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ObjectiveTo obtain the status of latent tuberculosis infection （LTBI） among tuberculosis （TB）-related health-care workers （HCWs） in Shanghai， and to explore the risk factors related to TB infection. MethodsA multi-center cross-sectional study was conducted by recruiting medical workers from multiple designated TB hospitals， centers for disease control and prevention， and community health service centers in Shanghai. Each subject was required to complete a questionnaire and to provide a blood sample for TB infection test. Univariate and multivariate analysis ware made in order to find risk factors relating to TB infection. ResultsA total of 165 medical workers were recruited， and the proportion of TB infection was 16.36% （95%CI： 11.49%‒22.76%）. Multivariate logistic analysis showed that clinical doctors and nurses （adjusted OR=9.756， 95%CI： 1.790‒53.188）， laboratory staffs （adjusted OR=78.975， 95%CI： 8.749‒712.918）， and nursing and cleaning workers （adjusted OR=89.920， 95%CI： 3.111‒2 598.930） had higher risk of TB infection. ConclusionThe overall LTBI prevalence among TB-related HCWs is low. However， working as doctors， nurses， laboratory staffs， nursing workers and cleaning workers are risk factors of TB infection. TB-related HCWs who work at hospitals are at risk of TB infection comparing to medical staffs who work outside hospitals.
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Objective To understand the quality of life in patients with pulmonary tuberculosis within three years after treatment， determine its related factors， and make suggestions for improving the short-term quality of life in patients with pulmonary tuberculosis after treatment. Methods A telephone survey was used to investigate registered tuberculosis patients in Shanghai in 2018 using the short form 12 （SF-12） and the chronic obstructive pulmonary disease （COPD） assessment test questionnaire （CAT）. Results A total of 975 patients with pulmonary tuberculosis who had completed the treatment were included in the study. The total physiological score was determined to be 49.18±10.25， and the total psychological score was 50.27±8.03 （t=5.62，P<0.000 1）. The average CAT score was 13.31±6.08. Multivariate linear regression analysis showed that quality of life was positively associated with high educational level， high monthly family income， and frequent physical exercise， whereas negatively associated with comorbidities， low self-care ability， and changing jobs. Conclusion We should pay more attention to the patients with pulmonary tuberculosis coexistent with COPD and other lung diseases. Measures should be implemented for the improvement in the quality of life， including providing financial support， encouraging regular exercise， and improving lung function.
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Objective To investigate the epidemic characteristics of pulmonary tuberculosis (TB) in Minhang District of Shanghai, and to provide a scientific basis for TB prevention and control. Methods Data from active TB patients registered in Minhang District of Shanghai from 2009 to 2019 was collected and analyzed using descriptive epidemiological method. Results From 2009 to 2019 the registration rates of TB patients in Minhang district of Shanghai showed a downward trend, with an average annual registration rate of 32.35/100 000, including 3 611 (41.08%) patients who were registered permanent residents of Shanghai and 5 179 (58.92%) patients who were non-permanent residents. The ratio of men to women was 2.04:1. Workers accounted for more cases (22.77%) than other occupations among patients without registered permanent residence, while retirees accounted for the majority of cases (38.60%) among patients with registered permanent residence. Among the TB patients without registered residence, the highest proportion (45.86%) was in the 20-29 years old group, while the highest proportion in permanent residents was in the 50-59 years old group (19.47%). The peak incidence occurred in May in patients without registered permanent residence, while the peak incidence was in June in patients with registered permanent residence. Conclusion It is necessary to strengthen the prevention and control of TB in people without registered permanent residence of Shanghai, and at the same time, to strengthen the prevention and control of TB in old people and students with registered permanent residence of Shanghai.
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Objective To investigate the effects of hysteroscopic resection for mild-to-moderate uterine incision diverticulum after cesarean section.Methods From September 2010 to September 2014, hysteroscopic resection was performed under B-ultrasonography in 102 cases of mild-to-moderate uterine incision diverticulum after cesarean section.Results The operation was completed successfully in all the cases, without surgical complications.Outcome evaluation at 1 year after surgery showed cured in 89 cases (87.3%, complete disappearance of symptoms and recovery of normal menstruation), improved in 7 cases (6.9%, menstrual period shortened by 5-7 d, with or without lower abdominal dull pain and menstrual exacerbation), and ineffective in 6 cases (5.9%, no or slight symptom improvement).Conclusion Hysteroscopic resection is a safe, effective, and minimally invasive method for mild-to-moderate uterine incision diverticulum after cesarean section in patients demanding clinical symptom improvement without desire of fertility.
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Objective To delineate the application of whole genome sequencing technology in the epidemiology of tuberculosis.Methods From 2009 to 2012,nine Mycobacterium tuberculosis that sharing identical variable number of tandem repeats genotype (VNTR) patterns were reported from two TB cases designated hospitals.Both whole-genome sequencing analysis (WGS) and epidemiologic investigations were performed to describe the transmission patterns of these Mycobacterium tuberculosis.Results By WGS analysis,two genomic clusters including 7 and 2 Mycobacterium tuberculosis were noticed,respectively.The cluster of 2 cases possessed more than 15 single nucleotide polymorphisms (SNPs) when compared to the cluster of 7 cases and suggesting that the transmission route was independent.The transmission chain based on the SNPs difference showed the process of the propagation direction and the accumulation of drug resistance mutations in each cluster.Conclusion Using a WGS-based genomic epidemiologic approach,we were able to reconstruct the tuberculosis transmission network,tracing the putative source of the transmission and determining the transmission direction or the missing links.
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Objective To delineate the application of whole genome sequencing technology in the epidemiology of tuberculosis.Methods From 2009 to 2012,nine Mycobacterium tuberculosis that sharing identical variable number of tandem repeats genotype (VNTR) patterns were reported from two TB cases designated hospitals.Both whole-genome sequencing analysis (WGS) and epidemiologic investigations were performed to describe the transmission patterns of these Mycobacterium tuberculosis.Results By WGS analysis,two genomic clusters including 7 and 2 Mycobacterium tuberculosis were noticed,respectively.The cluster of 2 cases possessed more than 15 single nucleotide polymorphisms (SNPs) when compared to the cluster of 7 cases and suggesting that the transmission route was independent.The transmission chain based on the SNPs difference showed the process of the propagation direction and the accumulation of drug resistance mutations in each cluster.Conclusion Using a WGS-based genomic epidemiologic approach,we were able to reconstruct the tuberculosis transmission network,tracing the putative source of the transmission and determining the transmission direction or the missing links.
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This paper reported 13 cases of delayed traumatic chest wall abscess from January 2012 to January 2015.All the patients were associated with type 2 diabetes.After local puncture for confirmative diagnosis, a chest wall abscess dissection was carried out as soon as possible.At each site of upper and lower pole, an indwelling drainage tube was placed for irrigation and negative pressure suction.Sensitive antibiotics were selected based on susceptibility test results.The drainage tubes were removed 7-14 days after surgery.There were 8 cases of primary healing of incision and 5 cases of secondary healing of incision.All the patients were cured.Follow-ups for 6-36 months (average, 17 months) showed no recurrence.
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Objective To use the fluorescence PCR‐melting curve method to detect CYP2C9 and VKORC1 gene polymorphism in Xinjiang Hui population ,to analyze their gene distribution and gene mutation frequency ,and to evaluate the clinical applicability of the fluorescence PCR‐melting curve method .Methods The fluorescence PCR‐melting curve method and sequencing method were adopted to contrastively detect CYP2C9*2 ,CYP2C9*3 and VKORC1(‐1639G/A)gene polymorphism .Results Among detected 228 Xinjiang Hui individuals ,199 cases of CYP2C9*1/*1 ,2 cases of CYP2C9*1/*2 ,26 cases of CYP2C9*1/*3 and only 1 case of CYP2C9*3/*3 were detected ,no case of CYP2C9*2/*2 and CYP2C9*2/*3 was detected .Two kinds of allele G and A were detected for VKORC1(‐1639G/A) ,in which VKORC1‐1639G/G type was detected in 2 cases ,VKORC1‐1639G/A type was detected in 39 cases and VKORC1‐1639A/A type was detected in187 cases ,compared with the sequencing method ,the results of the fluorescence PCR‐melting curve method were completely consistent .Conclusion Xinjiang Hui population also has CYP2C9 gene *2 ,*3 loci and VKORC1 gene(‐1639G/A) locus polymorphism ,their occurrence frequency has a certain difference with Xingjiang Uygur and other regional populations ,the adopted fluorescence PCR‐melting curve method used in the gene polymorphism detection can meet clinical detection requirements .