2026年 · 第06卷第04期

As pertussis resurgence has become a significant public health issue globally in recent years, the 2024 outbreak attracted substantial attention in China. Experts from various disciplines, including clinical medicine and public health, jointly formed an expert working group to analyze the current epidemiological characteristics of pertussis and bottleneck issues in the nation’s prevention and control of the infection. The working group developed the consensus and formulated recommendations and suggestions found here based on the concept of integrating medical care and prevention, evidence from the existing literature, and good principles of clinical practice. The group sought to enhance pertussis prevention, diagnosis, and management competencies for healthcare professionals by focusing on multidimensional core issues regarding the epidemiological characteristics of pertussis resurgence, the effectiveness and safety of vaccines containing pertussis and vaccination practices, and comprehensive case management and treatment and post-exposure prophylaxis regimens in the context of drug resistance background. It also recognized the importance of strengthening the collaborative monitoring between medical and prevention departments, as well as the monitoring level and public education through medical and preventive collaboration. The consensus aids in sustainably promoting and dynamically adjusting China’s pertussis prevention and control strategies.

Background: Pneumocystis pneumonia (PCP) is a severe fungal infection that predominantly affects individuals with compromised immune systems, specifically those with adaptive immunodeficiency. The mechanisms governing the remodeling of the innate immune system in the context of PCP, particularly in the presence of complete adaptive immunodeficiency, remain insufficiently elucidated. Here, using single-cell RNA sequencing (scRNA-seq) in a murine PCP model, we reveal how innate immune responses are remodeled in the absence of adaptive immunity, providing new mechanistic insights into PCP pathogenesis and a foundation for targeted therapy. Methods: An experimental model of PCP was established using male CB-17 SCID mice with adaptive immunodeficiency. Mice were weight-matched into six pairs and randomly divided into a PCP group and a control (CON) group (n = 6 per group) using a computer-generated random sequence; PCP mice received an intranasal instillation of 1 × 106 cysts in 100 μL sterile phosphate-buffered saline (PBS) under isoflurane anesthesia, whereas CON mice received an equal volume of sterile PBS alone. Lung tissues were collected for scRNA-seq to profile pulmonary innate immune cells. Bioinformatic analyses were employed to characterize several subsets of monocyte-derived macrophages, and immunofluorescence and quantitative reverse transcription PCR were used to validate these findings. Results: scRNA-seq indicated an expansion of Ccr2+ monocyte-derived Nckap5+ macrophages in PCP mice, which was associated with anti-inflammatory features and activation of pro-proliferative pathways. Inhibition of the MAPK pathway using Adezmapimod effectively reversed the induction of Nckap5 (4.463 ± 0.125 vs. 0.991 ± 0.052, P < 0.001) and the expression of anti-inflammatory cytokines, including Il10 (44.090 ± 1.246 vs. 4.131 ± 0.151, P < 0.001), Arg1 (2.455 ± 0.135 vs. 0.918 ± 0.018, P < 0.001) and Tgfβ (1.147 ± 0.043 vs. 0.994 ± 0.031, P < 0.01). Conclusion: This study advances understanding of PCP pathogenesis and identifies Nckap5+ macrophages as a potential therapeutic target for patients with compromised immune systems.

Psittacosis is a zoonotic infectious disease caused by the obligate intracellular Gram-negative bacterium Chlamydia psittaci. Despite over a century of research, its global burden remains underestimated owing to non-specific symptoms, poor clinical recognition, and limited diagnostic capacity. This review synthesizes epidemiological evidence from 1879 to 2024, outlining transmission routes, clinical manifestations, diagnostic approaches, and therapeutic strategies, with a focus on advances in molecular diagnostics and the management of high-risk populations and complications. Surveillance data document recurrent outbreaks across Europe, North America, and Asia, with a notable increase in reported cases in China and Europe since 2020. The disease spectrum spans from atypical pneumonia to life-threatening systemic complications, including neurological, cardiac, and pregnancy-related involvement. Conventional methods, such as culture and serology, are constrained by biosafety requirements and cross-reactivity, while polymerase chain reaction, metagenomic next-generation sequencing, and targeted next-generation sequencing provide superior sensitivity but face the challenges of cost and standardization. Tetracyclines remain the mainstay of therapy, macrolides are recommended for pregnant women and children, and newer tetracycline derivatives show promise in severe or refractory cases. Psittacosis should be recognized as a systemic disease of both clinical and public health importance. Future efforts must prioritize standardizing molecular diagnostic workflows, validating novel antimicrobials in clinical practice, and incorporating psittacosis surveillance into public health systems while raising awareness, broadening diagnostic access, and optimizing therapeutic strategies to enable early detection, precision treatment, and effective control.

Acute-on-chronic liver failure (ACLF) is a severe clinical syndrome that develops in patients with chronic hepatitis or liver cirrhosis. It is characterized by a high mortality rate, rapid progression, and complex pathological mechanisms. As it often involves multiorgan failure (e.g., of the liver, kidneys, and brain), traditional clinical indicators have limited predictive value and cannot support accurate, personalized treatment. However, the rapid development of omics sequencing technologies in recent years (e.g., genomics, transcriptomics, proteomics, metabolomics, and microbiomics) has provided unprecedented opportunities to analyze the molecular mechanisms of ACLF, discover novel biomarkers, and develop precise intervention strategies. Multiomics technology is an approach that systematically studies complex biological mechanisms of ACLF by integrating data from multiple omics disciplines. This approach overcomes the limitations of single-omics techniques, and offering a more comprehensive view of disease mechanisms, biomarker discovery, and precision medicine. In this review, we summarize studies on whole-genome sequencing, single-cell ribonucleic acid (RNA) sequencing, proteomics, lipidomics, and metabolomics in patients with ACLF and discuss associations between expression patterns, disease progression and prognosis, and the interconnections among multiomics.

Organoids, as in vitro three-dimensional structures derived from stem cell differentiation, have emerged as cutting-edge technologies in biomedical research due to their effectiveness in mimicking the complex architectures and physiological functions of human organs. Currently, researchers worldwide are extensively exploring the application of organoids in virology and have achieved remarkable progress. These innovations have enabled the successful cultivation of various viruses in vitro, the modeling of viral infection processes, and the clarification of cell tropism and host factor interactions. They have also advanced systematic explanations of related pathogenic mechanisms, providing an important avenue for antiviral drug screening and vaccine design. This paper elaborates on the biological characteristics of organoids, summarizes the methodologies for establishing virus-infected organoid models, and reviews advances in research on viruses such as severe acute respiratory syndrome coronavirus 2, influenza viruses, hepatitis viruses, Zika virus, and human noroviruses. This review will clarify how organoids have profoundly changed our understanding of the pathogenic mechanism of viruses and accelerated the clinical translation of antiviral strategies.

Mother-to-child transmission is the major route of hepatitis B virus (HBV) infection in children, and antiviral therapy is generally deferred in infancy due to presumed immune tolerance. Here, we report the clinical course and treatment response of two infants younger than 6 months with HBV infection who initiated antiviral therapy due to elevated serum transaminase levels indicative of an immune-active status. Notably, Case #01 achieved a functional cure after 25 months of antiviral treatment. Case #02 did not achieve a functional cure but attained HBV DNA clearance and HBeAg seroconversion at 12 and 5 months of therapy, respectively. At the last follow-up visit (month 67), the HBsAg level of Case #02 was 10.70 IU/mL. These findings suggest that early antiviral intervention, initiated before 6 months of age, may be beneficial for infants with HBV infection who are in an immune-active status. A potential treatment window may exist even during early infancy; however, treatment strategies should be individualized and guided by careful clinical assessment.

Severe fever with thrombocytopenia syndrome (SFTS) is a natural infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV). Central nervous system (CNS) involvement is not rare in SFTS. In this work, we report a case of SFTS with CNS symptom onset and the metagenomic next-generation sequencing of cerebrospinal fluid (CSF), confirming invasion of SFTSV into the CNS. The case’s lumbar puncture indicated an exceptionally low CSF opening pressure—an uncommon finding in other CNS infections and in case reports of SFTS. A spontaneous subdural effusion was observed on the fourth day of hospitalization. Moreover, a flow cytometry analysis of bone marrow revealed a restricted expression of the lambda light chain in monoclonal B cells and plasma cells. The patient succumbed to their severe illness. The early recognition of the disease may be crucial for prognosis despite the disease’s current lack of specific treatments.

The nonspecific presentation of leptospirosis and delays in serologic confirmation often make its diagnosis challenging. The presence of comorbidities or potential drug toxicities, which can mimic or obscure clinical findings, further adds to this diagnostic difficulty. Here, we present the case of a 46-year-old male with well-controlled HIV infection on antiretroviral therapy, who presented with a four-day history of fever, malaise, and jaundice. The patient is a pilot with recent travel to the United Kingdom and prior travel throughout North America, Central America, and the Caribbean. On admission, he was febrile and tachycardic, with laboratory studies demonstrating elevated creatinine and transaminases. Broad-spectrum antibiotics were initiated and subsequently de-escalated to doxycycline, while antiretroviral therapy was temporarily held. A renal biopsy demonstrated acute tubulointerstitial nephritis. The patient improved clinically with doxycycline, with normalization of liver and kidney function by the time of discharge. Post-discharge serologic testing returned positive for Leptospira IgM antibodies, confirming the diagnosis of Weil’s disease. This case underscores the diagnostic challenges of leptospirosis, particularly in patients without clear exposure histories, and highlights the importance of early empiric therapy when clinical suspicion is high.