1.Application of SAT-TB in the evaluation of curative effect of initial treatment of smear-positive pulmonary tuberculosis patients
Jingwen LAI ; Kehao PENG ; Liuyue XU ; Xiaoyu LAI ; Jingzhong LI ; Meiling YU ; Hongdi LIANG ; Xunxun CHEN
International Journal of Laboratory Medicine 2024;45(21):2577-2581,2587
Objective To evaluate the application value of simultaneous amplification and testing for Myco-bacterium tuberculosis(SAT-TB)in evaluating the curative effect of initial treatment of smear-positive pul-monary tuberculosis patients.Methods A total of 62 newly treated smear positive pulmonary tuberculosis pa-tients from June 2022 to June 2023 in Guangzhou Panyu District Chronic Disease Control Station were selected as the study objects,and the curative effect was evaluated by liquid-based sandwich cup method,Roche culture method and SAT-TB detection method.All patients received the standard anti-tuberculosis treatment regimen of 2HRZE/4HR standard regimen,and sputum samples were detected by liquid-based sandwich cup method,Roche culture method,and SAT-TB detection method at the 2nd,4th,and 8th week of treatment,respectively.Results Among 62 patients,54 cases were positive and 8 cases were negative using Roche culture method,47 cases were positive and 15 cases were negative using SAT-TB detection method.60 cases were positive and 2 cases were negative by Mycobacterium tuberculosis(MTB)-DNA test.The positive rates of the three methods were 87.10%(54/62),75.81%(47/62)and 96.77%(60/62),respectively.Taking Roche culture method re-sults as the standard,the sensitivity of SAT-TB detection method and MTB-DNA was 97.87%(46/47)and 90.00%(54/60),and the specificity was 46.67%(7/15)and 100.00%(2/2),respectively.There were signifi-cant differences between Roche culture method and SAT-TB detection method and MTB-DNA test(x2=20.070,P<0.05,x2=13.985,P<0.05),the difference between the results of SAT-TB detection method and MTB-DNA test was also statistically significant(x2=8.365,P<0.05).The negative conversion rates of MTB in sputum samples were 69.35%(43/62),29.03%(18/62)and 41.94%(26/62)at the 2nd,4 th,and 8 th weeks,respectively.77.42%(48/62),59.68%(37/62),58.06%(36/62),82.26%(51/62),79.03%(49/62),75.81%(47/62).There were significant differences in the negative conversion rates of MTB in sputum sam-ples between SAT-TB and liquid-based sandwich cup method at the 2nd and 4th weeks(x2=8.365,P<0.05,x2=4.465,P<0.05),while there was no significant difference between the results of Roche culture method at the 2nd,4th and 8th weeks(x2=1.726,P>0.05,x2=0.000,P>0.05,x2=0.046,P>0.05).Conclusion The use of SAT-TB detection method in clinical practice to evaluate the efficacy of smear positive pulmonary tuberculo-sis patients could accurately and quickly assess the negative conversion rate and treatment effect of patients,and provide a reliable basis for guiding clinical treatment.It could be considered as an effective auxiliary diag-nosis and evaluation method of curative effect,worthy of promotion and practical application.
2.Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis
Yi CHANG ; Xiangan ZHANG ; Haixia GUO ; Jing LIU ; Liuyue MI ; Yuting XU ; Jingwen AN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):229-236
Ulcerative colitis (UC) is one of the chronic refractory inflammatory bowel diseases characterized by abdominal pain, diarrhea, and mucus, pus and blood in the stool. In recent years, with changes in human life style and improvements of the diagnosis, the incidence and prevalence of UC have been increasing. The pathogenesis of UC is closely related to intestinal mucosal immune dysfunction, intestinal flora disturbance, and abnormal bile acid secretion. Patients with UC have abnormal bile acid secretion and intestinal flora imbalance. A large number of studies have found that abnormal bile acid secretion inhibits immune function, affects signal transduction, and destroys the intestinal mucosal barrier. Intestinal flora disturbance has an important impact on the occurrence and development of inflammation, immune homeostasis, and stress. Bile acids indirectly or directly affect the structure and function of intestinal flora, and at the same time, they produce secondary bile acids under the modification of intestinal flora, entering the liver through enterohepatic circulation. Therefore, the complex dialogue mechanism of bile acid-intestinal flora axis is closely related to the occurrence and development of UC. Based on the basic theory of traditional Chinese medicine(TCM) and clinical research, it is found that emotion is an important factor that induces this disease, spleen and stomach weakness is the root of the disease, and liver depression and spleen deficiency are the key pathogenesis of UC. Combined with modern medicine and molecular biology research, it is believed that abnormal secretion of bile acids is a microscopic manifestation of liver depression in TCM, and intestinal flora disturbance is the biological basis of spleen deficiency. In the pathogenesis of UC, the imbalanced bile acid-intestinal flora axis is consistent with the pathogenesis of liver depression and spleen in TCM. The exploration of the biological connotation of the pathogenesis of UC with liver depression and spleen deficiency from the perspective of bile acid-intestinal flora axis can better explain the scientific nature of its pathogenesis, which provides new clinical solutions and reliable references for studying the pathogenesis of UC with liver depression and spleen deficiency and finding representative prescriptions to prevent and treat this disease.