Table of Content

20 August 2025, Volume 6 Issue 4

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Interpretation of Standards

Interpretation of the World Health Organization key updates for endTB regimens to treat multidrug-resistant tuberculosis

Duan Hongfei

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  361-364.  doi:10.19983/j.issn.2096-8493.20250030

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Multidrug-resistant tuberculosis (MDR-TB) remains a major risk for human health. Recently, World Health Organization (WHO) has recommended new regimens for MDR-TB based on the endTB study. These regimens include drugs such as bedaquiline (Bdq), delamanid (Del), linezolid (Lzd), levofloxacin (Lfx) or moxifloxacin (Mfx), clofazimine (Cfz), and pyrazinamide (Z). Effective combinations include Bdq-Lzd-Mfx-Z, Bdq-Cfz-Lzd-Lfx-Z and Bqd-Del-Lzd-Lfx-Z. The new regimens expand the applicability of short-course regimens to MDR-TB patients with extensive lesions and are also suitable for special populations such as children, pregnant individuals, and people living with HIV. It is definitely an important event in the treatment of multidrug-resistant tuberculosis. The author briefly introduces research history, eligibility, and precautions of endTB study.

Guideline·Standard·Consensus

Expert consensus on the application of Mycobacterium tuberculosis infection detection technologies

Tuberculosis Control Branch of Chinese Antituberculosis Association, Standardization Professional Branch of Chinese Antituberculosis Association, Elderly Tuberculosis Control Branch of Chinese Antituberculosis Association

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  365-381.  doi:10.19983/j.issn.2096-8493.20252001

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Mycobacterium tuberculosis infection test is an essential method for identifying latent tuberculosis infection and clinically diagnosing tuberculosis. To better guide clinical practice, this consensus was jointly organized by the Tuberculosis Control Branch, Standardization Professional Branch and Elderly Tuberculosis Control Branch of Chinese Antituberculosis Association. Based on domestic and international research progress and clinical practice experiences, and taking into account the specific situations in different scenarios, recommendations on the application of Mycobacterium tuberculosis infection detection technologies are proposed. The consensus provides a detailed introduction to the characteristics and applications of various Mycobacterium tuberculosis infection tests and offers specific suggestions for the selection and application of detection technologies in different application scenarios, such as high-risk populations, key venue populations, and clinical tuberculosis diagnosis. In addition, the application of infection test results in tuberculosis treatment efficacy evaluation is discussed. This consensus aims to provide references for professionals related to tuberculosis prevention and control, diagnosis and treatment in medical and health institutions at all levels and types, in order to help achieve the goal of “ending the TB epidemic”.

Expert consensus on the standardization of broth microdilution method for drug susceptibility testing of Mycobacterium tuberculosis in China

Tuberculosis Basic Professional Branch, Chinese Antituberculosis Association

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  382-392.  doi:10.19983/j.issn.2096-8493.20252002

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Drug resistant tuberculosis has long been a serious challenge in the field of global public health. At present, it is difficult to provide accurate and effective treatment plans for patients based solely on binary phenotypic drug sensitivity and genotypic drug sensitivity tests. The microbroth dilution drug sensitivity test based on the microplate not only covers a variety of drugs and multiple concentrations at one time, but also provides quantitative drug resistance information for the clinic, so it is receiving more and more attention. In order to use the microbroth dilution drug sensitivity test in a reasonable, scientific, and standardized manner, the Tuberculosis Basic Professional Branch of Chinese Antituberculosis Association had organized experts in relevant fields to formulate this consensus on technical characteristics, application value, standardized operation, result interpretation, and precautions in actual operation of this drug sensitivity method, and proposed 12 recommendations, aiming to provide unified guiding principles for clinical and laboratory staff who are related to tuberculosis.

Original Articles

Investigate the regulatory effect of Astragalus Polysaccharides on lung cancer tissue infiltrating PD-1^hiCD8⁺T cell subsets in mice

Fan Guiqin, Lyu Hong, Qu Qiuxia

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  393-400.  doi:10.19983/j.issn.2096-8493.20250023

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Objective: To investigate the regulatory effect of Astragalus Polysaccharides (APS) on lung cancer tissue infiltrating PD-1^hiCD8⁺T cell subsets in mice. Methods: A tumor-bearing mouse model was constructed using 3LL lung cancer cells. 24 hours after model being established, 10 mice were randomly assigned into two groups. Control group mice were given 100 μl of sterile water for injection by gavage daily, while APS group were given APS (300 mg/kg) dissolved in 100 μl of sterile water for injection by gavage daily. Both groups were administered for 21 consecutive days. From day 5, the long and short diameters of abdominal tumors in mice were measured every 3 days. Mice were sacrificed when the tumor volume reached 2000 mm³. The experiment was repeated for 3 times to compare subcutaneous tumor volume and survival time between the two groups. Another 10 mice were similarly grouped, sacrificed 14 days after continuous administration following modeling. Tumor tissues were collected to prepare single-cell suspensions for examining the proportions of tumor CD8⁺ T cells, PD-1 expressions, IFN-γ secretions, as well as infiltrating mitochondrial metabolism (MTG: for mitochondrial structure; Rhod-2: for mitochondrial Ca²⁺ overload; TMRE: for mitochondrial membrane potential; Mito-SOX: for mitochondrial superoxide) and their correlation with IFN-γ secretion. The experiment was repeated 3 times, and flow cytometry analysis was performed using results from the latter 2 experiments. Results: Compared with the control group, the APS group significantly inhibited tumor growth from day 11 ((135.81±42.98) mm³ vs. (92.13±22.53) mm³;t=3.583, P=0.001) and significantly prolonged the survival time of tumor-bearing mice (χ²=12.180, P<0.001). Flow cytometry showed that the levels of PD-1⁺CD8⁺ and PD-1^hiCD8⁺ in APS group ((78.81±2.61) % and (21.52±1.94) %) were significantly lower than those in the control group ((83.41±1.95) % and (31.16±5.84) %, t=4.467, P<0.001; t=4.597, P<0.001), while the proportion of PD-1^intCD8⁺ ((57.48±2.84) %) was significantly higher than that in the control group ((52.20±5.83) %, t=2.542, P=0.020). The Rhod-2 level in PD-1^intCD8⁺ T cells ((57.10±6.25) %), and the expression of Rhod-2 and Mito-SOX in PD-1^hiCD8⁺ T cells ((69.25±5.56) % and (14.78±3.14) %) in APS group were significantly lower than those in the control group ((68.18±10.47) %, (78.95±9.48) %, and (24.66±5.54) %, t=2.873, P=0.010; t=2.791, P=0.012; t=4.907, P<0.001), while the MTG expression in PD-1^hiCD8⁺ T cells ((65.15±8.89) %) was significantly higher than that in the control group ((51.43±6.34) %, t=3.975, P<0.001). The secretion levels of IFN-γ in PD-1⁺CD8⁺, PD-1^hiCD8⁺, and PD-1^intCD8⁺ T cells in the APS group ((50.55±4.08) %, (70.48±3.62) %, (40.76±4.32) %) were significantly higher than those in the control group ((41.56±6.25) %, (58.87±6.54) %, (36.97±3.30) %, t=3.810, P=0.001; t=4.910, P<0.001; t=2.204, P=0.041). The IFN-γ secreted by PD-1^hiCD8⁺ T cells was significantly correlated with the expression of mitochondrial MTG, Rhod-2, and Mito-SOX (r=0.728, P<0.001; r=-0.618, P=0.004; r=-0.657, P=0.002), while the IFN-γ secreted by PD-1^intCD8⁺ T cells was only moderately associated with MTG and Rhod-2 expression (r=0.448, P=0.048; r=-0.550, P=0.012). Conclusion: APS can inhibit tumor growth in mice with lung cancer, significantly reduce the infiltration of PD-1^hiCD8⁺ T cells, remarkably enhance IFN-γ secretion in PD-1^hiCD8⁺ T cells, and regulate the anti-tumor effect of PD-1^hiCD8⁺ T cells through the mitochondrial metabolic pathway.

The construction of health education program for inhaled medication in patients with chronic obstructive pulmonary disease based on the PRECEDE-PROCEED Model

Peng Xia, Bai Yuting, Dong Fuyan, Ge Jingjing, Liu Yongmei, Shen Lili, Hao Haiqin

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  401-407.  doi:10.19983/j.issn.2096-8493.20250051

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Objective: To construct a health education program on inhaled medication for patients with chronic obstructive pulmonary disease (COPD), covering knowledge of inhaled drugs, usage skills, behavioral changes, etc., so as to provide a reference for the management of inhaled medication in COPD patients. Methods: Based on the preliminary status survey, literature review and the theoretical foundation of the PRECEDE-PROCEED model, a draft of the health education program was developed, followed by revision and improvement through two rounds of expert consultation. Results: The positive coefficient of experts in the two rounds of correspondence consultation were 93.33% and 100.00% respectively, and the expert authority coefficient was 0.86. The finalized program included 3 first-level items, 5 second-level items and 19 third-level items. Conclusion: The constructed health education program on inhaled medication for patients with COPD demonstrates high scientific validity and can provide a reference for improving the adherence of inhaled medication in COPD patients.

Analysis of status and influencing factors of respiratory function exercise compliance in elderly COPD patients

Wang Qian, Chen Qinpei, Yu Xiaobing

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  408-412.  doi:10.19983/j.issn.2096-8493.20250079

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Objective: To explore the status and influencing factors of respiratory function exercise compliance in elderly patients with chronic obstructive pulmonary disease (COPD) and analyze intervention measures. Methods: A total of 123 elderly COPD patients admitted to the First Hospital of Putian City from March 2022 to October 2024 were selected as research subjects. A self-developed respiratory function exercise compliance scale was used to evaluate their compliance, and general information such as gender, age, education level, disease course, drug dependence, anxiety and depression were collected. Multivariable logistic regression was used to analyze the influencing factors of respiratory function exercise compliance. Results: Among the 123 elderly COPD patients, 39 had poor compliance (31.71%), while 84 had good compliance (68.29%). Multivariable logistic regression analysis showed that education level of junior high school or below (OR=2.941, 95%CI:1.327-6.517), disease duration <5 years (OR=2.735, 95%CI:1.251-5.893), drug dependence (OR=2.500, 95%CI:1.140-5.481), anxiety (OR=4.222, 95%CI:1.882-9.473), depression (OR=2.565, 95%CI:1.185-5.552), and low level of social support (OR=3.054,95%CI:1.390-6.709) were all risk factors affecting respiratory function exercise compliance in elderly COPD patients. Conclusion: The compliance of respiratory function exercise in elderly COPD patients is related to their educational level, disease duration, drug dependence, anxiety and depression, and social support level. Effective intervention measures should be taken based on this in clinical practice.

Study on the diagnostic value of nanopore sequencing technology for non-tuberculous mycobacterial pulmonary disease

Huang Gaoyan, Su Shenxiao, Zhao Juanjuan, Liang Baoyuan, Meng Xiayan, He Huawei

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  413-419.  doi:10.19983/j.issn.2096-8493.20250024

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Objective: To explore the diagnostic value of nanopore sequencing technology for detecting non-tuberculous mycobacterial pulmonary disease (NTM-PD) in bronchoalveolar lavage fluid (BALF). Methods: A total of 155 patients with suspected NTM-PD admitted to the Tuberculosis Department of Nanning Fourth People’s Hospital from January 1, 2022, to December 31, 2024, were enrolled. BALF samples collected via bronchoscopy were subjected to mycobacterial culture and identification, fluorescence PCR melting curve method, and nanopore sequencing. The diagnostic efficiencies of these three methods were compared. Results: Among the patients, 96 were diagnosed with NTM-PD (NTM-PD group) and 59 with non-NTM pulmonary diseases (including 29 cases of pulmonary tuberculosis and 30 cases of other pneumonias). The sensitivity, diagnostic concordance rate, and Kappa value of nanopore sequencing for NTM-PD diagnosis were 92.71% (95%CI: 85.98%-96.75%), 86.45% (95%CI: 79.81%-91.56%), and 0.706 (95%CI: 0.586-0.808),The sensitivity of nanopore sequencing was significantly higher than that of mycobacterium identification by fluorescence PCR melting curve method (63.54%,95%CI:53.18%-73.09%;71.61%,95%CI:63.91%-78.49%;0.445,95%CI:0.350-0.618), mycobacterium culture and identification (63.54%,95%CI:53.18%-73.09%;74.84%,95%CI:67.35%-81.44%;0.515,95%CI:0.453-0.703), and the combination of the latter two methods (84.38%,95%CI:75.53%-90.94%;82.58%,95%CI:75.67%-88.23%;0.634,95%CI:0.523-0.761). However,the specificity of nanopore sequencing was 76.27%(95%CI:63.60%-86.37%), which was lower than that of mycobacterium identification by fluorescence PCR melting curve method (84.75%,95%CI:72.90%-92.71%), mycobacterium culture and identification (93.22%,95%CI:83.54%-98.01%), and the combination of the latter two methods (79.66%,95%CI:67.34%-89.14%). Conclusion: Nanopore sequencing technology has high diagnostic efficiency for NTM-PD and can directly identify bacterial species, but specificity issues should be considered in clinical application.

Identification and drug resistance analysis of non-tuberculous mycobacterial pulmonary disease pathogens in suburban areas of Hangzhou

Wu Yifei, Li Qingchun, Jia Qingjun, Huang Yinyan, Bai Xuexin, Cheng Qinglin

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  420-425.  doi:10.19983/j.issn.2096-8493.20250062

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Objective: To understand the prevalence and drug resistance of non-tuberculous mycobacteria (NTM) caused lung disease pathogens in suburban counties in Hangzhou in recent years. Methods: PNB/TCH growth tests were used to preliminarily identify 3311 NTM strains isolated from mycobacterium-positive culture samples from patients visiting tuberculosis designated hospitals in 8 suburban counties and districts in Hangzhou from January 2021 to December 2024. The species of NTM isolates were confirmed using mycobacterium molecular linear probe method and sequencing of PCR product of 16S rRNA, ITS and Hsp65 gene. Concentration proportional method was applied to detect the susceptibility of NTM isolates to isoniazid, rifampicin, streptomycin, ethambutol, ofloxacin, levofloxacin, moxifloxacin, and kanamycin. Results: PNB/TCH growth tests showed that 12.4% (409/3311) of the 3311 mycobacterium-positive culture samples were positive. Out of these 409 specimens preliminarily identified as NTM, 22 (5.4%) strains were Mycobacterium tuberculosis, 19 (4.6%) strains were non mycobacterial. The total number of NTM patients included in this study was 368. The mycobacterium molecular linear probe hybridization and PCR product sequencing confirmed that among these 368 NTM samples, 22 types of nontuberculous mycobacteria were identified, 60.6%(223/368) were identified as Mycobacterium intracellulare, followed by Mycobacterium abscessus (11.7%, 43/368), Mycobacterium kansasii (6.5%, 24/368), Mycobacterium avium (5.2%, 19/368), Mycobacterium chelonei (4.6%, 17/368) and Mycobacterium marseillense (2.7%, 10/368). The resistance rates of 368 NTM isolates to isoniazid, rifampicin, streptomycin, ethambutol, ofloxacin, levofloxacin, moxifloxacin, and kanamycin were 99.2% (365/368), 82.3% (303/368), 93.5% (344/368), 73.4% (270/368), 87.2% (321/368), 86.1% (317/368), 85.1% (313/368), and 80.7% (297/368), respectively. Conclusion: Mycobacterium intracellulare is the predominant NTM species in Hangzhou suburban areas. Moreover, NTM isolates have high resistance against commonly used antituberculosis drugs.

Study on the correlation between serum soluble PD-1 and the severity and prognosis of pulmonary tuberculosis patients in ICU

Wei Yunxia, Wang Xin, Lin Hongxia, Li Yishuai

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  426-431.  doi:10.19983/j.issn.2096-8493.20250032

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Objective: To evaluate the value of serum soluble programmed death receptor-1 (PD)-1 in assessing prognosis of the patients with pulmonary tuberculosis (PTB) in intensive care unit (ICU). Methods: A total of 102 pulmonary tuberculosis patients admitted to the ICU of Hebei Provincial Chest Hospital from April 2022 to April 2024 were included in this study, and they were divided into survival group and death group respectively, according to their survival status after 28 days in ICU. The serum soluble PD-1 levels of the patients in the two groups were compared, and its correlation with the severity, prognosis score and nutritional indicator of pulmonary tuberculosis patients in ICU was analyzed. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of serum soluble PD-1 in assessing prognosis of the patients with pulmonary tuberculosis in ICU. Results: Among the 102 pulmonary tuberculosis patients in ICU who were included in this study, 42 patients died (death group) with the case fatality rate of 41.2% (42/102), and 60 patients survived (survival group) with the survival rate of 58.8% (60/102). Compared with the patients in the survival group, the serum PD-1 level increased significantly among those patients in the death group (PD-1 (pg/ml): 47.25 (41.48, 51.15) vs. 35.45 (28.40, 41.80), Z=―6.399, P<0.001). PD-1 level was positively correlated with APACHE Ⅱ and SOFA scores (r=0.580, P<0.001; r=0.575, P<0.001), negatively correlated with prealbumin level (r=―0.297, P=0.002), and not correlated with lactate level (r=0.104, P=0.297). The results of ROC curve analysis showed that the area under the ROC curve (AUC) of PD-1 in predicting death of pulmonary tuberculosis patients after entering ICU 28 days was 0.873 (95%CI: 0.809-0.938). The optimal cutoff value of serum PD-1 was 38.45 pg/ml, with the sensitivity and the specificity were 95.2% and 65.0% respectively. While PD-1 value was combined with APACHE Ⅱ, the sensitivity was more than 99.9% and the specificity was 76.7%. Conclusion: The serum soluble PD-1 level is significantly increased in the death patients with pulmonary tuberculosis in ICU. Serum soluble PD-1 has certain clinical value in evaluating the severity and prognosis of tuberculosis patients admitted to the ICU.

Original article

Comparison of ultrasound imaging characteristics between pulmonary tuberculosis and bacterial pneumonia in high-altitude environments

Liu Jing, Zhao Yuejuan

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  432-435.  doi:10.19983/j.issn.2096-8493.20250043

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Objective: To investigate the ultrasound imaging features of subpleural pulmonary tuberculosis and bacterial pneumonia in a high-altitude environment. Methods: Using a retrospective research method, 47 patients diagnosed with subpleural pulmonary tuberculosis (pulmonary tuberculosis group) and 40 patients diagnosed with bacterial pneumonia (pneumonia group) at Yunnan Provincial Infectious Disease Hospital from January to December 2024 were selected as the study subjects. All patients underwent routine ultrasound examination to compare the ultrasound imaging features of the two groups, including lesion morphology (wedge-shaped, quasi circular, irregular), fragmentation sign (uneven local echoes with scattered bright spots), waterfall sign (layered hypoechoic area extending parallel to the pleural line, recording its extension range and clarity of layered structure), and liquefaction necrosis lesion (gas hyperechoic or “comet tail sign” visible inside the hypoechoic area). Results: In the pulmonary tuberculosis group, wedge-shaped lesions accounted for 61.7% (29/47), round lesions for 29.8% (14/47), and irregular lesions for 8.5% (4/47). In the pneumonia group, wedge-shaped lesions accounted for 62.5% (25/40), and round lesions for 37.5% (15/40). There was no statistically significant difference in lesion morphology between the two groups (Fisher’s precision probability test, P>0.05). The proportion of patients with fragmented signs in the pulmonary tuberculosis group was 29.8% (14/47), significantly lower than the 82.5% (33/40) in the pneumonia group, and the difference was statistically significant (χ²=14.490, P=0.001). The incidence of “waterfall sign” in the pulmonary tuberculosis group was 61.7% (29/47), significantly higher than the 27.5% (11/40) in the pneumonia group, and the difference was statistically significant (χ²=10.177, P=0.001). The incidence of liquefied necrosis lesions in the pulmonary tuberculosis group was 80.9% (38/47), significantly higher than the 25.0% (10/40) in the pneumonia group, and the difference was statistically significant (χ²=28.301, P=0.001). 68.1% (32/47) of the pulmonary tuberculosis group had peripheral blood flow signals, and there were no cases of central blood flow; in the pneumonia group, 77.5% (31/40) had peripheral blood flow signals, while 2.5% (1/40) had central blood flow signals, with no statistically significant difference (χ²=0.976, P=0.317). Conclusion: The ultrasound imaging of pulmonary tuberculosis in high-altitude environments is characterized by layered hypoechoic (waterfall sign) with strong gas echoes, while bacterial pneumonia is mainly characterized by fragmented signs and small liquefied lesions, with blood flow signals mainly distributed in the periphery.

Original Articles

The effect of different doses of esketamine on perioperative lung function and postoperative pulmonary complications in patients with pulmonary tuberculosis undergoing thoracoscopic surgery

Liu Caifang, Zong Hua, Gao Yunfei, Yan Jin

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  436-443.  doi:10.19983/j.issn.2096-8493.20250060

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Objective: To investigate the effects of different doses of esketamine on perioperative lung function and postoperative pulmonary complications in patients with pulmonary tuberculosis undergoing thoracoscopic surgery. Methods: A prospective study was conducted at the Sixth People’s Hospital of the Xinjiang Uygur Autonomous Region from September 2023 to September 2024, enrolling 90 patients with pulmonary tuberculosis who underwent elective thoracoscopic surgery. The patients were randomly divided into three groups: the low-dose group (continuous intraoperative infusion of esketamine at 0.125 mg·kg^-1· h^-1), the high-dose group (continuous intraoperative infusion of esketamine at 0.25 mg·kg^-1· h^-1), and the control group (continuous intraoperative infusion of an equal volume of normal saline), with 30 patients in each group,then calculated their oxygenation index, alveolar-arterial oxygen pressure difference, and pulmonary dynamic compliance at 5 minutes after bilateral lung ventilation (T1), 15 minutes after unilateral lung ventilation (T2), and 90 minutes after unilateral lung ventilation (T3) for each group of patients, examined their interleukin 6 and serum glucose concentrations using enzyme-linked immunosorbent assay one day before surgery and on the first and third day after surgery. Time-sensitive indicators such as surgery/anaesthesia time, tube removal time, and postoperative hospitalisation time were recorded, and the usage of vasoactive drugs were simultaneously recorded, also for adverse reactions within 3 postoperative days and pulmonary complications within 7 postoperative days. Results: (1) The average oxygenation index at time points T2 and T3 for the low-dose group, high-dose group, and control group were ((245.8±26.5) mmHg, (258.2±25.2) mmHg, and (229.1±30.9) mmHg;(239.9±28.0) mmHg, (241.3±32.7) mmHg and (223.5±23.5) mmHg), and the average alveolar-arterial oxygen pressure difference were ((140.5±29.3) mmHg, (137.6±25.6) mmHg and (163.4±32.9) mmHg; (139.7±28.0) mmHg, (131.8±35.3) mmHg and (162.9±25.1) mmHg), with statistically significant differences (F values were 10.818, 3.665, 6.924, and 8.841, and P values all <0.05). (2) The average IL-6 levels in the low-dose group, high-dose group, and control group at post-operative Day1 and Day3 were ((158.77±23.50) ng/L, (154.71±28.90) ng/L, and (173.16±26.13) ng/L; (44.99±16.32) ng/L, (42.85±21.46) ng/L, and (78.40±22.61) ng/L), with statistically significant differences (F values of 4.086 and 28.891, respectively, and P values all <0.05).The average GLU concentrations at postoperative Day3 in the low-dose group, high-dose group, and control group were (5.40±0.63) mmol/L, (4.86±0.48) mmol/L, and (6.18±2.08) mmol/L, showed statistically significant differences (F=8.001, P<0.05). (3) Adverse reactions within 3 postoperative days in all three groups were nausea and vomiting. The incidence rates in the low-dose group, high-dose group, and control group were 33.3% (10/30), 36.7% (11/30), and 70.0% (21/30), respectively, with statistically significant differences (χ²=5.424, P<0.05). The incidence rates of pulmonary complications within 7 postoperative days in the 3 groups were 33.3% (10/30), 26.7% (8/30), and 36.7% (11/30), respectively, with no statistically significant difference (χ²=0.712, P>0.05). However, compared with the control group, the incidence of pleural effusion was lower in the high-dose group, the low-dose group, high-dose group, and control group got rates of 13.3% (4/30), 3.3% (1/30), and 26.7% (8/30),respectively (χ²=6.653, P<0.05). Conclusion: In thoracoscopic surgery, continuous infusion of esketamine can improve intraoperative oxygenation of patients with pulmonary tuberculosis, reduce postoperative stress responses, protect lung function, and accelerate postoperative recovery.

Analysis of drug resistance of 2941 clinical isolates of Mycobacterium tuberculosis in Gansu Province

Wei Daijue, Sun Jianjun, Chen Yan, Wang Shijun, Chang Yamei, Wei Nianhuan, Zhang Xin, Tong Chongxiang

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  444-448.  doi:10.19983/j.issn.2096-8493.20250061

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Objective: To analyze the drug resistance of clinical isolates of Mycobacterium tuberculosis (MTB) in Gansu Provincial Infectious Diseases Hospital from 2022 to 2024, so as to provide scientific basis for precise prevention, control and treatment of drug-resistant tuberculosis in Gansu Province. Methods: A total of 2941 clinical isolates of MTB cultured and identified from sputum or bronchoalveolar lavage fluid in Gansu Provincial Infectious Disease Hospital from 2022 to 2024 were selected. The results of drug sensitivity tests on 9 anti-tuberculosis drugs, including isoniazid (INH), rifampicin (RFP), ethambutol (EMB), levofloxacin (Lfx), propiconazole (Pto), sodium aminosalicylate (PAS), moxifloxacin (Mfx), capreomycin (Cm), and amikacin (Am), were collected and analyzed. Results: Among 2941 clinical isolates of MTB, drug sensitive strains accounted for 62.39% (1835/2941) and drug-resistant strains accounted for 37.61% (1106/2941). The single drug resistance rate of the strain was 7.14% (210/2941), the poly-drug resistance rate was 12.58% (370/2941), the multi-drug resistance rate was 11.39% (335/2941), and the extensive-drug resistance rate was 6.49% (191/2941). The resistance sequence of the 9 anti-tuberculosis drugs as follows: INH (28.66%, 843/2941), RFP (20.50%, 603/2941), Lfx (10.34%, 304/2941), Mfx (9.49%, 279/2941), EMB (8.06%, 237/2941), PAS (1.73%, 51/2941), Pto (1.67%, 49/2941), Cm (0.92%, 27/2941), Am (0.78%, 23/2941). There were a total of 71 drug resistance spectra, including 8 single drug resistance spectra, 26 poly-drug resistance spectra, 15 multi-drug resistance spectra, and 22 extensive-drug resistance spectra. Conclusion: The clinical isolates of MTB from tuberculosis patients in Gansu Provincial Infectious Diseases Hospital have a high resistance rate, mainly poly-drug resistance and multi-drug resistance. The resistance spectrum presents complexity and diversity, and drug resistance screening of tuberculosis patients should be emphasized, and monitoring of drug-resistant patients should be strengthened.

Epidemiological characteristics of tuberculosis and the establishment of seasonal autoregressive integrated moving average (SARIMA) model in Daxing district, Beijing, from 2015 to 2024

Zhang Wen, Cui Hongyan, Hou Wenjun

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  449-455.  doi:10.19983/j.issn.2096-8493.20250059

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Objective: To analyze the epidemiological trends of pulmonary tuberculosis (PTB) in Daxing District, Beijing, from 2015 to 2024, and to predict the disease incidence by Seasonal Autoregressive Integrated Moving Average (SARIMA). Methods: PTB cases data from 2015 to 2024 were collected from the “Infectious Disease Monitoring System”, a subsystem of the “China Disease Prevention and Control Information System”. Descriptive epidemiological methods were used to analyze the distribution of PTB, while Joinpoint regression was employed to analyze annual incidence trends. The SARIMA model was constructed using RStudio software with data from 2015—2023 as the training set to predict the number and incidence rate in 2024, which were then compared with actual observations. Results: From 2015 to 2024, a total of 5548 PTB cases were notified in Daxing District, with an average annual incidence of 32.1/100000(5548/17303714). Among these, 2299 cases were etiologically confirmed PTB, 1829 cases were etiologically negative, and 1420 cases had no etiological results. The overall PTB incidence decreased by 49.3% from 2015 to 2024 was, with an average annual decrease rate of 7.3%. The proportion of etiologically positive cases increased from 30.7% (189/615) to 69.0% (256/371)(Z=22.387,P<0.001), while the proportion of etiologically negative cases decreased from 38.9% (239/615) to 20.2% (75/371)(Z=-12.400,P<0.001), and the cases without etiologically results decreased from 30.4% (187/615) to 10.8% (40/371)(Z=-11.914,P<0.001). The highest PTB incidence rates occurred in the ≥80 age group (126.4/100000, 324/256359), followed by the 70-79 (69.1/100000, 457/661535), and 60-69 age groups (40.4/100000, 588/1454785). The top five occupations among PTB cases were homemakers and unemployed individuals (38.1%, 2116/5548), farmers (14.5%, 805/5548), workers (11.6%, 646/5548), retirees (10.6%, 587/5548), and cadre staff members (8.2%, 453/5548). The top five town/subdistricts with the highest number of TB cases were Huangcun Town (12.4%, 689/5548), Jiugong Town (10.9%, 606/5548), Xihongmen Town (10.0%, 556/5548), Qingyuan Subdistrict (6.9%, 381/5548), and Yizhuang Town (6.7%, 372/5548). The ARIMA(0,1,1)(1,0,0)_[12] model predicted the 2024 PTB cases and incidence rate with Mean Absolute Percentage Errors (MAPE) of 24.008% and 32.493%, respectively, and actual observed values fell within the 95% confidence intervals of prediction. Conclusion: PTB incidence in Daxing District has shown a annually decline, with an increasing proportion of etiologically confirmed cases from 2015 to 2024. The elderly (≥60 years) exhibited higher incidence rates, and homemakers/unemployed individuals and farmers were the most affected occupational groups. High-incidence areas included densely populated regions such as Huangcun and Jiugong. The ARIMA (0,1,1)(1,0,0)_[12] model demonstrated reasonable accuracy for PTB incidence prediction in the district.

Analysis of the etiological positive rate among pulmonary tuberculosis patients in designated tuberculosis hospitals in Ordos,Inner Mongolia Autonomous Region, 2015—2024

Qi Dan, Wang Sheng, Liu Min, Gao Meiqin, Shi Feng, Li Bing, Bai Jun, Hao Ruixia, Wang Dong

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  456-463.  doi:10.19983/j.issn.2096-8493.20250056

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Objective: To analyze the etiological positive rate among pulmonary tuberculosis (PTB) patients in Ordos City, Inner Mongolia Autonomous Region from 2015 to 2024, and to evaluate the application value of molecular diagnostic techniques in the early diagnosis of PTB. Methods: Data from 4394 PTB patients with laboratory testing results, reported by nine designated TB hospitals in Ordos City between 2015 and 2024, were extracted from the “Tuberculosis Information Management System” of Chinese Center for Disease Control and Prevention. The usage rates and positive rates of three diagnostic methods were assessed: acid-fast bacilli (AFB) smear microscopy, Mycobacterial culture, and molecular diagnostic assay. Results: From 2015 to 2017, AFB smear microscopy was the primary diagnostic method. Molecular diagnostic assays were gradually introduced begining in 2018. The utilization rate of smear microscopy remained 93.95%-100.00% in most years, except in 2018 (84.12%, 445/529). In contrast, the utilization rates of culture and molecular methods increased from 1.70% (9/529) and 25.90% (137/529) in 2018 to 76.72% (356/464) and 92.24% (428/464) in 2024, respectively, showing significant annual upward trend ( {\chi }_{trend}^2=1885.69, P<0.001; {\chi }_{trend}^2=2150.208, P<0.001).The overall etiological positive rate for PTB in Ordos significantly increased from 28.44% (128/450) in 2015 to 75.44% (344/456) in 2024 ( {\chi }_{trend}^2=682.623, P<0.001). Between 2018 and 2024, the overall positive rate of molecular methods (74.38% (1405/1889)) was significantly higher than that of culture (54.85% (921/1679)) and smear microscopy (33.40% (1425/4267)), with significant difference (χ²=922.943, P<0.001). Among all etiologically positive results, the proportion of positive cases only by smear microscopy decreased from 98.44% (126/128) in 2015 to 2.91% (10/344) in 2024, while the proportion detected only by culture consistently remained between 0.45% (1/221) and 5.71% (16/280). Conversely, the proportion of cases positive with molecular biological methods increased from 0.00% before 2018 to 90.41% (311/344) in 2024, with the most significant increase in cases detected only by molecular methods (rising from 17.55% (43/245) in 2019 to 36.34%(125/344) in 2024) and by all three methods combined (rising from 10.20% (25/245) in 2019 to 27.62% (95/344) in 2024). For smear-negative patients, the molecular detection positive rates at citywide, municipal-level, and county-level designated hospitals increased from 0.33% (1/303), 0.54% (1/185), and 0.00% (0/118) in 2018 to 60.00% (165/275), 53.37% (95/178), and 72.16% (70/97) in 2024, respectively, all showing significant annual upward trends ( {\chi }_{trend}^2=867.785, P<0.001; {\chi }_{trend}^2=421.652, P<0.001; {\chi }_{trend}^2=445.559, P<0.001). Notably, the positive rate at banner (district)-level hospitals surpassed that at municipal-level hospitals in 2024, with statistically significant difference ( {\chi }_{trend}^2=9.240, P=0.002). Conclusion: From 2015 to 2024, both the etiological positive rate of pulmonary tuberculosis and the positive rate among smear-negative patients in Ordos City showed continuous annual increases. Although the utilization rate of smear microscopy remained high, its dominant role in positive diagnosis has gradually diminished. While the utilization rates of both culture and molecular testing increased annually, the positive detection rate of culture has consistently been low, resulting in limited clinical impact. Consequently, molecular testing has become the primary diagnostic method. It is recommended to adopt molecular testing for etiological confirmation. Furthermore, attention should be paid to improving the positive detection rate among smear-negative patients in municipal-level designated hospitals.

Review Articles

Research progress on prognostic factors and comprehensive prevention and treatment strategies of tuberculous pericarditis

Xie Xuping, Zeng Xiaogang, Li Fuping, Sun Nannan, Yu Limei, Jiang Qilong, Tang Wenshuai

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  464-471.  doi:10.19983/j.issn.2096-8493.20250031

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Tuberculous pericarditis (TBP) is a rare yet serious tuberculous heart disease, characterized by a high mortality and morbidity rate, facing challenges in diagnosis and treatment. This article reviews the epidemiology, current diagnosis and treatment status, and prognostic factors of TBP from the perspective of social-ecological system theory. It highlights the importance of multidisciplinary collaboration in facilitating early diagnosis and standardized treatment, optimizeing prevention and care delivery systems, strengthening information technology infrastructure, improveing patient support mechanisms, and prioritizing talent training and scientific research. These comprehensive prevention and control strategy recommendations offer a robust foundation for enhancing clinical management and informing policy improvements related to TBP.

Research progress on the role of interleukin-24 in lung-related diseases

Zhu Mengyang, Xiao Li, Zhang Tao

Journal of Tuberculosis and Lung Disease. 2025, 6(4):  472-476.  doi:10.19983/j.issn.2096-8493.20250019

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Interleukin-24 (IL-24), a key member of the IL-10 cytokine family, is widely expressed in immune system-related tissues and cells. In response to inflammatory conditions or external micro-environmental stimuli, IL-24 activates signaling pathways such as STAT, ERK, and SOCS, through binding to receptors either intracellularly or extracellularly after secretion. This activation promotes immune cells chemotaxis and expression, thereby contributing to the pathophysiological processes of various pulmonary diseases. Expression levels of IL-24 are associated with non-small cell lung cancer, pulmonary fibrosis, asthma and other lung-related disorders. Targeting IL-24 and its receptors has shown potential to mitigate disease progression and improve prognosis. This review highlights the latest research progress on IL-24 in pulmonary diseases, aiming to provide valuable insights into its mechanisms and therapeutic applications.