ABSTRACT
Compared with conventional radiotherapy, FLASH radiotherapy has advantages in protecting normal tissues, while the dose rate is increased by more than 100 times. If the shielding design of the treatment room is carried out according to the existing standard, the thickness and cost of the shielding wall will be significantly increased, or even hardly to meet the requirement of the standards, resultsing in the failure of the application of FLASH radiotherapy. By investigating the domestic and foreign standards and literature, this paper analyzes the challenges brought by FLASH radiotherapy technology to the shielding design of radiotherapy treatment room in China. Dose rate control standards adopted by different countries in the shielding design are emphatically compared as well. In several countries, the average dose rate under the actual treatment conditions was considered in the shielding design. In China, the method of instantaneous dose rate taking acount of occupancy factor is adopted. However, if FLASH radiotherapy technology is applied, the requirement of instantaneous dose rate will be difficult to meet. In order to improve the high dose rate radiotherapy technology such as FLASH radiotherapy, the revision of the existing standards is advised if the authorized limits are not changed. To use the average dose rate limit within a certain period of time for control, or to raise the control standard in the case of flash radiotherapy, are also avaliable.
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Pathogen metagenomic next-generation sequencing (mNGS) testing is highly sophisticated. Its requirements for laboratory environment, equipment, and technical capabilities of personnel are very high. How to orderly develop, standardize management, and application of mNGS technology in hospitals is a scientific topic that practitioners must treat with caution. In this article, the establishment mode of the mNGS detection system in clinical laboratories, the analytical and clinical validation of the detection system, the risk management (which from biological factors, detection procedures, and the bioinformatics analysis and information transmission), as well as the requirements for pathogen databases, bioinformatics analysis talents, and diagnostic reports, have been professionally considered and discussed. It is expected to provide scientific advice for the completely implementation of mNGS testing in a clinical laboratory affiliated to a hospital, promoting the standardized application and healthy development of this technology in hospitals.
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Objective To investigate the clinical distribution and antimicrobial resistance characteristics of carbapenem-resistant Acinetobacterbaumannii (CRAB).Methods CRAB isolated from all inpatients in a hospital in January-December 2015 were performed retrospective analysis,antimicrobial susceptibility testing result was analyzed.Results A total of 721 AB strains were detected,231 (32.04%)of which were CRAB,isolation rates of CRAB in quarter 1-4 were 48.99% (73/149),41.98%(68/162),27.39%(63/230),and 15.00%(27/180) respectively,which showed a decreased trend (P<0.001).CRAB mainly came from sputum specimen(n=140, 60.61%),followed by secretion of wound(n=33,14.28%)and urine specimen(n=24,10.39%).CRAB mainly distributed in intensive care unit,accounting for 43.72%(n=101),following by department of neurosurgery(n=37,16.02%),and burn/plastic surgery (n=22,9.52%).Resistance rates of CRAB to ampicillin/sulbactam, gentamicin,levofloxacin, and ciprofloxacin were 85.28% -90.48%,resistance rate to tobramycin was low (19.48%),no strains were found to be resistant to polymyxin B.Conclusion Antimicrobial resistance of CRAB is serious,it is necessary to focus on management of key departments,take scientific prevention and control measures, so as to effectively reduce the incidence of healthcare-associated infection.
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Objective To study the distribution and molecular characteristics of Vibrio parahaemolyticus(VP) in patients with a‐cute diarrhea ,and provide a scientific basis for the prevention and control of VP infection .Methods From 2010 to 2014 ,62 VP iso‐lates were collected from patients with acute diarrhea ,for serotyping and virulence gene (tdh and tdh) detection of VP .Molecular characteristics analysis was carried out by using multi‐locus sequence typing (MLST) .Results 7 different serotypes were found from the 62 isolates .O3∶K6 was the most common serotype of VP ,accounting for 74 .19% (46 isolates) ,followed by O4∶K68 (6 isolates) .Tdh gene was the mainly virulence gene ,with a percentage of 95 .16% (59 isolates) ,only three isolates were trh positive . 7 STs were found through MLST analysis of 62 VP isolates ,among which ,ST3 was the most important type ,accounted for 85 .50%(53 isolates) .Conclusion O3∶ K6 serotype VP was the most prevalent type .Tdh gene is the most important virulence gene of WP .ST3 was the the dominant epidemic type .
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Objective To provide a scientific reference for the choice of antimicrobial drugs by analyzing the distributions and the antimicrobial resistances of Carbapenem‐resistant Acinetobacter baumannii (CR‐AB) and methicillin‐resistant Staphylococcus au‐reus (MRSA) in the Northern Jiangsu People′s Hospital .Methods All the CR‐AB and the MRSA isolated from hospitalized pa‐tients from January 2011 to March 2014 were collected and analyzed .Use the disk diffusion method for antimicrobial resistance tes‐ting .Results A total of 170 CR‐AB strains and 168 MRSA strains were isolated .CR‐AB mainly distributed in the ICU ,which ac‐counting for 61 .17% (104/170) .MRSA mainly isolated in neurosurgery ,about 27 .98% (47/168) .67 .06% of CR‐AB strains and 54 .17% of MRSA strains were from Sputum specimens .The antimicrobial resistance rate of CR‐AB to most antimicrobial drugs were reached 50 .00% ,the resistance rates to cefoperazone/sulbactam (27 .65% ) ,minocycline (21 .18% ) ,amikacin (19 .41% ) and tobramycin (12 .35% ) were all less than 30 .00% ,the strain that resistant to polymyxin was not found .The sensitivity rates of MR‐SA to linezolid ,vancomycin ,and tigecycline were 100 .00% ,and the resistance rates to nitrofurantoin and kuinuputing/ dalfopristin were low (less than 2 .00% ) .Conclusion The antimicrobial resistances of CR‐AB and MRSA are serious .In order to control effec‐tively the spreading of CR‐AB ,MRSA and other multi‐drug resistant bacteria ,it′s necessary for us to strengthen the management of key departments ,and select antimicrobial drugs based on the results of drug susceptibility testing .
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Objective To investigate the infection status and distribution characteristic of Helicobacter pylori (Hp)in different groups of population in Yangzhou.Methods 2 917 individuals from outpatients,hospitalized patients,and physical examination pop-ulation were recruited in the study.Serum samples from the subjects were rapidly detected using Helicobacter pylori urease antibody detection kits(Colloidal Gold method).The results were statistically analyzed.Results The totally Hp-detection rate of the 2 917 individuals was 32.9% (959/2 917).The Hp-detection rates of outpatients,hospitalized patients,and physical examination popula-tion were 33.1%,34.5% and 30.0% respectively.There were no significant difference in the positive rates between the male and female individuals(P >0.05).Overall,The Hp-positive rates increased with age.The minors(juveniles and children)had the lowest Hp-positive rate 16.0%(285/1 529);The Hp-positive rate of young adults was 34.0%(221/650),which was at the middle;elderly group had the highest Hp-positive rate 61.38%(453/758).59.8% of the patients diagnosed with gastrointestinal diseases were Hp positive.Among which,patients with peptic ulcer(74.4%)and gastric cancer(70.6%)have the highest detection rates.Some pa-tients with blood diseases,cardiovascular disease and some other diseases were also found with high Hp-detection rates.Conclusion The distribution of the Hp infection in population is positively correlated with age,but not with gender.Gastrointestinal diseases, especially peptic ulcers and gastric cancer,have high Hp infection rates,the relationships of Hp infections with some other diseases cannot be ignored and need to be further explored.