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Abstract Background China braces for coronavirus disease 2019 (COVID-19) surge after adjusting the “zero COVID” strategy. We aimed to evaluate and compare the prevalence of clinical symptoms of the Omicron variant infection among people living with HIV (PLWH) and HIV-free people. Methods A cross-sectional study was conducted in Wuchang District, Wuhan, Hubei Province, in December 2022 by a self-administered online survey during the Omicron wave. Participants aged ≥ 18 years with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis were recruited. PLWH managed by the local healthcare system were recruited, while HIV-free people were recruited by sending out online surveys through WeChat. We compared the prevalence of clinical symptoms of COVID-19 between PLWH and HIV-free people, and factors associated with symptom occurrence among PLWH were accessed. Results Total, 687 PLWH and 1222 HIV-free people were enrolled. After adjusting sex, age, body mass index, comorbidities and COVID-19 vaccination status, the prevalences of all symptoms, including higher degree and long duration of fever (aOR 0.51, 95%CI 0·42 − 0·61; aOR 0.52, 95%CI 0·43 − 0·63), were significantly lower among PLWH than among HIV-free people. Among PLWH, CD4+ T lymphocyte count (CD4 count) between 350 ~ 499 cells/µL and detectable HIV viral load (HIV-VL) were associated with significantly decreased risks of fever (aOR 0·63, 95%CI 0·40 − 0·97; aOR 0·56, 95%CI 0·33 − 0·94), headache (aOR 0·61, 95%CI 0·41 − 0·91; aOR 0·55, 95%CI 0·34 − 0·92) and muscle soreness (aOR 0·57, 95%CI 0·39 − 0·84; aOR 0·57, 95%CI 0·39 − 0·84). No apparent association between the symptoms prevalence and three/four doses of inactivated COVID-19 vaccination among PLWH was observed; both males and older age were associated with significantly decreased risks of nasal congestion/runny nose (aOR 0·52, 95%CI 0·32 − 0·82; aOR 0·97, 95%CI 0·96 − 0·99) and headache (aOR 0·58, 95%CI 0·36 − 0·92; aOR 0·96, 95%CI 0·95 − 0·98); older age was associated with significantly decreased risks of higher degree of fever (aOR 0·97, 95%CI 0·95 − 0·98). Conclusions PLWH have significantly milder symptoms of the Omicron variant infection than HIV-free people. PLWH who are male, older, have low CD4 count, and detectable HIV-VL have reduced occurrence of COVID-19 symptoms. However, continuous monitoring should be conducted among PLWH during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has severely impacted public health. In 2022, the Omicron variant of SARS-CoV-2 rapidly became the dominant circulating variant in the local COVID-19 outbreaks in Tianjin Municipality, China. To gain a deeper understanding of the genetic variations of the Omicron variant in Tianjin, specimens from individuals who tested positive for SARS-CoV-2 between December 2021 and November 2022 were used for virus whole genome sequencing and phylogenetic analysis. A total of 1,674 high-quality Omicron sequences were obtained, consisting of 1,339 sequences from local cases belonging to 20 Phylogenetic Assignment of Named Global Outbreak (PANGO) lineages and 335 sequences from imported cases belonging to 70 lineages. Tianjin experienced five waves of local outbreaks, accompanied by multiple substitutions among subvariants, ranging from the initial BA.1.1 lineage to the subsequent BA.2, BF.7, and BA.5.2 lineages. The evolutionary rate of local strains, estimated to be 28.999 substitutions per year, and the evolutionary rate of imported strains, estimated to be 24.946 substitutions per year, were lower than that of the strains circulating globally. The additional substitutions and deletions of local strains have been used to identify and disrupt the virus transmission chains. The subvariants such as BA.5.2.48, BA.5.2.49, BF.7.14, and XBB.1 circulating in the fifth epidemic wave presented criterial immune escape mutations including S: R346T, S: L452R and S: F486V. It is essential to implement genomic surveillance strategies to investigate further the development of genomic mutation characteristics in the SARS-CoV-2 variant. This ongoing monitoring will contribute to a better understanding of the virus's genetic changes and aid in effective control measures.

Abstract The severe Zn‐dendrite growth and insufficient carbon‐based cathode performance are two critical issues that hinder the practical applications of flexible Zn‐ion micro‐ssupercapacitors (FZCs). Herein, a self‐adaptive electrode design concept of the synchronous improvement on both the cathode and anode is proposed to enhance the overall performance of FZCs. Polypyrrole doped with anti‐expansion graphene oxide and acrylamide (PPy/GO‐AM) on the cathode side can exhibit remarkable electrochemical performance, including decent capacitance and cycling stability, as well as exceptional mechanical properties. Meanwhile, a robust protective polymeric layer containing reduced graphene oxide and polyacrylamide is self‐assembled onto the Zn surface (rGO/PAM@Zn) at the anode side, by which the “tip effect” of Zn small protuberance can be effectively alleviated, the Zn‐ion distribution homogenized, and dendrite growth restricted. Benefiting from these advantages, the FZCs deliver an excellent specific capacitance of 125 mF cm−2 (125 F cm−3) at 1 mA cm−2, along with a maximum energy density of 44.4 µWh cm−2, and outstanding long‐term durability with 90.3% capacitance remained after 5000 cycles. This conformal electrode design strategy is believed to enlighten the practical design of high‐performance in‐plane flexible Zn‐based electrochemical energy storage devices (EESDs) by simultaneously tackling the challenges faced by Zn anodes and capacitance‐type cathodes.

BackgroundIncomplete immune recovery in people living with HIV/AIDS (PLWHA) remains an important clinical challenge with the lack of an effective strategy currently available to restore their T-cell immune response. This study aimed to evaluate the effect of Albuvirtide (ABT) on immune recovery in immunological non-responders (INRs) and attempted to explore potential mechanisms of ABT on the functionality of immune cells.MethodsIn this prospective, open-label, controlled clinical study, participants with incomplete immune reconstitution (continuous ART over 5 years and CD4+T lymphocyte absolute count of

BackgroundWuhan is located in the hinterland of China, in the east of Hubei Province, at the intersection of the Yangtze River and Hanshui River. It is a national historical and cultural city, an important industrial, scientific, and educational base, and a key transportation hub. There are many schools in Wuhan, with nearly a thousand of all kinds. The number of students is ~2.2 million, accounting for nearly one-fifth of the resident population; college or university students account for ~60% of the total student population. The geographical location of these colleges is relatively concentrated, and the population density is relatively high, making it prone to tuberculosis cluster epidemic.ObjectiveThis study analyzed the epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China, during 2017–2022 to provide the basis for the scientific development of tuberculosis prevention and control strategies and measures in schools.MethodsThis study adopted the methods of descriptive epidemiology to analyze the epidemic characteristics of tuberculosis aggregation in schools in Wuhan from January 2017 to December 2022, collecting the relevant data on tuberculosis prevention and control in all kinds of schools in the city using Questionnaire Star, an application of the China network questionnaire survey, and analyze the influencing factors of tuberculosis aggregation by using multifactor logistic regression analysis.ResultsFrom 2017 to 2022, 54 outbreaks of pulmonary tuberculosis aggregation in schools were reported in Wuhan, which involved 37 different schools, including 32 colleges or universities and five senior high schools; 176 cases were reported, among which 73 were positive for pathogens and 18 were rifampicin or izoniazid resistant. The median duration of a single cluster epidemic was 46 (26,368) days. Universities were more prone to cluster outbreaks than middle schools (χ2 = 105.160, P = 0.001), and the incidence rate among male students was higher than that of female students in cluster epidemics (χ2 = 12.970, P = 0.001). The multivariate logistic regression analysis results showed that boarding in school (OR = 7.60) is the risk factor for a tuberculosis cluster epidemic in schools. The small number of students (OR = 0.50), the location of the school in the city (OR = 0.60), carry out physical examinations for freshmen (OR = 0.44), carry out illness absence and cause tracking (OR = 0.05), dormitories and classrooms are regularly ventilated with open windows (OR = 0.16), strict implement the management of sick student's suspension from school (OR = 0.36), and seeking timely medical consultation (OR = 0.32) were the protective factors for a tuberculosis cluster epidemic in schools.ConclusionWe successfully identified the epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan. The results revealed the influence and status of various factors and indicated ways for schools to improve their TB prevention and control measures in their daily activities. These measures can effectively help curb the cluster epidemic of tuberculosis in schools.

Abstract Background Triangular fibrocartilage complex (TFCC) injuries commonly manifest as ulnar-sided wrist pain and can be associated with distal radioulnar joint (DRUJ) instability and subsequent wrist functional decline. This study aimed to assess the diagnostic value of MRI compared to wrist arthroscopy in identifying traumatic TFCC injuries and to determine the distribution of different TFCC injury subtypes in a normal clinical setting. Methods The data of 193 patients who underwent both preoperative wrist MRI and wrist arthroscopy were retrospectively reviewed. The analysis focused on the proportion of subtypes and the diagnostic value of MRI in traumatic TFCC injuries, utilizing Palmer’s and Atzei’s classification with wrist arthroscopy considered as the gold standard. Results The most prevalent subtype of TFCC injuries were peripheral injuries (Palmer 1B, 67.9%), followed by combined injuries (Palmer 1 A + 1B, 14%; Palmer 1B + 1D, 8.3%). Compared with wrist arthroscopy, the diagnostic sensitivity, specificity, negative predictive value (NPV), and Kappa value of MRI was as follows: traumatic TFCC tears 0.99 (95% CI: 0.97-1), 0.90 (0.78-0.96), 0.97 (0.87-1), and 0.93; styloid lamina tears 0.93 (0.88-0.96), 0.53 (0.30-0.75), 0.47 (0.26-0.69), and 0.44; and foveal lamina tears 0.85 (0.74-0.92), 0.38 (0.29-0.49), 0.79 (0.65-0.89), and 0.21. Conclusions The diagnostic value of MRI in traumatic TFCC injuries has been confirmed to be almost perfect using Palmer’s classification. In more detailed classification of TFCC injuries, such as pc-TFCC tears classified by Atzei’s classification, the diagnostic accuracy of MRI remains lower compared to wrist arthroscopy. Radiological associated injuries may offer additional diagnostic value in cases with diagnostic uncertainty.

Abstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain. Methods In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD. Results The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70–0.86, P

BackgroundAntiretroviral therapy (ART) prolongs lifespan and decreases mortality of HIV infected patients. However, many patients do not achieve optimal immune reconstitution. The influence of non-optimal immune recovery on non-AIDS related diseases is not well defined in aged HIV-infected patients receiving ART.MethodsA retrospective study was conducted at Tianjin Second People’s Hospital, China to evaluate the association of an inadequate immunological response and non-AIDS diseases in HIV infected patients ≥60 years of age and virally suppressed for at least 2 years by ART.ResultsThe study included patients (n = 666) who initiated ART between August 2009 and December 2020. The prevalence of patients with an inadequate immunological response was 29.6%. The percentage of non-AIDS diseases such as hypertension, cardiovascular disease (CVD), diabetes, tumor, and chronic kidney disease (CKD) was 32.9, 9.9, 31, 4.1, and 13%, respectively. In addition to baseline CD4+ T cell counts, CVD and tumor were associated with poor immune reconstitution in aged Chinese HIV-1 infected patients. The adjusted odds ratios (95% confidence interval) were AOR 2.45 (95% CI: 1.22–4.93) and 3.06 (95% CI: 1.09–8.56, p = 0.03). Inadequate immunological response was associated with greater mortality (AOR: 2.83, 95% CI: 1.42–5.67, p = 0.003) in this cohort.ConclusionThese results tend to demonstrate appropriate drug selection at ART initiation and prevention of non-AIDS complications during ART decreased mortality of and an inadequate immunological response in aged HIV infected patients.

The heterogeneity of concrete is a major challenge for acoustic emission monitoring. A method of active-passive joint acoustic emission monitoring considering the heterogeneity of concrete is presented herein, and the time-frequency-space multi-parameter response characteristics of active and passive acoustic emission signals were studied in relation to the damage evolution of concrete. This method provides an idea of evaluating the damage state of concrete more actively and quantitatively than traditional methods. The results show that the microscopic damage model of concrete based on the acoustic emission penetrating wave velocity and amplitude is in agreement with the damage process of concrete. The standard deviation of the wave velocity up to 1000 m/s and the change rate of the amplitude up to −0.66 can be adopted as two signs that the load of concrete reached 70% of the ultimate load. The time-of-arrival localization based on variable velocity was used to correct the acoustic emission localization results, and the localization accuracy was increased by 44.74%. The damage process of concrete undergoes diverse changes; that is, the distribution of damage changes from heterogeneous to homogeneous and then back to heterogeneous. Hence, it is necessary for researchers to consider the heterogeneity of concrete when using acoustic emission monitoring. The active-passive joint acoustic emission monitoring is an effective method.

It is of high interests to design catalysts for CO2 electroreduction with enhanced selectivity and activity. Here, the authors report Sn-Bi bimetallic interface-rich material with enhanced performance for CO2 reduction to formate comparing to that of Sn-Bi bulk alloy.

Summary: With the impact of the COVID-19 lockdown, global supply chain crisis, and Russo-Ukrainian war, an energy-intensive society with sustainable, secure, affordable, and recyclable rechargeable batteries is increasingly out of reach. As demand soars, recent prototypes have shown that anode-free configurations, especially anode-free sodium metal batteries, offer realistic alternatives that are better than lithium-ion batteries in terms of energy density, cost, carbon footprint, and sustainability. This Perspective explores the current state of research on improving the performance of anode-free Na metal batteries from five key fields, as well as the impact on upstream industries compared to commercial batteries.

Abstract Background Acute coronary syndrome (ACS) has become a vital disease with high mortality in the Uygur populations. Clopidogrel plays an important role in reducing the risk of recurrent cardiovascular events after ACS; however, it is a prodrug that requires biotransformation by cytochrome P450 (CYP450). Objectives To determine the effect of genetic polymorphisms in CYP2C19*2, *3, and *17, and along with clinical, demographic factors, on variation in response to clinical outcomes in Uygur patients. Methods A total of 351 patients with ACS were treated with clopidogrel and aspirin for at least 12 months; we recorded major adverse cardiovascular events (MACE) or bleeding within 1 year. Multivariable logistic regression analyses were carried out to identify factors associated with MACE or bleeding. Results We analyze risk factors include age, BMI (body mass index), smoking, alcohol intake, NSTEMI (non-ST-segment elevation myocardial infarction), hypertension, dyslipidemia, concomitant medication, CYP2C19*2 carriers, CYP2C19*17 carriers and metabolizer phenotype. CYP2C19*2 carriers had an odds of having MACE of 2.51 (95% CI: 1.534–4.09) compared with noncarriers (P 0.05). Conclusion The CYP2C19*2 gene polymorphism contributes to the risk of MACE in dual clopidogrel—treated Uygur population with ACS with or without PCI (percutaneous coronary intervention). These data may provide valuable insights into the genetic polymorphisms affecting clopidogrel metabolism among minority groups in China.

Sleeve grouting compactness has a significant effect on the mechanical properties of rebar connections. However, a detection method for the grouting compactness inside the sleeve is still lacking. Therefore, the aim of this paper is to propose a new acoustic emission (AE) detection technology for horizontal defects and vertical defects in sleeves with different grout compactness. The basic waveform characteristic of the AE signal is analyzed. The results show that the count of acoustic emission signals decreases with the increase of grouting compactness, and the reduction rate of vertical defects is larger than that of horizontal defects. The acoustic emission waveform is further processed through wavelet packet decomposition. It is found that with the increase of grouting compactness, the composition of approximately 125–187.5 kHz in the signal is accelerated to approximately 62.5–125 kHz. The grouting compactness index is constructed by wavelet packet energy ratio. With the increase of grouting compactness, the compactness index decreases exponentially, indicating that the presence of defects can greatly reduce the attenuation of elastic wave energy. The compactness index is highly consistent with the size of defects and has little relationship with the distribution of grout materials. Experiments show that the proposed method is effective when grout defects reach a certain degree and provides a new method for sleeve grouting compactness detection.

Stable solid electrolyte interface (SEI) is heavily investigated due to its role in improving lithium metal batteries. Here, the authors present a new strategy by employing electrolyte additives to construct stable multifunctional SEI via in situ anionic polymerization.

Low intrinsic activity and accessibility of active sites limit the application of metal-organic framework as catalyst for Zn-air battery. Here, authors present a cation substitution strategy to regulate the electronic state of metal sites and modify its porosity, which enables battery operation.

Interest in rechargeable Zn-air batteries has been renewed in recent years, however, their oxygen electrocatalysts remain not fully understood. Here the authors reveal the presence of a current-driven oxyhydroxide shell in a so-called dynamic eletrocatalyst that enables optimized battery performance.

Abstract Worldwide trends in mobile electrification, largely driven by the popularity of electric vehicles (EVs) will skyrocket demands for lithium‐ion battery (LIB) production. As such, up to four million metric tons of LIB waste from EV battery packs could be generated from 2015 to 2040. LIB recycling directly addresses concerns over long‐term economic strains due to the uneven geographic distribution of resources (especially for Co and Li) and environmental issues associated with both landfilling and raw material extraction. However, LIB recycling infrastructure has not been widely adopted, and current facilities are mostly focused on Co recovery for economic gains. This incentive will decline due to shifting market trends from LiCoO2 toward cobalt‐deficient and mixed‐metal cathodes (eg, LiNi1/3Mn1/3Co1/3O2). Thus, this review covers recycling strategies to recover metals in mixed‐metal LIB cathodes and comingled scrap comprising different chemistries. As such, hydrometallurgical processes can meet this criterion, while also requiring a low environmental footprint and energy consumption compared to pyrometallurgy. Following pretreatment to separate the cathode from other battery components, the active material is dissolved entirely by reductive acid leaching. A complex leachate is generated, comprising cathode metals (Li+, Ni2+, Mn2+, and Co2+) and impurities (Fe3+, Al3+, and Cu2+) from the current collectors and battery casing, which can be separated and purified using a series of selective precipitation and/or solvent extraction steps. Alternatively, the cathode can be resynthesized directly from the leachate.

Abstract Lithium anode‐based batteries (LBs) are highly demanded in society owing to the high theoretical capacity and low reduction potential of metallic lithium. They are expected to see increasing deployment in performance critical areas including electric vehicles, grid storage, space, and sea vehicle operations. Unfortunately, competitive performance cannot be achieved when LBs operating under extreme temperature conditions where the lithium‐ion chemistry fail to perform optimally. In this review, a brief overview of the challenges in developing LBs for low temperature (60 °C) operation are provided followed by electrolyte design strategies involving Li salt modification, solvation structure optimization, additive introduction, and solid‐state electrolyte utilization for LBs are introduced. Specifically, the prospects of using lithium metal batteries (LMBs), lithium sulfur (Li‐S) batteries, and lithium oxygen (Li‐O2) batteries for performance under low and high temperature applications are evaluated. These three chemistries are presented as prototypical examples of how the conventional low temperature charge transfer resistances and high temperature side reactions can be overcome. This review also points out the research direction of extreme temperature electrolyte design toward practical applications.

Abstract The present work deals with a poly(vinyl alcohol)‐based membrane mixed with poly(4‐styrenesulfonic acid) to be used as a proton‐conducting solid‐state electrolyte in an electrochemical gas sensor for the detection of alcohol. A cross‐linking bonding semi‐interpenetrating network is formed between the polymer backbones, providing the membrane with superior mechanical property and excellent water retention. Meanwhile, the graphene oxide nanosheets are incorporated into the polymer fibrous backbones, creating impermeable block layers to limit ethanol gas penetration. Importantly, the modification of graphene oxide facilitates the protons transportation in both in‐plane and through‐plane channels of the membrane, boosting excellent conductivities of 0.13 S cm−1 (in‐plane) and 22.6 mS cm−1 (through‐plane) at 75°C, respectively. An alcohol fuel cell sensor assembled with this semi‐interpenetrating network solid electrolyte membrane is fabricated based on direct ethanol fuel cell principle, exhibiting excellent sensitivity, linearity, as well as low ethanol detection limits of 25 ppm.

Conversion electrodes possess high energy density but suffer a rapid capacity loss over cycling compared to their intercalation equivalents. Here the authors reveal the microscopic origin of the fading behavior, showing that the formation and augmentation of passivation layers are responsible.

Concrete is a multiphase composite material composed of coarse aggregate, cement mortar, and interface transition zone (ITZ). It is of great significance to study the effect of ITZ and coarse aggregate on chloride microscopic diffusion behavior for predicting the service life of reinforced concrete (RC) structures. By introducing the random distribution function, a random coarse aggregate model considering the randomness of the thickness of the ITZ was established. Furthermore, a two-dimensional (2D) chloride ion diffusion mesoscopic model was developed by specifying different diffusion properties for different phase materials of concrete. Moreover, the effects of coarse aggregate rate, ITZ thickness, and ITZ diffusion property on chloride ion diffusion behavior were investigated in this paper. The research showed that the aggregate has hindrance and agglomeration action on chloride ion diffusion. Although the volume content of the ITZ was very small, less than 0.2% of the total volume of concrete, the effect of the ITZ on the chloride diffusion in concrete cannot be ignored. More importantly, the mechanism of promoting chloride diffusion in the ITZ was revealed through the chloride diffusion trajectory. The research revealed the transmission mechanism of chloride ions in the meso-structure of concrete and provides theoretical support for the design of RC structures in coastal areas.

Abstract Background Cystic echinococcosis is a worldwide chronic zoonotic disease caused by infection with the larval stage of Echinococcus granulosus. Previously, we found significant accumulation of myeloid-derived suppressor cells (MDSCs) in E. granulosus infection mouse models and that they play a key role in immunosuppressing T lymphocytes. Here, we compared the long non-coding RNA (lncRNA) and mRNA expression patterns between the splenic monocytic MDSCs (M-MDSCs) of E. granulosus protoscoleces-infected mice and normal mice using microarray analysis. Methods LncRNA functions were predicted using Gene Ontology enrichment and the Kyoto Encyclopedia of Genes and Genomes pathway analysis. Cis- and trans-regulation analyses revealed potential relationships between the lncRNAs and their target genes or related transcription factors. Results We found that 649 lncRNAs were differentially expressed (fold change ≥ 2, P < 0.05): 582 lncRNAs were upregulated and 67 lncRNAs were downregulated; respectively, 28 upregulated mRNAs and 1043 downregulated mRNAs were differentially expressed. The microarray data was validated by quantitative reverse transcription-PCR. The results indicated that mRNAs co-expressed with the lncRNAs are mainly involved in regulating the actin cytoskeleton, Salmonella infection, leishmaniasis, and the vascular endothelial growth factor (VEGF) signaling pathway. The lncRNA NONMMUT021591 was predicted to cis-regulate the retinoblastoma gene (Rb1), whose expression is associated with abnormal M-MDSCs differentiation. We found that 372 lncRNAs were predicted to interact with 60 transcription factors; among these, C/EBPβ (CCAAT/enhancer binding protein beta) was previously demonstrated to be a transcription factor of MDSCs. Conclusions Our study identified dysregulated lncRNAs in the M-MDSCs of E. granulosus infection mouse models; they might be involved in M-MDSC-derived immunosuppression in related diseases.

Novel cathode design holds the key to enabling high performance lithium-sulfur batteries. Here the authors utilize anthraquinone to chemically stabilize polysulfides, revealing that the keto groups of anthraquinone play a critical role in forming strong Lewis acid-based chemical bonding.

Schistosomiasis is endemic to many regions of the world and affects approximately 200 million people. Conventional adaptive T cell responses are considered to be the primary contributors to the pathogenesis of Schistosoma japonicum infection, leading to liver granuloma and fibrosis. However, the functional polarization of macrophages and the associated underlying molecular mechanisms during the pathogenesis of schistosomiasis remains unknown. In the present study, we found that excretory-secretory (ES) antigens derived from S. japonicum eggs can activate macrophages, which exhibit an M2b polarization. Furthermore, ES antigen-induced M2b polarization was found to be dependent on enhanced NF-κB signaling mediated by the MyD88/MAPK pathway in a TLR2-dependent manner. In addition, the cytokine profile of the liver macrophages from wild-type-infected mice are quite distinct from those found in TLR2 knockout-infected mice by quantitative PCR analysis. More importantly, the size of granuloma and the severity of the fibrosis in the livers of TLR2-/- mice were significantly reduced compared to that in WT mice. Our findings reveal a novel role for M2b polarization in the pathogenesis of schistosome infection.