Objective To analyze epidemiological and genetic characteristics of human metapneumovirus (HMPV) in acute respiratory infections (ARI) in Guangdong Province from 2023 to 2024, and to provide baseline data for the epidemiological surveillance, prevention, and control of HMPV. Methods A total of 17 308 ARI cases in Guangdong Province from July 2023 to December 2024 were included in the study. The demographic characteristics of the cases were collected, and multiplex respiratory pathogen detection kits were used to conduct multi-pathogen nucleic acid testing. The F gene of the HMPV target gene was sequenced by Sanger method, and phylogenetic analysis was performed. Results Among the 17 308 ARI cases, the overall HMPV nucleic acid positivity rate was 3.88% (672/17 308), with rates of 4.07% (391/9 616) in males and 3.65% (281/7 692) in females; the difference was not statistically significant (P = 0.162). Among all age groups, the < 1-year age group showed the highest HMPV positive rate of 7.13% (34/477), followed by children aged 1-<3 years [6.85% (195/2 846)], 3-<6 years [5.09% (145/2 847)], 6-<18 years [2.97% (100/3 363)], 18-<60 years [2.24% (114/5 079)], and ≥ 60 years [3.12% (84/2 696)]. Among children aged ≤6 years, the HMPV-positive rate showed a downward trend with increasing age (χ² = 8.803, P = 0.012). No significant difference in HMPV-positive rate was observed between influenza-like illness (ILI) and severe acute respiratory infection (SARI) cases overall [3.84% (430/11 211) vs. 3.97% (242/6 097); P = 0.664]. However, among children aged 6-<18 years, ILI cases had a higher positivity rate than SARI cases (P<0.05), whereas in the 18-<60 year group, SARI cases showed higher positivity than ILI cases (P<0.001); no statistically significant differences were observed in other age groups (all P>0.05). Temporally, HMPV infection peaked in October 2023 and August 2024, with persistently elevated activity from August 2023 through March 2024. Among HMPV-positive patients, the co-infection rate was 39.29% (264/672). The most common co-infecting pathogens were human rhinovirus and Streptococcus pneumoniae. Genotypic analysis showed that only subtypes A2b, B1, and B2 were identified among circulating strains, with A2b predominating [78.35% (152/194)], followed by B2 [18.04% (35/194)]. Conclusions In this study, infants aged < 1 year were the high-risk group for HMPV infection. Among children aged < 6 years and the elderly, HMPV-positive nucleic acid cases were evenly distributed between ILI and SARI. The epidemic pattern of HMPV in Guangdong Province differed from the traditional winter-spring epidemic; it did not show a strict seasonal pattern, and A2b was the predominant circulating strain in Guangdong Province from 2023 to 2024.

Objective To evaluate the effect of point-of-care testing (POCT) technology combined with a refined management model on improving timeliness of pathogen detection, clinical decision-making efficacy, and clinical outcomes of patients in fever clinics, provide insights for the management practices of medical institutions in China. Methods A retrospective cohort study was conducted, including 300 patients from the fever clinic of a tertiary hospital in Beijing between October 2024 and March 2025. To control for baseline confounders, 1∶1 propensity score matching was performed on the 260 eligible patients after screening. Ultimately, 240 patients were successfully matched and divided into a POCT group (January-March 2025, n=120) and a PCR group (October-December 2024, n=120). The POCT group underwent bedside testing using the Flash 10 analyzer following standardized training, along with refined management measures; while the PCR group received conventional centralized laboratory testing. The detection efficiency [turnaround time (TAT), consultation duration], clinical decision-making efficacy (targeted treatment rate, time to medication decision-making), and clinical outcomes (7-day revisit rate, hospitalization rate) were compared between the two groups. Results The median TAT was 0.72 (0.63, 0.75) h in the POCT group, which was significantly shorter than that in the PCR group 15.55 (10.89, 18.78) h, with a statistically significant difference (Z=-11.32, P<0.001). The median total consultation duration was 2.48 (2.25, 2.62) h in the POCT group, which was significantly shorter than that in the PCR group 17.41 (12.77, 21.78) h, with a statistically significant difference (Z=-11.89, P<0.001). The targeted treatment rate was 90.0% (108/120) in the POCT group, which was significantly higher than that in the PCR group 65.0% (78/120) with a statistically significant difference (χ²=21.28,P<0.001); The median time to medication decision-making was 0.4 (0.3, 0.6) h in the POCT group, which was significantly shorter than that in the PCR group 2.1 (1.9, 2.4) h, with a statistically significant difference (Z=-10.75,P<0.001). The 7-day revisit rate (7.5% vs 14.2%) and hospitalization rate (1.7% vs 5.8%) were both lower in the POCT group than those in the PCR group, with statistically significant differences (χ²=4.51,P<0.05; Fisher's exact test, P<0.05). Conclusions This integrated mode can significantly shorten pathogen detection time, improve diagnostic and therapeutic precision, and enhance patients' clinical outcomes, form a chain effect of "rapid detection-precise treatment-outcome improvement". This mode provides a practical basis for managing respiratory infectious diseases in fever clinics. Future efforts should focus on optimizing equipment throughput, strengthening community training, and enhancing emergency response capacity.

Objective To explore the epidemic trends and etiological characteristics of influenza in Ningxia Hui Autonomous Region (hereinafter referred to as Ningxia) from 2015 to 2024, thereby offering a scientific foundation for formulating effective control and prevention strategies in the region. Methods Surveillance data were obtained from China Influenza Surveillance Information System, pertaining to influenza-like illness (ILI) and pathogen detection in Ningxia from 2015 to 2024. The analysis employed descriptive epidemiological approaches, with statistical processing conducted via Excel and SPSS 26.0. Results From 2015 to 2024, a total of 88 321 specimens from influenza-like illness cases were collected at sentinel hospitals in Ningxia, among which 9 619 tested positive for influenza, with a positive rate of 10.48%. The positive rates in different years showed statistically significant differences (χ²=1 289, P<0.001), peaking in 2019 (16.76%) and reaching the lowest in 2020 (4.16%). In terms of pathogenology, the predominant strain was H3N2 subtype of influenza A (38.70%), followed by Victoria lineage of influenza B (29.40%) and H1N1 subtype of influenza A (26.26%), with alternating variations in predominant strains across different years. Concentration analysis showed that the influenza virus transmission showed a strong seasonal pattern in Ningxia from 2015 to 2024. After analyzing with the weighted positive rate, it was discovered that the overall seasonal intensity over the decade and in more than half of the years was significantly weakened. The increase in the conclusion of "even time distribution" after correction indicated that the weighted processing helped to more objectively restore the natural time distribution pattern of the virus activity. By conducting a circular distribution of the weighted positive rate, the results suggested that the overall trend of influenza wss not significant in Ningxia. The P values of all years were greater than 0.05, indicating that there was no significant concentration pattern of influenza during the observation period, and the distribution was relatively uniform or random, with the peak of influenza virus activity concentrated from December to March of the following year. Pearson correlation analysis showed that there was no significant correlation between the concentration M value and the circular distribution γ value. (r=-0.164，P=0.65). Conclusions From 2015 to 2024, influenza exhibited strong seasonality in Ningxia, with different viral strains circulating alternately across years, and the dominant strains were different. There were strict seasonality in 2016 and 2023, strong seasonality in 2017, 2019 and 2022, relatively strong seasonality in 2021 and 2024, some seasonality in 2015 and 2018, and uniform distribution in 2020. The peak of influenza virus activity varied slightly from year to year, but the peak of influenza virus activity was concentrated from December to March of the next year in most years.

Objective To analyze the neuraminidase (NA) resistance and molecular characteristics in the influenza A(H1N1)pdm09 viruses circulating in Hunan Province from 2023 to 2025, so as to provide a reference for viral pathogenic risk assessment and clinical medication of influenza viruses. Methods A total of 44 influenza A(H1N1)pdm09 strains were randomly selected from influenza virus isolates submitted by influenza surveillance network laboratories in Hunan Province during 2023-2025. Wholegenome sequencing was performed using nextgeneration sequencing (NGS), a phylogenetic tree was constructed based on the NA gene sequences, and the molecular characteristics of the NA protein were analyzed. Selected A(H1N1)pdm09 strains were further tested with an NA inhibition assay (fluorescence-based NA-Fluor assay) to determine their susceptibility to two neuraminidase inhibitors (NAIs), oseltamivir and zanamivir. Results From 2023 to 2025, influenza A(H1N1)pdm09 virus predominated in Hunan Province, accounting for 40.49% (3 381/8 350), 40.91% (2 813/6 876) and 45.34% (4 470/9 858) of the influenza virus nucleic acid-positive specimens in each of the three years, respectively. Among the 44 A(H1N1)pdm09 strains, the NA genes of 16 strains were assigned to molecular evolutionary clade C.5.3, while those of 36 strains belonged to clade D; among the latter, 3 and 11 strains further evolved into subclades D.1 and D.2, respectively. Three strains carried key resistance-associated substitutions in the NA protein, I223R and H275Y: two strains harbored the H275Y substitution, with the half maximal inhibitory concentration (IC₅₀) of oseltamivir being more than 1 600-fold higher than that of the sensitive reference strain, whereas one strain carried the I223R substitution, with a 70.90-fold increase in IC₅₀. Deglycosylation at the 50NKS (asparagine-lysine-serine) motif of the NA protein was observed in 29.54% (13/44) of the A(H1N1)pdm09 strains. Conclusions From 2023 to 2025, the A(H1N1)pdm09 subtype predominated in Hunan Province, with three strains bearing resistance substitutions H275Y or I223R in the neuraminidase. Continuous surveillance of influenza A(H1N1)pdm09 viruses is necessary to monitor changes in resistance to NAIs, so as to provide a reference for clinical medication and prevention of influenza virus transmission.

Objective To analyze the epidemiological characteristics, lineage distribution, and molecular evolution of influenza B viruses in Anhui Province from 2016 to 2025, so as to provide a scientific basis for formulating local influenza prevention and control strategies, selecting vaccine strains, and implementing vaccination in the province. Methods Respiratory specimens from influenza-like illness (ILI) cases were collected through sentinel hospitals of the Anhui influenza surveillance network. Real-time fluorescent RT-PCR was used for influenza B virus screening and lineage identification. Virus isolation was performed on nucleic acid-positive specimens, followed by amplification of the HA and NA genes and next-generation sequencing. Bioinformatics software was used for sequence alignment and phylogenetic tree construction to analyze the genetic evolution characteristics of the virus. Data on the number of outpatient ILI cases and infections with different influenza types from sentinel hospitals between 2016 and 2025 were collected and statistically analyzed. Results Before 2020, both lineages of influenza B circulated annually. The B/Victoria lineage was the predominant lineage during March-August 2016, March-May 2017, and April 2019-January 2020, with longer epidemic duration and higher positive detection rates than the B/Yamagata lineage, making it the dominant sub-lineage. During November 2017-January 2018, cases of B/Yamagata lineage infection increased; in other surveillance periods, its positive detection rate remained below 10%, with weaker epidemic intensity and shorter duration. After 2020, no B/Yamagata lineage positive samples have been detected in Anhui Province, while the B/Victoria lineage was predominant from September 2021 to March 2022. Amino acid alignment with corresponding vaccine strains revealed that most B/Victoria lineage strains had amino acid mutations in the 120-loop, 150-loop, 160-loop, and 190-helix, whereas only a few B/Yamagata lineage strains had mutations in the 120-loop. The mutation frequency at receptor-binding sites was higher in the Victoria lineage than in the Yamagata lineage. No key site mutations were found in the NA gene of influenza B viruses. Phylogenetic analysis showed that the Victoria lineage strains circulating in Anhui Province since 2016 belonged to the V1A clade, while the Yamagata lineage strains belonged to the Y3 clade. Except for the 2021-2022 surveillance season, the annual circulating influenza B strains were generally well matched with the corresponding vaccine strains. However, receptor-binding site mutations were frequent, suggesting the possibility of antigenic changes driven by HA conformational alterations and the risk of reduced vaccine effectiveness. Conclusions Since 2021, no circulation of influenza B/Yamagata lineage viruses has been detected in Anhui Province. In contrast, influenza B/Victoria lineage viruses exhibit frequent mutations in the receptor-binding site region, a feature that may attenuate the protective efficacy of influenza vaccines. Vaccination remains the most critical measure for influenza prevention and control. Continuous enhancement of etiological surveillance for influenza viruses should be implemented to dynamically track viral variation characteristics and provide important scientific evidence for the selection of candidate influenza vaccine strains.

Objective To analyze the epidemiological changes and clinical characteristics of pertussis infection in children in this region and provide the up-to-date basis for its diagnosis, prevention and control. Methods A retrospective analysis was conducted on pertussis nucleic acid test data and clinical information of patients under 18 years of age who visited the Children's Hospital of Hebei Province due to suspected pertussis infection from August 2022 to December 2025. Epidemiological and clinical characteristics, such as the population and seasonal distribution of pertussis, were statistically analyzed. Results The detection rate of pertussis varied across different years. The detection rate of pertussis was the highest in 2022 (37.98%, 602/1 585) and the lowest in 2025 (3.77%, 84/2 228), and the difference was statistically significant (χ²=815.82, P<0.001). The detection rate of pertussis in summer 2022 was higher than that in autumn and winter. The detection rate of pertussis was the highest in winter and the lowest in spring in 2023. Subsequently, the peak detection rates of pertussis in 2024 and 2025 were both concentrated in spring and summer. The differences in detection rates among the various seasons in 2022, 2023, and 2024 were statistically significant (χ²=22.23, χ²=53.31, χ²=852.33, all P<0.001). In 2022, the pertussis detection rate was the highest in the group under 6 months. In 2024 and 2025, the detection rate of pertussis was the highest in the group aged 7 to <18 years old, followed by the group under 6 months old. The differences in detection rates among age groups in 2022, 2024, and 2025 were all statistically significant (χ²=27.22, χ²=538.74, χ²=44.16, all P<0.001). The detection rate of pertussis in hospitalized children (14.01%, 751/5 359) was lower than that in outpatients (34.04%, 5 237/15 386), and the difference was statistically significant (χ²=776.12, P<0.001). Among the outpatients with pertussis, the group aged 7 to < 18 years old had the largest number, while among the inpatients with pertussis, the group under 6 months old had the largest number. The most common clinical symptoms among hospitalized children with pertussis were paroxysmal cough (64.58%, 485 cases), facial flushing after coughing (68.97%, 518 cases), and nocturnal cough (49.67%, 373 cases). Among the 404 hospitalized children, 263 cases were simultaneously detected with other respiratory pathogens, and the co-infection rate was 65.10%. The pathogen with the highest co-infection detection rate was rhinovirus (33.17%, 134/404). Except for post-tussive vomiting, there were no statistically significant differences between the simple pertussis group and the co-infection group in terms of paroxysmal coughing, nocturnal coughing, inspiratory whoop at the end of coughing, wheezing, facial flushing after coughing, fever, and the duration of coughing (all P>0.05). Among all the children with pertussis, 260 children had no history of pertussis vaccination (4.34%), and 5 728 children had a history of immunization (95.66%). Conclusions The epidemiological characteristics of pertussis are continuously evolving under the influence of multiple factors. In 2025, the detection rate decreased significantly, and the proportion of older children increased. Medical institutions should continuously enhance their surveillance and diagnostic capabilities.

Objective To characterize seroprevalence of IgM antibodies against eight common respiratory pathogens and delineate their epidemiological features among patients with respiratory tract infections (RTIs) at a tertiary hospital in Taiyuan, and this study will provide scientific evidence for antimicrobial stewardship, hospital infection control, and regional public health surveillance. Methods A retrospective observational study was conducted on 26 148 initial test records with RTIs from outpatients, emergency cases, and inpatients at a tertiary hospital in Taiyuan, Shanxi between January 2015 and February 2025. Serum samples were analyzed for IgM antibodies against eight common respiratory pathogens. Multivariable binary logistic regression models were fitted with overall positivity and pathogen-specific IgM positivity as dependent variables. The ordered yearly trend of overall positivity was assessed using the Cochran-Armitage trend test. Joint effects of sex and age group on infection risk were evaluated using logistic regression models with interaction terms. Monthly patterns in respiratory pathogen detection were visualized by heatmaps, and correlations were assessed by Spearman rank analysis. Results The overall IgM seropositive rate for eight pathogens was 49.11% (12 840 cases), with single infections of 20.89% (5 462 cases), and co-infections of 28.22% (7 378 cases). The specific positive rates ranked as follows: influenza B virus (34.33%, 8 976 cases), influenza A virus (29.16%, 7 626 cases), Mycoplasma pneumoniae (12.04%, 3 149 cases), Legionella pneumophila (5.99%, 1 567 cases), Chlamydia pneumoniae (2.38%, 622 cases), parainfluenza virus (1.56%, 409 cases), respiratory syncytial virus (0.85%, 223 cases), and adenovirus (0.69%, 180 cases). The overall positive rate showed an increasing trend from 2015 to 2024 (χ²_trend=2 965.807, P<0.001), with the highest in 2024 and the lowest in 2016. There was a statistically significant difference among months (Wald χ²=326.829, P<0.001), with the highest in November and the lowest in May. The overall positive rate differed significantly across age groups (Wald χ²=1 078.489, P<0.001), with the lowest in the group under 1 year and the highest in children aged 6-<15 years. Females had a higher overall positive rate than males (51.87% vs 46.64%, Wald χ²=50.894, P<0.001). Conclusions Patients with respiratory infections exhibited a generally high overall positive rate for IgM antibodies in Taiyuan, with a significant proportion of co-infection cases. The predominant pathogens were influenza B and A viruses. There were significant differences in terms of year, month, age, and gender, indicating the need to implement preventive measures targeting high-risk periods for infection (November-December) and key populations.

Objective To understand the epidemiological characteristics of common respiratory infectious diseases in China, identify key priorities for their prevention and control, and provide a scientific basis for optimizing and improving prevention and control strategies and measures for respiratory infectious diseases in the future. Methods From the China Information System for Disease Control and Prevention, case data on eight common respiratory infectious diseases nationwide from 2015 to 2024 were collected and organized. These diseases include measles, pulmonary tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps, and rubella. Descriptive statistical methods were adopted to analyze the distribution characteristics of respiratory infectious diseases, and to calculate the annual percent change and the seasonal index. Results From 2015 to 2024, the average annual reported incidence rate of common respiratory infectious diseases in China was 293.52/100 000, and the reported incidence rate showed an upward trend (average annual percent change, AAPC=30.16%, 95%CI: 12.49%-50.60%). The top five diseases in terms of reported incidence rate among respiratory infectious diseases were influenza (220.34/100 000), pulmonary tuberculosis (51.56/100 000), mumps (12.24/100 000), pertussis (4.63/100 000), and scarlet fever (3.74/100 000). The reported incidence rates of measles, pulmonary tuberculosis, and mumps showed a downward trend (P<0.05), while the reported incidence rates of pertussis and influenza showed an upward trend (P<0.05); the incidence of meningococcal meningitis, scarlet fever, and rubella showed no significant trend over the years (P>0.05). The reported incidence rate of respiratory infectious diseases was higher in males than in females (P<0.001). Among all age groups, the 0-5 age group (1 096.68/100 000) had the highest average annual reported incidence rate, followed by the 6-19 age group (599.86/100 000), while the 20-59 age group (149. 49/100 000) had the lowest. The peak season for respiratory infectious diseases was from December to April of the following year, with January being the incidence peak. The reported incidence rate of respiratory infectious diseases was higher in southern provinces (361.82/100 000) than in northern provinces (197.29/100 000), and higher in coastal provinces (311.17/100 000) than in inland provinces (279.54/100 000), with statistically significant differences (P<0.001). Conclusions From 2015 to 2024, the overall reported incidence rate of common respiratory infectious diseases in China exhibited an increasing trend, with variations in high-risk populations and peak seasons across different diseases. Targeted prevention and control measures should be implemented for key populations during the annual high-incidence season of different respiratory infectious diseases so as to effectively curb the transmission and spread of diseases.

Objective To analyze the molecular characteristics of Bordetella pertussis (Bp) in Sichuan Province from 2022 to 2024, explore the causes of pertussis outbreaks in Sichuan Province in recent years, and provide a scientific basis for epidemic prevention and control, clinical treatment, and vaccine research. Methods Genome extraction was performed on 17 strains of bacteria collected from sentinel hospitals of the Pathogen Identification Network in Chengdu, Neijiang, Deyang, and Ziyang in Sichuan Province from 2022 to 2024. Whole-genome sequencing was conducted using the Illumina second-generation sequencing platform PE150. The data were assembled and concatenated for multilocus sequence typing (MLST) analysis, 23S rRNA and ptxP3 gene mutation site analysis, multilocus antigen sequence typing (MAST) analysis, prn and autotransporter gene typing analysis, and whole-genome single nucleotide polymorphism (wg-SNP) analysis. Results All 17 strains were ST-2 type and belonged to the ST-2 complex clone group. And all the type of 23S rRNA gene was 23S rRNA-13 and harbored the A2047G mutation. All MAST types of Bordetella pertussis belong to BPagST-4. The predominant MAST type was ptxP-3/ptxA-1/ptxB-1/ptxC-4/ptxD-1/ptxE-4/fhaB-2/fim2-1/fim3-1 (76.47%), the second MAST type was ptxP-3/ptxA-1/ptxB-1/ptxC-4/ptxD-1/ptxE-4/fhaB-deficient/fim2-1/fim3-1 (23.53%). The prn genotype was mainly prn150 type(88.24%), with the remaining being prn-deficient (11.76%). The autotransporter genotype was bapC1, brkA1, vag8-4, and tcfA2. The results of phylogenetic analysis demonstrated that all the strains were highly homologous, with a homology of up to 94.00%, and belonged to different evolutionary branches from the vaccine strains. Conclusions From 2022 to 2024, the predominant antigen genotype of Bordetella pertussis in Sichuan Province carried the antigen genotype ptxP-3/ptxA-1/ptxB-1/ptxC-4/ptxD-1/ptxE-4/fhaB-2/fim2-1/fim3-1, the prn genotype prn150, and the A2047G mutation. Continuous monitoring should be strengthened in the future.

Objective To evaluate the application of the modified pre-moistened wipe sampling and enrichment method in the surveillance of environmental surface respiratory pathogens, analyze the correlation and temporal relationship between environmental SARS-CoV-2 concentrations and the number of clinical influenza-like illness (ILI） cases, assess the feasibility of this technology in infectious disease early warning, and provide evidence for improving the integrated environment-clinical surveillance system. Methods From October 2024 to September 2025, eight community public venues and two hospitals in Longgang District, Shenzhen were selected as monitoring sites. Environmental surface samples were collected using a pre-moistened electrostatic wipe sampling method combined with polyethylene glycol (PEG） precipitation-enrichment method, and 23 types of respiratory pathogens were detected by real-time fluorescent PCR. Throat swab samples of ILI cases from sentinel hospitals in the same period were collected for SARS-CoV-2 nucleic acid detection. The χ² test and Spearman rank correlation were used to analyze the characteristics of pathogen distribution, and Kendall’s tau and time-lag cross-correlation were used to analyze the correlation between environmental and clinical surveillance data. Results A total of 144 environmental surface samples were collected throughout the year, with 22 types of respiratory pathogens detected, and the total positive rate was 94.44% (136/144）. The maximum number of pathogens detected in a single sample was 16. The pathogen detection rate in medical institutions was higher than that in community public places, and the pathogen detection rate in population-intensive community places was higher than that in low population density places. Some pathogens showed seasonal epidemic characteristics: SARS-CoV-2 prevailed in spring and summer, coronavirus OC43 concentrated in autumn and winter, and human metapneumovirus and respiratory syncytial virus were only detected in winter and spring. Spearman rank correlation analysis showed that the cycle threshold (Ct） values of four pathogens (Streptococcus pneumoniae, adenovirus, human bocavirus, and SARS-CoV-2） were negatively correlated with the site detection rates, among which the correlations of Streptococcus pneumoniae (r_s=-0.78, P=0.005） and adenovirus (r_s=-0.69, P=0.021） were the most significant. Kendall's tau analysis showed that the concentration of SARS-CoV-2 N gene in the environment was moderately positively correlated with the number of clinical SARS-CoV-2 cases among ILI patients (correlation coefficient=0.412, Z=2.687, P=0.007<0.05）. Time-lagged cross-correlation analysis revealed that changes in SARS-CoV-2 concentration in environmental samples preceded the increase in clinical cases by approximately two weeks. Conclusions The modified pre-moistened electrostatic wipe sampling combined with PEG precipitation-enrichment method is a relatively reliable technology for large-area surveillance of respiratory pathogens on environmental surfaces. It can effectively capture the characteristics of pathogen distribution and seasonal variation, has clinical early-warning value, and can serve as an important supplement to the traditional clinical surveillance system.

Objective This study aims to isolate viruses and conduct whole-genome sequencing analysis from human H9N2 infection cases and concurrent environmental positive samples in Shiyan City in 2024, and evaluate the cross-species transmission risk of the virus, to provide evidence for local prevention and control. Methods Whole-genome next-generation sequencing was carried out on one human-derived strain and four environmental strains from Shiyan City in 2024. Phylogenetic analysis, homology analysis, key amino acid mutation analysis of the HA/NA genes, as well as temporal divergence and population dynamics analysis of the HA gene were conducted. Results All five strains belonged to the H9N2 lineage Beijing/1/94. The nucleotide and amino acid homologies of the HA gene were 98.25%-99.87% and 99.03%-100.00%, respectively; the nucleotide and amino acid homologies for the NA gene of the three strains were 99.57%-99.93% and 99.57%-100%, respectively. The time to the most recent common ancestor (TMRCA) was 1 982.74 years of the HA gene of 201 H9N2 strains epidemic in China from 2020 to 2025, with an evolutionary rate of 4.110×10^-3 (95%CI: 3.695×10^-3-4.537×10^-3) substitutions/(site·year); the divergence time of the HA gene of the current strains was 2 021.61 years. Population dynamics analysis revealed a stable population size remained from 1982 to 2015, followed by a gradual increase after 2015, an explosive growth in 2022, a peak in 2023, and a rapid decline thereafter. The HA cleavage site motif was PSRSSR↓GLF in all strains (characteristic of low-pathogenicity). Mutations in the receptor-binding domain included S158N/D, S/F/A160N, H183N, E190V, Q226L, and Q227M. Compared with classic reference strains, the 105NGT and 218NRT sites were deleted, while a new 313NCS site was added, resulting in a total of seven conserved potential N-glycosylation sites. Three strains showed a deletion of TEI at positions 63-65 in the NA protein stalk, and mutations K368N and D369S in the erythrocyte-binding site; no mutations were found at neuraminidase inhibitor (oseltamivir and zanamivir) resistance sites. Conclusions This human infection originated from exposure in live poultry markets, and the epidemic strains have acquired key mutations that enhance human-type receptor binding ability, showing significant genetic evolution. It is recommended to strengthen routine surveillance and disinfection of live poultry markets, continuously conduct whole-genome monitoring of human and environmental strains, closely track mutations and drug resistance dynamics, and provide timely early warnings

The role of antiviral therapy in influenza now extends beyond shortening symptom duration to the early identification of high-risk patients, reduction of the risk of disease progression, antiviral resistance surveillance, and mitigation of transmission risk. Recent guidelines, randomized controlled trials, systematic reviews, and antiviral susceptibility surveillance indicate that neuraminidase inhibitors remain the mainstay of treatment. Cap-dependent endonuclease inhibitors targeting the polymerase acidic protein can be used for the early treatment of non-severe influenza and for post-exposure prophylaxis; however, the overall benefit of their routine combination with neuraminidase inhibitors in hospitalized patients with severe influenza and special populations has not been established. The detection of resistance-associated substitutions alone should not be regarded as evidence of treatment failure or as an indication to switch therapy. Such findings should be interpreted together with viral load, duration of viral shedding, immune status, clinical progression, and transmission risk. Influenza treatment should move beyond comparisons between drug classes toward dynamic management guided by virological feedback. Rapid testing and risk stratification should inform treatment initiation, whereas virological reassessment and resistance monitoring should guide treatment duration and regimen adjustment, with public health measures implemented when warranted.

Objective To investigate of resistance phenotypes and mutations in kdr and ace-1 genes in wild populations of Aedes albopictus to different insecticides in Jinghong City, and we will provide theoretical support for the scientific control of dengue vectors aedes. Methods From July to August 2025, larvae of wild populations of Ae.albopictus were collected and raised in the urban area of Jinghong City. After determining their resistance levels to four insecticides using the adult mosquito filter paper contact tube method, the mutations of kdr and ace-1 genes were detected through direct sequencing. Results Adult Ae.albopictus mosquitoes from Jinghong have developed varying degrees of resistance to permethrin and deltamethrin, but remained sensitive to propoxur and malathion. A total of 174 sequences were obtained at locus 1016: two alleles were identified, the wild-type GTA/V (valine) and the mutant type GGA/G (glycine), with frequencies of 74.71% and 25.29%, respectively; three genotypes were found, the wild-type homozygote V/V, the wild-type/mutant heterozygote V/G, and the mutant homozygote G/G, with frequencies of 64.37%, 20.69%, and 14.94%, respectively. A total of 174 sequences were obtained at locus 1532: two alleles were identified, the wild-type ATC/I (isoleucine) and the mutant type ACC/T (threonine), with frequencies of 99.14% and 0.86%, respectively; two genotypes were found, the wild-type homozygote I/I and the wild-type/mutant heterozygote I/T, with frequencies of 98.28% and 1.72%, respectively. A total of 174 sequences were obtained at locus 1534: 4 alleles were identified, wild-type TTC/F (phenylalanine), mutant type TGC/C (cysteine), mutant type TCC/S (serine), and mutant type TTG/L (leucine), with frequencies of 20.98%, 18.10%, 59.20%, and 1.72%, respectively; 7 genotypes were identified, wild-type homozygote F/F, wild-type/mutant heterozygote F/S, F/L, mutant heterozygote C/S, mutant homozygote L/L, C/C, and S/S, with frequencies of 5.17%, 30.46%, 1.15%, 6.32%, 1.15%, 14.94%, and 40.80%, respectively. A total of 6 types of combined mutations were identified, among which two types (V1016G + F1534S, G1016 + C1534) of combined mutations account for the higher proportion, with frequencies of 17.24% and 13.79%, respectively. There were no statistically significant differences in the mutation frequencies at loci 1016, 1532, and 1534 between resistant and sensitive phenotypes of permethrin and deltamethrin. A total of 176 sequences were obtained at locus 119, and 2 allelic genotypes were found, both encoding glycine (GGA/G and GGG/G). The wild-type GGA/G had the highest allele genotype frequency of 90.63%. The other synonymous mutation type GGG/G had a lower allele genotype frequency of 9.37%. The three genotypes: frequency of the wild-type homozygous G/G genotype was 85.80%, frequency of the synonymous mutation homozygous G/G genotype was 4.55%, and frequency of the wild/mutant heterozygous G/G (GGA/GGG) genotype was 9.65%. Conclusions Despite the high diversity and frequency of kdr gene mutations, no significant link was established between these mutations and phenotypic resistance. At the locus 119, only a single base mutation was observed, and it did not cause any change in the corresponding amino acid. In the context of severe pyrethroid resistance, the alternate use of carbamates or organophosphates is currently a reasonable and effective strategy choice.

Objective To analyze peripheral blood HIV DNA levels and associated factors among HIV-infected individuals receiving long-term antiretroviral therapy (ART), so as to provide a scientific basis for the effective prevention and control of HIV. Methods A retrospective cohort study was conducted among HIV-infected individuals in Fuyang, Anhui Province, who had received ART for ≥ 10 years. EDTA-anticoagulated peripheral blood samples were collected for CD4⁺T lymphocyte counting, viral load testing, drug resistance genotyping, and HIV DNA quantification. Logistic regression was used to identify factors associated with HIV DNA ≥ 2.00 log10 copies/106 PBMCs. Variables with P<0.20 in univariable analysis were included in a multivariable stepwise logistic regression, and adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were calculated. Results A total of 175 HIV-infected individuals were enrolled. At the endpoint of follow-up, the median duration of ART was 16.71 (P₂₅, P₇₅: 15.64, 17.28) years, and the median CD4⁺T lymphocyte count was 473 (P₂₅, P₇₅: 326, 659) cells/μL. A total of 9.1% (16/175) of participants had a viral load ≥ 50 copies/mL, and 5.2% (9/173) presented drug resistance. The median HIV DNA level among subjects was 2.46 (P₂₅, P₇₅: 2.12, 2.70) log₁₀ copies/10⁶ PBMCs, and 82.9% (145/175) of participants had HIV DNA levels ≥ 2.00 log₁₀ copies/10⁶ PBMCs. Multivariable regression analysis indicated that the factors independently associated with HIV DNA ≥2.00 log₁₀ copies/10⁶ PBMCs included initial ART initiation age of 40 to < 50 years (aOR=4.56, 95%CI: 1.31~15.79), pre-treatment CD4⁺T lymphocyte count ≥350 cells/μL (aOR=0.12, 95%CI: 0.02-0.70), ART regimen switching ≥3 times (aOR=25.26, 95%CI: 2.57-247.91), and a low proportion of sustained viral suppression.(50%-99%: aOR=5.51, 95%CI: 1.19-25.45; <50%: aOR=25.85, 95%CI: 2.98-224.41). Conclusions After long-term ART, HIV DNA levels remained relatively high in individuals living with HIV. HIV DNA levels were significantly associated with baseline CD4⁺T lymphocyte count, viral suppression status during ART, and the number of ART regimen switches, suggesting that strengthening whole-course management and improving medication adherence may represent important strategies for controlling the HIV-1 reservoir. Furthermore, these findings provide essential epidemiological baseline data to support future intervention studies aimed at achieving a functional cure for HIV-1.

Objective To analyze the molecular epidemiological characteristics of 46 Listeria monocytogenes strains isolated from clinical cases and food sources in Hainan Province during 2020-2025; to clarify their antimicrobial resistance, genomic features; and this study will provide data support for surveillance of listeriosis in Hainan Province. Methods A total of 46 L. monocytogenes isolates were included in Hainan Province from 2020 to 2025, comprising 13 isolates from clinical patients, 4 isolates from patients' family members, and 29 foodborne isolates. Whole-genome sequencing was performed for all isolates, and their epidemiological characteristics were systematically analyzed. Bioinformatic methods were used to predict serogroups and sequence types (STs), screen virulence and antimicrobial resistance genes, and conduct single-nucleotide polymorphism analysis to reveal the population structure and molecular epidemiological characteristics of the isolates. Results From 2020 to 2025, a total of 13 listeriosis cases were reported in Hainan Province, with a hospitalization rate of 100% and a fatality rate of 53.85% (7 cases). Patients aged over 60 years accounted for 38.46% (5 cases). The main clinical manifestation was bacteremia/septicemia (61.54%, 8 cases), fever was the most common symptom (92.31%, 12 cases); blood and cerebrospinal fluid were the main clinical specimens. Among all food-borne isolates, poultry meat was the most common source, followed by edible mushrooms and aquatic products. Among the 46 isolates, one foodborne isolate showed dual resistance to tetracycline and erythromycin, one clinical isolate showed intermediate susceptibility to ciprofloxacin, and the remaining isolates were susceptible to all tested antibiotics. Whole-genome analysis showed that 15 isolates belonged to lineage Ⅰ(clinical isolates accounted for 53.33%), while 30 isolates belonged to lineage Ⅱ (food-borne isolates accounted for 70.00%). A total of 19 STs were identified, including one novel ST assigned to clonal complex 7, and these isolates were classified into 15 clonal complexes. Serogroup Ⅱa was predominant, accounting for 54.35%(25 strains). All isolates carried LIPI-1; 6 carried LIPI-3, 6 carried LIPI-4, 27 carried SSI-1, and 5 carried SSI-2. Two ST87 isolates carried the antimicrobial resistance genes msrD, mefA, and tetM. ST8 and ST87 were the predominant sequence types. SNP analysis showed no SNP differences among four isolates from maternal-neonatal vertically transmitted infection cases. Only 3 SNPs differed between one ST8 clinical isolate and one ST8 foodborne isolate, and only 1 SNP differed between one ST87 clinical isolate and one ST87 foodborne isolate from the same year, indicating high genetic relatedness, although direct epidemiological contact evidence was lacking. Conclusions Although the number of reported listeriosis cases was limited in Hainan Province, the fatality rate was high, and the proportion of patients aged over 60 years was notable. Poultry meat had the higher contamination rate. ST8 and ST87 were the predominant sequence types in food-borne and clinical isolates, respectively. It is suggested that relevant regulatory authorities should strengthen the whole chain monitoring of high-contamination foods such as poultry meat, and health authorities should strengthen the traceability of ST8, ST87 and other key types.

Objective To investigate the prevalence, antimicrobial resistance profiles and genetic characteristics of Staphylococcus aureus (S. aureus) in meat and seafood products in Ningbo region, this study will provide support for local food safety testing and public health protection. Methods From April 20 to August 5, 2025, six supermarkets and eight wet markets were selected as sampling sites in the Ningbo area using convenience sampling. Meat and seafood samples were collected from sampling sites for bacterial isolation and PCR identification. The Kirby-Bauer (K-B) disk diffusion method was applied to determine the antimicrobial resistance of the isolates. Whole genome sequencing (WGS) was performed via next-generation sequencing (NGS) technology to analyze the molecular and genetic characteristics of the isolates. Results A total of 23 strains of Staphylococcus aureus were isolated from 134 samples of fresh meat and seafood, with an overall detection rate of 17.2%. These isolates exhibited resistance to 7 antimicrobial agents, with the highest resistance rate to penicillin at 91.3% (21/23). The detection rates of multidrug-resistant (MDR) strains and methicillin-resistant Staphylococcus aureus (MRSA) were 52.2% (12/23) and 13.0% (3/23), respectively. Hemolysin genes (hlgA/hlgB/hlgC and hla/b) and biofilm formation genes (icaA/icaB/icaC/icaD) were detected in 82.6% of the isolates, while the sea enterotoxin gene was exclusively found in strains belonging to sequence type 6 (ST6). ST3055-T84 was the dominant epidemic clone (21.7%, 5/23). Phylogenetic analysis based on whole-genome sequencing single-nucleotide polymorphisms (WGS-SNP) revealed that, all five ST3055-T84 strains were derived from fresh pork (4 strains) and seafood (1 strain) obtained from different wet markets, suggesting the local epidemic of this clonal group; and the three MRSA strains were isolated from fresh pork samples collected from supermarkets and wet markets, among which 2 strains shared a closer genetic relationship. Conclusions S. aureus strains isolated from meat and seafood exhibit multidrug resistance with a broad resistance spectrum in Ningbo, and carry multiple virulence genes. The isolation of MRSA strains in these food samples poses a potential threat to public health. Therefore, it is necessary to strengthen surveillance of S. aureus, particularly MRSA strains in this region.

Objective Using quantitative nucleic acid testing for Mycobacterium tuberculosis as an effective tool for screening tuberculosis infection, this study examines factors affecting the positive detection rate in suspected TB patients, and evaluates inadequacies in detection efficiency and patient numbers for pulmonary tuberculosis(PTB) and extra-pulmonary tuberculosis (EPTB). It also assesses the impact of these factors on developing in vitro diagnostic (IVD) products. Methods The detection outcomes of the tuberculosis molecular diagnosis initiative in "Quantitative Nucleic Acid Detection for Mycobacterium tuberculosis (TB-PCR)" were systematically analyzed at a hospital from January 2018 to October 2022. The study compared variations in the positive detection rates influenced by four factors: sample type (respiratory vs. non-respiratory sources), test frequency (once, twice, and three times or more), statistical method (initial laboratory tests vs. all laboratory tests), and severity of illness (outpatients, general inpatients, and intensive care unit patients). Additionally, the study examined the differences in distribution of copy numbers and its associated trends of target gene IS6110. Results A total of 8 441 patients with respiratory tract origins and 2 211 patients with non-respiratory tract origins were included in the study. Among outpatients, general inpatients, and intensive care unit patients, the positive detection rate for samples originating from the respiratory tract was significantly higher than that from non-respiratory tract origins（χ²=166.175，P<0.001；χ²=52.026，P<0.001；χ²=82.421，P<0.001）. The number of patients with testing frequencies of 1, 2, and 3 or more were 6 563, 1 401, and 477, respectively. The positive detection rates of the three "test frequency types" demonstrated statistical significance exclusively among outpatients and general inpatients（χ²=48.897，P<0.001；χ²=23.935，P<0.001）. However, no statistical significance was observed among intensive care unit patients (χ²=5.384，P=0.068). A total of 8 441 patients were included in the analysis of initial laboratory test and all laboratory test. Among the three types of patients, there was no statistically significant difference in positive detection rates between the two statistical methods （χ²=2.054，P=0.152；χ²=2.086，P=0.149；χ²=2.668，P=0.102）；Among the samples from respiratory tract and non-respiratory tract, there were 3 752 cases and 1 393 cases, 3 242 cases and 464 cases, 1 447 cases and 35 cases among the three types of patients, respectively. Under fixed conditions (test frequency or statistical method), the positive detection rates were statistically significant of the three types of patients (χ²=307.882，P<0.001；χ²=28.679，P<0.001；χ²=26.574，P<0.001；χ²=325.894，P<0.001；χ²=37.571，P<0.001；χ²=103.216，P<0.001）; The copy number of IS6110 in the patients exhibited a statistically significant upward trend correlating with the deterioration of their condition (J-T value=6.795, P<0.001). Conclusions The positive detection rate can be influenced by three factors: sample type, testing frequency, and disease severity; The detection rate and sensitivity of EPTB are significantly lower than those of PTB, there is an urgent need for the development of more advanced testing methods. Outpatients and general inpatients should undergo testing a minimum of two to three times, however, there is an observed issue of inadequate testing among patients. Increasing the testing frequency is crucial for individuals suspected of tuberculosis; The influence of sample type and illness severity on the positive detection rate holds substantial significance for guiding the research and development of IVD products.

Objective To investigate the impact of bacteriologically positive pulmonary tuberculosis (BPTB) complicated with diabetes mellitus (DM) on immune T cells, evaluate the interaction of the two coexisting diseases, and provide epidemiological clues and clinical evidence for elucidating the underlying mechanisms of BPTB complicated with DM. Methods The clinical data of 1 082 pulmonary tuberculosis patients admitted to the Sixth People's Hospital of Zhengzhou from January 1, 2023, to December 25, 2024, were retrospectively selected by cluster sampling. Based on tuberculosis etiology results and diabetes status, patients were assigned to 4 groups: bacteriologically negative pulmonary tuberculosis (BNTB), BNTB with DM, BPTB, and BPTB with DM. The absolute levels of T lymphocyte subsets in each group were detected, and inter-group differences were compared. A linear regression model was established to analyze the comorbidity interaction of BPTB and DM, identify its action direction, and quantify the effect size. Results There were statistically significant inter-group differences in total T cells (F=7.463, P<0.001), helper T cells (F=4.934, P=0.002), and suppressor T cells (F=5.407, P=0.001) among tuberculosis patients. BPTB with DM group exhibited markedly lower levels of total T cells, helper T cells, and suppressor T cells than the other three groups, with statistically significant differences(P<0.05). No significant difference in T cells counts was found among the BNTB, BPTB, and BNTB with DM groups. General linear regression analysis revealed that Mycobacterium tuberculosis positivity and DM exerted a combined negative predictive effect on total T cells levels (B=-157.522, P<0.05). Similar trends were observed for helper T cells (B=-72.106, P=0.053) and suppressor T cells (B=-65.603, P<0.05). Conclusions The comorbidity of BPTB and DM substantially reduces immune T cells counts, and the combined immunosuppressive effect of the two diseases is several times greater than that of either single condition alone. This may partly explain the difficulty in achieving cure and the high recurrence rate of pulmonary tuberculosis in patients with concurrent DM.

Objective To explore the factors influencing mortality outcomes of pulmonary tuberculosis patients complicated with malignant tumors in Nanjing, and this study will provide the basis for early comorbidity screening of pulmonary tuberculosis and malignant tumors. Methods Through the "Tuberculosis Information Management System", tuberculosis patients diagnosed and registered whose cases have been concluded were exported in Nanjing from January 2016 to December 2025. The classification and diagnosis of tuberculosis shall be defined according to the relevant standards. A case-control study was conducted, patients with tuberculosis complicated with malignant tumors were regarded as the case group, and tuberculosis patients registered and diagnosed during the same period were randomly matched with the case group at a ratio of 1:4 based on age and gender. Logistic regression model was used to analyze baseline data, clinical data and the influencing factors of tuberculosis complicated with malignant tumors, and to predict mortality outcomes for patients with tuberculosis complicated with malignant tumors. Results A total of 340 patients were included in this study, with 270 males (79.41%) and 70 females (20.59%). Of these, 185 (54.41%) patients sought direct medical consultation, while 155 (45.59%) were referred, tracked, or from other sources. Multivariate logistic stepwise regression analysis showed that the source of patients being non-direct referral (OR=2.27, 95%CI: 1.30-3.95) was an independent risk factor for tuberculosis complicated with malignant tumors. Compared with other treatments, standard short-course regimens of 2HRZE/4HR (OR=0.36, 95%CI: 0.18-0.72) and long-term regimens (OR=0.31, 95%CI: 0.14-0.69) were protective factors for tuberculosis complicated with malignant tumors. Whereas increasing age (OR=1.08, 95%CI: 1.02-1.14) and occupation types of farmers and workers (OR=4.78, 95%CI: 1.55-14.67) increased the risk of mortality in patients with tuberculosis complicated with malignant tumors. Conclusions Indirect referral pathways may lead to missed or delayed diagnosis of tuberculosis complicated with malignant tumors, highlighting the need to optimize referral and screening processes. Standardized regimens can significantly improve outcomes. It is urgently necessary to strengthen the prevention and control of tuberculosis among populations such as the elderly and rural workers, and to carry out early screening for co-diseases of tuberculosis and malignant tumors.

Objective To analyze the genetic evolution and molecular characteristics of whole genome sequences of dengue virus type 1 (DENV-1) detected in Changsha from 2019 to 2025, and this study will provide a scientific basis for dengue prevention and control. Methods DENV-1 positive specimens from confirmed dengue cases detected were screened for whole genome sequencing in Changsha during 2019 and 2025. Based on the obtained whole genome sequences, a series of bioinformatics analyses were performed sequentially, including sequence homology alignment, calculation of nucleotide and amino acid variation rates of each gene segment, phylogenetic tree construction, and screening of amino acid mutation sites. Results A total of 51 whole genome sequences of DENV-1 were obtained in this study, with genome coverage ranging from 98.29% to 99.20%. Phylogenetic analysis revealed that all the strains belonged to genotype I: Specifically, 45 strains in 2025 clustered together with 3 strains in 2023 belonged to the clade K.1; one strain in 2024 and another strain in 2025 belonged to the clade K.2; the strain in 2019 belonged to the clade E.1. Statistical analysis of gene variation showed that there was no significant differences in the nucleotide and amino acid variation rates among different gene segments. Amino acid mutation analysis demonstrated that all strains carried mutations V324I and V380I in the E protein, accompanied by multiple virulence-associated substitutions. Two strains harbored the N293S mutation in the NS1 protein, while the core functional domains of non-structural proteins remained highly conserved in most other strains. Conclusions All DENV-1 strains isolated in Changsha from 2019 to 2025 belonged to Genotype I, and the evolutionary clades showed diversified characteristics. Multiple variations were observed in key amino acid sites and functional domains. These findings suggest that continuous case surveillance and early warning should be strengthened to prevent local transmission.

Objective To investigate the distribution characteristics and potential clinical value of QFT-Plus antigen-stimulated CD8⁺T lymphocyte responses in different states of tuberculosis, this study will provide a new auxiliary basis for early differentiation, disease severity assessment, and immune monitoring of tuberculosis. Methods The clinical data of 3 624 patients after QFT-Plus test who were admitted to the Third People's Hospital of Shenzhen in 2023 were retrospectively analyzed, including 925 patients diagnosed with active tuberculosis (ATB) through culture, 1 425 latent tuberculosis infections (LTBI), and 1 274 healthy controls. The differences of TB1-Nil, TB2-Nil, and TB2-TB1 were compared among the three groups. Patients diagnosed with ATB were reclassified into low, moderate, and high bacterial load groups based on their sputum smear results. The positive rate of QFT-Plus was compared across these different bacterial load groups. Additionally, differences in the distribution of TB1-Nil, TB2-Nil, TB2-TB1, as well as CD4⁺ T and CD8⁺ T lymphocytes were analyzed among the groups, and their correlations were examined. Results QFT-Plus TB2-TB1 was higher in the ATB patients [0.260(0, 1.000) IU/mL] than that of the LTBI group [0.190 (-0.030, 0.670) IU/mL] and control group [0 (-0.010, 0.010) IU/mL], with statistically significant differences（Z=4.903，P=0.027）. The positive rate of QFT-Plus in the high bacterial load group (94.850%) was higher than that in the low bacterial load group (81.490%) and the medium bacterial load group (82.610%), with a statistically significant difference (χ²=14.713, P<0.001). There was a statistically significant difference in TB2-TB1 among different bacterial load groups (H=12.685, P=0.002). TB2-TB1 was positively correlated with the bacterial load of Mycobacterium tuberculosis (MTB) (r=0.117, P<0.001), and the proportion of CD8⁺ T lymphocytes among total lymphocytes (r=0.088, P=0.029). Conclusions QFT-Plus specific CD8⁺ T lymphocyte response（TB2-TB1） not only can distinguish ATB and LTBI, but also provides certain clinical reference value for monitoring the progress of tuberculosis and indicating the severity of the disease.

Objective To construct an early treatment network for heat stroke based on cooling time window management, aiming to improve early treatment efficiency and reduce the incidence of severe heat stroke and patient mortality. Methods A systematic analysis of relevant domestic and international literature was conducted. Integrating the military's practical experience in heat stroke prevention and treatment, and taking inspiration from the successful standardized time-management model of chest pain centers [e.g., the "door-to-balloon time" (D2B) for acute myocardial infarction], an early treatment system for heat stroke was built by consolidating four core components: on-site management, pre-hospital emergency care, in-hospital treatment, and quality control evaluation. Results The key time-effectiveness indicator, "Cooling to Target Temperature Time" (C2T), was innovatively proposed for heat stroke management. Five key implementation pathways were established around the C2T metric: implementing an early cooling time window management plan centered on the "golden 30 minutes"; optimizing the treatment chain to ensure seamless among on-site self-rescue and mutual rescue, pre-hospital emergency care, and in-hospital treatment, while strictly adhering to the "cool first, transport second" principle; establishing standardized heat stroke treatment units equipped with rapid cooling devices and core body temperature monitoring systems; constructing a hierarchical and collaborative regional treatment network to form a closed-loop management mechanism; and developing a quality evaluation standard system covering the three dimensions of process, structure, and outcome. Through the implementation of this system, the goals of rapid identification and rapid cooling can be achieved, and meeting the C2T standard can significantly reduce mortality and the risk of multiple organ damage. Conclusions The early treatment system for heat stroke, grounded in cooling time window management and incorporating the C2T indicator, optimized treatment processes, standardized units, and a collaborative network, can significantly enhance cooling efficiency and treatment success rates, thereby effectively improving patient prognosis. This system provides a vital theoretical foundation and practical framework for safeguarding the health of high-temperature environment workers. Future efforts should prioritize continuous development in equipment innovation, public education, and big data applications.

Objective To analyze the epidemiological characteristics of the first confirmed case of mpox virus Ⅰb in Changzhou City, Jiangsu Province, this study summarizes the findings and disposal process, trace the source of infection, and provide scientific evidence for prevention and control of mpox. Methods An epidemiological investigation of mpox virus Ⅰb confirmed case was conducted in Changzhou city, Jiangsu Province on August 9, 2025. Clinical samples from the case and close contacts, such as oropharyngeal swab, rash smear and serum, and the relevant environment were taken for the detection of nucleic acid of mpox virus by real-time RT-PCR. Results The case had a high-risk exposure history to an imported case from Tanzania in Zhejiang Province on July 28, 2025. On August 2, the case had a fever with a peak temperature of 39 ℃. On August 4, pustular rashes was developed on the genital and surrounding skin, accompanied by itching and pain. On August 9, mpox virus Ⅰb nucleic acid was detected in throat swab, rash smear and serum specimen, and the case was diagnosed with mpox. None of the 17 close contacts have developed related symptoms, and all oropharyngeal swabs and serum were tested negative. A total of 30 environmental samples were collected (17 from the hotel room, 8 from the clinic, and 5 from the car). In these samples, 13 tested positive for the mpox virus (12 from the hotel room, 1 from the car), while the other 17 tested negative. Conclusions This was the first confirmed infection case of mpox virus Ⅰb in Jiangsu Province, which was imported from another province. The characteristics of short incubation period and heterosexual transmission suggest that it is necessary to refine the clinical management protocols and optimize the prevention and control strategies for mpox.

Multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) remains a major challenge for global TB control, with suboptimal overall treatment outcomes due to factors such as prolonged therapy duration, limited drug options, unsatisfactory efficacy, and frequent adverse drug reactions. This study retrospectively analyzes the diagnosis and treatment of a patient with MDR pulmonary tuberculosis complicated by tracheobronchial tuberculosis. Under circumstances of restricted drug options, the clinical efficacy and safety of extending the delamanid regimen were evaluated. In this case, the delamanid regimen was extended to 78 weeks, combined with bronchoscopic balloon dilatation. No obvious adverse drug reactions occurred during the entire treatment course, and a favorable treatment outcome was ultimately achieved. Based on the summary of clinical data analysis and literature review results, extending the delamanid regimen can serve as a feasible therapeutic option when choices for drug-resistant tuberculosis chemotherapy are limited. Although extended use beyond conventional duration will increase the risk of moderate ECG QTc interval prolongation, its serious cardiac risks are controllable under close monitoring. The therapeutic exploration of this case provides important experience for the clinical diagnosis and treatment of multidrug-resistant tuberculosis complicated by tracheobronchial tuberculosis.