Objective:To explore the reliability of Xpert MTB/RIF (Xpert) in the diagnosis of pulmonary tuberculosis and to understand the characteristics of retreated patients, so as to provide clues for the investigation of retreated patients.Methods:905 patients sputum with suspected tuberculosis from July 2019 to December 2019 were collected from the Tuberculosis Department of Changsha Central Hospital. Xpert was used for rapid screening of tuberculosis. MGIT960 and Roche culture method were used for rapid sputum culture and drug sensitivity, respectively. Rifampin (RIF) resistance was compared between Xpert and Roche culture. The gender, age, RIF resistance, occupation and diabetes mellitus of patients with positive Xpert were compared, and the risk factors of RIF resistance were analyzed by binary logistic regression.Results:The total detection rate of Xpert was 28.7%(260/905) in 905 suspected pulmonary tuberculosis patients; RIF resistance rate accounted for 20.8%(54/260) in 260 positive patients, and the main mutation types were probe-E and probe-D. There was no significant difference between traditional drug sensitivity and Xpert method in RIF resistance detection ( P>0.05); There was no significant difference between Xpert method and traditional drug sensitive cases in predicting isoniazid (INH) resistance ( P=0.293); there were significant differences in age ( t=-3.835, P<0.05), gender, RIF resistance rate and proportion of farmers between newly treated and retreated patients (χ 2=5.091, 16.862, 4.808, P<0.05); Binary logistic regression showed that retreatment was a risk factor for RIF resistance ( OR=3.739, P=0.004). Conclusions:Xpert has high clinical value in the diagnosis of pulmonary tuberculosis and RIF resistance; The retreated patients were older, and the proportion of male farmers was larger, with higher resistance rate to RIF.

Objective To evaluate the activities of daily living (ADL) and investigate its influential factor in primary angle-closure glaucoma patients.Methods One hundred primary angle-closure glaucoma patients (acute phase) diagnosed definitely from April to October 2014 were collected.The status of sex,gender,education,income were recorded.Barthel Index (BI),Hospital Anxiety and Depression Scale (HADS) and Glaucoma Quality of Life-15 (GQL-15) were respectively used to assess the ADL,anxiety and depression symptoms and visual quality of life in primary angle-closure glaucoma patients.At the same time the factors affecting ADL of primary angle-closure glaucoma were analyzed.Results There were no dysfunction in 12 patients,46 patients with mild dysfunction,32 patients with moderate dysfunction and 10％ (10/100) patients with severe dysfunction.BI was negatively correlated with anxiety and depression score,GQL-15 results and disease course (r=-0.819-0.395,P ＜ 0.01),and positively correlated with average monthly income (r=0.453,P ＜ 0.01).There were no correlation with gender,sex and education (r=-0.159-0.172,P ＞ 0.05).Conclusions ADL of primary angle-closure glaucoma patients has varying degrees of dysfunction,and disease course,average monthly income,anxiety,depression and visual quality of life are closely related with it.

This paper focuses mainly on the study of optimal fermentation conditions of S-adenosyl-L-methionine.Effects of carbon sources,nitrogen sources,inorganic constituents,growth factors and adding time of L-methionine on the yield,the content and biomass of S-adenosyl-L-methionine are studied.And ingredients of the culture medium are also optimized by the method of uniform design.The final optimum culture medium contains: glucose 30 g,Yeast powder 11 g,(NH_4)_2SO_4 12 g,K_2HPO_4?3H_2O 5 g,KH_2PO_4 10 g,MnSO_4?H_2O 0.09 g,ZnSO_4?7H_2O 0.14 g,MgCl_20.5 g,CaCl_2 0.3 g,CuSO_4 0.005 g per liter. Using that optimum culture medium,the yield of S-adenosyl-L-methionine can reach 0.9 g/L in Erlenmeyer flask which is 30 % higher than before.Experiment on 5 L fermenter reveals that the accumulation of S-adenosyl-L-methionine can reach 2.66 g/L.Biomass is 23.4 g/L.

Objedtve To summarize the experience of single-stage repair of coarctation of aorta(CoA) or interrupted aortic arch (IAA)and associated intracardiac defects through median stemotomy.Methods From Jan 2007 to Jul 2008,a total of 24 pa-tients with CoA or IAA and associated intracardisc defects were surgically repaired in single-stage through median stermotomy,inchud-ing 9 coanctation of aorta,12 coarctation with aortic arch hypoplasia,and 3 interrupted aorlic arch,.The associated intracardiac de-fects were Taussing-Bing anomaly 4,non-restricted VSD 22,subaortic stenosis 1 and pulmonary vein stenosis 1.The age ranged form 1 to 99 months (average 16 months) and the body weight ranged from 4 to 19 kg(average 9.3 kg).Aortic arch reconstruction was performed by hypothermic continuous low flow bypass using regional perfusion for all patients.Three patients with LAA and 9 patients with CoA underwent end-to-end ansetomosis.Of the 12 patients with coarctation and aortic arch hyipoplasia,8 patiellts underwent ex-tended end-to-end anastomosis,2 patients underwent end-to-side anastomosis and 2 patients underwent aortoplasfy.Results 2 cases were dead. One infant with Taussig-Bing type heart was dead of severe infection after 47 days postoperative,the other one who associ-ated with LAA and VSD dead of pulmonary hypertension crisis due to pneumonia after 15 days postoperative.No patient presented neu-rdogieal complication and renal insufficiency during the perioperation.2 cases presented recurrent respiratory problem.During the 18months follow-up,no patient presented with recoarctation except one with pressure gradient more than 20 mm Hg.Conclusion Pa-tients with coarctation of aorta or interrupted aortic arch and associsted intracardisc defects should be surgically treated as early as pos-sible when diagnosis was mode.Single-stage sortic arch reconstruction through median stemotomy using continuous regional perfusion is an effective and safe procedurd.Sufficient resection of ductus,extensive dissection of thoracic vessels and optimal tissus-tissue anas-tomosis techmique are very important for successful repair and avoiding recoarctation.

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

To explore the dynamic state of traditional Chinese medicine (TCM) syndromes in acute ischemic stroke patients within 30 days of onset when treated with acupuncture, and to analyze the discrimination effects of the functions based on "decision trees" in identification of TCM syndromes of ischemic stroke.

Objective To observe the morphology of ethanol-wet dentin surfaces and detect their nano-scale adhesion force (Fad) by atomic force microscopy (AFM) in order to explore the potential mechanism of ethanol-wet bonding in improving clinical dentin bonding effectiveness.Methods Dentin slices from human premolar roots were prepared into flat ones, polished, and then randomly divided into five groups.All the specimens were acid-etched, rinsed, and left moist.They were then treated with 100％ ethanol for 0s (control group), 20s, 60s, 3×60s, or stepwise ethanol application.Afterwards, each group was scanned for the morphology in air and the Fad was probed by AFM.One-way ANOVA followed by Tukey`s test was employed for multiple comparisons using SPSS16.0.Results Compared with control group, ethanol-wet dentine produced a less undulating and relatively smooth surface topography.Ethanol-wet protocol significantly decreased the value of Fad in the experimental groups (P<0.001), in which 3×60s and stepwise ethanol application groups showed the lowest Fad.No difference was found between these two groups (P>0.05).Conclusion When using AFM in air, ethanol-wet protocol with longer time can produce a less undulating and relatively smooth surface topography and decrease the Fad, whichindicates that the water saturated in dentin matrix was replaced more thoroughly by longer ethanol application time.This will benefit hydrophobicity of the dentin bonding interface.

Objective To understand the present condition of preclinical dental undergraduate in-terns' AIDS-related knowledge. Methods The questionnaire was designed referring to domestic and foreign relevant questionnaires. The cluster sampling method was used to conduct the questionnaire survey among the undergraduates who started their clinical internship in July 2016 in three domestic colleges, using SPSS 14.0 statistical software to analyze it. Results In this survey, 144 questionnaires were distributed, and 144 ones were filled out and sent back. The survey results suggested that 97.22％ (140) of interns held a posi-tive attitude towards aiding HIV-infected patients despite that 96.53％ (139) of interns knew that dental medical staff was considered to be highly susceptible with HIV. In spite of the fact that most interns knew AIDS-related knowledge and protection measures, 40.28％ (58) of interns were not clear about incubation period of AIDS, and the average awareness of children's AIDS and methods to disinfect HIV-infected dental instruments was less than half in the interns. Meanwhile it was found that 86.81％ (125) of interns didn't perform well in terms of complying with the principles of confidentiality in AIDS prevention and treatment. Conclusion Dental clinical interns' attitudes towards AIDS-infected patients should be praised. Further-more, they should accept education about infection control to have a deeper understanding about AIDS-related clinical manifestations and legal knowledge in order to reduce the probability of nosocomial infec-tion of AIDS.

0.05)in healthy volunteers.

0.05).Conclusion CYPIA1 MspⅠ polymorphism is not related to the susceptibility to colorectal carcinoma.