Risk of Active Pulmonary Tuberculosis among Patients with Coal Workers'Pneumoconiosis:A Case-control Study in China

The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.

Incidence and Associated Factors for Single and Recurrent Falls among the Elderly in an Urban Community of Beijing

Objective To investigate the incidence of falls and recurrent falls, and explore associated factors for single and recurrent falls among urban community-dwelling elderly in Beijing. Methods A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district, Beijing in 2009. Data regarding the incidence of fall and recurrent falls in the previous year, as well as associated factors were collected from the elderly through face-to-face interviews. Results The incidence of falls and recurrent falls was 17.8% and 6.1%, respectively, and it increased with age （X^2for trend=21.06, 19.20, P=0.001, 0.002）. Binary logistic stepwise regression analysis showed that age （OR=2.20）, living alone （OR=4.67） and gait disturbance （OR=1.27） were risk factors, while housing with elevators （OR=0.35）, appropriate width/height of stair steps （0R=0.78）, sufficient lighting for stairway （OR=0.45） and regular exercise （OR=0.12） could lower the risk for single fall; factors such as low monthly family income （OR=1.39）, poor vision （OR=1.83）, low physical ability （OR=4.47）, abnormal static balance （OR=2.48）, and fear of falls（OR=2.23） were risk factors, while appropriate width/height of stair steps （OR=0.49） and easiness of access to daily supplies （OR=0.41） were protective factors for recurrent falls. Conclusion The incidence of falls in commun and their related injuries have been associated ty-dwelling elderly people in Beijing is common, and falls with both intrinsic and extrinsic factors.

Evaluation of the Xpert MTB/RIF assay for diagnosis of tuberculosis and rifampin resistance in county-level laboratories in Hunan province, China

Background The Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis （TB） countries.However,there were little data obtained by validation or demonstration study of the assay in China.In this study,the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province,China.Methods Consecutive patients with suspected pulmonary tuberculosis （PTB） and suspicion for multidrug-resistant tuberculosis （MDR-TB） were enrolled.For each patient suspected to have PTB,three sputum specimens （one spot sputum,one night sputum,and one morning sputum） were collected and each sputum was tested with smear microscopy,L（o）wenstein-Jensen （LJ） culture,and Xpert MTB/RIF test.For comparison across subgroups and testing methods,95％ confidence intervals were calculated.All analyses were done with SPSS 16.0,and P ＜0.05 was regarded as significant.Results For case detection,the sensitivity of Xpert MTB/RIF was 100％ for smear-and culture-positive TB and 88.6％ for smear-negative and culture-positive TB; the overall sensitivity was 94.5％ for all culture-positive patients.The specificity was 99.8％.The sensitivity of Xpert MTB/RIF assay was 22.0％ in clinical TB patients and the specificity reached 100.0％ in the group of patients who are infected with nontuberculous mycobacteria.For the detection of rifampin resistance,the sensitivity of MTB/RIF RIF-resistance detection was 92.9％,and the specificity was 98.7％.Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests,20 （76.9％） patients were infected by MDR-TB.Conclusions The Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance,which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China.Further evaluations in county-level laboratories for implementing the assay are still required.

Multivalent Display of Lipophilic DNA Binders for Dual-Selective Anti-Mycobacterium Peptidomimetics with Binary Mechanism of Action

We made oligoamidine-based peptidomimetics highly specific for mycobacteria eradication by introducing and arraying lipophilic DNA binding motifs on macromolecular backbones.The short poly(amidino-phenylindole)(PAPI)structures feature an alternating amphiphilic structure with cationic,lipophilic DNA-binding moieties,enabling fast and selective eradication of mycobacteria through binary,membrane-and DNA-selective mechanisms of action.More importantly,PAPIs address the primary treatment challenge by combating mycobacteria in eukaryotic cells and working as a sensitizer for conventional antibiotics,in bothways promoting more thorough removal of pathogens and reducing the mycobacteria’s resistance generation rate during treatment.Structural optimizationwas achieved to counter specific pathogens,including Mycobacterium tuberculosis,in the Mycobacterium genus.One of the hit peptidomimetics was evaluated in a zebrafish-based aquatic infection model using Mycobacterium fortuitum and a mice tail infection model using Mycobacterium marinum,both revealing excellent in vivo performance.