Non-tuberculous mycobacterial(NTM)pulmonary disease and pulmonary tuberculosis(TB)are mycobacterium-associated lung disorders that share overlapping clinical and radiological features,yet diverge significantly in path...Non-tuberculous mycobacterial(NTM)pulmonary disease and pulmonary tuberculosis(TB)are mycobacterium-associated lung disorders that share overlapping clinical and radiological features,yet diverge significantly in pathogenic mechanisms,therapeutic regimens,and long-term prognoses.Traditional east Medicine(TCM)constitution theory,a foundational framework for personalized healthcare,exerts a pivotal influence on disease susceptibility,pathological progression,and clinical outcomes.This review synthesizes state-of-the-art clinical evidence to systematically dissect key discrepancies in TCM constitution distribution between the two conditions,focusing on three core dimensions:distinctive patterns of constitution type distribution,the interplay between constitution and clinical variables,and the clinical relevance of these constitutional differences.Its primary goal is to deliver rigorous theoretical support and actionable guidance for TCM-based differential diagnosis,syndrome-specific interventions,and preventive healthcare strategies for both diseases.展开更多
BACKGROUND Tuberculosis(TB)is a common infection causing huge morbidity and mortality to mankind.The analytical methods used in diagnosing TB are not sensitive in paucibacillary infections and also require trained tec...BACKGROUND Tuberculosis(TB)is a common infection causing huge morbidity and mortality to mankind.The analytical methods used in diagnosing TB are not sensitive in paucibacillary infections and also require trained technical personnel.MicroRNAs are stable in serum and other body fluids,and hold great potential in the diagnosis of TB.AIM To analyze the dysregulated microRNA profiles among patients with cavitatory and non-cavitatory pulmonary TB.METHODS The prospective study will be conducted in a tertiary care center in India.Adult patients with newly diagnosed pulmonary TB will be included.There will be two groups:Patients with sputum positive pulmonary TB with cavity and without cavity(group1),and apparently healthy individuals(group 2).The participants will undergo sputum examination,Xpert Mycobacterium TB complex/resistance to rifampin(Mtb/RIF)assay,chest X-ray,and blood investigations and serum microRNA detection.Ethics approval has been obtained.Written informed consent will be obtained.Appropriate statistical analyses will be used.RESULTS MicroRNAs will be correlated with sputum positivity,Xpert Mtb/RIF assay,radiological involvement,inflammatory markers,and course of the disease among cases and controls.CONCLUSION MicroRNAs could serve as potential diagnostic biomarkers in diagnostically challenging TB patients.展开更多
Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoki...Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS.This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB.Methods Lung tissues from 36 male patients(18 smokers and 18 non-smokers)who underwent surgical resection for pulmonary TB were included in this study.Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS,and chest computed tomography(CT)was used to assess the severity of lung lesions.The correlation between the TLS quantity and TB lesion severity scores was analyzed.The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers.Results Smoker patients with TB had significantly higher TLS than non-smokers(P<0.001).The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT(parenchyma:r=0.5767;peribronchial:r=0.7373;both P<0.001).Immunohistochemical analysis showed increased B cells,T cells,and C-X-C motif chemokine ligand 13(CXCL13)expression in smoker patients with TB(P<0.001).Conclusion Smoker TB patients exhibited increased pulmonary TLS,which was associated with exacerbated lung lesions on chest CT,suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.展开更多
BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical im...BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical improvement after bedaquiline is stopped at 24 wk.However,there is no recommendation or guideline on bedaquiline administration beyond 24 wk,which is an important consideration when balancing the benefit of prognosis for XDR-TB against the uncertain safety concerning the newer antibiotics.CASE SUMMARY This paper reported 2 patients with XDR-TB(a female of 58 years of age and a female of 18 years of age)who received bedaquiline for 36 wk,as local experience to be shared.The 2 cases had negative cultures after 24 wk of treatment,but lung imaging was still positive.After discussion among experts,the consensus was made to bedaquiline prolongation by another 12 wk.The 36-wk prolonged use of bedaquiline in both cases achieved a favorable response without increasing the risk of cardiac events or new safety signals.CONCLUSION Longer regimen,including 36-wk bedaquiline treatment,might be an option for patients with XDR-TB.More studies are needed to explore the effectiveness and safety of prolonged use of bedaquiline for 36 wk vs standard 24 wk in the treatment of multidrug-resistant/XDR-TB or to investigate further the biomarkers and criteria indicative for extension of bedaquline to facilitate clinical use of thisnovel drug.展开更多
Tuberculosis of the uterine cervix is grouped under genital tuberculosis. Other sites for genital tuberculosis include the Fallopian tubes and the endometrium. Genital tuberculosis and other types of tuberculosis outs...Tuberculosis of the uterine cervix is grouped under genital tuberculosis. Other sites for genital tuberculosis include the Fallopian tubes and the endometrium. Genital tuberculosis and other types of tuberculosis outside the lungs are referred to as extra-pulmonary tuberculosis (EPTB). Genital tuberculosis presents with unspecific symptoms and signs;and because of this, most often, the diagnosis is made incidentally during investigations for other conditions that present with similar clinical pictures. Therefore, misdiagnosis and wrong treatment are not uncommon. We present a case of tuberculosis of the uterine cervix which was incidentally diagnosed when the patient was being investigated for cervical cancer, and successfully treated with a 6-months rifampicin regimen, 2RHZE/4HRE. Health providers have a duty to highly suspect tuberculosis of the cervix among women who present with abnormal vaginal discharge, abnormal vaginal bleeding and post-coital bleeding especially in countries where HIV and TB are endemic. If properly diagnosed and correctly treated, tuberculosis of the uterine cervix is curable.展开更多
BACKGROUND Orificial tuberculosis is a rare type of tuberculosis,which is easy to be misdiagnosed,and can cause great damage to the perianal skin and mucosa.Early diagnosis can avoid further erosion of the perianal mu...BACKGROUND Orificial tuberculosis is a rare type of tuberculosis,which is easy to be misdiagnosed,and can cause great damage to the perianal skin and mucosa.Early diagnosis can avoid further erosion of the perianal muscle tissue by tuberculosis bacteria.CASE SUMMARY Here,we report a case of disseminated tuberculosis in a 62-year-old male patient with a perianal tuberculous ulcer and active pulmonary tuberculosis,intestinal tuberculosis and orificial tuberculosis.This is an extremely rare case of cutaneous tuberculosis of the anus,which was misdiagnosed for nearly a year.The patient received conventional treatment in other medical institutions,but specific treatment was delayed.Ultimately,proper diagnosis and treatment with standard anti-tuberculosis drugs for one year led to complete cure.CONCLUSION For skin ulcers that do not heal with repeated conventional treatments,consider ulcers caused by rare bacteria,such as Mycobacterium tuberculosis.展开更多
Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its asso...Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB.展开更多
Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and fore...Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and foreign nationals.Methods:This study included patients aged 18 and over,both Turkish citizens and foreign nationals,diagnosed with PTB or EPTB between 2016 and 2022.All patients were divided into PTB and EPTB group,and demographic characteristics,clinical findings,and laboratory results were compared.Patients with both PTB and EPTB were not included in the comparison.Multivariate logistic regression analysis was conducted to identify potential risk factors for PTB.Results:Among the 261 TB cases included,46 patients(17.6%)had PTB,and 188(72%)had EPTB.The percentage of female patients was significantly higher(P=0.003)in EPTB compared to PTB group.While the prevalence of diabetes mellitus(P=0.002),hypertension(P=0.017),coronary obstructive pulmonary disease(P=0.001),congestive heart failure(P=0.005),coronary artery disease(P=0.001)and immunosuppressive medication use(P=0.017)were significantly higher in PTB patients than in EPTB patients.Multivariate logistical analysis reveals that male(OR 2.6,95%CI 1.3-5.5,P=0.009),diabetes mellitus(OR 2.7,95%CI 1.2-6.1,P=0.015),and asthma(OR 6.3,95%CI 1.2-33.9,P=0.032)were associated with an increased risk of PTB.Social security coverage(P<0.001)and regular employment status(P<0.001)were found to be lower and the presence of multidrug resistance(P=0.002),isoniazid resistance(P=0.012),and rifampin resistance(P=0.012)were found to be significantly higher in foreign-national TB patients comparing with Turkiye citizens.Conclusions:Patients with PTB need to be evaluated for comorbidities and PTB should be investigated in men,in patients with diabetes mellitus or asthma if there are clinical findings suspicious for TB.TB screening for foreign nationals upon entry into the country is essential for TB control and elimination.展开更多
BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of sec...BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.展开更多
Background: Tuberculosis (TB) is an infectious disease and it is a public health concern due to the endemic nature of the disease. Nigeria’s health systems still rely heavily on out-dated tuberculosis diagnostic test...Background: Tuberculosis (TB) is an infectious disease and it is a public health concern due to the endemic nature of the disease. Nigeria’s health systems still rely heavily on out-dated tuberculosis diagnostic tests;including sputum smear microscopy and chest radiography. This necessitated the urgent need to explore a more reliable, effective method that can rapidly enhance simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance. Aims: We evaluated the prevalence of MTB and rifampicin resistance and the influence of socio-demographic factors. Methods: A longitudinal, descriptive study that employs the Xpert MTB/RIF automated molecular method for rapid detection of rifampicin resistance. Secondary data were collected from the medical record from March 2017 to December 2018. Primary data were collected by direct clinical observations and analysis with gene expert machine from January 2019-March 2019. Results: Study populations were 1893 subjects pooled as secondary data at the Gene Expert laboratory, with a mean age of 44.92 years and were categorized based on sex, 1125 (59.4%) males and 768 (40.6%) females respectively. The MTB detected were 117 (15.7%) for males while 76 (9.9%) were positive for females. 948 (84.3%) were negative for males and 692 (90.1%) negative for females. Also, the categories for age were grouped into three but the older age groups (29 - 54) and (55 - 80) were more vulnerable to MTB having a p = 0.506 which is statistically non-significant;only 14 (5.5%) have RIF while 239 (94.5%) do not have RIF resistance strains. Logistic regression analysis of MTB detected showed a significant association (p < 0.05) for sex and a non-significant association (p > 0.05) for age. The prevalence rate for RIF Resistance is 5.53%, there is a statistical difference p = 0.001 between RIF Resistance and MTB in Ilorin. Conclusion: The utilization of validated molecular technique for MTB strain identification has shown stronger epidemiological impetus for an improved care management outcome specifically in resources limited areas.展开更多
Aim:To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis.Methods:The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in ...Aim:To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis.Methods:The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed.All patients underwent conventional chest radiography and spiral CT chest enhanced scan.The number of tuberculosis diagnosis,the detection rate of special site lesions,and the detection rate of active pulmonary tuberculosis signs by the two methods were compared.Results:In 60 patients,the pathological results confirmed the existence of 75 tuberculosis lesions.The detection rate of spiral CT was 98.67%,which was not statistically significant compared with the detection rate of 92.00%(P>0.05)in the conventional chest X-ray.The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%,which was significantly higher than that of conventional chest X-ray of 7.69%,and the accuracy rate of active pulmonary tuberculosis signs was 98.85%higher than that of conventional chest X-ray of 79.31%.P<0.05).The difference was statistically significant(P<0.05).Conclusion:Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography,but also accurately determine active pulmonary tuberculosis in adults,which is of high diagnostic value.展开更多
The efficacy of levofloxacin combined with traditional anti-tuberculosis drugs was compared between the two groups. Methods: The trial was conducted between January 2021 and March 2022 and included a total of 78 patie...The efficacy of levofloxacin combined with traditional anti-tuberculosis drugs was compared between the two groups. Methods: The trial was conducted between January 2021 and March 2022 and included a total of 78 patients. In this trial, 39 patients received conventional anti-tuberculosis therapy;Results: Forty patients received conventional antituberculous drugs combined with levofloxacin. The efficacy of the two methods was compared, including safety and efficacy. Results: The efficacy of the two groups were statistically significant (P<0.05), significantly higher than that of the control group. In terms of safety, there was no difference in side effects or overall morbidity between the two groups (P>0.05). The content of inflammatory factors in the experimental group was significantly lower than that in the control group, while the immune function index was significantly higher than that in the control group (P<0.05). Conclusion: Levofloxacin combined with conventional anti-tuberculosis regimen in the treatment of pulmonary tuberculosis patients can not only enhance the efficacy, but also have high safety, which is worthy of active application during the clinical treatment.展开更多
The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A match...The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.展开更多
In order to investigate the influence of functional polymorphisms of macrophage migration inhibitory factor （M/F）, Fcg receptors CD16A （FCGR3A） and CD32A （FCGR2A） genes on susceptibility to pulmonary tuberculos...In order to investigate the influence of functional polymorphisms of macrophage migration inhibitory factor （M/F）, Fcg receptors CD16A （FCGR3A） and CD32A （FCGR2A） genes on susceptibility to pulmonary tuberculosis （PTB） in the Moroccan population, we analyzed 123 patients with PTB and 154 healthy controls. The genotyping for M/F-173 （G/C） （rs755622）, FCGR2A- 131H/R （rs 1801274） and FCGR3A-158V/F （rs396991） was carried out using TaqMan SNP Genotyping Assay method. We found a statistically significant in- crease of the MIF-173CC homozygote genotype and M/F-173＂C allele frequencies in PTB patients compared with healthy controls （17.07% versus 5.84%, P = 0.003; and 35.37% versus 26.30%, P = 0.02; respectively）. In contrast, no association was observed between FCGR2A-131H/R and FCGR3A-158V/F polymorphisms and tuberculosis disease. Our finding suggests that M/F-173℃ variant may play an important role in the development of active tuberculosis.展开更多
Objective To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis （PTB）. Methods Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and...Objective To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis （PTB）. Methods Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and Xi＇an Chest Hospital from January to December in 2014. The sputum samples of smear negative PTB suspects were collected and decontaminated. The sediment was used to conduct MTBDRplus V2, Xpert MTB/RIF and drug susceptibility test （DST）. All the samples with discrepant drug susceptibility result between molecular methods and phenotypic method were confirmed by DNA sequencing. Results A total of 1973 cases were enrolled in this study. The detection rates of Mycobacterium tuberculosis complex （MTBC） by MTBDRplus V2 and Xpert MTB/RIF were 27.67% and 27.98%, respectively. When setting MGIT culture result as a gold standard, the sensitivity and specificity of MTBDRplus V2 were 86.74% and 93.84%, and the sensitivity and specificity of Xpert MTB/RIF were 86.55% and 93.43%, respectively. For the detection of the resistance to rifampin, the sensitivity and specificity of MTBDRplus V2 were 94.34% and 96.62%, and the sensitivity and specificity of Xpert MTB/RIF were 88.68% and 95.96%, respectively. For the detection of the resistance to isoniazid, the sensitivity and specificity of MTBDRplus V2 were 77.38% and 98.02%, respectively. Conclusion MTBDRplus V2 and Xpert MTB/RIF can be used to detect MTBC in smear negative samples with satisfactory performance.展开更多
Objective:To determine the polymorphisms of Interleukin-10(IL-10)(-592,-1082) in pulmonary tuberculosis(PTB)with and without type 2 diabetes(T2D).Methods:We studied a Mexican mestizo population of 37 patients with TB ...Objective:To determine the polymorphisms of Interleukin-10(IL-10)(-592,-1082) in pulmonary tuberculosis(PTB)with and without type 2 diabetes(T2D).Methods:We studied a Mexican mestizo population of 37 patients with TB in remission(TBr) and 40 with active pulmonary TB (PTB),21 patients with TB + T2D.47 blood donors accepted,and 13 healthy health-care workers with tuberculin skin lest positive.Determination of IL-10 polymorphisms was performed by real-lime Polymerase chain reaction.Results:IL-10-592C/A presented in a greater proportion in healthy individuals than in patients with type 2 diabetes and TB in a not quite significant statistically manner.IL-10-1082A/A presented more frequently in the group of patients with both diseases,not being statistically significant in comparison with the group of healthy subjects. Conclusions:This study describes two important new findings.First,it reveals that the IL-10 (-592 A/A and -592 C/C) polymorphisms were found in a greater proportion in a group of patients with T2D and TB than in healthy subjects.Second,the study provides evidence that the(-1082 G/G) polymorphism presented with greater frequency in healthy individuals than in patients with both ol these diseases.展开更多
Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α...Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.展开更多
It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of th...It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.展开更多
Objective:To investigate the application value of loop-mediated isothermal amplification(LAMP),GeneXpert,mycobacterial culture,smear microscopy,TSPOT.TB(TSPOT),ratio of TB-specific antigen to phytohemagglutinin(TBAg/P...Objective:To investigate the application value of loop-mediated isothermal amplification(LAMP),GeneXpert,mycobacterial culture,smear microscopy,TSPOT.TB(TSPOT),ratio of TB-specific antigen to phytohemagglutinin(TBAg/PHA ratio)in the detection of mycobacterium tuberculosis in the bronchoalveolar lavage fluid.Methods:A retrospective analysis was performed on the patients who underwent bronchoscopy from December 2018 to November 2019 in Tongji Hospital.The patients with positive tuberculosis culture or positive GeneXpert in bronchoalveolar lavage fluid were selected as the case group,and those without tuberculosis served as the control group.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of LAMP,GeneXpert,culture,smear microscopy,TSPOT,and TBAg/PHA ratio.Results:For the patients with positive cultures as case,the sensitivity of LAMP,GeneXpert,smear microscopy,TSPOT and TBAg/PHA ratio was 73.49%,89.16%,25.30%,80.00%,33.85%,respectively,the specificity was 99.00%,100.00%,99.00%,86.00%,100.00%,respectively,the area under the ROC curve(AUC)was 0.849,0.938,0.633,0.830,0.669,respectively.For the patients with positive GeneXpert as case,the sensitivity of LAMP,mycobacterial culture,smear microscopy,TSPOT and TBAg/PHA ratio was 73.20%,74.23%,22.68%,68.92%,29.73%,respectively,the specificity was 99.00%,100.00%,99.00%,86.00%,100.00%,respectively,the AUC was 0.853,0.878,0.623,0.775,0.649,respectively.Conclusion:The sensitivity of GeneXpert was best.The sensitivity and diagnostic value of LAMP were slightly lower than those of GeneXpert,and were similar to tuberculosis culture.The sensitivity of smear microscopy was low.The specificity of TSPOT was low.When TBAg/PHA ratio>0.2 was used as a diagnostic index,the specificity was improved,but the sensitivity was low.展开更多
Iron overload is reported to be associated with immune alterations and increased susceptibility to infections. HIV infection is characterized by progressive immunodeficiency leading to invasion by opportunistic pathog...Iron overload is reported to be associated with immune alterations and increased susceptibility to infections. HIV infection is characterized by progressive immunodeficiency leading to invasion by opportunistic pathogens. It was of interest to find out if disease course in HIV type-1 infection could have any relation with alteration in body iron status among individuals with history of oral iron intake. A follow-up study of immunologic and virologic markers in relation to disease progression was undertaken on asymptomatic HIV-1 positive blood donors with history of oral iron intake (subgroup I) compared to those without such history (subgroup II). High serum iron was associated with elevated levels of Th2 category of cytokines, heightened immune activation, faster decline in CD4 + T lymphocyte count and higher viral set point. Pulmonary tuberculosis (PT) was the most common AIDS related illness (ARI) (>70%) recorded among subgroup I compared to non-PT category of ARI. Median ARI free duration (months) was shorter among those who developed PT compared to those developing non-PT category of ARI i.e. 30 (95% CI as 26,32) versus 67(95% CI as 60,71) in subgroup I and 47 (95% CI as 42,49) versus 80 (95% CI as 72,87) in subgroup II (P P < 0.001 for PT versus non-PT in both subgroups). The present study indicates that body iron overload resulting from excess intake of iron may be associated with qualitative defects in cell mediated immunity at early stage of HIV-1 infection that may facilitate subsequent acquisition of pulmonary tuberculosis, shorter ARI free duration and reduced survival.展开更多
文摘Non-tuberculous mycobacterial(NTM)pulmonary disease and pulmonary tuberculosis(TB)are mycobacterium-associated lung disorders that share overlapping clinical and radiological features,yet diverge significantly in pathogenic mechanisms,therapeutic regimens,and long-term prognoses.Traditional east Medicine(TCM)constitution theory,a foundational framework for personalized healthcare,exerts a pivotal influence on disease susceptibility,pathological progression,and clinical outcomes.This review synthesizes state-of-the-art clinical evidence to systematically dissect key discrepancies in TCM constitution distribution between the two conditions,focusing on three core dimensions:distinctive patterns of constitution type distribution,the interplay between constitution and clinical variables,and the clinical relevance of these constitutional differences.Its primary goal is to deliver rigorous theoretical support and actionable guidance for TCM-based differential diagnosis,syndrome-specific interventions,and preventive healthcare strategies for both diseases.
文摘BACKGROUND Tuberculosis(TB)is a common infection causing huge morbidity and mortality to mankind.The analytical methods used in diagnosing TB are not sensitive in paucibacillary infections and also require trained technical personnel.MicroRNAs are stable in serum and other body fluids,and hold great potential in the diagnosis of TB.AIM To analyze the dysregulated microRNA profiles among patients with cavitatory and non-cavitatory pulmonary TB.METHODS The prospective study will be conducted in a tertiary care center in India.Adult patients with newly diagnosed pulmonary TB will be included.There will be two groups:Patients with sputum positive pulmonary TB with cavity and without cavity(group1),and apparently healthy individuals(group 2).The participants will undergo sputum examination,Xpert Mycobacterium TB complex/resistance to rifampin(Mtb/RIF)assay,chest X-ray,and blood investigations and serum microRNA detection.Ethics approval has been obtained.Written informed consent will be obtained.Appropriate statistical analyses will be used.RESULTS MicroRNAs will be correlated with sputum positivity,Xpert Mtb/RIF assay,radiological involvement,inflammatory markers,and course of the disease among cases and controls.CONCLUSION MicroRNAs could serve as potential diagnostic biomarkers in diagnostically challenging TB patients.
基金supported by the Peking University Medicine Fund of Fostering Young Scholars'Scientific&Technological Innovation[grant number BMU2024YFJHPY014]the Fundamental Research Funds for the Central Universities+1 种基金the Key Clinical Projects of Peking University Third Hospital[grant number BYSYZD2022014]the Capital’s Funds for Health Improvement and Research[grant number 2022-2G-40910]。
文摘Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS.This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB.Methods Lung tissues from 36 male patients(18 smokers and 18 non-smokers)who underwent surgical resection for pulmonary TB were included in this study.Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS,and chest computed tomography(CT)was used to assess the severity of lung lesions.The correlation between the TLS quantity and TB lesion severity scores was analyzed.The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers.Results Smoker patients with TB had significantly higher TLS than non-smokers(P<0.001).The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT(parenchyma:r=0.5767;peribronchial:r=0.7373;both P<0.001).Immunohistochemical analysis showed increased B cells,T cells,and C-X-C motif chemokine ligand 13(CXCL13)expression in smoker patients with TB(P<0.001).Conclusion Smoker TB patients exhibited increased pulmonary TLS,which was associated with exacerbated lung lesions on chest CT,suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.
文摘BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical improvement after bedaquiline is stopped at 24 wk.However,there is no recommendation or guideline on bedaquiline administration beyond 24 wk,which is an important consideration when balancing the benefit of prognosis for XDR-TB against the uncertain safety concerning the newer antibiotics.CASE SUMMARY This paper reported 2 patients with XDR-TB(a female of 58 years of age and a female of 18 years of age)who received bedaquiline for 36 wk,as local experience to be shared.The 2 cases had negative cultures after 24 wk of treatment,but lung imaging was still positive.After discussion among experts,the consensus was made to bedaquiline prolongation by another 12 wk.The 36-wk prolonged use of bedaquiline in both cases achieved a favorable response without increasing the risk of cardiac events or new safety signals.CONCLUSION Longer regimen,including 36-wk bedaquiline treatment,might be an option for patients with XDR-TB.More studies are needed to explore the effectiveness and safety of prolonged use of bedaquiline for 36 wk vs standard 24 wk in the treatment of multidrug-resistant/XDR-TB or to investigate further the biomarkers and criteria indicative for extension of bedaquline to facilitate clinical use of thisnovel drug.
文摘Tuberculosis of the uterine cervix is grouped under genital tuberculosis. Other sites for genital tuberculosis include the Fallopian tubes and the endometrium. Genital tuberculosis and other types of tuberculosis outside the lungs are referred to as extra-pulmonary tuberculosis (EPTB). Genital tuberculosis presents with unspecific symptoms and signs;and because of this, most often, the diagnosis is made incidentally during investigations for other conditions that present with similar clinical pictures. Therefore, misdiagnosis and wrong treatment are not uncommon. We present a case of tuberculosis of the uterine cervix which was incidentally diagnosed when the patient was being investigated for cervical cancer, and successfully treated with a 6-months rifampicin regimen, 2RHZE/4HRE. Health providers have a duty to highly suspect tuberculosis of the cervix among women who present with abnormal vaginal discharge, abnormal vaginal bleeding and post-coital bleeding especially in countries where HIV and TB are endemic. If properly diagnosed and correctly treated, tuberculosis of the uterine cervix is curable.
文摘BACKGROUND Orificial tuberculosis is a rare type of tuberculosis,which is easy to be misdiagnosed,and can cause great damage to the perianal skin and mucosa.Early diagnosis can avoid further erosion of the perianal muscle tissue by tuberculosis bacteria.CASE SUMMARY Here,we report a case of disseminated tuberculosis in a 62-year-old male patient with a perianal tuberculous ulcer and active pulmonary tuberculosis,intestinal tuberculosis and orificial tuberculosis.This is an extremely rare case of cutaneous tuberculosis of the anus,which was misdiagnosed for nearly a year.The patient received conventional treatment in other medical institutions,but specific treatment was delayed.Ultimately,proper diagnosis and treatment with standard anti-tuberculosis drugs for one year led to complete cure.CONCLUSION For skin ulcers that do not heal with repeated conventional treatments,consider ulcers caused by rare bacteria,such as Mycobacterium tuberculosis.
文摘Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB.
文摘Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and foreign nationals.Methods:This study included patients aged 18 and over,both Turkish citizens and foreign nationals,diagnosed with PTB or EPTB between 2016 and 2022.All patients were divided into PTB and EPTB group,and demographic characteristics,clinical findings,and laboratory results were compared.Patients with both PTB and EPTB were not included in the comparison.Multivariate logistic regression analysis was conducted to identify potential risk factors for PTB.Results:Among the 261 TB cases included,46 patients(17.6%)had PTB,and 188(72%)had EPTB.The percentage of female patients was significantly higher(P=0.003)in EPTB compared to PTB group.While the prevalence of diabetes mellitus(P=0.002),hypertension(P=0.017),coronary obstructive pulmonary disease(P=0.001),congestive heart failure(P=0.005),coronary artery disease(P=0.001)and immunosuppressive medication use(P=0.017)were significantly higher in PTB patients than in EPTB patients.Multivariate logistical analysis reveals that male(OR 2.6,95%CI 1.3-5.5,P=0.009),diabetes mellitus(OR 2.7,95%CI 1.2-6.1,P=0.015),and asthma(OR 6.3,95%CI 1.2-33.9,P=0.032)were associated with an increased risk of PTB.Social security coverage(P<0.001)and regular employment status(P<0.001)were found to be lower and the presence of multidrug resistance(P=0.002),isoniazid resistance(P=0.012),and rifampin resistance(P=0.012)were found to be significantly higher in foreign-national TB patients comparing with Turkiye citizens.Conclusions:Patients with PTB need to be evaluated for comorbidities and PTB should be investigated in men,in patients with diabetes mellitus or asthma if there are clinical findings suspicious for TB.TB screening for foreign nationals upon entry into the country is essential for TB control and elimination.
基金Supported by The Science and Technology Innovation Program of Changde City.
文摘BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.
文摘Background: Tuberculosis (TB) is an infectious disease and it is a public health concern due to the endemic nature of the disease. Nigeria’s health systems still rely heavily on out-dated tuberculosis diagnostic tests;including sputum smear microscopy and chest radiography. This necessitated the urgent need to explore a more reliable, effective method that can rapidly enhance simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance. Aims: We evaluated the prevalence of MTB and rifampicin resistance and the influence of socio-demographic factors. Methods: A longitudinal, descriptive study that employs the Xpert MTB/RIF automated molecular method for rapid detection of rifampicin resistance. Secondary data were collected from the medical record from March 2017 to December 2018. Primary data were collected by direct clinical observations and analysis with gene expert machine from January 2019-March 2019. Results: Study populations were 1893 subjects pooled as secondary data at the Gene Expert laboratory, with a mean age of 44.92 years and were categorized based on sex, 1125 (59.4%) males and 768 (40.6%) females respectively. The MTB detected were 117 (15.7%) for males while 76 (9.9%) were positive for females. 948 (84.3%) were negative for males and 692 (90.1%) negative for females. Also, the categories for age were grouped into three but the older age groups (29 - 54) and (55 - 80) were more vulnerable to MTB having a p = 0.506 which is statistically non-significant;only 14 (5.5%) have RIF while 239 (94.5%) do not have RIF resistance strains. Logistic regression analysis of MTB detected showed a significant association (p < 0.05) for sex and a non-significant association (p > 0.05) for age. The prevalence rate for RIF Resistance is 5.53%, there is a statistical difference p = 0.001 between RIF Resistance and MTB in Ilorin. Conclusion: The utilization of validated molecular technique for MTB strain identification has shown stronger epidemiological impetus for an improved care management outcome specifically in resources limited areas.
文摘Aim:To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis.Methods:The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed.All patients underwent conventional chest radiography and spiral CT chest enhanced scan.The number of tuberculosis diagnosis,the detection rate of special site lesions,and the detection rate of active pulmonary tuberculosis signs by the two methods were compared.Results:In 60 patients,the pathological results confirmed the existence of 75 tuberculosis lesions.The detection rate of spiral CT was 98.67%,which was not statistically significant compared with the detection rate of 92.00%(P>0.05)in the conventional chest X-ray.The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%,which was significantly higher than that of conventional chest X-ray of 7.69%,and the accuracy rate of active pulmonary tuberculosis signs was 98.85%higher than that of conventional chest X-ray of 79.31%.P<0.05).The difference was statistically significant(P<0.05).Conclusion:Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography,but also accurately determine active pulmonary tuberculosis in adults,which is of high diagnostic value.
文摘The efficacy of levofloxacin combined with traditional anti-tuberculosis drugs was compared between the two groups. Methods: The trial was conducted between January 2021 and March 2022 and included a total of 78 patients. In this trial, 39 patients received conventional anti-tuberculosis therapy;Results: Forty patients received conventional antituberculous drugs combined with levofloxacin. The efficacy of the two methods was compared, including safety and efficacy. Results: The efficacy of the two groups were statistically significant (P<0.05), significantly higher than that of the control group. In terms of safety, there was no difference in side effects or overall morbidity between the two groups (P>0.05). The content of inflammatory factors in the experimental group was significantly lower than that in the control group, while the immune function index was significantly higher than that in the control group (P<0.05). Conclusion: Levofloxacin combined with conventional anti-tuberculosis regimen in the treatment of pulmonary tuberculosis patients can not only enhance the efficacy, but also have high safety, which is worthy of active application during the clinical treatment.
基金supported by the Research program on occupational poisoning and occupational lung disease[2014BAI12B01]
文摘The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.
基金supported in part by the grants SAF06-00398/CTS1880,Spainin another part by the National Institute of Hygiene,Rabat,Morocco
文摘In order to investigate the influence of functional polymorphisms of macrophage migration inhibitory factor （M/F）, Fcg receptors CD16A （FCGR3A） and CD32A （FCGR2A） genes on susceptibility to pulmonary tuberculosis （PTB） in the Moroccan population, we analyzed 123 patients with PTB and 154 healthy controls. The genotyping for M/F-173 （G/C） （rs755622）, FCGR2A- 131H/R （rs 1801274） and FCGR3A-158V/F （rs396991） was carried out using TaqMan SNP Genotyping Assay method. We found a statistically significant in- crease of the MIF-173CC homozygote genotype and M/F-173＂C allele frequencies in PTB patients compared with healthy controls （17.07% versus 5.84%, P = 0.003; and 35.37% versus 26.30%, P = 0.02; respectively）. In contrast, no association was observed between FCGR2A-131H/R and FCGR3A-158V/F polymorphisms and tuberculosis disease. Our finding suggests that M/F-173℃ variant may play an important role in the development of active tuberculosis.
文摘Objective To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis （PTB）. Methods Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and Xi＇an Chest Hospital from January to December in 2014. The sputum samples of smear negative PTB suspects were collected and decontaminated. The sediment was used to conduct MTBDRplus V2, Xpert MTB/RIF and drug susceptibility test （DST）. All the samples with discrepant drug susceptibility result between molecular methods and phenotypic method were confirmed by DNA sequencing. Results A total of 1973 cases were enrolled in this study. The detection rates of Mycobacterium tuberculosis complex （MTBC） by MTBDRplus V2 and Xpert MTB/RIF were 27.67% and 27.98%, respectively. When setting MGIT culture result as a gold standard, the sensitivity and specificity of MTBDRplus V2 were 86.74% and 93.84%, and the sensitivity and specificity of Xpert MTB/RIF were 86.55% and 93.43%, respectively. For the detection of the resistance to rifampin, the sensitivity and specificity of MTBDRplus V2 were 94.34% and 96.62%, and the sensitivity and specificity of Xpert MTB/RIF were 88.68% and 95.96%, respectively. For the detection of the resistance to isoniazid, the sensitivity and specificity of MTBDRplus V2 were 77.38% and 98.02%, respectively. Conclusion MTBDRplus V2 and Xpert MTB/RIF can be used to detect MTBC in smear negative samples with satisfactory performance.
基金supported by a grant of the Mexican Council for Research and Science(CONACYT)(grant No.39 891M1 PI.CRGB)
文摘Objective:To determine the polymorphisms of Interleukin-10(IL-10)(-592,-1082) in pulmonary tuberculosis(PTB)with and without type 2 diabetes(T2D).Methods:We studied a Mexican mestizo population of 37 patients with TB in remission(TBr) and 40 with active pulmonary TB (PTB),21 patients with TB + T2D.47 blood donors accepted,and 13 healthy health-care workers with tuberculin skin lest positive.Determination of IL-10 polymorphisms was performed by real-lime Polymerase chain reaction.Results:IL-10-592C/A presented in a greater proportion in healthy individuals than in patients with type 2 diabetes and TB in a not quite significant statistically manner.IL-10-1082A/A presented more frequently in the group of patients with both diseases,not being statistically significant in comparison with the group of healthy subjects. Conclusions:This study describes two important new findings.First,it reveals that the IL-10 (-592 A/A and -592 C/C) polymorphisms were found in a greater proportion in a group of patients with T2D and TB than in healthy subjects.Second,the study provides evidence that the(-1082 G/G) polymorphism presented with greater frequency in healthy individuals than in patients with both ol these diseases.
基金supported by grants from China National Programs for Science and Technology Development (Grant No. 2003BA712A11-24)Scientific Research Fund of North China Coal Medical College (Grant No. 2005-14)
文摘Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.
文摘It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.
文摘Objective:To investigate the application value of loop-mediated isothermal amplification(LAMP),GeneXpert,mycobacterial culture,smear microscopy,TSPOT.TB(TSPOT),ratio of TB-specific antigen to phytohemagglutinin(TBAg/PHA ratio)in the detection of mycobacterium tuberculosis in the bronchoalveolar lavage fluid.Methods:A retrospective analysis was performed on the patients who underwent bronchoscopy from December 2018 to November 2019 in Tongji Hospital.The patients with positive tuberculosis culture or positive GeneXpert in bronchoalveolar lavage fluid were selected as the case group,and those without tuberculosis served as the control group.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of LAMP,GeneXpert,culture,smear microscopy,TSPOT,and TBAg/PHA ratio.Results:For the patients with positive cultures as case,the sensitivity of LAMP,GeneXpert,smear microscopy,TSPOT and TBAg/PHA ratio was 73.49%,89.16%,25.30%,80.00%,33.85%,respectively,the specificity was 99.00%,100.00%,99.00%,86.00%,100.00%,respectively,the area under the ROC curve(AUC)was 0.849,0.938,0.633,0.830,0.669,respectively.For the patients with positive GeneXpert as case,the sensitivity of LAMP,mycobacterial culture,smear microscopy,TSPOT and TBAg/PHA ratio was 73.20%,74.23%,22.68%,68.92%,29.73%,respectively,the specificity was 99.00%,100.00%,99.00%,86.00%,100.00%,respectively,the AUC was 0.853,0.878,0.623,0.775,0.649,respectively.Conclusion:The sensitivity of GeneXpert was best.The sensitivity and diagnostic value of LAMP were slightly lower than those of GeneXpert,and were similar to tuberculosis culture.The sensitivity of smear microscopy was low.The specificity of TSPOT was low.When TBAg/PHA ratio>0.2 was used as a diagnostic index,the specificity was improved,but the sensitivity was low.
文摘Iron overload is reported to be associated with immune alterations and increased susceptibility to infections. HIV infection is characterized by progressive immunodeficiency leading to invasion by opportunistic pathogens. It was of interest to find out if disease course in HIV type-1 infection could have any relation with alteration in body iron status among individuals with history of oral iron intake. A follow-up study of immunologic and virologic markers in relation to disease progression was undertaken on asymptomatic HIV-1 positive blood donors with history of oral iron intake (subgroup I) compared to those without such history (subgroup II). High serum iron was associated with elevated levels of Th2 category of cytokines, heightened immune activation, faster decline in CD4 + T lymphocyte count and higher viral set point. Pulmonary tuberculosis (PT) was the most common AIDS related illness (ARI) (>70%) recorded among subgroup I compared to non-PT category of ARI. Median ARI free duration (months) was shorter among those who developed PT compared to those developing non-PT category of ARI i.e. 30 (95% CI as 26,32) versus 67(95% CI as 60,71) in subgroup I and 47 (95% CI as 42,49) versus 80 (95% CI as 72,87) in subgroup II (P P < 0.001 for PT versus non-PT in both subgroups). The present study indicates that body iron overload resulting from excess intake of iron may be associated with qualitative defects in cell mediated immunity at early stage of HIV-1 infection that may facilitate subsequent acquisition of pulmonary tuberculosis, shorter ARI free duration and reduced survival.
