Monitoring and analysis of lens dose to interventional radiology workers at some hospitals in Shaanxi province from 2018 to 2020 / 中华放射医学与防护杂志

Objective:To analyze and learn about the dose to the lens of the eye of interventional radiology workers in some hospitals in shaanxi province from 2018 to 2020.Methods:From 2018 to 2020, three tertiary hospitals in shaanxi province were selected to monitor the dose to the lens of the eye of interventional radiology workers for three consecutive years. Monitoring was made for 152 person times, lasting for a monitoring period of 3 months. Analysis and comparison were carried out of dose equivalents to the interventional radiology workers in terms of different sexes, positions and departments, together with associated influencing factors during the three years.Results:The difference in equivalent dose between the three years is statistically significant ( χ2=29.15, P<0.05), and a downward trend in the average annual equivalent dose was found from 2018 to 2020. The number of interventional radiology workers who received doses to the lens of the eye mainly between MDL and 5.0 mSv accounted for 69.08%. The difference in the average annual equivalent dose in different positions and departments was statistically significant ( H=18.44, 22.55, P<0.05). The average annual equivalent dose to doctor was higher than for nurses and technicians ( Z=-3.36, -3.02, P<0.05). The average annual equivalent dose in cardiovascular medicine department was higher than in other departments, with statistically significant difference ( Z=-2.58, -3.76, -3.40, P<0.05). Logistics regression analysis showed that radiation working hours, positions, routine personal doses, workload and exposure time are the factors that affect the average annual equivalent dose. Conclusions:The annual equivalent dose to the lens of the eye of interventional radiology workers in shaanxi province meets the relevant national standards. However, the annual dose to some radiological workers has a normal high value. Therefore, it is necessary to strengthen the continued monitoring of the dose to the lens of the eye of the interventional radiology workers, and adjust the types of work for the workers based on radiation work hours, position, routine personal dose, workload and exposure time, so as to effectively reduce the dose level of the eye lens.

The challenges of precision radiotherapy technology to the traditional theory of radiobiology / 中华放射医学与防护杂志

With the development of modern computing technology and medical physics,radiotherapy has made great progress.The theoretical basis of radiobiology seems to lag behind the clinical application of radiotherapy,which hampers the further improvement of treatment efficacy and the optimization of treatment modality.In this paper,some emerging challenges of precision radiotherapy technology to the traditional theory of radiobiology,such as radiosensitivity,dose-response curve and survival curve,linear-quadratic model,4Rs theory,as well as the interaction between cancer and microenvironment,radiation-induced second primary cancers (RISPC),will be discussed.The interplay between precision radiotherapy and traditional radiobiology theories will be addressed with the aim to potentially solve some of the challenging problems.

An analysis of influence of drinking plenty of water at different time in differentiated thyroid carcinoma patients after 131I treatment on the equivalent dose rate / 中华护理杂志

Objective To explore the optimal time for starting to drink plenty of water after 131I treatment in differentiated thyroid carcinoma(DTC) patients.Methods Totally 83 cases of DTC patients were randomly divided into three groups,and started to drink plenty of water at 12 h(group A),24 h(group B),and 36 h(group C) after treatment with 131I therapy.We measured and compared equivalent dose rate using the Inspector Alert gamma ray monitor at 1 meter in front of the patient's abdomen and neck at 6 h,12 h,24 h,36 h,48 h,72 h after taking 131I.We compared the discharge rate at different time and evaluated the curative effect.Results Equivalent dose rate of the abdomen at 24 h and 36 h after treatment and the discharge rate at 36 h and 48 h after treatment among three groups showed significant differences(P＜0.05).There were no statistically significant differences in the curative effect(P＞0.05).Conclusion Starting to drink plenty of water at 12 h after taking 131I can accelerate the decreasing of equivalent dose rate with no influence on the curative effect and improve the discharge rate at early.

Research progress on linear quadratic and biological equivalent dose models for high-dose-per- fraction radiotherapy / 中华放射肿瘤学杂志

The linear quadratic (LQ) model and deduced biological equivalent dose (BED) model are widely applied in the radiobiological studies and the mathematic models of radiation oncology in clinical practice. However, the LQ model cannot accurately fit the experimental and clinical data in the high-dose region under the high-dose-per-fraction treatment mode. To resolve this issue, researchers have made modifications to the LQ models since 2008. In the paper, first, the theoretical basis and the application scope of LQ and BED models were introduced and the debate on whether LQ model is applicable to the high-dose-per-fraction radiotherapy was reviewed. Second, five modified models were introduced in two categories and their characteristics were summarized. Finally, current research situation and existing problems of radiotherapy using biological equivalent dose (BED) models were briefly summarized and the development trend of models was predicted.

Effect of oxycodone on hemodynamics and stress response in general anesthesia induction / 实用医学杂志

Objective To investigate the effect of oxycodone and sufentanil with equivalent dose on hemo-dynamics and stress response in general anesthesia induction. Methods One hundred and twenty ASA I orⅡpa-tients with abdominal surgery were randomly divided into oxycodone group(group O,n=60)and sufentanil group (group S,n = 60). Anesthesia was induced with iv oxycodone 0.20 mg/kg(group O)or sufentanil 0.25 μg/kg (group S)respectively,together with iv propofol 2.0 ~ 2.5 mg/kg and cisatracurium 0.2 mg/kg. The patients were tracheally intubated using a single-lumen endotracheal tube. Mean arterial pressure(MAP),heart rate(HR),plas-ma levels of epinephrine(E)and norepinephrine(NE),cortisol(Cor)and blood sugar(Glu)and the occurrence of bucking before anesthesia induction(T0),immediately before intubation(T1),at the moment of intubation(T2), 1 min(T3)and 5 min(T4)after intubation were observed. Results Compared with these at T0,MAP and HR in 2 groups were lower at T1(P0.05). MAP and HR were significantly higher at T2 and T3(P 0.05). Plasma levels of E ,NE,Cor and Glu increased obviously at T2 and T3 in 2 groups(P 0.05). Conclusion Compared with sufentanil ,oxycodone of equivalent dose used for general anesthesia induction can effectively keep smooth on hemodynamics and decrease stress response.

Comparison of whole-body equivalent doses from volumetric modulated arc therapy and static intensity-modulated radiotherapy for cervical cancer / 中华放射肿瘤学杂志

Objective To compare the whole-body equivalent doses from volumetric modulated arc therapy (VMAT) and static intensity-modulated radiotherapy (IMRT) for patients with cervical cancer.Methods Nine patients with cervical cancer admitted to our hospital in 2014 were included in this study.Both VMAT and IMRT were planned for each patient.Each patient's personal dose equivalent (Hp (10)) was measured using thermoluminescent dosimeters placed at the xiphoid process and glabella during IMRT and VMAT.The whole-body equivalent doses were estimated based on the results measured at the xiphoid process and compared between the VMAT and IMRT techniques.The paired t test was used for difference analysis.Results The Hp (10) values measured at the xiphoid process and glabella of every patient were lower for VMAT than for IMRT.At a prescribed dose of 50 Gy,if the mean Hp (10) values measured at the xiphoid process were considered to represent the whole-body equivalent doses,the whole-body equivalent doses for VMAT and IMRT were 364 mSv and 538 mSv,respectively.Conclusions VMAT results in a lower whole-body equivalent dose to patients compared with IMRT.The decreased whole-body equivalent dose delivered by VMAT may reduce the likelihood of a radiation-induced secondary malignancy.

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.

Application of stereotactic body radiation therapy in early stage non-small-cell lung cancer / 肿瘤研究与临床

Stereotactic body radiation therapy (SBRT) has been increasingly used in the treatment of early-stage non-small-cell lung cancer (NSCLC).Different from conventional radiotherapy,SBRT is characterized by the delivery of high-dose radiation in 1 to 5 fractions with a high degree of precision and steep dose gradients that minimize the dose to normal tissues,and image guidance technology,image fusion technology and respiratory gating system make the therapy more accurate.SBRT delivers higher biological equralent dose (BED) than conventional radiotherapy.The latest small sample data have suggested outcomes for SBRT patients that superior to the success rate of surgery,and the evidence for SBRT over conventional radiotherapy has resulted in a major change in the standard of care for inoperable NSCLC patients.

Dosimetry in dentistry.

Aim: The purpose of this paper was to review various dosimeters used in dentistry and the cumulative results of various studies done with various dosimeters. Materials and Methods: Several relevant PubMed indexed articles from 1999 to 2013 were electronically searched by typing “dosimeters”, “dosimeters in dentistry”, “properties of dosimeters”, “thermoluminescent and optically stimulated dosimeters”, “recent advancements in dosimetry in dentistry.” The searches were limited to articles in English to prepare a concise review on dental dosimetry. Titles and abstracts were screened, and articles that fulfilled the criteria of use of dosimeters in dental applications were selected for a full‑text reading. Article was divided into four groups: (1) Biological effects of radiation, (2) properties of dosimeters, (3) types of dosimeters and (4) results of various studies using different dosimeters. Conclusion: The present review on dosimetry based on various studies done with dosimeters revealed that, with the advent of radiographic technique the effective dose delivered is low. Therefore, selection of radiological technique plays an important role in dental dose delivery.

Study on the Relationship between the Perioperative Application of Antibiotics in Caesarean Operation and Neonatal Hyperbilirubinemia / 中国药房

OBJECTIVE:To investigate the relationship between the perioperative application of antibiotics in caesarean opera-tion and neonatal hyperbilirubinemia,and to provide reference for reducing the incidence of neonatal hyperbilirubinemia. METH-ODS:264 cases of cesarean section women were randomly divided into control group and observation group,with 132 cases in each group. Control group was given antibiotics after operation,and observation group was given prophylactic application of antibi-otics before operation,and equivalent dose of intravenous injection after operation. Postoperative maximum and average tempera-ture,white blood cell(WBC),neutrophils(NEUT),complications and economic index were compared between 2 groups after op-eration. RESULTS:There was no statistically significant difference in postoperative maximum and average temperature,WBC count,NEUT proportion,wound infection and fever rate between 2 groups (P>0.05). The costs of medication,drug dosage per capita,hospital stay and the incidence of neonatal hyperbilirubinemia in observation group were significantly lower than in control group,with statistical significance (P<0.05). CONCLUSIONS:The perioperative standard use of antibiotics in caesarean opera-tion could effectively reduce the incidence of postoperative neonatal hyperbilirubinemia and hospitalization cost,and cut down treat-ment time. It also has a high economic value and worthy of promotion.

A study of influencing factors and predictors for radiation encephalic necrosis after CyberKnife radiotherapy / 中华放射肿瘤学杂志

Objective To investigate the influencing factors and predictors for radiation encephalic necrosis after CyberKnife radiotherapy.Methods Ninety-four patients (104 targets) with primary or metastatic intracranial tumors who were treated with CyberKnife radiotherapy from 2006 to 2011 were retrospectively analyzed.All surgeries adopted skull tracking modes with a dose of 12-45 Gy in 1-8 fractions prescribed to 60％-87％ isodose line.Radiation encephalic necrosis was determined by imaging or pathological examination.Logistic regression analysis was used to analyze the relationship between radiation encephalic necrosis and factors including diabetes,cardio-cerebrovascular diseases,target volume,isodose line,prescribed dose,number of fractions,combination with whole-brain irradiation (WBI),and biologically equivalent dose (BED).Predictability and critical threshold of all influencing factors for radiation encephalic necrosis were determined by the receiver operating characteristic (ROC) curve.Results Twelve targets (11.54％) had radiation encephalic necrosis.According to the result of logistic regression analysis,BED,combination with WBI,and number of fractions were influencing factors for radiation encephalic necrosis.In the ROC curves,the areas under curves for the above three factors were 0.892 ± 0.034,0.650± 0.072,and 0.712 ± 0.064,respectively,indicating that only BED can well predict radiation encephalic necrosis after CyberKnife radiotherapy with a dose threshold of ＞ 7410 cGy.Conclusions BED,combination with WBI,and number of fractions are influencing factors for radiation encephalic necrosis.BED is the best predictor of radiation encephalic necrosis with a dose threshold of ＞ 7 410 cGy.

The investigation on radiation level and radiation protection in nuclear medicine diagnosis workplace / 中华放射医学与防护杂志

Objective To investigate the current situation of radiation protection in nuclear medicine diagnosis workplace.Methods The study was performed in 3 hospitals in northeast,north and central of China from February to December in 2013.The γ dose rate instrument was used to detect the workplace ambient dose equivalent rate of medicine preparation,leaching,packing,injection and imaging.Individual effective dose and equivalent dose were evaluated by photoluminescent dosimeter.Results The ambient dose equivalent rate was up to 1.92 mSv/h at repacking place and 1.2 mSv/h at injection place.The ambient dose equivalent rate of patients after injection was 5.36-240 μ,Sv/h.The hand equivalent dose was 0.01-0.02 mGy.Moreover,there were problems of staff route intersection,as well as the patients after injection staying in the public area.Conclusions Radiation workers should pay more attention to individual protection,and improve the operation proficiency to shorten the operation time.Furthermore,in order to protect public from unnecessary irradiation,there should be some changes in staff route and patients administration.

Radiation Dose Assessment on Gonad and Thyroid during PET-CT Procedures / Jurnal Sains Kesihatan Malaysia

Thyroid and gonads are radiosensitive organs which requires radiation shield to reduce the dose received. However, radiation shielding is not widely used in radionuclide imaging because it is heavy, uncomfortable and can cause pain in the spine. Therefore, a research was carried out to determine the ability of thyroid and gonad radiation shield which is thinner and lighter in reducing radiation dose. A study was conducted in Hospital Putrajaya to determine the radiation dose received by the thyroid and gonads during a complete Positron Emission Tomography-Computed Tomography (PET-CT) procedure with and without radiation shield. A total of six male staffs have been chosen as subject and data from 33 complete PET-CT procedures have been collected. For every PET-CT procedure, the subject’s thyroid and gonad were shielded using 0.5-mm thick radiation shielded, model Mavig 615 (USA) and Shielding International (USA) respectively. Thermal luminescent dosimeter (TLD) chips were used as radiation dose detector. The average 18FFDG radioactivity administered to the patient was 387 MBq and the average scan time is 9.224 ± 1.797 minutes. The results showed that the mean equivalent dose received by the thyroid with and without shielding were 0.080 ± 0.033 mSv and 0.078 ± 0.039 mSv respectively. The mean equivalent dose received by gonad with and without shielding were 0.059 ± 0.040 mSv and 0.061 ± 0.030 mSv respectively. Radiation shield with 0.5 mm thickness is unable to reduce radiation dose received by the thyroid (p = 0.76) and gonads (p = 0.79) because it is too thin to resist the high-energy radiation during PET-CT procedures. Thyroid receive higher radiation dose of 0.016 m Sv compared to the gonads (p < 0.05) because the thyroid’s position is more exposed to radiation sources which are 18F-FDG during radiopharmaceutical preparation and patients after administered with 18F-FDG during PET-CT procedure.

Radiation Exposure to the Orthopaedic Surgeon during Fracture Surgery / 대한정형외과학회잡지

PURPOSE: To assess the risk of radiation exposure by measuring the equivalent dose during fracture surgery. MATERIALS AND METHODS: Two orthopedic trauma surgeons were enrolled in this study from April to June 2009. The equivalent dose was measured using thermoluminiscent dosimeters placed at the left (in and out of the lead apron). RESULTS: The equivalent dose measured from the apron over the 3 month period were 5.22 mSv, 4.34 mSv(outside), and 1.83 mSv and 0.71 mSv(inside). The rate of radiation reduction was 64.9% and 83.6% respectively. CONCLUSION: The estimated annual equivalent dose outside the apron was close to or higher than the maximum limit of radiation exposure. These findings highlight the need for surgeons to be more cautious about radiation exposure during fracture management and take active steps to minimize radiation exposure, such as wearing a radio-protective apron.

Comparison of equivalent dose between intensity modulated radiotherapy and conventional radiother-apy for patients with nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To estimate and compare the equivalent dose between the intensity modula-ted radiotherapy (IMRT) and conventional radiotherapy (CR) for patients with nasopharyngeal carcinoma (NPC). Methods The peripheral equivalent dose of NPC patients was measured by TLD during IMRT and CR. The whole-body equivalent dose was calculated. Results When prescribed tumor dose of 70 Gy was given, the mean number of accelerator output units were 25235 MU and 8575 MU, and the whole-body e-quivalent dose were 73.65 mSy and 15.28 mSy for IMRT and CR, respectively. Conclusion The equiva-lent dose in IMRT is 4.8 times higher than that in CR for patients with nasopharyngeal carcinoma.

A Dose Volume Histogram Analyzer Program for External Beam Radiotherapy / 대한방사선종양학회지

PURPOSE: To provide a simple research tool that may be used to analyze a dose volume histogram from different radiation therapy planning systems for NTCP (Normal Tissue Complication Probability), OED (Organ Equivalent Dose) and so on. MATERIALS AND METHODS: A high-level computing language was chosen to implement Niemierko's EUD, Lyman-Kutcher-Burman model's NTCP, and OED. The requirements for treatment planning analysis were defined and the procedure, using a developed GUI based program, was described with figures. The calculated data, including volume at a dose, dose at a volume, EUD, and NTCP were evaluated by a commercial radiation therapy planning system, Pinnacle (Philips, Madison, WI, USA) for comparison. RESULTS: The volume at a special dose and a dose absorbed in a volume on a dose volume histogram were successfully extracted using DVH data of several radiation planning systems. EUD, NTCP and OED were successfully calculated using DVH data and some required parameters in the literature. CONCLUSION: A simple DVH analyzer program was developed and has proven to be a useful research tool for radiation therapy.