Objective:To investigate the clinical significance of intraoperative prepositioning of dual mediastinal drains in elderly patients developing anastomotic leakage(AL)after a total endoscopic Ivor-Lewis procedure.Methods:This retrospective case-control study analyzed the clinical data of 500 elderly patients who underwent total endoscopic Ivor-Lewis surgery for esophageal or cardia cancer from January 2020 to December 2022.In the control group, one mediastinal drainage tube was placed intraoperatively, while in the study group, two mediastinal drainage tubes were placed.Both groups had a chest tube placed conventionally.The study compared the incidence of anastomotic leak(AL)at 1 month postoperatively, inflammatory indexes in patients with AL, grading of AL, rate of nasal fistula placement, incision infection, anastomotic stenosis, and incidence of hoarseness.Additionally, it compared ICU occupancy, ventilator use, and ICU length of stay between the two groups.Results:The analysis included clinical data from 455 elderly patients.Among the patients who developed AL, the study group had significantly lower peak body temperature[(39.58±1.03)℃ vs.(38.05±0.56)℃, t=4.298, P<0.05], white blood cell count[(18.63±3.35)×10 9/L vs.(14.28±2.78)×10 9/L, t=3.450, P<0.05], and C-reactive protein(CRP)levels[(154.66±41.64)mg/L vs.(122.19±31.29)mg/L, t=2.131, P<0.05]. The study group also had a significantly lower grading of AL and rate of nasal fistula placement(82.4% vs.30.0%, P<0.05). In terms of ICU indicators, the study group had a significantly lower ICU admission rate(64.7% vs.10.0%, P<0.05), shorter period of ventilator use[(6.47±8.15)days vs.(0.90±2.23)days, t=2.62, P<0.05], and shorter ICU stay[(11.70±8.89)days vs.(4.70±6.27)days, t=2.184, P<0.05]. Conclusions:Double mediastinal drainage tubes, have been found to significantly alleviate inflammation, decrease the rate of nasal fistula placement and ICU admission, and shorten the length of ICU stay in elderly patients.Therefore, they are considered safe and deserving of clinical promotion.

Vaccination is an effective public health measure to prevent and control vaccine-preventable diseases for individual and society. However, China currently confronts significant challenges, including a dearth of skilled professionals in the field of vaccination and disparities in the capacity for immunization services. This review introduced the experiences of four prime international vaccinology education models, including London School of Hygiene & Tropical Medicine, Johns Hopkins University, Leading International Vaccinology Education, and the Bill & Melinda Gates Foundation, in the aspect of personnel development, academic research and communication platforms establishment. It is supposed to give some insights and feasible suggestions on the establishment and advancement of vaccinology as a sub-discipline within high-level public health school in China, with the aim of development of a robust vaccinology education framework in China, which is essential for nurturing the next generation of public health leaders and practitioners for our country.

Vaccination is an effective public health measure to prevent and control vaccine-preventable diseases for individual and society. However, China currently confronts significant challenges, including a dearth of skilled professionals in the field of vaccination and disparities in the capacity for immunization services. This review introduced the experiences of four prime international vaccinology education models, including London School of Hygiene & Tropical Medicine, Johns Hopkins University, Leading International Vaccinology Education, and the Bill & Melinda Gates Foundation, in the aspect of personnel development, academic research and communication platforms establishment. It is supposed to give some insights and feasible suggestions on the establishment and advancement of vaccinology as a sub-discipline within high-level public health school in China, with the aim of development of a robust vaccinology education framework in China, which is essential for nurturing the next generation of public health leaders and practitioners for our country.

Humans ; Cross-Sectional Studies ; SARS-CoV-2 ; COVID-19 Vaccines/therapeutic use* ; Pandemics ; COVID-19/prevention & control* ; China/epidemiology* ; Attitude ; Vaccination

Human still has limited understanding of respiratory infectious diseases, especially emerging acute respiratory infectious diseases. Once the pandemic of this kind of infectious disease occur, it would be a serious challenge to health, political security, the economic development, and social stability. People hope to detect the changes in infectious diseases in early phase through surveillance and give early warning in time. In the field of public health, more attention has been paid to syndrome surveillance as an effective supplement to traditional surveillance. This paper summarizes the current surveillance system of infectious diseases abroad, introduces the syndrome surveillance system of acute respiratory infectious disease and its application in China, and discusses the development of syndrome surveillance and early warning technology for acute respiratory infectious diseases in the future.

Intelligent syndromic surveillance is an important part of multi-point triggering and multi-channel surveillance system of intelligent early warning of infectious diseases in China, and an inevitable development process of traditional syndromic surveillance as the constant emergence of new technologies. Intelligent syndromic surveillance collects not only the medical data of patients seeking medical care in hospitals but also massive non-medical information. However, along with its rapid development, challenges in intelligent syndromic surveillance have emerged, such as information explosion, cost-effective balance, information sharing, data security and privacy. This paper summarizes the concept and development of intelligent syndromic surveillance to provide references for the method and technique development of intelligent early warning of infectious diseases and new thought for the prevention and control of infectious diseases in China and in the world.

BACKGROUND: World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS: In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS: A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION: Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION PROSPERO, CRD42022333747.
Humans ; COVID-19/epidemiology* ; SARS-CoV-2 ; Influenza, Human ; Intensive Care Units ; Vaccination

The COVID-19 continues to spread throughout the world, and local clusters and outbreaks related to overseas imports have occurred in many places in China. Vaccination against COVID-19 is one of the most effective tools to prevent disease, severe illness and death. For vaccines developed and used by China, it is particularly important for scientific and targeted prevention and control to study different outbreak scenarios, to conduct in-depth real-world research on SARS-CoV-2 variants, and to further promote vaccine development and technical reserves. This article commented the effectiveness of COVID-19 vaccine, and prospected the future research on vaccine efficacy, immunization strategy and vaccine development, which provided evidence for optimizing vaccination strategy.

The COVID-19 continues to spread throughout the world, and local clusters and outbreaks related to overseas imports have occurred in many places in China. Vaccination against COVID-19 is one of the most effective tools to prevent disease, severe illness and death. For vaccines developed and used by China, it is particularly important for scientific and targeted prevention and control to study different outbreak scenarios, to conduct in-depth real-world research on SARS-CoV-2 variants, and to further promote vaccine development and technical reserves. This article commented the effectiveness of COVID-19 vaccine, and prospected the future research on vaccine efficacy, immunization strategy and vaccine development, which provided evidence for optimizing vaccination strategy.

Objective    To evaluate the early and mid-term safety of transcatheter aortic valve replacement via transfemoral (TF), transapical (TAp) and transsubclavian (TSc) approaches by meta-analysis. Methods    We systematically searched the clinical comparative trials published from inception to June 2019 from PubMed, Web of Science, EMbase and The Cochrane Library, to evaluate the safety of transcatheter aortic valve replacement through TF, TAp or TSc approaches. The information of all-cause mortality at 30 days, 1 year, 2 years and the incidence of common complications at 30 days after operation (including pacemaker-dependent block, major vascular complications, severe bleeding events, acute renal injury and stroke) were exacted, and a meta-analysis was conducted by RevMan 5.3 software. Results    This study included 11 literatures, with a total of 7 833 patients, among whom 5 348 patients were treated by TF TAVR, 1 796 patients by TAp TAVR and 689 patients by TSc TAVR. The results of the meta-analysis were as follows: (1)  at 30 days after operation, the mortality of TF and TSc approaches were lower than that of the TAp approach (TF vs. TAp:OR=0.57, 95%CI 0.39-0.84, P=0.004; TSc vs. TAp: OR=4.12, 95%CI 1.93-8.79, P=0.000 3). There was no statistical difference between the TF and TSc approaches (TF vs. TSc: OR=0.98, 95%CI 0.38-2.51, P=0.97); at 1 year, there was no statistical difference in mortality among the three approaches (P>0.05); at 2 years, there was no statistical difference between TSc and TF or TAp approaches (TF vs. TSc: OR=1.21, 95%CI 0.95-1.54, P=0.13; TSc vs. TAp: OR=1.02, 95%CI 0.76-1.36, P=0.91). (2) The incidence of acute kidney injury after TF approach was lower than that of the TAp approach (OR=0.30, 95%CI 0.22-0.41, P<0.000 01). (3) There was no statistical difference in major vascular complications between TSc and TF or TAp approaches (TF vs. TSc: OR=0.75, 95%CI 0.38-1.49, P=0.41; TSc vs. TAp: OR=1.37, 95%CI 0.56-3.32, P=0.49). (4) There was no statistical difference in severe bleeding events between TF and TSc (OR=0.97, 95%CI 0.53-1.76, P=0.92). (5) There was no statistical difference in the incidence of postoperative stroke, pacemaker dependent block among the three approaches (P>0.05). Conclusion    TAp and TSc approaches are safe and effective. They are not only an alternative to TF approach, but also the first choice in some patients with poor condition of iliofemoral artery.