An Integrated Field Study of Turbulence and Dispersion Variations in Road Microenvironments.

Traffic-related air pollutants (TRAPs) emitted from vehicle tailpipes disperse into nearby microenvironments, posing potential exposure risks. Thus, accurately identifying the emission hotspots of TRAPs is essential for assessing potential exposure risks. We investigated the relationship between turbulent kinetic energy (TKE) and pollutant dispersion (D) through an integrated field measurement. A five-year near-road sampling campaign (5 min based) near a light-duty vehicle-restricted roadway and an on-road sampling campaign (5 s based) on isolated proving grounds were conducted. The D was first calculated based on vehicle emission and pollutant concentrations and then paired with TKE measurements. Here, 198 near-road and 377 on-road measurement pairs were collected. In the near-road measurements, TKE and D showed a positive relationship (R2 ≥ 0.69) with the vehicle flow rate, while they showed similar decay patterns and sensitivity to vehicle types in the on-road measurements. A relationship between TKE and D (TKE-D) was developed through these measurements, demonstrating a robust correlation (R2 ≥ 0.61) and consistent slope values (1.1-1.3). These findings provide field evidence for the positive association between TKE and D, irrespective of the measurement techniques or locations. The TKE-D relationship enables vehicle emission estimation with TKE as the sole input, facilitating the identification of emission hotspots with high spatiotemporal resolution.

Province-Level Decarbonization Potentials for China's Road Transportation Sector.

Decarbonizing road transportation is an important task in achieving China's climate goals. Illustrating the mitigation potentials of announced policies and identifying additional strategies for various vehicle fleets are fundamental in optimizing future control pathways. Herein, we developed a comprehensive analysis of carbon dioxide (CO2) emissions from on-road vehicles as well as their mitigation potentials based on real-world databases and up-to-date policy scenarios. Total CO2 emissions of China's road transportation are estimated to be 1102 million tons (Mt) in 2022 and will continue to increase if future strategies are implemented as usual. Under current development trend and announced policy controls (i.e., integrated scenario), annual CO2 emissions are estimated to peak at 1235 Mt in 2025 and then decline to approximately 200 Mt around 2050. The scenario analysis indicates that electrification of passenger vehicles emerges as the most imperative decarbonization strategy for achieving carbon peak before 2030. Additionally, fuel economy improvement of conventional vehicles is identified to be effective for CO2 emission reduction for trucks until 2035 while new energy vehicle promotion shows great mitigation potentials in the long term. This study provides insight into heterogeneous low-carbon transportation transition strategies and valuable support for achieving China's dual-carbon goals.

Persistent Environmental Injustice due to Brake and Tire Wear Emissions and Heavy-Duty Trucks in Future California Zero-Emission Fleets.

The adoption of zero-emission vehicles (ZEVs) offers multiple benefits for the climate, air quality, and public health by reducing tailpipe emissions. However, the environmental justice implications of the nonexhaust emissions from future ZEV fleets for near-roadway communities remain unclear. Here, we model the on-road fine particulate matter (PM2.5) emissions across all California counties and assess the near-roadway exposure disparities at the census block group level in the Los Angeles County in 2050, when almost all passenger vehicles are projected to be ZEVs. We found that promoting zero-emission heavy-duty trucks generates more air quality benefits for disadvantaged communities than light-duty passenger vehicles. Persistent disparities in near-roadway PM2.5 levels, however, exist due to the remaining brake and tire wear emissions and increased truck traffic in disadvantaged communities. We recommend implementing fleet-specific ZEV policies to address brake and tire wear emissions and optimizing freight structures to address these persistent environmental justice issues in California.

Long-term plume-chasing measurements: Emission characteristics and spatial patterns of heavy-duty trucks in a megacity.

Assessing the emissions of heavy-duty diesel trucks (HDDTs) is crucial for managing air quality in megacities, especially concerning nitrogen oxides (NOX) and black carbon (BC). This study employed mobile plume chasing to monitor the real-world emissions of over 7778 HDDTs in Shenzhen. The findings indicate that the real-world NOX emission factors (EF) of China IV trucks did not differ significantly from those of China III, whereas China V and VI vehicles demonstrated fleet-averaged reductions of 27% and 85%, respectively. For China V, a significant decrease in the NOX EF for HDDTs registered after 2017 was attributed to the installation of advanced aftertreatment systems, including diesel oxidation catalysts (DOC) and Diesel Particle Filters (DPF), along with selective catalytic reduction (SCR). These technologies led to an average reduction of 42% in NOX and 61% in BC emissions. Seasonal variations were pronounced, with winter (∼20 °C) NOX EF 40% higher than summer (∼35 °C) levels. Conversely, BC EF decreased by 26% in winter, indicating significant impacts of ambient temperature on emissions. Spatial analysis revealed that the average NOX EF of HDDTs on east freeways was 1.4 times higher than that on urban expressways, influenced by variations in the proportion of vehicle types segmented by usage. These findings offer a comprehensive perspective on HDDTs emissions, highlighting the importance of large-scale emission monitoring through plume chasing for precise and effective control of real-world HDDTs emissions.

Assessing traffic emissions during the summer world university games 2023: Insights for multisectoral synergetic decontamination.

Implementing temporary traffic control measures is a common strategy to prevent air pollution and alleviate traffic congestion during mega-events. Accurate assessment of event-time vehicular emissions is useful for local authorities to develop effective policies. However, many previous assessments were based on policy-based scenarios, which often failed to capture the synergistic impact from other sectors (e.g., the industrial sector). Here, we conducted both traditional scenario-based ex-ante evaluation and data-driven real-time emissions tracking to evaluate the impacts of traffic restriction policies during the Summer World University Games 2023 in Chengdu, China. Real-time tracking revealed that average vehicle kilometers traveled (VKT), traffic emissions of nitrogen oxides (NOX), and volatile organic compound (VOC) decreased by 18.3 %, 37.9 %, and 18.4 %, respectively, compared to the non-event period. The scenario-based ex-ante evaluation substantially underestimated NOX emission reduction from the truck fleet due to the lack of consideration for multisectoral synergistic effects. Event-time interventions in the industrial sector accounted for an additional 18.1 % reduction in truck NOX emissions. This study underscores the importance of considering cross-sectoral synergy when establishing policies for future mega events.

Coordination engineering of single-atom ruthenium in 2D MoS2 for enhanced hydrogen evolution.

This study investigates the enhancement of catalytic activity in single-atom catalysts (SACs) through coordination engineering. By introducing non-metallic atoms (X = N, O, or F) into the basal plane of MoS2 via defect engineering and subsequently anchoring hetero-metallic Ru atoms, we created 10 types of non-metal-coordinated Ru SACs (Ru-X-MoS2). Computations indicate that non-metal atom X significantly modifies the electronic structure of Ru, optimizing the hydrogen evolution reaction (HER). Across acidic, neutral, and alkaline electrolytes, Ru-X-MoS2 catalysts exhibit significantly improved HER performance compared with Ru-MoS2, even surpassing commercial Pt/C catalysts. Among these, the Ru-O-MoS2 catalyst, characterized by its asymmetrically coordinated O2-Ru-S1 active sites, demonstrates the most favorable electrocatalytic behavior and exceptional stability across all pH ranges. Consequently, single-atom coordination engineering presents a powerful strategy for enhancing SAC catalytic performance, with promising applications in various fields.

High emission of black carbon in heavy-duty diesel vehicles: Insights from microscopic operating conditions.

The in-depth investigation of the high black carbon (BC) emission scenarios of heavy-duty diesel vehicles (HDDVs) is a crucial step toward developing effective control strategies. Chassis dynamometer tests were conducted for three in-use HDDVs, namely, vehicle #1, #2, and #3, focusing on the instantaneous BC characterizations during multiple driving conditions, i.e., speed phases and acceleration intervals. BC emission was found to increase with positive acceleration, and high acceleration could result in instantaneous BC spikes. The total BC emissions during velocity-acceleration interval 15-60 km h-1 and 0.1-0.9 m s-2 contributed to 43.4 ± 10.2 % of the whole-cycle emissions, while the proportions of time spent in the velocity-acceleration interval to the whole cycle were 23.1 ± 7.6 %. The cold-start microscopic operating condition was assessed by the cold-start extra emissions (CSEEs). Under various pre-defined cold-start durations, the proportions of CSEEs in the total cycle emissions were 9.4-21.0 %, 0-9.1 %, and 6.8-39.4 % for vehicles #1, #2, and #3, respectively. The CSEEs exhibited an initial rise, followed by a plateau as the assumed cold-start durations extended. A uniform cold-start duration of 600 s was established based on the criterion that the relative standard deviation (RSD) of CSEEs during the plateau period was <10 %. We proposed that the updated cold-start duration can enhance the accuracy and consistency of cold-start corrections in emission inventory models.

Integrated Benefits of Synergistically Reducing Air Pollutants and Carbon Dioxide in China.

China's advancements in addressing air pollution and reducing CO2 emissions offer valuable lessons for collaborative strategies to achieve diverse environmental objectives. Previous studies have assessed the mutual benefits of climate policies and air pollution control measures on one another, lacking an integrated assessment of the benefits of synergistic control attributed to refined measures. Here, we comprehensively used coupled emission inventory and response models to evaluate the integrated benefits and synergy degrees of various measures in reducing air pollutants and CO2 in China during 2013-2021. Results indicated that the implemented measures yielded integrated benefits value at 6.7 (2.4-12.6) trillion Chinese Yuan. The top five contributors, accounting for 55%, included promoting non-thermal power, implementing end-of-pipe control technologies in power plants and iron and steel industry, replacing residential scattered coal, and saving building energy. Measures demonstrating high synergies and integrated benefits per unit of reduction (e.g., green traffic promotion) yielded low benefits mainly due to their low application, which are expected to gain greater implementation and prioritization in the future. Our findings provide insights into the effectiveness and limitations of strategies aimed at joint control. By ranking these measures based on their benefits and synergy, we offer valuable guidance for policy development in China and other nations with similar needs.

Characterization of on-road nitrogen oxides and black carbon emissions from high emitters of heavy-duty diesel vehicles in China.

Heavy-duty diesel vehicles (HDDVs) significantly contribute to atmospheric nitrogen oxides (NOX) and black carbon (BC), with high emitters within the HDDV fleet impacting the total emissions. However, emission patterns and contributions of high emitters are rarely explored from a fleet-perspective. We investigated NOX and BC emission factors (EFs) from 1925 HDDVs in Shenzhen by the plume-chasing method, and found that the fleet-average EFs decreased with stricter emission standards. Unexpectedly, the average NOX EF for the China IV fleet was comparable with that for the China III fleet due to possible ineffective aftertreatment in high-emitter sectors of China IV HDDVs. Decreasing trend in average NOX EF since 2017 reflected the effective emission controls by the implementation of China V standard. Besides, semi-trailer tractors exhibited a higher incidence of NOX over-emissions, whereas BC high emitters were more pronounced in box trucks. Total NOX and BC emissions from HDDVs in Shenzhen were revisited, reaching 54.0 and 1.1 Gg·yr-1, with updated NOX EF correcting a 26.2 % underestimation in national guidelines. Notably, eliminating high emitters yields greater emission reduction benefits than merely retiring old HDDVs, with BC reduction outpacing NOX. This study provides new insights into the implementation of targeted emission reduction measures for HDDVs.

Corilagin relieves atherosclerosis via the toll-like receptor 4 signaling pathway in vascular smooth muscle cells.

INTRODUCTION: Corilagin possesses a diverse range of pharmacologic bioactivities. However, the specific protective effects and mechanisms of action of corilagin in the context of atherosclerosis remain unclear. In this study, we investigated the impact of corilagin on the toll-like receptor (TLR)4 signaling pathway in a mouse vascular smooth muscle cell line (MOVAS) stimulated by oxidized low-density lipoprotein (ox-LDL). Additionally, we examined the effects of corilagin in Sprague-Dawley rats experiencing atherosclerosis. METHODS: The cytotoxicity of corilagin was assessed using the CCK8 assay. MOVAS cells, pre-incubated with ox-LDL, underwent treatment with varying concentrations of corilagin. TLR4 expression was modulated by either downregulation through small interfering (si)RNA or upregulation via lentivirus transfection. Molecular expression within the TLR4 signaling pathway was analyzed using real-time polymerase chain reaction (PCR) and Western blotting. The proliferation capacity of MOVAS cells was determined through cell counting. In a rat model, atherosclerosis was induced in femoral arteries using an improved guidewire injury method, and TLR4 expression in plaque areas was assessed using immunofluorescence. Pathological changes were examined through hematoxylin and eosin staining, as well as Oil-Red-O staining. RESULTS: Corilagin demonstrated inhibitory effects on the TLR4 signaling pathway in MOVAS cells pre-stimulated with ox-LDL, consequently impeding the proliferative impact of ox-LDL. The modulation of TLR4 expression, either through downregulation or upregulation, similarly influenced the expression of downstream molecules. In an in vivo context, corilagin exhibited the ability to suppress TLR4 and MyD88 expression in the plaque lesion areas of rat femoral arteries, thereby alleviating the formation of atherosclerotic plaques. CONCLUSION: Corilagin can inhibit the TLR4 signaling pathway in VSMCs, possibly by downregulating TLR4 expression and, consequently, relieving atherosclerosis.

Gut Dysbiosis Drives Inflammatory Bowel Disease Through the CCL4L2-VSIR Axis in Glycogen Storage Disease.

Patients with glycogen storage disease type Ib (GSD-Ib) frequently have inflammatory bowel disease (IBD). however, the underlying etiology remains unclear. Herein, this study finds that digestive symptoms are commonly observed in patients with GSD-Ib, presenting as single or multiple scattered deep round ulcers, inflammatory pseudo-polyps, obstructions, and strictures, which differ substantially from those in typical IBD. Distinct microbiota profiling and single-cell clustering of colonic mucosae in patients with GSD are conducted. Heterogeneous oral pathogenic enteric outgrowth induced by GSD is a potent inducer of gut microbiota immaturity and colonic macrophage accumulation. Specifically, a unique population of macrophages with high CCL4L2 expression is identified in response to pathogenic bacteria in the intestine. Hyper-activation of the CCL4L2-VSIR axis leads to increased expression of AGR2 and ZG16 in epithelial cells, which mediates the unique progression of IBD in GSD-Ib. Collectively, the microbiota-driven pathomechanism of IBD is demonstrated in GSD-Ib and revealed the active role of the CCL4L2-VSIR axis in the interaction between the microbiota and colonic mucosal immunity. Thus, targeting gut dysbiosis and/or the CCL4L2-VISR axis may represent a potential therapy for GSD-associated IBD.

Single-cell landscape reveals the immune heterogeneity of bone marrow involvement in peripheral T-cell lymphoma.

The prognosis of patients with peripheral T-cell lymphoma (PTCL) depends on bone marrow involvement (BMI). The bone marrow (BM) tumor microenvironment in PTCL remains unclear. We performed single-cell RNA sequencing (scRNA-seq) on 11 fresh BM samples from patients with BMI to reveal the associations of immune landscape and genetic variations with the prognosis of PTCL patients. Compared with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL) had a higher number of T cells, lower number of lymphocytes, and greater inflammation. Immune heterogeneity in AITL is associated with prognosis. In particular, specific T-cell receptor (TCR) T cells are enriched in patients with good response to anti-CD30 therapy. We observed RhoA mutation-associated neoantigens. Chidamide-treated patients had a higher number of CD4+ regulatory cells and a better treatment response compared with other patients. In the nonresponder group, T-cell enrichment progressed to secondary B-cell enrichment and subsequently diffuse large B-cell lymphoma. Moreover, AITL patients with lymphoma-associated hemophagocytic syndrome had more T follicular helper (Tfh) cells with copy number variations in CHR5. To our knowledge, this study is the first to reveal the single-cell landscape of BM microenvironment heterogeneity in PTCL patients with BMI. scRNA-seq can be used to investigate the immune heterogeneity and genetic variations in AITL associated with prognosis.

Prenatal Diagnosis of Cerebellar Cortical Dysplasia: Case Report.

This was a study of 12 cerebellar cortical dysplasias (CCDs) fetuses, these cases were characterized by a disorder of cerebellar fissures. Historically, CCD diagnosis was primarily performed using postnatal imaging. Unique to this study was the case series of CCD for prenatal diagnosis using prenatal ultrasound, as well as we found that AXIN1 and FOXC1 mutations may be related to CCD.

Regulatory Insights for On-Board Monitoring of Vehicular NOx Emission Compliance.

Nitrogen oxide (NOx) emissions from heavy-duty diesel vehicles (HDDVs) have adverse effects on human health and the environment. On-board monitoring (OBM), which can continuously collect vehicle performance and NOx emissions throughout the operation lifespan, is recognized as the core technology for future vehicle in-use compliance, but its large-scale application has not been reported. Here, we utilized OBM data from 22,520 HDDVs in China to evaluate their real-world NOx emissions. Our findings showed that China VI HDDVs had a 73% NOx emission reduction compared with China V vehicles, but a considerable proportion still faced a significant risk of higher NOx emissions than the corresponding limits. The unsatisfactory efficiency of the emission treatment system under disadvantageous driving conditions (e.g., low speed or ambient temperature) resulted in the incompliance of NOx emissions, especially for utility vehicles (sanitation/garbage trucks). Furthermore, the observed intertrip and seasonal variability of NOx emissions demonstrated the need for a long-term continuous monitoring protocol instead of instantaneous evaluation for the OBM. With both functions of emission monitoring and malfunction diagnostics, OBM has the potential to accurately verify the in-use compliance status of large-scale HDDVs and discern the responsibility of high-emitting activities from manufacturers, vehicle operators, and driving conditions.

A new In Situ Oxidized 2D Layered MnBi2Te4 Cathode for High-Performance Aqueous Zinc-Ion Battery.

Recently, aqueous zinc ion batteries (AZIBs) with the superior theoretical capacity, high safety, low prices, and environmental protection, have emerged as a contender for advanced energy storage. However, challenges related to cathode materials, such as dissolution, instability, and structural collapse, have hindered the progress of AZIBs. Here, a novel AZIB is constructed using an oxidized 2D layered MnBi2Te4 cathode for the first time. The oxidized MnBi2Te4 cathode with large interlayer spacing and low energy barrier for zinc ion diffusion at 240 °C, exhibited impressive characteristics, including a high reversibility capacity of 393.1 mAh g-1 (0.4 A g-1), outstanding rate performance, and long cycle stability. Moreover, the corresponding aqueous button cell also exhibits excellent electrochemical performance. To demonstrate the application in practice in the realm of flexible wearable electronics, a quasi-solid-state micro ZIB (MZIB) is constructed and shows excellent flexibility and high-temperature stability (the capacity does not significantly degrade when the temperature reaches 100 °C and the bending angle exceeds 150°). This research offers effective tactics for creating high-performance cathode materials for AZIBs.

Impacts of ethanol blended fuels and cold temperature on VOC emissions from gasoline vehicles in China.

The Chinese central government has initiated pilot projects to promote the adoption of gasoline containing 10%v ethanol (E10). Vehicle emissions using ethanol blended fuels require investigation to estimate the environmental impacts of the initiative. Five fuel formulations were created using two blending methods (splash blending and match blending) to evaluate the impacts of formulations on speciated volatile organic compounds (VOCs) from exhaust emissions. Seven in-use vehicles covering China 4 to China 6 emission standards were recruited. Vehicle tests were conducted using the Worldwide Harmonized Test Cycle (WLTC) in a temperature-controlled chamber at 23 °C and -7 °C. Splash blended E10 fuels led to significant reductions in VOC emissions by 12%-75%. E10 fuels had a better performance of reducing VOC emissions in older model vehicles than in newer model vehicles. These results suggested that E10 fuel could be an option to mitigate the VOC emissions. Although replacing methyl tert-butyl ether (MTBE) with ethanol in regular gasoline had no significant effects on VOC emissions, the replacement led to lower aromatic emissions by 40%-60%. Alkanes and aromatics dominated approximately 90% of VOC emissions for all vehicle-fuel combinations. Cold temperature increased VOC emissions significantly, by 3-26 folds for all vehicle/fuel combinations at -7 °C. Aromatic emissions were increased by cold temperature, from 2 to 26 mg/km at 23 °C to 33-238 mg/km at -7 °C. OVOC emissions were not significantly affected by E10 fuel or cold temperature. The ozone formation potential (OFP) and secondary organic aerosol formation potential (SOAFP) of splash blended E10 fuels decreased by up to 76% and 81%, respectively, compared with those of E0 fuels. The results are useful to update VOC emission profiles of Chinese vehicles using ethanol blended gasoline and under low-temperature conditions.

FOSL1 regulates hyperproliferation and NLRP3-mediated inflammation of psoriatic keratinocytes through the NF-kB signaling via transcriptionally activating TRAF3.

Psoriasis is a common and immune-mediated skin disease related to keratinocytes hyperproliferation and inflammation. Fos-like antigen-1 (FOSL1) is an important transcription factor involved in various diseases. FOSL1 has been reported to be differentially expressed in psoriasis. However, the roles and mechanism of FOSL1 in psoriasis progression remain largely unknown. FOSL1 is an upregulated transcription factor in psoriasis and increased in M5-treated HaCaT cells. FOSL1 had a diagnostic value in psoriasis, and positively associated with PASI score, TNF-α and IL-6 levels in psoriasis patients. FOSL1 silencing attenuated M5-induced HaCaT cell hyperproliferation through decreasing cell viability and proliferative ability and increasing cell apoptosis. FOSL1 knockdown mitigated M5-induced NLRP3 inflammasome activation and it-mediated inflammatory cytokine (IL-6, IL-8 and CCL17) expression. TRAF3 expression was increased in psoriasis patients and M5-treated HaCaT cells. FOSL1 transcriptionally activating TRAF3 in HaCaT cells. TRAF3 overexpression reversed the suppressive effects of FOSL1 silencing on M5-induced hyperproliferation and NLRP3-mediated inflammation. FOSL1 knockdown attenuated M5-induced NF-κB signaling activation by reducing TRAF3. Activation of NF-κB signaling reversed the effects of FOSL1 knockdown on hyperproliferation and inflammation in M5-treated cells. FOSL1 silencing prevented M5-induced hyperproliferation and NLRP3-mediated inflammation of keratinocytes by inhibiting TRAF3-mediated NF-κB activity, indicating FOSL1 might act as a therapeutic target of psoriasis.

Unpacking the factors contributing to changes in PM2.5-associated mortality in China from 2013 to 2019.

From 2013 to 2019, a series of air pollution control actions significantly reduced PM2.5 pollution in China. Control actions included changes in activity levels, structural adjustment (SA) policy, energy and material saving (EMS) policy, and end-of-pipe (EOP) control in several sources, which have not been systematically studied in previous studies. Here, we integrate an emission inventory, a chemical transport model, a health impact assessment model, and a scenario analysis to quantify the contribution of each control action across a range of major emission sources to the changes in PM2.5 concentrations and associated mortality in China from 2013 to 2019. Assuming equal toxicity of PM2.5 from all the sources, we estimate that PM2.5-related mortality decreased from 2.52 (95 % confidence interval, 2.13-2.88) to 1.94 (1.62-2.24) million deaths. Anthropogenic emission reductions and declining baseline incidence rates significantly contributed to health benefits, but population aging partially offset their impact. Among the major sources, controls on power plants and industrial boilers were responsible for the highest reduction in PM2.5-related mortality (∼80 %), followed by industrial processes (∼40 %), residential combustion (∼40 %), and transportation (∼30 %). However, considering the potentially higher relative risks of power plant PM2.5, the adverse effects avoided by their control could be ∼2.4 times the current estimation. Our power plant sensitivity analyses indicate that future estimates of source-specific PM2.5 health effects should incorporate variations in individual source PM2.5 effect coefficients when available. As for the control actions, while activity levels increased for most sources, SA policy significantly reduced the emissions in residential combustion and industrial boilers, and EOP control dominated the contribution in health benefits in most sources except residential combustion. Considering the emission reduction potential by source and control actions in 2019, our results suggest that promoting clean energy in residential combustion and enforcing more stringent EOP control in the iron and steel industry should be prioritized in the future.

Drug recommendation for optimization on treatment outcome for MDR/RR-TB based on a multi-center, large scale, retrospective cohort study in China.

OBJECTIVE: With the change in drug-resistant pattern, MDR/RR-TB was faced with underlying changes in regimens. A multi-center, large-scale, retrospective study performed aims to provide a recommendation of drug selection on optimization of outcome for the patients. METHOD: The study was conducted in six TB-specialized hospitals in China. Patients were included from 2018-2021 and followed up throughout the treatment. Using a multivarariable and propensity score-matched logistic regression analysis, we evaluated associations between outcomes and drug use, as well as clinical characteritics. RESULTS: Of 3112 patients, 74.29% had treatment sucess, 14.52% lost to follow-up, 9.67% failure, and 1.51% died. Treatment success was positively associated with Bedaquiline(Bdq), Linezolid(Lzd), and Cycloserin(Cs). Capreomycin(Cm) increased the risk of unfavorable outcomes. other drugs such as Amikacin(Amk) and clofazimine had no significant effect on outcomes. If isolates were susceptible to fluoroquinolones(FQs), FQs could decrease the risk of unfavorable outcomes. CONCLUSIONS: The recommendation order for the treatment of MDR/RR-TB is Bdq, Lzd, and Cs. FQs were decreased in use intensity. Injection drugs, whether Amk or Cm, are not recommended.