RÉSUMÉ
@#Abstract： Objective To analyze the value and influencing factors of cross-primer isothermal amplification technology(CPA) in clinical screening and diagnosis of tuberculosis (TB). Methods We collected 543 inpatients in the Second Affiliated Hospital of Hainan Medical College from January 1, 2018 to December 31, 2021, including 179 patients with tuberculosis, 187 patients with pneumonia and 177 patients with other diseases. The patients' sputum, alveolar lavage fluid, pleural effusion and midstream urine were detected by CPA, smear microscopy, culture method and gene detection. The value of CPA detection in the diagnosis of tuberculosis and its influencing factors were evaluated. Statistical analysis was performed using SPSS 26.0. Results The total positive rate of CPA was 14.4% (78/543), and the positive rate of sputum samples accounted for 29.1% (39/134). Among the 78 cases of CPA positive patients, the tuberculosis group accounted for 69.2% (54/78), followed by pneumonia group 21.8% (17/78), and other diseases group accounted for 9.0% (7/78). Taking CPA test as the reference method, the "sensitivity" of smear microscopy was lower than that of genetic testing and culture, while the "specificity" was higher than that of culture and gene testing, and the "missed diagnosis rate" of smear microscopy was higher than that of genetic testing and culture. CPA test positive was related to gender, ESR and pneumonia. There is a good agreement between CPA test and culture method and gene test (Kappa>0.9), and a moderate agreement between CPA test and smear microscopy (Kappa=0.616). Conclusions Sputum specimen is the best choice for CPA detection, while the value of pleural effusion detection is relatively limited. Sputum, alveolar lavage fluid and midcourse urine can be used as clinical specimens for screening and diagnosis of "tuberculosis group and other disease group", while sputum can be used for screening and diagnosis of "tuberculosis group and pneumonia group". Gender, ESR and pneumonia are the influencing factors of CPA positive patients. Therefore, CPA testing is worthy of clinical promotion, but more clinical research data are needed.
RÉSUMÉ
@#Abstract: Objective To explore the regional, age and annual characteristics of distribution and variation trend of children and adolescents with poor vision in Hainan Province, and to provide a theoretical basis for the formulation of targeted and effective prevention and treatment strategies. Methods The eyesight monitoring data of 5 657 231 children and adolescents aged 6 to 19 from 17 cities and counties in Hainan Province from 2013 to 2020 were analyzed. Using the "Standard Logarithmic Vision Chart" (GB11533-2011) that complies with national standards for testing. Results The rate of poor vision among children and adolescents in Hainan Province increased significantly from 2013 to 2020, and the difference between the years was statistically significant (P<0.001). The total poor vision rate in the left eye increased 10.09% (32.79% to 42.88%), and that of severe poor vision rate increased 6.68%, while that of the right eye increased 9.80% (33.11% to 42.91%) and 6.49%. The poor vision rate was significantly higher in females than in males of same year (P<0.001), but the increase pattern was the same. In 2020, there were significant differences between the same age groups in different cities and counties and between different age groups in the same city and county (P<0.001), and they all tended to increase with age. The result of analyzing the distribution characteristics of the total poor vision rate of different age groups children in the eastern (Qionghai), southern (Sanya), western (Changjiang), northern (Haikou) and central (Dingan) cities showed that the regional rate difference was small at 6-7 years old, and then increased with the increase of age. The poor vision rate of Haikou City ranked the first in all age groups, and reached the highest at 17 years old, with 76.32% and 80.89% of total poor vision rate of left and right eyes respectively. Sanya City ranked second, Qionghai ranked third. The poor vision rate of Changjiang County was lower and the growth rate was slower according to age. Conclusions From 2013 to 2020, the total and severe poor vision rates in left and right eyes of children aged 6-19 in Hainan Province increased year by year, with the ascension range of female higher than that of male, and right eye higher than that of left eye. In the same year, the poor vision rate increase rapidly with age. It is recommended to further strengthen the daily intervention and management of key populations and special age groups to reduce the rate of low vision in children and adolescents.