Comparative analysis on radiological health technical services in China in 2021 and 2022 / 中国职业医学

ObjectiveTo analyze the quality and status of technical service items of radiation health technical service institutions (RHTSI) in China. Methods A total of 608 and 622 RHTSIs with radiation health technical service qualifications from 31 provinces, autonomous regions, and municipalities in the years of 2021 and 2022 were selected as the research subjects. The data of quality monitoring of radiological health technology services, comparison of radiological health testing capabilities, and investigation of the current status of technical support institutions were collected to analyze the status of technical service items which was conducted by RHTSIs from 2021 to 2022. Results A total of 622 RHTSIs in China obtained technical service institution qualifications in 2022, an increase of 14 from 608 in 2021. While a total of 404 of 622 RHTSIs conducted radiological health technology services, a decrease of 11.4% from 456 in 2021. A total of 241 804 technical service items were conducted in 2022, an increase of 39.7% from 173 064 in 2021. The median number of technical service items by non-health system RHTSIs was higher than that of the health system RHTSIs in 2021 and 2022, (203 vs 40 items, 215 vs 55 items, all P<0.01). The number of technical service institutions and technical service items conducted in different regions from high to low were the eastern, central, and western regions in 2021. The number of technical service institutions in different regions was highest in the eastern region, followed by the central and western regions, while the number of technical service items from high to low were the eastern, western, and central regions in 2022. The number of provincial, municipal, and county-level health system RHTSIs decreased by 6.5%, 26.3%, and 27.3%, respectively, in 2022 compared with 2021. The number of technical service items conducted by provincial health system RHTSIs increased by 48.6%, while those conducted by municipal and county-level health system RHTSIs decreased by 13.8% and 21.3%, respectively. Conclusion Although the number of RHTSI conducting technical services decreases in 2022 compared with 2021, the number of technical service items conducted increases. Non-medical RHTSI undertake the majority of technical service items. Within the medical institutes, the number of technical service items conducted by provincial RHTSI is higher than that of municipal and county-level RHTSI.

Analysis of individual dose intercomparison results for province-level health institutions during 2009—2022 / 中华放射医学与防护杂志

Objective:To summarize and analyze the results of the individual dose intercomparison in which province-level health institutions participating, and explore the role of ability intercomparison in improving the detection capabilities of province-level health institutions.Methods:From 2009 to 2022, the results obtained by the province-level CDCs and occupational prevention and control institutions in the individual dose intercomparison countrywide for time periods of 2009—2020 and 2021—2022 were summarized. The intercomparison results were analyzed and compared for three regions of east, central and west China divided according to the method from China Health Statistics Yearbook 2022.Results:A total of 24 province-level CDCs and 14 occupational prevention and control institutions countrywide participated in the ability intercomparison from 2009—2022 for 13 times. Number of participating institutions increased from 26 in 2009 to 37 in 2022. The qualified rates of the intercomparison results among the province-level health institutions in the three regions were maintained at higher than 85% for 37 times and 100% for 28 times. The pass rate and excellent rate of the three regions were higher than the overall level at whole country level (2009-2020) and national level (2021-2022) in the same period for 9 and 5 times, respectively. The excellent rate of province-level health institutions in central region were higher than that of the other two regions in 9 intercomparisons.Conclusions:With the improvement of the intercomparison standard, the province-level health institutions in various regions have maintained a relatively stable and high detection capability. The ability intercomparison effectively improve the detection ability and the quality control of the province-level health organizations. Many province-level agencies have listed the ability intercomparison as the regular work.

Investigation and analysis of the current situation of radiation health technical services in China / 中国辐射卫生

Objective To investigate the current situation of radiological health technical service institutions and their technical services in China, and to provide a basis for better utilizing radiological health technical service resources and strengthening institutions’ capability building. Methods From October to December 2021, we conducted quality monitoring, ability comparison, capability building surveys, and other investigations on radiation health technical services to collect information on the qualifications and technical services of radiation health service institutions. The data were pooled and analyzed using SPSS software. Results By the end of 2021, there were 608 radiological health technical service institutions across China, with 47.0% of them located in the eastern region, and the percentage of institutions in the health system (42.6%) was less than that in the non-health system (57.4%). Institutions of grade A offered 62.3% of technical services, while institutions of grade B provided 37.7% of technical services; technical services provided by the non-health system and the health system accounted for 84.2% and 15.8%, respectively; institutions in the health system at the province, prefecture, and county levels offered 37.1%, 50.6%, and 12.3% of technical services, respectively. Conclusion In recent years, the proportion of institutions in the non-health system has increased significantly, but the proportion of institutions in the health system with radiological health qualifications is small, and the development is uneven in the numbers of institutions, technical services, and professional and technical personnel in the eastern, central, and western regions and at the province, prefecture, and county levels in China. It is necessary to further encourage and support health system institutions in strengthening capability building and applying for radiological health qualifications, and to increase construction and investment in the western region and at the district/county levels, in order to improve the overall capability and level of radiological health technical services in the country.

Results and analysis of national personal dose monitoring intercomparison in 2021 / 中国辐射卫生

Objective@#To improve radiation testing institutions’ ability and levels of personal dose monitoring for external exposure and standardize monitoring work.@*Methods@#According to Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016), the intercomparison programme was made, the 2021 class-based personal dose monitoring intercomparison were organized by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention and provincial monitoring institutions.@*Results@#A total of 150 institutions participated in the 2021 national intercomparison of personal dose monitoring capability. Of them, 143 (95.3%) passed the assessment, including 51 excellent institutions (excellent rate, 34.0%), and 7 (4.7%) failed to pass the assessments.@*Conclusion@#The 2021 national personal dosimetry performance intercomparison showed great improvements in the pass rate and excellent rate compared with previous national assessments. However, still seven institutions failed to pass this assessment, including four institu- tions with class A qualifications. The testing institutions need to find out the reasons to increase their testing ability. This class-based intercomparison improved the point-to-plane relationship between the organizing and testing institutions, help- ing the organizing institution focus on improving the testing ability of provincial testing institutions and class A radiation health service institutions.

Discussion on dose estimation methods for internal exposure to tritiumm / 中国辐射卫生

@#<b>Objective</b> To discuss the selection of dose estimation methods for internal exposure to tritium, their applicable working scenarios, and accurate dose estimation. <b>Methods</b> We compared the process and formula of two methods of urine tritium concentration monitoring in estimating the committed effective dose, explained the limitations of the atmospheric tritium concentration monitoring method, and compared the three methods from the aspects of the application scope and measurement methods. <b>Results</b> The atmospheric tritium concentration monitoring and urine tritium concentration monitoring methods provided opposite results of the magnitude of the committed effective doses for persons 3 and 10. The mean of the absolute values of the percentages by which <i>E</i>(<i>τ</i>)₁values were higher than <i>E</i>(<i>τ</i>)₃values was 29.6%, and that of <i>E</i>(<i>τ</i>)₂ higher than <i>E</i>(<i>τ</i>)₃was 72.4%. The consistency between the reference man-based tritium dose estimation method and the atmospheric tritium concentration monitoring method was better. The atmospheric tritium concentration monitoring method tended to underestimate the committed effective dose of tritium. <b>Conclusion</b> We suggest urine tritium concentration monitoring for estimating the committed effective dose, rather than atmospheric tritium concentration monitoring. The use of the reference man-based tritium dose estimation method or urine tritium activity concentration integration method should be based on individual metabolic conditions, working environment, and intake time, and urine sampling should be on time and repeated for monitoring..

A Pilot Study on Using Forcemyography to Record Upper-limb Movements for Human-machine Interactive Control.

Forcemyography (FMG) is a useful method to record real-time body motions, which has application potentials for human-machine interactive control. The FMG registers the change of force distribution in the normal direction on muscle surface during limb movements, and the body motions can be recognized by decoding the FMG patterns. In this study, we used FMG to record upper-limb movements and evaluated the influence of different configurations of signal channel and feature on motion classification performances. A four-channel wearable FMG acquisition system was developed to record seven upper-limb movements on each of six able-bodied subjects. The preliminary results showed that the signal channel number has significant influence on motion classification performance; however, the influence of signal feature number on motion classification was insignificant. In addition, the influence of channel combination and feature combination were also discussed in this paper. This work would support the application potential of FMG for body motion recording and may provide useful instructions for the application of FMG in human-machine interactive control.

A Novel Flexible Sensor for Muscle Shape Change Monitoring in Limb Motion Recognition.

Human limb movement intent recognition fundamentally provides the control mechanism for assistive devices such as exoskeleton and limb prosthesis. While different biopotential signals have been utilized for limb movement intent decoding, they seldom could account for spatial information associated with changes in muscle shape that could also be used to characterize the limb motor intent. Therefore, this study developed a novel nano gold stretchable-flexible sensor that captures spatial information associated with the muscle shape change signal (MSCS) during different muscle activation patterns. The novel sensor consists of 2-channels to acquire MSCS at a sampling rate of 125 Hz, corresponding to multiple classes of upper limb movements acquired across six able-bodied subjects. By utilizing the linear discriminant analysis algorithm on the acquired data with a single extracted feature, an overall average motion decoding accuracy of 90.9% was achieved. In addition, the waveform analysis results show that the novel sensor's recordings were less affected by external interferences, thus yielding high quality signals. This study is the first to utilize nano gold stretchable-flexible material for sensor fabrication in pattern recognition of upper limb movement intent, which may facilitate the development of effective assistive devices.

Impact of Preoperative Hepatitis B Virus Levels on Prognosis After Primary and Repeat Hepatectomies for Hepatocellular Carcinoma Patients-a Retrospective Study.

BACKGROUND: Chronic HBV plays an important role in hepatocellular carcinoma pathogenesis. Previously, most studies have been focusing on HBV DNA levels before the primary curative hepatectomy. However, the association of virus level before repeat hepatectomy with the degrees of inflammation and fibrosis on histopathology and prognosis has not been surveyed. METHODS: From January 2002 to December 2009, all patients who were seropositive for hepatitis B surface antigen (HBsAg) were enrolled and assigned into four groups based on their HBV DNA levels before the primary and repeat hepatectomies. The cancer prognoses of these four groups of patients after the first and second operations were assessed and compared. The disease-free survival and overall survival were estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify risk factors for the primary and repeat hepatectomies. RESULTS: For the 385 patients in this study, a low level of serum HBV DNA before repeat hepatectomy, but not primary hepatectomy, was significantly associated with improvement in prognosis, in terms of tumor recurrence, liver fibrosis, and liver-related mortality. CONCLUSION: The levels of HBV DNA before hepatectomies were crucial prognostic risk factors of HBV-related hepatocellular carcinoma patients. Surveillance of serum HBV DNA levels at multiple time points, rather than at a single time point, and antiviral therapy to suppress the virus to a low level had beneficial effects for these patients.

Initial Experience in the Application of Virtual Touch Tissue Quantification in the Differential Diagnosis of Focal Pancreatic Lesions / 中国医学科学院学报

Objective To explore the potential value of the virtual touch tissue quantification (VTQ) in the differential diagnosis of focal pancreatic lesions. Methods Totally 51 patients with focal pancreatic lesions underwent the quantitative analysis by VTQ. Based on the pathologic or clinical diagnosis,the VTQ values including lesional shear wave velocity (LSWV),parenchymal shear wave velocity (PSWV),and difference shear wave velocity (DSWV)(DSWV=LSWV-PSWV) were compared between the lesions and background parenchyma. Results The mean LSWV and PSWV were (2.39±1.25) m/s(0.60-4.39 m/s) and (1.59±0.63) m/s (0.76-3.22 m/s) in malignant group,(1.92±1.07) m/s(0.79-4.00 m/s) and (1.43±0.41) m/s(0.80-2.23 m/s) in potentially malignant group,and (2.40±1.10) m/s (0.89-3.42 m/s) and (1.48±0.44) m/s (1.03-2.11 m/s) in benign group. There were statistically significant difference between LSWV and PSWV in bengin and malignant group (P=0.029,P=0.005),while no statistical significance in potential malignant group (P=0.087). However,LSWV,PSWV,and DSWV showed no significant difference among these three groups (P=0.401,P=0.638,P=0.625,respectively). LSWV was not significantly associated with the tumor size (r=0.253,P>0.05) but had negative correlation with the depth of region of interest (r=-0.413,P<0.05). Conclusion VTQ may be valuable in the differential diagnosis of focal pancreatic lesions,although further research is still required.

Analysis on related factors of axillary lymph node metastasis in patients with cT1-2 N0 breast cancer / 吉林大学学报(医学版)

Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT1-2 N0 breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy.Methods 687 patients with cT1-2 N0 breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node,and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis.Results In 687 cases of cT1-2 N0 breast cancer,156 (22.7%)cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage, pathological type,vascular invasion,perineural invasion estrogen receptor (ER),progesterone receptor (PR), and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age < 35 years, cT2 , invasive ductal carcinoma, vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses (r = 3.440,P = 0.010;r =1.770,P =0.007;r = 3.397,P = 0.001;r = 7.434,P = 0.000;r = 2.212,P = 0.015).Conclusion In the patients with cT1-2 N0 breast cancer,the age,cT,pathological type,vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.

Diagnosis of thyroid nodules with ultrasound-guided fine needle aspiration: comparison of solid lesion and complex lesion / 中华超声影像学杂志

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

Application of real-time gray-scale contrast-enhanced ultrasound in the diagnosis of benign and malignant breast lesions / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the patterns of benign and malignant breast lesions using real-time gray-scale contrast-enhanced ultrasound and assess its value in the differential diagnosis of begign and malignant breast tumors.</p><p><b>METHODS</b>Totally 116 breast lesions (benignity n = 63; malignancy n = 53) underwent real-time gray-scale contrast-enhanced ultrasound. The patterns of their enhancement were assessed from 6 aspects: degree of enhancement, process of enhancement, completeness of enhancement, homogeneity of enhancement, boundary of the enhanced lesions, and exhistance of radial enhancement around the lesions. The results were compared with the pathologic findings.</p><p><b>RESULTS</b>Contrast-enhanced sonographic patterns were significantly different between benign and malignant breast lesions. Most malignant lesions were non-centripetally, incompletely, and inhomogeneously enhanced. After having been injected with the microbubble contrast medium, the boundary of the lesions became unclear, and the radial enhancement around lesion were mainly seen in the malignant lesions.</p><p><b>CONCLUSION</b>The patterns of real-time gray-scale contrast-enhanced ultrasound are remarkably different between malignant and benign breast lesions, showing promising values for its clinical application.</p>

Diagnostic performance of contrast-enhanced ultrasound in liver metastases and its clinical application / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the performance of liver metastases with contrast-enhanced ultrasound (CEUS) and assess its clinical application.</p><p><b>METHODS</b>Twenty-one patients with 21 untreated liver metastases underwent CEUS with low mechanical index imaging. The characteristic appearances of CEUS in different vascular phases were observed.</p><p><b>RESULTS</b>Of 21 metastases, 19 (90.5%) were identified as fast-in and fast-out enhancement pattern. In the arterial phase, all the 21 lesions showed enhancement but with varied appearances: 12 (57.1%) showed early diffuse enhancement, 8 (38.1%) showed ring-like enhancement, and the remaining one lesion of large size showed slowly enhomogenous minor enhancement. In the late phase, sharp defects were found in 20 lesions (95.2%), and more lesions were detected in 3 patients (14.3%).</p><p><b>CONCLUSION</b>CEUS can show the characteristic appearance of liver metastases, and can be used for the screening and diagnosis of liver cancers.</p>

A quantitative method using one marker for simultaneous assay of ginsenosides in Panax ginseng and P. notoginseng / 药学学报

Current quality control patterns are limited to industrial application, for most of the natural chemical reference substances are expensive and unavailable. Herein, a method, quantitative analysis of multi-components with single marker (QAMS), was established and validated to simultaneously determine nine ginsenosides (ginsenoside Rg1, Re, Rf, Rh1, Rb1, Rc, Rb2, Rb3, Rd) in P. ginseng and four ginsenosides (ginsenoside Rg1, Rh1, Rb1, Rd) in P. notoginseng. Using ginsenoside Rb1 as the contrast, the relative correction factors (RCF) of the other eight ginsenosides were determined by HPLC-DAD. Within the linear ranges, the values of RCF of ginsenoside Rb1 to ginsenoside Rg1, Re, Rf, Rh1, Rc, Rb2, Rb3 and Rd were 1.400, 1.215, 1.517, 1.801, 0.944, 1.012, 1.143, and 1.135, respectively. The RCF had a good reproducibility in various instruments, chromatographic columns (RSD = 0.30% - 3.9%). According to their RCF, we simultaneously determined nine ginsenosides in P. ginseng only using one marker. In addition, the RCF of ginsenosides were used to simultaneously quantitative analysis of four ginsenosides in P. notoginseng. The results of QAMS method were validated by comparing with that of external standard method, and no obvious significant difference was found.

Logistic regression analysis of the features of thyroid nodules on gray scale and color Doppler ultrasound / 中华超声影像学杂志

Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.

Study of endometrial carcinoma by using contrast-enhanced ultrasound / 中华超声影像学杂志

Objective To observe the enhancement pattern and time-intensity curve of endometrial carcinomas by using contrast-enhanced ultrasound(CEUS). Methods Altogether 30 endometrial carcinomas were evaluated with real-time gray-scale CEUS, using pulse inversion harmonies technique. The enhancement patterns were observed. Twenty tumors were compared for the size between traditional ultrasound and CEUS. In 21 cases, the parameters of time-intenaity curve were compared between the endometrial lesion and un-involved myometrium. Results The contrast agent arrived at the feeding vessels firstly and then branched into the endometrial tumors. All of the endometrial tumors were enhanced completely except for the necrosis area. In 73.3 % (22/30) of cases, the tumors washed out earlier than the un-involved myometrium. By using CEUS 76. 7% (23/30) of cases showed the feeding vessels of tumor. 43.3% (13/30) of cases showed more clearly than traditional ultrasound in tumor base, position and boundary. The mean enhancement sizes of tumor were bigger than the size showed by traditional ultrasound in 85% of cases by (0. 62±0.50)cm. More than 90% cases showed the tumors start to enhance and wash-out earlier than or at the same time as myometrium. The arrival time and peak time of cancer group were significantly earlier than myometrium group. The peak intensity, enhancement intensity and the rising rate of the tumor group were significantly higher than those of the myometrium group. Conclusions There are some characteristic points in CEUS of endometrial carcinomas. CEUS can provide richer information in tumor imaging than traditional ultrasound and has certain clinical value.

Diagnostic value of focal liver lesions by contrast-enhanced ultrasound: compare with contrast-enhanced CT / 中华超声影像学杂志

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.