Objective To explore the gene mutation of isoniazid resistant Mycobacterium tuberculosis(Mtb) and its possible drug resistance mechanism, and to provide theoretical basis for molecular biological diagnosis and clinical drug use of drug-resistant tuberculosis. Methods The drug concentration gradient induction strategy was adopted to induce the international standard strain H37Rv of Mtb into strains with different degrees of INH resistance. Meanwhile, Mtb clinical isolates with similar resistance levels to the laboratory-induced strains were screened out from the biological sample bank. Then, drug sensitivity tests and whole-genome sequencing analyses were conducted on the induced strains and clinical isolates. Results Whole-genome sequencing analysis indicated that gene mutations of katG p.Trp505*, crp p.Ile142Val, rv1048c p.Arg25Ser, glgP p.Val477Leu, ugpB p.Ala254Thr and pckA p.Thr449Ala have a cumulative effect in the INH-resistant Mtb strain model, and the INH resistance of Mtb may be related to the above gene mutations. In addition, sequencing analysis of Mtb clinical isolates also discovered novel mutation sites potentially associated with INH resistance, such as katG (p.Arg463Leu, p.Arg595Leu, p.Leu343Arg, p.Lys143Glu, p.PHe408Ser, p.Arg249His), crp (p.Thr94Ile, p.Asp45Asn, p.Val99Ala), rv1048c (p.Glu23Asp, p.Ala368Val, p.Arg25Cys), glgP (p.Arg781Gly, p.Arg801Ser, p.Arg727Leu, p.Lys255Glu) and ugpB (p.Ala267Thr, p.Ala17Ser, p.Leu309Met). Conclusion The whole-genome sequencing analysis of INH-resistant strains explained at the molecular level that the resistance of Mtb to INH might be related to gene mutations at specific sites. In addition to the classical mutations, the 19 novel mutation sites potentially related to INH resistance still require further experimental verification. The INH-resistant Mtb model constructed in this study provides a relatively complete biological model for further research of INH-resistant tuberculosis.

Objective To explore novel strategies for early identification of pulmonary tuberculosis patients in primary healthcare institutions by leveraging machine learning to fully exploit the value of routine blood parameters in early tuberculosis diagnosis, thereby providing evidence for clinical early identification and screening of tuberculosis in clinical practice. Methods A retrospective analysis was conducted on 1 388 patients who visited Kunming Third People's Hospital (our hospital) and Cangyuan Wa Autonomous County People's Hospital (external hospital) between January 2022 and September 2024. These patients were divided into an experimental group (pulmonary tuberculosis patients) and a control group (healthy individuals undergoing physical examination). Among them, 483 patients in the experimental group and 489 patients in the control group from our hospital were used as the training set, while 226 patients in the experimental group and 190 patients in the control group from the external hospital were used as the validation set. Clinical data of the study subjects were collected. Variable selection was performed using Support Vector Machine-Recursive Feature Elimination (SVM-RFE), Least Absolute Shrinkage and Selection Operator (LASSO), Boruta algorithm, and Random Forest (RF). Multicollinearity among variables was tested using Spearman correlation coefficient and variance inflation factor (VIF). A predictive model was fitted based on logistic regression, presented in the form of a mathematical equation and a nomogram. The model was evaluated using clinical decision curves, clinical impact curves, calibration curves, and external validation. Results A total of 1 388 subjects were included in the study, with 972 in the training set and 416 in the validation set. Twenty-seven routine blood test parameters and combined indicators were included, yielding six potential indicators: mean corpuscular hemoglobin concentration (MCHC), monocyte-to-lymphocyte ratio (MLR), lymphocytes count (LYM), Red Cell Distribution Width-Standard Deviation (RDW-SD), Mean Corpuscular Volume (MCV), and platelets count (PLT). The ROC curve showed the predictive performance of these six indicators as follows: MCHC (AUC: 0.878, 95%CI: 0.856-0.878), RDW-SD (AUC: 0.797, 95%CI: 0.770-0.797), MLR (AUC: 0.790, 95%CI: 0.762-0.791), LYM (AUC: 0.777, 95%CI: 0.748-0.777), MCV (AUC: 0.665, 95%CI: 0.631-0.665), and PLT (AUC: 0.606, 95%CI: 0.570-0.606). To improve the diagnostic performance of the model, indicators with an AUC less than 0.7 were discarded, leaving MCHC, MLR, RDW-SD, and LYM as the predictive factors. Multicollinearity analysis of these four variables showed that all Spearman correlation coefficients were <0.6 and VIFs were <2, indicating no significant collinearity. The predictive model was established as follows: Logit(P) =Y=16.542+0.163×RDW-SD+4.609×MLR-0.069×MCHC-0.796×LYM, where P=1/(1+e^-ʸ) (Y: predictive index, P: predictive probability). In the training set, the model had achieved an AUC of 0.918 (95%CI: 0.900 5-0.935 0), with an optimal cutoff value of 0.544, sensitivity of 78.5%, specificity of 90.2%, and Youden's index of 0.687. In the validation set, the model had achieved an AUC of 0.931 (95%CI: 0.906 3-0.956 4), with an optimal cutoff value of 0.459, sensitivity of 90.7%, specificity of 87.9%, and Youden's index of 0.786. Calibration curves were plotted for both sets. In the training set, the goodness-of-fit test showed: χ²=0.037, P=0.847. In the validation set, the Hosmer-Lemeshow test showed: χ²=3.115 4, P=0.078. Clinical decision curves and impact curves in both training and validation sets demonstrated that the model could provide benefits to patients. The good performance of the model in the validation set indicated that the model had good stability. Shapley Additive explanations (SHAP) were employed to illustrate the model decision-making process. The SHAP summary plot showed that among the four indicators used for modeling, MCHC contributed the most to the model, while LYM contributed the least. Conclusion The prediction model established in this study, based on blood routine parameters and combined indicators, can be used for screening pulmonary tuberculosis patients and guiding early diagnosis. The model has demonstrated high predictive value, good discrimination, clinical applicability, and stability, with broad applicability unrestricted by medical resources.

Objective To evaluate the diagnostic value of nanopore sequencing technology in detecting bronchoalveolar lavage fluid specimens for the diagnosis of pulmonary tuberculosis and its drug resistance. Methods Bronchoalveolar lavage fluid samples were randomly collected from 84 patients with suspected pulmonary tuberculosis admitted to Xi'an Chest Hospital from June 2023 to May 2024. These samples underwent Mycobacterium tuberculosis (MTB) nucleic acid testing, MTB RNA isothermal amplification, mycobacterial culture, mycobacterial smear, and nanopore sequencing. The diagnostic performance of these five detection techniques for pulmonary tuberculosis was evaluated against the final clinical diagnosis as the reference standard. Meanwhile, the drug resistance screening rates of nanopore sequencing were compared with those of the melting curve method and a microplate-based method. Results For diagnosing pulmonary tuberculosis, nanopore sequencing demonstrated a significantly higher sensitivity (86.5%) compared to MTB nucleic acid testing(43.2%), RNA isothermal amplification (41.9%), mycobacterial culture (40.5%), and mycobacterial smear (21.6%). It also showed superior consistency with the clinical diagnosis, with a higher agreement rate (86.9% vs. 50.0%, 48.8%, 47.6%, and 31.0%, respectively) and a stronger kappa coefficient (0.551 vs. 0.154, 0.147, 0.140, and 0.062, respectively). The area under the receiver operating characteristic (ROC) curve for nanopore sequencing was 0.882, outperforming the other four methods (0.716, 0.709, 0.703, and 0.608, respectively). All the above differences are statistically significant. For drug resistance detection, nanopore sequencing achieved a significantly higher detection rate than both melting curve analysis and the microplate-based method (P<0.01). Conclusion Nanopore sequencing can improve the detection rate of pathogens and the screening rate of drug resistance genes in pulmonary tuberculosis, and it has great clinical significance in the diagnosis of pulmonary tuberculosis and its drug resistance.

Objective To describe and analyze the epidemiological characteristics of Xinjiang Uygur Autonomous Region from 2005 to 2023, and to provide evidence-based support for scientific decision-making regarding tuberculosis (TB) prevention and control in Xinjiang. Methods Data on reported pulmonary tuberculosis cases from 2005 to 2023 were obtained from the National Infectious Disease Reporting System. The study analyzed the spatiotemporal trends of TB incidence in Xinjiang as a whole and in its southern and northeastern regions, etiological characteristics, and demographic distribution (gender, age, and occupation) of the cases. Results From 2005 to 2023, Xinjiang reported a total of 750 103 cases of pulmonary tuberculosis (including tuberculous pleurisy), with the number of reported cases showing an initial rise followed by a decrease. In 2023, the etiological positivity rate of reported tuberculosis patients in Xinjiang was 58.50%, which represents an increase of 31.37% compared to the 44.54% reported in 2005. The incidence rate generally declined from 2005 to 2015 [annual percent change (APC)=-1.97%], rose significantly from 2015 to 2018 (APC=18.20%), dropped markedly from 2018 to 2021 (APC=-35.45%), and experienced a slight rebound from 2021 to 2023 (APC=7.36%). In the five prefectures of southern Xinjiang, incidence increased from 2005 to 2018 (APC=3.76%) and fell from 2018 to 2023 (APC=-24.10%), while northeastern Xinjiang experienced a continuous decline throughout the same period (APC=-5.15%). More males were affected than females (Male-to-female ratio=1.17∶1). The proportion of cases among children <15 years old decreased (APC=-5.29%), while the proportion among elderly individuals ≥65 years old increased (APC=1.99%). Farmers, herdsmen, and fishermen constituted the primary affected group, accounting for 69.93% of cases. Conclusion From 2005 to 2023, the reported TB incidence rate in Xinjiang exhibited a fluctuating downward trend. Notably, after implementing the "Xinjiang Model" TB incidence in Xinjiang significantly decreased, demonstrating substantial progress in TB control. Moving forward, it is essential to implement region-specific and category-based strategies to ensure the high-quality and sustainable advancement of the "Xinjiang Model", there by accelerating progress toward ending the TB epidemic.

Objective To evaluate the implementation effectiveness of the brucellosis prevention and control project in Xinjiang Uygur Autonomous Region (Xinjiang), thus providing a scientific basis for future brucellosis prevention and control measures. Methods Monitoring data-including reported incidence characteristics, screening and serological surveillance of high-risk populations, and livestock epidemic data-from four national surveillance sites (Wushi County in Aksu Prefecture, Yanqi Hui Autonomous County in Bayingolin Mongolian Autonomous Prefecture, Hutubi County in Changji Hui Autonomous Prefecture, and Emin County in Tacheng Prefecture) during 2018-2023 were collected and analyzed using a descriptive epidemiological approach. Results From 2018 to 2023, a total of 1 912 cases were reported across the four surveillance sites, yielding an average annual incidence rate of 66.04 per 100 000 population. During this period, 25 412 person-times from high-risk populations underwent screening, with 1 138 confirmed cases detected, resulting in an overall positivity rate of 4.48%. Annual seropositivity rates fluctuated between 3.11% and 6.28%, with no statistically significant difference across the years (χ²=0.257, P=0.612). Surveillance of high-risk occupational personnel identified 685 new confirmed cases, 298 individuals with previous infections, and 155 asymptomatic infections. Across the four surveillance sites, a total of 2 941 249 sheep were tested, with 790 positives (positivity rate: 0.03%), and 369 754 cattle were tested, with 714 positives (positivity rate: 0.19%). Notably, the seropositivity rates for both cattle (β=-0.137, R²=0.50, P<0.001) and sheep (β=-0.055, R²=0.65，P<0.001) showed a significant downward trend. In 2018, 48 samples (whole blood or other body fluids) from acute-phase patients were cultured, from which three Brucella strains were isolated, resulting in a bacterial culture positivity rate of 6.25%. During the surveillance period, one public health emergency, one outbreak, and one emerging cluster were recorded and properly managed. Conclusion From 2018 to 2023, the brucellosis epidemic at the monitoring sites exhibited a fluctuating pattern of an initial decline followed by a rebound, consistent with the overall epidemiological characteristics in Xinjiang. Continuous targeted screening of high-risk populations has substantially enhanced early case detection. Simultaneously, the significant decrease in seropositivity rates among cattle and sheep has contributed to a reduction in both human and animal infections, confirming the efficacy of the integrated prevention and control strategy. Nevertheless, the epidemic situation remains severe. It is therefore recommended to further strengthen routine surveillance, implement targeted health education initiatives, and enhance inter-departmental information sharing to consolidate existing achievements and mitigate potential risks.

Objective To analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Hainan Province from 2014 to 2023, and provide a scientific basis for the control and prevention of HFMD in the region. Methods hfmd data in hainan province from 2014 to 2023 were collected through the chinese disease control and prevention information system. Etiological specimens were collected from a subset of reported cases. The joinpoint regression model and other descriptive epidemiological methods were used to analyze the distribution and trends of the disease. Results from 2014 to 2023, hainan province reported a cumulative total of 316 041 cases, with an average annual incidence rate of 330.51/100 000. Among these, there were 997 severe cases and 13 fatalities. Joinpoint regression analysis indicated a decreasing trend in the overall incidence rate, but the difference was not statistically significant (β=-44.52, t=2.298, P=0.051); while the proportion of severe cases showed a statistically significant decreasing trend over the years(AAPC=-50.61, t=-4.915, P=0.001). The incidence of HFMD exhibited clear seasonality, with bimodal peaks observed in Apr. to Jul. and Sep. to Oct., and severe cases primarily occurring from Apr. to Aug.; Cases have been reported in all counties and cities across the province, with the highest incidence rate observed in Tunchang County (647.60/10⁵), and the lowest in Ledong County (152.94/10⁵). Population distribution showed an imbalanced trend in the reported incidence rates between males and females. The reported incidence rate in males showed a statistically significant decreasing trend (β=-52.14, t=-2.382, P=0.044), while the decreasing trend in females was not statistically significant (β=-36.04, t=-2.185, P=0.060). The majority of cases occurred in children under 5 years old (accounting for 95.44%); severe cases were mainly in children under 3 years old (accounting for 93.48%). Scattered children (79.28%) and preschool children (17.85%) were the main affected population. Regarding pathogen types: EV-A71 predominated in 2014, CVA16 predominated in 2021, while EV-A71, CVA16, and other enteroviruses had similar proportions in 2016. In other years, other enteroviruses were the predominant serogroups. Conclusion Hainan Province is a high-prevalence area for HFMD, with a decreasing trend in both incidence and severe case proportions. Other enteroviruses have gradually become primary pathogens. Effective comprehensive prevention and control measures should be implemented for key populations during the pre-epidemic and epidemic periods.

Objective To analyze the epidemiological and genomic characteristics of Listeria monocytogenes infection in the first case of a pregnant woman's family in Hainan Province, to understand the risk factors of infection, and put forward control and prevention measures and suggestions. Methods Field epidemiological investigation was carried out in a maternal family in Haikou,Hainan in 2021, especially to understand their dietary habits, and suspicious residual food samples, environmental samples and related human biological specimens were collected for laboratory detection. Whole genome sequencing, characteristics analysis and phylogenetic tree analysis were carried out for Listeria monocytogenes detected in all family members, to understand the genetic relationship of strains at the gene level, to identify the source of infection; Through follow-up, the health outcomes of the maternal family and the effectiveness of health education were understood. Results On October 18, 2021, the pregnant woman presented with fever, lower abdominal pain, and diarrhea, to the hospital for symptomatic treatment. The woman delivered a live female infant via cesarean section the same day, and the infant was transferred to the neonatal care. From October 20 to 21, 2021, Listeria monocytogenes were successively detected positive in the mother, the infant and the spouse. Whole genome sequencing was performed on 5 positive strains, and the results showed that one strain from non-mother-to-child transmission was serogroup Ⅱb and ST87. The four strains of serogroup Ⅱa and ST8 from mother-to-child transmission formed an independent and highly homologous evolutionary cluster, which belonged to a major branch cluster in China. The outcome of the telephone follow-up in the first half of 2025 was that the child grew up healthily, no sequelae associated with listeria disease, and changes in health-related behaviors in the family. Conclusion The diversity of dining places brings great uncertainty to food traceability. Listeria monocytogenes can infect fetus through vertical transmission from mother to child. Early identification and timely treatment in hospital are important guarantees for the recovery of the newborn. Health education promotes the formation of health-related behaviors.

Objective To analyze the composition and antimicrobial resistance patterns of pathogenic bacteria isolated from urine specimens in Qinghai Province from 2019 to 2024, and to provide data support for the anti-infection treatment of urinary tract infection patients in Qinghai Province. Methods Data on bacterial isolates from urine specimens were collected from 24 member hospitals of the National Bacterial Resistance Surveillance Network in Qinghai Province between 2019 and 2024. Data are presented as counts and percentages (%). The WHONET 5.6 software was utilized to analyze the species distribution and temporal changes in antimicrobial resistance patterns. Duplicate isolates (i.e., subsequent isolates of the same bacterial species from the same patient) were excluded, retaining only the first isolate for each patient. Bacterial identification was performed using automated bacterial identification systems in the microbiology laboratories of the participating institutions. Antimicrobial susceptibility testing was conducted via the micro-broth dilution method and the disk diffusion (K-B) method, with results interpreted according to the CLSI M100 (ED35) guidelines. Results A total of 26 319 bacterial isolates were obtained from urine specimens during the study period. Gram-negative bacteria accounted for 20 021 isolates (76.1%), while Gram-positive bacteria constituted 6 298 isolates (23.9%). The most frequently isolated pathogens were Escherichia coli (15 617 isolates, 59.2%), followed by Enterococcus faecium (2 055 isolates, 7.8%), Enterococcus faecalis (1 940 isolates, 7.3%), Klebsiella pneumoniae (1 330 isolates, 5.0%), Enterobacter cloacae (582 isolates, 2.0%), Proteus mirabilis (531 isolates, 1.9%), Klebsiella oxytoca (429 isolates, 1.5%), Streptococcus agalactiae (410 isolates, 1.5%), and Pseudomonas aeruginosa (339 isolates, 1.2%). Among Enterobacterales (including E. coli, K. pneumoniae, P. mirabilis, E. cloacae, and K. oxytoca), resistance rates to cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, ertapenem, and amikacin were low (below 9%). In contrast, high resistance rates were observed for ampicillin (8 757 isolates, 84.8%), and cefazolin (7 771 isolates, 56.7%). P. aeruginosa exhibited low resistance to amikacin (below 3%) but higher resistance to levofloxacin (328 isolates, 18.7%). Enterococci isolates demonstrated low resistance to linezolid, vancomycin, and teicoplanin (below 2.2%). All S. agalactiae isolates remained susceptible to penicillin G, ampicillin, vancomycin, and linezolid. Conclusions From 2019 to 2024, Gram-negative bacteria were the predominant pathogens isolated from urine specimens in Qinghai Province, with no significant annual variations in the distribution of bacterial species. Clinicians should reasonably use antibiotics according to the drug sensitivity results to reduce the production of drug-resistant bacteria.

Objective To analyze the relationship between HIV-specific immune response in the plasma and viral reservoir size of individuals with human immunodeficiency virus (HIV) infection, and to explore new markers for evaluating HIV reservoirs. Methods A total of 96 HIV-infected individuals diagnosed at Chongqing Public Health Medical Center and followed up for at least 3 years from July 2021 to May 2024 were enrolled in this study. HIV DNA and cell-associated RNA (CA-HIV RNA) in peripheral blood mononuclear cells (PBMCs) were detected by fluorescence quantitative PCR, and HIV antibody levels in peripheral blood were quantitatively measured by immunosorbent assay. Combined with clinical infection parameters, correlation analysis was performed using the Spearman correlation coefficient. Results The median (interquartile range, IQR) age of the 96 participants was 51 (36, 59) years. Following long-term antiretroviral therapy (ART), the plasma viral load of all participants was suppressed to undetectable levels. The median M(P₂₅, P₇₅) levels of HIV DNA and CA-HIV RNA levels were 2.81 (2.29, 3.10)log10 copies / 10⁶ PBMCs and 2.68（2.28, 2.98）log10 copies/10⁶ PBMCs, respectively, and they were positively correlated (r=0.606 9, P<0.01). HIV DNA was positively correlated with baseline HIV RNA at 4.91 (4.40, 5.39) log₁₀ copies/mL (r=0.3292, P<0.01). HIV DNA and CA-HIV RNA were both negatively correlated with baseline CD4⁺ cell counts of 177 (72, 287) cells/µL (r=-0.513 3, P<0.01; r=-0.322 8, P<0.01), while positively correlated with HIV p24 antibody levels of 2.61 (1.96, 3.08) light units (r=0.37, P<0.01; r=0.371 1, P<0.01), respectively. Conclusions In chronically HIV-infected individuals, pre-ART clinical parameters and post-ART specific antibody levels are closely associated with the size of the HIV reservoir. Therefore, monitoring these indicators could be valuable for assessing the viral reservoir in people living with HIV.

Objective To assess the trends in late presentation among HIV/AIDS patients in Guiyang City from 2012 to 2024, and to predict the number of late-detected incidents for 2025-2026, thereby providing a reference basis for the development of precise prevention and control strategies for early-detected cases. Methods The study combined descriptive epidemiological analysis with time-series forecasting. The newly reported HIV/AIDS cases in Guiyang City from 2012 to 2024 were selected from the China AIDS Comprehensive Prevention and Control Information System. The time trend of late presentation was analyzed by using the Joinpoint regression model; an Autoregressive Integrated Moving Average (ARIMA) model was used to predict the number of late presentation patients for 2025-2026. Results From 2012 to 2024, 14 128 new HIV/AIDS cases were reported in Guiyang City, and the incidence rate increased from 10.20/100 000 in 2012 to 20.09/100 000 in 2024, with an overall increasing trend [Average Annual Percent Change (AAPC)=4.16%, P<0.001]. During 2012-2024, there were 10 521 late presentation cases, with an overall late presentation rate of 74.47%, which declined slowly over time (AAPC=-1.05%, P=0.003). The proportion of late presentations was higher in the ≥50 age group (80.28%) compared to the <50 age group (71.17%), and higher for heterosexual transmission (77.87%) compared to homosexual transmission (64.58%). Joinpoint regression model analysis indicated a slow downward trend in the proportion of late presentations across different genders, age groups, and modes of transmission. The AAPCs for males, ≥50 years, and homosexual transmission were -0.81%, -0.87%, and -1.15%, respectively, with no statistically significant change. In contrast, the AAPCs for females, <50 years, and heterosexual transmission were -1.87%, -1.42%, and -1.24%, respectively (all P<0.05). Conclusion From 2012 to 2024, the overall incidence of HIV/AIDS in Guiyang showed an increasing trend. Although the proportion of late presentations has been slowly decreasing, it remains high-particularly among individuals aged ≥50 years and those infected via heterosexual transmission-who should be prioritized in HIV prevention and control. Tailored health education and optimized testing strategies should be developed for these key populations to enhance early detection.

Objective To identify and conduct phylogenetic analysis of four newly recorded species of Ixodidae (hard ticks) discovered during tick surveillance in Anhui Province, China. Methods Tick specimens were collected from domestic animals and pets in Chaohu City, Qimen County, and Mengcheng County, Anhui Province. After preliminary morphological identification, mitochondrial large subunit ribosomal RNA (16S rRNA) and cytochrome c oxidase subunit I (COI) genes of the ticks were amplified via PCR and sequenced. The obtained sequences were compared in the GenBank database. Phylogenetic trees were constructed using MEGA11, and genetic distance matrices were analyzed. Results The newly recorded tick species included Haemaphysalis formosensis, Haemaphysalis campanulata, Haemaphysalis yeni of the genus Haemaphysalis, and Rhipicephalus turanicus of genus Rhipicephalus. Phylogenetic analysis of 16S rRNA sequences confirmed that the newly recorded species clustered with their respective counterparts in GenBank. Kimura-2P genetic distance analysis revealed 16S rRNA sequences of the four newly recorded tick species of the Ixodidae family in Anhui Province had an intraspecific distances of 0-0.07, and interspecific distances of 0.08-0.19 among the three Haemaphysalis species. COI-based phylogenetic analysis indicated that H. formosensis clustered with Haemaphysalis flava, while also forming a larger clade with Haemaphysalis longicornis and Haemaphysalis hystericis. In contrast, H. yeni and H. campanulata formed a separate clade. Kimura-2P analysis of COI sequences showed intraspecific distances of 0-0.09, and interspecific distances of 0.12-0.20 among the three Haemaphysalis species. Conclusions Integrated morphological and molecular analyses confirmed the presence of H. formosensis, H. campanulata, H. yeni, and R. turanicus in Anhui Province. It is necessary to enhance surveillance of ecology and pathogen-carrying status of these newly recorded tick species.

Objective Analyze the characteristics of virulence genes, drug resistance genes, molecular typing, and genetic evolutionary relationships of Salmonella in clinical and food samples in Cangzhou City in 2024, to provide data support for optimizing regional food safety regulatory strategies. Methods A total of 43 Salmonella strains (30 clinical isolates and 13 foodborne isolates) collected from food risk monitoring and active surveillance samples of foodborne diseases in Cangzhou were subjected to antimicrobial susceptibility testing and whole genome sequencing (WGS). Bioinformatics tools were applied for serotyping, multilocus sequence typing (MLST), identification of AMR and virulence genes, and construction of a phylogenetic tree. Results Whole-genome sequencing analysis of the 43 Salmonella strains identified 5 serogroups and 15 serotypes in total. Among these, serogroups B and D were the dominant serogroups, and the predominant serotypes were Salmonella Typhimurium monophasic variant 1,4,[5],12:i:- of serogroup B (8 strains) and Salmonella Enteritidis of serogroup D (12 strains). MLST identified 15 sequence types (STs), the serotypes corresponded highly with the ST types, with ST11 (associated with S. enteritidis) and ST34 (linked to S. Typhimurium monophasic variant) as dominant clones. A total of 88.37% of strains exhibited antimicrobial resistance, with the highest resistance rate to ampicillin (79.07%, 34/43). Multidrug-resistant (MDR) strains accounted for 65.12% (28/43), among which one strain showed resistance to up to 12 antimicrobial agents across 10 classes, highlighting the severe problem of multi-drug resistance. WGS analysis identified 65 AMR genes and 131 virulence genes. Phylogenetic tree analysis indicated high genetic homology among strains of the same serotype. Conclusion The dominant serotype of Salmonella isolated in Cangzhou is Salmonella Enteritidis, mainly ST11. These strains carry a variety of AMR genes and virulence factors, posing potential epidemic risks. Therefore, it is necessary to strengthen the monitoring, prevention and control of Salmonella infections in this city.

Objective To investigate the impact of baseline HBV DNA viral load on treatment decision-making and virological response in patients with chronic hepatitis B, analyze independent factors affecting virological response, and provide evidence for individualized clinical treatment. Methods Clinical data from 196 patients with chronic hepatitis B enrolled in Hainan General Hospital from 2021 to 2024 were retrospectively analyzed. Patients were stratified into low, medium, and high viral load groups based on baseline HBV DNA levels. Baseline characteristics, treatment indications, actual treatment status, and virological response rates were analyzed across groups. Logistic regression analysis was used to identify independent factors affecting virological response. Results This study included 196 patients with chronic hepatitis B, comprising 133 males（67.9%）, with age of (52.1±12.8) years. Based on baseline HBV DNA levels, patients were divided into low viral load group（74 cases）, medium viral load group（69 cases）, and high viral load group（53 cases）. High viral load was positively correlated with disease severity. The rate of normal ALT decreased with increase of viral load（P<0.001）, while HBeAg positive rate increased significantly（P<0.001）. All liver function parameters deteriorated with increase of viral load（all P<0.05）. Treatment rates showed viral load dependency: 10.8% in the low viral load group, 42.0% in the medium viral load group, and 67.9% in the high viral load group（P<0.001）. The virological response rate in the treatment group was significantly higher than that in the untreated group（P<0.001）, with antiviral therapy showing greater benefit in medium and high viral load groups（P<0.001）. Multivariate analysis revealed that antiviral therapy was an independent protective factor（OR=3.85, P=0.046）, while liver cirrhosis was an independent risk factor（OR=0.28, P=0.008）. Conclusion HBV DNA viral load is associated with disease severity and treatment decision-making. Antiviral therapy significantly improves virological response, with greater benefit observed in medium and high viral load groups. Antiviral therapy and liver cirrhosis are independent factors affecting virological response.

Objective To investigate the clinical distribution and antimicrobial resistance trends of Gram-negative bacilli isolated from sterile body fluid specimens in 23 hospitals within the North-South Medical Consortium of Suzhou region, and to provide a scientific basis for formulating treatment strategies and antibacterial drug use plans for patients. Methods Retrospective analysis was conducted using WHONET 5.6 and SPSS 29.0 software on the departmental distribution and antimicrobial resistance patterns of Gram-negative bacilli isolated from sterile body fluid specimens collected from 23 hospitals in the Suzhou North-South Medical Consortium between 2019 and 2023. Results After removing duplicates, a total of 3 882 Gram-negative bacilli were identified from sterile body fluid specimens across the 23 hospitals. The top five isolated bacteria ranked as follows: Escherichia coli (37.7%-42.3%), Klebsiella spp. (19.8%-23.1%), Proteus spp. (8.8%-10.4%), Enterobacter spp. (6.2%-9.1%), and Pseudomonas aeruginosa (4.2%-8.9%). The median age of patients was 56 years, with a male-to-female ratio of 1.14∶1. The three departments with higher detection rates of Gram-negative bacilli were general surgery (1 035 cases, 26.7%), intensive care unit (691 cases, 17.8%), and oncology (590 cases, 15.2%). Blood specimens had the highest positive detection rate (70.9%), followed by pleural/ascitic fluid (16.1%), bile (12.6%), and cerebrospinal fluid (0.4%). E. coli exhibited varying degrees of decreased resistance to amtronam, cefepime, ceftazidime, ceftriaxone, cefazolin, ampicillin, levofloxacin, ciprofloxacin and amoxicillin/clavir, while Klebsiella spp. showed a significant upward trend in resistance to gentamicin, levofloxacin, compound sulfamethoxazole, ciprofloxacin, tetracycline and amoxicillin/clavulanic acid (P<0.05). The detection rate of imipenem-resistant P. aeruginosa increased. Carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant P. aeruginosa (CRPA) detection rates rose significantly (P<0.05). Carbapenem-resistant A. baumannii (CRAB) detection rates showed no significant variation (P>0.05). Conclusions From 2019 to 2023, the overall resistance rates of Gram-negative bacilli isolated from sterile body fluids in 23 hospitals across the Suzhou north-south medical consortium have gradually increased. However, significant differences in strain resistance exist among different patient populations and departments. Clinical medication decisions require individualized approaches with close monitoring of resistance evolution.

Objective To analyze epidemiology trends and influencing factors of influenza (referred to as flu for short) in Guiyang City from 2014 to 2024, providing scientific evidence for influenza control and prevention in Guiyang City. Methods Influenza incidence report data and influenza pathogen typing data in Guiyang from 2014 to 2024 were collected from the "Chinese Disease Control and Prevention Information System", and influenza vaccination data was exported from the "Guizhou Province Immunization Program Information System". The Joinpoint regression model was used to analyze the temporal trend of influenza incidence, and descriptive statistical analysis was performed on the epidemiological characteristics of pathogens and influenza vaccination status. Results A total of 82 104 influenza cases were reported in Guiyang from 2014 to 2024, with an average annual incidence rate of 145.20/100 000. The overall incidence of influenza showed an upward trend in Guiyang from 2014 to 2024 (AAPC=50.72%, P=0.01), among which the upward trend of incidence rate in men (AAPC=49.65%, P=0.01) was consistent with that in women (AAPC=51.89%, P=0.01). Seasonal indices showed a bimodal distribution, with the peak in December in winter at 3.6, followed by a secondary peak in March of the following spring at 3.0. From 2019 to 2024, a total of 1 998 119 doses of influenza vaccine were administered in Guiyang City, with an average annual vaccination rate of 5.93%. The influenza vaccine coverage rate for entire population has consistently remained low. The incidence of influenza and vaccination rates exhibited different trends across various age groups. The incidence rate and vaccination rate showed a divergence between 5-<10 age group and 20-<30 age group, while the incidence rate and vaccination rate in other age groups tend to align. The epidemiological characteristics of influenza virus showed clear annual fluctuations and changes in virus types, with H3N2 influenza A being the predominant epidemic strain. Conclusion The overall influenza incidence has shown an upward trend in Guiyang from 2014 to 2024, with a sharp increase in incidence after 2022, closely related to public behavior, the type of pathogens, and vaccination rates. It is recommended to strengthen monitoring, track influenza epidemics, actively promote influenza vaccination campaigns, and adjust vaccination strategies promptly for different populations to effectively control the influenza epidemic.

Objective To analyze the clinical characteristics, etiology, diagnostic findings, and treatment of tinea capitis and tinea vellus caused by zoophilic dermatophytes in a tertiary A hospital in Wuhan from 2023 to 2024, aiming to provide reliable laboratory evidence for clinical diagnosis. Methods Data from 46 patients with tinea capitis, 38 patients with tinea vellus, and 12 patients with concurrent tinea capitis and tinea vellus were collected for the study. All patients had zoophilic dermatophytes cultured at their initial visit to the dermatology outpatient department of Wuhan No. 1 Hospital from January 2023 to December 2024. All patients underwent dermoscopy and ultraviolet-enhanced fluorescence dermoscopy (UEFD) observations using the Chuanghong Medical Dermoscopy Workstation, and the characteristics under the dermoscopy were recorded. All patients were followed up for 6 months as required. Results Among the 96 patients, 34 were male and 62 were female, with ages ranging from 8 months to 69 years and a median age of 5 (4,9) years. A total of 65 Microsporum canis strains and 31 Trichophyton mentagrophytes strains were isolated. Seventy-eight patients met the criteria for documented animal contact history, with cats being the primary source of exposure, accounting for 57.69% (45/78). Direct microscopic examination revealed endothrix infection in 57 patients and ectothrix infection in 39 patients. Among them, the proportion of ectothrix infection caused by Microsporum canis was significantly higher than that caused by Trichophyton mentagrophytes (χ²=22.167, P<0.001). Both Microsporum canis and Trichophyton mentagrophytes can cause tinea capitis and tinea vellus. Regarding the site of infection, compared with Microsporum canis, Trichophyton mentagrophytes was more likely to cause infections on the head, face, and neck (χ²=6.862, P<0.05), while Microsporum canis was more likely to cause infections on the trunk and upper limbs (χ²=4.873, P<0.05). In terms of the morphology of skin lesions, Trichophyton mentagrophytes frequently presented as single ring-shaped skin lesions compared with Microsporum canis (χ²=10.267, P<0.05), while Microsporum canis more commonly manifested as multiple coin-shaped skin lesions (χ²=10.852, P<0.05). In terms of dermoscopic features, the detection rate of zigzag or barcode-like hair in Microsporum canis infections was significantly higher than in Trichophyton mentagrophytes infections (χ²=30.553, P<0.05), while white follicular pustules were more frequently observed in Trichophyton mentagrophytes infections (χ²=9.377, P<0.05). Moreover, the positive rate of UEFD in Microsporum canis infections was significantly higher than in Trichophyton mentagrophytes infections (χ²=34.706, P<0.001). Treatment follow-up revealed that the treatment duration was shorter for patients with tinea vellus than for those with tinea capitis, and shorter for common tinea vellus and tinea capitis compared to pustular tinea vellus and tinea kerion. Conclusion Microsporum canis and Trichophyton mentagrophytes are important pathogenic fungi of zoophilic dermatophytes, each with distinct primary parasitic hosts. Fungal fluorescence staining combined with UEFD can serve as an important tool for the diagnosis and therapeutic effect evaluation of zoophilic dermatophytes. Understanding the pathogenic fungi, parasitic hosts, and characteristics of UEFD of zoophilic dermatophytes is helpful for the early diagnosis, standardized treatment, and prevention of this disease.

Objective To analyze the current status and development trends of chikungunya research in China using bibliometric methods, and to provide a reference for optimizing control and prevention strategies. Methods Literature related to chikungunya from 2006 to 2025 was retrieved from CNKI, VIP, and Wanfang databases. VOSviewer 1.6.18 was used to visualize authors and keywords. Python 3.10 was applied to generate word clouds. CiteSpace was used to perform keyword emergence analysis, and Excel 2019 was used to calculate annual publication volume and institutional distribution. Results A total of 295 publications were included. The annual volume of publications fluctuated, with peaks in 2008, 2012, 2014, and 2020, followed by a downward trend in the recent five years. Institutional analysis showed that the Guangdong Entry-Exit Inspection and Quarantine Bureau (21 articles) and the Chinese Center for Disease Control and Prevention (17 articles) were the most productive institutions, mainly located in Category Ⅰ and Ⅲ risk regions. Author analysis identified HUANG Jicheng (15 articles) and ZHENG Kui (14 articles) as core authors. Keyword frequency analysis indicated that the top three high-frequency keywords were "chikungunya virus" "chikungunya fever", and "imported". Keyword co-occurrence clustering revealed that the main research topics included viral molecular characteristics, arbovirus identification and control (e.g., dengue virus, Zika virus), clinical and pathological features, epidemiological surveys, monitoring of imported cases, and diagnostic techniques. The keyword timeline indicated research hotspots shifted from early research on imported cases to detection techniques, with recent focus on vaccine development and co-circulating arbovirus surveillance and identification. Conclusion Chikungunya research in China shows an outbreak-driven fluctuation pattern, and the number of studies is expected to increase in the next 1-2 years. It is recommended to focus on broad-spectrum antiviral drug development and diffusion risk modeling, strengthen team collaboration, and establish a joint prevention and control platform linking epidemic areas in southern China with research institutions.

Objective Stagnant water in flower vases in a cemetery can become a breeding ground for mosquitoes, especially in warm and humid climates. The purpose of this survey is to determine whether the physical characteristics of the flower vases affect mosquito breeding. Methods The physical characteristics of a total of 527 flower vases and their impact on mosquito breeding were investigated in an old cemetery in Gainesville, Florida, during summers from 2000 to 2003, intermittently. Results The vases were categorized into five types based on their shape and material. Approximately 94.1%(496) of vases were made of stone, 3.2% (17) were made of glass, 1.9%(10) were made of metal, and 0.8%(4) were made of plastic or other materials. Approximately 44.6% (235/527) of the vases or containers were located in shady areas, most of which were under trees. Approximately 17.3% (91/527) of vases and containers held water, ranging from 100 mL to 1 000 mL. About 48.4% (44/91) of the water-holding containers presented mosquito larvae. They were Aedes aegypti (5%), Aedes albopictus (60%), Aedes triseriatus (30%), Culex quinquefasciatus (2%), and Toxorhynchites. rutilus (2%). In addition, the prevention and management of mosquito breeding in cemetery flower vases have been proposed and discussed. Conclusions The physical characteristics of the flower vases impacted the container-inhabiting mosquitoes in the old urban cemetery.

This paper reports the discovery, diagnosis, treatment, and epidemiological survey of three epidemiologically linked cases of Chlamydia psittaci infection, originating from a common source across two incidents in Wuhan City in 2024, aiming to provide a reference for the diagnosis, treatment, and prevention of Chlamydia psittaci infection. One confirmed case was attributed to environmental exposure; the patient, who frequently took naps and enjoyed the cool on his own balcony, was infected by feathers, feces, and other secretions from homing pigeons kept on the balcony of an upstairs neighbor. The diagnosis was confirmed by a positive targeted next-generation sequencing (tNGS) result for Chlamydia psittaci. Two additional clinically diagnosed cases were traced to direct contact through the breeding of homing pigeons; these individuals had exchanged pigeons with the breeder whose birds carried the pathogen. All three cases recovered and were discharged after receiving anti-infective and symptomatic treatment. Subsequent investigation found that five environmental samples tested positive for Chlamydia psittaci nucleic acid, whereas all samples from human contacts tested negative. These cases highlight that Chlamydia psittaci poses a risk to specific populations and underscore the importance of obtaining a detailed epidemiological history for timely diagnosis and identification. To effectively prevent and control Chlamydia psittaci infection, there is an urgent need to formulate relevant prevention and control plans and technical guidelines to standardize diagnosis, treatment, and disease transmission control.

This report details the diagnosis, investigation, and treatment process of the first imported case of chikungunya fever in Haikou City, Hainan Province. The patient, Mr. Yang, is a 34-year-old male student returning from Germany. He departed from Berlin, Germany, on July 21, 2025, and transited through Guangzhou, Guangdong Province, where he was stranded for three days in Tianhe District due to a typhoon. On July 24, he took a flight back to Haikou, Hainan. At 20:00 on July 26, the patient noticed a round red papule with tenderness on the inner side of his left thigh and sought medical attention at the emergency department of Hainan General Hospital. Laboratory testing by the Haikou Center for Disease Control and Prevention using RT-PCR was positive for chikungunya virus (CHIKV) nucleic acid but negative for dengue virus nucleic acid. Both IgM and IgG antibodies for chikungunya were negative, confirming the diagnosis of chikungunya fever. The patient was hospitalized under mosquito-proof isolation and received supportive care for 8 days, including intermittent oral acetaminophen for fever and pain relief, oral rehydration salts for supportive care, and other symptomatic treatments. The patient's temperature normalized, and his condition improved. Repeat testing showed negative chikungunya virus nucleic acid, and the patient was discharged after mosquito-proof isolation measures were lifted. The prevention and control practice of the first imported case of chikungunya fever in Haikou City, Hainan Province, highlights the core principles of early detection, early diagnosis, early mosquito-proof isolation, and early intervention. Furthermore, active surveillance of imported cases and vector control measures can substantially minimize the risk of local transmission caused by imported cases.