Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020.

Objective: To describe the trend of tuberculosis (TB) diagnosis in the migrant city Shenzhen, China, and analyze the risk factors of diagnosis delays. Methods: Demographic and clinical information of TB patients from 2011 to 2020 in Shenzhen were extracted. A bundle of measures to enhance TB diagnosis had been implemented since late 2017. We calculated the proportions of patients who underwent a patient delay (>30 days from syndrome onset to first care-seeking) or a hospital delay (>4 days from first care-seeking to TB diagnosis). Multivariable logistic regression was used to analyze the risk factors of diagnosis delays. Results: During the study period, 43,846 patients with active pulmonary TB were diagnosed and registered in Shenzhen. On average, the bacteriological positivity rate of the patients was 54.9%, and this increased from 38.6% in 2017 to 74.2% in 2020. Overall, 30.3 and 31.1% of patients had a patient delay or a hospital delay, respectively. Molecular testing significantly increased bacteriological positivity and decreased the risk of hospital delay. People >35 years old, the unemployed, and residents had a higher risk of delays in both patient care-seeking and hospital diagnosis than younger people, workers, or migrants. Compared with passive case-finding, active case-finding significantly decreased the risk of patient delay by 5.47 (4.85-6.19) times. Conclusion: The bacteriological positivity rate of TB patients in Shenzhen increased significantly but the diagnosis delays were still serious, which may need more attention when active case-finding in risk populations and optimization of molecular testing.

[Alteration of bladder function in response to surgical reduction in bladder capacity: conventional-fill cystometry in awake rabbit model].

OBJECTIVE: To investigate alteration of bladder function in response to surgically reduced bladder capacity by using an awake rabbit model. METHODS: Forty rabbits were divided into two groups, one was experimental group in which the rabbits underwent semi-cystectomy to reduce 50% bladder capacity (n=20), another was control group in which the rabbits received sham operation (n=20). A conventional-fill cystometric investigation was performed as the animal under awake condition at the times of 4 weeks and 8 weeks after operation. RESULTS: Compared with control subjects, the maximum cystometric capacity in experimental group was remarkably decreased at week 4 [(35.3 +/- 8.2) mL vs. (71.6 +/-12.9) mL, P < 0.05), and week 8 [(46.2 +/- 12.1) mL vs. (82.7 +/- 20.1) mL, P < 0.05] respectively; while the maximum voiding detrusor pressure was significantly enhanced at week 4 [(24.4 +/- 7.0) vs. (16.5 +/- 7.2) cm H2O, P < 0.05) and week 8[(27.7 +/- 8.0) vs. (16.8 +/- 7.5) cm H2O, P < 0.05) respectively. CONCLUSION: Alteration of bladder function, which mainly presented as the increase of maximum voiding detrusor pressure, was elicited at four to eight weeks after surgical reduction of bladder capacity in rabbit.