BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spi...BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.展开更多
BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,an...BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,and treatment,prompting a growing interest in research over recent years.The advancements in imaging,diagnostics,and treatment strategies have driven an increased focus on publishing clinical outcomes,review articles,and case series related to spinal TB(STB).AIM To perform a bibliometric analysis of STB research published over the last 5 years(2019-2023)to identify trends in publication volume,contributions by country,and the nature of the research being conducted.METHODS A comprehensive bibliometric analysis was conducted using the PubMed database,focusing on research articles published between 2019 and 2023.Keywords such as“spine tuberculosis,”“spinal TB,”“TB spine,”and“Pott’s spine”were utilized to capture relevant publications.Articles were analyzed based on the type of research(e.g.,case reports,review articles,cohort studies,randomized controlled trials[RCTs]),number of citations,and country of origin based on the corresponding author's details.Further subgroup analysis was performed according to the TB burden in various countries to assess research trends in high-burden regions.RESULTS A total of 528 articles met the inclusion criteria for this bibliometric analysis.The majority of articles were published between 2020 and 2023(440/528;83.3%),while the lowest number was published in 2019(88/528;16.7%).India led the global contributions with 25.8%of the total publications,followed by China(19.9%)and the United States(10.4%).Combined,African countries contributed 6.8%of the research on STB.Regarding the type of articles,case reports and case series dominated the literature(353/528;66.9%),followed by review articles(120/528;22.7%)and cohort studies(45/528;8.5%).Only 1.9%(10/528)of the studies were RCTs.Countries such as the United States,Germany,the United Kingdom,and Japan have pioneered the use of artificial intelligence(AI)in the diagnostic processes for STB,while India,China,South Africa,and other countries have been pivotal in conducting clinical trials and improving clinical management strategies.CONCLUSION This bibliometric analysis revealed a significant increase in STB research over the last 5 years,with India and China being the leading contributors.However,most publications are case reports or case series,with a limited number of RCTs.The results highlighted the need for more high-quality research,especially in terms of RCTs and innovations in diagnostic technologies.Additionally,the application of AI to STB diagnostics shows promise in developed countries,while high-burden countries are focusing on clinical trials and management strategies.展开更多
BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of ...BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of spinal tuberculosis after organ transplantation. METHOD: Two cases were diagnosed as spinal tuberculosis after liver transplantation and were treated with socarboxazide, rifampicin, streptomycin and ethambutol for more than one year. RESULTS: After treatment with anti-tuberculosis drugs for several months, the symptoms of both patients clearly improved. Back pain disappeared, and erythrocyte sedimentation and body temperature returned to normal. CONCLUSIONS: We should highly suspect spinal tuberculosis if notalgia and night sweats are present after organ transplantation. Anti-tuberculosis therapy is an effective treatment for spinal tuberculosis after organ transplantation.展开更多
Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess th...Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.展开更多
This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose les...This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association（ASIA） impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association（JOA） scores and oswestry disability index（ODI） of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.展开更多
Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients wit...Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal展开更多
Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of l...Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of life with high incidences of deformity and disability.The onset of spinal tuberculosis is related to many factors such as gender,age,environment,habits and hereditary factor.As a genetic factor,gene polymorphism plays an important role in the occurrence and development of tuberculosis.This article reviews the research progress of the susceptibility of spinal tuberculosis and its related gene polymorphisms,in order to provide reference for early prevention and treatment of spinal tuberculosis.展开更多
Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in ou...Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in our hospital from February 2017 to January 2020 were retrospectively analyzed.A11 the cases were grouped according to different nursing plans,patients who received routine care were included in the control group(n=50),and the ones with intensive psychological care were included in the observation group(n=52).Compare negative emotions after nursing[assessment using self-assessment scale of anxiety(SAS),depression self-assessment scale(SDS)]and solutions[assessment using medical response questionnaire(MCMQ)]of the two groups.Results:After nursing,the SAs,SDs scores,avoidance and yield scores of the two groups were reduced,and the coping scores were increased,and the change of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Spinal tuberculosis surgery patients were treated with intensive psychological care,which can relieve patients'negative emotions,improve solutions and are worthy of clinical use.展开更多
BACKGROUND Tuberculosis (TB) mostly attacks the lungs, and extrapulmonary TB involving thecentral nervous system is uncommon;among these cases, spinal intramedullaryTB is even more rare. The clinical manifestations of...BACKGROUND Tuberculosis (TB) mostly attacks the lungs, and extrapulmonary TB involving thecentral nervous system is uncommon;among these cases, spinal intramedullaryTB is even more rare. The clinical manifestations of spinal intramedullary TB aresimilar to those of intramedullary spinal cord tumors. Therefore, it is necessary tomake a careful differential diagnosis of spinal intramedullary lesions to achievethe appropriate treatment and favorable prognosis. We report a rare case of ayoung male patient with paraplegia due to spinal intramedullary TB, which isuncommon and regrettable.CASE SUMMARY A 23-year-old male presented with fever accompanied by nausea and vomitinglasting for 2 mo and was then diagnosed with tubercular meningitis. After anti-TBtreatment, his symptoms were significantly improved. However, 2 mo after thediagnosis of tubercular meningitis, the patient felt numbness below the costal archlevel, which lasted for 1 wk, and he paid no attention to this symptom. Whatfollowed was paraplegia and urine/fecal incontinence. Magnetic resonanceimaging of the thoracic spine showed a ring-enhanced intramedullary cord lesionat T8-T9. Lesion exploration showed enlargement of the spinal cord at T8-T9, andthe lesion could be observed by incision. The lesion was adhered to the peripheraltissue and was grayish-white and tough with a poor blood supply and a diameterof approximately 0.8 cm. The lesion was resected completely. The results ofpathological examination by both hematoxylin-eosin staining and acid-fast bacillistaining confirmed TB, accompanied by acute and chronic suppurativeinflammation and granulation tissue formation. The patient was instructed tocontinue anti-TB treatment after the operation, but he did not follow the medicaladvice. Follow-up continued for ten years, the patient had persistent paraplegia,the numbness disappeared and urine/fecal sensation recovered.CONCLUSION Although TB is a kind of benign disease, some cases progress rapidly. Moreover,spinal intramedullary TB may seriously endanger quality of life and still needstimely diagnosis and proper treatment.展开更多
Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 20...Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 2020 were selected for the study. All patients received CT and MRI imaging diagnosis successively, and the results of the two imaging examinations were compared and analyzed. Results: the diagnosis results of the two methods for bone disc loss and paravertebral mass are exactly the same, P > 0.05. The detection rate of ligament diffusion, dural cyst and meningeal enhancement by MRI was significantly higher than that by CT, while the detection rate of calcification was significantly lower than that by CT, P<0.05. Conclusion: in the clinical diagnosis of spinal tuberculosis, both CT and MIR have high application value and the diagnostic accuracy of MIR is relatively higher.展开更多
Objective:The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracic-lumbar vertebrae spinal tuberculosis treated with One-stage Posterior debridement bone grafts an...Objective:The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracic-lumbar vertebrae spinal tuberculosis treated with One-stage Posterior debridement bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosisMethods: The study was a prospective follow-up of 26 patients with active lumbar spinal tuberculosis who underwent Application of One-stage Posterior debridement,bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosis . These patients had posterior stabilization of the involved segment of the spine.Results:The average follow up was 26months (range,24 -30 months).all patients had a neurological function improvement At 6 months after operation, the patients with abnormal erythrocyte sedimentation rate(ESR) and Creactive protein (CRP)visua analogue scale(VAS)had recovered to normalConclusions: One-stage Posterior debridement bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosis seems to be adequate for obtaining satisfactory healing of the lesions. In operation as far as possible Tuberculosis lesions removal and post operation chemotherapy of tuberculosis of Spinal tuberculosis critical for successful outcome with this technique.展开更多
Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and geneti...Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and genetic mechanisms and can be derived from an individual's somatic cells(e.g.,blood or skin).This enables patient-specific paradigms for precision neurotrauma research,pa rticula rly relevant to the over 300,000 people in the United States living with chronic effects of spinal cord injury(SCI).展开更多
Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level b...Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level biosafety containment or fail to repli-cate human skeletal pathology.Methods:This study developed a biosafe,accessible,and versatile murine model of skeletal TB using Mycobacterium smegmatis,a fast-growing,nonpathogenic myco-bacterial species with high genomic homology to Mycobacterium tuberculosis.Three infection routes-subperiosteal calvarial injection,intratibial injection,and intra-cardiac inoculation-were systematically evaluated for their ability to induce lo-calized versus disseminated bone infection under standard biosafety level(BSL)-1 conditions.Results:Subperiosteal calvarial and intratibial injection of M.smegmatis induced local-ized bone lesions characterized by osteolysis,sequestrum formation,granulomatous inflammation,and increased osteoclast activity.Intratibial infection additionally trig-gered compartment-specific immune responses,including neutrophil and macrophage expansion,transient B-cell depletion,and activation of interferon-γ^(+)(IFN-γ^(+))T cells,reflecting active immune remodeling at the infection site.Systemic dissemination via intracardiac injection reproducibly generated progressive vertebral and tibial bone destruction with organized granuloma formation and immune cell infiltration but without prominent sequestrum formation.Compared to intratibial infection,intracar-diac delivery exhibited lower intragroup variability and more closely recapitulated the diffuse progression of extrapulmonary skeletal tuberculosis.Conclusions:This M.smegmatis-based murine model provides a straightforward,reliable,and immunopathologically relevant platform for exploring host-pathogen dynamics,immune-driven bone destruction,and early-stage therapeutic testing in skeletal TB,all within standard BSL-1 laboratories.This model fills a critical gap by enabling BSL-1 research into skeletal TB mechanisms and drug development.展开更多
BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complet...BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.展开更多
The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cel...The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.展开更多
Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and...Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.展开更多
Tuberculosis(TB)continues to pose a significant threat to global public health,necessitating rapid and precise diagnostic methods and comprehensive detection of antimicrobial resistance(AMR)to facilitate timely clinic...Tuberculosis(TB)continues to pose a significant threat to global public health,necessitating rapid and precise diagnostic methods and comprehensive detection of antimicrobial resistance(AMR)to facilitate timely clinical management.Traditional diagnostic techniques suffer from extended turnaround times and limited ability to comprehensively profile AMR,often resulting in delayed therapeutic interventions.Highthroughput sequencing(HTS)technologies have revolutionized pathogen research by significantly improving diagnostic speed and accuracy.In the context of TB,diverse sequencing strategies and platforms are being employed to fulfill specific research goals,ranging from elucidating the molecular mechanisms underlying AMR to characterizing the genomic diversity among clinical isolates.This review systematically examines current progress in the application of HTS for rapid pathogen identification,comprehensive AMR profiling,epidemiological studies,advances in novel drugs,and vaccine development.Furthermore,we address existing technological limitations and bioinformatics challenges and explore the future directions necessary for effectively integrating HTS-based methodologies into global TB control efforts.展开更多
Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients...Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.展开更多
Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This...Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.展开更多
Traumatic spinal cord injury(SCI)is a pathological condition that impairs both sensorimotor and cognitive functions.While research has long focused on understanding the pathophysiology of SCI and developing treatments...Traumatic spinal cord injury(SCI)is a pathological condition that impairs both sensorimotor and cognitive functions.While research has long focused on understanding the pathophysiology of SCI and developing treatments,only a few studies have investigated the cellular and molecular consequences that occur in the brain after trauma.From the earliest stages,the injury triggers microglial activation,increased neuronal death,and reduced hippocampal neurogenesis in the dentate gyrus.展开更多
基金Supported by Lanzhou City Science and Technology Development Guiding Plan Project,No.2023-ZD-170Lanzhou Science and Technology Plan Project,No.2023-2-11High-Level Talent Training Project At the 940th Hospital of the Joint Logistics Force,No.2024-G3-5.
文摘BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.
文摘BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,and treatment,prompting a growing interest in research over recent years.The advancements in imaging,diagnostics,and treatment strategies have driven an increased focus on publishing clinical outcomes,review articles,and case series related to spinal TB(STB).AIM To perform a bibliometric analysis of STB research published over the last 5 years(2019-2023)to identify trends in publication volume,contributions by country,and the nature of the research being conducted.METHODS A comprehensive bibliometric analysis was conducted using the PubMed database,focusing on research articles published between 2019 and 2023.Keywords such as“spine tuberculosis,”“spinal TB,”“TB spine,”and“Pott’s spine”were utilized to capture relevant publications.Articles were analyzed based on the type of research(e.g.,case reports,review articles,cohort studies,randomized controlled trials[RCTs]),number of citations,and country of origin based on the corresponding author's details.Further subgroup analysis was performed according to the TB burden in various countries to assess research trends in high-burden regions.RESULTS A total of 528 articles met the inclusion criteria for this bibliometric analysis.The majority of articles were published between 2020 and 2023(440/528;83.3%),while the lowest number was published in 2019(88/528;16.7%).India led the global contributions with 25.8%of the total publications,followed by China(19.9%)and the United States(10.4%).Combined,African countries contributed 6.8%of the research on STB.Regarding the type of articles,case reports and case series dominated the literature(353/528;66.9%),followed by review articles(120/528;22.7%)and cohort studies(45/528;8.5%).Only 1.9%(10/528)of the studies were RCTs.Countries such as the United States,Germany,the United Kingdom,and Japan have pioneered the use of artificial intelligence(AI)in the diagnostic processes for STB,while India,China,South Africa,and other countries have been pivotal in conducting clinical trials and improving clinical management strategies.CONCLUSION This bibliometric analysis revealed a significant increase in STB research over the last 5 years,with India and China being the leading contributors.However,most publications are case reports or case series,with a limited number of RCTs.The results highlighted the need for more high-quality research,especially in terms of RCTs and innovations in diagnostic technologies.Additionally,the application of AI to STB diagnostics shows promise in developed countries,while high-burden countries are focusing on clinical trials and management strategies.
文摘BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of spinal tuberculosis after organ transplantation. METHOD: Two cases were diagnosed as spinal tuberculosis after liver transplantation and were treated with socarboxazide, rifampicin, streptomycin and ethambutol for more than one year. RESULTS: After treatment with anti-tuberculosis drugs for several months, the symptoms of both patients clearly improved. Back pain disappeared, and erythrocyte sedimentation and body temperature returned to normal. CONCLUSIONS: We should highly suspect spinal tuberculosis if notalgia and night sweats are present after organ transplantation. Anti-tuberculosis therapy is an effective treatment for spinal tuberculosis after organ transplantation.
基金funded by the National Natural Science Foundation of China (No. 81460259)
文摘Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.
文摘This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association（ASIA） impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association（JOA） scores and oswestry disability index（ODI） of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.
文摘Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal
基金Fund Project:Traditional Chinese Medicine Research Project of Hubei Provincial Health Commission(ZY2019F025)the Clinical Research Supported by Wu Jieping Medical Foundation(No.320.6750.17566)。
文摘Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of life with high incidences of deformity and disability.The onset of spinal tuberculosis is related to many factors such as gender,age,environment,habits and hereditary factor.As a genetic factor,gene polymorphism plays an important role in the occurrence and development of tuberculosis.This article reviews the research progress of the susceptibility of spinal tuberculosis and its related gene polymorphisms,in order to provide reference for early prevention and treatment of spinal tuberculosis.
文摘Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in our hospital from February 2017 to January 2020 were retrospectively analyzed.A11 the cases were grouped according to different nursing plans,patients who received routine care were included in the control group(n=50),and the ones with intensive psychological care were included in the observation group(n=52).Compare negative emotions after nursing[assessment using self-assessment scale of anxiety(SAS),depression self-assessment scale(SDS)]and solutions[assessment using medical response questionnaire(MCMQ)]of the two groups.Results:After nursing,the SAs,SDs scores,avoidance and yield scores of the two groups were reduced,and the coping scores were increased,and the change of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Spinal tuberculosis surgery patients were treated with intensive psychological care,which can relieve patients'negative emotions,improve solutions and are worthy of clinical use.
文摘BACKGROUND Tuberculosis (TB) mostly attacks the lungs, and extrapulmonary TB involving thecentral nervous system is uncommon;among these cases, spinal intramedullaryTB is even more rare. The clinical manifestations of spinal intramedullary TB aresimilar to those of intramedullary spinal cord tumors. Therefore, it is necessary tomake a careful differential diagnosis of spinal intramedullary lesions to achievethe appropriate treatment and favorable prognosis. We report a rare case of ayoung male patient with paraplegia due to spinal intramedullary TB, which isuncommon and regrettable.CASE SUMMARY A 23-year-old male presented with fever accompanied by nausea and vomitinglasting for 2 mo and was then diagnosed with tubercular meningitis. After anti-TBtreatment, his symptoms were significantly improved. However, 2 mo after thediagnosis of tubercular meningitis, the patient felt numbness below the costal archlevel, which lasted for 1 wk, and he paid no attention to this symptom. Whatfollowed was paraplegia and urine/fecal incontinence. Magnetic resonanceimaging of the thoracic spine showed a ring-enhanced intramedullary cord lesionat T8-T9. Lesion exploration showed enlargement of the spinal cord at T8-T9, andthe lesion could be observed by incision. The lesion was adhered to the peripheraltissue and was grayish-white and tough with a poor blood supply and a diameterof approximately 0.8 cm. The lesion was resected completely. The results ofpathological examination by both hematoxylin-eosin staining and acid-fast bacillistaining confirmed TB, accompanied by acute and chronic suppurativeinflammation and granulation tissue formation. The patient was instructed tocontinue anti-TB treatment after the operation, but he did not follow the medicaladvice. Follow-up continued for ten years, the patient had persistent paraplegia,the numbness disappeared and urine/fecal sensation recovered.CONCLUSION Although TB is a kind of benign disease, some cases progress rapidly. Moreover,spinal intramedullary TB may seriously endanger quality of life and still needstimely diagnosis and proper treatment.
文摘Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 2020 were selected for the study. All patients received CT and MRI imaging diagnosis successively, and the results of the two imaging examinations were compared and analyzed. Results: the diagnosis results of the two methods for bone disc loss and paravertebral mass are exactly the same, P > 0.05. The detection rate of ligament diffusion, dural cyst and meningeal enhancement by MRI was significantly higher than that by CT, while the detection rate of calcification was significantly lower than that by CT, P<0.05. Conclusion: in the clinical diagnosis of spinal tuberculosis, both CT and MIR have high application value and the diagnostic accuracy of MIR is relatively higher.
基金Key research and development program of Shanxi province(No.2018SF-196).
文摘Objective:The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracic-lumbar vertebrae spinal tuberculosis treated with One-stage Posterior debridement bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosisMethods: The study was a prospective follow-up of 26 patients with active lumbar spinal tuberculosis who underwent Application of One-stage Posterior debridement,bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosis . These patients had posterior stabilization of the involved segment of the spine.Results:The average follow up was 26months (range,24 -30 months).all patients had a neurological function improvement At 6 months after operation, the patients with abnormal erythrocyte sedimentation rate(ESR) and Creactive protein (CRP)visua analogue scale(VAS)had recovered to normalConclusions: One-stage Posterior debridement bone grafts and internal fixation combined with lesion clearance and Chemotherapy catheter for the treatment of lumbar tuberculosis seems to be adequate for obtaining satisfactory healing of the lesions. In operation as far as possible Tuberculosis lesions removal and post operation chemotherapy of tuberculosis of Spinal tuberculosis critical for successful outcome with this technique.
基金supported by the Belle Carnell Regenerative Neurorehabilitation Fundthe National Institutes of Health(R01NS113935 to CKF)。
文摘Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and genetic mechanisms and can be derived from an individual's somatic cells(e.g.,blood or skin).This enables patient-specific paradigms for precision neurotrauma research,pa rticula rly relevant to the over 300,000 people in the United States living with chronic effects of spinal cord injury(SCI).
基金Southwest Hospital Boqing Innovation Fund,Grant/Award Number:2024BQCXJJ-9Fundings for Young Investigators of PLA,Grant/Award Number:2022-JCJQ-QT-004+3 种基金NSFC Key Projects of the Regional Innovation and Development Joint Fund,Grant/Award Number:U23A20413China Postdoctoral Science Foundation,Grant/Award Number:2023M744280National Natural Science Foundation of China,Grant/Award Number:82103778,82172449 and 82172489Southwest Hospital Postdoctoral Starting Fund,Grant/Award Number:5175ZA36BP。
文摘Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level biosafety containment or fail to repli-cate human skeletal pathology.Methods:This study developed a biosafe,accessible,and versatile murine model of skeletal TB using Mycobacterium smegmatis,a fast-growing,nonpathogenic myco-bacterial species with high genomic homology to Mycobacterium tuberculosis.Three infection routes-subperiosteal calvarial injection,intratibial injection,and intra-cardiac inoculation-were systematically evaluated for their ability to induce lo-calized versus disseminated bone infection under standard biosafety level(BSL)-1 conditions.Results:Subperiosteal calvarial and intratibial injection of M.smegmatis induced local-ized bone lesions characterized by osteolysis,sequestrum formation,granulomatous inflammation,and increased osteoclast activity.Intratibial infection additionally trig-gered compartment-specific immune responses,including neutrophil and macrophage expansion,transient B-cell depletion,and activation of interferon-γ^(+)(IFN-γ^(+))T cells,reflecting active immune remodeling at the infection site.Systemic dissemination via intracardiac injection reproducibly generated progressive vertebral and tibial bone destruction with organized granuloma formation and immune cell infiltration but without prominent sequestrum formation.Compared to intratibial infection,intracar-diac delivery exhibited lower intragroup variability and more closely recapitulated the diffuse progression of extrapulmonary skeletal tuberculosis.Conclusions:This M.smegmatis-based murine model provides a straightforward,reliable,and immunopathologically relevant platform for exploring host-pathogen dynamics,immune-driven bone destruction,and early-stage therapeutic testing in skeletal TB,all within standard BSL-1 laboratories.This model fills a critical gap by enabling BSL-1 research into skeletal TB mechanisms and drug development.
基金Supported by Russian Science Foundation Grant,No.24-15-00185.
文摘BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.
基金supported by Grant 3195 from Paralyzed Veterans of America Research Foundation (to BRK)
文摘The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.
基金supported by the National Natural Science Foundation of China(82574173,82003516)Jiangsu Provincial Natural Science Foundation(BK20251958)+2 种基金Jiangsu Provincial Medical Key Discipline(ZDXK202250)Top Talent Awards Project Fund(RDF-TP-0023,RDF-TP-0030)Postgraduate Research Fund(PGRS2112022)at Xi'an Jiaotong-Liverpool University.
文摘Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-I2M-1-038 and 2023-I2M-2-001)the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2019PT310029 and 2023-PT310-04).
文摘Tuberculosis(TB)continues to pose a significant threat to global public health,necessitating rapid and precise diagnostic methods and comprehensive detection of antimicrobial resistance(AMR)to facilitate timely clinical management.Traditional diagnostic techniques suffer from extended turnaround times and limited ability to comprehensively profile AMR,often resulting in delayed therapeutic interventions.Highthroughput sequencing(HTS)technologies have revolutionized pathogen research by significantly improving diagnostic speed and accuracy.In the context of TB,diverse sequencing strategies and platforms are being employed to fulfill specific research goals,ranging from elucidating the molecular mechanisms underlying AMR to characterizing the genomic diversity among clinical isolates.This review systematically examines current progress in the application of HTS for rapid pathogen identification,comprehensive AMR profiling,epidemiological studies,advances in novel drugs,and vaccine development.Furthermore,we address existing technological limitations and bioinformatics challenges and explore the future directions necessary for effectively integrating HTS-based methodologies into global TB control efforts.
基金funded by the National Key Research and Development Program of China(grant number 2022YFC2305204).
文摘Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.
基金supported by the National Science and Technology Major Project for the Prevention and Control of Emerging and Major Infectious Diseases[2025ZD01908702]Peking University Medicine Fund of Fostering Young Scholars’Scientific&Technological innovation[BMU2024YFJHP014]supported by Fundamental Research Funds for the Central Universities+1 种基金Key Clinical Projects of Peking University Third Hospital[BYSYZD2022014]Peking University Third Hospital[2025024].
文摘Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.
文摘Traumatic spinal cord injury(SCI)is a pathological condition that impairs both sensorimotor and cognitive functions.While research has long focused on understanding the pathophysiology of SCI and developing treatments,only a few studies have investigated the cellular and molecular consequences that occur in the brain after trauma.From the earliest stages,the injury triggers microglial activation,increased neuronal death,and reduced hippocampal neurogenesis in the dentate gyrus.
