Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases最新文献

{"title":"[Several issues in interpreting the results of metagenomic next generation sequencing of lower respiratory tract infection].","authors":"H Zhou","doi":"10.3760/cma.j.cn112147-20221117-00903","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221117-00903","url":null,"abstract":"<p><p>Metagenome next generation sequencing (mNGS) is an important method for pathogen diagnosis of lower respiratory tract infection, but there are many difficulties in interpreting mNGS reports. The Expert Consensus on Clinical Interpretation Path of mNGS of Lower Respiratory Tract Infection, completed by Chinese Thoracic Society, provides a detailed path and guidance for report interpretation. The expert consensus covers clinical medicine, microbiology, molecular diagnosis and other aspects. On this basis, several important clinical issues need to be highlighted. First, the lower respiratory tract specimens used for mNGS must be obtained in a timely and qualified manner. Second, the correct interpretation of the mNGS report needs to be based on a full understanding of the patients and their conditions. Third, the quality of the report should be analyzed according to the main parameters in the mNGS report. Fourth, an understanding of basic microbiology knowledge is beneficial to identify valuable pathogens in the mNGS report. Fifth, other microbiological methods should be actively used during mNGS detection. Sixth, to seek the help of the team when necessary and organize multidisciplinary discussions are vital. Seventh, it is important to constantly adjust the diagnosis and treatment strategies according to the clinical treatment response to treatment and the evolution of the disease. In a word, the interpretation of mNGS results needs to refer to specimen types and sequencing parameters, to combine with the specific conditions of patients in detail, to collect a variety of microbiological test results, to carefully screen and make judgement according to the treatment effect and disease outcome, and finally to make the diagnosis. The interpretation of mNGS report also requires us to have more knowledge of microbiology, sequencing and bioinformatics analysis, and to pay more attention to the strength of the team to discriminate the truth in multidisciplinary collaboration.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"319-321"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of <i>Mycobacterium tuberculosis</i> protein Rv0309 on intracellular survival of <i>Mycobacterium</i> smegmatis by inhibiting macrophage autophagy via protein STUB1].","authors":"L Li,&nbsp;Y Y Liu,&nbsp;J F Yuan,&nbsp;X Peng,&nbsp;Y Pang,&nbsp;J Lu,&nbsp;S J Tang","doi":"10.3760/cma.j.cn112147-20221125-00928","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221125-00928","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the molecular regulatory mechanism of <i>Mycobacterium tuberculosis</i> (MTB) protein Rv0309 to promote the survival of <i>Mycobacterium smegmatis</i> (Ms) in macrophages. <b>Methods:</b> Using Ms as a model to study <i>Mycobacterium tuberculosis</i>, recombinant Ms transfected with pMV261 and PMV261-RV0309 in the control group and RAW264.7 cells were constructed. The effect of Rv0309 protein on intracellular survival of Ms was investigated by counting colony forming units (CFUs). Mass spectrometry was used to screen proteins interacting with host protein Rv0309, and immunocoprecipitate (Co-IP) was used to verify that host protein STUB1 could interact with host protein Rv0309. <i>STUB1</i> gene knock-out RAW264.7 cells were infected with Ms, and CFUs were counted to explore the effect of protein Rv0309 on intracellular survival of Ms after <i>STUB1</i> gene knock-out. <i>STUB1</i> gene knock-out RAW264.7 cells were infected with Ms, and after obtaining samples, Western blotting assay was performed to explore the effect of protein Rv0309 on autophagy function of macrophages after <i>STUB1</i> gene knock-out. Statistical analysis was performed using GraphPad Prism 8 software. <i>T</i>-test was selected for analysis in this experiment, with <i>P</i><0.05 was considered statistically significant. <b>Results:</b> Western blotting showed that Rv0309 was expressed in M. smegmatis and secreted extracellularly. The CFUs of the Ms-Rv0309 group was higher than that of Ms-pMV261 group at 24 h after THP-1 macrophage infection, and the difference was statistically significant (<i>P</i><0.05). The trend of infected RAW264.7 macrophages was the same as that of infected THP-1 macrophages. The Co-IP results showed that the corresponding Flag and HA bands appeared in the results of immunoprecipitation (IP):Flag and IP: HA. The level of CFUs in the experimental group with <i>STUB1</i> deletion was significantly higher than that in the control group without <i>STUB1</i> deletion. Compared with Ms-pMV261, the CFUs in the Ms-Rv0309 group was significantly higher than that in the Ms-pMV261 group. The gray scale of LC3Ⅱ bands of Ms-Rv0309 in experimental group was lighter than that of Ms-pMV261 in the control group at the corresponding time point, and the result was most significant at 8 h (LC3Ⅱ/β-actin: 0.76±0.05 vs 0.47±0.07), the difference being statistically significant (<i>P</i><0.05). After <i>STUB1</i> genome knock-out, the gray level of LC3Ⅱ bands at the corresponding time was lighter than that without <i>STUB1</i> genome knock-out. Comparison of the results of Ms-pMV261 and Ms-Rv0309 strains revealed that LC3Ⅱ band gray Rv0309 group was lighter at the corresponding time compared with pMV261 group. <b>Conclusions:</b> MTB protein Rv0309 can be successfully expressed in M. smegmatis and secreted extracellularly, which can inhibit the autophagy process of macrophages. Protein Rv0309 interacts with host protein STUB1 to inhibi","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"396-403"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9602367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Thromboprophylaxis and management of anticoagulation in hospitalized patients with COVID-19: clinical pathway and practices].","authors":"","doi":"10.3760/cma.j.cn112147-20230206-00053","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20230206-00053","url":null,"abstract":"<p><p>Inpatients infected with SARS-CoV-2 are prone to various complications during clinical treatment, especially venous thromboembolism (VTE), which significantly increases the risk of unexpected death. In recent years, a series of authoritative guidelines and high-quality evidence-based medicine research evidence have been published internationally. This working group has recently formulated the Guidelines for Thrombosis Prevention and Anticoagulant Management of Hospitalized Patients with Novel Coronavirus Infection with multidisciplinary experts in the fields of VTE prevention, critical care and evidence-based medicine from international and domestic experts. Based on this, the working group elaborated on 13 clinical issues in urgent need of attention and solution in current clinical practice on the basis of the guidelines and defined standardized operational paths, including VTE risk and bleeding risk assessment in hospitalized patients with COVID-19, VTE prevention and anticoagulant management of hospitalized COVID-19 patients with different severity and special patient populations complicated with pregnancy, malignant tumors, underlying diseases or organ insufficiency, usage of antiviral and anti-inflammatory drugs or thrombocytopenia, in addition to VTE prevention and anticoagulant management of discharged COVID-19 patients, anticoagulant management of COVID-19 patients complicated with VTE during hospitalization, anticoagulant management in patients undergoing VTE therapy with COVID-19, risk factors of bleeding in hospitalized patients with COVID-19, clinical classification and corresponding management. In particular, by referring to the latest international guidelines and research evidence, this paper provides clear implementation recommendations on how to accurately determine the standard preventive dose anticoagulation and therapeutic dose anticoagulation for hospitalized patients with COVID-19. This paper is expected to provide standardized operational procedures and implementation norms for healthcare workers to managing thrombus prevention and anticoagulation in hospitalized patients with COVID-19.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"336-351"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9203463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress on specific and non-specific immune effects of Bacille Calmette-Guerin].","authors":"Y Su,&nbsp;Y Cao,&nbsp;R L Wang,&nbsp;E J Dong,&nbsp;W J Zhao,&nbsp;J L Du","doi":"10.3760/cma.j.cn112147-20220711-00589","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20220711-00589","url":null,"abstract":"<p><p>Currently, Bacille Calmette-Guerin(BCG) is still the only admitted vaccine to prevent tuberculosis around the world. The target population is infants and children, but its protective efficacy is limited. As more and more studies have shown that re-vaccination with BCG protects against tuberculosis in adults, BCG can also induce non-specific immunity against other respiratory diseases and some chronic diseases by training immunity, especially the immune effects against COVID-19. At present, the epidemic of COVID-19 has not been effectively contained, and it is worth considering whether BCG vaccine can be used as an intervention to prevent COVID-19. The WHO and China do not have a policy to support BCG revaccination, and as more and more BCG vaccines are discovered, whether selective revaccination can be carried out in some high-risk populations and whether the vaccine can be used more widely have led to intense discussions. This article reviewed the effects of specific immunity and non-specific immunity of BCG on tuberculosis and non-tuberculous diseases.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"413-418"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9274161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic value and consideration of low sequence pathogens detected by metagenomic next-generation sequencing in lower respiratory tract infection].","authors":"Y Shi,&nbsp;P Li","doi":"10.3760/cma.j.cn112147-20221129-00939","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221129-00939","url":null,"abstract":"<p><p>Pathogenic diagnosis of lower respiratory tract infection has always been a clinical problem. The widespread application of metagenomic next-generation sequencing(mNGS)provides a rapid and accurate method for pathogenic diagnosis. However, how to interpret the results of mNGS detection, especially whether it has diagnostic value in detecting pathogens with low sequence number, has always puzzled clinicians. This paper discusses the definition of low sequence number (lower reads)detected by mNGS in lower respiratory tract infection, the cause of occurrence, the method to determine the reliability of the results, and how to correctly interpret the low sequence number report in combination with clinical practice. It is hoped that by comprehensively mastering the detection knowledge, the proper clinical analysis thinking can be established to improve the diagnostic ability of pathogens with low sequence number detected by mNGS in lower respiratory tract infection.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"311-314"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Basic competence for etiological diagnosis of lower respiratory tract infection after application of metagenomic next-generation sequencing].","authors":"B H Lu","doi":"10.3760/cma.j.cn112147-20221121-00915","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221121-00915","url":null,"abstract":"<p><p>In addition to clinical manifestations, medical history, and imaging, the diagnosis of low respiratory tract infection (LRTI) depends mainly on the ability of the clinical microbiology laboratory to detect the pathogens. However, conventional culture may be time-consuming, the sensitivity of microscopy is low, and nucleic acid-based targeted tests (e.g., PCR) could only cover limited range of pathogens. The use of mNGS technology has improved the diagnostic rate of LRTI, but the conventional microbiology detection has been neglected to some extent. This review addressed the appropriate use of these methods with the aim of strengthening the ability of traditional microbiology methods in LRTI diagnosis after mNGS application.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"315-318"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese experts consensus statement: diagnosis and treatment of cystic fibrosis (2023)].","authors":"","doi":"10.3760/cma.j.cn112147-20221214-00971","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221214-00971","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is one of the most common autosomal recessive genetic diseases in Caucasians, but CF patients in China are rare, and it was listed as the first batch of rare diseases in China in 2018. In recent years, CF has been gradually recognized in China, and the number of CF patients reported in China in the past 10 years is more than 2.5 times the total number in the previous 30 years, and the total number of CF patients is estimated to be more than 20 000. The research progress of CF gene modification has led to the innovation of CF treatment. However, the sweat test as an important test for the diagnosis of CF has not been widely implemented in China. At present, the diagnosis and treatment of CF in China still lacks standardized recommendations. In view of these updates, the Chinese Experts Cystic Fibrosis Consensus Committee has formed \"the Chinese experts consensus statement: diagnosis and treatment of cystic fibrosis\" based on extensive opinion gathering, literatures review, multiple meetings and discussions. This consensus collects 38 core issues related to CF, including pathogenesis, epidemiology, clinical characteristics, diagnosis, treatment, rehabilitation, and patient management. Finally, 32 recommendations were formulated. The consensus used the modified GRADE methodology to grade the evidence evaluation and recommendations. This is the current state of CF consensus in China, and we hope to improve the diagnosis and treatment of CF in China in the future.<b>Summary of recommendations</b><b>Question 1: How can CF be identified?</b>CF should be suspected if there is: (1) a family history of CF; (2) delayed meconium expulsion or meconium ileus; (3) pancreatic exocrine insufficiency, mainly characterized by long-standing steatorrhea and malnutrition; (4) recurrent lower respiratory tract infections of infantile onset, especially <i>Pseudomonas aeruginosa (PA), Staphylococcus aureus</i> infections of respiratory aetiology; (5) chronic sinusitis, especially when combined with juvenile presentation of nasal polyps; (6) chest CT abnormalities such as the presence of air trapping, bronchiectasis (upper lobe predominant); (7) pseudo-Bartter syndrome; (8) absence of vas deferens in males; (9) clubbing in young bronchiectasis patients(1C).<b>Question 2: What are the diagnostic criteria for CF?</b>1.1 Presence of one or more of the characteristic clinical manifestations or family history consistent with CF, and meeting at least one of the following definite diagnostic criteria in 1.2 or 1.3.1.2 Sweat chloride testing:(1) Concentrations of more than 60 mmol/L are diagnostic; (2) concentrations between 30-59 mmol/L are intermediate, and genetic variation must be considered to confirm the diagnosis; (3) concentrations less than 30 mmol/L are considered normal.1.3 Genetic testing:(1) Detection of two disease-causing <i>CFTR</i>(cystic fibrosis transmembrane conductance regulator) mutations on biallelic alleles; (2) The <i>CFTR</i> v","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"352-372"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application and progress of photodynamic therapy in combination therapy of lung cancer].","authors":"X W Chen,&nbsp;X L Song","doi":"10.3760/cma.j.cn112147-20221214-00974","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221214-00974","url":null,"abstract":"<p><p>Lung cancer is one of the most common malignant tumors with high morbidity and mortality. At present, the traditional treatments of lung cancer include surgical resection, radiotherapy, chemotherapy, targeted therapy and immunological therapy. The modern model of diagnosis and treatment tends to be multidisciplinary, individual, focusing on systemic therapy combined with local therapy. Recently, PDT(photodynamic therapy) becomes an emerging cancer treatment due to its advantages of low trauma, high selectivity, hypotoxicity, good reutilization. PDT has a good effect in the radical treatment of early airway cancer and palliative treatment of advanced airway tumor by using its photochemical reactions. Nevertheless, more attention is focused on combination therapy of PDT Combination with surgery can reduce tumor burden and eliminate potential lesions; Combination with radiotherapy can reduce the amount of radiation and improve therapeutic effect; Combination with chemotherapy achieves the combination of local and systemic therapy; Combination with targeted therapy can enhance anti-cancer targeting; combination with immunotherapy can improve anti-cancer immunity, <i>etc</i>. This article focused on PDT as a part of a combination therapy in the treatment of lung cancer, to provide a new treatment method for patients with poor therapeutic effect with traditional treatment.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 4","pages":"424-429"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on off-label administration of drugs in COVID-19].","authors":"","doi":"10.3760/cma.j.cn112147-20230127-00038","DOIUrl":"10.3760/cma.j.cn112147-20230127-00038","url":null,"abstract":"<p><p>The challenges for clinical management of coronavirus disease 2019 (COVID-19) consist of the unfamiliarity of immunomodulator prescription, the difficulty in drug administration in special patient populations (e.g., patients with dysphagia or severe renal insufficiency) and limited medication accessibility. Off-label administration of some medications for COVID-19 has been documented. Here, we highlight several issues pertinent to the clinical application of COVID-19 medications by soliciting multidisciplinary experts. We aggregated the drug specifications from and outside mainland China, the guidelines for clinical management of COVID-19 and the evidence from high-quality research. Recommendations were formed through teleconference with the consensus conference method by taking into account the levels of effectiveness and recommendation, and the strength of evidence of the Thomson Micromedex. We have formulated 10 recommendations for off-label drug administration, including three recommendations for off-label modification of drug dosage form for oral or gastric tube feeding administration (dissolving nirmatrelvir-ritonavir tablets into suspension, solution preparation for monulpiravir capsules, and solution of dispersed baricitinib tablets), five recommendations for off-indication use (intravenous injection of tocilizumab or baricitinib for severe or critically ill patients with COVID-19, subcutaneous injection of tocilizumab for severe or critically ill patients with COVID-19 in case of inaccessible intravenous tocilizumab or baricitinib tablets, substitution with tofacitinib 10 mg twice daily in case of the inaccessibility of tocilizumab and baricitinib; Methylprednisolone or prednisone for severe or critically ill patients with COVID-19 to reduce all-cause mortality), and two recommendations for off-label use among the targeted populations (no titration of tocilizumab doses for COVID-19 patients with severe renal insufficiency, baricitinib 2 mg once every other day or 1 mg daily for severe or critically ill patients with severe renal insufficiency and eGFR 15-30 ml/(min·1.73m²)). This consensus document aims to provide the reference for rational use of medications among clinicians and the pharmacovigilance monitoring.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on surgical treatment of multidrug-resistant and rifampicin-resistant pulmonary tuberculosis in China (2022 edition)].","authors":"","doi":"10.3760/cma.j.cn112147-20221222-00986","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221222-00986","url":null,"abstract":"<p><p>The cure rate of multidrug-resistant and rifampicin-resistant pulmonary tuberculosis in the world is about 60%, and timely surgical intervention can increase the cure rate to more than 85%. The treatment of multidrug-resistant and rifampicin-resistant pulmonary tuberculosis requires multidisciplinary involvement of tuberculosis department, thoracic surgery department, imaging department, laboratory department and other disciplines to significantly reduce its morbidity and mortality. Although the World Health Organization has defined the role and status of surgery in the treatment of multidrug-resistant and rifampicin-resistant pulmonary tuberculosis, there are significant differences in the cognition and diagnosis and treatment methods of domestic clinicians on multidrug-resistant and rifampicin-resistant pulmonary tuberculosis. Therefore, it is urgent to develop expert consensus on surgical treatment of multidrug-resistant and rifampicin-resistant pulmonary tuberculosis for clinicians to learn from in clinical diagnosis and treatment practice. The Chinese Society for Tuberculosis,Chinese Medical Association organized experts in tuberculosis thoracic surgery to write the first draft of consensus based on the expert suggestion on surgical diagnosis and treatment of multidrug-resistant pulmonary tuberculosis written by the European Office of the World Health Organization in 2014 and the 2019 version of China's multidrug-resistant and rifampicin-resistant pulmonary tuberculosis expert consensus, and combined with China's national situation. This consensus systematically elaborated seven aspects, including surgical indications, contraindications to surgery, conditions and timing of surgery, surgical methods and indications of various surgical procedures, preoperative and postoperative chemotherapy, treatment of surgical complications, and perioperative management of patients with multidrug-resistant and rifampin-resistant pulmonary tuberculosis. After discussion and voting by experts, six recommendations were formed, aiming to provide reference for clinicians in the treatment of multidrug-resistant and rifampin-resistant pulmonary tuberculosis and further improve the standardized diagnosis and treatment level of multidrug-resistant and rifampin-resistant pulmonary tuberculosis in China.</p>","PeriodicalId":23961,"journal":{"name":"Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases","volume":"46 2","pages":"111-120"},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}