目的:对天津市1例输入基孔肯雅热病例开展病毒基因分型，确定基孔肯雅病毒（CHIKV）与全球主要流行株的关系。方法:提取临床症状疑似为CHIKV感染患者血清中RNA，采用荧光定量RT-PCR法检测CHIKV核酸。两步RT-PCR法扩增编码CHIKV包膜糖蛋白E1的基因，扩增产物经测序后开展测序分析。将测序结果与全球其他地区流行毒株一同构建系统发生树。结果:天津市输入型CHIKV基因分型属于能够感染白纹伊蚊并在其体内繁殖的东/中/南非基因型印度洋亚型（ECSA-IOL）。系统发生树分析表明，此次输入的CHIKV与2016-2017年在巴基斯坦、意大利、孟加拉国等国家流行的CHIKV毒株高度同源，序列的同源性高达99.4%，并与这些国家流行的CHIKV毒株共同组成1个基因分型簇。结论:此次输入性基孔肯雅热病例感染的毒株更容易在人群中传播，提示应加强对基孔肯雅热输入性病例的防控工作，以防止该蚊媒传染病在我国发生本地聚集性传播。

目的:分析轮状病毒G2P[4]型2020BJ株的近似全基因组进化特征。方法:运用逆转录－聚合酶链式反应(reverse transcription-polymerase chain reaction, RT-PCR)进行轮状病毒基因组扩增，将扩增产物测序，对所得序列进行系统进化和同源性分析。结果:获得人轮状病毒G2P[4]型2020BJ株近似全长的11个节段核酸序列，序列分析表明其为G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2基因型(DS-1-Like)；进化分析表明与日本、印度、孟加拉及意大利等国家毒株亲缘关系较近；亲缘关系较近的毒株间抗原表位的氨基酸存在差异。结论:与2020BJ亲缘关系较近的5株G2P[4]型轮状病毒VP7和VP4的抗原表位的氨基酸存在差异，可能导致流行特征不同，应加强轮状病毒监测。

Objective::This study was performed to compare the efficacy and safety of methotrexate (MTX) plus prednisolone versus prednisolone monotherapy in patients with erythema nodosum leprosum (ENL).Methods::This comparative clinical study was performed in the Chittagong Medical College Hospital, Bangladesh from June 2018 to December 2019. Nineteen patients were selected according to inclusion criteria and randomly allocated to either the MTX plus prednisolone group (Group A, n= 10) or the prednisolone monotherapy group (Group B, n = 9). All patients were followed up until the end of the 6-month duration of therapy to observe the clinical outcomes and adverse effects. Results::All patients in both groups showed significant improvement ( P= 0.005 and P= 0.008 in Group A and B, respectively). However, prednisolone-related adverse events were more frequent in Group B. Conclusion::The present study has demonstrated that a combination of prednisolone and MTX is a safer and more effective treatment than steroid monotherapy in ENL patients including the healing of nodules. However, this combination therapy did not appear to have a significant steroid-sparing effect, possibly because of the small sample size and short study period. Therefore, a well-designed multicenter randomized controlled trial is recommended for validation of MTX with prednisolone for the management of ENL.

目的:分析孟加拉国女性生殖健康相关指标1999-2018年变化趋势，评估是否能达成2030年可持续发展目标（SDGs）。方法:数据来源于孟加拉国人口健康调查及孕产妇死亡率和卫生保健调查数据库，分析和比较1999-2018年生殖健康相关的SDGs指标的变化趋势，计算其年均变化速度；采用发展指数，评价各指标实现可持续发展目标的难度。结果:孕产妇死亡率从2001-2016年呈现先增长后平缓的趋势；1999-2018年，生殖卫生保健服务覆盖率、对自己医疗保健有决定权的女性比例总体上均为增长趋势，有未满足避孕需求的比例、认为伴侣暴力是正当的女性比例、早婚率、早育率呈现不同程度的下降。产前保健覆盖率、医疗机构分娩率、由专业接生人员接生的比例、产后访视率发展指数<1，孕产妇死亡率发展指数接近1，其他指标均>1。结论:孟加拉国各生殖健康相关SDGs指标从1999-2018年均取得不同程度的进展，但对于大部分指标，现在年均变化速度还低于达成2030年的既定目标所需速度，需要在未来几年加快进展。

Objective::Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials::This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages.Results::Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60 years, with a mean age of 38 ± 0.966 years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common non-infective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of <200 cells/mm 3. Conclusions::A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

目的 对2024年5月中国境外发生的全球传染病事件进行监测,并评估对我国的输入风险和海外旅行风险.方法 运用多种来源的互联网开源情报信息,对重点关注传染病开展基于事件的监测,并采用风险矩阵法,从传播可能性和后果严重性两个维度,整合疾病、国家和事件特异性指标构建指标体系,对传染病境外输入风险和海外旅行风险开展评估.结果 2024年5月监测到12种传染病在全球36个国家形成突发事件或暴发疫情.对我国的输入风险方面,低风险事件39个;海外旅行风险方面,中风险事件32个.结论 建议一般关注南美洲、非洲和亚洲部分国家的登革热,埃塞俄比亚、刚果(金)、津巴布韦、喀麦隆、科摩罗、索马里和莫桑比克的霍乱,刚果(金)、泰国、印度尼西亚和南非的猴痘,安哥拉、乍得、阿富汗、尼日利亚、也门、埃塞俄比亚、几内亚、巴基斯坦、刚果(金)、尼日尔的脊髓灰质炎,玻利维亚的黄热病,刚果(金)的埃博拉出血热,也门的白喉可能带来的输入风险.海外旅行风险方面,无重点关注疫情,建议出国旅行者一般关注中国周边亚洲国家(孟加拉国、新加坡、老挝、尼泊尔、斯里兰卡、泰国、柬埔寨、越南、马来西亚、印度尼西亚)、巴西、阿根廷、危地马拉和布基纳法索的登革热疫情,莫桑比克、埃塞俄比亚、刚果(金)、喀麦隆、科摩罗、索马里和津巴布韦的霍乱疫情,安哥拉、乍得、阿富汗、尼日利亚、也门、埃塞俄比亚、几内亚、巴基斯坦、刚果(金)和尼日尔的脊髓灰质炎,刚果(金)、泰国、印度尼西亚的猴痘、吉尔吉斯斯坦和印度的炭疽,刚果(金)的埃博拉出血热,沙特阿拉伯的中东呼吸综合征,也门的白喉,美国的H5N1高致病性禽流感,玻利维亚的黄热病可能带来的感染风险.

目的 对2024年4月中国境外发生的全球传染病事件进行监测,并评估对我国的输入风险和海外旅行风险.方法 运用多种来源的互联网开源情报信息,对重点关注传染病开展基于事件的监测,并采用风险矩阵法,从传播可能性和后果严重性两个维度,整合疾病、国家和事件特异性指标构建指标体系,对传染病境外输入风险和海外旅行风险开展评估.结果 2024年4月监测到29种传染病在全球43个国家形成突发事件或暴发疫情.对我国的输入风险方面,中风险事件27个;海外旅行风险方面,高风险事件22个,中风险事件33个.结论 建议一般关注南北美洲、非洲、大洋洲和亚洲部分国家的登革热,柬埔寨和美国的猴痘,埃塞俄比亚、也门和莫桑比克的霍乱,巴西的黄热病,巴西和阿根廷的基孔肯雅热,格鲁吉亚、捷克、俄罗斯和拉脱维亚的百日咳,俄罗斯的麻疹可能带来的输入风险.海外旅行风险方面,建议出国旅行者重点关注中国周边亚洲国家(越南、泰国、柬埔寨、印度尼西亚、尼泊尔、马来西亚、斯里兰卡和新加坡)、马里、阿根廷、巴西、法国和秘鲁的登革热疫情,也门、索马里、刚果(金)和莫桑比克的霍乱疫情,阿根廷和巴西的基孔肯雅热,尼日利亚的拉沙热,亚美尼亚的猩红热以及巴西的黄热病疫情,一般关注格鲁吉亚、捷克、俄罗斯、拉脱维亚的百日咳疫情,苏丹、智利、孟加拉国、萨摩亚和法属波利尼西亚的登革热疫情,马拉维、埃塞俄比亚、津巴布韦、尼日利亚、阿富汗、巴西和科摩罗的霍乱疫情,索马里、南苏丹、也门、刚果(金)、乍得和尼日利亚的脊髓灰质炎疫情,美国、柬埔寨和刚果(金)和刚果(布)的猴痘疫情,俄罗斯、布基纳法索、吉尔吉斯斯坦、伊拉克、波斯尼亚和黑塞哥维那、阿富汗的麻疹疫情,阿根廷的鹦鹉热疫情可能带来的感染风险.

本文综述了全球和中国消除乙型肝炎的新进展.虽然全球乙型肝炎疾病负担正在下降,但各国消除乙型肝炎的进展差异较大,在疾病负担最严重的20个国家中,孟加拉国、印度、印度尼西亚、日本和俄罗斯取得显著进展.中国继续保持新生儿乙型肝炎疫苗高覆盖率,首剂及时接种率为95.6%,3剂接种率为99.6%.从2016年到2022年,中国慢性乙型肝炎患者的诊断率由19%升至24%,治疗率由11%升至15%,但与世界卫生组织提出的2023年目标仍有较大距离.全球和中国仍需继续努力,砥砺奋进,加速实现2030年消除病毒性肝炎的宏伟目标.

目的:观察光化学法构建视网膜分支静脉阻塞(branch retinal vein occlusion, BRVO)大鼠模型的自然病程和不良事件.方法:选取30只SD(Sprague Dawley)大鼠尾静脉注射孟加拉红1min后,532nm激光(80mW,100μm,100ms)于视盘颞侧视网膜静脉二级分叉处进行单光点光凝50点建立BRVO模型.分别于1、3、5、7、10、14和21d检测全视野视网膜电图(electroretinogram,ERG)、荧光素眼底血管造影(fundus fluorescein angiography, FFA)和相干光断层扫描(optical coherence tomography,OCT).于1、5和21d各时间点随机处死2只大鼠行HE病理和血管内皮生长因子-a(vascular endothelial growth factor-a,VEGF-a)免疫组化染色.结果:光凝后,3只大鼠死亡,3只严重出血导致视网膜大部分脱离,1只出现视网膜凹陷,1只白内障.FFA和眼底(荧光)彩照发现BRVO大鼠模型造模成功率为73%(22/30),1d时近端变粗,远端变细,3~7d光凝血管完全再通.ERG示光凝1d后暗适应3.0反应b波降低至正常眼的0.694±0.042倍,5 ~7d下降至最低点约为正常眼0.487 ± 0.064倍,之后开始上升,21d 上升至初始值0.708±0.0465倍.OCT和HE病理切片分别于在体和离体水平发现第1d视网膜节细胞层和外核层水肿,3 ~5d水肿消失且激光光凝点视网膜附近250μm外核层开始凋亡变薄,到21d外核层变薄只剩3~4层细胞.免疫组化发现激光光凝部位VEGF-a第1d表达水平大于光凝前,第5d光凝处VEGF-a表达量无明显差异,21d光凝处VEGF-a表达略低于光凝前.结论:激光光凝制作 BRVO 模型是一种切实可行的方法,其疾病的演变和发展可以部分模拟人体BRVO的进程.同时由于造模成功率较低以及激光光凝相关并发症较多,在实际使用中有待进一步改进方法.