Tuberculosis, commonly known as “consumption”, is a highly contagious chronic wasting disease caused by the invasion of Mycobacterium tuberculosis into the human body. It is not affected by age, gender, race, occupation, or region, and many organs and systems in the body can suffer from TB, with pulmonary TB being the most common. More than 90% of TB infection is transmitted through the respiratory tract, and TB patients are infected by coughing, sneezing, or making loud noises, causing droplets with TB bacilli to be ejected from the body and inhaled by healthy people. Tuberculosis is a chronic infectious disease with a long history of harming human health, and in the early 20th century, when it was seriously prevalent, it spread around the world and caused millions of deaths. It was only in the 20th century that it gradually disappeared and was even forgotten by most people, thanks to advances in medicine and improved sanitation. In recent years, however, tuberculosis has resurfaced worldwide and is now the leading cause of death among all infectious diseases. In response to the worsening global tuberculosis epidemic, the World Health Organization has proposed a “global tuberculosis emergency” and designated March 24 each year as World Tuberculosis Day, requiring the world to take urgent measures to fight tuberculosis. China is now one of the 22 countries with a high burden of tuberculosis, with the second highest number of tuberculosis cases in the world, second only to India. According to the survey, one-third of the country’s population has been infected with TB bacteria, and 10% of those infected with TB bacteria develop TB disease. The current prevalence of infectious tuberculosis in China is 157.8/100,000, and it is estimated that there are 2 million infectious tuberculosis patients in the country. The “Law of the People’s Republic of China on Infectious Diseases” classifies tuberculosis as a Class B infectious disease, which must be categorized and treated. Resistance of Mycobacterium tuberculosis Mycobacterium tuberculosis is highly resistant to certain physicochemical factors. It survives for 6-8 months in dry sputum, and can remain infectious for 8-10 days if it adheres to dust. It can tolerate 30 minutes in strong acid and alkaline solutions. However, it is weakly resistant to humid heat, ultraviolet light, and alcohol. It dies when heated in liquid to 62-63°C for 15 minutes, in direct sunlight for 2-3 hours, and in 75% alcohol for a few minutes. How tuberculosis bacteria are transmitted The first time tuberculosis bacteria invade the body is mainly through the respiratory tract into the lungs and multiply there, called primary infection. The primary infection forms a primary lesion from which the bacillus enters the bloodstream along the lymphatics, called hematogenous dissemination. The tuberculosis bacilli enter the organs through bloodstream dissemination, and some of them develop immediately, with serious cases of cornual tuberculosis and tuberculous meningitis; some tuberculosis bacilli are latent in various organs and develop when the immunity of the body decreases. Only TB patients with positive sputum smear for antacid bacilli are infectious and are the source of TB infection. In other words, infectious TB patients have a lot of TB bacteria in their lung lesions, and when they speak loudly, cough or sneeze, a large number of TB bacteria will spread out from the respiratory tract and attach to the air droplets, and stay suspended in the air for a long time. If a healthy person inhales these droplets containing tuberculosis bacilli, he or she will be infected with tuberculosis bacilli, and a lesion will first form in the lung. Therefore, the contagiousness of tuberculosis is related to the patient’s condition, the amount of bacilli excreted, the frequency of coughing, the ventilation of the house where he lives and the closeness and resistance of the contact person. Therefore, spitting is a bad habit. Sputum is the secretion of human respiratory tract, which plays a protective role for people, and normal people have very little sputum. When a person inhales colder and drier air, the oxygenated air entering the lungs can be moistened and heated through the respiratory tract, and the dust and toxic particles in the inhaled air and dust particles containing bacteria in the air can be adsorbed on the moist bronchial walls and pushed to the upper respiratory tract through the cilia movement of the bronchial epithelium and discharged from the body by coughing, which plays a role in protecting the lungs. However, when a person inhales irritating gases, dust, bacteria and viruses, the upper respiratory tract or lungs become inflamed, the secretions from the respiratory tract increase, the amount of sputum increases, and the nature of sputum changes from clear mucous sputum to yellow pus sputum. For example, in case of tuberculosis cavity formation and purulent inflammation of the lungs, the amount of yellow pus sputum increases and it contains a large amount of pathogenic bacteria. Mycobacterium tuberculosis is transmitted mainly through the respiratory tract, and spitting most directly pollutes the environment in which we live and is the culprit in spreading respiratory diseases. This is a vice that should be condemned by society. We should start with our children to develop good hygiene habits by not spitting anywhere. Not spitting anywhere is not the same as swallowing spit into your belly, because spit contains a lot of bacteria and poisons. When you have spit, you must spit in the spittoon or spit into the toilet paper and throw it into the garbage bin to reduce the pollution of spit. In addition, there is digestive tract infection, because in addition to people, cattle can also get tuberculosis, if a cow has tuberculosis, then its milk will also carry tuberculosis bacteria, people can get infected with tuberculosis if they drink raw milk, so farmers are advised to drink milk produced by local cows must be boiled before drinking. Pathogenicity of Mycobacterium tuberculosis The pathogenic effect of Mycobacterium tuberculosis may be related to the inflammatory response caused by the tenacious value-added of bacteria in tissue cells and the induction of delayed metabolic injury in the body. Mycobacterium tuberculosis enters the body through the respiratory and digestive tracts and broken skin mucosa, invades various tissues and organs, and causes tuberculosis in the corresponding organs. If the resistance (immunity) of the body is low, the invading bacilli will not be destroyed by the body’s defense system and will multiply, causing tuberculosis. How to detect tuberculosis at an early stage In addition to damage to the lungs, tuberculosis also causes neurological and endocrine dysfunction and systemic symptoms, such as fatigue, loss of appetite, indigestion, emaciation, night sweats, afternoon fever, and flushing of the cheeks. Some children may also have personality changes, crying and temper tantrums; some female patients may also have menstrual disorders or amenorrhea. Respiratory symptoms are common, mainly manifested as mild cough, spitting or blood in the sputum; patients with tuberculous pleurisy may have chest tightness, shortness of breath or even chest pain. Some patients may present with high fever, which is often treated as a cold and delayed. Once the above symptoms are detected, patients should go to the hospital and do the necessary tests, such as chest X-ray, sputum smear for tuberculosis bacteria, tuberculin test, blood sampling for blood sedimentation, etc., in order to confirm the diagnosis as soon as possible. Chest X-ray is one of the important methods to diagnose tuberculosis, especially chest fluoroscopy is simple and easy to perform. It is recommended that people with the following conditions should be examined regularly: 1. 4.Patients with long-term hypothermia or allergic manifestations of tuberculosis, such as pain in the joints, rapid blood sedimentation, poor anti-rheumatic treatment, or those suffering from erythema nodosum or herpetic conjunctivitis; 5.Patients who are frequently exposed to dust; 6.For healthy people, chest fluoroscopy should also be done every 1-2 years; 7.Patients with long-standing cold, cough, persistent fever, and those with shadows in the lungs, who are treated with regular anti-inflammatory therapy for two weeks and still If no absorption is seen after two weeks of regular anti-inflammatory treatment, you should think of the possibility of tuberculosis for further examination. The “cross” principle for the treatment of tuberculosis is 1. Early diagnosis and treatment of tuberculosis are essential. Early treatment can avoid irreversible damage to the tissues of the body, which makes repair difficult. In the early stage of tuberculosis, there is inflammatory cell infiltration and fibrin exudation in the alveoli, but the alveolar structure is still intact. At the same time, TB bacilli multiply vigorously and phagocytes are active in the body, so anti-TB drugs can best inhibit and kill the metabolically active and multiplying TB bacilli. Early treatment can facilitate the absorption and dissipation of lesions without leaving traces. 2. Combination Whether primary or secondary patients need a combination of drugs. Combination of drugs can avoid or delay the emergence of drug resistance, but also can improve the bactericidal effect. Combined drugs should have both intracellular bactericidal drugs and extracellular bactericidal drugs, both bactericidal drugs for acidic environment and bactericidal drugs for alkaline environment, so as to achieve the best efficacy, shorten the course of treatment and reduce unnecessary economic waste. 3, the right amount Almost all anti-tuberculosis drugs have toxic side effects, such as too large a dose, the drug concentration in the blood is too high, the digestive system, nervous system, urinary system, especially for the liver and kidneys and other important organs can produce toxic side effects; if the dose is not enough, the blood concentration is too low, and can not achieve the purpose of antibacterial, bactericidal, but also easy to produce resistance. So be sure to use the drug under the guidance of a specialist, using the appropriate dose. 4, regular Be sure to use the drug regularly under the guidance of a specialist. Tuberculosis is a kind of stubborn bacteria with long division cycle, slow growth and reproduction, and difficult to kill. If the medication is not regular and is discontinued when the symptoms are relieved, it will cause drug resistance of the tuberculosis bacteria, resulting in treatment failure and making future treatment more difficult. Therefore, it must be used regularly without compromise. 5.The whole course The whole course of medication is the time required by the doctor to complete the chemotherapy program according to the patient’s condition assessment, a course of three months, the whole course of one year or one and a half years. The short course of chemotherapy is not less than 6 months or 10 months. The above “cross” principles must be strictly followed in order to treat TB completely. The short course of supervised chemotherapy is mainly carried out at home, without hospitalization, and in rural areas, without leaving the workplace, except for those with serious illnesses such as comorbidities and complications, which require hospitalization. Patients who are not excreting bacteria, have stable lesions and have mild symptoms can rest at home for treatment. The role of home recuperation in the recovery and physical and mental health of TB patients should not be underestimated.