深圳市2018年数字减影血管造影（DSA）放射防护分析

目的 了解深圳市2018年数字减影血管造影（DSA）介入诊疗场所的放射防护状况,为卫生行政部门放射卫生管理提供参考。方法 根据GBZ 130—2013的方法要求,对深圳市17家医疗机构的18台DSA设备进行状态检测,检测DSA设备透视防护区测试平面上的空气比释动能率和机房外的周围剂量当量率。结果 18台DSA设备透视防护区测试平面上空气比释动能率合格率为44.4%,透视防护区测试平面上空气比释动能率第二术者位结果略高于第一术者位,经非参数Wilcoxon秩和检验分析,差异无统计学意义（P > 0.05）,第一术者位的腹部位置和第二术者位的胸部位置所受的辐射剂量值最高。DSA设备机房外周围剂量当量率合格率为88.9%,机房外介入放射工作场所处于安全水平。结论 介入放射工作人员在诊疗活动中,应重视腹部区域的防护问题,重点关注第二术者位的防护问题,介入放射工作人员应自觉规范穿戴铅橡胶围裙等个人防护用品和使用辅助防护设施。     

杭州市部分数字减影血管造影介入诊疗工作场所辐射水平调查

目的了解杭州市DSA介入诊疗工作人员职业照射情况。方法对杭州市15家医疗机构22台DSA设备透视防护区工作人员位置空气比释动能率及工作机房外周围辐射水平进行调查,并对DSA介入诊疗工作人员个人剂量监测结果进行统计分析。结果 DSA机房外周围辐射水平合格率为90.1%,DSA设备透视防护区工作人员位置空气比释动能率合格率只有50%,第二术者位总体空气比释动能率要高于第一术者位,中部(胸部、腹部、下肢)检测点的空气比释动能率要远高于两端(头部和足部)。DSA介入诊疗工作人员个人平均年受照剂量为0.41 m Sv。结论杭州市DSA介入诊疗工作人员职业受照剂量水平较低,但开展DSA介入诊疗操作时要注意规范使用辅助防护设施和个人防护用品。     

2016年福建省34台数字减影血管造影(DSA)透视防护区空气比释动能率防护情况分析

目的了解2016年度福建省34台数字减影血管造影(DSA)机透视防护区的空气比释动能率以及符合GBZ130-2013标准限值要求情况;方法使用X、γ辐射剂量仪451P并按照GBZ130-2013方法进行检测。结果 34台DSA的透视防护区第一术者位和第二术者位的合格率为38.2%和29.4%,总合格率为29.4%,其中头部的合格率最高、腹部的合格率最低。荷兰飞利浦、美国GE、德国西门子、日本东芝的空气比释动能率均值为355.9±44.5μGy/h、574.2±136.4μGy/h、886.8±141.2μGy/h和771.9±170.5μGy/h;四个公司DSA透视防护平面区的腹部区域的空气比释动能率平均值高于其它部位;工作人员和患者的个人防护用品配置率达100.0%,辅助防护设施配置率为94.1%。结论加强DSA透视防护区放射防护。     

2016-2017年介入放射学工作人员职业性外照射个人剂量水平调查分析

目的 调查介入放射学工作人员的职业性外照射个人剂量水平和防护现状,为加强介入放射学工作人员的放射防护与监督管理提供科学依据。方法 采用热释光剂量测量方法监测介入放射学工作人员职业性外照射个人剂量当量H_p（10）,利用X、γ散漏射线巡测仪451P检测DSA设备透视防护区空气比释动能率。结果[HT5"SS]2016年共监测介入放射工作职业性外照射757人,有效监测536人,有效监测率为70.81%,人均年剂量当量为1.29 mSv;2017年共监测1 123人,有效监测309人,有效监测率为27.52%,人均年剂量当量为1.47 mSv;2017年不同岗位放射工作人员人均年剂量当量的差异有统计学意义（χ²=11.612,P<0.01）;第二术者位总体空气比释动能率要高于第一术者位,且头部空气比释动能值均高于其他部位。结论 2016—2017年介入放射学工作人员的外照射个人剂量处于较低剂量照射水平但有效监测率偏低;放射防护工作仍需不断完善,重点应加强对介入放射学工作人员及其管理人员的辐射防护培训。     

某医疗机构数字减影血管造影放射风险评估探讨

目的 评估某医疗机构放射风险水平,为医疗机构做好DSA的放射防护工作提供科学依据。方法 调查广州某医院的DSA放射防护基本情况和放射事故历史资料并进行现场剂量监测。参照国家有关法规标准,利用AS/NZS ISO31000: 2009风险评估指数矩阵法对DSA放射风险因素进行识别、分析和评价,并提出控制对策。结果 DSA机房外各检测点周围剂量当量率范围为0.17～1.69 μSv/h;近台同室操作中,第一术者位剂量当量率范围为95～153 μGy/h,第二术者位为82～318 μGy/h;放射工作人员年有效剂量范围为0.16～1.12 mSv,平均年有效剂量为（0.49 ±0.31） mSv。机房放射防护措施合理并有效,工作人员健康状况良好,基本符合相关法规标准要求。该医院DSA放射风险因素主要来源于设备安全性、环境安全和防护、人员安全和防护、安全与应急管理等4方面。初步确定设备参数安全不稳定、个人防护用品缺乏或失效、职业技能欠缺或操作失误、因手术复杂而增加透视时间、安全防护意识不足及无放射事故应急预案属于高风险事件。结论 初步建立了放射风险评估体系,能相对有效地评估该医院DSA机房的放射风险水平。     

介入放射X射线机的辐射防护性能检测与分析

目的检测和分析介入放射X射线机辐射的防护水平,对机房内工作人员防护区剂量水平进行研究。方法于2012年6月—2013年9月以《医用X射线诊断卫生防护监测规范》为参考依据。结果通过对介入放射X射线机进行研究发现,其有用线束入射体表空气的比释动能率的平均数值为9.6 m Gy/min,X射线源组件发生泄露辐射的平均数值是38 LGy/h,而防护区的空气比释动能率的平均数值是110 LGy/h。结论在透视的状态下,有用线束的输出量可以通过脉冲透视进行降低,而且还能降低工作人员防护区的空气比释动能率,因此在进行介入放射X射线机操作时,应该制定出相关的辐射防护监测技术标准方法。     

数字减影设备透视防护区测试平面剂量率检测与分析

目的分析数字减影血管造影X射线设备(简称DSA)透视防护区测试平面剂量率的特点,评价DSA设备在透视防护区的防护效果。方法结合2016年广西医疗卫生机构医用辐射防护监测项目,对监测哨点医院的DSA设备,按照《医用X射线诊断放射防护要求》(GBZ130-2013)要求,检测DSA设备透视防护区测试平面的剂量率。结果 17台DSA设备,有9台设备在透视防护区防护效果不合格。结论定期做好DSA设备防护性能检测和维护保养,保障介入放射工作人员的辐射防护与安全。     

凉山州41个放射诊疗单位建设项目放射防护控制效果评价

目的 为了解职业病危害控制效果,对凉山州放射诊疗单位建设项目职业病危害控制效果放射防护情况进行综合评价分析.方法 对41个放射工作单位的92台放射诊疗设备及场所进行检测,按照相关标准、法规和建设项目职业病危害控制效果放射防护报告规范的要求进行评价和分析.结果 放射工作单位放射诊疗设备及工作场所的检测结果 是合格的,立位透视防护区、卧位透视防护区、泄漏辐射符合要求,防护性能均符合要求,对放射工作人员的危害控制在较低水平.机房面积合格率比较过去有很大提高,医用x射线诊断机的机房面积的合格率达95.16%;CT机的机房面积合格率达92.31%.机房主防护墙、副防护墙的防护厚度都符合屏蔽要求.有部分X射线诊断机的四周墙体厚度达40 cm,增加了建设成本,没能达到防护最优化的原则.受检者防护用品的配置率较低.结论 建设项目职业病危害放射防护控制效果基本达到了要求,确保了放射工作人员和公众所接受的个人辐射剂量低于年剂量和剂量率控制目标值.     

2009-2017年南通市某三甲综合医院介入放射工作人员个人剂量和工作场所监测结果分析

目的 分析南通市某三甲医院介入放射工作人员2009-2017年个人剂量以及现场辐射状况,为保障医院介入放射工作人员健康提供数据支撑。方法 介入放射工作现场辐射剂量率检测采用辐射检测仪（AT1123）,个人剂量检测系统采用热释光剂量仪（RGD-3D、FJ-427A）。结果 该三甲医院2台介入设备透视防护区测试平面空气比释动能率为39.74~492.48 μGy/h、17.28~198.72 μGy/h,2009-2017年介入放射工作人员年个人剂量值均高于普放科室工作人员（2015年除外）,差异具有统计学意义。结论 介入放射科机房内的辐射剂量率要明显高于机房外,介入手术的工作人员个人剂量要明显高于其他放射工作人员。因此,介入放射工作人员应当正确佩戴个人防护用品科学操作介入放射设备。     

2016年西藏日喀则市医疗机构医用辐射防护现状调查分析

目的 了解西藏日喀则市医用辐射防护现状。方法 采用放射诊疗机构基本情况调查表进行现场调查并记录,根据放射卫生相关标准规范对所选取医疗机构的放射诊断设备进行性能质量控制检测和工作场所的放射防护检测,并对结果进行分析。结果 5家医疗卫生机构共检测设备13台,放射工作场所13个,合格率均为84.62%;其中DR合格率80%,CT合格率100%,影像增强透视机合格率为75%,不合格主要指标为DR的曝光时间指示偏离和影像增强器入射屏前空气比释动能率;个人防护用品平均配置率1.3件/台。结论 调查的5家医疗机构个人防护用品配置不足,工作人员防护意识缺乏;场所防护和设备性能检测均未严格根据相关标准规定执行。建议进一步加强放射诊疗设备管理与检测等相关工作。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

Changes in Fatty Acid Composition in Beef in Italy

Results from a study conducted in Italy concerning the updating of composition data of beef consumed in Italy are reported here. The study required a very wide sampling plan with regard to both animals and cuts to analyse. Data related to lipid composition of the most widely used type of beef consumed in Italy (young bull, 16–22 months old) show a reduction in total lipid content (which, according to the cuts, ranges between 1.8 and 10.2%) and a substantial change in fatty acid composition, with a high % of polyunsaturated fatty acids (mean 20% of total fatty acids). Such data have been confirmed by other studies conducted in Italy, and are in contrast with data reported in the tables of food composition from other countries, reporting a fatty acid composition characterized by a high fatty acid saturation degree. The occurrence of long-chain polyunsaturated fatty acid is probably due to the high ratio of phospholipids: triglycerides, occurring when the content in intramuscular lipid is very low; to the young age of animals; to the reduced activity of the rumen, where saturation of fatty acids occurs. It may be concluded that a fatty acid composition, which is particularly rich in polyunsaturated fatty acids, seems typical for Italian products.     

Changes in immune function in asthma in the elderly

Asthma is an inflammatory disorder of the airway. The airway inflammation of asthma is typically an allergic inflammation characterized by cells and mediators described as a "Th2" inflammatory response. There is a growing body of evidence describing changes in the function of immune cells upon aging, a phenomenon referred to as "immunosenescence". Several studies utilizing animal models and human subjects with asthma have begun to explore age-related effects on the airway inflammation in asthma. This review explores the existing data on the presence and effects of immunosenescence or age-related changes in immune function in asthma.     

Increase in social inequality in health expectancy in Denmark

AIMS: Health expectancy represents the average lifetime in various states of health and differs among social groups. The purpose of the study was to determine trends in social inequality in health expectancy since 1994 between groups with high, medium and low educational levels in Denmark. METHODS: The study was based on data from nationwide registers on educational level and mortality during the period 1994-2005 and data on health status derived from the Danish Health Interview Surveys carried out in 1994, 2000 and 2005. Expected lifetime in self-rated good and poor health, lifetime without and with longstanding illness and expected lifetime without and with long-lasting difficulties or restrictions were estimated by Sullivan's method. RESULTS: Between 1994 and 2005, life expectancy at age 30 years increased by 1.9 years for men and 1.5 years for women with a low educational level. For people with a high educational level, the increase was 2.7 years for men and 2.2 years for women. The difference between people with low and high educational level in expected lifetime in self-rated good health increased by 2.0 and 1.3 years for 30-year-old men and women, respectively. The social gap also increased for other indicators. CONCLUSIONS: During the past 12 years, social inequality in life expectancy and health expectancy has increased in Denmark, but the proportion of the population with a low educational level has decreased.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。