Background: Vaccination is a highly effective strategy for the prevention of enterovirus A71 (EV-A71)—hand, foot, and mouth disease (HFMD). Three inactivated EV-A71 vaccines in China have demonstrated remarkable efficacy against EV-A71-HFMD during clinical trials, exhibiting vaccine effectiveness (VE) exceeding 90% and few adverse events (AEs). However, the effectiveness of vaccines in the real world and its impact on the epidemiological characteristics of HFMD after the use of EV-A71 inactivated vaccine are uncertain. Methods: The odd ratio (OR) and 95% confidence (CI) were used as the effect estimates of the meta-analysis in the test-negative design (TND), and the OR was used to calculate VE: VE = (1 − OR) × 100%. Results: According to the literature search strategy, a comprehensive search was conducted in PubMed, Web of Science (including Chinese Science Citation Database and MEDLINE), and Embase, and 18 records were ultimately included in this study. Subsequently, the overall VE and 95% CI of different vaccine doses were analyzed, with the one-dose vaccine at 66.9% (95% CI: 45.2–80.0%) and the two-dose vaccine at 84.2% (95% CI: 79.4–87.9%). Additionally, the most reported AEs were mild general reactions without any rare occurrences. Simultaneously, the widespread use of the EV-A71 vaccine would lead to a reduction in both the incidence of EV-A71-associated HFMD and severe cases caused by EV-A71. Conclusion: The administration of the two-dose EV-A71 vaccine is highly effective in preventing HFMD in the real world, and the widespread use of the EV-A71 vaccine leads to a reduction in the incidence of EV-A71-associated HFMD and that of severe cases caused by EV-A71. The findings suggest that administering the two-dose EV-A71 inactivated vaccine to children aged 6 months to 71 months can be effective in preventing EV-A71-associated HFMD, highlighting the need for developing a multivalent HFMD vaccine for preventing cases not caused by EV-A71.

Background: A growing number of countries implement prenatal pertussis vaccination policies to safeguard unvaccinated infants. This meta-analysis aimed to evaluate the efficacy, immunogenicity, and safety of antenatal Tdap vaccination in pregnant individuals. Methods: We systematically searched PubMed, Embase, and Web of Science from their inception to 16 February 2025, rigorously screening studies and including seven randomized controlled trials and 10 case-control studies published between 2014 and 2024. For the test-negative design meta-analysis, odds ratios with 95% confidence intervals served as effect estimates, and vaccine efficacy was calculated accordingly. Standardized mean differences were used to assess geometric mean concentrations, while relative risks evaluated safety. Results: Maternal vaccination during pregnancy demonstrated 85% vaccine effectiveness (95% CI: 78–89%) in protecting infants under 3 months old. Pooled standardized mean differences for cord blood IgG antibodies against pertussis toxin, pertactin, and filamentous hemagglutinin were 1.57 (95% CI: 1.25–1.89), 2.15 (95% CI: 1.82–2.48), and 2.25 (95% CI: 1.81–2.68), respectively, indicating higher antibody levels in infants of vaccinated women before their first immunization. Safety analysis showed no significant association between Tdap vaccination during pregnancy and serious adverse events in infants (RR = 0.76, 95% CI: 0.46–1.24) and pregnant women (RR = 1.22, 95% CI: 0.83–1.81). Conclusion: Our findings support the implementation of pertussis vaccination during pregnancy.

Background: extensive-stage small cell lung cancer (ES-SCLC) were the majority of SCLC patients. Recently the combination of chemotherapy with immune checkpoint inhibitors (ICIs) have emerged as the new first-line treatment standard for ES-SCLC. However, the specific patient populations that are most likely to benefit from this treatment remains to be clearly identified making the establishment of baseline biomarkers critical.Methods: We recruited ES-SCLC patients who were treated at the First Affiliated Hospital of Zhengzhou University and conducted a propensity score-matched analysis (PSM). And used the Kaplan-Meier (K-M) method and Cox proportional hazards regression to compare the survival outcomes. In addition, univariate and multivariate COX regression analyses were conducted to identify predictors.Results: After-PSM, chemotherapy group had a longer median overall survival (mOS) of 15.23 months (95%CI: 14.00-17.87) and hazard ratio (HR) of 0.576 (95% confidence interval (CI): 0.404-0.821), P=0.002), and the median progression free survival (mPFS) in the chemotherapy group was shorter: 6.05months (95%CI: 4.33-7.87), HR=0.707 (95%CI: 0.526 -0.950, P=0.021) compared to before PSM. Multivariate analysis confirmed that Eastern Cooperative Oncology Group performance status (ECOG PS) =1 (HR: 2.36, 95% CI: 1.38-4.03, P=0.002) and brain metastases (HR: 2.08, 95% CI: 1.05-4.14, P=0.038) were independent prognostic factors for PFS, and only systemic inflammation response index (SIRI)> 2.63 (HR: 0.06, 95% CI: 0.01-0.29, P<0.001) was an independent prognostic factor for OS.Conclusion: our findings indicate that incorporating ICIs into first-line chemotherapy significantly improves PFS and OS in ES-SCLC patients, while maintaining safety. Moreover, poor ECOG PS, brain metastases, and high SIRI at baseline may serve as valuable prognostic indicators for disease progression and survival in ES-SCLC patients undergoing first-line chemotherapy plus ICIs. It is worth noting that these findings should be interpreted as hypothesis-generating, not definitive clinical conclusions.

Objective: The purpose of this study is to study laboratory indicators for the identification of hand, foot, and mouth disease (HFMD) severity. Methods: We searched PubMed, Embase, and the Web of Science for literature that was published before May 2022. The main results are presented as forest plots. Subgroup analyses, sensitivity analyses, and publication bias were also performed. Results: Our study indicated that white blood cells (WBC) (95%CI: 0.205–0.778), blood glucose (95%CI: 0.505–0.778), lymphocytes (95%CI: 0.072–0.239), creatinine (95%CI: 0.024–0.228), interleukin (IL)-2 (95%CI: 0.192–1.642), IL-6 (95%CI: 0.289–0.776), IL-8 (95%CI: 0.499–0.867), IL-10 (95%CI: 0.226–0.930), interferon-γ (IFN-γ) (95%CI: 0.193–2.584), tumor necrosis factor-α (TNF-α) (95%CI: 1.078–2.715), and creatine kinase MB isoenzyme (CK-MB) (95%CI: 0.571–1.459) were associated with an increased risk of HFMD severity, and the results of the sensitivity analysis of these indicators were stable and free of publication bias. Conclusions: Our results suggest that various deleterious immune and metabolic changes can increase the risk of HFMD severity, which can provide a basis for predicting the prognosis and useful evidence for clinicians to manage patients efficiently.

Severe fever with thrombocytopenia syndrome (SFTS) is a newly discovered tick-borne disease caused by SFTS virus (SFTSV) infection. Patients present with high fever, thrombocytopenia, and multiple organ dysfunction, with a high mortality rate and a lack of specific treatment, all of which indicate that research on the deterioration mechanism and treatment of this disease is urgent. Currently, multiple studies have indicated that cytokine storm is one of the core factors contributing to the deterioration of the disease. SFTSV inhibits the host’s type I interferon response through its non-structural protein NSs, thereby promoting immune evasion and viral replication. Extensive viral stimulation leads to dysfunction and abnormal polarization of immune cells (including monocytes, macrophages, dendritic cells, T cells, and B cells), triggering the massive release of pro-inflammatory factors(such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β)), anti-inflammatory factors (such as interleukin-10 (IL-10)), and chemokines(such as interferon-gamma inducible protein 10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), and interleukin-8 (IL-8)). This cytokine storm exacerbates the imbalance between pro-inflammatory and anti-inflammatory factors, as well as immune paralysis, leading to vascular endothelial damage, microthrombosis, and ultimately, multi-organ failure, which determines the clinical outcome. Simultaneously, specific cytokines and immune cell phenotypes can serve as biomarkers for disease severity and prognosis. In terms of treatment, this article further summarizes the intervention strategies targeting the aforementioned immune links, including intravenous immunoglobulin (IVIG), tocilizumab (targeting the IL-6 receptor), inhibitors of Janus kinase (JAK) and nuclear factor-kappa B (NF-κB) signaling pathways, interferon, neutralizing antibodies, and other immunotherapy methods. By analyzing the dynamic changes and mechanisms of cytokine storm in the course of SFTS, and summarizing current potential immunotherapy methods, this article aims to provide a theoretical framework for the future treatment of SFTS.