Objective To explore the clinical data of children with Talaromyces marneffei (TM) infection admitted to the pediatric intensive care unit (PICU) to improve the diagnosis and treatment of TM infection in children. Methods The clinical data of 23 children with TM infection treated in four PICUs in southern China from January 2013 to December 2022 were retrospectively analyzed, including clinical characteristics, laboratory tests, treatment regimens, and outcomes. Results Among the 23 children, there were 14 boys and 9 girls, with a median age of 24 months. The time from onset to admission was 15 (range 10-30) days, and one patient had immunodeficiency disease. Common symptoms included fever (91.3%, 21 cases), cough (78.3%, 18 cases), and hepatosplenomegaly (78.3%, 18 cases). Severe clinical complications included multiorgan dysfunction (69.6%, 16 cases), septic shock (65.2%, 15 cases), and acute respiratory distress syndrome (65.2%, 15 cases). All patients elevated CRP levels, and 69.2% (9/13) had a positive G test. Elevated IgE levels were observed in 53.3% (8/15) cases, CD4/CD8 inversion in 17.6% (3/17) cases, and reduced NK cells in 84.2% (16/19) cases. HIV tests were negative in all cases. TM was most frequently detected by blood and bone marrow cultures. Seven cases were diagnosed with immunodeficiency by genetic testing. With monotherapy or combination of amphotericin B or/and voriconazole, followed by oral medication, 13 (56.5%) children died. Conclusions TM infection is clinically atypical in HIV-negative children, and patients admitted to PICU have rapidly deteriorated, with severe complications and a high mortality rate. Early use of multiple samples, and multiple methods to detect TM, combined with immune function and genetic test, is helpful to early diagnosis. The antifungal treatment strategies still need further study.

Objective To analyze the epidemiological and clinical characteristics of confirmed mpox cases in Sichuan Province in 2023 and to provide a scientific basis for the prevention and control of the mpox epidemic, and provide reference for the prevention and control of other emerging infectious diseases. Methods The data were collected from the information of confirmed mpox cases residing in Sichuan Province reported in the National Infectious Disease Reporting Information Management System until 24:00 on December 31, 2023, as well as the epidemiological investigation report of mpox cases. Excel 2020 software was used to input, sort out and plot the data, SPSS 23 statistical software was used to analyze the data, and descriptive epidemiological methods were used to analyze the basic characteristics of the cases. Results The first mpox case was reported in Sichuan Province on June 30, 2023, and the peak period of reported cases was from July to August. As of December 31, 2023, a total of 141 mpox cases had been reported. The cases were predominantly male (99.3%), aged 30-<40 years (49.6%), and MSM (men who have sex with men, accounting for 93.0% of male cases). 35.4% of cases reported HIV infection. The interval from onset of symptoms to diagnosis ranged from 2 to 90 days, with M(P₂₅，P₇₅) being 4 (6, 8) days. The incubation period for cases ranged from 1 to 21 days, with M(P₂₅，P₇₅) being 7 (4, 10) days. The majority of cases were discovered through proactive medical consultation (96.4%). The initial symptoms were rash (70.9%) and fever (31.2%). The main symptoms were rash (95.7%), fever (55.3%), and lymph node enlargement (35.5%). Conclusion Mpox outbreaks mainly occur in MSM population. It is necessary to make full use of the comprehensive intervention service system for AIDS prevention and treatment to publicize and educate key groups, timely monitor the variation of monkeypox virus, especially strengthen the surveillance of inbound cases, implement early detection and control of cases, and reduce the risk of epidemic transmission.

Objective To analyze the epidemiological characteristics of reported cases of dengue fever in mainland China from 2019 to 2023 and provide a scientific basis for dengue prevention and control efforts. Methods The temporal, spatial, and population distribution characteristics, as well as the trends of dengue fever cases reported in the National Notifiable Disease Reporting System (NNDRS) of China were analyzed using software such as Joinpoint regression, SaTScan, and ArcGIS. Results From 2019 to 2023, a total of 43 095 cases were reported in China, with an average incidence rate of 61/100 000. The annual reported incidence rate fluctuated significantly (AAPC=-3.16%, 95%CI:-54.16%-91.47%), mainly concentrated in 2019 and 2023, accounting for 96.83% of the total reported cases over the past five years. All age groups were susceptible to the disease, with the 30 to <40 age group comprising 22.6% of cases. Cases were reported throughout the year, with a rapid increase starting in June and a peak period concentrated between August and October (n=34 780, RR=12.44, LLR=29 262.52, P<0.05). The epidemic was primarily characterized by imported cases leading to autochthonous transmission, with the majority of imported cases originating from Southeast Asia (86.56%), particularly from Cambodia (46.11%, 3 284 cases) and Myanmar (25.99%, 1 851 cases). The epidemic characteristics varied significantly across different years, with high risks of autochthonous transmission epidemics in Southwest, South, and Southeast China. High-risk local transmission were mainly distributed in Yunnan and Guangdong. The duration of the peak period of the epidemic was affected by the timeliness of early detection of local transmission, and the peak value of the epidemic was related to the effectiveness of prevention and control measures. The scale of the epidemic was influenced by the pressure of by cross-border transmission and the ability to implement local measures for dengue prevention and control. Conclusions With the increasing trend of global dengue transmission, the risk of autochthonous transmission of dengue in China is rising. It is recommended to strengthen proactive early outbreak surveillance, along with well preparation of personnel, technology, and resources for dengue prevention and control.According to autochthonous conditions, reasonable management and risk assessment of cross-border travelers should be explored to effectively.

Objective To explore the clinical features and survival prognosis of stage Ⅳ non-small cell lung cancer (NSCLC) and provide a reference for prognosis evaluation and prevention and treatment of the disease. Methods A retrospective analysis was performed on 195 patients with stage Ⅳ NSCLC admitted to the Department of Medical Oncology and the Department of Respiratory Medicine of the First Affiliated Hospital of Hainan Medical University from 2016 to 2020, who were diagnosed pathologically and available for the analysis and study. Patients' hospitalization records and follow-up information were collected to analyze the survival of the patients at the cut-off of follow-up. The Kaplan-Meier method was used to calculate survival rates, and the Log-rank method was employed for univariate analysis of factors affecting survival. The risk factors for patients' survival prognosis were analyzed by multivariate Cox regression model. Results The median survival time for patients with stage Ⅳ NSCLC was 17.05 months (95% CI: 12.64-21.45), with cumulative survival rates of 70.7%, 41.5%, and 22.0% at 1, 2, and 3 years, respectively. The results of multivariate analysis suggested that gender (HR=0.697, 95% CI: 0.486-0.999, P=0.049), functional status scale (Karnofsky, KPS) (HR=1.535, 95% CI: 1.038-2.270, P=0.032), computed tomography (CT) tumor location (HR=1.481, 95%CI:1.003-2.186, P=0.036), pathology type (HR=1.181, 95%CI:0.715-1.950, P=0.019), metastatic site (HR=1.710, 95%CI:1.214-2.409, P=0.002), N stage (HR=2.094, 95%CI:0.973-4.509, P=0.006), gene mutation (HR=2.387, 95%CI:1.590-3.584, P<0.001), treatment with chemotherapy-containing regimen (HR=1.713, 95%CI:1.094-2.683, P= 0.019), and combination therapy (HR=1.874, 95%CI:1.253-2.802, P=0.002) were independent prognostic factors affecting the survival of patients with stage Ⅳ NSCLC (all P<0.05). In the subgroup analysis, metastatic site and chemotherapy-containing treatment regimen were independent prognostic factors affecting the survival of mutation-positive patients with stage Ⅳ NSCLC, and patients who received targeted therapy had longer survival time. The metastatic site, chemotherapy-containing treatment regimen, and combination therapy were prognostic factors affecting the survival prognosis of patients with gene mutation-negative stage Ⅳ NSCLC or unknown status. Conclusions In this study, gender, KPS score, CT tumor location, pathologic type, metastatic site, N stage, gene mutation, treatment with chemotherapy-containing regimen, and combination therapy were the important factors affecting the survival prognosis of patients with stage Ⅳ NSCLC. In terms of treatment options, chemotherapy remains an indispensable basic treatment option. Moreover, comprehensive treatment can prolong survival compared to a single treatment option. Patients with positive gene mutations who received targeted drugs had longer survival times; therefore, detecting gene mutation status and selecting corresponding targeted drugs in the treatment of stage Ⅳ NSCLC could extend survival periods.

Objective To analyze the incidence trends and spatiotemporal distribution characteristics of dengue fever in China based on the data from the China Disease Control Information System and the "National Statutory Infectious Disease Epidemic Overview" published by the National Health Commission of the People's Republic of China, and to provide a scientific basis for the prevention and control of dengue fever epidemics. Methods The incidence rates and monthly case numbers of dengue fever in China from 2015 to 2023 were collected. Provinces were classified according to the severity of the epidemic and the distribution status of the Aedes vector. The incidence trends, seasonal distribution, and spatial aggregation of dengue fever in China were statistically analyzed. Results The top five provinces with the highest average annual incidence rates from 2015 to 2023 were Yunnan (6.16/100 000), Guangdong (1.70/100 000), Hainan (1.13/100 000), Fujian (1.13/100 000), and Chongqing (0.74/100 000). The average annual incidence rate of dengue fever in China increased by 70.79% from 2015 to 2019 (AAPC=70.79, P=0.045). In Class Ⅰ regions, the incidence of Guangxi and Hainan showed a linear regression trend, with average annual increases of 844.73% (AAPC=844.73, P=0.021) and 516.51% (AAPC=516.51, P=0.013), respectively. In Class Ⅱ regions, except for Shanghai, the incidence of other provinces showed a linear regression trend, with Jiangxi having the highest average annual increase of 610.16% (AAPC=610.16, P=0.021), followed by Chongqing at 345.12% (AAPC=345.12, P=0.038). In Class Ⅲ regions, the incidence of Hebei, Shanxi, and Liaoning had a linear regression trend, with average annual increases of 80.67% (AAPC=80.67, P=0.028), 202.31% (AAPC=202.31, P=0.001), and 70.19% (AAPC=70.19, P=0.031), respectively. The epidemic of dengue fever showed no obvious seasonality in 2021, strict seasonality in 2022, and strong seasonality in the rest of the years. The epidemic peak days were mostly concentrated in the middle and late September to early October of each year, and the epidemic peak periods were mainly concentrated in August-early November. From 2015 to 2018, the incidence rate had no spatial aggregation nationwide, and the incidence rate in 2019 had spatial aggregation nationwide. In 2015-2019 and 2023, there were no high-low gathering areas in the country, and high-high gathering areas appeared in 2018 (Fujian, Hainan) and 2019 (Guangxi). Conclusions The situation of dengue fever prevention and control in China is grim. High-risk epidemic areas of dengue fever will no longer be limited to Class Ⅰ provinces, and the risk of expansion to Class Ⅱ provinces is increasing.

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.

Objective To explore the application of factorial design in field trapping experiments for flies, and to provide more ideas for screening the best fly control method. Methods A 2×2 factorial design was used to analyze the main effects of the height of the fly cage (hanging fly cage, standing fly cage) and the type of bait (commercial bait, smelly tofu bait), and the interaction between the two factors. The fly trapping methods were divided into four combinations: hanging fly cage and commercial bait, hanging fly cage and smelly tofu bait, standing fly cage and commercial bait, standing fly cage and smelly tofu bait. The experiment was repeated 7 times for each combination and carried out according to the National Vector Biological Surveillance Implementation Plan. The best fly trapping method was identified by factorial design analysis of variance. Results A total of 2 296 flies were trapped in this study, with a cumulative deployment of 28 traps in the field, resulting in an average total density of 82.0 flies per cage. Among them, the number of flies attracted by the combination of standing fly cage and smelly tofu was the largest, accounting for 44.16% (1 014/2 296) of the total number of flies caught, with an average fly density of 144.8 flies per trap. This was followed by the combination of hanging fly cage and smelly tofu, hanging fly trap and commercial bait, and standing fly cage and commercial bait, accounting for 42.73% (981/2 296), 8.71% (200/2 296), and 4.40% (101/2 296) of the total, with average fly densities of 140.1, 28.6, and 14.4 flies per trap, respectively. The differences in field fly density among different trapping methods were statistically significant (F=49.441, P<0.001), and the differences in fly population composition were also statistically significant (χ²=259.980, P<0.001). The main effect of trap height was not significant (F=0.223, P=0.641), while the main effect of bait type was significant (F=147.206, P<0.001), and the interaction effect between trap height and bait type was not significant (F=0.894, P=0.354). Conclusions Compared with the single-factor design method, the factorial design method can not only analyze the main effects of each factor but also the interactions between the factors. The combination of standing fly cage and smelly tofu is preferred to have a better fly control effect.

Objective The objective of this research is to construct a technical indicator framework for preventing the of re-establishment of imported malaria at the county level in China, excluding border areas, with the aim of guiding specialist agencies to prevent the re-establishment of imported malaria in a scientific, feasible and comprehensive way. Methods The preliminary framework was built based on literature review and on-site research. Two rounds of Delphi consultation were carried out. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated. The weights and the combined weights for the indicators were determined using the analytic hierarchy process and probability method, respectively. Results Twenty experts were invited in the 1^st round of consultation, and twenty-six in the 2^nd round. The authority coefficients of the experts for two rounds were 0.955 and 0.968, respectively. The P value of the degree of coordination of two rounds were less than 0.05. The final framework included 5 primary indicators, 19 secondary indicators and 42 tertiary indicators. Primary indicators included government-led, joint control and prevention, surveillance and response, capacity building and organization guarantee, whose weights were 20.2%, 2.4%, 20.1%, 44.7% and 12.5%, respectively. Among the secondary indicators, the highest combined weight was medical institutions (25.0%) of capacity building, and the lowest was cross-sectoral cooperation (0.3%) of joint control and prevention. The three tertiary indicators with higher combined weights were: "1.2.1 There is a comprehensive plan for preventing the re-establishment of imported malaria, and the responsibilities of relevant departments are clearly defined" accounting for 14.9%; "4.1.4 Laboratory personnel in medical institutions possess the ability to conduct microscopic examinations for malaria detection" accounting for 10.6%; and "4.2.1 Specialized malaria surveillance laboratories have been established and are fully equipped with the necessary capabilities to conduct effective surveillance" accounting for 7.6%. Conclusions A framework has been created for the prevention of re-establishment of imported malaria at the county level in China, excluding border areas. The framework provides an operational, scientific and comprehensive technical guidance for county-level areas from the perspective of the effectiveness of government-led, joint prevention and control, surveillance and response, capacity building and organizational support. The importance of maintaining the capacity to prevent re-establishment of imported malaria and whole-process case management under medical and preventive cooperation in the post-elimination stage was highlighted.

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 identify the temporal-spatial distribution patterns and changing of hotspot areas of malaria importations, and high-risk importation areas for imported malaria in Jiangsu Province, in order to provide the scientific evidence for prevention of malaria reintroduction in China. Methods Cases with imported malaria in Jiangsu Province from 2016 to 2022 were accessed from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China. The county-level vector map of Jiangsu Province was obtained from the National Fundamental Geographic Information System, China. ArcGIS 10.7 software was utilized to create a thematic map depicting the distribution of imported malaria cases in Jiangsu Province at the county level. Global and local autocorrelation analysis was then conducted to investigate the spatiotemporal changes in malaria import hotspot counties. Results There were a total of 1 189 cases with imported malaria reported in 77 counties (81.05%, 77/95) of Jiangsu Province from 2016 to 2022. The global spatial autocorrelation analysis showed that a global spatial cluster of imported malaria in Jiangsu was only identified in 2020 ( Moran's I =0.46, Z=4.37, P<0.01), but local spatial autocorrelation analysis found that a total 60 hotspot counties existed from 2016 to 2022. There are 23 counties in central Jiangsu (38.33%), and 20 counties in southern Jiangsu (33.33%), 17 counties in northern Jiangsu (28.33%). The distribution of hotspot counties exhibits continuity. For instance, Chongchuan District, which falls under the jurisdiction of Nantong City, has consistently emerged as a hotspot county for 2016-2021. Since 2020, two recurring hotspot counties emerged in northern Jiangsu and southern Jiangsu. These counties are Ganyu District, under the jurisdiction of Lianyungang City, and Lishui District, under the jurisdiction of Nanjing City. Conclusions The spatial-temporal cluster of cases with imported malaria was identified at the county level in Jiangsu, that hotspot counties were consistently detected. It is essential to maintain the sustainability of malaria surveillance and response in hotspot counties which were new detected, and strengthen the capacity of surveillance and response in hotspot counties which were continually detected based on the spatial-temporal distribution characteristics and changing rules of imported malaria.

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 To analyze the epidemiological characteristics of dengue fever in Guangzhou and provide a scientific basis for dengue fever prevention and control. Methods The data of dengue cases in Guangzhou, Guangdong Province reported between 2019 and 2023, were retrieved from the China Disease Prevention and Control Information System. Cross-sectional analysis was used to describe the temporal, spatial, and demographic distribution, and analyze the epidemiological characteristics. Results A total of 3 518 cases of dengue fever were reported in Guangzhou from 2019 to 2023, including 3 101 local cases (88.15%) and 417 imported cases (11.85%). The annual average incidence rate ranged from 0.09 to 17.59 per 100 000 population. Imported dengue fever cases were reported in all months, with the peak reported from May to November (374 cases, 89.69%). Local cases were first reported in May and the last in December, with the highest incidence from August to November (2 960 cases, 95.45%). The cases were reported in all 11 administrative districts; the top three were Baiyun District, Yuexiu District, and Liwan District. Male and female cases accounted for 53.52% and 46.48%, respectively; the age group mainly concentrated between 20-<60 years (2 547 cases, 72.40%). The top three occupations were business services (784 cases), housework and unemployment (738 cases), and retirees (596 cases). The average time from onset to diagnosis for local cases was 4.06 days, and 4.60 days for imported cases. The overseas imported cases mainly came from Southeast Asia 88.10%(311/353), with the most being imported from Cambodia. Cases imported from other provinces mainly came from Yunnan Province, and cases imported from other cities within the province mainly came from Foshan City. Conclusions In recent years, the incidence of dengue fever in Guangzhou has remained at a high level, with obvious imported and seasonal characteristics. Relevant departments should pay attention to key populations and take effective measures to reduce the density of mosquito vectors, and strictly prevent the spread of dengue fever.

Objective To analyze the changing trends of severe dengue (SD) among adults and children in China and compare the clinical manifestations between the two groups, providing scientific evidence to optimize dengue prevention strategies and reduce severe cases. Methods Literature related to clinical or infection aspects of dengue fever clinical or infection studies published from database inception to December 31, 2023, were retrieved from CNKI, Wanfang, VIP, and Scopus databases using keyword searches. The literature was screened according to predefined inclusion and exclusion criteria, and a meta-analysis was conducted using R (4.2.3) software. Results A total of 7 148 records were retrieved, ultimately including 30 studies on adults and 12 studies on children, involving eight provinces. The severe dengue comorbidity rate in adults decreased from 6.6% during 1978-1995 to 0.9% during 2014-2023, while in children, it significantly dropped from 15.8% during 1980-1995 to 0.5% during 2014-2019. In adult studies, the primary clinical manifestations and their comorbidity rates were: fever (99.2%), myalgia (55.6%), headache (52.0%), rash (45.5%), and fatigue (34.4%). In pediatric studies, the primary clinical manifestations and their comorbidity rates were: fever (97.6%), headache (38.8%), anorexia (31.9%), rash (30.5%), and lymphadenopathy (20.5%). Conclusions In recent years, the severe dengue comorbidity rates have significantly decreased in both adults and children, indicating that China's dengue prevention and control strategies have achieved remarkable results. The prominent clinical manifestations in adults are associated with organ damage, while children predominantly show gastrointestinal symptoms. Moving forward, efforts should be made to strengthen early diagnosis and standardized treatment to further reduce the clinical impact of dengue fever.

Acute viral respiratory tract infections, particularly acute viral lower respiratory tract infections, are a prevalent etiology of severe pediatric respiratory illness. In addition to the harm caused by viral replication itself, excessive inflammatory responses and immune homeostasis imbalances in the body can trigger cytokine storms, resulting in severe tissue and organ damage, and leading to multiple organ dysfunction or even mortality. With the continuous promotion and application of various etiological detection techniques in clinical practice, early and accurate diagnosis of the virus can be achieved. Reasonable selection of antiviral drugs, standardized implementation of non-drug intervention measures, and active immunization are helpful to prevent and control infection.

It has long been thought that immune memory is an exclusive hallmark of adaptive immunity, but recent studies have shown that innate immunity also has characteristics similar to immune memory. Innate immune cells, upon being stimulated by pathogens such as lipopolysaccharide (LPS) and β-glucan, can develop a form of immune memory. Upon a secondary encounter with the stimulus, these innate immune cells can produce a stronger immune response, providing nonspecific protection. This immune phenomenon is termed "trained immunity". The mechanism of trained immunity mainly involves the epigenetic reprogramming and metabolic reprogramming of innate immune cells and the interaction between them. This article reviews the main research progress and mechanism of pathogen infection-induced trained immunity.

Mosquitoes and mosquito-borne illnesses remain one of the major public threats which is intensified by the emergence and resurgence of new and existing vector species. Mosquito control is often the only sustainable measure to combat mosquito-borne diseases due to lack or limitation in vaccinations and/or effective medications. Among mosquito control interventions, larviciding to target aquatic habitats is more cost-effective and feasible as opposite to adulticiding which focuses on air-borne adult stages. The available mosquito larvicides are at a historical low owing to numerous reasons. Currently, available larvicides are based on microbial agents, insect growth regulators (IGRs), and a few others of botanical origins. In the IGR arena, juvenile hormone mimics have drawn a lot of attention in research, development, and application. Pyriproxyfen (PPF) was first developed in the early 1970s by Sumitomo Chemical Co. Ltd. (SCC). Its great potential and safety profile to control a wide variety of arthropod pests have been recognized ever since. The current review provides general information and highlights the following advantages of PPF: unique mode of action to mimic the action of natural juvenile hormone (JH) in mosquitoes, broad target spectrum against many mosquito species, the highest bioactivity against mosquitoes as compared with all other known or potential mosquito larvicides, low risk in resistance development and lack of cross-resistance with other larvicides studied, and high activity against species in Stegomyia group. Recently, more potential uses of PPF against adult mosquitoes in bait, barrier treatment, and bed net treatment have been on the horizon. Environmental concerns about PPF residues and their metabolites are also discussed. In general, PPF is one of the critical tools in combating mosquito species of public health importance for now and the foreseeable future.

Antimicrobial resistance (AMR), is regarded as one of the top 10 global public health threats. Addressing AMR through the One Health strategy has become a global consensus. AMR monitoring plays a crucial role as the cornerstone of AMR response strategies. This study thoroughly analyzed current situation and progress of AMR monitoring based on the One Health concept in China, the United Kingdom, the United States, and the European Union, and comprehensively compared the similarities and differences of AMR monitoring systems across these countries and regions. The research found that cross-national, cross-regional, and cross-sectoral cooperation in AMR monitoring is increasingly strengthening. However, notable discrepancies still exist among different countries and regions. Notably, most AMR monitoring systems prioritize human and animal health, with relatively insufficient monitoring in the environmental sector. Given the current landscape, China still needs to continue to promote standardized AMR monitoring data sharing and integration across the human, animal, food, and environmental fields, striving to construct a comprehensive and systematic "whole-chain" AMR monitoring system to better tackle this global public health challenge effectively.

Objective To compare the different effects of body mass index (BMI) and lean body mass index (LBMI) on the risk of all-cause death among elderly Chinese individuals. For the more scientific, accurate and convenient measurement of the elderly physique, analysis and evaluation of the health risk factors of the elderly in China. Methods This study is based on follow-up data from 2014 to 2018, involving 5 990 participants who met the inclusion criteria in the Chinese Longitudinal Healthy Longevity Survey. Participants were grouped according to their BMI and LBMI, and both univariate and multivariate Cox proportional hazard models were established to compare the effects of BMI and LBMI on the risk of death in the elderly. According to gender, age, activities of daily living, and comorbidities, subgroup analysis was conducted to study the influence of LBMI in different subgroups. Results The study population predominantly comprised females (52.9%, 3 167/5 990), with an average age of (84.7 ± 10.1) years, and most participants lived in rural areas (55.1%, 3 298/5 990). A majority were non-smokers (82.7%, 4 952/5 990) and non-drinkers (84.3%, 5 050/5 990). The prevalence of hypertension was 32.8% (1 966/ 5 990), diabetes 5.6% (334/5 990), and heart disease 12.9% (774/5 990). In the analysis of the impact of BMI on all-cause death in the elderly, univariate analysis showed that an increase in BMI was associated with a reduced risk of mortality. After adjusted by multiple factors (age, gender, living environment, marital status, average arterial pressure, number of children, smoking, drinking, hypertension, diabetes, heart disease, cerebrovascular disease, tumor, ADL/IADL, number of complications), compared to the normal group, the emaciated group (BMI<18.5 kg/m²) had the highest risk of death (HR=1.15,95%CI: 1.01-1.30); the overweight group (24.0 kg/m²≤BMI<28.0 kg/m²) had a lower risk of death (HR=0.78, 95%CI: 0.67-0.91). In the analysis of the impact of LBMI on the risk of death in the elderly, compared to moderate LBMI, lower LBMI was associated with a higher risk of death. Multivariate analysis showed that compared with moderate LBMI, a decrease in LBMI increased the risk of death, whereas an increase in LBMI did not show statistically significant differences in mortality risk in the elderly. Conclusion In measuring fitness and quality of life in the elderly, LBMI has better representativeness and practical value.

Objective To provide a scientific basis for improving the prevention and control strategies of dengue fever by analyzing the epidemiological characteristics and influencing factors of reported cases in Hainan Province from 2008 to 2023. Methods Descriptive epidemiological methods were used to analyze the temporal, spatial, and demographic distribution characteristics and influencing factors of reported dengue fever cases in Hainan Province from 2008 to 2023. Spearman correlation analysis was used to explore the correlation between local cases and imported cases. ArcGIS 10.8 and R 4.3.0 were used for graphic production, and SaTScan 10.1.3 software was used for spatiotemporal scanning analysis. Results From 2008 to 2023, a total of 810 cases of dengue fever were reported in Hainan Province, including 164 imported cases and 646 local cases. The 646 local cases reported from June to December, showed a significant seasonal pattern, with September to October being the peak months. The cases were mainly distributed in Haikou City (41.18%) and Ledong County (39.32%). There were two large-scale outbreaks of dengue fever in 2019 and 2023, with 302 and 328 local cases reported respectively (accounting for 97.52% of the total local cases). The male-to-female ratio of local cases was 1.57:1, and cases in the age group of 25 to under 65 accounted for 69.50% of the total. The top three occupations of local cases were housework and unemployment (17.65%), migrant workers (17.34%), and business services (13.78%). From 2008 to 2023, a total of 164 imported cases were reported, with cases reported every month. The peak months were from June to November, accounting for 82.32% of the total imported cases. A total of 66 domestically imported cases were reported, originating from Guangdong Province, Yunnan Province, and Guangxi Zhuang Autonomous Region; 98 cases were overseas imports, mainly from Thailand and Cambodia. The male-to-female ratio of imported cases was 1.65:1, and cases in the age group of 25 to under 55 accounted for 68.29% of the total. The top three occupations of imported cases were business service (33.54%), housework and unemployment (10.37%), and farmers (9.76%). From 2008 to 2013, the years when domestic imported cases were reported in Hainan Province were 2014, 2018, 2019, and 2023, coinciding with the years local cases were reported from 2008 to 2013. There was a positive correlation between local cases and domestic imported cases (r=0.892, P<0.001), while no statistically significant correlation was found with overseas imported cases. Spatiotemporal scanning analysis detected 5 clusters, concentrated in September to October in the years 2019 and 2023. Conclusions Dengue fever is prevalent in Hainan Province, mainly caused by imported cases leading to local outbreaks without forming local epidemics. It exhibits significant seasonal characteristics. Imported cases mainly originate from Cambodia, Thailand, and other Southeast Asian countries, as well as domestically from Guangdong Province, Yunnan Province, and Guangxi Zhuang Autonomous Region. Local cases are mainly distributed in coastal cities and counties.

Objective To analyze the incidence trend and epidemiological characteristics of dengue fever in Fujian Province from 2009 to 2023, identify the high-incidence population and hotspot areas, and a scientific basis for formulating targeted prevention and control measures. Methods The surveillance data of dengue fever during 2009-2023 in Fujian Province were obtained from the National Disease Reporting Information System and analyzed using descriptive epidemiological methods, and the spatial autocorrelation analysis of dengue fever incidence at county/district levels was performed with ArcGlS 10.8. Results A total of 3 586 cases of dengue fever were reported in Fujian Province from 2009 to 2023, with an average annual incidence rate of 0.61/100 000, showing an overall increasing trend year by year (Z=18.35, P<0.001). Among them, there were 2 362 local cases and 1 224 imported cases, with a local/imported ratio of 1.93:1 (2 362/1 224). The local cases were mainly distributed in Fuzhou, Putian, and Nanping, accounting for 87.81% (2 074/2 362). The imported cases were mainly distributed in Quanzhou, Fuzhou, and Xiamen, accounting for 72.55% (888/1 224). The local/imported ratio in Fuzhou, Nanping, and Putian was 6.20:1 (1 557/251), 3.92:1 (145/37), and 3.32:1 (372/112), respectively, all significantly higher than the provincial average level. The spatial distribution of the local cases showed a clustered pattern, with 12 hotspots of incidence, all located in the counties and districts under the jurisdiction of Fuzhou. The onset of the disease had obvious seasonality: imported cases from other countries or regions mainly occurred from July to September (accounting for 45.73%, 519/1 135), imported cases from other provinces mainly occurred from August to November (accounting for 93.25%, 83/89), and local cases mainly occurred from August to October (accounting for 97.50%, 2 303/2 362). The gender ratio for local cases was 0.88:1, and for imported cases, it was 3.04:1. The average age of onset for local cases was 48 years old (Q₁=32 years old, Q₃=62 years old), while the average age for imported cases was 35 years old (Q₁=28 years old, Q₃=44 years old). Conclusions From 2009 to 2023, the dengue fever epidemic in Fujian Province showed a continuous upward trend, with spatiotemporal clustering of incidence. Therefore, prevention and control measures should be strengthened in key areas and populations during the high-incidence season.

Objective Aedes albopictus is the main indigenous vector of dengue fever in China. Understanding the spatial genetic structure of Aedes albopictus populations, migration, and gene flow is crucial for the effective prevention and control of vector-borne diseases. Methods From June to September 2023, mosquitoes were collected and morphologically identified from eight different geographic locations across tropical, subtropical, and temperate zones of China. Genomic DNA was extracted from individual female mosquitoes, and the mitochondrial cytochrome C oxidase I gene was amplified and sequenced. Population genetic diversity and associated population characteristics were assessed using software such as BioEdit, DnaSP version 6, Arlequin 3.5, and Mega 11. Results A total of 233 samples from eight Aedes albopictus populations across the three climatic zones were successfully sequenced, yielding a gene fragment sequence of 632 bp with 19 variable sites and no insertion or deletion mutations. A total of 21 haplotypes were detected, with H4 being the dominant shared haplotype among the three climate types. Haplotype diversity (Hd) ranged from 0.191 (Beijing population) to 0.887 (Xishuangbanna population), and nucleotide diversity (Pi) ranged from 0.000 51 (Beijing population) to 0.002 98 (Xishuangbanna population), suggesting high haplotype diversity and low nucleotide diversity in Aedes albopictus. The genetic differentiation indices ranged from 0.026 to 0.641, with higher genetic differentiation between temperate and tropical/subtropical regions. The analysis of molecular variation supported that genetic differentiation mainly came from within populations (60.45%). Conclusions The ecological and climatic environment in the tropics results in higher genetic diversity of Aedes albopictus. Human activities have exacerbated the risk of dengue transmission across different climatic zones.

Objective This study aims to explore the roles of interferon-stimulated gene cholesterol-25-hydroxylase (CH25H) on the replication of Japanese encephalitis virus (JEV) and its underlying mechanisms, providing potential targets for developing anti-JEV drugs and theoretical support for the research. Methods First, we investigated whether CH25H could be induced by type Ⅰinterferons or JEV infection in human kidney HEK293T cells through real-time fluorescence quantitative PCR. The cells were stimulated with different concentrations of interferon α (IFN-α), and 12 hours later, CH25H expression was measured via real-time fluorescence quantitative PCR. HEK293T cells were infected with JEV at different multiplicities of infection (MOI), and 24 hours later, changes in CH25H mRNA expression levels were assessed. Eukaryotic expression plasmid pcDNA3.1-CH25H-3×HA was constructed for overexpression of CH25H in HEK293T cells, and its effect on JEV replication was analyzed using real-time fluorescence quantitative PCR and plaque formation assay. The reasonable use concentration of 25-hydroxycholesterol (25HC), the enzyme active product of CH25H, in HEK293T, BHK21, and Vero cells was obtained by CCK8 assay, and the roles of 25-hydroxycholesterol (25HC), the enzyme active product of CH25H, in JEV replication and its impact on JEV life cycle, were further studied by qPCR, viral plaque assay, immunofluorescence assay and adsorption assay. Point mutation was employed to construct an enzymatically inactive mutant, CH25HM, which was transfected into HEK293T cells. After 24 hours of JEV infection, the dependence of CH25H-mediated impact on JEV replication on its enzymatic activity was revealed through qPCR and plaque formation assay. Results CH25H could be induced by IFN-α in HEK293T cells, but after JEV infection, CH25H mRNA expression was downregulated. Overexpression of CH25H in HEK293T cells significantly inhibited JEV replication. 25HC, the enzyme product of CH25H, can inhibit JEV replication in HEK293T, BHK21, and Vero cells. In terms of mechanism, 25HC can inhibit JEV replication by affecting the virus adsorption process. Expressing the enzymatically inactive mutant CH25HM in HEK293T cells, also significantly inhibited JEV replication. Conclusions JEV infection down-regulates the expression of interferon-stimulated gene CH25H, while CH25H inhibits JEV replication in a manner dependent on enzyme activity and non-enzyme activity.

Objective To fully understand and analyze the epidemic patterns of dengue fever in Mengla County, Xishuangbanna, and provide a basis for the prevention and control of local outbreaks of dengue fever in Xishuangbanna and other border areas of Yunnan Province. Methods Descriptive epidemiological methods were employed to systematically analyze the temporal, geographical, and demographic distribution characteristics of dengue fever in Mengla County, Xishuangbanna Prefecture, from 2013 to 2023. Results From 2013 to 2023, a total of 3 220 cases of dengue fever were reported, including 2 850 local cases (88.51%) and 370 imported cases (197 cases imported from overseas, 173 cases imported domestically), accounting for 11.49%. Local cases and imported cases were concentrated between July and October, showing seasonal and local characteristics, with a high incidence from August to October, mainly distributed in Mengla Town and Mohan Town. The male-to-female ratio of local cases from 2013 to 2023 was 1.17∶1, and the 20-50 age group accounted for 66.91% of cases. There was a statistically significant difference in the incidence of dengue fever across different age groups for local cases from 2013 to 2023 (χ²=372.711, P<0.05). The top three occupations with the highest number of local cases were farmers 43.79% (1 248/2 850), students 11.19% (319/2 850), and business service workers 7.54% (215/2 850), with the number of imported cases were farmers 126 cases (34.05%), business service workers 61 cases (16.49%), and students 27 cases (7.30%). The number of imported cases peaked in 2023 with 163 cases (44.05% of the total number of imported cases). The Breteau index (BI) from 2013 to 2023 showed an increase in vector density starting in May, with BI between 5-15; a peak in vector density from July to September, with BI between 10-40, and most BI between 20-40; and a gradual decline in October and November, with BI between 5-20. Conclusions The dengue fever outbreak in Mengla County of Xishuangbanna is caused by imported cases, leading to local outbreaks, and exhibiting significant local and seasonal characteristics. The imported cases mainly originated from Southeast Asian countries. Mengla County should remain vigilant, strengthen the monitoring of cross-border transmission, thoroughly implement case surveillance and mosquito prevention and control measures, and adopt timely and effective prevention and control measures at the early stage of the outbreak to prevent large-scale outbreaks and epidemics.

Objective To analyze the epidemiological characteristics of human brucellosis in Hebei Province, and to explore strategies and measures for its prevention and control. Methods Data on brucellosis cases reported in Hebei Province were collected from the National Notifiable Infectious Disease Reporting Information System. The total situation of brucellosis was described, and the epidemiological characteristics of brucellosis in Hebei Province were analyzed. The spatial autocorrelation analysis method was used to explore the spatial distribution characteristics of brucellosis incidence at the county level in Hebei Province. Results From 2018 to 2023, a total of 21 718 cases of brucellosis were reported in Hebei Province, with 1 death (in 2021). The annual incidence rate fluctuated between 3.91/100 000 to 6.26/100 000, with an average annual reported incidence rate of 4.84/100 000. The epidemic peak was from April to July, showing obvious seasonal characteristics. The incidence in males was higher than in females, with a male-to-female ratio of 2.81∶1. The incidence age was concentrated 30-<70 years, accounting for 85.33% of the total cases. The primary occupational group affected was farmers, accounting for 88.59%. The top three cities with the highest average annual incidence rate were Zhangjiakou, Chengde, and Hengshui, which reported a total of 7 801 cases, representing 35.92% of the total cases in the province. From the perspective of spatial distribution: the global spatial autocorrelation analysis showed clustering distribution in Hebei Province from 2018 to 2023, and there were hot spots in local spatial autocorrelation analysis. The high-incidence areas of brucellosis were mainly concentrated in Zhangjiakou (13.651 3/100 000) and Chengde (13.116 7/100 000) in the north of Hebei Province during the past six years. The "low-low" clustering areas were mainly distributed in Tangshan, Shijiazhuang, and Handan. The "low-high" clustering areas were mainly located around the "high-high" cluster areas, in some counties of Zhangjiakou and Chengde. Conclusions The situation of human brucellosis prevention and control in Hebei Province remains challenging. It is recommended to strengthen the management of infection sources, enhance the surveillance of human brucellosis, focus on health education and behavior intervention in high-risk groups, and intensify prevention and control efforts in the hotspot areas.

Globally, dengue fever is experiencing a gradual expansion in epidemiological scope, with high infection rates and significant adverse impacts on human health. Dengue fever in China remains predominantly an imported disease and/or a local transmission disease from imported cases, and there is no evidence yet that it has become endemic. Changes in vector distribution, climate changes, and population mobility were reported to correlate with dengue fever epidemic. The most key measure for preventing and controlling dengue fever is to cut off transmission route through comprehensive environmental management, control of mosquito vectors, and elimination of mosquito breeding sites. Dengue fever is an environmental and community disease, and the concept of "One Health" should be adopted, requiring government leadership, multi-sectoral cooperation, and mobilization of the whole society, with everyone participating in the elimination of breeding sites. Prevention and control of dengue fever are feasible, but remain "an uphill battle".

Objective To comprehend the gastroenteritis outbreak triggered by sapovirus (SaV) in a middle school located in Chaozhou City in 2022, ultimately providing a scholarly reference for the implementation of preventive and control measures against contagious diarrhea within educational institutions. Methods Descriptive epidemiological methods were employed to analyze the epidemiological characteristics of the outbreak. A 1∶3 case-control study was conducted to identify potential correlation factors. Anal swab specimens from students and kitchen workers, food samples from the cafeteria, and environmental swab samples were collected for nucleic acid PCR testing of Sapovirus, Norovirus, Staphylococcus aureus, five types of enterotoxigenic Escherichia coli, Salmonella, and Bacillus cereus. One SaV-positive nucleic acid sample was randomly selected for VP1 capsid protein sequencing. Results A total of 148 sapovirus cases and 6 asymptomatic infections were reported in this outbreak. The predominant clinical manifestations were vomiting (83.1%), nausea (38.5%), and vertigo (24.3%), with no fever symptoms reported. The peak incidence was recorded on March 20, showing a propagative and point source exposure pattern. Cases were distributed across 83.3% of the classes in the school, with the highest incidence rate of 32.69% in Class 311. The case-control study revealed that having lunch on campus on March 18 was a significant correlation factor for the disease (OR=4.17, 95%CI: 1.58-11.00). A total of 43 students and 23 kitchen workers anal swab specimens, 7 food samples, and 9 cafeteria environmental swab samples were collected. Of these, 20 students and 6 kitchen workers anal swab specimens tested positive for SaV nucleic acid, while the remaining samples returned negative results. Gene sequencing indicated the presence of the GI.6 genotype. Hygiene investigation exposed improper food handling practices among some kitchen workers. Conclusions This outbreak was caused by a GI.6 genotype SaV infection, with exposure in the cafeteria on March 18 being the primary contributing factor for the outbreak and subsequent spread.

Objective To evaluate the control efficacy of mosquito densovirus and Bacillus thuringiensis subsp. israelensis (MDV·Bti) oil suspension against the larvae of Culex pipiens pallens and Aedes albopictus under laboratory conditions, providing references for the selection of mosquito larvicidal agents. Methods Thirty larvae of mosquito were placed in enamel pots containing different types of larvicide using the larval dipping method in the laboratory, and the mortality time, pupation, and emergence of the larvae were observed and recorded. The median lethal time (LT₅₀) and 95% confidence interval (CI), along with the toxicity regression equations, were calculated using SPSS 18.0 software for statistical analysis. Results The LT₅₀ of MDV·Bti oil suspension, temephos, and Bacillus sphaericus (Bs) for the early-instar larvae of Culex pipiens pallens were 85.7, 73.2, and 109.8 minutes, respectively, and for the late-instar larvae of Culex pipiens pallens were 82.8, 71.6, and 128.2 minutes, respectively. The times required for a 100% mortality rate of early-stage larvae of Culex pipiens pallens by MDV·Bti oil suspension, temephos, and Bs were 260, 160, and 200 minutes, respectively, and for the late-instar larvae were 240, 140, and 300 minutes, respectively. The 24-h mortality rate of both early-instar and late-instar larvae of Culex pipiens pallens by Bti was 0%. The times required for 100% mortality of late-instar larvae of Aedes albopictus by new larvicide 1, 2, and 3 were 280, 260, and 180 minutes, respectively, with LT₅₀ values of 95.8, 68.8, and 54.3 minutes, respectively. The 24-hour mortality rate for Aedes albopictus larvae by temephos and Bti was 100%, with LT₅₀ values of 222.0 and 272.5 minutes, respectively. Conclusions MDV·Bti oil suspension demonstrates a good control effect against the larvae of Culex pipiens pallens and Aedes albopictus under laboratory conditions. Compared with the commonly used larvicides, MDV·Bti oil suspension presents advantages in controlling efficacy, suitable for mosquito larvae control.

Objective To understand the population composition and quantitative changes of plague hosts and vectors in Menglian County, Yunnan Province, to monitor and investigate the epidemic dynamics of plague, and to evaluate the epidemic risk of plague, providing a scientific basis for plague prevention and control in Yunnan's border areas. Methods Animal plague surveillance was carried out according to the "Yunnan Provincial Plague Surveillance Program", and the data of plague surveillance in Menglian County from 2016 to 2020 were collected and analyzed. In 2020, a plague survey was conducted in two border towns in Menglian County. The samples of host animals and their surface parasitic fleas in residential, agricultural, and forest areas were collected, and serum samples of border residents and plague indicator animals were collected. Yersinia pestis was isolated and cultured from host animal organs and flea samples, and indirect hemagglutination assay (IHA) was used to detect F1 antibody in serum samples. Results A total of 793 host animals, encompassing 11 species across 7 genera and 4 families in 3 orders, were captured in animal plague surveillance in Menglian County, from 2016 to 2020. Rattus tanezumi was identified as the dominant indoor and outdoor species, with composition ratios of 93.58% and 83.91%, respectively. Suncus murinus, Rattus nitidus, Tupaia belangeri, and Rattus andamanensis were common species. The average rodent density indoors and outdoors was 1.33% and 1.65%, respectively. In 2020, the special survey in Menglian County's border areas captured 313 host animals, including 15 species across 9 genera and 4 families in 3 orders. The dominant species were Rattus tanezumi, Rattus andamanensis, and Suncus murinus, with composition ratios of 47.60%, 20.13%, and 10.86%, respectively. The capture rates of indoor and outdoor host animals were 3.25% and 18.81%, respectively. There were statistically significant differences in the capture rates of indoor and outdoor host animals and the density of indoor and outdoor Rattus tanezumi between routine monitoring and special investigation (χ²=30.682，1641.931，32.690，320.415，P<0.001). From 2016 to 2020, the flea infection rate of Xenopsylla cheopis on Rattus tanezumi was 30.97%, with a flea index of 0.79. In the 2020 special survey in Menglian County's border areas, a total of 99 fleas were captured across 7 species, 7 genera, and 4 families, with Xenopsylla cheopis and Palaeopsylla remota as the dominant ectoparasitic flea species, having composition ratios of 69.70% and 20.20%, and an infection rate of 9.90%. The infection rate of Xenopsylla cheopis on the surface of Rattus tanezumi was 12.08% (18/149 ), with a flea index of 0.46. There was a significant difference in the infection rate of Xenopsylla cheopis on the surface of Rattus tanezumi between routine monitoring and special investigation (χ²=22.773, P<0.001). Laboratory test results from both routine monitoring and special investigation were negative. Conclusions The primary species of the main hosts and vectors of plague in Menglian County are prominent, and the density of rodents in the outdoor environment is relatively high. The monitoring and investigation did not find the infection of residents and animals in recent years. However, given the localized low-grade plague endemics in the surrounding areas, it is necessary to continuously strengthen the professional and technical training at the grass-roots level and enhance the monitoring and investigation of plague and other rodent-borne diseases in the border areas to effectively improve the quality and sensitivity of monitoring, timely carry out preventive prevention and control measures, effectively detect the epidemic, and reduce the risk of epidemic.

Objective To understand the epidemiological and pathogenic characteristics of hand, foot, and mouth disease (HFMD) cluster outbreaks in Tianjin from 2020 to 2023, and to provide a scientific basis for effectively controlling HFMD cluster outbreaks. Methods Epidemic information of Tianjin was collected through the "China Disease Prevention and Control Information System" from 2020 to 2023. Descriptive analysis was used to analyze the time, regional occurrence, and serum typing of HFMD cluster outbreaks. The chi-square test was used to compare the incidence rates in epidemic sites, public and private childcare institutions. The Spearman correlation analysis was performed to explore the correlation between the time interval from onset to reporting and the outbreak scale and duration of the epidemic. Result From 2020 to 2023, 1 111 HFMD clustered outbreaks were reported in Tianjin, with the highest proportion (49.24%) in 2023 and the highest proportion (47.16%) in childcare institutions. A total of 3 175 cases were involved in cluster outbreaks, with an incidence rate of 11.49%. The peak incidence was from September to October, with the incidence rates of cluster outbreaks in childcare institutions, primary schools, and secondary schools being 5.49%, 3.70%, and 2.68%, respectively. There were statistically significant differences in the incidence of cluster outbreaks among various institutions (χ⊃2;=43.498, P<0.001). The duration of the epidemic ranged from 1 to 18 days, with a median of 3 days. The reporting time of the epidemic was positively correlated with the duration of the epidemic (r=0.609, P<0.05) and the number of cases (r=0.515, P<0.05). Coxsackievirus A6 (CV-A6) caused the majority of cluster outbreaks (615 cases, 76.59%), followed by Coxsackievirus A16 (CV-A16) (131 cases, 16.31%). Conclusions HFMD outbreaks in Tianjin predominantly occurred in childcare institutions, with a high incidence of cluster outbreaks during the autumn school opening period. During this period, key places should strengthen morning and afternoon examinations, registration of absences due to illness, and early screening of cluster outbreaks to reduce the scale and duration of the epidemic.

To report a case of clonorchiasis (Clonorchis sinensis infection) combined with intrahepatic cholangiocarcinoma and review relevant literature to improve the awareness of the clinical physicians regarding Clonorchis Sinensis and provide references for clinical diagnosis and treatment. A retrospective analysis was conducted on a case of clonorchiasis combined with intrahepatic cholangiocarcinoma, admitted to Guangzhou Red Cross Hospital of Jinan University on March 15, 2021, along with a review of related literature. The patient, a 55-year-old male, presented with abdominal distension and poor appetite for over two months and had a history of diabetes and hypertension for many years. He had been consuming raw fish for more than ten years. Upon admission, physical examination revealed a solid mass measuring 8 cm×8 cm was palpable below the xiphoid process in the upper abdomen, with an uneven surface, slightly hard texture, poor mobility, and positive tenderness. Laboratory tests revealed the presence of Clonorchis Sinensis eggs in the stool, and the patient tested positive for Clonorchis Sinensis IgG antibodies. After a comprehensive evaluation that included abdominal ultrasound, abdominal plain CT scan, and contrast-enhanced CT, the patient was diagnosed with "intrahepatic cholangiocarcinoma with multiple intrahepatic metastases." Due to the patient's poor liver function, praziquantel was not administered, and albendazole was instead used at a dose of 10 mg/(kg·d) once daily for seven days. Upon re-admission one month after discharge, no Clonorchis Sinensis eggs were found in the stool. A follow-up after 12 months revealed that the patient had passed away due to liver failure. The serious infection of Clonorchis Sinensis is relatively rare, but it can lead to severe consequences in high-risk individuals, especially when it progresses to intrahepatic cholangiocarcinoma. Clinicians should enhance their awareness of clonorchiasis and promptly identify and provide symptomatic treatment for infections, as early as possible and provide appropriate treatment. Early diagnosis and treatment are crucial for improving the prognosis of patients.

Objective This study aims to investigate the drug resistance, resistance mechanisms, and serotype epidemiological features of clinically isolated Streptococcus pneumoniae (SP) in Shanxi Province. Methods SP strains were isolated between January 2021 and July 2023 from Shanxi Provincial People's Hospital. An automatic microbiological identification and drug sensitivity analysis system was used to identify strains and conduct antibiotic susceptibility assay. The species identification was also carried out using a MALDI-TOF mass spectrometer, optochin assay, and amplification of the CPSA gene. Finally, the polymerase chain reaction (PCR) technique was implemented for drug-resistant and virulence gene detection and serotyping. Results A total of 117 strains were isolated including 115 strains (98.3%) being erythromycin-resistant Streptococcus pneumoniae (ERSP). The ERSP was composed of 114 macrolide-lincosamide-streptogramin B (MLSB) resistant strains, carrying the ermB (114/114) and mefA (42/114) gene, and one M-resistant strain absent of ermB and tetM. The most common pneumococcal six serotypes in ERSP strains were 19F, 3, 34, 19A, 6A/6B, and 23F, respectively, totaling 71 strains (61.7%). Compared with pediatric and adult, serotype 19F in geriatric patients was the dominant type with a significant difference (χ²=6.315, P=0.043). Compared with adult patients, the strains isolated from pediatric and elderly patients showed a higher rate of insensitivity (resistance and intermediate) to oral penicillin (χ²=7.277, P=0.026). Serotype 19F strains showed high insensitivity to oral penicillin (81.0%), compound sulfamethoxazole (100.0%), tetracycline (94.7%), and ceftriaxone (9.5%). The serotypes 19A and 23F strains also showed high insensitivity to penicillin (>70%), tetracycline (100%) and compound sulfamethoxazole (>85%). However, serotype 3 strains had low insensitivity to oral penicillin (8.3%), ceftriaxone (0%), and compound sulfamethoxazole (27.3%). There were 42 strains positive for ermB+mefA, of which serogroup 19 was the main type, accounting for 64.3% (27/42). Of these strains, 88.1% (37/42) carried ply, lytA, and HylA genes simultaneously. Conclusion Drug resistance to ERSP still to be a serious problem for human health. There are differences in serotype distribution in terms of age, resistance genes, and drug resistance. Therefore, the vaccination of pneumococcal conjugate vaccine 13 (PCV13) is an essential and effective measure to prevent SP infection in this region.

Objective To analyze epidemiological characteristics of influenza in Nanning from 2013 to 2022, to provide a reference for the prevention and control of influenza. Methods The data of influenza incidence and etiology surveillance results of the influenza virus in Nanning from 2013 to 2022 were collected to build a database. Data statistical analysis was performed through SPSS 21.0 and Joinpoint software to explore the epidemic trend and epidemic characteristics of the influenza virus in Nanning, and the seasonal index method was used to analyze the epidemic seasons. Results The reported incidence of influenza in Nanning showed an overall upward trend from 2013 to 2022, with an annual percent change (APC) of 47.63% (P<0.05), and an average annual incidence rate of 84.47/10⁵ (ranging from 6.65/10⁵ to 302.55/10⁵). The peak months for influenza in Nanning were January, June, and December, with the seasonal indices of influenza all exceeding 100%, and the proportions of reported cases was 12.69%, 29.41%, and 25.97%, respectively. Both male and female incidence rates showed an upward trend without significant difference (P=0.66). The male-to-female case ratio was 1.24∶1, with the highest case distribution in the 5-<10 years age group, accounting for 31.17%, mainly among students, scattered children, and preschoolers. Xixiangtang District reported the largest influenza cases (21.12%), and Xingning District had the highest annual incidence (214.72/10⁵). Influenza outbreaks mainly occurred in schools and kindergartens, accounting for 97.84%; primary schools accounted for 63.07% of the total. From 2013 to 2022, the dominant strains of influenza viruses alternated in Nanning, with a higher proportion of influenza A (H1N1) and (H3N2) viruses from Jan. 2013 to Mar. 2019. The dominant strains from April 2019 to Dec. 2022 were influenza A (H3N2) and B (Victoria) lineage. Conclusions The intensity of the influenza epidemic in Nanning City showed an increasing trend from 2013 to 2022, with obvious seasonality. The dominant subtypes of influenza viruses varied each year. The main affected groups were students and children, and the outbreaks mainly occurred in schools. Therefore, it is necessary to strengthen the prevention and control of influenza in schools, and the timely detection and handling of outbreaks.

Objective To analyze the changes in the pathogen spectrum of severe lower respiratory tract viral infections in children before and during the outbreak of the COVID-19 pandemic, and to explore the epidemiological characteristics to provide a basis for preventing respiratory viral infections. Methods We conducted a retrospective analysis of clinical data from patients with severe viral pneumonia admitted to the pediatric intensive care unit (PICU) of Shenzhen Children's Hospital from January 2017 to December 2021. Taking the outbreak of the COVID-19 pandemic as the cut-off point, it is separated into the period before the outbreak of the COVID-19 pandemic and the period during the pandemic. Virus spectrum and clinical data between the two groups were analyzed using the chi-square test or Fisher's exact probability method. Results A total of 712 cases of severe viral pneumonia were reported, including 469 males and 243 females, with a median age of 1.25 (0.50, 3.83) years. Among them, 495 cases were under 3 years old, and 626 cases were under 6 years old. The median duration of illness before admission to the PICU was 3.00 (2.00, 5.00) days. Hospital-acquired infections were seen in 6.88% of the children. Firty-four children had been hospitalized ≥2 times due to repeated infections. The detected viruses were influenza viruses (IVA and IVB) in 223 cases (160 IVA and 70 IVB), respiratory syncytial virus (RSV) in 215 cases, human rhinovirus (HRV) in 125 cases, adenovirus (ADV) in 91 cases, human parainfluenza viruses (HPIV) in 53 cases, human bocavirus (HBoV) in 34 cases, cytomegalovirus (CMV) in 26 cases, human metapneumovirus (HMPV) in 17 cases, and human coronavirus (HCoV) in 7 cases. A total of 634 cases were infected with a single virus, while 78 cases were infected with multiple viruses. The top three viruses, sorted by age, were as follows: <1 year: RSV, IVA/B, and HRV; 1-<3 years: IVA/B, RSV, and ADV; 3-<6 years and 6-<10 years: IVA/B, HRV, and ADV; 10-<14 years: HRV, IVA/B, and CMV; sorted by time distribution: March-May and June-August: RSV, IVA/B, and ADV; September-November: RSV, HRV, and IVA/B; December-February: IVA/B, RSV, and HRV. Before the COVID-19 epidemic, the top three viruses were IVA/B, RSV, and ADV, while during the COVID-19 epidemic were HRV, RSV, and HPIV. Conclusions During the COVID-19 pandemic, the viral spectrum of severe lower respiratory tract viral infections in the PICU changed. Before the pandemic, IVA/B, RSV, and ADV were prevalent, while during the pandemic, HRV, RSV, and HPIV were more prevalent. The viral spectrum varies among children of different age groups and in different months.

Objective To investigate the function and molecular mechanism of LRH-1 in regulating the sensitivity of hepatocellular carcinoma (HCC) cells to oxaliplatin, providing new ideas for the treatment of liver cancer. Methods Knockdown and overexpression of LRH-1 in HCC cell lines were constructed, and the effect of LRH-1 on oxaliplatin resistance of HCC cells was explored by detecting IC₅₀, cell proliferation, and plate colony formation assay. The transcriptional regulation of the MDR-1 gene by LRH-1 was detected through quantitative PCR. The transcriptional activation ability of LRH-1 on the MDR1 gene was evaluated by luciferase reporter assay. Results In HuH7 cells overexpressing LRH-1, the IC₅₀ significantly increased to 18.012 μmol/L under oxaliplatin treatment, significantly higher than the 2.042 μmol/L in the HuH-7 control group, showing statistically significant differences (P<0.05). After overexpression of LRH-1 in HuH-7 cells, the cell proliferation ability was significantly increased, with a noticeable increase in MDR1 mRNA level. In HepG2 cells with knockdown LRH-1 expression, the IC₅₀ significantly dropped to 1.012 μmol/L, significantly lower than the 6.294 μmol/L in the HepG2 control group, with statistically significant differences (P<0.05). After knockdown of LRH-1 in HepG2 cells, the cell proliferation and plate colony formation ability were significantly inhibited, with a notable decrease in MDR1 mRNA expression level. Luciferase reporter assay confirmed that LRH-1 can activate the transcriptional activity of the MDR1 promoter in a dose-dependent manner, and its specific inhibitor ML-180 can significantly reduce LRH-1's transcription activation ability on the MDR1 promoter. Conclusions LRH-1 may promote oxaliplatin resistance in hepatocellular carcinoma cells by regulating the transcriptional activity of MDR1 gene. Since its specific small molecule inhibitor has been successfully synthesized, LRH-1 can potentially become a target for the treatment of drug resistance in hepatocellular carcinoma.

Objective The aim of this study was to observe the expression levels and clinical significance of peripheral blood interferon γ-inducible protein-10 (IP-10) and various cytokines in patients with different infection statuses of tuberculosis and to assess the efficacy of latent tuberculosis infection (LTBI) in the progression to active tuberculosis (ATB). Methods Seventy-six outpatient and inpatient cases from the Third People's Hospital of Kunming were collected and analyzed from March 2023 to February 2024. The patients were divided into three groups: ATB group (31 cases, 17 males, median age 33 years), LTBI group (27 cases, 17 males, median age 29 years), and healthy control (HC) group (18 cases, 11 males, median age 25 years). Peripheral blood samples from the three groups were taken and the expression levels of IP-10 and cytokines IL-6, IL-4, IL-8, IL-10, IL-12, IL-2, and TNF-α were detected using enzyme-linked immunosorbent assay (ELISA) methods. The t-test was used for normally distributed samples, while the Mann-Whitney U test was used for skewed distributions. For comparisons between multiple groups, the Kruskal-Wallis H test was first employed, followed by Dunn's multiple comparison test for pairwise comparisons. Finally, the effectiveness of each cytokine in distinguishing different population groups was analyzed. Results The expression levels of peripheral blood IP-10 were higher in the LTBI and ATB groups than in the HC group, but the area under the curve (AUC) of the receiver operating characteristic (ROC) of the subjects showed moderate sensitivity (AUC:0.7-0.9) and low specificity (AUC:0.5-0.7). The IL-6 expression levels were in the order of high to low in the ATB group, LTBI group, and HC group, where the HC group was significantly lower than the ATB and LTBI groups (F=12.15, P<0.001). The sensitivity and specificity of the ATB group were higher than those in the HC group. Conclusions IP-10 exhibits unique advantages in distinguishing different tuberculosis statuses. The predictive efficacy of a single cytokine is limited. Combining multiple cytokines such as IL-6 with clinical manifestations, a more accurate and comprehensive prediction model can be established.

Objective To investigate the cause of poisoning leading to multi-organ damage in a patient with an unexplained condition, to confirm the type and exposure amount of the pathogenic factor, to identify the sources of pathogenic factors, and to provide references and bases for the clinical treatment and the prevention of such events. Methods Starting with the unknown traditional Chinese medicine taken by patients for a long time, the targeted screening strategy was initially used to screen for alkaloid poisoning. Subsequently, a non-targeted screening strategy using Information-dependent Acquisition Mode (IDA) was used to screen the patient's blood, urine, and drug samples. Combining the toxicological effects of suspected compounds with the patient′s clinical manifestations, the main pathogenic factors were determined. Quantitative methods were established according to standard substances to quantify the pathogenic factors in all the samples. An epidemiological investigation was conducted to obtain the patient's medication history, and combined with the examination of the medication's specifications and content, the exposure dose of each pathogenic factor was determined. Finally, a Data data-independent acquisition (DIA) mode termed Sequential Window Acquisition of All Theoretical Fragment-Ion Spectra (SWATH) was used to screen all samples, unbiasedly collecting secondary mass spectrometry information of compounds, thereby verifying and supplementing the confirmed pathogenic factors. Results Targeted screening ruled out common alkaloid poisoning. Tadalafil was detected in the patient's blood and urine. Tadalafil, sildenafil, chloropretadalafil, acetaminophen, and diclofenac were detected in unknown traditional Chinese medicine. The side effects of these compounds were consistent with the clinical manifestations of the patient. The highest daily average exposure doses of tadalafil, sildenafil, chloropretadalafil, acetaminophen, and diclofenac were 30.5 mg, 15.8 mg, 0.05 mg, 45.6 mg, and 3.2 mg respectively, which were seriously excessive. The SWATH mode also screened out the above five drugs. In addition, palmatine chloride was also detected. Conclusions Combining the patient's clinical manifestations and epidemiological data, this study integrated targeted screening, untargeted screening, targeted quantitative strategies, data-dependent, and DIA mode to confirm that this case is a drug poisoning event caused by long-term overdose consumption of traditional Chinese medicine adulterated with chemical components. This study provides insights for the diagnosis and investigation of patients with poisoning for unknown causes, offering references for emergency detection and management of related poisoning incidents.

Objective To analyze the genetic evolution and molecular characteristics of the H5N6 avian influenza virus A/Changsha/1/2022(H5N6) in a human infection case in Changsha City, providing insights for the prevention and control of H5N6 avian influenza transmission to humans. Methods The sample underwent whole-genome sequencing on a third-generation sequencing platform. Reference sequences were downloaded from the NCBI and GISAID databases for comparison. The phylogenetic tree was constructed and key amino acid mutation sites were analyzed using MEGA7 software. Results The sequence analysis results revealed that the strain studied belongs to the H5 subtype Clade 2.3.4.4b branch. The PB1 gene shared 99.69% homology with the H5N6 virus A/duck/Hunan/S40199/2021(H5N6) from Hunan Province; PB2 had 98.58% homology with A/Whooper swan/Sanmenxia/Y36/2020(H5N8); and other sequences showed high homology with the strain A/Guangdong/1/2021(H5N6) discovered in Guangzhou in 2021. These results indicate that an infection with a recombinant H5N6 subtype avian influenza virus caused the case. The amino acid composition of the cleavage site was RERRRKR↓GLF, consistent with high-pathogenicity avian influenza characteristics. The HA sequence showed no mutations at the Q226L and G228S sites, indicating the preservation of characteristics binding to avian receptors. However, mutations at the S127P, S137A, T160A, T192R, and A267T sites increased the virus's affinity for humans. A deletion found in positions 59-70 of the NA protein stalk implies enhanced viral virulence in mammals. Mutations were noted in the internal genes; S622G in PB1, K389R and V598T in PB2, N409S in PA, N30D and T215A in M1, and P42S in NS1, which may enhance the virulence of avian influenza virus in infecting mice. Conclusions The H5N6 virus strain detected in a human case in Changsha City in this study is highly pathogenic, prone to bind to avian receptors, but numerous mutations at key amino acid sites facilitate infection in humans. Continuous monitoring and research on H5N6 avian influenza virus should be strengthened

Dengue fever prevention and control is an urgent need for addressing major infectious diseases in China, and the control strategies need theoretical innovation and technological breakthroughs. Aedes albopictus, the dengue-borne mosquito, exhibits polymorphism in urban environments, resulting in heterogeneous mosquito habitats. This heterogeneity is evident in two aspects: firstly, varying mosquito densities across different habitats, and secondly, differences in vector competence of Aedes albopictus within the same city. The distribution of Aedes albopictus with high vector competence forms discrete "mosquito islands" within the city, analogous to small islands in the sea. Identifying the distribution and scope of these "mosquito islands", combined with vector Aedes daily activity rhythm and innovative ultra-low volume spray technology, can facilitate targeted mosquito control strategies during dengue outbreaks. This approach reduces insecticide spraying, improves mosquito control efficiency, and enables rapid dengue epidemic control.

Objective To elucidate the distribution characteristics of mosquito species and the population genetic diversity of important mosquito species in the Wuyi Mountain Nature Reserve, with the aim of providing a scientific basis for the prevention and control of mosquito-borne diseases in the region. Methods Within Wuyi Mountain Nature Reserve 2022-2023, 16 sampling sites were selected, where larvae were collected using the pipette method and adult mosquitoes were collected using the mosquito trap lamp method. Mosquito species identification was accomplished by integrating morphological characteristics and molecular identification techniques based on COⅠand COⅡ gene sequences. Software tools such as ClustalX, DnaSP v5.0, and Network v4.6.1.0 were utilized to analyze the genetic differentiation (Fst), gene flow (Nm) among populations of Aedes japonicus, Aedes albopictus and Armigeres subalbatus. Results The mosquito specimens collected from the Wuyi Mountain Nature Reserve were identified as 30 species belonging to 8 genera within the Culicidae family. Among them, there were 10 species of Aedes, 13 species of Culex, 1 species each of Armigeres, Orthopodomyia, Uranotaenia, Tripyeroides, and Anopheles, and 2 species of Toxorhynchites. Analysis of the genetic structure of important mosquito populations showed that the haplotype diversity index (Hd) of Ae. japonicus was 0.994 7, with a generally moderate degree of differentiation between populations and a higher degree of genetic differentiation between populations 6 and 12; Aedes albopictus had a haplotype diversity index of 0.634 0, with significant genetic differentiation between populations 1 and 2 compared to other groups; Armigeres subalbatus had a haplotype diversity index of 0.703 3, with substantial genetic differentiation and limited gene flow between population 2 and populations 3, 4, 6, and 7. Conclusions The mosquito species are rich in Wuyi Mountain Nature Reserve. A comprehensive survey of the composition and distribution of mosquito populations was carried out, and the characteristics of the population genetic structure of the important species of Ae. japonicus, Ae. Albopictus, and Ar. subalbatus populations were analyzed, providing valuable scientific data reference for local mosquito-borne ecological research and disease prevention and control.

Objective To investigate the anti-human immunodeficiency virus-1 (HIV-1) activity of Euonymus fortunei extract and its mechanism, providing a theoretical basis for the research and development of traditional Chinese herbal resources in the treatment of acquired immunodeficiency syndrome (AIDS). Methods The peripheral blood mononuclear cells (PBMCs)-HIV-1_bal cell model system was used as the experimental model, and the effect of Euonymus fortunei extract on the cell activity and anti-HIV-1 activity of PBMCs was investigated by CellTiter-Glo assay and HIV-1 p24 antigen assay. Additionally, the mechanism of anti-HIV-1 action of Euonymus fortunei extract was determined through the time-of-addition assay and HIV-1 enzymatic assays. Results In the PBMCs-HIV-1_bal cell model, Euonymus fortunei extract showed no significant effect on cellular activity at the highest concentration, with a median cytotoxic concentration (CC₅₀)>40 μg/mL. Within the non-cytotoxic concentration range, the level of HIV-1_bal decreased with the increase of the extract concentration, with the IC₅₀=0.084 μg/mL, and the SI>476.19. Time-of-addition assay revealed that Euonymus fortunei extract had the highest inhibitory activity on HIV-1_IIIB when it was added to cells at the same time as the virus, and the inhibitory rate of HIV-1 activity decreased at 2 h and gradually lost its inhibitory effect on the virus at 18-24 h, similar to the known HIV entry inhibitor Enfuvirtid (T-20). Key HIV-1 enzyme activity experiments found that the extract had no significant inhibitory effect on reverse transcriptase activity but exhibited dose-dependent inhibition of integrase activity, with integrase activity decreasing with increasing extract concentration (IC₅₀=0.18 μg/mL); The extract could inhibit the activity of HIV-1 protease in a certain concentration range (IC₅₀=39.18 μg/mL). Conclusions In this study, it was found that Euonymus fortunei extract has a strong inhibitory activity against HIV-1 activity, which may exert anti-HIV-1 effects by acting on viral entry into cells and inhibiting integrase activity, and has a good application prospect in the research and development of multi-target new drugs against HIV-1.