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 explore the value of the single-direction lobectomy in the treatment of complicated pulmonary tuberculosis.MethodsA retrospective analysis was performed on 88 patients with complicated pulmonary tuberculosis who received lobectomy in our hospital from 2017 to 2019. There were 64 males and 24 females, with an average age of 21-70 (47.67±13.39) years. According to the surgical procedure, patients who received single-direction lobectomy were divided into a single-direction group (n=32), and those who received traditional lobectomy were divided into a control group (n=56).ResultsThe two groups had no statistical differences in gender, age, primary disease and complications, lesion morphology, clinical symptoms, operative site, interlobitis adhesion or hilar mediastinal lymph node calcification (P>0.05). Operation time [210.0 (180.0, 315.0) min vs. 300.0 (240.0, 320.0) min], intraoperative blood loss [200.0 (100.0, 337.5) mL vs. 325.0 (200.0, 600.0) mL], postoperative lung air leak time [3.0 (2.0, 5.0) d vs. 9.0 (6.8, 12.0) d] and the postoperative hospital stay [11.5 (8.0, 14.8) d vs. 18.0 (14.0, 22.0) d] of the single-direction group were less or shorter than those of the control group (P<0.05). There was no statistical difference between the single-direction group and the control group in the incidence of surgical complications [1 patient (3.12%) vs. 10 patients (17.86%)] or the cure rate [32 patients (100.00%) vs. 54 patients (96.43%)].ConclusionThe single-direction lobectomy can reduce lung injury and bleeding, shorten the duration of operation and accelerate the postoperative recovery in patients with complicated pulmonary tuberculosis, which has certain advantages compared with traditional lobectomy.
Objective To describe the underlying conditions of chronic pulmonary aspergillosis (CPA). Methods A retrospective study was performed. Details of the clinical, imaging features, and the underlying conditions of CPA patients admitted to a tertiary university teaching hospital from January 2009 to December 2016 were extracted from clinical records. The classification distribution of CPA, and underlying conditions were analyzed. Results Among the 108 CPA patients, 87 cases had underlying conditions, 21 cases had no underlying conditions. Seventy two (66.7%) patients were engaged in agriculture, the proportion of which was significantly higher in the cases without underlying conditions (85.7% vs. 62.1%). Chronic necrotizing pulmonary aspergillosis (CNPA) was the most common type of these CPA cases. The cases without underlying conditions had significantly more proportion of CNPA than the cases with underlying conditions (85.7% vs. 62.1%). The cases with systemic underlying conditions had significantly more proportion of CNPA than the cases only with pulmonary underlying conditions (82.8% vs. 51.7%). Chronic cavity pulmonary aspergillosis (24/108, 22.2%) only existed in the cases with pulmonary underlying conditions. Underlying conditions were identified in 87 cases of CPA, with 85.1% (74/87) pulmonary and 33.3% (29/87) systemic underlying diseases. Previous tuberculosis mycobacterial infection, bronchiectasis and chronic obstructive pulmonary disease were the most common pulmonary underlying conditions (40.2%, 39.1% and 35.6%, respectively). Diabetes (16.1%) and glucocorticoid using (13.8%) were the most two common systemic underlying conditions. Conclusions CPA can occur in patients with and without underlying diseases. CNPA is the most common type of these CPA, the proportion of which is higher in cases without underlying conditions and cases with systemic underlying conditions. Farming maybe the risk factors of CPA. Chronic pulmonary primary diseases are the most common underlying conditions. The most common systemic factors are diabetes and glucocorticoid using.
ObjectiveTo explore the relationship between the single nucleotide polymorphisms of interleukin (IL)-23R gene and susceptibility to pulmonary tuberculosis in Southwest Chinese Han population.MethodsA total of 680 pulmonary tuberculosis patients (pulmonary tuberculosis group) and 680 healthy controls (healthy control group) diagnosed or examined between January 2014 and February 2016 were recruited from West China Hospital, Sichuan University. Improved multiplex ligation detection reaction (iMLDR) method was used to detect the polymorphism of rs1495965, rs7518660, rs7532161, rs10889677 and rs11465802 of IL-23R gene. The differences in allele frequency distribution, genotype, and genetic model of these five loci between pulmonary tuberculosis patients and healthy control were conducted by using SPSS20.0 and PLINK 1.07. Linkage disequilibrium and haplotype analysis were also carried out by Haploview 4.2.ResultsFinally, 657 pulmonary tuberculosis patients and 669 healthy controls were enrolled for further analyzed. The difference in the allele frequency distribution A (P=0.048), AA genotype (P=0.048) and additive model AA/GG (P=0.048) in rs1495965 was significant between the pulmonary tuberculosis group and healthy control group when we adjusted the gender and age. However, after correction by Bonferroni, the differences in allele frequency distribution, genotype and additive model of all these five loci between the two groups were not statistically significant (P>0.05). rs7518660, rs10889677 and rs11465802 had strong linkage disequilibrium (LD) with each other (r2>0.80); however, there was no association between haplotype GCA and tuberculosis susceptibility (P=0.343).ConclusionsThere is no association between rs1495965, rs7518660, rs7532161, rs10889677 and rs11465802 of IL-23R gene and genetic pulmonary tuberculosis susceptibility in Southwest Chinese Han population. To add loci in the coding region and analysis in different populations is necessary.
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.
ObjectiveTo observe the impact of perioperative nursing intervention on pulmonary tuberculosis patients undergoing lung resection. MethodThirty-six pulmonary tuberculosis patients going to undergo lung resection hospitalized between January and December 2013 were randomly divided into intervention group and control group with 18 in each. Patients in the intervention group received routine perioperative care plus nursing intervention including preoperative, environmental, dieting and pain intervention. Then, complications, hospitalization time and costs, as well as patients' satisfaction with the nursing work were compared between the two groups. ResultsAfter nursing intervention, complications, hospitalization time, hospital costs of patients in the intervention group were significantly less than the control group (P<0.05), and patients' satisfaction was significantly higher (P<0.05). ConclusionsPerioperative nursing intervention on lung resection treatment and rehabilitation of patients play an active and effective role, which can reduce complications, shorten hospitalization time, reduce hospital costs and improve patients' satisfaction.
ObjectiveTo investigate the diagnostic value of products triggered by endotoxin including cytokines and procalcitonin for differentiating bacterial pneumonia from pulmonary tuberculosis. MethodsFifty patients diagnosed to have hospital-acquired pneumonia and another 50 patients diagnosed with tuberculosis admitted into West China Hospital between January and August 2015 were recruited in this study. The frequencies of CD4+ interferon (IFN)-γ+, CD4+ tumor necrosis factor (TNF)-α+, CD4+ interleukin (IL)-2+, CD4+ IL-10+ as well as CD8+IFN-γ+, CD8+TNF-α+, CD8+IL-2+, CD8+IL-10+ populations in peripheral blood were detected by flow cytometry after endotoxin stimulation. Meanwhile, the levels of procalcitonin, IL-6 and C reactive protein were measured by immunofluorescence staining. ResultsThe frequencies of CD4+ IFN-γ+, CD4+ TNF-α+, CD4+ IL-2+, CD4+ IL-10+ as well as CD8+ IFN-γ+, CD8+ TNF-α+, CD8+ IL-2+, CD8+ IL-10+ populations in the pneumonia group increased significantly compared with those in the tuberculosis group (P < 0.05). The levels of procalcitonin, IL-6 and C-reactive protein in the pneumonia group increased statistically compared with the counterparts in the tuberculosis group (P < 0.05). The positive rates of procalcitonin, IL-6 and C-reactive protein in the pneumonia group were significantly higher than those in the tuberculosis group (P < 0.05). ConclusionMeasurement of products triggered by endotoxin is beneficial for differential diagnosis of pneumonia from tuberculosis.
Objectives To evaluate the effect and safety of mycobacterium vaccae in the treatment of recurrent treated pulmonary tuberculosis. Methods We searched PubMed (1997 to 2006), VIP (1997 to 2006), Wanfang database (1997 to 2006), The Cochrane Central Register of Controlled Trials (Issue 4, 2006) and the National Research Register (1996 to 2006). Randomized controlled trials comparing the mycobacterium vaccae immunotherapy group and the control group were included. Two reviewers independently performed data extraction and quality assessment. Data were analyzed using RevMan 4.2.2 software by The Cochrane Collaboration. Results Eleven high quality trials were included. Meta-analyses showed that mycobacterium vaccae immunotherapy plus chemotherapy resulted in higher sputum negative conversion rate (RR=1.36, 95%CI 1.21 to 1.54), higher lesion absorption rate (RR=1.39, 95%CI 1.13 to 1.72), and lower lesion non-absorption rate (RR=0.46, 95%CI 0.36 to 0.60), compared with the control group. These differences were all statistically significant. No serious adverse events were reported. Conclusion As an adjunct to chemotherapy, mycobacterium vaccae is helpful for patients with recurrent treated pulmonary tuberculosis in terms of improving cell-medicated immunity, sputum negative conversion and X-ray manifestation. More high quality studies are needed for further analysis.
Objective To analyze the report status of the pulmonary tuberculosis in the elderly people aged ≥ 65 years old. Methods The reported data of senile pulmonary tuberculosis and the whole population pulmonary tuberculosis at West China Hospital of Sichuan University between January 1, 2012 and December 31, 2022 were retrospective selection. Descriptive methods were used to analyze the different characteristics and etiology of senile pulmonary tuberculosis. Results A total of 2 182 senile pulmonary tuberculosis were reported. The report was mainly positive reports of etiology [1091 cases (50.00%)], and the component ratio increased year by year (χ2=49.986, P<0.001). The proportion of senile pulmonary tuberculosis in the whole population pulmonary tuberculosis increased from 17.62% in 2012 to 29.04% in 2022, and the difference between different years was statistically significant (χ2=40.261, P<0.001). In the reported patients, the male to female ratio was 2.30∶1. There were 7 cases of rifampicin resistant, 1 091 cases of etiology positivity, 674 cases of etiology negativity, and 410 cases of no etiology results. The number of reported cases in the age group of 65-74 was higher than that in the age group of 75 and above. The seasonal distribution was not obvious (concentration<0.3). The patients were mainly from other cities of the province [919 cases (42.12%)], and the Department of Pulmonary and Critical Care Medicine (including the Tuberculosis Ward) was reported the most [1439 cases (65.95%)]. The majority of occupations were retired individuals [952 cases (43.63%)]. Conclusions From 2012 to 2022, the prevention and treatment of senile pulmonary tuberculosis has achieved some results, but the overall burden is still very heavy. The detection of senile pulmonary tuberculosis should be strengthened.
ObjectiveTo explore the single locus mutation that related to hepatitis B virus (HBV) co-infection by means of genome-wide association study (GWAS) in Chinese Han patients with pulmonary tuberculosis (TB).MethodsA total of 946 patients with pulmonary TB enrolled between March 2013 and March 2018 were genotyped by Illumina Human Omni Express gene chip. After quality control, 389 972 single nucleotide polymorphisms (SNPs) of 703 patients with single TB infection and 53 patients with TB-HBV co-infection were included in the follow-up association analysis.ResultsThe SNP with the strongest statistical correlation signal was rs118122819 (P=2.923×10−12, odds ratio=7.933) located on chromosome 8p23.1. Other potential susceptibility genes included CDH4 (rs73309833), MARCH1 (rs3797020), and DNER (rs13393112), etc. In addition, a strong linkage imbalance between rs118122819 and rs4840365 (D’=0.88, r2=0.76) was found, while rs4840365 was located in the MFHAS1 gene region.ConclusionsThis study provides evidence for the presence of susceptibility gene locus for HBV co-infection in pulmonary TB patients, and provides important clues for the mechanism research, disease prevention, and treatment of co-infection. But these associations must be replicated and validated in larger studies.