To address the growing challenge of an increasing number of elderly lung cancer patients amidst China's aging population and to fill the gap in quality control standards for surgical treatment in this special population, this study aimed to develop a standardized surgical evaluation system for elderly lung cancer patients tailored to China's national conditions. The system was established through a literature review, integrated the pathophysiological characteristics of elderly patients, and was constructed following review, feedback, and revision by experts from multiple thoracic surgery centers. Employing a 100-point scoring system, it comprises three primary domains: physical infrastructure and geriatric adaptability foundational conditions (10 points); management level and perioperative care models (20 points); and technical proficiency and clinical outcomes (70 points). The system places a strong emphasis on geriatric adaptability, proposing specific, quantifiable indicators for age-friendly facility modifications, control of elderly-specific complications, multidisciplinary collaboration, and standardized perioperative management. It provides a convenient and measurable assessment tool for quality control in the surgical treatment of elderly lung cancer in China, which is expected to promote the standardization and homogenization of diagnosis and treatment.

Objective To evaluate the cost-effectiveness of low-dose steroid combined with tacrolimus or cyclophosphamide in treating adult idiopathic membranous nephropathy(IMN).Methods A prospective cohort design was used to collect clinical data on IMN patients admitted to the Affiliated Hospital of Hebei University from December 2018 to April 2022.The patients were divided into the exposure group(low-dose steroid combined with tacrolimus)and control group(low-dose steroid combined with cyclophosphamide)according to the treatment regimen.Propensity score matching was employed to balance the baseline characteristics between the two groups.The total response rate was taken as the effect index,cost-effectiveness analysis was conducted by using the decision tree model,and single factor sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the cost-effectiveness analysis results.Results A total of 112 patients with IMN were included.After propensity score matching,46 patients were included in the exposed and control groups,respectively.The total remission rate of the exposure group was 84.78％,with the cost of 13,352.64 yuan and the cost-effectiveness ratio of 157.50.In the control group,the total remission rate was 80.43％,the cost was 8,154.18 yuan,and the cost-effectiveness ratio was 101.38.The incremental cost-effectiveness ratio of the two groups was 1 195.05,and the sensitivity analysis results were consistent with those of the cost-effectiveness analysis.Conclusion The two treatment schemes have their own advantages in the treatment of IMN.The cost-effectiveness ratio of low-dose hormone combined with tacrolimus is relatively higher,and the combination of low-dose hormone with cyclophosphamide is more economical.Both schemes have certain clinical promotion value..

Objective To investigate the impact of different application methods of tissue compensators(bolus)on the skin dose delivered to the chest wall following radical mastectomy for breast cancer.Methods A retrospective analysis was conducted on 60 female patients who underwent radical mastectomy and required chest wall radiotherapy at the hospital between January 2023 and March 2025.The Pinnacle3 9.10 radiotherapy planning system(TPS)was utilized to design two VMAT dual semi-arc radiotherapy plans for each patient,with a prescribed target dose of 50 Gy delivered in 2 Gy fractions over 25 sessions.In Plan 1,a Bolus was applied and optimized during the first 15 fractions,and subsequently removed for the remaining 10 fractions without re-optimization.The sub-field configuration and dose weighting from the initial optimization were retained,and only dose recalculations were performed.The final treatment plan combined both the Bolus-included and Bolus-excluded phases.In contrast,Plan 2 involved the application and optimization of Bolus during the first 15 fractions,followed by its removal and re-optimization of the plan for the last 10 fractions.The two optimized plans were then combined for the overall treatment delivery.Data from the two plan groups were analyzed using a paired sample t-test with SPSS 29.0 software.Results There was a statistically significant difference(P＜0.05)in skin Dmean,V52.5,and V55;heart Dmean,V5,V30,and V40;affected lung Dmean,V5,and V20;PRVcord Dmean and Dmax;healthy breast Dmean,V5,and V10;affected humeral head Dmean and V30;as well as PTV Dmean,V50,V55,D2％,D98％,CI,and MU.Moreover,the dose distribution on the target layer and the DVH curves showed marked differences.However,no statistically significant difference was observed in PTV HI(P=0.125).Conclusion The combination of the two optimized plans,consisting of 15 fractions with bolus and 10 fractions without bolus,more accurately reflects the dose distri-bution within the planned target area and organs at risk,thereby providing enhanced protection for the patient's chest wall skin.

Objective To evaluate the cost-effectiveness of low-dose steroid combined with tacrolimus or cyclophosphamide in treating adult idiopathic membranous nephropathy(IMN).Methods A prospective cohort design was used to collect clinical data on IMN patients admitted to the Affiliated Hospital of Hebei University from December 2018 to April 2022.The patients were divided into the exposure group(low-dose steroid combined with tacrolimus)and control group(low-dose steroid combined with cyclophosphamide)according to the treatment regimen.Propensity score matching was employed to balance the baseline characteristics between the two groups.The total response rate was taken as the effect index,cost-effectiveness analysis was conducted by using the decision tree model,and single factor sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the cost-effectiveness analysis results.Results A total of 112 patients with IMN were included.After propensity score matching,46 patients were included in the exposed and control groups,respectively.The total remission rate of the exposure group was 84.78％,with the cost of 13,352.64 yuan and the cost-effectiveness ratio of 157.50.In the control group,the total remission rate was 80.43％,the cost was 8,154.18 yuan,and the cost-effectiveness ratio was 101.38.The incremental cost-effectiveness ratio of the two groups was 1 195.05,and the sensitivity analysis results were consistent with those of the cost-effectiveness analysis.Conclusion The two treatment schemes have their own advantages in the treatment of IMN.The cost-effectiveness ratio of low-dose hormone combined with tacrolimus is relatively higher,and the combination of low-dose hormone with cyclophosphamide is more economical.Both schemes have certain clinical promotion value..

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease with a high mortality rate. Many countries worldwide have already reported local transmission, and the number of reported cases has been increasing yearly, with an ever-expanding region. No specific treatment drugs or vaccines have seriously threatened public health safety in epidemic regions. This article reviews the epidemiological characteristics, transmission routes, and control measures of SFTS.

Objective:To understand the pathogenic composition and epidemiological characteristics of febrile respiratory syndrome (FRS) in elderly people aged 60 and above in China, and to provide a reference basis for the scientific and precise prevention and control of FRS in the elderly.Methods:Based on FRS cases surveillance data from information management system of National Technical Platform for Infectious Disease Surveillance, National Science and Technology Major Project of China, the surveillance pathogens included 8 viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (HAdV), parainfluenza virus (HPIV), metapneumovirus (HMPV), coronavirus (HCoV), bocavirus and rhinovirus (HRV); 7 bacterias, namely Streptococcus pneumoniae ( S.pneumoniae), Staphylococcus aureus ( S.aureus), Klebsiella pneumoniae ( K.pneumoniae), Pseudomonas aeruginosa ( P.aeruginosa), Group A Streptococcus ( GAS), Haemophilus influenzae ( H.influenzae) and Legionella pneumophila ( L. pneumophila), in addition to Chlamydia pneumoniae ( C. pneumoniae) and Mycoplasma pneumoniae ( M. pneumoniae). A descriptive epidemiological approach was used to analyze the pathogenic composition and major epidemiological characteristics of FRS cases aged 60 years and older nationwide from 2009 to 2021. Results:The predominant viruses of FRS cases aged≥60 years accounted for 87.93% of the pathogen spectrum in China, including IFV (42.42%), HRV (16.71%), HPIV (11.53%), HCoV (9.52%), and RSV (7.75%), while the pathogen spectrum of the major bacteria accounted for 94.60%, including S. pneumoniae (25.71%), P. aeruginosa (24.97%), K. pneumoniae (22.47%), H. influenzae (12.23%), and S. aureus (9.22%). Influenza viruses have always been at the top of the viral pathogen spectrum, and P. aeruginosa, K. pneumoniae and S. pneumoniae, ranked high in the bacterial pathogen spectrum. Among them, the proportions of HRV, HPIV, RSV, K. pneumoniae, and H. influenzae fluctuated and increased during the 13 years of observation. The positive rate of any pathogen in FRS cases was higher in out patient emergencies (32.83%) than in hospitalized cases (27.26%) ( χ2 =125.89, P<0.001). The positive rate of IFV was higher in cases aged 60-74 years (13.66%). The positive rate of P. aeruginosa and K. pneumoniae were higher in cases aged ≥90 years (10.71%, 9.40%) and in northern regions (8.32%, 7.30%). The positive rate of any pathogen in FRS cases was higher in winter (33.82%) than in other seasons ( χ2=212.03, P<0.001). The positive rate of IFV and HRV were higher in winter (22.87%) and autumn (5.98%) and the positive rate of P.aeruginosa (8.11%) and K.pneumoniae (8.30%) were higher in summer. Conclusions:IFV, HRV, HPIV, S. pneumoniae, P. aeruginosa and K. pneumoniae were respectively the top three pathogens in the viral and bacterial pathogen spectrum of FRS cases aged 60 years and above in China from 2009 to 2021, and the positive rate of these main pathogens showed differences between age groups, seasons, and geographic regions. In the future, the dynamic surveillance of various pathogens in the elderly with respiratory tract infections should be continuously strengthened.

Objective To investigate the impact of different application methods of tissue compensators(bolus)on the skin dose delivered to the chest wall following radical mastectomy for breast cancer.Methods A retrospective analysis was conducted on 60 female patients who underwent radical mastectomy and required chest wall radiotherapy at the hospital between January 2023 and March 2025.The Pinnacle3 9.10 radiotherapy planning system(TPS)was utilized to design two VMAT dual semi-arc radiotherapy plans for each patient,with a prescribed target dose of 50 Gy delivered in 2 Gy fractions over 25 sessions.In Plan 1,a Bolus was applied and optimized during the first 15 fractions,and subsequently removed for the remaining 10 fractions without re-optimization.The sub-field configuration and dose weighting from the initial optimization were retained,and only dose recalculations were performed.The final treatment plan combined both the Bolus-included and Bolus-excluded phases.In contrast,Plan 2 involved the application and optimization of Bolus during the first 15 fractions,followed by its removal and re-optimization of the plan for the last 10 fractions.The two optimized plans were then combined for the overall treatment delivery.Data from the two plan groups were analyzed using a paired sample t-test with SPSS 29.0 software.Results There was a statistically significant difference(P＜0.05)in skin Dmean,V52.5,and V55;heart Dmean,V5,V30,and V40;affected lung Dmean,V5,and V20;PRVcord Dmean and Dmax;healthy breast Dmean,V5,and V10;affected humeral head Dmean and V30;as well as PTV Dmean,V50,V55,D2％,D98％,CI,and MU.Moreover,the dose distribution on the target layer and the DVH curves showed marked differences.However,no statistically significant difference was observed in PTV HI(P=0.125).Conclusion The combination of the two optimized plans,consisting of 15 fractions with bolus and 10 fractions without bolus,more accurately reflects the dose distri-bution within the planned target area and organs at risk,thereby providing enhanced protection for the patient's chest wall skin.

Objective:To analyze the epidemiological characteristics and natural focus distribution of marburg virus disease (MVD), and provide evidence for the prevention and control of MVD.Methods:A systematic literature retrieval was conducted, and descriptive epidemiological method was used to analyze the temporal, spatial, and population distributions of MVD as well as its natural hosts. The case fatality rate of MVD was evaluated through Meta-analysis, and the phylogenetic analysis of viral genomes was done by using software IQ-TREE 2.3.6.Results:Marburg virus has endemic spread in Africa and can be detected in various animals such as primates and bats. The positive rate is higher in Egyptian fruit bats, and the disease epidemic areas continue to expand. The human infections occur frequently. As of December 20, 2024, a total of 18 MVD outbreaks had been reported worldwide, resulting in 722 reported cases and 548 deaths. Meta- analysis showed a case fatality rate of about 65.19% (95% CI: 48.07%-80.50%). Populations are generally susceptible, with a higher proportion of the cases in miners and medical workers. Marburg virus specific antibody can be detected in populations and animals in some countries and regions where no cases have been reported in Africa, indicating the potential of virus transmission. Conclusion:The transmission capacity of Marburg virus shows no significant changes, but the areas affected by the virus transmission expands, indicating increased risk for MVD outbreak.

[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.