Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

Intrinsic gallium-68 labeling of nanoclays was developed with high labeling yield and radiostability that did good for their in vivo tracking.Image 1.

Objective: To develop the Adolescent Peer Bullying Knowledge-Attitude-Practice (KAP) Questionnaire and to evaluate its reliability and validity, so as to provide an effective tool for evaluating the KAP level regarding peer bullying among adolescents. Methods: A preliminary framework was developed through literature review, expert consultation, and group discussions. In September 2024, 2 203 students in grades 7 to 9 from two regular junior high schools in Anhui Province were selected using cluster sampling for a preliminary survey aimed at questionnaire development, including item screening and reliability and validity testing. Results: The initial KAP questionnaire on adolescent peer bullying consisted of 25 items: two items, "Behavior 6" and "Behavior 7", were excluded as their correlation coefficients with the total KAP score being only 0.08 and 0.05, respectively, falling below the preset criteria(0.4). The final questionnaire comprised 23 items, divided into three dimensions: knowledge, attitude, and behavior. Reliability testing showed that the overall Cronbach α coefficient of the questionnaire was 0.89, with Cronbach α coefficients for the knowledge, attitude, and behavior dimensions being 0.91, 0.67 and 0.79, respectively. The overall splithalf reliability of the questionnaire was 0.87, with split half reliabilities for the knowledge, attitude, and behavior dimensions being 0.82, 0.64 , and 0.66, respectively. Testretest reliability ranged from 0.82 to 0.97. Confirmatory factor analysis results indicated that the questionnaire had RMSEA=0.062, NFI=0.924, CFI =0.931, with good discriminant validity. Conclusion The developed KAP questionnaire on adolescent peer bullying demonstrates good reliability and validity and can be used as an assessment tool for evaluating the KAP level regarding peer bullying among adolescents.

Objective: To evaluate the effectiveness of a family-school-community integrated intervention based on the microsystem theory in reducing peer bullying among junior high school students, so as to provide empirical evidence and feasible pathways for junior high school students bullying prevention and control in China. Methods: A combining convenience with clustering method was employed to select 6 268 students from three regular junior high schools in Fuyang and Anqing cities, Anhui Province, as the study subjects in October 2024, and randomly assigned by drawing lots to three groups: family-school-community integrated intervention ( n =2 063), school only intervention ( n =1 864), and control group ( n =2 341). From October 10, 2024, to January 10, 2025, the intervention was implemented for three months using posters, brochures, and videos, with one session every half month, each lasting 40 minutes. The family-school-community integrated intervention group received multi level interventions involving families, schools, and communities, while the school only intervention group received only school based interventions. The control group received routine school health education but no other interventions. Before and after the intervention, data on peer bullying among junior high school students were collected using the Peer Bullying Scale, and comparison of detection rate of peer bullying by Chi square test. Results: After the intervention,group comparison results showed that the incidence rates of various types of peer bullying in the family-school-community integrated intervention group, the school only intervention group, and the control group all showed statistically significant differences ( χ 2=28.61-66.85, all P <0.05). The detection rates of verbal bullying ( 7.51 %), relational bullying (5.62%), physical bullying (3.34%), cyberbullying (1.75%), being bullied (10.81%), verbal bullying others (2.67%), relational bullying others (1.55%), physical bullying others (1.36%), cyberbullying others (1.41%), and overall peer bullying (3.64%) in the family-school-community integrated intervention group were all lower than those in the control group (12.52%, 11.58%, 6.24%, 5.00%, 19.14%, 7.56%, 4.49%, 4.53%, 3.80%, 9.40%); additionally, the detection rates of verbal bullying others, overall peer bullying , verbal bullying, and being bullied , in the family-school-community integrated intervention group were all lower than those in the school only intervention group (4.67%, 6.65%, 13.14%, 16.42%), with statistically significant differences ( χ 2=30.04, 48.49, 19.75, 34.60, 58.89, 52.65, 31.32, 37.37, 24.14, 58.26; 11.25, 18.53, 33.93, 26.41, all P <0.016 7). Group comparison showed that in both intervention groups, the majority of peer bullying behaviors decreased after the intervention ( χ 2=4.86-171.01, all P <0.05). Conclusions The family-school-community integrated intervention based on the microsystem can effectively reduce peer bullying among junior high school students, with better efficacy than the single school intervention. The model can serve as a practical reference for establishing a multi level prevention and intervention system for junior high school students bullying in China.

Ultrasound has become one of the most important imaging modalities for prenatal screening because of its advan-tages of not requiring irradiation and easy operation,and it is widely used throughout pregnancy.With the rapid development of artificial intelligence,ultrasound image recognition based on deep learning has been researched extensively in the application of prenatal screening and has shown significant advantages in the detection of fetal cranial and cardiac structures and fetal anoma-lies.This technology can improve the efficiency of prenatal ultrasound screening,increase the detection rate of fetal anomalies,optimize the quality of healthcare services,and improve patient professionalism and patient satisfaction.Moreover,it plays a cru-cial role in improving healthcare access in rural and low-income areas,supporting existing clinical practices,and streamlining workflow processes.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

Objective:To synthesize Gd labeled probe targeting transporter protein(TSPO) 2-(8-amino-2-(4-chlorophenyl)imidazo[1, 2-a]pyridine-3-yl)- N, N-dipropylacetamide (CB86)-diethylene triamine pentaacetic acid (DTPA), and investigate its MRI effect in rheumatoid arthritis (RA) model. Methods:CB86-DTPA was prepared by coupling a bifunctional chelating agent, and then chelated with Gd to obtain MRI targeted contrast agent CB86-DTPA-Gd. The cytotoxicity, MR relaxation rate and in vitro stability of CB86-DTPA-Gd were determined. RA model was established with Freund′s adjuvant and the biodistribution study and MRI was performed. The RA lesion and its surrounding normal tissue were used as regions of interest (ROI) to calculate the signal to noise ratio (SNR). Independent-sample t test was used to analyze the data. Results:CB86-DTPA-Gd had excellent biosafety and a good MR relaxation rate ( r1=11.05 mmol·L -1·s -1). The survival rate of RAW264.7 cells and 4T1 cells was still more than 90% at the maximum concentration (20 μmol/L) of Gd 3+. CB86-DTPA-Gd also exhibited good stability in human serum and phosphate buffer saline solution (PBS; pH=7.4). The in vivo biodistribution showed that CB86-DTPA-Gd had better inflammatory targeting efficiency, and the uptake of Gd in the inflamed site of the ankle joint was still (2.33±0.29) percent dose rate per gram of tissue (%ID/g) at 120 min after injection. MicroMRI showed that the inflammation of the right ankle joint displayed significant enhancement after the injection of CB86-DTPA-Gd and Gd-DTPA. The SNR of CB86-DTPA-Gd group was up to 23.21±1.44, and the maximum intensification time was 90 min after injection, and can be significantly inhibited by CB86-DTPA at all time points ( t values: 6.083-12.451, all P<0.05), while the Gd-DTPA group had a strengthening time of 30 min after injection with the SNR of 16.12±1.24. Conclusion:CB86-DTPA-Gd shows good macrophage targeting and good uptake in arthritic reaction sites, and is expected to be a novel MRI molecular probe for peripheral inflammation imaging.

Objective:To explore the effective method for treatment of small and short penis after hypospadias surgery.Method:s From November 2017 to November 2018, 57 children aged 4 to 14[mean age(7.91±2.89)years] with hypospadias who met the diagnostic criteria of small penis were reexamined at the First Affiliated Hospital of Xin-xiang Medical University.They were randomly divided into the physical treatment group and the drug treatment group according to the order of visits, and the untreated patients were included in the control group.Among them, 21 patients in the physical treatment group were treated with penile rehabilitation therapy apparatus, supplemented by Salvia mil-tiorrhiza bath (30 minutes/time, once/day, 10 days), and 20 patients in the drug treatment group were treated with Testosterone cream topically (3 times/day, 10 days). Penile relaxation length, stretch length, transverse and longitudinal diameters of glans in 2 groups before and after the treatment were measured.The relevant indexes of 16 patients in the control group measured before and after 10 days and compared with those in the treatment group.Result:s (1)The penile relaxation length in the physical treatment group increased from (25.48±6.13) mm to (30.72±6.49) mm, the length of stretch increased from (34.90±7.71) mm to (41.08±8.43) mm, the transverse diameter of glans increased from (14.81±3.40) mm to (16.57±3.42) mm, and the longitudinal diameter increased from (13.94±3.15) mm to (15.82±3.52) mm, and the differences were statistically significant (all P<0.05). (2)The penile relaxation length in the drug treatment group increased from (21.07±4.26) mm to (31.32±4.72) mm, the length of stretch increased from (31.94±7.96) mm to (45.39±7.24) mm, the transverse diameter of glans increased from (13.38±1.77) mm to (16.64±2.10) mm, and the longitudinal diameter increased from (13.09±1.77) mm to (16.62±1.86) mm, and the differences were statistically significant (all P<0.05). (3)There was no significant difference in penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans before and after 10 days in the control group (all P>0.05). (4) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the physical treatment group increased significantly, and the differences of growth values between the two groups were statistically significant (all P<0.05). (5) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the drug treatment group also increased significantly, and the difference of growth values between the two groups were statistically significant (all P<0.05). (6) The growth of penile relaxation length, the length of stretch and transverse and longitudinal diameters in the drug treatment group were higher than those in the physical treatment group, and the difference of growth values were statistically significant (all P<0.05). Conclusions:Both the negative pressure suction method and topical application of Testosterone cream are effective in the treatment of small and short penis after hypospadias surgery.However, Testosterone cream is difficult to obtain, and the treatment of negative pressure suction is simple, noninvasive, painless and free of adverse reactions.

Objective To synthesize a novel 18 F labeled probe targeting translocator protein ( TSPO) ligand 2-( 5, 7-diethyl-2-( 4-( 2-fluoroethoxy ) phenyl ) pyrazolo [ 1, 5-a ] pyrimidin-3-yl )-N, N-diethylacet-amide (VUIIS1008), and evaluate its biodistribution and imaging in rheumatoid arthritis (RA) model. Methods The tosylate substrate was labeled with 18 F using a tosyloxy for fluorine nucleophilic aliphatic substitution to obtain 18 F-VUIIS1008. The labeling efficiency, radiochemical purity, and stability in vitro were determined. In vitro cellular uptake and competitive binding assay were performed on RAW264.7 mac-rophage cells. Biodistribution and microPET/CT imaging were investigated on RA mice established by Com-plete Freund's Adjuvant. Two-sample t test was used to analyze the data. Results 18 F-VUIIS1008 was syn-thesized with the labeling yield up to (41.00±5.00)％, the radiochemical purity>98.00％, and the specific radioactivity >1. 52 × 108 MBq/mmol. 18 F-VUIIS1008 was highly stable with the radiochemical purity >98. 00％ at 4 h after incubation in mouse serum. In vitro, it also exhibited high specific TSPO binding in RAW264.7 macrophage cells. The uptake ratio was (14.00±0.30)％ at 1 h after incubation, and decreased significantly ((4.00±0.70)％;t=12.894, P<0.05) after adding excessive unlabeled VUIIS1008. The half maximal inhibitory concentration (IC50) of 18F-VUIIS1008 binding to TSPO was 0.05 nmol/L in RAW264.7 macrophage cells. In vivo distribution results showed that the uptake of 18 F-VUIIS1008 in the left arthritic ankles reached the peak value of (1.33±0.02) percentage activity of injection dose per gram of tissue (％ID/g) at 1 h after injection. The radioactivity ratio of left ankle arthritic tissue to blood ( A/B) and to normal muscle ( A/M) was 4.40±0.22 and 1.65±0.07 respectively. MicroPET/CT imaging demonstrated that 18F-VUIIS1008 could specifically target and retained in the inflammation site. Conclusion 18 F-VUIIS1008 can be easily synthe-sized with high radiochemical purity and can clearly visualized in RA imaging with low background, suggesting its potential as a novel promising molecular probe targeting TSPO for RA PET imaging.