Table of Content

30 December 2020, Volume 1 Issue 3

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Special Articles

The new era of systematic immunology of tuberculosis

ZHU Guo-feng, LIU Xiao-qing

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  195-212.  doi:10.3969/j.issn.2096-8493.2020.03.002

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With the breakthrough of key technologies, the achievements based on the gene knockout MTB mutant library and animal models of tuberculosis, enable the development of systematic immunology of tuberculosis (SIT). In this review, we described the data framework of SIT, and we also discussed how the SIT database will benefit the prosperity of novel vaccine and drug development against the tuberculosis disease.

Original Articles

Analysis of 23 cases of imported coronavirus disease 2019

HUANG Jin-bao, LAN Chang-qing, LYU Xiao, CHEN Lu-lu, WANG Xin-hang, CHEN Yu-rong, HUANG Ming-xiang

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  213-219.  doi:10.3969/j.issn.2096-8493.2020.03.003

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Objective To investigate the clinical characteristics of the imported patients with coronavirus disease 2019 (COVID-19). Methods The clinical data, including the epidemiologic features, clinical symptoms, laboratory examinations, imaging manifestations and treatment outcomes of the 23 imported patients with COVID-19 admitted to the designated hospital in Fuzhou of Fujian from March 1st, 2020 to May 31th, 2020 were retrospectively analyzed. Results The median age of the patients was 44 years with the age range of 7 to 69 years and 47.8% (11/23) of the patients were female. The median incubation period was 7 days. 43.5% (10/23) of the patients had underlying diseases and the most common ones were diabetes (13.0%, 3/23) and hypertension (13.0%, 3/23). The most common symptoms were fever (69.6%, 16/23), cough (52.2%, 12/23) and expectoration (39.1%, 9/23). 8.7% (2/23) of the patients had smell and taste impairments. The 23 cases consisted of 18 moderate patients and 5 severe patients without mild and critically patients. Among the 23 cases, leukopenia and lymphopenia occurred in 5 cases (21.7%) and 12 cases (52.2%), respectively. Elevated CRP and IL-6 were found in 7 (30.4%) and 11 (47.8%), respectively. T lymphocyte subsets were detected in 21 cases. CD3⁺ T lymphocytes decreased in 33.3% (7/21) of the patients, CD4⁺ T lymphocytes decreased in 38.1% (8/21) and CD8⁺ T lymphocytes in 33.3% (7/21), respectively. The median times from onset to positive results of serum novel coronavirus IgM and IgG antibodies were 7 days and 13 days, respectively. All the cases had abnormalities on chest CT, including patchy consolidation (52.2%, 12/23), ground glass opacity (65.2%, 15/23), nodular shadow (43.5%, 10/23) and fibrous stripe shadow (43.5%, 10/23), and pleural effusion (4.3%, 1/23) was extremely rare. All the patients received antiviral treatment, among whom one received glucocorticoid (methylprednisolone) therapy and 3 cases were treated with convalescent plasma of COVID-19 patients. All patients were discharged without death. Follow-up chest CT showed that most of the patients (82.6%, 19/23) had mild residual lung lesions which gradually improved with sustained absorption. Conclusion Imported patients with COVID-19 are relatively young and have a longer incubation period. Some patients may develop abnormalities of smell and taste. There is a delay in the emergence of novel coronavirus specific antibodies. The condition of patients is relatively mild, and the patients recovered well after timely diagnosis and treatment.

Analysis of characteristics of chest CT imaging and immune indexes in 84 COVID-19 patients

LIU Bo-fei, WANG Fang, LIU Bo-xia, MA Yu-jie, FENG Tao, XU Lin, ZHAO Gui-xia, HONG Yuan, LIU Guang-tian, ZHOU Pan, CAO Xiang-yuan

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  220-225.  doi:10.3969/j.issn.2096-8493.2020.03.004

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Objective To anlyze the characteristics of chest CT imaging and immune indexes in patients with COVID-19. Methods A total of 84 COVID-19 patients in Ningxia between January 24, 2020 and March 7, 2020 were retrospectively studied, including 75 confirmed cases (difinite epidemiological history, fever and/or typical chest CT images, and positive in nucleic acid test) and 9 clinically diagnosed cases (difinite epidemiological history or close contact, typical chest CT imaging, but negative in two nucleic acid tests). According to the dynamic CT imaging and results of immune indexes, the relationship between the changes of chest CT 72 hours after admission and the clinical classification and immune status of COVID-19 patients were analyzed. Results Within 24 hours of admission, the 84 patients were divided into mild (n=14), ordinary (n=59), and severe/critical types (n=11). By CT scan, the proportions of interstitial lesions in bilateral lung and diffuse lesions in bilateral lung in ordinary patients were significantly lower than those in severe/critical patients (1.7% (1/59) vs. 18.2% (2/11), χ²=6.144, P=0.013; 5.1% (3/59) vs. 27.3% (3/11), χ ²=5.824, P=0.016). The classification of 9 patients was progressing 72 hours after admission, therefore, numbers of mild, ordinary, and severe/critical types were changed to 10, 58 and 16, respectively. By CT scan, compared with those in patients of severe/critical type, few/occasional patchy lesions lesions and multiple lesions in bilateral lung in patients of ordinary type were significantly higher (20.7% (12/58) vs.0.0% (0/16), χ ²=3.951, P=0.047; 62.1% (36/58) vs. 18.8% (3/16), χ ²=9.441, P=0.002); while interstitial lesionsn and diffuse lesions in bilateral lung in patients of ordinary type were significantly lower (0.0% (0/58) vs. 31.2% (5/16), χ ²=19.438, P<0.001; 8.6% (5/58) vs. 50.0% (8/16), χ ²=14.828, P<0.001).The relevant immune tests were performed on 43 patients with deterioration (deterioration group) in CT and 41 patients without deterioration (non-deterioration group). It was found that, the WBC count (M(Q₁,Q₃)), T lymphocyte, CD3 ⁺, CD3⁺CD4⁺, CD3⁺CD8⁺, CD3⁺CD4⁺CD8⁺ and CD45⁺ cells in deterioration group were siginificantly lower than those in non-deterioration group (4.460 (3.560, 4.900)×10⁹/L vs. 5.130 (4.225, 7.050)×10 ⁹/L, 1.290 (0.900, 1.520)×10⁹/L vs. 1.600 (1.295,2.090)×10 ⁹/L, 496.000 (304.000, 802.000)/μl vs. 1001.000 (766.500, 1230.000)/μl, 325.000 (183.000,480.000)/μl vs. 590.000 (468.500, 765.000)/μl, 186.000 (99.000, 330.000)/μl vs. 380.000.(227.500, 535.000)/μl, 2.000 (1.000, 5.000)/μl vs. 10.000 (5.000, 18.000)/μl, 998.000 (500.000, 1198.000)/μl vs. 1530.000 (1064.000,1885.000)/μl; U=542.500, 503.500, 348.000, 348.000, 457.000, 261.000, and 359.000, respectively; P_WBC=0.002, and all of others P<0.001). Complement C3 in deterioration group was siginificantly higher than that in non-deterioration group (1.200 (1.000, 1.330) g/L vs. 1.060 (0.960, 1.225) g/L; U=118.500, P=0.034). Conclusion The deterioration of pulmonary lesions in patients with COVID-19 within 72 hours after admission may be related to the changes of immune status. Monitoring the changes of chest CT and immune indexes is of guiding significance for diagnosis and treatment.

Adult-onset mendelian susceptibility to mycobacterial disease: a case report and literature review

YANG Yang, LU Shui-hua

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  226-232.  doi:10.3969/j.issn.2096-8493.2020.03.005

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Objective To explore the characteristics of clinical and genetic deficiency, diagnosis, treatment and prognosis of adult-onset Mendelian susceptibility to mycobacterial disease (MSMD). Methods We retrospectively analyzed the clinical data, diagnosis, treatment and follow-up result of an adult-onset MSMD patient admitted to Shanghai Public Clinical Center on 20, July 2020, and then performed the literature review. “Mendelian susceptibility to mycobacterial disease” was used as the search term in PubMed and Google Scholar. The corresponding translated Chinese words of “Mendelian susceptibility to mycobacterial disease” and “Mendelian inheritance” and “mycobacterial disease” were used as search terms in China National Knowledge Infrastructure, Wanfang database and Weipu database to search Chinese literature. The publication date was set to be before October 2020. All of 459 English papers and 21 Chinese papers were found, and after deleting duplicate or irrelevant papers, a total of 6 papers related to adult-onset MSMD case reports were selected. All of them are in English, 9 patients were involved. Combined with the patient reported in this study, characteristics of clinical and genetic deficiency, diagnosis, treatment and prognosis of adult-onset MSMD were analyzed. Results A 27-year-old male initiated with “tuberculosis” at the age of 18 who then got improved after receiving standard treatment. During the next 9 years, he was diagnosed with “cellulitis”“rheumatoid arthritis”“non-tuberculosis infection” and some other diseases, having used more than 10 kinds of antibiotics, but still relapsed and progressed occasionally. Finally, he was diagnosed as “MSMD (TYK2 mutation), pulmonary non-tuberculous mycobacterial disease”. After treatment with intravenous gamma globulin, antibiotics and recombinant human interferon-γ (rhIFN-γ), his condition got improved significantly. As of October 2020, he was still receiving interferon-γ therapy. A total of 10 patients were included in the literature review: 6 males and 4 females; aged 18-47 years old; 4 had IFN-γR1 deficiency, 3 had IL-12Rβ1 deficiency, 2 had NEMO deficiency and 1 had TYK2 deficiency; 6 were infected with Mycobacterium avium, 1 with Mycobacterium tuberculosis, 1 with Mycobacterium asiaticum, 1 with Brucella Mycobacterium, 1 with Mycobacterium chelonae combined with Mycobacterium gordonae. Affected organs were mainly lymph nodes (7 cases), lungs (4 cases), skin (4 cases),bone (4 cases), etc. Conclusion Adult-onset MSMD presents with complex clinical manifestations and is difficult to diagnose. For mycobacterium infected patients with multi-lesions (such as lymph nodes, lungs, skin, bone, etc.) and long-lasting disease course, MSMD should be considered. The diagnosis should be made with genetic test without delay.

Exploration of medication rules of Chinese herb formulae for bronchiectasis based on modern literature and data mining

QIU Lei, YANG Ming, ZHANG Shao-yan, XUE Ling-na, TIAN Li-ming, LI Cui, WU Xian-wei, LU Zhen-hui, WU Ding-zhong

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  233-239.  doi:10.3969/j.issn.2096-8493.2020.03.006

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Objective To initially clarify the medication rules of Chinese herb formulae for bronchiectasis based on modern literature review and data mining. Methods The Chinese herb formulae for bronchiectasis published in CNKI, Wanfang and CQVIP, from establishment to July 31, 2020, with evidence for efficacy were collected. A total of 1056 references were retrieved, and of them, 110 eligible articles and 141 Chinese herb formulae were included. Frequency analysis, association rules and cluster analysis were used to analyze the data, to explore the potential medication rules for bronchiectasis. Results Using frequency analysis, it was found that 209 Chinese medicines were involved and 28 of them were used more than 15 times. By association rule analysis, 17 two-drug pairs and 15 three-drug pairs were found. By cluster analysis, 7 types of prescriptions or single drugs were found, and they focused on the functions of clearing lung heat, drying dampness, resolving phlegm, regulating qi, and replenishing qi, mainly for the syndrome of phlegm heat that obstruct the lung, the syndrome of the phlegm-dampness retention in the lung, and the syndrome of qi deficiency of both lung and spleen. Conclusion This study preliminarily determined the core framework of medication rules of Chinese herb formulae for bronchiectasis including core drugs, core types of herb, two-drug or three-drug drug pairs and core Chinese herb formula, which provides a beneficial exploration for revealing the general medication rules of chronic lung diseases such as bronchiectasis.

Application evaluation of three methods for identification between Mycobacterium tuberculosis complex and non-tuberculous mycobacteria

YI Jun-li, YANG Xin-yu, ZHANG Jie, TIAN Li-li, DING Bei-chuan, WU Wen-qing

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  240-244.  doi:10.3969/j.issn.2096-8493.2020.03.007

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Objective To evaluate the application of PNB/TCH growth test, Mycobacterium tuberculosis antigen (MPB64) detection and PCR-fluorescent probe method in identification of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM). Methods A total of 11 standard strains including MTB H37Rv and 10 NTM standard strains were all from the National Tuberculosis Reference Laboratory. And 238 clinical isolates were frozen positive strains cultured from outpatients of Beijing Research Institute for Tuberculosis Control from January to December 2019, all of them were positive in acid fast smear staining. Eleven standard strains and 238 clinical isolates were identified by PNB/TCH growth test, MPB64 detection, PCR-fluorescent probe method and gene chip technology. Based on the identification results of microarray gene chip method, the efficiency of PNB/TCH growth test, MPB64 detection method and PCR-fluorescent probe method to identify MTBC and NTM was evaluated. Results Compared to strain identification with gene chip technology, the sensitivities of PNB/TCH growth test, MPB64 detection and PCR-fluorescent probe method were 100.0% (206/206), 98.5% (203/206) and 100.0% (206/206), respectively; the specificities were 96.9% (31/32), 100.0% (32/32), 100.0% (32/32). The coincidence rates were 99.6% (237/238), 98.7% (235/238) and 100.0% (238/238), respectively; the Kappa values were 0.98, 0.95 and 1.00, respectively. The detection times of PNB/TCH growth test, MPB64 detection method and PCR-fluorescent probe method were 28 days, half an hour, and half of the day, respectively; the average detection costs were RMB 20 yuan, 40 yuan and 60 yuan. Both PNB/TCH growth test method and MPB64 detection method need cultures, while PCR-fluorescent probe method requires laboratories and operators with professional ability of nucleic acid detection. Conclusion PNB/TCH growth test, MPB64 detection and PCR-fluorescent probe method could be used to identify MTBC and NTM. PCR-fluorescent probe method has high sensitivity and specificity, and the detection results are more accurate and reliable. MPB64 detection is simple, rapid and with low cost, it is suitable for the preliminary identification in primary laboratories.

Diagnostic value of melting curve method in detecting resistance of Mycobacterium tuberculosis to rifampicin and isoniazid

SU Bi-yi, ZHOU De-wang, MA Pin-yun, GUAN Ping, TAN Yao-ju

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  245-248.  doi:10.3969/j.issn.2096-8493.2020.03.008

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Objective To evaluate the efficacy of fluorescence PCR probe melting curve technique (hereinafter referred to as melting curve technique) in detecting for the resistance of Mycobacterium tuberculosis to rifampicin and isoniazid. Methods Sputum specimens of 832 smear-positive pulmonary tuberculosis patients were cultured in liquid, and the results showed that specimens of 35 cases were contaminated, 52 were culture negative, and 745 were positive. Seven hundred and forty-five positive cultures were then tested with gene chip which found 7 cases of mixed infection, 60 cases of non-mycobacterium tuberculosis, and 678 cases of Mycobacterium tuberculosis complex. The BACTEC MGIT 960 (“MGIT 960”) liquid drug sensitivity test and melting curve method were then performed on specimens of those 678 cases to detect drug resistance of rifampicin and isoniazid. The results of the melting curve method in rifampicin detection were invalid (impossible to tell whether it’s resistant) in 31 cases and isoniazid in 34 cases,for the remaining 639 cases valid results were reported for both rifampicin and isoniazid. Taking MGIT 960 liquid drug sensitivity test method as the golden standard to analyze the performance of melting curve method. Results The rate of concordance, sensitivity, specificity, positive predictive value and negative predictive value to rifampicin detection were 96.2% (615/639), 93.3% (126/135), 97.0% (489/504), 89.4% (126/141) and 98.2% (489/498) respectively. The Kappa value was 0.89. The rate of concordance, sensitivity, specificity, positive predictive value and negative predictive value to isoniazid detection were 93.6% (598/639), 83.1% (157/189), 98.0% (441/450), 94.6% (157/166) and 93.2% (441/473) respectively. The Kappa value was 0.84. Conclusion The melting curve method has high sensitivity and good specificity for detecting rifampicin and isoniazid resistance, thus is of great value for early diagnosis of drug-resistant tuberculosis.

Analysis of epidemiological characteristics of pulmonary tuberculosis in Fujian Province from 2011 to 2019

DAI Zhi-song, LIN Shu-fang, WEI Shu-zhen, ZHOU Yin-fa

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  249-255.  doi:10.3969/j.issn.2096-8493.2020.03.009

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Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Fujian Province from 2011 to 2019, providing basis for tuberculosis prevention and control strategy. Methods The data of reported PTB cards and resident population in Fujian Province from 2011 to 2019 were collected and analyzed based on “China Disease Prevention and Control Information System”. Reported incidence was calculated, and information such as demographic characteristics and diagnostic classification of the report cards were combined to analyzed the epidemiological characteristics of PTB using the SPSS 18.0. Results A total of 172003 PTB cases were reported in Fujian Province from 2011 to 2019 with an average annual reported incidence of 50.14/10⁵ (172003/343024397), and sputum smear positive patients were 47.04% (80907/172003). The reported incidences of active PTB declined from 57.65/10⁵ (21268/36894320) in 2011 to 45.82/10⁵ (18058/39410119) in 2019, and the reported incidences of patients with positive pathogen declined from 28.49/10⁵ (10 511/36894320) to 21.92/10⁵ (8637/39410119), differences of the trend changs were both statistically significant ($X^{2}_{trend}$=765.216, 901.777; both P<0.001). From 2011 to 2019, the peak of reported cases was all in January, accounting for 9.41% (16184/172003) of all. Among the reported PTB cases, male: female≈2.77∶1 (126427∶45576). The reported incidence of male and female decreased from 82.29/10⁵ (15619/18981102) and 31.54/10⁵ (5649/17913218) in 2011 to 65.56/10⁵ (13217/20161296) and 25.15/10⁵ (4841/19248823) in 2019.Differences of the trend changes were both statistically significant ($X^{2}_{trend}$=516.143, 211.541, both P<0.001). In all reported PTB cases, 45- years old group accounted for the highest proportion (18.95% (32599/172003)), and 0- year old group was the lowest (0.43% (740/172003)) every year. The reported incidence of 0- and 75- year old groups presented the increasing trend from 2011 to 2019 (the annual increase rate was 2.92% and 0.14%), while the other age groups showed negative growth. Farmer was the occupation with the highest proportion of all patients (48.48% (83390/172003)). Conclusion The reported incidence of active PTB was decreasing from 2011 to 2019. Groups of the infant, the elder, the male, and the farmer should be paid more attention in the prevention and control of tuberculosis.

Comparision of the work quality before and after reformation of tuberculosis control and prevention service system in Hu’nan Province

LI Yan-hong, TAO Xue-yong, XIE Ying, WANG Qiao-zhi, CHENG Ling-zhi, TANG Yi, XU Zu-hui, LIU Li-qin, TANG Xi-liang

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  256-261.  doi:10.3969/j.issn.2096-8493.2020.03.010

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Objective To provide reference for improving the construction of new type of tuberculosis (TB) control and prevention service system by comparing the working quality before and after reformation in Hunan Province. Methods A total of 131 counties/districts in 14 cities/states of Hu’nan Province before and after reformation were selected, 15 indexes such as the registration rate of tuberculosis, clinic visit rate due to symptoms and so on were collected from “China Information System for Disease Control and Prevention” to describe and compare case detection, referral and diagnosis, laboratory examination, treatment and management of TB patients in Hunan Province before (2014-2016), during (2017-2018) and after (2019) reformation. Chi-square test was used to analyze the differences before and after reformation by SPSS 17.0, P<0.05 was considered statistically significant. Results Before reformation, the rate of smear-positive PTB patients in active PTB patients, clinic visit rate due to symptoms, pathogenic positive rate, the drug resistance screening rate in high-risk population, exclusion rate of suspected patients after confirming, treatment enrolled rate of rifampicin-resistant patients were 38.47% (62759/163147), 38.44% (62782/163330), 39.00% (62759/160938), 40.95% (3919/9570), 54.47% (97246/178526) and 55.96% (906/1619), respectively. And those indexes were 45.33% (24680/54449), 22.21% (12114/54543), 46.44% (24680/53144), 78.45% (2341/2984), 44.63% (31161/69813), 64.55% (477/739), respectively after reformation. The work quality of those indexes were significantly improved after reformation (χ²=524.584, P=0.000; χ²=3395.102, P=0.000; χ²=604.545, P=0.000; χ²=897.304, P=0.000; χ²=1123.304, P=0.000; χ²=9.739, P=0.002). Before reformation, the registration rate of tuberculosis,rate of sputum test in initial patients, rate of non-sputum test in active PTB patients at the end of 2 or 3 months, cure rate of new smear-positive TB patients, sputum negative conversion rate after 2- or 3-month treatment in smear-positive PTB patients were 80.84/100000 (163330/202032200), 94.74% (536808/566601), 1.64% (1033/62805), 92.35% (58511/63357) and 98.11% (61620/62805), respectively; and those indexes were 79.06/100000 (54543/68987700), 92.60%(161429/174329), 4.36% (863/19776), 87.17% (15519/17803) and 95.16% (18819/19776), respectively after reformation. The working quality of those indexes were significantly declined after reformation (χ²=7.718, P=0.005; χ²=75.790, P=0.000; χ²=26.658, P=0.000; χ²=287.790, P=0.000; χ²=59.985, P=0.000). Conclusion Part of the working quality has been steadily improved after reformation, however, we should pay attention to those declined indexes, such as the registration rate of tuberculosis, the rate of sputum examination in initial patients and so on.

Analysis of epidemiological characteristics of pulmonary tuberculosis in Ji’nan from 2010 to 2019

WANG Mei-hua, ZHANG Wen-qian, JING Rui, ZHANG Guang-li

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  262-264.  doi:10.3969/j.issn.2096-8493.2020.03.011

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Objective To analyze the epidemiological characteristics of the pulmonary tuberculosis in Ji’nan from 2010 to 2019, providing data basis for epidemic prevention and control. Methods The data of pulmonary tuberculosis patients in Ji’nan from 2010 to 2019 were selected from “China Information System for Disease Control and Prevention Infectious Disease Surveillance System”. The annual demographic data of Ji’nan were collected from the “Ji’nan Statistical Yearbook”. Descriptive epidemiological methods were used to analyze the data of the pulmonary tuberculosis surveillance report in Ji’nan from 2010 to 2019, and the main characteristics of the incidence were also summarized. Results From 2010 to 2019, 25495 cases of pulmonary tuberculosis were reported in Ji’nan, with an average annual reported incidence of 36.41/10⁵. The reported incidence decreased from 48.96/10⁵ (3024/6176000) in 2010 to 31.90/10⁵ (2380/7460400) in 2019, showing a downward trend year by year ($X^{2}_{trend}$=371.225, P<0.01). The average annual reported incidences of Tianqiao District (42.97/10⁵, 3001/6984000), Shanghe District (41.65/10⁵, 2489/5976600) and Lixia District (39.74/10⁵, 2959/7445500) were the top three; the number of reported pulmonary tuberculosis cases in Licheng District (4402, 17.27%) was the most in Ji’nan. The annual reported incidence rate of the male was significantly higher than that of the female (47.25/10⁵ (16747/35446400) vs. 25.30/10⁵ (8748/34578200), χ²=2316.435, P<0.01). The male cases mainly aged 15-25 years old (17.22%, 2884/16747) and the 55-65 years old (18.12%, 3034/16747),and of the female cases, 25-35 years old (21.96%, 1921/8748) was the most common age of onset. As to occupation distribution, the farmer was the most (10800, 42.36%), followed by the housework and unemployment (4417, 17.32%), retired personnel (2607, 10.23%), students (2218, 8.70%) and the worker (2114, 8.29%). Conclusion The incidence of pulmonary tuberculosis in Ji’nan showed a downward trend from 2010 to 2019. The pulmonary tuberculosis prevention and control should be enhanced in young adults, farmers and students.

Analysis of the effect of extended nursing service by QQ group on health education for tuberculosis patients

AN Hong-xia, YANG Feng-qin, LU Chuan, MA Xiu-xia

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  265-269.  doi:10.3969/j.issn.2096-8493.2020.03.012

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Objective To analyze the effect of health education and extended nursing services for tuberculosis patients using internet QQ platform. Methods From July 2017 to December 2018, 422 tuberculosis patients diagnosed and discharged from the Xinjiang Uygur Autonomous Region Chest Hospital (change to the Eighth Affiliated Hospital of Xinjiang Medical University) were selected as the research subjects. Those who aged <15 years or >65 years; with consciousness disorders, mental illnesses or cognitive dysfunction; without normal reading or writing skills; cannot receive publicity, education or consultations on the internet QQ platform were excluded. Based on the principle of voluntary participation and enrollment of patients, 422 cases were divided into the telephone follow-up group (control group, regular telephone follow-up for health education and extended services, n=211) and internet QQ platform+telephone follow-up group (observation group, the health education and extended services were carried out by internet QQ platform implements and telephone). Improvements after intervention, 3-month after discharge of the two groups, including medication compliance (using the Morisky scale), satisfaction with consultation services, dietary guidance, adherence to medication, rehabilitation exercise, supervision and follow-up consultation, social support, and local follow-up consultation during treatment outcome guidance were analyzed. Results The patients with good medication compliance in the observation group were significantly higher than those in the control group (63.51% (134/211) vs. 46.92% (99/211), χ²=16.060, P=0.000). In the observation group, improvements during the disease treatment, including diet guidance, persistent on taking medication, rehabilitation exercise, actively participate in society activities or continued work to communicate with others, guide to local follow-up consultation results were all significantly higher than those in the control group (91.47% (193/211) vs. 65.88% (139/211), χ²=42.401; 80.09% (169/211) vs. 63.03% (133/211), χ²=16.884; 77.25% (163/211) vs. 54.03% (114/211), χ²=26.664; 79.62% (168/211) vs. 61.14% (129/211), χ²=17.390; 70.62% (149/211) vs. 54.98% (116/211), χ²=11.134, respectively; all P=0.000). The proportion of patients who were very satisfied with extended care services in the observation group was significantly higher than that in the control group (96.68% (204/211) vs. 84.36% (178/211), χ²=18.897, P=0.000). Conclusion The extended nursing services by internet QQ platform could help patients and their families to grasp the knowledge of tuberculosis prevention and treatment, as well as improve the compliance with treatment and satisfaction with consulting services.

Analysis of situation and influencing factors of patient delay in tuberculosis in tuberculosis patients from Heilongjiang in 2004

SUN Ming-lei, WU Qun-hong, GUAN Li, ZHAO Juan, WANG Chen, ZOU Dan-dan, LIANG Li-bo

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  270-275.  doi:10.3969/j.issn.2096-8493.2020.03.013

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Objective To explore tuberculosis patient delay and influencing factors. Methods From January to December, 2004, a stratified cluster sampling method was used to determine 30 survey sites in 113 tuberculosis control units in Heilongjiang Province. In each survey site, the survey of 56 newly treated smear-positive pulmonary tuberculosis patients and retreated smear-positive pulmonary tuberculosis patients during this period should be finished, and finally 1989 cases were included. The basic and clinical information, as well as medical record of the cases were collected to analyze patient delay and influencing factors. Results Among the 1989 cases, the delay time (median (quartile)) was 35 (15, 88) d; 836 cases (42.0%) had a delay of ≤30 d, and 1153 (58.0%) cases had a delay of more than 30 d. In the group with a delay of ≤30 d, proportions of the employed and cases who chose tuberculosis prevention and treatment unit for the first visit were significantly higher than that in the group with a delay of more than 30 d (52.0% (435/836) vs. 50.2% (579/1153, χ²=10.325, P=0.006) (31.6% (100/316) vs. 20.6% (58/281), χ²=9.551, P=0.023). However, proportion of patients whose first symptom was fatigue in the group with a delay of ≤30 d was significantly lower than that in the group with a delay of more than 30 days (44.2% (369/834) vs. 50.1% (577/1151), χ²=6.716, P=0.010). Multivariate logistic regression analysis showed that compared with non-employed persons, the patient delay of the employed was shorter (OR (95%CI)=0.600 (0.007-0.505)); those who with fatigue as the first symptom had more delay than those who without fatigue (OR (95%CI)=1.778 (1.263-2.503)); compared to those who chose a general hospital for the first visit, cases who chose a tuberculosis prevention and treatment center for the first visit was had shorter visit delay (OR (95%CI)=0.611 (0.396-0.942)). Conclusion The patient delay of tuberculosis patients in Heilongjiang was obvious. It was more likely to happen ine non-employed, patients whose first symptom was fatigue, and patients who chose general hospitals for the first visit.

Review Articles

Research progress on the mechanism of latent tuberculosis infection progressing to active tuberculosis

MA Hui-min, ZHANG Li-fan, LIU Xiao-qing

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  276-280.  doi:10.3969/j.issn.2096-8493.2020.03.014

Abstract ( 655 )   HTML ( 11 )   PDF (868KB) ( 986 )   Save

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Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens with no evidence of clinically manifest active tuberculosis. Up to one third of the world’s population is estimated to be infected with Mycobacterium tuberculosis, and 5%-10% of those infected people will develop active tuberculosis disease sometime during their lives. Therefore, it is of great significance for tuberculosis prevention and control to study the mechanism of LTBI progressing to active tuberculosis. We reviewed this hot issue from the aspects of Mycobacterium tuberculosis infection process, immunological changes during LTBI progressing to active tuberculosis and the risk factors that induce LTBI reactivation, etc.

Progress on changes of micronutrients and nutritional therapy of active pulmonary tuberculosis

WANG Le-le, YANG Song, TANG Shen-jie

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  281-284.  doi:10.3969/j.issn.2096-8493.2020.03.015

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Patients with active pulmonary tuberculosis (PTB) exist protein-energy malnutrition, essential microelements and vitamins deficiency, and all of them are high risk factors of pathogenesis and progression of disease. There is an obvious two-way causal relationship between malnutrition and active PTB. But the proper attention is not yet paid to nutritional problems of tuberculosis, especially for deficiency of microelements and vitamins. Having referred to a lot of documents, the authors have done a deep review about the type, characteristics, the damage of malnutrition, and the benefits of nutrient supplement to the active PTB patients, in order to improve the level of awareness in clinical treatment of clinicians.

Research progress on correlation between bronchial asthma and psychological disorders

Rena·Abulaiti, Kelibiena·Tuerxun, Dilinuer·Wufuer

Journal of Tuberculosis and Lung Disease. 2020, 1(3):  285-288.  doi:10.3969/j.issn.2096-8493.2020.03.016

Abstract ( 471 )   HTML ( 6 )   PDF (850KB) ( 870 )   Save

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Bronchial asthma is a chronic airway inflammatory respiratory disease with great impact globally. The incidence rate is increasing year by year, causing more and more attention in the medical field. With the transformation of medical models, bronchial asthma is considered to be a chronic non-communicable disease caused by a combination of genetic factors, biological factors, psychological factors and social factors. Research on the role of psychological factors in the occurrence and development of bronchial asthma has progressed rapidly. This article briefly discusses the correlation between bronchial asthma and psychological disorders.