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Objective@#To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments.@*Methods@#History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan.@*Results@#At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal.@*Conclusions@#The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .
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Objective To estimate the absorbed dose and effective dose to the examined adult patients during digital tomosynthesis and to provide reference data for radiation dosimetry.Methods The phantom experiments were grouped according to the examined site(main beam scanned site),and the data displayed in real time during digital tomosynthesis are used as conditions for the phantom experiments.The effective doses to the examined patients were estimated on the basis of phantom scanning and tissue-absorbed dose calculation.Results During digital tomosynthesis,the effective doses to the examined patients of various groups were 0.524 mSv for head,0.736 mSv for cervical spine,2.719 mSv for thoracic vertebra,1.810 mSv for chest,1.240 mSv for lumbar spine,2.317 mSv for abdomen and 2.316 mSv for pelvis,respectively.Conclusions During digital tomography,the highest value of effective doses was estimated to be 2.719 mSv in thoracic vertebra group,followed by abdominal group 2.317 mSv and pelvic group 2.316 mS,with the lowest 0.524 mSv in head group.The main factors influencing the effective dose include tube voltage,total mAs,irradiation field size,main beam irradiation range,and the number of tissues or organs in scanned range.
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Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.
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Objective To investigate a dose response curve based on a genetic workstation with automatic analysis system of dicentric chromosome assay (DCA) for establishing a high speed dose estimation method.Methods Peripheral blood from three healthy volunteers was irradiated in vitro using 60Co γ-rays,and then lymphocytes were cultured and fixed on slides using the standard protocol for DCA.Dicentric chromosome in metaphase cells was analyzed automatically with the genetic workstation and confirmed manually,and the dose response curve of automated dicentric chromosome was fitted.Dicentric chromosome of another peripheral blood sample irradiated with different doses was manually analyzed to verify the accuracy of the above automated DCA.Results The yield of automated DCA was well fitted by an equation Y =0.018 06D2 + 0.012 79D + 0.000 489 1 with a correlation coefficient R2 =0.961.The biological dose of radiation could be accurately estimated by this dose response curve within a few minutes.Conclusions We had successfully established a new dosimetry method by analyzing dicentric chromesome automatically,which can save a lot of manual analysis time and hence has important significance for emergency rescue in nuclear accidents.
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Objective To explore the correlation of the anti-stress ability of nuclear power plant operators with their heart rate,blood pressure and mental health.Methods A total of 136 male nuclear power plant operators received the continuous performance test (CPT) and mental health test (MHT),while 37 male senior students were used as the control group.Heart rate and blood pressure were recorded before and after the test.The nuclear power plant operators were divided to high score group and low score group by CPT scores.The correlation of the anti-stress ability and blood pressure,heart rate and their mental health was analyzedd.Results The scores of CPT and MHT test with the operators were significantly higher than those of the control group(t =- 1.25,6.25,P ＜ 0.05).After the test,the heart rate,systolic pressure and diastolic pressure of the operators were all significantly lower than those of the control group ( t =- 2.07,3.28,2.74,P ＜ 0.05 ).The CPT score of the high score group was lower in the heart rate,systolic pressure and diastolic pressure than the low score group(t=-3.15, -2.78, -2.54,P ＜0.05),while the scores of CPT and MHT were better(t =0.63,6.90,P ＜ 0.05).CPT scores were negatively correlated with the increasing range of the heart rate,systolic pressure and diastolic pressure( r =- 0.69,- 0.94,and - 0.62,P ＜ 0.05 ),and positively correlated with the MHT scores ( r =0.54,P ＜ 0.05 ).Conclusions To a certain extent,CPT and MHT test can reflect the anti-stress ability and be used as one of the bases to select nuclear power plant operators and to assess their competence.
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Objective To explore the status of nuclear power plant operators in mental health and its correlation with emotional stability,liveliness,anxiety and urgency.Methods 255 male operators were randomly selected from three nuclear power bases,meanwhile 61 undergraduates were used as control group.The mental health and neurobehavioral evaluation system of Chinese nuclear power plant operators was developed by Second Affiliated Hospital of Soochow University,which was used to assess mental health of the subjects.The scores of mental health personality factors were recorded,together with four main personality factors including emotional stability,liveliness,anxiety and urgency.Results The score of lie was lower than 8 which showed all inspected groups were normal. 1.57％ (4/255) operators had psychological disorders,3.92％ ( 10/255 ) had poor mental health,27.84％ ( 71/255 ) had general mental health,66.7％ (170/255) had excellent mental health,whereas 9.84％ (6/61)for control group had psychological disorders.Obvious difference was observed in the final scores between the nuclear power plant operators and control group.The former gained higher scores on mental health,emotional stability,and lower scores on anxiety and urgency ( t =3.437,4.423,- 2.493,- 2.093,P ＜ 0.05 ).Both groups aged over 27 years and with length of service over 5 years were awarded higher scores on mental health,emotional stability( t =2.585,2.349 ; t =2.606,2.947,P ＜ 0.05 ),lower scores on anxiety and urgency (t =- 3.407,- 2.138 ; t =- 2.941,- 2.256,P ＜ 0.05).The mental health was positively correlated with emotional stability and liveliness ( r =0.721,0.650,P ＜ 0.05),but negatively correlated with anxiety and urgency(r =- 0.809,- 0.693,P ＜ 0.05 ).Conclusions The majority of nuclear power plant operators had excellent psychological quality,but some factors should be paid more attention,such as different ages and length of service time.
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Objective To understand the operators'psychosomatic health status in nuclear power plant;and provide the scientific basis of measures for preventing and reducing mental disorders in operators.Methods The Psychosomatic Health Battery(PSHB) was used to assess the psychosomatic health status in 109 operators who were random selected from Qinshan nuclear power plant,etc.They were tested from lie,emotional stability,liveliness,tension,apprehension,mental health,such as psychopathic deviatesuch 7 personality traits.Results Lie < 8,all inspected groups were normal.Psychopathic deviate:98.2% for normal group 0.9% for both of groups occurred possible mental health problems and confirmed mental health problems ;Mental health:80.7% (88/109) for fine mental health ones,29.4% (32/109) for those with excellent mental health,51.4% (56/109) for good mental health ones,13.8% (15/109) for general mental health ones,5.5% (6/109) for poor mental health ones.Age factor could influence the mean values of the factors of apprehension,tension,mental health and psychopathic deviate.Correlation analysis showed that there was a correlation between tension and psychopathic deviate(r = 0.664 ,P < 0.01),and the other correlation coefficient was between apprehension and mental health(r =-0.789 ,P < 0.01).Conclusions There is an excellent condition of psychosomatic health in most of the operators,however,there are still a very small percentage of psychosomatic disorders among these operators,to improve the quality of their psychosomatic health,psychological counseling should be particularly strengthened to those with problems of psychosomatic health.
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Objective To explore the personality features of nuclear power plant operators and the influencing factors thereof.Methods Minnesota Multiphasic Personality Inventory was used to examine the personality features of 136 nuclear power plant operators randomly selected from 2 cooperative units,all males.The results were compared with the nationwide norms and subsequently an inter-block contrast analysis was carried out.Results Obvious difierence was observed in the final scores between the nuclear power plant operators and nationwide norms.The former got higher scores on hysteria(t=3.05,P<0.05).and lower scores on hypochondriasis,depression,morbid personality,masculinity-femininity,paranoia,psychasthenia,schizophrenia,hypomania,and social introversion(t=7.47,7.47,7.3 1,2.23,15.09,16.15,19.28,7.88,11.10,P<0.05).The scores on hypochondriasis,depression,schizophrenia,and social introversion of those with the length of services over 3 years were all significantly higher than those ofwith the length of services less than 3 years(t=3.25,2.51,2.76,3.00,P<0.05).The scores on hypochondriasis,depression,psychop8thicdeviate,and social introversion of the operators aged over 30 were all significantly higher than those of the operators aged below 30(t=2.36,2.35,2.01,2.54,P<0.05).Conclusions The psychological quality of the nuclear power plant operators is superior to that of the general population.