This research introduced four models of overseas physician competency assessment , and their methodology ,and hotspot′Milestone′project in the USA. The authors propose to provide a national assessment benchmark in favor of industry consensus. In terms of physician assessment methods ,they recommended to test the validity and reliability of these tools ,rather than merely focusing on the development of new assessment tools. Regarding physician assessment phasing ,the paper proposed to build a dynamic and process-based assessment system .

Post-translational modification of host proteins induced by pathogenic microorganism plays a critical role in the development, treatment and prevention of diseases. Mycobacterium tuberculosis ( Mtb) is an intracellular pathogen that causes tuberculosis. The post-translational modification induced by Mtb infection is essential in the development and progression of tuberculosis. In recent years, it has been found that Mtb-induced host protein acetylation plays an important role in the regulation of host immunity against tuberculosis, which significantly affects the development of tuberculosis. This review focused on the role and mechanism of Mtb in regulating host protein acetylation, aiming to provide reference for future investigation on potential immunotherapy for tuberculosis.

The definition of adjuvant in immunology is the non-specific immunopotentiator, which only performs auxiliary functions. With the appearance of various adjuvants and their successful application in some vaccines against infectious disease, they have received extensive attention and been studied in-depth. This review focused on the types, functions and prospects of adjuvants used in tuberculosis vaccines, aiming to provide reference for adjuvant selection and development in future.

Tuberculosis as an infectious disease is still one of the leading causes of morbidity and mortality throughout the world. The current diagnosis and treatment strategies cannot solve all clinical problems. Newer and more rapid tuberculosis diagnostic technologies with higher sensitivity, as well as more personalized host-oriented treatment strategies are still the important research directions in the future. Tuberculosis-related long non-coding RNAs (lncRNAs) have been one of the research hot spots in recent years. A series of lncRNA candidates with the potential diagnostic value for tuberculosis have been obtained using transcriptome sequencing and microarray technology. Meanwhile, lncRNAs have been also discovered to play an important role in antimicrobial defense mechanisms by regulating immune cell differentiation, autophagy/apoptosis, inflammatory responses and other biological processes. The current findings of lncRNAs as diagnostic candidates and their roles in tuberculosis were summarized in this review.

This research introduced four models of overseas physician competency assessment, and their methodology, and hotspot "Milestone"project in the USA.The authors propose to build a national assessment benchmark framework in favor of industry consensus.In terms of physician assessment methods, they recommended to test the validity and reliability of these existing tools,rather than merely focusing on the development of new assessment tools.Regarding physician assessment phasing,the paper proposed to build a dynamic and process-based assessment system.

Objective:To detect the inflammatory reaction of macrophages induced by lipoglycans of different genotypes of Mycobacterium tuberculosis ( Mtb) in vitro and to analyze the differences in lipoglycan virulence. Methods:Lipoglycans were extracted from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv by Triton X-114 liquid phase method and the crude extracts of lipoglycans was used to stimulate RAW264.7 macrophages. Changes in cytokine and receptor expression and cell apoptosis were detected 24 h after stimulation. The virulence of lipoglycans from different genotypes of Mtb was analyzed and compared. One-way analysis of variance and Tukey′s multiple comparisons test were used to compare the differences in various indexes between groups. Results:The expression of IL-10 at mRNA level induced by lipoglycans from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv was (0.94±0.24), (1.86±0.24), (1.90±0.24) and (2.55±0.75) times that of the control group. Moreover, IL-10 mRNA expression induced by lipoglycans from Mtb of Beijing genotype was significantly lower than that of H37Rv group ( P<0.05). After stimulating RAW264.7 cells with the crude extracts of lipoglycans, the proportions of living cells in H37Rv, Beijing genotype, T1 genotype and MANU2 genotype groups were (72.75±2.25)%, (60.99±0.13)%, (80.66±0.40)% and (79.06±1.19)%, and the total cell apoptosis ratios was (10.42±0.23)%, (8.30±0.03)%, (9.24±0.79)% and (8.04±0.48)%, respectively. The proportion of living cells in Beijing genotype group was the lowest ( P<0.05), and the proportions of living cells in T1 and MANU2 genotype groups were higher than that in H37Rv group ( P<0.05). There was no significant difference in cell apoptosis ratio among the groups ( P>0.05). Lipoglycan-induced cell death was increased in Beijing genotype group, and the lipoglycan from Beijing genotype Mtb was more virulent than those from Mtb of T1 and MANU2 genotypes. Conclusions:Lipoglycan from Mtb of Beijing genotype could induce a higher level of cell death in vitro. It was an antigen component with stronger virulence than those from Mtb of T1 and MANU2 genotypes.

Objective:To explore the feasibility of U6 and Cel-miR-39 as reference genes for quantitative detection of microRNA (miRNA) in cerebrospinal fluid (CSF) of tuberculous meningitis (TBM), and validate the difference of miRNAs between tuberculous and viral meningitis (VM).Methods:The remaining CSF specimens after routine examination were collected in Beijing Chest Hospital of Capital Medical University. A total of 36 TBM and 34 VM patients were enrolled based on the information in the medical records. Total RNA were extracted from the CSF samples, and Taqman based real-time quantitative PCR (RT-CR) analysis were performed to determine the concentration of the miRNAs in CSF. GeNorm, NormFinder and Bestkeeper software were used for stability analysis of the two reference genes. 2 -ΔCt method was used to determine the relative gene expression. Accordance of repeated tests was analyzed by Pearson correlation test. Continuous variables were compared by the t-test. Results:Among the 70 samples, the average cycle threshold (Ct) value of U6 was 30.40±3.30, while the average Ct value of Cel-miR-39 was 21.49±0.70. The expression level of Cel-miR-39 was higher than that of U6. Correlation analysis showed good accordance of the repeated tests among the reference genes and target genes analysis in the randomly selected 10 samples ( r>0.931, P<0.001). Based on the analyses results of the three software, including GeNorm, NormFinder and Bestkeeper, Cel-miR-39 presented better stability in RT-PCR analysis and was more suitable as a reference gene for miRNA quantitative determination in CSF sample of TBM patients. The relative expression levels of the three target miRNAs were calculated using Cel-miR-39 as the reference gene, and miR-126-3p (1.13±0.41 vs 3.34±0.82, t=2.452, P=0.016), miR-130a-3p (0.56±0.10 vs 2.59±0.70, t=2.960, P=0.004) and miR-151a-3p (0.64±0.25 vs 2.11±0.33, t=3.536, P<0.001) were showed significant lower expression levels in CSF in TBM group than that in VM group. Conclusions:Cel-miR-39 can be used as a reference gene for quantitative detection of miRNAs in CSF of TBM patients. Significant differences were detected in expression level of miR-126-3p, miR-130a-3p and miR-151a-3p between TBM and VM group.

Mycobacterium abscessesus (MAB) is the most common species of rapidly growing pathogenic nontuberculous mycobacteria (NTM). MAB is also an opportunistic pathogen with high drug resistance. The unique structure of cell wall enables it to exist in different forms and to undergo morphological transformation, making it the "shapeshifter of the mycobacterial world" , which facilitates its survival in natural environment in a saprophytic manner; and also facilitates its invasion into the host with long-term survival and being pathogenic. This article reviews research progress on the specific deformability of MAB and the mechanism associated with its phenotypic transformation; discusses the evolutionary characteristics of MAB to adapt environmental changes to provide reference for better understanding the biological characteristics and pathogenicity of MAB.

Objective:To observe the characteristics of the phagocytosis and bactericidal function of multidrug-resistant Mycobacterium tuberculosis(MDR- Mtb)-infected macrophage model, and the changes of the immune response and metabolic function in the process of phagocytosis and bactericidal function, aiming to provide reference for studying the role and mechanism of macrophages in the occurrence and development of multidrug-resistant tuberculosis(MDR-TB). Methods:We established MDR- Mtb and H37Rv-infected macrophage models, and used the colony-forming unit (CFU), Magnetic Luminex ? Assay and Cholesterol Assay kit to observe the effects on phagocytosis and bactericidal function, the secretion of Th1(IL-12/23 p40, IL-27 and TNF-α) and Th2 cytokines (IL-6 and IL-10) and cholesterol metabolism. The data were analyzed by SPSS25.0 software. The data were expressed as Mean± SD and analyzed by t test or F test. P<0.05 was considered statistically significant. Results:(1) After MDR- Mtb-infected macrophages, the intracellular CFU gradually increased and reached the highest at 24 h, while the extracellular CFU gradually decreased and reached the lowest at 24 h. The intracellular CFU at 48 h was lower than that at 24 h, while the extracellular CFU was higher than that at 24 h ( P<0.05). Both intracellular and extracellular CFU at 48 h were close to those at 4 h ( P>0.05). The intracellular CFU was lower than the H37Rv group at 8-48 h, while the extracellular CFU was higher than the H37Rv group ( P<0.05). (2) The level of IL-12/23 p40, IL-27, TNF-α, IL-6 and IL-10 of MDR-TB group were higher than those of blank group ( P<0.05), but the level of TNF-α and IL-6 at 24 h and 48 h were higher than that at 4 h ( P<0.05). IL-12/23 p40 and TNF-α at 48 h and IL-6 at 24 h were lower than those of the H37Rv group, while IL-27 at 48 h was higher than that of the H37Rv group ( P<0.05). (3) The levels of cholesterol of MDR-TB group at 24 h and 48 h were lower than those of 4 h and blank group ( P<0.05), but the level of cholesterol was similar to the H37Rv group at any time ( P>0.05). (4) TNF-α reached the highest when the intracellular CFU reached the highest at 24 h, and IL-6 reached the highest when the intracellular CFU decreased at 48 h. With the decreasing of cholesterol expression, the intracellular CFU increased and then decreased. Conclusions:MDR- Mtb could induce the phagocytosis and bactericidal function of macrophages, increase the expression of Th1 and Th2 cytokines and promote the utilization and consumption of cholesterol, but this function was weaker than that of H37Rv strain.