Background:The diagnosis of tuberculous pleurisy(TP)presents a significant challenge due to the low bacterial load in pleural effusion(PE)samples.Cell-free Mycobacterium tuberculosis DNA(cf-TB)in PE samples is conside...Background:The diagnosis of tuberculous pleurisy(TP)presents a significant challenge due to the low bacterial load in pleural effusion(PE)samples.Cell-free Mycobacterium tuberculosis DNA(cf-TB)in PE samples is considered an optimal biomarker for diagnosing TP.This study aimed to evaluate the applicability of cf-TB testing across diverse research sites with a relatively large sample size.Methods:Patients suspected of TP and presenting with clinical symptoms and radiological evidence of PE were consecutively enrolled by treating physicians from 11 research sites across 6 provinces in China between April 2020 and August 2022.Following centrifugation,sediments obtained from PE were used for Xpert MTB/RIF(Xpert)and mycobacterial culture,while the supernatants were subjected to cf-TB testing.This study employed a composite reference standard to definite TP,which was characterized by any positive result for Mycobacterium tuberculosis(MTB)through either PE culture,PE Xpert,or pleural biopsy.Results:A total of 1412 participants underwent screening,and 1344(95.2%)were subsequently enrolled in this study.Data from 1241(92.3%)participants were included,comprising 284 with definite TP,677 with clinically diagnosed TP,and 280 without TP.The sensitivity of cf-TB testing in definite TP was 73.6%(95%CI 68.2%-78.4%),significantly higher than both Xpert(40.8%,95%CI 35.3%-46.7%,P<0.001)and mycobacterial culture(54.2%,95%CI 48.4%-59.9%,P<0.001).When clinically diagnosed TP was incorporated into the composite reference standard for sensitivity analysis,cf-TB testing showed a sensitivity of 46.8%(450/961,95%CI 43.7%-50.0%),significantly higher than both Xpert(12.1%,116/961,95%CI 10.2%-14.3%,P<0.001)and mycobacterial culture(16.0%,154/961,95%CI 13.8%-18.5%,P<0.001).The specificities of cf-TB testing,Xpert,and mycobacterial culture were all 100.0%.Conclusions:The performance of cf-TB testing is significantly superior to that of Xpert and mycobacterial culture methods,indicating that it can be considered as the primary diagnostic approach for improving TP detection.Trial registration:The trial was registered on Chictr.org.cn(ChiCTR2000031680,https://www.chictr.org.cn/showproj.html?proj=49316).展开更多
The fossil shells on the sedimentary rocks were collected from The Historical Park,Ban Sap Noi Geopark,Phetchabun Province,Thailand.However,the fossils remained in this area were investigated on the characteristic spe...The fossil shells on the sedimentary rocks were collected from The Historical Park,Ban Sap Noi Geopark,Phetchabun Province,Thailand.However,the fossils remained in this area were investigated on the characteristic species only in geological studies with taxonomy for fossil age predicting.To fill up the gap of these studies,the material characterization techniques were used to study the chemical composition and structure of fossil shells I,II and III.The results clearly showed that the morphologies of all fossil shells were Brachiopod fossils with different species.The functional group and elemental composition of all fossil shells showed that the high content of calcium carbonate was a major composition.In addition,the high content of quartz indicated the silica precipitation phenomenon in all fossil shells.The element composition of cross-sectional morphology and energy dispersive spectroscope (EDS mapping) were used to confirm the presence of Si element in each zone of fossil shells.The crystal structures of all fossil shells were investigated and indicated that the calcium carbonate compound was a calcite phase and silicon dioxide compound was a quartz phase.Moreover,the crystal structure of quartz phase was used to calculate the crystallinity index.The crystallinity index values in all fossil shells indicated a well-crystallized quartz.The age of fossil shells was estimated and found to be brachiopod fossil in carboniferous period with the age of about 359.2 to 299.0 million years.展开更多
Background: The diagnosis of bacterium-negative pulmonary tuberculosis(TB) and extra-pulmonary TB is challenging clinically. The detection of the anti-TB antibody has an important, auxiliary, clinical diagnostic value...Background: The diagnosis of bacterium-negative pulmonary tuberculosis(TB) and extra-pulmonary TB is challenging clinically. The detection of the anti-TB antibody has an important, auxiliary, clinical diagnostic value. Therefore, TB antibody detection kits should be screened and evaluated, and the reagents with the highest sensitivity and specificity should be chosen and used clinically.Methods: The diagnostic performance of 7 commercially available TB antibody detection kits(kits A, B, C, D, E, F and G) based on the gold immunoassay detection of immunoglobulin(Ig) G or IgM antibodies were simultaneously evaluated and compared in 62 TB cases and 56 non-TB cases in a laboratory. A retrospective analysis including 2549 cases was carried out to assess the clinical diagnosis values of bacteriological examinations and TB antibody tests(kits B and H used in the clinic).Results: The sensitivities of TB antibody kits A, B, C, D, E, F and G in the sera from 62 TB patients were 50.0%, 83.9%, 38.7%, 9.7%, 48.4%, 69.4% and 79.0%, respectively; the sensitivities in the sera from 24 smear-negative TB patients were 29.2%, 79.2%, 29.2%, 12.5%, 29.2%, 54.2% and 79.2%, respectively; the specificities in the sera from 56 nonTB patients were 73.2%, 25.0%, 85.7%, 96.4%, 78.6%, 78.6% and 50.0%, respectively. Of the 2549 clinically diagnosed cases, there were 1752 pulmonary TB cases, 505 extra-pulmonary TB cases, 87 old pulmonary TB cases and 205 non-TB cases. The positive results for smear, culture, TB antibody kit B and kit H in pulmonary TB cases were 39.8%(543/1365), 48.6%(372/765), 45.8%(802/1752) and 25.2%(442/1752), respectively; the results in extra-pulmonary TB cases were 3.4%(6/178), 5.8%(4/69), 35.4%(179/505), and 11.3%(57/505), respectively; the results in old pulmonary TB cases were 0%(0/64), 0%(0/30), 32.2%(28/87), and 9.2%(8/87), respectively; and the results in non-TB cases were 0%(0/121), 0%(0/56), 21.5%(44/205), and 2.4%(5/205), respectively. Of 624 smear-positive and/or culture-positive pulmonary TB cases, the sensitivities of antibody test kits B and H were 53.0% and 36.4%, respectively. Of 901 smear-negative and/or culture-negative pulmonary TB cases, the sensitivities of antibody test kits B and H were 42.5% and 19.0%, respectively. The positive rate of antibody detection in the bacterium-positive pulmonary TB cases was significantly higher than that in the bacterium-negative pulmonary TB cases(P<0.05).Conclusion: The colloidal gold-labeled TB antibody IgG detection assay is a simple, rapid and economical method that provides a better clinical auxiliary diagnosis value on TB, especially in smear-negative pulmonary TB and extrapulmonary TB. The production, quality control, screening and evaluation of antibody detection kits are very important for its clinical application.展开更多
Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreat...Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.展开更多
Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pul...Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pulmonary tuberculosis patients with lung cancer admitted to our hospital were selected as the research subjects.Using the random number table method,the patients were divided into two groups,a control group and a study group,with 30 cases in each group.The chest computed tomography(CT)examination results,mental state assessment(including depression scale and anxiety scale)scores,incidence of adverse reactions,treatment effect,and length of hospital stay were compared between the two groups.Results:The treatment effect of the patients in the study group was better than that of the patients in the control group(P<0.05);the duration of hospitalization,chest CT examination results,mental state assessment scores,and incidence of adverse reactions of the study group and the control group,were significantly different(P<0.05).Conclusion:The integrated medical care model combined with psychological intervention can effectively improve the treatment effect of pulmonary tuberculosis patients with lung cancer and prevent the occurrence of adverse reactions;thus,it should be promoted in clinical practice.展开更多
Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis ...Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.展开更多
Background Coronavirus disease 2019(COVID-19)and tuberculosis(TB)co-infection(COVID-19-TB)has the potential to exacerbate lung damage;however,information about the clinical features of COVID-19-TB is limited.This stud...Background Coronavirus disease 2019(COVID-19)and tuberculosis(TB)co-infection(COVID-19-TB)has the potential to exacerbate lung damage;however,information about the clinical features of COVID-19-TB is limited.This study aims to clarify the clinical characteristics and outcomes of patients with COVID-19-TB.Methods In this single-center retrospective study,the clinical features and outcomes of patients with COVID-19 with active TB who were admitted to Beijing Chest Hospital,Beijing,China,from 1 December 2022 to 18 January 2023 were collected.The severity of COVID-19 and TB was graded according to guidelines from the World Health Organization.The relationships of demographic and clinical variables with intensive care unit(ICU)admission were evaluated using univariable and multivariable logistic regression models.Results Overall,102 patients with COVID-19-TB were enrolled.The mean age was 54.5 years(range 36.5-70 years).The most common clinical manifestations were cough(68.63%),sputum production(53.92%),fever(51.96%),and ground-glass opacities(35.29%).Complications included acute respiratory distress syndrome(11.76%),sepsis(9.8%),and respiratory failure(7.84%).Patients with COVID-19-TB had high concentrations of various proinflammatory cytokines,including interferon-γ,interleukin-1β,interferon-γ-inducible protein 10 kD,and monocyte chemoattractant protein-1.Sixteen of the 102 patients with COVID-19-TB(15.69%)were admitted to the ICU,and 10(9.80%)died during hospitalization.The significant risk factors for ICU admission were respiratory failure,pulmonary fungal infection,and ventilation and oxygen therapy.Conclusions The mortality rate of COVID-19-TB was 9.80%.Several demographic and clinical characteristics were associated with adverse outcomes,indicating the importance of early recognition and treatment.展开更多
Objective Moxifloxacin(MFX)shows good in vitro activity against Mycobacterium abscessus and can be a possible antibiotic therapy to treat M.abscessus infection;however,other studies have shown a lower or no activity.W...Objective Moxifloxacin(MFX)shows good in vitro activity against Mycobacterium abscessus and can be a possible antibiotic therapy to treat M.abscessus infection;however,other studies have shown a lower or no activity.We aimed to evaluate MFX activity against M.abscessus using zebrafish(ZF)model in vivo.Methods A formulation of M.abscessus labeled with CM-Dil was micro-injected into ZF.Survival curves were determined by recording dead ZF every day.ZF were lysed,and colony-forming units(CFUs)were enumerated.Bacteria dissemination and fluorescence intensity in ZF were analyzed.Inhibition rates of MFX and azithromycin(AZM,positive control)were determined and compared.Results Significantly increased survival rate was observed with different AZM concentrations.However,increasing MFX concentration did not result in a significant decrease in ZF survival curve.No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations.Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration.However,with increasing MFX concentration,fluorescence intensity decreased slightly when observed under fluorescence microscope.Transferring rates at various concentrations were comparable between the MFX and AZM groups,with no significant difference.Conclusion MFX showed limited efficacy against M.abscessus in vivo using ZF model.Its activity in vivo needs to be confirmed.展开更多
Tuberculosis(TB)is an infectious disease caused by Mycobacterium tuberculosis.Although the diagnostic technology of pulmonary tuberculosis(PTB)has advanced,accurate and differential diagnoses of PTB are still challeng...Tuberculosis(TB)is an infectious disease caused by Mycobacterium tuberculosis.Although the diagnostic technology of pulmonary tuberculosis(PTB)has advanced,accurate and differential diagnoses of PTB are still challenging.In recent years,the rapid development of artificial intelligence(AI)and its wide application in the medical field have provided new opportunities for diagnosing and treating TB and PTB.The machine learning model of AI has not only helped physicians improve diagnostic accuracy,but also enabled them to make early preventive diagnoses for individuals at increased risk of infection.Furthermore,AI can guide physicians to formulate targeted treatment strategies for PTB patients with different conditions.展开更多
Objective:To explore the application effect of detailed nursing in tuberculous meningitis nursing.Methods:A total of 52 patients with tuberculous meningitis who were admitted to our hospital from May 2019 to February ...Objective:To explore the application effect of detailed nursing in tuberculous meningitis nursing.Methods:A total of 52 patients with tuberculous meningitis who were admitted to our hospital from May 2019 to February 2022 were selected as the research objects,and divided into 25 patients in the control group and 27 patients in the study group according to the random table method,and the compliance,quality of life,recurrence,nursing satisfaction,depression,anxiety and PSQI scores of the two groups were observed and analyzed.Results:In the study group,the number of patients with complete compliance,partial compliance and non-compliance were 13,11 and 3,respectively,and the compliance rate was 88.89%.In the control group,the number of patients with complete compliance,partial compliance and non-compliance were 11,5 and 9,respectively,and the compliance rate was 67.86%,and P<0.05 was considered statistically significant.The quality-of-life score of the control group was 48.36±2.24,which was lower than that of the study group,50.23±2.12,(P<0.05).The rate of recurrence of the control group was 36.00%,which was significantly higher than 7.41%in the study group(P<0.05).There was no significant statistical difference between the SAS,SDS,and PSQI scores of the two groups before nursing,(P>0.05).After nursing,both groups showed a decrease in SDS and SAS scores,with the study group showing significantly lower scores than the control group(P<0.001).Besides,the PSQI dimension scores and total score in the study group were lower than those in the control group(P<0.001).Moreover,the nursing satisfaction of the patients in the study group was significantly higher than that in the control group(93.02%>71.79%),(P<0.05).Conclusion:A full range of detailed care is not only helpful for accurate diagnosis and treatment of patients,but also helps to create a satisfactory hospital environment for patients.Results from this study showed that detailed nursing care for patients with tuberculous meningitis shows a significant positive effect and should be applied in clinical practices.展开更多
Objective:Observe and analyze the clinical significance of the differences in the expression levels of sCD163,haptoglobin and cytokines.Methods:120 patients with tuberculous pleural effusion diagnosed in our hospital ...Objective:Observe and analyze the clinical significance of the differences in the expression levels of sCD163,haptoglobin and cytokines.Methods:120 patients with tuberculous pleural effusion diagnosed in our hospital from January 2019 to December 2021 were randomly selected as the experimental group.On the other hand,40 patients with non-tuberculous pleural effusion admitted in the same period were selected as the control group.The expression levels of sCD163,haptoglobin and cytokines were observed and analyzed.Results:The expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)of the control group were 31.26±14.12,32.14±18.79,401.23±24.36 and 1.32±0.14,respectively.As for the experimental group,the expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)were 74.12±14.78,113.25±19.45,612.12±36.98 and 4.12±0.56 respectively,and p<0.05 which shows that the data was statistically significant.Conclusion:The level of inflammatory cytokines in the pleural fluid of tuberculous pleural effusion patients are higher,which can be used for the diagnosis of auxiliary tuberculous pleurisy.Tuberculous pleural effusion patients has a significantly increased expression levels of sCD163 and haptoglobin in the pleural fluid.The combination of sCD163 and haptoglobin in the diagnosis of tuberculous pleural effusion has higher clinical diagnostic value,and sCD163 and haptoglobin are not interfered by inflammatory factors in the diagnosis of tuberculous pleural effusion。展开更多
To the Editor： A patient presented with oral mucosa, ulcerated pain, and limitation of mouth opening from January 2016. Local doctors diagnosed him with oral ulcer and prescribed courses of related medicine which did...To the Editor： A patient presented with oral mucosa, ulcerated pain, and limitation of mouth opening from January 2016. Local doctors diagnosed him with oral ulcer and prescribed courses of related medicine which did not relieve symptoms. Frozen section of oral mucosa （March 31, 2016） showed granulomatous reaction [Figure 1 ]. He was referred to our hospital.展开更多
Background: To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose o...Background: To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods: This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results: A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled;66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64]vs. 42.4% [14/33];difference of conversion rate 27.9%;95% confidence interval [CI], 7.7%-48.1%;P=0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 daysvs. 12.0 days;hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060,P=0.006), symptom of fever (median 3.0 daysvs. 12.0 days;HR: 18.990, 95% CI: 5.350-67.410,P<0.001), as well as hospitalization (median 12.5 daysvs. 20.0 days;P<0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 daysvs. 14.5 days;P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression.Conclusions: SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.展开更多
The coronavirus disease 2019(COVID-19)has been declared as a pandemic by the World Health Organization.[1]Most COVID-19 patients exhibit mild to moderate symptoms,while approximately 15%progress rapidly to severe pneu...The coronavirus disease 2019(COVID-19)has been declared as a pandemic by the World Health Organization.[1]Most COVID-19 patients exhibit mild to moderate symptoms,while approximately 15%progress rapidly to severe pneumonia,and about 5%eventually develop acute respiratory distress syndrome(ARDS),[2]which requires mechanical ventilation(MV)and even extracorporeal membrane oxygenation.The mortality of COVID-19 patients who received MV was reported to be as high as 66%.[3]Therefore,the treatments aiming to improve mortality should focus on two aspects:first,prevention of the aggravation of the disease in mild and moderate COVID-19 patients;second,the rescue therapy for patients in serious conditions.We have been applying high-dose intravenous vitamin C(HDIVC)in the treatment of critical illnesses for almost 10 years in our center.Our previous in vivo research showed that HDIVC protected hemorrhagic shock-related multiple organ failure(MOF)by inhibiting inflammatory cytokines and oxidative indicators through activating Sirtuin1 pathway.展开更多
基金supported by the Beijing Municipal Science and Technology Project(Z191100006619079)the General Program of the National Natural Science Foundation of China(82072381).
文摘Background:The diagnosis of tuberculous pleurisy(TP)presents a significant challenge due to the low bacterial load in pleural effusion(PE)samples.Cell-free Mycobacterium tuberculosis DNA(cf-TB)in PE samples is considered an optimal biomarker for diagnosing TP.This study aimed to evaluate the applicability of cf-TB testing across diverse research sites with a relatively large sample size.Methods:Patients suspected of TP and presenting with clinical symptoms and radiological evidence of PE were consecutively enrolled by treating physicians from 11 research sites across 6 provinces in China between April 2020 and August 2022.Following centrifugation,sediments obtained from PE were used for Xpert MTB/RIF(Xpert)and mycobacterial culture,while the supernatants were subjected to cf-TB testing.This study employed a composite reference standard to definite TP,which was characterized by any positive result for Mycobacterium tuberculosis(MTB)through either PE culture,PE Xpert,or pleural biopsy.Results:A total of 1412 participants underwent screening,and 1344(95.2%)were subsequently enrolled in this study.Data from 1241(92.3%)participants were included,comprising 284 with definite TP,677 with clinically diagnosed TP,and 280 without TP.The sensitivity of cf-TB testing in definite TP was 73.6%(95%CI 68.2%-78.4%),significantly higher than both Xpert(40.8%,95%CI 35.3%-46.7%,P<0.001)and mycobacterial culture(54.2%,95%CI 48.4%-59.9%,P<0.001).When clinically diagnosed TP was incorporated into the composite reference standard for sensitivity analysis,cf-TB testing showed a sensitivity of 46.8%(450/961,95%CI 43.7%-50.0%),significantly higher than both Xpert(12.1%,116/961,95%CI 10.2%-14.3%,P<0.001)and mycobacterial culture(16.0%,154/961,95%CI 13.8%-18.5%,P<0.001).The specificities of cf-TB testing,Xpert,and mycobacterial culture were all 100.0%.Conclusions:The performance of cf-TB testing is significantly superior to that of Xpert and mycobacterial culture methods,indicating that it can be considered as the primary diagnostic approach for improving TP detection.Trial registration:The trial was registered on Chictr.org.cn(ChiCTR2000031680,https://www.chictr.org.cn/showproj.html?proj=49316).
基金supported by the Science Achievement Scholarship of Thailand (SAST)the support of Office of Atom for Peace,Thailand and Thailand Institute of Nuclear Technology (a public organization) for providing facilities for some experiment in this work。
文摘The fossil shells on the sedimentary rocks were collected from The Historical Park,Ban Sap Noi Geopark,Phetchabun Province,Thailand.However,the fossils remained in this area were investigated on the characteristic species only in geological studies with taxonomy for fossil age predicting.To fill up the gap of these studies,the material characterization techniques were used to study the chemical composition and structure of fossil shells I,II and III.The results clearly showed that the morphologies of all fossil shells were Brachiopod fossils with different species.The functional group and elemental composition of all fossil shells showed that the high content of calcium carbonate was a major composition.In addition,the high content of quartz indicated the silica precipitation phenomenon in all fossil shells.The element composition of cross-sectional morphology and energy dispersive spectroscope (EDS mapping) were used to confirm the presence of Si element in each zone of fossil shells.The crystal structures of all fossil shells were investigated and indicated that the calcium carbonate compound was a calcite phase and silicon dioxide compound was a quartz phase.Moreover,the crystal structure of quartz phase was used to calculate the crystallinity index.The crystallinity index values in all fossil shells indicated a well-crystallized quartz.The age of fossil shells was estimated and found to be brachiopod fossil in carboniferous period with the age of about 359.2 to 299.0 million years.
基金supported by a grant from the Key Project of Army "Twelfth Five-year Plan" Scientific Research Foundation(BWS11J050)
文摘Background: The diagnosis of bacterium-negative pulmonary tuberculosis(TB) and extra-pulmonary TB is challenging clinically. The detection of the anti-TB antibody has an important, auxiliary, clinical diagnostic value. Therefore, TB antibody detection kits should be screened and evaluated, and the reagents with the highest sensitivity and specificity should be chosen and used clinically.Methods: The diagnostic performance of 7 commercially available TB antibody detection kits(kits A, B, C, D, E, F and G) based on the gold immunoassay detection of immunoglobulin(Ig) G or IgM antibodies were simultaneously evaluated and compared in 62 TB cases and 56 non-TB cases in a laboratory. A retrospective analysis including 2549 cases was carried out to assess the clinical diagnosis values of bacteriological examinations and TB antibody tests(kits B and H used in the clinic).Results: The sensitivities of TB antibody kits A, B, C, D, E, F and G in the sera from 62 TB patients were 50.0%, 83.9%, 38.7%, 9.7%, 48.4%, 69.4% and 79.0%, respectively; the sensitivities in the sera from 24 smear-negative TB patients were 29.2%, 79.2%, 29.2%, 12.5%, 29.2%, 54.2% and 79.2%, respectively; the specificities in the sera from 56 nonTB patients were 73.2%, 25.0%, 85.7%, 96.4%, 78.6%, 78.6% and 50.0%, respectively. Of the 2549 clinically diagnosed cases, there were 1752 pulmonary TB cases, 505 extra-pulmonary TB cases, 87 old pulmonary TB cases and 205 non-TB cases. The positive results for smear, culture, TB antibody kit B and kit H in pulmonary TB cases were 39.8%(543/1365), 48.6%(372/765), 45.8%(802/1752) and 25.2%(442/1752), respectively; the results in extra-pulmonary TB cases were 3.4%(6/178), 5.8%(4/69), 35.4%(179/505), and 11.3%(57/505), respectively; the results in old pulmonary TB cases were 0%(0/64), 0%(0/30), 32.2%(28/87), and 9.2%(8/87), respectively; and the results in non-TB cases were 0%(0/121), 0%(0/56), 21.5%(44/205), and 2.4%(5/205), respectively. Of 624 smear-positive and/or culture-positive pulmonary TB cases, the sensitivities of antibody test kits B and H were 53.0% and 36.4%, respectively. Of 901 smear-negative and/or culture-negative pulmonary TB cases, the sensitivities of antibody test kits B and H were 42.5% and 19.0%, respectively. The positive rate of antibody detection in the bacterium-positive pulmonary TB cases was significantly higher than that in the bacterium-negative pulmonary TB cases(P<0.05).Conclusion: The colloidal gold-labeled TB antibody IgG detection assay is a simple, rapid and economical method that provides a better clinical auxiliary diagnosis value on TB, especially in smear-negative pulmonary TB and extrapulmonary TB. The production, quality control, screening and evaluation of antibody detection kits are very important for its clinical application.
基金supported by the National Natural Science Foundation No. 81400041 and No. 81871212the National Natural Science Foundation of China Youth Fund Project No. 81400038cohort study project of the Peking University Third Hospital Y70545-04。
文摘Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.
文摘Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pulmonary tuberculosis patients with lung cancer admitted to our hospital were selected as the research subjects.Using the random number table method,the patients were divided into two groups,a control group and a study group,with 30 cases in each group.The chest computed tomography(CT)examination results,mental state assessment(including depression scale and anxiety scale)scores,incidence of adverse reactions,treatment effect,and length of hospital stay were compared between the two groups.Results:The treatment effect of the patients in the study group was better than that of the patients in the control group(P<0.05);the duration of hospitalization,chest CT examination results,mental state assessment scores,and incidence of adverse reactions of the study group and the control group,were significantly different(P<0.05).Conclusion:The integrated medical care model combined with psychological intervention can effectively improve the treatment effect of pulmonary tuberculosis patients with lung cancer and prevent the occurrence of adverse reactions;thus,it should be promoted in clinical practice.
基金Baoding Science and Technology Plan Project“The Effect of Medical-Nurse Integrated Nursing Model Combined with Psychological Intervention on the Clinical Curative Effect of Tuberculosis and Lung Cancer Patients”(Project number:2141ZF318).
文摘Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.
基金funded by Beijing Public Health Experts Project(2022-3-040)Beijing Research Ward Excellence Program(BRWEP2024W042160119,BRWEP2024W042160102)+4 种基金Beijing Municipal Health and Health Technology Achievements and Appropriate Technology Promotion Project(BHTPP2024082,BHTPP2024083)the Capital's Funds for Health Improvement and Research[grant number 2022-1G-2162,2022-2-1132,2020-2-2094]Beijing Hospitals Authority's Ascent Plan(DFL20221102)Public service development and reform pilot project of Beijing Medical Research Institute(BMR2021-3)supported by a UTS Chancellor's Postdoctoral Research Fellowship.
文摘Background Coronavirus disease 2019(COVID-19)and tuberculosis(TB)co-infection(COVID-19-TB)has the potential to exacerbate lung damage;however,information about the clinical features of COVID-19-TB is limited.This study aims to clarify the clinical characteristics and outcomes of patients with COVID-19-TB.Methods In this single-center retrospective study,the clinical features and outcomes of patients with COVID-19 with active TB who were admitted to Beijing Chest Hospital,Beijing,China,from 1 December 2022 to 18 January 2023 were collected.The severity of COVID-19 and TB was graded according to guidelines from the World Health Organization.The relationships of demographic and clinical variables with intensive care unit(ICU)admission were evaluated using univariable and multivariable logistic regression models.Results Overall,102 patients with COVID-19-TB were enrolled.The mean age was 54.5 years(range 36.5-70 years).The most common clinical manifestations were cough(68.63%),sputum production(53.92%),fever(51.96%),and ground-glass opacities(35.29%).Complications included acute respiratory distress syndrome(11.76%),sepsis(9.8%),and respiratory failure(7.84%).Patients with COVID-19-TB had high concentrations of various proinflammatory cytokines,including interferon-γ,interleukin-1β,interferon-γ-inducible protein 10 kD,and monocyte chemoattractant protein-1.Sixteen of the 102 patients with COVID-19-TB(15.69%)were admitted to the ICU,and 10(9.80%)died during hospitalization.The significant risk factors for ICU admission were respiratory failure,pulmonary fungal infection,and ventilation and oxygen therapy.Conclusions The mortality rate of COVID-19-TB was 9.80%.Several demographic and clinical characteristics were associated with adverse outcomes,indicating the importance of early recognition and treatment.
基金supported by Beijing Hospital Authority Youth Programme[QML20171602]Tongzhou District’s Two Supreme Talent[YH201911]+1 种基金Key Laboratory of Capital Medical University Open Research Project and Beijing Tuberculosis&Thoracic Tumor Research Institute Cultivation Project13th Five National Major Scientific and Technological Projects[2017ZX09304009]。
文摘Objective Moxifloxacin(MFX)shows good in vitro activity against Mycobacterium abscessus and can be a possible antibiotic therapy to treat M.abscessus infection;however,other studies have shown a lower or no activity.We aimed to evaluate MFX activity against M.abscessus using zebrafish(ZF)model in vivo.Methods A formulation of M.abscessus labeled with CM-Dil was micro-injected into ZF.Survival curves were determined by recording dead ZF every day.ZF were lysed,and colony-forming units(CFUs)were enumerated.Bacteria dissemination and fluorescence intensity in ZF were analyzed.Inhibition rates of MFX and azithromycin(AZM,positive control)were determined and compared.Results Significantly increased survival rate was observed with different AZM concentrations.However,increasing MFX concentration did not result in a significant decrease in ZF survival curve.No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations.Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration.However,with increasing MFX concentration,fluorescence intensity decreased slightly when observed under fluorescence microscope.Transferring rates at various concentrations were comparable between the MFX and AZM groups,with no significant difference.Conclusion MFX showed limited efficacy against M.abscessus in vivo using ZF model.Its activity in vivo needs to be confirmed.
基金supported by the Special Research on Health and Epidemic Prevention(No.22FYFH13).
文摘Tuberculosis(TB)is an infectious disease caused by Mycobacterium tuberculosis.Although the diagnostic technology of pulmonary tuberculosis(PTB)has advanced,accurate and differential diagnoses of PTB are still challenging.In recent years,the rapid development of artificial intelligence(AI)and its wide application in the medical field have provided new opportunities for diagnosing and treating TB and PTB.The machine learning model of AI has not only helped physicians improve diagnostic accuracy,but also enabled them to make early preventive diagnoses for individuals at increased risk of infection.Furthermore,AI can guide physicians to formulate targeted treatment strategies for PTB patients with different conditions.
文摘Objective:To explore the application effect of detailed nursing in tuberculous meningitis nursing.Methods:A total of 52 patients with tuberculous meningitis who were admitted to our hospital from May 2019 to February 2022 were selected as the research objects,and divided into 25 patients in the control group and 27 patients in the study group according to the random table method,and the compliance,quality of life,recurrence,nursing satisfaction,depression,anxiety and PSQI scores of the two groups were observed and analyzed.Results:In the study group,the number of patients with complete compliance,partial compliance and non-compliance were 13,11 and 3,respectively,and the compliance rate was 88.89%.In the control group,the number of patients with complete compliance,partial compliance and non-compliance were 11,5 and 9,respectively,and the compliance rate was 67.86%,and P<0.05 was considered statistically significant.The quality-of-life score of the control group was 48.36±2.24,which was lower than that of the study group,50.23±2.12,(P<0.05).The rate of recurrence of the control group was 36.00%,which was significantly higher than 7.41%in the study group(P<0.05).There was no significant statistical difference between the SAS,SDS,and PSQI scores of the two groups before nursing,(P>0.05).After nursing,both groups showed a decrease in SDS and SAS scores,with the study group showing significantly lower scores than the control group(P<0.001).Besides,the PSQI dimension scores and total score in the study group were lower than those in the control group(P<0.001).Moreover,the nursing satisfaction of the patients in the study group was significantly higher than that in the control group(93.02%>71.79%),(P<0.05).Conclusion:A full range of detailed care is not only helpful for accurate diagnosis and treatment of patients,but also helps to create a satisfactory hospital environment for patients.Results from this study showed that detailed nursing care for patients with tuberculous meningitis shows a significant positive effect and should be applied in clinical practices.
文摘Objective:Observe and analyze the clinical significance of the differences in the expression levels of sCD163,haptoglobin and cytokines.Methods:120 patients with tuberculous pleural effusion diagnosed in our hospital from January 2019 to December 2021 were randomly selected as the experimental group.On the other hand,40 patients with non-tuberculous pleural effusion admitted in the same period were selected as the control group.The expression levels of sCD163,haptoglobin and cytokines were observed and analyzed.Results:The expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)of the control group were 31.26±14.12,32.14±18.79,401.23±24.36 and 1.32±0.14,respectively.As for the experimental group,the expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)were 74.12±14.78,113.25±19.45,612.12±36.98 and 4.12±0.56 respectively,and p<0.05 which shows that the data was statistically significant.Conclusion:The level of inflammatory cytokines in the pleural fluid of tuberculous pleural effusion patients are higher,which can be used for the diagnosis of auxiliary tuberculous pleurisy.Tuberculous pleural effusion patients has a significantly increased expression levels of sCD163 and haptoglobin in the pleural fluid.The combination of sCD163 and haptoglobin in the diagnosis of tuberculous pleural effusion has higher clinical diagnostic value,and sCD163 and haptoglobin are not interfered by inflammatory factors in the diagnosis of tuberculous pleural effusion。
文摘To the Editor： A patient presented with oral mucosa, ulcerated pain, and limitation of mouth opening from January 2016. Local doctors diagnosed him with oral ulcer and prescribed courses of related medicine which did not relieve symptoms. Frozen section of oral mucosa （March 31, 2016） showed granulomatous reaction [Figure 1 ]. He was referred to our hospital.
基金Shanghai Top-Priority Clinical Key Disciplines Construction Project(No.2017ZZ02014)Shanghai Key Laboratory of Emergency Prevention,Diagnosis and Treatment of Respiratory Infectious Diseases(No.20dz2261100)Cultivation Project of Shanghai Major Infectious Disease Research Base(No.20dz2210500)。
文摘Background: To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods: This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results: A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled;66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64]vs. 42.4% [14/33];difference of conversion rate 27.9%;95% confidence interval [CI], 7.7%-48.1%;P=0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 daysvs. 12.0 days;hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060,P=0.006), symptom of fever (median 3.0 daysvs. 12.0 days;HR: 18.990, 95% CI: 5.350-67.410,P<0.001), as well as hospitalization (median 12.5 daysvs. 20.0 days;P<0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 daysvs. 14.5 days;P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression.Conclusions: SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.
基金This study was supported by the grants from the second batch of the emergency key scientific and technological project of Shanghai Municipal Committee of Science and Technology(Nos.20411950300 and 20411950301)。
文摘The coronavirus disease 2019(COVID-19)has been declared as a pandemic by the World Health Organization.[1]Most COVID-19 patients exhibit mild to moderate symptoms,while approximately 15%progress rapidly to severe pneumonia,and about 5%eventually develop acute respiratory distress syndrome(ARDS),[2]which requires mechanical ventilation(MV)and even extracorporeal membrane oxygenation.The mortality of COVID-19 patients who received MV was reported to be as high as 66%.[3]Therefore,the treatments aiming to improve mortality should focus on two aspects:first,prevention of the aggravation of the disease in mild and moderate COVID-19 patients;second,the rescue therapy for patients in serious conditions.We have been applying high-dose intravenous vitamin C(HDIVC)in the treatment of critical illnesses for almost 10 years in our center.Our previous in vivo research showed that HDIVC protected hemorrhagic shock-related multiple organ failure(MOF)by inhibiting inflammatory cytokines and oxidative indicators through activating Sirtuin1 pathway.
