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.

F-FDG PET/CT is an ideal auxiliary tool for early and accurate diagnosis of malignant tumors in children.This guideline aimed to standardize 18F-FDG PET/CT examination process for malignant tumors in children,hence providing references for nuclear medicine professionals.

Objective:To investigate the clinical manifestations, histological features, immunophenotype, molecular characteristics, and treatments of uterine inflammatory myofibroblastic tumor (UIMT).Methods:Clinical and pathological data of 4 UIMT cases diagnosed at the Peking Union Medical College Hospital, Beijing, China from 2020 to 2024 were collected. Their clinicopathological and genetic characteristics were analyzed.Results:The patients′ ages were 63, 42, 53 and 37 years, respectively. The tumors were located in the submucosa and intermuscular walls of the uterus, with a diameter ranging from 1.5 to 6.0 cm. All tumors were suspected by the clinician as leiomyosarcoma. Histologically, 3 of the 4 tumors showed spindle cells that appeared like leiomyoma. Prominent myxoid stroma and inflammatory cells infiltration were observed, with mitotic figures of 1-2 per 10 high-power fields. One case was primarily composed of spindle cells arranged in fascicles, with inflammatory cell infiltration, inconspicuous myxoid stroma and mitotic figures of 3 per 10 high-power fields. Two cases exhibited a pushing pattern of invasion and slightly unclear boundaries, while the other two showed infiltrative growth with unclear boundaries. The immunohistochemistry revealed diffuse and strong, cytoplasmic granular staining of ALK in all 4 cases. RNA sequencing was performed in 3 cases, of which 2 cases showed ALK gene rearrangements, and 1 case did not. One case underwent FISH testing and showed ALK gene translocation. Follow-up showed that no recurrence or metastasis was observed after surgery in all patients.Conclusions:UIMT is a rare mesenchymal tumor of the uterus and lacks specific clinical manifestations. When tumor cells exhibit mild atypia, indistinct borders, myxoid stroma, inflammatory cell infiltration, and decreased expression of ER and PR on immunohistochemistry, immunohistochemical staining of ALK is recommended to confirm the diagnosis of UIMT. This tumor shares many features with myogenic tumors and endometrial stromal sarcomas. Molecular testing may also be needed to assist in diagnosis when necessary. For patients who are not suitable for surgery or have recurrence and metastasis, targeted therapy with ALK inhibitors can be used.

Objective To analyze the current situation of department configuration and discipline development of medical record management in China,identify existing problems and challenges,and provide a reference for medical record management.Methods Based on the functions of word frequency analysis,coding and statistics of Nvivo 20 software,the sample literature was comprehensively interpreted by the content analysis method.Results Currently in China,medical record departments are mainly established as secondary departments in healthcare institutions with generally insufficient staffing.The professional title distribution presents a"pyramid"structure with senior∶intermediate∶junior ratio at 1∶3∶4,showing complex professional backgrounds and low proportion of postgraduate degree holders.The informatization level varies significantly with hospital grades,with basic-level hospitals below secondary level demonstrating relatively low informatization.There exist substantial gaps in on-the-job training and continuing education,while scientific paper output and research project applications remain generally weak.Conclusion Under the new circumstances,it is necessary to improve the academic education and continuing education system for medical record management,strengthen discipline construction and informatization development,enhance selection and train-ing of inter-disciplinary talents in medical records,optimize professional title promotion channels,and continuously increase at-tention and investment in medical record departments to meet the needs of hospital modernization development.

We reported a case with huge mass in the anterior neck region, which pathological diagnosis was thyroid metastasis from hepatocellular carcinoma(HCC). A tracheotomy was performed, and a tracheostomy tube was placed because of postoperative dyspnea. Thyroid metastasis from HCC is very rare. The causes include hematogenous metastasis, lymphatic metastasis and other factors. Furthermore, Hepatitis B virus (HBV) infection also plays an important role in tumor progression. Combined with the literature review, surgical resection of thyroid in the treatment of metastatic thyroid malignant tumors can prolong the survival. In clinical work, it is still necessary to develop a reasonable, standardized and comprehensive diagnosis and treatment strategy to improve the quality of life of patients and the therapeutic efficacy.

Objective To analyze the current situation of department configuration and discipline development of medical record management in China,identify existing problems and challenges,and provide a reference for medical record management.Methods Based on the functions of word frequency analysis,coding and statistics of Nvivo 20 software,the sample literature was comprehensively interpreted by the content analysis method.Results Currently in China,medical record departments are mainly established as secondary departments in healthcare institutions with generally insufficient staffing.The professional title distribution presents a"pyramid"structure with senior∶intermediate∶junior ratio at 1∶3∶4,showing complex professional backgrounds and low proportion of postgraduate degree holders.The informatization level varies significantly with hospital grades,with basic-level hospitals below secondary level demonstrating relatively low informatization.There exist substantial gaps in on-the-job training and continuing education,while scientific paper output and research project applications remain generally weak.Conclusion Under the new circumstances,it is necessary to improve the academic education and continuing education system for medical record management,strengthen discipline construction and informatization development,enhance selection and train-ing of inter-disciplinary talents in medical records,optimize professional title promotion channels,and continuously increase at-tention and investment in medical record departments to meet the needs of hospital modernization development.

OBJECTIVE To construct an evaluation index system for the core competencies of ethics committee members of drug clinical trial institution,providing a basis for optimizing the training system for committee members,improving the quality of ethical review,and fully safeguarding the safety and rights of subjects.METHODS Using methods such as literature research and expert consultation,a preliminary core competency evaluation index system was constructed.The Delphi method was employed to revise and validate it,ultimately forming an evaluation index system for the core competencies of ethics committee members.Based on this system,a questionnaire survey was conducted among 90 ethics committee members from 29 drug clinical trial institutions nationwide,comparing their importance rating and self-assessment scores of the core competency indexes.RESULTS The evaluation system constructed included 4 primary indicators(ethics and professional knowledge,ethics review ability,communication and expression ability,moral integrity and work style)and 39 secondary indicators(familiarity with the content of clinical trial-related laws and regulations,ability to complete project ethics review and identify ethical defects in research protocols within a short period of time,ability to judge the scientific value of clinical research,etc.).The results of questionnaire survey showed that the interviewed ethics committee members had significant capability gaps in dimensions such as regulatory knowledge,ethical norms,review efficiency,risk judgment,and problem analysis.The differences between the importance rating scores of corresponding secondary indicators and the self-assessment scores were all no less than 0.38.CONCLUSIONS This study has developed a quantifiable and stratified core competency assessment tool for ethics committee members.It can provide a scientific framework for committee member training,qualification certification,and standardized management of ethics committees.

F-FDG PET/CT is an ideal auxiliary tool for early and accurate diagnosis of malignant tumors in children.This guideline aimed to standardize 18F-FDG PET/CT examination process for malignant tumors in children,hence providing references for nuclear medicine professionals.

Objective:To investigate the clinical manifestations, histological features, immunophenotype, molecular characteristics, and treatments of uterine inflammatory myofibroblastic tumor (UIMT).Methods:Clinical and pathological data of 4 UIMT cases diagnosed at the Peking Union Medical College Hospital, Beijing, China from 2020 to 2024 were collected. Their clinicopathological and genetic characteristics were analyzed.Results:The patients′ ages were 63, 42, 53 and 37 years, respectively. The tumors were located in the submucosa and intermuscular walls of the uterus, with a diameter ranging from 1.5 to 6.0 cm. All tumors were suspected by the clinician as leiomyosarcoma. Histologically, 3 of the 4 tumors showed spindle cells that appeared like leiomyoma. Prominent myxoid stroma and inflammatory cells infiltration were observed, with mitotic figures of 1-2 per 10 high-power fields. One case was primarily composed of spindle cells arranged in fascicles, with inflammatory cell infiltration, inconspicuous myxoid stroma and mitotic figures of 3 per 10 high-power fields. Two cases exhibited a pushing pattern of invasion and slightly unclear boundaries, while the other two showed infiltrative growth with unclear boundaries. The immunohistochemistry revealed diffuse and strong, cytoplasmic granular staining of ALK in all 4 cases. RNA sequencing was performed in 3 cases, of which 2 cases showed ALK gene rearrangements, and 1 case did not. One case underwent FISH testing and showed ALK gene translocation. Follow-up showed that no recurrence or metastasis was observed after surgery in all patients.Conclusions:UIMT is a rare mesenchymal tumor of the uterus and lacks specific clinical manifestations. When tumor cells exhibit mild atypia, indistinct borders, myxoid stroma, inflammatory cell infiltration, and decreased expression of ER and PR on immunohistochemistry, immunohistochemical staining of ALK is recommended to confirm the diagnosis of UIMT. This tumor shares many features with myogenic tumors and endometrial stromal sarcomas. Molecular testing may also be needed to assist in diagnosis when necessary. For patients who are not suitable for surgery or have recurrence and metastasis, targeted therapy with ALK inhibitors can be used.

Objective: To investigate protective effects of nicotinamide mononucleotide (NMN) on ethanol-induced DNA damage in L02 cells, so as to provide the evidence for adjuvant therapy of NMN on alcoholic liver diseases. Methods: L02 cells were pretreated with different concentrations of NMN (0, 1, 2, 4 and 8 mmol/L) for 6 h, and then were exposed to 0.4% ethanol for 12 h. The treated cells were divided into the control group, 0.4% ethanol group and different concentrations of NMN groups. Cell viability was analyzed using trypan blue staining for determining the concentration of NMN as a protective agent. The effects of NMN on ethanol-induced DNA damage in L02 cells were evaluated using immunofluorescence detection and reactive oxygen species (ROS) assay. L02 cells were exposed to 0.4% ethanol for 12 h, cultured in a medium containing a protective concentration of NMN, and divided into PBS group and NMN group. Cell viability was detected at 0, 2, 4, 8, 16 and 32 h, and the effects of NMN on repairing ethanol-induced DNA damage were evaluated by alkaline comet assay. Results: The cell viability was lower in 0.4% ethanol group than than in the control group, and was higher in different concentrations of NMN groups than in 0.4% ethanol group (all P<0.05), with no significant difference in the cells viability between 4 mmol/L and higher concentrations of NMN groups and the control group (all P>0.05). Therefore, 4 mmol/L NMN was selected as a protective agent. The cell tail moments, relative immunofluorescence intensities of γH2AX and relative levels of ROS were higher in 0.4% ethanol group than in the control group, and lower in 4 mmol/L and higher concentrations of NMN groups than in 0.4% ethanol group (all P<0.05). The cell viability was increased and the cell tail moment was shortened with the increase of 4 mmol/L NMN intervention time; and the cell viability in 4 h and more of NMN groups were higher, and the cell tail moment were lower than that in PBS group (all P<0.05). Conclusions NMN attenuates DNA damage in a dose-dependent manner and promotes the repair of DNA damage in a time-dependent manner. NMN has a protective effect on ethanol-induced DNA damage in hepatocytes.