1.Standards for the Application of Hemodynamic Monitoring Technology in Critical Care
Hua ZHAO ; Hongmin ZHANG ; Xin DING ; Huan CHEN ; Jun DUAN ; Wei DU ; Bo TANG ; Yuankai ZHOU ; Dongkai LI ; Xinchen WANG ; Cui WANG ; Gaosheng ZHOU ; Xiaoting WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(1):73-85
With the rapid advancement of hemodynamic indices and monitoring technologies, their classification methods and application processes have become increasingly complex. Currently, no unified standard hasbeen established, making it difficult to fully meet the clinical requirements for hemodynamic management. To assist in hemodynamic monitoring assessment and therapeutic decision-making in critically ill patients, the Critical Hemodynamic Therapy Collaborative Group, in conjunction with the Critical Ultrasound Study Group, has jointly developed the Standard for the Application of Hemodynamic Monitoring Techniques in Critical Care. The first part of this standard systematically categorizes hemodynamic indicators into flow indicators, pressure and its derivative indicators, and tissue perfusion indicators, while elaborating on the clinical application of each. The second part establishes a standardized clinical implementation pathway for hemodynamic monitoring. It proposes a tiered monitoring strategy-comprising basic, advanced, indication-specific, and special scenario monitoring-tailored to different clinical settings. It emphasizes the central role of critical care ultrasound across all levels of monitoring and establishes hemodynamic assessment standards for organs such as the brain, kidneys, and gastrointestinal tract. This standard aims to provide a unified framework for clinical practice, teaching, training, and research in critical care medicine, thereby promoting standardized development within the discipline.
2.Construction of Syndrome Diagnosis Scale for Chronic Atrophic Gastritis with Turbid Toxin and Stomach Accumulation Based on Delphi Method and Analytic Hierarchy Process
Zhihua LIU ; Xiaoyu LIU ; Yuman WANG ; Runze LI ; Hua LI ; Runxue SUN ; Shaopo WANG ; Jianming JIANG ; Yanru DU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):235-243
ObjectiveTo construct a scale for the diagnosis of chronic atrophic gastritis (CAG) with turbid toxin accumulating in the stomach. MethodsFirst, a research group was established to construct the scale framework. Relevant literature of CAG with syndrome of turbid toxin accumulating in the stomach was searched in CNKI, Wanfang Database (WF), and VIP Database (CQVIP) from April 1, 2003 to April 1, 2023, and items were preliminarily selected after standardization of terms. Through clinical investigation, the discrete trend method, correlation coefficient method, Cronbach's coefficient method, and factor analysis method were used to screen symptom items, and the frequency method was used to screen signs, tongue coating, and pulse conditions. Three rounds of Delphi expert consultation were conducted to determine the items of the scale. The weight of each item was obtained by the analytic hierarchy process. ResultsA total of 49 articles were included, and 45 items were obtained after primary screening, including 28 symptoms, 2 signs, 10 tongue coatings, and 5 pulse conditions. After clinical investigation, 15 symptoms were retained, and 8 signs and pulse conditions of tongue coating were retained. The positive coefficients of experts in three rounds of Delphi expert consultation were 100%, 96.67%, and 100%, respectively. The expert authority coefficients were 0.86, 0.87, and 0.87, respectively, and the coordination coefficients were 0.18, 0.25, and 0.30. After core group discussion, Delphi method investigation, and AHP weight assignment, the diagnostic scale items of CAG with turbid toxin accumulating in stomach syndrome were finally established, namely, dark red or purplish tongue proper with yellow greasy (or dry) coating (30 points), epigastric stuffiness and fullness or pain (15 points), sticky and unsmooth defecation (10 points), taste disturbance (sticky mouth, fetid breath, bitter taste, 7 points), heartburn or acid regurgitation (6 points), dizziness and clouding (5 points), general heaviness and fatigue (5 points), slippery, string‑slippery, or slippery‑rapid pulse (5 points), dysuria (or yellow or deep yellow urine, 4 points), poor appetite (4 points), dull complexion (3 points), sticky, greasy, and fetid secretions (3 points), and poor sleep (3 points). ConclusionBased on the establishment, screening, confirmation, and weighting of an item pool, combined with subjective and objective approaches as well as qualitative and quantitative methods, a diagnostic scale for CAG with the syndrome of turbid toxin accumulating in the stomach was successfully constructed.
3.Surveillance of Oncomelania hupensis snails following interruption of schistosomiasis transmission in Yunnan Province
Siqi NING ; Yi DONG ; Chunhong DU ; Lifang WANG ; Yun ZHANG ; Yuhe HE ; Hua JIANG ; Jiayu SUN ; Chunqiong CHEN ; Jiaqi YAN ; Jihua ZHOU ; Zongya ZHANG ; Hongqiong WANG ; Meifen SHEN ; Jing SONG
Chinese Journal of Schistosomiasis Control 2026;38(2):200-206
Objective To investigate the distribution characteristics of Oncomelania hupensis snails in Yunnan Province fol-lowing interruption of schistosomiasis transmission, so as to provide the evidence for assessing the risk of schistosomiasis transmission and scientifically formulating the schistosomiasis surveillance program. Methods According to the requirements of the National Schistosomiasis Surveillance Scheme (2020 Edition), O. hupensis snail surveillance data were collected from 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province from 2020 to 2024, including area of snail survey, area of snail habitats, area of re-emerging snail habitats, number of frames surveyed, number of frames with O. hupensis snails, number of O. hupensis snails captured, and number of living snails, and the occurrence of frames with snails and mean density of living snails were calculated. Changes in snail status over the 5-year period from 2020 to 2024 and the differences in snail distributions specified by epidemic intensity, environmental type, and vegetation type were analyzed. Results The areas of snail survey increased from 1 727.96 hm2 in 2020 to 3 894.45 hm2 in 2024 (peak) across 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province during the period from 2020 through 2024. The areas of snail habitats increased from 70.36 hm2 in 2020 to a peak in 2023 (172.04 hm2), followed by a reduction to 132.36 hm2 in 2024, and the areas of re-emerging snail habitats increased from 42.71 hm2 in 2020 to a peak in 2022 (78.43 hm2), followed by a reduction to 40.21 hm2 in 2024. The occurrence of frames with snails and mean density of living snails increased from 1.24% (3 025/244 404) and (0.033 2 ± 0.038 7) snails/0.1 m2 in 2020 to peaks at 2.03% (6 231/307 563) and (0.066 9 ± 0.068 4) snails/0.1 m2 in 2023, followed by reductions to 1.04% (5 829/559 941) and (0.032 6 ± 0.057 7) snails/0.1 m2 in 2024, respectively. There was a significant difference in the occurrence of frames with snails over the 5-year study period (χ2 = 1 962.95, P < 0.05), and the occurrence of frames with snails reduced by 48.71% in 2024 relative to in 2023 (χ2 = 1 411.05, P < 0.005); however, there was no significant difference in the mean density of living snails over the 5 years (H = 5.310, P > 0.05). There were significant differences in the occurrence of frames with snails (χ2 = 481.27, P < 0.05) and mean density of living snails (H = 6.872, P < 0.05) in schistosomiasis-endemic areas with different epidemic intensities. The occurrence of frames with snails (χ2 = 25.32 and 38.70, both P values < 0.017) and mean density of living snails (Z = 28.55 and 49.96, both P values < 0.017) were higher in schistosomiasis transmission-interrupted and eliminated areas with snails than in schistosomiasis-eliminated areas without snails, and the occurrence of frames with snails (χ2 = 453.54, P < 0.017) and mean density of living snails (Z = −56.97, P < 0.017) were higher in schistosomiasis-eliminated areas with snails than in schistosomiasis transmission-interrupted areas with snails. O. hupensis snails were mainly distributed in paddy fields, dry farmlands and ditches; however, the occurrence of frames with snails (13.40%, 424/3 164) and mean density of living snails [(0.252 8 ± 0.158 7) snails/0.1 m2] were higher in ponds/weirs than in other types of environments (both P values < 0.05). Rice, dry farmland crops and weeds were main vegetations in which O. hupensis snails were distributed, and the occurrence of frames with snails (2.29%, 7 111/310 140) and mean density of living snails [(0.072 3 ± 0.018 9) snails/0.1 m2] were higher in weeds than in other types of environments (both P values < 0.05). Conclusions O. hupensis snails have been effectively controlled in Yunnan Province following implementation of integrated schistosomiasis control measures; however, there are still risk factors for schistosomiasis transmission, including reduced attention to schistosomiasis control and snail re-emergence. Improved control efforts and surveillance system construction and timely identification of risk factors of snail status and timely management are recommended to ensure the achievement of the target of schistosomiasis elimination as scheduled.
4.Automated Management of Zebrafish Strains and Zebrafish Facilities
Jiwen BU ; Ye HUA ; Shirong JIN ; Ningxin REN ; Funing LI ; Jiulin DU
Laboratory Animal and Comparative Medicine 2026;46(3):416-425
ObjectiveThis study aims to improve the management efficiency of zebrafish strains and zebrafish facilities and to transform the traditional management model that relies on manual labor. The goal is to promote a comprehensive transition from traditional manual operation to standardized, digitalized, automated, and refined management, thereby significantly improving management quality and work efficiency. MethodsThe research group independently developed the "Zebrafish Facility and Zebrafish Strain Automation Management System V1.0" (Software Copyright Registration No. 2021SR0236837), which comprehensively recorded all operational data of the zebrafish facilities and completed data on zebrafish strains. By combining in-depth mining of these data with management experience, management regulations were transformed into executable system instruction sets, and a full-process automated closed-loop management framework of "Monitoring–Analysis–Early Warning–Task Assignment–Execution–Recording" was established. ResultsThis management system has been operating stably for 5 years and has been successfully applied in 3 zebrafish facilities, cumulatively supporting 78 researchers and efficiently managing 1 108 plasmids and 1 123 zebrafish strains, among which 291 strains has been incorporated into zebrafish sperm bank management. A Likert scale survey of 28 core users covering 14 evaluation dimensions across 4 major categories showed average scores of 4.46–4.89, all far above the midpoint (3 points) of the scale, indicating that users gave high evaluations to all dimensions of the system. Meanwhile, the standard deviations of most dimensions were low (s ≤ 0.44), reflecting good consistency in user evaluations. ConclusionThis study integrates information technology, big data analysis, and modern management concepts to achieve a virtuous cycle of "data collection–analysis and execution–system optimization" in zebrafish facility management. It significantly improves management efficiency and refinement and promotes the development of management models toward automation.
5.Clinical features of nontuberculous Mycobacteria pulmonary disease patients with previous pulmonary tuberculosis
Fei WANG ; Xiaojun WANG ; Qian JIN ; Duo HUA ; Juan DU ; Lihui ZHAO ; Jian YU ; Jing XU ; Lu HAN ; Yi REN
Chinese Journal of Nosocomiology 2025;35(10):1483-1488
OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78%in the PPTB-NTMPD group,41.25%in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17%in the PPTB-NTMPD group,65.68%in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00%in the PPTB-NTMPD group,35.31%in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35%in the PPTB-NTMPD group,12.87%in the NPPTB-NTMPD group(x2=13.766,P<0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83%in the PPTB-NTMPD group,14.19%in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78%in the PPTB-NTMPD group,2.97%in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P<0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P<0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P<0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.
6.Retrospective analysis of protein A column immunoadsorption in the treatment of refractory anti-N-methyl-D-aspartate receptor encephalitis in children
Ying WANG ; Le MA ; Zhangyan GUO ; Yanqiang DU ; Hua ZHANG ; Weikai WANG ; Yi WANG
Chinese Pediatric Emergency Medicine 2025;32(1):33-37
Objective:To evaluate the safety and efficacy of immunoadsorption with protein A column(PA-IA) in refractory anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children.Methods:The clinical data of 8 children with anti-NMDAR encephalitis who failed to receive first-line treatment from January 2022 to June 2023 in PICU of Xi'an Children's Hospital were retrospectively collected.Clinical features,modified Rankin score (mRS),anti-NMDAR antibody titers in serum and cerebrospinal fluid(CSF),cells count in CSF,protein level in CSF,serum IgG,complement C3,C4 level were analyzed before and after immunoadsorption therapy. All adverse events that occurred during treatment were recorded in detail.Result:Among the 8 children,there were 5 males and 3 females,aged 5 to 12 years old,and each patient was immunized 6 to 10 times,and 75 times of PA-IA treatment were performed. The mRS score decreased in 8 children after PA-IA treatment. Blood IgG level,CSF cell number,protein level in CSF,blood complement C3 and C4 levels,and antibody titers related in blood and CSF were all lower than those before PA-IA treatment. The differences were all statistically significant ( P<0.001).During 75 times of treatment,only 1 case of membrane rupture occurred during treatment,the treatment was stopped and continued after the plasma separator was replaced,with no other adverse reactions. Conclusion:PA-IA could effectively improve the clinical symptoms and neurological function of children with refractory anti-NMDAR encephalitis with good safety,but its exact efficacy in children with anti-NMDAR encephalitis needs to be verified by prospective studies with larger samples.
7.Mechanism of curcumin on improving cell damage induced by ultraviolet B irradiation
Ying CHEN ; Ju-hua ZHAO ; Yu YANG ; Xiu-jun DU ; Hai-xia LIU ; Ling-ling XIONG ; Hua-di ZHUANG
Journal of Regional Anatomy and Operative Surgery 2025;34(9):753-758
Objective To explore the effect of curcumin(CUR)on oxidative damage of keratinocytes induced by ultraviolet B(UVB)irradiation through Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)/nucleotide-binding oligomerization domain-containing protein 3(NLRP3)signaling pathway.Methods Human keratinocytes of HaCaT were cultured normally in vitro,and the keratinocyte oxidative damage model was established by the irradiation of 57 mJ/cm2 UVB.The cells with normal culture were as the control group,the cells treated after modeling were as the UVB group,the cells treated with 5 μmol/L CUR after modeling were as the CUR group,the cells treated with 100 μg/L TLR4 inhibitor of TAK-242 after modeling were as the TAK-242 group,and the cells treated with 5 μmol/L CUR and 100 nmol/L TLR4 activator of lipopolysaccharide(LPS)were as the CUR+LPS group.qRT-PCR was applied to detect the relative expression levels of TLR4,NF-κB,and NLRP3 mRNAs of cells in each group.CCK-8 was applied to detect the cell proliferation in each group.The relative content of reactive oxygen species(ROS),the viabilities of superoxide dismutase(SOD)and catalase(CAT),and the concentrations of glutathione(MDA)and glutathione(GSH)of cells in each group were detected by fluorescence assay according to the kit instruction.ELISA kit was used to detect the expression of inflammatory factors of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)of cells in each group.Flow cytometry was applied to detect the cell apoptosis in each group.Western blot was applied to detect the expression of proliferation related protein of proliferating cell nuclear antigen(PCNA),apoptosis related proteins[B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)],and TLR4/NF-κB/NLRP3 signaling pathway related proteins(TLR4,NF-κB and NLRP3)of cells in each group.Results Compared with the Control group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the UVB group decreased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 increased(P<0.05).Compared with the UVB group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the TAK-242 group and CUR group increased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 decreased(P<0.05).Compared with the CUR group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the CUR+LPS group decreased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 increased(P<0.05).Conclusion CUR can increase the antioxidant stress level of keratinocytes,alleviate inflammatory response,promote cell proliferation,and improve cell damage caused by UVB irradiation,which may be related to the inhibition of TLR4/NF-κB/NLRP3 signaling pathway.
8.Noninvasive assessment of liver function reserve in NAFLD patients by 13C-MBT based on infrared isotope spectrometry
Qian WEN ; Yajing XIAN ; Li YANG ; Hua KE ; Lulu DU ; Dongling LIN
China Medical Equipment 2025;22(1):76-81
Objective:To evaluate the value of noninvasive assessment of the 13C-methacetin breath test (13C-MBT) based on infrared isotope spectrometry for liver function reserve in patients with nonalcoholic fatty liver disease (NAFLD). Methods:A total of 120 NAFLD patients met the diagnostic criteria,who admitted to Department of Liver Diseases of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to January 2024,were prospectively selected. Patients were divided into three groups based on liver stiffness measurement (LSM) of FibroTouch:mild fibrosis group (LSM<7.0 kPa,n=40),moderate fibrosis group (7.0≤LSM<9.5 kPa) and severe fibrosis group (LSM≥9.5 kPa,n=40). Meanwhile,40 healthy subjects were selected as a healthy control group. All subjects underwent 13C-MBT and conventional liver function tests. The differences of 13C-MBT parameters and liver function indicators among various groups were compared,and the correlations between 13C-MBT parameters and the degree of liver fibrosis,and between liver function indexes and the degree of liver fibrosis were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the judgment ability of 13C-MBT parameters to the degree of liver fibrosis. Results:The 13C-MBT parameters in NAFLD patients were lower than those in healthy control group,and the differences were statistically significant (F=27.413,28.635,29.851,P<0.05). With the aggravation of liver fibrosis,13C-MBT parameters in NAFLD patients gradually decreased. The 13C-MBT parameters of severe fibrosis group were significantly lower than those in the mild and moderate fibrosis groups,with statistically significant differences (t=12.331,13.020,14.232,22.033,21.032,29.332,P<0.05),respectively. The 13C-MBT parameters were positively correlated with liver function indicators,and were negatively correlated with LSM,and the absolute values of the correlation coefficients were>0.5,all of them showed statistically significant differences (r=0.375,-0.875,P<0.05). The 13C-MBT parameters had higher sensitivity and specificity in judging the degree of liver fibrosis. Taking MVmax40 as an example,when the limit value was 9.5 kPa,the sensitivity was 86.3%,and the specificity was 83.8%,and the accuracy was 85.0%,and the area under curve (AUC) was 0.913. Conclusion:13C-MBT based on infrared isotope spectrometry is a non-invasive,safe,rapid and accurate detection method,which can reflect the liver function reserve and liver fibrosis degree of NAFLD patients,and has important clinical value for the diagnosis and treatment of NAFLD.
9.Effect of PHC combined with RIPC on postoperative cognitive function in patients with lung cancer
Hua CHAI ; Yulong DU ; Wenyong PENG
China Modern Doctor 2025;63(4):6-10
Objective To investigate the effects of permissive hypercapnia(PHC)combined with remote ischemic preconditioning(RIPC)on regional brain oxygen saturation(rSO2)and postoperative cognitive function in patients undergoing thoracoscopic radical resection for lung cancer.Methods A total of 80 patients who underwent thoracoscopic lung cancer resection in Jinhua Municipal Central Hospital from January to December 2022 were selected and divided into control group,RIPC group,PHC group and PHC+RIPC group according to random number table method,with 20 cases in each group.rSO2 levels were observed before anesthesia induction(T0),before unilateral ventilation(T1),10min after unilateral ventilation(T2),30min after unilateral ventilation(T3),at the end of after unilateral ventilation(T4)and after surgery(T5)in four groups.The level of serum interleukin(IL)-6,IL-10,tumor necrosis factor-α(TNF-α)and cognitive function at T0,T4,the first day after surgery(T6)and the third day postoperative(T7)were recorded.Results After surgery,the levels of IL-6,TNF-α,and IL-10 in four groups first increased and then decreased(P<0.05).At T4 and T6,there were statistically significant differences in IL-6 levels among four groups(P<0.05),and the IL-6 level of control group was significantly higher than that of other three groups(P<0.05).At T4,T6 and T7,there were statistically significant differences in IL-10 and TNF-α levels among four groups(P<0.05),and the IL-10 level in control group was significantly lower than that in other three groups,and the TNF-α level was significantly higher than that in other three groups.At T2,T3,T4 and T5,there were statistically significant differences in rSO2 between four groups(P<0.05),and PHC+RIPC group>RIPC group>PHC group>control group.At T6,the score of mini-mental state examination scale of control group was significantly lower than that of other three groups(P<0.05).Conclusion PHC combined with RIPC can improve rSO2 and postoperative cognitive function in patients with thoracoscopic lung cancer resection,reduce the level of inflammatory factors,and reduce the occurrence of postoperative cognitive dysfunction.
10.Clinical features of nontuberculous Mycobacteria pulmonary disease patients with previous pulmonary tuberculosis
Fei WANG ; Xiaojun WANG ; Qian JIN ; Duo HUA ; Juan DU ; Lihui ZHAO ; Jian YU ; Jing XU ; Lu HAN ; Yi REN
Chinese Journal of Nosocomiology 2025;35(10):1483-1488
OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78%in the PPTB-NTMPD group,41.25%in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17%in the PPTB-NTMPD group,65.68%in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00%in the PPTB-NTMPD group,35.31%in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35%in the PPTB-NTMPD group,12.87%in the NPPTB-NTMPD group(x2=13.766,P<0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83%in the PPTB-NTMPD group,14.19%in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78%in the PPTB-NTMPD group,2.97%in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P<0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P<0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P<0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.

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