Table of Content

30 March 2014, Volume 3 Issue 1

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Expert Forum

The treatment of pulmonary fungal infection: a big problem around the world

WU Hong, ZHANG Wei-zhen, CAI Shao-xi

Journal of Tuberculosis and Lung Health. 2014, 3(1):  7-10.  doi:10.3969/j.issn.2095-3755.2014.01.002

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Diagnosis and treatment of pulmonary fungal infection is a big problem around the world. In recent years, along with the development of medical and other factors, the population of fungal infection is increasing. The people of fungal infection of pulmonary are the most. The invasive pulmonary fungal infection remains to Aspergillus and Candida infection. It’s not only the difficult clinical diagnosis but also the low efficacy in the clinical practice for pulmonary fungal infection. The diagnosis and treatment of pulmonary fungal infection was reviewed in this paper.

Original Articles

Frequency and clinical significance of antigen-specific multifunctional Th1 cells in tuberculosis patients

LI Mei-zhong,QIU Zhen-gang, ZHANG Ming-xia,YANG Hui, ZHANG Jie-yun,CHEN Xin-chun

Journal of Tuberculosis and Lung Health. 2014, 3(1):  11-14.  doi:10.3969/j.issn.2095-3755.2014.01.003

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Objective To study the frequency and clinical significance of antigen-specific multifunctional Th1 cells in the peripheral blood and pleural effusion of tuberculosis (TB) patients.Methods Ninety-three patients with active TB(including 27 patients with tuberculous pleurisy), 30 latent TB infection individuals (LTBI) and 66 healthy controls (HD) were collected in this study. Separate the peripheral blood monouclear cells (PBMCs) from all of the individuals and also the pleural fluid mononuclear cells (PFMCs) from the tuberculous pleurisy patients. The PBMCs and PFMCs were co-cultured with the specific antigen of M. tuberculosis (Mtb), and then detected the frequency of multifunctional CD4⁺ T cells (including of 7 subgroups: IL-2⁺IFN-γ⁺TNF-α⁺,IL-2⁺IFN-γ⁺,IL-2⁺ TNF-α⁺,IFN-γ⁺TNF-α⁺,IL-2⁺,TNF-α⁺,IFN-γ⁺ CD4⁺ T cells) using intracellular cytokine staining and flow cytometric analysis. The results were showed as (x±s) and all data were analyzed by using GraphPad Prism 4.0. The Wilcoxon matched pair t test was used to analyze the antigen-specific multifunctional Th1 cells in the peripheral blood and pleural effusion. The ANOVA was used to analyze the differences of antigen-specific multifunctional Th1 cells in HD,TB and LTBI. Differences were considered significant when the P value was less than 0.05.Results The frequency of antigen-specific multifunctional Th1 cell subsets (IL-2⁺IFN-γ⁺TNF-α⁺CD4⁺T cells) in TB patients was (0.107±0.278)%, which was higher than that in LTBI(0.019±0.032)% and HD(0.008±0.016)%(F=5.675, P=0.004). The frequency of IL-2⁺TNF-α⁺ CD4⁺ T cells was (0.049±0.123)% in TB patients and (0.046±0.050)% in LTBT, those were higher than that in HD (0.003±0.014)% (F=5.435, P=0.005). The frequency of IFN-γ⁺TNF-α⁺ CD4⁺ T cells and IL-2⁺IFN-γ⁺ CD4⁺ T cells in TB patients were (0.136±0.256)% and (0.146±0.347)%, respectively, which were higher than those in HD (0.052±0.082)% and (0.029±0.042)% (F=3.774, P=0.024;F=4.912, P=0.008). The frequency of antigen-specific multifunctional Th1 cells, IL-2⁺TNF-α⁺ CD4⁺ T cells, IFN-γ⁺TNF-α⁺ CD4⁺ T cells, IL-2⁺ CD4⁺ T cells, IFN-γ⁺ CD4⁺ T cells in PFMCs were (0.719±0.996)%, (0.628±1.284)%, (0.704±0.829)%, (0.955±1.538)%, (1.188±1.924%), respectively, which were higher than those in PBMCs (0.033±0.065)%, (0.095±0.174)%, (0.137±0.317)%,(0.285±0.434)%, (0.318±0.598)% (t=3.700, P=0.001;t=2.125, P=0.043;t=3.216, P=0.003;t=2.144, P=0.041;t=2.412, P=0.023).Conclusion Antigen-specific multifunctional Th1 cells were correlative with Mtb infection, and may play a protective immune role in TB.

Analysis on non-tuberculous mycobacteria identification in Guangzhou during 2003—2012

LUO Chun-ming^*, ZOU Gui-min, LIU Guo-biao, HUANG Ye-lun, TAN Shou-yong, TAN Yao-ju, CAI Xing-shan, DAI Shu-ting, LUO Shao-zhen

Journal of Tuberculosis and Lung Health. 2014, 3(1):  15-20.  doi:10.3969/j.issn.2095-3755.2014.01.004

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Objective To investigate the prevalence status of non-tuberculous mycobacteria(NTM) in old town of Guangzhou during the last 10 years.Methods One thousand and fifty-eight samples of NTM confirmed by culture and strain identification from Guangzhou Research Institute for Tuberculosis Prevention and Treatment were analyzed.Results Seven thousand five hundred and forty-one samples were performed mycobacterium culture and identified between Mycobacterium tuberculosis(Mtb) and NTM, in which 20.00% (1508/7541) of samples were NTM and 228 samples were positive twice by culture. Samples which presented over 1 time of culture positive and same strain identification in one patient in a year were analyzed as one sample, 6797 samples were mycobacterium, in which 1120 were NTM. Constituent ratio of NTM rose to 24.22% (232/958) in 2012 from 12.87% (135/1049) in 2003. Seven hundred and sixty-two of 1120 samples were performed strain identification and 22 species were found. The top of 11 species in NTM constituent ration included 43.18% (329/762) of M. chelonae-abscessus complex, 18.24% (139/762) of M. avium-intracellulare complex, 8.53% (65/762) of M. gordonae, 6.96% (53/762) of M. fortuitum, 4.33% (33/762) of M. scrofulaceum, 3.67% (28/762) of M. kansasii, 3.15% (24/762) of M. smegmatis, 2.62% (20/762) of M. nonchromogenicum, 1.57% (12/762) of M. szulgal, 1.57% (12/762) of M. simiae, and 1.57% (2/762) of M. malmoense. 60.23% (459/762) were male and 39.77% (303/762) were female. The age groups of the highest load rate of bacteria for both male and female was 25-<35 years old, 16.99% (78/459) and 20.13% (61/303), respectively. One hundred and eighteen samples were confirmed as NTM containing 11 species, in which included 66.95% (79/118) of M. chelonae-abscessus complex, 16.95% (20/118) of M. avium-intracellulare complex, 4.24% (5/118) of M. fortuitum, 3.39% (4/118) of M. kansasii, 2.54% (3/118) of M. gordonae, 1.69% (2/118) of M. smegmatis, 0.85% (1/118) of M. scrofulaceum, 0.85% (1/118) of M. nonchromogenicum, 0.85% (1/118) of M. simiae, 0.85% (1/118) of M. simiae, and 0.85% (1/118) of M. chelonae- fortuitum.Conclusion Guangzhou is a high-prevalence area of NTM, and M. chelonae-abscessus complex and M. avium-intracellulare complex are main pathogenic bacteria. Patients with NTM are younger and on rise. It is more important for acid-fast bacillus culture and strain identification to make differential diagnosis and treatment.

Detection of peripheral blood Th17 cell subsets and serum IL-17A and IL-23 in the patients with pulmonary tuberculosis

LUO Yong-qiang^*, LIN Dong-zi, ZENG Jin-cheng

Journal of Tuberculosis and Lung Health. 2014, 3(1):  21-24.  doi:10.3969/j.issn.2095-3755.2014.01.005

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Objective To study Th17 cell subsets, serum IL-17A and IL-23 level and analyze their clinical significance in the patients with pulmonary tuberculosis (PTB).Methods Collected 47 PTB cases from Dongguan Hospital for Prophylaxis and Treatment of Chronic Disease in June 2012 to June 2013, of which 19 patients were treated with the conventional anti-TB therapy within 3days, 28 patients were 28-35days. 19 cases were sputum smear-positive, and 28 cases were sputum smear-negative. Twenty-six healthy individuals were selected as control. The frequency of Th17 cell subsets in PBMC was measured by flow cytometry (FCM). Serum IL-17A and IL-23 levels were detected by ELISA. Their correlation was analyzed.Results The frequence of Th17 cell subsets in peripheral blood of PTB patients (3.18±0.15)％ was significantly lower than that in healthy volunteers (HV) ((5.02±0.21)％,t=7.116,P<0.001). The frequence of Th17 cell subsets in PTB patients was significantly increased from (2.90±0.21)％ to (3.60±0.20)％ after drug treatment (t=2.321, P<0.05), and the frequence of Th17 cell subsets in sputum smear-positive PTB patients (2.51±0.20)% was significantly lower than that in sputum smear-negative patients ((3.64±0.21)%,t=4.185,P<0.001). Serum IL-17A levels in PTB patients (71.24±8.03)pg/ml were significantly higher than those on HV groups ((30.46±2.24)pg/ml, t=2.588, P<0.05), but serum IL-23 levels in PTB patients (26.02±1.35)pg/ml were significantly lower than those in HV groups ((35.06±2.66) pg/ml, t=3.511, P<0.05). Serum IL-17A levels in PTB patients were significantly decreased from (77.36±4.29) pg/ml to (65.50±3.35) pg/ml (t=2.678, P<0.05), but serum IL-23 levels in PTB patients were significantly increased from (24.10±1.22) pg/ml to (30.06±2.63) pg/ml (t=2.716, P<0.05). Serum IL-17A levels in sputum smear-positive PTB patients (80.28±4.16) pg/ml were significantly higher than those in sputum smear-negative patients ((65.32±3.37) pg/ml, t=2.678 P<0.05), but serum IL-23 levels in sputum smear-positive PTB patients (23.65±1.21) pg/ml were significantly higher than those in sputum smear-negative patients ((29.75±2.35) pg/ml, t=3.143,P<0.05). There was positive correlation between Th17 cell subsets and serum IL-23 or IL-17A levels in PTB patients (r=0.324, P<0.05; r=0.215, P<0.05), but there was no correlation between serum IL-23 and IL-17A levels in PTB patients (r=0.078, P>0.05).Conclusion Th17 cell subsets, IL-17A and IL-23 may play different role during PTB development.

Imaging manifestations of the severe cases of pneumonia caused by H7N9 subtype human avian influenza virus

ZENG Zheng, LU Pu-xuan, ZHOU Bo-ping, LIU Ying-xia, YUAN Jing, LI Guo-bao, DENG Qun-yi

Journal of Tuberculosis and Lung Health. 2014, 3(1):  25-28.  doi:10.3969/j.issn.2095-3755.2014.01.006

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Objective To explore imaging examination methods for the severe cases with pneumonia caused by H7N9 subtype human cases of avian-origin influenza virus(H7N9 virus) and the imaging features in chest X-ray and CT.Methods A retrospective ana1ysis of the relevant c1inical and imaging materials of 17 cases with pneumonia caused by H7N9 virus,whose diagnosis were confirmed by Centers for Disease Control of Guangdong and Shen-zhen.Results The imaging features of the chest X-ray and CT were: (1)Patchy ground glass opacity and pulmona-ry consolidations were observed in 17 cases and 3 cases showed lung air sac. (2)The ground glass opacity and pulmonary consolidation were mainly observed at lower lobe and dorsal lung (17/17), shown by an extensive involvement of multiple lobes and segments of both 1ungs, the lesions of 17 cases involved in 3 or more lobes, of which 16 cases involved in 4 to 6 lobes.(3) Small amount of pleural effusion were observed frequently(13/17), but much less of enlarged lymph nodes in hilar and mediastinal can be seen(1/17). (4) Rapid spreading and variations of the lesions were common, lesions spread more than 50% lung feild within 48 h in 17 advanced cases. Longer with the recovery time, patchy shadows and fibrous bundles can be seen in all these cases.Conclusion The severe cases with pneumonia caused by H7N9 virus has the clinical imaging features of early ground glass opacity and pulmonary consolidation in lungs and mainly happened at lower lobe and dorsal lung and rapid spreading and absorption of the di-sease focuses with prolongation in time.Imaging examination and diagnosis remain to be the important measures for making clinical diagnosis and treatment options,and eva1uating therapeutic effects.

Study on risk factors of acquired drug resistance of tuberculosis in Guangxi

YANG Ji-jun^*, HUANG Li-hua, ZHOU Li-sha, GENG Wen-kui, DONG Fang, LIN Ding-wen, DONG Wen-yi, DONG Yi-rong

Journal of Tuberculosis and Lung Health. 2014, 3(1):  29-34.  doi:10.3969/j.issn.2095-3755.2014.01.007

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Objective To understand the status of acquired drug-resistant tuberculosis (ADR-TB) and explore main risk factors of ADR-TB, and to provide evidence for the development of prevention and control measures of ADR-TB.Methods The data of 445 adult patients of pulmonary tuberculosis (PTB) (sputum culture positive for Mycobacterium tuberculosis), including 224 cases of drug-resistant TB (the DR group) and 221 cases of non-drug resistant TB (the control group), who sought for medical care in an infectious diseases hospital affiliated to Guangxi from 1 January, 2004 to 30 December, 2007 were collected. Multivariate unconditioned logistic regression analysis was used to analyze the risk factors.Results The rate of mono-resistant TB was 38.84% (87/224), and that of multi-drug resistant tuberculosis (MDR-TB) was 39.29%(88/224), the first three rates of drug resistance were isoniazid 73.21% (164/224), rifampin 56.70% (127/224) and streptomycin 50.89% (114/224). The result of multivariate unconditioned logistic regression analysis showed that risk factors for drug resistance included treatment interruption (OR=39.641, 95%CI=20.366-51.369, P=0.000), retreatment (OR=35.874, 95%CI=21.569-55.786, P=0.000), combined with diabetes (OR=8.964, 95%CI＝5.365-18.971, P=0.009), long course of disease(OR=6.001, 95%CI=3.047-8.635,P=0.012), non-TB control institute as the first institute of treatment (OR=5.003, 95%CI＝3.089-8.114, P=0.007), male (OR=0.321, 95%CI=0.378-0.826, P=0.013), migrant population (OR=2.968, 95%CI=1.677-4.486, P=0.041), living in countryside (OR=2.746, 95%CI=1.024-6.243, P=0.047), low educational level (OR=0.389, 95%CI=0.225-0.978, P=0.000), elder (OR=0.439, 95%CI=0.277-0.834, P=0.000) and smoking (OR=1.758, 95%CI=1.067-3.374,P=0.049).Conclusion We should attach great significance to the aforementioned risk factors of ADR-TB and carry out effective intervention measures to reduce the incidence rate of ADR-TB in the future.

Research status analysis of tuberculosis prevention and control work of village doctors in China

WANG Ji-chun^*,SONG Yu-dan, XING Jin,LAI Yu-ji,ZHAO Fei,FAN Hai-ying,GENG Meng-jie,HE Guang-xue

Journal of Tuberculosis and Lung Health. 2014, 3(1):  35-39.  doi:10.3969/j.issn.2095-3755.2014.01.008

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Objective To understand the research status of TB prevention and control work of village doctors in China.Methods A literature review method was used to search paper with key words of “village doctors”, “tuberculosis” or “rural doctors”,“tuberculosis” from CNKI and PubMed, 448 literatures were retrieved. News, letters, comments, editorials, information science articles were excluded and duplicates or articles unrelated to tuberculosis prevention and control of rural doctors were stripped out. Twenty-four articles were enrolled eventually. We sort those articles from village doctor’s discovery and management of TB patients, the awareness of TB related knowledge of village doctors, incentive policy, and health education.Results Most of the articles used survey methods. An article reviewed how village doctors detect suspicious TB patients. An article used the comparison study to evaluate TB knowledge training effect of village doctors, while an article used community intervention trial. In the included articles, only two from provincial funds supported projects, 13 from the Global Fund and other international cooperation projects.Conclusion Current research reveals that the discovery of suspect TB patients and TB patients management are low for village doctors. We should strengthen the funding input and attention to village doctors. It’s necessary to study the situation of TB infection and TB prevalence of village doctors.

Analysis on drug-resistance of smear-positive tuberculosis patients in Foshan city

YUAN Lei-ling, LI Jia-zheng, ZOU Yuan-hua, WU Zhi-long

Journal of Tuberculosis and Lung Health. 2014, 3(1):  40-45.  doi:10.3969/j.issn.2095-3755.2014.01.009

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Objective To understand the drug-resistance situation among patients with smear-positive pulmonary tuberculosis (PTB) in Foshan city and to provide evidence for policy making of TB control.Methods All smear-positive PTB patients newly registered from February 2008 to February 2013 in the Global Fund multi-drug resistance TB (MDR-TB) project in Foshan City were enrolled in this study. Drug-susceptibility testing (DST) for Mycobacterium tuberculosis complex strains from enrolled patients was performed, and to the 4 first-line anti-TB drugs including Sm, INH, RFP and EMB. SPSS software, version 16.1 was used for statistical analysis. χ² test was used to compare difference in drug-resistance patterns between different groups of patients, and a significance level was P<0.05.Results A total of 1924 smear-positive PTB patients were enrolled in this study, and results of DST were available for 1 375 patients. The total resistance rate of smear-positive PTB patients was 28.80% (396/1375), respectively 20.55% (215/1046) for new smear-positive PTB patients and 55.02% (181/329) for retreatment smear-positive PTB patients. The total MDR-TB rate of smear-positive PTB patients was 11.71% (161/1375), respectively 3.82% (40/1046) for new patients and 36.78% (121/329) for retreatment patients. Mycobacterium tuberculosis strains isolated from the enrolled new patients had the highest rate of any resistance to Sm (15.77%, 165/1046), followed by resistance to INH (9.08%, 95/1046), RFP (5.93%, 62/1046) and EMB (3.35%, 35/1046); Mycobacterium tuberculosis strains isolated from the enrolled retreatment patients had the highest rate of any resistance to INH (45.29%, 149/329), followed by resistance to RFP (40.73%, 134/329), Sm (32.83%, 108/329) and EMB (20.36%, 67/329). The drug-resistance rates of patients in different age groups: 12.50% (2/16) in patients aged 7-17 years, 30.28% (195/644) in patients aged 18-39 years, 28.37% (141/497) in patients aged 40-59 years, 26.61% (58/218) in patients aged 60 years and above; there was no significant difference in the drug-resistant rate among patients of different age groups (χ²=0.03-6.39, P>0.05). The drug-resistance rates of male and female patients were 27.58% (275/997) and 32.01% (121/378) respectively, there was no significant difference in drug-resistance rate between male and female patients (χ²=2.62, P>0.05). The drug-resistance rates of patients from resident and floating population were 29.90% (180/602) and 27.94% (216/773) respectively, there was no statistically significant difference in drug-resistance rate between patients of different population groups (χ²=0.63, P>0.05).Conclusion The drug-resistance of patients with smear-positive PTB is in a serious condition in Foshan City. Studies on methods of TB treatment and management should be strengthened.

Effects of different ways of nursing intervention on bronchial tuberculosis airway stenosis treaded by balloon dilatation with fiberoptic bronchoscopy

WEI Yan-fang, KUANG Hao-bin, MA Zhi-ming, FU Hong-mei, XIE Yi-kai, LIAO Ya-yi, TAN Xiao-yan

Journal of Tuberculosis and Lung Health. 2014, 3(1):  46-50.  doi:10.3969/j.issn.2095-3755.2014.01.010

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Objective To explore the effects of different ways of nursing intervention on bronchial tuberculosis airway stenosis treaded by balloon dilatation with fiberoptic bronchoscopy.Methods Of 107 patients with bronchial tuberculosis airway stenosis were randomly divided into study group (54 patients) and control group (53 patients). On the basis of routine tuberculosis medical care, comprehensive care was given to the patients in study group, including the establishment of the preoperative good relationship between doctor and patient, psychological care delivery, the intraoperative and postoperative condition observation, the nursing care during fiexible bronchofiberscope going through the glottis, the nursing care of postural drainage combined with posture productive cough therapy and guidance after discharge, etc. Routine TB medical care was given to patients of control group. The nursing effect was evaluated by periodic review rate, treatment complement rate and effective rate of treatment after discharge. SPSS 13.0 was used for data analysis. Chi-square test was applied to compare the rates between two groups. P<0.05 was set as the criteria of statistical significance.Results The periodic review rate, the treatment complement rate and the effective rate of treatment were 100.0% (54/54), 98.1%(53/54) and 96.3% (52/54) in the study group, which were significant higher than those in the control group (77.4% (41/53), 56.6% (30/53) and 56.6% (30/53)) (χ² values were 13.771, 26.533 and 23.535. all P<0.05).Conclusion On the basis of the routine tuberculosis medical care, comprehensive care should be given to the patients with bronchial tuberculosis airway stenosis, including individualized care program, psychological care delivery, the preoperative, intraoperative and postoperative nursing intervention in the bronchial balloon dilatation, such as psychological care, the nursing care during fiexible bronchofiberscopy going through the glottis, the nursing care of postural drainage combined with posture productive cough therapy and guidance after discharge, which can by which the compliance, the completed treatment rate and the effective rate of the treatment can improve the compliance of treatment, the treatment complement rate and effective rate of treatment, and is worthy of clinical application.

Analysis on treatment satisfaction of 102 patients with pulmonary tuberculosis in Guangxi,China

WU Teng-yan,LIU Fei-ying,HUANG Shu-hai,LIANG Da-bin

Journal of Tuberculosis and Lung Health. 2014, 3(1):  51-55.  doi:10.3969/j.issn.2095-3755.2014.01.011

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Objective In order to provide evidence for improving the quality of tuberculosis (TB) treatment service in Guangxi, a investigation of patients satisfaction with TB treatment was conducted among pulmonary TB (PTB) patients.Methods Six counties with different models of TB control were selected as the investigation sites, including 2 counties implementing the CDC Model, 2 counties implementing the TB designated hospital model, 1 county implementing the TB hospital model and 1 county implementing the independent TB dispensary model. In each country, 5% of each type of notified PTB patients (i.e. new smear-positive, new smear-negative and retreatment smear-positive PTB patients) was enrolled in this study. A self-designed questionnaire was used for the face to face interviews to the enrolled patients. Constitute ratios of patients satisfaction were calculated; Chi-square test and fisher’s exact test were used to analyze the patients satisfaction with treatment costs, a value of P<0.05 was regarded as a significant difference.Results A total of 102 PTB patients were enrolled in this study. All those patients received complete interview and all questionnaires were valid for analysis. The effective response rate was 100.0%. The degrees of patients satisfaction with five items which were investigated were as follows (from high to low): attitude of health workers (94.1%, 96/102), health education on TB (92.2%, 94/102), environment of TB clinic (81.4%, 83/102), procedures of diagnosis and treatment (78.4%, 80/102), as well as the total treatment costs (41.2%, 42/102); the overall patients satisfaction with treatment was 77.5% (395/510). The patients satisfaction with the total treatment costs was different in counties implementing different TB control models: it was 35.7% (10/28) in the CDC model counties, 30.8% (8/26) in the TB designated hospital model counties, 33.3% (9/27) in the TB hospital model county and 71.4% (15/21) in the independent TB dispensary model county; a significant difference (χ²=10.128, P=0.018) was showed, and the patients in the TB designed hospital model counties had the lowest satisfaction with the total treatment costs (30.8%, 8/26).Conclusion TB patients were more satisfied with the health workers’ attitude and the health education on TB that was provided by the health workers. Howe-ver, the TB clinic environment and the procedures of diagnosis and treatment need to be improved; measures for reducing the financial burden of TB patients need to be explored.

The analysis of case detection rate among close contacts of smear positive pulmonary tuberculosis patients in Taoyuan county

SONG Jiang-lin, LIN Qiu-e,HUA Wei-xiang

Journal of Tuberculosis and Lung Health. 2014, 3(1):  56-59.  doi:10.3969/j.issn.2095-3755.2014.01.012

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Objective To analyze case detection rate among close contacts of smear positive pulmonary tuberculosis patients, and to provide suggestions for future early case detection work.Methods Among 16145 people consulting for TB clinic, 5121 were close contacts of smear positive pulmonary tuberculosis patients from 2009 to 2012 in Taoyuan County. And we made descriptive analysis on type, age, sex, symptoms, sputum smear results of these close contacts.Results Among the 5121 close contacts, a total of 58 tuberculosis patients were detected with the detection rate of 1.13% (58/5121), and the annual rate of 0.75%-1.69%. 24 of them were checked out from family members(the detection rate is 0.59%(24/4079)),and the checking out rate among none-family members is 3.26%(34/1042), and the difference is statistically significant(χ²=14.967,P<0.01). The smear positive rate accounted for 46.55% (27/58) and 53.45% (31/58) for smear negative, and the difference is not statistically significant (χ²=1.210,P>0.05). In terms of age group, no one was checked out among those under the age of 20 and highest among those over 60(3.23%(31/960)), and the difference is statistically significant(χ²=47.747,P<0.01). In terms of gender, the detection rate is 1.85% (47/2543) among males and 0.43% (11/2578) among those females, and the difference is not statistically significant (χ²=1.011,P>0.05). As for whether with suspected symptoms, the rate is 0.04%(2/4676) among those without any symptoms and 12.58%((27+29)/445) among those with suspected symptom, and the difference is statistically significant(χ²=1101.950,P<0.01).Conclusion Extensive publication of national tuberculosis prevention and control policies, close contacts and other key people check, will benefit the early detection of tuberculosis patients and reducing the epidemic.

Review Articles

The role of IL-17 in immune response to tuberculosis

LI De-xian^*, ZHANG Tian-tuo, TAN Shou-yong

Journal of Tuberculosis and Lung Health. 2014, 3(1):  60-63.  doi:10.3969/j.issn.2095-3755.2014.01.013

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Along with the discovery of new CD4⁺ T-cell subsets has the concepts of immune response to tuberculosis renewed. T helper cell (Th) 17 that secretes interleukin (IL)-17, which is a novel subset of CD4⁺ T-cell different from Th1, Th2 and other regulatory t cells. It is found recently that there is a wide spectrum of Th17 phenotypes with differences in their cytokine production and effector functions. Early study suggests IL-17 and Th17 play critical roles in autoimmune diseases. Recent data suggest they play important roles in fighting Mycobacterium tuberculosis (Mtb) infection, but whether protective immunity or mediate immunopathology in response to Mtb infection is still controversial. In this review, we summarize the roles and the regulations of immune response of IL-17 and Th17 to tuberculosis. Understanding these mechanisms will enable us to develop specific immunotherapy against Mtb infection.

Research progress of the association between cytokine and diabetes mellitus complicated with tuberculosis

LI Yu-ze, LI Nan, LI Xiao-nan, JIANG Yan, LI Dian-zhong

Journal of Tuberculosis and Lung Health. 2014, 3(1):  64-67.  doi:10.3969/j.issn.2095-3755.2014.01.014

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One third of the world’s population has been infected with mycobacterium tuberculosis. Tuberculosis (TB) is closely associated with diabetes mellitus (DM), and DM patient is regarded as one of the TB susceptible population, with high infection rate, high TB prevalence and high mortality rate as characteristics. Through reviewing relevant literatures in recent years, this paper introduces the domestic and overseas research status of effect of some cytokine changes on the prevalence and clinical cure rate of DM complicated with TB. The high prevalence of DM complicated with TB is also explained from the aspects of cytokine immune. The basic information of the pathogenesis, early detection and treatment of DM complicated with TB are introduced as well.