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Objective@#To investigate the reference level of surface radiation dose of digital radiography (DR) among adult examinees in Beilun District, Ningbo City, so as to provide insights into the optimization of the parameters of DR systems and rational management of the radiation dose.@*Methods@#Based on the cloud imaging system covering 14 DR systems in 11 public hospitals in Beilun District, the diagnosis of adults receiving DR and DR systems check were collected from May 2020 to April 2021. The air kerma-area product ( PKA ) was selected as a measure, and the local diagnostic reference level ( LDRL ), the regional median dose ( RMD ), the regional lowest dose predicted level ( LDPL ) and the typical dose in the DR imaging room were defined using the quartile method according to the examination site, projection direction and radiography positions. The PKA value was transformed into incident air kerma ( Ka, e ), and compared with the recommended value in the Requirements for Radiological Protection in Diagnostic Radiology ( GBZ 130-2020 ).@*Results@#DR was performed among 133 065 person-times from May 2020 through April 2021 in Beilun District. The greatest RMD was found on abdomen AP DR in the supine position ( 120 μGy·m2 ), and the lowest RMD was seen on chest PA DR in the standing position ( 17 μGy·m2 ). The maximums of typical dose in the DR imaging room on chest PA ( 33 vs. 30 μGy·m2 ), abdomen AP ( 161 vs. 153 μGy·m2 ) and pelvis AP DR ( 164 vs. 162 μGy·m2 ) were greater than LDRL in the supine position, and the minimums of typical dose on chest PA ( 10 vs. 11 μGy·m2 ) and chest LAT DR ( 33 vs. 34 μGy·m2 ) were lower than LDPL in the standing position. Following transformation into Ka, e, the LDRL ranged from 0.27 to 3.80 mGy, and the maximums of typical dose ranged from 0.25 to 3.55 mGy, which was much lower than the recommended dose proposed in the national criteria.@*Conclusions@#The reference level of surface radiation dose of DR is established among adults in Beilun District, which is lower than the recommended dose in the national criteria of China. Such a reference level may be employed by medical institutions for optimization of the parameters of DR systems. Key words： digital radiography radiation dose diagnostic reference level air kerma-area product
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Objective:To explore the incidence of vascular leakage after acute hemodilution in patients with traumatic orthopedics by using 6% hydroxyethyl starch 130/0.4 (HES).Methods:Using prospective cohort study method, 48 orthopedic trauma patients in in Yantaishan Hospital from June 2018 to December 2018 were selected as the subjects of observation.The American Society of anesthesiologists (ASA) grade was divided into grade I-III.According to the degree of trauma, they were divided into two groups: general orthopedic patients group (24 cases) and severe trauma orthopedic patients group (24 cases). According to the formula of blood volume, the blood volume of the patients in the two groups was calculated.After intubation, 10% of the blood volume of HES was infused intravenously at the rate of 0.5 ml/(kg·min) for acute hemodilution.Plasma colloidal osmolality and hemoglobin were measured immediately before acute hemodilution (T0), 15 minutes (T1) and 30 minutes (T2) after acute hemodilution.The concentrations of HES in T1 and T2 plasma were measured.The urine volume from the beginning of infusion to 30 minutes after the end of infusion was saved.The urine volume and hes concentration were measured to calculate the urine hes content.Results:The amount of HES input was the same in the general orthopedic patients group and the severe trauma orthopedic patients group, which were (7.71±0.3) ml/kg and (7.70±0.2) ml/kg, and the expansion ratio was about 100%.Compared with T0, plasma colloid osmotic pressure at T1 and T2 were (27.9±1.5) mmHg(1 mmHg=0.133 kPa)) and (27.7±1.5) mmHg in the general traumatic orthopedics patients, which was higher than T0((26.5±1.5) mmHg, P<0.05). There was no significant difference of COP at T1 and T2 ((27.0±1.6) mmHg and(26.9±1.5) mmHg) compared with T0((26.3±1.7) mmHg, P>0.05) in the severe trauma orthopedic patients). The concentration of plasma HES in the severe trauma orthopedic patients ((6.8±0.6) g/L and (5.8±0.5) g/L) was lower than in the general traumatic orthopedics patients ((7.7±0.5) g/L and (7.1±0.5) g/L, t=5.660 and 6.755, all P<0.05) at T1 and T2.There was no significant difference of the urine HES content ((29.0±3.5 ) mg vs.(28.4±3.3) mg, t=0.61, P>0.05 )between the two groups after infusion. Conclusion:The ratio of acute hemodilution and volume expansion of HES was the same in the two groups.The changes of plasma colloid osmotic pressure and HES concentration were lower in patients with severe trauma orthopedics, and there was more obvious extravascular leakage in patients with severe trauma orthopedics.
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Objective@#To realize the efficient monitoring of frequency of medical exposure and dose monitoring in Ningbo by means of informatization.@*Methods@#Data transmission process and the key elements of frequency of medical exposure and individual dose were investigated. According to standardization principles of data elements, the standardized data elements for frequency of medical exposure and individual dose were determined. On this basis, modules and functions of data receiving platform on the frequency of medical exposure and individual dose in Ningbo were designed.@*Results@#Totally 59 data elements on frequency of medical exposure and individual dose were formed. According to their functions, the data receiving platform was divided into the distribution of radiodiagnosis and radiotherapy resources, the frequency monitoring of medical exposure and dose monitoring for permanent residents, and the dose monitoring.@*Conclusions@#The establishment of frequency and dose information monitoring platform on medical exposure in Ningbo and the determination of standardized data elements will be conducive to further progress in medical exposure information monitoring in Ningbo.
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Objective To realize the efficient monitoring of frequency of medical exposure and dose monitoring in Ningbo by means of informatization. Methods Data transmission process and the key elements of frequency of medical exposure and individual dose were investigated. According to standardization principles of data elements, the standardized data elements for frequency of medical exposure and individual dose were determined. On this basis, modules and functions of data receiving platform on the frequency of medical exposure and individual dose in Ningbo were designed. Results Totally 59 data elements on frequency of medical exposure and individual dose were formed. According to their functions, the data receiving platform was divided into the distribution of radiodiagnosis and radiotherapy resources, the frequency monitoring of medical exposure and dose monitoring for permanent residents, and the dose monitoring. Conclusions The establishment of frequency and dose information monitoring platform on medical exposure in Ningbo and the determination of standardized data elements will be conducive to further progress in medical exposure information monitoring in Ningbo.
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Objective To make comparison of consistency between the ESD's informationcalculated values and TLD readout values based on PHILIPS DigitalDiagnost so as to provide reference for realizing information management of medical exposure radiation dose during DR diagnosis and treatment.Methods TLDs were used to obtain the ESD values on chest,abdomen,vertebral body,pelvis and limbs.The exposure parameters were collected from the DICOM files,and the information value of ESD were calculated through the dose area product (DAP) method and the exposure parameter method.The consistency between information value and TLD readout value was compared by intraclass correlation coefficient and the Bland-Altman method.Results The ESD values obtained from DAP method,exposure parameter method and TLD method are,respectively,(0.730 ± 0.870) mGy,(0.720 ± 0.863) mGy and (0.770 ±0.948) mGy.ICC was 0.988 for ESDDAP-TLD and 0.982 for ESDParameters-TLD,respectively.The Bland-Altman map showed that the D-value of ESD obtained from DAP-TLD and Parameters-TLD beyond the 95％ consistency interval was 6.7％.Conclusions The PHILIPS DR daily diagnosis and treatment process is based on fixed-mode programmed diagnosis and treatment.Under the premise of qualified equipment quality control,the information calculated value based on DICOM files has a good consistency with TLD readout value.