中华预防医学杂志最新文献

Objective: To analyze the epidemiological characteristics and intervals of onset-to-diagnosis and diagnosis-to-report for meningococcal meningitis in Zhejiang Province from 2014 to 2024. Methods: Meningococcal meningitis case data were collected from the National Notifiable Disease Reporting System (NNDRS) and the Meningococcal Meningitis Surveillance Information Management System in Zhejiang Province (2014 to 2024). The Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences in the onset-to-diagnosis time among case groups with different characteristics. Results: From 2014 to 2024, Zhejiang Province reported 45 meningococcal meningitis cases (3 deaths), with a case fatality rate of 6.67%. The average annual incidence and mortality rates were 0.065 per million and 0.004 per million, respectively. The mean annual age-specific incidence rates for the 0-4, 5-9, 10-14, and ≥15-year-old groups were 0.793, 0.063, 0.074, and 0.032 per million, respectively. Of 39 isolated strains, serogroup B dominated (53.85%, 21 strains), followed by Y (10.26%, 4), C (10.26%, 4), W (7.69%, 3), and non-groupable strains (17.95%, 7). Among the 0-4-year-old group, serogroup B accounted for 75.00% (15/20 strains). The median onset-to-diagnosis interval M (Q₁,Q₃) was 6 (3, 8) d, while the diagnosis-to-report interval was 0 (0, 0) d. For cases with petechiae/purpura, the median onset-to-diagnosis interval was 3 (2, 6) d, while for cases without petechiae/purpura, it was 6 (5, 10) d, with a statistically significant difference (U=134.50, P=0.008). Conclusion: From 2014 to 2024, the incidence of meningococcal meningitis in Zhejiang Province remains low. In the general population, serogroup B is the predominant strain, with co-circulation of multiple serogroups including Y, C, and W. The 0-4-year-old group has a relatively higher incidence, with serogroup B being the predominant strain in this age group. In the future, more efforts should be devoted to strengthen the sensitivity of monitoring for meningitis and improve the ability of medical institutions to differentiate and diagnose atypical symptoms of meningitis.

Objective: To conduct a molecular epidemiological investigation and genetic characteristics of the local outbreak of Chikungunya fever in Guangzhou City in July 2025, clarify the source, genotype, and variation characteristics of the virus, and provide a scientific basis for traceability and prevention and control of the outbreak. Method: Epidemiological data and serum samples of confirmed cases were collected. The virus nucleic acid testing, whole genome sequencing, phylogenetic tree reconstruction, and E1/E2 protein amino acid site analysis were performed. Results: By August 6, 2025, 104 autochthonous Chikungunya cases had been confirmed in Guangzhou City, showing a spatially scattered transmission pattern with limited cluster potential in areas such as Xintang Town. Fifty-one full-genome sequences were obtained, all belonging to the East/Central/South African (ECSA) genotype, Central African subclade, with a similarity of 99.96% to the Réunion Island strains (2024-2025). Fifteen amino acid mutations were identified in E1/E2 proteins, of which 13 were unique, including adaptive mutations such as E1-A226V and E2-I211T. Conclusion: The outbreak is caused by a single imported ECSA-genotype strain, potentially from the Indian Ocean region. There may be a risk of small-scale outbreaks in Guangzhou City. Continuously strengthening mosquito-borne disease surveillance, early warning systems, and etiological monitoring is significant for disease prevention and control.

Objective: Profiling tumor cell heterogeneity before and after chemotherapy in breast cancer patients to delineate the cellular evolutionary trajectory at single-cell resolution, thereby identifying potential targets for intervention. Methods: Using a case-control study design, a female patient with breast cancer admitted to the Department of Breast Surgery, The First Affiliated Hospital of Hunan University of Chinese Medicine in September 2020 was enrolled as the subject. Fresh tumor tissue samples, collected both before and after chemotherapy, were subjected to single-cell RNA sequencing to assess transcriptomic profiles and observe the impact of chemotherapy on the intratumoral microenvironment. Specifically, a pre-chemotherapy biopsy sample was obtained in June 2020, and a post-chemotherapy surgical resection sample was obtained in September 2020. Pathological diagnosis confirmed Grade Ⅲ invasive ductal carcinoma for both samples, with a molecular subtype of Luminal B. Results: A significance threshold of |log₂FC|>2 and a P-value <0.05 were set to define statistically significant differences for subsequent bioinformatic analysis. Sequencing data revealed that a total of 8 599 cells were profiled in this study, with 4 180 (48.6%) and 4 419 (51.4%) cells derived from pre- and post-chemotherapy tumor tissues, respectively. It characterized the cellular composition of the tumor microenvironment and identified 13 distinct cell clusters. These included basal cells, pericytes, plasma cells, T cells, B cells, fibroblasts, endothelial cells, NK cells, mast cells, epithelial cells, macrophages, cycling cells, and plasmacytoid dendritic cells. Signaling pathways and transcription factors associated with these cell clusters were subsequently analyzed and subjected to enrichment analysis. Furthermore, this study delineated the precise cellular architecture and developmental trajectories of breast cancer before and after chemotherapy. It also predicted that the APOD, ELN, and F2R genes may play pivotal roles in disease progression. Conclusion: This study utilized single-cell RNA sequencing to analyze intra-tumoral cellular heterogeneity in a breast cancer patient before and after chemotherapy. The findings may provide a clinically informative direction for identifying novel potential therapeutic targets during chemotherapy, prior to primary tumor resection.

The impact of circadian rhythm disruption on immune system function has been widely studied; however, the precise mechanisms by which it modulates immune system structure and function at the single-cell level remain poorly understood. This study was conducted from April to November 2024 in the Department of Pediatrics, the Third Xiangya Hospital, Central South University. In this study, a zebrafish model of circadian rhythm disruption was established by exposing larvae to constant light (24 h LL) for three days, while control groups were maintained under a standard 14-hour light/10-hour dark (14∶10 h LD) cycle. Single-cell RNA sequencing was performed to comprehensively profile the immune cells from both groups. Immune cell subpopulations, their proportional shifts, and developmental trajectories were characterized through UMAP-based clustering, marker gene annotation, and Monocle pseudotime trajectory analysis. A total of seven immune-related cell subtypes were identified, including hematopoietic progenitors, T cell progenitor-like cells, activated T cell-like cells, macrophages, neutrophils, NK cells, and migratory/repair-associated cells. Notably, the proportion of activated T cells was increased in the circadian rhythm-disrupted group (18.11%) compared with the control group (7.61%), accompanied by enhanced expression of immune activation markers such as cd40lg, il2rb,tnfrsf9b (log₂FC=7.49, 5.58, 3.76, adjusted P<0.01). Pseudotime analysis revealed bifurcated differentiation paths along myeloid and lymphoid lineages. Although the core developmental trajectories remained intact under circadian rhythm disturbance, alterations were observed in the distribution and maturation pace of terminal lymphoid cells. Overall, the findings demonstrate that circadian rhythm disruption induces structural and functional remodeling of the zebrafish immune system, characterized by enhanced activation of T and NK cells and a shift in immune response status. These results provide single-cell-level insights into the immunological mechanisms underlying sleep-related disorders.

Objective: To investigate the genotype and epidemiological characteristics of Human Coronavirus NL63 (HCoV-NL63) epidemic strains in Shanghai, China. Methods: Whole genome sequencing of HCoV-NL63 was performed with the nucleic acid-positive specimens collected from the acute respiratory infection surveillance system in Shanghai from 2019 to 2024. Phylogenetic, homology, and key mutation site analysis of the S gene were conducted in combination with international reference sequences. Results: Seven whole genome sequences of HCoV-NL63 were obtained, including five (2020-2022) of subtype B2 and two (2024) of subtype C3. The B2 subtype sequences were highly homologous to the Guangzhou 2018 strain, while the C3 subtype sequences were highly homologous to the Japanese 2023 strain. There were 44 amino acid mutation sites located on the S gene of five B2 strains, with E572A in the receptor binding domain (RBD) region. There were 15 amino acid mutation sites in the S gene of C3 subtype, with I507L and E572A in the RBD region, and I507L as the signature mutation of C3 subtype, closely related to viral virulence. Conclusion: The B2 and C3 subtypes coexist among the prevalent strains in Shanghai, and the related strains are highly homologous to the domestic and international strains causing severe infections, indicating the need to strengthen continuous monitoring and functional research on HCoV-NL63 variants in Shanghai.

Vaccination is widely acknowledged as one of the most successful and cost-effective health interventions. Vaccines play a critical role in addressing common diseases among the elderly. Promoting vaccination in this demographic helps realize the full potential and value of immunization. Currently, China offers a diverse range of vaccines for older adults; however, vaccination rates remain low, and vaccination services are not adequately tailored to their needs. Against the backdrop of population aging, it is essential to adopt a scientific, systematic, and application-oriented approach to comprehensively optimize vaccination service models. Efforts should be made to further integrate healthcare and preventive services, enhance the accessibility of vaccination services, improve support mechanisms for elderly vaccination, strengthen the development of public health infrastructure, foster a health-conducive environment for vaccination among older adults, and explore a vaccination service system suited to their needs.

To analyze the changes in the pathogen spectrum of hand, foot, and mouth disease (HFMD) in Guangzhou City from 2015 to 2023, and to investigate the time trends of pathogen detection rates by gender and age stratification using Joinpoint regression. Pathogen surveillance data from sentinel hospitals for HFMD in Guangzhou were collected. A total of 9 677 cases were included in the study, among which 7 036 tested positive for enterovirus, yielding a positivity rate of 72.71%. During the study period, statistically significant differences were observed in the overall positive detection rates among different pathogens (χ²=12 988.49, P<0.001). CV-A6 consistently maintained a high detection rate throughout the monitoring period, with an overall positive detection rate of 37.05%, becoming the dominant pathogen. Trend analysis showed that both EV-U (APC=-4.89, P<0.001) and CV-A16 (APC=-20.98, P=0.032) had a significant declining trend, whereas the trend for CV-A6 was not statistically significant (APC=-9.63, P=0.116). Age stratification revealed that only the detection rate of EV-U in the ≤3-year-old group had a declining trend (APC=-5.01, P=0.006). In summary, from 2015 to 2023, the pathogen spectrum of HFMD in Guangzhou City has undergone significant changes, with CV-A6 replacing traditional pathogens as the dominant strain. Although the overall detection rate of EV-U has shown a downward trend, this decline was only evident among children aged ≤3 years. It is recommended to focus on strengthening prevention and control measures for children aged over 3 years old, accelerating the development of multivalent vaccines, and consistently strengthening pathogen surveillance and the construction of medical resources to cope with pathogen variations and changes in epidemiological features.