Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ²_trend = 708.387, P<0.001). The patients mainly came from referrals, accounting for 71.86%, and the proportion of referrals varied significantly among different years (χ²=355.541, P<0.001). The diagnosis type was mainly pathogenic negative, accounting for 49.12%. The proportion of pathogenic negative had statistically significant difference among different years (χ²=1 354.830, P<0.001). The proportion of patients cured and completed the course of treatment reached 93.98%, with statistically significant differences in the proportions among different years (cured, χ²=1 080.252, P<0.001; completed the treatment course, χ²= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

Lactic acid bacteria(LAB) have biological functions such as nutrition,bacteriostasis and immune regulation,which play important roles in the fields of food,agriculture and animal husbandry,industry,medicine and so on. At present,in the clinical application research of LAB,the focus of attention is on gastrointestinal diseases,urinary tract infections,allergic rhinitis,anti-tumor,etc.,but there are few introductions to the research progress of LAB in ocular application. In addition to regulating inflammation,the mechanism of action of lactic acid bacteria in the treatment of eye diseases is also affected by different mechanisms,which can be divided into direct and indirect effects. This article reviews the application of lactic acid bacteria in ocular surface diseases,fungal keratitis,lens and retinal diseases,summarizes and summarizes lactic acid strains and their related mechanisms,compares the differences of different lactic acid strains in the treatment of ophthalmic diseases. The in vitro,in vivo and clinical evidence of lactic acid bacteria in ophthalmic research are summarized,and the use of lactic acid bacteria in the treatment has high safety. The application of ophthalmic diseases has shown significant innovation and clinical significance,broadened the application scope of lactic acid bacteria in ophthalmology,and provided new ideas for future clinical treatment.

Sarcopenia is an age-related syndrome with progressive, generalized loss of muscle mass, strength, and physiological function. Low muscle mass is an important diagnostic criterion for sarcopenia. Ultrasound is safe, convenient and cost-effective, with extensive availability. It's a promising diagnostic tool for muscle mass assessment and sarcopenia screening in the elderly population. This review focuses on the specific methods and latest research progress on ultrasound assessment of sarcopenia.

Objective:To analyze the correlation between nasal resistance and lung function in children with allergic rhinitis（AR）, and explore whether AR children with increased nasal resistance are accompanied by potential lower respiratory tract involvement. Methods:A total of 88 children diagnosed with AR from December 2021 to December 2022 were selected as the study group, while 20 normal children were selected as the control group during the same period. Both the study group and the control group children underwent lung function tests, bronchodilator tests, and nasal resistance measurements. Spearman correlation analysis and multiple linear regression analysis were performed on the results of nasal resistance and lung function tests to explore the relationship and influencing factors between the two groups.According to the results of nasal resistance measurement, children with increased nasal resistance and abnormal lung function were divided into a mild increase in nasal resistance with abnormal lung function group and a moderate to severe increase in nasal resistance with abnormal lung function group. The degree of increased nasal resistance was analyzed to determine whether it would affect lung function. Results:The FEF25, FEF50, and FEF75 levels in the study group were significantly lower than those in the control group（P<0.05）. The FEV1of children with moderate to severe increase in AR nasal resistance was significantly lower than that of children with mild increase in AR nasal resistance（P<0.05）. There was a correlation between nasal resistance and FEV1/FVC, R20 in AR children, and FEV1/FVC, R20 were the influencing factors of nasal resistance in AR children（P<0.05）. There was no correlation between total serum IgE, lung function, and bronchodilation test in AR patients（P>0.05）. Conclusion:The nasal ventilation function of AR patients has changed, and there is a downward trend in small airway function. Children with moderate to severe increase in AR nasal resistance have a more significant decrease in lung ventilation function than those with mild increase. The nasal resistance of AR children is influenced by FEV1/FVC and R20, and FEV1/FVC and R20 decrease as the nasal resistance value increases. The improvement rate of lung function and FEV1 are not influencing factors for the elevation of total serum IgE.
Humans ; Child ; Rhinitis, Allergic/diagnosis* ; Nasal Polyps ; Respiratory Function Tests ; Nose ; Immunoglobulin E

In the online teaching of Biochemistry course, a variety of network resource platforms (such as Zhihuishu learning network, teleconference, WeChat, QQ, etc) were used to establish a learning community. The teaching content and teaching plan were carefully designed and implemented, enriching the knowledge system of the learning community. And then blending teaching was performed through the combination of live broadcasting and online interaction. In addition to teaching students the basic knowledge of biochemistry, it is also combined with clinical cases and life examples to interact and discuss with students in various forms, giving full play to the advantages of learning community and improving the quality and effect of online learning.

Objective:To explore the effect of acupoint pressure pill massage combined with salt pack hot compress and free body position alone for labor analgesia.Methods:One hundred and eighty pregnant women hospitalized in the Sixth People′s Hospital of Huizhou from January 2019 to December 2020 were selected and randomly divided into the control group and the observation group, each group with 90 patients. The control group received free body position to relieve labor pain. On the basis of the control group, the observation group used acupoint pressure pill massage combined with salt pack hot compress to relieve labor pain. The effects of the two methods on patients′ pain and the visual analogue scale (VAS) during different stages of labor and the outcome of the two groups were compared.Results:The rate of labor analgesia efficacy in the observation group was better than that in the control group : 98.89%(89/90) vs. 92.22%(86/90), the difference was statistically significant ( χ2 = 4.71, P<0.05). The scores of VAS in the observation group during the first, second and third stages of labor were lower than those in the control group ( P<0.01). The time of the first, second and third stages of labor and the total time of labor in the observation group were all lower than those in the control group ( P<0.01). At the end of the first stage of labor, the levels of β-endorphin and norepinephrine in the observation group were higher than those in the control group: (173.98 ± 32.87) ng/L vs. (139.43 ± 38.94) ng/L, (80.43 ± 10.98) nmol/L vs. (72.02 ± 11.21) nmol/L; the levels of dopamine were lower than those in the control group: (1.04 ± 0.23) mg/L vs. (1.23 ± 0.25) mg/L, the differences were statistically significant ( P<0.01). The rate of natural delivery in the observation group was higher than that in the control group: 95.56%(86/90) vs. 86.67% (78/90), χ2 = 4.39, P<0.05. Conclusions:Acupoint pressure pill massage combined with salt pack hot compresscan effectively alleviate the pain of child birth, reduce their pain, but also shorten their labor process, promote them to deliver rapidly.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020, and to provide a basis for the scientific development of interventions and strategies. Methods: Epidemiological distribution, time of onset and treatment, as well as treatment outcomes of student tuberculosis in Wuhan from 2011 to 2020 registered in the national tuberculosis information management system were described. Results: During 2011-2020, 4 337 student tuberculosis patients in Wuhan were registered. The average annual incidence rate was 22.44/10 million, and the annual decreasing rate of 7.86% The incidence of male and female patients was 1.76:1, and the incidence rate of male was higher than that of female( χ 2=184.18, P <0.01). Most of patients aged 19-22 years old, accounting for 47.89%; Tuberculosis reports were highest during March to May, and September to November, and lowest during January to February, and July to August. Student patients were mainly concentrated in Hongshan District, Jiangxia District and Wuchang District, where schools were more distributed in Hongshan District, Dongxihu District, Wuchang District and Xinzhou District. The median duration from tuberculosis onset to treatment was 9(3, 21) days, which varied significantly by region, age, nationality, and patient residence ( Z =-9.25, 47.14, 9.88,43.96, P <0.01). The treatment and outcome of student tuberculosis patients were varied significantly by year and nationality( P <0.05). Conclusion The incidence of student tuberculosis in Wuhan City showed a slow downward trend. Most of student tuberculosis are college and high school students. Time and place of case detection are relatively fixed. The time of treatment and the outcome of treatment vary significantly. Tuberculosis prevention and control strategies should be formulated according to the local conditions according to the tuberculosis distribution characteristics, as well as enhancing surveillance, health promotion, active discovery and supervision management of tuberculosis in school settings.

Objective:To examine the survival and influential factors of an integrated approach of novel agents, autologous hematopoietic stem cell (auto-HSCT) , and maintenance therapy in patients with multiple myeloma (MM) patients from a single center over the past 15 years.Methods:In our center, 300 MM patients who received an integrated strategy of new agents, auto-HSCT, and maintenance therapy over 15 years were retrospectively and prospectively analyzed.Results:The complete remission rates (CR) and ≥very good partial remission rates (VGPR) following induction therapy, transplantation, and maintenance therapy were respectively 35.3% and 55.2% , 72.4% and 80.0% , 89.2% , and 93.4% . When compared to patients receiving double-drug induction, the ≥VGPR and ORR of patients receiving triple-drug induction were improved. No difference existed in CR, ≥VGPR, and ORR between the PAD (bortezomib + liposome doxorubicin+ dexamethasone) and RAD (lenalidomide + liposome doxorubicin + dexamethasone) regimens, but the benefits speed differed. The negative rate of flow minimal residual disease following induction, transplantation, and maintenance was 18.8% (54 cases) , 41.4% (109 cases) , and 58.7% (142 cases) , respectively. The median time to progress (TTP) was 78.7 months and the median overall survival (OS) was 109 months. The median TTP for RISS-Ⅰ-Ⅲ patients were 111.8 months, 77.4 months, and 30.6 months, and the median OS was 118.8 months, 91.4 months, and 48.5 months, respectively. At various points during treatment, the TTP and OS of patients obtaining CR and MRD negative were longer than those of patients who did not obtain CR and MRD negative. TTP was noticeably shorter in high-risk cytogenetic patients compared to standard-risk patients even when CR was acquired during induction. There was no difference in TTP between patients with high-risk cytogenetics and those with standard-risk cytogenetics if MRD negative was acquired during induction. According to a multivariate analysis, the R-ISS stage was a poor predictor of TTP and OS at various treatment intervals. Therapeutic effectiveness was a newly independent prognostic factor following treatment.Conclusion:A median survival of almost 10 years is possible for MM patients who receive an integrated strategy of induction regimens followed by auto-HSCT and maintenance therapy, which significantly improves prognosis. However, this approach did not significantly benefit high-risk cytogenetic MM patients.

Objective To determine the genotype and clustering characteristics of multidrug-resistant (MDR) mycobacterium tuberculosis in Wuhan City. Methods A total of 149 mycobacterium tuberculosis strains from MDR tuberculosis (MDR-TB) patients were genotyped by DTM-PCR, mycobacterial interspersed repetitive unit–variable number tandem repeat typing (MIRU-VNTR) and sequencing of drug-resistant associated genes. The Hunter-Gaston discriminatory index (HGDI), clustering rate and recent minimum estimated infection rate were calculated. Results The cumulative HGDI of all MIRU loci was 0.9944. Gene locus with the highest HGDI（0.6467）was QUB11b. Combing MIRU-VNTR and DTM-PCR, 111 unique genotypes and 11 clustered genotypes（38 strains）from 149 isolates were identified. The clustering rate was 25.50%, and the recent minimum infection rate was estimated to be 18.12%. After further genotyping by sequencing of drug-resistant associated genes, the results showed that 17 (44.74%) strains in each cluster shared the same mutation sites, while the other strains had different mutation sites. Conclusion The combination of DTM-PCR, 24 locus MIRU-VNTR typing and drug resistance gene sequencing demonstrates a relatively high discriminatory power, which is suitable for the genotyping of multi drug resistant mycobacterium tuberculosis in Wuhan. The epidemic of MDR-TB in Wuhan is mainly caused by reactivation, and the recent transmission rate is not high.

Objective:To investigate the efficacy difference of totally laparoscopic total gastrectomy (TLTG) and laparoscopically assisted total gastrectomy (LATG) on radical gastrectomy for gastric cancer, and further to explore the safety and feasibility of totally laparoscopic esophagojejunostomy.Methods:PubMed, Web of Science, Wanfang and CNKI database were searched for all relevant articles regarding to TLTG versus LATG for gastric cancer published up to September 2019. The search keywords included: gastric/stomach cancer, total gastrectomy, totally/completely laparoscopic, laparoscopic-assisted/laparoscopy-assisted/laparoscopically assisted, esophagojejunostomy/esophagojejunal anastomosis. Meta-analysis was performed with RevMan 5.3 software.Results:A total of 258 articles were retrieved, and 11 studies were finally included after layer by layer screening, with a total sample size of 2421 cases, including 1115 cases in the TLTG group and 1306 cases in the LATG group. There were no statistical difference in age and gender between the two groups, while the mean BMI in the TLTG group was significantly higher than that in the LATG group ( P=0.01). Compared to the LATG group, shorter surgical incision ( P<0.001), less intraoperative blood loss ( P=0.003), larger number of retrieved lymph nodes ( P=0.04), less time to first oral intake ( P=0.03), and shorter postoperative hospital stay ( P=0.02) were found in the TLTG group. There were no significant differences in operation time, anastomotic time, tumor size, proximal resection margin length, postoperative pain score, time to first flatus, rate of postoperative anastomosis-related complication (including anastomotic fistula, stenosis and bleeding) and the overall incidence of postoperative complications ( P>0.05). Conclusions:Totally laparoscopic esophagojejunostomy is safe and feasible, and also suitable for obese patients. TLTG has advantages of minimally invasive, less intraoperative blood loss and easier access to lymph nodes compared to LATG. Totally laparoscopic gastrectomy will probably be the surgical trend for gastric cancer in the future.