Progress of research on the preventive and therapeutic agents against radiation-induced injuries / 中国辐射卫生

Radiation-induced injury, a body dysfunction caused by irradiation, is associated with the dose, duration, and speed of radiation and is predominantly derived from radiation therapy for patients with malignant tumors. The current clinical treatment mainly includes amelioration of injury, alleviation of symptoms, and improvements in function restoration of the affected sites because of lack of targeted agents specific to radiation-induced injuries. Research and development of preventive and therapeutic agents against radiation-induced injuries are of great significance to reduce the body damages caused by radiotherapy and improve the quality of life of cancer survivors. This review summarizes the radiation-induced injury and its mechanisms, radioprotectants, and therapeutic agents for radiation, and proposes future development directions, so as to provide a reference for alleviation of radiation-induced injury and improvement in prognosis.

Occupational health management of radiation workers in non-medical institutions in Shanxi Province, China / 中国辐射卫生

Objective To understand the basic information of the number, classification, and distribution of radiation work units in non-medical institutions in Shanxi Province, China, and to analyze the status quo of health management and radiation protection measures for radiation workers, so as to provide a scientific basis for occupational exposure protection in non-medical radiation work units and better protect the occupational health rights and interests of radiation workers. Methods A questionnaire survey was conducted to investigate some non-medical institutions in Shanxi Province. On-site testing was carried out to determine the risk factors for radioactive occupational diseases in the selected non-medical institutions. Results In 220 non-medical institutions, there were 340 radiation devices and 2284 radioactive sources. The rate of individual dose monitoring was 92.7% and the rate of occupational health examination was 87.2%. These devices were equipped with 325 detection instruments for radiation protection, 1316 personal protective equipment, and 730 personal dose alarms. Radiation occupational disease risk factors were investigated in 101 institutions. Conclusion The occupational health management of radiation workers in non-medical institutions in Shanxi Province is generally in line with the national standards. However, there is still a big gap with the level of occupational health management in medical institutions. The health administration departments should clarify the management measures for non-medical institutions and strengthen their supervision and management functions.

Analysis of current radiation protection and occupational health management in non-medical institutions in Hebei Province, China, 2022 / 中国辐射卫生

Objective To investigate the number, distribution, and types of radiation of non-medical radiation institutions in Hebei Province, China, and to explore the current radiation protection in the employing units and occupational health management of radiation workers in 2022. Methods A questionnaire survey was conducted in the non-medical institutions engaged in nuclear technology application in Hebei Province, and different types of employing units were selected to monitor the radioactivity level in the workplace. Results A total of 681 non-medical institutions engaged in radiation technology application completed the survey, covering all cities with subordinate districts in the province, including 1605 radioactive devices, 2960 active devices, 45 non-uranium metal mines, and 14 non-sealed workplaces. A total of 8617 radiation workers were surveyed, with a personal dose monitoring rate of 70.9%, a radiation protection training rate of 61.1%, and an occupational health examination rate for radiation workers of 59.3%. A total of 614 radiation protection monitoring instruments were provided, with a personal protective equipment allocation rate of 51.1% and a personal dose alarm device allocation rate of 51.8%. The radiation occupational hazardous factor testing was completed for 54 workplaces, and the results were all qualified. Conclusion There are still significant deficiencies in personal dose monitoring in the radiation work units in non-medical institutions and occupational health examination in the radiation work units in our province. The health administrative departments should strengthen health supervision and law enforcement, enhance radiation protection and skill training for employers, and more effectively control the impact of radiation hazards on personnel health.

Analysis of current status of radiation protection in non-medical radiation workplaces in Yantai, China, 2022 / 中国辐射卫生

Objective To investigate the current status of radiation protection in non-medical radiation workplaces in Yantai, China, and to provide a scientific basis for occupational health management in non-medical radiation workplaces. Methods Non-medical radiation workplaces in Yantai were investigated using a questionnaire survey in 2022, including radiation source term, occupational health examination, personal dose monitoring, personal protective equipment, and radiation protection testing workplaces. Data were entered by a double-entry method and then analyzed. Results There were 56 non-medical radiation workplaces in Yantai, covering manufacturing, nonferrous metal ore mining, nuclear power plant, transportation, and technical services. There were 0 Class I radiation device, 150 Class II radiation devices, and 10 Class III radiation devices; there were 80 Class I radiation sources, 16 Class II radiation sources, 14 Class III radiation sources, 62 Class IV radiation sources, and 135 Class V radiation sources. There were 998 radiation workers, with an occupational health examination rate and personal dose monitoring rate of 98.3%. Among the 56 non-medical radiation workplaces, 47 (83.9%) were equipped with radiation protection monitoring instruments, 24 (51.1%) workplaces had verified the radiation protection monitoring instruments, with 2017 personal dose monitoring instruments and 2327 personal protective equipment in place, 42 (75%) workplaces carried out occupational health assessments, 44 (78.6%) workplaces carried out self-detection, and 53 (94.6%) workplaces carried out entrusting detections (monitoring pass rate: 100% [53/53]). The declaration rate of occupational hazard items was 87.5% (49/56). Conclusion There is still a gap between the current status and the requirements in the national regulations and standards regarding radiation protection in non-medical radiation workplaces. Therefore, the supervision and management of non-medical radiation workplaces should be further strengthened, especially the configuration and verification of radiation protection monitoring instruments.

Regulatory Mechanism of Radiation Therapy for Lung Cancer with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Lung cancer is the fastest-growing cancer type in terms of incidence and mortality worldwide， posing a huge threat to the health and life of the population. Radiation therapy is one of the main methods for treating lung cancer， and there is a clear dose-effect relationship between the radiation dose and local control rate of lung cancer. However， the lung is a radiation dose-limiting organ， and the radiation resistance of lung cancer tissues and the radiation damage to normal tissues limit the radiation efficacy for lung cancer. The pathogenesis of lung cancer in traditional Chinese medicine （TCM） is characterized by an initial deficiency in vital Qi， followed by the internal invasion and gradual accumulation of pathogenic Qi. After radiation therapy for lung cancer， the body's vital Qi becomes weaker， and syndromes of phlegm coagulation， Qi stagnation， and static blood blocking collaterals become more severe， leading to radiation resistance of lung cancer tissues. Therefore， the key issue to better clinical efficacy of radiation therapy for lung cancer patients is to use drugs to enhance the radiation sensitivity of lung cancer cells and improve the radiation tolerance of normal lung tissues. TCM can be used as a radiation sensitizer by regulating the cell cycle to increase the proportion of cells in the radiation-sensitive phase， promoting upregulation of pro-apoptotic genes and downregulation of anti-apoptotic genes to induce cell apoptosis， enhancing DNA damage caused by radiation and inhibiting damage repair， improving blood circulation and tissue oxygen supply， and so on， to enhance the sensitivity of tumor cells to radiation and amplify the toxicity of radiation to tumor tissues. TCM can also be used as a radiation protector by inhibiting cell damage， regulating cytokines and immune balance， reducing the release of inflammatory and fibrotic factors， and inhibiting the activation of related signaling pathways to prevent and treat radiation-induced lung injury. This article systematically reviewed the research results of TCM on radiation sensitization and radiation protection in lung cancer in recent years， aiming to elucidate the mechanism of TCM in regulating the effect of radiation therapy for lung cancer and provide more theoretical and practical basis for TCM to participate in improving the prognosis of lung cancer patients undergoing radiation therapy.

Niveles de referencia diagnósticos en equipos de radiografía dental en Bogotá, Colombia

Introducción: Las radiografías dentales son una de las exposiciones médicas más frecuentes a la radiación ionizante. El uso de radiación ionizante está asociado a un riesgo probable de desencadenar efectos biológicos adversos y posibles daños a la salud del paciente. Para evitar que los pacientes reciban dosis innecesariamente altas durante estas exposiciones, la Comisión Internacional de Protección Radiológica recomienda la utilización de los niveles de referencia para diagnóstico, como una herramienta efectiva de ayuda a la optimización de la protección radiológica de los pacientes. Objetivo: Estimar los niveles de referencia para diagnóstico en radiografía dental intraoral y panorámica en la ciudad de Bogotá, D. C. Metodología: Se evaluaron los parámetros de exposición radiográficos de los equipos y la calidad de imagen en 68 equipos de radiografía dental periapical y 23 equipos de radiografía panorámica. Se estimaron las magnitudes dosimétricas de kerma incidente en aire (Kai) en equipos intraorales para la radiografía de un maxilar molar de un adulto y el producto kerma aire-área (PKA) en equipos de radiografía panorámica en un examen de un adulto estándar. Resultados: El tercer cuartil de la distribución de kerma incidente en aire para radiografía intraoral fue de 3,3 mGy y del producto kerma aire-área para radiografía panorámica fue de 103,9 mGycm2. En la distribución de frecuencias de kerma incidente en aire para radiografía intraoral, el porcentaje más alto de equipos estuvo en el rango de 2,0-3,0 mGy. En la distribución de frecuencias del producto kerma aire-área para los equipos de radiografía panorámica, el porcentaje más alto de equipos estuvo en el rango de 60 a 80 mGycm2. Discusión: Las instituciones consideradas para establecer los Niveles de Referencia para Diagnóstico en este estudio contaron con una adecuada calidad de la imagen evaluada con un maniquí dental, pero las variaciones en las dosis de radiación entre instituciones señalan la necesidad de implementar herramientas que contribuyan a la optimización de las prácticas. Conclusiones: Se recomienda usar los valores de los niveles de referencia para diagnóstico encontrados en esta investigación para optimizar la protección radiológica en las exposiciones radiológicas dentales, y se espera que este estudio sirva de base para nuevas investigaciones en las demás ciudades del país.

Introduction: Dental X-rays are one of the most frequent medical exposures to ionizing radiation. The use of ionizing radiation is associated with a probable risk of triggering adverse biological effects and possible damage to the patient's health. To prevent patients from receiving unnecessarily high doses during these exposures, the International Commission on Radiological Protection recommends the use of diagnostic reference levels as an effective tool to help optimize radiological protection for patients. Objective: To estimate diagnostic reference levels in intraoral and panoramic dental radiography in the city of Bogotá, D.C. Methodology: In 68 periapical dental radiography equipment and 23 panoramic radiography equipment, the radiographic exposure parameters of the equipment and image quality were evaluated. The dosimetric magnitudes of incident air kerma (Ka,i) in intraoral equipment for the radiography of a maxillary molar of an adult and the air kerma-area product (PKA) in panoramic radiography equipment in a standard adult examination were estimated. Results: The third quartile of the incident air kerma distribution for intraoral radiography was 3,3 mGy and the air kerma-area product for panoramic radiography was 103,9 mGycm2. In the frequency distribution of incident air kerma for intraoral radiography, the highest percentage of equipment was in the range of 2,0-3,0 mGy, and in the frequency distribution of the air kerma-area product for equipment of panoramic radiography, the highest percentage of the equipment was in the range of 60 to 80 mGy cm2. Discussion: The institutions considered to establish the diagnostic reference levels in this study had an adequate quality of the image evaluated with a dental phantom, but the variations in radiation doses between institutions indicate the need to implement tools that contribute to the optimization of the practices. Conclusions: It is recommended to use the values of the diagnostic reference levels found in this research to optimize radiological protection in dental radiological exposures, and it is expected that this study will serve as a basis for further research in other cities of the country.

Protección radiológica en endoscopia

La endoscopía digestiva ha evolucionado de una técnica puramente diagnóstica a un procedimiento terapéutico. Esto es posible en muchos casos gracias al uso de fluoroscopía, lo cual conlleva la exposición a radiaciones ionizantes tanto de los pacientes como del personal actuante. La colangiopancreatografía retrógrada endoscópica (CPRE), que requiere necesariamente de fluoroscopia, es catalogada por la Food and Drug Administration como un examen con potencial riesgo de desencadenar lesiones inducidas por radiación. El presente artículo de revisión repasa los efectos biológicos de las radiaciones, los tipos de equipos radiológicos utilizados en CPRE, así como las magnitudes y unidades dosimétricas, para finalmente abordar los elementos de radio protección en la sala de endoscopia. El objetivo es brindar al lector la informacion para poder realizar estos procedimientos con la mayor seguridad radiológica tanto para los pacientes como para el personal ocupacionalmente expuesto.

Endoscopy has evolved from a purely diagnostic technique to a therapeutic procedure. This is possible in many cases thanks to the use of fluoroscopy, which entails exposure to ionizing radiation for both patients and the personnel involved. Endoscopic retrograde cholangiopancreatography (ERCP), which necessarily requires fluoroscopy, is classified by the Food and Drug Administration as an examination with a potential risk of triggering radiation induced injuries. This article reviews the biological effects of radiation, the types of radiological equipment used in ERCP, as well as the magnitudes and dosimetric units, to finally address the radio protection elements in the endoscopy room. The objective is to provide the reader with the information to be able to perform these procedures with the greatest radiological safety for both patients and occupationally exposed personnel.

Uso de barreras primarias en función del ángulo del gantry en búnker de radioterapia / Uso de barreiras primárias em função do ângulo do gantry em bunkers de radioterapia / Use of primary barriers as a function of gantry angle in radiotherapy bunker

Introducción: el diseño de los búnkeres de radioterapia es de vital importancia no solo por la seguridad radiológica, sino también por el costo que implican. Los cálculos de blindaje de las paredes primarias de los búnkeres de los aceleradores lineales de radioterapia se determinan a partir del factor de uso de estas paredes. Los documentos internacionales como el NCRP 151 utilizan para el cálculo de estas barreras un factor de uso igual a 0.25. Objetivo: estudiar la distribución del uso de las barreras primarias en función de los tratamientos realizados buscando contrastar la homogeneidad en el uso de las barreras. Material y Métodos: con los datos de pacientes realizados durante un año (2021) en dos aceleradores lineales, uno dual y otro monoenergético, se generó una base de datos con la que se calculó la frecuencia de uso de las paredes primarias. En el presente trabajo se evalúa la diferencia entre el uso dado de las barreras y las estimaciones de uso internacional. Resultados: se encuentra que en el acelerador dual en la energía de 15X los campos más usados tienen ángulos de gantry 0º, 90º, 180º, 270º, teniendo un peso acumulado aproximado al 65% al igual que la carga de trabajo para esos ángulos, esto implica que los ángulos diferentes a estos tienen un uso muy inferior al previsto por el cálculo inicial. En el acelerador dual en la energía de 6X el campo más usado es a 0º teniendo un peso aproximado al 14%, pero la carga de trabajo a 0º no se diferencia apreciablemente del resto de los ángulos ya que la distribución no tiene direcciones preferenciales, ninguno de los valores llega a 10% que concuerda con el uso homogéneo de la barrera. En el acelerador monoenergético el peso relativo de los ángulos de 90º y 270º en el uso de las barreras es aproximadamente 34% para cada una, superior al 25% estimado inicialmente. Conclusiones: las barreras primarias de los búnkeres de radioterapia tienen espesores marcados por el cálculo de blindaje, los cuales se pueden hacer basados en documentos internacionales que son referencia del tema. Se considera en las referencias para la barrera primaria un factor de uso igual para las mismas, sin embargo en la práctica clínica se pueden tener un factor de uso no uniforme respondiendo a los tipos de tratamientos que se designen realizar en el equipo. Esta realidad abre la puerta para plantear blindajes optimizados que podrían generar búnkeres más económicos y mejor utilización del espacio de acuerdo a las condiciones dadas para cada caso en particular.

Introduction: The design of radiotherapy bunkers is of vital importance not only for radiation safety, but also for the cost involved. The shielding calculations of the primary walls of radiotherapy linear accelerator bunkers are determined from the use factor of these walls. International documents such as NCRP 151 use for the calculation of these barriers a usage factor equal to 0.25. Objective: to study the distribution of the use of primary barriers according to the treatments performed, seeking to contrast the homogeneity in the use of the barriers. Material and Methods: with the data of patients performed during one year (2021) in two linear accelerators, one dual and the other monoenergetic, a database was generated with which the frequency of use of the primary walls was calculated. The present work evaluates the difference between the given use of the barriers and the estimates of international use. Results: it is found that in the dual accelerator at 15X energy the most used fields have gantry angles 0º, 90º, 180º, 270º, having an accumulated weight of approximately 65% as well as the workload for those angles, this implies that the angles different from these have a use much lower than the one foreseen by the initial calculation. In the dual accelerator at 6X energy the most used field is at 0º having an approximate weight of 14%, but the workload at 0º is not appreciably different from the rest of the angles since the distribution does not have preferential directions, none of the values reaches 10% which is consistent with the homogeneous use of the barrier. In the monoenergetic accelerator, the relative weight of the 90º and 270º angles in the use of the barriers is approximately 34% for each one, higher than the 25% initially estimated. Conclusions: the primary barriers of radiotherapy bunkers have thicknesses marked by the shielding calculation, which can be made based on international documents that are a reference on the subject. It is considered in the references for the primary barrier an equal use factor for them, however in clinical practice they can have a non-uniform use factor responding to the types of treatments that are designed to be performed in the equipment. This reality opens the door to propose optimized shielding that could generate more economical bunkers and better use of space according to the conditions given for each particular case.

Introdução: O projeto de bunkers de radioterapia é de vital importância não apenas para a segurança da radiação, mas também para o custo envolvido. Os cálculos de blindagem para as paredes primárias dos bunkers de aceleradores lineares de radioterapia são determinados com base no fator de uso dessas paredes. Documentos internacionais, como o NCRP 151, usam um fator de uso igual a 0,25 para o cálculo dessas barreiras. Objetivo: estudar a distribuição do uso de barreiras primárias de acordo com os tratamentos realizados, buscando contrastar a homogeneidade no uso das barreiras. Material e métodos: com os dados de pacientes tratados durante um ano (2021) em dois aceleradores lineares, um dual e outro monoenergético, foi gerado um banco de dados com o qual foi calculada a frequência de uso das paredes primárias. Este artigo avalia a diferença entre o uso determinado de barreiras e as estimativas internacionais de uso. Resultados: verifica-se que no acelerador duplo com energia de 15X os campos mais utilizados são os ângulos de pórtico 0º, 90º, 180º, 270º, com um peso acumulado de aproximadamente 65%, assim como a carga de trabalho para esses ângulos, o que implica que os ângulos diferentes desses têm um uso muito menor do que o previsto pelo cálculo inicial. No acelerador duplo a 6X de energia, o campo mais utilizado é o de 0º com um peso aproximado de 14%, mas a carga de trabalho em 0º não é sensivelmente diferente do resto dos ângulos, já que a distribuição não tem direções preferenciais, nenhum dos valores chega a 10%, o que é consistente com o uso homogêneo da barreira. No acelerador de monoenergia, o peso relativo dos ângulos de 90º e 270º no uso das barreiras é de aproximadamente 34% para cada um, superior aos 25% estimados inicialmente. Conclusões: as barreiras primárias dos bunkers de radioterapia têm espessuras balizadas pelo cálculo de blindagem, que pode ser feito com base em documentos internacionais que são referência no assunto. As referências para a barreira primária consideram um fator de uso igual para elas, mas na prática clínica elas podem ter um fator de uso não uniforme, dependendo do tipo de tratamento que o equipamento foi projetado para realizar. Essa realidade abre as portas para uma blindagem otimizada que poderia gerar bunkers mais econômicos e melhor uso do espaço de acordo com as condições dadas para cada caso específico.

Radiation safety measures in diagnostic nuclear medicine, based on the potential radiation dose emitted by radioactive patients / Cuidados de radioproteção em medicina nuclear diagnóstica baseados no potencial de dose de radiação emitida por pacientes radioativos

Abstract Objective: To measure the potential radiation dose emitted by patients who have recently undergone diagnostic nuclear medicine procedures, in order to establish optimal radiation safety measures for such procedures. Materials and Methods: We evaluated the radiation doses emitted by 175 adult patients in whom technetium-99m, iodine-131, and fluorine-18 radionuclides were administered for bone, kidney, heart, brain, and whole-body scans, as measured with a radiation detector. Those values served as the basis for evaluating whole-body radiopharmaceutical clearance, as well as the risk for the exposure of others to radiation, depending on the time elapsed since administration of the radiopharmaceutical. Results: The mean time to clearance of the radiopharmaceuticals administered, expressed as the effective half-life, ranged from 1.18 ± 0.30 h to 11.41 ± 0.02 h, and the mean maximum cumulative radiation dose at 1.0 m from the patients was 149.74 ± 56.72 µSv. Even at a distance of 0.5 m, the cumulative dose was found to be only half and one tenth of the limits established for exposure of the general public and family members/caregivers (1.0 mSv and 5.0 mSv per episode, respectively). Conclusion: Cumulative radiation doses emitted by patients immediately after diagnostic nuclear medicine procedures are considerably lower than the limits established by the International Commission on Radiological Protection and the International Atomic Energy Agency, and precautionary measures to avoid radiation exposure are therefore not required after such procedures.

Resumo Objetivo: O objetivo deste trabalho foi levantar o potencial de dose de radiação emitida por pacientes em procedimentos diagnósticos, visando a estabelecer cuidados de radioproteção mais otimizados. Materiais e Métodos: Taxas de dose de radiação emitidas por 175 pacientes administrados com os radionuclídeos 99mTc, 131I e 18F para cintilografias óssea, renal, cardíaca, cerebral e corpo inteiro, foram mensuradas com um detector de radiação, servindo para avaliar o clareamento do radiofármaco no organismo e risco de exposição após administração dos radiofármacos. Resultados: O clareamento, representado pela meia-vida efetiva, variou de 1,18 ± 0,30 h até 11,41 ± 0,02 h e a dose de radiação máxima acumulada oferecida pelos pacientes a 1,0 m foi de 149,74 ± 56,72 µSv. Mesmo para distâncias de 0,5 m, as doses estimadas foram, respectivamente, duas e dez vezes inferiores ao nível de restrição para o público geral (1,0 mSv) e exposição médica (5,0 mSv/episódio). Conclusão: Doses de radiação oferecidas por pacientes em procedimentos diagnósticos são inferiores aos níveis de restrição recomendados pela International Commission on Radiological Protection e International Atomic Energy Agency, e assim, cuidados de radioproteção são geralmente desnecessários.

Ambient dose equivalent in 99mTcO4- single photon emission computed tomography of the thyroid among patients with hyperthyroidism / 预防医学

Objective@#To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance.@*Methods@#Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model.@*Results@#Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck.@*Conclusions@#The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.

Investigation on awareness of and attitudes towards radiation safety and protective measures among clinical nurses in liver interventional department / 中国辐射卫生

Objective To investigate the awareness of and attitudes towards radiation safety and protective measures among clinical nurses in liver interventional department, so as to provide insights into the formulation of radiation-protective measures among clinical healthcare workers. Methods A cross-sectional study was performed. Clinical nurses in liver interventional departments of class A tertiary hospitals in Jiangsu Province were sampled, and the awareness of and attitudes towards radiation safety and protective measures were investigated using self-designed questionnaires. Results A total of 112 questionnaires were allocated, and 97 valid questionnaires were recovered, with an effective recovery rate of 86.61%. The awareness of questions including “interventional therapy may cause radiation exposure” and “wearing lead apron may reduce radiation exposure” was both 100.00% among respondents, and the awareness of questions including “radiation exposure may cause congenital malformations in babies”, “radiation exposure may cause cancers such as skin cancer and leukemia”, “radiation exposure may cause death”, “wearing lead goggles may reduce radiation exposure”, and “wearing thyroid shields may reduce radiation exposure” was all higher than 95.00%, while the awareness of questions “radiation exposure may cause cataract of the eye lens” and “radiation exposure may cause bone marrow depression” was relatively low. Respondents presented high-level attitudes towards lead aprons, and low-level attitudes towards goggles and thyroid shields. Conclusion The awareness of radiation safety knowledge is high among clinical nurses in liver interventional departments; however, an overall low-level attitude is seen towards radiation-protective measures. Health education pertaining to radiation safety and protective measures is required to be improved, so as to increase the compliance to radiation-protective measures.

Discussion on the evaluation of radiation protection of “four-in-one” dental X-ray equipment / 中国辐射卫生

Objective To evaluate the radiation protection of “four-in-one” dental X-ray equipment and to investigate the safety interlock of the equipment by measuring the scattered radiation at the position of the patient during operation. Methods A cone-beam CT dental phantom was used to simulate the patient’s head. The intra-oral and extra-oral components of the “four-in-one” X-ray equipment were installed in a 5 m2 room. The scattered radiation at patient position was measured using a γ/X-ray survey meter, and the effects of intra-oral and extra-oral components were compared. Results For a 5 m2 room, when CBCT was exposed under typical conditions, the dose at the patient's position was 10.70 uSv/h when there was an intra-oral component and 10.60 uSv/h when there was no intraoral component. The intra-oral part did not affect the radiation dose at the patient's position. When the intra-oral component was exposed, the dose rate at the patient's position was 4.05-6.85 uSv/h, and the extra-oral part did not affect the scattered dose of the patient examined with intra-oral components. Conclusion The evaluation of radiation protection of new equipment must comprehensively consider radiation safety and equipment operation safety. The results of this study provide suggestions for clinical radiation protection supervision and evaluation of “four-in-one” dental X-ray equipment.

Response of radioactivity meter in vertical direction of ionization chamber / 中国辐射卫生

Objective To determine the responses of radioactivity meter at different positions in the vertical direction of the ionization chamber by measuring different radioactive sources. Methods The radiation of cesium-137, cobalt-60, and americium-241 nuclides was measured at different positions in the vertical direction of the ionization chamber with commonly used clinical radioactivity meters. The measured values were fitted to obtain three trend lines. The maximum deviation of the measured values was estimated according to the trend line, and the deviation was estimated at different syringe needle heights. Results According to the trend lines, the maximum deviation of the radioactivity meter CRC-55tR in measuring cesium-137, cobalt-60, and americium-241 nuclides was 5.15%, 5.98%, and 6.25% respectively. The radioactivity meter RM-905a was used to measure three nuclides at different syringe needle heights, and the maximum deviations were −4.33%, −9.9%, and −12.65%, respectively. Conclusion The three nuclides showed different change patterns in measurement with CRC-55tR and RM-905a but similar change patterns in measurement with the same radioactivity meter. The values measured with the same radioactivity meter showed significant deviations at different positions in the vertical direction of the ionization chamber. It is recommended to make position correction for commonly used nuclides. Reducing measurement error and improving measurement accuracy of nuclides are of great significance for radiation protection.

Research progress of radiation protection in interventional diagnosis and treatment of pediatric heart disease / 中国基层医药

Interventional diagnosis and treatment of heart disease is the gold standard to evaluate the anatomy and physiology of children with congenital heart disease. It plays an important role in the treatment of congenital heart disease. However, ionizing radiation is inevitably harmful to the health of children and surgery operators to varying degrees. More and more attention has been paid by surgery operators to children's unique characteristics, protective awareness and skills. This paper reviews recent literature regarding the application, radiation hazards, and research status of interventional surgery in children with congenital heart disease, which hope to help people to better understand the importance of ionizing radiation protection.

A child in radiation examination without protective equipment: A case analysis / 中国辐射卫生

This paper reviews the investigation of examining a child without protective equipment exposed to an exceptionally large radiation field, in order to provide a reference for the investigation and handling of similar cases in the future. Based on the analysis of the way of obtaining evidence and the application of law, the authors put forward some suggestions, such as improving the standards, laws, and regulations related to radiation, enhancing the protective facilities, standardizing the law enforcement procedures, and strengthening the publicity and training of radiation hygiene. The health-related rights and interests of the examinees shall be effectively protected.

A survey of interventional radiology resources and radiation protection equipment and personal dosimeter wearing rate in Qingdao, China / 中国辐射卫生

Objective To investigate the current status of interventional radiology resources, radiation protection equipment, and the rate of wearing of personal dosimeters in Qingdao, China, and to provide a data basis for strengthening radiation protection and health management for interventional radiation workers. Methods A questionnaire survey was performed on all medical institutions with interventional radiation services in Qingdao. The data from April 1, 2020 to March 31, 2021 were pooled and analyzed. Results A total of 31 medical institutions in Qingdao were investigated, including 23 (74.20%) tertiary hospitals and 8 (25.80%) secondary hospitals. There were 88 pieces of interventional radiation equipment in total in Qingdao, 89.77% of which were in tertiary hospitals. A total of 921 interventional professionals participated, with 865 (93.92%) from tertiary hospitals and 56 (6.08%) from secondary hospitals. The mean annual number of visits to interventional services was 5.72 per 1000 people. Among personal protective equipment, the equipment rates of lead-rubber aprons, lead-rubber caps, and lead-rubber collars were highest, all being 100%. The rate of equipment of interventional protective gloves was lowest, which was only 51.61%. The mean number of each accessory protective equipment for each interventional machine was less than 1. The rate of wearing of dual-dosimeters was 84.36%. Conclusion Tertiary hospitals were dominant among the medical institutions in this survey of interventional radiology services in Qingdao. The most frequently equipped personal protective goods were lead-rubber aprons, caps, and collars. The equipment rates of interventional protective gloves and protective accessories and the rate of wearing of dual-dosimeters were relatively low.

Research progress of epigallocatechin gallate in radiation protection / 中国辐射卫生

Epigallocatechin gallate (EGCG) is a major polyphenol component in green tea. EGCG has high free radical scavenging activity, radiation protection efficiency, and metal-chelating capacity due to its unique structure with hydroxyl groups. EGCG and its derivatives have been reported in various fields. This paper reviews the effects of EGCG, including radiation protection, heavy metal ion adsorption, and promotion of heavy metal ion excretion. EGCG has the potential to be used as an ideal radiation protection agent, heavy metal adsorbent, and even excretion promoting agent.

Research progress of cell death in radiation protection and radiosensitization / 中国辐射卫生

@#The rapid advances in technology and medicine have greatly facilitated the application of ionizing radiation. Clinically, radiotherapy is one of the major treatments for malignant tumors. However, besides killing tumor cells, ionizing radiation inevitably leads to radiation damage and even death of normal cells. How ionizing radiation causes cell death and the forms of cell death have always been important research topics in this field. Recently, several forms of cell death induced by irradiation have been discovered. Apart from apoptosis, pyroptosis, necroptosis, ferroptosis, autophagic cell death, and methuosis have gradually become research hotspots, and provide new targets for the development of radioprotective drugs and radiosensitizers. In this review, we summarize various forms of ionizing radiation-induced cell death and related molecular mechanisms. We also introduce the latest progress in radiation protection and radiosensitization based on these cell death mechanisms. This review will provide a reference for the research and development of radioprotective drugs and radiosensitizers in the future.

Experience in radiation protection management in the tertiary general hospital / 中国辐射卫生

@#With widespread popularization, the radiological diagnosis and treatment technology has played an increasingly important role in clinical practice. The tertiary general hospital is generally featured as multiple types of radioisotope and radiation equipment, wide involvement of departments and persons, and many ways of use and potential harms of the radiological diagnosis and treatment technology. Radiation protection has become a content that cannot be ignored in hospital management. This article analyzes the radiation protection management structure of the tertiary general hospital - Guangdong Provincial People’s Hospital. The hospital radiation protection management is gradually improved by clarifying the main leading department, refining duties and responsibilities, strengthening multi-departmental communication and cooperation, and sorting out key connection links. A closed loop of refined management is formed through digging and correcting problems and continuously improving the management level and work efficiency. Valid qualifications are ensured to be obtained in time by radiation workers, radioactive drugs, equipment, and the venues to guarantee the radiation safety of radiation workers and patients and to further promote the construction of the Safe Hospital.

Influence of radiation protection on layout of fuel reprocessing plant and countermeasures / 中国辐射卫生

@#Radiation protection is an important requirement in the design of spent nuclear fuel reprocessing plant. The design of all main process plants should consider the impact of radiation on staff and environment, while radiation protection is not required in the design of general industrial and civil buildings. This difference puts forward higher requirements for the architectural design of spent nuclear fuel reprocessing plant. From the perspective of architectural design, this paper analyzed the differences between spent nuclear fuel reprocessing plant and ordinary plant, as well as the compatibility of radiation protection requirements and current architectural design specifications. We proposed corresponding countermeasures based on our engineering experience, and summarized important design principles related to radiation protection requirements, which can be used as a reference by architectural designers in designing spent nuclear fuel reprocessing plants.