Abstract: Objective To investigate the type and distribution of drug resistance of Mycobacterium tuberculosis (MTB) in Hainan tuberculosis hospital from 2019 to 2021, and to provide reference for the development of drug resistant tuberculosis prevention and control strategy. Methods From 2019 to 2021, a total of 1 687 strains of sputum were isolated and cultured and identified as MTB. Drug sensitivity testing was performed on eight anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP, R), ethambutol (EMB), streptomycin (SM), kanamycin (KM), capreomycin (CPM), ofloxacin (OFX), and propylthioisoniacamide (PTO). The drug resistance analysis was conducted. Results Among the 1 687 MTB strains, the overall drug resistance rate was 41.32% (697), with a single drug resistance rate of 11.62% (196), a multi-drug resistance rate of 4.10% (69), a extensive drug resistance rate of 23.71% (400), a pan-drug resistance rate of 1.90% (32), and a rifampicin resistance rate of 28.10% (474), and the main drug resistance types were extensive drug resistance and rifampicin resistance. The order of resistance to the eight drugs was OFX (64) > SM (62) > INH (48) > RFP (19) > CPM (2) > KM (1) > EMB (0) and PTO (0). The rate of resistance to INH and RFP of first-line drugs in newly treated patients was lower than that in retreated patients (χ2=0.110, 0.765; P>0.05); the rate of resistance to second-line drugs OFX, CPM and KM in initially treated patients was lower than that in retreated patients (χ2=1.037, 1.212, 1.653; P>0.05). The total drug resistance rate in 2019 was 51.16%, which was higher than that in 2020 (35.08%) and 2021 (38.89%). The difference between groups was significant (χ2=29.25,16.60; P=0.000), but there was no significant difference in overall drug resistance rate between 2020 and 2021 (χ2=1.823, P=0.177). Among the occupational types of tuberculosis patients, farmers were the main ones, accounting for 56.25% (949). The patients with drug-resistant tuberculosis were mainly distributed in Haikou City (165) > Wanning City (72) > Chengmai County(64) > Wenchang City (51) = Dongfang City (51) > Danzhou City (48), and patients in these six areas accounting for 64.71%(451/697). Conclusions The drug resistance rate of tuberculosis in Hainan Province is relatively high, with OFX and SM resistance being the main types of drug resistance. The extensive drug resistance rate is higher than the national average level. Therefore, surveillance and treatment should be strengthened and optimized to reduce the prevalence of drug-resistant tuberculosis.

Abstract: Objective To investigate the occurrence of multidrug-resistance among tuberculosis patients in Hainan Province from 2014 to 2020 and to analyze the influencing factors, aiming to provide reference for formulating drug-resistant tuberculosis control strategies in this region. Methods This study collected sputum samples from the patients with pulmonary tuberculosis admitted to the Second Affiliated Hospital of Hainan Medical University from 2014 to 2020, and performed isolation and identification of Mycobacterium tuberculosis and drug susceptibility testing. After the strains were identified as positive, drug sensitivity tests were conducted, and multi-drug resistant patients were found. Clinical data was retrospectively collected, and chi-square test and unconditioned logistic regression were used to analyze the influencing factors of multidrug resistance. Results A total of 2 672 patients underwent sputum culture, strain identification, and drug susceptibility testing in TB designated hospitals in Hainan Province from January 1, 2014 to December 31, 2020. Among them, 1 942 patients with available drug susceptibility test results and complete clinical data were enrolled, among which 398 cases with drug-resistant TB were included in the case group, and 1 544 cases without drug resistance were included in the control group. Multivariate logistic regression analysis showed that farmers, rural residence, treatment history of retreatment, irregular medication history, number of pulmonary cavities ≥3, and BMI<18.5 were independent risk factors for MDR-TB. The risk of MDR-TB in farmers was higher than that in non-farmers (OR=1.542, 95%CI: 1.150-2.020); patients living in rural areas had a higher risk of multidrug resistance than those living in urban areas (OR=1.445, 95%CI: 1.095-1.907); the risk of MDR in the retreatment patients was higher than that in the initial treatment patients (OR=5.616, 95%CI: 4.250-7.421); the risk of multi-drug resistance in patients with irregular medication was higher than that in patients with regular medication (OR=2.665, 95%CI: 2.012-3.531); the risk of multidrug resistance in patients with pulmonary cavity number ≥3 was higher than that in patients with pulmonary cavity number <3 (OR=5.040, 95%CI: 3.768-6.740); compared with patients with BMI<18.5, patients with BMI=18.5-24.0 and BMI≥24.0 had a lower risk of multidrug resistance (OR=0.735, 95%CI: 0.555-0.975 and OR=0.447，95%CI:0.225-0.888, respectively). Conclusions Retreatment, farmer occupation, rural residence, irregular medication and low BMI may be the risk factors for multidrug resistance in Hainan Province.

Objective To evaluate the safety of national immunization program (NIP) vaccines and non-NIP vaccines in Fujian Province from 2011 to 2015.Methods The adverse events following immunization (AEFI) case information reported in Fujian Province from 2011 to 2015 was collected from the National AEFI Information Management System and vaccination data of NIP vaccines (11 species) and nonNIP vaccines (19 species) in the same period in Fujian Province were collected from the National Immunization Program Information Management System.The collected monitoring data were descriptively analyzed.The total and severe AEFI reporting rates and their 95％ confidence intervals (CI) were calculated.Results From 2011 to 2015,a total of 70 976 300 doses of vaccines were inoculated in Fujian Province and a total of 8 987 cases of AEFI were reported,including 192 cases (2.14％) of severe AEFI.The incidence (95％CI) of reported AEFI was 12.66 (12.40-12.93) per 100 000 doses and the incidence (95％CI) of reported severe AEFI was 2.71 (2.34-3.12) per one million doses.A total of 55 702 100 doses of NIP vaccines were inoculated and 7 347 cases of AEFI were reported,of which 138 (1.88％) were severe AEFI cases.The incidence (95％ CI) of reported AEFI was 13.19 (12.89-1.49)per 100 000 doses of NIP vaccines and the incidence (95％ CI) of reported severe AEFI was 2.48 (2.08-2.93) per one million doses.Among the 11 NIP vaccines,the incidence (95％ CI) of reported AEFI ranged from 0.95 (0.88-1.13) per 100 000 doses to 43.71 (40.72-46.75) per 100 000 doses and the incidence (95％ CI) of reported severe AEFI ranged from 1.04 (0.32-1.76) per one million doses to 6.41 (2.78-10.04) per one million doses.A total of 15 271 600 doses of non-NIP vaccines were inoculated and 1 640 cases of AEFI were reported,of which 54 (3.54％) were severe AEFI cases.The total incidence (95％ CI) of reported AEFI was 10.74 (10.23-11.27) per 100 000 doses and the incidence (95％ CI) of reported severe AEFI was 3.54 (2.66-4.61) per one million doses.Among the 19 non-NIP vaccines,the incidence (95 ％ CI) of reported AEFI ranged from 2.06 (0.38-3.71) per 100 000 doses to 45.22 (35.29-55.10)per 100 000 doses and the incidence (95％ CI) of reported severe AEFI ranged from 0.52 (0-1.53) per one million doses to 20.89 (0-44.51) per one million doses.Conclusion From 2011 to 2015,the incidences of reported AEFI and severe AEFI for NIP and non-NIP vaccines circulated in Fujian Province were low,which had good safety.

Objective To evaluate the safety of national immunization program (NIP) vaccines and non-NIP vaccines in Fujian Province from 2011 to 2015.Methods The adverse events following immunization (AEFI) case information reported in Fujian Province from 2011 to 2015 was collected from the National AEFI Information Management System and vaccination data of NIP vaccines (11 species) and nonNIP vaccines (19 species) in the same period in Fujian Province were collected from the National Immunization Program Information Management System.The collected monitoring data were descriptively analyzed.The total and severe AEFI reporting rates and their 95％ confidence intervals (CI) were calculated.Results From 2011 to 2015,a total of 70 976 300 doses of vaccines were inoculated in Fujian Province and a total of 8 987 cases of AEFI were reported,including 192 cases (2.14％) of severe AEFI.The incidence (95％CI) of reported AEFI was 12.66 (12.40-12.93) per 100 000 doses and the incidence (95％CI) of reported severe AEFI was 2.71 (2.34-3.12) per one million doses.A total of 55 702 100 doses of NIP vaccines were inoculated and 7 347 cases of AEFI were reported,of which 138 (1.88％) were severe AEFI cases.The incidence (95％ CI) of reported AEFI was 13.19 (12.89-1.49)per 100 000 doses of NIP vaccines and the incidence (95％ CI) of reported severe AEFI was 2.48 (2.08-2.93) per one million doses.Among the 11 NIP vaccines,the incidence (95％ CI) of reported AEFI ranged from 0.95 (0.88-1.13) per 100 000 doses to 43.71 (40.72-46.75) per 100 000 doses and the incidence (95％ CI) of reported severe AEFI ranged from 1.04 (0.32-1.76) per one million doses to 6.41 (2.78-10.04) per one million doses.A total of 15 271 600 doses of non-NIP vaccines were inoculated and 1 640 cases of AEFI were reported,of which 54 (3.54％) were severe AEFI cases.The total incidence (95％ CI) of reported AEFI was 10.74 (10.23-11.27) per 100 000 doses and the incidence (95％ CI) of reported severe AEFI was 3.54 (2.66-4.61) per one million doses.Among the 19 non-NIP vaccines,the incidence (95 ％ CI) of reported AEFI ranged from 2.06 (0.38-3.71) per 100 000 doses to 45.22 (35.29-55.10)per 100 000 doses and the incidence (95％ CI) of reported severe AEFI ranged from 0.52 (0-1.53) per one million doses to 20.89 (0-44.51) per one million doses.Conclusion From 2011 to 2015,the incidences of reported AEFI and severe AEFI for NIP and non-NIP vaccines circulated in Fujian Province were low,which had good safety.

Objective To investigate the anti carcinoma role of integrin targeted photodynamic therapy (PDT) on pancreatic carcinoma cells in vitro.Methods Pancreatic carcinoma cells SW1990 were divided into four groups:cells without quantum dots (QDs) and light-treated as blank control group,pure light-treated group,photosensitizer group and PDT group.The targeting of QDs-arginine,glycine,aspartic acid (RGD) and integrin probe was confirmed by laser confocal microscopy.And as a photosensitizer for photodynamic therapy,after treated for 48 hours the morphology changes of pancreatic carcinoma cells of each group were observed.After 48 hours,the cell proliferation,apoptosis and cell cycle changes were detected by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry (FCM).The expressions of myeloid cell leukemia-1 (Mcl-1),protein kinase B(Akt) and tumor necrosis factor-related apoptosis inducing ligand (TRAIL) were detected by reverse transcriptase polymerase chain reaction(RT-PCR).The amount of reactive oxygen species (ROS) of each group were evaluated by fluorescence probe.One-way ANOVA was performed for comparison between groups to analyze the treatment effects of PDT group.Results The QDs RGD probe could effectively targeting pancreatic carcinoma cells.The MTT results indicated that the relative inhibition rate of pancreatic carcinoma cells proliferation of PDT group was statistically higher than that of the other groups at 24,48,72 h (F=73.00,85.10,126.58; all P＜0.01).The FCM results revealed that the cell apoptosis rate of PDT group (17.860％ ±1.230％) was higher than that of the other groups (F=130.617,P＜0.01) and cell cycle G0/G1 phase (69.14％±2.63％) and S phase (24.41％ ± 2.67 ％) retardance was also significant (all P＜0.05).The expression of proliferation and apoptosis related gene Mcl-1 and Akt at mRNA level was lower than that of the other groups however the expression of apoptosis-inducing ligand TRAIL at mRNA level was higher than that of the other groups (F=567.456,446.817,145.238; all P＜0.05).The ROS level of PDT group was higher than that of the other groups (F=3262.559,P＜0.01).Conclusion PDT with a QDs-RGD probe could significantly inhibit pancreatic carcinoma cell proliferation and promote cell apoptosis.

Objective To discuss the validity and the feasibility of modified specific immunotherapy of hypoglossis allergen in the treatment of children allergic asthma. Methods 100 children with allergic asthma were selected from October,2007 to April ,2008 in our hospital and divided into the observation group and the control group. The control group adopted routine method, the observation group made modifi-cation based upon routine nursing, placing emphasis on intervention of cognition and behavior of children and their parents, improvement of treatment compliance, whole- process, dynamic and continuous observa-tion of the treatment process, making individualized health education plan. The treatment compliance, total score of asthma control, and pulmonary function examination of impulse oscillation(IOS) were compared be-tween the two groups. Results The observation group was superior to the control group in treatment com-pliance, pulmonary function examination and the control results of asthma. Conclusions Specific im-munotherapy of hypoglossis allergen combined with modified nursing method can increase treatment com-pliance of children and lead to better results.

Aim To study the inhibitory effect of ginkgolide B (BN52021) on the PAF induced changes of chemotaxis of murine peritoneal macrophages and the related polymerization of F-actin.Methods Chemotaxis assays were performed using a modified 48-well Boyden chamber. Actin polymerization of murine peritoneal macrophages was analyzed by flow cytometry using a specific fluorescent stain. Results Peritoneal macrophages significantly migrated toward platelet-activating factor(PAF) through a micropore filter; however, in the presence of PAF receptor antagonist BN52021 (0. 01the actin polymerization of murine peritoneal macrophages induced by PAF in the presence of Ca2+ , but not in Ca2+ -free medium. Conclusion The results suggested that preventing polymerization of F-actin may be a pathway by BN52021 to inhibit the chemotaxis of macrophages, and this effect seems to be Ca2+dependent. The data further indicated that inhibition of PAF induced macrophage chemotaxis is an important mechanism underlying the anti-inflammatory action of BN52021.

AIM: To observe the effects of different doses of L-dopa on the rotational behavior and amounts of cells expressing D_2 receptors in striatum in hemiparkinsonian rats.METHODS: A hemiparkinsonian model was established in rats by pretreatment with 6-hydroxydopamine.The D_2 receptor expression were detected by immunohistochemical staining.The numbers of rotations induced by apomorphine was counted within 30 min before and after L-dopa(10 mg?kg~(-1)?d~(-1),50 mg?kg~(-1)?d~(-1) or 100 mg?kg~(-1)?d~(-1),ip) was introduced to Parkinson's disease(PD) model rats for 15 days.RESULTS: In successful PD model rats,the increased percentage of D_2 receptor in lesioned side compared with intact side was associated linearly with the numbers of rotations within 30 min(r=0.927,P

AIM: By Applying magnetic resonance spectroscopy(MRS) to distinguish delayed neuronal death and reactive glial proliferation in ipsilateral hippocampus of MCAO reperfusion rats.METHODS: Sixteen adult Wistar rats with MCA occlusion for 1 h then perfusion through remove the embolus were used in the experiment.10 pseudooperaton rats were served as control.MRS and pathologic examination were performed six weeks after operation.The hippocampus modality,cell density and immunohistochemical results with N-acetylaspartate,creatine and myo-inositol changes were compared.RESULTS: The values of NAA,Cr and NAA/Cr ratio of ipsilateral hippocampus lesion in MCAO reperfusion rats(2.05?0.33,2.42?0.41 and 0.86?0.10) were decreased distinctly than those in opposite side(3.45?0.58,3.10?0.93,1.18?0.32) and control group(3.42?0.43,3.57?0.47,0.98?0.14).MI value and mI/Cr ratio in ischemic hippocampus(1.47,1.30) were visible increased than those in control group(0.15,0.15).CONCLUSIONS: MRS is a perfect technique for observing the cellular metabolic changes in CA1 region.Decrease in NAA resulted from neuron delayed injury and increase in mI resulted from reactive astrocytes proliferation can be matched respectively.However,the decrease in NAA is not perfectly corresponded to the degree of neuron lost.This change has closed correlation with reactive astrocytes proliferation.

0.05,respectively).Plasma Mg2+,intracellular Mg2+,the beta 2-AR mRNA and protein in lung tissue in group C at 21st d and 34th d were significantly higher than those in group A at 21st d and 34th d 21st d:(0.84?0.09)mmol/L vs 0.57?0.10)mmol/L,(2.39?0.14)mmol/L vs(2.11?0.08)mmol/L,(0.75?0.09)pmol/g vs(0.59?0.06)pmol/g,(88.50?8.50)pmol/g vs(60.10?7.70)pmol/g,P