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":"[Progress on the safety and efficacy of bedaquiline for the treatment of drug-resistant tuberculosis in special populations].","authors":"Y P Zhang,&nbsp;Y Y Niu,&nbsp;P J Tang","doi":"10.3760/cma.j.cn112147-20230103-00003","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20230103-00003","url":null,"abstract":"<p><p>Antimicrobial resistance in <i>Mycobacterium tuberculosis</i> is a serious threat to global tuberculosis(TB) control. WHO listed bedaquiline as one of the first-choice drugs for the treatment of MDR/RR-TB in 2018. Bedaquiline is marketed for adult patients with MDR-TB and XDR-TB. However, there are few studies of bedaquiline in adolescents, pregnant women, the elderly, and other special populations with drug-resistant TB. This paper aimed to review the effectiveness and safety of bedaquiline in the treatment of special populations of drug-resistant TB for the clinical use.</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 6","pages":"619-624"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576380","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":"[Development in diagnostic criteria for allergic bronchopulmonary aspergillosis].","authors":"Y F Ma,&nbsp;Y L Ma,&nbsp;X Chen,&nbsp;P A Zhang,&nbsp;M Q Zhang","doi":"10.3760/cma.j.cn112147-20221124-00925","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221124-00925","url":null,"abstract":"<p><p>Allergic bronchopulmonary aspergillosis (ABPA) is an allergic lung disease caused by the sensitization of <i>Aspergillus fumigatus</i>. In recent years, the research into ABPA has progressed, the testing methods have improved and the diagnostic criteria have been continuously updated. There is no gold standard for the diagnosis of the disease. The diagnostic criteria for ABPA include predisposing diseases, fungal-related immunoassay and pathological examination. Understanding the clinical significance of ABPA diagnostic criteria may help to prevent irreversible bronchopulmonary injury, improve respiratory function and improve the prognosis of patients.</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 6","pages":"624-631"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576382","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":"[Hereditary pulmonary hypertension family with <i>BMPR2</i> gene variation: a case report and literature review].","authors":"Y K Lin,&nbsp;D H Yang,&nbsp;C Lei,&nbsp;H Luo","doi":"10.3760/cma.j.cn112147-20221123-00922","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221123-00922","url":null,"abstract":"<p><p><b>Objective:</b> To describe the clinical characteristics, diagnosis, genetic features and treatment of hereditary pulmonary hypertension complicated with suspected hereditary hemorrhagic telangiectasia (HHT). <b>Methods:</b> Firstly, we summarized and analyzed the clinical data of two cases of suspected HHT admitted to the Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University. Secondly, the genes of peripheral blood of patients and their families were completely sequenced and sanger sequencing was performed to verify the variation sites, and then the mRNA deletion caused by the variation was further verified. Thirdly, \"HHT\" \"FPAH\" and \"<i>BMPR2</i> gene variation\" were used as keywords,and the related literatures of Wanfang database and PubMed database from January 2000 to November 2021 were searched and reviewed. <b>Results:</b> We found two patients in a family from Yiyang, Hunan province, who had symptoms of hemoptysis or pulmonary hypertension without epistaxis or other clinical features of HHT. However, both patients had pulmonary vascular abnormalities and pulmonary hypertension in their lungs. We found that <i>BMPR2</i> gene variation (NM_001204.7:c.1128+1G>T) was positive and ENG, ACVRL1 and SMAD4 genes were negative. Family analysis and Sanger verification were carried out on 16 individuals in 4 generations of the family (7 of whom were found to carry the mutant gene), and then transcriptional level mRNA sequencing further confirmed that the variation resulted in the deletion of exon 8 and exon 9, and amino acid sequence estimation revealed that the amino acids of the protein from 323 to 425 were deleted. We thought that the incomplete translation of <i>BMPR2</i> gene could lead to BMPRⅡ dysfunction. Therefore, it was diagnosed as hereditary pulmonary hypertension with suspected HHT. Both patients were suggested to reduce the pulmonary artery pressure, and at the same time, the whole-body imaging examination should be performed to screen other arteriovenous malformations, and the annual cardiac color Doppler ultrasound should be reviewed to evaluate the changes of pulmonary artery pressure. <b>Conclusions:</b> Hereditary pulmonary hypertension (HPAH) is a group of diseases with increasing pulmonary vascular resistance caused by genetic factors, including familial PAH and simple PAH. Variation in the <i>BMPR2</i> gene is an important pathogenic factor of HPAH. Therefore, we should pay attention to the inquiry of family history when we clinically encounter young patients with pulmonary hypertension. If the cause is unknown, genetic testing is recommended. HHT is a rare autosomal dominant genetic disease. The possibility of this disease should be considered in clinical manifestations such as familial pulmonary vascular abnormality, pulmonary hypertension and recurrent epistaxis. There is no effective specific treatment for HPAH and HHT, which are treated symptomatically (including ","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 6","pages":"558-564"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584658","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 of veno-arterio-venous extracorporeal membrane oxygenation in patients with critical respiratory failure combined with refractory shock].","authors":"Y Li,&nbsp;X Y Li,&nbsp;X Tang,&nbsp;R Wang,&nbsp;C Y Zhang,&nbsp;S Q Wang,&nbsp;X Yuan,&nbsp;L Wang,&nbsp;Z H Tong,&nbsp;B Sun","doi":"10.3760/cma.j.cn112147-20221008-00803","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221008-00803","url":null,"abstract":"<p><p><b>Objective:</b> To preliminarily analyze the application experience of veno-arterio-venous extracorporeal membrane oxygenation (VAV-ECMO).The VAV-ECMO is a rescue strategy for patients with extremely critical respiratory failure combined with refractory shock. <b>Methods:</b> From February 2016 to February 2022, the characteristics and outcomes of patients who were started on either veno-venous or veno-arterial ECMO due to respiratory or hemodynamic failure, and then converted to VAV-ECMO in respiratory intensive care unit (ICU) of Beijing Chaoyang Hospital were analyzed. <b>Results:</b> A total of 15 patients underwent VAV-ECMO, aged 53 (40, 65) years, and 11 of whom were male. Within the group, VV-ECMO was initially used in 12 patients due to respiratory failure, but then VAV-ECMO was used due to cardiogenic shock (7/12) and septic shock (4/12), while VAV-ECMO was established in two patients due to lung transplantation. One patient was diagnosed with pneumonia complicated by septic shock, which was initially determined to be VA-ECMO, but then switched to VAV-ECMO because it was difficult to maintain oxygenation. The time from the establishment of VV or VA-ECMO to the switch to VAV-ECMO was 3 (1, 5) days and the VAV-ECMO support time was 5 (2, 8) days. ECMO-related complications were bleeding, mostly in the digestive tract (<i>n</i>=4) and airway hemorrhage (<i>n</i>=4), without intracranial hemorrhage, and poor arterial perfusion of the lower limbs (<i>n</i>=2). Among these 15 patients, the overall ICU mortality was 53.3%. The mortality of patients who received VAV-ECMO due to septic shock and cardiogenic shock was 100% (4/4) and 42.8% (3/7), respectively. Two patients who received VAV-ECMO due to lung transplantation all survived. <b>Conclusion:</b> VAV-ECMO may be a safe and effective treatment for carefully selected patients with critical respiratory failure associated with cardiogenic shock or end-stage lung disease lung transplantation transition, however, patients with septic shock may benefit the least.</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 6","pages":"565-571"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576384","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":"[Comprehensive clinical evaluation of bedaquiline in the treatment of multidrug-resistant tuberculosis].","authors":"X Geng,&nbsp;Y Yang,&nbsp;X T Wen,&nbsp;H F Long,&nbsp;Y X Li,&nbsp;Y X Liu,&nbsp;Z F Mao","doi":"10.3760/cma.j.cn112147-20221031-00859","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20221031-00859","url":null,"abstract":"<p><p><b>Objective:</b> To assess the clinical value of bedaquiline in five dimensions: effectiveness, safety, economics, appropriateness, and social benefits, to provide a reference for medical and health insurance-related decisions. <b>Methods:</b> A total of 792 patients with multidrug-resistant tuberculosis who were hospitalized at Wuhan Pulmonary Hospital, Ganzhou Fifth People's Hospital and Jiangxi Chest Hospital between January 2018 and December 2020 were included in the study. Based on a retrospective survey of case data, and each evaluation dimension of bedaquiline was statistically analyzed by causal analysis or chi-square test, using linezolid as the reference drug. <b>Results:</b> In terms of effectiveness, bedaquiline significantly increased treatment success by 23.9% (95%<i>CI</i>:4.8%-43.0%) and shortened treatment duration by 64 days(95%<i>CI</i>:18-109 days). In terms of safety, the incidence of adverse reactions to bedaquiline and the discontinuation rate of adverse reactions (5.11%,4.55%) were significantly lower than those for linezolid (22.49%,15.24%), with statistically significant differences (χ²=27.50,<i>P</i><0.001;χ²=14.09,<i>P</i><0.001). In terms of economics, patients treated with bedaquiline had a significantly higher anti-TB drug course cost of RMB 48 209.4 Yuan(95%<i>CI</i>: 28 336.0-68 082.8 Yuan). In terms of appropriateness, the proportion of bedaquiline in patients' initial treatment regimens was lower than that of linezolid (16.7% <i>vs.</i> 86.5%) in the 2020 observation sample, with a statistically significant difference (χ²=238.96,<i>P</i><0.001). In terms of social benefits, the infection control rate was significantly increased by 27.8% (95%<i>CI</i>:8.2%-47.5%) in patients using bedaquiline. <b>Conclusions:</b> Bedaquiline performed well in terms of efficacy, safety, and social benefits. However, it was less economical and the actual use rate of bedaquiline in clinical practice was lower than that of its counterpart drug, linezolid. Price reductions might be needed to increase the clinical use and performance of bedaquiline in the future.</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 6","pages":"572-579"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582674","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":"[A case of lymphatic vessel abnormality with chylous pneumonia].","authors":"L R Xu,&nbsp;Y Zhang,&nbsp;C X Ma,&nbsp;L Gao,&nbsp;F L He,&nbsp;H Zhao,&nbsp;D H Zhao","doi":"10.3760/cma.j.cn112147-20220806-00658","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20220806-00658","url":null,"abstract":"<p><p>Chylous pneumonia is a rare respiratory disease. The main clinical manifestation is coughing up chylous sputum with a variety of causes which can be clarified by lymphangiography. The lack of understanding of the disease, and infrequent lymphangiography have led to a high rate of misdiagnosis and missed diagnosis. Here, we reported a case of bronchial lymphatic fistula caused by lymphatic abnormality that led to the diagnosis and treatment of chylous pneumonia, with the aim of improving clinicians' understanding of this disease.</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 6","pages":"599-602"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576383","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":"[Efficacy of high-frequency electrotome combined with balloon dilatation and cryotherapy through electronic bronchoscope in the management of lumen occlusion type of tracheobronchial tuberculosis].","authors":"L Luo,&nbsp;L Z Luo,&nbsp;Z B Lu,&nbsp;Y B Xiao","doi":"10.3760/cma.j.cn112147-20220928-00786","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20220928-00786","url":null,"abstract":"<p><p>The lumen-occlusion type of tracheobronchial tuberculosis is the most severe type of tracheobronchial stenosis of tuberculosis, often leading to atelectasis or even lung damage in patients. Some patients require surgical resection of the diseased airways and lungs, which can seriously affect their quality of life and even be life-threatening. In order to improve the treatment ability of bronchoscopy physicians for lumen occlusion type of tracheobronchial tuberculosis, this article retrospectively analyzed 30 cases of tracheobronchial tuberculosis with lumen occlusion in Hunan Chest Hospital, and summarized the experience of achieving better results by high-frequency electrotome combined with balloon dilatation and cryotherapy.</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 6","pages":"587-591"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584657","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":"[Screening for occult cancer in patients with unprovoked venous thromboembolism].","authors":"L S Qiao,&nbsp;X M Xu","doi":"10.3760/cma.j.cn112147-20220815-00683","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20220815-00683","url":null,"abstract":"<p><p>Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is the third most common cardiovascular disease. Unprovoked VTE can be the initial presentation of occult cancer. Up to 10% of patients with unprovoked VTE are diagnosed with cancer within a year. Cancer screening in patients with unprovoked VTE is beneficial for early cancer diagnosis and treatment, which may theoretically reduce cancer-related morbidity and mortality. The epidemiology of occult cancer in patients with unprovoked VTE, screening strategies originated from evidence-based medicine, risk factors of cancer and different models of risk assessment are reviewed in this article.</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 5","pages":"498-502"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628296","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":"[Comments on the systemic corticosteroid strategy for the coronavirus disease 2019 (COVID-19)].","authors":"H Huang","doi":"10.3760/cma.j.cn112147-20230115-00022","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20230115-00022","url":null,"abstract":"<p><p>Systemic corticosteroid is considered effective in treating severe or critical coronavirus disease 2019 (COVID-19) patients in both Chinese and international consensus and/or guidelines. Dexamethasone (6 mg daily for up to 10 days) is usually recommended. However, based on the outcomes of variable clinical trials and our clinical experience in treating the COVID-19 patients, the starting time, initial dosage and course of corticosteroid might be varied case by case. Individualized administration of corticosteroid is suggested according to the COVID-19 patient's demographic characteristics, underlying disease and immune status, severity and progression rate of COVID-19, inflammatory condition and concomitant use of non-steroidal anti-inflammatory drugs.</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 5","pages":"521-524"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777527","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":"[Advances in clinical characteristics of talaromycosis combined with other opportunistic infections].","authors":"Z M Yang,&nbsp;J Huang,&nbsp;X M Chen,&nbsp;X Meng,&nbsp;Y Qiu,&nbsp;W Zeng,&nbsp;J Q Zhang","doi":"10.3760/cma.j.cn112147-20220807-00659","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20220807-00659","url":null,"abstract":"<p><p>Talaromycosis (TSM) is an opportunistic deep mycosis prevalent in southeast Asia and southern China, affecting HIV-positive, anti-interferon-gamma autoantibody-positive and other immunodeficiency hosts. These hosts are often co-infected with mycobacterium tuberculosis, non-tuberculosis mycobacteria, bacteria, fungi, viruses and other opportunistic infections. The clinical characteristics and the pathogenic spectrum of TSM with opportunistic infections vary with different immune states. The rates of misdiagnosis, missed diagnosis and mortality are high. This review summarized the clinical characteristics of TSM with opportunistic infections in order to improve the level of clinical diagnosis and 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 5","pages":"503-506"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9425052","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}