OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

BACKGROUND: Congenital heart disease (CHD) is a leading cause of birth defect-related mortality. However, more recent CHD mortality data for China are lacking. Additionally, limited studies have evaluated sex, rural-urban, and region-specific disparities of CHD mortality in China. METHODS: We designed a population-based study using data from the Dataset of National Mortality Surveillance in China between 2008 and 2021. We calculated age-adjusted CHD mortality using the sixth census data of China in 2010 as the standard population. We assessed the temporal trends in CHD mortality by age, sex, area, and region from 2008 to 2021 using the joinpoint regression model. RESULTS: From 2008 to 2021, 33,534 deaths were attributed to CHD. The period witnessed a two-fold decrease in the age-adjusted CHD mortality from 1.61 to 0.76 per 100,000 persons (average annual percent change [AAPC] = -5.90%). Females tended to have lower age-adjusted CHD mortality than males, but with a similar decline rate from 2008 to 2021 (females: AAPC = -6.15%; males: AAPC = -5.84%). Similar AAPC values were observed among people living in urban (AAPC = -6.64%) and rural (AAPC = -6.12%) areas. Eastern regions experienced a more pronounced decrease in the age-adjusted CHD mortality (AAPC = -7.86%) than central (AAPC = -5.83%) and western regions (AAPC = -3.71%) between 2008 and 2021. Approximately half of the deaths (46.19%) due to CHD occurred during infancy. The CHD mortality rates in 2021 were lower than those in 2008 for people aged 0-39 years, with the largest decrease observed among children aged 1-4 years (AAPC = -8.26%), followed by infants (AAPC = -7.01%). CONCLUSIONS CHD mortality in China has dramatically decreased from 2008 to 2021. The slower decrease in CHD mortality in the central and western regions than in the eastern regions suggested that public health policymakers should pay more attention to health resources and health education for central and western regions.
Humans ; Heart Defects, Congenital/mortality* ; Male ; Female ; China/epidemiology* ; Infant ; Child, Preschool ; Adult ; Child ; Adolescent ; Infant, Newborn ; Middle Aged ; Young Adult ; Aged ; Rural Population

Objective To analyze the predictive value of serum inflammatory factors in multidrug-re-sistant pulmonary tuberculosis.Methods A total of 151 newly treated pulmonary tuberculosis patients admit-ted to Quzhou Hospital Affiliated to Wenzhou Medical University from February 2021 to February 2023 were enrolled for standardized treatment.Based on whether multidrug resistance developed after treatment,patients were divided into multidrug-resistant group and non-multidrug-resistant group.Pretreatment serum levels of inflammatory factors were measured and compared between groups,including hypersensitive C-reactive pro-tein(hs-CRP),procalcitonin(PCT),IL-1α,IL-1β,IL-1 receptor antagonist(IL-1RA),IL-2,IL-4,IL-5,IL-6,IL-8,IL-9,IL-10,IL-12,IL-13,IL-15,IL-17,IL-18,IL-22,IL-35,tumor necrosis factor-α(TNF-α),TNF-γ,and CD40 ligand(CD40L).Logistic regression identified influencing factors for multidrug-resistant pulmonary tu-berculosis.Receiver operating characteristic(ROC)curves evaluated the predictive value of these indicators.Results The incidence of multidrug-resistant pulmonary tuberculosis was 21.85%(33/151).The levels of se-rum inflammatory factors in the drug-resistant group were higher than those in the non-drug-resistant group before treatment(P<0.05).History of alcohol consumption,presence of cavities,severe illness,adherence to treatment,and pre-treatment serum hs-CRP,PCT,IL-6,IL-18,TNF-α levels were all influencing factors for multidrug resistance in pulmonary tuberculosis patients(P<0.05).The sensitivity and area under curve(AUC)of the combined prediction of serum hs-CRP,PCT,IL-6,IL-18,TNF-α levels before treatment for multidrug-resistant pulmonary tuberculosis were higher than those of individual predictions.Conclusion The levels of serum inflammatory factors are related to multidrug resistance in pulmonary tuberculosis,and the combina-tion of serum hs-CRP,PCT,IL-6,IL-18,TNF-α can predict multidrug resistance in pulmonary tuberculosis.

Objective To explore the effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement.Methods The clinical data of 127 patients with knee osteoarthritis who underwent joint replacement in the hospital from June 2019 to September 2022 were retrospectively collected.According to the preservation of infrapatellar fat pad,the subjects were divided into a control group(removing infrapatellar fat pad,67 cases)and an observation group(preserving infrapatellar fat pad,60 cases).The changes in length of patellar tendon,pain,knee function and range of motion were analyzed.The occurrence of adverse reactions was statistically analyzed.Results At 12 months after surgery,the length of patellar tendon was reduced.The length of patellar tendon in observation group[(38.8±6.24)mm]was longer than that in control group[(36.2±6.71)mm](P＜0.05).Observation group of patellar tendon length rate is lower than the control group[(4.1±1.18)％vs(10.7±3.01)％],there was statistical significance between the two groups(P＜0.05).Pain in both groups was alleviated at 1 month,3 months,6 months and 12 months after surgery.The changes in observation group were greater than those in control group(P＜0.05).During follow-up,the incidence of adverse reactions in observation group(6.67％)was lower than that in control group(14.93％)(P＞0.05).The range of motion and function of knee joint were improved at 12 months after surgery,and the improvement in observation group was greater than that in control group(P＜0.05).Conclusion Preserving infrapatellar fat pad is more beneficial to relieving postoperative pain and restoring knee function in patients with knee osteoarthritis after joint replacement.Therefore,the intact infrapatellar fat pad should be preserved as possible in clinical practice.

Objective To explore the effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement.Methods The clinical data of 127 patients with knee osteoarthritis who underwent joint replacement in the hospital from June 2019 to September 2022 were retrospectively collected.According to the preservation of infrapatellar fat pad,the subjects were divided into a control group(removing infrapatellar fat pad,67 cases)and an observation group(preserving infrapatellar fat pad,60 cases).The changes in length of patellar tendon,pain,knee function and range of motion were analyzed.The occurrence of adverse reactions was statistically analyzed.Results At 12 months after surgery,the length of patellar tendon was reduced.The length of patellar tendon in observation group[(38.8±6.24)mm]was longer than that in control group[(36.2±6.71)mm](P＜0.05).Observation group of patellar tendon length rate is lower than the control group[(4.1±1.18)％vs(10.7±3.01)％],there was statistical significance between the two groups(P＜0.05).Pain in both groups was alleviated at 1 month,3 months,6 months and 12 months after surgery.The changes in observation group were greater than those in control group(P＜0.05).During follow-up,the incidence of adverse reactions in observation group(6.67％)was lower than that in control group(14.93％)(P＞0.05).The range of motion and function of knee joint were improved at 12 months after surgery,and the improvement in observation group was greater than that in control group(P＜0.05).Conclusion Preserving infrapatellar fat pad is more beneficial to relieving postoperative pain and restoring knee function in patients with knee osteoarthritis after joint replacement.Therefore,the intact infrapatellar fat pad should be preserved as possible in clinical practice.

OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis（PTB）.Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed，including 628 cases with favourable treatment outcomes（favourable group）and 98 cases with unfavourable treatment outcomes（unfavourable group）. After excluding the lost to follow-up cases and non-tuberculosis-related death cases，there were 659 survival cases（survival group）and 16 cases of tuberculosis-related death（fatal group）. Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes，42 cases died from non-tuberculosis causes，32 cases lost follow-up，16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60（ OR=2.515，95% CI 1.461-4.330），retreatment of tuberculosis（ OR=2.502，95% CI 1.255-4.989），chronic obstructive pulmonary disease（ OR=2.796，95% CI 1.607-4.865），respiratory failure（ OR=6.373，95% CI 2.320-17.506），hypoproteinemia（ OR=3.149，95% CI 1.876-5.286）and elevated C-reactive protein（ OR=1.007，95% CI 1.002-1.012）were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients（all P<0.01）；retreated pulmonary tuberculosis（ OR=4.542，95% CI 1.182-17.449），complicated respiratory failure（ OR=14.186，95% CI 3.038-66.252）and body mass index<18.5 kg/m 2（ OR=5.179，95% CI 1.333-20.119）were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients（ P<0.05 or <0.01）. Conclusion:The older age，low BMI，hypoproteinemia，elevated C-reactive protein，comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.

Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis（PTB）.Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed，including 628 cases with favourable treatment outcomes（favourable group）and 98 cases with unfavourable treatment outcomes（unfavourable group）. After excluding the lost to follow-up cases and non-tuberculosis-related death cases，there were 659 survival cases（survival group）and 16 cases of tuberculosis-related death（fatal group）. Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes，42 cases died from non-tuberculosis causes，32 cases lost follow-up，16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60（ OR=2.515，95% CI 1.461-4.330），retreatment of tuberculosis（ OR=2.502，95% CI 1.255-4.989），chronic obstructive pulmonary disease（ OR=2.796，95% CI 1.607-4.865），respiratory failure（ OR=6.373，95% CI 2.320-17.506），hypoproteinemia（ OR=3.149，95% CI 1.876-5.286）and elevated C-reactive protein（ OR=1.007，95% CI 1.002-1.012）were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients（all P<0.01）；retreated pulmonary tuberculosis（ OR=4.542，95% CI 1.182-17.449），complicated respiratory failure（ OR=14.186，95% CI 3.038-66.252）and body mass index<18.5 kg/m 2（ OR=5.179，95% CI 1.333-20.119）were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients（ P<0.05 or <0.01）. Conclusion:The older age，low BMI，hypoproteinemia，elevated C-reactive protein，comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.

Menopause leads to significant changes in serum levels of reproductive hormones and increased incidences of menopause-related diseases.Because of the impact of follicle-stimulating hormone(FSH)and its receptor(FSHR)on women's physical and mental health and quality of life, research has been conducted and progress has been made concerning their involvement in the pathogenesis of osteoporosis, abnormal lipid metabolism, cardiovascular disease, cancer, cognitive impairment and other disorders, thus laying the foundation for an understanding of the molecular mechanisms underlying the development of these postmenopausal diseases.

Objective:To analyze the influencing factors related to false-negative results of interferon-γ release assay (IGRA) QFT-GIT in patients with confirmed pulmonary tuberculosis.Methods:Clinical data of 389 patients with bacteriologically confirmed pulmonary tuberculosis who underwent QFT-GIT in Quzhou Hospital Affiliated to Wenzhou Medical University between January 1 and December 31 2020 were retrospectively analyzed. Univariate and multivariate logistic regression were used to analyze the influencing factors related to the false-negative results of QFT-GIT.Results:Among 389 confirmed patients, 347 cases had positive QFT-GIT results and 42 cases had negative results. Univariate analysis showed that the false-negative results of QFT-GIT were associated with low BMI, reduced CD4 + T lymphocyte count, decreased lymphocyte count, increased C-reactive protein, negative sputum smear, anemia, diabetes mellitus, malignant tumor and sepsis ( P<0.05 or P<0.01). Multivariate conditional logistic regression analysis showed that BMI <18.5 kg/m 2( OR=1.585, 95% CI 1.076-2.336), complicated with diabetes( OR=5.157, 95% CI 2.340-11.365), malignant tumors ( OR=5.596, 95% CI 2.048-15.295)and sepsis ( OR=4.141, 95% CI 1.042-16.459) were independent risk factors for the false-negative results of QFT-GIT ( P<0.05 or P<0.01). Conclusion:When the pulmonary tuberculosis patients are extreme emaciation, complicated with diabetes, malignant tumor or sepsis, the QFT-GIT results will be false negative.