Objective To investigate the external radiation doses and occupational health examination data of radiation workers in medical institutions in Zhangjiagang City, China, explore the effects of long-term exposure to low-dose ionizing radiation on their health, and provide a reference for occupational health monitoring. Methods The radiation workers of medical institutions in Zhangjiagang City were selected as the research subjects. Their personal radiation doses and occupational health examination data were collected. A scale was used for mental health survey. The data were analyzed according to different clinical characteristic groups. Results During the 5-year period from 2019 to 2023, the average annual radiation dose received by radiation workers in medical institutions in Zhangjiagang City was 0.21 mSv/year. There were significant differences in the average annual radiation dose across these years and radiation workers with different occupations. The results of occupational health examinations showed significant difference in the total abnormal detection rate among these years (P < 0.01). There were significant differences in the abnormal rates of blood pressure, blood routine, and electrocardiogram across these years (P < 0.05). There were significant differences in the abnormal rate of routine blood test in radiation workers with different sexes, years of service, and radiation occupations (P < 0.01). There were significant differences in the abnormal rate of blood pressure in radiation workers with different sexes, ages, and years of service (P < 0.01). The mental health survey showed significant differences between the radiation and the non-radiation groups in terms of occupational stress, anxiety score, and depression score (P < 0.05). Conclusion Long-term low-dose ionizing radiation may have adverse effects on the physical and mental health of radiation workers, and it is necessary to strengthen the occupational health examination and radiation protection of radiation workers.

Objective:To screen out and analyze the key genes of follicular lymphoma (FL) according to transcriptome data in Gene Expression Omnibus (GEO) database.Methods:Transcriptome datasets GSE32018 and GSE55267 were collected by using GEO database. R software was used for variance analysis to screen differentially expressed genes. FunRich 3.13 software was used to analyze common differential genes. The biological processes and pathways were analyzed with Cytoscape 3.7.2 software to screen potential genes related to the pathogenesis of FL. By analyzing clinical data from Oncomine database for survival analysis, the screened differential genes were verified.Results:A total of 141 up-regulated genes and 199 down-regulated genes were identified by differentially analyzing GSE32018 and GSE55267 datasets. Finally, 12 key genes including CXCL8, KRT19, CYCS, CDKN3, SFN, RRM2, FN1, APOE, CXCL12, VWF, GATA3 and TIMP1 were screened out; CYCS, CXCL8 and CXCL12 were closely related with the early survival rate of patients. Overexpression of CXCL12 and low expression of CYCS were found to be associated with poor prognosis of FL patients. CXCL8 expression was decreased in lymphoma tissues, but the relatively high expression of CXCL8 in survival analysis showed shortened overall survival, which might be related to the early development of FL. GO, KEGG and Reactome pathways were screened out including GO: 0001892, KEGG: 04115, R-HSA: 2559582, GO: 0060968, R-HSA: 6785807, GO: 0043627, GO: 0001936 and GO: 0043062.Conclusion:The selected genes CYCS, CXCL8 and CXCL12 may provide more effective biomarkers for the treatment of FL.

Objective To evaluate the difference of set-up errors between thermoplastic mask and breast bracket in patients receiving intensity-modulated radiotherapy after breast conserving surgery,and the impact of clinical factors associated with set-up errors.Methods A total of 34 patients treated with intensity-modulated radiotherapy after breast conserving surgery from January 2016 to June 2018 were reviewed.Eighteen patients were fixed with thermoplastic mask,and sixteen were with breast bracket.Weekly CBCT scan records were used to analyze set-up errors,and group systematic and random errors were computed.The influence of clinical factors on set-up errors was also analyzed.Results The immobilization technique with thermoplastic mask showed great superior in comparison with breast bracket;however,only in the Ty(translation) and Ry(rotation),the differences had significance.Based on group systematic and random errors,PTV margins in Tx,Ty and Tzwere 2.65,4.36 and 2.87 mm in thermoplastic mask group,as well as 5.71,6.07 and 4.20 mm in breast bracket group,respectively.Multi-factor regression analysis showed that BMI was independent factors affecting set-up errors.Conclusions Compared with breast bracket,the immobilization technique with thermoplastic mask has the potential of reducing set-up errors and PTV margins in patients receiving intensity-modulated radiotherapy after breast conserving surgery,especially in patients with high BMI.

Objective To investigate the relationship between the body mass index (BMI)/body mass index improved (BMIIMPd) and the dose of the small intestine as well as the acute radiation colitis in the intensity-modulated radiation therapy after cervical cancer surgery.Methods Thirty-nine cervical cancer patients underwent postoperative adjuvant radiotherapy.All patients received Philips large bore CT scan for enhanced CT scan,target delineation and organ at risk.All patients were treated with a single arc 10 MV VMAT plan.The correlation between the radiation dose of the small intestine and the acute radiation enteritis and BMI/BMIIMPd was analyzed.Results The BMI was calculated as (22.23±2.80) kg/m2,BMIIMPd was (21.49±3.95) kg/m2,the small intestine volume VSI was (1 155.71 ± 419.33)cc3.The volume of the small intestine received more than 10 Gy (V10_SI) VMAT was (66.50± 27.01) ％,and the equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were (4 098.87± 184.93) cGy and (7.98±8.73)％.One way ANOVA demonstrated that under the VMAT technology,the BMIIMPd,V30,V40,EUD (or=50) and NTCP in the small intestine were the influencing factors of the occurrence of acute radiation enteritis.Conclusions If the improved BMIIMPd is utilized to distinguish the BMI,the high dose area of the small intestine will be larger and the incidence of acute radiation enteritis will be higher for patients with BMIIMPd between 10.1 and 16.9(normal and thin).Conventional BMI cannot be utilized as a basis for the prediction of the incidence of acute radiation enteritis in patients with cervical carcinoma.

Objective To study the geometric difference between six different ITV generation methods from 4DCT for patients with non?small cell lung cancer ( NSCLC) treated with stereotactic ablative radiotherapy technique ( SABR) . Methods Between Dec. 2013 and Mar. 2014,16 patients were enrolled in this retrospective study. All patients underwent imaging with 4DCT scans. The MI and DI index were evaluated between six ITV generation methods:combining GTV from all 10 respiratory phases ( ITV10 );combining GTV from four respiratory phases, including two extreme phases ( 0% and 50%) plus two intermediate phases ( 20% and 70%) ( ITVYeo ) which was proposed by Seung?Gu Yeo of Soonchunhyang University;combining GTV from two extreme phases ( ITVEI+EE ) . And combining GTV from five odd phases (10%,30%,50%,70%,90%)(ITVodd).Accordingly the ITVEVEN which was combined from the remaining five even phases (20%,40%,60%,80%,0%),and ITVAVG,ITVMIP were contoured from two reconstructed 4DCT sequences,finally,a method which was not sensitive to the tumor volume and motion characteristic was selected for clinical use. Data were compared using a variance analysis followed by Student?Newman?Keulsa test both in same group or between groups. At the same time, the volume and the three dimensional movements of the tumor, the relativity of MI and DI were analyzed by Multi?parameter regression analysis. Results The mean (range) tumor motion (RLR,RAP,RCC,and R3D) are 3. 5 mm (1. 4?8. 4 mm),4. 5 mm (1. 1?8. 6 mm),9. 5 mm (0?10 mm),12. 3 mm (2. 5?55. 3 mm) respectively. The IGTVx volume are Underestimated by 25. 7%,35. 6%,17. 9%,12. 8%,3. 6%,4. 8%( P=0. 000) respectively. The MI index comparisons between six ITV generation methods and ITV10 showed statistical significance:0. 69,0. 62,0. 80, 0. 86,0. 93,0. 91 ( P=0. 006 ) . The DI index showed no statistical significance:0. 98, 0. 98, 0. 97, 0. 97, 0. 99,0. 98(P=0. 130).The tumor size and motion amplitude were certified not the independent factors for the MI index of ITVodd and ITVEVEN . Conclusions IGTVODD/EVEN based on odd or even 4DCT phases is not sensitive to the tumor size or motion characteristic and is proved to have a good marching with ITV10 meanwhile maintaining a reasonable contouring efficiency,it can be recommend to the institutions which was not equipped with the deformable registration systems.