Table of Content

20 June 2025, Volume 6 Issue 3

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Special Topic

The burden, prevention and control status, and prospects of global lung cancer

Wang Ning, Wang Baohua

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  256-260.  doi:10.19983/j.issn.2096-8493.20250048

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Lung cancer is the most common cancer worldwide and the leading cause of cancer-related deaths. Despite certain progresses made in areas such as early screening, targeted therapy and immunotherapy in recent years, lung cancer remains a major global public health challenge. This article describes the burden and prevalence of lung cancer globally and in China, analyzes the disparities in lung cancer burden across regions with varying Human Development Index, and discusses the current status and prospects of lung cancer prevention and treatment.

Evidence-baced Nursing

Summary of the best evidence for nutritional management in patients with acute exacerbation of chronic obstructive pulmonary disease

Zou Jingjing, Cai Bin, Shi Jixia, Yang Li, Zhang Lumin

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  261-268.  doi:10.19983/j.issn.2096-8493.20250053

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Objective: To search and analyze the relevant evidence of nutritional management in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to summarize the best evidence to provide scientific guidance for clinical practice. Methods: Based on the “6S” evidence model, the search time limit was from January 1, 2015 to January 31,2025, and the evidence-based nursing method was used to raise questions about the nutrition management of AECOPD patients. The literature evidence that meets the quality evaluation criteria was evaluated, and then extracted and summarized in combination with professional judgment. Results: A total of 16 articles were included, including 4 clinical decisions, 4 guidelines, 4 systematic reviews, 2 randomized controlled trials and 2 expert consensus. The best evidence for AECOPD patient nutrition management was formed from 24 aspects, including multidisciplinary system construction, nutrition risk screening and assessment, nutrition demand calculation, nutrition intervention strategy and follow-up management. Conclusion: This study summarizes the best evidence of nutritional management in AECOPD patients and provides an evidence-based basis for clinical medical staff to develop nutritional management programs.

Original Articles

The mediating effect of self-efficacy between self-perceived burden and willingness to use remote rehabilitation in patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation

Zhao Panpan, Li Na, Wang Yan

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  269-276.  doi:10.19983/j.issn.2096-8493.20250047

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Objective: To examine the relationship between self-efficacy, self-perceived burden, and willingness to use telerehabilitation among pulmonary rehabilitation patients with chronic obstructive pulmonary disease (COPD), and to explore whether there is a mediating effect of self-efficacy between self-perceived burden and willingness to use telerehabilitation among pulmonary rehabilitation patients with COPD. Methods: This prospective study enrolled 108 patients with COPD who were admitted to the Department of Respiratory and Critical Care Medicine at Tianjin Medical University General Hospital between June and November 2024. Participants were selected using a convenience sampling approach. Data were collected using four validated instruments: a general information questionnaire, the Self-Perceived Burden Scale, the COPD Self-Efficacy Scale, and the Telerehabilitation Willingness Scale for COPD patients. A mediation model was subsequently constructed and tested to evaluate the indirect effects of self-efficacy. Results: The mean total score for self-efficacy among patients with COPD undergoing pulmonary rehabilitation was 89.96±15.54, while the mean scores for self-perceived burden and willingness to use telerehabilitation were 28.36±5.30 and 76.84±23.09, respectively. Pearson correlation analyses revealed that self-efficacy was strongly negatively associated with self-perceived burden (r=-0.834, P<0.05), whereas willingness to engage in telerehabilitation was also negatively correlated with self-perceived burden (r=-0.713, P<0.05). In contrast, self-efficacy was positively associated with willingness to use telerehabilitation (r=0.792, P<0.05). Structural equation modeling indicated that self-efficacy partially mediated the relationship between self-perceived burden and willingness to use telerehabilitation, accounting for 28.17% of the total effect. Conclusion: Among patients with COPD undergoing pulmonary rehabilitation, self-perceived psychological burden was found to directly influence their willingness to participate in telerehabilitation. Moreover, enhancing self-efficacy exerted an indirect facilitating effect on this willingness, underscoring its mediating role in the rehabilitation decision-making process.

Effectiveness of transtheoretical model-guided early rehabilitation exercise in patients with chronic obstructive pulmonary disease and frailty

Qiu Quying, Wang Xiufang, Sheng Caijuan, Lu Ye

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  277-283.  doi:10.19983/j.issn.2096-8493.20250005

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Objective: To explore the effectiveness of early rehabilitation exercise guided by transtheoretical model (TTM) in patients with chronic obstructive pulmonary disease (COPD) and frailty. Methods: A total of 116 patients with COPD and frailty admitted to Qingpu Branch of Zhongshan Hospital affilitated with Fudan University from January to August 2023 were selected according to the inclusion criteria, and randomized into a control group and an observation group. After one case of spontaneous pneumothorax was removed, the patients in control group (n=58) were given routine nursing care, while patients in observation group (n=57) were given TTM-guided early rehabilitation exercise combined with routine care. Behavioral changes, frailty score, extent of dyspnea, 6-minute walking distance (6MWD), and quality of life were evaluated and compared between the two groups before and after the intervention. Results: After intervention, the patients in observation group presented significantly lower no-intention-to-change rate in pre-intention period compared with control group (15.79% (9/57) vs. 60.34% (35/58)). Whereas the proportions of patients who had changed behavior and whose behavior change maintained for ≥6 months were significantly higher in observation group compard to control group ((52.63% (30/57) vs. 31.03% (18/58)) and (28.07% (16/57) vs. 3.45% (2/58)), with statistically significant difference (Z=-5.405, P<0.001). The proportions of patients with grade 1 and grade 2 dyspnea in the observation group (28.07% (16/57) and 52.63% (30/57)) were significantly higher than those in control group (24.14% (14/58) and 29.31% (17/58)), while the proportions of patients with grade 3 and grade 4 dyspnea in the observation group (17.54% (10/57) and 1.75% (1/57)) were lower than those in the control group ((37.93% (22/58) and 8.62% (5/58)), with statistically significant differences (Z=-2.312, P=0.021). The patients in observation group demonstrated significantly better outcomes in frailty score, 6MWD, and CAT score compared to the control group (3.14±0.64 vs. 3.88±0.73, (323.75±52.62) m vs. (299.38±61.26) m), 17.07±3.98 vs. 19.00±5.28, the differences were also statistically significant (t=5.784, P<0.001; t=-2.287, P=0.024; t=2.211, P=0.029). Conclusion: TTM-guided early rehabilitation exercise can effectively enhance patients’ willingness to adopt behavioral changes, promote the establishment of their exercise behavior pattern, which ultimately alleviate the dyspnea level and frailty syptoms in COPD patients, and improve quality of life. This model could be recommended in clinical practice.

Qualitative study of patients with poor cooperation in pulmonary function tests guided by the theory of planned behavior

Zhang Xiaoli, Yang Siben, Li Xiuping, Sha Li, Duan Zhizhen, Li Li

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  284-290.  doi:10.19983/j.issn.2096-8493.20250013

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Objective: This study explores the influencing factors of patients with poor cooperation in pulmonary function tests based on the Theory of Planned Behavior, aiming to provide a basis for constructing a pulmonary function test plan for such patients and improving the quality of pulmonary function tests. Methods: The phenomenological research method in qualitative research was adopted. Fifteen patients with poor cooperation in pulmonary function tests from June to August 2024 in Dali Prefecture People’s Hospital were selected as the research objects through purposive sampling. Semi-structured interviews were conducted, and the interview data was analyzed using Colaizzi’s seven-step analysis method. Results: Combining with the Theory of Planned Behavior, 3 themes were extracted, including behavioral attitude (negative emotions towards the disease, lack of attention to the disease, insufficient understanding of pulmonary function specialized examinations), subjective norms (medical support, influence of social roles, peer effect), and perceived behavioral control (discomfort during the examination, poor communication environment, need for examination guidance). Conclusion: On the basis of improving patients’ understanding of pulmonary function tests, reducing discomfort, and alleviating psychological pressure, providing personalized examination guidance according to patients’ needs is an important way to improve patient’s cooperation towards pulmonary function tests.

Effect observation of feed forward intervention management mode in preventing catheter-related bloodstream infections in patients undergoing long-term veno-venous extracorporeal membrane oxygenation (ECMO)

Zhong Xiaofeng, Liu Hengming, Yuan Kuan, Li Zi, Zhao Simin, Li Xuewen

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  291-296.  doi:10.19983/j.issn.2096-8493.20250026

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Objective: This study aimed to explore the impact of feedforward control in preventing catheter-related bloodstream infections in patients undergoing long-term veno-venous extracorporeal membrane oxygenation (V-V ECMO) treatment. Methods: A retrospective observational study was conducted on 18 patients receiving long-term V-V ECMO treatment at an ICU in Wuhan Pulmonary Hospital from January 2021 to December 2023. The study assembled a feedforward control special management team, engaged multidisciplinary medical infection control professionals for quality management, utilized ‘experiential’ and ‘scenario simulation exercise’ teaching methods for medical operation training and assessment, and applied treatment forms for quality control. Indicators such as ECMO catheter-related bloodstream infection rate, effective ECMO withdrawal rate, ECMO survival rate, and patient prognosis were monitored. Results: Totally 18 patients underwent 540 days of ECMO treatment without any catheter-related bloodstream infections. Among these patients, 10 were successfully weaned off ECMO, resulting in an effective withdrawal rate of 55.6%. Seven patients survived post-discharge, indicating a survival rate of 38.9%. Two patients returned to work, while two managed self-care at home, and two required assistance with daily activities. One patient, suffering from craniocerebral disease, was bedridden and needed daily care. Conclusion: The study concludes that the implementation of feedforward control measures can enhance patient safety during long-term V-V ECMO treatment, reduce the risk of ECMO catheter-related bloodstream infections.

Clinical significance of serum PⅢNP, homocysteine, and hs-CRP/prealbumin ratio in patients with chronic heart failure complicated by pleural effusion

Lin Hong, Yu Jinfeng, Zhang Shouxia, Liu Ye, Chen Yanmin

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  297-303.  doi:10.19983/j.issn.2096-8493.20250040

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Objective: This study aimed to investigate the clinical significance of the N-terminal propeptide of type Ⅲ procollagen (PⅢNP), homocysteine (Hcy), and the high-sensitivity C-reactive protein to prealbumin ratio (hs-CRP/PAB) among patients diagnosed with CHF complicated by pleural effusion. Methods: This prospective study enrolled 140 patients with chronic heart failure (CHF) who were hospitalized in the Department of Cardiology at Harbin Chest Hospital between January and December 2024. Based on the presence or absence of pleural effusion, patients were categorized into a pleural effusion group (n=60) and a non-effusion group (n=80). Serum levels of PⅢNP, Hcy, and hs-CRP/PAB were statistically compared between the two groups. Patients with pleural effusion were further stratified into small-, moderate-, and large-volume subgroups according to effusion volume, and biomarker levels were compared among these three subgroups. The diagnostic performance of PⅢNP, Hcy, and hs-CRP/PAB—alone and in combination—for identifying CHF complicated by pleural effusion was evaluated using receiver operating characteristic (ROC) curve analysis.Patients were also divided into a favorable prognosis group (n=35) and a poor prognosis group (n=25) based on clinical outcomes. Clinical characteristics and biomarker levels were compared between the two prognosis groups. Results: Serum levels of PⅢNP, Hcy, and the hs-CRP/PAB ratio were significantly elevated in patients with pleural effusion compared to those without ((133.19±33.56) ng/ml vs. (94.16±12.37) ng/ml; (24.07±6.19) μmol/L vs. (16.54±4.32) μmol/L; 0.06±0.02 vs. 0.02±0.01; t=9.580, 8.475 and 13.874, respectively, all P<0.001). Stratification by pleural effusion volume revealed progressive increases in all three biomarkers. Patients with moderate effusion (129.97±30.05 ng/ml PⅢNP, 23.31±4.45 μmol/L Hcy, 0.05±0.01 hs-CRP/PAB) and large effusion (156.32±35.48 ng/ml, 29.19±6.68 μmol/L, and 0.07±0.02, respectively) had significantly higher levels than those with small effusion ((106.79±15.37) ng/ml, (18.41±3.97) μmol/L and 0.03±0.01; all P<0.001; F=9.650, 15.670 and 33.930, respectively). Receiver operating characteristic (ROC) analysis demonstrated that the combination of PⅢNP, Hcy, and hs-CRP/PAB yielded an area under the curve (AUC) of 0.848, outperforming any single biomarker (AUCs of 0.763, 0.773 and 0.746 for PⅢNP, Hcy, and hs-CRP/PAB, respectively). Additionally, patients in the poor prognosis group showed markedly elevated levels of PⅢNP ((152.15±36.19) ng/ml vs. (119.65±29.46) ng/ml, Hcy (28.28±5.16) μmol/L vs. (21.06±3.45) μmol/L), and hs-CRP/PAB (0.07±0.01 vs. 0.04±0.01), compared with those in the favorable prognosis group (all P<0.001; t=3.829, 6.500 and 10.220, respectively). Conclusion: Serum levels of PⅢNP, Hcy, and the hs-CRP/PAB ratio were significantly associated with both the presence and volume of pleural effusion in patients with CHF. These biomarkers exhibited a stepwise increase corresponding to effusion severity. Combined detection of PⅢNP, Hcy, and hs-CRP/PAB ratio demonstrated superior diagnostic performance compared to individual markers, particularly in identifying CHF complicated by pleural effusion. Moreover, elevated levels of these biomarkers were significantly correlated with poor clinical prognosis, suggesting their potential utility in both diagnostic evaluation and prognostic risk stratification.

Spatiotemporal analysis on pulmonary tuberculosis in the Xizang Autonomous Region, 2010—2022

Nima Qucuo, Lyu Hengliang, Hu Fengmei, Zhang Wenyi, Xu Yuanyong

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  304-309.  doi:10.19983/j.issn.2096-8493.20250041

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Objective: To analyze the spatiotemporal of pulmonary tuberculosis (PTB) in the Xizang Autonomous Region (Xizang) and provide references for formulating PTB prevention and control policies. Methods: The cases of PTB with onset dates between January 1, 2010 and December 31, 2022, and current residence in Xizang were extracted from “Infectious Disease Surveillance System of the National Health Security Information Project-Disease Prevention and Control Information System”. Joinpoint regression was used to analyze the time trend of the incidence rate of PTB, and the annual percentage change (APC) was used to evaluate the change trend. Global autocorrelation and spatiotemporal scan statistic were used to analyze the overall and space-time clusters of PTB in Xizang. The log likelihood ratio (LLR) was used to evaluate the risk within the clustered area relative to outside the area. Results: A total of 60391 PTB cases were reported in Xizang from 2010 to 2022, with an average reported incidence rate of 141.97 per 100000 population. The reported incidence rate increased from 118.34 per 100000 population in 2010 to 182.38 per 100000 population in 2019 (APC=4.56%, 95%CI: 2.98%-6.18%), and then decreased to 95.96 per 100000 population in 2022 (APC=-16.50%, 95%CI: -23.22--9.20%). The increase in female incidence rate from 2010 to 2020 (APC=5.45%, 95%CI: 3.93%-6.99%) was higher than that in male incidence from 2010 to 2019 (APC=3.32%, 95%CI: 2.27%-4.38%). Spatiotemporal scan statistic analysis revealed that the most likely cluster area was identified in Changdu City (LLR=2105.41, P<0.001), with a clustering period from January 2016 to June 2022. The secondary cluster area was mainly identified in the eastern part of Naqu City (LLR=434.55, P<0.001) with its clustering period spawning from January 2018 to April 2022. Conclusion: The reported incidence rate of PTB in Xizang from 2010 to 2022 exhibited a trend of initial increase followed by a subsequent decline. The PTB incidence showed significant spatiotemporal aggregation, particularly clustered in Changdu and eastern Nagqu. Future efforts should prioritize strengthening health education and enhancing screening measures for populations in these high-risk regions.

Epidemiological trends of tuberculosis in Yuexi County, Liangshan Yi Autonomous Prefecture, Sichuan Province, 2005—2023

Gu Yong, Mo Hui, Chen Hongmei, Lu Bo, Yi Chunmei, Gao Zhidong, Zhou Xiaofeng, Zhang Hongtai

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  310-315.  doi:10.19983/j.issn.2096-8493.20250035

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Objective: To examine the epidemiological trends of pulmonary tuberculosis in Yuexi County, Liangshan Yi Autonomous Prefecture, Sichuan Province, from 2005 to 2023, and to evaluate potential influencing factors including economic growth and transportation infrastructure development, with the aim of informing tuberculosis control strategies in resource-limited settings. Methods: Pulmonary tuberculosis case data from 2005 to 2023 were retrieved from the China Disease Control and Prevention Information System. Population and economic indicators were obtained from annual statistical yearbooks of Yuexi County. Descriptive epidemiological techniques were applied to assess incidence trends and their associations with macro-level socioeconomic variables. Results: Between 2005 and 2023, a total of 9856 pulmonary tuberculosis cases were reported in Yuexi County, corresponding to an average annual incidence rate of 151.66/100000 (9856/6498778). A statistically significant upward trend was observed over the study period (Z=11.519, P<0.01), with an average annual growth rate of 1.77%. A geographic shift in reporting sources was noted: from 2005 to 2018, more than half of the cases were reported locally (e.g., 86.81% (375/432) in 2008), whereas since 2019, the majority of cases were reported by medical institutions outside the county (e.g., 60.16% (379/630) in 2023). Of these out-of-county reports, 91.57% (3530/3855) were within Sichuan Province, predominantly from Xichang City (64.57%) and Chengdu City (18.13%). Marked spatial heterogeneity was observed across townships: Laji Township recorded the highest average incidence (211.58/100000, 193/91219), whereas Zhongsuo Town had the lowest (79.07/100000, 311/393300). Among all reported pulmonary tuberculosis cases, 65.57% (6463/9856) were male, with an incidence rate of 170.70/100000 (6463/3786111), significantly higher than that observed in females (92.99/100000, 3393/3648931)(χ²=867.890, P<0.001). The highest burden was observed among individuals aged 18-60 years, who constituted 75.66% (7557/9856) of all cases, with an incidence of 185.09/100000 (7457/4028798). Farmers represented the predominant occupational group, accounting for 80.32% (7916/9856) of all cases. Joinpoint regression analysis indicated that the average annual percent change (AAPC) in tuberculosis incidence from 2005 to 2023 was 1.70%, with notable surges during 2005—2007 (annual percent change (APC)=19.13%) and 2013—2016 (APC=31.87%). During the same period, the per capita gross domestic product (GDP) in Yuexi County increased at an average annual rate of 9.06%, exhibiting a weak positive correlation with the tuberculosis incidence rate, described by the fitted curve: y=121+0.00242x. Conclusion: The burden of pulmonary tuberculosis in Yuexi County has continued to rise in parallel with economic development. Improvements in transportation infrastructure have facilitated cross-regional healthcare-seeking behavior, contributing to increased case detection outside the county. Young and middle-aged male farmers represent the primary high-risk population for tuberculosis in this setting.

Influencing factors and risk prediction of delayed tuberculosis diagnosis in a tertiary hospital in Wuhan, China

Hou Kun, Wu Jinyi, Wang Xiaojun, Peng Peng

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  316-322.  doi:10.19983/j.issn.2096-8493.20250069

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Objective: To investigate the current status of delayed diagnosis of pulmonary tuberculosis (PTB) at Wuhan Fourth Hospital, analyze its influencing factors of delayed diagnosis and develop a risk prediction model, thereby providing evidence for optimizing the prevention and control strategies of PTB. Methods: A total of 125 PTB patients reported by Wuhan City between January 1, 2020 to December 31, 2022, and who had medical visits to Wuhan Fourth Hospital within six months before reporting were selected from the Chinese Disease Prevention and Control Information System based on inclusion criteria. Demographic characteristics and clinical data of the patients were collected from the hospital’s medical record information system. Descriptive statistics, univariate analysis and multivariate logistic regression were used to analyze the influencing factors associated with diagnostic delay. A risk prediction model was constructed and evaluated using the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and calibration curve (CC). Results: The median (interquartile range, IQR) of reporting interval was 49 (13, 110) days. The overall diagnostic delay rate was 74.40% (93/125), and 66 patients (52.80%) received imaging or TB tests. Among those reported by Wuhan Fourth Hospital itself (n=34, 27.20%), the median reporting interval was 10 (5, 81) days, with a diagnostic delay rate of 44.12% (15/34) and 100.00% (34/34) received imaging or TB tests. Among patients reported by other hospitals (n=91, 72.80%), the median reporting interval was 58 (23, 114) days, the diagnostic delay rate was 85.71% (78/91), and only 35.16% (32/91) received imaging or TB tests. Statistically significant differences were observed between our hospital and other hospitals in terms of reporting interval, proportion of imaging or TB tests, and diagnostic delay rate (Z=-3.199, P=0.001; χ²=41.750, P=0.001; χ²=22.486, P=0.001). The delay rate in the respiratory department (33.33% (7/21)) was significantly lower than that in other departments (82.69% (86/104)) (χ²=22.349, P<0.001). Multivariate logistic regression analysis identified first consultation in the respiratory department (OR=0.182, 95%CI: 0.055-0.597) and ordering of imaging or TB-related tests at the initial hospital visit (OR=0.196, 95%CI: 0.065-0.588) as independent protective factors against diagnostic delay. The AUC of the risk prediction model was 0.820, and 0.833 in the internal validation set. DCA demonstrated that the model was clinically applicable across a threshold probability range of 6% to 80%. The calibration curve indicated good agreement between predicted and actual outcomes. Conclusion: The delayed diagnosis rate of PTB in our hospital is high. The independent risk factors for diagnostic delay are the first visit in non-respiratory medicine department and the absence of imaging or tuberculosis test. The constructed risk prediction model demonstrated favorable predictive performance. It is recommended to strengthen the first diagnosis of tuberculosis, improve the ability of doctors in general hospitals, especially non-respiratory specialists, to identify PTB through systematic and long-term training, and improve the timeliness of hospital report.

Analysis of the detection and treatment outcomes of MTB/HIV co-infected patients in Hefei from 2014 to 2023

Cao Hong, Deng Xiaolan, Li Zhen, He Yuqin, Wu Jinju, Lu Lunshan

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  323-329.  doi:10.19983/j.issn.2096-8493.20250002

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Objective: To provide a scientific basis for improving the prevention and control of MTB/HIV co-infection by analyzing the detection and treatment outcomes of MTB/HIV co-infected patients in Hefei from 2014 to 2023. Methods: A retrospective study method was conducted. Demographic characteristics and clinical data of HIV/AIDS patients registered and followed up in the Department of STD/AIDS Prevention and Control in districts and counties in Hefei City, as well as tuberculosis (TB) patients registered in seven TB designated hospitals from 2014 to 2023 were collected. Data on bi-directional screening of TB and HIV/AIDS were also collected. Key indicators such as screening rate, detection rate, cure rate, and treatment success rate were used to analyze the detection and treatment outcomes of MTB/HIV co-infected patients. Results: From 2014 to 2023, the TB screening rate among HIV/AIDS patients was 99.49% (24096/24219), and the HIV antibody testing rate among TB patients was 75.95% (29307/38589). The bi-directional screening rates showed a significant increasing trend over the decade ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=59.634, P=0.000; {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=2210.488, P=0.000). The TB detection rate among HIV/AIDS patients was 0.39% (94/24096), significantly higher than the HIV/AIDS detection rate among TB patients at 0.06% (19/29307), with a statistically significant difference (χ²=66.260, P=0.000). The TB registration rate of MTB/HIV co-infected patients was 89.38% (101/113), with the majority being male (94.06% (95/101)), aged 30-39 (30.69% (31/101)), farmers (44.55% (45/101)), local residents (93.07% (94/101)), living in Baohe District (16.83% (17/101)), referred patients (72.28% (73/101)), delayed diagnosis (63.37% (64/101)), negative etiology (46.53% (47/101)), and being new cases (92.08% (93/101)). All registered co-infected patients received both antiretroviral therapy and anti-TB treatment. The anti-TB treatment success rate was 93.07% (94/101). The cure rate for those with positive etiological findings was 66.67% (30/45). Conclusion: During 2014—2023, Hefei City has achieved remarkable results in the bi-directional screening of TB and HIV/AIDS. Attention should be paid to the quality of TB screening among HIV/AIDS patients, improve the detection rate of TB in HIV/AIDS patient, with a particular focus on HIV antibody testing for TB patients who are young and middle-aged males, farmers, housework and unemployed, so as to early detect and treat MTB/HIV co-infected patients, reduce medical diagnostic delay, improve the effectiveness of anti-TB therapy.

Prognostic value of neutrophil-to-lymphocyte ratio combined with serum procalcitonin in patients with severe pulmonary tuberculosis

Wei Yunxia, Wang Xin, Long Xuejuan

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  330-334.  doi:10.19983/j.issn.2096-8493.20250028

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Objective: To evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and serum procalcitonin (PCT) in ICU patients with severe pulmonary tuberculosis. Methods: All of 144 patients with severe pulmonary tuberculosis admitted to the ICU of Hebei Chest Hospital from January 2021 to December 2023 were retrospectively analyzed. Patients were divided into a survival group (n=67) and a death group (n=77) according to their survival status after 28 days in ICU. Basic clinical data. the results of NLR, serum PCT and other laboratory tests results within 24 hours of ICU admission were collected. The predictive efficacy of these indicators individually and in combination for prognosis of ICU patients with severe tuberculosis were compared between groups. Results: The levels of NLR and serum PCT in the death group were higher than those in the survival group (NLR: 12.76 (9.49, 23.44) vs 8.13 (6.24, 15.06)), PCT: 4.18 (2.64, 5.66) ng/ml vs 2.31 (1.09, 3.52) ng/ml), and the difference was statistically significant (Z=-5.501、-5.343, both P<0.001). For individual prognostic prediction in ICU patients with severe pulmonary tuberculosis, the area under the receiver operating characteristic curve (AUC) of NLR was 0.766, with a sensitivity of 75.3% and specificity of 70.1%. The AUC for PCT was 0.759, with a sensitivity of 77.9% and specificity of 65.7%. The AUC of the combination of the two indicators was 0.833, with a sensitivity of 81.8% and specificity of 73.1%. Conclusion: Compared to a individual test, the combined NLR and serum PCT detection demonstrates higher prognostic value for ICU patients with severe pulmonary tuberculosis, providing valuable insights for clinical diagnosis and treatment.

Influencing factors of diagnostic delay in pulmonary tuberculosis patients: a comparative study using three classification models

Zhang Leijie, Li Pei, Wang Dan, Li Huiping, Zhu Ni

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  335-342.  doi:10.19983/j.issn.2096-8493.20250036

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Objective: To investigate the diagnostic delay status of pulmonary tuberculosis (PTB) patients in Lianhu District, Xi’an City, and analyze its influencing factors based on three classification models, providing a basis for adjusting prevention and control strategies. Methods: Data of 642 PTB patients registered in Lianhu District from 2023 to 2024 were collected through the “Tuberculosis Information Management System”, a subsystem of the “China Information for Disease Control and Prevention”. Descriptive epidemiological methods were used to analyze patients’ baseline characteristics and diagnostic delay. Multivariable logistic regression, decision tree, and Bayes discriminant model were applied to identify the influencing factors of diagnostic delay of PTB patients. Their performances were evaluated using ROC curve analysis. Results: The median healthcare-seeking delay in PTB patients of Lianhu District was 16 (5, 35) days, with a delay rate of 51.40% (330/642). The median diagnostic delay was 2 (0, 9) days, with a delay rate of 17.76% (114/642). All three models consistently identified the following factors: seeking healthcare in 2024 (OR=1.882, 95%CI: 1.221-2.901) and residing in other districts of Xi’an city (OR=3.798, 95%CI: 1.760-8.198) as risk factors for diagnostic delay, while having TB-related symptoms (OR=0.334, 95%CI: 0.215-0.518) and experiencing healthcare-seeking delay (OR=0.559, 95%CI: 0.365-0.858) were protective factors. The AUC values for logistic regression, decision tree, and Bayes discriminant model were 0.709, 0.696 and 0.706, respectively. Sensitivity values were 75.44%,61.40% and 80.70%, specificity values were 57.01%, 68.00% and 50.19%, and Youden indices were 0.325, 0.294 and 0.309, respectively. Conclusion: Delay in healthcare-seeking and diagnosis among PTB patients in Lianhu District are prevalent. The three classification models consistently identified influencing factors for diagnostic delay, with comparable overall predictive performance, but each model had its specific focus on certain indicators.

Review Articles

Research progress on the caregiving burden of family members of patients with chronic obstructive pulmonary disease

Qian Guilan, Wang Lin

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  343-347.  doi:10.19983/j.issn.2096-8493.20250046

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Chronic obstructive pulmonary disease (COPD), as a global public health issue, seriously affects the daily life of patients due to its chronic and progressive nature. At the same time, it brings a heavy care burden to the family members of patients. This article comprehensively reviews the relevant concepts, assessment tools, current burden situation, influencing factors, and intervention strategies of the caregiver burden borne by the family members of COPD patients. The aim is to enhance the attention of medical staff to the caregiver burden of the family members of COPD patients, provide a reference basis for in-depth research in related fields, and promote the further development of this field.

Advances in the application of virtual reality in respiratory training for patients with chronic obstructive pulmonary disease

Zheng Ling, Xia Binxue, Yang Haiyan, Cheng Yan, Xiong Hong

Journal of Tuberculosis and Lung Disease. 2025, 6(3):  348-353.  doi:10.19983/j.issn.2096-8493.20250054

Abstract ( 34 )   HTML ( 2 )   PDF (771KB) ( 4 )   Save

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Patients with chronic obstructive pulmonary disease (COPD) have a heavy disease burden, and pulmonary rehabilitation breathing training can effectively improve patients’ symptoms and reduce the disease burden. However, in the process of breathing training, there are problems such as low patient compliance and inability to feedback the training results in time. Virtual reality technology has become an effective breathing training aid due to its immersive, interactive and fun nature. In this study, the application methods and effects of virtual reality in pulmonary rehabilitation respiratory training were reviewed. This paper proposes the problems, limitations and prospects of using virtual reality in respiratory training, aiming to provide a reference for clinical medical workers to conduct virtual reality breathing training for COPD patients.