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    20 February 2023, Volume 4 Issue 1
    Interpretation of Standard
    Interpretation of the Evidence-based Guidelines for Active Screening of Pulmonary Tuberculosis in Chinese Communities
    Fan Mingkuan, Zhang Hui
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  1-4.  doi:10.19983/j.issn.2096-8493.20230012
    Abstract ( 152 )   HTML ( 20 )   PDF (961KB) ( 170 )   Save
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    In order to provide evidence-based basis for improving and optimizing the active pulmonary tuberculosis screening strategy in key population groups in the communities, to raise the effectiveness of active pulmonary tuberculosis screening. The two professional branches (Tuberculosis Control and Geriatric Tuberculosis Control) of the Chinese Antituberculosis Association together with the editorial committee of Chinese Journal of Antituberculosis, organized experts to formulate Evidence-based Guidelines for Active Screening of Pulmonary Tuberculosis in Chinese Communities. The authors describe the formulation background, main contents, characteristics and key points of the guidelines in detail, in order to better and more convenient applied for tuberculosis screening in grassroots by relevant personnel.

    Original Articles
    Analysis of the status of tuberculosis prevention and control in schools in Yunnan Province, 2015—2020
    Cheng Yuyu, Yang Rui, Li Ling, Pan Ying, Xu Lin
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  5-12.  doi:10.19983/j.issn.2096-8493.20230007
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    Objective: To investigate the implementation of school tuberculosis prevention and control measures during the 13th Five-Year Plan for tuberculosis prevention and control, and to provide targeted suggestions and basis for optimizing school tuberculosis prevention and control strategies. Methods: A typical sampling method was used to select 33 junior high schools, 17 high schools and 6 universities in Yunnan Province to conduct on-site questionnaire surveys using the school tuberculosis prevention and control status questionnaire from January to April in 2022. Data collected was analyzed descriptively. Results: From 2015 to 2020, the proportion of schools listing tuberculosis screening in their new student admission medical examinations in non-boarding junior high schools, boarding junior high schools, high schools, and universities in Yunnan Province all continued to increase ( χ t r e n d 2=30.292, 2.706, 20.163, and 5.121, P≤0.001, 0.097, <0.001, 0.024, respectively), from 37.93% (11/29), 1/4, 29.41% (5/17), 4/6 in 2015 to 89.66% (26/29), 3/4, 88.24% (15/17), and 6/6 in 2020. The average annual screening rates of students in middle school, high school, and university were 47.48% (31508/65948), 54.61% (32483/59485), and 99.98% (127915/127944), respectively, with statistically significant differences (χ2=83 425.379, P<0.001), and the screening rates of new students’ physical examination for tuberculosis in junior high schools, high schools all showed a yearly upward trend, rising from 24.46% (2584/10565) and 14.64% (1226/8377) in 2015 to 77.11% (8734/11326) and 93.93% (10063/10713) in 2020 ( χ t r e n d 2=9430.664, 20362.110, respectively; All Ps<0.001). Tuberculosis detection rate in high schools and universities both rose from 81.57/100000 (1/1226) and 11.56/100000 (2/17305) in 2015 to 119.25/100000 (12/10063) and 34.37/100000 (8/23276) in 2020, respectively. Conclusion: The proportion of screening for tuberculosis in new students’ physical examinations in Yunnan Province continued to increase from 2015 to 2020, but tuberculosis epidemics still occurred from time to time, suggesting that standardized routine prevention and control measures are increasingly important, and universities in highly infected areas are still the focus of tuberculosis prevention and control efforts.

    Investigation of pulmonary tuberculosis cluster in a boarding school in Beijing
    Jia Xuejiao, Hu Yuanlian, Zhang Dongyan, Xue Xiao, Deng Ling, Ai Ping, Chen Wei, Yang Guoliang, Xin Zhenjiang
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  13-19.  doi:10.19983/j.issn.2096-8493.20220150
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    Objective: To investigate and analyze a cluster epidemic of pulmonary tuberculosis in a boarding school in Fengtai District of Beijing, and to provide reference for the prevention and control of pulmonary tuberculosis in boarding schools and students from high-risk areas. Methods: A descriptive epidemiological method was used to investigate an outbreak of pulmonary tuberculosis in a school in Fengtai District of Beijing. According to the epidemiological investigation of the first case, the range of close contacts was determined. Symptom screening, tuberculin skin test (TST) and chest X-ray were used to screen the close contacts, and those with abnormal chest X-ray were further diagnosed. From June 2018 to April 2019, a total of 4 close contacts were screened, once every 3 months. Results: A total of 23 active pulmonary tuberculosis patients and 81 latent tuberculosis patients were found in the school, of which 17 patients were found by chest X-ray screening.The attack rate of pulmonary tuberculosis in senior high school was 4.8% (23/483), of which the attack rate of the first case class was 28.3% (15/53), and the attack rate of other classes was 1.9% (8/430). The risk of tuberculosis in class 5 was higher than that in other classes, and the difference was statistically significant (χ2=72.74,P<0.001), which was 15.21 (95%CI: 6.06-38.17) times that of other classes in senior high school. The overall attack rate of students in the class composed of students in Yushu Tibetan Autonomous Prefecture of Qinghai Province (referred to as ‘Yushu class’) was 8.7% (20/229), the latent infection rate of Mycobacterium tuberculosis was 27.3% (62/227), and the latent infection rate of Mycobacterium tuberculosis in other classes was 7.5% (19/252). The infection risk of students in Yushu class was higher than that in other classes, and the difference was statistically significant (χ2=33.23,P<0.001), which was 3.62 (95%CI: 2.09-6.29) times that of other classes. Conclusion: It is necessary to strengthen the standardization of the infectious disease prevention and control system in boarding schools. In particular, it is necessary to develop effective prevention and control measures for collectively enrolled students in Beijing in areas with high incidence of tuberculosis, rationally use chest X-ray examination, detect tuberculosis patients as early as possible, and effectively curb the spread of tuberculosis in schools.

    Analysis on the operation of Tuberculosis Automated-alert System in schools in Guangzhou from 2018 to 2021
    Wang Ting, Du Yuhua, Lei Yu, Wu Guifeng, Zheng Boning, Liu Jianxiong
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  20-26.  doi:10.19983/j.issn.2096-8493.20230003
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    Objective: To analyze the operation of Automated-alert System for tuberculosis in schools in Guangzhou, and to provide suggestions for further application and improvement of the system. Methods: The signals and response of school tuberculosis in Guangzhou from July 2018 to December 2021 was derived from the Automated-alert System for Tuberculosis, and was analyzed and evaluated according to the spatial, temporal and population distribution, the effect of the System was evaluated by comparing epidemiological survey report of pulmonary tuberculosis in schools in the same period. Results: A total of 12034 early-warning signals were issued by Automated-alert System for Tuberculosis in schools from July 2018 to December 2021 with a response rate of 100.00%, and 98.76% (11885/12034) of signals were responded in 24 hours. The responding time (M(Q1,Q3)) was 2.02 (0.61, 6.58) h, 23.01% (2769/12034) of early-warning signals were finally identified as suspected events. From 2018 to 2021, the overall signal response time decreased from 2.51 (0.63, 11.71) h to 2.01 (0.67, 7.01) h, and the suspected event rate increased from 19.94% (429/2151) to 33.70% (548/1626). Baiyun District had the most warning signals (n=2735), and Yuexiu District had the highest suspected event rate (38.52%, 156/405). The 22-24-year-old group had the most warning signals (n=5318), and the 12-14-year-old group had the highest suspected event rate (64.56%, 133/206). Male accounted for 60.10% (232/12034) of the total signals, the proportion was higher than that of female (39.90%, 4802/12034). The housework and unemployed population group had the most warning signals (n=3708), and the nursery governess and housekeeper population group had the highest suspected event rate (8/9). With the increase of the diagnostic basis of pulmonary tuberculosis, the number of early warning signals decreased from 7969 to 56, the etiological negative pulmonary tuberculosis had the highest suspected event rate (31.03%, 818/2636). The Automated-alert System had the sensitivity of 41.18% (7/17) of aggregation tuberculosis outbreaks in Guangzhou schools. Conclusion: The signal sending function of the Automated-alert System for Tuberculosis in Guangzhou schools play a positive role, however, there are still some parts need to be improved. If the signal sending of cross-regional cases could be improved, the sensitivity of alert signals to the clustering epidemic situation could be further improved.

    Clinical features and literature review of active tuberculosis associated with PD-1/PD-L1 pathway inhibitors
    Ren Tantan, Zhan Senlin, Wang Yuxiang, Yu Hong, Zheng Junfeng, Yang Min, Deng Guofang, Zhang Peize
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  27-32.  doi:10.19983/j.issn.2096-8493.20220161
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    Objective: To study the relation of tuberculosis and inhibitors of programmed death protein-1 and its ligand (PD-1/PD-L1), to improve the understanding of development of active tuberculosis in tumor patients treated with PD-1/PD-L1 antibody. Methods: The clinical characteristics and treatment outcomes of 5 patients who developed active tuberculosis when using PD-1/PD-L1 inhibitors for their malignant tumor from February 2017 to October 2022 were retrospectively analyzed. Literature associated tuberculosis related to PD-1/PD-L1 inhibitors from 2016 January 1st to 2022 June 25th included in PubMed, Cochrane Library and CNKI was reviewed. Reported clinical features of active tuberculosis in patients with PD-1/PD-L1 inhibitors therapy were summarized. Results: Among 5 patients, 4 were male and 1 was female. None of them had been screened for tuberculosis before the use of PD-1/PD-L1 inhibitors. Active pulmonary tuberculosis developed at 3rd to 12th months after administration of PD-1/PD-L1 inhibitors. All patients were diagnosed with active pulmonary tuberculosis by etiological examination. After anti-tuberculosis treatment, 2 patients got improved, 2 patient was cured and 1 patient died; 2 patients restarted using PD-1/PD-L1 inhibitors. Among 14 patients reported in 12 literature, the median time of tuberculosis onset was the 5th month after administration of PD-1/PD-L1 inhibitors. Eleven patients were active pulmonary tuberculosis and 3 were extrapulmonary tuberculosis; 10 patients got improved after anti-tuberculosis treatment, 2 patients died and 2 with unknown outcomes. There were 7 patients restarted PD-1/PD-L1 inhibitors therapy. Conclusion: It is necessary to be alert to the occurrence of active tuberculosis during the treatment of PD-1/PD-L1 inhibitors. It is relatively safe to restart PD-1/PD-L1 inhibitors therapy after tuberculosis is controlled.

    Meta-analysis of efficacy and safety of inhaled nitric oxide in the treatment of severe and critical novel coronavirus pneumonia
    Zhou Yongfang, Fu Jiangquan, Dong Wentao, Fang Donghai, Hu Xiaochun
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  33-40.  doi:10.19983/j.issn.2096-8493.20220145
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    Objective: To evaluate the clinical efficacy and safety of inhaled nitric oxide (iNO) in the treatment of severe and critical novel coronavirus infection by Meta-analysis. Methods: Chinese database (CNKI,Wanfang,Wiper) and English database (PubMed, Embase Web of Science, Cochrane) were searched to retrieve the randomized controlled trials (RCTs) and observational studies about the iNO in the treatment of novel coronavirus infection published from January 2020 to November 2021. The outcomes included oxygenation index (PaO2/FiO2), mortality, needs for endotracheal intubation, length of hospital stay, viral load and incidence of complications. The Cochrane manual and Newcastle Ottawa scale (NOS) were used to evaluate the quality of the included studies, and RevMan 5.3 software was used to perform meta-analysis of the literature that met the quality criteria. Results: Fifteen studies were included, including 538 patients, with an average age of 58.5±3.0 years and 67.5% (363/538) male, including 1 RCT study with quality evaluation of “B” and 14 observational studies with NOS score above 5. Meta-analysis showed that oxygenation index was significantly improved after iNO treatment compared with before iNO treatment (SMD=-0.52, 95%CI: -0.73--0.31). There was no significant difference in short-term mortality between the non-iNO treatment group and the iNO treatment group (OR=0.76, 95%CI: 0.17-3.44), and there was no significant difference in mortality between the positive and negative iNO treatment groups (OR=0.66, 95%CI: 0.24-1.80). Conclusion: In patients with novel coronavirus infection, iNO treatment was safe and could improve oxygenation in a short time, but had no effect on short-term mortality.

    Meta analysis of the incidence of peripheral neuritis during the treatment of multidrug-resistant tuberculosis
    Wang Mengmeng, Sha Li, Li Xinyue, Tang Suyao
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  41-47.  doi:10.19983/j.issn.2096-8493.20220147
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    Objective: To systematically evaluate the incidence of peripheral neuritis during the treatment of multidrug-resistant tuberculosis (MDR-TB). Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and CBM database were systematically searched for the literature on the occurrence of peripheral neuritis during the treatment of MDR-TB from the establishment of the database to July 2022. At the same time, the literature is supplemented by the method of reference tracing and manual retrieval. Search terms were tuberculosis, multidrug-resistant, MDR-TB, side effect, adverse, adverse reactions, toxic effects, safety, neuritis, peripheral neuritis, multiple neuropathy, polyneuropathy both in Chinese and English. Literature screening, data extraction and quality evaluation were carried out by two researchers independently, and Stata 16.0 software was used for Meta analysis. Results: Finally 12 articles were included, the total number of MDR-TB patients was 2726, and 373 of them had peripheral neuritis. Meta analysis showed that the incidence of peripheral neuritis in MDR-TB patients during treatment was 19% (95%CI: 13%-25%). The results of subgroup analysis showed that the incidence of peripheral neuritis in MDR-TB patients was 21% (95%CI: 12%-29%) in Asia, 43% (95%CI: 26%-59%) in Africa, and 7% (95%CI: 4%-10%) in other regions; the incidences of peripheral neuritis in MDR-TB patients in the study before 2015 and in the study after 2015 were 13% (95%CI: 6%-20%) and 29% (95%CI: 17%-40%), respectively; the incidence of peripheral neuritis in patients with MDR-TB using standardized treatment scheme and individualized treatment scheme was 16% (95%CI: 4%-27%) and 21% (95%CI: 14%-28%), respectively; the incidences of peripheral neuritis in MDR-TB patients with sample size ≤100, 101-399 and ≥400 were 29% (95%CI: 16%-43%), 18% (95%CI: 8%-29%) and 7% (95%CI: 4%-9%), respectively. Conclusion: The incidence of peripheral neuritis in MDR-TB patients is high. Medical staff should pay more attention to the occurrence of peripheral neuritis during the treatment of MDR-TB patients, so as to achieve early assessment, early diagnosis and early intervention.

    Analysis of detection and treatment prognosis of 154 elderly pulmonary tuberculosis patients
    Zhang Yajing, Jiang Ying, Sun Hao, Tang Guiqin, Zhao Ying
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  48-53.  doi:10.19983/j.issn.2096-8493.20220158
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    Objective: To analyze and summarize the characteristics of detection and treatment outcome of elderly pulmonary tuberculosis (PTB) patients, so as to provide reference for diagnosis, treatment, prevention and control of PTB among elderly people. Methods: One hundred and fifty-four elderly active PTB patients treated at the Tuberculosis Control and Prevention Institute of Shijingshan District Center for Disease Control and Prevention from 2010 to 2020 were selected as the research objects. Their data were reviewed and analyzed. Results: Among 154 elderly patients, 46.10% (71/154) were relatively young (60-69 years old), 33.12% (51/154) were middle-aged (70-79 years old), and 20.78% (32/154) were older (≥80 years old); 81.17% (125/154) of them were detected passively, and 18.83% (29/154) were detected actively. Among all clinical symptoms, the incidence of cough and expectoration (68.18%, 105/154) was the highest, followed by fatigue (20.13%, 31/154) and fever (17.53%, 27/154). A majority of patients got lesions invaded more than two lung fields (64.94%, 100/154), and the presence of cavities accounted for 48.70% (75/154), of which single cavity accounted for 40.91% (63/154), and multiple cavities accounted for 7.79% (12/154). The etiologically positive rate before treatment was 67.97% (104/153). The sputum negative conversion rate of them in three age groups at the end of the treatment course were 95.12% (39/41), 83.33% (30/36) and 70.37% (19/27), respectively, with statistically significant difference (χ2=7.731, P=0.021). The successful treatment rate of 154 patients was 86.36% (133/154). There was a statistically significant difference among the three age groups (95.77% (68/71), 84.31% (43/51), 68.75% (22/32), χ2=13.951, P=0.001). Conclusion: The elderly PTB patients were mainly detected passively. Their imaging manifestations were complex, the etiologically positive rate was high, and the treatment prognosis was not ideal. We should strengthen the active detection of elderly PTB patients, especially by performing regular health examination, and reduce the proportion of adverse treatment outcomes.

    Preliminary investigation and analysis on the current situation of tuberculosis laboratories in 146 medical institutions in Gansu Province
    Kong Wanru, Zhang Haojun, Wu Minghua, Hu Fengjing, Zhang Yinghua, Lin Xia
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  54-59.  doi:10.19983/j.issn.2096-8493.20220143
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    Objective: To investigate the current situation of tuberculosis laboratories in medical institutions in Gansu Province and provide reference for proposing countermeasures. Methods: One hundred and fifty medical institutions with tuberculosis laboratories in Gansu Province filled out the self-designed online questionnaires by scanning QR codes attached to documents issued by the Health Commission between July 21 and August 10, 2021. The contents of the questionnaire included the basic information of the hospital, the development of the tuberculosis laboratory testing projects, the management of infection control, the configuration of hand hygiene and protective equipment, and the configuration of identification, etc. A total of 150 questionnaires were recovered, of which 146 were valid, with an effective rate of 97.33%. Results: Among the 146 medical institutions, 96 (65.75%) were secondary hospitals, 38 (26.03%) were tertiary hospitals, 12 (8.22%) were ungraded hospitals; 97 (66.44%) general hospitals and 49 (33.56%) specialized hospitals; 146 (100.00%) hospitals carried out acid-fast bacillus smear microscopy, 116 (79.45%) carried out mycobacterium culture, and 99 (67.81%) carried out drug susceptibility testing. The proportion of mycobacterial culture and drug susceptibility testing in specialized hospitals (91.84% (45/49) vs. 87.76% (43/49), respectively) was significantly higher than that in general hospitals (73.20% (71/97) vs. 57.73% (56/97), respectively), the differences were statistically significant (χ2=6.929, P=0.008; χ2=13.443, P<0.001). Weaknesses in laboratory infection control management were that only 80 (54.79%) laboratories had vaccination programmes to prevent infection risk, 5 (3.42%) laboratories could not classify laboratory waste, and 20 (13.70%) laboratories could not deploy biosafety cabinets (17 were secondary medical institutions). Among the 96 secondary hospitals, 13 (13.54%) hospitals did not clearly mark the clean area, buffer zone, contaminated area and did not conduct biological laboratory risk assessment, 11 (11.46%) did not carry out regular training for cleaning staff, 7 (7.22%) out of 97 general medical institutions did not develop the procedures of tuberculosis laboratory access system. In terms of facility and important sign configuration, the allocation rates of goggles, hand-washing charts, operating pathogenic biological agents and biological protection levels were low in ungraded hospitals (83.33% (10/12), 83.33% (10/12), 74.66% (109/146) and 85.62% (125/146), respectively), and 5 (13.16%) of tertiary hospitals no-marked emergency contact information. Conclusion: More specialized hospitals carried out mycobacterium culture and drug sensitivity test than general hospitals in Gansu Province. Management measures related to laboratory infection control and hardware configuration of low-level medical institutions need to be strengthened to ensure safe operation of tuberculosis laboratories.

    Efficacy observation of Xiaoluo Sanjie Powder combined with conventional anti-tuberculosis drugs in the treatment of infiltrating lymph node tuberculosis
    Wang Guowei, Liang Yachong, Liu Yufei, Li Cuiqiao, He Ping
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  60-65.  doi:10.19983/j.issn.2096-8493.20230014
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    Objective: To observe the efficacy of Xiaoluo Sanjie Powder combined with conventional anti-tuberculosis drugs in the treatment of infiltrating superficial lymph node tuberculosis and the effect on immunity. Methods: According to the inclusion criteria, a prospective study was conducted in 80 patients with infiltrating cervical superficial lymph node tuberculosis from Hebei Chest Hospital between March 2019 and March 2021. They were divided into observation group (n=40, conventional anti-tuberculosis treatment+Xiaoluo Sanjie Powder groups) and control group (n=40,conventional anti-tuberculosis treatment group) according to the random number table method. The clinical effective rate, integral changes of traditional chines medicine (TCM) syndrome (pain, low fever, fatigue, night sweats), immune levels (CD3+, CD4+, CD8+, CD4/CD8) 2 months after treatment, and the cure rate, follow-up and adverse reactions at the end of the 10-month-treatment were observed. At the end of the 2-month intensive period treatment, 1 and 3 cases were off in the observation group and control group, respectively. Results: Two months after treatment, the total effective rate in the observation group (97.4% (38/39)) was significantly higher than that in the control group (83.8% (31/37)), the difference was statistically significant (χ2=4.232, P=0.040).The scores of TCM syndromes such as pain, low fever, fatigue, and night sweats in the observation group were all improved (0.38±0.08, 0.38±0.08, 0.56±0.08, and 0.41±0.08, respectively), significantly higher than those in the control group (0.76±0.10, 0.68±0.09, 0.92±0.09, and 0.68±0.08, respectively; t=-2.971, P=0.040; t=-2.481, P=0.015; t=-2.948, P=0.004; t=-2.375, P=0.020, respectively),and the levels of CD3+, CD4+, CD4/CD8 in the observation group were also significantly higher than those in the control group ((66.89±3.58) % vs. (62.68±3.61) %, t=5.101, P<0.001; (39.92±3.73) % vs. (32.19±2.96) %, t=9.989, P<0.001; 1.47±0.23 vs. 1.06±0.12, t=9.447, P<0.001, respectively);while CD8+ was significantly lower than those in the control group ((26.81±2.99) % vs. (30.81±2.56) %, t=-6.245, P<0.001, respectively). After the 10-month-treatment, the cure rate in the observation group (100.0% (39/39)) was significantly higher than that in the control group (86.5% (32/37)) (χ2=5.641, P=0.024); and no skin ulceration was found in the observation group,however, in the control group 3 cases (8.1%) had ulceration and 2 cases (5.4%) were not healed and needed continuous medication. There was no significant difference in the incidence of adverse reactions between the two groups (5.1% (2/39) vs. 8.1% (3/37),χ2=0.274, P=0.671). Conclusion: Xiaoluo Sanjie Powder combined with conventional anti-tuberculosis drugs can improve the immunity, clinical effective, curative effect, and TCM syndromes in patients with infiltrating superficial lymph node tuberculosis. It has good safety and can be widely used in clinic.

    Diagnostic value of loop-mediated isothermal amplification method in non sputum or smear negative pulmonary tuberculosis
    Zeng Fang, Zhu Xiaoxia, Gong Rui, Liu Chuanhong, Shi Dejun, Zhao Ling, Yang Song
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  66-71.  doi:10.19983/j.issn.2096-8493.20230001
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    Objective: To explore the diagnostic value of loop-mediated isothermal amplification (LAMP) in detecting bronchoalveolar lavage fluid (BALF) in non sputum or smear negative pulmonary tuberculosis. Methods: The prospective study method was adopted, with the subjects being the sputum free or smear negative suspected pulmonary tuberculosis patients who were admitted to Wushan County People’s Hospital of Chongqing from April 2021 to April 2022 and met the inclusion criteria; they all brushed under bronchoscope for fluorescent staining microscopy (referred to as “smear”), and took BALF for LAMP and GeneXpert MTB/RIF (referred to as “Xpert”) to detect Mycobacterium tuberculosis complex DNA. With the final clinical diagnosis as the reference standard, the detection efficiency of the three methods was analyzed. Results: A total of 232 patients were included in the study. The patients were divided into smear negative/sputum free pulmonary tuberculosis patients (139 cases) and non tuberculosis pulmonary disease patients (93 cases) according to the final clinical diagnosis. The positive rates of LAMP, Xpert and smear in 232 patients with suspected pulmonary tuberculosis were 43.53% (101/232), 43.97% (102/232) and 8.19% (19/232), respectively. Taking the final clinical diagnosis as the reference standard, the detection sensitivity of LAMP, Xpert and smear for sputum free or smear negative pulmonary tuberculosis were 71.94% (100/139), 72.66% (101/139) and 13.67% (19/139) respectively; the specificity were 98.92% (92/93), 98.92% (92/93) and 100.00% (93/93) respectively; the diagnostic coincidence rates were 82.76% (192/232), 83.19% (193/232) and 48.28% (112/232); the Yoden index were 0.709, 0.716 and 0.137, respectively. Conclusion: The detection efficiency of LAMP for BALF in patients with sputum free or smear negative pulmonary tuberculosis is basically consistent with that of Xpert, significantly improving the early diagnosis rate; in addition, LAMP is easy to operate and cheap, which is more suitable for the promotion and application of grass-roots medical institutions.

    Review Articles
    Progress in diagnosis and treatment of gastrointestinal tuberculosis
    Zheng Jianbao, Wu Qianhong, Ma Tao, Cui Yuanbo, Li Jing, Liu Xin, Dong Zepeng, Sun Xuejun
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  72-77.  doi:10.19983/j.issn.2096-8493.20220139
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    Gastrointestinal tuberculosis is a main extrapulmonary tuberculosis that can affect the esophagus, stomach, duodenum, small intestine, colon, rectum and anus. The symptoms of gastrointestinal tuberculosis are non-specific and difficult to differentiate from other gastrointestinal diseases (such as inflammatory bowel disease, tumors, etc.). Although a series of emerging molecular and immunodiagnostic methods such as nucleic acid amplification test have developed rapidly, it is difficult to rapidly and accurately diagnosis gastrointestinal tuberculosis by a single laboratory examination method and the final diagnosis should be made based on combination of clinical manifestations, imaging,histopathology,and multiplenucleic acid amplification test.Early diagnosis and initiation of anti-tuberculosis therapy as well as prompt surgical treatment are essential to reduce the mortality. The authors review the etiology,clinical features,laboratory test and treatment strategies of gastrointestinal tuberculosis, in order to improve the early diagnosis and treatment of this disease.

    Research progress on the mechanism of there relationship between asthma and pertussisin children
    Yan Jinyan, Li Xiaomin, Ma Xiang
    Journal of Tuberculosis and Lung Disease. 2023, 4(1):  78-84.  doi:10.19983/j.issn.2096-8493.20220136
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    Bronchial asthma is a common chronic respiratory disease, and its main pathological mechanism is airway inflammation and airway remodeling, which is associated with a variety of respiratory pathogenic infections. In recent years, the relationship between pertussis and asthma has been paid more and more attention because of the recurrence of pertussis all over the world. The correlation between pertussis and asthma has been suggested by a large number of clinical studies, but the related mechanism is not yet clear. The molecular, cellular and tissue-level mechanisms involved in these two mechanisms are reviewed in this paper. Pertussis infection can cause airway inflammation and airway remodeling at the molecular level. After pertussis infection,pertussis toxin can induce cytoskeletal reorganization, and then lose the integrity of cell junctions, trigger airway inflammation, and promote airway remodeling, at the cellular level. Both pertussis toxin and tracheal cytotoxin can cause significant airway histological changes, including extrusion and destruction of ciliated respiratory epithelium by tracheal cytotoxin, leading to airway inflammation and airway remodeling.

Bimonthly, Established in June 2020
ISSN 2096-8493
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