Objective:To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) in Shaanxi Province from 2015 to 2023, and provide reference for the prevention and control of pulmonary TB in Shaanxi.Methods:The registration data of etiologically positive pulmonary TB cases in Shaanxi from 2015 to 2023 were collected from the tuberculosis subsystem of Chinese Disease Control and Prevention Information System. Descriptive method was used to analyze the basic characteristics of the etiologically positive pulmonary TB cases. Linear trend χ2 test was used to analyze trends in registration rate and pathogen positive rate. Software SPSS 25.0 was used for statistical analysis. Software ArcGIS 10.8 was used for global spatial autocorrelation and hotspot analysis to explore spatial clustering of the etiologically positive pulmonary TB cases. Software SaTScan 10.0 was used for spatiotemporal scan statistics, and software ArcGIS 10.8 was used to visualize the spatiotemporal clustering. Results:A total of 64 148 cases of etiologically positive pulmonary TB were registered in Shaanxi from 2015 to 2023, with an average annual registration rate of 18.33/100 000. The registration rate and pathgen positive rate all showed upward trends from 2015 to 2023, and the differences were significant (the trend χ2=4 555.18 and 19 330.43, both P<0.001). Global spatial autocorrelation and hotspot analysis showed that the registration rate of etiologically positive pulmonary TB in Shaanxi from 2017 to 2023 showed a spatial clustering. The hotspots were mainly in Zhenba and Xixiang counties of Hanzhong, six counties (districts) of Ankang, and Yanchuan and Yanchang counties of Yan'an. The coldspots were mainly in parts of the Guanzhong area, including Baoji, Xi'an, and Xianyang. A total of 4 spatiotemporal clustering areas were explored by spatiotemporal scanning analysis (all P<0.001), in which the first-level clustering areas covered 17 counties (districts), mainly Zhenping, Ziyang, Zhenba, in southern Shaanxi from 2019 to 2022, the second-level clustering areas covered 6 counties (districts), mainly Yanchuan, Yanchang, Qingjian, in northern Shaanxi from 2018 to 2021, the third-level clustering areas covered 14 counties (districts), mainly Yanta, Chang'an, Jingyang, in Guanzhong area from 2018 to 2019, and the fourth-level clustering areas covered 10 counties (districts) from 2019 to 2021. Conclusions:The registration rate of labortory confirmed pulmonary TB cases in Shaanxi showed an upward trend, with obvious differences in spatiotemporal clustering distribution. The clustering areas were mainly in southern Shaanxi, such as Zhenba, Zhenping, Hanbin, Langao, Pingli, Xunyang, Ziyang counties, and northern Shaanxi, such as Yanchuan and Yanchang counties, as well as in capital city, Xi'an and the adjacent Guanzhong area. It is necessary to develope targeted measures according to local conditions for the improvement of pulmonary TB prevention and control strategies in Shaanxi.

Objective:To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) in Shaanxi Province from 2015 to 2023, and provide reference for the prevention and control of pulmonary TB in Shaanxi.Methods:The registration data of etiologically positive pulmonary TB cases in Shaanxi from 2015 to 2023 were collected from the tuberculosis subsystem of Chinese Disease Control and Prevention Information System. Descriptive method was used to analyze the basic characteristics of the etiologically positive pulmonary TB cases. Linear trend χ2 test was used to analyze trends in registration rate and pathogen positive rate. Software SPSS 25.0 was used for statistical analysis. Software ArcGIS 10.8 was used for global spatial autocorrelation and hotspot analysis to explore spatial clustering of the etiologically positive pulmonary TB cases. Software SaTScan 10.0 was used for spatiotemporal scan statistics, and software ArcGIS 10.8 was used to visualize the spatiotemporal clustering. Results:A total of 64 148 cases of etiologically positive pulmonary TB were registered in Shaanxi from 2015 to 2023, with an average annual registration rate of 18.33/100 000. The registration rate and pathgen positive rate all showed upward trends from 2015 to 2023, and the differences were significant (the trend χ2=4 555.18 and 19 330.43, both P<0.001). Global spatial autocorrelation and hotspot analysis showed that the registration rate of etiologically positive pulmonary TB in Shaanxi from 2017 to 2023 showed a spatial clustering. The hotspots were mainly in Zhenba and Xixiang counties of Hanzhong, six counties (districts) of Ankang, and Yanchuan and Yanchang counties of Yan'an. The coldspots were mainly in parts of the Guanzhong area, including Baoji, Xi'an, and Xianyang. A total of 4 spatiotemporal clustering areas were explored by spatiotemporal scanning analysis (all P<0.001), in which the first-level clustering areas covered 17 counties (districts), mainly Zhenping, Ziyang, Zhenba, in southern Shaanxi from 2019 to 2022, the second-level clustering areas covered 6 counties (districts), mainly Yanchuan, Yanchang, Qingjian, in northern Shaanxi from 2018 to 2021, the third-level clustering areas covered 14 counties (districts), mainly Yanta, Chang'an, Jingyang, in Guanzhong area from 2018 to 2019, and the fourth-level clustering areas covered 10 counties (districts) from 2019 to 2021. Conclusions:The registration rate of labortory confirmed pulmonary TB cases in Shaanxi showed an upward trend, with obvious differences in spatiotemporal clustering distribution. The clustering areas were mainly in southern Shaanxi, such as Zhenba, Zhenping, Hanbin, Langao, Pingli, Xunyang, Ziyang counties, and northern Shaanxi, such as Yanchuan and Yanchang counties, as well as in capital city, Xi'an and the adjacent Guanzhong area. It is necessary to develope targeted measures according to local conditions for the improvement of pulmonary TB prevention and control strategies in Shaanxi.

BACKGROUND:Bone marrow stem cell transplantation can improve heart function and prevent ventricle remodeling.At present,the adult bone marrow stem cells used for transplantation primarily included bone marrow mononuclear cells (BM-MNCs) and mesenchymal stem cells (MSCs),and endothelial progenitor cells.The curative effects and precise mechanisms of transplantation of various bone marrow stem cells remain unknown.OBJECTIVE:To compare the effects of transplantation of autologous BM-MNCs and MSCs via the coronary artery on ventricle remodeling subsequent to acute myocardial infarction (AMI). DESIGN,TIME AND SETTING:Randomized controlled animal experiment performed at the Center for Clinical Research,Hebei Provincial People's Hospital,Electron Microscope Room,Hebei Medical University between March 2005 and December 2006.MATERIALS:Thirty-six male Jizhong pigs,were randomly divided into 4 groups:control group (n = 6),infarct model group (n = 10),BM-MNC group (n = 10),and MSC group (n = 10).METHODS:Porcine autologous BM-MNCs were isolated by gradient density centrifugation,and MSCs were obtained by adherence method.Prior to transplantation,both BM-MNCs and MSCs were colloidal gold labeled.Except the infract model group,pigs in the other 3 groups were developed into AMI models by oppressing the left anterior descending branch with balloon catheter.Ninety minutes after modeling,(6.0±1.3)×107 autologous BM-MNCs and (4.5±2.1)x 107 MSCs were respectively transplanted into pigs in the BM-MNC group and the MSC group via the coronary artery and cultured for 28 days.MAIN OUTCOME MEASURES:Observation of pathological changes of cardiac muscle tissue by light and electron microscope;Examination of cardiac function by ultrasonograph;Detection of the number of blood vessels and apoptotic myocardial cells,and expression of nuclear factor-κB (NF-κB) and troponin Ⅰ and its correlation to cardiac function by immunohistochemistry;Detection of mRNA expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the cardiac tissue as well as its correlation to cardiac function by reverse transcription-polymerase chain reaction (RT-PCR).RESULTS:In the MSC group,there was proliferation of a great deal of blood vessels as well as growth of abnormal cell masses around the coronary vessels,while the BM-MNC group exhibited the "budding" of many capillary vessels.Prior to transplantation,cardiac function indices were basically similar among each group (F = 1.550,P＞0.05).Twenty-eight days after transplantation,left ventricular ejection fraction was significantly lower in the control,BM-MNC,and MSC groups than in the infarct model group (F = 5.30,P＜0.05),while endocardial fractional shortening was significantly higher (F = 10.67,P＜0.01).Compared with the infarct model group,the number of blood vessels in the infarct zone and infarct border zone was increased in the BM-MNC group (F=29.56-34.87,P＜0.01) and had no apparent change in the MSC group.In the BM-MNC and MSC groups,apoptotic myocardial cells in the infarct zone and infarct border zone were significantly reduced (F=14.31-35.34,P＜0.01 ) and troponin I expression rate was significantly increased (F=19.05,P＜0.01 ),as compared with the infarct model group.In addition,NF-κB positive rate in the infarct border zone was significantly lower in the BM-MNC and MSC groups than in the infarct model group (F=19.05,P＜0.01).VEGF gene expression level in the infarct border zone was significandy higher in the BM-MNC group than in the infarct model group and MSC group (F = 49.41,P＜0.01).bFGF gene expression level in the infarct border zone was significantly higher in the MSC group than in the infarct model and BM-MNC groups (F=4.71,P＜0.01).LVEF was negatively correlated to myocardial cell apoptosis rate and NF-κB level (r=-0.441 1,P＜0.05;r=-0.579 6,P＜0.01 ).LVEF was positively correlated to number of blood vessels,VEGF and bFGF expression (r=0.775,P＜0.01;r=0.565 1,P＜0.05;r=0.573 5,P＜0.05).CONCLUSION:Transplantation of both autologous BM-MNC and MSC via coronary artery can improve the condition of left ventricular remodeling subsequent to myocardial infarction.The improvement of cardiac functions is related to the increase of blood vessels,VEGF and bFGF expression,the decrease of myocardial cell apoptosis and NF-κ B level in cardiac muscle tissues after stem cell transplantation.BM-MNC transplantation better promotes blood vessel proliferation and VEGF expression in the cardiac tissue but produces worse effects on bFGF gene expression than MSC transplantation.