Objectlve To evaluate the clinical value of the detection of Myeobacterium tuberculosis (MTB)and its L-forms(MTB-L)in pefipheral blood.Methods MTB and MTB-L in blood samples of 156 patients with tuberculosis and 147 patients with lung cancer were detected by hemolysis centrifugal drop Intensified Kinyoun's acid fast staining (IK) and hemolysis centrifugal culture with 42 healthy persons as controls.MTB DNA was detected by TaqMan-PCR technique in plasma mononuclear cells and whole blood from aforementioned groups.Results Among each groups detected by IK.the MTB positive rate was 1.3%(2/156),0.7%(1/147),and 0%(0/42)respectively.The positive rate of culture was 0.6%(1/156),0%(0/147),and 0%(0/42)respectively.MTB-L positive rate detected by IK was 41.0%(64/156),32.7%(48/147)and 7.2%(3/42).MTB-L positive rate detected by culture was 25.6%(40/156)and 39.5%(58/147).0%(0/42).MTB positive rate were significantly different from the MTB-L positive rate (P＜0.01).Among the 98 strains L-forms,81 strains were from human,17 strains were from bovis,and 44 strains were back to the ancestors.The positive rate of mononuclear ceHs and whole blood obtained from the tuberculosis group detected by TaqMan-PCR were 77.6%(121/156) and 68.6%(107/156)(P＜0.05).The positive rate of mononuclear cells and whole blood from lung cancer group were 59.2%(87/147)and 48.3%(52/147)(P＜0.05),which were higher than the plasma positive rate 12.2%(18/147)(P＜0.05).The result of individual bloed constituents (except for plasma) from two groups were significantly different from the control(P＜0.01).Conclusions MTB-L was found in the peripheral blood of the tuberculosis and lung cancer patients.Hemolysis centrifugal culture is a rapid,simple and reliable method for detecting MTB-L TaqMan-PCR showed the positive rate of MTB DNA in plasma and whole blood samples were significantly higher than that in the plasma.

Objective To explore the characteristics of mycobacterium dependend antituberculous drug. Methods 137 strains of mycobacterium were tested for resistance by the absolute concentration method on Lowenstein Jensen medium. Dependent positive were the coloun that on higher concentration drug medium stronger than lower concentration than controls. Results 12(8.76%) of the 130 strains M. tuberculosis and 7 strains nontuberculous mycuberculous (NTM) were found dependent, in which strains dependend on INH, RFP and SM were 3(2.19%), 10(7.3%) and 3(2.19%) respectively, 4(2.92%) were dependend on two drugs. Conclusions Were NTM dependent, Not found all detected from multiple strains.

Objective:To explore the associations of malnutrition, sarcopenia and disability in older hospitalized patients.Methods:A retrospective study was conducted on 180 patients who were admitted to the department of geriatrics of our hospital from November 2015 to September 2020 and completed 1-year follow-up.Malnutrition and sarcopenia were diagnosed as the Global Leadership Initiative on Malnutrition(GLIM)criteria and the 2019 sarcopenia criteria issued by the Asian Working Group for Sarcopenia(AWGS2019).Disability was defined as a score of less than or equal to 95 on the Barthel Index(BI).At the end of the 1-year follow-up, a decrease of ≥5 points in the total BI score from baseline was defined as aggravation of the disability.Multivariate Logistic regression models were used to analyze the effects of malnutrition and sarcopenia on the occurrence and aggravation of the disability.Results:Among the 180 elderly patients, 27.2%(49/180)met the diagnosis of malnutrition and 39.4%(71/180)of sarcopenia, and 22.2%(40/180)of malnutrition and sarcopenia overlapped.The incidence of disability was 36.7%(66/180)at baseline and the incidence of an aggravation of disability was 31.7%(57/180)at 1-year follow-up.After adjustment for confounding factors, multivariate Logistic regression analysis showed that malnutrition( OR=3.70, 95% CI=1.27-10.80, P=0.017)and sarcopenia( OR=2.93, 95% CI=1.12-7.64, P=0.028)were risk factors for disability in elderly patients, and sarcopenia was a risk factor for aggravation of disability in elderly patients after a 1-year follow-up( OR=3.99, 95% CI=1.47-10.83, P=0.007). Conclusions:Malnutrition and sarcopenia are closely associated with the occurrence and development of disability in older hospitalized patients.

Fetal STR typing of aborted tissue has long been a major problem in forensic DNA.Especially for the first trimester abortion tissue,it is difficult to isolate the embryonic components by histomorphological means,resulting in the inability to accurately obtain the STR typing of the fetus.The mixed STR typing results of mother and fetus can provide a key basis for the identification of suspects in cases of rape-induced pregnancy.In this study,next generation sequencing was used to successfully detect mixed STR typing of mother and suspected fetus or single STR typing of suspected fetus in 4 rape-induced early pregnancy abortion tissues.Combined with Y-STR and flank sequence information,it provides a more comprehensive and reliable genetic basis for the identification of suspects.

Objective:To explore the short-term and long-term effects of pregnancy with aortic dissection (AD) on newborns.Methods:In this retrospective cohort study, 31 live births of pregnant women with AD admitted to Beijing Anzhen Hospital, Capital Medical University from June 2010 to June 2022 were selected as the AD group.Among them, 19 preterm births were in the preterm AD group.Additionally, 100 neonates delivered by pregnant women without pregnancy complications were selected as the normal control group, and 50 preterm infants delivered by pregnant women without pregnancy complications were selected as the preterm control group during the same period.The differences between the AD group and the normal control group, and between the preterm AD group and the preterm control group were compared using the independent samples t-test, Chi-square test, and Fisher′s exact test.Patients in the AD group were followed up for 5 years. Results:(1) The incidence rates of small for gestational age (SGA) (12.90% vs. 1.00%), neonatal respiratory distress syndrome (NRDS) (16.13% vs. 2.00%), digestive tract hemorrhage (16.13% vs. 1.00%), nervous system disease (16.13% vs. 1.00%), multiple organ dysfunction syndrome (MODS) (12.90% vs. 0), premature infant (61.29% vs. 5.00%), asphyxia (35.48% vs. 1.00%), cardiopulmonary resuscitation (64.52% vs. 1.00%), respiratory support (38.71% vs. 2.00%), transfer to the department of pediatrics within 24 hours of birth (90.32% vs. 13.00%), caesarean section (100% vs. 25.00%), and low birth weight infant (38.71% vs. 2.00%) in the AD group were significantly higher than those in the normal control group, while the gestational age[(34.90±2.80) weeks vs. (38.87±1.50) weeks], length [(45.65±3.56) cm vs. (50.17±0.81) cm], and weight [(2 456.77±634.02) g vs. (3 383.90±413.05) g] were significantly less than those in the normal control group, and the differences were statistically significant (all P<0.05).(2) The gestational age [(33.26±2.31) weeks vs. (34.80±1.29) weeks], length [(43.89±3.36) cm vs. (46.64±2.89) cm], and weight [(2 158.95±558.92) g vs. (2 418.20±431.20) g] in the preterm AD group were less than those in the preterm control group, while the incidence rates of NRDS (26.32% vs. 4.00%), digestive tract hemorrhage (21.05% vs. 4.00%), nervous system disease (26.32% vs. 6.00%), MODS (21.05% vs. 2.00%), caesarean section (100% vs. 52.00%), cardiopulmonary resuscitation (73.68% vs. 8.00%), respiratory support (63.16% vs. 10.00%), and asphyxia (47.37% vs. 2.00%) were significantly higher than those in the preterm control group, and the differences were statistically significant (all P<0.05).(3) Twenty-seven cases in the AD group survived, and 4 cases were lost to follow-up.Among them, 9 cases had abnormal physical development, 3 cases had eye disease, and 1 case was mentally retarded.None of them underwent genetic detection. Conclusions:Neonates born to mothers with AD in pregnancy have poor physical development, high incidence of complications, and reduced quality of life, and need long-term monitoring and follow-up in their growth and development.

Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of atopic dermatitis (AD) .Methods:An ambispective study was conducted on 123 AD patients treated with dupilumab in Department of Dermatology, the Second Xiangya Hospital of Central South University from July 2020 to March 2022, clinical data were collected, and efficacy and safety of dupilumab were evaluated. Primary outcomes included scores of eczema area and severity index (EASI) , patient-oriented eczema measure (POEM) , peak pruritus numerical rating scale (NRS) and dermatology life quality index (DLQI) before and after 4-, 8-, 12- and 16-week treatment, and adverse reactions and events were recorded. Comparison of scores before and after treatment was performed using paired t test or repeated measures analysis of variance, Mann-Whitney U test was used for the comparison of efficacy among patients with different types of skin lesions or different IgE levels, and multiple regression model based on robust standard errors was used to analyze factors influencing the efficacy. Results:Among the 123 AD patients, 107 were enolled into the efficacy analysis, and 85 (79.44%) completed at least 4 weeks of treatment, including 6 (7.06%) achieving EASI75 and 23 (27.06%) achieving EASI50, and the EASI, NRS, POEM, DLQI scores (10.41 ± 6.72, 4.12 ± 1.74, 8.60 ± 4.29, 7.81 ± 4.38, respectively) significantly decreased compared with those before treatment (18.08 ± 10.69, 7.21 ± 2.01, 16.88 ± 5.74, 12.95 ± 5.95, respectively; all P < 0.001) in the 85 patients. Among the 107 patients, 47 (43.93%) completed at least 16 weeks of treatment. Among the 47 patients, 23 (82.14%) of 28 adults and 17 (89.47%) of 19 adolescents and children achieved 75% or greater improvement in EASI score; the EASI, NRS, POEM and DLQI scores before the treatment all significantly differred from those 4, 8, 12, 16 weeks after the treatment (all P < 0.001) , and all the scores were significantly lower at weeks 4, 8, 12 and 16 than at the previous adjacent time points (all P < 0.05) . At week 4 during the treatment, the EASI improvement rate was significantly lower in the AD patients with prurigo nodularis than in those without ( U = 151.00, P = 0.006) , while there was no significant difference in the EASI improvement rate between the AD patients with xeroderma and those without ( P > 0.05) ; at week 16 during the treatment, there was no significant difference in the EASI improvement rate between patients with prurigo nodularis or xeroderma and those without (both P > 0.05) . Multiple regression analysis based on robust standard errors at week 16 showed that the improvement degree in the EASI score was not correlated with the type of skin lesions ( β = 3.20, P = 0.075) , but correlated with age ( β = -0.22, P = 0.030) , whether patients were in adulthood ( β = 9.54, P = 0.049) , immediate family history ( β = 7.46, P = 0.017) ; the improvement degree in the NRS score was correlated with the type of skin lesions ( β = 0.55, P = 0.032) , age ( β = -0.04, P = 0.033) , weight ( β = -0.05, P = 0.020) , whether patients were in adulthood ( β = 2.06, P = 0.003) and whether patients received combined treatment with antihistamines ( β = -1.91, P = 0.001) . Adverse reactions: among the 123 patients, 6 (4.88%) developed conjunctivitis, and 2 (1.63%) developed facial erythema. Adverse events: vitiligo-like changes occurred on the right forehead of 1 patient, and 3 patients discontinued the treatment with dupilumab due to Henoch-Sch?nlein purpura, distal axonal damage in peripheral nerves in both upper limbs, and epilepsy, respectively. The causal relationship between these adverse events and dupilumab was unclear. Conclusion:Dupilumab is effective in the treatment of AD with high overall safety, and can serve as a new treatment option for AD patients with an unsatisfactory response to traditional treatment.