in the scale content and the prolixity of their questionnaires, these tools often fail to capture the nuanced experiences of patients, thereby compromising the reliability and validity of the results. The Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ), developed by the Spine Oncology Study Group, offers a tailored metric for spinal metastases, encapsulating both specificity and inclusivity. Its proven robust reliability and validity make it invaluable for decision-making and therapeutic efficacy appraisals. The Patient-Reported Outcome Measurement Information System (PROMIS), a novel metric suitable across many medical disciplines, facilitates cross-sector data acquisition, substantially augmenting the precision, sensitivity, and credibilityof assessments, and is pivotal in clinical investigations and interventions. As it continually evolves, PROMIS consistently outperforms traditional metrics in evaluative capacities, exhibiting impressive and consistent proficiency in prognostications, preoperative assessments, and therapeutic outcome evaluations within the spinal metastasis domain. Presently, Chinese research on the HRQoL of spinal metastasis patients remains scant, and choosing an apt, precise, and dependable metric holds significant clinical relevance. Drawing upon extant scholarly publications, this review concluded the current global HRQoL tools for spinal metastases, aiming to furnish insights for the clinical management and research pertaining to spinal metastases.

Objective:To establish a method for correction of tail vein extravasation based on PET images and to improve the accuracy of SUV.Methods:The simulation method was established by phantom on Nano PET/CT and images were reconstructed by a three-dimensional ordered-subsets exception maximum algorithm. PET images were analyzed by using the Interview Fusion 1.0 software. The optimal scanning time and the ROI delineated method were found. The accuracy of the simulation method was verified by comparing the activity of simulation method with the mice tail activity measured by the dose calibrator directly on Kunming (KM) mouse ( n=11). Using the simulation method, the impact of extravasation on SUV was proved. Independent-sample t test was used to analyze data. Results:Ten minutes was selected as the optimal scanning time and SUV max 42% threshold was selected as the ROI delineated method. The specific correction formula was as follows: actual activity=image activity/(4.48× V+ 77.05)×100 (0.3 MBq/ml≤leakage concentration<6.5 MBq/ml); actual activity=image activity/(6.65× V+ 71.10)×100 (6.5 MBq/ml