Table of Content

20 August 2023, Volume 4 Issue 4

Previous Issue    Next Issue

Special Articles

Systematic immunology of tuberculosis,a critical step in the global war against tuberculosis disease

Zhu Guofeng, Yu Weiye, Wang Yuan, Liu Xiaoqing, Gao Qian, Li Liang, Lu Hongzhou

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  261-271.  doi:10.19983/j.issn.2096-8493.20230073

Abstract ( 114 )   HTML ( 20 )   PDF (1177KB) ( 56 )   Save

Figures and Tables | References | Related Articles | Metrics

A new era of novel vaccine and drug development against tuberculosis disease arrived with the failed clinical trial of MVA85A published in 2013. The breakthrough of systematic immunology of tuberculosis, which is the most critical challenge in developing novel technologies and products to end tuberculosis, is leading the reconstruction of the feature and position of strength of all countries in the ongoing struggle of global tuberculosis control.

Expert Note

Analysis of current situation of respiratory medical quality control system at home and abroad

Liao Yixuan, Ju Yang, Wang He, Chen Jing, Du Xiaoman, Zhang Fan, Li Yanming

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  272-276.  doi:10.19983/j.issn.2096-8493.20230056

Abstract ( 83 )   HTML ( 12 )   PDF (1038KB) ( 62 )   Save

References | Related Articles | Metrics

Medical quality is the cornerstone of medical safety. There is no unified model for medical quality control system. This paper expounded the concepts related to medical quality, summarized the international respiratory medical quality control system, and putted forward the existing problems and improvement direction of the respiratory medical quality control system in China, in order to continuously improve and perfect the respiratory medical quality control system.

Original Articles

Study on impact of COVID-19 on medical services of tuberculosis designated hospitals in Hunan Province

Gong Yabo, Liu Liqin, Xu Zuhui, Yang Yuan

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  277-282.  doi:10.19983/j.issn.2096-8493.20230068

Abstract ( 83 )   HTML ( 12 )   PDF (769KB) ( 102 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To explore the impact of COVID-19 prevention and control response on the medical services of tuberculosis designated hospitals in Hunan Province. Methods: Taking all tuberculosis designated hospitals in Hunan Province as survey subjects from Jan to Jun, 2021, questionnaire survey was conducted to investigate the situation of human resources and site requisition of designated tuberculosis hospitals (including outpatient service, ward, examination, radiology and pharmacy opening) after the outbreak of COVID-19 in 2020; the number of outpatient visits and the number of tuberculosis patients reported in 2019 and 2020 were compared; and the change of hospital infection control in 2020 were investigated. A total of 126 questionnaires were distributed, and 119 (94.44%, 119/126) valid questionnaires were retrieved. Results: Of the 114 (95.80%, 114/119) hospitals undertook the COVID-19 epidemic prevention and control tasks in 2020. The medical staff of 98 (82.35%, 98/119) hospitals, 1343 person-times, were requisitioned in total, and the median (quartile) person-times of requisitioned medical staff was 8 (2, 18). In 2020, the normal opening rates of tuberculosis clinic, ward, laboratory, radiology, and pharmacy were 48.74% (58/119), 27.44% (31/113), 88.24% (105/119), 89.92% (107/119), 94.12% (112/119), respectively. The outpatient visit rate among all populations in 2019 and 2020 were 254.18/100000 (169613 patients) and 222.48/100000 (148775 patients) respectively. In 2019 and 2020, the notification rate of pulmonary tuberculosis patients was 82.38/100000 (54968 patients); 76.55/100000 (51188 patients), and the notification rate of pulmonary tuberculosis patients decreased by 12.47% \left(\frac{(254.18-222.48)}{254.18}\times 100\mathrm{\%}\right) and 7.08% \left(\frac{(82.38-76.55)}{82.38}\times 100\mathrm{\%}\right), the differences were all statistically significant (χ²=1409.310, P<0.001; χ²=142.870, P<0.001). 99.16% (118/119) of hospitals strengthened infection control measures. Conclusion: The COVID-19 epidemic prevention and control squeezed the medical resources of the designated hospitals of tuberculosis in Hunan Province to varying degrees, resulting in the lack of medical service capacity and the decline of patient numbers. In order to ensure the prevention of COVID-19 epidemic and tuberculosis at the same time, it is necessary to strengthen the resource reserve of tuberculosis designated hospitals.

Analysis of the status and effects of the public-funded free 23-valent pneumococcal polysaccharide vaccination among elderly aged 60 years or older in Shanghai, 2013—2023

Peng Xiangdong, Xu Yaoyao, Hu Xiaojiang, Guo Lijun, Bo Jia

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  283-294.  doi:10.19983/j.issn.2096-8493.20230064

Abstract ( 257 )   HTML ( 10 )   PDF (1282KB) ( 65 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To analyze the overall implementation of the public funded 23-valent pneumococcal polysaccharide vaccine project (PPV23 project) for elderly aged 60 and above in Shanghai in 2013—2023, and to provide insights for the promotion of vaccination among the elderly and the further improvement of vaccination rate in China. Methods: Keywords including ‘Shanghai’‘elderly’‘pneumococcal polysaccharide vaccine’ or ‘pneumococcal vaccine’ were searched from academic database, government and public institution websites, media reports and social media articles. The vaccination rate was estimated, and the antibody positive conversion rate, protection rate, safety, and vaccination willingness and satisfaction with vaccination services were analyzed by extracting and summarizing the relevant data. Results: From 2013 to 2023, 1.818 million elderly people aged 60 or above in Shanghai received free PPV23 vaccination, of which 1.5686 million are still alive. The estimated gross vaccination coverage of PPV23 in 2023 was 27.74% (1568600/5655100). The PPV23 coverage increased rapidly in 2013—2015 (APC (95%CI)=39.65% (29.95%-49.80%); {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=176388.24, P<0.001),and increased slightly in 2016—2020 (APC (95%CI)=3.53% (2.01%-5.17%); {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=35475.49, P<0.001),and showed a slow declining trend in 2020—2023 (APC (95%CI)=-1.07%(-1.68%--0.46%); {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=1255.63, P<0.001). The antibody positive conversion rate was 60.50% (121/200) after 3 months of vaccination. The protection rate against pneumonia ranged 57.70%-88.00% in different regions one year after vaccination, and 52.30%-59.50% 3 years after vaccination. After 5 years, the protection rate against community acquired pneumonia (CAP) was 41.60%. The monitoring data of adverse events following immunization (AEFI) during 2013—2017 reported 433 AEFI cases out of 1310660 doses of PPV23. The incidence rate was 33.04/100000 doses, of which 90.53% (392 cases) were mild reactions, and 3.93% (17 cases) were abnormal reactions, which were cured or improved after treatment. There were 5.31% (23 cases) coincidences and 0.23% (1 case) psychogenic reactions. Conclusion: From 2013—2023, the PPV23 free vaccination project for elderly people aged 60 and above in Shanghai achieved good health benefits,but the vaccination rates remained stagnant after reaching around 30%. It is recommended to scientifically develop strategies based on the changing trend of the aging population structure, allocate adequate resources to vaccination institutions, strengthen research on the elderly people’s vaccination willingness, collect evidence, and promote and improve information disclosure,in order to breakthrough the bottleneck of vaccination rate of PPV23.

The application of nurse led rehabilitation management program in stroke patients with dysphagia associated pneumonia

Wang Lin, Si Fen, Zhang Zinan

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  295-300.  doi:10.19983/j.issn.2096-8493.20230071

Abstract ( 72 )   HTML ( 8 )   PDF (771KB) ( 46 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To analyze the intervention effect of nurse led rehabilitation management program on patients with pneumonia associated with dysphagia after stroke. Methods: The method of historical control study was used to select the patients with pneumonia associated with dysphagia after stroke who were hospitalized in the respiratory rehabilitation department of the Second Rehabilitation Hospital of Shanghai. The patients from January 1, 2021 to December 31, 2021 and from January 1, 2022 to December 31, 2022 were divided into the control group (87 cases) and the observation group (79 cases), respectively. The control group adopted a routine nursing model for stroke rehabilitation treatment (including neurological rehabilitation nursing routine, disease education, rehabilitation and drug treatment, respiratory care, etc.). A nurse led rehabilitation management plan based on the conventional nursing mode were provided in the observation group (including assessment of risk factors for pulmonary infection prognosis, establishment of rehabilitation management plan, tracking and evaluation of management effectiveness, etc.). The incidence of respiratory complications during hospitalization, the improvement rate of pneumonia at the second weekend of intervention, and the changes of comfort and activities of daily living (ADL) at the fourth weekend of intervention were compared between the two groups. Results: The incidence of respiratory complications in the observation group was 6.33% (5/79), significantly lower than that in the control group (20.69% (18/87)), and the difference was statistically significant (χ²=6.827, P=0.009). The improvement rate of pneumonia in the observation group at the end of the second week was 92.24% (73/79), which was significantly higher than that in the control group (80.46% (70/87)), and the difference was statistically significant (χ²=4.950, P=0.026). The comfort score and ADL score of the observation group at the end of the intervention fourth week were 57.25±8.54 and 56.90±10.20, respectively, higher than those of the control group ((48.29±7.34) and (49.37±10.70)), with statistically significant differences (t=-4.675 and -4.631, P values <0.05). Conclusion: The nurse led rehabilitation management program can reduce the incidence of respiratory complications in patients with dysphagia after stroke who have associated pneumonia, improve the improvement rate of pneumonia, and improve the comfort and activities of daily living of patients.

Analysis of pathological types and imaging features of lung cancer under bronchoscopy

Wang Yao, Liu Min, Hu Zhimin, Yu Panli, Wu Mingdi, Jing Qiusheng

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  301-307.  doi:10.19983/j.issn.2096-8493.20230061

Abstract ( 81 )   HTML ( 7 )   PDF (1304KB) ( 49 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To analyze the pathological types and imaging characteristics of lung cancer under electronic bronchoscopy and its diagnostic value. Methods: A retrospective analysis was conducted to collect the clinical data of 213 patients who underwent electronic bronchoscopy in the Endoscopy Center of Wuhan Pulmonary Hospital from July 2020 to June 2022. Gender, age, microscopic lesion characteristics and location, number of biopsy forceps samples and pathological type of lung cancer were analyzed. Results: All of 213 cases of lung cancer, 108 cases (50.7%) had squamous cell carcinoma, 51 cases (23.9%) had lung adenocarcinoma, 24 cases (11.3%) had lung small cell carcinoma, and 30 cases (14.1%) had malignant tumor of other types or could not be clearly classified, among them 2 male patients had lung squamous cell carcinoma complicated with lung small cell carcinoma. Among the 213 cases of lung cancer, the majority of them were male (85.4%, 182/213). Squamous cell carcinoma was mostly found in male (98.1%, 106/108) and adenocarcinoma in female (64.5%, 20/31), there was a significant difference of pathological types between the two genders (χ²=48.293, P=0.000). The most frequent sites of the lesions were: right branch (59.2%, 126 cases) >left branch (42.7%, 91 cases) >main trachea (16.9%, 36 cases). The squamous cell carcinoma was mainly hyperplastic (66.7%, 72/108), showing as new organism grew into the lumen under microscope, often accompanied by erosion, ulcer or white necrosis (36.1%, 39/108); 58.8% (30/51) of adenocarcinoma and 70.8% (17/24) of small cell carcinoma were found to be infiltrated under microscope. There were 41.2% (21/51) of adenocarcinoma and 87.5% (21/24) of small cell carcinoma getting lesions with vascular abnormalities, such as dense, thickened, disordered and tortuous vessels. There was a significant difference in the microscopic manifestations of different pathological types of lung cancer (χ²=31.113, P=0.000). 62.0% (132/213) patients with lung cancer required 3 pieces or less biopsy tissues for pathological diagnosis,and only 6.6% (14/213) of lung cancer patients needed more than 6 pieces. Conclusion: Bronchoscopy could directly observe the lesion and its imaging manifestations which could be of help to determine the pathological type of lung cancer, also could directly take the biopsy tissue for pathological diagnosis. Therefore, it is an important way to detect and diagnose lung cancer.

Analysis of diagnosis and treatment of 76 cases of chronic tuberculous empyema treated by complete thoracoscopy with process optimization method

Zhang Ying, Lao Haijun, Lin Bing, Liu Junting, Sun Dongmei

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  308-312.  doi:10.19983/j.issn.2096-8493.20230063

Abstract ( 63 )   HTML ( 6 )   PDF (745KB) ( 35 )   Save

References | Related Articles | Metrics

Objective: To explore the feasibility of the process optimization method in the treatment of chronic tuberculous empyema under complete thoracoscopy. Methods: The data of 76 patients with chronic tuberculous empyema who underwent complete thoracoscopic surgery with procedure optimization method in the Fourth Hospital in Chaoyang City from April 2015 to February 2019 were retrospectively analyzed. The process optimization methods mainly include changing the incision design sequence of thoracoscopic surgery, improving the technology of thoracoscopic operation space establishment, unifying the sequence of fiberboard stripping, and unique thoracic drainage tube placement. The evaluation time of long-term efficacy was based on the time of 9-12 months of standardized anti-tuberculosis drug treatment after surgery. Results: Video-assisted thoracoscopic surgery was successfully completed in all 76 patients, and a total of 77 surgeries were performed, among which 1 patient with bilateral chronic tuberculous empyema underwent staging surgery without conversion to thoracotomy. The operation lasted 60 to 260 minutes, with the median of 120 (90, 160) minutes, and the intraoperative bleeding was 150 to 2000 ml, with the median of 700 (540, 800) ml. Drainage tube indwelling time was 4-22 days (median, 7 (6, 11) days). Postoperative hospitalization lasted 6 to 26 days (median, 8 (7, 13) days). The incidence of postoperative complications was 19.5% (15/77), including delayed incision healing in 6 cases, persistent lung leakage in 8 cases and chylothorax in 1 case. Postoperative follow-up was 9 to 55 months (median, 26 (20, 37) months), no cases recurrence or underwent second operation. The long-term outcome was evaluated: 88.2% (67/76) achieved grade Ⅰ, 9.2% (7/76) achieved grade Ⅱ, and 2.6% (2/76) achieved grade Ⅲ. Conclusion: The long-term effect of complete video-assisted thoracoscopic surgery used to treat chronic tuberculous empyema by process optimization method is good. For patients with surgical indications, it is worth promoting.

Value of interferon-γ release assays in the diagnosis of tuberculosis

Song Yiyan, Ma Liling, Chen Hui, Hang Yin, Chen Sufang, Xu Junchi, Wu Minjuan, Xu Ping

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  313-317.  doi:10.19983/j.issn.2096-8493.20230044

Abstract ( 80 )   HTML ( 11 )   PDF (748KB) ( 51 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To explore the application value of interferon-γ release assays (IGRA) in the diagnosis of tuberculosis. Methods: A retrospective study was conducted in 331 suspected tuberculosis patients with tuberculosis related symptoms and (or) signs from the tuberculosis clinic of the Fifth People’s Hospital of Suzhou from July to October 2022. All the subjects underwent IGRA testing and sputum smear testing. The diagnostic efficacy of IGRA and sputum smear for tuberculosis was evaluated by referring to the results of clinical comprehensive diagnosis. Results: Of the 331 subjects, 199 (60.12%) were diagnosed as tuberculosis, of which, the positive rate of IGRA was 83.92% (167/199), significantly higher than that of sputum smear (21.61% (43/199), χ²=155.000, P<0.01); the positive rate of IGRA detection in patients with prior pulmonary tuberculosis was 66.67% (10/15), which was significantly higher than that of sputum smear (6.67% (1/15), χ²=11.630, P<0.01); the positive detection rate of IGRA in active pulmonary tuberculosis patients was 83.83% (140/167), which was significantly higher than that of sputum smear (24.55% (41/167), χ²=118.200, P<0.01). The positive detection rate of IGRA in patients with other respiratory diseases was 31.82% (42/132), which was significantly lower than that in patients with tuberculosis (χ²=92.570, P<0.01). Taking the clinical comprehensive diagnosis results as reference, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of IGRA in detecting tuberculosis were 83.92% (167/199), 68.18% (90/132), 79.90% (167/209), 73.77% (90/122) and 77.64% (257/339) respectively; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of IGRA and sputum smear in parallel detection of tuberculosis were 87.44% (174/199), 60.61% (80/132), 76.99% (174/226), 76.19% (80/105) and 76.74% (254/339), respectively. Conclusion: IGRA has good auxiliary diagnostic value for tuberculosis.

Analysis of latent tuberculosis infection and related factors in close contacts of pulmonary tuberculosis patients

Jiang Jun, Li Yun, Jiang Wei, Zhang Xiaolong

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  318-322.  doi:10.19983/j.issn.2096-8493.20230065

Abstract ( 95 )   HTML ( 20 )   PDF (821KB) ( 64 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To analyze latent tuberculosis infection (LTBI) and related factors in close contacts of pulmonary tuberculosis patients. Methods: Tuberculosis patients (76 cases) and their close contacts (498 cases) registered and managed in Zhangjiagang City of Suzhou area from January 1 to December 31, 2021 were taken as research objects. The demographic characteristics and contact approaches of the research objects were investigated, and LTBI was determined by tuberculin skin test. The non-conditioned Binary Logistic stepwise regression model was used to screen the influencing factors of LTBI among close contacts of tuberculosis patients, and a forest plot was drawn. Results: Among 498 subjects, there were 179 cases of LTBI, resulting in an infection rate of 35.94%. The LTBI rate of close contacts of etiologically positive patients (37.64%, 172/457) was significantly higher than that of etiologically negative patients (17.07%, 7/41; χ²=6.910, P<0.001). Multivariable analysis showed that compared with the lowest three quartiles of age (<20 years) as the reference, the OR (95%CI) values of the risk of LTBI among close contacts of tuberculosis patients aged 20-39 years and ≥40 years were 1.768 (1.132-2.763) and 2.020 (1.093-3.733), respectively, showing an increasing trend of infection risk with increasing age ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=15.743, P<0.001). The infection risk of LTBI among non-family close contacts was 2.892(95%CI: 1.673-4.999) times of that of family close contacts. Conclusion: The LTBI rate among close contacts of tuberculosis patients in Zhangjiagang City, Suzhou area was relatively high. Close contacts of patients with etiologically positive pulmonary tuberculosis, close contacts aged 40 years and older, and non-family close contacts were at high risk of LTBI, and targeted preventive medication interventions should be carried out.

Epidemiological characteristics of pulmonary tuberculosis patients in central urban area of Tianjin City from 2011 to 2020

Zhang Yuhua

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  323-327.  doi:10.19983/j.issn.2096-8493.20230069

Abstract ( 74 )   HTML ( 10 )   PDF (741KB) ( 59 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: The epidemiological characteristics of active tuberculosis patients diagnosed and registered in 2011—2020 in the central urban area of Tianjin City was analyzed to provide a basis for the formulation of tuberculosis prevention and control policies. Methods: Descriptive statistics was used to describe pulmonary tuberculosis patients registered in the 2011—2020 Tuberculosis Information Management System in central area of Tianjin City. Results: From 2011 to 2020, a total of 12968 cases of active pulmonary tuberculosis were confirmed in the central urban area of Tianjin, the average registration rate was 30.57/100000 (12968/42.42 million), and the registration rate was generally stable in 10 years, with no significant downward trend ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=2.771,P=0.096). The proportion of patients from the central urban area among all patients in Tianjin was 38.47% (12968/33707). The etiologically positive rate of tuberculosis patients was increasing from 36.21% (533/1472) in 2011 to 63.76% (769/1206) in 2019, showing a statistically significant upward trend ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=5.461, P=0.019). The registration number peaked in March-April and July-August, accounting for 40.85% (5298/12968) of all patients; 9003 were male tuberculosis patients, 3965 were females, male-female sex ratio was 2.27∶1; patients mainly aged 45-64 years old which accounted for 35.66% (4625/12968), male peaked in 45-64 years old group (accounting for 40.18% (3617/9003)), female peaked in 15-34 years old group (accounting for 41.69% (1653/3965)); patients’ occupations were mainly housework and unemployed which accounted for 34.18% (4432/12968). Conclusion: In the past 10 years, the pulmonary tuberculosis epidemic in Tianjin central urban area had gradually decreased, and targeted prevention and control strategies should be formulated according to the characteristics of the epidemic in the central urban area.

An investigation on a cluster of pulmonary tuberculosis in an off-campus study room

Wang Weibing, Li Na, Hao Jing, Jing Rui

Journal of Tuberculosis and Lung Disease. 2023, 4(4):  328-333.  doi:10.19983/j.issn.2096-8493.20230070

Abstract ( 74 )   HTML ( 5 )   PDF (1303KB) ( 57 )   Save

Figures and Tables | References | Related Articles | Metrics

Objective: To investigate and analyze an epidemic situation of pulmonary tuberculosis in an off campus study room, and put forward opinions and suggestions for the optimization of tuberculosis prevention and control for students in the future. Methods: On January 30th, 2022, Disease Control and Prevention Center of Ji’nan Shizhong District received the early warning information of a single case of school pulmonary tuberculosis from the Disease Control and Prevention Center of other cities. According to the relevant requirements of the Guidelines for Tuberculosis Control and Prevention in Chinese Schools (2020 Edition), the center immediately conducted a case epidemiological telephone survey of the index case (during the holidays). According to the contact intensity, the contact persons were informed to go to the local tuberculosis fixed-point hospital to complete tuberculosis screening (including symptom screening, tuberculin skin test (TST) and chest X-ray examination, further pathogenic examination was conducted for those with abnormalities in the three, and species identification and drug sensitivity test were conducted for those with positive etiology), and the screening results were reported to the school and our district control center for summary. Results: A total of 5 active pulmonary tuberculosis patients were found in the tuberculosis cluster epidemic in the school, and all of them were treated with anti-tuberculosis drugs. Among them, the first round of close contacts screening in the dormitory and off-campus study room of the index case found 3 cases, including 2 cases who prepared for the test in the same off-campus study room and 1 case who prepared at home from different schools in the same off-campus study room. In the second round of general contact investigation, 1 case was found to be a student preparing for examination in an adjacent off-campus study room on the same dormitory floor of the index case, and the further investigation was terminated because the management of the study room stopped cooperating with the notification work. A total of 82 contacts were screened from this epidemic investigation, including 22 close contacts, the strong positive rate of TST was 36.36% (8/22), and the abnormal rate of chest X-ray was 13.64% (3/22); a total of 60 general contacts were screened, with a strong positive TST rate of 8.33% (5/60) and an abnormal chest X-ray rate of 1.67% (1/60); the difference of strong positive rates was statistically significant (χ²=7.496, P=0.006), but there was no statistically significant difference in the abnormal rate of chest X-ray imaging (χ²=2.726, P=0.099). All 13 cases with strong positive TST were monitored. No new patients were found within 3 month follow-up of student patients, TST positive patients and their families. Conclusion: The prevention and control of tuberculosis among students should strengthen the implementation of the main responsibility of school tuberculosis management, especially the health management of students in the graduation preparation or internship stage. The prevention and control of tuberculosis among students should not only pay attention to the close contacts in the school, but also verify whether there is a stay history in the crowded places such as the study room outside the school through epidemiological investigation. Education departments, health supervision agencies, market supervision departments and community street administrative department should jointly do a good and new solution in the prevention and control of tuberculosis among students.