IntroductionBedaquiline (BDQ) is recommended in China as component of oral short-course regimens (SCR) for MDR-TB patients. However, the efficacy and safety of BDQ containing oral SCRs remain insufficiently validated in large-scale, well-designed clinical trials involving the Chinese population.MethodsA randomized, non-inferiority, open-label trial was conducted at 17 hospital clinics in China, enrolling adult patients with MDR-TB. Participants were assigned in a 1:1 ratio to receive either a 40-week oral BDQ-containing SCR or a 40-week oral non BDQ-containing SCR. The primary endpoint was the proportion of participants achieving favorable outcome at the end of treatment. The non-inferiority margin of the difference in proportion between the BDQ and control groups in the modified intent-to-treat (mITT) population was set at -15%.ResultsA total of 217 participants were randomized. Among 182 patients in the mITT population, the BDQ-containing SCR group achieved an 80.0% favorable outcome compared to 59.8% in the non-BDQ group, with an adjusted difference of 22.27% (95% CI 9.41-35.13%). BDQ-containing SCR was also associated with higher proportions of modified favorable outcomes and cure rates. Additionally, BDQ-containing SCR resulted in a higher culture conversion rate at the end of treatment and a shorter time to culture conversion. Serious adverse events occurred in 16 of 110 participants (14.5%) in the BDQ-containing SCR group and 25 of 107 participants (23.4%) in the non-BDQ-containing SCR group.Conclusion40-week BDQ-SCR proved non-inferior and superior, safe, and well tolerated in Chinese patients with MDR-TB. Further investigation into the long-term safety and efficacy of the BDQ-containing regimen is still needed in China. ClinicalTrials.gov NCT05306223. Prospectively registered on 16 March 2022.

PANoptosis is a recently identified, inflammatory programmed cell death pathway that amalgamates features of pyroptosis, apoptosis, and necroptosis, executed via multiprotein complexes called PANoptosomes. Increasing evidence highlights PANoptosis has emerged as a potentially pivotal factor in the pathogenesis of several diseases, including viral and bacterial infections and malignancies. Given its extensive pathophysiological relevance, this review systematically explores the conceptual underpinnings, molecular mechanisms, and structural composition of PANoptosome. Special attention is devoted to elucidating the pathophysiological interactions between PANoptosis and tuberculosis (TB), with the aim of developing integrated diagnostic-therapeutic strategies and targeted pharmaceutical innovations for TB. Tuberculosis, a respiratory infectious disease caused by Mycobacterium tuberculosis(M.tb), continues to pose a significant global health challenge.

Conventional methods for detecting mycobacteria were insufficient for comprehensive species identification and full-spectrum drug resistance profiling. This study aimed to evaluate the diagnostic value of nucleic acid matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for mycobacterial detection, species identification, and Mycobacterium tuberculosis drug resistance testing. A retrospective study was performed on clinical specimens (including sputum, bronchoalveolar lavage fluid, pleural fluid, pus, and other lesion samples) obtained from patients with tuberculosis, nontuberculous mycobacterial infection, or other infectious diseases at the Eighth Medical Center of Chinese PLA General Hospital between December 2020 and July 2023. Specimens were examined using nucleic acid MALDI-TOF MS, Gene Xpert MTB/RIF (Xpert), and Mycobacterium tuberculosis culture. Diagnostic performance and agreement were assessed using Mycobacterium tuberculosis culture and composite clinical diagnosis (integrating clinical manifestations, imaging findings, and multiple laboratory tests according to WS288-2017 Diagnostic Criteria for Tuberculosis of China) as reference standards. A total of 138 specimens were included in the final analysis. Compared with Mycobacterium tuberculosis culture, nucleic acid MALDI-TOF MS exhibited relatively high analytical nucleic acid sensitivity (97.7

Background:The incidence of spinal infections is increasing; However, pathogen identification remains challenging. Although Q fever spinal infection is reported infrequently, its accrual incidence is likely underestimated. The causative agent, Coxiella burnetii, cannot be routinely cultured. Consequently, physicians often misdiagnose Q fever spinal infection as spinal tuberculosis, leading to severe patient harm. Thus, improving clinicians' awareness of the clinical characteristics of Q fever spinal infection is urgently needed. Methods:We present a case of Q fever spinal infection and conducted literature searches in PubMed and the Chinese core journals of the Wanfang Database using keywords including "Q fever," "Coxiella burnetii," "spinal infection," "osteomyelitis," "spondylodiscitis," and "psoas abscess." Additional reports were identified through cross-referencing, with a cutoff date of 6 November 2024. Cases were included if patient age, sex, and baseline medical history were documented. Clinical data were retrospectively analyzed, and clinical features were compared between the aneurysm-associated group and the isolated spinal infection group. Fisher's exact probability test was used to evaluate the incidence difference. Results:A total of 39 adult patients were enrolled (mean age: 67.82 ± 10.51 years, male: 34,87.2%), Eleven cases reported potential pathogen exposure. Thirty-three cases presented with early-onset of lower back pain, and 13 developed fever during the disease course. Thirty-four cases involved the lumbar spine, exhibiting continuous lesions of 1-3 vertebral bodies, with imaging features of vertebral osteomyelitis, discitis, paravertebral soft-tissue swelling, and/or adjacent aneurysmal changes. Among 21 cases with routine blood tests, 2 showed elevated leukocyte counts, 5 had mild anemia, and the remainder were normal. Serological testing was performed in 34 cases, with 29 testing positive on the first time; PCR testing was conducted in 25 cases, with 23 cases detecting positive specimens; and rapid diagnosis confirmed in all 3 cases via metagenomic next-generation sequencing (mNGS). Inflammatory reactions were identified in all 21 biopsied cases, with inflammatory granulomas reported in 7 and explicitly excluded in 4. There were 24 cases complicated with aneurysm and 15 cases with isolated spinal infection. A significant difference in CRP elevation rate was observed between the two groups (14/15, 93.33% vs 4/8, 50.00%, P = .033). Early local lesion debridement combined with doxycycline-based multidrug therapy showed favorable outcomes. Serological monitoring demonstrated low sensitivity for assessing therapeutic efficacy. Conclusions:This study systematically summarizes the clinical characteristics of Q fever spinal infection and, for the first time, reports features associated with its distinct clinical subtypes. Q fever should be considered in case of chronic spinal infections-especially those complicated with vascular lesions. Based on clinical history evaluation, rapid diagnosis may be achieved through mNGS of specimens from local lesions. Combined with early initiation of doxycycline-based regimens, timely debridement of necrotic tissues and purulent material may improve treatment outcomes. Further investigations are needed to identify reliable biomarkers for monitoring therapeutic efficacy and to establish optimal treatment strategies for subtypes of Q fever spinal infection.

ObjectiveTuberculous meningitis (TBM) is the most severe form of tuberculosis (TB). The purpose of this study was to explore the relationship between the number of natural killer (NK) cells and adaptive immune status, and disease severity in TBM patients.MethodsWe conducted a retrospective study on 244 TB patients and 146 healthy control subjects in the 8th Medical Center of the PLA General Hospital from March 2018 and August 2023.ResultsThe absolute count of NK cells in the peripheral blood of TBM patients was significantly lower than that in normal controls (NC), latent tuberculosis infection (LTBI), and non-severe TB (NSTB) patients (p < 0.05). The proportion of TBM patients (48.7%) with a lower absolute count of NK cells than the normal reference value was significantly higher than that in NC (5.2%) and LTBI groups (4.0%) (p < 0.05), and slightly higher than that in NSTB group (36.0%) (p > 0.05). The absolute counts of lymphocyte subsets in TBM combined with other active TB group, etiology (+) group, IGRA (−) group, and antibody (+) group were lower than that in simple TBM group, etiology (−) group, IGRA (+) group, and antibody (−) group, respectively. The CD3+ T, NK, and B cells in BMRC-stage III TBM patients were significantly lower than those in stage I and stage II patients (p < 0.05). The counts of CD3+ T, CD4+ T, and B cells in the etiology (+) group were significantly lower than those in the etiology (−) group (p < 0.05).ConclusionThe absolute counts of lymphocyte subsets in the peripheral blood of TBM patients were significantly decreased, especially in NK cells. The reduction of these immune cells was closely related to the disease severity and had a certain correlation with cellular and humoral immune responses. This study helps to better understand the immune mechanism of TBM and provides reliable indicators for evaluating the immune status of TBM patients in clinical practice.

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BACKGROUND:Although the incidence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) is increasing annually, it is easily misdiagnosed as pulmonary tuberculosis (PTB). This study aimed to screen and identify the immunological and radiological characteristics that differentiate NTM-PD from PTB and to construct a discriminatory diagnostic model for NTM-PD, providing new tools for its differential diagnosis.METHODS:Hospitalised patients diagnosed with NTM-PD or PTB between January 2019 and June 2023 were included in the study. Immunological and radiological characteristics were compared between the two groups. Based on the selected differential features, a logistic regression algorithm was used to construct a discriminatory diagnostic model for NTM-PD, and its diagnostic performance was preliminarily analysed.RESULTS:Patients with NTM-PD were significantly older than those with PTB and the tuberculosis-specific interferon-gamma release assay (TB-IGRA) positivity rate was significantly lower in the NTM-PD group. Moreover, the absolute counts of total T lymphocytes, CD4+ T lymphocytes, CD8+ T lymphocytes, NK cells, and B lymphocytes were significantly lower in patients with NTM-PD and PTB than in healthy controls. Additionally, patients with NTM-PD had a significantly lower absolute count of B lymphocytes than the PTB group. Radiological analysis revealed significant differences between patients with NTM-PD and PTB in terms of cavity wall thickness, bronchial dilation, lung consolidation, pulmonary nodule size, pulmonary emphysema, lung bullae, lymph node calcification, pleural effusion, mediastinal and hilar lymphadenopathy, and the tree-in-bud sign. Bronchial dilation was identified as the predominant risk factor of NTM-PD, whereas TB-IGRA positivity, lymph node calcification, pleural effusion, and mediastinal and hilar lymphadenopathies were protective factors. Based on this, we constructed a discriminatory diagnostic model for NTM-PD. Its receiver operating characteristic curve demonstrated good diagnostic performance, with an area under the curve of 0.938. At the maximum Youden index of 0.746, the sensitivity and specificity were 0.835 and 0.911, respectively.CONCLUSIONS:Patients with NTM-PD and PTB exhibited impaired humoral and cellular immune functions as well as significant differences in radiological features. The constructed NTM-PD diagnostic model demonstrated good diagnostic performance. This study provides a new tool for the differential diagnosis of NTM-PD.

肺类癌属于一种神经内分泌肿瘤,占所有肺肿瘤的1％至5％,根据分化程度的不同,分为典型类癌和不典型类癌.不典型类癌占肺类癌的10％ [1] ,临床上较为少见,症状及影像学缺乏特征性,易与其他肺部疾病尤其是结核病相混淆.现将本科室收治的1例肺不典型类癌报道如下.

Background:The incidence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) has increased in recent years. However, the clinical and immunologic characteristics of NTM-PD patients have received little attention.Methods:NTM strains, clinical symptoms, underlying diseases, lung CT findings, lymphocyte subsets, and drug susceptibility tests (DSTs) of NTM-PD patients were investigated. Then, the counts of immune cells of NTM-PD patients and their correlation were evaluated using principal component analysis (PCA) and correlation analysis.Results:135 NTM-PD patients and 30 healthy controls (HCs) were enrolled from 2015 to 2021 in a certain tertiary hospital in Beijing. The number of NTM-PD patients increased every year, and Mycobacterium intracellulare (M. intracellulare), M. abscessus, M. avium, and M. kansasii were the major pathogens of NTM-PD. The main clinical symptoms of NTM-PD patients were cough and sputum production, and the primary lung CT findings were thin-walled cavity, bronchiectasis, and nodules. In addition, we identified 23 clinical isolates from 87 NTM-PD patients with strain records. The DST showed that almost all of M. abscessus and M. avium and more than half of the M. intracellulare and M. avium complex groups were resistant to anti-tuberculosis drugs tested in this study. M. xenopi was resistant to all aminoglycosides. M. kansasii was 100% resistant to kanamycin, capreomycin, amikacin, and para-aminosalicylic acid, and sensitive to streptomycin, ethambutol, levofloxacin, azithromycin, and rifamycin. Compared to other drugs, low resistance to rifabutin and azithromycin was observed among NTM-PD isolates. Furthermore, the absolute counts of innate and adaptive immune cells in NTM-PD patients were significantly lower than those in HCs. PCA and correlation analysis revealed that total T, CD4+, and CD8+ T lymphocytes played an essential role in the protective immunity of NTM-PD patients, and there was a robust positive correlation between them.Conclusion:The incidence of NTM-PD increased annually in Beijing. Individuals with bronchiectasis and COPD have been shown to be highly susceptible to NTM-PD. NTM-PD patients is characterized by compromised immune function, non-specific clinical symptoms, high drug resistance, thin-walled cavity damage on imaging, as well as significantly reduced numbers of both innate and adaptive immune cells.

ABSTRACT A novel oxazolidinone for the treatment of Mycobacterium tuberculosis has been developed, but the activity of contezolid (MRX-I) still needs to be clarified. In this study, we isolated Mycobacterium tuberculosis from 48 clinical patients with pulmonary tuberculosis. Roche drug susceptibility tests identified drug-sensitive and 39 drug-resistant M. tuberculosis isolates. Drug susceptibility assays indicated that MRX-I exhibited anti-Mycobacterium tuberculosis activity against both drug-sensitive and drug-resistant isolates, with an advantage against drug-resistant isolates. The results also showed that the anti-Mycobacterium tuberculosis activity was comparable to that of linezolid. IMPORTANCE Currently, Mycobacterium tuberculosis has exhibited increased drug resistance, leading to ineffective drug treatment in many patients with tuberculosis. Among the anti-Mycobacterium tuberculosis drugs, oxazolidinones have been gradually developed. Contezolid (MRX-I) has been newly developed in China with advantages versus the first oxazolidinone antibiotic approved by the Food and Drug Administration for clinical use, but the anti-M. tuberculosis activity needs to be further clarified. In this study, in vitro activities of MRX-I against M. tuberculosis were tested. The drug susceptibility assays indicated that MRX-I exhibited anti-M. tuberculosis activity comparable to that of linezolid, with an advantage against drug-resistant isolates.

Objective:To make a systematic evaluation of the clinical efficacy of thymopentin combined with antituberculous drugs in treating drug-resistant pulmonary TB (PTB).Methods:Relevant studies were retrieved from PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database, CNKI, and Wanfang Database. STATA software was used to evaluate the differences in focal absorption rate, the time to cough symptom remission, sputum culture-negative rate, CD3+ T, CD4+ T, and CD8+ T cell levels after treatment.Results:A total of 23 randomized controlled trials literature involving 2031 cases were included. Meta-analysis revealed that compared with conventional therapy, the sputum culture-negative rate was significantly increased after 2-3 months and 6-9 months of treatment and the whole course of combined thymopentin treatment. The risk ratio (RR, 95% CI) was 1.44 (1.26-1.64), 1.47 (1.21-1.78), and 1.27 (1.18-1.36), respectively. In the combined thymopentin treatment group, the focal absorption rate was higher, with RR (95% CI) = 1.36 (1.25-1.47), the time of cough remission was shortened, with WMD (95% CI) =-9.46d (-10.36,-8.57) and the differences were all statistically significant. Combined thymopentin therapy could effectively improve the levels of CD3+ T and CD4+ T lymphocytes in patients with drug-resistant PTB after 2-3 months, 6-9 months of treatment. The WMD (95% CI) were 9.96% (7.84, 12.08), 4.68% (2.90, 6.47) and 10.26% (7.81, 12.71), 7.21% (6.28, 8.15), respectively, and could also reduce the level of CD8+ T lymphocytes after 2-3 months and 6-9 months of treatment. The WMD (95% CI) were -4.06% (-4.96, -3.13), -3.52%, (-4.07,-2.98), respectively, and the differences were all statistically significant.Conclusion:Thymopentin adjuvant treatment for drug-resistant PTB can promote the therapeutic effect and improve the immune indexes in patients with drug-resistant PTB.

结核病一直是全球严重的公共卫生问题.据2021年世界卫生组织(World Health Organization, WHO)报告,2020 年约有 987 万例新发结核病患者,128万例死于结核病,由于受新型冠状病毒肺炎疫情的影响,相较于2019年,获得诊断、治疗的结核病患者数明显下降,导致死亡例数增加[1-2].目前,化学药物治疗是结核病的主要治疗方式,单纯化疗不仅疗程长且难以彻底清除结核分枝杆菌(Mycobac-terium tuberculosis ,MTB)休眠菌或持留菌;同时,随着耐多药结核病患者的增多,其治愈率低及药物不良反应等难题迫切需要建立新的抗结核治疗方法.

ObjectiveThis study aimed to systematically evaluate the factors influencing the restoration of spontaneous circulation (ROSC) after cardiopulmonary arrest (CA).MethodsRelevant papers on the factors influencing the ROSC in patients with CA were retrieved from PubMed, Embase, Cochrane Library, China Biology Medicine disk, China National Knowledge Infrastructure, Wanfang, and VIP databases. After screening, data extraction, and quality evaluation of the papers, a meta-analysis was carried out.ResultsA total of 36 papers, involving a total sample size of 2,305 cases, were included. The meta-analysis revealed that the location and time of onset of CA, the type of cardiac rhythm at first monitoring, the start time of cardiopulmonary resuscitation (CPR), the use of electric defibrillation, and the cumulative dose of adrenaline all significantly impacted the ROSC (p < 0.05) and may have affected its success rate. The pH value at CA onset, combined use of adrenaline and vasopressin, CPR duration, mechanical cardiac compression use, and whether CA was caused by heart disease had no significant effect on ROSC.ConclusionThe location and time of onset of CA, the cardiac rhythm at first monitoring, the start time of CPR, the use of electric defibrillation, and the cumulative dose of adrenaline significantly impacted the ROSC.

目的:系统评价γ-干扰素(IFN-γ)联合抗结核药物治疗肺结核的临床疗效和安全性,为IFN-γ在肺结核临床治疗中的应用提供依据.方法:检索PubMed、Embase、中国生物医学文献数据库、中国知网、万方数据库,纳入自建库以来至2022年3月1日公开发表的IFN-γ联合抗结核药物治疗肺结核的临床随机对照试验(RCT)研究.根据Cochrane手册,应用Review Manager 5.4软件对纳入文献进行质量评价.应用STATA 12.0软件对IFN-γ联合抗结核药物治疗组(观察组)和单纯抗结核药物治疗组(对照组)肺结核患者治疗2～3个月及6～9个月后痰菌阴转率、病灶吸收率、空洞闭合率及两组不良反应发生率,以及治疗后外周血CD4+T细胞、CD8+T细胞百分比的差异进行评价.结果:共纳入18篇文献,共计1341例患者.Meta分析结果显示,与对照组比较,观察组患者治疗2～3个月和6～9个月后,痰菌阴转率RR(95％CI)值分别为1.40(1.26～1.56)和1.41(1.12～1.76);病灶吸收率RR(95％CI)值分别为1.43(1.09～1.88)和2.84(1.65～5.00);空洞闭合率RR(95％CI)值分别为2.07(1.47～2.92)和1.56(1.28～1.91),均显著高于对照组(P值均<0.05).此外,与对照组比较,治疗后观察组外周血CD4+T细胞百分比升高更明显、CD8+T细胞百分比降低更明显(P值均<0.05),加权均数差(WMD;95％CI)分别为5.18(2.53～7.84)和—3.16(—6.08～—0.23).与对照组比较,观察组不良反应发生率RR(95％CI)值为1.06(0.70～1.60),其中,肝功能异常发生率、皮肤过敏反应发生率、胃肠道不良反应发生率RR(95％CI)值分别为1.02(0.95～1.11)、1.03(0.95～1.11)和1.01(0.93～1.11),差异均无统计学意义(P值均>0.05).结论:IFN-γ联合抗结核药物治疗肺结核,可以促进患者病灶吸收、痰菌阴转率,且能改善肺结核患者的免疫指标.

Abstract Background The aim of the present study is to investigate the clinical value and characteristics of peripheral blood lymphocyte subsets in patients with pulmonary tuberculosis (PTB) using flow cytometry. Methods The absolute counts of T, CD4+T, CD8+T, natural killer (NK), NKT and B lymphocytes in 217 cases of PTB were detected, and the variations in lymphocyte subset counts between different ages and genders and between aetiological detection results and chest radiography results were analysed. Results In 75.3% of the patients with PTB, six subset counts were lower than the normal reference range, and 44% showed lower‐than‐normal CD4+T lymphocyte levels. The counts of T, CD4+T, CD8+T and B lymphocytes were significantly lower in patients aged >60 years, and the NKT cell counts were significantly lower in female patients than in male patients. Among the patients with positive aetiological results, 40.8% had reduced CD8+T counts; these were significantly lower than those in patients with negative aetiological results (P = 0.0295). The cell counts of T, CD4+T, CD8+T and B lymphocytes reduced as lesion lobe numbers increased. The counts of T, CD4+T and CD8+T lymphocytes were significantly higher in the group with lesions affecting one lobe than in the groups with two to three lobes or four to five lobes, and the counts of B lymphocytes were significantly higher in the group with one lobe and the group with two to three lobes than in the group with four to five lobes. The counts of CD4+T and CD8+T lymphocytes were highest in the no cavity group and showed a downward trend with the increase in cavities; the T lymphocyte count was significantly higher in the no cavity group than in the group with five or more cavities (P = 0.014), and the CD8+T lymphocyte count was significantly higher in the no cavity group than in the group with one to two cavities and the group with five or more cavities (P = 0.001 and 0.01, respectively). Conclusions In most patients with tuberculosis, immune function is impaired. The absolute counts of peripheral blood lymphocyte subsets are closely related to the aetiological results and lesion severity in patients with PTB; this could be used as evidence for immune intervention and monitoring curative effects.

1 Tuberculosis Prevention and Control Key Laboratory, Senior Department of Tuberculosis, The 8th Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China, 2 Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China, 3 Huadong Research Institute for Medicine and Biotechniques, Nanjing, China

目的 通过对比观察在院外急救心搏骤停患者心肺复苏抢救流程中应用气管插管方式人工通气与喉罩方式人工通气的临床疗效及预后,进一步提高院外急救心搏骤停患者的复苏时效与抢救成功率.方法 选取2018年1月—2019年1月石家庄市急救中心院外急救出诊时给予心肺复苏操作的62例心搏骤停患者为研究对象,根据心肺复苏过程中人工气道建立方式的不同分为观察组与对照组,观察组(n=31)采用喉罩方式建立人工气道,对照组(n=31)采用气管插管方式建立人工气道,对两组患者一次性人工气道建立成功率、人工气道建立操作时间、自主循环恢复成功率、通气改善情况以及并发症发生率等方面进行对比分析.结果 观察组一次性人工气道建立成功率明显高于对照组,人工气道建立操作时间明显短于对照组,差异有统计学意义(P<0.05).观察组自主循环恢复成功率明显高于对照组,建立人工气道时并发症发生率明显少于对照组,差异有统计学意义(P<0.05),通气改善情况与对照组结果接近(P>0.05).结论 院外急救心搏骤停患者在心肺复苏抢救流程中应用喉罩建立人工气道,可有效提高一次性人工气道建立成功率,缩短人工气道建立时间,有效提高自主循环恢复成功率及患者通气改善情况,减少并发症发生,值得在院外急救心搏骤停患者心肺复苏抢救流程中广泛推广与应用.

Background: Multidrug-resistant pulmonary tuberculosis (MDR-PTB) has become a major cause of high morbidity and mortality related to TB. Conventional drug regimens are ineffective for the treatment of MDR-PTB patients with cavities. This study aimed to evaluate the clinical efficacy and safety of one-way endobronchial valves (EBVs) for the treatment of cavities in MDR-PTB patients. Methods: MDR-PTB patients with positive sputum cultures, sputum smears, and cavities were treated with EBVs in the drainage bronchus of the pulmonary cavity between November 2013 and March 2018. The participants comprised those who had failed previous anti-tuberculosis therapy, as determined by drug susceptibility testing. Results: Thirty-five MDR-PTB patients were included, three of whom were lost during follow-up. The size of the lung cavity was reduced in all of the patients after EBV implantation, including the three lost to follow-up. In the remaining 32 patients, the sputum culture conversion (SCC) rate reached 100%, and the cavity closure rate was 68.8%. There were no significant differences in the cavity closure rate between patients aged ≤40 and >40 years, between the upper and lower lobes, or between the use and non-use of linezolid groups (p > 0.05). Interestingly, the cavity closure rate was higher in women than in men (p = 0.005). Moreover, the cavity closure rate correlated with the time to SCC (correlation coefficient, 0.8933; p < 0.0001). There were no severe adverse events in the patients treated with EBV implantation. Conclusion: EBV installation is effective and safe for the treatment of cavities in MDR-PTB patients. The efficacy of EBV treatment may not be affected by age, disease course, or the location of the lung lobe in the cavity.

目的 探究院外心搏骤停的流行病学现状及其结局影响因素.方法 收集2018年2月至2019年1月石家庄市急救中心接诊的3127例院外心搏骤停患者的临床资料,分析其病因、发生地点、气道建立方式、胸外按压方式、心电监护、除颤次数、急诊绿色通道是否畅通、复苏结果、有无目击者、目击者进行心脏复苏救治等情况,分析心搏骤停后自主循环恢复的影响因素.结果 院外心搏骤停51.90％发生在家中,其次为工作地点(32.71％)、公共场所(13.46％).有59.51％的患者被目击,但仅4.45％的患者由目击者进行心脏复苏救治,19.87％的患者院外进行气管插管,51.93％的患者院外进行肾上腺素治疗.临床病因分析发现,院外心搏骤停的原因以心源性疾病最多(46.02％),其次分别为创伤性(31.53％)、其他(10.97％)、溺水(7.39％)、呼吸系统疾病(4.09％).自主循环恢复的例数有目击者(52例)、目击者进行心脏复苏救治(64例)、初始心律可电击(43例)、急救反应时间≤6min(48例)、院外除颤(45例)分别高于无目击者(25例)、目击者未进行心脏复苏救治(13例)、初始心律不可电击(34例)、急救反应时间>6min(29例)、院外未除颤(32例),差异有显著性(P<0.05).Logistic回归分析显示,有目击者、目击者进行心脏复苏救治、初始心律可电击、急救反应时间≤6min、院外除颤是院外心搏骤停患者自主循环恢复的独立影响因素.结论 院外心搏骤停患者大部分发生在家中,其次为工作地点、公共场所,有目击者、目击者进行心脏复苏救治、初始心律可电击、急救反应时间≤6min、院外除颤是其自主循环恢复的独立影响因素.

1Department of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, 100091, People’s Republic of China; 2Department of Emergency, The Eighth Medical Center of PLA General Hospital, Beijing, 100091, People’s Republic of China; 3Tuberculosis Prevention and Control Key Laboratory, Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Institute for Tuberculosis Research, Senior Department of Tuberculosis, The 8th Medical Center of Chinese PLA General Hospital in China, Beijing, 100091, People’s Republic of China