Objective To explore and establish a technical pathway for size-specific dose estimate (SSDE) in pediatric CT patients of different age groups based on structured dose files and DICOM files, and to provide an effective method for precise monitoring of medical radiation exposure in pediatric CT scans. Methods Structured radiation dose reports (SR files) for pediatric patients aged 15 and under, who underwent CT scans between January and December 2023, were exported from the hospital information system. Scanning parameters and dose information were extracted using specialized software, and SSDE was calculated based on the patient body size parameters. The data were grouped by age (0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years) for statistical analysis. Results From January to December 2023, a total of 2706 pediatric CT scans were performed at the hospital, including 385 (14.23%) head scans, 1990 (73.54%) chest scans, 143 (5.28%) abdominal scans, 112 (4.14%) limb scans, and 76 (2.81%) other scans. The typical volume CT dose index (CTDI_vol) for head CT in the age groups of 0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years were 36.21, 35.29, 37.27, and 41.18 mGy, respectively; the corresponding SSDE values were 41.27, 32.82, 30.56, and 28.41 mGy, respectively. For chest CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 1.91, 2.11, and 2.51 mGy, respectively; the corresponding SSDE values were 2.36, 2.21, and 3.50 mGy, respectively. For abdominal CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 3.94, 4.33, and 6.26 mGy, respectively; the corresponding SSDE values were 5.77, 7.10, and 9.79 mGy, respectively. Conclusion This study developed a technical pathway to estimate the medical radiation doses of pediatric CT patients of different ages based on structured dose files and DICOM files. The feasibility of this approach was validated using data collected over a one-year period.

The catalytic activity of 3-mercaptopyruvate (3MP) sulfurtransferase (MPST) converts 3MP to hydrogen sulfide (H₂S). However, the regulatory mechanisms governing MPST and its impact on the brain remain largely unexplored. Our study reveals the neuroprotective role of endothelial MPST-generated H₂S, regulated by protein phosphatase 2A (PP2A). Bioinformatics analysis and RNA sequencing demonstrated that endothelial PP2A is associated with neurodegenerative disease pathways. Cerebral ischemic mice exhibited significant inactivation of endothelial PP2A, evidenced by the reduction of PP2Acα in the brain endothelium. Mice with endothelium-specific null PP2A (PP2A^EC-cKO) exhibited neuronal loss, cognitive dysfunction, and long-term potentiation deficits. Postnatal inactivation of endothelial PP2A also contributes to cognitive dysfunction and neuronal loss. However, regaining endothelial PP2A activity by overexpressing Ppp2ca rescued neuronal dysfunction. Mechanistically, PP2A deficiency is intricately linked to the MPST-H₂S signaling pathway. A robust reduction in endothelial MPST-dependent H₂S production followed PP2A deficiency. Exogenous H₂S treatment and AAV-mediated overexpression of MPST in brain endothelial cells significantly mitigated neuronal dysfunction in PP2A^EC-cKO mice. Furthermore, PP2A deficiency promotes an increase in calcium influx and calpain2 phosphorylation, subsequently leading to MPST degradation. The PP2A activator (FTY720) and MPST activator (3MP sodium) both remarkably restored endothelial MPST-dependent H₂S production, subsequently rescuing ischemia-induced neurological deficits. In conclusion, our study demonstrates that endothelial PP2A deficiency leads to MPST degradation by activating calpain2, thus damaging neuronal function.

Objective: To evaluate the long-term effectiveness of an intelligent blood transfusion system in intraoperative blood management by comparing its performance with clinicians' decisions. Methods: A retrospective analysis of 26 760 surgical cases (2017-2024) was conducted, comparing pre- and post-implementation (2017-2019 vs 2020-2024) metrics, including transfusion prediction accuracy, rationality of blood use, and clinical outcomes. The system, powered by XGBoost, integrated patient demographics, laboratory results, and surgical data to predict red blood cell transfusion needs. Results: The intelligent blood transfusion systems achieved an accuracy of 80.62% in predicting transfusion necessity, significantly outperforming clinicians (24.83%, P<0.001). Its blood-use rationality rate was 83.92% vs 18.02% for clinicians (P<0.001). Post-implementation, major surgeries (grades Ⅲ-Ⅳ) increased while the requested blood units decreased. High physician compliance (>75%) correlated with 88.18% rationality. Conclusion: The intelligent blood transfusion system significantly improves the accuracy of transfusion decision-making, reduces excessive red blood cell use, optimizes perioperative transfusion management, and enhances the utilization of blood medical resources.

ObjectiveTo determine the prevalence and determinants of Mycobacterium tuberculosis latent infection among primary and secondary school students in Cixi City, Zhejiang Province, so as to provide references for the prevention and control of tuberculosis in school settings. MethodsInterferon-γ release assay (IGRA) testing was performed to fourth-grade primary school students , as well as to those grade 7 and grade 10 students of the academic year 2024‒2025 in Cixi City. Individuals tested positive for IGRA were subsequently subjected to chest X-ray examination and sputum tests (including three smear microscopy examinations and one mycobaterial culture), and epidemiological investigations were carried out for confirmed cases. Infection rates were compared across student categories by χ² tests, while factors influencing infection were analysed through multivariate logistic regression. ResultsA total of 36 214 students completed tuberculosis screening, with an infection rate of 0.72% (260/36 214). The tuberculosis infection rates among fourth-grade primary school students, non boarding grade 7 students, boarding grade 7 students, grade 10 students of senior high school and of vocational high school were 0.68% (89/13 139), 0.75% (86/11 501), 0.51% (13/2 553), 0.76% (52/6 819), and 0.91% (20/2 202), respectively. Multivariate logistic regression analyses indicated that students with a history of close contact with tuberculosis patients (OR=21.435, P<0.001) had a higher risk of tuberculosis infection, students with a geographic origin outside Zhejiang Province (OR=1.485, P=0.002) had a higher risk of infection than those within Zhejiang Province. Furthermore, students from ethnic minority classes (OR=4.232, P<0.001) might be high-risk groups for tuberculosis infection in high school settings. One IGRA-positive student was confirmed as bacteriologically positive pulmonary tuberculosis by liquid culture of sputum collected one month later. ConclusionSchools should prioritize tuberculosis screening. Students with a history of close contact, those with a geographic origin outside Zhejiang Province, and those enrolled in minority classes should be taken as priority targets for future tuberculosis screening programmes. A tracking and follow-up system must be established for IGRA-positive students to prevent persistent transmission of Mycobacterium tuberculosis within the school settings.

Objective To assess the predictive value of computed tomography pulmonary angiography(CTPA)cardiovascular parame-ters for chronic thromboembolic pulmonary hypertension(CTEPH)under the 2022 European Society of Cardiology/European Respiratory Society(ESC/ERS)guidelines,and to compare with the 2021 Chinese guidelines.Methods A total of 201 suspected CTEPH patients were retrospectively selected.All patients underwent right heart catheterization(RHC)and CTPA evaluation.According to the Euro-pean guidelines,they were divided into three groups:mean pulmonary artery pressure(mPAP)≤20 mmHg control group(63 cases)(1 mmHg=0.133 kPa),mPAP＞20 mmHg CTEPH group(138 cases),and mPAP≥25 mmHg CTEPH group(123 cases).Inter-group comparison of CTPA cardiovascular parameters was performed,and receiver operating characteristic(ROC)curve analysis was performed for each parameter.Results Under the 2022 European guidelines,the diagnostic efficacy of the diameter of the main pulmonary artery trunk(MPAd)was the highest[area under the curne(AUC)was 0.933].The binary logistic regression analysis revealed that the MP Ad,right ventricular free wall thickness(RVWT),and interventricular septal angle(IVSA)were inde-pendent risk factors for the diagnosis of CTEPH(P＜0.05).Under both the Chinese and European guidelines,the MPAd,the transverse diameter and area of the right atrium,the transverse diameter and area of the bi-ventricle,the RVWT,and the IVSA showed significant statistical differences in CTEPH and control groups(P＜0.05).Conclusion Under both the Chinese and European guidelines,the MP Ad measured by CTPA has the highest diagnostic efficacy for CTEPH,while the IVSA has the strongest correlation with clinical prognostic indicators.The right atrium structure also has evaluation value.

OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.

Objective To develop an unmanned aerial vehicle (UAV)-borne radiation monitoring system with high detection efficiency and nuclide identification ability for airborne monitoring in nuclear emergency. Methods The UAV-borne CeBr₃ radiation monitoring system was composed of four cerium bromide (CeBr₃) crystal detectors coupled with silicon photomultipliers (SiPMs) and other components including integrated modules, intelligent electronic devices, and new composite materials. Results According to various performance tests on the system, the crystal energy resolution was better than 5% (@0.662 MeV), the peak drift of the energy spectrum was within ±1 channel, the linear fit of energy was 0.99997, the change in the count rate of each energy window during 12 h long-term measurement was less than 5%, and the detection efficiency was higher compared with that of NaI (Tl) detectors of the same volume. Conclusion Through ground point source testing and theoretical calculation, the system has reliable ability to identify radionuclides, which can be used in nuclide identification and the preparedness and response for nuclear and radiation emergencies.

【Objective】 To explore the the potential risks of antiretroviral therapy(ART) drugs on blood safety among blood donors in Shenzhen. 【Methods】 High pressure liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used to measure ART drugs concentrations in the plasma of regular blood donors (negative control group, n=86) and anti-HIV positive individuals (experimental group, n=98, detected from approximately 440 000 blood donors during 2019—2023). The baseline plasma concentrations of ART drugs in the negative control group were clarified, and the impact of ART drugs on blood safety was analyzed. 【Results】 The baseline concentrations of ART drugs were not detected in 86 samples of negative control group. Four positive ART drugs samples were detected in 1∶2 pooled plasma samples of 98 anti-HIV positive blood donors plasma in the resolution test. The ART positive rate of anti-HIV positive donors was 4.08%, with tenofovir, lamivudine and efavirenz detected in three blood donors and lamivudine, lopinavir, ritonavir and zidovudine detected in one blood donor. 【Conclusion】 ART drugs were found among anti-HIV positive blood donors in Shenzhen. Additional research is needed to investigate the motivation of these specific donors, so as to ascertain the groups most susceptible to potential risks, and guarantee blood safety.

Objective To measure the air-absorbed dose rate of gamma radiation in public areas for the situation of the local radiation environment. Methods Using a large-volume γ spectrometer system with a NaI(Tl) detector mounted on a UAV, we conducted large-scale airborne radiation monitoring in public areas in southwestern China, to measure the air-absorbed dose rate at a height of 1 m from the earth’s surface. Results The airborne radiation monitoring data were used to analyze the local radiation environment. The mean air-absorbed dose rate at a height of 1 m was 43.6 ± 12.9 nGy/h. Seven abnormal radiation points were detected, and two of them were located where construction was ongoing. At one of the abnormal radiation points, FH40G meter measurements showed that the air-absorbed dose rate at a height of 1 m was up to 22.0 μGy/h. Field soil samples were collected for HPGe γ spectrometer analysis: the ²³²Th radionuclide activity concentration was 96.0 kBq/kg, and the ²²⁶Ra radionuclide activity concentration was 9.9 kBq/kg. Conclusion Using the UAV-mounted large-volume γ spectrometer system with NaI(Tl) detectors for large-scale airborne monitoring is a fast and effective method for dragnet monitoring of the level of radiation in public areas.

Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.