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Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis (TB) and can be difficult to diagnose and treat. We aimed to describe the clinical presentation, diagnosis, disease spectrum, outcome, and prognostic factors of patients treated for TBM in China. Methods: A multicenter retrospective study was conducted from 2009 to 2019 enrolling all presumptive TBM patients referred to Xijing tertiary Hospital from 27 referral centers in and around Shaanxi province, China. Patients with clinical features suggestive of TBM (abnormal CSF parameters) were included in the study if they had adequate baseline information to be classified as "confirmed," "probable," or "possible" TBM according to international consensus TBM criteria and remained in follow-up. Patients with a confirmed alternative diagnosis or severe immune compromise were excluded. Clinical presentation, central nervous system imaging, cerebrospinal fluid (CSF) results, TBM score, and outcome--assessed using the modified Barthel disability index--were recorded and compared. Findings: A total of 341 presumptive TBM patients met selection criteria; 63 confirmed TBM (25 culture positive, 42 Xpert-MTB/RIF positive), 66 probable TBM, 163 possible TBM, and 49 "not TBM." Death was associated with BMRC grade III (OR = 5.172; 95%CI: 2.298-11.641), TBM score = 15 (OR = 3.843; 95%CI: 1.372-10.761), age > 60 years (OR = 3.566; 95%CI: 1.022-12.442), and CSF neutrophil ratio = 25% (OR = 2.298; 95%CI: 1.027-5.139). Among those with confirmed TBM, nearly one-third (17/63, 27.0%) had a TBM score < 12; these patients exhibited less classic meningitis symptoms and signs and had better outcomes compared with those with a TBM score = 12. In this group, signs of disseminated/miliary TB (OR = 12.427; 95%CI: 1.138-135.758) and a higher TBM score (=15, OR = 8.437; 95%CI: 1.328-53.585) were most strongly associated with death. Conclusion: TBM patients who are older (>60 years) have higher TBM scores or CSF neutrophil ratios, have signs of disseminated/miliary TB, and are at greatest risk of death. In general, more effort needs to be done to improve early diagnosis and treatment outcome in TBM patients. [ABSTRACT FROM AUTHOR]

The wavelet analysis can he used to disclose the evolution law of drought disaster ratio time series (DDRTS), which is important to the drought disaster early warning. Based on the wavelet and fractal analysis on the 59 years time series of drought disaster ratio in China, the original time series was decomposed and reconstructed using Mallat multi-resolution wavelet algorithm. The fractal analysis results showed that the Chinese DDRTS had obvious fractal characteristics, which minimum embedding dimension is six. The multi-resolution wavelet analysis results showed that the Chinese DDRTS had obvious multi-period characteristics, which the 30-35 years change period has maximum energy density. The following conclusions can be drawn. 1) The minimum embedding dimension of fractal analysis can be served as a maximum effective decompose level for the Mallat multi-resolution wavelet analysis, which is helpful to enlarge the application field of fractal analysis. 2) The evolution of Chinese DDRTS was driven by six independent state variables, and had obvious multi-period characteristic. As a whole, the drought disaster ratio remained to be in a growth period at present. [ABSTRACT FROM AUTHOR]