Severe fever with thrombocytopenia syndrome (SFTS) is an acute infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV), whose incidence has shown a year-by-year upward trend in recent years. Clinical practice has demonstrated that early intervention during the disease course can significantly improve the prognosis, whereas the mortality rate remains high in patients who progress to severe disease. Patients with SFTS have a high incidence of concurrent bacterial and fungal infections, which are closely associated with disease prognosis and constitute independent risk factors affecting clinical outcomes. To standardize the early identification, diagnosis, treatment, prevention and control of SFTS complicated with bacterial and fungal co-infections, this consensus has been formulated by an expert panel in collaboration with multidisciplinary specialists in infectious diseases, emergency medicine, critical care, laboratory medicine, pharmacy and epidemiology, based on the evidence from clinical research since the first discovery of SFTS in 2009 and combined with practical clinical experience. This consensus aims to provide the scientific and actionable guidance for clinical medical professionals and improve the comprehensive diagnosis and treatment of bacterial and fungal co-infections of patients with SFTS.

Acquired immunodeficiency syndrome (AIDS) is caused by human immunodeficiency virus (HIV). Due to HIV-mediated immunosuppression, infected individuals are more prone to frequent and severe opportunistic infections. Bacterial pneumonia is one of the most common complications among HIV-infected individuals. Recurrent bacterial pneumonia warrants vigilance for AIDS in clinical practice, which may even be life-threatening if it is not treated promptly and standardly. Currently, no guideline or expert consensus on the diagnosis and treatment of bacterial pneumonia in patients with AIDS have been issued in China. Therefore, this consensus was developed by the National Center for Infectious Diseases and Beijing Ditan Hospital, Capital Medical University, in combination with well-known domestic experts in relevant fields with reference to literature at home and abroad, aiming to improve the comprehensive diagnosis and treatment capabilities of clinical healthcare workers for AIDS complicated with bacterial pneumonia.

Mpox has undergone significant epidemiological and clinical changes since the global outbreak in 2022, predominantly affecting men who have sex with men (MSM) and individuals co-infected with HIV. Disruption of skin and mucosal barriers and immune dysfunction predispose patients to secondary infections, including bacterial, sexually transmitted and fungal infections, increasing the disease severity. This consensus, based on current evidence and clinical practice, summarizes the epidemiology, common pathogens, and transmission routes of mpox-associated co-infections, and proposes 23 recommendations covering early identification, risk stratification, pathogen detection, antimicrobial treatment, and prevention strategies. It aims to standardize clinical management and reduce severe outcomes and transmission risk.

JC polyomavirus (JCPyV) is a widely distributed DNA virus in the human population, typically remaining latent in immunocompetent hosts. When the immune function of the host is compromised, JCPyV can be reactivated and cause progressive multifocal leukoencephalopathy (PML), a severe central nervous system demyelinating disease. This review summarizes the global epidemiological characteristics, molecular biological properties, pathogenesis and related disease research progress of JCPyV, and discusses current diagnostic methods, therapeutic strategies and future research directions, providing theoretical references for the prevention and treatment of JCPyV-associated diseases.

To investigate the distribution characteristics of pathogens causing community-acquired pneumonia (CAP) in children in Zunyi region from 2020 to 2024, and to analyze their variations by year, age and season, in order to provide evidence for empirical anti-infection therapy.

Clinical data of hospitalized children with bacterial CAP from five hospitals in Zunyi were collected, retrospectively. Total of 21 546 cases with positive sputum cultures and meeting CAP diagnostic criteria were included. The pathogen spectrum and its distribution across different years, age groups and seasons were analyzed. The characteristics of pathogen composition across different ages and seasons were analyzed by Pearson Chi-square test, and the pathogen distribution across different years was analyzed by Chi-square trend test.

Total of 21 546 children with CAP who had positive sputum cultures were enrolled, including 13 307 males (61.8%) and 8 239 females (38.2%). There were statistically significant differences in the distribution of children among different years, seasons and age groups (χ²=1 103.4, 1 083.9, 3 733.9; all P<0.001). The detection rates of Gram-negative bacteria and Gram-positive bacteria showed significant differences in distribution among different years (χ²=189.5, P<0.001), and the detection rate of Gram-negative bacteria (53.0%) exceeded that of Gram-positive bacteria (47.0%) in 2024. The top 5 pathogens in terms of detection rate were Haemophilus influenzae (6 972 cases, 32.4%), Streptococcus pneumoniae (5 746 cases, 26.7%), Staphylococcus aureus (3 825 cases, 17.8%), methicillin-resistant Staphylococcus aureus (MRSA) (2 027 cases, 9.4%) and Escherichia coli (852 cases, 4.0%). Age distribution: children in infant group were mainly infected with Haemophilus influenzae (3 344/11 073, 30.2%), Staphylococcus aureus (2 702/11 073, 24.4%) and Escherichia coli (742/11 073, 6.5%); children in the toddler and preschool group were mainly infected with Streptococcus pneumoniae [37.9% (2 228/5 879) and 33.1% (1 217/3 672)] and Haemophilus influenzae [39.3% (2 308/5 879) and 31.2% (1 145/3 672)]; children in the school-age group had the highest detection rate of MRSA (348/922, 37.7%). Seasonal distribution: the bacterial infection rate was higher in autumn and winter. Haemophilus influenzae and Streptococcus pneumoniae were the main pathogens in all four seasons, among which Haemophilus influenzae had the highest detection rate in winter (2 627/6 238, 42.1%) and Streptococcus pneumoniae had the highest proportion in autumn (1 821/5 435, 33.4%). Drug resistance analysis showed that Haemophilus influenzae was highly resistant to trimethoprim-sulfamethoxazole, ampicillin and cefuroxime [resistance rates were 95.3% (6 644/6 972), 89.6% (6 247/6 972) and 73.4% (5 142/6 972)]. The resistance rates of Escherichia coli to ampicillin, cefuroxime and ceftriaxone were 91.1% (752/825), 83.0% (685/825) and 78.4% (647/825), respectively, and Escherichia coli was sensitive to piperacillin/tazobactam and meropenem; The resistance rate of Streptococcus pneumoniae to tetracycline was 100% (5 746/5 746), while the resistance rate of Staphylococcus aureus to penicillin was 92% (3 519/3 825), and the resistance rate of MRSA to clindamycin and erythromycinhad were both higher than 90%, and all the above Gram-positive bacteria were sensitive to vancomycin, linezolid, etc.

There were significant differences in the detection rates of pathogens from children with CAP in Zunyi region among different years, seasons and age groups. In 2024, the detection rate of Gram-negative bacteria exceeded that of Gram-positive bacteria. The dominant pathogenic bacteria varied among different age groups, and the infection rates were higher in autumn and winter. Common pathogenic bacteria were highly resistant to various conventional antibiotics. It is necessary to select reasonable antibiotics according to the drug sensitivity test results.

To investigate the diagnostic value of plasma methylation levels of human Runt-related transcription factor 3 (RUNX3), E-cadherin and Ras-association domain family 1A (RASSF1A) genes in hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).

Clinical data of 30 patients with HCV-related HCC (HCC group), 30 patients with HCV-related liver cirrhosis (liver cirrhosis group), 30 patients with simple HCV infection (HCV group) and 30 healthy individuals undergoing physical examination (healthy control group) admitted to Huzhou First People’s Hospital from June 2022 to February 2024 were analyzed, retrospectively. General data, alpha-fetoprotein (AFP) which was a traditional indicator for HCC screening, and methylation levels of gene RUNX3, E-cadherin and RASSF1A were compared among the four groups, respectively. The levels of AFP corresponding to high and low methylation levels of the three genes were compared in each group. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of the three gene methylations and AFP alone or in combination for HCV-related HCC. Multivariate Logistic regression was applied to analyze whether the three gene methylations and AFP level were influencing factors for HCV-related HCC.

There were significant differences in total bilirubin (TBil) (F=339.823, P<0.001), alanine aminotransferase (ALT) (F=681.714, P<0.001), AFP (F=1488.962, P<0.001), and methylation levels of RUNX3 (F=92.207, P<0.001), E-cadherin (F=39.316, P<0.001) and RASSF1A (F=21.705, P<0.001) among the four groups. The area under the ROC curve (AUC) of the combined diagnosis of HCV-related HCC by hypermethylation of RUNX3, E-cadherin and RASSF1A genes plus AFP was 0.916, with the sensitivity of 82.50% and specificity of 55.00%. In the HCC group, AFP levels corresponding to low (<0.23%) and high (≥0.23%) RUNX3 methylation levels, low (<0.14%) and high (≥0.14%) E-cadherin methylation levels, as well as low (<0.41%) and high (≥0.41%) RASSF1A methylation levels all showed significant differences (t=3.304, P=0.002; t=4.495, P<0.001; t=3.158, P=0.003). Multivariate Logistic regression analysis showed that RUNX3 methylation (OR=8.306, 95%CI: 1.862-37.058, P=0.006), RASSF1A methylation (OR=7.205, 95%CI: 2.080-25.268, P=0.002), and AFP level (OR=8.793, 95%CI: 1.725-44.825, P=0.009) were all risk factors for HCC in HCV-infected patients, while E-cadherin methylation was a protective factor (OR=0.457, 95%CI: 0.122-0.897, P=0.025).

Plasma methylation levels of RASSF1A, E-cadherin and RUNX3 gene can serve as effective diagnostic indicators for HCV-related HCC and may play important roles in predicting the progression of liver cirrhosis to HCC.

To investigate the relationship between lactate dehydrogenase (LDH) levels and abnormal liver function as well as glucose metabolism characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) of different ages.

Total of 199 children with MPP hospitalized at Woyang Branch of Anhui Provincial Hospital from May 2020 to November 2023 were selected. All children were divided into infant group (≤3 years old, 75 cases), preschool group (3-6 years old, 64 cases) and school-age group (≥6 years old, 60 cases) according to age. Additionally, the children were divided into normal liver function group (119 cases) and abnormal liver function group (80 cases) based on whether their serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were abnormal. The mediating effect of LDH on the relationship between fasting blood glucose and glycated hemoglobin (HbA1c) was tested by the Bootstrap method; the nonlinear association between LDH and the risk of liver dysfunction was analyzed by the restricted cubic spline regression method; and the relationship between LDH and liver function in children of different age groups was analyzed by the generalized linear mixed-effects model (GLMMs).

There were statistically significant differences among different age groups. Age, duration of hospital stay, days of fever, C-reactive protein (CRP), neutrophils (NEU), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), LDH, ALT, AST, fasting blood-glucose and HbA1c were significantly different among infant group, preschool group and school-age group (all P<0.05). Levels of CRP, NEU, ESR, PCT, LDH, ALT, AST, fasting blood-glucose and HbA1c were significantly different between children of normal liver function group and abnormal liver function group (all P<0.05). Bootstrap method test results showed that LDH played a partial mediating role between blood glucose and HbA1c: during normal liver function group, the mediating effect value of LDH was 0.082 (95%CI: 0.041-0.132), and the proportion of mediating effect in the total effect was 38.26%; During the abnormal liver function group, the mediating effect value of LDH was 0.105 (95%CI: 0.057-0.158), and the proportion of mediating effect in the total effect was 41.47%. The restricted cubic spline regression analysis showed that there was a significant nonlinear relationship between LDH and the risk of liver function (P_overall<0.001, P_nonlinear=0.023). GLMMs results showed that among different age groups of children with MPP, LDH levels deviating from the normal range were associated with an increased risk of abnormal liver function, with significant differences (all P<0.05).

There is a significant mediating effect between LDH level of children with MPP of different age groups and the indicators of glucose metabolism. Moreover, LDH level shows a significant nonlinear dose-response relationship with the risk of liver dysfunction. LDH can be used as a potential biomarker for assessing the risk of liver function impairment and glucose metabolism disorders among children with MPP.

To raise the awareness of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), which presents as tumefactive demyelinating lesions, and to improve the early diagnosis and treatment, and to avoid the misdiagnosis and inappropriate management.

The clinical data and management of a patient with MOGAD admitted to the Affiliated Hospital of Jining Medical University on December 30th, 2024 were analyzed, retrospectively, and relevant literature were reviewed.

A 60-year-old female patient presented with dizziness and headache lasting more than 20 days, as well as unsteady gait and aphasia for 6 days, whose clinical presentation was consistent with a brain tumefactive demyelinating lesions. The patient’s serum and cerebrospinal fluid samples were both positive for anti-myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) antibodies at a titre of 1∶10+. Cranial magnetic resonance imaging (MRI) revealed subcortical brain tissue swelling with abnormal signals in the bilateral temporal and frontal lobes, presenting as tumour-like changes. A diagnosis of MOG-associated demyelinating encephalopathy (MOGAD) was confirmed. The patient was treated with a corticosteroid pulse therapy of 500 mg/d of methylprednisolone, gradually tapered to 62.5 mg/d, followed by combination therapy with the immunosuppressant mycophenolate mofetil capsules, resulting in significant symptom relief. A follow-up MRI performed longer than three months after discharge showed that the abnormal intracranial signals had resolved by approximately 70% compared with the previous scan, with a favourable prognosis.

The clinical presentation of MOG is complex and requires differential diagnosis from other central nervous system disorders, and the importance of MOG-IgG testing must be given high priority to avoid misdiagnosis and inappropriate treatment.