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Objective To evaluate the current status of radioactive occupational hazards in the construction of some medical institutions in Tianjin, discover existingproblems and deficiencies, and provide a technical basis for radiation protection management. Methods Based on the requirements of relevant regulations and standards, we comprehensivelyevaluated the results of the pre-evaluation and control effect evaluation of 81 radioactive occupational hazards in Tianjin. Results Among the 35 proposed protective measures for pre-evaluation of radiation occupational hazards constructionprojects, the lowest compliance rate is warning signs and personal protective equipment. Among the 46 construction projects of radioactive occupational hazard control evaluation, the pass rate of protective measures was between 73.9% and 100%, with the lowest pass rate for personal protective equipment. Besides, the pass rate of radiation protectionmanagement evaluation was 95.7% ～ 100%, with the lowest pass rate for the protection management system.The initial inspectionpass rateof the equipment quality control acceptancewas 98.6%, while the pass rate was 97.1% for the relevant workplace radiation protection during the initial inspection. Conclusion The pre-evaluation completion rate of radiological occupational hazard evaluation in Tianjin medical institution construction project, unilateral and area of construction room, workplace layout and zoning, ventilation, shielding measures, personal dose management and occupational health inspection all meet the requirements of regulations and standards. However, there are still some deficiencies in the personal protective equipment, warning signs and the radiation protection management system. Therefore, the regulatory department should further strengthen the evaluation of medical institutions, especially the key supervision and management of non-conformities.
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Objective:To understand the current status of quality control of medical X-ray diagnostic equipment in Tianjin, discuss the problems existing in the process of quality control, and provide technical basis for the relevant regulatory agencies.Methods:Using stratified random sampling, a total of 401 pieces of medical X-ray diagnostic equipment distributed over 111 medical institutions in Tianjin was used for this study. X-ray multifunctional dosimeters and other types of equipment were used to perform quality control testing and evaluation under the relevant health industry standards.Results:The initial testing pass rate of these equipment was 90.0%, with the pass rates of X-ray imaging equipment lower than those of X-ray fluoroscopy equipment, digital subtraction angiography (DSA) and X-ray computed tomography (CT) ( χ2=9.203, 3.383, 5.754, P<0.05). Among the imaging equipment, the screen X-ray equipment had the lowest pass rate, followed by the breast X-ray equipment and medical digital radiography (DR). The main unqualified items were output repeatability, deviation of tube voltage indication and limit spatial resolution. DR accounted for the highest percentage of X-ray equipment that were below testing condition. The unqualified proportion of X-ray imaging equipment was higher than that of X-ray fluoroscopy equipment ( χ2=8.216, P <0.05). Among the imaging equipment, the screen X-ray equipment was seen to have the highest unaqualified proportion, followed by computed radiography (CR). Among the 401 devices in this study, the initial testing pass rates of private medical institutions was not statistically different from those of public medical institutions ( P>0.05). The initial pass rates of domestic equipment was lower than those of imported equipment ( χ2=4.576, P<0.05). Conclusions:The performance of medical X-ray diagnostic equipment in Tianjin needs to be further improved. Medical institutions should pay attention to the quality control testing of medical X-ray diagnostic equipment. The relevant regulatory agencies should strengthen oversight and management of equipment that contains unqualified items, no baseline values and below the testing conditions.
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0bjective Exploration of the application effect of a new way of collecting patient′s telephone information to emergency diagnosis and treatment process reengineering in outpatient and emergency department. Methods Relying on the hospital information system platform, design and implement timely collection and validity verification mechanism of mobile phone data in outpatient and emergency department network sub-platform; before and after the implementation of the evaluation of 500 cases of patient registration time, telephone information accuracy. Statistics before and after using the 200 patients with critical value received report (short message, telephone) response time should be again;medical treatment satisfaction. Results The sub-platform realized the timely modification of telephone information through multi-function exchange terminal when patients visited the hospital. There was no statistical significance in the time of registration of patients in the two groups (P>0.05), the registration time was not extended. The accuracy rate of telephone information was 98.4% (492/500) in the experimental group, and 66.6% (333/500) in the control group, there was differences between the two groups (χ2=176.70,P<0.05). After the implementation, the number of the 200 patients who received critical value report (text message, phone call) and answered again within 30 minutes was 189, and there were 132 cases before implementation, there was difference before and after implementation (χ2=69.38, P<0.05). The patients′satisfaction with emergency treatment in the control group and the experimental group was 68.5%(137/200), 95.5%(191/200), there was significant difference (χ2=51.80, P<0.05). The doctors′satisfaction with the system in the experimental group and the control group was 94.0%(188/200), 65.5% (131/200), there was significant difference (χ2=51.25, P<0.05). Conclusions The method of telephone information collection of patients was optimized, and the quality and management level of emergency diagnosis and treatment were improved, and the information construction of door and emergency room was promoted.
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Objective To ensure the effectiveness and safety of domiciliary subcutaneous injection of biological agents, a safety implementation process was constructed for the treatment of patients with rheumatic diseases by domiciliary subcutaneous injection of biological agents. Methods Based on analyzing the existing clinical work and consulting the relevant documents, using Delphi expert consultation method, 10 experts and 30 patients were treated with 2 rounds of questionnaire to conduction. Results After 2 rounds of expert consultation, the safety implementation process was developed, including 7 items and 27 sub-items. The positive coefficient of the experts was 100％ and 90％respectively, the authority coefficient was 0.84, and the sub projects coordination coefficient was 0.454. Conclusions On the clauses in the safety implementation process of the domiciliary subcutaneous injection of biological agents in the Department of rheumatism which constructed with the Delphi method, experts opinions was consistence, having high credibility of the research results. By systematically managing the home patients who receiving the injective biological agents, transferring the part of the simple treatment from the hospital to the home was acceptance, the effectiveness and safety of domiciliary injection was improved.
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Objective To obtain the concentrations and daily intakes of 15 rare earth elements in foods for adult men in four areas in China.Methods With duplicate portion study,120 mixed diet samples were collected from adult men in cities of Tianjin,Chengdu,Zhenjiang and Taiyuan,which belong to 4 areas with different dietary types in China.The concentrations of cerium,dysprosium,erbium,gadolinium,lanthanum,lutetium,holmium,neodymium,praseodymium,scandium,samarium,terbium,thulium,yttrium and ytterbium in these samples were determined by Inductively Coupled Plasma Mass Spectrometry(ICP-MS) after pretreatment,and the daily intakes of them were also calculated.Results The concentrations of 15 rare earth elements and their daily intakes in foods for adult men were obtained.Conclusions The concentrations of these elements in each area are consistent with normal distribution.The total rare earth element concentration in the diet of adult men ranges from 24.68 to 109.27 μg/g.The daily intake of total rare earth elements is about 24 μg/d.Reference values of the rare earth element concentrations in the diet and daily intake of Chinese adult men were updated.
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Objective To evaluate the effects of chain model of kindred-like nursing on self-nursing of patients with ankylosing spondylitis (AS). Methods Sixty patients with AS were randomized into test group and control group. Based on the therapy with same drugs, test group were given contact cards and served with continuous health care, while control group were only given routine instruction on functional exercises. Both groups were measured with Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) before and after treatment. Results After treatment for 3 months, BASDAI and BASFI of test group were significantly improved compared with control group(P＜0.05). Conclusion Chain model of kindred-like nursing improves nursing ability at home, and plays an important role in disease activity and function recovery of patients with AS.
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Objective To establish a method for the determination of 14 kinds of lanthanide (La) series elements in human feces at the same time by ICP-MS.Methods In January 2009,human feces were collected for three consecutive days from 30 subjects in Tianjin area,the fecal samples for the three-day period were weighed and homogenized;then dried;grinded and ashed,the samples were digested by HNO3 before determination.The solution was directly analyzed by ICP-MS to determine the concentrations of the 14 kinds of La series elements in human faces with rhenium (Re) internal standard calibration.Results The linear ranges were 0-10 ?g/L with a correlation coefficient for each element of more than 0.999.The detection limits of 139La,140Ce,141Pr,143Nd,147Sm,151Eu,158Gd,159Tb,163Dy,165Ho,166Er,169Tm,174Yb and 175Lu in human feces were 0.48,0.49,0.47,1.6,1.9,0.46,0.79,0.18,0.65,0.39,0.38,0.17,0.09 and 0.09 ng/L respectively.The recoveries of this method were 93.42%-108.21%,and RSDs were 2.91%-9.20%.The analytical values of the certified reference material of human hair GBW 09101a by this method showed closed agreement with the reference values.Conclusion This method has relatively higher sensitivity and less interference,and is applicable to the rapid determination of 14 kinds of La series elements in human faces at the same time.
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Objective: To evaluate the potential effect of zinc, copper, and selenium on placental cadmium transport. Methods: Pregnant women were selected from Daye,Hubei Province. Whole blood, cord blood and placenta were collected, and Cd levels were determined by inductively coupled plasma emission mass spectroscopy. Zn, Cu, and Se levels in whole blood were also determined. The potential association between essential elements and placental Cd transport was evaluated. Results: Whole blood Cd (0.8–25.2?g/L) in 47 pregnant women aged 20 to 34 years was significantly higher than that in cord blood(0.020–1.48?g/L). Placental Cd ranged from 0.082 to 3.97 ?g/g dry weight. Multiple linear regression indicated that lower maternal blood Cu was significantly associated with higher cord blood Cd. Placental Cd in pregnant women with lower maternal Zn was significantly higher than that in those with normal Zn level. Placental Cd in pregnant women with lower maternal Se was significantly lower than that in those with normal Se level. Conclusion: Essential elements, such as Cu, Se, and Zn might affect placental Cd transport.