Current Issue

2026 Vol.11 No.3 Published:30 June 2026

Original Articles

Analysis of influencing factors for adverse reactions to anti-tuberculosis fixed-dose combination therapy in elderly patients with pulmonary tuberculosis He Weiyun, Lai Jingwen, Chen Liang 2026, 11 (3):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.001 Abstract ( 103)    PDF (754KB) ( 46 )    Objective To identify time-dependent risk factors for anti-tuberculosis drug-related adverse drug reactions (ADRs) in elderly patients with pulmonary tuberculosis treated with fixed-dose combination (FDC) formulations, providing evidence-based support for the development of phased monitoring protocols in clinical practice. Method By using retrospective study design, the medical records of 649 elderly tuberculosis patients registered and treated in Yuexiu District, Guangzhou from January 2019 to December 2023 were collected through the "China Disease Prevention and Control Information System" subsystem "Tuberculosis Management Information System" and the "Guangzhou Chest Hospital HIS System". This study analyzed the occurrence of ADRs in elderly tuberculosis patients treated with FDC and employed the Cox proportional hazards regression model to evaluate the influencing factors. Result Among the 649 patients, 385 experienced ADRs (incidence rate 59.48%), with the time range of ADRs occurrence spanning 1 to 288 days, and the median occurrence time was 20 days. Multivariate Cox regression analysis revealed that female patients (aHR=1.705,95%CI: 1.368-2.125), positive sputum smear (aHR=1.423, 95%CI: 1.135-1.784), and estimated glomerular filtration rate (eGFR) 30-<60 ml/min (aHR=1.913,95%CI: 1.495-2.448) were independent risk factors for ADRs in elderly tuberculosis patients receiving anti-tuberculosis FDC therapy. Conclusion Elderly patients with pulmonary tuberculosis have a relatively high incidence of ADRs when receiving anti-tuberculosis treatment with FDC. Female sex, positive etiological findings, and a baseline eGFR of 30-<60ml/min are independent risk factors for ADRs. Clinical monitoring should be strengthened for the above high-risk populations during the early stage of treatment, and ADRs should be identified and managed promptly to improve treatment adherence.

A randomized controlled study on the diagnostic efficacy of bronchoalveolar lavage guided by augmented reality navigation versus conventional bronchoscopy for smear-negative pulmonary tuberculosis Zhou Yong, Li Fengjuan, Ruan Chao, Cai Huafeng, Li Yuchen 2026, 11 (3):  7-12.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.002 Abstract ( 57)    PDF (1126KB) ( 15 )    Objective To explore the diagnostic efficacy of augmented reality navigation and traditional bronchoscopic-guided alveolar lavage in the diagnosis of smear-negative pulmonary tuberculosis.Provide a reference basis for optimizing diagnostic and therapeutic strategies for this patient population in clinical practice. Method A prospective study was conducted to screen 200 suspected smear-negative pulmonary tuberculosis patients who were admitted to Xi'an Chest Hospital from January 2024 to June 2025. The patients were randomly divided into a control group and an experimental group using a random number table, with 100 cases in each group. Among them, the patients in the control group only underwent diagnosis using the traditional bronchoscopy alveolar lavage technique; while the patients in the experimental group underwent diagnosis using the augmented reality navigation bronchoscopy-guided alveolar lavage technique. The study compared the positive detection rates and diagnostic efficacy between the two groups. Result The average recovery rate of bronchoalveolar lavage fluid was (68.5%±10.2%) in the experimental group and (61.3%±12.4%) in the control group. In the experimental group, the success rate of specimen acquisition under AR navigation guidance was 94.0%., which was significantly higher than 82.0% in the control group, with a statistically significant difference (P<0.05). The positive detection rate of smear-negative pulmonary tuberculosis in the experimental group was 67.00%, also significantly higher than 53.00% in the control group (P<0.05).Receiver operating characteristic (ROC) curve analysis revealed that the augmented reality-guided bronchoscopic bronchoalveolar lavage yielded higher sensitivity (0.834), specificity (0.691) and area under the curve (AUC) (0.811) for the diagnosis of smear-negative pulmonary tuberculosis compared with conventional bronchoscopic bronchoalveolar lavage, and the difference was statistically significant (P<0.05). There were no significant differences in operation time, intraoperative minor bleeding volume and postoperative pneumothorax incidence between the two groups (P>0.05). Conclusion Augmented reality navigation-guided bronchoalveolar lavage demonstrates superior diagnostic efficacy for smear-negative pulmonary tuberculosis compared with conventional bronchoscopy, with favorable safety and clinical application value.

A comparative study on the clinical efficacy of different splenic artery embolization procedures in the treatment of hypersplenism in patients with hepatitis B liver cirrhosis Liu Wenhao, Zhou Yun, Xiao Liang, Kang Zhilong, Huang Xiangrong, Wang Mingbo, Feng Kai, Yang Gendong, Huang Hua 2026, 11 (3):  13-18.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.003 Abstract ( 67)    PDF (859KB) ( 28 )    Objective To compare the clinical efficacy of partial splenic embolization (PSE), main splenic artery embolization (MSAE), and combined MSAE plus PSE in the treatment of hypersplenism secondary to hepatitis B-related cirrhosis, so as to provide evidence for optimizing interventional strategies for hypersplenism. Method A retrospective analysis was performed on 85 patients with hepatitis B cirrhotic hypersplenism who received interventional embolization therapy in Shenzhen Third People's Hospital from January 2023 to April 2025. Patients were divided into three groups according to different surgical procedures: group A (n=22) underwent PSE alone, group B (n=33) underwent MSAE alone, and group C (n=30) underwent combined MSAE and PSE. The operative success rate, dynamic changes in peripheral blood three-line cell counts at different postoperative time points, and incidence of procedure-related adverse reactions were compared among the three groups. Result The operative success rate was 100% in all three groups. At 1 month postoperatively, white blood cell and platelet counts in all three groups were significantly higher than preoperative levels (P<0.05), and the elevation magnitude of platelet count in group C was significantly greater than that in group A and group B (P<0.05). At 2-month follow-up, white blood cell count in group A remained significantly higher than baseline (P<0.05), while red blood cell and platelet counts in group C remained significantly elevated compared with preoperative levels (P<0.05). In addition, the incidence of postoperative splenic artery occlusion in group B and group C was significantly higher than that in group A (P<0.05). Conclusion All three interventional embolization procedures can effectively improve thrombocytopenia and leukopenia induced by hypersplenism in the short term. Conclusion All three interventional embolization procedures can effectively improve thrombocytopenia and leukopenia induced by hypersplenism in the short term. Combined MSAE plus PSE achieves superior efficacy in elevating and maintaining platelet counts.

Analysis of influencing factors and immune indicators of EBV and cytomegalovirus co-infection in patients with HIV infection/AIDS Ji Kaige, Chen Yingying, Liu Bingxue, Xu Tan, Teng Xiaoyan, Li Jinlong 2026, 11 (3):  19-23.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.004 Abstract ( 51)    PDF (770KB) ( 18 )    Objective To investigate the influencing factors and related immune marker characteristics of co-infection with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in patients with HIV infection/AIDS, so as to provide a reference for early clinical screening, diagnosis and treatment. Method Clinical data of 384 patients with HIV infection/AIDS were retrospectively collected from January 1 to December 31, 2024 at the Second Hospital of Nanjing. Peripheral blood CD4+T lymphocyte count was detected by flow cytometry, and loads of HIV RNA, EBV DNA and CMV DNA were measured by real-time fluorescent quantitative polymerase chain reaction. Multivariate Logistic regression was used to analyze the influencing factors of EBV and CMV co-infection. Spearman rank correlation was applied to evaluate the correlation between CD4+T lymphocyte count and HIV RNA load. Result Among the 384 HIV/AIDS patients, 80 had EBV and CMV co-infection, with a co-infection rate of 20.8%. The difference in co-infection rate among groups with different CD4+T lymphocyte counts was statistically significant (χ2=42.573, P<0.001). Multivariate Logistic regression analysis showed that age >50 years, CD4+T lymphocyte count <200 cells/μl, and HIV RNA load ≥200 copies/ml were independent risk factors for EBV and CMV co-infection (all P<0.05). Correlation analysis revealed that CD4+T lymphocyte count was negatively correlated with HIV-RNA load in HIV-EBV-CMV co-infected patients (r=-0.336, P=0.002). Conclusion Age >50 years, CD4+T lymphocyte count <200 cells/μl and HIV RNA load ≥200 copies/ml increase the risk of EBV and CMV co-infection in HIV-infected/AIDS patients, and co-infection can further aggravate immune impairment. Active screening, early identification and timely intervention should be carried out for such high-risk populations to improve the prognosis.

The research on the value of quantitative real-time PCR in the diagnosis and treatment monitoring of Talaromycosis marneffei infection Liu Xia, Zou Jun, Lu Yibo, Qin Xiaoying, Xu Qiuna, Liang Cuijin, Zhao Rui, Lan Jian, Xiao Qiuye, Huang Tian, Wei Yinduo, Qin Jinmei, Yang Shixiong 2026, 11 (3):  24-29.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.005 Abstract ( 40)    PDF (820KB) ( 13 )    Objective To evaluate the application value of real-time quantitative PCR (qPCR) in the diagnosis of Talaromyces marneffei (T. marneffei) infection and in the monitoring of antifungal therapy, and to provide laboratory evidence for optimizing antifungal treatment strategies. Method Patients with confirmed T. marneffei infection at the Fourth People's Hospital of Nanning from January to June 2022 were enrolled. Using fungal culture as the diagnostic gold standard, baseline paired specimens were collected. The sensitivity of qPCR for diagnosing fungal infection was evaluated by comparing the positive rates of qPCR and fungal culture. Spearman correlation analysis was used to assess the correlation between baseline fungal load and the time to positivity in culture. A linear mixed-effects model was constructed to analyze the changes in fungal load during antifungal therapy. Result A total of 64 culture-confirmed T. marneffei infected patients were included. At baseline, plasma qPCR demonstrated a sensitivity of 95.3% (61/64), exceeding the positivity rates of concurrent blood culture (90.7%) and bone marrow culture (91.7%). Baseline plasma fungal load was significantly and negatively correlated with the time to culture positivity (r=-0.495, P<0.001). During treatment, fungal load demonstrated a significant declining trend over time (β=-0.3216, P<0.001), whereas no statistically significant difference in the rate of fungal load decline was observed between treatment regimens with and without amphotericin B (P=0.532); substantial inter-individual heterogeneity was noted in both baseline fungal load and treatment response. On the day of blood culture conversion to negative (days 4-13 after treatment initiation), qPCR results simultaneously converted to negative in 50 patients (78.1%), while 14 patients (21.9%) remained qPCR-positive in blood. Conclusion The qPCR method demonstrates high sensitivity for diagnosing T. marneffei infection and can be used for early auxiliary diagnosis. In treatment monitoring, qPCR can dynamically reflect changes in fungal load and can identify patients with persistent infection even after blood cultures have become negative, thereby facilitating efficacy assessment and adjustment of individualized therapy.

Effect of early tracheotomy on patients with tuberculous meningitis who need invasive mechanical ventilation Cheng Yao, Wu Guihu, Mao Yi, Luo Haixia, Li Yuke 2026, 11 (3):  30-35.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.006 Abstract ( 46)    PDF (807KB) ( 22 )    Objective To explore the effect of early tracheostomy(ET) on patients with tuberculous meningitis requiring invasive mechanical ventilation(IMV). Method A case-control study was conducted. Patients with tuberculous meningitis who received IMV treatment in the Intensive Care Unit of Chengdu Public Health Clinical Medical Center from January 2022 to December 2024 were enrolled. Patients undergoing ET were assigned to the ET group(n=29), and those receiving late tracheostomy during the same period were set as the control group(n=58). Epidemiological characteristics, comorbidities, neurological complications, the highest Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score within 48 hours after ICU admission, the initial Glasgow coma scale(GCS) score upon ICU admission, indications for IMV initiation, laboratory parameters before IMV, analgesia duration, duration of IMV, IMV-related complications, length of ICU stay, and 28-day in-hospital clinical outcomes (survival and death) were collected and compared between the two groups. Result Repeated aspiration caused by poor airway clearance was the leading indication for IMV support in patients with tuberculous meningitis. Compared with the control group, the ET group presented significantly shorter sedation duration, IMV duration and ICU stay length [(8.8±1.9）d vs (12.7±2.6)d, P<0.001; median:10.2d vs 16.4d, P<0.001; median:12.3d vs 17.5d, P<0.001]. There were no significant differences between the two groups in the incidence of ventilator-associated pneumonia, pneumothorax, subcutaneous emphysema, mediastinal emphysema, airway hemorrhage, airway stenosis, tracheoesophageal fistula, and 28-day in-hospital prognosis (P>0.05). Conclusion For patients with tuberculous meningitis requiring IMV, early tracheostomy can shorten sedation duration, IMV duration and ICU stay length, while it cannot improve the 28-day in-hospital prognosis.

Clinical characteristics and risk factors of tuberculous constrictive pericarditis Xiong Yanmei, Sun Nannan, Cen Wuqiang, Hu Qingliang 2026, 11 (3):  36-41.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.007 Abstract ( 50)    PDF (875KB) ( 17 )    Objective To investigate the clinical characteristics of patients with tuberculous constrictive pericarditis(TBCP) and analyze its risk factors,so as to provide a reference for the clinical diagnosis of TBCP. Method Clinical data of 118 patients diagnosed with tuberculous pericarditis(TBP) at Chongqing Public Health Medical Center from July 2023 to June 2025 were retrospectively collected.Patients were divided into a TBCP group(n=67) and a non-TBCP group(n=51) based on the progression to constrictive pericarditis. Clinical data were compared between the two groups. A stratified analysis was performed based on whether pericardial puncture was performed.Multivariate logistic regression was used to identify independent risk factors for TBCP. Result Compared with patients in the non-TBCP group, patients in the TBCP group had a longer disease course, and their main clinical symptom was cough accompanied by dyspnea on exertion, with statistically significant differences between the groups (all P<0.05). Laboratory examination results showed that compared with the non-TBCP group, the levels of troponin, N-terminal pro-brain natriuretic peptide, total bilirubin, and indirect bilirubin in the TBCP group were significantly higher, while the levels of direct bilirubin and erythrocyte sedimentation rate were significantly lower, and all the above inter-group differences were statistically significant (all P<0.05). Imaging characteristics showed that patients in the TBCP group had a characteristic septal bounce, accompanied by pericardial thickening, a small amount of pericardial effusion, and biatrial enlargement. Hemodynamic examination suggested that compared with the non-TBCP group, the superior vena cava pressure, right atrial pressure, right ventricular pressure, pulmonary artery pressure, and pulmonary artery wedge pressure in the TBCP group were increased, while the cardiac index and cardiac output were decreased, and all the above differences were statistically significant (all P<0.05). Intervention analysis showed that the incidence of pericardial constriction was 40.0% (22/55) in the pericardiocentesis group, which was significantly lower than 71.4% (45/63) in the non-pericardiocentesis group, with a statistically significant difference (P=0.001). The results of multivariate Logistic regression analysis indicated that the duration of illness (OR=1.480, 95%CI: 1.150-1.910), pericardial thickness (OR=1.470, 95%CI: 1.090-2.000), and pericardial effusion volume (OR=0.920, 95%CI: 0.860-0.980) were independent influencing factors for the occurrence of TBCP. Conclusion Patients with TBCP have a longer course of disease, mainly presenting with cough accompanied by fatigue, along with characteristic changes in laboratory tests, imaging, and hemodynamics, and pericardiocentesis can reduce the risk of its occurrence. Prolonged duration of illness and increased pericardial thickness are independent risk factors for TBCP, while increased pericardial effusion volume is an independent protective factor. Clinically, attention should be paid to the above characteristics, and early intervention should be strengthened to reduce the incidence risk.

Analysis of clinical and imaging features of pregnancy complicated with active tuberculosis Yin Quhua, Wen Xiaojian, Huang Heping, Yang Jiao, Ling Jie, Yao Qineng, Wang Liwei, Wu Liji 2026, 11 (3):  42-48.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.008 Abstract ( 58)    PDF (940KB) ( 20 )    Objective To summarize the clinical patterns and specific imaging manifestations of active tuberculosis during pregnancy, so as to provide evidence for optimizing clinical diagnosis and treatment strategies. Method A retrospective analysis was conducted on the clinical data, including clinical features, laboratory tests, imaging, and etiology, of 23 patients with pregnancy complicated by active tuberculosis admitted to Hunan Chest Hospital and The Inner Mongolia Fourth Hospital from January 2020 to December 2024. Result The 23 patients ranged in age from 19 to 39 years, among whom 17 were rural residents (73.91%). Cough and expectoration were the most common clinical manifestations, while poor appetite, fever, fatigue and other symptoms were also relatively frequent. In terms of pregnancy stage, there were 16 cases of early pregnancy, 5 cases of second-trimester pregnancy, 1 case of third-trimester pregnancy and 1 case of puerperium. In terms of tuberculosis types, 15 cases (65.22%) were secondary pulmonary tuberculosis,among which 11 cases showed patchy exudation, cavitation, and tree-in-bud opacities on chest CT, mainly distributed in the apical-posterior segments of bilateral upper lobes and superior segments of the lower lobes; 4 cases had atypical imaging manifestations with clustered micronodules and reversed halo sign. Hematogenous disseminated pulmonary tuberculosis was the next most common (4 cases, 17.39%), including 3 cases post-in vitro fertilization and 1 case postpartum.Among the 15 cases of secondary pulmonary tuberculosis, a total of 16 lesion-sites of concurrent extrapulmonary tuberculosis were identified, including 9 cases of bronchial tuberculosis, 3 cases of cervical lymph node tuberculosis, 2 cases of tuberculous pleurisy, and 1 case each of laryngeal tuberculosis and urinary tuberculosis. Among the 4 cases of hematogenous disseminated pulmonary tuberculosis, a total of 5 lesion-sites of concurrent extrapulmonary tuberculosis were identified, including 3 cases of meningeal and parenchymal tuberculosis, 1 case of spinal meningeal tuberculosis, and 1 case of tuberculous pleurisy.As for pregnancy outcomes, 20 cases (86.96%) underwent abortion or induced labor, 2 cases had preterm delivery, and 1 severe case received emergency uterine curettage due to incomplete abortion, resulting in maternal and fetal death. Conclusion Pregnancy complicated with active tuberculosis is often clinically nonspecific, predominantly affecting women in rural areas and during early pregnancy. It presents with diverse imaging manifestations, rapid disease progression, and a high incidence of multi-site tuberculosis, resulting in poor maternal and infant prognosis. These findings highlight the need for strengthened early identification, accurate diagnosis, and timely intervention in clinical practice.

The predictive value of red cell distribution width-to-albumin ratio combined with interferon-α and tumor necrosis factor-α for prognosis in patients with fever with thrombocytopenia syndrome Zhang Xuechen, Fang Mingxia, Jiang Hao, Lu Hu 2026, 11 (3):  49-54.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.009 Abstract ( 48)    PDF (1266KB) ( 31 )    Objective To evaluate the predictive value of the red cell distribution width-to-albumin ratio (RAR) combined with interferon-α(IFN-α) and tumor necrosis factor-α(TNF-α) for early identification of poor prognosis in patients with severe fever with thrombocytopenia syndrome (SFTS). Method A retrospective cohort study was conducted, enrolling 396 SFTS patients admitted to Nanjing Second Hospital between June 2023 and August 2025. Based on 28-day outcomes, patients were categorized into a cured group (n=304) and a poor prognosis group (n=92). Clinical data and laboratory parameters (including RAR, IFN-α, and TNF-α) collected at admission were analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. The predictive performance of individual indicators and a combined model was assessed using receiver operating characteristic (receiver operator characteristic curve, ROC) curve analysis. Result The poor prognosis group had significantly higher levels of age, RAR, viral load, TNF-α, IFN-α, total bilirubin (TBIL), glucose (GLU), and blood urea nitrogen (BUN) compared to the cured group (all P<0.05). Multivariate analysis confirmed these indicators as independent risk factors for poor prognosis (all P<0.05). ROC analysis showed that the areas under the curve (AUC) for RAR, TNF-α, and IFN-α alone were 0.762, 0.582, and 0.762, respectively. The AUC for the combined model increased to 0.864 (95%CI: 0.832-0.896), with a sensitivity of 72.8% and a specificity of 86.6%, demonstrating superior predictive performance compared to any single indicator. Conclusion RAR, IFN-α, and TNF-α are independent risk factors for poor prognosis in SFTS patients. The combined prediction model incorporating these three indicators shows good discriminative ability and may serve as a valuable tool for the early identification of high-risk patients, facilitating stratified clinical management.

Application of a combined model of ultrasound radiomics features and routine clinical ultrasound indicators in the differential diagnosis of tuberculous lymph nodes and metastatic lymph nodes Huang Yulan, Pan Yanxi, Huang Yinghua, Huang Xiaogui, Meng Nengfang, Jiang Kaimao, Lu Yibo 2026, 11 (3):  55-60.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.010 Abstract ( 33)    PDF (1596KB) ( 17 )    Objective To evaluate the diagnostic efficacy of a combined model based on ultrasound radiomics features and conventional sonographic features in differentiating tuberculous lymph nodes from metastatic lymph nodes, so as to provide more reliable evidence for clinical auxiliary diagnosis. Method A total of 346 patients with tuberculous lymph nodes and 109 patients with metastatic lymph nodes diagnosed in the Fourth People's Hospital of Nanning from January 2020 to December 2024 were retrospectively enrolled. Complete ultrasound images and clinical data were collected. Patients were divided into training set (242 tuberculous lymph nodes, 76 metastatic lymph nodes) and test set (104 tuberculous lymph nodes, 33 metastatic lymph nodes) at a 7:3 ratio using a random number table method. Lesion regions of interest (ROI) were delineated, statistically significant ultrasound radiomics features were screened out to establish the radiomics model. Conventional sonographic features with statistical differences were selected to construct the clinical model. The combined model was established by integrating radiomics features and conventional sonographic features, and its diagnostic performance was assessed. Result Age, gender, minimal short diameter and internal echo showed statistically significant differences between tuberculous and metastatic lymph nodes in both training and test sets(P<0.05). Finally, 8 radiomics features were screened out through LASSO regression. In the training set, the AUC of the combined model was 0.872 (95%CI:0.826-0.918), the sensitivity was 0.730, and the specificity was 0.868. In the test set, the AUC was 0.875 (95%CI:0.805-0.945), the sensitivity was 0.765, and the specificity was 0.833. DeLong test showed that the AUC of the combined model was significantly higher than that of the radiomics model and clinical model in both sets (all P<0.05), indicating favorable clinical application value. Conclusion The combined model constructed by ultrasound radiomics features and conventional sonographic features exhibits satisfactory diagnostic performance in differentiating tuberculous lymph nodes from metastatic lymph nodes.

Knowledge and influencing factors of healthcare workers on comprehensive surveillance and prevention of emerging and key infectious diseases Xu Ruiyi, Wang Ziqi, Niu Dandan, Zhang Xindong, Feng Tiejian, Chen Yixiong 2026, 11 (3):  61-66.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.011 Abstract ( 40)    PDF (942KB) ( 14 )    Objective To investigate the current status and influencing factors of healthcare workers' knowledge on comprehensive surveillance and prevention of emerging and key infectious diseases in Bao'an District, Shenzhen, and to provide evidence for optimizing prevention strategies. Method A cross-sectional study was conducted among 669 healthcare workers from 8 key medical institutions in Bao'an District using a questionnaire covering six dimensions: Awareness of emerging infectious diseases, reporting, epidemiological investigation, response, infection control, and laboratory utilization. Descriptive statistics, chi-square tests, and logistic regression were used for data analysis. Result The overall knowledge awareness rate was 48.79%, with the highest rate in awareness of emerging infectious diseases (63.90%), followed by response (56.29%), reporting (50.93%), laboratory utilization (45.35%), infection control (42.24%), and epidemiological investigation (24.21%). Multivariate analysis revealed that participation in comprehensive surveillance (OR=2.24, 95%CI: 1.36-3.68), ≤5 years of work experience (OR=2.14, 95%CI: 1.29-3.54), working in laboratory (OR=2.03, 95%CI: 1.24-3.33), employment in tertiary hospitals (OR=1.86, 95%CI: 1.28-2.69), and training attendance (OR=1.80, 95%CI: 1.28-2.54) were significant positive factors. Conclusion Healthcare workers' knowledge on surveillance and prevention needs improvement, particularly in epidemiological investigation and infection control.Therefore, targeted training programs should be implemented, and the roles of tertiary hospitals and laboratory departments should be leveraged to enhance regional capacity.

Clinical characteristics of patients with pulmonary tuberculosis complicated by pulmonary thromboembolism: a retrospective analysis Zhang Lin, Xiao Haihao, Su Wenjie 2026, 11 (3):  67-71.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.012 Abstract ( 49)    PDF (879KB) ( 21 )    Objective To compare the clinical characteristics of patients with pulmonary tuberculosis complicated by pulmonary thromboembolism (PTE) versus those with PTE alone, and to provide a reference for the clinical identification of pulmonary tuberculosis in patients with PTE. Method A total of 53 patients diagnosed with PTE at Guangzhou Chest Hospital from January 1 2021 to May 1 2024 were enrolled. Among them, 14 patients with pulmonary tuberculosis and PTE were assigned to the study group, and the remaining 39 patients with PTE alone served as the control group. An exploratory analysis was performed on the two groups. For continuous variables, normality was assessed using the Shapiro-Wilk test. Data conforming to a normal distribution were expressed as mean±standard deviation and compared using the independent samples t-test; data not conforming to a normal distribution were expressed as median (interquartile range) and compared using the Mann-Whitney U test. Categorical variables were presented as counts (percentages), and intergroup comparisons were performed using appropriate methods based on theoretical frequencies (Pearson's chi-square test or Fisher's exact test). Result The study group (n=14) had a lower body mass index and higher incidences of cough and expectoration than the control group (n=39) (all P<0.05). Plasma D-dimer level in the study group was 9.7 (6.8, 14.2) mg/L, which was higher than that in the control group [2.0 (1.0, 3.2) mg/L]; the High-sensitivity cardiac troponin I level was 47.0 (36.2, 65.7) ng/L in the study group versus 4.3 (2.2, 8.0) ng/L in the control group, with statistically significant differences (P<0.001).No statistically significant differences were observed between the two groups in terms of age, gender composition, or PTE risk factors (P>0.05). Similarly, no statistically significant differences were found regarding clinical manifestations such as fever, chest pain, dyspnea, hemoptysis, white blood cell counts, or CTPA imaging findings between the two groups (P>0.05). There was also no significant difference in PTE-related in-hospital mortality between the two groups (P>0.05). Conclusion Compared with patients with PTE alone, patients with pulmonary tuberculosis combined with PTE have a lower body mass index, a higher prevalence of cough and expectoration, and more pronounced elevations in plasma D-dimer and High-sensitivity cardiac troponin I levels.

Case Report

Clinical and epidemiological characteristics of a couple infected with Zika virus after returning from abroad in Shenzhen, China Wu Yanjie, Lin Zhiping, Shi Xiaolu, Cai Jianguang, Long Wenting, Guan Yuan, Yang Ying, Li Jie, Zhang Xiaowen, Ye Yuhui 2026, 11 (3):  72-76.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.013 Abstract ( 53)    PDF (773KB) ( 11 )    Zika virus disease is an acute viral infectious disease transmitted by Aedes mosquitoes, with clinical manifestations primarily including fever, rash, conjunctivitis, and arthralgia. In recent years, epidemics have remained active in Southeast Asia. Although sporadic imported cases have been reported in China, concurrent infection in a married couple is extremely rare. This article reports one pair of imported Zika virus disease cases in a married couple identified in Shenzhen. From September 27 to October 3, 2025, both patients traveled together to Semporna, Sabah, Malaysia, where they had a clear history of mosquito bites. On October 4, the male patient developed symptoms first, mainly presenting with chills, high fever, scattered red maculopapular rash over the body, and mild fatigue, accompanied by mild conjunctival congestion and joint pain. On October 5, the female patient subsequently became ill, with milder symptoms consisting only of low-grade fever, mild headache, and symmetrically distributed red maculopapular rash on the neck, trunk, and limbs. Laboratory testing showed positive Zika virus nucleic acid in both cases, while dengue virus and chikungunya virus nucleic acid tests were negative. After symptomatic and supportive treatment, the symptoms of both patients significantly improved within 3-5 days of hospitalization, with no neurological complications observed. Epidemiological investigation determined that the two cases were co-exposed imported infections. The community where the patients resided promptly implemented mosquito vector surveillance and control measures, and no secondary cases were identified. In summary, clinical manifestations of concurrent Zika virus infection in a married couple can show individual differences. Early recognition and intervention can alleviate the disease severity and effectively prevent local transmission, providing reference for the diagnosis, treatment, and prevention of imported Zika virus disease.

A case of pulmonary tuberculosis presenting with diffuse ground-glass opacities on imaging Chen Yaling, Xu Chuanjun, Chi Yun, Sun Binghu, Hu Zhiliang 2026, 11 (3):  77-80.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.014 Abstract ( 39)    PDF (1046KB) ( 16 )    Pulmonary tuberculosis is rarely characterized by symmetrical bilateral diffuse ground-glass opacities on chest imaging, which can lead to diagnostic confusion. We report a case of a 52-year-old male who initially presented with bilateral pulmonary diffuse ground-glass opacity as the primary manifestation on chest CT, initially diagnosed as pneumocystis carinii pneumonia. purified protein derivative test and tuberculosis interferon gamma release assay were both negative. Sputum smears, mycobacterial cultures, and GeneXpert MTB/RIF were also negative. However, targeted second-generation sequencing of the bronchoalveolar lavage fluid detected specific sequences of the Mycobacterium tuberculosis complex, leading to the final diagnosis of pulmonary tuberculosis. After receiving regular anti-TB treatment, the patient exhibited improvements in clinical symptoms and resolution of lung lesions. This case suggests that pulmonary tuberculosis can manifest as bilateral, diffuse ground-glass opacities. When traditional detection methods do not suggest pulmonary tuberculosis, it should not be entirely ruled out, and consideration may be given to performing targeted next-generation sequencing of pulmonary lavage fluid to assist in differential diagnosis.

Review

Post-tuberculosis nontuberculous mycobacterial pulmonary disease: epidemiology and latest advances in diagnosis and treatment Lai Xiaoyu, Chen Xunxun, Liao Qinghua, Wen Wenpei, Wu Yue 2026, 11 (3):  81-88.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.015 Abstract ( 1012)    PDF (769KB) ( 330 )    ObjectiveWith the global expansion of the tuberculosis survivor population, post-tuberculous nontuberculous mycobacterial pulmonary disease (post-TB NTM-PD) has become a severe public health challenge. "Post-tuberculous" is defined as a state of secondary NTM pulmonary infection caused by residual pulmonary structural and immune damage after standardized anti-tuberculosis treatment with cure or failure. The global incidence of NTM-PD is rising steadily, in sharp contrast to the declining tuberculosis incidence. In China, NTM-PD shows high prevalence in northeastern and southeastern coastal areas with distinct geographic heterogeneity, and the predominant pathogens are Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus complex (MABC). Its pathogenesis is associated with residual pulmonary structural damage, local immune dysfunction and NTM biofilm formation. Due to high clinical overlap with tuberculosis recurrence, delayed diagnosis, misdiagnosis and missed diagnosis are prominent, with a median diagnosis time of 21.2 months for delayed patients. This paper reviews its epidemiological characteristics and pathogenesis, and focuses on the application value of HRCT radiomics, mNGS and MALDI-TOF MS in accurate differential diagnosis. In terms of treatment, besides individualized multi-drug combination regimens based on species identification and drug susceptibility testing, it explores the application of novel drugs such as inhaled liposomal amikacin (ALIS) and bedaquiline in refractory cases, and evaluates surgical indications and efficacy. Finally, it emphasizes the importance of multidisciplinary comprehensive management for improving prognosis, and points out the existing challenges such as the popularization of molecular diagnosis. By systematically reviewing the research advances and existing challenges in this field, this review aims to provide a reference for clinicians to enhance early recognition of post-TB NTM-PD and optimize diagnostic and treatment strategies, as well as to identify future research directions.

Research progress of multimodal imaging in evaluating HIV infection complicated with cardiovascular disease Ruan Gaowa, Liu Xiaolin 2026, 11 (3):  89-94.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.016 Abstract ( 32)    PDF (746KB) ( 11 )    As a major public health problem worldwide, HIV infection has posed a severe test to national health systems since its discovery. With the wide application of antiretroviral therapy (ART), the life cycle of HIV-infected patients has been significantly prolonged, and cardiovascular diseases (CVD) have gradually become one of the main causes of death and disability in this population. The pathological mechanism of HIV infection complicated with CVD is complex, the clinical manifestations are diverse and the early symptoms are not typical. The clinical diagnosis and treatment are difficult, so early accurate identification and intervention are particularly critical. Multimodal imaging integrates echocardiography, cardiac computed tomography, cardiac magnetic resonance, nuclear medicine and other imaging techniques, which breaks the limitations of single imaging method and can be comprehensively evaluated from anatomical structure, cardiac function and molecular level. This article reviews the research progress of multimodal imaging technology in HIV infection complicated with CVD, in order to provide reference for early diagnosis, clinical management and prognosis evaluation of the disease.

Standards/Guidelines/Consensus

Diagnosis and treatment protocol for Ebola virus disease (2026 edition) General Office of the National Health Commission, General Department of the National Administration of Traditional Chinese Medicine 2026, 11 (3):  95-99.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.017 Abstract ( 48)    PDF (706KB) ( 13 )

Education Fields

Research on the optimization of the training model for professional master's degree candidates in infectious diseases Zheng Xuyang, Li Yi, Li Fangfang, Kang Wen, Zhang Ying 2026, 11 (3):  100-103.  DOI: 10.19871/j.cnki.xfcrbzz.2026.03.018 Abstract ( 38)    PDF (733KB) ( 17 )    The model integrating professional master's degree education in clinical medicine and standardized training for resident physicians has become an important way in the training of clinical medical personnel in China. This model plays an important role in strengthening the clinical training of the candidates and improving their working ability after graduation. Infectious diseases currently belongs to the category of internal medicine. Under the current training model for professional master's degree candidates in infectious diseases, there is a gap between the learning content in the department of infectious diseases in standardized training for internal medicine and the needs of infectious disease prevention and treatment. The learning content of courses needs to be improved. The clinical research training for candidates is insufficient. These problems influence the quality of thesis, the professional capacity, and the development potential of the candidates. Education organizations should ensure well coordination between training stages, formulate reasonable requirement for academic research, and strengthen the clinical research training for candidates, so as to provide talent support for the prevention and treatment work of infectious diseases.