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Objective:To evaluate the efficacy and adverse reactions of the regimen containing Bedaquiline in elderly patients with multi-drug resistant tuberculosis.Methods:From March 2019 to June 2022, patients with multi-drug resistant pulmonary tuberculosis admitted to Anhui Chest Hospital were randomly divided into two groups: the observation group was given a treatment containing Bedaquiline, and the control group was given a treatment without Bedaquiline.Patients were also divided into elderly patients(age ≥60 years old)and non-elderly patients(age <60 years old)according to age.Sputum culture conversion, lesion absorption and adverse reactions were compared between the observation group and the control group in general, elderly and non-elderly patients, respectively.Results:A total of 170 cases were collected, including 79 in the observation group and 91 in the control group.Sputum culture conversion: The sputum culture conversion rates of observation groups in general, non-elderly and elderly patients were better than that of control groups at the 3rd month after treatment(the general, 96.2% vs.75.8%, χ2=14.001, P<0.001; the non-elderly, 94.9% vs.82.1%, χ2=4.675, P=0.031; the elderly, 100.0% vs. 65.7%, χ2=8.771, P=0.003), and at the 6th month, the rates of overall observation group was better than that of control group(98.7% vs.92.3%, χ2=3.895, P=0.048); the rates of non-elderly and elderly observation group and control group were all greater than 90%, with no statistical significance( P>0.05). Lesion absorption: Overall and non-elderly observation groups were better than control group in lesion absorption at the 3rd month(the general, 84.8% vs.68.1%, χ2=12.962, P=0.002; the non-elderly, 88.1% vs.71.4%, χ2=9.832, P=0.007; and the 6th month(the general, 88.6% vs.76.9%, χ2=14.888, P=0.001; the non-elderly, 89.8% vs.82.1%, χ2=8.618, P=0.013). The focal absorptivity of senile observation group at the end of March and June were 75.0% and 85.0%, respectively, both better than control group, but the difference was not statistically significant( P>0.05). Adverse reactions: Overall and non-senile observation groups had longer QT interval than control groups( P<0.05), but no patients stopped bedaquiline because of this, and there was no significant difference in QT interval between the two groups( P>0.05). Conclusions:In elderly patients with multi-drug resistant pulmonary tuberculosis, early sputum culture conversion turns fast after treatment with Bedaquiline, which has good therapeutic effect, good tolerance and controllable adverse reactions.
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Objective To analyze the therapeutic effects and investigate the differences in clinical characteristics betweenpatients with tuberculosis complicated by HIV/AIDS and those withtuberculosis alone.Methods The data on 189 patients with pulmonary tuberculosis who had received treatment and follow-up from January 2011 to December 2011.According to the CD4+T level of ＞ or ＜ 200/μL,We divided 102 individuals into group A (CD4+ T ≤ 200/μL),and group B(CD4+T ＞ 200/μL).The rest 87 patients were assigned to group C.The clinical symptoms,laboratory examinations,manifestations of chest X-rays,and efficacy were respectively analyzed.Results As compared with groups B and C,in group A the clinical appearance was mainly systemic symptoms;and the positive rate of laboratory examinations was lower.The chest X-ray showed more diffusepatchy andblurring shadows,commonly in multiple lung fields,and less fiber strand and cavity formation.More diffusion in multiple lung fields was seen in group B than in group C.The total effective rate was lower in group A than in groups B and C,but after the course was extended for 3 months,the total effective rate was not significantly different compared with groups B and C.Conclusions Detection of CD4+T lymphocytesin patients with suspect HIV/AIDS complicated by tuberculosis has important significance in the early diagnosis and treatment and isolation.
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[Summary] To evaluate the relationships between plasma GPC4 levels and HbA1C . Plasma GPC4 levels were measured in subjects with different glucose tolerances. The relationship between plasma GPC4 levels and HbA1C were studied. Increasing levels of GPC4 showed a significant linear trend and were independently associated with HbA1C . GPC4 levels gradually declined after gradually increased , which is similar with Fins, 2hIns, and AUCinsulin . GPC4 may be involved in the regulation of blood glucose and GPC4 may be regulated by insulin.
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Objective To determine the power-time-ablation scope correlogram of a water-cooled single needle electrode radiofrequency (RF) ablation system and to establish a theoretical basis for its practical application.Methods RF ablations were performed using a water-cooled single needle electrode radiofrequency ablation system developed by the authors using fresh ox liver as well as liver and muscles of healthy adult New Zealand white rabbits.The temperature of the ablation area was monitored using a multichannel thermometric system.The maximum ablation scope was determined by detecting the rim at which the temperature was no less than 50 °C.The specific absorption rate (SAR) of the isolated liver tissue was calculated.Results In the treatment voltage range of 100-130V,the process was smooth and steady.No impedance variation was obvious.The maximum diameter of a single ablation was 51 cm.With the treatment voltage at 140-170 V,a larger ablation area could be reached in less time,but eventually the impedance began to increase while the ablation area was no longer expanded.When the treatment voltage reached the range of 180-200 V the impedance almost always increased rapidly out of limits,and the treatment system stopped automatically.The measured SAR value was consistent with the theoretical value.Pathology confirmed that both liver tissue and muscle tissue manifested typical coagulative necrosis.Conclusions The power amplifier,cooling,thermometric and control sections of the RF ablation system worked stably,and the practical ablation effect met the design and clinical treatment requirements.
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Objective To investigate the clinical manifestations and laboratory findings of patients with the late onset systemic lupus erythematosus(LOSLE) and the elderly onset SLE. Methods Forty one patients with SLE onset beyond the age of 50 years(including 20 patients SLE onset beyond the age of 60 years) were identified and compared with 41 patients who had SLE onset before the age of 50 (General SLE). Patients in the group of general SLE were selected by 1 to 1 individual matching according to sex, course of diseases, date of admission. The presenting clinical features, laboratory findings, incidence rate of complication, efficacy of glucocorticoid and the prognosis of patients in two groups of LOSLE and general SLE were compared and analyzed. In addition, 20 cases of elderly onset SLE were also compared and analyzed. Results There were significant differences in symptoms between groups of LOSLE and General SLE. The LOSLE group had less occurrence of rash (39 0% vs 73 2%, P
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Objective To improve the understanding of osteoarticular pain presented as rheumatic syndromes of cancers and malignant skeleton metastasis associated. Methods To analyse the clinical data of 32 patients initially manifested as osteoarticular pain. Results Forteen patients of 32 cases was diagnosed as cancer associated rheumatic syndromes, characterized by gradually deteriorated chronic recurrent vague pain. The effect of non-steroid anti-inflammatory drugs (NSAIDs) and glucocorticoid was not satisfactory. Pain subsided after removal of carcinous mass. Eighteen patients had malignant skeleton metastasis, vague pain at onset, but gradually progressed to be, severe persistent pain. NSAIDs and glucocorticoid were ineffective. Narcotic analgesics could produce short time relief. The nature and distribution of tumour were comparatively extensive. The clinical misdiagnosis rate was high. Conclusion Clinical doctors often neglect the coexistence of tumor because they are not familiar with the relation between osteoarticular pain and tumor. So patients who is over sixty and is not sensitive to commonly used analgesics and glucocorticoid with osteoarticular muscular pain should be considered the possibility of malignant tumor after excluding diffuse connective tissue disease.
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Objcetive To evaluate tumor necrosis factor-alpha(TNF-?) in differentiating diagnosis of tuberculous and non-small cell lung cancer with cytology-positive pleural effusion.Methods We measured TNF-? of serum in 25 patients with tuberculous effusion,26 cases of lung adenocarcinoma,21 cases of lung squamous cell carcinoma with pleural effusion and controls by enzyme-linked immunosorbant assays.Results Serum TNF-? levels in patients with tuberculous pleural effusion were lower than that in patienrts with lung adenocarcinoma and lung squamous cell carcinoma(P