A prediction model for prognosis of nephrotic syndrome with tuberculosis in intensive care unit patients: a nomogram based on the MIMIC-IV v2.2 database.

Background: Currently, a scarcity of prognostic research exists that concentrates on patients with nephrotic syndrome (NS) who also have tuberculosis. The purpose of this study was to assess the in-hospital mortality status of NS patients with tuberculosis, identify crucial risk factors, and create a sturdy prognostic prediction model that can improve disease evaluation and guide clinical decision-making. Methods: We utilized the Medical Information Mart for Intensive Care IV version 2.2 (MIMIC-IV v2.2) database to include 1,063 patients with NS complicated by TB infection. Confounding factors included demographics, vital signs, laboratory indicators, and comorbidities. The Least Absolute Shrinkage and Selection Operator (LASSO) regression and the diagnostic experiment the receiver operating characteristic (ROC) curve analyses were used to select determinant variables. A nomogram was established by using a logistic regression model. The performance of the nomogram was tested and validated using the concordance index (C-index) of the ROC curve, calibration curves, internal cross-validation, and clinical decision curve analysis. Results: The cumulative in-hospital mortality rate for patients with NS and TB was 18.7%. A nomogram was created to predict in-hospital mortality, utilizing Alb, Bun, INR, HR, Abp, Resp., Glu, CVD, Sepsis-3, and AKI stage 7 days. The area under the curve of the receiver operating characteristic evaluation was 0.847 (0.812-0.881), with a calibration curve slope of 1.00 (0.83-1.17) and a mean absolute error of 0.013. The cross-validated C-index was 0.860. The decision curves indicated that the patients benefited from this model when the risk threshold was 0.1 and 0.81. Conclusion: Our clinical prediction model nomogram demonstrated a good predictive ability for in-hospital mortality among patients with NS combined with TB. Therefore, it can aid clinicians in assessing the condition, judging prognosis, and making clinical decisions for such patients.

Rare tuberculosis in recipients of allogeneic hematopoietic stem cell transplantation successfully treated with contezolid-a typical case report and literature review.

Background: Tuberculosis (TB) is a rare but potentially devastating complication in hematopoietic stem cell transplantation (HSCT) recipients. Myelosuppression-related antibiotics should be used cautiously in patients with hematological malignancies, especially those undergoing bone marrow transplantation and receiving bone marrow suppression therapy. Although linezolid has become the recommended drug for severe TB, its hematological toxicity is still an obstacle to its clinical application. Contezolid is a new representative of oxazolidinones in clinical development, showing superior anti-infection efficacy, but there have been no reports on the treatment of post-HSCT TB. Case presentation: We reported a patient with acute lymphoblastic leukemia suffered from pulmonary TB infection after HSCT. During anti-TB treatment, the patient had a poor response to linezolid-containing regimen, and developed side effects such as gingival bleeding and thrombocytopenia, so the administration was switched to contezolid. After 15 days of continuous treatment, the patient's platelet increased to 58×109/L, and he was discharged in stable condition. During subsequent anti-TB treatment with contezolid for more than 7 months, the platelets remained stable, and no hematological adverse reactions and no symptoms of peripheral neuropathy were observed. Moreover, repeat imaging showed that the bilateral lung lesions were significantly reduced, indicating a good outcome for the patient. Conclusion: This was the first successful case of post-HSCT TB patients treated with contezolid-containing antibiotic management strategies, which exhibited remarkable efficacy and good safety in this deadly disease.

Mutation characterization of gyrA and gyrB genes in levofloxacin-resistant Mycobacterium tuberculosis clinical isolates from Guangdong Province in China.

OBJECTIVE: Fluoroquinolone (FQ)-resistant Mycobacterium tuberculosis (MTB) clinical isolates have emerged in many areas of the world. The aim of this study was to observe the molecular characterization of gyrA and gyrB genes in FQ-resistant MTB clinical isolates from Guangdong Province in China. MATERIALS AND METHODS: A total of 62 MTB clinical strains were originally isolated from patients with pulmonary tuberculosis. The phenotype of susceptibility of each strain was determined by the absolute concentration method and the sequences of the QRDR in gyrA and gyrB genes were detected with DNA direct sequencing technique. RESULTS: 44 of 60 (73.3%) levofloxacin-resistant MTB clinical isolates, including 17 of 18 (94.4%) high-level resistant strains and 27 of 42 (64.3%) low-level resistant strains, had mutation in QRDR of gyrA gene. The mutation patterns involved six patterns of single codon mutation (H70R, A90V, S91A, D94G, D94A or D94N) and one pattern of double codons mutation (A90V with D94A). Of 60 levofloxacin-resistant MTB clinical isolates, only one (1.6%) mutated in gyrB gene (T511N). CONCLUSIONS: These findings confirm that mutations of gyrA codons 90, 91 and 94 constitute the primary mechanism of FQ resistance in MTB. Furthermore, our findings indicate that the regional investigations are necessary for the comprehensive understanding of FQ resistance of MTB.

[Microscopic infrared spectral imaging of oily core].

In the present paper, the authors examined some oily core by microscopic infrared spectral imaging methods. Those methods can be classified in three modes, referred to as "transmission mode", "reflection mode" and "attenuated total reflection (ATR) mode". The observed oily core samples belong to siltstone. The samples were made of quartz (-20%), feldspar(-50%) and other rock (igneous rock 25%, metamorphic rocks 1%, sedimentary rock 4%); a little recrystallized calcite (-1%) was in the pore, and the argillaceous matter was distributed along the edge of a pore. The experimental work has been accomplished using SHIMADZU Model IRPrestige-21 Fourier transform infrared spectrophotometer plus AIM8800 infrared microscope. For IRPrestige-21, the spectral range is 7 800-350 cm(-1) spectral resolution is 1 cm(-1), and AIM8800 microscope with motorized stages has a resolution of 1 micrometer. The experiment was preformed at room temperature. In "transmission mode" infrared spectral imaging method, the spectral range was limited in wavenumbers greater than 2 000 cm(-1) because the base glass piece has strong light absorption. In contrast with "transmission mode", in "attenuated total reflection (ATR) mode", the depth of penetration into sample is very small (1-2 micrometer), then the absorbance value has nothing to do with base glass piece light absorption. In microscopic infrared transmission spectra, the experimental result shows that there are some strong absorption peaks at 2 866, 2 928, 3 618 and 2 515 cm(-1) respectively. The former two peaks correspond to methyl(methylene) symmetrical and unsymmetrical stretch vibration mode, respectively. The latter two peaks correspond to hydroxyl-stretch vibration mode and S-H, P-H chemical bond stretch vibration mode, respectively. In microscopic longwave infrared ATR spectra, there are other stronger absorption peaks at 1 400, 1 038 and 783 cm(i1)respectively, corresponding to methyl(methylene) widing vibration mode and optical mode of quartz crystal, respectively. On the basis of the above-mentioned experimental result, the authors have separately accomplished microscopic infrared transmission and ATR spectral imaging using mapping procedure. The "transmission mode" and "ATR mode" have their own advantage and disadvantage. According to specific structural and spectral properties of sample and the practical research goall we should select a practical procedure.

The surface relaxation and band structure of Mo(112).

The experimental and theoretical surface band structures of Mo(112) are compared. This surface band structure mapping is presented with corrections included for the lattice relaxation of the Mo(112) surface. Quantitative low energy electron diffraction (LEED) has been used to determine the details of the Mo(112) surface structure. The first layer contraction is 14.9% by LEED intensity versus voltage analysis and is in general agreement with the 17.6% contraction found from total surface energy optimization. The electronic band structure is mapped out along [Formula: see text]-[Formula: see text] and [Formula: see text]-[Formula: see text] of the surface Brillouin zone (SBZ). There is strong evidence of electron-phonon coupling particularly in the region of the Fermi level band crossing at 0.54 Å(-1).

[Microscopic raman spectral imaging of oily core].

In the present paper, the authors examined some oily core by Raman spectral imaging methods. Those methods can be classified into two categories, referred to as "parallel or direct imaging" (Imaging) and "series or indirect imaging" (Mapping) techniques. The observed oily core samples which belong to siltstone that was from LONG-HU-PAO structure in SONG-LIAO basin. The samples were made from quartz (approximately 60%), feldspar (approximately 25%) and other impurity, a little recrystallized calcite (approximately 1%) was in the pore, and the argillaceous matter was distributed along the edge of a pore. The experimental work was accomplished using Renishaw MKI2000 Model Raman spectrometer including System 1000 plus filter wheel and filter set. The experimental condition is as follows: room temperature, back-scattering geometry, and excitation wavelength 514. 5 nm (Ar ion laser). In organic matter region, the microscopic Raman spectrum shows that there are two strong scattering peaks at 1 587. 2 and 1334.5 cm(-1), respectively. The former corresponds to intralayer bi-carbon-atomic stretch mode, referred to as "graphite peak"; the latter is disorder-induced feature because of the relaxation of the wave-vector selection rule resulting from finite crystal size effects, referred to as "disorder peak". In pure core substrate region, we observed a sharper peak at 462.7 cm(-1), corresponding to Raman active nonpolar optical mode of quartz crystal. On the basis of the above-mentioned experimental result, we accomplished Raman spectral imaging using mapping (indirect-imaging) procedure and imaging (direct-imaging) procedure, separately. In mapping (indirect-imaging) procedure, although the Raman spectra possess a high spectral resolution (approximately 1 cm(-1)) in every spatial dot, the restructured picture shows a low spatial resolution power (approximately 1 micrometer) because the smallest laser beam radius on the sample plane was restricted by objective lens NA. In imaging (direct-imaging) procedure, the Raman spectra possess a low spectral resolution power (approximately 10-20 cm(-1)), but the picture shows a high spatial resolution power (approximately 0.25-0.30 micrometer) because we need not restructure the picture whose spatial resolution power was only restricted by the optical wavelength. According to the specific structural and spectral properties of sample, and the practical research goal, the authors should select either imaging (direct-imaging) procedure or mapping (indirect-imaging) procedure.