Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

Objective:To investigate the correlation between mean platelet volume (MPV) and clinical outcome in patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Consecutive patients with AIS treated with standard dose alteplase intravenous thrombolysis in the Department of Neurology, the Second People's Hospital of Hefei from July 1, 2019 to August 30, 2020 were enrolled retrospectively. The clinical, laboratory, and imaging data of the patients were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after onset, and a score of >2 was defined as a poor outcome. Multivariate logistic regression model was used to analyze the independent correlation between MPV and clinical outcome. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of MPV for clinical outcome. Results:A total of 104 patients with AIS who received intravenous thrombolytic therapy were included, including 40 males (38.5%), 64 females (61.5%), and their age was 68.7±12.5 years. The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 6 (interquartile range, 4-11), and the time from onset to intravenous thrombolysis was (128.5±55.9) min. Seventy-five patients (72.1%) had a good outcome, 29 (27.9%) had a poor outcome, and there was no death. The baseline NIHSS score, C-reactive protein, MPV, MPV/platelet count ratio and the proportion of patients with anterior circulation infarction in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that MPV (odds ratio [ OR] 1.868, 95% confidence interval [ CI] 1.277-2.732; P=0.001) and baseline NIHSS score ( OR 1.199, 95% CI 1.083-1.328; P<0.001) were the independent risk factors for poor outcome. ROC curve analysis showed that the area under the curve for predicting poor outcome was 0.714 (95% CI 0.606-0.821; P=0.001). The optimal cut-off value was 11.25 fl, the predictive sensitivity and specificity were 65.5% and 70.5%, respectively. Conclusions:There was a significant independent correlation between MPV and the clinical outcome in patients with AIS after intravenous thrombolysis. A higher baseline MPV had a certain predictive value for poor outcome.

Objective:To investigate the correlation between neutrophil to lymphocyte ratio (NLR) and 30-day clinical outcomes in patients with spontaneous cerebral hemorrhage and whether adding NLR to ICH score improve the accuracy of predicting poor outcomes.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurology, the Second People's Hospital of Hefei from March 2018 to April 2019 were enrolled retrospectively. The demographic and baseline clinical and imaging data were documented. The absolute neutrophil counts and absolute lymphocyte counts within 24 h of onset were obtained and NLR was calculated. At 30 d after the onset of cerebral hemorrhage, the modified Rankin Scale was used to evaluate the outcomes. Good outcome was defined as ≤2, and poor outcome was defined as >2. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline NLR, ICH score and NLR+ ICH score for poor outcomes in patients with spontaneous cerebral hemorrhage. Results:A total of 159 patients with spontaneous cerebral hemorrhage were enrolled, including 106 males (66.67%), age 62.29±15.10 years. Neutrophil count was (7.30±3.95)×10 9/L, lymphocyte count was (1.41±0.67)×10 9/L, and NLR was 6.94±7.66. Baseline hematoma volume was 17.93±25.87 ml, median ICH score 0 (interquartile range 0-1). The outcomes of 60 patients (37.7%) were poor at 30 d. Univariate analysis showed that coronary heart disease, systolic blood pressure, diastolic blood pressure, high-sensitivity C-reactive protein, fasting blood glucose, white blood cell count, neutrophil count, NLR, hematoma broken into the ventricle, hematoma volume, NIHSS and ICH scores in the poor outcome group were significantly higher than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage (odds ratio 1.135, 95% confidence interval 1.092-2.321; P=0.038). The ROC curve analysis showed that the best cut-off value of NLR was 6.679, and the sensitivity and specificity of predicting poor outcomes were 51.67% and 76.77% respectively; the best cut-off value of ICH score was 1.0, and the sensitivity and specificity of predicting poor outcomes were 69.71% and 89.80% respectively; the sensitivity and specificity of the combined application of NLR + ICH score to predict poor outcomes were 74.58% and 82.65% respectively. Conclusions:NLR was independently associated with poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage. Adding it to the ICH score could improve the accuracy of predicting poor outcome.

Depression is a common emotional disorder, which has high incidence rate and mortality worldwide. Ascorbic acid (AA) is also known as vitamin C. As a kind of reducing vitamin, AA participates in anti-oxidation, enzyme assistance and neuro-modulation in the central nervous system. Clinical evidence and animal studies show that AA has anti-depressant effect. This article reviews the function of AA in the nervous system, the current researches on relation between AA and depression, and possible mechanism, and analyzes its therapeutic significance in this disease, hoping to provide new ideas for the clinical treatment of depression.

Objective:To investigate the predictive value of platelet-to-neutrophil ratio (PNR) on hemorrhagic transformation (HT) and poor outcomes at 90 d after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received IVT in Hefei Second People's Hospital from July 2019 to June 2021 were retrospectively enrolled. HT was defined as intracerebral hemorrhage found by CT reexamination within 24 h after IVT, and the poor outcome was defined as the modified Rankin Scale score ≥3 at 90 d after onset. Multivariate logistic regression analysis was used to determine the independent predictors of HT and poor outcomes at 90 d, and the predictive value of PNR on HT and poor outcomes at 90 d was analyzed by receiver operating characteristic (ROC) curve. Results:A total of 202 patients with AIS treated with IVT were included, of which 32 had HT and 50 had poor outcomes at 90 d after onset. Multivariate logistic regression analysis showed that PNR at 24 h after IVT was significantly and independently negatively correlated with the poor outcomes (odds ratio [ OR] 0.959, 95% confidence interval [ CI] 0.928-0.991; P=0.012); PNR at admission ( OR 0.886, 95% CI 0.827-0.948; P<0.001) and PNR at 24 h after IVT ( OR 0.923, 95% CI 0.879-0.969; P=0.001) were significantly independently and negatively correlated with HT. ROC curve analysis showed that the area under the curve of PNR at 24 h after IVT for predicting poor outcomes was 0.733 (95% CI 0.659-0.807; P=0.012), the best cutoff value was 35.03, and the predictive sensitivity and specificity were 70.4% and 74%, respectively. The area under the curve of PNR at admission for predicting HT was 0.830 (95% CI 0.774-0.886; P<0.001), the best cutoff value was 34.81, and the predictive sensitivity and specificity were 70% and 93.7%, respectively. The area under the curve of PNR at 24 h after IVT for predicting HT was 0.770 (95% CI 0.702-0.839; P=0.001), the best cutoff value was 41.73, and the predictive sensitivity and specificity were 53.5% and 96.9%, respectively. Conclusion:For patients with AIS treated with IVT, lower PNR at 24 h after IVT is an independent predictor of the poor outcomes at 90 d, while PNR at admission and 24 h after IVT are the independent predictors of HT.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

Non-small-cell lung cancer (NSCLC), the most common type of lung cancer accounting for 85% of the cases, is often diagnosed at advanced stages owing to the lack of efficient early diagnostic tools. 5-Hydroxymethylcytosine (5hmC) signatures in circulating cell-free DNA (cfDNA) that carries the cancer-specific epigenetic patterns may represent the valuable biomarkers for discriminating tumor and healthy individuals, and thus could be potentially useful for NSCLC diagnosis. Here, we employed a sensitive and reliable method to map genome-wide 5hmC in the cfDNA of Chinese NSCLC patients and detected a significant 5hmC gain in both the gene bodies and promoter regions in the blood samples from tumor patients compared with healthy controls. Specifically, we identified six potential biomarkers from 66 patients and 67 healthy controls (mean decrease accuracy >3.2, P < 3.68E-19) using machine-learning-based tumor classifiers with high accuracy. Thus, the unique signature of 5hmC in tumor patient's cfDNA identified in our study may provide valuable information in facilitating the development of new diagnostic and therapeutic modalities for NSCLC.
5-Methylcytosine ; analogs & derivatives ; blood ; Biomarkers, Tumor ; blood ; genetics ; Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; genetics ; Case-Control Studies ; Circulating Tumor DNA ; blood ; DNA Methylation ; Epigenomics ; Female ; Humans ; Lung Neoplasms ; blood ; diagnosis ; genetics ; Male ; Middle Aged