目的 分析2018-2022年全国放射诊疗设备质量控制检测技术培训情况,总结培训效果.方法 收集整理中国疾病预防控制中心辐射防护与核安全医学所2018-2022年举办的"全国放射诊疗设备质量控制检测技术培训班"资料,分析培训执行情况.结果 2018-2022年共举办5期"全国放射诊疗设备质量控制检测技术培训班";培训天数均为4天;授课教师中具有正高级职称的比例为87.5％(35/40);共培训放射卫生专业技术人员1045人次,其中87.1％(910/1045)具有本科及以上学历,75.1％(785/1045)为中级及以下职称;培训合格率为97.7％(905/926);在培训关键环节如授课内容、教学安排等方面,学员满意度均高于96.0％.结论 全国放射诊疗设备质量控制检测技术培训工作执行情况良好,培训合格率和满意率均达到95.0％以上,培训效果良好,有助于专业人员更好地了解和掌握放射诊疗相关设备的质量控制检测技术,促进放射卫生继续医学教育高质量发展.

Objective:To determine the peak skin dose (PSD) to patients from neuro-interventional procedures and evaluate the risk of the deterministic effect.Methods:Gafchromic XR RV3 films were used in a level A tertiary hospital in Beijing to measure the patients′ PSD from neuro-interventional procedures, mainly three common types of procedures, including vascular embolization, vascular angioplasty and vascular angiography. The films were scanned by Epson Expression 10000XL, read by ImageJ software, and analyzed by Film QA Pro?2014 software.Results:PSD was measured in 23 embolizations, 14 stentings and 12 arteriography. There were 20 patients whose PSD were equal or greater than 2 Gy, including 15 in vascular embolization and 5 in angioplasty. The PSDs to patients in cerebral arteriography were all below 2 Gy. The PSDs to some of the patients were higher than the threshold for deterministic effect recommended by ICRP Publication 118.Conclusions:There is a risk of deterministic effect in neurointerventional procedures. It is suggested that the patients be followed up to observe their radiation injury as well as to know in time the subsequent diagnosis and treatment.

目的:研究含铅与无铅防护服的衰减性能及防护效果,为其合理使用提供科学依据.方法:检测常用的含铅和无铅两种防护服的衰减比及铅当量值,比对研究两种防护服随X射线管峰值管电压的变化规律.结果:在两种防护服中,无铅防护服的衰减比及其铅当量相对于含铅防护服而言,随着X射线峰值管电压的变化较大,约为12％.结论:同等标称铅当量的无铅防护服,其防护效果优于含铅防护服,但应标明检测时对应的X射线峰值管电压(kVp).

Objective To investigate the entrance surface dose to the examined patients in radiography using digital and screen-film system in hospitals at different levels in 15 provinces and municipalities in China,in order to provide data for developing diagnostic reference level of radiography suitable for our national physical characteristics.Methods According to the requirements of the Technical Study on Medical Radiation Hazard Assessment and Control,the examined patients aged 20-70 years were selected,with body weight ranging from 55 to 80 kg for male and 50 to 70 kg for female.TLDs were used to measure the entrance surface dose to adult patients in radiography.No less than 10 examined patients were required at each body position,with examined locations including head (PA,LAT),chest (PA,LAT),abdomen (AP),pelvis (AP),lumbar (AP,LAT),and thoracic vertebra (AP,LAT).Results A total of 19 975 individuals undergoing radiography and 1 813 radiographic equipment of different types including screen-film radiography,computed radiography (CR) and digital radiography (DR),were investigated in 342 hospitals in 15 provinces and municipalities throughout the country.For these three types of equipment,the average entrance surface dose to the examined were 1.75,1.9,and 1.15 mGy in head (PA),1.69,1.46and 1.03 mGy in head (LAT),0.75,0.65 and 0.36 mGy in chest (PA),1.81,1.26 and 0.88 mGy in chest (LAT),4.37,3.77 and 2.15 mGy in abdomen (AP),3.73,3.56 and 2.75 mGy in pelvis (AP),5.49,5.84 and 4.17 mGy in lumbar (AP),12.01,9.37 and 6.82 mGy in lumbar (LAT),4.53,3.65 and 2.49 mGy in thoracic vertebra (AP),and 6.91,6.43 and 4.15 Gy in thoracic vertebra (LAT).Conclusions Entrance surface dose caused by radiography examination varies dependent on different exposure locations.Entrance surface doses caused by digital radiography are all lower than by screen-film radiography;those caused by digital radiography are lower than by computed radiography,except for thoracic vertebra (AP).In all examinations,no difference of statistical significance is found between CR and screen-film radiography in entrance surface dose.

目的:在分析标准实验室中的校准依据、方法的基础上,对常用的环境及个人剂量监测用热释光剂量计(TLD)进行校准评价,方法:按照国际标准化组织(ISO)、国际辐射单位与测量委员会(ICRU)及国际辐射防护委员会(ICRP)等相关国际标准,以及我国现行有效的国家标准(GB、GB/T),在国际原子能机构(IAEA)北京二级标准剂量学实验室(SSDL)的标准辐射场中对TLD进行校准.结果:国产TLD的线性及能量响应等项性能均符合国际和国内相关标准的要求.结论:经过校准的TLD可以用于放射场所及工作人员的个人剂量监测.

目的 分析个人剂量监测技术培训工作开展情况,以更好地提升个人剂量监测技术培训质量.方法 通过收集整理中国疾病预防控制中心辐射防护与核安全医学所2014-2018年举办的“个人剂量监测技术培训班”资料,应用Excel 2010分析培训执行情况.结果 2014-2018年共举办5期“个人剂量监测技术培训班”;培训天数以3～4天为主;授课教师中具有正高级职称的比例为88.6％ (31/35);中级及以下职称学员所占比例为79.6％ (656/824);绝大多数学员具有本科及以上学历;学员普遍对授课内容、教学安排和教材编写等培训关键环节比较满意.结论 个人剂量监测技术培训工作执行情况良好,提升了技术服务机构的个人剂量监测质量和技术水平,应继续做好个人剂量监测技术培训工作.

Objective To investigate the CT scanning parameters in hospitals at different levels in 15 provinces and cities in China and the doses to patients undergoing CT examination,in order to provide the basis for establishing CT diagnostic reference level suitable for our country.Methods As required in the implementation program for Technical Study on Medical Radiation Hazard Assessment and Control,the information on the patients examined and the CT scanning parameters in clinical practices were investigated.The CT dose index (CTDI100,CTDIW,CTDIVOL) of CT scanner was measured by using the CT ionization chamber.The dose length product (DLP) was calculated on the basis of the scan length of the patients examined.Results A total of 6 524 CT scanning procedures and 483 different types of CT scanning equipment were surveyed in 166 hospitals in 15 provinces in China.For head,chest,abdomen,and lumbar vertebrae,the average weighted CTDIW were 43,15,19 and 25 mGy,respectively,and the third quartile of CTDIw were 50,19,23 and 32 mGy,respectively.The average DLP were 540,397,503 and 376 mGy· cm,respectively.The third quartile of DLP were 659,525,632 and 479 mGy· cm respectively.Conclusions Through this survey,the doses to CT-examined patients in some provinces were basicly ascertained.The third quartile of doses to four body parts of the examined patients are different from the diagnostic reference level given in publications in other countries and regions.It is important to establish the CT diagnostic reference level suitable for our CT-examined patients according to Chinese national physical characteristics and therefor to promote the optimization of medical radiation protection in CT examination.

Objective: To carry out comparative study on energy respond characteristics of 4 kinds of medical diagnostic X-ray dosimeters that included general new imported equipment and domestic equipment.Methods: In the standard radiation field of secondary standard dosimetry laboratory(SSDL)of IAEA,substitution method was adopted to complete contrast measurement of 10 kinds of X-ray diagnosis radiations which voltage were 60-150 kV,tube current were 10 mA and 2.5 mmAl was used as filterable addition.Results: The results of energy respond performances of domestic RD-98 diagnosis dosimeter and imported dosimeter indicated that all of these responses of different energy to dose were within ±5％when X-ray range was 6-150 kV.Conclusion: The energy response characteristics of 4 kinds of new diagnosis X-ray dosimeter were better,and the response of different energy to dose conforms to the requirement of IEC in diagnosis dosimeters of semiconductor detector and air ionization chamber.

Objective:To establish the X-ray standard was used to calibrate Hp(3) dosimeter in order to satisfy the requirement of eye-lens dose equivalents for the radiological occupational staff.Methods:The conventional values (Hp(3)) on the reference point of the narrow beams of X-ray fields were obtained by means of the product of air kerma (Kair) and the conversion coefficients (hp(3,ɑ)) recommended by ICRP116 recommendation. And these researches can be used by standard ionization chamber dosimeter. Finally, provided the conventional true value Hp(3) at calibrate point.Results:The standards and calibration program of calibrations eye-lens dose equivalent dosimeter were established under the X-ray radiation field. The detection error between slab phantom recommended by ISO and head phantom recommended by the 116th publication of ICRP was lower when the TLD was used to detect result.Conclusions:The standards for calibration Hp(3) dosimeters can satisfy the requirement of calibration for radiological occupational staff. It also provides theoretical foundation for detection data that assessed Hp(3) dosimeters and then improves trace ability and reliability of detection data of Hp(3) in national radiation supervision and inspection network.

Objective To provides reasonable and feasible suggestions for radiological protection to interventional staff by measuring the dose level in different auxiliary protective facilities at the standing position of interventional staff.Methods According to the characteristics of DSA equipment,451P ionization chamber tourimeter was used to measure the ambient Dose Equivalent rate at different heights of interventional staff with using different auxiliary protective equipment.The effect of radiological protection was compared between different auxiliary protective facilities.Results The dose level of double-tube exposure is much bigger than that of the single-tube exposure.The shielding effect of using a lead semen for the first surgeon is better than the second surgeon.The using of a lead screen in double-tube exposure can reduce the dose of 31％ ～ 99％ for the first surgeon and reduce the dose of 12％ ～90％ for the second surgeon.The using of a lead screen in single-tube exposure can reduce the dose of the first surgeon 4％ ～ 65％ of the dose,and reduce the 2％ ～ 30％ of the dose for the second surgeon.The dose of head,chest and abdomen of interventional staff can be significantly reduced through improving the existing auxiliary protective facilities,but the protective effect to the foot is not obvious.Conclusion The using of lead screens and improving the auxiliary protective equipment can shield the X-rays of interventional staff in varying degrees,it can protect interventional staff and reduce the radiation dose level.

Objective To establish a method for reducing the dose to the eye lens of interventional staff,and provide the data basis for improving radiological protection measures.Methods One piece of interventional equipment coupled with conventional auxiliary protective devices and two types of common neural interventional procedures were selected to monitor 46 and 35 procedures before and after the device modification.The doses to the eye lens of staff were measured with direct-reading dosimeters for analysis of dose trends.Results After modification of the devices,the average dose to the left eye lens decreased from (9.71 ±10.86) to (3.23 ±5.59) μSv for the first operator,from (9.51 ± 12.34) to (0.68 ± 0.78) μSv for the second in cerebral angiography;whereas the dose decreased from (14.83 ± 19.13) to (4.17±4.59) for the first operator and from (14.12±21.76) to (1.23 ±1.57)μSv for the second in embolization procedure,respectively.The left eye lens doses measured before and after the modification showed significant difference (U =-2.760,-2.467,-1.967,-2.655,P ＜0.05).Conclusions The modification of the auxiliary radiological protective devices may effectively reduce the dose to the eye lens dose.This method was shown to be feasible for the improvement of radiological protection of interventional staff.

Objective To analyze the effect on the advanced training in radiation hygiene in National Institute for Radiological Protection,China CDC,during the “12th Five Year Plan”,and discuss the key role of the further education in improving the professional knowledge and the whole capacity in above area.Methods Based on the current situation,find out the problems,realize the cause and provide the solution,to further explore the core work in training and management system.Results Sine the most refresher staff are young with,low professional titles,short-time training and poor professional skill,personalized training plan was developed to promote the whole capacity in practical skill and scientific research work.Conclusion The advanced training is making an important role in improving the expertise level and abilities of young talents,thereby promoting the capacities in the whole professional field.

Objective To establish the method for extremity dose measuring for interventional staff,and compare the extremity dose to interventional staff on traditional interventional devices with single X-ray tube to that on the new devices with double tubes,and thus support the monitoring of the doses and the improvement of the radiological protection.Methods Thethermoluminescence dosimeters (TLD) were calibrated with personal dose equivalent Hp (0.07).The extremity doses of 231 person-time from 4 kinds of interventional procedures were measured on 2 interventional devices with single X-ray tube and 3 devices with double X-ray tubes.The doses obtained on different kinds of interventional devices were analyzed.Results The TLD shows good linear fitting with Hp (0.07) calibration.The extremity doses,which in the therapeutic procedures were higher than those in the graphic ones,perform positively relevance to the exposure time.Comparing the same kind of interventional procedures on devices with double and single X-ray tubes,the former shows shorter exposure time with higher extremity dose to interventional staff than the latter.Conclusion The interventional devices with double X-ray tubes significantly improve the efficiency of the interventional procedures while increase the dose to interventional staff.The radiological protection should be strengthened to protect the health of the interventional staff.

Objective To establish the methods for measuring the dose to occupational staff's eye lens in interventional procedures with direct-reading dosimeters,and to realize the real-time monitoring of eye lens dose and warning for high dose rate,thus providing the scientific basis of the staff radiological protection in interventional procedures.Methods Direct-reading dosimeters were calibrated with personal dose equivalent HP (3).The eye lens doses for occupational staff in different kinds of interventional procedures were measured by the devices with both single-and double X-ray tubes.The data obtained fromthe direct-reading dosimeters was compared to those obtained from TLDs.Results Direct-reading dosimeters showed good linear fitting with the calibration of HP (3),and the coefficients of variation were lower than 5％.The average eye lens HP (3) for the main operator in coronary arteriography and stent implantation in brain obtained by direct-reading dosimeters were 12.0 and 24.5 μSv,respectively,whereas those obtained by TLDs were 11.9 and 22.7 μSv,respectively.The direct-reading dosimeters gave similar t~nds as TLDs do so.The direct-reading dosimeters were able to provide eye lens HP (3) in each individual interventional procedure,and to monitor the real-time dose rate as well.Conclusions The calibration of HP (3) and the data gained by direct-reading dosimeters are reliable.Therefore,the methods for real-time measurement of eye lens dose for occupational staff in interventional procedures are successfully established.

Objective To establish methods of measuring the eye lens dose to interventional staff,to obtain relevant dose data and to provide a scientific basis for reducing eye lens dose.Methods Two kinds of dosimeters,thermoluminescent dosimeter (TLD) and optically stimulated luminescence dosimeter (OSLD),were selected to measure the personal dose equivalent HP (3) to eye lens of occupational staff in several kinds of interventional procedures,including cardiovascular interventional procedures,cerebrovascular interventional procedures etc.Five types of Digital Subtraction Angiography (DSA) equipment were chosen in the study,including single tube equipment and double tube equipment.Results The eye lens dose HP (3) to interventional staff varied significantly with different interventional procedures.The lowest dose is shown in the coronary angiography procedure,while the highest dose shown in the cerebral stenting procedure.For the same type of interventional procedure,the eye lens dose to the primary interventionist was the highest.For same interventionist,the dose to the left eye was obviously higher than that to the right eye.In addition,the measured results of OSLD were apparently higher than that of TLD.Conclusions Both TLD and OSLD could be used to measure eye lens dose,and the ways of calibrating TLD to evaluate personal dose equivalent HP (3) were feasible.The reason of significant difference between the measured results of TLD and OSLD needs further research.

Objective To establish the standard X/γ radiation fields with respect to the wrist dosimeter calibration curve as required by the international electrotechnial commission (IEC) technical specifications and the relevant national standard.Methods Air-kerma rate was determined in the X-ray beams,137Cs and 60Co radiation fields by a standard dosimeter.The wrist thermduminescent dosimetry (TLD) dosimeter was calibrated with personal dose equivalent values Hp (0.07) on the organization for standardization(ISO) wrist-phantom based on the radiation fields.Results The standard X/γ radiation field for the wrist dosimeter irradiation was established.Conclusions Established X/γ standard radiation field can be used for suc h technical services as wrist dosimeter calibration curve and energy response characteristics experiment.

Objective:To establish an information management system that can cover the public health special projects and can simplify the management process, realizing network management. Methods: According to the job functions and tasks undertaken, as well as the requirements analysis of the public health special projects information management system, we organized the system development and design.Results: We organized the development of the public health special projects information management system, including five modules, such as project management, statistical reports, query management, human resource management and system management. The system realized the network management of the public health special work, consisting of application, interim evaluation, summary and the relevant audit work. Meanwhile, the system set the public health special work platform of declaration, supervision and integrated management, improving the work efficiency significantly and ensuring the smooth development of radiological health and medical response to nuclear emergency.Conclusion: The application of this system has greatly promoted the ability of technological administration and work efficiency, providing an effective management platform and modern means to promote the standardization and scientification of radiological health and medical response to nuclear emergency.

目的 通过调查全国15个省市不同级别医疗机构乳腺X射线摄影曝光参数并测量计算受检者乳腺平均剂量,分析我国乳腺X射线摄影中受检者压迫后乳房厚度分布及乳腺受照剂量水平,为建立适合我国成年女性受检者乳腺X射线摄影的剂量指导水平提供依据.方法 按照《医用辐射危害评价与控制技术研究》实施方案的要求,调查临床实际乳腺摄影受检者的年龄、乳房压迫厚度、曝光参数、摄影体位等相关信息,通过手动曝光测量该条件下乳房压迫厚度处的入射空气比释动能(Ka,i),计算受检者的乳腺平均剂量(AGD).结果 共在全国15个省的149家医院调查了4372例乳腺X射线摄影体位,273台不同类型乳腺X射线摄影设备,包括屏片乳腺X射线摄影、计算机乳腺X射线摄影(乳腺CR)和直接数字乳腺X射线摄影(乳腺DR)设备,对于这三种类型的设备,头尾(CC)位投照时受检者AGD的平均值分别为1.21,1.77,1.61 mGy,AGD的75％位分别为1.36,2.22,1.81 mGy;斜侧(MLO)位时受检者AGD平均值分别为1.02,1.78,1.66 mGy,AGD的75％位分别为1.23,2.46,1.81 mGy.CC位和MLO位时乳房压迫厚度的中位数分别为4.2和4.5 cm.结论 不同类型乳腺X射线摄影设备中,屏片乳腺X射线摄影设备致受检者的乳腺平均剂量最低,其次是乳腺DR设备,乳腺CR设备致患者剂量最高.

目的 分析与研究放射卫生继续医学教育工作,为提高放射卫生继续医学教育质量提供参考.方法 通过收集整理中国疾病预防控制中心辐射防护与核安全医学所2005至2015年度举办的国家级继续医学教育项目的资料,应用Excel 2010、SPSS 19.0对项目执行情况进行统计分析.结果 2005至2015年度获批项目执行率为100.00％;培训天数以4至6天为主;授课教师中具有正高级职称的比例为89.66％(390/435);所有继教项目主要安排理论授课;中级及以下职称学员群体所占比例为68.10％ (5383/7904);不同年份学员职称分布不完全相同(x2=61.06,P=0.000);所有学员中具有本科学历的占大多数;学员普遍对培训内容比较满意.结论 2005至2015年度项目总体执行情况良好,为做好全国放射卫生与核应急工作打下了坚实的基础,今后将加强项目监督和评价,提高培训项目质量.

Objective: To research on the postgraduate cultivation mode in medical and health research institutes and to improve the postgraduate quality. Methods: Through the current situation of postgraduate cultivation, we adopted the mode from four aspects including ideological and moral character, education, scientific research and management. We carried out the research integrity education, improved the postgraduate scientific moral level, set the curriculum according to the requirements, enhanced the basic training and promoted the postgraduate academic ability through combining education with practice. Results: The four integration mode can improve the postgraduate cultivation quality. It is beneficial to play an important role in the scientific research. Conclusion: Medical and health research institutes attach great importance to the postgraduate cultivation and optimize the cultivation mode. It is realistically significant to improve the quality of postgraduate cultivation.