OBJECTIVE To formulate the Expert Consensus on the Management of Radiopharmaceuticals in Medical Institutions （hereinafter referred to as “the Consensus”）， focusing on key aspects such as the procurement of radiopharmaceuticals， the management of self-made radiopharmaceutical preparations， standardized clinical application， and patient medication safety management， so as to provide a reference for improving the whole-process management of radiopharmaceuticals in medical institutions.METHODS The Consensus was initiated by the Chinese Society of Nuclear Medicine， the Clinical Pharmacy Professional Committee of the China Anti-Cancer Association， and the Committee of Integrative Oncology Pharmacy of the China Anti-Cancer Association. Organized by the consensus drafting group more than 90 experts from the fields of nuclear medicine， nuclear pharmacy， and pharmacy science across China were involved. The Consensus was developed through systematic review of relevant laws， regulations， policy documents， and existing experience in radiopharmaceutical management， followed by extensive discussion and deliberation to finalize the consensus. RESULTS &CONCLUSIONS The Consensus establishes 10 key points for whole-process management of radiopharmaceuticals in medical institutions， covering organizational management and personnel requirements， procurement， preparation， acceptance， storage， risk prevention and control during use， radiation protection， and waste disposal. The Consensus provides a reference for improving radiopharmaceutical management in medical institutions and for ensuring their efficacy and safety in clinical application.

Peanut, a major economic and oil crop known for the high protein and oil content, is extensively cultivated in China. Peanut plants have the ability to form nodules with rhizobia, where the nitrogenase converts atmospheric nitrogen into ammonia nitrogen that can be utilized by the plants. Analysis of nodule fixation is of positive significance for avoiding overapplication of chemical fertilizer and developing sustainable agriculture. In this study, AhNIGT1.2, a member of the NIGT family predominantly expressed in peanut nodules, was identified by bioinformatics analysis. Subsequent spatiotemporal expression analysis revealed that AhNIGT1.2 was highly expressed in nodules and showed significant responses to high nitrogen, low nitrogen, high phosphorus, low phosphorus, and rhizobia treatments. Histochemical staining indicated that the gene was primarily expressed in developing nodules and at the connection region between mature nodules and peanut roots. The fusion protein AhNIGT1.2-GFP was located in the nucleus of tobacco epidermal cells. The AhNIGT1.2-OE significantly increased the number of peanut nodules, while AhNIGT1.2-RNAi reduced the number of nodules, which suggested a positive regulatory role of AhNIGT1.2 in peanut nodulation. The AhNIGT1.2-OE in roots down-regulated the expression levels of NRT1.2, NRT2.4, NLP1, and NLP7, which indicated that AhNIGT1.2 influenced peanut nodulation by modulating nitrate transport and the expression of NLP genes. The transcriptome analysis of AhNIGT1.2-OE and control roots revealed that overexpressing AhNIGT1.2 significantly enriched the differentially expressed genes associated with nitrate response, nodulation factor pathway, enzymes for triterpene biosynthesis, and carotenoid biosynthesis. These findings suggest that AhNIGT1.2 play a key role in peanut nodulation by regulating nitrate transport and response and other related pathways. This study gives insights into the molecular mechanisms of nitrogen and phosphorus in regulating legume nodulation and nitrogen fixation, and sheds light on the development of legume crops that can efficiently fix nitrogen in high nitrogen environments.
Arachis/physiology* ; Nitrates/metabolism* ; Plant Proteins/physiology* ; Transcription Factors/metabolism* ; Plant Root Nodulation/physiology* ; Gene Expression Regulation, Plant ; Root Nodules, Plant/metabolism* ; Nitrogen Fixation

Objective To analyze the relationship between clinical drug utilization and the risk of nosocomial infections among hospitalized patients,and provide evidence for the prevention and control of nosocomial infections.Methods This study adopted a retrospective case-control design.The case group included 209 patients with nosocomial infection reported from January 2023 to December 2023 in a tertiary hospital.The control group included 209 patients without nosocomial infection during the same period.The patients in the control group were selected by stratified sampling based on Charlson Comorbidity Index(CCI).Results Univariate analysis showed that proton pump inhibitors,antacids,immunosuppressants and prior antimicrobial combination therapy increased the risk of nosocomial infection(P＜0.05).Multivariate log-binomial regression analysis showed that proton pump inhibitors,immunosuppressive drugs,and prior antimicrobial combination therapy were correlated with nosocomial infection.The corresponding relative risk(RR)was 1.31(95％CI:1.07-1.60),1.40(95％CI:1.02-1.91),and 1.66(95％CI:1.01-2.74),respectively.Further analysis indicated that the patients with nosocomial infection had longer time in use of proton pump inhibitors and prior antimicrobial combination therapy than the patients in the control group(Z=-6.331,P＜0.001;Z=-2.667,P=0.008).The trend Chi-square test showed that there was a dose-response relationship for proton pump inhibitors(x2=73.869,P＜0.001),immunosuppressive drugs(x2=16.530,P＜0.001),and prior antimicrobial combination therapy(x2=35.107,P＜0.001).Conclusions The use of immunosuppressants,proton pump inhibitors and antimicrobial combination therapy increases the risk of nosocomial infections in hospitalized patients.The prolonged use of these drugs will further increase the risk of nosocomial infection.

Objectives:To investigate the relationship between locations of ventricular septal perforation and 30-day prognosis in patients with acute myocardial infarction complicated by ventricular septal perforation.Methods:Clinical data of 150 acute myocardial infarction patients with ventricular septal perforation admitted to Fuwai Hospital of Chinese Academy of Medical Sciences and People's Hospital of Xinjiang Uygur Autonomous Region from January 2009 to October 2023 were retrospectively analyzed.Kaplan-Meier method was used to compare the difference in 30-day survival rate among patients with different sites of ventricular septal perforation.The impact of locations of ventricular septal perforation on 30-day prognosis of acute myocardial infarction patients was evaluated by multivariate Cox regression analysis(forward stepwise).Results:In acute myocardial infarction patients,the occurrence of anterior ventricular septal perforation was higher than that of posterior ventricular septal perforation(79.5%vs.20.5%,P<0.001).In the anterior ventricular septal perforation patients,females were more common(50.0%vs.22.6%,P=0.006),the blood glucose level was higher([10.51±5.99]mmol/L vs.[8.02±2.81]mmol/L,P=0.026),the left ventricular end-diastolic diameter was smaller([50.7±6.1]mm vs.[55.1±5.0]mm,P<0.001),the ventricular septal aperture was also smaller([9.8±4.6]mm vs.[12.6±5.4]mm,P=0.004),30-day mortality was higher(55.8%vs.35.5%,P=0.043)compared with posterior ventricular septal perforation patients.Multivariate Cox regression analysis(forward stepwise)showed that no transthoracic surgery or transcatheter closure(HR=26.344,95%CI:8.261-84.009,P<0.001)and anterior ventricular septal perforation(HR=2.432,95%CI:1.281-4.619,P=0.007)were associated with increased risk of 30-day all-cause mortality in patients with acute myocardial infarction complicated by ventricular septal perforation.Conclusions:In patients with acute myocardial infarction complicated by ventricular septal perforation,the incidence of anterior ventricular septal perforation is higher than posterior ventricular septal perforation and the 30-day all-cause mortality of anterior ventricular septal perforation patients is also higher.No transthoracic surgery or transcatheter closure and anterior ventricular septal perforation are the independent influential factors of 30-day all-cause mortality in patients with acute myocardial infarction and ventricular septal perforation.

Objective:To analyze the efficacy and safety of a modified cystic wall peeling method combined with Zhang′s tension-reduced suture in the treatment of sebaceous cysts.Methods:Twenty-eight patients with sebaceous cysts, 22 males and 6 females, aged 18-44 (27.3±5.7) years, who were treated with modified cystic wall peeling combined with Zhang′s tension-reduced suture at the 940 Hospital of the Joint Logistic Support Force from July 2022 to October 2023 were prospectively included. A simple cyst peeler was self-made using a sterile tear duct probe with a diameter of 0.5 mm and a length of 7.3 cm. The skin was incised directly when the cyst protruded <5 mm from the skin surface; a shuttle incision was used to remove excess skin when the cyst protruded ≥5 mm from the skin surface. After incision of the skin, the cavity between the cyst wall and the surrounding normal tissue at the incision site was peeled off with ophthalmic scissors, and the cyst peeler was inserted into the cavity up to the bottom of the cyst and rotated along the cystic wall for 1 week to achieve complete blunt peeling within the cyst from the surrounding normal tissue. After the peeling was completed, the sebaceous cyst was squeezed by hand to discharge the cystic wall and its contents; if it could not be discharged, the cyst contents were released first and then squeezed. Absorbable sutures were used to close the residual cavity with Zhang′s tension-reduced suture, and then the incision was closed intermittently with non-absorbable sutures, and the surgical site was bandaged with pressure. Postoperative follow-up was performed for 1 year by telephone or WeChat to assess the overall postoperative effective rate, overall satisfactory rate, modified sebaceous cyst score and incidence of incisional scarring hyperplasia, and to record the occurrence of adverse reactions.Results:The preoperative modified sebaceous cyst score of 28 patients was (5.39±1.34) scores, which decreased to (0.25±0.59) scores one year after surgery, and the difference was statistically significant ( P<0.001). The overall postoperative effective rate was 100% (28/28), and the overall satisfactory rate was 96.4% (27/28), and all patients had no scarring hyperplasia. One patient had localized epidermal necrosis at the skin edge of the chest incision, one patient had erythema and scattered ecchymosis in the surgical area of the buttocks, and one patient had pain at the surgical site of the left upper extremity, which were cured after symptomatic treatment. Conclusion:Modified cystic wall peeling combined with Zhang′s tension-reduced suture is effective in the treatment of sebaceous cysts, and the incidence of adverse effects is low.

Objective To evaluate the feasibility and effectiveness of 3D digital holographic imaging combined with intraoperative navigation technology in the context of partial nephrectomy.Methods A total of 46 patients who underwent laparoscopic partial nephrectomy in the Department of Urology at the Second People's Hospital of Hefei City between June 2023 and January 2025 were randomly assigned to either the experimental group or the control group.The experimental group(n=23)utilized preoperative planning and intraoperative real-time navigation based on 3D digital holographic imaging,whereas the control group(n=23)relied on preoperative planning using optimized two-dimensional images obtained via contrast-enhanced CT and MRI scans.Preoperative data—including gender,age,body mass index(BMI),tumor diameter,and RENAL score—were collected.Intra-operative parameters such as total operative time,warm ischemia time,intraoperative blood loss,hemoglobin levels,postoperative hospitalization duration,and time to drain removal were recorded.Renal function changes were assessed by comparing serum creatinine levels and estimated glomerular filtration rates(eGFR)before surgery and one month post-surgery.Additionally,the incidence of intraoperative complications—particularly injury to the renal collecting system—and postoperative complications—including positive surgical margins,bleeding,subcutaneous emphysema,and urinary fistula—was analyzed.Results In this study,holographic images were successfully reconstructed for 23 patients with renal tumors in the experimental group.Each anatomical structure—including the kidney and tumor lesions,collecting system,renal arteries and veins,adrenal glands,and inferior vena cava—was color-coded to enable intuitive visualization.These images were used for preoperative planning and provided real-time spatial orientation to accurately locate and guide resection of the tumor during surgery.In the control group,23 patients underwent preoperative planning based on contrast-enhanced CT and MRI scans acquired using optimized parameters.All 46 patients underwent laparoscopic partial nephrectomy performed by the same qualified surgeon,and postoperative pathological analysis confirmed renal tumors,including 27 cases of clear cell carcinoma,7 cases of chromophobe cell carcinoma,5 cases of papillary cell carcinoma,2 cases of sarcomatoid carcinoma,and 5 cases of angiomyolipoma.No significant differences were observed in baseline clinical characteristics(including age,body mass index,tumor diameter,and RENAL score)between the two groups(P＞0.05).The experimental group showed significantly lower values in total operative time,warm ischemia time,intraoperative blood loss,pre-to postoperative hemoglobin changes,and pre-surgical to one-month post-surgical creatinine changes compared to the control group(P＜0.01).Additionally,the experimental group exhibited smaller changes in hospitalization duration,time to drain removal,and glomerular filtration rate from preoperative to one month post-surgery;however,these differences were not statistically significant(P=0.175,P=0.331,and P=0.273).There were no intraop-erative complications or damage to the collecting system in either the experimental or control groups.Postopera-tively,the control group experienced one case of positive surgical margin,one case of hemorrhage,and one case of subcutaneous emphysema.No statistically significant differences were observed between the groups(P＞0.05).Conclusions 3D digital holographic imaging combined with intraoperative navigation technology,based on the fusion of MRI and CT data,facilitates preoperative planning and precise intraoperative guidance.This approach helps reduce operative time,preserve renal function,and lower perioperative risks while ensuring therapeutic efficacy.

Objective To analyze the relationship between clinical drug utilization and the risk of nosocomial infections among hospitalized patients,and provide evidence for the prevention and control of nosocomial infections.Methods This study adopted a retrospective case-control design.The case group included 209 patients with nosocomial infection reported from January 2023 to December 2023 in a tertiary hospital.The control group included 209 patients without nosocomial infection during the same period.The patients in the control group were selected by stratified sampling based on Charlson Comorbidity Index(CCI).Results Univariate analysis showed that proton pump inhibitors,antacids,immunosuppressants and prior antimicrobial combination therapy increased the risk of nosocomial infection(P＜0.05).Multivariate log-binomial regression analysis showed that proton pump inhibitors,immunosuppressive drugs,and prior antimicrobial combination therapy were correlated with nosocomial infection.The corresponding relative risk(RR)was 1.31(95％CI:1.07-1.60),1.40(95％CI:1.02-1.91),and 1.66(95％CI:1.01-2.74),respectively.Further analysis indicated that the patients with nosocomial infection had longer time in use of proton pump inhibitors and prior antimicrobial combination therapy than the patients in the control group(Z=-6.331,P＜0.001;Z=-2.667,P=0.008).The trend Chi-square test showed that there was a dose-response relationship for proton pump inhibitors(x2=73.869,P＜0.001),immunosuppressive drugs(x2=16.530,P＜0.001),and prior antimicrobial combination therapy(x2=35.107,P＜0.001).Conclusions The use of immunosuppressants,proton pump inhibitors and antimicrobial combination therapy increases the risk of nosocomial infections in hospitalized patients.The prolonged use of these drugs will further increase the risk of nosocomial infection.

Objective:To investigate the effect of circular RNAs (circRNAs) expressions in peripheral blood of residents around radon hot springs.Methods:Totally 51 residents around radon hot springs were selected as the radon hot sping group, and another 51 residents around non-radon hot springs were selected as the control group. Questionnaires were used to collect demographic information and the radon exposure levels in the two groups. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative expressions of selected circRNA candidates in peripheral blood of the two groups. Mann-Whitney U test was used to compare the differences in the relative expressions of the circRNAs between the two groups. Results:The cumulative doses of radon exposure per capita for residents around radon hot springs was (111.47±99.03) mSv, with dose range 3.32-458.68 mSv. The difference in the relative expressions of hsa_circ_0040573 between the two groups was statistically significant ( Z=-2.88, P<0.05). The expression of hsa_circ_0040573 was suppressed by radon exposure ( t=-2.52, P<0.05) with a dose-dependent manner ( H=12.21, P<0.05). Conclusion:Hsa_circ_0040573 has a potential to serve as a radiological response biomarker for radon exposure, contributing to early diagnosis and monitoring of health risks associated with radon exposure.

Objective:To investigate the feasibility and value of nomogram based on base line clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics for pretreatment predicting the depth of myometrial invasion and tumor grade of endometrioid endometrial carcinoma (EEC).Methods:Preoperative baseline clinical characteristics and DCE-MRI characteristics of 194 EEC patients were prospectively collected at Obstetrics and Gynecology Hospital, Fudan University from October 2020 to January 2022 and used as a training set. Univariate analysis was conducted to compare baseline clinical characteristics and DCE-MRI quantitative parameters [including tumor volume, and mean, median, and standard deviation of volume transfer constant (K trans), rate constant (K ep), extravascular extracellular volume fraction (V e), and initial area under the enhancement curve (iAUC)] between patients with deep myometrial invasion (DMI) and those with superficial myometrial invasion (SMI), as well as between high-grade and low-grade EEC. Multivariate logistics regression analysis was used to identify independent predictors for the construction of nomogram. An independent external testing set comprising 127 EEC patients was retrospectively collected from Zhongshan Hospital, Fudan University and Zhongshan Hospital, Fudan University (Xiamen Branch). The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used for evaluating the model′s predictive performance and clinical net benefit, respectively. Results:(1) The depth of myometrial invasion: univariate analysis showed that in the training set, the EEC patients with DMI differed significantly from those with SMI in clinical characteristics including higher proportion of postmenopausal state and overweight [body mass index (BMI)≥25 kg/m2], and abnormal levels of serum cancer antigen (CA) 125, CA 199, and human epididymis protein 4 (HE4), and in DCE-MRI quantitative parameters including tumor volume, and median, mean, and standard deviation of K trans, median of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, CA 199, tumor volume, and mean of iAUC were independent predictors of the depth of myometrial invasion, and constructed the nomogram (recorded as Nomogram_1), achieving an AUC of 0.861 (95% CI: 0.803-0.919) in the training set. In the independent external testing set, the AUC was 0.876 (95% CI: 0.815-0.938), with corresponding sensitivity of 82.0%, specificity of 80.7%, accuracy of 81.1%, positive predictive value (PPV) of 65.3%, and negative predictive value (NPV) of 91.0% for predicting DMI. (2) The EEC grade: univariate analysis showed that in the training set, high-grade EEC patients differed significantly from low-grade EEC in clinical characteristics including patient′s age, the proportion of postmenopausal state and overweight, and abnormal levels of serum CA 125, and in DCE-MRI quantitative parameters including tumor volume, median, mean, and standard deviation of K trans, median and mean of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, tumor volume, and median of V e emerged as independent predictors of EEC grade, and constructed the nomogram (recorded as Nomogram_2), achieving an AUC of 0.845 (95% CI: 0.786-0.893) in the training set. While in the external testing set, the AUC was 0.819 (95% CI: 0.744-0.894), with corresponding sensitivity of 72.4%, specificity of 72.4%, accuracy of 72.4%, PPV of 43.8%, and NPV of 89.9% for predicting high-grade EEC. (3) The DCA curves demonstrated that both Nomogram_1 and Nomogram_2 yielded obvious positive clinical net benefits across a wide range of threshold probabilities. Conclusion:The nomogram based on pretreatment clinical and DCE-MRI characteristics has the potential to noninvasive predict the depth of myometrial invasion and grade of EEC, providing valuable reference information for clinical management decision-making.

Objective:To understand the activity concentrations of varying chemical forms of 131I in nuclear medicine workplaces and assess the internal irradiation doses of 131I to workers. Methods:A high-volume air sampler was used for air sampling of 131I. Glass fiber filters, activated carbon filters, and iodine cartridges, which were connected in series, were employed to collect aerosol iodine, gaseous inorganic iodine, and gaseous organic iodine, respectively. A method for analyzing the activity of 131I unevenly distributed in the iodine cartridge was developed, and an HPGe γ spectrometer was used to determine the activity of 131I in samples collected from the nuclear medicine workplaces of 15 hospitals. Results:The concentrations of aerosol iodine, inorganic iodine, and organic iodine in 15 hospitals were determined at 0.19-206.67, 0.27-138.45, and 2.35-3 821.11 Bq/m 3, respectively, with arithmetic means of 22.04, 12.79 and 365.08 Bq/m 3, respectively. The maximum annual committed effective doses of varied forms of 131I inhaled by workers were determined at 0.19, 0.19, and 3.81 mSv, respectively, with a maximum total committed effective dose of 4.13 mSv. Conclusions:Gaseous organic iodine is identified as the primary form of 131I in the air within nuclear medicine workplaces. Therefore, it is necessary to highlight the monitoring and protection of gaseous organic iodine.