Objective    This study aims to explore the prevalence, temporal trends and influencing factors of HIV and syphilis among men who have sex with men (MSM) in Tianjin, and to provide reference for developing scientific and precise intervention and prevention strategies. Methods   Serial cross-sectional surveys were conducted among MSM in Tianjin annually from April to June during 2019–2025, with the support of community-based organizations. Participants were recruited via online recruitment, on-site mobilization, and snowball sampling. Demographic and behavioral data were collected, and blood specimens were obtained for HIV and syphilis testing. The chi-square trend test was applied to analyze changing trends of infection prevalence, and univariate and multivariate logistic regression models were used to identify factors correlated with HIV and syphilis infections. Results   A total of 6 952 MSM were enrolled, and the overall prevalence of HIV, syphilis and HIV-syphilis co-infection was 2.8%, 8.1% and 0.6%, respectively. The prevalence of both HIV and syphilis presented a significant declining trend from 2019 to 2025 (HIV: χ⊃2;=34.143, P<0.001; syphilis: χ⊃2;=17.42, P<0.001). Multivariate logistic regression analysis indicated that educational attainment, marital status, duration of local residence, recruitment approach, sexual role in anal intercourse, consistent condom use during homosexual anal sex in the past six months, and receipt of HIV intervention services in the past year were statistically associated with HIV infection. Educational attainment, occupation, recruitment approach, sexual role in anal intercourse, and consistent condom use during anal sex in the past six months were statistically associated with syphilis infection. Conclusions   The prevalence of HIV and syphilis among MSM showed a downward trend in Tianjin during 2019 to 2025. Targeted health education should be strengthened for MSM with low educational level and high migration, precise intervention strategies should be implemented for subpopulations, and integrated screening and joint prevention of HIV and syphilis need to be further promoted.

Objective   This study aims to establish a diagnostic system based on the combination of etiological and imaging characteristics to differentiate pulmonary nocardiosis from pulmonary tuberculosis, thereby to enhance early discrimination and reduce misdiagnosis and mistreatment. Methods   Clinical data of patients with pulmonary infections admitted to Beijing Chest Hospital, Hebei Chest Hospital, and the Fifth Hospital of Shijiazhuang were analyzed from October 2018 to December 2025. The nocardiosis group consisted of 43 cases initially diagnosed as suspected pulmonary tuberculosis, who were subsequently identified as Nocardia infection by etiological assays. The tuberculosis group consisted of 45 contemporaneous patients confirmed as Mycobacterium tuberculosis infection by culture or molecular biological methods. Standardized MSCT scanning, reconstruction, and image interpretation criteria were applied, and CT signs were independently assessed by two experienced radiologists using a single-blind method. The distribution of lesions, morphological changes, characteristics of cavities, secondary intrapulmonary changes (calcification, satellite lesions, bronchiectasis, air bronchogram, etc.), as well as involvement of pleura and lymph nodes, were compared between the two groups. Additionally, the mechanisms of misdiagnosis were comprehensively analyzed in conjunction with the biological characteristics and pathological changes of Nocardia. Results   The baseline age and gender were comparable between the two groups. Bilateral lung and upper lobe involvement predominated in both diseases, with high overlap in radiological manifestations including patchy opacities, nodules, consolidation, and cavities. The incidence of bronchiectasis in the nocardiosis group (79.07%) was significantly higher than that in the tuberculosis group (15.56%) (χ⊃2;=36.72, P<0.001). Essential differences were observed in cavity characteristics: purulent thick-walled cavities, irregular inner walls, and air-fluid levels within the cavities typically presented in the nocardiosis group, while caseous thin-walled cavities with smooth inner walls, and less presence of fluid components mainly presented in the tuberculosis group (Fisher’s exact test, P<0.05). Regarding secondary and associated signs, significantly higher detection rates of calcification, satellite lesions, and lymph node calcification showed in the tuberculosis group, while proportions of air bronchogram and reactive pleural effusion showed higher in the nocardiosis group (χ⊃2;=7.86 and 6.83, respectively; P<0.01). Among the 43 cases in the nocardiosis group, except for partial isolates of Nocardia farcinica morphologically resembling tuberculosis bacilli, the microscopic features of other strains were distinctly different from Mycobacterium tuberculosis. Species identification was achieved in 39 cases via MALDI-TOF MS and in 4 cases via 16S rRNA sequencing, Nocardia cyriacigeorgica, Nocardia farcinica, and Nocardia otitidiscaviarum were the predominant clinical strains. Conclusion   Pulmonary nocardiosis and active pulmonary tuberculosis are prone to misdiagnosis due to their high similarity in terms of predilection sites and macroscopic imaging. However, there are characteristic differences in fine CT signs including cavity pathological configuration, bronchiectasis, calcification, satellite lesions, and pleural involvement between the two diseases. The combined application of Nocardia culture and molecular biology offers superior diagnostic efficiency. Integrating imaging and etiological examination can effectively enhance the efficacy of differential diagnosis and reduce the rate of misdiagnosis.

Objective  This study aims to compare the differences in the incidence, types, and distribution characteristics of drug resistance mutations between HIV-1 elite controllers (HECs) and normal progressors (NPs), to preliminarily characterize the drug resistance mutation spectrum in the HECs, and to provide a reference for improving the HIV-1 drug resistance surveillance system and elucidating the evolutionary patterns of drug resistance. Methods  A total of 132 HIV-1 infected individuals, who were antiretroviral therapy-naïve in Hebei Province from 2010 to 2022, were enrolled in this study. Based on viral load and CD4⁺T cell counts, patients were divided into an HECs group (n=14) and an NPs group (n=118). The protease-reverse transcriptase (PR-RT) and integrase (IN) coding regions of the HIV-1 pol gene were amplified by PCR and sequenced by Sanger sequencing. Obtained sequences were submitted to the Stanford University HIV Drug Resistance Database (HIV db) for identification of drug resistance mutations and drug susceptibility. Results  There was no statistically significant differences in demographic characteristics between the two groups (P>0.05). A total of 114 PR-RT and 85 IN sequences were successfully amplified. In terms of genotype distribution, CRF07_BC (50.00%) and CRF01_AE (41.67%) were predominant in the HECs group, whereas CRF01_AE (47.06%) and CRF07_BC (36.27%) were predominant in the NPs group, with no significant difference in genotype distribution between the two groups (P>0.05). Regarding drug resistance mutations, there were no significant differences in the overall detection rates of mutations in the PR, RT, and IN coding regions between the two groups (P>0.05); however, no protease inhibitor (PI)-associated mutations were observed in the HECs group. Non-nucleoside reverse transcriptase inhibitor (NNRTI)-associated mutations were the most prevalent in both groups, although the mutation spectrum in the HECs group was narrower than that in the NPs group. Drug resistance analysis revealed that the prevalence of drug resistance was 28.57% in the HECs group, higher than that in the NPs group (6.78%). Only distribution of NRTIs resistance showed a statistically significant difference between the two groups (P<0.05). Conclusions  The results speculated that these mutations are more likely to be acquired upon transmission, and some mutations that reduce viral replicative capacity may contribute to host virological control. This study adds to the baseline drug resistance data among the HECs population in Hebei Province, providing evidence for refining regional HIV drug resistance surveillance strategies and informing individualized initial antiretroviral therapy regimens tailored to individuals with different patterns of disease progression.

The rising prevalence of HIV drug resistance in China, poses a major challenge to clinical antiretroviral therapy. Standardized resistance surveillance, optimization of individualized treatment regimens, and comprehensive follow‑up management are critical for improving treatment success rates and quality of life in patients. This article reviews a case of an adult patient with multidrug‑resistant HIV infection treated at Daye Municipal Hospital of Traditional Chinese Medicine in Hubei Province, detailing the fluctuations in viral load, the evolution of genotypic resistance testing results, and the treatment course, summarizing clinical experience in managing multidrug‑resistant cases. In this patient, first‑line antiretroviral therapy failed; a protease inhibitor‑based regimen achieved short‑term virological suppression but subsequently failed again. After regimen adjustment based on the initial resistance test, viral load rebounded. A comparison of the two resistance test results revealed significant discrepancies, this case highlights that drug-resistant HIV strains are often detectable only under specific drug selection pressure, and underscoring the constraint that archived resistance imposes on subsequent treatment options. Although the patient eventually achieved virological suppression on a regimen combining an integrase strand transfer inhibitor with a partially active protease inhibitor, whether this strategy has generalizable value requires confirmation in more cases; furthermore, future monitoring is required to assess the potential emergence of integrase inhibitor resistance. Concurrently, it is also necessary to strengthen adherence education and health education to reduce HIV drug resistance and improve patients' quality of life.

Objective  To elucidate the species composition, diversity, and 15-year spatiotemporal dynamics of mosquito communities surrounding Beijing Capital International Airport, and to identify meteorological gradients and key source habitats associated with community succession, this study will provide a basis for port-of-entry vector biosafety and precision control strategies. Methods   From May to October annually between 2011 and 2025, adult mosquito surveillance was conducted at seven monitoring sites around the airport using CO₂-baited light traps. Shannon, Simpson, and Pielou diversity indices were calculated, and their inter-annual trends were assessed using the Mann–Kendall test. Canonical correspondence analysis (CCA) was used to analyze the relationships between community composition and temperature, humidity, and precipitation; PERMANOVA based on Bray–Curtis dissimilarity was applied to test differences in community structure across time periods and monitoring sites; and indicator species analysis (IndVal) was conducted to identify habitat-specific indicator species. Results   Over the 15-year period, 246 621 mosquitoes were captured, comprising eight species across four genera, with Culex pipiens pallens as the dominant species (76.08%). The community underwent significant succession: the proportion of C. p. pallens declined from 86.93% (2011–2017) to 52.54% (2018-2025), while Aedes vexans (0.55%→22.13%) and Aedes albopictus (0.61%→12.40%) increased significantly during the same period. All three diversity indices increased significantly over the years (P<0.01). The first axis of CCA explained 40.4% of community variation, with temperature, humidity and precipitation showing positive loadings in the same direction; Aedes species were positioned at the end characterized by “high-temperature–high-humidity–high-precipitation". Community composition differed significantly between the two periods (P=0.001), but showed no significant differences among monitoring sites (P=0.22). IndVal indicated that riparian/wetland areas were significant indicator habitats for Anopheles sinensis, C. p. pallens, Culex tritaeniorhynchus and A. vexans (P<0.05). Conclusion   Against a background of warming and humidification, mosquito communities around the airport are shifting from Culex species dominance toward Aedes species (including Aedes albopictus), with rising diversity; riparian zones and wetlands are critical source habitats. Biosafety surveillance for Aedes albopictus and related species should be strengthened, with source control focused on riparian/wetland habitats.

 Objective  To analyze the biological characteristics of three Yersinia pestis bacteriophages 117, Y280 and Y272 isolated from the plague foci in Yushu Prefecture, Qinghai Province, this study will provide a reference for the prevention, treatment and control of plague in this plague focus. Methods  Using the Yersinia pestis vaccine strain EV76 as the host bacterium, three representative strains of Yersinia pestis bacteriophages were isolated from 167 colonic samples of Himalayan marmots collected from the plague foci in Yushu Prefecture, Qinghai Province, by the double-layer agar plate method. After purification, these isolated phages were amplified. Their morphological characteristics were observed under an electron microscope, and biological characteristics including pH stability, thermal stability, ultraviolet sensitivity, lysis spectrum, and one-step growth curve were determined. Whole-genome sequencing was performed to analyze the genomic features of the three phages. Results  Morphological identification showed that, all three phages belonged to Myoviridae family, and formed clear plaques with a diameter ranging from 0.5 to 2.5 mm on LB agar plates. Biological characteristic analysis revealed that the isolated phages exhibited lytic activity against three strains of Escherichia coli. They remained relatively stable at 60 °C and within a pH range of 5 to 10, and were completely inactivated within 30 minutes of ultraviolet exposure. Whole-genome analysis indicated that the total genome length of phage 117 was 30.68 Kb, with a GC content of 52.9%; the genome of Y272 was 29.49 Kb in length, with a GC content of 51.77%; and Y280 had a genome length of 28.80 Kb, and a GC content of 51.98%. Conclusion  In this study, three Yersinia pestis bacteriophages were isolated and purified, all of which exhibited excellent lytic activity and environmental stability. To a certain extent, this indirectly reflects the stable ecological environment of this plague focus, and can provide a reference for basic research related to the quiescent period of plague epidemiology in this region.

Objective To analyze the chemical composition of Houttuynia cordata essential oil and evaluate the larvicidal and adulticidal effects of the oil and its major active component, 2-Undecanone, against Anopheles stephensi. Methods The essential oil was extracted by steam distillation, and its chemical composition was analyzed by gas chromatography-mass spectrometry (GC-MS). Larvicidal activity of Houttuynia cordata essential oil and its major active component, 2-Undecanone, against the 3^rd-instar larvae of Anopheles stephensi was determined using the Probit analysis bioassay method, while the adulticidal activity was evaluated by a closed fumigation method. Results GC‑MS analysis revealed 15 major components in the essential oil, including 2-Undecanone, β‑pinene, and β‑myrcene. Both the essential oil and 2-Undecanone demonstrated potent dose‑dependent insecticidal effects. For the crude oil, the 6‑, 12‑, and 24‑h median lethal concentrations (LC₅₀) against larvae, as derived from linear regression models, were 89.125, 82.414, and 80.910 µL/L, respectively. In adult bioassays, the median knockdown times (KT₅₀) at concentrations of 2, 4, 6, 8, and 10 µL/L were 13.732, 11.505, 9.523, 8.210, and 6.794 min, respectively, with a consistent 24‑h post‑exposure mortality of 100% across all tested concentrations. For 2-Undecanone, the LC₅₀ values against larvae at 1, 3, and 6 h were 21.488, 17.319, and 15.580 µL/L, respectively; the corresponding KT₅₀ values against adults at 1, 2, 3, 4, and 5 µL/L were 18.808, 14.558, 9.522, 8.339, and 5.791 min, with 24‑h mortality rates exhibiting a clear concentration‑dependent increase. Conclusions Houttuynia cordata essential oil and its major active component 2-Undecanone exhibit potent insecticidal activity against Anopheles stephensi, suggesting their potential as botanical insecticides.

Objective  To investigate the effects and underlying mechanism of loureirin B on neuronal pyroptosis in cerebral infarction rats by regulating the cysteinyl aspartate specific proteinase-3 (Caspase-3)/gasdermin E (GSDME) signaling pathway, this study will provide new experimental evidence for the therapeutic application of loureirin B in ischemic cerelral infarction. Methods  SPF-grade male SD rats were randomly divided into seven groups (n=27 per group): sham group, model group, loureirin B low-dose group (5 mg/kg), loureirin B high-dose group (20 mg/kg), edaravone group (3 mg/kg), Caspase-3 inhibitor (Z-DEVD-FMK) group (0.5 μg/mL, 10 μL), and loureirin B high-dose + Caspase-3 activator (PAC-1) group (20 mg/kg + 3.5 mg/kg). The rat middle cerebral artery occlusion/reperfusion model was established using the modified Longa suture method. In the Sham group, only the arterial dissection was underwent without occlusion. After the final administration, neurological function was assessed using the Zea-Longa score. Serum levels of interleukin (IL)-1β and IL-18 were measured by ELISA. The percentage of cerebral infarction area was measured by TTC staining. Brain water content was calculated using the wet-dry weight method. Brain histopathological morphology was observed by HE staining. The ultrastructure of neurons was observed by transmission electron microscopy. Neuronal pyroptosis was detected by double immunofluorescence labeling of neuronal nuclei (NeuN) and GSDME N-terminal fragment (GSDME-N). Protein levels of Cleaved-Caspase-3, Caspase-3, GSDME-N, GSDME, interleukin (IL)-1β, and IL-18 were determined by Western blot. Results  Compared with the sham group, rats in the model group showed increased Zea-Longa scores, elevated serum levels of IL-1β and IL-18, higher percentage of cerebral infarction area, increased brain water content, increased number of NeuN⁺/GSDME-N⁺ neurons, and upregulated protein levels of Cleaved-Caspase-3, GSDME-N, IL-1β, and IL-18 in brain tissue (P<0.05). Compared with the model group, the above indicators were significantly decreased in the loureirin B low-dose group, loureirin B high-dose group, edaravone group, and Z-DEVD-FMK group (P<0.05). Compared with the loureirin B high-dose group, the above indicators were significantly increased in the loureirin B high-dose+PAC-1 group (P<0.05). Morphological examination revealed disorganized, shrunken, and vacuolated neurons with typical pyroptotic changes under electron microscopy in the model group. These neuronal injuries and pyroptotic features were significantly attenuated in the loureirin B high-dose group, but aggravated in the loureirin B high-dose+PAC-1 group. Conclusion  Loureirin B alleviates neuronal pyroptosis in rats with cerebral infarction by inhibiting the Caspase-3/GSDME pathway, thereby exerting neuroprotective effects.

Objective  To explore the application of intelligent monitoring systems in surveillance of rodent communities in the natural foci of plague, and this study will provide scientific basis for intelligent and digital prevention and control of plague. Methods  Six sample plots were selected within the monitoring area of the natural plague reservoir in Kangbao Pasture, Hebei Province in 2024–2025. Intelligent monitoring terminals for rodent pest control were placed in each plot to monitor the rodent community in real time. Data were collected regularly via the intelligent monitoring platform of the rodent pest information network, and were processed and analyzed using SPSS 20.0 software. Results  From 2024 to 2025, a total of 3 391 individual observations were recorded across 8 species belonging to 5 genera and 3 families of rodents, with 1 341 days of monitoring conducted, and the average rodent density was 2.53 individuals per day. The trend of change was non-linear, expressed as y=-0.078x² +0.6784x+1.486 6, R²=0.396 2. Meriones unguiculatus and Citellus dauricus were dominant rodent species, while Meriones meridianus Pallas and Cricetulus barabensis were common species. The species diversity and community structure of the 6 sample plots were not exactly the same. The endemic rodent species were Meriones unguiculatus and Meriones meridianus Pallas in plots A, B, D, and E, while the endemic species was Citellus dauricus in plots C and F. In 2024, the rodent community diversity index H was 1.04, the evenness index J was 2.02, and the dominance index D was 0.43. The dominant rodent specie was Meriones unguiculatus in spring, summer, and autumn, while was Meriones meridianus in winter. In 2025, the diversity index H was 1.43, the evenness index J was 2.78, and the dominance index D was 0.3. The dominant rodent specie was Meriones unguiculatus in spring and summer, Cricetulus barabensis in autumn, and Meriones meridianus in winter. The average number of rodent species over 24 hours was 3.96±1.36, with the highest species diversity occurring at 1:00, 2:00, and 24:00, each recording six species. Both Meriones unguiculatus and Meriones meridianus Pallas were active throughout 24 hours, but their activity peaks differed. Conclusion  The intelligent monitoring system can reflect the community structure, population density, biodiversity, seasonal changes and activity rhythms in a natural state. It can be used as a means for intelligent monitoring of epidemic sources, realizing a new approach of digital and intelligent monitoring, and providing important experience for plague prevention and control.

Abstract  Objective   To systematically evaluate the diagnostic performance of the fluorescent PCR melting curve analysis kit for Mycobacterium identification (Myco assay) in clinical samples, and to compare its consistency with six other commonly used detection methods for Mycobacterium tuberculosis, this study will provide a basis for the rational application of this method in clinical laboratories. Methods   A total of 412 clinical samples from suspected tuberculosis patients were collected at Xi'an Chest Hospital between 2022 and 2025, and detected by Myco assay, MTB-DNA fluorescent PCR assay, MTB/NTM-DNA fluorescent PCR assay, MTB-DNA isothermal amplification assay, MTB-RNA isothermal amplification assay, Xpert assay and culture assay, respectively. The positive rate of each method, diagnostic performance with culture as the gold standard, diagnostic performance with clinical diagnosis as the gold standard were analyzed, and the inter-method consistency of each detection assay was evaluated. Results   Among 412 samples, sputum accounted for 70.9% (292/412), and bronchoalveolar lavage fluid accounted for 26.7% (110/412). With culture as the gold standard, Myco assay showed the highest sensitivity (97.7%), while MTB-RNA isothermal amplification assay had the highest specificity (98.4%). With clinical diagnosis as the gold standard, the specificity of Myco assay was 98.18% (54/55), and the positive predictive value was 99.33% (149/150). Among 211 samples tested by all seven methods, the pairwise Kappa consistency coefficients ranged from 0.617 to 0.890 (mean 0.769). A total of 64 (30.3%) samples were positive in all seven methods, 95 (45.0%) were all negative, and 75.4% of samples showed a completely consistent result pattern. Notably, Myco assay additionally detected 3 samples that were positive only by itself, while only MTB/NTM-DNA fluorescent PCR assay had 2 similar cases among other methods. Conclusion   The Myco assay exhibits good specificity and positive predictive value, and its positive results offering strong diagnostic certainty and clinical practicability. In clinical practice, appropriate testing methods or combined testing strategies should be selected according to testing objectives. The Myco assay can be prioritized in scenarios requiring highly definitive positive results.

Abstract: Objective  This study aims to grasp community structure and seasonal dynamics of fleas in rodent nest within plague focus of wild rodents in Yunnan Province, and to provide a scientific basis for formulating plague prevention and control measures. Methods  Between 2023 and 2024, field margins in agricultural land habitats were selected, samples of nest fleas were collected by the rodent nest excavation method once a month, in the core areas of historical epidemic areas in Jianchuan County and Yulong County, Yunnan Province. Flea species collected from rat nests and their contents, were identified through morphology, classification, counting and statistical analysis according to "A Catalogue of Flea Species in Yunnan". Indicators such as flea infestation rate, flea index, diversity index, evenness index were calculated, and dominance index and the concentration distribution method were used to analyze the seasonal concentration trends and peak periods of flea abundance in rat nests. Results  A total of 655 rodent nests were excavated in this investigation, among which 95 were infested with fleas, with a flea-infestation rate of 14.50%. A total of 708 rodent nest fleas were collected, with an overall flea index of 1.08. The fleas belonging to 11 species of 6 genera and 3 families. The dominant species were Stenischia montanis montanis (33.47%), Ctenophthalmus quadrodentus (33.47%), and Neopsylla specialis specialis (15.54%). Both the flea infestation rate and flea index peaked in January, reaching 32.69% and 3.54, respectively. No fleas were collected in August. Female fleas accounted for 65.82%, significantly outnumbering males. The concentration ratio (M) was 0.39, indicating a certain degree of seasonal aggregation in flea abundance. The circular distribution method revealed a mean angle of ā=26.104°, corresponding to a peak day of January 26, with the peak period occurring from November 16 to April 8 of the following year (Rayleigh test, Z=19.268, P<0.001). The diversity index peaked in May (1.458), the evenness index peaked in January (0.883), and the dominance index was highest in June and September (1.000). Conclusion  The rodent nest flea community in the plague focus of wild rodents is rich in species in Yunnan Province. The vector activities show distinct seasonal aggregation. The current flea index is at a relatively high level, and there is a potential risk of plague transmission. It is suggested that targeted preventive flea and rodent control work be carried out before the determined peak period, and the dynamic monitoring of the main vector flea species-the nominate subspecies of Neopsylla specialis specialis be strengthened to reduce the risk of plague occurrence.

Objective   This study aimed to identify independent risk factors associated with the occurrence of drug-resistant pulmonary tuberculosis (DR-PTB), and based on these factors, to develop and validate a nomogram risk prediction model for clinical auxiliary diagnosis, thereby providing a reference for assisting in the diagnosis of DR-PTB. Methods   Using a convenience sampling method, 329 pulmonary tuberculosis patients admitted to the Sixth People's Hospital of Zhengzhou City were selected as study subjects between June 2022 and April 2024. Based on drug susceptibility test results, all patients were divided into a drug-resistant group (178 cases) and a non-drug-resistant group (151 cases). Multivariate logistic regression analysis was employed to identify independent risk factors, then used to construct a nomogram risk prediction model. The model's performance was systematically evaluated using receiver operating characteristic (ROC) curve, calibration tests, and decision curve analysis. Results   Univariate analysis revealed that patients who were male, aged ≥40 years, BMI ≤18.50 kg/m⊃2;, engaged in manual labor, a history of smoking or alcohol consumption, comorbidities such as diabetes or chronic liver disease/drug-induced liver injury, cough or expectoration lasting ≥3 weeks, fever, pulmonary cavities, a history of interrupted treatment, retreatment cases, anemia, or hypoproteinemia had statistically significant higher rates of drug resistance. The absolute counts of total T cells and helper T cells were significantly lower in the drug-resistant group compared to the non-drug-resistant group. Multivariate logistic regression analysis identified the following as independent predictive factors for DR-PTB: manual labor (OR=13.790, 95% CI: 6.115-31.099), presence of pulmonary cavities (OR=3.397, 95% CI: 1.469-7.854), comorbidity with anemia (OR=3.423, 95% CI: 1.126-10.410), and BMI ≤18.50 kg/m⊃2;. The nomogram model established based on these factors demonstrated an area under the ROC curve (AUC) of 0.914 (95% CI: 0.879-0.948). The Hosmer-Lemeshow goodness-of-fit test yielded c⊃2;=9.461, P=0.305 >0.05, indicating good consistency between the model's predicted probabilities and actual observations, suggesting ideal calibration. Conclusion Manual labor, low BMI, pulmonary cavities, and anemia are independent risk factors for development of drug-resistant pulmonary tuberculosis. The nomogram prediction model constructed based on these factors in this study, demonstrates excellent discriminatory ability and calibration, showing potential for application in clinical practice as an auxiliary diagnostic tool.

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