Chikungunya fever is widely distributed in tropical and subtropical regions around the world. In the past 20 years, this disease been seriously epidemic in the Indian Ocean Region, South Asia and Southeast Asia, and has led to the occurrence of imported cases at least 16 provinces (municipalities and autonomous regions) in China. Among them, indigenous epidemics have occurred in Guangdong, Zhejiang and Yunnan provinces. Chikungunya virus (CHIKV) gene sequences have been detected in serum samples from fever of unknown origin cases and mosquito specimens collected from Yunnan Province, mosquitoes from Zhejiang Province and midges from Guangxi Zhuang Autonomous Region. The epidemic strains of CHIKV in China were mainly the Indian Ocean clade lineage of the East/Central/South African genotype, and the Asian genotype. Aedes albopictus is widely distributed in central, eastern and southern China, and Ae. aegypti is distributed in some parts of Hainan, Guangdong, Yunnan and Taiwan. These two kinds of Aedes mosquitoes in China are highly susceptibility and transmissibility to CHIKV. There is still a risk of outbreak or pandemic of chikungunya fever in the distribution areas of Ae. albopictus and Ae. aegypti in China. The monitoring and management of imported cases and the control of the vector Aedes mosquitoes is an important focus of prevention and control work that needs to strengthened at present. This article reviews the epidemiology and pathogenic biology on chikungunya fever in China, which can provide a reference for the prevention and control of this disease.

Objective To analyse the crude detection rate and trends of newly detected HIV/AIDS cases in medical institutions in China from 2017 to 2023, and to provide a reference for optimizing HIV testing strategies in medical institutions. Methods Data on HIV testing and newly reported HIV/AIDS cases were analysed using data from the Comprehensive AIDS Prevention and Control Information System of the China Information System for Disease Control and Prevention for the period from 2017 to 2023. HIV testing in medical institutions includes patients tested preoperatively, those tested before transfusion, those tested in sexually transmitted disease (STD) clinics, prenatal care clinics, and other types of patients. Descriptive statistical analysis and χ² test were performed using SAS 9.4 software. Joinpoint regression was performed using Joinpoint 4.9.0 software to analyse trends of the crude detection rates over time. Results From 2017 to 2023, the person-times of HIV tests in medical institutions increased from 143 million to 255 million, with an increase of 78.07%. The number of newly detected HIV/AIDS cases increased from 74 000 to 88 000 and then declined to 69 000. The crude detection rate of new HIV/AIDS cases declined from 5.18/10 000 to 2.71/10 000, showed a declining trend, the mean annual percentage change was -9.99%(P<0.001). The crude detection rate of new HIV/AIDS cases in STD clinics was the highest among all types of clinic visits (12.79/10 000-24.47/10 000), and the crude detection rate of new cases among all types of clinic visits showed a decreasing trend(P<0.05). Among different medical institutions, general hospitals were the most important source of the number of tests and the number of newly detected HIV/AIDS cases, accounting for more than 62.93% and 62.68%, respectively. Specialised medical institutions had the highest crude detection rate of new cases, which was maintained at more than 5.13/10 000. The crude detection rate of new cases for all four types of medical institutions, except for primary medical institutions, showed a decreasing trend (P<0.05). Conclusions The detection rate of new cases in medical institutions showed a decreasing trend in 2017-2023, and the efficiency of STD clinics testing and detection was higher among all types of attendees. General hospitals are the main source of new cases detection, and testing in specialised medical institutions is more efficient. Testing should be strengthened in key groups of patients and in key medical institutions.

Chronic hepatitis B (CHB) caused by the hepatitis B virus (HBV), constitutes a significant public health issue, with approximately 254 million individuals affected globally, of which 75 million are in China. HBV infection not only severely impacts individual health, leading to conditions such as liver cirrhosis, hepatocellular carcinoma, and liver failure, but also imposes considerable economic burdens on society. This review provides an overview of the current epidemiological characteristics and disease burden of CHB, along with the progress towards, and challenges faced in achieving the World Health Organization's (WHO) goal of eliminating viral hepatitis as a public health threat by 2030. It delves into strategies aimed at reducing new infections, enhancing diagnosis rates, and improving treatment coverage. These strategies include universal screening, expanding the scope of antiviral therapy, and implementing specific measures for treating patients with end-stage liver disease. The review underscores critical actions necessary to accelerate the elimination of hepatitis B-related harms, proposing an integrated control and prevention strategy that incorporates new technologies and approaches. Achieving WHO's 2030 target requires concerted efforts from governments, healthcare institutions, and the broader community, alongside active public participation and support.

Echinococcosis is a parasitic disease caused by the larval stage of Echinococcus tapeworms, posing a severe threat to patients' health. Its diagnostic techniques play a vital role in clinical diagnosis and treatment, surgical planning, and prognostic evaluation. Currently, the diagnostic methods for echinococcosis mainly include etiological, immunological, imaging, and molecular biological diagnostic techniques. This article comprehensively reviews existing diagnostic techniques for echinococcosis, analyzes the advantages and limitations of various methods, and explores their application prospects. With continuous advancements in scientific technology, emerging diagnostic approaches are expected to substantially enhance the efficiency and accuracy of echinococcosis diagnosis. These research findings will provide valuable references for the development of rapid clinical diagnostic detection products at the current stage, potentially improving cure rates, alleviating patients' disease burden, and offering robust support for the prevention, control, and treatment of echinococcosis.

Objective To analyze the epidemiological characteristics of varicella infectious diseases in Hainan Province from 2014 to 2023, and explore the epidemic patterns of varicella in Hainan Province. Methods Download data related to chickenpox in Hainan Province from the Infectious Disease Reporting Information Management System and the Public Health Emergency Management System of the Chinese Disease Control and Prevention Information System, descriptive epidemiological methods were used to analyze the incidence characteristics of varicella; ARIMA model was used to predict the incidence trend. Results From 2014 to 2023, a total of 65 832 cases of varicella and one death case were reported in Hainan, with an average annual incidence rate of 66.50/100 000, and the incidence rate fluctuated between 47.31/100 000 and 89.01/100 000. A incidence rate peak occurred every other year. The incidence of varicella showed a seasonal bimodal distribution, with peaks in January and April. The incidence of varicella was negatively correlated with temperature (r=-0.349，P<0.05). Children aged 0-14 years were the main incidence group, and the incidence rate reached its peak in the age group of 5-6 years. Students and young children were the main groups affected by the disease. The incidence rate of male (68.15/100 000) was higher than that of female (62.22/100 000)(χ²=16.80, P<0.05). The incidence rate of male (68.15/100 000) was higher than that of female (62.22/100 000). The 1 dose vaccination rate for 1-year-old children was on the rise, reaching a maximum of 43.2%; The two doses vaccination rate for children aged 4-6 years has been increasing year by year, with the highest reaching 9.9%. A total of 65 cases of varicella PHEE were reported, with M(P₂₅, P₇₅) of 24 (18, 32) cases per case, and a total incidence rate of 2.64%. Primary schools were the main places of occurrence. The ARIMA model has a good predictive fitting effect, and the results show that the predicted incidence in 2024 will increase compared to 2023. There may be peaks in incidence in January to June and October to December. Conclusions The incidence rate of varicella is high in Hainan Province; A lower vaccination rate for varicella in children cannot break the natural prevalence of varicella among healthy children.

Objective This study aims to explore the impact of demographic characteristics, sexual behavioral, and epidemiological history on mpox infection among the MSM in Chengdu, providing a theoretical basis for prevention and control of mpox. Methods A case-control study was conducted, including mpox patients in Chengdu from June 2023 March 2024 as the study group and MSM without mpox as controls, we carried out a retrospective investigation. Basic information, sexual history and behavior, and travel history were obtained for both mpox patients and controls. Univariate and multivariate logistic regression analysis were used to explore the risk factors for mpox infection. Results In this study, 128 MPXV cases (including 53 HIV individuals) and 151 controls (including 50 HIV individuals) were investigated. The average age of the cases was (32.48±6.67) years, all of whom were male, 101 were single, 100 had a college degree or higher, 60 were business services and self-owned occupations, 89 were homosexual, and 116 reported history of having homosexual behavior; 109 had an average of four or fewer homosexual behavior per month; 48 used condoms usually. The proportion of unmarried and those with a college degree or higher was lower in the monkeypox case group than the control group, while proportion of those with sexually transmitted diseases other than HIV was higher than the control group (P<0.05). Bisexuals or heterosexuality had a higher risk of MPXV compared to homosexuals (OR=4.65), the ones who never use condoms during homosexual activities were at higher risk for monkeypox (OR=3.25). There were no significant differences in epidemiological history between the two groups. Multivariate logistic regression showed that being unaware of other STD infections was negatively associated with MPXV infection, while having other STDs other than HIV, being bisexual or heterosexual sexual behavior were positively associated with MPXV infection. Conclusion The MSM in Chengdu with concurrent infection with other sexually transmitted diseases other than HIV, bisexual or heterosexual sexual orientation were risk factors for mpox. It is necessary to strengthen health education for the ones at high-risk.Chengdu

Objective To analyze the epidemiological characteristics and infection pathways and virulence factors of one cholera outbreak in Fengxian District, Shanghai, China, in 2024, and to provide scientific basis for epidemic control and prevention. Methods Epidemiologic data of cases of one cholera outbreak in Fengxian District in 2024 were collected using on-site epidemiologic survey methods; RT-PCR nucleic acid testing and bacterial culture were applied to carry out pathogenicity testing of cases, close contacts, environment, and food samples; and the genome sequences of the strains were obtained using second-generation gene sequencing. Results The case was a 62-year-old woman, who presented to the doctor with diarrhea for 4 consecutive days, 4-5 times a day, with watery stools, which was not effectively relieved by self-administered medication. There was no history of traveling away from Shanghai for 5 days before the onset of the disease, and she was engaged in the preparation and delivery of food for rural banquets during the period. Vibrio cholerae O139 was detected in the anal swab sample of the case and the septic tank of the workplace on the 4th day after the onset of the disease; samples of turtle and links in the store selling turtle were cultured for Vibrio cholerae O139. The isolate carried several virulence-related genes such as ctxA, ctxB, HlyA, zot, rtxA, hapA, nanH, tdh, and T3SS. Comparison of the isolate with the O139 strain of cholera cluster within our country through the National Pathogenic Bacteria Recognition Network (NPBN) in recent years suggests that the closest environmental or aquatic animal isolate to the sequence of this strain is the turtle isolate uploaded at a place in Guangdong. Conclusion This outbreak was a disseminated outbreak caused by the case's contact with turtle contaminated with Vibrio cholerae O139, and early detection of enteric infectious diseases such as cholera can be achieved by relying on the outpatient enteric cholera surveillance network.

Objective This study aims to investigate and compare the clinical characteristics and prognostic factors among primary liver cancer (PLC) patients who had hepatitis B virus (HBV)-induced cirrhosis associated with liver cancer, alcoholic cirrhosis associated with liver cancer, or both HBV and alcoholic cirrhosis associated with liver cancer. Methods Inpatients diagnosed with PLC admitted to the First Affiliated Hospital of Fujian Medical University between January 2010 and September 2020 were enrolled and divided into three groups based on the etiology. The follow-up period ends in October 2024. Survival analyses were performed using Kaplan-Meier curves, univariate analysis, and multivariate Cox regression. Results During the study period, 45 cases of alcoholic cirrhosis associated liver cancer (ALD group), and 71 cases of hepatitis B combined with alcoholic cirrhosis associated liver cancer (HBV+ALD group) were enrolled. At the same time, 73 patients with hepatitis B cirrhosis associated liver cancer (HBV group) during the same period were randomly selected with a ratio of about 1∶1.5, totaling 189 cases. And 183 (96.8%) of the patients were male and 6 (3.2%) were female. The age was (55.93±10.20) years. 109 deaths (57.7%) were recorded. The median survival times were 12 months for the entire cohort, 55 months for HBV group, 36 months for ALD group and 11 months for HBV+ALD group. And the 10-year death rate was 42.5% in HBV group, compared to 66.7% in ALD group and 67.6% in HBV+ALD group. In this study, 93 patients chose either the surgical resection or the radiofrequency ablation as their treatments. The recurrence rate was 69.9%, the median recurrence time was 8 months and the median overall survival time was 39 months. Univariate Cox regression identified that etiology of HBV and ALD, alpha-fetoprotein (AFP)>1 200 ng/mL, Child-Pugh class B and C, Barcelona Clinic Liver Cancer (BCLC) stages of C and D and curative therapies such as surgery and radiofrequency ablation were significantly correlated with overall survival (all P<0.05). Multivariate Cox regression revealed that patients with both HBV and ALD (HR=1.750，95%CI: 1.107-2.765，P=0.017), AFP>1 200 ng/mL (HR=1.649，95%CI: 1.060-2.564，P=0.027), and BCLC stages of C and D (HR=3.404，95%CI: 2.254-5.142，P<0.001) were independent risk factors of mortality in PLC patients with cirrhosis. Conclusions Among HBV, ALD and HBV+ALD groups, the HBV+ALD group had the shortest median survival time and the highest overall mortality rate, suggesting that alcohol consumption and HBV infection may accelerate the progression of PLC with cirrhosis and worsen its prognosis. HBV infection combined with alcoholic consumption, AFP>1 200 ng/mL, and BCLC stages of C and D were independent risk factors for mortality in PLC patients with cirrhosis.

Objective To conduct an epidemiological investigation and analysis on one imported cholera case in Shenzhen in 2024, providing a reference for cholera prevention and control. Methods A cholera case and 86 close contacts in 2024 were investigated using methods of field epidemiological investigation. Real-time RT-PCR was employed for Vibrio cholerae nucleic acid detection and typing of collected specimens, followed by isolation culture, whole genome sequencing and analysis. Results One severe cholera case was confirmed in an Indian businessman, who recovered and was discharged after rescue and rehabilitation. The pathogen was identified as the toxigenic strain of Vibrio cholerae O1 serotype Ogawa, and genetic evolution analysis showed that it had a very close genetic relationship with Vibrio cholerae isolated from multiple countries such as Bangladesh and Pakistan. Among the 86 close contacts under medical observation, no abnormalities were found. A total of 75 close contact specimens and 38 environment smear specimens from epidemic sites were collected, all testing negative. Conclusion This is an imported cholera epidemic originating from India. The sensitivity of medical institutions to monitoring key infectious diseases such as cholera needs to be improved.

Objective To investigate the distribution characteristics of genetic subtypes among newly reported human immunodeficiency virus type 1 (HIV-1) cases in Tongzhou District, Beijing, from 2021 to 2022, and to analyze the molecular epidemiological characteristics and drug resistance patterns of HIV-1 in the area. Methods Newly reported HIV-1 cases in Tongzhou District, Beijing, from 2021 to 2022, were taken as the study population. Nested PCR was used to amplify the HIV-1 pol region gene, and the gene sequences were obtained through first-generation sequencing. A phylogenetic tree was constructed to analyze the HIV-1 genetic subtypes and drug resistance. Results There were 308 new HIV-1 cases reported in Tongzhou District, Beijing from 2021 to 2022. A total of 230 HIV-1 pol region gene sequences were obtained, with a case coverage rate of 74.68%. Seven HIV-1 genotypes were identified, with CRF07_BC (42.17%) and CRF01_AE (36.09%) being the main prevalent strains. Furthermore, new epidemic types such as CRF55_01B, CRF01_AE, and BC recombinants were detected. There were statistically significant differences (χ²=17.845, P<0.05; χ²=7.731, P<0.05) in the genotype composition ratio among newly reported HIV-1 cases across different age groups and detection routes, while no significant differences (P>0.05) were observed concerning gender, transmission route, marital status, and others. A total of 64 cases (27.83%) showed drug-resistant mutations, with 27 mutation sites identified in total. There were significant differences (χ²=53.674, P<0.05) in the mutation rates among different HIV-1 genotypes, with the highest mutation rate (100.0%) observed in CRF55_01B. Drug resistance to PIs, NRTIs, and NNRTIs was observed in 18 cases (7.83%), with resistance rates of 3.04%, 0.87%, and 4.35%, respectively. High-level drug resistance was observed in eight cases, including one case of NRTI resistance (mutation site M184V) and the remainder exhibiting NNRTI resistance, involving sites such as M184V, K103N, Y188L, and Y188C. Conclusions The genotype of HIV-1 in Tongzhou District is diverse, with CRF07_BC and CRF01_AE as the predominant strains. The total drug resistance rate reached a moderate level. We should strengthen the analysis of HIV-1 genotypes and drug resistance monitoring, focusing unique recombinants and resistance-related gene mutations.

Objective To understand the serotypes and sources of dengue virus (DENV) in Yunnan Province in 2023, providing a scientific basis for dengue fever prevention and control. Methods DENV nucleic acid testing and virus isolation were performed on the serum samples of dengue fever cases diagnosed at three national monitoring sites in Yunnan Province (Longchuan County, Menghai County, Hekou County) in 2023. Dengue virus envelope (E) gene sequencing was performed on positive serum samples and dengue virus isolates, and phylogenetic analysis was conducted using molecular biology software. Results A total of 1 006 dengue fever cases were reported at three monitoring sites in 2023, including 838 imported cases, 161 cases imported from other counties and cities in Yunnan, and 7 autochthonous cases. Among 371 serum samples, 351 were found DENV-positive, including 305 DENV-1 positive samples (174 imported from Myanmar, 1 imported from Laos, 1 imported from Vietnam, 99 imported from Jinghong, 26 imported from Ruili, and 4 local cases), 43 DENV-2 positive samples (8 imported from Myanmar, 6 imported from Jinghong, 26 imported from Ruili, and 3 local cases), 1 DENV-3 positive sample (imported from Myanmar), 1 DENV-4 positive sample (introduced from Ruili), and 1 untyped case. A total of 23 DENV strains were isolated, including 9 strains of DENV-1, 12 strains of DENV-2, 1 strain of DENV-3, and 1 strain of DENV-4. All DENV-1 strains from three monitoring sites belong to genotype I but were located on different evolutionary branches. The DENV-2 strains from Menghai County and Longchuan County belonged to the Cosmopolitan genotype and Asian I genotype, respectively. The DENV-3 strain from Longchuan County belonged to genotype I, and the DENV-4 strain from Longchuan County belonged to genotype I. Conclusions During the dengue fever epidemic season, the border regions of Yunnan Province face dual pressures from both international and domestic imported dengue cases. Imported or introduced cases carried DENVs of serotypes 1-4 (with five genotypes in total), leading to local outbreaks caused by these cases. Imported and local DENVs originated from Southeast Asian countries and exhibited distinct geographic distribution characteristics.

Objective To analyze and investigate a hospital-acquired outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) in a hospital's neurosurgical intensive care unit (NSICU), and to implement rectification based on the investigation results, providing valuable insights and recommendations for controlling similar outbreaks caused by multi-drug-resistant strains. Methods The field epidemiological investigation was conducted to investigate five cases of clustered CRKP pulmonary infection in the NICU in Shandong in 2021. Hygienic monitoring of the environment was undertaken. The main occurrence stages were analyzed, effective control measures were taken, and the effectiveness of the control measures was evaluated. Results The study identified an outbreak of CRKP infections that occurred in the neurosurgical intensive care unit, with the beds of infection cases and spatial positions being centrally distributed. Hygienic monitoring was performed on environmental surfaces, as well as the hands and nasal cavities of medical and cleaning staff. In the first sampling, 3 samples from the patient bed units tested positive for CRKP, while no CRKP was detected on other surfaces, or in samples from the hands and nasal passages of the medical staff and air specimens. The CRKP strains found on surfaces had antibiotic resistance profiles consistent with the patient strains. No further related cases occurred after comprehensive control measures were implemented. Conclusions The comprehensive control measures, including enhanced ward disinfection and isolation, strict management of hand hygiene among medical staff, and personnel training, can effectively control the outbreak of CRKP hospital-acquired infections in NSICU.

The human gut constitutes a complex microecosystem comprising bacteria, fungi, archaea, and other microorganisms. Although the gut mycobiome accounts for a minor proportion of this ecosystem, it plays indispensable roles in regulating the host's homeostasis, immunity, and metabolism, and is associated with the occurrence and development of various diseases. In recent years, with the advancements in gut microbiome research, gut mycobiome studies have achieved significant progress, with an expanding repertoire of intestinal fungi being precisely identified. Deciphering the gut mycobiota holds profound implications for human health maintenance. This review synthesizes current knowledge on the human gut mycobiome, focusing on its taxonomic composition, developmental dynamics, interkingdom interactions (fungi-bacteria and fungi-host crosstalk), and multifaceted interactions with host health. Additionally, we critically evaluate methodological innovations in gut mycobiome research, hoping to provide ideas and directions for future gut mycobiome research.

Objective This report analyzes the investigation and emergency response to a case of imported chikungunya fever, along with the monitoring of mosquito vectors in the same period, to provide a reference basis for the prevention and control of chikungunya fever. Methods An epidemiological investigation was conducted in 2024 to study a case of chikungunya fever, including case search, emergency surveillance of mosquito vectors, and mosquito control measures. Pearson χ² test was used to analyze mosquito surveillance data, including larval density in different habitats. Results Investigation revealed that the case had traveled to the Maldives with his wife from May 24 to June 1, 2024. After returning to Shanghai, he developed a fever on June 3. He visited Hospital A on June 4 and received treatments, including antipyretics and psychological counseling for stress relief, with no symptom improvement. On June 5, he presented to Hospital B, where an acute-phase serum sample was collected and sent to the CDC for nucleic acid testing for both dengue and chikungunya viruses. On June 7, the laboratory confirmed a positive result for chikungunya virus nucleic acid. The patient recovered following isolation and treatment, and no secondary cases were reported. Surveillance of Aedes vectors in July showed a Breteau index (BI) of 8.85 and a mosquito ovitrap index (MOI) of 7.19. A comparison of MOI in different habitats in 2024 revealed no statistically significant difference (χ²=5.45, P>0.05). ). Mosquito control and emergency surveillance were initiated on the day of diagnosis. After three consecutive days of mosquito control measures, the BI in the core area dropped rapidly from 10 to 3 by June 11, and the human-bait tent trap index dropped from an initial 4 mosquitoes/(trap·h) to 2 mosquitoes/(trap·h). Through sustained vector control measures, the BI and tent trap indices in the core area and precautionary area were maintained within safe limits throughout the outbreak period. Conclusion There is a risk of local transmission caused by imported chikungunya fever cases in Jing'an District, Shanghai. Early diagnosis and timely implementation of mosquito control measures are essential to prevent potential local epidemics.

To analyze the investigation and disposal of an H5N6 human infection with animal derived influenza epidemic in Quanzhou City in 2024, and provide reference for the control and prevention of animal derived influenza epidemics in future.According to Technical Guidelines for Control and Prevention of Human infected with Zoonotic Influenza Viruses (Trial), we investigated the diagnosis and treatment of the case, suspected exposure, infection sources and routes, by the method of field epidemiological investigation. The case, close contacts, and relevant environmental samples were collected for nucleic acid testing and gene sequencing. A nasopharyngeal carcinoma patient who rapidly progressed to severe pneumonia and died of multiple organ failure after being diagnosed with H5N6. The H5N6 virus nucleic acid test results of 5 close contacts and 37 suspected exposed individuals were all negative, and no second-generation cases occurred. Through on-site investigation and genetic sequencing analysis, it is highly likely that the source of infection is the outdoor environment of free range poultry contaminated with H5N6 virus in the vicinity of the patient's home.Patients with nasopharyngeal carcinoma or other immune restricted diseases should take personal protective measures, stay away from poultry and livestock breeding and trading places, and avoid close contact with poultry or other animals as much as possible. We should strengthen the training of management personnel of third-party testing institutions, enhance the work of thematic risk assessment and the application of risk assessment results,and expand the scope of monitoring human infected with zoonotic influenza viruses in breeding farms, live poultry markets, and migratory bird habitats.

Objective To analyze the clinical characteristics and prognostic factors for clinical cure in chronic hepatitis B virus (HBV) infected patients with pegylated interferon-α-2b (PEG-IFN-α-2b) based therapy. Methods This is a retrospective study. Chronic HBV infected patients receiving PEG-IFN-α-2b therapy were enrolled in Yuncheng Central Hospital affiliated to Shanxi Medical University between August 2020 and November 2023. Treatment-naïve patients received PEG-IFN-α-2b monotherapy, while nucleoside (acid) analogs (NAs)-experienced patients received PEG-IFN-α-2b add-on therapy. The study endpoint was hepatitis B surface antigen (HBsAg) negative in accompany with HBV DNA below the detection limit (course of treatment < 48 weeks) or treatment for 48 weeks. The general characteristics, virological variables, blood routine test, and liver function of patients were collected at baseline and study endpoint. Student’s t test or Mann-Whitney U test was used for comparison. The prognostic factors of clinical cure were examined using univariate and multivariate stepwise logistic regression models. Results A total of 61 chronic HBV infected patients were enrolled, including 39 males and 22 females. The age were (39.13±7.53) years. Twenty-one cases were treatment-naïve, while 40 patients were NAs-experienced. Nineteen cases were positive for HBV DNA at baseline. The baseline HBsAg levels were 211.30(50.93, 2 110.00) IU/mL. Thirty-four patients achieved clinical cure at the study endpoint with 25.50 weeks of median course of PEG-IFN-α-2b treatment. Twenty-seven patients did not achieve clinical cure at the study endpoint, and the course of treatment was 48 weeks. Clinical cure group had significant lower baseline HBsAg level when compared with non-clinical cure group [78.66(19.54, 204.60) IU/mL vs 2 078.00(442.20, 4 237.00) IU/mL, P<0.001]. At the study endpoint, the white blood cell, platelet, red blood cell, hemoglobin levels were lower than those in baseline (P<0.05), while alanine aminotransferase and asparatate aminotransferase levels were higher than those in baseline (P<0.05). There were no remarkable differences in blood routine tests or liver function between clinical cure and non-clinical cure group at either baseline or study endpoint (P>0.05). Baseline low HBsAg level was a predictor for clinical cure in patients receiving PEG-IFN-α-2b therapy (OR=0.998, 95%CI: 0.998-0.999). No severe adverse events were happened during therapy. Conclusion PEG-IFN-α-2b-based therapy was well-tolerant, and could achieve high rate of clinical cure in chronic HBV-infected patients who had low baseline HBsAg level.

Objective To determine the insecticide resistance levels of rural Aedes albopictus populations in Guangzhou, assess the impact of dengue vector control on insecticide resistance, and discuss the rational use of insecticides and resistance management strategies. Methods In July 2024, larval samples of Aedes albopictus were collected from four rural residential sampling sites within a 20-40 km radius of Guangzhou (with a distance of ≥20 km between each site). In the past three years, Dongxiang and Suishi villages had reported 18 and 3 cases of dengue fever, respectively; Xinhai and Donglong villages had reported none. The insecticide resistance levels of field-collected mosquitoes across all sampling sites were evaluated against beta-cypermethrin (conventional insecticide) along with propoxur and temephos (non-conventional insecticides). Insecticide resistance was determined by the larval immersion bioassays. Using the median lethal concentration (LC₅₀) of a specific sampling site as the control, Probit regression analysis was conducted for each insecticide to determine whether inter-site differences in resistance were statistically significant. Results Using the LC₅₀ of the sensitive population as the base, the test insects from Dongxiang village showed high resistance to beta-cypermethrin (116.85-fold), while those from Suishi and Donglong villages showed moderate resistance (21.41-fold and 12.63-fold, respectively); the test insects from Xinhai village showed moderate resistance to temephos (10.79-fold); all four populations demonstrated low-level resistance to propoxur, with resistance ratios ranging from 3.24 to 4.42. Using Xinhai as the reference population for beta-cypermethrin, resistance in Dongxiang and Suishi was significantly higher (P<0.05). In Dongxiang, resistance to temephos and propoxur was significantly lower than that to beta-cypermethrin (P<0.05). Conclusion In rural areas of Guangzhou where dengue outbreaks have been reported, Aedes albopictus exhibits high resistance to commonly used insecticides but lower resistance to less frequently used agents. In areas without dengue cases, resistance levels to all tested insecticides remain low. Local governments should scientifically use insecticides through environmental sanitation management, insecticide combinations, insecticide rotation, or the use of synergists to avoid or delay the development of resistance in Aedes albopictus during the handling of outbreaks.

Objective To investigate the potential association between amino acid site mutations in the pre-S/S region of hepatitis B virus (HBV) and the progression of liver cirrhosis, providing scientific evidence for further understanding of the role of HBV mutations in disease progression and the development of targeted therapeutic strategies. Methods A specialized cohort of chronic hepatitis B (CHB) patients was established from 2018 to 2022 at Wuwei Tumor Hospital in Gansu Province, enrolling 3,882 patients who were positive for hepatitis B surface antigen (HBsAg). By the end of the follow-up period on December 31, 2022, next-generation sequencing (NGS) was performed on serum samples to analyze the pre-S/S region of HBV. After translating the sequences and genotyping, patients with genotype C were identified. Patients with cirrhosis and non-cirrhosis were matched 1∶1 by age (±5 years) and gender. Amino acid mutation rates and Shannon entropy were calculated. A sparse logistic regression (SLR) model was constructed to analyze the characteristics of amino acids in the pre-S/S region of HBV associated with cirrhosis. Results A total of 196 patients with complete genotype C sequences were included, among whom 22 had cirrhosis and 174 did not. After matching by age (±5 years) and gender, there were 20 cases each in the cirrhosis and non-cirrhosis groups. The proportion of patients receiving antiviral therapy was statistically significantly higher in the non-cirrhosis group compared to the cirrhosis group (χ⊃2;=4.912, P<0.05). In the cirrhosis group, both the mean mutation frequency and Shannon entropy of the pre-S1 region were significantly higher than those in the non-cirrhosis group (Z=3.793, 3.057, P<0.05). Eight amino acid sites exhibited statistically significant differences in mutation frequencies between the two groups, of which six were validated as effective mutation sites. Specifically, the mutation frequencies at sites T68, G73, M120, and G318 were significantly higher in the cirrhosis group compared to the non-cirrhosis group (Z=2.029, 2.191, 2.299, 2.029, P<0.05), whereas the frequencies at sites T84, L267, L283, and N380 were significantly lower (Z=2.380, 2.056, 2.353, 2.462, P<0.05). The established SLR model identified the mutation frequency at site N380 as having the highest contribution degree (Z=2.462, P<0.05), while the contribution of other indicators, though ranked among the top 10, showed no statistically significant differences between the two groups. Conclusion Mutations in the amino acid sites of the pre-S/S region of HBV may influence the progression of cirrhosis, with higher mutation frequencies in the pre-S1 region being associated with an increased likelihood of cirrhosis. The application of the SLR model provides a new direction for predicting cirrhosis and precision treatment.

Objective A predictive model should be established during the early stages of dengue progression to evaluate the likelihood of severe dengue and dengue with warning signs, thereby preventing delayed clinical management and reducing dengue-related mortality. Methods Clinical and laboratory examination data of 831 patients admitted to Ruili People's Hospital of Yunnan Province during 2019-2023 were retrospectively collected. The dataset was divided into a training set and a validation set in a 7∶3 ratio. Statistical description and univariate analysis were performed on the training set, with LASSO regression employed to screen variables, followed by logistic regression to develop a risk prediction model for severe dengue. Model performance was validated using ROC curves on both the training set and validation set. Results A total of 831 dengue patients were included in the study, with a mean age of (44.20±15.02) years. Among them, 52.59% were male and 5.42% were Myanmar nationality. In total, 122 cases (14.68%) exhibited severe dengue or dengue with warning signs, predominantly female (58.20%). LASSO regression was used in the training set to screen 11 variables related to the risk of severe dengue and dengue with warning signs: Age, dizziness, vomiting, prothrombin time, partial activated thromboplastin time, hematocrit, platelet, monocyte percentage, absolute value of monocytes, hemoglobin, C-reactive protein (λ_min= 0.011 59); Logistic regression identified statistically significant variables for the risk model of severe dengue and dengue with warning signs as follows: age [OR=1.034 (95%CI: 1.016-1.053)], red blood cells deposited [OR=1.258 (95%CI: 1.143-1.519)], platelet [OR=0.991 (95%CI: 0.985-0.997)], hemoglobin (OR=0.919 (95%CI: 0.873-0.950)], C-reactive protein [OR=1.019 (95%CI:1.004-1.034)]. The model achieved an AUC of 0.894 (95%CI: 0.796-0.867) in the training set and 0.862 (95%CI: 0.709-0.827) in the validation set. At a cut-off threshold of 0.197, sensitivity and specificity were 0.850 and 0.743, respectively. Conclusion This study established a LASSO-logistic regression model, which can predict the risk of severe dengue and dengue with warning signs. The model enhances the capability of hospitals to prevent and manage severe dengue and provides valuable guidance for clinical decision-making.

Objective To identify the clinical characteristics of a case of abdominal multiple cystic echinococcosis in Shenzhen City, Guangdong Province, and to characterize the molecular biology of pathogen, in order to provide a basis for control and prevention of echinococcosis. Methods Clinical and epidemiological data of 1 case of echinococcosis in Shenzhen City in January 2024 were collected. The pathological sections of the cyst tissue removed by surgery were examined by microscopy after staining. Nucleic acids were extracted from cyst tissue samples, and the ND1 and Cox1 gene sequences were amplified and sequenced by PCR. Sequence comparison and phylogenetic tree analysis were performed using Mega X, BLAST and other software. Results The patient, male, 29 years old, a resident of Nyerong County, Nagqu City, Xizang Autonomous Region, had a history of exposure to domestic dogs and hepatic echinococcosis. Imaging showed abdominal multiple placeholder, consider echinococcosis recurrence; 12 pieces of cystic lesions from different parts of the abdominal cavity were surgically removed, and the pathological sections of cystic tissues showed cuticle layer, germinal layer, protoscolex of echinococcosis. PCR amplification of the specific genes ND1 and Cox1 were positive, and the amplified fragments were about 510 bp and 285 bp, respectively. Sequence comparison and phylogenetic tree analysis results showed that the homology between the sequences in this study and the ND1 gene of Echinococcus granulosus type G1 (JX217890.1, Qinghai), and Cox1 gene (MH050610.1, Xizang) in the GenBank database was 99%. It is closely related to the epidemic strains of Echinococcus granulosus in Xizang, Qinghai and Xinjiang in the phylogenetic tree, and is in the same evolutionary branch (type G1). Conclusion The patient was an imported case of abdominal multiple cystic echinococcosis, and the genotype was G1, with a high probability that the infection originated in Xizang. It is recommended to enhance the surveillance and management of echinococcosis in non-endemic areas, and to strengthen the inspection and quarantine of livestock and agricultural by-products imported from endemic areas to prevent the spread of echinococcosis.

Objective To investigate the level of pertussis antibody in 344 healthy population in Hebei Province in 2023, and to understand the infection status and estimate the potential infection of pertussis. Methods A total of 344 healthy people of all ages from 7 cities (counties) in Hebei Province in 2023 were stratified by random sampling method. The demographic characteristics, vaccination history and pertussis history of the subjects were collected. Serum IgG antibody against pertussis toxin (PT-IgG) were determined by enzyme-linked immunosorbent assay (ELISA). Results The geometric mean concentration (GMC) of PT-IgG in 344 healthy people was 5.28 IU/mL, and the antibody positive rate (PT-IgG concentration ≥ 40 IU/mL) was 6.10% (21/344). There was no significant difference in proportion of antibody levels and antibody concentration ≥40 IU/mL between males and females. The top three regions with the highest antibody positive rate were Xinhe County in Xingtai (20.00%), Lianchi District in Baoding (11.43%), and Shijiazhuang (9.37%). There was a significant difference in pertussis antibody levels among different regions (P=0.007), but no significant difference in pertussis antibody concentration ≥40 IU/mL among different regions (P=0.100). The GMC of antibody was the highest in the 1~<3 years old group (11.45 IU/mL), followed by the <1 year old group (8.15 IU/mL). There was a significant difference in the pertussis antibody levels among different age groups (P=0.001). The proportion of antibody concentration ≥40 IU/mL was the highest in the 1~<3 years old group (20.83%), followed by the <1 year old group (12.77%). There was a significant difference in the proportion of antibody concentration ≥40 IU/mL among different age groups (P=0.028). And 303 (88.08%) cases of the 344 healthy people had a history of DTaP, 4.62%, 46.86% and 48.52% of healthy people had completed 1-2, 3 and 4 doses of DTaP, respectively. Among the healthy people who had completed 1-2 doses of DTaP, there was no significant difference in the level of pertussis antibody among different age groups (P=0.47). Among the healthy people who had completed 3 doses of basic immunization and 4 doses of complete immunization, there was a significant difference in the level of pertussis antibody among different age groups (P=0.04, P=0.01). There was no significant difference in the proportion of PT-IgG concentration ≥40 IU/mL among different age groups and different immunization doses (P=0.72). Conclusion The overall antibody level and proportion of PT-IgG concentration ≥40 IU/mL in the healthy population of Hebei Province in 2023 were both low, indicating the inadequacy of the protective effect of the current immunization program for children, although vaccinated people could still infect with pertussis disease, we need to further monitoring and optimization of immune strategies indicating.

Vector Aedes mosquitoes can transmit a wide array of pathogens and therefore pose a serious threat to public health. Controlling Aedes mosquito population is an important way of interrupting the transmission of mosquito-borne diseases. Long-term large-scale use of chemical insecticides not only damages the environment and endangers human health, but also leads to insecticide resistance in wild mosquito populations, thereby increasing the challenges of mosquito control. To slow down the emergence of drug resistance and achieve sustainable, eco-friendly management, modern green control strategies regard the "human-environment-vector" system as an integrated whole, seeking to curb Aedes vectors effectively while simultaneously protecting human health and conserving ecological integrity. This review introduces the strategy of green governance from four perspectives: reducing environmental tolerance, controlling Aedes mosquito population through food-web manipulation and biotechnological measures, employing environmentally friendly insecticidal formulations, and enhancing resident education. It further discusses the latest research and application advancements in Aedes mosquito control, encompassing the incompatible insect technique, sterile insect technique, genetic engineering, microbial insecticides, and insect growth regulators. Green governance strategies for Aedes mosquito vectors are expected to provide a scientific basis for the rational formulation of mosquito-borne disease prevention and control programs.

Chronic hepatitis B virus (HBV) infection remains a major global public health concern. The persistent presence of intrahepatic covalently closed circular DNA (cccDNA) poses a major challenge to the complete cure of chronic HBV infection. Therefore, identifying reliable and effective serological surrogate markers for cccDNA holds great clinical significance in evaluating antiviral efficacy, predicting prognosis, and guiding the clinical management of chronic HBV-infected patients. In recent years, serum HBV RNA has emerged as a promising non-invasive alternative marker for cccDNA, offering the potential for monitoring disease progression and predicting prognosis in chronic HBV-infected patients. In this review, we summarize recent studies on HBV RNA, highlighting its ability to assess the immune and histological status of patients, and discussing its value in guiding the timing of antiviral therapy. Furthermore, we systematically summarize the clinical significance of HBV RNA in multiple domains: monitoring viral replication, evaluating antiviral treatment efficacy, predicting relapse after treatment cessation, and guiding new antiviral strategies. This review aims to provide clinicians with valuable insights for better utilizing this marker in the clinical management of chronic HBV infection.

Objective To understand the genetic diversity and evolutionary dynamics of seasonal influenza A/H3N2 in Longgang District, Shenzhen City, in 2023, and provide scientific evidence for the control and prevention of influenza A/H3N2 in the region. Methods Nucleic acid detection and virus isolation were conducted on throat swab samples from influenza-like illness (ILI) cases monitored by 5 sentinel hospitals and 233 school cluster epidemics in Longgang District in 2023. Based on the epidemic pattern of H3N2 positive samples in 2023, a total of 10 representative strains of influenza A virus (H3N2) were selected from four quarters of year for whole genome sequencing and protein structure prediction. Bioinformatics softwares, including FastTree, AlphaFold2, and NetNGlyc, were utilized to analyze genetic evolution characteristics and evaluate vaccine efficacy (VE). Results In 2023, 2 841 ILI samples were tested in the district, and positive rate of influenza A/H3N2 was 16% (461/2 841), which was dominant in the young and middle-aged influenza positive group (15-<55 years old). HA genes of the 10 selected viruses belonged to 3C.2a1b.2a.2a.1b and 3C.2a1b.2a.2a.3a.1, while NA genes belonged to B.2 and B.4.3. Among them, HA genes of 9 strains exhibited an evolutionary relationship distinct from that of NA genes, suggesting potential genetic reassortment. Mutations of A epitope N138D, B epitope I156K, and D epitope I208F were identified at HA antigenic sites, with VE (100%) values ranging from 74% to 84%. Glycosylation site analysis revealed that a total of 7 conserved sites with strong potential were located in HA and NA genes, including NST24-26, NGT38-40, NCT79-81, NVT181-183, NGS301-303, NIT61-63 and NGT234-236. No resistance mutation sites to oseltamivir were detected in NA sequences. Conclusion The H3N2 virus genomes in Longgang District underwent a branching evolution in 2023, which may lead to reduce vaccine efficacy due to antigenic drift. There is an urgent need for new broad-spectrum vaccines and prevention, control and publicity of influenza transmission should be strengthened in the district; meanwhile, it is essential to initiate the establishment of influenza A virus genome surveillance network to provide basic information of potential value for the clinical diagnosis and treatment of severe influenza.

Objective To analyze the changes in wastewater disinfection quality and influencing factors of medical institutions in Nanjing from 2020 to 2024, providing a reference for infection control departments in medical institutions regarding wastewater monitoring and management. Methods A total of 28 medical institutions in Nanjing were selected as the survey subjects. Microbial and total residual chlorine tests were conducted on hospital wastewater samples from 2020 to 2024 to compare the changes in the qualified rate of wastewater disinfection over the past five years. A current status investigation was also carried out on wastewater disinfection management, wastewater discharge, wastewater treatment equipment, and wastewater online monitoring systems in these hospitals. Results From 2020 to 2024, 140 samples of hospital wastewater were collected. Over the past five years, the disinfection quality of hospital wastewater showed a downward trend, with statistically significant differences (χ⊃2;_trend=6.986, P<0.05). The qualified rate for microbial indicators was 82.14% (115/140), while the on-site qualified rate for the total residual chlorine test in 2024 was only 56.52%. Among the 28 surveyed medical institutions, 85.71% (24/28) outsourced disinfection work to third-party companies, while 14.29% (4/28) carried out disinfection by institutional staff, with no statistically significant difference (χ²=0.200, P>0.05) in the qualified rate of disinfection. Sodium hypochlorite was used to disinfect wastewater in 82.14%(23/28) of the institutions, while other disinfection methods included chlorine dioxide (7.14%, 2/28), potassium monopersulfate (7.14%, 2/28), and ozone (3.57%, 1/28). A statistically significant difference in disinfection qualification rates was observed between sodium hypochlorite and chlorine dioxide (χ²=6.802, P<0.05). Additionally, wastewater online monitoring systems had been installed in 25 institutions, but 16.00% (4/25) of them had yet to achieve full project monitoring coverage. Conclusion From 2020 to 2024, the quality of wastewater disinfection in medical institutions in Nanjing has declined, highlighting an urgent need to enhance wastewater monitoring. This would help reduce the impact of pathogenic microorganisms and other pollutants from hospital wastewater on the living environment.

Mpox virus, a zoonotic orthopoxvirus, has emerged as a major public health concern in recent years due to its recurrent global outbreaks, posing a serious threat to human health. Currently, pathogen detection methods are widely used to confirm infections and classify mpox virus strains, thereby facilitating the study of its epidemiological characteristics. However, these approaches fail to elucidate the interaction mechanisms between the host immune system and the virus. With the development of immunological detection technologies, an increasing number of methods for evaluating host immune responses have been developed, playing a critical role in the disease diagnosis, prevention, control, and vaccine development for mpox. This article comprehensively dissects the immunological testing landscape from various perspectives: protein detection (antigens, antibodies, and cytokines), cellular immune characteristics (T-cell epitope recognition and dynamic cytokine monitoring), providing detailed analysis of their detection principles, clinical advantages, and technical limitations. By integrating multi-omics data and clinical validation studies, the review further outlines future development directions, including standardized detection protocol establishment, multi-modal technology integration strategies, and AI-assisted diagnostic models. These insights offer theoretical support and translational pathways for establishing a new research paradigm in mpox virus immunodiagnostic technologies.

Objective To analyze and study the status quo and deficiencies in the construction of talent teams at all levels of CDCs in Hainan Province and put forward countermeasures to provide a reference basis for the high-quality development of talent team construction in all levels of CDCs in Hainan Province. Methods Using field surveys and data retrieval, spatial analysis was employed to compare the overall differences in human resource status of the provincial-level CDC and CDCs in five regional areas (East, West, South, North, and Central Hainan). The coordination between human resource allocation and development strategies was analyzed. A descriptive analysis mainly utilized CDC survey questionnaires and other research forms to explore the health human resources of the province's CDCs. Results The professional and technical personnel in the provincial CDCs comprise 1 431 individuals, accounting for 82.3% (1 431/1 739) of the total number of actual employees, which falls short of the Central Institutional Reform Commission's (CIRC) mandate that technical professionals comprise at least 85% of the total workforce (CIRC Document [2014] No. 2). Among Hainan's CDC personnel, 115 individuals are recognized as high-level talents within the Hainan Free Trade Port framework. These include one Class C talent, 22 Class D talents, and 93 Class E talents. Class A, B, and C-level talents are deficient. The majority of staff at both the provincial and regional CDCs hold bachelor's degrees. There is a significant proportion of staff with associate degrees or lower qualifications, coupled with a severe shortage of highly educated personnel. Postgraduates with master’s degrees or above account for 27.8% (65/233) in the provincial CDC, indicating low educational credentials among personnel in Hainan's CDCs. The central region, characterized by slower economic and social development, faces greater challenges in attracting and retaining high-level talent. There is a scarcity of public health professionals with interdisciplinary expertise. Some public health staff lack clinical knowledge, experience, and skills in disease treatment. Furthermore, there is a need to strengthen on-site emergency response capabilities for public health emergencies. The structural ratio of senior, intermediate, and junior professional and technical positions in the provincial CDC is 40%∶45%∶15%. The position settings are limited to ranking levels without distinction by professional category, leading to a bottleneck-type competition like crossing the "one log bridge" for technical position promotions. Conclusion Hainan Province faces significant challenges in developing its public health workforce, both in technical expertise and management capacity. Especially under the context of the closure operation of the Hainan Free Trade Port, it is necessary to continuously strengthen top-level talent design to cultivate a favorable policy, system, and cultural environment, thereby promoting the sustained and healthy development of the province's public health career.

Objective To investigate the resistance levels of adult Culex quinquefasciatus mosquitoes to three commonly used pyrethroid insecticides in Xingyi City, Guizhou Province, as well as to examine the changes in metabolic detoxification enzyme activities and mutations in the knockdown resistance (kdr) gene thereby providing a scientific foundation for the prevention and control of Culex quinquefasciatus in the region. Methods In 2024, the larvae of Culex quinquefasciatus were collected from different locations in Xingyi and reared to adult mosquitoes in the laboratory, and their resistance to pyrethroid insecticides was determined using the adult mosquito contact tube method. Surviving samples (resistant population) from the resistance tests were examined for the activities of mixed function oxidase (MFO), glutathione-S-transferase (GST), and non-specific esterase (NSE) using a microplate reader. The genomic DNA of individual adult Culex quinquefasciatus mosquitoes was extracted, and the voltage-gated sodium channel (VGSC) gene fragment was amplified via PCR and sequenced to analyze the mutations in the kdr gene. Results The 24-h mortality rates of adult Culex quinquefasciatus exposed to 0.25% permethrin, 0.025% deltamethrin, and 0.025% beta-cypermethrin were 1.00%, 0%, and 0.88%, respectively, indicating all populations of Culex quinquefasciatus exhibited resistance to the three pyrethroid insecticides. The activity of MFO in permethrin-resistant population followed a normal distribution, while deltamethrin-resistant and cypermethrin populations exhibited skewed distributions. The resistance ratios (RRs) for the three populations were 1.17, 1.03, and 1.07 times, respectively, with no statistically significant differences in MFO activity between field populations and susceptible strains (all P>0.05). However, the GST activities of permethrin-resistant and beta-cypermethrin-resistant field populations were 1.06 and 1.45 times higher than those of sensitive strains (P<0.05). Sequencing of the VGSC gene fragments of adult Culex quinquefasciatus resistant to pyrethroid insecticides revealed that mutations occurred solely at 1014 locus, presenting two alleles: wild type TTA(L) (1.26%) and mutant TTT(F) (98.74%). Two genotypes were identified: wild/mutant heterozygotes L/F (2.52%) and mutant homozygotes F/F (97.48%). No statistically significant differences were observed in the frequency of resistance gene mutations among populations resistant to the three pyrethroid insecticides (P>0.05). Conclusion The adult mosquitoes of Culex quinquefasciatus in Xingyi have developed resistance to three commonly used pyrethroid insecticides, with changes observed in metabolic detoxification enzyme activities and mutations in the kdr gene. The resistance of Culex quinquefasciatus in Xingyi is the result of multiple mechanisms. Understanding the resistance level and mechanism can provide a reliable basis for mosquito control and resistance management. It is recommended to enhance the monitoring of mosquitoes' resistance to insecticides, prioritize environmental management focused on eradicating breeding sites, reduce the use of pyrethroid insecticides, and rotate with other classes of insecticides to delay the onset of resistance.

Objective To enhance the understanding of cryptococcal meningitis and identify critically ill patients to improve clinical cure rates through describing the demographic characteristics, laboratory tests, and prognostic factors of AIDS patients complicated with cryptococcal meningitis. Methods The clinical data and laboratory tests of AIDS patients diagnosed with cryptococcal meningitis in Yunnan Provincial Infectious Disease Hospital from June 2017 to August 2022 were retrospectively collected. Prognostic follow-up was conducted, and patients were divided into improved and mortality groups based on outcomes. Categorical variables were compared using a chi-square test, while continuous variables were analyzed with an independent sample t-test. Statistically significant variables were further incorporated into a binary logistic multivariate regression analysis (full entry method) to identify independent high-risk factors for mortality. Results A total of 111 patients with AIDS patients complicated with cryptococcal meningitis were included in this study. The male-to-female ratio was 2∶1, with 76.58% (85/111) aged 18 to 50 years. Sexual transmission accounted for 80.18% (89/111) of infection routes. The mean CD4⁺T lymphocyte count of the patients was (74.48±8.64) cells/μL, with 92.79% of patients having CD4⁺T lymphocyte counts <200 cells/μL and 52.25% <50 cells/μL. The main clinical manifestations of the patients included headache (78.38%,87/111), fever (65.77%, 73/111), and vomiting (50.45%, 56/111). The mean initial cerebrospinal fluid pressure was (260.54±71.37) cmH₂O. The overall mortality rate of the patients in this study was 24.32%. Multivariate analysis identified repeated therapeutic lumbar punctures as a protective factor, while consciousness disorder and low plasma albumin were risk factors for mortality. Conclusion AIDS patients with cryptococcal meningitis in this study were predominantly young and middle-aged males, presenting with headache and fever as the main clinical manifestations and exhibiting a high mortality rate. Consciousness disorder and low plasma albumin were associated with poor prognosis. Repeated therapeutic lumbar punctures, in addition to aggressive antifungal therapy, may improve survival rates.

Objective To monitor the dynamic changes in liver stiffness and their correlation with clinical indicators among chronic hepatitis B virus (HBV) infected individuals in Wuwei City, Gansu Province, and to provide important evidence for the early detection and effective intervention of liver fibrosis (LF) progression. Methods Based on the Wuwei Hepatitis B Specialty Cohort, this study conducted annual serological and FibroScan ultrasonographic examinations for 3 882 chronic HBV-infected individuals. Over an average of 4 years of follow-up, the liver fibrosis outcome was monitored, and influencing factors were analyzed by constructing a logistic regression model. Results Among the 2 053 chronic HBV-infected individuals who completed at least one follow-up, baseline LF grades F0 to F4 were distributed as follows: 1 581 cases (77.0%), 164 cases (8.0%), 99 cases (4.8%), 110 cases (5.4%), and 99 cases (4.8%), respectively. Significant differences were observed among the five groups in terms of age, gender, smoking, antiviral treatment, liver function indicators, control attenuation index (CAP), and liver stiffness measurement (LSM) (P<0.05). After an average of 4 years of follow-up, 1 686 cases (17.9/100 person-years) showed no significant change in LF grade, 260 cases (2.8/100 person-years) demonstrated a decrease in LF grade, and 107 cases (1.1/100 person-years) exhibited an increase in LF grade. Stratified by baseline treatment status, among patients with chronic HBV infection who did not undergo treatment, baseline alanine aminotransferase (ALT) (OR=5.50, 95%CI：1.79-16.83, P=0.003) and LSM (OR=3.35, 95%CI：1.23-9.13, P=0.018) were identified as risk factors for LF progression. In contrast, among patients who underwent antiviral treatment, baseline aspartate aminotransferase (AST) (OR=2.23, 95%CI：1.41-3.53, P<0.001) and total bilirubin (TBIL) (OR=1.79, 95%CI：1.14-2.81, P=0.012) levels were identified as risk factors for LF progression. Conclusion LSM and liver function indicators, such as ALT, AST, and TBIL, are important influencing factors for LF progression. The monitoring of LSM and liver function indicators will be of great significance for the prevention and early diagnosis of liver cirrhosis.

Objective Exploring the role of Nestin in liver repair in mice infected with Echinococcus multilocularis. Methods The expression of Nestin in the liver of normal Nestin-cre/Rosa26-tdTomato transgenic mice at 1, 2 and 8 weeks of birth was detected by immunofluorescence method, and the transgenic mice model of Echinococcus multilocularis infection was established. HE was used to detect the pathological damage of Echinococcus multilocularis infected liver, and the expression of Nestin in the liver after Echinococcus multilocularis infection was detected by immunofluorescence. Transwell experiment detected the migration ability of Nestin positive cells stimulated by EmP. Immunofluorescence assay was used to detect the co localization of Nestin and ALB in the liver of transgenic mice infected with Echinococcus multilocularis, and immunohistochemistry was used to detect the expression of Ki67 in the liver of infected mice. Results A Nestin-cre/Rosa26-tdTomato transgenic mouse genotype was established. Immunofluorescence detection revealed that Nestin expression was highest in the liver of mice at 1 week of birth, and gradually decreased after 2 and 8 weeks (P<0.001); The Nestin content in the liver of mice infected with Echinococcus multilocularis gradually increased after 1, 3, and 5 months of infection, and the difference was statistically significant (P<0.001). Transwell experiments showed that EmP at a concentration of 5 μg/mL enhanced the migration ability of Nestin positive cells (P<0.001). Immunofluorescence detection revealed co localization of Nestin and ALB in the liver of mice infected with Echinococcus multilocularis. Immunohistochemistry showed that the expression level of Ki67 in the liver of infected mice gradually increased with infection time of 1, 3, and 5 months (P<0.001). Conclusion After infection with Echinococcus multilocularis, Nestin expression is enhanced in the liver, and Nestin-positive cells are recruited to participate in the process of liver injury repair.

Objective To investigate the adaptive changes and genetic mechanisms underlying Pseudomonas aeruginosa in the airways of bronchiectasis patients, aiming to provide valuable insights and considerations for developing effective anti-infection strategies in this patient population. Methods A case of bronchiectasis complicated with chronic Pseudomonas aeruginosa infection was collected from October 2022 to January 2024 in the central theater general hospital, during which bronchoalveolar lavage fluid (BALF) samples were collected. Six strains of Pseudomonas aeruginosa were isolated and identified (designated as PA-08, PA-09, PA-10, PA-11, PA-12, and PA-13 in chronological order). Subsequently, third-generation whole genome sequencing was performed to analyze genetic evolution and conduct biological phenotype identification. The aim was to elucidate the relationship between their adaptive changes and clinical outcomes. Results The genome sequencing results revealed that the aforementioned six strains of Pseudomonas aeruginosa originated from a common ancestor, yet their genome sizes exhibited variations of up to 1.6 Mbp. Further analysis demonstrated that PA-09, PA-10, and PA-12 all experienced a loss of a 14.47 kbp fragment encompassing 12 genes responsible for encoding pyocyanin and ferriferin, when compared to PA-08. Additionally, PA-12 also underwent a loss of a segment spanning approximately 1.5 Mbp. The distinction lies in the fact that PA-13 exhibits significant gene acquisition, with only minor fragment deletions and translocations compared to the PA-08 genome. Phenotypic analysis revealed a decrease in virulence of subsequent isolates, when compared to PA-08. E-test drug susceptibility testing demonstrated the antibacterial effect of common anti-gram-negative drugs on the above strains was related to the genome. Concurrently, as the strain's genotype and phenotype underwent changes, although patient symptoms exhibited fluctuations, overall disease progression displayed a trend of gradual exacerbation due to persistent and progressive. Conclusion The present study elucidates the molecular mechanism underlying microevolution and adaptation of Pseudomonas aeruginosa in the airways of bronchiectasis patients, thereby implying a close association between disease progression in bronchiectasis patients and chronic infection by Pseudomonas aeruginosa.

Objective To understand the situation of plague host vectors, indicator animals and residents infected with plague bacteria in Cangyuan County, Yunnan Province, China-Myanmar border region, and to explore the risk of plague epidemic, so as to provide reference basis for supplementary plague data and prevention and control in this area. Methods A plague survey was carried out in three townships in Cangyuan County in 2023. The collected host animals organs and body surface parasitic fleas were bacterial cultured. Serum collected from border residents, indicator animals, and host animals was tested for plague F1 antibodies using indirect hemagglutination assay (IHA). The positive samples were rejudged by IHA, immune colloidal gold assay(GICA) and up-converting phosphor technology(UPT). Results Totally 294 serum samples were collected from border residents, with an average age of (48.48±14.27) years old, with more females than males. Three were positive for F1 antibody against Yersinia pestis, with a positive rate of 1.02%. And 65 samples of indicator animal serum and 31 samples of Rattus tanezumi serum were collected, and the detection of plague F1 antibody was negative. And 198 rodents belonging to 3 orders, 5 families, 11 genus and 14 species were captured, with a total capture rate of 7.93%, with Rattus tanezumi (46.97%) and Rattus andamanensis (19.19%) as the dominant species. The capture rate in residential indoor areas was 3.72%, and Rattus tanezumi was the absolutely dominant species (100.00%). The capture rate in farming areas was 10.26%, the dominant species were Rattus tanezumi (36.36%), Rattus andamanensis (23.03%), Mus pahari (10.30%) and Hylomys suillus (10.30%). And 60 fleas belonging to 3 families, 5 genera and 6 species were seized, the average infection rate of fleas was 11.62%, and the total flea index was 0.30. The dominant species were Xenopsylla cheopis (28.34%), Palaeopsylla remota (23.33%), Ctenophthalmus quadratus (18.33%), Stivalius aporus (15.00%) and Palaeopsylla incurua (11.67%). A total of 198 murine organ samples were isolated and cultured, and 24 groups of flea samples were obtained, no Yersinia pestis was isolated. Conclusion The investigation has not found any recent infection with Yersinia pestis in rodents, body surface parasitic fleas and indicator animals; however, it is found that there is still a certain proportion of positive population of plague F1 antibody in the serum of residents. Rattus tanezumi and Xenopsylla cheopis are the first dominant species of host and vector in the county, the indoor density of Rattus flavipectus exceeds 3%, reaching the animal pestis IV early warning, and there is a risk of recurrence in the plague foci.

Objective The vaginal microecology is crucial for women's reproductive health. This study aimed to systematically evaluate the impact of microbial infections on vaginal microecology, with a particular focus on the characteristics of fungal infections and their related health effects. Methods A total of 8 750 vaginal secretion samples were collected from the gynecology outpatient department of The First Hospital of Changsha in 2024. Fluorescent microscopy was used to detect pathogen infections. Cases were divided into infection group and control group based on the pathogen infection status; and further classified into fungal positive group and fungal negative group according to the results of fungal detection. Based on the detection results, the effects of different infection types on vaginal cleanliness, pH levels, Lactobacillus abundance, and white blood cell counts were analyzed. The study focused on the epidemiological characteristics of fungal infections and their co-infections with other pathogen. Results Fungal infection was the most common type of pathogen infection, accounting for 23.82% (2 084/8 750) of all tested samples. It predominantly affects young women aged 20-<30 years, with the highest detection rate observed in March. Fungal infection impacts vaginal cleanliness grading, with a statistically significant difference (P<0.01). In the fungal-positive group, the proportions of grade III and IV vaginal cleanliness were 54.41% and 9.74%, respectively, compared to 32.61% and 3.33% in the fungal-negative group. Additionally, the pH value in the fungal-positive group was 4.35, which was significantly lower than the 4.46 observed in the fungal-negative group (P<0.05). Furthermore, fungal infections were often accompanied by co-infections with pathogen such as Gardnerella anaerobes and trichomonads, exacerbating vaginal microecological imbalance. Conclusion This study revealed the significant impact of fungal infections on vaginal microecological imbalance, particularly in terms of vaginal cleanliness and pH levels. The findings provide important insights for the diagnosis, prevention, and intervention of vaginal microecological imbalances and are of great significance for safeguarding women's reproductive health.

Objective The objective of this study is to identify tuberculosis-specific biomarkers in peripheral blood by integrating bioinformatics analysis with machine learning algorithms, thereby improving the differential diagnostic efficiency between pulmonary tuberculosis and lung cancer. Methods Based on the dataset GSE42834 downloaded from the Gene Expression Omnibus (GEO) database, differentially expressed genes (DEGs) between pulmonary tuberculosis and lung cancer were screened. Tuberculosis-specific DEGs were identified using Venn diagrams. Subsequently, the least absolute shrinkage and selection operator (LASSO) algorithm and random forest (RF) algorithm was conducted a two-step screening of candidate genes to select core diagnostic biomarkers. The expression and diagnostic performance of these biomarkers were further validated in independent datasets (GSE157657 and GSE198048) using clinical cohorts (84 pulmonary tuberculosis cases, 31 lung cancer cases, and 54 healthy controls). Results A total of 277 tuberculosis-specific DEGs were identified. Through joint screening with LASSO algorithm and random forest algorithm, four shared signature genes (Gbp6, Batf2, Gbp5, and Tap1) were selected as diagnostic biomarkers for pulmonary tuberculosis. When diagnosing pulmonary tuberculosis by a single gene, area under the receiver operating characteristic (ROC) curve (AUC) values were exceeding 0.98. Analysis of validation datasets (GSE157657 and GSE198048) revealed significant upregulation of these genes in peripheral blood of tuberculosis patients (P<0.000 1), while their expression showed no significant differences in lung cancer patients. By collecting clinical samples for assessment of diagnostic efficiency, it was found that the expressions of Gbp6, Batf2, Gbp5, and Tap1 were significantly higher in tuberculosis group than in healthy controls and lung cancer group (P<0.000 1). ROC analysis demonstrated that AUC values of single genes (Gbp6, Batf2, and Tap1) achieved >0.8 for discriminating tuberculosis (including both culture-negative and culture-positive cases) from lung cancer and healthy controls. When the four genes are used in combination, the model achieved an AUC of 0.99 for the overall diagnosis of pulmonary tuberculosis (AUC for smear-negative pulmonary tuberculosis was>0.98). Conclusion The tuberculosis-specific gene biomarkers (Gbp6, Batf2, Gbp5, and Tap1) identified in this study demonstrate high diagnostic efficacy and hold significant clinical value for differential diagnosis, offering a novel strategy for non-invasive discrimination of pulmonary tuberculosis. Future multicenter prospective studies should be conducted to validate their generalizability and explore their diagnostic specificity across other infectious diseases.

Objective To retrospectively analyze the screening and prevalence trend of MTB/HIV（tuberculosis/human immunodeficiency virus） co-infection patients in Shaanxi Province from 2018 to 2022, and to provide scientific basis for further improving the prevention and control strategy of MTB/HIV co-infection in Shaanxi province. Methods Through annual reports and National Tuberculosis Information Management System of MTB/HIV co-infection, the screening, treatment and outcomes of MTB/HIV co-infected patients in Shaanxi Province from 2018 to 2022 were collected and analyzed． Results From 2018 to 2022, HIV antibodies were detected in 49 252 patients, with detection rate of 55.41%, and 57 patients of HIV infection were detected. During the same period, among HIV/AIDS patients, the screening rate of tuberculosis symptoms in newly detected HIV/AIDS patients was 95.91%, the detection rate of tuberculosis was 94.25%, and 174 MTB/HIV patients were found. The screening rate of tuberculosis symptoms in previously-recognized HIV/AIDS patients was 96.94%, the detection rate of tuberculosis was 95.45%, and 135 MTB/HIV patients were found. From 2018 to 2022, the overall trends of HIV detected in tuberculosis patients (χ²_trend=4 589.301, P<0.05), screening of tuberculosis in newly detected and previous HIV (χ²_trend=47.400, P<0.05; χ²_trend=60.196, P<0.05), examination of tuberculosis in newly detected and previous HIV(χ²_trend=755.856, P<0.05; χ²_trend=526.498, P<0.05), were fluctuating and rising year by year. The screening rate, inspection rate and detection rate of newly detected and previous HIV in each year had statistical differences(P<0.05), except for the inspection rate in 2020 and 2022. Among the MTB/HIV patients, 336 (91.80%) were males, 30 (8.20%) were females. The anti tuberculosis treatment rate for all MTB/HIV patients was 89.62%, and the successful treatment rate for tuberculosis was 87.80%. Conclusion The quality of two-way screening and prevention work in Shaanxi Province is gradually improving. MTB patients have a higher detection rate in newly detected HIV/AIDS. Strengthening the screening of MTB in newly detected HIV/AIDS is beneficial to earlier found and treatment of MTB/HIV, improve the success rate of TB treatment and reduce the death rate of MTB/HIV patients.

Objective To investigate whether modulation of the host lung tissue PPAR-γ/RXR-α signaling attenuates inflammation induced by Paragonimus proliferus (P. proliferus) infection by elevating the rate of fatty acid β-oxidation, thereby providing a scientific basis for the prevention and control of P. proliferus. Methods A rat model of pulmonary paragonimiasis induced by P. proliferus infection was established and treated with either the PPAR-γ agonist rosiglitazone or the RXR-α agonist bexarotene for intervention. Then, whole-transcriptome sequencing of rat lung tissues was performed on the DNBSEQ platform. qRT-PCR, western blotting, and immunofluorescence were used to quantify the mRNA and protein expression of key target molecules of PPAR-γ/RXR-α signaling, respectively. Co-immunoprecipitation (CoIP) was used to assess the protein-protein interactions between PPAR-γ and RXR-α. The rate of fatty-acid β-oxidation in lung tissue was measured colorimetrically, and serum levels of IL-1β, IL-6, and TNF-α were determined by ELISA. Results Transcriptome analysis revealed differential expression of fatty-acid β-oxidation-related genes, including Cpt1a, Cpt1b, Cpt1, Cpt1c, Cpt2, Fabp4, Fabp5, Fat4, Acox1, Rxr-α, and Rxr-b in the rat model of P. proliferus infection. qRT-PCR, western blotting, and CoIP assays showed that the mRNA and protein expression of PPAR-γ and RXR-α were down-regulated in rat lung tissues of the model group, whereas both bexarotene and rosiglitazone significantly restored their expression and enhanced PPAR-γ/RXR-α interaction (all P<0.05). The fatty acid β-oxidation rates of the rat lung tissues in healthy control, model, bexarotene, and rosiglitazone groups were 60 (55.76, 64.92), 44 (41.33, 47.77), 63.00 (54.00, 67.41), and 59.90 (49.60, 67.00) μmol/(min·mg), respectively. Corresponding serum IL-1 levels were 105.61 (96.52, 113.90 ), 147.54 (143.32, 182.88), 94.98 (92.85, 111.25), and 94.25 (79.61, 115.22) pmol/L; IL-6 levels were 1 398.06 (1 258.22, 2 220.21), 4 538.12 (3 427.64, 5232.93), 1 950.00 (1 429.68, 2 359.00) and 663.91 (604.67, 770.61) pg/mL; and TNF-α levels were 153.86 (136.50, 156.88), 183.1847 (169.58, 194.24), 151.78 (144.69, 162.48) and 165.90 (158.97, 171.78) pmol/L, respectively. Overall differences among the four groups were significant (H=10.45, 13.24, 19.72, and 13.59, all P<0.05); furthermore, the model group differed from the healthy control, and both treatment groups (bexarotene or rosiglitazone group) differed from the model group (all P<0.05). Conclusion Activation of PPAR-γ/RXR-α signaling reduces the level of inflammation induced by P. proliferus infection by elevating the rate of fatty acid β-oxidation in rat lung tissues.

Objective To establish a real-name vaccination work system and evaluate the implementation effectiveness of real-name vaccinations. Methods Based on the on-site research of preventive vaccination and the actual work needs, a real-name vaccination system for Henan Province was developed and constructed. The Henan Provincial Immunization Planning Management System was used to collect data on real-name vaccination from July 2022 to September 2024. The progress of real-name vaccination implementation and the quality of preventive vaccination data were descriptively analyzed. Results Henan Province began implementing real-name vaccination in July 2022, achieving real-name vaccination rates of 92.29% (2.279 0 million/2.469 5 million), 95.28% (2.418 9 million/2.538 8 million), and 99.03% (2.546 2 million/2.571 2 million) by March, August, and September 2023, respectively. A total of 56.994 3 million person-times of real-name vaccination were administered across the province. As of September 30, 2024, there were 83.808 9 million real-name records in the Immunization Program Information Management System of Henan Province, with a real-name rate of 78.62% (83.808 9 million/106.599 6 million). The rate of duplicate records in the immunization program information system showed a downward trend, dropping to 1.30 per 10 000 by September 2024; the real-time entry rate exhibited a fluctuating upward trend, reaching 99.96% (3.166 2 million/31.673 2 million) in September 2024. Spearman rank correlation analysis revealed significant correlations between the real-name vaccination rate and the real-time entry rate (correlation coefficient =0.805) as well as the duplicate record rate (correlation coefficient =-0.778), with P values both less than 0.001. Among children born between 2017 and 2023 who were vaccinated from July 2022 to September 2024, the completeness rates of basic information entered into vaccination records were 90.68%, 92.18%, 84.44%, 88.86%, 91.32%, 96.35%, and 97.53% for respective birth years. Conclusion The adoption of the second-generation resident identification card as the core identity identifier optimized the preventive vaccination process, improved the work efficiency of staff, and reduced work errors. Real-name vaccination also ensured the integrity and authenticity of key information in preventive vaccination records, providing a foundation for making vaccination more efficient, precise, and scientific.

Objective To analyze the hepatitis B (HBV) incidence trend and intervention measures implemented over 15 years (2009-2023) following the establishment of Wuwei demonstration zone and to explore a new model suitable for hepatitis B prevention and control in rural areas of western China. Methods Data on reported hepatitis B cases (1994-2023) were collected from Wuwei City's Disease Monitoring Report Management Information System, vaccination records from the Immunization Planning Information Management System, hepatitis B maternal-to-child transmission prevention data from the Management Information System for Prevention of HIV, Syphilis, and Hepatitis B Mother-to-Child Transmission. Additionally, field epidemiological survey data, serological test results, and intervention measures were also used to analyze using descriptive epidemiological methods. Results Over the 15-year period, the average annual incidence rate of hepatitis B in the demonstration area was 200.48 per 100 000, representing a 38.76% reduction compared to the pre-construction period (1994-2008, 327.35 per 100 000). Post-establishment, the incidence decreased from 637.70 per 100 000 in 2009 to 87.45 per 100 000 in 2023, showing an average annual decline of 13.23%. In intensified intervention areas, the incidence decreased by 89.28%, and the rate stabilized in the mid-to-late stages. Among pregnant women, the HBsAg-positive rate was 4.41%, with 99.42% of newborns born to HBsAg-positive mothers receiving hepatitis B immunoglobulin immunization. The prevalence of chronic hepatitis B, liver cirrhosis, and liver cancer-related diseases decreased by 42.19%, while the mortality rate of hepatitis B patients declined from 8.69% to 2.00%. Public awareness of hepatitis B prevention and control increased from 43.48% to 83.79%. A hepatitis B prevention and control model suitable for impoverished western regions—the “Wuwei Model”—was established and validated. This model emphasizes short-course vaccination, early intervention, integration of prevention and treatment, and collaborative efforts. Conclusion The “Wuwei Model” significantly reduced the incidence and mortality of hepatitis B in the demonstration area, demonstrating effective disease control. Further validation and promotion of this model are needed. Continued efforts should focus on expanding whole-population screening for chronic hepatitis B infection, improving the management of chronic hepatitis B carriers, and increasing immunization rates among susceptible adult populations.

The nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domain-containing 3 inflammasome (NLRP3) inflammasome is an important intracellular immune sensor, and recent studies have shown that it plays a key role in various lung diseases. Lung injury and lung cancer are major health issues that lead to high mortality rates worldwide, and understanding the underlying molecular mechanisms is crucial for developing new therapeutic strategies. Currently, research on the role of the NLRP3 inflammasome in these diseases is gradually increasing, but related mechanisms remain unclear, especially regarding its interactions between lung injury and lung cancer. This article aims to explore the mechanisms of the NLRP3 inflammasome in the development of lung injury and lung cancer by analyzing its activation mechanisms, its role in lung injury, and its relationship with lung cancer, revealing the potential of the NLRP3 inflammasome as a therapeutic target and biomarker. The review will incorporate the latest research findings to provide new insights for the prevention and treatment of lung diseases.