Objective:To analyze the epidemiological and clinical characteristics of respiratory syncytial virus (RSV) infection in children in Jiangsu Province from 2014 to 2023.Methods:The acute respiratory infection cases in children aged 0-14 years were selected from outpatient/emergency or inpatient departments in 2 surveillance sentinel hospitals, respectively, in Nanjing, Suzhou and Taizhou of Jiangsu from 1 July 2014 to 31 December 2023, and RSV nucleic acid test was conducted and the intensity of the RSV infection was accessed by WHO influenza epidemiological threshold method, and case information and clinical data were collected. χ2 test was used to compare the differences between groups, and the Bonferroni method was used for pairwise comparisons between groups. Results:In 4 946 cases of acute respiratory infections, the RSV positive rate was 8.21% (406/4 946), and the age M( Q1, Q3) of the cases was 1 (0, 3) years. The RSV positive rate was 10.92% (258/2 362) during 2014-2019 and 6.06% (118/1 948) during 2019-2023, the difference was significant ( χ2=31.74, P<0.001). RSV infection mainly occurred from October to March during 2014-2019, with the incidence peak in December and moderate or higher intensity. The seasonality of RSV infection was not obvious during 2019-2023, with low intensity. The RSV positive rate was highest in children in age group 0- years (17.85%, 151/846), and the positive rate declined gradually with age ( χ2=184.51, P<0.001). The RSV positive rate was higher in inpatient cases (9.84%, 244/2 480) than in outpatient/emergency cases (6.57%, 162/2 466) ( χ2=17.54, P<0.001). In the 155 RSV infection cases with complete clinical data, the clinical symptoms mainly included cough (99.35%, 154/155), fever (55.48%, 86/155), and shortness of breath (45.16%, 70/155). In the cases aged <6 months, the proportion of those with fever was low, but the proportion of those with shortness of breath, transferred to intensive care units, and receiving oxygen therapy were higher (all P<0.05). Children aged <6 months and those with underlying diseases were more likely to have severe RSV infection (all P<0.05). Conclusions:RSV infection in children in Jiangsu Province showed seasonal prevalence in winter from 2014 to 2019. Since 2020, the seasonal characteristics of the epidemic have changed, the epidemic period has been dispersed and the epidemic intensity has decreased. Infants <1 year old were at high risk for RSV infection, and those <6 months old and with underlying diseases might have severe infection.

Frailty denotes a nonspecific clinical condition characterized by a decrease of physiological reservation in multiple systems, which makes individuals extremely vulnerable to stressors. Frailty increases the incidence of adverse outcomes and death of patients. However, frailty is reversible and preventable. Therefore, this article reviews theoretical models, assessment tools and influencing factors of frailty in elderly patients with hematologic maligilancy, so as to provide references for medical staff to carry out frailty management and related research in elderly patients with hematologic maligilancy.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective:To study the risk of malnutrition and related factors of cancer patients in community of Shanghai.Methods:From October 2018 to January 2019, four communities, Pengpu New Village Street, Pengpu Town, Jiangning Road Street, and Caojiadu Street, from 14 communities in Jing ′an District, Shanghai City, were selected by using a random cluster sampling method based on the Shanghai Cancer Registration and reporting system. All cases of malignant tumors and benign tumors of the central nervous system were included. A total of 4 396 questionnaires were distributed. After the exclusion of 9 invalid questionnaires, 3 310 valid questionnaires were included with a rate of 99.73%. A self-designed questionnaire was used to collect data including basic demographic characteristics, history of malignant, physical and psychological pain, nutritional demands and cognitive status. Malnutrition Universal Screening Tools (MUST) was used to analyze the nutritional risk of cancer patients in the community. Multivariate logistic regression model was applied to analyze potential factors.Results:Among the 3 310 cancer patients who completed the survey, the average age of study participants was (64.05±13.02), and 1 467 cases (44.32%) were males. The incidence rate of nutritional risk was 12.84% (425/3 310). The result of logistic regression analysis showed that compared with male, other cancer patients and no physical pain, the risk factors of the occurrence of nutritional included: female ( OR=1.53,95% CI:1.23-1.92), head and neck malignant tumors ( OR=1.42,95% CI:1.07-1.90), bronchus/lung malignant tumors ( OR=1.93,95% CI:1.43-2.61), liver, biliary/pancreatic malignant tumors ( OR=2.11,95% CI:1.21-3.65) and upper gastrointestinal malignant tumors ( OR=6.04,95% CI:4.31-8.46), patients with physical pain ( OR=1.39,95% CI:1.02-1.89). Conclusion:Nutritional risk of cancer patients is higher in community of Shanghai. Gender, location of tumors and physical pain are associated with the occurrence of nutritional risk.

Objective:To study the risk of malnutrition and related factors of cancer patients in community of Shanghai.Methods:From October 2018 to January 2019, four communities, Pengpu New Village Street, Pengpu Town, Jiangning Road Street, and Caojiadu Street, from 14 communities in Jing ′an District, Shanghai City, were selected by using a random cluster sampling method based on the Shanghai Cancer Registration and reporting system. All cases of malignant tumors and benign tumors of the central nervous system were included. A total of 4 396 questionnaires were distributed. After the exclusion of 9 invalid questionnaires, 3 310 valid questionnaires were included with a rate of 99.73%. A self-designed questionnaire was used to collect data including basic demographic characteristics, history of malignant, physical and psychological pain, nutritional demands and cognitive status. Malnutrition Universal Screening Tools (MUST) was used to analyze the nutritional risk of cancer patients in the community. Multivariate logistic regression model was applied to analyze potential factors.Results:Among the 3 310 cancer patients who completed the survey, the average age of study participants was (64.05±13.02), and 1 467 cases (44.32%) were males. The incidence rate of nutritional risk was 12.84% (425/3 310). The result of logistic regression analysis showed that compared with male, other cancer patients and no physical pain, the risk factors of the occurrence of nutritional included: female ( OR=1.53,95% CI:1.23-1.92), head and neck malignant tumors ( OR=1.42,95% CI:1.07-1.90), bronchus/lung malignant tumors ( OR=1.93,95% CI:1.43-2.61), liver, biliary/pancreatic malignant tumors ( OR=2.11,95% CI:1.21-3.65) and upper gastrointestinal malignant tumors ( OR=6.04,95% CI:4.31-8.46), patients with physical pain ( OR=1.39,95% CI:1.02-1.89). Conclusion:Nutritional risk of cancer patients is higher in community of Shanghai. Gender, location of tumors and physical pain are associated with the occurrence of nutritional risk.

Objective To investigate the incidence and risk factors of chronic post-surgical pain (CPSP) and its effects on the quality of life in a large sample prospective study.Methods A total of 1098 patients of either sex,aged 18-70 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery,were enrolled in the study.Data regarding patient age,gender,body mass index,educational level,marital status,living situations,occupation,pre-surgical pain in the site of surgery,complications,type of surgery,surgery time and anesthesia method were recorded.The highest numeric rating scale scores within 3 days after surgery were also recorded.The patients were followed up at 3,6 and 12 months after surgery to record the development of CPSP.The patients were divided into CPSP group and non-CPSP group according to whether or not CPSP developed.Multivariable logistic regression analysis was performed to identify the risk factors for CPSP,and the quality of life was scored.Results A total of 981 patients completed the 1 year follow-up after surgery,the incidence of CPSP was 35.7％,and the constituent ratio of the distribution of the course was as follows:3 months ≤ postsurgical course ＜ 6 months was 33.1％;6 months ≤ postsurgical course ＜ 12 months was 16.8％;postsurgical course ≥ 12 months was 50.1％.Female,no diabetes mellitus and pre-surgical pain in the site of surgery were the independent risk factors for CPSP (P＜ 0.05).Compared with non-CPSP group,the physiological function score,professional function score,body pain score,vitality score,social function score,mental health score and general health score were significantly decreased (P＜0.01),and no significant change was found in the emotional function score in CPSP group (P＞0.05).Conclusion The probability of development of CPSP is high and the course is long,and the quality of life score is decreased;female,no diabetes mellitus and pre-surgical pain in the site of surgery are the independent risk factors for CPSP.

Objective To explore cost effective means for early detection of malignant tumors in individuals undergoing health check-up.Methods This was a retrospective study involving 280,477 participants who had undergone health check-up including essential items from 2012 to 2016 at the Health Assessment and Intervention Research Center of Jiangsu Province.The protocol was composed of four steps.First,essential items were decided and conducted for all health examination participants.Second,cases with a high risk of malignant tumors were collected and additional tests were specified.Third,suspected malignant tumor cases were identified and recommendations for referrals and follow-up were made.Finally,physicians in charge of follow up would urge suspected cases to visit an oncologist,update case files,give regular instructions,and track recall results.Results There were 517 microscopically confirmed cases of malignant tumors,representing a detection rate of 184/100,000(1.84‰)in individuals seeking regular health check-up and of 2,023/100,000 (20.23‰)in those receiving follow ups.The five most prevalent malignant tumors were thyroid cancer (140 cases or 0.499‰),lung cancer(120 cases or 0.428‰),breast cancer(35 cases or 0.374‰),kidney cancer(55 cases or 0.196‰)and prostate cancer (33 cases or 0.177‰).Conclusions Essential examination items in combination with subsequent special tests,specialist referrals and follow ups are a cost effective way for early detection of malignant tumors in people seeking regular health examinations.

Background and purpose:At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of99mTcO4- combined with99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging in diagnosis of thyroid nodules.Methods:The results of ultrasound scoring method and99mTcO4- combined with99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated.Results:A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of99mTcO4- combined with99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging was higher than ultrasound scoring method or99mTcO4-+99mTc-MIBI imaging along (100.00%vs 80.00%, 100.00%vs 80.00%,χ2 value was 4.444 4 and 4.444 4,P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24%vs 64.71%,χ2 value was 5.230 8,P value was 0.022 2). However, no factorial negative thyroid nodule was found by ul-trasound scoring method+99mTcO4-+99mTc-MIBI imaging.Conclusion:Ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

Objective To investigate the influencing factors of 18F-FDG uptaking in head and neck malignancy by SPECT/CT coincidence imaging. Methods 18F-FDG SPECT/CT coincidence imaging was performed in 32 patients with head and neck malignancy after surgery, radiotherapy or radiotherapy + chemotherapy. The radio of target/no target (T/N) was calculated. The gender, age, fasting blood glucose level, size of tumor, location of tumor, pathological classification, de-gree of cell differentiation and treatment modalities were analyzed between groups. Results The single-factor analysis of variance showed that the T/N value was significantly higher in >70 yeas old, group than that of 41-50 yeas old group and 51-60 yeas old group (P<0.05). The T/N value was significantly lower in tumor size<2 cm group than that of 2-5 cm group and>5 cm group (P<0.05). And it was lower in poor differentiated tumor group than that of. undifferentiated tumor group (P<0.05). There were no significant differences in T/N values between other indicator groups (P>0.05). The multiple linear regression analysis showed that 18F-FDG uptaking in head and neck malignancy (T/N=Y) was related to the age of patients (X2), the diameter of tumor (X4) and the degree of cell differentiation (X9): =-4.389 25+0.053 03 X2+1.617 86 X4+0.718 35 X9. Conclusion Tumor recurrence is more likely to occur in patients with age>70 years old, the diameter of tumor≥2 cm, and the anaplastic head and neck malignancy.We should pay much attention to the diagnosis and follow-up for these pa-tients.

Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.