Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis in Ningbo City from 2011 to 2020, so as to provide the evidence for developing the control measures of pulmonary tuberculosis. Methods: The data pertaining to pulmonary tuberculosis cases in Ningbo City from 2011 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The temporal distribution, population distribution, regional distribution and case report by hospitals were descriptively analyzed. Results: Totally 38 305 pulmonary tuberculosis cases were reported in Ningbo City from 2011 to 2020, with an incidence rate of 48.71/105. The incidence of pulmonary tuberculosis appeared a tendency towards a decline ( P<0.05 ), with an annual reduction rate of 5.29%. There were 15 784 smear-positive cases ( 41.21% ), and the proportion of smear-positive cases appeared a tendency towards a reduction from 2011 to 2015 ( P<0.05 ), and a rise from 2016 to 2020 ( P<0.05 ). The number of reported pulmonary tuberculosis cases peaked from March to May (10 973 cases, 28.65%), and a higher incidence rate of pulmonary tuberculosis was found in men than in women ( 64.55/105 vs. 32.20/105, P<0.05 ). The highest incidence of pulmonary tuberculosis was found in cases at ages of 15 to 25 years ( 72.93/105 ), followed by in cases at ages of 65 years and greater ( 69.97/105 ), and farmers were the predominant occupation among the pulmonary tuberculosis patients ( 12 279 cases, 32.06% ). During the period from 2011 to 2020, pulmonary tuberculosis cases were reported across the 10 districts or counties of Ningbo City, and the top three high incidence of pulmonary tuberculosis were seen in Yinzhou District ( 59.91/105 ), Fenghua District ( 56.19/105 ) and Beilun District ( 56.01/105 ). The proportion of pulmonary tuberculosis cases reported by designated pulmonary tuberculosis hospitals increased from 72.16% in 2011 to 99.74% in 2020 in Ningbo City. Conclusions The incidence of pulmonary tuberculosis appeared a tendency towards a decline in Ningbo City from 2011 to 2020, and the annual decline rate meets the requirements of the WHO strategic goal of ending pulmonary tuberculosis; however, the control measures for pulmonary tuberculosis require to be intensified among men, youths, and farmers.

48 h) in the IABP Group (14/19) was significantly higher than that in the Control Group (19/45) ( ? 2=4 110, P =0 043). Conclusions In the absence of prophylactic IABP, OPCAB can be safely operated on in patients with low ejection fraction.

Background Intraocular neovascularization is a primary cause of visual reduce in proliferative diabetic retinopathy (PDR) , and intravitreal injection of ranibizumab is one of treating approachs.Researching the mechanism of intravitreal injection of ranibizumab for PDR is a new target for the prevention and management of PDR.Objective This study was to determine the levels of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of PDR eyes before and after intravitreai injection of ranibizumab.Methods Self-controlled observational study was designed.Fifteen eyes of 15 PDR patients with type 2 diabetes mellitus were included in Fuzhou General Hospital of Nanjing Military Command from January to August 2014, and 1 eye combined with neovascular glaucoma and iris rubeosis.Aqueous samples of 0.1 ml at each time were collected before and 7 days after the injection of ranibizumab from all patients under the informed consent.The changes of aqueous VEGF and PEDF concentrations were detected and analyzed by enzyme-linked immunosorbent assay.This study complied with Declaration of Helsinki and the protocol was approved by this hospital.Results The freeVEGF concentrations before and 7 days after intravitreal injection were (179.4±136.5) pg/ml and (27.1 ±23.5) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =4.172, P =0.001).PEDF concentrations before and 7 days after intravitreal injection were (394.0-±237.2) pg/ml and (267.7±199.6) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =5.443, P =0.000).Intraocular neovascularization vanished after intravitreal injection of ranibizumab and vitrectomy was carried out at the seventh day after intravitreal injection.Conclusions Free VEGF and PEDF levels in aqueous humor appear to be significantly decreased after intravitreal injection of ranibizumab, and ocular neovascularization disappears at same time,which avoids intraoperative bleeding during vitrectomy.

Objective To analyze the concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of patients with proliferative diabetic retinopathy (PDR) before and after intravitreal injection of ranibizumab.Methods Twenty-five eyes of 20 PDR patients were collected as the PDR group.Twenty-five eyes of 21 senile cataract patients were collected as the control group.There were no statistical significance in gender (x2 =0.223), age (Z=-1.555) and intraocular pressure (Z=0.225) between the two groups (P＞0.05).Samples of aqueous humor (0.1 ml) were collected just before and 7 days after the injection of ranibizumab in PDR group.Samples of aqueous (0.1 ml) humor were collected just before cataract surgery in control group.The concentrations of VEGF and PEDF in the aqueous humor were measured by enzyme-linked immunosorbent assay.Results The VEGF and PEDF concentration in the aqueous humor were reduced significantly after intravitreal injection of ranibizumab in PDR group (Z=-4.072,-4.319;P＜0.05).The concentrations of VEGF and PEDF in the aqueous humor before intravitreal injection of ranibizumab in PDR group were significantly higher than the control group (Z=-5.228, 4.706;P＜0.05).The VEGF concentration in the aqueous humor after intravitreal injection of ranibizumab in PDR group were similar to control group (Z=-1.557,P＞ 0.05).However, the concentration of PEDF in the aqueous humor after intravitreal injection of ranibizumab in PDR group still higher than control group (Z=-2.475, P＜0.05).The ratio of VEGF/PEDF before and after intravitreal injection of ranibizumab was statistically different (Z=-2.058, P＜0.05), but was the same between PDR group and control group (Z=-0.456,-0.844;P＞0.05).The aqueous humor concentrations of VEGF and PEDF were not significantly correlated with each other, neither in PDR group (r=-0.195,-0.174;P＞0.05) nor in control group (r=-0.286, P＞0.05).Conclusions Aqueous humor concentrations of VEGF and PEDF are significantly elevated in eyes with PDR.Intravitreal injection of ranibizumab significantly decreased the VEGF and PEDF in the aqueous humor after 7 days.

Objective To observe the effect of preoperative intravitreal ranibizumab injection (IVR) on the operation duration of vitrectomy and postoperative vision for the treatment of proliferative diabetic retinopathy (PDR).Methods A prospective study was carried out with the 90 PDR patients (90 eyes) who underwent vitrectomy.The 90 patients(90 eyes)were assigned to the vitrectomy only group(43 eyes) and the IVR combined with vitrectomy group (47 eyes).The IVR was performed 5-13 days prior to vitrectomy in the IVR combined with vitrectomy group.There were 15 eyes with fibrous proliferation PDR (FPDR),16 eyes with advanced PDR (APDR) without involving the macular and 16 eyes with APDR involving the macular in the vitrectomy only group.There were 14 eyes with FPDR,15 eyes with APDR without involving the macular and 14 eyes with APDR involving the macular patients in the IVR combined with vitrectomy group.All the eyes in the two groups were regularly operated by the same doctor to complete the vitrectomy.The start and end time of vitrectomy were recorded.The average follow-up time was 10 months.The changes of best corrected visual acuity (BCVA) before and 1,3 and 6 months after surgery were compared between the two groups.Results The duration of operation of the FPDR type (t=-8.300) and the APDR involving the macular type (t=-2.418) in the IVR combined with vitrectomy group was shorter than vitrectomy only group (P＜0.05).The comparison of duration of operation of the APDR without involving the macular type in the two groups has no statistically significant difference (t=-1.685,P＞0.05).At 1 month after surgery,the comparison of BCVA of the IVR combined vitrectomy group and the vitrectomy only group in APDR involving the macular type has no statistically significant difference (t=0.126,P＞0.05).At 3,6 months after surgery,the BCVA of the IVR combined vitrectomy group in APDR involving the macular type was significantly better than the BCVA of the vitrectomy only group (t=8.014,7.808;P＜0.05).At 1,3,and 6 months after surgery,the BCVA of the IVR combined vitrectomy group in FPDR type (t=3.809,1.831,0.600) and APDR without involving the macular type (t=0.003,1.092,3.931) compared with pre-treatment,the difference were not statistically significant (P＞0.05);the BCVA in APDR without involving the macular type compared with pre-treatment,the difference was distinctly statistically significant (t=2.940,4.162,6.446;P＜0.05);the BCVA in APDR involving the macular type (t =0.953,1.682,1.835) compared with pre-treatment,the difference were not statistically significant (P＞0.05).Conclusion Preoperative IVR of PDR can shorten the operation duration and improve the BCVA of APDR involving the macular type.

Objective To establish a real-time quantitative PCR assay for the identification of Campylobacter jejuni in fecal samples.Methods Specific primers of the PCR were designed according to the conserved sequences of Campylobacterjeju-ni,and the real-time quantitative PCR assay was established.150 cases of fecal samples were tested by both culture and PCR methods.With the culture testing results as the reference standard,the sensitivity,specificity,accuracy and repetition of the real-time quantitative PCR were validated.Kappa test was used to estimate the difference between the two detection meth-ods.Results The standard carve of the real-time quantitative PCR assay fitted the equationY=-3.51Log(X)+37.09 (R2=0.996)well.The sensitivity,specificity,and accuracy of the established method were 92.4%,95.8% and 94%,respective-ly.The theoretical detection limit of the PCR method was 102 CFU/ml,and its reproducibility was good (CV<5%).Statisti-cal analysis demonstrated that the results of the two methods were consistent,and the consistent strength was very strong (Kappa=0.88,P<0.05).Conclusion The established real-time PCR method can assay the Campylobacterjejuni in human fecal samples rapidly and accurately.

Objective To establish a real-time fluorescence PCR method to detect the drug resistance genes of pathogenic Campylobacter jejunum in human stool samples,and investigate the relationship between quinoloneantibiotic resistance and the related genes in Campylobacter jejuni .Methods According to the gyrA and gyrB gene sequences that related with the fluoroquinolone resistance in Campylobacter jejuni ,the primers of the PCR method was designed and synthesized.A rapid real-time fluorescence PCR method to detect the drug resistance genes in Campylobacter jejuni samples was established,and the optimum reaction system and conditions were screened through an optimized approach.The developed method was com-pared with the classical drug susceptibility assay.Results It was found in the compared results that,there were 8 inconsis-tent strains of Campylobacter jejuni ,2 of the 8 strains were drug sensitive but contented the drug resistance gene,while 6 strains were drug resistant but had no drug resistant gene.Conclusion The established method can be applied to detect the drug resistance relative genes of gyrA and gyrB in Campylobacter jejuni .There was some correlation between the drug re-sistance representation and its genotype,but this point requires further studies.

Objective To investigate the learning curve of minimally invasive direct coronary artery bypass ( MIDCAB) via left anterior small thoracotomy. Methods We retrospectively reviewed results of a consecutive series of 80 patients underwent MIDCAB via left anterior small thoracotomy performed by a single surgeon.The patients were divided into 4 groups ( group A, B, C, D, n=20 in each group) according to the sequence of the operation.The left internal mammary artery ( LIMA) harvesting time, anastomosis time, total operative time, the drainage volume of the first day postoperation, mechanical ventilation time, hospital stays postoperation, in-hospital morbidity and mortality were compared.The learning curve was assessed by means of regression analysis with logarithmic curve fitting. Results The basic clinical characters were similar in all groups before the operation.The operations were accomplished successfully in all the 80 cases.No intraoperative conversion to sternotomy, death, or perioperative myocardial infarction happened.The LIMA-harvesting time in the group B, C, and D was significantly shorter than that in the group A [(53.7 ±19.2) min, (50.2 ±17.7) min, and (43.2 ±10.3) min vs.(77.0 ±30.0) min, P =0.001, 0.000, and 0.000].There was no difference between group B and C, B and D, C and D in the LIMA-harvesting time (P>0.05).The total operative time in the group B, C, and D was significantly shorter than in the group A [ (128.7 ±21.7) min, (129.0 ±33.3) min, and (112.2 ±14.5) min vs. (165.2 ±41.8) min, all P=0.000], without difference between the group B and C, B and D, C and D (P>0.05).The learning curve models were obtained: LIMA-harvesting time ( min) =113.77 -16.869 × ln ( operation number); total operative time (min)=220.281 -25.276 ×ln (operation number). Conclusion MIDCAB via left anterior small thoracotomy is safe and effective, with a learning curve of approximately 20 cases.

Objective : To analyze the screening results of Mycobacterium tuberculosis (MTB) and HIV co-infections in Ningbo City from 2012 to 2020, so as to provide insights into improving the tuberculosis control strategy. Methods : Data pertaining to HIV antibody testing among tuberculosis patients, MTB testing among HIV/AIDS patients, treatment of patients with MTB and HIV co-infections and prognosis of anti-tuberculosis therapy were collected from the annual working reports for the management of MTB and HIV co-infections in Ningbo City from 2012 to 2020, and the screening, treatment and prognosis of MTB and HIV co-infections were analyzed. Results : A total of 35 385 newly identified tuberculosis patients were reported in Ningbo City from 2012 to 2020, and there were 5 854 cases receiving HIV testing. The annual mean percentage of HIV screening was 17.57%, and the HIV screening rate appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=4 926.309, P<0.001). Eleven patients were tested positive for HIV, with an annual mean HIV positive rate of 0.19%. A total of 26 043 HIV/AIDS patients received MTB screening, with an annual mean screening rate of 95.78%, and the annual screening rate of MTB appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=79.077, P<0.001). A total of 81 tuberculosis patients were detected, with an annual mean detection rate of 0.31%. Among the 92 patients with MTB and HIV co-infections, there were 81 patients receiving anti-tuberculosis and antiviral therapy simultaneously (88.04%), 8 cases receiving anti-tuberculosis therapy alone (8.70%), 2 cases receiving antiviral therapy alone (2.17%) and 1 case without therapy (1.09%). Among the 89 MTB and HIV co-infected patients receiving anti-tuberculosis therapy, 27 cases were cured (30.34%), 53 cases completing the course of treatment (59.55%) and 7 cases died. Conclusions The MTB screening rate among HIV/AIDS patients and the percentage of MTB and HIV co-infected patients with successful anti-tuberculosis treatment were high in Ningbo City from 2012 to 2020; however, the HIV screening rate should be improved among tuberculosis patients.

Objective To observe the changes of subfoveal choroidal thickness (SFCT) in diabetic patients with non-proliferative diabetic retinopathy (NPDR) and clinically significant macular edema(CSME),and then investigate diabetic SFCT and the relationship of diabetic CT with diabetic retinopathy (DR).Methods The patients were divided into 2 groups according to clinical guidelines of DR in China in 2014,including NPDR CSME + group(21 eyes) and NPDR CSME-group(36 eyes).All patients were underwent best corrected visual acuity (BCVA),intraocular pressure,axial length,slit lamp microscope,indirect ophthalmoscope,EDI-OCT examination,and mean arterial blood pressure measurement.The differences of BCVA,central retinal thickness (CRT) and SFCT between NPDR CSME + group and NPDR CSME-group were studied as well by means of using SPSS 18.0 for data statistics.Results There was no significant difference in gender,age,eye axis and intraocular pressure between NPDR CSME + group and NPDR CSME-group (all P ＞ 0.05).There was significant difference in BCVA between the two groups (P =0.001).The mean SFCT were (328.24 ± 101.92) μm in the NPDR CSME + group and (235.31 ± 66.98) μm in the NPDR CSME-group,and the difference was statistically significant (t =4.156,P=0.000).And plotting changes in CRT against changes in SFCT in patients with CSME revealed a positive correlation(r =0.473,P =0.000).Conclusion SFCT in NPDR CSME + patient is thicker than that in NPDR CSME-patient.And plotting changes in CRT against changes in SFCT in patients with CSME reveals a positive correlation.