Objective:To explore the diagnostic reference level(DRL)of computed tomography(CT)based on size-specific dose estimate(SSDE)for child's head,and estimate the SSDE by using tube current time production.Methods:The CT data of head of 1259 pediatric patients who underwent CT examination in Children's Hospital of Nanjing Medical University from January 2023 to December 2023 were retrospectively collected.They were divided into six groups according to different ages:<6 months group,6 months to<1 year group,1 to<3 years group,3 to<6 years group,6 to<12 years group,and≥12 years group.Additionally,they were divided into five groups based on body size:<12.5 cm group,12.5 to<14 cm group,14 to<15 cm group,15 to<16 cm group,and≥16 cm group.The volume CT dose index(CTDIVOL),tube current time production(mAs),left and right diameter(LRD),area(AROI)and CT value(CTROI)of region of interest of different age groups were respectively measured and recorded.The water equivalent diameter(DW),conversion factor(f H16)and SSDE based on DW(SSDEDW)were calculated.The DRLs distribution based on age and body size was analyzed by statistic method,and the correlation between DW and mAs was analyzed by regression analysis,and a regression model between SSDEDW and mAs was further established.The intra-group correlation coefficient(ICC)was used to analyze the consistency.Results:In DRLs of various age groups,the CTDIVOL range and SSDEDW range were respectively(12.32 mGy-21.66 mGy)and(13.47 mGy to 17.83 mGy).In the DRL of various body size groups,the CTDIVOL range and SSDEDW range were(13.52 mGy-21.86 mGy)and(13.91 mGy-17.92 mGy).In different ages group of pediatric patients,the range of deviation rates of local DRL(LDRLs)value of radiation dose on head of CTDIVOL value to SSDEDW was-8.54%-21.48%.There were strong positive correlations between DW and mAs at 100 and 120 kVp(r=0.96,0.89,P<0.001),respectively.There was stronger consistency between the calculated value by using SSDEDW and actual measurement value by using sAs(ICC=0.98).Conclusion:SSDEDW can more accurately reflect radiation dose,and SSDEDW can be more quickly calculated to control the radiation dose by using the regression models between SSDEDW and mAs.

Objective:To explore the diagnostic reference level(DRL)of computed tomography(CT)based on size-specific dose estimate(SSDE)for child's head,and estimate the SSDE by using tube current time production.Methods:The CT data of head of 1259 pediatric patients who underwent CT examination in Children's Hospital of Nanjing Medical University from January 2023 to December 2023 were retrospectively collected.They were divided into six groups according to different ages:<6 months group,6 months to<1 year group,1 to<3 years group,3 to<6 years group,6 to<12 years group,and≥12 years group.Additionally,they were divided into five groups based on body size:<12.5 cm group,12.5 to<14 cm group,14 to<15 cm group,15 to<16 cm group,and≥16 cm group.The volume CT dose index(CTDIVOL),tube current time production(mAs),left and right diameter(LRD),area(AROI)and CT value(CTROI)of region of interest of different age groups were respectively measured and recorded.The water equivalent diameter(DW),conversion factor(f H16)and SSDE based on DW(SSDEDW)were calculated.The DRLs distribution based on age and body size was analyzed by statistic method,and the correlation between DW and mAs was analyzed by regression analysis,and a regression model between SSDEDW and mAs was further established.The intra-group correlation coefficient(ICC)was used to analyze the consistency.Results:In DRLs of various age groups,the CTDIVOL range and SSDEDW range were respectively(12.32 mGy-21.66 mGy)and(13.47 mGy to 17.83 mGy).In the DRL of various body size groups,the CTDIVOL range and SSDEDW range were(13.52 mGy-21.86 mGy)and(13.91 mGy-17.92 mGy).In different ages group of pediatric patients,the range of deviation rates of local DRL(LDRLs)value of radiation dose on head of CTDIVOL value to SSDEDW was-8.54%-21.48%.There were strong positive correlations between DW and mAs at 100 and 120 kVp(r=0.96,0.89,P<0.001),respectively.There was stronger consistency between the calculated value by using SSDEDW and actual measurement value by using sAs(ICC=0.98).Conclusion:SSDEDW can more accurately reflect radiation dose,and SSDEDW can be more quickly calculated to control the radiation dose by using the regression models between SSDEDW and mAs.

Objective To explore the application values of fixed tube current based on head circumference(HC)in children's head CT examinations.Methods A total of 573 children's head CT imaging data were collected retrospectively,the tube current and HC were recorded.Pearson's correlation analysis was used to determine the relationship of tube current with HC,counted the median tube current values of each group based on HC and used them as the prefixed tube current.Seventy-two children were prospectively collected.According to the random number table method,the children were divided into the control group and the experimental group,with 35 cases in the control group and 37 cases in the experimental group.The control group used automatic exposure control(AEC)technology for tube current,while the experimental group used the median value of tube current corresponding to HC group-ing.The difference in radiation doses and image qualities between the two groups was compared.Results Pearson analysis of 573 retrospec-tive cases showed that the correlation between HC and tube current was considerably strong(r=0.95,P＜0.001).The median tube current values of each group based on HC were 70-130 mAs.There were statistically significant differences in CTDIvol.16 and SSDEDW based on water equivalent diameter(DW)between the two groups(t=-11.27,2.81,P＜0.05).Compared with the control group,CTDIvol.16 and SSDEDW in the experimental group decreased by 10.83％and 12.59％respectively.There were no statistically signifi-cant differences in signal-to-noise ratio(SNR)between the two groups(t=-1.26,P＞0.05)and there were also no statistically significant differences in the subjective evaluation of images(Z=-0.45,P＞0.05).Conclusion Measuring children's HC before examination and setting the fixed tube current corresponding to HC grouping can reduce radiation doses while maintaining image qualities.

Objective To evaluate the safety, effectiveness and feasibility of robotic-assisted kidney transplantation (RAKT). Methods Clinical data of 16 patients who underwent kidney transplantation were collected. Among them, 8 recipients received RAKT (RAKT group) and 8 cases underwent open kidney transplantation (OKT) with the contralateral kidney from the same donor (OKT group). Perioperative status and the recovery of renal allograft function were compared between two groups. Results All patients successfully completed the surgery. In the RAKT group, no patient was converted to open surgery. The operation time in the RAKT group was longer than that in the OKT group (P=0.015). No significant differences were observed in the serum creatinine levels before surgery and upon discharge between two groups (both P>0.05). In the OKT group, one recipient developed delayed graft function (DGF), and the remaining recipients did not experience perioperative complications. No significant difference was noted in the short-term recovery of renal allograft function between two groups (P>0.05). Conclusions Postoperative recovery of the recipients in the RAKT group is equivalent to that of their counterparts in the OKT group. RAKT is a safe and effective procedure for the team expertise in kidney transplantation.

Objective:To investigate the role of ferroptosis in testicular injury in adolescent male mice induced by TDCIPP.Methods:In December 2021, 30 healthy 3-week-old male C57BL/6 mice, with a body weight of (13±2) g, were selected and fed adaptive for one week. They were divided into control group, low-dose group, medium-dose group, high-dose group and iron death inhibitor group according to a random number table, with 6 mice in each group. Mice in low, medium and high dose groups were treated with 5, 25 and 125 mg/ (kg·d) TDCIPP for 28 days, respectively, while the control group was treated with the same amount of corn oil for 28 days. The iron death inhibitor group was given 125 mg/ (kg·d) TDCIPP intragastric administration for 28 days, and 30 mg/kg DFO saline solution was intraperitoneally injected three times a week. After the treatment, the mice were killed, the epididymis was separated, and sperm count was performed. HE staining was used to observe the morphological changes of mouse testis, and iron content in testis was detected by tissue iron detection kit. The level of reactive cxygen species, MDA content, and the mitochondrial membrane potential level of mice were detected. Western blot analysis of testicular glutathione peroxidase (GPX4) and internal cyclooxygenase-2 (COX2) protein expression.Results:Compared with the control group, the spermatogenic cells in the testes of mice treated with medium-and high-dose of TDCIPP were disorderly arranged, showing a vacuolar structure. the number of sperm in the epididymis was significantly reduced ( P=0.009, 0.004), while the sperm deformity rate was significantly increased ( P=0.010, 0.000). Moreover, the content of ROS, iron ion and MDA in the testes increased significantly ( P<0.05), and the mitochondrial membrane potential of mouse testicular cells decreased significantly ( P<0.05). The expression of GPX4 proteins decreased ( P<0.05). while the expression of COX2 increased significantly ( P<0.01). Compared with high-dose group group, spermatogenic cells in ferroptosis inhibitor group were closely arranged and normal, and ROS and Fe contents in testicular tissue were significantly decreased ( P<0.01) ; GPX4 protein expression was significantly increased while COX2 protein expression was significantly decreased ( P<0.05) . Conclusion:Ferroptosis is involved in TDCIPP-induced testicular damage in male pubertal mice.

Objective:To investigate the role of ferroptosis in testicular injury in adolescent male mice induced by TDCIPP.Methods:In December 2021, 30 healthy 3-week-old male C57BL/6 mice, with a body weight of (13±2) g, were selected and fed adaptive for one week. They were divided into control group, low-dose group, medium-dose group, high-dose group and iron death inhibitor group according to a random number table, with 6 mice in each group. Mice in low, medium and high dose groups were treated with 5, 25 and 125 mg/ (kg·d) TDCIPP for 28 days, respectively, while the control group was treated with the same amount of corn oil for 28 days. The iron death inhibitor group was given 125 mg/ (kg·d) TDCIPP intragastric administration for 28 days, and 30 mg/kg DFO saline solution was intraperitoneally injected three times a week. After the treatment, the mice were killed, the epididymis was separated, and sperm count was performed. HE staining was used to observe the morphological changes of mouse testis, and iron content in testis was detected by tissue iron detection kit. The level of reactive cxygen species, MDA content, and the mitochondrial membrane potential level of mice were detected. Western blot analysis of testicular glutathione peroxidase (GPX4) and internal cyclooxygenase-2 (COX2) protein expression.Results:Compared with the control group, the spermatogenic cells in the testes of mice treated with medium-and high-dose of TDCIPP were disorderly arranged, showing a vacuolar structure. the number of sperm in the epididymis was significantly reduced ( P=0.009, 0.004), while the sperm deformity rate was significantly increased ( P=0.010, 0.000). Moreover, the content of ROS, iron ion and MDA in the testes increased significantly ( P<0.05), and the mitochondrial membrane potential of mouse testicular cells decreased significantly ( P<0.05). The expression of GPX4 proteins decreased ( P<0.05). while the expression of COX2 increased significantly ( P<0.01). Compared with high-dose group group, spermatogenic cells in ferroptosis inhibitor group were closely arranged and normal, and ROS and Fe contents in testicular tissue were significantly decreased ( P<0.01) ; GPX4 protein expression was significantly increased while COX2 protein expression was significantly decreased ( P<0.05) . Conclusion:Ferroptosis is involved in TDCIPP-induced testicular damage in male pubertal mice.

Behcet's Disease (BD) is a multisystem vasculitis characterized by disease alternated with recurrent episodes and remissions, involving genital, oral, ocular uvea, cutaneous, and articular manifestations. The nuclear factor (NF)-κB signaling pathway paly an important role in the BD progression. It encompasses diverse gene, protein, and cellular regulatory mechanisms operating across various levels, alongside microbiological and experimental studies involving animals and cells. At the protein research findings, activation of the NF-κB pathway in BD patients is marked by elevated plasma levels of soluble CD40 ligand, which stimulates neutrophils to release reactive oxygen species and extracellular traps, thereby promoting inflammation. At the cellular research findings, macrophages in BD patients polarize towards classically activated macrophages phenotype through the NF-κB pathway, exacerbating the inflammatory response. The activation of NF-κB is associated with increased expression of anti-apoptotic proteins in T cells, leading to prolonged inflammation. Microbiological investigations reveal that the decreased gut microbiota diversity in BD patients compromises intestinal barrier integrity. NF-κB pathway involvement in regulating neutrophil and type 1 helper T cell (Th) 1/Th17 cell function worsens inflammation. Genetically, BD patients exhibit polymorphisms in immune regulatory genes, which contribute to inflammation through the NF-κB pathway. Mutations in NF-κB-associated genes elevate the risk of BD, while mutations in the endogenous inhibitor A20 lead to abnormal NF-κB activity, sustaining inflammation. Animal experiments and in vitro experiments corroborate the efficacy of NF-κB inhibitors in attenuating inflammation. Targeting upstream inflammatory factors within the NF-κB pathway yields positive outcomes in BD patients. In summary, the NF-κB signaling pathway plays a pivotal role in the development of BD. Developing NF-κB inhibitors may open new avenues for treating BD. Further research is necessary to comprehensively elucidate the precise mechanisms by which NF-κB operates in the pathogenesis of BD, as well as its potential clinical applications in therapy.

Objective To systematically evaluate the relationship between the intake of fruits and vegetables and the risk of prostate cancer, so as to provide relevant evidence for formulating the prevention strategies of prostate cancer. Methods Pubmed, Embase, and Web of Science databases were searched by computer for cohort studies and related literatures evaluating the relationship between vegetable and/or fruit intake and prostate cancer risk. The quality of the included literature was rated, and meta-analysis was carried out using R software (4.0. 3 version). Results A total of 20 cohort studies were included. Four studies only reported the relationship between fruit intake and the risk of prostate cancer, 4 studies only reported the relationship between vegetable intake and the risk of prostate cancer, and 12 studies reported the relationship between fruit and vegetable intake and the risk of prostate cancer. Meta-analysis results indicate that although dietary intake of vegetables in the high-intake group may reduce the risk of prostate cancer, the difference was not statistically significant (RR, 0.97; 95% CI (0.94, 1.01), P=0.11); I²=21.3%, P=0.21). There was no significant correlation between fruit intake and the risk of prostate cancer (RR, 1.00; 95% CI (0.96, 1.04) , P=0.99). Conclusion There is no significant correlation between the intake of vegetables and/or fruits and the risk of prostate cancer.

Primary vitreoretinal lymphoma (PVRL) is one of the most common type of primary intraocular lymphoma. The current treatment options include local ocular radiotherapy (radiotherapy), systemic chemotherapy (chemotherapy), local ocular chemotherapy, and combination therapy. The treatment options are different at different stages of PVRL, however, there is no uniform treatment guideline. Local ocular chemotherapy can make the drug reach effective therapeutic concentration in the eye, and it can be repeated many times. At the same time, it can avoid the adverse reactions caused by systemic medication or radiotherapy. It is an ideal choice for relieving ocular symptoms. At present, the mainstream ocular local chemotherapeutics are methotrexate (MTX) and rituximab (RTX). The basic consensus about the intravitreal injection of MTX (IVM) is the induction-consolidation-maintenance model, however, the time of each stage and frequency of IVM are diverse. The time interval of intravitreal injection of RTX is also variable, ranging from 1 time/week to 1 time/months and so on. Corneal epithelial lesions caused by frequent MTX injections and the higher recurrence rate after RTX treatment are the main reasons for changing the treatment plan. For patients with primary central nervous system lymphoma and PVRL, combined treatment with neurology department is necessary to save patient's lives, ophthalmology treatment relieves ocular symptoms and improves the patient's quality of life. For patients with PVRL alone without central nervous system involvement, ophthalmology treatment is necessary to control patient's eye symptoms, and close follow-up should be followed to find the involvement of the central nervous system in time, and then combined with neurological treatment to save patient’s lives.

Purpose: Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods: Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results: Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.