2021年国家级个人剂量监测能力比对结果与分析

目的 提升放射卫生检测机构的外照射个人剂量监测能力和水平,规范监测工作。方法 根据《外照射个人剂量系统性能检验规范》（GBZ 207—2016）制定比对方案,中国疾病预防控制中心辐射防护与核安全医学所和各省级监测机构分级组织2021年度个人剂量监测能力比对工作。结果 2021年参加国家级个人剂量监测能力比对的机构共有150家。其中143家合格（含优秀51家）,合格率95.3%（含优秀率34.0%）,7家不合格,不合格率4.7%。结论 相较于以往的全国性个人剂量能力考核,2021年国家级能力比对的合格率和优秀率有较大提高,但仍有包括4家甲级资质机构在内的7家机构结果不合格,检测机构需要认真查找原因,进一步提高检测能力。分级比对改善了组织机构和检测机构之间“点对面”的关系,有助于组织机构重点提升省级检测机构和甲级放射卫生技术服务机构的检测水平。     

2017年-2019年我国三级公立医院肿瘤住院患者医疗服务与质量安全分析

目的了解全国三级公立医院肿瘤住院患者医疗服务与质量安全现状。方法利用医院质量监测系统收集2017年1月-2019年12月三级公立医院肿瘤住院患者病案首页信息,对住院人次、平均住院日、次均费用、住院死亡率等指标进行描述性统计分析。结果2017年-2019年纳入分析的三级公立医院数量分别为1 768家、1 788家、1 799家,合计病案首页31 560 302份。3年来三级公立医院肿瘤住院患者住院人次呈增长趋势,平均住院日、次均费用以及住院死亡率均呈下降趋势。手术治疗、化学治疗、放射治疗是肿瘤住院患者常见治疗方式,肺癌、乳腺癌、结直肠癌、胃癌、肝癌是常见癌种,不同治疗方式、不同癌种的医疗服务与质量安全水平有差异。结论病案首页信息为我国开展肿瘤质控工作提供了参考。     

2008-2019年陕西省儿童大骨节病病情监测结果分析

目的掌握陕西省大骨节病病情变化,为制定大骨节病防治策略、调整大骨节病防治重点提供科学依据。方法在陕西省,2008年选取4个市6个病区县12个乡(镇)的15个行政村;2009-2011年,按全国大骨节病监测方案抽样要求,每年抽取7个病区县,每个病区县抽取4个乡(镇),每个乡(镇)抽取1个村;2012-2015年,每年选取31个病区县,2016-2018年,分别选取43、12、12个病区县,每个病区县抽取5个乡(镇),每个乡(镇)抽取3个村;2019年抽取全部62个病区县的全部病区村作为调查点。抽取7~12岁儿童(2009-2011年临床检查抽取7~16岁儿童)进行大骨节X线和临床检查。计算大骨节病临床阳性检出率、X线阳性检出率和干骺端阳性检出率,并进行病区病情判定。结果2009-2011年临床共检查7~16岁儿童7628人,2008、2012-2019年临床共检查7~12岁儿童323356人,均未检出大骨节病临床阳性病例。2008-2018年共对114199名7~12岁儿童进行大骨节病X线检查,检出X线阳性48例,检出率为0.04%(48/114199);其中干骺端阳性47例,检出率为0.04%(47/114199)。各年份X线阳性检出率均<3.0%,且2011年后全省儿童大骨节病X线阳性检出率和干骺端阳性检出率一直保持在0.10%以下,处于低位波动。2012-2016、2018、2019年监测的所有病区村均达到了大骨节病消除标准。2017年监测的195个病区村,99.49%(194/195)的病区村达到了消除标准。结论2008-2019年,陕西省大骨节病病情持续下降,病区村大骨节病病情均已达到消除水平,并处于持续消除状态。     

Vaccine complacency and dose distribution inequities limit the benefits of seasonal influenza vaccination,despite a positive trend in use

Sustainable demand for seasonal influenza vaccines is a component of national security strategies for pandemic preparedness. However, the ongoing COVID-19 pandemic has revealed many weaknesses in the capacity of countries to design and execute sustainable vaccination programs. An influenza pandemic remains a global threat and yet there is no global monitoring system for assessing progress towards influenza vaccination coverage targets. The International Federation of Pharmaceutical Manufacturers and Associations’ (IFPMA) Influenza Vaccine Supply International Task Force (IVS) developed a survey method in 2008 to estimate seasonal influenza vaccination coverage rates, which in turn serves as a crude estimate of pandemic preparedness. It provides evidence to guide expanded efforts for pandemic preparedness, specifically for increasing COVID-19 vaccine immunization levels. Furthermore, the results presented herein serve as a proxy for assessing the state of pandemic preparedness at a global and regional level. This paper adds data from 2018 and 2019 to the previous analyses. The current data show an upward or stable global trend in seasonal influenza vaccine dose distributed per 1,000 population with a 7% increase between 2017 and 2018 and 6% increase between 2018 and 2019. However, considerable regional inequities in access to vaccine persist. Three regions, Africa, the Middle-east, and Southeast Asia together account for 50% of the global population but only 6% of distributed seasonal influenza vaccine doses. This is an important finding in the context of the ongoing COVID-19 pandemic, as distribution of influenza vaccine doses in many ways reflects access to COVID-19 vaccines. Moreover, improving seasonal vaccine uptake rates is critical for optimizing the annual benefits by reducing the huge annual influenza-associated societal burdens and by providing protection to vulnerable individuals against serious complications from seasonal influenza infections.     

Posterior circumflex humeral artery pathology and digital ischemia in elite volleyball: Symptoms,risk factors & suggestions for clinical management

Objectives

To assess the association between posterior circumflex humeral artery (PCHA) pathology (PCHAP), symptoms and associated risk factors, in elite volleyball players, and to suggest profiles for clinical management and monitoring.

Role of DW-MRI and ADC value in monitoring therapy of head and neck squamous cell carcinoma

Aim

To evaluate role of DW-MRI and ADC value in monitoring therapy of head and neck squamous cell carcinoma (HNSCC).

免疫抑制剂用量对肾移植受者细胞因子谱系的影响

目的 探讨长期使用不同剂量的免疫抑制剂对肾移植受者细胞因子谱系的影响。方法 采用多种高灵敏度试剂盒，分别对存活3年以上，且长期使用低剂量免疫抑制剂者（低剂量组），使用常规剂量者（常规组）和慢性移植肾功能丧失者（失功组）的外周血多种细胞因子进行检测，分析细胞因子谱系的变化与临床用药量和移植效果的关系。结果 长期存活且肾功能正常者的白细胞介素4（IL-4）水平升高，在低剂量组升高尤其明显，而失功组明显降低；各组白细胞介素2受体（IL-2R）水平移植后均有升高，但低剂量组与正常人接近，失功组升高最明显；各组白细胞介素10（IL-10）和转化生长因子β1移植后均下降，前者在低剂量组和常规组中水平相近。后者以失功组下降最为明显。结论 细胞因子谱系与免疫抑制剂的用量和移植肾功能有关，监测IL-2R和IL-4可能对评价肾移植受者的免疫状态有帮助。     

Risk assessment and management of new and existing chemicals

An evaluation was made of the recently developed risk assessment methodologies for new and existing chemicals in the European Communities. The evaluation also included the methodologies to prioritize chemicals and procedures for risk management, i.e., the (draft) guidance document for the development of strategies for risk reduction. The way in which chemicals are prioritized is accepted with only very few comments. Clear progress has been made in the development and harmonization of risk assessment methodologies and the application of estimation methodologies. Nevertheless, improvements are necessary for the estimation of consumer and occupational exposure, the derivation, use and transparency of assessment factors for chemicals and classes of chemicals based on the mode of toxic action, environmental exposure models and their validation and relation with monitoring data. As far as risk management is concerned it was recommended to improve the integration of the myriad of directives and regulations, to clarify definitions, to provide clear guidance on the determination and weighing of advantages and implications of risk reduction measures and to develop tools, including voluntary agreements, to speed up the slow chemical-by-chemical approach.