Current Issue

2024 Vol.9 No.1 Published:28 February 2024

Special Topic on Diagnosis and Treatment of Mycoplasma Pneumoniae Pneumonia

Analysis of risk factors for necrotizing pneumonia caused by severe mycoplasma pneumoniae pneumonia in children in 2023 Li Yaowen, Lin Jieqiong, Fan Qimeng, Xiong Hairui, Zeng Hongwu 2024, 9 (1):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.001 Abstract ( 88)    PDF (2564KB) ( 76 )    Objective To analyze and summarize the clinical manifestations and chest imaging features of necrotizing pneumonia caused by severe mycoplasma pneumoniae pneumonia in 2023, and to identify risk factors for necrotizing pneumonia. Method The clinical data and radiology data were collected on 50 children with severe mycoplasma pneumoniae pneumonia treated in Shenzhen Children's Hospital from September to November 2023. Children were examined with the chest CT scan and enhancement, and were divided into necrotizing and non-necrotizing pneumonia groups based on the enhancement of the lung parenchyma with or without necrosis. Clinical and radiology features were compared between two groups. Multivariate Logistic regression analysis was applied to analyze the indexes with significant differences in the univariate analysis. The ROC curve was used to analyze the diagnostic efficiency of different indicators and combined indicators. Result There were 25 males and 25 females among 50 children with a mean age of (6.56±3.13) years. Six cases (12.00%) had underlying diseases. Multiple lobes and segments of both lungs were involved, with partial wedge-shaped consolidation and bronchial wall thickening. Twenty-nine cases (58.00%) had a small amount of pleural effusion, with hilar lymph node enlargement in 44 cases (88.00%), pulmonary parenchyma necrosis in 28 cases (56.00%) and typical necrotizing cavities in 3 cases. All patients recovered and discharged. There was no significant difference in sex, age, hypoxemia, high fever or C-reactive protein between these two groups (P>0.05). The median hospitalization days, D-dimer, actate dehydrogenase (LDH) , alanine aminotransferase (ALT) and pleural effusion in necrotizing pneumonia group were significantly higher than those in the non-necrotizing pneumonia group (P<0.05). Multivariate Logistics regression analysis showed that LDH (OR=1.007, 95%CI 1.001-1.013) and pleural effusion(OR=35.060, 95%CI 4.523-271.777) were independent predictors of necrotizing pneumonia in children with severe mycoplasma pneumoniae pneumonia. When LDH and pleural effusion were used for joint prediction, the sensitivity was 0.778, the specificity was 0.773, and the area under the curve was 0.852 (95%CI 0.746-0.958). Conclusion Children with severe mycoplasma pneumoniae who present with pleural effusions and apparently elevated LDH should be alerted to the possibility of combination with necrotizing pneumonia. Early recognition and effective clinical intervention should be performed.

Analysis of clinical and imaging features of mycoplasma pneumoniae pneumonia in children Ma Shuai, Wen Puzheng, Kang Lihui, Liu Jingzhe 2024, 9 (1):  7-11.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.002 Abstract ( 100)    PDF (2598KB) ( 62 )    Objective The clinical manifestations and imaging features of mycoplasma pneumoniae pneumonia in children were retrospectively analyzed to provide basis for clinical diagnosis and treatment. Method The general clinical data, chest CT imaging data and etiological examination results of 200 outpatients and inpatients with mycoplasma pnuemoniae pneumonia in the First Hospital of Tsinghua University and the Children's Hospital Affiliated to Capital Institute of Pediatrics from November 2023 to January 2024 were retrospectively analyzed. Chest CT imaging indicators included the distribution of lesions in the lung, thickening of the bronchial wall, imaging manifestations of lesions in the lung, presence or absence of plastic bronchitis, presence or absence of pleural effusion,etc. Result A total of 200 children with mycoplasma pneumoniae pneumonia were included, ranging from 1 month to 15 years old, with an average age of (8.29±2.81) years, including 107 boys (53.5%) and 93 girls(46.5%). The main clinical symptom was fever in 165 cases (66.0%). The duration of fever ranged from 1 to 30 days, with a median of 7 days. Followed by 162 cases of cough (64.8%), the duration of cough ranged from 2 to 60 days, with a median of 10 days days. Other symptoms in order of frequency were expectoration, wheezing, runny nose, sore throat, vomiting, headache, chest pain, dyspnea, urticaria, etc. The most involved lung lesions were left inferior lobe, followed by right inferior lobe. The most common imaging findings were bronchial wall thickening, tree-in-bud sign, and consolidation. Mycoplasma pneumoniae pneumonia in children with adenovirus infection is the most common. The children with plastic bronchitis and non-plastic bronchitis had statistically significant differences in respiratory syncytial virus infection, tree-in-bud sign, acinar nodules, consolidation, atelectasis and pleural exudation. Conclusion The main clinical manifestations of mycoplasma pneumoniae pneumonia in children are fever and cough. Thickening of bronchial wall, tree-in-bud sign, tree-in-fog sign, and mass consolidation are the most common characteristic imaging manifestations. The presence of plastic bronchitis should be considered when the pulmonary imaging of children with mycoplasma pneumoniae pneumonia shows acinar nodules, consolidation, atelectasis and pleural exudation.

Epidemiological characteristics of 2108 children infected with respiratory pathogens Cao Xianzhen, Ma Jieyan, Hu Liang, Li Gaochi, Liu Weiqiang 2024, 9 (1):  12-16.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.003 Abstract ( 61)    PDF (1723KB) ( 62 )    Objective To explore the pathogenic spectrum characteristics of hospitalized children infected with respiratory pathogens in order to provide a basis for the diagnosis, treatment, prevention and control of related infectious diseases. Method From June 2022 to March 2023, 2108 respiratory pathogen samples of hospitalized children were collected in Longgang District Maternal and Child Health Hospital, Shenzhen. Multiple polymerase chain reaction (PCR) was used to detect influenza A virus (FluA), influenza B virus (FluB), respiratory syncytial virus (RSV), adenovirus (ADV), rhinovirus (HRV), and mycoplasma pneumoniae (MP) in the samples, and the overall detection situation was analyzed. The characteristics of pathogen distribution in different age groups, genders, disease diagnoses, months, and time periods were compared. Result The total positive detection rate of pathogens was 50.05%. HRV (333 cases, 15.80%), RSV (237 cases, 11.24%), and FluA (194 cases, 9.20%) accounted for a high proportion of single infections. The combined frequency of HRV and RSV was the highest in mixed infections. There were statistical differences in the positive detection rates of pathogen single infection and mixed infection (except the positive rate of three pathogens) in hospitalized children of different age groups (P<0.05). There was no significant difference in the positive detection rate of pathogen single infection and mixed infection among hospitalized children of different genders (P>0.05). The detection rate of FluA was the highest in children with acute bronchitis (27.24%), RSV was the highest in bronchial pneumonia (19.14%), ADV was the highest in children with acute pharyngitis (47.06%), and HRV and RSV were the highest in children with asthmatic bronchitis (50.00% and 48.08%). The positive rate of MP was the highest in children with severe pneumonia (36.73%). FluA detection rate had two small peaks in July 2022 and March 2023; RSV detection rate was the highest in December 2022; HRV detection rate had two small peaks in November 2022 and February 2023; and ADV and MP were detected every month. Conclusion The main pathogens responsible for infections in hospitalized children with respiratory infections are HRV and RSV, and attention should also be paid to the prevention and control of multiple infections.

Original Articles

Drug-resistance in pulmonary tuberculosis patients in Nanjing,2018-2022 Kong Jun, Niu Yulan, Huang Yan, Zhang Xiangrong 2024, 9 (1):  17-20.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.004 Abstract ( 68)    PDF (896KB) ( 56 )    Objective To analyze the drug resistance of pulmonary tuberculosis patients in Nanjing during the past 5 years, and to provide clinical basis for the diagnosis and treatment of pulmonary tuberculosis. Method The clinical data of patients with positive sputum culture concurrent with bacterial species identification and drug susceptibility testing in Nanjing Second Hospital from January 2018 to December 2022 were collected, and their drug resistance trends and characteristics were analyzed. Result A total of 4824 clinical isolates were included, including: 3855(79.91%) strains of human Mycobacterium tuberculosis, 39(0.81%) Mycobacterium bovis strains and 930(19.28%) nontuberculous Mycobacterium strains. Among the 3855 strains of Mycobacterium tuberculosis, there were 1077 drug-resistant strains, and the overall drug resistance rate was 27.94%. Among them, 462(11.98%) strains were resistant to rifampicin, and 218(5.66%) strains were multidrug-resistant. 201(5.21%) strains were poly-resistant, and 41(1.06%) strains were extensively drug-resistant. Univariate analysis showed that age 30≤age<60 years and retreatment were risk factors for drug resistance. The overall drug resistance rate of tuberculosis patients in Nanjing area showed a slow rising trend in the preceding four years, reaching a peak of 31.21% in 2021,and decreasing to 25.56% in 2022. Rifampicin resistance rate fluctuated slightly, stabilizing at 11%-12% from 2018 to 2020, rising sharply to 16.56% in 2021, and decreasing to 10.31% in 2022. Among the nine anti-tuberculosis drugs tested, the sequence of drug resistance of Mycobacterium tuberculosis strains was: isoniazid (16.78%), streptomycin (15.80%), rifampicin (11.93%), levofloxacin (8.87%), ethambutol (4.88%), amikacin (1.79%), kanamycin（1.50%）, para aminosalicylic acid (1.45%) and capreomycin (1.32%). The sequence of drug resistance during 2018-2022 was similar, with the top five being isoniazid, streptomycin, rifampicin, levofloxacin and ethambutol, and the drug resistance rates of the second-line injection anti-tuberculosis drugs amikacin, capreomycin and kanamycin were all lower. Conclusion In the period of 2022, the prevention and control of tuberculosis in Nanjing area achieved certain results, and the overall drug resistance rate and rifampicin resistance rate decreased compared with the rate of 2018-2021. It is necessary to pay special attention to young men and patients with retreatment, and rationally select anti-tuberculosis drugs according to drug susceptibility results to reduce the spread of drug-resistant mycobacterium tuberculosis.

Analysis of the prevalence trend and characteristics of influenza in Shenzhen, 2014–2022 Chen Zhigao, Ou Weihui, Cheng Yanpeng, Chen Nixuan, Liu Tinting, Song Lixia, Li Yingying, Zhang Zhen 2024, 9 (1):  21-25.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.005 Abstract ( 58)    PDF (1324KB) ( 62 )    Objective To analyze the epidemic law of influenza virus in Shenzhen from 2014 to 2022,study the epidemiological characteristics of influenza virus during the epidemic period, and provide the basis for formulating the comprehensive prevention and control measures of influenza. Method According to the number of permanent residents at the end of the year published by Shenzhen Municipal Bureau of statistics, the weekly influenza incidence rate of the whole population from 36th week of 2014 to the 35th week of 2022 was calculated. The epidemic law of influenza virus in Shenzhen was analyzed by using the moving epidemic method, and the epidemic intensity and population characteristics of influenza virus during the epidemic period were studied by using the epidemiological. Result Six of the eight surveillance cycles in Shenzhen 2014-2022 entered the influenza virus epidemic period, mainly in winter, spring and summer, the peak incidence rate showed an increasing trend year by year (χ2trend=28 958.392, P<0.001). There were differences in the cumulative weeks of epidemic intensity exceeding the threshold of epidemic period in each district(χ2=100.634,P<0.001), Among the six monitoring cycles with epidemic periods, Nanshan District was the first enter the epidemic period, and the epidemic duration was longest in five monitoring cycles. Children under 14 years old were the main population(accounting for 69.5%),mainly students and nursery children. Conclusion The epidemic law of influenza virus in Shenzhen is obviously seasonal, and presents certain regional differences. Nanshan District enter the epidemic period first and the duration is often longer. In the follow-up, comprehensive and in-depth analysis should be made in combination with climate change, pathogenic changes, vaccination and population flow rules.

Study on the construction of death risk prediction model for pulmonary tuberculosis patients with respiratory failure Fu Lina, Rui Limei, Peng Jianhua, Wang Huaquan 2024, 9 (1):  26-30.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.006 Abstract ( 64)    PDF (948KB) ( 66 )    Objective The study aimed to analyze the main clinical risk factors of death in patients with pulmonary tuberculosis secondary respiratory failure, and build a quantitative risk prediction model to provide reference for clinical practice. Method A total of 105 patients with pulmonary tuberculosis secondary respiratory failure to Danyang Hospital affiliated to Kangda College of Nanjing Medical University from March 2019 to June 2022 were retrospectively summarized. According to the clinical outcome, they were divided into death group (n=30, 28.6%), and survival group (n=75, 71.4%). The general clinical datas of the two groups were analyzed, including gender, age, sputum smear positive rate, sputum culture positive rate, nucleic acid quantitative detection Xpert MTB/RIF positive rate, comorbid diseases, complications, tuberculosis classification, admission pulmonary function (forced vital capacity, tidal volume, residual gas), admission arterial blood gas analysis[arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), oxygen saturation (SaO2), PaO2/FiO2], APACHEⅡ score, C-reactive protein (CRP), white blood cell count, neutrophil/lymphocyte ratio(NLR), mean arterial pressure (MAP), albumin when arriving at hospital; Then, multivariate Logistic regression analysis was used to screen the main risk factors those may affect the death outcome, and the risk prediction model was constructed. Finally, the receiver operating curve (ROC curve) was used to evaluate the diagnostic efficacy. Result Compared with the survival group, the complications in the death group were increased, the hospital forced vital capacity was decreased, PaO2/FiO2 was decreased, NLR was increased, and albumin was decreased (P<0.05). In the death group,the bacterial resistance rate and invasive ventilation rate were increased, ventilation time was prolonged, treatment 3d-PaO2/FiO2 was decreased, APACHEⅡ score was increased, CRP and NLR were increased, albumin was decreased (P<0.05). Logistic regression model showed that PaO2/FiO2, NLR, albumin, APACHEⅡ score and CRP after three-day treatment were the main risk factors to death (P<0.05). The risk prediction model Y=2.563-0.248×(PaO2/FiO2)+0.166×NLR-0.318×albumin-0.074×(APACHEⅡ score)+0.396×CRP. ROC analysis showed that the accuracy of Y value for predicting death was 0.856, sensitivity was 82.6%, specificity was 75.5%, and cut-off value was 0.869. Conclusion Pulmonary tuberculosis secondary respiratory failure has a high in-hospital fatality rate. Lower of PaO2/FiO2 and albumin, higher of NLR, APACHEⅡ score and CRP after three-day treatment may be the main risk factors affecting death outcome, which has good accuracy and application value to build a quantitative risk prediction model for evaluating death.

Research value of risk assessment of multidrug resistant organisms based on big data mining Wang Xiaojing, Yao Yanling, Li Wenyu, Tian Ping 2024, 9 (1):  31-36.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.007 Abstract ( 62)    PDF (1377KB) ( 61 )    Objective Based on big data, the risk prediction model of multidrug resistant organisms infection was constructed and its application value was evaluated. Method From January 2018 to December 2022, 405 patients in the Fifth Affiliated Hospital of Xinjiang Medical University were divided into non-MDRO group（n=324） and MDRO group（n=324） according to whether multidrug-resistant organisms (MDRO) were infected, and the correlation between each index and the risk of MDRO was compared and analyzed. Build a big data risk prediction model, analyzing the importance of each index and verify its accuracy. Result The proportion of patients with diabete and primary lung infection in MDRO group, the time of mechanical ventilation, the use of broad-spectrum antibiotics and the level of procalcitonin were significantly higher than those in non-MDRO group, while the levels of hemoglobin and albumin were significantly lower than those in non-MDRO group (all P<0.05). Correlation analysis showed that the risk of MDRO was highly correlated with factors such as diabete mellitus and primary lung infection, and there was a high correlation between diabete mellitus and primary lung infection and combined use of antibiotics. The big data model shows that factors such as antibiotic using time and swallowing dysfunction are more important, while hemoglobin and albumin are less important. The AUC of the big data model in predicting the risk of MDRO is significantly higher than that of the Logistic regression model (Z=2.415, P=0.016), and there is no statistical difference in the prediction accuracy of the training set between the two prediction models (P>0.05). However, the prediction accuracy, sensitivity and specificity of test set are significantly higher than those of Logistic regression model (χ2=9.062, 5.385, 4.267;All P<0.05). Conclusion Supplementary factors such as diabetes mellitus, primary lung infection and combined use of antibiotics have certain correlation with the risk of MDRO, and the big data model based on MDRO risk factor indicators has high predictive value for the risk of MDRO.

Analysis of clinical features of 80 cases of central nervous system tuberculosis in children Wang Xiaoxia, Tan Shouyong, Huang Shaomei, Hu Haixia 2024, 9 (1):  37-41.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.008 Abstract ( 44)    PDF (1556KB) ( 50 )    Objective To analyze the clinical characteristics of central nervous system tuberculosis (CNSTB) in children for early clinical diagnosis and treatment. Method A total of 80 cases of CNSTB in children treated in Guangzhou Chest Hospital from February 2016 to April 2022 were retrospectively collected as the study group and 41 cases of CNSTB in adults as the control group. The clinical characteristics of the two groups were compared and analyzed. Result The main clinical manifestations of the children in the study group were fever (88.8%), vomiting (38.8%) and cough (33.8%), among which 58.8% had a clear history of contact with tuberculosis, 73.8% had a course of disease longer than 14 days before diagnosis, 56.3% had biochemical abnormalities of cerebrospinal fluid, and 41.2% showed meningeal type on head MRI. There were significant differences between the study group and the control group in pulmonary tuberculosis contact history, disease duration before diagnosis, cerebrospinal fluid biochemical abnormality rate, and head MRI findings (χ2=21.43, 10.30, 4.92, 6.19, all P<0.05). There were no significant differences in clinical symptoms (except headache), nervous system physical examination, clinical stage, blood tuberculosis infection T-cell spot test (T-SPOT.TB), tuberculin pure protein derivative (PPD) test, hydrocephalus and poor prognosis between the two groups (all P>0.05). There was a statistically significant difference in the rate of critical illness between patients with uncomplicated tuberculosis and those with complicated tuberculosis in the study group(χ2=5.83, P<0.05). Conclusion The clinical symptoms of children with CNSTB are non-specific, but are usually accompanied by a clear history of pulmonary tuberculosis exposure. Brain MRI mainly showed meningeal involvement, Children with CNSTB without pulmonary tuberculosis are prone to severe cases. Clinical doctors should improve their understanding of the clinical characteristics of CNSTB in children.

Analysis of risk factors of disease progression in patients with cervical lymph node tuberculosis Zhong Ming, Li Gang, Wang Ning, Yao Xiaojun, Jiang Liangshuang 2024, 9 (1):  42-46.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.009 Abstract ( 69)    PDF (800KB) ( 61 )    Objective To analyze the clinical characteristics of cervical lymph node tuberculosis patients in the process of standardized anti-tuberculosis treatment, and analyze the related influencing factors, so as to provide a new idea and basis for the treatment of this kind of diseases. Method A retrospective analysis method was adopted to collect the clinical data of patients diagnosed as cervical lymph node tuberculosis with standardized anti-tuberculosis treatment in Chengdu Public Health Clinical Center from March 2020 to March 2022. According to the prognosis of the disease, the patients were divided into progressive group and non-progressive group. The baseline data such as sex, age, immune cell count and complications of the two groups were statistically analyzed, and the related factors affecting the disease progress were analyzed by univariate and multivariate analysis. Result A total of 129 patients with cervical lymph node tuberculosis were included in this study, including 70 cases in the progressive group and 59 cases in the non-progressive group. The comparative analysis between the progressive group and non-progressive group of cervical lymph node tuberculosis showed significant statistical differences（P<0.05）in CD4+T lymphocyte count(P<0.05), CD8+T lymphocyte count(P=0.005), NK cell count(P<0.05),combined with mediastinal lymphadenopathy (P<0.05), treatment and retreatment of tuberculosis(P<0.05), and drug resistance (P=0.004). Multivariate analysis showed that lower NK cell count (OR=39.968, 95%CI 9.324-171.333, P<0.05), age equal to or younger than 45 years(OR=7.972, 95%CI 1.114-60.598, P=0.036), retreatment of tuberculosis(OR=24.118, 95%CI 4.563-127.479,P<0.05) and combined with mediastinal lymphadenopathy were independent risk factors for the progression of cervical lymph node tuberculosis. Conclusion This study found that lower NK cell count, age≤45 years old, retreatment of tuberculosis and combined with mediastinal lymphadenopathy were independent risk factors for the progress and recurrence of cervical lymph node tuberculosis during standardized anti-tuberculosis treatment.

Case Report

A case of severe tuberculosis combined with pulmonary embolism and literature review Xiong Yanmei, Li Tongxin, Yang Song, Sun Nannan 2024, 9 (1):  47-50.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.010 Abstract ( 63)    PDF (1874KB) ( 59 )    With the high incidence of active tuberculosis combined with pulmonary embolism, diversified clinical manifestations and high mortality rate, early detection and treatment are particularly important for the prognosis of patients. This paper reports a young male patient who was admitted to the hospital due to abdominal distension and wheezing. Previous physical health, and no underlying disease. The initial diagnosis of tuberculosis was combined with multiple serosal fluid effusion, chronic heart failure. After anti-tuberculosis and corrected heart failure, the symptoms were not relieved and the condition was gradually aggravated. After further examination, it was found with deep vein thrombosis and pulmonary embolism of both lower limbs. The clinical diagnosis was severe tuberculosis with pulmonary embolism, and after the addition of anticoagulant drugs such as edoxaban, the patient's symptoms were significantly relieved, and the thoracic and abdominal fluid absorption was improved and discharged from hospital. Through this case, this paper discusses the clinical characteristics, imaging manifestations of severe tuberculosis combined with pulmonary embolism, and the active and effective comprehensive treatment methods, and discusses the relevant literature review, aiming to improve the vigilance of clinicians, reduce the rate of missed diagnosis, improve the diagnosis and treatment level of severe tuberculosis combined with pulmonary embolism, and reduce the risk of death.

A case of brain abscess caused by Acrophialophora levis infection Huang Sailin, Xu Shaoqiang, Gu Youming, Lin Qinjian, Liang Qianwen, Xiang Xuan, Ye Nafen 2024, 9 (1):  51-54.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.011 Abstract ( 56)    PDF (4921KB) ( 48 )    With the wide application of antimicrobial drugs, anticancer drugs and hormones and the advancement of invasive treatment, the morbidity and mortality of invasive fungal infections have been increasing year by year, and some rare fungi have been increasingly recognized as clinically pathogenic, which has attracted clinical attention. The genus Acrophialophora contains 24 species, among which Acrophialophora fusispora and Acrophialophora levis have been reported to be clinically pathogenic. Brain abscesses caused by Acrophialophora levis infection are rare, and the optimal clinical treatment is still unclear. In this article, we analyze the clinical manifestations, imaging changes, pathogenetic examination, and diagnostic process of a patient with brain abscess caused by smooth telangiectasia infection admitted to our hospital, improving the awareness of invasive fungi causing infection with brain abscess.

Health Management and Prevention and Control Strategies

Practice path and thinking of transformation and development of infectious disease hospital Dai Feifei, Hu Liang, Chen Lei, Zhang Shaofeng, Yi Yongxiang 2024, 9 (1):  55-59.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.012 Abstract ( 67)    PDF (893KB) ( 84 )    For a long time, the development of infectious diseases hospitals in China has been faced with the pressure and challenges of few patients, lack of talents, weak disciplines, difficult operation, and more competition. With the occurrence and response of major public health events, infectious diseases hospitals are facing the opportunities and adjustments for transformation and development. Taking The Second Hospital of Nanjing for example, this manuscript elaborated the practice path of comprehensive transformation and development of infectious disease hospitals from six aspects: to clarify the transformation and development strategy, to fully launch the discipline platform construction, to focus on promoting talent echelon training, to continuously improve medical service level, to make up the depression of science and education development, and to gradually explore fine hospital management. After the practice and development for many years, the hospital has achieved the hierarchical growth in scale and volume, the significantly enhancement of comprehensive medical service ability, the complement of comprehensive discipline category construction, the distinct characteristics of sub-specialty development, the quick development of new technologies and projects, the continuous optimization of operation efficiency, and the persistent improvement of patients' satisfaction. In the past five years, there has been a significant increase in the number of outpatient and emergency departments, the number of discharged patients, and the number of surgical procedures performed on discharged patients; The average length of hospital stay and outpatient expenses have significantly decreased, which tested the feasibility of the transformation development path effectively. Under the high-quality development of public hospitals in the new era, the connotation development of infectious disease hospitals in the new stage after the comprehensive transformation is also proposed.

Review

The latest research progress on Nipah virus: a systematic review Yao Weiming, Wang Fuxiang, Lu Hongzhou 2024, 9 (1):  60-66.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.013 Abstract ( 101)    PDF (3115KB) ( 94 )    Nipah virus (NiV) is an enveloped, pleomorphic virus with a diameter ranging from 40 to 600 nanometers. It belongs to the Henipavirus genus, the family Paramyxoviridae, and the order of single stranded negative strand RNA viruses. NiV is able to cause zoonotic diseases in humans and be transmitted from person-to-person, and with multiple outbreaks in South Asia, Southeast Asia. NiV primarily invades the respiratory system and central nervous system, causing acute fever, headaches and varying degrees of consciousness disorders, with a mortality rate of up to 40%-75%. Currently, NiV has been listed in the World Health Organization's Blueprint list of priority pathogens as one of the eight most dangerous pathogens, requiring monitoring and preparedness measures to prevent pandemics. However, effective vaccines and specific antiviral drugs are still lacking, and treatment mainly relies on systemic supportive therapy. This review provides a detailed overview of the latest research progress in virology, pathogenesis, clinical features, diagnosis, antiviral drugs, vaccine development and epidemiology of NiV, aiming to provide references for further research, prevention and control.

Research progress on the characteristics of monkeypox combined with HIV-infected diseases Wang Cheng, Tang Xiangyi, Lin Zixun, Li Qian, Lu Hongzhou 2024, 9 (1):  67-72.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.014 Abstract ( 72)    PDF (903KB) ( 79 )    The widespread transmission of monkeypox virus poses a significant threat to people living with HIV. On the one hand, the HIV infection rate among people infected with monkeypox virus remains high, and at the same time, the infection rate of other sexually transmitted diseases is also increasing, such as syphilis and gonorrhea. On the other hand, although monkeypox is a self-limiting disease, compared with non-HIV-infected monkeypox patients, monkeypox and HIV-infected patients have a significantly higher risk of severe illness and death, especially in HIV-infected patients with incomplete immune reconstitution. In addition, in patients with monkeypox and HIV infection, the clinical symptoms are more persistent and severe, especially in HIV-infected patients with incomplete immune reconstitution whose CD4+T lymphocyte count is less than 200 cells/μl, making diagnosis and treatment more difficult. Therefore, a comprehensive understanding of the disease characteristics of monkeypox and HIV-infected patients is crucial to effectively prevent and reduce the spread of monkeypox. This article describes the etiological characteristics, epidemiological characteristics, clinical characteristics, diagnosis, treatment and prevention of patients with monkeypox and HIV infection, aiming to enhance the comprehensive understanding of patients with monkeypox and HIV infection, and provide guidance for this special group of patients. Provide theoretical support for the population to formulate precise prevention and control strategies.

Guidelines and Consensus

Expert consensus on clinical diagnosis and treatment of long COVID syndrome Shenzhen Third People's Hospital, National Clinical Research Center for Infectious Diseases, Shenzhen Infectious Disease Quality Control Center 2024, 9 (1):  80-87.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.016 Abstract ( 81)    PDF (919KB) ( 104 )    At present, our country has entered the routine control stage of the COVID-19 epidemic. However, “long COVID” associated with COVID-19 may present with multi-system symptoms, leading to enduring effects and introducing new challenges to global public health. In China, consensus is lacking on the diagnosis, treatment, follow-up, and multidisciplinary management of long COVID syndrome. Progress in related diagnostic and therapeutic efforts primarily relies on the collective experiences of various disciplines and hospitals. This consensus is rooted in clinical and foundational research data on long COVID syndrome gathered from both domestic and international sources, supplemented by evidence from evidence-based medicine. It comprehensively addresses aspects such as epidemiology, definition, clinical manifestations in various systems, examinations, diagnosis, treatment, follow-up, and management strategies of long COVID syndrome. We distill 16 recommendations and hope to provide theoretical foundations and practical references to guide the accurate assessment and management of long COVID syndrome in clinical practice.

Education Fields

Pathological and imaging manifestations of mycoplasma pneumoniae pneumonia in children Sun Longwei, Chen Jiehua, Li Yaowen, Lin Jieqiong, Xiong Hairui, Zeng Hongwu 2024, 9 (1):  98-103.  DOI: 10.19871/j.cnki.xfcrbzz.2024.01.017 Abstract ( 95)    PDF (7110KB) ( 30 )    Mycoplasma pneumoniae pneumonia (MPP) is the most common type of community-acquired pneumonia in children in China. Early identification of severe cases, appropriate treatment, and reduction of sequelae are the crucial elements in the diagnosis and treatment of MPP. The pathogenesis of MPP is characterized by direct respiratory tract damage caused by mycoplasma pneumoniae and aberrant host immune response. Pathologic manifestations include pulmonary airway and interstitial inflammation, plastic bronchitis, alveolar inflammatory exudation, necrotizing pneumonia, pulmonary artery embolism, and pleural effusion. Radiographic imaging plays an important role in the severity determination and prognostic assessment of MPP. The main imaging features include plastic bronchiolitis, tree bud sign, centrilobular nodule, tree mist sign, pulmonary consolidation, pulmonary necrosis, pulmonary artery embolism, and pleural effusion. Notably, pulmonary necrosis and pulmonary artery embolism are important indications for the diagnosis of severe MPP. Clinical symptoms of pulmonary necrosis are characterized by persistent high fever and elevated CRP levels. Pulmonary embolism manifestations include chest pain and/or hemoptysis, elevated D-dimer, and bloody pleural effusion. With advancements in related research, this article presents a graphic-text analysis on the imaging features, pathogenesis and pathological manifestations of MPP. We also summarize the correlation between various imaging features and clinical characteristics of MPP, aiming to improve the understanding of MPP in children among pediatricians and radiologists.