Efficacy analysis of blinatumomab in treatment of relapsed/refractory B-cell acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective:To explore the efficacy and safety of blinatumomab in treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL).Methods:The data of 8 patients with relapsed/refractory B-ALL treated with blinatumomab in Shanghai Zhaxin Traditional Chinese and Western Medicine Hospital from September 2020 to December 2021 were retrospectively analyzed, and their clinical characteristics, overall survival, lymphocyte subsets, cytokines, tandem transplantation and adverse reactions were analyzed.Results:The median follow-up time of 8 patients was 143 d (range: 41-534 d). Five of the 8 patients were alive; among them, 4 of 6 patients assessed to be in minimal residual disease (MRD)-negative complete remission (CR) and 1 of 2 patients assessed to be in non-remission at the time of belintuzumab discontinuation were alive. The median duration of treatment with belintuzumab was 28 d (10-56 d), and it was 23 d (10-56 d) for patients with MRD-positive at baseline and 28 d (25-31 d) for the 4 non-remission patients. Six patients achieved MRD-negative CR after treatment, of which 4 were assessed as MRD-positive at baseline and 2 were assessed as non-remission at baseline. All 4 patients with MRD-positive CR achieved MRD-negative CR after treatment with belintuzumab, including 1 patient with Philadelphia chromosome-positive (Ph +) ALL bridged to autologous hematopoietic stem cell transplantation, and 1 patient with Ph + ALL and 1 patient with Ph - ALL received sequential allogeneic hematopoietic stem cell transplantation and had persistent MRD-negative CR. Two of the 4 non-remission patients achieved MRD-negative CR after treatment with belintuzumab, including 1 patient with Ph + ALL bridged to autologous hematopoietic stem cell transplantation, and 1 patient with Ph - ALL received sequential allogeneic hematopoietic stem cell transplantation, and the 2 patients had persistent MRD-negative CR. Leukocyte counts and neutrophils decreased in both MRD-positive CR and non-remission patients after receiving belintumomab. The proportion and absolute number of CD3 + T and CD3 + CD8 + T lymphocytes in patients with MRD-positive CR were higher than those in patients without remission, and both decreased after drug administration. Median interleukin-6 (46.23, 1.42 pg/ml), interleukin-8 (17.85, 2.10 pg/ml), interleukin-10 (7.43, 1.49 pg/ml) and interferon-γ (11.82, 0.39 pg/ml) levels were elevated in MRD-positive CR and non-remission patients at week 3 of treatment. Grade 1 cytokine release syndrome occurred in 1 case with clinical manifestations of fever, which improved after drug suspension. Three cases developed infections, 2 of which were pulmonary and 1 of which was upper respiratory tract infection. No immune effector cell-associated neurotoxic syndrome was observed. Conclusions:Belintumomab is effective for MRD clearance in relapsed/refractory B-ALL with manageable adverse reactions, providing an effective therapeutic option for bridging hematopoietic stem cell transplantation to prolong the survival of patients.

Genealogical Clustering and Coordination Analysis of Knowledge-Driven Labor Competitiveness in the Context of Sharing Economy.

In recent years, with the continuous development of information technology and the advent of the Internet + era, the sharing economy has not only changed people's life and consumption patterns but also reconstructed the value cocreation process between enterprises and customers. Unlike the traditional economic model in which the enterprise is the dominant player, in the sharing economy, the enterprise withdraws from the dominant position in the value creation process and becomes a platform to support and serve the value creation of users (customers in the traditional economic model), and users become the dominant player in value creation. Users are not only the core subject of value cocreation in the sharing economy model but also the key factor determining the profitability of enterprises and the image of the platform. Bilateral users create rich value for individual users, platform enterprises, and society through value creation behaviors such as trading of the right to use idle resources and online and offline communication and interaction. Therefore, it is necessary to study the value cocreation behaviors of bilateral users of shared service platforms. This paper studies the value cocreation of bilateral users of shared service platforms, hoping to help platform enterprises further understand user behavior and needs, better fulfill the role of support and service in the process of value cocreation, provide a good value cocreation environment for bilateral users, enhance the reputation and influence of platform enterprises through user value cocreation behaviors, expand market share, and form competitive advantages. This paper stands in the perspective of intellectual enterprises and studies the problem of knowledge sharing. From the perspective of individuals, it mainly analyzes the willingness and ability of individual knowledge sharing, focusing on the "prisoner's dilemma" in game theory to study the willingness of individuals to share. From the perspective of knowledge, we mainly analyze the interference brought by the implicit and exclusive nature of knowledge to knowledge sharing, focusing on the implicit nature of knowledge. In addition, this paper only studies the influence of value cocreation of consumer users on value cocreation of resource users and does not deeply explore whether the value cocreation of resource users influences the value cocreation of consumer users.

Output dose investigation and analysis of external beam radiotherapy in Beijing / 中国辐射卫生

Objective@#To study the output dose of external beam radiotherapy in Beijing and analyze the cause of output dose  deviation.  Guidance  is  given  on  the  selection  of  measurement  methods,  calculation  formulas  and  parameters.@*Methods@#During 2020, the output doses of medical electron accelerators, tomotherapy, cyberknife, and γ-knife were meas- ured based on the water absorbed dose calibration factor combined with the requirements in the IAEA TRS398 and TRS483 reports, and low-energy X-rays were measured based on the air kerma calibration factor combined with the requirements in the AAPM protocal. The output dose was measured and compared with the preset irradiation value.@*Results　@#A total of 59 external beam radiation therapy equipments’s output dose were investigated.2 of the 49 accelerators’s absolute value of relative deviation between the system indication value and the measurement exceeded 3%; the deviation of other external beam radiotherapy equipments was less than 3%.@*Conclusion　@#A unified method and multi-party quality control can ensure the accuracy of the output dose. In the routine operation of the equipment, the hospital should strictly implement periodic inspections to ensure accurate and reliable radiotherapy.

Monitoring and analysis of activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020 / 中华放射医学与防护杂志

Objective:To monitor and analyze the activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020. Methods:Totally 1 074 atmospheric aerosol samples were collected by high flow air sampler (SnowWhite) including 275 in spring, 266 in summer, 262 in autumn and 271 in winter and subjected to analysis by low background high-purity germanium gamma-ray spectrometery (ORTEC) to determine the activity concentrations of 7Be and 210Pb. Results:The activity concentrations of 7Be in atmospheric aerosol were from 0.56 to 14.84 mBq/m 3, with an avearage of 6.84 mBq/m 3, and from 0.01 to 9.37 mBq/m 3 for 210Pb, with an avearage 3.19 mBq/m 3. The differences in activity concentrations of 7Be and 210Pb in atmospheric aerosol among differernt seasons were statistically significant ( F=32.66, 93.93, P<0.05). Activity concentration of 7Be was highest in spring, followed by autumn, and lowest in summer and winter. Activity concentration of 210Pb ranged from winter, autumn, spring to summer in descending order. Conclusions:The activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020 fluctated within the range of normal level.

Monitoring and analysis of radioactivity in soils in Beijing during 2017-2018 / 中华放射医学与防护杂志

Objective:To investigate radionuclide content in soil at 19 spots in Beijing, in order to provide scientific basis for the accurate evaluation of the levels of radioactive contamination.Methods:GEM-MX7080P4 HPGe γ spectrometer was used to analyse the activity concentrations of radionuclide 226Ra, 232Th, 40K and 137Cs in all 38 soil samples from 16 districts of Beijing from 2017 to 2018. Results:The mean activity concentration of 226Ra, 232Th and 40K were 23.9 and 24.1 Bq/kg, 31.2 and 31.7 Bq/kg, 600 and 578 Bq/kg respectively for the two consecutive years. The mean activity concentration of 137Cs in the two years was 1.21 Bq/kg, with the highest values of 5.48 and 6.18 Bq/kg, about 4.5 times and 5.1 times the average values in those years. Conclusions:All the result are within the range of the values from previous Beijing municipal and countrywide survey of environmental background, with 137Cs in soil arising almost from the previous nuclear activities or nuclear incidents.

Forensic Analysis on 52 Medical Malpractice Cases of Cardiac Death / 法医学杂志

OBJECTIVES@#To synthetically analyse the medical malpractice cases of cardiac death in forensic identification, and to explore the generality and characteristic of cause of death, medical malpractice and assessment of participation degree.@*METHODS@#Totally 52 medical malpractice cases of cardiac death examined in the Xiaoshan Branch Office, Hangzhou Minghao Forensic Judical Appraisal Institute, from January 2015 to April 2018 were collected. The general information of cases, medical institutions and situations of hospital stay, cause of death, medical malpractice and assessment of participation degree were retrospectively analysed.@*RESULTS@#In 52 cases, the male to female ratio was 2.25:1, and most subjects aged >50-60. Cardiac death caused by hypertensive heart disease or coronary heart disease was most common （67.3%）, followed by viral myocarditis and cardiomyopathy （13.5%）. There were 24 cases involved surgery, and the survival time after surgery was from 1 h to 118 d with a 7 d medium value. There were 63 medical institutes involved in these medical malpractices. Medical malpractice presented in most hospitals more or less, and the participation degree was >20%-30%.@*CONCLUSIONS@#Forensic appraisal contributes to determine causes of death, which not only provides scientific evidence for medical malpractice identification, but also improves diagnosis and treatment levels of medical institutions.

Analysis of performance test results of 141 CT scaners in Beijing / 中华放射医学与防护杂志

Objective To analyze the performance differences of CT scanners with different detector rows between different manufacturers,and to provide the basis for the rational allocation and use of these CT scanners.Methods According to the result from the sentinel surveillance in 2014,a total of 148 medical institutions were equipped with CT scanners in 16 districts of Beijing,including general hospital(53),cancer hospital(5),TCM hospitals(25),children′s hospitals(2),community hospitals(30)and other specialized medical institutions(33).According to the principle of simple random sampling,40 medical institutions are selected,including 14 general hospitals,1 cancer hospital,7 Chinese medicine hospitals,1 children′s hospital,8 community hospitals and 9 other specialized medical institutions.A total of 141 CT scanners are selected from all CT sets of the selected medical institutions from 2012 to 2014.According to GB 17589-2011 X-ray computed tomography device quality assurance testing status test,four parameters related closely to image quality were tested,including CT value(water),noise,high contrast resolution,and low contrast detectability.Results No significant differences were found in CT value(water),noise and low contrast detectability among CT scanners produced by different manufacturers(P＞0.05),whereas high contrast resolution was found to have a remarkable difference(χ2＝34.706,P＜0.05).Significant differences were found in noise,high contrast resolution and low resolution detectability between the CT scanners with ＜64 detector rows and ≥64 detector rows(χ2＝6.978,10.040,15.973,P＜0.05).However,there is no difference in CT value(water)(P＞0.05).For less-than-64 detector row CT scanners,no significant difference was found in CT value(water),noise and low contrast detectability among different manufacturers(P＞0.05).only high contrast resolution differed remarkably(χ2＝9.941,P＜0.05).For more-than-or equal-to-64 detector row CT scanners,CT value(water)and noise have no differences among different manufacturers(P ＞0.05),whereas,there were significant difference in high contrast resolution and low contrast detectability(χ2＝31.376,32.967,P＜0.05).Conclusions There were a few differences in the performance testing of CT scanners from different manufacturers,and the less-than-64 detector row CT scanners have advantages in noise and low contrast detectability compared with the more-than-64 detector row CT scanners,whereas the latter have advantages in high contrast resolution and scanning time,allowing its wider application in medical institutions with more special diseases.

Clinical value of preoperative serum CA125 in the diagnosis and therapy of gallbladder carcinoma / 复旦学报（医学版）

Objective To analyze the clinical value of preoperative serum tumor marker CA125 in the diagnosis and treatment of gallbladder carcinoma.Methods The data of serum tumor marker CA125 from 58 gallbladder carcinoma patients,74 healthy people,25 acute cholecystitis patients and 14 gallbladder adenoma patients who received treatment in Huadong hospital,Fudan University from Jul.,2003 to Jan.,2016.Results When gallbladder carcinoma patients did not suffer from lymph metastases,the positive rate of serum CA125 was only 2.86％ (1/35),and the positive rate for patients suffering from lymph metastases was 91.30％ (21/23).The positive level of preoperative serum CA155 was related with lymphatic metastatic lesions (x2 =46.12,P =0.00),and it had considerable accuracy to predict lymphatic metastatic lesions (AUC =0.96).The difference of serum CA125 level between patients with hilar (n =12) or distant (n =11) lymph metastases was not statistically significant.Preoperative serum CA125 level was the independent factors of patient's prognosis.The survival time and rate of patients with the negative result were better than those with the positive result,and the difference was statistically significant (P＜0.05).Conclusions Preoperative serum CA125 corrrelates with the lymph node metastasis of gallbladder carcinoma patients,and the long-term survival rate of negative patients is better than the positive one.

Effects and mechanisms of receptor-interacting serine-threonine kinase 3 in the formation of cholestatic hepatic injury / 中华消化外科杂志

Objective To investigate the effects and mechanisms of receptor-interacting serine-threonine kinase 3 (RIP3) in the formation of cholestatic hepatic injury.Methods The experimental study was conducted.(1) Processing and viability of hepatic stellate cell line HSC-T6:HSC-T6 cells were transfected by RIP3-siRNA and NC-siRNA,respectively.The viabilities of un-transfected,RIP3-siRNA-transfected and NC-siRNA-transfected HSC-T6 cells were respectively measured by cell-counting kit-8 (CCK-8).HSC-T6 cells were treated by 100 μmol/L Glycochenodeoxycholic acid (GCDCA) at 0,2,4,8 and 12 hours,and then were extracted and stored,12-hour cell viability was measured by CCK-8.RIP3 that was treated by 100 μmol/L GCDCA knocked down HSC-T6 cells to establishment RIP3 knockdown HSC-T6 cells (RIP3-KD cells).RIP3-KD cells were cultured for 12 hours,and cell viability was measured.(2) Mice model of bile duct ligation (BDL):40 adult mice were randomly divided into 8 groups,5 mice in each group.Sham group:bravery manager was only separated,without ligation,and bloods of inferior vena cava and liver tissues were extracted at 7 days postoperatively.The BDL-1,-3,-5,-7,-14,-21 and-28 d groups:bloods of inferior vena cava and liver tissues were extracted at 1,3,5,7,14,21 and 28 days postoperatively,respectively.(3) The relative expressions of RIP3,α-SMA and TNF-αmRNA in the cells and liver tissues were detected by quantitative real-time polymerase chain reaction (RT-PCR).(4) The relative expressions of RIP3,α-SMA and TNF-α proteins were detected by Western blot.Measurement data with normal distribution were represented as-x±s.The ANOVA was used for data analysis in different time gradient.Comparisons among groups were analyzed using the ANOVA.Pairwise comparison was done by the t test.Results (1) The HSC-T6 cells viability and expressions of RIP3,α-SMA,TNF-α mRNA and proteins:results of CCK8 test showed that 12-hour viabilities of GCDCA-treated HSC-T6 cells,GCDCA-treated RIP3-KD cells,HSC-T6 cells and RIP3-KD cells were 61.3％ ±0.3％ and 83.2％ ±0.4％ and 98.4％ ±0.7％ and 97.4％ ±0.7％ respectively,showing statistically significant differences in the viabilities among them (F =115.200,P＜ 0.05),and showing no statistically significant difference in the viabilities between HSC-T6 cells and RIP3-KD cells (t =1.283,P＞ 0.05).There were statistically significant differences in the viabilities between HSC-T6 cells and GCDCA-treated HSC-T6 cells or GCDCA-treated RIP3-KD cells (t =17.910,6.604,P＜ 0.05) and between GCDCA-treated HSC-T6 cells and GCDCA-treated RIP3-KD cells (t=7.186,P＜0.05).Results of RT-PCR test showed relative expressions of RIP3 mRNA in un-transfected,RIP3-siRNA-transfected and NC-siRNA-transfected HSC-T6 cells were respectively 0.012 1±0.001 3,0.011 2±0.003 1 and 0.002 8±0.000 5,with a statistically significant difference (F =20.410,P ＜ 0.05).There was no statistically significant difference in relative expressions of RIP3 mRNA between un-transfected and NC-siRNA-transfected HSC-T6 cells (t =0.483,P ＞0.05).The relative expression of RIP3 mRNA in RIP3-siRNA-transfected HSC-T6 cells was significant different from that in un-transfected and NC-siRNA-transfected HSC-T6 cells (t =11.760,4.586,P＜0.05).The relative expressions of RIP3 mRNA,α-SMA mRNA and TNF-α mRNA in GCDCA-treated HSC-T6 cells at 0,2,4,8 and 12 hours were 0.012 1±0.001 3,0.011 2±0.003 1,0.021 2±0.002 2,0.027 8±0.002 1,0.029 8±0.002 3 and 0.571±0.012,0.611±0.024,0.691±0.021,0.711±0.021,0.752±0.031 and 0.873±0.022,0.912± 0.024,1.015±0.031,1.210±0.042,1.471±0.041,respectively,showing an increased trend over time and statistically significant differences (F=70.720,30.050,166.700,P＜0.05).The relative expressions of RIP3 mRNA in HSC-T6 cells and GCDCA-treated HSC-T6 cells were 0.012 1±0.001 3 and 0.029 8±0.002 3,with a statistically significant difference (t=13.970,P＜0.05).Results of Western blot showed that relative expressions of RIP3 protein in un-transfected,RIP3-siRNA-transfected and NC-siRNA-transfected HSC-T6 cells were respectively 0.054 ± 0.012,0.013 ± 0.008 and 0.052± 0.021,with a statistically significant difference (F =7.410,P＜0.05).There was no statistically significant difference in relative expressions of RIP3 protein between un-transfected and NC-siRNA-transfected HSC-T6 cells (t =0.143,P ＞ 0.05),and statistically significant differences were found in relative expressions of RIP3 protein between RIP3-siRNA-transfected HSC-T6 cells and un-transfected or NC-siRNA-transfected HSC-T6 cells (t =4.924,3.006,P＜0.05).The relative expressions of RIP3,α-SMA and TNF-oα proteins in GCDCA-treated HSC-T6 cells at 0,2,4,8 and 12 hours were 0.045±0.024,0.047±0.034,0.062±0.025,0.121±0.015,0.154±0.034 and 0.064±0.031,0.072±0.017,0.097±0.035,0.078±0.031,0.254±0.051 and 0.078±0.025,0.094±0.037,0.129±0.041,0.198±0.011,0.324±0.061,respectively,showing an increased trend over time and statistically significant differences (F =9.658,15.810,20.090,P＜0.05).The relative expressions of RIP3 protein in HSC-T6 cells and GCDCA-treated HSC-T6 cells at 12 hours were 0.045±0.024 and 0.154±0.034,with a statistically significant difference (t =4.536,P＜0.05).(2) Expressions of RIP3,α-SMA and TNF-α mRNA in hepatic tissues of mice in each group:the results of RT-PCR showed that relative expressions of RIP3 mRNA,α-SMA mRNA and TNF-α mRNA in the Sham,BDL-1 d,BDL-3 d,BDL-5 d,BDL-7 d,BDL-14 d,BDL-21 d,BDL-28 d groups were 0.047 3±0.003 1,0.041 2±0.007 8-0.339 7±0.017 1 and 2.948±0.612,2.654± 1.032-8.387±0.910 and 0.563±0.078,0.610±0.113-1.078± 0.289,respectively,with statistically significant differences (F =25.180,27.820,7.425,P＜0.05).The results of western blot showed that relative expressions of RIP3,α-SMA and TNF-α proteins in Sham,BDL-1 d,BDL-3 d,BDL-5 d,BDL-7 d,BDL-14 d,BDL-21 d,BDL-28 d groups were 0.245±0.011,0.228±0.023-1.018±0.052 and 0.424±0.057,0.392±0.041-0.985±0.081 and 0.551 ±0.052,0.588±0.087-0.962±0.074,respectively,with statistically significant differences (F=19.160,94.410,22.750,P＜0.05).Conclusion Cholestasis promotes hepatic injury and fibrosis by inducing TNF-α pathway activation and upregulation RIP3.

Low molecular weight guluronate prevents TNF-α-induced oxidative damage and mitochondrial dysfunction in C2C12 skeletal muscle cells.

Muscle wasting is associated with a variety of chronic or inflammatory disorders. Evidence suggests that inflammatory cytokines play a vital role in muscle inflammatory pathology and this may result in oxidative damage and mitochondrial dysfunction in skeletal muscle. In our study, we used microwave degradation to prepare a water-soluble low molecular weight guluronate (LMG) of 3000 Da from Fucus vesiculosus obtained from Canada, the Atlantic Ocean. We demonstrated the structural characteristics, using HPLC, FTIR and NMR of LMG and investigated its effects on oxidative damage and mitochondrial dysfunction in C2C12 skeletal muscle cells induced by tumor necrosis factor alpha (TNF-α), a cell inflammatory cytokine. The results indicated that LMG could alleviate mitochondrial reactive oxygen species (ROS) production, increase the activities of antioxidant enzymes (GSH and SOD), promote mitochondrial membrane potential (MMP) and upregulate the expression of mitochondrial respiratory chain protein in TNF-α-induced C2C12 cells. LMG supplement also increased the mitochondrial DNA copy number and mitochondrial biogenesis related genes in TNF-α-induced C2C12 cells. LMG may exert these protective effects through the nuclear factor kappa B (NF-κB) signaling pathway. These suggest that LMG is capable of protecting TNF-α-induced C2C12 cells against oxidative damage and mitochondrial dysfunction.

Investigation and analysis of patient dose levels from diagnostic radiology in Beijing / 中华放射医学与防护杂志

Objective To investigate the radiation dose levels to the adults examined from diagnostic exposure in Beijing. Methods The radiation doses to the examined individuals were measured by using individual diagnostic radiology equipments in 30 random hospitals from a total of 10 districts and suburban areas, including 1 182 samples of X-ray photography,542 samples of mammography and 410 samples of CT examination. Results 2 134 samples were measured in this study. The dose ranges of X-ray photography, CR, and DR were 0?4 -24?1, 0?3 -13?9 and 0?1 -15?9 mGy, respectively. The average dose range of glandular breast was 0?3-5?4 mGy. In 410 CT samples the value of CTDIw , CTDIvol and DLP were 28?1 - 96?3 mGy, 7?0 - 23?4 mGy, and 162?2 - 898?1 mGy·cm, respectively. Conclusions Several dose levels from diagnostic examination were higher than guidance level for medical exposure in GB 18871-2002,which should be noted.

Radioxenon monitoring in Beijing following the Fukushima Daiichi NPP accident.

This paper reports the brief process and results of radioxenon monitoring and analysis in Beijing following the Fukushima Daiichi nuclear power plant accident. The accident and release of volatile radionuclides were caused by 9.0 magnitude earthquake and tsunami on March 11, 2011. The maximum concentrations of (133)Xe and (131 m)Xe were in excess of 0.90 Bq.m(-3) and 0.047 Bq.m(-3), respectively. The activity ratio of (131 m)Xe to (133)Xe and the dynamic trend of (133)Xe activity concentration were analyzed.

A study on monitoring and assessment of leakage and scattering radiation in a helical tomotherapy room / 中华放射医学与防护杂志

Objective To study the radiation dose level and dose distribution of leakage and scattering radiation in a helical tomotherapy (TOMO) room,and to identify the dose distribution characteristic which is different from the conventional radiotherapy so as to provide scientific data for the radiation protection of TOMO.Methods A helical tomotherapy facility typed Tomotherapy Hi-Art was employed as the radiotherapy device.The air kerma from leakage radiation and scattering radiation distributed on the couch plane and in TOMO room were detected mainly by GR-200A TLDs of LiF(Mg,Cu,P),while 100 Gy were being accumulated under the condition of simulation radiation treatment.Then,the leakage radiation ratio and scattering-leakage radiation ratio (the ratio of site radiation dose to isocenter standard output dose) were calculated.Results The radiation level and dose distribution of leakage radiation and scattering radiation in the TOMO treatment room were in bilateral symmetry to the rotation isocenter and the treatment couch longitudinal axis,and the radiation level in front of the radiotherapy device was significantly higher than that of the rear of the TOMO equipment.In the plane of treatment couch,the maximum leakage radiation ratio at the position 100 cm away from the isocenter was only 1.3 × 10-4,and the mean value of the leakage radiation ratio at the position 300 cm away from the isocenter was lower than 2.0 × 10-5.The scattering radiation at 200-300 cm away from the isocenter was accounted for 25％-30％ of the leakage radiation from the responding sites,and the indoor scattering radiation decreased faster than leakage radiation with the distance from the isocenter.Conclusions The radiation level of leakage and scattering in a TOMO room is significantly lower than that in a conventional radiotherapy room.

[Analysis of 12 death cases of medical tangles after trauma].

OBJECTIVE: To explore the main problems and ideas in the death cases of medical tangles after trauma. METHODS: Twelve death cases of medical tangles after trauma were selected from a forensic science institute during recent six years. Traumatic conditions, medical malpractices and contribute degree of malpractice were estimated and analyzed. RESULTS: The reasons of trauma included accidents and intentional injury. Among these cases, there were 10 involved in malpractice, of which 7 cases played secondary role. CONCLUSION: Diagnosis, symptom observation and emergency therapy are the important keys for determining the responsibility in death cases of medical tangles after trauma.

Analysis of 12 death cases of medical tangles after trauma / 法医学杂志

OBJECTIVE@#To explore the main problems and ideas in the death cases of medical tangles after trauma.@*METHODS@#Twelve death cases of medical tangles after trauma were selected from a forensic science institute during recent six years. Traumatic conditions, medical malpractices and contribute degree of malpractice were estimated and analyzed.@*RESULTS@#The reasons of trauma included accidents and intentional injury. Among these cases, there were 10 involved in malpractice, of which 7 cases played secondary role.@*CONCLUSION@#Diagnosis, symptom observation and emergency therapy are the important keys for determining the responsibility in death cases of medical tangles after trauma.

Monitoring and analysis of radioactive contamination in Beijing following the Japanese Fukushima nuclear accident / 中华放射医学与防护杂志

Objective To monitor the levels of radioactive contamination due to the Japanese Fukushima nuclear accident in Beijing,so as to provide scientific technical information for government to draw effective controlling strategy and processing mechanism.Methods The system of nuclear emergency nmonitoring was started,then the radioactive contamination levels of atmosphere,rain water,surface water and vegetables in Beijing were detected according to the relative survey regulations and technology criterions.Results During the period from 15 to 41 d after the accident,obvious radioactive contamination was found in the atmosphere of Beijing.The maximum radioactivity concentration of 131I ( 5.89 mBq/m3 ) was detected at 22 d after the accident.The radioactivity concentrations of 137Cs and 134Cs were surveyed forming their corresponding peaks at 20 d after the accident,but they were one magnitude lower than the peak value of 131I at least.In addition,the gross β radioactivity level in the water of Chao Bai-he river was verified to be in the range of 0.314 - 0.602 Bq/L. Conclusions The radioactive contamination due to Fukushima nuclear accident has not done visible harm to the public health in Beijing,but monitoring should be continued to observe the long-term effect of the accident.

Evaluation of radiation dose to working operator in three types of interventional fluoroscopic procedures / 中华放射医学与防护杂志

Objective To assess the level of radiation exposures of operators in three typical types of interventional fluoroscopic procedures.Methods Alderson Radiation Therapy (ART) phantom was used to stimulate the practices of diagnosis and therapy using TLDs for dose measurement.The radiation exposures of eye lens, neck, and breast were measured when the lead shielding of machine was on/off and the equivalent dose and effective dose to the eye lens were estimated.Results Radiation exposure of head was obviously reduced by 85% -90% when the lead shielding was on.The doses in different procedures were different.In cerebral angiography the dose equivalent of eye len was the highest in the three procedures.The annual effective dose for the operators was smaller in peripheral vascular interventions than that in cardiovascular interventional therapy and that in cerebral angiography.Conclusions The operators involved in intervention will receive an annual effective dose of less than 20 mSv as recommended by the ICRP under the protection conditions provided by the current study, except for eye lens.Attention should be paid to the protection of the eyes of operators.

Relation of serum estradiol and progesterone levels with abortive anticipation in pregnant women with fetal irritability and vaginal bleeding / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the serum levels of estradiol (E2) and progesterone (P) in patients with the auras of threatened abortion (ATA), i.e., fetal irritability and vaginal bleeding, and the relation with prognosis.</p><p><b>METHODS</b>Chinese medicine syndrome of 598 pregnant women with ATA consulted in authors' hospital were differentiated into 5 types, 151 patients of Shen-deficiency type; 151 of Pi-Shen deficiency type; 36 of qi-blood insufficiency type, 235 of blood-heat type, and 25 of traumatic injured type. Their serum levels of E2 and P at the 5th to 13th gestation week were monitored by competitive chemiluminescnet enzyme immunoassay. And the outcome of pregnancy, continued or defeated, was observed.</p><p><b>RESULTS</b>(1) From the 7th gestation week on, serum E2 level in women with continued pregnancy (CP) increased continuously, showed a higher value than that at the previous week (P < 0.05), and was higher than that in women with defeated pregnancy (DP) of same gestation age (P < 0.05). (2) Serum P level was not different in CP women at various gestation age (P > 0.05), but from the 7th week on, it was higher in CP women than in DP women of same gestation age (P < 0.05). (3) The comparison of serum E2 in CP versus DP of women with Shen-deficiency type or Pi-Shen deficiency type was identical to that in CP versus DP of all women enrolled.</p><p><b>CONCLUSIONS</b>Serum levels of E2 and P in women with ATA at 5th to 13th gestation weeks were obtained. The 7th week of pregnancy is the critical period of pregnancy development, a comparative high E2 levels and its sustained and steady elevation indicates the good-ending of pregnancy with fetal irritability and vaginal bleeding. The Chinese medicine syndrome presented in women with ATA is dominantly the Shen-deficiency type. The variation of serum E2 is one of the important material foundation in pregnancy with fetal irritability and vaginal bleeding of Shen-deficiency type.</p>

[Forty-five cases on re-assessing the personal disability].

OBJECTIVE: To discuss the reasons for the alterations of the conclusions in re-assessment for personal disability in road traffic accidents, work-related accidents and other accidents. METHODS: Forty five cases of re-assessing the personal disability from 2007 to 2009 in our institute were collected and analyzed. RESULTS: The disability grade of 12 cases (26.7%) was altered in re-assessment. The reasons for the alternation included assessment standard items misquoted, assessment time mischosen, injury misdiagnosed and omitted, artificial prostheses mismanaged, injury-disease relationship erroneous judgment and disability grade promoted incorrectly. CONCLUSION: The attention for assessment of disability grade should been paid to correct time for assessment, correct items of identification standard, appropriate medical and forensic technology, and correct understand about all relevant regulations.