The number of interventional procedures has increased significantly due to the advantages of minor trauma, rapid recovery, and low incidence of complications. In 2018, there were approximately 24 million interventional procedures worldwide, representing a six-fold increase compared with 3.6 million procedures in 2008. From 2020 to 2021, the percentage of medical institutions with independent interventional departments in China increased from 50.49% to 63.18%. Interventional procedures inherently involve exposure to ionizing radiation, which poses a greater risk of radiation-related harm to the pediatric population due to their increased sensitivity, Consequently, the radiation dose levels experienced by children undergoing these procedures have become a growing concern, emerging as a focus of research both nationally and internationally. This article summarizes the reports published by the International Commission on Radiological Protection (ICRP), the National Council on Radiation Protection and Measurements (NCRP), and the International Atomic Energy Agency (IAEA) as well as academic articles, and reviews the dose optimization measures in the interventional procedures for pediatric patients. Regular radiation safety training for interventional radiation workers, enhancing radiation safety awareness, optimizing intraoperative techniques, and timely updating imaging equipment can effectively reduce the radiation dose received by pediatric patients. This approach helps reduce the doses to an acceptable range while still meeting interventional procedural requirements, thereby protecting the physical health of pediatric patients.

ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.

ObjectiveTo investigate the deafness genetic mutation spectrum in nonsyndromic hearing impairment (NSHI) associated with enlarged vestibular aqueducts (EVA). MethodsFrom October, 2015 to August, 2016, 85 patients with NSHI from Hubei Yichang Special Education School were examined with temporal bone CT, and 20 deafness-related gene mutations in GJB2, GJB3, SLC26A4 and mtDNA 12S rRNA were detected with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. ResultsA total of 31 patients were found EVA with temporal bone CT. Compared with non-EVA patients, the proportion of deafness-related gene mutations was more in patients with EVA (χ² = 11.160, P = 0.001), especially for c.919-2A>G mutation of SLC26A4 (χ² = 23.870, P < 0.001). ConclusionThe deafness gene mutation spectrum is different in NSHI patients with or without EVA. It is needed to optimize genetic testing scheme for deafness for early diagnosis and intervention of NSHI associated with EVA.

Objective:To develop a neural network model for the evaluation of glomerular filtration rate (GFR) based on multilayer perceptual neural network, and to compare with the improved Chinese based creatinine GFR evaluation formula (C-GFR cr) and the evaluation formula (EPI-GFR cr) of the American Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for the clinical applicability of multilayer perceptual neural network model in evaluating GFR. Methods:A total of 684 chronic kidney disease (CKD) patients used for developing a modified version of China′s based creatinine GFR evaluation formula were taken as the research object. The data of 454 patients were randomly selected as the development group and the data of the other 230 patients were as the verification group. The multilayer perceptual neural network GFR evaluation model (M-GFR cr) was established. With the double plasma GFR as the reference value (rGFR), the correlation, mean difference, mean absolute difference, precision and accuracy of C-GFR cr, EPI-GFR cr and M-GFR cr were compared. Results:Among the 684 CKD patients, there were 352 males and 332 females, with age of (49.9±15.8) years. The correlation between M-GFR cr and rGFR was the highest (Pearson correlation =0.93, P<0.001). The mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=9.929, P<0.001) and EPI-GFR cr ( Z=10.573, P<0.001). The mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=3.953, P<0.001) and EPI-GFR cr ( Z=4.210, P<0.001). The accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=26.068, P<0.001) and EPI-GFR cr ( χ2=23.154, P<0.001). The accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=8.264, P=0.001) and EPI-GFR cr ( χ2=11.963, P=0.001). The results of different stages of CKD showed that in the early stage of CKD (CKD 1-2), the mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=7.401, P<0.001) and EPI-GFR cr ( Z=8.096, P<0.001); the mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=4.723, P<0.001) and EPI-GFR cr ( Z=4.946, P<0.001); the accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=23.547, P<0.001) and EPI-GFR cr ( χ2=26.421, P<0.001); the accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=12.089, P=0.001) and EPI-GFR cr ( χ2=16.168, P<0.001). But there was no significant difference in the applicability among C-GFR cr, EPI-GFR cr and M-GFR cr in the advanced stages of CKD (CKD 3-5). Conclusion:Compared with the improved Chinese based creatinine GFR evaluation formula C-GFR cr and CKD-EPI evaluation formula EPI-GFR cr, the accuracy of multilayer perceptual neural network model to evaluate GFR in CKD patients has been significantly improved, especially in CKD 1-2 stage.

DNA methylation is a prevalent epigenetic modification in vertebrates, and it has been shown to be involved the regulation of gene expression and embryo development. However, it remains unclear how DNA methylation regulates sexual development, especially in species without sex chromosomes. To determine this, we utilized zebrafish to investigate DNA methylation reprogramming during juvenile germ cell development and adult female-to-male sex transition. We reveal that primordial germ cells (PGCs) undergo significant DNA methylation reprogramming during germ cell development, and the methylome of PGCs is reset to an oocyte/ovary-like pattern at 9 days post fertilization (9 dpf). When DNA methyltransferase (DNMT) activity in juveniles was blocked after 9 dpf, the zebrafish developed into females. We also show that Tet3 is involved in PGC development. Notably, we find that DNA methylome reprogramming during adult zebrafish sex transition is similar to the reprogramming during the sex differentiation from 9 dpf PGCs to sperm. Furthermore, inhibiting DNMT activity can prevent the female-to-male sex transition, sug-gesting that methylation reprogramming is required for zebrafish sex transition. In summary, DNA methylation plays important roles in zebrafish germ cell development and sexual plasticity.

Objective To investigate the expression of long chain non-coding(lnc) RNA LOC285194 in breast cancer tissue and paracancerous tissue and its clinical significance.Methods Forty-two samples of paraffin embedded breast cancer tissue and 16 samples of paraffin embedded paracancerous tissue were selected.The expression of lncRNA LOC285194 in these tissue were detected by using quantitative real-time polymerase chain reaction(PCR).Then its correlation with clinicopathological features was analyzed.Results The expression level of lncRNA LOC285194 in breast cancer tissue was significantly lower that in the paracancerous tissue (P＜0.01);the level of lncRNA LOC285194 in human epidermal growth factor receptor-2(HER2)overexpression tissues was up-regulated compared with HER2 negative breast cancer tissue(P =0.013),there was a positive correlation between them(r=0.385,P=0.012).Conclusion lncRNA LOC285194 may play the role of cancer suppressor gene and may be involved in the generation of breast cancer by HER2 association,which may become a target gene of breast cancer treatment.

Objective To investigate the prevalence and drug resistance profile of the strains isolated from cerebrospinal fluid of neurosurgery patients so as to provide guidance for the prevention and treatment of intracranial infection.Methods The prevalence and drug resistance of strains isolated from cerebrospinal fluid of neurosurgery patients admitted from Jan 2011 through Dec 2015.Results A total of 1 060 strains were isolated from 23 259 CSF samples.The positive rate of culture was 4.56％.After 1 060 strains were categorized and some of the same species were eliminated,419 strains of different species were obtained,including 103 (24.6％) strains of gram-positive bacteria,293 (69.9％) strains of gram-negative bacteria and 23 (5.5％) strains of fungus.The three leading strains isolated were Acinetobacter spp.(165 strains,39.4％),Klebsiella pneumoniae (72 strains,17.2％),coagulase negative staphylococcus (54 strains,13.6％).The Acinetobacter baumannii isolates showed high resistance rate to meropenem (82.3％) and to cefoperazone sulbactam (76.4％),while the rates of drug resistance to colistin and amikacin were quite low found to be 3.1％ and 29.8％,respectively.The drug resistance of Klebsiella pneumonia was serious in which the rate of drug resistance to meropenem was 72.6％,and the rate of drug resistance to cefoperazone sulbactam was 79.0％,and rates of drug resistance to colistin and Amikacin were quite low found to be 0％ and 35.2％,respectively.The detection rates of MRSA,MRSE and MRSH were high found to be 76.5％,100％ and 100％ respectively.Non-susceptible to vancomycin and teicoplanin strains in staphylococci species were not found.Conclusions The majority of strains isolated from the cerebrospinal fluid were gram-negative bacteria,and the detection rates of Acinetobacter and Klebsiella pneumoniae were high,and the rates of drug resistance of Acinetobacter baumannii and Klebsiella pneumoniae were high.Doctor should pay more attention to the prevalence of pathogenic strains isolated from cerebrospinal fluid and drug resistance of those strains in order to rational use of antibiotic according to the drug resistance detection.

Brain metastases ( BM ) are a frequent complication of non-small cell lung cancer (NSCLC), with various treatment strategies. The widespread use of tyrosine kinase inhibitor (TKI) has significantly prolonged the survival of NSCLC patients with epidermal growth factor receptor mutations. This article reviews recent progress in TKI therapy for BM in NSCLC patients and discusses a combination of TKI and radiotherapy.

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.

Nowadays, nanotechnologies have shown wide application foreground in the biomedical field of medicine laboratory tests, drug delivery, gene therapy and bioremediation. However, in recent years, nanomaterials have been labeled poisonous, because of the disputes and misunderstandings of mainstream views on their safety. Besides, for the barriers of technical issues in preparation like: (1) low efficacy (poor PK & PD and low drug loading), (2) high cost (irreproducibility and difficulty in scale up), little of that research has been successfully translated into commercial products. Currently, along with the new theory of "physical damage is the origin of nanotoxicity", biodegradability and biocompatibility of nanomaterials are listed as the basic principle of safe application of nanomaterials. Combining scientific design based on molecular level with precision control of process engineering will provide a new strategy to overcome the core technical challenges. New turning point of translational medicine in nanotechnology may emerge.