Objective To analyze the status quo and existing problems of radiation protection for veterinary X-ray facilitiesin Beijing-Tianjin region, China, and to provide a basis for improving radiation protection management level. Methods According to the requirements of the Technical guidelines for status quo assessment of occupational hazard of the employing unit (AQ/T 4270—2015), the study performed status quo assessment on the workplaces of veterinary X-ray facilities in 16 pet hospitals in Beijing-Tianjin region, and comprehensively analyzed the impact of the workplaces on the health of radiation workers and the public. Results In terms of personnel management, the pass rates of occupational health management post setting, personnel training, personal protective equipment, individual monitoring of occupational external exposure, notification of occupational hazards, and occupational health surveillance were 100%, 81.3%, 100%, 75%, 37.5%, and 25%, respectively. In terms of workplace management, most workplaces had reasonable layout and zoning and complete protection and emergency devices. However, there were some problems in some places, such as non-standard radiation warning signs, no notice board of occupational hazards, and no radiation protection testing. In terms of document management, all institutions had imperfect system documents. Conclusion The workplaces of veterinary X-ray facilities in 16 institutions basically meet the requirements for radiation protection, but there are also some problems, such as inadequate management of personnel and workplace radiation protection, and imperfect system documents. Institutions should strengthen the study of radiation protection knowledge. The competent authorities should strengthen supervision, formulate corresponding standards for radiation protection, enhance training, and improve the professional level of staff.

Objective To establish a high performance liquid chromatography(HPLC) method for simultaneous determination of the contents of 7 components of chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein, and wogonin in Piqin oral liquid. Methods A double-wavelength HPLC method was performed. The column was Agilent Zorbax SB-C₁₈ (250 mm × 4.6 mm, 5 μm). The mobile phase was 0.02% phosphoric acid aqueous solution (A)-acetonitrile (B) gradient elution; Flow rate: 1.0 ml/min; Column temperature: 35℃; Injection volume: 20 μl; Detection wavelength: 0-18.0 min, 325 nm (detect chlorogenic acid, caffeic acid); 18.0-65.0 min, 280 nm (detect paeoniflorin, baicalin, baicalein, ammonium glycyrrhizinate, wogonin). Results The chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein and wogonin were completely separated. Seven components have a good linear relationship between the peak area and concentration, with the recoveries between 96.41% and 99.70%. Conclusion This method is simple, accurate and reproducible, and can be used for the quality control of Piqin oral liquid.

Clinical data of 62 patients with gastrointestinal submucosal tumors (diameter ≥1 cm) who were treated with kissing suture by single-channel endoscope after endoscopic full-thickness resection (EFR) in the First Affiliated Hospital of Zhengzhou University from February 2017 to May 2019 were analyzed retrospectively to evaluate the clinical value of kissing suture technique by single-channel endoscope in defect closure after EFR. All the post-EFR defects were successfully closed (100%). No postoperative anastomotic leakage or other serious complications occurred. The mean maximum diameter of lesions was 3 cm (ranged 1-7 cm), and 13 (21%) of them were greater than or equal to 5 cm.The mean number of clips used was 25.7 (ranged 7-78). The mean procedure time was 168 min (ranged 44-300 min), and the mean suture time was 63 min (ranged 13-211 min). The mean postoperative hospital stay was 7 days (ranged 4-12 days). Endoscopic reexamination 3-6 months after operation showed that all wounds healed well. Kissing suture method by single-channel endoscope is a safe, effective, easy and feasible for closing gastrointestinal defect after EFR.

Objective To evaluate the current status of radioactive occupational hazards in the construction of some medical institutions in Tianjin, discover existingproblems and deficiencies, and provide a technical basis for radiation protection management. Methods Based on the requirements of relevant regulations and standards, we comprehensivelyevaluated the results of the pre-evaluation and control effect evaluation of 81 radioactive occupational hazards in Tianjin. Results Among the 35 proposed protective measures for pre-evaluation of radiation occupational hazards constructionprojects, the lowest compliance rate is warning signs and personal protective equipment. Among the 46 construction projects of radioactive occupational hazard control evaluation, the pass rate of protective measures was between 73.9% and 100%, with the lowest pass rate for personal protective equipment. Besides, the pass rate of radiation protectionmanagement evaluation was 95.7% ～ 100%, with the lowest pass rate for the protection management system.The initial inspectionpass rateof the equipment quality control acceptancewas 98.6%, while the pass rate was 97.1% for the relevant workplace radiation protection during the initial inspection. Conclusion The pre-evaluation completion rate of radiological occupational hazard evaluation in Tianjin medical institution construction project, unilateral and area of construction room, workplace layout and zoning, ventilation, shielding measures, personal dose management and occupational health inspection all meet the requirements of regulations and standards. However, there are still some deficiencies in the personal protective equipment, warning signs and the radiation protection management system. Therefore, the regulatory department should further strengthen the evaluation of medical institutions, especially the key supervision and management of non-conformities.

From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.

Objective:To understand the current status of quality control of medical X-ray diagnostic equipment in Tianjin, discuss the problems existing in the process of quality control, and provide technical basis for the relevant regulatory agencies.Methods:Using stratified random sampling, a total of 401 pieces of medical X-ray diagnostic equipment distributed over 111 medical institutions in Tianjin was used for this study. X-ray multifunctional dosimeters and other types of equipment were used to perform quality control testing and evaluation under the relevant health industry standards.Results:The initial testing pass rate of these equipment was 90.0%, with the pass rates of X-ray imaging equipment lower than those of X-ray fluoroscopy equipment, digital subtraction angiography (DSA) and X-ray computed tomography (CT) ( χ2=9.203, 3.383, 5.754, P<0.05). Among the imaging equipment, the screen X-ray equipment had the lowest pass rate, followed by the breast X-ray equipment and medical digital radiography (DR). The main unqualified items were output repeatability, deviation of tube voltage indication and limit spatial resolution. DR accounted for the highest percentage of X-ray equipment that were below testing condition. The unqualified proportion of X-ray imaging equipment was higher than that of X-ray fluoroscopy equipment ( χ2=8.216, P <0.05). Among the imaging equipment, the screen X-ray equipment was seen to have the highest unaqualified proportion, followed by computed radiography (CR). Among the 401 devices in this study, the initial testing pass rates of private medical institutions was not statistically different from those of public medical institutions ( P>0.05). The initial pass rates of domestic equipment was lower than those of imported equipment ( χ2=4.576, P<0.05). Conclusions:The performance of medical X-ray diagnostic equipment in Tianjin needs to be further improved. Medical institutions should pay attention to the quality control testing of medical X-ray diagnostic equipment. The relevant regulatory agencies should strengthen oversight and management of equipment that contains unqualified items, no baseline values and below the testing conditions.

0bjective Exploration of the application effect of a new way of collecting patient′s telephone information to emergency diagnosis and treatment process reengineering in outpatient and emergency department. Methods Relying on the hospital information system platform, design and implement timely collection and validity verification mechanism of mobile phone data in outpatient and emergency department network sub-platform; before and after the implementation of the evaluation of 500 cases of patient registration time, telephone information accuracy. Statistics before and after using the 200 patients with critical value received report (short message, telephone) response time should be again;medical treatment satisfaction. Results The sub-platform realized the timely modification of telephone information through multi-function exchange terminal when patients visited the hospital. There was no statistical significance in the time of registration of patients in the two groups (P>0.05), the registration time was not extended. The accuracy rate of telephone information was 98.4% (492/500) in the experimental group, and 66.6% (333/500) in the control group, there was differences between the two groups (χ2=176.70,P<0.05). After the implementation, the number of the 200 patients who received critical value report (text message, phone call) and answered again within 30 minutes was 189, and there were 132 cases before implementation, there was difference before and after implementation (χ2=69.38, P<0.05). The patients′satisfaction with emergency treatment in the control group and the experimental group was 68.5%(137/200), 95.5%(191/200), there was significant difference (χ2=51.80, P<0.05). The doctors′satisfaction with the system in the experimental group and the control group was 94.0%(188/200), 65.5% (131/200), there was significant difference (χ2=51.25, P<0.05). Conclusions The method of telephone information collection of patients was optimized, and the quality and management level of emergency diagnosis and treatment were improved, and the information construction of door and emergency room was promoted.

Objective To ensure the effectiveness and safety of domiciliary subcutaneous injection of biological agents, a safety implementation process was constructed for the treatment of patients with rheumatic diseases by domiciliary subcutaneous injection of biological agents. Methods Based on analyzing the existing clinical work and consulting the relevant documents, using Delphi expert consultation method, 10 experts and 30 patients were treated with 2 rounds of questionnaire to conduction. Results After 2 rounds of expert consultation, the safety implementation process was developed, including 7 items and 27 sub-items. The positive coefficient of the experts was 100％ and 90％respectively, the authority coefficient was 0.84, and the sub projects coordination coefficient was 0.454. Conclusions On the clauses in the safety implementation process of the domiciliary subcutaneous injection of biological agents in the Department of rheumatism which constructed with the Delphi method, experts opinions was consistence, having high credibility of the research results. By systematically managing the home patients who receiving the injective biological agents, transferring the part of the simple treatment from the hospital to the home was acceptance, the effectiveness and safety of domiciliary injection was improved.

OBJECTIVE:To optimize the dry granulation technology conditions for Yinqiao baidu tablet. METHODS:Using granulating difficulty degree and disintegration time as investigation indexes,ratio and amount of accessories microcrystalline cellu-lose and compressible starch in Yinqiao baidu tablet,moisture content of the sprayed powder were screened. Using yield of particle and angle of repose as indexes,L9(34)orthogonal test was used to optimize the wheel pressure,rotating speed and feeding speed in dry granulation technology,and verification test was conducted. RESULTS:The ratio of microcrystalline cellulose and compress-ible starch was 7:3,and mixing ratio of the two with spray powder+inclusion compound was 1:5. The moisture content of spray powder was controlled in 1％-2％. The optimal technology was as follow as wheel pressure of 3.5 MPa,roller speed of 4 r/min and feeding speed of 10 r/min. In verification test,average yield of particle was 69.2％ and angle of repose was 31.5 °. Transfer rate of chlorogenic acid had reached over 92％,and RSD of each index was below 2.53％(n=3). CONCLUSIONS:Each index of parti-cle prepared by optimized accessories formulation and technology shows good reproducibility and feasibility,and the technology is stable and suitable for production.