Objective To investigate the changes and clinical significance of pyroptosis and inflammation in children with acute lymphoblastic leukemia after chemotherapy.Methods A retrospective analysis was con-ducted on the clinical data of 98 children with acute lymphoblastic leukemia who received chemotherapy in the pediatrics and hematology and oncology departments of the hospital from May 2023 to August 2024.Accord-ing to the results of blood culture,the selected children were divided into the Gram-positive bacteria group,the Gram-negative bacteria group,the fungal group and the non-bloodstream infection group,and drug sensitivity tests were conducted.After chemotherapy,the children were divided into the granulocytosis group and the non-granulocytosis group according to the granulocyte level.The relevant indicators were detected and com-pared by methods such as blood routine,flow microsphere array technology,enzyme-linked immunosorbent assay(ELISA),and Western blot.Results After chemotherapy,the pyroptosis related indicators caspase-1,caspase-4,caspase-5,caspase-11,interleukin(IL)-1 β,IL-18,the proportion of pyroptosis cells and the relative expression level of GSDMD protein in children of each infection type were significantly increased compared with those before chemotherapy(P＜0.05).After chemotherapy,the levels of IL-4,IL-6,IL-10 and interfer-on-γ(IFN-γ)in the granulocytosis group were significantly higher than those in the non-granulocytosis group(P＜0.05),and the granulocyte level was negatively correlated with the levels of IL-4,IL-6,IL-10 and IFN-γ(P＜0.05).There were statistically significant differences in the levels of IL-4,IL-6,IL-10 and IFN-γ in dif-ferent infection states after chemotherapy(P＜0.05).Conclusion The number of granulocytes and the levels of serum cytokines can serve as potential indicators of infection in children with leukemia.The regulation of pyroptosis may provide new strategies for the treatment of childhood leukemia.

Objective:To verify and calibrate the CT modeling curves of three CT devices in RayStation proton treatment planning system (TPS).Methods:CT-mass density (CT-MD) curves were established by CT Hounsfield units of different tissue substitute materials obtained by scanning the model with CT equipment. CT-stopping power (CT-SP) curves were established by calculation based on the chemical composition of various human tissues. The equivalent water thickness of tissue substitute modules was calculated with different CT modeling curves in TPS. The actual equivalent water thickness of various modules was measured by a Bragg peak detector, and compared with the calculated values of TPS to verify the accuracy of different CT models.Results:The differences of CT modeling curves were significantly different under different tube voltage scanning protocols. Compared with CT-MD curves, CT-SP curves based on the stoichiometric calibration were more suitable for proton dose calculation. However, the values of stopping power corresponding to high CT values still needed to be optimized, and the calculation error after calibration was less than 3%.Conclusion:The method of verifying and calibrating CT unit curves of proton TPS is described, proving that the CT-SP curves after stoichiometric calculation are more suitable for proton dose calculation.

Objective To investigate the separation efficiency of three physical separation methods for gaseous ¹⁴C, namely membrane separation, adsorption separation, and low-temperature separation, to screen for the optimal separation method, and to provide a reference for the separation and enrichment of ¹⁴CO₂ in online monitoring of ¹⁴C. Methods The experimental plan was designed, and three devices were constructed for separation and purification experiments. The purity, recovery rate, and separation time of CO₂ separated by the three methods were analyzed. Results All the three methods achieved the separation of CO₂. Under certain conditions, 20 mL of sample gas was obtained. The separation time of membrane separation method was 0.5 hour, CO₂ gas with a sample purity of 0.0486%-0.0488%VOL was obtained, and the recovery rate was only 2.5%−12.7%. The separation time of MOF material adsorption separation method was 24−30 hours, CO₂ gas with a sample purity of 20.2%−47.5%VOL was obtained, and the recovery rate was 57.3%−63.2%. The separation time of low-temperature separation method was 3 hours, CO₂ gas with a sample purity of 96.0%−99.8%VOL was obtained, and the recovery rate was 81.5%−92.5%. Conclusion The purity and recovery rate of CO₂ with low-temperature separation method were higher compared to membrane separation method and MOF material adsorption separation method. The separation time of low-temperature separation method was moderate. The low-temperature separation method can provide a reference for the enrichment technology of ¹⁴C in the rapid measurement of gaseous ¹⁴C effluent.

Objective: To analyze the impact of persistent obesity on their lung function, so as to offer insights for implementing intervention measures to increase lung function in obese school age children. Methods: A total of 335 children from the Sheyang Mini Birth Cohort established in 2009 in Yancheng City, Jiangsu Province, who participated in the follow up at the ages of 7 years (2016) and 10 years (2019), were selected as the study participants. Physical measurements including height, weight, and lung function were recorded. According to the World Health Organization standard, that is, gender and age specific to correct the body mass index to calculate the body mass index Z score, was used to evaluate the obesity status of children at the age of 7 and 10. Children were divided into four groups, including sustained non obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Meanwhile, the lung function prediction equations recommended by the Global Lung Function Initiative were used to standardize the lung function indexes of children. Pulmonary function differences among these groups were examined, and the relationship between childhood obesity and pulmonary function was longitudinally analyzed using generalized estimating equations. Results: The prevalence of obesity were 9.0% and 16.1% at the age of 7 and 10 years, respectively. The proportion of both newly classified and persistent obesity group were 8.1%, respectively. The forced expiratory volume in one second (FEV 1) and forced vital capacity (FVC) were (1 269.90±202.70) and (1 415.70±230.00) mL, respectively, at the age of 7 years. FEV 1 and FVC at the age of 10 years were (1 440.80±403.20) and (1 555.60±517.60) mL, respectively. Cross sectional analysis at age 7 showed that forced expiratory flow at 75% vital capacity (FEF 75 ) ( β=-0.52, 95%CI =-0.96--0.07) and maximal mid expiratary flow (MMEF) ( β=-0.45, 95%CI =-0.89--0.00) were significantly lower in obese children compared to their non obese peers ( P < 0.05). Longitudinal analysis indicated that obese children had lower levels of lung pulmonary function, with a statistically significant difference in FEV 1 ( β=-0.44, 95%CI=-0.85--0.02, P <0.05). There was no significant difference among the various obesity groups ( P >0.05), while gender stratified results revealed significant reductions in FEV 1/FVC in newly classified obese girls at age 10 years ( β=-1.76, 95%CI =-3.13--0.38) and in MMEF in persistently obese girls at age 10 years ( β=-1.44, 95%CI = -2.79- -0.09) ( P <0.05). Conclusion Obesity may contribute to reduced lung function levels in school aged children, with newly classified and persistent obesity having more pronounced effects on lung function in girls.

【Objective】 To investigate the status quo of disease perception and partner support of erectile dysfunction (ED) patients, and to analyze their correlation. 【Methods】 With convenient sampling method, 220 ED patients in a first-class hospital in Taiyuan were surveyed with the short version of disease perception questionnaire (BIPQ) and partner support coping questionnaire (DCI). 【Results】 The BIPQ score was (41.90±7.33), and the DCI score was (116.79±20.37). Pearson correlation analysis showed that except life influence, treatment control and emotional influence, the mutual support dimension of partner support of ED patients was correlated with all dimensions of disease perception (r=-0.173, 0.151, -0.182, 0.163, 0.188,P<0.05).Except cognitive comprehension, the negative support dimension of partner support of ED patients was correlated with the dimensions and total score of disease perception (r=0.399, 0.185, -0.167, -0.306, 0.269, 0.445, 0.320, 0.357,P<0.05). 【Conclusion】 ED patients have negative disease perception, and their partners have better coping strategies. Medical staff may pay more attention to partner support so as to reduce patients’ negative perception of disease and promote recovery.

Objective To explore the efficacy and safety of subretinal injection of conbercept in treating refractory neovascular age-related macular degeneration(nAMD).Methods In this prospective clinical study,17 eyes of 17 pa-tients diagnosed with refractory nAMD at the Department of Fundus Disease,the Affiliated Eye Hospital of Nanchang Uni-versity from March 2022 to September 2023 were enrolled.The 10 g·L-1 conbercept was injected into the subretinal area of the macular area using a 41G ultra-fine microneedle.If retinal exudation was found in the macular area by optical coherence tomography during the follow-up,the intravitreal injection of 10 g·L-1 conbercept was performed.The best corrected vis-ual acuity(BCVA),central macular retinal thickness(CMT),number of injections and complications were recorded before and 1,3,6,and 12 months after the operation.Results Compared with the preoperative values,the BCVA of patients significantly improved(all P＜0.001)1,3,6 and 12 months postoperatively.There was no significant change in BCVA at each time point after operation(all P＞0.05).Compared with pre-operation,CMT of patients significantly decreased at 1,3,6 and 12 months after operation(all P＜0.001).From 1 month to 12 months after the operation,the CMT of patients gradually decreased(all P＜0.001).Pearson correlation analysis showed that there were positive correlations between pre-operative BCVA and preoperative CMT,preoperative BCVA and 12-month postoperative BCVA(r=0.643,P=0.005;r=0.634,P=0.006).During the treatment,the number of anti-vascular endothelial growth factor injections in 17 eyes was(1.35±0.61)times,with 1 time in 12 eyes,2 times in 4 eyes,and 3 times in 1 eye.Correlation analysis showed that the number of injections was positively correlated with preoperative CMT(r=0.664,P=0.004).No intraoperative or postop-erative complications related to the operation occurred in 17 eyes.Conclusion Subretinal injection of conbercept,which can reduce CMT and improve visual prognosis,is a safe and effective treatment method for refractory nAMD.

Objective:To analyze the efficacy of high-throughput hemodialysis (HFHD) therapy on the application of serum ferritin (SF), transferrin saturation (TSAT), ferromodultin (Hepc) and soluble transferrin receptor (sTfR) levels in maintenance hemodialysis (MHD) with renal anemia.Methods:The uremic patients with MHD treatment in the Third People′s Hospital of Hangzhou City from August 2020 to July 2023 were selected as the study object. They were divided into high throughput (30 cases) and low throughput (30 cases) according the treatment methods. The general data; anemia indexes, including red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT), percentage of reticulocytes (Ret); iron metabolism indexes (SF, TSAT, Hepc and sTfR); inflammations indexes, including β 2-microglobulin (β 2-MG), C-reactive protein (CRP), interleukin-6 (IL-6); renal function indexes, including blood creatinine (SCr), urine creatinine (Cr), blood urea nitrogen (BUN); and adverse reaction were collected. Results:After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the high-throughput group were increased compared with those before treatment: (3.33 ± 0.43) × 10 12/L vs. (2.12 ± 0.24) × 10 12/L, (118.08 ± 11.36) g/L vs. (98.23 ± 8.58) g/L, 0.354 ± 0.030 vs. 0.228 ± 0.037, (486.23 ± 68.22) μg/L vs. (149.34 ± 39.62) μg/L, (36.24 ± 5.82)% vs. (18.72 ± 6.14)%, After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the low-throughput group were increased compared with those before treatment: (2.79 ± 0.32) × 10 12/L vs. (2.19 ± 0.27) × 10 12/L, (111.98 ± 9.07) g/L vs. (97.60 ± 8.33) g/L, 0.330 ± 0.036 vs. 0.214 ± 0.037, (332.73 ± 56.35) μg/L vs. (151.25 ± 39.90) μg/L, (22.23 ± 6.60)% vs. (17.97 ± 5.72)%. In the high-throughput group, after treatment compared with before treatment, Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels all decreased: (1.02 ± 0.58)% vs.(1.64 ± 0.99)%, (71.56 ± 5.67) μg/L vs. (89.56 ± 7.62) μg/L, (395.07 ± 37.10) μg/L vs. (471.37 ± 41.18) μg/L, (8.38 ± 1.94) μg/L vs. (13.79 ± 2.09) μg/L, (1.07 ± 0.23) mg/L vs. (2.28 ± 0.20) mg/L, (11.40 ± 2.84) ng/L vs. (22.74 ± 6.38) ng/L, (351.54 ± 62.05) μmol/L vs. (530.04 ± 85.06) μmol/L, (6.32 ± 1.49) nmol/L vs. (11.52 ± 2.37) nmol/L, (6.75 ± 1.51) mmol/L vs. (18.37 ± 4.52) mmol/L, compared with before and after treatment in low throughput group, Ret value, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels decreased: (1.40 ± 0.65)% vs. (1.67 ± 0.78)%, (84.33 ± 7.45) μg/L vs. (88.97 ± 7.79) μg/L, (431.20 ± 37.59) μg/L vs. (459.56 ± 42.22) μg/L, (11.35 ± 1.06) μg/L vs. (14.00 ± 1.90) μg/L, (1.57 ± 0.27) mg/L vs. (2.19 ± 0.23) mg/L, (16..85 ± 3.02) ng/L vs. (23.38 ± 6.17) ng/L, (389.48 ± 67.03) μmol/L vs. (531.02 ± 78.07) μmol/L, (9.80 ± 1.33) nmol/L vs. (11.34 ± 2.18) nmol/L, (7.55 ± 1.21) mmol/L vs. (18.37 ± 4.52) mmol/L, In addition, RBC, Hb, HCT, SF and TSAT levels in high-flux group were higher than those in low-flux group ( P<0.05), while Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels were lower than those in low-flux group, with statistical significance ( P<0.05). There was no significant difference in the incidence of adverse drug effects between the two groups ( P>0.05). Conclusions:HFHD treatment for patients with renal anemia in MHD has better treatment effect than LFHD, which can effectively correct the anemia state of patients, improve the body iron metabolism response, reduce inflammatory response and improve kidney function, and has certain clinical application value.

Objective To analyze the daily quality assurance(QA)measurement results of IBA Sphinx Compact device on the Mevion compact pencil beam scanning proton therapy system for evaluating its clinical application value in proton therapy.Methods The daily QA measurement of Mevion S250i proton therapy system was carried out with Sphinx Compact device for 30 consecutive days,and the measurement results were analyzed.Results The average deviation between the positioning laser and the image center was(0.42±0.27)mm in 30 days.All of the proximal and distal depth errors of the high-and low-energy pencil beams were within 0.50 mm.The position deviation of all the spots measured did not exceed 1.00 mm,and the size deviation was less than 7.5%.The deviation between the image center and the beam center was not more than 0.75 mm.The relative deviation of the flatness of the rectangular field was about 0.5%.The deviation of the output dose of the square field was within 1.0%.Conclusion The proton system daily QA measurement items recommended by AAPM TG-224 report can be accurately and rapidly measured with Sphinx Compact device.The device is a practical and efficient daily QA tool with high practical value in clinic.

Objective To develop a simplified phantom for the calibration of whole-body counters. Methods A simplified phantom design method for the calibration of whole-body counters was established based on the process and method of calibrating whole-body counters. By using the established method and Monte Carlo method, a simplified phantom including the total body, thyroid, lungs, and gastrointestinal tract was designed to calibrate the ORTEC-Stand FAST II whole-body counter. The simplified phantom was compared with the BOMAB phantom through experimental measurements. Results Within the range of 50 keV to 2 MeV, for rays of the same energy in the same organ of the simplified phantom and BOMAB phantom, the simulated data of detection efficiency by whole-body counting showed an error within 5%, and the experimental measurements showed an error within 10%. Conclusion We developed a simplified phantom for the calibration of the whole-body counter, demonstrating the feasibility of using the simplified phantom instead of a physical body phantom for whole-body counter calibration, which can greatly facilitate whole-body counter calibration for internal radiation monitoring.

Objective:To develop a specialized clival-cervical plate fixation (CCPF) for anterior surgery to treat craniovertebral instability, and to compare it with a posterior occipitocervical fixation (POCF) in biomechanical validation.Methods:Based on the measurement of 40 adult dry bones and 30 volunteers CT images, the clival-cervical plate was designed and manufactured. 8 cadaveric specimens (occiput-C 3) were tested in five conditions including the intact status, the intact+CCPF status, the injury status, the injury+CCPF status, and the injury+POCF status. Specimens were applied a pure moment of 1.5 N·m in flexion, extension, lateral bending, and axial rotation. Calculating and comparing the range of motion (ROM) and neutral zone (NZ) for the occiput to C 2. The effects of different fixation methods on the distribution of ROMs at the occipitocervical region were compared. Results:The injury+CCPF status constrained ROMs to 1.7° in flexion ( q=4.68, P=0.055) , 1.2° in extension ( q=0.39, P=0.9922) , 2.8° in lateral bending ( q=1.25, P=0.814) , and 4.3° in axial rotation ( q=5.08, P=0.035) , resulted in larger ROM in axial rotation but similar ROMs in other directions ( P>0.05) when compared with the injury+POCF status. There were no significant differences between the above two fixation methods in flexion-extension ( q=1.94, P=0.554) , lateral bending ( q=1.79, P=0.611) and axial rotation ( q=2.14, P=0.478) for the NZs. For the flexion, extension,lateral bendingand axial rotation direction, the proportion of the C 1, 2 ROM to the overall ROM was 28%, 25%, 34% and 56% respectively in the injury+CCPF status, and it was 59%, 53%, 42% and 71% respectively in the injury+POCF status. Conclusion:CCPF is a biomechanically effective alternative or supplemental method of POCF for the craniocervical instability.