Objective:To analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis in Shandong Province from 2015 to 2024.Methods:Data on pertussis cases in Shandong Province from 2015 to 2024 were collected from the China Information System for Disease Control and Prevention. The ArcGIS spatiotemporal method was used to analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis, and determine the hotspots of incidence.Results:From 2015 to 2024, 46 172 cases of pertussis were reported in Shandong Province, with an average annual incidence rate of about 4.60/100 000. The reported incidence rate showed an overall upward trend, and in 2024, the reported incidence rate reached the highest level in history (19.20/100 000) since the implementation of children′s planning immunization. The areas with high incidence rates were mainly located in the central and western regions of Shandong Province, including Jinan city, Liaocheng city, Tai′an city, Zibo city, Binzhou city, Jining city, Dezhou city, Zaozhuang city, and Dongying city. The global spatial autocorrelation analysis showed that the Moran′s I index of incidence rate of pertussis in Shandong Province in each year from 2015 to 2024 was >0.00, showing obvious spatial clustering. Local spatial autocorrelation analysis showed that the "high high" clustering areas were mainly distributed in some counties (cities, districts) in the central and western regions of Shandong Province, which were hotspots for pertussis incidence in Shandong Province. The spatial trend surface analysis showed that the annual incidence rate of pertussis in each year basically decreased from west to east. In the early stage of the north-south direction, there was a curved trend of low north-south and high in the middle. In the middle and later stages, the northern part was mostly in a higher position, indicating that the central and western regions were the high-risk areas for pertussis in Shandong Province. Conclusions:The pertussis epidemic in Shandong Province from 2015 to 2024 has obvious spatiotemporal clustering, and the central and western regions are the key areas for pertussis prevention and control.

Objective:To analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis in Shandong Province from 2015 to 2024.Methods:Data on pertussis cases in Shandong Province from 2015 to 2024 were collected from the China Information System for Disease Control and Prevention. The ArcGIS spatiotemporal method was used to analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis, and determine the hotspots of incidence.Results:From 2015 to 2024, 46 172 cases of pertussis were reported in Shandong Province, with an average annual incidence rate of about 4.60/100 000. The reported incidence rate showed an overall upward trend, and in 2024, the reported incidence rate reached the highest level in history (19.20/100 000) since the implementation of children′s planning immunization. The areas with high incidence rates were mainly located in the central and western regions of Shandong Province, including Jinan city, Liaocheng city, Tai′an city, Zibo city, Binzhou city, Jining city, Dezhou city, Zaozhuang city, and Dongying city. The global spatial autocorrelation analysis showed that the Moran′s I index of incidence rate of pertussis in Shandong Province in each year from 2015 to 2024 was >0.00, showing obvious spatial clustering. Local spatial autocorrelation analysis showed that the "high high" clustering areas were mainly distributed in some counties (cities, districts) in the central and western regions of Shandong Province, which were hotspots for pertussis incidence in Shandong Province. The spatial trend surface analysis showed that the annual incidence rate of pertussis in each year basically decreased from west to east. In the early stage of the north-south direction, there was a curved trend of low north-south and high in the middle. In the middle and later stages, the northern part was mostly in a higher position, indicating that the central and western regions were the high-risk areas for pertussis in Shandong Province. Conclusions:The pertussis epidemic in Shandong Province from 2015 to 2024 has obvious spatiotemporal clustering, and the central and western regions are the key areas for pertussis prevention and control.

In recent years, with the in-depth research on rosacea, dermatologists′ understanding of rosacea has gradually increased. However, misdiagnosis and overdiagnosis emerge as a tendency because some doctors roughly equate erythema with rosacea, neglecting the differential diagnosis with other similar skin problems. This article discusses clinical manifestations and diagnostic criteria of rosacea, elaborates on how to make a correct diagnosis, and lists key points in differential diagnosis between rosacea and other skin diseases, with a view to providing a reference for clinicians in the treatment of rosacea, and to reducing its misdiagnosis and overdiagnosis.

Objective:To investigate the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with rosacea, and to analyze the relationship between breath test results and the occurrence of rosacea.Methods:Patients with rosacea were enrolled from the outpatient department of Xiangya Hospital from March 2022 to June 2023. The methane-hydrogen breath test was used to detect intestinal levels of methane and hydrogen in all patients to investigate the prevalence of SIBO. The basic information, clinical symptoms and severity, quality of life scores, gastrointestinal symptoms, and past medical history of the patients were collected. Statistical analysis was carried out by using the chi-square test, nonparametric test and multivariate logistic regression models to investigate the relationship between SIBO and the occurrence of rosacea.Results:A total of 116 patients with rosacea completed the methane-hydrogen breath test. They were aged 18 to 56 years (median [ Q1, Q3]: 25 [22, 33] years), and included 7 males (6.0%) and 109 females (94.0%) ; there were 43 cases (37.1%) of erythematotelangiectatic rosacea, and 73 (62.9%) of papulopustular rosacea. As the breath test showed, 94 patients were diagnosed with SIBO (81.0%, 95% CI: 72.7% - 87.7%) based on the breath tests, 84 showed positive hydrogen breath test results (72.4%, 95% CI: 63.3% - 80.3%), and 47 had positive methane breath test results (40.5%, 95% CI: 31.5% - 50%). Among the 67 patients with moderate to severe erythema, 33 (49.3%) showed positive methane breath test results, and 14 of 49 (28.6%) patients with mild erythema showed positive methane breath test results, with a rate difference of 20.7% ( P = 0.025, 95% CI: 13.9% - 27.5%) ; there were no significant differences in the positive rates of SIBO and hydrogen breath test results between the patients with moderate to severe erythema and those with mild erythema (both P > 0.05). No significant differences were observed in the age, gender, clinical subtypes, severity of papulopustules, flushing and burning sensation, or rosacea quality of life index scores between the SIBO-positive and -negative groups, between hydrogen-positive and -negative groups, and between methane-positive and -negative groups (all P > 0.05). Multivariate logistic regression analysis showed that methane positivity on breath test was associated with the severity of erythema in rosacea ( OR = 2.495, 95% CI: 1.102 - 5.649, P < 0.05) . Conclusions:The prevalence of SIBO was relatively high in the patients with rosacea. However, only the positive rate of methane breath test differed between the rosacea patients and non-rosacea controls, and there was some correlation between methane positivity on breath test and increased severity of rosacea erythema.

Studies have shown that rosacea is related to inflammatory factors, neurovascular function, micro-ecological environment and other factors. The Janus kinase (JAK) -signal transducer and activator of transcription (STAT) signaling pathway involves a variety of inflammatory cytokines, and plays an important role in cell proliferation, differentiation, apoptosis, angiogenesis and immune regulation. This review summarizes the JAK-STAT signaling pathway and explores its potential role in rosacea.

Objective:To analyze the willingness-to-pay (WTP) for the treatment of acute facial inflammatory dermatoses with red and yellow light from light-emitting diodes (LEDs), and to evaluate their cost-effectiveness.Methods:A questionnaire survey was conducted on outpatients with or without acute facial inflammatory dermatoses, which mainly manifested as erythema and swelling, in Department of Dermatology, Xiangya Hospital from August 2019 to June 2020. The WTP for the treatment of acute facial inflammatory dermatoses of varying severity with red and yellow light from LEDs were investigated, clinical data on the prevalence of facial skin diseases, previous medical visits and quality of life were collected, and a benefit-cost analysis was conducted. Logistic regression analysis was conducted to investigate factors influencing the patients′ WTP for the LED treatment.Results:The median WTP of the subjects was 200, 300 and 300 RMB yuan for 1-session treatment of three cases of acute facial inflammatory dermatoses of increasing severity assumed to require 1-, 3-, and 5-session LED treatments respectively, and the WTP for 1-session treatment of case 2 and case 3 was higher than the cost of 1-session LED treatment (217 RMB yuan). The subjects with high family incomes (≥ 100 000 RMB yuan/year) were significantly more willing to pay for the treatment than those with low family incomes (< 100 000 RMB yuan/year) (case 1: 40.46% vs. 27.50%, χ2 = 7.00, P = 0.008; case 2: 60.69% vs. 44.5%, χ2 = 9.75, P = 0.002; case 3: 51.20% vs. 48.8%, χ2 = 6.54, P = 0.011), and the subjects who never suffered from facial inflammatory dermatoses were significantly more willing to pay for the treatment than those who ever suffered (case 1: 35.49% vs. 28.82%, χ2 = 1.56, P = 0.212; case 2: 56.10% vs. 42.34%, χ2 = 5.92, P = 0.015; case 3: 68.32% vs. 56.75%, χ2 = 4.58, P = 0.032). No significant difference in the WTP was observed among patients with different facial dermatoses, different degrees of impairment on quality of life, or different treatment experience (all P>0.05) . Conclusion:The cost of red and yellow light from LEDs for the treatment of acute facial inflammatory dermatoses manifesting as erythema and swelling was highly acceptable in this population, and it was worthy of clinical promotion.

Pseudomyogenic hemangioendothelioma (PHE) is a rare angiogenic tumor. Histologically, the morphological characteristics of neoplastic vessels and endothelial differentiation are not obvious, and it is easy to be confused with epithelioid sarcoma, epithelioid hemangioendothelioma and myogenic tumor. PHE usually occurs in arms and legs in young people and has a significant male predominance. The tumor has a predilection for the distal extremities and its typical manifestation is multiple center invasion of a single limb, which can involve all layers of skin and subcutaneous tissues,and is often accompanied by abvious pain. Histologically, PHE is characterized by infiltrative growth of tumor. Most tumor lesions are composed of sheets and loose fascicles of plump spindle or epithelioid cells within a background of variably prominent inflammatory infiltration, which was commonly composed of neutrophils. Some cells may resemble rhabdomyoblasts, and nuclear atypia and mitosis were rare. The tumor cells generally expressed positive cytokeratin (CK), ETS-related gene (ERG), Friend leukemia virus integration 1 (FLI1) and integrase interactor 1(INI1). In some cases, the tumor cells expressed CD31. A case of a young woman was reported in this paper, who presented with a subcutaneous mass with severe pain and was chronologically misdiagnosed with herpes zoster, low-grade malignant fibrous histiocytoma and epithelioid hemangioendothelioma. In this study, the clinical and pathological features, differential diagnosis and the latest progress in therapy of PHE were analyzed based on relevant literature.
Adolescent ; Adult ; Biomarkers, Tumor ; Child ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Hemangioendothelioma, Epithelioid/pathology* ; Hemangioma ; Histiocytoma, Malignant Fibrous/diagnosis* ; Humans ; Male ; Pain ; Precancerous Conditions/diagnosis*

Objective:To investigate the willingness to pay (WTP) for treatment and its influencing factors, to evaluate the correlation between the disease burden (quality of life) index and dermatology life quality index (DLQI) in patients with rosacea, and to provide a basis for individualized diagnosis and treatment.Methods:Patients with rosacea were enrolled via a WeChat platform at Department of Dermatology, Xiangya Hospital from August 2019 to February 2020. An online questionnaire survey was performed to investigate the WTP for a single session of treatment by which rosacea is assumed to be cured, and general information as well as data about clinical characteristics and DLQI scores were collected. Factors influencing high WTP were analyzed by using a logistic regression model.Results:Among the 435 respondents, 397 (91.3%) were females and 38 (8.7%) were males, with an age of 28.46 ± 8.33 years (range, 18- 63 years) . The respondents spent 10 474.95 ± 834.19 ( M[ P25, P75], 5 000 [1 000, 10 000]) RMB Yuan on previous medical treatment; the WTP was 12 510.86 ± 990.84 ( M[ P25, P75], 5 000[2 000, 10 000]) RMB Yuan; the DLQI score was 11.2 ± 0.38. Logistic regression analysis showed that lesions on the cheeks ( OR= 1.89, P= 0.041) , annual household income of > 100 000 RMB Yuan ( OR= 1.63, P= 0.029) , disease duration of > 1 year ( OR= 2.82, P < 0.001) , high number of visits in the past 1 year ( OR= 1.62, P < 0.001) , high self-rated rosacea severity score ( OR= 1.16, P= 0.002) and high DLQI score ( OR= 1.52, P < 0.001) were associated high WTP for treatment. Spearman correlation analysis showed that the DLQI score was positively correlated with WTP ( rs= 0.27, P < 0.05) and relative WTP (the proportion of WTP to monthly income, rs= 0.133, P < 0.05) . Conclusions:Among the patients with rosacea in Changsha, the WTP was at a moderate to high level, reflecting a serious impact on the quality of life. The WTP value can indirectly reflect the quality of life and help to rapidly understand the burden of disease in patients with rosacea.

Livedoid vasculopathy is a rare chronic ischemic necrotic skin disease caused by microvascular thrombosis in superficial vascular plexuses.Effective treatments are lacking.Efficacy of anticoagulants has been clinically proven in the treatment of this disease,but the administration route and adverse reactions limit their extensive application.The new oral factor Xa inhibitor rivaroxaban,which has many advantages,such as no need for coagulation monitoring,few adverse reactions and convenient oral administration,can be used in the prevention and treatment of thrombosis and post-thrombotic ulcers.In this article,3 patients with livedoid vasculopathy were treated with rivaroxaban alone or in combination,and satisfactory efficacy was obtained.

Objective:To investigate clinical features of intermittent flushing in patients with rosacea, and to evaluate its impact on the quality of life of patients.Methods:A prospective study was conducted, a total of 728 patients with rosacea were enrolled from Department of Dermatology, Xiangya Hospital from August 2017 to August 2019. Data were collected by using flushing symptom questionnaire (FSQ) , clinician erythema assessment scale (CEA) , patient′s self-assessment (PSA) and visual analogue scale (VAS) . Clinical features and severity of intermittent flushing episodes, degree of bother and impact on life, and correlation of flushing scores with persistent erythema scores were analyzed. Statistical analysis was carried out by using chi-square test and Spearman correlation analysis.Results:Among the 728 patients with rosacea, intermittent flushing most frequently occurred on the cheek (682 cases, 93.7%) and zygomatic region (617 cases, 84.8%) ; the proportion of patients with a flushing duration of 5 minutes to 2 hours was the highest (484 cases, 66.5%) ; 317 (43.6%) had flushing episodes after stimulation, and 233 (32.0%) had multiple flushing episodes every day. Moreover, 503 patients (69.1%) had an overall flushing score above the moderate level; 412 (56.6%) considered that flushing could affect sleep to varying degrees, of which 59 (8.1%) considered that the impact was severe or very severe; 662 (90.9%) considered that flushing had impact on life to different degrees, of which 304 (41.8%) thought that the impact was severe. Both the overall flushing score and life bother score were positively but lowly correlated with the CEA scores ( rs = 0.166, 0.151 respectively, both P < 0.05) , and were positively correlated with the PSA scores ( rs = 0.518, 0.500 respectively, both P < 0.05) . Conclusion:Intermittent flushing occurs at typical sites of patients with rosacea, with long duration of episodes and high frequency, and affects quality of life of patients, so attention needs to be paid by clinicians.