Objective　To analyze the current situation and influencing factors of health-care seeking delay among pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022, and to provide a scientific basis for tuberculosis prevention and control. Methods　The data of pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022 was collected through the China Tuberculosis Information Management System to describe the distribution and change trend of the delay in health-care seeking. Univariate analysiswas performed using the chi-square (χ²) test, and the time trend of rates was tested with the trend chi-square (trend χ²) test. Multivariate logistic regression model analyzed the influencing factors of the delay in health-care seeking. Results　From 2011 to 2022, there were 3 488 cases of pulmonary tuberculosis in Qingpu District, with 1 438 patients experiencing health-care seeking delay. The median (quartile) number of days of delay was M (P25, P75) = 10 (2, 24) days, and the rate of health-care seeking delay was 41.23%. The annual rate of health-care seeking delay fluctuated between 33.88% and 50.45% from 2011 to 2022, with statistically significant differences between different years (χ²=38.355, P<0.001), and an upward trend in the health-care seeking delay rate was observed from 2020 to 2022 (χtrend²=13.290, P<0.001). Multivariate logistic regression analysis showed that compared to male, those under 25 years old, with local household registration, and detected through health check-ups, females (OR=1.21, 95%CI:1.04-1.41), those aged 45 to <65 (OR=1.36, 95%CI:1.06-1.75), intra-city migrants (OR=1.35, 95%CI:1.09-1.68), inter-provincial/overseas migrants (OR=1.50, 95%CI:1.23-1.83), and patients who directly sought medical care (OR=3.52, 95%CI:2.27-5.47), transfer treatment (OR=2.07,95%CI：1.31-3.25), referral (OR=2.16, 95%CI:1.36-3.44), follow-up (OR=3.07, 95%CI:1.74-5.44) patients with pulmonary tuberculosis were more likely to delay health-care, and the differences were statistically significant (P<0.05). Compared to sputum-positive patients, those with sputum-negative tests (OR=0.76, 95%CI: 0.59-0.97) were less likely to experience delayed health-care, and the difference was statistically significant (P<0.05). Conclusions　Health-care seeking delay of pulmonary tuberculosis patients is relatively common in Qingpu District of Shanghai. Corresponding intervention measures should be adopted for risk factors and key populations to further improve the health-care seeking delay.

Objective To explore the ART willingness and influencing factors of male HIV/AIDS patients in a special prison area in Shanghai. Methods The information was collected from face-to-face questionnaire survey of HIV/AIDS patients conducted from July 1, 2019, to December 31, 2019. Data was analyzed by univariate and multivariate analysis. The influence of social demographic characteristics, basic situation of detention, AIDS epidemiology, knowledge of AIDS ART, and family awareness on the willingness of anti-virus treatment was investigated. Results A total of 121 HIV / AIDS patients were investigated in this study. The results of multivariate analysis showed that HIV / AIDS patients who were less likely to receive ART included patients with multiple custody, patients with ART knowledge score less than 8, patients whose family members were unaware of their HIV infection, patients thought that they met the treatment standard but had no symptoms and did not need to take medicine, and patients thought that they could discontinue taking medicine at will. Conclusion A variety of factors have an impact on ART willingness of HIV/AIDS patients in custody. It is suggested that HIV / AIDS patients should be provided with more targeted ART knowledge training and social care and family support as far as possible.

OBJECTIVE:To establish a method for the simultaneous determination of tetracycline hydrochloride and cortisone acetate in Cortisone tetracycline eye ointment. METHODS:HPLC was performed on the column of Phenomenex C18 and shimaduz GL C18 with mobile phase of 0.01 mol/L Sodium dodecyl sulfate solution(adjusted to pH 2.5 with phosphoric acid)-acetonitrile(60∶40,V/V)at flow rate of 1.0 ml/min,detection wavelength was 254 nm,column temperature was 30 ℃,and the injection volume was 20 μl. RESULTS:The linear range was 11.36-227.18 μg/ml for tetracycline hydrochloride(r=0.999 9)and 11.11-222.21 μg/ml for cortisone acetate(r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 1.2%;recoveries were 96.89%-100.67%(RSD=1.1%,n=9)and 100.04%-101.02%(RSD=0.3%,n=9),respectively. CONCLUSIONS:The method is simple,accurate and specific,and can accurately determine the contents of tetracycline hydrochloride and cortisone acetate in Corti-sone tetracycline eye ointment.

Objective To investigate the safety and efficacy of mechanical thrombectomy (MT) compared with In?tra-arterial Thrombolysis (IAT) treatment in patients with severe acute ischemic stroke (AIS) caused by large cerebral ar?tery occlusion. Method The patients with AIS caused by large cerebral artery occlusion and underwent MT or IAT from 2005 May to 2014 May was included. A retrospective analysis was conducted on the onset to emergency(OTE)time, emergency to acupuncture(ETA)time, acupuncture to recanalization (ATR) time, stroke severity as measured by the Na?tional Institutes of Health Stroke Scale (NIHSS) score, and site of arterial occlusion on magnetic resonance angiography (MRA). A comparison was made between MT and IAT patients in rates of recanalization, symptomatic intracranial bleed?ing (SIB), mortality, and functional outcome. Three-month favourable outcome was defined as a modified Rankin Scale (mRS) score≤2. Result One hundred and two AIS patients were treated with MT and 50 with IAT. There was no differ?ence between MT and IAT groups with regard to demographics, onset NIHSS score (13.37±6.95 vs. 12.70±6.11;P=0.572) and discharge NIHSS score (8.40 ± 6.69 vs. 7.53 ± 7.28, P= 0.522) and the change of NIHSS score (3.87 ± 7.14 vs. 4.26 ± 5.42, P=0.766). There were significantly differences between MT and IAT groups in the OTE time (Median 300 min vs. 120 min,Z=-5.704,P=0.000) , ATR time (Median 30 min vs. 65 min,Z=-5.011,P=0.001) ,recanalization (91.2%vs. 60.0%,P =0.01),the rate of AIB(21.7% vs. 36.0%,P =0.046),3-month mortality (16.6% vs. 26.0%,P =0.043). The above parameters were better in MT group than in the IAT group. There were no significant differences between MT and IAT groups in the rate of SIB (12% vs. 16%,P =0.055), the NIHSS change(Median 3 vs. 4,Z =-0.236,P =0.823) and mRS score on 90d ( 48.2%vs. 46.0%, P=0.823). MT patients had significantly higher percentages of stent use (22.5%vs. 8%,P=0.018) . The Recanalization for ICA(81.8%vs. 55.6%,P=0.048),BA(93.1%vs. 55.6%,P=0.032)and MCA( 97.5% vs. 60.0%,P =0.026)was higher in MT group than in IAT group .The SIB rate for ICA(13.8% vs. 33.3%,P =0.000),BA(13.8%vs. 33.3%,P=0.000)was lower in MT group than in IAT group . The mortality rate of was significant?ly lower in MT than in IAT group for MCA (2.5%vs. 20.0%,P=0.000) . the good outcome rate for BA was higher in MT group than in IAT group(41.3%vs. 22.2%,P﹤0.01). Conclusions Compared to IAT,MT can provide broader time win?dow,higher recanalization rate and better outcome in patients with severe acute ischemic stroke (AIS) caused by large ce?rebral artery occlusion.

Objective To assess the quality of life(QOL)of advanced schistosomiasis patients,and understand its influenc-ing factors. Methods A questionnaire survey was carried out by using WHOQOL-BREF,and the information of demography, family,illness,health status,and health service was collected. Results Among the 217 advanced patients,the average age was (75.33±6.94)years,the ratio of male to female was 2∶5,89.86%of them were farmers,75.58%were illiterate or semi-illiterate, and 88.94%belonged to the splenomegaly type. Totally 61.29%of the cases had the scores over average for the overall QOL,but the scores for the health and well-being were lower. There were a significant difference among the average scores of different do-mains of QOL(χ2 =23.46,P<0.01). Both the year of being diagnosed and clinical classification was not associated with the scores of QOL. Regularly taking physical activities was significantly associated with each of all the 4 domains. The factors such as onset of acute disease in 2 weeks,taking therapeutic pills daily,marital status,age,etc. impacted the specific domains of QOL. The overall QOL and the 4 domains of the patients were at medium level;meanwhile,the score of physiological domain was lower than the scores of the other 3 domains. Conclusions The QOL(s)of advanced schistosomiasis patients in Qingpu District are rel-atively good. It is important to provide effective community health services and encourage the patients to take part in tempered sports or physical activities in order to keep their normal activities of daily living.

This article was aimed to study the correlation among traditional Chinese medicine (TCM) syndrome elements in the first year after ischemic stroke. Data of TCM four examinations were collected among subjects all over China by cross-sectional study, using the same observing rating scale. The results showed that internal-heat, internal-wind and phlegm-damp syndrome were risk factors with obvious positive correlation. On the contrary, blood-stasis, internal-heat and qi-deficiency syndrome were in obvious negative correlation. But syndrome of yin-deficiency had no significant correlation with other syndrome elements. It was concluded that there were remarkable positive correlations on excess syndromes, such as wind, fire and phlegm. The syndromes of excess in the branch are easily to be combined.

Objective To investigate the therapeutic effects of enhanced external counterpulsation (EECP) on cerebral edema and cerebral blood flow perfusion with MRI following cardiac arrest (CA) and on successful return of spontaneous circulation (ROSC) by cardiopulmonary resuscitation (CPR) in dogs.Methods Sixteen beagle dogs were induced CA with alternating current on epicardium,then were randomly (random number) divided into the EECP and control group after successful ROSC.MR scanning brain of all animals was carried out by diffusion-weighted imaging (DWI) and perfusion weighted imaging (PWI) before CA and on the first,second and third days after ROSC.Blood pressure,right common carotid artery flow,and intracranial microcirculation perfusion were measured.Results There were no significant differences in mean artery pressure at all intervals between two groups (P ＞ 0.05).There was significant increase in right common carotid artery blood flow and intracranial microcirculation of dogs in EECP group compared with the control group (P ＜ 0.05).Apparent diffusion coefficients (ADC) of water molecule on the first and third days after ROSC were significantly higher in the EECP group than those in the control group (P ＜ 0.05).Ratios of post-ROSC relative cerebral blood flow (RCBF) /original cerebral blood flow were higher in the EECP group than those in the control group on the first,second and third days after ROSC (P ＜ 0.05).Conclusions EECP treatment could improve cerebral blood flow perfusion and relieve ischemic cerebral edema,alleviating brain injury in dogs following CA and successful ROSC.

Objective To study the effects of mild hypothermia (MH) on blood coagulation and cerebral microcirculation in rabbits after cardiopulmonary resuscitation (CPR). Method A total of 24 New Zealand rabbits were randomly (random number) divided equally into normothermic group (NT) and MH group. CPR model was established by ventricular fibrillation induced by using alternating current. The rabbits of NT group were observed for 12 h in room temperature after restoration of spontaneous circulation (ROSC). The mild hypothermia was induced in the rabbits of group MH by surface cooling after ROSC, and maintained for 12 h after the aimed low temperature reached. The PT (prothrombin time), APTT (activated partial thromboplastin time), INR (international normalized ratio of prothrombin), D-dimmer (DD) , blood platelet count (BPC) , anti-thrombin Ⅲ activity (AT-Ⅲ) and protein C activity (PC) were measured before CPR and 4 h, 8 h and 12 h after ROSC, and at the same time the cerebral microcirculation was measured by using PERIMED Multichannel Laser Doppler system. One-way ANOVA or Mann-Whitney rank was used to determine the statistical significance between two groups. LSD-t test was used for multiple comparisons,t test for comparisons of means between two independent samples, and Pearson correlation test for correlation analysis. Results The PT, APTT and INR showed a trend of gradually shortening during the course. The APTT in 12 h after ROSC was significantly shorter than that before CPR (23.32 ±5.19 vs. 29.53 ±5.10,P = 0.025), and the activity of AT- Ⅲ and PC were decreased significantly. Compared with the group NT,the PT, APTT and INR in group MH were increased significantly, while there were no differences in the activity of AT- Ⅲ, PC and D-D between two groups. The rates of cerebral microcirculation in group NT before CPR and 4 h, 8 h and 12 h after ROSC were 401.60 ± 11.76 mL/min, 258.86 ± 34. 58 mL/min,317.59 ± 23.36 mL/min and 371.98 ± 5.79 mL/min, respectively, and those in group MT were 398.18 ±12.91 mL/min, 336.19 ± 19.27 mL/min, 347.76 ± 13.80 mL/min and 383.78 ± 3.29 mL/min, respectively. There were significant differences between two groups at each interval after ROSC (4 h: t = - 6.025,df=16, P=0.000;8 h: t= -2.942, df=12, P=0.012;12 h: t= -3.959, df=8, P=0.004). The Pearson correlation test showed that the rate of cerebral microcirculation was positive correlated with APTT after ROSC (4 h:R =0.503,P=0.033;8 h:R=0. 565,P=0. 035;12 h:R=0. 774,P=0. 009), and was not correlated with the other blood coagulants. Conclusions The mild hypothermia led to the inhibition of blood coagulation and improved the cerebral microcirculation concomitantly, which may be one of the mechanism of cerebral protection.

Objective To explore the safety and rate of intraperitoneal cooling in rabbits after cardiopulmonary resuscitation(CPR). Method There were two experiments. In the experiment one: 15 healthy adult NewZealand rabbits were divided into five groups as per the various amounts, 30, 40, 60, 80, and 100 mL/kg, of priming volume of 4 ℃ cold balanced salts solution injected into peritoneal cavity of rabbits. After injection of priming cold solution, the tympanic temperature between 33 ℃～ 35 ℃. For the maintenance of this mild hypothermia, a intraperitoneal infusion device(patent number ZL200820201265) was connected to the rabbits. The rabbits were rewarmed by using the same device after 12-hour hypothermia. The biochemical parameters were assayed during the experiment. After the rabbits were sacrificed, the liver, ileocecal junction of intestine and kidneys were removed to fix them in 3 % formalin, and examined by using H.E. staining. In the experiment two, another 12 healthy adult New Zealand rabbits were induced into ventricular fibrillation by alternating electric current and then gave CPR for 2 minutes. After return of spontaneous circulation(ROSC), the priming volume of 4 ℃ cold liquid was infused into peritoneal cavity of rabbits, and then the rabbits were connected to the intraperitoneal cooling device to maintain hypothermia for 12 hours. Matched-pairs t test was used for the comparison of biomarkers before and after intraperitoneal cooling. A two-tailed value of P < 0.05 was considered statistically significant. Results In the experiment one, the tympanic temperature of rabbits with priming volume of 80 mL/kg cold solution was decreased quickly reaching the target temperature in(30±2.00) minutes. During the induction of hypothermia, the intraperitoneal temperature reached the target temperature in less than 10 minutes, and was 1 -2℃ lower than the tympanic temperature during the maintenance of hypothermia. The intraperitoneal cooling did not cause damage in the liver, ileocecal junction of intestine and kidney, and did not alter the biomarkers. In the experiment two, the tympanic temperature of rabbits after ROSC was decreased quickly after intraperitoneal infusion of 80 mL/kg 4 ℃ cold solution, and reached the target temperature in(26.00±6.99) minutes, and the intraperitoneal temperature was lowered to reach the target temperature in less than 10 minutes. This cooling method after CPR didn' t disturbance water-electrolyte and acid-base balance. Conclusions The intraperitoneal cooling can safely and quickly induce hypothermia after CPR in rabbits.

Objective To observe the growing shape and function of Madin-Darby canine kidney (MDCK) cells implanted on the polysilicon nanopore membrane by micro-electro-mechanical system (MEMS). Methods The polysilicon nanomembrane was made by silicon film processed via whirling photoresist, wet etching, electroplating and so on, and then it was coated by extracellular matrix and implanted with MDCK cells. The cell growth shape and function was observed or examined by scanning electron microscope or MTT test and Trypan Blue staining.Results The nanomembrane with regular slit pores was successfully fabricated. Extracellular matrix-coated nanomembrane, especially for collagen Ⅳ coating, was more suitable for MDCK cells to adhere and proliferate without membrane injury. The polysilicon nanomembrane coated with extracellular matrix did not induce the cell death and also not stimulate cells releasing the cytokines such as interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α). Under scanning electron microscope, MDCK cells formed a flat single-cell fusion with tight junction on the surface of polysilicon nanomembrane and there was a large number of microvillus on the top of cells.Conclusion The collagen-coated polysilicon nanomembrane made by MEMS techniques, with no cytotoxicity and good biocompatibility, is valuable to frame the artificial glomerular filtration membrane