TLD质量核查调强放射治疗非均匀野剂量方法

目的核查放射治疗计划系统(TPS)计算病人治疗剂量的非均匀野剂量校正。方法将插有TLD的聚苯乙烯固体模体,聚苯乙烯/肺固体模体,聚苯乙烯/骨固体模体分别经CT扫描,影像分别传入TPS并计算高能X射线下监督单位数,使传递给中心束轴TLD剂量为2 Gy。在高能X射线下完成TLD照射,照射后的TLD经测量、剂量计算,D(TLD)与D(TPS)剂量比值在0.95~1.05范围为可接受范围。结果核查结果表明,光子线束均匀模体轴上(P)剂量和非均匀骨模体轴上(BP)剂量核查结果较好。非均匀肺模体轴上(LP)和离轴(LL)剂量核查结果误差很大。结论光子线束非均匀性剂量校正在放射治疗中是非常重要,尤其是肺组织。校正不当,对于肺组织剂量误差也可达到11.1%,离轴情况下更多达18.4%。对于骨组织剂量误差较小。     

肉类样品中总汞的直接测定方法研究

目的探讨直接测定肉类样品中汞含量的方法。方法应用测汞仪建立汞标准应用液含量标准曲线,肉类样品经粉碎机捣碎后称取适量直接测定汞含量,并与原子荧光光谱法测定汞含量进行比较。结果试验筛选出肉类样品直接测定法最佳测定条件分别为干燥温度200℃,时间1 min;分解温度650℃,时间1.5 min。标准曲线相关系数≥0.999 8,加标回收实验汞回收率93%-98%,标准物质质控样品测定相对标准偏差4.79%-5.37%,与原子荧光光谱法测定汞含量差异无统计学意义（t=0.608,P〉0.05）。结论采用测汞仪直接测定样品中总汞含量,方法简便、快速、准确、重复性好、样品勿须前处理。     

National survey of physicians in Japan regarding their use of diagnostic tests for legionellosis

IntroductionBacterial culture remains the gold standard for the diagnosis of legionellosis. However, past reports indicate that most physicians use the urinary antigen test (UAT) alone. Combining it with other tests is important, especially in patients with negative UAT results. The aim of this study was to investigate the current situation of legionellosis diagnostics and clarify the issues that need to be addressed.MethodsBetween March 1, 2021 and April 30, 2021, a questionnaire survey was conducted in an anonymous manner among physicians working in Japan. Questionnaires were generated on a website and asked questions in a multiple-choice format.ResultsValid responses were received from 309 physicians during the study period. Most (92.9%) physicians reported using UAT as the initial test for patients suspected of having legionellosis, and <10% reported using other tests (e.g., culture, nucleic acid amplification test [NAAT], Gimenez staining, and serum antibody titer measurement [ATM]). When the initial test result was negative, 63% of physicians reported not conducting additional tests. Even when they chose to run additional tests, at most 27.8%, 23.6%, 12.3%, and 10.4% of all physicians used NAAT, culture, Gimenez staining, and serum ATM, respectively. The major reasons for not using tests other than UAT were “unavailability in the medical facility,” “long turn-around time,” and “difficult to collect sputum.”ConclusionsThe present survey revealed that most physicians in Japan used UAT alone for diagnosing legionellosis. Eliminating barriers to creating a reasonable environment and edification of physicians are needed to improve the current situation.     

Progress in prophylactic human papillomavirus (HPV) vaccination in 2016: A literature review

Prophylactic human papillomavirus (HPV) vaccine represents a revolutionary step forward in preventing HPV-related cancers, especially cervical carcinoma. Alongside appropriate screening, it has the potential to dramatically reduce cervical cancer incidence and even eradicate it. Following extensive evaluations in clinical trials, the first decade of routine HPV vaccine use provides overwhelming evidence of the vaccines’ safety and their real-life effectiveness. In 2016, further clinical trials showed high vaccine efficacy in adult women, especially those that were HPV DNA-negative at baseline, and indicated possible protection from HPV-related diseases after treatment of precancerous cervical lesions. The recommendation for a two-dose schedule in individuals under 15 is further supported for all three licensed vaccines by immunogenicity studies that show non-inferior immune responses and similar clinical efficacy compared to the three-dose schedule. So far, natural competition between HPV types has not been confirmed and therefore vaccine-induced clinically significant type replacement is unlikely. The real-world effectiveness data showed cross-sectional reduction in the prevalence/incidence of vaccine-related HPV types, genital warts and precancerous cervical lesions in countries and regions with HPV vaccination coverage. These declines were evident not only in vaccinated females, but also in unvaccinated females and males, strongly suggesting herd protection. Despite an excellent safety profile consistently demonstrated in clinical trials and confirmed in real-life settings, recently invented controversial syndromes allegedly linked to HPV vaccines temporarily compromised some previously very successful vaccination programs and significantly contributed to the failure of HPV vaccine implementation in some countries with the highest prevalence of cervical cancer. However, several safety studies failed to confirm any association of these syndromes with HPV vaccination in various settings and geographic locations. The main challenges remain implementing HPV vaccination in national vaccination programs, especially in low-and middle-income countries with the highest burden of cervical cancer, and achieving and sustaining high vaccine coverage rates.     

Feasibility of biochemical verification in a web-based smoking cessation study

Background and aimsCogent arguments have been made against the need for biochemical verification in population-based studies with low-demand characteristics. Despite this fact, studies involving digital interventions (low-demand) are often required in peer review to report biochemically verified abstinence. To address this discrepancy, we examined the feasibility and costs of biochemical verification in a web-based study conducted with a national sample.MethodsParticipants were 600 U.S. adult current smokers who registered on a web-based smoking cessation program and completed surveys at baseline and 3 months. Saliva sampling kits were sent to participants who reported 7-day abstinence at 3 months, and analyzed for cotinine.ResultsThe response rate at 3-months was 41.2% (n = 247): 93 participants reported 7-day abstinence (38%) and were mailed a saliva kit (71% returned). The discordance rate was 36.4%. Participants with discordant responses were more likely to report 3-month use of nicotine replacement therapy or e-cigarettes than those with concordant responses (79.2% vs. 45.2%, p = 0.007). The total cost of saliva sampling was $8280 ($125/sample).ConclusionsBiochemical verification was both time- and cost-intensive, and yielded a relatively small number of samples due to low response rates and use of other nicotine products during the follow-up period. There was a high rate of discordance of self-reported abstinence and saliva testing. Costs for data collection may be prohibitive for studies with large sample sizes or limited budgets. Our findings echo previous statements that biochemical verification is not necessary in population-based studies, and add evidence specific to technology-based studies.