Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Objective With the increase in pet-owning households in China, veterinary clinics have increased at an annual rate of 19.86%. However, the management blind area that may exist in multi-department supervision has led to a significantly worse working environment of radiation workers in veterinary clinics than that of medical institutions. The purpose of this study was to understand the levels of occupational external exposure of radiation workers in veterinary clinics in China, analyze the occupational risks faced by radiation workers in veterinary clinics, contribute to the protection of the occupational health of radiation workers, and provide data and scientific basis for the formulation of national relevant regulations and standards. Methods The individual dose monitoring data of radiation workers in selected veterinary clinics in 2022 were obtained from the National Individual Dose Registration System. Results This study involved 1868 radiation workers from 1216 veterinary clinics in 28 provinces and municipalities in China. The maximum annual effective dose was 8.93 mSv, the annual collective dose was 536.77 man·mSv, the average annual effective dose was 0.29 mSv, and the median was 0.15 mSv. The largest proportion of individuals (94.5%) received a dose of less than 1.0 mSv, while 5.4% had doses ranging from 1.0 mSv to less than 5.0 mSv. For radiation workers with an annual effective dose of 1.0 mSv and above, the individual distribution ratio of radiation workers in veterinary clinics was significantly higher compared with those in medical institutions and industrial applications (P < 0.05). Conclusion The levels of occupational external exposure of radiation workers in veterinary clinics meet the requirements of national standards. However, attention should still be paid to the radiation protection of radiation workers in veterinary clinics. This includes enhancing the responsibility awareness of veterinary clinic owners, strengthening protection training for radiation workers, protecting the occupational health of practitioners, and preventing the occurrence of occupational radiation diseases.

Objective To analyze the factors influencing the levels of occupational exposure in medical radiation workers in China, and to provide a scientific basis for determining the key points of radiation protection in the medical sector. Methods The individual monitoring data on occupational external exposure in medical radiation workers in 2021 were collected from the “National Individual Dose Registry”. The Chi-squared test and logistic regression were used to analyze the factors influencing the levels of occupational exposure in medical radiation workers. Results The Chi-squared test showed that gender, occupational category, medical institution category, region, number of radiation workers per thousand population, and regional per capita GDP were significantly associated with occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv and an annual effective dose limit of 20 mSv (χ² = 21.456−262.329, 7.601−78.650, P < 0.05). The logistic regression analysis further showed that gender, occupational category, region, and number of radiation workers per thousand population were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv (χ² = 14.621−170.857, P < 0.05); gender, occupational category, region, and regional per capita GDP were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 20 mSv (χ² = 5.401−48.709, P < 0.05). Conclusion Male radiation workers in interventional radiology and in central China have high risks of exceeding annual effective doses of 5 and 20 mSv. Moreover, high number of radiation workers per thousand population and regional per capita GDP are associated with low risks. Medical institutions should maintain a sufficient number of radiation workers and strengthen training on radiation protection knowledge for male and interventional radiology workers to enhance their radiation protection awareness. Investigation of the factors contributing to the high occupational exposure in central China should be intensified, and targeted effective measures should be conducted to reduce the occupational exposure in medical radiation workers.

Objective:To determine the regional boundary of para-aortic lymph node (PAN) metastasis in cervical cancer, and to explore the clinical target volume (CTV) margin.Methods:Eight-six patients with cervical cancer metastasis to PAN below and above left renal vein (LRV) were retrospectively included in this study. The anatomical relationship of the metastatic PANs and surrounding structures were analyzed according tocontrast-enhanced computed tomography (CT) and three dimensional reconstruction images.Results:Eight-six patients had metastatic PANs belowLRV: metastatic nodes were located onthe medial side of ovarian vessels and ureters, behind the renal veins, duodenum, mesenteric vessels, in front of the anterior border of lumbar vertebra and psoas. The inferior mesenteric vein was close to the left anterior side of PANs. Where the duodenum appeared, no node was presenton the anterolateral side of the inferior vena cava (IVC).Above the LRV, 27 patients had retrocrural node involvement along the azygos and hemiazgos vein, and 25/27 cases were located below the junction level of cardia and oesophagus, and 5/27 patients had metastatic lymph nodes between IVC and the right crura of diaphragm, all below the level of coeliac trunk artery.Conclusions:CTV margin delineation of PAN below and above LRV is recommended:superiorly, the junction level of cardia and oesophagus; laterally, crura and the medial side of ovarian vessels and ureters and inferior mesenteric vein; anteriorly, the posterior side of the coeliac trunk artery and renal veins and duodenum, mesenteric vessels; posteriorly, the anterior border of lumbar vertebra and psoas.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.

Objective:To analyze the dose range distribution of abnormal result, the distribution of occupational categories, the incidence of abnormal result of different occupational categories, the causes of abnormal result and the factors influencing abnormal values, on the basis of investigated abnormal result of individual monitoring for occupationally external exposure, in order to provide the scientific basis for the formulation of the relevant regulations and standards and the hospital radiation protection management.Methods:The abnormal result of 389 radiation workers in medical institutions receiving annual individual doses each exceeding 1.25 mSv, reported in 2017 in 19 provinces, were collected and analyzed.Results:Dose distribution range of abnormal result were mainly between 1.25 and 5 mSv; diagnostic radiology workers accounted for the highest fraction, 59.64% of the totals; and interventional radiology workers had the highest incidence, 4.17‰ of abnormal result. The abnormal result was mainly caused by improper wearing or operating personal dosimeters; the abnormal values in the eastern regions were higher than those in other regions, with a median of 6.41 mSv; the abnormal values in the cause-unknown group was higher than those in other groups, with a median of 10.32 mSv.Conclusions:The publicity and training of radiation protection knowledge should be further strengthened to improve the protection awareness of radiation workers. The occupational exposure of interventional radiology workers should receive special attention.

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.

Objective:To grasp the occupational health monitoring of radiation workers in medical institutions across the country, and to discover weak links in the prevention and treatment of occupational radiation diseases.Methods:In 2020 January, according to the monitoring data of the "National Radiation Health Information Platform" (Occupational Radiation Disease and Occupational Health Monitoring Subsystem and Occupational Radiation Disease Reporting Subsystem) , the national occupational health monitoring data from January 1 to December 31, 2019, including the number of radiation workers in medical institutions, occupational health examinations, personal dose monitoring and occupational radiation disease diagnosis, were descriptive analyzed.Results:There were a total of 394436 radiation workers in medical institutions across the country. The number of radiation workers in various provinces was quite different, with a median of 10206, which was positively correlated with the number of permanent residents in each province ( r=0.947) . There were 376 personal dose monitoring institutions nationwide, and the personal dose monitoring rate of radiation workers in medical institutions was 96.61% (381045/394436) . There were 419 occupational health inspection institutions for radiation workers across the country, and 269 (64.20%) used software to print physical examination forms. A total of 334455 radiation workers in medical institutions had been subjected to occupational health examinations. The rate of occupational health examinations for radiation workers in medical institutions was 84.79% (334455/394436) . The abnormal rate of chromosomal aberrations in peripheral blood lymphocytes of radiation workers in medical institutions was 0.33% (776/233571) , the detection rate of posterior posterior subcapsular turbidity was 0.63% (2093/334455) , and the abnormality rate of thyroid color ultrasound was 28.49% (14946/52464) . In 2019, a total of 16 cases of occupational radiation diseases were reported. Conclusion:The personal dose monitoring rate and occupational health examination rate of medical radiation workers nationwide are relatively high, but the quality of lymphocyte chromosome aberration analysis, eye lens examination and thyroid color photograph examination needs to be further improved.

Objective:To grasp the occupational health monitoring of radiation workers in medical institutions across the country, and to discover weak links in the prevention and treatment of occupational radiation diseases.Methods:In 2020 January, according to the monitoring data of the "National Radiation Health Information Platform" (Occupational Radiation Disease and Occupational Health Monitoring Subsystem and Occupational Radiation Disease Reporting Subsystem) , the national occupational health monitoring data from January 1 to December 31, 2019, including the number of radiation workers in medical institutions, occupational health examinations, personal dose monitoring and occupational radiation disease diagnosis, were descriptive analyzed.Results:There were a total of 394436 radiation workers in medical institutions across the country. The number of radiation workers in various provinces was quite different, with a median of 10206, which was positively correlated with the number of permanent residents in each province ( r=0.947) . There were 376 personal dose monitoring institutions nationwide, and the personal dose monitoring rate of radiation workers in medical institutions was 96.61% (381045/394436) . There were 419 occupational health inspection institutions for radiation workers across the country, and 269 (64.20%) used software to print physical examination forms. A total of 334455 radiation workers in medical institutions had been subjected to occupational health examinations. The rate of occupational health examinations for radiation workers in medical institutions was 84.79% (334455/394436) . The abnormal rate of chromosomal aberrations in peripheral blood lymphocytes of radiation workers in medical institutions was 0.33% (776/233571) , the detection rate of posterior posterior subcapsular turbidity was 0.63% (2093/334455) , and the abnormality rate of thyroid color ultrasound was 28.49% (14946/52464) . In 2019, a total of 16 cases of occupational radiation diseases were reported. Conclusion:The personal dose monitoring rate and occupational health examination rate of medical radiation workers nationwide are relatively high, but the quality of lymphocyte chromosome aberration analysis, eye lens examination and thyroid color photograph examination needs to be further improved.