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 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.

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 current epidemic status of soil-transmitted helminthiasis (STHs) in China, providing reference data for the prevention and control of soil-transmitted helminthiasis. Methods Surveillance data on soil-transmitted helminthiasis in China from 2017 to 2022 were collected and statistically analyzed to investigate the infection status, infection trends, and spatial autocorrelation. Results From 2017 to 2022, the average annual infection rate (AAIR) of soil-transmitted helminthiasis was 1.12% (25 123/2 251 632), with hookworm, roundworm, and whipworm having AAIRs of 0.70%, 0.26%, and 0.20% (15 827 cases, 5 836 cases and 4 586 cases), respectively. The infection rate of soil-transmitted helminths decreased annually by an average of 17.16% (AAPC =-17.16, P=0.007), with annual decreases in the infection rates of hookworm, roundworm, and whipworm being 14.70%, 22.13%, and 20.56%, respectively (AAPC=-14.70, P=0.025; AAPC=-22.13, P=0.015; AAPC =-20.56, P=0.029). The spatial distribution of hookworm, roundworm, and whipworm exhibited spatial positive correlation (Moran's I=0.09, P=0.121; Moran's I=0.46, P=0.001; Moran's I=0.23, P=0.013), with roundworm showing the highest spatial aggregation. The AAIRs of males and females were 1.03% (11 308/1 100 016) and 1.20% (13 851/1 149 286), respectively, with statistical significance (χ²=154.19, P<0.001). The highest AAIR was 1.85% (10 949/590 621) in individuals over 60 years old, with statistical significance across different age groups (χ²=4426.44, P<0.001). Hookworm, roundworm, and whipworm were mainly mild infections. The average annual positive rates of soil ascaris eggs and hookworms were 4.06% (649/15 984) and 2.45%(391/15 984), respectively, with statistical significance (χ²=66.16,P<0.001). Conclusions The infection rate of soil-transmitted helminthiasis in China is relatively low and shows a downward trend. Yet, there are local high-prevalence areas, with the elderly and females being the risk-prone populations. Comprehensive measures including expanding the monitoring scope, innovating monitoring technology, and promoting the rural toilet revolution are necessary to block the spread of soil-transmitted helminthiasis further.

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 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.

A 32-year-old female patient experienced a foreign body sensation in her esophagus on the evening of September 22, 2024, after consuming undercooked grass carp at a restaurant in Wuhan. Esophagoscopy conducted at the hospital revealed no abnormalities. Three days later, she had a stabbing pain in the pharynx. On October 8, upon self-examination, she noticed a red brown worm exhibiting stretching and contracting movements attached near the uvula in her pharynx and then went to the hospital. During the removal of the worm, the doctor observed the ulcers on the mucous membrane. Serological antibody tests for seven common human parasitic worms, including Schistosoma japonicum, Paragonimus westermani, Clonorchis sinensis, cysticercus of Taenia solium, sparganum, hydatid cyst, and Trichinella spiralis, were all negative. The isolated worm was reddish brown, measuring 4 mm in length and 2 mm in width. Staining with hydrochloric carmine dye revealed a morphology consistent with Clinostomum complanatum (Rud., 1819), characterized by an oral sucker at the anterior end, a pharynx connecting to intestinal branches, and two intestinal branches extending to the posterior end of the body with small sub-branches. The ventral sucker, larger than the oral sucker, was located at the front 1/4 of the body. A pair of testes were arranged longitudinally in the mid-posterior part, with an ovary located between the two testes and a uterus located above the upper testis. A comprehensive search of 188 databases comprising more than 460 million full-text articles through the library of Huazhong University of Science and Technology confirmed the first reported case of Clinostomum complanatum infection in humans in China.

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.

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 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 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.

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 To analyze the antibiotic resistance of clinical isolates from Western China in 2021, providing a reference for guiding the rational use of antibiotics in clinical practices and controlling nosocomial infections. Methods Bacterial samples were collected from nine hospitals in 5 autonomous regions and provinces in Northwest China (690 strains in Ningxia, 141 strains in Gansu, 133 strains in Xinjiang, 179 strains in Qinghai, and 151 strains in Shaanxi) in 2021. MALDI-TOF mass spectrometry was used to confirm bacterial identification, and bacterial susceptibility testing was performed using automated susceptibility testing systems. The results of the susceptibility tests were interpreted according to the 2021 CLSI standards. Results A total of 1 294 clinical strains (non-duplicates) were collected, primarily sourced from sputum specimens 312 strains (24.11%), urine specimens 235 strains (18.16%), pus specimens 147 strains (11.36%), and blood specimens 128 strains (9.89%). Among the 1 294 pathogenic strains, Gram-negative bacteria accounted for 69.47%, whereas Gram-positive bacteria accounted for 30.53%. From the Gram-negative organisms, the most common Enterobacterales strains included E.coli 258 strains (19.94%), K.pneumoniae 166 strains (12.83%), E.cloacae 39 strains (3.01%), and K.oxytoca 36 strains (2.78%). Non-fermentative Gram-negative bacilli constituted 20.63% of all isolates, mainly including P.aeruginosa 129 strains (9.97%) and A.baumannii 87 strains (6.72%). Among Gram-positive bacteria, S.aureus 267 strains (20.63%), E. faecium 68 strains (5.26%), and E.faecalis 48 strains (3.71%) were predominant. Enterobacteriaceae remained highly sensitive to carbapenem antibiotics; however, K.oxytoca had a resistance rate exceeding 15%. P.aeruginosa showed resistance rates of 29.5% and 14% to imipenem and meropenem, respectively; A.baumannii showed resistance rates of 63.2% to both drugs. The detection rate of MRSA was 36.7%, with MRSA showing significantly higher resistance rates than MSSA to most tested drugs. No S.aureus isolates were found resistant to vancomycin, teicoplanin, or linezolid. E.faecium strains demonstrated much higher resistance rates to most of the tested drugs compared to E.faecalis, with a few vancomycin-resistant strains found in both. Conclusions Bacterial resistance to commonly used antibiotics was still severe in Western China. Therefore, medical institutions should continue to enhance the monitoring of bacterial resistance, standardize the management and use of antibiotics, and reduce the transmission and spread of resistant bacteria within hospitals.

Objective To analyze the whole genome sequence characteristics of dengue serotype 2 virus (DENV-2) strains isolated from Guangzhou in 2023, providing new foundational data to support local dengue fever prevention and control efforts. Methods Dengue viruses were isolated from serum samples of dengue fever patients using C6/36 cells. Whole genome sequencing of dengue virus was performed using Nanopore sequencing technology (Nanopore platform). The sequencing data were assembled utilizing IPH-NANO v1.0 software, and homology analysis, phylogenetic analysis, and amino acid site variation analysis of the dengue virus genome sequence were conducted using software such as BioEdit7.0.9.0, MEGA11, and iqTree1.6.12. Results A total of 13 DENV-2 isolates were obtained from the serum samples of dengue fever patients in Guangzhou in 2023, all of which were derived from locally infected cases. The whole genome sequences obtained by sequencing and splicing ranged from 10 429-10 439 nt in length. The nucleotide (amino acid) homology among the 13 isolates was 99.7%-99.9% (99.6%-9.9%). A genome-wide phylogenetic analysis showed that the genotypes of all 13 Guangzhou isolates were identified as the Cosmopolitan genotype and were grouped in the same evolutionary clade as isolates from Réunion (French overseas territory), Djibouti, Kenya, and other regions. Compared with the reference sequence (NC001474), a total of 26 amino acid site variations were identified in the C/prM/E protein regions of the 13 isolates, including 4 variations in the C protein region, 8 in the prM protein region, and 14 in the E protein region. Conclusion The DENV-2 strains isolated from Guangzhou in 2023 exhibited high homology, with closely related isolates primarily originating from countries or regions such as Réunion, Djibouti, and Kenya, it highlights the need for further assessment of the risk of dengue fever importation from East Africa, South Asia, and other regions.

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 evaluate the in vitro synergistic antimicrobial effect of allicin combined with imipenem on clinically isolated carbapenem-resistant Klebsiella pneumoniae (CRKP), providing a reference for further in vivo pharmacodynamic studies. Methods Twenty-two strains of CRKP were selected as experimental subjects based on clinical drug sensitivity results. Pulling assay together with carbapenem inhibition enhancement assay were leveraged to identify the high adherence and β-lactamase phenotypes of CRKP. The combined effect of allicin and imipenem was confirmed using the zero interaction potency (ZIP) method. The antimicrobial effects of allicin, imipenem, and their combination against CRKP were tested separately in vitro by agar paper diffusion method. The organic combination of allicin and imipenem was exploited for detecting the diameter of the CRKP inhibitory circle and minimal inhibitory concentration (MIC). The crystal violet semi-quantitative method was utilized to observe the effect of allicin combined with imipenem on CRKP biofilm formation. Results Among the 22 strains of CRKP, 6 strains exhibited high adhesion, accounting for 27.27%. The results of carbapenem inhibition enhancement demonstrated that all strains of CRKP were class A β-lactamase-producing. Allicin had a strong bactericidal effect on CRKP. According to the results of one-way ANOVA, the diameter of the circle of inhibition of allicin combined with imipenem (15.91±2.76)mm was significantly higher than that of the imipenem alone group (8.23±3.46) mm(F=46.39, P<0.001). The ZIP scoring and MIC methods confirmed that the combination of allicin and imipenem primarily exerted an additive effect. One-way ANOVA analysis of crystal violet absorbance values showed that compared to the control group (0.213±0.056), the total CRKP biofilm amount in the allicin combined with imipenem group was reduced (0.134±0.045) (F=3.211, P=0.045). Conclusions The results of bacterial inhibition experiments in vitro show that the combination of allicin and imipenem significantly increases the inhibitory ability of CRKP and inhibits biofilm formation effectively.

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.

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 effects of capsaicin on gut microbiota and antimicrobial peptide expression of Anopheles stephensi, providing experimental references for the application of capsaicin in mosquito-borne disease prevention and control. Methods Anopheles stephensi were continuously fed with sugary water containing capsaicin or DMSO for the capsaicin-treated group and the control, respectively. The DNA of the female mosquito's midguts and gut bacteria was extracted. Bacterial 16S rDNA high-throughput sequencing and real-time fluorescence quantitative PCR were used to analyze and compare the bacteria diversity, gut flora composition, relative abundance, and total bacterial load in female mosquitoes’ midgut between the control and capsaicin treatment groups. Total RNA was extracted from the midguts of the two groups of Anopheles mosquitoes, and the transcriptional levels of important antimicrobial peptides were detected and compared by reverse transcription and real-time fluorescence quantitative PCR. Results A total of 10 phyla, 11 classes, 28 orders, 43 families, and 62 genera were identified in the two groups. The capsaicin-treated group had fewer taxa, with significantly reduced bacterial diversity, and different community composition and relative abundance of the flora compared to the control group. At the phylum level, Bacteroidota, Proteobacteria, and Firmicutes predominated in both two groups. At the order level, Flavobacteriales, Acetobacterales, Pseudomonadales, and Lactobacillales were the dominant bacteria, with reduced relative abundance of Pseudomonadales and Acetobacterales and increased relative abundance of Flavobacteriales and Lactobacillales in the capsaicin-treated group. At the genus level, Elizabethkingia was predominantly abundant in both samples, with higher relative abundance of Elizabethkingia, Leuconostoc, and Gluconobacter in the capsaicin-treated group, while Asaia and Acinetobacter had significantly lower relative abundance compared to the control group. In addition to these changes, the total bacterial load was increased and the transcriptional levels of attacin C, cecropin A, and defensin were significantly decreased by capsaicin treatment. Conclusions Capsaicin treatment significantly affects the composition of the gut flora in Anopheles stephensi and increases the total bacterial load while inhibiting the expression of antimicrobial peptides. Based on the analysis, it indicates that capsaicin might affect the fecundity and vector competence of Anopheles by changing the energy metabolism and immune-related bacteria.

This paper reports the discovery, diagnosis, treatment, and epidemiological survey of an imported confirmed visceral leishmaniasis (kala-azar) case in Wuhan City, providing a reference experience for enhancing awareness of imported visceral leishmaniasis among medical professionals in non-endemic healthcare institutions and reducing misdiagnosis. The patient had worked in Yangquan, Shanxi Province, for more than one year. After returning to his hometown in Hubei Province in 2020, he began to show symptoms such as intermittent fever, pancytopenia, progressive splenomegaly, and significant weight loss. Leishmania amastigotes were found in bone marrow smears. The rapid diagnostic test using the rk39 strip was positive for antibodies. Furthermore, both loop-mediated isothermal amplification (LAMP) and quantitative polymerase chain reaction (qPCR) assays confirmed the presence of Leishmania nucleic acid. Based on a comprehensive analysis of the epidemiological history, clinical manifestations, and laboratory test results, the case was confirmed as an imported visceral leishmaniasis case. This case presented with low parasite density and abnormal autoimmune indicators such as increased rheumatoid factor, leading to its prolonged misdiagnosis as a hematologic or autoimmune disease without effective treatment. It was only diagnosed after having left the endemic area for four years. Non-endemic areas should pay attention to the inquiry of epidemiological history and improve healthcare institutions' diagnostic awareness and treatment capabilities related to visceral leishmaniasis to avoid delays in treatment.

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.

Objective To investigate the effect of andrographolide on enterovirus 71 (EV71) and coxsackievirus A16 (CA16) in vitro. Methods Cytopathic CPE assay and thiazolyl blue tetrazolium bromide (MTT) assay were used to determine the maximum non-toxic dose of andrographolide on RD cells and the inhibitory effect of andrographolide on EV71 and CA16 infection in vitro. The effects of andrographolide on the virus VP1 gene and cellular inflammatory factors (IL-1β, IL-6, and TNF-α) at gene levels were detected by quantitative fluorescence PCR. Results MTT results showed that the maximum non-toxic dose of andrographolide on RD cells was 78.00 μg/mL. Upon infection with hand-foot-mouth disease viruses, cells treated with andrographolide solutions at concentrations of 78.00, 39.00, 19.50, 9.75, 4.88, and 2.44 μg/mL showed increased survival rates to (82.41±1.76)%, (79.54±2.91)%, (81.02±1.99)%, (71.81±2.26)%, (52.87±1.51)%, and (50.41±0.93)% for EV71 and (81.00±0.64)%, (79.72±1.38)%, (61.59±3.47)%, (53.37±0.53)%, (52.41±1.37)%, and (43.69±0.40)% for CA16, respectively, indicating a significant reduction in the cytopathic effect caused by EV71 and CA16. When infected with hand-foot-mouth viruses and treated with andrographolide solutions at concentrations of 78.00, 39.00, 19.50, and 9.75 μg/mL, the expression levels of VP1 in EV71 and CA16, along with pro-inflammatory factors IL-1β, IL-6, and TNF-α in RD cells, were significantly lower compared to the virus control group. These results indicated that after infection with hand-foot-mouth viruses, treatment with andrographolide solution significantly inhibits the expression of the VP1 gene and reduces the mRNA levels of IL-1β, IL-6, and TNF-α. Conclusions Andrographolide exhibits obvious in vitro antiviral effects against EV71 and, potentially through the inhibition of the expression of pro-inflammatory factors IL-1β, TNF-α, and IL-6, thereby exerting its antiviral effects.

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 analyze the epidemic characteristics of plague epidemics, host and vector community structure, and abundance in plague focus of wild rodents in Yunnan Province, 2017-2023, providing a scientific basis for formulating plague prevention strategies and forecasting warning for this epidemic foci. Methods Following the requirements of the "National Plague Surveillance Plan" and the "Yunnan Provincial Plague Surveillance Plan", host-vector surveillance, etiology, and serological testing were carried out, and plague epidemic data and host-vector surveillance data in plague focus of wild rodents in Yunnan Province, 2017-2023 were collected and sorted using Excel 2019 software to create a database for descriptive analysis. Results From 2017 to 2023, 11 animal plague epidemics were discovered in the wild plague foci of Yunnan Province, with 18 epidemic spots. From the altitude distribution point of view, 7 epidemic spots were distributed at an altitude of 2 800-3 000 meters, another seven at 3 000 and 3 200 meters, and four spots were located in areas with an altitude of ≥3 200 meters; a total of 36 samples of host and vector animals were detected positive, including 28 positive samples of host animals and 8 positive samples of vector animals, and 29 strains of Yersinia pestis were isolated; in terms of species composition, Eothenomys miletus accounted for the largest proportion of 41.67%, followed by Apodemus chevrieri at 22.22%; Ctenophthalmus quadratus at 11.11%; Rattus tanezumi and Neopsylla specialis each at 8.33%, and Dremomys pernyi, rat carcass, and Frontopsyllas padix each accounted for 2.78%; the epidemic peaked in April, and no human cases were found. A total of 453 220 rat cages (traps) were placed, capturing 27 677 rodents, with an average capture rate of 6.11%. A total of 25 075 main hosts, Apodemus chevrieri and Eothenomys miletus, were captured, accounting for 90.60% of the total capture rate. A total of 14 700 fleas were seized on the surface of small animals, with a total flea infection rate of 23.13% and a flea index of 0.59. The main vectors were Ctenophthalmus quadratus and Neopsylla specialis, with constituting ratios of 45.71% and 22.69%, respectively. Conclusions From 2017 to 2023, the population density of main host animals in Yunnan's wild rodent plague foci was relatively high and showed an upward trend, possibly related to the local planting structures. Plague plays a regulatory role in host population structures. Epidemics among animals showed obvious seasonality, with a trend of expanding epidemic areas. No human cases were found, but Yersinia pestis was detected in Rattus tanezumi in human settlements, raising the possibility that animal plague could spread to humans. It suggests strengthening the monitoring of areas adjacent to the epidemic source, eradicating rats and fleas in spring, improving the accuracy of plague prediction and early warning, providing strong technical support for the early detection of plague among animals, and preventing the spread of the epidemic to humans.

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.

Objective To analyze the in vitro yeast-phase drug susceptibility testing of 82 Talaromyces marneffei (TM) strains isolated at Yunnan Infectious Disease Hospital and their association with patient therapeutic outcomes. The study aims to investigate the antifungal resistance breakpoint for TM through in vitro susceptibility tests, evaluate the stability of the susceptibility testing methods, and assess the correlation between in vitro susceptibility test results and different clinical outcomes in HIV/AIDS patients with TM. This research provides a theoretical basis for the clinical selection of highly effective and low-toxicity antifungal drugs in treating HIV/AIDS with TM infection and aims to improve the clinical treatment quality. Methods Clinical data from 82 HIV/AIDS patients co-infected with TM from 2017 to 2021 were retrospectively collected. The minimum inhibitory concentration (MIC) of TM strains from these patients was tested using the microdilution method at Yunnan Provincial Infectious Disease Hospital. Patients were divided into two groups based on therapeutic outcomes: good and poor. Statistical analyses were performed on epidemiological data, clinical characteristics, laboratory data, and treatment regimens between the two groups. Correlations between different MIC results and therapeutic outcomes were analyzed, and independent risk factors affecting prognosis were identified using multivariate logistic regression. The predictive value of the diagnostic indicators was assessed using the Receiver Operating Characteristic (ROC) curves. Results Clinical efficacy: Out of the 82 patients, 38 had good outcomes and 44 had poor outcomes. Univariate analysis showed statistically significant differences (P<0.05) in abnormal imaging features, CD4⁺T lymphocyte count, duration of antifungal therapy, white blood cell (WBC) count, total protein (TP), albumin (ALB), and use of itraconazole. Patients who received itraconazole had better outcomes, with statistically significant differences (P<0.05). In vitro susceptibility testing: MICs for 82 TM strains were <4 to 4 mg/L for 5-fluorocytosine, <0.5 to 0.5 mg/L for amphotericin B, <1 to 8 mg/L for fluconazole, <0.125 mg/L for itraconazole, and <0.06 to 0.06 mg/L for voriconazole. There were no statistical differences in efficacy among patients with different susceptibility results for the same drug. Prognostic model: A significantly reduced CD4⁺T cell count was an independent risk factor for poor TM treatment outcomes, with a ROC curve area under the curve (AUC) of 0.983 (95%CI: 0.963-1.000), specificity of 0.955, and sensitivity of 0.919. Conclusion The tested TM strains showed good sensitivity to all five antifungal drugs. Sequential treatment with itraconazole can improve patient prognosis, and CD4⁺T cell count is an independent risk factor affecting the prognosis of patients with TM infection.

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.

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 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.

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.

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 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 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.