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.

Objective To evaluate and improve missing data imputation methods to enhance the performance of binary classification prediction model.Methods By simulating data missing scenes,the effects of direct elimination,mean imputation,random forest(RF)imputation algorithm,and multiple imputation-random forest(MI-RF)on the performance of the prediction model were jointly evaluated by receiver operating characteristic area under curve(AUC)and root mean square error(RMSE).Bayesian Network was introduced for the random forest imputation algorithm to optimize the imputation method using the correlations between variables.Results Under different missing proportions,both AUC and RMSE indicated that Bayesian network optimized random forest(BN-RF)imputation algorithm was better.In addition,when the missing proportion was 10％-20％,various imputation methods had roughly the same improvement effect for the prediction model;when the proportion of missing data was 30％-40％,compared to the mean imputation,except for the BN-RF,RF was more effective and its effect was slightly better than MI-RF;however,when the proportion of missing data was close to 50％,even if the model performance was still appropriate,the imputation data gradually deviated from the true data features,resulting in a decrease in the usability of the model.Conclusion The overall effect of BN-RF is satisfactory,and it should be chosen when random missing was 30％-40％.

Objective To study the shielding effect of water body on γ spectrometer during underwater measurements.Methods A mathematical model of water immersion was constructed for the 3-inch(ф76.2 mm×76.2 mm)lanthanum bromide detector.The totipotent peak count rate of 10 typical γ characteristic energies under different radius water sphere conditions was calculated by MCNP software,and the relationship was established.Results The effective radii of γ photons of different energies based on the 3-inch lanthanum bromide detector was obtained.The relation of energy and effective radius was established,and the effective radius of Tl-208@2614keV was 102.99 cm.Conclusion The quantitative relationship between photons of different energies of a typical 3-inch lanthanum bromide detector and effective radius had been established theoretically,which provides a theoretical basis for measuring and analyzing radioactive water body by γ spectrometer.

Objective To study the shielding effect of water body on γ spectrometer during underwater measurements.Methods A mathematical model of water immersion was constructed for the 3-inch(ф76.2 mm×76.2 mm)lanthanum bromide detector.The totipotent peak count rate of 10 typical γ characteristic energies under different radius water sphere conditions was calculated by MCNP software,and the relationship was established.Results The effective radii of γ photons of different energies based on the 3-inch lanthanum bromide detector was obtained.The relation of energy and effective radius was established,and the effective radius of Tl-208@2614keV was 102.99 cm.Conclusion The quantitative relationship between photons of different energies of a typical 3-inch lanthanum bromide detector and effective radius had been established theoretically,which provides a theoretical basis for measuring and analyzing radioactive water body by γ spectrometer.

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.

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.