Objective:To assess the burden and development trends of tuberculosis (TB) in China from 1990 to 2021 to provide a reference for TB prevention strategies.Methods:Utilizing the 2021 Global Burden of Disease Study data, the study evaluates the burden of TB and latent TB infection (LTBI) in China using age-standardized incidence, prevalence, disability-adjusted life years (DALYs), and infection rates. The Joinpoint regression model was employed to analyze changing trends, and the autoregressive moving average model was integrated to forecast multidrug-resistant TB incidence and LTBI infection rates from 2022 to 2030.Results:In 2021, the age-standardized TB incidence in China was 36.28 per 100 000, the age-standardized prevalence was 30 557.45 per 100 000, the age-standardized DALY rate was 76.22 per 100 000, and the LTBI age-standardized infection rate was 30.48%. Compared to 1990, these figures dropped by 66.72%, 2.82%, 89.41%, and 2.47%, respectively. The age-standardized incidence, prevalence, DALY rate, and infection rate were elevated in individuals aged ≥70 years, and the TB burden was greater in males than in females. The age-standardized TB incidence declined between 1990 and 2021, while the proportion of multidrug-resistant TB patients among newly diagnosed cases, nationwide rose from 3.11% (36 367/1 167 807) in 1990 to 4.12% (25 431/617 725) in 2021. The LTBI age-standardized infection rate exhibited a fluctuating declining trend, averaging a decrease of 0.09%. Predictions for 2022-2030 indicate that China's multidrug-resistant TB incidence will decline slowly, and the LTBI infection rate will initially rise and then gradually fall, reaching 1.10/100 000 and 31.11%, respectively, by 2030.Conclusions:The TB burden in China declined from 1990 to 2021, but TB prevalence and LTBI infection rates remain high, especially among multidrug-resistant cases, males, and the elderly. Implementing systematic LTBI interventions, enhancing early detection/diagnosis in key populations such as the elderly, and promoting short-course treatments are recommended.

Objective To observe the value of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies.Methods Totally 118 fetuses with intracranial anomalies diagnosed through cranial MRI/induced labor specimen dissection who underwent prenatal ultrasound examination were retrospectively enrolled.Two-dimensional,three-dimensional ultrasound and microvascular flow imaging manifestations of fetal intracranial anomalies were observed,and the accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was analyzed.Results The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was 93.22％(110/118),of isolated and non-isolated intracranial anomalies was 97.47％(77/79)and 84.62％(33/39),respectively.Six fetuses were missed diagnosis of malformations of cortical development(1 fetus of tuberous sclerosis,4 of abnormal morphology of the sulci gyrus and 1 of schizencephaly)and 1 fetus of intracranial softening lesion,while posterior fossa arachnoid cyst in 1 fetus was misdiagnosed as mega cisterna magna.Conclusion The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was relatively high.

Objective To observe prenatal ultrasonic findings of fetal malformation of cortical development(MCD).Methods Totally 37 singleton fetuses with MCD diagnosed by fetal cranial MRI and/or genetic examination were retrospectively enrolled,and prenatal ultrasonic manifestations were observed.Results Among 37 fetuses,29(29/37,78.38％)were found with abnormal Sylvian fissure,26(26/37,70.27％)with widened/asymmetrical lateral ventricles,22(22/37,59.46％)with abnormal surface sulci,14(14/37,37.84％)with abnormal cavity of septum pellucidum(CSP)/corpus callosum(CC),11(11/37,29.73％)with midline deviation/curvature,11(11/37,29.73％)with widened subarachnoid space,10(10/37,27.03％)with head circumference＜2 standard deviation below mean value,9(9/37,24.32％)with abnormalities in the cerebellar hemisphere/vermis,7(7/37,18.92％)with abnormal echoes in the brain parenchyma,7(7/37,18.92％)with midline cysts and 2(2/37,5.41％)with enlarged ganglion eminence.Conclusion Fetal MCD mainly presented as abnormal Sylvian fissure,widened/asymmetrical lateral ventricles and abnormal surface sulci,which might accompanied by abnormal CSP/CC,midline deviation/curvature,widened subarachnoid space and abnormal head circumference in prenatal ultrasound.

Objective:To assess the burden and development trends of tuberculosis (TB) in China from 1990 to 2021 to provide a reference for TB prevention strategies.Methods:Utilizing the 2021 Global Burden of Disease Study data, the study evaluates the burden of TB and latent TB infection (LTBI) in China using age-standardized incidence, prevalence, disability-adjusted life years (DALYs), and infection rates. The Joinpoint regression model was employed to analyze changing trends, and the autoregressive moving average model was integrated to forecast multidrug-resistant TB incidence and LTBI infection rates from 2022 to 2030.Results:In 2021, the age-standardized TB incidence in China was 36.28 per 100 000, the age-standardized prevalence was 30 557.45 per 100 000, the age-standardized DALY rate was 76.22 per 100 000, and the LTBI age-standardized infection rate was 30.48%. Compared to 1990, these figures dropped by 66.72%, 2.82%, 89.41%, and 2.47%, respectively. The age-standardized incidence, prevalence, DALY rate, and infection rate were elevated in individuals aged ≥70 years, and the TB burden was greater in males than in females. The age-standardized TB incidence declined between 1990 and 2021, while the proportion of multidrug-resistant TB patients among newly diagnosed cases, nationwide rose from 3.11% (36 367/1 167 807) in 1990 to 4.12% (25 431/617 725) in 2021. The LTBI age-standardized infection rate exhibited a fluctuating declining trend, averaging a decrease of 0.09%. Predictions for 2022-2030 indicate that China's multidrug-resistant TB incidence will decline slowly, and the LTBI infection rate will initially rise and then gradually fall, reaching 1.10/100 000 and 31.11%, respectively, by 2030.Conclusions:The TB burden in China declined from 1990 to 2021, but TB prevalence and LTBI infection rates remain high, especially among multidrug-resistant cases, males, and the elderly. Implementing systematic LTBI interventions, enhancing early detection/diagnosis in key populations such as the elderly, and promoting short-course treatments are recommended.

Objective To observe the value of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies.Methods Totally 118 fetuses with intracranial anomalies diagnosed through cranial MRI/induced labor specimen dissection who underwent prenatal ultrasound examination were retrospectively enrolled.Two-dimensional,three-dimensional ultrasound and microvascular flow imaging manifestations of fetal intracranial anomalies were observed,and the accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was analyzed.Results The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was 93.22％(110/118),of isolated and non-isolated intracranial anomalies was 97.47％(77/79)and 84.62％(33/39),respectively.Six fetuses were missed diagnosis of malformations of cortical development(1 fetus of tuberous sclerosis,4 of abnormal morphology of the sulci gyrus and 1 of schizencephaly)and 1 fetus of intracranial softening lesion,while posterior fossa arachnoid cyst in 1 fetus was misdiagnosed as mega cisterna magna.Conclusion The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was relatively high.

Objective To observe prenatal ultrasonic findings of fetal malformation of cortical development(MCD).Methods Totally 37 singleton fetuses with MCD diagnosed by fetal cranial MRI and/or genetic examination were retrospectively enrolled,and prenatal ultrasonic manifestations were observed.Results Among 37 fetuses,29(29/37,78.38％)were found with abnormal Sylvian fissure,26(26/37,70.27％)with widened/asymmetrical lateral ventricles,22(22/37,59.46％)with abnormal surface sulci,14(14/37,37.84％)with abnormal cavity of septum pellucidum(CSP)/corpus callosum(CC),11(11/37,29.73％)with midline deviation/curvature,11(11/37,29.73％)with widened subarachnoid space,10(10/37,27.03％)with head circumference＜2 standard deviation below mean value,9(9/37,24.32％)with abnormalities in the cerebellar hemisphere/vermis,7(7/37,18.92％)with abnormal echoes in the brain parenchyma,7(7/37,18.92％)with midline cysts and 2(2/37,5.41％)with enlarged ganglion eminence.Conclusion Fetal MCD mainly presented as abnormal Sylvian fissure,widened/asymmetrical lateral ventricles and abnormal surface sulci,which might accompanied by abnormal CSP/CC,midline deviation/curvature,widened subarachnoid space and abnormal head circumference in prenatal ultrasound.

Objective:To summarize the prenatal ultrasound characteristics of fetal malformations with amniotic band syndrome (ABS) in early pregnancy, in order to improve the ultrasound detection rate of this disease.Methods:Pregnant women who underwent systematic ultrasound screening of early pregnancy fetal malformations in Beijing Obstetrics and Gynecology Hospital from January 2017 to October 2023 were retrospectively collected. Twenty-three cases of early pregnancy ABS were collected and confirmed by ultrasound diagnosis and induced abortion results. Clinical data, images, and examination results of these cases were studied and the ultrasound characteristics of early pregnancy ABS were summarized.Results:In all 23 cases, adhesions between the intrauterine amniotic band and the affected parts of the fetus were found during ultrasonography, and the malformations in each case were different and closely related to the damage to different body surface parts of the fetus. Multiple fetal malformations accounted for 78% (18/23) and single cases accounted for only 22% (5/23). Among the 23 cases, 19 (83%) involved fetal limbs, 11 (48%) brains, 11 (48%) thoracic and abdominal walls, 10 (43%) spine, 5 (22%) faces, and 5 (22%) umbilical cords.23 (100%) patients were confirmed to have ABS after induction of labor, which was consistent with the ultrasound diagnosis, but 11 (48%) of them did not accurately describe fetal limb or facial abnormalities.Conclusions:The fetal malformation of ABS in the first trimester is closely related to the amniotic band, which has the characteristics of multiple properties, uniqueness, randomness and asymmetry. The most affected parts are the fetal limbs, brain, and body wall, and severe malformations are common.Prenatal ultrasound can provide suggestive diagnosis.

Objective To investigate serum vitamin D levels in tuberculosis (TB) patients with different blood glucose status.Methods Two hundred and forty seven TB patients were recruited from tuberculosis clinics in Jilin province and 80 normal subjects who underwent health check up in Beijing Hospital served as controls.Blood samples were collected,fasting blood glucose (FBG) and serum vitamin D [25 (OH)D] levels were measured.Results FBG results showed that there were 95 patients with normal FBG,69 with pre-diabetes (pre-DM) and 83 with diabetes mellitus (DM).Vitamin D measurement showed that 25(OH) D level in TB patients with normal FBG,pre-DM and DM was 16.1 (10.7,26.2) μg/L,12.9 (9.6,20.1) μg/L and 12.4 (10.4,16.9) μg/L,respectively,(x2 =19.608,P ＜ 0.001) and were much lower than that in the normal controls (20.5 μg/L) (x2 =21.701,P ＜ 0.001).Proportion of TB patients with 25 (OH)D sever deficiency(＜ 10.0 μg/L)in patients with normal FBG,pre-DM and DM was 20.0％ (19/95),31.9％ (22/69),and 24.1％ (20/83) respectively (x2 =6.376,P ＜ 0.05);proportion of 25 (OH) D deficiency (10.0-19.9 ng/ml) in three groups was 41.1％ (39/95),40.6％ (28/69),and 57.8 ％ (48/83),respectively (x2 =15.141,P ＜ 0.05);sufficient 25 (OH) D (≥ 30.0 μg/L) was 14.7％ (14/95),7.2％ (5/69),and 1.2％ (1/83),respectively (x2 =19.118;P ＜0.05).While the proportion of TB patient with 25 (OH) D insufficiency (20.0-29.9 ng/ml) was 24.2％ (23/95),20.3％ (14/69),and 16.9％ (14/48) respectively (x2 =0.933,P =0.627).In TB patients with normal FBG,risk factors for 25 (OH) D deficiency were smoking (OR =5.619,95％ CI:1.293-24.424,P =0.021),cold season (OR =14.402,95％CI:4.070-50.965,P ＜ 0.001) and smear negative TB (OR =6.194,95 ％ CI:1.873-20.481,P =0.003).Living in rural area (OR =3.429,95％ CI:1.040-11.299,P =0.043) was the risk factor for 25 (OH) D deficiency in TB patients with pre-DM and age ≥ 60 years (OR =2.474,95％CI:1.086-5.623,P =0.031) was risk factor for 25 (OH) D deficiency in those with DM.Conclusions Vitamin D level is lower in TB patients than that in normal controls.The diabetic TB patients have the lowest 25 (OH) D level and have highest proportion of vitamin D deficiency and sever deficiency,particularly for elderly patients.

Objectives To explore the clinical value of preoperative three-dimensional ultrasound imaging for ovarian tumors for reflecting the anatomy postoperatively.Methods Forty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital,Capital Medical University were evaluated by two-dimensional (2D) and three-dimensional (3D) ultrasound examination within one week before surgery from January 2008 to December 2009.Every ovarian mass was examined by three-dimensional ultrasound and tomographic ultrasound imaging (TUI) and the results was compared with the specimen postoperatively.Results Forty-seven ovarian masses were confirmed by pathology,including 23 benign masses and 24 malignant masses (six borderline tumors).Compared with the postoperative specimens,the accuracy of preoperative 3D ultrasound imaging of ovarian tumors for the anatomical structures was 89.4％ (42/47).The misdiagnosis causes in 5 cases included failure to detect tiny papillae on the Sturface and small cysts in the mass,failure to display the compressed structures accurately,wrongly believe the teeth on the tumor wall as papillae and wrongly believe two adjacent ovarian tumors as one unilateral mass.Conclusions Compared with postoperative specimens,the anatomy of ovarian tumors could be reflected accurately by 3D ultrasound imaging preoperatively.It could be helpful for differential diagnosis between benign and malignant ovarian tumors and the decision of surgical plan.

Objective To evaluate the correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density (MVD).Methods Fifty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital,Capital Medical University were evaluated by three-dimensional (3D) power ultrasound within one week before surgery from January 2008 to December 2009.We captured 3D power imaging in the interested and solid areas of tumors,and used three-dimensional histogram from virtual organ computer-aid analysis (VOCAL) to calculate vascularization index (Ⅵ),flow index (FI) and vascularization-flow index (VFI).After operation the specimens underwent immunohistochemistry staining and MVD and vascular endothelial growth factor (VEGF) were calculated.Two independent-samples t tests were used to compare MVD between ovarian benign and malignant tumors.Rank sum test was used to compare VEGF.Spearman was used to analyze the relationship between 3D PD vascular indices and MVD.Results Sixty-two ovarian masses in 57 patients were confirmed by pathology (5 cases were bilateral tumors),including 22 benign and forty malignant messes (including eight borderline tumors).Fifty-four tumors underwent immunohistochemistry staining.MVD and VEGF were calculated.Both of MVD and VEGF in ovarian malignant tumors were obviously higher than those in benign ones (t=-5.255,Z=-3.868,both P ＜ 0.01).Both of Ⅵ and VFI were positive correlative to MVD (r=0.295,0.280,both P ＜ 0.05).Conclusions There was a positive correlation between vascular indexes and microvessel density.The vascular indexes could reflect the density of angiogenesis in ovarian tumors before surgery,and they could provide valuable information for early-stage diagnosis of ovarian cancer.