Objective To analyze the current situation, change trend and influencing factors of the delay in the treatment of tuberculosis patients in Xianning from 2008 to 2021, and to provide a scientific basis for controlling the tuberculosis epidemic. Methods The current situation and trend of the delay in the treatment of tuberculosis patients in Xianning City from 2008 to 2021 were described, and the multivariate Logistic regression analysis model was used to explore the influencing factors of the treatment delay in tuberculosis patients. Results The delay rate of seeking medical care for tuberculosis patients in Xianning from 2008 to 2021 was 58.53%, and the delay rate in the first six years tended to be stable. From 2014 to 2016, it increased slightly and then decreased year by year to 44.76% in 2021. Different gender and age groups showed the same trends as overall patients. The analysis results of the multivariate Logistic regression analysis model showed that females, household registration address in Jiayu County, occupations including service industries, workers, farmers and herdsmen, retirees, and others, the diagnosis result being positive for etiology, and the direct treatment in the patient source were high-risk factors for patients with delayed treatment. The risk of delay in treatment in ≥ 65-year-old patients was lower than that of < 25-year-old patients. Conclusion From 2008 to 2021, the phenomenon of delay in the treatment of patients with pulmonary tuberculosis in Xianning City is relatively common, and the high-risk factors of the delay in treatment need to be paid more attention to.

Objectives:The risk factors affecting the blood perfusion of side branch(SB)in coronary bifurcation lesions were explored by the three-dimensional quantitative coronary angiography(3D-QCA)and the Murray's law based quantitative flow ratio(μQFR),and a risk prediction model affecting SB perfusion disorders was established to provide reference for the percutaneous coronary intervention(PCI)strategies of bifurcation lesions. Methods:From October 2022 to April 2023,393 bifurcation lesions were evaluated by coronary angiography in Hunan Provincial People's Hospital.The general clinical evaluation index of the patient,the anatomical index of coronary bifurcation lesion,and the μQFR representing branch perfusion in bifurcation lesion were collected.All samples were randomly divided into training set and test set at the 8:2 ratio.Univariate logistic regression was used to determine filter variables,and the influencing factors of branch perfusion in bifurcated lesions were evaluated by multivariate logistic regression analysis.A risk prediction model was established,and the accuracy of the model was further verified in the test set. Results:The maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,as well as the branch maximum diameter stenosis rate,and length of the bifurcation lesion are independent predictors of SB perfusion disorders(SB μQFR<0.8),P<0.05.A SB perfusion disorder risk prediction model was established based on the above five independent risk factors.The area under the ROC curve of the model was 0.926(95%CI:0.896-0.958),the sensitivity was 0.864(95%CI:0.818-0.910),and the specificity was 0.850(95%CI:0.780-0.920).This model was applied to the test set,the results showed that the area under the ROC curve of this model was 0.897(95%CI:0.817-0.976),the sensitivity was 0.870(95%CI:0.756-0.936),and the specificity was 0.923(95%CI:0.759-0.986). Conclusions:The blood perfusion of branches in coronary bifurcation lesions is mainly related to multiple anatomical factors of the main branch and SB.Among them,the maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,branch maximum diameter stenosis rate and length of the bifurcation lesion are independent predictors of perfusion disorders in the SB.Future studies are needed to validate the clinical value of the established risk prediction model of the SB perfusion disorders in daily clinical practice.

Abstract: Objective To analyze the resistance and spatial distribution of Mycobacterium tuberculosis (MTB) to six commonly used anti-tuberculosis drugs in Qinghai Province from 2016 to 2019, so as to provide a reference for tuberculosis treatment and drug-resistant tuberculosis control. Methods A total of 1 182 identified strains of Mycobacterium tuberculosis in Qinghai Province from 2016 to 2019 were collected, and 6 anti-tuberculosis drugs were subjected to drug susceptibility tests and strain confirmed by the proportional method. By means of ArcMap10.7 and SaTScan10.1 software, map visualization, spatial autocorrelation analysis and spatial scanning of MTB drug resistance were performed to identify MTB drug resistance clusters in Qinghai Province. Results From 2016 to 2019, the total drug resistance (TDR) rate of 1 182 Mycobacterium tuberculosis strains in Qinghai Province was 23.77% (281/1 182), with a mono-resistance (MR) rate of 11.08% (131/1 182), a poly-resistance (PDR) rate of 3.89% (46/1 182), a multi-drug resistance (MDR) rate of 8.80% (104/1 182), and an extensive drug resistance (XDR) rate of 0.85% (10/1 182). The rates of MDR, XDR and TDR all showed a decreasing trend year by year (P<0.01). The drug resistance spectrum displayed 21 combinations. The TDR rate and MDR rate in the retreatment patients were higher than those of the initial treated patients, and the difference was statistically significant (χ2 TDR=22.784, χ2MDR=45.082, P<0.01). In terms of demographic characteristics, the TDR rate in males was higher than that in females, and the middle-aged group was higher than other age groups, and the differences were statistically significant (χ2=7.541, 10.825, P<0.05). The results of global spatial autocorrelation analysis showed that there was no statistical significance in the autocorrelation and obvious spatial clustering of MTB drug resistance in Qinghai Province from 2016 to 2019 (P>0.05), which indicated a random distribution. The results of spatiotemporal scanning showed that there was a kind of clustering area, but the clustering effect was not significant (P>0.05), indicating a random distribution. Conclusions The TDR of MTB in Qinghai Province from 2016 to 2019 showed a downward trend year by year. In comparison with the national average, the rate of multi-drug resistance and extensive drug resistance was still high, and most of the multi-drug resistance resulted from rifampicin and isoniazid. The drugresistant population mainly consisted of retreatment, males, and young and middle-aged pop

Objective: The study aims to explore the epidemiological characteristics of tuberculosis among students in Qinghai Province, to provide scientific basis for the prevention and control of students tuberculosis. Methods: Data on tuberculosis among students from 2016 to 2019 in Qinghai province were collected and epidemiological characteristics were analyzed, the spatial distribution map were drawn by using ArcMap 10.8. Results: During 2016-2019, there were 2 691 reported cases of tuberculosis among students in Qinghai Province the reporting rate were 46.10/10 5, 68.50/10 5, 73.49/10 5, 85.96/10 5, increased year by year( χ 2=116.45, P <0.01). With a high incidence from March to September each year. The tuberculosis patients were mainly aged 18 years and above, with more reported female cases than male cases and more Tibetan cases. Most of students tuberculosis cases were reported in southern Qinghai, especially in Yushu and Guoluo areas, and sharp increase was observed in Xining during 2018 to 2019. Conclusion Students tuberculosis in Qinghai is still serious. Schools should strengthen education on tuberculosis prevention, especially those in southern Qinghai and Xining.

Objective To observe the level of cellular immune function in the patients with stable chronic obstructive pulmonary disease(COPD),and also to investigate the effects of hyperbaric oxygen (HBO) on the cellular immune function in the patients with stable COPD.Methods One hundred and sixty-seven cases of stable COPD were divided into 2 groups,the drug inhalation group (n =81),which inhaled tiotropium bromide and the HBO group (n =86),which received HBO therapy in addition to drug inhalation.Another 33 normal health subjects were recruited as the normal control group.Immune function indexes of the 3 groups were detected and analyzed before and after therapy.Results The IL-2R level and lymphatic metastasis rate of the HBO group and the drug inhalation group were respectively [(218.95 ± 106.60) μg/ml,(235.60 ± 67.85)μg/ml] and [(42.15 ± 5.75)％,(42.52 ± 5.75)％],CD3 and CD4 levels were respectively [(47.05±7.76)％,(47.20 ±7.63)％] and [(36.20 ±6.05)％,(34.67 ±4.51)％].Statistical significance could be found when they were compared with those of the normal control group [(389.13 ± 191.42)μg/ml,(77.60±5.29)％,(65.70±6.30)％,(44.50±4.70)％](P＜0.01).For the HBO group,significant improvement could be seen in cellular immune indexes,pulmonary ventilation function and hypoxemia after therapy,and there was statistical significance when compared with those data before therapy (P ＜ 0.05).There was also significant improvement in cellular immune indexes for the patients of the HBO group,as compared with those of the drug therapy group,and statistical significance could be noted when comparisons were made between the 2 groups (P ＜ 0.01).Conclusions The cellular immune levels of the patients with stable COPD were decreased to various degrees.HBO therapy could significantly improvethecellular immune function of the patients with stable COPD,rectify hypoxia and carbon dioxide retention and improve pulmonary function.

Objective To observe the level of cellular immune function in the patients with stable chronic obstructive pulmonary disease(COPD),and also to investigate the effects of hyperbaric oxygen (HBO) on the cellular immune function in the patients with stable COPD.Methods One hundred and sixty-seven cases of stable COPD were divided into 2 groups,the drug inhalation group (n =81),which inhaled tiotropium bromide and the HBO group (n =86),which received HBO therapy in addition to drug inhalation.Another 33 normal health subjects were recruited as the normal control group.Immune function indexes of the 3 groups were detected and analyzed before and after therapy.Results The IL-2R level and lymphatic metastasis rate of the HBO group and the drug inhalation group were respectively [(218.95 ± 106.60) μg/ml,(235.60 ± 67.85)μg/ml] and [(42.15 ± 5.75)％,(42.52 ± 5.75)％],CD3 and CD4 levels were respectively [(47.05±7.76)％,(47.20 ±7.63)％] and [(36.20 ±6.05)％,(34.67 ±4.51)％].Statistical significance could be found when they were compared with those of the normal control group [(389.13 ± 191.42)μg/ml,(77.60±5.29)％,(65.70±6.30)％,(44.50±4.70)％](P＜0.01).For the HBO group,significant improvement could be seen in cellular immune indexes,pulmonary ventilation function and hypoxemia after therapy,and there was statistical significance when compared with those data before therapy (P ＜ 0.05).There was also significant improvement in cellular immune indexes for the patients of the HBO group,as compared with those of the drug therapy group,and statistical significance could be noted when comparisons were made between the 2 groups (P ＜ 0.01).Conclusions The cellular immune levels of the patients with stable COPD were decreased to various degrees.HBO therapy could significantly improvethecellular immune function of the patients with stable COPD,rectify hypoxia and carbon dioxide retention and improve pulmonary function.

The epileptic eye and head movements during epileptic seizures may be much more complicated thanpeople originally understood, which can be ipsilateral or contralateral to the electroencephalographyfocus. Here, we describe a male patient with drug resistant focal seizures associated with a directionalseparation between head and eye movement before evolving into generalized tonic-clonic seizure.His contralateral head leading turning showed forced, sustained, and unnatural features companiedby ipsilateral eye staring. Stereoeletroencephalography monitoring was performed, and 4 habitualseizures were recorded over 5 days. Three seizures showed left head leading turning and generalizedtonic-clonic seizure, and only one showed dizziness and ringing in the ears. All the seizures showedthat the ictal onset contacts were located in the posterior inferior temporal sulcus which borders onthe anterolateral part of medial superior temporal area. The patient underwent a resection includingtemporooccipital region, and the histopathology showed focal cortical dysplasia type Ic. He has beenseizure free for two years after operation. The scores of the intelligence and memory quotient improvedhalf year after operation.

Objective To investigate the protective effect of CRISPLD 2 protein on acute respiratory disease syndrome ( ARDS) induced by lipopolysaecharide ( LPS) in mice.Methods Healthy male Kunming mice were randomly divided into 3 groups:the control group (or group A) which received lipopolysaecharide via the intratracheal instillation at a dosage of 5 mg/kg, the LPS pre-conditioning group (or group B) which had intraperitoneal injection of LPS at a dosage of 2mg/kg and at day 8 received LPS via intra-tracheal instillation also at a dosage of 5mg/kg.The recombinant CRISPLD2 preconditioning group ( or group C) which was injected with recombinant CRISPLD2 at a dosage of 50mg/kg via cauda vein, and then at hour 6 received LPS via intratracheal instillation at the same dosage.(1)Thirty mice were randomly divided into group A1, group B1 and group C1, each consisting of 10 animals.The mice were sacrificed 6 hours after LPS intratracheal instillation .Then, W/D and LPI were measured.(2) Ninety mice were randomly divid-ed into group A2, group B2 and group C2, each consisting of 30 animals.The death of the animals in each group was closely observed and the survival curve was described .Results W/D, lung index and mortality after 5 days in group B and C were significantly lower , as compared with those of group A (P<0.05).The detected data of various indexes in group B were lower than those in group C (P>0.05).Conclusion Increased serum concentration of CRISPLD2 could obviously produce protective effect on ARDS induced by LPS , lighten injury on the lungs and improve permeability of pulmonary capillary and decrease mortality .

Objective To investigate the effect of CRISPLD 2 protein on the expression of inflammatory cytokine in LPS-in-duced acute respiratory distress syndromes ( ARDSs) mice.Methods Forty male Kunming mice were randomly divided into 5 groups;the control group (group A), which was given 0.1mg LPS via the intratracheal instillation;the rCRISPLD2 group 1 (group B) and the rCRISPLD2 group 2 (group C), which were respectively treated with 1mg and 0.4mg rCRISPLD2 by tail vein, and after 6 hours rC-RISPLD2 was injected intratracheally;the rCRISPLD2 group 3 (group D) and the rCRISPLD2 group 4 (group E), which were first given 0.1mg LPS intratracheally and then were injected with 1mg and 0.4mg rCRISPLD2 by tail vein.At hour 12 after intratracheal in-jection of LPS in the mice of all the groups , bronchoalveolar lavage fluid (BALF) was collected.After centrifugation, the number of neutrophils was counted , and the levels of TNF-α, IL-1βand IL-6 were detected in supernatant fluid and blood samples .Results The number of neutrophils(0.31 ±0.07、0.76 ±0.08), TNF-α(8.88 ±17.37、134.63 ±24.44), IL-1β(48.63 ±15.61, 99.75 ±12.30) and IL-6 (80.75 ±21.03,140.12 ±29.29)in serum and BALF in groups B and C were all significantly lower than those of group A , D and E, and statistical significance could be noted , when comparisons were made between these groups (P<0.05).The detected data of group B were obviously lower than those of group C , also with statistical significance (P<0.05).Conclusion rCRISPLD2 could down-regulate the expression levels of LPS-induced inflammatory factors , and dosage dependence could be noted to a certain extent .

Objective To investigate the effects of natural seawater and lipopolysaccharide (LPS) on acute respiratory distress syndromes (ARDS) induced by seawater drowning .Methods Fifty male Kunming mice were randomly divided into 5 groups, each consisting of 10 animals.They were: the blank control group (group A); the normal saline (NS) group (group B), which was injected 4ml/kg NS into the airway passage;the low salinity artificial seawater group (group C), which was injected 4ml/kg artificial seawater at a salinity of 1.67％ into the airway passage; the LPS antagonism group (group D), which was first given LPS injection (2 mg/kg) in the abdominal cavity and then 4 ml/kg natural seawater in the airway passage at day 8; the seawater group (group E), which was injected 4 ml/kg of natural seawater in the airway passage .Four hours after injection of seawater, the animals were sacrificed, LPI and wet /dry ratio (W/D) were detected, bronchis-alveolar lavage fluid (BALF) was collected, and levels of neutrophi , TNF-α, IL-1βwere detected.Results As compared with those of the blank control group , the levels of LPI, W/D, neutrophil[group D:(1.69 ± 0.09) ×106 /L,group E:(2.11 ±0.12) ×106 /L], TNF-α[group D:(202.31 ±28.76) ng/L, group E:(233.72 ±26.41) ng/L] and IL-1β[group D:(178.16 ±24.85) ng/L,group E:(206.38 ±20.56) ng/L] in the groups B,C D and E were all significantly elevated 4 hours after injection of seawater .The levels of group E were >those of group C >those of group B >those of group A, and statistical significance could be seen when comparisons were made between the groups (P <0.05).All the values in group E were higher than those in group D, and there was statistical significance in the levels of neutrophi , TNF-αand IL-1β, when comparisons were made between them.Conclusions Both the salinity and lipopolysaccharide content of seawater were the main causative agents of acute respiratory distress syndromes after seawater drowning .