Objective To analyze the epidemiological characteristics, spatiotemporal distribution patterns, and risk factors for local transmission of chikungunya cases in Shenzhen City in 2025, providing scientific evidence for precise prevention and control of mosquito-borne diseases in megacities. Methods Analyzed the sociodemographic and spatiotemporal distribution of cases; used Spearman's cross-correlation and negative binomial regression to examine the lagged association between incidence and population inflow.Global and local spatial autocorrelation analyses together with hotspot shift analysis were conducted to explore street-level spatial clustering and evolutionary characteristics. Logistic regression models were used to identify risk factors for local transmission of imported cases. Results In 2025, a total of 818 chikungunya fever cases were reported in Shenzhen, comprising 313 imported cases and 505 locally acquired cases.Imported cases were mainly from Foshan and Guangzhou in Guangdong Province (125 cases, accounting for 39.94%), and Guangxi Zhuang Autonomous Region was the predominant source outside Guangdong Province (59 cases, 18.85%).The male-to-female ratio was 1:0.6, with cases predominantly occurring among working-age adults aged 20-49 years (65.6%). By occupation, workers accounted for 28.1% of all cases.The cases occurred from July to December, with an epidemic curve showing a unimodal distribution. The peak of onset was observed on October 11 (54 cases, accounting for 6.6% of the total).The incidence of chikungunya fever in Shenzhen showed a 6-day lagged association with population inflow (Spearman r=0.164, P=0.0387). For every 10,000 increase in population inflow, the daily number of cases after 6 days increased by 4.2% (IRR=1.042, 95%CI: 1.026-1.060).Cases exhibited significant spatial clustering. The global Moran's I value was 0.3329 (Z = 4.94, P < 0.001) for imported cases and 0.2534 (Z = 3.59, P < 0.001) for locally acquired cases, respectively.Over time, the epidemic hotspots in the city shifted from the peripheral areas toward the central urban area. Residence in urban villages was an independent risk factor for local transmission (OR=4.472, 95%CI: 1.928–11.739), while arthralgia symptoms (OR=0.459, 95%CI: 0.224–0.940)and self-medication (OR = 0.26, 95% CI: 0.04-0.93, likelihood ratio test P=0.037) were protective factors. Conclusion The chikungunya fever epidemic in Shenzhen was driven by population inflow from the Pearl River Delta region, forming high-risk clusters in central urban areas. Residence in urban villages significantly increases the risk of local transmission and should be prioritized for prevention and control. Arthralgia and self-medication reduce transmission, but mild cases pose a higher occult risk, necessitating enhanced health education and surveillance. It is recommended to establish cross-regional collaborative surveillance, focus on vector control in urban villages, and strictly implement mosquito bite prevention and isolation measures for mild cases.

Abstract: Objective　To establish a rapid and efficient liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for screening and quantitative analysis of 12 target compounds in biological samples from patients suspected of anticoagulant rodenticide poisoning. Methods    A total of 100 μL serum or urine samples were directly extracted using a mixture of methanol and acetonitrile. The separation was performed on an Atlantis T3 column (150 × 2.1 mm, 3 μm) with a gradient elution using ammonium acetate solution (5 mM) and acetonitrile. Mass spectrometry analysis was conducted in the negative electrospray ionization mode with multiple reaction monitoring (MRM). The method was comprehensively validated for linearity, sensitivity, accuracy, and precision, and it was applied to the clinical detection of a critically ill patient in late pregnancy. Results    Method validation demonstrated good linearity (r≥0.997) for all 12 anticoagulant rodenticides within a range of 0-400 μg/L. The limits of detection (LOD) and quantification (LOQ) were 0.1-0.5 μg/L and 0.3-1.7 μg/L, respectively. Spiked recoveries for blood and urine samples were 79%-129% and 67%-118%, respectively, with relative standard deviations (RSDs) below 11%, indicating satisfactory accuracy and precision. When applied to clinical cases, the method rapidly detected a concentration of warfarin as high as 1 664 μg/L in the mother's serum and 360 μg/L in the newborn's serum. The maternal-neonatal serum concentration ratio and their respective blood-urine distribution ratios were consistent with the pharmacokinetic characteristics of warfarin. Conclusion    The developed LC-MS/MS method features minimal sample volume, simple pretreatment, fast analysis, high sensitivity, and good accuracy, making it suitable for emergency toxicological screening. The detection of high warfarin concentrations in both maternal and neonatal serum, alongside clinical symptoms and coagulation tests, confirmed warfarin poisoning. This method proved effective for rapid diagnosis and therapeutic monitoring, providing reliable technical support for clinical management and emergency responses to anticoagulant rodenticide poisoning.

Abstract: Objective   To analyze the characteristics of viral load variations and their influencing factors among patients during the chikungunya fever outbreak in Guangdong Province in 2025, providing a scientific basis for precise assessment and the formulation of intervention and management measures. Methods  Data of Chikungunya fever cases in Guangdong Province from July 18 to November 5, 2025, were extracted from the China Disease Control and Prevention Information System and the Guangdong  Provincial Field Epidemiological Investigation System. The cycle threshold (Ct value) obtained from real-time fluorescence quantitative RT-PCR testing of chikungunya virus nucleic acid in case samples was analyzed to examine its variation characteristics over the course of the disease and the influencing factors. Results   A total of 4 409 patients were included in the analysis, with an average age of 39.41±19.98 years and an average Ct value of 25.06±5.52. The distribution of Ct values showed an inverted U-shaped pattern across different age groups. In the multivariate analysis, elderly individuals (≥65 years) had lower Ct values than those aged 18–64 years, and the difference was statistically significant (P<0.001). Children (<6 years) also had lower Ct values compared with the 18–64 age group, but the difference was not statistically significant (P=0.093). Ct values gradually increased over time after disease onset, with a more gradual increasing trend in elderly and pediatric populations. Multivariate regression analysis indicated that elderly patients (≥65 years) had lower Ct values (β = -3.21, 95% CI: -3.68 to -2.73), while those from the eastern Guangdong (β = 0.82, 95% CI: 0.37 to 1.28) and those with a longer interval from disease onset to detection (β = 1.14, 95% CI: 1.05 to 1.24) had higher Ct values. After adjusting for basic characteristics, fever (β = -3.06, 95% CI: -4.09 to -2.04) and arthralgia (β = -2.64, 95% CI: -3.60 to -1.69) were associated with lower Ct values, while rash (β = 1.60, 95% CI: 0.78 to 2.41) was associated with higher Ct values. Conclusion   The viral load of Chikungunya patients in Guangdong Province in 2025 varied across different disease courses, age groups, and symptomatic populations, which can be integrated into infection risk assessments. Special attention should be given to elderly and pediatric patients, and timely intervention should be provided for patients presenting with fever and arthralgia.

Abstract: Objective    To evaluate the diagnostic value of nanopore targeted next-generation sequencing (tNGS) of tissue specimens combined with pathological testing for paucibacillary tuberculosis. Methods    A total of 81 patients with suspected tuberculosis were enrolled. Using the final definitive diagnosis as the standard, the positive rates of tNGS, pathology, GeneXpert, TB-DNA, Mycobacterium tuberculosis culture, and acid-fast staining were compared; the diagnostic efficacies of tNGS, histopathology, and the combined detection were evaluated. Results    Among the 81 cases, 67 were ultimately confirmed as active tuberculosis. Based on definitive diagnosis and regarding two categories of tuberculosis pathological diagnosis as positive indicators, the positive rates of tNGS, pathology, GeneXpert, TB-DNA, Mycobacterium tuberculosis culture, and acid-fast staining were 85.07%, 70.15%, 36.67%, 21.88%, 8.89%, and 7.14%, respectively. The differences between tNGS and other methods were statistically significant (P<0.05). The combination of tNGS and pathology showed a higher diagnostic value compared to individual methods, with an area under the curve of 0.899, sensitivity of 94.03%, specificity of 85.71%, and Kappa value of 0.755. An increase in tNGS read count was significantly associated with a higher proportion of tuberculosis diagnoses, and the final diagnostic composition varied significantly across different read count ranges (χ⊃2;=22.352, P=0.0004). As the number of detected Mycobacterium tuberculosis sequences increased in the pathological tissues, the proportions of necrotic lesions and hyperplasia gradually rose; necrotic changes were most prominent in the group with sequence reads ≥10 000 reads, showing statistically significant differences (χ⊃2;=15.338, P=0.009 0). Conclusion    When detecting Mycobacterium tuberculosis in tissue lesions, tNGS demonstrates higher sensitivity than traditional methods. The combination of tNGS and pathology exhibits superior diagnostic efficacy. The read count of tNGS serves as a promising trend indicator for supporting tuberculosis diagnosis.

Abstract: Objective    To establish a universal real-time reverse transcription polymerase chain reaction (RT-PCR) method for rapid and specific detection of all lineages of the Chikungunya virus (CHIKV). Methods    Specific primers and  TaqMan probes were designed and synthesized targeting the major CHIKV lineages, including the Asian genotype, the East-Central-South African (ECSA) genotype—Central African clade, the ECSA genotype—Indian Ocean lineage, and the West African genotype. A real-time RT-PCR detection system was subsequently established. The specificity, repeatability, reproducibility, and limit of detection (LOD) of the method were systematically evaluated and validated. Finally, the developed assay was applied to clinical samples for validation. Results    A pan-lineage real-time RT-PCR assay for CHIKV detection was successfully developed. The sensitivity of the assay reached 200 copies/mL for all three major CHIKV lineages. The coefficients of variation (CVs) for repeatability were 1.51%, 0.95%, 0.97%, and 0.69%, and those for reproducibility were 0.76%, 1.57%, 1.07%, and 1.08%, demonstrating excellent repeatability and reproducibility. Specificity testing showed no cross-reactivity with dengue virus (serotypes 1–4), Zika virus, or yellow fever virus genes, confirming good specificity. In a prospective clinical evaluation of 1 740 samples, the assay correctly identified all 24 CHIKV-positive samples, with a detection rate of 100% (24/24) and Ct values ranging from 18 to 35. Notably, no false positives were detected in the remaining 1 716 CHIKV-negative samples, which comprised a challenging panel of 64 dengue virus-positive cases, 76 malaria-positive cases, and 1 576 other negative controls. This demonstrates the method's excellent clinical sensitivity and specificity. Conclusion   The real-time RT-PCR method established in this study enables rapid, sensitive, and specific detection of CHIKV, and is suitable for early clinical diagnosis of CHIKV infection.

Abstract: Objective    To investigate the diversity of species, distribution characteristics, and genetic evolutionary relationships of mosquitoes in Guizhou Province, a mosquito population survey and phylogenetic analysis were conducted across multiple regions, aiming to provide a scientific basis for the prevention and control of mosquito-borne infectious diseases in the area. Methods    Female mosquitoes were collected using methods such as ultraviolet light traps, BG-Trap CO₂ mosquito traps, and the human landing catch method. Specimens were morphologically identified, and representative samples, as well as individuals difficult to identify, were selected for tissue DNA extraction. A fragment of the mitochondrial cytochrome c oxidase subunit I (COI) gene was amplified by PCR and sequenced. Multiple sequence alignment was performed using BioEdit 7.0 software, and a phylogenetic tree was constructed using MEGA 12.0 software to analyze the genetic relationships and geographical origins of different mosquito species. Results    A total of 20 739 female mosquitoes were collected, primarily from cattle sheds (12 980) and pigsties (6 785). Combined morphological and molecular identification revealed 10 species belonging to 4 genera. Armigeres subalbatus (43.7%), Anopheles sinensis (29.4%), and Culex tritaeniorhynchus (21.7%) were the dominant species across the province. Geographically, Anopheles sinensis, Culex quinquefasciatus, and Armigeres subalbatus were widespread throughout the province, while Culex tritaeniorhynchus was distributed in all regions except Liupanshui. The remaining species (For example, Lutzia vorax and Culex bhutanensis were collected in Anshun City, while Anopheles minimus and Culex murrelli were collected in Qiannan Prefecture. Aedes vexans npponii was recorded in both Anshun City and Qiannan Prefecture.) were only collected in specific areas. Phylogenetic analysis indicated that the COI sequences of Anopheles sinensis, Armigeres subalbatus, Aedes albopictus, Culex quinquefasciatus, and Culex murrelli clustered with reference strains from China, suggesting that these species have formed stable populations in Guizhou Province and other domestic regions. Lutzia vorax and Anopheles minimus not only clustered with domestic strains but also fell within the same clade as foreign strains. In contrast, Aedes vexans npponii and Culex bhutanensis clustered with geographical strains from countries such as Japan, South Korea, Vietnam, and Bhutan, respectively, indicating their presence and formation of small local populations, which may suggest a risk of introduction from abroad. Conclusion    Mosquito species in Guizhou Province are relatively diverse and widely distributed, with clearly defined dominant species. Lutzia vorax is a newly recorded species in Guizhou Province, and Culex bhutanensis is a newly recorded species in China. The potential introduction of certain species from abroad may increase the transmission risk of mosquito-borne diseases.

Abstract: The Expert Consensus on the Construction Standards of Heat Stroke Medical Rescue Systems (2025) represents the first guiding document in China to systematically construct a full-process rescue system for heat stroke. In the context of increasing risks of heat stroke under global warming, this consensus aims to “reduce incidence rate, improve treatment success rates, and enhance long-term prognosis” by proposing an integrated prevention and control strategy covering “prevention-pre-hospital emergency care-in-hospital treatment-rehabilitation-chronic disease management.” Its core components focus on four key dimensions: promoting the shift of the prevention threshold forward to "heat not causing illness"; strengthening pre-hospital emergency care with "golden half-hour" rapid cooling; establishing a multidisciplinary in-hospital treatment system; and incorporating rehabilitation and chronic disease management into the standardized pathway for the first time. The consensus further clarifies standardized construction requirements, including a four-tier rescue network structure, the setup of dedicated rescue units, and the establishment of heat tolerance testing laboratories, with the goal of achieving systematic, standardized, and homogeneous heat stroke prevention and treatment. The implementation of this consensus provides critical guidance for addressing health threats posed by extreme climate events and enhancing national public health emergency response capabilities.

Abstract: Objective    To obtain near-full-length HIV sequences using near-full-length gene amplification combined with next-generation sequencing, and to identify their recombination forms. Methods    From two newly reported HIV-1 infected individuals in Liaoning Province in 2023 harboring potential URFs, near-full-length viral genomes were amplified from target samples using semi-genomic amplification technology. Near-full-length HIV genome sequences were acquired by next-generation sequencing (NGS), which underwent recombination analysis using SimPlot and BootScan. Recombination fragments were validated through segmented phylogenetic trees. Results    Two full-length sequences were ultimately obtained with lengths of 9 261 bp and 9 073 bp, covering all HIV structural genes. Phylogenetic and recombination analyses revealed that both sequences (LNJZ230022 and LNDL230042) possessed an HIV-1 subtype B backbone. LNJZ230022 sequence incorporated CRF07_BC and CRF01_AE gene fragments, with recombination occurring in gag and env regions and breakpoints at positions 803, 1 147, 2 120, 6 323, 7 758, and 9 274 (HXB2). LNDL230042 was inserted by CRF07_BC gene fragments, with recombination regions in vpr and env and breakpoints at 779, 5 608, 5 870, 6 745, 7 541, and 9073 (HXB2). Sample LNDL230042 exhibited an N88T mutation at position 88 in the PR region, classified as moderate resistance, and an F53L mutation at position 53, indicating low-level resistance. Sample LNJZ230022 exhibited no resistance mutations. Conclusion    The two novel HIV-1 URFs identified in newly infected individuals in Liaoning Province reflect the complex co-circulation of subtype B, CRF07_BC, and CRF01_AE strains. By employing NGS to assemble full-length HIV genomes, we successfully identified two URFs from HIV-infected individuals in Liaoning and conducted detailed characterization of their recombination patterns. This approach captured large-scale recombination events in the env gp120 region, providing a critical molecular foundation for understanding recombination and immune escape in locally circulating strains. This study not only expands our understanding of HIV-1 genetic diversity and recombination trends in Liaoning Province but also demonstrates the feasibility and importance of using NGS to obtain near-full-length sequences for precise monitoring of novel circulating recombinant HIV-1 strains.

Chikungunya fever, as an important arthropod-borne infectious disease, is intrinsically linked to cross-border transmission and population mobility. This article systematically reviews research progress in China on the association between overseas labor export and the risk of chikungunya virus importation. It is found that China's overseas labor export shows a significant regional concentration feature, with Asia (especially Southeast Asia) and Africa being the main destinations, jointly accounting for approximately 80% of the total. Concurrently, Guangdong Province, as the main entry point for returning laborers, shows high concentration of laborers returning from Asia and Africa. Based on the global chikungunya fever epidemic data from 2020 to 2024 and traceability results from a 2025 outbreak in Guangdong Province, it is suggested that the return of overseas laborers is a key route for virus importation. Due to high exposure risk, delayed detection during entry quarantine, and delayed medical treatment upon returning home, laborers from chikungunya fever-endemic areas such as Southeast Asia and Africa have become a critical vulnerable link in the importation and transmission chain of arthropod-borne diseases in China, especially in Guangdong Province. In the future, it is necessary to strengthen multi-departmental collaboration and multi-source data integration, enhance the quarantine and epidemiological research on overseas laborers at ports of entry, and establish an arthropod-borne infectious disease importation risk assessment system based on the domestic and overseas mobility patterns, thereby providing scientific support for the effective prevention and control of local outbreaks of arthropod-borne infectious diseases.

In recent years, the increasing frequency of extreme weather events worldwide has driven a sustained rise in the incidence of heatstroke. As a fatal emergency that can lead to multiple organ failure, heatstroke involves highly complex pathological mechanisms. The gut microbiota, serving as the largest microecosystem in the human body, has been found to play a key role in the occurrence and development of heatstroke. This article systematically reviews the bidirectional interaction between heatstroke and the gut microbiota. On the one hand, the sudden elevation of core body temperature, intestinal ischemia/reperfusion injury, and systemic inflammatory response triggered by heatstroke can disrupt the integrity of the intestinal barrier, leading to microbial ecological dysbiosis. On the other hand, the dysregulated gut microbiota further amplifies heatstroke-induced organ damage through several mechanisms: exacerbating intestinal barrier damage, generating harmful metabolites such as trimethylamine N-oxide (TMAO) and hydrogen sulfide, and perturbing the central nervous system through the "gut-brain axis", thereby establishing a vicious cycle. Based on this, this paper further explores potential therapeutic strategies targeting the intestinal microecology, including the preconditioning protective effects of heat acclimatization, microencapsulation technology, nanotechnology, mucosal adhesion technology, and synbiotic preparations, aiming to provide a new theoretical basis and direction for the prevention and treatment of heatstroke.

Abstract：Objective To investigate the impact of different anticoagulation initiation timings on organ function in exertional heat stroke (EHS), and to analyze the related risk factors for prognosis. Methods A retrospective case-control study was conducted, to collect clinical data of 75 EHS patients admitted to the 900th Hospital of PLA Joint Logistic Support Force between 2014 and 2024. Patients were divided into an ultra-early anticoagulation group (initiated within 6 h of EHS diagnosis) and an early anticoagulation group (initiated after 6 h of EHS diagnosis), based on the timing of initiating anticoagulation therapy after admission. Differences in D-Dimer, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg), D-dimer/fibrinogen ratio (DFR), platelet count (PLT), creatinine (Cr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), myoglobin (Myo), and creatine kinase (CK) were compared between the two groups of patients on the 1st, 3rd, 5th, and 7th days after admission to the EICU. Partial correlation was used to analyze the correlation between prognosis and the aforementioned indicators. Multivariate logistic regression was employed to identify independent risk factors for prognosis. Results A total of 75 patients were ultimately included, with 55 in the ultra-early group and 20 in the early group. Compared to the early group, the ultra-early group demonstrated superior improvement in coagulation function: PT, APTT, and TT showed a shortening trend (P<0.05), while Fg and PLT showed an increasing trend (P<0.05). D-Dimer levels in both groups showed an initial increase followed by a decrease, but the decline was more significant in the ultra-early group after peaking on the third day. Regarding liver function, ALT and AST improved more significantly in the ultra-early group (P<0.05). Correlation analysis revealed that, 28-day mortality was positively correlated with early (first 3 days in EICU) D-Dimer, DFR, ApacheⅡscore, incidence of DIC, Cr, ALT, AST, Myo, and PT (P<0.05), and negatively correlated with early PLT (P<0.05). Multivariate logistic regression indicated that age and ALT level on day 1 in EICU were independent risk factors for 28-day mortality. Conclusion Both ultra-early and early anticoagulation therapy can improve coagulation and liver function in EHS patients. However, the ultra-early anticoagulation strategy demonstrates superior early organ protective effects compared to early anticoagulation.

 Objective    To explore the role of monocyte pyroptosis in heat stroke-induced thrombosis using animal models combined with clinical samples. Methods    Forty C57BL/6J mice were randomly divided into a control group, a heat stroke group, a heat stroke thrombosis group (inferior vena cava constriction + heat shock), and a sham operation group. At 3 and 72 hours post-modeling, coagulation function [four coagulation parameters, thromboelastography (TEG)], thrombus formation (ultrasound, laser speckle), and inflammatory markers [interleukin-6 (IL-6), tissue factor (TF)] were measured. Peripheral blood was collected from 32 patients with heat stroke, and changes in monocyte subsets were analyzed using flow cytometry. The pyroptotic morphology of monocytes in the thrombi was observed by transmission electron microscopy, which was combined with transcriptome sequencing, pseudotime analysis, and Western blot to explore the underlying molecular mechanism. Results: The mice with heat stroke exhibited a hypercoagulable state as early as 3 hours after heat shock, peaking at 72 hours. Definite thrombus formation was observed in the inferior vena cava and intracranial venous sinuses, accompanied by massive inflammatory cell infiltration. The proportion of non-classical monocytes (CD14^-CD16⁺) significantly increased in the peripheral blood of patients with heat stroke and in mouse thrombi; these cells exhibited typical pyroptotic morphology, including membrane rupture and vesicle formation. Transcriptomic analysis revealed that the NLRP3/Caspase-1/GSDMD pyroptosis pathway was significantly activated in non-classical monocytes within the thrombus, with the upregulated expression of hypoxia-inducible factor-1α (HIF-1α) and the prothrombotic molecule thrombospondin-1 (THBS1). Pseudotime analysis suggested that classical monocytes infiltrated the thrombi and transformed into a non-classical phenotype, which highly expressed neutrophil chemokines such as CXCL2 and CXCL8. Conclusion    In heat stroke, circulating monocytes transform into a non-classical phenotype (CD16⁺), which undergoes pyroptosis in the thrombotic microenvironment and may promote thrombosis formation by recruiting neutrophils.

 Objective    To investigate the protective effect of butyrate preconditioning on intestinal barrier injury in mice with classical heatstroke (CHS) and explore its potential mechanism based on transcriptomic analysis. Methods    C57BL/6J mice were randomly divided into four groups: control group (CON), butyrate group (NaB), heatstroke group (HS), and butyrate preconditioning + heatstroke group (NaB+HS), with 10 mice in each group. Mice in the NaB and NaB+HS groups were intragastrically administered sodium butyrate solution for 2 consecutive weeks. A mouse model of CHS was then established, and core body temperature and survival rate were monitored. Intestinal pathological damage and intestinal permeability were detected by HE staining and FITC-dextran assay, respectively. The expression of tight junction proteins (ZO-1, Occludin) was measured by Western blot, and the intestinal ultrastructure was observed by transmission electron microscopy (TEM). Ileal tissues were collected for transcriptome sequencing; KEGG and GO enrichment analyses were performed on differentially expressed genes (DEGs), with results verified by quantitative reverse transcription polymerase chain reaction. Results    Butyrate preconditioning significantly slowed the elevation of core body temperature (P<0.001) and improved the survival rate of HS mice (from 60% to 100%, P=0.029). It also alleviated intestinal mucosal structural damage induced by heat exposure and reduced intestinal permeability. Western blot and TEM results showed that butyrate preconditioning significantly upregulated the expression of ZO-1 and Occludin proteins in the intestines of HS mice (P<0.05) and maintained the integrity of tight junction structures. Transcriptomic analysis identified 2 136 DEGs between the HS and CON groups, primarily enriched in immune and inflammation-related pathways. In contrast, 1 429 DEGs were found between the NaB+HS and HS groups, primarily involved in metabolic regulation and vascular permeability regulation. qRT-PCR verification confirmed that the expression changes of key DEGs, including Gpr182, Lyve1, and Ddit4, were consistent with the sequencing results. Conclusion    Butyrate preconditioning protects intestinal barrier function in mice with CHS by alleviating intestinal injury and enhancing the expression of tight junction proteins. Its mechanism may be associated with the regulation of immune-metabolic balance, providing a theoretical basis for developing butyrate as a preventive intervention strategy for CHS. 

Objective    To investigate the distribution of regulatory T cells (Tregs) in different organs/tissues and their correlation with the survival outcomes in a murine model of heat stroke, to further elucidate the potential role of Tregs in the immune dysregulation associated with heat stroke. Methods    Male BALB/c mice were exposed to heat to establish a mouse model of classic heat stroke. The heat-stressed mice were allocated to the survivor group or the non-survivor group based on their survival outcomes. An additional normal control group was set up without heat exposure. At 24 h after the onset of heat stroke, core body temperature, body weight, and liver and kidney function indicators were measured in each group to assess the severity of heat stroke. Subsequently, flow cytometry was employed to quantify the proportion of Tregs among CD4⁺ T cells and the number of Tregs in the peripheral blood, spleen, and liver to determine the distribution of Tregs in different organs/tissues. Additionally, the levels of Tregs in peripheral blood prior to heat exposure were determined by flow cytometry to reflect baseline levels. Results    Compared with the survivor group, the non-survivor group exhibited hypothermia, more pronounced weight loss, and markedly elevated indicators of liver and kidney at 24 h post the onset of heat stroke, indicating an increased severity of heat stroke. At 24 h after heat stroke, no statistically significant differences were observed in the frequency of Tregs among CD4⁺ T cells across groups in either spleen or liver. However, the numbers of Tregs in the peripheral blood, spleen, and liver of the non-survivor group were remarkably lower than those in the survivor group. Although Treg numbers of the peripheral blood, spleen, and liver in the survivor group decreased compared to controls, significant differences were only observed in the peripheral blood. Furthermore, comparable baseline levels of Tregs were observed in the peripheral blood of both survivor and non-survivor groups prior to heat exposure. Conclusion    The numbers of Tregs in the peripheral blood, spleen, and liver closely correlate with heat stroke severity and prognosis; this quantitative difference is not attributable to baseline variations prior to heat exposure.

Objective    To analyze the molecular genetic characteristics of Japanese Encephalitis Virus (JEV) isolated from Anopheles sinensis in Xingren City, Guizhou Province, in 2023. Methods    Mosquito specimens were collected from different habitats in six cities/prefectures of Guizhou Province from July to September 2023. Virus isolation was performed using C6/36 and BHK-21 cells. The complete genome was obtained by RTPCR and sequencing, followed by genetic evolution, amino acid variation, and protein structure analyses using MEGA, DNAStar, and SWISSMODEL. Results    One JEV strain (GZ23M09) was isolated from a pool of Anopheles sinensis collected in Xingren City, Qianxinan Prefecture. Phylogenetic analysis indicated that the strain belongs to the GIb genotype and is closely related to recent epidemic strains from Guizhou, Ningxia, Sichuan, Guangxi, and other regions. Compared with the vaccine strain SA14142, multiple amino acid variations were identified in the E protein, including seven key sites associated with neurovirulence, such as E138 and E176. Additionally, a V206A substitution at site E206 was observed, which was a unique variation not detected in other Guizhou or domestic epidemic strains included in the comparison. Structural prediction revealed that three important antigenic epitopes in domain III (E337–E345, E377–E382, and E397–E403) maintained conformational consistency with the vaccine strain. Conclusion    This study reports the first isolation of a GIb genotype JEV from Anopheles sinensis in Xingren City, Qianxinan Prefecture, Guizhou Province. Analysis of the isolate GZ23M09 reveals its dual molecular characteristics: the presence of virulencerelated mutation risks alongside highly conserved core neutralizing epitopes. These findings provide important evidence for assessing local viral evolution, transmission risks, and vaccine protection efficacy.

Objective　To investigate the distribution of Bacillus anthracis bacteriophages in the soil of the anthrax endemic focus in Yuanmou County, Yunnan Province, and to explore their potential role and application prospects in anthrax epidemic prevention and control. Methods　Based on previously identified epidemic locations, five representative epidemic sites were selected for soil sample collection and testing. Transport blanks and non-epidemic site controls were established concurrently. Soil samples were collected using stratified random sampling. With extraction blanks included as controls, anthrax phage isolation, purification, and general characterization were performed through double-layer plate assays, electron microscopy, and lysis spectrum analysis. Results   A total of 88 soil samples were collected from 5 epidemic sites, yielding 10 isolated anthrax phages with a positivity rate of 11.36%. The positivity rates in Yuanma Town and Jiangyi Township were 50.00% and 20.00%, respectively. The differences in phage positivity rates among sampling sites were statistically significant, with Yuanma Town's rate (50.00%) significantly higher than other townships (Fisher's exact test, P<0.05). Spearman's rank correlation analysis revealed a statistically significant association between epidemic site positivity rates and cumulative case numbers in previous years (2007-2013) (r=1.000, P<0.001). The phages isolated in this study exhibited strong lytic activity against both the anthrax vaccine strain A16R and clinical strains. Some phages also demonstrated lytic activity against Bacillus cereus. Conclusion　Bacillus anthracis phages are prevalent in the soil of the anthrax epidemic focus in Yuanmou County, with positivity rates showing significant township-level variation. These can serve as a supplementary indicator of the risk of the epidemic focus independent of case number. It is recommended that townships with a phage-positive rate >20.00 % be classified as “green surveillance areas” for routine monitoring. Historical epidemic sites with a 0% positive rate should be designated as high-risk areas, with a focus on inspecting abandoned carcasses of dead animals. The LP202 strain isolated in this county completely lysed 8 clinical strains from Yunnan Province at 37°C, demonstrating potential for both identification and ecological load reduction. However, temperature-dependent cross-reactions need to be corrected before their use for preliminary screening of suspicious colonies at the grass-roots level. This finding provides a valuable reference for exploring environmental anthrax monitoring in natural endemic foci.

Objective: To evaluate the clinical value of the Heatstroke Severity Score System (HSSS) in assessing disease severity and predicting prognosis in patients with heatstroke (HS). Methods: A retrospective analysis was conducted on the clinical data of 143 patients with heatstroke. Patients were stratified into mild (score 1-10, n=110), moderate (score 11-20, n=23), and severe (score ≥21, n=10) groups based on their HSSS scores. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Glasgow Coma Scale (GCS) scores, as well as clinical indicators including blood counts, coagulation function, liver and kidney function, lactate levels, and mortality rates, were compared among groups. Spearman’s rank correlation test was used to analyze the relationship between HSSS and SOFA/APACHE II scores. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of HSSS for mortality, calculating the Area Under the Curve (AUC) and optimal cutoff value. Survival curves were generated using the Kaplan-Meier method, and a Cox proportional hazards model was employed to identify independent risk factors for mortality in heatstroke patients. Age, SOFA score, APACHE II score, and HSSS score were incorporated into the multivariate Cox regression model to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs). Additionally, the distribution patterns of combined organ system injuries were characterized. Results: The mortality rate in the severe group was 90.0%, significantly higher than in the mild and moderate groups (both 0.0%, P < 0.001). Analysis of organ injury patterns revealed that three-system involvement was the most common (40 cases, 28.0%), with the combination of thermoregulatory dysfunction (hyperthermia), central nervous system (CNS) dysfunction, and renal impairment being the most frequent. This was followed by four-system involvement (36 cases, 25.2%), predominantly involving hyperthermia, CNS dysfunction, renal impairment, and hepatic injury. As HSSS scores increased, APACHE II scores, SOFA scores, and lactate levels significantly increased, while GCS scores significantly decreased; the severity of coagulation disorders and liver/kidney injury also markedly worsened (P < 0.05). Correlation analysis showed a strong positive correlation between HSSS and SOFA (r = 0.942, P < 0.001) and APACHE II scores (r = 0.816, P < 0.001). ROC analysis demonstrated that the AUC of HSSS... was 0.986... The AUC of HSSS was significantly higher than that of APACHE II (Z=2.384, P=0.017) and comparable to SOFA (P=0.093). at an optimal cutoff of 20 points, sensitivity was 100% and specificity was 93.4%. Survival analysis indicated that patients with HSSS ≥20 had a significantly increased mortality risk (HR = 2.06, 95% CI: 1.11-3.84, P = 0.02) and significantly lower cumulative survival compared to those with scores <20 (Log-rank P < 0.0001). Conclusion: The HSSS can accurately assess disease severity and reliably predict adverse outcomes in patients with heatstroke.

Objective To construct a heat tolerance assessment scale and evaluate its reliability, validity, and application value systematically in quantifying heat tolerance levels and screening for individuals at high risk of heatstroke. Methods: Based on a systematic review of theories related to heat stress physiology and heat acclimatization, and with reference to exertional heat illness diagnosis and prevention guidelines of the U.S. and British military, a preliminary framework of a Heat Tolerance Assessment Scale was developed through literature analysis, item pool construction, and expert consultation. The scale consists of four dimensions—subjective perception, physiological sensation, physical performance, and training load—comprising a total of 13 items.The Delphi expert consultation method was used to conduct multiple rounds of evaluation and revision of the scale items to ensure their scientific validity and practical feasibility. Subsequently, a questionnaire survey was conducted among 383 military personnel from Fujian and Hebei provinces. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the structural validity of the scale, and internal consistency indices were used to assess its reliability.On this basis, a further questionnaire survey was carried out among 1,451 military personnel from Hainan, Jiangxi, and Xinjiang. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive validity of the scale.Results: The Kaiser-Meyer-Olkin value of the questionnaire was 0.792, and the Bartlett test χ⊃2;=2892.832 (P<0.001), EFA extracted 4 common factors with a cumulative variance contribution rate of 76.88%. The CFA fit indices were good (χ⊃2;/df=1.836, RMSEA=0.047, CFI=0.983, TLI=0.977). The overall Cronbach’s α was 0.832, and the α value for each dimension was >0.75. ROC analysis demonstrated that the scale exhibited good discriminative validity for identifying the risk of exertional heat illness (AUC = 0.789) and excellent predictive validity for determining superior heat tolerance levels (AUC = 0.894), with corresponding cutoff values of 38.5 and 45.5, respectively. Conclusion: The heat tolerance assessment scale has good reliability and validity and can be used as an effective tool for assessing the heat tolerance levels of military personnel and screening for individuals at high risk of exertional heatstroke. 

 Objective    To investigate the diversity and composition of viruses carried by Culex tritaeniorhynchus, the dominant mosquito species in certain areas of southeastern Yunnan Province, and to provide a scientific basis for the surveillance, prevention, and control of local arboviral diseases. Methods    From July to August 2023, mosquitoes were collected from diverse habitats, including farmhouses, pig pens, and cattle sheds in Kaiyuan City and Huaning County. Following morphological identification, four sample pools of female Culex tritaeniorhynchus were constructed (50 mosquitoes per pool, with two biological replicates per region). Total RNA was extracted from the samples and subjected to metavirome sequencing using the Illumina NovaSeq 6000 platform. Bioinformatics methods were employed for data quality control, sequence alignment, viral annotation, relative abundance analysis, and phylogenetic studies. Results    A total of 5 640 adult mosquitoes were collected, with Culex tritaeniorhynchus being the dominant species (71.28%). A total of 41 400 325 viral reads were obtained, from which 2 067 viral contigs were assembled. In total, 104 viruses belonging to 28 viral families were identified. Vertebrate-associated viral sequences dominated the composition (55.60%), followed by insect viruses (8.83%) and a large proportion of unclassified viruses (32.43%). Both mosquito sample pools from the two regions contained viral families such as Coronaviridae, Flaviviridae, Herpesviridae, Solinviviridae, Mimiviridae, and unclassified viruses. Japanese encephalitis virus (JEV) was detected in all four sample pools, and phylogenetic analysis indicated that it belonged to genotype I. Compared with the vaccine strain SA14-14-2, 103 amino acid differences were observed; however, the key antigenic regions of the E protein remained completely identical. Additionally, other mosquito-associated viruses such as Quang Binh virus, Hubei mosquito virus 2, Wuhan mosquito orthophasmavirus 2, and Menghai rhabdovirus were detected. Conclusion    This study preliminarily reveals the diversity of viruses carried by Culex tritaeniorhynchus in Southeastern Yunnan, confirms the presence of important arboviruses such as JEV, identifies a variety of insect-specific viruses and unclassified viruses. These findings provide baseline data for assessing arboviral risks in the region. The results highlight the need for continuous monitoring of viral evolutionary dynamics and further research to clarify viral transmission mechanisms and public health risks.

Abstract: Objective    To delineate the population structure, drug resistance profiles, and transmission dynamics of Mycobacterium tuberculosis (MTB) in Qinghai Province, China, and to provide molecular epidemiological evidence for precision tuberculosis (TB) control strategies in this high-burden region. Methods    Clinical isolates from 194 TB patients in Qinghai Province (2015–2024) were analyzed through whole-genome sequencing (WGS). Lineage classification, drug resistance-associated mutation detection, and phylogenetic reconstruction were performed using core genome single-nucleotide polymorphism (SNP) profiling to evaluate genetic clustering and recent transmission events. Results    The overall drug resistance rate among MTB strains was 30.4%, comprising mono-drug resistance (21.6%), multidrug-resistant TB (MDR-TB, 4.1%), and pre-extensively drug-resistant TB (pre-XDR-TB, 0.5%). Streptomycin resistance was most prevalent (15.5%). Phylogenetic analysis revealed Lineage 2 (L2) as the overwhelmingly dominant lineage (83.2%, 159/191), with the L2.2.1 sub-lineage being the most predominant (66.5%). WGS identified diverse mutations, including promoter region variants, nonsynonymous (amino acid-altering), and synonymous (nucleotide-changing) mutations, predominantly in rpsL, katG, and rpoB. Mutations associated with drug resistance detected by WGS showed significant correlations with clinical treatment outcomes (P<0.05). Genetic clustering analysis (using ≤12 SNPs as the genetic distance threshold) identified 16 transmission clusters comprising 57 isolates, yielding an overall clustering rate of 29.4%. Multivariate analysis demonstrated that pre-XDR-TB strains were more likely to cluster than drug-susceptible strains (P<0.05). Furthermore, isolates collected during 2015–2017 exhibited significantly higher clustering rates than those from 2023–2024. Conclusion    Clonal spread of Lineage 2 dominates the Mycobacterium tuberculosis epidemiology in Qinghai Province, with high prevalence of diverse resistance mutations to first-line anti-tuberculosis drugs. Prioritizing cluster-level interventions targeting recent transmission is critical for implementing precision TB control strategies.

Objective   To preliminarily investigate the role of the Rv0305c (PPE6) protein in Mycobacterium tuberculosis (Mtb) pathogenesis through experimental and bioinformatics analyses, thereby laying the groundwork for elucidating its molecular mechanism and identifying novel targets for anti-tuberculosis drug development. Methods    The Mtb Rv0305c gene knockout strain (ΔRv0305c) was constructed from the Mtb H37Rv wild-type (WT) strain using CRISPR-Cas-assisted non-homologous end joining gene editing technology. Subsequently, the complemented strain (ΔRv0305c::Rv0305c) was generated by electroporation with an Rv0305c expression vector. Bacterial morphology was examined by scanning electron microscopy. Growth curves were plotted by measuring the optical density at 600 nm (OD₆₀₀) of the bacterial cultures using an ultraviolet-visible spectrophotometer. Dynamic expression differences of inflammation-related cytokines in THP-1 macrophages infected with the three strains were analyzed by reverse transcription quantitative PCR (RT-qPCR). For bioinformatic characterization of Rv0305c, the following tools were employed: AlphaFold for protein three-dimensional (3D) structure modeling, STRING for protein-protein interaction network analysis, SignalP for signal peptide prediction, DeepTMHMM for transmembrane structure prediction, InterPro for family and domain analysis, DeepLocPro for subcellular localization prediction, and ELM for eukaryotic-like short linear motif analysis. Results    The ΔRv0305c and ΔRv0305c::Rv0305c strains were successfully constructed. Deletion of the Rv0305c gene did not affect the morphology or growth rate of Mtb. However, it significantly upregulated the expression of IL-6 and TNF-α and downregulated the expression of IL-10 in macrophages at 2 h, 24 h, and 48 h post-infection (all P<0.05), whereas no significant differences in cytokine levels were observed between the complemented strain and the wild-type strain. Bioinformatic analyses revealed the following: Rv0305c is genomically adjacent to PPE5 and is transcribed in the same direction; the Rv0305c protein belongs to the glutamine-rich protein 2 family and contains specific domains; its predicted 3D structure model has an average confidence score of 78.19; its interaction network includes several PE/PPE family members, as well as CpnT, Rv2082, and Rv1004c; Rv0305c may contain eukaryotic-like short linear motifs; it lacks a signal peptide, is predicted to be an non-transmembrane extracellular globulin, and shows the highest probability of extracellular localization (0.721 8). Conclusion    Rv0305c contributes to the suppression of the inflammatory response in Mtb-infected macrophages and is predicted to be a eukaryotic-like non-classically secreted protein.

Chikungunya virus (CHIKV), an arbovirus transmitted by Aedes mosquitoes, is rapidly spreading across Asia, Africa, and South America, triggering multiple large-scale outbreaks and posing a serious threat to global public health security. Since the clinical manifestations of CHIKV infection are similar to those of dengue fever, Zika virus disease, and other illnesses, accurate and rapid diagnostic techniques are of great significance for disease differentiation and epidemic prevention and control. This review outlines recent progress in CHIKV detection, including real-time quantitative PCR, isothermal amplification, CRISPR-assisted detection, and rapid diagnostic tests, with emphasis on their advantages and limitations in terms of sensitivity, specificity, and field application feasibility.  Furthermore, research findings on CHIKV whole-genome sequencing and genotyping are summarized, elaborating the epidemiological characteristics of different genotypes and their role in viral tracing, mutation monitoring, and vaccine development.

 Objective To analyze the etiology, drug resistance and genome evolution of three cases of Meningococcal meningitis(MM) in 2024 in Zunyi City. Methods Three samples of cerebrospinal fluid from patients with suspected Nm infection were detected by macrogene sequencing and Real-time PCR, and 143 throat swabs from close contacts were detected by Real-time PCR. The isolates were isolated. Biochemical identification, serotyping, Etest and genome analysis were performed on the isolates. Results  The results of Real-time PCR showed that Nm was detected in 3 cases of cerebrospinal fluid and 18 samples of close contacts. No pathogen was isolated from the case samples, and 6 Nm strains were isolated from close contacts. Serotype distribution: cases 1, 2 and 15 were closely divided into group B, and case 3 was mixed infection of group B and group Y. Phenotypic resistance results showed that 6 strains were sensitive to ceftriaxone, meropenem, minocycline, chloramphenicol and rifampin, and all were intermediate resistant to ampicillin, 5 strains were resistant to penicillin and co-trimoxazole, and resistant to levofloxacin, ciprofloxacin and azithromycin, and 2 strains were resistant to cefotaxime. The 5 strains successfully isolated had farA, farB, macA, resistance genes.All strains carried virulence genes such as NmB0315, OpaA, and OpcA. Phylogenetic analysis showed that strains P171 and P173 clustered with strains 116953, 116959, 116962, and 116960, while strains P175 and P176 clustered with strains 116951, 87062, 131547, 131546, 131548, 116948, and 133566. These two clusters showed significant differences from P174. Conclusion  There is a risk of transmission of Neisseria meningitidis group B and Y in Zunyi City in 2024. The Nm strains exhibit multidrug resistance and carry multiple virulence genes, suggesting potential trans-temporal and trans-spatial transmission across the country.It is suggested to strengthen pathogen monitoring and drug sensitivity detection, guide clinical accurate drug use, and contain the spread of epidemic situation.

Abstract: Objectives    To preliminarily evaluate the immunoprotective efficacy and potential as a vaccine candidate of the 41.5 kDa recombinant cysteine protease of Clonorchis sinensis (rCsCP). Methods    The signal peptide-truncated 41.5 kDa CsCP protein was expressed in E. coli BL21. Purified protein combined with Freund’s adjuvant was used to immunize BALB/c mice, with PBS and PBS+Freund’s adjuvant groups serving as controls. Immunization was administered every 2 weeks for a total of 3 times. Serum samples were collected before each immunization and 2 weeks after the last immunization. Specific IgG and its subclasses (IgG1/IgG2a) antibody titers were measured by enzyme-linked immunosorbent assay (ELISA). Two weeks after the last immunization, mice were infected with C. sinensis metacercariae. Liver tissues were taken at 0, 2, and 4 weeks post-infection for hematoxylin-eosin (HE) staining, Masson’s trichrome staining, and immunohistochemistry. Splenocytes were isolated to measure the levels of interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-4, and IL-10 in culture supernatants. Results  After rCsCP immunization, specific IgG, IgG1, and IgG2a antibody titers continuously increased, with IgG antibody titer reaching 1:25 600 two weeks after the last immunization, predominantly IgG1. Compared with PBS and PBS+adjuvant groups, the rCsCP immunization group showed significantly reduced inflammatory cell infiltration and peribiliary collagen deposition in liver tissue (P<0.005). Immunohistochemistry indicated decreased expression of α-smooth muscle actin (α-SMA) and type I collagen (Collagen-I) in liver tissue of the rCsCP immunization group (P<0.005). Cytokine detection revealed that two weeks after the last immunization (i.e., 0 weeks post-infection), the secretion levels of IFN-γ, IL-2, and IL-10 in the rCsCP immunization group were significantly higher than those in the PBS and PBS+adjuvant groups (P < 0.05), but decreased rapidly after infection. However, IL-4 levels increased continuously from the 2nd week post-infection, rising to more than 20 times that of the PBS and PBS + adjuvant groups by the 4th week (P<0.005), suggesting that rCsCP activated a mixed Th1/Th2 response dominated by Th2. Conclusion    Immunization with 41.5 kDa rCsCP can significantly reduce liver inflammation and fibrosis injury caused by C. sinensis infection. Its protective mechanism may be related to the induction of high-titer specific antibodies and a Th2-dominant mixed Th1/Th2 immune response.

Abstract: Objective    To prevent the occurrence and cross-border spread of major epidemics such as plague in border areas both domestically and internationally. This study reviews the discovery of natural plague foci along the China-Kazakhstan border historically and the recent event of the first isolation of plague bacteria in the Altai Mountain area of the China-Mongolia border, providing a reference for future monitoring. Methods      From the perspective of the history of science and technology, historical documents were reviewed and analyzed, combined with the latest survey data to examine the discovery, transmission risks, and early warning mechanisms of plague in the border areas of China-Kazakhstan and China-Mongolia ports and their surrounding regions. Results    In the surrounding areas of the four ports along the China-Kazakhstan and China-Mongolia borders, 9 plague-positive sites were discovered successively for the first time. A total of 74 batches of 27 types of disease vectors, including rats, fleas, ticks, cockroaches, bats, and wild animals, were intercepted in the port clearance areas. The risk of cross-border transmission of pathogens carried by disease vectors in the border areas and the epidemic dynamics of major infectious diseases such as plague both domestically and internationally warrant alert. Conclusion      To address the threat of cross-border transmission of major infectious diseases such as plague originating from natural epidemic foci in the the port clearance zones and the border line areas, advanced monitoring and early warning identification technologies for blocking cross-border epidemic transmission should be further developed. Moreover, the application and refinement of the 'five-level monitoring barrier' theory and practice for major infectious diseases like plague are crucial to eliminate outbreaks in their nascent stages, both abroad and at the border.

Abstract: Objective To assess the disease and economic burden of dengue fever patients in Hainan Province in 2019, and to compare the economic costs per disability-adjusted life year (DALY) across provinces in China, thereby providing a scientific basis for quantifying the disease burden of dengue fever and formulating region-specific strategies for disease prevention, control, and resource allocation. Methods A retrospective analysis was conducted using clinical data from 330 confirmed dengue fever cases at Hainan General Hospital in 2019 to estimate the disease and economic burden for all 368 reported cases in the province. Furthermore, a systematic literature search was performed to compile data on the economic burden of dengue fever from other provinces in China, calculate the economic cost per DALY for each province, and compare the differences across regions. Results Among the 330 dengue fever patients, the average DALY burden was 0.03 person years. The M (P25, P75) of the total economic burden was 1 822.11 (162.61, 2 601.74) yuan, with the M (P25, P75) of the direct economic burden at 1 513.03 (162.61, 2 144.84) yuan and the M (P25, P75) of the indirect economic burden at 219.28 (0, 438.56) yuan. The total DALY burden of dengue cases in Hainan Province in 2019 was 11.33 person-years. The estimated total  economic burden was 670 536.48 yuan (95%UI: 575 537.30-751 654.70), comprising direct economic burden of 556 795.04 yuan (95%UI: 488 810.70-626 089.40) and indirect economic burden of 80 695.04 yuan (95%UI: 53 797.92-107 592.20). The estimated economic cost per DALY for dengue cases in the entire province was 59 182.39 yuan. Among provinces studied for denue fever economic burden in China (Guangdong, Zhejiang, Guangxi, Yunnan, and Chongqing), Guangdong Province exhibited the highest economic cost per DALY and per capita economic burden. Conclusion The economic burden of dengue patients in Hainan Province is substantial. Measures such as expanding health insurance coverage and improving crossregional insurance settlement are recommended to alleviate the direct economic burden on patients. Given the significant variations in economic burden across provinces in China, dengue prevention and compensation policies should be tailored to regional characteristics to optimize resource allocation.

Abstract: Objective    To analyze the temporal trends in the disease burden of cysticercosis in China from 1990 to 2021 and project future trends from 2022 to 2035, thereby providing epidemiological evidence for the prevention and control of cysticercosis in China. Methods   Data on age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life years rate (ASDR) of cysticercosis in China, along with their 95% uncertainty intervals (UIs), were extracted from the 2021 Global Burden of Disease (GBD) database. The Joinpoint regression model was used to analyze the changing trends of cysticercosis burden in China from 1990 to 2021. An age-period-cohort (APC) model was constructed to assess the effects of age, period, and cohort on the cysticercosis burden in China during the same period. Additionally, a Bayesian age-periodcohort (BAPC) model was applied to predict the ASPR and ASDR up to 2035. Results   The ASPR of cysticercosis in China decreased by 37.16%, from 56.00 per 100 000 population (95%UI: 39.43, 75.54) in 1990 to 35.19 per 100 000 population (95%UI: 24.27, 49.00) in 2021. Similarly, the ASDR declined by 54.35%, from 18.75 per 100 000 population (95%UI: 11.94, 27.67) in 1990 to 8.56 per 100 000 population (95%UI: 4.99, 13.71) in 2021. Joinpoint analysis showed that from 1990 to 2021, both ASPR and ASDR of cysticercosis in China initially rose, then entered a period of sustained decline, followed by a recent resurgence. The APC analysis model identified age, period, and cohort were all important factors influencing the cysticercosis burden. Predictions from the BAPC model revealed an upward trend in cysticercosis burden in China from 2022 to 2035, with a more significant increase in females than in males. Conclusion   While the disease burden of cysticercosis in China decreased substantially from 1990 to 2021, recent trends and future projections indicate an upward trajectory. Therefore, this highlights the need for continued and strengthened investment in medical resources to address the prevention, control, diagnosis, and treatment of cysticercosis in China.

Objective To explore the association between the exposure of air pollutants sulfur dioxide (SO₂), nitrogen dioxide (NO₂), inhalable particles (PM₁₀), fine particulate matter (PM_2.5), carbon monoxide (CO) and ozone (O₃) and the incidence risk of pulmonary tuberculosis (PTB) among students, so as to provide a scientific basis for the development of environmental risk prevention and control strategies for students’ tuberculosis. Methods We conducted a time-series analysis using weekly PTB cases and air pollutant concentrations (SO₂, NO₂, PM₁₀, PM_2.5, CO, and O₃) from thirteen major cities in Jiangsu Province during 2014-2024. Generalized additive models (GAM) were employed to estimate the percentage change in PTB risk per standardized increase in pollutant concentrations at lag times of 0-25 weeks. Models were adjusted for time-varying confounders including meteorological factors (temperature and relative humidity), as well as socio-economic factors including GDP per capita and population density. Sensitivity analyses included dual-pollutant models and generalized additive mixed models (GAMM) with city as a random effect to account for heterogeneity. Restricted cubic spline functions were used to fit exposure-response curves to examine the linearity of dose-response relationships. Results Between 2014 and 2024, there were 11,084 newly diagnosed PTB cases among students reported in the 13 cities. Significant positive associations were observed between PTB risk and short-term NO₂ (12.41%, 95% CI: 7.07-18.02% at lag 0), PM₁₀ (9.19%, 95% CI: 4.32-14.29% at lag 6 weeks), O₃ (10.04%, 95% CI: 4.27-16.12% at lag 5 weeks), and PM_2.5 (9.83%, 95% CI: 5.07-14.81% at lag 5 weeks) per 10-μg/m⊃3; increase. These associations remained robust in dual-pollutant models and GAMM sensitivity analyses. Concentration-response curves indicated approximately linear relationships for NO₂, O₃, and PM_2.5. There is a generally positive correlation between PM₁₀ and PTB incidence risk, but the curve remains relatively flat within the low concentration range, with more pronounced risk increases in the medium to high concentration range. Conclusions This study provides evidence that exposure to NO₂, PM₁₀, PM_2.5, and O₃ is associated with increased PTB risk among students in Jiangsu Province, with effects manifesting at different lag times. The findings highlight students as a vulnerable population to air pollution-related PTB. These findings suggest that integrating stringent air pollution control measures may contribute to PTB prevention strategies.

Abstract: Visceral leishmaniasis (VL) was once one of the five major parasitic diseases posing a serious threat to public health in China. Through dedicated control efforts, the disease had been basically eliminated in most endemic areas by the early 1980s. However, since the 21st century, a rapid resurgence of mountain-type zoonotic visceral leishmaniasis has occurred in central and western China, with numerous historically endemic counties experiencing re-emergence and a continuous geographical expansion of the epidemic area, currently spanning seven provinces/municipalities: Gansu, Sichuan, Shaanxi, Shanxi, Henan, Hebei, and Beijing. This article systematically reviews the current epidemiological characteristics, spatiotemporal distribution, and monitoring status of vector sandflies and reservoir hosts (dogs). It analyzes the drivers of the resurgence under the combined effects of global climate change, ecological environmental shifts, and social factors. Existing control measures focusing on case management, reservoir host and vector control, along with their associated challenges, are summarized. To advance sustainable control and elimination, recommendations are proposed, including strengthening integrated research, promoting the translation of technologies into practice, and establishing a multi-sectoral collaborative governance network.

Abstract: Objective　To analyze the epidemiological characteristics and influencing factors of treatment outcomes of patients with pulmonary tuberculosis with diabetes mellitus (TB-DM) in Guizhou Province from 2017 to 2023, and to provide a reference for scientific formulation for the control and prevention strategies of co-morbidities. Methods　The information data of pulmonary tuberculosis patients registered in Guizhou Province from 2017 to 2023 were collected from Tuberculosis Information Management System under National Health Insurance Disease Control Information System. The prevalence of TB-DM patients was analyzed using descriptive epidemiological methods, and the influencing factors of treatment outcomes were analyzed using binary logistic regression. Results　From 2017 to 2023, a total of 7 892 TB-DM patients were registered in Guizhou Province, with an average registration rate of 2.94/100 000. The registration rate showed an increasing trend year by year, with an average annual increase of 28.84% (95%CI: 22.16%-35.87%, t=12.36, P<0.001); the proportion of TB-DM patients among pulmonary tuberculosis population was 3.14%, increasing from 1.24% in 2017 to 6.35% in 2023, showing an increasing trend (χ2trend=2 841.53, P<0.001). The proportion of males, 45-<65 years old, the proportion of farmers, positive etiological examinations, referrals for diagnosis, primary treatment patients, and secondary pulmonary tuberculosis in TB-DM patients were all higher than those in non-TB-DM patients, and the differences were statistically significant (P<0.05). The successful treatment rate of TB-DM patients in the province was 91.95%, and adverse outcome incidence was 8.05%. The adverse outcomes were mainly adverse reactions (3.34%) and treatment failure (2.49%). The results of multivariate logistic regression analysis showed that age≥65 years (OR=1.47, 95%CI: 1.17-1.85) and retreatment (OR=1.78, 95%CI: 1.14~2.78) were risk factors for adverse outcomes in TB-DM patients. Conclusion　The number and proportion of registered TB-DM patients showed an upward trend in Guizhou Province from 2017 to 2023, and the incidence of adverse outcomes was high. We should focus on elderly people aged 65 and above, as well as patients with co-morbidities who have been retreated, and further do a good job in tuberculosis and diabetes mellitus bidirectional screening.

Abstract：Objective　Investigate the detection rate of hyperuricemia (HUA) among the personnel stationed on Xisha Islands, analyze the correlation as well as influencing factors between HUA and various biochemical indicators, so as to provide a scientific basis for the prevention and treatment of HUA. Methods　A cross-sectional study method was adopted using the laboratory data from the physical examination (n=2 100) of the personnel stationed on the islands at the People's Hospital of Sansha City in Xisha Islands. Statistical analysis was carried out on biochemical test indicators. The differences in biochemical test indicators between the HUA group (n=724) and the control group (n=1 376) were compared. Pearson correlation analysis and logistic regression model were used to analyze the independent risk factors for HUA. Results　The total detection rate of HUA was 34.48%. The uric acid (UA) level in the HUA group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The levels of CR, BUN, ALT, AST, TBIL, ALB, TC, TG, and LDL-C in the HUA group were all higher than those in the control group (P<0.05), and the HDL-C level in the HUA group was lower than that in the control group, with a statistically significant difference (P<0.05). Pearson correlation analysis showed that the uric acid (UA) level was positively correlated with CR, BUN, ALT, AST, TBIL, ALB, TC, TG, and LDL-C, while HDL-C was negatively correlated with the UA level. Logistic regression model analysis showed that CR, ALT, AST, TBIL, ALB, TC, TG, and LDL-C were independent risk factors for the occurrence of HUA, while HDL-C was a protective factor for the occurrence of HUA. Binary logistic regression analysis showed that abnormal renal function, abnormal transaminase, and hyperlipidemia were risk factors for the occurrence of HUA. Conclusion　The detection rate of HUA among the personnel stationed on Xisha Islands is relatively high. There is a significant correlation between abnormal renal function indicators, abnormal transaminase indicators, hyperlipidemia, and HUA. It is recommended to establish a regular monitoring mechanism for this group, and implement lifestyle intervention and drug prevention strategies for those with abnormal metabolic indicators.