Objective:To analyze the epidemiological, etiological characteristics and transmission of an imported D8 genotype measles case in a child in Shandong Province, August 2023.Methods:A study was conducted on a measles case and 16 contacts in Shandong Province in August 2023. Field epidemiological surveys, including recent exposure and immunization history, were conducted. Serum and throat swab samples were collected from all 16 subjects. Measles IgM and IgG antibody levels and avidity were measured by ELISA, while virus detection and genotyping were performed using fluorescence quantitative PCR and RT-PCR. Genetic evolutionary analysis of the obtained sequences was conducted using MEGA and Beast software.Results:The case was an 11-year-old boy, a fifth-grade student, who developed symptoms on August 28, 2023. A total of five close contacts were investigated, including three family members (grandfather, father and sister) and two playmates. Additionally, 11 classmates who had close contact with the case′s sister during the infectious period (within five days after the rash onset) were also investigated. Among the 16 serum samples tested, only one case was positive for IgM, while the other 15 samples were negative for IgM. The results of the serum antibody avidity test showed that among the 16 serum samples, 14 were positive for IgG. Of these, eight had a relative avidity index >55%, indicating high-avidity antibodies; one had a relative avidity index <45%, indicating low-avidity antibodies; and five had an avidity index between 45% and 55%. The IgG detection OD values for the case′s sister and grandfather were higher than those of the other contacts. Based on the vaccination history of the subjects and the results of IgM and IgG tests, it was preliminarily determined that the case had a recent wild-type measles virus infection. The case′s sister and grandfather had a history of measles wild-type virus infection, while the high-avidity antibodies in the other contacts were likely induced by the measles vaccine. The results of the pharyngeal swab tests showed that only the case was positive for measles virus nucleic acid, while the remaining 15 samples were negative for measles virus. The genetic evolutionary analysis revealed that the viral sequence of this case (Mvs/Shandong.CHN/38.23) had a 100% homology with the Hong Kong strain sequence from August 2023. It belonged to a different transmission chain from the D8 genotype strains that appeared in Shandong Province between 2018 and 2019, with sequence homology ranging from 98.0% to 98.8%. The sequence homology within the transmission chain of this case was between 99.1% and 100%. The evolutionary rate of this transmission chain was approximately 8.38×10 -3 sub/site/year, and the most recent common ancestor was estimated to have emerged around the year 2011. Conclusion:This case is the first imported D8 genotype measles case in Shandong Province. There is no spatio-temporal correlation between this case and adult cases of D8 genotype imported from Shandong Province in 2018-2019, indicating a new D8 genotype imported epidemic.

On May 2025,European Association for the Study of the Liver published Clinical Practice Guidelines on extrahepatic abdominal surgery in patients with cirrhosis and advanced chronic liver disease.The guidelines systematically elaborate on the preoperative assessment,various surgical indications,and perioperative management of patients with cirrhosis or advanced chronic liver disease undergoing extrahepatic surgery,in order to provide comprehensive recommendations for preoperative assessment and perioperative management in patients with cirrhosis and advanced chronic liver disease who have surgical indications.This article makes an excerpt of the methodology and key recommendations of the guidelines.

Objective To evaluate the utility of tuberculosis antibody(TB-Ab),adenosine deaminase(ADA),and carbohydrate antigen 125(CA125)alone or in combination for differentiating tuberculous from non-tuberculous pleural effusion.Methods This retrospective study included 75 patients initially diagnosed with tuberculous pleural effusion(observation group)and 75 patients hospitalized with non-tuberculous pleural effusion(control group)between January 2020 and June 2024.Receiver operating characteristic(ROC)curve analysis was used to compare the diagnostic performance of TB-Ab,ADA,CA125 alone or in combination for diagnosing tuberculous pleurisy.Results The patients with tuberculous pleural effusion showed significantly higher TB-Ab positive rate than the patients with non-tuberculous pleural effusion(control group)(60.00％vs 9.33％,P＜0.001).Tuberculous pleural effusion was associated with significantly higher levels of ADA[(43.44±15.51)U/L]and CA125[(175.57±64.66)U/mL]compared to the control group[(27.81±3.42)U/L]and(122.35±41.22)U/mL,respectively(P＜0.001).Taking 34 U/L as cutoff value,ADA showed good diagnostic performance with an AUC of 0.856,sensitivity of 98.67％,and specificity of 78.67％.Taking 180 U/mL as cutoff value,CA125 demonstrated high sensitivity(89.94％)but low specificity(52.33％)with an AUC of 0.739.CA125 alone was not so specific for detecting tuberculous pleurisy.TB-Ab had an AUC of 0.753 in detecting tuberculous pleurisy,with a sensitivity of 90.67％and specificity of 61.22％.These three markers in combination significantly improved diagnostic performance,with an AUC of 0.926,sensitivity of 90.67％,and specificity of 86.67％.Conclusions TB-Ab,ADA,and CA125 in combination performed better than these biomarkers alone in diagnosing tuberculous pleurisy.

Objective To evaluate the utility of tuberculosis antibody(TB-Ab),adenosine deaminase(ADA),and carbohydrate antigen 125(CA125)alone or in combination for differentiating tuberculous from non-tuberculous pleural effusion.Methods This retrospective study included 75 patients initially diagnosed with tuberculous pleural effusion(observation group)and 75 patients hospitalized with non-tuberculous pleural effusion(control group)between January 2020 and June 2024.Receiver operating characteristic(ROC)curve analysis was used to compare the diagnostic performance of TB-Ab,ADA,CA125 alone or in combination for diagnosing tuberculous pleurisy.Results The patients with tuberculous pleural effusion showed significantly higher TB-Ab positive rate than the patients with non-tuberculous pleural effusion(control group)(60.00％vs 9.33％,P＜0.001).Tuberculous pleural effusion was associated with significantly higher levels of ADA[(43.44±15.51)U/L]and CA125[(175.57±64.66)U/mL]compared to the control group[(27.81±3.42)U/L]and(122.35±41.22)U/mL,respectively(P＜0.001).Taking 34 U/L as cutoff value,ADA showed good diagnostic performance with an AUC of 0.856,sensitivity of 98.67％,and specificity of 78.67％.Taking 180 U/mL as cutoff value,CA125 demonstrated high sensitivity(89.94％)but low specificity(52.33％)with an AUC of 0.739.CA125 alone was not so specific for detecting tuberculous pleurisy.TB-Ab had an AUC of 0.753 in detecting tuberculous pleurisy,with a sensitivity of 90.67％and specificity of 61.22％.These three markers in combination significantly improved diagnostic performance,with an AUC of 0.926,sensitivity of 90.67％,and specificity of 86.67％.Conclusions TB-Ab,ADA,and CA125 in combination performed better than these biomarkers alone in diagnosing tuberculous pleurisy.

Objective:To analyze the epidemiological, etiological characteristics and transmission of an imported D8 genotype measles case in a child in Shandong Province, August 2023.Methods:A study was conducted on a measles case and 16 contacts in Shandong Province in August 2023. Field epidemiological surveys, including recent exposure and immunization history, were conducted. Serum and throat swab samples were collected from all 16 subjects. Measles IgM and IgG antibody levels and avidity were measured by ELISA, while virus detection and genotyping were performed using fluorescence quantitative PCR and RT-PCR. Genetic evolutionary analysis of the obtained sequences was conducted using MEGA and Beast software.Results:The case was an 11-year-old boy, a fifth-grade student, who developed symptoms on August 28, 2023. A total of five close contacts were investigated, including three family members (grandfather, father and sister) and two playmates. Additionally, 11 classmates who had close contact with the case′s sister during the infectious period (within five days after the rash onset) were also investigated. Among the 16 serum samples tested, only one case was positive for IgM, while the other 15 samples were negative for IgM. The results of the serum antibody avidity test showed that among the 16 serum samples, 14 were positive for IgG. Of these, eight had a relative avidity index >55%, indicating high-avidity antibodies; one had a relative avidity index <45%, indicating low-avidity antibodies; and five had an avidity index between 45% and 55%. The IgG detection OD values for the case′s sister and grandfather were higher than those of the other contacts. Based on the vaccination history of the subjects and the results of IgM and IgG tests, it was preliminarily determined that the case had a recent wild-type measles virus infection. The case′s sister and grandfather had a history of measles wild-type virus infection, while the high-avidity antibodies in the other contacts were likely induced by the measles vaccine. The results of the pharyngeal swab tests showed that only the case was positive for measles virus nucleic acid, while the remaining 15 samples were negative for measles virus. The genetic evolutionary analysis revealed that the viral sequence of this case (Mvs/Shandong.CHN/38.23) had a 100% homology with the Hong Kong strain sequence from August 2023. It belonged to a different transmission chain from the D8 genotype strains that appeared in Shandong Province between 2018 and 2019, with sequence homology ranging from 98.0% to 98.8%. The sequence homology within the transmission chain of this case was between 99.1% and 100%. The evolutionary rate of this transmission chain was approximately 8.38×10 -3 sub/site/year, and the most recent common ancestor was estimated to have emerged around the year 2011. Conclusion:This case is the first imported D8 genotype measles case in Shandong Province. There is no spatio-temporal correlation between this case and adult cases of D8 genotype imported from Shandong Province in 2018-2019, indicating a new D8 genotype imported epidemic.

On May 2025,European Association for the Study of the Liver published Clinical Practice Guidelines on extrahepatic abdominal surgery in patients with cirrhosis and advanced chronic liver disease.The guidelines systematically elaborate on the preoperative assessment,various surgical indications,and perioperative management of patients with cirrhosis or advanced chronic liver disease undergoing extrahepatic surgery,in order to provide comprehensive recommendations for preoperative assessment and perioperative management in patients with cirrhosis and advanced chronic liver disease who have surgical indications.This article makes an excerpt of the methodology and key recommendations of the guidelines.

Objective:To understand the dilemma of active management in young and middle-aged postoperative patients with lumbar disc herniation, in order to provide reference for the formulation of active intervention program of self-health management meeting the needs of patients.Methods:Using the phenomenological research method, a total of 16 middle-aged and young patients with lumbar disc herniation were selected for semi-structured in-depth interviews, and the themes were analyzed and extracted by Colaizzi 7-step analysis method.Results:Three themes and nine sub-themes were extracted namely, inadequate disease response capacity and response resources (lack of disease symptom management capacity, limited access to disease management information, difficult use of disease management information, difficulty in maintaining positive self-management for a long time (forced to stop behavior change due to stress, lack of motivation to achieve good behavior change, doubts about the effectiveness of self-management) and multi-dimensional negative emotions (contrast between maintaining independence and dependence on others, fear of being misunderstood, fear of relapse) .Conclusions:Medical staff should provide comprehensive health information services for young and middle-aged postoperative patients with lumbar disc herniation, improve the out-of-hospital follow-up mechanism with the help of information technology, further improve family and social support strategies, reduce the difficulties faced in the process of active management and achieve long-term active disease management.

Objective:To explore the quality of working life and its related factors in patients with breast canc-er returned to work after surgery.Methods:A total of 316 patients with breast cancer who had returned to work af-ter surgery were selected,and they were investigated with the General information questionnaire,Quality of Working Life Questionnaire for Cancer Survivors(QWLQ-CS),Breast Cancer Survivors Resilience Scale(BCRS)and Strat-egies Used by People to Promote Health(SUPPH).Multivariate linear regression analysis was used to analyze the related factors of quality of working life.Results:Multiple linear regression analysis showed that the QWLQ-CS score was positively correlated with education level,per capita monthly income of family,work pattern,return to work time,personal protection and social protection score of BCRS,and positive attitude scores of SUPPH(β=1.05,1.23,2.26,0.69,0.95,1.00,0.13),while negatively correlated with the complications(β=-3.83).Con-clusion:The quality of working life for patients with breast cancer after surgery needs to be improved after they re-turn to work,psychological resilience and self-efficacy are positively correlated with quality of working life.

Objective:To study the complete genome characterization of Human Astrovirus (HAstV) in Shandong Province.Methods:Stool samples from acute flaccid paralysis (AFP) surveillance in Shandong Province from 2020 to 2022 were collected, and HAstV nucleic acid was examined by real-time quantitative PCR (qPCR). Next-generation sequencing (NGS) was conducted for the positive samples to obtain complete genome sequences and identify the genotype. Homology comparison and phylogenetic analysis were performed by using BioEdit and Mega software.Results:A total of 667 samples were examined by qPCR, of which 14 were HAstV-positive (2.1%), including HAstV-1 ( n=6), MLB1 ( n=6), MLB2 ( n=1), and VA2 ( n=1). The complete genome sequences were obtained from 11 samples. The six HAstV-1 sequences of this study had 98.2% to 99.9% nt similarities with each other and 87.6% to 98.6% with those from other regions. The four MLB1 sequences of this study had 99.1% to 99.9% nt similarities with each other and 92.2% to 99.4% with those from other regions. The VA2 sequence of this study had 96.0% to 96.3% nt similarities with those from other regions. Phylogenetic analysis based on ORF2 region showed that the local HAstV-1 sequences were most closely related to Japanese strains, and had distinct topology with phylogenies based on ORF1a and ORF1b regions. Conclusion:The complete genome sequences of 11 HAstV strains are obtained, and the VA2 complete genome is found.

To review the research status, assessment tools, influencing factors and intervention measures of social grooming in patients with gynecological malignant tumors, so as to provide a theoretical basis for improving the social alienation of patients with gynecological malignant tumors and better integrating into society.