Indoor Air Quality Real-Time Monitoring Results of Pathology Department

In this work, the objectives were to provide a scientific basis for environmental governance and to ensure staff health by real-time monitoring of indoor air quality of the pathology department. Using eagle eye environment monitor to make a real-time dynamic monitoring of the air quality of the pathological technical room for 30 days, the paper records the monitoring data of PM 2.5, PM 10, formaldehyde, CO2, total volatile organic compounds (TVOC) every day at Beijing time 3 a.m, 10 am, 1 pm, 4 pm, and 10 pm, and makes a summarization and analysis. The average value of CO2 concentration of the 5 time points is (0.05 ± 0.01)%, and each time point concentration are different (P 0.05);the average TVOC concentration of the 5 time points is (0.08 + 0.31) mg/m3. They are all different between the concentration at each time point (P 2 and NO are not checked out. Through the real-time online monitoring of the pathology room, we find that the formaldehyde concentration of different time periods is far more than the safety value standard, and the concentration of formaldehyde, CO2, PM 2.5, PM 10 and total volatile organic compound (TVOC) is different at different time periods, and the concentrations at working time are higher than the non-working time. We must take effective measures to control the concentration of harmful gases in order to ensure the staff’s health.

Analytic Study of Spinal Infections: Clinical Picture, Treatment, and Outcomes in King Fahad Military Medical Complex in Dhahran, Saudi Arabia

Objective: To evaluate the prevalence of spinal infection in a hospital located in the eastern region of Saudi Arabia through a retrospective review and to identify the associated etiological agents in terms of clinical picture, treatment, and outcomes. Design: Retrospective cross-sectional study. Setting: Single hospital in Dhahran, Saudi Arabia. Patients: Patients with any type of spinal infection and/or who had undergone neurosurgical intervention for spinal infection between January 2006 and December 2018. Methods: We collected data on all patients with an established diagnosis of spinal infection from January 2006 to December 2018 in the King Fahad Military Medical Complex in Dhahran, Saudi Arabia. A validated and structured checklist was used for data collection. Spinal infection diagnosis was based on the clinical manifestation, microbiological evidence, radiological findings, and antimicrobial therapy response. Results: Seventeen patients were included in this study, and their mean age was 54.93 years. Twelve of the patients were male and four were female. The approximate time from symptom onset to diagnosis was 2 - 6 months. Most of the patients experienced back pain, with lumbosacral spondylitis being the most commonly cited type (61.11%), followed by thoracolumbar spondylodiscitis (25%) and cervical spondylodiscitis (6.25%). The most frequently isolated organism was Mycobacterium tuberculosis (8 patients, 50%), followed by extended-spectrum beta lactamase (ESBL)-producing Escherichia coli (4 patients, 25%), Brucella spp (3 patients, 18.75%), Staphylococcus aureus (1 patient, 6.25%), and Quambalaria cyanescens (1 patient, 6.25%). Totally, in 50% of the patients with thoracolumbar and lumbosacra site involvement, tuberculosis spondylodiscitis was observed, while another 50% of the cases showed complications associated with paravertebral abscess that required surgical drainage. Conclusion: M. tuberculosis was found to be the major cause of infectious spondylodiscitis. Additionally, Quambalaria cyanescens was isolated;this is the second reported case of the organism being isolated and the first associated with spinal infection.

Trans-synaptic degeneration as a mechanism of neurodegeneration in multiple sclerosis

Multiple sclerosis(MS) is regarded as an immunemediated,demyelinating disorder of the central nervous system,however neuroaxonal degeneration is accepted as the principal substrate of disability accumulation(Dutta and Trapp,2011).

医务人员呼吸防护用品适合性检验和密合性检查有效性的系统综述

目的呼吸防护在医疗卫生工作中至关重要,应使用适当的颗粒过滤呼吸器和等效的呼吸防护用品,以确保良好的佩戴气密性,最大限度地降低医务人员的空气传播感染风险。该文旨在对呼吸防护用品适合性检验和密合性检查有效性研究进行综述和分析。方法系统检索了2003年1月至2022年4月发表的文献,检索范围包括CINAHL、Cochrane图书馆、EMBASE、PubMed、Ovid数据库Medline子库和灰色文献。研究方案已在PROSPERO注册(CRD42020213968)。结果共检索出561篇文献,25篇被纳入该综述,包括22项量性研究和3篇指南文献。在评估呼吸防护用品的有效性方面,适合性检验是更有效且被广泛采用的可靠方法,但呼吸防护程序应该同时包括适合性检验和密合性检查,以最大限度地提高呼吸防护用品的有效性。新型冠状病毒疫情凸显了医务人员相关知识的缺乏,相关教育培训可有效提高呼吸防护用品使用的有效性。结论为确保医务工作者的安全,适合性测试和密合性检查均应采用。建议由专业人员实施全面的呼吸防护项目,包括教育培训、适合性测试和密合性检查,还需要探索适用于实际使用环境的适合性检验方法。

Hepatitis B vaccination status and associated factors among health science students

Objective:To evaluate hepatitis B virus(HBV)vaccine coverage and its associated factors among health science students in Vietnam.Methods:This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022.Data were collected using a structured questionnaire with items on sociodemographic characteristics,knowledge and attitude about HBV,and vaccination status.A multivariable logistic regression model was used to explore the factors associated with vaccination status.Results:The majority of participants were female(65.8%)and enrolled at the medical school(56.2%).A total of 30.3%participants received the full dose of the HBV vaccine.The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2%and 43.4%,respectively.Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year[adjusted odds ratio(aOR)11.8,95%CI 3.1-45.1,P<0.001],and the coverage was also significant higher in those who had sufficient knowledge(aOR 2.0,95%CI 1.1-3.9,P<0.05)and positive attitudes(aOR 3.0,95%CI 1.9-4.8,P<0.05)than in their counterparts.Conclusions:The majority of students were not fully vaccinated against HBV,indicating they were vulnerable to the disease.Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine,enhance their awareness and knowledge of HBV,and improve attitudes toward HBV infection prevention.

Immune formulation-assisted conventional therapy on anti-infective effectness of multidrug-resistant Mycobacterium tuberculosis infection mice

Objective:To study the effect of immune formulation-assisted conventional therapy on antiinfective ability of multidrug-resistant Mycobacterium tuberculous infection mice.Methods:BALB/c mice were used as experimental animals,multidrug-resistant Mycobacterium tuberculosis infection models were built,randomly divided into model group,moxifloxacin group,thymopentin group and combined treatment group and given corresponding drug intervention,and then colony numbers in the spleen and lung,T lymphocyte subset contents and programmed death-1(PD-1) expression levels in peripheral blood were detected.Results:Colony numbers in lung and spleen of moxifloxacin group and thymopentin group were significantly lower than those of model group and colony numbers in lung and spleen of combined treatment group were significantly lower than those of moxifloxacin group and thymopentin group:contents of CD3^+CD4^+T cells,Thl and Thl7 in peripheral blood of moxifloxacin group and thymopentin group were higher than dtose of model group,and contents of CD3^+CD8^+T cells.Th2 and Treg were lower than those of model group;contents of CD3^+CD4^+T cells.Th 1 and Th 17 in peripheral blood of combined treatment group were higher than those of moxifloxacin group and thymopentin group,and contents of CD3^+CD8^+T cells.Th2 and Treg were lower than those of moxifloxacin group and thymopentin group:PD-I expression levels on T lymphocyte,B lymphocyte and monocyte surface in peripheral blood of moxifloxacin group and thymopentin group were lower than those of model group,and PD-I expression levels on T lymphocyte.B lymphocyte and monocyte surface in peripheral blood of combined treatment group were lower than those of moxifloxacin group and thymopentin group.Conclusions:Immune formulation thymopentin can enhance the anti-infective ability of multidrug-resistant Mycobacterium tuberculosis infection mice,decrease bacterial load in lung and spleen,and enhance immune function.

Clinicopathological and prognostic significance of aberrant Arpin expression in gastric cancer

AIM To detect the expression of Arpin, and determine its correlation with clinicopathological characteristics and the prognosis of gastric cancer(GC) patients.METHODS A total of 176 GC patients were enrolled as study subjects and classified into groups according to different clinicopathological variables. GC mucosal tissues were obtained via surgery. Another 43 paraffin-embedded tissue blocks of normal gastric epithelium(> 5 cm away from the edge of the tumor) were included in the control group. Immunohistochemistry(IHC) for the Arpin and Arp3 proteins was performed on the formalinfixed, paraffin-embedded GC tissues. Additionally, expression of the Arpin protein in 43 normal gastric tissues was also determined using IHC.RESULTS Expression of the Arpin protein in GC was lower than that in normal gastric mucosa(30.68% vs 60.47%, P < 0.001). A χ2 test of the 176 GC samples used for IHC showed that decreased Arpin expression was associated with advanced TNM stage(P < 0.01) and the presence or absence of lymph node metastasis(80.92% vs 35.56%, P < 0.001). Additionally, a significant correlation was observed between the expression of Arpin and the presence of the Arp2/3 complex in GC tissues(χ2 = 30.535, P < 0.001). Moreover, a multivariate Coxregression analysis revealed that Arpin expression [hazard ratio(HR) = 0.551, P = 0.029] and TNM stage(HR = 5.344, P = 0.001) were independent prognostic markers for overall survival of GC patients. Regarding the 3-year disease-free survival(DFS), the recurrence rate of GC patients with low Arpin expression levels(median DFS 19 mo) was higher than that in the highArpin-expression group(median DFS 34 mo, P = 0.022).CONCLUSION Low Arpin levels are associated with clinicopathological variables and a poor prognosis in GC patients. Arpin may be regarded as a potential prognostic indicator in GC.

Emergency management of nursing human resources and supplies to respond to coronavirus disease 2019 epidemic

Objective:To introduce the emergency management of nursing human resources and supplies of a large general hospital when facing the outbreak of coronavirus disease 2019(COVID-19).Method:The Nursing Department of the hospital fully executed its functional authority to establish a three-level echelon of sustainable support,allocate human recourses dynamically,organize pre-service training,supervise the key working steps,formulate positive incentive methods,and deploy medical supplies scientifically.Result:By taking these strategies,the hospital effectively improved the coping capacity of the nursing team and played a positive role in the prevention and treatment of COVID-19.Conclusion:The emergency management of nursing human resources and material resources for COVID-19 of the hospital is successful.But several deficiencies were identified as well,which indicated that the hospital needs to establish an efficient emergency management system,and pay attention to the practice of nursing emergency plans to enhance coping capacities in public health emergencies.

Value of ^(18)F-FDG PET/CT and MRI in diagnosing primary endometrial small cell carcinoma

Primary small cell carcinoma（SCC） is a group of aggressive neoplasms that mainly arise from the lung and digestive tract. Endometrial small cell carcinoma（ESCC） is extremely rare. To our knowledge, less than 90 cases have been reported, and most of these reports were dedicated to describing the clinicopathologic or immunochemical features of ESCC. Herein, we present a new case of ESCC involving a 51-year-old woman and mainly focus on the magnetic resonance imaging（MRI） and positron emission tomography/computed tomography（PET/CT） findings. MRI showed that the uterus was significantly enlarged（11.6 cm × 11.1 cm × 14.4 cm）, and a giant irregular mass（7.5 cm × 8.4 cm × 8.5 cm） was observed in the uterine cavity. The lesion demonstrated an extremely low apparent diffusion coefficient（ADC） value [（0.553±0.088）×10^–3 mm^2/s] and a high FDG uptake value（22.7）. Multiple metastatic lymph nodes（LNs） were identified at different positions, with diameters ranging from 0.3 to 2.8 cm and a maximum standardized uptake value（SUV max） ranging from 6.9 to 19.3.

COVID-19 vaccination intention among healthcare workers in Vietnam

Objective:To assess the acceptance of coronavirus disease(COVID-19)vaccine among healthcare workers at two general hospitals in Vietnam when it is available.Methods:A cross-sectional study was conducted using a convenience sampling from January to February 2021 among 410 healthcare workers at two general hospitals in Vietnam via a selfadministered questionnaire.A multivariable regression analysis was performed to determine predictors of vaccine acceptance including the demographic factors,COVID-19 knowledge,and vaccine beliefs based on the domains of Health Belief Model.Results:Among 410 healthcare workers,76.10%showed vaccination willingness.Predictors of acceptance were determined that the group reporting as“vaccine acceptance”was more likely to be positive towards the perceived susceptibility and severity of COVID-19(OR 2.45;95%CI 1.48-4.06,P<0.05),perceived benefits of vaccination,and cues to action(OR 4.36;95%CI 2.35-8.09,and OR 5.49;95%CI 2.84-10.61,respectively,all P<0.001),but less likely to have the perceived barriers to vaccination(OR 0.19;95%CI 0.09-0.38;P<0.001)compared with the no acceptance group.Besides,people who had a good knowledge regarding the severity of illness were 3.37 times more likely to have identified as vaccine acceptance(OR 3.37;95%CI 1.04-10.86,P<0.05).The demographic factors were also associated with willingness to receive the vaccine,with participants who were staff and received COVID-19 information from relatives were less likely to accept the vaccine over those who were doctors and not receiving information from relatives(OR 0.36;95%CI 0.13-0.96,and OR 0.37;95%CI 0.17-0.78,respectively,all P<0.05).Conclusions:A rate of willingness to get vaccinated against COVID-19 was relatively high with discrepancies between occupation,receiving information from relatives,knowledge toward the severity of illness,and the elements of Health Belief Model.The findings will provide information for the management authorities to develop relevant interventions to promote COVID-19 vaccination uptake.

趋化因子IL-8、MCP-1和MIP-1α在胆囊癌中表达的临床病理学意义(英文)

Objective: Gallbladder carcinoma was one of the malignant tumors in the digestive system, characterized by high recurrence and invasion. Recent research indicates that chemotactic factors such as IL-8, MCP-1 and MIP-1α have played an important role in such aspects as formulation, growth, shifting of the tumor. The aim of this study was to investigate expressions of IL-8, MCP-1 and MIP-1α in gallbladder adenocarcinoma tissues. Methods: Gallbladder adenocarcinoma and noncancerous tissues were routinely formalin-fixed and paraffin-embedded, and in situ hybridization assay for IL-8, MCP-1and MIP-1α mRNA. Results:(1) The positive rates or the scorings of IL-8, MCP-1 and MIP-1α mRNA were significantly higher in human gallbladder adenocarcinoma than those in human chronic cholecystitis(P < 0.01). The positive rates or the scorings of three factors were lower in well-differentiatiated gallbladder adenocarcinoma than in poorly-differenfiatted ones, whereas there was only one significant difference between MCP-1 mRNA(P < 0.05). The closely positive correlation were found among IL-8, MCP-1 and MIP-1α mRNA.(2) Both the positive rates of IL-8 mRNA and MCP-1 mRNA as well as their scorings were tightly related to their invasion of the common bile duct and the occurrence of lymph node transfer, moreover, the positive rates of MIP-1α mRNA and its scorings were tightly related to its invasion of liver.(3) Close positive correlation exists not only in IL-8 mRNA and MCP-1 mRNA(r = 0.528), but also in MIP-1α mRNA and IL-8 mRNA(r = 0.422), so does in MCP-1mRNA and MIP-1α mRNA(r = 0.638). Conclusion: The positive rates or the scorings of IL-8, MCP-1 and MIP-1α mRNA are significantly higher in human gallbladder adenocarcinoma than those in human chronic cholecystitis, and the closely positive correlation are found among them, which suggests that IL-8, MCP-1 and MIP-1α regulate and influence the development and transformation of the gallbladder adencarcinoma together.

Novel Antiviral Agents Targeting HIV Entry and Transmission

Studies of the mechanism of HIV entry and transmission have identified multiple new targets for drug development. A range of inhibitors have demonstrated potent antiretroviral activity by interfering with CD4-gp120 interaction,coreceptor binding or viral-cell fusion in preclinical and clinical studies. One of these agents,fusion inhibitor enfuvirtide,is already in clinical use. Here we review the progress in the development of specific entry inhibitors as novel therapeutics. The potential of entry inhibitors as topical microbicides to block HIV transmission is also discussed.

Effects of entecavir on platelet function, PTA and HBV-DNA levels in patients with hepatitis B cirrhosis

Objective: To explore the effect of entecavir on platelet function, PTA and HBV-DNA levels in patients with hepatitis B cirrhosis. Methods: A total of 132 patients with hepatitis B cirrhosis admitted in our hospital from September 2012 to May 2016 were randomly divided into control group (n=66) and observation group (n=66). The two groups were treated with routine treatment, such as reducing enzyme activity and protecting liver function. The control group was treated with lamivudine on the basis of routine treatment and the observation group was treated with entecavir. The changes of liver function, liver fibrosis, platelet index, PTA and HBV-DNA expression level in the two groups were compared. Results: Before treatment, there was no significant difference between alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), type III procollagen (PC III), laminin (LN), type IV collagen (IV-C), hyaluronidase (HA), platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), prothrombin activity (PTA) and hepatitis B virus RNA (HBV-DNA). After treatment, ALT, AST, TBIL, PC III, IV-C, LN and HA in both groups were significantly decreased than those before the treatment, and the decrease of PC III, IV -C, LN and HA in observation group was more significant than that of the control group;PLT and PTA in both groups were significantly increased than before treatment, while MPV, PDW and HBV-DNA were obviously decreased than before treatment, and PLT and PTA in the observation group were remarkably increased than control group, while MPV, PDW, and the control group were significantly lower than those in the control group. Conclusions: Entecavir in the treatment of hepatitis B liver cirrhosis, can reduce the HBV-DNA level, and then obviously enhance the liver function, inhibit the development of liver fibrosis, correct the abnormal platelet parameters and improve coagulation function.

Hand Hygiene among Anesthesiologists and Microorganisms Contamination in Anesthesia Environments:A Single-Center Observational Study

Objective To investigate the baseline levels of microorganisms’growth on the hands of anesthesiologists and in the anesthesia environment at a cancer hospital.Methods This study performed in nine operating rooms and among 25 anesthesiologists at a cancer hospital.Sampling of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after decontamination.Results Microorganisms’growth results showed that 20%(5/25)of anesthesiologists’hands carried microorganisms(>10 CFU/cm^(2))before patient contact began.Female anesthesiologists performed hand hygiene better than did their male counterparts,with fewer CFUs(P=0.0069)and fewer species(P=0.0202).Our study also found that 55.6%(5/9)of ready-to-use operating rooms carried microorganisms(>5 CFU/cm^(2)).Microorganisms regrowth began quickly(1 hour)after disinfection,and increased gradually over time,reaching the threshold at 4 hours after disinfection.Staphylococcus aureus was isolated from the hands of 20%(5/25)of anesthesiologists and 33.3%(3/9)of operating rooms.Conclusion Our study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene,daily cleaning rate of the operating room may be insufficient,and we would suggest that there should be a repeat cleaning every four hours.

Bronchoscopy for diagnosis of COVID-19 with respiratory failure:A case report

BACKGROUND Although the imaging features of coronavirus disease 2019(COVID-19)are starting to be well determined,what actually occurs within the bronchi is poorly known.Here,we report the processes and findings of bronchoscopy in a patient with COVID-19 accompanied by respiratory failure.CASE SUMMARY A 65-year-old male patient was admitted to the Hainan General Hospital on February 3,2020 for fever and shortness of breath for 13 d that worsened for the last 2 d.The severe acute respiratory syndrome coronavirus 2 nucleic acid test was positive.Routine blood examination on February 28 showed a white blood cell count of 11.02×109/L,86.9%of neutrophils,6.4%of lymphocytes,absolute lymphocyte count of 0.71×109/L,procalcitonin of 2.260 ng/mL,and C-reactive protein of 142.61 mg/L.Oxygen saturation was 46%at baseline and turned to 94%after ventilation.The patient underwent video bronchoscopy.The tracheal cartilage ring was clear,and no deformity was found in the lumen.The trachea and bilateral bronchi were patent,while the mucosa was with slight hyperemia;no neoplasm or ulcer was found.Moderate amounts of white gelatinous secretions were found in the dorsal segment of the left inferior lobe,and the bronchial lumen was patent after sputum aspiration.The right inferior lobe was found with hyperemia and mucosal erosion,with white gelatinous secretion attachment.The patient’s condition did not improve after the application of therapeutic bronchoscopy.CONCLUSION For patients with COVID-19 and respiratory failure,bronchoscopy can be performed under mechanical ventilation to clarify the airway conditions.Protection should be worn during the process.Considering the risk of infection,it is not necessary to perform bronchoscopy in the mild to moderate COVID-19 patients.

Clinical features of elderly patients with COVID-19 in Wuhan,China

BACKGROUND Elderly patients with coronavirus disease 2019(COVID-19)who have comorbidities,frailty or profound disabilities experience poor outcomes.We analyzed the clinical characteristics of elderly patients from Wuhan who had COVID-19 during the early stages of the pandemic.AIM To identify factors affecting the early mortality of elderly patients with COVID-19.METHODS The records of 234 patients who were 65-years-old or more and were hospitalized in Wuhan Huoshenshan Hospital from February 4 to March 4,2020 were reviewed.All patients had confirmed COVID-19 and the final date of follow-up was April 4,2020.RESULTS There were 163 cases of mild disease(69.66%),39 cases of severe disease(16.67%)and 32 cases of critical disease(13.68%).Twenty-nine patients died within 1 mo(12.40%),all of whom had critical disease.Surviving patients and deceased patients had no significant differences in age or chronic diseases.Overall,the most common symptoms were fever(65.4%),dry cough(57.3%),fatigue(47.4%)and shortness of breath(41%).The deceased patients had higher levels of multiple disease markers(C-reactive protein,D-dimer,lactate dehydrogenase,alanine amino transferase,aspartate aminotransferase,creatinine kinase and creatinine kinase-MB)and higher incidences of lymphocytopenia and hypoproteinemia.CONCLUSION This single-center study of elderly patients from Wuhan,China who were hospitalized with COVID-19 indicated that age and chronic diseases were not associated with mortality.Hypertension,diabetes and cardiovascular disease were the most common comorbidities and the most common symptoms were fever,dry cough,fatigue and shortness of breath.Lymphocytopenia,increased levels of D-dimer and other markers indicative of damage to the heart,kidneys or liver were associated with an increased risk of death.

Study on the Effect of High Quality Nursing on the Compliance of Patients with Chronic Hepatitis B

Objective: to explore the effect of high quality nursing on the compliance of patients with chronic Hepatitis B (CHB), and to use it as a reference for clinical nursing. Methods: 42 patients with chronic Hepatitis B (CHB) admitted in our infectious department within one year in 2014 were selected for traditional nursing care, 54 patients were selected for quality nursing, and the two groups were used as control group and study group, respectively. The drug compliance of the two groups was compared. Conclusion: for patients with chronic Hepatitis B, the use of quality nursing can improve their compliance to take medicine and arouse their enthusiasm subjectively, which is very important for the improvement of their condition. The effect is satisfactory to most patients and family members.

Abscess in Primary Tuberculosis of Breast: Case Report

Purpose: To highlight the diagnostic challenges of breast tuberculosis. Mammary tuberculosis is a rare disease. Its clinical and radiological characteristics are similar to other breast diseases in young women, such as granulomatous mastitis and breast carcinoma. Materials and Methods: We report a case of primary tuberculosis of a 34 years old woman who presented bilateral abscess with refractory secretion of blood and pus drainage to previous treatment with conventional antibiotic therapy of granulomatous mastitis. Results: A tuberculous mammary was observed and confirmed in the case. The diagnosis was based on imaging tests and complementary tests. Anti-tuberculosis treatment was prescribed during 6 months, and the evolution was favorable for one patient. Conclusion: Tuberculosis continued to present diagnostic difficulties, particularly in its breast tuberculosis form.

Drug Resistance Trends and Patterns of Mycobacterium Tuberculosis Isolates from Pulmonary Tuberculosis Patients at a Tertiary Care Hospital in Turkey

Background: We aim to determine the proportions and patterns of resistance to first-line drugs: isoniazid (H), rifampicin (R), ethambutol (E) and streptomycin (S) among pulmonary tuberculosis patients. Methods: Strains were obtained from 1584 culture positive pulmonary tuberculosis patients. All specimens were inoculated into L?wenstein-Jensen media (LJ) and TK selective;drug susceptibility tests (DST) were performed for first-line drugs. Results: Multidrug resistant (MDR) were detected in 146 (9.2%) isolates. Three hundred (18.9%) isolates were resistant to H;220 (13.9%) to R;168 (10.6%) to S;137 (8.6%) to E. Any drug resistance was detected in 442 (27.9%) isolates. MDR rate was higher in male patients than females (P = 0.006). MDR rates were different according to the age groups (P = 0.02). The highest rate was in 35 - 44 years and the lowest rate was in 15 - 24 years. Conclusions: We found an association between middle age and male gender and MDR tuberculosis.

Perceived susceptibility,severity,and reinfection of COVID-19 may influence vaccine acceptance-Authors'reply

Authors’reply:We would like to thank you for your interesting comments.Our study aims to understand healthcare workers’intention to receive a COVID-19 vaccination and the factors that affect their ability to do so,based on the domains of the Health Belief Model(HBM)in the period that COVID-19 vaccine was not available in Vietnam.