Risk factors for multidrug resistance in tuberculosis patients with diabetes mellitus.

OBJECTIVE: To study the risk factors and prediction models of multidrug resistance in patients with tuberculosis and diabetes and those with a history of tuberculosis treatment. METHODS: A total of 256 tuberculosis patients with diabetes who were registered in Luoyang city, Henan Province, from January 2018 to December 2021. Logistic regression analysis was performed to analyse the risk factors for multidrug resistance. ROC curves were used to analyse the predictive model for multidrug resistance. RESULTS: Age < 65 years old, HbA1c, and a history of tuberculosis treatment were independent risk factors for multidrug resistance in patients with tuberculosis and diabetes (P < 0.05). The area under the ROC curve of predictive model for MDR was 0.878 (95% CI (0.824, 0.932)). Age < 65 years old and HbA1c were independent risk factors for MDR in patients with TB and diabetes with a history of TB treatment. The area under the ROC curve of predictive model for MDR was 0.920 [95% CI (0.831, 0.999)]. CONCLUSION: The predictive model had certain prediction value for the risk of multidrug resistance in patients with tuberculosis and diabetes.

Identification of a novel homozygous LAMB3 mutation in a Chinese male with junctional epidermolysis bullosa and severe urethra stenosis: A case report.

Introduction: Epidermolysis bullosa (EB) is a skin fragility disorder that is caused by molecular aberrations in the epidermal basement membrane zone. Based primarily on the cleavage plane within the skin, EB is classified into four major subtypes: EB simplex; junctional EB (JEB); dystrophic EB; and Kindler EB. The junctional form (JEB) can lead to blistering and a variety of extracutaneous complications, including genitourinary tract involvement. Despite therapeutic progress, treatment modalities for urological complications of JEB are currently limited. Results: We present the case of a Chinese male with intermediate JEB and profound urinary tract stenosis. Due to the progression of the urinary tract stenosis, he presented with repeated urological symptoms, such as high frequency of urination, painful urination, and difficult voiding. After birth, multiple blisters on the fingers, feet, and limbs, as well as nail dystrophies and spare hair were noted. Mutation analysis revealed that the patient carried a homozygous frameshift mutation in the LAMB3 gene [c.1172_1179delinsTGTGTGTGCAAGGAG/p. (P391Lfs*23)]. After receiving treatment for urethral dilatation, lingual mucosa for anterior urethroplasty, and repair of urethral stricture using a ventral onlay penile skin flap, the patient still experienced a relapse of urinary tract stenosis. Finally, the patient underwent perineal urethrostomy. In contrast, his older brother with similar urological symptoms received regular urethral dilatation, and the curative effect was positive. Conclusion: Here we report on a case with a novel LAMB3 mutation that led to JEB with profound urinary tract stenosis, which has expanded our experience in the treatment of EB urological complications.

A modified Khorana score as a risk assessment tool for predicting venous thromboembolism in newly diagnosed advanced lung cancer.

The aim of this study was to evaluate the Khorana score and modified Khorana score as risk assessment tools for predicting the development of VTE in newly diagnosed advanced lung cancer. Information on the clinical data and laboratory indicators of the study group between 2014 and 2018 and the validation group between January 2019 to June 2020 of newly diagnosed advanced lung cancer patients at The First Affiliated Hospital of Henan University of Science and Technology was collected. We conducted an analysis of the risk factors affecting VTE development and the predictive risk value of the Khorana score and the modified Khorana score for VTE in newly diagnosed advanced lung cancer patients. A total of 124 patients were included in the study group. D-dimer is an independent risk factor for VTE in newly diagnosed advanced lung cancer patients (OR 1.620, 95% CI 1.220, 2.152, p = 0.001). The best cutoff value of D -dimer for the prediction of VTE development risk was 1.14 mg/L. The AUC of the Khorana score to predict the occurrence risk of VTE in newly diagnosed advanced lung cancer patients was 0.706; when the best cutoff value was 2, the sensitivity was 70.83%, and the specificity was 65%. The AUC of the modified Khorana score was 0.870; when the cutoff value was 2, the sensitivity was 100%, and the specificity was 50%. A total of 237 patients were included in the validation group, the AUC of the modified Khorana score for predicting the occurrence risk of VTE was 0.875; when the cutoff value was 2, the sensitivity was 100%, and the specificity was 52.1%. The modified Khorana score after incorporating D-dimer has a higher predictive value for the occurrence risk of VTE in newly diagnosed lung cancer patients; when the score ≥ 2, its sensitivity is higher, and it can more fully identify high-risk groups of VTE.

[Endoplasmic reticulum stress promotes the apoptosis of testicular germ cells in hyperlipidemic rats].

OBJECTIVE: To investigate the role of endoplasmic reticulum stress in the apoptosis of testicular germ cells in hyperlipidemic rats. METHODS: We randomly assigned 42 four-week-old male Wistar rats into a normal control group (n = 12) and a high-fat group (n = 30) to be fed on a normal diet and a high-fat diet, respectively, for 10 weeks. Then we measured the concentrations of triglyceride (TG) and total cholesterol (TC) in the serum using an automatic biochemistry analyzer, detected the apoptosis of testicular germ cells by TUNEL staining, and determined the protein and mRNA expressions of GRP78 and. caspase-12 in the testis tissue by immunohistochemistry and RT-PCR, respectively. RESULTS: The concentrations of TG and TC were significantly increased in the animals of the high-fat group ([3.00 ± 0.92] and [3.04 ± 0.39] mmol/L) as compared with the control rats ([1.43 ± 0.41] and [1.55 ± 0.23] mmol/L) (P < 0.01), and so was the apoptosis index of the testicular germ cells ([37.17 ± 2.74]% vs [5.16 ± 0.81]%, P < 0.01). The high-fat group, in comparison with the control, also showed remarkably upregulated protein and mRNA expressions of GRP78 (0.32 ± 0.03 and 0.86 ± 0.05 vs 0.19 ± 0.01 and 0.37 ± 0.03, P < 0.01) and caspase-12 (0.34 ± 0.02 and 0.87 ± 0.01 vs 0.12 ± 0.01 and 0.34 ± 0.03, P < 0.01) in the testis tissue. CONCLUSION: The apoptosis of testicular germ cells is increased in hyperlipidemic rats, which may be attributed to endoplasmic reticulum stress.