BackgroundRisk factors of anxiety and depression symptoms in patients with chronic obstructive pulmonary disease (COPD) have been widely researched, but most of them cannot be addressed clinically. The aim of this study was to investigate whether COPD knowledge level is a risk factor of anxiety and/or depression in COPD patients in addition to functional capacity and quality of life, and to determine the key topics of COPD knowledge.MethodsA total of 364 COPD patients from four centers were recruited into this cross-sectional survey. Subjects’ general medical information, assessments of lung function, dyspnea, quality of life, and exercise capacity, and responses to the Hospital Anxiety and Depression Scale (HAD) and the Bristol COPD Knowledge Questionnaire (BCKQ) were collected. Partial correlation analysis was performed, and a multivariable model testing risk factors of anxiety and depression as well as a multivariable model of 13 topics of knowledge derived from BCKQ were constructed.ResultsSubjects with anxiety or depression were more likely to have less COPD knowledge. Partial correlation analysis revealed that HAD score was negatively correlated with BCKQ score (rho = −0.153, P = 0.004). BCKQ score was significant in the multivariable model that tested risk factors of anxiety and depression (P = 0.001, OR = 0.944). Topics of epidemiology (P < 0.001, OR = 0.653) and infections (P = 0.006, OR = 0.721) were significant in the multivariable model evaluating 13 topics.ConclusionsThe level of patients’ disease knowledge is a significant risk factor of anxiety and depression in COPD patients. Epidemiology and infections are key topics of COPD knowledge to target in the Chinese population.Trial registrationChiCTR-OCS-12002518

Background and Aims: Tuberculosis, a chronic infectious disease caused by Mycobacterium tuberculosis, may invade all organs but mainly affect lungs. Most hepatic tuberculosis could be a part of systemic miliary tuberculosis. Methods: We reported a case of pulmonary tuberculosis combined with hepatic tuberculosis and reviewed the relevant literature. Results: A 40-year-old Chinese male with fatigue for half a year and cough as well as night sweat for 2 months was admitted to our hospital. The chest computed tomography (CT) showed multiple nodules combined with bronchial stenosis and lymphadenectasis in the mediastina at the right hilum of lung. The epigastrium CT showed lumps in the liver and retroperitoneal lymphadenectasis in the peritoneal cavity. The abdominal color Doppler ultrasound revealed lumps in the liver. The lung and liver puncture biopsy revealed granulomatous lesions, chronic inflammatory changes in the strip-like fibrous tissues and plenty of caseification, all of which suggest the diagnosis of tuberculosis. Conclusion: Hepatic tuberculosis is usually associated with atypical clinical manifestations. Imageological examination combined with imaging-guided fine needle aspiration biopsy may be the best method for the confirmed diagnosis.

Abstract.To evaluate the role of low-dose-rate interstitial brachytherapy using trans-bronchoscope 125 I radioactive seeds implantation in patients with pulmonary atelectasis induced by lung cancer, in terms of feasibility, safety, quality of life (QOL), and survival time. Between April 2008 and June 2011, 15 patients from two medical institutions that had obstructive pulmonary atelectasis caused by inoperable lung cancer were assigned to receive 125 I implantation endoluminal brachytherapy by bronchoscopy. Subsequent to the implantation of 125 I seeds, the outcomes were measured in terms of procedure success rate, reopening of atelectasis, complications associated with the procedure, Karnofsky performance status (KPS) scores and survival time. The surgical procedure was successfully performed in all 15 patients. No procedure-associated mortality occurred and the complications were mild and considered acceptable. Irritable cough and temporary increase of hemoptysis occurred in 11 (73.3%) and 10 (66.7%) patients respectively, and were the most common complications. The pulmonary atelectasis reopening rate subsequent to the procedure was 86.7, 76.9, 80.0, 75.0 and 50.0% at 2, 6, 12, 18 and 24 months, respectively. The KPS score significantly improved following the implantation of 125 I seeds and the duration of improvement ranged between 3 and 27 months. The median and mean survival times were 15.6 and 16 months, respectively. Actuarial survival rates at 6, 12 and 24 months after the procedure were 86.7, 66.7 and 13.3%, respectively. In patients with advanced lung cancer and those presenting with obstructive pulmonary atelectasis, treatment with intraluminal implantation of 125 I seeds is a safe and effective therapy option with easy accessibility.

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Background: The aim of this study was to clarify the characteristics of gene mutation related to multidrug-resistance (MDR) of tuberculosis (TB) and diabetes in Zunyi.Methods: A total 763 patients with TB were screened for TB-DNA, TB-RNA, and acid-fast staining (all were positive). They were divided into the tuberculosis (TB) group and the diabetes mellitus-tuberculosis (DM-TB) group. We compared and analyzed the MDR gene rpoB, KatG, and inhA characteristics of gene mutations in the two groups by polymerase chain reaction (PCR)-reverse dot hybridization, and collected relevant clinical data to explore its correlation with the occurrence of multidrug resistance.Results: Multidrug resistance occurred in 32 of the 525 patients in the TB group, and extensive drug resistance occurred in 15 of the 207 patients in the DM-TB group. In the DM-TB group, the mutation rates of ropBS531L and ropB531 (both 53.33%) were lower than those of the TB group (both 59.38%) in rifampicin resistance mutations. Most of the mutations were at the KatG315N site, conferring isoniazid resistance. Conclusions:The mutation sites of multidrug-resistant patients in Zunyi are mainly ropB531 and ropBS531L mutations, which are prone to co-occurrence; patients with MDR-TB alone are prone to mutations at the KatG315N site, while patients with diabetes and MDR-TB are more likely to have inhA-15M site mutations.