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    Radiation Health/Original Articles
  • Radiation Health/Original Articles
    A survey of management status of radiation workers in medical institutions in Dongcheng District, Beijing in 2019
    ZHAO Sijing, WEI Xiang
    2020, 29(6): 583-585,597. https://doi.org/10.13491/j.issn.1004-714X.2020.06.001
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    Objective To understand the management status and level of radiation workers in medical institutions, and to provide a basis for strengthening supervision.Methods To design the questionnaire in a unified manner including the following contents: basic information, training, physical examination, certification, file and personal dose of radiation workers, statistical methods using χ2 test and variance analysis, significant level α = 0.05, P < 0.05 was statistically significant.Results There were 1209 radiation workers in the hospital, including 682 males (56.4%), 603 people (49.9%) with junior professional titles, 449 people (37.1%) with intermediate professional titles, 157 people (13.0%) with senior professional titles, and 826 people (68.4%) with bachelor degree or above. The distribution of gender, professional title and educational background of radiological staff in different hospitals was different and the differences are statistically significant (P < 0.001); the trend χ2 test results show that the higher the hospital level, the higher the titles and degree of the radiation workers (P < 0.001); The radiation staff training rate, personal dose monitoring filing rate and occupational health examination filing rate were all 100%. The radiation staff physical examination rate and certificate holding rate are 98.5% and 99.6%, respectively. There was no statistically significant difference between the physical examination rate and the certification rate of the staff in different hospitals (P > 0.05); The personal dose monitoring rate and frequency rate were 100.0% and 93.7%, respectively. The collective annual dose and the average annual dose were 201.55 mSv and 0.17 mSv, respectively. The difference in the average annual dose (P < 0.001) of different hospitals was statistically significant. The average annual dose of radiology staff in tertiary hospitals was significantly higher than that in other hospitals (P < 0.05). The difference in the average annual dose (P < 0.001) of different positions was statistically significant. The average annual dose of radiotherapy and nuclear medicine radiology workers was significantly higher than that of other positions (P < 0.05).Conclusion Medical institutions should improve the management of radiation workers and strengthen the monitoring of personal doses and personal protection.
    • Medical Exposure/Original Articles
  • Medical Exposure/Original Articles
    Investigation and analysis of radiotherapy and nuclear medicine exposure frequency of 13 hospitals in Shandong Province in 2016
    YANG Shuhui, LIU Qian, SONG Gang, LI Hailiang, NIU Fei, CHEN Rui, MIN Nan, LIU Fang, CHEN Yingmin
    2020, 29(6): 586-589. https://doi.org/10.13491/j.issn.1004-714X.2020.06.002
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    Objective To provid basic data for understanding the current development of medical exposure by investigating and analyzing the medical exposure frequency of radiation therapy and nuclear medicine in 13 hospitals in Shangdong province in 2016.Methods To collect relevant data with the help of the existing hospital system (such as PACS system, HIS system, hospital charge system, etc.) or copy the registration notes and so on. The data are reunified into the questionnaire of the survey on the dose. The information of sampled hospital was processed and analyzed by using EXCEL software and SPSS18.0 software.Results A total of 13 hospitals were investigated, 12 of which carried out radiotherapy, and 6 hospitals have carried out the diagnosis and treatment of nuclear medicine. A total of 14598 cases of radiation therapy were carried out throughout the year, the frequency range of radiation therapy is: 0.25～28.68/thousand man year. There were 34034 cases of nuclear medical examination, the frequency range of nuclear medical examination was: 0.36～37.04/thousand man year. A total of 1295 cases of nuclear medicine were treated, the frequency range of nuclear medicine treatment was 0.25～0.44/thousand man year.Conclusion The current status of radiation therapy and nuclear medicine of 13 hospitals can be basically mastered by this survey. It provides a scientific basis for understanding the development of radiotherapy and nuclear medicine in our province, and also provides a new enlightenment for the further investigation of the medical exposure frequency.
  • Medical Exposure/Original Articles
    The estimation of patient's exposure dose during esophageal stent placement under X-ray fluoroscopy
    ZHANG Lin, YANG Shuhui, NIU Fei, MIN Nan, LI Zhen, LI Hailiang, SONG Gang, SUN Weihang, LIU Hanxiao, ZHU Jianguo
    2020, 29(6): 590-593. https://doi.org/10.13491/j.issn.1004-714X.2020.06.003
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    Objective To estimate patient's exposure dose during esophageal stent placement under X-ray fluoroscopy through anthropomorphic phantom experiments.Methods Investigated 60 cases of esophageal stent implantation provincial tertiary hospitals and recorded intraoperative fluoroscopy time, tube voltage, tube current and other information. The anthropomorphic phantom experiments were divided into 3 groups according to the duration of fluoroscopy, cumulative dose and the size of the DAP, and a pyroelectric dosimeter was placed in predetermined holes within the anthropomorphic phantom to restore the surgical procedure in groups according to the experimental conditions. The patient's dose was estimated based on the results of the thermoluminescence dosimeter.Results In this study, under X-ray fluoroscopic esophageal stent placement, the effective doses for patients in the high, medium, and low dose groups were 10.773, 4.004 and 1.889 mSv, respectively. The highest values of absorbed dose from different tissues or organs in the three dose groups (high, medium and low) were in the red bone marrow, followed by muscle, esophagus and lung, with the lowest values in the testes.Conclusion Estimates of the effective dose to patients were proportional to the duration of fluoroscopy, cumulative dose, and size of DAP in the experimental conditions. The magnitude of the absorbed dose to the same tissue and organ increases with increasing fluoroscopy time in different dose groups. The amount of absorbed dose to different tissues and organs in the same dose group is closely related to the tissue weighting factor, the magnitude of the mass-energy absorption coefficient and whether the tissue or organ is irradiated by the main beam.
  • Medical Exposure/Original Articles
    Discussion on reconstruction of nuclear medicine radiological protection
    WANG Chao, LIU Jinyan, MENG Qianqian, WANG Jingjie, LI Xiaozhen, ZHANG Huifang, BAI Bin
    2020, 29(6): 594-597. https://doi.org/10.13491/j.issn.1004-714X.2020.06.004
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    To evaluate the layout, personnel flow and protective facilities of the radioactive workplace with objective and scientific methods such as data access, field investigation, detection and comprehensive analysis according to its characteristics based on the analysis of the reconstruction of the nuclear medicine department in a grade-THREE grade A general hospital, the paper. To describe objectively description of the plane layout, ventilation, personnel flow, radioactive drugs and radioactive waste flow, and protective test results of the nuclear medicine discipline construction project. The reconstruction of nuclear medicine palces can basically meet the requirements of radiation protection and control the radiation occupational disease hazards in normal operation, but there are still some problems that need to be improved. This paper has summarized some practical experience for reference in the reconstruction of similar nuclear medicine places, and put forward some requirements, principles and matters needing attention in the reconstruction of similar nuclear medicine places, so as to provide a reference for other medical institutions in the reconstruction of nuclear medicine places.
  • Medical Exposure/Original Articles
    Analysis of the frequency of children's CT examination based on hospital computer information system in 17 hospitals in Shandong Province
    LIU Qian, YANG Shuhui, SONG Gang, MIN Nan, LIU Fang, NIU Fei, LI Zhen, CHEN Yingmin
    2020, 29(6): 598-602. https://doi.org/10.13491/j.issn.1004-714X.2020.06.005
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    Objective Randomly selected 17 hospitals in 8 prefecture-level cities in Shandong Province to investigate the frequency of CT examination of children and get a preliminary understanding of the frequency composition.Methods With reference to and modification of the national unified questionnaire on medical irradiation, 17 hospitals in 8 cities in Shandong Province were randomly selected as a sample by stratified random sampling method, the contents of the survey included the level of medical institutions and information on the diagnosis and treatment of examines obtained from the computer information management system, etc.Results A total of 45114 children were surveyed, of whom 27307 (60.53%) were boys and 17807 (39.47%) were girls; 8091 (17.93%) were in the infant group (< 1 year old), 8910 (19.75%) in the toddler group (1～< 3 years old), 7656 (16.97%) in the preschool group (3～< 6 years old), and 20457 children (45.35%) in the adolescent group (10～< 15 years old). The top two cumulative frequencies of irradiation in children of different ages were cranial and thoracic, with 18398 (35.4%) and 15359 (29.5%) irradiation frequencies, respectively. Plain scans were the predominant CT scanning modality, with 45194 (86.87%) scans and 5200 (10.0%) enhanced scans. The top two sites for enhanced scans were cranial and thoracic, accounting for 16.36% and 13.20% of the scans, respectively. Among the different age groups, the highest proportion of repeat examination was the preschool group, with 14.64% having two examinations and 2.49% three examinations; the highest proportion of repeat examinations among the different sites examined was coronary angiography.Conclusion Due to the high frequency of CT scans for children, relevant departments should take strong measures to optimize medical exposure protection and reduce radiation hazards.
    • Radiation Monitoring/Original Articles
  • Radiation Monitoring/Original Articles
    Problems and countermeasures of the examinee surface shielding protection in computed tomography
    LI Rungen, SHI Chaogang, BAI Hao, LIU Ying
    2020, 29(6): 603-606. https://doi.org/10.13491/j.issn.1004-714X.2020.06.006
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    In CT non-scanning area, body surface shielding protection is a simple and effective method to reduce the radiation dose of the examinee, and it is also the basic requirement of the national industry standards. According to a review of some investigative reports in our country, there are some problems existing to varying degrees in different areas and different levels of medical institutions such as for CT examinee personal radiation protective equipment, configuration rationality is deficient, utilization rate is not high, use method is improper, routine maintenance is not in place, and the medical personnel, the public or the examinee does not know enough about the basic knowledge of radiation protection, etc which need to be improved constantly.
  • Radiation Monitoring/Original Articles
    Comparison and evaluation of dose at reference point between the displayed value and measured value of interventional radiology equipment
    XU Hui, YUE Baorong, ZHAO Xipeng, SUN Quanfu
    2020, 29(6): 607-610,614. https://doi.org/10.13491/j.issn.1004-714X.2020.06.007
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    Objective By measuring the relationship between the reference point dose and the display dose of interventional radiology equipment in fluoroscopy mode, the accuracy of the display dose of equipment was verified, and the rationality of using the display reference point dose to guide physicians to optimize radiation protection was evaluated.Methods Two different brands of flat panel detectors for interventional radiology equipment were selected and recorded as device A and Device B respectively. A 30 cm×30 cm and 20 cm thick PMMA phantom and copper plates of different thickness were combined and placed on one side of the plate detector. The RF detector of unfors Xi dosimeter was used to measure the dose rate at the reference point position, and compare the incident dose at the reference point with the displayed value. Different thickness phantom were used to measure the dose rates of the interventional reference points, and the relationship between the output per mA·min and kV was fitted.Results For device A, the deviation between the dose rate displayed and the measured dose rate in the field was within 6%. For device B, the deviation between the dose rate displayed and the measured dose rate in the field reached 85.6% or more. The output of each mA·min of the device has a power exponential relation with kV.Conclusion Medical technicians in interventional radiology should be aware of the accuracy of the reference dose displayed by their X-ray systems for interventional radiology, and periodically verify and control the quality of the interventional radiology equipment to ensure the accuracy and referability of the displayed dose. Interventional physicians and technicians can use the displayed dose to roughly estimate the level of the exposed dose on the patient's body surface to avoid the patient's deterministic effect.
  • Radiation Monitoring/Original Articles
    Analysis of individual dose monitoring results of radiation workers in Yunfu City from 2013 to 2018
    CHEN Xiaoyue, CHEN Jichao, SU Xiaotang, HUANG Qinhai
    2020, 29(6): 611-614. https://doi.org/10.13491/j.issn.1004-714X.2020.06.008
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    Objective To analyze and evaluate the results of personal dose monitoring of radiation workers in Yunfu City to provide reference for the regulatory authorities and radiation work units in formulating relevant management measures. Methods Detected the individual doses of medical radiation workers by thermoluminescence measuring method and analyzed the results of individual dose monitoring in Yunfu City from 2013 to 2018. Results From 2013 to 2018, a total of 2043 radiation workers in Yunfu City conducted personal dose monitoring for occupational external exposure, with an overall monitoring rate of 95.7% and an annual effective dose per capita of 0.28 mSv/a. Interventional radiology and nuclear medicine workers had a higher annual effective dose per capita of 0.33 mSv/a and 0.32 mSv/a, respectively, with statistically significant differences between the different types of workers (P < 0.05). The annual effective dose per capita of radiology staff varies among the level of the unit, with the highest value (0.35 mSv/a) in township-level units and the lowest value (0.22 mSv/a) in mining enterprises, with a statistically significant difference (P < 0.05). Conclusion The average annual individual effective dose of radiation staffs in Yunfu from 2013 to 2018 are in line with national health standards, It is recommended that the supervision and training of radiation workers in positions of interventional radiology, nuclear medicine and township level units should be strengthened.
  • Radiation Monitoring/Original Articles
    Preliminary study on radon sampling method in mine by activated carbon box
    LIU Chao, XING Yafei, ZHAO Xiao, SONG Zhiwei, CHEN Yu, ZHANG Yanwei
    2020, 29(6): 615-617,624. https://doi.org/10.13491/j.issn.1004-714X.2020.06.009
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    Objective In this paper, the influence of factors such as adding filter membrane on the adsorption surface of the carbon box and changing the direction of the adsorption surface in the radon sampling process of the activated carbon box method on the measurement results was studied. It provides technical support for the application of this method to the detection of radon concentration in high humidity and high dust environments in mines.Methods Arranged the activated carbon box according to the experimental scheme. After the adsorption time, put on a sealed lid and weighed it. After 5 hours, used the HD-2001 low background gamma spectrometer to test the radon concentration. In order to compare the measurement results, RAD7 radon concentration detector was used to measure the radon concentration in the test room synchronously.Results Radon concentrations in the air measured with the adsorption surface of the activated carbon box up or down were (227.2 ±3.0) Bq/m3 and (229.8 ±3.7) Bq/m3 respectively. The relative deviation of the measurement results of the two placement methods was only 1.1%. The radon concentrations in the air were (224.3 ±3.0) Bq/m3 and (231.8 ±3.0) Bq/m3 respectively after quantitative filter paper or Hi-Q dust accumulation filter membrane added on the adsorption surface of the activated carbon box. The relative deviation between the measured results with and those without filter membrane were -1.3% and 2.0%, respectively. At 89.5% ambient humidity, the radon concentrations in the air measured by the active carbon box were between 221.5 Bq/m3 and 238.1 Bq/m3. Under the same condition, the radon concentration measured by the RAD-7 instrument was 243 Bq/m3, and the relative deviation between the two methods was only -6.1%.Conclusion Under this test condition, a quantitative filter paper or hi-q dust filter membrane was added to the adsorption surface of the activated carbon box during sampling, and the adsorption surface of the activated carbon box was placed downward, which had no significant effect on the measurement results. This sampling method can avoid the dust, slag and other impurities in the mine falling into the activated carbon box and affecting the measurement results.
  • Radiation Monitoring/Original Articles
    Analysis of individual dose level of Songjiang radiation workers exposed to external radiation from 2017 to 2018
    ZHANG Luqian, WANG Yanmei, JIANG Song, WANG Guimin, JIANG Yuanqiang
    2020, 29(6): 618-620. https://doi.org/10.13491/j.issn.1004-714X.2020.06.010
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    Objective In order to further provide guidance on occupational safety and protection for radiation workers, we collected the individual dose levels of radiation workers in Songjiang District and evaluated the protection status of radiation workers.Methods Analyzing and evaluating the results of dose monitoring of radiation workers by pyroelectric dosimetry systems according to the Specifications for individual monitoring of occupational external exposure (GBZ 128—2016).Results A total of 620 people were monitored in Songjiang District in 2017—2018, with a per capita annual dose equivalent of 0.448 mSv·a-1 and a two-year collective dose equivalent of 277.514 people·mSv, with per capita annual dose equivalent of 0.259～1.276 mSv·a-1 for radiological staff in different occupational categories. Annual dose equivalent per capita in nuclear medicine is higher than in the other four categories (P < 0.05) and in interventional radiology than in diagnostic radiology, diagnostic dentistry and radiotherapy (P < 0.05).Conclusion The personal dose level of radiation workers in Songjiang District is far below the national limit of 20 mSv·a−1, which means the working environment is relatively safe, however, it is still necessary to raise the awareness of radiation workers to strengthen their own protection.
  • Radiation Monitoring/Original Articles
    Intercomparison of milk powder 90Sr, 60Co and 137Cs analysis among laboratories
    LU Ying, LOU Hailin, LI Aiyun, TU Xingming, WANG Shaolin
    2020, 29(6): 621-624. https://doi.org/10.13491/j.issn.1004-714X.2020.06.011
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    Objective In order to improve the analysis and monitoring level of 90Sr, 60Co and 137Cs in food in the national key radiation environmental laboratories.Methods Organize national key radiation environmental laboratories to compare milk powder 90Sr, 60Co and 137Cs standard samples. The comparison result was judged by the relative deviation of the reference value.Results Milk 90Sr samples were compared within 8 laboratories, the relative deviation was less than 10%, accounting for 25%; 10%～20%, accounting for 12.5%; 20%～30%, accounting for 62.5%. Milk 60Co、137Cs samples were compared within 14 laboratories, 60Co: relative deviation was less than 10%, accounting for 85.7%; 10%～20%, accounting for 14.3%; 137Cs: relative deviation was less than 10%, accounting for 71.4%; 10%～20%, 28.6%. The overall comparison result is acceptable.Conclusion The laboratories participating in this comparison have good overall comparison results.
  • Radiation Monitoring/Original Articles
    The influence of the detection window wrapped with plastic film on the surface contamination detection
    CHEN Zhongmin, HU Hongfang, LI Wei, DONG Suhe, YU Huijie, WANG Sinian, LV Xiaoli, DENG Zhirong
    2020, 29(6): 625-627. https://doi.org/10.13491/j.issn.1004-714X.2020.06.012
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    Objective To study the influence of the detection window of the surface contamination detector wrapped with plastic film on the surface contamination detection.Methods RDA150 and Como170 type surface contamination detectors were selected to measure the surface α-ray contamination level of Americium-241 source under the condition of no film, single-layer film and double-layer film covering the observation window of the equipment, respectively.Results Under the condition of no film, the average measurement result of RDa150 surface contamination detector's 5 measurements was 228.01 Bq/cm2, and that of Como170 type surface contamination detector was 231.05 Bq/cm2; Under the condition of single-layer film covering, the average measurement results of RDa150 type surface contamination detector's 5 measurements was 96.34 Bq/cm2, and the Como170 surface contamination detector were 100.31 Bq/cm2 which decreased by about half. Under the condition of double-film coverage, the average measurement results of RDa150 type surface contamination detector's 5 measurements were 0.45 Bq/cm2, and the Como170 type surface contamination detector were 0.65 Bq/cm2.Conclusion When the surface contamination level is high, a single layer of plastic film can be used to cover the equipment detection window to reduce the risk of equipment contamination. When the decontamination is completed or the level of surface contamination is low, the equipment detection window cannot be wrapped with plastic film.
  • Radiation Monitoring/Original Articles
    Analysis of total Uranium concentration in drinking water source
    HU Chenjian, LIU Changjun, HUANG Guofu, LI Tianyang, XU Hong, HU Xiaoyan, XU Chao
    2020, 29(6): 628-631. https://doi.org/10.13491/j.issn.1004-714X.2020.06.013
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    Objective To investigate the total uranium in various types of drinking water sources, and analyze the concentration, the annual intake and the annual committed effective dose, so as to provide scientific basis for radiation environmental safety supervision.Methods Analyze and calculate the concentration, the annual intake and the annual committed effective dose of total uranium in drinking water source by Laser fluorescence method from 2010 to 2018.Results From 2010 to 2018, the total uranium concentration in drinking water source water is 0.09～4.50 μg/L, the maximum annual intake for children and adults is 62.58 Bq and 125.16 Bq, respectively. The corresponding annual committed effective dose is 4.63 μSv and 6.13 μSv, respectively, which is in line with the public annual effective dose limit.Conclusion The total uranium concentration in the coastal seawater is high, while in the lake reservoir water and groundwater is low and stable. The total uranium concentration in surface water near the sea is sometimes high, which may be caused by the tide. Considering the influence of uranium in drinking water sources on the public, the concentration limit of uranium element should be established.
  • Radiation Monitoring/Original Articles
    Image quality test and clinical photographs evaluation of 808 medical magnetic resonance imaging systems in China during 2013—2018
    FAN Shengnan, TAN Zhan, WANG Bo, ZHOU Kaijian, YIN Handong, ZHANG Jin, DENG Jun
    2020, 29(6): 632-636. https://doi.org/10.13491/j.issn.1004-714X.2020.06.014
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    Objective To evaluate the image qualities of medical magnetic resonance imaging (MRI) systems in four provinces in China from 2013 to 2018.Methods According to the national standard of "Specification of image quality test and evaluation for medical magnetic resonance imaging equipment", the signal-to-ratios and the other seven main performance indexes of 808 MRI equipments were measured by phantoms of Victoreen 76-907 type, 76-908 type and Magphan SMR170 type, USA. In addition, the qualities of clinical photographs taken by the systems were assessed. Moreover, fisher exact test was carried out on the results of imported equipment and domestic equipment using SPSS 22.0 statistical software.Results A total of 508 MRI equipments in Hebei province, 177 in Guangdong Province, 90 in Chongqing municipality and 33 in Inner Mongolia Autonomous Region were tested for image quality. The pass rates of relative deviation of resonance frequency, signal-to-noise ratio, image uniformity, geometric distortion, high contrast spatial resolution, slice thickness deviation, slice non-uniformity and aspect ratio were 100%, 97.5%, 100%, 99.6%, 97.4%, 99.8%, 100% and 100%, respectively. It was showed that the high contrast spatial resolution of imported equipment was significantly higher than that of domestic equipment (P = 0.036 < 0.05). The evaluation results of the clinical photo quality of 463 MRI equipments in Hebei Province showed that there were 323 sets of grade A, 82 sets of grade A-, 0 sets of grade B+, 48 sets of grade B, 8 sets of grade B-, and 2 sets of grade C.Conclusion The image qualities of the 808 MRI devices are overall good, basically meeting the requirements of relevant national standards. However, it is necessary to further strengthen the state detection and quality assurance of MRI equipment, and pay attention to the training of technical staff in clinical operation. It is recommended to revise the current relevant standards in order to improve the image quality and better protect the rights and interests of the examinees.
  • Radiation Monitoring/Original Articles
    Analysis on the results of Ningxia's participating in the national personal dose monitoring ability assessment in 2019
    JI Xuli, WEI Qiong, SHEN Mei, LU Guicai, SUN Yanling, LI Hongcheng, DONG Liang
    2020, 29(6): 637-639. https://doi.org/10.13491/j.issn.1004-714X.2020.06.015
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    Objective To understand the operation status of personal dose monitoring system in provincial laboratory by analyzing the assessment results of personal dose monitoring ability of national radiation workers in 2019, to further improve the monitoring ability and level of Ningxia.Methods The provincial laboratory participated in the National Radiation Workers' personal dose monitoring ability assessment in 2019, and the assessment results were analyzed and summarized.Results In this comparison, 10 full marks were obtained for the ability assessment results of the test report, and the single group performance deviation was -0.04～0.01 (all in line with |Pi| ≤ 0.10), while the comprehensive performance deviation was B2 + S2 ≤ 0.10 (B was the comprehensive judgment index, S was the comprehensive standard deviation). Therefore, 70 full marks could be obtained for the experiment, and the total score could meet the requirements of 80 points to qualify for participating in the evaluation of excellence. After evaluation, the quality control score was 17.3 points, the Q value was 97.3 (excellent if Q ≥ 95), so the assessment result of individual dose monitoring ability of the laboratory wsa excellent.Conclusion The assessment results show that the system of Ningxia individual dose monitoring laboratory operates well, the test result is accurate and the error range is small, which can meet the requirements of relevant national standards for individual dose monitoring of occupational external exposure.
  • Radiation Monitoring/Original Articles
    Analysis of dose monitoring results of the ward for permanent seed source implantation treatment in a hospital
    LIU Yi, TANG Bo, XU Ruicai, GAO Jin, LIU Jianwei, SUN Liang
    2020, 29(6): 640-645. https://doi.org/10.13491/j.issn.1004-714X.2020.06.016
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    Objective To study the external radiation dose level and distribution in the ward for permanent seed source implantation treatment in a hospital, and evaluate its radiation risk, so as to provide scientific basis for strengthening the radiation protection and supervision of radiation workers in permanent implantation therapy. At the same time, reasonable suggestions for radiation protection are put forward.Methods The thermoluminescence dosimetry was used to monitor the dose levels of different areas of the ward for permanent seed source implantation treatment for a period of one year, The areas included 10 types of regions in Inpatient Ward. The dose analysis was carried out according to the number of implanted seeds and the days of hospitalization.Results During the period of one year, a total of 1232 patients were admitted to the ward, of which 432 (190) were treated with permanent implantation of seed source, with a total activity of 2.746843×1011 Bq (7423.9 mCi), and an average of 6.3566×108 Bq (17.18 mCi) per capita of seed source implanted. The annual hospitalization days of patients treated with permanent seed source implantation were 2478 days, with an average of 6 days. The results of thermoluminescence dose monitoring showed that the dose range of each monitoring point was 0.23 mSv～13.94 mSv, the average value was 3.37 mSv, and the median value was 1.90 mSv. Among them, the dose range on both sides of the bed and at the infusion rack was significantly higher than that at other points. By dose / activity and dose / (activity · day) analysis, there were statistical differences.Conclusion There is a point where the external radiation dose is on the high side in the ward for permanent seed source implantation treatment, and the medical staff and accompanying staff should reduce the time of staying at this point or stay away from this point.The annual personal dose monitoring results of medical staff are much lower than the requirements of national standards, and also lower than the results of this experimental site dose monitoring, which is related to the actual work and residence of medical staff.When workers wear protective equipment, within the safe range of dose, the seed implantation activity and average hospital stay can be increased appropriately. Patients wearing protection after operation can significantly reduce their external radiation dose to medical staff.
    • Radiation Security/Original Articles
  • Radiation Security/Original Articles
    Present situation and countermeasures of radioactive waste management in Beijing
    WANG Yue, CHEN Dongbing, CHANG Wei
    2020, 29(6): 646-648,652. https://doi.org/10.13491/j.issn.1004-714X.2020.06.017
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    Beijing has a large number of nuclear technology utilization units and involves a wide range of industries. The application of nuclear technology has brought great benefits to mankind, and at the same time, the amount of radioactive waste produced in the city is also increasing day by day. The "safety" of radioactive waste is not only one of the key factors affecting the sustainable development of the nuclear technology application, but also related to the social stability, public health and environmental safety of the capital. According to the existing laws and regulations, based on the actual situation of Beijing and combined with the practice of Radioactive Waste Management, some suggestions are put forward to improve the safety management of radioactive waste in Beijing.
  • Radiation Security/Original Articles
    Analysis of the radiation effect of Cobalt-60 radioactive source package dropping accident during transportation
    CHEN Liangping, HAN Chuncai, XU Huiping, XU Zhongyang
    2020, 29(6): 649-652. https://doi.org/10.13491/j.issn.1004-714X.2020.06.018
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    Objective This paper discussed the radiation effects on the staff and the public from the serious falling accident of type B (U) Cobalt-60 transport package, as well as from the restarted transport after the accident treatment.Methods A typical transportation route running through the north and south of China was selected, which was used in the serious dropping accident analysis of the radiation effect of type B (U) Cobalt-60 transport package.Result Due to the falling accident of type B (U) Cobalt-60 transport package, the maximum dose to the accident handling personnel was 3.2 mSv, and the maximum dose to the public at 10 m away from the accident point was 5.6×10-2 mSv; the maximum dose to the driver during the re-shipment from the damaged package was 9.6 mSv, and the maximum dose to the public along the transportation line was 5.2×10-2 mSv.Conclusion After the falling accident of type B (U) Cobalt-60 transport package, the dose to the accident handling personnel and the relevant staff who restarted the transport after the accident handling was lower than the dose control value of the accident handling personnel by 10 mSv; the dose to the public near the accident point and the public along the transport line after the restart of the transport was lower than the dose control value of the accident public by 1 mSv.
  • Radiation Security/Original Articles
    Investigation on the use and protection of X-ray machines of pet hospital in Beijing
    XIE Weiyi, LI Yuxiang, ZHU Kai, ZHANG Guiying, NIU Dongsheng
    2020, 29(6): 653-656. https://doi.org/10.13491/j.issn.1004-714X.2020.06.019
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    Objective To evaluate the usage situations and protection levels of X-ray diagnostic equipment used in pet hospitals in Beijing.Methods A total of 292 pet hospitals in 13 municipal districts of Beijing have been investigated. The radiation levels of 35X-ray rooms in these pet hospitals have been measured.Results The investigation results have been indicated with the utilization rate of X-ray diagnostic equipment, the application rate of occupational hazards, the annual measurement rate of radiation levels, the training rate of radiation protection, the monitoring rate of personal dose, and the examination rate of occupational health being 49.66%, 6.90%,25.52%, 22.07%, 22.76% and 16.55% in these pet hospitals respectively. Only 2.7% meet all of requirements above in all the pet hospitals investigated. Only 34.29% meet the standard requirements for the radiation protection levels of X-ray diagnostic equipment used in 35 pet hospitals in Beijing that received field tests.Conclusion Attention should be paid by management department for the relatively high utilization rate and low protection levels of X-ray diagnostic equipment in pet hospitals in Beijing.
  • Radiation Security/Original Articles
    Analysis of the nuclear medicine radioactive waste management status in 37 medical institutions
    FENG Dongying, DONG Zhenjun, YIN Junqing, SHEN Aiguo, SHEN Lijun, DUAN Xingli, CHANG Jin
    2020, 29(6): 657-660. https://doi.org/10.13491/j.issn.1004-714X.2020.06.020
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    Objective To study the basic situation of radioactive waste management in clinical nuclear medicine departments of medical institutions in Hebei province, so as to provide the effective data and theoretical basis for the improving regulatory effectiveness. Methods The questionnaire for radioactivity waste disposal in nuclear medicine was designed, and then and relevant investigations were conducted on radioactive waste disposal in nuclear medicine by combining self-examination of medical institutions and on-site investigation of medical institutions within the jurisdiction by health supervision institutions.Results By the end of 2018,there were 37 medical institutions established clinical nuclear medicine departments carrying out nuclear medicine in Hebei province, among which 37 had radioactive waste storage rooms with a total area of 329 m2, 35 had radioactive waste water decay pools with a total volume of 2449 m2, which were dominated by mainly three-stage decay and controlled by self-overflow.Conclusion It is necessary to improve and pay more attention to the radioactive waste management model of medical institutions in Hebei province, to effectively ensure the quality of radioactive waste treatment.
    • Supervision and Management/Original Articles
  • Supervision and Management/Original Articles
    Retrieval path and application analysis of standards for examination and evaluation of radiological health technical services
    JIA Tianjiao, YAO Zhu, ZHANG Wei
    2020, 29(6): 661-664,671. https://doi.org/10.13491/j.issn.1004-714X.2020.06.021
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    The main retrieval path of radiological protection standards was introduced in this paper. The contents included, retrieval methods, standard description information and full-text acquisition methods were compared, and the application of examination and evaluation standards for radiological health technical services was analyzed for facilitating radiological health technical service institutions to retrieve relevant radiological protection standards, and guiding the quality management practice of examination and evaluation in technical service organization of radiation health.
  • Supervision and Management/Original Articles
    Analysis and discussion on the assessment level of laboratory quality management intervention in radiological hygiene testing ability
    CHEN Xue, YIN Chen, ZHAI Hezheng, RUAN Shuzhou, SU Kaijun, HAO Jianxiu, LIU Qingfen
    2020, 29(6): 665-667. https://doi.org/10.13491/j.issn.1004-714X.2020.06.022
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    Through the analysis of laboratory quality management work, combined with participating in the national radiological health testing ability assessment, to discuss how to improve the level of radiological health testing ability assessment for reference by other radiological health technical service institutions. The effective implementation of the laboratory quality management work can promote the gradual development and maturity of radiological health ability assessment and the standardization of testing techniques. The radiological health institutions should pay more attention to the quality management of laboratories, and take targeted measures for quality management and improvement so as to further improve the assessment level of radiological health detection capabilities and the ability to deal with nuclear radiation emergencies.
  • Supervision and Management/Original Articles
    Practice and experience of an occupational health management system in general hospital
    ZHAO Ran, WANG Anyong, CHEN Xiangcun
    2020, 29(6): 668-671. https://doi.org/10.13491/j.issn.1004-714X.2020.06.023
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    Radiological diagnosis and treatment technology are widely used in general hospitals, while the long-term exposure for Radiation-related staff to ionizing radiation will cause some harm to their health.This paper introduces the specific practices and results of a four-level protection management system in general hospital. After comparing the practices and managenment results before and after the establishment of the management system, it turns out to be a good way to promote the development of special work, and the normalization of supervision is conducive to the construction of the protection management system,which can be used to improve the management level by information means.
    • Diagnosis and Treatment/Original Articles
  • Diagnosis and Treatment/Original Articles
    Effect of hyperthermia combined with chemoradiotherapy on locally advanced rectal cancer
    GUAN Tianwen, BIAN Guolin, YIN Xiaodong
    2020, 29(6): 672-674. https://doi.org/10.13491/j.issn.1004-714X.2020.06.024
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    Objective To observe the clinical effects of combined capecitabine, radiotherapy and hyperthermia in patients with locally advanced rectal cancer.Methods 48 patients with locally advanced rectal cancer admitted to our hospital from February 2015 to February 2019 were selected as observation subjects, and the patients were divided into 24 cases each in the combined group and control group according to different treatment plans. Both groups received capetabine and radiotherapy, and the combined group combined with hyperthermia.Comparing the overall efficiency, T-lymphocyte subpopulation, incidence of adverse events, relapse rate, and metastasis rate between the two groups.Patients with complete remission and partial remission underwent surgery recorded with the operation rate and progression free survival time for both groups.Results The overall effective rate of the combined group (87.50%) was statistically significantly better than that of the control group (58.33%) (χ2 = 5.1692，P < 0.05); The incidence of adverse events (12.50%), recurrence (4.17%), and metastasis (8.33%) were statistically lower in the combined group than in the control group (45.83%), (25.00%), (33.33%) (χ2 = 6.4538, 4.1812, 4.5474, P < 0.05); The subpopulations of T lymphocytes in the combined group had higher levels than those in the control group (P < 0.05). The operative rate (83.33%) in the combined group was significantly higher than that in the control group (50.00) (χ2 = 6.0000, P < 0.05), and the PFS time (56.2 ±5.2 month) in the combined group was significantly longer than that in the control group (42.6 ±5.8 month) (t = 8.5531, P < 0.05).Conclusion For patients with locally advanced rectal cancer, the combination of capecitabine, radiotherapy and hyperthermia can optimize the overall therapeutic effect, enhance immunity, reduce adverse reactions, and prevent tumor metastasis, with prominent recent therapeutic effects, increased operation rate and significantly prolonged PFS.
  • Diagnosis and Treatment/Original Articles
    CT lymphography in the diagnosis of lower extremity chylous reflux lymphedema
    WANG Haiyang, HU Junjie, REN Yanli, WANG Rengui, YANG Guoren
    2020, 29(6): 675-677. https://doi.org/10.13491/j.issn.1004-714X.2020.06.025
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    Objective To investigate the imaging of multisliecs helieal CT (MSCT) in chylous reflux lymphedema of lower extremities.Methods The imaging data of 51 patients with chylous reflux lymphedema of lower extremities confirmed by operation or clinic were retrospectively analyzed. All patients underwent direct lymphangiography followed by CT scan of the chest and abdomen. The location of the lesion was analyzed and the constituent ratio of the classified variable data was used to describe the lesion.Results MSCT of 51 patients showed abnormal lymphatic vessels in different areas, organs and tissues, involving lower limbs, pelvis, abdomen, thorax and pericardium; the cases were divided into 14 mild cases, 22 medium cases, and 15 severe cases by disease type, and the course between different disease types was statistically significant.Conclusion Chylomicron reflux lymphedema of the lower extremities manifests in multi-sites and multi-systems, and its condition is highly correlated with the course. Therefore, MSCT can provide an important basis for the diagnosis and differential diagnosis of the disease.
  • Diagnosis and Treatment/Original Articles
    The follow-up analysis of hyperbaric oxygen combined with mucosal protectant in the treatment of long-term radiation enteritis
    FU Juan, HUANG Yong, BI Jinling
    2020, 29(6): 678-681. https://doi.org/10.13491/j.issn.1004-714X.2020.06.026
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    Objective To investigate the efficacy and safety of hyperbaric oxygen (HBO) combined with mucosal protective agents in the treatment of distant radiation enteritis (RE) in abdominopelvic malignancies.Methods Eighty-six patients with radiation enteritis admitted to our hospital from January 2010 to December 2016 were divided randomly into control group and HBO treatment group, both received mucosal protective agent treatment for 4 weeks and in the latter group, combined with HBO treatment. Comparative analysis of clinical efficacy, adverse effects, nutritional status and quality of life of the two groups of patients.Result The effective rate of HBO treatment group (83.7%) was significantly higher than that of the control group (55.8%), and the difference between the groups was statistically significant (P < 0.05). During HBO treatment, there were 5 cases of headache (11.6%), 7 cases of nausea and vomiting (16.3%), and 2 cases of tinnitus (4.6%). The average BMI of the HBO treatment group showed no significant decrease at the end of follow-up compared to pre-radiation (t=1.17, P > 0.05). The overall quality of life between HBO treatment group and control group was (60.37 ±16.64) points and (51.75 ±14.30) points respectively, with 83% and 55% of the group having a good prognosis respectively.Conclusion HBO treatment can significantly improve the clinical efficacy of long-term radiation enteritis along with the quality of life and nutritional status of patients with severe complications, which is of high clinical application value.
  • Diagnosis and Treatment/Original Articles
    Application of equivalent uniform dose optimization in the treatment of rectal cancer with intensity-modulated radiotherapy
    YANG Huihui, LIU Jingang, WANG Xing, LI Xiaoshan, DENG Daping
    2020, 29(6): 682-685,690. https://doi.org/10.13491/j.issn.1004-714X.2020.06.027
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    Objective Comparing the dosimetric differences between equivalent uniform dose based bio-optimization and dose-volume based physical optimization in retrograde intensification therapy plans for rectal cancer, and exploring the plan optimization methods on plan quality.Methods Among the rectal cancer patients of 15 cases who had already undergone intensified radiotherapy were randomly selected. Three reverse intensified radiotherapy plans were formulated according to different optimization methods by the Varian Eclipse treatment planning system, in which group A used traditional dose-volume (DV) physical optimization, group B adopted equivalent uniform dose (EUD) bio-optimization, and group C was optimized by adding biological optimization (DV + EUD) to the physical optimization. The dosimetric differences among the three optimization methods were compared and evaluated by dosimetric parameters.Results There were no statistically significant differences in the planing target volume (PTV) dosimetric indicators of the three groups (P > 0.05). In the protection of bladder and femoral head, there was no significant difference between group B and group C(P > 0.05)and both of them were better than group A (P < 0.01). In protecting the small intestine, group C was better than group B (P < 0.05), group B and group C was significantly better than group A (P < 0.01).Conclusion Simultaneously using physical and biological optimization in intensity modulated radiation therapy planning for rectal cancer can better protect endangered organs in the premise of meeting target area dose requirements.
  • Diagnosis and Treatment/Original Articles
    The value of DWI and dynamic contrast-enhanced MRI in the diagnosis of tongue squamous cell carcinoma
    ZHANG Ruizong, LI Wenwu, SHAO Shuo
    2020, 29(6): 686-690. https://doi.org/10.13491/j.issn.1004-714X.2020.06.028
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    Objective To explore the value of diffusion-weighted imaging (DWI) and dynamic contrast enhanced MRI in the diagnosis of tongue squamous cell carcinoma.Methods Retrospective analysis of 65 patients with surgically and pathologically proven tongue squamous cell carcinoma, 38 with neck lymph node metastasis and 27 without lymph node metastasis; 55 of 65 patients underwent dynamic contrast enhanced scanning. The size and apparent diffusion coefficient (ADC) of lesions between groups with or without lymph node metastasis were measured and compared. The time-intensity curves (TIC) of the lesions were analyzed and the parameters of tongue squamous cell carcinoma with different T stages and pathological grades were compared.Results The mean length diameter of tongue squamous cell carcinoma of 65 patients was (28.2 ±11.7) mm, the mean short diameter was (17.7 ±9.4) mm, the mean thickness was (26.8 ±11.9) mm, and the ADC mean value was (1.029 ±0.142)×10−3 mm2/s. Between the groups with and without cervical lymph node metastasis, the differences of length diameter, short diameter, thickness and ADC value were statistically significant. Lymph node metastases are more likely to occur in patients with squamous cell carcinoma growing across the midline. Among the 55 cases with enhanced scanning, there were 42 cases of TIC curve type I (rapid ascending platform) and 13 cases of type II (rapid ascending outflow). ADC value (1.090 ±0.113)×10−3 mm2/s in the early (T1+T2) tongue cancer group and ADC value (1.001 ±0.147)×10−3 mm2/s in the advanced (T3+T4) tongue cancer group means statistically significant differences between the groups. The ADC values of highly differentiated, moderately differentiated and poorly differentiated squamous cell carcinoma were (1.101 ±0.101) 1×10−3 mm2/s, (0.992 ±0.139)×10−3 mm2/s and (0.819 ±0.125)×10−3 mm2/s, respectively, with statistically significant differences between the groups. 1.011×10−3 mm2/s and 0.928×10×10−3 mm2/s were served as cut-off points for the diagnosis of highly differentiated and poorly differentiated tongue squamous cell carcinoma, with sensitivity and specificity of 85.7%, 63.3% and 81.4%, and 83.3%, respectively.Conclusions DWI and dynamic contrast enhanced MRI can better reflect the characteristics of tongue squamous cell carcinoma, which is of great value in its characterization, pathological grading, staging and prediction of lymph node metastasis.
  • Diagnosis and Treatment/Original Articles
    Imaging and pathological features of congenital mesodermal nephroma in children
    LIU Hongxia, HAN Yanxiu, LI Ping, LIU Fei, LI Hongjian, WEN Xin, MIAO Zhongyan, FANG Zehui
    2020, 29(6): 691-695. https://doi.org/10.13491/j.issn.1004-714X.2020.06.029
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    Objective TO investigate CT manifestations and pathological features of pediatric congenital mesangial nephroma (CMN).Methods The clinical data of 8 cases of CMN confirmed by operation and pathology were analyzed retrospectively.Results All nephroma of eight cases were unilateral, with swelling growth and unclear border with kidney. The lumps were cystic and mixed in density, necrosis and cystic change, four of them had patchy hemorrhagic foci. In contrast-enhanced scanning, eight cases showed heterogeneous enhancement, cystic non enhancement area, tortuous and enhanced vascular shadow in six cases, delayed enhancement and peripheral ring enhancement in eight cases. No calcification or lymph node metastasis was found.Conclusion Summarizing the specific imaging signs of CMN in children and comparing them with pathology is helpful for the diagnosis of CMN.
  • Diagnosis and Treatment/Original Articles
    Correlation between pelvic active bone marrow and hematological toxicity in radiotherapy of cervical cancer
    LIU Jingwen, REN Hongrong, ZHOU Chong, ZHOU Yun, WANG Tao, YIN Haitao
    2020, 29(6): 696-699. https://doi.org/10.13491/j.issn.1004-714X.2020.06.030
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    Objective To evaluate the related factors of hematological toxicity in perimenopausal and postmenopausal patients with cervical cancer after radiotherapy.Methods Retrospective analysis was performed on patients aged ≥ 45 years who received radiotherapy after radical cervical cancer treatment in our hospital from August 2017 to June 2019. The bone volume of the entire irradiation area was defined as TBM, which was divided into TBM1 (hip) and TBM2 (lumbosacral). In addition, We defined the corresponding active bone marrow expressed as ABM, ABM1 and ABM2 by T1-weighted image fusion technique of CT and MR. Bone and active bone marrow within the irradiated area of the patient were added as endangered organs on the original TPS plan and the volume, V5～V45, CV5～CV45 (categorical volume) of each variable were extracted from the TPS plan. Analyzed the predictive value of each variable for Grade 3 or above hematological toxicity in the radiotherapy process of the patient by the ROC curves and obtained the cutoff values via the Jordon index.Results The proportion of ABM2, the high-dose irradiation area V30, V40, V45 of TBM, ABM, TBM1, ABM1,and the absolute volume CV40 of the active bone marrow of the hip can predict the occurrence of Grade 3 or above hematological toxicity events.de 3 or above hematological toxicity events.Conclusion High dose irradiated volume of pelvic active bone marrow was a good predictor of Grade 3 or above acute hematologic toxicity during radiotherapy for cervical cancer.
    • Review Articles
  • Review Articles
    Research progress of radiation dose for interventional surgeons
    LI Cong, LIU Weiwu
    2020, 29(6): 700-703,707. https://doi.org/10.13491/j.issn.1004-714X.2020.06.031
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    In recent years, interventional radiology technology has been developed rapidly. With the continuous improvement of interventional radiology diagnosis and treatment technology, and interventional surgeons will be exposed to higher radiation dose due to close operation, which will cause damage to health, therefore, more and more attention is paid to the study on the radiation dose of interventional surgeons. A summary of the relevant literature shows that there are many methods to evaluate the exposure dose of interventional surgeons, such as single dosimeter, double dosimeter, phantom method and Monte Carlo simulation method, etc., and many experimental data have been obtained. This indicates that the error in estimating the total body dose is gradually reduced on the one hand, and on the other hand, the estimation of the dose of a certain disease is gradually developed into a comprehensive study of a variety of diseases, various surgical types and surgical sites. This paper analyzes and summarizes the literatures on the dose of exposure of interventional surgeons, providing important basis for the protection of interventional surgeons.
  • Review Articles
    Discussion on occupational health surveillance of astronauts
    SONG Xueshu, CHEN Yanxia, LIU Yulong
    2020, 29(6): 704-707. https://doi.org/10.13491/j.issn.1004-714X.2020.06.032
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    Astronauts, a high-risk and special profession, work in the complex, harsh and uncertain space environment. At present, the recognized occupational risk factors for astronauts mainly come from space radiation, and their special working environment has extremely high demands on mental health. Here, we mainly discuss the physical and mental occupational health monitoring of astronauts in China, and provide reference for occupational health work.