Table of Content

30 September 2021, Volume 2 Issue 3

Previous Issue    Next Issue

Guideline·Standard·Consensus

Expert consensus on diagnosis and prevention of inactive pulmonary tuberculosis

Chinese Antituberculosis Association

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  197-201.  doi:10.3969/j.issn.2096-8493.20210085

Abstract ( 611 )   HTML ( 32 )   PDF (1046KB) ( 641 )   Save

Figures and Tables | References | Related Articles | Metrics

With the development of global tuberculosis prevention and control strategy, continuous and in-depth research on screening and prevention of high-risk groups, and inactive pulmonary tuberculosis is as a high-risk group, more and more attention has been paid by the international community. However, diagnosis procedures and requirements of inactive tuberculosis is not clear, research on the development of inactive tuberculosis into active tuberculosis are insufficient, and no intervention measures on inactive tuberculosis have been taken into the high-risk population of tuberculosis in China.To strengthen the understanding to inactive pulmonary tuberculosis, standard the diagnostic method of inactive tuberculosis, formulate the prevention and cure measure of inactive tuberculosis to develop active tuberculosis. Thus, Chinese Antituberculosis Association organized experts in tuberculosis control, clinical, imaging and research fields to write the China’s Expert consensus on diagnosis of inactive pulmonary tuberculosis. This consensus puts forward the definition and diagnosis evidence of inactive tuberculosis, analyzes the risk of the occurrence of inactive tuberculosis, and puts forward the measures to prevent the occurrence of inactive tuberculosis, which provides reference for improving the prevention strategy and vaccine research of the high-risk population of tuberculosis in China.

Expert Note

Four-wheel-driven accelerated prevention and control of chronic pulmonary diseases in the post-epidemic era

WU Jing

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  202-204.  doi:10.3969/j.issn.2096-8493.20210058

Abstract ( 302 )   HTML ( 9 )   PDF (957KB) ( 182 )   Save

References | Related Articles | Metrics

Chronic pulmonary diseases are characterized by high prevalence, high disability rate, high fatality rate and high disease burden, and the population awareness rate is low, especially the lung function detection rate is lower. But with the impact of COVID-19, the comprehensive prevention and control of chronic pulmonary diseases must be accelerated in the post-epidemic era. We have the confidence to fulfill the tasks in the post-epidemic era by giving full play to the powerful power brought by the four-wheel drive of law engine, policy engine, planning engine and practice engine. At the same time, the combination of prevention and treatment, and the collaboration between medical and prevention is an effective way to solve the operational problems in the prevention and control of chronic respiratory diseases.

Original Articles

Diagnostic value of bronchoscopic cryobiopsy for diagnosing peripheral lung nodule

ZHANG Qun-cheng, LI Xiang-nan, XU Zhi-wei, SUN Guan-nan, YANG Hui-zhen, CHENG Dong-jun, ZHANG Xiao-ju

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  205-209.  doi:10.3969/j.issn.2096-8493.20210038

Abstract ( 613 )   HTML ( 12 )   PDF (1603KB) ( 180 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the diagnostic value of ultrasound-guided bronchoscopic cryobiopsy in diagnosing peripheral lung nodule. Methods From January 2019 to January 2021, 97 patients whose chest CT test showed lung nodules (8 mm < nodule diameter ≤30 mm) and then took electric bronchoscope were enrolled in He’nan Provincial People’s Hospital. Random number table method was used to allocate them into cryobiopsy group (TBCB group; 47 patients) and conventional forceps biopsy group (TBLB group; 50 patients). The difference of diagnosis rate, operation time, tissue sample satisfaction and complication occurrence between the two methods were observed. Results Diagnostic rate of TBCB group was 87.2% (41/47), significantly higher than the TBLB group (70.0%, 35/50; χ ²=4.240, P=0.039). Average total operating time of TBCB group was (32.5±11.2) min, no significant difference was observed compared with TBLB group ((34.2±10.3) min, t=0.938, P=0.351). Tissue sample satisfaction rate of TBCB group was 87.2% (41/47), significantly higher than the TBLB group (56.0%, 28/50; χ ²=11.510, P<0.001). All patients were able to tolerate bronchoscopy, no serious adverse reactions such as chest tightness, chest pain occurred. Thirteen (27.7%, 13/47) patients in the TBCB group had a mild to moderate amount of bleeding, while the TBLB group had 5 (10.0%, 5/50) patients experienced this. All of them stopped bleeding after receiving balloon occlusion, suction or local medication. The incidence of bleeding in TBCB group was significantly higher than the TBLB group (χ ²=4.999, P=0.025). Conclusion Cryobiopsy could be used to improve the positive rate of peripheral nodule diagnosis. The most common complication caused by cryobiopsy was bleeding, it should be performed with a preset balloon or using rigid bronchoscope sheath.

Rare angiosarcoma of thoracic soft tissue: a case report and literature review

LIU Xin, WU Qian-hong, CHEN Qi-liang, LI Jun-xiao, XU Jun-li, GUO Le

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  210-215.  doi:10.3969/j.issn.2096-8493.20210057

Abstract ( 456 )   HTML ( 12 )   PDF (1698KB) ( 206 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To review the clinical manifestations, pathological morphology, imaging findings, treatment and prognosis of thoracic soft tissue angiosarcoma. Methods The clinical data, diagnosis, treatment and follow-up of a patients with pleural soft tissue angiosarcoma admitted to Shaanxi Tuberculosis Control Hospital on May 8, 2020 were retrospectively analyzed with review of literatures. Taking “angiosarcoma” as the search term, the Chinese literature was searched through the CNKI and Wanfang, and “lung angiosarcoma” and “hemangiosarcoma” as the search terms, 56 domestic and 21 foreign related literatures were retrieved through the PubMed. Fifteen patients with complete data in 12 case reports were selected and summarized. The clinical characteristics, diagnosis and treatment of them were analyzed with the reported case. Results The patient was 34 years old, male, and the main symptom was “hemoptysis for 1 month”. The hemostatic effect was poor after interventional embolization on May 9 and 14, 2020. On June 12, 2020, the left thoracic focus was removed and the left lower lobe of lung was resected, the thoracic cavity continued to bleed after operation. On June 24, 2020, the thoracic exploration, hemostasis and pleural biopsy were performed. There was still a lot of bleeding in the thoracic cavity after operation. On February 1, 2021, thoracotomy exploration and thoracoplasty were performed. After operation, immunohistochemistry platelet-endothelial cell adhesion molecule, artificial hematopoietic progenitor cell antigen, vimentin, cell proliferation marker index-67 and ETS-related genes were positive, and the patient was diagnosed as Angiosarcoma and transferred to tumor hospital for blood transfusion. Half a month later, the patient died. Of the 16 patients (including 15 obtained from the literature), 10 were male and 6 were female, and the average age was 54 years. Clinical symptoms: hemoptysis in 8 cases, chest tightness and shortness of breath in 6 cases, cough in 7 cases and chest pain in 4 cases; 1 case was complicated with pulmonary tuberculosis and tuberculous empyema, 1 case was complicated with lung cancer. Of the 7 unilateral pulmonary cases: 3 in left lung and 4 in right lung.Bilateral lung lesions were found in 9 cases, platelet-endothelial cell adhesion molecule was positive in 16 cases, artificial hematopoietic progenitor cell antigen was positive in 9 cases, vimentin was positive in 4 cases, cell proliferation marker index-67 was positive in 3 cases, plasma coagulation factor Ⅷ was positive in 7 cases, ETS related gene was positive in 2 cases and Fried leukemia virus insertion site 1 was positive in 2 cases. All the 16 patients were confirmed by pathological examination, 3 were puncture biopsy and 13 were thoracoscopic biopsy; 10 cases received surgical treatment, 3 cases received chemotherapy, 2 cases received surgery+chemotherapy, and 1 case gave up treatment; 13 cases died and 3 cases were lost in follow-up. The average survival time was (7.2±2.1) months. Conclusion Thoracic soft tissue angiosarcoma is a very rare malignant tumor from soft tissue with poor prognosis. The treatment methods include surgery, radiotherapy and chemotherapy, and molecular targeted therapy.

Analysis of characteristics and diagnosis delay of 629 elderly tuberculosis patients

XU Jing, LUO Ping, HE Xiao-xin

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  216-222.  doi:10.3969/j.issn.2096-8493.20210068

Abstract ( 425 )   HTML ( 16 )   PDF (945KB) ( 155 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the characteristics of elderly patients with tuberculosis (TB) admitted to a municipal-level designated medical institution in Beijing, and to provide basis for TB prevention and control in elderly population of Beijing. Methods We descriptively analyzed data of 629 elderly TB patients (≥60 years old) admitted to Beijing Research Institute for Tuberculosis Control from 2011 to 2020,and compared them with the data of 2275 non-elderly patients of the same period. Results From 2011 to 2020, the elderly TB patients registered in Beijing Research Institute for Tuberculosis Control accounted for 21.66% (629/2904) of all TB patients in the same period. In recent 10 years, the proportion of elderly patients increased year by year (13.78% (43/312), 19.24% (71/369), 15.50% (53/342), 18.33% (66/360), 21.57% (55/255), 21.27% (57/268), 14.29% (30/210), 28.77% (84/292), 34.22% (90/263), 34.33% (80/233),Z_trend=5.046,P<0.001).There were 392 males and 237 females, and the ratio of male to female was 1.65∶1. 60-64 age group was the main age group, which was 24.01% (151/629) of all elderly patients. Primary patients accounted for 80.29% (505/629) and retreatment patients accounted for 19.71% (124/629);The proportion of retreatment among elderly patients was significantly higher than that of non-elderly patients (8.09%, 184/2275,χ²=70.247,P<0.001).The etiologically positive rate and smear positive rate of elderly patients were 50.87% (320/629) and 42.45% (267/629), respectively, which were significantly higher than those of non-elderly patients (30.07% (684/2275) and 25.41% (578/2275),χ²=94.324,P<0.001; χ²=69.366,P<0.001).The patient delay rate of elderly patients (61.69%, 388/629) was significantly higher than that of non-elderly patients (45.19%, 1028/2275; χ²=53.684,P<0.001). The diagnosis delay rate of elderly patients was 33.55% (211/629), no significant difference was found compared with that of non-elderly patients (29.89%, 680/2275; χ²=3.096, P=0.079).The median time from disease onset to medical visit for elderly patients (27 (5,68) d) was significantly higher than that for non-elderly patients (11 (1,38) d, U=-7.563,P<0.001). The median time from medical visit to TB diagnosis was 6 (0,28) d, no significant difference was found compared with non-elderly patients in the same period (7 (1,18) d, U=-0.799, P=0.425). Conclusion Compared with non-elderly patients, elderly pulmonary TB patients were characterized with high etiologically positive rate, high smear positive rate, high retreatment rate, high patient delay rate, long time of patient delay. We should strengthen active detection of elderly TB patients, especially by organizing regular health examinations and further reducing the detection and diagnosis delay.

Clinical characteristics and drug resistance of 84 patients with non-tuberculous mycobacterium pulmonary disease

WANG Yi, LU Jing, LI Su-mei, ZHU Xue-feng, ZENG Ling-wu

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  223-227.  doi:10.3969/j.issn.2096-8493.20210054

Abstract ( 480 )   HTML ( 11 )   PDF (784KB) ( 191 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the clinical characteristics, strain distribution and drug resistance to common anti-tuberculosis drugs in patients with non-tuberculous mycobacteria (NTM) lung disease. Methods The clinical data of 84 patients with NTM lung disease (NTM group) and 84 patients with pulmonary tuberculosis (pulmonary tuberculosis group) diagnosed in Suzhou Fifth People’s Hospital from January 2016 to January 2021 were collected by retrospective analysis according to the inclusion criteria, and the differences between the two groups in previous medical history, clinical symptoms and imaging manifestations at the initial stage of admission were analyzed. The identification results of NTM isolates and the drug resistance of each strain to isoniazid, streptomycin, p-aminosalicylic acid, amikacin, levofloxacin, rifampicin, ethambutol and isonicotinamide were recorded. Results The patients in NTM group had chronic respiratory diseases (22.6% (19/84)), fever (27.4% (23/84)), cough (95.2% (80/84)), hemoptysis (29.8% (25/84)), chest tightness (40.5% (34/84)), with pulmonary cavity (38.1% (32/84)) and bronchiectasis (45.2% (38/84)) and negative γ-interferon release test (77.4% (65/84)) were significantly higher than those of tuberculosis group (2.4% (2/84), 3.6% (3/84), 57.1% (48/84), 9.5% (8/84), 15.5% (13/84), 21.4% (18/84), 7.1% (6/84), 2.4% (2/84)), the differences were statistically significant (χ²=15.728,P<0.001;χ²=18.202,P<0.001;χ²=38.403,P<0.001;χ²=10.898,P=0.001;χ²=13.028,P<0.001;χ²=5.581,P=0.018;χ²=31.531,P<0.001;χ²=98.536,P<0.001).The top three strains of 84 NTM isolates were Mycobacterium intracellular (58 strains, 69.0%), Mycobacterium Kansas (15 strains, 17.9%) and M.chelonicus/abscess (6 strains, 7.1%). According to the results of drug sensitivity test, in this study, the resistance rates of 84 patients with NTM to 8 anti-tuberculosis drugs were INH (84 strains, 100.0%)>Sm (83 strains, 98.8%)>PAS (82 strains, 97.6%)>Am(77 strains, 91.7%)>Lfx=RFP (69 strains, 82.1%)>EMB (22 strains, 26.2%)>Pto (13 strains, 15.5%). Conclusion NTM-PD is common in elderly patients with respiratory diseases, negative γ-interferon release test can distinguish NTM lung disease from pulmonary tuberculosis early and timely. It has a high resistance rate to commonly used anti-tuberculosis drugs and is accompanied by great treatment difficulty. Early diagnosis and active drug sensitivity testing are of great importance.

Investigation of cognition and diagnosis and treatment on chronic obstructive pulmonary disease of physicians in Yanqing District Primary Hospital of Beijing

YUAN Feng, WU Guo-xia, WU Rui, SHI Chang-qing, LI Ya-li, YAN Wen-min, WU Na, SU Yu-hao, ZHAO Jing-nan, WANG Hong-shuo, YOU Sen, WANG Ying

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  228-233.  doi:10.3969/j.issn.2096-8493.20210053

Abstract ( 339 )   HTML ( 9 )   PDF (738KB) ( 488 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To evaluate the cognition and diagnosis and treatment on chronic obstructive pulmonary disease of physicians in Yanqing District Primary Hospital of Beijing in order to provide direction and basis for further improving the ability of diagnosis and treatment of COPD in primary hospitals. Methods The questionnaire was designed according to the relevant problems in the diagnosis and treatment of COPD, including doctors’ risk factors for COPD, comprehensive evaluation, education and management, initial treatment scheme recommendation, follow-up, oxygen therapy strategy, family noninvasive ventilation strategy, and understanding and application of the guidelines. After joint demonstration by experts, the final draft was formed by using the questionnaire star technology platform, then an anonymous questionnaire survey was conducted among 160 in-service physicians in 10 community hospitals in Yanqing District. A total of 160 questionnaires were collected, and the response rate was 100.0%. After removing 4 unqualified questionnaires, 156 valid questionnaires (97.5%). The results of 156 questionnaires were summarized and analyzed. Results The survey showed that most physicians in grass-roots hospitals (82.7%, 129/156) were familiar with the risk factors of COPD, but only a few (22.4%, 35/156) could correctly conduct comprehensive evaluation, and only 23.7% (37/156) could give a reasonable initial treatment plan according to the guidelines; Most (96.2%, 150/156; 76.9% (120/156) doctors did not pay much attention to the follow-up, education and management of COPD patients, and only 3.8% (6/156) doctors followed the guidelines strictly; Most doctors in primary hospitals (76.9%, 120/156) were familiar with oxygen therapy strategy, but only 23.7% (37/156) were familiar with the application of noninvasive ventilator. The survey data also showed that the cognition and mastery of COPD diagnosis and treatment knowledge of doctors with bachelor degree or above (37.1%, 23/62), intermediate title or above (33.3%, 23/69) and female (30.1%, 28/93) were significantly higher than those of doctors with lower academic qualifications (12.8%, 12/94), junior title or below (13.8%, 12/87) and male (11.1%, 7/63), respectively (χ²=12.709, P=0.001; χ ²=8.443, P=0.004; χ ²=7.788, P=0.005). Conclusion Physicians in most grass-roots hospitals can not accurately evaluate COPD; There are deficiencies in the follow-up, education and management of COPD patients, the use of family noninvasive ventilator, and the learning and implementation of guidelines. In view of the above problems, we need to strengthen the promotion of COPD knowledge and diagnosis and treatment technology, especially the training of physicians with low academic qualifications and low professional titles in grass-roots hospitals.

The impact of COVID-19 epidemic on tuberculosis control in Kashgar of Xinjiang Uygur Autonomous Region

Xirizhati ·Mamut, Maiweilanjiang ·Abulimiti, Diermulati ·Tusun, Gulimina ·Abulimiti, LIU Zhen-jiang, LI Guan-zhen, Liwayiding ·Aersila, HUANG Fei, ZHAO Yan-lin, ZHANG Li-jie, OU Xi-chao

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  234-238.  doi:10.3969/j.issn.2096-8493.20210071

Abstract ( 503 )   HTML ( 10 )   PDF (718KB) ( 206 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective Explore the impact of COVID-19 epidemic on tuberculosis (TB) control and prevention in Kashgar, and provide scientific basis for formulating corresponding prevention and control strategies. Methods TB registration and sputum examination at the end of 2nd month and at the end of treatment were compared between 2020 and 2019 based on the routine surveillance from TB Information Management System which is the subsystem of the “China Disease Prevention and Control Information System”, to explore the potential impact of COVID-19 epidemic on TB control and prevention. Results The number of registered TB patients in Kashgar in 2020 was 11159, a decrease of 7504 from the number of registered 18663 patients in 2019. The average daily number of registrations decreased from 51 in 2019 to 31 in 2020, a decrease of 39.22%. In 2020, the number of TB patients who required sputum examination at the end of second month of treatment was 28419, and 17715 patients can perform sputum examination within 7 days, the sputum examination rate is 62.34%, which was significantly lower than the 67.45% in 2019 (7894/11703) (χ ²=94.04, P<0.05). In 2020, the number of TB patients who required sputum examination at the end of treatment was 12816, and 5205 patients can perform sputum examination within 7 days, the sputum examination rate was 40.61%, which was significantly lower than the 42.24% (17370/41124) (χ ²=10.60, P<0.05) in 2019. Conclusion The COVID-19 epidemic has a certain impact on the TB control and prevention in Kashgar in the short term, this lead to a decrease in the number of TB patient discovery and in the rate of timely follow-up for sputum examination.

Analysis of 44 drug resistance patients with tuberculosis and received repeated treatment

SONG Yi-yan, CHEN Jie, LI Fang-hua, LI Ruo-nan, ZHAO Jing, YU Da-wei, SONG Hua-feng, XU Jun-chi, WU Min-juan, XU Ping

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  239-242.  doi:10.3969/j.issn.2096-8493.20210043

Abstract ( 400 )   HTML ( 7 )   PDF (719KB) ( 167 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the drug resistance of Mycobacterium tuberculosis in the patients who had tuberculosis and received repeated treatment with the treatment interval ≥2 years. Methods A retrospective analysis method was used. The data and information of 44 tuberculosis patients, who were repeatedly treated with two years or more treatment interval in the Infectious Diseases Hospital Affiliated to Soochow University from January 2013 to December 2020 were collected. Their drug resistance situation (including rifampicin, isoniazid, amikacin, ethambutol, moxifloxacin, levofloxacin, p-aminosalicylic acid, prothionamide and streptomycin) at baseline and after received repeated treatment were compared and analyzed. Results The baseline drug resistance rates of rifampicin, isoniazid, amikacin, levofloxacin, p-aminosalicylic acid and streptomycin in those 44 tuberculosis patients were 20.5% (9/44), 31.8% (14/44), 22.7% (10/44), 7.9% (3/38), 5.4% (2/37) and 3.1% (1/32) respectively and there were no drug resistance strains to ethambutol, moxifloxacin and prothionamide; After received repeated treatment, the drug resistance rates of rifampicin, isoniazid, amikacin, ethambutol, moxifloxacin, levofloxacin, p-aminosalicylic acid, prothionamide and streptomycin in those patients were 38.6% (17/44), 43.2% (19/44), 20.5% (9/44), 13.6% (6/44), 12.8% (5/39), 15.8% (6/38), 8.1% (3/37), 18.4% (7/38) and 6.2% (2/32) respectively. The types of drug resistance increased in 17 patients. Five patients developed pre-extensive drug resistance. Conclusion The increased drug resistance rate of Mycobacterium tuberculosis and the increased types of drug resistance are related to the history of tuberculosis treatment. During the anti-tuberculosis treatment, the drug resistance should be closely paid attention and monitored, and the anti-tuberculosis drugs should be rationally used.

Characteristics analysis of diagnosis delay among elderly tuberculosis patients in Dongguan City from 2009 to 2018

GUAN Fu-yuan, CHEN Zhi-hao, LI Wen-hui, YE Xiao-hua, ZHONG Xin-guang

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  243-250.  doi:10.3969/j.issn.2096-8493.20210033

Abstract ( 234 )   HTML ( 9 )   PDF (800KB) ( 147 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the characteristics of diagnosis delay among elderly tuberculosis patients in Dongguan City from 2009 to 2018, so as to provide scientific basis for improving the prevention and control of elderly tuberculosis. Methods Medical information regarding 1637 elderly tuberculosis patients from Dongguan was collected from the subsystem of China Information System for Disease Control and Prevention-Tuberculosis Information Management System from 2009 to 2018, which included gender, age, domicile place, treatment category, source of patient, etc. Univariate and multivariate logistic regression were used to analyze the influencing factors of patient delay and facility delay. Results The patient delay of elderly TB patients was 74.3% (1216/1637), and the facility delay was 13.5% (221/1637). The multivariate analyses of patient delay indicated that the patient delay rate of local patients was significantly higher than that in nonlocal patients (OR (95%CI): 1.31 (1.04-1.66)). Taking urban area/central area/northeast area/northwest area as reference, the patient delay rates were higher in patients in southwest area (OR (95%CI): 1.49 (1.04-2.12)), but lower in patients in southeast area (OR (95%CI): 0.71 (0.50-0.99)). The patient delay rate in patients with positive etiology and only tuberculosis pleurisy was significantly higher than that in patients with negative etiology (OR (95%CI): 2.08 (1.61-2.70)). The patient delay rate in patients from 2014 to 2018 was significantly higher than that from 2009 to 2013 (OR (95%CI): 1.63 (1.29-2.06)). The patient delay rate in retreatment patients was lower than that in new patients (OR (95%CI): 0.45 (0.29-0.70)). The multivariate analyses of facility delay indicated that the rate of facility delay was higher in retreatment patients than in new patients (OR (95%CI): 1.94 (1.09-3.47)), was higher in patients with clinical consultation than that in tracing and other patients (OR (95%CI): 3.24 (1.49-7.05)), was lower in patients with positive etiology and only tuberculosis pleurisy than that in patients with negative etiology (OR (95%CI): 0.49 (0.34-0.69)), and was lower in patients from 2014 to 2018 than that from 2009 to 2013 (OR (95%CI): 0.50 (0.37-0.67)). Conclusion It is not optimistic about the diagnosis delay of elderly tuberculosis patients in Dongguan City. Targeted publicity and education should be carried out continually for the elderly.

Analysis of Mycobacterium tuberculosis drug resistance in drug-resistance monitoring sites in Chongqing Municipality (2014-2019)

FENG Xin, HU Yan, SHEN Jing, ZHAN Jian

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  251-255.  doi:10.3969/j.issn.2096-8493.20210039

Abstract ( 265 )   HTML ( 9 )   PDF (718KB) ( 162 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the situation of Mycobacterium tuberculosis drug resistance in the tuberculosis drug resistance monitoring sites in Chongqing Municipality and provide reference for formulating future TB control policy. Methods The information of 935 tuberculosis patients from the two surveillance sites (Fengdu county and Fengjie County) of Chongqing from 2014 to 2019 were collected. Mycobacterium tuberculosis complex isolates from those patients were tested for drug resistance of isoniazid (INH), rifampicin (RFP), streptomycin (Sm), ethambutol (EMB),ofloxacin (Ofx) and kanamycin (Km). Results Among 953 Mycobacterium tuberculosis complex isolates, 797 strains (83.63%) were isolated from newly treated patients and 156 (16.37%) were from re-treated patients. Drug resistance rate among new and retreated patients were 13.30% (106/797) and 24.36% (38/156) respectively, and the total drug resistance rate was 15.11% (144/953).The drug resistance rates of INH, RFP and Sm in re-treated patients from 2014 to 2019 were 13.46% (21/156), 9.62% (15/156) and 12.18% (19/156), respectively, which were significantly higher than those in the new patients (6.65% (53/797), 3.51% (28/797) and 6.90% (55/797)), with statistical significance (χ ²=8.452,P=0.004;χ²=11.276,P=0.001;χ²=5.076,P=0.024). Conclusion The drug resistance rate of the retreated patients was higher than that of the newly treated patients in Chongqing tuberculosis drug resistance surveillance sites, and the drug resistance was controlled to a certain level after the implementation of “trinity of tuberculosis care provider” in tuberculosis management.

Review Articles

Research progress of tumor ablation in lung cancer

LI Xiang-nan, ZHANG Xiao-ju

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  256-261.  doi:10.3969/j.issn.2096-8493.20210050

Abstract ( 505 )   HTML ( 23 )   PDF (776KB) ( 322 )   Save

References | Related Articles | Metrics

Radical resection is the first choice for early lung cancer. However, most patents have lost the chance of operation when they were diagnosed. They have to seek non-surgical treatments, including chemotherapy, radiotherapy, targeted drug therapy, immunotherapy, image guided thermal ablation, etc. Tumor ablation is an important treatment option for nonsurgical lung cancer and pulmonary metastatic patients. It is a minimally invasive alternative to surgical resection, and has been proved to be a safe and effective treatment. The methods of tumor ablation include: radiofrequency ablation, microwave ablation, cryoablation, laser ablation, high-intensity focused ultrasound, and irreversible electroporation. The physiologic basis of thermal ablation is that coagulative necrosis and cell death occur at temperatures above 60℃. Tumor ablation therapy can make patients obtain relatively long survival time and better life quality, as lung ablation provides repeatability and respiratory function worsening has not been observed.

Application of predictive model in early diagnosis of lung cancer

LIU Hai-yang, ZHANG Xiao-ju

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  262-266.  doi:10.3969/j.issn.2096-8493.20210037

Abstract ( 223 )   HTML ( 11 )   PDF (740KB) ( 316 )   Save

References | Related Articles | Metrics

Early diagnosis of lung cancer is an important measure and necessary to reduce the mortality of lung cancer and improve the prognosis. The predictive model can stratify the malignant risk of lung nodules found in lung cancer screening, help clinicians making more scientific clinical decisions, and improve the early diagnosis rate of lung cancer. The application and problems of predictive model in early diagnosis and follow-up management of lung cancer were reviewed.

Advances in clinical application of endobronchial ultrasound-guided transbronchial needle aspiration

YANG Hui-zhen, ZHANG Qun-cheng, ZHANG Xiao-ju

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  267-272.  doi:10.3969/j.issn.2096-8493.20210036

Abstract ( 292 )   HTML ( 4 )   PDF (761KB) ( 188 )   Save

References | Related Articles | Metrics

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can effectively identify benign and malignant thoracic lesions adjacent to the trachea or bronchus, and it also plays an important role in staging lung cancer. In order to further improve the diagnostic accuracy of EBUS-TBNA and reduce operation related complications, a series of clinical studies have been carried out, mainly focusing on whether to use suction and guide wire, how to decide the needle size, times of aspiration and the application of EBUS-TBNA auxiliary diagnostic techniques (such as elastography, rapid onsite cytological evaluation, etc.). In this paper, the advances in clinical application of EBUS-TBNA on chest diseases are summarized.

Research progress on the application of biomarkers in differential diagnosis of benign and malignant pulmonary nodules

CUI Kai, ZHANG Xiao-ju

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  273-276.  doi:10.3969/j.issn.2096-8493.20210035

Abstract ( 373 )   HTML ( 10 )   PDF (717KB) ( 275 )   Save

References | Related Articles | Metrics

Biomarker detection is a simple and convenient method for monitoring and follow-up, which is widely used in the qualitative diagnosis of pulmonary nodules and the study of malignant evolution. Different biomarkers have different specificity and sensitivity in the diagnosis of malignant pulmonary nodules. The combined detection of multiple biomarkers or the evaluation combined with low-dose spiral CT can significantly improve the diagnostic efficiency of malignant pulmonary nodules. The clinical value and research progress of biomarkers in the differential diagnosis of benign and malignant pulmonary nodules were reviewed to provide reasonable suggestions for clinical diagnosis and treatment, and hierarchical management of patients with pulmonary nodules.

Research progress on free DNA detection of Mycobacterium tuberculosis of non-sputum samples in tuberculosis diagnosis

LI Jing, ZHANG Yan, WU Qian-hong

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  277-282.  doi:10.3969/j.issn.2096-8493.20210069

Abstract ( 307 )   HTML ( 4 )   PDF (764KB) ( 205 )   Save

References | Related Articles | Metrics

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, pulmonary tuberculosis is the most common. Laboratory test mainly respiratory specimens (sputum, lavage) as test objects, however, the test effective is unfavorable for children, extrapulmonary tuberculosis, and TB/HIV or AIDS patients. Thus, new diagnosis method based on non-sputum samples in continuous research in order to positive test rate of above population. Free DNA (cfDNA) is a DNA fragment released from primitive cells into various body fluids, which has a broad application prospect in the diagnosis of various diseases. In the article, application, factors affecting extraction pretreatment, extraction and detection methods of Mycobacterium tuberculosis cfDNA detection in blood or urine specimen will be discussed by authors, in combination with literature and clinical experience.

Research progress on risk factors of liver injury caused by anti-tuberculosis drugs

GU Yu-ren, TANG Pei-jun

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  283-288.  doi:10.3969/j.issn.2096-8493.20210055

Abstract ( 283 )   HTML ( 8 )   PDF (816KB) ( 288 )   Save

References | Related Articles | Metrics

China is still a country with a high burden of tuberculosis. Anti-tuberculosis drugs drug-induced liver injury (ATLI) is one of the common adverse reactions during the anti-tuberculosis treatment and rather harmful. ATLI is one of the key factors that affect the anti-tuberculosis treatment. There are many risk factors for ATLI. The research progress of ATLI risk factors in recent years were reviewed from the host factors, drug factors, environmental factors and so on.

Research progress of delay in diagnosis of tuberculosis and its influencing factors

JIANG You-li, ZHANG Pei-ze, DENG Guo -fang, CHEN Jing-fang

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  289-293.  doi:10.3969/j.issn.2096-8493.20210073

Abstract ( 289 )   HTML ( 6 )   PDF (736KB) ( 408 )   Save

References | Related Articles | Metrics

Tuberculosis diagnosis delay is quite common throughout the world, especially in countries and regions with high tuberculosis burdens. Delayed diagnosis causes disease progress and patients may miss the best time for treatment, which leads to further transmission of tuberculosis in the population. Diagnosis delay is not only related to patient’s personal factors, but also affected by medical care services and national policies. Therefore, the author intends to make an overview of the relevant factors affecting the delay of tuberculosis diagnosis, and provides reference for adopting comprehensive intervention strategies to reduce the delay in diagnosis.

Short Articles

Analysis of clinical features of Mycobacterium intracellulare pulmonary disease and Mycobacterium kansas pulmonary disease

YAN Jin-yu, ZOU Tao, GUO Jian, XU Yong, TANG Pei-jun, FENG Yan-jun

Journal of Tuberculosis and Lung Disease. 2021, 2(3):  294-297.  doi:10.3969/j.issn.2096-8493.20210049

Abstract ( 190 )   HTML ( 5 )   PDF (716KB) ( 171 )   Save

Figures and Tables | References | Related Articles | Metrics

The clinical data (including sex, age, smoking history, lymphocyte subsets, and comorbidity of pulmonary diseases, immune system diseases and diseases of other systems) of 168 cases of Mycobacterium intracellulare pulmonary disease (intracellulare group) and 90 cases of Mycobacterium kansas pulmonary disease (kansas group) diagnosed in the Fifth People’s Hospital of Suzhou from March 2014 to April 2021 were analyzed. As it turned out, the intracellulare group patients were of significant differences from the Kansas group in a number of figures (the intracellulare group: male (47.62% (80/168)), average age ((62.23±1.01) years old), smoking history (5.36% (9/168)), complicated with pulmonary diseases (58.93% (99/168)), complicated with hypertension (15.48% (26/168)), complicated with diseases of other systems (20.83% (35/168)), the expression rates of CD4 ⁺T lymphocytes ((34.82±0.73) %) and NK cells ((21.26±0.94) %); the Kansas group: (91.11% (82/90), (45.82±1.58) years old, 18.89% (17/90), 26.67% (24/90),5.56% (5/90), 10.00% (9/90), (38.66±1.03) %, (16.55±1.07) %), (χ²=47.447, P=0.000; t=4.145, P=0.000; χ ²=11.842, P=0.001; χ ²=24.452, P=0.000; χ ²=5.456, P=0.020; χ ²=4.862, P=0.027; t=-3.058, P=0.003; t=3.117, P=0.002)). The clinical characteristics of Mycobacterium intracellulare pulmonary disease and Mycobacterium kansas pulmonary disease are different in sex, age, complicated diseases, and lymphocyte subsets, which has certain reference value for the clinical differential diagnosis of those two diseases.