Objective: To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) in hospitalized children in Ningbo City, so as to provide insights into developing prevention and control strategies for RSV. Methods: Basic information, clinical data and throat swab samples were collected from hospitalized children with respiratory infection in Ningbo University Affiliated Women and Children's Hospital from July 2019 to December 2023. Multiple fluorescence PCR-capillary electrophoresis was employed to detect nucleic acids of 11 non-bacterial respiratory pathogens. RSV detection in hospitalized children by time, gender and age was descriptively analyzed. Results: A total of 49 449 throat swab samples of hospitalized children with respiratory infections were detected. There were 4 310 samples positive for RSV, with a detection rate of 8.72%. The detection of positive specimens peaked from November to February in 2019 and 2020, from August to October in 2021, and from May to September in 2023. The RSV detection rate in boys was higher than that in girls (9.25% vs. 8.04%, P<0.05). The detection rate of RSV was highest in the children under 1 year of age (16.37%). The RSV detection rate tended to decrease with age (P<0.05). Among the specimens with positive RSV detection, 3 407 were positive for RSV alone (79.05%), while 903 were detected as mixed infections (20.95%). The non-bacterial pathogens with higher percentages of mixed detection were human rhinovirus, Mycoplasma pneumoniae and human parainfluenza virus. Conclusion Atypical seasonal epidemic of RSV infections appeared in 2021 and 2023 among hospitalized children in Ningbo City, with high detection rates in boys and children under 1 year of age, and a certain percentage of mixed infections.

To analyze the infection and drug-resistant gene 23S rRNA mutations of mycoplasma pneumoniae (Mp) in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023. Throat swabs were collected from hospitalized children with respiratory tract infections in Ningbo University Affiliated Women and Children′s Hospital from 2019 to 2023. They were subjected to real-time fluorescence quantitative polymerase chain reaction detection to analyze Mp infection and drug-resistant gene (23S rRNA) mutations. Intergroup comparisons were made by the Chi-square test or Fisher′s exact probability method. A total of 18 968 hospitalized children were included, with a total positive rate of 30.37% (5 760/18 968). The total positive rate of drug-resistant gene mutations was 82.45% (4 749/5 760). The positive rate of Mp in male children was 29.26%, which was lower than that in female children (31.67%, χ 2=12.948, P<0.001). The positive rate of Mp drug-resistant gene mutations in male children was 82.52%, which was higher than that in female children(82.37%, χ 2=0.021, P=0.885). The positive rates of Mp increased with age ( χ 2=1 722.21, P<0.001). The positive rates of Mp drug-resistant gene mutations also increased with age ( χ 2=13.152, P<0.001). In the four seasons, the total positive rate of Mp in summer and autumn was significantly higher than that in winter and spring ( χ 2=1 085.149, P<0.001). Among them, the Mp positive rates in the summer and autumn of 2019 were as high as 38.26% and 34.49%, while in the summer and autumn of 2020, the Mp positive rates were 2.55% and 1.65%, respectively, which were the lowest in previous years. In the summer and autumn of 2023, the Mp positive rates increased to 47.22% and 51.06%. There was no statistically significant difference in the detection rate of Mp drug-resistant gene mutations among the four seasons. In Conclusion, Mp infection was more prevalent in the summer and autumn in Ningbo city and females and children aged 7-17 were more susceptible. The epidemic of Mp infection in Ningbo occurred in the summer of 2019. After the COVID-19 pandemic in 2020, the positive rate of Mp rapidly decreased and later remained in a low incidence state. After the lifting of restrictive prevention and control measures in 2023, the Mp positive rate returned to an epidemic state. The positive rate of Mp drug-resistant gene (23S rRNA) mutations was relatively high.

To analyze the infection and drug-resistant gene 23S rRNA mutations of mycoplasma pneumoniae (Mp) in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023. Throat swabs were collected from hospitalized children with respiratory tract infections in Ningbo University Affiliated Women and Children′s Hospital from 2019 to 2023. They were subjected to real-time fluorescence quantitative polymerase chain reaction detection to analyze Mp infection and drug-resistant gene (23S rRNA) mutations. Intergroup comparisons were made by the Chi-square test or Fisher′s exact probability method. A total of 18 968 hospitalized children were included, with a total positive rate of 30.37% (5 760/18 968). The total positive rate of drug-resistant gene mutations was 82.45% (4 749/5 760). The positive rate of Mp in male children was 29.26%, which was lower than that in female children (31.67%, χ 2=12.948, P<0.001). The positive rate of Mp drug-resistant gene mutations in male children was 82.52%, which was higher than that in female children(82.37%, χ 2=0.021, P=0.885). The positive rates of Mp increased with age ( χ 2=1 722.21, P<0.001). The positive rates of Mp drug-resistant gene mutations also increased with age ( χ 2=13.152, P<0.001). In the four seasons, the total positive rate of Mp in summer and autumn was significantly higher than that in winter and spring ( χ 2=1 085.149, P<0.001). Among them, the Mp positive rates in the summer and autumn of 2019 were as high as 38.26% and 34.49%, while in the summer and autumn of 2020, the Mp positive rates were 2.55% and 1.65%, respectively, which were the lowest in previous years. In the summer and autumn of 2023, the Mp positive rates increased to 47.22% and 51.06%. There was no statistically significant difference in the detection rate of Mp drug-resistant gene mutations among the four seasons. In Conclusion, Mp infection was more prevalent in the summer and autumn in Ningbo city and females and children aged 7-17 were more susceptible. The epidemic of Mp infection in Ningbo occurred in the summer of 2019. After the COVID-19 pandemic in 2020, the positive rate of Mp rapidly decreased and later remained in a low incidence state. After the lifting of restrictive prevention and control measures in 2023, the Mp positive rate returned to an epidemic state. The positive rate of Mp drug-resistant gene (23S rRNA) mutations was relatively high.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To build an intelligent interactive discharge follow-up platform,and to explore its applica-tion effect in the management of discharge follow-up.Methods A research team was established to construct the intelligent interactive discharge follow-up platform,which includes 3 modules,namely follow-up plan customization module,follow-up execution module,and information backup and statistical analysis module.The discharge follow-up data of branch A and B of a tertiary hospital in Beijing from January to December 2022 were selected.Patients in branch A were given manual telephone follow-up by nurses,and patients in branch B were applied by the intelli-gent interactive discharge follow-up platform,and the follow-up efficiency of the 2 branches was compared.100 cas-es of discharged patients in each of 2 hospital branches were randomly selected as research subjects,and the fol-low-up time and nursing manpower of 2 groups were compared.Results The follow-up rate and effective follow-up rate of branch A were 99.96％and 95.10％,while those of branch B were 99.84％and 99.66％,respectively,and the difference was statistically significant(x2=19.028,2 081.008,P＜0.001).The opinion collection rate of branch A was 0.47％,which was higher than that of the branch B(0.01％)(x2=249.365,P＜0.001).The time and nursing man-power spent on follow-up was even less.Conclusion The intelligent interaction discharge follow-up platform real-izes human-robot multi-party intelligent interaction,which can release nursing manpower and time,improve the fol-low-up rate of discharged patients.

Objective To analyze the influencing factors of disaster resilience in medical rescue workers,to construct a prediction model for the low-level risk of disaster resilience in medical rescue workers,and to verify the predictive effect of the model.Methods Using the convenience sampling method and the snowball method,1 037 medical rescue workers who participated in disaster rescue in 18 provinces(autonomous regions and municipalities)were selected as the participants from May to July 2022.Online questionnaire surveys were conducted using general information questionnaires,disaster resilience measuring tools for healthcare rescuers,the Mindful Attention Awareness Scale,the Simple Coping Style Questionnaire and the Depression-Anxiety-Stress Scale.Univariate and multivariate logistic regression analyses were used to determine the independent influencing factors for the low level of disaster resilience of medical rescue workers.A risk prediction model was constructed,and a nomogram chart was drawn.The model's effectiveness was evaluated using the receiver operating characteristic curve(ROC)and calibration curve.The Bootstrap method was applied for internal validation.Results The logistic regression analysis showed that per capita monthly income of households,whether to participate in on-site disaster rescue,positive coping,mindfulness level,and adequacy of rescue supplies were independent influencing factors for the disaster resilience of medical rescue workers(P＜0.05).The predictive formula for the low-level risk of disaster resilience in medical rescue workers was established as follows:Logit(P)=8.741-0.381 x per capita monthly income of households-0.891 x whether to participate in on-site disaster rescue-2.544 x positive coping-0.020 x mindfulness level-0.222 x adequacy of rescue supplies.The area under the ROC curve was 0.823,and the optimal critical value was 0.353.The sensitivity and specificity were 79.12％and 71.43％,respectively.The Hosmer-Lemeshow test showed that x2=12.250(P=0.140),and the predicted curve fitted well with the ideal curve.The external validation showed that the sensitivity and specificity of the model were 75.00％and 66.39％,respectively,and the overall accuracy was 69.95％.Conclusion The prediction model in this study has sound predictive effects and can provide references and guidance for managers to select,recruit,and train medical rescue workers.

Objective:To describe the characteristics and change trends of incidence, mortality and disease burden of acute myocardial infarction (AMI) in Qingdao from 2014 to 2020.Methods:We analyzed the incidence data of AMI retrieved from Qingdao Chronic Diseases Surveillance System. The average annual percent change (AAPC) of morbidity and mortality of AMI were evaluated by using Joinpoint log-linear regression model. Disability adjusted life year (DALY) was used to estimate disease burden of AMI in Qingdao.Results:A total of 70 491 AMI cases and 50 832 deaths of AMI occurred in Qingdao from 2014 to 2020. The age-standardized morbidity and mortality were 54.71/100 000 and 36.55/100 000, respectively. During 2014-2020, the AAPC of age-standardized morbidity was 2.86% (95% CI: 0.42%-5.35%), and 4.30% (95% CI: 1.24%-7.45%) in men and 0.78% (95% CI: -0.89%-2.47%) in women, respectively. The log-linear regression model showed that age-standardized morbidity in age groups 30-39, 40-49 years increased rapidly, with the AAPCs of 8.92% (95% CI: 2.23%-16.06%) and 6.32% (95% CI: 3.30%-9.44%), respectively. The trend was also observed in age groups 30-39, 40-49 and 50-59 years in men, with the AAPCs of 11.25% (95% CI: 3.54%-19.54%), 6.73% (95% CI: 2.63%-10.99%) and 6.72% (95% CI: 2.98%-10.60%), respectively. There was no significant change in age-standardized mortality. The DALY rate increased from 7.49/1 000 in 2014 to 8.61/1 000 in 2020, with the AAPC of 1.97% (95% CI: 0.36%-3.60%). Conclusions:The age-standardized morbidity of AMI in men increased in Qingdao, especially in those aged 30-49 years, while age-standardized mortality rate of AMI was relatively stable from 2014 to 2020. The burden of disease of AMI increased in both men and women.

Objective:To explore the risk factors for postoperative delirium in colorectal cancer patients based on Meta-analysis.Methods:A computer search was conducted on PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and China Biology Medicine disc, and literatures on influencing factors of postoperative delirium of colorectal cancer published by each database until April 6, 2022 were selected. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature using Newcastle-Ottawa Scale (NOS) . Stata 15.0 statistical software was used to conduct a Meta-analysis of the included literatures.Results:A total of 19 articles were included, including 5 295 patients. The Meta-analysis results showed that the combined odds ratio ( OR) values and 95% confidence interval (95% CI) of various factors for postoperative delirium in colorectal cancer patients were advanced age [1.10 (1.06-1.14) ] , male [2.29 (1.81-4.44) ] , alcohol abuse [3.14 (1.63-6.06) ] , preoperative physical condition grading (≥level 3) [1.47 (1.13-1.91) ] , comorbidities [1.59 (1.16-2.17) ] , history of mental illness [7.86 (4.57-13.54) ] , history of cerebrovascular disease [5.74 (3.78-8.72) ] , cognitive impairment [3.31 (1.20-9.08) ] , albumin [0.81 (0.66-0.99) ] , perioperative blood transfusion [2.29 (1.41-3.69) ] and C-reactive protein [2.24 (1.11-4.53) ] , all P<0.05. Conclusions:The risk factors for delirium in colorectal cancer patients after operation are old age, male, alcoholism, preoperative physical condition grading≥level 3, combined diabetes and other basic diseases, history of mental disease, history of cerebrovascular disease, cognitive dysfunction, low albumin, perioperative blood transfusion and elevated C-reactive protein.

Objective:To improve the understanding of chronic lymphoblastic leukemia (CLL) with t(14;18)(q32;q21).Methods:The clinical data of 3 cases diagnosed as CLL with t(14;18)(q32;q21) in the Tianjin KingMed Medical Laboratory from January 2020 to January 2021 were retrospectively analyzed. The clinicopathological data, morphological examination, immunophenotype, cytogenetics and somatic mutation of immunoglobulin heavy chain variable region genes of patients were comprehensively analyzed, and the literature was reviewed.Results:All the 3 patients showed lymphatic proliferative diseases, and their morphological characteristics and immunophenotype were typical characteristics of CLL.Conclusions:The diagnosis of CLL is mainly based on the typical morphology and immunophenotype of tumor cells. The presence of t(14;18) should not be used to exclude the diagnosis of CLL.

Objective:To evaluate the effects of proton pump inhibitors (PPIs) on the clinical outcomes for advanced solid tumor patients treated with immune checkpoint inhibitors (ICIs).Methods:A total of 204 patients with advanced solid tumors who received ICIs in the Affiliated Hospital of Yangzhou University from November 2016 to December 2020 were retrospectively analyzed. The patients were divided into PPIs group ( n=73) and Non-PPIs group ( n=131) according to whether they received PPIs within 1 month before or after the initiation of ICIs treatment. The correlations between the uses of PPIs and the clinical characteristics of patients were explored, and the clinical efficacy of the two groups was evaluated. Kaplan-Meier survival curve was applied to analyze the effects of PPIs uses on overall survival (OS) and progression-free survival (PFS) of patients. The Cox proportional hazards model was used to clarify whether PPIs was an independent indicator of patients′ prognosis. Results:During ICIs treatment of advanced solid tumors, the use of PPIs was not correlated with the patients′ gender, age, tumor type, the score of the United States Eastern Collaborative Group, types of immunotherapy drugs and treatment strategy (all P>0.05). The objective response rate of the Non-PPIs group was better than that of the PPIs group (45.0% vs. 24.7%, χ2=8.286, P=0.004). The disease control rate of the Non-PPIs group was better than that of the PPIs group (75.6% vs. 52.0%, χ2=11.755, P=0.001). In patients with advanced solid tumors, the median OS (3.4 months vs. 6.1 months) and median PFS (2.8 months vs. 4.0 months) in the PPIs group were shorter than those in the Non-PPIs group ( χ2=9.563, P=0.002; χ2=5.761, P=0.016). Univariate analysis showed that among patients with advanced solid tumors treated with ICIs, PPIs uses was significantly correlated with OS ( HR=1.85, 95% CI: 1.24-2.76, P=0.003); PPIs uses( HR=1.65, 95% CI: 1.09-2.51, P=0.019) and age ( HR=1.56, 95% CI: 1.05-2.32, P=0.029) were significantly correlated with PFS. Multivariate analysis showed that PPIs uses was an independent prognostic factor affecting OS ( HR=1.90, 95% CI: 1.27-2.85, P=0.002) and PFS ( HR=1.73, 95% CI: 1.12-2.65, P=0.013). Meanwhile, subgroup analysis discovered that in the course of ICIs treatment of lung cancer patients, the median OS (3.2 months vs. 6.2 months) and median PFS (2.2 months vs. 3.8 months) in the PPIs group ( n=64) were shorter than those in the Non-PPIs group ( n=34) ( χ2=16.187, P<0.001; χ2=5.106, P=0.020). Univariate analysis showed that PPIs uses was associated with OS ( HR=2.97, 95% CI: 1.70-5.22, P<0.001) and PFS ( HR=1.97, 95% CI: 1.09-3.55, P=0.025) in lung cancer patients treated with ICIs. Multivariate analysis showed that PPIs uses was an independent prognostic factor for OS ( HR=3.38, 95% CI: 1.87-6.11, P<0.001) and PFS ( HR=2.31, 95% CI: 1.22-4.38, P=0.010) in lung cancer patients treated with ICIs. Conclusion:The use of PPIs reduces the effect of ICIs in the treatment of advanced solid tumor, especially in lung cancer. PPIs should be used cautiously in patients with advanced solid tumors treated with ICIs.