Objective To evaluate the current radiation doses in pediatric non-cardiac interventional procedures, and analyze the associated clinical factors, and to provide data references for reducing pediatric radiation exposure. Methods We conducted a retrospective analysis of the radiation doses of children who had undergone non-cardiac interventional procedures at the interventional department of a tertiary pediatric hospital in Jinan from January 2022 to October 2024. The collected data included basic demographic information, surgical date, anatomical site, disease type, and radiation dose parameters (cumulative fluoroscopy time, cumulative dose area product in cine mode, cumulative air kerma, and the number of images acquired). The Kruskal-Wallis H test was used for comparative analysis between groups (P < 0.05 was considered statistically significant). Results Among the 475 included children, 99 cases (20.8%) had infantile hemangioma (median P_ka, 0.136 Gy·cm²; median K_a,r, 0.38 mGy), 235 cases (49.5%) had venous malformation (median P_ka, 9.82 Gy·cm²; median K_a,r, 40.99 mGy), 75 cases (15.8%) had lymphatic malformation (median P_ka, 0.06 Gy·cm²; median K_a,r, 0.18 mGy), 32 cases (6.7%) had retinoblastoma (median P_ka, 6.58 Gy·cm²; median K_a,r, 52.34 mGy), 12 cases (2.5%) had arteriovenous malformation (median P_ka, 42.3 Gy·cm²; median K_a,r, 162.87 mGy), and 22 cases (4.6%) had other vascular malformations (median P_ka, 21.7 Gy·cm²; median K_a,r, 89.1 mGy). There were significant differences between children with different disease types in the cumulative fluoroscopy time, cumulative dose area product in cine mode, cumulative air kerma at the patient entrance reference point, and the number of images acquired during non-cardiac interventional procedures (all P < 0.01). Conclusion This study presented the types and proportions of pediatric non-cardiac interventional procedures, evaluated the radiation dose levels of different surgical types, and analyzed the effects of weight and anatomical site on radiation exposure, which can be useful for preliminary assessment of radiation doses in pediatric non-cardiac interventional procedures.

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.

Objective To apply a phantom for dose measurement in interventional therapy for pediatric vascular diseases, and calculate the effective dose (E) and conversion coefficient of dose area product (DAP) to E, and to provide a dose reference for studying radiation dose and radiation protection in children. Methods Thermoluminescent dosimeters were placed in the organs of the phantom. Low-, medium-, and high-dose groups were set for three types of vascular anomalies based on the duration of fluoroscopy. Digital subtraction angiography was used to simulate exposure conditions at different dose levels. The organ dose was measured, and the effective dose was calculated. Results For the three groups of vascular anomalies in the head and face, the red bone marrow doses were 8.15, 30.34, and 43.53 mGy, respectively, the effective doses were 12.88, 47.84, and 73.12 mSv, respectively; and the average conversion coefficient of DAP to E was 2.16. For the three groups of vascular anomalies in the trunk, the red bone marrow doses were 2.11, 15.62, and 31.21 mGy, respectively; the effective doses were 12.39, 70.56, and 134.60 mSv, respectively, and the average conversion coefficient of DAP to E was 3.03. For the three groups of vascular anomalies in the lower extremities, the red bone marrow doses were 3.58, 6.50, and 12.28 mGy, respectively, the effective doses were 3.64, 7.04, and 14.85 mSv, respectively, and the average conversion coefficient of DAP to E was 0.73. Conclusion Patient dose and DAP-to-E conversion coefficient are in the following order: vascular anomalies in the trunk > vascular anomalies in the head and face > vascular anomalies in the lower extremities. The dose data obtained can be used to estimate children’s radiation exposure.

Objective:To study the effect of psoralen on the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells cultured in vitro, and to further explore the internal mechanism of psoralen inhibiting renal cancer.Methods:The experimental group was HTB-47 and CRL-1932 renal cancer cells treated with dimethyl sulfoxide solution containing 30 μg/ml psoralen, and the control group was renal cancer cells treated with dimethyl sulfoxide. Scratch test, CCK8, Transwell, and Western blot were used to detect the effect of psoralen on renal cancer cells.Results:Compared with the control group, the proliferation, invasion and migration of renal cancer cells treated with psoralen in the experimental group were significantly inhibited. In the renal cancer cells treated with psoralen, the protein expression levels of MKI67, PCNA, MMP2 and MMP9 were significantly decreased (all P<0.05). Conclusions:Psoralen can significantly inhibit the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells in vitro. The mechanism may be to inhibit the progression of renal cancer by regulating MKI67, PCNA, MMP2 and MMP9.

Objective:To explore cardiac repair effect of AKT gene transfected amniotic fluid mesenchymal stem cells (AFMSC) transplantation on ischemic reperfusion injured myocardium in rabbit model . Methods :AKT overex‐pressed lentiviral vector was established to transfect AFMSC ;New Zealand rabbits were randomly divided into low glucose DMEM (L‐DMEM) group (group A) ,AFMSC group (group B) and AKT transfected AFMSC group (AKT‐AFMSC group ,group C) .Then rabbit myocardial ischemia reperfusion injury model was established .Before reper‐fusion ,0.2ml L‐DMEM ,AFMSC and AKT‐AFMSC was directly injected into infarct area and surrounding myocar‐dial epicardium in corresponding group . On 21 days after operation , left ventricular end‐diastolic dimension (LVEDd) ,left ventricular shortening fraction (LVFS) ,left ventricular ejection fraction (LVEF) ,infarct size and pathological changes were compared among three groups .Results:Compared with L‐DMEM group and AF‐MSC group ,there was significant reductions in LVEDd [ (16.37 ± 0.84) mm ,(15.06 ± 1.01) mm vs .(13.51 ± 0.85) mm] and infarct size [ (37.3 ± 2.1)% ,(26.6 ± 0.7)% vs .(18.1 ± 1.2)% ] ,and significant rise in LVFS [ (29.18 ± 2.36)% ,(33.65 ± 2.81)% vs .(36.89 ± 3.02)% ] and LVEF [ (58.62 ± 3.47)% ,(67.42 ± 3.03)% vs .(72.02 ± 2.89)% ] , P< 0.05 or < 0.01. Pathological injury significantly relieved in AKT‐AFMSC group than those of group A and group B .Conclusion:Compared with amniotic fluid mesenchymal stem cells ,AKT‐transfected amniotic fluid mesenchymal stem cells possesses better effects of repairing injured myocardium and improving myocardial function in ischemic reperfusion injured myocardium .

Objective To explore the new thought of developing the open management of "parent-child caregiving" in department of neonatology to provide a reference for perfecting the nursing management. Methods The "parent-child caregiving" was carried out in the closed neonatal ward without caregivers in a class III grade A children′s hospital. A total of 274 pediatric patients were admitted in the non-caregiving area of department of neonatology from December 2015 to February 2016. At the time, a total of 66 pediatric patients was admitted to the "parent-child caregiving" area. The hospital day, hospital expense, nosocomial infection incidence, and satisfaction of the parent or guardian of pediatric patients were compared between two groups.Results The median of the hospital day of pediatric patients with pneumonia in the area of "parent-child caregiver" was 6.5 d which was statistically lower than that in the area without caregivers (Z=-4.672, P<0.01). The hospital expense (18902.68 yuan) in the area of "parent-child caregiving" was higher than that in the area without caregivers (Z=-6.985,P<0.01). There was one case with nosocomial infection in the area without caregivers. The satisfaction with the medical staff of the parent or guardian of pediatric patients was 95.98% and 97.29% before and after carrying out "parent-child caregiving".Conclusions The development of the open "parent-child caregiving" which is based on the family centered care mode can help to meet requirements of pediatric patients and their parents or guardians under different circumstances and has immeasurable effects on pediatric patients and their families. The method is worth spreading.

Objective To summarize the management experience of Children's Hospital of Shanghai in extracorporeal membrane oxygenation (ECMO) bedside first-aid coordination, and to further strengthen the operation room's emergency management capacity for first-aid of children.Methods Our hospital formed a technical group for ECMO surgical nursing, cultivated nurses' capacity in ECMO first-aid coordination, standardized surgical safety management in multiple departments and areas, and improved relevant management systems to ensure easy access to ECMO first-aid.Results In 2016, our hospital conducted totally 11 ECMO bedside treatment, and there was no wound infection after the treatment, with a weaning success rate of >90% and a hospitalization survival rate of >70%.Conclusions Emergency management strategies play a positive part in improving surgical safety and the operation room's emergency service capability.

Objective:To study influence of renal sympathetic denervation (RDN)on cardiac function of dogs with heart failure (HF).Methods:A total of 40 dogs were randomly and equally divided into RDN group [received bilat- eral renal artery radiofrequency ablation (RFA)]and model group (only received femoral puncture).Pacemaker was implanted in every dog,and dog HF model was established using rapid right ventricular pacing.Cardiac and re-nal function indexes,BNP and sympathetic activity index levels were observed and compared between two groups be- fore RFA/sham operation,instant and four weeks after model establishment.Results:After operation four weeks, compared with model group,there were significant reductions in levels of epinephrine (E)[(362.69±42.54)ng/ml vs.(290.36±42.32)ng/ml],renin (R)[(305.46± 39.68)ng/ml vs.(230.04±32.80)ng/ml],aldosterone (AD)[(408.00±38.56)ng/ml vs.(246.00± 48.37)ng/ml],angiotensin Ⅱ (ATⅡ)[(280.00±48.08)pg/ml vs.(172.00±25.04)pg/ml]and norepinephrine (NE)[(425.65±50.54)ng/ml vs.(316.76±46.29)ng/ml]in RDN group (P<0.05 all);there were significant reductions in HR,respiratory rate (RR)and BNP level in RDN group,P<0.05 all;there were significant rise in SBP,LVEF,CO,CI,left ventricular pressure maximal rising rate (+dp/dtmax),left ventricular pressure maximal dropping rate (-dp/dtmax)and left ventricular end-systolic pressure (LVESP),and significant reductions in left ventricular end-systolic dimension (LVESd),left ventricular end-diastolic dimension (LVEDd)and left ventricular end-diastolic pressure (LVEDP)in RDN group,P<0.05 all.Conclusion:RDN can decrease renal sympathetic activity,improve heart function,inhibit myocardial remode- ling,its therapeutic effect is significant

Objective To compare the single-shot fields irradiated by three focusing modes of γ-knife and explore the approaches for improving the quality of stereotactic radiosurgery.Methods GAFCHROMIC(R) EBT3 mode flushing-free film was used to measure the single-shot fields irradiated by multi-source static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode of γ-knife.Also the uniformity and penumbra of the single-shot fields were compared.Results The 2D dose distribution of the single-shot fields irradiated by three focusing modes of γ-knife was different.In the axis (x,y,z),the rang of penumbra axial length ratios of multisource static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode were 0.13-0.48,0.17-0.33 and 0.28-0.54,in the diagonal direction of the wings plane (NSD,PSD),were 0.31-0.39,0.38-0.43 and 0.54-0.72,respectively;the penumbra axial length ratio of single-source double-axis rotating focusing mode was bigger than in multi-source static focusing modes and multi-source single-axis rotating focusing mode.On the no-wings plane,the area ratios of 80％ dose curve enveloped and 50％ dose curve enveloped(A80％/A50％)were 0.40,0.47 and 0.19,on the wings plane,were 0.61,0.53 and 0.35,respectively.The field uniformity of multi-source static focusing modes and multi-source single-axis rotating focusing mode were superior to single-source doubleaxis rotating focusing mode.Conclusions Considering dose distribution of the single-shot fields,the multi-source static focusing modes devices and the multi-source single-axis rotating focusing mode devices should be preferred,when important tissues and organs are adjacent to the target areas.Compared with single-source double-axis rotating focusing mode,both multi-source static focusing modes and multi-source single-axis rotating focusing mode could make more target areas to be surrounded by high dose region.

Objective:To observe the influence of long-term exercise training on carotid intima-media thickness (IMT)in patients with mild-to-moderate hypertension.Methods:A total of 92 patients with mild-to-moderate es-sential hypertension (EH)were randomly and equally divided into exercise group and routine treatment group.Exer-cise group received exercise training based on routine treatment.All patients were followed up one year.Influence of long-term exercise training on carotid artery diameter and carotid IMT was observed in EH patients.Results:Af-ter one year,there were significant reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),ca-rotid artery diameter and carotid IMT in both groups,P<0.05 all;compared with routine treatment group,there were significant reductions in SBP [(145.72±11.31)mmHg vs.(130.89±13.01)mmHg],DBP [(88.49±7.32) mmHg vs.(81.71±8.45)mmHg],carotid artery diameter [(6.34±1.23)mm vs.(6.22±1.01)mm]and carotid IMT [(0.89±0.21)mm vs.(0.84±0.11)mm]in exercise group after treatment,P<0.05 all.Conclusion:Long-term exercise training can effectively reverse early arteriosclerosis lesion of carotid wall and effectively control blood pressure.