Objective To verify the radiation shielding effects of a self-developed protective shield for infant bedside X-ray radiography, and measure the dose distribution in the indoor radiation field with and without the shield, and to provide guidance for the radiation protection of infants sharing the room. Methods A MUX-100J mobile medical diagnostic X-ray machine was used as the radiographic device to simulate the exposure conditions of infant bedside X-ray radiography. The ambient dose equivalent rates at measurement points in eight directions on the irradiation plane in the indoor radiation field were measured with and without the protective shield using an AT1121 X/γ dose rate meter under the conventional condition of 56 kV and the maximum single exposure time. Results During infant bedside X-ray radiography, the dose levels in all directions on the irradiation plane within 150 cm from the scatterer center were essentially symmetrically distributed. The ambient dose equivalent rate at 100 cm from the scatterer center on the irradiation plane was (8.01-8.28)×10³ μSv/h without the protective shield and 48-84 μSv/h with the shield. At various distances from the scatterer center in all directions on the irradiation plane, the doses measured with the protective shield ranged from 0.34% to 14.12% of those measured without the shield, with an average of 1.85%. Conclusion The dose levels in the indoor radiation field were significantly reduced with the protective shield during infant bedside X-ray radiography. The use of the protective shield can effectively reduce the radiation risk for individuals near the radiographic site within the same room.

Objective To verify the radiation shielding effects of a self-developed protective shield for infant bedside X-ray radiography, and measure the dose distribution in the indoor radiation field with and without the shield, and to provide guidance for the radiation protection of infants sharing the room. Methods A MUX-100J mobile medical diagnostic X-ray machine was used as the radiographic device to simulate the exposure conditions of infant bedside X-ray radiography. The ambient dose equivalent rates at measurement points in eight directions on the irradiation plane in the indoor radiation field were measured with and without the protective shield using an AT1121 X/γ dose rate meter under the conventional condition of 56 kV and the maximum single exposure time. Results During infant bedside X-ray radiography, the dose levels in all directions on the irradiation plane within 150 cm from the scatterer center were essentially symmetrically distributed. The ambient dose equivalent rate at 100 cm from the scatterer center on the irradiation plane was (8.01-8.28)×10³ μSv/h without the protective shield and 48-84 μSv/h with the shield. At various distances from the scatterer center in all directions on the irradiation plane, the doses measured with the protective shield ranged from 0.34% to 14.12% of those measured without the shield, with an average of 1.85%. Conclusion The dose levels in the indoor radiation field were significantly reduced with the protective shield during infant bedside X-ray radiography. The use of the protective shield can effectively reduce the radiation risk for individuals near the radiographic site within the same room.

Objective To verify the radiation shielding effects of a self-developed protective shield for infant bedside X-ray radiography, and measure the dose distribution in the indoor radiation field with and without the shield, and to provide guidance for the radiation protection of infants sharing the room. Methods A MUX-100J mobile medical diagnostic X-ray machine was used as the radiographic device to simulate the exposure conditions of infant bedside X-ray radiography. The ambient dose equivalent rates at measurement points in eight directions on the irradiation plane in the indoor radiation field were measured with and without the protective shield using an AT1121 X/γ dose rate meter under the conventional condition of 56 kV and the maximum single exposure time. Results During infant bedside X-ray radiography, the dose levels in all directions on the irradiation plane within 150 cm from the scatterer center were essentially symmetrically distributed. The ambient dose equivalent rate at 100 cm from the scatterer center on the irradiation plane was (8.01-8.28)×10³ μSv/h without the protective shield and 48-84 μSv/h with the shield. At various distances from the scatterer center in all directions on the irradiation plane, the doses measured with the protective shield ranged from 0.34% to 14.12% of those measured without the shield, with an average of 1.85%. Conclusion The dose levels in the indoor radiation field were significantly reduced with the protective shield during infant bedside X-ray radiography. The use of the protective shield can effectively reduce the radiation risk for individuals near the radiographic site within the same room.

Objective To establish a transgenic mouse model of facioscapulohumeral muscular dystrophy(FSHD)using tamoxifen induction and Myf6-CreERT2 and FLExDUX4 mice.Methods Dual transgenic(M6D4/+)mice were generated by crossbreeding Myf6-CreERT2 hemizygous and FLExDUX4 hemizygous mice.Full-length DUX4(DUX4-fl)expression was induced by tamoxifen starting at 3 weeks old.The disease model was evaluated at 9 weeks old by assessing changes in body mass,four-limb strength,inverted screen test,skeletal muscle weight ratio,hematoxylin/eosin,Picrosirius Red,and immunofluorescent staining of skeletal muscle paraffin sections,quantitative real-time polymerase chain reaction(RT-PCR),and RNA-sequencing(RNA-seq)of skeletal muscle.Results Dual transgenic heterozygous mice(M6D4/+)were successfully obtained.These mice exhibited significant physiological and pathological changes at 9 weeks,including delayed weight gain,reduced four-limb strength and endurance,decreased skeletal muscle weight ratio,and increases in centrally nucleated muscle fibers and fibrosis.Expression levels of DUX4 and its targeted genes were significantly up-regulated in skeletal muscle,as demonstrated by RT-PCR.RNA-seq revealed up-regulation of immune regulation-,interleukin-6,and tumor necrosis factor-related genes and down-regulation of skeletal muscle development-and differentiation-related genes.Conclusions M6D4/+mice effectively simulated the skeletal muscle phenotype of FSHD and thus provide a good animal model for research into the pathogenesis,intervention,and treatment of FSHD.

Objective:To analyze the value of 18F-FDG PET/CT combined with MRI in the diagnosis and differential diagnosis of ductal carcinoma in situ (DCIS) and early stage invasive ductal carcinoma (IDC). Methods:From September 2019 to December 2023, 12 patients with DCIS (all females; age 36-67 years) and 34 patients with early stage IDC (all females; age 36-73 years) in Qingdao Central Hospital were retrospectively analyzed. The general clinical information, MRI features, and 18F-FDG PET/CT features of patients were analyzed. χ2 test, Fisher exact test, and Mann-Whitney U test were used to analyze the data. The independent predictors of DCIS were analyzed by logistic regression analysis. The value of different indicators in diagnosing DCIS was analyzed using ROC curves analysis, and Delong test was used to assess the differences among AUCs. Results:The differences in tumor metabolic volume (MTV; 18.55(10.90, 76.30) vs 4.00(2.00, 11.45)cm 3) and total lesion glycolysis (TLG; 44.85(25.30, 125.30) vs 9.40(6.68, 22.35)g) of breast lesion, enhancement pattern (non-mass enhancement (NME); 8/12 vs 29.4%(10/34)), lobulation sign (0/12 vs 58.8%(20/34)), and apparent diffusion coefficient (ADC; 1.33 (1.16, 1.63)×10 -3vs 1.08 (0.75, 1.28)×10 -3mm 2/s) between DCIS and early stage IDC groups were statistically significant ( Z values: from -3.91 to -2.56, χ2=5.17, all P<0.05). When differentiating DCIS from early stage IDC, NME (odds ratio ( OR)=36.50, 95% CI: 2.15-618.52, P=0.013), ADC ( OR=7.85, 95% CI: 1.11-55.46, P=0.044), and TLG ( OR=1.06, 95% CI: 1.02-1.11, P=0.007) were independent predictors. The AUC of the three predictors combination was 0.941, which was higher than those of single predictors ( Z values: 2.00-2.80, P values: 0.005-0.046). Conclusion:The combination of 18F-FDG PET/CT and MRI improves the efficacy of differential diagnosis between DCIS and early stage IDC, thereby providing a basis for developing personalized treatment plans for patients.

Objectives:To investigate the incidence of tyrosine kinase inhibitor (TKI) withdrawal syndrome and psychological issues, and their associated factors, in patients with chronic-phase chronic myeloid leukemia (CML-CP) after TKI discontinuation.Methods:We retrospectively analyzed the clinical data of CML-CP patients who discontinued TKI therapy at Peking University People's Hospital after September 2012. Logistic regression models were used to identify independent factors associated with the occurrence of TKI withdrawal syndrome and psychological issues.Results:A total of 158 patients were included, of whom 92 (58%) were female. The median age at discontinuation was 50 ( IQR, 35-60) years. With a median follow-up of 25 ( IQR, 11-49) months, the 4-year rate of sustained major molecular response (MMR) was 60% (95% CI: 51%-70%) . Fifty-one (32%) patients experienced TKI withdrawal syndrome at a median of 1.3 ( IQR, 0.5-2.0) months after TKI discontinuation. Fifty-one (32%) patients reported psychological issues such as anxiety. These concerns stemmed from fears of fluctuating BCR::ABL1 levels or disease relapse, and, for those who discontinued TKI for pregnancy, worries about adverse fetal effects and/or the fetus inheriting CML. Multivariable analyses revealed that older age at discontinuation [ P=0.003 when adjusting for TKI therapy duration; P=0.002 when adjusting for deep molecular response (DMR) duration], longer TKI therapy duration ( P=0.010) , and longer DMR duration before discontinuation ( P=0.005) were significantly associated with a higher risk of TKI withdrawal syndrome; a university degree or higher ( P=0.010) and TKI discontinuation due to pregnancy or adverse events ( P=0.001) were significantly associated with psychological issues after discontinuation. The occurrence of TKI withdrawal syndrome or psychological issues had no impact on the probability of major molecular response loss after discontinuation. Conclusion:TKI withdrawal syndrome and psychological issues are common in CML patients who discontinue TKI therapy. Older age at discontinuation and longer TKI therapy duration or DMR duration are significantly associated with TKI withdrawal syndrome. Higher education level and TKI discontinuation due to pregnancy or adverse events are significantly associated with psychological issues.

Urothelial carcinoma (UC), including bladder urothelial carcinoma and upper tract urothelial carcinoma (UTUC), is the most common malignant tumor in the urinary system. Traditional cell line models fall short in simulating its tumor microenvironment and in vivo behavior. Patient-derived organoid (PDO) models offer a new way to overcome these shortcomings. This paper reviews the construction techniques of PDO models in UC, their biological simulation capabilities, and their applications in preclinical research. It also analyzes the technical limitations of these models. PDO models can retain the histological, genomic, and transcriptomic features of the parent tumor and accurately simulate the tumor microenvironment and biological behavior. They have been widely used in bladder cancer research, providing a precise platform for drug screening, personalized treatment, and immunotherapy evaluation. However, their use in UTUC research is still in its infancy. In the future, through technological optimization, PDO models are expected to enhance their value in UC research, advancing precision medicine research and clinical translation.

Objective:To investigate the clinical outcomes of nephron-sparing surgery (NSS) for tuberous sclerosis complex(TSC) -associated renal angiomyolipoma (RAML). Methods:This retrospective case-series study analyzed the clinical data of 15 TSC-RAML patients who underwent NSS at the Department of Urology, Peking Union Medical College Hospital between April 2013 and July 2024. The cohort included 4 males and 11 females. The age at TSC diagnosis was (28.5±14.5) years (range: 5 to 62 years), and the age at first surgery was (33.3±10.8) years (range: 18 to 62 years). The maximum tumor diameter( M(IQR)) was 6.4(7.9)cm (range: 3.5 to 31.5 cm). Patient baseline characteristics, surgical approach, TSC-RAML staging, imaging findings, and laboratory data were collected. Relationships between variables were analyzed using Generalized Estimating Equations with post-hoc tests. Results:A total of 18 surgical procedures were performed on the 15 patients. These included 7 open surgeries, 9 laparoscopic surgeries, and 2 laparoscopic procedures converted to open surgery. The mean preoperative serum creatinine level was (70.2±14.2) μmol/L (range: 50 to 101 μmol/L), which increased to (99.2±29.8) μmol/L (range: 47 to 171 μmol/L) on postoperative day 1. However, at one year postoperatively, serum creatinine was (76.8±13.5)μmol/L (range: 55 to 106 μmol/L),showed no significant difference from preoperative levels ( P>0.05). At the 6-month postoperative follow-up, the Utrecht Interventional Classification stage for all treated tumors had decreased to grade 1 or 2. At the 12-month follow-up (available for 13 patients), 11 patients showed no disease progression. Conclusions:NSS is a viable treatment option for rigorously selected patients with high-stage TSC-RAML. Although NSS causes transient renal function impairment, it provides effective tumor burden control. In stringently selected patients with high-stage disease and under long-term follow-up, NSS is associated with limited long-term renal impairment.

Objective To analyze the incidence and mortality of gastric cancer in countries and territories with different human development index(HDI)levels in 2022,and to understand the burden of gastric cancer globally and in China.Methods Data on gastric cancer incidence and mortality were collected from GLOBOCAN 2022 and HDI data for all countries were obtained from the Human development report 2022.Spearman correlation was applied to examine the associations between the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),mortality-to-incidence ratio(M/I),and HDI for gastric cancer.The Wilcoxon rank-sum test was used to assess the differences in ASIR and ASMR between males and females.Results In 2022,gastric cancer ranked the 5th in both incidence and mortality among all cancer types globally.In China,gastric cancer ranked the 5th in incidence and the 3rd in mortality among all cancer types.The ASIR and ASMR of gastric cancer showed a descending trend from high,very high,medium to low HDI countries and territories.The ASIR of gastric cancer was positively correlated with HDI(rs=0.256,P=0.001),while ASMR showed no significant correlation with HDI(rs=-0.008,P=0.918).The M/I was negatively correlated with HDI(rs=-0.831,P＜0.001).The ASIR and ASMR of gastric cancer in males were significantly higher than those in females globally,in China,and across all HDI groups(all P＜0.05).Globally,both ASIR and ASMR of gastric cancer remained relatively stable before the age of 45,but showed a consistently rising trend after the age of 45.In China,the ASIR and ASMR of gastric cancer exceeded global average level across all age groups.Conclusion The burden of gastric cancer incidence and mortality is higher in very high and high HDI countries and territories compared to medium and low HDI countries and territories.In China,the burden of gastric cancer incidence and mortality is above the global average,highlighting the need for targeted prevention and control measures.

Objective To construct intrauterine adhesion (IUA) mouse models induced by two different concentrations of ethanol injury, compare the phenotypes, and optimize a more stable IUA modeling method. Methods Twenty 8-week-old female C57BL/6N mice were randomly divided into two groups: the 95% ethanol injury group and the 50% ethanol injury group. Using a self-control method, the left uterine horn was infused with ethanol to establish the IUA model, while the right uterine horn was infused with saline as the sham operation. Five mice from each group were euthanized on day 7 and 15 after modeling, and uterine tissues were collected. Hematoxylin-eosin (HE) staining was used to observe the endometrial pathology, and Masson staining was used to assess the degree of endometrial fibrosis. Quantitative real-time PCR was employed to detect the expression levels of fibrosis markers and pro-inflammatory factors in the uterine tissues. Results Compared to the sham operation, these two ethanol injury led to a significant reduction in elasticity of the uterus, an increase in inflammatory infiltration, and a marked increase in the degree of fibrosis on day 7 after modeling (P<0.05). The 95% ethanol injury group showed a significant decrease in endometrial thickness (P<0.05), whereas no significant change was observed in the 50% ethanol injury group when compared to the sham operation (P>0.05). The expression levels of fibrotic marker molecules collagen type Ⅳ alpha 1 chain (Col4A1), α-smooth muscle actin (α-SMA), transforming growth factor-β (TGF-β), and pro-inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were significantly elevated in the 50% ethanol injury group when compared to the sham operation (P<0.05), although there was an increasing trend of the same markers in the 95% ethanol injury group, the differences were not statistically significant (P>0.05). On day 15 after modeling, the histopathological changes in both ethanol injury groups were not significant when compared to the sham operation, the expression levels of Col4A1, TGF-β, TNF-α and IL-1β remained significantly higher in the 50% ethanol injury group (P<0.05), while only IL-1β was significantly elevated in the 95% ethanol injury group (P<0.05). Conclusion Uterine infusion with 95% ethanol results in more marked histopathological changes in the IUA mouse model compared to the 50% ethanol injury group. The 95% ethanol injury model is suitable for histopathological studies. However, the 50% ethanol injury group shows higher expression levels of fibrosis markers and pro-inflammatory factors compared to the 95% ethanol injury group, suggesting that the 50% ethanol injury model is more suitable for molecular pathological study.