Implementation and revision of the Measures for the Management of Radiation Workers’ Occupational Health / 中国辐射卫生

Since the implementation of the Measures for the Management of Radiation Workers’ Occupational Health in November 2007, it has played an extremely important role in protecting the occupational health of radiation workers. There are more than 700 000 radiation workers in about 100 000 workplaces with potential radiation exposure, as well as a large number of miners exposed to high levels of radon. As the radiation health monitoring project suggests, measures of occupational health management such as personal dose monitoring and occupational health examination of radiation workers have been widely implemented and achieved good results in the protection of radiation workers. However, the risks of chromosomal aberration and specific turbidity of the eye lens of radiation workers have increased in high-risk positions such as interventional radiology, nuclear medicine, and industrial flaw detection. The control of high radon exposure in miners needs to be strengthened. It is necessary to adapt to the new situation in view of new challenges and actively promote the revision of the Measures for the Management of Radiation Workers’ Occupational Health, so as to further improve the occupational health management of radiation workers in China.

Evaluation and analysis on diagnostic criteria for common occupational radiation-induced diseases among radiation workers in some provinces and cities of China / 中华放射医学与防护杂志

Objective:To investigate the application of diagnostic criteria for common occupational radiation-induced diseases to radiation workers, in order to provide a basis for the revision, publicity and standardization of the standards.Methods:Radiation workers were selected from 1 city, 7 provinces and 1 corporation by using cluster random sampling method from January 2021 to May 2021. Awareness of the criteria and the effects of ionizing radiation, and the suggestions for diagnostic works were investigated and analyzed.Results:A total of 2 839 radiation workers were investigated. There were differences in the awareness of different diagnostic criteria, the inclusions in complex diagnostic criteria, the materials required for applying for diagnosis, and the ways of knowing the diagnostic criteria( χ2=416.06, 2 924.14, 83.45, 895.67, 815.94, P<0.001). The correct understanding rates of deterministic effects and stochastic effects were 80.63% and 43.64%, respectively. The acceptance rates in applicable materials were 96.79% for occupational exposure history, 94.72% for occupational health monitoring records and 93.55% for individual monitoring of occupational exposure, respectively. Pre-employment training rate was 80.20%, on-job training rate was 81.19%, and untrained rate was 3.77%. The suggestions to the diagnosis of occupational radiation-induced diseases are to strengthen training, pay attention to individual monitoring, occupational health examination, and strengthen health supervision and law enforcement. Conclusions:Radiation workers have a low awareness rate of certain diagnostic standards and a high awareness rate of diagnostic procedures. Publicity and training of health effects of ionizing radiation and diagnostic criteria of occupational radiation-induced diseases should be strengthened. Diagnostic procedure should be optimized.

Analysis of chromosome aberration in peripheral blood lymphocytes of underground miners in non-uranium metal mines / 中华放射医学与防护杂志

Objective:To investigate chromosomal aberrations in peripheral blood lymphocytes of underground miners, in order to explore the influencing factors involved in chromosomal aberration levels of non-uranium metal mines.Methods:Totall 135 workers were recruited from an iron mine and a gold mine located in different cities of Henan province, where 69 workers worked aboveground and 66 miners worked underground in the metal mines. The radon concentration in the mines was measured by solid-state nuclear track detectors. Chromosomal aberrations in peripheral blood lymphocytes from the subjects were detected using conventional analysis method, and the influence factors of chromosomal aberrations were analyzed.Results:Radon concentration was 30-2 943 Bq/m 3 in the aboveground workplace of the mines, and 62-28 314 Bq/m 3 in underground. The age of the underground group was obviously lower than that of the aboveground group( t=2.12, P<0.05), but the frequencies of dicentrics, translocation, acentric fragment, and total chromosome-type aberrations in the underground group were significantly higher than those in the aboveground group ( χ2=10.49, 16.74, 8.15, 29.50, P<0.01). Consistent results were obtained when only male workers were regarded as object of observation ( χ2=8.44, 11.63, 4.94, 20.81, P<0.05). The frequency of translocation ( χ2=8.44, P<0.05) was dependent on the length of service in the underground group. Poisson regression analysis indicated that the aboveground and undergroud grouping partly affected the levels of dicentrics, translocation, acentric fragment, and total chromosome-type aberrations (the underground group IRR=3.25, 2.69, 1.97, 2.18, P<0.05). Conclusions:The radon exposure in the underground workplace of the metal mines may be the main factor resulting in the increase of chromosome-type aberrations of miners. The occupational health and safety of the miners who may be exposed to high radon levels are worthy of great attention.

Biodosimetry estimation of a case of large area back skin injury caused by accidental irradiation in interventional procedure / 中华放射医学与防护杂志

Objective:To evaluate biological dose and retrospective biodosimetry of a case of large area back skin injury caused by suspected interventional procedure.Methods:Peripheral blood from the patient was collected at about 7 months after interventional procedure, and the chromosomal aberrations in peripheral blood cells were analyzed to evaluate the retrospective biodosimetry using the correction factor of dose estimation, Dolphin′s model and Qdr method, respectively. Results:Based on the amounts of semi-automated dic and manually detected dic plus ring, the whole-body average absorbed dose of the victim was estimated to be 0.68-0.95 Gy by four different dose response curves. Over dispersion of dic or dic plus ring was also detected, and the efficiency of dose assessment was obviously increased using dic semi-automatic detection. Based on three different retrospective biodosimetry models, the estimated average absorbed dose was further corrected to be between 1.80-2.86 Gy, which was consistent with clinical diagnosis of degree Ⅳ radiation skin injury.Conclusions:A case of suspected radiation skin injury was confirmed by chromosomal aberration analysis and it’s biodosimetry was reconstructed, suggesting that the unstable chromosomal aberration analysis may be applicable to assess the retrospective biodosimetry of non-uniform local radiation exposure.

Investigation and analysis of an extensive skin injury to the back caused by accidental irradiation in interventional procedure / 中华放射医学与防护杂志

Objective:To carry out investigation and analysis of an extensive skin radiation injury to the back accidentally caused by interventional procedure and to explore the problems faced in the event with emphasis on avoiding the reoccurance of similar events in the future.Methods:The data were collected by consulting the patient′s detailed medical history, collecting and analyzing clinical diagnosis and treatment data, tracking and observing their clinical manifestations and signs. The patient′s peripheral blood samples were also collected, together with the biological dose estimated and the equipment data collected on the site of the interventional treatment hospital.Results:The whole body dose to the patient was estimated to be 0.95 Gy. The typical values of kerma rate of radiation incident on the body surface due to fluoroscopic procedures were 373.5 mGy/min in subtraction modality and 47.8 mGy/min in fluoroscopy modality, respectively. The annual effective dose to the interventional radiologist was 20.51 mSv due to his operation in long-time radiation exposure conditions, higher than 3.09 mSv for other interventional radiologists with similar workload in the same department. The whole body and local clinical manifestations of the patients were in line with radiation injury. No clear diagnosis has been obtained in several hospitals, nor can obvious treatment outcomes be obsevered.Conclusion:Combined with the biological dose estimation result and clinical manifestations, the case was diagnosed as degree Ⅳ skin radiation injury. Radiation injury is closely related to whether the operation is conducted according to the standard and the output dose of X-ray machine. Non-specialized hospitals should strengthen clinical diagnosis and treatment of radiation injury.

The 20-year follow-up of five victims externally exposed in " 4.26" 60Co radiation accident in Henan province / 中华放射医学与防护杂志

Objective:To investigate the late effects induced by external ionizing radiation through long-term follow-up of the victims exposed to 60Co radiation source at " 4.26" accident in Henan in 1999, and to provide valuable experience in the radiological medicine. Methods:Medical observations of the clinical symptoms, signs, eye lens examination and previous medical history of the five exposed victims were performed and recorded. The changes of the laboratory routine examinations, immune function, thyroid function, reproductive hormone levels, tumor markers, radiation genetic indicators as well as ultrasound examination of thyroid, cardiac, reproductive system, electrocardiogram, chest CT were systematically reviewed.Results:The typical radiation-induced cataract was found in " Mei" 2-3 years after 60Co accidental irradiation. 13 years after irradiation, the cataract surgery and intraocular lens implantation in left eye were performed followed by the same operation in right eye in November 2019. Different degrees phacoscotasmus under the posterior capsule or equatorial part of the eyes were also found in the rest of victims. ECG result of " Mei" indicated myocardial ischemia 7 years after accident. " Tian" confirmed diagnosis coronary heart disease 12 years after irradiation, and the surgery about coronary angiography heart stent implantation was taken at 20 years after irradiation. Five victims showed increased serum total cholesterol and/or triglycerides, and 4 victims showed bilateral or unilateral common carotid atherosclerotic plaque formation. Higher levels of thyroid stimulating hormone (TSH) were observed in " Mei" at 11 years after the irradiation. The thyroglobulin antibody (TGA)and thyroid microsomal antibody (TMA) were obviously increased in " Yi" , accompanied by thyroid uneven found by ultrasound. The thyroid nodules in " Mei" and " Min" were observed at 15 years after irradiation. The diagnosis of diffuse large B cell lymphoma(DLBL) in " Tian" was confirmed at 13 years after irradiation. Slightly higher of Neuron-specific enolase(NSE) were found in " Tian" , " Min" and " Yi" . A small nodule was detected from chest CT of " Tian" . Most of the chromosome aberrations observed in peripheral blood lymphocytes from the victims were stable chromosomal aberration such as translocation (t) with a few dicentric chromosome (dic) and acentric fragment (ace) in " Wang" and " Tian" . Conclusions:Ionizing radiation can cause variable degrees of deterministic effects in lens, thyroid gland and cardiovascular circulatory system and stochastic effects such as neoplasm. The genetic damages will last long in the patients.

Preliminary study on ICD coding for occupational radiation diseases in China / 中华放射医学与防护杂志

Objective:To improve the accuracy of the coding of occupational radiation diseases in China, to provide standardized basis for the research on the management of such diseases as well as the informatization management of medical records and the formulation of relevant policies, and to improve the level of prevention and control.Methods:According to the nomenclature and disease characteristics of occupational radiation diseases in China, the diseases were coded by ICD-10 coding rules.Results:The system of occupational radiation diseases in China is the sum of all kinds of diseases caused by ionizing radiation, which is different from the common clinical symptom. The coding of such diseases must be based on the location, clinical manifestations, pathological changes, and other characteristics.Conclusions:The accuracy of occupational radiation diseases coding directly affects the accuracy of disease statistical data. Standardizing the coding of these diseases is a very necessary supplement to the system of occupational radiation diseases in China.

Effect on the treatment of patients with occupational coal worker′s pneumoconiosis using multistep breathing training combined with acupoint plastering / 中国职业医学

OBJECTIVE: To observe the clinical effect of multistep breathing training combined with acupoint plastering on the treatment of patients with occupational coal worker's pneumoconiosis(CWP). METHODS: Eighty cases of male occupational CWP patients were selected as the research subject using convenient sampling method. They were divided into control group(40 cases) and treatment group(40 cases) according to random number table method. The control group was given conventional treatment, while the treatment group received multistep respiratory training combined with acupoint plastering for 12 weeks based on conventional symptomatic treatment. Before and after treatment, clinical curative effect, pulmonary function, immune function, the total score of Chronic Obstructive Pulmonary Disease Assessment Test(CAT) Questionnaire and 6 minutes walk distance(6 MWDS) in two groups were observed. RESULTS: Before treatment, there was no statistical difference on forced vital capacity(FVC), ratio of forced expiratory volume in one second(FEV_1)/FVC, lymphocyte cluster of differentiation(CD) 4~+/CD8~+ ratio, percentage of natural killer cells(NK), total CAT scores and 6 MWD(P>0.05). After treatment, the FVC, FEV_1/FVC ratio and lymphocyte CD4~+/CD8~+ ratio increased [median: 78.3% vs 80.7%, 68.7% vs 72.5%, 1.16 vs 2.00, P<0.01], 6 MWD was increased [(430.6±45.9) vs(494.8±58.7) m, P<0.01], and CAT total score was decreased [(18.1±5.6) vs(15.5±5.3) points, P<0.01] in the treatment group compared with the control group. There was no significant difference in NK cell percentage between the two groups(P>0.05). CONCLUSION: Multistep respiratory training combined with acupoint plastering can alleviate the clinical symptoms such as cough, and shortness of breath of patients with CWP, improve their lung function, regulate the function of immunity, as well as improve sports endurance.

Serum 8-hydroxy-2-deoxyguanosine level of radiation workers in hospitals / 中华放射医学与防护杂志

Objective To explore the influence of long-term low-dose ionizing radiation on 8-hydroxy-2-deoxyguanosine(8-OHdG) level in the serum of radiation workers in hospitals.Methods 307 age-and sex-matched hospital radiation workers were recruited by stratified random sampling method.After deleting the subjects without dosage information,230 individuals were divided into four groups according to their job title [including diagnostic radiology (n =75),radiotherapy (n =60),nuclear medicine (n =41) and interventional radiology (n =54)].Serum 8-OHdG level was measured by ELISA assay.Results According to the statistical analysis,there was significant difference in the serum 8-OHdG level among four groups (F =9.071,P ＜ 0.05),and the content of serum 8-OHdG was significantly higher in the interventional radiology group than that in the groups of diagnostic radiology,radiotherapy and nuclear medicine (t =-4.473,-3.011,-2.189,P ＜ 0.05).There were significant differences in serum 8-OHdG level among different dose groups and working period groups(F =7.659,3.058,P ＜ 0.05).The serum 8-OHdG levels significantly increased along with exposure dose and working period (r =0.300,0.142,P ＜ 0.05).Conclusions Serum 8-OHdG may be a potential biomarker of oxidative DNA damage in radiation workers exposed to low-dose ionizing radiation.

Follow-up of radiosensitive tissues in children with congenital heart disease treated by interventional operation / 中华放射医学与防护杂志

Objective To understand effects of the interventional operation on thyroid,peripheral blood indexes and chromosomal aberrations (CA) of peripheral lymphocyte of children with congenital heart disease (CHD).Methods Follow-up studies were conducted in 70 child patients undergoing cardiac catheterization and 23 with open heart surgery as control from 2010 to 2013.Postoperative follow-up examinations included thyroid ultrasound,blood routine indexes and analyses of CAs.Results Difference in thyroid ultrasound abnormality rate was not statistically significant between children with cardiac catheterization and control group (40.0％ vs.43.5％,P ＞ 0.05).There was no significant difference in white blood cell (WBC) count between interventional group and control group (P ＞ 0.05).The effects of disease type and operation time on thyroid ultrasound and WBC count were not observed (P ＞ 0.05).The frequency of chromosome aberrations,including acentric fragment,dicentrics and translocation in interventional group [(0.76 ± 0.07) ％],was higher than in control group [(0.25 ± 0.07) ％,(Z =-3.631,P ＜ 0.05],and the rates of acentric fragment and translocation were also higher in interventional group (Z =-2.531,-2.397,P ＜ 0.05).Conclusions Effect of intervention therapy on thyroid structure and WBC count in children with CHD was not observed,but the genotoxic effects remain in children with cardiac catheterization.

Effects of blood lead level on the occupational health examination index in workers with lead exposure / 中国职业医学

OBJECTIVE: To investigate the effects of blood lead level on the occupational health examination index in workers with lead exposure. METHODS: Using judgment sampling method,412 workers exposed to lead from a lead acid battery factory were selected. According to the blood lead levels,the participants were divided into 5 groups( < 100. 0,100. 0-,200. 0-,300. 0- and 400. 0- μg / L). The effects of blood lead level on the health status of the workers such as clinical symptoms,electrocardiogram( ECG),routine urine and blood pressure,liver function and blood routine were analyzed.RESULTS: The median( the 25 th and 75 th percentiles) of the blood lead level was 169. 0( 76. 6,320. 4) μg / L in the 412 workers,and over standard rate was 12. 6%. Male workers 'blood lead level was higher than that of female workers[225. 8( 91. 3,351. 2) vs 131. 0( 64. 6,248. 9) μg/L,P < 0. 01]. In the female workers,the abnormal rate of ECG in the < 100. 0 μg / L group was lower than those of the 400- μg / L group( 6. 7% vs 41. 2%,P < 0. 005); the level of diastolic pressure in the < 100. 0 μg / L group was lower than that of the 300. 0- μg / L group [( 78. 4 ± 11. 7) vs( 72. 6 ±5. 6) mm Hg,P < 0. 01]. It was no correlation between blood lead level and urine β2-microglobulin( rS=- 0. 044,P =0. 82),while it was positive correlation between blood lead level and 24 hours urine lead content( rS= 0. 657,P < 0. 01).CONCLUSION: Lead exposed could cause the increase of cardiovascular abnormalities in female workers than that of male workers. Routine blood index,liver function index and routine urine index( urine protein) could not early reflect the blood,liver and kidney toxicity of lead.

Follow-up observation of eye lens in ten victims accidentally exposed to 60Co radiation source / 中华放射医学与防护杂志

Objective To observe late effect of 60Co radiation accident on eye lens in the victims.Methods Medical observations of eye lens were performed on ten victims accidentally exposed to 60Co sources in four radiation accidents that have occurred from 1986 to 2000 in Henan Province.Pathological changes of the eye lenses were examined by using slit lamp microscopy after mydriasis with compound tropicamide.Results Of these ten victims, Liang in a radiation accident in Kaifeng (in 1986), Mei in Xinxiang (in 1999) and Xu in Xuchang (in 2000) all had typical radiation-induced cataract 2, 3 and 6 years after irradiation, respectively.Follow-up observation of the lens showed the punctate and/or granular opacities present in the eye posterior subcapsular of Yan in Kaifeng accident, Jie in Zhengzhou (1987), and Tian, Yong and Yi in Xinxiang accident, featuring the early changes of radiation-induced cataract, but the posterior subcapsular opacities were not observed in Wang and Min in Xinxiang accident.Conclusions Focus should be on the eye lens as the target organ of radiation exposure in long-term follow-up of victims accidentally exposed to radiation source.Severity of the lens opacity induced by ionizing radiation is closely associated with radiation doses.

Serum levels of matrix metalloproteinase 9 and 19 in the patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To measure peripheral serum levels of matrix metalloproteinase 9 (MMP9) and matrix metalloproteinase 19 (MMP19) in patients with pneumoconiosis, and to investigate their feasibility as potential biomarkers for pneumoconiosis.</p><p><b>METHODS</b>Ninety-eight male patients with pneumoconiosis (49 patients in phase I, 36 patients in phase II, and 13 patients in phase III) were enrolled as subjects, which included 41 patients with silicosis and 57 patients with coal workers' pneumoconiosis. Ninety-eight healthy male physical examinees were used as controls. A fasting blood sample (3 ml) was collected from the peripheral venous blood of each patient or control, and the serum was separated from the blood sample. The expression levels of MMP9 and MMP19 in serum were measured by enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Serum levels of MMP9 and MMP19 in patients with silicosis or coal workers' pneumoconiosis were significantly lower than those in the control group (P < 0.05). Serum levels of MMP19 in patients with silicosis were significantly higher than those in patients with coal workers' pneumoconiosis (P < 0.05). Serum levels of MMP19 in patients exposed to dust for less than 7 years were significantly higher than those in patients exposed to dust for more than 20 years (P < 0.05). There were no significant differences in serum levels of MMP9 and MMP19 between patients with different levels of pulmonary function impairment (P > 0.05). Serum expression levels of MMP9 and MMP19 were positively correlated with each other in both patients with pneumoconiosis and those in the control group (P < 0.05). The serum expression level of MMP9 was negatively correlated with the stage of pneumoconiosis (P < 0.05).</p><p><b>CONCLUSION</b>Serum MMP9 and MMP19 may be used as potential biomarkers for pneumoconiosis.</p>

Analysis of lens opacity among 730 radiation workers / 中华放射医学与防护杂志

Objective To explore whether low-dose occupational ionizing radiation exposure can affect the prevalence of lens opacity.Methods Annual occupational health checkup data of 1 007 radiation workers was taken from a provincial medical institution for the purpose of statistical analysis.Logistic regression analysis was used to estimate occupational exposure odds ratios (OR) of lens opacity,adjusted for age,gender and length of service.Eye lens opacity was grouped into cortical,nuclear and posterior subcapsular opacity according to the position of the opacity occurrence site.Opacity occurred in any one of the both eye lens was recorded as turbidity.Results Only 730 cases coupled with complete information could be used in the statistical analysis.The rate of lens opacity for all the radiation workers was 10.27％.The rates of lens opacity by exposure group were estimated to be 9.07％ for radiation diagnosis and therapy group,11.11％ for intervention group,18.18％ for nuclear medicine group,and 9.33％ for industrial application group,respectively.Compared with those in the radiation diagnosis and therapy group,the workers engaged in intervention medicine,or nuclear medicine,were more likely to suffer from the lens opacity in posterior subcapsular position.The OR and its 95％ confidence intervals were 3.00 (1.23-7.33),4.12 (1.68-10.11) for the workers in intervention medicine or nuclear medicine group.Conclusions Medical radiation workers,who were exposed to long-term low-dose of ionizing radiation,especially those who engaged in intervention or nuclear medicine,were at significantly higher risk to develop lens opacity.

Analysis of chromosomal aberration in seven medical staffs suspected with exposure to ionizing radiation / 中华放射医学与防护杂志

Objective To investigate the chromosomal aberrations in seven medical staffs suspected with exposure to ionizing radiation and to speculate its possible causation.Methods The hospital staffs,including 6 females and 1 male,worked in a clinical laboratory where a CT room was located downstairs.The thickness of precast slab between these two rooms was 6 cm.Peripheral blood lymphocytes of seven staffs were examined for conventional chromosomal aberrations.Results The frequencies of dicentrics in the peripheral lymphocytes of 4 females were from 0.40％ to 1.60％ that was significantly higher than the spontaneous frequency of dicentrics (0.03％,x2 =36.79,P ＜ 0.05).The translocation was observed in the lymphocytes from all subjects with frequencies from 0.33％ to 1.20％,obviously higher than its spontaneous frequency of 0.01％ (x2 =42.90,P ＜ 0.05).Conclusion These staffs suffer from ionizing radiation.

Long-term health effect of 25 persons overexposed to ionizing radiation / 中华放射医学与防护杂志

Objective To explore the long-term health effects of overexpose to radiation.Methods The 32 -41-year medical followed-up observations were performed for 25 persons exposed to ionizing radiation in the dose range of 0.10 -0.33 Gy. Observations were made of clinical symptom,eye lens,cytogenetics,immune function and endocrine function for these persons. Results The incidence of neurasthenic symptom was higher in exposed group than that in control group.2 cases suffered from liver cancer and esophageal cancer,respectively. Posterior capsule punctate phacoscotasmus of the lens wereobserved in 7 cases.There was I case of cataract in the exposed group. The frequencies of chromosomeaberration and micronucleis in peripheral blood lymphocyte in the exposed group were significantly higherthan those in control group (x2 =8.88,8.71,40.60,45.63,P ＜ 0.05 ).The average value of serum IgG was higher(t =2.16,P ＜0.05 ),while that of IgM was obviously lower in the exposed group (t =2.03,P ＜0.05).The average values of serum triiodothyronine (T3),thyroxine (T4 ) and thyroid-stimulating hormone (TSH) in the exposed group were obviously lower than those in the control group (t =2.40,3.54,2.13,P ＜0.05 ).Conclusions Overexposure has effect on lens,immune function,cytogenetics to some degree.It is important to observe the long-term health effect on overexposed persons.

Clinical reaserch on DCTAA and CIK from stem in treating patients of moderate and advanced stage lung cancer / 肿瘤研究与临床

ObjectiveTo observe the treatment effects in 48 cases of advanced lung cancer patients,with the immune therapy of the dendritic cells loading of tumor autologous antigen (DCTAA) combining with the cells induced factor of the killer cells(CIK)from the matched umbilical cord blood cells.MethodsThe peripheral blood mononuclear cell(PBMC)from the matched umbilical cord blood cells was seperated,and induced to CIK and DC with some cytokines in vitro, such as CD3McAb, IL-2, IFN-γ IL-1α, etc. After 12 to 15 days, the amplified CIK cells obtained were obtained, with the strict quality control, infused the CIK cells to the patients body back in six times,about(5-8)×109 CIK cells in each time.In the fifth day of the cultivation,DETAA cells were loaded and DCTAA cells were collected in the eighth day,and then hypodermic injection was done. The patient' s general situation after the immune treatment was observed, such as the size of the tumors, clinical symptom score, the quality of life and immune indexes. Karnofsky score, weight, toxic side effects and the patient's survival were also studied.ResultsIn the 48 cases with the DCTAA-CIK treatment, complete remission (CR), partial remission (PR)was 37 cases, the overall remission rate was 77.1％. The improvement rate of clinical symptom scores was from 78.9 ％ to 84.7 ％, the increasing rate of Karnofsky score was 89.6 ％ (43/48). 1-year survival reached to 80.6 ％. There were significant difference in little toxic side effects(P ＜ 0.01). The proportion of CD3, CD4 and NK cells in peripheral blood cells increased significantly (P ＜ 0.01) after DCTAA-CIK cells treatment[(42.21±6.12)％, (24.42±3.01)％, 0.99±0.34, (24.98±3.02) ％; (71.58±7.64) ％, (37.25±2.13) ％, 1.62±0.45, (35.23±4.11) ％](t = 6.34, 5.67, 0.25, 4.43, P ＜0.01).ConclusionThe DCTAA-CIK immune therapy is benefit for advanced lung cancer,not only improve the immune function but also ameliorate the clinical symptoms.

Liver transplantation for treating idiopathic adulthood ductopenia One case report and literature review / 中国组织工程研究

To summarize and explore the etiopathogenisis, clinical 'characteristics, diagnosis and treatment and prognosis of idiopathic adulthood ductopenia. We described a 27-year-old Chinese female initially manifested with jaundice, pruritus, dark urine, and pallor of the stools in October, 2002. Symptoms occurred repetitively and severed progressively, and she received therapy at the General Hospital of Chinese People's Armed Police Forces. B-ultrasound demonstrated that hepatic lesion and slightly swelling spleen. Pathological diagnosis of liver biopsy showed that she affected idiopathic adulthood ductopenia. The outcome of treatment of ursodeoxycholic acid and adrenal cortical hormone was not significant. She received orthotopic liver transplantation on June 24~(th), 2005. After liver transplantation, pruritus and jaundice were promptly disappeared. Each index of hepatic function recovered to a normal level. In March 2007, decreased dose of hormone induced an abnormal hepatic function, with mildly acute rejection. Drug dose was regulated, and hepatic function gradually returned to normal. During follow-up 51 months after the operation, she was doing well and was free of symptoms with normal liver function and no evidence of allograft dysfunction. The pathogenesis of idiopathic adulthood ductopenia is still unknown. There are still no precise and effective drugs for treatment of idiopathic adulthood ductopenia. Liver transplantation offers an effective therapy for end-stage patients with idiopathic adulthood ductopenia.

Gene expression profiles in human bladder epithelial cells stimulated with uropathogenic Escherichia coli / 中华微生物学和免疫学杂志

Objective To investigate the interaction between uropathogenic Escherichia coli (UPEC) and host uroepithelial cells, define the role uroepithelial cells play in initiating and modulating the host response to infection with UPEC strain. Methods The human bladder transitional epithelial EJ cells were evaluated for their capacities to allow the adherence and invasion by UPEC132, a clinical strain isolated from Tianjin, China, and a cDNA microarray for 22 000 human genes was used to identify the gene expression differences between EJ cells infected with UPEC132 and uninfected EJ cells. Results Microscope observation showed that UPEC132 could adhere to EJ cells with the adherence rate of (73.20 ± 5.26)%. And visualization by confocal microscope revealed that this microorganism could be seen within the cells. EJ cells infected with UPEC132 changed mRNA expression of a total of 29 genes, including 28 genes up-regulated and 1 gene down-regulated. Of these, regulators of growth and proliferation, cytokines, and modulators of apoptotic responses were the most prominent. Conclusion The gene expression profiling of EJ cells is affected by the infection of UPEC strain. The differentially expressed genes may contribute to further investigate the interaction of UPEC and uroepithelial cells.

Pulmonary Fungal Infection in Mid-later Stage after Liver Transplantation / 中华医院感染学杂志

-?-D-glucan test.CT finding indicated the pulmonary nodules or masses in 9 cases.Plaque and flocculation lesion found in 3 cases.Ten cases were treated,in which 8 cases were cured,1 case was improved,1 case was dead.The effective rate was 90%,the curative rate was 80%,and the mortality rate was 8.3%.The two cases without treatment were stable.CONCLUSIONS The leading etiologic species of pulmonary fungal infections in the mid-later stage after liver transplantation are Aspergillus and Cryptococcous.It is different between early stage and mid-later stage after liver transplantation on clinical feature,outcome and anti-fungal medicine tolerability.