Résumé
@#Objective To investigate the diagnostic value of Xpert MTB/RIF combined with metagenic high-throughput sequencing in bacterial negative tuberculosis.Methods Retrospective analysis of 70 patients diagnosed with bacterial negative pulmonary tuberculosis from December 2019 to May 2022 enrolled in the study.Xpert MTB/RIF testing,high-throughput metagenomic sequencing,and a combination of the two were performed,respectively.Solid culture and proportional methods were used to diagnose biochemical pathogens and analyze diagnostic efficacy.The receiver operating characteristic curve was drawn with the predicted value.Results The positive rate of Xpert MTB/RIF diagnosis was 75.57%,and the negative rate was 21.43%.The positive rate of high-throughput sequencing for metagenomics was 78.57%,while the negative rate was 21.43%;The positive rate of combined diagnosis was 88.57%,and the negative rate was 11.43%.The detection sensitivity of Xpert MTB/RIF was 77.55%,the specificity was 59.86%,and the area under the curve(AUC)was 0.827.The sensitivity of high-throughput sequencing for metagenomes was 77.47%,the specificity was 61.02%,and the AUC was 0.808.The sensitivity of the combined detection was 89.75%,the specificity was 89.57%,and the AUC was 0.925.The results showed that the diagnostic sensitivity and specificity of Xpert MTB/RIF combined with high-throughput metagenomic sequencing in bacterial negative pulmonary tuberculosis were higher than those of single detection(P<0.05).Conclusion Xpert MTB/RIF combined with metagenic high-throughput sequencing has good application value in the diagnosis of bacterial negative pulmonary tuberculosis,and is worthy of clinical application.
Résumé
Objective To investigate the efficacy and safety of montelukast sodium combined with fluticasone propionate in treatment of children with cough variant asthma.Methods Two hundred and forty children diagnosed as cough variant asthma in our hospital during February 2013 to January 2015 were randomized into three groups.Children in group Mon + Flu were given montelukast sodium combined with inhaled fluticasone propionate,children in group Flu was given inhaled corticosteroids alone and children in group Mon was given montelukast sodium alone.Cough,lung function and adverse reactions were observed after 8 and 12 weeks of treatment and the recurrences of cough symptoms were followed up within 24 weeks.Results After 8 weeks of treatment,the score of cough in group Mon + Flu (1.1 ± 0.7) was lower than those in groups Flu (1.7 ±0.8) and Mon (1.6 ±0.8) (t =4.973,4.353,P ＜0.05),while there was no significant difference between group Flu and group Mon(t =0.560,P ＞ 0.05).Meantime,the percentage of predicted in FEV1 in group Mon+ Flu (93.4 ± 15.8) was significantly higher than those in group Flu (87.4 ± 11.0) and group Mon (86.5 ± 9.8) (t =2.804,3.315,P ＜ 0.05).The percentage of predicted in PEF in group Mon + Flu(89.8 ± 15.4)was significantly higher than those in group Flu(84.9 ± 13.4)and group Mon(85.1 ± 12.3) (t =2.126,2.124,P ＜ 0.05),and there was no significant difference between latter two groups (t =0.525,0.082,P ＞ 0.05).After 12 weeks of treatment,there was no significant difference in scores of cough and percentage of predicted in FEV1 and PEF among three groups (P ＞ 0.05).There was no significant difference in incidence of adverse reactions among three groups (x2 =1.026,P ＞ 0.05).The recurrence rate of group Mon + Flu (3.85％) and group Flu(5.26％) were significantly lower than that of group Mon (17.33％) (x2 =7.428,5.505,P ＜ 0.05),while there was no difference between groups Mon + Flu and Flu (P ＞ 0.05).Conclusions For children with cough variant asthma montelukast sodium combined with fluticasone propionate has better efficacy than monotherapy in 8 weeks of treatment,but there was no difference in 12 weeks of treatment.The recurrence rate in group Mon + Flu and group Flu is lower than that in group Mon.