Objective To explore the clinical value of tuberculous infection of T cells spot test (T-SPOT. TB)for diagnosing tuberculous pleurisy in immunocompromised patients. Methods The sensitivities of T-SPOT. TB,ADA, TB-DNA and tuberculosis antibodies to tuberculous pleurisy in 54 immunocompromised patients were compared.Among these patients,22 were retested by T-SPOT. TB after 2 months anti-tuberculosis treatment. Spot forming cells(SFCs) were compared before and after treatment. Results The diagnostic sensitivity of T-SPOT.TB (79.63%)was significantly higher than those of ADA (64.81%),TB-DNA (48.15%)and tuberculosis antibodies (55.56%) (P<0.05).22 patients were retested by the T-SPOT.TB after anti-TB treatment (2 months), the results showed that the positive rate of T-SPOT.TB was 90.91%,not significantly than previous tests (P<0.05).Both ESAT-6 and CFP-10 specific SFCs decreased significantly compared with those before anti-TB treatment (t=2.728 and 2.400,P<0.05 respectively). Conclusions T-SPOT.TB assay has satisfactory sensitivity and could be used in diagnosis of tuberculous pleurisy in immunocompromised patients.

ObjectiveTo examine the application of functional reach test(FRT) in the assessment of fall risk in stroke patients with hemiplegia.MethodsThis study used a randomized repeated measures trial design. 51 post-stroke patients with hemiplegia were recruited and were assigned into three groups, fallen group, falling group and no-fall group, according to the result of the survey on the patients' history of fall. FRT was performed for the three groups respectively to obtain confidence interval that predict fall risk more effectively according to the result of FRT. Fall risk by confidence lower limit was predicted.ResultsThe reaching distance anteriorly and posteriorly in FRT was highly correlated of the number of fall(r=-0.788，P<0.01). When the reaching distance was lower than 42.15 cm, the fall risk of the examinee was highest.ConclusionFRT can be applied to predict the fall risk of the examinee, and can also be used in the assessment of fall risk in stroke patients with hemiplegia.

Objective To assess the prevalence of dyslipidemia among children and adolescents aged 6-18 years in Yinchuan.Methods A stratified,random cluster sampling was used to select a target samples (1 939 cases) of children from elementary schools,middle schools and high schools in different age groups,with medium economic status.The levels of serum total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and triglycerides (TG) were measured.Results The prevalence of total dyslipidemia was 15.5 ％ (300/1 939 cases).The prevalence of high TG,high TC,high LDL-C,low HDL-C,high non-HDL-C and hyperlipemia were 5.8％ (113/1 939 cases),0.8％ (18/1 939 cases),1.1％ (21/1 939 cases),10.6％ (205/1 939 cases),0.9％ (18/1 939 cases) and 6.4％ (124/1 939 cases),respectively.Boys were more likely to have dyslipidemia than girls (17.7％ vs.13.3％) and a low HDL-C level (13.1％ vs.8.2％),and the differences between 2 groups were statistically significant (x2 =7.178,P =0.007;x2 =12.337,P ＜ 0.001).Individuals aged 16-18 years had the highest prevalence of total dyslipidemia [19.1％ (89/466 cases)] than other age groups,and the difference was statistically significant(x2 =11.393,P ＜ 0.01).Prevalence of dyslipidemia among the obese,the overweight and the normal weight individuals were 39.7％ (69/174 cases),20.8％ (60/289 cases) and 11.6％ (171/1 469 cases),respectively.Moreover,prevalence of dyslipidemia increased significantly with gravity of obesity,and the difference was statistically significant(x2 =100.180,P ＜ 0.01).Individuals with abdominal obesity had higher prevalence rates of dyslipidemia than that of the non-abdominal obese individuals [31.5％ (92/292 cases) vs.12.6％ (207/1 064 cases)],and the difference was statistically significant (x2 =67.578,P ＜ 0.01).Approximately 39.7％ (69/174 cases) and 31.5 ％ (92/292 cases) obese individuals and abdominal obesity were candidates for taking intervention measures including nutritional counseling,school-based lifestyle as well as community fitness programs.Conclusions Screening and prevention should be regarded for dyslipidemia among children and adolescents,especially for boys and teenagers in Yinchuan.

Objective: To investigate the surgical outcomes and prognosis of spinal cord anaplastic astrocytoma (AA). Methods: A total of 27 consecutive patients diagnosed as spinal cord AA between January 2008 and May 2015 in Department of Neurosurgery of Beijing Tiantan Hospital were retrospectively reviewed. There were 18 males and 9 females, the mean age was (30.7±13.0) years (ranging from 5 to 52 years). The lesions were located at cervical level in 8 patients, at thoracic level in 9 patients, at cervicothoracic level in 3 patients, and at thoracolumbar level in 7 patients, the average number of vertebral was 3.3±1.3.The median time from onset of symptom to surgery was 4 months, ranging from 3 days to 48 months. The clinical presentations were weakness (23 cases), paresthesia (22 cases), pain (20 cases), sphincter disorder (15 cases) and paralysis (7 cases). The preoperative modified McCormick scale was as follows: grade Ⅱ for 6 cases, grade Ⅲ for 7 cases, grade Ⅳ for 7 cases, grade Ⅴ for 7 cases. The tumors were surgically removed via posterior median approach with the monitoring of the somatosensory-evoked potentials to minimize the neurological injury. All of the patients were recommonded to receive adjuvant chemotherapy and radiotherapy postoperatively after pothological verified and followed up by clinic interview or telephone postoperatively. Log-rank test was used to calculate the survival rate. Results: Gross total resection and subtotal resection were achieved in 18 patients and partial resection in 9. Twenty patients received adjuvant chemotherapy and (or) radiotherapy, 7 patients did not received chemoradiation postoperatively. Nineteen patients died and 8 were alive at the last follow-up. The median survival time was 23 months with 1 and 2-year survival rates of 85.2% and 50.0%.There was no statistical significance between subtotal resection group and partial resection group(χ²=0.089, P=0.880), the survival rates of patients in chemotherapy group and radiotherapy group were increased significantly(χ²=6.687, P=0.001; χ²=14.887, P=0.002). Conclusions Spinal cord AA is a rare spinal high-grade astrocytoma with aggressive nature, the prognosis remains poor even after comprehensive treatments. Microsurgery followed by adjuvant chemoradiation is recommended for the treatment.

Objective To build the indicators system to collect patient safety monitoring information, focusing on medical complaints. Methods With such methods as literature review and expert advice, building the system for medical complaints collection and monitoring. Such indicators are modified and improved in pilot operations. Results The framework of the medical complaint monitoring indicators system is built in five dimensions, comprising 8 grade-1 indicators including patient complaint causes and hospital cause analysis, and 20 grade-2 indicators. Conclusion These indicators are scientific and operable to detect adverse patient safety events.

Objective To evaluate the clinical value of T-SPOT.TB in the diagnosis of tuberculous pleu-risy. Methods A total of 180 cases of hospitalized patients with pleural effusion ( hospitalized between January 2013 to January 2015)were enrolled. Efficiency of T-SPOT.TB in the diagnosis of tuberculosis was evaluated and the effects of immune state on the number of spot forming cells were analyzed. Results The sensitivity and speci-ficity of the T-SPOT.TB in diagnosis of tuberculous pleural effusion were 82.24％(88/107)and 72.60％(53/73). The sensitivity and specificity of the T-SPOT.TB in immunocompromised patients were72.73％(40/55) and 52.63％(20/38).The sensitivity and specificity of the T-SPOT.TB in non-immunocompromised were 92.31％(48/52) and 94.29％(33/35).The sensitivity and specificity of those in non-immunocompromised were significantly higher than those in immunocompromised. ESAT-6 and CFP-10 specific SFCs of immunocompromised patients de-creased significantly compared with non-immunocompromised(Z is -26.817 and-43.756,P<0.05 ). Conclusion T-SPOT.TB has high sensitivity ,specificity in the diagnosis of tuberculous pleurisy.T-SPOT.TB and is a promising clinical test in the diagnosis of non-immunocompromised with suspected TB ,but its diagnostic performance in im-munocompromised patients is reduced compared with in non-immunocompromised patients.

Objective: To analyze the differences of cardiovascular(CV) risk factors between middle school students with normal weight but high body fat and students with normal weight and normal body fat in urban area of Yinchuan,to provide a theoretical basis for early detection of their invisible obesity and controlling CV metabolism disease. Methods: During 2017 to 2018, a total of 1 043 secondary school students in urban area of Yinchuan were selected through cluster sampling. Questionnaire survey, physical examination, body composition and blood lipid test were conducted among all the participants.745 middle school students with normal body mass index (BMI) were included in the analysis. Results: Nearly 31.1% students with normal BMI had high body fat, with girls significantly higher than that in boys across different age groups(χ2=10.37，106.49，P<0.01). Total cholesterol (TC) in boys with normal-weight obesity was higher than that in the normal group, while diastolic blood pressure (DBP), triglyceride (TG), TC and lowdensity lipoprotein cholesterol (LDL-C) in girls with normal-weight obesity were significantly higher than that in the normal group, with statistically significant differences (t=-2.37，-3.82，-3.48，-4.46，-4.68，P<0.01). The detection rates of high blood pressure, high TC level and high LDL-C level in normalweight obese girls were all higher than those in normal group (χ2=4.17，8.77，5.91，P<0.05). The detection rate of CV risk factors ≥2 in normal-weight obesity group was higher than that in the normal group, and the difference was statistically significant(χ2=7.05，P<0.01). Conclusion Normal-weight obesity among middle school students in urban area of Yinchuan is prevalent, which is mainly concentrated in female students. Moreover, cardiovascular risk factors are more common among those normal-weight obese students compared with normal students. Interventions for preventing and controlling normal-weight obesity should be developed and implemented as early as possible.

Objective: To elucidate age and sex specific characteristics in fat free mass (FFM) among middle and high school adolescents in Yinchuan City, China, and to provide a scientific basis for healthy development, chronic disease prevention and intervention in children and adolescents. Methods: Using a convenient cluster sampling method, 1 175 middle and high school adolescents, aged 10 to 20 years old, from Yinchuan, China, were selected to participate in a questionnaire survey and physical examination, which involved body composition by bioelectrical impedance analysis(BIA). Results: For adolescents aged 12 to 18 years, FFM and the fat free mass percentage (FFMP) of boys increased with age(from 39.78 to 52.63 kg; 77.51% to 83.80%, respectively), the age trends of the FFM and FFMP of body parts were in the similar pattern, and were significantly higher than those of girls(all P <0.05). In girls, the FFM reached a peak of 40.96 kg at 15 years old, and decreased slightly between the ages of 15 and 18 years, the age trends of the FFM of body parts were in the similar pattern, and the FFMP decreased with age (from 75.63% to 71.91 %). In addition, in girls, the age trends of the FFMP of left and right legs were the same as the general trend, while the FFMP of left and right arms increased with age. The FFMP of the trunk reached a minimum of 29.93% at 15 years old and increased from 15 to 18 years old(all P <0.05). Conclusion For middle and high school adolescents aged 12 to 18 years old in Yinchuan City, China, the distribution of FFM changed in accordance with age and gender differences, in accordance with the characteristics of the adolescents growth and development.

Objective: To analyze the interaction of fat mass (FM) and fat free mass (FFM) on the aggregation of cardiovascular disease risk factors (CVRFs) among children and adolescents in Yinchuan City, China, so as to provide scientific basis for the prevention of CVRFs and cardiovascular disease in children and adolescents. Methods: A total of 1 822 children and adolescents aged 12 to 18 years in Yinchuan City were randomly selected for questionnaire survey, physical examination, body composition assessment and laboratory tests, through a cluster sampling method from 2017 to 2020. Binary Logistic regression was used to analyze the relationship between FM, FFM and the aggregation of CVRFs, and their interaction was analyzed. Results: After adjusting for sex and age, the risk of having CVRFs aggregation ≥1 in high FM and low FFM group and high FM and high FFM group was 2.01(95% CI =1.46-2.77) and 3.64(95% CI =2.66-4.98) times higher than that in low FM and low FFM group, and the risk of having CVRFs aggregation ≥2 was 1.67(95% CI =1.06-2.63) and 4.20 (95% CI =2.76-6.38) times, respectively( P <0.05). There was a multiplicative interaction between FM and FFM, which increased the risk of CVRFs aggregration ≥1 and ≥2. The adjusted OR and 95% CI were 1.58(1.04-2.40) and 1.95(1.12-3.42), respectively( P <0.05). Conclusion The results indicated the additive and multiplicative interactions between high levels of fat mass and fat free mass on the aggregation of cardiovascular risk factors, which increased the risk of aggregation of cardiovascular risk factors.

Objective To investigate the correlation between postmenopausal estrogen levels and diabetic retinopathy in patients with type 2 diabetes.Methods Two hundred cases of postmenopausal type 2 diabetes admitted to the Eighth Affiliated Hospital,Sun Yat-sen University from January 2015 to January 2017 were selected as the subjects and divided into the retinopathy group (93 cases) and the normal retina group (107 cases) according to the resuhs of fundus angiography.The general data of the two groups were compared,and the blood glucose index,blood lipid index and estrogen level were measured and compared.Logistic regression analysis was used to analyze the related factors of the patients with retinopathy.Results (1) The disease duration of patients in the retinopathy group was longer than that in the normal retina group ((14.67 ±3.48) years vs.(10.20±2.85) years;t=9.983,P＜0.05).The fasting blood glucose (FBG),glycosylated hemoglobin of patients in the retinopathy group were higher than those in the normal retina group (FBG:(8.01 ± 1.21) mmol/L vs.(6.93 ± 1.20) mmol/L,FBG:(8.32 ± 1.56) mmol/L vs.(7.39 ± 1.43) mmol/L;t =6.324,4.397,P＜0.05).The total cholesterol (TC),triglyceride (TG) and low density lipoprotein (LDL-C) of patients in the retinopathy group were higher than those in the normal retina group [TC:(4.93±0.87) mmol/ Lvs.(4.23± 0.69) mmol/L,TG:(1.91 ± 0.42) mmol/L vs.(1.63 ± 0.32) mmol/L,LDL-C:(2.61 ± 0.90) mmol/L vs.(1.78±0.53) mmol/L;t =6.340,5.340,8.067,P＜0.05],while high density lipoprotein (HDL-C) was lower than that in the normal retina group ((1.23±0.37) mmol/L vs.(1.76±0.45) mmol/L;t =9.014,P ＜0.05).The E2 level in the retinopathy group was lower than that in the normal retina group ((23.91 + 8.51) ng/L vs.(32.18 + 9.80) ng/L;t=6.325,P＜0.05).Logistic regression analysis showed that the duration of diabetes,FBG,HbAlc,TC,TG and LDL-C were risk factors of retinopathy (OR (95％ CI) =1.049 (1.011 ～ 1.056),1.071(1.061 ～ 1.093),1.092(0.984～ 1.275),1.099(1.661 ～ 1.993),1.863(1.661 ～ 1.993),1.652 (1.461 ～ 1.893),P＜ 0.05),while HDL-C and E2 were protective factors of retinopathy (OR (95 ％ CI) =0.172(0.061 ～ 0.293),0.955 (0.861 ～ 1.093),P＜0.0S).Conclusion Estrogen level is related to retinopathy in postmenopausal diabetic patients.It may be a protective factor for diabetic retinopathy.