To investigate the epidemiological characteristics of co-infection involving macrolide-resistant Mycoplasma pneumoniae (MRMP) and non-bacterial pathogens in hospitalized children at Women and Children′s Hospital of Ningbo University from 2021 to 2024, a retrospective cross-sectional study was conducted. Throat swabs were collected from children admitted for respiratory tract infections between January 2021 and December 2024. A total of 22 311 children aged 0-18 years old were included, including 12 021 males and 10 290 females. The median age was 5.00 years and the mean age was (5.02±3.25) years. Real-time fluorescence quantitative polymerase chain reaction (PCR) and multiplex PCR were employed to determine the MP infection rate, the prevalence of MRMP, and the co-infection rates with non-bacterial pathogens across different years. Patients with MRMP were categorized into two groups based on the presence or absence of co-infections: simple infection group and mixed infection group. The differences in age, gender, and onset time between these groups were analyzed, along with the distribution of pathogens in the mixed infection group. Chi-square tests were used for intergroup comparisons. The results showed that the overall positive rate of MP among the 22 311 children was 39.42% (8 794/22 311), with a detection rate of MP drug resistance gene mutations at 70.42% (6 193/8 794). The co-infection rate of MRMP was 24.29% (1 504/6 193). Statistically significant differences were observed in the MP positive rate and the detection rate of drug resistance gene mutations from 2021 to 2024 ( χ2=1 674.420, P<0.05; χ2=67.733, P<0.05), with peak values in 2023 (50.87% and 73.83%, respectively). Among the annual co-infections, the highest rate was in 2024 (28.72%), while the lowest was in 2022 (7.30%). In the age distribution, the rate of mixed infections decreased with increasing age ( χ2=84.742, P<0.05). Seasonally, the infection rates in winter 2023 and the spring, summer, and autumn of 2024 were significantly higher than those in 2022 ( χ2=24.243, 13.101, 26.181, and 10.687, respectively; all P<0.05), with the lowest mixed infection rate observed in winter 2022 over the four-year period. Over the four years, the highest positive rate for rhinovirus was consistently observed in MRMP co-infections each year, particularly in the 3-to 6-year-old age group. The positive rate for mixed infections involving respiratory syncytial virus, human bocavirus, and parainfluenza virus was notably higher in the 0- to 3-year-old age group. Following the removal of non-pharmaceutical interventions (NPIs) in December 2022, the co-infection rate of other respiratory viruses and MRMP increased in Ningbo City. In conclusion, the positive rate of MRMP has shown an upward trend from 2021 to 2023. Post-NPI removal, MRMP mixed infections have become more prevalent in 2023 and 2024, predominantly affecting children aged 0-6 years, with rhinovirus being the most common co-pathogen.

Objective:To analyze the long-term trends in cause-specific mortality across different sexes and age groups in China from 1990 to 2021, and quantitatively assess the impact of population aging on cause-specific deaths by sex.Methods:Based on data from the Global Burden of Disease Study 2021, this study extracted the number of deaths, crude mortality rates and age-standardized mortality rates (ASMRs) for all causes, Level 1 causes (communicable, maternal, neonatal, and nutritional diseases; non-communicable diseases; injuries) and Level 3 causes in China from 1990 to 2021, stratified by sex and age group. This study analyzed the current situation and long-term trends in mortality in China, applying decomposition analysis to quantify the impact of population aging on the number of deaths.Results:In 2021, the ASMRs of all-cause death and the three primary causes of death in Level 1 in China were 644.68, 26.59, 575.55, and 41.82 per 100 000, respectively. The ASMRs of the three primary causes continued to decline, with the smallest decrease observed in non-communicable diseases [EAPC=-1.79%, 95% CI (-1.92%, -1.66%)] and the largest in communicable, maternal, neonatal, and nutritional diseases (CMNND) [EAPC=-5.86%, 95% CI (-6.06%, -5.65%)]. The ASMRs were higher in males than females, with a smaller decline. Mortality was higher in the elderly. CMNND deaths mainly occurred in children under 5 and the elderly; non-communicable disease deaths were concentrated in the elderly; injury deaths were relatively evenly distributed across age groups. The proportion of CMNND deaths decreased annually, while the proportion of non-communicable disease deaths increased. From 1990 to 2021, population aging contributed to an increase of 8.11 million all-cause deaths, 167 464.42 CMNND deaths, 7.74 million non-communicable diseases deaths, and 196 287.78 injury deaths. The impact of population aging differed by sex and disease, with male and female aging-related deaths increasing by 4.47 million and 3.70 million, respectively. Compared to 1990, the age-specific mortality rate contributions in 2021 were -72.82% for males and -93.87% for females, with variations by sex and disease. Conclusion:The composition of disease-related deaths in China has changed notably. Population aging is linked to the sharp rise in deaths, with varying impacts across sexes and diseases. Reducing disease mortality can help lessen the negative effects of population aging.

Vaccination is an effective measure to control infectious diseases and provides lifelong health protection for the public. In recent years, vaccination for adults, especially the elderly, has gradually attracted attention in China, but its vaccination rate is significantly lower than that in some developed countries. To improve adult vaccine coverage, an immunization service model featuring adult vaccine prescriptions has been explored in some provinces of China. This study describes the implementation and characteristics of an adult vaccine prescription pilot program in Shandong Province and discusses considerations related to the concept, compliance, advantages, and difficulties of the vaccine prescription model. Suggestions for developing the vaccine prescription system in China are also provided.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

To evaluate the effectiveness of the modified post anesthesia care unit (PACU) discharge assessment tool in the field of bone oncology, in order to prevent and reduce postoperative adverse events in patients undergoing bone tumor surgery. This is a prospective controlled study. 81 bone tumor patients who underwent general anesthesia surgery in the PACU from January to December 2023 were prospectively selected as the study subjects. They were randomly divided into a control group and an intervention group using a random number table method, with 43 and 38 cases, respectively. The control group and intervention group respectively used the fast track scoring system and the improved fast track scoring system as exit assessment tools. Independent sample t-test was used to compare the duration of PACU stay, mean arterial pressure (MAP) at PACU exit, heart rate, and blood oxygen saturation (SpO 2) between two groups of patients. Chi square test was used to compare the occurrence of adverse events between the two groups. The results showed that there was no statistically significant difference between the intervention group and the control group in terms of PACU dwell time [(55.58±23.83) min vs. (46.14±21.87) min], MAP at PACU [(88.23±11.52) mmHg vs. (86.25±10.62) mmHg], heart rate [(86.25±10.62) beats/min vs. (72.93±18.86) beats/min], and SpO 2 [(99.84±0.68)% vs. (99.86±0.91)%] ( t=1.859, 0.805, 1.003, 0.101,all P>0.05). The total incidence of adverse events in the intervention group was significantly lower than the control group (68.42% vs. 90.70%, χ2=4.988, P<0.05). In conclusion, the modified fast-tracking criteria can significantly reduce the incidence of adverse events in PACU patients undergoing bone tumor surgery, but does not affect PACU dwell time and patient circulatory status.

The morbidity and mortality associated with diphtheria have been effectively managed through mass immunization strategies. Nevertheless, recent outbreaks of diphtheria have been reported in various regions of Africa and Asia. In addition to infections among children, there has been a notable increase in cases among middle-aged and elderly individuals, underscoring the necessity of continued vigilance in the control of diphtheria. This paper reviewed the epidemiology of diphtheria, the current application of vaccines, and immunization strategies, with the aim of providing evidence for the prevention and control of this disease.

Capillary malformations (CM), the most common type of vascular malformations, has a wide range of clinical needs for diagnosis and treatment. In-depth research and effective management strategies need to be developed for this disease. Beyond the simplex forms of CM, there exists a broad category of disorders manifested as CM-related syndromes, closely associated with somatic mutations in the GNAQ and GNA11 genes. These diseases present numerous commonalities and differences in clinical manifestations, associated symptoms, and management outcomes, posing challenges for clinical diagnosis, differential diagnosis, and standardized treatment. Considering this, this article aims to provide an overview of the latest research advancements in the spectrum of GNAQ/ GNA11 related capillary malformation diseases, offering a comprehensive summary and in-depth discussion of their pathogenic mechanisms, clinical presentations, and treatment options.

In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

The research investigated the characteristics of lymphocyte subsets in peripheral blood of children with mycoplasma pneumoniae pneumonia in different infection states. The retrospective cross-sectional study selected 194 children with pneumonia from October 2023 to January 2024 in Zhongnan Hospital of Wuhan University as the study objects, patients aged 7 months to 13 years old, including 91 female children and 103 male children. According to the types of pathogens, the children with pneumonia were divided into single MP infection group (80 cases), non-MP infection group (29 cases) and mixed pathogen infection group (85 cases). According to the mutation of MP23S rRNA gene, the MPP children were divided into drug-resistance group (112 cases) and non-drug-resistance group (53 cases). According to the results of bronchoscopy and imaging, the MPP children were divided into severe group (35 cases) and mild group (130 cases). Pathogen infection, the percentage and absolute count of lymphocyte subsets in peripheral blood, hypersensitive CRP, interferon-γ, tumor necrosis factor-α, interleukin-10, interleukin-4, interleukin-6 and interleukin-2 in each group were analyzed retrospectively. The levels of the test items in each group were compared. The value of peripheral blood lymphocyte subsets in the diagnosis of MPP in children was evaluated by ROC curve. The results showed that the co-infection rate of MPP children was 51.51% (85/165). Streptococcus pneumoniae was the most common co-infection (39/85, 45.88%), followed by Haemophilus influenzae (26/85, 30.89%). The mutation rate of MP resistance gene was 67.88% (112/165) in MPP children tested for tNGS in bronchoalveolar lavage fluid. The absolute counts (cells/μl) of CD3 +, CD3 +CD4 +, CD3 +CD8 +, CD3 -CD19 +, CD3 -CD16 +CD56 +and CD3 +CD16 +CD56 + in the simple MP group (1 164, 612, 415, 242, 168, 50) and the mixed pathogen group (1 285, 694, 457, 313, 176, 52) were significantly lower than those in the non-MP group (2 092, 1 037, 660, 541, 295, 86) ( P<0.05). There was no significant difference between drug-resistant group and non-drug-resistant group ( P>0.05). The CD3 +CD4 +% (34.91) and the absolute counts of CD3 -CD16 +CD56 + (148 cells/μl) in severe group was significantly lower than that in mild group (37.91, 187 cells/μl), and CD3 -CD19 +% (19.48) was significantly higher than that in mild group (16.33) ( P<0.05). The median values (cells/μl) of CD3 + (1 093, 925), CD3 +CD4 + (576, 543), CD3 +CD8 + (401, 356), CD3 -CD19 + (238, 234) and CD3 -CD16 +CD56 + (181, 153) in MPP children aged 4 to 8 years and 9 to 12 years were lower than the reference range in corresponding age. ROC curve analysis showed that the AUC of peripheral blood lymphocyte subsets for MPP diagnosis was 0.813, and the sensitivity was 79.3%, the specificity was 75%. In conclusion, the co-infection rate of MPP children was higher than single MP infection. The characteristics of peripheral blood lymphocyte subsets in children with pneumonia were that the absolute count test value of MPP children was significantly lower than that of non-MP infection, and there are differences between MPP children clinical types.

Based on the Global Burden of Disease (GBD) 2019, this study characterized the burden of dietary iron deficiency across 154 countries participating in the Belt and Road Initiative (BRI). A joinpoint regression model was employed to assess temporal trends in disease burden. Pearson correlation analysis and locally weighted regression were utilized to investigate the relationship between burden and the socio-demographic index (SDI). Slope indices and concentration indices were calculated to evaluate health inequalities, while frontier analysis explored disease burden benchmarks. Key metrics included prevalence and disability-adjusted life years (DALYs). Results revealed downward trends in age-standardized prevalence rates and age-standardized DALYs rates of dietary iron deficiency among children under 10 years old in 117 and 125 BRI countries, respectively, from 1990 to 2019. A significant negative correlation was observed between disease burden and SDI in 2019 ( R=-0.80, P<0.001). The slope indices decreased from -936 (95% CI:-1 006, -806) in 1990 to -1 128 (95% CI:-1 256, -999) in 2019, while the concentration indices declined from -0.24 (95% CI:-0.28, -0.20) to -0.35 (95% CI:-0.39, -0.30) during the same period. Frontier analysis further identified substantial gaps between observed outcomes and optimal performance thresholds in several countries.