Sputum smears and culture conversion are frequently used to evaluate treatment response in pulmonary tuberculosis patients. Limited data are available on the evaluation of the correlation between under-treatment sputum smear results and culture conversion.This prospective study included sputum culture-proven pulmonary tuberculosis patients at six hospitals in Taiwan. At least two sets of sputum were collected at the completion of 8 weeks of TB treatment. The sensitivities and specificities of 2-month sputum smears were estimated based on culture conversion status.A total of 371 patients were enrolled for analysis. Factors associated with culture conversion included having a smear positive before treatment, presence of a cavity on radiography, rifampicin resistance and usage of the DOTS (directly observed therapy, short course) strategy. The sensitivities of 2-month sputum smears for culture conversion among all patients, initially smear-positive patients and initially smear-negative patients were 64.3, 71.4 and 38%, respectively, and the specificities were 81.6, 69.9 and 92.8%, respectively. In patients who were 2-month sputum smear-positive, the 2-month culture conversion rate was 80% if the patients were under DOTS and without cavitary lesions in radiograms.The predictive value of 2-month sputum smears in culture conversion was limited and highly influenced by clinical factors in pulmonary tuberculosis patients.KEYWORDS: Culture, directly observed therapy short course implementation, Mycobacterium tuberculosis, pulmonary tuberculosis, sputum P ulmonary tuberculosis (PTB) is an airborne infectious disease that requires multiple-drug combination therapy and long treatment duration. Despite great advances in molecular diagnosis, sputum cultures of Mycobacterium tuberculosis (MTB) remain the gold standard for PTB diagnosis. After initiation of anti-tuberculosis (anti-TB) treatment, sputum acidfast bacilli (AFB) smears and cultures of MTB are regularly checked during the treatment period and serve as important indicators of treatment response. Achievement of sputum sterilisation, which is determined by sputum culture conversion, is a cardinal index of treatment success. Previous studies have demonstrated that the time to sputum negativity is an important determinant of relapse [1][2][3]. Failure to achieve sputum culture conversion in ,2 months will lead to a worse treatment outcome [4]. Documentation of sputum culture conversion is also recommended as a necessary criterion before completion of anti-TB treatment in current treatment guidelines [5]. Based on the high predictive value of sputum culture conversion in treatment response [4,6,7], identification of the clinical factors that are associated with a lower sputum culture conversion rate is of crucial importance in PTB management [8][9][10].In spite of the high accuracy of sputum culture conversion in the assessment of treatment response, the long yield time limits its usefulness in clinical practice. As a simple and rapid test, sputum smears are fre...

As a highly heterogeneous disease, acute myeloid leukemia (AML) needs fine risk stratification to get an optimal outcome of patients. MicroRNAs have florid biological functions and have critical roles in the pathogenesis and prognosis in AML. Expression levels of some single microRNAs are influential for prognosis, but a system integrating several together and considering the weight of each should be more powerful. We thus analyzed the clinical, genetic and microRNA profiling data of 138 de novo AML patients of our institute. By multivariate analysis, we identified that high expression of hsa-miR-9-5p and hsa-miR-155-5p were independent poor prognostic factors, whereas that of hsa-miR-203 had a trend to be a favorable factor. We constructed a scoring system from expression of these three microRNAs by considering the weight of each. The scores correlated with distinct clinical and biological features and outperformed single microRNA expression in prognostication. In both ours and another validation cohort, higher scores were associated with shorter overall survival, independent of other well-known prognostic factors. By analyzing the mRNA expression profiles, we sorted out several cancer-related pathways highly correlated with the microRNA prognostic signature. We conclude that this 3-microRNA scoring system is simple and powerful for risk stratification of de novo AML patients.

Retrograde catheterization of the left ventricle in patients with aortic valve stenosis is commonly performed using a pigtail or coronary arterial catheter. This approach, although usually ultimately successful, may be highly tedious. To overcome the limitations of these conventional catheter shapes, we have designed a catheter specifically for crossing stenotic aortic valves. In a group of 17 patients, mean aortic valve area 0.75 cm2, the average time to cross the aortic valve was 2 minutes 45 seconds and the median time 30-40 seconds. Once the proper size catheter was selected, the average time to cross was 59 seconds. The success of this catheter is based on the operator's ability to "scan" or interrogate the surface of the valve thoroughly by manipulating the catheter and a moveable core straight tip guidewire.

1.1 Background: Percutaneous Transhepatic Biliary Drainage (PTBD) and endoscopic retrograde biliary drainage (ERBD) had been widely used for unresectable perihilar cholangiocarcinoma (PHC). The optimal type of biliary drainage is still a matter of debate. We aim to compare the efficacy and complications of PTBD and ERBD in the unresectable PHC. Patients and Methods:From January 2013 to December 2020, 1145 patients were diagnosed with cholangiocarcinoma or gall bladder cancer in a tertiary hospital cancer registry. We excluded those with resectable tumor, combination intrahepatic tumor or without any treatment. Twenty-seven patients received initial ERBD (n = 18) or PTBD (n = 9) for palliative treatment of unresectable PHC. Results:Age, gender, tumor stage, or Bismuth type were similar between the two groups. The clinical successful rates of drainage were similar between the PTBD and the ERBD groups (66.7% vs. 50.0%, p = 0.683). Two groups had similar complication rates. The PTBD group had a longer survival time in trend (p = 0.184) than ERBD group in the 1-year follow-up. There was a higher dislocation rate in the PTBD (55.5%) than the ERBD (14.3%) group in trend (p = 0.066), as the consequence of shorter patency time in the PTBD than ERBD group (47.0 ± 32.8 days vs. 156 ± 151.1 days, p = 0.083) 1.4. Conclusions: ERBD and PTBD were used as therapeutic op-tions to improve obstructive jaundice in palliative PHC patients with similar complications and could be each other's rescue method if initial drainage approach had no clinical response.