Table of Content

10 May 2024, Volume 46 Issue 5

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Guideline·Standard·Consensus

Expert consensus on nursing practice for nutritional management of pulmonary tuberculosis patients

The Nursing Branch of Chinese Antituberculosis Association, Shanghai Pulmonary Hospital Affiliated to Tongji University Dw

Chinese Journal of Antituberculosis. 2024, 46(5):  495-501.  doi:10.19982/j.issn.1000-6621.20240071

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The incidence of nutritional risk in hospitalized patients with pulmonary tuberculosis ranges from 38.5% to 86.1%. If the nutritional risk is not corrected in time, it is easy to develop nutrition-related diseases, such as malnutrition, drug-induced liver injury, immune dysfunction, lung infections, etc., which increases the risk of failure in the anti-tuberculosis treatment. Nutrition management is one of the most important auxiliary methods in the treatment of pulmonary tuberculosis, however, there are still some related problems, such as lack of nutrition knowledge among nursing staff, unclear nutrition assessment standards and imperfect management procedures. Therefore, it is of great significance to standardize nutrition care for tuberculosis. The Nursing Branch of Chinese Antituberculosis Association and Shanghai Pulmonary Hospital Affiliated to Tongji University jointly organized experts to formulate the Expert consensus on nursing practice for nutritional management of pulmonary tuberculosis patients based on clinical practice, literature analysis, combined with the work experience of experts in the field of tuberculosis, aiming at providing guidance for clinical nurses to implement nutrition management, and standardizing the nutrition management nursing practice of hospitalized adult tuberculosis patients in China.

Special Topic

Intrudoction of study on the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment and payment standard

Zhang Jingyi, Dai Shanshan, Zhang Liliang, Tian Jiashuai, Cai Xinyu, Gao Guangying

Chinese Journal of Antituberculosis. 2024, 46(5):  502-508.  doi:10.19982/j.issn.1000-6621.20240057

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The spread of tuberculosis will bring negative externalities, while medical insurance payment methods can promote hospitals to actively control costs and reduce the burden on patients. Based on domestic and international experience, the author established a full-course capitation compensation bundled payment model that was in line with the characteristics of tuberculosis prevention and control. The full course of treatment was packaged according to disease type, the service package, its payment standard, and the total annual prepaid fund were calculated by the clinical pathways and historical data, to mobilize the enthusiasm of designated hospitals at all levels. The calculation results of the payment standard in Yichang City showed that this model was suitable for tuberculosis,which was conducive to controlling unreasonable medical insurance expenditures, improving fund efficiency, and regulating hospital diagnosis and treatment behavior by leveraging the leverage of medical insurance payments, thereby forming a people-oriented full-course and full-cycle health management model. Above all, this study will provide a valuable reference and reliable basis for the reform of tuberculosis payment methods in other regions and countries.

Original Articles

Analysis of average hospitalization costs and factors affecting extrapulmonary tuberculosis and tuberculous pleurisy patients in designated tuberculosis hospitals, 2018—2020

Liu Yanfei, Li Tao, Xia Yinyin, Zhu He, Zhao Yanlin, Chen Wei

Chinese Journal of Antituberculosis. 2024, 46(5):  509-518.  doi:10.19982/j.issn.1000-6621.20230376

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Objective: To analyze the average hospitalization costs, cost components and their influencing factors for patients with extrapulmonary tuberculosis (EPTB) and tuberculous pleurisy, in order to reduce the economic burden on patients. Methods: All of 2940 patients (a total of 3211 admissions) aged ≥15 years with EPTB and tuberculous pleurisy discharged from 9 designated tuberculosis hospitals from 2018 to 2020 were selected to collect their demographic characteristics (gender, age, marital status, region, medical insurance, etc.), clinical characteristics (nature and level of hospital, time and route of admission, transfers, surgery, type of tuberculosis, time of discharge, duration of hospitalization, etc.), and hospitalization expenses (total cost and individual costs, etc.). Non-parametric rank sum test was used to analyze the influencing factors of hospitalization expenses; multiple linear regression model was used for multifactor analysis. Results: The median expense of hospitalization for patients with extrapulmonary tuberculosis and tuberculous pleurisy was 9408.16 (IQR: 5768.50, 15540.58) Yuan, the highest median hospitalization expense was for neurological tuberculosis (12865.89 Yuan). In the composition of hospitalization expenses, drug expenses (27.96% (4317.48/15438.94)) account for the highest proportion, followed by the cost of laboratory tests (18.40% (2841.42/15438.94)). Of the drug cost components, the highest proportion of cost was for other drugs (49.33% (2129.80/4317.48)), the followed by second-line anti-tuberculosis drugs (22.80% (984.75/4317.48)) and first-line anti-tuberculosis drugs (18.52% (799.41/4317.48)). Length of stay was 17 (IQR: 9, 28) days. Multiple linear regression model analysis showed that hospitalization costs were significantly associated with the hospitalization days (β'=0.644, P<0.001), age (β'=0.076, P<0.001), male (β'=0.033, P=0.008), living in the West (β'=0.172, P<0.001), insurance participation (β'=0.045, P=0.002), general hospital diagnosis and treatment (β'=0.170, P<0.001), referral for treatment (β'=0.103, P<0.001), surgical treatment (β'=0.208, P<0.001), tuberculosis pleurisy (β'=0.047, P<0.001), and bone and joint tuberculosis (β'=0.067, P<0.001), negative correlation with discharged in 2018 (β'=-0.039, P=0.004), married (β'=-0.045, P=0.005), diagnosis and treatment in tertiary hospitals (β'=-0.047, P=0.015), first admitted (β'=-0.044, P=0.004) and lymph node tuberculosis (β'=-0.068, P<0.001). Conclusion: Compared with the income of the population, the hospitalization costs of patients with extrapulmonary tuberculosis and tuberculous pleurisy are still high, exacerbating the financial burden on individuals and families, and measures to reduce the hospitalization costs of patients with extrapulmonary tuberculosis can be formulated in the areas of reasonable control of hospitalization days, optimization of the structure of costs, increase in the scope of medical care coverage, specialized hospital treatment, and standardization of hospital diagnostic and therapeutic behaviors.

Analysis of influencing factors of anti-tuberculosis treatment effect for pulmonary tuberculosis patients complicated with diabetes in Yunnan Province from 2017 to 2021

Yang Rui, Li Ling, Chen Jinou, Xu Lin

Chinese Journal of Antituberculosis. 2024, 46(5):  519-524.  doi:10.19982/j.issn.1000-6621.20240006

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Objective: To analyze the treatment outcomes and risk factors among patients with rifampicin-sensitive tuberculosis-diabetes mellitus comorbidity (PTB-DM) patients in Yunnan Province, to provide evidence for improving the effect of anti-tuberculosis treatment for PTB-DM by. Methods: The medical data of PTB-DM patients registered in Yunnan Province from January 1, 2017 to December 31, 2021 were obtained through the “Monitoring Report Management System” of the “China Disease Prevention and Control Information System” subsystem, including sociodemographic information, tuberculosis diagnosis, anti-tuberculosis treatment and judgment of the treatment, 3984 cases were finally included. The effectiveness of anti-tuberculosis treatment in PTB-DM patients was analyzed, and the risk factors of the treatment outcome were analyzed using Cox regression model. Results: The success rate of anti-tuberculosis treatment in 3984 PTB-DM patients was 89.36% (3560/3984), the incidence of adverse treatment outcomes of 10.64% (424/3984), the mortality was 4.27% (170/3984), and 2.46% (98/3984) were lost during treatment, with failure of 2.31% (92/3984) and discontinuation of treatment due to adverse drug reactions of 1.61% (64/3984). Of adverse outcomes, 44.22% (179/424) occurred in the first 2 months of treatment. Cox regression model analysis showed that individuals aged ≥65 had a higher risk of adverse treatment outcomes compared to those who aged <35 (HR=2.612, 95%CI: 1.483-4.601); the risk of adverse treatment outcomes in retreated patients was 1.405 times higher than that in newly treated patients (95%CI: 1.072-1.843), and the risk of adverse treatment outcomes in pathogen positive patients was 1.473 times higher than that in other patients (95%CI: 1.183-1.834). Conclusion: The effectiveness of anti-tuberculosis treatment for PTB-DM patients in Yunnan Province is not satisfactory, and attention should be paid to PTB-DM patients, especially elderly people aged 65 and above, re-treated, and pathogen-positive patients. During the anti-tuberculosis treatment, monitoring of treatment effectiveness and health management should be carried out, and timely intervention should be given.

Risk factors of latent tuberculosis infection among close contacts of drug-resistant pulmonary tuberculosis patients

Ye Xinchun, Liu Saiduo, Cheng Fang, Jiang Xiangao, Ning Hongye, Wu Zhengxing, Zhou Yueying, Qiu Chaochao, Pan Ning, Shi Jichan

Chinese Journal of Antituberculosis. 2024, 46(5):  525-530.  doi:10.19982/j.issn.1000-6621.20230402

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Objective: To explore the situation and risk factors of latent tuberculosis infection (LTBI) in close contacts of drug-resistant pulmonary tuberculosis patients. Methods: Using a prospective research method, 306 close contacts of 154 drug-resistant pulmonary tuberculosis (including rifampicin resistant pulmonary tuberculosis and multidrug-resistant pulmonary tuberculosis) patients admitted to the Wenzhou Central Hospital from July 2020 to January 2022 were selected as the study subjects. Collected information included the sociodemographic characteristics, history of BCG vaccination, disease history, and contact with indicated cases of the research subjects; in addition, HIV antibody screening, chest CT scan, T-SPOT.TB and/or PPD test, etc. were conducted. The LTBI situation of the research subjects was investigated, and logistic regression models were used to analyze the influencing factors of their occurrence of LTBI. Results: The LTBI rate among the study subjects was 18.6% (57/306). The results of multivariate analysis showed that, for the close contacts, aged ≥40 years, female, physical workers, and those with clinical symptoms such as cough and sputum in the indication case were at a higher risk of developing LTBI (OR (95%CI) values of 6.501 (1.371-30.827), 2.961 (1.472-5.956), 2.716 (1.368-5.391), 3.100 (1.278-7.521), and 3.065 (1.336-7.031), respectively); family monthly income ≥RMB 5000 yuan was a protective factor for close contacts to develop LTBI (OR (95%CI)=0.308 (0.156-0.607)). Conclusion: Close contacts of drug-resistant pulmonary tuberculosis patients have a higher LTBI rate. Elderly, female, physically active workers, low-income individuals, as well as close contacts with relapsed drug-resistant pulmonary tuberculosis patients and drug-resistant pulmonary tuberculosis patients with clinical symptoms such as cough and sputum, are high-risk population for latent infection.

Analysis of Mycobacterium tuberculosis drug resistance monitoring in Anhui Province from 2016 to 2022

Bao Xundi, Liang Suo, Li Jun, Ye Qian, Wu Dandan, Wang Shu, LI Yue, Ding Yunsheng, Liu Jie

Chinese Journal of Antituberculosis. 2024, 46(5):  531-537.  doi:10.19982/j.issn.1000-6621.20240029

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Objective: To analyze the change trend of drug resistance spectrum of Mycobacterium tuberculosis isolated from four national drug resistance monitoring sites in Anhui Province from 2016 to 2022, and then to understand the prevalence and control effect of tuberculosis and drug-resistant tuberculosis in Anhui Province. Methods: A total of 3073 laboratory-confirmed pulmonary tuberculosis patients, who were continuously enrolled from four drug resistance surveillance sites between 2016 and 2022, were included in the study. General information of the patients was collected, and sputum specimens were collected for isolation and cultured. Strain identification was performed on the cultured isolates, and a total of 2336 strains of Mycobacterium tuberculosis were obtained. Drug susceptibility testing was performed on the Mycobacterium tuberculosis strains using the proportion method for six anti-tuberculosis drugs (isoniazid (INH), rifampicin (RFP), streptomycin (Sm), ethambutol (EMB), ofloxacin (Ofx), and kanamycin (Km). Results: Among the 2336 strains of Mycobacterium tuberculosis, 1893 strains (81.04%) were sensitive to all the six anti-tuberculosis drugs, and 443 strains were resistant to at least one or more anti-tuberculosis drugs, with a drug resistance rate of 18.96% (443/2336), of which 16.80% (348/2071) were newly treated, 35.85% (95/265) were retreated, and 98 (4.20%) were multidrug resistant. Among the six anti-tuberculosis drugs, the prevalence of single resistance to anti-tuberculosis drugs were decreased from INH (10.55%, 236/2336) to Sm (8.18%, 183/2336), Ofx (6.53%, 146/2336), RFP (5.95%, 133/2336), EMB (2.37%, 53/2336), Km (1.97%, 44/2336). The resistance rates to Ofx, INH, EMB and Km showed a downward trend from 2016 to 2022 (the resistance rates of Ofx, INH, EMB and Km were 10.49% (30/286), 12.24% (35/286), 1.75% (5/286) and 2.45% (7/286) in 2016, respectively; 3.89% (18/463), 9.29% (43/463), 0.86% (4/463), 1.08% (5/463) in 2022); $χ_{rend}^2$ values were 16.964, 15.989, 15.798, and 26.075, respectively, all Ps<0.05). The drug resistance rate and multidrug-resistance rate of newly diagnosed patients (22.76% (56/246) and 6.50% (16/246) in 2016, 14.15% (60/424) and 1.89% (8/424) in 2022) also showed a downward trend ($χ_{rend}^2$=14.445, 16.688, All Ps<0.05). Among different age groups, the drug resistance rate of Mycobacterium tuberculosis strains in the 40-59 years old group was the highest (22.74%, 146/642). Conclusion: The situation of drug resistance tuberculosis is still serious in Anhui province. More attention should be paid to drug resistance in retreatment patients, people aged 40-59 years and patients living in urban areas.

Analysis of effects of lipoprotein Rv1411c on Mycobacterium tuberculosis lipid metabolism based on non-targeted lipomics

Sun Yuting, Quan Shuting, Sun Baixu, Tian Xue, Qi Hui, Jiao Weiwei, Shen Adong, Sun Lin

Chinese Journal of Antituberculosis. 2024, 46(5):  538-548.  doi:10.19982/j.issn.1000-6621.20230427

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Objective: To explore the effects of lipoprotein Rv1411c on Mycobacterium tuberculosis (MTB) lipid metabolism based on non-targeted lipomics. Methods: The H37Rv-Rv1411c gene knocked-out strain (ΔRv1411c) was constructed and its optical density values (A₆₀₀) was measured and growth curve was drawn to be compared with that of the MTB standard strain (H37Rv). The lipid compositions of the two strains were extracted from the culture supernatant and were further analyzed using liquid chromatography-mass spectrometry technology (LC-MS) and non-targeted lipomics analysis platform. Partial leastsquares discriminant analysis (PLS-DA) and Kyoto Encylopaedia of Genes and Genomes (KEGG) enrichment analysis were used to explore metabolic product differences and pathways between the two groups. Results: Based on the LC-MS analysis, 460 lipid metabolites which belonged to 28 classes were identified. Then 158 lipid metabolites belonged to 17 classes with variable importance in projection (VIP) >1 were further selected based on PLS-DA model. Using the fold change (FC)>1.5 or<0.67 and P<0.05 as screening criteria, 36 lipids with significant difference were confirmed. Among them, 12 lipids were upregulated and 24 lipids were downregulated. KEGG pathway analysis suggested that the differentiating metabolites were mainly involved in eight metabolic pathways: glycerophospholipid metabolism pathway, linolenic acid-metabolism pathway, alpha-linolenic acid metabolism pathway, glycosylphosphatidylinositol (GPI)-anchor biosynthesis pathway, glycerolipid metabolism pathway, sphingolipid metabolism pathway, arachidonic acid metabolism pathway and biosynthesis of unsaturated fatty acids pathway. Glycerophospholipid metabolism pathway had the highest impact factor, followed by glycerolipid metabolism and glycosylphosphatidylinositol (GPI)-anchor biosynthesis pathway. Conclusion: Lipoprotein Rv1411c can significantly affect the lipid metabolism of MTB and may participate in the regulation of MTB lipid metabolism.

Study on the determination of isoniazid and its metabolites concentration in plasma by high-performance liquid chromatography-mass spectrometry

Ge Fei, Zhu Hui, Cheng Kai, Lu Yu, Xu Jian

Chinese Journal of Antituberculosis. 2024, 46(5):  549-556.  doi:10.19982/j.issn.1000-6621.20240059

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Objective: To establish a method for simultaneous determination of isoniazid and its metabolites— acetylhydrazine and hydrazine in the plasma of pulmonary tuberculosis patients using high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS). Methods: Plasma samples were collected from 104 confirmed pulmonary tuberculosis patients (all receiving standardized anti-tuberculosis treatment, taking isoniazid at a dose of 300-500 mg once a day, and venous blood was collected 2 hours after medication) from Beijing Chest Hospital, Capital Medical University. After protein precipitation in methanol, plasma samples were subjected to derivatization using isoniazid-D4 as the internal standard and p-methylbenzaldehyde as the derivatization reagent. The analyte was separated using an InfinityLab Poroshell 120 HILIC-Z column (100 mm×2.1 mm, 2.7 μm). The binary elution system (A phase was an aqueous solution containing 0.1% formic acid and 5 mmol ammonium formate; B phase was acetonitrile) was used for gradient elution, with a column temperature of 30 ℃ and a flow rate of 0.4 ml/min); electro spray ionization positive ion mode detection and multi-reaction monitoring mode scanning was adopted, and the operation time was 8 min. Results: This determination method was not affected by endogenous substances in plasma. Isoniazid, acetylhydrazine, and hydrazine had good linearity in the range of 50-6000, 25-3000, and 1-120 ng/ml, respectively (determination coefficients (R²) >0.99); intra-day and inter-day precision <15%; absolute accuracy value <15%; the extraction recovery rates were all above 85%; the matrix effect ranges from 85% to 115%; the stability was good. The method was applied to detect the concentrations of isoniazid, acetylhydrazine, and hydrazine in 104 patients with pulmonary tuberculosis, which were (2402.33±1248.57) ng/ml, (1902.51±596.82) ng/ml, and (26.50±17.13) ng/ml, respectively. Conclusion: The HPLC-MS/MS method established in this study was easy to operate, rapid, specific, and sensitive. It could be applied to monitor the therapeutic drug concentration of isoniazid and its metabolites (acetylhydrazine and hydrazine) in patients with pulmonary tuberculosis.

A preliminary study of the in vitro bactericidal effect of low-temperature plasma technology on the Mycobacterium tuberculosis

Xue Lian, Ju Meng, Huang Yi, Zhao Guolian, Zhang Yuhao, Wang Sihan, Lei Ying, Dang Liyun, Zuo Lei

Chinese Journal of Antituberculosis. 2024, 46(5):  557-561.  doi:10.19982/j.issn.1000-6621.20240014

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Objective: Preliminary investigation of the killing effect of low-temperature plasma technology on different Mycobacterium tuberculosis in vitro experiments, aiming to provide a new technical method for killing common Mycobacterium tuberculosis. Methods: Mycobacterium tuberculosis H37Rv strain, extensive drug-resistant Mycobacterium tuberculosis (XDR-MTB) and multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) mycobacterial fluids were inoculated on the culture medium, configured as a 0.5 mycobacterial suspensions within 3 weeks of incubation, and then multiply diluted to the test mycobacterial suspensions, and 2.0 ml of mycobacterial suspension samples were taken into sterile test tubes, the suspensions were ablated for 0, 3, 6, 9, 12 and 15 s by PLACOAG mode of low-temperature plasma surgery system, and then cultured in incubators. After 21 days, the number of the mean survival count, log10 reduction, and killing efficiency of each group at each treatment time point were calculated. Results: (1) The log10 reduction of H37Rv (F=20.313, P=0.003), XDR-MTB (F=13.956, P=0.006), and MDR-MTB (F=20.355, P=0.006) were statistically different at different treatment times. There was a statistically significant difference in the log10 reduction of three bacterial groups at 9 seconds (F=61.603, P=0.004), with XDR-MTB was the lowest (0.50±0.00), followed by H37Rv (1.14±0.12), and MDR-MTB was the highest (1.23±0.00), and the log10 reduction of the three groups reached the maximum value at 15 seconds, which were MDR-MTB (1.71±0.00), H37Rv (1.83±0.00), XDR-MTB (1.35±0.21). (2) The killing efficiency of H37Rv (F=10.458, P=0.012), XDR-MTB (F=10.945, P=0.011), and MDR-MTB (F=9.424, P=0.015) were statistically different at different treatment times. There was a statistically significant difference in the killing efficiency of three bacterial groups at 9 seconds (F=287.890, P<0.001), with XDR-MTB was the lowest ((68.25±0.00) %), followed by H37Rv ((92.59±2.10) %), and MDR-MTB was the highest ((94.12±0.00) %), and the killing efficiency of the three groups reached the maximum value at 15 seconds, which were MDR-MTB (100.00±0.00) %, H37Rv (96.26±1.05) %, XDR-MTB (99.35±5.16) %. Conclusion: In this study, in vitro experiments confirmed that low-temperature plasma technique has a rapid and significant killing effect on three Mycobacterium tuberculosis species, and that the killing effect varies and requires individualized strategy.

A comparative study on the therapeutic effects of total hip joint type spacer and pressure model spacer in patients with mid to late stage hip tuberculosis

Song Hongge, Liu Weigao, Chen Li

Chinese Journal of Antituberculosis. 2024, 46(5):  562-566.  doi:10.19982/j.issn.1000-6621.20230456

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Objective: To evaluate and compare the quality of life in patients with advanced hip joint tuberculosis (TB), who received one-stage open placement treatment with a total hip joint type spacer device (composite prosthesis composed of bone cement, femoral stem, ceramic joint head, etc.) and a conventional pressure model spacer device, within 5 years after surgery. Methods: A retrospective analysis was conducted. The clinical data of 52 patients with advanced hip joint TB admitted at Henan Provincial Infectious Disease Hospital from January 2016 to December 2018 were analyzed. Within 2-5 years after surgery, 2 cases died due to other reasons or illness, and the remaining 50 cases received follow-up and their relevant data were completely collected. According to the treatment method, the patients were divided into two group, namely: 22 cases were in the total hip joint type group, who were treated with a total hip joint type spacer device; 28 cases were in the pressure model group, who were treated with conventional pressure model spacer. Compare the Harris joint scores, completion rate of the 20 kg walking test as well as the incidence of postoperative complications such as pain, dislocation and rupture of the spacer device between two groups of patients before surgery and at 1, 3, 6, 12, 24, 36, 48, 60 months after surgery. Results: Due to the high incidence of dislocation and fracture in the pressure model group during the period of 6 to 24 months after surgery, Harris joint scores and completion rates of the 20 kg walking test were no longer compared between the two groups at different time periods of 36 to 60 months after surgery. The Harris joint scores in the total hip joint type group (76.45±5.23, 86.55±3.78, 89.32±3.15, 92.05±2.72, 94.09±1.90) at 1, 3, 6, 12 and 24 months after surgery were respectively higher than those in the pressure model group (61.00±6.13, 71.93±5.38, 76.82±11.41, 81.75±15.00 and 78.93±15.75). The differences were statistically significant (t-values were 9.427, 10.809, 4.978, 3.558, and 5.047 respectively, with all P-values <0.001); at 1, 3, 6, 12 and 24 months after surgery, the completion rates of the 20 kg walking test in the total hip joint type group (27.3% (6/22), 81.8% (18/22), 100.0% (22/22), 100.0% (22/22) and 100.0% (22/22)) were significantly better than those in the pressure model group (0.0% (0/28), 7.1% (2/28), 17.9% (5/28), 21.4% (6/28) and 17.9% (5/28)), and the differences were statistically significant(χ² values were 9.416, 28.626, 33.466, 30.867 and 33.466 respectively, with P-values of 0.002, <0.001, <0.001, <0.001, <0.001); the dislocation rate (0.0% (0/22)) and fracture rate (0.0% (0/22)) of the total hip joint type group were significantly lower than those of the pressure model group (7.1% (2/28) and 21.4% (6/28)), with statistical significance(χ² values were 14.351 and 11.928 respectively, with all P-values <0.001). Conclusion: The use of total hip joint type spacer device can accelerate the recovery process of patients with hip joint TB after one-stage open placement surgery, reduce the occurrence of complications such as dislocation and fracture of open placement implants, and improve the quality of life of patients in mid to late stage who have long-term postoperative open placement implants.

Analysis of the characteristics of highly cited literature on the topic of “tuberculosis” based on bibliometrics

Guo Meng, Wu Wen, Li Jingwen, Fan Yongde

Chinese Journal of Antituberculosis. 2024, 46(5):  567-577.  doi:10.19982/j.issn.1000-6621.20240075

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Objective: To study highly cited literature in the field of tuberculosis in China, understand the current development status of this research field, and study future development trends. Methods: Using CiteSpace visualization application software, we analyzed the publication time, journal sources, authors, and content of highly cited literature (citation frequency ≥30 times) with “tuberculosis” as the theme in the “Wanfang Database”. Results: The publication of highly cited literature in the field of tuberculosis in China mainly concentrated in 2012 and 2013, with 106 and 100 articles respectively. The Chinese Journal of Antituberculosis, Chinese Journal of Tuberculosis and Respiratory Disease, and Journal of Clinical Pulmonary Medicine were the main journals published those highly cited literature, with 127, 34, and 25 articles respectively. Researchers mainly focused on topics of “tuberculosis diagnosis”“risk factors”“drug resistance”“diabetes”“rifampicin”“spinal tuberculosis”, and “health education”, with the keyword frequency of 46, 35, 26, 26, 20, 17 and 16 times respectively. Conclusion: The publication of papers in the field of “tuberculosis” is booming. In the future, we need to continue to pay attention to hot areas such as tuberculosis resistance, diabetes comorbidity, spinal tuberculosis, health education, etc., and to further collaborate with hot authors to create high-level papers leading academic development.

Review Articles

Research progress on nanopore-based targeted sequencing in identification of Mycobacterium tuberculosis and detection of drug-resistant genes

Yang Chen, Gao Weiwei, Guo Yicheng, Zeng Yi

Chinese Journal of Antituberculosis. 2024, 46(5):  578-583.  doi:10.19982/j.issn.1000-6621.20240049

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The Global Tuberculosis Report 2023 showed that the epidemiological situation of tuberculosis is still serious. The current detection methods exhibit limitations in accurately identifying mycobacterial species and detecting drug-resistant genes. There is an urgent need to develop clinically applicable detection technologies that are more convenient, efficient, and precise to adapt the needs for early diagnosis and treatment of tuberculosis. Nanopore sequencing presents a promising avenue with its inherent advantages of convenience, efficiency, long-read lengths, and extensive sequencing capabilities, thereby offering novel prospects for diagnosing and treating tuberculosis as well as drug-resistant strains. This paper provides a comprehensive review of the principles and characteristics of nanopore-based targeted sequencing along with its applications in mycobacterial identification and drug-resistant gene detection, aiming to provide references for clinical staff to explore the innovative technology.

Research progress on the regulation of host anti-tuberculosis effect by tyrosine kinase inhibitors

Duan Shujuan, Wang Wei, Pang Yu, Li Ling

Chinese Journal of Antituberculosis. 2024, 46(5):  584-589.  doi:10.19982/j.issn.1000-6621.20240079

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Although existing anti-tuberculosis treatment regimens have achieved remarkable results in the treatment of patients with drug-susceptible tuberculosis, the problems of drug toxicity and resistant strains are increasingly prominent. As a result, new drugs and treatment strategies are developed to better treat tuberculosis. Host-directed therapy (HDT) uses small molecule compounds to modulate the host’s immune response, thereby to protect tissues and eliminate pathogens. The main purpose of HDT is to enhance the host’s anti-tuberculosis immune function while shorten the duration of traditional antibiotic therapy and improve the treatment effect, which is regarded as a promising method for the treatment of tuberculosis. Tyrosine kinase (PTK) is mainly involved in activating cell signal transduction, to regulate a series of physiological and biochemical processes such as cell growth, proliferation, and death. Tyrosine kinase inhibitor (TKI) is a novel anticancer drug that can target overexpressed cellular pathways in a variety of malignant tumors, and can also exert antitumor activity by inducing autophagy and activating other signaling pathways. It has been found that TKI can also regulate the signal transduction process in macrophages and reduce the intracellular Mycobacterium tuberculosis (MTB) load, which has great therapeutic potential. Therefore, TKI can be used as potential candidates for HDT in the clinical adjuvant treatment of tuberculosis. In this paper, the potential targeted drug research for the treatment of tuberculosis by transferring PTK and signaling were reviewed, aiming to provide a reference for better application of existing drugs and the development of new drugs for the treatment of tuberculosis.

Development strategy and prospect of tuberculosis mRNA vaccines

Yang Jing, Xiao Lijuan, Fang Tanwei

Chinese Journal of Antituberculosis. 2024, 46(5):  590-595.  doi:10.19982/j.issn.1000-6621.20240086

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To deal with the serious challenge of the epidemic of tuberculosis (TB) epidemic, a major infectious disease that endangers global human health, there is urgent need to develop an effective new TB vaccine. Although lots of types of new TB vaccines are currently being developed, and some of vaccines have entered clinical trials, a more effective new TB vaccine that can replace the traditional BCG vaccine has not yet been obtained. With the breakthrough of mRNA vaccine development technology, its advantages of short development cycle, high efficiency, safety and low production cost make it a very promising new direction of vaccine research and development. In this paper, the research progress of the technical principle, advantages and preparation techniques of mRNA vaccine, and the development strategy and the current situation of TB-mRNA vaccine was reviewed, so as to provide reference for the development of TB-mRNA vaccine.

Current situation and research progress of co-infection of HIV/AIDS and subclinical tuberculosis

Liu Meijun, Li Feng

Chinese Journal of Antituberculosis. 2024, 46(5):  596-600.  doi:10.19982/j.issn.1000-6621.20230459

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Human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) co-infection has always been a global public health concern, as well as a key point and challenge in clinical diagnosis and treatment. The importance of subclinical tuberculosis (STB) in the disease spectrum has been gradually realized as we improve the awareness of tuberculosis. The authors discussed in detail the prevalence, clinical characteristics, screening and diagnosis, treatment and prevention of STB in HIV-Infected patients and AIDS patients, aiming to draw concern from public health and clinical practitioners, encourage further in-depth researches and more attention on STB in HIV/AIDS population,so as to provide scientific basis for developing strategies to reduce the comorbidity of HIV/AIDS and STB.