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In 2003, the responsibility of radiation source safety supervision was redivided and transferred from the health department to the environmental protection department. After the promulgation and implementation of the Rule on the Administration of Radiodiagnosis and Radiotherapy in 2006, due to the incorporation of a large number of medical practice supervision rules, the radiation health supervision of medical institutions has evolved into the radiodiagnosis and radiotherapy supervision. In the past 16 years, radiation, occupational health supervision, and medical practice supervision have not been well integrated, and there are many legal problems in radiodiagnosis and radiotherapy supervision. The regulation rules of environmental protection, metrology, and other relevant departments on radiation sources and radiation devices have been constantly changing, resulting in overly complex regulatory requirements on radiodiagnosis and radiotherapy, which increases the burden of medical institutions. This paper reviews the historical evolution and legal system changes of radiodiagnosis and radiotherapy supervision, analyzes the problems and challenges faced by the relevant regulatory departments, and proposes ways to improve the supervision system.
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OBJECTIVE@#To investigate the changes in gray matter volume in depressive-like mice and explore the possible mechanism.@*METHODS@#Twenty-four 6-week-old C57 mice were randomized equally into control group and model group, and the mice in the model group were subjected to chronic unpredictable mild stimulation (CUMS) for 35 days. Magnetic resonance imaging was performed to examine structural changes of the grey matter volume in depressive-like mice. The expression of brain-derived neurotrophic factor (BDNF) in the grey matter of the mice was detected using Western blotting and immunofluorescence staining.@*RESULTS@#Compared with the control mice, the mice with CUMS showed significantly decreased central walking distance in the open field test (P < 0.05) and increased immobile time in forced swimming test (P < 0.05). Magnetic resonance imaging showed that the volume of the frontal cortex was significantly decreased in CUMS mice (P < 0.001, when the mass level was greater than or equal to 10 756, the FDRc was corrected with P=0.05). Western blotting showed that the expression of mature BDNF in the frontal cortex was significantly decreased in CUMS mice (P < 0.05), and its expression began to decrease after the exposure to CUMS as shown by immunofluorescence staining. The volume of different clusters obtained by voxel-based morphometry (VBM) analysis was correlated with the expression level of mature BDNF detected by Western blotting (P < 0.05).@*CONCLUSION@#The decrease of frontal cortex volume after CUMS is related with the reduction of mature BDNF expression in the frontal cortex.
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Animals , Mice , Blotting, Western , Brain-Derived Neurotrophic Factor , Cerebral Cortex , Depression/physiopathology , Frontal Lobe/pathologyABSTRACT
Objective To investigate the status and problems of hospitalization management and radiation protection in 131I treatment for thyroid cancer, and to provide suggestions for medical institutions to implement relevant standards. Methods We investigated the status of radiation protection and management in 10 medical institutions conducting 131I treatment for thyroid cancer (6 in Shanghai, 2 in Zhejiang Province, and 2 in Jiangsu Province, China) by consulting written materials, expert interviews, and on-site inspection and testing. Results The average activity of 131I therapy for thyroid cancer in the 10 medical institutions was 110~120 mCi (4.07~4.44 GBq). All patients who received the treatment were hospitalized, with a stay of 3~7 days. Seven institutions carried out 131I dispensing, 6 of which used automatic 131I dispensing instruments. Nine institutions had an independent ventilation system in the wards, 8 of which regularly changed the filters. All the 10 institutions set special toilets and shower rooms in the wards, and had shielding facilities between sickbeds, with the lead equivalent from 0.5 mm Pb (lowest) to 10 mm Pb (highest). All the 10 institutions had intercom and monitoring facilities in the wards, 9 of which had a one-way access control system, and 4 of which had dose monitoring equipment. Nine institutions carried out surface pollution monitoring in the workplace, but none performed air pollution testing. All the 10 institutions required the radioactivity in the body of patients be less than 400 MBq before discharge, and five of them estimated the activity by measuring the dose rate at a certain distance from the body surface of patients. All the 10 institutions had radioactive sewage decay ponds, but none of them conducted regular monitoring. Rapid on-site surface pollution testing in the wards showed that highest value was 31.9 Bq/cm2. Conclusion The 10 medical institutions carried out 131I treatment for thyroid cancer basically according to the requirements of national laws, regulations, and standards, but there are still some problems in ward construction, radiation protection facilities, and patient hospitalization management, which should be further standardized.
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The purpose of this article is to review the research progress on fear of dementia， and to provide references for clinical treatment and nursing care. Fear of dementia is a widespread problem for adults， and adults with high degrees of fear were more likely to develop adverse psychological consequences， including aggravation of anxiety and depression， decreased inclination toward health-promoting behaviours， avoidance of medical treatment， and suicidal ideation. At present， domestic and foreign studies have mainly focused on the current situation and influencing factors of fear of dementia. Therefore， this article gives a review on the fear of dementia in terms of its concept， incidence， impact， influencing factors， assessment tools and intervention measures， with a view to provide a reference for the subsequent studies.
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It is an important technical means to ensure that the radiodiagnosis and radiotherapy equipment can be put into use normally to carry out acceptance test after the newly installed, maintained or replaced important components. Health inspection found that medical institutions are often easy to ignore the acceptance test in the process of use, and do not carry out acceptance test on the radiodiagnosis and radiotherapy equipment after maintenance or replacement of important components. However, it is difficult to ask medical institutions to correct them without the definition and scope of ‘important components’ according to laws or technical standards. This paper studies and discusses the definition of ‘important components’ of radiodiagnosis and radiotherapy equipment, and puts forward some suggestions onthe practical application of the research results.
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Objective:To investigate whether the Garden indexes can serve as a criterion for rotational displacement of femoral neck fracture.Methods:Ten cadaveric specimens of healthy human proximal femur were used for this study. They came from 3 males and 2 females who had died at the age from 45 to 70 years old. A Kirschner wire of 2.0 mm in diameter was implanted into the center of the femoral head. Osteotomy was conducted perpendicular to the middle line of the femoral neck. The rotational angles were marked on the distal osteotomy surface. Each cadaveric specimen was rotated sequentially at pronation and supination angles of 0°, 10°, 20°, 30°, 40°, 50°, 70° and 90°, respectively. X-ray images of anterior-posterior and lateral views were taken to record all the rotations of the specimens. Picture Archiving and Communication Systems (PACS) were used to measure the Garden indexes and compare them among anterior-posterior and lateral X-ray films of different pronation and supination angles. Changes in the area of the femoral head fovea at different rotation angles were observed as well.Results:There were no significant differences in the auterior-posterior or latera Garden indexes from 0° to pronation or supination 30°, with all the Garden values >155° ( P>0.05); from pronation of 40° to pronation of 90°, the Garden indexes were 152.36°±1.41°, 146.04°±1.64°, 143.95°±0.60° and 141.73°±0.60° for anterior-posterior views and 172.54°±0.86°, 168.57°±0.98°, 157.18°±1.17° and 156.47°±1.63° for lateral views, showing a significant difference between rotational angles ( P<0.05); from supination of 40° to supination of 90°, the Garden indexes were 151.67°±1.06°, 147.32°±1.82°, 142.77°±0.75° and 139.88°±1.48° for anterior-posterior views and 172.28°±0.79°, 166.76°±1.02°, 155.67°±1.74° and 154.16°±1.27° for lateral views, showing a significant difference between rotational angles ( P<0.05). The area of the femoral head fovea decreased gradually with the increase in pronation angle, and increased gradually with the increase in supination angle. Conclusions:The Garden indexes cannot serve as an accurate indication of rotational displacement in reduction of femoral neck fracture when the pronation or supination angles ranges from 0° to 30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture.
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Objective To develop a multiple polymerase chain reaction (PCR) technique based assay for rapid detection of vanA, vanB, vanD and vanM in high-level vancomycin-resistant enterococci.Methods After analyzing the uncleotide sequence divergence among D-Ala∶D-Lac ligase genes, an multiplex PCR assay for vanA, vanB, vanD and vanM genes in high-level vancomycin-resistant enterococci were designed.By using recombination plasmids containing vanA, vanB, vanD and vanM genes as positive control, and non-vancomycin resistant enterococci (non-VRE) common pathogenic bacterial DNA as negative control, the sensitivity and specificity of the assay were evaluated.Fifty vancomycin-resistant enterococci (VRE) isolates were detected by the assay.Fifty clinical strains of VRE were isolated from 9 hospitals in Shanghai from January 2006 to December 2014.The results were compared with the conventional PCR and sequencing methods.Results The identity of the D-Ala∶D-Lac ligase genes were 60.8%-71.3% of vanA, vanB, vanD and vanM genes.The multiplex PCR assay could identify the genotypes of the positive control samples accurately.No false positive results were found in negative control samples.Among fifty VRE strains detected by the assay, 18 were vanA genotype and 32 were vanM genotype.Comparison of the multiplex PCR assay and sequencing methods revealed sensitivity and specificity of 100%.The detection limit of the assay was 2×10 copies/PCR reaction.The experiment could be done within 3.5 h.Conclusions A multiplex PCR assay is developed to rapid identify the genotype of the high-level vancomycin-resistant enterococci, which can be used for the molecular epidemiology research and detection of VRE.
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Objective To investigate thein vitro activity of tigecycline and minocycline against VanM-type vancomycin-resistant Enterococcusfaecium.Methods A total of 45 strains of VanM-type vancomycin-resistantE. faecium were obtained from hospitals in Shanghai between 2006 and 2014. Species and vancomycin resistance genotype were identiifed by PCR and sequencing analysis. Minimal inhibitory concentrations (MICs) of ten antimicrobial agents against these strains were determined.Results All the 45 isolates were VanM-type vancomycin-resistantE. faecium, and resistant to vancomycin (MIC: 128 to >256 mg/L). And 71.1%of the strains were resistant to teicoplanin. Almost all isolates showed resistance to levolfoxacin (100%) and ampicillin (97.8%). About 15.6%, 64.4% and 82.2% of the strains were resistant to minocycline, gentamicin and rifampicin, respectively.Conclusion Tigecycline and minocycline exhibit excellentin vitro activity against these VanM-type vancomycin-resistantE. faecium isolates.
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Objective To analyze the clinical characteristics and CT manifestations of pediatric testicular yolk sac tumor,to im-prove the CT diagnostic level of the disease.Methods Five pediatirc patients with testicular yolk sac tumor was retrospectively en-rolled in this study.All cases underwent spiral CT scan and enhancement scan prior to operation.Furthermore,the clinical and ima-ging data of these 5 cases were analyzed.Results Image features were unilateral testicular mass with uneven density,including patchy necrosis area,no obvious calcification and fatty density on CT scan.Obvious uneven reinforcement was revealed in the sub-stantial part of the masses after enhancement scan,no obvious reinforcement was revealed in necrotic area.Homogeneous enlarge-ment of the spermatic cords was demonstrated in all 5 cases,and the density was uniform.Obvious reinforcement was revealed in all affected spermatic cords,and the degree of the reinforcement was more obvious than those normal sides.The preoperative diagnosis of 5 cases was stage I malignant germ cell tumor Yolk sac tumor.The diagnosis of all 5 cases was basically in the line with surgical and pathological results.Conclusion CT scan is not only valuable in determining the nature of the tumor,but also helps to tumor management.