Current Issue

2025 Vol.10 No.5 Published:31 October 2025

Original Articles

Analysis of the positive rate of Mycobacterium tuberculosis culture in 576 cases of pleura effusion and the sensitivity of 14 kinds of drugs Tang Liusheng, Dong Jie, Meng Xuejia, Zeng Qingxue, Liu Aimei 2025, 10 (5):  1-5.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.001 Abstract ( 19)    PDF (728KB) ( 10 )    Objective Based on the BS1000 fully automatic Mycobacterium tuberculosis culture instrument and a combination of multiple technologies, this study explored the positive detection rate of Mycobacterium tuberculosis in 576 pleural effusion samples, and applied the minimum inhibitory concentration(MIC) method to determine the sensitivity of 14 anti-tuberculosis drugs, thereby providing a scientific basis for clinical practice. Method The BS1000 fully automatic Mycobacterium tuberculosis culture instrument was used to culture and detect 576 samples of pleural effusion clinically submitted for examination between January and December 2024 at the Chest Hospital of Guangxi Zhuang Autonomous Region. After the acid-fast bacilli in the positive culture samples were confirmed using intelligent scanning and optimized staining technology, the strains were identified through antigen detection and the traditional p-nitrobenzoic acid (PNB) method. The MIC method was used to detect the sensitivity of 14 anti-tuberculosis drugs for the Mycobacterium tuberculosis isolates, and the detection rate and drug-resistance characteristics of Mycobacterium tuberculosis were statistically analyzed. Result Mycobacterium tuberculosis strains were isolated from 88 of the 576 pleural effusion samples, with a detection rate of 15.5% (88/576). There was a statistically significant difference was observed in the positive rate of Mycobacterium tuberculosis culture in pleural effusion among patients with different clinical diagnoses (χ2=25.6, P=0.001). The highest positive rate was observed in patients with pulmonary shadows (22.6%), while the positive rates were relatively low among patients with diseases such as lung cancer (5.3%) and extrapulmonary tuberculosis (5.5%). The total drug resistance rate of 88 Mycobacterium tuberculosis strains was 21.6% (19/88). The drug resistance rate to streptomycin was the highest (7.9%), and no drug-resistant strains were detected against six drugs including ethambutol and rifabutin. Among first-line drugs, no resistant strains were detected for ethambutol; among second-line drugs, no resistant strains were detected for levofloxacin, amikacin, and multi-drug resistance was mainly characterized by streptomycin inclusion. Conclusion The detection rate of Mycobacterium tuberculosis in pleural effusion was associated with clinical diagnosis. In clinical practice, drugs should be selected according to the disease condition and drug-resistance characteristics, and personalized treatment plans should be developed. In addition, the monitoring of high-risk drugs such as streptomycin should be strengthened.

The value analysis of serum survivin, 4-hydroxynonenal, and homocysteine protein 61 for the diagnosis and disease assessment of community-acquired pneumonia in children Zheng Ting, Li Xiaoling, Xu Yuqi, Cai Jianxin 2025, 10 (5):  6-11.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.002 Abstract ( 27)    PDF (943KB) ( 12 )    Objective To investigate the clinical significance of combined detection of serum survivin, 4-hydroxynonenal (4-HNE), and cysteine-rich 61 (CYR61) in the diagnosis and condition assessment of childhood community-acquired pneumonia (CAP). Method A total of 132 CAP children admitted to our hospital between September 2021 and September 2023 were prospectively selected as the study group. According to the severity of their condition, they were divided into a mild group (n=92) and a severe group (n=40). Another 74 healthy children during the same period were selected as the control group. Serum levels of survivin, 4-HNE, and CYR61 in each group were measured using ELISA. Pearson correlation analysis was used to analyze the correlation between serum survivin, 4-HNE, CYR61 levels and clinically relevant serum indicators. Multivariate logistic regression was applied to identify the influencing factors of severe CAP. Receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic value of serum survivin, 4-HNE, and CYR61 levels for CAP and severe CAP. Result The serum levels of 4-HNE and CYR61 in the study group were significantly higher than those in the control group, while the survivin level was significantly lower than that in the control group (P<0.05). The area under the curve (AUC) of serum survivin, 4-HNE, CYR61 alone and in combination for diagnosing CAP were 0.780, 0.809, 0.858, and 0.944, respectively. The combined detection of the three markers showed higher diagnostic accuracy than any single marker. Compared with the mild group, the levels of white blood cell (WBC) count, procalcitonin (PCT), C reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), 4-HNE, and CYR61 in the severe group were significantly higher, while the survivin level was significantly lower (P<0.05). WBC, PCT, CRP, IL-6, and TNF-α were all negatively correlated with serum survivin level (P<0.05), and positively correlated with 4-HNE and CYR61 levels (all P<0.05). Elevated serum CRP, 4-HNE, CYR61 levels and decreased survivin level were risk factors for severe CAP (P<0.05). The AUC of serum survivin, 4-HNE, CYR61 alone and in combination for diagnosing severe CAP were 0.864, 0.753, 0.782, and 0.941, respectively. The combined detection demonstrated greater diagnostic value than single-marker detection. Conclusion Combined detection of serum survivin, 4-HNE, and CYR61 has high value in diagnosis and condition assessment of childhood CAP, with certain clinical significance.

The impact of glycated hemoglobin A1c levels on drug resistance development in diabetes mellitus-pulmonary tuberculosis patients: the mediating effect of C reactive protein levels Li Wenshan, Ji Xueqin, Lin Mei, Qi Yan, Wang Wenli, Wang Chaoyi, Ding Xiao, Li Tongxia 2025, 10 (5):  12-16.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.003 Abstract ( 29)    PDF (766KB) ( 19 )    Objective The objective of this study was to explore the mediating role of C reactive protein (CRP) levels in the relationship between glycated hemoglobin A1c (HbA1c) and the occurrence of drug-resistant pulmonary tuberculosis (DR-PTB) in patients with diabetes mellitus-pulmonary tuberculosis. Method A total of 352 patients diagnosed with Diabetes mellitus-pulmonary tuberculosis at Qingdao public health clinical center from 2022 to 2024 were included. To analyze the mediating effect of CRP levels in the relationship between HbA1c and DR-PTB occurrence, with validation performed using the bootstrap method. Result Among the patients, 85 cases (24.1%) were identified with DR-PTB. HbA1c showed positive correlations with CRP levels (r=0.459, P<0.01) and DR-PTB occurrence (r=0.359, P<0.01). CRP levels were also positively correlated with DR-PTB occurrence (r=0.441, P<0.01). Regression analysis indicated that both HbA1c control (β=0.81) and CRP levels (β=1.17) significantly influenced DR-PTB occurrence (P<0.001). The total effect of HbA1c on DR-PTB occurrence was 1.30, with a direct effect of 0.81. The mediating effect of CRP levels was 0.49, accounting for 37.69% of the total effect. Conclusion HbA1c and CRP levels are associated with DR-PTB occurrence in patients with diabetes mellitus-pulmonary tuberculosis,and there is a partial mediating effect of CRP levels between HbA1c and the occurrence of drug-resistant tuberculosis.

Role of Th1/Th2 cytokines in the efficacy evaluation of pediatric patients with human metapneumovirus pneumonia Sun Wei, An Shuhua, Zhou Jianwei, Dong Weiran, Yan Zhihui, Tian Liyuan 2025, 10 (5):  17-21.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.004 Abstract ( 28)    PDF (781KB) ( 10 )    Objective The objective of this study was to explore the relationship between T helper cell type 1/T helper cell type 2 (Th1/Th2) cytokines and the therapeutic efficacy in children with human metapneumovirus pneumonia, and to assess their potential value as biomarkers for predicting therapeutic efficacy, thereby providing a theoretical basis for optimizing clinical treatment strategies. Method A total of 156 pediatric patients with human metapneumovirus pneumonia admitted to Hebei Children's Hospital from January 2022 to January 2024 were selected as the study subjects. Symptomatic supportive treatment was administered, and the patients were divided into an effective group(134 cases) and an ineffective group(22 cases) based on treatment efficacy. General information, pulmonary function indicators, Th1 cytokines [interferon-γ (IFN-γ), interleukin-2 (IL-2)], and Th2 cytokines (IL-4, IL-6) of the two groups were compared. Pearson correlation analysis was used to examine the correlation between Th1/Th2 cytokines and pulmonary function indicators. Logistic regression analysis was conducted to investigate the impact of Th1/Th2 cytokines on the efficacy of treatment for human metapneumovirus pneumonia. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the predictive value of Th1/Th2 cytokines for treatment efficacy. Result Compared with the effective group, the ineffective group had lower respiratory ratio (spiratory time/expiratory time, TI/TE), tidal volume (VT), IFN-γ, and IL-2 levels, and higher respiratory rate (RR), IL-4, IL-6 levels, and moderate disease severity (P<0.05). IFN-γ and IL-2 were positively correlated with TI/TE and VT, whereas negatively correlated with RR; IL-4 and IL-6 were negatively correlated with TI/TE and VT, and positively correlated with RR (P<0.05). After adjusting for confounding factors, IFN-γ, IL-2, IL-4, and IL-6 were associated with the efficacy of treatment in children with human metapneumovirus pneumonia (P<0.05). The combined prediction of IFN-γ, IL-2, IL-4, and IL-6 for the efficacy of treatment in children with human metapneumovirus pneumonia was superior to that of individual indicators (AUC: 0.927, 0.805, 0.791, 0.789, 0.777). Conclusion IFN-γ, IL-2, IL-4, and IL-6 are influencing factors for the therapeutic efficacy in children with human metapneumovirus pneumonia, and are closely associated with lung function indicators. They can be used jointly to predict the therapeutic efficacy efficacy and help guide clinical diagnosis and treatment.

Analysis of the drug resistance of pathogenic microorganisms in alveolar lavage fluid of patients with mycoplasma pneumonia and correlation between the expression levels of YKL-40 and Gal-3 in peripheral blood and the severity and prognosis of the disease Yue Chunya, Jiang Shan, Deng Zhixia, Chen Dachuan 2025, 10 (5):  22-29.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.005 Abstract ( 22)    PDF (1200KB) ( 8 )    Objective The objective of this study was to explore the drug resistance of pathogenic microorganisms in the alveolar lavage lavage fluid of patients with mycoplasma pneumoniae pneumonia, and to clarify the association between chitinase protein 40 (YKL-40) and galectin-3 (Gal-3) and the severity and prognosis of the disease. It provides a scientific basis for rational selection of antibacterial drugs, early assessment of patient's condition risk and development of individualized prognostic intervention strategies. Method A total of 162 patients with mycoplasma pneumoniae pneumonia admitted to Dujiangyan People's Hospital from January 2021 to January 2024 were selected as the observation group, and 162 healthy individuals who underwent physical examinations during the same period were selected as the control group. The observation group was divided into a severe group of 68 cases and a mild group of 94 cases aBased on symptoms, signs, and chest X-ray results. According to the symptoms, signs and chest X-ray results of the patients after treatment, they were divided into a good prognosis group of 111 cases and a poor prognosis group of 51 cases. The drug resistance of pathogenic microorganisms in alveolar lavage fluid of each group was compared respectively. To analyze the correlation between the levels of YKL-40 and Gal-3 in the peripheral blood of patients and the severity of the disease, multivariate logistic regression was used to analyze the influencing factors of poor prognosis of patients, and the receiver operating characteristic (ROC) curves were constructed to evaluate the predictive value of the levels of YKL-40 and Gal-3 in the peripheral blood of patients for the poor prognosis of patients with mycoplasma pneumoniae pneumonia. The patients in the observation group were further divided into a training set (113 cases) and a validation set (49 cases) to predict the area under the curve for the prognosis of Mycoplasma pneumoniae pneumonia patients. Result A total of 180 pathogenic bacteria were cultured from the alveolar lavage fluid of 162 patients with mycoplasma pneumoniae pneumonia, including 135 from the severe group, and 45 in the mild group. A total of 140 strains were detected in the poor prognosis group and 40 strains were detected in the good prognosis group. The resistance rate to levofloxacin was the highest among the four groups of pathogenic bacteria. YKL-40 and Gal-3 levels in peripheral blood were positively correlated with disease severity in patients with mycoplasma pneumonia (r=0.584, 0.722, P<0.05). The levels of YKL-40 and Gal-3 in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The levels of YKL-40 and Gal-3 in peripheral blood were independent risk factors for poor prognosis in patients with mycoplasma pneumonia (P<0.05). The ROC area under the curve of the combined prediction of peripheral blood YKL-40 and Gal-3 levels for poor prognosis of patients with Mycoplasma pneumonia was 0.837 (95%CI: 0.771~0.891, P<0.001), which was higher than that of single detection. The AUC (95%CI) of the training set and the validation set were 0.67 (0.56~0.77) and 0.72 (0.55~0.88) for the prediction of the prognosis of mycoplasma pneumonia patients with the training set and the validation set. The DCA curve shows that the probability threshold of the nomogram model at 20%~50% provided a higher net benefit. Conclusion Patients with Mycoplasma pneumoniae pneumonia exhibit the highest resistance rate to levofloxacin. Levated peripheral blood levels of YKL-40 and Gal-3 are positively correlated with disease severity of mycoplasma pneumoniae pneumonia. High levels of YKL-40 and Gal-3 are independent risk factors for poor prognosis in patients with mycoplasma pneumoniae pneumonia, and the combined detection has a high value in evaluating the poor prognosis of patients.

Research on the relationship between CD4+T cell count and postoperative pulmonary complications in hiv-positive patients after cholecystectomy Feng Shifeng, Cheng Xingzhen, Zhao Yong, Chen Tingyu, Liu Dongxu, Wei Guo 2025, 10 (5):  30-35.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.006 Abstract ( 48)    PDF (759KB) ( 11 )    Objective To analyze the correlation between CD4+T lymphocyte count and postoperative pulmonary complications (including bacterial pneumonia, fungal pneumonia, pleuritis, pleural effusion, respiratory failure and other serious adverse events in the lungs) in patients with HIV infection who underwent cholecystectomy. The aim is to provide a reference for reducing postoperative pulmonary complications and optimizing perioperative management in HIV-infected patients. Method A retrospective analysis was conducted on the clinical data of 122 HIV-infected patients who underwent cholecystectomy at the Chengdu Public Health Clinical Medical Center between June 2017 and November 2024. Logistic regression analysis was used to evaluate the correlation between CD4+T cell count and postoperative pulmonary complications. Result Among the 122 HIV-infected patients, 53（43.44%）were female and 69 （56.56%）were male, with an average age of (50.24±11.97) years. The median CD4+T cell count was 366 (246, 481) cells/µl, and the incidence of postoperative pulmonary complications was 16.39%. Statistically significant association was observed between CD4+T cell count and postoperative pulmonary complications (OR=0.996, 95%CI：0.993-0.999,P=0.021), further stratified analysis revealed significant findings. Using HIV-infected patients with CD4+T cell counts <200 cells/µl as the reference group, those with CD4+T cell counts ≥500 cells/µl demonstrated a negative correlation with postoperative pulmonary complications (OR=0.154, 95%CI：0.028-0.843,P=0.031). This negative association persisted after adjusting for confounding factors (OR=0.169, 95%CI：0.029-0.997,P<0.050). Conclusion The risk of pulmonary complications after cholecystectomy in HIV-infected patients was lower when the CD4+T lymphocyte count was ≥500 cells/µl. Effective antiviral therapy should be administered to HIV-infected patients to maintain adequate CD4+T lymphocyte count and and thereby reduce the risk of postoperative pulmonary complications.

VP1 gene characteristics of predominant enterovirus serotype of 182 hand, foot, and mouth disease and herpangina patients from Shenzhen in 2023 Li Shengyong, Mai Guangxing, Yan Zehao, Xiao Kelin 2025, 10 (5):  36-40.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.007 Abstract ( 35)    PDF (1201KB) ( 14 )    Objective To investigate enterovirus serotypes in children with hand, foot, and mouth disease (HFMD) or herpangina (HA) in Shenzhen during 2023, and analyze evolutionary traits of the predominant serotype. Method Fecal sample or throat swabs, collected from 182 HFMD/HA patients in Shenzhen during 2023. Enteroviruses were detected by quantitative real-time PCR, and positive samples were typed via PCR-sequencing; besides, the full-length VP1 sequences of the predominant serotype of enterovirus were obtained for phylogenetic tree construction using MEGA X, and sequence similarity analysis using Bioedit. Result Enterovirus prevalence was 62.1% (113/182), with coxsackievirus A6 (CV-A6) as the predominant serotype. Phylogenetic analysis resolved CV-A6 into 4 lineages (A-D),with all 2023 Shenzhen isolates assigned to the D3a subclade of linages D. Nucleotides and amino acid sequence identities with representative strains of lineages A-C were 82.0%-85.1% and 93.7%-96.7%, respectively. Conclusion CV-A6 was the predominant enterovirus serotype in 2023 HFMD/HA pediatric cases from Shenzhen, belonging to the globally circulating D3a subclade of lineage D.

Differences in gut microbiota composition in children with acute gastroenteritis due to human norovirus Wang Tingting, Lei Fang, Yang Yang, Chen Cen, Zhou Yan 2025, 10 (5):  41-46.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.008 Abstract ( 26)    PDF (2184KB) ( 13 )    Objective To investigate the characteristics of gut microbiota in children with symptomatic human norovirus (HNoV) infection and to perform functional analysis. Method Twenty-five preschool children who received treatment for acute gastroenteritis caused by HNoV infection in the Pediatrics Department of Dazu Hospital affiliated to Chongqing Medical University from July 2024 to November 2024 were included as the HNoV group. In addition, 25 healthy children who tested negative for HNoV GII gene amplification were included as the control group according to the propensity score matching principle. Fecal samples from both groups were collected to analyze gut microbiota characteristics. Evaluate alpha-diversity, beta-diversity, taxonomic groups with different abundance, and microbial functions through bioinformatics analysis. Result Compared with the control group, the gut microbiota of the HNoV group was enriched in Firmicutes (62.25% vs 57.24%), while the proportions of Actinobacteria (1.57% vs 3.02%) and Bacteroidetes (0.22% vs 1.14%) were relatively reduced, and leading to an increased Firmicutes/Bacteroidetes ratio(11.20% vs 17.21%, P=0.003). Similarly, significant microbial differences were observed at both the family and genus levels between the two groups. The abundances of Vibrio (P=0.006), Pseudomonas (P=0.017), Enterococcus (P=0.020), and Clostridium (P=0.036) in the HNoV group were higher than those in the control group. The differences in these microorganisms were accompanied by genetic variations involved in the biosynthesis, transport, and catabolism of secondary metabolites, particularly an increased function of nitrate reductase and an elevated abundance of alkyl hydroperoxide reductase subunit C, which may contribute to greater susceptibility to HNoV. Conclusion HNoV infection leads to significant reduction in gut microbiota abundance and diversity and significant dysregulation of gut microbiota composition and function in children.

Construction and verification of norovirus infection risk nomogram model in children Shi Linyan, Meng Bei, Zhou Minping 2025, 10 (5):  47-52.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.009 Abstract ( 31)    PDF (940KB) ( 8 )    Objective To establish the risk nomogram model for norovirus (NoV) infection in children through clinical symptoms and routine blood biochemical indicators, and verify the predictive efficacy, so as to provide a reference for early and rapid screening of NoV infection in clinical practice. Method A total of 412 children (3 months to 16 years old) diagnosed with acute viral gastroenteritis in the Third People's Hospital of Zhangjiagang City from January 2023 to October 2024 were retrospectively included as a training set, and were randomly divided into a modeling group (330 cases) and an internal validation group (82 cases) at a ratio of 4:1. In addition, 202 children with acute viral gastroenteritis from the Children's Hospital of Soochow University between October 2023 to June 2024 were selected as the external validation group. Real-time quantitative PCR (rq-PCR) was used to confirm NoV infection. The clinical symptoms and blood biochemical indicators were compared between NoV-positive and NoV-negative children in the modeling group. Multivariate Logistic regression was used to screen predictors and construct a nomogram model. The receiver operating characteristic curve was used to evaluate the predictive efficacy of the model in the internal validation group (n=82) and external validation group (n=202). Result Single-factor comparison showed that white blood cell count (WBC), absolute counts of neutrophils and lymphocytes (NE and LY), and platelet count (PLT) in positive children were significantly higher than those in negative children,vomiting, diarrhea, and upper respiratory tract infection symptoms were were more common, and clinical symptoms and treatment methods were more complicated as well, too(P<0.05). Multivariate logistic regression analysis showed that vomiting (OR=1.859, 95%CI=1.325-2.253, P=0.001), upper respiratory tract infection (OR=1.234, 95%CI=1.052-1.564, P=0.007), WBC (OR=2.325, 95%CI=1.857-2.659, P<0.001), LY ≥3.42×109/L (OR=1.425, 95%CI=1.124-1.865, P=0.003) and PLT (OR=3.023, 95%CI=2.425-3.756, P<0.001) were the predictive factors ot NoV infection. The nomogram model constructed based on the above factors had a total score of 220. In the internal validation group, the area under the curve (AUC) for predicting NoV infection was 0.842 (95%CI=0.768-0.899, P<0.001) with a sensitivity of 78.9% and specificity of 75.0%. In the external validation group, the AUC was 0.896 (95%CI=0.845-0.943, P<0.001) with a sensitivity of 83.3% and specificity of 81.9%. Conclusion The nomogram model established based on clinical symptoms and routine blood biochemistry of children with acute viral gastroenteritis shows good potential for diagnosing NoV infection, and can assist in rapid and accurate clinical screening of NoV.

Analysis of the diagnostic value of molecular diagnostic techniques combined with cytokine expression for differentiating pulmonary tuberculosis from nontuberculous mycobacterial lung infections Zhao Yun, Xu Fang, Wang Chen, Sheng Fang 2025, 10 (5):  53-58.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.010 Abstract ( 26)    PDF (1268KB) ( 10 )    Objective To investigate the diagnostic efficacy of integrating molecular diagnostic methods with cytokine expression for distinguishing from pulmonary tuberculosis and nontuberculous mycobacterial(NTM) lung disease. Method A study was carried out to retrospectively analyze the clinical data of 70 patients diagnosed with pulmonary tuberculosis (referred to as the observation group) and 40 patients with NTM lung disease (the control group) treated at our hospital between January 2022 and July 2024. All individuals underwent testing using Xpert MTB/RIF Ultra, and their peripheral blood serum cytokine expression profiles were assessed, including interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-12/23p40, IL-17 and tumor necrosis factor α (TNF-α). Binary logistic regression analysis was performed to investigate risk factors risk factors closely associated with the accurate identification of pulmonary tuberculosis. The effectiveness of each risk factor in combination for discriminating pulmonary tuberculosis was assessed using methods such as the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Result The detection rate of Xpert MTB/RIF Ultra testing and the mean levels of IL-4, IL-6, and IL-12/23p40 in the observation group were significantly higher compared to those in the control group, whereas the mean level of TNF-α was significantly lower than that in the control group (P<0.05). Univariate and multivariate logistic regression analysis demonstrated that Xpert MTB/RIF Ultra testing, IL-6, IL-12/23p40, and TNF-α were independent factors influencing the diagnosis of pulmonary tuberculosis (P< 0.05). The ROC curve analysis revealed that the AUC (95%CI) for the combined differential diagnosis of pulmonary tuberculosis utilizing Xpert MTB/RIF Ultra testing, IL-6, IL-12/23p40, and TNF-α was 0.889 (0.821-0.957). Both the calibration curve and DCA curve confirmed that the combined diagnostic model based on these parameters exhibited high accuracy and substantial clinical returns. Conclusion The efficacy of the model utilizing the molecular diagnostic method Xpert MTB/RIF Ultra together with IL-6, IL-12/23p40, and TNF-α in discriminating between pulmonary tuberculosis and NTM lung disease is considerable.

Analysis of factors influencing the occurrence of HBeAg seroconversion in chronic HBV-infected pregnant women continuing antiviral therapy after delivery Wei Li, Zhong Wenting, Huang Futong, Zheng Jie, Rao Kemeng, Lu Changchun, Zhou Jiao, Chen Tianyan, Lin Yongmei 2025, 10 (5):  59-63.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.011 Abstract ( 22)    PDF (755KB) ( 8 )    Objective To understand the rate of hepatitis B virus e antigen (HBeAg) seroconversion in chronic hepatitis B virus (HBV)-infected pregnant women in the immune-tolerant phase and receive nucleos(t)ide analogues (NAs) therapy in mid-pregnancy and continue NAs therapy after delivery,and to explore independent factors influencing HBeAg seroconversion. Method This was a case-control study that included 161 pregnant women with chronic HBV infection who were HBeAg positive, had an alanine aminotransferase (ALT) less than twice the upper limit of normal during pregnancy, were treated with NAs in mid-pregnancy, and continued NAs after delivery in The First Affiliated Hospital of Xi'an Jiaotong University and the 301 Hospital between January 2014 and December 2020. They were divided into a conversion group and a non-conversion group according to whether they had or had not occurred HBeAg seroconversion in the postpartum period, and the independent influencing factors of HBeAg seroconversion were analyzed using univariate analysis and multivariate logistic regression model. Result 27.95% of chronically HBV-infected pregnant women had HBeAg seroconversion within 96 weeks postpartum. The levels of baseline ALT and aspartate aminotransferase (AST) in the conversion group were significantly higher than those in the non-conversion group (P<0.05). The titers of HBeAg were significantly lower than those in the non-conversion group (P<0.05), and the reductions and reduction rates of HBeAg and hepatitis B virus DNA(HBV DNA) in the conversion group from the second trimester to the prenatal period were higher than those in the non-conversion group (P<0.05). Univariate and multivariate logistic regression analysis showed that the rate of decline in hepatitis B virus DNA(HBV DNA) from mid-pregnancy to prenatal period (OR=1.035,95%CI：1.005-1.065,P=0.023) and the rate of decline in HBeAg(OR=1.056,95%CI：1.025-1.087,P<0.001) were the independent influencing factors for the occurrence of HBeAg seroconversion postpartum. Conclusion HBeAg-positive pregnant women with chronic HBV who are given NAs treatment antiviral therapy from mid-pregnancy to after delivery are more likely to develop HBeAg seroconversion. The greater the decrease in HBV DNA load and HBeAg titer from mid-pregnancy to prenatal period, he higher the likelihood of HBeAg seroconversion with continuous postpartum NA therapy, which provides a valuable reference for clinicians in evaluating the postpartum condition of chronic HBV-infected pregnant women and developing management strategies.

Epidemiological investigation of a local case of Leptospira in Shenzhen Cao Liming, Kong Dongfeng, Liu Wei, Chen Wushen, Kuang Cuiping, Huang Yanfei, Jiang Shiqing, Chen Linxiang, Gu Weizhi, Wan Jia 2025, 10 (5):  64-68.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.012 Abstract ( 25)    PDF (1350KB) ( 13 )    Objective To conduct a field epidemiological investigation and analysis on a local case of leptospirosis in Shenzhen, providing a reference for the prevention and control of leptospirosis in urban areas. Method An epidemiological investigation and laboratory testing were conducted on a leptospirosis case reported in Nanshan District, Shenzhen on November 13, 2024, along with rodent density monitoring at potential exposure risk sites of the patient. Real-time PCR was used to detect Leptospira nucleic acid in the blood and urine samples of the case, as well as in the blood, liver, spleen, kidney tissue, and urine samples of the captured rodents, and in stream water samples. Result The early symptoms of the patient were not obvious. Six days after the onset of the disease, the patient was diagnosed as a suspected leptospirosis case based on Hirsch reaction, and then he was diagnosed as leptospirosis typhi by metagenomic next-generation sequencing and nucleic acid detection. According to the epidemiological investigation, the patient had gone to W scenic spot on foot and traced the creek three times one month before the onset of the disease, during which he was pierced by branches, and the wounds were soaked in creek water. The epidemiological investigation team set up 203 traps along both banks of the stream in the W scenic area and captured 19 rats. The positive rate of leptospira was 36.84%. No other infected persons were identified. Conclusion This patient with leptospirosis has sufficient evidence of local infection. The infection site was determined to be the W scenic area. The mode of infection is through contact with water contaminated by urine of rodents through wounds.

Case Report

One case of Klebsiella pneumoniae liver abscess invasion syndrome misdiagnosed as hemorrhagic fever with renal syndrome and literature review Zhang Penglei, Fu Bolun, Chen Peng, Duan Jianping 2025, 10 (5):  69-72.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.013 Abstract ( 29)    PDF (149KB) ( 23 )    This article reports a case of invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS). The patient was transferred to Qingdao Public Health Clinical Center with suspected hemorrhagic fever with renal syndrome (HFRS). Diagnostic evaluations confirmed liver abscess and septic shock. Blood and pus cultures both identified Klebsiella pneumoniae (KP). The patient developed concurrent heart failure and respiratory failure but was ultimately cured through anti-infection therapy, mechanical ventilation, and multi-organ support. This case highlights that KP infection is a common cause of liver abscess and may rapidly progress to IKPLAS. Characterized by critical severity, rapid progression, and high mortality, IKPLAS necessitates early blood cultures and antimicrobial susceptibility testing to guide targeted antibiotic therapy. Notably, the initial misdiagnosis of HFRS in this case underscores the importance of differentiating sepsis from HFRS. Although these conditions share overlapping clinical and laboratory features, their distinct pathogenesis and treatment strategies demand prompt diagnostic investigations to clarify the diagnosis and guide therapy. By reviewing this case, we aim to provide clinical insights into distinguishing HFRS from sepsis, as well as optimizing the management of sepsis and IKPLAS, thereby reducing mortality and improving prognosis.

Review

Advances in clinical and radiological studies of multidrug-resistant Acinetobacter baumannii pneumonia Wang Jie, Fan Bing 2025, 10 (5):  73-78.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.014 Abstract ( 33)    PDF (734KB) ( 9 )    Acinetobacter baumannii (Ab) is an opportunistic Gram-negative pathogen that is widely distributed in both natural and medical environments. It has strong survival and adaptability capabilities and is a common pathogen causing nosocomial infections. This bacterium possesses multiple intrinsic drug-resistance genes, and coupled with the overuse of antibiotics in recent years, carbapenem-resistant Acinetobacter baumannii (CR-Ab) and multidrug-resistant Acinetobacter baumannii (MDR-Ab) have become widespread globally, with MDR-Ab posing a serious threat to human health. Due to the limited treatment options and poor prognosis of MDR-Ab pneumonia in clinical practice, along with its high mortality rate, it has long been a challenging issue for the global medical community. In this clinical predicament, early and accurate diagnosis plays a crucial role in the effective treatment and improved prognosis of MDR-Ab pneumonia. With the continuous development of imaging technology, imaging, as a non-invasive diagnostic method, can promptly detect can promptly detect MDR-Ab pneumonia and extrapulmonary manifestations, playing an irreplaceable role in the early identification, disease assessment, and treatment monitoring of MDR-Ab pneumonia. The application of artificial intelligence technology in imaging analysis also provides new approaches for early diagnosis and prognosis assessment. This paper reviews the latest progress in etiology, clinical characteristics, and imaging findings of MDR-Ab pneumonia at home and abroad, and discusses the application value of artificial intelligence in it.

Advances in imaging studies of diabetic foot osteomyelitis Sun Wenxue, Lai Shengyuan, Luo Jiawen 2025, 10 (5):  79-85.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.015 Abstract ( 28)    PDF (744KB) ( 8 )    Diabetic foot is one of the common and severe complications faced by diabetic patients, primarily caused by neuropathy and peripheral arterial disease. As the disease progresses, patients gradually develop diabetic foot infections and diabetic foot osteomyelitis（DFO）, the latter often necessitating lower limb amputation, which severely impacts the quality of life of patients. Imaging examinations play a crucial role in the early diagnosis of DFO. X-rays have certain value in initial screening and follow-up, while MRI offers higher accuracy and sensitivity in diagnosing DFO, although there are contraindications for the examination. 18F-fluorodeoxyglucose positron emission tomography/computed tomography（18F-FDG PET/CT）has high sensitivity. However, its high cost and relatively low clinical prevalence somewhat limit its widespread clinical application. In comparison, single-photon emission computed tomography/computed tomography (SPECT/CT) combining different technologies offers a more convenient and safe option for diagnosing DFO, and can effectively evaluate the location and extent of the infection. Ultrasound examination has the advantages of high clinical prevalence and lower examination costs, but its diagnostic efficacy largely depends on the operator's experience, leading to considerable variability. Additionally, dual-energy CT (DECT), as an emerging imaging technology, has shown promising diagnostic potential in the midfoot and hindfoot regions. This article summarizes the indications, diagnostic efficacy, and clinical limitations of various imaging examination methods reported in recent literature for the diagnosis of DFO, aiming to provide clinicians with a reference for selecting appropriate imaging examination methods, thereby improving the early diagnosis rate of DFO and enhancing patient prognosis.

Research advances in gut microbiota among HIV-infected men who have sex with men Zhang Peiyan, Wu Weibo, Yao Weiming, Lin Yuanlong, Wang Fuxiang 2025, 10 (5):  86-90.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.016 Abstract ( 31)    PDF (733KB) ( 12 )    Acquired immune deficiency syndrome (AIDS) is a chronic infectious disease caused by infection with the human immunodeficiency virus (HIV). Characterized by high transmissibility and incurability, AIDS predominantly affects men who have sex with men (MSM). The gut microbiota plays a crucial role in maintaining intestinal mucosal barrier function, regulating innate immunity, and preserving intestinal homeostasis. However, HIV infection disrupts the host's gut microbiota through multiple pathways. Given their distinct sexual practices, MSM are more susceptible to gut microbiota dysbiosis and exhibit a higher risk of HIV acquisition, suggesting a more pronounced interplay between HIV and gut microbiota in this population. Furthermore, inflammatory cytokines are intricately linked to both HIV infection and gut microbiota impairment, rendering HIV-infected MSM particularly vulnerable to inflammation-associated gut microbial damage. Different antiretroviral therapy (ART) regimens exert significantly varied impacts on the gut microbiota of people living with HIV (PLWH), highlighting the need to carefully consider the potential effects of medications on gut microbial ecology when selecting clinical treatment strategies. This review synthesizes current knowledge on the relationship between HIV infection and gut microbiota in MSM, aiming to inform future exploration of microbiota-targeted interventions for HIV-associated comorbidities.

Standards/Guidelines/Consensus

Expert consensus on imaging diagnosis of human infection with avian influenza China Research Hospital Society, Specialty Committee of Infectious, Inflammatory Radiology, Radiology Science Editorial Department, Radiology of Infectious Diseases Editorial Department, Electronic Journal of Emerging Infectious Diseases Editorial Department 2025, 10 (5):  91-99.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.017 Abstract ( 36)    PDF (3681KB) ( 18 )    Avian influenza virus infects humans through various pathways such as respiratory tract or direct contact, with the lungs being the most common site of the disease. In recent years, cases of human infection with avian influenza appeared sporadically in China, with new subtypes constantly emerging, such as H7N4, H9N2, H10N8, and H10N3. Human infection with avian influenza has become a significant public health issue threatening human health. Imaging plays an important role in the early diagnosis of human infection with avian influenza. In order to promote the standardization of imaging diagnosis and treatment for human infection with avian influenza in China, experts in the fields of infectious diseases, radiology, pathology, and laboratory medicine have collaboratively developed an expert consensus on imaging diagnosis, including 7 recommendations. The consensus is based on the latest research data and clinical practice to form imaging diagnosis recommendations, aim to provide clear Imaging diagnostic suggestions for clinicians.

Education Fields

The interpretation of the Report of WHO Consultation on Asymptomatic Tuberculosis Zhan Mei, Zhao Songtao, Guo Jianqiong, Li Tongxin, Yang Song 2025, 10 (5):  100-104.  DOI: 10.19871/j.cnki.xfcrbzz.2025.05.018 Abstract ( 33)    PDF (750KB) ( 25 )    Tuberculosis (TB) remains a leading infectious disease of morbidity and mortality worldwide. The clinical manifestations spectrum of TB, which driven by the interaction between Mycobacterium tuberculosis (MTB) and immunological status of the host, range from the mildest asymptomatic condition to the most serious disseminated stage. It is well established that most infected immunocompetent individuals are asymptomatic status, with only 5%～10% of these individuals will eventually develope to active TB during their lifetime. Because of asymptomatic or imperceptibly mild symptoms, the diagnosis and treatment of these patients with asymptomatic tuberculosis (aTB) are often delayed. Furthermore, the clinical and public health significance of aTB has not been given sufficient attention. For the above reasons, the World Health Organization (WHO) released the Report of WHO Consultation on Asymptomatic Tuberculosis on February 28th, 2025. This report includes the natural history of TB, the definition of aTB its clinical and public health significance of aTB, and its clinical and public health significance, and the rationale for a revised definition of aTB. Additionally, it outlines the priority research directions and critical knowledge gaps. This paper aims to highlight the key findings of the WHO consultation on asymptomatic tuberculosis, while also calling for greater awareness of the potential impact of aTB on clinical diagnosis and treatment as well as public health work, which will promote the solutions to related issues and advance progress toward WHO's goal of End-TB.