Table of Content

20 April 2022, Volume 3 Issue 2

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Diagnosis and treatment of tuberculosis complicated with diabetes

TIAN Yao, LIU Hui-min, FU Man-jiao, BEI Cheng-li

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  91-95.  doi:10.19983/j.issn.2096-8493.20210111

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Tuberculosis is one of the most important public health problems in the world. Diabetes is the third major chronic non-communicable disease threating human health. Tuberculosis patients with diabetes are more likely to meet treatment failure and have a higher risk of death. In this paper, the mutual harm, diagnosis, treatment and management of tuberculosis and diabetes comorbidity are discussed in order to raise the attention of clinical health care workers and provoke further research.

Clinical evaluation of chest X-radiograph computer aided diagnostic system for pulmonary tuberculosis applied in primary hospitals

ZHANG Xiu-lei, WANG Qian, XIA Li, LIU Yuan-Ming, HAO Yan, GUO Lin

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  96-101.  doi:10.19983/j.issn.2096-8493.20210129

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Objective: To evaluate the clinical performance of using artificial intelligence (AI) based computer aided diagnostic (CAD) system on detecting pulmonary tuberculosis (TB) in primary tuberculosis control and prevention facilities.Methods: A retrospective study enrolling 396 untreated presumptive tuberculosis cases was conducted from November 2020 to April 2021 in 8 TB dispensaries in Shandong province, and the clinical performance of the AI system was analyzed by making a comparison between the results from the AI system and from local radiologists.Results: The TB detection rate of AI system on 396 presumptive cases was higher than that of local radiologists (97.8% (131/134)) vs (75.4% (101/134))(χ²=28.88, P<0.05). The consistency between the AI system and local radiologists was 86.1% (341/396), and the false positive rates of the AI system and local radiologists were 0.8% (2/260) and 6.5% (17/260), respectively. In general, the sensitivity, specificity, positive predictive value, negative predictive value, and the accuracy of the AI system were 97.8% (95%CI: 93.3%-99.5%), 99.2% (95%CI: 97.1%-99.9%), 98.5% (95%CI: 94.3%-99.9%), 98.6% (95%CI: 96.5%-99.8%) and 98.7% (95%CI: 97.0%-99.6%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of local radiologists were 75.4% (95%CI: 67.4%-81.9%), 93.5% (95%CI: 89.8%-96.0%), 85.6% (95%CI: 78.0%-90.9%), 88.1% (95%CI: 83.8%-91.5%) and 87.4% (95%CI: 83.7%-90.3%).Conclusion: The AI system could help local radiologists in primary facilities improve diagnostic efficiency and accuracy.

Clinical analysis of 17 patients with occupying lesions of the pulmonary artery trunk

MA Ran, JIANG Qian, GU Ying-ying, ZHAO Jin, WANG Tao, WANG Xin-ni, YANG Xin-yan, SU Xiao-fen, ZHANG Nuo-fu, LIU Chun-li

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  102-109.  doi:10.19983/j.issn.2096-8493.20210168

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Objective: To analyze the etiology and clinical features of occupying lesions of the pulmonary artery trunk. Methods: A retrospective study was conducted in 17 patients with pathologically diagnosed occupying lesions of the pulmonary artery trunk hospitalized at the First Hospital of Guangzhou Medical University from January 2012 to August 2021. Of the 17 patients, 8 were male and 9 were female; their ages ranged from 26 to 70 years, with a mean of (52.1±15.8) years. The etiology was divided into thrombosis (n=5), cancer embolism (n=10), and bacterial embolism (n=2). Of the patients with cancer embolism, 8 were pulmonary artery sarcoma, 1 was pulmonary artery metastasis from choriocarcinoma, and 1 was leukemia with intrapulmonary artery myeloid sarcoma. One case of bacterial embolism and one case of fungal embolism were included in the patients with bacterial embolism. The clinical symptoms, laboratory findings, imaging features, and therapeutic prognosis of the patients were analyzed. Results: Of the 17 patients, the median time interval from first diagnosis to diagnosis was 10.0 (4.0, 12.0) months, and the median time to diagnosis in patients with carcinoma emboli was 11.5 (8.0, 12.0) months. The main symptoms were shortness of breath (94.1%, 16/17), chest pain (82.4%, 14/17), cough (88.2%, 15/17), expectoration (47.1%, 8/17), and hemoptysis (29.4%, 5/17). In patients with cancer thrombosis, platelet count was 274.00 (217.25, 405.00)×10⁹/L, D-dimer was 0.71 (0.51, 0.97) ng/L, and fibrinogen was 6.30 (4.95, 7.72) g/L; in patients with thrombosis, those were 156.00 (126.50, 274.00)×10⁹/L, 1.96 (1.11, 5.02) ng/L and 4.31 (2.43, 6.09) g/L. Abnormal ECG was found in 15 cases, the abnormalities were sinus tachycardia (35.3%, 6/17), T-wave hypoplasia (64.7%, 11/17), and right bundle branch block (35.3%, 6/17). Increased right ventricular load was present on cardiac ultrasound in 11 cases. The estimated PASP was 60.50 (44.00, 98.00) mmHg in patients with cancer embolism and was 49.50 (32.25, 63.75) mmHg in patients with thrombus. The prognosis of 2 patients with bacterial embolism and 3 patients with thrombus were good. Conclusion: Clinicians should pay attention to the etiologic screening of occupying lesions of the pulmonary artery trunk. Elevated platelet counts may be of some value in differentiating carcinoma emboli.

Analysis of characteristics, diagnosis and referral of pulmonary tuberculosis in respiratory wards of a general hospital in Beijing

GUO Hua-zheng, XING Zhen-chuan

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  110-117.  doi:10.19983/j.issn.2096-8493.20210152

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Objective: To analyze the characteristics of pulmonary tuberculosis (PTB) patients and diagnosis and referral in respiratory wards of general hospital, in order to provide help for early detection of PTB patients and referral to tuberculosis (TB) prevention and control institutions. Methods: A total of 68 PTB patients (including presumptive cases, clinically diagnosed cases and confirmed cases) diagnosed in the respiratory wards of Beijing Luhe Hospital from May 2018 to January 2020 were collected. After discharge, 57 cases were diagnosed as PTB (including clinical diagnosis and confirmed cases) in TB designated hospitals or TB control dispensaries. We descriptively analyzed data of 57 PTB patients, and compared them with the data of 114 cases with PTB related symptoms and excluding PTB diagnosis in the same period. Results: Among the 57 PTB patients, 33 were males and 24 were females, aged from 20 to 93 years old, and the proportion of patients ≥60 years old was the highest, accounting for 61.4% (35/57). The most common clinical symptoms were cough (51 cases, 89.5%), followed by expectoration (44 cases, 77.2%), chest tightness and shortness of breath (32 cases, 56.1%) and fatigue (30 cases, 52.6%). The main diagnosis on admission was pleural effusion (17 cases, 29.8%), pneumonia (16 cases, 28.1%) and lung shadow of unknown origin (15 cases, 26.3%), and the most common complication was hypoproteinemia (20 cases, 35.1%). The diagnosis of PTB mainly depended on acid-fast staining of specific bacteria (26 cases, 45.6%) and nucleic acid detection of Mycobacterium tuberculosis (24 cases, 42.1%). The positive rate of bronchoalveolar lavage fluid samples (91.3% (21/23)) was higher than that of sputum (19.6% (9/46)), tracheoscope brushes (17.1% (7/41)) and pleural effusion (10.0% (2/20)); Chest CT examination reported 3 cases of pulmonary tuberculosis, and the positive rate was 5.3%. The proportion of patient delay rate among PTB patients was 24.6% (14/57), while the proportion of diagnosis delay was 43.9% (25/57). Among the 68 patients discharged with PTB, 54 cases were referred to TB designated hospitals and finally confirmed, 3 cases were referred to TB control dispensaries and finally confirmed, 6 cases were referred to TB designated hospitals and excluded, 2 cases with mild symptoms were not referred to TB control dispensaries as required, 3 cases temporary visitors to Beijing were lost to follow up with unknown referral and diagnosis details. The comparison of two groups showed that patients with PTB had higher proportions of emaciation (33.3% (19/57)), chest pain (31.6% (18/57)), unilateral pleural effusion (45.6% (26/57)), pulmonary consolidation (33.3% (19/57)), tracheal stenosis (14.0% (8/57)) than those of control group (14.9% (17/114), 16.7% (19/114), 12.3% (14/114), 14.0% (16/114), 2.6% (3/114)), the differences were statistically significant (χ ²=12.108, P=0.001; χ ²=3.958, P=0.047; χ ²=23.561, P=0.000; χ ²=8.694, P=0.003; χ ²=23.561, P=0.008). Conclusion: PTB patients in respiratory wards of general hospital are mainly elderly people, the positive rate of PTB screened through chest CT images is low. Emaciation, chest pain, unilateral pleural effusion, intrapulmonary consolidation and tracheal stenosis etc. have certain reference value for clinical diagnosis.

Clinical observation of patients with acute axcerbation of chronic obstructive pulmonary disease and patients with chronic obstructive pulmonary disease plus community-acquired pneumonia

ZHU Dan, CHEN Yan, SHUANG Qing-cui, ZENG Hui-hui

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  118-124.  doi:10.19983/j.issn.2096-8493.20210166

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Objective: To compare the clinical manifestations of acute axcerbation of chronic obstructive pulmonary disease (AECOPD) and chronic obstructive pulmonary disease (COPD) plus community-acquired pneumonia (CAP),thus to improve clinical diagnosis and treatment and reduce case fatality rate of them.Methods: We retrospectively collected 101 cases with definite COPD diagnosis hospitalized in Department of Respiratory in The Second Xiangya Hospital of Central South University and The First Hospital of ShaoYang University between January 2017 and June 2017. They were divided into AECOPD group and COPD-CAP group according to their medical histories and results of chest CT examination. The general information, clinical symptoms, signs, inflammation index, nutritional status, and results of blood gas analysis, pulmonary function test results, complications, and clinical outcomes were compared between the two groups.Results: (1) The incidence of chill, fever, lung rales in COPD-CAP group were 15.3% (9/59), 27.1% (19/59), 83.1% (49/59) respectively, which were significant higher than that of AECOPD group (2.4% (1/42), 9.5% (4/42), 64.3% (27/42), χ ²=4.558, 3.448, 11.053, P=0.033, 0.043, 0.037). (2)In the COPD-CAP group, median/mean of CRP, PCT, ESR, BNP and PaCO₂ were 34.10 (7.37,79.30) mg/L, 0.17 (0.09,0.25) ng/ml, 32.00 (14.00,53.00)mm/1h、430.00 (140.00,2253.00)pg/ml, and (51.26±16.15)mmHg (1mmHg=0.133kPa) respectively, which were significant higher than that of the AECOPD group ((5.62 (2.94,13.95))mg/L, 0.10 (0.04,0.22)ng/ml, 18.50 (8.00,27.00)mm/1h、150.70 (100.00,547.00)pg/ml, and (45.71±9.94)mmHg, Z=-4.648,P=0.000;Z=-0.818,P=0.024;Z=-3.182,P=0.001;Z=-3.172,P=0.002;t=-3.621,P=0.035). The lung function of the two groups were all abnormally decreased,and the levels of FEV₁%pred and FEV₁/FVC% in the COPD-CAP group were (45.00±14.70)% and (50.28±7.31)%, which were lower than those in the AECOPD group ((52.02±15.42)%, (61.92±17.92)%), and the differences were statistically significant (t=5.124, 2.726, P=0.000, 0.047). (3) The occurrence rate of heart failure, mechanical ventilation, mortality in COPD-CAP group were 28.8% (17/59), 27.1% (16/59), and 6.8% (4/59),which were significantly higher than the AECOPD group (11.9% (5/42), 9.5% (4/42), 2.4% (1/42), χ²=1.719, 2.824, 0.059, P=0.042, 0.003, 0.027). The average length of stay in COPD-CAP group was (9.38±3.66) days, longer than AECOPD group ((6.28±2.04) days), the difference was statistically significant (t=-1.237,P=0.011).Conclusion: There were differences in clinical symptoms and signs between AECOPD group and COPD-CAP group. Compared with AECOPD group, hospitalized patients in COPD-CAP group got more obvious inflammatory reaction, more severe disease and worse prognosis, thus need to be closely monitored and timely treated in clinic practice.

Analysis on treatment outcomes and influencing factors of coal worker’s pneumoconiosis complicated with pulmonary tuberculosis

YANG Xiao-li, LI Hong-yan, WANG Jiao-lei, ZHANG Yun-yun, HE Bing, LI Yue, ZHANG Chun-xia

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  125-130.  doi:10.19983/j.issn.2096-8493.20210160

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Objective: To analyze the treatment outcomes and influencing factors of patients with coal worker’s pneumoconiosis complicated with pulmonary tuberculosis, and to provide scientific basis for effective prevention and control of this complication disease.Methods: A total of 122 patients, all male, who were diagnosed and registered as pneumoconiosis complicated with tuberculosis in the Department of Pneumoconiosis and Tuberculosis of Beijing Jingmei Group General Hospital from 2016 to 2021 and completed the prescribed course of anti-tuberculosis treatment were included, excluding the cases of treatment suspension, diagnosis change, or drug resistance. Patients’ demographic characteristics (age, education, drinking history, place of residence, BMI), sources of patients, and disease characteristics (results of etiological examination, stage of pneumoconiosis, working years with dust exposure, lesion location of pulmonary tuberculosis, whether being severe cases, primary or retreatment cases, whether with diabetes mellitus or pulmonary cavity), etc. were collected, then treatment outcome and influencing factors were analyzed.Results: Among the 122 patients, 30 cases were cured and 73 cases completed the course of treatment. The treatment success rate was 84.43% (103/122), and the rate of adverse outcomes was 15.57% (19/122). Three cases (2.46%) died of non-tuberculosis, seven (5.74%) died of tuberculosis, one (0.82%) refused treatment, and eight other cases (6.56%). Multivariate logistic regression analysis showed that patients with stage Ⅰ pneumoconiosis (OR=0.085, 95%CI: 0.013-0.550) and stage Ⅱ pneumoconiosis (OR=0.156, 95%CI: 0.033-0.746) complicated with pulmonary tuberculosis were more likely to gain treatment success. Patients aged 51-65 years old (OR=33.311, 95%CI: 2.184-507.947), patients being referred with symptoms or having sought care with symptoms (OR=14.641, 95%CI: 3.632-59.026), patients with disease condition deemed as severe (OR=164.962, 95%CI: 25.418-1070.603)were more likely to fail in treatment.Conclusion: The poor treatment outcomes of patients with coal worker’s pneumoconiosis complicated with pulmonary tuberculosis was related to referral or seeking care with symptoms, aged 51-65 years old and being severe cases. We should strengthen the active detection of patients and pay attention to 51-65 years old patients and severe cases, to improve the treatment success rate and prognosis.

Application value of artificial hydrothorax in preoperative preparation of medical thoracoscopy

LU Zhi-bin, LUO Li, LUO Lin-zi, XIAO Yang-bao

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  131-136.  doi:10.19983/j.issn.2096-8493.20220004

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Objective: To explore the clinical value and safety of artificial hydrothorax in preoperative preparation of medical thoracoscopy.Methods: The clinical datas of 163 patients who hospiyalized in the Endoscopy Center of Hu’nan Chest Hospital and underwent medical thoracoscopic surgery because of pleural effusion or pleural disease from May 2014 to November 2019 were retrospectively analyzed. From January 2017 to November 2019, 115 pleural effusion patients who underwent artificial hydrothorax before the medical thoracoscopy were selected as the observation group. From May 2014 to December 2016, 48 pleural effusion patients who did not undergo artificial pleural thoracic examination before medical thoracoscopy were selected as the control group. The success rate and the complications in the observation group were analyzed, and the effective rate and lung injury of medical thoracoscopy were compared between the two groups.Results: The success rate of artificial hydrothorax in the observation group was 100.0% (115/115). A total of 27 cases (23.5%) had mild to moderate cough, dyspnea, subcutaneous mass in the chest wall, and local pain in the chest cavity during the water injection process. After oxygen inhalation, supine rest, adjust the body position and respiratory rate, stopping the operation, and other disposal, all patients were relieved, and there were no serious complications such as subcutaneous emphysema, hemothorax, infection, needle tract transfer, and air embolism related to the operation of artificial hydrothorax. In the observation group, the direct pathological diagnosis rate of medical thoracoscopy was significantly higher than that in the control group (92.2% (106/115) vs. 72.9% (35/48), χ ²=10.757, P=0.001), the operational efficiency was significantly higher than that in the control group (97.4% (112/115) vs. 85.4%(41/48), χ ²=6.481, P=0.011), and the lung injury rate was significantly lower than that of the control group (4.3% (5/115) vs. 18.8% (9/48), χ ²=7.206, P=0.007).Conclusion: The implementation of artificial hydrothorax before medical thoracoscopy can safely and effectively detect the thoracic cavity, improve the operation efficiency, expand the operation space, reduce lung injury during the operation.

Mechanism of rapamycin target protein/autophagy signaling pathway in tuberculous tracheal bronchial stenosis

ZHOU Lei, LUO Li, LU Zhi-bin, DING Yan, XIAO Yang-bao

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  137-141.  doi:10.19983/j.issn.2096-8493.20210135

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Objective: To investigate the expression and role of rapamycin target protein/autophagy (mTOR/autophagy) signaling pathway in tuberculous tracheobronchial stenosis.Methods: A total of 10 patients with pulmonary Aspergillus who needed surgical resection in Hu’nan Chest Hospital from June 2020 to June 2021 were collected as the normal control group. And 27 patients with tuberculous tracheal bronchial stenosis over the same period were collected, including 13 patients with tuberculous hyperplasia (tuberculous hyperplasia group) and 14 patients with tuberculous scar (tuberculous scar group). The tracheal bronchial tissue of each group was collected. Immunohistochemistry was used to detect mTOR, autophagy-related protein LC3, transform growth factor-β1 (TGF-β1), collagen 1 (COL-1) protein expression, Western blotting was used to detect mTOR and the expression of LC3 prote, and PCR was used to detect the expression of TGF-β1 and COL-1 mRNA.Results: (1) By immunohistochemistry and western blotting, mTOR protein expressions in tuberculous hyperplasia group and tuberculous scar group were significantly higher than those in the normal control group ((0.074±0.008) vs. (0.028±0.004), t=0.045, P<0.001; (3.397±0.312) vs. (0.028±0.004), t=2.419, P<0.001; (0.041±0.004) vs. (0.980±0.091), t=0.013, P=0.036; (2.261±0.175) vs. (0.980±0.091), t=1.283, P<0.001). (2) By immunohistochemistry and and mRNA, TGF-β1 protein expressions in tuberculous hyperplasia group,and the tuberculous scar group were (0.062±0.008) and (0.039±0.006), (6.930±0.606) and (3.350±0.582), respectively; which were significantly higher than those in the normal control group (immunohistochemistry, 0.019±0.006, t=0.043, P<0.001 and t=0.020, P=0.009, respectively; mRNA, 1.000±0.000, t=5.930, P<0.001 and t=2.353, P=0.001, respectively). (3) In tuberculous hyperplasia group and the tuberculous scar group, COL-1 protein expressions were (0.056±0.009) and (0.032±0.003) by immunohistochemistry and (6.803±1.110) and (2.730±0.547) by mRNA, which were significantly higher than those in the normal control group ((0.018±0.002) and (1.000±0.000), t=0.038, P<0.001; t=0.013, P=0.026; t=0.013, P=0.026; t=5.803, P<0.001; t=1.730, P=0.025, respectively). (4) By immunohistochemistry and Western blotting, LC3 protein expressions in the tuberculous hyperplasia group andin the tuberculous scar group were (0.023±0.007) and (0.046±0.008), (0.140±0.030) and (0.236±0.030), which were significantly lower than those in the normal control group ((0.070±0.005) and (0.320±0.049), t=0.047, P<0.001; t=0.023, P=0.009; t=0.179, P<0.001; t=0.083, P=0.034).Conclusion: Tuberculous tracheobronchial stenosis may be related to fibrosis caused by overexpression of TGF-β1 and COL-1 after activation of mTOR/autophagy signaling pathway.

Analysis of features of drug resistance and risk factors of multidrug-resistant tuberculosis in pulmonary tuberculosis patients in Songjiang District of Shanghai

LI Yong, LU Li-ping, LI Jin, ZOU Jin-yan

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  142-147.  doi:10.19983/j.issn.2096-8493.20210109

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Objective: To analyze the drug resistance and risk factors of multidrug-resistant tuberculosis (MDR-TB) in patients with pulmonary tuberculosis in Songjiang District of Shanghai. Methods: A retrospective study was conducted in 1513 pulmonary tuberculosis patients diagnosed as Mycobacterium tuberculosis in the Songjiang District Central Hospital from 2012 to 2018. Data of the patients were collected from “Tuberculosis Information Management System”, and “First registration of pulmonary tuberculosis patients” and “Mycobacterium tuberculosis culture and drug sensitivity registration”of Songjiang District Central Hospital. Mycobacteriu tuberculosis resistance to first-line anti-TB drugs and risk factors for mutidrug-resistance tuberculosis were analyzed. Results: The overall drug resistance rate of 1513 pulmonary tuberculosis patients was 19.50% (295/1513), and the multidrug-resistance rate was 4.30% (65/1513). The drug resistance rates to the four first-line anti-tuberculosis drugswere streptomycin (Sm, 14.34%, 217/1513), isoniazid (INH, 10.38%,157/1513), rifampicin (RFP, 5.29%, 80/1513) and ethambutol (EMB, 3.83%,58/1513). The overall drug resistance rate, multidrug-resistance rates and poly-restance rate of newly treated patients were significant lower than those of relapse patients (18.46% (261/1414) vs. 34.34% (34/99), χ ²=14.874; 3.54% (50/1414) vs. 15.15% (15/99),χ²=30.361; 3.54% (50/1414) vs. 13.13% (13/99),χ²=21.347, respectively; all P=0.000). Multivariate logistic regression analysis showed that occupation as workers (OR=2.078, 95%CI=1.196-3.609) and retreatment (OR=5.195, 95%CI=2.782-9.700) were risk factors for MDR-TB. Conclusions: The rates of drug resistance and multidrug-resistance in Songjiang District of Shanghai was low. However, drug resistance screening should be actively carried out for key groups such as retreated patients and worker, and attention should be paid to the monitoring of drug resistance in newly diagnosed patients, to control the occurrence of MDR-TB.

Analysis of tuberculosis infection screening in primary and secondary schools of the third division of Xinjiang Production and Construction Corps in 2020

WANG Kun-peng, HE Jing-jing, ZHAO Yong-nian, YE Zhi-ping, JIANG Yuan-yuan, ZHAO Li-zhi, YANG Hong-chun, ZHANG Chun-ju, ZHOU Xiao-yong, WANG Shi-yi, WANG Yuan-zhi, HAN Feng, OU Xi-chao

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  148-152.  doi:10.19983/j.issn.2096-8493.20210114

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Objective: To analyze the tuberculosis infection and prevalence among all teachers and students of primary and secondary schools in the third divisions of Xinjiang Production and Construction Corps.Methods: According to the requirements of notice on carrying out tuberculosis screening on school students, the Center for Disease Control and Prevention of the third division carried out tuberculosis infection screening in its jurisdiction, for 34066 teachers and students of primary and secondary school from March to May 2020, including suspected symptoms of pulmonary tuberculosis, tuberculin skin test (TST), sputum smear and chest X-ray examination.Results: Of all the subjects, 2068 were positive, the positive rate was 6.07%, and 302 were strong positive,the rate was 0.89%. With the increase of students’ grade,the positive rate and strong positive rate increased from 5.23% (1174/22463) and 0.38% (85/22463) in primary school group to 10.34% (206/1993) and 3.36% (67/1993) in high school group, respectively, the differences were significant (χ²=91.92 and 245.01, respectively, both P<0.001). The positive rate and strong positive rate of faculty were significantly higher than those of students (13.70% (158/1153) vs. 5.80% (1910/32913),χ²=121.93, P<0.001; and 3.04% (35/1153) vs. 0.81% (267/32913),χ²=62.73, P<0.001, respectively). The strong positive rate of Uighur teachers and students was significantly lower than that of Han teachers and students (0.74% (162/21878) vs. 1.15% (140/12188),χ²=14.84,P=0.001). Sputum smear and chest X-ray examination were performed on 302 teachers and students who were strong positive. Five students with abnormal chest X-ray were diagnosed as active pulmonary tuberculosis patients, 18 teachers and students with strong positive in close contact took preventive medicine.Conclusion: The strong positive rate of TST increased with the increase of students’ grade. TST screening should be carried out regularly for senior students, which played an important role in mastering the recent infection of tuberculosis and preventing the occurrence of school aggregated tuberculosis.

Research progress on drug resistance of Mycobacterium tuberculosis to Delamanid and its molecular mechanism

ZHOU Ming, LIU Huang-rong, TANG Liu-sheng, LIU Sang, LIU Ai-mei

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  153-157.  doi:10.19983/j.issn.2096-8493.20210131

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Tuberculosis (TB) is one of the major causes of death for infectious diseases. The emergence of drug-resistant TB increased the difficulty for TB prevention and control. As a new anti-tuberculosis drug, Delamanid performs its bactericidal action by inhibiting the synthesis of mycolic acid of Mycobacterium tuberculosis cell wall, and has good tolerance and safety. However, within a year of clinical application, drug resistance against Delamanid has already been observed. This paper reviewed the clinical application, antibacterial mechanism, drug susceptibility test technologies, epidemiological investigation and molecular mechanism of drug resistance of Delamanid,in order to promote clinical understanding of Delamanid and provide more reference for rational treatment of drug-resistant tuberculosis patients.

Research progress of CT roundness measurement in evaluating the invasiveness of GGN-like lung adenocarcinoma

JIANG Ge-ge, LIANG Yuan, DU Li-na, WU Jian-lin

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  158-161.  doi:10.19983/j.issn.2096-8493.20210154

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The scientific management of ground-glass lung nodules (GGN) is a hot topic of clinical concern. It is challenge for radiologists to make an accurate diagnosis of invasive degree for the GGN-like lung nodules. Recently, the roundness measurement based on CT images has gradually been applied for GGN evaluation, and the diagnosis value has shown good clinical application prospects. The author reviews and summarizes the current research status and progress in this area.

Research progress of music therapy in rehabilitation treatment of lung diseases

REN Jing-juan, ZHAO Yan-lin

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  162-165.  doi:10.19983/j.issn.2096-8493.20220005

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Music therapy is a new interdisciplinary subject with physiological and psychological effects based on psychology. It can promote the physical and mental health of patients through the unique melody, rhythm and frequency of music. At present, it has been widely used in the field of clinical medicine, and the effect is relatively ideal. Therefore, the author reviews the status quo, mechanism and application of music therapy in rehabilitation treatment of pulmonary diseases, in order to provide scientific reference for the rehabilitation of more diseases in the future.

Nursing care of 1 case of severe tuberculous meningitis complicated by diabetic ketoacidosis

WANG Xiao-fei, ZHANG Li

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  166-169.  doi:10.19983/j.issn.2096-8493.20220007

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On February 22, 2021, a 38 year old male patient with severe tuberculous meningitis was treated in the First Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University. The patient was complicated by cerebral infarction, renal insufficiency, severe malnutrition, pulmonary infection, and diabetic ketoacidosis. During hospitalization, through the nursing and management mode of cooperation of nursing professional team, with the help of various nursing record sheets, evaluation sheets and monitoring sheets, condition observation content was established to closely monitor patients, risk events were reported and monitored, and standardized communication mode was implemented for the shift handover of critically ill patients. Special management on blood glucose was implemented to achieve individualized blood glucose control objectives, and improve the nutritional status of patients through whole process nutritional management. First-aid procedures were formulated for serious potentially fatal complications especially such as cerebral hernia, asphyxia and respiratory failure, blood coagulation and other indicators were closely monitored, and physical therapy such as lower limb massage and wearing compression elastic socks were used to prevent the occurrence of deep venous thrombosis. At the same time, the implementation of safety protection measures was strengthened to avoid the occurrence of security events such as falling into the bed and unexpectedly drawn tubes. Strict drug treatment management was carried out, the dual route drug infusion of external jugular central venous catheter and upper limb superficial venous catheter were implemented and a daily drug input plan was formulated to ensure that the drugs could be input on time, in quantity, safely and in time to achieve the treatment effect. After careful nursing, no complications occurred during hospitalization, and 22 days after hospitalization, the patient was transferred to the local tuberculosis specialist hospital for further treatment.

Application value of Mycobacterium tuberculosis scanning system in tuberculosis diagnosis

ZHANG Si-qi, LI Jing, WU Qian-hong

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  170-172.  doi:10.19983/j.issn.2096-8493.20220003

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All of 1717 sputum specimens from suspected tuberculosis patients in Shaanxi Tuberculosis Prevention and Control Institute were collected and stained with Ziehl-Neelsen staining method. First, Mycobacterium tuberculosis scanning system was used for microscopic examination, and then the same batch of specimens were examined by manual microscopy. Using sputum culture and detection of Mycobacterium tuberculosis as the standard, the positive detection rate of Mycobacterium tuberculosis scanning system and manual microscopy in the diagnosis of tuberculosis were compared. The positive detection rate of Mycobacterium tuberculosis scanning system and manual microscopy were 94.67% (231/244) and 59.02% (144/244), the difference was statistically significant (χ²=87.166, P=0.001). Compared with manual microscopy, Mycobacterium tuberculosis scanning system has higher positive detection rate, and higher application value in the diagnosis of tuberculosis.

Analysis of manual liquid culture method in county-level laboratory to detect Mycobacterium tuberculosis

QIU Yong, LI Meng, QU Rong, TIAN Fa-jun

Journal of Tuberculosis and Lung Disease. 2022, 3(2):  173-176.  doi:10.19983/j.issn.2096-8493.20210136

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Sputum specimens were collected from 1370 presumptive tuberculosis patients attending to the tuberculosis clinic of Center for Disease Control and Prevention in Wusheng County of Sichuan Province from July 1, 2018 to December 31, 2020. The sputum was cultured using manual liquid culture method and neutralization centrifugal solid culture method at the same time. The positive rate of the manual liquid culture method was 25.8% (353/1370), significantly higher than that of the neutralization centrifugal solid culture method (20.0%, 274/1370) (χ²=12.907, P<0.001). The median time to detection was 2 (2, 3) weeks for the manual liquid culture method, which was significantly shorter than that for the solid culture method (3 (2, 4) weeks, Z=-9.491, P<0.001). The manual liquid culture method significantly improved the positive rate, significantly shortened the time to detection, and was comparable in cost to solid culture, making it suitable for application in county-level laboratory.