Objective To investigate the distribution characteristics of Oncomelania hupensis snails in Yunnan Province fol-lowing interruption of schistosomiasis transmission, so as to provide the evidence for assessing the risk of schistosomiasis transmission and scientifically formulating the schistosomiasis surveillance program. Methods According to the requirements of the National Schistosomiasis Surveillance Scheme (2020 Edition), O. hupensis snail surveillance data were collected from 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province from 2020 to 2024, including area of snail survey, area of snail habitats, area of re-emerging snail habitats, number of frames surveyed, number of frames with O. hupensis snails, number of O. hupensis snails captured, and number of living snails, and the occurrence of frames with snails and mean density of living snails were calculated. Changes in snail status over the 5-year period from 2020 to 2024 and the differences in snail distributions specified by epidemic intensity, environmental type, and vegetation type were analyzed. Results The areas of snail survey increased from 1 727.96 hm² in 2020 to 3 894.45 hm² in 2024 (peak) across 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province during the period from 2020 through 2024. The areas of snail habitats increased from 70.36 hm² in 2020 to a peak in 2023 (172.04 hm²), followed by a reduction to 132.36 hm² in 2024, and the areas of re-emerging snail habitats increased from 42.71 hm² in 2020 to a peak in 2022 (78.43 hm²), followed by a reduction to 40.21 hm² in 2024. The occurrence of frames with snails and mean density of living snails increased from 1.24% (3 025/244 404) and (0.033 2 ± 0.038 7) snails/0.1 m² in 2020 to peaks at 2.03% (6 231/307 563) and (0.066 9 ± 0.068 4) snails/0.1 m² in 2023, followed by reductions to 1.04% (5 829/559 941) and (0.032 6 ± 0.057 7) snails/0.1 m² in 2024, respectively. There was a significant difference in the occurrence of frames with snails over the 5-year study period (χ² = 1 962.95, P < 0.05), and the occurrence of frames with snails reduced by 48.71% in 2024 relative to in 2023 (χ² = 1 411.05, P < 0.005); however, there was no significant difference in the mean density of living snails over the 5 years (H = 5.310, P > 0.05). There were significant differences in the occurrence of frames with snails (χ² = 481.27, P < 0.05) and mean density of living snails (H = 6.872, P < 0.05) in schistosomiasis-endemic areas with different epidemic intensities. The occurrence of frames with snails (χ² = 25.32 and 38.70, both P values < 0.017) and mean density of living snails (Z = 28.55 and 49.96, both P values < 0.017) were higher in schistosomiasis transmission-interrupted and eliminated areas with snails than in schistosomiasis-eliminated areas without snails, and the occurrence of frames with snails (χ² = 453.54, P < 0.017) and mean density of living snails (Z = −56.97, P < 0.017) were higher in schistosomiasis-eliminated areas with snails than in schistosomiasis transmission-interrupted areas with snails. O. hupensis snails were mainly distributed in paddy fields, dry farmlands and ditches; however, the occurrence of frames with snails (13.40%, 424/3 164) and mean density of living snails [(0.252 8 ± 0.158 7) snails/0.1 m²] were higher in ponds/weirs than in other types of environments (both P values < 0.05). Rice, dry farmland crops and weeds were main vegetations in which O. hupensis snails were distributed, and the occurrence of frames with snails (2.29%, 7 111/310 140) and mean density of living snails [(0.072 3 ± 0.018 9) snails/0.1 m²] were higher in weeds than in other types of environments (both P values < 0.05). Conclusions O. hupensis snails have been effectively controlled in Yunnan Province following implementation of integrated schistosomiasis control measures; however, there are still risk factors for schistosomiasis transmission, including reduced attention to schistosomiasis control and snail re-emergence. Improved control efforts and surveillance system construction and timely identification of risk factors of snail status and timely management are recommended to ensure the achievement of the target of schistosomiasis elimination as scheduled.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild murines in schistosomiasisendemic areas of Yunnan Province, so as to provide the evidence for improving the schistosomiasis surveillance and early warning capability and implementing precise interventions in the province. Methods A total of 56 natural villages were sampled from 14 schistosomiasis-endemic counties (cities, districts) in Yunnan Province as surveillance sites from 2024 to 2025. Wild murines were captured using traps at night and characterized for species. Liver samples were collected from wild murines, S. japonicum eggs and miracidia were simultaneously detected using liver tissue compression microscopy, liver tissue homogenate microscopy, and liver tissue homogenate hatching. In addition, stool samples were collected from wild murine rectum, with S. japonicum eggs detected using a modified Kato-Katz thick smear technique and S. japonicum miracidia detected using the hatching test with nylon gauzes. Results A total of 15 577 valid murine traps were recovered, and 891 wild murines belonging to 16 species were captured, with a capture rate of 5.72%(891/15 577). The captured wild murines were predominantly districted in paddy fields, dry lands, ditches, ponds and marshlands, with Apodemus chevrieri, Rattus norvegicus, Crocidura attenuata, R. rattus sladeni, R. flavipectus, and Eothenomys miletus as dominant species. No S. japonicum eggs or miradicia were in laboratory; however, other parasites were identified in 25 wild murines. The prevalence rates of Schistosoma sinensis, Capillaria hepatica and Hymenolepis nana were 2.24% (20/891), 0.90% (8/891) and 0.56% (5/891), and the prevalence of S. sinensis and C. hepatica co-infection was 0.90% (8/891), respectively. Conclusions S. sinensis, C. hepatica and H. nana are predominant parasite species in wild murines in schistosomiasis-endemic areas of Yunan Province. No S. japonicum infection was detected during the study period; however, there is still a risk of wild murines as a potential source of infection for schistosomiasis transmission. Continuous intensified surveillance of S. japonicum infections in wild murines is a critical programme in schistosomiasis surveillance and early warning in Yunnan Province.

Objective To explore the incidence and prognosis of citrin deficiency in Maoming,and to understand mutation types and frequency of SLC25A13 gene.Methods A total of 88 322 newborns born in Maoming from April 2022 to January 2025 were selected as research subjects.These specimens were screened using tandem mass spectrometry.Newborns with elevated citrulline levels or suspected clinical symptoms of citrin deficiency were recalled immediately for further genetic confirmation,and treated confirmed cases were followed up.Results Among 88 322 newborns,53 cases were positive for citrulline by tandem mass spectrometry,43 cases were recalled with positive initial screening,23 cases were still positive for citrulline after re-examination.Finally,1 case of neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD)was clinically diagnosed,and 10 cases were diagnosed with SLC25A13 gene,of which 1 case was false negative.Therefore,the total positive predictive value was 18.87％(10/53),and the prevalence rate of NICCD in Maoming was 1/8029(11/88 322).A total of 5 mutation sites were detected in 10 neonates with NICCD gene diagnosis,and the top 3 mutation sites in the order of proportion were:c.852-855delTATG accounted for 65.0％(13/20),c.615+5G>A accounted for 15.0％(3/20),IVS16ins3kb accounted for 10.0％(2/20).Among the 11 cases,1 case refused treatment and died of liver failure,while the remaining 10 cases were developing well after standardized treatment.Conclusion The incidence of neonatal citrin deficiency in Maoming is significantly higher than in other areas.Tandem mass spectrometry enables rapid early detection of citrin deficiency,though false-negative results may occur in individual cases.Combining genetic sequencing can improve diagnostic accuracy,and achieve precise management of inherited metabolic diseases.

This article summarized the clinical experience of national TCM master Zhang Zhen in treating gastroesophageal reflux cough by applying the theory of"dredging and regulating qi".Professor Zhang Zhen believes that the pathogenesis of gastroesophageal reflux cough lies in the abnormal ascending and descending of qi movement in the viscera.Specifically,it is manifested as weakness of the spleen and stomach,dysfunction of the pivot mechanism,failure of the liver to dredge and disperse,failure of the lung qi to descend,insufficiency of kidney yang,and failure of the kidney to receive qi.Clinically,the treatment method of dredging and regulating qi is adopted,and the Shutiao Decoction is used as the basic prescription.The disease is treated from three aspects,namely strengthening and regulating the spleen and stomach,soothing the liver and purifying the lung,and tonifying the kidney and helping it receive qi.The regulation of the qi movement of the whole body is organically combined with that of the local areas to jointly smooth the operation of the qi movement throughout the body.It is hoped that this can provide references and ideas for the treatment of gastroesophageal reflux cough in TCM.

OBJECTIVE To formulate an expert consensus on the prevention and control of respiratory infectious diseases in railway stations and trains in China,and to standardize the prevention and control of respiratory infec-tious diseases in railway stations and trains scientifically.METHODS The government authorities organized multi-ple prevention and control experts from transportation,medical care and prevention fields to conduct in-depth re-search through methods such as meetings and on-site investigations,and combined with their practical experi-ence in this field to formulate this expert consensus.RESULTS In-depth studies were conducted on the prevention and control strategies,measures and emergency response system construction of respiratory infectious diseases in railway stations and trains,and this expert consensus was formed.CONCLUSION This expert consensus supple-ments improves the existing prevention and control system for respiratory infectious diseases in railway stations and trains,and provides an important reference basis for the prevention and control of respiratory infectious disea-ses in railway stations and trains.

Objective To compare the distribution characteristics and drug resistance of mucous and non-mucous Streptococcus pneumoniae(SP).Methods SP isolated from clinical specimens of the Second Affiliated Hospital of Xiamen Medical College from January 2023 to June 2024 were collected.They were isolated,cultured and identified,and their susceptibility to antibacterial drugs was determined.Results A total of 291 SP strains were isolated,of which 20 strains were mucous SP and 271 strains were non-mucous SP.Children played a dominant role of non-mucous SP infection,but mucous SP mainly infected adults and the children above 5 years old.Both phenotypes of SP were mainly characterized by pulmonary infection.Non-mucous SP had a relatively high sensitivity rate to vancomycin,linezolid,penicillin,ertapenem,chloramphenicol,levofloxacin,moxifloxacin and ofloxacin.It had a high resistance rate to compound sulfamethoxazole,clindamycin,erythromycin and tetracycline.Mucous SP was completely sensitive to penicillin,amoxicillin,cefotaxime,ceftriaxone,ertapenem,vancomycin,linezolid,levofloxacin and moxifloxacin,and had a relatively high resistance rate to clindamycin,erythromycin and tetracycline.Conclusion The laboratory should enhance the detection capacity of mucous SP.Mucous SP is highly sensitive to common antibiotics.Clinicians should select antibiotics based on drug sensitivity results to delay the occurrence of drug resistance.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective To explore the incidence and prognosis of citrin deficiency in Maoming,and to understand mutation types and frequency of SLC25A13 gene.Methods A total of 88 322 newborns born in Maoming from April 2022 to January 2025 were selected as research subjects.These specimens were screened using tandem mass spectrometry.Newborns with elevated citrulline levels or suspected clinical symptoms of citrin deficiency were recalled immediately for further genetic confirmation,and treated confirmed cases were followed up.Results Among 88 322 newborns,53 cases were positive for citrulline by tandem mass spectrometry,43 cases were recalled with positive initial screening,23 cases were still positive for citrulline after re-examination.Finally,1 case of neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD)was clinically diagnosed,and 10 cases were diagnosed with SLC25A13 gene,of which 1 case was false negative.Therefore,the total positive predictive value was 18.87％(10/53),and the prevalence rate of NICCD in Maoming was 1/8029(11/88 322).A total of 5 mutation sites were detected in 10 neonates with NICCD gene diagnosis,and the top 3 mutation sites in the order of proportion were:c.852-855delTATG accounted for 65.0％(13/20),c.615+5G>A accounted for 15.0％(3/20),IVS16ins3kb accounted for 10.0％(2/20).Among the 11 cases,1 case refused treatment and died of liver failure,while the remaining 10 cases were developing well after standardized treatment.Conclusion The incidence of neonatal citrin deficiency in Maoming is significantly higher than in other areas.Tandem mass spectrometry enables rapid early detection of citrin deficiency,though false-negative results may occur in individual cases.Combining genetic sequencing can improve diagnostic accuracy,and achieve precise management of inherited metabolic diseases.