Objective To analyse and evaluate the status of drug-resistant tuberculosis of urban area of Chongqing ,and to pro-vide advice for the work of drug-resistant tuberculosis .Methods The smear positive TB cases registered between September 2009 and June 2010 were administered to questionnaire survey .At the same time ,the relating testing ,such as the sputum culture testing and drug susceptibility testing ,etc were conducted ,then analysis .Results The drug resistance rate and multi-drug resistant rate of smear positive TB cases of urban area were 27 .62% and 10 .50% respectively .The multi-drug resistant rate of new cases and re-treatment cases were 27 .62% and 23 .68% .The sequence of the rates of resistance were as follows :isoniazid(19 .34% ) ,streptomy-cin(18 .23% ) ,rifampicin(13 .26% ) ,ethambutol(11 .05% ) ,ofloxacin(6 .085% ) ,kanamycin(2 .21% ) .There were 20 types of drug-resistant spectrum among the 50 drug-resistant TB cases .The difference of the male gender and TB treatment and cough more than 2 weeks between the drug-resistant cases and the non drug-resistant cases were statistically significant (P<0 .05) .Conclusion The epidemic situation of drug-resistant tuberculosis of urban area is severe ,and the work of resistance monitoring should be routine . The correlative resistance factor should be concerned .

Objective To investigate the epidemiological characteristics of tuberculosis (TB)in children in Chongqing and provide a data support for the establishment of children tuberculosis prevention and control strategy.Methods The TB data of chil-dren aged between 0 to 14 from 2009 to 2013 was analyzed.Results The average prevalence rates and registration rate of TB in children were 7.22/ 100 000 and 4.48/ 100 000,respectively.The cases mainly concentrated between10 to 14 years old.The epi-demic situation in southeast of chongqing was higher.And most of them were secondary tuberculosis of lung.The cases were mainly detected in referral,follow and clinical consultation.Conclusion The prevalence of TB in children of Chongqing was serious.It should take comprehensive measures to strengthen the prevention and control of children tuberculosis.

Objective To know the vaccination status of BCG in Gaoxin district of Chongqing and explore the associated impact factors on seroconversion rate .Methods PPD was used to test the seroconversion status after PDG vaccination in infants under 3 months .Results There was no significant differences of seroconversion rate between different sex ,birth weight and vaccination age (P>0 .05) .But the rate was significantly higher in infants with normal birth weight than that in fetal macrosomia which was signif-icantly higher than that in low-birth weight .The rate was significantly decreased in infants of 1-2 months ,2-3 months and 0-1 months in order .The rate of infant with vaccination scar was significantly higher than that without scar (χ2 =80 .057 ,P<0 .01) . Conclusion There was no significant differences of seroconversion rate between different sex ,birth weight and vaccination age ,and the scar can indirectly show the seroconversion condition of vaccination .

Objective To evaluate the resistance of multidrug-resistant Mycobacterium tuberculosis ( M. tb) strains to bedaquiline ( BDQ) and to analyze the relationships between their genotypes and BDQ-re-sistant phenotypes in order to provide a scientific basis for rational use of BDQ for the treatment of multidrug-resistant tuberculosis ( MDR-TB) in clinical practice. Methods A total of 387 clinical M. tb strains, inclu-ding 100 pan-susceptible strains and 287 strains isolated from patients with MDR ( MDR-TB strains) , were enrolled in this study. Of the 287 MDR-TB strains, 77 strains were collected in Chongqing in 2015 and the other strains were collected in a national drug-resistant tuberculosis survey conducted in China during 2007 to 2008. Minimum inhibitory concentrations (MIC) of BDQ against those strains were detected. Genotypes of those strains were analyzed by Spoligotyping. Differences in the resistant rates against BDQ between Beijing genotype and non-Beijng genotype MDR-TB strains were comparatively analyzed. Results MIC50 and MIC90 of BDQ against the 287 MDR-TB strains were 0. 03 μg/ml and 0. 25 μg/ml, respectively. Nineteen out of the 287 MDR-TB strains (6. 6%) were resistant to BDQ. Based on the Spoligotyping, 195 strains were clas-sified into Beijing genotype, and the other 92 strains belonged to non-Beijing genotype. Statistical analysis revealed that the BDQ-resistant rate in Being genotype strains (4. 6%, 9/195) was lower than that in non-Beijing genotype strains (10. 9%, 10/92, χ2=3. 955, P=0. 047). In addition, the MIC50 and MIC90 of BDQ against pan-susceptible strains were 0. 03 μg/ml and 0. 12 μg/ml, respectively. Sixty-three pan-sus-ceptible strains belonged to Beijing genotype and the other 37 strains belonged to non-Beijing genotype. None of the pan-susceptible strains was resistant to BDQ. Conclusion This study indicates that BDQ showed stronger in vitro antibacterial activity against the MDR-TB strains isolated in China. A correlation between non-Beijing genotype and BDQ resistance is observed in those MDR strains. MDR strains of Beijing genotype are more susceptible to BDQ than those of non-Beijing genotype.

Objective: To provide the evidence for tuberculosis pvevalence for high school freshmen by analyzing data of entrance physical exarnination of Chongqing in 2018. Methods: The TB information management system of schools in Chongqing was used to collect the data of TB physical examination for high school freshmen in 2018. Excel 2007 was used to establish database, SPSS 25.0 software was used for statistical analysis, including descriptive analysis, chi square test. Results: In 2018, a total of 118 370 freshmen from 146 general education high schools and a total of 30 842 freshmen from 30 secondary vocational schools had TB screening during physical examination for freshmen. The proportion of school and freshmen participating in the TB examination was 40.09% and 44.28% respectively. The rates of school (57.03%) and freshmen (58.81%) participating in the examination of tuberculosis in senior high school students of general education were higher than those in secondary vocational education schools(16.39%, 22.73%), the difference was statistically significant(χ2=73.38, 42 744.64, P<0.01). 84 cases of active pulmonary tuberculosis (APTB) were detected in the physical examination of high school freshmen, mainly smear negative patients (92.86%)，and there was no significant difference in the prevalence of tuberculosis among the freshmen with different education, school and screening methods(P>0.05). The detection rates of TB among freshmen in general education and vocational education were 49.00/100 000 and 54.62/100 000 respectively. The detection rates of tuberculosis among freshmen in public schools and private schools were 50.29/100 000 and 124.88/100 000 respectively(χ2=5.42, 10.92, P<0.05). The detection rate of direct chest X-ray examination was 62.90/100 000. The first screening method was PPD test and the detection rate of chest X-ray examination was 84.30/100 000 for those with strong positive PPD test, the differences was no significant(χ2=0.29, P>0.05). Conclusion The tuberculosis screening program for high school freshmen is of great significance to the prevention and control of tuberculosis. Effective screening methods should be adopted and strengthened in secondary vocational schools.

Objective To evaluate the contribution of medical institutions in improving pulmonary tuberculosis(PTB) casefinding by analyzing the referral and diagnosis situation of PTB reported by medical institutions.Methods Thenumber of pulmonary tuberculosis cases and the number of tuberculosis patients diagnosed by the network of medical institutions in Chongqing from 2006 to 2015 were obtained by monthly report of tuberculosis control work and Tuberculosis Management Information System in Chongqing county districts,x2 test was used to analyze the reporting level and number of confirmed case with different year and different types of medical institutions.Results PTB or suspected PTB reported by medical institutions though network were 323 603 cases,which showed a upward trend year by year.The referral arrival rate was lower than national average level,and showed a downward trend in recent years.The proportion of confirmed PTB patients reported by medical institutions was found to increase year by year.Contribution rate of active PTB was increased from 10.14％ in 2006 to 52.09％ in 2015(x2 =25 610.75,P＜0.01),and contribution rate of smear positive PTB patients was increased from 6.42％ in 2006 to 52.46％ in 2015(x2 =10 520.65,P＜0.01).Contribution rate of multi-drug resistant PTB patients was 44.9％.Patients found by Municipal or County General Hospital was increased year by year(P＜0.01).The delay time of patients form medical institutions was 56 days,and the average delay rate patient was 79.62 ％.Conclusion The contribution of medical institutions to PTB case-finding is increasing,but the situation of delay is serious.

Objective:To explore the short-term efficacy and safety of intra-arterial thrombolysis (IAT) in the treatment of retinal artery occlusion (RAO) with the assistance of the rescue green channel in the eye stroke center.Methods:A prospective, interventional, single-center study. Thirty-eight eyes from 38 RAO patients who received IAT treatment in Guangdong Provincial People’s Hospital were enrolled. All the patients were rescued via the green channel in our eye stroke center. Data from comprehensive ocular examinations including best-corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) were collected. BCVA was measured with Snellen chart and converted to the logarithmic minimum angle of resolution (logMAR) unit for statistical analysis. RTVue XR OCTA was used to measure vascular densities (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary (RPC), and central retinal thickness (CRT). All RAO eyes attempted IAT treatment and 34 eyes were successful. Four eyes failed to complete IAT because of the occlusion of internal or common carotid arteries on the same side with the RAO eyes. Ocular examinations in post-operative 1-3 days were performed with the same devices and methods as those before surgery. Parameters measured before and after surgery include BCVA, VD of SCP, DCP, RPC, and CRT. Data of the green channel collected include the time intervals from onset of RAO to first presentation in local hospitals, and from onset of RAO to our eye stroke center. Comparisons of VD and CRT between the RAO eyes and contralateral healthy eyes were performed with independent samples Mann-Whitney U test; comparisons of VD and CRT in RAO eyes before and after IAT surgery were performed with paired samples Wilcoxon Rank Sum test. Results:Among the 34 RAO patients who had successful IAT surgery, 18 (52.9%, 18/34) were males and 16 (47.1%, 16/34) were females; the mean age was (51.0±12.9) years old. There were 30 and 4 eyes diagnosed as central RAO and branch RAO respectively. The logMAR BCVA before and after IAT surgery was 2.52±0.61 and 2.18±0.85 respectively, and the difference was statistically significant ( Z=-3.453, P=0.002). Before surgery, VD of SCP, DCP and RPC were significantly decreased and CRT was significantly increased in the affected eye compared with the contralateral healthy eyes, with the statistical significance ( P<0.001). Compared with those before surgery, the VD of SCP and DCP were significantly improved after surgery ( Z=-2.523, -2.427; P=0.010, 0.014), while there was no difference in VD of RPC and CRT ( Z=-1.448, -1.454; P=0.150, 0.159). The time interval between onset of RAO and first visit to the hospital was (6.56±6.73) hours; the time interval between onset of RAO and the arrival at our hospital was (24.11±19.90) hours. No cerebral stroke was observed in the early postoperative period and no cerebrocardiovascular events were observed later. he time interval between onset of RAO and the arrival at our hospital was (24.11±19.90) hours. No cerebral stroke was observed in the early postoperative period and no cerebrocardiovascular events were observed later. Conclusions:The short-term efficacy and safety of IAT in the treatment of RAO were satisfactory. The rescue time window might be prolonged.

Objective:To compare the accuracy of different stone scoring systems for predicting the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS).Methods:The clinical data of 227 patients with lithiasis undergoing RIRS from June 2017 to December 2020 in Affiliated Benq Hospital of Nanjing Medical University and Qingdao Fuwai Hospital were retrospectively analyzed. There were 152 males and 75 females. The average age was (53.0±10.4) years old. The average body mass index was (26.9±2.1)kg/m 2. The maximum diameter of the stone was (22.7±12.8)mm. The stone is located in left side in 133 cases and in right side in 94 cases. The stones of 44 cases were located in upper ureter, upper calyceal or renal pelvis, that of 23 cases were in medium calyceal, 157 cases in lower calyceal, and 3 cases in calyceal diverticulum.The average CT value of stone was (778.3±350.4)HU. American Society of Anesthesiology (ASA)scores: 86 cases of grade Ⅰ, 129 cases of grade Ⅱ, 12 cases of grade Ⅲ. Preoperative non-contrast CT was conducted and three-dimensional data were constructed. A single observer reviewed and entered the modified S.T.O.N.E., RUSS, modified S-ReSC, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E., stone free index (SFI) scores. Logistic analysis were performed between every score and SFR. Receiver operating characteristic (ROC) curve was drawn to detect sensitivity and specificity of every score in predicting the SFR. The predictive accuracies of all scores were compared. Results:The SFR was 83.0%(189/227). There were statistically significant differences in modified S. T.O.N.E.(10.5±1.9 vs. 12.7±1.8), RUSS[1(0, 4) vs. 3(0, 6)], modified S-ReSC (8.2±5.6 vs. 11.8±6.0), R.I.R.S.(6.2±1.4 vs. 8.1±1.2), SHA.LIN (9.9±2.4 vs. 13.0±2.1), Ito nomogram (12.1±5.8 vs. 4.3±3.3), S. O.L.V.E. (6.8±1.6 vs. 8.7±1.2), SFI score (7.9±1.1 vs. 6.3±0.9) between the stone-free group and the stone remaining group ( P <0.05). Logistic regression revealed that modified S.T.O.N.E., RUSS, modified S-ReSC, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E. and SFI score were significantly associated with SFR( P<0.05). There were no significant differences in the area under the curve (AUC) between the modified S. T.O.N.E., RUSS, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E. and SFI score( P>0.05), but there were significant differences in the AUC between modified S-ReSC score and other score ( P<0.05). When the cutoff of SHA.LIN, SFI and R. I.R.S. score was determined as 10, 6 and 6 scores, the specificity of SHA.LIN, SFI and R. I.R.S. score was 94.7%, 92.6% and 89.5%, respectively. Conclusions:All score could predict the postoperative SFR of RIRS, while the SHA.LIN, SFI and R.I.R.S. score were more accurate than the other scores. The accuracy of the modified S-ReSC in predicting SFR after RIRS was slightly worse than other scores.