Abstract:Objective To analyze the epidemiological and clinical characteristics of psittacosis patients and to provide a scientific reference for the prevention and control strategies of Cps pneumonia in this region.Methods A retrospective study was conducted on 5 patients with Cps infection diagnosed by metagenomic next-generation sequencing(mNGS)who were admitted to the Second People's Hospital of Huai'an,Jiangsu,between December 2022 and December 2024.The basic information,epidemiological history,clinical manifestations,laboratory tests,imaging findings,treatment and prognosis of the patients were analysed descriptively.Results Among the 5 patients,3 were male and 2 were female;the average age was 61 years,ranging from 52 to 70 years.All patients had a history of contact with bird or poultry,including 1 patients with exposure to the domestic parrot(the parrot had died),and 4 patients had exposure to domestic poultry(pigeons,chickens,ducks,or geese).The main clinical manifestations were recurrent high fever.Most patients showed normal white blood cell count,elevated neutrophil percentage and C-reactive protein level,decreased lymphocyte percentage and eosinophil percentages,variable inflammatory response and malnutrition.Initial CT predominantly revealed unilateral lower-lobe infiltrates that progressed to bilateral involvement.All patients recovered after tetracycline-based therapy and were discharged.Conclusion Cps infection mainly affects elderly and middle-aged individuals with avian exposure,presents with recurrent high fever and pulmonary infiltrates,and carries a favourable outcome when promptly treated..Increased awareness of psittacosis can reduce diagnostic delay and improve clinical outcomes.

Abstract:Objective To investigate the value of serum fibroblast growth factor 21(FGF-21)and endothelin-1(ET-1)in assessing the severity of enterovirus 71(EV71)hand,foot,and mouth disease(HFMD)in children,and their impact on the time for fecal viral nucleic acid to turn negative.Methods A prospective study was conducted,enrolling 80 children with EV71 HFMD treated at our hospital as research subjects.Based on clinical manifestations,the children were divided into a mild group(40 cases),a severe group(30 cases),and a critical group(10 cases).Additionally,40 healthy children undergoing routine physical examinations during the same period were selected as a control group.Serum levels of FGF-21 and ET-1 were measured in all subjects,and EV71 viral nucleic acid in feces was detected.Differences in serum FGF-21 and ET-1 levels among the groups and their correlations with clinical indicators were analyzed,and their effects on the time for fecal viral nucleic acid to turn negative were evaluated.Results Clinical data were collected from 80 pediatric patients with EV71-associated HFMD and 40 healthy children.Children with HFMD had higher body temperature,WBC,CRP,and blood sugar levels than the healthy control group(P<0.001).Serum FGF-21 and ET-1 levels in children with HFMD were significantly higher than those in the healthy control group(P<0.001);with the aggravation of the disease,serum FGF-21 and ET-1 levels gradually increased,critical group>severe group>mild group(P<0.001).Serum FGF-21 and ET-1 levels in children with HFMD were significantly higher than those in healthy controls(P<0.001);as the disease worsened,serum FGF-21 and ET-1 levels gradually increased,with the critical group>severe group>common group(P<0.001).Serum FGF-21 and ET-1 levels were positively correlated with body temperature,WBC,CRP,and blood glucose(r=0.652,0.584,0.721,0.563;all P<0.001).In severe and critical cases,serum FGF-21 and ET-1 levels were positively correlated with WBC in cerebrospinal fluid(r=0.674,P<0.001).Serum FGF-21 and ET-1 levels were positively correlated with the time for viral nucleic acid in feces to turn negative(r=0.715 and 0.683,respectively,P<0.001).ROC curve analysis showed that the area under the curve(AUC)for serum FGF-21 in predicting severe EV71-associated HFMD was 0.862(95%CI:0.789-0.935),with a sensitivity of 85.0%and specificity of 82.5%;for ET-1,the AUC was 0.837(95%CI:0.758-0.916),with a sensitivity of 82.5%and specificity of 80.0%.Multivariate logistic regression analysis revealed that serum FGF-21 and ET-1 levels were independent risk factors for the progression of EV71-associated HFMD(OR=1.928,1.754;P<0.001).Conclusion Serum FGF-21 and ET-1 levels are associated with the severity of EV71 HFMD in pediatric patients.These markers can serve as effective biomarkers for assessing the severity of EV71 HFMD and determining the time to negative fecal viral nucleic acid conversion.They hold clinical significance for disease prognosis assessment and optimization of clinical treatment strategies.

Abstract:Objective To evaluate the clinical efficacy and safety of Huanglian Jiedu Tang combined with Maxing Shigan Tang integrated with conventional Western medicine therapy in children with severe Mycoplasma pneumoniae pneumonia(MPP)presenting with toxin-heat obstructing the lung syndrome.Methods A retrospective analysis was conducted on 100 children with severe MPP admitted to Yuncheng Central Hospital Affiliated to Shanxi Medical University between January 2023 and June 2024.According to the treatment received,patients were divided into a combination group(n=50)and a control group(n=50).The control group received conventional Western medicine alone,while the combination group received Huanglian Jiedu Tang and Maxing Shigan Tang in addition to conventional Western medicine.The two groups were compared in terms of clinical efficacy,time to improvement of symptoms and signs,levels of inflammatory markers,alveolar injury markers,and the incidence of adverse reactions.Results The total effective rate was significantly higher in the combination group than in the control group(P<0.05).The combination group showed shorter time to fever resolution,cough relief,disappearance of pulmonary wet rales,imaging absorption,and total hospital stay compared with the control group(P<0.05).After treatment,levels of C-reactive protein,white blood cell count,and procalcitonin decreased in both groups,with lower levels in the combination group(P<0.05).Levels of salivary liquefied glycoprotein antigen-6(KL-6)and surfactant protein D also decreased in both groups,with greater reductions in the combination group(P<0.05).The incidence of adverse reactions was lower in the combination group than in the control group(P<0.05).Conclusion The combination of Huanglian Jiedu Tang and Maxing Shigan Tang with conventional Western medicine has a significant therapeutic effect on severe MPP,which can shorten the duration of symptoms and hospital stay in children.It can effectively shorten the duration of symptoms and hospital stay,and its mechanism may be related to enhancing anti-inflammatory effects and reducing alveolar damage,while also minimizing the risk of adverse reactions caused by conventional Western treatments in children.

Abstract:Objective To investigate the association of dendriticcell-specific intercellular adhesion molecule-3-grabbing nonintergrin(DC-SIGN)single nucleotide polymorphisms(SNPs)with enterovirus 71(EV71)infection and disease severity in children with hand-foot-mouth disease(HFMD).Methods A total of 180 children with HFMD infected with EV71 admitted to Dazu Hospital affiliated to Chongqing Medical University during the high incidence season of HFMD(April to July and October to November each year)from 2020 to 2024 were selected as the research subjects.They were categorized into mild-to-moderate HFMD group(n=90)and severe HFMD group(n=90)according to the severity of the disease.Ninety healthy children who underwent physical examination in the hospital during the same period were included as the control group.Real-time fluorescence quantitative polymerase chain reaction was performed to determine the expression level of DC-SIGN messenger ribonucleic acid(mRNA)in peripheral blood mononuclear cells(PBMCs),and the DC-SIGN promoter region was directly sequenced.Results Compared with healthy controls,DC-SIGN mRNA levels in PBMCs in HFMD group were significantly increased(P<0.05),and the levels of DC-SIGN mRNA were significantly higher in PBMCs of the severe HFMD group compared to the mild-to-moderate HFMD group(P<0.05).The Receiver Operating Characteristic curve showed the diagnostic value of relative DC-SIGN mRNA expression levels for HFMD caused by EV71 infection and the severity of HFMD disease.After direct sequencing and comparison of DC-SIGN promoter regions from healthy controls and HFMD group only the rs7248637 GG genotype was slightly higher than that of healthy controls(P<0.05),whereas the dominant genotype GA+AA,as well as allele A,was slightly lower than that of healthy controls(P<0.05).The binary logistic model showed that the DC-SIGN rs7248637 AA genotype,and the G allele were strongly associated with the occurrence of HFMD and severe HFMD caused by EV71 infection(P<0.05).In addition,DC-SIGN mRNA levels,and the proportion of patients with severe HFMD were significantly lower compared with the GG genotype(P<0.05).Conclusion DC-SIGN SNPs are associated with susceptibility to EV71 virus and progression of HFMD disease,particularly in children carrying the rs7248637 GG genotype.The role of DC-SIGN in diagnosis of EV71-HFMD deserves further attention.

Abstract:Objective To explore the magnetic resonance imaging(MRI)features of hepatic epithelioid hemangioendothelioma(HEHE).Methods A retrospective analysis was conducted on the MRI data of 15 treatment-naïve patients with pathologically confirmed HEHE.These patients were from the Fifth Medical Center of the PLA General Hospital and the outpatient department dispatched by the Xinjiang Military Region General Hospital from October 2011 to January 2025.The MRI characteristics of the lesions were evaluated.Results A total of 157 lesions were identified among the 15 patients.Fusion of lesions was observed in 12 cases,and hepatic capsular retraction was present in 4 patients(26.67%).Lung metastases occurred in 4 patients(26.67%).MRI revealed a multi-layer ring appearance,which was most clearly demonstrated on T2-weighted images(T2WI)and delayed-phase images.Two-and three-layer structures were the most common,while a four-layer structure was observed in only one patient.On diffusion-weighted imaging(DWI),all lesions exhibited a double-layer appearance:hyperintense in the peripheral and slightly hyperintense in the center.Blood vessel penetration was observed in most lesions,including 133(84.71%)portal vein branches,15(9.55%)hepatic vein branches,and 6(3.82%)hepatic artery branches.Notably,all four patients with hepatic vein branch penetration developed lung metastases.Conclusion The multi-layer ring appearance and vascular penetration sign are two characteristic MRI features of HEHE,which may have significant implications for the clinical diagnosis and treatment.

Abstract:Objective To analyze the prevalence,risk factors and the outcomes of standardized treatment for Helicobacter pylori(Hp)infection in the Suixi area of Anhui Province,thereby providing a theoretical basis for improving gastrointestinal health and reducing the risk of gastric cancer and other related diseases among local residents.Methods A total of 13 188 patients who underwent 14C-urea or 13C-urea breath tests as outpatients or inpatients at the Affiliated Hospital of Huaibei Vocational and Technical College between July 2023 and March 2025 were included.Data on Hp infection rates,demographic characteristics,risk factors,and treatment outcomes were analyzed using SPSS 26.0.Strict quality control measures,including instrument calibration and standardized procedures,were implemented prior to testing to ensure the accuracy of the results.Results Among the 13 188 patients included in the analysis,7 736 were Hp-positive,yielding an infection rate of 58.63%.The infection rate in rural areas(58.10%)was significantly higher than that in urban areas(41.90%)(P<0.001).Multivariate analysis identified male gender(OR=1.234),age≥50 years(OR=2.156),communal dining habits(OR=1.345),and a family history of Hp infection(OR=2.567)as independent risk factors for Hp infection(P<0.001).The standardized treatment rate(with a 14-day bismuth-containing quadruple therapy)was 82.30%(6 365/7 736),and the effective treatment rate(successful eradication)was 78.59%(5 002/6 365).The primary reasons for treatment failure included clarithromycin resistance(15.20%),metronidazole resistance(12.30%),and poor patient compliance(72.50%).Conclusion The Hp infection rate in Suixi area of Anhui Province is relatively high,demonstrating an epidemiological profile characterized by a higher prevalence in rural than urban areas than in urban settings and significant household clustering.Although the standardized treatment rate is satisfactory,the effective treatment rate is substantially compromised by antibiotic resistance and poor patient adherence.It is recommended to mitigate the Hp infection burden in this region through enhanced public health education,targeted family screening,and the optimization of personalized treatment regimens.

Abstract:Objective To understand the epidemiological characteristics of pertussis in Inner Mongolia Autonomous Region from 2019 to 2024,and provide evidence for the prevention and control of pertussis in Inner Mongolia Autonomous Region.Methods Using descriptive epidemiological and spatio-temporal analysis methods,an analysis and study was conducted on the incidence of pertussis and the vaccination status of pertussis vaccine in Inner Mongolia Autonomous Region from 2019 to 2024.Results From 2019 to 2024,a total of 5 161 cases of pertussis were reported in Inner Mongolia Autonomous Region,with an average annual incidence rate of 3.58 per 100 000.The incidence rate showed an upward trend;it was more prevalent in spring and summer(accounting for 60.56%);the incidence rate was the highest in Ordos City(17.60 per 100 000);the cases were mainly concentrated in the≤1-year-old group(74.21 per 100 000,accounting for 18.41%)and the 5-9-year-old group(41.71 per 100 000,accounting for 57.42%).After analyzing the immunization history of cases with pertussis components vaccines,it was found that 45.45%of those aged 3-12 months had not received the vaccine,but 80.03%of the cases in the 5-9-year-old group had completed the full course of immunization.Spatial-temporal scanning analysis revealed that the high incidence clusters occurred in the central and western regions of Inner Mongolia,including Ordos City,Hohhot City,and Baian'ao'er City,with log-likelihood ratios of 4 573.34,644.64,and 321.60 respectively from 2019 to 2024.Conclusion From 2019 to 2024,the reported incidence of pertussis in Inner Mongolia Autonomous Region showed a generally upward trend.The reported incidence had certain differences in terms of time and region.The affected population was mainly children under 1 year old and those aged 5 to 9.This suggests that the timeliness of pertussis-containing vaccine inoculation should be strengthened,and the pertussis vaccine immunization program in China should be adjusted in a timely manner according to the incidence of pertussis.

Abstract:Objective This study explores the characteristics of changes in α4β7high CD4+T cells in human immunodeficiency virus(HIV)infected individuals during antiretroviral therapy(ART)and reveals the potential significance of this cell subset in immune recovery.Methods Twenty-eight HIV-infected patients who were diagnosed at the Fifth Medical Center of the PLA General Hospital and received ART for at least five years from 2012 to 2018 were selected as the research subjects.Peripheral venous blood samples were collected at baseline(before treatment)and at 1,3,and 5 years after treatment.Peripheral blood mononuclear cells(PBMCs)were isolated from the samples by density gradient centrifugation.The absolute count of CD4+T cells,the absolute count of α4β7high CD4+T cells and the CD4/CD8 ratio were detected by flow cytometry.At the same time,the level of HIV DNA in PBMCs was quantitatively determined by fluorescence quantitative PCR technology.Data analysis was performed using GraphPad Prism 8.0 software.Paired t-tests were used for comparisons between groups,and Pearson correlation tests were employed for correlation analysis.Results Data analysis was performed using GraphPad Prism 8.0 software.Paired t-tests were used for comparisons between groups.During the ART 0-3 year period,the count of α4β7high CD4+T cells showed a significant upward trend(P<0.05),while it remained relatively stable during the ART 3-5 year period(P>0.05).The correlation analysis revealed that the dynamic changes in the absolute count of α4β7high CD4+T cells during the ART process were significantly positively correlated with the CD4+T cell count(r=0.890,P<0.0001)and the CD4/CD8 ratio(r=0.408,P<0.0001),and negatively correlated with the HIV DNA level(r=-0.285,P=0.021).Conclusion During ART,the changes of α4β7high CD4+T cell counts may play an important role in the immune recovery in HIV infected patients.

Abstract:Objective To investigate the correlation between intraoperative monitoring parameters and pain relief rates in patients with postherpetic neuralgia(PHN)undergoing computed tomography(CT)-guided pulsed radiofrequency therapy.Methods A total of 120 PHN patients who underwent CT-guided pulsed radiofrequency treatment at Ningde Normal University Affiliated Ningde Municipal Hospital from January 2021 to December 2023 were enrolled.Relative parameters such as intraoperative impedance,nerve stimulation threshold,pulsed target temperature,and pulse duration were recorded.Pain levels were assessed through visual analogue scale(VAS)before treatment and at 1 week,1 month,3 months,and 6 months after treatment.Additionally,quality of life(QOL)scores and pain relief were recorded before and after treatment.Patients were divided into marked response(≥75%),response(50%-74%),and non-response(<50%)groups based on the improvement rate of VAS scores at 3 months postoperatively.Parameter characteristics of each group and their correlation with pain relief rates were analyzed.Multiple linear regression analysis was used to determine independent factors affecting(continuous)pain relief rates.Results There were significant differences in intraoperative impedance values,stimulation thresholds,pulse target temperatures,and pulse durations among the three groups of patients(P<0.05).The marked response group had higher impedance values,higher pulse target temperatures,lower stimulation thresholds,and longer pulse durations(P<0.05).There were significant differences in VAS scores between treatment groups at various time points post-treatment(P<0.05),with marked response group<the response group<the non-response group;there were also significant differences in VAS scores within each group at various time points post-treatment compared to pre-treatment(P<0.05).There were significant differences in QOL scores between treatment groups at 3 months post-treatment(P<0.05),with the marked response group>the response group>the non-response group;QOL scores in all groups improved significantly post-treatment compared to pre-treatment(P<0.05).Correlation analysis showed that resistance impedance,pulse target temperature,and pulse duration were significantly positively correlated with the 3-month pain relief rate,while the stimulation threshold was significantly negatively correlated with the pain relief rate(P<0.05).Resistance impedance value,stimulation threshold,pulse target temperature,and pulse duration are all independent factors affecting the pain relief rate(P<0.05).Conclusion Intraoperative monitoring parameters during CT-guided pulsed radiofrequency therapy for patients with PHN are closely related to pain relief rates.By monitoring and adjusting parameters such as impedance values,stimulation thresholds,pulse target temperatures,and pulse durations,treatment accuracy and pain relief rates can be significantly improved,providing important guidance for the development of individualized pulsed radiofrequency therapy protocols.

Abstract:Objective To construct a nomogram prediction model for carbapenem resistant Enterobacteriaceae(CRE)infections in the pediatric intensive care unit(ICU).Methods A retrospective cohort study design was adopted,and 174 pediatric patients admitted to and treated in the ICU of Wolong District Maternal and Child Health Hospital in Nanyang City from October 2019 to November 2023 were included as the study subjects.Based on the bacterial test results,the pediatric patients were divided into a CRE infection group(62 cases)and a non-CRE infection group(112 cases).Multiple logistic regression analysis was used to screen for independent risk factors CRE infection.Based on this,a nomogram prediction model for CRE infection in ICU pediatric patients was constructed.Calibration curves,receiver operating characteristic(ROC)curves,and Hosmer-Lemeshow(H-L)tests were used to evaluate the performance of model;decision curve analysis(DCA)was used to assess the clinical efficacy of the nomogram.Results A total of 84 CRE strains were isolated from 62 pediatric patients with CRE infection,with Klebsiella pneumoniae being the predominant strain(73.81%).The specimens of 62 children with CRE infection mainly came from the respiratory tract(72.58%),followed by blood(11.29%),urine(9.68%),and incision secretions(6.45%).The results of multiple logistic regression analysis showed that age<12 years old,an ICU stay≥10 days,a history of carbapenem antibiotic use,indwelling urinary catheters,indwelling central venous catheters,and mechanical ventilation are independent risk factors for CRE infection in ICU pediatric patients(P<0.05).In ROC analysis,the area under the curve(AUC)was 0.928.The H-L goodness of fit test(χ2=7.976,P=0.436)shows that the model fits well.,the calibration curve showed good fit with the ideal curve.The results of DCA showed that the interventions based on nomograms had good clinical benefits when the probability threshold was between 0.04 and 0.94.Conclusion The nomogram model constructed based on independent risk factors has good predictive ability for CRE infection in ICU pediatric patients and can serve as a reference for the formulation of clinical prevention and treatment strategies.

Abstract:Objective To investigate the combined predictive value of hepatitis B virus DNA(HBV DNA)load,liver stiffness measurement(LSM),and serum inflammatory markers for the progression and prognosis of decompensated hepatitis B-related cirrhosis(HBV-DC).Methods A prospective cohort study was conducted involving 168 patients with HBV-DC admitted between May 2023 and April 2024.A standardized follow-up protocol was established:dynamic monitoring was performed at months 1,3,6,9,and 12 post-enrollment,with the 12-month endpoint following treatment initiation.Patients were categorized into the improvement group(n=96)and the progression group(n=72).Baseline characteristics,HBV DNA levels,liver stiffness,and serum inflammatory markers[procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP)]were compared between groups.Logistic regression models analyzed factors influencing HBV-DC progression and prognosis.ROC curves assessed the predictive value of combined HBV DNA levels,liver stiffness,and serum inflammatory factors for HBV-DC progression and prognosis.Finally,validation cohort data were incorporated into the constructed combined prediction model to evaluate the efficacy of the inflammatory combination prediction.Results Significant differences were observed between the improvement group and the progression group in terms of age,concomitant diabetes,type of first decompensated event,ALT,AST,and Child-Pugh score(P<0.05).At all time points,the improvement group exhibited lower levels of HBV DNA,LSM,PCT,and hs-CRP compared to the progression group.Notably,LSM and HBV DNA levels in the progression group increased significantly over time,whereas the improvement group showed a decreasing trend.These indicators demonstrated divergent temporal trends between groups(P<0.05).Logistic regression analysis revealed that age,Child-Pugh score,elevated HBV DNA,LSM,PCT,and hs-CRP were independent predictors of HBV-DC progression and prognosis(P<0.05).ROC curve analysis indicated optimal predictive thresholds for HBV-DC progression and prognosis:HBV DNA≥4.85 log10 IU/mL,≥9.14 kPa,≥0.78 ng/mL,and≥9.63 mg/L,respectively.The combined predictive sensitivity and specificity for HBV-DC progression and prognosis were 76.73%and 86.72%,demonstrating superior predictive efficacy.Hosmer-Lemeshow goodness-of-fit testing confirmed high calibration accuracy for the combined predictive model.Conclusions HBV DNA load,liver stiffness,and serum inflammatory markers(PCT,hs-CRP)serve as independent predictors of HBV-DC progression and prognosis,with their combined predictive value being even higher.

Abstract:Objective To investigate the epidemiological characteristics of respiratory pathogens in Tong'an,Xiamen.Methods Pharyngeal swab were collected from 5 439 respiratory infection cases in the Third Hospital of Xiamen from 2022 to 2023.Common respiratory pathogens were detected by real-time fluorescent polymerase chain reaction technology.Epidemiological characteristics of respiratory pathogens were analyzed statistically across different genders,age groups,years and months.Statistical analysis was performed by χ2 test.Results Among the 5 439 throat swab specimens,1 774(32.62%)tested positive for nucleic acid of respiratory pathogens.The detection rate of influenza A virus(Flu A)was the highest(11.42%).A single infection was predominant(92.00%).Among mixed infections,the most common pattern was Flu A+Mycoplasma pneumoniae(MP)(33.80%).The detection rate of MP was higher in female patients than in male patients(P<0.05).Statistically significant differences in detection rates were observed across different age groups for parainfluenza virus type 1,parainfluenza virus type 3(PIV-3),respiratory syncytial virus(RSV),adenovirus(ADV),influenza B virus(Flu B)and MP(P<0.05).Patients with positive respiratory pathogen nucleic acid detection were predominantly concentrated in the age group of<18 years.Detection rates of PIV-3,RSV,Flu A,ADV and Flu B also showed statistically significant differences between 2022 and 2023(P<0.05).The prevalence of different pathogens varied with the changing of months.Conclusion Flu A is one of the primary pathogens causing respiratory diseases among residents in Tong'an,Xiamen.Detection rates of pathogens varied across different age groups,genders,years,and months.Relevant departments should implement targeted prevention and control measures accordingly.

Abstract:Objective To analyze the epidemiological characteristics and spatio-temporal clustering of hand,foot and mouth disease(HFMD)in China before and after the application of inactivated enterovirus 71(EV71)vaccine,and to provide a scientific basis for optimizing the vaccination strategy and formulating precise prevention and control measures.Methods The surveillance data of HFMD in China from 2011 to 2019 were collected through the Chinese Public Health Science Data Center.Excel 2016 software and SPSS 24.0 software were used for data sorting and descriptive statistical analysis.ArcGIS 10.8 software was used for global and local autocorrelation analysis.Spatiotemporal scan analysis was performed using SaTScan 10.2.5 software to analyze the spatio-temporal clustering characteristics.Results From 2011 to 2019,the average annual reported incidence rate of HFMD in China was 154.82/105,and the standardized incidence rate was 148.94/105.The average annual reported incidence rate of the EV71 vaccine after application(148.89/105)was lower than that before(157.86/105),and the standardized incidence rates were 141.66/105 and 152.77/105.There was an obvious seasonal fluctuation of the onset,and the peak incidence was mainly concentrated in April to July.Most of the cases were reported among 0-4 years old accounting for 89.37%,and the incidence rate after application of EV71 vaccine was lower than that before with statistically significant difference(χ2=45 371.564,P=0.000).The top three annual reported incidence rates before and after the application of EV71 vaccine were Hainan,Guangxi and Guangdong,and the incidence rate after the application of EV71 vaccine in Hainan and Guangxi were lower than those prior to vaccination(χ2Hainan=6 805.520,χ2Guangxi=9 355.466,P=0.000).Spatial analysis showed that the incidence of HFMD in China from 2011 to 2019 had spatial clustering(Moran's I=0.263-0.547,P<0.05),spatio-temporal scanning analysis identified six clusters,of which the first type cluster encompassing four provinces of Guangdong,Hainan,Guangxi and Hunan,and the aggregation time was 2014-2017.Conclusion The incidence rate of HFMD in China from 2011 to 2019 fluctuated slightly within a small range,and the average annual reported incidence rate after application of the EV71 vaccine was lower than that before.Comprehensive measures should be adopted to control the epidemic trend of HFMD,including enhancing immunization strategies,strengthening surveillance and early warning systems,and deepening health education initiatives.

Abstract:Objective To explore nursing-related risk factors for hepatic encephalopathy(HE)after transjugular intrahepatic portosystemic shunt(TIPS)in patients with portal hypertension and establish a risk warning model to guide clinical nursing interventions.Methods A total of 125 patients undergoing TIPS were enrolled.During hospitalization,daily voice broadcast education was implemented,while post-discharge management included guidance to follow a departmental health management public account(weekly health information updates)and monthly telephone follow-ups.Univariate and multivariate Logistic regression analyses were performed to identify HE-related factors.A nomogram prediction model was constructed based on independent influencing factors,and its performance was validated using ROC curves,calibration curves,and decision curve analysis.Results The incidence of HE was 14.4%(18/125).Logistic regression revealed that age(OR=1.266,P=0.000),postoperative gastrointestinal bleeding complications(OR=14.971,P=0.001),and non-compliance with educational broadcasts(OR=53.075,P=0.000)were independent risk factors for hepatic encephalopathy after TIPS surgery for portal hypertension.The prediction model achieved an AUC of 0.827,with calibration curves showing good predictive accuracy.Conclusion Age,postoperative gastrointestinal bleeding,and non-compliance with educational broadcasts are independent risk factors for post-TIPS hepatic encephalopathy.The constructed prediction model can effectively identify high-risk patients and provide guidance for individualized nursing care.

Abstract:Objective To explore the changes in immunophenotypic indicators during the severe process of elderly influenza patients,to identify relevant independent risk factors,and to construct predictive models to assess their discriminative efficacy.Methods This study retrospectively enrolled120 elderly hospitalized patients diagnosed with influenza at Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2019 to December 2023.Demographic information,underlying diseases,clinical characteristics,laboratory indicators,and immune phenotype detection data within 24 hours of admission were collected.Univariate and multivariate logistic regression analyses were used to identify independent factors influencing severity.Receiver operating characteristic curves,calibration curves,and decision curves were plotted to evaluate model performance.Results The multiple factor analysis showed that the number of underlying diseases,the proportion of CD4+T cells,the ratio of CD4/CD8,the proportion of natural killer cells and the level of interleukin-6 were independent influencing factors for the severe disease in elderly influenza patients(P<0.05).The multivariate logistic regression model constructed based on these factors showed good discrimination,with an area under the curve of 0.872,sensitivity of 81.3%,and specificity of 78.5%.Conclusion Multiple immunophenotypic features and inflammatory factors have important early warning value in the process of severe influenza in the elderly.The constructed prediction model has high performance and can provide decision support for early identification and intervention of high-risk groups of influenza in the elderly.

Abstract:Objective To analyze the clinical characteristics of HIV/AIDS patients with sepsis,and to provide reference for the early diagnosis and treatment of HIV/AIDS patients with sepsis.Methods HIV/AIDS patients with sepsis admitted to Nanning Fourth People's Hospital from January 2021 to December 2022 were selected as the study subjects.Based on 30-day clinical outcomes,they were divided into a survival group and a death group.General data,infection distribution,and laboratory test results were compared between the two groups,and pathogen distribution was analyzed.Results A total of 431 patients were included,with 269(62.4%)in the survival group and 162(37.6%)in the death group.Among them,383(88.9%)patients had multiple infections,with the respiratory system being the most common site of infection.The death group had significantly higher age,bleeding rate,shock rate,organ failure rate,sequential organ failure assessment(SOFA)score,proportion of comorbid malignancies,and proportion of cryptococcal antigenemia compared to the survival group(P<0.05).The survival group had higher body mass index,proportion of comorbid syphilis infection,and hospitalization duration than the death group(P<0.05).The death group also had higher rates of central nervous system infections and multi-organ infections(P<0.05).Laboratory results showed that the death group had significantly higher white blood cell count,procalcitonin,C-reactive protein,absolute neutrophil count,lactate,lactate dehydrogenase,and prothrombin time compared to the survival group(P<0.05).Conversely,hemoglobin,albumin,and CD4+T-cell counts were lower in the death group(P<0.05).In terms of pathogens,351(81.4%)patients had positive pathogen cultures,with 199(56.7%)showing two or more pathogens.Fungal infections predominated,with the most common pathogens being Candida albicans(180 cases,25.8%),Talaromyces marneffei(119 cases,17.1%),Klebsiella pneumoniae(54 cases,7.7%),Mycobacterium(45 cases,6.5%),and Escherichia coli(36 cases,5.2%).Conclusion HIV/AIDS patients with sepsis primarily present with multiple infections,most commonly in the respiratory system.Fungal infections are predominant,with diverse pathogen profiles.Treatment should involve broad-spectrum and combined antimicrobial therapy.

Abstract:Objective To investigate the impacts of the combination therapy of Kangfuxin liquid and Bedaquiline(BDQ)on the lung function,immune function,and nutritional status in patients with multidrug-resistant pulmonary tuberculosis.Methods From January 2022 to December 2023,150 patients with multidrug-resistant pulmonary tuberculosis who seek treatment in our hospital were assigned into a conventional group,a BDQ group,and an innovative group via a random number table.The conventional group received treatment with conventional drugs,the BDQ group received treatment with BDQ,while the innovative group received treatment with Kangfuxin liquid in addition to BDQ group treatment.After 24 weeks of treatment,the clinical efficacy(cavity improvement rate,lesion absorption rate,sputum negative conversion rate)and adverse reactions(peripheral neuropathy,gastrointestinal reactions,QT interval prolongation,bone pain)were compared;in addition,the pulmonary function[forced vital capacity in one second(FEV1%),maximum ventilation per minute(MVV%),and forced vital capacity(FVC%)],nutritional status(nutritional risk score,body mass index,hemoglobin,albumin),and immune function(CD4+T cells,CD8+T cells,CD4+/CD8+)of both groups before and after treatment were tested.Results The cavity improvement rate,sputum negative conversion rate,and lesion absorption rate of the BDQ group were all higher than those in the conventional group after 24 weeks of treatment(P<0.05),while the cavity closure rate,sputum negative conversion rate,and lesion absorption rate of the innovative group were all higher than those in the BDQ group(P<0.05).The FEV1%,MVV%,FVC%,CD4+T cells,CD4+/CD8+,body mass index,hemoglobin,and albumin levels of both groups increased compared to before treatment(P<0.05),while CD8+T cells and nutritional risk score decreased compared to before treatment(P<0.05),and the difference between before and after treatment in the BDQ group was greater than that of the conventional group(P<0.05),while the difference between before and after treatment in the innovative group was greater than that of the BDQ group(P<0.05).There was no significant difference in the total adverse reactions among the 3 groups(P>0.05).Conclusion The combination of Kangfuxin liquid and BDQ can improve the efficacy and safety of multidrug-resistant pulmonary tuberculosis patients,and improve their symptoms,pulmonary function,immune function,and nutritional status.

Abstract:Objective To compare and analyze the sex hormone characteristics of male patients with hepatitis B related liver cancer and alcohol related liver cancer,and explore the relationship between sex hormone and liver cancer.Methods Male patients diagnosed with liver cancer who visited our hospital from November 15,2016 to November 10,2024.According to clinical diagnosis,the patients were categorized into hepatitis B related liver cancer and alcohol related liver cancer.Serum testosterone(T),follicle stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2)and other sex hormones were detected by chemiluminescence method.The liver function,kidney function,and coagulation function indicators of patients were detected using the rate method and immunoturbidimetric method.Use polymerase chain reaction(PCR)to detect the viral load of patients.T-test or χ2 analysis was used to compare the level of sex hormones in patients with hepatitis B related liver cancer and alcohol related liver cancer.Results There were significant differences in sex hormones between hepatitis B related liver cancer group and alcohol related liver cancer group.The testosterone level in hepatitis B related liver cancer group was significantly higher than that in alcohol related liver cancer group(t=5.620,P=0.036).The levels of prolactin and estradiol in alcohol related liver cancer group were significantly higher than those in hepatitis B related liver cancer group(t=0.780,P=0.016;t=1.060,P=0.029).The ratio of serum testosterone to prolactin(T/PRL)was significantly correlated with the PCT level(P=0.011,P=0.022)and CRP level(P=0.021,P=0.005)in hepatitis B related liver cancer group and alcohol related liver cancer group.Conclusion Sex hormone levels in patients with hepatitis B and alcohol related liver cancer are different.T/PRL ratio is expected to serve as a potential biomarker for monitoring the occurrence and prevention of liver cancer.

Abstract:Objective To investigate the significance of the expression of CD38,human leukocyte antigen DR(HLA-DR)and Ki-67 on the surface activation molecules of Mycobacterium tuberculosis(MT)specific CD154+CD4+T cells in differentiating smear-negative and smear-positive pulmonary tuberculosis(PTB)and monitoring anti-tuberculosis therapy.Methods A total of 100 newly treated PTB patients admitted to the hospital from January 2021 to June 2023 were selected as the study objects,and further divided into the smear negative group(n=48)and the smear positive group(n=52).All patients received standard anti-tuberculosis therapy.Sputum culture was detected after 2 months of intensive treatment.CD4+T cells from peripheral blood mononuclear cells responding to purified Mycobacterium tuberculosis purified protein derivative(PPD)or 6kD early secretory antigenic target/culture filtrate protein10(ESAT-6/CFP-10)were analyzed.Based on the expression profiles of the proliferation marker nuclear-associatedantigenki-67(Ki-67),the activation marker differentiation cluster of differentiation(CD38),and human leukocyte antigen DR(HLA-DR),the activation status of tuberculosis antigen-reactive T cells identified by the surface expression of CD154+was evaluated.Results There was no statistically significant difference in the proportion of PPD reactive CD154+CD4+T cells between the negative and positive groups(P>0.05);The proportion of ESAT-6/CFP-10 reactive CD154+CD4+T cells in the smear-positive group was higher than that in the smear-negative group,and the difference was statistically significant(P<0.05).However,in the working characteristic curve of the subjects,the area under the curve for distinguishing the proportion of ESAT-6/CFP-10 reactive CD154+CD4+T cells in the positive group was only 0.601.In addition,the proportion of CD38+,HLA DR+or Ki-67+PPD or ESAT-6/CFP-10 specific CD154+CD4+T cells in the smear-positive group was significantly higher than that in the smear-negative group,and the difference was statistically significant(P<0.05).The results of receiver operating characteristic curve analysis showed that the sensitivity and specificity of the proportion of CD38+,HLA-DR+,Ki-67+PPD or ESAT-6/CFP-10 reactive CD154+CD4+T cells in differentiating smeg-positive patients were 59.62%to 86.54%and 72.92%to 91.67%,respectively.There was no statistically significant difference in the expression of CD38+,HLA-DR+and Ki67+in the smear-negative group before treatment and 2 months after treatment(P>0.05),but the proportion of MT-specific T cells of CD38+,HLA-DR+and Ki-67+in the smear-positive group decreased significantly 2 months after anti-tuberculosis treatment(P<0.05).Among smear-positive PTB patients,the proportions of CD38+,HLA-DR+and Ki-67+MT-specific CD154+CD4+T cells in the sputum non-negative conversion group after 2 months of treatment were significantly higher than those in the sputum negative conversion group(P<0.05).Moreover,the decrease amplitudes of the proportions of CD38+,HLA-DR+and Ki-67+MT-specific CD154+CD4+T cells in the group without sputum turning negative were significantly lower than those in the group with sputum turning negative(P<0.05).Conclusion The expression of MT-specific CD154+CD4+T cell activation and proliferation markers CD38,HLA-DR,and Ki-67 is helpful to distinguish sputum smear-negative and smear-positive PTB and monitor the anti-tuberculosis treatment response of smear-positive PTB patients.

Abstract:Objective To develop a predictive model for varicella in Taicang City using the Moving Epidemics Method(MEM)and provide scientific evidence for comprehensive varicella control.Methods The MEM was applied to weekly varicella case data from the China Infectious Disease Surveillance Information System for the period 2017-2024.The model was used to evaluate the thresholds for varicella epidemic intensity and to assess the incidence of varicella for the 2024-2025 season.Results Based on the data from 2017-—2021 and 2023-2024,the optimal MEM model was established with a parameter δ of 2.3.The model demonstrated strong fitting capability,with a sensitivity of 0.79,specificity of 0.93,and Youden's index of 0.72.The thresholds for the start and end of the epidemic were 51 cases and 32 cases,respectively.The thresholds for moderate,high,and very high epidemic intensity were 103 cases,183 cases,and 216 cases,respectively.Using this model,the 2024-2025 season was evaluated,and the weekly case numbers were found to be within the baseline level.Conclusion The MEM model developed for varicella in Taicang City showed good fitting performance.This model can be effectively used for early warning of varicella outbreaks and to guide comprehensive varicella control measures.