Table of Content

20 October 2025, Volume 6 Issue 5

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Guideline·Standard·Consensus

Diagnosis and treatment of the integrated Chinese and western medicine guidelines for drug-resistant pulmonary tuberculosis

Chinese Association of Integrative Medicine China Association of Chinese Medicine Chinese Medical Association

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  477-494.  doi:10.19983/j.issn.2096-8493.20252003

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Drug-resistant pulmonary tuberculosis is characterized by complex treatment regimens, long treatment courses, high medical costs, low treatment compliance, and low cure rates. It is a difficult and key issue in tuberculosis control in China. In recent years, the clinical application of traditional Chinese medicine (TCM) in the treatment of drug-resistant pulmonary tuberculosis has become increasingly widespread, and the evidence-based evidence for the prevention and treatment of drug-resistant pulmonary tuberculosis through the combination of Chinese and Western medicine has been continuously accumulating. However, in clinical practice, there are often phenomena of non-standard and unreasonable application of TCM or combined TCM and Western medicine treatment plans. Currently, there is no industry guideline for the combined diagnosis and treatment plan of drug-resistant pulmonary tuberculosis with Chinese and Western medicine. Therefore, Chinese Association of Integrative Medicine, China Association of Chinese Medicine, and Chinese Medical Association have organized experts in related fields to formulate the “Diagnosis and treatment of the integrated Chinese and western medicine guidelines for drug-resistant pulmonary tuberculosis” based on the actual situation of the combined diagnosis and treatment of drug-resistant pulmonary tuberculosis with Chinese and Western medicine in China. This guideline is oriented towards clinical key issues, adheres to the basic principles of evidence-based medicine and the characteristics of evidence-based medicine in TCM, objectively evaluates the clinical evidence of the combined diagnosis and treatment of drug-resistant pulmonary tuberculosis with Chinese and Western medicine, and covers aspects such as the diagnosis, treatment, and prevention and regulation of drug-resistant tuberculosis with Chinese and Western medicine. The aim is to fully leverage the theoretical characteristics of TCM, highlight the synergistic and detoxifying advantages of the combined diagnosis and treatment of drug-resistant pulmonary tuberculosis with Chinese and Western medicine, further standardize the combined diagnosis and treatment process of drug-resistant pulmonary tuberculosis, and improve the diagnosis and treatment level of drug-resistant pulmonary tuberculosis in China.

Expert consensus on the diagnosis and treatment of coexistent pulmonary tuberculosis and lung cancer

Multidisciplinary Diagnosis and Treatment Branch of Chinese Antituberculosis Association , National Clinical Research Center for Infectious Disease/Shenzhen Third People’s Hospital, Beijing Chao-Yang Hospital , Capital Medical University , Guangdong Lung Cancer Institute

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  495-515.  doi:10.19983/j.issn.2096-8493.20252004

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Comorbidity of pulmonary tuberculosis and lung cancer refers to the condition where the same patient is affected by both pulmonary tuberculosis and lung cancer either simultaneously or sequentially. The occurrence of such comorbidity increases the difficulty in diagnosis and differential diagnosis, easily resulting in missed diagnoses, misdiagnoses, and delayed treatment. There exist complex interactions between lung cancer chemotherapy, targeted drugs, and anti-tuberculosis drugs, which not only impair the efficacy of anti-tuberculosis and anti-tumor treatments but also significantly elevate adverse drug reactions. Hence, there is an urgent need to develop standardized diagnosis and treatment consensus through multidisciplinary collaboration to guide clinical practice. The Multidisciplinary Diagnosis and Treatment Branch of Chinese Antituberculosis Association and the National Clinical Research Center for Infectious Diseases/Shenzhen Third People’s Hospital, in collaboration with Beijing Chao-Yang Hospital, Capital Medical University, Guangdong Lung Cancer Institute and other institutions, have jointly developed the Expert consensus on the diagnosis and treatment of coexistent pulmonary tuberculosis and lung cancer. This consensus elaborates on the epidemiological characteristics, clinical manifestations, diagnosis, and treatment of pulmonary tuberculosis-lung cancer comorbidity. It also addresses the screening and management of latent tuberculosis infection. Special emphasis is placed on key clinical challenges, such as drug-drug interactions, optimization of treatment regimens, and the appropriate timing of surgery and radiotherapy. The consensus provides 22 specific recommendations to support standardized and evidence-based clinical decision-making.

Original Articles

The value of serum inflammatory index combined with chest CT in differential diagnosis of benign and malignant pulmonary nodules

Xu Siyun, Lu Nihong

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  516-524.  doi:10.19983/j.issn.2096-8493.20250065

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Objective: To analyze the value of serum inflammatory indexes combined with chest CT on differential diagnosis of benign and malignant pulmonary nodules. Methods: Two hundred and fifty-three patients with lung nodules who visited the Third People’s Hospital of Kunming from August 2022 to August 2024 were enrolled as study subjects, all of whom were diagnosed by CT-guided percutaneous lung puncture technique after admission to the hospital, with clear pathological examination results. Among them, 127 patients with lung cancer were deemed as the malignant lung nodule group, and 126 patients with benign lung nodules were deemed as the benign lung nodule group. The patients’ medical history, imaging data, serum inflammatory markers and other data were collected to explore the differences between the two groups in cell count-related indexes, cytokines, and acute-phase reactive proteins, and then these statistically significant different indexes were used as independent variables to be included in binary logistic regression analysis to screen out independent risk factors of lung cancer, and finally, receiver operating characteristic curve (ROC) was used to evaluate these risk factors’ diagnostic value in the differentiation of malignant and benign lung nodules. Results: The number of nodules, nodule diameter, lobular sign, burr sign, vascular bundle sign, CT value, NLR, LMR, SII, IL-5, IL-2, IL-6, IL-1β, IL-10, IFN-γ, IL-8, IL-17, TNF-α, CRP, PCT, and SAA were statistically significantly different in benign and malignant lung nodules (P<0.05). The result of binary logistic regression analysis showed the nodule diameter being 8-15 mm (OR=10.268, 95%CI: 1.719-61.321), nodule diameter being 15-30 mm (OR=59.194, 95%CI: 11.155-314.124), burr sign positive (OR=27.373, 95%CI: 3.901-192.055),LMR (OR=0.469, 95%CI: 0.282-0.779), IL-5(OR=1.557, 95%CI: 1.145-2.118), IL-2(OR=0.831, 95%CI: 0.748-0.924), SAA (OR=2.625, 95%CI: 1.407-4.897) and PCT (OR=1.763, 95%CI: 1.240-2.507) were related factors to differentiate benign and malignant nodules. Using ROC curve analysis, the AUC (95%CI) of nodule diameter, burr sign, LMR, IL-5, IL-2, SAA, and PCT for distinguishing benign and malignant nodules were 0.732 (0.669-0.795), 0.649 (0.581-0.717), 0.398 (0.532-0.672), 0.516 (0.445-0.588), 0.380 (0.311-0.450), 0.773 (0.715-0.830), and 0.821 (0.767-0.874), respectively. The AUC (95%CI) for distinguishing benign and malignant lung nodules by combined test metrics reached 0.983 (0.971-0.995). Conclusion: The combination of serum inflammatory index and chest CT examination has good differential diagnostic value in distinguishing benign and malignant nodules.

The diagnostic value of adenosine deaminase in pleural fluid, whole blood γ-interferon, and interleukin-2 for tuberculous pleurisy

Wei Daijue, Tong Chongxiang

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  525-531.  doi:10.19983/j.issn.2096-8493.20250068

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Objective: To evaluate the diagnostic performance of pleural fluid adenosine deaminase (ADA), whole blood γ-interferon (IFN-γ), and interleukin-2 (IL-2) in tuberculous pleurisy (TBP). Methods: A retrospective study was conducted, clinical data from 353 patients with pleural effusion admitted to Lanzhou Chest Hospital between 2023 and 2024 were collected. The data included gender, age, ADA levels, serum total protein (TP) and lactate dehydrogenase (LDH) levels, as well as whole blood IFN-γ and IL-2 levels. Based on the final clinical diagnosis, patients were divided into a TBP group (n=193) and a non-TBP group (n=160). The levels of ADA, IFN-γ, and IL-2 levels were compared. The diagnostic efficacy of each indicator individually and in combination were evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and Kappa values. Results: The levels of ADA, IFN-γ, and IL-2 (35.00 (19.00, 46.90) U/L, 13.50 (1.42, 65.26) pg/ml, and 6.32 (0.67, 43.36) pg/ml, respectively) in the TBP group were significantly higher than those in the control group (9.00 (5.00, 20.00) U/L, 2.95 (0.00, 15.06) pg/ml, and 2.38 (0.00, 13.52) pg/ml, respectively)(Z=17.603, P<0.001; Z=14.816, P<0.001; Z=65.693, P<0.001). For individual indicators, the sensitivities of ADA, IFN-γ, and IL-2 were 82.38% (159/193), 55.96% (108/193), and 59.07% (114/193); the specificities were 67.50% (108/160), 71.88% (115/160), and 62.50% (100/160), respectively; the positive predictive values were 75.36% (159/211), 70.59% (108/153), and 65.52% (114/174), the AUC values were 0.800, 0.649, and 0.605, and Kappa values were 0.459, 0.257, and 0.177, respectively. For combined detection, the sensitivities of ADA+IFN-γ, ADA+IL-2, IFN-γ+IL-2, and ADA+IFN-γ+IL-2 were 69.43% (134/193), 75.13% (145/193), 44.04% (85/193), and 68.91% (133/193), respectively, while the specificities were 80.00% (128/160), 75.00% (120/160), 81.25% (130/160), and 82.50% (132/160), respectively. The positive predictive values were 80.72% (134/166), 78.38% (145/185), 73.91% (85/115), and 82.61% (133/161). The corresponding AUC values were 0.807, 0.800, 0.644, and 0.808, and Kappa values were 0.387, 0.452, 0.249, and 0.410, respectively. Conclusion: Pleural fluid ADA alone demonstrates high diagnostic efficiency for TBP. When combined with whole blood IFN-γ and IL-2, it further improves the specificity and positive predictive value without compromising diagnostic performance, thereby increasing detection rates and reducing missed diagnoses. The combined detection strategy can be applied in the clinical diagnosis of TBP to maximize its diagnostic advantages.

A case of central nervous system tuberculosis with pituitary involvement and diabetes insipidus: A literature review

Chen Fang, Zhao Yajun, Wang Rui, Feng Yanguo, Zhang Dezhi

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  532-537.  doi:10.19983/j.issn.2096-8493.20250095

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Objective: To investigate the clinical characteristics of central nervous system tuberculosis (CNS-TB) complicated by diabetes insipidus (DI), with the aim of providing insights to inform and improve clinical diagnosis and management. Methods: We present a case of central nervous system tuberculosis (CNS-TB) in which DI was the initial manifestation, describing the clinical presentation, laboratory findings, imaging characteristics, treatment course, and clinical outcome. In addition, a comprehensive literature review was conducted by searching PubMed, Wanfang, VIP, and the China National Knowledge Infrastructure (CNKI) databases using the keywords “tuberculosis” “tuberculous meningitis” and “diabetes insipidus”. The search covered publications from January 2000 to June 2025. Case reports with complete clinical data were included, while reviews, duplicate publications, and studies with incomplete information were excluded. A total of 16 eligible cases of CNS-TB complicated by DI were identified and analyzed. Results: A 54-year-old male patient presented with polydipsia, polyuria, headache, and loss of appetite. Laboratory investigations revealed low urine specific gravity and elevated plasma osmolality. A water deprivation test followed by desmopressin administration confirmed a diagnosis of central diabetes insipidus (CDI). Chest computed tomography (CT) demonstrated inflammatory changes in the right lung, accompanied by right-sided pleural effusion and secondary atelectasis of adjacent lung tissue. Magnetic resonance imaging (MRI) of the brain revealed thickening of the pituitary stalk, abnormal enhancement in the pituitary and pineal regions, and preserved hyperintensity in the posterior pituitary. The patient received diagnostic anti-tuberculosis therapy for three months but discontinued treatment on his own. Six months after discharge, repeat chest CT showed resolution of the pleural effusion, and pituitary MRI no longer showed abnormal findings; however, CDI persisted. A total of 16 additional cases of CNS-TB complicated by DI were identified through literature review, yielding 17 cases including the present report. Among these, 10 patients were male and 7 were female, with ages ranging from 5 to 63 years. Pulmonary tuberculosis was documented in 6 cases and subcutaneous nodular tuberculosis in 1 case. Imaging findings revealed sellar or suprasellar tuberculomas in 10 patients, pituitary stalk thickening in 7 patients, and cerebral edema in 2 patients. Six patients developed panhypopituitarism, and two had CDI accompanied by central hypothyroidism. Six patients with visual impairment underwent decompressive surgery, and one had visual field defects. During follow-up, CDI remained unresolved in 3 patients, hypothyroidism persisted in 1, and both adrenal insufficiency and hypothyroidism persisted in 2. All patients with visual acuity or field deficits showed clinical improvement. Imaging abnormalities resolved or regressed in 14 patients. Two patients died. Conclusion: CNS-TB may involve the sellar region, resulting in pituitary dysfunction and compression of the optic apparatus. Early assessment of pituitary function and regular follow-up are essential. Decompressive surgery should be considered in cases where visual function is threatened by mass effect.

Summary of the best evidence for nutritional management in patients with both pulmonary tuberculosis and diabetes

Zhang Ying, Ye Yun, Zuo Xiuying, Ding Jiaqi, Wang Fang

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  538-543.  doi:10.19983/j.issn.2096-8493.20250098

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Objective: To screen and summarize the evidence of nutrition management in patients with pulmonary tuberculosis complicated with diabetes, so as to provide basis for medical staff to carry out nutrition management. Methods: The evidence on nutritional management of pulmonary tuberculosis patients with diabetes published on domestic and foreign guide websites, databases and websites of relevant organizations was systematically searched. The search time was limited from the establishment of the database to September 2024. Results: A total of 12 articles were included, including 2 guidelines, 1 systematic review, 4 expert consensus papers, and 5 original studies. Twenty-three pieces of evidence were summarized from 9 aspects: body mass management, energy requirements, macro nutrients, micronutrients, nutritional supplements, fasting foods, recommended foods, blood glucose management and individualized nutrition guidance. Conclusion: The process of summarizing evidence in this study is standardized, and the content of the summarized evidence is comprehensive. Medical staff should choose the best evidence based on the actual situation of patients to improve their prognosis.

Analysis of the status quo and influencing factors of early ambulation in patients with lung cancer after thoracoscopic surgery with enhanced recovery after surgery concept nursing

Yan Wenhua, Chen Wenjun, Shi Zhiqiang

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  544-550.  doi:10.19983/j.issn.2096-8493.20250087

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Objective: To explore the current status and influencing factors of early ambulation in patients with lung cancer after thoracoscopic surgery with enhanced recovery after surgery (ERAS) concept nursing, and to provide evidence for optimizing the ERAS rehabilitation program after lung cancer surgery. Methods: This observational study enrolled patients who underwent thoracoscopic lung cancer surgery at Shanxi Hospital Cancer Hospital of Chinese Academy of Sciences and Taiyuan Fourth People’s Hospital between June 1, 2023, and May 31, 2024, according to the inclusion criteria. Data were collected using a general information questionnaire (including age, gender, marital status, education level, smoking status, surgical methods, frequency of medical guidance, exercise time, postoperative pain score, etc.) and scales (including early ambulation log and self-efficacy expectation scale (SEES), digital rating scale (NRS), social support rating scale (SSRS)). Univariate and multivariate logistic regression analysis were performed to examine early ambulation status and its influencing factors. Results: A total of 189 patients met the inclusion criteria, and 189 questionnaires and scales were distributed. Of these, 164 were validly returned, with an effective response rate of 86.77% (164/189). Therefore, 164 patients were finally included in the analysis. Among them, 60 cases (36.59%) achieved early ambulation within 24 h after surgery. Multivariate logistic regression analysis showed that older age and severe postoperative pain scores were significantly associated with reduced likelihood of early ambulation (OR (95%CI): 1.046 (1.009-1.084), 1.979 (1.512-2.598), respectively). Conversely, a frequency of medical guidance 3 times per week and ≥4 times per week, high SSRS scores were significantly associated with an increased likelihood of early ambulation rate ((OR (95%CI): 0.213 (0.152-0.343), 0.160 (0.123-0.253), and 0.611 (0.474-0.789), respectively). Conclusion: The completion rate of early ambulation within 24 hours after surgery in patients with lung cancer requires improvement. Nursing management and health education should be strengthened for patients with severe postoperative pain, older age, low social support and infrequent medical guidance. Targeted measures should be formulated to optimize the ERAS rehabilitation program.

Barriers to inhaled medication behavior among patients with chronic obstructive pulmonary disease: A qualitative study based on theoretical domains framework

Wang Kaixuan, Chen Jing, Lyu Bohan, Hao Wanming, Sui Fengxiang

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  551-557.  doi:10.19983/j.issn.2096-8493.20250102

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Objective: To explore the barriers of inhaled medication behavior among patients with chronic obstructive pulmonary disease (COPD), and to provide basis for formulating targeted intervention strategies and improving inhaled medication management practice. Methods: Using descriptive research method, an interview outline was designed based on theoretical domains framework (TDF), and 14 stable COPD patients admitted to Qingdao Municipal Hospital from November 2024 to February 2025 were selected for semi-structured interview using purpose sampling method. The interview data was compiled using TDF as coding framework, and analyzed with targeted content analysis method. Results: A total of 3 themes and 13 sub-themes were extracted, including limited management ability (low disease and medication literacy, insufficient inhaled medication use skills, lack of priority setting, low self-efficacy), insufficient behavioral motivation (poor expected results, negative emotions, stigma, lack of goals, instability of goals), and lack of external support (scarce resources, lack of family support, lack of medical support, lack of social support), which were mapped to 9 theoretical domains in TDF: knowledge, skills, memory/attention/decision-making, ability beliefs, outcome beliefs, emotions, goals, environment and resources, and social impact. Conclusion: Inhaled medication behavior of COPD patients is affected by multiple barriers. Multi-dimensional collaborative intervention should be carried out through improving medication management capabilities, stimulating behavioral motivations, and establishing and improving support systems to standardize the inhaled medication behavior of COPD patients and improve their medication compliance.

Analysis of the changing trend and influencing factors of healthcare-seeking delays among pulmonary tuberculosis patients in Liangping District, Chongqing from 2018 to 2024

Zhao Jing, Liao Ying, Pang Yan, Wang Lei, Tu Longcheng, You Maolin, He Gaoqin

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  558-565.  doi:10.19983/j.issn.2096-8493.20250058

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Objective: To analyze the changing trend and influencing factors of healthcare-seeking delays among pulmonary tuberculosis (PTB) patients in Liangping District of Chongqing from 2018 to 2024, and to provide a reference for optimizing comprehensive PTB prevention and control measures. Methods: Medical records of 1751 eligible PTB patients in Liangping District of Chongqing from 2018 to 2024 were collected from the “Surveillance, Report and Management” subsystem of “China Disease Prevention and Control Information System”. The distribution of healthcare-seeking delays was described. The annual percentage change (APC), average annual percentage change (AAPC), and multivariate logistic regression models were used to analyze the trend and influencing factors of healthcare-seeking delay. Results: The healthcare-seeking delay rate among PTB patients in Liangping District during 2018—2024 was 62.76% (1099/1751), with a median delay duration (interquartile range) (M(Q₁,Q₃)) of 31 (16, 87) days. The healthcare-seeking delay rates for the entire population, males, females, the 45-64 age group, the 65-96 age group, urban areas, and rural townships decreased from 80.65% (275/341), 78.91% (217/275), 87.88% (58/66), 83.85% (135/161), 84.62% (66/78), 84.09% (74/88), and 79.45% (201/253) in 2018, respectively, to 60.59% (123/203), 60.36% (102/169), 61.76% (21/34), 65.38% (68/104), 61.02% (36/59), 65.33% (49/75), and 57.81% (74/128) in 2024. Overall, all groups showed a declining trend, with AAPCs of -5.723%, -5.057%, -8.083%, -5.036%, -5.751%, -5.949%, and -5.773%, respectively (all P<0.05). Multivariable analysis revealed that the 45-64 age group, the ≥65 age group, and patients whose source was categorized as “direct visit/referral”, “referral”, “tracking”, or “other” had a higher risk of healthcare-seeking delay (OR (95%CI): 2.414 (1.440-4.046), 2.280 (1.321-3.935), 2.983 (1.067-8.339), 2.871 (1.045-7.888), 6.010 (1.805-20.018), 12.584 (1.279-123.806), respectively). Conclusion: Although the healthcare-seeking delay rate among PTB patients in Liangping District remained high, but showed an overall downward trend. Targeted interventions addressing the identified risk factors and key populations are necessary to improve the situation of healthcare-seeking delays.

Analysis of characteristics and treatment outcomes of patients with rifampicin-resistant pulmonary tuberculosis in Jilin Province, 2018—2022

An Yuan, Bai Yunlong, Zhao Qinglong, Jiang Xue, Pan Yan, Yang Fan

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  566-572.  doi:10.19983/j.issn.2096-8493.20250057

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Objective: To analyze the characteristics and treatment outcomes of rifampicin-resistant pulmonary tuberculosis (RR-PTB) patients in Jilin Province from 2018 to 2022, and to provide evidence for optimizing RR-PTB prevention and control strategies. Methods: Data of RR-PTB cases in Jilin Province from 2018 to 2022 were collected through the “Tuberculosis Information Management System,” a subsystem of the “China Information System for Disease Control and Prevention.” Descriptive method was conducted to analyze patient characteristics and treatment outcomes. Binary logistic regression model was used to analyze the influencing factors of treatment outcomes. Results: A total of 3994 RR-PTB patients were registered in Jilin Province during 2018—2022, with a registration rate of 3.31 per 100000 population (3994/120543700), showing a downward trend (${\chi }_{trend}^{2}$=191.473, P<0.05). RR-PTB patients were predominantly male (75.44%, 3013/3994), aged 45-64 years (50.20%, 2005/3994), Han ethnicity (94.79%, 3786/3994), farmers (44.09%, 1761/3994), and local residents (84.78%, 3386/3994). The proportion of ethnic minority patients fluctuated upward (${\chi }_{trend}^{2}$=5.581, P<0.05), whereas the proportion of migrant patients showed a fluctuating downward trend (${\chi }_{trend}^{2}$=84.376, P<0.05). The treatment initiation rate for RR-PTB patients was 83.32% (3328/3994), with a treatment success rate 52.01% (1731/3994). The multivariate logistic regression analysis revealed that the age group ≥65 years (OR=3.011, 95%CI: 2.061-4.398), ethnic minority status (OR=1.545, 95%CI: 1.136-2.100), retreatment (OR=1.272, 95%CI: 1.102-1.468), floating population (OR=1.945, 95%CI: 1.595-2.372) were risk factors for unfavorable treatment outcomes among RR-TB patients. Conclusion: The prevention and control of RR-PTB in Jilin Province remains challenging. Efforts should focus on improving treatment initiation and success rates, particularly for elderly individuals over 65 years old, ethnic minorities, retreatment patients, and floating population.

Comparative analysis of epidemiological characteristics of elderly tuberculosis patients aged 65 years and above with other patients in Kunming, 2014—2023

Ye Jinxin, Chang Sisi, Jiang Guilin, Yin Ting

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  573-578.  doi:10.19983/j.issn.2096-8493.20250088

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Objective: To analyze and compare the epidemiological characteristics of pulmonary tuberculosis (TB) patients among the elderly and other populations in Kunming City, providing scientific references for TB prevention and control in the elderly. Methods: The case information of patients with active tuberculosis in Kunming was collected from 2014 to 2023 through the Tuberculosis Information Management System, a subsystem of the China Information System for Disease Control and Prevention. Patients were categorized into elderly (≥65 years) and non-elderly (<65 years) groups. The epidemiological characteristics and registration status of the two groups of patients were compared. Results: From 2014 to 2023, a total of 21011 patients with active tuberculosis were registered in Kunming, including 4502 elderly patients (21.43%) and 16509 other patients (78.57%). The average registration rate of elderly patients was 60.85/100000, which was 2.49 times higher than that of other patients (24.47/100000). The registration rate of elderly patients exhibited a unimodal distribution, peaking at 81.24/100000 in 2019 (580 cases), then decreasing to 49.79/100000 in 2022 (481 cases), and rising again to 52.11/100000 in 2023 (519 cases). The proportion of elderly patients among all patients showed an upward trend (${\chi }_{trend}^{2}$=109.875, P<0.001), increasing from 16.67% (280/1680) in 2014 to 27.12% (519/1914) in 2023. The positive rate of etiology among elderly patients was 51.67% (2326/4502), which was higher than that of other patients (44.68% (7376/16509), the difference being statistically significant (χ²=70.047, P<0.001). The positive rate of etiology among elderly patients exhibited an upward trend (${\chi }_{trend}^{2}$=152.621, P<0.001), increasing from 43.21% (121/280) in 2014 to 66.67% (346/519) in 2023. The proportion of elderly patients with comorbid diabetes among all registered tuberculosis patients showed an upward trend (${\chi }_{trend}^{2}$=43.886, P<0.001), increasing from 5.71% (16/280) in 2014 to 17.15% (89/519) in 2023. Conclusion: The situation of tuberculosis epidemic among the elderly in Kunming is severe, and the level of patient detection needs to be improved. It is necessary to strengthen active screening and health education, and continue to implement standardized management for elderly patients.

Epidemiological characteristics and treatment outcomes of pulmonary tuberculosis patients with diabetes and hypertension in Daxing District, Beijing from 2022 to 2024

Hou Wenjun, Tian Feifei, Zhang Shiyu, Zhang Yaowen, Dou Yamei, Xue Han, Cui Hongyan

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  579-586.  doi:10.19983/j.issn.2096-8493.20250093

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Objective: To describe the epidemiological characteristics of pulmonary tuberculosis patients comorbid with diabetes mellitus and hypertension in Daxing from 2022 to 2024, and analyze the influencing factors of treatment outcomes, and provide a basis for the prevention and treatment of PTB and chronic disease comorbidity. Methods: Information on PTB patients notified in Daxing from 2022 to 2024 was extracted from the National Tuberculosis Management Information System. The data on diabetes mellitus and hypertension were investigated through the basic public health service information system, Hospital Information System, residents’ electronic health records, and questionnaires. Results: A total of 992 pulmonary tuberculosis patients were included in the analysis. Among them, 12.10% (120/992) had comorbid diabetes, 17.14% (170/992) had comorbid with hypertension, 16.73% (166/992) had both diabetes and hypertension. Higher proportions of comorbid with diabetes, hypertension, and both diabetes mellitus and hypertension were observed among males (14.63% (90/615), 19.03% (117/615), 18.37% (113/615)), farmers (15.26% (18/118), 32.20% (38/118), 25.42% (30/118)), local residents (12.36% (91/736), 20.25% (149/736), 19.97% (147/736)), and pathogen-positive (14.87% (88/592), 18.24% (108/592), 20.27% (120/592)) patients. The proportion of PTB patients with diabetes (15.50% (42/271)) was higher in the group aged 45-64, while the proportions of PTB patients with comorbid hypertension (36.30% (102/281)) and with diabetes mellitus and hypertension (30.25% (85/281)) were higher in the group aged ≥65. The re-treated patients had a higher proportion of comorbid diabetes (27.59% (16/58)), while new patients had higher proportions of hypertension (17.67% (165/934)), and with both diabetes mellitus and hypertension (17.24% (161/934)). The treatment course was the longest for patients combined diabetes (371.00 (274.25, 398.00) days), and shortest for those comorbid with hypertension (234.00 (192.00, 321.75) days)(Z=48.189, P<0.001). Multivariate logistic regression analysis showed that patients in the ≥65-years group (OR=3.105, 95%CI: 1.378-7.113), retreated patients (OR=6.372, 95%CI: 2.074-19.663), and those with comorbid diabetes (OR=4.717, 95%CI: 1.529-14.078) had a higher risk of adverse outcomes, while a longer treatment course (OR=0.980, 95%CI: 0.976-0.984) was associated with a lower risk of adverse outcomes. Conclusion: Pulmonary tuberculosis patients with diabetes and hypertension in Daxing District are predominantly male, older, farmer, local residents, and pathogen-positive. Patients with diabetes are more likely to be retreated and have longer treatment course, while patients with hypertension are more likely to be new treated and have shorter treatment course. Elder, retreatment, combined diabetes, and short treatment course are associated with higher risk of adverse outcomes.

Review Articles

2024 global advances in tuberculosis drug development: multi-target strategies, breakthroughs in drug resistance mechanisms, and personalized treatment

Abulimiti Abudukadier, Li Peibo, Xie Jianping

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  587-597.  doi:10.19983/j.issn.2096-8493.20250049

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Tuberculosis, as a global public health challenge, faces severe tests in treatment due to the issue of drug resistance. Current research and development of anti-tuberculosis drugs focus on key targets such as mycobacterial cell wall synthesis (e.g., the mycolic acid synthesis pathway), energy metabolism, protein synthesis and degradation, DNA replication and repair, and host immune regulation. In the field of mycolic acid synthesis, Pks13-TE inhibitors (such as compound 44, N-aryl indole derivatives), non-covalent DprE1 inhibitors, and MmpL3 transporter inhibitors (indole-2-carboxamide compounds) have demonstrated high antibacterial activity. Studies on resistance mechanisms have found that the activation of nitroimidazole drugs depends on Rv0077c metabolic regulation, and folate pathway Rv2172c mutations mediate PAS resistance through methionine accumulation. Emerging technologies like CRISPRi enhance antibiotic efficacy by inhibiting the inhA gene, and PROTAC technology reduces bacterial survival by degrading the ClpC1 protein. Pharmacogenomics has revealed that NAT2 acetylation phenotypes and ATP7B genotypes significantly affect the risk of isoniazid-induced hepatotoxicity, and HLA-DPB1 alleles are associated with drug side effects. The short-course chemotherapy regimen BpaL (bedaquiline, pretomanid, linezolid) shows significant efficacy (90% cure rate) but has severe side effects; alternative regimens BpaS (spectinamide 1599) and TBI-223 combinations exhibit better safety profiles. Future research trends emphasize multi-target combination therapy, precision intervention in resistance mechanisms, and optimization of molecular diagnostic techniques to achieve the efficiency and individualization of tuberculosis treatment.

Advances in nursing management of sleep disorders in elderly patients with chronic obstructive pulmonary disease

Wang Yaqian, Li Jiao, Yuan Min

Journal of Tuberculosis and Lung Disease. 2025, 6(5):  598-603.  doi:10.19983/j.issn.2096-8493.20250100

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Sleep disorders are highly prevalent among elderly patients with chronic obstructive pulmonary disease (COPD), typically characterized by fragmented sleep architecture, nocturnal hypoxemia, and decreased sleep efficiency—factors that significantly impair disease prognosis and overall quality of life. This review synthesizes current domestic and international evidence on the underlying pathophysiological mechanisms and recent advances in nursing management of sleep disorders in COPD. The aim is to inform the development of evidence-based, individualized sleep care strategies for improved clinical outcomes.