Table of Content

20 July 2012, Volume 1 Issue 1

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Expert Forum

An exploration on sustainable development of tuberculosis prevention and control in China

ZHANG Hui,CHENG Jun,WANG Li-xia

Journal of Tuberculosis and Lung Health. 2012, 1(1):  7-10. 

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Tuberculosis (TB) is a major public health concern worldwide. China has the second highest TB burden globally. We analyzed the current situation and major challenge of TB prevention and control in China and concluded that to ensure the Governments’ leadership and funding, improve tuberculosis control service system and to take effective control measures are the key to ensure sustainable development of TB prevention and control.

Current medical treatment of tuberculosis and its prospects

TANG Shen-jie, XIAO He-ping

Journal of Tuberculosis and Lung Health. 2012, 1(1):  11-14. 

Abstract ( 201 )   PDF (778KB) ( 332 )   Save

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Medical treatment for tuberculosis has mutated from sanatoria treatment, artificial pneumothorax and artificial pneumoperitoneum therapy at the beginning to the emergence of streptomycin and chemotherapy, and then to the advent of rifampicin and short course chemotherapy, finally to current combined treatment, including chemotherapy, immunotherapy and intervention. Facing the trend of deteriorated drug resistance, medical treatment for tuberculosis in future will no doubt to be focusing on the research and development of new anti-TB drugs, the research of therapeutic vaccines as well as the application of nanotechnology in TB.

Medical therapy for advanced non-small-cell lung cancer

ZHANG Shu-cai,ZHANG Hui

Journal of Tuberculosis and Lung Health. 2012, 1(1):  15-21. 

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The 5-year survival rate of advanced non-small cell lung cancer(NSCLC), is less than 5%. Clinically chemotherapy and targeted therapy are currently used in NSCLC treatment. In recent years, with the emergence of molecular targeted therapy drugs, such as human epidermal growth factor tyrosine kinase inhibitors, angiogenesis inhibitors, the anti-tumor monoclonal antibodies and multi-target drugs, the overall survival of advanced non-small cell lung cancer had been extended significantly and the quality of patient’s life improved remarkably. Molecular targeted therapy has become the most promising treatment and can significantly improve the prognosis of advanced NSCLC.

Progress of early lung cancer diagnosis and treatment

ZHI Xiu-yi

Journal of Tuberculosis and Lung Health. 2012, 1(1):  22-26. 

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The surgery is the first choice for early lung cancer treatment. The standard approach is lobectomy plus lymph node dissection. In recent years, thoracoscopic minimally invasive surgical technique is widely carried out clinically; the safety of thoracoscopic lobectomy has been recognized. With the advances in medical imaging techno-logy, more cases of early lung cancer has been detected, for early peripheral lung cancer with the carcinoma less than 2cm in diameter, whether pulmonary segmentectomy or wedge resection could replace lobectomy as the standard operation of this type of lung cancer yet to the emergence of new evidence.

Progress in diagnosis and treatment of bronchial asthma

SHI Guo-chao, WANG Lin-lin

Journal of Tuberculosis and Lung Health. 2012, 1(1):  27-31. 

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In recent year, with the development of the etiology and pathogenesis of bronchial asthma, its diagnosis and treatment has made great progress. New diagnostic examinations emerged including analysis of exhaled NO and exhaled breath condensate component, airway remodelling imaging evaluation and phenotypic analysis. New treatment technologies developed including bronchial thermoplasty, the application of inflammatory mediators’ antagonists, sublingual specific immunotherapy, as well as vitamin D, anti-fungal therapy and the application of proton pump inhibitors. These developments in diagnosis and treatment provide more choices for asthma prevention and control.

Diagnosis, treatment and education of childhood asthma

CHEN Yu-zhi

Journal of Tuberculosis and Lung Health. 2012, 1(1):  32-35. 

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Asthma is a children’s most common chronic respiratory inflammatory disease. In recent years, with the improvement of people’s living conditions and changes of lifestyle, the prevalence of childhood asthma increased from 0.91% in 1990 to 2.50% in 2000. Therefore, timely and accurate diagnosis and adherence to long-term, continuous, standardized and individualized treatment is important to patients, especially to young children under 5 years old. Additionally, strengthening education and training of primary health care workers and family members of patients, making use of modern media to disseminate asthma knowledge, will have play active part on early intervention and control of asthma.

Advances in etiology of acute respiratory tract in children and its detecting technology

YU Sang-Jie, YANG Yong-hong

Journal of Tuberculosis and Lung Health. 2012, 1(1):  36-41. 

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Acute respiratory tract infections are the most common pediatric diseases with high incidence and mortality. At the same time, symptoms tend to be hidden and atypical due to the immaturity of the child’s immune system. In addition, lower respiratory tract specimens in children are not readily available, the etiological research has lagged behind, resulting in the difficulties of clinical diagnosis and irrational use of antibiotics in clinical, and causing great difficulties for respiratory tract infection with children prevention and control. With the rapid progress of molecular biology methods in recent years, the clinics have achieved remarkable results of the main pathogens of respiratory tract infection in children. Respiratory tract infections were caused by many pathogens, including viruses, bacteria, mycoplasma, etc. Traditionally, respiratory syncytial virus (RSV) is the most common pathogen, human rhinoviruses (HRV), influenza virus A and B (INF), parainfluenzaviruses 1, 2 and 3 (PIV) and adenovirus are also the major virus pathogens. The recently described human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human polyomavirus KI (KIV) and Wu virus (WUV) have been detected in samples collected from acute respiratory infection with children. Streptococcus pneumoniae (Sp) is the most common bacterial infectious pathogen, followed by Haemophilus influenzae (HI), Staphylococcus aureus (SA) and Moraxella catarrhalis (MC). In addition, Bordetella pertussis, Streptococcus pyogenes and gram-negative enteric bacteria are also common. Finally, Mycobacterium tuberculosis and Mycoplasma pneumoniae also account for a certain percentage. Pathogen detection is very important for the diagnosis of respiratory infections in children. In addition to traditional culture methods of pathogens, the progress of molecular biology techniques, especially polymerase chain reaction (PCR) technology appears, greatly improving the detection rate and detection time of pathogens.

Control tobacco hazards, promote lung health

JIANG Guo-hong

Journal of Tuberculosis and Lung Health. 2012, 1(1):  42-44. 

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Numerous scientific studies and epidemiological surveys have shown that smoking can lead to various diseases, especially lung diseases. Smoking is both harmful to smokers’ health, also seriously endangering others’ health through secondhand smoke. Loss of the economic costs of tobacco use causes far more than the benefits of tobacco. WHO advocated for the members to control the dangers of tobacco extensively, and promulgated “WHO FCTC” and “MPOWER”. China’s implementation of tobacco control convention would be long and arduous, but we will eventually move towards smoke-free China as long as the whole society pay the unremitting efforts.

Smoking cessation strategies in tobacco control in China

YANG Ting-zhong^*,YANG Gong-huan

Journal of Tuberculosis and Lung Health. 2012, 1(1):  45-47. 

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The authors systematically reviewed domestic and international literatures related to smoking cessation, then discussed tobacco cessation strategies suitable to Chinese context on the basis of literature review. The population-based studies showed that both quitting and relapse rates are high. It was found that most Chinese quitted by themselves but few of them quitted through specialized medical institutes of smoking cessation services. In recent years, many smoking cessation clinics were built in cities but have received very few smoking visitors. This may related to the emphasis of the culture's emphasis on spirit and perseverance. The authors recommend: Advocacy for environmental and social support measures, encouragement of self-help to stop smoking, and to implement brief cessation intervention in general clinics.

Smoking and health

WU Ye-qing^*,XIAO He-ping

Journal of Tuberculosis and Lung Health. 2012, 1(1):  48-51. 

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Cigarettes contain various carcinogens and harmful ingredients, smoking is not only harmful to the health of smokers, but also to “involuntary smoking” people. There are some misunderstandings about smoking. Secondhand smoke is the important source of indoor air pollution. At present, in our country smoking banning status is not optimistic and smoke-free laws and regulations are not perfect. It is imperative to maintain national health and ban smoking.

The global and domestic situation and strategy of tuberculosis infection control

HE Guang-xue,XIONG Yong-chao^*, HOU Yue-yun^*,GUO Hui

Journal of Tuberculosis and Lung Health. 2012, 1(1):  52-54. 

Abstract ( 227 )   PDF (711KB) ( 494 )   Save

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Tuberculosis (TB) is a chronic infectious disease. It is still a significant public health concern as the prevalence of TB infection and prevalence remains high in China. However, TB infection control work is gene-rally inadequate and is considered to be the weak link in TB control worldwide. Very few studies on TB infection control have been performed in China. Previous research findings indicated that health care workers (HCWs) are at higher risk of TB infection and disease in comparison with the general population. Currently, the implementation of regular screening of TB infection and disease, protective measures and powerful TB infection control policy are not systematically performed in China. Therefore, strengthening TB infection control in HCWs has become an urgent public health priority. In order to protect the HCWs and reduce their risk of TB infection and disease, TB infection control program should be integrated with the general infection control program and bring it into the National Tuberculosis Control Program.

Current progress on surgery treatment for pulmonary tuberculosis

DING Jia-an, XIE Dong

Journal of Tuberculosis and Lung Health. 2012, 1(1):  55-59. 

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Surgical treatment indications for pulmonary tuberculosis includes: localized MDR-TB, massive hemoptysis, tuberculoma, tuberculous cavity, tuberculosis sequelae, tuberculous empyema, bronchopleura fistula, collapsed lung, bronchial tuberculosis, intrathoracic lymph node tuberculosis and so on. The principle of surgical treatment of pulmonary tuberculosis is to resect lesions or lobar in a small area without active foci in resectional surface in order to preserve lung function, improve the quality of life and prevent complications. Postoperative sputum conversion rate, complications, operative mortality, postoperative quality of life and other factors should be consi-dered for assessment of the therapeutic efficacy. The standard anti-TB drug treatment should be still provided after surgery.

The application values and status of modern medical imaging techniques in the diagnosis of pulmonary tuberculosis

WU Jian-lin^*,WANG Shuai

Journal of Tuberculosis and Lung Health. 2012, 1(1):  60-62. 

Abstract ( 243 )   PDF (701KB) ( 914 )   Save

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In view of epidemic situation and new features of pulmonary tuberculosis in China, modern medical imaging techniques play more important role in the clinical diagnosis and treatment of pulmonary tuberculosis. Though conventional chest X-ray film is still mainly the first choice, the multislice spiral CT (MSCT) plays an increasingly important role in the diagnosis, activity judgment and follow-up examination. In special situation, MRI and positron emission tomography (PET) CT could be used as the aiding method, which is valuable for the differential diagnosis between tuberculoma and other solitary pulmonary nodules.

Lung biopsy and pathological diagnosis for interstitial lung diseases

SUN Yong-chang

Journal of Tuberculosis and Lung Health. 2012, 1(1):  63-65. 

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The diagnosis of interstitial lung diseases (also known as diffuse parenchymal lung diseases) which often needs to be established by lung tissue biopsy, is a challenge for respiratory physicians. Different biopsy me-thods including transbronchial lung biopsy(TBLB), percutaneous lung biopsy, and video-assisted thoracoscopic lung biopsy(VATS), all have their specific indications based on patients’ clinical manifestations and radiological features. For diffusely distributed lesions, the minimally invasive TBLB may be considered as the first choice, followed by percutaneous lung biopsy or VATS if the tissue is not adequate to establish the diagnosis. It is noteworthy, for many interstitial lung diseases, a pathological result is not the final diagnosis. The establishment of the diagnosis requires a combination of clinical and radiological findings, the so-called clinical-radiological-pathological (CRP) diagnosis.

Hospital-associated latent Mycobacterium tuberculosis infection

HAN Chao-nan^*,XIAO He-ping

Journal of Tuberculosis and Lung Health. 2012, 1(1):  66-69. 

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Latent Mtb infection in hospitals is one of the hidden dangers of the epidemic of tuberculosis and affects health-care workers (HCWs) mainly. To assess the risk factors of Mtb infection among HCWs would be beneficial to provide potent supports for further policy making. This article reviewed the relevant domestic and international literature, reports and studies in recent years and indicated that the risk of Mtb infection in hospital is influenced by multiple factors, including epidemiology background, age, working place, occupation and hospital environment etc.

The research status of programmatic treatment and management of MDR-TB

CHEN Ming-ting,CHEN Cheng

Journal of Tuberculosis and Lung Health. 2012, 1(1):  70-73. 

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The epidemic of Multi-drug resistance Tuberculosis (MDR-TB) is very serious in China. Globally China is the largest country of MDR-TB. The control and prevention of MDR-TB admits of no delay. The author reviewed the measures of programmatic treatment and management of MDR-TB issued by World Health Organization and control measures of non-MDR-TB in China, and put forward their views and recommendations for strengthening the management of MDR-TB which are of great significance in guiding the MDR-TB control and prevention in the coming period of time.

Progress in the immune regulation of Mycobacterium tuberculosis infection and the development of vaccine against tuberculosis

LIU Hai-peng, GE Bao-xue

Journal of Tuberculosis and Lung Health. 2012, 1(1):  74-79. 

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Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Mtb) which is a big public health threat. The pathogen-related molecular patterns (PAMPs) of Mtb is recognized by pattern recognition receptors (PRRs) expressed on innate immune cells including macrophages and dendritic cells (DC) and induces the production of specific cytokines and activation of those cells. The activated macrophages and DC are not only able to directly phagocytose Mtb or Mtb infected cells, but also activate adaptive immune responses by releasing active mo-lecules and antigen presentation. However multiple immune evasion strategies have been developed during the co-evolution of Mtb and host immune systems, including inhibiting the production of cytokines, the fusion of phagosome with lysosome, autophagy of macrophages, apoptosis of immune cells as well as maturation and antigen presentation of dendritic cells, which ensure the persistent survival of Mtb in macrophages. Currently, BCG is the solely available TB vaccine however is not very effective. Novel and high effective vaccine development is impeded by the lack of understanding on the pathogenesis of TB. Although many progresses in the development of novel vaccine have been made and more than ten candidate vaccines have stepped into clinical stage, yet there is still a long way to go to fulfill clinical application. Novel vaccines are divided into recombinant BCG vaccine, subunit vaccine, live vector vaccine and attenuated Mtb vaccine according to immune strategies and improvement methods. There are several key problems to develop novel vaccines. Firstly, good antigens have to be obtained. Secondly, excellent adjuvant has to be acquired so as to enhance the protective effect of antigen. Thirdly, the processing and presentation of antigens should be ensured correctly and effectively. Fourthly, the immune memory of BCG vaccination should be enhanced. Fifthly, the toxicity of BCG vaccination should be reduced. Lastly, a simple and reliable vaccine evaluation platform should be set up.