Abstract:Objective To explore the correlation between levels of serum Krebs Von den Lungen-6(KL-6),T-cell immunoglobulin and mucin domain-containing molecule-4(TIM-4)and the severity and poor prognosis of pulmonary tuberculosis(TB)patients.Methods From July 2021 to July 2023,158 TB patients who visited Liyang Branch of Jiangsu Provincial People's Hospital were regarded as the TB group,and another 158 healthy people who underwent physical checkups were as the control group.Disease severity was assessed using the Bandim tuberculosis score,classifying patients into severe(n=61)and mild(n=97)groups.According to the prognosis,patients were divided into favorable(n=101)and poor(n=57)prognosis groups.Logistic regression analysis was used to analyze the influencing factors of prognosis of TB patients;Spearman's correlation analysis was used to analyze the correlation between serum KL-6 and TIM-4 levels and the severity of the TB,and the receiver operating characteristic curve was used to analyze the predictive efficiency of serum KL-6 and TIM-4 for prognosis of TB patients.Results Compared with the control group,the levels of serum KL-6 and TIM-4 in the TB group were markedly higher(P<0.05).Serum levels of KL-6 and TIM-4 were significantly elevated in the severe group compared to the mild group(P<0.05).Compared with the favorable group,the levels of serum KL-6 and TIM-4 in the poor group were significantly higher(P<0.05).Serum KL-6 and TIM-4 levels were both independent influencing factors for the poor prognosis of TB patients(P<0.05).The area under the curve(AUC)of serum KL-6 and TIM-4 in predicting the prognosis of TB patients was 0.789 and 0.803,respectively,the AUC of their combination was 0.914,and the predictive power of the combination was better than that of any single indicator(zcombination-KL-6=3.375,P=0.001,zcombination-TIM-4=3.514,P=0.000).Conclusion The levels of serum KL-6 and TIM-4 in TB patients increase,and they are closely related to the severity of disease and poor prognosis.Moreover,the combined prediction of these two biomarkers has a high predictive value for the poor prognosis of TB patients.

Abstract:Objective To analyze the factors associated with co-infection with hepatitis B virus(HBV)in human immunodeficiency virus(HIV)-infected patients,and to develop and validate a nomogram prediction model based on clinical characteristics and T-cell subsets.Methods A retrospective study was conducted on 150 HIV-infected patients admitted to Nantong Third People's Hospital between January 2017 and June 2022.Based on their HBV co-infection status,the patients were divided into co-infected group and non-co-infected group.Clinical data and laboratory indicators of patients were collected and compared between the 2 groups.Variables that showed significant differences in univariate analysis were screened for multicollinearity,and those without collinearity were included in multivariate logistic regression analysis to identify predictors factors for HBV co-infection.Using R software,a nomogram prediction model was constructed based on statistically significant variables from the multivariate logistic analysis,and internal validation was performed.Results Among the 150 HIV-infected individuals,22 cases(14.67%)were co-infected with HBV and 128 cases(85.33%)were not co-infected.There were statistically significant differences between the 2 groups in terms of age,family history of HBV,history of hepatitis B vaccination,CD4+T lymphocytes,and CD4+/CD8+levels(P<0.05),and there was no collinearity problem among these variables(VIF≤10,tolerance≥0.1).Multivariate Logistic regression analysis showed that Age(OR=3.846,P=0.029),family history of HBV(OR=46.750,P=0.001),and no history of hepatitis B vaccination(OR=3.278,P=0.035)were risk factors for concurrent HBV infection(P<0.01).CD4+T lymphocytes(OR=0.942,P=0.001)and CD4+/CD8+(OR=0.004,P=0.001)were protective factors(P<0.01).A nomogram prediction model was constructed based on the above 5 predictors.Internal validation showed that the area under the receiver operating characteristic curve was 0.955(95%CI:0.913-0.998),the calibration curve fitted well(P=0.353),Cox-Snell R2=0.689,Nagelkerke R2=0.39,suggesting that the model had good discrimination and calibration,and no overfitting occurred.Decision curve analysis shows that this nomogram has a relatively high clinical net benefit within a large threshold range.Conclusion Age,family history of HBV,history of hepatitis B vaccination,CD4+T lymphocytes,and CD4+/CD8+are all independent influencing factors affecting HBV infection in HIV-infected individuals.The nomogram prediction model constructed based on the above factors has good predictive efficacy.It can provide quantitative tools for the early stratified screening of the risk of HBV infection in HIV-infected individuals.

Abstract:Objective To investigate the prevalence of Helicobacter pylori(Hp)infection and its associated risk factors among the freshmen of Lanzhou University in 2023.Methods This study adopts a cross-sectional research design and selects 420 freshmen from the 2023 cohort of Lanzhou University as the research subjects through cluster sampling.A questionnaire survey and Hp antigen testing were conducted separately for all selected subjects.Analyze the infection rate of Hp and its influencing factors.The questionnaire survey covers information such as gender,ethnicity,place of birth,living environment,family income,number of family members,dietary habits,smoking and drinking.Use ¹³C urea breath test to detect Hp infection,and analyze the influencing factors of Hp infection using multiple logistic regression.Results The Hp infection rate among 420 freshmen selected from the 2023 grade of Lanzhou University is 18.6%.The female Hp infection rate was 19.2%and the male Hp infection rate was 17.7%,with no statistically significant difference(P>0.05).The Hp infection rate among rural and urban students was 20.4%,while the Hp infection rate among urban students was 14.3%,with no statistically significant difference(P>0.05).The results of multiple logistic regression analysis showed that high salt,high-fat,and spicy diet habits(OR=6.482),drinking well water at home(OR=6.872),and having more than 5 family members(OR=4.651)were independent risk factors for Hp infection(P<0.05);Long term exercise habits(OR=0.314)and cafeteria dining experience(OR=0.098)are independent protective factors against Hp infection(P<0.05).Conclusion The Hp infection rate among the freshmen of Lanzhou University in 2023 is relatively low.Dietary habits,drinking water hygiene,and family size are independent risk factors for Hp infection.Improving dietary habits and increasing physical activity may reduce the risk of Hp infection.

Abstract:Blastomycosis,also known as North American blastomycosis,is an endemic fungal infection mainly caused by Blastomyces dermatitidis.In China,only a small number of cases have been reported,and most of them have manifestations of skin infection,while asymptomatic primary pulmonary blastomycosis is more rare,so rapid and accurate diagnosis is crucial for treatment.In this article,we report a case of pulmonary blastomycosis in Shandong Province.The patient was ineffective in antibiotic treatment for"pulmonary nodule",and multidisciplinary consultation considered the possibility of early lung cancer,but finally diagnosed as pulmonary blastomycosis infection by pathology after surgical treatment.The relevant examination and laboratory results were negative 4 months later.The purpose of this paper is to improve the knowledge of clinicians about pulmonary blastomycosis by reviewing the case data and related literature,and to alert the occurrence of indigenous cases,especially those with a history of exposure to humid environment,so as to make a clear diagnosis as soon as possible.

Abstract:Objective To investigate the clinical characteristics,pathogenic risk factors and adverse prognostic factors of esophagogastric variceal bleeding(EGVB)in patients with hepatitis B cirrhosis(HBV-related cirrhosis).Methods A retrospective analysis was performed on 150 patients with HBV-related cirrhosis complicated with EGVB admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from October 2017 to October 2023,who were enrolled as the bleeding group.Meanwhile,another 150 patients with HBV-related cirrhosis complicated with esophagogastric varices(EGV)without bleeding were enrolled as the non-bleeding group.The clinical characteristics between the two groups were compared,and logistic regression analysis was applied to identify the risk factors for EGVB in patients with HBV-related cirrhosis.All 150 patients in the bleeding group were followed up for 1 year.According to the follow-up outcomes,20 patients who died or were readmitted due to recurrent bleeding within 1 year were assigned to the poor prognostic group,and the remaining 130 patients were assigned to the good prognosis group.The clinical characteristics of the two prognosis groups were compared,and logistic regression analysis was used to explore the factors influencing poor prognosis of EGVB in patients with HBV-related cirrhosis.Results Compared with the non-bleeding group,the bleeding group showed significant differences in the course of cirrhosis,Child-Pugh classification,degree of esophageal varices,presence of red signs,complicated cirrhotic ascites,history of accidental trauma,portal vein internal diameter,and alanine aminotransferase(ALT)levels(P<0.05);Logistic regression analysis revealed that Child-Pugh grade C,severe esophageal varices,presence of red signs,complicated cirrhotic ascites,history of accidental trauma,and ALT≥40 U/L were the main risk factors for EGVB in patients with HBV-related cirrhosis(P<0.05);Between the poor prognosis group and the good prognosis group,there were statistically significant differences in Child-Pugh classification,complicated cirrhotic ascites,complicated hepatic encephalopathy,complicated hemorrhagic shock,time from onset to treatment,bleeding volume≥500 mL,serum albumin level,and prothrombin time(P<0.05).Child-Pugh grade C,complicated hepatic encephalopathy,complicated hemorrhagic shock,time from onset to treatment≥4 hours,bleeding volume≥500 mL,and serum albumin<30 g/L were identified as the major risk factors for poor prognosis of EGVB in patients with HBV-related cirrhosis(P<0.05).Conclusion For patients with HBV-related cirrhosis,early assessment of Child-Pugh classification,degree of esophageal varices,presence of the red signs,complicated cirrhotic ascites,history of accidental trauma,and ALT level can help identify the risk of EGVB.After the occurrence of EGVB,close monitoring should be strengthened for patients with high Child-Pugh classification,complicated hepatic encephalopathy,complicated hemorrhagic shock,prolonged time from onset to treatment,bleeding volume≥500 mL or low serum albumin level,so as to adjust the treatment regimen in a timely manner and improve the prognostic outcomes.

Abstract:Objective To investigate the association of serum soluble cluster differentiation 163(sCD163),sphingosine-1-phosphate(S1P),mean platelet volume-to-lymphocyte ratio(MPVLR)and the severity and prognosis of Mycoplasma pneumoniae pneumonia with atelectasis.Methods A total of 120 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2021 to December 2024 were selected,and divided into a group with atelectasis(64 cases)and a group without atelectasis(56 cases)according to whether they were accompanied by atelectasis.The serum sCD163,S1P,MPVLR levels,arterial carbon dioxide partial pressure,and arterial oxygen partial pressure of all children were detected to observe the prognosis,and the predictive efficacy was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the non-atelectasis group,serum levels of sCD163,S1P,and MPVLR in the atelectasis group were significantly increased(P<0.05).Compared with the non-atelectasis group,the partial pressure of carbon dioxide in arterial blood was higher in the atelectasis group(P<0.05),and the partial pressure of oxygen in arterial blood was lower(P<0.05).Through Pearson correlation analysis,the levels of serum sCD163,S1P,and MPVLR in children with Mycoplasma pneumoniae pneumonia accompanied by atelectasis were positively correlated with the partial pressure of carbon dioxide in arterial blood(P<0.05)and negatively correlated with the partial pressure of oxygen in arterial blood(P<0.05).Serum levels of sCD163,S1P,and MPVLR in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).ROC curve analysis showed that serum sCD163 and S1P combined with MPVLR had a sensitivity of 91.42%,specificity of 58.73%,and AUC of 0.893 in predicting poor prognosis of children with Mycoplasma pneumoniae pneumonia with atelectasis.Conclusion Serum sCD163,S1P,and MPVLR are closely related to the severity of Mycoplasma pneumoniae pneumonia with atelectasis,and the combination of these three indicators showed good predictive performance for prognosis and worthy of clinical attention.

Abstract:Objective Cervical cancer prevention and control among Chinese women of childbearing age infected with human immunodeficiency virus(HIV)have not received sufficient attention,and cervical cancer screening has not been incorporated into routine check-up items in HIV antiretroviral therapy clinics.This study aims to systematically evaluate the current status of human papillomavirus(HPV)infection and cervical lesions in Chinese HIV-infected women of childbearing age through meta-analysis,providing evidence-based data for developing targeted cervical cancer screening strategies.Methods Case-control studies on cervical cancer screening among Chinese HIV-infected women of childbearing age were systematically retrieved from databases such as CNKI,Wanfang,VIP,and PubMed.The incidence rates of high-risk HPV infection,low-risk HPV infection,multiple HPV infections,cervical low-grade lesions,and cervical high-grade lesions were extracted and analyzed for HIV-infected women(observation group)and HIV-negative women(control group).Statistical analysis was performed using STATA 15.0 software,and publication bias was assessed using Begg's test.Results A total of 16 articles(14 in Chinese and 2 in English)were included.The incidence rates of high-risk HPV infection,low-risk HPV infection,multiple HPV infections,cervical low-grade lesions,and cervical high-grade lesions in the observation group were 34.34%,14.20%,19.54%,14.00%,and 9.46%,respectively.In the control group,the incidence rates were 17.42%,8.15%,5.24%,4.11%,and 2.64%,respectively.Meta-analysis showed that high-risk HPV infection(OR=3.78,95%CI:2.36-3.36,P<0.05),multiple HPV infections,and cervical high-grade lesions were calculated using a random-effects model,with 95%confidence intervals of 2.82(2.36-3.36),3.78(1.99-7.18),and 3.15(1.51-6.58),respectively,and the statistical P-values were all<0.05,indicating significant differences.Low-risk HPV infection was calculated using a random-effects model,with a 95%confidence interval of 1.62(0.97-2.69),but the statistical P-value was>0.05,indicating no significant difference.Cervical low-grade lesions were analyzed using a fixed-effects model,with a 95%confidence interval of 2.94(2.05-4.22),and the difference was not statistically significant(P=0.08).The results indicate that HIV infection can significantly increase the risk of high-risk HPV infection,multiple HPV infections,and cervical high-grade lesions in Chinese women.Although the risk of low-risk HPV infection and cervical low-grade lesions appears elevated in HIV-infected Chinese women,the differences are not statistically significant.Conclusion HIV infection can significantly increase the risk of high-risk HPV infection,multiple HPV infections,and cervical high-grade lesions in Chinese women.

Abstract:Objective To explore and analyze the clinical diagnostic value of chest computed tomography(CT)combined with serum microribonucleic acid(miR-146a)and miR-124-3p for pulmonary tuberculosis.Methods From July 2021 to July 2024,106 patients with suspected tuberculosis admitted to our hospital were included as objects,and were assigned into tuberculosis group(n=62)and non tuberculosis group(n=44)according to their pathological test results.The 80 healthy individuals selected for medical examination were healthy controls.Logistic regression was applied to analyze the effects of miR-146a and miR-124-3p on pulmonary tuberculosis.The receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of miR-146a and miR-124-3p for pulmonary tuberculosis.Kappa was applied to analyze the consistency between the combined examination of chest CT,serum miR-146a and miR-124-3p and the pathological examination results..Results The differences in serum miR-146a(1.00±0.11 vs.0.71±0.09 vs.0.88±0.10)and miR-124-3p(1.00±0.11 vs.0.66±0.08 vs.0.81±0.09)levels between the healthy control group,the non-tuberculosis group,and the pulmonary tuberculosis group were statistically significant(all P<0.05)MiR-146a[OR,95%CI(0.665,0.448-0.986)]and miR-124-3p[OR,95%CI(0.748,0.597-0.937)]were both protective factors that affected the occurrence of pulmonary tuberculosis(P=0.042,0.012).ROC curve results showed that the AUC for diagnosing pulmonary tuberculosis using miR-146a and miR-124-3p was 0.829 and 0.849,respectively.Chest CT had a high concordance Kappa value of 0.622 when compared to pathologic examination(P<0.05).The combined detection of chest CT,serum miR-146a and miR-124-3p had extremely high consistency with pathological examination,with a Kappa value of 0.828(P<0.05).The specificity,positive predictive value,and accuracy of the combination of the three in diagnosing pulmonary tuberculosis were obviously higher than those of chest CT,miR-146a,and miR-124-3p alone(P<0.05).Conclusion The levels of serum miR-146a and miR-124-3p are reduced in patients with pulmonary tuberculosis,and chest CT combined with serum miR-146a and miR-124-3p has certain clinical value in the diagnosis of pulmonary tuberculosis.

Abstract:Objective To evaluate the diagnostic value of the chemiluminescence-based tuberculosis interferon-gamma assay(TB-IGRA)for active pulmonary tuberculosis in HIV-infected populations,and to analyze its sensitivity,specificity,and related influencing factors.Methods We retrospectively collected the clinical and laboratory data from 108 HIV-infected inpatients admitted to Xiaogan First People's Hospital between January 2021 to March 2023.Among them,76 cases were clinically diagnosed with active pulmonary tuberculosis(study group),while the remaining 32 patients without tuberculosis infection served as the control group.By comparing TB-IGRA test results between the 2 groups,we aimed to evaluate the diagnostic performance of TB-IGRA for tuberculosis in HIV-infected individuals.Furthermore,the study group was subdivided into negative group and the positive group based on TB-IGRA results.Spearman'rank correlation analysis was performed to assess the associations between HIV viral load,CD4+T-lymphocyte count,and TB-IGRA outcomes.Additionally,multivariate logistic regression analysis was conducted to indentify independent predictors of TB-IGRA sensitivity in this population.Results The sensitivity of TB-IGRA for diagnosing active pulmonary tuberculosis in HIV-infected individuals was 71.05%,with a specificity of 90.63%,positive predictive value(PPV)of 94.74%,negative predictive value(NPV)of 56.86%,and overall accuracy of 76.85%.Multivariate analysis revealed that age,CD4+T-lymphocyte count,and HIV viral load were independent predictors of TB-IGRA sensitivity.Conclusion TB-IGRA demonstrates high specificity and accuracy for diagnosing active pulmonary tuberculosis in HIV-infected individuals,but its sensitivity is relatively low.The test results are significantly by age,HIV viral load,and CD4+T-lymphocyte count.

Abstract:Objective This study aims to analyze the epidemiological characteristics of notifiable infectious diseases in the Beijing Economic-Technological Development Area(BDA)from 2022 to 2024,and to provide scientific evidence for prevention and control of infectious disease in the region,and to serve as a reference for other national-level economic and technological development zones.Methods Data on the incidence of notifiable infectious diseases in the BDA from 2022 to 2024 was obtained from the Infectious Disease Monitoring System of the China Disease Prevention and Control Information System.A descriptive analysis was conducted on the dataset.Results A total of 17 notifiable infectious diseases were reported from 2022 to 2024,with an average incidence rate of 2 757.38/100 000.Only one case of Class A infectious disease was reported.The average incidence rate of Class B infectious diseases was 879.27/100 000.The average incidence rate of Class C infectious diseases was 1 877.94/100 000.Epidemic Characteristics by Transmission Route(Class A and B):The average incidence rate of respiratory infectious diseases(Class A and B)was 840.14/100 000,representing the main transmission route.The average incidence rate of intestinal infectious diseases(Class A and B)was 6.02/100 000.The average incidence rate of blood-borne and sexually transmitted diseases(Class A and B)was 32.78/100 000.The average incidence rate of natural foci and insect-borne infectious diseases(Class A and B)was 0.5/100 000.Conclusion The spectrum of notifiable infectious diseases in BDA are relatively concentrated,with respiratory infectious diseases being the key focus of prevention and control.It is crucial to enhance public awareness of prevention and control measures to effectively block the transmission of respiratory infectious diseases.Priority should be given to strengthening prevention and control work in workplaces,schools and childcare facilities,and community venues.

Abstract:Objective The purpose is to conduct a bibliometric analysis of the literature related to the pathogenesis of Long COVID using CiteSpace software,in order to reveal the research status,hotspots,and future trends,providing a reference for subsequent research.Methods Using the Web of Science Core Collection(WoSCC)as the retrieval source,literature from January 1,2020,to November 23,2024,was searched.CiteSpace 6.3.3(64-bit)Advanced was used for visual analysis to create co-occurrence knowledge maps.Results A total of 2 853 English articles were included,with the number of publications increasing annually.The research directions covered general internal medicine,immunology,neuroscience,and neurology,etc.Journals such as Frontiers in Immunology and The Lancet had a high number of publications,and core author teams played an important role in this field.The United States had the most publications,the United Kingdom had the highest centrality,and University College London ranked first in the number of publications,with Harvard University having the highest centrality.Keywords with high frequency included'COVID-19','infection','impact',etc.,and emergent keywords such as'transmission'and'effectiveness'have continued to this day,forming seven largest clustering groups including deep learning,molecular docking,mental health,etc.Conclusion Research on the pathogenesis of Long COVID has become a hotspot in the global medical field,involving multidisciplinary cross-over.Future research needs to be further integrated,focused,and deepened,especially in the areas of mental health and transmission risk assessment.

Abstract:The common antiretroviral drugs targeting different stages of the human immunodeficiency virus(HIV)lifecycle have made great progress in clinical treatment of HIV infection.However,due to the long-term incubation of the virus library and its persistent presence in a few infected cells,it cannot be completely eliminated through antiretroviral therapy(ART);There are also some drug-resistant mutations and adverse drug reactions in the treatment process,while the cure research and vaccine development of AIDS are still in the experimental stage.Therefore,in the absence of protective vaccines and enhanced efficient antiretroviral therapy that cannot eradicate the virus,eradicating latent reservoirs is currently an urgent need for the treatment of HIV infection.This review mainly discussed HIV antiviral targets and strategies for eradicating latent virus pools from three aspects:drug targets and mechanisms of HIV,factors affecting ART treatment efficacy,and eradication strategies for latent virus pools.The aim was to providere fer ence for further searching for new drug action modes and targets.

Abstract:Previous reports of Warthin tumor of the parotid gland were mostly male smokers,but cases combined with HIV infection are rarely reported.This article reports a case of Warthin tumor of parotid gland complicated with HIV infection.The patient had high HIV viral load with compromised immune function at the time of diagnosis.After ART,the volume of Warthin tumor in the parotid gland reduced,and the symptoms related to tumor compression were significantly alleviated.Based on the characteristics of this case and a review of the literature,HIV infection may be a risk factor for parotid Warthin tumor.Therefore,receiving ART actively is of great significance for HIV/AIDS patients.To improve the understanding of parotid Warthin Tumor combine with HIV/AIDS,the detailed report of the case is reported as follows.

Abstract:Objective To investigate the clinical and pathological characteristics of AIDS complicated with talaromycosis marneffei of upper digestive tract.Methods A retrospective analysis was conducted on the clinical data of 3 cases of AIDS patients with upper gastrointestinal talaromycosis marneffei infection.The clinical and pathological characteristics,treatment and outcome were summarized.Results All 3 patients all were male with CD4+T lymphocytes counts less than 50 cell/μL.All patients had gastrointestinal symptoms such as abdominal pain,abdominal distension,diarrhea and fecal occult blood.One case had hematemesis.All patients had rash and weight loss.Laboratory tests showed an elevated percentage of neutrophils,anemia and hypoalbuminemia of varying degrees,and positive cultures of Talaromyces marneffei from different samples.Superficial and deep abdominal lymph nodes as well as hepatosplenomegaly.Microendoscopy revealed mucosal erosion or ulceration.One case of ulcer showed a chisel like appearance,resembling the changes after cytomegalovirus infection.One case had pyloric stenosis.Pathological features include chronic mucosal inflammation of with erosion or ulceration,proliferation and aggregation of a large number of foamy histiocytes,and pale gray yeast-like fungi visible both intracellularly and extracellularly.Special stains reveal the fungi as round or oval-shaped,some sausage-shaped,with visible central septa.All 3 patients were treated with antifungal therapy.One patient requested discharge after 1 week of treatment and was lost to follow-up,and the other 2 patients showed improvement after completing the full course of standardized treatment,and remained in stable condition during long-term outpatient follow-up.Conclusion There are few individual reports on AIDS complicated by upper gastrointestinal talaromycosis marneffei and the clinical symptoms are non-specific.When the CD4+T lymphocytes are obviously decreased,patients have a history of living in endemic areas,fever,rash,weight loss,and hepatosplenomegaly,etiological or histopathological examination should be promptly performed for timely diagnosis and treatment.

Abstract:Objective To explore the correlation between sputum viscosity,disease severity,and prognosis in adult patients with Mycoplasma pneumoniae pneumonia.Methods A retrospective cohort study was conducted on 300 adult patients with Mycoplasma pneumoniae pneumonia admitted to our hospital from March 2022 to March 2025.According to the severity of the patients'condition,they were divided into mild group(n=145),moderate group(n=105),and severe group(n=50).The three groups were compared for sputum viscosity related evaluation indicators(viscosity grading,wire drawing test,sputum pH value),and the correlation between sputum viscosity and disease severity in adult patients with Mycoplasma pneumoniae pneumonia was analyzed.All patients were followed up in hospital after 14d of treatment,and were divided into poor prognosis group(n=55)and good prognosis group(n=245)according to their prognosis level.By comparing the general data of patients and sputum viscosity related indicators,the prognostic value of sputum viscosity related indicators was analyzed for adult MPP patients,and the factors affecting the prognosis of adult mycoplasma pneumonia were analyzed by Logistic regression.Results The viscosity grading of sputum in the mild group was better than that in the moderate and severe groups,and the moderate group was better than the severe group.The length of the sputum drawing test in the mild group was lower than that in the moderate and severe groups,and the pH value of sputum was higher than that in the moderate and severe groups(P<0.05);There is a positive correlation between viscosity grading and disease severity(ρ=0.537,P=0.001),a positive correlation between wire drawing test length and disease severity(ρ=0.644,P=0.001),and a negative correlation between sputum pH value and disease severity(ρ=-0.532,P=0.001);Age of poor prognosis group and good prognosis group CRP/There were significant differences(P<0.05)in the comparison of lung consolidation,viscosity grading,antibiotic course,glucocorticoid course,wire drawing test length,and sputum pH value;The length of the wire drawing test,sputum viscosity grading,and sputum pH value all have good predictive value for poor prognosis in adult MPP patients(AUC>0.7,P<0.001);The results of logistic regression analysis showed that,CRP/The combination of pulmonary consolidation,viscosity grading,wire drawing test length,and sputum pH value are all independent prognostic factors for adult Mycoplasma pneumoniae pneumonia(P<0.05).Conclusion The viscosity of sputum in adult patients with Mycoplasma pneumoniae pneumonia is closely related to the severity of the disease,and in addition to routine laboratory and imaging indicators,viscosity grading,wire drawing test length,and sputum pH value are also independent prognostic factors for patients.

Abstract:Objective To investigate the relationship between immune indicators including proportion of lymphocyte subsets and immunoglobulin(Ig)levels,and severity of Mycoplasma pneumoniae pneumonia(MPP)in children,and to evaluate their clinical significance.Methods A retrospective analysis was performed on the clinical data of children with MPP hospitalized in the Department of Pediatrics,First Affiliated Hospital of Naval Medical University,from July 2023 to December 2024.Patients were divided into a severe group(n=213)and a mild group(n=220).Indicators including routine blood tests,inflammatory factors,Ig levels,and lymphocyte subsets were compared between the 2 groups.Binary logistic regression analysis was used to identify factors influencing the progression to severe MPP.Results Compared with the mild group,the severe group had a longer hospital stay,higher platelet count,higher IgA and IgM levels,and a higher proportion of CD3-CD19+(B lymphocytes).In contrast,the severe group showed a lower proportion of CD3+CD4+(helper T lymphocytes)and a lower CD4+/CD8+ratio.All these differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups in C-reactive protein,procalcitonin,white blood cell count,neutrophil count,lymphocyte count,monocyte count,red blood cell count,IgG,complement C3,complement C4,the proportion of CD3+CD8+(cytotoxic T lymphocytes),or the proportion of CD3-CD16+CD56+(natural killer cells)(P>0.05).Univariate analysis showed that IgA and IgM were positively correlated with severe MPP,while the CD3+CD4+proportion and the CD4+/CD8+ratio were negatively correlated.Multivariate analysis indicated that IgM was an independent risk factor for severe MPP(OR=1.411,95%CI:1.023-1.945,P=0.036).Conclusion Both cellular and humoral immunity are involved in the progression to severe MPP in children.Children with severe MPP exhibit elevated IgM and IgA levels,along with decreased CD3+CD4+proportion and CD4+/CD8+ratio.Early detection of these immune indicators can aid in assessing disease severity.

Abstract:Objective To analyze the factors that influence the rapid initiation of antiretroviral therapy(ART)in HIV-infected men who have sex with men(MSM).This study aims to provide guidance for clinical practice.Methods The study targeted newly diagnosed HIV-infected adult MSM at the Sexually Transmitted Diseases and AIDS Clinic of Beijing Youan Hospital from March 2021 to September 2022.Sociological/demographic information was collected through questionnaires,and clinical data were retrieved from the medical record system.Participants were divided into 2 groups based on whether they initiated ART within 14 days of diagnosis:the Rapid Treatment Group(Rapid Group)and the Non-Rapid Treatment Group(Non-Rapid Group).The data were analyzed using t-tests or χ2 tests for univariate analysis,and a binary logistic regression model was applied to identify independent influencing factors for rapid ART initiation.Results A total of 353 HIV-infected individuals were included,with 256 cases(72.5%)in the Rapid Group and 97 cases(27.5%)in the Non-Rapid Group.Univariate analysis showed that"living alone,""actively seeking HIV testing,""believing that rapid initiation of ART is necessary,"and"having friends/peers who are HIV-infected"were factors with statistically significant differences between the 2 groups(χ2 values were 5.902,4.573,4.709,and 7.037,respectively;all P<0.05).Multivariate analysis indicated that"actively seeking HIV testing,""living with family,friends,or peers,"and"having HIV-infected individuals around"were the main factors promoting the rapid initiation of ART(OR values of 2.062,1.970,and 2.128,respectively;P<0.05).Conclusion MSM individuals who actively seek HIV testing,have HIV-infected peers around them,and live with family,friends,or peers are more likely to initiate ART rapidly after confirming HIV infection.Clinically,more attention should be given to MSM without these conditions.Enhanced care and support should be provided to improve their rate of rapid treatment initiation.

Abstract:Objective To understand the seroprevalence of hepatitis E virus antibody in general population in China from 2015 to 2024,and to provide reference for the development of public health prevention and control measures for hepatitis E virus(HEV).Methods The relevant literature on the seroepidemiological survey of HEV conducted in China from January 1,2015 to December 31,2024 was searched in PubMed,The Cochrane Library,Web of Science,EMbase,Wanfang Database,VIP and China National Knowledge Infrastructure.R 4.3.3 software was used for meta-analysis of the included literature.Results A total of 37 articles were included,including 31 anti-HEV IgM and 36 anti-HEV IgG.The results of meta-analysis showed that the seropositive rates of HEV IgM and IgG in the general population of China from 2015 to 2024 were 1.3%(95%CI:0.9%～1.6%)and 22.9%(95%CI:18.1%～27.7%),respectively.The results of subgroup analysis showed that the positive rate of anti-HEV IgM/G in both male and female were 1.2%(95%CI:0.7%～1.6%),21.9%(95%CI:15.6%～28.2%)and 1.0%(95%CI:0.7%～1.4%)/19.0%(95%CI:13.9%～24.1%),respectively.The serum positive rates of anti-HEV IgM and IgG increased with age.The provinces of Yunnan(anti-HEV IgM seroprevalence:2.9%,95%CI:0.6%～5.1%)and Qinghai(anti-HEV IgM seroprevalence:50.9%,95%CI:44.2%～57.5%)had the highest prevalence of HEV antibodies.The serum positive rate of anti-HEV fluctuated greatly in different years.The positive rates of anti-HEV IgM and IgG were the highest in 2017,which were 2.4%(95%CI:1.2%～3.5%)and 35.3%(95%CI:11.9%～58.7%),respectively.Conclusion The positive rate of anti-HEV serum in China is high,and there are significant differences between different regions.The positive rate of anti-HEV serum increases with age,and the public health prevention and control measures of HEV should be further strengthened.

Abstract:Under extreme environmental conditions such as high temperature,high humidity,low temperature,and extreme cold,infectious diseases are more likely to occur and spread due to enhanced pathogenicity,increased transmission efficiency,and expanded susceptible population of the pathogens.The combined assault of extreme environment and pathogen,usually make patients more prone to develop multiple organ dysfunction(MOD),medical resources more deficient,and the prevention and control of infectious diseases more challenging.These factors make the treatment of MOD caused by infectious diseases even more difficult.This consensus aims to provide practical and technical guidance for clinicians by reviewing the relevant epidemiological characteristics,the impact of extreme environments on infectious diseases,early warning and diagnostic methods for MOD caused by infectious diseases in extreme environments,and treatment principles.

Abstract:Objective To investigate the correlation of peripheral blood CD4+and CD8+T-cell counts and the CD4+/CD8+ratio with the degree of coronary artery stenosis and adverse prognosis in patients with human immunodeficiency virus(HIV)and comorbid coronary heart disease.Methods A retrospective analysis was conducted on the clinical data of 59 HIV-infected patients with coronary heart disease admitted to the Department of Cardiology at the Third People's Hospital of Kunming from 2020 to 2023.The severity of coronary artery stenosis was assessed using the Gensini score,and patients were classified into mild,moderate,and severe groups based on the Gensini score.The CD4+,CD8+T cell counts,and CD4+/CD8+ratios were compared among the 3 groups.Follow-up was performed to record major adverse cardiovascular events(MACE)in HIV-infected patients with acute coronary syndrome after discharge,and patients were divided into MACE and non-MACE groups.The CD4+,CD8+T cell counts,and CD4+/CD8+ratios were compared among the 2 groups.Results In patients with HIV infection and comorbid coronary heart disease,the severe coronary stenosis group exhibited significantly lower CD4+T-cell counts and a lower CD4+/CD8+ratio compared to the mild stenosis group(P<0.05).Additionally,the MACE group demonstrated significantly lower CD4+T-cell counts than the non-MACE group(P<0.05).Conclusion Lower CD4+T-cell counts and CD4+/CD8+ratios in patients with HIV and comorbid coronary heart disease are associated with a greater degree of coronary artery stenosis.Furthermore,decreased CD4+T-cell counts may be correlated with the occurrence of MACE in HIV patients with acute coronary stenosis.