Objective To investigate the diagnostic value of T-SPOT.TB in patients with fever.Methods T-SPOT.TB was carried out in 456 febrile patients who had no determined reason for fever or who could not be excluded from infection with Mycobacterium tuberculosis.These patients were followed up for their final clinical diagnosis and the diagnostic value of T-SPOT.TB was evaluated using the receiver operating characteristic (ROC) curve.Results In the present study,85 patients were clinically diagnosed with tuberculosis (TB) (including 34 cases of pulmonary TB,24 cases of TB infection defined as T-SPOT.TB positive without TB lesion,but effective with anti-TB treatment,10 cases of tuberculous pleurisy and 17 cases of other extrapulmonary TB) and 371 patients had no definite evidence of Mycobacterium tuberculosis infection (including 42 cases of suspected TB and 329 cases of other diseases).T-SPOT.TB had a high sensitivity of 84.3％ in TB patients and a high negative predictive value of 94.2 ％,but the specificity was 68.1％ and the positive predictive value was 41.4 ％.The Kappa value was 0.380 and the area under ROC curve was 0.762 (95％CI:0.707-0.817).T-SPOT.TB had a higher sensitivity in extrapulmonary TB than in pulmonary TB (88.2 ％ vs 78.1 ％),with the negative predictive values of 95.3 ％ and 92.6 ％,Kappa values of 0.438 and 0.299,and the areas under ROC of 0.791 (95 ％ CI:0.724-0.857) and 0.719 (95％CI:0.623-0.815),respectively.Ninety-nine cases were T-SPOT.TB positive out of 329 patients diagnosed with other diseases.Conclusions T-SPOT.TB test can be used as a method for TB diagnosis in patients without obvious TB lesions.Due to its relatively high negative predictive value,T-SPOT.TB can be used to rule out infection with Mycobacterium tuberculosis.

Objective: To evaluate the effects of clinical pharmacists on the community hypertension and coronary heart disease management.Methods: The clinical pharmacy service management program for community chronic disease patients was designed, and the medication files of the patients with hypertension and coronary heart disease were established, and then the medication safety cognition and chronic disease medication of the patients were investigated.Pharmaceutical interventions were given twice for the irrational drug use and living habits and the views of pharmacy were put forward.The improvement of medication compliance, pharmaceutical opinion acceptance and blood pressure etc was evaluated, and then the drug cost and the cost of health care products were analyzed and evaluated.Results: The medication and hypertension compliance increased, the patients were satisfied with the clinical pharmacy service, and the acceptance rate of pharmaceutical intervention opinions was improved significantly.The total cost of medication was without significant change, and the cost of health care products decreased significantly.Conclusion: It is an effective way to expand the impact of clinical pharmacy performed by clinical pharmacists on chronic disease medication management in communities, which can improve the rationality and safety of drug use in the patients with chronic diseases and has positive effects in promoting the management of community chronic diseases.

The outbreak of COVID-19 has infected millions of people and caused hundreds of thousands of deaths worldwide. As there is no specific medicines or effective vaccines against 2019-nCoV at present, it is an alternative strategy to repurpose existing drugs for new diseases. Cyclosporin A inhibits the replication of coronaviruses by binding to cellular cyclophilins. Chloroquine/hydroxychloroquine can block virus-receptor binding through interfering with terminal glycosylation of the cellular receptor angiotensin-converting enzyme 2 (ACE2). Trastuzumab prevents the binding of IL-6 to both sIL-6R and mIL-6R and thereby inhibits the cytokine storm syndrome induced by COVID-19. This paper discussed the potential anti-2019-nCoV effects of some common immunosuppressant including cyclosporine, chloroquine/hydroxychloroquine, and tocilizumab.

Frailty denotes a nonspecific clinical condition characterized by a decrease of physiological reservation in multiple systems, which makes individuals extremely vulnerable to stressors. Frailty increases the incidence of adverse outcomes and death of patients. However, frailty is reversible and preventable. Therefore, this article reviews theoretical models, assessment tools and influencing factors of frailty in elderly patients with hematologic maligilancy, so as to provide references for medical staff to carry out frailty management and related research in elderly patients with hematologic maligilancy.