Objectives: This study aims to describe the clinical profile of patients with tuberculosis of the spine admitted at PCMC from the year 2012-2022. Moreover, this study aims to describe the clinical profile (age, gender, BMI, area of residence) of the patients with tuberculosis of the spine admitted at PCMC from the years 2012-2022. It also aims to present the known BCG vaccination status, exposure and risk factors (nutritional factors, comorbidities), of these patients. This study presents the symptomatology (including the spinal level of involvement, and severity, sensory or motor dysfunction) and the medical and/or surgical treatment and the outcome of these identified patients.

Materials and Methods: A retrospective chart review at PCMC analyzed children under 19 diagnosed with Pott’s Disease from January 2013 to December 2022. The study, approved by the Institutional Review Board, included demographic data, clinical manifestations, BCG vaccination status, treatment details, and outcomes, while excluding non-Filipino patients and readmissions.

Results: This study examined 41 pediatric patients with Pott’s disease at the Philippine Children’s Medical Center from 2012 to 2022, primarily affecting males aged 10-15. Most patients were from low-income backgrounds. Symptoms included chronic back pain, fever, and neurological issues, with advanced imaging required for diagnosis. While 93% had received BCG vaccinations, the correlation with disease severity was inconclusive. Treatment involved anti-tuberculous agents, with surgery for severe cases. Despite improvements, none were disease-free, highlighting chronic disabilities. The findings emphasize the need for better management of spinal tuberculosis and increased BCG vaccination among children in high TB-burden areas.

Conclusion: The study evaluated the clinical profile and clinical features of children with Pott’s Disease who were treated at the Philippine Children’s Medical Center (PCMC) between the years 2012-2022. The data from the study identifies the BCG vaccine may not prevent the onset of Pott's disease.

Keywords: Pott’s Disease, Clinical Profiles, Treatment Outcomes

Human ; Male ; Female ; Infant Newborn: First 28 Days After Birth ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; General Surgery ; Child ; Bcg Vaccine ; Mycobacterium Bovis ; Patients ; Risk Factors ; Tuberculosis, Spinal ; Vaccination

This study aims to develop a method to detect bovine multi-cytokines based on flow cytometry. Previously we have prepared and screened monoclonal antibodies against bovine cytokines IFN-γ, IL-2, TNF-α, IP-10 and MCP-1. These bovine cytokine monoclonal antibodies were fluorescently labeled, and the combination of antibody and cell surface molecules were used to develop the method for detecting bovine multi-cytokines. Subsequently, the developed method was used to determine the cytokine expression profile of Mycobacterium bovis BCG infected bovine peripheral blood mononuclear cells in vitro, and evaluate the cytokine expression level of peripheral blood CD4⁺ T cells of tuberculosis-positive cattle. The bovine multi-cytokine flow cytometry detection method can effectively determine the cytokine expression of BCG-infected bovine peripheral blood T lymphocytes. Among them, the expression levels of IFN-γ, IL-2, and TNF-α continue to increase after 40 hours of infection, while the expression levels of IP-10 and MCP-1 decreased. The combined detection of IFN-γ, IL-2, and TNF-α on CD4⁺ T lymphocytes in peripheral blood of cattle can effectively distinguish tuberculosis-positive and tuberculosis-negative samples. This method may facilitate evaluating the level of cellular immune response after bovine pathogen infection and vaccine injection.
Cattle ; Animals ; Cytokines ; BCG Vaccine/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Interleukin-2 ; Flow Cytometry/methods* ; Chemokine CXCL10/metabolism* ; Leukocytes, Mononuclear ; CD4-Positive T-Lymphocytes/metabolism* ; Tuberculosis ; Antibodies, Monoclonal/metabolism*

OBJECTIVE: To investigate the inhibitory effects of levofloxacin (LEV) combined with cellulase against bacille CalmetteGuerin (BCG) biofilms in vitro. METHODS: The mature growth cycle of BCG biofilms was determined using the XTT method and crystal violet staining. BCG planktonic bacteria and BCG biofilms were treated with different concentrations of LEV and cellulose alone or jointly, and the changes in biofilm biomass were quantified with crystal violet staining. The mature BCG biofilm was then treated with cellulase alone for 24 h, and after staining with SYTO 9 and Calcofluor White Stain, the number of viable bacteria and the change in cellulose content in the biofilm were observed with confocal laser scanning microscopy. The structural changes of the treated biofilm were observed under scanning electron microscopy. RESULTS: The MIC, MBC and MBEC values of LEV determined by broth microdilution method were 4 μg/mL, 8 μg/mL and 1024 μg/mL, respectively. The combined treatment with 1/4×MIC LEV and 2.56, 5.12 or 10.24 U/mL cellulase resulted in a significant reduction in biofilm biomass (P < 0.001). Cellulase treatments at the concentrations of 10.24, 5.12 and 2.56 U/mL all produced significant dispersion effects on mature BCG biofilms (P < 0.001). CONCLUSION LEV combined with cellulose can effectively eradicate BCG biofilm infections, suggesting the potential of glycoside hydrolase therapy for improving the efficacy of antibiotics against biofilmassociated infections caused by Mycobacterium tuberculosis.
Levofloxacin/pharmacology* ; Gentian Violet/pharmacology* ; BCG Vaccine/pharmacology* ; Anti-Bacterial Agents/pharmacology* ; Biofilms ; Cellulases/pharmacology* ; Microbial Sensitivity Tests

INTRODUCTION: Usage of metformin is associated with improved survival in lung, breast and prostate cancer, and metformin has been shown to inhibit cancer cell growth and proliferation in in vitro studies. Given the lack of clinical data on metformin use in patients with bladder cancer, we aimed to evaluate the role of metformin in their oncological outcomes. METHODS: Medication use data from a prospectively maintained database of 122 patients with non-muscle-invasive bladder cancer treated with intravesical Bacille Calmette-Guerin (BCG), who were recruited under a randomised, double-blinded, controlled clinical trial, was collected and analysed. Kaplan-Meier curves were used to assess overall survival (OS) and disease-specific survival (DSS). RESULTS: At a median follow-up duration of 102 (range 3-357) months, 53 (43.4%) patients experienced disease recurrence and 21 (17.2%) experienced disease progression. There was no significant difference in mortality between patients with and without diabetes mellitus. There was significant difference in OS between patients without diabetes mellitus, patients with diabetes mellitus on metformin and patients with diabetes mellitus but not on metformin (p = 0.033); patients with diabetes mellitus on metformin had the best prognosis. Metformin use was associated with significantly lower DSS (p = 0.042). Other oral hypoglycaemic agents, insulin or statins were not associated with disease recurrence or progression. CONCLUSION Metformin use was associated with improved oncological outcomes in patients with non-muscle-invasive bladder cancer treated with intravesical BCG. Prospective studies with larger patient populations are needed to validate the role of metformin as potential therapy for bladder cancer.
Adjuvants, Immunologic/therapeutic use* ; Administration, Intravesical ; BCG Vaccine/therapeutic use* ; Diabetes Mellitus ; Disease Progression ; Humans ; Male ; Metformin/therapeutic use* ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Prospective Studies ; Retrospective Studies ; Urinary Bladder Neoplasms/drug therapy*

To investigate the application of bromocresol green Colorimetry (BCG) method in measuring serum albumin (ALB) and to evaluate its influencing factors in different diseases. This study was a cross-sectional study that included 128 people admitted to the department of nephrology, department of general surgery, department of infectious diseases and other departments of the Third Xiangya Hospital of Central South University in July 2021. They were divided into groups according to disease types, including chronic kidney disease group (47 cases), liver disease group (40 cases), other diseases group (41 cases), serum ALB was detected by BCG method and immunoturbidimetry at the same time, and the results were expressed as ALB_BCG and ALB_I respectively, each group was subdivided into three subgroups according to ALB_I results: relatively high-value subgroup, relatively intermediate-value subgroup and relatively low-value subgroup of albumin. ALB_I and ALB_BCG were compared in all groups and subgroups. Passing-Bablok regression and Bland-Altman diagram analysis were used to evaluate the application of ALB_BCG in each group. Immunoturbidimetry was used as a reference method to evaluate the bias of ALB_BCG, and the differences between ALB_I and ALB_BCG were shown as follows:ΔALB= ALB_BCG-ALB_I. Pearson correlation analysis and multiple linear regression analysis were used to assess the correlation between ΔALB and ALB autoconcentration (ALB_I), α₁-globulin, α₂-globulin, β₁-globulin, β₂-globulin, γ-globulin, creatinine (Cr), urea (UN), uric acid (UA), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil), and C-reactive protein (CRP) levels.The results showed that ALB_BCG were higher than ALB_I in the relative low subgroups of total patients group, chronic kidney disease group, liver disease group and other disease groups, and the differences were statistically significant (t value was 8.025, 6.878, 2.628, 4.915, respectively, P<0.05). In the relatively high value subgroup, ALB_BCG was lower than ALB_I, and the differences were statistically significant in the relative high value subgroup of total patients group, liver disease group and other disease groups (t value was -4.388, -2.927, -3.979, P<0.05). Passing-Bablok regression and Bland-Altman analysis showed that the BCG method had proportional bias. In the chronic kidney disease group, the concentrations of ALB_I and Cr had the greatest influence on BCG bias, and the regression model equation was ΔALB=5.437-0.146× Alb_I-0.001 ×Cr, R²=0.505. In the liver disease group, the concentrations of ALB_I, α₁-globulin, β₁-globulin had the greatest influence on BCG bias, and the regression model equation was ΔALB=3.652-0.230×ALB_I+0.398×α₁-globulin+1.171×β₁-globulin, R²=0.658. In the other disease group, the concentration of ALB_I and α₂-globulin had the greatest influence on BCG bias, and the regression equation was ΔALB=5.558-0.225×Alb_I-0.281×α₂-globulin, R²=0.646. The BCG method has a proportion error, and its bias may lead to unacceptable differences. BCG method is mainly affected by the concentration of ALB itself, and may also be affected by α₁-globulin, α ₂-globulin, β₁-globulin, Cr.
BCG Vaccine ; Bilirubin ; Bromcresol Green ; Colorimetry ; Cross-Sectional Studies ; Globulins ; Humans ; Renal Insufficiency, Chronic ; Retrospective Studies ; Serum Albumin/analysis*

HPV vaccination is the most effective way for preventing the cervical cancer. To respond the WHO calling for cervical cancer elimination, some Chinese provincial governments are launching the Free HPV Vaccination Programs for teenagers. Basing on the current stage of domestic utilization and the global immunization strategies of HPV vaccination, this paper provides a comprehensive review of the key aspects in the process of HPV vaccination, including subjects and priority vaccination population, vaccination dose and time interval, the principal of vaccination replacement, and the vaccination suggestion on special populations, etc. The article above contents and gives the advice on the immunization strategy of HPV vaccination in China.
AIDS Vaccines ; Adolescent ; BCG Vaccine ; China ; Diphtheria-Tetanus-Pertussis Vaccine ; Female ; Humans ; Immunization Programs ; Influenza Vaccines ; Measles-Mumps-Rubella Vaccine ; Papillomavirus Infections/prevention & control* ; Papillomavirus Vaccines ; Respiratory Syncytial Virus Vaccines ; SAIDS Vaccines ; Uterine Cervical Neoplasms ; Vaccination

OBJECTIVE: To investigate the role of tumor necrosis factor receptor-associated factor 6 (TRAF6) in regulating Bacillus Calmette-Guérin (BCG)-induced macrophage apoptosis. METHODS: The expression of TRAF6 in peripheral blood samples of 50 patients with active tuberculosis (TB) and 50 healthy individuals were detected using quantitative real-time PCR (qPCR). RAW264.7 macrophages were infected with BCG at different MOI and for different lengths of time, and the changes in expressions of Caspase 3 and TRAF6 were detected with Western blotting and qPCR. In a RAW264.7 cell model of BCG infection with TRAF6 knockdown established using RNA interference technique, the bacterial load was measured and cell apoptotic rate and mitochondrial membrane potential (MMP) were determined with flow cytometry. The expression levels of TRAF6, Caspase 3, PARP, BAX and Bcl-2 in the cells were detected using Western blotting, and the expressions of TRAF6 and Caspase 3 were also examined with immunofluorescence assay. RESULTS: The expression of TRAF6 was significantly upregulated in the peripheral blood of patients with active TB as compared with healthy subjects (P < 0.001). In RAW264.7 cells, BCG infection significantly increased the expressions of Caspase 3 and TRAF6, which were the highest in cells infected for 18 h and at the MOI of 15. TRAF6 knockdown caused a significant increase of bacterial load in BCG-infected macrophages (P=0.05), lowered the cell apoptotic rate (P < 0.001) and reduced the expressions of Caspase 3 (P=0.002) and PARP (P < 0.001). BCG-infected RAW264.7 cells showed a significantly increased MMP (P < 0.001), which was lowered by TRAF6 knockdown (P < 0.001); the cells with both TRAF6 knockdown and BCG infection showed a lowered BAX expression (P=0.005) and an increased expression of Bcl-2 (P=0.04). CONCLUSION TRAF6 promotes BCG-induced macrophage apoptosis by regulating the intrinsic apoptosis pathway.
Apoptosis ; BCG Vaccine ; Caspase 3/metabolism* ; Humans ; Intracellular Signaling Peptides and Proteins ; Macrophages ; Mycobacterium bovis/metabolism* ; Poly(ADP-ribose) Polymerase Inhibitors ; TNF Receptor-Associated Factor 6/metabolism* ; bcl-2-Associated X Protein/metabolism*

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q₁,Q₃) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q₁,Q₃) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.
BCG Vaccine ; Cost of Illness ; Financial Stress ; Humans ; Infant ; Lymphadenitis/epidemiology* ; Male ; Vaccination

INTRODUCTION: Kawasaki disease (KD) is a challenging diagnosis. Erythema and induration of the Bacillus Calmette-Guérin (BCG) site is increasingly recognised as a significant clinical clue. However, there is little data to support its specificity for KD as compared to other febrile illnesses. We aimed to evaluate BCG reaction or induration as a diagnostic tool for KD. METHODS: A retrospective case-controlled study of patients discharged with a diagnosis of KD from 2007 to 2010 was conducted. Another group of patients admitted over the same period for possible KD, but later found not to have KD, served as control. RESULTS: Significantly more infants with KD (69.7%) had BCG site changes than older children (27.8%; p < 0.001). It also presented earlier in the course of KD; < 5 days (53.3%) compared to ≥ 5 days of fever (30.0%; p < 0.001). Positive predictive value of BCG site reaction or induration for KD was 90.8% (95% confidence interval [CI] 0.819-0.962) for infants and 96.2% (95% CI 0.868-0.995) for older children. The prevalence rate of changes at the BCG site was 9.9% among patients with non-KD febrile illnesses and 42.6% among patients with KD. CONCLUSION BCG site reaction or induration is a useful clinical clue for the diagnosis of KD in both infants and older children, with a higher prevalence in infants. Physicians should consider KD in children with febrile illness and redness or crust formation at the BCG site, especially in view of low rates of BCG reaction or induration in non-KD febrile illnesses.
BCG Vaccine ; administration & dosage ; adverse effects ; Case-Control Studies ; Child, Preschool ; Erythema ; complications ; epidemiology ; Female ; Fever ; complications ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; epidemiology ; Risk Factors ; Singapore ; epidemiology

Tuberculosis (TB) is a serious infectious diseases threating human health, bacillus balmette-guerin vaccine (BCG) is the only available TB vaccine now, neonatal vaccination can significantly reduce the incidence and death of tuberculosis. However, due to its limited protection period, one dose vaccination after birth does not have a protective effect for adolescents and adults. Therefore, how to reduce the prevalence of TB in adolescents and adults effectively is essential for TB prevention and control. In this paper, we reviewed the literature from PubMed, CNKI, and Wanfang database to analyze and summarize the characteristics of BCG vaccine, immune effects and immunity endurance, the effects of BCG vaccination and repeated BCG vaccination in adolescents adults and discuse the change of attitude and trends of BCG use in the three documents issued by the World Health Organization on position of BCG.
Adolescent ; Adult ; Age Factors ; BCG Vaccine/immunology* ; Child ; Child, Preschool ; Humans ; Time Factors ; Tuberculosis/prevention & control* ; Tuberculosis Vaccines ; Vaccination ; World Health Organization