Objective To analyze the current situation of pediatric CT examination protection and cognition in Linyi City, China, and to promote the safe and standardized development of pediatric CT examination. Methods The radiation protection facilities of 58 medical institutions, the use of protective equipment among 158 pediatric patients undergoing CT examinations, and the cognition of radiation knowledge by 188 radiographers were investigated, and the data were analyzed. Results All 58 medical institutions installed ionizing radiation warning signs according to the standards, the normal operation rate of the work indicator lights was 81.0%, and the proper provision rate of protective equipment was 72.4%. The utilization rate of protective equipment was 59.5%, and there were significant differences among hospitals at different levels (P < 0.05). Radiographers had the highest awareness rate of radiation hazards (93.6%). The awareness rate of radiation basic knowledge differed significantly among radiographers with variuos educational backgrounds and professional titles (P < 0.05). The awareness rate of protection knowledge differed significantly with sex, age, and professional title (P < 0.05). There were significant differences in the awareness rate of emergency knowledge and laws and regulations based on age, educational background, and professional title (P < 0.05). Conclusion The availability and utilization of protective facilities and equipment for pediatric CT examinations in medical institutions in Linyi City require further improvement. Radiographers have a high level of awareness of radiation hazards. However, there remain gaps in their awareness rates of fundamental radiation hygiene knowledge, radiation protection knowledge, emergency knowledge, and laws and regulations. Increased efforts in education and training are recommended.

Objective : To evaluate the coverage and spatial clustering of 13-valent pneumococcal conjugate vaccine(PCV13) among the 2017—2023 birth cohorts in Anhui Province. Methods : Obtained vaccination data of PCV13 for children born in 2017—2023 from the Anhui Immunization Information Management System.We estimated coverage levels and described characteristics of coverage.The spatial autocorrelation analysis of coverage was conducted. Results : Cumulative coverage,cumulative primary immunization coverage and cumulative full-series coverage of PCV13 were 17.19%,12.12% and 9.09% among the 2017—2023 birth cohort in Anhui Province.The coverage of PCV13 increased from 1.14% in the 2017 birth cohort to 41.59% in the 2022 birth cohort.The first dose of PCV13 at ages under 3,3—6,7—11,12—23 and not less than 24 months were 45.35%,29.84%,5.52%,10.75% and 8.53%,respectively.There were significant differences in the ages of the first dose between children of different years of born and kinds of PCV13(P<0.001).Significant differences were also observed in the cumulative coverage,cumulative primary immunization coverage,cumulative full-series coverage of PCV13 and ages of the first dose among children from various residence regions(P<0.001).From 2018 to 2023 birth cohort,the coverage of PCV13 in Anhui Province showed obvious positive spatial autocorrelation.Local spatial autocorrelation analysis showed that the "high-high" agglomeration areas were concentrated in the central area of Anhui. Conclusion The coverage of PCV13 was low in Anhui Province with significant regional differences.

Objective:To improve the understanding of acute lymphoblastic leukemia (ALL) secondary to Burkitt lymphoma (BL) in children.Methods:The clinical data of a child with ALL secondary to BL who was admitted to Children's Hospital Affiliated to Zhengzhou University in June 2024 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was a boy with the age of 8 years and 8 months. He presented with a neck mass at the age of 4 years and 6 months, and pathological examination revealed a diagnosis of BL with clinical stage Ⅲ. The patient was given regular chemotherapy according to the Chinese Children's Lymphoma Group non-Hodgkin lymphoma mature B-cell 2017 protocol-B2 regimen. PET-CT showed recurrence of lymphoma in 6 months after the suspension of treatment. The patient was given with placement of 125I particles, oral etoposide and dexamethasone, and traditional Chinese medicine. The patient was admitted to hospital at the age of 8 years and 8 months with fever and skin hemorrhagic spots, bone marrow morphology, immunology, cytogenetics and molecular biology typing indicated a diagnosis of B-ALL with TCF3::PBX1 fusion gene. The patient received induction chemotherapy according to the Chinese Children's Leukemia Group-ALL 2018 protocol. A review of bone marrow cytology achieved complete remission on the 33rd day of chemotherapy, and minimal residual disease detected by flow cytometry indicated less than 0.01%. TCF3::PBX1 fusion gene was negative. Conclusions:ALL secondary to BL in children is rare, and the ALL treatment regimens are effective.

Objective To investigate the relationship between 9 immunoinflammatory indicators derived from complete blood count and the severity of Mycoplasma pneumoniae pneumonia(MPP)in children of different ages.Methods Totally 2 132 children with MPP who were hospitalized in the Department of Pediatrics of The First Affiliated Hospital of Naval Medical University from Jul.1,2023,to Dec.31,2024 were enrolled,and were assigned to severe MPP(SMPP)or non-severe MPP(NSMPP)groups.According to age and gender 1∶1 matching,the children were assigned to 2 subgroups according to age(1-6 years old and＞6-16 years old).The basic data,laboratory examination and immunoinflammatory indicators from complete blood count of each group were collected and compared.The influencing factors of SMPP were analyzed by univariate and multivariate Cox proportional hazards regression models.Receiver operating characteristic curves were used to analyze the predictive value of indicators that showed statistically significant differences for SMPP.Results There were 220 patients with SMPP,accounting for 10.3%of MPP.In children aged 1-6 years,compared with the NSMPP group,the SMPP group had a longer hospital stay,higher platelet(PLT)count,platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio,derived neutrophil-to-lymphocyte ratio and systemic immune-inflammation index(all P＜0.05).PLR was an independent risk factor for SMPP(odds ratio=1.010,95%confidence interval[CI]1.003-1.018,P=0.007).The area under curve predicted by PLR for SMPP was 0.635(95%CI 0.560-0.711,P＜0.001),the best cut-off value was 125.04,and the corresponding sensitivity and specificity were 57.7%and 70.2%,respectively.All the children were assigned to low PLR group or high PLR group using the best cut-offvalue as the boundary,and the severe disease rate in the high PLR group was significantly higher than that in the low PLR group(65.9%[60/91]vs 37.6%[44/117],P＜0.001).All the children were assigned to Q1-Q4 groups by quartile,and the severe disease rate of the Q4 group(71.2%,37/52)was significantly higher than that of the Q1-Q3 group(all P＜0.05).In children aged＞6-16 years,compared with the NSMPP group,the PLT and PLR in the SMPP group were higher(both P＜0.05),but neither was an independent risk factor.All the children were assigned to low PLR group or high PLR group using the best cut-offvalue(137.03)as the boundary,and the severe disease rate in the high PLR group was significantly higher than that in the low PLR group(57.0%[77/135]vs 40.2%[39/97],P=0.011).All the children were assigned to Q1-Q4 groups by quartile,and the severe disease rate of the Q4 group(65.5%,38/58)was significantly higher than that of the Q1-Q3 group(all P＜0.05).Conclusion The immunoinflammatory indicators derived from complete blood count,especially PLR,have certain application value in predicting the severity of MPP children in different ages.

Objective To develop and validate a risk prediction model for infiltration/extravasation in peripheral intravenous catheter therapy.Methods This retrospective study analyzed 942 patients who completed the Infiltration/Extravasation Risk Assessment Form between January and June 2023 at the First Affiliated Hospital of Army Medical University(including Departments of Neurology,Endocrinology,Gastroenterology and Hepatobiliary Surgery).Patients were allocated to a derivation cohort(n=628)and validation cohort(n=314)in a 2∶1 ratio based on catheterization chronology.The derivation cohort served for model development and internal validation,while the validation cohort underwent external validation.Logistic scoring method constructed the risk model,with Hosmer-Lemeshow(HL)test assessing goodness-of-fit and ROC curve evaluating predictive performance.Twenty-one potential risk factors were assessed,including age,gender,chronic diseases,clinician experience,treatment compliance,and total infusion volume.Results Infiltration/extravasation occurred in 48 cases(5.10%incidence:31 derivation/17 validation).Among 21 factors,15 showed significant association(P<0.05),with 6 independent predictors:junior high school education or below(OR=5.2),chronic disease history(OR=3.1),poor compliance(OR=2.8),lower extremity venipuncture(OR=4.1),total infusion≥1 000 mL(OR=3.5),and hyperosmotic/corrosive medications(OR=6.7).The final prediction model was:Y=2×(low education)+1×(chronic disease)+1×(poor compliance)+1×(lower extremity puncture)+1×(volume≥1 000 mL)+2×(corrosive agents).For the derivation cohort,AUC was 0.967(95%CI:0.936～0.998),specificity 0.911,sensitivity 0.935,with good calibration(χ2=4.135,P=0.845).Validation cohort showed AUC 0.939(0.853～1.000),specificity 0.919,sensitivity 0.941,and acceptable calibration(χ2=8.998,P=0.085).Conclusion This model demonstrates excellent discriminative ability and calibration,providing an effective tool for identifying high-risk patients and guiding targeted preventive strategies.

Chrysophanol(Chr)and physcion(Phy)are primary active ingredients of a well-known traditional Chinese medicine namely rhubarb(Chinese name:Dahuang),and their glucuronides have been revealed as the dominant forms presenting in rats after oral administration.Either Chr or Phy has two glycosylation sites,resulting in a pair of positional isomers for glucuronides of either compound(CG1&CG2 and PG1&PG2).To confirmatively identify these glucuronides,energy-resolved mass spectrometry(ER-MS)was used to pursue the fragmentation trajectories of the targeted fragment ions,and the resultant breakdown graphs that were described by the optimal collision energy(OCE)were expected to exhibit the differences of glycosidic bond cleavage between the isomers.Quantum chemical calculation was thereafter conducted to produce the bond dissociation energy(BDE)of the glycosidic bonds.The isomers were unambiguously identified through applying the positive correlation rule between OCE and BDE.Fortunately,the glucuronides of Chr and Phy in vivo were observed through liver microsomes incubationin vitro.ER-MS was utilized to collect the Gaussian-shaped breakdown graphs in response to the neutral loss of 176 Da,and the absolute values of OCE were compared between positional isomers.The results revealed that CG1(-32.31 eV)>CG2(-31.61 eV),and nonetheless,PG1(-30.00 eV)Chr-8-GluA(-48.787 kJ/mol),and nonetheless,Phy-1-GluA(-48.672 kJ/mol)

AIM:To observe the defocus state and myopia control in myopic children wearing single-vision, defocus, and orthokeratology lenses using multispectral refraction topography(MRT).METHODS: A total of 279 myopic patients aged 8-14 years old, with a spherical equivalent(SE)from -7.00 to -0.50 D, treated at the Chengdu Aier Eye Hospital from June 2022 to December 2023. Patients who volunteered for the study were assigned to three groups. A total of 94 cases were provided with single-vision spectacle lenses(SVL group), 90 cases received individualized ocular refraction customization(IORC group), and 95 cases received orthokeratology lenses(OK group). Simultaneously, the three groups were further categorized into low(-3.00 to -0.50 D), moderate(-6.00 to -3.25 D), and high myopia(-7.00 to -6.25 D)groups according to different SE. MRT was used to measure and compare the defocus changes of the retina in supperior, inferior, nasal, and temporal quadrants(RDV-S, RDV-I, RDV-N, RDV-T), and three angles of field of view, including 0-15°, 15°-30°, and 30°-45°(RDV-15, RDV-30, RDV-45)in the three groups(the data divide for the connected regions is grouped to the latter group). A one-way analysis of variance was used for intergroup comparisons. Univariate and multivariate linear regression analyses were used to analyze the factors related to changes in the axial length(AL)at 1 a after intervention.RESULTS:There were significant differences in 1-year SE and AL growth among patients in the SVL, IORC, and OK groups before and after intervention(P<0.001). The 1-year SE and the difference of AL growth in patients with low myopia was significantly different among SVL, IORC, and OK groups(P<0.001); however, there was no significant difference between the IORC and OK groups(P>0.05); there were significant differences in the SE and AL growth changes between the OK group and the IORC and SVL groups in moderate myopia(P<0.001); and there were significant differences between the OK group and the IORC and SVL groups in SE and AL growth of high myopia group after wearing lenses for 1 a(P<0.001), while there were no significant differences between the IORC and SVL groups(P>0.05). In addition, there were significant differences in the relative peripheral refractive errors(RPRE)of 4 quadrants and 3 eccentric regions among the three groups of patients in different degrees of myopia groups(P<0.001). Pair-wise comparison of the growth difference of eccentric D-RDV-15 in low myopia group after wearing lenses for 1 a showed significant differences between the SVL, IORC, and OK groups(P<0.001), but no significant differences between the IORC and OK groups(P>0.05). The angle of field of view D-RDV-30 in moderate myopia subgroups was statistically different between the SVL group and the IORC and OK groups after wearing lenses for 1 a(P<0.001), while the IORC and OK groups showed no significant differences(P>0.05); the angle of field of view D-RDV-15 in high myopia subgroups was statistically different between the OK group and the IORC and SVL groups after wearing lenses for 1 a(P<0.001), but there was no significant difference between the IORC and SVL groups(P>0.05). Univariate and multivariate linear regression model analysis showed that the changes in D-TRVD, D-RDV-45, D-RDV-N, and D-RDV-I correlated with the increase in the difference in 1 a AL.CONCLUSION: MRT can be used to guide the clinical control of myopia. Myopia development is related to the peripheral retinal defocus state, and the difference of defocus quantity in the inferior nasal side at 30°-45° eccentricity may be a factor regulating the rapid progression of myopia.

As China accelerates its efforts in deep space exploration and long-duration space missions, including the operationalization of the Tiangong Space Station and the development of manned lunar missions, safeguarding astronauts’ physiological and cognitive functions under extreme space conditions becomes a pressing scientific imperative. Among the multifactorial stressors of spaceflight, microgravity emerges as a particularly potent disruptor of neurobehavioral homeostasis. Dopamine (DA) plays a central role in regulating behavior under space microgravity by influencing reward processing, motivation, executive function and sensorimotor integration. Changes in gravity disrupt dopaminergic signaling at multiple levels, leading to impairments in motor coordination, cognitive flexibility, and emotional stability. Microgravity exposure induces a cascade of neurobiological changes that challenge dopaminergic stability at multiple levels: from the transcriptional regulation of DA synthesis enzymes and the excitability of DA neurons, to receptor distribution dynamics and the efficiency of downstream signaling pathways. These changes involve downregulation of tyrosine hydroxylase in the substantia nigra, reduced phosphorylation of DA receptors, and alterations in vesicular monoamine transporter expression, all of which compromise synaptic DA availability. Experimental findings from space analog studies and simulated microgravity models suggest that gravitational unloading alters striatal and mesocorticolimbic DA circuitry, resulting in diminished motor coordination, impaired vestibular compensation, and decreased cognitive flexibility. These alterations not only compromise astronauts’ operational performance but also elevate the risk of mood disturbances and motivational deficits during prolonged missions. The review systematically synthesizes current findings across multiple domains: molecular neurobiology, behavioral neuroscience, and gravitational physiology. It highlights that maintaining DA homeostasis is pivotal in preserving neuroplasticity, particularly within brain regions critical to adaptation, such as the basal ganglia, prefrontal cortex, and cerebellum. The paper also discusses the dual-edged nature of DA plasticity: while adaptive remodeling of synapses and receptor sensitivity can serve as compensatory mechanisms under stress, chronic dopaminergic imbalance may lead to maladaptive outcomes, such as cognitive rigidity and motor dysregulation. Furthermore, we propose a conceptual framework that integrates homeostatic neuroregulation with the demands of space environmental adaptation. By drawing from interdisciplinary research, the review underscores the potential of multiple intervention strategies including pharmacological treatment, nutritional support, neural stimulation techniques, and most importantly, structured physical exercise. Recent rodent studies demonstrate that treadmill exercise upregulates DA transporter expression in the dorsal striatum, enhances tyrosine hydroxylase activity, and increases DA release during cognitive tasks, indicating both protective and restorative effects on dopaminergic networks. Thus, exercise is highlighted as a key approach because of its sustained effects on DA production, receptor function, and brain plasticity, making it a strong candidate for developing effective measures to support astronauts in maintaining cognitive and emotional stability during space missions. In conclusion, the paper not only underscores the centrality of DA homeostasis in space neuroscience but also reflects the authors’ broader academic viewpoint: understanding the neurochemical substrates of behavior under microgravity is fundamental to both space health and terrestrial neuroscience. By bridging basic neurobiology with applied space medicine, this work contributes to the emerging field of gravitational neurobiology and provides a foundation for future research into individualized performance optimization in extreme environments.

Objective To investigate the efficacy of leaflet augmentation technique to repair the recurrent mitral valve (MV) regurgitation after mitral repair in children. Methods A retrospective analysis was conducted on the clinical data of children who underwent redo MV repair for recurrent regurgitation after initial MV repair, using a leaflet augmentation technique combined with a standardized repair strategy at Fuwai Hospital, Chinese Academy of Medical Sciences, from 2018 to 2022. The pathological features of the MV, key intraoperative procedures, and short- to mid-term follow-up outcomes were analyzed. Results A total of 24 patients (12 male, 12 female) were included, with a median age of 37.6 (range, 16.5–120.0) months. The mean interval from the initial surgery was (24.9±17.0) months. All children had severe mitral regurgitation preoperatively. The cardiopulmonary bypass time was (150.1±49.5) min, and the aortic cross-clamp time was (94.0±24.2) min. There were no early postoperative deaths. During a mean follow-up of (20.3±9.1) months, 3 (12.5%) patients developed moderate or severe mitral regurgitation (2 severe, 1 moderate). One (4.2%) patient died during follow-up, and one (4.2%) patient underwent a second MV reoperation. The left ventricular end-diastolic diameter was significantly reduced postoperatively compared to preoperatively [ (43.5±8.6) mm vs. (35.8±7.8)mm, P<0.001]. Conclusion The leaflet augmentation technique combined with a standardized repair strategy can achieve satisfactory short- to mid-term outcomes for the redo mitral repair after previous MV repair. It can be considered a safe and feasible technical option for cases with complex valvular lesions and severe pathological changes.

Objective To analyze the diagnostic value of serum biomarkers in patients with pulmonary tuberculosis complicated by invasive pulmonary aspergillosis.Methods A retrospective collection of laboratory test results,including blood analysis,liver function,lymphocyte counts,and cytokine levels,from 54 patients diagnosed with pulmonary tuberculosis and invasive pulmonary aspergillosis admitted to the Third People's Hospital of Kunming between January 2021 and May 2024.Additionally,70 patients with simple pulmonary tuberculosis and 50 healthy individuals were collected as control groups to compare serum biomarker levels across the three groups and analyze relevant factors and diagnostic value for pulmonary tuberculosis patients with invasive pulmonary aspergillosis.Results Among different age groups,the incidence of pulmonary tuberculosis with invasive pulmonary aspergillosis was 29 cases(53.7％)in youth,15 cases(27.8％)in middle age,and 10 cases(18.5％)in the elderly.In terms of gender distribution,there were 41 males(75.9％)and 13 females(24.1％).The serum levels of CRP(6.85[2.10,27.0])ng/L,PCT(0.05[0.05,0.15])ng/mL,RBC(4.55±0.65)× 1012/L,Hb(129.13±19.10)g/L,TP(66.23±6.82)g/L,ALB(37.03±4.77)g/L,and CHOL(4.30[3.71,4.91])mmol/L in the invasive pulmonary aspergillosis group showed no significant difference compared to the simple tuberculosis group and healthy control group(P＞0.05).The levels of CD3+T,CD4+T,and CD8+T in the invasive pulmonary aspergillosis group were significantly lower than those in the simple tuberculosis group and healthy control group(P＜0.05).The levels of IL-2,IL-4,IL-5,IL-8,IL-10,IL-12p70,IFN-α,and TNF-α in the invasive pulmonary aspergillosis group were significantly higher than those in the healthy control group(P＜0.05);IL-8,IL-12p70,and IFN-α were also higher compared to the simple tuberculosis group,with statistical significance(P＜0.05).Conclusion The population with pulmonary tuberculosis complicated by invasive pulmonary aspergillosis is predominantly male and younger.The serum indicators of infection severity and nutritional status in these patients are similar to those with simple tuberculosis and lack specificity;however,their immune function is significantly lower than that of simple tuberculosis patients.Multiple cytokines are elevated,particularly IL-8,IL-12p70,and IFN-α,which can aid in the differential diagnosis of pulmonary tuberculosis infection.