Current Issue

2025 Vol.10 No.2 Published:30 April 2025

Diagnosis and Treatment of Avian Influenza in Humans

Analysis of veno-venous extracorporeal membrane oxygenation treatment strategies and literature review for the first case of human infection with H10N3 avian influenza complicated by severe acute respiratory distress syndrome in Guangxi Tan Shiji, Wei Jing, Liu Sheng, Lu Ning, Lu Yuming, Li Youling, Li Mei, Chen Yuehua, Cen Ping, Xie Zhouhua 2025, 10 (2):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.001 Abstract ( 20)    PDF (1421KB) ( 2 )    Objective To explore the application value and feasibility of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in the treatment of patients infected with H10N3 avian influenza complicated with severe acute respiratory distress syndrome (ARDS). Method A retrospective analysis was performed on the process and effect of VV-ECMO adjuvant treatment in the first case of human infection with H10N3 avian influenza complicated with ARDS in Guangxi. Result The main clinical manifestations of the patient were fever, cough and shortness of breath. The patient was confirmed to be infected with H10N3 avian influenza by the Chinese Center for Disease Control and Prevention (China CDC) through deep sequencing of influenza virus in respiratory samples. After receiving VV-ECMO supportive treatment, the pulmonary lesions were absorbed, and the patient ultimately recovered. Conclusion The application of VV-ECMO in patients infection with H10N3 avian influenza complicated with ARDS has shown remarkable therapeutic effects. It can efficiently provide oxygenation and remove carbon dioxide, winning precious time for disease control and pulmonary function recovery, and significantly improving patient survival rates.

Imaging manifestations and pathological mechanism analysis of human infection with H10N3 avian influenza virus pneumonia: a report of two cases Li Minyuan, Shan Qiulan, Zhang Le, Qin Chunle, Li Xiang, Lu Yibo 2025, 10 (2):  7-13.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.002 Abstract ( 20)    PDF (3973KB) ( 2 )    Human infection with H10N3 avian virus pneumonia is a rare respiratory infectious disease caused by H10N3 subtype avian influenza virus. While demonstrating low pathogenicity in avian populations, cross-species infection in humans may manifest as severe viral pneumonia, potentially progressing to life-threatening complications including acute respiratory distress syndrome (ARDS) and multi-organ failure. The first confirmed case of human infection with H10N3 avian influenza virus iwas reported in Jiangsu Province in 2021, followed by three more cases in China. This study conducted comprehensive analyses of imaging manifestations and underlying pathological mechanisms based on clinical data from confirmed cases in Yunnan and Guangxi regions, aiming to elucidate the characteristic imaging features of human H10N3 avian influenza virus pneumonia. The investigation revealed a triphasic temporal pattern in radiological evolution, demonstrating distinct stage-specific radiological characteristics that can be categorized into three progressive phases: ① Early stage (day 1-7 of disease progression): ground glass density with patchy consolidation appeared in both lungs. ② Progression period (day 8-20 of disease progression): enlargement and fusion of consolidation areas, thickening of interlobular septa, and air bronchogram sign. ③ Recovery period (day ≥ 21 of disease progression): tractional bronchiectasis and reticular fibrosis lesions. his study provides certain guiding significance for people in understanding the imaging manifestations, clinical diagnosis, differential diagnosis, efficacy evaluation, and prognosis judgment of human infection with H10N3 avian influenza virus pneumonia.

Orginal Article

A study on the correlation between acute episodes of brucellosis and blood flow signals in tendons and surrounding synovium based on color doppler ultrasonography Wu Guohua, Qi Xiu, Kang Fujia, Guo Fangfang, Su Yumei, Zhang Shuyu, Li Ping 2025, 10 (2):  14-18.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.003 Abstract ( 15)    PDF (1202KB) ( 2 )    Objective This study aims to investigate the correlation between acute episodes of brucellosis and increased blood flow signals in tendons or surrounding synovial membranes, evaluating the potential of musculoskeletal ultrasound with color Doppler imaging for identifying active phases of brucellosis. Method Ninety patients diagnosed with brucellosis from August 2023 to April 2024 at the Second Hospital of Hohhot were included in the study. Based on the presence of fever and laboratory findings, they were divided into an acute episode group and a non-acute episode group. All cases underwent musculoskeletal ultrasound with color Doppler imaging to observe blood flow signals in tendons and surrounding synovial membranes. Statistical analyses were conducted to compare the groups. Result The acute episode group included 56 patients (62.2%), of whom 19 (33.9%) showed increased blood flow signals, while 37 (66.1%) had no significant blood flow signals. In the non-acute episode group of 34 patients (37.8%), 4 (11.8%) exhibited increased blood flow signals, while 30 (88.2%) showed no significant signals. Chi-square tests revealed a significant difference in the imaging characteristics between the two groups, with statistical significance (P=0.019). Correlation testing using the Phi coefficient yielded a value of 0.246, indicating a moderate positive correlation with statistical significance (P=0.019). Logistic regression analysis revealed that the likelihood of patients with increased blood flow signals being in the acute phase was 3.851 times higher than those without significant blood flow signals, with a statistically significant relationship (P=0.025). Conclusion Increased blood flow signals in tendons or surrounding synovial membranes are moderately correlated with acute episodes of brucellosis. These findings can complement other clinical diagnostic indicators, making musculoskeletal ultrasound with color Doppler imaging a promising auxiliary tool for assessing active phases of brucellosis. This technique may provide clinicians with more accurate diagnostic and management strategies.

The analysis of the prophylactic treatment effects for latent tuberculosis infection in schools in Nanning from 2021 to 2022 Huang Xianzhen, Tan Jie, Huang Aichun, Zhu Qingdong, Wei Liuying, Xie Zhouhua 2025, 10 (2):  19-23.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.004 Abstract ( 11)    PDF (751KB) ( 1 )    Objective To evaluate the effectiveness of preventive medication in preventing the development of tuberculosis among school students with latent tuberculosis infection and to provide a scientific basis for the necessity of preventive treatment for these students by conducting a two-year follow-up study on 272 cases of latent tuberculosis infection identified at the tuberculosis clinic of Nanning Fourth People's Hospital from 2021 to 2022. Method Students diagnosed with latent tuberculosis infection following tuberculosis screening at Nanning Fourth People's Hospital from January 2021 to January 2022 were divided into an intervention group (preventive medication group) and a control group (non-preventive medication group). The intervention group consisted of 149 individuals, and the control group consisted of 123 individuals, aged 3 to 18 years. General characteristics such as age, gender, boarding status, and history of tuberculosis contact were collected, and the subjects were followed up for 24 months to analyze the incidence of tuberculosis in both groups and to further analyze the risk factors for developing active tuberculosis. Result During the 24 months follow-up, 2 cases out of 149 in the intervention group progressed to active tuberculosis (with 1 case occurring within 1 year), in the control group of 123, a total of 10 cases progressed to active tuberculosis (with 8 cases occurring within 1 year). A statistically significant difference in the incidence of tuberculosis was observed when comparing the two groups at 12 months and 24 months of follow-up (P<0.05). Logistic regression analysis of the factors associated with the development of active tuberculosis from school latent tuberculosis infectors showed that preventive anti-tuberculosis treatment was a protective factor against the progression of latent tuberculosis to active tuberculosis (OR=0.071, P<0.05), and having a history of pulmonary tuberculosis contact was a risk factor for the progression of latent tuberculosis to active tuberculosis (OR=5.546, P<0.05). Follow up results showed that latent tuberculosis patients who did not take preventive medication were more likely to develop symptoms within one year (P=0.019). Conclusion Proactive screening for tuberculosis in schools to identify latent tuberculosis infectors early, and initiating preventive treatment as soon as possible, especially for those with a history of close contact with pulmonary tuberculosis, and conducting preventive treatment within 1 year of confirming recent tuberculosis infection, can reduce the incidence of tuberculosis and help reduce the spread of tuberculosis in schools.

Clinical value of Mycobacterium tuberculosis RNA detection in efficacy monitoring of drug-resistant pulmonary tuberculosis patients Zhou You, He Xi, Huang Lihua, Luo Lanbo, Hu Min, Chen Guibin, Liu Aimei, Huang Qiwen, Yang Xiaobing 2025, 10 (2):  24-28.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.005 Abstract ( 13)    PDF (757KB) ( 1 )    Objective The positive detection rate of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection was compared with that of traditional methods, and the clinical value of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection in monitoring the efficacy of drug-resistant pulmonary tuberculosis patients was explored. Method A total of 117 patients with drug-resistant pulmonary tuberculosis who were hospitalized in the tuberculosis Department of Guangxi Chest Hospital from November 2022 to May 2024 were selected. The positive detection rates of TB-RNA, smear and solid culture were compared at baseline and from 1 to 6 months after treatment. Kappa test was used to evaluate the consistency of TB-RNA and smear results with solid culture results. Result Using clinical diagnosis as a reference standard, the positive detection rate of sputum specimens for TB-RNA testing was higher than that of solid cultures and smears at baseline and during the treatment period of 1-6 months.Among them, there was a statistically significant difference between the baseline and the treatment period of 1 month, 2 month, 4 month and 5 month (P<0.05). At baseline and during 1, 2 and 4 months of treatment, the difference was statistically significant compared with solid culture (P<0.05).Using the results of solid culture and strain identification as reference standards, the sensitivity and negative predictive value of TB-RNA were higher than that of smear at baseline and during 1, 2 and 4 months of treatment. Kappa concordance between TB-RNA and solid culture results was higher than smear. Conclusion TB-RNA has good efficacy in monitoring the efficacy of drug-resistant pulmonary tuberculosis. At present, although it cannot completely replace traditional methods, TB-RNA is more suitable for long-term efficacy monitoring of drug-resistant pulmonary tuberculosis.

Study on the predictive value of serum HNL, IL-6 and PCT for the risk of catheter-related bloodstream infection in long-term hemodialysis Xu Xiaohong, Bian Shuaibo, Dong Jinshan, Zhang Liang 2025, 10 (2):  29-34.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.006 Abstract ( 15)    PDF (843KB) ( 4 )    Objective To explore the influencing factors of long-term hemodialysis catheter-associated bloodstream infection, and evaluate serum human neutrophil lipocalin (HNL), interleukin-6 (IL-6), procalcitonin (PCT). The predictive value of PCT for long-term hemodialysis catheter-related bloodstream infection (CRBSI). Method A total of 82 patients with long-term hemodialysis in Suqian Hospital of Jiangsu Provincial People's Hospital from August 2022 to February 2024 were selected as the study subjects and divided into two groups, namely CRBSI group (n=21) and non-CRBSI group (n=61), according to the CRBSI standard in the Expert Consensus on Vascular Access for Hemodialysis in China. The distribution of pathogenic bacteria, baseline data, disease data, dialysis status and serum HNL, IL-6 and PCT levels in the CRBSI group were analyzed by univariate and multivariate Logistic regression analysis, and the expression levels of serum HNL, IL-6 and PCT in the two groups were compared. Receiver operating characteristic (ROC) was plotted, and the diagnostic efficacy of HNL, IL-6 and PCT for CRBSI was analyzed by using the area under the curve (AUC). Result Blood culture of 21 patients in CRBSI group was performed to identify 48 isolates of pathogenic bacteria. Among them, 10 strains (20.83%) are infected by Gram-negative bacteria (G-) and 38 strains (79.17%) are infected by Gram-positive bacteria (G+). The occurrence of CRBSI was the dependent variable of Logistic regression analysis. Whether CRBSI occurred was the dependent variable of Logistic regression analysis. Logistic regression analysis showed that femoral vein placement site, dialysis time ≥1 year, catheter type without tunnel catheter, increased HNL, IL-6 and PCT were risk factors(P<0.05). The expression levels of serum HNL, IL-6 and PCT in CRBSI group were higher than those in non-CRBSI group (t=3.795, 6.450 and 3.670, all P<0.05). The AUC of HNL, IL-6, PCT and the combined diagnosis of CRBSI were 0.724, 0.875, 0.735 and 0.917, respectively, and the area under the combined curve of the three was the largest. The sensitivity and specificity of the combined prediction of CRBSI were 95.24% and 85.25%, respectively. The sensitivity was significantly higher than that of HNL, IL-6 and PCT single index, and the specificity was significantly higher than that of IL-6 and PCT single index, which had high predictive value (P<0.05). There was no significant difference between the specificity and HNL (P>0.05). Conclusion Elevated serum HNL, IL-6, and PCT have significant value in predicting the risk of long-term CRBSI in hemodialysis. Therefore, the combined application of HNL, IL-6 and PCT in the clinic is conducive to early identification of the risk of CRBSI, providing a strong basis for clinical treatment and prognosis assessment, so as to reduce the risk of infection and case fatality rate of hemodialysis patients.

Relationship between serum procalcitonin, C-reactive protein, soluble myeloid cells trigger receptor-1, soluble cluster of differentiation antigen 14 and infection after fracture internal fixation Qi Rongfu, Zhou Jie, Xie Tong, Yin Haijian 2025, 10 (2):  35-39.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.007 Abstract ( 14)    PDF (944KB) ( 1 )    Objective To explore bacterial distribution and their relationship with serum procalcitonin (PCT), C-reactive protein (CRP), soluble myeloid cells trigger receptor-1 (sTREM-1) and soluble cluster of differentiation antigen 14 (sCD14) in patients with infection after fracture internal fixation. Method A total of 88 patients with infection and 88 patients without infection after fracture internal fixation in Nanjing Tongren Hospital Affiliated to Southeast University School of Medicine were retrospectively enrolled as infection group and control group between March 2021 and March 2024, respectively. The distribution of postoperative infection pathogens was statistically analyzed. The inflammatory indexes were compared among patients with different pathogens and between infection group and control group, and their diagnostic value in postoperative infection was analyzed. The risk factors of postoperative infection in patients with fracture internal fixation were analyzed by univariate and multivariate regression analysis. Result In the 88 patients with postoperative infection, including Gram-negative bacteria [53.41%, mainly on Escherichia coli (25.00%)] and Gram-positive bacteria [46.59%, mainly on Staphylococcus aureus (23.86%)]. Among the 88 patients with postoperative infection, there were 47 cases with Gram-negative bacteria infection (Gram-negative bacteria group) and 41 cases with Gram-positive bacteria infection (Gram-positive bacteria group). The levels of PCT, CRP, sTREM-1 and sCD14 in Gram-negative bacteria group were higher than those in Gram-positive bacteria group (P<0.05). Compared with control group, levels of PCT, CRP, sTREM-1 and sCD14 were higher in infection group (all P<0.05). The results of ROC curves analysis showed that AUC of PCT combined with CRP, sTREM-1 and sCD14 in the diagnosis of postoperative infection was 0.956, greater than that of single index (P<0.05). Univariate analysis showed that there were significant differences in incision type, invasive operation, diabetes mellitus, hypoproteinemia, postoperative use time of antibiotics, PCT, CRP, sTREM-1 and sCD14 between the two groups (P<0.05). Multivariate Logistic regression analysis showed that diabetes mellitus, hypoproteinemia, postoperative antibiotics use time >15d, PCT >101.13mg/L, CRP >72.61mg/L, sTREM-1 >190.37mg/ml and sCD14 >2.13μg/ml were all independent risk factors of postoperative infection in patients with fracture internal fixation (P<0.05). Conclusion The levels of serum PCT, CRP, sTREM-1 and sCD14 are increased in patients with infection after fracture internal fixation, and the incease of inflammatory factors in patients with Gram-negative bacteria infection is more significant than those with Gram-positive bacteria infection. The combined detection of serum PCT, CRP, sTREM-1 and sCD14 has higher diagnostic value in infection after fracture internal fixation.

Analysis of clinical characteristics of patients with TB-damaged pulmonary hypertension Sun Nannan, Xiong Yanmei, Yang Song, Cen Wuqiang, Liu Xueyan 2025, 10 (2):  40-46.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.008 Abstract ( 9)    PDF (802KB) ( 4 )    Objective To analyze the laboratory tests, imaging, echocardiography and hemodynamic characteristics of pulmonary hypertension (PH) associated with tuberculous lung destruction, and to provide clinical evidence for the diagnosis and treatment of such patients. Method A retrospective collection was made of 44 patients with PH associated with tuberculous lung destruction who were hospitalized at Chongqing Public Health Medical Treatment Center from July 1, 2023 to June 30, 2024. Basic demographic information, the extent of lung destruction, laboratory tests, imaging, echocardiography and right heart catheterization data of the patients were collected, and the clinical characteristics of the patients were analyzed. Result The age of patients with PH associated with tuberculous lung destruction was (56.64±11.10) years, and the body mass index (BMI) was (17.95±2.87)kg/m2. The proportion of male patients was 2.1 times that of female patients. D-dimer was 1.06 (0.42, 2.02)mg/L, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 453.00(191.00,1178.00)pg/ml. The left lung was the most frequently involved site of destruction (54.55%). Bronchiectasis was present in 29 cases (65.91%), and pulmonary cavities in 23 cases (52.27%). Pleural thickening was present in 43 cases (97.73%). The estimated pulmonary artery systolic pressure by echocardiography was 53.0 (40.25, 60.75) mmHg. The diameter of the main pulmonary artery was wider in female patients than in male patients (P<0.05). The mean pulmonary artery pressure (mPAP) of the 12 patients who underwent right heart catheterization was 31.00 (29.00, 35.25) mmHg, and the pulmonary vascular resistance (PVR) was 6.02 (3.87, 8.91) WU. Conclusion Patients with PH associated with tuberculous lung destruction have a low BMI level, a higher proportion of male patients than female patients, elevated D-dimer and NT-proBNP, and the destruction often involves the left lung. They also have multiple lung destructions, and hemodynamic indicators suggest a significant increase in PVR.

Correlation between Inflammatory cytokine expression profiles and anti-tuberculosis treatment failure in type 2 diabetes mellitus patients complicated with active tuberculosis Li Jingping, Liu Kai, Kadiliya Abuduweili 2025, 10 (2):  47-53.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.009 Abstract ( 10)    PDF (1252KB) ( 0 )    Objective To explore the correlation between the expression profiles of inflammatory cytokines and anti-tuberculosis treatment failure in type 2 diabetes mellitus (T2DM) patients complicated with active tuberculosis (ATB) (hereinafter referred to as ATB-T2DM patients). Method A total of 294 ATB-T2DM patients who were treated in People's Hospital of Xinjiang Uygur Autonomous Region from December 2020 to September 2023 were selected as the research subjects. All patients received 6 month standard anti-tuberculosis treatment. According to the treatment outcomes within 12 months after starting anti-tuberculosis treatment, they were divided into the treatment failure group(73cases) and the treatment success group(221cases). The basic clinical data and the expression profiles of serum inflammatory cytokines [interleukins (ILs), CXC chemokine ligands (CXCLs)] of the two groups were compared. Binary logistic regression analysis was used to evaluate the risk factors associated with treatment failure. The receiver operating characteristic curve (ROC) and the area under the curve (AUC curve) were employed to assess the efficacy of each risk factor in independently and jointly predicting treatment failure. The calibration curve and the decision curve were utilized to evaluate the accuracy of the joint prediction of each risk factor. Result Among the enrolled patients, 73 cases had treatment failure, with a treatment failure rate of 24.83%. There was a significant difference in the proportion of patients with pulmonary cavities between the treatment success group and the treatment failure group (P<0.05). The levels of IL-1β, IL-6, IL-10, CXCL2, CXCL5, CXCL8, and CXCL10 in the treatment failure group were significantly higher than those in the treatment success group (P<0.05). Binary logistic regression analysis showed that high levels of serum IL-1β, IL-6, IL-10, CXCL5, CXCL8, and CXCL10 were all risk factors for treatment failure (P<0.05). ROC curve analysis indicated that the AUCs of IL-1β, IL-6, IL-10, CXCL5, CXCL8, CXCL10 in independently and jointly predicting anti-tuberculosis treatment failure in ATB-T2DM patients were 0.649, 0.665, 0.617, 0.643, 0.626, 0.650, and 0.819 respectively. The joint prediction efficacy was significantly higher than that of each factor independently (P<0.05). The calibration curve suggested that the joint prediction model based on ILs and CXCLs had a good fit (Hosmer-Lemeshow χ2=10.068, P=0.260), and the decision curve indicated that this model had a high net benefit of use within the risk threshold range of 0-0.9. Conclusion The anti-tuberculosis treatment outcomes of ATB-T2DM patients are closely related to the levels of IL-1β, IL-6, IL-10, CXCL5, CXCL8, and CXCL10. The risk model for treatment failure constructed based on the above-mentioned indicators has a high predictive value.

New Technology Promotion

High dependence of ADC on T2 relaxation time explained by the multiple T2 elements model Wang Yixiang 2025, 10 (2):  54-62.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.010 Abstract ( 11)    PDF (2658KB) ( 0 )    For in vivo diffusion weighted imaging , apparent diffusion coefficient (ADC) has been considered to reflect tissue diffusion. The ADC is widely used in clinical practice, including in the imaging of infectious lesions. It is generally assumed that the diffusion of tumors is restricted, while the diffusion of tissues with more water will be freer. However, the ADC values obtained in actual clinical work often deviate from the expected tissue diffusion. For example, although the abscess contains liquid components, the ADC measured for the abscess fluid is generally very low; while the ADC of some hard tissues such as cartilage and intervertebral discs is very high. Although the abscess fluid may have certain viscosity, myxomas often have high ADC. HCC ADC has been noted to have restricted diffusion relative to the liver. However, as HCCs are mostly associated with increased blood supply and increased proportion of arterial blood supply and higher water content, it is unlikely that HCC has a true lower diffusion. In fact, with the slow diffusion coefficient (SDC) method recently proposed by us, we measured faster diffusion for HCC than for the adjacent liver parenchyma. We proposed that in vivo ADC measure is strongly associated with T2 relaxation time (T2). T2 can be divided into short T2 band (<60ms), intermediate T2 band (60-80ms), and long T2 band (>80 ms, all 3T values). For the short T2 time band, there is a negative correlation between T2 and ADC. For the long T2 time band, there is a positive correlation between T2 and ADC. A tissue likely measures a low ADC if its T2 is close to 70 ms. In this article, we attempt to explain the T2 dependency of ADC with the concept of the intravoxel incoherent motion model. We suggest that we do not routinely use the term of "diffusion restriction" when interpreting clinical high b-value DW images and ADC maps.

Health Management and Prevention and Control Stragegies

Health economic evaluation of Tuberculosis management based on digital technology Li Chengkun, Wang Jinhua, Liu Zhidong, Chen Hao, He Chuwen, Li Xiaofen, Chen Wenjie, Lin Yanwei 2025, 10 (2):  63-69.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.011 Abstract ( 15)    PDF (1543KB) ( 0 )    Objective Evaluate the cost-effectiveness of the WeChat-based Integrated Mobile Management System for Tuberculosis Prevention and Control (refer to We-Supervision System) in tuberculosis control and prevention management. Method The study subjects were TB patients managed in Huizhou City from January 2019 to December 2023, with data sourced from the Huizhou TB Management System. A markov model was constructed to compare the cost-effectiveness of the We-Supervision system with two on-site supervision modes under the directly observed therapy shortcourse (DOTS) strategy. The model operates on an annual cycle over a 30-year time horizon. A 5% annual discount rate was used to discount costs and effects within the model, and net monetary benefit (NMB) was calculated for cost-effectiveness analysis. One-way and probabilistic sensitivity analyses were conducted to assess the impact of parameter uncertainty on the results. Result Compared with the two on-site management modes, the We-Supervision online management achieved a higher cure rate at a lower cost (with a cure rate of 0.4726 at an average cost of 3,681.50 RMB per person). Under the same cost, the effects (cure rates) of the two on-site management decreased by 0.0675 and 0.0831, respectively, compared to We-Supervision. Compared with the on-site management modes of medical staff home visits and patients visiting medical institutions, the NMB of We-Supervision online management were 8,015.39 RMB and 9,216.90 RMB, respectively. The effectiveness of various management strategies were the primary factors influencing the model outcomes. There was a 97.50% probability that the We-Supervision management is cost-effective, indicating that it has cost-effectiveness. Conclusion The We-Supervision System demonstrates cost-effective advantages in tuberculosis management by effectively reducing operational costs while achieving superior control outcomes,as a powerful supplement to the DOTS strategy, it can further improve the effect of tuberculosis prevention and control.

Case Report

2 cases report of abnormal routine blood test results due to Plasmodium infection Zhou Sutao, Cao Xinran, Xu Xueqing, Zhang Bin 2025, 10 (2):  70-74.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.012 Abstract ( 11)    PDF (1391KB) ( 0 )    Due to the reproductive characteristics of Plasmodium parasites, special inclusion bodies are formed in the red blood cells infected with Plasmodium parasites, which can be identified by microscopic examination. Microscopic examination of blood smears has become the most commonly used method for laboratory diagnosis of malaria. However, in the absence of information such as the patient's medical history, diagnosis or corresponding examination orders, laboratory doctors lack sensitivity to Plasmodium parasite infections. This study reports two cases of Plasmodium parasite-infected patients whose red blood cells infected with Plasmodium parasites in peripheral blood led to abnormal blood routine test results. One of the patients showed a pseudo-increase in eosinophils, and the position of eosinophils in the white blood cell scatter plot was abnormal. The other patient showed a pseudo-increase in reticulocyte count, and the reticulocyte scatter plot presented a "starry sky" shape. It was confirmed by microscopic examination of peripheral blood smears and analyzed in combination with the patient's medical history, microscopic counting, and the principle of instrument detection. It was determined that different developmental stages of Plasmodium parasites in red blood cells could lead to different lateral scattered light and lateral fluorescence intensities detected by the instrument and be misjudged as different cells. This analysis can provide a reference for laboratories and clinicians to warn or identify Plasmodium parasite infections through blood routine scatter plots.

An imported case of genotype c severe fever with thrombocytopenia syndrome in shenzhen: clinical and molecular characteristics insights Chen Nixuan, Wu Yanjie, Wan Jia, Chen Yihua, Kong Dongfeng, Zhang Zhen, Shi Xiaolu, Lyu Ziquan, Yang Fan, Wu Chunli, Wang Xiran, Ye Yuhui 2025, 10 (2):  75-80.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.013 Abstract ( 18)    PDF (1605KB) ( 1 )    Severe fever with thrombocytopenia syndrome (SFTS) is an acute natural focal infectious disease caused by the SFTS virus (SFTSV), characterized by fever,gastrointestinal disturbances,thrombocytopenia,and leukopenia. This study reports a severe SFTS case of genotype C imported from Anhui Province to Shenzhen. The patient, an elderly male, resided in a rural area of Taihu County, Anqing City, Anhui Province (a known SFTS natural endemic focus with high tick vector density) and engaged in frequent farming activities two weeks prior to symptom onset, suggesting probable tick-borne transmission. The patient presented with acute onset of persistent fever, leukopenia, progressive thrombocytopenia (minimum 26×109/L), and multi-organ dysfunction (elevated hepatic and myocardial enzymes), meeting diagnostic criteria for severe SFTS. Laboratory testing confirmed SFTSV nucleic acid positivity in both blood and throat swab specimens (Ct values: 27 and 33, respectively), with IgM seropositivity and IgG seronegativity.The whole-genome sequencing results showed that the strain of the case belonged to the C genotype, which was closely related to the Hubei isolate. Supportive therapies including platelet transfusion, intravenous immunoglobulin, and albumin supplementation resulted in clinical recovery after 13 days of treatment. By systematically reviewing the epidemiological history, clinical manifestations, and molecular characteristics of SFTSV, this study highlights the potential risk of cross-regional transmission of SFTSV strains and emphasizes the necessity for non-endemic regions to strengthen early identification and prevention measures for imported SFTS cases, providing critical insights for clinical management and epidemiological surveillance of SFTS.

Review

Advance of common AIDS related opportunistic infections He Xiaoqing, Liu Min, Chen Yaokai 2025, 10 (2):  81-88.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.014 Abstract ( 18)    PDF (783KB) ( 2 )    Opportunistic infections (OIs) are important signs of the manifestation of AIDS in HIV-positive patients, and they often result in their hospitalization and subsequent death. Of note, thanks to the wide distribution and administration of modern antiretroviral therapy (ART), the incidence and mortality of AIDS-related OIs have significantly decreased worldwide. However, due to the high rate of late presentation, the absence of treatment, and/or failure of ART regimen, OIs remain critical causes of hospitalization and death among HIV/AIDS-infected patients in China. A regular screening of patients at higher risk, an early diagnosis, and a standardized treatment are crucial to improve the prognosis of AIDS complicated with OIs. This article aims to review the scientific advances made in the studies of five common OIs, namely pneumocystis pneumonia, cryptococcal meningitis, Talaromycosis marneffei, cerebral toxoplasmosis, and cytomegalovirus retinitis.

Advances in expression and diagnostic value of cleft nucleated cells in patients with pertussis Quan Nali, Peng Mei, Lu Yuanbin, Wang Huiting, Lin Siqiang 2025, 10 (2):  89-93.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.015 Abstract ( 12)    PDF (746KB) ( 2 )    Pertussis is a common infectious disease that seriously endangers the physical and mental health of patients. Its pathogenesis is complex, closely associated with factors such as Bordetella pertussis, toxins, cellular damage, and persistent cough. Clinically, pertussis has a high incidence and numerous risk factors, making early diagnosis and timely treatment particularly critical. In recent years, cleft nucleated cells—special morphological forms of lymphocytes—have garnered extensive attention in pertussis research. These cells can serve as an auxiliary indicator for early diagnosis due to their specific expression in pertussis patients. However, relying solely on cleft nucleated cells for diagnosis may lead to missed or misdiagnosis. Therefore, combining this marker with other specific indicators and detection methods can enhance clinical diagnostic efficacy. Based on domestic and international literature, this paper reviews the expression levels of cleft nucleated cells in pertussis patients and advances in their application for early diagnosis. The goal is to provide a reference for integrating cleft nucleated cells into rapid early diagnostic protocols for pertussis.

Education Feilds

Exploration and analysis of scenario simulation teaching models in the training of advanced physicians for infectious diseases Li Xiaoli, Zou Yang 2025, 10 (2):  100-104.  DOI: 10.19871/j.cnki.xfcrbzz.2025.02.017 Abstract ( 18)    PDF (669KB) ( 1 )    Objective The purpose of this study was to provide training on infectious disease-related knowledge to advanced physicians and explore the advantages of using a scenario simulation teaching model in clinical education. Method A total of 60 advanced physicians who came to Beijing Friendship Hospital, Capital Medical University for advanced training were selected as the research subjects. These participants were randomly divided into a control group and a scenario simulation teaching group. The study focused on malaria, specifically imported malaria cases. The control group received conventional teaching and the scenario simulation teaching group underwent scenario simulation teaching．After completing the teaching sessions, participants were evaluated through both theoretical and practical exams. A survey was conducted to assess their learning experience and effectiveness. Result The scenario simulation group outperformed the control group in both theoretical and practical exams (P<0.05). Participants in the scenario simulation group reported higher interest, better understanding, greater participation, and greater satisfaction with their learning experience compared to the control group (statistically significant with P<0.05). Conclusion The scenario simulation teaching model is a more effective medical education method, which can alleviate the disconnection between the teaching content of infectious diseases and clinical practice, cultivate the clinical thinking of physicians, and improve the ability of doctor-patient communication.