Objective:To construct and validate a predictive model for postoperative recurrence in early non-small cell lung cancer patients.Methods:The clinical data of 252 patients with early non-small cell lung cancer admitted to the 926th Hospital of Joint Logistic Support Force of PLA from January 2016 to January 2018were retrospectively collected. All of the patients underwent surgical treatment and they were followed up for 5 years after surgery, according the recurrence after surgery, they were divided into the recurrence group (103 cases) and non- recurrence group (149 cases). The risk factors for postoperative recurrence in early non-small cell lung cancer patients were analyzed. A predictive model for postoperative recurrence in early non-small cell lung cancer patients was constructed and validated.Results:The results of Logistic regression analysis showed that tumor long diameter≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction were independent risk factors for postoperative recurrence in early non-small cell lung cancer patients ( P<0.05). Using R4.0.3 statistical software, the dataset was randomly divided into a training set and a validation set, with a sample size of 176 cases in the training set and 76 cases in the validation set. A prediction model was constructed, with thearea under the curve (AUC) of the receiver operating characteristic (ROC) curve of 0.754 (95% CI 0.679 - 0.828) in the training set and AUC of 0.749 (95% CI 0.634 - 0.864) in the validation set. The model was subjected to a Hosmer-Lemeshow Goodness-of-Fit Test in the validation set, χ2 = 11.31, P = 0.185. Conclusions:The predictive model base on tumor long diameter ≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction can identify patients at high risk of postoperative recurrence in early non-small cell lung cancer effectively.

ObjectiveTo understand the epidemic characteristics of influenza in Beijing from 2023 to 2024, and to provide a scientific basis for the prevention and control of influenza. MethodsData on influenza-like illness (ILI) from secondary level and above hospitals, etiology surveillance data, and influenza clusters outbreaks data from 2023‒2024 were used to analyze the epidemic trend and pathogenic characteristics of influenza. Furthermore, an influenza comprehensive index was used to categorize the epidemic intensity at the severity level. ResultsA total of 2 065 857 ILI cases were reported in 2023‒2024 epidemic season, and the percentage of ILI was 3.67%. The age group of 5‒14 years accounted for the highest proportion of ILI (30.48%). A total of 41 766 throat swabs from ILI were detected, with a positive rate of 17.28%.A (H3N2) (51.86%) and B Victoria (41.93%) were the most prevalent subtypes of influenza virus. Clustered influenza outbreaks occurred mainly in primary schools (57.78%) and middle schools (35.55%), mainly caused by the influenza A (H3N2) subtype (85.93%). According to the influenza comprehensive index (I), the period of influenza activity and above (I>0.5) lasted for a total of 37 weeks, accounting for 71.15% of the entire influenza season. ConclusionCompared with previous years, the epidemic level of influenza in Beijing was increased in 2023‒2024, and the peak time became earlier. The comprehensive index method can objectively evaluate the level of influenza epidemic and provide suggestions for the future prevention and control of influenza in Beijing.

Objective:To analyze the effect of influenza vaccination on influenza cluster epidemic in primary and secondary schools in Beijing during the 2023-2024 surveillance season and provide evidence for the improvement of influenza vaccination strategies.Methods:The incidence data of influenza cluster epidemic and influenza vaccination coverage in the schools in Beijing during 2023-2024 were collected. Descriptive epidemiological methods were used to analyze cluster epidemic characteristics, and χ2 test was used to compare incidence differences between groups, and OR value and vaccine effectiveness [VE=(1- OR)×100%] were calculated. A negative binomial regression model was used to evaluate the association between school vaccination rates and cluster epidemic risk. Joinpoint regression was used to analyze trends in relative risk ( RR) with increasing vaccination coverage and to determine the optimal vaccination threshold. Results:A total of 126 influenza cluster epidemic were reported in 115 primary and secondary schools in Beijing during 2023-2024 with the median size of 15 case, the average attack rate was 36.26% (2 033/5 607). The epidemics mainly occurred in urban area (70, 55.56%). Primary schools were the main setting (78, 61.90%), and influenza A(H3N2) was the predominant subtype (108, 85.71%). The overall influenza vaccination coverage in the primary and secondary students was 54.26%, while the average vaccination in classes affected by the epidemics was 58.57%. The overall protection rate was 47.62%, the protection rate was higher in primary schools (49.65%) than in secondary schools (46.60%). The protection rates against influenza A(H1N1)pdm09 (80.93%) and influenza B (Victoria lineage) (81.65%) were significantly higher than that against influenza A(H3N2) (44.19%). When school vaccination coverage reached ≥76.00%, the epidemic risk decreased by 52.82%.Conclusions:Even the match between influenza vaccine strains and circulating strains is suboptimal, increasing influenza vaccination coverage in schools can effectively reduce the risk for influenza cluster epidemic. In the future, measures such as policy guidance and public health education should be taken to further improve vaccination coverage, thereby establishing herd immunity and reducing the transmission risk of influenza in schools.

Objective:To investigate the predictive value of systemic immune inflammation index for the efficacyof neoadjuvant chemotherapy in triple negative breast cancer patients, and analyzed the relationship between pathological complete response (pCR) and prognosis.Methods:The clinical data of 146 patients with triple-negative breast cancer admitted to the 926th Hospital of the Joint Service Support Force of the PLA from January 2018 to December 2020 were retrospectively collected. All patients received neoadjuvant chemotherapy. After chemotherapy, the patients were divided into pCR group (62 cases) and non-pCR group (84 cases) according to whether the patients achieved pCR. Pathological characteristics and systemic immunoinflammatory index levels of the two groups were compared. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of systemic immunoinflammatory index for pCR after neoadjuvant chemotherapy in patients with triple-negative breast cancer, and survival curves were drawn to compare the disease-free survival of the two groups.Results:The rate of axillary lymph node metastasis in pCR group was lower than that in non-pCR group: 37.10% (23/62) vs. 64.29% (54/84), there was statistical difference ( χ2 = 10.58, P<0.01). There were no significant differences in TNM stage, Ki-67 level and histological grade between the two groups ( P>0.05). Compared with the non -pCR group, the systemic immune inflammation index in the pCR group was significantly reduced: 617.42 ± 166.40 vs. 853.67 ± 202.41, P<0.01. Systemic immune inflammation index was valuable in predicting non-pCR of triple negative breast cancer patients after neoadjuvant chemotherapy, and the area under the curve was 0.807 (95% CI: 0.738 - 0.875, P<0.01). Compared with the non-pCR group, the disease-free survival of patients in the pCR group was significantly prolonged ( P = 0.033). Conclusions:Systemic immune inflammation index was related to the efficacy of neoadjuvant chemotherapy in triple negative breast cancer patients, and can be used as a biological indicator to predict the efficacy of neoadjuvant chemotherapy in triple negative breast cancer.

Objective:To analyze the effect of influenza vaccination on influenza cluster epidemic in primary and secondary schools in Beijing during the 2023-2024 surveillance season and provide evidence for the improvement of influenza vaccination strategies.Methods:The incidence data of influenza cluster epidemic and influenza vaccination coverage in the schools in Beijing during 2023-2024 were collected. Descriptive epidemiological methods were used to analyze cluster epidemic characteristics, and χ2 test was used to compare incidence differences between groups, and OR value and vaccine effectiveness [VE=(1- OR)×100%] were calculated. A negative binomial regression model was used to evaluate the association between school vaccination rates and cluster epidemic risk. Joinpoint regression was used to analyze trends in relative risk ( RR) with increasing vaccination coverage and to determine the optimal vaccination threshold. Results:A total of 126 influenza cluster epidemic were reported in 115 primary and secondary schools in Beijing during 2023-2024 with the median size of 15 case, the average attack rate was 36.26% (2 033/5 607). The epidemics mainly occurred in urban area (70, 55.56%). Primary schools were the main setting (78, 61.90%), and influenza A(H3N2) was the predominant subtype (108, 85.71%). The overall influenza vaccination coverage in the primary and secondary students was 54.26%, while the average vaccination in classes affected by the epidemics was 58.57%. The overall protection rate was 47.62%, the protection rate was higher in primary schools (49.65%) than in secondary schools (46.60%). The protection rates against influenza A(H1N1)pdm09 (80.93%) and influenza B (Victoria lineage) (81.65%) were significantly higher than that against influenza A(H3N2) (44.19%). When school vaccination coverage reached ≥76.00%, the epidemic risk decreased by 52.82%.Conclusions:Even the match between influenza vaccine strains and circulating strains is suboptimal, increasing influenza vaccination coverage in schools can effectively reduce the risk for influenza cluster epidemic. In the future, measures such as policy guidance and public health education should be taken to further improve vaccination coverage, thereby establishing herd immunity and reducing the transmission risk of influenza in schools.

Objective:To investigate the predictive value of systemic immune inflammation index for the efficacyof neoadjuvant chemotherapy in triple negative breast cancer patients, and analyzed the relationship between pathological complete response (pCR) and prognosis.Methods:The clinical data of 146 patients with triple-negative breast cancer admitted to the 926th Hospital of the Joint Service Support Force of the PLA from January 2018 to December 2020 were retrospectively collected. All patients received neoadjuvant chemotherapy. After chemotherapy, the patients were divided into pCR group (62 cases) and non-pCR group (84 cases) according to whether the patients achieved pCR. Pathological characteristics and systemic immunoinflammatory index levels of the two groups were compared. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of systemic immunoinflammatory index for pCR after neoadjuvant chemotherapy in patients with triple-negative breast cancer, and survival curves were drawn to compare the disease-free survival of the two groups.Results:The rate of axillary lymph node metastasis in pCR group was lower than that in non-pCR group: 37.10% (23/62) vs. 64.29% (54/84), there was statistical difference ( χ2 = 10.58, P<0.01). There were no significant differences in TNM stage, Ki-67 level and histological grade between the two groups ( P>0.05). Compared with the non -pCR group, the systemic immune inflammation index in the pCR group was significantly reduced: 617.42 ± 166.40 vs. 853.67 ± 202.41, P<0.01. Systemic immune inflammation index was valuable in predicting non-pCR of triple negative breast cancer patients after neoadjuvant chemotherapy, and the area under the curve was 0.807 (95% CI: 0.738 - 0.875, P<0.01). Compared with the non-pCR group, the disease-free survival of patients in the pCR group was significantly prolonged ( P = 0.033). Conclusions:Systemic immune inflammation index was related to the efficacy of neoadjuvant chemotherapy in triple negative breast cancer patients, and can be used as a biological indicator to predict the efficacy of neoadjuvant chemotherapy in triple negative breast cancer.

Objective:To construct and validate a predictive model for postoperative recurrence in early non-small cell lung cancer patients.Methods:The clinical data of 252 patients with early non-small cell lung cancer admitted to the 926th Hospital of Joint Logistic Support Force of PLA from January 2016 to January 2018were retrospectively collected. All of the patients underwent surgical treatment and they were followed up for 5 years after surgery, according the recurrence after surgery, they were divided into the recurrence group (103 cases) and non- recurrence group (149 cases). The risk factors for postoperative recurrence in early non-small cell lung cancer patients were analyzed. A predictive model for postoperative recurrence in early non-small cell lung cancer patients was constructed and validated.Results:The results of Logistic regression analysis showed that tumor long diameter≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction were independent risk factors for postoperative recurrence in early non-small cell lung cancer patients ( P<0.05). Using R4.0.3 statistical software, the dataset was randomly divided into a training set and a validation set, with a sample size of 176 cases in the training set and 76 cases in the validation set. A prediction model was constructed, with thearea under the curve (AUC) of the receiver operating characteristic (ROC) curve of 0.754 (95% CI 0.679 - 0.828) in the training set and AUC of 0.749 (95% CI 0.634 - 0.864) in the validation set. The model was subjected to a Hosmer-Lemeshow Goodness-of-Fit Test in the validation set, χ2 = 11.31, P = 0.185. Conclusions:The predictive model base on tumor long diameter ≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction can identify patients at high risk of postoperative recurrence in early non-small cell lung cancer effectively.

Objective:To clarify the M protein ( emm gene) types and drug susceptibility characteristic variations of Group A Streptococcus (GAS) in children in Beijing. Methods:The GAS strains isolated from throat swab samples of children diagnosed with scarlet fever and pharyngeal infection in scarlet fever etiology surveillance sentinel hospitals in 16 districts of Beijing in 2018, 2019 and 2021 were analyzed retrospectively.PCR amplification and sequencing were used for emm genotyping, and the minimum inhibitory concentrations (MIC) of 10 antibiotics were determined by the broth microdilution method.The data were analyzed using χ2 test and Fisher′ s exact method between groups. Results:A total of 557 GAS strains were collected, and 11 emm genotypes ( emm1, emm3, emm4, emm6, emm11, emm12, emm22, emm75, emm89, emm128, and emm212) were detected.Of 557 strains, 238 trains were of emm1 type (42.73%), 271 strains were of emm12 type (48.65%) and 48 strains were of other emm types (8.62%). The detection rates of emm1, emm12 and other emm type genes in 2018, 2019, and 2021 were [37.50% (105/280 strains), 57.14% (160/280 strains), 5.36% (15/280 strains)], [49.05% (129/263 strains), 39.54% (104/263 strains), 11.41% (30/263 strains)], and [28.57% (4/14 strains), 50.00% (7/14 strains), 21.43% (3/14 strains)], respectively.In children infected with emm12 in 2018 and 2019, there were more children under 6 years old than children over 6 years old (62.50% vs.46.88%, 46.36% vs.30.36%) (χ 2=7.182, 6.973; all P<0.05). Drug susceptibility testing results suggested that 225 randomly selected GAS strains were all 100.00% sensitive to 7 antibiotics including Penicillin, Levofloxacin, Meropenem, Linezolid, Cefotaxime, Cefepime and Vancomycin.The rates of resistance to Erythromycin, Tetracycline and Clindamycin were [88.57% (93/105 strains), 87.62% (92/105 strains), 86.67% (91/105 strains)], and [94.34% (100/106 strains), 94.34% (100/106 strains), 87.74% (93/106 strains)] in 2018 and 2019, respectively.The test strains were 100.00% (14/14 strains) resistant to the above 3 antibiotics in 2021.MIC 50 and MIC 90 values of Penicillin in 2018, 2019, and 2021 were (0.03 mg/L, 0.03 mg/L), (0.03 mg/L, 0.06 mg/L), and (0.06 mg/L, 0.06 mg/L), respectively.Among 225 GAS strains, 207 strains had drug resistance and were resistant to more than one drug.Specifically, 94.69% (196/207 strains) were resistant to Erythromycin, Tetracycline and Clindamycin.About 4.35% (9/207 strains) were resistant to both Erythromycin and Clindamycin.A total of 0.97% (2/207 strains) were resistant to Erythromycin and Tetracycline. Conclusions:The emm genotypes of GAS in children in Beijing are diverse in 2018, 2019 and 2021.The dominant genotypes are emm12 and emm1, and emm12 is the main epidemiological type.GAS strains maintain highly resistant to Erythromycin, Clindamycin and Tetracycline, and sensitive to Penicillin and other antibiotics.However, MIC 50 and MIC 90 of Penicillin shows an ascending trend.

A 65-year-old female patient with chronic renal failure undergoing continuous hemodialysis received an IV infusion of cefmenoxime 1 g twice daily for acute pancreatitis. The values of prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were within the normal range before treatment. After 11 days of treatment, the patient developed multiple ecchymoses on the skin and bleeding from the venipuncture site which was not easily stopped. The reexamination of coagulation function showed PT 127 s, INR 10.72, and APTT 86 s. Coagulation dysfunction was considered and an IV infusion of leukocyte-reduced fresh-frozen plasma 150 ml was given. Examination of coagulation function next day showed PT 101 s, INR 8.49, and APTT 65 s. Mixing study for evaluation of abnormal coagulation testing showed that PT and APTT could be corrected, suggesting coagulation factor deficiency. Blood coagulation disorders caused by cefmenoxime was considered. Then the drug was discontinued and switched to amoxicillin sodium and clavulanate potassium, and a subcutaneous injection of vitamin K 1 10 mg was given once daily. Three days after the drug withdrawal, her coagulation function returned to within the normal range (PT 15 s, INR 1.19, APTT 36 s).

Objective:To explore the self-management trajectory of patients with percutaneous coronary intervention (PCI) , in order to provide better guidance for disease self-management of patients with PCI.Methods:From April to December in 2019, a total of 15 patients with PCI who were treated and followed up in a Class Ⅲ Grade A hospital in Harbin and a Class Ⅲ Grade A hospital in Tianjin were selected as the research objects. All 15 patients were interviewed and recorded. Then the records were transcribed and analyzed with open coding, axial coding and selective coding according to the grounded theory put forward by Strass and Corbin, to identify the categories and core category.Results:The core category of disease self-management of patients undergoing PCI was "crisis-conscious path of PCI patient self-management", that was, the path of PCI patient self-management presented a dynamic process with the change of disease risk cognition. When patients were aware of the disease risk, they would enter the path of active health management, and when patients were unaware of the disease risk or risk cognition declines, they would enter the path of ignoring the disease self-management.Conclusions:Medical staff should pay attention to and strengthen the early postoperative risk awareness education of PCI patients; quantify patients' cognitive needs of health education and give targeted health education intervention measures; strengthen supervision and management outside the hospital, and establish the concept of lifelong self-management for patients.