Table of Content

10 June 2023, Volume 45 Issue 6

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Guideline·Standard·Consensus

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

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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.

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

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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.

Original Articles

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

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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.

Preliminary study on the gene function of Mycobacterium tuberculosis Rv2333c in macrophages

He Ping, Wang Yiting, Song Zexuan, Xia Hui, Wang Shengfen, He Wencong, Zheng Yang, Zhao Yanlin

Chinese Journal of Antituberculosis. 2023, 45(6):  566-574.  doi:10.19982/j.issn.1000-6621.20230059

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Objective: To explore the gene function of Mycobacterium tuberculosis (MTB) Rv2333c by overexpressing Rv2333c in Mycolicibacterium (M.) smegmatis in the process of infected macrophages. Methods: Overexpression of Rv2333c in M.smegmatis was achieved based on the construction of pSUM-MCS2-Rv2333c. Samples were collected at different time points after infecting macrophages with the empty strain (Ms_Vec) or the overexpression strain (Ms_Rv2333c). Then, the bacterial intracellular viability was assessed by counting colony-forming units (CFU) and the cytotoxicity of Rv2333c to the cell was detected by measuring the lactate dehydrogenase (LDH) activity in the cell media. Total RNA was extracted and the supernatant of culture media and cell lysates was collected to investigate Rv2333c effect on cytokines secretion and NF-κB/MAPK pathway in macrophages through reverse transcription-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and Western blotting experiments. Results: Rv2333c of MTB was successfully expressed in M.smegmatis. The cytotoxicity significantly decreased at the early stage (6 h) of macrophages infected with Ms_Rv2333c (LDH: Ms_Vec: (52.55±0.90) %, Ms_Rv2333c: (27.87±1.77) %; t=17.560, P<0.001), but the intracellular proliferation of Ms_Rv2333c was not affected (log₁₀CFU: Ms_Vec: 7.45±0.05, Ms_Rv2333c: 7.35±0.16; t=1.069, P=0.345). RT-PCR revealed that IL-1β mRNA was downregulated at the early stage (6 h, Ms_Vec: 657.43±20.96, Ms_Rv2333c: 521.36±25.97; t=5.767, P=0.005), but upregulated at the late stage of macrophages infected with Ms_Rv2333c (48 h, Ms_Vec: 1548.53±125.17, Ms_Rv2333c: 2168.13±130.00; t=4.855, P=0.008). However, IL-6 mRNA was upregulated at the early (6 h) and late stage (48 h) of macrophages infected with Ms_Rv2333c (Ms_Vec: 2.46±0.49 & 776.41±15.38, Ms_Rv2333c: 6.02±0.37 & 1642.76±51.15; t=8.234 & 22.940, P=0.001 & <0.001, respectively). And the interferon-γ (IFN-γ) mRNA was also upregulated (Ms_Vec: 2.52±0.09 & 2.76±0.32, Ms_Rv2333c: 17.24±0.47 & 8.52±0.08; t=43.760 & 25.090, all P<0.001, respectively). The results of Western blotting showed that the expression of NF-κB and phosphorylation of ERK1/2 significantly increased in macrophages 3 hours after infecting with Ms_Rv2333c and maintained at high level even at 24 h (3 h, Ms_Vec: (1.00±0.14) % & (1.00±0.06) %, Ms_Rv2333c: (1.85±0.29) % & (1.74±0.03) %; t=3.765 & 15.040, P=0.020 & <0.001, respectively; 24 h, Ms_Vec: (1.00±0.14) % & (1.00±0.02) %, Ms_Rv2333c: (1.45±0.15) % & (1.17±0.04) %; t=3.041 & 5.538, P=0.038 & 0.005, respectively). Conclusion: Rv2333c plays an important role in the pathogenesis of MTB. Rv2333c inhibited apoptosis at the early stage of infection, which is helpful for the survival of bacteria in macrophages. In addition, Rv2333c can promote the expression of inflammatory factors at the middle and late stages of infection to induce inflammatory reaction in cells. It can also indirectly participate in transferring of NF-κB to the nucleus and regulating the activity of transcription factors by affecting the ERK1/2 phosphorylation capacity.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

Review Articles

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

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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.

Research progress on long non-coding RNA’s anti infection function against Mycobacterium tuberculosis

Dong Jing, Shi Yuting, Pan Liping, Zhang Zongde

Chinese Journal of Antituberculosis. 2023, 45(6):  613-619.  doi:10.19982/j.issn.1000-6621.20220521

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The pathogenesis and immunological mechanism of Mycobacterium tuberculosis (MTB) infection and further development of active tuberculosis have not yet been fully elucidated. Recently, long non-coding RNA (lncRNA) has received more attention in MTB infection and active tuberculosis development study, for it is involved in a variety of biological processes, such as gene expression regulation, cell cycle regulation, cell differentiation, and so on. It is of great significance to illustrate the regulation mechanism of aberrant lncRNA in the developing and progression of tuberculosis, which could help us further understand the mechanism of host immunological response to MTB infection and progression. Therefore, we reviewed the research progress of impact and specific mechanisms of lncRNA affecting human immunological response to MTB infection, to facilitate future development of novel lncRNA-based immunotherapy of tuberculosis.

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

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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.