China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective To investigate and analyze epidemiological characteristics of patients with mycoplasma pneumoniae pneumonia (MPP) from 2020 to 2023, and the risk factors for plastic bronchitis (PB), To provide data support for developing preventive measures. Methods The medical records of 2 257 patients with respiratory tract infection treated at Huai'an Hospital Affiliated to Xuzhou Medical University from 2020 to 2023 were collected. Count the number of MPP patients and analyze the MP detection rate. Multivariate logistic regression analysis and ROC curve was used to screen the risk factors for PB. Results A total of 858 cases were positive for MP antibodies, and the detection rate was 38.02%. There are statistically significant differences in MP detection rates among different genders, age groups, and years (P<0.05). Among the 286 patients diagnosed with MPP and undergoing bronchoscopy, 68 (23.78%) patients had PB. According to univariate and multivariate logistic regression analysis, small age, higher N%, D-D, LDH and AST levels were independent risk factors for PB (P<0.05). ROC curve analysis shows that age and combined detection are the most effective indicators for PB prediction, with areas under the curve of 0.998 and 0.961, respectively. Conclusion MP is the main pathogen of respiratory tract infections in the area from 2020 to 2023. Women and children are more susceptible to MP infection. Small age, high N%, DD, LDH and AST levels are independent risk factors for PB in patients with MPP. Targeted preventive measures should be taken for MP susceptible population, and close attention should be paid to PB related risk factors to prevent disease progression and the occurrence of PB.

OBJECTIVE To investigate the current status of air quality in clean operating rooms in Xi'an and explore the possible influencing factors,thus to provide data support for improving the quality of operating room manage-ment.METHODS According to GB50333-2013"Architectural technical code for hospital clean operating depart-ment",on-site monitoring was conducted from 2017 to 2021 on the air quality of 242 clean operating rooms in 41 hospitals in Xi'an,and the results were compared and analyzed.RESULTS Among the operating rooms being sur-veyed,130 were from secondary hospitals,112 from tertiary hospitals;seventy-nine were ClassⅠoperating rooms,26 were ClassⅡ,137 were ClassⅢ.The pass rate for settling bacterial was 98.35%,with 94.94%for ClassⅠoperating rooms,which was significantly lower than that in ClassⅡand ClassⅢ operating rooms(χ2=6.565,P=0.022).The pass rate for dust particles was 69.01%,with 43.04%for ClassⅠoperating rooms,and there was significant difference among different levels of operating rooms(χ2=37.304,P<0.001).The pass rate for dust particles in tertiary hospitals was 61.61%,lower than that in secondary hospitals(75.38%;χ2=5.340,P=0.021).The pass rate for dust particles≥0.5μm and≥5μm were 85.12%and 74.79%,respectively.Among the operating rooms with unqualified dust particles,those with both≥0.5 μm and≥5 μm dust particles not meeting standards accounted for 29.33%,and those with only≥0.5 μm dust particles not meeting standards accounted for 18.67%.Multivariate logistic regression analysis showed that influencing factors for air quality in clean operating rooms included the year of monitoring and the level of the operating room,while the sampling area and hospital level were not statistically associated with the outcomes.CONCLUSION The overall air quality of op-erating rooms in Xi'an is not optimistic,the pass rate is affected by the year of monitoring and the clean levels of the operating rooms,indicating a need to strengthen routine management and monitoring of clean operating rooms.

Objective:To explore the value of chromosomal microarray analysis (CMA) in the genetic diagnosis of different types of fetal growth restriction (FGR).Methods:A retrospective analysis was conducted on 120 cases who were diagnosed with FGR by ultrasound and underwent prenatal diagnosis at the Department of Obstetrics & Gynecology and Reproductive Medicine, Peking University First Hospital, from January 2016 to December 2021. The cases were divided into three groups based on the gestational age at the first diagnosis:<28 weeks (40 cases), 28-31 +6 weeks (65 cases), and ≥32 weeks (15 cases). They were also categorized into isolated and non-isolated FGR based on the presence of other ultrasound abnormalities (69 and 51 cases in each). Chromosomal karyotype analysis and CMA were conducted on all patients. The prenatal diagnosis results were analyzed, as well as the detection of chromosomal abnormalities in different gestational age groups and types of FGR. Statistical analysis was performed using Fisher's exact test. Results:(1) A total of 14 abnormalities were detected by CMA and four cases were detected by chromosomal karyotype analysis. The abnormal detection rate of CMA was higher than that of chromosomal karyotype analysis [11.7% (14/120) vs. 3.3% (4/120), P=0.025]. Among the total 14 cases of chromosomal abnormalities, there were seven pathogenic copy number variations (CNVs) and four variants of unknown significance (VUS), as well as two cases of trisomy-18 and one case of Turner syndrome. Among the 14 cases, eight had associated ultrasound abnormalities. Eleven of the 14 cases opted for induced abortion; three continued pregnancy to delivery, with two neonates showing no abnormalities and one exhibiting slightly delayed physical development. Both methods detected three cases of aneuploidy mnumber abnormalities (2.5%, 3/120) For chromosomal abnormalities <10 Mb, the detection rate of CMA was higher than that of chromosomal karyotype analysis [9.2% (11/120) vs. 0.8% (1/120), Fisher's exact, P=0.005]. Both methods detected one case of <10 Mb CNV, while CMA alone detected ten cases of <10 Mb microdeletions/microduplications (8.3%, 10/120), including six cases of pathogenic CNVs and four cases of VUS. (2) Among the 40 cases in the <28 weeks group, six cases (15.0%) of chromosomal abnormalities were detected, including three cases of aneuploidy, two cases of pathogenic CNVs, and one case of VUS. Among the 65 cases in the 28-31 +6 weeks group, seven cases (10.8%) of chromosomal abnormalities were detected, including five cases of pathogenic CNVs and two cases of VUS. Of the 15 cases in the ≥32 weeks group, one case of chromosomal abnormality was detected, which was VUS. (3) No statistically significant difference was found in the detection rate of chromosomal abnormalities between the isolated FGR and the non-isolated FGR groups [8.7%(6/69) vs. 15.7%(8/51), Fisher's exact, P=0.263]. (4) After excluding the ≥32 weeks non-isolated FGR group (only one case), the <28 weeks non-isolated FGR group had the highest detection rate of chromosomal abnormalities (1/18), while no abnormalities were detected in the ≥32 weeks isolated FGR group. Conclusions:Among FGR fetuses, the highest detection rates of chromosomal abnormalities are found in early-onset and non-isolated FGR. Prenatal diagnosis with CMA testing can significantly improve the detection rate of genetic causes in various types of FGR fetuses.

X-ray is usually used to determine anatomy and localization during conventional permanent pacemaker implantation.But X-ray exposure might induce radiation injury to fetus.In this paper,we reported 2 cases successful double cavity permanent pacemaker implantation in pregnant women woman at 13 weeks of gestation under the guidance of transthoracic echocardiography.The postoperative pacing parameters were good,the whole process was finished with zero radiation,and there were complications during pregnancy.Both cases resulted in full-term pregnancies and the natural delivery of healthy newborns.Pacemaker electrodes were in normal position as confirmed by post-delivery X-ray examinations.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective To compare imaging quality and semi-quantitative parameters of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners.Methods Thirty-four patients who underwent 18F-FDG whole-body scanning using NeuWise and Philips Ingenuity TF PET/CT systems respectively on the same day were enrolled.The imaging quality and semi-quantitative parameters of 2 kind images,also the mean standard uptake value(SUVmean)of normal tissue,the maximum standard uptake value(SUVmax),peak standard uptake value(SUVpeak),SUVmean of lesions,total lesion glycolysis(TLG)and metabolic tumor volume(MTV)were compared.Results No significant difference of imaging quality nor semi-quantitative parameters of lesions(all P＞0.05),while significant differences of SUVmean of aortic arch,liver,lumbar vertebra and spinal cord were found between 2 kind images(all P＜0.05).Strong correlations of SUVmax,SUVmean,MTV and TLG of lesions(r,=0.734-0.890,P＜0.001),and high correlation of SUVpeak(rs=0.919,P＜0.001)were found between 2 kind images.The consistency of SUVmax,SUVpeak,SUVmean,TLG and MTV at the lesion site between 2 kind images were very good to extremely good(ICC=0.891-0.986,all P＜0.001),and the differences of all above semi-quantitative parameters were within 95％confidence interval.Conclusion Imaging quality of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners could meet the requirements of clinical diagnosis and treatment,and semi-quantitative parameters obtained based on both images had good consistencies.

Objective To compare imaging quality and semi-quantitative parameters of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners.Methods Thirty-four patients who underwent 18F-FDG whole-body scanning using NeuWise and Philips Ingenuity TF PET/CT systems respectively on the same day were enrolled.The imaging quality and semi-quantitative parameters of 2 kind images,also the mean standard uptake value(SUVmean)of normal tissue,the maximum standard uptake value(SUVmax),peak standard uptake value(SUVpeak),SUVmean of lesions,total lesion glycolysis(TLG)and metabolic tumor volume(MTV)were compared.Results No significant difference of imaging quality nor semi-quantitative parameters of lesions(all P＞0.05),while significant differences of SUVmean of aortic arch,liver,lumbar vertebra and spinal cord were found between 2 kind images(all P＜0.05).Strong correlations of SUVmax,SUVmean,MTV and TLG of lesions(r,=0.734-0.890,P＜0.001),and high correlation of SUVpeak(rs=0.919,P＜0.001)were found between 2 kind images.The consistency of SUVmax,SUVpeak,SUVmean,TLG and MTV at the lesion site between 2 kind images were very good to extremely good(ICC=0.891-0.986,all P＜0.001),and the differences of all above semi-quantitative parameters were within 95％confidence interval.Conclusion Imaging quality of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners could meet the requirements of clinical diagnosis and treatment,and semi-quantitative parameters obtained based on both images had good consistencies.

X-ray is usually used to determine anatomy and localization during conventional permanent pacemaker implantation.But X-ray exposure might induce radiation injury to fetus.In this paper,we reported 2 cases successful double cavity permanent pacemaker implantation in pregnant women woman at 13 weeks of gestation under the guidance of transthoracic echocardiography.The postoperative pacing parameters were good,the whole process was finished with zero radiation,and there were complications during pregnancy.Both cases resulted in full-term pregnancies and the natural delivery of healthy newborns.Pacemaker electrodes were in normal position as confirmed by post-delivery X-ray examinations.

OBJECTIVE To investigate the current status of air quality in clean operating rooms in Xi'an and explore the possible influencing factors,thus to provide data support for improving the quality of operating room manage-ment.METHODS According to GB50333-2013"Architectural technical code for hospital clean operating depart-ment",on-site monitoring was conducted from 2017 to 2021 on the air quality of 242 clean operating rooms in 41 hospitals in Xi'an,and the results were compared and analyzed.RESULTS Among the operating rooms being sur-veyed,130 were from secondary hospitals,112 from tertiary hospitals;seventy-nine were ClassⅠoperating rooms,26 were ClassⅡ,137 were ClassⅢ.The pass rate for settling bacterial was 98.35%,with 94.94%for ClassⅠoperating rooms,which was significantly lower than that in ClassⅡand ClassⅢ operating rooms(χ2=6.565,P=0.022).The pass rate for dust particles was 69.01%,with 43.04%for ClassⅠoperating rooms,and there was significant difference among different levels of operating rooms(χ2=37.304,P<0.001).The pass rate for dust particles in tertiary hospitals was 61.61%,lower than that in secondary hospitals(75.38%;χ2=5.340,P=0.021).The pass rate for dust particles≥0.5μm and≥5μm were 85.12%and 74.79%,respectively.Among the operating rooms with unqualified dust particles,those with both≥0.5 μm and≥5 μm dust particles not meeting standards accounted for 29.33%,and those with only≥0.5 μm dust particles not meeting standards accounted for 18.67%.Multivariate logistic regression analysis showed that influencing factors for air quality in clean operating rooms included the year of monitoring and the level of the operating room,while the sampling area and hospital level were not statistically associated with the outcomes.CONCLUSION The overall air quality of op-erating rooms in Xi'an is not optimistic,the pass rate is affected by the year of monitoring and the clean levels of the operating rooms,indicating a need to strengthen routine management and monitoring of clean operating rooms.