ObjectiveTo study the latent tuberculosis infection (LTBI) in the new recruits with enzymelinked immunospot assay (ELISPOT), and evaluate the value of ELISPOT on the detection of LTBI .MethodsA total of 366 new recruits were intradermally injected with purified protein derivative (PPD) ,and detected with ELISPOT assay with recombinant CFP10/ESAT6 fusion protein (rCFP10/ESAT6) as a stimulus. New recruits who were ELISPOT and PPDnegative were vaccinated by intradermal injection with Bacillus CalmetteGuerin (BCG) vaccine, they were detected by PPD skin test and ELISPOT assay again 10 months later.ResultsAmong 366 new recruits , the positive rate of PPD skin test and ELISPOT assay was 44.81% and 31.69%, respectively. Of 202 PPDnegative and 164 PPDpositive new recruits, 53 (26.24%) and 63 (38.41%) were ELISPOT positive, respectively， overall consistency between two tests was 57.92% (212/366), the difference was statistically significant(χ2=14.34，P<0.001). Among new recruits with BCG vaccination , PPD and ELISPOTpositive rate was 58.53% (127/217) and 29.03% (63/217) respectively, spot forming cell (SFC) were 32.44±26.52; Among new recruits without BCG vaccination , PPD and ELISPOTpositive rate was 24.83% (37/149) and 35.57% (53/149) respectively, SFC were 41.81±30.48. 78.18% of 110 new recruits vaccinated by BCG vaccine 10 months later were PPDpositive, but all of they were ELISPOTnegative. ConclusionELISPOT technique has high specificity and sensitivity for screening TB infection.

ObjectiveTo investigate the status of tuberculosis (TB) infection among health care workers (HCWs) in an infectious diseases hospital, and explore the risk and influencing factors of TB infection.MethodsAll HCWs in an infectious diseases hospital were surveyed through questionnaire and purified protein derivative (PPD) testing.ResultsIncidence of TB infection among all HCWs in this hospital was 48.18%. There was no significant difference in TB infection among HCWs in different departments（P＞0.05）. TB infection among HCWs of different working seniority, different ages, and different job titles were all significantly different （all P＜0.05）. Risk factors for TB infection were education level, job title, living condition, and working time in TB clinics or wards, OR (95%CI) were 1.70（1.03-2.80）, 1.95（1.10-3.45）,1.84（1.03-3.28）,and 2.38（1.40-4.04）respectively；personal protection was a protective factor for TB infection (OR,0.92 ［95% CI, 0.85- 0.99］）.ConclusionHCWs in infectious diseases hospital are at high risk of TB infection, they should improve their selfprotection consciousness, and take protective measures as early as possible.

ObjectiveTo explore the expression levels of serum nitric oxide (NO) and nitric oxide synthase(NOS) between Han and Uyghur nationality patients with antituberculosis druginduced liver injury(ATDLI). MethodsPatients with confirmed ATDLI in Chest Hospital of Xinjiang Uyghur Autonomous Region and First Affiliated Hospital of the Medical College of Shihezi University between January 2015 and May 2016 were chosen and divided into Han group and Uyghur group. By detecting the expression levels of NO and NOS in serum of ATDLI patients, expression levels of serum NO and NOS in ATDLI patients of different gender, body mass index (BMI), and liver function injury were compared.Results100 ATDLI patients in Han group and 135 in Uyghur group were recruited in study. Expression levels of NO and TNOS in Han group were (134.24±27.60) μmol/L and (33.01±4.23) U/mL respectively, in Uyghur groups were (97.10±17.41) μmol/L and (27.41±3.95) U/mL respectively, serum levels of NO, TNOS, iNOS, and eNOS in Han patients were all higher than Uyghur patients, difference was statistically significant (P<0.01). In Han ATDLI group, serum levels of NO and TNOS in male patients were both higher than female patients (P<0.05); in Uyghur ATDLI group, serum levels of NO, TNOS, and iNOS in male patients were all higher than female patients(P<0.01). The expression levels of serum NO, TNOS, and iNOS of Han group were all higher than the same gender in Uyghur group (P<0.001), difference in levels of NO and TNOS among different body mass index (BMI) groups in Han and Uyghur patients were both statistically significant (P<0.01). In both group, levels of NO and TNOS in obese patients were both higher than lean patients and normal weight patients (P<0.05). The correlation analysis showed that NO levels of Han and Uyghur groups were both positively correlated with BMI (r= 0.444, 0.677, respectively, P<0.01). There were significant differences in serum NO and NOS levels between Han and Uyghur patients with different degrees of liver injury (P<0.05); NO and NOS levels in both groups with mild liver injury were both lower than those with moderate and severe injury (P<0.001).ConclusionSerum NO and NOS levels between ATDLI Han group and Uyghur group are different, serum NO level is related to BMI, and it can increase with the degree of liver injury.

ObjectiveTo explore the effect of meticulous nursing intervention and multidisciplinary team(MDT) collaboration on the compliance and correctness of wearing masks of tuberculosis(TB) patients going out for checkup. MethodsTB patients in the tuberculosis department of a hospital from October 2015 to December 2016 were investigated. OctoberDecember 2015 was pre intervention group（without intervention）, JanuaryDecember 2016 was postintervention group, meticulous nursing intervention and MDT collaboration were adopted, wearing status of medical surgical masks and awareness of TB prevention and control measures in TB patients going out for checkup before and after intervention were compared. Results799 TB patients were admitted in hospital, 160 cases were in pre intervention group and 639 in postintervention group. Before intervention, mask wearing rate and correct mask wearing rate were 50.63% and 86.42% respectively; after intervention, mask wearing rate and correct mask wearing rate were 95.31% and 98.52% respectively. Wearing rate and correct wearing rate of masks of TB patients at different seasons before and after intervention were compared, difference were both statistically significant (χ2=222.94, 38.512，respectively, both P=0.000）. After intervention, patients’ awareness of tuberculosis and prevention and control measures were both higher than before intervention, difference were both statistically significant (both P<0.001). ConclusionMeticulous nursing intervention and MDT collaboration can improve the wearing rate and correct wearing rate of masks in TB patients going out for checkup.

耐多药结核（multidrugresistant tuberculosis, MDRTB）是指结核分枝杆菌对至少2种一线抗结核药物耐药，其中至少包括同时对异烟肼和利福平耐药。MDRTB具有治疗费用高、治愈率低、死亡率高的特点，其发生率的增高以及广泛传播对结核病治疗及控制带来严峻挑战和威胁，令结核重新成为顽症。耐多药肺结核（MDRPTB）是MDRTB的主要组成部分。

ObjectiveTo understand the clinical significance of interleukin12(IL12) in pulmonary tuberculosis (TB).MethodsSerum IL12 in 80 TB patients before receiving antiTB treatment were detected by enzymelinked immunosorbent assay, and were compared with 30 healthy volunteers (healthy control) and 20 patients with 6month followup after effective antiTB treatment, significance of IL12 was studied in patients who were subdivided into several groups according to common clinical indicators of TB.ResultsThe average serum IL12 level in 80 pulmomary TB patients was (41.49±34.22)pg/mL, which was significantly lower than (58.12±44.92)pg/mL in healthy control group(t=2.51,P<0.05). Serum IL12 level in 20 followedup patients increased from (12.93±12.48)pg/mL before treatment to (66.26±20.97)pg/mL after treatment (t=-6.88,P<0.05). There was no significant difference in serum IL12 level between 20 followedup patients and healthy control group(t=-0.60,P>0.05).There was no statistical difference in serum IL12 level between the following groups respectively: simple pulmonary TB/pulmonary TB associated with tuberculous pleurisy, pulmonary cavity/nonpulmonary cavity, lung lesions showed by CT <3 lobes/≥ 3 lobes, sputum TB positive/negative, tuberculin test positive/negative, elevated erythrocyte sedimentation rate (ESR)/ normal ESR, PPD strongly positive/ nonstrongly positive (all P>0.05).ConclusionIL12 level is closely related with activity in pulmonary TB, it can reflect the immune state in patients, and judge activity and prognosis of pulmonary TB.

ObjectiveTo explore the difference in CD4+CD25+Foxp3+T lymphocytes and their secretion of cytokines transforming growth factorβ1（TGFβ1） and interleukin10 （IL10）among drugresistant tuberculosis (DRTB) patients, nondrugresistant tuberculosis(nonDRTB) patients and healthy control subjects, and evaluate its role in the inhibition of specific cellular immune response.MethodsFlow cytometry was applied to detect the expression levels of peripheral blood CD4+CD25+T lymphocytes and CD4+CD25+Foxp3+T lymphocytes in 30 healthy subjects（control group）, 39 nonDRTB patients（nonDRTB group） and 35 DRTB patients（DRTB group） ; enzymelinked immunosorbent assay (ELISA) was used to detect TGFβ1 and IL10 levels in peripheral blood in different groups.ResultsCD4+CD25+T and CD4+CD25+Foxp3+T lymphocytes accounted for (17.09±5.43)% and (0.78±0.88)% respectively of total number of CD4+T cells in the peripheral blood of control group, (22.12±3.43)% and (2.79±1.65)% respectively in nonDRTB group, (24.01±5.65)% and (4.51±1.47)% respectively in DRTB group. The percentage of CD25+CD4+T lymphocytes in CD4+T lymphocytes in DRTB group was higher than that of nonDRTB group, but the difference was not significant(P>0.05); the percentage of CD4+CD25+Foxp3+T lymphocytes in CD4+T lymphocytes in DRTB group was significantly higher than control and nonDRTB group (P＜0.05), and levels of TGFβ1(［4.15±1.39］ρ/ng·L-1) and IL10(［872.17±269.75］μg/L) were significantly higher than those of nonDRTB group (［3.03±1.42］ρ/ng·L-1 and ［266.83±57.09］μg/L, respectively) as well as control group (［2.12±0.77］ρ/ng·L-1 and ［105.21±23.56］μg/L, respectively) (P＜0.05).ConclusionCD4+CD25+Foxp3+T lymphocytes may weaken elimination funtion of immune system on Mycobacterium tuberculosis in TB patients,and related to the progress of tuberculosis infection as well as multidrugresistance. TGFβ1 and IL10 may be involved in the inhibition of cellular immunity and have some correlation with the formation and the severity of the DRTB.

我国结核病感染人数和死亡人数均较多，疗效欠佳。结核病感染耐药率高达46%，被世界卫生组织(WHO)列入特别引起警示的国家和地区之一［1］。急性粟粒型肺结核，病情重，来势凶猛，难以救治，病死率高。本文报道1例应用肾上腺皮质激素（以下简称激素）治疗肾病综合征患者合并感染急性粟粒型肺结核，经治疗无效死亡的病例，以期引起临床关注。

ObjectiveTo investigate drug resistance of Mycobacterium tuberculosis (M. tuberculosis) isolated from inpatients with pulmonary tuberculosis in Shenyang Chest Hospital in recent 4 years.MethodsRetrospective analysis of drug susceptibility test of M. tuberculosis to isoniazid(INH), streptomycin(SM), ethambutol (EB) and rifampicin (RFP) was conducted, M. tuberculosis were isolated from new cases and retreated pulmonary tuberculosis patients with positive sputum culture in Shenyang Chest Hospital from January 1, 2003 to December 31, 2006. ResultsThe total drugresistant rate of M. tuberculosis was 39.11% (79/202), multidrugresistant rate was 10.89%(22/202). The initial drugresistant rate and acquired drugresistant rate was 35.11% and 46.48% respectively. The acquired multidrugresistant rate was 16.90%,which was obviously higher than that of initial multidrugresistant rate of 7.63%（χ2=4.08，P=0.049）. In 2004, the acquired multidrugresistant rate (36.36%) was obviously higher than that of initial multidrugresistant rate (5.66%)（χ2=5.95，P=0.02）. However in 2006, the two rates were the same(13.51%).The retreated patients showed a higher drug resistance to INH (47.89%), SM (46.48%) and RFP (36.62%). Multidrugresistant rate of retreated patients was 35.21%, single drugresistant rate and multidrugresistant rate of initial patients were both 16.03%.ConclusionThe results showed that the drug resistance and multidrug resistance of pulmonary tuberculosis are still serious, especially the initial drug resistance and multidrug resistance. So effective control of drug resistant tuberculosis is critical task currently.

肺结核并发肺脓肿、胸膜腔脓肿常规治疗效果往往不佳，手术可以很大程度清除病灶，配合抗结核治疗能够收到明显效果。2011年3月，我们实施肺结核伴肺内及胸膜腔内多发结核性脓肿手术治疗1例，疗效明显，现总结报告如下。

ObjectiveTo evaluate the changes and significance of T lymphocyte subsets and cytokines in peripheral blood of patients with drugsensitive and multidrugresistant pulmonary tuberculosis（MDR pulmonary TB）.MethodsFrom July 2011 to July 2012, T lymphocyte subsets (CD3+,CD4+,and CD8+T)and cytokines(IFNγ and IL10) were detected in patients with drugsensitive pulmonary TB (DS group, 20 cases),MDR pulmonary TB (MDR group, 15 cases) and healthy physical examination persons (control group,26 cases) in a hospital, data of three groups were compared.ResultsNo significant differences were found in percentages of CD3+,CD4+,and CD8+T among three groups(P>0.05);there were significant differences in absolute counts of CD3+,CD4+,and CD8+T among three groups（P＜0.01）,and the difference between every two groups was also significant (P<0.05), which was highest in control group(CD3+［1 426±485］/μL;CD4+［825±306］/μL;CD8+T［516±213］/μL）and lowest in MDR group（CD3+ ［746±358］/μL；CD4+ ［461±204］/μL；CD8+T ［213±101］/μL）. There were significant differences in IFNγ value among three groups（P＜0.01）, and the difference between every two groups was also significant (P<0.05), which was highest in control group (［65.04±36.31］pg/mL) and lowest in MDR group(［23.32±14.04］pg/mL). No significant differences were found in IL10 among three groups（P＞0.05）.ConclusionThe absolute counts of T lymphocyte subsets CD3+,CD4+,and CD8+T as well as IFNγ declined in drugsensitive pulmonary TB patients and MDR pulmonary TB patients, which may accelerate the progress of TB and be one of the causes of MDR pulmonary TB.

ObjectiveTo investigate protection status among close contacts of sputum smearpositive pulmonary tuberculosis (TB) patients, so as to improve the prevention and control of TB infection.MethodsOnthespot and questionnaire survey were adopted to investigate 125 persons who had close contact with 54 cases of sputum smearpositive pulmonary TB patients.ResultsThe average awareness rate of knowledge about prevention and control on TB infection among family members, colleagues, and classmates of smearpositive TB patients was 65.80%, 74.05% and 70.53% respectively, the average awareness rate among different close contacts had no statistical difference (χ2=3.96, P=0.151）.Of 125 close contacts, the percentage of persons who had implementation of management measures, environmental control (environmental ventilation, disinfection of environmental surfaces, and disinfection of patients’ sputum), and personal protection was 96.00%,64.80%,and 59.20% respectively, the qualified implementation rate of measures was 80.00%,74.90%,and 31.08% respectively; the percentage of implementing measures among different close contacts had statistical difference（χ2=29.32，P=0.002）, the qualified implementation rate of measures had no statistical difference（χ2=1.85，P=0.416）.ConclusionClose contacts of pulmonary TB patients lack selfprotection awareness, protective measures are inadequate, there is a risk of infection, education about prevention and control of pulmonary TB should be intensified.

ObjectiveTo understand the awareness rate of pulmonary tuberculosis(TB) prevention and control among residents in Beijing, so as to provide basis for giving publicity on knowledge of pulmonary tuberculosis prevention and control. MethodsResidents in Beijing were randomly selected for questionnaire survey, the main content of questionnaire included “The 2006 national survey on knowledge, attitudes and practice about tuberculosis prevention and control”, the core knowledge of pulmonary TB prevention and control, as well as the related symptoms of suspected tuberculosis were also included. ResultsA total of 520 questionnaires were collected, 503 of which were qualified, the effective rate was 96.73%. Among respondents, the total awareness rate of five core knowledge about pulmonary TB prevention and control was 40.87%, 78.93% of the respondents knew that pulmonary TB was a chronic respiratory infectious disease which could seriously damage people’s health，48.51% knew that the majority of patients with pulmonary TB could be cured as long as they persisted in correct treatment, only 19.68% knew that examination and treatment of pulmonary TB in the county (district) level TB control institutions could enjoyed national free policy. Nearly 53.48% of respondents knew 4 or more suspected pulmonary TB symptoms, only 7.36% of respondents could recognize all eight symptoms of pulmonary TB. ConclusionResidents in Beijing have low awareness of pulmonary TB prevention and control knowledge. If patients in the early stage of pulmonary TB can not identify symptoms, it is not only delay treatment and increase the spread of tuberculosis, but also induce the transmission of multidrugresistant Mycobacterium tuberculosis, so produce more challenges to pulmonary TB prevention and control.

ObjectiveTo evaluate application effectiveness of  quality control circle (QCC) in increasing the face mask wearing rate of hospitalized pulmonary tuberculosis (TB) patients.MethodsNine nurses in department of tuberculosis formed a ‘circle’,   the  theme of ‘improving the face mask wearing rate of hospitalized pulmonary TB patients’ was established, rectification measures were formulated and implemented, face mask wearing rates of patients before and after implementing QCC activities were analyzed statistically.ResultsThe face mask wearing rate of hospitalized pulmonary TB  patients after implementing  QCC activities  was higher than that before implementing  QCC activities (87.50% ［147/168］ vs 65.54%［116/177］, P<0.05). The abilities of every ‘circle member’ have been improved in the following aspects: problemsolving skills, sense of responsibility, communication skills, selfconfidence, team working, enthusiasm, qualitycontrol techniques, and cooperation abilities,the total average score increased from 23.78 before implementing QCC to 33.78 after implementing QCC.ConclusionQCC activities can not only improve the face mask wearing rate of hospitalized pulmonary TB patients, but also enhance circle members’ qualitycontrol skills and team spirit.

Immune response of T lymphocytes in patients with pulmonary tuberculosis combined with chronic hepatitis B GUO Haoyu1, LIU Hongbo2, ZHANG Chengguo1 (1 Changsha Central Hospital, Changsha 410004, China; 2 Xiangya Hospital, Central South University, Changsha 410008, China )［Abstract］ObjectiveTo study the serum levels of Th1 lymphocyte factor and the expression pattern of Th1 and Th2 in patients with pulmonary tuberculosis (PT)combined with chronic hepatitis B (CHB)．MethodsSerum levels of tumor necrosis factorα(TNFα),interferonγ(IFNγ),interleukin12 (IL12) in 21 patients with PT combined with positive HBsAg, 30 simple PT patients and 30 healthy controls were detected with enzymelinked immunosorbent assay (ELISA) ;and the expression pattern of CD4+T lymphocytes,Th1 and Th2 cells in peripheral blood were detected by flow cytometry．ResultsThe serum levels of TNFα in patients with simple PT and PT coinfected with CHB were both higher than that in healthy group (both P<0.01)；the serum levels of IFNγ and IL12 in patients with simple PT were both lower than that in healthy group (both P<0.05)；the serum levels of IFNγ and IL12 in patients with PT coinfected with CHB were both lower than that in simple PT patients (both P<0.01).The expression of CD4+ T lymphocytes and Th1 cells in simple PT patients were significantly lower than that in healthy group (P<0.05，P<0.01)；The expression of Th2 cells in simple PT patients was significantly higher than that in healthy group (P<0.05)；The expression of CD4+ T lymphocytes and Th1 cells in PT coinfected with CHB patients were significantly lower than that in simple PT patients (P<0.05，P<0.01).ConclusionPatients with PT showed lower expression of Th1 and higher expression of Th2; patients with PT coinfected with CHB showed further lower expression of Th1 and higher expression of Th2.

ObjectiveTo evaluate the clinical efficacy of a combination therapy with capreomycin, levofloxacin and sodium aminosalicylate in the treatment of multidrug resistant pulmonary tuberculosis ( MDRPTB). MethodsOne hundred and twenty patients with MDRPTB were divided  into treatment group（60 cases） and control group（60 cases）. In the treatment group, patients mainly received treatment of capreomycin, levofloxacin and sodium aminosalicylate, and combined with rifapentine, isoniazid  and  pyrazinamide; in control group, patients mainly received treatment of amikacin, ethambutol, combined treatment was the same with that of treatment group, the course of treatment were both 16 months. ResultsAll patients received 16 months treatment, the sputum negative conversion rate of the treatment group was 83.33%, which was significantly higher than 65.00% of control group (χ2=5.26, P=0.02); The focal absorption rate and cavity closure rate in treatment group was 90.00% and 71.43% respectively, which was obviously higher than 66.67% and 31.25% of control group respectively (χ2=9.62, P=0.00; χ2=10.82, P=0.00); Adverse effects  in treatment group and control group was 35.00% and 33.33% respectively, there was no significant difference between two groups  (χ2=0.04, P=0.85). ConclusionThe combination treatment  of  capreomycin, levofloxacin  and sodium aminosalicylate is effective and safe for patients with MDRPTB.

ObjectiveTo analyze the registration of pulmonary tuberculosis(PTB) among students in Hunan Province, understand the epidemiological characteristics, provide evidence for improving tuberculosis control strategy in schools in Hunan Province.MethodsRegistration rate and epidemiological characteristics of students with tuberculosis in Hunan Province were analyzed through data registered in China Tuberculosis Information Management System between 2012 and 2017.ResultsFrom 2012 to 2017, 7 940 students with PTB were found in Hunan Province, the registered incidence was 13.23/1 00 000, 2 203 cases were smear positive for PTB, registered incidence was 3.67/1 00 000. Registered incidence of active PTB students in 2012-2017 was significantly different （χ2=80.079，P<0.001）；registered incidence of smear positive PTB students in 2012-2017 was significantly different （χ2=112.213，P<0.001）. The number of registered PTB students in the second quarter was the largest (32.2%), mainly male (60.8%) and students aged 15-19 years (61.8%). There was a significant difference in the registration of PTB students in different cities from 2012 to 2017 (χ2=320.432, P<0.001). The top three regions of the total number of registrations were Changsha, Xiangxi and Hengyang. From 2012 to 2017, the registered PTB students were mainly referral (38.8%), 99.8% of the patients received antituberculosis treatment, diagnosis and treatment were mainly for smearnegative, nonsevere, nondrugresistant, and newly treated patients, accounting for 67.9%, 95.2%, 99.5%, and 99.3% respectively.ConclusionIt is necessary to strengthen the prevention and control of tuberculosis in schools, screen tuberculosis among freshmen in high schools and universities, publicize tuberculosis knowledge, and improve awareness of tuberculosis prevention and control in schools.

近20年来，不合理、不规律化学治疗导致结核菌耐药株逐渐增加。耐药结核病已成为引起全球结核病急剧上升的四大原因之一，特别是耐多药肺结核(MDRTB)的发生对结核病控制计划的实施构成严重威胁［1］。我国是世界上第二高发结核病大国，约有500万肺结核患者，具有耐药率高，继发耐多药者逐年增多的特点，近几年甚至有初始耐多药肺结核病(initial MDRTB)的局部流行［2］。耐多药和多耐药肺结核已成为结核治疗的难点和治疗失败的主要原因。目前合理的化学药物仍是治疗MDRTB的最有效武器［3］。但由于肺结核病变的发展阶段和个体身体营养状况不同，化学治疗往往达不到满意的疗效或继发再感染。而且有些患者因长期抗结核化学治疗产生药物副作用而放弃治疗，此外医患的依从性、免疫抑制剂的应用等因素影响药物剂量，从而导致最终治疗失败。因此，更新治疗观念和研制有效、低毒的创新药物十分重要。近年来，国内研究者分别在中药对结核菌体外抑菌作用、对结核病的治疗作用、对结核菌感染免疫力影响等方面进行了研究，有的甚至已深入到分子和基因水平。现对近年来有关中药治疗肺结核，尤其是耐多药肺结核的研究进展作一综述。

ObjectiveTo evaluate the clinical significance of serum procalcitonin (PCT) in early diagnosis of pulmonary tuberculosis (PTB) complicated with pulmonary infection. MethodsClinical data of active PTB patients admitted to a hospital between August and December 2013 were collected, patients were divided into bacterial infection group(n=104), fungal infection group(n=37) and control group (n=95) according to whether patients were associated with bacterial infection, fungal infection, and without infection, serum PCT concentrations in three groups were compared, receiver operating characteristic (ROC) curve analysis was conducted. ResultsThe median PCT concentrations in bacterial infection and fungal infection group was 0.44ng/mL and 0.30ng/mL respectively，which was significantly higher than 0.16ng/mL of control group（Z=9.49，3.51 respectively，both P<0.001）. The area under curve (AUC) was 0.89（0.84-0.93）and 0.69（0.61-0.77）respectively; cutoff point was 0.31 ng/mL and 0.27 ng/mL respectively; sensitivity was 79.81%（70.57%-86.80%）and 59.46%（42.19%-74.80%） respectively; specificity was 83.16%（73.79%-89.78%） and 73.68%（63.48%-81.95%）respectively.ConclusionPCT level is a valuable predictor for early diagnosis of PTB complicated with pulmonary infection, and can provide reference for the rational use of antimicrobial agents.

ObjectiveTo investigate therapeutic effect of interventional injecting medicines through fiberbronchoscope on multidrug resistant cavernous pulmonary tuberculosis (MDRTB).MethodsEightsix patients (treatment group) with cavernous pulmonary MDRTB were treated with both injecting levofloxacin, amikacin, isoniazid, pyrazinamide through fiberbronchoscope catheter and routine chemotherapy, 94 cases in the control group were only given routine general chemotherapy. ResultsAfter 1,3,6 months treatment, the sputum negative conversion rate in treatment group was 17.44%, 65.11% and 87.21% respectively, which were significantly higher than those in control group（0.00%， 30.85% and 55.32%）respectively（P＜0.01）. After 3 months treatment, the effective rate in treatment group was 95.35%, cavity closure rate was 38.37%; which were significantly higher than those in control group (58.51% and 13.83%) respectively (P＜0.01）. ConclusionThe therapeutic effect of MDRTB treated with intervention injecting drugs in cavity by fiberbronchoscope and routine chemotherapy is superior to only routine chemotherapy.

ObjectiveTo understand the drug resistance of Mycobacterium tuberculosis(MTB) and susceptibility of multidrugresistant MTB (MDRMTB) to linezolid in Hebei Province, so as to guiding clinical treatment of MDR tuberculosis.MethodsThe isolated strains and clinical information of patients with tuberculosis in 6 hospitals of 5 cities in Hebei Province between January and December 2016 were collected, susceptibility of MTB to antituberculous drugs isoniazid (INH), rifampicin（RFP）, streptomycin (SM), ethambutol（EMB）, ofloxacin（OFX）, and kanamycin（KM）were detected, 100 strains of MDRMTB were selected by stratified random sampling method, susceptibility to linezolid was detected.ResultsDrug resistance rate and MDR rate of the initially treated cases were 26.6%（200/753）and 13.5%（102/753） respectively, drug resistance rate and MDR rate of the retreatment cases were 59.7%（132/221）and 53.4（118/221）respectively, drug resistance rate and MDR rate of the retreatment cases were both statistically higher than initially treated cases（χ2=83.7，P＜0.01; χ2=93.5，P＜0.01）. Resistance rates of MTB to firstline antituberculous drugs INH, RFP, SM, and EMB were 25.8%, 23.7%, 16.7%, and 7.1% respectively, to secondline antituberculous drugs OFX and KM were 4.7%（37/782）and 4.0%（31/782） respectively；susceptibility of MDRMTB to linezolid was 80.8% (59/73).ConclusionDrug resistance rate and MDR rate of the retreated tuberculosis patients are higher than initially treated patients, linezolid has good in vitro antimicrobial activity against MDRMTB.

术后线结排异反应属于Ⅳ型变态反应，与患者体质密切相关［1］。2015年11月医院收治了1例剖宫产术后迟发性线结排异反应合并结核分枝杆菌感染患者，现报告如下。

ObjectiveTo establish a reliable approach for quantification of colony forming unit(CFU) of Mycobacterium tuberculosis(M.tb) by measuring optical density(OD).MethodsM.tb suspension H37Ra was prepared using lowpower ultrasonic or glass bead beating methods, and was twofold serially diluted, OD at 600nm (OD600) of each dilution ratio was measured respectively, OD600 and dilution curve were analyzed to determine the optimum approach for preparing bacterial suspension，linear range of OD600, as well as linear relationship between OD600 and CFU.ResultsOD600 was 0.1-0.6, linear regression analysis of OD600 and dilution ratio within linear range revealed that correlation coefficient (R2) of glass bead beating and lowpower ultrasonic methods were 0.98 and 1.00 respectively，both presented a good correlation, lowpower ultrasonic method was better than glass bead beating method, bacterial suspension dispersed more evenly. Linear regression analysis results of OD600 and CFU values showed that the regression equation of glass bead beating method and lowpower ultrasonic method were CFU=2.35×107×OD600+4.42×105 and CFU=3.26×107×OD600+6.89×105 respectively.ConclusionLowpower ultrasonic method is a good method for preparation of M.tb suspension，combined the measurement of OD600 value， it can be a reliable and rapid method for quantitative analysis of M.tb.

ObjectiveTo investigate status and risk factors of drug resistance of smearpositive pulmonary tuberculosis (TB) patients in Hunan Province, and provide reference for the prevention and control of drugresistant TB.Methods1 935 Mycobacterium tuberculosis (MT) complex strains identified by 20 TB prevention and control institutes in Hunan Province between 2012 and 2014 were collected and performed drug susceptibility testing，and influencing factors associated with drug resistance of TB were analyzed statistically.ResultsOf 1 935 MT complex strains, 1 207 （62.38%）were sensitive to 6 kinds of antituberculosis drugs, 728 were drugresistant strains, overall drug resistance rate was 37.62%；467 (24.13%) were multidrugresistant (MDR) strains, 64 of which were extensively drugresistant (XDR) strains, XDR rate was 3.31%, resistance rates from high to low were as follows: isoniazid（INH）29.32%, rifampicin(RFP) 25.84%, streptomycin（SM）20.73%,thambutol（EMB）9.00%, ofloxacin（OFX）7.83%, and kanamycin（KM）2.21%. Multivariate logistic regression analysis showed that patients having a history of treatment, aged 20-39 and 40-60 years old were risk factors for drug resistance and MDR of pulmonary TB. Among patients who failed in retreatment, OR (95% CI) of resistance to INH, RFP, SM, EMB, OFX, KM, and MDR were 13.5(9.9-18.4), 21.2(15.2-29.5), 5.3(3.9-7.2),11.9(7.6-18.7), 7.6(4.6-12.6), 7.9(3.6-17.5), and 25.0(17.7-35.1) respectively; among patients who had recurrence, OR(95% CI) of resistance to INH, RFP, SM, EMB, OFX, and MDR were 7.4(5.5-10.0), 10.3(7.4-14.2), 3.5(2.5-4.8), 7.3(4.5-11.9), 4.1(2.5-6.8), and 12.2(8.7-17.1) respectively；among patients who failed in initial treatment, OR (95% CI) of resistance to INH,RFP,SM,EMB, and MDR were 7.6(4.7-12.3), 9.8(5.9-16.0), 4.1(2.5-6.8), 12.1(6.5-22.7), and 11.4(6.9-18.9) respectively. Among patients aged 20-39 years old, OR (95% CI) of resistance to INH,RFP,SM, and MDR were 2.5(1.8-3.4), 3.6(2.5-5.2), 2.9（2.0-4.1）, and 4.1（2.8-6.1） respectively；among patients aged 40-60 years old, the OR(95% CI) of resistance to INH,RFP,SM, and MDR were 2.2(1.6-3.0),3.1(2.2-4.4),2.3（1.6-3.2）, and 3.3（2.3-4.7）respectively.ConclusionDrug resistance of smearpositive pulmonary TB patients is serious in Hunan Province, patients receiving antituberculosis treatment and aged between 20-60 years old have high risk for drug resistance and MDR.

20世纪80年代以来，结核病（tuberculosis，TB）疫情呈全球性回升趋势，我国作为全球最大的发展中国家，同时也是全球TB疫情最严重的国家之一［1］。随着全球耐药结核病（drugresistant tuberculosis，DRTB）的出现和传播，特别是耐多药结核病（multidrugresistant TB，MDRTB）、广泛耐药结核病（extensively drugresistant TB，XDRTB）,以及全耐药结核病（totally drugresistant TB，TDRTB）发生率的增高，全球TB的有效治疗和控制受到严重威胁。深入研究结核分枝杆菌（Mycobacterium tuberculosis，MTB）的耐药分子机制，发现基因突变是MTB产生耐药的重要原因。现就各抗结核药物的耐药表型与耐药基因型的相关性研究进行综述。

ObjectiveTo study the relationship between the mutations in rpoB gene of rifamycinresistant Mycobacterium tuberculosis(M. tuberculosis) and the level of rifabutin resistance.MethodsThe minimal inhibition concentrations(MICs) of 64 rifamycinresistant isolates and 6 sensitive isolates of M. tuberculosis to rifabutin were determined by the dilution method, their isonicotinyl hydrazide (INH) resistance were analyzed. The whole rpoB gene were amplified and sequenced, then the relationship between the mutations in rpoB gene and the level of rifabutin resistance and multidrug resistance were analyzed.ResultsThe sensitive isolates had no mutations in rpoB gene and their MICs were 0.25 mg/L -0.50 mg/L. All rifamycinresistant isolates had mutations in rpoB gene. Among 37 highlevel rifabutinresistant strains (MICs≥4 mg/L), mutations of S531L, H526R, and Y389C were found in 27,2 and 2 isolates respectively, comutation of S531W, H526Y, Q513K, V176F, D516Y and Q253R was in 1 strain, comutation of D516G and L511P was in 1 strain. Of 17 intermediatedlevel rifabutinresistant strains (MICs 2-4 mg/L), 16 isolates were with S531L mutation and 1 with D516G combined with L511P and S509R mutation,respectively . Of 10 lowlevel rifabutinresistant strains (MICs 0.25-1 mg/L), single mutation of L533P, H526L, H526S, D516V, and D516Y were found in 2 isolates respectively. 93.75％(60/64) of rifamycinresistant isolates were also resistant to INH.ConclusionDetection of rpoB mutation can preliminarily screen multidrugresistant M. tuberculosis; The predominant mutations of rpoB gene in highand middlelevel rifabutinresistant isolates are S531L, the mutation positions and types of rpoB gene in M. tuberculosis correlates with the level of rifabutin resistance.

全球1/3的人口感染结核分枝杆菌(Mycobacterium tuberculosis,MTB)，其中大部分为潜伏感染［1］。研究人员对MTB潜伏感染的关注度日益增高。笔者针对当前研究MTB潜伏感染所使用的各种动物模型进行综述，分析包括小鼠、豚鼠、兔以及非人灵长类的动物模型优势和局限性，以期为研究人员正确选择合适的MTB潜伏感染动物模型以及深入开展潜伏感染的研究提供帮助。

ObjectiveTo investigate the baseline condition of initial and acquired drug resistance in patients with pulmonary tuberculosis in Xi’an city, and provide a scientific basis for the prevention and control of drugresistant tuberculosis.MethodsPatients with positive Mycobacterium tuberculosis(MT) culture and received initial treatment and retreatment in tuberculosis clinics of 14 districts (counties) in Xi’an  and Xi’an Chest Hospital in 2015 were included in the study, antimicrobial susceptibility testing of 4 kinds of firstline antituberculosis drugs were performed.ResultsThe overall drug resistance rate of MT in Xi’an city was 31.9%, multidrug resistance rate (MDR) was 7.0%. Drug resistance rate and MDR in initial treatment group were 27.3% and 3.5% respectively, in retreatment group were 59.5% and 28.6% respectively, drug resistance rate and MDR in retreatment group were both higher than initial treatment group (both P<0.001).ConclusionThe overall drug resistance rate of pulmonary tuberculosis patients in Xi’an city is lower than the whole nation, but MDR is slightly higher than the national level, although TB prevention and control work has achieved some success, the situation is still serious, the management of patients with initial treatment should be strengthened to reduce the occurrence of drug resistance.

ObjectiveTo explore drug resistance and distribution of multidrugresistant（MDR） Mycobacterium tuberculosis (M. tuberculosis) in a countylevel hospital, so as to strengthen the prevention and control of healthcareassociated infection with M. tuberculosis. MethodsSpecimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing, and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively. ResultsOf 488 patients with tuberculosis, 254 were positive for sputum smear, 122 M. tuberculosis strains were isolated from positive sputum smear patients，120 isolates were performed drug susceptibility testing, results revealed that 86 isolates were drugresistant strains, 46 of which were monodrugresistant, 40 were MDR. Of MDR strains, 16 were all resistant to  isoniazide,  rifampicin,  streptomycin, and  ethambutol. The percentage of monodrugresistance, MDR, pandrug resistance was 9.43%, 8.20%, and 3.28% respectively.  Medical imaging department, ultrasound department, and respiratory disease department were the main units of M.tuberculosis exposure. ConclusionThe percentage of MDR M. tuberculosis is high among M. tuberculosis, surveillance should be intensified, so as to prevent the transmission in hospital.

ObjectiveTo understand the mutation characteristics of rifampicin resistance gene rpoB as well as isoniazid resistance genes katG and inhA of Mycobacterium tuberculosis(MTB) in a hospital, and provide scientific basis for the prevention and treatment of drugresistant tuberculosis.MethodsMTB strains were isolated from sputum specimens of 83 patients with tuberculosis, rifampicin and isoniazid resistance was detected by BD960 liquid culture method, DNA of MTB was extracted, complete genome of rpoB, katG and inhA were amplified by polymerase chain reaction, the amplified product was sequenced and analyzed.ResultsAmong 83 strains from specimens, 39 strains were resistant to rifampicin and 51 were resistant to isoniazid. The mutation rate of rpoB gene of rifampicinresistant strain was 97.44% (38/39), mutation rate of locus 531 and locus 526 were 60.53% (23/38) and 23.68%（9/38）respectively, combined mutation of multilocus appeared in 32 strains. The mutation rate of katG gene in isoniazidresistant strains was 98.04% (50/51), a total of 16 types of mutations were found, the majority of which were point mutations at katG 315, accounting for 70.00% (35/50), and one isolate was combined mutation of katG and inhA.ConclusionResistance of multidrugresistant(MDR) MTB is related to mutation in rpoB and katG genes, detection of MDR gene mutation in MTB can provide reference for early and rapid diagnosis of tuberculosis.

ObjectiveTo evaluate the value of recombinant culture filter protein10early secretory antigenic target 6 （rCFP10ESAT6） protein from Mycobacterium tuberculosis (M. tuberculosis) on the serodiagnosis of tuberculosis (TB), and to develop more effective diagnostic reagents for tuberculosis. MethodsThe rCFP10ESAT6 protein was expressed and purified by metal chelation chromatography. Sera of 192 healthy persons and 210 TB patients were detected the antibodies against M. tuberculosis rCFP10ESAT6 antigens by ELISA. ResultsThe rCFP10ESAT6 protein existed in inclusion bodies of Escherichia coli, and amounted to 25% of total bacterial protein, its molecular weight was estimated about 28 kD. Of sera from 210 TB patients, the sensitivity of antibody detection using rCFP10ESAT6 protein was 30.10% (31/103) and 28.97％ (31/107) in 103 bacteriumpositive patients and 107 bacteriumnegative patients, overall sensitivity was 29.52% (62/210);of 192 healthy subjects, the sensitivity of antibody detection using rCFP10ESAT6 protein was 2.11% (2/95) in 95 PPDnegative persons and 6.19% (6/97) in 97 PPDpositive persons, respectively, overall specificity was 95.83% (184/192).ConclusionThe recombinant CFP10ESAT6 might be used as one of multiple antigens in the serodiagnosis of tuberculosis.

结核病自古以来就威胁着人类的健康，每年导致约200万人死亡。特别是近年来，耐多药结核病、广泛耐药结核病以及结核分枝杆菌与人免疫缺陷病毒（HIV）共感染的出现，给结核病的临床治疗带来了新的困难。耐多药结核病是耐受2种抗结核病一线药物的结核病，广泛耐药结核病是在耐多药的基础上至少耐受3种二线药物的结核病。耐药结核病的蔓延已经成为全球性的公共卫生问题，据世界卫生组织（WHO）最新的2009年度报告，2007年全球新发结核病病例927万例，死亡175万例，现有的1 370万例活动性结核病患者中，耐多药者达50万［1］。外排泵系统的泵出作用是导致结核分枝杆菌耐药的重要机制之一。本文综述了近年来国际上在结核分枝杆菌外排泵及其抑制剂方面的研究进展。

ObjectiveTo investigate the status of tuberculosis (TB)infection control in healthcare facilities.MethodsAccording to Monitoring and evaluation form of tuberculosis infection control in healthcare facilities, 22 healthcare facilities in Beijing, Shanghai and Inner Mongolia were surveyed, and data about TB infection control were collected and analyzed.ResultsOf 22 surveyed healthcare facilities, 20 developed TB infection control system, but only 7 regularly carried out monitoring and evaluation of TB infection control; most facilities isolated patients with infectious diseases from patients with other diseases, but only 5 isolated cough patients from other patients;18 facilities regularly maintained ultraviolet lamps, however, the layout of waiting areas and outpatient department were not very well; 14 facilities provided medical protective masks for health care workers, but only 5 carried out fitness tests of medical protective masks and relevant trainings.ConclusionSome achievements about TB infection control in healthcare facilities have been obtained, TB infection control monitor and evaluation screen still need to be strengthened, triage, isolation, layout and personal protection in healthcare facilities should be reinforced to reduce the risk of TB.

ObjectiveTo analyze the epidemic characteristics of multidrugresistant tuberculosis (MDRTB) in Hunan Province from 2013 to 2016, and provide theoretical basis for the prevention and control of tuberculosis. MethodsInformation about TB patients in Hunan Province reported by China Information System for Disease Control and Prevention between January 2013 and December 2016 was analyzed retrospectively. ResultsFrom 2013 to 2016, the total drug resistance registration rate in Hunan Province was 5.53/million（1 496/270 330 000）, multidrug registration rate was 5.40/million（1 459/270 330 000）, drug resistance rate and multidrug resistance rate showed an upward  trends (trend χ2 =113.605, 96.590，respectively, both P<0.001）. Among MDRTB patients, male were more than females (74.09% vs 25.91%), most were more than 25 years of age, especially 45～ age group(27.07%); the proportion of patients with MDRTB retreatment was higher than that of the initial treatment (69.91% vs 30.09%). From 2013 to 2016, distribution range of MDR registration rates in different regions were 4.07/million - 7.23/million. ConclusionMDRTB in Hunan Province in 2013-2016 is increasing year by year, and mainly concentrate on young people over 20 years old. There are more cases of male and retreatment; it is necessary to strengthen regular treatment and prevention of key population, enhance the ability to identify and diagnose MDRTB patients, and reduce the spread of MDRTB.

ObjectiveTo understand the general selfefficacy level of patients with tuberculosis(TB patients) and its influencing factors, provide evidence for improving the general selfefficacy of TB patients. MethodsAll TB inpatients in a comprehensive pulmonary hospital were conducted facetoface survey through a general questionnaire and general selfefficacy scale, selfefficacy level of TB patients and its influencing factors were analyzed. ResultsMean scale of general selfefficacy of 402 TB patients was (20.4±4.2), of which only 14 cases（3.5%）showed a high level selfefficacy. 163（40.5%）, 225（56.0%）, and 14（3.5%）patients were with low（10～）,medium（20～）, and high（30～） selfefficacy scale. The general selfefficacy level of TB patients was influenced by the course of disease（P<0.001）, residence（P=0.012）, whether or not attended the lecture on tuberculosis education（P=0.034）, whether or not conducted physical exercise（P=0.053，stepwise multiple linear regression analysis: P=0.017）, working status（P=0.027）, No. of hospitalization due to TB（P=0.002）, family economic situation（P=0.027）, and education level（P=0.020）. ConclusionTB patients’ selfefficacy level is low, and the general selfefficacy level and its influencing factors should be assessed by health care workers during the followup for patients, individualized nursing intervention for improving the TB patients’ selfefficacy level should be developed.

ObjectiveTo investigate the awareness of tuberculosis(TB)related knowledge and the status of occupational protection among health care workers (HCWs) in a general hospital.MethodsQuestionnaires were used to investigate the awareness of TBrelated knowledge and the status of occupational protection among HCWs.ResultsA total of 333 HCWs were enrolled in the investigation, correct response rate in the TBrelated knowledge was 62.84%-93.09%; correct response rate in national TBrelated policy was 59.52%-77.27%.The implementation rate of protective measures was not significantly different between the awareness group and the unawareness group (［10.74%-79.34%］ vs ［10.38%-82.55%］,P>0.05), but implementation rate of regular medical examination in awareness group was significantly higher than unawareness group（92.56% vs 79.25%， P＜0.05）.ConclusionThe knowledge about tuberculosis and occupational protection training should be strengthened among HCWs in general hospitals.

ObjectiveTo investigate the influencing factors for postdischarge treatment compliance of patients with multidrugresistant tuberculosis (MDRTB). MethodsMDRTB patients who were hospitalized in a tuberculosis hospital between November 2011 and January 2013 were chosen， postdischarge followup was conducted regularly through telephone call. Medicinetaking  and reexamination of patients was inquired， factors influencing patients’ treatment compliance were analyzed.Results299 patients were included in the study，the total treatment compliance rate was 81.94% (n=245)； 249（83.28%）patients regularly took medicine，50（16.72%） didn’t regularly take medicine； 254（84.95%）were reexamined on time，45（15.05%）were not reexamined on time； 37（12.37%）discontinued treatment，  260（86.96%） continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate, timely reexamination rate, interrupted treatment rate， and total compliance rate）was significantly different among MDRTB patients of different  ages, education levels, treatment time, and with or without adverse reactions（all P＜0.05）.Logistic regression analysis revealed that treatment compliance of MDRTB patients was negatively correlated with treatment time（β=-1.47，Wald χ2=24.28，P＜0.05） and adverse reactions（β=-2.02，Waldχ2=24.24，P＜0.05）,while positively correlated with education levels（β=0.79，Wald χ2=6.50，p＜0.05）.ConclusionProlonged treatment time and adverse reactions can reduce the treatment compliance of MDRTB patients, the higher education levels of MDRTB patients have, the better treatment compliance they implement.

结核病是由结核分枝杆菌（Mycobacterium tuberculosis, MTB）感染引起的慢性传染病，仍然是全世界公共卫生面临的重大威胁。据世界卫生组织统计［12］，我国2014年的新发肺结核人数位居全球第三位，是22个全球结核病高负担国家之一。目前肺结核的诊断主要依靠痰涂片抗酸染色，但由于痰涂片对标本的含菌量要求高，导致其诊断结核病的敏感度较低。诊断结核病的金标准是MTB培养［3］，由于MTB生长缓慢的习性，导致培养所需时间较长（2～6周），仅用MTB培养诊断结核病可能延误治疗。耐多药结核病的传统诊断方法是药物敏感试验［4］，该方法有对实验室要求高及耗时长的缺点。因此，寻求快速诊断结核病和耐多药结核病的方法成为控制结核病的重点。近些年涌现出许多基于分子生物学或免疫学的方法，利福平耐药实时荧光定量核酸扩增检测技术（Xpert MTB /RIF）就是其中最有应用前景的方法之一。本文就Xpert MTB /RIF的发展、应用现状以及对特殊人群的诊断价值进行综述。

ObjectiveTo understand medical coping mode and its influencing factors among patients with tuberculosis(TB), and provide evidence for the development of clinical nursing strategies for TB patients.MethodsGeneral questionnaire and medical coping mode questionnaire(MCMQ) were used to investigate 402 TB patients in tuberculosis unit of a tertiary firstclass hospital in Changsha, medical coping mode and its influencing factors among TB patients were analyzed.ResultsThe scores of confrontation, avoidance, and acceptanceresignation dimensions of TB patients were (18.91±3.05), (15.49±2.62), and（10.00±3.01）respectively, score of confrontation dimension was statistically lower than domestic norm(P<0.05), but score of avoidance and acceptanceresignation dimensions were statistically higher than domestic norm(P<0.01). Factors influencing confrontation coping mode of TB patients were residence (city and town residents had a higher score, b=1.01, P=0.036), whether attending lecture on tuberculosis education (participants scored higher, b=1.71, P=0.001), and degree of understanding the disease conditions (the more understanding, the higher the score, b=0.55, P<0.001); factors that had significant influence on the avoidance dimension was the way of living (leading solitary life had a higher score, b=1.19, P=0.004); factors influencing acceptanceresignation of TB patients were course of tuberculosis(long duration scored higher, b=0.53, P=0.008), education degree (higher education level had lower score, b=-0.35, P=0.047), times of hospitalization due to tuberculosis (more hospitalization scored higher, b=0.58, P=0.002) and so on.ConclusionTB patients are prone to take avoidance and acceptanceresignation coping mode. The coping mode of TB patients is influenced by both demographic factors and disease factors such as residence， education level, the course of disease, times of hospitalization due to tuberculosis and so on.

ObjectiveTo quantitatively analyze the epidemic situation of tuberculosis(TB) by modeling the data of tuberculosis in prefectures of Xinjiang, and predict the new cases of tuberculosis in prefectures of Xinjiang.MethodsA dynamic model was used to fit the data of TB in 14 prefectures in Xinjiang from 2005 to 2014, the results of the fitting were verified by tuberculosis data in 2015-2017, verified results were evaluated, estimated values and basic reproductive numbers (R0) of parameters in each region were obtained, data of new TB in 2018-2022 were predicted.ResultsThe verification of TB data in 2015-2017 showed that the actual values fell within the 95% confidence interval of the predictive value curve, model was fit well. R0 in Southern Kashgar was 11.38 (95%CI:11.33-11.50), R0 in Urumqi City in Eastern Xinjiang and Ili Kazak Autonomous Prefecture in Northern Xinjiang were 5.46 (95% CI: 5.28-5.50) and 2.22 (95% CI: 2.18-2.28) respectively. The epidemic situation of TB in Southern Xinjiang was more serious than that in Northern and Eastern Xinjiang, epidemic situation of TB in Kashgar Prefecture was most serious. The predicted results showed that the number of new TB from 2018 to 2022 will slowly grow in most prefectures.ConclusionThe dynamical model of TB fits well and is feasible in this study, it can be used for prediction of new TB cases, intervention and management in Southern Xinjiang should be strengthened to control the prevalence of TB.

ObjectiveTo investigate the value of TSPOT in the diagnosis of tuberculosis（TB） in children. Methods43 children who were admitted to a hospital and confirmed with TB between March 2015 and May 2016 were as TB group, 50 children who were excluded TB as well as healthy children in the outpatient and inpatient departments of this hospital during the same period were as control group, two groups were underwent detection of TSPOT, PPD, MTBAb, and acid fast stain, results were compared, subgroup analysis was conducted on the positive of TSPOT in children with different infection sites and in different age groups. ResultsSensitivity and negative predictive value of TSPOT were significantly higher than the other three methods（P＜0.05），specificity was also higher than that of PPD（P＜0.05）；positive rates of TSPOT in pulmonary tuberculosis and extrapulmonary tuberculosis were 88.9% and 81.3% respectively，difference was not statistically significant（P＞0.05）；positive rates of TSPOT in children ≤5 years and >5 years were 70.6% and 96.2% respectively，difference was statistically significant（P<0.05）. The sensitivity and specificity of combined detection of TSPOT and PPD for diagnosis of TB were 95.3% and 98.0% respectively，which were both higher than the single method（P＜0.05）.ConclusionThe sensitivity and specificity of TSPOT for detecting TB in children are both superior to traditional methods, TSPOT is also suitable for the detection of extrapulmonary tuberculosis, and can be used as the main method for laboratory diagnosis of tuberculosis in children, but it is uncertainty in children under 5 years of age, and should be rationally combined with PPD to improve the diagnosis of TB among children.

ObjectiveTo analyze the prevalence and risk factors of tuberculosis (TB) infection and TB disease among health care workers (HCWs), and to provide evidence for intensifying control of TB.MethodsA systematic review was applied to analyze the literatures about TB infection control status in healthcare facilities from 1995 to 2010．ResultsThe prevalence of TB infection among Chinese HCWs was 60.4%-62.8%, which was much higher than that of general population;the prevalence of TB disease was also higher than that of general population, the highest prevalence was 6.7/1 000 population/year. A higher risk of acquiring TB disease was associated with many factors, including certain work locations, healthcare facility design, working environment, and personal protective measures.ConclusionTB is a significant occupational problem among HCWs,available evidence reinforces the need to design and implement effective and affordable TB infection control programs in healthcare facilities in China.