[Retrospective analysis of diagnosis and treatment of tuberculosis in designated medical institutions in China from 2017 to 2022].

Objective: To understand the status of tuberculosis diagnosis and treatment capacity and the development and changes of tuberculosis diagnosis and treatment in provincial and municipal designated medical institutions in China from 2017 to 2022, so as to provide a basis for the formulation of relevant policies for the improvement and development of designated medical institutions for tuberculosis and the tuberculosis prevention and treatment service system, and to provide reasonable support for further strengthening the capacity of designated medical institutions for tuberculosis. Methods: This study was initiated and carried out by Beijing Chest Hospital affiliated to Capital Medical University/Clinical Center for Tuberculosis Prevention and Control of China CDC (hereinafter referred to as "Clinical Center") by means of questionnaire survey, and the investigation was carried out from March to November 2023. During this period, the clinical center distributed questionnaires to the hospital member units of "Beijing Tuberculosis Diagnosis and Treatment Technology Innovation Alliance", retrospectively collected their tuberculosis-related diagnosis and treatment data from 2017 to 2022, and used descriptive statistical methods to analyze the number of tuberculosis beds, outpatients and hospitalizations in medical institutions. The results were expressed in absolute numbers (percentages), and three-line tables, bar charts and line charts were drawn to describe the analysis results and changing trends. Results: The 54 medical institutions surveyed in this survey included 21 provincial-level designated medical institutions and 33 prefecture-level designated medical institutions. Most medical institutions have set up clinical departments, auxiliary departments and functional departments to undertake public health tasks of infectious diseases. The tuberculosis laboratory in the hospital has a comprehensive ability and has the detection technology needed for most tuberculosis diagnosis; The number of tuberculosis beds, children's tuberculosis beds and ICU beds all showed an increasing trend from 2017 to 2022. The proportion of tuberculosis beds in the hospital decreased slightly, from 39.31% in 2017 to 34.76% in 2022, showing a slight downward trend. Compared with the hospital surveyed, the number of tuberculosis outpatients in 2019 was 562 029, and the number of outpatients in 2020-2022 was 462 328, 519 630 and 424 069 respectively, which was significantly lower than that in 2019. The number of tuberculosis outpatients in medical institutions decreased significantly from 2020 to 2022. By analyzing the proportion of patients with different types of tuberculosis, the proportion of sensitive tuberculosis outpatients in 2017-2022 decreased from 84.49% in 2017 to 78.05% in 2022, showing a downward trend year by year. The proportion of patients with multidrug-resistant/ rifampin-resistant tuberculosis increased from 2.03% in 2017 to 7.18% in 2022. From 2017 to 2019, the total number of inpatients with tuberculosis showed an upward trend. Compared with 2019, the number of inpatients in 2020, 2021 and 2022 showed a downward trend, and the decline in 2020 was large (down 14.94% compared with 2019). Among the inpatients, the absolute number and proportion of patients with sensitive pulmonary tuberculosis remained relatively stable, and the number and proportion of inpatients with multidrug-resistant/rifampin-resistant pulmonary tuberculosis increased year by year. Conclusions: Most medical institutions have the capacity to carry out routine diagnosis and treatment of tuberculosis, but the public health function needs to be strengthened. The transformation of medical institutions requires proper guidance and adequate support. During 2019-2022, most medical institutions were affected by the COVID-19 epidemic, and their tuberculosis diagnosis and treatment work also changed to varying degrees. During this period, hospitals took various measures to overcome difficulties and tried their best to maintain the normal development of tuberculosis diagnosis and treatment, and the tuberculosis diagnosis and treatment work of various institutions gradually resumed in 2022.

[Correlation of carbon dioxide derived parameters during cardiopulmonary bypass with acute kidney injury after pediatric cardiac surgery].

Objective: To explore the correlation of the ratio of venous-arterial carbon dioxide (CO2) tension difference to arterial-venous O2 content difference (Pv-aCO2/Ca-vO2) and venous-arterial CO2 gradient (Pv-aCO2) during cardiopulmonary bypass (CPB) with acute kidney injury (AKI) after pediatric cardiac surgery. Methods: The clinical data of children (1 month ≤ age ≤ 3 years old) who underwent open heart surgery under CPB in West China Hospital of Sichuan University from March 2021 to August 2022 were retrospectively analyzed. All paired blood gases of the children during CPB (the sampling time interval of arterial and venous blood was within 10 minutes) were collected. According to the Failure, Loss, End-Stage Renal Disease (pRIFLE) diagnostic criteria, the children were divided into AKI group and non-AKI group. Multivariate logistic regression analysis was performed to identify the risk factors of postoperative AKI in pediatric cardiac surgery. Results: A total of 213 children were enrolled (101 males and 112 females), aged 12(6, 24) months, and 84 of them (39.4%) developed AKI. Three children died in AKI group, with a mortality of 3.6%. There were no deaths in non-AKI group. The incidence of postoperative low cardiac output syndrome (LCOS) was higher in AKI group [29.8% (25/84) vs 7.0% (9/129), P<0.001]. In addition, compared with the non-AKI group, children in AKI group had longer recovery time [15 (6, 78) h vs 6 (3, 19) h, P<0.001], mechanical ventilation time [17 (7, 97) h vs 6 (4, 20) h, P<0.001], intensive care unit (ICU) stay [6 (4, 11) d vs 3 (2, 5) d, P<0.001], and hospital stay [12 (9, 18) d vs 9 (8, 11) d, P<0.001]. A total of 317 arterial and venous blood gas pairs from 30 (n=207), 60 (n=75) and 90 min (n=35) after aortic clamping were included in the analysis. Univariate analysis showed that Pv-aCO2/Ca-vO2 (P=0.015) at 30 min after aortic clamping, Pv-aCO2 (P=0.041) and Pv-aCO2/Ca-vO2 (P=0.014) at 60 min after aortic clamping, peak Pv-aCO2 (P=0.009), peak Pv-aCO2/Ca-vO2 (P<0.001) and the average value of Pv-aCO2/Ca-vO2 (P=0.001) were higher in AKI group. Multivariate logistic regression analysis showed that longer duration of CPB (OR=1.013, 95%CI: 1.003-1.023, P=0.012), higher peak Pv-aCO2/Ca-vO2 (OR=1.337, 95%CI: 1.037-1.723, P=0.025) were risk factors for AKI. Conclusion: The occurrence of AKI after pediatric cardiac surgery is related to the short-term adverse clinical prognosis, and longer duration of CPB and higher peak Pv-aCO2/Ca-vO2 are independent risk factors for AKI.

[miR-200a involvement in the biological behavior of hepatoma carcinoma cells by targeting the regulatory expression of mesenchymal-epithelial transition factor].

Objective: To study the regulatory effect of miR-200a on mesenchymal-epithelial transition factor (MET) and its impact on the biological behavior of hepatoma carcinoma cells. Method: A luciferase reporter assay was used to determine miR-200a's regulatory impact on MET. Human hepatoma HepG2 cells were divided into a control group, a miR-200a group, a MET overexpression group, and a co-transfection group (miR-200a+MET). After culture, cell proliferation ability, cell migration ability, apoptosis, cell invasion ability, and the expression of MET and apoptosis-related (Bcl-2, Caspase-3, Bax) proteins were detected and observed by cell counting kit-8 (CCK-8), scratch assay, Annexin V-FITC staining, transwell chambers, and western blotting. The two groups were compared using the independent sample t-test. The multiple groups were statistically analyzed using one-way ANOVA. Results: The luciferase experiment showed that miR-200a had target MET. The proliferation rate, number of invasions in cells (55.00 ± 7.21, 85.00 ± 7.94, 164.67 ± 19.22, 104.00± 12.29), scratch healing rate (28.33% ± 5.03%, 61.67% ± 4.04%, 74.67% ± 7.02%, 49.33% ± 9.02%), and expression levels of MET, Bcl-2, and Caspase-3 proteins were lower in the miR-200a group than those in the control group, MET overexpression group, and co-transfection group, while the MET overexpression group had higher indexes than the other three groups, with statistically significant differences between the groups (P <0.05). The apoptosis rate of HepG2 cells and the expression level of Bax protein were higher in the miR-200a group than those in the control group, MET overexpression group, and co-transfection group (19.25% ± 2.98%, 6.80% ± 1.15%, 3.42% ±0.76%, 9.90% ± 2.72%), while the levels of various indexes in the MIF overexpression group were lower than those in the other three groups. The control group and co-transfection group were between the two groups, and the difference between the groups was statistically significant (P <0.05). Conclusion: HepG2 cell proliferation, migration, invasion, and cell apoptosis induction can be inhibited by miR-200a, and the functional mechanism for this may be associated with the miR-200a target's ability to down-regulate MET expression in HepG2 cells.