Objective: To analyze adverse event following immunization(AEFI) with the domestic bivalent human papilloma virus (HPV) vaccine among female students in primary, junior, and senior high schools in Hebei Province from 2022 to 2024, aiming to provide evidence for the vaccination program. Methods: On May 14, 2025, AEFI case data and vaccination data for the domestic bivalent HPV vaccine among female students in primary, junior, and senior high schools in Hebei Province from 2022 to 2024 were collected from the China Disease Control and Prevention Information System and the Hebei Provincial Immunization Program Information Management System, respectively. Statistical analysis was performed by using descriptive and analytical epidemiological methods, with intergroup comparisons conducted by using the Chi square test or Fisher s exact probability test. Results: From 2022 to 2024, a total of 817 900 doses of the domestic bivalent HPV vaccine were administered to female students in primary, junior, and senior high schools in Hebei Province. A total of 68 AEFI cases were reported, comprising 57 common vaccine reactions, 7 rare vaccine reactions, 3 coincidental events, and 1 psychogenic reaction. The overall AEFI reporting rate was 8.31 per 100 000 doses, 4 cases (2.30/100 000 doses), 31 cases (8.73/100 000 doses), and 33 cases (11.41/100 000 doses) were reported in 2022, 2023, and 2024, respectively, with a statistically significant difference across years ( χ 2=10.97, P <0.01). The reporting rates for common and rare vaccine reactions were 6.97 per 100 000 doses and 0.86 per 100 000 doses, respectively. The AEFI reporting rates were 15.14 per 100 000 doses among primary school girls and 8.20 per 100 000 doses among secondary school girls, though the difference was not statistically significant (Fisher s exact test, P =0.30). The reporting rate was higher after the first dose (10.91/100 000 doses) than after the second dose (5.96/100 000 doses; χ 2=5.85, P =0.02).The second quarter recorded the highest AEFI reporting rate at 11.21 per 100 000 doses. The majority of AEFI cases (56 cases, 82.35%) occurred within 24 hours post vaccination. Conclusion The domestic bivalent HPV vaccine demonstrates a favorable safety profile among female students in Hebei Province, with a low overall AEFI reporting rate that consisted predominantly of general reactions and occasional cardiac related reactions.

Objective To evaluate the short-term efficacy of transcatheter aortic valve replacement (TAVR) using Venus A-Plus valve delivery system in patients with severe aortic stenosis. Methods The clinical data of patients undergoing TAVR in our hospital from August 2018 to March 2022 were collected and they were divided into a Venus A-Plus and a Venus A group according to the type of valve delivery system used. The perioperative data of the two groups were compared. Results A total of 121 patients were included, including 70 patients in the Venus A-Plus group [45 males and 25 females with a mean age of (67.81±6.62) years], and 51 patients in the Venus A group [33 males and 18 females with a mean age of (68.25±7.01) years]. All patients underwent TAVR, and the postoperative hemodynamic features (left ventricular ejection fraction, mean cross-valve pressure difference, peak flow rate) were significantly improved (P<0.05). There was no statistical difference in surgical success rate, all-cause mortality, conversion to thorax opening, valve-in-valve placement, moderate or above perivalvular regurgitation, new left bundle branch block or new right bundle branch block between the two groups (P>0.05). Conclusion TAVR with Venus A-Plus valve delivery system in patients with severe aortic stenosis shows comparable efficacy to the first-generation Venus A system and is satisfactory, safe and reliable.

This paper summarizes the experience of professor LIU Shangyi in differentiating and treating rectal carcinoma from the perspective of "treating ulcers as tumors". It is believed that the manifestations of rectal cancer， such as anal itching， cauliflower-like or ulcerative tumors， and bloody stools， are similar to external skin itching， skin ulceration， swelling， and skin bleeding. Therefore， the treatment principles of sores and ulcers department can be applied to treat tumors. Following the diagnostic and treatment approach of dermatology regarding the clinical typical symptoms， for anal itching， the main treatment is to dispel wind and remove dampness， clear heat to relieve itching， using "skin medicinals" such as Difuzi （Fructus Kochiae） and Baixianpi （Cortex Dictamni）， as well as wind medicinals such as Shengma （Rhizoma Cimicifugae） and Fangfeng （Radix Saposhnikoviae）. For constipation， the method of clearing heat and resolving toxins， unblocking the bowels and discharging heat can be used， commonly using Baitouweng （Radix Pulsatillae）， Donglingcao （Herba Rabdosiae Rubescentis） and Dahuang （Radix et Rhizoma Rhei）. In terms of mucosal ulcers， it is critical to differentiate between yin and yang； the treatment of yang ulcers should focus on clearing heat and resolving toxins， commonly using modified Xianfang Huoming Beverage （仙方活命饮）； for yin ulcers， emphasis should be placed on removing dampness and resolving phlegm， commonly with modified Yiyi Fuzi Baijiang Powder （薏苡附子败酱散）. For bloody stool， differentiation is made between deficiency and excess， with the use of Diyu （Radix Sanguisorbae） and Huaihua （Flos Sophorae） for excess syndrome to cool and stop blee-ding， and both herbs dry-fried until charred combined with liver-tonifying medicinals for deficiency syndrome

Objective To analyze the clinical characteristics of measles cases in the measles elimination stage and to provide a scientific basis for the prevention, control, diagnosis and treatment of measles. Methods The descriptive epidemiological method was used to analyze the clinical characteristics of 442 confirmed measles cases in Hebei Province from 2018 to 2020. Results Among the 442 measles cases, the main symptoms were rash (96.61%), fever (90.50%), cough (56.11%), and Koplik spots (30.09%). Complications were mainly pneumonia (12.22%). There were significant differences in symptoms among different age groups (P < 0.05). The incidence of symptoms in children under 5 years old (except cough) was higher than that in other age groups. Immunization history had no significant impact on the symptoms of fever and rash (P > 0.05), but the incidence of symptoms such as cough, conjunctivitis, Koplik's spots and catarrhal rhinitis in the immunized group was lower than that in the non-immunized group (P < 0.05). The group with an interval of 0 days from fever to rash was the largest, and the proportion of people with an immunization history in the 0-day group (68.06%) was significantly higher than that in the 3-4-day group (49.44%) (P < 0.05). Pneumonia complications were mainly concentrated in children under 5 years old (87.03%), and most of the cases had a 0-dose immunization history (81.48%). Conclusion In the measles elimination stage, the incidence of fever and rash in cases is relatively high, while the incidence of Koplik spots is relatively low. The symptoms are more obvious in the younger age group. Vaccination can reduce the incidence of specific symptoms. The change in the time of rash appearance suggests that the diagnosis and treatment plan need to be adjusted. This study provides key data support for the formulation of measles prevention, control and treatment strategies.

Objective: To investigate the associations between childhood obesity and performance of six minute walk test (6MWT), providing evidence for exercise tolerance assessment and exercise intervention strategies for children and adolescents. Methods: From March 2021 to December 2023, a cohort study was conducted among students recruited from a primary and secondary school in Chongqing, a total of 709 valid samples were included. The 6MWT was used to assess exercise tolerance, with vital signs measured before and after the test. Anthropometric indicators, including height, weight, and waist circumference, were measured using standardized procedures. Generalized additive models (GAM) and restricted cubic spline (RCS) regression were employed to analyze the nonlinear relationships between obesity related indicators and six minute walk distance (6MWD). Results: The mean 6MWD of participants was (602.59±70.73)m. GAM showed that after adjusting for confounding factors, body mass index (BMI) and weight had non linear relationships with 6MWD [effective degrees of freedom were 1.55 and 7.13 respectively], and overweight/obesity was associated with a decrease in 6MWD ( β =-18.65) (all P <0.01). Further RCS regression analysis showed that both BMI and weight showed an "inverted U shaped" non linear relationship with 6MWD in the overall population and sex stratified subgroups; the 6MWD of females was lower than that of males, and it showed a significant downward trend with the increase of BMI or weight (all P <0.05). Conclusion Body weight and BMI in children and adolescents have an important impact on 6MWD, and obesity in children and adolescents is markedly associated with decline in exercise tolerance.

Objective To establish an expert consensus on the management of mini-midline catheters(hereinafter referred to as the'consensus')to guide nurses in standardizing the insertion and maintenance of mini-midline catheters.Methods Evidence was systematically retrieved,scientifically evaluated,and synthesized using evidence-based methods to draft the initial version of the consensus.From December 2023 to July 2024,totally 2 rounds of expert correspondence and 2 rounds of expert panel discussions were conducted to revise the content,resulting in the final version.Results There were 17 experts from tertiary A general hospitals in Beijing,Shanghai,Hunan,Hubei,Sichuan,Jiangsu,Hainan,Guangxi Zhuang Autonomous Region,and Shandong participating in the consultation,with a 100％response rate.In the 2 rounds of expert correspondence,the authority coefficients were 0.947 and 0.962,respectively.The mean importance scores of all items exceeded 4.00 points.The coefficients of variation(CV)were 0-0.32(first round)and 0-0.15(second round).Kendall's concordance coefficients were 0.097 and 0.101(both P＜0.001).The consensus covers 11 sections,including definition,indications,contraindications,qualification training,pre-insertion preparation,catheter insertion,catheter use,catheter maintenance,catheter removal,prevention and management of common complications,and health education.Conclusion The Consensus demonstrates scientific rigor and comprehensively addresses key procedures before,during,and after the insertion of mini-midline catheters,providing actionable guidance for nurses in catheter insertion and maintenance.

Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G-EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Thyroid cancer (TC) is the most prevalent malignancy of the endocrine system. While most patients achieve favorable prognoses with early treatment, patients with advanced TC face a scarcity of effective therapeutic strategies. The thyroid gland is one of the most immunogenic tissues in the human body. With the deepening understanding of immune evasion mechanisms in TC and the application of immunotherapy in various solid malignancies, immune checkpoint therapy for TC has shown considerable therapeutic potential, offering new hope for patients with advanced TC. This paper focuses on summarizing the latest advancements in immune checkpoint therapy for TC, aiming to provide new directions for future research.

We retrospectively analyzed 8 patients who had been on hemodialysis for over 30 years from two dialysis centers in Dalian, China. A literature review was conducted by searching PubMed, CNKI, Wanfang databases,and Chinese Medical Journal Network for cases of patients on hemodialysis for over 30 years. The 8 patients had good baseline health, with chronic glomerulonephritis as the primary renal disease and no comorbidities before initiating dialysis. They started hemodialysis between 21 and 38 years of age, predominantly using arteriovenous fistulas for vascular access. Dialysis was regular and adequate (KT/V 1.23-1.88). Key laboratory parameters, including hemoglobin (88-118 g/L), albumin (27.7-39.7 g/L), calcium (1.88-2.55 mmol/L), and phosphate (0.76-1.99 mmol/L), were generally within target ranges. Body mass index ranged from 15.20 to 22.96 kg/m2. This literature review of the study included 12 case reports and 4 orginal articles. Factors influencing long-term survival included baseline health status, primary renal disease, absence of comorbidities before dialysis initiation, age at dialysis initiation, type of vascular access, dialysis adequacy, complication management, and medical support. Standardized management and timely correction of complications can significantly improve prognosis and enhance long-term survival in hemodialysis patients.