Impact of normalized COVID-19 prevention and control measures on lower respiratory tract infection pathogenesis in hospitalized children.

Objective: This study aimed to investigate the epidemiological characteristics of common pathogens contributing to childhood lower respiratory tract infections (LRTIs) in Xiangtan City, Hunan Province before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A total of 11,891 enrolled patients, aged 1 month to 14 years, diagnosed with LRTIs and admitted to Xiangtan Central Hospital from January 2018 to December 2021 were retrospectively reviewed in this study. Specifically, the epidemiological characteristics of these pathogens before and during the COVID-19 pandemic were analyzed. Results: There was a significant decrease in the number of children hospitalized with LRTIs during the COVID-19 pandemic (2020-2021) compared to data from 2018 to 2019 (before the COVID-19 pandemic). Of these cases, 60.01% (7,136/11,891) were male and 39.99% (4,755/11,891) were female. 78.9% (9,381/11,891) cases occurred in children under 4 years of age. The average pathogen detection rate among 11,891 hospitalized LRTIs children was 62.19% (7,395/11,891), with the average pathogen detection rate of 60.33% (4,635/7,682) and 65.57% (2,670/4,209) before and during COVID-19 pandemic, respectively. The detection rates of adenovirus (ADV), bordetella pertussis (BP) and moraxella catarrhalis (M. catarrhalis) decreased dramatically, while the detection rates of influenza viruses (IFV), parainfluenza viruses (PIV), respiratory syncytial virus (RSV), haemophilus influenzae (H. influenzae), streptococcus pneumoniae (S. pneumoniae), and staphylococcus aureus (S. aureus) increased significantly during the COVID-19 pandemic. Overall, RSV, mycoplasma pneumoniae (MP), H. influenzae, and IFV were the major pathogens causing LRTIs in hospitalized children before and during the COVID-19 pandemic. Conclusion: Public health interventions for COVID-19 prevention are beneficial to reduce the incidence of LRTIs in children by limiting the prevalence of ADV, MP, BP, and M. catarrhalis, but which have limited restrictive effects on other common LRTIs-associated pathogens. Collectively, the data in this study comprehensively investigated the effects of COVID-19 pandemic on the epidemiological characteristics of respiratory pathogens, which will be beneficial for improving early preventive measures.

Comparison of Laparoscopic Percutaneous Extraperitoneal Internal Ring Closure by Two-Hook Hernia Needle and Open Repair for Pediatric Inguinal Hernia.

Purpose: In children, pediatric inguinal hernia (PIH) is a prevalent condition. PIH is currently more frequently managed by laparoscopic closure of the hernia sac. We improved this minimally invasive technique; that is, laparoscopic two-hook hernia needle percutaneous extraperitoneal internal ring closure. Safety and effectiveness were evaluated by comparing the differences between laparoscopic repair (LR) and open repair (OR) in terms of operation time, surgical complications, contralateral metachronous hernia incidence, and recurrence rate. Methods: A retrospective clinical data analysis was performed on pediatric patients who had hernia surgery utilizing the LR or OR method between June 2019 and June 2021. Medical records of all of the children were gathered, and clinical traits, information about the procedure, and follow-up were all analyzed. Results: A total of 370 patients' inguinal hernias were repaired. For 136 patients undergoing OR and 234 patients undergoing LR, all procedures were completed satisfactorily. There were 98 cases of bilateral hernias and 272 cases of unilateral hernias (180 on the right side and 92 on the left). In the LR group, 58 patients who had been initially diagnosed with unilateral hernias developed contralateral occult hernias intraoperatively. Inguinal hernia operations took an average of 13.82 (LR) and 32.07 (OR) minutes for unilateral cases, and 21.00 (LR) and 54.85 (OR) minutes for bilateral cases. For LR and OR, the average follow-up time was 22.41 months and 23.10 months, respectively. The perioperative complications included peritoneal rupture in 3 patients, scrotal edema or hematoma in 5, hydrocele in 3, and groin pain in 6. In the LR group, 1 patient experienced the postoperative recurrence, whereas 8 individuals in the OR group did. Conclusions: Our initial research showed that laparoscopic two-hook hernia needle percutaneous extraperitoneal internal ring closure inguinal hernia repair is a safe and effective procedure. The LR method has the benefits of concealing the incision, a quicker procedure, having a lower risk of complications, and finding contralateral patent processus vaginalis. Therefore, promoting and using this surgical technique in clinical practice are merited. Clinical Trial Registration number: Medical Association of Xiangtan (2022-xtyx-28).

Diagnostic and Prognostic Nomograms for Lung Metastasis in Triple-Negative Breast Cancer.

Background: The lungs are one of the common sites of metastasis of triple-negative breast cancer (TNBC). Patients with lung metastases (LM) have a shorter duration of survival. This study is aimed at determining the prognostic factors of patients with TNBC with LM and constructing two nomograms to assess the risk of LM and the prognosis of patients with TNBC with LM. Methods: Clinicopathological and follow-up data of patients with TNBC between 2010 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analyses were used to screen for independent predictors of LM in patients with TNBC and identify the independent prognostic factors of patients with TNBC with LM. The two nomograms were appraised using calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Results: A total of 27,048 patients with TNBC were included in this study. Age, tumour size, T stage, and N stage were identified as independent risk factors for LM in patients with TNBC. Histological type, marital status, prior surgery, chemotherapy, bone metastases, brain metastases, and LM were confirmed as independent prognostic factors for patients with TNBC with LM. The area under the ROC curve (AUC) of the diagnostic nomogram was 0.838 (95% confidence interval 0.817-0.860) in the training cohort and 0.894 (95% confidence interval 0.875-0.917) in the verification cohort. The AUC values of the 6-, 12-, and 18-month prognostic nomograms in the training cohort were 0.809 (95% confidence interval 0.771-0.868), 0.779 (95% confidence interval 0.737-0.834), and 0.735 (95% confidence interval 0.699-0.811), respectively, and the corresponding AUC values in the validation cohort were 0.735(95% confidence interval 0.642-0.820), 0.672 (95% confidence interval 0.575-0.758), and 0.705 (95% confidence interval 0.598-0.782), respectively. According to the calibration curves and data analysis, both nomograms exhibited good performance. Conclusion: We successfully constructed and verified two valuable nomograms for predicting the incidence of LM and prognosis of patients TNBC with LM.