核与辐射事故应急药物储备研究进展

在当前国际形势下,存在核战争和核恐怖发生的可能性,核与辐射事故应急不可懈怠。世界卫生组织(WHO)于2023年1月27日发布出版物,更新了应对辐射和核紧急情况建议储备的药物清单,这是自2007年以来的首次更新。出版物里建议的药物储备清单,包括防止或减少辐射影响的药物,以及在受照后用于治疗损伤的药物。围绕该药物清单,从核与辐射事故应急、应急药物储备概况、一些国家的药物储备和当前的思考等几个方面进行综述,以期为我国核与辐射事故应急医学救援提供参考。     

指甲电子顺磁共振信号在剂量重建中的研究进展

随着核技术在各方面应用的普及,核、辐射事故发生的潜在危险也在增加,一年前发生的福岛核事故使很多人改变了对核能利用的态度,即使平民百姓也有可能受到核事故产生的电离辐射的威胁[1].当核、福射事故的剂量达到1.5～4.5 Gy时,就可能会引起人体的生物效应,导致放射性疾病综合征.为了进行合理有效的医学应急处理,事故后进行快速准确的剂量重建,对事故现场人群的受照水平进行筛查是非常关键的一步[2].     

核和辐射事故医学应急救治准备实践

核能和辐射技术应用中,虽采取了一系列安全防护措施,但尚不能完全避免发生事故.针对核和辐射事故的发生及事故后的医学救援问题,国际原子能机构( IAEA)推荐了医学应急处理原则和一般程序.我国也已经建立了比较完整的核和辐射事故医学应急救援体系[1],并且开展了一系列医学应急准备工作.笔者按照核和辐射事故二级医疗救治的基本任务要求,结合医院基础建设和设施准备以及队伍培训、演练等工作实际,阐述了在核和辐射事故应急实践中的体会.     

核与辐射突发事件的医学救援

核与辐射突发事件是指突然发生的、由放射性物质或其他放射源造成或可能造成严重影响公众健康的紧急事件.一旦发生核与辐射突发事件,放射线在对机体损伤的同时,还会对人员造成心理和精神压力,导致一系列的社会心理效应.核与辐射突发事件的医学救援的关键是采取有效措施,最大限度地减轻核与辐射突发事件造成的人员伤害,维护社会稳定.本文从核与辐射突发事件发生后的人员防护、现场抢救、各类伤害的处置原则以及公众心理效应预防等方面作一阐述.     

日本核与放射事故医学应急体系及思考

核与放射事故医学应急是整个核应急工作的重要组成部分.其主要任务是对受照射人员进行及时、正确的医学处理,最大限度地减少人员伤亡和远期危害,有效地保护公众的安全与健康.为解决核与放射事故后的医学救援问题,国际原子能机构(IAEA)推荐了医学应急处理原则和一般程序[1-3].欧美一些发达国家在建立核与放射事故医学应急的体制机构方面积累了不少先进经验[4-5].我国也已经建立了比较完整的核与放射事故医学应急救援体系,并且开展了一系列医学应急准备工作[6-8].     

我国核与辐射事故应急关键技术及公众防护对策研究进展

核与辐射技术是一把"双刃剑".随着我国经济实力的增强,核与辐射技术在国民经济各个行业中的应用日益普及,我国核与辐射事故医学应急工作面临前所未有的挑战和发展机遇.     

我国核与辐射事故应急关键技术及公众防护对策研究进展

核与辐射技术是一把"双刃剑".随着我国经济实力的增强,核与辐射技术在国民经济各个行业中的应用日益普及,我国核与辐射事故医学应急工作面临前所未有的挑战和发展机遇.     

《卫生部核事故和辐射事故卫生应急预案》的解读

为适应当前我国核事故和辐射事故应急的新形势,进一步做好核事故和辐射事故卫生应急工作,卫生部近日对<卫生部核事故与放射事故应急预案>[1](以下简称<应急预案>)进行了修订,于2009年10月15日将修订后的<卫生部核事故和辐射事故卫生应急预案>[2](以下简称<卫生应急预案>)印发实施,并配发相关通知,要求各地、各有关单位切实做好突发核事件和辐射事件卫生应急工作[3].笔者结合参与<应急预案>修订所做的工作,谈谈学习和贯彻实施<卫生应急预案>的一些体会.     

日本福岛第一核电站事故中的应急照射及剂量管理

2011年3月11日,发生在日本宫城县附近海域的里氏9.0级强烈地震以及由此引发的巨大海啸,袭击了福岛第一核电站,最终导致国际核事件分级(INES)7级的核事故.该电站隶属于东京电力株式会社( TEPCO).事故期间,TEPCO及其合同商的大量人员进入福岛第一核电站进行应急作业.在系统设备严重损毁、环境辐射水平大幅升高等不利因素下,TEPCO如何对应急工作人员实施个人剂量控制和管理,这是应急照射管理关注的问题.     

海军医学研究系列讲座（18）：日本核事故应急医学研究进展

自19世纪末发现X射线及核能以来,人类一直在设法开发和利用放射线。应该说放射线和核能在能源、医疗、科研、育种等方面都得到了很好的应用。但是也应该看到,放射性污染或受放射线照射对健康及环境造成的危害,特别是核事故情况下的危害更为严重和持久。因此,预防核辐射事故的发生和在核辐射事故中实施正确的医学应急救援就显得非常重要。现将日本核事故应急医学研究进展介绍如下。     

Large differences in education and training of radiographers in Europe and Central Asia: Results from an IAEA coordinated study

IntroductionEducation and training of radiographers is known to be diverse between countries and regions. Under an IAEA project, this work collected data on radiographer education for the Europe and Central Asia region with a particular focus on radiation protection gaps and potential actions.MethodsFollowing piloting, an electronic questionnaire was distributed to all national counterparts for the IAEA Technial Coopearation (TC) Europe region (n = 33 countries) and nominated national representatives. Contacts were additionally invited to a virtual workshop to discuss and rank common problems in education and training of radiographers and to propose potential solutions.ResultsResponses were received from 31 countries, including 14 from the European Union. Just over half of countries reported radiographer education being in higher education with 71% having program durations more than 3 years (range: 1 month-4 years). Programs included a spectrum of both clinical training and radiation protection hours with ten-fold variations noted across the region. Inclusion of core radiation protection topics within curricula varied similarly, as did radiographers’ clinical involvement in both justification and optimisation between countries. Workshop participants identified five common training problems, namely education availability, lack of standardisation, radiation protection course quality, teamwork problems and lack of equipment.ConclusionRadiographer education in the IAEA Europe region is heterogeneous with substantial differences in duration and quality of training programs between countries, which likely impact on quality of patient care delivered. Common problems have been identified and potential solutions proposed to focus quality improvement initiatives.Implications for practiceRadiographer education and training is diverse throughout the IAEA TC Europe region, with likely impacts on radiation protection practices applied. Clinical involvement of radiographers in justification and optimisation differs, potentially limiting adherence to radiation protection principles.     

河南省杞县60Co卡源事件居民认知研究

目的 了解2009年6月河南省杞县利民辐照厂60Co卡源事件后,当地居民对核与辐射的知晓程度和对核能的接受性、对当地政府处理卡源事件的评价,以及对事件原因的分析.方法 2010年3月至4月,在杞县利民辐照厂10 km范围内,抽取5个乡镇的23个自然村和2所学校;在未受事件影响的135 km以外的辉县,选取3个乡镇的3个自然村和2所学校作为对照人群.对18岁以上的一般公众,意见代表(医生、教师、行政人员、官员、私营企业业主等)和学生(初三及高一),进行人户问卷调查.结果 本调查收回有效调查问卷1340份.两地居民对核与辐射的知晓程度都较低,杞县居民对核与辐射的知晓程度高于辉县.学生对核与辐射知识的知晓程度最高,意见代表次之,一般公众最低.男性、受教育程度较高者对核与辐射的知晓程度较高.40.0%以上的被调查者认为我国应当增加建设核电站,但仅一小部分被调查者支持在当地建设核电站,学生、受教育程度较高者更反对当地建设核电站.60%以上的一般公众和63.2%的意见代表"非常相信"或"比较相信"当地政府在"Co卡源事件中对他们的劝解.超过80%的受访者对当地政府在处理60Co卡源事件的能力持负面态度.与对政府官员的信任度评价相同,学生对当地政府的评价最低,意见代表次之,对政府的评价最高的为一般公众.60Co卡源事件导致大规模居民离家避险的主要原因有:谣言泛滥占67.2%、缺乏辐射知识占61.9%、随众效应占59.2%,以及政府未及时向群众公布事件真相占42.3%.结论 公众对核与辐射的了解较少.公众对当地政府的信任度比较高.但是对政府在处理60Co卡源事件中的表现不是很满意.学生的负面评价值得关注.     

河南省杞县60 Co卡源事件居民认知研究

目的 了解2009年6月河南省杞县利民辐照厂60Co卡源事件后,当地居民对核与辐射的知晓程度和对核能的接受性、对当地政府处理卡源事件的评价,以及对事件原因的分析.方法 2010年3月至4月,在杞县利民辐照厂10 km范围内,抽取5个乡镇的23个自然村和2所学校;在未受事件影响的135 km以外的辉县,选取3个乡镇的3个自然村和2所学校作为对照人群.对18岁以上的一般公众,意见代表(医生、教师、行政人员、官员、私营企业业主等)和学生(初三及高一),进行人户问卷调查.结果 本调查收回有效调查问卷1340份.两地居民对核与辐射的知晓程度都较低,杞县居民对核与辐射的知晓程度高于辉县.学生对核与辐射知识的知晓程度最高,意见代表次之,一般公众最低.男性、受教育程度较高者对核与辐射的知晓程度较高.40.0%以上的被调查者认为我国应当增加建设核电站,但仅一小部分被调查者支持在当地建设核电站,学生、受教育程度较高者更反对当地建设核电站.60%以上的一般公众和63.2%的意见代表"非常相信"或"比较相信"当地政府在"Co卡源事件中对他们的劝解.超过80%的受访者对当地政府在处理60Co卡源事件的能力持负面态度.与对政府官员的信任度评价相同,学生对当地政府的评价最低,意见代表次之,对政府的评价最高的为一般公众.60Co卡源事件导致大规模居民离家避险的主要原因有:谣言泛滥占67.2%、缺乏辐射知识占61.9%、随众效应占59.2%,以及政府未及时向群众公布事件真相占42.3%.结论 公众对核与辐射的了解较少.公众对当地政府的信任度比较高.但是对政府在处理60Co卡源事件中的表现不是很满意.学生的负面评价值得关注.

Abstract：

Objective To investigate radiation risk perception and nuclear acceptance after the 60Co stuck source incident in June 2009 in Qixian County,Henan Province.Methods From March to April 2010,23 hamlets and 2 schools from 5 towns in Qixian County were selected,while 3 hamlets and 2 schools from 3 towns were used as control in Huixian County,1 35 km away where no any impact of the incident was found.Face-to-face questionnaire survey was conducted among three groups including mass public,elite public(representatives of public opinion,such as physicians,teachers,govemmental officials,administrative personnel,private entrepreneurs),and middie school students(the third grade students in junior middle schools and the first grade students in senior middle schools).Results A total of 1 340 valid questionnaires were collected.The public knowledge levels about radiation and nuclear power were low among all groups in two areas and public knowledge levels in Qixian County were higher than those in Huixian County.In both areas.the knowledge levels of the students were higher tIIan those among the elite public,and that among the general public were the lowest.The knowledge levels of males and those with higher educational levels were higher than those of females and those with lower educational levels.More than 40.0% of the respondents supported the idea to build nuclear power plants in China.but only a small part of them supported to build nuclear power plants in their own areas.The percentages of opponents against local nuclear power plant construction were especially higher among the students and those with higher educational levels.More than 60% of the mass public and elite public believed the explanation of the government.More than 80% of the respondents held negative attitudes towards the performance of the Qixian County Government in dealing with this incident.The student gave the lowest evaluation of the credibility and the specific performance of the local government,whereas the elite public placed themselves between the students and the mass public.The reasons why the local people left their homes to evade risk included rumors(67.2%),lack of radiation knowledge(61.9%),group psychology(59.2%),and failure of the government to inform the truth to the public in time(42.3%).Conclusions The public still fails to know enough about radiation and nuclear power.Although they trust the government,they are dissatisfied with the performance of the local government in dealing with the incident.The negative evaluation of the students is worth concerning.     

How safe is Australian radiotherapy?

Many incidents and near-incidents are known to occur in Australian radiation oncology departments. The vast majority of incidents are minor in nature; however, a small percentage represent major threats to good patient care, administrative structures and public confidence. A small, but regular, number of incidents result in ad hoc local and/or state committees of enquiry or tort actions, and inevitably have substantial personal and departmental repercussions. Apart from some local databases on treatment-delivery incidents maintained by radiation therapists, no systematic data collection or analysis of treatment incidents exists for radiation oncology in Australia. The present paper argues the case for a prospective, systematic approach to the recording and analysis of treatment-related incidents and near incidents. Major barriers to such a scheme, including fear of litigation, misuse of information and lack of understanding on the nature of an incident are discussed.     

Communicating risk information in medical practice.

The public's preceptions about the risks of radiation are adversely influenced by the many negative reports by the media on the hazards of all radiation. As a result, patients express concern about the risks of radiation from radiologic examinations. Radiologists are well positioned to dispel these fears because of their training and their access to and ability to interpret information from scientific organizations specifically concerned with the determination of radiation risk. To do this, radiologists must be willing to communicate with patients and be accessible. Pamphlets and handouts can be given to anxious patients before examinations. In direct interaction with patients, the radiologist must listen to them and be prepared to address their concerns, especially those about repeat examinations, exposure during pregnancy, inadvertent exposure of the fetus, exposure of children, use of radiation in research, and misadministration of radionuclides. In addition, radiologists can help patients by educating referring physicians, other medical staff, and nurses. They can also reach the public by being a spokesperson at meetings of local organizations or by accepting opportunities to speak to the media. All these efforts help counteract negative perceptions aroused by the media.     

Current situation and future of gastric cancer screening examinations: from the viewpoint of gastric X-ray screening

In Japan, screening examinations for gastric cancer have been conducted for 50 years because of the high prevalence of this type of cancer. Gastric X-ray screening examinations have contributed to the detection early gastric cancer. In 2001, Hisamichi et al. reported that X-ray examination is a valid technique in gastric cancer screening. However, they indicated that problems in the uncertainty of accuracy and the risk of radiation exposure at a young age. On the other hand, endoscopic screening examination, pepsinogen-method and H. pylori method are not acceptable because of incident risk. Our future goals are to improve the precision of gastric X-ray examinations in cancer screening nationwide and to advocate for annual gastric screening examinations in higher risk groups. As a result, it is hoped that gastric cancer X-ray screening examinations can contribute to preventive medicine.     

Case of Triple Homicide and Attempted Suicide with Incidental Leucotomy-Like Effects

This article gives a background to police cooperation approaches in both Australia and the EU. Cooperation strategies are divided into Australian Federal/European Union strategies and regional (Australian state and territory and EU member states) cooperation strategies. Examples are highlighted where cooperation is hampered by national or state and territory sovereignty interests. Problems are discussed in relation to both entities, such as the different legal regimes, lack of trust, media attention and funding, the importance of the ‘personal factor’ andeducation. This article focuses in particular on the role of the practitioner. Practitioners, on the one hand, may overcome the negative attitude of their organisations and develop personal networks which transcend borders. On the other hand, a practitioner can embody the obstructive attitude of the organisation he/she represents. The article concludes by giving recommendations for future legislative and practical responses to the existing problems.     

The importance of education and training in reducing patient doses

Education and training in radiological protection of patients is an important part of a quality assurance program and it is recognised that the knowledge in radiation protection helps prescriber to a correct indication to procedures and practitioner to design and conduct an optimised examination. In the European Union, the international recommendations have been translated in the European Directive 97/43/Euratom asking proper education and training for professionals involved in medical exposures, both for diagnosis and therapy. International and European guidelines, together with guidelines proposed by international and national bodies and associations, are helping institutions to set up education and training programs. Several experiences and research projects have demonstrated the impact on reduction of patient doses when a quality assurance and training program in radiation protection has been conducted.     

Development of forensic medicine in Rwanda- past,present, and future perspectives

The Republic of Rwanda is a landlocked country with more than 12.6 million people. Similar to other nations in Africa, Rwanda is still developing its forensic medicine capabilities. This paper attempts to provide a concise history of forensic medicine in Rwanda, as well as a critique of the current state of affairs and recommendations for reform. The Rwanda Investigation Bureau (RIB) investigates any suspicious or unexplained deaths in the country, after which the body is sent to the nearest public hospital for medico-legal autopsy. Except for the Rwanda Forensic Laboratory, which has forensic practitioners with minimal training in forensic medicine, the majority of medical practitioners engaged in medicolegal activities in Rwanda lack forensic medicine training. To standardize medico-legal practices and forensic medicine education in the country, a competent medico-legal authority must be established to host frequent seminars, conferences, and various training programs for both forensic and non-forensic medicine experts.