Current Issue

2026 Vol.11 No.4 Published:31 August 2026

Original Articles

Analysis of the microbial profile of bronchoalveolar lavage fluid in patients with pulmonary tuberculosis complicated by lower respiratory tract infection using metagenomic sequencing Liu Yu, Tang Junxia, Zhao Qianqian, Liu Zonglin, Jia Lina, Tian Yueyou, Hu Weidong 2026, 11 (4):  1-12.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.001 Abstract ( 84)    PDF (14233KB) ( 46 )    Objective To investigate the microbial profiling characteristics of bronchoalveolar lavage fluid (BALF) in patients with pulmonary tuberculosis complicated by lower respiratory tract infection (PTB-LRTI), and to preliminarily elucidate the potential mechanisms of microbiota involvement in the disease, thereby providing a theoretical basis for the diagnosis of PTB-LRTI. Method BALF samples were collected from 98 patients treated at Gansu Provincial People's Hospital from June 2023 to December 2024, including 60 patients in the PTB-LRTI group and 38 patients in the LRTI group. Metagenomic next-generation sequencing (mNGS) was employed to analyze the microbial composition of BALF. The microbial community structure and functional differences between the two groups were compared using α-diversity analysis, linear discriminant analysis effect size (LEfSe) analysis, and Kyoto encyclopedia of genes and genomes CCCCCC(KEGG) functional annotation. Result Compared with the LRTI group, the PTB-LRTI group showed significantly higher α-diversity of the BALF microbial profile (P<0.05). The abundances of Firmicutes, Actinobacteria, and Bacteroidetes were increased in the PTB-LRTI group, with significant enrichment of Mycobacterium, Nocardia, Mycobacterium tuberculosis, and Nocardia farcinica. In the LRTI group, Proteobacteria, as well as Streptococcus, Klebsiella, and Haemophilus, were predominantly enriched. The number of species identified in the PTB-LRTI group was higher than that in the LRTI group (396 vs. 145 species). LEfSe analysis revealed significant differences between the two groups at multiple taxonomic levels. KEGG functional analysis showed significant differences in terpenoid backbone biosynthesis, cyclic adenosine monophosphate signaling pathway, and phosphonate biosynthesis between the two groups (P<0.05). Conclusion The BALF microbial community structure and functional profiles in patients with PTB-LRTI are significantly altered, characterized by enrichment of Firmicutes, Actinobacteria, and Mycobacterium. The differential microbiota are associated with disturbances in metabolic functions, including terpenoid backbone biosynthesis, suggesting that BALF microbial profiling analysis may provide a novel theoretical basis for the etiological diagnosis and mechanistic research of PTB-LRTI.

The diagnostic value of Xpert MTB/RIF detection in different types of samples of tuberculosis patients Zhang Yaxi, Li Jing, Yang Qianting, Wang Min, Zhan Senlin, Chen Qi 2026, 11 (4):  13-17.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.002 Abstract ( 62)    PDF (838KB) ( 44 )    Objective This study aimed to evaluate the diagnostic performance of the GeneXpert Mycobacterium tuberculosis/rifampicin assay (Xpert MTB/RIF), a real-time fluorescent quantitative nucleic acid amplification test, in different clinical specimens from patients with active tuberculosis (TB), so as to provide evidence for specimen selection in clinical TB diagnosis. Method A retrospective analysis was performed. Clinical data and Xpert MTB/RIF test results of various specimens were collected from patients diagnosed with active TB at the Third People's Hospital of Shenzhen between January and December 2023. The positive detection rates across specimen types were statistically compared. Paired samples of bronchoalveolar lavage fluid (BALF) versus sputum, and tissue versus pus were analyzed for detection rate differences. The prevalence of rifampicin resistance was also compared between patients with newly treated TB and retreated TB. Result A total of 1,443 specimens were enrolled. The overall positive detection rate of Xpert MTB/RIF was 69.02% (996/1443). The positive rates of different specimens sorted in descending order were as follows: pus 89.11% (221/248), bronchoalveolar lavage fluid 84.50% (169/200), sputum 74.74% (361/483), tissue 71.42% (100/140), urine 56.96% (45/79), stool 42.86% (42/98), cerebrospinal fluid 34.14% (28/82), and pleural effusion 26.55% (30/113). Paired analysis for pulmonary TB patients revealed that the detection rate of BALF (87.90%, 109/124) was significantly higher than that of sputum (67.74%, 84/124), with a statistically significant difference (χ2=18.939,P<0.001). For extrapulmonary TB patients, the detection rate of pus (86.76%, 59/68) was markedly higher than that of tissue specimens (64.71%, 44/68) (χ2=9.000, P=0.002). Rifampicin resistance testing showed an overall resistance rate of 8.59% (124/1443), including a resistance rate of 2.84% in newly treated TB patients and 5.75% in retreated TB patients. Conclusion Xpert MTB/RIF assay features rapid detection, simple operation, high specificity, and the capability to identify rifampicin resistance. However, its diagnostic yield varies substantially by specimen type. Targeted selection of clinical specimens can effectively improve the etiological diagnostic accuracy of tuberculosis.

Prevalence and influencing factors of latent tuberculosis infection among household close contacts of pulmonary tuberculosis patients in ethnic minority populations of Sichuan province Liang Li, Ma Yao, Lai Min, Guo Zhouli, Wu Guihui 2026, 11 (4):  18-23.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.003 Abstract ( 70)    PDF (854KB) ( 36 )    Objective To investigate the prevalence and influencing factors of latent tuberculosis infection (LTBI) among household close contacts of ethnic minority patients with pulmonary tuberculosis in Sichuan province, and to provide evidence for developing targeted LTBI intervention strategies for ethnic minority groups. Method Participants were household close contacts of ethnic minority patients with etiologically confirmed pulmonary tuberculosis admitted to Chengdu Public Health Clinical Center from June to December 2024. All participants received LTBI screening and questionnaire surveys, and were divided into LTBI group and non-LTBI group according to screening results. General demographic data, household living conditions, living habits and clinical data of index cases were compared between the two groups. Binary logistic regression model was used to analyze the independent influencing factors of LTBI. Result A total of 168 household close contacts were included. The overall LTBI prevalence was 39.3% (66/168), and only 2 (3.0%) LTBI-positive participants were willing to receive preventive treatment. Multivariate logistic regression analysis indicated that other occupations (OR=0.160, 95%CI: 0.047-0.553) and unemployed/retired status (OR=0.162, 95%CI: 0.050-0.529) were independent protective factors against LTBI. Per capita living area less than 50m2 (OR=4.412, 95%CI: 1.665-11.689), consanguineous kinship with index cases (OR=2.931, 95%CI: 1.284-6.687), and index cases with pulmonary cavities involving more than 2 lung fields (OR=6.013, 95%CI: 1.641-22.033) were independent risk factors for LTBI. Conclusion Household close contacts of ethnic minority pulmonary tuberculosis patients in Sichuan province have a high LTBI prevalence and extremely low acceptance of preventive treatment, with a high risk of active tuberculosis. Contacts engaged in other occupations or being unemployed/retired have a lower risk of LTBI. In contrast, those who are consanguineous relatives of index cases, live in per capita living space below 50 m2, or have contact with index cases with pulmonary cavities involving more than 2 lung fields are at higher risk of LTBI, and should be regarded as the key high-risk population for LTBI prevention and control.

Comparative analysis of diagnostic efficacy of five laboratory assays for pulmonary aspergillosis Wu Hang, Li Jianying, Yang Han, Li Aifang, Yang Jingfen, Zheng Huiqiang, Zhang Xin, Ma Jinbao, Li Dongmin 2026, 11 (4):  24-29.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.004 Abstract ( 72)    PDF (935KB) ( 50 )    Objective To evaluate and compare the clinical diagnostic value of five laboratory methods for pulmonary aspergillosis (PA): fungal polymerase chain reaction (PCR) using bronchoalveolar lavage fluid (BALF), BALF galactomannan test (GM test), fungal culture (culture method), serum GM test, and serum (1,3)-β-D-glucan test (G test), and to provide evidence for selecting an efficient diagnostic strategy for PA in clinical practice. Method A retrospective analysis was conducted on 841 hospitalized patients with suspected community-acquired pneumonia admitted to Xi’an Chest Hospital from December 2024 to April 2025. All patients underwent the above five tests. Using clinical diagnosis as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and Kappa value were calculated for each method. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was computed to compare the diagnostic performance comprehensively. Result In single-test analysis, the sensitivities of PCR and BALF-GM were 0.519 and 0.577, respectively, significantly higher than those of serum GM (0.096), G test (0.077), and culture method (0.077). The positive predictive values of culture method (1.000) and PCR (0.750) were significantly higher than those of BALF-GM (0.484), serum GM (0.156), and G test (0.333). ROC curve analysis showed that the AUCs of PCR (0.754) and BALF-GM (0.768) were both significantly greater than those of serum GM (0.531), G test (0.533), and culture method (0.567). In combined testing, when PCR was used as the base test and sequentially combined with BALF-GM and serum GM, the diagnostic sensitivity increased to 0.673 and 0.712, respectively; further addition of G test or culture method did not improve the sensitivity further (both remained 0.712). Conclusion PCR alone demonstrates excellent overall diagnostic performance for PA and has high clinical application value. Compared with single tests, the combination of PCR, BALF-GM, and serum GM effectively improves the diagnostic sensitivity for PA.

Development and evaluation of a musculoskeletal ultrasound-based prediction model for knee joint involvement in brucellosis Qi Xiu, Ma Lingfeng, Li Ping 2026, 11 (4):  30-35.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.005 Abstract ( 56)    PDF (1834KB) ( 39 )    Objective To explore the high risk factors of knee joint involvement in patients with brucellosis based on musculoskeletal ultrasound, to construct and verify the prediction model of knee joint involvement, and to provide theoretical support for early clinical screening, risk stratification and individualized intervention. Method A total of 132 patients with brucellosis who were admitted to the Second Hospital of Hohhot from October 2023 to October 2025 were enrolled, including 60 patients with knee joint involvement. General data and musculoskeletal ultrasound images were collected. Independent risk factors were screened by χ2 test and Logistic regression analysis, and a prediction model was constructed. Bootstrap method was used for internal verification. The accuracy and clinical practicability of the prediction model were evaluated by receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, calibration curve, decision curve analysis (DCA), Shapley Additive Explanations (SHAP) and nomogram. Result Blood flow signal of infrapatellar fat pad and joint cavity / suprapatellar bursa effusion were independent risk factors (all P<0.05). The model was well distinguished and the calibration degree was high. The clinical net income was good when the threshold probability of DCA was 0.07-0.65. SHAP showed that the blood flow signal of infrapatellar fat pad contributed the most, followed by joint cavity / suprapatellar bursa effusion, both of which positively increased the risk. The prediction probability of the nomogram visualization model is 64.89%. Conclusion Blood flow signal of infrapatellar fat pad and joint cavity / suprapatellar bursa effusion is an independent risk factor for knee joint involvement in patients with brucellosis. The prediction model has the ability to predict the risk of knee joint involvement.

Analysis of factors influencing cognitive impairment and the predictive value of CD4+ T lymphocyte count in patients with HIV/AIDS Xiong Lei, Zhang Shuying, Li Tao, He Jianglin, Lu Xiaoxi, Wan Ting, Xie Liqiu, Yang Jia, Gao Yueqin, Xiong Wei, Ge Yang, Wang Yin, Fu Siqi, Zhang Na, Hou Keke 2026, 11 (4):  36-43.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.006 Abstract ( 81)    PDF (934KB) ( 39 )    Objective To investigate factors associated with cognitive impairment in patients with HIV/AIDS and to evaluate the discriminative performance of CD4+ T lymphocyte count for cognitive impairment, thereby providing evidence for the early clinical identification of individuals at high risk of cognitive impairment. Method A cross-sectional study was conducted. A total of 71 patients with HIV/AIDS who attended Chengdu Public Health Clinical Medical Center between January 1, 2024 and November 30, 2025 were enrolled. According to cognitive function assessment results, the patients were divided into a cognitively normal group (n=43) and a cognitive impairment group (n=28). General clinical data, sociodemographic characteristics, and laboratory indicators were collected from the hospital electronic medical record system, and quantitative brain structural imaging parameters were also obtained. Univariate analysis was performed to compare differences between the two groups. Based on the results of univariate analysis, statistical independence of variables, and clinical accessibility, a binary logistic regression model was constructed to identify independent factors associated with cognitive impairment. Receiver operating characteristic (ROC) curve analysis was further performed for significant variables to evaluate their discriminative performance. Result Univariate analysis showed that CD3+ T lymphocyte count and CD4+ T lymphocyte count were significantly lower in the cognitive impairment group than in the cognitively normal group (t=2.128,P=0.037; t= 6.044, P<0.01, respectively). Marital/partner status differed significantly between the two groups (χ2=6.303,P=0.012). Temporal lobe gray matter volume tended to be lower in the cognitive impairment group, and the difference was statistically significant in the uncorrected between-group comparison (t=2.114, P=0.038); however, the difference was no longer significant after false discovery rate correction. Binary logistic regression analysis showed that CD4+ T lymphocyte count (OR=0.987, 95%CI: 0.980-0.994, P<0.001) and marital/partner status (single vs. non-single: OR=5.702, 95%CI: 1.193-27.251, P=0.029) were significantly associated with cognitive impairment. ROC curve analysis indicated that CD4+ T lymphocyte count had good discriminative performance for cognitive impairment, with an area under the curve of 0.886 (95%CI: 0.812-0.961, P<0.001). At a cutoff value of approximately 260 cells/μl, the sensitivity was 93.0% and the specificity was 67.9%. Conclusion Decreased CD4+ T lymphocyte count and being single were the main factors associated with cognitive impairment in patients with HIV/AIDS. CD4+ T lymphocyte count demonstrated good screening value for cognitive impairment and may serve as a reference indicator for early identification of high-risk patients and follow-up management.

Clinical characteristics and therapeutic efficacy analysis of lymphatic fistula-type tracheobronchial tuberculosis in children Li Cuiping, Huang Shaomei, Chen Pinru, Song Min, Fang Weijun 2026, 11 (4):  44-48.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.007 Abstract ( 73)    PDF (1089KB) ( 37 )    Objective To summarize and analyze the clinical characteristics, bronchoscopic findings, and clinical efficacy of combined systemic drug therapy and interventional treatment for tracheobronchial tuberculosis (TBTB) with lymph node fistula in children, providing a reference for the clinical diagnosis, treatment, and standardized management of this condition. Method Clinical data of 45 children diagnosed with lymph node fistula type TBTB at Guangzhou Chest Hospital from July 2015 to September 2025 were retrospectively reviewed. General information, clinical manifestations, imaging features, bronchoscopic characteristics, and interventional treatment outcomes were analyzed. Result All 45 pediatric patients were pathologically diagnosed via bronchoscopic biopsy. Among them, 17 were male and 28 were female, ranging in age from 1 to 15 years, with a mean age of (11.24±3.30) years; the duration of illness ranged from 1 week to 1 year. The main clinical manifestations were fever and cough. Imaging studies revealed enlarged hilar or mediastinal lymph nodes, accompanied by pulmonary consolidation or atelectasis. Bronchoscopic classification revealed granulomatous/polypoid type in 30 cases (66.67%) and simple/ulcerative perforation type in 15 cases (33.33%). A total of 90 fistula openings were identified, with multiple lesions being the predominant type; they were mainly distributed in the left and right main bronchi, with a higher prevalence on the right side. The median number of interventional procedures for children with a single lesion (22 cases) was 3.5, while for those with multiple lesions (23 cases) it was 7; the difference between the two groups was statistically significant (P<0.05). The treatment efficacy rate was 100%, and no serious complications occurred either during or after treatment. Conclusion In children with lymph node fistula type TBTB, the bronchoscopic classification is predominantly the granulomatous/polypoid type. Lesions are often multiple and mainly located in the right main bronchus. Systemic anti-tuberculosis drugs combined with bronchoscopic interventional therapy is effective and safe.

Analysis of the epidemiological characteristics of respiratory tract infection pathogens among 12 508 inpatients at Gansu Provincial People's Hospital during 2023-2024 Shen Xiwen, Jia Lina, Tian Yueyou, Liu Zonglin, Liu Ting, Hu Weidong 2026, 11 (4):  49-56.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.008 Abstract ( 71)    PDF (1499KB) ( 43 )    Objective To analyze the distribution characteristics of pathogens in hospitalized patients with respiratory tract infections, describe their detection status across different genders, groups, and seasons, and provide a reference for the clinical diagnosis, treatment, and prevention and control of respiratory tract infections in this region. Method In this single-center retrospective study, we enrolled hospitalized patients with respiratory tract infections who underwent pathogen testing at Gansu Provincial People's Hospital from January 1, 2023 to December 31, 2024. Clinical and etiological data were collected to calculate detection rates and to analyze the epidemiological features of pathogens by sex, age, season, and co-infection status. Result A total of 12 508 hospitalized patients with respiratory tract infections were included in this study, of whom 7088 were male (56.7%) and 5420 were female (43.3%), with a male-to-female ratio of 1.31∶1. The top three pathogens by detection rate were mycoplasma pneumoniae (MP) with 6121 cases (48.8%), influenza (IAV) with 4436 cases (35.4%), and influenza B virus (IBV) with 4239 cases (33.9%). There were 5631 cases of single infection (45%) and 6877 cases of mixed infection (55%), with IAV IBV MP being the common co-infection combination, accounting for 1155 cases (16.8% of mixed infection cases). Conclusion Among the 12 508 hospitalized patients with respiratory infections at Gansu Provincial People's Hospital between 2023 and 2024, Mycoplasma pneumoniae was the most common pathogen, followed by influenza A virus and influenza B virus; mixed infections were also relatively prevalent.

Analysis of clinical characteristics and influencing factors of postoperative recurrence in patients with cervical lymph node tuberculosis Fang Yuchen, Chen Xiaohui, Shi Weicheng, Chen Zhuohong, Shao Cheng, Liu Zengwei, You Peitao 2026, 11 (4):  57-62.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.009 Abstract ( 59)    PDF (848KB) ( 36 )    Objective To explore the clinical characteristics of patients with cervical lymph node tuberculosis, analyze the influencing factors of lesion recurrence after surgical treatment, and provide evidence for clinical diagnosis and treatment of cervical lymph node tuberculosis. Method A retrospective analysis was performed on the clinical data of 707 patients with cervical lymph node tuberculosis who underwent surgical treatment in Guangzhou Chest Hospital from June 2019 to April 2025. Clinical indicators including gender, age, lesion location, pathological type, lymph node size, number of involved cervical lymph node regions, and complications were statistically analyzed. The chi-square test was used to compare the differences in sample rates among different groups. Multivariate Logistic regression analysis was applied to identify the factors affecting postoperative recurrence in patients with cervical lymph node tuberculosis. Result The male-to-female ratio of the patients was 1∶1.69, and the proportions of minor, young, middle-aged and elderly patients were 6.4%, 75.3%, 14.6% and 4.6%, respectively. A total of 13 types of underlying comorbidities were identified, among which pulmonary tuberculosis was the most common, occurring in 379 patients. In terms of lesion distribution, 210 cases were located in the left neck, 246 in the right neck, 230 in the bilateral neck, and 21 in the anterior cervical region. The pathological types included nodular type (64 cases), infiltrative type (124 cases), abscess type (398 cases), and ulcerative type (121 cases). All patients were grouped according to the maximum diameter of the largest lymph node in the lesion. Among them, 172 cases had a maximum diameter of less than 1.8 cm, 368 cases of 1.8-3.3 cm, and 167 cases of more than 3.3 cm. Regarding the number of involved cervical lymph node regions, 289 cases involved 1 region, 224 involved 2 regions, 100 involved 3 regions, and 94 involved ≥4 regions. The postoperative recurrence rates of nodular, infiltrative, abscess, and ulcerative types were 1.56% (1/64), 1.61% (2/124), 19.60% (78/398), and 12.40% (15/121), respectively, with statistically significant differences among groups (χ2=35.437, P<0.001). The postoperative recurrence rates of patients with lesions involving 1, 2, 3, and ≥4 cervical lymph node regions were 7.61% (22/289), 11.16% (25/225), 20.00% (20/100), and 30.85% (29/94), respectively, and the differences were statistically significant (χ2=37.294, P<0.001). Multivariate Logistic regression analysis demonstrated that abscess type, ulcerative type, and involvement of ≥3 cervical lymph node regions were independent risk factors for postoperative recurrence (all OR>1, all P<0.05). Conclusion Cervical lymph node tuberculosis is highly prevalent in young adults, and pulmonary tuberculosis is its primary comorbidity. Patients with abscess-type or ulcerative lesions and involvement of ≥3 cervical lymph node regions have an increased risk of postoperative recurrence.

Case Report

A case report of AIDS complicated with disseminated cryptococcosis secondary to cat scratch disease central nervous system lesions and tuberculosis He Xiaoqing, Huang Rui, Liu Qian, Zeng Yanming, Yu Qing, Liu Yu, Liu Min 2026, 11 (4):  63-69.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.010 Abstract ( 62)    PDF (1269KB) ( 43 )    This article reports the diagnosis and treatment of a rare case involving a patient with advanced AIDS who developed disseminated cryptococcosis complicated by central nervous system (CNS) injury caused by cat-scratch disease (CSD) and tuberculosis. A 49-year-old female patient was initially admitted due to recurrent headache and fever. Laboratory tests revealed a CD4+T-lymphocyte count of 19 cells/μl and a positive HIV confirmatory test. Combined with positive cryptococcal culture in cerebrospinal fluid (CSF) and chest CT findings, she was diagnosed with AIDS complicated by disseminated cryptococcosis (including cryptococcal meningitis and pulmonary cryptococcosis). Her condition improved after anti-cryptococcal therapy, and antiretroviral therapy (ART) was subsequently initiated. Due to irregular secondary prophylaxis with fluconazole, the patient experienced a relapse of cryptococcal meningitis, which stabilized after re-treatment. During standard ART and fluconazole secondary prophylaxis, the patient again developed headache and fever, accompanied by new intracranial lesions. Metagenomic next-generation sequencing (mNGS) of CSF detected sequences of Bartonella henselae. Based on this result and a history of multiple cat scratches, a diagnosis of CNS involvement of CSD was made. Treatment with rifampin combined with doxycycline led to symptomatic relief. However, during treatment, the patient’s condition recurred, presenting with meningeal irritation signs, progressively elevated CSF protein levels, and new intracranial lesions. Subsequent mNGS of bronchoalveolar lavage fluid detected Mycobacterium tuberculosis sequences. In accordance with the patient’s clinical manifestations, CSF biochemical characteristics, and international diagnostic criteria and clinical scoring systems for tuberculous meningitis, a clinical diagnosis of tuberculous meningitis was established. The patient showed significant improvement and normalization of CSF parameters after combined anti-tuberculosis therapy with isoniazid, rifampin, ethambutol, pyrazinamide, and levofloxacin, and follow-up indicated a favorable prognosis. This case highlights the complexity and overlapping nature of CNS infections in patients with advanced AIDS. It suggests that when clinical manifestations are inconsistent with a single infection or treatment response is suboptimal, clinicians should move beyond a “single-etiology” mindset. By integrating epidemiological history, multi-site imaging features, and molecular diagnostic techniques, a high suspicion of mixed infections is essential to achieve comprehensive diagnosis and precise treatment.

Successful treatment of a case of imported cerebral malaria complicated by multi-organ failure Wu Ting, Yao Weiming, Song Haihui, Luo Jinhong, Huang Siran, Wang Zhi, Cao Weipeng, Chen Xiaochun, Hu Lihua, Wang Fuxiang, Tang Ming 2026, 11 (4):  70-74.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.011 Abstract ( 70)    PDF (1540KB) ( 37 )    Cerebral malaria (CM) is a common and fatal neurological disorder caused by Plasmodium falciparum. The neurological damage it induces is irreversible and lethal, with clinical manifestations primarily including impaired consciousness and seizures. Artesunate is the first-line treatment for CM, yet the management of severe CM remains clinically challenging, and survivors may experience cognitive impairment or behavioral abnormalities. This study presents a successfully treated case of CM complicated with multiple organ dysfunction syndrome (MODS). The patient was a middle-aged Chinese male who worked as a laborer in Africa and had lived and worked there for six months. He initially presented with recurrent fever and chills, followed by neuropsychiatric symptoms, impaired liver and kidney function, and respiratory failure. On the basis of adequate and full-course artesunate antimalarial therapy, combined with comprehensive treatment including antibiotics, corticosteroids, continuous renal replacement therapy (CRRT), and mechanical ventilation, the patient's condition stabilized. His consciousness cleared, and organ functions showed significant improvement. This report aims to highlight the clinical features of multi-system involvement in CM and its comprehensive treatment strategies, in order to assist clinicians in providing more targeted and effective treatment for patients with severe malaria, thereby improving prognosis and reducing hospital stays.

Health Management and Prevention and Control Strategies

Andes virus-associated hantavirus cardiopulmonary syndrome and human-to-human transmission: insights from the MV Hondius cruise ship outbreak Zhou Nianqi, Wang Fuxiang, Fu Lei, Peng Shifang 2026, 11 (4):  75-80.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.012 Abstract ( 76)    PDF (839KB) ( 54 )    Hantaviruses are important zoonotic pathogens that can cause hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). Andes virus (ANDV) is the only hantavirus with clear evidence of human-to-human transmission. In April-May 2026, an ANDV-related outbreak occurred on the MV Hondius cruise ship. The World Health Organization (WHO) confirmed on July 2nd that the outbreak was under control, ultimately reporting 13 cases: 12 laboratory-confirmed cases, 1 probable case, and 3 deaths. The incubation period for ANDV infection ranges from 4 to 42 days. The clinical course usually includes a prodromal phase followed by a rapidly progressive cardiopulmonary phase, and severe cases may develop capillary leak, non-cardiogenic pulmonary edema, myocardial depression, and shock. Specific IgM can be detected in the majority of patients with acute HCPS at the onset of symptoms or shortly thereafter, but presymptomatic viremia may precede antibody presentation. Previous household outbreaks, the 2018-2019 Epuyén outbreak in Argentina, and the current cruise ship incident all indicate that human-to-human transmission primarily occurs in close, continuous contact situations. The specific transmission routes and the risk of pre-symptomatic transmission require further clarification. This review, based on the 2026 cruise ship outbreak, summarizes the virology, epidemiology, clinical manifestations and management, evidence of human-to-human transmission, predictors of severe disease, and isolation and surveillance strategies for ANDV, with the aim of providing a reference for the identification and prevention of travel-related imported cases.

Review

Application progress of metagenomic next-generation sequencing in the early diagnosis of psittacosis Liang Ruoxuan, Kong Dongfeng, Liu Wei 2026, 11 (4):  81-87.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.013 Abstract ( 64)    PDF (851KB) ( 51 )    Chlamydia psittaci infection is a globally distributed zoonotic respiratory disease characterized by diverse and nonspecific clinical manifestations and is therefore frequently misdiagnosed as community-acquired pneumonia. Early and accurate diagnosis is crucial for controlling disease transmission and improving patient outcomes. However, conventional etiological diagnostic methods, including serological antibody assays, are limited by low sensitivity and long turnaround times. Metagenomic next-generation sequencing (mNGS), as a rapid and highly sensitive tool for pathogen detection, has demonstrated notable advantages in the diagnosis of psittacosis, particularly in patients with severe disease. By rapidly identifying the causative pathogen, mNGS provides an effective new strategy for the early clinical diagnosis and treatment of C. psittaci infection. Nevertheless, the widespread clinical implementation of mNGS continues to face several challenges, including insufficient standardization of sample pretreatment procedures.Based on a review of relevant literature from China and other countries, this article summarizes the clinical application scenarios, performance advantages, and clinical value of mNGS in the early diagnosis of C. psittaci infection and discusses the current challenges and future directions of this technology. This review aims to provide a theoretical basis for the prevention and control of C. psittaci infection and to promote the appropriate application and continuous optimization of mNGS in clinical practice.

Research progress on influencing factors of clinical cure achieved by pegylated interferon alpha in chronic hepatitis B Mei Xinran, Chen Jing 2026, 11 (4):  88-94.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.014 Abstract ( 60)    PDF (844KB) ( 37 )    Chronic hepatitis B (CHB) remains a major global public health issue, and achieving clinical cure, defined as clearance of hepatitis B surface antigen (HBsAg), is a primary goal of current antiviral therapy. Pegylated interferon alpha (PEG-IFNα) possesses both immunomodulatory and direct antiviral effects, making it a key therapeutic agent for promoting clinical cure in CHB. However, its efficacy varies considerably among individuals, and the clinical cure rate is influenced by multiple interacting factors, including virological, host-related, and treatment-related variables. This review focuses on the factors influencing the achievement of clinical cure with PEG-IFNα therapy in CHB. Current evidence indicates that virological markers are helpful in identifying favorable populations, host immune response characteristics are closely associated with treatment response, genetic polymorphisms may affect individual efficacy by modulating interferon signaling pathways, and appropriate selection of treatment strategies also significantly impacts the clinical cure rate. This review also critically evaluates current research bottlenecks, such as the limited predictive efficacy of single markers and insufficient prospective validation, and proposes that future efforts should integrate multidimensional dynamic indicators to construct personalized predictive models, thereby enabling precise screening of favorable populations and optimization of treatment decisions, ultimately further improving the clinical cure rate of CHB.

Research progress in circulating cell-free DNA detection for tuberculosis diagnosis Zhang Yu, Huang Hua, Wang Weihua, Tan Ying 2026, 11 (4):  95-100.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.015 Abstract ( 59)    PDF (839KB) ( 31 )    Tuberculosis remains a major global public health challenge. Although molecular detection techniques have advanced in recent years, existing diagnostic methods still have limitations in terms of sensitivity, detection speed, and biosafety. Therefore, there is an urgent need to develop more precise, efficient, and rapid new diagnostic strategies for tuberculosis. Circulating cell-free DNA (cfDNA), a highly fragmented DNA present in human blood circulation and free from cells, has emerged as a promising novel biomarker. Among these, mycobacterium tuberculosis cfDNA (MTB-cfDNA) can indicate the presence of the pathogen in the host and shows potential for the early and precise diagnosis of tuberculosis. This review systematically summarizes the application progress of MTB-cfDNA detection technology in tuberculosis diagnosis from the perspectives of technical comparison, clinical diagnostic application, sample types, and technological optimization. It further discusses the processing techniques, detection efficiency, and applicable scenarios of MTB-cfDNA in different clinical sample types, aiming to provide a theoretical basis for the rapid and accurate diagnosis of tuberculosis..

Standards/Guidelines/Consensus

Diagnosis and treatment protocol for Nipah virus disease (2026 edition) General Office of the National Health Commission, General Department of the National Administration of Traditional Chinese Medicine 2026, 11 (4):  101-104.  DOI: 10.19871/j.cnki.xfcrbzz.2026.04.016 Abstract ( 40)    PDF (816KB) ( 28 )