Background To investigate the recent epidemiological trends of gastric neuroendocrine neoplasms (GNENs) and establish a new tool to estimate the prognosis of gastric neuroendocrine carcinoma (GNEC) and gastric neuroendocrine tumor (GNET). Methods Nomograms were established based on a retrospective study on patients diagnosed with GNENs from 1975 to 2016 in Surveillance, Epidemiology and End Results database. External validation was performed among 246 GNENs patients in Jiangsu province to verify the discrimination and calibration of the nomograms. Results The age-adjusted incidence of GNENs has increased from 0.309 to 6.149 per 1,000,000 persons in the past 4 decades. Multivariate analysis indicated independent prognostic factors for both GNEC and GNET including age, distant metastasis and surgical intervention (P < 0.05). In addition, T, N staging and grade were significantly associated with survival of GNEC, while size was a predictor for GNET (P < 0.05). The C-indexes of the nomograms were 0.840 for GNEC and 0.718 for GNET, which were higher than those of the 8th AJCC staging system (0.773 and 0.599). Excellent discrimination was observed in the validation cohorts (C-index of nomogram vs AJCC staging for GNEC: 0.743 vs 0.714; GNET: 0.945 vs 0.927). Survival rates predicted by nomograms were close to the actual survival rates in the calibration plots in both training and validation sets. Conclusions The incidence of the GNENs is increasing steadily in the past 40 years. We established more excellent nomograms to predict the prognosis of GNENs than traditional staging system, helping clinicians to make tailored decisions.

Efforts are currently underway to develop a vaccine against Clostridium difficile infection (CDI). We developed two decision analytic Monte Carlo computer simulation models: (1) an Initial Prevention Model depicting the decision whether to administer C. difficile vaccine to patients at-risk for CDI and (2) a Recurrence Prevention Model depicting the decision whether to administer C. difficile vaccine to prevent CDI recurrence. Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially when being used post-CDI treatment to prevent recurrent disease.

The clinical symptoms of clonorchiasis are non-specific, and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history. The infection of clonorchis sinensis is related to occupations, bad eating habits and lack of knowledge about prevention of the disease.

Background: Information on the intention of parents of children with special diseases to vaccinate their children against coronavirus disease 2019 (COVID-19) is scarce.Methods: In this survey, all participants (n = 914) were enrolled from a tertiary children's hospital between September 2020 and April 2021. A face-to-face questionnaire interview was conducted to collect information on the special diseases of children and parental attitudes about the COVID-19 vaccine. We compared the demographic and disease factors between the group of parents who were willing to vaccinate their children against COVID-19 and the group who were unwilling to vaccinate.Results: Among 941 children, 58.1% (n = 547) were boys. The Mean age was 1.4 (SD 1.9) years. If the COVID-19 vaccine becomes available for the child, 470 (49.9%) of parents were willing to provide vaccination for their children. The less the education levels of the father or mother, the more likely they were to vaccinate their children (P = 0.003, P = 0.007). However, more intentions to vaccinate were provided in parents of children with COVID-19 prevention and control education (P &lt; 0.001).Conclusion: Our findings provided evidence that some parents are willing to vaccinate their children with special diseases against COVID-19. Professional knowledge about COVID-19 prevention and control may contribute to increased parental intention.