Objective: To evaluate the incremental vaccine effectiveness (VE) of two dose of the mumps containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies. Methods: A 1∶2 frequency matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu an, Hefei, Ma anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE). Results: There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination( χ 2/t=0.05, 0.20, 0.94, -0.02, P >0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95% CI=3.03%-63.77%, P <0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95% CI=1.90%-78.56%, P <0.05), while for children with a period of <1 year, it was 30.63% (95% CI=-28.59%-62.58%, P >0.05). The incremental VE of the second dose of MuCV was 30.36% (95% CI=-25.95%-61.50%, P >0.05) in kindergarten children and 66.73% (95% CI=14.92%-86.99%, P <0.05) in elementary and secondary school students. The incremental VE was 28.78% (95% CI=-27.46%-60.21%, P >0.05) within five years of the last dose of MuCV vaccination and 66.07% (95% CI=-41.56%-91.87%, P >0.05) for vaccinations administered beyond five years. Conclusions The second dose of MuCV may offer additional protection for children; however, extending the interval between two dose of MuCV (<1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.

OBJECTIVE: To compare the effectiveness and shoulder function of reverse total shoulder arthroplasty (RTSA) and open reduction and internal fixation (ORIF) in the treatment of Neer three/four-part proximal humeral fractures in the elderly. METHODS: Randomized controlled analysis was conducted on 68 patients over 70 years old with Neer three/four-part proximal humeral fractures treated with RTSA or ORIF between January 2020 and June 2022. The patients were randomly divided into RTSA group ( n=32) and ORIF group ( n=36). There was no significant difference ( P>0.05) in the baseline data such as age, gender, body mass index, injured side, Neer classification, and preoperative Charlson comorbidity index, visual analogue scale (VAS) score, Constant shoulder score, Oxford shoulder score (OSS), and hemoglobin (Hb). The operation time, intraoperative blood loss, reduction of Hb on the 3rd day after operation, hospital stay, total cost of hospitalization, complication incidence, range of motion of shoulder joint at 2 years after operation, VAS score before operation and at 5 days and 1 month after operation, Constant shoulder score and OSS score before operation and at 2 years after operation, and imaging results during follow-up were recorded and compared between the two groups. RESULTS: Compared with the ORIF group, the RTSA group had longer operation time, less intraoperative blood loss, and higher total cost of hospitalization ( P<0.05). There was no significant difference in Hb reduction on the 3rd day after operation between the two groups ( P>0.05). The VAS scores significantly improved in both groups at 5 days and 1 month after operation ( P<0.05), but there was no significant difference between the two groups ( P>0.05). All patients were followed up 26-35 months, with an average of 31.2 months. In the RTSA group, there were 2 cases of poor healing of superficial incision and 1 case of transient nerve injury. There was no complication such as bone resorption around the prosthesis, lucent band, prosthesis loosening, or periprosthetic fracture in all patients. In the ORIF group, there was 1 case of poor healing of superficial incision, 3 cases of nonunion of fracture, 1 case of arthritis secondary to humeral head necrosis, and 1 case of bone absorption of large tuberosity, and no displacement or fracture failure of internal fixation was found in all patients. There was no significant difference in the incidence of complications [9.4% (3/32) vs 16.7% (6/36)] between the two groups [ OR (95% CI): 0.828 (0.171, 4.014), P=0.814]. In the RTSA group, 28 cases were graded 0 and 4 cases were graded 1 at 2 years after operation. Constant and OSS scores of RTSA group were significantly better than those of ORIF group ( P<0.05). The Constant score was significantly better than ORIF group in activity and strength, range of motion, lifting, abduction, and external rotation ( P<0.05), and there was no significant difference in pain, daily function, and internal rotation between the two groups ( P>0.05). The RTSA group had a significantly greater range of motion in lifting, abduction, and external rotation than ORIF group ( P<0.05), but there was no significant difference in internal rotation between the two groups ( P>0.05). CONCLUSION Application of RTSA as the initial treatment of Neer three/four-part proximal humeral fractures in the elderly can achieve better rehabilitation of joint activity and lower risk of early reoperation, and improve the quality of life of elderly fracture patients. However, the difficulty of revision and the high cost of treatment require the surgeon to pay full attention and strictly grasp the indications.
Humans ; Fracture Fixation, Internal/instrumentation* ; Male ; Female ; Shoulder Fractures/surgery* ; Arthroplasty, Replacement, Shoulder/methods* ; Aged ; Bone Plates ; Open Fracture Reduction/methods* ; Range of Motion, Articular ; Treatment Outcome ; Shoulder Joint/physiopathology* ; Aged, 80 and over ; Operative Time ; Postoperative Complications/epidemiology* ; Length of Stay

Objective:To analyze the application efficacy of employing high-density porous polyethylene （Su-por） in combination with temporoparietal fascial flaps via a minimally invasive scalp incision in auricular reconstruction. Methods:This study carried out a retrospective analysis of 50 patients （50 ears in total） who underwentprimary auricular reconstruction with a Su-por scaffold in our hospital from June 2022 to January 2024. All patients underwent primary auricular reconstruction using a minimally invasive scalp incision with high-density porous polyethylene （Su-por） and temporoparietal fascial flaps. The postoperative treatment effects and complications were statistically analyzed. Results:The reconstructed ears of all patients survived. After 6 months of follow-up, the scar hyperplasia of the scalp minimally invasive incision was not obvious in any patient, and no significant hair loss was observed. The reconstructed auricle of 48 patients had a realistic shape and strong three-dimensional sense. With the extension of follow-up time, the three-dimensional structure of the auricle became clearer, and patient satisfaction increased. Among the remaining two patients, one case of flap necrosis survived after skin grafting and dressing changes. One patient had scar hyperplasia at the incision of the reconstructed ear due to a scar-prone constitution, and the shape of the auricle was not ideal, but the scar hyperplasia at the scalp incision was not obvious. Conclusion:One-stage ear reconstruction with high-density porous polyethylene （Su-por） combined with superficial temporal fascia flap through a minimally invasive scalp incision can better show the fine structure of the reconstructed ear. The minimally invasive scalp incision can effectively reduce the occurrence of scar hyperplasia and postoperative alopecia at the scalp incision.
Humans ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Surgical Flaps ; Tissue Scaffolds ; Polyethylene ; Ear Auricle/surgery* ; Male ; Scalp/surgery* ; Female ; Skin Transplantation ; Fascia/transplantation* ; Porosity ; Adult ; Middle Aged

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective:To evaluate the safety and efficacy of radiofrequency ablation（RFA）in the treatment of papillary thyroid microcarcinoma（PTMC）near and remote from the thyroid capsule.Methods:The clinical data，ultrasound images，ablation parameters and postoperative follow-up metrics were prospectively collected from 130 patients with pathologically confirmed PTMC in the Second Affiliated Hospital of Xi'an Jiaotong University who underwent RFA treatment between January 2023 and December 2024. According to whether the nodule margin was ≤ 2 mm from the thyroid capsule，the patients were divided into the subcapsular group（60 cases）and the remote from the capsule group（70 cases）. The clinical data，ablation parameters，complication rate，absorption of ablation lesions，tumor recurrence and metastasis were compared between the two groups.Results:The success rates of RFA in both groups were 100%. There was a statistically significant difference between the two groups at baseline in the location of nodules（ χ2=13.266， P=0.001）. After 12 months of routine follow-up，the incidence of complications was 5.00%（3/60）in the subcapsular group and 1.43%（1/70）in the remote from the capsule group，all complications recovered within 1 month，with no statistically significant difference（ P=0.407）. There were no significant changes in thyroid function［including free triiodothyronine（FT3），free thyroxine（FT4）and thyroid-stimulating hormone（TSH）］before and one month after RFA in the two groups（all P>0.05）. A statistically significant difference in the volume reduction rate（VRR）between the two groups was observed only when maximum diameter ≤ 5?mm at the 1st and 3rd months（all P<0.05）. For the remaining postoperative follow-up periods，there were no statistically significant differences in ablation zone volume or VRR between the two groups（all P>0.05）. At the final follow-up，for lesions with maximum diameter ≤ 5?mm，the tumor disappearance rate was 100% in both the subcapsular and remote from the capsule groups. For lesions with maximum diameter >5 mm，the rates were 78.4%（29/37）and 89.7%（26/29）in the respective groups，with no statistically significant difference between the two groups（ χ2 = 1.489， P =0.222）.There was no local tumor progression，lymph node metastasis or distant metastasis in either group. Conclusions:RFA is a safe and effective treatment for subcapsular PTMC，demonstrating comparable efficacy to that for PTMC located remote from the thyroid capsule.

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

The proposition of New Qualitative Productive Forces provides significant theoretical guidance for the development of China's healthcare sector.The Marxist concept of development serves as a foundational theoretical framework for empowering high-quality advancement in healthcare through these new productive forces.The Communist Party of China has consistently upheld Marxism as the guiding ideology for national governance.Based on the Marxist concept of development to analyze the new quality of productive forces,this is an important theoretical innovation of the Communist Party of China,which has important guiding significance for the development of China's health undertakings.

Objective:To explore protective effect and possible mechanism of electroacupuncture at Zusanli combined with Yupingfengsan Jiawei on rats with acute lung injury.Methods:A total of 50 Wistar rats were randomly divided into control group,model group,Yupingfengsan Jiawei group(YPFSJW),electroacupuncture group(EA),acupuncture-medicine combination group(EA+YPFSJW),and acute lung injury model rats were constructed by intraperitoneal injection of lipopolysaccharide except control group.Lung tissue injury,oxidative damage and inflammatory factors were detected by wet/dry weight ratio,HE staining,TUNEL staining,myeloperoxidase(MPO),malondialdehyde(MDA),superoxide dismutase(SOD)and ELISA.qRT-PCR,immunohistochemical staining and Western blot were used to detect mRNA and related protein expressions.Results:Compared with control group,structure of lung tissue in model group was significantly damaged,alveolar wall was thickened,accompanied by pathological damage such as congestion and inflammatory cell infiltration,wet/dry ratio of lung tissue,apoptosis rate,inflammatory factors,oxidative damage level and mRNA expressions were significantly increased,and protein expressions of TLR4,MyD88,p-p65 and p-IκBα were significantly increased(P<0.05);compared with model group,Yupingfengsan Jiawei group,electroacupuncture group and acupuncture-medicine combination group had less inflammatory cell infiltration and congestion in lung tissue,wet/dry weight ratio of lung tissue,cell apopto-sis rate,inflammatory factors,oxidative damage levels and mRNA expressions were decreased,and TLR4,MyD88,p-p65,p-IκBαprotein expressions were decreased(P<0.05);compared with Yupingfengsan Jiawei group and electroacupuncture group,lung tissue alveolar structure of combined acupuncture and medicine group was relatively complete and clear,wet/dry weight ratio of lung tissue,cell apoptosis rate,inflammatory factors,oxidative damage levels and mRNA expressions were decreased,TLR4,MyD88,p-p65,p-IκBα protein expressions were decreased(P<0.05).Conclusion:Electroacupuncture combined with Yupingfengsan Jiawei can reduce acute lung injury in rats,whose mechanism may be related to regulation of protein levels related to NF-κB signaling pathway.

The proposition of New Qualitative Productive Forces provides significant theoretical guidance for the development of China's healthcare sector.The Marxist concept of development serves as a foundational theoretical framework for empowering high-quality advancement in healthcare through these new productive forces.The Communist Party of China has consistently upheld Marxism as the guiding ideology for national governance.Based on the Marxist concept of development to analyze the new quality of productive forces,this is an important theoretical innovation of the Communist Party of China,which has important guiding significance for the development of China's health undertakings.

Objective:To explore protective effect and possible mechanism of electroacupuncture at Zusanli combined with Yupingfengsan Jiawei on rats with acute lung injury.Methods:A total of 50 Wistar rats were randomly divided into control group,model group,Yupingfengsan Jiawei group(YPFSJW),electroacupuncture group(EA),acupuncture-medicine combination group(EA+YPFSJW),and acute lung injury model rats were constructed by intraperitoneal injection of lipopolysaccharide except control group.Lung tissue injury,oxidative damage and inflammatory factors were detected by wet/dry weight ratio,HE staining,TUNEL staining,myeloperoxidase(MPO),malondialdehyde(MDA),superoxide dismutase(SOD)and ELISA.qRT-PCR,immunohistochemical staining and Western blot were used to detect mRNA and related protein expressions.Results:Compared with control group,structure of lung tissue in model group was significantly damaged,alveolar wall was thickened,accompanied by pathological damage such as congestion and inflammatory cell infiltration,wet/dry ratio of lung tissue,apoptosis rate,inflammatory factors,oxidative damage level and mRNA expressions were significantly increased,and protein expressions of TLR4,MyD88,p-p65 and p-IκBα were significantly increased(P<0.05);compared with model group,Yupingfengsan Jiawei group,electroacupuncture group and acupuncture-medicine combination group had less inflammatory cell infiltration and congestion in lung tissue,wet/dry weight ratio of lung tissue,cell apopto-sis rate,inflammatory factors,oxidative damage levels and mRNA expressions were decreased,and TLR4,MyD88,p-p65,p-IκBαprotein expressions were decreased(P<0.05);compared with Yupingfengsan Jiawei group and electroacupuncture group,lung tissue alveolar structure of combined acupuncture and medicine group was relatively complete and clear,wet/dry weight ratio of lung tissue,cell apoptosis rate,inflammatory factors,oxidative damage levels and mRNA expressions were decreased,TLR4,MyD88,p-p65,p-IκBα protein expressions were decreased(P<0.05).Conclusion:Electroacupuncture combined with Yupingfengsan Jiawei can reduce acute lung injury in rats,whose mechanism may be related to regulation of protein levels related to NF-κB signaling pathway.