Table of Content

10 April 2026, Volume 48 Issue 4

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Guideline·Standard·Consensus

Guidelines for the diagnosis and treatment of superficial lymph node tuberculosis with integrated traditional Chinese and Western medicine

Chinese Journal of Antituberculosis. 2026, 48(4):  429-447.  doi:10.19982/j.issn.1000-6621.20250509

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Developing high-quality clinical guidelines is not only essential for improving the overall standard of healthcare services but also crucial for reducing medical costs and patient burden，thereby promoting rational utilization of healthcare resources. The Chinese Medical Association published Clinical Practice Guidelines：Tuberculosis and Clinical Practice Guidelines：Surgery in 2005 and 2006，respectively，which included western medical diagnosis and treatment protocols for lymph node tuberculosis. The Chinese Association of Traditional Chinese Medicine issued Guidelines for diagnosis and treatment of common surgical diseases in traditional Chinese medicine in 2012，containing traditional Chinese medicine （TCM） diagnostic and therapeutic approaches for scrofula. In 2023，the Chinese Anti-tuberculosis Association released Expert consensus on diagnosis and treatment of superficial lymph node tuberculosis，marking the first time that integrated Chinese and Western medicine content was included. However，it provided limited details on TCM syndrome differentiation and standardized external treatment techniques，making it insufficient for guiding daily clinical decision-making in specialized departments and primary-level hospitals. In recent years，emerging research evidence on the diagnosis and treatment of superficial lymph node tuberculosis have accumulated，yet evidence-based guidelines integrating Chinese and Western medicine remain lacking. Therefore，led by Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine，and jointly initiated by the Second Affiliated Hospital of Tianjin University of Chinese Medicine，the Eighth Medical Center of the People’s Liberation Army General Hospital，and the Ulcerology Committee of the Chinese Association of Integrative Medicine，a multidisciplinary team was established. Using the GRADE methodology，an evidence-based Guidelines for the diagnosis and treatment of superficial lymph node tuberculosis with integrated Chinese and Western medicine was developed. The guidelines provide principle-based recommendations for clinical practice，covering disease definition，diagnosis and staging，TCM syndrome differentiation，with highlights on the advantages of integrated therapy，and also include the diagnosis and treatment of special populations. It aims to standardize diagnostic criteria，optimize integrated treatment pathways，and improve patient outcomes.

Original Articles

Spatio-temporal distribution and clustering characteristics of comorbidities among tuberculosis inpatients in Guangdong Province from 2016 to 2024

Ji Lianrong, Xue Yunlian, Jiang Xue, Yuan Shasha, Liu Guihao, Wang Xiaowan, Zou Xia, Wang Tingting, Zhou Zhanqi, Zhou Lin

Chinese Journal of Antituberculosis. 2026, 48(4):  448-458.  doi:10.19982/j.issn.1000-6621.20250453

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Objective：To analyze the characteristics of the comorbidity spectrum，spatio-temporal distribution pattern and spatial clustering mode of hospitalized tuberculosis patients in Guangdong Province from 2016 to 2024，so as to provide scientific evidence for regionalized and precise prevention and control. Methods：Based on the Guangdong Provincial Health Statistical Information Network Reporting System，the front page information of medical records of hospitalized tuberculosis patients （ICD-10：A15-A19） was extracted，and 20 common types of comorbidities were identified. Descriptive statistical analysis was adopted to analyze the epidemiological characteristics of comorbidities. Global and local Moran’s I were applied to examine the spatial autocorrelation and clustering characteristics of the major comorbidity combinations，namely tuberculosis-hypertension，tuberculosis-diabetes mellitus，and tuberculosis-chronic obstructive pulmonary disease. Results：A total of 729937 tuberculosis patients were enrolled，among whom 64.07% （467645/729937） had at least one comorbidity. The comorbidity rate of tuberculosis-hypertension increased from 13.71% （11285/82329） in 2016 to 21.00% （16697/79495） in 2024；that of tuberculosis-diabetes mellitus increased from 12.17% （10020/82329） to 19.53% （15524/79495）；and the comorbidity rate of tuberculosis-chronic obstructive pulmonary disease fluctuated from 9.28% （7229/77870） to 11.22% （9238/82329），remaining at approximately 10.00% overall. Spatial analysis revealed that the tuberculosis-hypertension exhibited a distribution pattern of “high in peripheral areas and low in core areas”，and the high-high clustering areas gradually shifted from multiple cities in the Pearl River Delta region （2016—2021，2023） to Jieyang City （2023—2024）. Tuberculosis-diabetes mellitus remained highly prevalent in eastern Guangdong，with the strongest spatial autocorrelation （Moran’s I>0.34）. Tuberculosis-chronic obstructive pulmonary disease showed a distribution pattern of “high in the north and low in the south”，and the high-high clustering areas were stably concentrated in northern Guangdong （2016—2024） and parts of eastern Guangdong （2016—2024）. Conclusion：The burden of tuberculosis comorbidities in Guangdong Province has continued to escalate with significant spatio-temporal heterogeneity and clustering characteristics. A regionalized and categorized precision prevention and control system should be established，and differentiated interventions should be implemented for the dominant comorbidity types in different regions，so as to enhance the overall prevention and control efficacy of tuberculosis comorbidities.

Epidemiological characteristics of pulmonary tuberculosis among residents in Haidian District，Beijing from 2012 to 2022 and its correlation with population density

Liu Xi, Liu Yuze, Hua Weiyu, Li Jie, Zhang Ying, Dong Bin

Chinese Journal of Antituberculosis. 2026, 48(4):  459-467.  doi:10.19982/j.issn.1000-6621.20250413

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Objective：To analyze the trend of pulmonary tuberculosis （PTB） incidence among residents in Haidian District，Beijing from 2012 to 2022，and to investigate the relationship between PTB incidence and population density，thereby providing a theoretical basis for formulating regional PTB prevention and control measures. Methods：Utilizing data from the PTB case notification cards of PTB patients in Haidian District，Beijing （2012—2022），the crude incidence rate （CIR） and age-standardized incidence rate （ASIR） of PTB were calculated. The Estimated Annual Percentage Change （EAPC） was used to analyze the temporal trend of PTB incidence among residents during this period. A piecewise linear regression model （PLRM） was employed to evaluate the associations between PTB incidence and migrant population density，as well as resident population density，respectively. Results：From 2012 to 2022，a total of 11657 PTB cases were reported among residents in Haidian District. The average annual number of incident cases was 1059.73，and the age-standardized average annual number of incident cases was 1076.15. The average annual permanent resident population was 3.417 million. The number of male cases （7193） was 1.61 times that of female cases （4464）. The average CIR and ASIR were 31.01 per 100000 （1059.73/3.417 million） and 31.49 per 100000 （1076.15/3.4170 million），respectively. Specifically，CIR decreased from 43.24 per 100000 （1452/3.3582 million） in 2012 to 24.14 per 100000 （754/3.1240 million） in 2022，and ASIR decreased from 44.68 per 100000 （1446.29/3.2370 million） in 2012 to 21.24 per 100000 （687.54/3.2370 million） in 2022，both showing a significant downward trend （EAPC=-5.37% and -6.21%，respectively，both P<0.001）. For males，CIR decreased from 52.90 per 100000 （916/1.7316 million） in 2012 to 27.55 per 100000 （429/1.5570 million） in 2022，and ASIR decreased from 56.54 per 100000 （937.90/1.6413 million） in 2012 to 23.79 per 100000 （390.47/1.6413 million） in 2022. For females，CIR decreased from 32.95 per 100000 （536/1.6265 million） in 2012 to 20.74 per 100000 （325/1.5670 million） in 2022，and ASIR decreased from 32.88 per 100000 （524.70/1.5956 million） in 2012 to 18.79 per 100000 （299.88/1.5956 million） in 2022. All gender-specific rates showed significant downward trends （EAPC=-6.06%，-6.84%，-4.11% and -4.88%，respectively，all P<0.001）. The crude incidence rate in the 0-24 age group dropped from 39.30 per 100000 （437/1.1120 million） in 2012 to 4.52 per 100000 （50/1.1059 million） in 2022，with the largest decline （EAPC=-13.52%，P<0.001）. The rates in the 55-64 age group and the ≥75 age group decreased from 47.61 per 100000 （130/0.2730 million） and 120.84 per 100000 （145/0.1200 million） in 2012 to 29.18 per 100000 （117/0.2132 million） and 75.93 per 100000 （147/0.1936 million） in 2022，respectively，with relatively mild declines （EAPC=-3.19% and -3.83%，respectively，both P<0.001）. The crude incidence rate showed a trend of initial decrease followed by increase at a floating population density of 5.119 thousand persons/km² and a permanent resident population density of 12.354 thousand persons/km² （R²=0.156，P<0.001；R²=0.191，P<0.001）. Conclusion：The overall incidence of PTB among residents in Haidian District，Beijing showed a downward trend from 2012 to 2022. Given the potential association between PTB incidence and population density，targeted PTB prevention and control strategies should be formulated，and relevant work should be strengthened according to local conditions.

Survey of Mycobacterium tuberculosis infection rate and analysis of associated factors among three priority populations in Yingde’s zero-TB community pilot areas，Guangdong Province

Wang Yongbing, Zhong Yuexiang, Fu Xiuying, Zhang Ying, Weng Wenpei, Zhou Fangjing, Yang Yingzhou, Luo Jilun

Chinese Journal of Antituberculosis. 2026, 48(4):  468-476.  doi:10.19982/j.issn.1000-6621.20250444

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Objective：To investigate the prevalence of Mycobacterium tuberculosis （MTB） infection and its associated factors among key populations screened with the recombinant Mycobacterium tuberculosis fusion protein （EC） assay in Yingde’s zero-TB community pilot areas. This study aimed to provide data support and a scientific basis for optimizing the national zero-TB community screening strategy. Methods：The study included close contacts of active pulmonary tuberculosis patients，diabetic patients，and self-presenting respiratory disease patients who underwent EC-based screening in two pilot townships （Wangbu，Shihuipu） of Yingde City in 2023. The study analyzed the EC screening coverage，MTB infection prevalence，and employed multivariable binary logistic regression to identify factors associated with MTB infection in each subgroup. Results：A total of 1524 key individuals were screened，with a screening rate of 87.44% （1524/1743）. Among them，142 tested positive，resulting in an infection rate of 9.32% （142/1524）. The screening rate among close contacts was 88.43% （757/856） with an infection rate of 10.30% （78/757）；for diabetic patients，the rates were 82.97% （570/687） and 8.42% （48/570），respectively；and for self-presenting respiratory disease patients，the rates were 98.73% （233/236） and 9.87% （23/233）. Multivariable logistic regression analysis indicated that among household contacts of tuberculosis patients，close contact with bacteriologically confirmed patients （OR=1.972，95%CI：1.178-3.301） and self-reported smoking history （OR=2.047，95%CI：1.012-4.140） were associated with MTB infection. Among respiratory disease patients seeking medical care，male sex was associated with MTB infection （OR=2.740，95%CI：1.088-6.903）. Conclusion：The EC test demonstrated feasibility for investigating tuberculosis infection rates. Populations requiring focused attention include close contacts of etiologically positive index cases，close contacts with a smoking history，and male self-presenting patients with respiratory symptoms.

Genotypic and drug resistance of Mycobacterium tuberculosis in Beijing，2024

Miao Honghao, Zhang Jie, Pang Mengdi, Ren Yixuan, Deng Yang, Yi Junli, Fan Ruifang, Chen Shuangshuang, Chen Hao, Yu Lan, Li Jie, Li Chuanyou, Yang Xinyu

Chinese Journal of Antituberculosis. 2026, 48(4):  477-484.  doi:10.19982/j.issn.1000-6621.20250450

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Objective：To characterize the genotypic characteristics and drug resistance features of Mycobacterium tuberculosis （MTB） clinical isolates from management of pulmonary tuberculosis （PTB） patients in Beijing in 2024，as well as the correlation between them，providing scientific evidence for tuberculosis prevention and control in Beijing. Methods：A total of 923 clinical isolates of MTB and their epidemiological data were systematically collected from registered PTB patients in Beijing Tuberculosis Prevention and Care System between January and December，2024 who met the study criteria. Polymerase chain reaction （PCR） was used for species identification of all strains. The Beijing genotype and non-Beijing genotype were identified using the RD105 deletion gene detection method，and ancient and modern Beijing genotypes were distinguished according to the integrity of the NTF region. Genotyping was conducted using 15-locus Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat （MIRU-VNTR 15） analysis. The polymorphism and discriminatory power of each VNTR locus and the entire typing system were evaluated by the Hunter-Gaston Index （HGI） and the overall Hunter-Gaston Discriminatory Index （HGDI）. Meanwhile，the clustering of genotypes was observed，and the minimum inhibitory concentration （MIC） method was used to perform drug susceptibility testing for 4 first-line and 4 Group A anti-tuberculosis drugs. Results：Species identification and genotyping results of 923 strains showed that there were 922 strains of MTB and 1 strain of Mycobacterium africanum. Among the MTB strains，the Beijing genotype accounted for 90.89% （838/922），mainly dominated by the modern type （85.20%，714/838）. MIRU-VNTR genotyping revealed an HGDI value of 0.998，among which two loci，QUB11b （HGI=0.722） and QUB26 （HGI=0.639），exhibited high polymorphism and were key loci for distinguishing strains. All 230 clustered MTB strains were of the Beijing genotype，with a clustering rate of 24.95% （230/922），and 98.26% （226/230） of them were modern Beijing genotype. A total of 63 clusters were formed，and the largest cluster contained 29 strains，all of which were modern Beijing genotype. Drug resistance testing showed that isoniazid had the highest resistance rate （12.26% （113/922）），while ethambutol had the lowest （0.22%，2/922）. The drug resistance rates of the Beijing genotype to isoniazid and levofloxacin （12.89% （108/838） and 9.79% （82/838），respectively） were significantly higher than those of the non-Beijing genotype （5.95% （5/84） and 2.38% （2/84），respectively）. The modern type had a significantly lower drug resistantce rate to isoniazid （11.76% （84/714）） and rifampicin （5.18% （37/714）） than the ancient type （19.35% （24/124） and 11.29% （14/124）），with all differences being statistically significant （χ²=3.415，P=0.039；χ²=5.055，P=0.012；χ²=5.421，P=0.018；χ²=6.897，P=0.011）. Conclusion：The modern Beijing genotype，characterized by high genetic diversity and transmission activity，is the dominant epidemic strain and the main genotype responsible for recent transmission of MTB in Beijing，with isoniazid resistance being the most prominent problem. Therefore，it is necessary to strengthen molecular monitoring and transmission chain tracing of modern Beijing genotype strains，especially for drug-resistant strains.

Study on the characteristics of rpoB gene mutations in Mycobacterium tuberculosis and its correlation with rifampicin resistance level in Shanghai

Li Jing, Zhang Yangyi, Yang Jinghui, Wu Zheyuan, Li Ningdi, Yu Chenlei, Wang Lili, Shen Xuhui, Jiang Yuan, Shen Xin

Chinese Journal of Antituberculosis. 2026, 48(4):  485-494.  doi:10.19982/j.issn.1000-6621.20250399

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Objective：To learn about the mutation characteristics of the rpoB gene in Mycobacterium tuberculosis （MTB） in Shanghai，and explore the correlation between rpoB gene mutation and rifampin resistance level. Methods：Strains of pulmonary tuberculosis patients who were newly registered and culture-positive in Shanghai from 2020 to 2022 were selected using a simple random sampling. Minimal inhibitory concentration （MIC） drug susceptibility test was performed on 2766 MTB strains. After excluding duplicate samples and those with failed tests，valid phenotypic drug susceptibility results were obtained from 2734 strains. Whole genome sequencing （WGS） was performed on 462 strains from these patients （176 retreatment and 286 primary patients）. After excluding 12 non-compliant samples，450 MTB strains were analyzed for rifampicin resistance gene mutations，then the relationship between rpoB mutation type and rifampicin MIC were analyzed with Wilcoxon rank sum test. Results：Among the 450 strains of clinical MTB，139 strains （including 8 RFP sensitive strains，18 strains with low-level RFP resistant and 113 strains with high-level RFP resistant） had RFP resistance gene mutations，among which 95.68% （133/139） of the mutations occurred in the rifampicin rpoB RRDR region. The most frequent rpoB gene mutations were observed at codons 450，445 and 435，which had mutated frequencies of 60.43% （84/139），21.58% （30/139） and 7.91% （11/139），respectively. The Wilcoxon rank sum test showed that rpoB_p.Ser450Leu，rpoB_p.Ser450Trp，rpoB_p.His445Asp，rpoB_p.His445Tyr，rpoB_p.Asp435Gly，rpoB_p.Asp435Val，rpoB_p.Asp435Tyr and rpoB_p.Leu452Pro were significantly associated with RFP resistance （Ps<0.05）. Among them，stains with these five mutations （rpoB_p.Ser450Leu，rpoB_p.Ser450Trp，rpoB_p.His445Asp，rpoB_p.His445Tyr and rpoB_p.Asp435Val） had a median MIC over 16 μg/ml，showing high level resistance. The median MIC values for rpoB_p.Asp435Gly，rpoB_p.Asp435Tyr and rpoB_p.Leu452Pro mutant strains were 4 μg/ml，1 μg/ml and 4 μg/ml，respectively，showing low-level resistance. Among the RFP-resistant strains with multicodon mutations，70.59% （12/17） of the rpoB RRDR gene mutation were accompanied by compensatory mutations of rpoA and rpoC or rpoB non-RRDR. All multicodon mutant strains showed high level resistance （MIC>16 μg/ml）. Lineage analysis of 450 MTB strains revealed that the L2 lineage predominated at 88.44% （398/450），the L4 lineage accounted for 10.90% （49/450），while the L1 lineage accounted for the least，only 0.44% （2/450）. One strain （0.22%） was identified as a mixed strain of both L2 and L4 lineages. Among RFP-resistant strains，the L2 lineage showed a higher proportion at 92.09% （128/139），while the L4 lineage accounted for 7.19% （10/139），and no L1 lineage resistant strains were detected. Analysis of sublineage distribution revealed that the L2 lineage was dominated by the L2.2.1 sublineage （55.78%，251/450），while the L4 lineage was primarily composed of the L4.4.2 and L4.5 sublineages，accounted for 4.00% （18/450） and 3.56% （16/450），respectively. Conclusion：Different rifampicin rpoB mutation types in Shanghai can cause different levels of RFP resistance. The mutation of rpoB_p.Ser450Leu，rpoB_p.Ser450Trp，rpoB_p.His445Asp，rpoB_p.His445Tyr and rpoB_p.Asp435Val are associated with high-level resistance of RFP. The mutation of rpoB_p.Asp435Gly，rpoB_p.Asp435Tyr and rpoB_p.Leu452Pro were associated with low-level resistance of RFP. Multicodon mutations，especially those carrying compensatory mutations，may synergistically enhance RFP resistance level.

Expression and clinical value of serum LncRNA LINC00707 and miR-382-5p in patients with pulmonary tuberculosis

Zhong Guowei, Zhang Shaoyi, Fan Huiling

Chinese Journal of Antituberculosis. 2026, 48(4):  495-503.  doi:10.19982/j.issn.1000-6621.20250383

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Objective：To investigate the expression of long non-coding RNA （LncRNA） LINC00707 and micro RNA-382-5p （miR-382-5p） in the serum of pulmonary tuberculosis patients and their clinical diagnostic values for pulmonary tuberculosis. Methods：From July 2021 to July 2023，pulmonary tuberculosis patients admitted to Shaanxi Provincial Tuberculosis Prevention and Treatment Institute were regarded as tuberculosis group，including 38 cases of active pulmonary tuberculosis and 27 cases of inactive pulmonary tuberculosis. And another 68 non-tuberculosis patients admitted to the respiratory outpatient department during the same period were selected as non-tuberculosis group，and 68 healthy individuals who underwent physical examinations were regarded as control group；the expression levels of serum LncRNA LINC00707 and miR-382-5p were compared among the four groups；the relationship between the expression levels of serum LncRNA LINC00707 and miR-382-5p in patients with pulmonary tuberculosis and their clinical pathological characteristics was analyzed；Bioinformatics website was used to predict the targeting relationship between miR-382-5p and LncRNA LINC00707；Multivariable logistic regression was performed to analyze factors affecting pulmonary tuberculosis’s occurrence；Receiver operating characteristic （ROC） curve was applied to analyze the diagnostic efficacy of serum LncRNA LINC00707 and miR-382-5p levels for pulmonary tuberculosis. Results：Analyzing the expression levels of serum TNF-α （（3.31±1.01），（20.15±5.47），（32.46±7.05），（42.89±8.96） ng/L），IL-1β （（13.62±3.87），（47.96±6.81），（65.86±9.14），（83.17±10.59） ng/L），LncRNA LINC00707 （（1.06±0.17），（1.21±0.23），（1.35±0.19），（1.63±0.32）） and miR-382-5p （（0.97±0.15），（0.91±0.11），（0.83±0.12），（0.74±0.09）） in the serum of the reference group，non-tuberculosis group，inactive tuberculosis group，and active tuberculosis group，it was found that TNF-α，IL-1β，LncRNA LINC00707 were highest in the active tuberculosis group and lowest in the control group，while miR-382-5p expression level was highest in the control group and lowest in the active tuberculosis group. The differences among the groups were all statistically significant （F=445.800，847.483，53.455，31.014，P<0.001）. Logistic regression analysis showed that LINC00707 （OR （95%CI）=1.735 （1.350-2.230）），miR-382-5p （OR （95%CI）=0.816 （0.735-0.905）），IL-1β （OR （95%CI）=1.413 （1.087-1.837）），TNF-α （OR （95%CI）=1.259 （1.001-1.584）） were influencing factors of pulmonary tuberculosis. ROC curve showed that the areas under the curve （AUCs） of serum LncRNA LINC00707，miR-382-5p levels，and their combined diagnosis for pulmonary tuberculosis were 0.805，0.758，and 0.903，respectively. The clinical efficacy of combined diagnosis was superior to that of solely using serum LncRNA LINC00707 and miR-382-5p （Z=2.070，P=0.038；Z=2.826，P=0.005）. Conclusion：The expression of serum LncRNA LINC00707 in patients with pulmonary tuberculosis is obviously increased，while the expression of miR-382-5p is obviously reduced. Combination of these two has a higher clinical efficacy in diagnosing pulmonary tuberculosis.

Clinical value of auramine O fluorescence staining automatic microscopic scanning and recognition system for detecting tuberculosis

Jiang Lina, Dai Wenxi, Ju Hanfang, Meng Sukai, Wang Chunhua

Chinese Journal of Antituberculosis. 2026, 48(4):  504-509.  doi:10.19982/j.issn.1000-6621.20250412

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Objective：To evaluate the application value of a fully automatic auramine O fluorescence staining microscopic scanning system （OF-AS，software recognition） in tuberculosis diagnosis. Methods：A total of 503 consecutive patients with suspected pulmonary tuberculosis who visited the outpatient department of Tianjin Tuberculosis Control Center for the first time from January to August 2025 were enrolled. Three initial sputum specimens were collected from each patient，with a total of 1509 specimens which all were subjected to auramine O fluorescence staining，and then microscopic examination was performed with double-blinded method using traditional manual microscopy （abbreviated as “manual microscopy”） and OF-AS respectively. One sputum specimen of good quality was selected from each patient for BACTEC MGIT 960 mycobacterial liquid culture （abbreviated as “MGIT 960 culture”），with a total of 503 cases completed. Taking MGIT 960 culture as the gold standard for the detection of pulmonary tuberculosis，the efficacies of manual microscopy and OF-AS in testing sputum specimens from patients with pulmonary tuberculosis were analyzed；rank correlation of positive results detected by both manual microscopy and OF-AS was analyzed. Results：The positive rate of manual microscopy （12.39%，187/1509） was higher than that of OF-AS （11.73%，177/1509），but the difference was not statistically significant （χ²=0.576，P>0.05）. Using MGIT 960 culture as the reference standard，the sensitivity and specificity of OF-AS for detecting tuberculosis were 51.76% （103/199） and 95.39% （290/304），respectively，which were slightly lower than those of manual microscopy （sensitivity：52.43%，108/206；specificity：96.97%，288/297）. Both diagnostic methods showed moderate agreement with the gold standard （Kappa values：0.529 and 0.508，respectively）. A total of 54 sputum smears had discordant results between OF-AS and manual microscopy，mainly due to missed detection by the scanner and interference from staining sediment. Eight sputum smears showed discordance between initial manual microscopy and repeated manual microscopy，all attributed to missed detection under microscopy. Conclusion：OF-AS （software recognition） has good application value in testing sputum specimens of suspected pulmonary tuberculosis patients，and its detection performance can meet the requirements of implementing traditional auramine O staining project for detecting mycobacterium.

Analysis of the clinical characteristics of post-tuberculosis bronchiectasis

Han Yanzhuo, Lu Zhenhui, Su Ben, Zhou Rui, Chen Jiajun, Wu Xianwei, Wu Dingzhong, Zhang Shaoyan, Qiu Lei

Chinese Journal of Antituberculosis. 2026, 48(4):  510-517.  doi:10.19982/j.issn.1000-6621.20250418

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Objective：To investigate the clinical characteristics of post-tuberculosis bronchiectasis （PTBE） to provide a basis for individualized diagnosis and treatment. Methods：A cross-sectional study was conducted. A total of 350 patients with stable bronchiectasis from Longhua Hospital Affilicated to Shanghai University of Traditional Chinese Medicine between July 2021 and December 2024 were enrolled. According to the history of pulmonary tuberculosis，patients were divided into a post-tuberculosis bronchiectasis group （PTBE group，n=86） and a non-post-tuberculosis bronchiectasis group （NPTBE group，n=264）.Demographic characteristics，acute exacerbations，pulmonary function，chest CT findings，colonization with pseudomonas aeruginosa，clinical symptoms and related scores，blood routine tests，albumin levels，and lymphocyte subsets were compared between the two groups. Results：The median disease duration in the PTBE group was 20.00 （15.00，23.00） years，significantly longer than the 11.00 （6.75，15.00） years in the NPTBE group （Z=-9.554，P<0.001）. The proportion of patients with ≥3 acute exacerbations within one year was 48.84% （42/86） in the PTBE group，significantly higher than 18.94% （50/264） in the NPTBE group （χ²=29.926，P<0.001）. The hospitalization rate due to acute exacerbations within one year was 51.16% （55/86） in the PTBE group，significantly higher than 27.65% （73/264） in the NPTBE group （χ²=16.113，P<0.001）. The proportion of patients with involvement of ≥3 lung lobes was 84.88% （73/86） in the PTBE group，significantly higher than 55.30% （146/264） in the NPTBE group （χ²=24.237，P<0.001）. The forced vital capacity percent predicted （FVC% pred） was 0.66±0.08 in the PTBE group，significantly lower than 0.70±0.09 in the NPTBE group （t=3.968，P<0.001）. The proportion of patients with a forced expiratory volume in one second percent predicted （FEV₁% pred）<70% was 48.84% （42/86） in the PTBE group，significantly higher than 27.65% （73/264） in the NPTBE group （χ²=13.197，P<0.001）. The rate of chronic Pseudomonas aeruginosa colonization was 62.79% （54/86） in the PTBE group，significantly higher than 29.17% （77/264） in the NPTBE group （χ²=31.321，P<0.001）. The incidence of hemoptysis was 18.60% （16/86） in the PTBE group，significantly higher than 6.82% （18/264） in the NPTBE group （χ²=10.275，P=0.001）. Conclusion：Patients with post-tuberculosis bronchiectasis present with a longer disease duration，more extensive pulmonary structural destruction，higher risk of chronic Pseudomonas aeruginosa colonization，and more frequent acute exacerbations. Early and intensive anti-infective therapy and pulmonary rehabilitation interventions are recommended for these patients..

Study on the health management journey map of 15 initially treated pulmonary tuberculosis patients

Gao Xianru, Cui Wenjuan, Zhang Mengran, Yang Kefan, Hao Huiyuan, Yang Lu, Sun Wenwen

Chinese Journal of Antituberculosis. 2026, 48(4):  518-524.  doi:10.19982/j.issn.1000-6621.20250406

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Objective：To clarify the specific needs and nursing gaps of 15 newly diagnosed pulmonary tuberculosis patients in health management based on the journey map，providing a reference for optimizing the health management of these patients throughout the entire journey. Methods：A descriptive research method was adopted. From late August to October 2025，semi-structured interviews were conducted with 15 initially treated pulmonary tuberculosis patients at Jining Public Health Medical Center. The data were analyzed with the Colaizzi 7-step method，and the journey map was drawn. Results：The patients’ health needs were summarized into 26 themes according to the timeline of diagnosis and treatment，from three dimensions including symptoms and behaviors，emotions and psychological reactions，and demand points. Nine themes were during the diagnosis period （（1） Delayed medical consultation due to ignoring early symptoms or in asymptomatic conditions，（2） Choosing the right medical institution and completing specialized examinations，（3） Taking active isolation measures，（4） Confusion，（5） Fear，anxiety and worry，（6） Relief upon clear diagnosis，（7） The need to identify early symptoms or conduct active screening，（8） The need for health education targeting weaknesses，（9） The need to adjust role conflicts）. Eight themes were in the hospitalization period （（1） Presence of discomfort symptoms and adverse reactions，（2） Following the guidance of medical staff，（3） Establishing a support system，（4） Resistance and a sense of stigma，（5） Changing a positive mindset，（6） Irritation，（7） Strategies to alleviate discomforts and adverse drug reactions，（8） Multi-channel popular science and need for essential information）. Nine themes were during the home treatment management period （（1） Self-management，（2） Active or passive social avoidance，（3） Avoiding or filtering part of the information，（4） Expecting recovery from the disease，（5） Insufficient psychological capital support，（6） Sense of benefit from the disease，（7） The need to rebuild social networks and return to work，（8） The need to strengthen doctor-patient communication，（9） The need to increase economic support）. The health management journey map was drawn. Conclusion：The health management journey of initially treated pulmonary tuberculosis patients is long and involves complex emotional evolution and changes in needs. Medical staff should accurately identify the demands of patients at different stages of diagnosis and treatment，provide professional guidance and care，and offer tailored services.

Effects of family participatory intervention on medication adherence and lung function based on health action process approach in elderly patients with pulmonary tuberculosis

Yang Jie, Dong Ning, Wei Xiaowen, Wu Yan, Dong Wenfang, Wu Yuanhao, Zhang Lin

Chinese Journal of Antituberculosis. 2026, 48(4):  525-533.  doi:10.19982/j.issn.1000-6621.20250365

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Objective：To explore the effects of family participatory intervention based on the health action process approach （HAPA） on medication adherence and lung function in elderly patients with pulmonary tuberculosis. Methods：Purposive sampling method was based to select patients. Sixty-five patient-family dyads were selected from the department of respiratory and critical care medicine of Shanghai Public Health Clinical Center from March 2023 to April 2024 as the control group and received routine health education. Another sixty-five patient-family dyads were selected from May 2024 to June 2025 as the intervention group and received family-participatory health education based on HAPA. During the follow-up period，seven dyads from the intervention group and six from the control group were dropped out. Consequently，the final analysis included 58 dyads in the intervention group and 59 in the control group. The medication adherence scale （MMAS-8） scores were assessed at the end of 1，2 and 3 months after discharge；the occurrence of adverse drug reactions （ADR），Family APGAR （APGAR） scale scores and pulmonary function parameters were also analyzed at the end of 3 months after discharge. Results：At the end of 1，2 and 3 months after discharge，the MMAS-8 medication adherence scale scores of the intervention group （7.79±0.41，7.62±0.49，7.64±0.49） were higher than those of the control group （7.58±0.50，7.37±0.76，7.37±0.49），and the differences were statistically significant （t=2.575，P=0.011；t=2.094，P=0.039；t=2.948，P=0.004）. During the three-month post-discharge follow-up，the occurrence of ADR in the intervention group （36.21% （21/58）） and the control group （32.20% （19/59）） showed no difference （χ²=0.208，P=0.648）；Scores of adaptation，partnership，growth，affection，and intimacy of APGAR scale （2.00 （2.00，2.00），2.00 （2.00，2.00），2.00 （2.00，2.00），2.00 （2.00，2.00），2.00 （2.00，2.00）） were higher than those of the control group （1.00 （1.00，2.00），1.00 （1.00，2.00），2.00 （1.00，2.00），2.00 （1.00，2.00），1.00 （1.00，2.00）），and the differences were statistically significant （Z=-2.708，P=0.007；Z=-5.430，P<0.001；Z=-2.977，P=0.003；Z=-3.212，P=0.001；Z=-5.702，P<0.001）；pulmonary function parameters were markedly better in the intervention group，including forced vital capacity （FVC：3.59 （3.14，4.23） L vs. （3.14 （2.47，4.18） L；Z=-2.604，P=0.009），forced expiratory volume in one second （FEV₁：2.85 （2.41，3.25） L vs. 2.23 （1.89，2.80） L；Z=-4.328，P<0.001），and the FEV₁/FVC （80.89 （75.37，90.19） % vs. 78.42 （67.73，81.85） %；Z=-2.767，P=0.006）. Conclusion：Family participatory intervention based on HAPA can enhance medication adherence and promote family function in elderly patients with pulmonary tuberculosis，as well as improve their lung functions.

Analysis of current developing situation of group standards of Chinese Antituberculosis Association

Du Fangfang, Cao Xuefang, Wang Jin, Jin Qi, Liu Jianjun, Gao Lei, Cheng Shiming

Chinese Journal of Antituberculosis. 2026, 48(4):  534-540.  doi:10.19982/j.issn.1000-6621.20250439

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Objective：To analyze the current development situation of group standards by Chinese Antituberculosis Association （CATA），summarize key challenges，and propose development suggestions. Methods：Tuberculosis-related standards were retrieved from the National Group Standard Information Platform and CATA Group Standard Management Platform. Word frequency analysis was used to identify hot topics，then a comprehensive analysis of development status was conducted. Results：From January 2019 to June 2025，CATA had approved to develop 91 group standards，51 of which had been officially released. Hot topics included tuberculosis，pulmonary tuberculosis，screening，designated medical institutions，diagnosis，infection control，and management. Among released standards：6 were adopted by government departments into prevention and control plans/guidelines；9 were applied in market activities such as bidding and contract performance；2 were approved to be developed as national industrial standards；2 were cited by WHO or international standards/guidelines. Released standards cover the entire chain of tuberculosis diagnosis，prevention，treatment，and management，with clinical field accounting for the highest proportion （37.3%，19/51）. A total of 648 experts participated in standard compilation for 1274 person-times：91.8% （595/648） with senior titles，60.6% （393/648） from provincial or higher institutions，68.8% （446/648） from eastern China，and 63.1% （409/648） from hospitals. A total of 264 institutions participated：48.1% （127/264） at provincial or higher level，58.7% （155/264） being hospitals，and 61.4% （162/264） from eastern China. The average time from approval of development to release of the 51 standards was 651 days，mostly 13-18 months. Conclusion：CATA has established a group standard system covered the full-chain of tuberculosis prevention and control. The development is led by senior experts and provincial or higher-level institutions. It is necessary to further strengthen planning，optimize promotion and implementation，improve supervision，management and evaluation mechanisms，and advance the quality and international influence of standards to promote the high-quality development of tuberculosis standardization.

Comparative analysis of published literature in Chinese and English on multidrug-resistant tuberculosis from 2004 to 2025

Zhou Wensi, Guo Meng, Chen Qingbo, Wang Quan, Li Wei

Chinese Journal of Antituberculosis. 2026, 48(4):  541-549.  doi:10.19982/j.issn.1000-6621.20260023

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Objective：To systematically compare the publication characteristics and research hotspot evolution patterns of multidrug-resistant tuberculosis （MDR-TB） studies in Chinese and English from 2004 to 2025，clarify the core differences and collaborative directions between domestic and international researches，and provide evidence-based reference for the high-quality development of MDR-TB researches and precise MDR-TB prevention and control in China. Methods：Using the Web of Science Core Collection and China National Knowledge Infrastructure （CNKI） as data sources，relevant MDR-TB research literature from 2004 to 2025 was retrieved. CiteSpace visualization analysis tools were employed to conduct comparative analyses across dimensions such as the distribution of literature by publication year，research hotspot clustering，and longitudinal evolution. Results：A total of 14991 English and 5218 Chinese articles were included. Both English and Chinese literature on MDR-TB showed a phased growth trend over time. From 2004 to 2014，the number of English articles increased from 326 to 985，with an average annual growth rate of 11.6%；the number of Chinese articles increased from 105 to 428，with an average annual growth rate of 15.1%. From 2015 to 2025，the total number of English articles reached 8461，an increase of 29.6% compared to the period from 2004 to 2014 （6530 articles），while the total number of Chinese articles was 3290，an increase of 70.6% compared to the period from 2004 to 2014 （1928 articles）. Additionally，the focus of Chinese and English MDR-TB literature varies aross different time periods，such as in the first phase （2004-2014），English researches focused on elucidating drug resistance mechanisms to establish a “basic-clinical-public health” three-dimensional integrated system，while Chinese researches concentrated on clinical nursing and foundational treatments. In the second phase （2015-2025），English researches continued to lead in underlying technological innovation，e.g. rapid diagnostic tests，while Chinese researches achieved partial breakthroughs in areas of basic management，such as community intervention models，Integrated Traditional Chinese and Modern Medicine. Conclusion：The number of Chinese publications on MDR-TB research has showed rapid growth. In the future，there is a need to further enhance the originality and continuity of researches，focus on disciplinary integration to contribute to realizing global MDR-TB prevention and control goals.

Review Articles

Research progress in digital twin technology for tuberculosis patient management

Qiu Yuxian, Huang Fang, Yang Xiaoyi, Yang Feng, Lu Hua, Zhang Tianyi, Zhang Yang, Yao Rong, Li Yuanyuan

Chinese Journal of Antituberculosis. 2026, 48(4):  550-555.  doi:10.19982/j.issn.1000-6621.20250473

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In recent years，digital twin （DT） technology，as an emerging concept，has gradually been applied to the management of tuberculosis patients. DT demonstrates significant potential in virtual patient modeling，drug development，clinical skills training，and public health resource allocation，while also showcasing foresight in disease risk prediction and treatment adherence support. However，current research efforts，both domestically and internationally，remain at an exploratory stage，necessitating the integration of existing findings to clarify its developmental trajectory. Accordingly，this review summarizes the fundamental information on DT，elaborates on the latest research applications of DT technology in tuberculosis patient management，analyzes challenges in technological implementation，and outlines future directions. By dong so，it aims to provide innovative strategies for global tuberculosis digital prevention and control，offering insights for enhancing precision-based management of tuberculosis patients.