Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

ObjectiveThis paper aims to investigate the intervention effect and molecular mechanism of Gancao Fuzitang （GCFZT） in knee osteoarthritis （KOA）. MethodsNetwork pharmacology was employed to predict the key targets and signaling pathways of GCFZT. Fifty SD rats were randomly divided into a sham group， a model group （KOA）， a low-dose GCFZT group （GCFZT-L， 2.8 g·kg^-1）， a high-dose GCFZT group （GCFZT-H， 5.6 g·kg^-1）， and a positive drug celecoxib group （Celecoxib， 20 mg·kg^-1）， with 10 rats in each group. The rats in the sham group and the model group were given an equal volume of distilled water. Except for the sham group， the other four groups underwent anterior cruciate ligament transection to establish the KOA rat model. After successful modeling， the rats in each group received intragastric administration once a day for eight consecutive weeks. The structural changes of cartilage and subchondral bone were assessed via micro-computed tomography （micro-CT） and histological staining. The levels of inflammatory factors in the serum， such as interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） were measured using an enzyme linked immunosorbent assay （ELISA） kit. Real-time quantitative polymerase chain reaction （Real-time PCR）， Western blot， and immunohistochemistry were used to detect changes in the expression of autophagy-related proteins such as microtubule-associated protein 1 light chain 3B （LC3B）， selective autophagy junction protein 62 （p62）， and autophagy key molecule yeast Atg6 homolog （Beclin-1） in articular cartilage， as well as key molecules of the phosphatidylinositol 3 kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway. ResultsNetwork pharmacology analysis suggests that GCFZT may exert anti-osteoarthritic effects through regulating the PI3K/Akt/mTOR pathway. In vivo experiment shows that GCFZT can significantly improve cartilage degeneration and attenuate subchondral bone destruction in KOA rats. Detection results of inflammatory factors in the serum reveal that， compared with those in the sham group， the levels of IL-6， IL-1β， and TNF-α in the serum of rats in the KOA group are significantly increased （P<0.05）. Compared with those in the KOA group， the levels of these three inflammatory factors in the GCFZT-L， GCFZT-H， and Celecoxib groups were significantly decreased （P<0.05）. However， there was no statistically significant difference in these three inflammatory factor levels between the GCFZT-H group and the celecoxib group. These findings suggest that GCFZT can effectively inhibit the systemic inflammatory response in KOA rats. Mechanism research indicates that GCFZT inhibits activation of the PI3K/Akt/mTOR pathway， thereby enhancing autophagic activity and improving chondrocyte function and matrix degeneration. ConclusionGCFZT improves cartilage and subchondral bone damage in KOA rats by inhibiting the PI3K/Akt/mTOR signaling pathway and promoting autophagy. These findings provide theoretical evidence for the application of GCFZT in the prevention and treatment of osteoarthritis.

Objective To comparatively evaluate the clinical efficacy of liposomal bupivacaine and ropiva-caine in transversus abdominis plane(TAP)block combined with intravenous patient-controlled analgesia(PCA)following cesarean section,and to explore the analgesic advantages of liposomal bupivacaine.Methods Eighty parturients scheduled for elective cesarean section were recruited and randomly allocated into two groups via a random number table:the liposomal bupivacaine group and the ropivacaine group.At the conclusion of the surgical procedure,both groups underwent ultrasound-guided bilateral TAP block.In the ropivacaine group,20 mL of 0.5%ropivacaine was administered per side.In the liposomal bupivacaine group,266 mg of liposomal bupivacaine was dissolved in 0.9%normal saline to a total volume of 40 mL,with 20 mL injected per side.The following parameters were compared between the two groups:Visual Analog Scale(VAS)scores at rest and during movement at various postop-erative time points,the overall scores of the 15-item Quality of Recovery(QoR-15)scale,postoperative opioid consumption,the time to first ambulation,the time to first flatus,and the incidence of adverse drug reactions such as nausea,vomiting,constipation,and pruritus.Results In comparison with the ropivacaine group,the liposomal bupivacaine group exhibited significantly lower Visual Analogue Scale(VAS)scores both at rest and during move-ment at 12 hours,24 hours,and 48 hours postoperatively(P<0.001).Significantly higher Quality of Recovery-15(QoR-15)scores were recorded in the liposomal bupivacaine group at 24 hours and during the 24-48-hour period postoperatively(P<0.001).The postoperative opioid consumption within 48 hours was markedly lower in the liposo-mal bupivacaine group(P<0.001).The time to first flatus was significantly shorter in the liposomal bupivacaine group(P<0.001).No significant differences were detected in the incidence of nausea,vomiting,or constipation between the two groups(P>0.05),and no cases of pruritus or other severe adverse reactions were observed.Conclusion Liposomal bupivacaine used for TAP block following cesarean section offers extended analgesia,reduces the need for opioids,enhances the quality of postoperative recovery,promotes gastrointestinal motility,and demonstrates excellent safety.

Objective To investigate the relationship between the expression of Osteoglycin(OGN)mRNA and Axis inhibitory protein 1(Axin1)mRNA and Epithelial-mesenchymal transition(EMT)and prognosis in cervical cancer(CC).Methods 142 patients with CC who were treated in Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University from April 2019 to April 2021 were collected.Real time fluorogenic quantitative PCR(RT-qPCR)was used to detect the expression of OGN mRNA,Axin1 mRNA and EMT markers Snail mRNA,N-cadherin(N-cad)mRNA,Vimentin(Vim)mRNA.The expression of OGN and Axin1 protein was detected by immunohistochemistry(IHC).Pearson correlation analysis was used to analyze the correlation between OGN mRNA,Axin1 mRNA and EMT indicators Snail mRNA,N-cad mRNA,Vim mRNA.The effect of OGN and Axin1 protein expression on the survival of CC was analyzed by Kaplan-Meier(K-M)survival curve and COX model.Results Compared with adjacent tissues,the expression of OGN mRNA in CC cancer tissues(0.84±0.22 vs 2.01±0.38)was lower,and the expression of Axin1 mRNA(2.41±0.42 vs 1.02±0.33)was higher,the differences were statistically significant(t=31.752,31.010,all P<0.001).Pearson correlation analysis,the expression of OGN mRNA was negatively correlated with that of Snail mRNA,N-cad mRNA and Vim mRNA(r=-0.765,-0.703,-0.697,all P<0.001).The expression of Axin1 mRNA was positively correlated with that of Snail mRNA,N-cad mRNA and Vim mRNA(r=0.771,0.798,0.690,all P<0.001).Compared with adjacent tissues,the positive rate of OGN protein in CC cancer tissues was lower[28.17%(40/142)vs 88.03%(125/142)],and the positive rate of Axin1 protein was higher[69.01%(98/142)vs 11.27%(16/142)],the differences were statistically significant(χ2=73.185,98.535,all P<0.001).Compared with patients with ⅠA-ⅠB1 and no lymph node metastasis,the positive rate of OGN protein in cancer tissues of patients with International Federation of Gynecology and Obstetrics(FIGO)stage Ⅰ B2-Ⅱ A and lymph node metastasis was lower,and the positive rate of Axin1 protein was higher,and the differences were statistically significant(χ2=4.315～13.252,all P<0.05).The 3-year overall survival rates of OGN positive group and negative group were 90.00%(36/40)and 70.59%(72/102),respectively,and the difference was statistically significant(Log-Rankχ2=7.140,P=0.008).The 3-year overall survival rates of Axin1 positive group and negative group were 69.39%(68/98)and 90.91%(40/44),respectively,and the difference was statistically significant(Log-Rankχ2=9.061,P=0.003).Axin1 positive,FIGO stage IB2～ⅡB,lymph node metastasis were risk factors for poor survival of CC,and OGN positive was a protective factor(Wald χ2=6.250～12.278,all P<0.05).Conclusion OGN is down-regulated and Axin1 is up-regulated in CC,which are related to EMT indicators and adverse survival outcomes of CC patients.

Objective To study the impact of tympanic membrane opening on respiratory-driven middle ear pressure in patients with patulous eustachian tube(PET),using a simplified in vitro model.Methods CT imaging data from a PET patient(with full-length eustachian tube opening observed during a Valsalva maneuver followed by breath-holding)were used to design a simplified eustachian tube model.Two simplified in vitro models of the eusta-chian tube were constructed using silicone-based 3D printing technology and connected to a pressure controller and pressure sensors.The pressure controller was activated to introduce negative-pressure airflow into the nasopharyn-geal model to simulate respiratory-induced middle ear pressure fluctuations.A hemostat was used to alternately open and close the external interface of the middle ear chamber,simulating conditions of an open and intact tympanic membrane,while middle ear pressure was continuously monitored using pressure sensors.Results In the first mod-el,with-800 mbar negative pressure applied at the nasopharynx,the middle ear pressure stabilized between-3.9 mbar and-4.3 mbar with tympanic membrane opening,and between-7.9 mbar and-8.2 mbar with intact tym-panic membrane.In the second model,under the same pressure setting,middle ear pressure stabilized between-2.7 mbar and-3.1 mbar with tympanic membrane opening,and between-5.0 mbar and-7.7 mbar with intact tympanic membrane.Conclusion This study,based on a simplified in vitro model,demonstrates that tympanic membrane opening can effectively reduce respiratory-driven pressure in the middle ear.This phenomenon may partly explain the clinical efficacy of tympanostomy tube insertion in certain PET patients.

Objective To analyze and compare the diagnostic criteria of dampness syndrome in clinical studies and construct a dampness syndrome entry pool,so as to provide theoretical support for the development of dampness-related scales,and then provide reference for clinical research.Methods By searching the literature collected by CNKI,VIP and Wanfang data database from 1960 to 2023,the clinical research literature of dampness syndrome was searched and screened,and the diagnostic criteria of dampness syndrome were summarized and analyzed.Results A total of 7651 articles were retrieved from the above database,and 52 articles were finally included.9 diagnostic criteria were obtained by combining the screening of teaching materials.They are The National Standard of Chinese Medicine Clinical Diagnosis and Treatment of Chinese Medicine(GB/T16751.2-1997),Syndrome element differentiation,Traditional Chinese Medicine Syndrome Standards,Traditional Chinese Medicine Syndrome Differentiation and Diagnosis,Diagnostics of Traditional Chinese Medicine(Fifth edition,sixth edition,second edition of the new century,People's Health Commission edition,and tenth edition of the National Higher Traditional Chinese Medicine College Planning Textbook).The diagnostic methods can be divided into three kinds:narrative method,primary and secondary disease(or see disease)classification diagnosis method,and assigning method.There are a total of 36 symptom components,which can be divided into four groups:the accumulation of muscle and striae group,the obstruction of meridians and joints group,the internal accumulation of organs group,and the dampness and obstruction of orifices group.The National Standard of Chinese Medicine Clinical Diagnosis and Treatment of Chinese Medicine(GB/T16751.2-1997)has been cited for a maximum of 22 times,covering 16 diseases.Conclusion The National Standard of Chinese Medicine Clinical Diagnosis and Treatment of Chinese Medicine is the most widely used in clinical research,and the new version of national standard in 2021 is more suitable for the current diagnosis and clinical research of dampness syndrome.

A 65-year-old male was admitted to Peking Union Medical College Hospital. The patient had intermittent fever for 2 months with a maximum body temperature of 39.3 ℃ and elevated serum creatinine levels for 1 week. He had no other suggestive symptoms or positive signs. Laboratory test results suggested acute kidney injury and a sharp elevation in serum lactic dehydrogenase levels. Abdominal enhanced computed tomography (CT) revealed multiple low-density lesions, and further biopsy pathology demonstrated chronic inflammation. Thereafter, positron emission tomography (PET)/CT showed abnormally elevated uptake value for the bones throughout the entire body, in addition to the liver and brain. Repeated bone marrow biopsy finally confirmed metastatic bone cancer, which possibly originated from the kidney according to immunohistochemical staining. In this rare case of fever of unknown origin, the primary lesion was a renal tumor with bone, liver, and brain metastases. Enhanced CT and PET/CT provided negative results, and the diagnosis was eventually confirmed by repeated bone marrow pathology.

Objective:To investigate the efficacy of two types of micro-focused ultrasound devices combined with botulinum toxin type A (BoNT-A) injection for facial rejuvenation.Methods:A retrospective study was conducted, including 60 female patients aged 28-70 (41.3±7.9) years, who received facial rejuvenation treatment at the Department of Plastic and Reconstructive Surgery, Zhongnan Hospital of Wuhan University, from April 2023 to April 2024. Patients were divided into two groups based on the treatment method: the control group (received only micro-focused ultrasound treatment, n=30) and the combined group (received both micro-focused ultrasound and BoNT-A injection, n=30). Additionally, patients were further categorized into four subgroups based on the type of micro-focused ultrasound device used: Peninsula Microultra? (PM) device group ( n=15), Intelligent Ultrasound? (IU) device group ( n=15), PM device + BoNT-A injection group ( n=15), and IU device + BoNT-A injection group ( n=15). The severity of facial wrinkles was assessed using the wrinkle severity rating scale (WSRS), the Merz aesthetic scale (MAS), and the global aesthetic improvement scale (GAIS) at baseline and 6 months post-treatment. Adverse event rates were also recorded. Results:At 6 months post-treatment, the combined group showed significantly lower WSRS and MAS scores than the control group (both P<0.001). No significant differences were found between the PM and IU device groups, or between the PM + BoNT-A and IU + BoNT-A groups regarding WSRS and MAS scores (all P>0.05). Self-reported GAIS improvement was 56.7% (17/30) for the control group and 80.0% (24/30) for the combined group, with the combined group showing superior results ( P=0.015). The physician-assessed GAIS improvement was 70.0% (21/30) for the control group and 96.7% (29/30) for the combined group, again with the combined group showing superior results ( P=0.007). No significant differences were found in self-reported or physician-assessed GAIS improvement between the PM and IU device groups, or between the PM + BoNT-A and IU + BoNT-A groups (all P>0.05). No severe adverse reactions, such as blisters, scabbing, purpura, bruising, scarring, peripheral facial paralysis, allergies, muscle weakness, dysphagia, or dysphonia, were observed in any patient. Conclusion:The combination of micro-focused ultrasound and BoNT-A injection for facial rejuvenation is more effective than micro-focused ultrasound alone, while there are no significant differences in efficacy between the two micro-focused ultrasound devices.