Table of Content

10 July 2026, Volume 48 Issue 7

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Guideline·Standard·Consensus

Expert consensus on nutritional therapy for tuberculosis and diabetes mellitus comorbidity

Chinese Antituberculosis Association, Nutrition Branch of the Chinese Antituberculosis Association, Hunan Antituberculosis Association, Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Shanghai Pulmonary Hospital, Xiangya School of Public Health, Central South University

Chinese Journal of Antituberculosis. 2026, 48(7):  913-924.  doi:10.19982/j.issn.1000-6621.20260187

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Tuberculosis (TB) and diabetes mellitus (DM) are two major global diseases, and the comorbid nutritional problems seriously compromise treatment outcomes. To standardize the clinical practice of nutritional therapy for patients with TB-DM comorbidity in China, the Chinese Antituberculosis Association jointly collaborated with multiple institutions and assembled a multidisciplinary expert panel. Based on available domestic and international research evidence and clinical practice experience, the panel comprehensively evaluated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System to formulate this consensus. This consensus systematically addresses 10 key components of nutritional therapy: principles and objectives, nutritional risk screening and assessment, dietary nutritional intervention, enteral and parenteral nutrition support, nutrition therapy monitoring, impacts of medications on nutritional management, nutritional intervention for comorbidities, nutritional care for special populations and health education. A total of 20 core recommendations have been established in this consensus. It aims to provide scientific, standardized and operational guidance for clinical nutritional diagnosis and management. By optimizing nutritional therapy, it can effectively improve glycemic abnormalities in patients and facilitate better anti-tuberculosis treatment outcomes.

Study Protocol

Effectiveness and safety of Yujieli as a nutritional supplement in newly diagnosed, nutritionally deficient patients with rifampicin-sensitive active pulmonary tuberculosis: a multicenter, randomized, controlled clinical trial

Zeng Yi, Gao Weiwei, Shi Cuilin, Su Shifang, Wang Hua, Tang Jun, Shi Jichan, Nie Qi, Sun Yan, Cui Junwei, Yang Junjun, Fan Jiahua

Chinese Journal of Antituberculosis. 2026, 48(7):  925-932.  doi:10.19982/j.issn.1000-6621.20250481

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Objective: To evaluate the effectiveness and safety of Yujieli^® (Isolated Protein Multi-vitamin and Mineral Special Food Powder) as a nutritional intervention in newly diagnosed active pulmonary tuberculosis patients with moderate to severe malnutrition. Methods: This is a multicenter, randomized, open-label, parallel-controlled superiority clinical trial. A total of 438 patients with newly diagnosed rifampicin-sensitive active pulmonary tuberculosis and moderate to severe malnutrition are planned to be enrolled. Participants will be randomly assigned with a 1∶1 ratio to either the study group (anti-tuberculosis therapy+conventional diet+Yujieli for 3 months) or the control group (anti-tuberculosis therapy+conventional diet). The primary effectiveness endpoint is the treatment success rate (cured+treatment completed). Secondary endpoints include sputum conversion rate and time, improvement in imaging findings, nutritional status indicators (BMI, albumin, hemoglobin, prealbumin, etc.), physical function, immune function, psychological status, and the incidence of adverse reactions. Conclusion: This study will provide high-level medical evidence for the application of the tuberculosis-specific nutritional formula “Yujieli” in newly treated active pulmonary tuberculosis patients with malnutrition and inform strategies for optimizing comprehensive tuberculosis treatment.

Original Articles

Risk factors and predictive model for poor prognosis among HIV-negative patients with disseminated tuberculosis admitted to intensive care unit

Liu Jia, Tan Jing, Tian Yao, Fu Manjiao, Liu Huimin, Chen Hongmei, Zhai An, Kang Yi, Chen Liang, Bei Chengli

Chinese Journal of Antituberculosis. 2026, 48(7):  933-940.  doi:10.19982/j.issn.1000-6621.20250491

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Objective: This study aimed to explore the risk factors for poor prognosis among human immunodeficiency virus (HIV)-negative patients with disseminated tuberculosis (DTB) admitted to intensive care unit (ICU). Methods: The clinical data of 204 HIV-negative patients with DTB admitted to the Tuberculosis ICU of Changsha Central Hospital between January 1, 2021 and December 31, 2023 was retrospectively analyzed. Patients were divided into a poor prognosis group (n=49) and a favorable prognosis group (n=155) according to their treatment outcomes at ICU discharge. The clinical characteristics of the two groups were compared, and multivariate logistic regression analysis was used to identify risk factors for poor prognosis in patients with DTB and a risk prediction model for poor prognosis was constructed. Results: Among the 204 HIV-negative patients with DTB, the incidence of poor prognosis in the ICU was 24.0% (49/204). Multivariate logistic regression analysis revealed that positive acid-fast bacilli in sputum smear (OR=2.878, 95%CI: 1.128-7.348, P=0.027), inadequate initial antituberculosis therapy at ICU admission (OR=2.779, 95%CI: 1.212-6.369, P=0.016), and concurrent severe pneumonia (OR=14.746, 95%CI: 4.204-51.727, P<0.001), and concurrent sepsis (OR=4.023, 95%CI: 1.788-9.051, P<0.001) were possible risk factors for poor prognosis among HIV-negative patients with DTB admitted to ICU. A risk prediction model for poor prognosis was constructed based on the above risk factors. The area under the receiver operating characteristic (AUC) curve of the model was 0.869 (95%CI: 0.815-0.923, P<0.001), with a sensitivity of 85.7% and a specificity of 72.3%, indicating that the model has good predictive value. Conclusion: For HIV-negative patients with DTB admitted to ICU, positive acid-fast bacilli in sputum smear, inadequate initial antituberculosis therapy on ICU admission, and concurrent severe pneumonia and sepsis are associated with an increased risk of poor prognosis. Clinically, early identification of these risk factors and targeted interventions are required to improve patients’ clinical outcomes.

Serfling regression model for analyzing tuberculosis epidemiological characteristics in Jinhua City,Zhejiang Province

Chen Yina, Li Weidan, Zhu Kaiqiang, Tang Huiling

Chinese Journal of Antituberculosis. 2026, 48(7):  941-947.  doi:10.19982/j.issn.1000-6621.20250523

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Objective: To establish an adjusted Serfling regression model for analyzing TB epidemic periods and excess cases, thereby providing evidence for control measures. Methods: Data of all clinically and laboratory-confirmed TB cases with disease onset between January 1, 2015, and October 31, 2025 and address in Jinhua City, was extracted from the Tuberculosis Information Management System, a subsystem of the China Disease Prevention and Control Information System. Descriptive analysis of TB epidemic characteristics was performed using X-13-ARIMA-SEATS, the Hodrick-Prescott (HP) filter, and the Joinpoint regression model. An adjusted Serfling regression model incorporating ARIMA error correction was established to identify the epidemic periods and estimate the number of excess cases, and predict the incidences from January to October 2025. Results: From 2015 to 2024, a total of 35659 TB cases were reported, with an average annual incidence rate of 51.73 per 100000 population (35659/68.936 million). The TB incidence rates in Jinhua City decreased from 63.44 per 100000 (4075/6.423 million) in 2015 to 43.72 per 100000 (3132/7.163 million) in 2024, showing a decline (AAPC=-5.05, P<0.001) trend. The adjusted Serfling regression model had a good fitting effect (AIC=521.19,BIC=533.66), a total of 46 epidemic months were identified, with March being a fixed epidemic month. The total number of excess cases was 2580 (95%CI: 2337-2822). The highest number of excess cases was recorded in 2017 (509 cases, 95%CI: 408-610), followed by 2018 (369 cases, 95%CI: 289-449). The prediction of TB incidence from January to October 2025 indicated that February and September 2025 would be epidemic months, with 49 (95%CI: 13-85) and 44 (95%CI: 8-80) excess cases, respectively. The peak of the predicted values was consistent with that of the actual incidence. Conclusion: From 2015 to 2024, the TB epidemic in Jinhua City showed a downward trend. Attention should be paid to TB prevention and control in spring. The adjusted Serfling regression model has a good fitting effect and can be used for early warning of TB and estimation of disease burden.

Construction of a clinical comprehensive evaluation system for anti-tuberculosis drugs based on Delphi and analytic hierarchy process

Ye Juexian, Zhou Qiankun, Li Donglan, Qin Xiongzhi, Fan Aimin, Liu Aimei

Chinese Journal of Antituberculosis. 2026, 48(7):  948-957.  doi:10.19982/j.issn.1000-6621.20250455

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Objective: To establish a multidimensional clinical comprehensive evaluation system for anti-tuberculosis drugs encompassing safety, effectiveness, economy, innovation, suitability, and accessibility, thereby providing a reference for rational drug use, new drug selection, and drug formulary optimization in healthcare institutions. Methods: Based on the indicator framework in the Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions (the Second Edition), the Delphi method was employed to screen and revise indicators, and to establish an evaluation framework tailored to anti-tuberculosis drugs. The analytic hierarchy process (AHP) was used to assign the weight of each indicator, forming a complete and quantifiable comprehensive evaluation system. An empirical evaluation was conducted on 6 drugs using for the treatment of multidrug-resistant tuberculosis (MDR-TB), including levofloxacin tablets, moxifloxacin hydrochloride tablets, linezolid tablets, clofazimine soft capsules, bedaquiline fumarate tablets and cycloserine capsules. Results: After two rounds of Delphi consultation with 15 experts, a comprehensive clinical evaluation system for anti-tuberculosis drugs was finally established, covering 6 dimensions (effectiveness, safety, economy, suitability, innovation and accessibility), the system comprised 6 first-level indicators, 20 second-level indicators and 35 third-level indicators. The questionnaire response rate reached 100.0%, the authority coefficient was 0.824 and the Kendall’s W for the final indicator system was 0.266 (P<0.001), indicating a high level of consensus among experts. By integrating the AHP judgment matrices from the 15 experts and passing the consistency test (CR<0.1), reliable indicator weights were obtained. The empirical evaluation results showed that the scores of levofloxacin tablets, moxifloxacin hydrochloride tablets, linezolid tablets, clofazimine soft capsules, bedaquiline fumarate tablets, and cycloserine capsules were 81.17, 67.17, 65.57, 62.77, 60.92, and 57.69, respectively, which were consistent with clinical practice. Conclusion: The anti-tuberculosis drug clinical comprehensive evaluation system constructed in this study aligns highly with the objectives and requirements of drug clinical comprehensive evaluation and demonstrates good scientific validity and practicality. It not only serves as a valuable reference for rational drug use, new drug selection, and drug formulary optimization in medical institutions but also provides a scientific foundation for regional health policy development.

Temporal trends and influencing factors of adverse treatment outcomes in patients with rifampicin-resistant pulmonary tuberculosis: a comparison based on different treatment regimens

Liu Liangli, Yang Yunbin, Yang Rui, Chen Jinou, Yang Xing, Qiu Yubing, Li Ling, Xu Lin

Chinese Journal of Antituberculosis. 2026, 48(7):  958-964.  doi:10.19982/j.issn.1000-6621.20260157

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Objective: To explore the temporal trends of adverse treatment outcomes in patients with rifampicin-resistant pulmonary tuberculosis (RR-PTB) under different treatment regimens, and to analyze the influencing factors of adverse treatment outcomes. Methods: In this retrospective study, data were collected from the Tuberculosis Management Information System of China Information System for Disease Control and Provention on patients with RR-PTB who initiated second-line anti-tuberculosis treatment at designated tuberculosis hospitals in Yunnan Province between January 2020 and June 2023. The collected information included demographic characteristics, comorbidities, detailed diagnostic and treatment information, as well as prior treatment history. The cumulative incidence method was used to describe the temporal trends of adverse treatment outcomes, and the Cox proportional hazards regression model was employed to identify factors associated with these outcomes. Results: A total of 1380 RR-PTB patients were included, of whom 71.5% (987/1380) received long-course treatment regimens and 28.5% (393/1380) received short-course treatment regimens. Compared with long-course treatment regimens, short-course treatment regimens had a higher treatment success rate (81.4% (320/393) vs. 55.1% (544/987)), but the rate of adverse treatment outcomes occurred faster (the cumulative incidence of adverse treatment outcomes at 5 months was 64.4% (47/73) for short-course treatment regimens and 54.6% (242/443) for long-course treatment regimens). Multivariate Cox regression analysis revealed that short-course treatment regimens (aHR=0.588, 95%CI: 0.455-0.759), being female (aHR=0.778, 95%CI: 0.634-0.954), and being non-farmers (aHR=0.634, 95%CI: 0.487-0.825) were protective factors for adverse treatment outcomes in RR-PTB patients; whereas being older (aHR=1.024, 95%CI:1.018-1.030), being a floating population (aHR=2.282, 95%CI: 1.795-2.900), having more than one previous anti-tuberculosis treatment history (aHR=1.451, 95%CI: 1.110-1.897), and not using bedaquiline treatment (aHR=1.282, 95%CI:1.005-1.636) were risk factors for adverse treatment outcomes. Conclusion: The short-term regimen is preferentially recommended for RR-PTB patients in clinical practice. Clinicians should pay close attention to high risk populations, including those receiving long-term regimens, males, farmers, elderly individuals, migrant populations, patients with more than one previous history of anti-tuberculosis treatment, and those not receiving bedaquiline. Timely individualized interventions should be implemented in these populations to reduce the incidence of adverse treatment outcomes.

Analysis of latent tuberculosis infection prevalence and its related factors in 1007 patients with diabetes mellitus

You Jicun, Tian Lei, Wang Lingyan, Yang Zhongrong, Shen Jianyong, Chen Bin

Chinese Journal of Antituberculosis. 2026, 48(7):  965-971.  doi:10.19982/j.issn.1000-6621.20260050

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Objective: To understand the prevalence of latent tuberculosis infection (LTBI) and its related factors in patients with diabetes mellitus, and to provide evidences for pulmonary tuberculosis prevention and control in this high-risk group. Methods: A cross-sectional survey was conducted for 1007 diabetes mellitus patients underwent LTBI screening in Anji County, Zhejiang Province from April 2024 to December 2024. The data of LTBI screening and diabetes mellitus patients were sourced from the local regional cloud medical information system. With the interferon gamma release assay (IGRA) for detection, the prevalence of LTBI in diabetes mellitus patients was described and related factors were analyzed with the multivariate logistic regression model. Results: Among 1007 diabetes mellitus patients, 149 were positive for IGRA, and no active pulmonary tuberculosis was found. The latent tuberculosis infection rate was 14.8%. The results of multivariate analysis showed that age ≥60 years (OR=1.788, 95%CI: 1.159-2.760), daily smoking ≤20 cigarettes (OR=1.694, 95%CI: 1.004-2.857), >20 cigarettes (OR=2.650, 95%CI: 1.079-6.506), and average psychological adjustment status (OR=1.674, 95%CI: 1.176-2.384) were related factors for LTBI in diabetes mellitus patients. Conclusion: The LTBI rate in diabetes mellitus patients is at a relatively high level, and age, smoking, and psychological status are related factors. It is suggested that active screening of pulmonary tuberculosis should be emphasized in the management of diabetes, and key interventions should be carried out for the elderly, smokers and those with poor mental status.

Investigation and analysis of a tuberculosis cluster outbreak in a primary psychiatric hospital

Zhang Ji, Zhao Wei, Zhang Zhiyu, Ji Liqin, Zhao Jie

Chinese Journal of Antituberculosis. 2026, 48(7):  972-977.  doi:10.19982/j.issn.1000-6621.20260054

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Objective: To conduct field epidemiological investigation and emergency response to a pulmonary tuberculosis (TB) cluster outbreak in a primary psychiatric hospital in a district of Tianjin, providing scientific basis for formulating TB prevention and control strategies in special settings. Methods: On April 16, 2025, three patients with etiologically-positive pulmonary tuberculosis were reported in a primary psychiatric hospital via the “China Information System for Disease Control and Prevention.” Field epidemiological investigation and outbreak management were conducted. The outbreak was followed up for 12 months, involving four rounds of screening, including detecting suspicious TB symptoms, Mycobacterium tuberculosis infection, and performing chest X-rays and laboratory tests. Descriptive epidemiological methods were used to systematically analyze the characteristics of the outbreak. Results: There were a total of 277 patients and staff in the hospital, including 74 close contacts (26.71%) and 203 general contacts (73.29%). A total of 154 individuals (55.60%) were identified as having latent tuberculosis infection (LTBI). IGRA positivity rate among close contacts was 77.03% (57/74), while that of general contacts was 47.78% (97/203); the difference was statistically significant (χ²=17.568, P<0.001). Comparing IGRA positivity rates across different wards, Ward 3 had the highest rate at 77.03% (57 positive cases) and identified most outbreak-related patients (6 cases); Ward 4 had the lowest rate at 38.36% (28 positive cases) and identified 1 patient. The difference between wards was statistically significant (χ²=20.254, P<0.001). A total of 13 PTB patients were identified in this outbreak. The first round of close contact screening revealed a high number of LTBI cases (154). Follow-up at 3 months identified 2 PTB patients (15.38%, 2/13), and follow-up at 6 months identified 8 patients (61.54%, 8/13). No new patients were found after the 9th month. Among the LTBI individuals, 45 cases (29.22%) received preventive treatment. Conclusion: As a key setting with high risk of PTB epidemic, primary psychiatric hospitals should conduct daily health monitoring for patients and medical staff. Suspected PTB cases should trigger statutory reporting procedures and be prioritized for referral to designated PTB diagnosis and treatment institutions. For individuals with LTBI, standardized pharmacological preventive interventions should be implemented, and the follow-up observation period for LTBI individuals should be extended to 2 years.

Expression and diagnostic value of SEMA4A in children with different Mycobacterium tuberculosis infection statuses

Wang Wenyu, Zhang Tongqiang

Chinese Journal of Antituberculosis. 2026, 48(7):  978-984.  doi:10.19982/j.issn.1000-6621.20260072

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Objective: To explore the expression of SEMA4A in different Mycobacterium tuberculosis infection states and evaluate its diagnostic value for active tuberculosis in children. Methods: The study prospectively collected 645 children who underwent flexible bronchoscopy in Tianjin Children’s Hospital from April 2020 to October 2025, and specimens were stored to establish a specimen bank. Two hundred and sixty-five children who met the inclusion and exclusion criteria were classified into four groups: active pulmonary tuberculosis (APTB) group, latent tuberculosis infection (LTBI) group, non-tuberculous respiratory inflammatory disease control (IDC) group, and non-infectious and non-tuberculosis control (NINTC) group. Frequency matching was used for balanced grouping, and a total of 200 cases were finally included, 50 cases per group. The concentrations of SEMA4A from serum and bronchoalveolar lavage fluid (BALF) were measured by ELISA. Level of SEMA4A mRNA from BALF was detected by qPCR, and SEMA4A protein expression by Western Blot. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic values. Results: The serum SEMA4A concentrations of the four groups measured by ELISA were: APTB group (5.505 (1.713, 7.101) pg/ml) was significantly higher than 3.909 (1.164, 5.146) pg/ml in the LTBI group, 3.061 (0.670, 4.249) pg/ml in the IDC group and 2.350 (1.103, 3.153) pg/ml in the NINTC group (Z=2.038, P=0.042; Z=2.684, P=0.007; Z=3.984, P<0.001). Overall inter-group difference among the four groups was statistically significant (H=9.327, P=0.025). qPCR detected average relative expression of SEMA4A mRNA in BALF of the APTB group was 6.112±0.440, higher than 4.124±0.272 in the LTBI group, 2.086±0.517 in the IDC group and 1.000±0.630 in the NINTC group. The LTBI group also had higher expression level compared with the IDC group and NINTC group, with all differences statistically significant (t=2.798, P=0.008; t=4.228, P<0.001; t=5.068, P<0.001; t=2.475, P=0.012; t=3.225, P=0.002). There was a significant difference among the four groups (F=128.387, P<0.001). Western Blot tested average relative expression of SEMA4A in BALF was 2.527±0.138 in the APTB group, which was higher than 1.917±0.384 in the LTBI group, 1.619±0.275 in the IDC group and 1.000±0.370 in the NINTC group. The LTBI group showed higher expression than the IDC group and NINTC group, and the differences were statistically significant (t=2.566, P=0.014; t=3.936, P<0.001; t=4.637, P<0.001; t=2.194, P=0.029; t=2.984, P=0.005). Significant inter-group difference was observed among the four groups (F=94.979, P<0.001).ROC curve analysis revealed that the AUC (95%CI) values of SEMA4A detected by ELISA, qPCR and Western Blot for active tuberculosis diagnosis were 0.776 (0.684-0.869), 0.848 (0.767-0.929) and 0.821 (0.736-0.906), respectively. Conclusion: Detection of SEMA4A expression can serve as an auxiliary indicator for the diagnosis of active tuberculosis in children, and qPCR assay of BALF exhibits the optimal diagnostic efficiency.

Performance evaluation of the Genewise-MTBC System in the rapid detection of the Mycobacterium tuberculosis complex

Wang Congli, Wang Haoran, Huang Hairong, Jiang Guanglu

Chinese Journal of Antituberculosis. 2026, 48(7):  985-991.  doi:10.19982/j.issn.1000-6621.20260027

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Objective: To preliminarily evaluate the performance of the Genewise-MTBC system for the Mycobacterium tuberculosis complex detection. Methods: Serially diluted type strains of M.tuberculosis and M.bovis were used to identify the limit of detection (LOD) of Genewise-MTBC. A total of 17 strains of nontuberculous mycobacteria (NTM) and 14 other pathogenic microorganisms were included to test its specificity. Meanwhile, potential interfering substances at their highest physiological concentrations were mixed with sputum to test the anti-interference ability of the system. Moreover, based on clinical diagnosis, Genewise-MTBC tests were performed on 71 clinical specimens in parallel with GeneXpert MTB/RIF assay to evaluate the clinical feasibility. Results: The LOD of Genewise-MTBC was defined as 18 CFU/ml for MTBC detection. Meanwhile, the test had no cross-reactivity with 17 NTM and 14 other respiratory pathogens. With clinical diagnosis as the gold standard, for the 71 clinical specimens, the sensitivities of Genewise-MTBC and GeneXpert MTB/RIF were 61.11% (33/54) and 57.41% (31/54), respectively; the specificities were 94.12% (16/17) and 100.00% (17/17), respectively; the positive predictive values were 97.06% (33/34) and 100.00% (31/31), respectively; and the negative predictive values were 43.24% (16/37) and 43.50% (17/40), respectively. Conclusion: The Genewise-MTBC system possesses high sensitivity, specificity, stability and anti-interference capability, which is worthy of a large-scale clinical evaluation in the future.

Risk factors for QTc interval >500 ms in patients with rifampicin-resistant tuberculosis treated with bedaquiline-containing regimens

Jiao Xiaoke, Dong Kexin, Yang Xinliang, Nie Wenjuan

Chinese Journal of Antituberculosis. 2026, 48(7):  992-999.  doi:10.19982/j.issn.1000-6621.20260087

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Objective: To investigate the risk factors for QTc interval >500 ms in patients with rifampicin-resistant tuberculosis (RR-TB) treated with bedaquiline (Bdq)-containing regimens, and to provide evidence for early identification of high-risk populations in clinical practice. Methods: A multicenter retrospective cohort study was conducted. Clinical data of 521 RR-TB patients treated with Bdq-containing regimens admitted to Beijing Chest Hospital Affiliated to Capital Medical University and Shaanxi Provincial Tuberculosis Prevention and Control Hospital from February 2018 to December 2025 was collected. The time from treatment initiation to the first occurrence of QTc interval >500 ms was used as the time variable, and a single electrocardiographic measurement of QTc >500 ms was defined as the endpoint event. Cox proportional hazards model was employed to analyze the relevant influencing factors. Results: Multivariable Cox regression analysis revealed that baseline QTc being 450-500 ms (adjusted hazard ratio (aHR)=6.640, 95% confidence interval (CI): 3.540-12.450), history of cardiac disease (aHR=5.840, 95%CI: 2.600-13.120), concurrent use of clofazimine (Cfz)(aHR=3.322, 95%CI: 1.247-8.855), concurrent use of delamanid (Dlm)(aHR=1.920, 95%CI: 1.040-3.550), triple-drug combination therapy (Bdq+Cfz+Dlm)(aHR=3.770, 95%CI: 1.320-10.790)were independent risk factors for QTc >500 ms. Conclusion: Baseline QTc being 450-500 ms, prior history of cardiac disease, concurrent use of Cfz or Dlm, triple-drug combination therapy (Bdq+Cfz+Dlm) all significantly increase the risk of QTc >500 ms in RR-TB patients. Enhanced electrocardiographic monitoring and individualized treatment strategies are recommended for these high-risk populations.

Evaluation of surgical outcomes in tuberculosis complicated with HIV/AIDS based on CD4⁺ T lymphocyte levels

Liu Aimei, Liu Sang, Feng Lizhen, Wang Qing

Chinese Journal of Antituberculosis. 2026, 48(7):  1000-1006.  doi:10.19982/j.issn.1000-6621.20260112

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Objective: To systematically evaluate the clinical indicators of patients with tuberculosis complicated by HIV/AIDS undergoing surgical treatment based on CD4⁺ T lymphocyte levels, analyze the changes in clinical and immunological indicators during long-term postoperative follow-up, and explore the factors influencing surgical efficacy and prognosis in this population. Methods: A retrospective study was conducted to collect the medical records of 59 patients with tuberculosis complicated by HIV/AIDS who underwent surgical treatment at Guangxi Zhuang Autonomous Region Chest Hospital from January 2017 to January 2023. The subjects were divided into the observation group (CD4⁺ T lymphocyte count <200 cells/μl, n=41) and the control group (CD4⁺ T lymphocyte count ≥200 cells/μl, n=18) according to preoperative CD4⁺ T lymphocyte counts. Preoperative general demographic characteristics, laboratory test indicators, as well as blood routine, liver and kidney function, immune function indicators and incision healing status at postoperative day 7, day 14, month 12 and month 24 were collected and compared between the two groups. Results: The proportion of non-tuberculous focus debridement in the observation group was 90.24% (37/41), significantly higher than 66.67% (12/18) in the control group; the proportion of grade Ⅰ/Ⅱ surgeries was 48.78% (20/41), significantly higher than 16.67% (3/18) in the control group; and the proportion of class Ⅰ incisions was 70.73% (29/41), significantly higher than 27.78% (5/18) in the control group, with statistically significant differences (χ²=4.940, 5.423, 11.763, all P<0.05). All subjects had poor preoperative nutritional status, with an abnormal hemoglobin rate of 71.19% (42/59) and an abnormal albumin rate of 66.10% (39/59). At 7 days postoperatively, the good incision healing rate was 72.88% (43/59), including 67.44% (29/43) in the observation group and 32.56% (14/43) in the control group; the poor incision healing rate was 27.12% (16/59), including 75.00% (12/16) in the observation group and 25.00% (4/16) in the control group. There was no statistically significant difference in incision healing status between the two groups at 7 days postoperatively (χ²=0.314, P=0.575). At 14 days postoperatively, only 4 subjects still had poor incision healing; at 28 days postoperatively, all incisions were completely healed, and no opportunistic infections or complications occurred during the entire period. During different postoperative follow-up periods, the abnormal rates of red blood cell count (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=9.692, P=0.002), white blood cell count (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=17.307, P<0.001), hemoglobin level (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=59.736, P<0.001), platelet count (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=9.637, P<0.001), aspartate aminotransferase level (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=12.320, P<0.001), total bilirubin level (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=5.494, P=0.019), direct bilirubin level (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=9.705, P=0.002) and albumin level (${\chi }_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}^{2}$=61.494, P<0.001) all showed a significant linear downward trend. Conclusion: The postoperative clinical recovery of patients with tuberculosis complicated by HIV/AIDS undergoing surgical treatment is closely related to their nutritional status, liver and kidney function, incision healing status and immune function. CD4⁺ T lymphocyte count <200 cells/μl is not an absolute contraindication to surgical treatment in this population. For patients scheduled for surgery with CD4⁺ T lymphocyte count <200 cells/μl, perioperative complication management should be completed under the guidance of infectious disease specialists, and surgery should be performed after comprehensive evaluation.

Effects of intervention scheme based on the theory of goal attainment on discharge readiness of patients with pulmonary tuberculosis

Wei Xiaowen, Dong Ning, Wu Yuanhao, Yang Jie, Yang Yijing, Shen Kelan, Zhang Lin

Chinese Journal of Antituberculosis. 2026, 48(7):  1007-1014.  doi:10.19982/j.issn.1000-6621.20260053

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Objective: To explore the application effects of a discharge preparation service program based on King’s theory of goal attainment in patients with pulmonary tuberculosis (PTB). Methods: Using purposive sampling, sixty-five patients with PTB from the TB department of Shanghai Public Health Clinical Center were enrolled as the control group (receiving routine discharge preparation) between August 2024 and October 2025. Another sixty-five PTB patients from the department of respiratory and critical care medicine were enrolled as the experimental group (receiving a discharge preparation service program based on King’s theory of goal attainment). During the study period, one patient dropped out from the experimental group and two from the control group, yielding a final sample of sixty-four patients in the experimental group and sixty-three in the control group. The two groups were compared on discharge readiness, length of hospital stay, self-management behaviors (pre- and post-intervention), unplanned readmission rates within two months after discharge, and the sputum negative conversion rate at the end of the second month after discharge. Results: After the intervention, the total score on the readiness for hospital discharge scale, as well as the scores on its personal status, adaptive ability, and anticipated support subscales, were significantly higher in the experimental group (89.82±9.69, 23.00 (20.00, 25.75), 37.75 (33.00, 40.50), 30.00 (25.25, 33.00)) than in the control group (79.62±11.03, 20.00 (18.00, 23.00), 34.50 (31.33, 37.00), 25.00 (22.00, 28.17)), with statistically significant differences (t=5.537, P<0.001; Z=-3.608, P<0.001; Z=-3.215, P=0.001; Z=-4.035, P<0.001). At two months after discharge, the total score on the self-management behavior scale, as well as the scores on its treatment adherence, treatment support, and transmission prevention subscales, were significantly higher in the experimental group (82.48±2.30, 23.31±1.77, 29.53±1.01, 29.64±0.76) than in the control group (78.05±4.27, 21.63±2.76, 27.78±1.87, 28.63±1.73), with statistically significant differences (t=7.271, P<0.001; t=4.068, P<0.001; t=6.563, P<0.001; t=4.236, P<0.001). The unplanned readmission rate within two months after discharge in the experimental group (14.06% (9/64)) was significantly lower than that in the control group (28.57% (18/63)), with a statistically significant difference (χ²=3.992, P=0.046). There was no statistically significant difference (Z=-0.230, P=0.818) in length of hospital stay between the experimental group (11.00 (9.00, 14.00) d) and the control group (11.50 (9.50, 14.00) d). At the end of the second month after discharge, the sputum negative conversion rate in the experimental group (91.67% (33/36)) showed no statistically significant difference (Fisher’s exact test,P=0.702) compared with the control group (87.88% (29/33)). Conclusion: The discharge preparation service based on King’s theory of goal attainment can effectively improve discharge readiness and self-management behavior, and reduce unplanned readmission rates within two months after discharge in patients with PTB, but has no significant effect on the length of hospital stay and sputum negative conversion rate at the end of the second month after discharge.

A qualitative study on symptom cluster experience and management needs of patients with post-tuberculosis lung disease

Zhou Wenxian, Qin Yamei, Yang Xuan, Zhao Na, Wu Kunli, He Qilian

Chinese Journal of Antituberculosis. 2026, 48(7):  1015-1020.  doi:10.19982/j.issn.1000-6621.20260172

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Objective: To explore symptom cluster experiences and needs for symptom cluster management in patients with posttuberculosis lung disease (PTLD), so as to provide evidence for developing targeted symptom cluster management protocols. Methods: Using purposive sampling, 15 patients with PTLD who met the inclusion and exclusion criteria and attended the Tuberculosis Department of Kunming Third People’s Hospital between December 2025 and January 2026 were recruited. Semistructured interviews were conducted, and Colaizzi’s method was used to transcribe, categorize, and extract themes from the interview data. Results: Three core themes were identified: core symptom cluster experiences (intertwined respiratory and systemic physical symptoms, coexisting psychological-emotional and sleep problems, insufficient disease awareness and misconceptions about medical care); diseaserelated practical burden (significant dual family and financial pressure); and core patient management needs (demand for individualized treatment and medication guidance, diseaserelated knowledge acquisition, and professional rehabilitation guidance). Conclusion: Symptom experiences in PTLD patients are multidimensional and intertwined, with overlapping physical, psychological, and financial burdens. Patients’ core needs regarding treatment, knowledge, and rehabilitation remain unmet. Clinically, an integrated management model combining individualized treatment, systematic health education, professional rehabilitation, and multidimensional support should be established to address patients’ physical and psychological needs as well as family practical pressures, thereby enhancing continuity of care and improving quality of life.

State-Target differentiation and treatment strategy for ulcerative lymph node tuberculosis with external application of Sanjie Plaster

Gao Xian, Shang Xiyu, Liu Tiantian, Yang Jie, Li Zixi, Sun Yange, Wei Jinsheng, Cheng Shiming, Ma Yan, Li Hongzhi

Chinese Journal of Antituberculosis. 2026, 48(7):  1021-1029.  doi:10.19982/j.issn.1000-6621.20260094

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Based on the “State-Target” theory proposed by Academician Tong Xiaolin, this study systematically elucidates the dynamic evolution of lymph node tuberculosis, establishes a “three-stage and four-state” syndrome differentiation framework. Within this framework, deeply analyzes the “state-regulating” and “target-hitting” mechanisms of the clinical empirical formula Sanjie Tie (Dispersion Plaster) in the external treatment of lymph node tuberculosis during the ulcerative stage. The disease course of lymph node tuberculosis follows a dynamic pathological evolution pathway of “stagnation (qi stagnation and phlegm coagulation, early stage)→stasis (phlegm and blood stasis, early stage)→fire (yin deficiency and fire effulgence, middle stage)→deficiency (qi and blood deficiency, late stage)”. For the core pathogenesis of “lingering heat stasis with qi-blood deficiency” in the ulcerative stage, Sanjie Plaster uses Huangqi (Astragali Radix) to tonify qi and nourish blood, eliminate toxins and promote tissue regeneration; and employs Danshen (Salviae Miltiorrhizae Radix), Tianhuafen (Trichosanthis Radix), Ruxiang (Olibanum) and Moyao (Myrrha) to clear heat and resolve stasis for state regulation. Meanwhile, it achieves target-striking effects through multi-components and multi-pathways, including promoting wound healing, alleviating pain, regulating abnormal cytokine levels and enhancing immune function, thus realizing the synergy of state and target as well as the combination of internal and external treatment. The “State-Target” theory provides an innovative theoretical framework for the precise differentiation and treatment of lymph node tuberculosis in traditional Chinese medicine, and the external treatment with Sanjie Tie demonstrates clear clinical efficacy and promotional value under the guidance of the theory.

Clinical study on adjuvant therapy of oral and external traditional Chinese medicine for abdominal tuberculosis complicated with intestinal obstruction

Li Jike, Luo Mei, Zou Liping, Ye Qing, Luo Xiangyi, Gong Mengmeng, Zhang Huifang, Cao Yuqing, Fu Xiaoyan, Feng Xia, Zhou Xiaolong, Yang Yingmei, Pang Wenxiao, Ma Yan, Wu Guihui

Chinese Journal of Antituberculosis. 2026, 48(7):  1030-1037.  doi:10.19982/j.issn.1000-6621.20260125

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Objective: To explore the adjuvant therapeutic value of combined oral and external traditional Chinese medicine (TCM) on intestinal function recovery in patients with abdominal tuberculosis complicated with intestinal obstruction on the basis of conventional Western medicine treatment. Methods: A retrospective cohort study was conducted. A total of 86 patients diagnosed with abdominal tuberculosis complicated with intestinal obstruction admitted between January 1, 2024 and December 31, 2024 were enrolled and divided into integrated traditional Chinese and Western medicine group and control group according to whether TCM therapy was applied. Patients in the control group received conventional Western medicine treatment, including standardized anti-tuberculosis therapy, gastrointestinal decompression, nutritional support and symptomatic treatment. On this basis, the integrated medicine group was additionally given comprehensive TCM interventions consisting of oral/nasogastric administration of TCM decoction, abdominal TCM hot compress and TCM enema. The time to relief of abdominal pain and abdominal distension, time to first flatus and defecation, recovery time of bowel sounds, imaging improvement time, incidence of complications, proportion of patients undergoing abdominal surgery due to intestinal obstruction and adverse reactions were compared between the two groups. Results: Among the 86 enrolled patients, 42 cases were assigned to the integrated medicine group and 44 cases to the control group. The median time to abdominal pain relief in the integrated medicine group was 30 (24, 48) h, which was significantly shorter than 72 (39, 96) h in the control group (Z=481.000, P<0.001). Meanwhile, the time to abdominal distension relief (72 (48, 96) h vs. 96 (54, 126) h), time to first flatus (24 (4, 24) h vs. 48 (36, 90) h), time to first defecation (48 (24, 72) h vs. 96 (48, 120) h), recovery time of bowel sounds (42 (24, 72) h vs. 72 (48, 120) h) and time for most disappearance of abdominal gas-fluid levels on imaging examination (72 (48, 96) h vs. 96 (72, 160) h) were all obviously shorter than those in the control group, with statistically significant differences (Z=600.000, P=0.004; Z=245.500, P<0.001; Z=377.500, P<0.001; Z=488.000, P<0.001; Z=449.500, P=0.015 respectively). The proportion of patients receiving abdominal surgery for intestinal obstruction was 9.5% (4/42) in the integrated medicine group, lower than that in the control group (20.5% (9/44)), while no significant difference was observed (χ²=2.001, P=0.157). There were no significant differences in the incidence of complications (57.1% (24/42) vs. 52.3% (23/44)) and adverse reactions (23.8% (10/42) vs. 45.5% (20/44)) between the two groups (χ²=0.206, P=0.650; χ²=1.952, P=0.162). Conclusion: Combined application of oral and external TCM therapy based on conventional Western medicine treatment can significantly accelerate the relief of clinical symptoms and promote the recovery of intestinal function in patients with abdominal tuberculosis complicated with intestinal obstruction, which possesses potential clinical application advantages.

An association study of the comorbidity spectrum and core traditional Chinese medicine syndromes in 832 elderly patients with pulmonary tuberculosis

Feng Yinping, Luo Shuirong, Liu Zhongda, Zhang Zunjing

Chinese Journal of Antituberculosis. 2026, 48(7):  1038-1043.  doi:10.19982/j.issn.1000-6621.20260160

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Objective: To characterize the comorbidity spectrum of elderly patients with pulmonary tuberculosis, explore its association with core traditional Chinese medicine (TCM) syndromes, and analyze differences across age and gender strata, so as to provide evidence for syndrome-disease integrated individualized management. Methods: A retrospective analysis was conducted. A total of 832 elderly patients with pulmonary tuberculosis hospitalized at Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2022 to October 2024 were enrolled. Demographic data, TCM syndromes, and comorbidities were collected via electronic medical records. The distribution of comorbidities and their associations with two core syndromes—qi-yin deficiency syndrome and yin-yang deficiency syndrome—were analyzed. Stratified analyses were performed by age (60-69 years, 70-79 years, ≥80 years) and gender. Results: Among the 832 patients, the overall comorbidity prevalence was 64.66% (538/832). The top three comorbidities were hypertension (32.57% (271/832)), respiratory diseases (29.57% (246/832)), and diabetes mellitus (25.00% (208/832)). Patients with ≥3 comorbidities accounted for 21.75% (181/832). The core TCM syndromes were qi-yin deficiency syndrome (39.30% (327/832)) and yin-yang deficiency syndrome (25.36% (211/832)). Compared with patients with yin-yang deficiency syndrome, those with qi-yin deficiency syndrome had higher rates of diabetes mellitus (44.65% (146/327) vs. 28.44% (60/211); OR=2.030, 95%CI: 1.400-2.944) and respiratory diseases (44.65% (146/327) vs. 26.54% (56/211); OR=2.230, 95%CI: 1.532-3.247). In contrast, they had lower rates of chronic kidney disease (3.67% (12/327) vs. 22.27% (47/211); OR=0.133, 95%CI: 0.069-0.257), malignancy (6.73% (22/327) vs. 17.06% (36/211); OR=0.351, 95%CI: 0.199-0.619), and multimorbidity (≥3 conditions)(25.69% (84/327) vs. 34.12% (72/211); OR=0.667, 95%CI: 0.460-0.968). Conclusion: Elderly patients with pulmonary tuberculosis carry a heavy comorbidity burden. Core TCM syndromes are distinctly associated with specific comorbidities, suggesting that stratified and individualized interventions should be implemented based on syndrome-disease interactions.

Adjuvant therapy with Zhonghe Decoction for abscess lymph node tuberculosis with Qi and blood deficiency syndrome: a randomized controlled trial on short-term efficacy

Zhao Liping, Zong Xingyu, Cao Yuqing, Jiang Hui, Cai Qiujie, Ma Yan, Mu Tingting, Liu Xiaoming, Liu Bin, Liang Bowen, Cao Yanhua, Li Bo, Luo Jingyue, Wang Guirong, Huang Mailing

Chinese Journal of Antituberculosis. 2026, 48(7):  1044-1050.  doi:10.19982/j.issn.1000-6621.20250480

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Objective: To evaluate the short-term efficacy of Zhonghe Decoction as an adjuvant therapy for abscess lymph node tuberculosis with Qi and blood deficiency syndrome. Methods: A prospective randomized controlled design was adopted. A total of 80 patients with non-drug-resistant cervical abscess lymph node tuberculosis (Qi and blood deficiency syndrome) admitted to Beijing Chest Hospital, Capital Medical University from January 2022 to December 2024 were enrolled and randomly divided into an observation group and a control group, with 40 cases in each group. After 7 dropouts, 36 cases were finally included in the observation group and 37 cases in the control group. Both groups received the H-R-Z-E (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) anti-tuberculosis regimen for one year. The observation group was additionally treated with Zhonghe Decoction for 6 months. Abscess size, Traditional Chinese Medicine (TCM) syndrome score, quality of life score, and adverse reactions were evaluated in both groups before treatment, at 6 weeks, and at 24 weeks of treatment. Results: At 6 weeks of treatment, the abscess improvement rate in the observation group was 77.78% (28/36), significantly higher than that in the control group (32.43%, 12/37)(χ²=15.150, P<0.05); the total effective rate for TCM syndrome efficacy was 88.89% (32/36) in the observation group, also superior to that in the control group (27.03%, 10/37)(χ²=28.590, P<0.05). At 24 weeks of treatment, the favorable outcome rate in the observation group was 72.22% (26/36), significantly higher than that in the control group (27.03%, 10/37)(χ²=14.920, P<0.05). Regarding quality of life,, after 6 weeks of treatment, the median (interquartile range) score for physical functioning in the observation group was 3.98 (-0.42, 8.38), while that in the control group was 0.34 (-4.86, 5.53), with a statistically significant difference (Z=226.290, P<0.05). The score for role-physical in the observation group was 59.93 (20.36, 99.50), compared to 33.24 (-26.76, 93.23) in the control group, showing a statistically significant difference (Z=212.203, P<0.05). The score for bodily pain in the observation group was 24.50 (-4.75, 53.75), while that in the control group was 12.50 (-4.12, 24.50), with a statistically significant difference (Z=224.837, P<0.05). No serious adverse events occurred in two groups. Conclusion: Zhonghe Decoction can promote the absorption of abscesses in lymph node tuberculosis, accelerate symptom relief, and improve patients’ quality of life, demonstrating definite efficacy and good safety.

Bibliometric analysis of research on post-tuberculosis sequelae (2006—2025): a preliminary exploration based on Web of Science

Yin Shiliu, Xu Dan, Li Zheng, Wang Yanqian, Li Fengsen

Chinese Journal of Antituberculosis. 2026, 48(7):  1051-1063.  doi:10.19982/j.issn.1000-6621.20260030

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Objective: To analyze the research characteristics, hot topics, and knowledge context in the field of post-tuberculosis sequelae using bibliometric methods, so as to provide references for further in-depth exploration in this field. Methods: Based on the Web of Science Core Collection database (a rigorously curated repository of high-quality academic resources covering multiple sub-databases including SCIE and SSCI, which systematically presents global research outcomes in the field), relevant “articles” and “reviews” on post-tuberculosis sequelae published between January 1, 2006, and December 1, 2025, were retrieved. Subsequently, two software tools—CiteSpaceV6.4.R1 and VOSviewer 1.6.18 were used to conduct a systematic analysis of the literature’s publication characteristics, distribution of countries/institutions/authors, journal distribution, cooperation networks, literature co-citation relationships, as well as the clustering, co-occurrence, burstiness, and timeline evolution of keywords. Results: From 2006 to 2025, the number of publications on post-tuberculosis sequelae gradually increased from 2 in 2006 to 42 in 2025, showing a steady growth trend. These publications involved 45 countries/regions and 44 journals. The top five countries in terms of publication volume were the United States (74 articles), the United Kingdom (55 articles), South Africa (48 articles), China (36 articles), and South Korea (23 articles). The top three high-yield institutions were the University of Cape Town (10 articles), Stellenbosch University (9 articles), and the University of the Witwatersrand (7 articles). Keyword analysis revealed a total of 333 keywords and 671 connections, with a network density of 0.012. The clustering graph showed Q=0.6656 and S=0.8486, and the clusters were airflow obstruction, pulmonary rehabilitation, antiretroviral therapy, pulmonary function impairment, chronic pulmonary aspergillosis, post-tuberculosis lung disease, chronic obstructive pulmonary disease, risk factors, lung neoplasm, and pulmonary fibrosis in sequence. Research hotspots focused on post-tuberculosis lung disease, pulmonary function impairment, epidemiological characteristics, risk factors, and social burden of post-tuberculosis sequelae, among which post-tuberculosis lung disease maintained a consistently high burst intensity. Conclusion: Current research on post-tuberculosis sequelae focuses on core topics such as airflow obstruction, post-tuberculosis lung disease, and pulmonary function impairment. Although there have been explorations related to pulmonary rehabilitation interventions, precise protocols and consensus guidelines are still lacking. Future research should focus on the core directions of pathogenesis, precise intervention, and rehabilitation management, increase research investment and exploration efforts, and improve the multidisciplinary collaboration system, so as to comprehensively enhance the quality of prevention and treatment of post-tuberculosis sequelae and the long-term health of patients.

Review Articles

Clinical research progress on isoniazid combined with rifapentine regimen in Chinese population with latent tuberculosis infection

Yang Tao, Song Yanhong, Shi Xiaoying, Zheng Yuanhang, Qian Kai, Li Jing, Luo Yi

Chinese Journal of Antituberculosis. 2026, 48(7):  1064-1068.  doi:10.19982/j.issn.1000-6621.20250475

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Tuberculosis (TB) remains a major global public health challenge. In China, the population with latent tuberculosis infection (LTBI) exceeds 200 million, and preventive therapy represents a pivotal pathway to ending the TB epidemic. Traditional long-course regimens are afflicted by low treatment coverage, stemming from poor patient adherence and concerns over adverse reactions. Endowed with the core advantages of shortened treatment duration and reduced therapeutic burden, the isoniazid-rifapentine (H-P) regimen has been further developed into a diverse array of short-course protocols tailored to distinct populations through targeted adjustment of dosage and administration frequency. The authors systematically review the advances in relevant domestic clinical researches over the past decade, with a focused analysis of treatment completion rate, adverse reaction profiles and preventive effectiveness of various H-P short-course regimens in both the general LTBI population and special populations including silicosis patients, hemodialysis recipients, elderly patients with diabetes. It further clarifies the clinical application scenarios and limitations of different regimens, aiming to provide evidence-based references for the safe and effective clinical selection of H-P short-course protocols for LTBI populations in China.