Diagnostic Value of TB-IGRA, PPD, TB-DNA-PCR and TB-Ab in Silicosis Complicated with Tuberculosis

Purpose: The purpose of this article is to investigate the clinical value of TB-IGRA (Tuberculosis-Interferon Gamma Release Assay), PPD (Intradermal Terbuculin Test), TB-DNA-PCR (Tuberculosis-Deoxyribonucleic-Polymerase Chain Reaction) and TB-Ab (Tuberculosis-Antibody) in diagnosing silicosis complicated with pulmonary tuberculosis. Methods: 53 cases of suspected silicosis complicated with pulmonary tuberculosis were selected in the time span ranging from February 2017 to May 2019. TB-IGRA test, PPD test, TB-DNA-PCR and TB-Ab detection were performed. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results: Silicosis and pulmonary tuberculosis were diagnosed in 11 cases, with an incidence of 20.75%. The positive rates of TB-IGRA, PPD, TB-DNA-PCR and TB-Ab were 66.04%, 30.19%, 5.67% and 26.42%, respectively. The sensitivity was 90.91%, 81.82%, 27.27% and 54.55% respectively. The specificity was 42.86%, 80.95%, 100% and 80.95% respectively. The positive predictive values were 28.57%, 50%, 100% and 42.86% respectively. The negative predictive values were 94.44%, 91.89%, 84% and 87.18%. The positive rate, sensitivity and negative predictive value of TB-IGRA were the highest, while the specificity of TB-DNA-PCR was the highest yet with low positive rate, sensitivity and positive predictive value. Conclusion: The positive rate and sensitivity of TB-IGRA were high, yet with poor specificity, so it was impossible to judge whether the cases belonged to active pulmonary tuberculosis. The combination of PPD and TB-DNA-PCR could improve the sensitivity, specificity and positive predictive value, and the diagnostic accuracy of active pulmonary tuberculosis, which showed satisfactory clinical value.

Effect of Rifapentine and Rifampicin on Anti-Tuberculosis

Objective: To investigate the clinical effect of rifapentine and rifampicin in the treatment of pulmonary tuberculosis. Methods: Seventy-two cases of patients with initial treatment of pulmonary tuberculosis who attended the First Hospital Affiliated to Hebei North University from February 2017 to August 2019 were selected. They were randomly divided into observation group and control group, with 36 cases in each group. The observation group was treated with isoniazid + rifapentine + ethambutol, while the control group was treated with isoniazid + rifampicin + ethambutol. The symptom relief, image absorption and adverse reactions were compared between the two groups. Results: The rate of symptom relief was 86.11% in the observation group and 94.44% in the control group, P < 0.05, which was statistically significant. Rifampin was more helpful than rifapentine in relieving clinical symptoms. The lesion absorption rate was 77.79% in the observation group and 88.89% in the control group, P < 0.05, and the difference was statistically significant. Rifampin was more beneficial to the absorption of TB lesions than rifapentine. The incidence of adverse reactions in the observation group was 16.67% much lower than that in the control group, which was 38.89%, indicating that the adverse reactions of rifapentine were less. Conclusion: Rifampicin is superior to rifapentine in clinical symptom relief and lesion absorption, but the incidence of adverse reactions is high.

Diagnostic Value of TB-IGRA, PPD, TB-DNA-PCR and ADA in Tuberculous Pleural Effusion

Objective: To investigate the clinical diagnostic value of TB-IGRA (Tuberculosis-Interferon Gamma Release Assay), PPD (Intradermal Tuberculin Test), TB-DNA-PCR (Tuberculosis-Deoxyribonucleic-Polymerase Chain Reaction) and ADA(Adenosine Aeaminase) in tuberculous pleural effusion. Methods: 60 patients with tuberculous pleural effusion discharged from our department from January 1, 2018 to December 31, 2019 were selected. Moreover, the TB-IGRA in peripheral blood, PPD test, TB-DNA-PCR and ADA in pleural effusion were detected. Subsequently, the positive rate, negative rate, sensitivity and omission diagnostic rate of TB-IGRA, PPD, TB-DNA-PCR, ADA and combined TB-IGRA were calculated. Results: The positive rate and sensitivity of TB-IGRA, PPD,TB-DNA-PCR, and ADA were 95%, 71.67%, 5% and 86.67% respectively. The omission diagnostic rate was 5%, 28.33%, 95% and 13.33%. TB-IGRA showed the highest positive rate and sensitivity, and TB-DNA-PCR represented the highest omission diagnostic rate. The sensitivity of TB-IGRA + PPD was 98.33%, while the omission diagnostic rate was 51.67%. The sensitivity of TB-IGRA + TB-DNA-PCR was 95%, while the omission diagnostic rate was 5%. The sensitivity of TB-IGRA + ADA was 100%, while the omission diagnostic rate was 0%. In addition, the TB-IGRA + ADA had the highest sensitivity and the lowest omission diagnostic rate. Conclusion: TB-IGRA has high positive rate, high sensitivity and low omission diagnostic rate, which is superior to the traditional sputum test for tuberculosis. Notably, the combination of PPD, TB-DNA-PCR, ADA is capable of improving the diagnosis rate, and the diagnosis rate can reach 100% when combined with ADA, which is able to provide solid diagnostic value in clinical practice.

Research Progress on Chemical Constituents,Extraction Methods and Pharmacological Effects of Sauropus spatulifolius Beille

Sauropus spatulifolius Beille is a small evergreen shrub in Sauropus of the Euphorbiaceae family.It mainly contains chemical components such as amino acids,proteins,carbohydrates,polypeptides,glycosides,saponins,tannins,organic acids,alkaloids,coumarin and lactones,volatile oils and oils.In addition,the chemical components obtained by different extraction processes are also different.S.spatulifolius Beille mainly has antitussive and expectorant,anti-inflammatory and analgesic,bacteriostatic,antioxidant,and anti-allergic effects.The rich biological activity of S.spatulifolius Beille makes it have clinical applications such as adjuvant treatment of pulmonary edema,recovery of lung function,and treatment of chronic laryngitis or chronic pharyngitis.In this paper,the main chemical components,extraction and identification methods and biological activity of S.spatulifolius Beille were described in depth,in order to further lay a solid foundation for the in-depth research,development and utilization of S.spatulifolius Beille.

[3＋3] Formal Cycloadditions of Nitrones from Isatins and Azaoxyallyl Cations for Construction of Spirooxindoles

A [3＋3] formal cycloaddition reaction between in situ formed azaoxyallyl cations and nitrones from isatins has been developed, furnishing a spectrum of spiro[1,2,4-oxadiazinan-5-one]oxindoles in good to excellent yields with excellent diastereoselectivity. This method provides direct and efficient access to potentially bioactive spirooxin- doles incorporating a six-membered heterocyclic scaffold.