Carrimycin in the treatment of acute promyelocytic leukemia combined with pulmonary tuberculosis: A case report

BACKGROUND Pulmonary tuberculosis(PTB)is prevalent in immunocompromised populations,including patients with hematologic malignancies,human immunodeficiency virus infections,and chronic diseases.Effective treatment for acute promyelocytic leukemia(APL)combined with PTB is lacking.These patients show an extremely poor prognosis.Therefore,studies should establish efficient treatment options to improve patient survival and prognosis.CASE SUMMARY A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital.Peripheral blood smear revealed 54%blasts.Following bone marrow examinations,variant APL with TNRC18-RARA fusion gene was diagnosed.Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions,partial atelectasis in the lower lobes of both lungs,and the bronchoalveolar lavage fluid gene X-Pert test was positive,indicative of PTB.Carrimycin,ethambutol(EMB),and isoniazid(INH)were administered since he could not receive chemotherapy as the WBC count decreased continuously.After one week of treatment with carrimycin,the patient recovered from fever and received chemotherapy.Chemotherapy was very effective and his white blood cells counts got back to normal.After being given five months with rifampin,EMB and INH and chemotherapy,the patient showed complete remission from pneumonia and APL.CONCLUSION We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.

Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus

BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.

Organizing pneumonia secondary to pulmonary tuberculosis:A case report

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.

Computed tomography imaging and clinical significance of bacterium-positive pulmonary tuberculosis complicated with diabetes

BACKGROUND The increasing prevalence of tuberculosis(TB)and diabetes on a global scale poses a significant health challenge,particularly due to their co-occurrence,which amplifies the severity,recurrence and mortality rates associated with both conditions.This highlights the need for further investigation into their interrelationship.AIM To explore the computed tomography(CT)imaging and clinical significance of bacterium-positive pulmonary TB(PTB)combined with diabetes.METHODS There were 50 patients with bacterium-positive PTB and diabetes,and 50 with only bacterium-positive PTB.The latter were designated as the control group.The CT imaging of the two groups of patients was compared,including lesion range,shape,density and calcification.RESULTS No significant differences were observed in age,gender,smoking and drinking history,high blood pressure,hyperlipidemia and family genetic factors between the groups.However,compared to the patients diagnosed solely with simple bacterium-positive PTB,those with concurrent diabetes showed a wider range of lesions and more complex and diverse morphology on CT images.Among them,intrapulmonary tuberculosis lesions were often accompanied by manifestations of pulmonary infection,such as cavity formation and bronchiectasis.At the same time,diabetes-related signs were often seen on CT images,such as pulmonary infection combined with diabetic pulmonary lesions.Logistic regression analysis identified age and medical history as significant factors influencing the degree of pulmonary infection and CT imaging outcomes in patients with both TB and diabetes.This suggests that older age and specific medical histories may increase the risk or severity of pulmonary damage in these patients.CONCLUSION CT imaging reveals more complex lesions in PTB patients with diabetes,emphasizing the need for careful evaluation and comprehensive analysis to enhance diagnostic accuracy.

Factors of Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Therapy among HIV-TB Co-Infected Individuals in the East Region, Cameroon in the COVID-19 Era: A Retrospective Cohort Study

Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.

Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges

Tuberculosis(TB)remains a leading cause of death among infectious diseases,particularly in poor countries.Viral infections,multidrug-resistant and ex-tensively drug-resistant TB strains,as well as the coexistence of chronic illnesses such as diabetes mellitus(DM)greatly aggravate TB morbidity and mortality.DM[particularly type 2 DM(T2DM)]and TB have converged making their control even more challenging.Two contemporary global epidemics,TB-DM behaves like a syndemic,a synergistic confluence of two highly prevalent diseases.T2DM is a risk factor for developing more severe forms of multi-drug resistant-TB and TB recurrence after preventive treatment.Since a bidirectional relationship exists between TB and DM,it is necessary to concurrently treat both,and promote recommendations for the joint management of both diseases.There are also some drug-drug interactions resulting in adverse treatment outcomes in TB-DM patients including treatment failure,and reinfection.In addition,autophagy may play a role in these comorbidities.Therefore,the TB-DM comorbidities present several health challenges,requiring a focus on multidisciplinary collaboration and integrated strategies,to effectively deal with this double burden.To effectively manage the comorbidity,further screening in affected countries,more suitable drugs,and better treatment strategies are required.

Perianal tuberculous ulcer with active pulmonary,intestinal and orificial tuberculosis:A case report

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.

Healthcare Worker-Related Factors Contributing to Tuberculosis Treatment Non-Adherence among Patients in Kisumu East Sub-County

Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.

BPaL/BpaLM regimen:A bright future for drug-resistant tuberculosis

Indonesia is one of the countries with the highest burden of tuberculosis and drug-resistant tuberculosis(DR-TB)across the world.Based on data from the World Health Organization(WHO)Global TB Report 2023,it is estimated that there are 10000 cases of DR-TB in Indonesia.Bedaquiline,a novel antitubercular drug,has been implemented to treat DR-TB globally.It was administered either a shorter(9 months)or individualized treatment regimen(18 months).However,long treatment duration with various adverse events affects patient compliance.Therefore,a short treatment with less medication is urgently required.In 2022,the WHO announced an alternative regimen-bedaquiline,pretomanid,linezolid,and moxifloxacin(BPaLM)to treat DR-TB patients for six months without resistance to fluoroquinolones[1].This recommendation is based on previous clinical trials of TB,Zenix TB,and TB-PRACTECAL.The introduction of BPaL and BPaLM provided a bright future for treating DR-TB patients.

Diabetes and tuberculosis:An emerging dual threat to healthcare

Tuberculosis(TB)remains a huge global healthcare challenge even in the 21^(st) century though the prevalence has dropped in developed countries in recent decades.Diabetes mellitus(DM)is an important risk factor for the development and perpetuation of TB owing to the immune dysfunction in patients with DM.The coexistence of both diseases in the same individual also aggravates disease severity,complications,and chance of treatment failure because of gross immune alterations posed by DM as well as TB.Various complex cellular and humoral immunological factors are involved in the dangerous interaction between TB and DM,some of which remain unknown even today.It is highly important to identify the risk factors for TB in patients with DM,and vice versa,to ensure early diagnosis and management to prevent complications from this ominous coexistence.In their research study published in the recent issue of the World Journal of Diabetes,Shi et al elaborate on the factors associated with the development of TB in a large cohort of DM patients from China.More such research output from different regions of the world is expected to improve our knowledge to fight the health devastation posed by TB in patients with diabetes.

INF-γ and IL-2 Profile as Therapeutic Markers in Tuberculosis Patients at the Jamot Hospital of Yaounde-Cameroon

Background: Tuberculosis (TB) is one of the top lethal infectious diseases worldwide. In recent years, interferon-γ (INF-γ) release assays (IGRAs) have been established as routine tests for diagnosing TB infection. However, produced INF-γ assessment cannot permit to distinguish active ATB from latent TB infection (LTBI), especially in TB epidemic areas. In addition to IFN-γ, interleukin-2 (IL-2), secreted by activated T cells, is involved in immune response against Mycobacterium tuberculosis. This could be involved in the follow up of treatment response. The aim of our study was to determine IFN-γ and IL2 cytokines profiles of patients under antituberculosis treatment. Materials and Methods: A six months’ cross-sectional study was conducted at the Jamot Hospital of Yaoundé, from May to August 2021. Sociodemographic and clinical data as well as 5 mL of blood were collected from each participant. INF-γ and IL-2 were determined using indirect Enzyme linked Immuno-Sorbent Assay (ELISA) according to the manufacturer’s recommendations and spectrum exam in combination with radiography and GeneXpert were used as standard. P-values Results: The results showed that men were more infected 14/61 (31.8%) with a high presence in active and resistant TB groups. The mean age was 41.3 ± 13.1 years with a 95% CI = [38.2 - 44.7], the age group with the highest infection rate was ranged between 31 and 40 years. The IL-2 and INF-γ means were respectively 327.6 ± 160.6 pg/mL and 26.6 ± 13.0 pg/mL in ATB patients, 251.1 ± 30.9 pg/mL and 21.4 ± 9.2 pg/mL in patients with resistant tuberculosis, while it was 149.3 ± 93.3 pg/mL and 17.9 ± 9.4 pg/mL in cured patients, 15.1 ± 8.4 pg/mL and 5.3 ± 2.6 pg/mL in participants presumed healthy (p γ and IL-2rates were observed between the different groups. Conclusion: Monitoring the serum levels of INF-γ and IL-2 would be useful for the follow-up of anti-tuberculosis patients, particularly in the both cytokines association case.

Pancytopenia and Pulmonary Tuberculosis: A Case Report

Background: Hematopoietic system is seriously affected by tuberculosis. It exerts a dazzling variety of hematological effects involving both cell lines and plasma components [1]. Anemia and leukopenia are not unusual with tuberculosis (TB), but pancytopenia is rare [2]. Findings: In this report, we described a case of a 42 years man presenting bleeding and pancytopenia;bacteriological pulmonary TB was established by genotypic rapid test and treatment following the WHO guidelines on drug-sensitive TB treatment. Patient recovered entirely with the WHO recommended regimen associated with general and local treatment of the bleeding. Conclusion: This case report emphasizes the importance of always suspecting tuberculosis in a tuberculosis-endemic area, even when the clinical manifestations are atypical, like pancytopenia and also of properly investigating the differential diagnosis. Even though prognosis seems to be less good, actual treatment regimen is still effective.

Treatment outcomes and adverse drug reactions among patients with drug-resistant tuberculosis receiving all-oral,long-term regimens:First record viewing report from Pakistan

Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.

Rate of Patient Delay among Students with Pulmonary Tuberculosis in China: A Meta-Analysis

Objective: To systematically review the rate of patient delay of pulmonary tuberculosis (PTB) patients among students in China. Methods: Databases including Web of Science Core Collection, PubMed, The Cochrane Library, CBM, CNKI, VIP, and WANFANG DATA were electronically searched to collect cross-sectional studies on the incidence of delayed consultation in students with PTB in China from January 1, 2000, to November 15, 2022. Two researchers independently screened studies, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by Stata 16.0 software. Results: In total, 60 cross-sectional studies with 260,707 cases involving 136,701 delayed consultation PTB patients were included. The results of meta-analysis showed that the rate of patient delay was 46.4% (95% CI 44.3% to 48.4%) among students with PTB in China. Results of subgroup analyses showed that: 1) The rates were 46.8% and 50.4% for male and female students, respectively. 2) The rates for the East, Central and West parts of China were 42.3%, 45.6% and 50.5%, respectively. 3) The rates were increased first and then decreased during 2007 to 2020. 4) The rates of students from primary school, junior high school, senior high school and university were 50.3%, 49.8%, 40.7% and 44.9%, respectively. 5) The rates for the Han and the other nationalities were 50.3% and 53.9%, respectively. 6) The rates for local and non-local students were 47.2% and 50.5%, respectively. 7) The rates of patients detected by consultation due to symptoms, recommendation due to symptoms, referral, tracking and healthy physical examination were 50.5%, 51.6%, 46.6%, 55.6% and 16.2%, respectively. 8) The rates of patients with initial PTB and retreatment PTB were 53.1% and 59.6%, respectively. 9) The rates of patients with positive etiology, negative etiology and without etiological results were 55.9%, 47.0% and 51.6%, respectively. 10) The rates of severe and non-severe patients were 59.4% and 52.9%, respectively. Conclusion: The patient delay rate for Chinese students with PTB is generally at a high level. There are substantial differences in the patient delay rate for students with PTB among different genders, regions, study stages, nationalities, household registration types, detection methods, and treatment classifications.

Prevalence of Pulmonary Tuberculosis and Associated Factors among Patients Admitted to the Amissa Bongo University Hospital Center in Franceville, Gabon

Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.

Tumor Necrosis Factor-Alpha (TNF)-308G/A and Interleukin 8(IL-8)-251C/T Polymorphisms in Pulmonary Tuberculosis Patients from Congo

Background: Tuberculosis (TB) is one of the world’s deadliest infectious diseases. Tumor necrosis factor-Alpha (TNF-α) and Interleukin 8 (IL-8) are involved in the pathogenesis of pulmonary TB (PTB). However, the contribution of polymorphisms of these cytokines to PTB susceptibility needed more investigation across geographic regions and ethnic groups. Purpose: The aim of this study was to investigate the association of the TNF-α-308 G/A and IL-8-251T/A polymorphisms with PTB risk in the Congolese population. Methods: This case-control study included 150 PTB patients and 160 control subjects. Blood samples were collected from all participants and were used for the TNF-α-308 G/A and IL-8-251T/A genotyping by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Odds ratios (OR) were calculated to estimate the potential polymorphism associations. A P level of Results: A significant difference was found between PTB patients and controls regarding the TNF-α-308AA genotype (P = 0.035) distribution. Moreover, this genotype was associated with risk to TB (OR = 7.19, 95% CI = 0.85 - 60.65, P = 0.035). The A allele was significantly more frequent in PTB patients than in controls, and was associated with risk to PTB (OR = 1.68, 95% CI = 1.05 - 2.68, P = 0.014). Regarding the IL-8-251T/A gene, TA and AA genotypes were significantly more frequent in PTB patients compared to controls, and were associated with increased risk to PTB (OR = 2.64, 95% CI = 0.97 - 7.18, P = 0.031 and OR = 3.0, 95% CI = 1.13 - 7.98, P = 0.014, respectively). However, the IL-8-251 A allele was not associated to PTB susceptibility (OR = 0.27, 95% CI = 0.15 - 0.44). Conclusion: TNF-α-308G/A and IL-8-251T/A polymorphisms may be associated to PTB susceptibility in the Congolese population, and the AA genotype of both cytokines could be a risk factor.

X-ray Manifestations of Pneumoconiosis Patients and Differential Analysis with Pulmonary Tuberculosis

[Objectives]This study was conducted to explore the X-ray manifestations of pneumoconiosis patients and differentiation from pulmonary tuberculosis.[Methods]Retrospective analysis was conducted on 103 patients who underwent lung examinations,including 47 cases of pneumoconiosis and 56 cases of pulmonary tuberculosis.The differences in nodule characteristics and accompanying cavity sign between pneumoconiosis and pulmonary tuberculosis were compared.[Results]The X-ray manifestations of pneumoconiosis patients mainly included various forms of lung images,which were uneven in density,and had blurry edges,and sometimes thickening of lung markings and reduction of lung volume could be observed.The acinar nodules observed in X-ray films of patients with hematogenous disseminated pulmonary tuberculosis appeared petal like.The uniformity of nodule appearance such as nodule distribution,nodule density,and nodule size was significantly lower in pneumoconiosis than in hematogenous disseminated pulmonary tuberculosis,showing a statistical significance(P<0.05).The diameter of cavities in patients with pneumoconiosis accompanied by cavity sign[(0.64±0.13 vs 3.37±0.95)cm]was lower than that in patients with secondary pulmonary tuberculosis accompanied by cavity sign.There was a significant difference in the thickness of the cavity wall between the two diseases,and patients with pneumoconiosis accompanied by cavity sign had a higher rate of thick wall cavities(>3 mm).The X-ray manifestations of pneumoconiosis and tuberculosis were relatively similar,but the distribution,density and size of nodules in pneumoconiosis were relatively uneven,and the patients accompanied by cavity sign had smaller cavity diameter and higher rate of thick-walled cavities.[Conclusions]This study provides a reference for the clinical differential diagnosis of pneumoconiosis and pulmonary tuberculosis.

Meta‑analysis of influencing factors associating with treatment outcome of multidrug resistant tuberculosis

Objective:To systematically review the influencing factors of the treatment outcome of multidrug-resistant pulmonary tuberculosis and provide reference for the prevention and treatment of multidrug-resistant pulmonary tuberculosis.Method:Case control studies on the factors influencing the treatment outcome of multidrug-resistant pulmonary tuberculosis in Chinese databases(CNKI,VIP,Wanfang,Sinomed)and English databases(Pubmed,Web of science,Medline,Embase,Scopus)were searched and collected by computer.The search period was from the establishment of the database to January 2023.After screening and quality evaluation,RevMan5.4 was used for meta-analysis.Result:Totally 18 articles were ultimately included,with a sample size of 7328 people.The results showed that retreatment,complications,adverse reactions,and gender were related to the treatment outcome of multidrug-resistant pulmonary tuberculosis.The OR values and 95%CI of each factor were 0.22(0.17-0.29),0.38(0.32-0.46),0.27(0.17-0.44),and 0.43(0.33-0.56),respectively.Conclusion:Complications,retreatment,adverse reactions,and male gender are effective risk factors for the treatment outcome of multidrug-resistant pulmonary tuberculosis.In clinical practice,more targeted measures are needed for different types of patients.Due to the limitations of the number of studies,the above conclusions require more research to support them.

Missed Opportunities for Diagnosing Bacilliferous Pulmonary Tuberculosis by Optical Microscopy versus GeneXpert MTB/RIF in Endemic Areas

Objective: To assess the missed opportunities from the diagnosis of bacilliferous pulmonary tuberculosis by optical microscopy compared to GeneXpert MTB/RIF between 2015 and 2019. Methods: This is a retrospective analysis of the diagnostic results of bacilliferous pulmonary tuberculosis in patients suspected of pulmonary tuberculosis at their first episode during the period. GeneXpert MTB/RIF (GeneXpert) and optical microscopy (OM) after Ziehl-Neelsen stained smear were performed on each patient’s sputum or gastric tubing fluid sample. Results: Among 341 patients suspected of pulmonary tuberculosis, 229 patients were declared bacilliferous tuberculosis by the two tests (67%), 220 patients by GeneXpert and 95 patients by OM, i.e. 64.5% versus 28% (p i.e. 58.5% of the positive cases detected by the two tests (134/229 patients) and 39.3% of the patients suspected of tuberculosis (134/341 patients). On the other hand, among 95 patients declared positive by OM, the GeneXpert ignored 9 (9.5%), i.e. 4% of all the positive cases detected by the two diagnostic tests (9/229 patients) and 3% of the patients suspected of tuberculosis (9/341 patients). The differences observed between the results of the two tests were statistically significant at the 5% threshold (p Conclusion: This study reveals missed diagnostic opportunities for bacilliferous pulmonary mycobacteriosis, statistically significant with optical microscopy than GeneXpert. The GeneXpert/optical microscopy couple could be a good contribution to the strategies for the elimination of pulmonary tuberculosis in sub-Saharan Africa.

Observation on the Effect of Integrated Medical and Nursing Care in Patients with Pulmonary Tuberculosis Combined with Lung Cancer

Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.