[Annual progress of interventional diagnosis and treatment of tuberculosis in 2023].

A series of studies on the interventional diagnosis and treatment of tuberculosis(TB)were carried out by domestic and foreign researchers in 2023. The combination of minimally invasive interventional procedures with endoscopes, guidance, material acquisition techniques by multiple ways and multichannel and highly accurate laboratory testing techniques is becoming more and more widely practiced clinically, which has played an important role in the accurate diagnosis of problematic TB. Diagnostic procedures for pulmonary TB, tracheobronchial TB, mediastinal lymphatic TB and extrapulmonary TB included conventional flexible bronchoscopy and specific types of bronchoscopy(ultrathin bronchoscopy and endobronchial ultrasound), transbronchial needle aspiration biopsy, endobronchial ultrasound and virtual bronchoscopic navigation system-guided forceps biopsy, thoracoscopic cryobiopsy of pleura, percutaneous biopsy, and so on. The time to diagnosis has been significantly reduced and the diagnostic efficacy has been improved by the clinical specimen detection using either Gene Xpert MTB/RIF, Ultra, loop-mediated isothermal amplification, metagenomic next-generation sequencing, or nanopore sequencing, etc. Interventional therapy was focused on the following diseases: pulmonary TB with massive hemoptysis, tracheobronchial TB, pleural TB and TB-related fistulas. Interventional treatment of tracheobronchial TB mainly included the application of rigid bronchoscopy, bronchoscopic cold and thermal ablation treatment, endoscopic clamp, dilatations of narrow airway with balloon and stent placement, etc. The interventional treatment of pulmonary TB complicated by massive hemoptysis included endovascular embolization, coated stent placement, etc. Interventional treatment of pleural TB involved the application of thoracoscopy, endoscopic forceps, the implantation of stent and other occlusive devices and the closure of fistulas with autologous fat transplantation. In this article, we reviewed the progress of interventional diagnosis and treatment of TB by the search of published literatures from October 2022 to September 2023.

[Application of modified fusion convergence index in intermittent exotropia].

Objective: To investigate a modified fusional convergence parameter-total convergence amplitude/distance angle and its relationship with exotropia control, stereoacuity, and other visual functions in intermittent exotropia. Methods: The cross-sectional study included children diagnosed with intermittent exotropia at the First Affiliated Hospital of Nanjing Medical University from August 2020 to June 2021. A modification was made by combining total convergence amplitude using synoptophore and distance angle at distance using prism bars to calculate total convergence amplitude/distance angle. Exotropia control at distance and near measured by Office-based Scale for Assessing Control was classified as good control (scale 0-1) and poor control (scale 2-5). Statistical analysis was performed using Spearman correlation analysis, Mann-Whitney U test, Fisher's exact test, χ2 test, logistic regression analysis, and mediation effect analysis. Results: The study included 212 patients, of which 105 (49.5%) were male and 107 (50.5%) were female. The median (interquartile range) age was 9.0 (8.0, 10.0) years. Of 211 cases, 201 (94.8%) had binocular fusional function, while 11 cases (5.2%) did not have binocular fusional function. Among patients with binocular fusional function, inverse correlation was observed between total convergence amplitude and exotropia control scores for both distance (r=-0.427, P<0.001) and near (r=-0.194, P=0.006). Total convergence amplitude/distance angle was an independent predictive factor for exotropia control at distance (OR=0.195; 95%CI, 0.060-0.630; P=0.006) and near (OR=0.252; 95%CI, 0.085-0.746; P=0.013). Stereoacuity at distance (OR=3.110; 95%CI, 1.311-7.379; P=0.010) and near (OR=2.780; 95%CI, 1.401-5.517; P=0.003) were also factors associated with distance exotropia control. Mediation analysis revealed that stereoacuity was not a mediating factor between the ratio and distance control (distance: P=0.066; near: P=0.181). In patients with ratio≥1.5 °/PD, all the 15 patients demonstrated good control. On the contrary, patients with ratio<1.5 °/PD showed worse exotropia control (distance: P=0.001; near: P=0.040) and larger angles of deviation (distance: P<0.001; near: P<0.001). Conclusion: The modified fusional ratio, total convergence amplitude/distance angle, combining synoptophore and prism bars, could be used to evaluate the severity of intermittent exotropia. A higher ratio may be associated with poorer exotropia control. Though it may also be associated with distance exotropia control, stereoacuity is not the mediating factor between the modified ratio and distance exotropia control.

[Research progress on AMPK activation in nonalcoholic fatty liver disease].

Nonalcoholic fatty liver disease (NAFLD) occurrence and progression are associated with lipid accumulation, insulin resistance, inflammation, liver damage, fibrosis, and other factors. AMP-dependent protein kinase (AMPK) is a key molecule that regulates bioenergy metabolism and participates in multiple biological processes, including lipid metabolism, autophagy, inflammation, and cell apoptosis. Promoting AMPK activation can reduce hepatic lipid accumulation and insulin resistance, alleviate the development of NAFLD, reduce liver inflammation and fibrosis, and inhibit the progression of NAFLD to nonalcoholic steatohepatitis.

[The progress in the clinical application of accommodative convergence/accommodation (AC/A)].

Accommodative convergence/accommodation (AC/A) ratio is an important concept in strabismus and amblyopia. Although AC/A ratio is a commonly used clinical index, most ophthalmologists do not have a thorough understanding of it, and there may be some deviations in its empirical application. In this paper, we reviewed the normal range, measuring method, classification, influencing factors and clinical application value of AC/A, aiming to provide the basis for the application of AC/A ratio in physical check-up of normal population, disease evaluation, diagnosis and treatment of strabismus patients.

[Analysis of the short-and medium-term curative effect of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis].

Objective: To evaluate the short- and medium-term clinical efficacy of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis. Methods: 63 cases with acute portal vein thrombosis treated in our center from May 2017 to July 2019 were studied retrospectively, including 49 males and 14 females, aged 35-61 (46 ± 5) years. TIPS approach (with/without) combined with Angiojet thrombus aspiration and gastroesophageal varices embolization was performed simultaneously according to the patient's condition. Regular follow-up for 3-33 (22 ± 3) months after surgery was used to observe the curative effect. Results: The technical success rate was 100%. Portal vein and superior mesenteric vein blood flow were returned to normal after the operation. Two cases of biliary tract injury were untreated. Simultaneously, two cases of intrahepatic arteriovenous fistula were treated with superselective arterial embolization. During the follow-up period, 47 cases (74.61%) had complete portal vein recanalization, 13 cases (20.63%) had partial recanalization, 3 cases (4.76%) had complete portal cavernoma, 7 cases (11.11%) had symptomatic hepatic encephalopathy, 1 case had received artificial liver treatment (1.59%), 1 case had peptic ulcer (11.11%), 6 cases (9.52%) had lost to follow-up, and there was no portal hypertension-related bleeding or death. Conclusion: TIPS approach combined with AngioJet thrombus aspiration technology is safe, effective and feasible in the treatment of acute portal vein thrombosis, and the short- and medium-term clinical effects are satisfactory.

[Clinical analysis of 10 cases of acute occupational poisoning caused by acetonitrile].

Objective: To investigate the first aid diagnosis and treatment of acute inhalation acetonitrile poisoning and to improve the ability of clinicians to diagnose and treat the disease. Methods: Retrospective analysis was performed on the diagnosis and treatment of 10 cases of acute occupational poisoning caused by acetonitrile gas, and clinical experience was summarized. Results: All the poisoned patients were cured and discharged after rescue and cooperation from various specialties. Conclusion: Acetonitrile poisoning treatment early to take the right first aid measures is the key, while safety education, training and enterprise supervision can not be ignored.

[Efficacy of Pipeline embolization device in the treatment of large and giant intracranial aneurysms].

Objective: To summarize the safety and efficacy of Pipeline embolization device in the treatment of large and giant intracranial aneurysms (maximum diameter ≥ 10 mm). Methods: The clinical and imaging data of 22 patients with intracranial aneurysms treated by Pipeline Embolization Device (PED) from February 2015 to July 2016 in the Zhengzhou University People's Hospital were retrospectively analyzed. The results about postoperative clinical and imaging follow-up and complications were evaluated. Results: The PED were successfully implanted in 22 patients with 22 intracranial aneurysms. Two aneurysms were treated with PED alone, and 20 aneurysms were treated with PED assisted coil embolization. Perioperative complications occurred in 3 patients (13.6%), and 1 patient died because aneurysm ruptured 3 days after operation. Nineteen patients (19 aneurysms) obtain imaging follow-up visit 3-17 months after operation, 13 of the 19 aneurysms (68.4%) received complete and subtotal occlusion, with no aneurysm recurrence. Eighteen patients obtain clinical follow-up visit 16-32 months after operation, with mRS (modified Rankin scale) score 1 in 5 patients, mRS score 0 in 13 patients, none developed new neurologic symptoms. Conclusions: PED has showed the high rate of obliteration for the treatment of large and giant intracranial aneurysms. But the complications needs to be further studied.

Effects of fish oil-derived fatty acids on suboptimal cardiovascular health: A multicenter, randomized, double-blind, placebo-controlled trial.

BACKGROUND AND AIMS: Suboptimal health and metabolic disorders are common in the general population. Both are related to cardiovascular disease. Suboptimal cardiovascular health is defined by the presence of both suboptimal health and metabolic disorders. The aim of the study was to investigate the potential benefit of n-3 long-chain polyunsaturated fatty acids (LCPUFA) in participants with suboptimal cardiovascular health. METHODS AND RESULTS: A total of 422 participants with suboptimal cardiovascular health, from two clinics in China, were enrolled from September 2014 to April 2015. All the enrolled participants were randomly assigned to receive 4 g/d of fish oil or placebo for three months. Suboptimal health was defined using an accepted questionnaire. Metabolic disorders were defined as one or more abnormalities in blood pressure, fasting plasma glucose, blood lipids, and body mass index (BMI). After treatment, the mean BMI fell significantly more in the n-3 LCPUFA group than in the placebo group (-0.29 ± 0.06 kg/m2 vs. -0.02 ± 0.06 kg/m2, P = 0.003). Similar results were found in the changes of suboptimal health status and suboptimal cardiovascular health status (P < 0.05 for all). In a multivariate analysis, the n-3 LCPUFA group was 5.44 (1.15, 25.67) times more likely to have optimal cardiovascular health status after treatment. CONCLUSIONS: n-3 LCPUFA intake improved suboptimal cardiovascular health in this placebo-controlled, randomized, double-blind trial. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.govNCT02103517.

Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study.

AIM: To evaluate retrospectively the incidence and predictors of massive bleeding after stent placement for malignant oesophageal stricture/fistulae. MATERIALS AND METHODS: This retrospective study comprised 519 patients with malignant oesophageal stricture/fistulae that were successfully treated with stent placement at three hospitals. The patients were divided into two groups based on the occurrence of massive bleeding. Univariate and multivariate analysis was performed to evaluate predictive factors of massive bleeding. RESULTS: Massive bleeding occurred in 54 of 519 patients 1-37 days following stent placement. All of the patients who developed massive bleeding died within 24 hours of the event. Univariate analysis showed massive bleeding was associated with the presence of a concomitant tracheal stent (p<0.001), the existence of concomitant oesophageal fistulae (p<0.001), and prior radiotherapy (p<0.001). Multivariate analysis exhibited that concomitant tracheal stent insertion (odds ratio [OR], 23.134; 95% confidence interval [CI], 9.523-56.199; p<0.001), the presence of oesophageal fistulae (OR, 3.724; 95% CI, 1.677-8.269; p=0.001), and prior radiotherapy (OR, 13.310; 95% CI, 5.464-32.421; p<0.001) were predictors of massive bleeding following stenting. CONCLUSIONS: The presence of oesophageal fistulae, prior radiotherapy, and concomitant tracheal stent are important factors contributing to bleeding after stenting.

Occupancy of orbitals and the quadrupole collectivity in 45Sc nucleus.

In the present work, the Doppler Shift Attenuation method (DSAM) was used to analyze the observed lineshapes of transitions from excited states in 45Sc, populated in the reaction 36Ar + 12C at a beam energy of 145 MeV. The interpretation and comparison of the experimental results have been performed with large-scale shell model calculations, involving different interactions like: GX1A, GX1J, FPD6, KB3 and ZBM2. KB3 and FPD6 (present work) interactions in the negative parity states, and in positive parity states ZBM2 are most pre-eminent in reproducing the results, due to the large configuration space describing strong collective effects. Furthermore, the present work also looks at the details of the shell model helping in improving the understanding for the occupancy of orbitals. The present investigation suggests the observation of stronger collectivity for positive parity states over negative parity states with predicted enhanced collectivity of states in 45Sc nucleus.

[Progress in research of epidemiology of extra pulmonary tuberculosis].

Currently, tuberculosis, including both pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB) still widely spread worldwide. EPTB has become one of research hotspots, changes in the incidence of EPTB and its composition in TB have occurred, the situation varied with country and region. The age and gender distributions of EPTB cases were different, even contradicted, indicated by different studies. The incidence rate and prevalence rate of EPTB might be underestimated due to insufficient attention paid to EPTB, inadequate diagnostic methods and low diagnosis rate. The cure rate of EPTB is always lower than PTB, posing challenges to global TB control. This paper summarizes the progress in research of EPTB epidemiology in recent years in terms of EPTB definition, epidemiological characteristics of EPTB in the world, correlation of different EPTB and related risk factors to provide reference for the prevention and control of EPTB.

Femtosecond laser-drilling-induced HgCdTe photodiodes.

Femtosecond-laser drilling may induce holes in HgCdTe with morphology similar to that induced by ion-milling in loophole technique. So-formed hole structures are proven to be pn junction diodes by the laser beam induced current characterization as well as the conductivity measurement. Transmission and photoluminescence spectral measurements on a n-type dominated hole-array structure give rise to different results from those of an ion-milled sample.

Leaf cell membrane stability-based mechanisms of zinc nutrition in mitigating salinity stress in rice.

Excess salt affects about 955 million ha of arable land worldwide, and 49% of agricultural land is Zn-deficient. Soil salinity and zinc deficiency can intensify plant abiotic stress. The mechanisms by which Zn can mitigate salinity effects on plant functions are not well understood. We conducted an experiment to determine how Zn and salinity effects on rice plant retention of Zn, K+ and the salt ion Na+ affect chlorophyll formation, leaf cell membrane stability and grain yield. We examined the mechanisms of Zn nutrition in mitigating salinity stress by examining plant physiology and nutrition. We used native Zn-deficient soils (control), four salinity (EC) and Zn treatments - Zn 10 mg·kg-1 (Zn10 ), EC 5 dS·m-1 (EC5 ), Zn10 +EC5 and Zn15 +EC5 , a coarse rice (KS-282) and a fine rice (Basmati-515) in the study. Our results showed that Zn alone (Zn10 ) significantly increased rice tolerance to salinity stress by promoting Zn/K+ retention, inhibiting plant Na+ uptake and enhancing leaf cell membrane stability and chlorophyll formation in both rice cultivars in native alkaline, Zn-deficient soils (P < 0.05). Further, under the salinity treatment (EC5 ), Zn inputs (10-15 mg·kg-1 ) could also significantly promote rice plant Zn/K+ retention and reduce plant Na+ uptake, and thus increased leaf cell membrane stability and grain yield. Coarse rice was more salinity-tolerant than fine rice, having significantly higher Zn/K+ nutrient retention. The mechanistic basis of Zn nutrition in mitigating salinity impacts was through promoting plant Zn/K+ uptake and inhibiting plant Na+ uptake, which could result in increased plant physiological vigour, leaf cell membrane stability and rice productivity.

Effects of thyrotropin-releasing hormone on myocardial adrenoceptors and dopaminergic receptors following hemorrhagic shock in the rat.

Although studies have indicated that thyrotropin-releasing hormone (TRH) produces various beneficial effects following low flow conditions, it remains unknown whether this agent has any salutary effect on myocardial alpha- and beta-adrenergic and dopaminergic (DA) receptors following hemorrhagic shock. To study this, rats (220-280 g) were bled to a mean arterial pressure of 40 mmHg and maintained for 1.5 h following shock. TRH or an equivalent volume of normal saline was administered. Receptor binding assay was carried out in myocardial plasma membrane preparations at 15 and 45 min after TRH administration. The results indicate that the maximal binding capacity (Bmax) of myocardial alpha- and beta-adrenergic receptors and their affinity decreased significantly following hemorrhage. The Bmax of DA receptors was also reduced, while the affinity was not significantly affected by hemorrhagic insult. Administration of TRH (5 mg/kg body wt) at 1.5 h after the onset of hemorrhage, however, markedly increased the Bmax of myocardial beta-adrenergic and DA receptors. The decreased affinity of beta-adrenoceptors observed in hemorrhaged animals was also improved with TRH treatment. TRH did not, however, significantly affect the altered Bmax and affinity of alpha-adrenoceptors following hemorrhagic shock. These results suggest that TRH-induced upregulation of beta-adrenoceptor and DA receptor binding capacity and the enhanced affinity of beta-adrenoceptors may be one of the mechanisms by which TRH produces the beneficial effects following hemorrhagic shock.

[Cytomegalovirus infection in pregnant women and perinatal infants].

Perinatal cytomegalovirus (CMV) infection was studied, using method of CMV-IgM ELISA, in 256 pregnant women at different periods and in the cord blood of 84 babies born by CMV positive mothers. Results showed that in 42 cases at early and midtrimester pregnancy, 17 were CMV-IgM positive with an infection rate of 40.48%. Among the 214 women at late pregnancy, 84 were positive (39.25%). There was a higher prevalence of perinatal morbidity, neonatal asphyxia, malformation, intrauterine death, and poor obstetrical outcome in the CMV positive mothers as compared with the CMV negative group (P < 0.01). This study showed that the presence of CMV-IgM indicated a recent or recurrent CMV infection during pregnancy and the babies should be carefully monitored.

[Clinical significance of the chemiluminescence (CL) of polymorphonuclear (PMN) and lymphocyte (LY) in bronchial asthma].

In the patients with bronchial asthma, the chemiluminescence (CL) of polymorphonuclear (PMN) and lymphocyte (LY) in blood had two peaks, maximal peak value decreased and peak time prolonged: cAMP, cAMP/cGMP, SOD in plasma decreased, IgE increased. The authors suggest that the pathogenetic mechanism of bronchial asthma may related to activated inflammatory cells, released mediators and inbalanced immuno opsonic functions.

[Preparation and isolation of chitin and chitosan from Kronopolites svenhedini (Verhoeff)].

Chitin was isolated from Kronopolites svenhedini and deacetylated to produce the derivative chitosan. The yield for chitin was 9%, and chitosan yield 57.4% and 77.5% respectively. After purification, their structures have been determined by spectroscopic methods.

New genotype of avian influenza H5N1 viruses isolated from tree sparrows in China.

The 2004 outbreaks of highly pathogenic avian influenza H5N1 disease in China led to a great poultry loss and society attention. A survey of avian influenza viruses was conducted on tree sparrows (Passer montanus) collected in China in 2004. Four viruses were isolated from free-living tree sparrows. The results of the whole-genome analysis indicated that an H5N1 virus with a new genotype is circulating among tree sparrows. The hemagglutinin and neuraminidase genes of the new genotype were derived from Gs/Gd/96-like viruses and the nuclear protein gene descended from the 2001 genotype A H5N1 viruses, while the other inner genes originated from an unknown influenza virus. In experimental infection, all four viruses were highly pathogenic to chickens but not pathogenic to ducks or mice. The four tree sparrow viruses were different from the 2003 tree sparrow strain (genotype Z) in Hong Kong. The results suggested that H5N1 viruses might be distributed widely in tree sparrows.