Table of Content

20 February 2025, Volume 6 Issue 1

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Original Articles

Analysis of all-night evaluation indexes and predictors of cardiovascular risk in patients with obstructive sleep apnea-hypopnea syndrome

Zeng Wenmei, Wu Sulong, Liu Zhuofan, Yuan Long, Chen Bilin, Rong Yan

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  1-7.  doi:10.19983/j.issn.2096-8493.2024132

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Objective: To explore overnight assessment indicators and cardiovascular disease risk predicators of obstructive sleep apnea using portable sleep monitoring. Methods: A retrospective, clinical case analysis was used to screen 192 outpatients and inpatients from May 2019 to July 2020. Physical measurements, blood pressure, past medical history, and biochemical indicators of the patients were recorded. Data of AHI, lowest oxygen saturation, average oxygen saturation, longest apnea duration, longest hypopnea duration, the ratio of overnight oxygen saturation below 90%, the ratio of total apnea time to sleep time, the ratio of total hypopnea time to sleep time and Epworth sleepiness scale were collected for analysis. According to the criteria, 152 patients were included for ASCVD risk analysis with China-PAR model, PM indexes that influence ASCVD risk were analyzed. Results: One hundred and seventy-nine patients diagnosed with obstructive sleep apnea-hypopnea syndrome. Among PM monitoring indexes, lowest oxygen saturation (OR=0.84, P=0.002) and longest apnea duration (OR=0.96, P=0.017) were negative corrected to AHI, total apnea time to sleep time ratio (OR=1.89, P<0.001), total hypopnea time to sleep time ratio (OR=2.23, P<0.001) were positive corrected to AHI, the others indexes were not statistically corrected to AHI. Statistically significant differences of T90% were found in severe AHI group and the other groups (severe AHI group vs. normal/mild/moderate AHI group:18.8±16.4 vs. 0.1±0.5/1.7±5.8/2.9±3.8, F=35.40, P<0.001). T90% and the ratio of total apnea time to sleep time were associated with 10-year ASCVD risk in obstructive sleep apnea-hypopnea syndrome patients (T90%: OR=1.15, P=0.001; total apnea time to sleep time: OR=1.09, P=0.013). Conclusion: The ratio of overnight oxygen saturation below 90% and total apnea time to test time ratio can be suggested as all-night evaluation indexes and indicator factors for ASCVD risk of obstructive sleep apnea-hypopnea syndrome patients.

Analysis on the reporting and case finding delay characteristics of pulmonary tuberculosis patients in Liangping District, Chongqing from 2018 to 2023

Liao Ying, Pang Yan, Zhao Jing, He Gaoqin, You Maolin, Wang Lei

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  8-13.  doi:10.19983/j.issn.2096-8493.2024137

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Objective: To analyze the reporting and case finding delay characteristics of pulmonary tuberculosis patients in Liangping District of Chongqing from 2018 to 2023, and to provide reference for optimizing the prevention and control strategy of pulmonary tuberculosis. Methods: The report data of tuberculosis in Liangping District of Chongqing from 2018 to 2023 were collected from the “Infectious Disease Surveillance System” subsystem of “China Disease Prevention and Control Information System”, and the management data of tuberculosis patients were collected from the subsystem “Tuberculosis Management information System”. Annual percentage change (APC), average annual percentage change (AAPC), monthly percentage change (MPC) and average monthly percentage change (AMPC) were used to analyze the trend of reporting incidence and delay of pulmonary tuberculosis. Results: From 2018 to 2023, the annual reporting incidence of pulmonary tuberculosis in Liangping District of Chongqing decreased from 44.85/100000 (293/653300) to 35.62/100000 (229/642912) and the monthly reporting incidence decreased from 6.43/100000 (42/653300) to 2.64/100000 (17/642917), with a general downward trend (AAPC=-6.005%, 95%CI: -9.877%--2.778%, P<0.001; MPC=AMPC=-0.595%, 95%CI: -0.941%--0.287%, P<0.001). The proportion of passive case finding on pulmonary tuberculosis was 98.10% (1499/1528). The case finding delay rate was 64.54% (404/625), and the delay days (M(Q₁,Q₃)) were 123 (12, 103) days. The diagnosis delay rate was 53.12% (332/625), and the delay days were 49 (9, 52) days. The rate of patient delay was 63.09% (964/1528), and the delay days were 30 (15, 82) days. Only the rate of patient delay fluctuated and decreased in each year (APC=AAPC=-12.918%, 95%CI: -22.311%--5.862%, P<0.001). The rate of patient delay in rural patients (64.96% (658/1013)) was higher than that in urban patients (59.57% (305/512))(χ²=4.238, P=0.040), and rate of patient delay in both showed a decreasing trend (AAPC=-11.447%, 95%CI:-20.166%--5.197%, P<0.001; AAPC=-15.442%, 95%CI: -25.038%--7.358%, P<0.001). Conclusion: The reporting incidence of pulmonary tuberculosis in Liangping District was a fluctuating downward trend. However, the passive case finding of pulmonary tuberculosis patients was the main part, resulting in a higher case finding delay rate and a longer delay time, especially rate of patient delay of township patients was significantly higher than that of urban patients.

Characterisation of isoniazid-resistant Mycobacterium tuberculosis mutations in China

Xu Yannan, Fang Zihao, Zhao Wenli, Zheng Jiaxiong, Liu Suyang, Lin Jianxiong, Ji Liwei, Chang Qiaocheng

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  14-21.  doi:10.19983/j.issn.2096-8493.2024118

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Objective: To summarize the mutation characteristics of isoniazid (INH)-resistant strains in terms of drug-resistant gene types, mutation sites and geographical differences, to provide a theoretical basis for the molecular diagnosis of anti-tuberculosis, clinical use of medicines, and the discovery of new drug-resistant genes. Methods: We searched for mutations in INH-resistant genes of Mycobacterium tuberculosis (M.tuberculosis) in China in China Knowledge Network (CNN), Weipu, and Wanfang database with the search terms of “isoniazid resistance” AND “mutation” AND “tuberculosis”, and searched for literature in English with the search terms of “Isoniazid OR INH” AND “mutation” AND “Mycobacterium tuberculosis” AND “China” in PubMed. 145 articles were initially identified, 22 articles were included, 12923 strains were included in the analysis, and 2824 INH-resistant strains were obtained. Taking year 2019 as a time point, the domestic information on INH drug-resistant gene mutations was divided into two parts for studying, then information on drug-resistant gene types, mutation sites, and geographic differences of drug-resistant strains was analyzed in detail. Results: Mutations in INH resistance genes were detected in 96.18% (2716/2824) of strains. The common mutated genes were katG (locus 315), accounting for 74.49% (1965/2638), for which AGC→ACC mutations were predominantly found, accounting for 52.26% (1027/1965). Mutations at locus -15 of the inhA gene were most frequent, accounting for 13.72% (362/2638) with C→T predominating at 89.23% (323/362). fabG1 mutation accounted for 1.97% (52/2638), and the most frequent combined mutation was katG+inhA, accounting for 2.20% (58/2638). Conclusion: Among drug-resistant genes of INH-resistant M.tuberculosis in China, mutations in katG, inhA, and fabG1 gene occured frequently. Mutation loci were dominated by katG315 and inhA15, the most frequent combined mutation was katG+inhA.

Evaluation on effect of health promotion for tuberculosis prevention and control in Tianjin City from 2010 to 2020

Wan Ying, Pang Xuewen, Zhang Fan

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  22-29.  doi:10.19983/j.issn.2096-8493.2024136

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Objective: To analyze the implementation of health promotion on tuberculosis (TB) prevention and control in Tianjin City from 2010 to 2020,evaluate its effect and develop suggestions according to new situation and new needs. Methods: Retrospective research methods and descriptive epidemiological methods were applied to analyze and summarize data of health promotion on TB prevention and control in Tianjin City from 2010 to 2020. Chi-square test was used to compare the awareness rate of key messages of TB prevention and control in 2010,2015 and 2020. Results: The overall awareness rates and all awareness rates of 5 key messages had been improved respectively from 62.2% (14281/22955) and 8.8% (406/4591) in 2010 to 76.4% (14952/19560) and 33.8% (1321/3912) in 2015,and then to 85.2% (5856/6870) and 42.2% (580/1374) in 2020.These differences were statistically significant (χ²=1820.569,P<0.001;χ²=1049.946,P<0.001). The overall awareness rates of participants aged 60-69 in 2010 (65.8%, 1457/2215) and people aged 20-29 in 2015 (81.5%, 2053/2520) were higher than other age groups of that year,and these differences were statistically significant (χ²=34.628,P<0.001;χ²=115.925,P<0.001). The difference among all age groups in 2020 was not statistically significant (χ²=9.993,P>0.05). The overall awareness rate of junior high school and equivalent education level (64.0%, 6181/9655) was higher than other groups in 2010. In 2015 and 2020, overall awareness rates increased with level of education. These differences were statistically significant (χ²=71.476, P<0.001;χ²=108.473, P<0.001;χ²=20.781, P<0.001). The overall awareness rate of agriculture workers was the highest in 2010 (65.1%, 3276/5035),and rates of government employee were the highest in 2015 and 2020 (79.8% (1615/2025) and 88.6% (359/405)). These differences were statistically significant (χ²=50.395,P<0.001;χ²=60.004,P<0.001;χ²=18.816,P<0.001). Comparing 2015 and 2020,“radio/television/film/internet/audiovisual materials”(76.2% (2979/3912) and 86.9% (1194/1374)) remained as most popular way for public to acquire health knowledge. The selection of “doctor promotion” had significantly decreased from 38.3% (1497/3912) to 19.1% (262/1374),“promotion by community/village committees”“other ways (including public transportation or outdoor new media promotion, listening to health lectures)”had respectively increased from 8.3% (323/3912) and 0.4% (17/3912) to 18.2% (250/1374) and 18.6% (255/1374). Conclusion: In the past 10 years, health promotion of TB prevention and control in Tianjin City had achieved remarkable results. In the future,it is necessary to advance with the times and further strengthen health promotion of TB prevention and control,to accelerate “ending TB epidemic”.

Analysis of the epidemiological characteristics of reported pulmonary tuberculosis in Xinjiang Production and Construction Corps, 2014—2023

Zhao Yongnian, Zhang Lijie, Wang Tongmin

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  30-34.  doi:10.19983/j.issn.2096-8493.2024165

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Objective: To analyze the epidemiological characteristics of reported pulmonary tuberculosis cases in Xinjiang Production and Construction Corps (hereinafter referred to as “Corps”) from 2014 to 2023, and to provide strategies for tuberculosis prevention and control in the Corps. Methods: 15697 laboratory confirmed and clinically diagnosed pulmonary tuberculosis cases with the onset date from January 1, 2014 to December 31, 2023 and the current address of the Corps were collected through the “Infectious Disease Reporting Information System”, a subsystem of the “China Disease Prevention and Control Information System”. The average reported incidence rate, the disstributation characteristics of gender, age, occupation and other epidemiological characteristics of pulmonary tuberculosis patients reported by 14 divisions of the Corps in the past 10 years were described. Results: From 2014 to 2023, a total of 15697 pulmonary tuberculosis were reported, with an average reported incidence rate of 51.70/100000 (15697/30361702), showing a downward trend ($\chi_{\text {ternd }}^{2}$=537.579, P<0.001). A total of 69 deaths had been reported, with an average reported mortality rate of 0.23/100000 (69/30361702). The top three cities with the highest average reported incidence rate were the Third Division (99.55/100000, 2463/2474134), the First Division (62.33/100000, 2314/3712694), and the Second Division (57.61/100000, 1256/2180238), all in southern Xinjiang. The reported incidence rate of pulmonary tuberculosis in southern Xinjiang was 70.12/100000 (6314/9004563), higher than that in northern Xinjiang (43.93/100000, 9383/21357139), with a statistically significant difference (χ ²=840.541, P<0.001). The average reported incidence rate of male and female was 62.18/100000 (9847/15836472) and 40.27/100000 (5850/14525230), respectively, with a significant difference (χ²=703.487, P<0.001). The male-to-female ratio of reported tuberculosis cases was 1.54∶1. The incidence rate increased with age, and the age group over 60 years old (164.27/100000,6680/4066595) increased significantly. The reported tuberculosis were mainly in retired personnel (29.80%, 4677/15697) and farmers (27.74%, 4355/15697). Conclusion: From 2014 to 2023, the reported incidence of pulmonary tuberculosis in Xinjiang Production and Construction Corps showed a downward trend, and the division cities in southern Xinjiang were higher than those in northern Xinjiang. It is necessary to strengthen the monitoring, prevention and treatment of specific populations, such as the elderly, retired people, and farmers.

Cost-effectiveness analysis of active tuberculosis screening among high-risk populations in Longyan City, Fujian Province

Zheng Jianli, Wu Yumei, Zhang Shili, Du Zixian, Li Turong, Chen Shisheng, Lin Wenge

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  35-39.  doi:10.19983/j.issn.2096-8493.2024163

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Objective: To evaluate the cost-effectiveness of tuberculosis screening among high-risk populations in Longyan City, Fujian Province, and to explore the feasibility of implementing active tuberculosis screening within community settings. Methods: A retrospective investigation was conducted to collect screening data from high-risk populations for tuberculosis (HIV/AIDS patients, individuals aged 65 years and older, diabetic patients, and close contacts of patients with etiologically confirmed pulmonary tuberculosis, hereafter referred to as “close contacts”) in Longyan City between 2019 and 2023. A cost-effectiveness analysis was subsequently performed. For HIV/AIDS patients, both chest radiographs and sputum smear examinations were conducted irrespective of the presence of suspicious symptoms of pulmonary tuberculosis. In contrast, for individuals aged 65 and older, diabetic patients, and close contacts, initial screening was performed to identify suspicious symptoms, followed by chest radiographs and sputum smear examinations for those with positive findings. Results: Between 2019 and 2023, active screening was conducted for 4412 HIV/AIDS patients, 20142 individuals aged 65 and older, 6031 diabetic patients, and 3083 close contacts. The screening rates were 98.68% (4412/4471), 1.23% (20142/1632144), 1.67% (6031/362143), and 50.31% (3083/6128), respectively. A total of 21, 139, 67, and 30 tuberculosis cases were identified in these groups, respectively. The additional cost per tuberculosis case detected was 13446 yuan, 9274 yuan, 5239 yuan, and 6577 yuan, respectively. Conclusion: Supported by adequate funding and policies, the simultaneous use of chest radiographs and symptom screening demonstrates high effectiveness in tuberculosis screening among key populations.

Epidemiologic characteristics of pulmonary tuberculosis in Zhuxi County, Shiyan City (2014-2023)

Yang Yan, Dong Wen, Chen Jianjun, Zhang Yu

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  40-45.  doi:10.19983/j.issn.2096-8493.2024155

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Objective: To examine the epidemiological trends and characteristics of pulmonary tuberculosis (PTB) in Zhuxi County, Shiyan City, over a ten-year period (2014-2023) and to provide scientific evidence to guide PTB prevention and control efforts. Methods: Data on PTB cases registered in Zhuxi County from 2014 to 2023 were retrieved from the “Tuberculosis Information Management System,” a component of the “Chinese Disease Prevention and Control Information System.” Collected variables included demographic characteristics, case detection methods, and etiological findings. Descriptive epidemiological methods were used to analyze the data. Results: From 2014 to 2023, a total of 2210 PTB cases were registered in Zhuxi County, comprising 1147 pathogen-positive cases (51.90%) and 1063 pathogen-negative cases (48.10%). The average annual registration rate was 72.42/100000, demonstrating a significant overall decline over the study period ($\chi_{\text {ternd }}^{2}$ end=6.104, P<0.01), with an average annual reduction rate of 2.25%. The majority of cases (97.56%, 2156/2210) were identified through symptomatic presentations and subsequent medical consultations. Seasonal variations were observed, with December recording the highest number of registrations (11.00%, 243/2210) and January the lowest (5.38%, 119/2210). The highest annual registration rate for tuberculosis was observed in Yingying Town, with 92.82/100000 (106 cases in total). Among the registered patients, the male-to-female ratio was 3.34∶1 (1701/509). The average annual registration rate for males was 108.54/100000, significantly higher than that for females at 34.36/100000 (χ²=575.217, P<0.01). Age distribution analysis revealed that individuals aged 0-14 years accounted for 1.26% (28/2210) of the cases, those aged 15-64 years constituted 81.48% (1801/2210), and individuals aged 65 years and older comprised 17.24% (381/2210). Occupationally, the majority of patients were farmers (85.66%, 1893/2210), followed by students (4.75%, 105/2210). Conclusion: The prevention and control of PTB in Zhuxi County remain a significant public health challenge. Tailored, comprehensive measures should be implemented based on local epidemiological conditions to enhance tuberculosis prevention and management, particularly in high-burden areas and among at-risk populations.

The epidemic characteristics and the trends of pulmonary tuberculosis in elderly and non-elderly in central urban area, Tianjin from 2006 to 2020

Qi Wei, Zhao Enyi

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  46-54.  doi:10.19983/j.issn.2096-8493.2024130

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Objective: To understand the epidemiological characteristics and the trends of pulmonary tuberculosis (PTB) among the elderly and non-elderly in the central urban area, Tianjin, and to provide reference for formulating relative policies. Methods: The case information of the TB patients managed and registered for the first time in the central urban area of Tianjin from January 1, 2006 to December 31, 2020 were collected from China Information System for Disease Control and Prevention, including the general demographic information, patient origin, the classification of treatment, the results of etiologic and drug sensitivity test, etc. The patients were divided into the elderly TB patients (≥60 years old) and non-elderly PTB patients (<60 years old), and the characteristics of PTB patients in the two groups were compared and analyzed. The Joinpoint regression model was used to analyze the temporal trend of the annual registration rate of PTB patients. Results: A total of 20950 cases of PTB were registered in the central urban area of Tianjin from 2006 to 2020, among whom 6217 cases (29.68%) were elderly patients. Compared with non-elderly patients, the proportion of male (OR=1.16, 95%CI: 1.09-1.24), Han nationality (OR=2.83, 95%CI: 2.03-3.95), local household registration (OR=6.28, 95%CI: 4.99-7.91), retreatment patients (OR=2.34, 95%CI: 2.18-2.52) and those with comorbid diabetes (OR=1.17, 95%CI: 1.04-1.32) were relatively higher among elderly patients with PTB. The Joinpoint regression model showed that the annual registration rate of PTB in the elderly decreased significantly decreased from 2006 to 2020 (APC=―4.693%, 95%CI: ―7.359%-―1.951%, P=0.003). The annual registration rate of non-elderly pulmonary TB showed an overall declining trend from 2006—2020 (AAPC=―4.767%, 95%CI: ―6.762%-―2.729%, P<0.001). Conclusion: Compared with non-elderly people, the elderly population had a higher PTB registration rate. The disease burden of PTB is heavier among the elderly, men, retreatment patients and patients with diabetes. With increasing aging in Tianjin more attention should be paid to the prevention and treatment of PTB in the elderly in order to achieve the goal of ending the epidemic of tuberculosis in Tianjin.

The value of ultrasound-guided microwave ablation in the treatment of localized tuberculous lesions

Yan Qinghu, Xue Feng, Yu Yong, Qin Yi, Yan Qingmei, Cui Jia

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  55-60.  doi:10.19983/j.issn.2096-8493.2024145

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Objective: This study aims to evaluate the clinical efficacy and potential applications of ultrasound-guided microwave ablation as an adjunct to conventional anti-tuberculosis pharmacotherapy in the management of localized tuberculous lesions. Methods: A retrospective analysis was conducted on 12 patients with localized tuberculous lesions who underwent ultrasound-guided microwave ablation at the Shandong Public Health Clinical Center and the Shandong First Medical University Affiliated Provincial Hospital between March 2020 and January 2023. The cohort included 6 cases of lymph node tuberculosis, 4 cases of chest wall tuberculosis, and 2 cases of liver tuberculosis. Contrast-enhanced ultrasound (CEUS) was performed post-ablation for all patients to evaluate treatment efficacy. Follow-up assessments were carried out at 3, 6, 9, 12, and 24 months post-ablation to measure the ablation lesion volume and calculate its reduction rate. Data were expressed as median (interquartile range, M(P₂₅, P₇₅)) and analyzed using the Z-test to assess the effectiveness of the ablation procedure. Results: Contrast-enhanced ultrasound confirmed complete ablation in all 15 localized tuberculous lesions across 12 patients immediately after the procedure. During follow-up at 3, 6, 9, 12, and 24 months post-ablation, the median lesion volumes were recorded as 2.82 (1.62,5.85) cm³, 1.95 (1.54,4.59) cm³, 1.62 (0.15,4.02)cm³, 1.52 (0.00,3.98)cm³, 0.00 (0.00,1.64)cm³, respectively. Correspondingly, the shrinkage rates of the ablation lesions were 51 (36,59)%, 62 (52,72)%, 69 (58,97)%, 71 (62,100)%, 100 (72,100)%. By the end of the follow-up period, 8 ablation lesions had completely resolved. The reduction rate of ablation lesions at 24 months post-surgery was significantly higher compared to those at 3, 6, 9, and 12 months, with corresponding χ² values of -3.41, -3.18, -3.06, and -2.52 (P=0.001, 0.001, 0.002, and 0.012, respectively). No complications, such as peripheral organ damage, needle track implantation, or tuberculosis dissemination, were observed during or after the procedure. Furthermore, no active disease progression or recurrence was detected throughout the follow-up period. Conclusion: Ultrasound-guided microwave ablation demonstrates significant efficacy and safety in the treatment of localized tuberculous lesions, highlighting its potential as a valuable minimally invasive therapeutic option deserving broader clinical application.

The value of QuantiFERON-TB Gold Plus in the clinical diagnosis of active pulmonary tuberculosis

Chen Jing, Qin Yali, Wang Mingdong, Yang Rubin, Wang Qian, Peng Yanqing, Qiu Jiyao, Zhang Xiao, Zhou Xinai

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  61-67.  doi:10.19983/j.issn.2096-8493.2024153

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Objective: To evaluate the efficacy of QuantiFERON-TB Gold Plus (QFT-Plus) for the detection of active tuberculosis. Methods: A total of 1360 patients who were hospitalized and underwent QFT-Plus test in Guiyang Public Health Clinical Centre from January 2023 to January 2024 were retrospectively collected. After excluding 36 uncertain patients, 985 patients were in the tuberculosis group and 339 patients were in the non-tuberculosis group. The basic information, clinical manifestations, laboratory test results and imaging examination data of the patients were collected. Sputum smear antacid bacilli, sputum culture, GeneXpert MTB/RIF test for carrier bacilli were graded in the TB group and analyzed in relation to the QFT-Plus test results; sputum smear antacid bacilli and sputum culture results were divided into a positive group and a negative group, and classified into 3 grades of mild, moderate, and severe tuberculosis according to the grading criteria of the degree of severity, and the IFN-γ in the tube of the antigens of TB1, TB2, TB2-TB1 was analysed in comparison. Results: Out of 1324 patients, 985 were in the tuberculosis group and 339 were in the non-tuberculosis group, the sensitivity of QFT-Plus for detecting active tuberculosis was 94.11% (927/985), specificity was 51.62% (175/339), positive predictive value was 84.97% (927/1091) and negative predictive value was 75.11% (175/233), the coincidence rate was 83.23% (1102/1324). The IFN-γ levels in TB1 tube, TB2 tube and TB2-TB1 in the tuberculosis group were 5.11 (2.00, 9.90) IU/ml, 6.24 (2.54, 10.00) IU/ml, and (0.66±1.58) IU/ml, which were higher than those in the non-tuberculosis group (0.38 (0.07, 3.37) IU/ml, 0.41 (0.08 4.12) IU/ml, (0.27±1.16) IU/ml), and the differences were statistically significant (Z=-14.970,P<0.001;Z=15.230,P<0.001;t=-4.910,P<0.001). The IFN-γ levels of TB2 and TB2-TB1 in the sputum smear antacids-positive group were 6.81 (3.27, 10.00) IU/ml and (0.85±1.80) IU/ml, which were higher than those in the negative group (5.61 (2.21, 10.00) IU/ml and (0.53±1.41) IU/ml), and the difference was statistically significant (Z=-3.060, P<0.001; t=-2.920, P<0.001). The IFN-γ levels of TB1 and TB2 in the positive group of sputum culture were 5.37 (2.46, 10.00) IU/ml and 7.08 (3.86, 10.00) IU/ml, which were higher than those of the negative group (4.44 (1.56, 9.41) IU/ml and 5.04 (1.90, 10.00) IU/ml), and the difference was statistically significant (Z=-3.450, -4.920, P<0.001). Comparison of IFN-γ levels in tuberculosis antigen tubes of different severity showed 5.12 (2.57,10.00) IU/ml, 6.04 (3.20,10.00) IU/ml, (0.49±1.16) IU/ml in TB1, TB2, TB2-TB1 and 5.33 (2.06,10.00) IU/ml, 6.45 (2.54,10.00) IU/ml, (0.62±1.46) IU/ml in the severe tuberculosis group and 4.27 (1.82,9.43) IU/ml, 5.97 (2.37,10.00) IU/ml, (0.79±1.85) IU/ml in the moderate tuberculosis group, the difference was not statistically significant (Z=4.040,P=0.133; Z=0.910, P=0.634; t=2.400, P=0.091). Conclusion: QFT-Plus test has good clinical value in the auxiliary diagnosis of active tuberculosis.

Evaluation of the application value of three detection methods for Mycobacterium tuberculosis in a comprehensive hospital

Gu Jinhua, Zhang Panpan

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  68-72.  doi:10.19983/j.issn.2096-8493.2024142

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Objective: This study aimed to compare the diagnostic performance of three sputum-based Mycobacterium tuberculosis detection methods:traditional acid-fast staining, the BACTEC MGIT 960 rapid liquid culture system, and Xpert MTB/RIF, as well as their combined application in diagnosing pulmonary tuberculosis in comprehensive hospitals. Methods: The study included clinical data of 652 pulmonary tuberculosis patients and 166 non-tuberculosis patients treated at Kunshan First People’s Hospital between January 2021 and June 2023. Data included sputum specimen testing results (acid-fast staining, rapid culture, and GeneXpert MTB/RIF) and clinical diagnostic information. Results: Acid-fast staining showed a sensitivity of 28.8% (188/652), specificity of 98.8% (164/166), positive predictive value (PPV) of 98.9% (188/190), negative predictive value (NPV) of 26.1% (164/628), and a Kappa value of 0.136 (95%CI: 0.109-0.163). BACTEC MGIT 960 rapid culture showed a sensitivity of 39.3% (256/652), specificity of 98.2% (163/166), PPV of 98.8% (256/259), NPV of 29.2% (163/559), and a Kappa value of 0.199 (95%CI: 0.164-0.234). GeneXpert MTB/RIF showed a sensitivity of 44.5% (290/652), specificity of 99.4% (165/166), PPV of 99.7% (290/291), NPV of 31.3% (165/527), and a Kappa value of 0.242 (95%CI: 0.204-0.281). Combination of the 3 methods achieved a sensitivity of 53.8% (351/652), specificity of 97.6% (162/166), PPV of 98.9% (351/355), NPV of 35.0% (162/463), and a Kappa value of 0.309 (95%CI: 0.263-0.354). Conclusion: Compared to individual detection methods, the integrated approach combining three testing methods can improve efficacy and accuracy of pulmonary tuberculosis diagnosis, providing important guidance for tuberculosis detection in comprehensive hospitals.

The value of digital health education in the preventive management of caregivers of patients with bacterial positive pulmonary tuberculosis

Yan Wenhua, Chen Wenjun

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  73-78.  doi:10.19983/j.issn.2096-8493.2024143

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Objective: To explore the application of digital health education in the preventive management of caregivers of bacterial positive pulmonary tuberculosis patients. Methods: According to the inclusion criteria, 200 caregivers of patienrs with bacterial positive pulmonary tuberculosis patients who were admitted to the Affiliated Pulmonary Hospital of Shanxi Medical University from May 1, 2022 to May 31, 2024 were enrolled. The enrolled caregivers were divided into a control group (using conventional health education management methods) and an observation group (using a knowledge-attitude-behavior health education model based on digital intelligence) baded on the random number table method, with 100 caregivers in each group. A questionnaire on the level of knowledge, attitude and behavior of health education was used to evaluate the scores of core information knowledge, positive attitude and preventive behavior of the caregivers of the two groups before and 3 months after the intervention. The satisfaction of the two groups on the care of the intervention and the rate of the first-time on-time follow-up of the patients were compared. Results: After intervention, the scores of awareness on tuberculosis prevention and treatment information, positive attitude, and behavior of the caregivers in the observation group ((86.47±11.38), (78.66±12.55), and (62.82±5.33) points, respectively) were higher than those of the control group ((69.16±9.45), (64.36±11.02), and (48.35±4.84) points, respectively), and the differences were statistically significant (t=4.722, P=0.040; t=4.763, P=0.000; t=3.841, P=0.012). The overall satisfaction rate of observation group with nursing interventions (95.0% (95/100)) was significantly higher than that in the control group (80.0% (80/100)), and the difference was statistically significant (χ²=4.997, P=0.024). The first-time on-time follow-up rate of the patients in the observation group (86.0% (86/100)) was significantly higher than that of the control group (73.0% (73/100)), and the difference was statistically significant (χ²=4.889, P=0.027). Conclusion: The preventive management interventions of digital intelligence based knowledge-attitude-behavior health education can improve the awarness rate of pulmonary tuberculosis related knowledge of the caregivers of patients with bacterial positive pulmonary tuberculosis patients, change the caregivers’s attitude in the prevention and treatment of tuberculosis, and promote their health behaviors, and the intervention effect is significant.

Preliminary study on the predicting of the popularity of papers in the core journals of respiratory disease and tuberculosis in China based on neural network

Guo Meng, Zhu Yuhui, Fan Yongde, Li Jingwen

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  79-86.  doi:10.19983/j.issn.2096-8493.2024011

Abstract ( 61 )   HTML ( 1 )   PDF (1814KB) ( 9 )   Save

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Objective: The neural network, a model based on statistics, is widely used to predict the popularity of microblog and WeChat official account. Based on that, this study aimed to explore the value of neural network in predicting the popularity of academic papers, and to provide a new auxiliary detection method for evaluating the level of academic paper. Methods: The titles, abstracts, keywords and publication days of papers from the domestic core journals of “Respiratory disease and tuberculosis” (Chinese Journal of Antituberculosis, Chinese Journal of Tuberculosis and Respiratory Diseases, Journal of Clinical Pulmonary Medicine, Chinese Journal of Respiratory and Critical Care Medicine, International Journal of Respiration, and Chinese Journal of Lung Diseases (Electronic Edition)) were collected as the input layer of the neural network from 2019 to 2021, and the features was obtained using segmentation tools to segment the input layer, thereby the citation count of the papers was predicted. Results: From 2019 to 2021, a total of 4729 papers were published in the core journals of “Respiratory disease and tuberculosis”, and 1690, 1534 and 1505 papers were published in each year from 2019 to 2021. According to the classification of citation frequency, from 2019 to 2021, the number of highly cited papers (30 to 250 times), moderately cited papers (4 to 29 times), low cited papers (1 to 3 times), and zero cited papers in the core journals of “Respiratory disease and tuberculosis” were 46, 1362, 1872, and 1449, respectively, accounting for 0.97%, 28.80%, 39.59%, and 30.64%. Using neural networks, the accuracy, precision, and recall of predicting article citation rates had reached 99.68%, 99.63%, and 99.65%, respectively. Conclusion: As a method of artificial intelligence technology, neural networks could be gradually introduced into the academic field to provide an auxiliary detection method for objectively and fairly evaluating the level of manuscripts, in order to compensate for the limitations of initial and external review by editors.

Review Articles

Research progress in the treatment of tuberculous tracheobronchial stenosis

Zhang Ying, Guo Chunhui

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  87-93.  doi:10.19983/j.issn.2096-8493.2024125

Abstract ( 73 )   HTML ( 10 )   PDF (909KB) ( 15 )   Save

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Tracheobronchial stenosis caused by tracheobronchial tuberculosis (TBTB) has been paid more and more attention to by clinicians. It endangers the health and quality of life of patients, and can lead to respiratory failure and even death in severe cases. The effect of anti-tuberculosis drugs alone is not satisfactory. The authors review the latest research progress and treatment strategies of tuberculous tracheobronchial stenosis, including interventional therapy (cryotherapy, thermal ablation, balloon dilatation, airway stent implantation, rigid bronchoscopy, microdebrider bronchoscopy), local radiotherapy, local drug treatment, biological reagents,gene therapy and surgical treatment,based on combining with anti-tuberculosis drug treatment, in order to find more efficient treatment methods and provide reference basis for improving quality of life of patients.

Advances in PD1/PD-L1 inhibitors in tuberculosis research

Yang Shuqi, Li Feng

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  94-101.  doi:10.19983/j.issn.2096-8493.2024141

Abstract ( 58 )   HTML ( 5 )   PDF (1194KB) ( 29 )   Save

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Tuberculosis remains one of the most threatening infectious diseases worldwide. In latent Mycobacterium tuberculosis infection, it can remain dormant for long period of time, waiting to be reactivated when the host’s immune function declines. The immune response to Mycobacterium tuberculosis relies on adaptive immunity, particularly T lymphocytes. Among them, CD4⁺ T lymphocytes activate macrophages by releasing interferon-γ, while CD8⁺ T lymphocytes directly kill infected host cells. Long-term chronic infection often leads to T-lymphocyte exhaustion and the immune system is unable to effectively clear pathogens. Programmed death 1(PD-1) and programmed cell death-ligand 1(PD-L1) inhibitors, as immune checkpoint inhibitors, have demonstrated a strong potential for restoring immune response and killing tumor cells, and have been widely used in cancer therapy. However, its functional mechanisms and therapeutic prospect in tuberculosis still need further research. In order to better promote the application of PD-1 and PD-L1 inhibitors in the field of infectious diseases, we reviewed characteristics of T-lymphocyte adaptive immunity in tuberculosis, functions of the PD-1/PD-L1 signaling pathway and their roles in tuberculosis, and summarized and discussed the latest research advances in blocking the PD-1/PD-L1 pathway in tuberculosis treatment, aiming to provide a reference for the application of immune checkpoint inhibitors in infectious diseases.

The research progress on the role of metal ions in tuberculosis

Chen Yu, Li Xiaorui, Wang Miaoran, Zhang Yuqi, Liu Chang, Wang Zhaohua, Shi Jie, Fan Lichao, Yin Zhihua, Xie Jianping

Journal of Tuberculosis and Lung Disease. 2025, 6(1):  102-112.  doi:10.19983/j.issn.2096-8493.20250006

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Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) infection, remains a major global public health challenge. Transition metals can stabilize substrates or reaction intermediates at the active sites of enzymes and are extensively involved in enzymatic catalytic processes. Both bacteria and host cells must precisely regulate the levels of these metal elements to meet physiological needs while avoiding potential toxicity. In recent years, increasing studies have uncovered new mechanisms of microbial direct metal poisoning, which are considered critical components of the host immune system to restrict pathogen survival. Host cells can regulate intracellular concentrations of metal ions, such as zinc, copper, and iron, as an innate immune mechanism to inhibit the growth of intracellular pathogens.In response to these challenges, MTB possesses complex metal detoxification systems. Through metal pumps, chelator, and antioxidant enzymes, MTB can maintain metal homeostasis under host-imposed metal stress and evade immune attacks. These detoxification mechanisms are essential for the pathogen’s survival and persistent infection. This study systematically explores the reprogramming of metal ion metabolism in host cells during MTB infection, providing an in-depth analysis of host cell regulation of various metal ions and their roles in antimicrobial defense. It reveals the dynamic changes in metal ion metabolism and its significance in infection defense. Understanding these metabolic processes aids in elucidating the pathogenesis of tuberculosis, offers new insights into its prevention and treatment, and provides a theoretical foundation for the development of novel anti-tuberculosis therapeutic strategies.