Objective To obtain the protective performance parameters of barium sulfate mortar against positron nuclide γ-rays, provide reference data for precise shielding calculations, and guide the design, evaluation, and construction of radiation shielding. Methods The FLUKA program was used to build a model for simulating the dose equivalent rate variation around points of interest under the irradiation of the most commonly used positron nuclide ¹⁸F with changes in the thicknesses of lead and barium sulfate mortar. The transmission curves of lead and barium sulfate mortar were fitted, and the half-value layer (HVL) and lead equivalence of barium sulfate mortar were calculated based on the fitted curves. Results The ambient dose equivalent rate coefficient of positron nuclide ¹⁸F was 1.339 4×10⁻¹ μSv·m²/MBq·h and the HVL for lead was 4.037 mm, with deviations of 0.043% and 1.53% compared to the values provided in the AAPM Report No. 108, respectively. The HVLs for γ-rays produced by ¹⁸F, using barium sulfate mortar with apparent densities of 4.20, 4.00, and 3.90 g/cm³ mixed with 35.2-grade cement in a 4∶1 mass ratio, were 2.914, 2.969, and 3.079 cm, respectively. The lead equivalences were 0.1385, 0.1360, and 0.1311 mmPb/mm, respectively. Conclusion The three types of barium sulfate mortar can provide good protection against γ-rays in positron imaging locations. As the apparent density of barium sulfate increases, its protective effect improves slightly but remains significantly better than common construction materials like concrete and solid bricks.

Objective:To assess the clinical outcomes of hip arthroscopy in patients with concurrent femoroacetabular impingement (FAI) and subspine impingement (SSI).Methods:Data were retrospectively reviewed for patients with both FAI and SSI who underwent hip arthroscopy surgery from August 2021 to May 2022. A total of 23 patients (23 hips) followed up for more than 1 year, including 10 males and 13 females, 9 left hips and 14 right hips, with an average age of 31.3±4.6 years (range, 25-45 years). Subspine decompression by anterior inferior spine (AIIS) shaping for SSI was performed during hip arthroscopy in addition to labral repair and bony correction for FAI in the patients with concurrent FAI and SSI. Clinical outcomes were evaluated using preoperative and 1-year postoperative measures: lateral center-edge (LCE) angle, α angle on 45° Dunn view X-rays, maximum hip flexion angle, hip flexion and knee extension strength, visual analogue scale (VAS) for pain, modified Harris Hip Scores (mHHS), and International Hip Outcome Tool-12 (iHOT-12).Results:Of the 23 patients, 20 had type 2 AIIS and 3 had type 3 AIIS. At 1-year follow-up after surgery, there were significant improvements: LCE angle decreased (33.3°±6.1° to 31.7°±4.1°, t=1.076, P=0.288), α angle reduced (63.7°±8.5° to 50.0°±6.6°, t=6.116, P<0.001), hip flexion angle increased (107.4°±6.0° to 120.2°±4.4°, t=8.269, P<0.001), VAS scores decreased (4.0±1.1 to 1.0±1.1, t=9.591, P<0.001), mHHS improved (62.6±4.9 to 87.5±8.1, t=12.700, P<0.001), and iHOT-12 scores rose (51.4±4.9 to 75.7±7.7, t=12.593, P<0.001). There was no significant difference in the strength of hip flexion and knee extension between preoperative and follow-up ( t=0.930, P=0.357 and t=0.050, P=0.960, respectively). There were no reports of traction-related complications (such as skin necrosis and nerve paralysis), severe adverse events (such as femoral neck fractures, deep vein thrombosis in the lower limbs, intra-articular infections, ectopic ossification and hip instability), or the need for revision surgery. Conclusion:Subspine decompression by anterior inferior spine (AIIS) shaping for SSI during conventional hip arthroscopy is safe and effective, enhancing hip function and alleviating pain at 1-year follow-up without significant complications.

Objective To simulate and analyze the dose distribution from external exposure and its influencing factors of induced radioactivity in proton therapy site. Methods Referencing a domestically under-construction proton therapy facility, a geometric model of the proton therapy site was constructed, and the FLUKA program was used to simulate the distribution of the induced radioactive dose of the proton therapy site under the conditions of different energies, beam angles, irradiation time, cooling time and medium of the treatment site. Results For a 230 MeV proton beam with a current of 3.0 nA, directed along the negative Z-axis and irradiating a phantom for two minutes, at the shutdown moment, the ambient dose equivalent rates in air and vacuum 5, 30, and 50 cm away from the phantom surface were (1 039.02±5.82)-(127.86±1.20) and (1 037.96±4.38)~(127.35±0.93) μSv/h, respectively. The mean difference was 0.51~1.06 μSv/h, and the air-immersed external irradiation accounted for <1% of the total irradiation, which rapidly decreased to 1/15 of the shutdown moment value after cooling for 10 minutes. Under the condition of 130~250 MeV, the ambient dose equivalent rates at the shutdown moments 5, 30 and 50 cm away from the surface of the phantom were (427.49±3.12)-(1 058.41±4.66), (100.36±0.92)-(259.70±1.69) and (50.15±0.68)-(131.93±1.11) μSv/h, respectively. Irradiation for one-five minutes, and at the moment of shutdown at 5, 30, and 50 cm from the surface of the phantom were (688.19±3.33)-(1 594.04±8.08), (167.60±1.35)-(388.24±2.96) and (84.73±0.69)-(195.94±1.56) μSv/h. The peripheral dose-equivalent rate of the sensed radioactivity decreases with the irradiation time, the energy of the beam, and the distance from the model. The peak dose equivalent rate around the induced radioactivity exists in the beam direction, which is significantly larger than that in the non-beam direction. Conclusion Proton therapy sites are characterized by relatively large levels of induced peripheral radioactive dose equivalent rates, mainly originating from patients. In actual practice, a suitable working position can be chosen according to the direction of the beam current, especially the direction of the final irradiation field beam current, in the non-beam current direction and as far away from the patient as possible. Within 10 minutes after the end of treatment, staff should try to avoid close contact with the patients.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.

Objective:This multi-centre study was conducted to assess the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease.Methods:From July 2021 to December 2021, plasma samples of patients admitted to 10 hospitals were collected for screening preoperative/pre-transfusion blood transmitted disease. Nucleic acid detection technology was used to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA and human immunodeficiency virus (HIV)(1+2) RNA, and the results were compared with the immuno-serological methods. χ 2 test and Kappa test were used to analyze the efficacy of these two methods. Results:A total of 8 655 valid specimens were collected from 10 hospitals. There was a statistically significant difference in the positive detection rate of HCV between the two methods ( P<0.001). There was no significant difference in the positive detection rate of HBV and HIV assessed by the two methods ( P>0.05), but the number of positive cases detected by HBV DNA and HIV RNA (218 and 4 cases) was significantly higher than the corresponding serological results (216 and 2 cases). At the same time, there were HBV, HCV and HIV immuno-serological omissions by the immuno-serological methods, among which 28 cases were HBsAg negative and HBV DNA positive, 2 cases were HCV antibody negative and HCV RNA positive, and 2 cases were HIV antigen/antibody negative and HIV RNA positive. In addition, in the 66 samples with inconsistent results from the two detection methods, 83.3% (55/66), 68.2% (45/66), 63.6% (42/66) and 62.1% (41/66) of patients aged was>45 years, tumor, surgery and male, respectively. Conclusions:Compared with immuno-serological tests, nucleic acid tests have the advantage in terms of sensitivity on detecting HBV, HCV and HIV infection and could reduce missed detection. The risk of transmission can be reduced by adding HBV, HCV, and HIV nucleic acid tests to preoperative/pre-transfusion immuno-serological tests screening for patients over 45 years of age and tumor patients.

Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.

Objective To analyze the occupational hazards and protective measures for personnel in an iodine-125(¹²⁵I) seed source production company. Methods In 2022, a ¹²⁵I seed source production enterprise in Guangdong Province was selected as the research subject. The occupational hazards in the workplace of the research subject was identified using the system engineering analysis method. The FLUAK program based on Monte Carlo method was used to simulate the blocking protection of the production of the ¹²⁵I seed source, and to estimate the dose of internal and external irradiation of seed source that affected workers. Results The main occupational radiation hazards in the seed production were non-sealed radioactive materials, including external irradiation from X-ray and γ ray and internal irradiation from aerosols formed by iodine volatilization. Estimated maximum dose equivalent rate around the chest and eye lens for workers were 0.52 and 0.02 μSv/h, respectively. The expected annual effective dose for workers in each work site was 0.035 mSv, and the expected annual equivalent dose to the eye lens for all workers in various work sites was 0.001 mSv. The maximum annual equivalent dose of operator's hand was 80.620 mSv. The maximum dose of internal irradiation to the worker was 18.750 mSv, which was caused by the volatilization of nuclides. Conclusion With effective protection measures for internal and external irradiation in place, the annual exposure doses for seed production personnel and operator’s hand are below the national limits. Adequate measures should be taken on hand protection.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective To analyze the dose distribution of induced radiation in fixed proton beam therapy room and the influence of shielding materials, and to provide a basis for radiation protection and shielding material selection in proton therapy. Methods FLUKA was used to simulate the dose distribution of induced radiation in fixed proton beam therapy room, the dose over time, and the influence of different concrete materials. Results The dose of induced radiation was mainly concentrated around the target, and the dose rapidly decreased to 1/5-1/10 of the value at the time of stopping irradiation after cooling for 3-5 min. The induced radiation in concrete formed a slightly higher dose area at the end of the main beam near the inner side of the shield. The content of Fe, O, and H in concrete had significant effects on induced radiation (P < 0.01), and the dose was negatively correlated with the content of Fe. Conclusion The patients after proton therapy as well as the induced radiation in air and shielding materials are the main sources of external radiation dose for workers, and waiting for a period of time is the most effective way to protect the staff. Without considering the difficulty in construction and based on the analysis of shielding materials in protection against external irradiation and their influence on induced radiation, heavy concrete with a relatively high level of Fe is the best choice of the shielding material for proton therapy room.