Drug-resistant tuberculous meningitis (TBM) is the most devastating and critical form of extrapulmonary tuberculosis. Here, we present a case of a 45-year-old male with pre-extensive drug-resistant tuberculosis meningitis (pre-XDR-TBM). He underwent emergency surgery for the long-tunneled external ventricular drainage (LTEVD). Molecular test and phenotypic drug sensitivity test (DST) of Mycobacterium tuberculosis in cerebrospinal fluid (CSF) showed that the isolate was resistant to both rifampin and fluoroquinolones. An anti-tuberculous regimen of isoniazid, pyrazinamide, cycloserine, moxifloxacin, clofazimine, and linezolid was tailored accordingly. We monitored the drug concentration in his plasma and CSF before (at 0-hour) and after anti-TB drugs administration (at 1-hour, 2-hour, 6-hour, and 12-hour) on 10 th day after treatment initiation. We hope to provide reference values of drug exposures in plasma and CSF for patients with pre-XDR-TBM.

Background : Previous studies have indicated that serum alanine aminotransferase ( ALT ) level, serum aspartate aminotransferase ( AST ) level or ALT/AST ratio may be bound up with diabetes. But the association of ALT/AST ratio and incident diabetes in Chinese adults have not been elaborated yet. The main objective of the present study was to analyze whether ALT/AST ratio was an independent risk factor which attached to the risk of incident diabetes in Chinese adults. Methods: From 2010 to 2016, 685,277 Chinese adults who received a health check in Rich Healthcare Group including all medical records, and the present article was a second retrospective cohort analysis based on above population. As the target independent variable, ALT/AST ratio was measured at baseline while the dependent variable, incident diabetes appeared during follow-up. We used Cox proportional hazard regression models to analyze the prognostic value of ALT/AST on the risk of incident diabetes. Results: ALT/AST demonstrated undeniable correlation with incident diabetes (HR=2.535, 95%CI: 2.190 to 2.934, P <0.00001). The association between ALT/AST and incident diabetes is only linear. The cumulative incidence (95% CI) rate of incident diabetes in total participants, ALT/AST quartile 1, 2, 3, and 4 was 2.112 (2.016-2.208), 0.992 (.0.857-1.127), 1.430 (1.274-1.586), 2.396 (2.192-2.600) and 3.559 (3.314-3.803), separately. The population with age (30 to <40 years), BMI (<24kg/m2) and SBP (<140mmHg) was found to be the stronger association in subgroup analysis. Conclusion: In Chinese adults, ALT/AST ratio is an independent risk factor for incident diabetes .

Background Previous studies have indicated that serum alanine aminotransferase (ALT) level, serum aspartate aminotransferase (AST) level or ALT/AST ratio may be bound up with diabetes. But the association of ALT/AST ratio and incident diabetes in Chinese adults have not been elaborated yet. The main objective of the present study was to analyze whether ALT/AST ratio was an independent risk factor which attached to the risk of incident diabetes in Chinese adults. Methods From 2010 to 2016, 685,277 Chinese adults who received a health check in Rich Healthcare Group including all medical records, and the present article was a second retrospective cohort analysis based on above population. As the target independent variable, ALT/AST ratio was measured at baseline while the dependent variable, incident diabetes appeared during follow-up. We used Cox proportional hazard regression models to analyze the prognostic value of ALT/AST on the risk of incident diabetes. Results ALT/AST demonstrated undeniable correlation with incident diabetes (HR = 2.535, 95%CI: 2.190 to 2.934, P < 0.00001). The association between ALT/AST and incident diabetes is only linear. The cumulative incidence (95% CI) rate of incident diabetes in total participants, ALT/AST quartile 1, 2, 3, and 4 was 2.112 (2.016–2.208), 0.992 (.0.857–1.127), 1.430 (1.274–1.586), 2.396 (2.192-2.600) and 3.559 (3.314–3.803), separately. The population with age (30 to < 40 years), BMI (< 24 kg/m2) and SBP (< 140 mmHg) was found to be the stronger association in subgroup analysis. Conclusion In Chinese adults, ALT/AST ratio is an independent risk factor for incident diabetes.