Transcatheter arterial embolization (TAE) is the mainstay for treating advanced hepatocellular carcinoma (HCC), and the performance of the embolization material is crucial in TAE. With the development of medical imaging and the birth of "X-ray-free" technologies, we designed a new dual-mode imaging material of dimethoxy tetraphenyl ethylene (DMTPE) via emulsification by mixing poly(N-isopropylacrylamide-co-acrylic acid) (PNA) with lipiodol and fluorocarbons, which was evaluated for temperature sensitivity, stability, and dual-mode visualization in vitro. Additionally, blood vessel casting embolization and renal artery imaging were assessed in healthy rabbits. In a rabbit model with a VX2 tumor, the effectiveness of TAE for treating HCC was examined, with an emphasis on evaluating long-term outcomes of embolization and its effects on tumor growth, necrosis, and proliferation through imaging techniques. In vitro experiments confirmed that the temperature-sensitive dual-oil-phase Pickering emulsion had good flow, stable contrast, and embolism when the oil-to-oil ratio and water-to-oil ratio were both 7:3 ( v/v) and stabilized with 8% PNA. Similarly, in vivo, arterial embolization confirmed the excellent properties of DMTPE prepared at the abovementioned ratios. It was observed that DMTPE not only has an antitumor effect but can also achieve dual imaging using X-rays and ultrasound, making it a promising excellent vascular embolization material for TAE in tumor treatment.

Objective:To establish a risk predictive model nomogram of acute kidney injury (AKI) in critically ill patients by combining urinary tissue inhibitor of metalloproteinase 2 (TIMP2) and insulin-like growth factor-binding protein 7 (IGFBP7), and to verify the predictive value of the model.Methods:A prospective observational study was conducted. The patients with acute respiratory failure or circulatory disorder admitted to the intensive care unit (ICU) of Northern Jiangsu People's Hospital from November 2017 to April 2020 were enrolled. The patients were enrolled within 24 hours of ICU admission, and their general conditions and relevant laboratory test indicators were collected. At the same time, urine was collected to determine the levels of biomarkers TIMP2 and IGFBP7, and TIMP2·IGFBP7 was calculated. Patients were divided into non-AKI and AKI groups according to whether grade 2 or 3 AKI occurred within 12 hours after enrollment. The general clinical data and urinary TIMP2·IGFBP7 levels of patients between the two groups were compared. The indicators with P < 0.1 in univariate analysis were included in the multivariate Logistic regression analysis to obtain the independent risk factors for grade 2 or 3 AKI within 12 hours in critical patients. An AKI risk predictive model nomogram was established, and the application value of the model was evaluated. Results:A total of 206 patients were finally enrolled, of whom 54 (26.2%) developed grade 2 or 3 AKI within 12 hours of enrollment, and 152 (73.8%) did not. Compared with the non-AKI group, the patients in the AKI group had higher body mass index (BMI), pre-enrollment serum creatinine (SCr), urinary TIMP2·IGFBP7 and proportion of using vasoactive drugs, and additional exposure to AKI (use of nephrotoxic drugs before enrollment) was more common. Multivariate Logistic regression analysis showed that BMI [odds ratio ( OR) = 1.23, 95% confidence interval (95% CI) was 1.10-1.37, P = 0.000], pre-enrollment SCr ( OR = 1.01, 95% CI was 1.00-1.02, P = 0.042), use of nephrotoxic drugs ( OR = 2.84, 95% CI was 1.34-6.03, P = 0.007) and urinary TIMP2·IGFBP7 ( OR = 2.19, 95% CI was 1.56-3.08, P = 0.000) was an independent risk factor for the occurrence of grade 2 or 3 AKI in critical patients. An AKI risk predictive model nomogram was constructed based on the independent risk factors of AKI. Bootstrap validation results showed that the model had good discrimination and calibration in internal validation. Receiver operator characteristic curve (ROC curve) analysis showed that the area under the ROC curve (AUC) of urinary TIMP2·IGFBP7 alone in predicting grade 2 or 3 AKI within 12 hours in critical patients was 0.74 (95% CI was 0.66-0.83), the optimal cut-off value was 1.40 (μg/L) 2/1?000 (sensitivity was 66.7%, specificity was 85.0%), and the predictive performance of the model incorporating urinary TIMP2·IGFBP7 was significantly better than that of the model without urinary TIMP2·IGFBP7 [AUC (95% CI): 0.85 (0.79-0.91) vs. 0.77 (0.70-0.84), P = 0.005], net reclassification index (NRI) was 0.29 (95% CI was 0.08-0.50, P = 0.008), integrated discrimination improvement (IDI) was 0.13 (95% CI was 0.07-0.19, P < 0.001). Conclusion:The AKI risk predictive model based on urinary TIMP2·IGFBP7 has high clinical value and is expected to be used to early predict the occurrence of AKI in critically ill patients.

Objective:To analyze the clinical features and follow-up data in children with neuropsychiatric lupus erythematosus (NPSLE), and provide reference for the diagnosis and treatment of NPSLE.Methods:The clinical data of 22 children with NPSLE who were admitted to the Department of Rheumatology Immunology and Allergy, Children′s Hospital of Zhejiang University School of Medicine from January 2019 to March 2022 were included and were followed-up for 24~60 months. The data were analyzed retrospectively. Statistical descriptive analysis was performed using the SPSS 23.0.Results:Twenty-two (26.8%, 22/82) children with NPSLE occurred in the hospitalized children with SLE during the study period. The ratio of male to female was 1∶4.5, and the onset age was (10.7±2.0) years. Among these cases, 86.4% (19/22) patients were newly diagnosed and had severe disease activity and 16 cases (72.7%) occurred within 1 month after disease onset. Nineteen cases (86.4%) had mucocutaneous involvement, 16 cases (72.7%) had lupus nephritis, 14 cases (63.2%) had hematological system involvement, 13 cases (59.1%) had skeletal muscle involvement, 10 cases (45.5%) had serositis, 10 cases (45.5%) were complicated with hypertension, and 8 cases (36.5%) with macrophage activation syndrome (MAS). The main clinical symptoms of the nervous system included headache (11/19, 57.9%), dizziness (10/19, 52.6%), listlessness (7/19, 36.8%), blurred vision (4/19, 21.1%), convulsions (3/19, 15.8%), lethargy (2/19, 10.5%). Twenty patients (20/22, 90.9%) demonstrated abnormal signals on brain MRI, 7 cases (7/12, 45.5%) showed abnormal signals on brain CT, 10 cases (10/22, 45.5%) showed abnormal waves on EEG, and 6 cases (6/20, 30.0%) demonstrated abnormal results of cerebrospinal fluids analysis. The follow-up duration was 34 (28, 48) months. Clinical remission or low disease activity was found in 19 patients (86.4%), and no death were observed. Three cases had residual cerebral infarction lesions, no neurological sequelae were found in all patients.Conclusion:The most common symptoms of NPSLE in children are headache and dizziness, which are more likely to occur in patients with initial onset and severe disease activity, and approximately 36.5% children with NPSLE may complicated by MAS.The results of 24-60 months follow-up showed that the prognosis of the disease is good.

Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.

Surfactant is a kind of substance that can significantly reduce the surface/interface tension.Surfactant is an important substance that affects the preparation technology,stability and safety of nanoformulation.By combing the structure classification of surfactants and their function mechanism in nanoformulation,combined with the research status at home and abroad,the application and research of surfactants in the listed nanoformulation were described,in order to provide reference for the research and development of new nanoformulation.

Objective To investigate the social support needs of medical staff in Guangzhou during the post-COVID-19 period,providing a basis for relevant departments to offer targeted social support for medical staff in Guangzhou and improve their of occupational quality of life.Methods A cross-sectional survey was conducted,employing a combination of quota and conven-ience sampling to select subjects,eligible medical staff were invited to complete an online questionnaire.Results The social sup-port with a total score of 20 for medical staff in Guangzhou scored 9(7,11).Among the dimensions of social support,media sup-port scored the lowest.Social support as a whole scored with statistically significant differences across groups of different age,ed-ucational background,and job position(all P＜0.05).The median score was the lowest for those under 25 years,for those with a college degree or below,and highest among administrative staff,with other positions showing equal median score.The five di-mensions of social support ranked on the top concerning the total number of the respondents included patients'understanding and trust for medical staff(93.03％),increasing in salaries and benefits(86.06％),accurate policy promotion and public opinion guidance by media(83.41％),attention to the living conditions of medical staff by media(80.29％),and enhanced regulation of false reporting and inappropriate commentary by media(76.92％).Medical staff under the age of 25 had a high need for pa-tients'following doctor's advice,and medical staff with a collegiate degree or below had a high need for family members or friends to care about their physical and mental health.The five strongest needs for social support ranked on the top concerning the total number of respondents included understanding and trust from patients(75.72％),increased salaries and benefits(53.85％),assistance with household matters by family or friends(42.55％),correct policy promotion and public opinion guidance by media(34.62％),and attention to the living conditions of medical staff from media(33.41％).Conclusion Social support for medical staff in Guangzhou are at a relatively low level,indicating a need for social support from all levels of society.

Objective:To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia.Methods:From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method.Results:Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated ( R=0.7671, P<0.001). Conclusion:Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

Objective To investigate the application effect of red furnace massage tank therapy in the patients with wind-cold Bizu type Xiangbi disease.Methods Eighty patients with wind-cold Bizu type Xiangbi disease admitted to this hospital from March 2022 to March 2023 were selected as the study subjects and di-vided into the test group and control group according to the random number table method,40 cases in each group.The control group was given the conventional treatment,the test group was given the red furnace mas-sage tank therapy.The cervical vertebral function symptoms,pain degree and clinical effect on 14 d after inter-vention were evaluated.The patients were followed up in 1 month after intervention.Results After interven-tion,the improvement degree in the test group was superior to that in the control group[total effective rate:100.0％vs.87.5％,VAS score:0.5(0,1.0)point vs.1.0(0,1.0)point,cervical spondylosis symptom scale(NPQ)score:(3.55±1.83)points vs.(5.15±2.99)points,Tanaka Yasuhisa score:(17.05±1.32)points vs.(14.88±2.10)points],and the differences were statistically significant(P＜0.05).No adverse reactions occurred in both groups.Conclusion Red furnace massage tank therapy could effectively improve the pain symptoms and cervical vertebral function of the patients with wind-cold Bizu type Xiangbi disease.

Primary ciliary dyskinesia(PCD)is a rare monogenic disorder primarily associated with structural and functional abnormalities of motile cilia.It is typically inherited in an autosomal recessive pattern.The disease affects multiple organs,and the variability in clinical phenotypes,along with genetic heterogeneity significantly complicates its diagnosis.Although the application of clinical exome sequencing has significantly improved the diagnostic rate of PCD,more than 30％of patients are still unable to obtain a definitive diagno-sis.This article reviews and discusses the pathogenesis,diagnostic methods,and expanding genetic diag-nostic approaches for patients with PCD that are negative for exome sequencing.The aim of this article is to assist clinicians in selecting more advanced emerging genetic testing technologies,with the hope of increasing the positive diagnostic rate of PCD,deepening the understanding of its genetic pathogenesis,and laying a foundation for the practice of gene therapy in the future.

[Objective]This study aims to investigate the awareness and educational needs regarding fertility preservation(FP)among healthcare professionals in clinical departments of hospitals at various levels in Southern China.[Methods]An online questionnaire survey was conducted from November 1,2022,to April 1,2024,targeting healthcare professionals in clinical departments from various levels of hospitals in Southwest and South China,including those working at and trained in our hospital.A total of 398 questionnaires were collected.After excluding 14 invalid questionnaires,384 valid responses were analyzed.Data collected included region,gender,age,job title,years of work experience,educational background,awareness of FP and educational needs.An ordinal Logistic regression analysis was performed to identify factors influencing FP awareness among healthcare professionals.[Results]Among the 384 healthcare professionals surveyed,there were 256 physicians and 128 nurses.Approximately 98.96%of the respondents believed that FP is important for family and social health development.Among various FP methods,the awareness rate of egg freezing was the highest,with awareness rates of 98.44%for physicians and 99.22%for nurses.Peer communication was the primary source of FP knowledge for healthcare professionals,with 92.97%of physicians and 89.06%of nurses acquiring FP knowledge through peer communication.Univariate analysis indicated that educational background,department,and work location were significantly associated with FP awareness(P<0.05).Multivariate Logistic regression analysis revealed that profession and department were key influencing factors(P<0.05).[Conclusion]With the promotion of FP in recent years,the awareness of FP among healthcare professionals has improved but remains insufficient.Although the awareness rate of FP among healthcare professionals in this survey is higher than that in previous studies,it is still only 78.13%,especially the wareness rate of ovarian tissue freezing technology is low,with the awareness rates of physicians and nurses being 69.53%and 53.13%,respectively.Appropriate educational strategies and directions should be adopted for different healthcare groups to further enhance their awareness of FP,thereby better serving patients in need.