Table of Content

30 September 2017, Volume 6 Issue 3

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Recent Transmission and Control of Tuberculosis in China

GAO Qian;YANG Chongguang

Journal of Tuberculosis and Lung Health. 2017, 6(3):  193-198.  doi:10.3969/j.issn.2095-3755.2017.03.001

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China still bears high Tuberculosis (TB) disease burden despite many achievements have been made in the past decades. For a long time, insufficient understanding on the transmission dynamics of TB has lead to a lack of targeted control strategies. Traditionally, the incident TB was believed to occur mainly due to reactivation of remote infection. However, with the development of molecular epidemiology, many studies from different areas and countries have shown evidence that recent transmission could be the main contributor to the TB epidemics. The authors’ previous studies also showed that recent transmission of TB is the key driver of the incident TB in China, and is recognized as the main reason for the high prevalence of MDR-TB. Here, based on these studies, the author propose that delineating the transmission model of TB by using the molecular epidemiology is crucial for the allocation of control resources and implementation of corresponding strategies. On this basis, the TB burden would not rapidly reduce in China in near future unless the recent transmission of TB is stemmed through multiple ways like to enforce the improvement of active case detection, to strengthen the laboratory testing capabilities, and to improve the rate of bacterially confirmed TB cases.

Current status and related problems of the diagnosis and treatment of spinal tuberculosis

Journal of Tuberculosis and Lung Health. 2017, 6(3):  201-203.  doi:10.3969/j.issn.2095-3755.2017.03.003

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Evaluation of tuberculosis in experimental animals

BAO Rong

Journal of Tuberculosis and Lung Health. 2017, 6(3):  204-207.  doi:10.3969/j.issn.2095-3755.2017.03.000

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The lesion of tuberculosis is important for safety and efficacy evaluation of vaccine and drug against tuberculosis, it could indicate the effect of drug, vaccine and strain virulence in tuberculosis (TB) animal model, which is very important for related investigation. Evaluation of tuberculosis may provide a reliable method for vaccine and drug development against anti-tuberculosis.

The application value of line probe assay for rapid diagnosis of osteoarticular tuberculosis

SHENG Jie，Tuersongjian·gHudabaierdi，GU Fu-ding，TANG Wei，MA Liang，Dilixiati·Abulizi

Journal of Tuberculosis and Lung Health. 2017, 6(3):  208-211.  doi:10.3969/j.issn.2095-3755.2017.03.004

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Objective To investigate the value of line probe assay for rapid diagnosis of osteoarticular tuberculosis. Method A total of 157 suspected osteoarticular tuberculosis patients who received focal cleaning were collected between January 2014 to February 2017 in our orthopaedics. Line probe assay, mycobacterial culture, acid-fast stain were used to test the samples at the same time. Taking clinical diagnosis as gold standards, the sensitivity, specificity of line probe assay were calculated. Combine the drug sensitivity test to evaluat the role of line probe assay for rapid diagnosis of osteoarticular tuberculosis. Results In 157 patients, 127 patients were diagnosed with osteoarticular tuberculosis, 30 patients were nontuberculosis. The sensitivity of line probe assay, mycobacterial culture, acid-fast stain were76.38%（97/127）、55.12%（70/127）、37.01%（47/127）, and the difference was significant(?2=40.06，P＜0.05); The specificity were 73.33%（22/30）、76.67%（23/30）、93.33%（28/30）, there was no statistical difference（?2=4.50，P=0.11）.Compared with mycobacterial culture and susceptibility testing，10 samples of drug-resistant strains, line probe assay to detect the total 10 samples of drug-resistant strains, with the above 10 samples for the same. Among them, 4 INH-resistant isolates were identified, line probe assay and mycobacterial culture results are consistent; 1 RFP-resistant isolate and 5 multi drug resistant isolates were identified, line probe assay inspection to INH and RFP resistance at the same time. Conclusion The line probe assay is a reliable method with high sensitivity, short time consuming, and the ability to detect drug resistance of INH and RFP simultaneously, can be used for the early screening and rapid diagnosis of osteoarticular tuberculosis.

Efficacy analysis of posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation in lumbosacral vertebral tuberculosis

XIA Yun-feng, PENG Xi-lin, DONG Ya-jun, SUN Peng

Journal of Tuberculosis and Lung Health. 2017, 6(3):  212-217.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To analyze the clinical feasibility of posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation in treating patients with lumbosacral vertebral tuberculosis. Methods A total of 35 patients who were treated by posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation in the Department of Orthopedics, Tuberculosis Hospital in Jilin Province were retrospectively analyzed. Among them, 30 patients completed a follow-up period of 18 months, including 17 males and 13 females, with an average age of (49.33 ± 10.98) years (ranged 29 to 68 years). The clinical outcome was evaluated by surgical treatment, postoperative fusion time of bone graft, spinal cord injury according to Frankel Grading System, pain visual analogue scale (VAS), and improvement in lumbosacral angle. Results There were no complications such as vascular injuries, incision infection and urinary incontinence occurred among the 30 patients. Three cases developed unilateral lower limb radiation pain, and the pain was relieved after 2 months, was conducted after surgery. Anteroposterior and lateral plain film X-rays were obtained to follow-up. The bone grafts were fused within 6 months in 23 patients, within 9 months in 2 patients, within 12 months in 2 patients, and within 18 months in 3 patients. Preoperative spinal cord injuries were classified as grade E in 15 cases, grade D in 13 cases, and grade C in 2 cases. The injury was improved 12 months after surgery (grade E in 27 cases and grade D in 3 cases). The VAS score and lumbosacral angle were (0.83±0.59) and (27.10±3.16)° 18 months after surgery, (2.23±0.63) and (29.20±3.48)° 1 week after surgery, and (5.03±1.99) and (22.49±3.85)° before surgery; the difference was statically significant (F=111.14, P<0.001; F=142.79, P<0.001). The lumbosacral angle was notably increased 1 week after surgery compared with before surgery; the difference was statically significant (t=－7.09, P<0.001). Eighteen months after surgery, the increase in lumbosacral angle was eliminated a little; however the increase was still significant when compared with the baseline before surgery (t=－5.08, P<0.001). Conclusion Posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation achieved good therapeutic efficacy for lumbosacral vertebral tuberculosis, and thus could be used as a promising operative method in clinical practice.

A preliminary report on the treatment of lumbar tuberculosis by percutaneous endoscopic lumbar discectomy

TANG Guo-ke, LI Da-wei, HU Kai, YUAN Ye, MA Yuan-zheng

Journal of Tuberculosis and Lung Health. 2017, 6(3):  218-221.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To evaluate the clinical value of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of spinal tuberculosis. Methods Nineteen patients with lumbar tuberculosis who conducted PELD from April 2012 to April 2015 were retrospectively analyzed, including 3 patients in Zhuzhou Central Hospital of Hunan Province and 16 patients in The 309th Hospital of Chinese People’s Liberation Army. During the regular anti-tuberculosis treatment, PELD was performed for lesion clearance and local anti-tuberculosis drug placement. The visual analog scale (VAS) score and erythrocyte sedimentation rate before and after surgery were compared. Results Nineteen patients were followed up from 18 to 48 months after surgery. The VAS score was reduced from 7.8 ± 1.3 before surgery to 3.2 ± 1.6 points one week after surgery; the difference was statistically significant (t=2.91, P<0.05). Laboratory erythrocyte sedimentation rate significantly declined from 55.0 ± 32.0 mm / 1h before surgery to 23.0 ± 7.0 mm / 1h one week after surgery (t=2.69, P<0.05). During the follow-up period, there were no cases with obvious symptom deterioration or recurrence cases. Out of 19 patients, 18 were cured, resulting in a cure rate of 94.7%. The remaining one case developed tuberculosis of gastrointestinal tract, and was transferred to The 309th Hospital of Chinese People’s Liberation Army for further treatment. Conclusion PELD treatment for spinal tuberculosis is an important supplement to the traditional open surgery, having good clinical efficacy.

The analysis of diagnosis and treatment on urinary tuberculosis complicated with chronic kidney disease(3 cases report)

CHEN Yu,LI Gui-qin

Journal of Tuberculosis and Lung Health. 2017, 6(3):  222-228.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To investigate the diagnosis and treatment of urinary tuberculosis complicated with chronic kidney disease and provide guides for the accurate treatment of urinary tuberculosis. Methods To collect the clinical data of three patients suffered urinary tuberculosis complicated with chronic kidney disease hospitalized from Jan.2016 to Dec.2016 in tuberculosis department of the Tenth People’s Hospital ,Shenyang. the history of medicationand treatment was analyzed in three patients who were farmers Results The 3 cases was delayed diagnosis from 5 to 10 years. Case 1 mainly presented with "urinary frequency, urgency, nocturia"; Case 2 had symptoms of" hematuria, urinary incontinence"; Case 3 with "fever, weak". All 3 patients had a long misdiagnosed history as other urinary tract bacteria infections or prostate disease and accepted an unfavorable treatment Cases 1 and 2 had imaging changes of pulmonary tuberculosis, but no symptom. Case 1 showed sterile pyuria, proteinuria, Xpert Mtb / RIF test, DNA amplification qualitative test, Mycobacterium tuberculosis rapid liquid culture (BACTEC MGIT 960) and Mycobacterium tuberculosis antigen MPB64 test in their urine specimen were all positive. Case 2 showed severe hematuria, urine tuberculosis-related test were negative. Case 3 had a acidic urine changes, urine tuberculosis-related examination was negative. The case 1’ showed bilateral multiple renal cavitation on his renal CT, unilateral kidney destruction，contralateral ureterohydronephrosis and extension. In Case 2 ,his CTU showed unilateral kidney damage, contralateral ureterohydronephrosis, contracted bladder presents with diffuse thickening of the bladder wall。 The feature of renal MRI in Case 3 was right autonephrectomy，bilateral multiple renal cavitation ,left renal parenchyma thinning. The three patients were diagnosed by urine Xpert Mtb / RIF positive test in case 1,’ histopathology of a sample obtained through renal surgery in Case 2; MRI imaging in Case 3, respectively. Two patients selected first-line drugs（isoniazid, rifampicin）and second-line fluoroquinolone（Moxisfloxacin）because of the chronic kidney disease stage 5, and hemodialysis alternative therapy., case 1 selected the same regiman but added pyrazinamide due to the normal range of uric acid. Case 2 suffered with urinary TB with chronic kidney disease stage 3, regimen of isoniazid, rifapentine, pyrazinamidewas selected. Followed up from 6 months to 1 year, 3 cases was stable. Conclusion Long-term diagnosis delay of urinary tuberculosis can easily lead to kidney damage,which should be noticed by urology doctors and tuberculosis doctors

Influence of two anesthesia methods on T lymphocyte subsets, NK cells and interferon gamma in spleen of mice infected with BCG vaccine

LIU Min-qiang, HAN Ya-kun, WANG Song, LI Zhi-chao, YU De-hui, WANG Hua, HE Ren-liang

Journal of Tuberculosis and Lung Health. 2017, 6(3):  229-234.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To compare the influence of general anesthesia and intravertebral anesthesia on T lymphocyte subsets, NK cells and interferon gamma in spleen of mice infected with BCG vaccine. Methods Fifty-four clean healthy male C57BL/6 mice were randomly divided into general anesthesia group (group G), intravertebral anesthesia group (group S), and control group (group C) with 18 cases each according to random number table and were established animal model infected with BCG. Each 6 mice from every group were sacrificed and calculated the CD3+, CD4+ and CD8+T lymphocyte, CD4+/CD8+ T lymphocyte ratio, natural killer cells (NK cells) and interferon gamma (IFN-γ) expression of spleen tissues using flow cytometer in 30 minutes before operation, 1 day after the operation and 3 days. Results The CD4+/CD8+ T lymphocyte ratio, NK cells and IFN gamma were 2.8±0.3 and 2.9±0.2, (22.3±2.3)% and(22.8±1.9)%, (1.4±0.4)% and (1.4±0.4)% in the 30mins before operation, 1.8±0.2 and 1.8±0.1, (15.6±1.4)% and (15.2±1.1)%, (0.6±0.2)% and (0.6±0.3)% in the first day after operation, 2.0±0.2 and 2.1±0.2, (18.7±2.0)% and (19.1±2.3)%, (1.1±0.2)% and (1.1±0.2)% in the third day in group G and group S, respectively. The comparison of values in three groups were in different time points were different significantly(F values were 65.40 and 83.02，41.30 and 53.65，27.77 and 7.47，all P were 0.000). In the third day after operation, the CD3+ T lymphocytes((20.9±3.1)% and (21.0±3.2)%), CD4+ T lymphocytes((13.9±1.9)% and (14.1±2.2)%) in Group G and S were lower those((26.5±5.1)% and (18.4±4.1)%) in the group T with significant difference statistically(F=8.00，P=0.001；F=8.54，P=0.001). The CD4+T lymphocytes in the third day after operation were lower those in the 30 min before operation((18.2±4.2)%, (17.8±3.5)%) with significant difference statistically(t=13.36，P=0.005；t=4.19，P=0.006). However, in the third day after operation, the CD3+ T lymphocytes((20.9±3.1)% and (21.0±3.2)%), CD4+ T lymphocytes((13.9±1.9)% and (14.1±2.2)%), CD4+/CD8+ T lymphocyte ratio((2.0±0.2) and (2.1±0.2)) and NK cells((18.7±2.0)% and (19.1±2.3)%) and IFN gamma((1.1 ± 0.2)% and (1.1 ± 0.2)%) were no significant difference in group G and S(t values were 0.12, 0.23, 0.39, 0.39 and 0.46，P were 0.902, 0.821, 0.697, 0.697 and 0.660). Conclusion T lymphocyte subsets, NK cells and IFN gamma expression in the spleen of mice infected with BCG can be inhibited by anesthesia, but CD3+ T lymphocytes, CD4+ T lymphocytes, NK cells, IFN gamma and CD3+/ CD4+ T lymphocyte ratio are no significant difference statistically in general anesthesia and intravertebral anesthesia.

The influence of dietary intervention on the treatment outcome of new smear positive pulmonary tuberculosis patients with malnutrition at the beginning of treatment

LI Bing, ZHANG Shi-xia, LV Shi-zhen

Journal of Tuberculosis and Lung Health. 2017, 6(3):  235-240.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To explore the influence of dietary intervention on the treatment outcome of new smear positive pulmonary tuberculosis (PTB) patients with malnutrition. Methods 60 new smear positive PTB patients with malnutrition admitted in our hospital from January 2013 to December 2013 were in control group, and 60 new smear positive PTB patients with malnutrition admitted in our hospital from January 2014 to December 2014 were in intervention group, the patients of both groups received anti-TB therapy. Routine health education was conducted for patients in control group during their stay in hospital. Patients’ nutritional assessment was performed within 24 hours of admission, two weeks after admission and when they left the hospital in intervention group, the individual energy standard of the patients was adjusted and dietary intervention was conducted by the doctors and nursed who received nutrition knowledge training by special monitoring group on nutrition. The reexamination of sputum and chest radiography of the patients in the two groups were performed at the enrollment, after 2 months’ treatment, 5 months’ treatment and 6 months’ treatment, in order to get the information of sputum conversion, the lesion changes and treatment outcome. Results When the patients were discharged from the hospital, the patients with malnutrition accounted for 20.00% (12/60) in the intervention group after treatment and intervention, which was significantly less than that (65.51%, 38/58) in the control group (χ2=25.023, P﹤0.01). The degree of satisfaction in the intervention group reached up to 96.67% (58/60), which was higher than the control group (77.58%, 45/58), and the difference was statistically significant (Z=9.72，P﹤0.05). The patients in the intervention group whose lesions were significantly absorbed accounted for 51.67% (31/60), which was obviously higher than the that in the control group (31.03%, 18/58)(χ2=37.168, P﹤0.01). The sputum negative conversion rate of the patients in the intervention group was 83.33% (50/60), and that in the control group was 53.44% (31/58), with statistically significant difference (χ2=12.237，P ﹤0.01). The rate of no changes in lesion in the intervention group (6.7%, 4/60) was significantly less than the that in the control group (29.3%, 17/58)(χ2=10.336, P﹤0.01). Conclusion Dietary intervention on smear positive PTB patients at the beginning of treatment can evidently correct the situation of malnourish, and it can also improve the cure rate of the patients.

Clinical study of Silibin Meglumine Tablets and Inosine Tablets on the prevention of drug induced liver injury by anti tuberculosis fixed dose combination

LIU Yi，LIU Yang，HAN Dong-wei

Journal of Tuberculosis and Lung Health. 2017, 6(3):  241-245.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To compare the effects of Silibin Meglumine Tablets and Inosine Tablets on the prevention and treatment of drug induced liver injury(DILI) by anti tuberculosis (TB) fixed dose combination (FDC). Methods From January 2015 to December 2015, 103 TB patients treated by TB clinic in Yingkou Center for Disease Control and prevention were selected and divided into group A（FDC+ Six Vitamin Pilles+ Silibin Meglumine Tablets, 52 cases）and group B（FDC+ Six Vitamin Pilles+ Inosine Tablets, 51 cases）randomly. The patients in the two groups were treated with 2HREZ/4HR regimen for TB, and the changes of liver function indexes and liver injury in the two groups were observed within 6 months. The measurement data were analyzed by t test, and the enumeration data were analyzed by chi square test (or Fisher exact probability method), and the rank data of clinical efficacy were analyzed by Wilcoxon rank sum test. The inspection level was two-sided test, the difference was statistically significant if P<0.05. Results There were no severe liver damage cases in the two groups. The numbers of abnormal liver function, slight liver damage and medium liver damage in the two groups were 3 vs. 6, 1 vs. 9 and 1 vs. 4 respectively. The incidence rate of drug-induced liver injury (DILI) were 9.6% (5/52) in group A and 37.3% (19/51) in group B, and that of group A was significantly lower than group B (Z=3.37, P=0.001).Of the 24 patients with DILI, only 1 of the B group occurred within 12 weeks after treatment, and the others occurred within 8 weeks after treatment. Conclusion The use of Silibin Meglumine Tablets for the prevention of DILI than Inosine Tablets has better preventive effect, and has clinical significance.

Clinical significance of peripheral blood mononuclear cells in tuberculosis patients

FAN Yin-mei, LIU Qun-qun, MIAO Yan-fang, TANG Shen-jie

Journal of Tuberculosis and Lung Health. 2017, 6(3):  246-249.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To investigate the relationship between peripheral blood mononuclear cells (PBMC) and tuberculosis. Methods 150 tuberculosis patients (tuberculosis group), 80 lung cancer patients (lung cancer group) and 100 healthy volunteers (control group) screened from the Fourth People's Hospital of Taiyuan between January 2013 and December 2016 were included in the present study. The tuberculosis group was divided into the initially treated young subgroup, initially treated old subgroup and retreated young subgroup. The percentage of PBMC in the tuberculosis group and the lung cancer group when admitted to hospital and that in the control group form physical examination record were collected and compared. Results Significant difference in PBMC percentage among the three group was detected (F=67.59, P<0.05). The PBMC percentage in the tuberculosis group was (10.8±2.94)%, which was higher than that in the control group (6.86 ± 1.42)% and the lung cancer group (7.95 ± 1.73)% (P<0.05). The PBMC percentage in the initially treated young subgroup, initially treated old subgroup and retreated young subgroup was (10.80±2.72)%, (10.40 ± 2.82)% and (10.52 ± 3.22)%; but there was no statistically significant difference (F = 0.22, P = 0.804). Conclusion The percentage of PBMC in patients with pulmonary tuberculosis was increased.

Clinical Significance of the Expression about EGF and bFGF in Tuberculosis Wound

WANG Li-wei, HAN Zhou, BIAN Ao-ao, TANG Hong-jie, WU Chang-qing, WU Mei-ying

Journal of Tuberculosis and Lung Health. 2017, 6(3):  250-253. 

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Objective To probe the mechanism of the tuberculosis wound repairing, through detect the Epidermal growth factor( EGF) and Basic fibroblast growth factor (bFGF ) in the wound fluid, compare those contents in the normal infected wound, to direct clinical practice. Methods Respectively, we divide 30 cases of tuberculosis wound & 30 cases of normal infected wound in experimental group & comparison group. We collect the wound fluid, detect the contents of EGF、bFGF, and record the entire heal time. We use the t-test and Pearson relation test process the data. Results The contents of EGF、bFGF in the experimental group in the 7d（ng/ml）: 0.200±0.019 ；0.021±0.003 evidently less than the control group in the 7d（ng/ml）:0.533 ± 0.023；0.069±0.003 (t＝6.725,P<0.05；t＝5.783，P<0.05) ; During the experimental group the contents of EGF 、bFGF in the late stage the 42d（ng/ml）：0.300±0.018,0.062±0.003, are much more than those in the early stage the 7d（ng/ml）： 0.200±0.019,0.021±0.003,（t’＝0.813， P＝0.015）(t’＝0.655，P＝0.110). The average heal time of between the two groups is （133.170±81.390）d and （21.000±1.900）d（t＝8.414，P＜0.05）, it has statistical difference. Conclusion There are less EGF、bFGF in the tuberculosis wound micro-environment. It’s the important reason of the delay healing of wound, adjust the contents of EGF、bFGF can improve the healing of wound.

Analysis of influencing factors of successful treatment of multidrug-resistant pulmonary tuberculosis

WANG Dan-ji, LU Peng, LIU Qiao, ZHOU Yang

Journal of Tuberculosis and Lung Health. 2017, 6(3):  254-259.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To analyze the treatment success of multidrug-resistant tuberculosis patients and to investigate factors that affect the success of treatment. Methods From January 2013 to December 2014, 524 multidrug resistant patients (at least simultaneously resistant to rifampin and isoniazid) in Xuzhou, Zhenjiang, Lianyungang and Nantong City of Jiangsu Province, were invited to join this retrospective study. In the end, 421 patients were included, excluding 3 pregnant women with MDR TB, 51 patients with severe gastrointestinal diseases or mental disorders and 28 patients who were unwilling to cooperate with the investigated. Research data was based primarily on the investigation of medical records with additional telephone interviews. Univariate analysis was performed by chi square test, and multivariable logistic regression analysis was applied to explore the factors that might affect the treatment success of MDR patients. Results Out of the 421 subjects included in this study, the successful rate of treatment was 52.7% (222/421). The complete treatment rate was 7.6% (32/421), and the cure rate was 45.1% (190/421). Treatment failure, loss and discontinue treatment cases accounted for 39.7% (167/421), 5.5% died due to tuberculosis (23/421), and 2.1% died due to non-tuberculosis (7/421). In the multivariable logistic regression analysis, age（aRR=2.643，95%CI=1.409～4.959，P=0.002）（aRR is an adjusted RR value）, adverse reaction history（aRR=1.872，95%CI=1.041～3.365，P=0.036）, positive sputum smear before treatment（aRR=2.835，95% CI=1.476～5.446，P=0.002）, and retreatment patients（aRR=4.512，95%CI=1.283～15.872，P=0.019）are the factors negatively affecting the success of multidrug-resistant pulmonary tuberculosis treatment. Conclusion Patients who are over 55 years old, with a history of adverse reactions, with a positive grade of sputum smear before treatment of ++～＋＋＋＋and retreatment patients have an obvious negative influence on the success of the treatment.

Awareness of knowledge on tuberculosis prevention and control and its influencing factors among new college students in Shijingshan District of Beijing

JIANG Ying， SUN Hao， LI Min，HE Xiao-xin

Journal of Tuberculosis and Lung Health. 2017, 6(3):  260-264.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To study the awareness rate and related behaviors about tuberculosis (TB) prevention and control among new college students in Shijingshan District, and to provide the evidences for developing the TB prevention and control measures in universities or colleges. Methods The cluster sampling method was adopted and a self-designed questionnaire with key knowledge on TB prevention and control was used. The investigation was conducted among the new students in 4 universities/colleges which locate in Shijingshan Disrict: North China University of Technology, Beijing Polytechnic College, Shougang Institute of Technology and School of Nursing Peking Union Medical College, from September 2016 to October 2016. A total of 4,000 questionnaires were distributed and 3,705 valid questionnaires were collected. The general information and the situation on TB knowledge awareness among the new students were analyzed. Epidata software was used to establish the database and SPSS17.0 was used to perform descriptive analysis. The χ2 test and logistic regression analysis of duality factors were used for statistical analysis. All the test level was α = 0.05. Results The overall awareness rate of TB prevention and control knowledge among 3,705 freshmen in the four universities/colleges in Shijingshan District was 57.2% (19 059/33 345); this awareness rate in male students and female students was 54.8% (11 146/20 340) and 60.9% (7 920/13 005) respectively, and the difference was statistically significant (χ2=25.292, P＜0.01); the awareness rate in the non-Beijing resident students and Beijing resident students was 4.9% (543/11 079) and 4.2% (935/22 266) respectively, the difference was statistically significant (χ2=47.1671, P＜0.01); the awareness rate in the different groups of students whose parents education level was high school (or equal) and below, junior college, bachelor degree and above, was 54.8% (6101/11 133), 52.4% (7187/13 716) and67.9% (5769/8496) respectively, the difference was statistically significant (χ2=10.405, P＜0.05); the awareness rate in the different groups of students whose family annual income level per capita was ＜5500yuan, 5500～yuan, 16 801～yuan, >45 000yuan was 59.1% (4562/7119), 58.5% (4459/7623), 55.3% (1797/3249), 55.4% (1137/2052) respectively, the difference was statistically significant (χ2=12.578, P＜0.05). The logistic analysis results showed that the students with the following characters had higher awareness: female students (OR=1.317, 95%CI: 1.117-1.554), non-Beijing resident students (OR=1.335; 95%CI: 1.119-1.594), parents had higher education level (OR=1.221; 95%CI: 1.091-1.366), low family annual income per capital (OR=0.926; 95%CI: 0.881-0.974). Conclusion The awareness rate on tuberculosis prevention and control knowledge among new college students in Shijingshan District is low. The targeted health education should be carried out in the universities/colleges to improve the awareness of the core knowledge on tuberculosis prevention and control. The male students, Beijing resident students, and the students whose parents with low educational level and have high household income, should be focused.

The effects of rational-emotive therapy on the negative emotion of patients with pulmonary tuberculosis

DONG Xia, ZHANG Qin, WANG Hong-mei, LI Bing

Journal of Tuberculosis and Lung Health. 2017, 6(3):  265-269.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Objective To discuss the effects of rational-emotive therapy on anxiety and depression in patients with pulmonary tuberculosis. Methods The hospitalized patients diagnosed with tuberculosis from Jan to Oct in 2016 in Wangkai Infectious Diseases Hospital were carried out psychological evaluation. The eighty cases with psychological disorder were sequenced from the first to the eightieth according to the admission time. The patients with odds number were divided in the intervention group, and the patients with even numbers were divided in the control group. Forty cases in each group. Control group followed the conventional method of communication and care, while the patients in the intervention group received targeted, personalized psychological care based on the rational-emotive therapy interventions.The anxiety and depression of the patients in the two groups were assessed by using Zung’s scale of anxiety and depression. The improvement of the patients in two groups in anxiety and depression before and after intervention were compared. Results Before the psychological intervention, the average anxiety score for the intervention group patients was 60.13±7.15, and the average depression score of 62.63±6.40. The average anxiety score for the control group patients was 60.18±7.36, and the average depression score of 62.10±6.44. The difference of the average score of anxiety and depression in the two groups were not statistically significant (t value were respectively－0.03 and－0.37 and P value were respectively 0.975 and 0.716). After the psychological intervention, the anxiety score for the intervention group patients was 52.97±6.98, and the average depression score of 55.60±6.23. The average anxiety score for the control group patients was 58.08±6.99, and the average depression score of 60.30±6.35. The average score of anxiety and depression in the intervention group were obviously lower than those in the control group, and the difference were statistically significant (t value were respectively－3.28 and－3.34 and P value were respectively 0.020 and 0.010). Conclusion Timely implementation of rational-emotive therapy in patients with pulmonary tuberculosis interventions can effectively reduce anxiety, depression, and emotional impact.

Progress in diagnosis and treatment in tuberculosis patients associated chronic obstructive pulmonary disease

XU Wei*, WU Li-juan, SHEN ning, CAO Wen-li

Journal of Tuberculosis and Lung Health. 2017, 6(3):  270-274.  doi:10.3969/j.issn.2095-3755.2017.03.000

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The tuberculosis associated COPD(TOPD) () as a common chronic airway inflammation is mostly found in elderly patients . TOPD may be prevented and treated in early stage , but in late stage，it presents as irreversible persistent airflow limitation followed by progressive exacerbation . Through literature review and analyses of TOPD risk factor, pathogenesis, missed diagnoses and misdiagnoses, and methods of diagnosis and treatment , We draw the following conclusions:TOPD patients were mostly male, 52% in nonsmokers, and the majority was elderly patients. TOPD had the clinical characteristics of tuberculosis and COPD, and hemoptysis was more common symptom in TOPD patients than in COPD patients, and its FVC and FEV1/FEV values were lower in TOPD patients than in COPD patients; TOPD had poor response to bronchodilators, and irreversible airway resistance was serious; TOPD patients with airflow limitation were more prone to acute exacerbation than those without airflow limitation . TOPD diagnosis should be made comprehensively based on the history of tuberculosis contacts, clinical symptoms and signs, and laboratory tests .It’s important to identify the etiologies. pulmonary rehabilitation should be done actively according to combined modality therapy.

Advances in the study of fluoroquinolones in the treatment of tuberculosis

CHENG Yan-zhi,LIU Qun-qun, MIAO Yan-fang, TANG Shen-jie

Journal of Tuberculosis and Lung Health. 2017, 6(3):  275-278.  doi:10.3969/j.issn.2095-3755.2017.03.000

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In recent years, more and more studies have been focused on the treatment of tuberculosis by fluoroquinolones. Fluoroquinolones have strong bactericidal effects on Mycobacterium tuberculosis. At present, it plays an important role in the clinical treatment of tuberculosis. However, there are many unreasonable phenomena in its application. In this review, we reviewed the progress of fluoroquinolones application in the treatment of newly diagnosed, recurrent, and drug-resistant tuberculosis, in order to provide a basis for better selection of fluoroquinolones in the treatment of tuberculosis.

Transient receptor potential channels proteins and the pathogenesis of pulmonary hypertension

XU Lei, FU Xiu-hua

Journal of Tuberculosis and Lung Health. 2017, 6(3):  279-293.  doi:10.3969/j.issn.2095-3755.2017.03.000

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Pulmonary hypertension is one of the diseases that seriously threaten to human health with significant mortality and disability rate. It is vital to explore the mechanism of pathogenesis of pulmonary hypertension for its prevention and treatment. The increase in Ca2+ concentration of pulmonary artery smooth muscles cells enhances cell proliferation and consequent causes occurrence of pulmonary hypertension, which plays a core role in the pathogenesis of pulmonary hypertension. The Ca2+ concentration of cells is regulated by calcium channels on cell membrane. The transient receptor potential channel C (TRPC) is the main component of calcium channels, and TRPC1/4/6 are involved in pathogenesis of pulmonary hypertension. In the present article, we reviewed the pathogenesis of pulmonary hypertension in detail.

A review of blood gas analysis

CHEN Xue-rong,FAN Hong, LUO Yan-jie

Journal of Tuberculosis and Lung Health. 2017, 6(3):  286-288.  doi:10.3969/j.issn.2095-3755.2017.03.000

Abstract ( 236 )   PDF (1071KB) ( 488 )   Save

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To review the application method and scope of blood gas analysis. Steward approach, a preferable method compared with formula method was introduced. Percutaneous non-invasive blood gas analysis, end-tidal carbon dioxide monitor and intravascular real-time blood gas analysis optimized measuring techniques. Moreover, blood gas analysis was applied in the fields of internal medicine include phthisiology, critical care medicine and surgery. Blood gas analysis has broad prospects for development.

Progress of evaluation method of the tuberculosis case detection rate

GUO Jun-tao

Journal of Tuberculosis and Lung Health. 2017, 6(3):  289-292.  doi:10.3969/j.issn.2095-3755.2017.03.022

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Case detection rate is one of the important indicator to evaluate the progress of tuberculosis control，but case detection rate is difficult to observe directly and is often calculated indirectly. Each kind of the method to estimate the case detection rate is different because the precision and range of application of each method variant,by reviewing the references, the author reviews the merits and demerits of the current evaluation methods

Study progress on anti-tuberculosis drug-induced hypersensitivity syndrome

YANG Song, YAN Xiao-feng

Journal of Tuberculosis and Lung Health. 2017, 6(3):  293-281.  doi:10.3969/j.issn.2095-3755.2017.03.000

Abstract ( 241 )   PDF (827KB) ( 399 )   Save

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Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening adverse drug reaction. DIHS reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, hematologic abnormalities (eosinophilia or increase of atypical lymphocytes) and damages of internal organs. So far, numerous drugs, such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, phenytoin, melbine, allopurinol, sodium valproate, minocycline, etc., have been reported to cause the DIHS. The anti-tuberculosis (anti-TB) drugs can also cause this potentially fatal syndrome and the anti-TB drug-induced hypersensitivity syndrome is considered to be a serious adverse reaction too. However, it remains much unclear regarding its characteristics and genetic risk factors. The diagnosis of DIHS is facing challenges because the pattern of cutaneous eruption and the type of organ damages are various. The treatment for DIHS is to stop using the culprit drugs and give corticosteroids. In this study, in order to increase the awareness of DIHS and improve the level of diagnosis and treatment of this disease, a literature review was done to elaborate the study progress on the pathogenesis, clinical manifestations, diagnosis and management of DIHS.

Research on progress of diagnosis and therapy of tracheobronchial tuberculosis

YANG Song, YAN Xiao-feng

Journal of Tuberculosis and Lung Health. 2017, 6(3):  294-285.  doi:10.3969/j.issn.2095-3755.2017.03.000

Abstract ( 230 )   PDF (825KB) ( 405 )   Save

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Tracheobronchial tuberculosis（TBTB）is one type of TB with microbiologically and histopathologically confirmed and occurs in the trachea and bronchi. The diagnosis of TBTB is often delayed due to its nonspecific clinical presentations and radiographic findings. It is often misdiagnosed as bronchial asthma, foreign body aspiration or lung cancer. TBTB is regarded as one of the risk factors for multidrug-resistant TB (MDR-TB) development, and may also cause other complications, such as bronchial stenosis with high morbidity. Early diagnosis and treatment of TBTB is therefore important and necessary. The development process and prognosis of TBTB are variable in different patients; some patients were cured while some became worse and developed to severe bronchial stenosis. In this review study, the clinical manifestations, early diagnosis and treatment of TBTB were evaluated. The aim is to improve the level of diagnosis and treatment of TBTB.