ObjectiveTo investigate the clinical characteristics of non-tuberculous mycobacterium (NTM) pulmonary disease and pulmonary tuberculosis, as well as the bacterial distribution of NTM pulmonary disease. Methods The bacterial distribution and clinical characteristics of 104 patients with NTM lung disease hospitalized in Jiangxi Provincial People’s Hospital from May 2017 to May 2020 were retrospectively analyzed, as well as the clinicplal characteristics of 155 patients with tuberculosis hospitalized during the same period. Results The age of NTM lung disease group [(60±15) years] was higher than that of tuberculosis group [(55±19) years]. There were statistically significant differences in basic diseases (such as malignant tumor, type 2 diabetes, old tuberculosis, bronchiectasis), laboratory examination (such as blood routine examination, albumin) and chest imaging characteristics between the two groups (P<0.05). There was no significant difference in clinical symptoms (such as cough, sputum or fever) (P>0.05). The common underlying diseases of NTM lung disease were malignant tumor (29%), bronchiectasis (21%), chronic obstructive pulmonary disease (19%), etc. The common clinical symptoms of NTM lung disease included cough, sputum, fever, hemoptysis, chest tightness and shortness of breath, and other non-specific respiratory symptoms. The common manifestations of NTM lung disease on chest high-resolution CT (HRCT) included patchy images (82%), mediastinal lymph node enalargement (35%), pleural thickening (31%), pleural effusion (26%) and other signs. The isolates of NTM included Mycobacterium avium (50%), Mycobacterium intracellulare (21%), Mycobacterium chelonae/abscessus (14%), Mycobacterium fortuitum (5%), Mycobacterium gordonae (4%), Mycobacterium gilvum (3%), and Mycobacterium smegmatis (3%). Multivariate Logistic regression analysis showed that advanced age (OR=1.027) was a risk factor for NTM lung disease. Conclusions The clinical manifestations of NTM lung disease and tuberculosis are similar and difficult to distinguish. For male patients over 60 years old with malignant tumor, old tuberculosis, bronchiectasis and other basic diseases, and the chest HRCT findings are mainly bronchiectasis, NTM lung disease should be actively excluded. There is little difference in clinical manifestations between different strains of NTM lung disease, and the treatment cycle of NTM lung disease is long and easy to be interrupted, requiring enhanced follow-up.
ObjectiveTo compare the clinical data of pulmonary lobectomy in patients with massive hemoptysis of pulmonary tuberculosis after bronchial artery embolization in the short and long term, so as to provide a reference for clinical choices of appropriate operation time.MethodsA retrospective analysis was conducted on 33 patients with massive hemoptysis of pulmonary tuberculosis, who had received pulmonary lobectomy after bronchial artery embolization in Wuhan Pulmonary Hospital from January 2015 to November 2017, including 29 males and 4 females aged of 23-66 (52.64±9.70) years. According to the time interval between bronchial artery embolization and lobectomy, the patients were divided into a short-term group (<2 weeks, 14 patients) and a long-term group (>1 month, 19 patients). The clinical data, such as operation time, intraoperative blood loss, postoperative extubation time and serious postoperative complications, were observed in the two groups for statistical analysis.ResultsThe operative time (297.13±75.69 min vs. 231.32±67.57 min, P=0.013), intraoperative blood loss (685.74±325.51 mL vs. 355.83±259.11 mL, P=0.002), postoperative extubation time (14.07±5.24 d vs. 8.90±3.57 d, P=0.003) of the short-term group were all higher than those in the long-term group.ConclusionFor the patients with massive hemoptysis of pulmonary tuberculosis, who had surgical indications and no risk of early rebleeding after bronchial artery embolization, pulmonary lobectomy should be performed late until the patient's physical condition and the primary disease was stable.
Objective To assess the effect of astragaulus membranaceus in the treatment of pulmonary tuberculosis. Methods Through applying the methods provided by the Cochrane Collaboration, the randomized controlled trials (RCTs) or quasi-RCTs of astragaulus membranaceus in the treatment of pulmonary tuberculosis were searched in The Cochrane Library (Issue 3, 2010), CNKI (1991 to May 2010), VIP (1989 to May 2010), EMbase (1981 to May 2010), and PubMed (1981 to May 2010). Two reviewers independently screened the included studies, extracted the data, assessed the quality, and cross checked then. The RevMan 5.0 software was used to conduct meta-analyses. Results Twelve RCTs involving 1 054 patients were included. All trials were tested in the mainland China. The results of meta-analyses showed that: a) The astragaulus membranaceus could assist the conventional drug to cure pulmonary tuberculosis, promote sputum negative conversion, focal absorption and cavity reduction in lung; b) The astragaulus membranaceus could reduce the adverse reactions of the conventional drug; c) The astragaulus membranaceus combined with the conventional drug could improve the patients’ symptoms and signs; and d) The astragaulus membranaceus combined with the conventional drug could reduce the bacterial relapse rates in follow-up after treatment. Conclusion The current evidence shows that the astragaulus membranaceus has some effects and is relatively safe to treat pulmonary tuberculosis. However, it is far from enough to recommend astragaulus membranaceus as a conventional adjuvant therapy for pulmonary tuberculosis because of no sufficient evidence obtained from this study for its small sample and low methodology quality. Therefore, more double-blind multi-center RCTs with high quality, large sample, and adequate follow up are required for further verification.
Ferroptosis is a unique way of cell death discovered in recent years, which involves the lethal process of iron ion accumulation and lipid peroxidation, which is obviously different from the traditional cell death pathway such as apoptosis and necrosis. For a long time, tuberculosis has been a major infectious disease in the field of global public health, which brings a serious burden to the society because of its high morbidity and mortality. The emergence of drug resistance aggravates the difficulty of treating tuberculosis, and new treatment strategies and drug targets are urgently needed. Combined with the latest research progress at home and abroad, This article will discuss the molecular mechanism of ferroptosis and pulmonary tuberculosis and the relationship between signal pathways, biomarkers and related genes, in order to provide a new perspective for the diagnosis and treatment of pulmonary tuberculosis.
Objective To investigate the evaluation value of serum interleukin-34 (IL-34), macrophage migration inhibitor (MIF), osteopontin (OPN) and hypersensitive C-reactive protein (hs-CRP) in the diagnosis and prognosis of active pulmonary tuberculosis. Methods Clinical data of 100 patients with active pulmonary tuberculosis admitted from June 2019 to June 2022 were selected as an observation group and retrospectively analyzed. All patients received standardized anti-tuberculosis therapy for 6 months and were divided into a good prognosis group (76 cases) and a poor prognosis group (24 cases) according to the prognosis. Another 80 healthy volunteers who underwent physical examination during the same period were selected as the control group. Serum levels of IL-34, MIF, OPN and hs-CRP were detected in each group, and the value of serum IL-34, MIF, OPN and hs-CRP in the diagnosis and prognosis of active pulmonary tuberculosis was analyzed by receiver operating characteristic curve (ROC curve). Results Serum levels of IL-34, MIF, OPN and hs-CRP in the observation group were higher than those in the control group (all P<0.05). ROC curve showed that serum IL-34, MIF, OPN, hs-CRP had a certain diagnostic value in active pulmonary tuberculosis, with area under ROC curve (AUC) of 0.864, 0.870, 0.865, and 0.880, respectively (all P<0.01), and the combination of the four indexes had a higher diagnostic value (AUC=0.902, P<0.01). Serum levels of IL-34, MIF, OPN and hs-CRP in the good prognosis group were lower than those in the poor prognosis group (all P<0.05). ROC curve showed that serum IL-34, MIF, OPN, hs-CRP had a certain value in evaluating the prognosis of active pulmonary tuberculosis, with AUC of 0.850, 0.874, 0.837, and 0.842, respectively (all P<0.01), and the combined value of the four indexes was higher (AUC=0.923, P<0.01). Conclusion The combined detection of serum IL-34, MIF, OPN and hs-CRP has high value in the diagnosis and prognosis assessment of active pulmonary tuberculosis.
ObjectiveTo investigate the feasibility of video-assisted thoracoscopic surgery (VATS) lung resection in the treatment of tuberculosis.MethodsWe retrospectively analyzed the clinical data of 164 tuberculosis patients who underwent lung resection in Xi'an Chest Hospital from 2013 to 2017. Patients were divided into two groups according to the surgical procedure: a VATS group (85 patients, 56 males and29 females) and a thoracotomy group (79 patients, 52 males and 27 females). The clinical effect of the two groups was compared.Results Compared to the thoracotomy group, the VATS group had less operation time (151.59±76.75 min vs. 233.48±93.89 min, P<0.001), amount of intraoperative blood loss (200.00 ml vs. 600.00 ml, P<0.001), the postoperative drainage (575.00 ml vs. 1 110.00 ml, P=0.001), extubation time (4 d vs. 6 d, P<0.001) and hospital stay (13.00 d vs. 17.00 d, P<0.001). There was no statistical difference in postoperative complications (10 patients vs.17 patients, P=0.092) between the two groups. A total of 97 patients underwent lobectomy, including 36 of the VATS group and 61 of the thoracotomy group. The operation time (211.39±70.88 min vs. 258.20±87.16 min, P=0.008), the intraoperative blood loss (400.00 ml vs. 700 ml, P<0.010), the postoperative drainage (800.00 ml vs. 1 250.00 ml, P=0.001), extubation time (5.00 d vs. 8.00 d, P=0.002) and hospital stay (13.11±4.45 d vs. 19.46±7.74 d, P<0.010) in the VATS group were significantly better than those in the thoracotomy group. There was no statistical difference in postoperative complication rate (4 patients vs. 14 patients, P=0.147) between the two[1], groups.ConclusionCompared with conventional thoracotomy, VATS lung resection has obvious advantages in treatment of tuberculosis, which may be the preferred technique.
ObjectiveTo be aware of the current situation of nurses' protective consciousness on pulmonary tuberculosis in one of the top hospitals, and to discuss its influencing factors, in order to provide references for better improving nurses' tuberculosis protection consciousness. MethodsBy using random sampling method, we selected the nurses who met the requirements to participate in the questionnaire investigation, between March and May 2014. According to the results, we evaluated their protective awareness on tuberculosis and its influencing factors. ResultsWe delivered 320 questionairs and took back 316. Nurses with different age, length of nursing work, professional rank, job title, educational background, and tuberculosis prevention knowledge training status had significantly different scores (P < 0.05). The multiple linear regression analysis was carried out with total scores of tuberculosis prevention knowledge as dependent variable, and age, professional rank, length of nursing work, educational background and tuberculosis prevention knowledge training as independent variable. The results showed that age, educational background, and tuberculosis prevention knowledge training were influencing factors of tuberculosis prevention knowledge scores (P < 0.05). ConclusionPulmonary tuberculosis prevention knowledge in nurses remains to be further promoted, and we should especially strengthen the prevention knowledge training for nurses with short working experience and low-degree education.