Objective To characterize the incidence of adverse drug reactions associated with tuberculosis preventive therapy (TPT) among incarcerated individuals and to develop a risk prediction model for adverse reactions, thereby providing a scientific basis for implementing targeted interventions and improving tuberculosis prevention and control in correctional facilities. Methods A prospective study was conducted on newly admitted prisoners in a women's prison in Eastern China from October 1, 2022, to October 31, 2023. Participants underwent chest imaging and screening for latent tuberculosis infection (LTBI). Individuals diagnosed with LTBI who provided informed consent received TPT and were monitored for adverse reactions during follow-up. Blood samples were collected for biochemical and cytokine analyses. Predictors selected by the LASSO regression model were incorporated into a multivariable logistic regression to develop a nomogram. Model performance was assessed using the area under the curve (AUC), calibration plots, and decision curve analysis (DCA), with internal validation performed using bootstrap resampling. Results A total of 1 096 newly admitted incarcerated individuals were enrolled, 243 of whom were diagnosed with LTBI. Among the 187 individuals eligible for TPT, 88 completed the treatment course. Adverse reactions occurred in 31.8% (28/88) of the treated participants, with hepatotoxicity (abnormal liver function) being the most prevalent. Elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were independent risk factors, whereas higher lymphocyte counts and interleukin-2 (IL-2) levels were protective factors. A nomogram incorporating these four variables demonstrated robust discriminatory performance with an AUC of 0.884, outperforming individual predictors. Internal validation using bootstrap resampling indicated good calibration with a mean absolute error of 0.055. Decision curve analysis showed that the combined model provided the greatest net clinical benefit across a threshold probability range of 0.2 to 0.8, with a maximum net benefit of 0.6. Conclusions Adverse reactions associated with TPT are relatively common among incarcerated women. The developed prediction model, integrating liver function and immune indicators, serves as an effective tool for stratifying the risk of adverse reactions in this population.
Objective This study aimed to explore the expression profiles of immunogenic cell death-related genes (ICDRGs) in active tuberculosis (ATB) and latent tuberculosis infection (LTBI) using bioinformatics and machine learning approaches, thereby providing novel biomarkers for differential diagnosis. Methods Gene expression datasets (GSE28623, GSE37250, and GSE19491) of ATB and LTBI subjects were obtained from the Gene Expression Omnibus (GEO) database, while ICDRGs were collected from the XDeathDB database and published literature. Using GSE28623 as the training set, differentially expressed genes (DEGs) analysis and weighted gene co-expression network analysis (WGCNA) were performed to screen candidate genes, which were then intersected with ICDRGs to identify candidate ICDRGs. A total of 113 machine learning algorithm classification models were constructed based on the training set data, and their performance was evaluated using the GSE37250 and GSE19491 as validation sets. Core ICDRGs were identified from the optimal model and subjected to single-gene validation and assessment in both training and validation sets. Finally, immune cell infiltration analysis was conducted to examine the association between core ICDRGs and immune cell profiles. Results A total of 439 DEGs were identified. WGCNA revealed the salmon module as the key module containing 263 genes. By intersecting the DEGs, WGCNA modules, and ICD genes, 15 candidate ICDRGs were identified. The random forest (RF) algorithm achieved an average AUC value of 0.953 in both the training set and validation set, ranking first among all models, and identified six core ICDRGs, including CD274, ANKRD22, FLVCR2, JAK2, SERPING1, and IGF2BP3. These genes were upregulated in ATB samples and exhibited AUC values ranging from 0.831 to 0.940 in the three datasets. Immune infiltration analysis indicated that the expression of these genes was positively correlated with the infiltration of monocytes, neutrophils, and macrophages. Conclusion This study identified six core ICDRGs (CD274, ANKRD22, FLVCR2, JAK2, SERPING1, and IGF2BP3) that play pivotal roles in immune regulation, cellular metabolism, and inflammatory responses. These genes exhibited strong diagnostic potential and could serve as novel biomarkers for differentiating ATB from LTBI.
Objective To analyse the factors influencing the occurrence of extensively drug-resistant tuberculosis (XDR-TB) in He'nan Province, providing a theoretical basis for formulating more suitable prevention and control policies for XDR-TB in He'nan Province. Methods The case group comprised XDR-TB patients registered and reported in the Tuberculosis Management Information System (a subsystem of the China Disease Prevention and Control Information System) between January 1, 2011, and August 31, 2021, in Henan Province. The control group consisted of multidrug-resistant tuberculosis (MDR-TB) patients from the same administrative region. Differences in gender, occupation, age, ethnicity, and household registration type were compared between the case and control groups. Factors showing statistical significance were selected for multivariate logistic regression analysis to identify the factors influencing the occurrence of XDR-TB. Results A total of 1 215 pulmonary tuberculosis patients were included, comprising 396 XDR-TB cases and 819 MDR-TB cases. Univariate analysis revealed that occupation (χ2=28.445,P<0.001), household registration status (χ2=12.240,P=0.02), educational attainment (χ2=11.297, P=0.023), marital status (χ2=313.707, P<0.001), alcohol consumption (χ2=4.868, P=0.027), regular exercise (χ2=4.664, P=0.031), and awareness of MDR-TB drug resistance patterns (χ2=7.658,P=0.006) were statistically significant. Multivariate logistic regression analysis indicated that occupation as farmer (OR=1.406, 95%CI: 1.067-1.852) and household registration type involving inter-city/inter-provincial migration (OR=1.791, 95%CI: 1.247-2.572) constituted risk factors for XDR-TB. Alcohol consumption (OR=0.720, 95%CI: 0.530-0.977) and awareness of MDR-TB drug resistance patterns (OR=0.705, 95%CI: 0.546-0.910) were protective factors against extensive drug resistance. Conclusion Priority should be given to tuberculosis patients whose occupation is farming and whose household registration status indicates inter-city/inter-provincial mobility. Efforts should be intensified to promote tuberculosis-related knowledge and education, with particular emphasis on the management and health education of these two groups.
Objective To analyze the relapse status and influencing factors of patients with successfully treated pulmonary tuberculosis in Guizhou Province from 2015 to 2023, and to provide a reference for improving control and prevention strategies for recurrent pulmonary tuberculosis patients. Methods The information of patients with successfully treated pulmonary tuberculosis in Guizhou Province from 2015 to 2023 was collected through the National Health Insurance Tuberculosis Information Management System of the Chinese Center for Disease Control and Prevention. The information was matched with the recurrent pulmonary tuberculosis patients registered from 2015 to 2024 using a retrospective cohort analysis method. The recurrence rate and cumulative recurrence rate of pulmonary tuberculosis patients in each observation year were calculated using the life table method, and the influencing factors of relapse were analyzed using the Cox proportional hazards regression model. Results Of the 280 574 successfully treated initially diagnosed pulmonary tuberculosis patients included in the study, 11 165 cases experienced recurrence by the end of the follow-up period, with a recurrence rate of 3.98%. The median recurrence time to relapse was 2.70 years, and the recurrence rate density was 0.79/100 person-years. The proportion of patients with recurrence within one year was 20.99%, with a 1-year recurrence rate of 0.86%. The proportion of patients with recurrence within three years was 54.32%, with a cumulative 3-year recurrence rate of 2.43%. The proportion of patients with recurrence within six to ten years was 21.92%, with a cumulative 10-year recurrence rate of 6.98%. Cox proportional hazards regression analysis showed that male (HR=2.74, 95%CI: 2.60-2.88), farmers (HR=1.55, 95%CI: 1.47-1.64), age 20-<40 years (HR=1.22, 95%CI: 1.14-1.30), age 40-<60 years (HR=1.11, 95%CI: 1.03-1.19), positive etiology (HR=1.60, 95%CI: 1.53-1.66), and co-existing diabetes (HR=1.73, 95%CI:1.55-1.93) were risk factors for recurrence in successfully treated pulmonary tuberculosis patients. While treatment with fixed dose combination drugs (HR=0.77, 95%CI: 0.71-0.83) was a protective factor against recurrence in successfully treated pulmonary tuberculosis patients. Conclusion The risk of recurrence in successfully treated pulmonary tuberculosis patients in Guizhou Province is relatively high. Emphasis should be placed on standardized diagnosis and treatment, and follow-up management for male patients, farmers, those aged 20-<40 and 40-<60 years, those with positive etiology, and those with pulmonary tuberculosis complicated by diabetes, and early intervention measures should be implemented to reduce recurrence.
Objective To evaluate the diagnostic value of a two-step CRISPR/Cas12a assay using tongue swab samples for pulmonary tuberculosis (PTB). Methods The data of hospitalized patients were collected from Wuxi Fifth People's Hospital between October 2024 and July 2025. Bronchoalveolar lavage fluid (BALF), tongue swabs, and blood samples were collected from participants. These samples underwent mycobacterial culture, GeneXpert assay, T-SPOT.TB test, two-step CRISPR/Cas12a assay, genetic chip testing, and fluorescent acid-fast staining smear microscopy. Results were compared and analyzed with the clinical composite reference standard. Results A total of 136 hospitalized patients were included from the Fifth People's Hospital of Wuxi City from October 2024 to July 2025, with 82 assigned to the tuberculosis group and 54 to the non-tuberculosis group. Comparison of the performance of tongue swab-related tests: The sensitivity of tongue swab CRISPR/Cas12a detection was 74.4%, significantly higher than that of tongue swab mycobacterial culture (12.2%), tongue swab acid-fast bacillus smear (2.4%), and tongue swab GeneXpert (32.6%), with a statistically significant difference (χ²=135.05, P< 0.001); its specificity was 96.3%, although lower than that of tongue swab acid-fast bacillus smear, tongue swab mycobacterial culture, and tongue swab GeneXpert (all with a specificity of 100.0%), the difference was not statistically significant (χ²=6.05, P>0.05). Comparison of the sensitivity of detection methods: The sensitivity of GeneXpert detection in bronchoalveolar lavage fluid (BALF) was the highest (87.8%), followed by BALF CRISPR/Cas12a in BALF (82.9%), CRISPR/Cas12a in tongue swab (74.4%), T-SPOT (73.1%), and mycobacterial culture in BALF (48.8%), and the differences in sensitivity among the above methods were statistically significant (χ²=38.04, P<0.001). Comparison of the specificity of detection methods: The specificity of GeneXpert and mycobacterial culture in BALF was both 100.0%, significantly higher than that of CRISPR/Cas12a in tongue swab (96.3%), CRISPR/Cas12a in BALF (96.3%), and T-SPOT (88.5%), with a statistically significant difference (χ²=13.01, P<0.05). Comparison of diagnostic efficacy (area under the ROC curve): The area under the ROC curve of GeneXpert detection in BALF was the largest (0.926), with the highest diagnostic efficacy; followed by CRISPR/Cas12a in BALF (0.914), CRISPR/Cas12a in tongue swab (0.852), T-SPOT (0.784), and mycobacterial culture in BALF (0.747). CRISPR technology only requires a detection time of 2 hours, which is comparable to that of GeneXpert, and much shorter than the 42 days of the culture method, and the single detection cost is much lower than that of GeneXpert. Conclusion The CRISPR/Cas12a assay using tongue swab samples demonstrates good diagnostic performance for PTB. It offers an innovative solution for TB screening in resource-limited settings and special populations, holding promise as an important supplement to the existing tuberculosis diagnostic system.
Objective To investigate the current status of latent tuberculosis infection (LTBI) and identify potential risk factors associated with LTBI among retired miners with occupational dust exposure but without pneumoconiosis, to provide a scientific basis for LTBI screening and intervention in this population. Methods A cross-sectional survey was conducted among retired miners with dust exposure but without pneumoconiosis, collecting general demographic characteristics and occupational characteristics related to dust exposure. LTBI detection was performed using the QuantiFERON-TB Gold In-Tube (QuantiFERON) test. Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with LTBI among dust-exposed workers. Results A total of 292 dust-exposed workers were surveyed; after excluding 11 participants with indeterminate QuantiFERON results, 281 participants were included in the LTBI analysis. The prevalence of LTBI was 32.4% (91/281), and 2.5% (7/281) had a history of tuberculosis. The LTBI rate was relatively higher among tunneling workers (46.2%,42/91). Alcohol consumption was independently associated with the risk of LTBI (Model A: aOR=2.030, 95%CI:1.195-3.779, P=0.026; Model B: aOR=2.003, 95%CI: 1.007-3.726, P=0.028). There was a significant difference in forced expiratory volume in one second (FEV1) between the non-LTBI group and the LTBI group (P=0.043). Conclusion The prevalence of LTBI is high among retired miners with occupational dust exposure but without pneumoconiosis, with approximately 2.5% having a history of tuberculosis. Alcohol consumption is an independent risk factor for LTBI in this population, and this population exhibits poorer lung function (FEV1). Screening for latent tuberculosis infection and implementing preventive treatment measures are necessary for retired miners with occupational dust exposure.
Objective To explore the value of the diagnostic models constructed by machine learning algorithm (MLA) in the diagnosis of smear-negative active pulmonary tuberculosis (SNAPT), providing new insights for the diagnosis and treatment of inactive pulmonary tuberculosis with negative bacterial cultures. Methods A retrospective study was conducted. According to the inclusion criteria, 318 patients with smear-negative active pulmonary tuberculosis and 900 patients with other respiratory diseases excluding pulmonary tuberculosis, admitted to Nantong Sixth People's Hospital from January 2020 to April 2025, were enrolled as the experimental and control groups, respectively. A total of 38 clinical indicators, including general clinical data, imaging examination results, and hematological indicators, were collected. Data collation and statistical analysis were performed using R 4.4.3 software. The 1 218 patients were randomly divided into a training set (n=853) and a validation set (n=365) at a 7∶3 ratio. Potential predictors were screened through three methods: univariate analysis, LASSO regression, and Boruta feature selection algorithm. Seven machine learning algorithms were used to establish prediction models. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was used to evaluate the discrimination ability of the prediction model. Calibration curves were used to evaluate the accuracy of the model. Decision curve analysis (DCA) was performed to evaluate the clinical practicability of the model and determine the optimal model. Shapley additive explanations (SHAP) are used to evaluate the importance and contribution of model feature variables and to analyze the mechanism of action of features and their impact on classification. Results Six predictors were selected by cross-validation of the three feature selection methods. Among the seven machine models, the artificial neural network (ANN) model performed the best, with an AUC of 0.929, an F1 Score of 0.756, an accuracy of 0.879, a sensitivity of 0.716, and a specificity of 0.937. In addition, the calibration curve and decision curve analysis show that this model outperformed other methods. The SHAP summary plot revealed that the top six key features included the presence of fever, hemoptysis, and chest pain symptoms, as well as elevated platelet to hemoglobin ratio (PHR), interferon-gamma (INF-γ), and interleukin-2 (IL-2) levels. Conclusion The diagnostic model of smear-negative active pulmonary tuberculosis based on artificial neural network algorithms demonstrates superior diagnostic performance and can identify smear-negative active pulmonary tuberculosis more simply, quickly, and effectively.
Objective To evaluate the in vitro antibacterial activity of plasma-activated water (PAW) against drug-resistant Mycobacterium tuberculosis (MTB), and to provide a theoretical basis for adjuvant treatment of drug-resistant tuberculosis or disinfection of the environment and medical devices. Methods Select the standard MTB strain H37Rv stored in the tuberculosis laboratory of the Tuberculosis Prevention and Control Hospital in Shaanxi Province, and determine the in vitro antibacterial effect of PAW on MTB under different solution media, activation water preparation time, concentration and treatment time; using the colony counting method to calculate the PAW inhibition rate as the result determination standard, and evaluating the antibacterial effect of PAW on drug-resistant MTB (including 6 rifampicin-resistant MTB strains, 2 multidrug-resistant MTB strains and 2 extensively drug-resistant MTB strains. Results The minimum inhibitory concentration (MIC) of plasma-activated physiological saline (PAS) after 25 minutes of activation was 12.5%, which was lower than 25% of that of plasma-activated distilled water (PAD); after treatment for 10, 20, 30, and 60 minutes, the colony counts of 50% and 75% PAS for MTB were (54.11±1.38) × 102 and (41.89±1.92) ×102 CFU/mL, (38.78±1.01) × 102 and (21.33±1.03) × 102 CFU/mL ，respectively, and the bacterial counts after incubation with 75% PAS were significantly lower than those with 50% PAS (F=662.398, 802.605, both P<0.001); the inhibition rates of 50% and 75% PAS for the H37Rv standard strain after incubation for 20 and 30 minutes were 98.5% and 98.8%, 98.9% and 99.4%, respectively, and the inhibition rates of 75% concentration PAS after incubation for different times were higher than those of 50% PAS; the inhibition rates of 75% concentration PAS for 10 clinical isolates of drug-resistant MTB treated were all > 90%, indicating that PAS has a strong inhibitory effect on drug-resistant MTB. Conclusion PAS exhibits excellent in vitro anti-MTB activity and has potential application value in assisting physical treatment for drug-resistant tuberculosis or in the disinfection of the environment and medical devices.
Tuberculosis remains one of the leading causes of death from infectious diseases worldwide. The emergence of drug-resistant tuberculosis poses significant challenges to global TB control and prevention efforts. Linezolid, contezolid, and tedizolid are new-generation oxazolidinone antibiotics widely used to treat multidrug-resistant Gram-positive bacterial infections. In 2018, the World Health Organization (WHO) classified linezolid as a core Group A drug for treating multidrug-resistant and rifampicin-resistant tuberculosis. Contezolid, a novel oxazolidinone drug independently developed in China, has shown remarkable efficacy in treating tuberculosis. Consequently, the Expert Consensus on Contezolid for Tuberculosis Treatment (2025) provided standardization and guidance for its use in TB management. However, with the widespread use of these drugs, resistance has gradually emerged. Accurate and timely detection of linezolid-, tedizolid-, and contezolid-resistant strains is crucial for curbing the spread of resistance and enhancing clinical therapeutic outcomes. This article reviews the resistance mechanisms and associated genetic mutations in Mycobacterium tuberculosis against linezolid, contezolid, and tedizolid, aiming to provide insights for future rapid detection of resistance to these three drugs and to support their rational use in clinical practice.
Objective To clarify the epidemic regularity, genetic evolution characteristics, and molecular variation of H9N2 subtype avian influenza virus (AIV) in Shanghai from 2016 to 2024, and to provide a basis for formulating targeted control and prevention measures for AIV infection. Methods Continuous surveillance was conducted in poultry farms and trading venues in Shanghai, with a total of 43 484 specimens, including throat swabs and fecal swabs, collected. Nucleic acid detection, virus isolation and culture, whole-genome sequencing, and bioinformatics analysis were performed to analyze the virus positive rate, regional/yearly distribution, lineage clustering, molecular characteristics, and recombination events. Results The total positive rate of influenza A virus was 8.10% (3 521/43 484), among which 2 334 were H9N2 subtype-positive. Temporal distribution of H9N2-positive specimens were concentrated in 2016-2019 (2 166/2 334, 92.8%); geographical distribution were mainly in Pudong (800/2 334, 34.3%), Songjiang (395/2 334, 16.9%), and Chongming (248/2 334, 10.6%) districts. The main sources were live poultry markets (1 475/2 334, 63.2%) and poultry farms (459/2 334, 19.7%); throat swabs (504/2 334, 21.6%) and fecal samples (405/2 334, 17.4%) were the primary specimen types. Eighty-six H9N2 AIV sequences were successfully isolated and sequenced, all belonging to lineage B, with dominant clusters B4.7.4 (33/86, 38.4%) and B4.7.1 (18/86, 20.9%). The cleavage site of hemagglutinin (HA) protein was the low pathogenicity characteristic sequence RSSR, and the high-frequency mutation sites in the HA gene included Q227M (100.0%), Q156R (88.4%), and T192R (87.2%). Recombination analysis indicated that the sequence FX201712051_HA was a recombinant product of PD18_022_0204112_HA and FX201610007_HA. Conclusion Although no human cases of avian-origin H9N2 influenza have been reported in Shanghai, the prevalent strains have evolved synchronously with the mainstream domestic lineages while exhibiting regional recombination characteristics that require attention. It is recommended to strengthen continuous surveillance and risk assessment of recombinant strains, clarify the transmission routes of the virus in poultry farms (e.g., airborne and contact transmission), so as to provide a basis for formulating targeted prevention and control measures.
Objective To investigate the genetic diversity, population differentiation, and phylogenetic relationships of Aedes albopictus geographic populations in major airports and port areas in China, assess the role of these transportation hubs in the cross-border spread of the species, and provide molecular evidence for vector surveillance and invasion-risk assessment at Chinese ports of entry. Methods From September 2023 to September 2024, a total of 22 Ae. Albopictus populations were collected from major airports and port areas in China. Genomic DNA was extracted from individual mosquitoes. The mitochondrial cytochrome c oxidase subunit Ⅰ (COⅠ) gene was amplified by PCR and sequenced. The obtained sequences were aligned using BLAST at NCBI and analyzed for population genetic structure and differentiation using DnaSP v6, Arlequin 3.5, and MEGA 11.0. Results A total of 136 mitochondrial COⅠ sequences (effective aligned length, 636 bp) were obtained from 22 Ae. albopictus populations across major airports and port regions in China. The mean A+T content was 67.43%, showing an A + T bias typical of mitochondrial DNA. Thirty haplotypes were identified by haplotype analysis, with shared haplotypes accounting for 30% of all haplotypes. Haplotypes 1 and 11 were the dominant types. Neutrality tests suggested that the populations might have experienced recent expansion or purifying selection. The Mantel test supported the "isolation by distance" effect, indicating more frequent gene flow among geographically proximate populations. Analysis of molecular variance (AMOVA) revealed that 38.89% of genetic variation occurred among populations. The fixation index (FST) and AMOVA jointly confirmed that population differentiation among different airports and port areas in China was significant, and intra-population diversity was dominant. Population genetic structure analysis (K=3) and phylogenetic reconstruction demonstrated that the 22 populations rapidly expanded from an ancestral gene pool and subsequently diverged into three subgroups associated with the geographical barrier of Hainan Island: the Hainan-Southwest dispersal subgroup, the East China Coast-Yangtze River Delta subgroup, and the Hainan Island subgroup. Conclusions Populations of Ae. albopictus in major airports and port areas across China show rapid post-bottleneck expansion and exhibit a pattern of multi-source introduction and regional dispersal along transportation networks, suggesting that convenient transport systems may facilitate the dispersal capacity of this species.
Objective To construct the prokaryotic expression plasmid pET30a-EgG1Y162-2(4)-Co1, induce its expression to produce the recombinant protein EgG1Y162-2(4)-Co1, and subsequently characterize its preliminary immunological properties and predict its secondary and tertiary structures using bioinformatics methods. Method The recombinant plasmid pET30a-EgG1Y162-2(4)-Co1 was constructed through DNA recombination. After validation by restriction enzyme digestion and sequencing, the confirmed plasmid was thermostatically transformed into E. coli BL21(DE3) competent cells. The expression of the recombinant protein was induced with an optimal concentration of isopropyl β-D-1-thiogalactopyranoside (IPTG) and subsequently purified using nickel-affinity chromatography. The purified protein was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and the final product was confirmed by Western blotting. The secondary and tertiary structures of EgG1Y162-2(4)-Co1 were predicted using online bioinformatics tools, including SOPMA and SWISS-MODEL. Results Through restriction enzyme digestion, we successfully constructed a 6 324 bp recombinant plasmid pET30a-EgG1Y162-2(4)-Co1. Following induction, a recombinant protein with a relative molecular mass of approximately 40 kDa was expressed. Western blot analysis demonstrated that the recombinant protein specifically bound to both anti-His-tag antibodies and specific antibodies present in the serum of Echinococcus granulosus-infected mice, with the reactive band appearing at 40 kDa as expected. Bioinformatics analysis revealed that the protein comprised 9.46% α-helices, 24.59% β-sheets, and 65.95% random coils, indicating that the protein can fold correctly to perform its potential immunological functions. Conclusion We successfully developed the pET30a-EgG1Y162-2(4)-Co1 prokaryotic expression plasmid for Echinococcus granulosus, induced the expression of the M-cell-targeting EgG1Y162-2(4)-Co1 recombinant protein, and predicted its spatial structure. These findings provide essential groundwork for advancing vaccine development targeting Echinococcus granulosus.
Objective To analyze the characteristics of lipid levels in HIV/AIDS patients who have received long-term antiretroviral therapy (ART） and the influencing factors for the first occurrence of dyslipidemia, to provide a basis for reducing risk of CVD occurrence in AIDS patients. Methods A retrospective cohort study design was adopted to collect the lipid data of HIV/AIDS patients who received ART at the outpatient department of a certain infectious disease hospital in Yunnan Province from 2020 to 2024. The patients were grouped according to the initial ART regimen: BIK group, DTG group, EFV group, LPV/r group, NVP group, and Other group. The follow-up period was 48 months. Logistic regression analysis was used to investigate the relationship between treatment regimen and lipid levels. Results A total of 445 patients were included. During the follow-up period, the time of the first occurrence of dyslipidemia in HIV/AIDS patients was 18 (12, 24） months. With the prolongation of antiviral treatment time, the incidence of hypertriglyceridemia was 19.10%, the incidence of hypercholesterolemia was 16.63%, and the incidence of mixed hyperlipidemia was 13.93%. Among all treatment regimens, the incidence of hypertriglyceridemia was the higher in the NVP group (20.00%） and the DTG group (19.44%）, the incidence of hypercholesterolemia was the higher in DTG group (18.06%） and the LPV/r group (18.00%）, and the incidence of mixed hyperlipidemia was highest in the BIK group (18.33%）. Multivariate logistic regression analysis found that using DTG-ART (OR=1.58,95% CI:1.03-2.72） and hyperglycemia (OR=1.38, 95% CI:1.10-2.15） were risk factors for hypertriglyceridemia in HIV/AIDS patients; using NVP-ART (OR=1.74, 95% CI:1.12-2.68） and hyperglycemia (OR=1.79, 95% CI:1.15-2.78） were risk factors for hypercholesterolemia in patients. Conclusions Different ART regimens have different effects on lipid levels in HIV/AIDS patients. Especially for patients using DTG and NVP regimens, it is recommended to regularly monitor their lipid levels and promptly assess whether to adjust the treatment regimen or take lipid-lowering drugs for patients with dyslipidemia to reduce the risk of cardiovascular diseases.
Objective To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) infection among children aged 0-14 years in Hainan Province, China, and to provide evidence for clinical prevention, early evaluation, and timely intervention of RSV infection. Methods Nasopharyngeal swab specimens were collected from pediatric patients (0-14 years) with acute lower respiratory tract infection who received RSV testing in outpatient, emergency, or inpatient departments at Hainan Women and Children's Medical Center from 2020 to 2024. RSV infection was confirmed using nucleic acid detection, multiplex PCR-capillary electrophoresis, and multiplex targeted amplification-based next-generation sequencing (tNGS). A comprehensive clinical database was established, and statistical analysis was performed to conclude. Results From 2020 to 2024, a total of 32 309 specimens were collected, among which 4 683 tested positive for RSV, yielding an overall positive detection rate of 14.49% (4 683/32 309). The RSV detection rate was 15.06% in male children, which was higher than 13.61% in female children (P<0.01). The highest RSV detection rate (24.97%) was observed in the infant group (1 month-1 year of age), with detection rates showing an overall decreasing trend with increasing age (P<0.01). RSV infections demonstrated distinct seasonal patterns, with autumn epidemics in 2020, summer-autumn epidemics in 2021, winter prevalence in 2022, and spring-summer epidemics in 2023-2024. Among RSV-positive specimens, single RSV infection was identified in 1 255 cases (26.8%), while mixed infections were detected in 3 428 cases (73.20%). The top three non-bacterial respiratory pathogens co-detected with RSV were human rhinovirus (HRV), Mycoplasma pneumoniae, and human parainfluenza virus (HPIV), in descending order of prevalence. RSV genotypes A and B exhibited alternating spatiotemporal epidemic patterns in Hainan Province. The RSV positive detection rate among severe pediatric cases was 12.49% (209/1 673), with the highest positivity rate in the neonatal group (33.33%), followed by the infant group (22.19%). Conclusion In Hainan Province, the peak period of RSV infection in children aged 0-14 years generally shifted forward, appearing as off-season epidemics, and gradually presented a phenomenon of low-level prevalence throughout the year. The RSV epidemic period basically coincided with the local rainy season. Both the overall positive detection rate and the positive detection rate among severe cases of RSV infection showed negative correlations with age. Epidemiologic surveillance demonstrated alternating spatiotemporal circulation patterns of RSV genotypes A/B, accompanied by substantial co-infection prevalence.
Objective To understand the species composition, density, and seasonal fluctuation patterns of ticks in Hefei, and to analyze environmental factors affecting capture, as to provide a scientific basis for efficient tick monitoring and control, as well as the prevention and control of tick-borne diseases. Methods A spatial multistage random sampling method was used to select 40 monitoring sites. At each site, 1-2 habitats were chosen as fixed survey locations, with no repeated habitat types. From March 2023 to February 2024, free-living ticks were surveyed monthly using the flagging method, and environmental factor data were collected. A binary logistic regression analysis was conducted to analyze the relationship between common environmental factors and successful tick capture. Results A total of 1 020 ticks comprising 5 species were captured, with 988 individual of Haemaphysalis longicornis (accounting for 96.86% of the total). The tick density was 0.222 3 ticks/（flag·100 m）. There were statistically significant differences in tick density and Haemaphysalis longicornis density between urban and rural areas, among counties (districts/cities), and across different habitat types (all P<0.01). The average tick density ranked as follows: farmland > forest land > wasteland grassland > suburban park > urban park. The dominant species in all five habitats was Haemaphysalis longicornis. The population dynamics of nymphs and larvae of Haemaphysalis longicornis led to a characteristic bimodal density pattern, with a primary peak in March and a secondary peak in September. There were statistically significant differences in tick density and in the density of Haemaphysalis longicornis across seasons (all P<0.01). Rural location, centered surface temperature and its square term, centered elevation, and centered surface humidity square term affected capture of ticks (all P<0.01). Centered surface temperature and its square term, centered surface humidity, and centered elevation showed a right-skewed inverted U-shaped, inverted U-shaped, and linear relationship with the odds of tick capture, respectively. The most suitable surface temperature and surface humidity were 22.59 °C and 64.45%, respectively. Conclusion Haemaphysalis longicornis is the dominant tick species in Hefei. The tick density exhibits bimodal seasonal peaks, primarily in spring and secondarily in autumn, and is significantly higher in rural areas and their habitats than in urban areas. Hierarchical monitoring and precision control should be prioritized for ticks, especially Haemaphysalis longicornis, in rural areas and habitats with suitable temperature and humidity, to comprehensively assess the risk of tick-borne infectious diseases and improve control effectiveness.
Objective To investigate the prevalence of Vibrio parahaemolyticus (VP) in environmental water and aquatic animal samples in Panyu District of Guangzhou, and to analyze antibiotic resistance (AMR) profiles of VP isolates from diverse sources, thereby providing theoretical support for the prevention of zoonotic diseases caused by VP. Methods From July 2023 to August 2024,, a total of 777 samples of water bodies and aquatic animal products were collected from Panyu District. VP isolation and identification were performed according to GB 4789.7-2013 "National Food Safety Standard—Microbiological Examination of Food—Examination of Vibrio parahaemolyticus". Antimicrobial susceptibility analysis was performed on 72 VP isolates from water bodies, aquatic products, and clinical sources using the broth microdilution method. Results Among the 777 samples, 212 tested positive for VP, yielding a detection rate of 27.3%. The highest detection rate was observed in ready-to-eat shrimp at 71.7% (86/120). Significant differences in VP detection rates were found among different environmental sources (χ2=143.765, P<0.01) and seasons (χ2=23.130, P<0.01). High detection rates were observed in spring and autumn, accounting for 36.5% (70/192) and 35.1% (53/151), respectively. The overall resistance rate of VP was 18.1% (13/72), with the highest resistance observed against ampicillin at 16.7% (12/72). Water-source VP isolates exhibited higher resistance rates than those from aquatic products and clinical sources. Ready-to-eat shrimp and the spring-autumn seasons are associated with a higher risk of VP contamination. Continuous surveillance of VP epidemiology and AMR trends in the environment is crucial for preventing human infections and aquaculture-related outbreaks caused by Vibrio parahaemolyticus, thereby reducing associated disease burdens and economic impacts.
Objective To investigate the therapeutic effects of luteolin (Lut) combination with entecavir (ETV) on replication of hepatitis B virus (HBV) by regulating Kelch-like ECH-associated protein 1/nuclear factor erythroid 2-related factor 2/antioxidant response element (Keap1/Nrf2/ARE) pathway, to provide new approaches for the clinical treatment of patients infected with HBV. Methods The human hepatocyte cell line HepG2.2.15 expressing HBV was cultured in vitro and the concentration of Lut was screened by cell counting kit-8(CCK-8) method. HepG2.2.15 cells were assigned into Control group, ETV group, Lut group, ETV+Lut group, ETV+Lut+pcDNA-NC group, and ETV+Lut+pcDNA-Keap1 group. The levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in the cell supernatant were detected by ELISA, the level of HBV DNA in the cell supernatant was detected by RT-PCR, and the protein expression levels of Keap1, Nrf2, NAD (P) H-quinone dehydrogenase 1(NQO1), HBsAg and HBeAg in the cells were detected by Western blot. A mouse model of HBV infection was established by injecting the AAV8-1.3 HBV recombinant adenovirus vector through the tail vein. The mice were divided into the Model group, ETV group, Lut group, ETV+Lut group, and ETV+Lut+ML385 group. The levels of HBsAg and HBeAg in serum, the activity of SOD and the content of MDA in liver tissue were detected by ELISA, and the protein expression levels of HBsAg, HBeAg, Keap1, Nrf2 and NQO1 in liver tissue were detected by immunohistochemistry and Western blot. Results Compared with the Control group, the levels of HBV DNA, contents of HBsAg and HBeAg, and protein expression in the supernatant of HepG2.2.15 cells in the ETV group and the Lut group decreased significantly, while the protein expression levels of Nrf2 and NQO1 in the Lut group increased significantly, and the protein expression level of Keap1 decreased (P<0.05). Compared with the ETV group and the Lut group, the levels of HBV DNA, HBsAg, HBeAg and protein expression in the supernatant of HepG2.2.15 cells in the ETV+Lut group decreased significantly (P<0.05). Compared with the ETV+Lut+pcDNA-NC group, the levels of HBV DNA, the contents of HBsAg and HBeAg, and the expression of Keap1 protein in the supernatant of HepG2.2.15 cells in the ETV+Lut+pcDNA-Keap1 group were significantly increased, while the expression levels of Nrf2 and NQO1 proteins were significantly decreased (P<0.05). Animal experiments showed that compared with the HBV group, the expression levels of HBsAg and HBeAg were significantly decreased in serum and liver tissues of mice in the ETV group and the Lut group. The protein expression levels of Nrf2 and NQO1 and the activity of SOD increased, while the protein expression level of Keap1 and the content of MDA decreased in the Lut group (P<0.05). Compared with the ETV group and the Lut group, the expression levels of HBsAg and HBeAg decreased significantly in serum and liver tissues of mice in the ETV+Lut group (P<0.05). Compared with the ETV+Lut group, the expression levels of HBsAg and HBeAg were significantly increased in serum and liver tissues of mice, while the protein expression of Nrf2 and NQO1 as well as SOD activity were decreased in liver tissues, and the MDA content was increased in the ETV+Lut+ML385 group (P<0.05). Conclusion The combination of Lut and ETV can more effectively inhibit the replication of HBV and clear HBsAg and HBeAg, which may be partly related to the Keap1/Nrf2/ARE pathway.
Objective To monitor and analyze the contamination status of avian influenza virus in poultry in the external environment and human infection characteristics of avian influenza virus in Urumqi, provide reference for early warning and scientific evidence for the control and prevention of avian influenza. Methods Samples were collected from environmental surveillance site in Urumqi from 2014 to 2024. Real-time RT-PCR was used to detect influenza A virus, including subtypes of H5, H7, H9. The data of human infection with avian influenza were systematically collected and analyzed by descriptive epidemiological methods. Results A total of 3 001 monitoring samples were collected in Urumqi from 2014 to 2024, 352 samples were positive for nucleic acid of avain influenza, the total positive rate was 11.73%. In the positive samples, the proportions of subtypes H5, H7, H9, and mixed positive samples were 11.08%, 7.10%, 73.30%, 8.52%, respectively. There were statistically significant differences in the positive rate among different years (χ2=130.211, P<0.01), monitoring sites （χ2=53.156, P<0.001）, and specimen types(χ2=28.702, P<0.01). And 9 cases of human H7N9 avian influenza were reported in Urumqi, all cases had history of poultry exposure, mainly retires and migrant workers, with an average age of 68.67 years. Most of the cases occurred in July and August (4 cases). There were no typical seasonal epidemic characteristics. There was a significant correlation between the number of human H7N9 avian influenza cases and the positive rate of H7 subtype in different years (r=0.941, P<0.01). Conclusion Avian influenza virus pollution remains ongoing in Urumqi external environment, H9 is the main subtype, H5 and H7 subtypes were also occasionally detected. High-risk exposure in highly contaminated areas is the greatest risk factor for avian influenza virus infection in humans. Etiological surveillance and comprehensive prevention and control measures should be carried out continuously to reduce the potential risk of human infection.
Lyme neuroborreliosis (LNB) an infectious disorder of the central nervous system caused by Borrelia burgdorferi, has witnessed notable diagnostic and therapeutic breakthroughs in recent years. Progress encompasses MRI-based auxiliary imaging techniques, pediatric serological panels incorporating inflammatory protein biomarkers, the introduction of metagenomic next-generation sequencing (mNGS) for pathogen detection, and cerebrospinal fluid CXCL13 as a highly specific diagnostic indicator. On the therapeutic front, innovations include in-silico modeling of Bb for drug-target discovery, identification of Tenascin-C as a potential intervention point, and endovascular approaches for LNB-associated cerebral vasculitis. This article systematically reviews the current knowledge on epidemiological characteristics, clinical manifestations, emerging diagnostic techniques, and evolving treatment strategies for LNB, and explores future research directions. The aim is to provide a reference for improving the diagnostic accuracy and treatment effectiveness of LNB, ultimately enhancing patient prognosis.
The number of malaria infections in the world remains high, and the resistance to antimalarial drugs is a recurring issue, which poses a serious challenge to prevention and treatment of malaria. The resistance mechanisms of different antimalarial drugs vary significantly. For instance, artemisinin resistance is associated with mutations in the Kelch 13 gene (PfK13), while chloroquine resistance is linked to genetic variations in chloroquine-resistance transporter (Pfcrt). Additionally, drugs such as piperaquine and mefloquine also encounter varying degrees of resistance issues. Although China has eliminated indigenous malaria, imported cases have been increasing annually, with some carrying drug-resistant genetic mutations. For this, we need to establish a systematic monitoring system, continuously track the efficacy of antimalarial drugs, in vitro susceptibility test results, and the development of resistance in malaria parasites, and adjust medication plans and prevention and control strategies on time. This article provides a review of the current status and monitoring methods of antimalarial drug resistance, providing scientific evidence to guide the rational use of antimalarial drugs and supporting the development of surveillance strategies for monitoring drug resistance in imported malaria cases, thereby addressing the current challenges of drug resistance in global malaria control.
Objective To analyze the investigation and response process of an incident involving a single dog attacking multiple people in He'nan Province in 2024, summarize the characteristics of the incident, evaluate the response effectiveness, and provide a reference for the investigation and management of similar incidents. Methods A self-designed questionnaire was used to collect information, including the basic information of exposed individuals, exposure details, post-exposure management, and outcomes. The rapid fluorescent focus inhibition test (RFFIT) was employed to detect rabies virus neutralizing antibodies (RVNA) after vaccination. Real-time fluorescent polymerase chain reaction (qPCR) was used to detect rabies virus nucleic acid in specimens from the attacking dog. Descriptive epidemiological methods were applied for data analysis and description. Results A total of 38 exposed individuals were involved in this incident, all of whom were classified as Category Ⅲ exposure. All patients received wound treatment, vaccination, and administration of passive immunizing agents. Among them, the rate of standardized wound treatment within 24 hours was 81.58% (31/38), the timely vaccination rate of the first dose of vaccine within 24 hours was 94.74% (36/38), and the administration rate of passive immunizing agents within 24 hours was 84.21% (32/38). The neutralizing antibody levels of all exposed individuals who underwent rabies virus antibody detection were >0.5 IU/m. Follow-up showed that none of the exposed individuals developed the disease. The stray dog responsible for the incident was culled on-site and disposed of harmlessly. Conclusion This incident was an event of multiple people being attacked by a rabies virus-carrying dog, involving a large number of people. However, the post-exposure response was timely and standardized, the neutralizing antibody levels after vaccination reached the protective level, and no cases or deaths occurred. This highlights the need to strengthen the monitoring and early warning of incidents involving multiple victims bitten by a single dog, improve source control, and conduct joint investigation and disposal through multi-departmental collaboration.
Objective To conduct an epidemiological investigation and traceability analysis of a case of falciparum malaria with an unknown source of infection reported in June 2024, in order to identify the source of infection and transmission route, and to enhance emergency response capabilities. Methods A comprehensive epidemiological investigation and collection of clinical data were carried out for the case. Blood samples from the patient and blood donors (suspected source of infection) were tested using three methods: blood smear microscopy, malaria rapid diagnostic test (RDT), and nested PCR. Positive nested PCR products were sequenced and subjected to homology analysis. Results The patient had no history of malaria infection or traveling to malaria-endemic areas. The microscopic examination of peripheral blood smears was diagnosed as P. falciparum infection, and both RDT and nested PCR tests were positive for P. falciparum. According to epidemiological investigation, the patient received three blood transfusions during hospitalization from May 19 to 27, 2024, and the blood sources were from three donors. The nested PCR test results of the blood samples retained by the donors showed that the blood sample retained by an Equatorial Guinea student was positive for P. falciparum. Sequence analysis of the nested PCR amplification products of SSU rRNA and PfMSP1 showed 100% homology between the patient and the donor. Conclusion This case was confirmed as transfusion-transmitted falciparum malaria, caused by a blood transfusion from an infected African international student.
Objective To conduct the epidemiological investigation of a confirmed case and a suspected case of psittacosis infection reported in Sandu Shui Autonomous County, Qiannan Buyei and Miao Autonomous Prefecture, Guizhou Province in 2024, to trace the source of the infection, and to provide insights for the prevention and control of psittacosis. Methods Field epidemiological investigation was used to collect data, and targeted next-generation sequencing (tNGS) and real-time fluorescence quantitative PCR were used to detect Chlamydia psittaci. Results On June 27, 2024, the confirmed case developed fever and cough of unknown etiology. Subsequently, on July 7, the patient sought treatment at a local health center and Sandu County People's Hospital, and a computed tomography (CT) scan revealed his lung infections and progressive worsening of pneumonia during treatment. On July 15, Chlamydia psittaci was detected in the patient's alveolar lavage fluid, leading to his isolation and treatment until his discharge on July 21. Concurrently, the patient's wife, considered a suspected case, sought medical attention at Sandu County People's Hospital due to fever. Her throat swab test for Chlamydia psittaci was negative, and she received isolation and treatment until July 22. The confirmed case purchased ducks from outside the province on two occasions, 13th and 19th June, at a temporary poultry market in T Community Street of Sandu County. The purchased ducks were raised together with the chickens already kept at home in an enclosure adjacent to the self-built house where the patient lived. The environmental hygiene of the enclosure was poor, and the patient did not adopt personal protective measures while feeding the ducks. During the feeding period, some ducks died of unknown causes, and Chlamydia psittaci nucleic acid was detected positive in the cloacal swab of one remaining duck. Conclusion The case of psittacosis infected through unprotected contact with imported ducks carrying Chlamydia psittaci. Therefore, the supervision of live poultry trading and health education on psittacosis-related knowledge among the public needs to be strengthened.
