The early diagnosis and treatment of foreign body aspiration (FBA) can significantly improve the overall prognosis of children. There are significant differences in the epidemiology and clinical characteristics of FBA in different regions. Therefore, we conducted a real-world study in the western region of China with over 4000 patients. The aim of this study was to improve the understanding of FBA in terms of its types, the specific months of its occurrence, and the distribution of primary caregiver characteristics in western China. We collected the clinical and epidemiological data of children who were diagnosed with FBA in our hospital over the past 20 years through a big data centre. We matched the data of healthy children who underwent routine physical examinations at the paediatric health clinic during the same period to analyse the differences in the data of actual guardians. A total of 4227 patients from five provinces were included in this study. Foreign bodies were removed by rigid bronchoscopy in 99.4% (4202/4227) of patients, with a median age of 19 months and a median surgical duration 16 min. January was the most common month of onset for 1725 patients, followed by February, with 1027 patients. The most common types of foreign objects were melon peanuts, seeds and walnuts, accounting for 47.2%, 15.3%, and 10.2%, respectively. In the FBA group, the proportion of grandparents who were primary caregivers was 70.33% (2973/4227), which was significantly greater than the 63.05% in the healthy group (2665/4227) (P < 0.01). FBA most commonly occurs in January and February. More than 60% of FBAs occur between the ages of 1 and 2 years, and the incidence of FBA may be greater in children who are cared for by grandparents. A rigid bronchoscope can be used to remove most aspirated foreign bodies in a median of 16 min.

Background: This study described and evaluated the safety and efficacy of a modified single incision non-thoracoscopic Nuss procedure in pectus excavatum (PE) children.Methods: PE patients undergoing the non-thoracoscopic Nuss procedure at the Children's Hospital of Chongqing Medical University between January 2017 and December 2020 were retrospectively enrolled. The patients were divided into two groups according to operation procedures: the double incision Nuss (DN) group and the modified single incision Nuss (SN) group. Propensity score matching (PSM) was applied before evaluation of operative and postoperative characteristics to reduce selection bias.Results: Of the 502 patients included, 261 were enrolled in the DN group, and 241 in the SN group. The operation time [35.0 (30.0–40.0) vs. 50.0 (40.0–55.0) minutes, P < 0.001] and postoperative inpatient stay [7.0 (6.0–8.0) vs. 7.0 (7.0–8.0) days, P < 0.001] of the patients in the SN group after PSM were significantly shorter than those of the patients in the DN group after PSM. Moreover, median blood loss was significantly less in the SN group after PSM than that in the DN group after PSM [2.0 (1.0–5.0) vs. 5.0 (2.0–5.0) ml, P < 0.001]. There were no significant differences in the incidence of complications between the two groups (P > 0.05). Bar removal was performed in 85 patients in the SN group within 24–42 months after surgery. Additionally, the SN group patients had a significantly lower Haller index (HI) after bar removal [2.36 (2.15–2.55) vs. 3.76 (3.18–4.26), P < 0.001] compared to the initial HI.Conclusions: The modified procedure is safe and effective for children with PE and is worthy of clinical application.

Objective: Mucinous breast cancer (MBC) is a kind of breast cancer (BC), which is rare in clinic, mainly for women, because of the low incidence rate, so there is no unified standard treatment protocol. Elderly patients have a poor prognosis due to their combined comorbidities. This study aims to investigate the effect of surgery and chemoradiotherapy on the prognosis of elderly female MBC patients and construct nomograms for predicting the OS and CSS in elderly female MBC patients.Methods: Data for female MBC patients over 65 years are obtained from the Surveillance, Epidemiology and End Results (SEER) database, patients were divided into two groups: the training set and the validation set. External validation data of the prediction model were provided by Kunming Hospital of Traditional Chinese Medicine. We used Cox regression modeling, which was used to identify independent risk factors affecting patient prognosis. After avoiding confounding bias according to the multifactorial Cox regression model, we used these screened statistically significant results to construct column‐line plots. The performance of the model was tested using the consistency index (c‐index), the calibration curve, and the area under the operating characteristic curve of the receiver (AUC). Subsequently, we used decision curve analysis (DCA) to examine the potential clinical value of our nomograms.Results: A total of 8103 elderly MBC female patients were extracted from the database SEER and were assigned to the training and validation set, randomly. A total of 83 patients from Kunming Hospital of Traditional Chinese Medicine were used in the external verification set. After multifactorial Cox regression analysis, we found that age, race, T‐stage, M‐stage, surgical approach, radiotherapy, and tumor size were independent risk factors for OS in elderly MBC patients. Similarly, independent risk factors of CSS included age, marital status, N stage, M stage, surgical approach, chemotherapy, and tumor size. The C‐index for the OS training, validation, and external verification set were 0.731 (95%CI 0.715–0.747), 0.738 (95%CI 0.724–0.752), and 0.809 (95%CI 0.731–0.8874). The C‐index of the training set, the validation set, and external verification set for CSS were 0.786 (95%CI 0.747–0.825), 0.776 (95%CI 0.737–0.815), and 0.84 (95%CI0.754–0.926), respectively. The AUC, calibration curves and DCA also showed good accuracy.Conclusions: In this study, we construct a new nomogram to predict the prognosis of elderly patients with MBC. The nomograms have undergone internal and external validation and have been confirmed to have good clinical applicability. At the same time, we found that for elderly female MBC patients, surgery and radiotherapy significantly benefit their survival, but chemotherapy is not conducive to patient survival.

It is controversial when surgery should be performed for pectus excavatum (PE). The study retrospectively compared the long-term prognosis in PE children undergoing the Nuss procedure at the age of 4–6 versus those performing surgery at the age of 12–14. 178 patients were included in the retrospective real-world research. Clinical Characteristics were collected at baseline. The endpoint of the study was set as the last follow-up at the age of 18 in outpatient services. Satisfaction and complication rate were set as the primary outcome and were collected at the endpoint. Hospital stay post-surgery and analgesia dosage were regard as the secondary outcome. To reduce potential bias between two different age groups, propensity score matching (PSM) analysis was analysized. The oral analgesic dosage of children in the 4–6 years old age group is significantly lower than that of the 12–14 years old group (0.70/kg, 0.30–1.50/kg versus 1.50/kg, 0.90–2.30/kg, P < 0.001), and children in the younger age group are discharged earlier. There was no difference in overall satisfaction (89.1 %, versus 88.20 %, P = 0.99) and recurrence rate (7.2 %, versus 6.8 %, P = 0.99) between the two groups of when they reach the age of 18. Performing Nuss procedure at the age of 4–6 does not affect the overall long-term satisfaction of the child or increase the long-term recurrence rate. Surgical intervention in children with pectus excavatum preschool can provide a better postoperative experience in hospital compared with intervention in adolescent.

Background: Nuss procedure is the most common method of surgical treatment to pectus excavatum (PE). A significant percentage of surgeons choose to use thoracoscopic assistance during the Nuss procedure (TNP) to avoid cardiac injury. However, our previous findings confirm the safety of single incision Non-thoracoscopic Nuss Procedure (SINTNP). Hence, Further studies, particularly prospective randomized controlled trials, are necessary to assess the value of SINTNP for PE.Methods: This study is a prospective, superiority, multicenter, non-masked, randomized controlled trial that investigates the outcome and hospitalization medical expense of SINTNP compared to TNP for PE. A total of 320 eligible patients according to sample size calculation by retrospective data will be randomly assigned to the SINTNP group or the TNP group at a 1:1 ratio using stratified blocked randomization and the zone length was set as four. Patients aged between 3 and 18 years old for the first surgery and without combination of complex anomalies such as Marfan syndrome and congenital heart disease will be considered for the study. The co-primary endpoint is thoracic related complications and medical expense during hospitalization. Thoracic related complications were defined as pneumothorax, pleural effusion, pneumonia and incision infection. The secondary endpoints include surgery duration and length of hospital stay.The registration number for this study protocol is ChiCTR230073081 (Chinese Clinical Trial Registry, A Primary Registry of International Clinical Trial Registry Platform, World Health Organization).