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Strive for excellence with an emphasis on fundamentals and innovations: interpretation of the WHO Global Tuberculosis Report 2022 Shu Wei, Liu Yuhong Chinese Journal of Antituberculosis    2023, 45 (5): 454-457.   DOI: 10.19982/j.issn.1000-6621.20230102 Abstract （745）   HTML （82）    PDF（pc） （1025KB）（538）       Knowledge map    Save Tuberculosis (TB) prevention and control work needs innovative research and development to accelerate the implementation of the World Health Organization (WHO) End TB Strategy. On 27th October 2022, WHO released the Global Tuberculosis Report 2022, updating the latest progress of global TB research and innovation. This paper reviews the key achievements in the areas of research and innovation for new diagnostics, drugs and regimens as well as vaccines introduced in the report, and discusses some of China’s indigenous progresses in related areas. This paper aims to make China’s TB professionals better informed about the latest research development in TB prevention and control around the globe, fostering indigenous TB innovation efforts with greater originality. Reference | Related Articles | Metrics

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Interpretation of WHO consolidated guidelines on tuberculosis: Module 3: diagnosis: tests for tuberculosis infection Xin Henan, Gao Lei Chinese Journal of Antituberculosis    2023, 45 (7): 639-643.   DOI: 10.19982/j.issn.1000-6621.20230128 Abstract （623）   HTML （80）    PDF（pc） （954KB）（746）       Knowledge map    Save On September 30, 2022, the World Health Organization (WHO) published the WHO consolidated guidelines on tuberculosis: Module 3: diagnosis: tests for tuberculosis infection. The medical evidence-based guideline systematically evaluated the performance of different tests and recommended using of Mycobacterium tuberculosis antigen-based skin tests for the diagnosis of tuberculosis infection for the first time. The author now introduces the development of the new guideline and interprets the three key recommendations hoping to provide evidence-based reference for tuberculosis infection test and control. Reference | Related Articles | Metrics

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Progress and reflections on development of laboratory diagnostic technology for tuberculosis Li Shanshan, Wang Yufeng, Shu Wei, Pang Yu Chinese Journal of Antituberculosis    2023, 45 (5): 446-453.   DOI: 10.19982/j.issn.1000-6621.20220535 Abstract （573）   HTML （66）    PDF（pc） （1721KB）（549）       Knowledge map    Save Rapid and accurate laboratory diagnostic techniques are of great importance for the prevention and control of tuberculosis (TB). Since the discovery of Mycobacterium tuberculosis by Robert Koch in 1882, significant achievements have been made in the development of TB diagnosis from traditional etiological diagnostics to immunological and molecular diagnostics. Nevertheless, the current diagnostic technologies remain unable to meet current requirements, thereby hampering the achievement of the End TB Strategy by 2035. In view of these challenges, the authors discuss the core diagnostic needs of TB prevention and control, and explore the important development pipeline of future laboratory diagnosis. Table and Figures | Reference | Related Articles | Metrics

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Interpretation of WHO consolidated guidelines on tuberculosis: Module 1: prevention: tuberculosis preventive treatment Guo Tonglei, Xin Henan, Gao Lei Chinese Journal of Antituberculosis    2023, 45 (8): 723-727.   DOI: 10.19982/j.issn.1000-6621.20230199 Abstract （570）   HTML （85）    PDF（pc） （1382KB）（590）       Knowledge map    Save World Health Organization (WHO) published the WHO consolidated guidelines on tuberculosis: Module 1: prevention: tuberculosis preventive treatment (2020 version guideline) on February 25, 2020, and guided the implementation of the 2020 version guideline through the implementation manual which contains the details of the implementation of guidance recommendations. The 2020 version guideline integrates the latest research since the WHO released Latent tuberculosis infection: updated and consolidated guidelines for programmatic management in 2018, and updates some recommendations. The author introduces the 2020 version guideline and interprets its key recommendations, hoping to provide a reference for the implementation of tuberculosis preventive treatment in China. Table and Figures | Reference | Related Articles | Metrics

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Expert consensus on clinical monitoring and management of QTc interval prolongation caused by anti-tuberculous drugs Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis, Beijing Chest Hospital, Capital Medical University Chinese Journal of Antituberculosis    2024, 46 (1): 8-17.   DOI: 10.19982/j.issn.1000-6621.20230271 Abstract （531）   HTML （37）    PDF（pc） （1793KB）（403）       Knowledge map    Save Bedaquiline, delamanid, clofazimine and fluoroquinolones such as levofloxacin and moxifloxacin are essential to improve the global cure rate of multidrug resistant and extensively drug-resistant tuberculosis. However, these drugs may lead to the prolongation of QTc interval corrected by electrocardiograph, which may cause serious adverse effects. Clinicians need to timely find, properly deal with and prevent adverse effects. This article aims at the common problems in clinical monitoring and management of QTc interval prolongation caused by anti-tuberculous drugs. According to the published research data and the application experience of participating experts, it was formed through discussion among many experts. Professional advice was given on the discovery, treatment and prevention of QTc interval prolongation caused by anti-tuberculous drugs, aiming at timely and standardized prevention and treatment of adverse reactions in the process of anti-tuberculous treatment. Table and Figures | Reference | Related Articles | Metrics

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Expert consensus on the diagnosis and treatment of superficial lymph node tuberculosis Senior Department of Tuberculosis, the th Medical Center of Chinese PLA General Hospital, Editorial Board of Chinese Journal of Antituberculosis, Tuberculosis Control Branch of China Intrnational Exchange and Promotive Association for Medical and Health Care Chinese Journal of Antituberculosis    2023, 45 (6): 531-542.   DOI: 10.19982/j.issn.1000-6621.20230120 Abstract （414）   HTML （55）    PDF（pc） （1407KB）（445）       Knowledge map    Save Superficial lymph node tuberculosis is the most common extrapulmonary tuberculosis. Due to the lack of specificity in its clinical symptoms, it is hard to differentiate it from non-tuberculous lymphadenitis, lymphoma, lymph node metastatic cancer, and other diseases. At present, there are many treatment methods for superficial lymphoid tuberculosis, mainly including systemic chemotherapy, local treatment, and integrated treatment with traditional Chinese and western medicine, while local treatment includes local injection of anti-tuberculosis drugs, ultrasonic drug penetration, and focal clearance and resection. Due to the advantages and disadvantages of each treatment scheme, it is better to choose appropriate treatment methods for specific types. How to select a reasonable treatment plan still lacks relevant guidance documents. Therefore, to standardize the diagnosis and treatment of superficial lymph node tuberculosis, and improve the level of clinicians to enable the patients to recover early and reduce recurrence, the Eighth Medical Center of Chinese PLA General Hospital, the Editorial Board of the Chinese Journal of Antituberculosis, and the Basic and Clinical Speciality Committees of the Tuberculosis Control Branch of China International Exchange and Promotive Association for Medical and Health Care jointly organized experts to combine the experience and methods of diagnosis and treatment of superficial lymph node tuberculosis in China, as well as research results related to diagnosis and treatment abroad, to formulate Expert consensus on the diagnosis and treatment of superficial lymph node tuberculosis. This consensus outlines the epidemiology, pathogenesis, pathophysiological characteristics and main clinical manifestations of superficial lymph node tuberculosis. It also introduces common examination methods, puts forward the diagnostic criteria, differential diagnosis, and prognosis, and gives treatment suggestions according to different clinical stages and pathological types, so that the clinicians can accurately diagnose and reasonably treat the patients with superficial lymph node tuberculosis. Table and Figures | Reference | Related Articles | Metrics

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Expert consensus on the clinical application of nucleic acid MALDI-TOF MS technique in the diagnosis of tuberculosis and non-tuberculosis mycobacteriosis Senior Department of Tuberculosis, the th Medical Center of Chinese PLA General Hospital, Editorial Board of Chinese Journal of Antituberculosis, Tuberculosis Control Branch of China Intrnational Exchange and Promotive Association for Medical and Health Care Chinese Journal of Antituberculosis    2023, 45 (6): 543-558.   DOI: 10.19982/j.issn.1000-6621.20230113 Abstract （405）   HTML （41）    PDF（pc） （3420KB）（331）       Knowledge map    Save Nucleic acid matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technique has been increasingly applied in the etiology and drug resistance diagnosis of tuberculosis and non-tuberculous mycobacteriosis, providing a rapid and accurate basis for early diagnosis, differential diagnosis, and drug resistance identification. However, it needs to be normalized that the clinician’s understanding and grasp of sample selection, retention, submitting time and precautions, and interpretation of report results. This consensus summarizes the clinical indications and specimen collection precautions of nucleic acid MALDI-TOF MS detection technique for the diagnosis of tuberculosis and non-tuberculous mycobacteriosis, and introduces how to correctly interpret the reported results of nucleic acid MALDI-TOF MS technique used to mycobacterial species and drug resistance. It has important significance to further standardize the clinical application of nucleic acid MALDI-TOF MS technique in the diagnosis of tuberculosis and non-tuberculous mycobacteriosis, improve the level of clinical diagnosis, and guide the early accurate and effective clinical treatment. Table and Figures | Reference | Related Articles | Metrics

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Exploration and prospect of the construction of primary tuberculosis preventive treatment clinic Wang Dakuan, Zhang Bin, Liu Zisen, Duan Weitao, Gao Lei Chinese Journal of Antituberculosis    2023, 45 (5): 442-445.   DOI: 10.19982/j.issn.1000-6621.20230083 Abstract （368）   HTML （38）    PDF（pc） （1009KB）（275）       Knowledge map    Save As one of the countries with a high burden of tuberculosis (TB) in the world, China needs to strengthen TB preventive treatment as a tool of achieving the global goals of the End TB. Identifying individuals with latent infection of TB and providing preventive treatment for those at high risk of developing active disease, such as HIV infections, close contacts of microbiologically confirmed pulmonary TB patients, and clinical immunosuppressed patients, are important measures to decline the risk of developing TB. In order to actively explore the management and intervention mode for the high-risk populations with latent TB infection at the grass-roots level, promote the implementation and optimization of TB preventive treatment strategies, and constantly develop and transform the preventive treatment in the direction of specialization, refinement, precision and sustainability, the Disease Prevention and Control Center of Zhongmu County, Zhengzhou City, Henan Province established an independent TB preventive treatment clinic in February 2023. During the trial operation period, a comprehensive evaluation will be conducted on the effectiveness of outpatient operations in a timely manner. In this paper, the author will carefully analyze and summarize the work basis and main content of the construction of primary TB preventive treatment clinic based on the exploratory work conducted in Zhongmu County. Reference | Related Articles | Metrics

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Diagnostic value of a nanopore sequencing assay of bronchoalveolar lavage fluid in smear-negative pulmonary tuberculosis Yan Xiaojing, Wang Qingfeng, Yang Yang, Chu Naihui, Nie Wenjuan Chinese Journal of Antituberculosis    2023, 45 (5): 487-492.   DOI: 10.19982/j.issn.1000-6621.20230036 Abstract （366）   HTML （29）    PDF（pc） （758KB）（4509）       Knowledge map    Save Objective: To determine the diagnostic accuracy of a nanopore sequencing assay for testing of bronchoalveolar lavage fluid (BALF) samples from suspected pulmonary tuberculosis (PTB) patients. Methods: Fifty cases with suspected PTB from Beijing Chest Hospital from November 2021 to April 2022 were collected. These cases were diagnosed based on results of MGIT 960 culture, GeneXpert MTB/RIF testing and nanopore sequencing of BALF samples collected during hospitalization. Taking the final clinical diagnosis as the reference standard, diagnostic accuracies of the three assays were compared. Results: Among the 50 cases analysed in this study, 22 (44.0%) were diagnosed as tuberculosis, 10 (20.0%) non-tuberculous mycobacteria and 18 (36.0%) bacterial pneumonia. Taking the clinic diagnosis as the reference standard, the sensitivity of nanopore sequencing assay technology, MGIT 960 culture and Xpert assay were 72.7% (16/22), 27.3% (6/22) and 31.8% (7/22), respectively, the specificity were 78.6% (22/28), 75.0% (21/28) and 96.4% (27/28), respectively, the accuracy were 76.0% (38/50), 54.0% (27/50) and 68.0% (34/50), respectively, and the Yoden index was 0.51, 0.02 and 0.28, respectively. Conclusion: Nanopore sequencing assay of BALF samples may have better diagnostic performance than Xpert and MGIT 960 cultures, and may improve the positive detection rate of BALF in suspected PTB patients. But this method cannot exclude pulmonary tuberculosis. Table and Figures | Reference | Related Articles | Metrics

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Interpretation of the World Health Organization’s Practical Manual on Tuberculosis Laboratory Strengthening (2022 Update) and consideration on strengthening tuberculosis laboratory network in China Xia Hui, Zhao Yanlin Chinese Journal of Antituberculosis    2023, 45 (5): 458-463.   DOI: 10.19982/j.issn.1000-6621.20230032 Abstract （361）   HTML （21）    PDF（pc） （1046KB）（245）       Knowledge map    Save The World Health Organization released Practical Manual on Tuberculosis Laboratory Strengthening (2022 Update) in January 2023. The manual updated and described the relevant elements of laboratory network strengthening. To help relevant staffs fully understand the contents of this manual, this article summarized and interpreted the key contents, and proposed some thoughts on strengthening tuberculosis laboratory network in China. Reference | Related Articles | Metrics

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Study on the detection of rifampicin resistance of Mycobacterium tuberculosis in sputum samples using fluorescence PCR probe melting curve technique Wang Nenhan, Tian Lili, Chen Shuangshuang, Zhao Yanfeng, Fan Ruifang, Chen Hao, Ren Yixuan, Zhang Jie, Yi Junli, Yang Xinyu, Yu Lan, Ding Beichuan, Li Chuanyou, Dai Xiaowei Chinese Journal of Antituberculosis    2023, 45 (6): 583-588.   DOI: 10.19982/j.issn.1000-6621.20230086 Abstract （357）   HTML （21）    PDF（pc） （956KB）（172）       Knowledge map    Save Objective: To evaluate the application value of the fluorescence PCR probe melting curve (MeltPro) technique in the detection of rifampicin-resistance of Mycobacterium tuberculosis (MTB) in sputum samples. Methods: Sputum samples of primary treated pulmonary tuberculosis (PTB) with positive GeneXpert MTB/RIF from Beijing Center for Disease Control and Prevention between May 2021 and May 2022 were collected. These sputum samples were tested using smear, mycobacterium isolation, and rifampicin-resistance by MeltPro technique. Drug sensitivity test (DST) of rifampicin was used for culturing positive strains, the differences in the detection rate of rifampicin resistance using DST, GeneXpert MTB/RIF, and MeltPro technique were compared. The proportional DST results of rifampicin were used as a standard to evaluate the drug-resistance detection efficiency of MeltPro technique. Results: A total of 158 qualified positive MTB sputum samples were collected, after mycobacterium culture, 130 strains were got. The success rate of the detection by MeltPro technique for rifampicin in sputum samples was 79.1% (125/158). As the grade of sputum smear results increased, the success rate of MeltPro technique increased from 59.3% (32/54, negative) to 100.0% (18/18, positive, grade +++); the success rate also increased with the increase of MTB grade detected by GeneXpert MTB/RIF, from 64.5% (20/31, extremely low) to 92.9% (26/28, high), the differences between each grade were statistically significant (H=22.271, P=0.001; H=15.637, P=0.001). The detection rates of rifampicin resistance using MeltPro technique, GeneXpert MTB/RIF method and proportional DST were 17.6% (22/125), 12.7% (20/158) and 13.1% (17/130), respectively. There was no statistically significant difference between the three methods (χ2=1.537, P=0.464). Based on the results of proportional DST, the sensitivity, specificity, positive predictive value, negative predictive value, Kappa of MeltPro technique in the detection of rifampicin were 100.0% (17/17), 94.6% (88/93), 77.3% (17/22), 100.0% (88/88), 0.845, respectively, and were 100.0% (17/17), 97.3% (110/113), 85.0% (17/20), 100.0% (110/110), 0.906, respectively of GeneXpert MTB/RIF in the detection of rifampicin. Conclusion: The MeltPro technique has high sensitivity and specificity in detecting rifampicin resistance of MTB in sputum samples of PTB, and can quickly and accurately screen the rifampicin resistance; attention should be paid to the quality of sputum samples when promoting the application in grassroots laboratories. Table and Figures | Reference | Related Articles | Metrics

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Development process of setting of critical concentrations for phenotypic drug susceptibility testing of Mycobacterium tuberculosis Song Yuanyuan, Xia Hui, Zhao Yanlin Chinese Journal of Antituberculosis    2023, 45 (7): 631-638.   DOI: 10.19982/j.issn.1000-6621.20230153 Abstract （348）   HTML （46）    PDF（pc） （1102KB）（395）       Knowledge map    Save Phenotypic drug susceptibility testing of Mycobacterium tuberculosis remains a crucial method for detecting drug resistance. However, the accuracy and reproducibility of certain drugs are sub-optimal with critical concentration being one of the key factors affecting results. This article provides a systematic summary and introduction on establishing and revising critical concentrations for anti-tuberculosis drug susceptibility testing, and offered valuable guidance to laboratory technicians and clinicians for accurately interpreting drug susceptibility testing methods and results, as well as to facilitate critical concentration research. Table and Figures | Reference | Related Articles | Metrics

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Progress on economic burden of patients with drug-resistant tuberculosis Wang Boning, Li Tao, Chen Wei Chinese Journal of Antituberculosis    2023, 45 (6): 607-612.   DOI: 10.19982/j.issn.1000-6621.20230018 Abstract （346）   HTML （48）    PDF（pc） （1005KB）（376）       Knowledge map    Save While the global tuberculosis epidemic has shown a decline trend in recent years, the economic burden induced by drug-resistant tuberculosis has increased. The reason is that the treatment of drug-resistant tuberculosis is expensive, the course of the disease is prolonged, and the side effects of treatment are serious. The authors reviewed the economic burden of drug-resistant tuberculosis and revealed the current research status of the economic burden of drug-resistant tuberculosis and its influencing factors to provide a reference for subsequent researches and medical insurance policy formulation. Reference | Related Articles | Metrics

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Application of ARIMA, ARIMAX, and NGO-LSTM models in forecasting the incidence of tuberculosis cases in Liaocheng City, Shandong Province Sun Minghao, Duan Yuqi, Zheng Liang, Yu Shengnan, Cheng Chuanlong, Zuo Hui, Chen Ming, Li Xiujun Chinese Journal of Antituberculosis    2023, 45 (12): 1177-1185.   DOI: 10.19982/j.issn.1000-6621.20230253 Abstract （337）   HTML （15）    PDF（pc） （2008KB）（102）       Knowledge map    Save Objective: The purpose of this study was to determine the optimal model for predicting tuberculosis incidence in Liaocheng City, Shandong Province by comparing the Autoregressive Integrated Moving Average (ARIMA) model, the Autoregressive Integrated Moving Average with Exogenous Regressors (ARIMAX) model, and the Long Short-Term Memory (LSTM) model combined with the Northern Goshawk Optimization (NGO) algorithm. Methods: Monthly tuberculosis case data from January 2011 to December 2018 were collected. We constructed ARIMA model, ARIMAX model, and NGO-LSTM model based on data from January 2011 to December 2017, respectively, and evaluate the performance of the three models in predicting the number of tuberculosis cases in 2018. Results: The mean absolute percentage errors (MAPE) for the ARIMA model, the multivariate ARIMAX model considering the monthly average relative humidity (lagged by 1 month) and the minimum temperature (lagged by 2 months), and the NGO-LSTM model for predicting tuberculosis incidence in 2018 were 9.293%, 8.419%, and 5.820%, respectively. The mean absolute errors (MAE) were 19.282, 16.997, and 13.119, respectively, and the root mean square errors (RMSE) were 23.773, 22.191, and 16.297, respectively. Conclusion: Among the three models, the NGO-LSTM model had the best predictive performance for monthly tuberculosis incidence in Liaocheng City, providing a new idea for the establishment of a tuberculosis alerting system and scientific basis for relevant departments to make decisions on tuberculosis prevention and control policy. Table and Figures | Reference | Related Articles | Metrics

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Recent advances in the source and biological function of bacterial DNA in extracellular vesicles Liu Dingyi, Sun Hong, Sheng Gang, Sun Zhaogang Chinese Journal of Antituberculosis    2023, 45 (7): 693-698.   DOI: 10.19982/j.issn.1000-6621.20230060 Abstract （331）   HTML （18）    PDF（pc） （736KB）（188）       Knowledge map    Save Cells can release their own substances or metabolites outside the cell through extracellular vesicles, which is also known as EV (exosomes). As research progressed, it is discovered that bacteria can also produce exosomes that encapsulate many macromolecules (including proteins, lipids, DNA and RNA) and that bacterial exosomes are closely linked to a variety of biological activities, including bacterial survival and development, as well as bacterial-mediated intra- and inter-species interactions. Researchers have also found that both Gram-negative and Gram-positive bacteria can produce exosomes containing DNA, and that bacterial exosomes DNA can perform biological functions such as mediating horizontal gene transfer, assisting in biofilm formation, and stimulating immunomodulatory mechanisms. In this paper, the production mode and biological functions of bacterial extracellular DNA have been elucidated, so that readers can have deeper understanding of bacterial exosomes DNA and promote further research and development of bacterial exosome DNA. Reference | Related Articles | Metrics

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The performance of interferon gamma-induced protein 10 mRNA detection technology in auxiliary diagnosis of tuberculosis Song Ruixue, Wei Rongrong, Dong Jing, Jia Hongyan, Du Boping, Sun Qi, Xing Aiying, Li Zihui, Zhu Chuanzhi, Zhang Zongde, Pan Liping Chinese Journal of Antituberculosis    2023, 45 (5): 471-476.   DOI: 10.19982/j.issn.1000-6621.20220518 Abstract （329）   HTML （65）    PDF（pc） （901KB）（173）       Knowledge map    Save Objective: To evaluate the performance of the interferon gamma-induced-protein 10 (IP-10) assay (IP-10.TB) in auxiliary diagnosis of tuberculosis (TB), and analyze the concordance between IP-10.TB assay and the whole blood interferon gamma release assay (QFT-GIT). Methods: Suspected TB patients were prospectively and consecutively recruited in Beijing Chest Hospital, Capital Medical University between November 2021 and July 2022. According to the clinical manifestations, routine biochemical examinations, histopathological, radiological and (or) etiological examinations, a total of 158 cases with conclusive diagnosis were finally included, and the subjects were divided into definite TB group (88 cases), clinically diagnosed TB group (29 cases) and non-TB group (41 cases). IP-10.TB and QFT-GIT assays were simultaneously performed on peripheral blood samples. The diagnostic performance of IP-10.TB and QFT-GIT were analyzed using the receiver operating characteristic curve. Accordance of IP-10.TB and QFT-GIT was analyzed by Cohen’s Kappa test. Results: Among the 158 participants, there were 7 cases (4.4%) with indeterminate results of IP-10.TB and 5 cases (3.2%) with indeterminate results of QFT-GIT, respectively. No significant difference was detected in the ratio of indeterminate results between IP-10.TB assay and QFT-GIT (χ2=0.346, P=0.556). The total sensitivity and specificity of IP-10.TB assay were 96.3% (95%CI: 90.1%-98.8%) and 64.1% (95%CI:47.2%-78.3%), respectively; while the total sensitivity and specificity of QFT-GIT assay were 97.2% (95%CI: 91.4%-99.3%) and 64.1% (95%CI: 47.2%-78.3%), respectively. The total concordance rate of these two methods was 92.5% (95%CI: 88.2%-96.8%), the positive concordance rate was 95.0% (95%CI: 91.0%-98.9%) and the negative concordance rate was 82.1% (95%CI: 68.0%-96.3%). The Cohen’s Kappa value was 0.760 (95%CI: 0.624-0.895, P<0.001) between IP-10.TB and QFT-GIT assays. Conclusion: These results showed that the performance of IP-10.TB was consistent with that of QFT-GIT for auxiliary diagnosis of TB. Table and Figures | Reference | Related Articles | Metrics

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Analysis of the incidence and risk factors of activepulmonary tuberculosis among close contacts in Kashgar, Xinjiang Uygur Autonomous Region Peng Xiaowang, Fan Xiaolei, Xiang Yang, Maiwulajiang·Yimamu , Hu Pengyuan, Wang Yanjie, Teng Zihao Chinese Journal of Antituberculosis    2023, 45 (6): 601-606.   DOI: 10.19982/j.issn.1000-6621.20230010 Abstract （326）   HTML （30）    PDF（pc） （948KB）（153）       Knowledge map    Save Objective: To analyze the incidence and influencing factors of close contacts of active pulmonary tuberculosis patients in Kashgar, Xinjiang Uygur Autonomous Region, and to provide a scientific basis for the development of close contact screening strategies. Methods: Data of 11411 active pulmonary tuberculosis (TB) patients registered and reported in Kashgar, Xinjiang Uygur Autonomous Region were collected, excluding 58 deaths, no close contacts, and incomplete information, 11353 active TB patients were actually included as indicated cases, from January to June 2018 reported in the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System”. Close contacts were identified through household interviews and face-to-face questionnaires, cohorts were established, general demographic information were obtained, and screening for suspicious symptoms of TB, chest X-ray and sputum smear, etc.. The comprehensive diagnosis was made by a team of experts from the designated TB medical institution, and close contacts not diagnosed with active TB were followed up for three years (once a year). Multifactorial logistic regression was used to analyze the risk factors of the occurrence of active TB in close contacts. Results: A total of 25577 close contacts were identified in 11353 indicated cases, with an average of approximately 2.25 close contacts traced per indicated case. Active TB was detected in 2106 cases during the 3-year follow-up period, with an incidence rate of 8.26%. Multifactorial logistic regression analysis showed that male (OR (95%CI): 1.396 (1.260-1.546)), primary treatment (OR (95%CI): 1.605 (1.413-1.824)), and age 15-34 years (OR (95%CI): 1.318 (1.033-1.682)) or 35-54 years (OR (95%CI): 3.054 (2.717-3.432)) were independent risk factors for the development of active TB in the close contacts. Close contacts with a history of previous TB disease (OR (95%CI): 22.447 (18.570-27.134)), age ≤14 years (OR (95%CI): 2.792 (2.224-3.507)) and ≥55 years (OR (95%CI): 2.089 (1.777-2.457)), and social relationships with the indicated case’s were parents (OR (95%CI): 6.521 (4.284-9.926)), spouse (OR (95%CI): 6.311 (4.478-8.894)), children (OR (95%CI): 6.708 (4.739-9.495)), grandchildren (OR (95%CI): 10.003 (6.702-14.930)), siblings (OR (95%CI): 4.851 (3.171-7.422)), grandparents (OR (95%CI)=9.976 (4.083-24.375)), relatives (OR (95%CI)=2.456 (1.363-4.428)), and village doctors (OR (95%CI): 7.166 (2.110-16.339)), were all independent risk factors for the development of active TB among them. Conclusion: The incidence of active TB is high among close contacts in Kashgar. In patient management and health education, emphasis should be focused on male, newly treated, and middle-aged and young patients; meanwhile, screening and follow-up should be focused on close contacts with a previous history of TB, the elderly, the young and those who with close social relations with the patients. Table and Figures | Reference | Related Articles | Metrics

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Interpretation of the World Health Organization's Use of targeted next-generation sequencing to detect drug-resistant tuberculosis Rapid communication, 2023 Huang Hairong Chinese Journal of Antituberculosis    2023, 45 (10): 921-924.   DOI: 10.19982/j.issn.1000-6621.20230311 Abstract （311）   HTML （25）    PDF（pc） （966KB）（223）       Knowledge map    Save The World Health Organization released “Use of targeted next-generation sequencing to detect drug-resistant tuberculosis Rapid communication,2023” recently, in order to timely share the important data and opinions formed accordingly on drug resistance detection by the targeted next-generation sequencing technique. Therefore, facilitate the understanding of this new technique and accelerate its promotion. This note interpreted the key data and the opinions in the rapid communication, so as to help the reader to recognize the value of the targeted next-generation sequencing technique in the diagnosis of drug resistant tuberculosis. Reference | Related Articles | Metrics

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Strengthening the capability of non-tuberculosis-designated medical institutions to improve the diagnosis of tuberculosis Liao Yixuan, Fang Chuangsen, Li Yanming Chinese Journal of Antituberculosis    2023, 45 (5): 437-441.   DOI: 10.19982/j.issn.1000-6621.20230001 Abstract （307）   HTML （44）    PDF（pc） （1108KB）（214）       Knowledge map    Save Tuberculosis remains a major public health problem worldwide. The epidemic of novel coronavirus infection (COVID-19) has negative impact on the prevention and treatment of global tuberculosis, the dual challenges of both traditional and emerging respiratory infectious diseases need to be dealt with. There are many problems in the prevention and control of tuberculosis in non-tuberculosis-designated medical institutions. Under the new situation, as a country with high burden of tuberculosis, China needs to improve the diagnosis of tuberculosis in non-tuberculosis-designated medical institutions from various aspects. Reference | Related Articles | Metrics

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Analysis of drug resistance characteristics of pulmonary tuberculosis in children in Guangdong, 2014—2020 Zhuo Wenji, Zhang Chenchen, Chen Xunxun, Wei Wenjing, Yu Meiling, Peng Kehao, Xu Liuyue, Chen Yanmei Chinese Journal of Antituberculosis    2023, 45 (7): 687-692.   DOI: 10.19982/j.issn.1000-6621.20230109 Abstract （306）   HTML （35）    PDF（pc） （797KB）（229）       Knowledge map    Save Objective: To investigate the drug resistance characteristics of Mycobacterium tuberculosis (MTB) isolates from children with pulmonary tuberculosis (PTB) in Guangdong Province from 2014 to 2020. Methods: According to the enrollment standard, 1274 (3.3%) MTB isolates from children aged 0 to 18 were collected from 32 sentinel sites of PTB resistance surveillance (39046 MTB isolates) in Guangdong Province from January 1, 2014 to December 30, 2020. Analysed the data of drug resistance of MTB isolates for first- and second-line of anti-TB drugs (including isoniazid (INH), streptomycin (Sm), ethambutol (EMB), rifampicin (RFP), kanamycin (Km), propylthioisoniacin (Pto), capreomycin (Cm), ofloxacin (Ofx), and sodium p-aminosalicylate (PAS)) and summarized the drug resistance characteristics. Results: The proportion of PTB children was dropped from 4.3% (123/2856) in 2014 to 3.1% (177/5760) in 2020, showing a downward trend of year by year ($X_{trend}^{2}$=25.864, P<0.001). The resistance rates of the isolates to anti-TB drugs from high to low were Sm (14.8% (189/1274))>INH (7.7% (98/1274))>RFP (6.3% (80/1274))>EMB (6.0% (77/1274))>Ofx (3.5% (44/1274))=PAS (3.5% (44/1274))>Pto (2.9% (37/1274))>Km (2.5% (32/1274))>Cm (2.2% (28/1274)), and the drug resistance rate, mono-resistance rate, poly-resistance rate, multidrug-resistance rate (MDR) and extensively drug resistance rate (XDR) of MTB of the 1274 isolates was 26.0% (331/1274), 15.4% (196/1274), 4.2% (54/1274), 3.1% (39/1274), and 0.8% (10/1274), respectively. The XDR of MTB in children aged 0 to 12 was significantly higher than that in children aged 13 to 18 (3.0% (3/100) vs. 0.6% (7/1174); χ2=6.837, P=0.038). In addition, the XDR of MTB in boys was significantly higher than that in girls (1.3% (10/749) vs. 0.0% (0/525); χ2=10.679, P=0.007), and the resistance rate of MTB in the Pearl River Delta was significantly higher than that in eastern and northwestern Guangdong (28.1% (213/758) vs. 22.9% (118/516); χ2=4.370, P=0.037). Conclusion: The prevalence of PTB in children in Guangdong Province is serious. The drug resistance in PTB children aged 0-12 years, who were boys, and who lived in Pearl River Delta should be paid special attention. Table and Figures | Reference | Related Articles | Metrics

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Research progress of subclinical tuberculosis Wang Hanfei, Zhao Yanlin, Xu Caihong Chinese Journal of Antituberculosis    2023, 45 (8): 808-813.   DOI: 10.19982/j.issn.1000-6621.20230159 Abstract （299）   HTML （23）    PDF（pc） （773KB）（278）       Knowledge map    Save Subclinical tuberculosis is a disease state between latent tuberculosis infection and active tuberculosis. Early detection and intervention of subclinical tuberculosis patients can reduce the risk of developing into active tuberculosis, improve the prognosis, and block the transmission of tuberculosis. This article reviewed domestic and international research progress of subclinical tuberculosis, including the definition, clinical characteristics, transmissibility, pathogenesis, biomarkers, screening and diagnostic methods, in order to identify the current research progress and challenges of subclinical tuberculosis, and provide novel research ideas to accelerate the research on subclinical tuberculosis and exploring more effective tuberculosis prevention and control strategies in China. Table and Figures | Reference | Related Articles | Metrics

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Chinese Journal of Antituberculosis    2023, 45 (7): 714-717.   DOI: 10.19982/j.issn.1000-6621.20230144 Abstract （291）   HTML （22）    PDF（pc） （1576KB）（1575）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Chinese Journal of Antituberculosis    2023, 45 (5): 526-530.   DOI: 10.19982/j.issn.1000-6621.20220538 Abstract （288）   HTML （7）    PDF（pc） （1637KB）（152）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Clinical value of common in situ pathological staining in diagnosis of pulmonary tuberculosis Li Hongna, Mao Xin, Xu Biyu, Wu Chenyang, Dong Liru, Song Xudong Chinese Journal of Antituberculosis    2023, 45 (5): 477-482.   DOI: 10.19982/j.issn.1000-6621.20220537 Abstract （281）   HTML （15）    PDF（pc） （2380KB）（142）       Knowledge map    Save Objective: To explore the clinical application value of four common in situ pathological detection techniques in the detection and diagnosis of pulmonary tuberculosis. Methods: Paraffin-embedded lung tissue samples were collected from 106 patients suspected of pulmonary tuberculosis in the Pathology Department of the North China University of Science and Technology Affiliated Hospital from January 2018 to June 2022. According to the clinical diagnostic criteria, 74 patients were diagnosed as pulmonary tuberculosis and 32 were diagnosed as non-pulmonary tuberculosis (including pulmonary sarcoidosis 10 cases, chronic non-necrotizing granulomatous inflammation 22 cases). Four common in situ pathological staining techniques (antacid staining, auramine O fluorescence staining, immunohistochemistry and in situ hybridization) and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) were used to analyze and compare the diagnostic efficacy of the four techniques in the histopathologic diagnosis of pulmonary tuberculosis. Results: Based on the clinical diagnosis results, the sensitivity, specificity and Kappa values of acid-fast bacillus staining of paraffin-embedded lung tissue samples were 35.1% (26/74), 100.0% (32/32) and 0.246, respectively. The sensitivity, specificity and Kappa values were 56.8% (42/74), 93.8% (30/32) and 0.399 of auramine O fluorescence staining, 47.3% (35/74), 100.0% (32/32) and 0.351 of immune-histochemical detection, 78.4% (58/74), 100.0% (32/32) and 0.686 of in situ hybridization, and 81.1% (60/74), 100.0% (32/32) and 0.721 of qRT-PCR, respectively. Compared with the clinical diagnosis results, among the four in situ pathological techniques, only in situ hybridization had a higher Kappa value of 0.686. Conclusion: Based on clinical diagnosis results and real-time PCR, among the four in situ pathological detection techniques, in situ hybridization has a high consistency with clinical diagnostic results, and can be used for patients with pulmonary tuberculosis that cannot be diagnosed by histopathological morphology. Table and Figures | Reference | Related Articles | Metrics

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Application of regression discontinuity in public health Yu Shengnan, Gao Qi, Zheng Liang, Shi Yuan, Chen Yijin, Li Xiujun Chinese Journal of Antituberculosis    2023, 45 (7): 644-650.   DOI: 10.19982/j.issn.1000-6621.20230130 Abstract （278）   HTML （22）    PDF（pc） （2270KB）（655）       Knowledge map    Save Regression discontinuity (RD) is a kind of statistical method for making causal inferences based on counterfactuals composed of both sides of the cutoff. In recent years, the application of RD has gradually increased in public health, especially in the fields of factors influencing air quality and the effects of related policy interventions, as well as vaccine effectiveness. Since the outbreak of the COVID-19, RD has also been increasingly applied to investigate the impact of the epidemic on public health and individual behavior. The application conditions of RD are relatively simple, and RD can reduce the effect of confounding and reflect the causal relationship between variables more realistically. In this study, based on the introduction of the idea and application of RD, the current status of its application in public health is reviewed. Table and Figures | Reference | Related Articles | Metrics

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The role of miR-99a-5p in the immune regulation of host macrophages infected by Mycobacterium tuberculosis Shi Yuting, Dong Jing, Jia Hongyan, Zhu Chuanzhi, Yang Bin, Li Zihui, Sun Qi, Du Boping, Xing Aiying, Zhang Zongde, Pan Liping Chinese Journal of Antituberculosis    2023, 45 (5): 464-471.   DOI: 10.19982/j.issn.1000-6621.20220532 Abstract （268）   HTML （17）    PDF（pc） （780KB）（152）       Knowledge map    Save Objective: To explore the role of specific microRNA in THP-1 cells mediated host defense against Mycobacterium tuberculosis (MTB) infection. Methods: Total RNA were extracted from THP-1 cells with or without MTB (H37Rv) infection, and then the miRNA expression profiles in THP-1 cells with or without MTB infection were identified using Illumina NovaSeq6000 next-generation sequencing platform. Four health controls were recruited and the human monocyte-derived macrophage (hMDM) were separated. Validation of differentially expressed miRNA between MTB infected and uninfected THP-1 cells, as well as that between MTB infected and uninfected hMDM, were performed by quantitative real-time PCR (qRT-PCR). The miRNA overexpression vector was constructed and transfected into THP-1 macrophages by lentivirus. The expression level of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ) and colony-forming unit (CFU) in H37Rv infected THP-1 cells which were transfected with miRNA overexpression vector or control empty vector was tested using qRT-PCR. Results: miR-99a-5p was selected as the study target gene (P=0.021) by not previously studied and most significantly different, from 16 miRNA molecules with significant expression differences in second-generation sequencing results. By qRT-PCR validation in THP-1 cells and primary macrophages, miR-99a-5p expression within THP-1 infected groups (0.482±0.148) and primary macrophages (0.433±0.072) were significantly lower than the uninfected group (1.536±0.290 and 1.113±0.218)(t=6.476,P<0.001; t=3.167,P=0.019). CFU results of the THP-1 cells infected by MTB showed that the intracellular bacteria amount of miR-99a-5p overexpression cells at 24 h after infection was 64.0×104 (52.0×104,87.0×104), which was significantly higher than that in the control cells (17.0×104 (16.0×104,24.0×104))(Z=-2.323, P=0.029). Furthermore, the expression levels of TNF-α and IFN-γ in MTB infected miR-99a-5p over expression cells were 1.018±0.310 and 1.687±0.135, which were significantly lower than TNF-α (0.740±0.001) and IFN-γ (0.631±0.374) those in the MTB infected control cells (t=4.631, P=0.010; t=3.349, P=0.010). Conclusion: miR-99a-5p can inhibit the release of TNF-α and IFN-γ, promote the growth of MTB in macrophages. Therefore, the decreased miR-99a-5p expression after MTB infection may play a protective role in host innate immunity against MTB infection. Table and Figures | Reference | Related Articles | Metrics

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Research progress on the correlation between intestinal microbiota short chain fatty acids and pulmonary tuberculosis Zhang Xiaomeng, Li Min, Chai Yinghui, Zhou Jing, Lei Hong Chinese Journal of Antituberculosis    2023, 45 (7): 699-706.   DOI: 10.19982/j.issn.1000-6621.20230079 Abstract （267）   HTML （11）    PDF（pc） （898KB）（534）       Knowledge map    Save Short chain fatty acids (SCFA) are the main metabolites of the gut microbiota, mainly including formic acid, acetic acid, propionic acid, butyric acid and their branched chain fatty acids, and some salts. Research has shown that there is a significant direct correlation between SCFA and the occurrence and development of pulmonary tuberculosis. Pulmonary tuberculosis leads to imbalance of gut microbiota, thereby reducing the abundance of SCFA, which affects the host immune system and the response of inflammatory factors; the disorder of host immune system and inflammatory factor will promote the occurrence and development of pulmonary tuberculosis.The author reviewed the correlation between SCFA and pulmonary tuberculosis, the possible regulatory mechanism between them, and whether it was possible to improve the abundance of SCFA in the body by regulating intestinal flora to achieve the purpose of treatment or adjuvant treatment of pulmonary tuberculosis. Table and Figures | Reference | Related Articles | Metrics

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Value of DNA real-time fluorescence isothermal amplification method and combined testing in early diagnosis of tuberculous pleurisy Zhao Guolian, Lei Qian, Wang Pei, Ren Yunxia, Guan Jing Chinese Journal of Antituberculosis    2023, 45 (7): 681-686.   DOI: 10.19982/j.issn.1000-6621.20230055 Abstract （267）   HTML （20）    PDF（pc） （1229KB）（98）       Knowledge map    Save Objective: To investigate the value of DNA real-time fluorescence isothermal amplification method (abbreviated as “constant temperature amplification method”), combined with adenosine deaminase (ADA) and peripheral blood tuberculosis infection T cell spot test (T-SPOT. TB) detection in the early diagnosis of tuberculous pleurisy. Methods: Using retrospective research method, 427 patients with pleural effusion of unknown causes admitted to Xi’an Chest Hospital from January 2020 to December 2021 were selected as the research objects. All patients underwent pleural effusion isothermal amplification, ADA, Mycobacterium tuberculosis culture, and peripheral blood T-SPOT.TB testing. Based on clinical comprehensive diagnostic criteria as a reference, the early diagnostic value of pleural effusion DNA constant temperature amplification combined with ADA and peripheral blood T-SPOT.TB for tuberculous pleurisy was analyzed. Results: Among 427 subjects, 279 cases (65.3%) were diagnosed as tuberculous pleurisy (tuberculous pleurisy group) and 148 cases were diagnosed as non-tuberculous pleurisy (non-tuberculous pleurisy group). The optimal threshold of ADA was 19.5 U/L. Among the single detection methods, the specificity and sensitivity of the constant temperature amplification method were 100.00% and 31.54%, which were similar to those of Mycobacterium tuberculosis culture (100.00% and 30.11%, respectively). The sensitivity of ADA and T-SPOT.TB in peripheral blood was 74.91% and 84.95%,respectively, and the specificity was 87.16% and 74.91%, respectively. ADA+T-SPOT.TB could obtain high sensitivity (94.27%) and specificity (99.32%) in parallel and series, respectively. The parallel detection efficiency of isothermal amplification method, ADA and T-SPOT.TB got the same value as that with the Mycobacterium tuberculosis culture method in parallel. Among the joint detection methods, ADA+T-SPOT.TB detection in series had the highest cost-effectiveness, with a cost effectiveness ratio (C/E) of 669.23. Conclusion: The constant temperature amplification method with rapid detection protocols such as ADA and peripheral blood T-SPOT.TB could provide strong evidence for the early diagnosis and treatment of tuberculous pleurisy patients. Table and Figures | Reference | Related Articles | Metrics

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Effect of microcard combined with vitamin D on the balance of CD4+ T cell subsets in initially treated patients with smear positive pulmonary tuberculosis Shang Yaomin, Zhou Xiaolei, Xue Yunling, Leng Xia Chinese Journal of Antituberculosis    2023, 45 (6): 575-582.   DOI: 10.19982/j.issn.1000-6621.20230078 Abstract （262）   HTML （21）    PDF（pc） （1043KB）（177）       Knowledge map    Save Objective: To evaluate the effect of the combination of microcard (Mycobacterium vaccae vaccine) and vitamin D adjuvant therapy on the balance of CD4+ T cell subsets in initially treated patients with smear positive pulmonary tuberculosis (PTB), and to analyze its clinical efficacy. Methods: A prospective study was designed. According to the inclusion criteria and patient’s willing, the initially treated patients with smear positive PTB (PTB group) admitted to Henan Chest Hospital from June 2019 to June 2022 were enrolled into conventional anti-tuberculosis treatment group (control group), conventional anti-tuberculosis with microcard treatment group (microcard group) and conventional anti-tuberculosis combined with microcard and vitamin D adjuvant therapy group (combined group). Excluding those who could not complete the 6-month treatment course due to various reasons, 74 cases in each group were included (222 patients). The proportion of Th1, Th2, Th17, Treg cells and the levels of IFN-γ, IL-4, IL-17, IL-10 in peripheral blood of patients/healthy subjects were detected in each group before treatment and after 6-month treatment, and the sputum negative conversion rate, lesion and pulmonary cavities and comprehensive efficacy were evaluated by the end of 6-month treatment. Results: After six months treatment, the Th1/Th2, Treg/Th17 ratios and IFN-γ levels in the combined group (2.32±0.39, 0.45±0.03 and (16.13±2.67) pg/ml) were significantly higher than those in the microcard group (2.19±0.25, 0.34±0.03 and (14.16±3.45) pg/ml; t=2.414, P=0.017; t=22.303, P=0.000; t=3.885, P=0.000) and control group (2.08±0.37, 0.26±0.02 and (12.34±1.73) pg/ml; t=3.840, P=0.000; t=45.331, P=0.000; t=10.248, P=0.000). The levels of IL-4, IL-17 and IL-10 ((36.54±2.01) pg/ml, (27.10±3.58) pg/ml and (35.46±3.84) pg/ml) in the combined group were significantly lower than those in the microcard group ((37.23±1.78) pg/ml, (28.43±2.16) pg/ml and (43.58±4.06) pg/ml; t=2.211, P=0.029; t=2.736, P=0.007; t=12.499, P=0.000) and control group ((38.89±2.16) pg/ml, (29.40±3.27) pg/ml and (50.24±4.22) pg/ml; t=6.851, P=0.000; t=4.732, P=0.000; t=22.284, P=0.000); the negative conversion rate of sputum smear (97.30% (72/74)) and the total effective rate (91.89% (68/74)) were significantly higher than those in the microgram group (83.78% (62/74) and 79.73% (59/74); χ2=7.889, P=0.005; χ2=4.495, P=0.034) and control group (78.38% (58/74) and 77.03% (57/74); χ2=12.397, P=0.000; χ2=6.229, P=0.013). Conclusion: Conventional anti-tuberculosis combined with microcard and vitamin D adjuvant therapy can significantly promote the balance restoration of T lymphocyte subsets Th1/Th2 and Th17/Treg, and effectively improve cytokines levels of IFN-γ, IL-4, IL-17 and IL-10, and it has a significant clinical benefit. Table and Figures | Reference | Related Articles | Metrics

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Analysis of risk factors for extensive lung focus and cavities in type 2 diabetes mellitus patients complicated with newly treated pulmonary tuberculosis Wang Min, Yuan Yuan, Tan Shouyong, Yang Zilong, Feng Zhiyu, Zhang Hong, Wu Di, Chen Zeying, Huang Xianlin, Kuang Haobin Chinese Journal of Antituberculosis    2023, 45 (8): 761-767.   DOI: 10.19982/j.issn.1000-6621.20230147 Abstract （261）   HTML （19）    PDF（pc） （785KB）（93）       Knowledge map    Save Objective: To explored the risk factors of extensive lung focus and cavities in type 2 diabetes mellitus (T2DM) patients complicated with newly treated pulmonary tuberculosis (PTB), to provide reference for clinical treatment strategies. Methods: Through electronic medical records and hospital information system, 955 T2DM patients complicated with newly diagnosed positive PTB who were hospitalized in Guangzhou Chest Hospital for the first time from January 2013 to January 2018 were collected for a conducted retrospective study. Univariate and multivariate logistic regression analysis was conducted with extensive lung focus (imaging lung lesions ≥3 lung fields) and cavity as dependent variables, and age, gender, diabetes course, glycosylated hemoglobin, lymphocyte (LY), neutrophil ratio (NLR), and whether metformin was used in recent three months as independent variables. Results: Among the 955 patients, 753 (78.8%) had extensive focus and 659 (69.0%) had cavities. The multivariate logistic regression analysis showed that the history of usage of metformin (OR=0.656, 95%CI: 0.449-0.957) and the high level of LY (OR=0.608,95%CI: 0.404-0.915) were protective factors for the extensive focus of both diseases. The occurrence of cavities (OR=2.094, 95%CI: 1.498-2.926) and the high level of NLR (OR=2.681, 95%CI: 1.860-3.864) were risk factors for the extensive focus of both diseases. The extensive focus (OR=1.945, 95%CI: 1.390-2.719) and high level of glycosylated hemoglobin (OR=1.206, 95%CI: 1.078-1.350), the high level of NLR (OR=1.390, 95%CI: 1.012-1.991) were the risk factors for cavitation. Conclusion: When T2DM complicated with PTB, the extensive focus and cavities were common, and both were risk factors for each other. Treatment that includes metformin should be the first choice for T2DM patients, and active monitoring and management of glycated hemoglobin, lymphocyte and NLR indicators should be carried out to alleviate the disease condition when complicated with tuberculosis. Table and Figures | Reference | Related Articles | Metrics

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Establishment and research progress of rabbit model of spinal tuberculosis Yang Jun, Deng Qiang, Peng Randong, Li Junjie, Wang Yurong, Yang Haiyun, Du Jianqiang Chinese Journal of Antituberculosis    2023, 45 (5): 520-525.   DOI: 10.19982/j.issn.1000-6621.20220516 Abstract （254）   HTML （7）    PDF（pc） （743KB）（149）       Knowledge map    Save Tuberculosis is caused by Mycobacterium tuberculosis by invading human organs. Spinal tuberculosis accounts for 50% of extra-pulmonary tuberculosis and has become a serious orthopedic disease that threatens human health. The pathogenesis of spinal tuberculosis has not yet been fully understood, and the available anti-tuberculosis drugs and treatment options are limited. As a powerful tool for studying the pathogenesis of diseases and therapeutic drugs, animal models have received considerable attention. New Zealand rabbits are widely used as animal models in the experimental study of spinal tuberculosis because of their similar anatomical structure of lumbar vertebrae to humans, the manifestation of bone tuberculosis can reproduce the pathological manifestations of human tuberculosis, and the convenient operation of constructing spinal tuberculosis models. This article reviewed the construction method of spinal tuberculosis rabbit models and the application value in the pathogenesis of tuberculosis, the development of new anti-tuberculosis drugs and local drug loading research, to provide reference for the establishment and application of rabbit models in basic research related to spinal tuberculosis. Table and Figures | Reference | Related Articles | Metrics

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Analysis of death related factors in tuberculosis destroyed lung patients undergoing invasive mechanical ventilation Cheng Yao, Chen Hongde, Wu Guihui, Lai Min, Luo Haixia, Cui Kunping, Li Yuke Chinese Journal of Antituberculosis    2023, 45 (7): 651-657.   DOI: 10.19982/j.issn.1000-6621.20230054 Abstract （252）   HTML （24）    PDF（pc） （737KB）（124）       Knowledge map    Save Objective: To explore the clinical characteristics and death-related factors of patients with tuberculosis-destroyed lung (TDL) undergoing invasive mechanical ventilation (IMV). Methods: A retrospective study was conducted in 107 TDL-IMV patients admitted to the intensive care unit of Chengdu Public Health Clinical Center from January 2017 to December 2021.The epidemiological data, complications, comorbidities, acute physiology and chronic health status scores (APACHE Ⅱ score), sequential organ failure scores (SOFA score), causes of IMV, laboratory test results, and clinical outcomes, etc., of the patients were collected. The above indicators in patients with different clinical outcomes were compared and analyzed, and unconditional multivariate logistic regression was used to analyze the influencing factors of death in TDL-IMV patients. Results: Of the 107 subjects, 42 (39.3%) died and 65 (60.7%) survived. Univariate analysis showed that 52.4% (22/42) of the patients in the death group were complicated with chronic obstructive pulmonary disease, which was significantly higher than that in the survival group (20.0%, 13/65, χ2=12.154, P=0.000); IMV for acute respiratory failure accounted for 52.4% (22/42), which was significantly higher than that of survival group (23.1%, 15/65, χ2=9.685, P=0.002); the albumin level ((25.34±4.22) g/L) was significantly lower than that in the survival group ((28.71±6.26) g/L, t=3.065, P=0.002); N-terminal pro-B-type natriuretic peptide level (median (quartile): 993.45 (869.32, 1096.61) ng/L) was significantly higher than that of survival group (649.26 (528.40, 789.82) ng/L, U=-7.085, P=0.000). Further multivariate logistic regression analysis showed that comorbidities with chronic obstructive pulmonary disease (OR=4.999, 95%CI: 1.253-19.937), IMV treatment for acute respiratory failure (OR=8.548, 95%CI: 2.045-35.729), hypoproteinemia (OR=13.069, 95%CI: 2.662-64.156) and high levels of N-terminal pro-B-type natriuretic peptide (OR=11.354, 95%CI: 2.809-45.888) were independent risk factors for the death of patients with TDL-IMV. Conclusion: Patients with TDL-IMV have a high risk of death, especially those who complicated with chronic obstructive pulmonary disease, undergoing IMV treatment due to acute respiratory failure, hypoproteinemia and high level of N-terminal pro-B-type natriuretic peptide. Table and Figures | Reference | Related Articles | Metrics

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Study on the effect of daily average temperature on the incidence of tuberculosis in Shufu County at Xinjiang, based on a distributed lag nonlinear model Meiheriban·Maimaiti , Mawlanjan·Emam , Lu Dongmei, Zheng Yanling, Zhang Xueliang, Peng Xiaowang Chinese Journal of Antituberculosis    2023, 45 (5): 507-513.   DOI: 10.19982/j.issn.1000-6621.20220488 Abstract （249）   HTML （8）    PDF（pc） （1659KB）（200）       Knowledge map    Save Objective: To investigate the effect of temperature on the incidence of pulmonary tuberculosis in Shufu County, Kashgar Region, Xinjiang Uygur Autonomous Region. Methods: The number of reported cases of pulmonary tuberculosis in Shufu County, Kashgar Region, Xinjiang Uygur Autonomous Region from January 1, 2017 to December 31, 2021 was sourced from the Chinese Infectious Disease Reporting System. Meteorological data for the same period in the region, including average daily temperature, average daily relative humidity, and average daily wind speed, were obtained from the China Meteorological Data Network. Spearman correlation analysis and distribution lag nonlinear model analysis were performed on the daily mean air temperature and daily incidence of tuberculosis cases to study the association effect of air temperature and daily incidence of pulmonary tuberculosis in Shufu County. Results: From 2017 to 2021, a total of 5212 cases of pulmonary tuberculosis were reported in Shufu County, including 2669 males and 2543 females; higher incidence in people aged ≥65 years old (3269 cases); the highest number of daily onset cases was 76; the median (quartile) of daily average temperature was 14.7 (2.30, 22.50) ℃. The Spearman correlation analysis showed a positive correlation between the daily incidence of tuberculosis and the daily average temperature (correlation coefficient 0.070, P<0.01). The results of the distributed lagged nonlinear model analysis showed a nonlinear relationship between air temperature and pulmonary tuberculosis. The effect of low temperature (-4 ℃) on the daily risk of pulmonary tuberculosis incidence in the 36-64-year-old population was more pronounced, and the RR values showed a trend of decreasing and then increasing with increasing lag time, reaching a maximum RR value at a lag of 28 d on the daily risk of pulmonary tuberculosis incidence in the 36-64-year-old population (RR (95%CI)=2.833 (1.581-5.078)). The effect of low temperature (-4 ℃) on the number of daily incidences of pulmonary tuberculosis in women was more pronounced, with a trend of decreasing and then increasing RR values as the lag time increased, also reaching a maximum RR value at a lag of 28 d on the risk of daily incidences of pulmonary tuberculosis in women (RR (95%CI)=2.377 (1.334-4.234)). Conclusion: Temperature was associated with the risk of pulmonary tuberculosis incidence in the population in Shufu County, Kashgar Region, Xinjiang Uygur Autonomous Region, and the risk of pulmonary tuberculosis incidence was increased in women and people aged 36-64 years in a low-temperature environment. Table and Figures | Reference | Related Articles | Metrics

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Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities National Center of Medical Quality Control for Respiratory Diseases , Tuberculosis Branch of Chinese Medical Association , Tuberculosis Control Branch of Chinese Antituberculosis Association , China-Japan Friendship Hospital Chinese Journal of Antituberculosis    2024, 46 (2): 127-140.   DOI: 10.19982/j.issn.1000-6621.20230428 Abstract （247）   HTML （42）    PDF（pc） （3712KB）（251）       Knowledge map    Save The diagnosis delay of pulmonary tuberculosis not only results in aggravation and treatment challenges for patients but also leads to the continuously group spreading of tuberculosis. Early detection in general medical facilities, the main primary diagnosis healthcare contact for pulmonary tuberculosis patients, plays a crucial role in achieving the goal of “End tuberculosis strategy”. The National Center of Medical Quality Control for Respiratory Diseases, Tuberculosis Branch of Chinese Medical Association, Tuberculosis Control Branch of Chinese Antituberculosis Association, and China-Japan Friendship Hospital jointly organized experts to formulate the Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities based on the results of China’s tuberculosis prevention practice and the relevant guidelines of the World Health Organization and supplement relevant research evidence at home and abroad. This guide systematically summarizes the characteristics of different diagnostic techniques for pulmonary tuberculosis and proposes tuberculosis screening strategies for different target populations seeking treatment in comprehensive medical institutions, providing evidence for improving and optimizing early detection of pulmonary tuberculosis in national and regional comprehensive medical institutions. Table and Figures | Reference | Related Articles | Metrics

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Nutritional status of drug-resistant pulmonary tuberculosis patients and the influencing factors: a multi-center, large-sample study Ding Qin, Zhang Shengkang, Ren Fei, Chen Xiaohong, Hu Chunmei, Chen Wei, Fan Lin Chinese Journal of Antituberculosis    2023, 45 (9): 826-832.   DOI: 10.19982/j.issn.1000-6621.20230047 Abstract （247）   HTML （38）    PDF（pc） （748KB）（150）       Knowledge map    Save Objective: To investigate the nutritional status of drug-resistant pulmonary tuberculosis patients and analyze the influencing factors. Methods: A retrospective study was conducted in 1766 drug-resistant pulmonary tuberculosis patients from 29 tuberculosis specialized hospitals in 17 provinces and 2 municipalities of China from January 1, 2020 to December 31, 2021. The age range of the patients was 18 to 90 years with the average age of (45.88±16.43) years, and the average body mass index (BMI) was 20.03±3.25. Among them, 1255 were male (71.06%) and 511 were female (28.94%). Demography information and clinical characteristics of the subjects were collected. The Nutritional Risk Screening-2002 (NRS-2002) was used to assess whether the subjects were at nutritional risk. Further assessment and diagnosis of malnutrition were conducted in accordance with the Global Leadership Initiative on Malnutrition (GLIM) standards. Multivariate logistic regression analysis was used to investigate the influencing factors of nutritional risk in drug-resistant pulmonary tuberculosis patients. Results: The NRS-2002 score of 1766 subjects fluctuated from 1 to 5, and the median score (Quartile) was 3 (1 to 4) points. A total of 1103 cases (62.46%) of the subjects had nutritional risks (NRS-2002 score ≥3 points). In the NRS-2002 score ≥3 group, 70.56% (254/360) of the patients aged 60-79 years old, 83.33% (25/30) aged ≥80 years old, and BMI of all the patients (100.0% (602/602)) <18.5, which were significantly higher than those in the NRS-2002 score <3 group (accounted for 29.44% (106/360), 16.67% (5/30), and 0, respectively)(χ2 values were 6.256 and 1345.000, respectively; P values were 0.012 and <0.01). Multivariate logistic regression analysis showed that older age (with 18-39 years old group as reference, 60-79 years old group: OR (95%CI)=2.130 (1.194-3.803); ≥80 years old group: OR (95%CI)=12.400 (3.114-49.369)) and lower BMI (with BMI ≥20.5 as reference, BMI <18.5: OR (95%CI)=56.937 (26.537-122.161)) were risk factors for nutritional risk in drug-resistant pulmonary tuberculosis patients. The incidence of malnutrition among the study subjects was 52.55% (928/1766). Among 1103 individuals at risk for nutrition, the incidence of malnutrition was 84.13% (928/1103). Conclusion: Drug-resistant pulmonary tuberculosis patients have a higher nutritional risk and a higher incidence of malnutrition. Therefore, it is necessary to conduct standardized nutritional risk screening and diagnosis of malnutrition for such patients as early as possible, with special attention paid to elder and low BMI patients. Table and Figures | Reference | Related Articles | Metrics

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Study on the predictive effect of seasonal auto regressive integrated moving average model on the incidence of pulmonary tuberculosis Ren Feilin, Liu Xiaoqi, Jin Meihua, Sun Xiuxiu Chinese Journal of Antituberculosis    2023, 45 (5): 514-519.   DOI: 10.19982/j.issn.1000-6621.20220517 Abstract （244）   HTML （13）    PDF（pc） （1598KB）（137）       Knowledge map    Save Objective: To analyze the accuracy of seasonal difference auto regressive moving average (SARIMA) model in predicting the incidence of pulmonary tuberculosis (PTB). Methods: From January 2010 to December 2021, PTB incidence data of Huzhou City, Zhejiang Province collected through “Infectious Disease Reporting System” which was a subsystem of the “Chinese Disease Prevention and Control Information System”. SARIMA models based on monthly incidence rate and case number were established using data from January 2010 to December 2020 while the validation of the model used data from January to December 2021. Prediction effect of the two models were evaluated by two indexes, the mean absolute percentage error (MAPE) and the relative root mean square error percentage (RMSEP). Results: The best model of SARIMA were (0,0,1)(0,1,1)12 for the case number and (0,0,1)(1,1,1)12 for the incidence. The actual reported case number in September 2021 was above the upper limit of 95% confidence interval of the model prediction with a difference of 28.571%. The reported case number of other months were all within the predicted 95% confidence interval (109 cases). All monthly reported incidences were within the predicted 95%CI range. The maximum difference between the predicted incidence and the actual incidence was 8.665%. Counting annual cumulative case number and incidence in 2021, the differences between the predicted value and the true value of the case number model and the incidence model were 4.866% and 2.483%, respectively. MAPE of the case number model was 9.925%, and RMSEP was 14.167%. MAPE of the incidence model was 3.798%, and RMSEP was 4.463%, both were smaller than those of the case number SARIMA model. Conclusion: The SARIMA model based on the monthly reported PTB incidence and case number in Huzhou City from 2010 to 2020 had a good fitting effect. The predictive effect of SARIMA model of the incidence was better than that of the case number model. Table and Figures | Reference | Related Articles | Metrics

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Current status and progress of imaging evaluation methods for detecting pulmonary tuberculosis combined with lung cancer Wen Limin, Hou Dailun Chinese Journal of Antituberculosis    2023, 45 (6): 620-624.   DOI: 10.19982/j.issn.1000-6621.20230045 Abstract （244）   HTML （25）    PDF（pc） （936KB）（166）       Knowledge map    Save Tuberculosis ranks second of the leading causes of communicable disease induced deaths worldwide. Lung cancer ranks first in both morbidity and mortality of malignant tumors in China. Because pulmonary tuberculosis and lung cancer can coexist, their differentiation is a clinical challenge. With the rapid development of imaging technology, the early identification of pulmonary tuberculosis and lung cancer using image evaluation provides great guide for diagnostic process of these two diseases. This paper mainly reviews the classic imaging evaluation methods and the latest research progress of novel methods for detecting pulmonary tuberculosis and lung cancer comorbidity, and analyzes the challenges of existing imaging evaluation methods and the future development direction. Reference | Related Articles | Metrics

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An analysis of the epidemic characteristics and treatment outcomes of tuberculosis patients aged ≥65 years old in Ningxia Hui Autonomous Region from 2019 to 2022 Tian Xiaomei, Sha Xiaolan, Liu Ye, Liu Guangtian, Lei Juan Chinese Journal of Antituberculosis    2023, 45 (9): 857-863.   DOI: 10.19982/j.issn.1000-6621.20230166 Abstract （244）   HTML （13）    PDF（pc） （751KB）（139）       Knowledge map    Save Objective: To analyze the epidemic characteristics and treatment outcomes of pulmonary tuberculosis patients aged ≥65 years old in Ningxia from 2019 to 2022 and to provide epidemiological basis for further prevention and control in the elderly tuberculosis cases. Methods: The number of whole population and that of population aged ≥65 years, number of pulmonary tuberculosis cases, age, sex, diagnosis category, treatment category, case finding ways, residence location, occupation, and treatment outcome in Ningxia in 2019-2022, were retrospectively extracted from the statistical analysis of tuberculosis module in the “Infectious Disease Surveillance System” subsystem of the “China Disease Prevention and Control Information System” and the integrated management of disease prevention and control module and the characteristics of the epidemic situation and the treatment outcome were analyzed. Results: From 2019 to 2022, the average notification rates of pulmonary tuberculosis and the pathogenic positive patients among the population aged ≥65 years old were 114.59/100000 (3155/2753300) and 74.42/100000 (2049/2753300), respectively. The notification rates decreased from 137.87/100000 (864/626700) and 86.64/100000 (543/626700) in 2019 to 99.53/100000 (757/760600) and 62.32/100000 (474/760600) in 2022, showing an annually decline trend ($\chi_{\text {trend}}^{2}$=47.824, P=0.000; $\chi_{\text {trend}}^{2}$=28.020, P=0.000). However, the notification rates of pulmonary tuberculosis and the pathogenic positive patients with ≥65 years accounted for 40.84% (3155/7725) and 45.90% (2049/4464) of the total tuberculosis patients, respectively, which increased from 36.06% (864/2396) and 41.45% (543/1310) in 2019 to 45.49% (757/1664) and 50.64% (474/936) in 2022, respectively, indicating an annualy increasing trend ($\chi_{\text {trend}}^{2}$=56.440, P=0.000; $\chi_{\text {trend}}^{2}$=23.053, P=0.000). From the clinical features perspective, the proportion of female, etiological positive, retreatment category and referral among elderly patients ≥65 years old were 53.44% (1686/3155), 64.94% (2049/3155), 6.59% (208/3155) and 76.89% (2426/3155), respectively, which were higher than those of patients <65 years old, respectively, accounting for 40.02% (1829/4570), 52.84% (2415/4570), 5.08% (232/4570) and 74.00% (3382/4570) (χ2=135.495, P=0.000; χ2=138.402, P=0.000; χ2=7.987, P=0.005; χ2=99.856, P=0.000). From the regional distribution, the proportion pulmonary tuberculosis with ≥65 years old with was higher in Zhongwei, Wuzhong and Shizuishan (47.78% (731/1530), 46.55% (783/1682) and 44.16% (367/831), respectively). In Shizuishan, the proportion increased from 37.55% (95/253) in 2019 to 52.02% (90/173) in 2022 with an annually increasing trend ($\chi_{\text {trend}}^{2}$=10.210, P=0.017). The proportions of elderly patients in Yinchuan and Guyuan were relatively lower (36.02% (857/2379) and 32.00% (417/1303), respectively). However, the proportions increased from 29.65% (223/752) and 26.21% (103/393) in 2019 to 41.30% (204/494) and 39.67% (119/300) in 2022, respectively, showing an increasing trend ($\chi_{\text {trend}}^{2}$=26.113, P=0.000; $\chi_{\text {trend}}^{2}$=17.234, P=0.001). From the perspective of occupational distribution, the proportion of farmer was higher (73.38% (2315/3155)), but decreased from 79.05% (683/864) in 2019 to 68.83% (521/757) in 2022. This was followed by household workers or unemployed and retirees (14.17% (447/3155) and 11.92% (376/3155), respectively). However, their share increased from 9.95% (86/864) and 10.42% (90/864) in 2019 to 17.57% (133/757) and 13.21% (100/757) in 2022. In terms of treatment outcome, the successful treatment rate of elderly tuberculosis patients (90.60% (2102/2320)) was statistically lower than that of patients <65 years (95.99% (3396/3538)) (χ2=70.394, P=0.000). The successful treatment rate of elderly patients increased from 88.28% (738/836) in 2019 to 92.31% (720/780) in 2021, showing an increasing trend ($\chi_{\text {trend}}^{2}$=8.605, P=0.014). Conclusion: From 2019 to 2022, the incidence of pulmonary tuberculosis in elderly patients aged ≥65 years old in Ningxia showed a decline trend, the proportion of elderly tuberculosis cases among whole tuberculosis cases showed an increasing trend. Therefore, health education and active screening of tuberculosis in spepcific populations, such as elderly women, etiological positive, retreatment, referral and follow-up, household worker, unemployed and retired people, and elderly patients in Shizuishan City, Yinchuan City and Guyuan City should be focused on to effectively reduce the tuberculosis epidemic in Ningxia. Table and Figures | Reference | Related Articles | Metrics

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Analysis of epidemiological characteristics and treatment outcomes of pulmonary tuberculosis patients in floating population in Tongzhou District of Beijing, 2012—2021 Yang Chao, Wang Jing, Tang Guilin, Geng Yang Chinese Journal of Antituberculosis    2023, 45 (6): 594-600.   DOI: 10.19982/j.issn.1000-6621.20220502 Abstract （243）   HTML （29）    PDF（pc） （1160KB）（163）       Knowledge map    Save Objective: To analyze the characteristics and treatment outcomes of pulmonary tuberculosis (PTB) in floating population in Tongzhou District of Beijing, so as to provide reference for formulating TB prevention and control strategies. Methods: Data of 3202 PTB cases of floating population in Tongzhou District of Beijing from 2012 to 2021 was collected through Tuberculosis Management Information System of China Information System for Disease Control and Prevention, which included gender, age, occupation, case source, treatment classification, treatment outcomes and so on. Descriptive statistics was used to analyze the patients’ characteristics, treatment and outcomes. The seasonal effect of time series was analyzed by using seasonal index. Results: From 2012 to 2021, a total of 4996 cases of PTB patients were registered in Tongzhou District of Beijing, among which 3202 cases were from floating population, accounting for 64.09% of total cases. The incidence of PTB patients of floating population increased from 34.48/100000 in 2012 to 62.36/100000 in 2016 ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=32.913,P<0.001), and then decreased to 37.80/100000 in 2021 ( {\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^2=15.061,P<0.001). The male-female ratio of patients was 1.75∶1. The main age group was 15-44 years old (79.17% (2535/3202)). The main occupation was housekeepers/unemployed people (41.41% (1326/3202)). The main source of patients was people refered from general hospitals (65.46% (2096/3202)), and the patients were generally delayed for health care visit (37.76% (1209/3202)). Most patients came from Hebei Province (22.49% (720/3202)) and Heilongjiang Province (9.81% (314/3202)). All patients received full-course supervision and management. The overall treatment success rate was 94.38% (3022/3202), while 85 cases (2.65%) defaulted, 12 cases (0.37%) died, and 36 cases (1.12%) developed multidrug-resistant TB. Conclusion: The epidemic of PTB among the floating population in Tongzhou District of Beijing were mainly male, young adults, housekeepers/unemployed and had high visit delay rates and differenciated regional distribution, thus corresponding prevention and control strategies should be formulated according to these epidemic characteristics. Table and Figures | Reference | Related Articles | Metrics

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Meta-analysis of effectiveness and safety of the cycloserine-containing treatment for multidrug-resistant pulmonary tuberculosis in China Zheng Rui, Zhao Mingrui, Yang Yuanzheng Chinese Journal of Antituberculosis    2023, 45 (7): 658-668.   DOI: 10.19982/j.issn.1000-6621.20230057 Abstract （241）   HTML （15）    PDF（pc） （5697KB）（160）       Knowledge map    Save Objective: The purpose of this study was to provide evidence for clinical treatment of multidrug-resistant pulmonary tuberculosis (MDR-PTB) by assessing the effectiveness and safety of using cycloserine (Cs)-containing anti-tuberculosis regimens in China. Methods: A search for “cycloserine”“multi-drug resistant pulmonary tuberculosis”“treatment effect” and “adverse effects” was conducted in database of China National Knowledge Infrastructure, Wanfang Data, VIP, China Biomedical Literature Service System, PubMed, Embase, and Cochrane Library for literature published from January 2011 to September 2022. Randomized controlled trials (RCT) of Cs-containing anti-tuberculosis regimens for the treatment of MDR-PTB in China were targeted. The literature was screened by two researchers and the Cochrane 5.1.0 bias risk assessment tool was used to evaluate the methodological quality of the included studies. Stata 17.0 MP software was used to analyze the outcome indicators. Results: A total of 35 included literature was divided into: Cs+conventional treatment compared with conventional treatment group, 1128 cases; thymosin+Cs+conventional treatment group compared with the conventional treatment group, 791 cases; Cs+conventional treatment group compared with para aminosalicylic acid+conventional treatment group, 433 cases; Cs+conventional treatment compared with ethambutol+conventional treatment, 419 cases. The results of Meta-analysis indicated that compared with conventional anti-tuberculosis treatment, Cs-containing regimens showed superior effectiveness in treating MDR-PTB (RR=2.191, 95%CI: 1.847-2.599), including the rate of sputum conversion (RR=2.002, 95%CI: 1.696-2.364), lesion absorption (RR=2.259, 95%CI: 1.836-2.779), and cavity shrinkage (RR=1.812, 95%CI: 1.482-2.217). The incidence of adverse reactions in mental and nervous system was higher in Cs-containing regimens (RR=1.696, 95%CI: 1.493-1.927). Conclusion: The results suggested that the Cs-containing regimens were more effective in treating MDR-PTB, but caution should be taken for adverse reactions in the central nervous system. Table and Figures | Reference | Related Articles | Metrics

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Value of CRISPR-Cas13a detection in the diagnosis of pulmonary tuberculosis Zhang Zhiguo, Shang Yuanyuan, Zhang Xuxia, Liu Rongmei, Ma Liping, Qin Lin, Kong Zhongshun, Ren Weicong Chinese Journal of Antituberculosis    2023, 45 (6): 589-593.   DOI: 10.19982/j.issn.1000-6621.20230014 Abstract （239）   HTML （30）    PDF（pc） （985KB）（106）       Knowledge map    Save Objective: To assess the diagnostic value of CRISPR-Cas13a detection in pulmonary tuberculosis (TB) using clinical samples. Methods: A retrospective study was conducted at Beijing Chest Hospital Affiliated to Capital Medical University. The bronchoalveolar lavage fluid (BALF) specimens of 102 patients with pulmonary TB confirmed by GeneXpert MTB/RIF test (Xpert test) from September 2022 to December 2022 were enrolled as TB group, and the BALF specimens of 100 patients (including lung cancer, bacterial pneumonia, bronchiectasis, and chronic obstructive pulmonary disease) during the same period were recruited as non-TB group. The BALF samples of all patients were subjected to acid-fast bacilli smear microscopy, culture, Xpert test and CRISPR-Cas13a test. The diagnostic value of CRISPR-Cas13a in the detection of BALF for pulmonary TB was evaluated based on the results of Xpert test. Results: Among 102 specimens in the TB group, 99 (97.1%) were positive for CRISPR-Cas13a, 40 (39.2%) were positive for smear, and 68 (66.7%) were positive for culture. The positive detection rate of CRISPR-Cas13a was significantly higher than those of smear and culture (smear: χ2=58.141, P<0.001; culture: χ2=30.250, P<0.001). Compared with traditional methods, CRISPR-Cas13a was able to identify 28 clinically confirmed TB patients which would be otherwise missed by either smear or culture. The positive detection rate of Xpert was 100.0% in TB group, and the negative detection rate of Xpert was 100.0% in non-TB group. Taking the results of Xpert as a reference, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CRISPR-Cas13a in detecting pulmonary TB were 97.1% (99/102), 96.0% (96/100), 96.5% (195/202), 96.1% (99/103) and 97.0% (96/99), respectively. Conclusion: Compared with traditional tests, CRISPR-Cas13a detection is simple and fast, with higher sensitivity and higher specificity in the detection of BALF for the diagnosis of pulmonary TB, and has a good application prospect. Table and Figures | Reference | Related Articles | Metrics

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Survey on satisfaction of external quality assessment among tuberculosis laboratory network in China Song Yuanyuan, Xia Hui Chinese Journal of Antituberculosis    2023, 45 (6): 559-565.   DOI: 10.19982/j.issn.1000-6621.20230013 Abstract （238）   HTML （23）    PDF（pc） （1707KB）（144）       Knowledge map    Save Objective: To identify the problems in the external quality assessment (EQA) of tuberculosis laboratories diagnosis and improve the quality through a satisfaction survey among tuberculosis laboratories network in China. Methods: The National Tuberculosis Reference Laboratory (NTRL) of Chinese Centre for Disease Control and Prevention designed and distributed online questionnaires to personnel involved in EQA in 2019, 2020 and 2021. The questionnaires were anonymously filled by personnel and then collected and analyzed by NTRL. The difference of satisfaction between 2019 and 2021 was analyzed, and the difference between personnel form different levels of institutes (provincial, prefecture, and county) in 2019 was also compared. Results: One thousand six hundred and fifteen, 30 and 314 personnel responded to the questionnaire in 2019, 2020 and 2021 respectively. Of the 25 questions in 2021, only psychological stress satisfaction (79.0%, 248/314) was less than 80%. Of the 26 questions in 2019, the satisfaction rate of four questions was below 80%, such as satisfaction of the impact on work load (69.3%, 1120/1615), satisfaction of the impact on economic burden (76.3%,1232/1615), satisfaction with psychological stress (66.1%, 1067/1615), and satisfaction of application for strains transportation permission (75.4%, 724/960). Among the 24 common questions in 2019 and 2021, the satisfaction rate of 22 questions in 2021 (79.0%-97.4%) was significantly higher than that in 2019 (66.1%-97.0%) except for the two questions related to results reporting time requirement that had no significant difference between 2019 and 2021. Conclusion: The satisfaction of respondents with most questions relevant with EQA is acceptable. Satisfactions with most questions has been improved after implementing of improvement measures. Some aspects, such as results reporting form and strain transportation still need further improvement, however. Table and Figures | Reference | Related Articles | Metrics

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Interpretation of WHO operational handbook on tuberculosis: module 1: prevention-infection prevention and control Sun Yuxian, Liu Yuhong Chinese Journal of Antituberculosis    2023, 45 (12): 1120-1124.   DOI: 10.19982/j.issn.1000-6621.20230365 Abstract （237）   HTML （41）    PDF（pc） （1026KB）（174）       Knowledge map    Save In August 2023, World Health Organization (WHO) published WHO operational handbook on tuberculosis: module 1: prevention-infection prevention and control, as a supporting material for WHO consolidated guidelines on tuberculosis: module 1: prevention-infection prevention and control released in December 2022, to provide feasible suggestions for the implementation of the recommendations on tuberculosis infection prevention and control in clinical as well as prevention and control programme. The author interprets the key content of this manual for reference. Reference | Related Articles | Metrics

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Investigation of nutritional status and analysis of influencing factors in patients with extrapulmonary tuberculosis Ding Qin, Chen Wei, Zhang Shengkang, Ren Fei, Chen Xiaohong, Hu Chunmei, Chen Danping, Fan Lin Chinese Journal of Antituberculosis    2023, 45 (9): 839-844.   DOI: 10.19982/j.issn.1000-6621.20230221 Abstract （237）   HTML （35）    PDF（pc） （740KB）（124）       Knowledge map    Save Objective: To investigate the nutritional status of patients with extrapulmonary tuberculosis and analyze the related factors. Methods: A total of 3223 inpatients with extrapulmonary tuberculosis from 5 tuberculosis specialized hospitals from January 1, 2020 to December 31, 2021 were selected as research subjects, including 1852 males (57.46%) and 1371 females (42.54%); the median (quartile) age was 41 (28,58) years old. The general demography characteristics and clinical characteristics of the subjects were collected (including gender, age, height, body mass, clinical diagnosis, location of extrapulmonary tuberculosis, complications, immune status, previous tuberculosis treatment history, etc.), as well as the nutrition risk screening-2002 (NRS-2002) score. All the subjects had complete medical records and information, and were definitely diagnosed with extrapulmonary tuberculosis. Nutritional risk screening was conducted when they had not yet received effective anti-tuberculosis treatment or control. The occurrence of nutritional risk in the subjects was analyzed and the influencing factors of nutritional risk in patients with extrapulmonary tuberculosis were analyzed using a multivariate logistic regression model. Results: Among the 3223 study subjects, 86.91% (2801/3223) involved only one extrapulmonary site, and 13.09% (422/3223) involved two or more sites. The NRS-2002 score of subjects fluctuated from 1 to 5, and the median (quartile) score was 3 (1, 4). A total of 1814 cases (56.28%) had nutritional risk (NRS-2002 score ≥3). Of the 422 study subjects with involvement in two or more extrapulmonary sites, 63.74% (269/422) were at nutritional risk; of the 2801 studies involving a single extrapulmonary site, 55.16% (1545/2801) had nutritional risks. Multivariate logistic regression analysis showed that low body mass index (body mass index <18.5)(OR (95%CI)=20.641 (19.745-26.307)), concomitant immunosuppression (OR (95%CI)=1.182 (1.023-1.421)), and retreatment (OR (95%CI)=1.804 (1.549-2.177)) were risk factors for nutritional risk in patients with extrapulmonary nodules. Conclusion: The incidence of nutritional risk in patients with extrapulmonary tuberculosis is relatively high, and more attention should be paid to their nutritional status in clinical treatment, especially for patients with low body mass index, combined immunosuppression, and retreatment. Table and Figures | Reference | Related Articles | Metrics

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Establishment of a cross primer isothermal amplification technique for rapid detection of Mycobacterium tuberculosis complex and nontuberculous mycobacteria Huang Wenbin, Chen Liping, Zhang Wang, Xiao Ting, Zhang Mane, Wu Dingchang Chinese Journal of Antituberculosis    2023, 45 (8): 734-743.   DOI: 10.19982/j.issn.1000-6621.20230088 Abstract （236）   HTML （22）    PDF（pc） （2130KB）（117）       Knowledge map    Save Objective: To establish a molecular cross primer isothermal amplification (CPA) detection system for rapid detection of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM). Methods: Six sets of CPA primers and three probes were designed for 16S rRNA-a highly conservative gene sequence of mycobacterium. Using a plasmid containing 16S rRNA gene sequence (with a concentration of 1000 copies/μl) as a positive template, the optimal primer probe combination was selected, and the sensitivity, specificity, and inclusiveness of the established optimal reaction system were analyzed. Samples of 125 presumptive tuberculosis patients with signs or symptoms of tuberculosis from the Second Hospital of Longyan, Fujian Province from February 8, 2022 to March 14, 2023, were collected and then detected by the mycobacterium nucleic acid detection kit (PCR-fluorescence probe method) and the established CPA method. The consistency of the test results between the two methods was statistically analyzed, setting Kappa value ≥0.75 as having good consistency. Results: MTBC/NTM-16S-6 primer and MTBC/NTM-16S-LR-FAM-3 were selected as the best primer probe combinations for the mycobacterium detection system. The minimum detection limit of the detection system was 100 copies/μl, and the detection time was 40 minutes. It could detect MTBC and clinically common NTM, and show no cross reaction with other common respiratory tract bacteria. Compared with the real-time fluorescence quantitative PCR (RT-PCR) detection method, the positive prediction value of the established CPA system was 95.65% (66/69), the negative prediction value was 85.71% (48/56), the total consistency rate was 91.20% (114/125), and the Kappa value was 0.82. Conclusion: A rapid detection system of MTBC and NTM based on CPA technology was successfully established, which could provide a new detection method for the prevention and control of tuberculosis epidemic in primary hospitals. Table and Figures | Reference | Related Articles | Metrics

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Evaluation of the effect of BS-400 Automatic Mycobacterium Liquid Culture System on Mycobacterium culture Yue Yongning, Fan Dapeng, Shang Xuechai, Li Hao, Li Huanyu, Zhou Jinyang, Cai Long Chinese Journal of Antituberculosis    2023, 45 (5): 483-487.   DOI: 10.19982/j.issn.1000-6621.20220411 Abstract （233）   HTML （9）    PDF（pc） （724KB）（115）       Knowledge map    Save Objective: To evaluate the effectiveness of the BS-400 Automatic Mycobacterium Liquid Culture System (BS-400 Culture System) in cultivating Mycobacterium in clinical specimens. Methods: A total of 427 specimens of suspected tuberculosis patients who visited Hangzhou Thoracic Hospital Affiliated to Zhejiang University School of Medicine from March to May 2022 were collected. The specimens included 331 respiratory tract specimens (including sputum and respiratory lavage fluid) and 96 non-respiratory tract specimens (including cerebrospinal fluid, tissues, secretions, urine, bone marrow, necrosis, etc.), except blood and feces. All specimens were simultaneously cultured using the BACTEC MGIT 960 liquid culture system (MGIT 960 culture system) and the BS-400 culture system. Bacterial isolation and species identification would be carried out on samples with positive culture results. The differences in the positive rate, detection time, contamination rate, and cost of two culture systems for different types of Mycobacterium specimens were compared, and the detection efficiency of the BS-400 culture system for Mycobacterium infections in different types of specimens was evaluated using the culture results of the MGIT 960 culture system as a reference standard. Results: The positive rate of BS-400 culture system for respiratory tract specimens was 32.02% (106/331), and the contamination rate was 5.14% (17/331); the positive rate of culture for non-respiratory tract specimens was 17.70% (17/96), and the contamination rate was 1.04% (1/96), compared with those of MGIT 960 culture system (32.93% (109/331) and 5.44% (18/331), 15.63% (15/96) and 2.08% (2/96), respectively), the difference was not statistically significant (χ2 values were 0.062, 0.030, 0.150, and 0.339, P values were 0.803, 0.862, 0.699, and 1.000, respectively). The detection time was 12.31 (7.89, 19.56) days of the BS-400 culture system, and was 9.79 (7.00, 16.58) days of the MGIT 960 culture system, with no statistically significant difference (Z=-1.895, P=0.058). Using the culture results of MGIT 960 culture system as a reference standard, the sensitivity and specificity of BS-400 culture system for detecting Mycobacterium infection specimens in respiratory tract were 93.58% (102/109) and 98.20% (218/222), and the Kappa value was 0.924; the sensitivity and specificity for detecting Mycobacterium infection specimens in non-respiratory tract were 100.00% (15/15) and 97.53% (79/81), and the Kappa value was 0.925. The testing cost of the BS-400 culture system (RMB (55±10) yuan per specimen) was approximately 70% of that of the MGIT 960 culture system (RMB (75±10) yuan per specimen). Conclusion: BS-400 culture system has high detection efficiency for Mycobacterium in clinical samples of suspected tuberculosis patients, and has good application value. Table and Figures | Reference | Related Articles | Metrics

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Prediction of the effectiveness and impact of the free healthcare policy for tuberculosis in China Zhou Wenyong, Wen Zexuan, Gao Mengxian, Li Tao, Zhang Hui, Wang Weibing Chinese Journal of Antituberculosis    2023, 45 (9): 845-856.   DOI: 10.19982/j.issn.1000-6621.20230143 Abstract （233）   HTML （28）    PDF（pc） （2917KB）（172）       Knowledge map    Save Objective: This study predicted the short-term and long-term epidemiological and economic impacts of the implementation of free tuberculosis (TB) healthcare policy in China, providing scientific evidence for the necessity and feasibility of free TB healthcare policy in China. Methods: Based on the natural history of TB, a TB dynamic model was developed, and two simulation scenarios were simulated to predict the impact of implementing free TB healthcare policy on the trend of TB epidemic, assuming a constant decline rate of annual incidence of TB and a gradually increasing decline rate of annual incidence of TB under other interventions, respectively. The cost-effectiveness, cost-utility, and cost-benefit analyses were conducted to evaluate the social benefits of the government’s investment on free TB healthcare policy. Results: With the free TB health care policy, when the decline rate is maintained at the current level, by 2035, 7584954 latent TB infections (LTBI) and 390333 TB cases can be avoided cumulatively, 195486 successfully treated drug-sensitive TB patients and 62251 drug-resistant TB patients can be increased cumulatively, and 2448501 disability-adjusted life years (DALY) and a social economic value of 273280420000 yuan can be saved. Every extra yuan invested by the government can generate a social economic value of 11.24 yuan. When the decline rate increases, by 2035, 5730438 LTBI and 273441 TB cases can be avoided cumulatively, 179592 successfully treated drug-sensitive TB patients and 49835 drug-resistant TB patients can be increased cumulatively, and 2179554 DALY and a social economic value of 233103460000 yuan can be saved. Every extra yuan invested by the government can generate a social economic value of 12.58 yuan. Conclusion: Implementing free TB healthcare policy can significantly reduce the transmission of TB and has a significant effect on saving social economic cost. These effects are more significant when the annual incidence of TB declines faster. It is recommended that the government shall implement free TB healthcare policy as soon as possible and other interventions to control the spread of TB. Table and Figures | Reference | Related Articles | Metrics

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Analysis of risk factors for acute cerebral infarction combined with intracranial tuberculosis Li Xiang, Qi Min, Jiang Jianjie, Wei Jialu, Fu Xuwen, Li Haiwen, Zhang Le Chinese Journal of Antituberculosis    2023, 45 (5): 499-506.   DOI: 10.19982/j.issn.1000-6621.20220507 Abstract （227）   HTML （10）    PDF（pc） （1974KB）（152）       Knowledge map    Save Objective: To analyze the clinical characteristics and the risk factors of acute cerebral infarction in patients with intracranial tuberculosis. Methods: A retrospective study was conducted to collect 84 patients with positive cultures of Mycobacterium tuberculosis in cerebrospinal fluid admitted to the Kuming Third People’s Hospital of Kunming from July 2019 to December 2021. The clinical symptoms, laboratory test results and imaging findings of these study subjects were collected; based on the cranial magnetic resonance imaging (MRI) performance, these study subjects were divided into cerebral infarction group (32 cases, 38.1%) and non-cerebral infarction group (52, 61.9%). Univariate and multivariate logistic regression were used to analyze the risk factors of intracranial tuberculosis complicated with acute cerebral infarction. Results: Commonly clinical symptoms of intracranial tuberculosis included headache (95.2%,80/84), fever (73.8%,62/84), vomiting (52.4%,44/84) and unconsciousness (48.8%,41/84). The convulsions (7.1%,6/84) was rare. The peripheral blood magnesium concentration (median (interquartile)) of 0.80 (0.75, 0.85) mmol/L (normal value 0.73-1.06 mmol/L) in the non-cerebral infarction group was significantly lower than that of 0.84 (0.81, 0.89) mmol/L in the cerebral infarction group, and the difference was statistically significant (Z=2.079, P=0.038). In the cerebral infarction group, cranial MRI showed thickened meninges in the basal/annular cistern in 31 cases (96.9%), thickened meninges in the lateral fissure cistern in 21 cases (65.6%), and combined with thickened arterial vessel walls in 31 cases (96.9%). In the non-cerebral infarction group, cranial MRI showed thickened meninges in the basal/annular cistern in 26 cases (50.0%), thickened meninges in the lateral fissure cistern in 18 cases (34.6%), and combined with thickened arterial vessel walls in 28 cases (53.8%). The incidence of basal/annular cistern meningeal thickening, lateral fissure cistern meningeal thickening and arterial vessel wall thickening were significantly higher in the cerebral infarction group than in the non-cerebral infarction group, with significant differences (χ2=19.956,P=0.000;χ2=7.659,P=0.006;χ2=17.545,P=0.000). Multivariate logistic regression analysis showed that arterial vessel wall thickening might be an independent risk factor for intracranial tuberculosis combined with acute cerebral infarction (OR (95%CI)=27.128 (3.393-216.917)). Conclusion: The common clinical symptoms of intracranial tuberculosis included headache, fever, vomiting and unconsciousness, and the MRI result showed that thickening of the arterial vessel wall might be an independent risk factor for acute cerebral infarction. Table and Figures | Reference | Related Articles | Metrics

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Research progress on blood transcriptomic biomarkers in the diagnosis of tuberculosis Bei Cheng, Li Meng, Gao Qian Chinese Journal of Antituberculosis    2023, 45 (8): 801-807.   DOI: 10.19982/j.issn.1000-6621.20230182 Abstract （224）   HTML （18）    PDF（pc） （803KB）（240）       Knowledge map    Save Development of convenient, rapid and accurate tuberculosis (TB) diagnostic assays is an important part of ending TB. Current detection assays have drawbacks such as difficulties in sputum collection, which are expected to be overcome by methods based on blood transcripomic biomarkers. We conducted a review about the progress, limitations, and prospects of blood-based transcripomic biomarkers in the diagnosis of TB. Table and Figures | Reference | Related Articles | Metrics

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Analysis of the public awareness rate of core knowledge of tuberculosis prevention and control in Shanxi Feng Miao, Huo Junfeng, Deng Junping, Wang Chunpu, Fan Yueling, Song Hong Chinese Journal of Antituberculosis    2023, 45 (8): 786-793.   DOI: 10.19982/j.issn.1000-6621.20230154 Abstract （223）   HTML （20）    PDF（pc） （790KB）（210）       Knowledge map    Save Objective: To investigate the awareness of core knowledge of tuberculosis prevention and control among residents in Shanxi, and provide scientific basis for strengthening health promotion and health education on tuberculosis control. Methods: From January to March 2021, a multi-stage stratified cluster random sampling method was applied to select 12 survey sites from each of the 11 cities in Shanxi. At least 100 participants were included in each survey site, resulting in a total of 132 survey sites (44 urban sites and 88 rural sites) and 13426 participants. A household survey was conducted using questionnaires to assess the participants’ awareness of core knowledge of tuberculosis prevention and control and the health education. A total of 13426 questionnaires were distributed, and 13426 valid questionnaires were collected with a response rate of 100.00%. Descriptive analysis and Chi-square tests were used to analyze the awareness of core knowledge of tuberculosis prevention and control. Results: The general awareness rate of all 5 key messages was 80.05% (53735/67130). The awareness rates of the five tuberculosis key messages were 71.80% (9640/13426), 88.99% (11948/13426), 89.65% (12037/13426), 80.73% (10839/13426), and 69.05% (9271/13426), respectively, which include “tuberculosis is a serious chronic infectious disease”, “tuberculosis is mainly transmitted through the respiratory tract”, “the suspicious symptoms of tuberculosis are cough and/or coughing with sputum for more than 2 weeks”, “the preventive measures of tuberculosis are mainly not spitting, covering the mouth and nose when coughing and sneezing, and wearing masks” and “the majority of pulmonary tuberculosis can be cured”. Among them, the total awareness rates of male participants, urban population, participants with younger age (15-19 years old), participants with a bachelor’s degree or above and participants from government institutions (80.30% (26091/32465), 82.30% (19020/23110), 84.43% (1372/1625), 84.18% (3405/4045) and 85.69% (3916/4570), respectively) were higher than those of female participants, rural population, aged 80 and above, illiterate or semiliterate population groups, and unemployed or self-employed individuals (79.75% (27644/34665), 78.86% (34712/44020), 69.45% (955/1375), 70.03% (2493/3560) and 77.68% (10269/13220), respectively). These differences were statistically significant (χ2=4.040, P=0.044; χ2=112.711, P<0.001; χ2=330.252, P<0.001; χ2=514.584, P<0.001; χ2=272.377, P<0.001, respectively). Furthermore, 78.69% (10565/13426) of the public population had received health education of tuberculosis. “Television” (55.88%, 5904/10565), “bulletin/wall newspapers/blackboard newspapers” (39.77%, 4202/10565), and “leaflets/folded pages/posters” (38.97%, 4117/10565) were the most common ways for receiving health education. “Radio/television/film/audiovisual materials” (62.75%, 8423/13423) remained the most popular way for the public population to acquire health knowledge. Conclusion: In recent years, the awareness of core knowledge of tuberculosis prevention and control among residents in Shanxi has increased significantly. However, it has not yet reached the national planning goals. Health education on tuberculosis control knowledge should be strengthened, especially for the populations with rural area, lower education, older ages, and unemployed or self-employed individuals. Table and Figures | Reference | Related Articles | Metrics