Current Issue

2024 Vol.9 No.6 Published:25 January 2025

Rural Revitalization

Promoting the high-quality development of the imaging discipline of infection and infectious diseases in China With the spirit of the Long March Xu Chuanjun, Gong Lianggeng, Liu Jingzhe, Yin Xiaoping, Bian Jie, Huang Xianping, Zhang Huijuan, He Bo, Lu Yibo, Xing Weihong, Lyu Shengxiu, Wang Gang, Zhang Hua, Tong Juan, Fang Weijun, Jing Yunhang, He Yulin, Shi Yuxin, Li Hongjun, Lu Puxuan 2024, 9 (6):  1-8.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.001 Abstract ( 166)    PDF (2793KB) ( 294 )    The Long March is an immortal monument in the history of the Chinese revolution, a heroic epic of the Chinese nation, and a great feat in human history. By retracing the Long March, we can better promote the spirit of the Long March, inspire people's patriotism and national pride, and promote the construction of socialist spiritual civilization. The expert team of infectious and contagious imaging in China, led by the core leaders of the society, Professor Li Hongjun, Professor Lu Puxuan, and Professor Shi Yuxin, held a series of public welfare activities on the Long March of Infectious Imaging from March to November 2024. A series of public welfare activities have been held successively in Ruijin, Zhaxi, Longyan, Chongqing Qijiang, Guilin, Shijiazhuang, Huining, Guangzhou, Zunyi, Yan'an, and other places. On November 7th, a summary meeting was held in Xiong'an, Hebei. The forms of this series of activities are rich and diverse, including academic achievement exchange, gifting professional and popular science book boxes to grassroots, case discussion and consultation for grassroots medical institutions, and conducting red education. With the theme of "pursuing the Long March, promoting the spirit of the Long March, shouldering the mission of the times, and helping the rejuvenation of China", we adhere to the purpose of "promoting patriotism as the core, academic exchange and dissemination as the carrier, and strengthening team humanistic construction as the connotation". 208 experts participated in the event, 11 academic exchanges were held, and more than 2300 grassroots radiologists participated in the learning. 15 on-site academic guidance sessions at the grassroots level, and 5 multidisciplinary consultations for difficult cases at the grassroots level. This series of activities has achieved good social benefits and fruitful results, effectively promoting the better inheritance and promotion of infectious imaging, more grassroots services, and higher medical quality development, making the Long March spirit shine brightly in the construction of China's infectious disease imaging discipline. In order to further promote the development of China's infection and infectious imaging industry, a summary and commendation conference was held on November 7, 2024 in Xiong'an New Area, Hebei. During the conference, the "Bole Award", "Spark Award" and "Future Star Award" were commended.

Prevention and Treatment of Dengue Fever

Analysis of the serum metabolome of 19 dengue fever patients in Shenzhen Hu Xiao, Gu Yuchen, Song Jiamin, Ke Zhiyi, Zeng Lijiao, Zhang Liting, Yuan Jing 2024, 9 (6):  9-13.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.002 Abstract ( 148)    PDF (1456KB) ( 203 )    Objective To explore the metabolomic changes in the serum of dengue patients through comparative analysis of the metabolome of patients infected with dengue virus (DENV) and healthy people. Differential analysis and pathway analysis were performed to understand the host's metabolic response to the virus and to search for possible biomarkers. Method 19 dengue fever patients who visited Shenzhen Third Peoples Hospital from June 2023 to October were used as the research subjects, and 11 healthy people were used as controls. Their serum was collected for non-targeted metabolomic analysis. Use bioinformatics methods to conduct differential analysis and pathway analysis to screen differentially expressed metabolites and find host metabolic pathways affected by viral infection. Result Overall principal component analysis (PCA) and relative standard deviation (RSD) showed that the quantitative results of biological replicate samples were statistically consistent. Compared with the normal population, the serum metabolites of dengue patients in the experimental group were significantly different. A total of 114 metabolites showed significant expression differences（P<0.05,Fold Change≥1.5 or ≤2/3）. The HMDB annotation classification of differential metabolites showed that the differential metabolites were mainly concentrated on lipid metabolites. Conclusion The serum metabolomic profile of dengue patients significantly differs from that of healthy individuals, primarily characterized by alterations in lipid metabolism. These findings suggest that dengue virus infection modifies the host's lipid metabolism pathway, providing a theoretical foundation for understanding the pathogenesis of dengue virus infection and contributing to the diagnosis and prognosis of dengue fever.

Epidemiological characteristics of dengue fever in Shenzhen, Guangdong Province, 2013-2023 Niu Dandan, Wan Jia, Kong Dongfeng, Lyu Qiuying, Niu Cong, Liu Wei, Yang Fan, Lin Liangqiang, Chen Yixiong, Zhu Yi, Huang Zhenyu, Zhang Zhen, Feng Tiejian 2024, 9 (6):  14-19.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.003 Abstract ( 321)    PDF (1302KB) ( 378 )    Objective To analyze the epidemiological characteristics of dengue fever in Shenzhen from 2013 to 2023 so as to provide the basis for formulating comprehensive prevention and control measures. Method According to the data from the Chinese Disease Prevention and Control Information System and the epidemiological investigation of dengue fever in Shenzhen, Guangdong Province, descriptive epidemiological methods were applied to analyze the distribution characteristics of the cases, the place of infection, the time from onset to diagnosis, the outbreak situation and the results of pathogen surveillance. Result From 2013 to 2023, a total of 1774 cases of dengue fever were reported in Shenzhen, including 955 local cases, 564 imported cases from abroad and 255 imported cases from China. 2014 (454 cases), 2019 (523 cases) and 2023 (386 cases) were the three high incidence years, among which 2014 and 2023 were dominated by local cases, and 2019 was dominated by imported cases. The cases were mainly concentrated from August to November (83.8%). Cases occurred in 10 administrative districts of Shenzhen, covering 94.6% of the total number of streets in the city. The mean age of the patients was 38.2±13.6 years, mainly in the age group of 20-<50 years. The male to female ratio was 1.9 to 1; Most of the cases were workers, domestic workers, unemployed people and business people, accounting for 49.3% (874/1774). Overseas imported cases were mainly from Southeast Asian countries (478/564, 84.8%), and domestic imported cases were mainly from the Pearl River Delta region (157/255, 61.6%). The median interval between the onset time and diagnosis time of cases was 4.7 (2.6, 6.8) days, and the interval showed a decreasing trend from 2016 to 2023, especially for local cases. There were 24 local outbreaks, mainly at construction sites (12), with the most occurring in October (11). There were a variety of dengue virus serotypes, and type Ⅰ was the dominant type, accounting for 87.2% (937/1075). Conclusion The risk of dengue epidemic transmission in Shenzhen was high, and the local cases were mainly caused by imported cases. It has obvious spatiotemporal aggregation.

Clinical characteristics of 84 adult patients with dengue fever complicated with central nervous system injury Yang Huiqin, Lin Zhuohang, Jin Kanghong, Liao Lu, Leng Xingyu, Wang Jian, Hong Wenxin, Wang Changtai, Zhao Lingzhai, Feng Jiamin, Li Linghua, Li Chuo, Zhang Fuchun 2024, 9 (6):  20-25.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.004 Abstract ( 158)    PDF (951KB) ( 177 )    Objective To analyze the clinical features of adult patients with dengue fever complicated with central nervous system(CNS) injury, and to provide evidence for the diagnosis and treatment of dengue fever complicated with CNS injury. Method The clinical database of dengue fever in our hospital was used to select adult patients with dengue fever complicated with CNS injury, and they were divided into non-elderly and elderly groups according to age <60 years. The general information, clinical manifestations, laboratory examination, cerebrospinal fluid examination, and cytokines detection results were compared and analyzed between the two groups. Result 84 cases of dengue fever complicated with CNS injury were included, 27 were non-elderly (32.1%), and 57 were elderly (67.9) %, with a median age of 72.5 years, 45 were male (53.6%), Of the 84 patients, the main forms of manifestations were encephalopathy (34 cases, 40.5%), lacunar infarction (15 cases, 17.9%), cerebral ischemia (11 cases, 13.1%), and encephalitis (11 cases, 13.1%). 72 cases (85.7%) were severe dengue, 86.2% of the patients were infected with dengue virus type 1. There were 64 cases (76.2%) of patients with underlying diseases, mainly hypertension (43 cases, 51.2%), diabetes (24 cases, 28.6%) and heart disease (20 cases, 23.8%). The clinical manifestations were mainly headache (36 cases, 42.9%), coma (36 cases, 42.9%), dizziness (29 cases, 34.5%), lethargy (23 cases, 27.4%), vomiting (18 cases, 21.4%), agitation/seizure (17 cases, 20.2%). 33 cases (39.3%) were found to have combined damage to other organs, 15 cases (17.9%) had serious bleeding in other parts of the body, and 54 cases (64.3%) showed signs of plasma leakage. The laboratory tests mainly showed a significant decrease in platelet and albumin levels, a significant increase in cytokine levels. Positive results for pathogenic examination of cerebrospinal fluid in 4 cases (22.2%). After treatment, 67 cases (79.8%) improved, while 17 cases (20.2%) deteriorated. The proportion of patients with underlying diseases, hypertension, and heart disease in the elderly group were significantly higher than that in the non-elderly group (P<0.05), and the proportion of patients with lethargy in the elderly group was significantly higher than that in the non-elderly group (35.1% vs 11.1%, P<0.05). There was no significant difference in prognosis between the two groups. Conclusion The majority of dengue fever patients with CNS injury are elderly, with a high proportion of combined with hypertension, diabetes and heart disease. Encephalopathy is the most common form. The manifestations are mainly headache, coma, lethargy, and dizziness, suggesting that it is necessary to be alert to the possibility of CNS injury when consciousness level changes, and early cerebrospinal fluid examination can help clarify the diagnosis.

Prevention and Treatment of Brucellosis

The value of MRI in differentiating Modic type Ⅰspinal degenerative changes from early spondylitis in patients with brucellosis Li Junlin, Ding Haitao, Wang Lina, Yin Songtao, Zhao Nan 2024, 9 (6):  26-31.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.005 Abstract ( 183)    PDF (1113KB) ( 142 )    Objective To explore the application value of MRI in the differential diagnosis of early spondylitis in brucellosis patients and Modic typeⅠ spinal degeneration, and to provide imaging reference for the differential diagnosis of the two. Method Fifteen patients diagnosed with early brucellosis spondylitis admitted to the People's Hospital of Inner Mongolia Autonomous Region from January 2020 to May 2024 were selected as the BS group, and 17 patients with lumbar Modic type Ⅰ spinal degeneration were selected as the MⅠ group. All patients underwent MRI examination. The morphology, signal, bone change and enhanced image pattern of the diseased vertebral body and adjacent discs of the two groups were compared respectively. Result The 15 patients in BS group had 28 vertebral body lesions, with an average age of 47.88 years. A total of 27 vertebral bodies were involved in 17 patients in MⅠ group with an average age of 53.60 years. Vertebrae prone to lesions in BS group: L4, accounting for 28.57% (8/28); The lesions were mainly characterized by hypointense on T1WI (13/28, 46.43%), clear boundary on T2WI (24/28, 85.71%) and discontinuous end-plate contour on T1WI (24/28, 85.71%). No positive DWI claw sign was found. Lesion enhancement 100% (17/17); 10.71% (3/28) of the vertebral bodies had bone destruction. Most lesions were fan-shaped or stripe-shaped (23/28, 82.14%). T2WI hyperintensity of intervertebral disc was 83.33% (15/18). In MⅠ group, the lesion was L5, accounting for 33.33% (9/27), and the lesion was mainly iso-hypointensity such as T1WI (18/27, 66.67%). The incidence of hyperintense in T1WI was 11.11% (3/27). The main lesions were blurred boundary on T2WI (18/27, 66.67%) and continuous endplate contour on T1WI (22/27, 81.48%). DWI claw positive 100% (7/7); Lesion enhancement 100% (7/7); Some vertebrae had bone destruction 14.81% (4/27); Segment or strip shape of the lesion 62.96% (17/27). Intervertebral disc T2WI hyperintense accounted for 20.00% (3/15). Conclusion :DWI claw sign is positive, indicating MⅠ clearly. T1WI endplate contour is continuous, MⅠ possibility is high; Involved intervertebral disc T2WI hyperintense, BS is more likely; T1WI hyperintense appeared in the lesion, indicating MⅠ. The above features are significant for the differential diagnosis of early spondylitis in brucellosis patients and ModicⅠspinal degeneration. Lesion morphology and enhancement have little value in the differential diagnosis of the two, and are not recommended as differential indicators.

Analysis of MRI signs of Brucella spondylitis based on clinical and biological examinations Yin Songtao, Ding Haitao, Li Junlin, Zhang Xiaoqin, Zhao Nan, Ma Yuting 2024, 9 (6):  32-35.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.006 Abstract ( 144)    PDF (1262KB) ( 123 )    Objective Analyze the MRI imaging characteristics of Brucella spondylitis to provide assistance for further clinical diagnosis and treatment. Method Retrospective analysis of spinal MRI imaging data confirmed by clinical pathology or biological examination from January 2022 to January 2024 for Brucella spondylitis, Statistical analysis of characteristic data, including the location and number of affected vertebral bodies, the morphology and signal intensity of affected vertebral bodies, the morphology and signal intensity of affected intervertebral discs, as well as changes in intervertebral spaces and paraspinal soft tissues. Result 23 patients with Brucella spondylitis comprised 16 males and 7 females, aged from 37 to 82 years with an average of 62.8 years. Lesions were identified in 2 cervical, 1 thoracic, and 2 sacral vertebra, with up to 18 cases in the lumbar vertebrae. A total of 45 vertebral bodies were affected, with the L4 vertebra being the most frequently involved (16 cases), sometimes extending to adjacent vertebral edges. In 23 cases, vertebral bodies exhibited abnormal morphology and signal, similarly, 18 cases had abnormal intervertebral disc morphology and signal, an incidence of 78.2%, 12 cases had intervertebral space abnormalities, an incidence of 52.2%, and 3 cases had paravertebral abnormalities, an incidence of 13.0%. The formation of osteophyte at the anterior edge of the diseased vertebral body (parrot beak sign) is a characteristic manifestation of BS, with MRI T1WI showing iso low signal and T2WI showing high signal. Conclusion MRI has certain advantages in the diagnosis of Brucella spondylitis. Drawing upon clinical presentations and biological assessments, along with MRI imaging features, one can accurately diagnose the condition.

New Technology Promotion

Magnetic resonance diffusion derived vessel density: concepts and potential diverse applications Wang Yixiang, Yao Dianqi, Li Caiying, Xiao Benheng, Akmal Sabarudin, Giuseppe Guglielmi 2024, 9 (6):  36-41.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.007 Abstract ( 253)    PDF (3560KB) ( 178 )    On diffusion-weighted (DW) imaging, blood vessels show high signal when there is no diffusion gradient (b=0s/mm2), while they show low signal even when very low b-values (such as b=1 or 2s/mm2) are applied. Thus, the signal difference between images when the diffusion gradient is ‘off’ and images when the diffusion gradient is‘on’reflects the extent of tissue vessel density. We measure this via MRI diffusion derived vessel density (DDVD). For spin-echo type echo-planar imaging sequence, the second motion probing gradient after the 180-degree radiofrequency pulse could not fully re-focus the flowing spins in vessel and micro-vessels after being de-phased by the first motion probing gradient before the 180-degree radiofrequency pulse. The analysis of DDVD requires only two b-values (with one being b=0s/mm2 and the other being a non-zero low b-value), with a significantly shorter scanning time than contrast enhanced CT/MRI while without the need of a contrast agent injection and without radiation associated with CT. DDVD measure appears to be useful as a straightforward imaging biomarker in diverse clinical scenarios, including hepatitis B liver fibrosis, hepatocellular carcinoma, rectal carcinoma, liver hemangioma, early preeclampsia placenta, placenta accreta spectrum disorder, ischemic penumbra of brain stroke.

Original Articles

Analysis of clinical characteristics of refractory Mycoplasma pneumoniae in macrolide-resistant children Zheng Jun, Wu Qiyue, Zeng Xia, Zhang Dufei 2024, 9 (6):  42-47.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.008 Abstract ( 178)    PDF (1212KB) ( 191 )    Objective Via observing the clinical characteristics of refractory Mycoplasma pneumoniae pneumonia (RMPP) caused by macrolide-resistant Mycoplasma pneumoniae (MRMP) infection in children, to explore its clinical significance in the timely diagnosis and treatment of children with RMPP. Method The clinical data of 1226 hospitalized children with RMPP from January 2022 to December 2023 in the Hainan Women and Children's Medical Center were analyzed retrospectively. Bronchoscopy and bronchoalveolar lavage fluid (BALF) were performed on each subject and MRMP-DNA in the BALF were taken to detect the 23S rRNA V region mutation sites. Children with RMPP were divided into macrolide-resistant group and control group (non-macrolide-resistant group) depending on the gene detection results. Result A total of 1226 children with RMPP were recruited, including 869 cases in the macrolide-resistant group and 357 cases in the control group. Among them, there were 369 males (51.7%) and 555 females (48.3%). The average age in the macrolide-resistant group [(6.12±2.98) y] was higher than that in the control group [(2.82±2.19) y] (P<0.001). The fever time in the macrolide-resistant group [(6.61±1.77) d] was longer than that in the control group [(5.33±1.09) d] (P<0.001). Compared with the children with RMPP in the control group, the values of white blood cell count(WBC), percentage of neutrophil (NE%), high sensitive C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), and interleukin-6 (IL-6) were higher in the macrolide-resistant group, the differences were statistically significant (P<0.05); Compared with the children with RMPP in the control group, the incidences of severe MPP (SMPP)/fulminant MPP (FMPP), extra-pulmonary complications, severe mucosal lesions(erosion, ulcer or necrosis), endotracheal plastic phlegm plug, pleural effusion and necrotic pneumonic were higher in the macrolide-resistant group, the differences were statistically significant (P<0.05). The average hospitalization day in the macrolide-resistant group [(6.59±1.63) d] was longer than that in the control group [(5.32±1.38) d] (P<0.001). Conclusion The clinical manifestations of RMPP children caused by MRMP infection were more serious, with longer fever time, longer hospital stay, more severe inflammatory reaction and more intrapulmonary and extrapulmonary complications. Timely implementing bronchoscopy in children with RMPP and collecting BALF samples for testing may have important values for guiding the correct clinical diagnosis and treatment.

Expression significance of miR-155 and miR-181a in peripheral blood of patients with HBV-associated hepatocellular carcinoma Wang Ling, Liu Zhidong, Zhou Dandan 2024, 9 (6):  48-53.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.009 Abstract ( 119)    PDF (1141KB) ( 159 )    Objective To explore the expression levels of microribonucleic acid-155 (miR-155) and microribonucleic acid-181a (miR-181a) in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), analyze their diagnostic value for HBV-related HCC, as well as their relationship with clinical pathological characteristics and survival prognosis. Method A total of 117 HBV-related HCC patients who received treatment in Chongqing Hospital of Traditional Chinese Medicine from January 2017 to January 2021 were selected as the hepatocellular carcinoma group, and 117 cases of HBV-related benign liver disease were selected as the benign liver disease group. The peripheral blood was collected for comparison between the two groups on miR-155 and miR-181a expression differences, and analysis of the relationship between miR-155 and miR-181a expression and the pathogenesis and clinical pathological characteristics of HBV-related HCC patients. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of peripheral blood miR-155 and miR-181a expression for HBV-related HCC. After a 3-year follow-up, the impact of miR-155 and miR-181a on the survival rate of HBV-related HCC patients was analyzed using Kaplan-Meier method. Result The expressions of miR-155 and miR-181a in peripheral blood of hepatocellular carcinoma group were higher than those of benign liver disease group (P<0.05). The expression of miR-155 and miR-181a in peripheral blood was positively correlated with the onset of HBV-related HCC, HBV-DNA load, portal vein invasion, clinical stage and lymph node metastasis, and negatively correlated with the differentiation degree (P＜0.05). The area under the curve (AUC) values of miR-155 and miR-181a in peripheral blood for diagnosing HBV-related HCC were 0.768 and 0.818, respectively, and the AUC value of combined diagnosis was 0.923, which was significantly higher than that of individual diagnosis. At this time, the optimal sensitivity and specificity were 83.76% and 88.03%, respectively. The 3-year survival rate of miR-155 high expression subgroup was 82.14%, significantly lower than that of low expression subgroup (94.74%) (P＜0.05). The 3-year survival rate of miR-181a in the high-expression subgroup was 80.36%, which was significantly lower than that in the low-expression subgroup (96.49%) (P＜0.05). Conclusion The expression of miR-155 and miR-181a in peripheral blood of HBV-related HCC patients is abnormally elevated, and both of them are involved in the pathogenesis and malignant progression of HBV-related HCC. The detection of their levels is of certain value for disease diagnosis and prognosis prediction.

Effects of antiviral therapy on HCV core antigen, hepatic steatosis, and fibrosis in patients with chronic hepatitis C genotype 1 Gao Xingjuan, Cheng Lei, Ma Xiuqing, Liu Shouzhu, Wang Baoying, Liu Haiyan, Cai Deji, Yang Xingtang 2024, 9 (6):  54-59.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.010 Abstract ( 161)    PDF (966KB) ( 123 )    Objective To determine the changes in hepatitis C virus core antigen (HCV Ag), controlled attenuation parameter (CAP), and fibrosis index based on 4 factors (FIB-4) during direct antiviral agent (DAA) treatment in patients with chronic hepatitis C (CHC) genotype 1, and their relationship with treatment outcomes. Method Fifty-one CHC patients who were treated with DAA in Our hospital from March 2020 to May 2021 were selected as the study objects. Sustained virological response (SVR) 12 was defined as a sustained virological response of less than 12U/ml at the end of 12 weeks of treatment HCV Ag and HCV RNA levels were assessed at baseline, 4 weeks of treatment, 8 weeks of treatment, at the end of treatment, and 12 weeks after the end of treatment. HCV Ag was determined by chemiluminescent microparticle immunoassay. CAP and FIB-4 were assessed at baseline, at the end of treatment, and 12 weeks after treatment. Result A total of 49 patients (96.08%) were positive for both HCV Ag (>3fmol/L) and HCV RNA at baseline, and the remaining 2 patients were positive only for HCV RNA (124U/ml and 876U/ml, respectively). By SPSS Spearman rank correlation analysis, there was a significant positive correlation between HCV Ag and HCV RNA at baseline (P< 0.001). During DAA treatment, 56.86% of patients had no detectable HCV Ag at week 4, 84.31% at week 8, and 100% at the end of treatment. Twelve weeks after the end of treatment, 49 patients (96.08%) achieved SVR 12, and HCV Ag and HCV RNA tests were highly consistent. Both HCV Ag and HCV RNA at 4 and 8 weeks of treatment had higher positive predictive values in predicting SVR12. CAP values were significantly increased at 12 weeks after treatment compared with baseline (P<0.05). FIB-4 values at the end of treatment and 12 weeks after treatment were significantly decreased (P<0.05), and FIB-4 was further decreased at 12 weeks after treatment than at the end of treatment (P<0.05). Finally, there was a positive correlation between the change in FIB-4 from baseline and baseline HCV Ag at 12 weeks after treatment (P<0.05). Conclusion During DAA treatment, the use of HCV Ag can monitor the treatment outcomes of genotype 1 HCV patients, and DAA improves liver fibrosis in patients. On the other hand, there is an increasing trend of liver steatosis.

Case Report

A case of childhood high immunoglobulin M immunodeficiency syndrome combined with Talaromyces marneffei infection and active pulmonary tuberculosis Zhao Chunyan, Song Chang, Li Qiang, Huang Aichun, Wei Xiaoying, Zeng Chunmei, Zhu Qingdong 2024, 9 (6):  60-63.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.011 Abstract ( 181)    PDF (1736KB) ( 163 )    High immunoglobulin M(HIGM) is a rare immune deficiency disorder caused by genetic mutations. Due to the compromised immune system, individuals are prone to various opportunistic infections and can develop the condition as infants. This case reports a 2-year and 8-month-old male child with HIGM immunodeficiency syndrome, who was diagnosed with the condition at another hospital due to recurrent pneumonia. He was later referred to our hospital for treatment after developing tuberculosis and lymph node tuberculosis. Despite anti-tuberculosis treatment, the patient continued to have fever and developed nausea and vomiting during hospitalization. A cerebrospinal fluid metagenomic analysis identified Talaromyces marneffei. Considering the intracranial infection by Talaromyces marneffei, we administered anti-tuberculosis and antifungal treatment along with immunoglobulin supplementation for immune support. The patient's temperature gradually decreased, and cerebrospinal fluid protein levels normalized. After completing the antifungal and anti-tuberculosis treatments, the patient received intravenous immunoglobulin every 3-4 weeks for immune support, along with clinical follow-up and monitoring of immunoglobulin levels. The patient's condition is currently stable with normal growth and development.

AIDS complicated with progressive multifocal leukoencephalopathy: a case report Hu Diangui, Chen Xiaodong, Wen Shifei, Zhu Daqing, Zhang Lunli 2024, 9 (6):  64-67.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.012 Abstract ( 157)    PDF (978KB) ( 161 )    AIDS patients are prone to central nervous system infection due to decreased immunity, and JC virus infection can lead to progressive multifocal leukoencephalopathy (PML). There is no specific treatment for this disease, and before the advent of antiviral therapy (HARRT), the case fatality rate was extremely high. This article reports a young male patient who developed symptoms of unilateral limb numbness and progressively worsened numbness in the hind limbs. He was initially screened positive for HIV antibodies and admitted to the hospital. Previously healthy with no underlying diseases. After admission, CD4+T lymphocytescount was 30 cells/µl, 6.64×104 copies/ml of HIV RNA in blood, 5.16×103 copies/ml of HIV RNA in cerebrospinal fluid, and JC virus was detected by metagenomic second-generation sequencing (mNGS) in cerebrospinal fluid. Combined with the MRI findings of the patient's head, PML caused by AIDS was clinically diagnosed. After early initiation of HARRT, the patient's limb function gradually recovered and returned to normal life. Through this case, the clinical characteristics, imaging manifestations and antiviral treatment plan of AIDS combined with PML are discussed in this paper, aiming to improve the vigilance of clinicians. When HIV patients have neurological dysfunction, it is necessary to determine whether PML is combined or not, and early initiation of HARRT can improve the prognosis of patients.

Review

Progress in the detection of human papillomavirus by isothermal amplification technology Li Hongyi, Ma Xuejun, Tie Yanqing, Shen Xinxin 2024, 9 (6):  68-73.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.013 Abstract ( 187)    PDF (906KB) ( 335 )    Cervical cancer is the fourth most common female cancer in the world. Almost all cases of cervical cancer are associated with human papillomavirus (HPV) infection, so early detection of HPV infection is essential for cervical cancer prevention. The World Health Organization recommended HPV DNA testing as the primary screening method. Isothermal amplification technology is more suitable for HPV testing because it is easier to operate and more efficient than variable temperature amplification technology, which requires less laboratory conditions, less operator effort, and lower economic costs. This paper comparatively analyses the advantages and disadvantages of isothermal amplification techniques used for HPV detection, commonly used amplification product readout methods and the current status of the application of isothermal amplification techniques in combination with other techniques (e.g., microfluidic chip technology, CRISPR-Cas technology, smartphone assay, and lateral flow dipstick) for detection of HPV. At last, the advantages and disadvantages of these methods and techniques are analyzed, their suitable application scenarios are elaborated, and the shortcomings of isothermal amplification techniques are summarized and the prospects for their development are outlooked.

Standards/Guidelines/ConsensusStandards/Consensus

Expert consensus on diagnosis and treatment of the post-tuberclulosis chronic pulmonary aspergillosis Zhang Peize, Zhao Manman, Wei Fangjun, Shi Huaifang, Deng Guofang, Lu Hongzhou 2024, 9 (6):  74-84.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.014 Abstract ( 368)    PDF (1019KB) ( 505 )    Chronic pulmonary aspergillosis (CPA) is a high fatality rate disease with atypical symptoms,and often occurring in residual cavities left after successful tuberculosis treatment. Due to its similar symptoms to tuberculosis, it is easy to be misdiagnosed. In China, a complete set of diagnosis and treatment norms for the post-tuberclulosis chronic pulmonary aspergillosis(post-TB CPA) has not been formulated. Therefore, this consensus referred to the relevant guidelines and consensus both domestically and internationally, organizing a centralized discussion among experts in the fields of tuberculosis, respiratory medicine, infectiology, microbiology, imaging and pathology. They formulated 13 recommendations to provide a reference for the standardized diagnosis and treatment and scientific management of patients with CPA after tuberculosis. These recommendations cover many aspects such as epidemiology, evidence-based medicine, and clinical diagnosis and treatment, aiming to improve the diagnosis and treatment level of post-TB CPA, reduce misdiagnosis and missed diagnosis, and ultimately improve patient outcomes.

Interpretation of Dengue fever diagnosis and treatment plan (2024 Edition) Wang Chenglong, Jiang Guochen, Liu Jingzhe 2024, 9 (6):  85-91.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.015 Abstract ( 495)    PDF (933KB) ( 538 )    With global climate change and increasing population mobility, the prevalence of dengue fever continues to expand, posing a threat to public health safety. The Dengue Diagnosis and Treatment Plan (2024 Edition) has emerged with the aim of standardizing clinical diagnosis and treatment work, and improving the diagnosis and treatment level of dengue fever. This article interprets the main content of the Dengue Fever Diagnosis and Treatment Plan (2024 Edition) and provides clinical doctors with diagnosis and treatment guidelines. Comprehensively analyze the pathogenic characteristics, epidemiological features, pathogenesis, clinical manifestations, laboratory tests, diagnosis, severe dengue fever, high-risk populations and early warning indicators, differential diagnosis, treatment principles, traditional Chinese medicine syndrome differentiation and treatment plans, prognosis and prevention measures of dengue fever. The 2024 diagnosis and treatment plan emphasizes the importance of early identification and treatment of dengue fever, proposes high-risk populations and early warning indicators for severe dengue fever, and highlights the key points of differential diagnosis. The treatment plan covers general treatment, symptomatic treatment, and treatment of severe dengue fever, with a special emphasis on the importance of traditional Chinese medicine's syndrome differentiation and treatment. The Dengue Diagnosis and Treatment Protocol (2024 Edition) provides a comprehensive set of diagnostic and treatment guidelines for clinical doctors, which helps to improve the diagnostic accuracy and treatment effectiveness of dengue fever, and reduce the severity and mortality rates. At the same time, the plan also emphasizes the importance of prevention measures, pointing out the criticality of cutting off transmission routes and strengthening personal protection.

2024 WHO Tuberculosis Report: key data analysis for China and the global world Li Yuanyuan, Xie Jingjing, Li Shutao, Su Dongdong, Zheng Tian, Lu Puxuan, Peng Yi 2024, 9 (6):  92-97.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.016 Abstract ( 1626)    PDF (1276KB) ( 830 )    It is estimated that in 2023, there were 10.8 million new cases of tuberculosis globally, with China recording 741 000 new cases (accounting for 6.8% of the global incidence rate), ranking third among the 30 high-burden countries for tuberculosis. The global death toll from tuberculosis was approximately 1.25 million, with an estimated 27 000 deaths in China. In 2023, there were about 400 000 cases of multi-drug resistant/rifampin-resistant tuberculosis globally, with approximately 29 000 cases in China. From 2015 to 2023, the incidence rate of tuberculosis decreased by 8.3%, and the net decrease in deaths was 23%. However, about 50% of tuberculosis patients and their families still face catastrophic expenses, which is far from the 2025 milestone set by the World Health Organization's End TB Strategy. In 2023, global tuberculosis diagnosis and treatment services further recovered, with 8.2 million new cases of tuberculosis diagnosed and reported globally, the highest since the WHO began monitoring global tuberculosis data in 1995. However, there is still a gap of approximately 2.7 million cases between the reported and estimated numbers. Against the backdrop of a rising global tuberculosis burden, it is urgent to strengthen resource investment and multi-party cooperation. The WHO calls on countries to increase their efforts in tuberculosis prevention and control to address this increasingly severe global health threat. Compared to global data, China has made certain progress in tuberculosis prevention and control, with a relatively high treatment success rate and wide coverage. However, China still has a significant gap with global goals in terms of drug resistance monitoring, economic support, and preventive treatment. In the future, it will require joint efforts from the government and all sectors of society to continuously increase investment and prevention and control efforts to achieve the strategic goal of "ending tuberculosis".

Education FieldEducation Field

The value of multi-disciplinary team combined with problem based learning teaching method in improving the cognitive ability of infectious diseases among master's students majoring in radiology Sun Mingyang, Luo Jiawen 2024, 9 (6):  99-103.  DOI: 10.19871/j.cnki.xfcrbzz.2024.06.017 Abstract ( 152)    PDF (1031KB) ( 205 )    Objective To explore the value of multi-disciplinary team (MDT) combined with problem based learning (PBL) in improving the cognitive ability of infectious diseases among master's students majoring in radiology, and to compare the effect with the traditional LBL teaching method. Method A total of 38 master's degree students in imaging were selected from the class of 2021-2023 in the Second Hospital of Dalian Medical University and randomly enrolled into either the MDT combined PBL group or the LBL group. The MDT combined PBL group adopted the MDT combined PBL teaching method, and the LBL group adopted the traditional LBL teaching method. The quality of teaching was assessed by student satisfaction and final examination at the end of the lectures. Result In the three aspects of learning interest development, understanding and application of theoretical knowledge, and cross-disciplinary knowledge mastery, the total satisfaction of the MDT joint PBL group was no statistical difference between the two groups (P>0.05). The two teachers graded the final papers of the students in the two groups separately, and intra-class correlation coefficient（ICC） was 0.927, the mean score of the final paper in the MDT combined with PBL group was (82.44±4.37), which was higher than the mean score of the LBL group (69.00±6.10), and the difference was statistically significant (P<0.05). Conclusion The teaching effect of MDT combined with PBL teaching method in the teaching of infectious diseases for master's degree students majoring in radiology is better than that of traditional teaching methods.