Objective:To explore the efficacy and prognosis of hepatectomy via Laennec membrane approach in patients with hepatocellular carcinoma (HCC).Methods:The data of 98 patients with HCC who underwent hepatectomy in the First Affiliated Hospital of Soochow University from January 2016 to December 2022 were retrospectively analyzed, including 76 males and 22 females, aged 61.0 (55.0, 66.0) years. Forty-eight patients treated with Laennec membrane approach hepatectomy were included in the study group and 50 patients treated with traditional approach hepatectomy were included in the control group. The age, gender, combined hypertension and diabetes, aspartate transaminase, alanine transaminase, albumin, total bilirubin, prealbumin, platelet, alpha-fetoprotein, carbohydrate antigen 19-9 and carbohydrate antigen 125 were compared between the two groups. The surgical bleeding, operation time and complications (abdominal bleeding, bile leakage, poor incision healing, etc.) were compared between the two groups. The prognosis of the two groups was compared.Results:There were no significant differences in gender, age, underlying diseases, preoperative biochemical and tumor serological indexes between the two groups (all P>0.05). The operation time of the study group was 180.0 (141.3, 227.3) min, which was lower than that of the control group 221.5 (187.5, 256.3) min ( Z=-0.41, P=0.002). The intraoperative blood loss in the study group was 295.0 (127.5, 350.0) ml, which was lower than that in the control group 300.0 (200.0, 500.0) ml, and the difference was statistically significant ( Z=-1.97, P=0.003). The levels of aspartate transaminase and alanine transaminase 1 week after surgery in the study group were 33.4 (24.0, 43.8) U/L and 64.5 (38.3, 119.1) U/L, respectively, which were lower than those in the control group 41.3 (29.7, 63.0) U/L and 102.8 (50.1, 140.7) U/L, the differences were statistically significant ( Z=-2.09, -2.38, P=0.035, 0.028). Postoperative complications occurred in 8 cases (16.7%) in the study group and 10 cases (20.0%) in the control group, with no significant difference between the two groups ( χ2=0.18, P=0.670). The median overall survival was 16 months in the study group and 18 months in the control group, respectively. There was no significant difference in cumulative survival between the two groups ( χ2=1.41, P=0.130). Conclusion:Laennec membrane approach hepatectomy can not only shorten the operation time and reduce the amount of blood loss, but also promote the recovery of liver function.

This article aims to improve the understanding of Lance-Adams syndrome （LAS） in clinical practice. By analyzing the clinical data of a patient diagnosed with LAS in 2021 and conducting a literature review， this article elaborates on the clinical symptoms， pathogenesis， diagnostic methods， and treatment regimens of LAS. LAS is a rare central nervous system disorder characterized by action myoclonus after cerebral hypoxia. The etiology of LAS is mainly associated with cerebral hypoxia， and cardiopulmonary resuscitation and asphyxia are the most common predisposing factors for LAS. Characteristic manifestations on electroencephalography have an important value in diagnosis. Clinicians should enhance their ability to identify LAS through typical clinical symptoms and electroencephalography in the early stage. This article also points out that there are still many challenges in the treatment of LAS， which requires further research and exploration. This article has an important reference value in improving the understanding， diagnosis， and treatment of LAS.
Electroencephalography

Objective To analyze the value of heparin-binding protein(HBP)and interleukin-17A(IL-17A)levels in bronchoalveolar lavage fluid in predicting prognosis of elderly patients with se-vere pneumonia.Methods A total of 105 elderly patients with severe pneumonia in the hospital from May 2022 to May 2024 were selected and divided into death group(n=32)and survival group(n=73)based on their survival outcomes within 28 days after admission.The levels of HBP and IL-17A in bronchoalveolar lavage fluid were compared between the two groups;the Logistic regression analysis was conducted to explore the influencing factors for prognosis in elderly patients with severe pneumoni-a;the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficiencies of HBP and IL-17A in bronchoalveolar lavage fluid for the prognosis of elderly patients with severe pneumonia.Results The levels of HBP and IL-17A in bronchoalveolar lavage fluid in the death group were significantly higher than those in the survival group(P＜0.01).There were significant differ-ences in the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and blood lac-tate(Lac)level between the two groups(P＜0.01).Logistic regression analysis showed that HBP(OR=3.084,95％CI,1.326 to 4.694),IL-17A(OR=4.521,95％CI,2.164 to 7.841),APACHE Ⅱscore(OR=2.039,95％CI,1.069 to 2.859),and Lac(OR=2.627,95％CI,1.168 to 3.058)were influencing factors for the prognosis of elderly patients with severe pneumonia(P＜0.05).When the optimal cut-off values were set at 15.92 ng/mL for HBP and 109.34 pg/mL for IL-17A,the area under the curve(AUC)for the combined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was 0.852,with a 95％CI of 0.801 to 0.948.The AUC for the com-bined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was significantly higher than that for single tests(Z=2.906,2.416,P=0.007,0.014).Conclusion Increased levels of HBP and IL-17A in bronchoalveolar lavage fluid,decreased APACHE Ⅱ score,and in-creased Lac are influencing factors for the prognosis of elderly patients with severe pneumonia.Com-bined detection of HBP and IL-17A in bronchoalveolar lavage fluid has high sensitivity in predicting the prognosis of elderly patients with severe pneumonia.

Objective:To evaluate the protective effectiveness (VE) of the acellular pertussis vaccine (aPV) against pertussis in children aged 2 months to 6 years.Methods:A test-negative case-control study was conducted among children aged 2 months to 6 years who sought medical care for cough and underwent pertussis nucleic acid testing at sentinel surveillance hospitals in Zhejiang Province in 2024. Cases were defined as those with positive pertussis nucleic acid test results, while controls were test-negative individuals matched 1∶1 based on propensity scores using the caliper matching method. Conditional logistic regression models were used to calculate odds ratios ( ORs) and VEs. Results:Among the 658 participants, 31.76% (209 cases) tested positive for pertussis. After propensity score matching, 203 cases and 203 controls were included in the analysis. The VE of 1-2, 3, and 4 doses of aPV against pertussis was 52.46% (95% CI:-39.82%-83.84%), 65.22% (95% CI: 6.86%-87.02%), and 72.21% (95% CI: 34.33%-88.24%), respectively. For pertussis-related hospitalization, the VE of 1-3 and 4 doses was 80.95% (95% CI:31.38%-94.71%) and 86.79% (95% CI: 51.89%-96.37%). The VE for those who completed 4 doses of vaccination and had intervals of less than 2 years, 2 years, 3 years, and 4 years or more after vaccination were 91.15% (95% CI: 67.61%-97.58%), 84.70% (95% CI: 43.71%-95.84%),56.23% (95% CI:-47.58%-87.02%), and 49.92% (95% CI:-83.74%-86.35%), respectively. Conclusion:The VE of aPV against pertussis in children aged 2 months to 6 years increases with the number of doses administered, and it is more effective in preventing hospitalization due to pertussis. The VE declines rapidly over time after the last dose. It is recommended to follow the new pertussis immunization program for timely and full vaccination.

The morbidity and mortality associated with diphtheria have been effectively managed through mass immunization strategies. Nevertheless, recent outbreaks of diphtheria have been reported in various regions of Africa and Asia. In addition to infections among children, there has been a notable increase in cases among middle-aged and elderly individuals, underscoring the necessity of continued vigilance in the control of diphtheria. This paper reviewed the epidemiology of diphtheria, the current application of vaccines, and immunization strategies, with the aim of providing evidence for the prevention and control of this disease.

OBJECTIVE To observe the distribution and drug resistance of pathogens isolated from the neonates with purulent meningitis and analyze the risk factors for prognosis.METHODS A total of 80 neonates with puru-lent meningitis who were treated in Maternity and Child Care Center of Xinyu and Xinyu People's Hospital from Jan.2020 to Dec.2022 were recruited as the research subjects.The distribution and drug resistance of the patho-gens isolated from the patients were observed.The neonates were divided into the poor prognosis group with 31 cases and the favorable prognosis group with 49 cases according to the treatment outcomes at the discharge from the hospital.The clinical data were compared between the two groups.The risk factors for the prognosis were ana-lyzed.RESULTS Totally 84 strains of pathogens were isolated from 80 children,the gram-positive bacteria accoun-ted for 36.90％,mainly including Staphylococcus epidermidis,Staphylococcus haemolyticus,Staphylococcus saprophyticus and Staphylococcus hominis;The gram-negative bacteria accounted for 63.10％,mainly including Escherichia coli and Klebsiella pneumoniae.The drug resistance rates of the major species of gram-positive bacte-ria to oxacillin,penicillin,cefoxitin and clindamycin were high.The drug resistance rates of the major species of gram-negative bacteria to levofloxacin,gentamycin and ceftriaxone were high.The drug resistance rates of the K.pneumoniae strains to gentamycin,levofloxacin and tobramycin were high.The proportion of neonates with coma and the total protein level of cerebrospinal fluid were higher in the poor prognosis group than in the favorable prog-nosis group(P＜0.05);the cerebrospinal fluid glucose level of the poor prognosis group was lower than that of the favorable prognosis group(P＜0.05).Coma,high level of total protein in cerebrospinal fluid and low level of cere-brospinal fluid glucose were the risk factors for the poor prognosis(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the neonates with purulent meningitis.The coma,total protein of cerebrospinal fluid and cerebrospinal fluid glucose are the risk factors for the poor prognosis.It is neces-sary for the hospital to rational use of antibiotics based on the results of culture of pathogens and drug susceptibili-ty testing and take intervention measures to the risk factors for the prognosis.

The morbidity and mortality associated with diphtheria have been effectively managed through mass immunization strategies. Nevertheless, recent outbreaks of diphtheria have been reported in various regions of Africa and Asia. In addition to infections among children, there has been a notable increase in cases among middle-aged and elderly individuals, underscoring the necessity of continued vigilance in the control of diphtheria. This paper reviewed the epidemiology of diphtheria, the current application of vaccines, and immunization strategies, with the aim of providing evidence for the prevention and control of this disease.

OBJECTIVE To observe the distribution and drug resistance of pathogens isolated from the neonates with purulent meningitis and analyze the risk factors for prognosis.METHODS A total of 80 neonates with puru-lent meningitis who were treated in Maternity and Child Care Center of Xinyu and Xinyu People's Hospital from Jan.2020 to Dec.2022 were recruited as the research subjects.The distribution and drug resistance of the patho-gens isolated from the patients were observed.The neonates were divided into the poor prognosis group with 31 cases and the favorable prognosis group with 49 cases according to the treatment outcomes at the discharge from the hospital.The clinical data were compared between the two groups.The risk factors for the prognosis were ana-lyzed.RESULTS Totally 84 strains of pathogens were isolated from 80 children,the gram-positive bacteria accoun-ted for 36.90％,mainly including Staphylococcus epidermidis,Staphylococcus haemolyticus,Staphylococcus saprophyticus and Staphylococcus hominis;The gram-negative bacteria accounted for 63.10％,mainly including Escherichia coli and Klebsiella pneumoniae.The drug resistance rates of the major species of gram-positive bacte-ria to oxacillin,penicillin,cefoxitin and clindamycin were high.The drug resistance rates of the major species of gram-negative bacteria to levofloxacin,gentamycin and ceftriaxone were high.The drug resistance rates of the K.pneumoniae strains to gentamycin,levofloxacin and tobramycin were high.The proportion of neonates with coma and the total protein level of cerebrospinal fluid were higher in the poor prognosis group than in the favorable prog-nosis group(P＜0.05);the cerebrospinal fluid glucose level of the poor prognosis group was lower than that of the favorable prognosis group(P＜0.05).Coma,high level of total protein in cerebrospinal fluid and low level of cere-brospinal fluid glucose were the risk factors for the poor prognosis(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the neonates with purulent meningitis.The coma,total protein of cerebrospinal fluid and cerebrospinal fluid glucose are the risk factors for the poor prognosis.It is neces-sary for the hospital to rational use of antibiotics based on the results of culture of pathogens and drug susceptibili-ty testing and take intervention measures to the risk factors for the prognosis.

OBJECTIVE To evaluate the current status of bacterial contamination control and prevention measures and construction of quality control laboratory in Chinese blood station,and find out the problems and put forward the improvement suggestions.METHODS A total of 41 questionnaires were sent out for performance comparison by secretariat of working group of Chinese blood collection and supply institutions from May 2024 to Jun.2024,and 40 questionnaires were received(14 blood centers and 26 central blood stations),39 of which were valid.The questionnaire survey covered four aspects,including disinfection and surveillance,construction of quality control laboratory,sterility test for blood component and monitoring of blood transfusion reactions.The data were pro-cessed through itemized statistics and descriptive analysis.RESULTS Totally 84.62％of the blood stations used io-dine-containing disinfectants for arm disinfection of the blood donors,and the monthly monitoring was the primary frequency.Among the quality control laboratories,43.59％were registered as biosafety level 2,while 35.90％lacked biosafety registration.As for the pressure settings of the laboratories,64.10％were under normal pres-sure,15.38％under negative pressure and 17.95％under positive pressure.In the sterility test,the utilization rate of ultra clean operating tables and biological safety cabinets was 48.72％,the blood stations that did not have the indoor quality control accounted for 79.49％,and only 35.90％participated the external quality assessment.Regarding the approaches to confirm the positive result,25.64％of the blood stations adopted the re-peated tests,and 15.38％adopted the combination with positive culture bottle.The shortage of fund was the ma-jor restricted factor for the sterility test,and the confirmation of positive result was the fundamental difficulty.The blood stations with the feedback of insufficient transfusion reactions reported from hospitals ac-counted for 53.85％,while the blood stations that encountered suspected bacterial transfusion reactions with nega-tive culture results accounted for 25.64％.CONCLUSIONS The infeciton control and prevention measures and the construction of quality control laboratory vary significantly in Chinese blood stations.The incomplete biosafety registration,non-standardized sterility test operation and weak surveillance of blood transfusion reactions are the major existing problems.It is suggested that the investment should be increased to push forward the standardi-zation and complete the laboratory biosafety system,and a hospital-blood station closed loop coordination mecha-nism should be established so as to raise the blood safety.

OBJECTIVE To evaluate the current status of bacterial contamination control and prevention measures and construction of quality control laboratory in Chinese blood station,and find out the problems and put forward the improvement suggestions.METHODS A total of 41 questionnaires were sent out for performance comparison by secretariat of working group of Chinese blood collection and supply institutions from May 2024 to Jun.2024,and 40 questionnaires were received(14 blood centers and 26 central blood stations),39 of which were valid.The questionnaire survey covered four aspects,including disinfection and surveillance,construction of quality control laboratory,sterility test for blood component and monitoring of blood transfusion reactions.The data were pro-cessed through itemized statistics and descriptive analysis.RESULTS Totally 84.62％of the blood stations used io-dine-containing disinfectants for arm disinfection of the blood donors,and the monthly monitoring was the primary frequency.Among the quality control laboratories,43.59％were registered as biosafety level 2,while 35.90％lacked biosafety registration.As for the pressure settings of the laboratories,64.10％were under normal pres-sure,15.38％under negative pressure and 17.95％under positive pressure.In the sterility test,the utilization rate of ultra clean operating tables and biological safety cabinets was 48.72％,the blood stations that did not have the indoor quality control accounted for 79.49％,and only 35.90％participated the external quality assessment.Regarding the approaches to confirm the positive result,25.64％of the blood stations adopted the re-peated tests,and 15.38％adopted the combination with positive culture bottle.The shortage of fund was the ma-jor restricted factor for the sterility test,and the confirmation of positive result was the fundamental difficulty.The blood stations with the feedback of insufficient transfusion reactions reported from hospitals ac-counted for 53.85％,while the blood stations that encountered suspected bacterial transfusion reactions with nega-tive culture results accounted for 25.64％.CONCLUSIONS The infeciton control and prevention measures and the construction of quality control laboratory vary significantly in Chinese blood stations.The incomplete biosafety registration,non-standardized sterility test operation and weak surveillance of blood transfusion reactions are the major existing problems.It is suggested that the investment should be increased to push forward the standardi-zation and complete the laboratory biosafety system,and a hospital-blood station closed loop coordination mecha-nism should be established so as to raise the blood safety.