Immunization represents the most effective strategy for the prevention and control of diseases. Nevertheless, some people may still get infected and contract the disease even after being fully vaccinated, which is known as a "breakthrough case." The presence of breakthrough cases shows that although vaccines significantly lower the rates of disease and death, they do not entirely eliminate the risk of illness.Addressing breakthrough cases, comprehending their epidemiological characteristics, and identifying the associated factors carry substantial public health implications for vaccine development, the optimization of vaccination strategies, and the implementation of intervention efforts. This review aims to provide a scientific reference for enhancing the prevention and control of vaccine-preventable diseases by summarizing the definitions, epidemiological characteristics, and relevant factors related to breakthrough infection cases across various diseases.

Objective To explore the risk factors and construct a predictive model for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis.Methods A total of 142 patients with hepatitis B cirrhosis admitted to the Second Affiliated Hospital of Shandong First Medical University from January 2023 to December 2024 were selected as subjects.Patients with first occurrence of gastrointestinal bleeding were classified as bleeding group(n=52),while patients without such history were devided into no bleeding group(n=90).Baseline data between groups were compared,and potential risk factors for the first occurrence of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis were analyzed.Results Grade C liver function classification,low red blood cell count(RBC),thrombocytopenia,prolonged fibrinogen concentration,serum albumin,prothrombin activity,and prothrombin time,high international standardized ratio,widened main portal vein diameter,and severe esophageal/gastric varices were the risk factors for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis(P＜0.05).Multivariate Logistic analysis demonstrated that RBC,portal vein diameter,and severe esophageal/gastric varices were independent risk factors for gastrointestinal bleeding in hepatitis B cirrhosis patients.Conclusion When RBC＜3.25×109/L,portal vein diameter＞14.5 mm and severe esophageal varices are present,the combined diagnosis has a high predictive value for the risk of first upper gastrointestinal bleeding in hepatitis B cirrhosis patients.

Objective To investigate the effect of Lianpu Yin on duodenal microinflammation in rats with functional dyspepsia(FD)by regulating NLRP3 activation.Methods Wistar rats were randomly divided into blank group and model group.FD rats were reconstructed by iodoacetamide method(2%sucrose solution containing 0.1%iodoacetamide),and the model was verified.FD model rats were randomly divided into model group,Lianpu Yin group and Moxapride group by random number expression method.After a period of two weeks of administration,measurements were taken to determine the body mass,three-hour food consumption,as well as the rates of gastric emptying and intestinal propulsion.The pathological structure of duodenal tissue was observed by HE staining.The serum levels of IL-1β and IL-18 were quantified using the enzyme-linked immunosorbent assay(ELISA)method.The expression levels of NLRP3 and Caspase-1 in each group were detected by Western blot.Expression levels of NLRP3 and Caspase-1 proteins were detected by immunofluorescence.Results Compared with the blank group,body weight,food intake at 3 h,gastric emptyand intestinal propulsion rate in model group were significantly decreased(P<0.01),and inflammatory infiltration of duodenum tissue appeared in the model group.Meanwhile,the expressions of NLRP3 and Caspase-1 proteins,as well as the levels of IL-1β and IL-18 in the duodenal tissue of the model group,showed significant increasing(P<0.05).Compared with the model group,rats in the Lianpu Yin and Moxapride groups displayed significant increasing in body weight,gastric emptying rate,and intestinal propulsion rate(P<0.01).Additionally,inflammatory infiltration of duodenum tissue reduced in these groups.Furthermore,NLRP3 and Caspase-1 protein expressions,as well as IL-1β and IL-18 levels,significantly decreased in the Lianpu Yin and Moxapride groups compared to the model group(P<0.05).Conclusion Lianpu Yin can treat FD rats by inhibiting duodenal microinflammation and then restoring gastrointestinal motility,which may be related to the abnormal activation of NLRP3 inflammasome.

Immunization represents the most effective strategy for the prevention and control of diseases. Nevertheless, some people may still get infected and contract the disease even after being fully vaccinated, which is known as a "breakthrough case." The presence of breakthrough cases shows that although vaccines significantly lower the rates of disease and death, they do not entirely eliminate the risk of illness.Addressing breakthrough cases, comprehending their epidemiological characteristics, and identifying the associated factors carry substantial public health implications for vaccine development, the optimization of vaccination strategies, and the implementation of intervention efforts. This review aims to provide a scientific reference for enhancing the prevention and control of vaccine-preventable diseases by summarizing the definitions, epidemiological characteristics, and relevant factors related to breakthrough infection cases across various diseases.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To explore the relationship of microRNA(miR)-155,miR-92a and miR-126 with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods A total of 118 elderly CHD patients receiving PCI in our hospital from January 2021 to June 2023 were enrolled,and according to whether ISR occurred by coronary angiography(CAG)at 1 year after surgery,they were divided into a stenosis group(45 cases)and a non-stenosis group(73 cases).Their baseline data,number of stent,stent diameter,medication,coronary artery lesion score,and serum expression levels of miR-155,miR-92a and miR-126 were compared between the two groups.The correlation of expression levels of the three miRNAs and clinical indicators was analyzed.Multivariate logistic regression analysis was performed to identify the risk factors of ISR in elderly CHD patients.ROC curve was adopted to analyze the diagnostic value of the three miRNAs for ISR in the elderly patients.Results Signifi-cantly higher BMI,SBP and DBP,and larger proportions of stent count ≥3 and stent diameter＜3 mm were observed in the stenosis group than the non-stenosis group(P＜0.05,P＜0.01).The expression levels of miR-155 and miR-126 were obviously lower,while that of miR-92a was nota-bly higher in the stenosis group than the non-stenosis group(P＜0.01).Pearson correlation analy-sis showed that miR-155 and miR-126 were negatively correlated with BMI,SBP,DBP,and stent count,and positively correlated with stent diameter(P＜0.01);miR-92a was positively correlated with BMI,SBP,DBP,and stent count,and negatively with stent diameter(P＜0.01).Multivariate logistic regression analysis suggested that stent count,stent diameter and miR-92a were risk fac-tors for ISR in elderly CHD patients after PCI,and miR-155 and miR-126 were protective factors(P＜0.05,P＜0.01).ROC curve analysis revealed that the AUC value of miR-155,miR-92a,and miR-126 alone and combined together was 0.742,0.778,0.751 and 0.853,respectively,with a sen-sitivity of 86.67％,71.11％,73.33％and 93.33％respectively,and the combined detection showed better diagnostic value for ISR than the single detection(P＜0.01).Conclusion Down-regulation of miR-155 and miR-126 and up-regulation of miR-92a may be involved in the occurrence of ISR in elderly CHD patients after PCI.Monitoring the three miRNAs is beneficial to auxiliary clinical prediction for ISR after PCI.

Objective To explore the predictive value of the atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index,and cerebral small vascular disease(CSVD)imaging load score regarding the early prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods A total of 379 inpatients diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023 were retrospectively analyzed.Relevant data were collected,and the CSVD imaging load score was evaluated.The patients were classified into the good prognosis group(≥18％)and the poor prognosis group(＜18％)based on the early neurological improvement rate 14 d after thrombolysis.An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis.The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic(ROC)curve analysis.Results Systolic blood pressure,AIP,TyG index,neutrophil to lymphocyte ratio(NLR),cerebral microbleeds(CMB),enlarged perivascular spaces(EPVS)and a CSVD imaging load score of 2 points or higher served as independent risk factors influencing the early prognosis in AIS patients undergoing thrombolysis.The ROC curve analysis revealed that the area under the curve(AUC)for the CSVD imaging load score was 0.821,with a sensitivity of 80.4％and a specificity of 74％.The AUC of the AIP was 0.951,with a sensitivity of 89.2％and a specificity of 91.7％.The AUC of the TyG index was 0.918,with a sensitivity of 93.1％and a specificity of 82.7％.Conclusions The AIP,TyG index,and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy.

Objective To explore the risk factors and construct a predictive model for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis.Methods A total of 142 patients with hepatitis B cirrhosis admitted to the Second Affiliated Hospital of Shandong First Medical University from January 2023 to December 2024 were selected as subjects.Patients with first occurrence of gastrointestinal bleeding were classified as bleeding group(n=52),while patients without such history were devided into no bleeding group(n=90).Baseline data between groups were compared,and potential risk factors for the first occurrence of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis were analyzed.Results Grade C liver function classification,low red blood cell count(RBC),thrombocytopenia,prolonged fibrinogen concentration,serum albumin,prothrombin activity,and prothrombin time,high international standardized ratio,widened main portal vein diameter,and severe esophageal/gastric varices were the risk factors for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis(P＜0.05).Multivariate Logistic analysis demonstrated that RBC,portal vein diameter,and severe esophageal/gastric varices were independent risk factors for gastrointestinal bleeding in hepatitis B cirrhosis patients.Conclusion When RBC＜3.25×109/L,portal vein diameter＞14.5 mm and severe esophageal varices are present,the combined diagnosis has a high predictive value for the risk of first upper gastrointestinal bleeding in hepatitis B cirrhosis patients.

Objective To investigate the effect of Lianpu Yin on duodenal microinflammation in rats with functional dyspepsia(FD)by regulating NLRP3 activation.Methods Wistar rats were randomly divided into blank group and model group.FD rats were reconstructed by iodoacetamide method(2%sucrose solution containing 0.1%iodoacetamide),and the model was verified.FD model rats were randomly divided into model group,Lianpu Yin group and Moxapride group by random number expression method.After a period of two weeks of administration,measurements were taken to determine the body mass,three-hour food consumption,as well as the rates of gastric emptying and intestinal propulsion.The pathological structure of duodenal tissue was observed by HE staining.The serum levels of IL-1β and IL-18 were quantified using the enzyme-linked immunosorbent assay(ELISA)method.The expression levels of NLRP3 and Caspase-1 in each group were detected by Western blot.Expression levels of NLRP3 and Caspase-1 proteins were detected by immunofluorescence.Results Compared with the blank group,body weight,food intake at 3 h,gastric emptyand intestinal propulsion rate in model group were significantly decreased(P<0.01),and inflammatory infiltration of duodenum tissue appeared in the model group.Meanwhile,the expressions of NLRP3 and Caspase-1 proteins,as well as the levels of IL-1β and IL-18 in the duodenal tissue of the model group,showed significant increasing(P<0.05).Compared with the model group,rats in the Lianpu Yin and Moxapride groups displayed significant increasing in body weight,gastric emptying rate,and intestinal propulsion rate(P<0.01).Additionally,inflammatory infiltration of duodenum tissue reduced in these groups.Furthermore,NLRP3 and Caspase-1 protein expressions,as well as IL-1β and IL-18 levels,significantly decreased in the Lianpu Yin and Moxapride groups compared to the model group(P<0.05).Conclusion Lianpu Yin can treat FD rats by inhibiting duodenal microinflammation and then restoring gastrointestinal motility,which may be related to the abnormal activation of NLRP3 inflammasome.

Objective To investigate the expression of C1q tumor necrosis factor-related protein 3(C1QTNF3)in liver cancer tissue,its association with the clinicopathological features of patients,and its potential value in predicting the prognosis of liver cancer.Methods Related data were collected from TIMER,UALCAN,TNMplot,and GEO databases,and the bioinformatics methods were used to measure the expression level of C1QTNF3 in pan-cancer,normal tissue/liver cancer tissue,and cancerous tissue/paracancerous tissue.Cancerous and paracancerous tissue samples were collected from 90 patients with liver cancer,and related clinical data were collected,including age,sex,tumor diameter,and tumor number.The independent-samples t test or the paired t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot survival curves,and the Log-rank test was used to investigate the association between the expression level of C1QTNF3 and the survival of patients with liver cancer.The Cox regression model was used to identify the risk factors for the prognosis of patients with liver cancer,and the receiver operating characteristic(ROC)curve was used to analyze the ability of C1QTNF3 expression at different time points for predicting the prognosis of patients with liver cancer.Results The bioinformatics analysis showed that the expression of C1QTNF3 was upregulated in various malignant tumors,especially in liver cancer tissue(P<0.001),and the expression level of C1QTNF3 in liver cancer tissue was significantly higher than that in normal tissue and paracancerous tissues(all P<0.01).The immunohistochemical staining results of 90 patients with liver cancer showed that C1QTNF3 was mainly expressed in cytoplasm,with a small amount in nucleus,and it had negative expression in paracancerous tissue and positive expression in liver cancer tissue.The positive expression rate and strong positive expression rate of C1QTNF3 protein in liver cancer tissue were significantly higher than those in paracancerous tissue(positive expression rate:76.67%vs 33.33%,χ2=34.141,P<0.01;strong positive expression rate:54.44%vs 5.56%,χ2=51.217,P<0.01).The liver cancer patients with a tumor diameter of≥5 cm,an advanced stage,the presence of liver cirrhosis,negative HBsAg,and gamma-glutamyl transpeptidase(GGT)≥50 U/L had a significantly higher strong positive expression rate of C1QTNF3 protein than those with a tumor diameter of<5 cm,an early stage,the absence of liver cirrhosis,positive HBsAg,and GGT<50 U/L(all P<0.05).The univariate Cox regression analysis showed that tumor diameter,recurrence,and C1QTNF3 expression were influencing factors for the prognosis of patients with liver cancer(all P<0.05),and the multivariate Cox regression analysis showed that the expression level of C1QTNF3 and recurrence were independent risk factors for the survival of patients with liver cancer(both P<0.05).The survival curve analysis showed that for all patients with liver cancer,the patients with high(strong positive)expression of C1QTNF3 had significantly lower overall survival rate and disease-free survival rate than those with low expression(χ2=17.010 and 13.647,both P<0.001);for liver cancer patients with a tumor diameter of≥5 cm,an early/advanced stage,recurrence,the presence of liver cirrhosis,positive HBsAg,alanine aminotransferase(ALT)<40 U/L,ALT≥40 U/L,and GGT≥50 U/L,the patients with high expression of C1QTNF3 had a significant reduction in overall survival rate(χ2=11.086,5.578,5.295,19.159,16.391,13.774,10.119,8.152,and 12.035,all P<0.05).The ROC curve analysis showed that C1QTNF3 expression had the strongest predictive potential at 5 years,with an area under the ROC curve of 0.77.Conclusion C1QTNF3 is highly expressed in liver cancer tissue,and the expression level of C1QTNF3 and recurrence are closely associated with the survival of patients with liver cancer.Patients with high expression of C1QTNF3 protein tend to have a lower survival rate.