Objective: To evaluate the value of T cell spot test of tuberculosis infection(T-SPOT.TB) and inflammatory indicators for diagnosis of active tuberculosis in patients with fever of unknown origin (FUO). Methods: Patients with FUO in Tongji Hospital from Jan 1st 2014 to Feb 28th 2015 were retrospectively enrolled, and general condition, laboratory examination including T-SPOT.TB, blood routine test, procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), serum ferritin (SF) and final diagnosis were collected and analyzed. Results: A total of 395 hospitalized patients with FUO were retrospectively enrolled into this study, among which there were 36 (9.11%) confirmed active tuberculosis (including 7 pulmonary cases and 29 extra-pulmonary cases), 189 (47.85%) bacterial infections, 50 (12.66%) viral infections, 4 (6.32%) fungal infections, 20 (5.06%) neoplastic diseases, 51(12.91%) autoimmune diseases, 25 (6.32%) other diseases. While 20 (5.06%) patients remained un-diagnosed. The sensitivity of T-SPOT.TB for the diagnosis of active TB in patients with FUO was 80.56% (95%CI: 63.43%-91.20%), and the specificity was 83.57% (95%CI: 79.23%-87.16%). The positive predictive value was 32.95% (95%CI: 23.52%-43.89%), and the negative predictive value was 97.72% (95%CI: 95.16%-99.00%). There were significant differences in positive LDH levels (187[141, 255] U/L vs 209[160, 343] U/L) and SF levels (296.2[191.3, 494.8] g/L vs 528.1[281.1, 1 022.0] μg/L) between active tuberculosis group and bacterial infection group (χ²=77.692, H=13.442, H=16.142, all P<0.05). The combination of T-SPOT.TB and multiple inflammatory indicators obtained most valuable efficiency (AUC=0.866) for TB diagnosis. Similarly, there were significant differences in positive ESR (31[15, 78] mm/1 h vs 10[6, 19] mm/1 h), ratio of neutrophil granulocytes ([71.17±12.59]% vs [57.08±20.38]%) between active tuberculosis group and viral infection group (H=32.797, F=6.171, all P<0.05). The combination acquired most valuable efficiency (AUC=0.929). Conclusions For patients with FUO, T-SPOT.TB combined with inflammatory indicators are valuable for the diagnosis of active tuberculosis.

OBJECTIVETo describe the prevalence and relationship between screen time and sub-health status among middle school students in weekdays and weekends.

METHODSWith multistage stratified random cluster sampling, 14 400 students from junior and senior middle schools in 288 classes of 30 schools in 4 cities( Shenyang, Chongqing, Xinxiang, Guangzhou) were investigated in October, 2011. A total of 13 817 valid questionnaires were retained for analysis. Survey content includes general demographic information, screen time, sub-health state. Logistic regression model was used to analyze the relationship between screen time and sub-health status.

RESULTSThe screen time among middle school students > 2 h/d on weekdays and weekends were 15.1% (2 085/13 817) and 58.5% (8 077/13 817) , respectively. Among them, the boys' screen time > 2 h/d on weekdays and weekends were 17.9% (1 187/6 644) and 61.3% (4 070/6 644), which were higher than girls (12.5% (898/7 173), 55.9% (4 007/7 173) )(χ² values were 76.95 and 41.35, respectively. P < 0.01). The prevalence of physical sub-health status, psychological sub-health status and sub-health status were 24.8% (3 431/13 817), 21.7% (2 997/13 817) and 22.1% (3 051/13 817), respectively. Among them, the girls' prevalence of physical sub-health status, psychological sub-health status and sub-health status were 26.0% (1 863/7 173), 22.9% (1642/7 173) and 23.1% (1 658/7 173) ), respectively, which were higher than boys' (23.6% (1 568/6 644), 20.4% (1 355/6 644) and 21.0% (1 393/6 644)) (χ² values were 10.39, 12.66 and 9.25, respectively. P < 0.05). The senior students' prevalence of physical sub-health status, psychological sub-health status and sub-health status were 31.6% (2 176/6 884) , 28.3% (1 946/6 884) and 28.9% (1 990/6 884), respectively, which were higher than junior students' (18.1% (1 255/6 933), 15.2% (1 051/6 933) and 15.3% (1 061/6 933)) (χ² values were 337.65, 349.46 and 371.54, respectively, P < 0.05). After adjusting on demographic characteristics, compared with screen time ≤ 2 h/d on weekday, screen time > 2 h/d on weekday was significantly associated with physical sub-health status, psychological sub-health status and sub-health status (OR (95% CI): 1.39 (1.25-1.55), 1.62 (1.45-1.81) and 1.59 (1.43-1.78)). And compared with screen time ≤ 2 h/d on weekend, screen time > 2 h/d on weekend was also significantly associated with physical sub-health status, psychological sub-health status and sub-health status (OR(95% CI):1.49 (1.37-1.61), 1.81 (1.66-1.98), and 1.71 (1.57-1.87)).

CONCLUSIONThe rate of the screen time > 2 h/d and the detection ratio of sub-health among the middle school students in Shenyang, Chongqing, Xinxiang, Guangzhou in 2011 were high. Screen time >2 h/d on weekdays or weekends was a risk factor for sub-health status.

Adolescent ; China ; epidemiology ; Cities ; Data Collection ; Female ; Health Status ; Humans ; Logistic Models ; Male ; Microcomputers ; statistics & numerical data ; Prevalence ; Risk Factors ; Schools ; Sex Factors ; Students ; Surveys and Questionnaires ; Television ; statistics & numerical data ; Urban Population ; statistics & numerical data

Objective To explore the changes and significance of Klotho protein levels in different stages of chronic kidney disease (CKD). Methods From March 2015 to December 2017,176 patients with CKD admitted to nephrology department of Inner Mongolia People＇s Hospital were selected as the study object (CKD group), and 80 healthy patients in our hospital were selected as the control group in the same period. The serum Klotho levels of CKD patients and control group at different stages were detected by double antibody sandwich ELISA, and the differences between each group were compared. Results The serum Klotho level of CKD group (( 4. 84 ± 1. 87) μg／L) was significantly lower than that of the control group ((9. 11± 3. 14) μg／L) ( t＝ 13. 82, P＜0. 01) . One-way anova showed that estimated renal glomerular filtration rate (eGFR),serum albumin (ALB),hemoglobin ( Hb),blood calcium ( Ca) and serum Klotho were gradually decreased,while phosphorus (P) and creatinine (Cr) in serum were gradually increased,and the difference was statistically significant among the five stages( all P＜0. 01). Spearman correlation analysis showed that Klotho level was positively correlated with eGFR and Ca,and negatively correlated with CKD stage,Cr and P (r＝0. 369,0. 160,－0. 200,－0. 250,－0. 230,all P＜0. 05). The multiple linear regression equation showed that Klotho level was positively and independently correlated with eGFR ( t＝ 3. 89, P＜0. 001),and negatively correlated with CKD staging independently (t＝－4. 12,P＜0. 001). Conclusion The expression level of serum Klotho protein in patients with CKD is lower than that of healthy people,and it decreases with the increase of CKD stages,which is closely related to the deterioration of renal function. It can be used as a reference index to evaluate the incidence and severity of CKD.

Objective:To retrospectively analyze clinical efficacy and safety of omalizumab in the treatment of chronic urticaria (CU) in southern Zhejiang, China.Methods:A retrospective observational study was conducted on CU patients who received omalizumab treatment at the First Affiliated Hospital of Wenzhou Medical University from January 1st, 2018 to August 1st, 2021. Through the outpatient follow-up visits, the disease activity, condition control, and quality of life were evaluated using the 7-day urticaria activity score (UAS7) , urticaria control test (UCT) , and dermatology life quality index (DLQI) . In addition, changes in disease condition, recurrence after withdrawal, and adverse events were assessed. Independent-sample t test was used for intergroup comparisons of normally distributed measurement data, Wilcoxon signed-rank sum test or Kruskal-Wallis H test was used for comparisons of non-normally distributed measurement data, and chi-square test or Fisher′s exact test was used for comparisons of enumeration data. Results:A total of 252 CU patients with poor response to antihistamines were included, with a baseline UCT score of 5.0 ± 2.4 points, a UAS7 score of 25.6 ± 6.2 points, and a DLQI score of 17.5 ± 4.7 points; among them, 204 (81.0%) were treated with omalizumab at an initial dose of 300 mg, and 48 (19.0%) with omalizumab at an initial dose of 150 mg. At the end points (12.0 ± 1.4 months after the start of treatment) , an overall control rate of 90.3% (224/248) was achieved after the omalizumab treatment; concretely, 137 (55.2%) patients achieved complete control (UCT = 16 points) , 87 (35.1%) achieved partial control (12 points ≤ UCT < 16 points) , and 24 (9.7%) showed no response (UCT < 12 points) , while 10 with partial response shifted to complete control after dose increase. During the treatment period, recurrence occurred in 50 patients (36.5%) , of whom 32 patients opted for retreatment with omalizumab, and then 30 (93.8%) achieved partial or complete control. Adverse events were reported in 8 patients (3.2%) , and all were mild or moderate.Conclusion:Omalizumab was effective in the real-world treatment of CU, and could improve patients′ quality of life, with a favorable safety profile.