1.Analysis of the eye lens dose and annual effective dose to some interventional radiation workers in Xinxiang city
Yuxuan MAO ; Bingjie ZHANG ; Yulong LIU ; Xuan WANG ; Tongzhen LIU ; Tianhe JIA ; Fengling ZHAO ; Quanfu SUN ; Dianhui WANG
Chinese Journal of Radiological Medicine and Protection 2024;44(3):216-222
Objective:To analyze the eye lens dose and annual effective dose to interventional radiation workers in some hospitals of Xinxiang city from 2020 to 2022, and to ascertain the dose to interventional radiation workers.Methods:By using TLDs, the eye lens dose Hp(3) and annual effective dose Hp(10) were monitored for three consecutive years in six hospitals in Xinxiang city. The lens doses and annual effective doses to intervention radiation workers in different years in different-level hospitals and departments were analyzed. Results:From 2020 to 2022, a total of 117 people were monitored. The left eye lens dose range was 0.12-164.24 mSv, and the right eye lens dose range was 0.07-51.64 mSv. The average annual dose was 8.56 mSv for left eye lens and 4.49 mSv for right eye lens The average annual dose distribution in the MDL-5 mSv range for the left and right eye lens was 60.68% and 73.50%, respectively. 9.41% (11 people) of the left eye lens doses exceeded 20 mSv. The annual effective doses range was 0.11-31.27 mSv, with average annual dose of 2.56 mSv. The proportion of average annual effective doses mainly distributed in the range of MDL to 1.25 mSv was 52.14%, with 2.56% annual effective dose exceeding 20 mSv. There was no significant difference in left and right eye lens dose and annual effective dose between the tertiary hospitals and the secondary hospitals in three years ( P>0.05). Compared with different departments, the cumulative per capita dose in three years was statistically significant (left eye H=11.42, right eye H=13.72, annual effective dose H=25.94, P<0.05). The lens dose and annual effective dose in neurology department were lower than those in cardiology department and comprehensive intervention department ( Zcardiology department=-3.33, -3.78, -4.83, P<0.05; Zcomprehensive intervention department=-2.71, -2.63, -4.39, P<0.05). Conclusions:Most of the annual equivalent dose and annual effective dose to eye lens of the interventional radiation workers in Xinxiang city meet the national limits, but some of them have higher doses and exceed the national limits. It is suggested that the routine and continuous monitoring of eye lens doses to interventional radiologists should be strengthened while routine monitoring of annual effective dose, and attention should be paid to the eye lens and annual effective dose to interventional radiologists in secondary hospitals to improve the awareness of protection.
2.Network Meta-analysis of the effects of different interactive modes of intervention on the rehabilitation of stroke patients
Shui LIU ; Fengling WANG ; Tiantian JIA ; Yunfen SUN
Chinese Journal of Practical Nursing 2024;40(31):2413-2421
Objective:To evaluate the effects of different interaction modes on the rehabilitation outcomes of stroke patients, and to provide reference for caregivers to choose the best interaction mode according to the rehabilitation goals.Methods:Computerized search of Web of Science, PubMed, Cochrane Library, EMbase, CNKI, Wanfang Database, VIP Database, and China Biomedical Literature Database for randomized controlled trials (RCTs) of interaction modes to improve rehabilitation outcomes of stroke patients was performed from the year of database construction to January 8, 2024. Two researchers independently screened the literature according to inclusion and exclusion criteria, evaluated the risk of bias in the included studies, and extracted data from them. Stata16.0 was used for a network meta-analysis.Results:A total of 22 articles were included that met the inclusion and exclusion criteria, involving 2 404 patients and 5 interaction modes, namely Cox health behavior interaction mode, doctor-patient interaction mode, King interaction compliance mode, dual track interaction mode, and online interaction mode. The results of the network Meta-analysis showed that in terms of improving self-care ability, the King interaction model [ SMD(95% CI)=0.25(0.05-0.45)], the network interaction model [ SMD(95% CI)=0.27(0.07-0.48)], and the Cox health behavior interaction model [ SMD(95% CI)=0.37(0.07-0.67)] were all superior to conventional nursing (all P<0.05). In terms of improving motor function, except for the dual track interactive mode, all other modes were superior to conventional nursing ( SMD values were -0.52--0.30, all P<0.05). There was no statistically significant difference in the application effects of different modes in improving the quality of life (all P>0.05). The ranking results of the area under the cumulative ranking probability curve (SUCRA) for improving self-care ability, motor fuction and quality of life were Cox health behavior interaction mode (SUCRA=83.7%), doctor-patient interaction mode (SUCRA=89.5%) and King interaction standard mode (SUCRA=78.2%). Conclusions:The Cox health behavior interaction model can improve the self-care ability of stroke patients, the doctor-patient interaction model can improve the motor function of stroke patients, and the King interaction standard model may have more advantages in improving the quality of life of stroke patients. It is suggested to combine the advantages of the three to maximize the rehabilitation effect of stroke patients.
3.Implementation and revision of the Measures for the Management of Radiation Workers’ Occupational Health
Shiyue CUI ; Yinping SU ; Fengling ZHAO ; Zhiwei XING ; Li LIANG ; Juan YAN ; Yuanyuan ZHANG ; Bo WANG ; Jianxiang LIU ; Changsong HOU ; Erdong CHEN ; Jun DENG ; Quanfu SUN
Chinese Journal of Radiological Health 2023;32(3):335-340
Since the implementation of the Measures for the Management of Radiation Workers’ Occupational Health in November 2007, it has played an extremely important role in protecting the occupational health of radiation workers. There are more than 700 000 radiation workers in about 100 000 workplaces with potential radiation exposure, as well as a large number of miners exposed to high levels of radon. As the radiation health monitoring project suggests, measures of occupational health management such as personal dose monitoring and occupational health examination of radiation workers have been widely implemented and achieved good results in the protection of radiation workers. However, the risks of chromosomal aberration and specific turbidity of the eye lens of radiation workers have increased in high-risk positions such as interventional radiology, nuclear medicine, and industrial flaw detection. The control of high radon exposure in miners needs to be strengthened. It is necessary to adapt to the new situation in view of new challenges and actively promote the revision of the Measures for the Management of Radiation Workers’ Occupational Health, so as to further improve the occupational health management of radiation workers in China.
4.Epidemiological investigation of SARS-CoV-2 infection in maintenance hemodialysis patients in Jiangsu province during the outbreak of SARS-CoV-2
Guang YANG ; Yifei GE ; Yaoyu HUANG ; Jizhuang LOU ; Chunming JIANG ; Guoyuan LU ; Fengling CHEN ; Jiansong SHEN ; Xiaolan CHEN ; Houyong DAI ; Changhua LIU ; Min YANG ; Xiurong LI ; Zhuxing SUN ; Liang WANG ; Bin LIU ; Donghui ZHENG ; Yong XU ; Maojie CHEN ; Ling WANG ; Yilai ZHANG ; Xu ZHANG ; Jianqiang HE ; Liyuan ZHANG ; Huiting WAN ; Honglei GUO ; Jiahui YANG ; Wei XU ; Changying XING ; Huijuan MAO
Chinese Journal of Nephrology 2023;39(12):895-902
Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.
5.Explanation of Diagnosis for occupational radiation thyroid disease
Wei GUO ; Fengling ZHAO ; Quanfu SUN ; Yumin LYU
Chinese Journal of Radiological Medicine and Protection 2023;43(12):1022-1026
In order to accurately master and understand the national occupational health standard Diagnosis for Occupational Radiation Thyroid Disease(GBZ 101-2020), the significance of the publication of this standard, the relevant background, the basic principles of the revision, the main basis for technical content revision, and the application of the standard are described. To provide guidance for t the physcians for occupational disease diagnosiss to understand the diagnostic principles, make correct diagnosis and avoid confusion in using the standard, so as to better protect the occupational health rights of radiation workers.
6.Investigation and analysis of an extensive skin injury to the back caused by accidental irradiation in interventional procedure
Yuxuan MAO ; Bingjie ZHANG ; Quanfu SUN ; Tianhe JIA ; Yumin LYU ; Yulong LIU ; Fengling ZHAO ; Jianwei WANG ; Xuan WANG ; Tongzhen LIU
Chinese Journal of Radiological Medicine and Protection 2021;41(12):881-885
Objective:To carry out investigation and analysis of an extensive skin radiation injury to the back accidentally caused by interventional procedure and to explore the problems faced in the event with emphasis on avoiding the reoccurance of similar events in the future.Methods:The data were collected by consulting the patient′s detailed medical history, collecting and analyzing clinical diagnosis and treatment data, tracking and observing their clinical manifestations and signs. The patient′s peripheral blood samples were also collected, together with the biological dose estimated and the equipment data collected on the site of the interventional treatment hospital.Results:The whole body dose to the patient was estimated to be 0.95 Gy. The typical values of kerma rate of radiation incident on the body surface due to fluoroscopic procedures were 373.5 mGy/min in subtraction modality and 47.8 mGy/min in fluoroscopy modality, respectively. The annual effective dose to the interventional radiologist was 20.51 mSv due to his operation in long-time radiation exposure conditions, higher than 3.09 mSv for other interventional radiologists with similar workload in the same department. The whole body and local clinical manifestations of the patients were in line with radiation injury. No clear diagnosis has been obtained in several hospitals, nor can obvious treatment outcomes be obsevered.Conclusion:Combined with the biological dose estimation result and clinical manifestations, the case was diagnosed as degree Ⅳ skin radiation injury. Radiation injury is closely related to whether the operation is conducted according to the standard and the output dose of X-ray machine. Non-specialized hospitals should strengthen clinical diagnosis and treatment of radiation injury.
7.Clincal value of NSE in the diagnosis of neuroblastoma in children
Jian LI ; Xiaobing SUN ; Jinyu DAI ; Fengling TONG
Chinese Journal of Primary Medicine and Pharmacy 2020;27(22):2749-2752
Objective:To evaluate the application value of serum neuron-specific enolase(NSE) in the diagnosis of neuroblastoma in children.Methods:The clinical data of 98 children with neuroblastoma admitted to Children's Hospital of Shanxi Province from January 2010 to January 2018 were retrospectively analyzed(study group), and 40 healthy children with physical examination during the same period were selected as control group.The serum NSE levels were detected in the study group at the time of diagnosis and after treatment, and in the control group at the time of physical examination, to evaluate the effectiveness of NSE level changes in the diagnosis of neuroblastoma in children.Results:The serum NSE level in the study group[(98.61±10.42)μg/L] was higher than that in the control group[(15.31±1.16)μg/L]( t=50.325, P<0.05). At the time of diagnosis, the serum NSE levels of stage II, III and IV were (31.56±12.82)μg/L, (78.65±20.1)μg/L and (127.45±32.48)μg/L, respectively, showed an increasing trend( F=111.556, P=0.000). The serum NSE level of the study group after treatment[(62.48±7.46)μg/L] was lower than that before treatment[(98.61±10.42)μg/L]( t=27.910, P<0.05), and the serum NSE levels of children at different stages were lower than those before treatment(all P<0.05). The receiver operating characteristic (ROC) curve was drawn with serum NSE as the variable, showed the area under the curve of 0.815, the Yoden index of 0.534, the sensitivity of 71.43%, and the specificity of 90.82%. Conclusion:Serum NSE detection plays an important role in the diagnosis of neuroblastoma in children, and is conducive to the judgment of the severity of the disease, the treatment effect, with high diagnostic performance.It is worthy of clinical promotion.
8.Preliminary study on ICD coding for occupational radiation diseases in China
Wei GUO ; Fengling ZHAO ; Yang LI ; Quanfu SUN
Chinese Journal of Radiological Medicine and Protection 2020;40(4):315-320
Objective:To improve the accuracy of the coding of occupational radiation diseases in China, to provide standardized basis for the research on the management of such diseases as well as the informatization management of medical records and the formulation of relevant policies, and to improve the level of prevention and control.Methods:According to the nomenclature and disease characteristics of occupational radiation diseases in China, the diseases were coded by ICD-10 coding rules.Results:The system of occupational radiation diseases in China is the sum of all kinds of diseases caused by ionizing radiation, which is different from the common clinical symptom. The coding of such diseases must be based on the location, clinical manifestations, pathological changes, and other characteristics.Conclusions:The accuracy of occupational radiation diseases coding directly affects the accuracy of disease statistical data. Standardizing the coding of these diseases is a very necessary supplement to the system of occupational radiation diseases in China.
9.Expression and clinical significance of CCDC8 and TGF-β1 in non-small cell lung cancer
Lichun SUN ; Dandan LI ; Jing LI ; Fengling YU
Practical Oncology Journal 2019;33(3):215-221
Objective The aim of this study was to investigate the expression of CCDC8(coiled-coil domain containing 8, P90)and transforming growth factor β 1(TGF- β1)in none small cell lung cancer(NSCLC),and its relationship with clinicopatho-logical characteristics. Methods The expression of CCDC8 and TGF-β1 in NSCLC was analyzed in the TCGA database. The Kap-lan-Meier curve was plotted to analyze its correlation with survival of patient. The expression of CCDC8 and TGF-β1 in 204 cases of conventional paraffin-embedded NSCLC was detected by immunohistochemical staining and their relationship with clinicopatholog-ical features of NSCLC was analyzed. The relationship between the expression of CCDC8 and TGF-β1 and the overall survival(OS) of patients was analyzed by Cox regression. Results The expression of CCDC8 in NSCLC patients was positively correlated with TGF-β1 expression in the TCGA data(P<0. 05). OS was low in patients with the low expression of CCDC8(HR=1. 32,P=0. 0437). In 204 NSCLC tissues,CCDC8 expression was positively correlated with TGF-β1 expression(P=0. 023). Cox univariate analysis of CCDC8 expression in NSCLC was associated with OS(P=0. 013);whereas the expression of CCDC8 and TGF-β1 was not associat-ed with survival in patients with NSCLC(P=0. 967,P=0. 816). Cox multivariate analyses of TNM staging and CCDC8 were progno-sis factors in patients with NSCLC(P=0. 016). Conclusion The expression of CCDC8 is correlated the expression of TGF-β1 in NSCLC. CCDC8 may be a prognostic factor for patients with NSCLC.
10. Screening of serological markers for differential diagnosis ischemic colitis and ulcerative colitis by proteomic techniques
Longgui NING ; Jinghua YU ; Guodong SHAN ; Zeyu SUN ; Wenguo CHEN ; Fenming ZHANG ; Fengling HU ; Hongtan CHEN ; Guoqiang XU
Chinese Journal of Digestion 2019;39(12):840-845
Objective:
To screen and identify serum protein biomarkers for the differential diagnosis between ischemic colitis (IC) and ulcerative colitis (UC) by tandem mass tag (TMT) combined with liquid chromatography/tandem mass spectrometry (LC-MS/MS).
Methods:
From January 2018 to January 2019, at the First Affiliated Hospital of School of Medicine of Zhejiang University, patients with UC or IC, and health controls, each 10 cases, were enrolled into UC group, IC group and normal control (NC) group, respectively. Fasting serum samples of all the subjects were collected. After removal of high-abundance protein, followed by proteolysis, peptide labeling and fractionating, the samples were then processed by mass spectrometry. The protein with TMT data of three groups was obtained and protein with TMT value 0 were removed. Heat map of protein was constructed. The differential protein was defined as the protein fold change over 1.5 or less than 0.67. The Reactome database was used to cluster the pathways of differential proteins among groups. Statistical methods included

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