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Objective This study assesses the status and determinants of treatment delays among patients with rifampicin-resistant tuberculosis (RR-TB) in Guizhou Province, 2016-2022, aiming to inform the development of RR-TB control strategies in the region. Methods Data on RR-TB patients from 2016 to 2022 were extracted from the "Tuberculosis Management Information System," a subsystem of the "China Disease Prevention and Control Information System." The trend in treatment delay rates over time was analyzed using Trend chi-square test, while logistic regression models were used to examine the factors influencing these delays. Results From 2016 to 2022, Guizhou Province reported 513 cases of treatment delays among patients with rifampicin-resistant tuberculosis (RR-TB), resulting in a treatment delay rate of 23.29%. The rate of treatment delays decreased from 2016 to 2019 (Trend chi-square test = 9.099, P = 0.003), reaching its lowest in 2018 at 10.53%. However, from 2020 to 2022, the rate of treatment delays exhibited an upward trend (Trend chi-square test = 5.937, P = 0.015), peaking in 2021 at 31.62%. Multivariable analysis indicated that compared to migrant populations, patients undergoing initial treatment, and those tested with molecular biological drug sensitivity tests, non-migrant patients (OR = 1.496, 95%CI = 1.198 to 1.867), new patients (OR = 1.774, 95%CI = 1.344 to 2.342), patients with relapse (OR = 1.494, 95%CI = 1.110 to 2.011), and those tested using traditional drug sensitivity methods (OR = 2.985, 95%CI = 2.323 to 3.834) were at higher risk for treatment delays. Conclusion From 2016 to 2022, the overall trend of treatment delays in rifampicin-resistant tuberculosis (RR-TB) patients in Guizhou Province showed a decline. However, there was an increasing trend during the COVID-19 pandemic. This suggests a need to enhance the prevention and control of drug-resistant tuberculosis in key areas such as Bijie City. There is also a need to intensify health education for patients with drug resistance, implement patient-centered care systems for those patients, expand the application of molecular biological drug sensitivity testing techniques, and strengthen the referral and admission mechanisms for RR-TB patients. [ABSTRACT FROM AUTHOR]

Objective To analyze adverse outcomes and influencing factors of elderly pulmonary tuberculosis patients in Guizhou Province and to provide a scientific basis for effective treatment of elderly pulmonary tuberculosis patients. Methods The medical records information of elderly pulmonary tuberculosis patients aged 65 and above in Guizhou Province from January 1, 2011, to December 31, 2022, was extracted from the Tuberculosis Monitoring Report Management Information System. The time trend of adverse outcomes was analyzed using the chi-square trend test, inter-group comparison was conducted using the chi-square test, and binary logistic regression was employed to analyze influencing factors. Results From 2011 to 2022, 10, 820 elderly patients with pulmonary tuberculosis had adverse outcomes in Guizhou Province, with an adverse outcome rate of 12.91 %. The rate of adverse outcomes increased from 2011 to 2015 (χtrend² = 62.080, P < 0.001), and decreased from 2016 to 2022 (χtrend² = 38.163, P < 0.001). Regarding regional distribution, Bijie City had the highest rate of adverse outcomes, and TongrenCity had the lowest rate (% = 808. 188, P < 0.001). The results of multivariate analysis showed that compared with the patients who were female, ethnic minorities, 65-69 years old, without comorbidities, newly treated, pathogenic negative, and without other tuberculosis, the patients were more likely to develop tuberculosis. Male (OR = 1.323, 95% CI = 1.267-1.380), Han ethnic group (OR = 1.168, 95% CI = 1.117-1.222), 70-74 years old (OR = 1.244,95% CI = 1.181-1.310),75-79 years old (Oft = 1.612, 95% CI = 1) 525-1.704), ≥80 years old (OR = 2.322, 95% CI = 2.178-2.476), comorbidities (OR = 1.261, 95% CI = 1.179-1.348), retreatment (OR = 1.526, 95% CI = 1.423-1.636), positive pathogen (OR = 1.244, 95% CI = 1.181-1.310) and other tuberculosis (OR = 1.245, 95% CI = 1.161-1.336) were risk factors for poor outcomes. Conclusion Since the implementation of the "13th Five-Year Plan" for tuberculosis prevention and treatment, the adverse outcome rate of elderly tuberculosis patients in Guizhou Province has shown a gradual decreasing trend, but the distribution of the adverse outcome rate is uneven, which suggests that we need to continue to maintain a high degree of vigilance and strengthen preventive and control measures. [ABSTRACT FROM AUTHOR]

The conserved residue Thr42 of ε-subunit of the chloroplast ATP synthase of maize ( Zea mays L.) was substituted with Cys, Arg, and Ile, respectively, through site-directed mutagenesis. The over-expressed and refolded ε-proteins were purified by chromatography on DEAE-cellulose and FPLC on mono-Q column, which were as biologically active (inhibiting Ca2+-ATPase activity and blocking proton gate) as the native ε subunit isolated from chloroplasts. The εT42C and εT42R showed higher inhibitory activities on the soluble CF1(−ε) Ca2+-ATPase than the εWT. The εT42I inhibited the Ca2+-ATPase activity of soluble CF1 and restored photophosphorylation activity of membrane-bound CF1 deficient in ε the most efficiently. Far-ultraviolet CD spectra showed that the portions of α-helix and β-sheet structures of the three mutants were somewhat different from εWT. Thus the conserved residue Thr42 may be important for maintaining the structure and function of the ε-subunit and the basic functions of the ε-subunit as far as an inhibitor of Ca2+-ATPase and the proton gate are related. [ABSTRACT FROM AUTHOR]

The chloroplast atpE genes from broad bean and maize were overexpressed in E.coli, respectively. After proper refolding and purification, two types of epsilon-subunit proteins with biological activity were obtained. When reconstituted with CF(1)(-epsilon)from different chloroplast ATPase, the effects of the reconstructed epsilon-subunit protein of maize CF(1) to the Ca(2+)-ATPase activity of epsilon-deficient CF(1) and to the proton leakage through CF(0) were markedly stronger than that of broad bean CF(1). It was also observed that the enhancing effect of maize epsilon-subunit protein to the chloroplast photophosphorylation activity was greater than that of broad bean epsilon-subunit protein. The results indicate that (1)the inhibition of epsilon-subunit is closely related to the its affinity with other parts of CF(1) (2)both functions of epsilon-subunit as inhibitor of ATPase and as proton pathway are closely linked. The circular dichroism was performed to show the differences in their secondary structure of these epsilon-subunit proteins based on the deduced primary sequences. Unconstrained analysis of the CD spectrum for the maize epsilon-subunit protein gave 22.6% alpha-helix, 30.6% beta-sheet, 9.3% beta-turn, and 37.7% unordered structure and 31.4%alpha-helix, 22.3% beta-sheet, 13.8% beta-turn, and 32.4% unordered structure for the epsilon-subunit from broad bean.