Objective To investigate the correlation between serum vascular endothelial growth factor(VEGF)level and the development and severity of diabetes mellitus cystoid macular edema(CME).Methods A total of 57 patients(57 eyes)with diabetic CME(the case group)and diabetes without eye complications(the control group)admitted to the Vitreoretinal Surgery Department of Tangshan Eye Hospital from June 2023 to June 2024 were prospectively selected,and all of them underwent systematic ophthalmic specialty examination and serum VEGF detection.Multivariate Logistic regression analysis was used to identify the risk factors of diabetes mellitus CME.The diagnostic value of VEGF in patients with diabetes CME was analyzed by receiver operating characteristic(ROC)curve.Spearman correlation was used to analyze the relationship between VEGF levels and the severity of CME in patients with diabetes,such as corrected visual,number of cystoid edema and non-round index of macular foveal avascular zone(FAZ).Results Compared with the control group,the course of diabetes in the case group was longer,the incidence of hypertension was higher,levels of glycosylated hemoglobin(HbA1c),serum creatinine and serum VEGF were higher,and the estimated glomerular filtration rate(eGFR)was lower(P＜0.05).Multivariate Logistic regression results showed that long duration of diabetes,increased levels of HbA1c and VEGF were risk factors for CME in diabetes mellitus patients,while elevated eGFR was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of VEGF in diagnosing diabetes mellitus CME was 0.758(95%CI:0.669-0.834).The AUC of the combined application of diabetes duration,HbA1c,eGFR and VEGF in the diagnosis of diabetes mellitus CME was 0.916(95%CI:0.877-0.941),which was significantly higher than that of the application of VEGF alone(P＜0.05).The VEGF level was negatively correlated with the corrected visual acuity[0.34(0.24,0.44)]in patients with diabetic CME,and positively correlated with the detection of cystoid macular edema[3(2,5)]and FAZ non-roundness index[1.16(1.08,1.20)](rs were 0.771,0.700,respectively,P＜0.05).Conclusion Serum VEGF levels are closely related to the onset and severity of CME,and which can be used as a reliable reference index for the diagnosis of CME.

Objective　To analyze the current situation and influencing factors of health-care seeking delay of tuberculosis patients registered in Changsha from 2019 to 2023, and to understand the current status of health-care seeking delay after the transformation of the tuberculosis prevention and treatment service model in Changsha, so as to provide reference bases for improving the patient discovery strategy and optimizing tuberculosis control and prevention measures. Methods　The case data of 23 371 tuberculosis patients registered in Changsha City from 2019 to 2023 were collected, and the time of health-care seeking delay and the rate of health-care seeking delay were calculated. Comparison of differences between groups with different characteristics using rank sum test and chi-square test, and the Cochran-Armitage method was used to analyze the trend of health-care seeking delay rate, and multifactorial analysis was carried out with the help of logistic regression model. Results　The median health-care seeking time of tuberculosis patients in Changsha City from 2019-2023 was 16 (5, 44) days, and the overall health-care seeking delay rate was 53.5%, with an overall increasing trend (Z=-7.256, P<0.001). Between-group comparisons revealed differences in health-care seeking delay time and health-care seeking delay rate between groups of patients with different gender, age group, occupation, current address, types of household registration, medical history, complication, diagnostic triage, pathogenic results and geographic accessibility (P<0.05). The results of multifactorial analysis showed that compared to the<25 years age group, the 25-<65 years age group (OR=1.579, 95%CI: 1.490-1.669) and the ≥65 years age group (OR=2.016，95%CI: 1.918-2.113) had a higher risk of health-care seeking delay, presence of complication (OR=1.213，95%CI:1.141-1.285), positive pathology (OR=1.503, 95%CI: 1.449-1.556), and average geographic accessibility of healthcare services (OR=1.073, 95%CI:1.017-1.129) were risk factors for health-care seeking delay, and the risk was relatively lower in the migrating population (OR=0.920, 95%CI: 0.815-0.989). Conclusion　The rate of delayed health-care seeking for tuberculosis patients in Changsha City in 2019-2023 is at a moderate level in the surrounding areas, and the overall trend is increasing. It suggests that proactive screening strategies for key populations should be optimized to improve the accessibility of healthcare services and reduce the rate of health-care seeking delay.

Objective To investigate the correlation between serum vascular endothelial growth factor(VEGF)level and the development and severity of diabetes mellitus cystoid macular edema(CME).Methods A total of 57 patients(57 eyes)with diabetic CME(the case group)and diabetes without eye complications(the control group)admitted to the Vitreoretinal Surgery Department of Tangshan Eye Hospital from June 2023 to June 2024 were prospectively selected,and all of them underwent systematic ophthalmic specialty examination and serum VEGF detection.Multivariate Logistic regression analysis was used to identify the risk factors of diabetes mellitus CME.The diagnostic value of VEGF in patients with diabetes CME was analyzed by receiver operating characteristic(ROC)curve.Spearman correlation was used to analyze the relationship between VEGF levels and the severity of CME in patients with diabetes,such as corrected visual,number of cystoid edema and non-round index of macular foveal avascular zone(FAZ).Results Compared with the control group,the course of diabetes in the case group was longer,the incidence of hypertension was higher,levels of glycosylated hemoglobin(HbA1c),serum creatinine and serum VEGF were higher,and the estimated glomerular filtration rate(eGFR)was lower(P＜0.05).Multivariate Logistic regression results showed that long duration of diabetes,increased levels of HbA1c and VEGF were risk factors for CME in diabetes mellitus patients,while elevated eGFR was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of VEGF in diagnosing diabetes mellitus CME was 0.758(95%CI:0.669-0.834).The AUC of the combined application of diabetes duration,HbA1c,eGFR and VEGF in the diagnosis of diabetes mellitus CME was 0.916(95%CI:0.877-0.941),which was significantly higher than that of the application of VEGF alone(P＜0.05).The VEGF level was negatively correlated with the corrected visual acuity[0.34(0.24,0.44)]in patients with diabetic CME,and positively correlated with the detection of cystoid macular edema[3(2,5)]and FAZ non-roundness index[1.16(1.08,1.20)](rs were 0.771,0.700,respectively,P＜0.05).Conclusion Serum VEGF levels are closely related to the onset and severity of CME,and which can be used as a reliable reference index for the diagnosis of CME.

Abstract On May 30 2022, Changsha Center for Disease Control and Prevention received a report of multiple cases of fever from a kindergarten. A field epidemiology investigation, laboratory testing, and control and prevention work were immediately conducted. A total of 76 cases were reported, and all were students, with an attack rate of 9.93%. The onset of illness was peaked between May 18 and June 8. The main clinical symptoms were fever, cough and sore throat, and all the cases were mild. There were 39 cases tested positive for human adenovirus (HAdV) nucleic acid or antigen, and 7 nucleic acid positive specimens were identified as HAdV-7 through virus isolation, culture and genotyping. The field epidemiology investigation and laboratory testing results concluded that it was a clustered outbreak caused by HAdV-7 infection. The main reason for the spread of the outbreak might be that the kindergarten failed to report it in time. High student density, poor classroom ventilation, lax morning and afternoon inspections, non-standard daily disinfection, and the prevalence of HAdV outbreaks in the community were also associated. Kindergartens should improve its infectious disease prevention and control mechanism, strictly follow the reporting regulations, implement the three early measures, standardize disinfection work, and enhance daily ventilation to avoid similar outbreaks in the future.

Objective To summarize the first experience with ultrasound-guided percutaneous ab lation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children.Methods From August 2013 to April 2015,PAT was used to treat 6 children with a total of 9 recurrent HB,including 5 patients with 8 tumors in the liver and 1 patient with 1 tumor in the lung.The mean size of ablated tumors was (1.5 ± 0.8) cm,and the tumor size range was 0.7 cm to 3.1 cm.Results Four patients were performed percutaneous radiofrequency ablation (RFA) for recurrent HB;and 2 patients were performed percutaneous ethanol injection (PEI).Ablation success was achieved in all patients (6/6,100％).The complete ablation rate after the first ablation session was 88.9％ (8/9) on a tumor-by-tumor basis.Only 1 patient developed a fever with temperature ＞ 39 ℃;it was resolved by conservative therapy.During the follow-up period of 5-30 months,3 patients died to tumor progression.The 1-and 2-year overall survival rates after ablation were 83.3％ and 41.7％,respectively.Conclusions PAT is a safe and promising therapy for children with recurrent HB after liver resection,and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.