1.Mechanism of baicalin mediated inflammatory response in rats with inflammatory bowel disease
Yi-pin XIANG ; Hui JIAN ; Yan-hong TU
Journal of Regional Anatomy and Operative Surgery 2025;34(2):110-116
Objective To explore the mechanism of baicalin mediating inflammatory response in rats with inflammatory bowel disease through microRNA(miR-21)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A total of 60 SD rats were selected to construct inflammatory bowel disease rat model by trinitro-benzene-sulfonic acid(TNBS)colon perfusion method,and randomly divided into 6 groups,with 10 rats in each group.They were divided into model group,low-dose group(gavage of 20 mg/kg baicalin),high-dose group(gavage of 80 mg/kg baicalin),high-dose+agomiR-NC group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miRNA negative control vector agomiR-NC),high-dose+agomiR-21 group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miR-21 agonist agomiR-21)and high-dose+agomiR-21+colivelin group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg agomiR-21,along with intraperitoneal injection of 1 mg/kg STAT3 activator colivelin).Another 10 SD rats were selected as control group without any treatment.The body mass of rats in each group was measured every two days during administration,and the status of rats in each group was observed after administration.Hematoxylin and eosin(HE)staining was used to evaluate the pathological damage.The myeloperoxidase(MPO)activity,inflammatory factors and oxidative stress indexes were detected by the test kit.The mRNA levels of miR-21,STAT3 were detected by qRT-PCR.The expression of STAT3 and p-STAT3 protein was detected by Western blot.Results Compared with model group,the status of inflammatory bowel disease and pathological damage degree of colon tissue in low-dose group and high-dose group were significantly improved,the levels of interleukin-13(IL-13),superoxide dismutase(SOD)and glutathione peroxidase(GSH)were increased(P<0.05),while the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),malondialdehyde(MDA),reactive oxygen species(ROS),and miR-21 mRNA,STAT3 mRNA,p-STAT3/STAT3 protein expression were decreased(P<0.05)in a dose-dependent manner.Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21 group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA,P-STAT3/STAT3 protein expression were increased(P<0.05).Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21+colivelin group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA and P-STAT3/STAT3 protein expression were increased(P<0.05).Conclusion Baicalin reduces inflammatory factors and oxidative stress levels through miR-21/STAT3 signaling pathway,and thereby ameliorates colonic injury in rats with inflammatory bowel disease.
2.Effects of continuous positive airway pressure on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome
Zelin TU ; Rui BAI ; Linyan ZHANG ; Jingyu WANG ; Shenda HONG ; Jingjing YANG ; Jun WEI ; Yan WANG ; Yanan LIU ; Xiaosong DONG ; Fang HAN ; Guoli LIU
Chinese Journal of Obstetrics and Gynecology 2025;60(3):171-176
Objective:To analyze the effect of continuous positive airway pressure (CPAP) on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome (OSAS), especially on the incidence of hypertensive disorder in pregnancy (HDP) in women with moderate to severe OSAS.Methods:A total of 180 pregnant women with OSAS who were diagnosed through sleep monitoring during pregnancy due to high-risk factors of OSAS and registered in Peking University People′s Hospital from January 2021 to May 2024 were selected as the study subjects. Clinical data were collected from medical records for retrospective analysis. According to whether they received standardized treatment with CPAP, they were divided into the CPAP treatment group (42 cases) and the control group (138 cases). The CPAP treatment group consisted of 9 pregnant women with moderate to severe OSAS, while the control group consisted of 34 pregnant women with moderate to severe OSAS. The maternal and neonatal outcomes, the incidence of HDP, placental weight after delivery and placental weight/neonatal birth weight ratio were compared between the two groups.Results:(1) The average gestational age of pregnant women in the CPAP treatment group was higher than that in the control group [(38.7±1.0) vs (38.0±1.4) weeks], the proportion of infants small for gestational age (SGA) in the CPAP treatment group was lower [0 (0/42) vs 12.3% (17/138)], and the birth weight of infants in the CPAP treatment group was bigger [(3 396±475) vs (3 082±710) g); the differences between the two groups were statistically significant (all P<0.05). There were no significant differences between the CPAP treatment group and the control group in terms of delivery mode, rates of postpartum hemorrhage and preterm birth, umbilical artery blood gas analysis pH<7.1, lactate≥6.0 mmol/L, base excess<-12.0 mmol/L and the incidence of gestational diabetes mellitus and HDP (all P>0.05). (2) The placental weight of the CPAP treatment group was significantly lower than that of the control group [(554.0±70.6) vs (615.7±119.1) g], the placental weight/newborn birth weight ratio of the CPAP treatment group was significantly lower than that of the control group (median: 0.17 vs 0.19), and the differences were statistically significant (all P<0.05). (3) The incidence of HDP in pregnant women with moderate to severe OSAS in the CPAP treatment group was lower than that in the control group [1/9 vs 61.8% (21/34)], and the difference was statistically significant ( P<0.05). Conclusions:CPAP treatment could prolong the gestational age in pregnant women with OSAS, reduce the incidence of SGA, increase the birth weight of infants, and reduce the incidence of HDP in pregnant women with moderate to severe OSAS, and is worth promoting in clinical practice. The improvement of neonatal outcomes by CPAP treatment is closely related to the placenta, which is worthy of further exploration.
3.Clinical characteristics and risk factors of delayed viral clearance in 562 Chikungunya fever patients in Shunde region, Guangdong Province, 2025
Zuning REN ; Guotao LYU ; Qun LIN ; Zhifeng HONG ; Shuichun WAN ; Feng KANG ; Yanling OUYANG ; Chunhua TU ; Guo RAO ; Hua LIANG ; Yawei LIU ; Yan ZHU ; Jie PENG ; Jie SHEN ; Hong LI
Chinese Journal of Infectious Diseases 2025;43(8):449-456
Objective:To analyze the clinical characteristics of the Chikungunya fever outbreak in Shunde District, Foshan City, Guangdong Province in July 2025 and the risk factors associated with delayed viral RNA clearance.Methods:A total of 562 patients with Chikungunya fever admitted to three designated hospitals in Shunde District from July 10 to 30, 2025 were enrolled. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into four age groups including minors (<18 years), young adults (18 to 39 years), middle-aged adults (40 to 64 years) and elderly adults (≥65 years). The differences of clinical characteristics among these age groups were analyzed. Intergroup comparisons were performed using chi-square test, one-way analysis of variance, or Kruskal-Wallis H test. Pairwise comparisons between groups were conducted using the Bonferroni or Games-Howell or Dunn method. Binary logistic regression was employed to analyze risk factors associated with delayed viral RNA clearance (>7 days). Results:The mean age of the 562 enrolled Chikungunya fever patients was (44.8±21.3) years. Fever, arthralgia and rash were the three core symptoms, with incidence rates of 87.5% (492/562), 88.4%(497/562) and 69.6%(391/562), respectively. At discharge, only 54.1%(304/562) of patients achieved complete symptom resolution, while 26.5%(149/562) still had arthralgia and 36.1%(203/562) had residual rash. Significant differences were observed among age groups in the incidence of fever ( χ2=9.43, P=0.024), peak body temperature ( F=6.54, P<0.001), incidence of arthralgia ( χ2=26.89, P<0.001), duration of arthralgia ( F=12.68, P=0.001), incidence of rash ( χ2=68.99, P<0.001), rate of residual rash at discharge ( χ2=32.37, P<0.001), lymphocyte count ( F=12.94, P<0.001), platelet count ( F=14.95, P<0.001), and C-reactive protein levels (CRP) ( H=94.18, P<0.001). Further pairwise comparisons revealed that compared to the middle-aged and elderly groups, the minor group had a higher incidence of fever and a lower incidence of arthralgia, and the duration of arthralgia was shorter than the elderly group (all P<0.008 3). Compared with the other three groups, the elderly group had lower incidence and residual rate of rash, and lower platelet counts (all P<0.008 3), and higher levels of CRP (all P<0.05). The elderly group had lower lymphocyte counts compared to the minor and young adult groups (both P<0.05). Significant differences were found among age groups in the time to viral RNA clearance ( F=5.77, P=0.003) and length of hospital stay ( F=11.64, P<0.001), with the elderly group having significantly longer duration for both compared to the other three groups (all P<0.05). Multivariate analysis showed that advanced age (odds ratio ( OR)=1.049, 95% confidence interval ( CI) 1.015 to 1.083), longer duration of fever ( OR=1.529, 95% CI 1.086 to 2.155) and longer duration of arthralgia ( OR=1.927, 95% CI 1.318 to 2.817) were independent risk factors for delayed viral RNA clearance (all P<0.05). Conclusions:Patients with Chikungunya fever in Shunde District primarily present with fever, arthralgia and rash. The incidence and characteristics of these three core symptoms show age-related variations. Elderly patients and those with longer durations of fever or arthralgia are more likely to experience delayed viral clearance.
4.Identification of novel pathogenic variants in genes related to pancreatic β cell function: A multi-center study in Chinese with young-onset diabetes.
Fan YU ; Yinfang TU ; Yanfang ZHANG ; Tianwei GU ; Haoyong YU ; Xiangyu MENG ; Si CHEN ; Fengjing LIU ; Ke HUANG ; Tianhao BA ; Siqian GONG ; Danfeng PENG ; Dandan YAN ; Xiangnan FANG ; Tongyu WANG ; Yang HUA ; Xianghui CHEN ; Hongli CHEN ; Jie XU ; Rong ZHANG ; Linong JI ; Yan BI ; Xueyao HAN ; Hong ZHANG ; Cheng HU
Chinese Medical Journal 2025;138(9):1129-1131
5.Rapid characterization and identification of non-volatile components in Rhododendron tomentosum by UHPLC-Q-TOF-MS method.
Su-Ping XIAO ; Long-Mei LI ; Bin XIE ; Hong LIANG ; Qiong YIN ; Jian-Hui LI ; Jie DU ; Ji-Yong WANG ; Run-Huai ZHAO ; Yan-Qin XU ; Yun-Bo SUN ; Zong-Yuan LU ; Peng-Fei TU
China Journal of Chinese Materia Medica 2025;50(11):3054-3069
This study aimed to characterize and identify the non-volatile components in aqueous and ethanolic extracts of the stems and leaves of Rhododendron tomentosum by using sensitive and efficient ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS) combined with a self-built information database. By comparing with reference compounds, analyzing fragment ion information, searching relevant literature, and using a self-built information database, 118 compounds were identified from the aqueous and ethanolic extracts of R. tomentosum, including 35 flavonoid glycosides, 15 phenolic glycosides, 12 flavonoids, 7 phenolic acids, 7 phenylethanol glycosides, 6 tannins, 6 phospholipids, 5 coumarins, 5 monoterpene glycosides, 6 triterpenes, 3 fatty acids, and 11 other types of compounds. Among them, 102 compounds were reported in R. tomentosum for the first time, and 36 compounds were identified by comparing them with reference compounds. The chemical components in the ethanolic and aqueous extracts of R. tomentosum leaves and stems showed slight differences, with 84 common chemical components accounting for 71.2% of the total 118 compounds. This study systematically characterized and identified the non-volatile chemical components in the ethanolic and aqueous extracts of R. tomentosum for the first time. The findings provide a reference for active ingredient research, quality control, and product development of R. tomentosum.
Rhododendron/chemistry*
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Chromatography, High Pressure Liquid/methods*
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Drugs, Chinese Herbal/chemistry*
;
Mass Spectrometry/methods*
;
Plant Leaves/chemistry*
6.Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study.
Jian-Feng TU ; Xue-Zhou WANG ; Shi-Yan YAN ; Yi-Ran WANG ; Jing-Wen YANG ; Guang-Xia SHI ; Wen-Zheng ZHANG ; Li-Na JIN ; Li-Sha YANG ; Dong-Hua LIU ; Li-Qiong WANG ; Bao-Hong MI
Journal of Integrative Medicine 2025;23(3):289-296
OBJECTIVE:
Varied acupoint selections represent a potential cause of the uncertainty surrounding the efficacy of acupuncture for knee osteoarthritis (OA). Skin temperature, a guiding factor for acupoint selection, may help to address this issue. This study explored thermal sensitization of acupoints used for the treatment of knee OA.
METHODS:
This cross-sectional case-control study enrolled cases aged 45-75 years with symptomatic knee OA and age- and gender-matched non-knee OA controls in a 1:1 ratio. All participants underwent infrared thermographic imaging. The primary outcome was the relative skin temperature of acupoint (STA), and the secondary outcome was the absolute STA of 11 acupoints. The Z test was used to compare the relative and absolute STAs between the groups. Principal component analysis was used to extract the common factors (CFs, acupoint cluster) in the STAs. A general linear model was used to identify factors affecting the STA in the knee OA cases. For the group comparisons of relative STA, P < 0.0045 (adjusted for 11 acupoints through Bonferroni correction) was considered to indicate statistical significance. For other analyses, P < 0.05 was used as the threshold for statistical significance.
RESULTS:
The analysis included 308 participants, consisting of 151 cases (mean age: [64.58 ± 6.67] years; male: 25.83%; mean body mass index: [25.70 ± 3.16] kg/m2) and 157 controls (mean age: [63.37 ± 5.96] years; male: 26.11%; mean body mass index: [24.47 ± 2.84] kg/m2). The relative STAs of ST34 (P = 0.0001), EX-LE2 (P < 0.0001), EX-LE5 (P = 0.0006), SP10 (P < 0.0001), BL40 (P = 0.0012) and GB39 (P = 0.0037) were higher in the knee OA group. No difference was found in the STAs of ST35, ST36, SP9, GB33 and GB34. Four CFs were identified for relative STA in both groups. The acupoints within each CF were consistent between the groups. The mean values of the relative STAs across each CF were higher in the knee OA group. In the knee OA cases, no factors were observed to affect the relative STA, while age and gender were found to affect the absolute STA.
CONCLUSION
Among patients with knee OA, thermal sensitization occurs in the acupoints of the lower extremity, exhibiting localized and regional thermal consistencies. The thermally sensitized acupoints that we identified in this study, ST34, SP10, EX-LE2, EX-LE5, GB39 and BL40, may be good choices for the acupuncture treatment of knee OA. Please cite this article as: Tu JF, Wang XZ, Yan SY, Wang YR, Yang JW, Shi GX, Zhang WZ, Jing LN, Yang LS, Liu DH, Wang LQ, Mi BH. Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study. J Integr Med. 2025; 23(3): 289-296.
Humans
;
Osteoarthritis, Knee/physiopathology*
;
Male
;
Cross-Sectional Studies
;
Middle Aged
;
Female
;
Acupuncture Points
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Case-Control Studies
;
Aged
;
Skin Temperature
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Acupuncture Therapy
7.Impact of peer dating behavior and cohabitation with parents on sexual behaviors among secondary vocational school students
JIA Xin, FANG Yuhang, JIN Yan, ZUO Xiayun, YU Chunyan, LIAN Qiguo, LI Lihe, HONG Ping, TU Xiaowen
Chinese Journal of School Health 2025;46(5):657-661
Objective:
To understand the moderating effect of cohabitation with parents on the association between peer dating behavior and sexual behaviors among secondary vocational school students, so as to provide a scientific basis for preventing sexual behaviors among secondary vocational school students.
Methods:
From March to April 2021, an electronic questionnaire survey was conducted among 3 180 students from 6 vocational schools in Shanghai (urban, suburban, exurban) and Shaanxi (Shangluo, Ankang, Baoji) using cluster sampling. Spearman correlation analysis was used to investigate the relationship of cohabitation with parents, peer dating behavior and sexual behaviors among secondary vocational school students. Binary Logistic regression analysis was performed to investigate the role of cohabitation with parents on peer dating behavior and sexual behaviors among secondary vocational students.
Results:
There was a significant negative between cohabitation with parents and sexual ( r =-0.04); and there was a positive correlation between peer dating behavior and sexual behaviors ( r =0.24), as well as cohabitation with parents and peer dating behavior ( r =0.04)( P <0.05). Multivariable Logistic regression analysis showed an association between peer dating behavior and the occurrence of sexual behaviors ( OR=2.79-12.95, P <0.05). Cohabitation with parents played a moderating role in the association between peer dating behavior and sexual behaviors, and a signification interaction was found between cohabitation with parents and reporting that a small part or about half of their peers had dating behavior ( OR =0.48, P <0.05).
Conclusions
The more peers dating behavior are associated with a higher risk of sexual behaviors among secondary vocational school students, and cohabitation with parents can partly reduce this risk. School and family sexuality education for secondary vocational students should be strengthened to improve their interpersonal skills and decision-making, and ability to resist peer pressure, so as to reduce their risk of sexual behaviors.
8.Effects of continuous positive airway pressure on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome
Zelin TU ; Rui BAI ; Linyan ZHANG ; Jingyu WANG ; Shenda HONG ; Jingjing YANG ; Jun WEI ; Yan WANG ; Yanan LIU ; Xiaosong DONG ; Fang HAN ; Guoli LIU
Chinese Journal of Obstetrics and Gynecology 2025;60(3):171-176
Objective:To analyze the effect of continuous positive airway pressure (CPAP) on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome (OSAS), especially on the incidence of hypertensive disorder in pregnancy (HDP) in women with moderate to severe OSAS.Methods:A total of 180 pregnant women with OSAS who were diagnosed through sleep monitoring during pregnancy due to high-risk factors of OSAS and registered in Peking University People′s Hospital from January 2021 to May 2024 were selected as the study subjects. Clinical data were collected from medical records for retrospective analysis. According to whether they received standardized treatment with CPAP, they were divided into the CPAP treatment group (42 cases) and the control group (138 cases). The CPAP treatment group consisted of 9 pregnant women with moderate to severe OSAS, while the control group consisted of 34 pregnant women with moderate to severe OSAS. The maternal and neonatal outcomes, the incidence of HDP, placental weight after delivery and placental weight/neonatal birth weight ratio were compared between the two groups.Results:(1) The average gestational age of pregnant women in the CPAP treatment group was higher than that in the control group [(38.7±1.0) vs (38.0±1.4) weeks], the proportion of infants small for gestational age (SGA) in the CPAP treatment group was lower [0 (0/42) vs 12.3% (17/138)], and the birth weight of infants in the CPAP treatment group was bigger [(3 396±475) vs (3 082±710) g); the differences between the two groups were statistically significant (all P<0.05). There were no significant differences between the CPAP treatment group and the control group in terms of delivery mode, rates of postpartum hemorrhage and preterm birth, umbilical artery blood gas analysis pH<7.1, lactate≥6.0 mmol/L, base excess<-12.0 mmol/L and the incidence of gestational diabetes mellitus and HDP (all P>0.05). (2) The placental weight of the CPAP treatment group was significantly lower than that of the control group [(554.0±70.6) vs (615.7±119.1) g], the placental weight/newborn birth weight ratio of the CPAP treatment group was significantly lower than that of the control group (median: 0.17 vs 0.19), and the differences were statistically significant (all P<0.05). (3) The incidence of HDP in pregnant women with moderate to severe OSAS in the CPAP treatment group was lower than that in the control group [1/9 vs 61.8% (21/34)], and the difference was statistically significant ( P<0.05). Conclusions:CPAP treatment could prolong the gestational age in pregnant women with OSAS, reduce the incidence of SGA, increase the birth weight of infants, and reduce the incidence of HDP in pregnant women with moderate to severe OSAS, and is worth promoting in clinical practice. The improvement of neonatal outcomes by CPAP treatment is closely related to the placenta, which is worthy of further exploration.
9.Mechanism of baicalin mediated inflammatory response in rats with inflammatory bowel disease
Yi-pin XIANG ; Hui JIAN ; Yan-hong TU
Journal of Regional Anatomy and Operative Surgery 2025;34(2):110-116
Objective To explore the mechanism of baicalin mediating inflammatory response in rats with inflammatory bowel disease through microRNA(miR-21)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A total of 60 SD rats were selected to construct inflammatory bowel disease rat model by trinitro-benzene-sulfonic acid(TNBS)colon perfusion method,and randomly divided into 6 groups,with 10 rats in each group.They were divided into model group,low-dose group(gavage of 20 mg/kg baicalin),high-dose group(gavage of 80 mg/kg baicalin),high-dose+agomiR-NC group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miRNA negative control vector agomiR-NC),high-dose+agomiR-21 group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miR-21 agonist agomiR-21)and high-dose+agomiR-21+colivelin group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg agomiR-21,along with intraperitoneal injection of 1 mg/kg STAT3 activator colivelin).Another 10 SD rats were selected as control group without any treatment.The body mass of rats in each group was measured every two days during administration,and the status of rats in each group was observed after administration.Hematoxylin and eosin(HE)staining was used to evaluate the pathological damage.The myeloperoxidase(MPO)activity,inflammatory factors and oxidative stress indexes were detected by the test kit.The mRNA levels of miR-21,STAT3 were detected by qRT-PCR.The expression of STAT3 and p-STAT3 protein was detected by Western blot.Results Compared with model group,the status of inflammatory bowel disease and pathological damage degree of colon tissue in low-dose group and high-dose group were significantly improved,the levels of interleukin-13(IL-13),superoxide dismutase(SOD)and glutathione peroxidase(GSH)were increased(P<0.05),while the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),malondialdehyde(MDA),reactive oxygen species(ROS),and miR-21 mRNA,STAT3 mRNA,p-STAT3/STAT3 protein expression were decreased(P<0.05)in a dose-dependent manner.Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21 group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA,P-STAT3/STAT3 protein expression were increased(P<0.05).Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21+colivelin group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA and P-STAT3/STAT3 protein expression were increased(P<0.05).Conclusion Baicalin reduces inflammatory factors and oxidative stress levels through miR-21/STAT3 signaling pathway,and thereby ameliorates colonic injury in rats with inflammatory bowel disease.
10.Clinical characteristics and risk factors of delayed viral clearance in 562 Chikungunya fever patients in Shunde region, Guangdong Province, 2025
Zuning REN ; Guotao LYU ; Qun LIN ; Zhifeng HONG ; Shuichun WAN ; Feng KANG ; Yanling OUYANG ; Chunhua TU ; Guo RAO ; Hua LIANG ; Yawei LIU ; Yan ZHU ; Jie PENG ; Jie SHEN ; Hong LI
Chinese Journal of Infectious Diseases 2025;43(8):449-456
Objective:To analyze the clinical characteristics of the Chikungunya fever outbreak in Shunde District, Foshan City, Guangdong Province in July 2025 and the risk factors associated with delayed viral RNA clearance.Methods:A total of 562 patients with Chikungunya fever admitted to three designated hospitals in Shunde District from July 10 to 30, 2025 were enrolled. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into four age groups including minors (<18 years), young adults (18 to 39 years), middle-aged adults (40 to 64 years) and elderly adults (≥65 years). The differences of clinical characteristics among these age groups were analyzed. Intergroup comparisons were performed using chi-square test, one-way analysis of variance, or Kruskal-Wallis H test. Pairwise comparisons between groups were conducted using the Bonferroni or Games-Howell or Dunn method. Binary logistic regression was employed to analyze risk factors associated with delayed viral RNA clearance (>7 days). Results:The mean age of the 562 enrolled Chikungunya fever patients was (44.8±21.3) years. Fever, arthralgia and rash were the three core symptoms, with incidence rates of 87.5% (492/562), 88.4%(497/562) and 69.6%(391/562), respectively. At discharge, only 54.1%(304/562) of patients achieved complete symptom resolution, while 26.5%(149/562) still had arthralgia and 36.1%(203/562) had residual rash. Significant differences were observed among age groups in the incidence of fever ( χ2=9.43, P=0.024), peak body temperature ( F=6.54, P<0.001), incidence of arthralgia ( χ2=26.89, P<0.001), duration of arthralgia ( F=12.68, P=0.001), incidence of rash ( χ2=68.99, P<0.001), rate of residual rash at discharge ( χ2=32.37, P<0.001), lymphocyte count ( F=12.94, P<0.001), platelet count ( F=14.95, P<0.001), and C-reactive protein levels (CRP) ( H=94.18, P<0.001). Further pairwise comparisons revealed that compared to the middle-aged and elderly groups, the minor group had a higher incidence of fever and a lower incidence of arthralgia, and the duration of arthralgia was shorter than the elderly group (all P<0.008 3). Compared with the other three groups, the elderly group had lower incidence and residual rate of rash, and lower platelet counts (all P<0.008 3), and higher levels of CRP (all P<0.05). The elderly group had lower lymphocyte counts compared to the minor and young adult groups (both P<0.05). Significant differences were found among age groups in the time to viral RNA clearance ( F=5.77, P=0.003) and length of hospital stay ( F=11.64, P<0.001), with the elderly group having significantly longer duration for both compared to the other three groups (all P<0.05). Multivariate analysis showed that advanced age (odds ratio ( OR)=1.049, 95% confidence interval ( CI) 1.015 to 1.083), longer duration of fever ( OR=1.529, 95% CI 1.086 to 2.155) and longer duration of arthralgia ( OR=1.927, 95% CI 1.318 to 2.817) were independent risk factors for delayed viral RNA clearance (all P<0.05). Conclusions:Patients with Chikungunya fever in Shunde District primarily present with fever, arthralgia and rash. The incidence and characteristics of these three core symptoms show age-related variations. Elderly patients and those with longer durations of fever or arthralgia are more likely to experience delayed viral clearance.


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