Tuberculosis remains a significant global public health threat.Early diagnosis and effective treatment are crucial to combat this disease.Yet,traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity,extended detection periods,and dependence on sputum samples.Molecular diagnostic techniques,while offering higher sensitivity,still primarily rely on sputum samples,thereby impeding significant advancements in tuberculosis diagnosis.In clinical settings,there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples.In recent years,extracellular vesicles(EVs),as emerging biomarkers,have demonstrated substantial potential in various diseases,including tumors and infectious diseases.A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis.This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis.It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis,treatment monitoring,and disease mechanism exploration,while addressing the challenges and future prospects in this field.The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.

Objective To investigate the mechanism of polyethylene glycol losenatide in improving non-alcoholic fatty liver disease by regulating lipophagy.Methods(1)32 C57BL/6 male mice were fed normally for 1 week and randomly divided into 4 groups with 8 mice in each group.Normal control group(fed normal diet),Normal+GLP-1RA(intraperitoneal injection of polyethylene glycol losenatide 0.3 mg/kg q3d),High fat group(fed with high fat diet),High-fat+GLP-1RA(on the basis of high-fat diet,intraperitoneally injected polyethylene glycol losenatide 0.3 mg/kg q3d),The molding lasts 16 weeks.Body weight,blood glucose and glucose tolerance test(GTT)were measured at the end of 16 weeks.Serum total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL)and other indexes were detected by Enzyme-linked immunosor-bent assay(ELISA),liver pathological changes were observed by Hematoxylin-eosin(HE)and oil red O sections,and the expression of microtubule-associated protein light chain 3(LC3),autophagy adaptor protein(P62),and transcription factor EB(TFEB).in liver were detected by Western blot(Wb).(2)The cell was divided into normal group(treated with bovine serum albumin,BSA);Normal+polyethylene glycol losenatide group(BSA+100 nmol/L GLP-1RA),High fat group(0.5 mmol/L PA);High fat+polyethylene glycol losenatide group(0.5 mmol/L PA+100 nmol/L GLP-1RA).After 24 h,the steatosis was observed by oil red O staining,the levels of TG in the supernatant were detected,Wb analysis was performed to detect protein expression levels of LC3,TFEB,and P62.Reverse transcription quantitative PCR(RT-qPCR)was used to measure mRNA levels of lipid synthesis-related factors.Results(1)Compared with normal control group,the body weight and blood glucose of mice in the high fat group increased significantly(P<0.01),reduced glucose tolerance(P<0.01),the levels of TC,TG and LDL in serum in liver of high fat group were significantly increased(P<0.01),while HDL was significantly decreased(P<0.01).Compared with high fat group,blood sugar in mice,the levels of TC,TG and LDL in serum and P62 in liver of high fat+GLP-1 group were significantly decreased(P<0.01);Glucose tolerance,HDL and and the protein expressions of LC3,TFEB were significantly increased(P<0.01).Compared with normal control group,the above indexes in normal+GLP-1 group were not significantly changed(P>0.05).(2)In vitro,The NAFLD HepG2 cell model was successfully constructed with 0.5 mmol/L PA.After 24 h of PA treatment,intracellular lipid drops were significantly increased(P<0.01),intracellular TG and the mRNA levels of lipid synthesis-related factors in the cells were increased(P<0.01).High fat+GLP-1 group improved the fatty degeneration induced by high fat,and the changes of the above indexes showed an opposite trend but the expres-sion of LC3,TFEB were significantly increased(P<0.01),lipid regulatory factor P62 protein in liver were decreased(P<0.01).Conclusion Polyethylene glycol losenatide can improve non-alcoholic fatty liver disease by regulating lipophagy.

Tuberculosis remains a significant global public health threat.Early diagnosis and effective treatment are crucial to combat this disease.Yet,traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity,extended detection periods,and dependence on sputum samples.Molecular diagnostic techniques,while offering higher sensitivity,still primarily rely on sputum samples,thereby impeding significant advancements in tuberculosis diagnosis.In clinical settings,there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples.In recent years,extracellular vesicles(EVs),as emerging biomarkers,have demonstrated substantial potential in various diseases,including tumors and infectious diseases.A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis.This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis.It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis,treatment monitoring,and disease mechanism exploration,while addressing the challenges and future prospects in this field.The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.

Objective To investigate the mechanism of polyethylene glycol losenatide in improving non-alcoholic fatty liver disease by regulating lipophagy.Methods(1)32 C57BL/6 male mice were fed normally for 1 week and randomly divided into 4 groups with 8 mice in each group.Normal control group(fed normal diet),Normal+GLP-1RA(intraperitoneal injection of polyethylene glycol losenatide 0.3 mg/kg q3d),High fat group(fed with high fat diet),High-fat+GLP-1RA(on the basis of high-fat diet,intraperitoneally injected polyethylene glycol losenatide 0.3 mg/kg q3d),The molding lasts 16 weeks.Body weight,blood glucose and glucose tolerance test(GTT)were measured at the end of 16 weeks.Serum total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL)and other indexes were detected by Enzyme-linked immunosor-bent assay(ELISA),liver pathological changes were observed by Hematoxylin-eosin(HE)and oil red O sections,and the expression of microtubule-associated protein light chain 3(LC3),autophagy adaptor protein(P62),and transcription factor EB(TFEB).in liver were detected by Western blot(Wb).(2)The cell was divided into normal group(treated with bovine serum albumin,BSA);Normal+polyethylene glycol losenatide group(BSA+100 nmol/L GLP-1RA),High fat group(0.5 mmol/L PA);High fat+polyethylene glycol losenatide group(0.5 mmol/L PA+100 nmol/L GLP-1RA).After 24 h,the steatosis was observed by oil red O staining,the levels of TG in the supernatant were detected,Wb analysis was performed to detect protein expression levels of LC3,TFEB,and P62.Reverse transcription quantitative PCR(RT-qPCR)was used to measure mRNA levels of lipid synthesis-related factors.Results(1)Compared with normal control group,the body weight and blood glucose of mice in the high fat group increased significantly(P<0.01),reduced glucose tolerance(P<0.01),the levels of TC,TG and LDL in serum in liver of high fat group were significantly increased(P<0.01),while HDL was significantly decreased(P<0.01).Compared with high fat group,blood sugar in mice,the levels of TC,TG and LDL in serum and P62 in liver of high fat+GLP-1 group were significantly decreased(P<0.01);Glucose tolerance,HDL and and the protein expressions of LC3,TFEB were significantly increased(P<0.01).Compared with normal control group,the above indexes in normal+GLP-1 group were not significantly changed(P>0.05).(2)In vitro,The NAFLD HepG2 cell model was successfully constructed with 0.5 mmol/L PA.After 24 h of PA treatment,intracellular lipid drops were significantly increased(P<0.01),intracellular TG and the mRNA levels of lipid synthesis-related factors in the cells were increased(P<0.01).High fat+GLP-1 group improved the fatty degeneration induced by high fat,and the changes of the above indexes showed an opposite trend but the expres-sion of LC3,TFEB were significantly increased(P<0.01),lipid regulatory factor P62 protein in liver were decreased(P<0.01).Conclusion Polyethylene glycol losenatide can improve non-alcoholic fatty liver disease by regulating lipophagy.

Objective To evaluate the application value of simultaneous amplification and testing for Myco-bacterium tuberculosis(SAT-TB)in evaluating the curative effect of initial treatment of smear-positive pul-monary tuberculosis patients.Methods A total of 62 newly treated smear positive pulmonary tuberculosis pa-tients from June 2022 to June 2023 in Guangzhou Panyu District Chronic Disease Control Station were selected as the study objects,and the curative effect was evaluated by liquid-based sandwich cup method,Roche culture method and SAT-TB detection method.All patients received the standard anti-tuberculosis treatment regimen of 2HRZE/4HR standard regimen,and sputum samples were detected by liquid-based sandwich cup method,Roche culture method,and SAT-TB detection method at the 2nd,4th,and 8th week of treatment,respectively.Results Among 62 patients,54 cases were positive and 8 cases were negative using Roche culture method,47 cases were positive and 15 cases were negative using SAT-TB detection method.60 cases were positive and 2 cases were negative by Mycobacterium tuberculosis(MTB)-DNA test.The positive rates of the three methods were 87.10％(54/62),75.81％(47/62)and 96.77％(60/62),respectively.Taking Roche culture method re-sults as the standard,the sensitivity of SAT-TB detection method and MTB-DNA was 97.87％(46/47)and 90.00％(54/60),and the specificity was 46.67％(7/15)and 100.00％(2/2),respectively.There were signifi-cant differences between Roche culture method and SAT-TB detection method and MTB-DNA test(x2=20.070,P＜0.05,x2=13.985,P＜0.05),the difference between the results of SAT-TB detection method and MTB-DNA test was also statistically significant(x2=8.365,P＜0.05).The negative conversion rates of MTB in sputum samples were 69.35％(43/62),29.03％(18/62)and 41.94％(26/62)at the 2nd,4 th,and 8 th weeks,respectively.77.42％(48/62),59.68％(37/62),58.06％(36/62),82.26％(51/62),79.03％(49/62),75.81％(47/62).There were significant differences in the negative conversion rates of MTB in sputum sam-ples between SAT-TB and liquid-based sandwich cup method at the 2nd and 4th weeks(x2=8.365,P＜0.05,x2=4.465,P＜0.05),while there was no significant difference between the results of Roche culture method at the 2nd,4th and 8th weeks(x2=1.726,P＞0.05,x2=0.000,P＞0.05,x2=0.046,P＞0.05).Conclusion The use of SAT-TB detection method in clinical practice to evaluate the efficacy of smear positive pulmonary tuberculo-sis patients could accurately and quickly assess the negative conversion rate and treatment effect of patients,and provide a reliable basis for guiding clinical treatment.It could be considered as an effective auxiliary diag-nosis and evaluation method of curative effect,worthy of promotion and practical application.

Clarifying the applicability （indications or contraindications） of traditional Chinese medicine （TCM） dietary regimens to different syndromes is a guarantee for the rational application and safety of TCM dietary therapy. By considering evidence from ancient literature， modern research and experts' experience， the Grading System for Syndrome Suitability of Dietary Therapy in TCM （GRADE-SSD） has been constructed. According to the currently available highest-quality evidence， GRADE-SSD classified the applicability of TCM dietary therapy to various TCM syndromes into 2 categories and 4 grades： "definitely" applicable/contradicted （Grade A）， "very likely" applicable/contradicted （Grade B）， "possibly" applicable/contradicted （Grade C）， and insufficient evidence to determine （Grade D）. When applying， first， systematically search the currently available ancient books and clinical research evidence. For different types of evidence （ancient TCM books， randomized controlled trials， observational studies， and meta-analyses）， use the prescribed tools to evaluate the quality of the evidence， and then determine the applicability level of TCM syndromes of dietary therapy based on the principle of "taking the highest" quality. If there is a lack of direct evidence， GRADE-SSD supports a downgraded evaluation based on indirect evidence of "similar prescriptions". When there is a lack of ancient books and clinical research， the GRADE-SSD plan can evaluate the quality of evidence from peer consensus or expert opinions for the applicability level of TCM syndromes of dietary therapy. Based on the requirements for the safety of TCM dietary therapy， when there is both "applicable" and "contradicted" evidence， it should be considered as "contradicted" evidence. GRADE-SSD also provides an evidence certainty update plan based on new evidence in the future. The evaluation results of GRADE-SSD can provide a basis for setting inclusion/exclusion criteria in clinical trials of TCM dietary therapy and stating the applicability of each syndrome in the labels of dietary therapy products.

Objective To evalute the drug resistance characteristics of tuberculosis(TB)patients of all ages in Guangdong Province during 2014-2020,and provide prevention and treatment strategies of tuberculosis.Method We used 39,048 clinical isolates of Mycobacterium tuberculosis(MTB)belonging to patients with confirmed TB from 2014 to 2020,from 32 TB drug-resistant surveillance sites in Guangdong Province,and we retrospectively analyzed the laboratories data of patients with drug-resistant TB,and grouped patients by age and region,to explore the trend of drug-resistance of MTB clinical isolates,the trend and incidence differences of multi-resistant TB(including monodrug-resistant TB(MR-TB),polydrug-resistant TB(PDR-TB),multidrug-resistant TB(MDR-TB)and exten-sively drug-resistant TB(XDR-TB)),and resistance characteristics of MTB clinical isolates to drugs in focus(rifam-picin and ofloxacin).Result The differences in the resistance rates of MTB clinical isolates to nine antituberculosis drugs among patients at 32 TB drug resistance surveillance sites in Guangdong Province from 2014 to 2020 were not statistically significant(P>0.05).The rates of MR-TB,PDR-TB,MDR-TB,XDR-TB,and total resistance isolates of MTB clinical isolates were 14.46%,5.16%,5.16%,4.58%,and 1.29%,respectively.he pediatric group had a higher MR rate(15.4%)than the adult and geriatric groups,while the adult and geriatric groups had higher MDR rates(5.0%and 5.0%,respectively).The geriatric group also had a higher XDR rate(2.1%),with statistically significant differences(P<0.001).The rates of MR-TB(14.8%),PDR-TB(5.3%),MDR-TB(4.7%),XDR-TB(1.4%),ofloxacin resistance(11.33%)and rifampicin resistance(6.92%)of MTB clinical isolates were higher in patients from the Pearl River Delta than in other regions of Guangdong Province,with statistically significant differ-ences(P<0.001).Conclusion According to the data from the surveillance sites,the epidemiological trend of drug-resistant TB in Guangdong Province is leveling off during the period 2014-2020.However,the incidence of drug-resistant TB is higher in specific populations(e.g.children and the elderly),and the incidence of drug-resistant TB and the rate of drug resistance to drugs in focus are higher in the Pearl River Delta than in other regions of Guang-dong Province,necessitating further investigation and the development of novel prevention and control strategies.

OBJECTIVETo investigate the epidemiological status of cholestasis in first-hospitalized patients with chronic liver disease in Shanghai, and to provide a scientific basis for developing prevention and treatment measures.

METHODSFrom April 2005 to September 2014, 5,146 first-hospitalized patients in Shanghai with a diagnosis of chronic liver disease were enrolled in this study. Clinical data of the 4,660 patients who fit the study criteria for participation were collected for retrospective analysis.Diagnosis of cholestasis was made according to serum alkaline phosphatase (ALP) levels higher than 1.5 times the upper limit normal (ULN) and gamma-glutamyltransferase (GGT) levels higher than 3 times the ULN. The incidence rate of cholestasis was assessed for relation to age, sex, etiology, and type of liver disease, and statistically compared to the general clinical data and specific biochemical indicators with potential sex-related differences. T-test and chi-square test were performed for the statistical analyses.

RESULTSOf the 4,660 study participants, 10.26% had cholestasis; the prevalence of cholestasis increased with increasing age in male patients. The distribution of the cholestasis incidence according to the type of chronic liver disease was: 75.00%, primary sclerosing cholangitis; 42.86%, primary biliary cirrhosis; 35.97%, hepatic tumor; 30.77%, autoimmune hepatitis; 28.31%, drug-induced liver disease; 16.46%, alcoholic hepatitis; 13.98%, cryptogenic cirrhosis; 12.99%, schistosomal cirrhosis; 7.53%, alcoholic cirrhosis; 7.32%, mixed cirrhosis; 5.94%, viral liver cirrhosis; 2.70%, nonalcoholic fatty liver disease. There was no significant difference in the prevalence of cholestasis between the two sexes. In the patients with cholestasis, the levels of GGT and total bilirubin were significantly different between the two sexes.

CONCLUSIONThe incidence rate of cholestasis in first-hospitalized patients with chronic liver disease was 10.26%, and the rate increased with increased age. Patients with primary sclerosing cholangitis or primary biliary cirrhosis had higher incidence rates of cholestasis. Incidence rates of cholestasis of the various chronic liver diseases were not related to sex.

Bilirubin ; China ; Cholestasis ; Chronic Disease ; Humans ; Incidence ; Liver Diseases ; Male ; Prevalence ; Retrospective Studies ; gamma-Glutamyltransferase