ABSTRACT
Objective@#To analyze the relationship between the risk of tuberculosis outbreaks in schools and the visit interval of index cases, so as to provide a scientific reference for predicting the risks of tuberculosis outbreak and making preventive measures.@*Methods@#A total of 630 index cases from school tuberculosis outbreaks were studied during January, 2015 to December, 2022. Data on demographics, consultation history, etiological diagnosis, and methods of detection were collected. Restricted Cubic Splines (RCS), unconditional Logistic regression, and the receiver operating characteristic curve (ROC curve) were used for analysis.@*Results@#The RCS fitted curve showed that the risk of a tuberculosis outbreak linearly increased when the consultation interval for etiologically negative patients exceeded 5.79 days, or for etiologically positive patients exceeded 8.37 days. After multi factor adjustment, for every additional day in the visit interval of the index case, the odds ratio ( OR ) value for a high risk outbreak was 1.10 (95% CI =1.07-1.13)( P <0.05). When analyzed by tertiles of visit intervals, compared to an interval of <14 days, the OR values (95% CI ) for high risk outbreaks in schools with intervals of 14-<28 days and ≥28 days were 10.32(3.04-35.10) and 82.58( 28.42 -239.95), respectively( P <0.01), indicating a trend of increasing outbreak risk with longer visit intervals. Based on the ROC curve analysis, the optimal threshold for predicting a high risk school tuberculosis outbreak was 23.5 days, with an area under the curve ( AUC ) of 0.93 (95% CI =0.89-0.98).@*Conclusion@#An extended visit interval of index cases is a good early warning indicator for high risk tuberculosis outbreaks in schools and could be considered a key factor in early intervention and risk control strategies.
ABSTRACT
Objective To investigate the clinical features,complications,treatment and prognosis of patients with Pcutz-Jeghers syndrome.Methods The clinical data of thirty-one cases of Pcutz-Jeghers syndrome treated in the First Hospital of Shanxi Medical University from January 1998 to December 2016 was analyzed retrospectively.Results There were11 cases with definite family history(35%,11/31).There were 21 cases of mucocutaneous pigmentation(67.7%,21/31),31 cases of gastrointestinal polyps(100%,31/31), including 8 cases of canceration(25.0%,8/31),24 cases of digestive tract bleeding(77.4%,24/31),20 cases of intussusception(64%,20/31),and 1 case of intestinal perforation(3.2%,1/31).6 cases were treated with endoscopic high frequency electrocoagulation,12 cases received polypectomy,17 cases underwent resection of intestinal tract.3 patients with intractable intussusception underwent plication of small intestine,and 4 patients with colon cancer underwent total colectomy combined with lymph node dissection.Conclusion Peutz-Jeghers syndrome often induce intractable intestinal obstruction and gastrointestinal tumor,resection of intestinal lesions should be favorable.For small intractable intussusception,the plication of small intestine has certain value; for its potential malignancy,it should be strictly monitored and actively treated.Gene therapy and drug therapy will guide for the future development.
ABSTRACT
Objective To investigate the clinical features,complications,treatment and prognosis of patients with Pcutz-Jeghers syndrome.Methods The clinical data of thirty-one cases of Pcutz-Jeghers syndrome treated in the First Hospital of Shanxi Medical University from January 1998 to December 2016 was analyzed retrospectively.Results There were11 cases with definite family history(35%,11/31).There were 21 cases of mucocutaneous pigmentation(67.7%,21/31),31 cases of gastrointestinal polyps(100%,31/31), including 8 cases of canceration(25.0%,8/31),24 cases of digestive tract bleeding(77.4%,24/31),20 cases of intussusception(64%,20/31),and 1 case of intestinal perforation(3.2%,1/31).6 cases were treated with endoscopic high frequency electrocoagulation,12 cases received polypectomy,17 cases underwent resection of intestinal tract.3 patients with intractable intussusception underwent plication of small intestine,and 4 patients with colon cancer underwent total colectomy combined with lymph node dissection.Conclusion Peutz-Jeghers syndrome often induce intractable intestinal obstruction and gastrointestinal tumor,resection of intestinal lesions should be favorable.For small intractable intussusception,the plication of small intestine has certain value; for its potential malignancy,it should be strictly monitored and actively treated.Gene therapy and drug therapy will guide for the future development.