Objective To investigate the basic situation and occupational health conditions of nuclear medicine radiation workers in Jiangsu Province based on the research protocol developed by the Institute of Radiation Medicine, Chinese Academy of Medical Sciences for the nationwide study on the health effects of nuclear medicine radiation in China, understand the impact of occupational radiation on the physical health of nuclear medicine radiation workers, and provide a basis for improving the occupational protection of nuclear medicine radiation workers and reducing the risk of occupational radiation-related health issues. Methods A census approach was used to collect general data and occupational health information of nuclear medicine radiation workers in Jiangsu Province. The analysis focused on the abnormalities in physical examination indicators among radiation workers of different genders, ages, and working years to evaluate the health effects of occupational radiation exposure. Results The occupational health examination data of 472 nuclear medicine radiation workers were collected from 76 medical institutions in Jiangsu Province. The results showed that the detection rate of abnormal hypothyroidism in female workers (8.90%) was higher than that in male workers (2.54%) (P=0.028). With increasing working years, the detection rates of cataract and continuous decrease in white blood cell count increased (P＜0.001). The multivariate logistic regression identified working years as a risk factor for cataract and continuous decrease in white blood cell count (OR=1.59, 95%CI=1.40-3.35, P=0.0003; OR=4.15, 95%CI=3.11-29.91, P=0.0001). In addition, working years was also a risk factor for hypertension, fatty liver, and tumor (OR=2.28, 95%CI=1.51-3.47, P=8.76 × 10⁻⁵; OR=1.69, 95%CI=1.10-2.58, P=0.0145; OR=2.04, 95%CI=1.00-4.16, P=0.0469). Conclusion The study found that working in nuclear medicine could increase the risk of various radiation-related diseases, and the risk is influenced by factors such as working years.

Objective To investigate the basic situation and occupational health conditions of nuclear medicine radiation workers in Jiangsu Province based on the research protocol developed by the Institute of Radiation Medicine, Chinese Academy of Medical Sciences for the nationwide study on the health effects of nuclear medicine radiation in China, understand the impact of occupational radiation on the physical health of nuclear medicine radiation workers, and provide a basis for improving the occupational protection of nuclear medicine radiation workers and reducing the risk of occupational radiation-related health issues. Methods A census approach was used to collect general data and occupational health information of nuclear medicine radiation workers in Jiangsu Province. The analysis focused on the abnormalities in physical examination indicators among radiation workers of different genders, ages, and working years to evaluate the health effects of occupational radiation exposure. Results The occupational health examination data of 472 nuclear medicine radiation workers were collected from 76 medical institutions in Jiangsu Province. The results showed that the detection rate of abnormal hypothyroidism in female workers (8.90%) was higher than that in male workers (2.54%) (P=0.028). With increasing working years, the detection rates of cataract and continuous decrease in white blood cell count increased (P＜0.001). The multivariate logistic regression identified working years as a risk factor for cataract and continuous decrease in white blood cell count (OR=1.59, 95%CI=1.40-3.35, P=0.0003; OR=4.15, 95%CI=3.11-29.91, P=0.0001). In addition, working years was also a risk factor for hypertension, fatty liver, and tumor (OR=2.28, 95%CI=1.51-3.47, P=8.76 × 10⁻⁵; OR=1.69, 95%CI=1.10-2.58, P=0.0145; OR=2.04, 95%CI=1.00-4.16, P=0.0469). Conclusion The study found that working in nuclear medicine could increase the risk of various radiation-related diseases, and the risk is influenced by factors such as working years.

Objective:To investigate the effects of long-term X-ray radiation exposure on the tumor risk of medical X-ray workers in Jiangsu province, and to provide a scientific basis for the development of occupational protection policies and the improvement of workers′ health.Methods:By using a combination of retrospective and prospective cohort research method, the medical diagnostic X-ray workers who worked in the radiology department of all hospitals in Jiangsu province between 1950 and 1980 were selected as the radiology group.In the meantime medical personnel in internal medicine, otorhinolaryngology, pediatrics and other medical departments who had not been engaged in radiology during the same period of time at the same hospital were selected as the control group to form a survey cohort. The cumulative number of person-years of observation of the cohort during 1950-2011 was calculated, and the relative risk of various malignant tumors among medical X-ray workers was calculated by using Cox regression model after adjusting for sex, attained age, year of birth, and year of work initiation.Results:A total of 6 954 follow-ups was completed for the cohort, including 3 649 in the irradiation group and 3 305 in the control group, totally 340 483 person-years of observation. As of December 31, 2021, there were 1 328 patients with malignant tumors in this cohort. Cox regression result showed that compared with the control group, the irradiation group who had developed lung cancer ( RR=1.60, 95% CI 1.24-2.08), lymphoma ( RR =4.28, 95% CI 1.54-11.93), solid cancer ( RR =1.17, 95% CI 1.04-1.31), and total cancer ( RR =1.29, 95% CI 1.14-1.46) had significantly higher relative risks ( Z=3.56, 2.78, 2.71, 3.96, P<0.05). Stratified analyses showed that the risks of lung, lymphoma, solid and total cancers were higher in the radiation group than in the control group for males and for those who arrived at the age of 61 years or older ( χ2=6.70-33.86, P<0.05). The risks of lung, solid and total cancers were higher in the radiation group than in the control group for those who started to work in the age group of 21 to 25 years ( χ2=6.46, 6.16, 5.62, P<0.05). Conclusions:The relative risks of lung, lymphoma, solid and total cancers among medical X-ray workers in Jiangsu province are significantly higher, suggesting that attention should be paid to strengthening radiation protection for radiation workers in their radiological practices.

Objective: To analyze the clinical characteristics of newly treated high-risk group neuroblastoma (NB) patients with bone marrow metastasis and to explore the prognostic factors. Methods: The clinical features (sex, age, stage, risk group, pathological type, metastatic site, etc.) of 203 newly treated high-risk NB patients with bone marrow metastasis admitted to Hematology Oncology Center, Beijing Children′s Hospital from January 2007 to December 2016 were analyzed retrospectively. There were 118 males (58.1%) and 85 females (41.9%). Kaplan-Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. Results: The age at onset of the 203 patients was 41 months (9-147 months). The metastatic sites at diagnosis were as follows: bone in 195 cases (96.1%), distant lymph nodes in 104 cases (51.2%), skull and endomeninx in 61 cases (30.0%), orbit in 30 cases (14.8%), pleura in 16 cases (7.9%), liver in 13 cases(6.4%), canalis spinalis in 13 cases (6.4%), other sites in 11 cases (5.4%) and skin and soft tissue in 10 cases (4.9%). In all, 194 cases were enrolled for prognostic analysis. The follow-up time was 36 months (1 day-138 months) , and the 5-years event free survival (EFS) and overall survival (OS) were 36.1% and 39.7%, respectively. A total of 118 patients (60.8%) had events (first relapse or death) with the time to event occurrence was 15 months (1 day-72 months), whereas 112 patients (57.7%) died with the event occurrence to death time was 3 months (1 day-21 months). There was no significant difference in 5-years OS between radiotherapy group and non-radiotherapy group (42.3% vs. 38.3%, χ²=3.671, P=0.055). The 5-years OS in transplantation group was significantly better than the non-transplantation group (44.3% vs. 35.5%, χ²=8.878, P=0.003), and the radiotherapy combined transplantation group also had a better 5-years OS rate than the non-radiotherapy combined transplantation group (45.8% vs. 37.3%, χ²=5.945, P=0.015). Univariate survival analysis showed lactate dehydrogenase ≥ 1 500 U/L, the amplification of MYCN, the metastatic sites of orbit, canalis spinalis and pleura were associated with poor prognosis of newly diagnosed high-risk NB patients (χ²=21.064, 13.601, 3.998, 6.183, 15.307, all P<0.05). The amplification of MYCN and the metastatic sites of pleura were risk factors for prognosis of newly diagnosed high-risk NB patients by Cox regression models (HR=1.896,1.100, 95%CI: 1.113-3.231, 1.020-1.187, both P<0.05). Conclusions The prognosis is unfavorable in high-risk group NB patients with BM metastasis. Radiotherapy combined with transplantation can further improve the prognosis of these patients. The amplification of MYCN and the metastatic sites of pleura were the poor prognostic factors for high-risk NB patients with bone marrow metastasis.

To analyze the clinical characteristics of newly treated high?risk group neuroblastoma (NB) patients with bone marrow metastasis and to explore the prognostic factors. Methods The clinical features (sex, age, stage, risk group, pathological type, metastatic site, etc.) of 203 newly treated high?risk NB patients with bone marrow metastasis admitted to Hematology Oncology Center, Beijing Children's Hospital from January 2007 to December 2016 were analyzed retrospectively. There were 118 males (58.1%) and 85 females (41.9%). Kaplan?Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. Results The age at onset of the 203 patients was 41 months (9-147 months). The metastatic sites at diagnosis were as follows: bone in 195 cases (96.1%), distant lymph nodes in 104 cases (51.2%), skull and endomeninx in 61 cases (30.0%), orbit in 30 cases (14.8%), pleura in 16 cases (7.9%), liver in 13 cases(6.4%), canalis spinalis in 13 cases (6.4%), other sites in 11 cases (5.4%) and skin and soft tissue in 10 cases (4.9%). In all, 194 cases were enrolled for prognostic analysis. The follow?up time was 36 months (1 day-138 months), and the 5?years event free survival (EFS) and overall survival (OS) were 36.1% and 39.7%, respectively. A total of 118 patients (60.8%) had events (first relapse or death) with the time to event occurrence was 15 months (1 day-72 months), whereas 112 patients (57.7%) died with the event occurrence to death time was 3 months (1 day-21 months). There was no significant difference in 5?years OS between radiotherapy group and non?radiotherapy group (42.3% vs. 38.3%, χ2=3.671, P=0.055). The 5?years OS in transplantation group was significantly better than the non?transplantation group (44.3% vs. 35.5%, χ2=8.878, P=0.003), and the radiotherapy combined transplantation group also had a better 5?years OS rate than the non?radiotherapy combined transplantation group (45.8% vs. 37.3%, χ2=5.945, P=0.015). Univariate survival analysis showed lactate dehydrogenase ≥1 500 U/L, the amplification of MYCN, the metastatic sites of orbit, canalis spinalis and pleura were associated with poor prognosis of newly diagnosed high?risk NB patients (χ2=21.064, 13.601, 3.998, 6.183, 15.307, all P<0.05). The amplification of MYCN and the metastatic sites of pleura were risk factors for prognosis of newly diagnosed high?risk NB patients by Cox regression models ( HR=1.896, 1.100, 95%CI :1.113-3.231, 1.020-1.187, both P<0.05). Conclusions The prognosis is unfavorable in high?risk group NB patients with BM metastasis. Radiotherapy combined with transplantation can further improve the prognosis of these patients. The amplification of MYCN and the metastatic sites of pleura were the poor prognostic factors for high?risk NB patients with bone marrow metastasis.