Vesicoureteral reflux(VUR)is a common congenital abnormality of the urinary tract in children,which often presents as urinary tract dilatation(UTD)and/or febrile urinary tract infection(fUTI).VUR may lead to renal scarring,hypertension or end-stage renal disease,while some cases may resolve spontaneously.Accurate identification of VUR in pediatric population is pivotal for early diagnosis,timely intervention and prevention of renal damage.Multimodal imaging plays a critical role in diagnosing and grading VUR,also in assessing complications such as acute pyelonephritis and renal scarring.This narrative review summarized the clinical application of multimodal imaging modalities in diagnosis,evaluation and management of VUR in children.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

OBJECTIVE To analyze the plasma-entering components of the ethanol extract of Yu-Ping-Feng-San by ultra-per-formance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(UPLC-Q-TOF-MS)technology,so as to pro-vide a reference for the study of the pharmacological substances of Yu-Ping-Feng-San.METHODS Male BALB/c mice were ga-vaged with the ethanol extract of Yu-Ping-Feng-San(6.5 g·kg-1),and plasma samples were collected before administration(0 h)and 1,2,4,6,8,and 12 h after administration.The UPLC-Q-TOF-MS technology was used to analyze and identify the components absorbed into the plasma.RESULTS A total of 73 chemical components in the ethanol extract of Yu-Ping-Feng-San were identi-fied,and 26 plasma-entering components were identified in all plasma samples.Among the plasma-entering components,11 compo-nents were from Saposhnikoviae Radix,and 15 components were from Radix Astragali.CONCLUSION The chemical components and plasma-entering components of the ethanol extract of Yu-Ping-Feng-San were analyzed comprehensively,which provides a reference for further clarifying the pharmacological substance basis and mechanism of action of Yu-Ping-Feng-San.

In recent years,the prevalence of porcine infectious pleuropneumonia caused by Actinoba-cillus pleuropneumoniae(APP)has significantly increased in large-scale pig farms in China.The i-solation,identification,and biological characteristic testing of newly prevalent strains have impor-tant clinical significance.This study isolated four suspected APP strains(named XB2T-56,JMTLP-443,YD-THB-755,SYZJ-291)from lung samples of pig farms suspected of outbreaks of porcine infectious pleuropneumonia in Hubei Province.They were identified by PCR amplification,and multiplex PCR serological typing,the biological properties were tested by detecting the growth a-bility,hemolytic activity and biofilm forming ability.The drug resistance of the strains was ana-lyzed by drug sensitivity testing,and the virulence of one strain(XB2T-56)in mice and piglets was evaluated.The PCR identification result showed that all four clinical isolates were APP serotype 15 strains.These four strains grew slower than serotype 1 standard strains,had weaker hemolytic activity,but could form stronger biofilms.These strains are all less sensitive to cephalosporin,tylo-sin,sulfamethoxazole,and doxycycline,but sensitive to cefotaxime and enrofloxacin.The mice and piglet infection experiments showed that the isolated strain XB2T-56 has strong virulence.Artifi-cial intranasal infection causes acute death in piglets,with typical symptoms of pleuropneumonia in the lungs,and serotype 15 strains can be isolated from the lesion site.This study indicates that the APP serotype 15 strain has strong virulence,providing new date for the clinical epidemiological characteristics of APP.

OBJECTIVE To analyze the plasma-entering components of the ethanol extract of Yu-Ping-Feng-San by ultra-per-formance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(UPLC-Q-TOF-MS)technology,so as to pro-vide a reference for the study of the pharmacological substances of Yu-Ping-Feng-San.METHODS Male BALB/c mice were ga-vaged with the ethanol extract of Yu-Ping-Feng-San(6.5 g·kg-1),and plasma samples were collected before administration(0 h)and 1,2,4,6,8,and 12 h after administration.The UPLC-Q-TOF-MS technology was used to analyze and identify the components absorbed into the plasma.RESULTS A total of 73 chemical components in the ethanol extract of Yu-Ping-Feng-San were identi-fied,and 26 plasma-entering components were identified in all plasma samples.Among the plasma-entering components,11 compo-nents were from Saposhnikoviae Radix,and 15 components were from Radix Astragali.CONCLUSION The chemical components and plasma-entering components of the ethanol extract of Yu-Ping-Feng-San were analyzed comprehensively,which provides a reference for further clarifying the pharmacological substance basis and mechanism of action of Yu-Ping-Feng-San.

In recent years,the prevalence of porcine infectious pleuropneumonia caused by Actinoba-cillus pleuropneumoniae(APP)has significantly increased in large-scale pig farms in China.The i-solation,identification,and biological characteristic testing of newly prevalent strains have impor-tant clinical significance.This study isolated four suspected APP strains(named XB2T-56,JMTLP-443,YD-THB-755,SYZJ-291)from lung samples of pig farms suspected of outbreaks of porcine infectious pleuropneumonia in Hubei Province.They were identified by PCR amplification,and multiplex PCR serological typing,the biological properties were tested by detecting the growth a-bility,hemolytic activity and biofilm forming ability.The drug resistance of the strains was ana-lyzed by drug sensitivity testing,and the virulence of one strain(XB2T-56)in mice and piglets was evaluated.The PCR identification result showed that all four clinical isolates were APP serotype 15 strains.These four strains grew slower than serotype 1 standard strains,had weaker hemolytic activity,but could form stronger biofilms.These strains are all less sensitive to cephalosporin,tylo-sin,sulfamethoxazole,and doxycycline,but sensitive to cefotaxime and enrofloxacin.The mice and piglet infection experiments showed that the isolated strain XB2T-56 has strong virulence.Artifi-cial intranasal infection causes acute death in piglets,with typical symptoms of pleuropneumonia in the lungs,and serotype 15 strains can be isolated from the lesion site.This study indicates that the APP serotype 15 strain has strong virulence,providing new date for the clinical epidemiological characteristics of APP.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Vesicoureteral reflux(VUR)is a common congenital abnormality of the urinary tract in children,which often presents as urinary tract dilatation(UTD)and/or febrile urinary tract infection(fUTI).VUR may lead to renal scarring,hypertension or end-stage renal disease,while some cases may resolve spontaneously.Accurate identification of VUR in pediatric population is pivotal for early diagnosis,timely intervention and prevention of renal damage.Multimodal imaging plays a critical role in diagnosing and grading VUR,also in assessing complications such as acute pyelonephritis and renal scarring.This narrative review summarized the clinical application of multimodal imaging modalities in diagnosis,evaluation and management of VUR in children.

Objective:To investigate the association between quantified CT (QCT)-measured body composition and metabolic syndrome (MS) components in obese populations before bariatric surgery.Methods:A cross-sectional study. A retrospective analysis was conducted on a cohort of 97 obese patients scheduled for weight-loss surgery at the First Affiliated Hospital of Wannan Medical College from January 2021 to March 2023. The patients′ body mass index (BMI), biochemical parameters and body composition measurements obtained by QCT were recorded. The patients were stratified into groups based on gender, obesity severity and the number of MS components. Differences in body composition among the groups were compared. Additionally, the correlations between each body composition parameter and metabolic indicators were analyzed. The diagnostic efficacy of each body composition parameter for identifying obese individuals with different MS components was assessed using receiver operating characteristic (ROC) curve analysis.Results:There were 75 females (77.3%). Male obese patients had higher total abdominal fat area [(693.23±148.90) vs (574.99±114.89) cm 2, t=-3.958, P<0.001], visceral fat area [(289.65±57.67) vs (195.60±57.37) cm 2, t=-6.753, P<0.001], fat content of pancreatic head [27.45%(21.65%, 45.48%) vs 21.60%(17.6%, 26.9%), Z=-2.675, P=0.007], and skeletal muscle index [73.36(68.74, 81.26) vs 61.52(55.74, 66.41) cm 2/m 2, Z=-5.246, P<0.001]. With the increase of obesity, abdominal fat mainly increases in subcutaneous fat. With the increase of MS components (MS2 group, MS3 group, MS4 group, MS5 group), the abdominal fat area, abdominal fat/subcutaneous fat, liver fat content, pancreatic head fat content, and skeletal muscle index of patients all increased accordingly. In diagnosing the presence of two components of MS, area under the curve of visceral fat area was the largest (AUC=0.706, 95% CI=0.577-0.834). For diagnosing the presence of three, four and five components of MS, area under curve of liver fat content were all the largest (MS3=0.712, 95% CI=0.605-0.818; MS4=0.652, 95% CI=0.537-0.766; MS5=0.706, 95% CI=0.576-0.836). Conclusion:There are differences in QCT body composition among obese patients with different MS components, and there is a correlation between each body composition and MS component. Among them, intra-abdominal fat area and liver fat content are of great value in evaluating obese patients with different MS components.

Objective To evaluate the clinical outcome of kidney transplantation from donation after brain death(DBD)donors complicated with acute kidney injury(AKI).Methods Clinical data of 216 DBD donors were retrospectively analyzed,and they were divided into the AKI group(n=69)and control group(n=147)according to the Kidney Disease:Improving Global Outcomes(KDIGO)guidelines.Donors in the AKI group were further divided into the KDIGO stage 1 and stage 2-3 subgroups.One hundred and thirty-five recipients were assigned into the AKI group and 288 recipients in the control group.Postoperative recovery of renal function and clinical outcomes of the recipients were recorded.The risk factors of delayed graft function(DGF)were identified.Results The highest serum creatinine(Scr)level,Scr level before procurement,the highest blood sodium level and blood sodium level before procurement in the AKI group were higher than those in the control group.The application duration of vasopressors in the AKI group was longer than that in the control group.In the AKI group,the amount of fluid resuscitation within 48 h was higher,the HCO3-level at admission was lower,and the incidence of diabetes insipidus and hypotension was higher than those in the control group.The highest Scr level and the Scr level before procurement in KDIGO stage 2-3 donors were significantly higher than those in KDIGO stage 1 counterparts(all P＜0.05).Compared with the control group,the incidence of DGF and acute rejection was higher,the proportion of continuous renal replacement therapy was higher,the Scr level within postoperative 90 d was higher,and the urine amount within postoperative 3 d was less than those of recipients in the AKI group.Compared with KDIGO stage 1 recipients,KDIGO stage 2-3 recipients had higher Scr levels at postoperative 3,4,5 and 15 d,and less urine amount at postoperative 2 d(all P＜0.05).Univariate analysis showed that donor age,the highest Scr level,the highest blood sodium level and the amount of fluid resuscitation within 48 h were the risk factors for DGF in recipients after kidney transplantation.Multivariate analysis showed that donor age was the independent risk factor for DGF in recipients after kidney transplantation(all P＜0.05).Conclusions For the application of DBD donors complicated with AKI,active organ maintenance should be performed to alleviate AKI.It exerts no effect upon graft function and survival rate at postoperative 6 months,which may achieve equivalent efficacy as non-AKI donors and may be used as a source of extended criteria donor kidneys.