Objective To investigate the radioactivity levels of gross α and gross β in foods around Zhangzhou nuclear power plant, China before operation. Methods Forty-nine samples from 33 kinds of foods in 5 categories of daily food around Zhangzhou nuclear power plant were collected, pretreated, dried, and ashed. The radioactivity levels of gross α and gross β were measured by the low-background α and β measuring instrument. The atomic absorption technique was employed to measure the level of potassium (K), and the radioactivity level of gross β (subtracting ⁴⁰K) was calculated with K concentrations in different foods consulted from the nutritional dietary system. Results The radioactivity levels of gross α in vegetables and fruits, grain, poultry and livestock, aquatic products, and tea around Zhangzhou nuclear power plant were < minimum detectable level (MDL)-7.97, < MDL-6.82, < MDL, < MDL-20.76, and 11.90-23.08 Bq/kg, respectively; the radioactivity levels of gross β were 34.56-122.81, 13.05-188.96, 56.00-108.34, 17.86-169.01, and 123.74-171.63 Bq/kg, respectively; the radioactivity levels of gross β (subtracting ⁴⁰K) were not detected (ND)-14.27, ND-27.86, ND-48.72, ND-45.85, and 6.69-13.79 Bq/kg, respectively. Conclusion The radioactivity of gross α and gross β in foods around Zhangzhou nuclear power plant before operation is basically at the same level as that in other areas of China.

Objective:To study the applicability of conventional detection method, gamma spectrometry and radiochemical analysis, for the determination of 137Cs activity concentratons in food samples and to compare the difference of such two methods for this purpose. Methods:By using both γ spectrometry and radiochemical analysis, the activity concentrations of 137Cs in different types of food were determined, to compare the required sample amounts, the sample pretreatment and preparation processes and the lower detection limits.With meat samples as a case study, the two method were compared for assessing the activity concentrations of 137Cs in meat samples and evaluating the uncertainties. Results:The deviation of measurement result obtained in meat by using gamma spectrometry and ammonium phosphomolybdate-β counting method is consistent, with relative extended uncertainties of 18.0% and 8.0%, respectively. The pretreatment process for γ spectrometry is characterized by its simplicity, but large sample amount required and time-comsuming process, while the ammonium phosphomolybdate method requires a small amount of sample but in need of separation and purification process.The detection limits of the two methods are 10.6 mBq/kg (sample mass 11.7 kg) and 5.1 mBq/kg (sample sample 2.1 kg ), respectively.Conclusions:The results of two methods for determinationf of the low activity concentrations of 137Cs in food samples are consistent. Therefore, when monitoring low activity concentrations of 137Cs in food samples, the appropriate detection method can be selected based on the specific objective and requirements of the monitoring study.

Objective To investigate the predictive value of inflammatory cells and clinical features in the prognosis of immune checkpoint inhibitors (ICIs) treating non-small cell lung cancer (NSCLC).Methods The data of 163 cases of stage Ⅲ and Ⅳ NSCLC patients treated with the ICIs in this hospital from January 1,2017 to December 31,2022 were collected.The CT examination was conducted after 6-8 weeks treatment.The pa-tients were divided into the objective remission group[complete remission (CR)+partial remission (PR)]and non-objective remission group[stable disease (SD)+progressed disease (PD)],disease control group (CR+PR+SD) and non-disease control group (PD),persistent clinical benefit group (DCB) and non-DCB group.The differences in clinical features and inflammatory cells indicators were compared among the differ-ent groups.The receiver operating characteristic (ROC) curve was adopted to evaluate the predictive efficiency of the inflammatory cells indicators for DCB.The influencing factors analysis of progression free survival (PFS) time and overall survival (OS) time adopted the Cox regression analysis.Results The lymphocyte count (ALC) in the disease control group was higher than that in the non-disease control group.The neutro-phil to lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR) and mononuclear lymphocyte ratio (MLR) were lower than those in the non-disease control group.The proportions of squamous cell carcinoma,stage Ⅲ,ECOG score 0-1 point,adverse reactions in the DCB group were higher than those in the non-DCB group (P<0.05),the PLT count,NLR,PLR and MLR were lower than those in the non-DCB group (P<0.05). The ROC curve analysis results showed that PLT,NLR,PLR and MLR could serve as the indicators for pre-dicting DCB,the area under of ROC curve (AUC) was 0.633,0.602,0.635 and 0.604 respectively,the opti-mal cut off values were 187×109/L (P=0.004),5.0 (P=0.026),235 (P=0.003) and 0.35 (P=0.024) re-spectively.The multivariate Cox regression analysis showed that non-squamous carcinoma including adenocar-cinoma (HR=1.565,95％CI:1.057-2.316) and other pathologic types (HR=2.285,95％CI:1.326-3.936),ECOG score 2-3 points (HR=2.375,95％CI:1.652-3.415),AMC≥0.65×109/L (HR=1.847,95％CI:1.160-2.938) and PLR≥235 (HR=1.557,95％CI:1.016-2.386) were the independent risk factors for short PFS.The ECOG score 2-3 points (HR=4.615,95％CI:2.882-7.391),AMC≥0.65×109/L (HR=5.161,95％CI:2.984-8.925) and PLR ≥235 (HR=1.732,95％CI:1.059-2.833) were the independent risk fac-tors for short OS (P<0.05),and having adverse reactions (HR=0.472,95％CI:0.294-0.757) was the independ-ent protective factor for short OS (P<0.05).Conclusion Lower PLT,AMC,NLR,MLR and PLR,higher ALC,squamous cell carcinoma,TNM stage Ⅲ,ECOG score 0-1 point and immunotherapy related adverse reactions could prompt that the prognosis is good in ICIs treating advanced NSCLC.PLT,NLR,PLR and MLR could serve as the indicators for predicting DCB.

Objective:To investigate the clinical characteristics, diagnosis, treatment and prognosis of acute leukemia (AL) with NUP98-DDX10 fusion gene-positive.Methods:The clinical data of 2 AL patients with NUP98-DDX10 fusion gene-positive who admitted to Blood Diseases Hospital, Chinese Academy of Medical Sciences in April 2020 and February 2021, respectively were retrospectively analyzed. Transcriptome gene sequencing was used to detect fusion gene, and the fusion gene fragment was amplified by using reverse transcription polymerase chain reaction (RT-PCR), and Sanger sequencing was used to clarify sequences. The clinical and experimental indicators characteristics were analyzed and the relevant literatures were reviewed.Results:According to the clinical diagnosis, 1 patient was diagnosed as acute myeloid leukemia M 5 (AML-M 5) and 1 patient was diagnosed as acute leukemia of ambiguous lineage, not otherwise specified (ALAL-NOS). The AML-M 5 patient presented with severe coagulation abnormalities, and fulfilled the diagnostic criteria for diffuse intravascular coagulation (DIC) at the initial visit. Transcriptome sequencing of 2 patients showed NUP98-DDX10 fusion gene- positive. RT-PCR confirmed that sequencing results identified 2 different splice fusion modes: one was NUP98 exon 14 fused with DDX10 exon 7(usually called "type Ⅱ"), the other was NUP98 exon 14 fused with DDX10 exon 13, which was never reported and named as "type Ⅳ". From 1997 to 2018, a total of 16 cases with NUP98-DDX10 related hematologic neoplasms were reported in the literature. A summary analysis of 16 cases added with 2 patients in our center included 13 males and 5 females with median age 31.5 years (0.08-61 years). The median overall survival was 12 months (1-46 months). Conclusions:A novel fusion gene NUP98-DDX10 transcriptome is identified in ALAL-NOS patient. Hematological malignancies with NUP98-DDX10 are very rare. They respond poorly to conventional treatment and require allogeneic hematopoietic stem cell transplantation (allo-HSCT) to improve the prognosis.

Objective:To ascertain the activity concentration of gross α and β in foods around Fuqing nuclear power plant (NPP) site.Methods:Totally 167 food samples of 25 kinds within 6 categories were collected from the surveillance areas and control areas around Fuqing NPP site. The total radioactivity was analyzed using the food samples. Paired rank sum test was used to determine the influence of the operation of Fuqing NPP on the total radioactivity in foods in surrounding areas. The multiple local rank sum test was used to assess the difference in total radioactivity in different types of foods.Results:The average gross α in poultry meat, vegetables, crops, aquatic products, milk and tea was 0.65, 1.96, 1.41, 3.80, 1.33, 7.67 Bq/kg in surveillance areas and 0.56, 3.24, 2.04, 3.70, 2.24, 9.05 Bq/kg in reference areas, respectively, around Fuqing NPP site. The average gross β (subtracting 40K) in poultry meat, vegetables, crops, aquatic products, milk and tea was 7.0, 10.5, 6.1, 23.5, 24.7, 8.6 Bq/kg in surveillance areas and 7.4, 8.3, 14.5, 22.1, 21.3, 11.0 Bq/kg in reference areas, respectively, around Fuqing NPP site. The Wilcoxon paired rank test showed that there was no significant difference in the gross α and β in foods between surveillance and reference areas around Fuqing NPP site ( P>0.05). The Kruskal-Wallis H test showed that the radioactivity of gross α and β in different foods was statistically significant ( χ2=23.325, 13.918, P<0.05). Conclusions:The increase was not found in total radioactivity in the surrounding foods since the operation of Fuqing NPP in 2015.

Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.

Objective To investigation the radioactivity level of ⁹⁰Sr in tea leaves within and outside 30 km range of Ningde nuclear power plant. Methods The tea leaves within and outside the 30 km range of Ningde Nuclear Power Plant were collected from 2013 to 2018. According to“Radiochemical analysis of strontium-90 in water and ash of biological samples” (HJ 815—2016), the separation and analysis of ⁹⁰Sr-⁹⁰Y were carried outusing the method of di (2-ethylhexyl) phosphate (HDEHP) chromatography. Results During the period of 2013-2018, the radioactivity concentrations of ⁹⁰Sr in the tea leaves within the range of 30 km around the Ningde nuclear power plant were 0.486～13.29 Bq/kg and that of ⁹⁰Sr in the tea leaves outside the range of 30 km around the nuclear power station were 1.021～17.19 Bq/kg. Conclusion During the six years of operation in Ningde Nuclear Power Plant, there was no increase in the radioactivity level of ⁹⁰Sr in the tea leaves around the nuclear power plant.

Objective:To explore the assessment methodology for internal dose to workers exposed to 131I radionuclide. Methods:Workers were chosen in a 131I radiopharmaceutial manufacturer and a nuclear medicine department in a hospital using 131I to treat hyperthyroidism and thyroid cancer. A portable high purity germanium (HPGe) gamma spectrometer was used to measure the content of 131I in the thyroid for 4 consecutive times in a period of 7 d. The internal dose was estimated combining with the work rotation mode for workers dealing with 131I. Results:When the monitoring month was used as a typical month to estimate the internal dose, the annual committed effective dose was 0.09-1.93 mSv for the production staff engaged in the repackaging of 131I radiopharmaceuticals in the surveyed enterprise, and 0.06-0.58 mSv for the nuclear medicine staff in the surveyed hospital. After adjusting the monitoring result of the current monitoring period based on the rotation mode, the annual committed effective dose was estimated to be 0.06-1.22 mSv for radiopharmaceutical production workers and 0.03-0.15 mSv for nuclear medicine workers, respectively. Conclusions:In the assessment of internal dose to radiation workers exposed to 131I, using a single time measurement result to estimate the annual dose would lead to a larger error. In the case of continuous monitoring, the result of subsequent monitoring periods should be corrected according to the result of previous monitoring periods. In order to accurately estimate the internal dose of workers exposed to 131I, it is necessary to take full account of the 131I exposure pattern, time and frequency and the internal contamination route. For workers who may be exposed to 131I with potential internal dose greater than 1 mSv/year, a 14 day-routine monitoring period was appropriate.

Objective:To explore the main risk factors and to assess the risk of thyroid 131I exposure among nuclear medical workers. Methods:From March to October in 2019, cluster sampling was adopted to collect the number of 131I automatic packer and patients treated for thyroid cancer, hyperthyroidism and liven cancer used 131I, the practicing categories, job rotation and 131I operation condition of nuclear medical staff were also investegated in the 21 nuclear medicine hospitals in Fujian Province that carried out 131I nuclide diagnosis and treatment in 2018. 131I aerosol and personnel thyroid 131I were measured in 20 hospitals using 131I for thyroid cancer or hyperthyroidism. The main risk factors leading to thyroid 131I exposure of nuclear medical staff were found and aninternal exposure risk assessment model was established. Results:The detection rate of 131I aerosol and personnel thyroid 131I were 80.0% (16/20) and 25.5% (62/243) in 20 hospitals. The situation of packaging and administration about 131I in the nearly 10 effective half-life, the concentration of 131I aerosol in the nuclear medicine workplace, the number of patients treated with 131I for thyroid cancer or hyperthyroidism were the main risk factors leading to thyroid 131I internal exposure ( OR=5.857, 6.808, 1.983, 1.150, P<0.05) . Conclusion:131I exposure is common among nuclear medical workers, attention should be paid to the protection of internal radiation, strengthen the control of main risk factors, so as to reduce the risk of internal radiation.

Objective:To investigate the effect of genetic polymorphisms of TPMT*2 rs1800462, TPMT*3B rs1800460, TPMT*3C rs1142345, and NUDT15 rs116855232 on the tolerance of 6-mercaptopurine (6-MP) therapy in adult acute lymphoblastic leukemia (ALL) .Methods:A total of 216 adult patients who were diagnosed with ALL and treated with cyclophosphamide, cytarabine, and 6-MP [complementary and alternative medicine (CAM) regimen] from September 2015 to December 2019 were included. Polymorphisms were detected by TaqMan SNP Genotyping Assay. Combined with clinical data, the influence of genetic polymorphism on the tolerance of 6-MP in the treatment of ALL was analyzed.Results:Among the 216 patients, 185 (85.65%) patients had B-ALL and 31 (14.35%) patients had T-ALL. 216 (100%) patients had CC genotype for both TPMT*2 rs1800462 and TPMT*3B rs1800460. The number of TT and TC genotypes for TPMT*3C rs1142345 was 209 (96.76%) and 7 (3.24%) , respectively. The allele frequency was 1.62% for TPMT*3C rs1142345. The number of CC, CT, and TT genotypes for NUDT15 rs116855232 was 166 (76.85%) , 48 (22.22%) , and 2 (0.93%) , respectively. The allele frequency was 12.04% for NUDT15 rs116855232. The TPMT*3C rs1142345 mutant group (TC+CC genotype) had less transfusion volume of packed red blood cell than the wild group (CC genotype) ( P=0.036) , and the mutant group (TC+CC genotype) had a higher risk to develop hepatotoxicity (increased aspartate aminotransferase) than the wild group (CC genotype) ( OR=9.559, 95% CI 1.135-80.475, P=0.038) . The durations of white blood cells (WBC) <1×10 9/L and absolute neutrophil count (ANC) <0.5×10 9/L in the NUDT15 rs116855232 mutation group (CT+TT genotype) were longer than that in the wild group (CC genotype) ( P=0.005, P=0.007) , and the transfusion volume of apheresis-derived platelets in the mutant group (CT+TT type) was greater than that in the wild group (CC genotype) ( P=0.014) . Conclusion:Genetic polymorphism of TMPT and NUDT15 has an effect on the tolerance of 6-MP in the treatment of adult ALL. Detecting genotypes of patients with ALL before treatment helps to optimize the dosage of 6-MP, which may help shorten the bone marrow suppression duration and reduce blood transfusion volume.