Objective To evaluate the early efficacy and safety of the regimens containing delamanid and linezolid in the treatment of rifampicin resistant tuberculosis(RR-TB).Methods A total of 47 patients diagnosed with RR-TB at Public Health Clinical Center of Chengdu from August 2020 to December 2021 were enrolled,including 22 cases(46.8％)of multidrug-resistant tuberculosis(MDR-TB),8 cases(17.0％)of RR-TB,and 17 cases(36.2％)of pre-extensively drug-resistant tuberculosis(pre-XDR-TB).All patients were treated with a regimen based on delamanid and linezolid.The efficacy and safety were evaluated at 24 weeks of treatment.Results Among the 47 patients,46(97.9％)completed 24 weeks of treatment and 1(2.1％)was lost to follow-up.At 24 weeks,the sputum culture conversion rate was 100％in the 43 patients with positive baseline sputum culture.The median conversion time was 2(2,8)weeks.Imaging examination showed absorption in 46 patients(97.9％).Overall,40 patients(85.1％)experienced varying degrees of adverse events(AEs)within 24 weeks.Eleven patients(23.4％)experienced AEs possibly related to delamanid,mainly including QTcF interval prolongation(12.8％),gastrointestinal reactions(8.5％),dizziness(2.1％),headache(2.1％),and allergy(2.1％).Six patients permanently discontinued delamanid due to AEs including gastrointestinal reactions(6.4％),prolonged QTcF interval(2.1％),severe dizziness(2.1％),and drug allergy(2.1％).Patients with low baseline CD4+T lymphocyte counts(OR=0.991,95％CI:0.984-0.999)were more likely to experience delamanid-related AEs.Thirty patients(63.8％)experienced AEs possibly related to linezolid,including myelosuppression(55.3％),peripheral neuropathy(6.4％),optic neuritis occurred(2.1％),and allergy(2.1％).Three patients(6.4％)discontinued linezolid permanently due to severe anemia,peripheral neuropathy,and allergy.Conclusions The treatment regimens containing delamanid and linezolid for RR-TB showed a high sputum culture conversion rate and good tolerance at 24 weeks.Attention should be paid to gastrointestinal reactions and cellular immunity during treatment.

Objective To evaluate the early efficacy and safety of the regimens containing delamanid and linezolid in the treatment of rifampicin resistant tuberculosis(RR-TB).Methods A total of 47 patients diagnosed with RR-TB at Public Health Clinical Center of Chengdu from August 2020 to December 2021 were enrolled,including 22 cases(46.8％)of multidrug-resistant tuberculosis(MDR-TB),8 cases(17.0％)of RR-TB,and 17 cases(36.2％)of pre-extensively drug-resistant tuberculosis(pre-XDR-TB).All patients were treated with a regimen based on delamanid and linezolid.The efficacy and safety were evaluated at 24 weeks of treatment.Results Among the 47 patients,46(97.9％)completed 24 weeks of treatment and 1(2.1％)was lost to follow-up.At 24 weeks,the sputum culture conversion rate was 100％in the 43 patients with positive baseline sputum culture.The median conversion time was 2(2,8)weeks.Imaging examination showed absorption in 46 patients(97.9％).Overall,40 patients(85.1％)experienced varying degrees of adverse events(AEs)within 24 weeks.Eleven patients(23.4％)experienced AEs possibly related to delamanid,mainly including QTcF interval prolongation(12.8％),gastrointestinal reactions(8.5％),dizziness(2.1％),headache(2.1％),and allergy(2.1％).Six patients permanently discontinued delamanid due to AEs including gastrointestinal reactions(6.4％),prolonged QTcF interval(2.1％),severe dizziness(2.1％),and drug allergy(2.1％).Patients with low baseline CD4+T lymphocyte counts(OR=0.991,95％CI:0.984-0.999)were more likely to experience delamanid-related AEs.Thirty patients(63.8％)experienced AEs possibly related to linezolid,including myelosuppression(55.3％),peripheral neuropathy(6.4％),optic neuritis occurred(2.1％),and allergy(2.1％).Three patients(6.4％)discontinued linezolid permanently due to severe anemia,peripheral neuropathy,and allergy.Conclusions The treatment regimens containing delamanid and linezolid for RR-TB showed a high sputum culture conversion rate and good tolerance at 24 weeks.Attention should be paid to gastrointestinal reactions and cellular immunity during treatment.

Objective    To study the clinical characteristics of overseas imported and related local COVID-19 patients in Chengdu. Methods    Fifty overseas imported patients who were Chinese and 14 related local patients with COVID-19 who were admitted to Public Health Clinical Center of Chengdu from November to December 2020 were selected. The epidemiological characteristics, clinical manifestations, auxiliary examination, treatment and prognosis were summarized and analyzed. Results    The local group were older, and they were mostly elderly and females (P≤0.05). Compared with the imported group, the proportion of the local group was higher in heart disease and tumor. More patients had cough, fever and expectoration symptoms (P≤0.05). C-reactive protein, fasting blood glucose and fibrinogen were higher, and the lymphocyte count, blood platelet count, CD3+ T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count were lower. The positive rate of novel coronavirus total antibody, IgG antibody and IgM antibody in the imported group were higher than those in the local group (P≤0.05). The negative conversion time of the median nucleic acid was shorter than that of local patients (P≤0.05). Conclusion    There are differences in sex ratio, age, complications, clinical manifestations, lymphocyte measurement value, T lymphocyte count and negative conversion time of nucleic acid between overseas imported and local COVID-19 patients in Chengdu. The local patients are mostly elderly and have more complicated conditions, but all of them have good prognosis.

At present, there has been no report in China that novel coronavirus specific immune globulin has been used to treat coronavirus disease 2019 (COVID-19). Recently, we had successfully treated one COVID-19 patient with intravenous injection of human immunoglobulin (COVID-19-IVIG). The female patient, aged 57 years, had clinical diagnosis: (1) COVID-19, common type; (2) postoperative colon cancer; (3) leukopenia; (4) low cellular immunity. 75 mL COVID-19 human immunoglobulin (Sinoptic Wuhan Blood Products Co., Ltd.) was intravenously injected twice. The patient was hospitalized for 49 days and had a good prognosis.

Objective:To investigate serum levels of 25-hydroxyvitamin D [25-(OH)D3], the vitamin D receptor(VDR), LL-37, cytokines such as interleukin 6(IL-6)and tumor necrosis factor-α(TNF-α)in elderly and non-elderly patients with pulmonary tuberculosis, and to study the correlation between serum vitamin D levels and clinical characteristics.Methods:A total of 56 elderly patients and 56 non-elderly patients with active pulmonary tuberculosis admitted to Chengdu Public Health Clinical Center from January 2019 to March 2019 were enrolled.The levels of 25-(OH)D3, VDR, LL-37, IL-6 and TNF-α were detected by ELISA and compared between the two groups.Clinical data such as the number of T lymphocytes, lesions and cavities in bilateral lung fields and extra-pulmonary tuberculosis were collected.Results:There were significant differences in serum vitamin D levels [(28.94±12.88)nmol/L vs.(34.47±12.78)nmol/L, t=3.650, P=0.025], while levels of VDR, LL-37, IL-6 and TNF-α(all P>0.05)were similar between the elderly and non-elderly groups.Besides, patients in the elderly group were associated with significantly lower levels of CD4 + T lymphocytes [(295.71±153.83)×10 6/L vs.(421.25±206.00)×10 6/L]and CD8 + T lymphocyte count [159.5(101.0, 239.0)×10 6/L vs.261.5(187.0, 409.0)×10 6/L]than those in the nonelderly group(all P=0.000). Also, there were more severe pulmonary tuberculosis cases in the elderly group than the non-elderly group [(51/56, 91.1%) vs.(28/56, 50.0%), χ2=22.730, P=0.000]. The serum level of 25-(OH)D3 was positively correlated with CD4 + T cell count in elderly patients( r=0.190, P< 0.05). Conclusions:Elderly patients with pulmonary tuberculosis have a high proportion of severe tuberculosis and reduced serum levels of vitamin D, CD4 + T cell count and CD8 + T cell count, compared with non-elderly patients.Attention should be paid to vitamin D levels and their potential impact on disease progression in elderly patients with active tuberculosis.

Objective To evaluate the application value of T cell infected with Mybacterium tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis .Methods In total ,145 patients with smear and culture negative pulmonary tu‐berculosis and 45 patients with non‐tuberculosis lung disease were enrolled in the study .All patients received T cell infected with Mybacterium tuberculosis test and sensitivity ,specificity ,positive predicted value ,negative predicted value of testing for the diagno‐sis of smear and culture‐negative TB patients were calculated .Results The sensitivity of specificity T cell infected with Mybacteri‐um tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis was 85 .5% ,the specificity was 84 .4% , positive predicted value was 94 .7% ,negative predicted value was 64 .4% .No statistical significance in age‐dependent groups(P>0 .05) .Conclusion T cell infected with Mybacterium tuberculosis assay has high positive predicted value in diagnosis of smear and culture negative pulmonary tuberculosis and is suitable for clinical auxiliary diagnosis .