Objective:To describe the distribution characteristics and trends of mortality and spatial aggregation of esophageal cancer in Shandong Province from 1970 to 2021.Methods:The mortality data of esophageal cancer were obtained from the death registration system of Shandong Province and three national all-cause mortality retrospective surveys. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR, the Segi′s world standard population) were used to describe the mortality of esophageal cancer. Mortality differential decomposition was applied to quantify the contributions of demographic and non-demographic factors. The death levels of esophageal cancer in different counties (cities and districts) in Shandong Province from 1970 to 1974 and 2020 to 2021 were visualized by the ArcGIS 10.8 software, and global and local autocorrelation analyses were conducted by using the GeoDa 1.12 software.Results:The CMR of esophageal cancer in Shandong Province increased first and then decreased from 1970 to 2021. The CMR of esophageal cancer decreased from 17.59/100 000 in the period of 1970—1974 to 14.32/100 000 in the period of 2020—2021. The ASMR of esophageal cancer decreased from 20.04/100 000 in the period of 1970—1974 to 6.53/100 000 in the period of 2020—2021. Compared with the period of 1970—1974, both demographic and non-demographic factors contributed to the increase in esophageal cancer mortality rate from 1990 to 1992. However, demographic factors continued to contribute to the increase in esophageal cancer mortality rate from 2004 to 2005, 2011 to 2013, and 2020 to 2021, while non-demographic factors contributed to the continuous decrease in esophageal cancer mortality rate. The global autocorrelation analysis results showed that the Moran′s I index of ASMR of esophageal cancer in each county (city, district) of Shandong Province from 1970 to 1974 and from 2020 to 2021 were 0.67 and 0.57, respectively. Local autocorrelation analysis showed that there were 19 and 13 areas of high-high clustering of esophageal cancer in the periods of 1970—1974 and 2020—2021, respectively, with 12 overlapping counties (cities, districts). Conclusion:From 1970 to 2021, the CMR of esophageal cancer increases first and then decreases, while the ASMR of esophageal cancer gradually decreases in Shandong Province. The distribution of esophageal cancer mortality has significant spatial aggregation and changes over time.

Objective:To describe the distribution characteristics and trends of mortality and spatial aggregation of esophageal cancer in Shandong Province from 1970 to 2021.Methods:The mortality data of esophageal cancer were obtained from the death registration system of Shandong Province and three national all-cause mortality retrospective surveys. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR, the Segi′s world standard population) were used to describe the mortality of esophageal cancer. Mortality differential decomposition was applied to quantify the contributions of demographic and non-demographic factors. The death levels of esophageal cancer in different counties (cities and districts) in Shandong Province from 1970 to 1974 and 2020 to 2021 were visualized by the ArcGIS 10.8 software, and global and local autocorrelation analyses were conducted by using the GeoDa 1.12 software.Results:The CMR of esophageal cancer in Shandong Province increased first and then decreased from 1970 to 2021. The CMR of esophageal cancer decreased from 17.59/100 000 in the period of 1970—1974 to 14.32/100 000 in the period of 2020—2021. The ASMR of esophageal cancer decreased from 20.04/100 000 in the period of 1970—1974 to 6.53/100 000 in the period of 2020—2021. Compared with the period of 1970—1974, both demographic and non-demographic factors contributed to the increase in esophageal cancer mortality rate from 1990 to 1992. However, demographic factors continued to contribute to the increase in esophageal cancer mortality rate from 2004 to 2005, 2011 to 2013, and 2020 to 2021, while non-demographic factors contributed to the continuous decrease in esophageal cancer mortality rate. The global autocorrelation analysis results showed that the Moran′s I index of ASMR of esophageal cancer in each county (city, district) of Shandong Province from 1970 to 1974 and from 2020 to 2021 were 0.67 and 0.57, respectively. Local autocorrelation analysis showed that there were 19 and 13 areas of high-high clustering of esophageal cancer in the periods of 1970—1974 and 2020—2021, respectively, with 12 overlapping counties (cities, districts). Conclusion:From 1970 to 2021, the CMR of esophageal cancer increases first and then decreases, while the ASMR of esophageal cancer gradually decreases in Shandong Province. The distribution of esophageal cancer mortality has significant spatial aggregation and changes over time.

This article explores the historical development of measures to prevent mother-to-child transmission (MCT) of human immunodeficiency virus (HIV), as well as the challenges faced at each stage. Since the mid-1980s, MCT of HIV drew public attention. In 1991, the United States and France launched the first clinical trial focused on pediatric acquired immune deficiency syndrome (AIDS)-PACTG 076, marking the beginning of clinical research on preventing MCT. The HIVNET 012 trial conducted in Uganda in 1997 further investigated the efficacy of single-dose nevirapine and zidovudine, which has a profound impact on the development of global strategies for preventing MCT of HIV. Without intervention, the MCT rate of HIV ranges from 15% to 45%. However, with the promotion of international intervention standards such as HIV screening during pregnancy and highly active antiretroviral therapy, the MCT rate in China has decreased to 3%, while in the United States and parts of Europe, the rate has fallen to below 1%. These advancements represent a significant achievement in the field of public health.

In 1961, the first documented case of a Caucasian male with 47,XYY karyotype was reported in the United States. During the 1960s, British geneticists postulated a potential association between XYY syndrome and criminal behavior, leading the media to label this karyotype the "criminal chromosome." Consequently, individuals with XYY syndrome faced stigmatization as "born criminals," a notion robustly refuted by contemporary research. With advancements in non-invasive prenatal testing (NIPT), screening for XYY syndrome now presents emerging ethical dilemmas. While NIPT enables screening, societal perceptions of sex chromosome abnormalities influence screening acceptance and may lead to selective termination. The intersection of technological progress and ethical challenges necessitates a cautious approach from the scientific community and demands societal efforts to establish the balance between reproductive autonomy, rights protection, and stigma elimination.

Objective:To analysis the prevalence characteristics of cancer mortality among the elderly in Qidong City, Jiangsu Province, from 1972 to 2021, and to provide scientific basis for the development of precise prevention and control strategies for cancer in the elderly.Methods:Data of cancers were obtained from Qidong Cancer Registry, a descriptive study method was used to calculate the crude mortality rate (CMR) of cancer among the elderly (≥60 years old). The China age-standardized rate (ASR-C) was calculated using the age structure of the Chinese population in 2000, and world age-standardized rate (ASR-W) was calculated using Segi's world standard population. Joinpoint regression analysis was performed using Joinpoint 4.9.1.0 software to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of mortality.Results:From 1972 to 2021, there were 74 723 cancer deaths in the elderly in Qidong, with CMR of 752.08/10 5, ASR-C of 666.03/10 5 (994.22/10 5 for males and 470.29/10 5 for females) and ASR-W of 681.11/10 5. The ASR-C showed little fluctuation before 2000, increased rapidly from 2001 to 2011, and then decreased from 2011 to 2021. From 2017 to 2021, the CMR was 791.01/10 5, the ASR-C was 689.80/10 5 (956.77/10 5 for males and 469.98/10 5 for females), and the ASR-W was 657.53 /10 5. The CMR for the 60-64, 65-69, 70-74, 75-79, and 80+ age groups from 2012 to 2021 were 385.42/10 5 505.51/10 5, 721.64/10 5, 1 213.28/10 5, and 1 705.32/10 5, respectively. The CMR of elderly under 75 years old were lower from 2012 to 2021 than in other periods, while those of elderly people aged more than 75 years were higher from 2012 to 2021 than in other periods. The AAPC for ASR-C of all cancers over the 50 years was 0.22%, with APC of -1.59% in 2008-2021 (both P＜0.05). Over the 50 years, the top five cancers in terms of mortality were lung cancer, gastric cancer, liver cancer, colorectal cancer, and esophageal cancer. Their AAPCs of ASR-C were 1.61%, -2.36%, -0.10%, 1.44%, and -2.03%, respectively. The increasing trends of mortality rates for lung cancer and colorectal cancer and the decreasing trends for gastric cancer and esophageal cancer were statistically significant ( P＜0.05). Conclusions:The mortality of cancers among elderly is at a high level in Qidong. The overall mortality since 2008 have shown a decreasing trend, and the prevention and control of some cancers have been effective.

Objective:To summarize the clinical features of Chlamydia pneumoniae pneumonia (CPP) in children. Methods:Case series study. Clinical data of 10 children with CPP hospitalized in Department No.2 of Respiratory Medicine of Beijing Children′s Hospital, Capital Medical University from January 2019 to August 2024 were retrospectively collected, including general information, clinical manifestations, chest imaging, laboratory examination and treatment. The clinical features and prognosis were summarized.Results:Among the 10 children with CPP, 7 were male and 3 were female. The age of onset was 11.2 (10.3, 13.1) years. The course were 17 (7, 23) days. Cough occurred in 9 cases with wet cough in 7 cases, while moderate and high fever occurred in 6 cases. Besides, chest pain occurred in 4 cases, rash and hemoptysis occurred in 1 case respectively. High density mass shadow was found in 7 cases chest CT imaging, accompanied by air bronchogram sign, surrounded by halo sign, 6 cases of which were distributed under the pleura, while patchy consolidation in the remaining 3 cases. Pulmonary embolism was present in 2 cases. Among the 10 children with CPP, bilateral lung involvement was found in 3 cases and unilateral lung involvement in 7 cases. The white blood cell count was 10.21 (7.45, 11.64)×10 9/L and the proportion of neutrophils was 0.69 (0.63, 0.71). C-reactive protein increased in 7 cases, with the level of 33 (16, 77) mg/L. D-dimer increased slightly in 3 cases (0.393, 0.396, 0.739 mg/L). Serum Chlamydia pneumoniae-IgM antibody test was positive in 6 cases. Chlamydia pneumoniae nucleic acid test by bronchoalveolar lavage fluid (BALF) next-generation sequencing was positive in 6 cases. Both serum IgM antibody and BALF nucleic acid tests were positive in 2 cases. Among the 10 children with CPP, azithromycin alone was used in 5 cases, while glucocorticoid was added in 1 case. Due to poor response to azithromycin in 4 cases, doxycycline was replaced in 3 cases and minocycline was replaced in 1 case, while glucocorticoid was added in 2 cases. Moxifloxacin combined with glucocorticoid therapy was adopted in 1 case with long course after the poor response to azithromycin and doxycycline. All patients were cured finally. Conclusions:CPP mostly occurs in elderly children. The main clinical manifestations include cough, fever and chest pain. The common chest imaging feature is subpleural high-density mass shadow with halo sign. Pulmonary embolism is present in a few cases. Nucleic acid detection and (or) serology is helpful for etiological diagnosis. Some cases need glucocorticoid therapy.

Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective: To improve the efficiency and standardization of preoperative anemia diagnosis and treatment by establishing a systematic intelligent management platform for preoperative anemia. Methods: A multidisciplinary collaborative model was adopted to develop a preoperative anemia management system that integrates intelligent early warning, standardized treatment pathways, and quality control. The system utilizes natural language processing technology to automatically capture laboratory data and establish evidence-based medical decision support functions. A pre-post study design was employed to compare changes in preoperative anemia screening rates, preoperative anemia intervention rates, reasonable use of iron supplements, and perioperative red blood cell transfusion rates before and after system implementation. Results: After system implementation, the standardization of anemia diagnosis and treatment significantly improved: 1) Screening effectiveness: The anemia screening rate increased to 50.00% (an increase of 27.24%); 2) Intervention effectiveness: The anemia treatment rate rose to 56.30% (an increase of 14.02%); 3) Treatment standardization: The reasonable use rate of iron supplements increased to 55.33% (an increase of 21.02%); the red blood cell transfusion rate decreased to 18.29% (a decrease of 4.07%), and the amount of red blood cell transfusions was reduced by 291 units. Conclusion: This system achieves full-process management of preoperative anemia through information technology, significantly enhancing the standardization of diagnosis and treatment as well as intervention effectiveness, providing an effective solution for perioperative anemia management.

Objective:To summarize the clinical features of Chlamydia pneumoniae pneumonia (CPP) in children. Methods:Case series study. Clinical data of 10 children with CPP hospitalized in Department No.2 of Respiratory Medicine of Beijing Children′s Hospital, Capital Medical University from January 2019 to August 2024 were retrospectively collected, including general information, clinical manifestations, chest imaging, laboratory examination and treatment. The clinical features and prognosis were summarized.Results:Among the 10 children with CPP, 7 were male and 3 were female. The age of onset was 11.2 (10.3, 13.1) years. The course were 17 (7, 23) days. Cough occurred in 9 cases with wet cough in 7 cases, while moderate and high fever occurred in 6 cases. Besides, chest pain occurred in 4 cases, rash and hemoptysis occurred in 1 case respectively. High density mass shadow was found in 7 cases chest CT imaging, accompanied by air bronchogram sign, surrounded by halo sign, 6 cases of which were distributed under the pleura, while patchy consolidation in the remaining 3 cases. Pulmonary embolism was present in 2 cases. Among the 10 children with CPP, bilateral lung involvement was found in 3 cases and unilateral lung involvement in 7 cases. The white blood cell count was 10.21 (7.45, 11.64)×10 9/L and the proportion of neutrophils was 0.69 (0.63, 0.71). C-reactive protein increased in 7 cases, with the level of 33 (16, 77) mg/L. D-dimer increased slightly in 3 cases (0.393, 0.396, 0.739 mg/L). Serum Chlamydia pneumoniae-IgM antibody test was positive in 6 cases. Chlamydia pneumoniae nucleic acid test by bronchoalveolar lavage fluid (BALF) next-generation sequencing was positive in 6 cases. Both serum IgM antibody and BALF nucleic acid tests were positive in 2 cases. Among the 10 children with CPP, azithromycin alone was used in 5 cases, while glucocorticoid was added in 1 case. Due to poor response to azithromycin in 4 cases, doxycycline was replaced in 3 cases and minocycline was replaced in 1 case, while glucocorticoid was added in 2 cases. Moxifloxacin combined with glucocorticoid therapy was adopted in 1 case with long course after the poor response to azithromycin and doxycycline. All patients were cured finally. Conclusions:CPP mostly occurs in elderly children. The main clinical manifestations include cough, fever and chest pain. The common chest imaging feature is subpleural high-density mass shadow with halo sign. Pulmonary embolism is present in a few cases. Nucleic acid detection and (or) serology is helpful for etiological diagnosis. Some cases need glucocorticoid therapy.