Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Purpose/Significance To construct a Chinese medical knowledge Q&A corpus dataset as a standardized evaluation bench-mark for large language models(LLMs)in the medical domain,so as to improve the accuracy and efficiency of LLMs in handling Chinese medical questions.Method/Process Chinese medical paper knowledge,medical terminology explanations and supplementary questions are acquired from the Chinese medical licensing examination,and open-source Chinese medical Q&A datasets are encompassed in the developed Q&A datasets.Result/Conclusion The Chinese medical knowledge Q&A corpus datasets enrich the sources of existing datasets and promote the objective and comprehensive quantitative evaluation of large models in the medical field.In the near future,additional data such as electronic medical records and those from online health communities will be used to strengthen the support of artificial intelli-gence for the Healthy China strategy.

Objective: To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines. Methods: The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed. Results: Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. Conclusions Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

Buckwheat is one of the most common source of food allergen in children.The clinical manifestations of buckwheat allergy are varied, which mainly affects the skin, and sometimes the respiratory and digestive system.Buckwheat allergy leads to a high incidence of anaphylaxis, which can even be life-threatening.In recent years, the prevalence of buckwheat allergy in Chinese children and adolescents is on the rise, although it is rarely reported in relevant literatures.This review summarized the prevalence, pathogenesis, clinical manifestations, diagnosis and management of buckwheat allergy in children, aiming to provide some suggestions.

Objective To explore the relationship between obstructive sleep apnea syndrome (OSA)and sarcopenia in elderly.Methods In the retrospective analysis,totally 320 elderly patients aged 65-85 years were successively enrolled from Department of Geriatrics,General Hospital of Tianjin Medical University from January 2015 to December 2017,and divided into the sarcopenia group (n=110) and the control group (n =210).Clinical and diagnostic data of OSA and sarcopenia were collected.The correlation between OSA and sarcopenia was evaluated by using multivariate Logistic regression.Results The average age was higher in the sarcopenia group than in the control group (P ＜ 0.001).Compared with the control group,the sarcopenia group had higher proportions of patients with male (P=0.015),with obesity,type 9 diabetes,dementia or OSA (P=0.005,0.021,0.032 and 0.018,respectively).Multivariate Logistic regression showed that risk factors for sarcopenia were age≥74.3 years (OR=1.63,95％CI:1.03～2.61),male (OR=1.79,95％CI:1.13 ～2.85),obesity (OR=1.70,95％CI:1.01～ 2.90),type 2 diabetes (OR=1.91,95％CI:1.11～3.29),dementia (OR=1.92,95％CI:1.05～3.49) and OSA (OR=2.24,95％CI:1.15～4.40)(P ＜0.001,0.015,0.038,0.021,0.032 and 0.018,respectively).OSA patients is more prone to sarcopenia than patients without OSA (OR =2,24,95 ％ CI:1.15 ～ 4.40).Conclusions OSA is correlated with sarcopenia in the elderly.

Objective To evaluate changes in brain natriuretic peptide(BNP)levels in predicting the risk of acute decompensated heart failure(ADHF)in rehospitalized elderly patients.Methods A cohort study was performed in 48 elderly(≥65 years)patients hospitalized for ADHF from June 2015 to June 2016.All patients underwent standard treatment in internal medicine and were followed up for one month after discharge.The study endpoint was rehospitalization for ADHF.According to whether there was an increase in BNP levels in one-month follow-up,participants were divided into two groups:a group with increased BNP (n =20) and a group without increased BNP (n =28).General clinical information,disease history,signs of circulatory congestion,cardiac ultrasound,and BNP levels were collected and compared between the two groups.Results Compared with the group without increased BNP,the group with increased BNP had higher rates of type 2 diabetes,positive hepatoj ugular reflu x,and jugular vein engorgement (x 2 =5.749,7.243,4.286,respectively,P ＜0.05 or P ＜0.01)and lower left ventricular ejection fraction(t =-3.558,P ＜0.01).BNP increase in the BNP group was higher than in the non-BNP group(394.2 ± 171.3 ng/L vs.94.2 ± 56.3 ng/L,P ＜0.01).The rehospitalizationrate in the BNP group was significantly higher than in the non-BNP group(55 ％ or 11 patients vs.17.8％ or 5 patients,P＜0.01).Multivariate Cox regression analysis found that the increase in BNP in the one-month follow-up was correlated with the increase in rehospitalization(HR =4.118,95％CI:1.427-11.884,P＜0.01).When the absolute value of BNP rose to over 310ng/L,the risk of rehospitalization in ADHF patients increased.Conclusions Increase in BNP one month after discharges is an effective predictor for rehospitalization in elderly patients with ADHF.

Objective To analyze the changes of levels of plasma diamine oxidase(DAO),D-lactate and endotoxin in children with different severity of hand-foot-mouth disease(HFMD),explore the changes of the function of intestinal mucosal barrier in children with HFMD,and investigate the sensitivity and early warning effect of the indexes described previously on the damage of intestinal mucosal barrier in children with severe HFMD.Methods Four hundred and seventy inpatient children in Xi′an Children′s Hospital from March 2016 to June 2017 suffered from HFMD were selected as the study group,and one hundred healthy children were selected as the control group in the same period.Children in the study group were divided into common group(n=300),severe group(n=110)and critical condition group(n=60)according to the sever-ity of the disease.The levels of plasma DAO,D-lactate and endotoxin from children in each group were com-pared.Results The plasma D-lactate level of the children in the study group was significantly higher than that in the control group,and the difference was statistically significant[(27.670 ± 6.273)mg/L vs.(25.585 ± 5.177)mg/L;t=3.515,P<0.05];but the differences of DAO and endotoxin compared with the control group were not statistically significant[(3.205 ± 0.956)U/L vs.(3.135 ± 0.884)U/L,P>0.05;(1.186 ± 0.486)U/L vs.(1.091 ± 0.494)U/L,P>0.05].The comparison of multiple groups showed that the differ-ence of plasma D-lactate levels was statistically significant(F=33.488,P<0.05),while the differences of the levels of DAO and endotoxin were not statistically significant among different severity groups(F=0.709, F=2.296,P>0.05).The level of plasma D-lactate in critical condition group[(32.502 ± 4.756)mg/L]was significantly higher than those in the severe group[(29.872 ± 6.468)mg/L],the common group [(25.896 ± 5.691)mg/L] and the control group,and the differences were statistically significant(P <0.05);the difference in plasma D-lactate levels in the severe and non-severe groups was statistically signifi-cant(P<0.05),and the difference between common group and control group was not statistically significant (P>0.05).Conclusion The intestinal permeability and intestinal mucosal barrier are impaired in children with severe and critical HFMD.Plasma D-lactate is significantly elevated in the early stage of intestinal barri-er injury.Compared with DAO and endotoxin,D-lactate is a sensitive and early warning index suggesting the impaired intestinal mucosal barrier function in severe and critical cases of HFMD.