Current Issue

2025 Vol.10 No.4 Published:31 August 2025

Special Topic on Prevention and Control of Chikungunya Fever

Epidemiological challenges and public health strategies for chikungunya fever prevention and control in China Xu Xuwen, Cai Shaohang, Mo Xichao, Xia Muye, Xu Yuyuan, Peng Jie 2025, 10 (4):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.001 Abstract ( 86)    PDF (921KB) ( 44 )    Chikungunya fever (CHIKF) is a mosquito-borne infectious disease caused by the chikungunya virus (CHIKV), primarily transmitted through Aedes aegypti and Aedes albopictus mosquitoes. In recent years, with global climate warming and the expansion of international travel, the endemic range of CHIKV has continued to expand, making it a significant global public health threat. Infected individuals typically present with fever, arthralgia, and rash, and some patients developing chronic arthritis that severely affects quality of life. Currently, there are no specific antiviral treatments for CHIKF, and vaccines have not yet achieved widespread coverage, making epidemic surveillance and vector control crucial for curbing disease transmission. This article reviews the virological characteristics, epidemiological status, clinical manifestations, and diagnostic methods of CHIKV, analyzes current challenges in prevention and control efforts, and proposes comprehensive strategies integrating multidisciplinary collaboration, technological empowerment, and social mobilization, providing insights for China's response to CHIKF and other mosquito-borne diseases.

Analysis of clinical characteristics of 213 adult cases of chikungunya fever in Foshan, 2025 Zhang Qingsen, Yan Haiming, Chen Xiaoyan, Li Zhandong, Tang Xi, Zhou Huiling, Gan Liangyan, Chen Songming, Pan Jiehui, Su Zhaobing, Liu Jinfeng, Zhang Cuiyun, Yue Yuanming, Han Jing, Chen Jian, Xu Huijuan, Luo Haifei, Yuan Wenchun, Lin Jinnian, Wang Wenjia, Bai Honglian, Ye Yinong 2025, 10 (4):  7-12.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.002 Abstract ( 104)    PDF (1366KB) ( 32 )    Objective This study aimed to explore the clinical characteristics of adult patients with chikungunya fever in Foshan, to provide a scientific basis for the early diagnosis and differential diagnosis of this disease. Method A total of 213 hospitalized confirmed chikungunya fever patients in July 2025 were investigated and analyzed. By collecting epidemiological data, clinical manifestations, and laboratory test results of these patients, we conducted a comprehensive analysis of their clinical characteristics. Result Among the 213 patients, the median age was 53 years, and males accounted for 53.5% (114/213). The initial symptoms included fever (32 cases, 15.0%), arthralgia (74 cases, 34.7%), and rash (18 cases, 8.5%). During the disease course, the incidences of clinical manifestations were as follows: arthralgia (90.1%), fever (83.1%), rash (70.0%), facial flushing (28.8%), fatigue (28.4%), chills (25.2%), headache (23.5%), pharyngeal (21.3%), pectoral erythema (16.7%), conjunctival congestion (16.5%), superficial lymphadenopathy (14.2%), anorexia (13.7%), and others. Leukopenia, lymphopenia, and thrombocytopenia were observed in 17.0% (34/200), 65.0% (130/200), and 4.0% (8/200) of patients, respectively. The mean Ct value of chikungunya virus nucleic acid at admission was 28.90±6.05, and that for patients aged ≥75 years was 25.82±1.49. Conclusion The main clinical manifestations of patients with chikungunya fever in this study included arthralgia, fever, and rash. Particular attention should be paid to the early identification and diagnosis of patients presenting with arthralgia or rash as the sole initial symptom. Elderly patients showed lower viral Ct values in their serum, which suggests that the elderly population may have a diminished capacity for viral clearance.

Expert Review

Pay more attention to the application of bronchoscopy in the clinical diagnosis of pulmonary infectious diseases Ding Weimin 2025, 10 (4):  13-18.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.003 Abstract ( 42)    PDF (891KB) ( 18 )    Early and accurate detection of pathogens in pulmonary infections is crucial for the clinical treatment of severe cases, the prevention of mild infections progressing to severe ones, and for control of widespread transmission of infectious pulmonary diseases. In the past, specimens such as sputum and gastric fluid were collected for etiological testing. When traditional specimens are difficult to obtain, bronchoscopy has gained increasing clinical attention as a method for acquiring more accurate specimens to diagnose lower respiratory tract infections. Following bronchoscopic intervention at the lesion site in the lower respiratory tract or the opening of the lesion's drainage bronchus, diagnostic techniques such as biopsy, needle aspiration, brushing, washing, and lavage can be precisely performed under direct visualization and guidance. The specimens obtained through these sampling methods can then be accurately analyzed for etiology, pathology and molecular biology. Conventional bronchoscopy allows for easy observation and specimen collection from central airway lesions, however, sampling peripheral lesions remains challenging. Accurate localization and sampling of such lesions are currently a hot topic and a significant challenge in clinical research. Advancement of specialized bronchoscopy techniques and navigational bronchoscopy,particularly the exploration and application of AI technology such as robot-assisted bronchoscopy, the era of precise sampling and detection--identifying true infectious pathogens through bronchoscopy—is becoming a reality.

Original Articles

Analysis of MSCT manifestation and clinical features of atypical active pulmonary tuberculosis Song Min, Fang Weijun, Han Yuanyuan, Liang Ruiyun 2025, 10 (4):  19-26.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.004 Abstract ( 45)    PDF (2028KB) ( 15 )    Objective To analyze MSCT features and clinical characteristics of atypical active pulmonary tuberculosis,to improve the understanding of atypical active pulmonary tuberculosis and to provide an imaging basis for clinical treatment. Method A total of 138 patients with atypical active pulmonary tuberculosis, 150 cases with typical secondary pulmonary tuberculosis (typical secondary group) and 41 cases with typical hematogenous disseminated pulmonary tuberculosis (typical hematogenous group) from January 2018 to June 2024 were collected at Guangzhou Chest Hospital. The CT image features and clinical features of different types of atypical pulmonary tuberculosis were compared and analyzed with the corresponding typical groups, and the imaging and clinical features of each type of atypical pulmonary tuberculosis were summarized. Result According to CT findings, 138 cases of atypical pulmonary tuberculosis were divided into interstitial type (48 cases), mass type (24 cases), multiple nodule type (46 cases), multiple cystic type (11 cases) and consolidation type (9 cases). "Fireworks sign" was showed in interstitial type, the clinical symptoms were mild, and the bacterial negative rate was higher in interstitial type than that of typical secondary group (P<0.05). In the patients with mass type, the rate of multiple pulmonary masses was higher than that of single mass, the rate of lesions in both upper lobes was lower than that in the typical secondary group, and the rate of calcification, delayed prognosis and age of onset was significantly higher than that of typical group (P<0.05). Type of multiple cystic variants was characterized by multiple pulmonary air sacs distributed along the bronchial tract, 64% (7/11) of which were complicated by ground-glass-opacity, and the ratio of delayed prognosis and poor prognosis in this group was significantly higher than that in typical secondary group (P<0.05). Random distribution of nodules in both lungs were showed in type of multiple nodules, which were larger than miliary nodules, and the rate of cases combined with other systemic tuberculosis was higher than that in Typical hematogenous group (P<0.05). The results showed that the incidence of lesions in the right middle lung in consolidation type was higher than that of typical secondary group, 33% (3/9) of which were combined with ground-glass-opacity, and the rate of delayed prognosis and poor prognosis in consolidation type was significally higher than that in the typical secondary group (P<0.05). Except for the interstitial type, the rate of combined underlying diseases in other types of atypical pulmonary tuberculosis was higher than that in the corresponding typical group (P<0.05). Conclusion The CT manifestations and distribution of most atypical pulmonary tuberculosis are highly specific, with high rates of underlying diseases and delayed prognosis.

The predictive value of neutrophil-to-lymphocyte ratio and international normalized ratio on short-term prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure Zhu Li, Wang Buyun, Hu Ruiqing, Wu Bei, Wang Li, Zeng Yilan 2025, 10 (4):  27-33.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.005 Abstract ( 47)    PDF (1030KB) ( 21 )    Objective To explore the predictive value of neutrophil-to-lymphocyte ratio (nlr) and international normalized ratio (INR) in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF),aiming to provide simple and practical early assessment indicators for clinical use. Method A retrospective study was conducted on 210 patients with HBV-ACLF who were admitted to the Department of Hepatology at Chengdu Public Health Clinical Medical Center from January 2021 to December 2022. Based on the 28-day follow-up outcomes, the patients were divided into the survival group (n=148) and non-survivor group (n=62). Clinical characteristics and laboratory parameters were compared between the two groups. Multivariate logistic regression analysis was performed to identify factors influencing treatment outcomes in HBV-ACLF patients. Result Compared to the survival group, the non-survival group exhibited significantly higher incidences of complications such as hepatic encephalopathy, gastrointestinal bleeding, and ascites, along with elevated levels of INR and NLR (P<0.05). Multivariate logistic regression analysis identified NLR, INR, and hepatic encephalopathy as independent risk factors influencing short-term prognosis in HBV-ACLF patients. Further analysis based on NLR and INR quartiles revealed that patients with NLR >6.73 and INR >2.45 had significantly increased 28-day mortality rates. Even after adjusting for confounding factors such as age, sex, and complications, NLR and INR remained independent predictors of short-term mortality in HBV-ACLF patients. Conclusion NLR,INR,and hepatic encephalopathy are independent risk factors for short-term prognosis in HBV-ACLF patients. NLR and INR can serve as simple and effective predictive indicators for assessing the early mortality risk in HBV-ACLF patients.

Diagnostic Value of combined detection of neutrophil percentage, hemoglobin, and D-dimer in pulmonary tuberculosis with tuberculous polyserositis Liu Xiaoning, Tang Fei, Mei Heng, Liu Shengsheng, Zhang Xinli, Zhang Liangzhu, Ma Fangfang, Li Ye 2025, 10 (4):  34-39.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.006 Abstract ( 41)    PDF (945KB) ( 15 )    Objective By analyzing the clinical data and the diagnostic efficacy of combined detection of neutrophil percentage (NEUT), hemoglobin (HGB) and D-dimer (D-D) in patients with tuberculosis combined with tuberculous pleural effusion, this study aims to identify patients with tuberculosis combined with tuberculous pleural effusion at an early stage and to guide the optimization of clinical anti-tuberculosis treatment. Method A total of 138 patients with pulmonary tuberculosis combined with tuberculous polyserositis, admitted to Anhui Chest Hospital from July 2022 to June 2024, were included as the observation group. Additionally, 146 patients with simple pulmonary tuberculosis, who were hospitalized during the same period, were included as the control group. Clinical data from two patient groups were analyzed using univariate analysis of laboratory test results including NEUT, HGB, D-D, platelet count (PLT), erythrocyte sedimentation rate (ESR), serum albumin (ALB), and hypersensitive C-reactive protein (hs-CRP). Factors demonstrating statistically significant effects were incorporated into a multivariate Logistic regression model. Receiver operating characteristics (ROC) curves were employed to evaluate diagnostic efficacy of these factors in diagnosing pulmonary tuberculosis complicated by tuberculous pleural effusion. Result There were no significant differences in the general characteristics between the observation group and the control group(age, diabetes, place of residence, occupation, marital status, gender, hypertension, type of diagnosis). There was no significant difference in white blood cell count levels between the two groups (P>0.05), while neutrophilpercentage, hemoglobin, blood platelet, ESR, serum albumin, hs-CRP, D-D showed statistically significant differences (P<0.05). The results of multi-factor Logistic regression analysis showed that NEUT and D-D levels are risk factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, and high HGB levels are protective factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion. ROC curve analysis revealed that, among the individual indicators, D-D had the highest AUC value of 0.871.The combined detection of neutrophil percentage, hemoglobin and D-dimer had an AUC value of 0.908 (95%CI: 0.873-0.942), with a sensitivity of 84.8%, a specificity of 83.6%, and a Youden index of 0.684. Conclusion NEUT and D-D levels are risk factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, whereas high HGB levels are protective factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, and the combined prediction model of NEUT, HGB and D-D has a high diagnostic efficacy for dentifying pulmonary tuberculosis combined with tuberculous serous cavity effusion.

Clinical analysis of 9 cases of AIDS complicated by central nervous system infection with Talaromyces marneffei Xie Luman, Lan Ke, Meng Zhihao, Lan Shuanglai, Wen Yuhong, Huang Kui 2025, 10 (4):  40-45.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.007 Abstract ( 36)    PDF (1757KB) ( 11 )    Objective To systematically analyze the clinical characteristics of patients with AIDS complicated by central nervous system Talaromyces marneffei (TM) infection, to enhance the effectiveness of early diagnosis, and optimize clinical management strategies. Method A retrospective case analysis was conducted, including 9 patients with AIDS complicated by central nervous system TM infection diagnosed by cerebrospinal fluid (CSF) microbiology at Chest Hospital of Guangxi Zhuang Autonomous Region from January 2021 to November 2024. Clinical data were systematically analyzed. Result The clinical manifestations of the nervous system in patients showed significant heterogeneity, mainly including headache, fever, altered mental status, abnormal mental behavior, and epileptic seizures. CSF examination results showed increased white blood cell count, decreased glucose, decreased chloride, and elevated protein levels in the CSF. Brain MRI showed intracranial infectious lesions and lateral ventricle dilation in all 9 patients. Metagenomic next-generation sequencing (mNGS) of CSF showed a 100% positive detection rate. After treatment with amphotericin B combined with itraconazole/voriconazole and timely initiation of antiretroviral therapy, 8 patients had good clinical outcomes, while 1 patient died of multiple organ failure. Conclusion AIDS complicated by central nervous system TM infection is characterized by complex clinical manifestations and poor prognosis. Timely and accurate diagnosis, along with standardized comprehensive treatment, are key to improving clinical outcomes.

Analysis of pathogenic fungi distribution and related risk factors of reproductive tract fungal infection in pregnant women Zhang Mei, Zhou Xiuyun, Mo Wenqi, Wang Chuanzhen 2025, 10 (4):  46-51.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.008 Abstract ( 42)    PDF (632KB) ( 28 )    Objective To investigate the distribution of pathogenic fungi and risk factors for genital tract fungal infections in women during pregnancy, with a view to improve guidance for clinical prevention and treatment of genital tract fungal infections during pregnancy. Method A total of 136 pregnant women with genital tract fungal infections attending our Obstetrics and Gynecology Clinic of Fuyang Women and Children's Hospital from May 2021 to May 2024 were retrospectively selected as the infected group, and another 174 pregnant women who did not develop infections during the same period were randomly selected as the uninfected group. Clinical data of all pregnant women were collected, risk factors were analyzed by multivariate logistic regression model, the predictive value was assessed by using receiver operating characteristic curve (ROC curve), and a decision tree model was constructed based on risk factors. Result A total of 149 fungal strains were detected in 136 pregnant women with genital tract fungal infections, of which Candida albicans was most common with 72 strains (48.32%). Univariate analysis showed that genital tract fungal infections in pregnant women were associated with age, gestational week, history of miscarriage, BMI, comorbid diabetes mellitus, history of reproductive tract infections, pre-pregnancy contraceptive use, long-term use of antibiotics, regular change of underwear, and exposure to health education during pregnancy, and the differences were statistically significant (all P<0.05); genital tract fungal infections in pregnant women were associated with history of labor and delivery, literacy level, comorbid hypertension, comorbid anemia, comorbid thyroid function abnormalities, and condom use during pregnancy were not related, and the differences were not statistically significant (all P>0.05). Logistic regression modeling multifactorial results showed that age ≥35 years (OR=2.453), gestational weeks ≥28 weeks (OR=2.708), history of miscarriage (OR=3.260), BMI ≥25kg/m2 (OR=3.202), comorbid diabetes mellitus (OR=2.075), history of reproductive tract infections (OR=2.457), pre-pregnancy contraceptive use (OR=1.766), long-term use of antibiotics (OR=1.976), non-regular underwear change (OR=2.627), and failure to be exposed to health education during pregnancy (OR=2.196) were risk factors for genital tract fungal infections in pregnant women (P<0.05). ROC curve analysis showed that the area under curve (AUC) of the above risk factors jointly predicted genital tract fungal infections in pregnant women was 0.803, with a 95% CI of 0.754-0.852, sensitivity of 0.741, and specificity of 0.743. The decision tree model showed that age ≥35 years was the most important predictor, and the classification accuracy of the model was 81.60%. Conclusion Age ≥35 years, gestational weeks ≥28 weeks, history of miscarriage, BMI ≥25kg/m2, comorbid diabetes mellitus, history of reproductive tract infections, pre-pregnancy use of contraceptives, long-term use of antibiotics, non-regular underwear change, and lack of exposure to health education during pregnancy are the risk factors for with genital tract fungal infections in pregnant women, and clinical attention should be paid to women with the above-mentioned risk factors in pregnancy and to actively prevent of genital tract fungal infections.

Clinical and imaging features of drug-resistant pulmonary tuberculosis in HIV/AIDS patients Huang Hua, Chen Shilin, Zhou Yun, Luo Weijun, Zheng Qiuting, Deng Yingying 2025, 10 (4):  52-57.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.009 Abstract ( 36)    PDF (2272KB) ( 18 )    Objective To analyze and compare the clinical manifestations and computed tomography(CT) findings of HIV/AIDS patients with drug-resistant pulmonary tuberculosis（DR-PTB）,and observe the dynamic changes of CT findings. Method The clinical and CT findings of 20 patients with HIV/AIDS diagnosed DR-PTB from May 2018 to February 2024 were analyzed retrospectively. Chest CT signs including micronodules, tree-in-bud appearance, consolidation,cavity, bronchial lesion, emphysema, pleural effusion and lymphadenopathy were analyzed, and their CT features, lesion involvement extent, and dynamic changes were compared between groups. Result The main clinical manifestations of DR-PTB in HIV/AIDS patients were cough (85.00%) and fever (65.00%). Micronodules and tree-in-bud appearance were the most frequent CT abnormalities and were seen in all DR-PTB patients (100.00%). Consolidations, bronchial lesions, lymphadenopathy, pleural effusion and cavities were found in DR-PTB patients with rate of 85.00%, 70.00%, 70.00%, 55.00% and 50.00% respectively. The lesion distribution in extensively drug-resistant pulmonary tuberculosis (XDR-PTB) patients was the widest, followed by multidrug-resistant pulmonary tuberculosis(MDR-PTB)and rifampicin-resistant pulmonary tuberculosis (RR-PTB) patients. As for Chest CT features and clinical manifestation,there were no significant differences between different DR-PTB types and between initial treatment and retreatment groups (P>0.05). 3 cases of hematogenous disseminated pulmonary tuberculosis with micronodules appeared in RR-PTB, MDR-PTB and XDR-PTB. The mean CD4+T lymphocytes were 38.67(20.00,55.00)cells/μl. The proportion of cavities in the retreatment group was 66.67%, which was higher than that in the initial treatment group (42.86%), which manifested thick-walled cavities involving multiple lobes (>3 lobes), but there was no statistically significant difference (P>0.05). Among 16 follow-up patients, symptoms improved in 14 patients (87.50%) ,showing lesion absorption,1 patients (6.25%) died showing increased lesions, and chest lesions didn't change in 1 patient(6.25%). Conclusion The CT findings of different DR-PTB in patients with HIV/AIDS were similar, and are related to the state of immunosuppression and tuberculosis treatment history. In the immunosuppressive state, CT findings are atypical, and hematogenous disseminated pulmonary tuberculosis is prone to occur. XDR-PTB tends to have more extensive distribution,the proportion of cavity in retreatment DR-PTB was high relatively.

Application of CT-based body adipose composition and radiomics in predicting adverse outcomes in patients with cirrhosis Xie Nan'ai, Liang Yiwen, Luo Zixin, Zou Guannan, Guo Feng, Jiang Yi 2025, 10 (4):  58-64.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.010 Abstract ( 33)    PDF (2627KB) ( 14 )    Objective This study aimed to explore the predictive efficacy of body adipose composition analysis using CT imaging for adverse outcomes in patients with cirrhosis and to enhance predictive performance by integrating a radiomics model based on liver and spleen regions. Method 243 patients with liver cirrhosis were retrospectively enrolled from two centers between September 2016 and December 2020, including 153 cases of hepatitis B or C virus-related cirrhosis. Patients were classified into non-adverse outcome group (n=119) and adverse outcome group (n=124) based on the occurrence of severe complications such as spontaneous bacterial peritonitis during the follow-up period (over 3 months). Quantitative measurements of body adipose composition were performed at the third lumbar vertebra level, and radiomic features of the liver and spleen were extracted. Multiple machine learning models were developed to evaluate predictive performance. Result The area under the receiver operating characteristic curve (AUC) for the adipose tissue model at the two centers was 0.804 and 0.749, respectively, outperforming the radiomics model (AUC=0.767 and 0.712). Shapley additive explanations (SHAP) analysis identified intermuscular fat ratio and subcutaneous fat volume as key predictors of adverse outcomes. The predictive efficacy of the combined model was significantly improved (AUC=0.856 and 0.780; integrated discrimination improvement index=0.125, 0.163, P<0.05). Conclusion body adipose composition can effectively predict the risk of adverse outcomes in patients with viral hepatitis-related cirrhosis. The integration of liver and spleen radiomics features further enhances predictive accuracy, offering a promising approach for individualized risk management and early intervention in viral liver diseases.

The predictive value of serum G-CSF, LDH3, and CysLTs for clinical outcomes in children with severe Mycoplasma pneumoniae pneumonia Song Dan, He Qiuhong, Liu Jianshe 2025, 10 (4):  65-70.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.011 Abstract ( 45)    PDF (987KB) ( 12 )    Objective To explore the levels of serum granulocyte colony-stimulating factor (G-CSF), lactate dehydrogenase 3 (LDH3), and cysteinyl leukotrienes (CysLTs) in children with severe Mycoplasma pneumoniae pneumonia, and to analyze their value in predicting clinical outcomes. Method From July 2022 to July 2024, 98 children with severe Mycoplasma pneumoniae pneumonia admitted to our hospital were regarded as the study subjects (severe group), simultaneously, 114 children with mild Mycoplasma pneumoniae pneumonia admitted to our hospital were included as the mild group, and 100 healthy children who underwent physical check-ups were selected as the control group. The general information, serum levels of G-CSF, LDH3, CysLTs, as well as indicators of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) were analyzed and compared among the three groups. Pearson correlation analysis was used to assess the correlation between serum G-CSF, LDH3, CysLTs and lung function indicators in children with severe Mycoplasma pneumoniae pneumonia. Based on the treatment effect, children with severe Mycoplasma pneumoniae pneumonia were assigned into the effective treatment group (n=67) and the ineffective treatment group (n=31). Logistic regression analysis was applied to analyze the factors affecting the outcome of children with severe Mycoplasma pneumoniae pneumonia. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum G-CSF, LDH3, and CysLTs ffor treatment efficacy in children with severe Mycoplasma pneumoniae pneumonia. Results The lymphocyte count, FEV1, and FEV1/FVC levels in the severe group were obviously lower than those in the mild group and the control group (P<0.05). The levels of serum G-CSF, LDH3, and CysLTs in the severe group were obviously higher than those in the control group and mild group (P<0.05). In children with severe Mycoplasma pneumoniae pneumonia, serum G-CSF, LDH3, and CysLTs were positively correlated with each other (P<0.05), and all three were negatively correlated with FEV1 and FEV1/FVC (P<0.05). The lymphocyte count, FEV1, and FEV1/FVC in the effective treatment group were obviously higher than those in the ineffective treatment group (P<0.05), while the levels of serum G-CSF, LDH3, and CysLTs were obviously lower than those in the ineffective treatment group (P<0.05). Higher levels of G-CSF, LDH3, and CysLTs were risk factors for ineffective treatment in children (P<0.05), while FEV1/FVC was a protective factor (P<0.05). The AUC of the combination of G-CSF, LDH3, and CysLTs for predicting treatment efficacy was 0.869, which was better than single indicator detection (ZG-CSF-combination=2.791, P=0.005, ZLDH3- combination=2.087, P=0.037, ZCysLTs-combination=2.963, P=0.003). Conclusion The serum levels of G-CSF, LDH3, and CysLTs in children with severe Mycoplasma pneumoniae pneumonia are elevated, and they are related to the disease outcome. Combined measurement of the three may have value in predicting the clinical outcome of children with severe Mycoplasma pneumoniae pneumonia.

Case Report

A case of AIDS combined with tropheryma whipplei pneumonia and cutaneous tuberculosis was reported Zhao Chunyan, Song Chang, Huang Aichun, Xu Chaoyan, Zeng Chunmei, Zhu Qingdong 2025, 10 (4):  71-75.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.012 Abstract ( 40)    PDF (1478KB) ( 12 )    This article reports a rare case of a 55-year-old female patient with AIDS complicated by tropheryma whipplei pneumonia and cutaneous tuberculosis. The patient was admitted to the hospital due to abdominal pain, fever, and cough. She had a history of HIV infection and had been receiving antiretroviral therapy. Laboratory tests showed elevated peripheral blood neutrophil count and CRP levels, and chest CT revealed nodular shadows in both lungs. Initially, she was diagnosed with bacterial pneumonia and treated with cefepime, but the treatment was ineffective. Subsequently, tropheryma whipplei sequences were detected in the bronchoalveolar lavage fluid through nanopore sequencing technology. After switching to trimethoprim-sulfamethoxazole for anti-infection treatment, the patient's body temperature decreased, and her respiratory symptoms improved. Meanwhile, a rash appeared on the patient's right lower limb. Pathological examination suggested granulomatous inflammation due to tuberculosis, and the diagnosis of cutaneous tuberculosis was confirmed in combination with a positive interferon-gamma release assay for tuberculosis. The patient was then treated with standard anti-tuberculosis therapy and her antiviral regimen was adjusted. The patient was discharged after her symptoms improved and continued to receive anti-tuberculosis and anti-AIDS treatment. This article emphasizes that tropheryma whipplei can cause pulmonary infections, and the diagnosis relies on clinical manifestations, histopathological examination, and molecular biological detection. Nanopore sequencing technology can provide rapid and accurate diagnosis. Cutaneous tuberculosis, a rare form of tuberculosis, is mainly diagnosed based on skin histopathological examination and requires long-term combination therapy. This case highlights the diagnostic and therapeutic challenges of infections caused by rare pathogens in HIV-infected individuals and the utility of nanopore sequencing technology in rapid diagnosis. It aims to provide practical diagnostic and therapeutic references for clinicians dealing with such complex infectious cases.

Review

Progress in the application of rifabutin in tuberculosis comorbidities He Mingjie, Xu Rong, Deng Guofang 2025, 10 (4):  76-82.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.013 Abstract ( 56)    PDF (910KB) ( 24 )    Rifabutin, an essential derivative of rifamycin, occupies a significant position in anti-infection treatment due to its strong cell membrane penetration, broad-spectrum antibacterial activity, and exceptional antibacterial efficacy. Although its use currently focuses mainly on treating Mycobacterium avium complex (MAC) and other non-tuberculous mycobacteria (NTM) infections, its potential for addressing comorbidities of tuberculosis is gradually gaining attention, particularly in complex combination therapy scenarios. Its low enzyme induction effect considerably reduces drug interactions with other medications, ensuring the safety and effectiveness of treatment. This article systematically reviews the pharmacological characteristics of rifabutin, explores its antibacterial activity and interaction mechanisms with other drugs, and summarizes its clinical value in treating comorbidities of tuberculosis. Clinical evidence has shown that rifabutin has good efficacy and tolerability for a variety of tuberculosis comorbidities, such as AIDS, hypertension, and diabetes. In addition, this article summarizes the possible adverse effects of rifabutin in clinical application to provide a reference for clinicians when selecting treatment options.

Application of host transcriptomics, radiomics and radiogenomics in the diagnosis and treatment of drug-resistant TB Song Shulin, Jin Guanqiao 2025, 10 (4):  83-88.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.014 Abstract ( 39)    PDF (903KB) ( 21 )    Tuberculosis (TB) has long been a major challenge to global public health, and the emergence of drug-resistant tuberculosis (DR-TB) has intensified the severity of TB. DR-TB not only threatens individual health but also imposes significant socio-economic burdens. Currently, the treatment of DR-TB remains dependent on drug therapy. Therefore, rapid, accurate, and convenient diagnostic technologies are crucial for controlling the spread of TB, particularly DR-TB. Advances of transcriptomics offer new hope for the diagnosis of DR-TB. By analyzing the molecular responses of the host to Mycobacterium tuberculosis (MTB) infection, researchers can identify the expression patterns of key genes. This provides new possibilities for the rapid screening and triage of DR-TB cases. Similarly, progress in radiomics has introduced new tools for the diagnosis and monitoring of TB treatment. Radiomics involves extracting high-throughput radiological features from imaging data, enabling the construction of models for diagnosis, prediction, and prognosis, as well as for studying the correlation between imaging data and clinical outcomes. Furthermore, radiogenomics integrates radiomics with genomics to explore the relationship between lesion imaging characteristics and genomic and molecular features. This integration offers innovative methods for non-invasive diagnosis, prognosis assessment, and treatment evaluation. This paper reviews the advancements in host transcriptomics, radiomics, and radiogenomics in the diagnosis and treatment of DR-TB. The aim is to provide new perspectives for research in this field and to deepen our understanding of the application of these technologies in managing DR-TB.

Standards/Guidelines/Consensus

Interpreting the WHO Consolidated Guidelines on Tuberculosis Module 3 Diagnosis Liu Ruihua, Jin Huifang, Wang Aixia, Zheng Wei, Liu Zhefang, Chen Chen, Song Xuefei, Wu liji, Wang Furong 2025, 10 (4):  94-104.  DOI: 10.19871/j.cnki.xfcrbzz.2025.04.016 Abstract ( 114)    PDF (944KB) ( 87 )    Tuberculosis (TB)is the infectious disease with the highest mortality rate attributable to a single pathogen,caused by Mycobacterium tuberculosis (Mtb). According to estimates by the World Health Organization (WHO), roughly one-quarter of the world's population is latently infected with Mtb; however, the proportion receiving preventive treatment remains insufficient, and drug resistance is exacerbating treatment difficulties. To bolster global TB control capabilities, the WHO has issued the Comprehensive Guidelines on Tuberculosis: Module 3—Diagnosis. This comprehensive document systematically integrates evidence-based strategies for TB infection management, diagnostic procedures, and drug-resistance testing. It classifies various TB diagnostic methods and introduces new recommendations to increase multi-sample testing, particularly for HIV-infected individuals and children.By emphasizing early, precise diagnosis and the accurate detection of drug resistance, these guidelines aim to enhance clinical decision-making and improve treatment success rates. They also provide vital technical support and policy frameworks essential for achieving the Objectives outlined in the WHO's “End TB Strategy”.