Objective To explore and establish a technical pathway for size-specific dose estimate (SSDE) in pediatric CT patients of different age groups based on structured dose files and DICOM files, and to provide an effective method for precise monitoring of medical radiation exposure in pediatric CT scans. Methods Structured radiation dose reports (SR files) for pediatric patients aged 15 and under, who underwent CT scans between January and December 2023, were exported from the hospital information system. Scanning parameters and dose information were extracted using specialized software, and SSDE was calculated based on the patient body size parameters. The data were grouped by age (0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years) for statistical analysis. Results From January to December 2023, a total of 2706 pediatric CT scans were performed at the hospital, including 385 (14.23%) head scans, 1990 (73.54%) chest scans, 143 (5.28%) abdominal scans, 112 (4.14%) limb scans, and 76 (2.81%) other scans. The typical volume CT dose index (CTDI_vol) for head CT in the age groups of 0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years were 36.21, 35.29, 37.27, and 41.18 mGy, respectively; the corresponding SSDE values were 41.27, 32.82, 30.56, and 28.41 mGy, respectively. For chest CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 1.91, 2.11, and 2.51 mGy, respectively; the corresponding SSDE values were 2.36, 2.21, and 3.50 mGy, respectively. For abdominal CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 3.94, 4.33, and 6.26 mGy, respectively; the corresponding SSDE values were 5.77, 7.10, and 9.79 mGy, respectively. Conclusion This study developed a technical pathway to estimate the medical radiation doses of pediatric CT patients of different ages based on structured dose files and DICOM files. The feasibility of this approach was validated using data collected over a one-year period.

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective:To explore the medical costs and influencing factors of patients diagnosed with Brucellosis in Xinjiang Uygur Autonomous Region (Xinjiang).Methods:Information on demographics, medical visits, and costs of patients diagnosed with Brucellosis were collected between January 1,2017 and December 31,2019. The effects of different genders, age groups, clinical stages, and comorbidities on patients' health care utilization and medical costs were analyzed by nonparametric tests. The median was used to describe the outpatient and inpatient costs of patients with Brucellosis.Results:A total of 13 532 patients (8 113 outpatient and 5 419 inpatient cases) were included in the analysis. A total of 67.8% (9 176/13 532) were male, with an average age of (42.7±15.4 ) years; age between 18-44 years (46.6%, 6 304/13 532) and 45-59 years (34.2%,4 622/13 532) were the dominant groups. The mean age of inpatients [(43.3±15.7) years] was higher than that of outpatients [(42.3±15.1) years, Z=-3.85, P<0.001]. When hospitalized patients are treated,systemic symptoms were common with fever (36.9%, 1 997/5 419) and fatigue (36.6%, 1 983/5 419), and with joint/muscle pain (68.9%, 3 735/5 419) being the highest proportion of local symptoms. A total of 79.1% (4 289/5 419) of inpatients were diagnosed with acute Brucellosis. A total of 46.5% (2 519/5 419) of inpatients had complications;skeletal system complications ranked the highest. The average number of outpatient visits per outpatient was (1.6±1.4) times. The duration of hospitalization was (11.3±4.2) days, with longer days for patients in the chronic phase and with complications ( P<0.05). A total of 89.3% (4 840/5 419) of inpatients had outpatient records in the same year,and the average number of outpatient visits per patient was (3.6±2.6) times. Outpatient medical costs were dominated by laboratory and drug costs (75.1%), and inpatient costs were dominated by drug, laboratory, and other costs (74.4%). Outpatient medical expenses M( Q1, Q3) were 61(52, 497) Yuan, 61 (51, 346) Yuan and 58 (46, 318) Yuan,respectively. Inpatients' medical expenses M ( Q1, Q3) were 8 214 (6 355, 10 721) Yuan,9 095 (7 018, 12 155) Yuan and 9 492 (7 530, 12 351) Yuan, respectively. For patients, age, clinical stages,complications,and joint/muscle pain symptoms were influential factors for hospitalization costs ( P<0.001). Conclusions:The economic burden was higher for inpatients, especially those in the high age group, with chronic phases and skeletal and neurological complications. Improving patients' awareness of early treatment, standardized treatment, and reducing chronicity and complications are the main points in reducing the economic burden caused by Brucellosis diagnosis and treatment.

Objective:To explore the medical costs and influencing factors of patients diagnosed with Brucellosis in Datong of Shanxi province.Methods:Information on demographics, medical visits, and costs of patients diagnosed with Brucellosis between January 1, 2017, and December 31, 2019, were collected. Health care utilization and medical costs were analyzed from different genders, age groups, underlying diseases, clinical stages, and comorbidities.Results:A total of 2 289 patients (1 715 outpatient and 574 inpatient cases) were included in the analysis. 72.0% (1 649/2 289) were male, with an average age of (49.6±15.5) years; age between 45-59 years was the dominant group (36.2%,829/2 289). The mean age of inpatients (51.4±16.0) was higher than that of outpatients (49.0±15.2)( Z=-4.01, P<0.001). The average number of outpatient visits per outpatient was (1.6±1.5) times. The duration of hospitalization was (14.6±9.9) and (20.8±11.4) days for patients with central nervous system complications and (16.6±9.5) days for vascular system complications. Of the inpatients, 51.0% (293/574) had underlying diseases, and 30.3% (174/574) had endocrine and metabolic diseases. 54.0% (310/574) of inpatients were diagnosed with acute Brucellosis, and 46.0% (264/574) were diagnosed with chronic Brucellosis. A total of 64.3% (369/574) of inpatients had complications, 30.3% (174/574) of digestive system complications, followed by skeletal system complications (29.1%, 167/574). Among outpatients, age significantly affected medical costs ( P<0.001). For inpatients, age and complications and treatment effect were influential factors ( P<0.05). Patients with the combined skeletal system and central nervous system complications had significantly higher medical costs ( P<0.001). Conclusions:The medical costs for outpatient cases of Brucellosis were moderate. However, the economic burden was higher for inpatients, especially those with skeletal and neurological complications. Early detection, diagnosis, and treatment of cases were essential to avoid chronic Brucellosis and its complications and reduce medical costs.

The radiotherapy modulators used in clinic have disadvantages of high toxicity and low selectivity. For the first time, we used the

Radiotherapy is one of the most important methods to treat malignant tumors. Due to the presence of radiation resistance, the effect of radiotherapy is not entirely satisfactory. To alleviate radiation resistance and improve the radiotherapy effect, radiosensitizers have emerged. As a newly discovered radiosensitizer, RRx-001 has a good clinical application prospect. This paper reviewed the research progress of RRx-001 in source, safety, radiotherapy sensitizing activity and related mechanisms.

Objective To synthesize a new kind of acid-sensitive doxorubicin prodrug nanoparticles and to evaluate its anti-brain glioma effect and efficiency through blood-brain barrier (BBB). Methods The prodrug acid-sensitive poly-ethylene glycol (PEG)-doxorubicin (PEG-DOX) copolymer was synthesized by Schiff base reaction, and PEG-DOX pro-drug nanoparticles (PEG-DOX NPs) were prepared by self-assembling. The character of PEG-DOX copolymer was detected by dynamic light scattering (DLS) instrument and 1H NMR. The morphology of PEG-DOX NPs was observed by transmission electron microscopy (TEM). The character of drug release was detected by UV mothed. The cellular uptake efficiency of glio-ma cells to PEG-DOX NPs was observed by inverted fluorescence microscope. The anti-brain glioma effects of PEG-DOX NPs and Free DOX were studied by MTT mothed. PS80-PEG-DOX NPs were gained by the modification of PEG-DOX NPs with Tween 80. Nine BALB/c mice were separated into Free DOX, PEG-DOX NPs and PS80-PEG-DOX NPs groups by ran-dom drawing lots. The mean fluorescence intensity of brain and main organs were observed by in vivo imaging system. Re-sults The copolymer of PEG-DOX can self-assemble into nanoparticles with the diameter of 100 nm. PEG-DOX NPs can quickly release DOX in acid environment. Although PEG-DOX NPs had slow cancer cell uptake than Free DOX, it had lon-ger accumulation. MTT results showed that PEG-DOX NPs had concentration dependent anti-brain glioma effect. Indepen-dent samples t-test indicated that the efficiency through BBB was significantly higher in PS80-PEG-DOX NPs group than that of Free DOX group and PEG-DOX NPs group. Conclusion PEG-DOX NPs show well anti-brain glioma effect in vi-tro, and can across BBB with high efficiency after modification, which make it possible for a potential therapeutic prodrug for brain glioma.

Objective To establish an accuracy test method for MDCT dose assessment based on information in DICOM images.Methods The type of MDCT studied in this paper was widely used in clinical practice.A software package developed by java language was used to automatically read doserelated information from DICOM files of MDCT.The CTDIvol and DLP of each pectoral or abdominal scan was calculated based on these information and the basic scan parameters such as collimation,mAs and pitch.The calculated values were compared with the displayed values.Results For pectoral scans,the difference between the calculated and displayed values was between-2％-8％ for CTDIvol,and-2％-5％ for DLP.For abdominal scan,the difference between the calculated and displayed values was 0-2％ for CTDIvol,and-2％-3％ for DLP.Conclusions This method is useful for MDCT dose assessment and is worth disseminating its application for general use.

Objective:To detect the levels of PA,FN,RBP,CRP,Iron,Zinc,VitD in peripheral blood of children with HFMD and to explore the relationship between them and the disease .Methods:The levels of PA,FN,RBP and CRP were detected by immune turbidimetric assay;and the levels of Iron and Zinc were detected by flame atomic absorption spectrometry ;while the levels of VitD were detected by electro chemilumin escence .Results:The levels of PA,FN,RBP,Iron,Zinc and VitD in the severe group were lower than those in other groups ,while the levels of CRP were higher than those in other groups ( P<0.05 );and the levels of PA ,FN and RBP in the general group were lower than that in the control group , while the levels of CRP were higher than that in the control group ( P<0.05 ) .And no significance were found of the levels of Iron ,Zinc and VitD in the general group and the control group ( P>0.05 ) .The levels of PA,FN,RBP,Fe,Zn and VitD in the convalescence were higher than those in the acute phase of the severe cases (P<0.01), and lower than those in the control group ( P<0.05 );And no statistical significance were found of the levels of CRP between the convalescent phase of severe cases and the control group (P>0.05).There were negative correlation between the levels of PA ,FN,RBP and the state of HFMD(P<0.05),while there were positive correlation between the levels of CRP and the state of HFMD (P<0.05). And there were low negative correlation between the levels of Iron , Zinc, VitD and the state of HFMD ( P <0.05 ), respectively.Conclusion:There were nutritional deficiency in severe cases of HFMD ,and the nutritional status should be assessed dy-namically,then proper amount of nutrition should be supplement .

Objective To synthesize poly asparagine derivatives and to evaluate its safety at the cellular level, which provide research platform for its potential application as drug carrier. Methods Polysuccinimide was synthesized by ther?mal polymerization of L-polyaspartic acid, and the target product of PSI-Phe-EA was obtained by the ring-opening reaction of polysuccinimide using L-phenylalanine methyl ester hydrochloride and ethanol amine. The structure of PSI-Phe-EA were characterized by 1H NMR. The rate of ring-opening of PSI was calculated by internal standard method of 1H NMR. The change of hydrophilicity was studied by the comparison of solubility. The cytotoxicity and morphology modification by PSI-Phe-EA at designate concentrations was investigated by MTT method and inverted microscopy respectively. The effects on cell cycles were analyzed by flow cytometry after propidium iodide (PI) staining. Results 1H NMR results confirmed the structure of PSI-Phe-EA and the ring-openning rate of PSI was 40%. The hydrophilicity of PSI-Phe-EA was greatly in?creased upon ring opening using ethanol amine. MTT test showed that the cell survival rates of NIH 3T3 and HepG2 cells were higher than 80%under the examined concentration (<100 mg/L). Inverted microscopy showed that 50 mg/L of PSI-Phe-EA treatment had no adverse effects on cell morphology. Cell cycle analysis indicated that PSI-Phe-EA treatment had no in?fluence on cell cycles of NIH 3T3 and HepG2 cell lines. Conclusion PSI-Phe-EA showed high hydrophilicity without sig?nificant effects on the cells survival, cells morphology and cell cycles. It is a kind of safe polymer material.