1, clinical features Patients with tuberculosis are prone to pneumoconiosis if they are exposed to dust, and pneumoconiosis patients are prone to complications of tuberculosis, and the two can promote each other. The reasons why pneumoconiosis is prone to tuberculosis infection are: (1) the large amount of insoluble dust deposited in the lungs of pneumoconiosis patients destroys a large number of macrophages, thus weakening their phagocytosis, digestion and bactericidal ability, and also affects the effector cells of cellular immunity, so that the invading Mycobacterium tuberculosis cannot be destroyed in time, which hinders the establishment of acquired immunity to tuberculosis; (2) the reduced number and function of peripheral cells in pneumoconiosis patients also affects the immune cells of tuberculosis (2) the peripheral cells of pneumoconiosis patients are reduced in number and function, which also affects the immune cells of tuberculosis, interfering with the release of lymphokines and impairing the function of macrophages; (3) both pneumoconiosis and tuberculosis have adjuvant effects, and the presence of dual adjuvants strengthens the reaction of both lesions. In addition, tuberculosis is the most common and major complication of silicosis, and the rate of silicosis combined with tuberculosis is about 20%. In order to avoid misdiagnosis and underdiagnosis, it is recommended that tuberculosis-related tests should be mandatory for pneumoconiosis patients. The combination of tuberculosis in all stages of pneumoconiosis significantly increases the rate of pneumoconiosis progression, shortens the average time to progression, and increases the death rate; the two diseases are mutually reinforcing, with tuberculosis promoting pneumoconiosis progression and death, and pneumoconiosis aggravating and spreading tuberculosis. Therefore, pneumoconiosis patients should be routinely examined for sputum antacid bacilli and PPD to rule out TB, especially if they have been exposed to infectious TB. Even if no TB is found, close observation and prophylactic medication should be administered. The diagnosis of pneumoconiosis and tuberculosis should be confirmed by first affirming the diagnosis of pneumoconiosis and then determining whether it is combined with tuberculosis. Since tuberculosis is intermittently excreted, and some patients even do not excrete bacteria, it is quite difficult to get the correct diagnosis for this part of the patients. Therefore, it is very important to insist on repeated and long-term sputum delivery, and even if the test is negative for several times, it is not advisable to give up easily. It should be considered in combination with clinical symptoms and signs. Since there is no specific drug for pneumoconiosis treatment, the treatment of pneumoconiosis combined with tuberculosis is actually the treatment of tuberculosis. It is the same as the five principles of treatment for simple tuberculosis (early, combination, appropriate amount, whole course, and regularity). When pneumoconiosis is complicated by tuberculosis, the treatment effect is significantly reduced and the death rate is significantly increased. Patients with combined pneumoconiosis have a longer treatment course than the control group, slower negative sputum tests, slower absorption of chest films, and longer symptom improvement time, so the development of a reasonable chemotherapy regimen is the key to treatment success. The course of treatment should be more than 9 months for primary patients and more than 12 months for re-treatment patients. At the same time, complications such as hemoptysis, respiratory infections, pulmonary heart disease and respiratory failure are actively treated. Hemoptysis is a common symptom in patients with pulmonary tuberculosis, mostly blood in the sputum or hemoptysis, and a small amount of hemoptysis. The cause of hemoptysis is mostly due to local inflammatory cell infiltration, toxins, histamine and other factors that increase the permeability of pulmonary capillaries during the activity of the lesion, and the extravasation of a large number of red blood cells; in a few cases, it is due to the erosion of the surrounding blood vessels by the lesion and damage to the blood vessels by the detachment of calcified foci. In individual patients using sodium p-aminosulfate, bleeding may occur due to abnormal coagulation mechanism because the drug inhibits the production of prothrombin in the liver. Patients with pneumoconiosis are older than the control group, and many of them have age-related diseases such as infectious diseases (bronchitis, bronchiectasis, pneumonia) and cardiovascular diseases (rheumatic heart disease, hypertension, etc.), and these diseases are also a cause of hemoptysis, so the incidence of hemoptysis is higher in pneumoconiosis patients. In addition to hemostatic drugs, the patient should rest in bed, take the affected side, turn the head to the side to prevent the spread of lesions and asphyxiation, and give the right amount of sedatives to those who are overly nervous.