Objective: To analyze the school tuberculosis (TB) outbreaks and preventive treatment in Hefei from 2022 to 2024, so as to provide reference for TB prevention and control in schools. Methods: Data were collected on all school based TB outbreaks occurring during 2022-2024 in Hefei, defined as ≥2 epidemiologically linked TB cases within the same school during a single semester. Statistical analyses were performed using the Chi square test. Results: Close contacts exhibited significantly higher TB incidence (2.88%) and latent mycobacterium tuberculosis infection (LTBI) rates (13.80%) in the school TB outbreaks, compared to non close contacts (0.12% and 2.63%, respectively). Among close contacts, secondary school students showed lower TB incidence (0.48%) and LTBI prevalence (3.42%) than both primary school or younger children (0.68%, 6.95%) and college students ( 0.78% , 6.50%), with statistically significant differences ( χ 2=360.91, 6.37; 791.71, 102.03, all P <0.05). The proportion of LTBI individuals recommended for preventive therapy was higher in primary school or younger groups (98.59%) than in secondary (95.25%) or college students (86.34%) ( χ 2=25.86, P <0.01). However, among those recommended, close contacts had higher uptake (85.82%) and completion rates (87.25%) of preventive therapy than non close contacts (69.63% and 70.57%); similarly, secondary school students demonstrated higher uptake (91.21%) and completion rates (86.45%) compared to primary school or younger (88.57%, 83.87%) and college students (57.28%, 64.08%) ( χ 2=30.52, 26.72; 125.17, 38.84, all P <0.01). Subsequent TB incidence among LTBI close contacts (13.30%) and among those who did not complete preventive therapy (22.73%) were significantly higher than among non close contacts (2.80%, 2.41%), respectively ( χ 2=32.19, 13.87, both P <0.05). Conclusions In school TB outbreaks, close contacts face higher LTBI prevalence and subsequent TB risk than non close contacts. College students show notably low adherence to preventive therapy. It is necessary to take targeted measures to improve the compliance of preventive measures among students.

Objective To explore the clinical efficacy and safety of endoscopic endonasal dorsum sellae and posterior clinoid process resection combined with pituitary hemi-transposition in the treatment of pan-sellar area lesions. Methods Clinical data from 57 patients with pan sellar diseases who underwent endoscopic transnasal resection of the posterior clinoid process combined with lateral pituitary displacement surgery in the neurosurgery department of Zhongshan Hospital, Fudan University from January 2019 to January 2025 were collected, and their clinical surgical characteristics and prognosis were analyed. Results A total of 57 patients with pan-sellar area lesions were included in this study, comprising 27 craniopharyngiomas, 7 giant suprasellar pituitary adenomas, 7 chordomas, 6 chondrosarcomas, 5 diaphragma sellae/dorsum sellae meningiomas, and 5 rare lesions. All procedures were completed successfully, and gross total or near-total resection was achieved in all patients. No new neurovascular complications occurred intraoperatively. The follow-up duration ranged from 3 to 24 months. New postoperative anterior pituitary insufficiency occurred in 3 patients (5.3%), and new posterior pituitary insufficiency requiring long-term hormone replacement therapy occurred in 4 patients (7.0%). No additional pituitary dysfunction was observed in the remaining patients. Cerebrospinal fluid rhinorrhea occurred in 1 patient (1.8%) and was successfully repaired. Intracranial infection occurred in 3 patients (5.3%) and resolved after medical treatment. Conclusion Endoscopic resection of the posterior clinoid process combined with lateral displacement of the pituitary gland can effectively expand the surgical space, while repositioning the pituitary gland can reduce the extent of skull base defects. In addition, the risk of pituitary dysfunction caused by lateral displacement of the pituitary gland is relatively low.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

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.

ObjectiveTo understand the epidemiological characteristics and post-exposure prophylaxis of rabies exposure cases in Suqian City of Jiangsu Province from 2021 to 2024, providing a reference for optimizing the allocation of health resources and formulating scientific prevention and control measures. MethodsData on individuals exposed to rabies and treated at Suqian’s rabies post-exposure prophylaxis (PEP) clinics from 2021 to 2024 were collected. Descriptive epidemiological methods were used to analyze patient characteristics, exposure classification, animal species responsible for injuries, wound management, and vaccination status. ResultsBetween 2021 and 2024, the number of outpatient visits for rabies PEP clinics in Suqian City totaled 333 450. The median age and the 25th and 75th percentiles of exposed individuals was 23 (9, 47) years. The highest proportion of exposed individuals was recorded in 2023 (27.09%); the majority were female (52.22%), aged 5‒9 years (17.49%), and in other occupations (37.05%). The rabies exposure rate in Suqian City from 2021 to 2024 was 16.75‰. The overall rabies exposure rate showed an upward trend (χtrend2=1 994.80, P<0.001). The exposure rate among males was lower than that among females (χ²=890.43, P<0.001). The highest exposure rate was observed in the 5‒9 age group (χ²=67 063.20, P<0.001). The number of individuals seeking medical care for rabies exposure exhibited a weak bimodal distribution, with the primary peak occurring in August and the secondary peak in January. The primary animal responsible for injuries was the cat (53.70%), and the source of these animals was predominantly domestic pets (88.90%). The proportion of exposed individuals bitten by cats showed an upward trend from 2021 to 2024 (χtrend2=548.44, P<0.001). Grade Ⅲ exposure accounted for the highest proportion (53.53%), and 301 652 cases (90.46%) presented within 24 hours of exposure. The coverage rate of rabies vaccine was 98.18% (13 625/13 877) for those with Grade Ⅰ exposure and 99.95% (319 413/319 573) for those with Grade Ⅱ and Ⅲ exposures; 64 042 individuals received rabies immunoglobulin or anti-rabies serum; 8 360 exposed individuals received tetanus vaccine, with the usage rate of tetanus vaccine among exposed individuals was only 2.51%, though the rate was on the rise (χtrend2=618.26, P<0.001). ConclusionBetween 2021 and 2024, the overall incidence of rabies exposure in Suqian City showed an upward trend, with a higher incidence among women than men. The incidence was particularly high among children and adolescents aged 14 and under, with the majority of injuries caused by cats; most injuries were inflicted by domestic animals. The overall uptake of tetanus vaccines showed an upward trend. Suqian City should step up health education on rabies exposure during January and August each year, with a particular focus on raising awareness of rabies exposure prevention among people aged 14 and under and women. It should also strengthen the management of domestic animals and ensure that they receive regular rabies vaccinations, particularly for pet cats. Preventive measures against tetanus should be strengthened for individuals exposed to rabies. Medical staff at rabies PEP clinics should receive enhanced training on the management of rabies exposures and the completion of information system reports to ensure the standardized operation of these clinics.

ObjectiveTo systematically sort out literatures regarding telemedicine, wearable devices and artificial intelligence in pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) from 2011 to 2025, to identify the research status, hotspots and development trends. MethodsOriginal articles and reviews published from January 1, 2011 to December 31, 2025 were retrieved from Web of Science Core Collection and Scopus. Bibliometric analyses were performed via VOSviewer, CiteSpace and Scimago Graphica, including annual publication volume, collaboration networks of countries, institutions and authors, co-citation of journals and references, and keyword co-occurrence, clustering and bursting. ResultsA total of 917 literatures were included. The annual number of publications showed a sustained upward trend. The United States and the United Kingdom took the leading position in publication output and academic influence. The University of Toronto was the most productive institution, and Anne E. Holland was the most prolific author. European Respiratory Journal and American Journal of Respiratory and Critical Care Medicine were high-impact journals. COPD, pulmonary rehabilitation, telerehabilitation and telemedicine were high-frequency core keywords. Machine learning, interstitial lung disease, virtual reality and digital health were the bursting keywords in recent years. ConclusionThe researches on digital pulmonary rehabilitation for COPD are increasing continuously in the past 15 years. The research focus has shifted from hospital-based standardized rehabilitation to community home digital rehabilitation centered on patient self-management. Future studies will focus on the deep integration of multiple digital technologies and extension of rehabilitation protocols to other chronic respiratory diseases.

OBJECTIVE To investigate the current status of informatization tools applied to antimicrobial stewardship in county hospitals in China， and to provide a reference for promoting the informatization development of antimicrobial stewardship in county hospitals.METHODS From August to September 2025， an online questionnaire survey was conducted among 1 007 county hospitals across 31 provinces（autonomous regions， and municipalities） in China. The survey focused on the application of four types of informatization tools：the real-time monitoring system for antimicrobial use， the pre-prescription review system， the irrational use warning system， and the electronic prescription evaluation system（hereinafter referred to as the “monitoring system”“review system”“warning system”“evaluation system”，respectively）. Correlation analysis and binary Logistic regression analysis were employed to explore the influencing factors.RESULTS Of the county hospitals， 80.83% were equipped with at least one type of informatization tool for antimicrobial stewardship， while 19.17% had no relevant tool. Only 18.87% of the hospitals were equipped with all four types of tools. The monitoring system exhibited the highest equipped rate （70.80%）， whereas the warning system was equipped in only 33.96% of the hospitals. Four types of tools are evenly and adequately deployed in the eastern region， the central and western regions have far lower deployment rates of intervention tools including review system and warning system， accompanied by prominent intra-provincial gaps. The total number of the health technicians， hospital grade， and prescription review rate of outpatient antibacterial drug were significantly and positively correlated with the deployment rates of the four informatization tools （ P ＜0.05）. The results of the Logistic regression model fitting indicated that the model of the review system was rated “excellent” [area under the receiver operating characteristic curve （AUC）＝0.81]， and the model of the warning system was rated “further improvement” （AUC＝0.67）. The total number of health technicians was significantly positively correlated with the deployment rates of all four types of informatization tools （all P ＜0.05）.CONCLUSIONS The informatization of antimicrobial stewardship in county hospitals in China remains in the initial stage of transitioning from “passive statistics” to “active prevention and control”， with challenges such as structural imbalance and regional disparities. In the future， differentiated support strategies should be implemented， the allocation of resources should be optimized， to enhance the level of refined antimicrobial stewardship.

Objective: To analyze the epidemiological characteristics, associated factors, and vaccine effectiveness of two pertussis cluster outbreaks in two primary schools in Yangzhong City in 2025, so as to provide evidence for school based epidemic prevention and control. Methods: From August 26 to 30, 2025, a pertussis questionnaire was administered to the epidemic affected classes of two primary schools (school A and school B) in Yangzhong City. A descriptive epidemiological retrospective analysis was used to characterize the pertussis cluster outbreaks in Yangzhong City from March to July 2025. A 1∶5 matched case control study (79 cases, 395 controls) was performed. Multivariate Logistic regression was used to identify associated factors, and the clinical symptom incidence rates, types of pertussis containing vaccines, and timeliness of vaccination were compared between groups using Fisher s exact test. Results: From March to July 2025, a total of 79 pertussis cases were reported in the two schools, with attack rates of 1.33% and 1.01%, respectively. Cases were predominantly aged 7-8 years (85.37% in school A, 73.68% in school B), and the main clinical manifestation was productive cough (63.29%). The pneumonia incidence rate among hospitalized cases ( 57.14 %) was higher than that among nonhospitalized cases(4.17%)(Fisher s exact test, P <0.01). The interval from the last dose to onset was concentrated at 6 to <7 years (44 cases). Logistic regression showed that children exposed to secondhand smoke in daily life ( OR = 3.86 ), those whose desk mates or front/back desk mates took leave due to cough ( OR =4.67), and those whose dining table mates or front/back table mates took leave due to cough ( OR =3.67) had significantly higher risks of pertussis (all P <0.05). A high proportion of both the case group and the control group received the acellular DTaP vaccine (97.47% and 96.96%, respectively),while a low proportion received the pentavalent vaccine (1.27% and 3.04%, respectively). Additionally, one case received only three doses of the acellular DTaP vaccine.The difference in vaccine type distribution between the two groups was not statistically significant (Fisher s exact test, P =0.31). Conclusions The outbreaks represent breakthrough infections under high vaccine coverage. Close contact and secondhand smoke exposure are the main risk factors. A booster immunization strategy with diphtheria-tetanus-pertussis vaccine should be implemented for school aged children.

Objective To evaluate the performance of lightweight Chinese large language models (LLMs) in answering specialized lung cancer questions, and to explore the impact of retrieval-augmented generation (RAG) on model performance. Methods Eleven lightweight Chinese LLMs with parameter sizes ranging from 7B to 32B were included. A lung cancer-specific evaluation dataset consisting of 200 questions [100 A1-type (basic knowledge) and 100 A2-type (clinical case) questions], constructed based on clinical guidelines and thoracic surgery textbooks, was used for assessment. Model performance was evaluated under two conditions (with and without RAG). Accuracy was used to assess model performance, and response latency was recorded to reflect inference efficiency. An accuracy–latency scatter plot was constructed for descriptive analysis of overall model performance. Results All models successfully completed the evaluation. With the introduction of RAG, the overall average accuracy improved from 61.68% to 76.36%. Smaller models demonstrated the most significant improvement (e.g., the accuracy of DeepSeek-7B increased from 32.50% to 60.00%, P<0.001). The average response latency increased from 12.58 s to 13.80 s. The Qwen3 series showed the best overall performance, and Qwen3-32B achieved the highest accuracy under both conditions (76.50% and 84.00%, respectively). After RAG integration, performance differences among model families were markedly reduced. Based on the accuracy-latency trade-off, Qwen3-32B achieved the best balance between accuracy and response latency under the baseline condition, whereas Qwen3-14B demonstrated superior overall performance in terms of accuracy, latency, and computational cost after RAG integration. Conclusion The integration of RAG technology improves the ability of lightweight Chinese LLMs to answer specialized lung cancer questions. Under the dual practical constraints of limited computational resources and medical data security requirements, the "lightweight model+RAG" technical framework may represent a promising deployment solution.

Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.