ABSTRACT
Objective@#To understand delay in treatment student tuberculosis (TB) patients in Wuhan from 2011 to 2018, and to provide a reference for prevention and control measures of tuberculosis in schools.@*Methods@#The medical cases of students with tuberculosis in Wuhan recorded by the national tuberculosis management information system during 2011-2018 were analyzed for the delay and change trend of medical treatment of students with tuberculosis, and Logistic regression was used to analyze influencing factors.@*Results@#The median number of student TB patients seeking treatment in Wuhan was 9(3,21) days, and 51.14% of student TB patients were delayed. From 2011 to 2018, the overall delay rate of TB patients in students decreased slowly and then gradually increased, decrea sing from the highest rate (56.4%) in 2011 to the lowest one (45.6%) in 2014, and then gradually increased to 53.8% in 2018, there was no significant difference in the delay rate between the first and the second four years(χ2=2.84, P=0.09); The delay rate of different gender students was the same as that of the whole. The fluctuation of female students was slightly obvious, but the difference was not statistically significant(χ2=0.07, P>0.05); Among the students of different age groups, the delay rate of 13-18 years old was the lowest(χ2=87.23, P<0.01). The delay rate of 19-22 years old and university groups of different school levels showed a slow decline, while that of other age groups and other school level groups showed an overall upward trend. The results of multivariate logistic regression analysis showed that the main factors affecting the delay rate of medical treatment were the remote urban area(OR=1.84, 95%CI=1.56-2.16), the ethnic minorities (OR=2.73, 95%CI=1.46-5.09) and the age of 13-18(OR=0.57, 95%CI=0.33-1.00).@*Conclusion@#Delay in treatment of TB patients in Wuhan is not optimistic, with more than half of the students have delayed in treatment, the main factors that affect the high rate of TB patients’ treatment delay are the students in the far urban areas and ethnic minorities. It is very important to take targeted prevention and control measures to guide the students to actively seek medical treatment according to the time, the place and the person.
ABSTRACT
<p><b>BACKGROUND</b>Left atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).</p><p><b>METHODS</b>Sixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.</p><p><b>RESULTS</b>Significant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.</p><p><b>CONCLUSIONS</b>RT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.</p>