Objective To evaluate the value of GeneXpert MTB/RIF assay in the clinical diagnosis of tuberculosis and tuberculosis associated rifampin resistance. Methods A total of 851 patients admitted to the Guangxi Longtan Hospital from September 22, 2015 to May 25, 2016 were enrolled. The smear microscopic examination, solid culture test, and GeneXpert MTB/RIF assay was performed on each patient. Drug sensitivity test of rifampicin using proportion method was done on patients infected with mycobacterium tuberculosis isolated by solid culture, and rifampicin resistance detection was performed on GeneXpert MTB/RIF positive patients. Bacteriological positive consistency test was performed on GeneXpert MTB/RIF and solid culture, and rifampicin resistance detection was compared bwtween GeneXpert MTB/RIF and drug sensitivity using proportion method. Culture and drug susceptibility testing were used as the gold standard, and the MTB sensitivity and specificity of smear microscopic examination, solid culture, and GeneXpert MTB/RIF assay was compared. Results Culture was used as the gold standard. Compared with culture, the sensitivity, specificity, positive predictive value, and negative predictive value of GeneXpert MTB/RIF was 95.48%(211/241), 94.91%(559/569), 87.55%(211/241), and 98.24%(559/569) respectively. The sensitivity of Xpert MTB/RIF for culture positive smear positive specimens and culture positive smear negative specimens was 98.78% (162/164) and 85.96%(49/57) respectively. Drug susceptibility testing was used as the gold standard. Compared with drug susceptibility testing, the sensitivity, specificity, positive predictive value, and negative predictive value of rifampin resistance measured by GeneXpert MTB/RIF was 98.70%(152/154), 92.98%(53/57), 97.44%(152/156) and 96.36%(53/55) respectively. The consistency rate of GeneXpert MTB/RIF and solid culture was 93.83% (Kappa = 0.847), and that of GeneXpert MTB/RIF rifampin resistance detection and proportion method for drug sensitivity was 96.38% (Kappa = 0.904). Conclusions The GeneXpert MTB/RIF detection is easily operated with high sensitivity and specificity compared with smear microscopic examination and solid culture, and it also possesses good consistency with solid culture and traditional drug sensitivity. Moreover, it could also be applied to diagnose the resistance to rifampin, which is very promising in application.

OBJECTIVE: To investigate the influence of intra cranial pressure (ICP) and cerebral perfusion pressure (CPP) on neurological det erioration and outcome of severe traumatic brain injury (STBI). METHODS: A total of 245 patients with severe traumatic brain in jury were studied retrospectively with univariate and multivariate studies to ev aluate the contribution of ICP/CPP to neurological deterioration and outcome. RESULTS: The mortality rates rose from 16.2% in 142 patient s whose course of disease was smooth to 66.7% in 103 patients who suffered f rom neurological deterioration. Correspondingly, the favorable outcome fall from 54.2% in the patients without neurological deterioration to 18.3% in th ose with neurological deterioration. In the patients with clinical evidence of n eurological deterioration, the relative influence of the ICP and the CPP on outc ome was assessed. The most powerful predictors of neurological deterioration was the presence of intracranial hypertension (ICP>30 mm Hg, 1 mm Hg=0.133 kPa). The CPP also had a prognostic power on neurological deterioration when its level less than 60 mm Hg. CONCLUSIONS: It suggests that it's very important to lower the intracranial hypertension and keep the CPP not less than 60 mm Hg during the t reatment of STBI.

Adolescent ; Adult ; Age Distribution ; Analysis of Variance ; Atrophy ; epidemiology ; pathology ; Female ; Glasgow Outcome Scale ; Hematoma, Epidural, Cranial ; diagnostic imaging ; pathology ; surgery ; Hematoma, Subdural, Acute ; diagnostic imaging ; pathology ; surgery ; Humans ; Incidence ; Injury Severity Score ; Intracranial Hemorrhage, Traumatic ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Probability ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Distribution ; Tomography, X-Ray Computed

The mechanisms underlying exercise-induced neuroprotective effects after traumatic brain injury (TBI) remained elusive, and there is a lack of effective treatments for TBI. In this study, we investigated the effects of an integrative approach of exercise and Yisaipu (TNFR-IgG fusion protein, TNF inhibitor) in a mouse TBI model. Male C57BL/6J mice were randomly assigned to a sedentary group or a group that followed a voluntary exercise regimen. The effects of 6-week prophylactic preconditioning exercise (PE) alone or in combination with post-TBI Yisaipu treatment on moderate TBI associated deficits were examined. The results showed that combined treatments of PE and post-TBI Yisaipu were superior to single treatments on reducing sensorimotor and gait dysfunctions in mice. These functional improvements were accompanied by reduced systemic inflammation largely via decreased serum TNF-α, boosted autophagic flux, and mitigated lesion volume after TBI. Given these neuroprotective effects, composite approaches such as a combination of exercise and TNF inhibitor may be a promising strategy for facilitating functional recovery from TBI and are worth further investigation.
Animals ; Brain Injuries, Traumatic/pathology* ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred C57BL ; Neuroprotective Agents/pharmacology* ; Recovery of Function ; Tumor Necrosis Factor Inhibitors