What is already known about this topic? Human rabies remains nearly universally fatal despite medical advances. Diagnosis is frequently delayed when patients present with atypical symptoms, and the failure to receive postexposure prophylaxis (PEP) continues to be a major contributor to mortality worldwide. What is added by this report? This represents the first confirmed human rabies case in Guangxi caused by the JSTZ190314 strain, successfully identified through metagenomic next-generation sequencing (mNGS). The patient initially presented with urinary symptoms that led to a misdiagnosis before characteristic neurological manifestations developed, ultimately progressing to brain death 28 days after neurological onset (34 days from initial urinary symptoms). What are the implications for public health practice? This case demonstrates the critical importance of mNGS in diagnosing atypical rabies presentations and emphasizes the urgent need for enhanced early clinical recognition, standardized PEP administration protocols, and strengthened regional viral surveillance systems.

This study aimed to investigate the biometric characterization of pathogenic microorganisms associated with bloodstream infections in patients bitten by venomous snakes, and to determine whether the composition of these microorganisms influences the effects of snake venom. The composition and relative abundance of microorganisms were statistically analyzed using metagenomic next-generation sequencing (mNGS) on blood samples from patients with varying degrees of snakebite injuries. These patients were admitted to the our study. In the light injury group (group L), the dominant phylum and genus were Pseudomonadota (73.31%) and Pseudomonas (35.32%). In the moderate injury group (group M), the predominant phylum was Bacillota (56.74%) and Aerococcus (45.45%). There was no statistically significant difference in the microbial composition between group L and group M based on α- and β-diversity analyses. LEfSe differential analysis revealed that the absolute abundances of Actinomycetota and Actinomycetes were higher in group L, while Pseudomonas aeruginosa emerged as a significantly differential species in Group M. The study found that differences in bacterial bloodstream infections due to venomous snakebite may enhance the effects of snake venom, leading to more severe injuries. The mNGS technique can rapidly detect pathogens related to venomous snakebites and has the potential for broader clinical use.

Objective: To establish an animal model of cerebral hernia induced by acute intracranial hypertension for subsequent research in emergency medicine. Methods: Six Guangxi Ba-Ma mini-pigs were injected with autologous arterial blood by micropump to induce intracranial hematoma in the frontal and temporal parietal lobes. Changes in intracranial pressure (ICP), mean arterial blood pressure (MAP) and cerebral perfusion pressure (CPP) were observed during hematoma formation. Morphological changes and the occupying effects of intracranial hematoma were analyzed using computed tomography (CT) and magnetic resonance imaging (MRI) of the head. Results: ICP, MAP and CPP gradually increased during blood injection, and they began to slowly decrease at 10 min after injection, though they remained higher than before injection. These three parameters were significantly different before blood injection, immediately after injection and at 10 min after injection (P < 0.05). Head CT and MRI showed cerebral hernia induced by acute intracranial hypertension. Conclusion: Micropump injection of autologous arterial blood can lead to acute intracranial hypertension in mini-pigs, which may be a useful model of cerebral hernia.

Rabies virus, transmitted mainly through animal bites and scratches, causes an almost invariably fatal disease. Guangxi is among the regions of China with a high rabies burden, yet large clinical datasets on exposure patterns and post-exposure prophylaxis (PEP) remain limited. We retrospectively analyzed the records of 19,239 patients with mammal-related injuries treated at the animal injury clinic of the International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine from 2020 to 2024. Cats (53.94%) and dogs (39.38%), predominantly owned animals, caused most injuries, and the proportion of cat-related injuries increased from 44.12% in 2020 to 56.66% in 2024 (p for trend < 0.001). Category III exposures accounted for 68.02% of cases, and repeat exposure rose from 7.81% to 18.47% (p for trend < 0.001). Overall, 32.98% of patients presented more than 24 h after injury. Standardized wound management was provided to 71.36% of patients; all patients received rabies vaccination, whereas human rabies immunoglobulin was administered in 44.86% of category III exposures and remained below 47% in every year. Delayed presentation and persistently incomplete passive immunization suggest gaps in PEP delivery. Targeted health education, animal vaccination and management, and standardized wound care and passive immunization may strengthen rabies prevention.

This study aimed to systematically analyze the disease burden of Alzheimer’s disease and other dementias (ADOD) attributed to tobacco in China and ASEAN countries from 1990 to 2021, and predict the disease burden in the next ten years to characterize the disparities in disease burden between the 2 sides, and to conduct a preliminary exploration of factors that may be associated with these disparities. Data on ADOD deaths, mortality, DALYs and DALY rates attributed to tobacco in China and ASEAN countries were extracted from GBD 2021, and the trend of disease burden was analyzed using Joinpoint regression model. R software was used for data analysis and visualization, and Joinpoint regression model was used to calculate the APC of each indicator; the disease burden attributable to tobacco in China and ASEAN countries was analyzed through the SDI; and the ARIMA was used to predict ADOD from 2022 to 2035. In China, the number of ADOD deaths (1990: 8126.47, 95% CI: 1822.19–22,577.84), mortality rate, DALYs, and DALY rate attributable to tobacco all exhibited significant and sustained upward trends from 1990 to 2021, and consistently exceeded the corresponding levels in the other ten ASEAN countries. The APC for mortality and DALY rates showed a significant increase in China and most ASEAN countries, with particularly rapid increases in mortality in China, Thailand, Cambodia, and Indonesia. Correspondingly, the DALY rate rose in most countries, indicating a growing overall disease burden. An exception was Myanmar, where the burden decreased. The burden of tobacco-attributable ADOD was consistently higher among males than females in all countries. Analysis based on SDI revealed a lower and more stable disease burden in high-SDI areas, whereas medium- and low-SDI countries demonstrated an upward trend. ARIMA model projections for 2022–2035 suggest that while mortality trends are diverse, an increasing trend is anticipated in most countries. The disease burden of ADOD attributable to tobacco use has continued to rise in China and ASEAN countries. This trend suggests a potential role for tobacco control in the prevention of ADOD, and also points to the value of strengthening tobacco regulation and paying early attention to cognitive interventions.