ObjectiveTo explore the clinical safety of Feilike Mixture （FLK） in the real world. MethodsThe safety of all children who received FLK from 29 institutions in 12 provinces between January 21，2021 and December 25，2021 was evaluated through prospective centralized surveillance and a nested case control study. ResultsA total of 3 035 juveniles were included. There were 29 research centers involved，which are distributed across 12 provinces，including one traditional Chinese medicine （TCM） hospital and 28 general hospitals. The average age among the juveniles was （4.77±3.56） years old，and the average weight was （21.81±12.97） kg. Among them，119 cases （3.92%） of juveniles had a history of allergies. Acute bronchitis was the main diagnosis for juveniles，with 1 656 cases （54.46%）. FLK was first used in 2 016 cases （66.43%），and 142 juvenile patients had special dosages，accounting for 4.68%. Among them，92 adverse drug reactions （ADRs） occurred，including 73 cases of gastrointestinal system disorders，10 cases of metabolic and nutritional disorders，eight cases of skin and subcutaneous tissue diseases，two cases of vascular and lymphatic disorders，and one case of systemic diseases and various reactions at the administration site. The manifestations of ADRs were mainly diarrhea，stool discoloration，and vomiting，and no serious ADRs occurred. The results of multi-factor analysis indicated that special dosages （the use of FLK）［odds ratio （OR） of 2.642， 95% confidence interval （CI） of 1.105-6.323］，combined administration： spleen aminopeptide （OR of 4.978， 95%CI of 1.200-20.655），and reason for combined administration： anti-infection （OR of 1.814， 95%CI of 1.071-3.075） were the risk factors for ADRs caused by FLK. Conclusion92 ADRs occurred among 3 035 juveniles using FLK. The incidence of ADRs caused by FLK was 3.03%，and the severity was mainly mild or moderate. Generally，the prognosis was favorable after symptomatic treatment such as drug withdrawal or dosage reduction，suggesting that FLK has good clinical safety.

Persistent left superior vena cava is a rare venous variant that is often combined with cardiovascular malformations. In thoracic surgery, especially mediastinal tumor resection, neglect of this variant may make the surgery difficult and risky, and careful preoperative imaging interpretation and adequate preoperative evaluation play an important role in the perioperative safety of the patient. In this paper, we reported a case of a 17-year-old female patient with a persistent left superior vena cava combined with mediastinal tumors. She was successfully discharged 5 days after thoracoscopic surgery, and after 3 years of postoperative follow-up, no tumor recurrence was observed.

Gastrointestinal (GI) cancers are a leading cause of cancer morbidity and mortality worldwide. Despite advances in treatment, cancer relapse remains a significant challenge, necessitating novel therapeutic strategies. In this study, we engineered nanobody-based chimeric antigen receptor (CAR) natural killer (NK) cells targeting cadherin 17 (CDH17) for the treatment of GI tumors. In addition, to enhance the efficacy of CAR-NK cells, we also incorporated CV1, a CD47-SIRPα axis inhibitor, to evaluate the anti-tumor effect of this combination. We found that CDH17-CAR-NK cells effectively eliminated GI cancers cells in a CDH17-dependent manner. CDH17-CAR-NK cells also exhibit potent in vivo anti-tumor effects in cancer cell-derived xenograft and patient-derived xenograft mouse models. Additionally, the anti-tumor activity of CDH17-CAR-NK cells is synergistically enhanced by CD47-signal regulatory protein α (SIRPα) axis inhibitor CV1, likely through augmented macrophages activation and an increase in M1-phenotype macrophages in the tumor microenvironment. Collectively, our findings suggest that CDH17-targeting CAR-NK cells are a promising strategy for GI cancers. The combination of CDH17-CAR-NK cells with CV1 emerges as a potential combinatorial approach to overcome the limitations of CAR-NK therapy. Further investigations are warranted to speed up the clinical translation of these findings.

Recent progress in targeted metabolic therapy of cancer has been limited by the considerable toxicity associated with such drugs. To address this challenge, we developed a smart theranostic prodrug system that combines a fluorophore and an anticancer drug, specifically 6-diazo-5-oxo-l-norleucine (DON), using a thioketal linkage (TK). This system enables imaging, chemotherapy, photodynamic therapy, and on-demand drug release upon radiation exposure. The optimized prodrug, DON-TK-BM3, incorporating cyanine dyes as the fluorophore, displayed potent reactive oxygen species release and efficient tumor cell killing. Unlike the parent drug DON, DON-TK-BM3 exhibited no toxicity toward normal cells. Moreover, DON-TK-BM3 demonstrated high tumor accumulation and reduced side effects, including gastrointestinal toxicity, in mice. This study provides a practical strategy for designing prodrugs of metabolic inhibitors with significant toxicity stemming from their lack of tissue selectivity.

Objective To explore the factors influencing the image quality of thyroid CT and the application value of optimization schemes in reducing streak artifacts in thyroid CT examinations.Methods A retrospective review of the data of 141 patients who underwent thyroid enhanced CT examinations was conducted to analyze the factors affecting image quality.After determining the influencing factors,a self-controlled study was conducted on 48 patients who underwent thyroid CT examinations to analyze the feasibility of the optimization scheme.Results The patients'body mass index(BMI),neck circumference,pharynx-jaw angle,and pharynx-jaw angle-to-neck circumference ratio showed statistically significant differences in their impact on image quality(P<0.05).Compared to the conventional scheme,the optimization scheme showed significantly higher subjective and objective image evaluations.The optimization scheme also significantly improved the diagnostic performance of the images,with statistically significant differences(P<0.05).There was no statistically significant difference in radiation dose between the two positions(P>0.05).Conclusion The optimization scheme can effectively reduce streak artifacts in thyroid CT examinations.

BACKGROUND:Early transient presence of M1 macrophages can play a beneficial role after the implantation of bone tissue engineering materials.Recently,strategies for manipulating M1 macrophages to produce an early moderate inflammatory response have been extensively studied and many research advances have been made in the design of bone tissue engineering materials. OBJECTIVE:To review the role of early transient presence of M1 macrophages in bone tissue engineering and recent research advances in the strategy for activating early transient presence of M1 macrophages in the field of bone tissue engineering. METHODS:Relevant literature included in PubMed,WanFang database,and CNKI Database from January 2012 to October 2022 was searched.Search terms were"M1,macrophage,bone immunoregulation,bone defect,osteogenesis,osteoimmunology,angiogenesis"in English and Chinese.After excluding articles irrelevant to the research purpose and repetitive articles,63 papers were finally included for review. RESULTS AND CONCLUSION:The early transient presence of M1 macrophages play a key role in bone tissue engineering by promoting angiogenesis,facilitating osteogenic differentiation of bone marrow mesenchymal stem cells and promoting an M2 macrophage phenotype.Strategies for inducing and activating early transient presence of M1 macrophages can modulate the local immune microenvironment for bone defect repair in a manner consistent with early natural bone healing,including modulation of the physicochemical properties of bone tissue engineering materials to promote appropriate M1 macrophage-mediated inflammatory responses,sequential delivery of cytokines,microRNAs or bioactive ions to facilitate the M1-to-M2 transition of macrophages,and controlled release of anti-inflammatory substances to achieve the maintenance of early inflammatory responses.

Objective To investigate the serum levels of semaphorin 3E(Sema3E)in patients with intracranial aneurysms,revealing the correlation between Sema3E and 1-month poor prognosis after interventional embolization.Methods This study was a prospective single-center cohort study,recruiting 102 consecutive patients with intracranial aneurysms who underwent interventional surgery from June 2020 to January 2022 in our hospital.Among them,11 patients were excluded.Clinical and radiological profiles were collected.Peripheral blood was collected after admission,and serum Sema3E levels were determined by enzyme-linked immunosorbent assay.All the aneurysms were treated with endovascular coil embolization or stent-assisted coil embolization.The primary outcome was evaluated with the Glasgow Outcome Scale(GOS)1 month after interventional therapy.The favorable outcome was defined as a GOS score of 4-5,and a poor outcome was defined as a GOS score of 1-3(severe disability,vegetative state,or death).Univariate and multivariate logistic regression analyses were used to identify potential prognostic factors after interventional therapy.Results The average age of 91 patients with intracranial aneurysm was 59.9±11.0 years old,including 70 cases(76.9%)with favorable prognosis and 21 cases(23.1%)with poor prognosis.The mean preoperative Glasgow Coma Scale(GCS)score of the poor prognosis group(9.4±4.5)was significantly lower than that of the favorable prognosis group(13.3±2.5;P<0.001).In the poor prognosis group,the Hunt-Hess grade(3.6±0.6 vs.2.0±1.3,P<0.001)and the serum Sema3E levels[(6.21±1.58)μg/L vs.(4.38±1.77)μg/L,P<0.001]were significantly higher than those in the favorable prognosis group.Logistic regression analysis showed the Hunt-Hess grade(OR =7.150,P =0.003),stent-assisted coil embolization(OR =15.777,P =0.010),and the serum Sema3E level(OR =1.756,P =0.027)were independent prognostic factors for intracranial aneurysms after interventional therapy.Conclusions The serum Sema3E level is closely correlated with the severity of intracranial aneurysms.The serum Sema3E level is a prognostic factor for interventional treatment,which can be used as a biomarker for predicting poor outcomes.

Objective To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical peri-odontal therapy(MINST)assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning(SRP)to therefore provide a reference for clinical periodontal treatment.Methods Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups:the MINST(MINST,20 cases,81 sites)group and the classic scaling and root planing(SRP,20 cases,80 sites)group.Before treatment and 12 and 24 months after treatment,probing depth(PD)and clinical attachment loss(CAL)were examined.Moreover,changes in the depth and angle of the intrabony defects were analyzed.Follow-up examination and maintenance treat-ment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.Results The PD and CAL of patients in both groups continued to decrease(P＜0.001),and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle(P＜0.001).The changes in the first 12 months were significantly greater than those in the last 12 months in both groups(P＜0.001).The de-creases in PD,CAL,and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group(P＜0.001).At 12 and 24 months after treatment,the PD and CAL in the MINST group were lower than those in the SRP group(P＜0.001).The defect height of the MINST group decreased more than that of the SRP group(P＜0.001),and the defect angle of the MINST group increased more than that of the SRP group(P＜0.001).Conclusion Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone.Imaging reflects that alveolar bone healing is rapid at first and then slows.Compared with traditional SRP,endoscopically assisted MINST can yield better clinical indicators and imag-ing changes in intrabony defects.

Pancreatic metastases originating in colon cancer are very rare clinically, and there are few reports on their imaging manifestations. In this paper, it improves the diagnosis of the disease by reporting a case of pancreatic head metastases and focusing on the appearance of contrast-enhanced ultrasound.