Table of Content

10 October 2019, Volume 41 Issue 10

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Expert Forum

Tuberculosis control strategy based on the discovery of infectious sources

Qian GAO,Jian MEI,Wei-guo TAN

Chinese Journal of Antituberculosis. 2019, 41(10):  1074-1079.  doi:10.3969/j.issn.1000-6621.2019.10.002

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With WHO’s grand goal of eliminating tuberculosis by 2035, preventive interventions for latent infections of TB have received significant attention as innovation strategies. China is the second-highest TB burden country in the world. It is even more necessary to understand the tuberculosis epidemic in China and to grasp the critical points of tuberculosis control. We reviewed the definition of latent infection, the incubation period of latent infection, and the successful experience of tuberculosis control in abroad. We emphasize that the new transmission is the leading cause for high TB burden countries, and discovery the source of infection is still the key for the TB control program. At the same time, it is an essential means to improve the quality of sputum and establish regional laboratories to enhance the ability of detection of TB in China, and to control the transmission of TB.

Special Articles

Overview of tuberculin products development

Wei-xin DU,Ai-hua ZHAO,Guo-zhi WANG,Jin-biao LU

Chinese Journal of Antituberculosis. 2019, 41(10):  1080-1083.  doi:10.3969/j.issn.1000-6621.2019.10.003

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The tuberculin products has been developed more than 120 years up to now, with different development stages of old tuberculin, purified protein derivative and new skin test diagnostic reagents. This paper introduced the research history, product characteristics and development trends of tuberculin products in order to make the users know the background knowledge and reasonably apply the products, and meanwhile provide reference for the study of new skin testing diagnostic reagents.

Original Articles

Meta-analysis of T-SPOT.TB test for diagnosing spinal tuberculosis

Li YAO,Jian SHENG,Bing WANG,Xi-yong DAI

Chinese Journal of Antituberculosis. 2019, 41(10):  1084-1089.  doi:10.3969/j.issn.1000-6621.2019.10.004

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Objective To systematically review the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis.Methods All literatures involved the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis which published from establishment to June 2019 were identified from CNKI, WanFang Data, VIP, PubMed, EMBASE, Cochrane Library, etc. Two researchers independently conducted literature search, screened the literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. MetaDisc 1.4 were used to conduct the meta-analysis.Results A total of 219 articles were retrieved and 8 articles were eventually included based on inclusion and exclusion criteria. The cumulative sensitivity of peripheral blood T-SPOT.TB test for the diagnosis of spinal tuberculosis was 88.0% (95%CI: 85.0% to 91.0%), and the specificity (SPE) was 90.0% (95%CI:86.0%-93.0%), the positive likelihood ratio (PLR) was 8.67 (95%CI:6.47-11.62), the negative likelihood ratio (NLR) was 0.13 (95%CI:0.10-0.16),the diagnosis odds ratio (OR) was 63.14 (95%CI:42.14-94.60), and the area under the curve (AUC) of summary receiver operating characteristics (SROC) was 0.95.Conclusion T-SPOT.TB test of peripheral blood plays a valuable role in the diagnosis of spinal tuberculosis and can be used as an effective method for rapid diagnosis of spinal tuberculosis.

The changes in peripheral blood of T lymphocyte subsets in patients with pulmonary tuberculosis and extra-pulmonary tuberculosis and its clinical significance

Wei HE,Qing CHEN,Tao HUANG,Xiao-qiu HUANG,Gui-hui WU

Chinese Journal of Antituberculosis. 2019, 41(10):  1090-1095.  doi:10.3969/j.issn.1000-6621.2019.10.005

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Objective To investigate the changes of CD3 ⁺, CD4 ⁺, and CD8 ⁺ T lymphocyte subsets as well as CD4 ⁺/CD8 ⁺ ratio in peripheral blood and its clinical significance in patients with extra-pulmonary tuberculosis (EPTB).Methods A total of 147 patients, including 63 cases of pulmonary tuberculosis (PTB), 60 cases of PTB combined with EPTB (PTB&EPTB) and 24 cases of EPTB, who hospitalized in the tuberculosis area in the Public Health Clinical Center of Chengdu from October 2017 to January 2019 were enrolled in this study. The absolute counts of CD3 ⁺, CD4 ⁺ and CD8 ⁺ T lymphocyte subsets in peripheral blood and the ratio of CD4 ⁺/CD8 ⁺ were detected by flow cytometry and four-color lymphocyte subset detection kit. Then the differences of CD3 ⁺, CD4 ⁺ and CD8 ⁺ counts combined with the ratio of CD4 ⁺/CD8 ⁺ between groups were analyzed.Results CD3 ⁺ and CD4 ⁺ counts in the peripheral blood of patients with PTB&EPTB were 596.000 (377.500, 823.250) cells/μl and 347.500 (214.000, 479.250) cells/μl, respectively, which were significantly lower than those in patients with PTB (698.000 (572.000, 904.000) cells/μl and 409.000 (311.000, 545.000) cells/μl) (Z=-2.507, P=0.012; and Z=-2.431, P=0.015, respectively). The CD8 ⁺ count and the ratio of CD4 ⁺/CD8 ⁺ in patients with PTB&EPTB were 195.500 (137.250, 278.750) cells/μl and 1.670 (1.258, 2.273), respectively, were decreased compared with patients with PTB (244.000 (154.000, 317.000) cells/μl and 1.770 (1.290, 2.350)), while without statistically significant difference (Z=-1.892, P=0.058; Z=-0.546, P=0.585, respectively). In addition, CD3 ⁺ and CD4 ⁺counts in the peripheral blood of patients with EPTB were 551.500 (283.750, 949.000) cells/μl and 295.500 (134.250, 461.750) cells/μl, were significantly lower compared to patients with PTB (698.000 (572.000, 904.000) cells/μl and 409.000 (311.000, 545.000) cells/μl) (Z=-2.089, P=0.037; and Z=-2.460, P=0.014, respectively). However, the CD8 ⁺ counts and the ratio of CD4 ⁺/CD8 ⁺ presented no significant difference (Z=-1.315, P=0.188; and Z=-1.429, P=0.153, respectively) between patients with EPTB (185.000 (92.000, 366.250) cells/μl and 1.455 (1.018, 2.128)) and patients with PTB (244.000 (154.000, 317.000) cells/μl and 1.770 (1.290, 2.350)).Conclusion With the gradual decrease of CD3 ⁺ and CD4 ⁺ counts in the peripheral blood of patients with PTB, Mycobacterium tuberculosis may more easily disseminate to the outside of the lung, while the roles of CD8 ⁺ counts and the ratio of CD4 ⁺/CD8 ⁺ in the mechanism of EPTB still need to be further explored.

Analysis of clinical characteristics in 177 children with osteoarticular tuberculosis

Lei YANG,Li ZOU,Pan-yi YANG,Xiao-dong YANG,Jun JIANG,Xue-yang TANG

Chinese Journal of Antituberculosis. 2019, 41(10):  1096-1100.  doi:10.3969/j.issn.1000-6621.2019.10.006

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Objective To understand the clinical characteristics of osteoarticular tuberculosis (TB) in pediatric patients and to provide reference for developing prevention and treatment strategy.Methods The clinical information and data of 177 children with osteoarticular tuberculosis admitted to the West China Hospital of Sichuan University from 2013 to 2017 were collected, including the number of cases admitted each year, sex and age distribution, lesion location of tuberculosis, source and area of the patients. Their clinical characteristics were analyzed.Results From 2013 to 2017, a total of 177 children with osteoarticular tuberculosis were admitted to the West China Hospital of Sichuan University and 143 cases out of them were from Sichuan Province. The average number of hospitalized patients each year was 35.4 cases; 111 patients were male while 66 patients were female, and the ratio of male to female was 1.68∶1; the age of the patients ranged from 1 year to 14 years with an average of 6.4±3.6 years, and the age-group distribution of the patients was as follows: the proportion of infant and before school age (1-6 years old) was 56.5% (100/177), school age (7-12 years old) was 37.3% (66/177) and aged 12 years old and above was 6.2% (11/177). The hip joint was the most commonly affected (59 cases), then followed by spine (54 cases), knee joint (42 cases) and ankle joint (10 cases). The number of the patients who were from Liangshan Yi Autonomous Prefecture, Ganzi Tibetan Autonomous Prefecture, Aba Tibetan Autonomous Prefecture and other areas in Sichuan Province accounted for 50.3% (72/143), 13.3% (19/143), 11.2% (16/143) and 25.2% (36/143), respectively.Conclusion The pediatric patients with osteoarticular tuberculosis admitted to the West China Hospital of Sichuan University are mainly from Liangshan Yi Autonomous Prefecture, Ganzi Tibetan Autonomous Prefecture and Aba Tibetan Autonomous Prefecture in Sichuan Province, so those areas are priority on early prevention and treatment of bone and joint TB. Furthermore, most of the pediatric patients with osteoarticular TB are young children, which is the key group population for TB prevention and screening.

Analysis of short-term curative effectiveness of 36 cases of simple tuberculous scoliosis treated by operation

Zeng-hui LU,Hui-jun ZHANG,Ji-an LI,Chang-sheng ZHU

Chinese Journal of Antituberculosis. 2019, 41(10):  1101-1106.  doi:10.3969/j.issn.1000-6621.2019.10.007

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Objective To investigate the short-term clinical effectiveness of one-stage anterior debridement, posterior bone grafting and fusion and posterior pedicle internal fixation in the treatment of tuberculous scoliosis.Methods 36 patients with spinal tuberculosis admitted in Xi’an Chest Hospital from January 2010 to December 2016 were retrospectively analyzed. One stage anterior debridement, posterior bone graft fusion and transpedicular internal fixation had been performed on those patients after sufficient anti-tuberculosis treatment, postoperative diagnosis were confirmed as spinal tuberculosis. The operation time, blood loss, incision healing, postoperative complications, status on last follow-up, and changes in the tuberculosis caused symptoms were recorded. The changes of visual analogue score (VAS) before operation, 2 weeks after operation and at the last flow-up were observed. The changes of Cobb angle were compared for before operation, 2 weeks after operation and at the last flow-up. Immediately after operation and at the last follow-up, X-ray films were taken to determine the changes of scoliosis and the complications associated with internal fixation.Results The operation time ranged from 150-300 minutes, with an average of (206.33±35.08) minutes. The intra-operative blood loss was 200-1000 ml, with an average of (525.00±193.31)ml. The mean follow-up duration ranged from 18-36 months, with an average of (24.16±5.82) months. All 36 cases were cured without recurrence, without pus and sinus formation and complications associated with screw insertion during follow-up period. All patients with tuberculosis related symptoms and pains disappeared in spine lesions area; visual analogue scale (VAS) decreased significantly: the average score was (6.13±2.06) before operation, (3.30±1.66) at 2 weeks after operation (t=16.337,P=0.00,with statistically significant difference) and (1.46±0.73) at the last follow-up (t=7.487,P=0.00,with statistically significant difference comparing with 2 weeks after operation); Kyphotic angles of all patients recovered well: the average Cobb angle of scoliosis was (23.03±7.44) °before operation, (7.63±2.83)° at 2 weeks after operation (t=11.924,P=0.00,with statistically significant difference) and (7.73±2.75) °(t=-1.795,P=0.08, without statistically significant difference comparing with 2 weeks after operation); X-ray films at last follow-up showed no obvious loss with scoliosis (convex), no loosening for internal fixation device and side nail, no shift or fracture fixation failure.Conclusion Tuberculous scoliosis of spine treated by single-stage anterior debridement, posterior fusion and internal fixation had a definite curative effectiveness.

The effect of bronchoscopic argon plasma coagulation combined with cryotherapy and endobronchial isoniazid administration in the treatment of tuberculous endobronchial fistula

Lin-zi LUO,Yang-bao XIAO,Zhao XI,Jie XIAO,Li LUO,Zhi-bin LU,Hai-long LUO,Yan DING

Chinese Journal of Antituberculosis. 2019, 41(10):  1107-1112.  doi:10.3969/j.issn.1000-6621.2019.10.008

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Objective To evaluate the therapeutic effect of argon plasma coagulation (APC) combined with cryotherapy and endobronchial isoniazid (INH) administration in patients with type Ⅵ endobronchial tuberculosis (EBTB) who developed mediastinal lymph node ulcer and fistula in bronchus.Methods A total of 65 eligible patients who received treatment in Hunan Chest Hospital from January 2013 to August 2018 were included. Thirty-one of them before January 2017, who received cryotherapy plus endobronchial local INH administration were control group; and the other 34 patients from January 2017 to August 2018, who received APC combined with cryotherapy and endobronchial local INH administration by using flexible bronchoscopy were test group. SPSS 19.0 software was used to analyzed the time to fistula recovery, efficacy, and complications after treatment. Quantitstive data were compared by t test or rank sum test, and count data were compared by χ ² test. P<0.05 was consedered statistically significant.Results Patients received endobronchial treatments 241 times (7.81±2.20 times per patient) in control group, which was significantly higher than test group (222 times (6.53±2.05 times per patient))(t=2.425, P=0.018). Patients received cryotherapy plus endobronchial local INH administration 3.45±0.91 times per patient in control group, and APC combined with cryotherapy and endobronchial local INH administration 2.59±0.82 times per patient in test group, the difference between two groups was statistically significant (t=3.987,P<0.001). Time to fistula recovery [M (Q₁,Q₃)] was 12.0 (10.0,12.0) weeks in control group, which was significantly higher than test group (10.0 (8.0,12.0) weeks)(Z=-2.001, P=0.045). Twenty-nine patients had a full recovery and 2 patients had a partial recovery in control group, while,33 patients and 1 patient in test group, Finally, the therapeutic efficacy were 100.00% in both two groups,and (χ ²=0.000,P=1.000). Severe complications including mediastinal bronchial fistula, fatal bleeding, and air embolism by APC did not occur during our procedures.Conclusion APC combined with cryotherapy and endobronchial INH administration is a safe and effective therapeutic approach which can reduce the times of endoscopic procedure and shorten the fistula recovery time for type Ⅵ EBEB patients with ulcer and fistula.

Effect of postoperative pain nursing intervention for patients with spinal tuberculosis

Ya-juan AI,Xiang-dong LIU,Na BI,Ying ZHANG,Ya-ru ZHANG,Xiao-bo LUO

Chinese Journal of Antituberculosis. 2019, 41(10):  1113-1117.  doi:10.3969/j.issn.1000-6621.2019.10.009

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Objective To explore the clinical effect of postoperative pain nursing intervention for patients with spinal tuberculosis.Methods A total of 40 patients with spinal tuberculosis who admitted in the Minimally Invasive Spine Surgery Department of the Eighth Medical Center of PLA from January 2016 to June 2017 were randomly selected as the control group, and 40 patients with spinal tuberculosis in the same hospital from July 2017 to January 2019 were randomly included as the observation group. Patients in the control group underwent postoperative routine nursing, and patients in the observation group underwent postoperative pain nursing intervention based on the routine nursing. Then the pain degree and comfort, wound healing time, postoperative hospitalization time, and postoperative complications were compared between the two groups on the 3rd day and 1 week after operation.Results Based on visual analogue scoring (VAS), the pain scores in the observation group were (4.22±0.81) points on the 3rd day after operation and (2.22±0.81) points at 1 week after operation, which were both lower than those in the control group ((4.98±1.12) points and (2.98±1.12) points), with significant statistical differences (t=3.48 and 3.48; P=0.000 and 0.000). The VAS scores of comfort in the observation group were (4.48±0.41) points on the 3rd day after operation and (2.20±0.80) points at 1 week after operation, which were also both lower than those in the control group ((4.92±0.98) points and (2.96±1.12) points), with significant statistical differences (t=2.62 and 3.49; P=0.005 and 0.000). In addition, the postoperative wound healing time ((13.46±1.38) d) and the postoperative hospitalization time ((13.49±1.87) d) in the observation group were both less than those in the control group ((14.76±1.92) d and (14.86±2.54) d), with significant statistical differences (t=3.48 and 2.75; P=0.000 and 0.003). The incidence of postoperative complications in the observation group was lower than that in the control group (5.0%(2/40) vs 25.0%(10/40), χ ²=6.28, P=0.012).Conclusion Postoperative pain nursing intervention for patients with spinal tuberculosis can relieve pain, improve physiological comfort, reduce complications, and promote early recovery and discharge.

Clinical value of multidisciplinary assistance team in the treatment of tuberculosis hemoptysis

Yu-ru LI,Yu-ping ZHU,Jing-wen ZHOU,Ying GAO,Lin WANG

Chinese Journal of Antituberculosis. 2019, 41(10):  1118-1123.  doi:10.3969/j.issn.1000-6621.2019.10.010

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Objective To evaluate the effect of multiple disciplinary team (MDT) in the treatment of massive hemoptysis of pulmonary tuberculosis.Methods A total of 200 patients with pulmonary tuberculosis complicated with massive hemoptysis admitted in Shanghai Pulmonary Hospital Affiliated to Tongji University from 2017 to 2018 were selected. Eighty-two out of 96 patients in 2017 who met the inclusion criteria were selected as control group which implemented conventional nursing, risk assessment of asphyxia and traditional treatment model (hemostasis, airway opening, vital sign monitoring, tracheal intubation, bronchial artery embolization). Ninty-seven out of 104 patients in 2018 who met the inclusion criteria were selected as observation group which implemented conventional nursing, risk assessment of asphyxia and MDT treatment model (MTD Team establishment, making routine and emergency consultation, establishing first aid process). SPSS 20.0 software was used to compare the χ ² test,t test and U test of the time of successful treatment, recurrence rate of hemoptysis, incidence of hemoptysis-related complications and hospitalization time between the two groups,and P<0.05 was considered to be statistically significant.Results After MDT treatment, the time of successful treatment for pulmonary tuberculosis complicated with massive hemoptysis was 100.0(88.5,119.2) h, the recurrence rate of hemoptysis after MDT treatment was 2.1% (2/97), the incidence of hemoptysis-related complications was 3.1% (3/97), the length of hospitalization was average(8.8±2.6) days, which was lower than control group (268.0(229.3,300.0) h, 14.6%(12/82), 13.4%(11/82),(15.4±4.3) d)(U=131.000,P=0.000;χ ²=8.276,P=0.004;χ ²=5.582,P=0.018;t=31.067,P=0.000)).Conclusion On the basis of ensuring the success of treatment, implementing of MDT treatment can shorten the time of successful treatment of pulmonary tuberculosis hemoptysis patients, reduce the recurrence rate of hemoptysis, reduce the occurrence of hemoptysis-related complications and shorten hospitalization time. It can be popularized in clinic.

Short Articles

Study on drug-susceptibility of linezolid and tedizolid against 40 clinical isolates of multidrug-resistant tuberculosis

Ming LUO,Hui-zheng ZHANG,Xiao-feng YAN,Yao-kai CHEN,Zheng-gu HUANG,Kan ZHOU,Tong-xin LI,Jun-gang LI,Jing WANG,Chuan-yu LIAO

Chinese Journal of Antituberculosis. 2019, 41(10):  1124-1126.  doi:10.3969/j.issn.1000-6621.2019.10.011

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In order to compare and analyze the drug-susceptibility of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) to linezolid (Lzd) and tedizolid (Tzd), 40 isolates, which were isolated and identified as MDR-MTB by drug susceptibility test in the central laboratory from Jan. 2018 to Nov. 2018, were selected from Chongqing Public Health Medical Center by direct selection method. Minimum inhibitory concentrations (MIC) of Lzd and Tzd against these isolates were determined by microplate method and the relative data were analyzed. The results showed that the MIC (M(Q₁,Q₃)) of Lzd against to MDR-MTB isolates was 0.500 (0.500, 1.000) mg/L, of which 87.5% (35/40) of the strains had MIC of 0.500-1.000 mg/L. And the MIC (M(Q₁,Q₃)) of Tzd against to MDR-MTB isolates was 0.250 (0.250, 0.250) mg/L, of which 87.5% (35/40) of the strains were in the range of 0.125-0.250 mg/L. The MIC₅₀ and MIC₉₀ of Lzd against to MDR-MTB isolates were 0.500 and 1.000 mg/L, respectively, while those of Tzd against to MDR-MTB isolates were both 0.250 mg/L. The MIC of Tzd was obviously lower than that of Lzd (Z=-5.51, P<0.001). According to the results of the proportional susceptibility test, 40 MDR-MTB clinical isolates were identified as 13 strains of MDR-MTB, 20 strains of pre-extensive drug-resistant Mycobacterium tuberculosis (pre-XDR-MTB) and 7 strains of XDR-MTB. The MICs (M(Q₁,Q₃)) of Lzd against to MDR-MTB, pre-XDR-MTB and XDR-MTB isolates were 0.500 (0.500, 1.000) mg/L; while those of Tzd were 0.250 (0.250, 0.250) mg/L, without significant difference between the MICs of Lzd or Tzd among MDR-MTB, pre-XDR-MTB and XDR-MTB (Lzd: H=0.84, P=0.659; Tzd: H=0.59, P=0.746). In conclusion, both Lzd and Tzd have good bactericidal effects on MDR-MTB strains, and the anti-tuberculosis effect of Tzd was better than that of Lzd.

Clinical effectiveness of Neixiao Luoli Slice adjuvant therapy for patients with primary treated pulmonary tuberculosis complicated with cervical lymphatic tuberculosis

Liang-jie FU,Xiao-hong NIU

Chinese Journal of Antituberculosis. 2019, 41(10):  1127-1131.  doi:10.3969/j.issn.1000-6621.2019.10.012

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A total of 77 patients with primary pulmonary tuberculosis complicated with cervical lymphatic tuberculosis admitted in Nanjing Integrated Traditional Chinese and Western Medicine Hospital from Mar. 2014 to Mar. 2018 were selected. All patients were diagnosed by imaging examinations, laboratory examinations and tuberculin tests and all met the inclusion criteria. They were divided into control group (n=32) and observation group (n=45) according to different treatment methods. The control group was treated with conventional western medicine (2H-R-Z-E/4H-R), while the observation group was treated with Neixiao Luoli slice on top of the control group treatment. The clinical effectiveness, sputum negative conversion rate, lesion absorption, change of inflammatory factors test results and adverse reactions were compared between the two groups. The total effective rate, sputum negative conversion rate, and obvious absorption rate of lesions in the observation group were 97.78% (44/45), 97.78% (44/45), and 80.00% (36/45) respectively, which were higher than those in the control group (81.25% (26/32), 75.00% (24/32), and 56.25% (18/32)) with statistically significant differences (χ ² values were 4.343, 9.400, 5.036, and P values were 0.037, 0.002, 0.002, respectively). After treatment, IL-6 and TNF-α levels in the observation group were (36.01±4.26) ng/L and (7.66±3.16) ng/L respectively, which were significantly lower than before treatment ((58.74±6.11) ng/L and (23.01±4.52) ng/L, t=20.471, P<0.001; t=18.671, P<0.001), and significantly lower than the control group ((43.21±5.22) ng/L and (12.12±3.96) ng/L, t=6.652, P<0.001; t=5.491, P<0.001). The incidence of adverse reactions was 42.22% in the observation group and 46.88% (15/32) in the control group, with no statistically significant difference between the two groups (χ ²=0.164, P=0.685). Our study shows that Neixiao Luoli slice combined with chemotherapy for the primary treatment of pulmonary tuberculosis complicated with cervical lymph node tuberculosis can effectively improve the immune function of patients, significantly reduce the level of inflammatory factors, and improve the clinical effectiveness.

Review Articles

Overview and control of human tuberculosis caused by Mycobacterium bovis

Yin-juan SONG,De-ming ZHAO,Xiang-mei ZHOU

Chinese Journal of Antituberculosis. 2019, 41(10):  1132-1135.  doi:10.3969/j.issn.1000-6621.2019.10.013

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Mycobacterium bovis (M.bovis) is the causative agent of bovine tuberculosis and can also cause zoonotic tuberculosis. Although the number of human tuberculosis cases caused by M.bovis is significantly less than that of Mycobacterium tuberculosis, the limitations of the diagnosis mean that the currently available epidemiological data M.bovis infections can not accurately estimate the true extent of zoonotic tuberculosis. This article summarizes the research on the burden of tuberculosis caused by M.bovis, pathogenic mechanism of M.bovis, the impact of zoonotic tuberculosis on public health and control measures.

Application and progress of new approaches for management of tuberculosis treatment

Bo WU

Chinese Journal of Antituberculosis. 2019, 41(10):  1136-1140.  doi:10.3969/j.issn.1000-6621.2019.10.014

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Improving treatment compliance is priority for TB control. DOT is help for improving the tuberculosis treatment compliance; however, general promotion is difficult because of some problems in implementation of DOT. Recently, new approaches to reminding patients to taking medication and re-examination, such as medicine kits with built-in reminder alarms, mobile short message, mobile video, mobile APP and drug sensor, have been used to improve treatment compliance. This review summarized these studies including background, application, advantages and disadvantages, as well as future development, in order to popularizing new management methods.