BackgroundAssociations between ambient air pollution and child health outcomes have been well documented in developed countries such as the United States; however, only a limited number of studies have been conducted in developing countries. This study aimed to explore the acute effects of five ambient air pollutants (inhalable particles [PM10], fine particles [PM2.5], sulfur dioxide [SO2], nitrogen dioxide [NO2] and 0zone [O3]) on children hospital outpatients with respiratory diseases in Shijiazhuang, China.MethodsThree years (2013–2015) of daily data, including cause-specific respiratory outpatient records and the concentrations of five air pollutants, were collected to examine the short-term association between air pollution and children’s respiratory diseases; using a quasi-Poisson regression generalized additive model. Stratified analyses by season and age were also performed.ResultsFrom 2013 to 2015, a total of 551,678 hospital outpatient records for children with respiratory diseases were collected in Shijiazhuang, China. A 10 μg/m3 increase in a two-day average concentration (lag01) of NO2, PM2.5, and SO2 corresponded to an increase of 0.66% (95% confidence interval [CI]: 0.30–1.03%), 0.13% (95% CI: 0.02–0.24%), and 0.33% (95% CI: 0.10–0.56%) in daily hospital outpatient visits for children with respiratory diseases, respectively. The effects were stronger in the transition season (April, May, September and October) than in other seasons (the hot season [June to August] and the cool season [November to March]). Furthermore, results indicated a generally stronger association in older (7–14 years of age) than younger children (< 7 years of age).ConclusionsThis research found a significant association between ambient NO2, PM2.5, and SO2 levels and hospital outpatient visits in child with respiratory diseases in Shijiazhuang, China.

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We reported a severe human pseudorabies encephalitis case and described a dynamic clinical manifestation with cerebrospinal fluid analyses and cytological and serological evaluation, which may elucidate the mechanism of PRV infection and facilitate clinical diagnosis and treatment in human.

A prospective multicentre study was conducted to compare the diagnostic accuracy of the GeneXpert MTB/RIF Ultra (Xpert Ultra) and cell-free DNA (cfDNA) assay for tuberculous meningitis (TBM) in China. Methods: A prospective cohort study was conducted among individuals with symptoms suggestive of TBM registered in three TB specialised hospitals in China between June 2018 and January 2019. Results: Overall, 84 patients suggestive of TBM were included in this analysis between June 2018 and January 2019. Using microbiological evidence as reference, the sensitivity/specificity for the diagnostic tests were Xpert Ultra 93.3%/100%, cfDNA 93.3%/92.6% and mycobacteria growth indicator tube (MGIT) culture 13.3%/100%. In addition, the sensitivity of culture was 6.7% when using clinical diagnosis criteria as the gold standard. Xpert Ultra correctly identified 28 cases as TBM, indicating a sensitivity of 46.7%. Notably, four additional TBM cases were detected by cfDNA compared with Xpert Ultra, yielding an overall sensitivity of 53.3%. Statistical analysis revealed that the sensitivity of Xpert Ultra and cfDNA was significantly higher than that of culture. Conclusions: The data demonstrate that Xpert Ultra and cfDNA assay showed optimal sensitivity compared with MGIT culture. In addition, there was no significant correlation between bacterial load and TBM severity in the participants.

This is the first adverse effect evidence of air pollution on T2DM in Shijiazhuang, a severely polluted city in China. Males were more vulnerable than females in severe pollution.

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Background Early diagnosis of tuberculosis meningitis (TBM) remains a great challenge during clinical practice. The diagnostic efficacies of cerebrospinal fluid (CSF)‐based mycobacterial growth indicator tube (MGIT) culture, modified Ziehl–Neelsen (ZN) staining, Xpert MTB/RIF, and metagenomic next‐generation sequencing (mNGS) for TBM remained elusive. Methods A total of 216 adult patients with suspicious TBM were retrospectively enrolled in this multi‐cohort study. The diagnostic performances for MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS using CSF samples were evaluated. Results Uniform clinical case definition classified 88 (40.7%) out of 216 patients as the definite TBM, 5 (2.3%) patients as probable TBM cases, and 24 (11.1%) patients as possible TBM cases. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite TBM were 25.0%, 76.1%, 73.9%, and 84.1%, respectively. Negative predictive values (NPVs) were 66.0%, 85.9%, 84.8%, and 90.1%, respectively. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite, probable, and possible TBM were 18.8%, 57.3%, 55.5%, and 63.2%, respectively. Negative predictive values (NPVs) were 51.0%, 66.4%, 65.6%, and 69.7%, respectively. mNGS combined with modified ZN stain and Xpert could cover TBM cases against a composite microbiological reference standard, yielding 100% specificity and 100% NPV. Conclusion Metagenomic next‐generation sequencing detected TBM with higher sensitivity than Xpert, ZN staining and MGIT culture, but mNGS cannot be used as a rule‐out test. mNGS combined with Xpert or modified ZN staining could enhance the sensitivity of diagnostic tests for TBM.

The present study aimed to investigate the effect of methylprednisolone (MP) on the activities of caspase-3, -6, -8 and -9 in rabbits with acute spinal cord injury (ASCI) and to explore the mechanism underlying the antiapoptotic effect of MP on ASCI. Modified Allen's method was employed to establish the ASCI animal model. The animals were randomly divided into a sham (S; n=12), ASCI (C; n=36) and MP group (T; n=36). At 8, 24 and 72 h and 7, 14 and 28 days after ASCI, the animals were sacrificed and the spinal cord was collected. The absorbance (A) was measured with a microplate reader and the activities of caspase-3, -6, -8 and -9 were calculated followed by comparisons among the groups. In the S group, the activities of the four caspases were low. In the C and T groups, the caspase activities increased at 8 h after injury, peaked at 24 h and remained at a high level 3 days after injury. However, the caspase activities began to decrease at 7 days after injury and were significantly reduced at 14 and 28 days after ASCI. Furthermore, the caspase activities in the T group were markedly lower than those in the C group at 8 and 24 h and 3 and 7 days after surgery (P<0.05), but significant differences were not observed at 14 and 28 days after injury (P>0.05). In conclusion, MP exerted an antiapoptotic effect via inhibition of the activities of caspase-3, -6, -8 and -9 in an animal model of ASCI.