Predicting the incidence of rifampicin resistant tuberculosis in Yunnan, China: a seasonal time series analysis based on routine surveillance data.

BACKGROUND: Rifampicin resistant tuberculosis (RR-TB) poses a growing threat to individuals and communities. This study utilized a seasonal autoregressive integrated moving average (SARIMA) model to quantitatively predict the monthly incidence of RR-TB in Yunnan Province which could guide government health administration departments and the centers for disease control and prevention (CDC) in preventing and controlling the RR-TB epidemic. METHODS: The study utilized routine surveillance reporting data from the infectious Disease Network Surveillance and Reporting System. Monthly incidence rates of RR-TB were collected from January 2019 to December 2022. A time series SARIMA model was used to predict the number of monthly RR-TB cases in Yunnan Province in 2023, and the model was validated using time series plots, seasonal and non-seasonal differencing, autocorrelation and partial autocorrelation analysis, and white noise tests. RESULTS: From 2019 to 2022, the incidence of RR-TB decreases as the incidence of all TB decreases (P < 0.05). There was no significant change in the proportion of RR-TB among all TB cases, which remained within 2.5% (P>0.05). The time series decomposition shows that it presented obvious seasonality, periodicity and randomness after being decomposed. Time series analysis was performed on the original series after 1 non-seasonal difference and 1 seasonal difference, the ADF test showed P < 0.05. According to ACF and PACF, the SARIMA (1, 1, 1) (1, 1, 0)12 model was chosen and statistically significant model parameter estimates (P < 0.05). The predicted seasonal trend of RR-TB incidence in 2019 to 2023 was similar to the actual data. The percentage accuracy in the prediction excesses 80% in 2019 to 2022 and is all within 95% CI. However there was a certain gap between the actual incidence and the predicted value in 2023, and the acutual incidence had increased by 12.4% compared to 2022. The percentage of accuracy in the prediction was only 70% in 2023. CONCLUSIONS: We found the incidence of RR-TB was based on that of all TB in Yunnan. The SARIMA model successfully predicted the seasonal incidence trend of RR-TB in Yunnan Province in 2019 to 2023, but the prediction precision could be influenced by factors such as new infectious disease outbreaks or pandemics, social issues, environmental challenges or other unknown risks. Hence CDCs should pay special attention to the post epidemic effects of new infectious disease outbreaks or pandemics, carry out monitoring and early warning, and better optimize disease prediction models.

Incomplete tuberculosis reporting and registration to the surveillance system in southwestern China of Yunnan Province: an inventory survey.

BACKGROUND: The real-world tuberculosis (TB) surveillance data was generally incomplete due to underreporting and underdiagnosis. The inventory study aimed to assess and quantify the incompletion of surveillance systems in southwestern China. METHODS: The inventory study was conducted at randomly selected health facilities (HF) by multi-stage stratified cluster sampling. The participants were included in the period between August of 2020 in province-level and prefecture-level HF, and in the period between June to December of 2020 in other categories of HF respectively. The clinical committee confirmed medical records were matched to the National Notifiable Disease Reporting System (NNDRS) and the Tuberculosis Information Management System (TBIMS) to define the report and register status. The underreporting and under-register rates were evaluated based on the matched data, and factors associated with underreport and under-register were assessed by the 2-level logistic multilevel model (MLM). RESULTS: We enrolled 7,749 confirmed TB cases in the analysis. The province representative overall underreport rate to NNDRS was 1.6% (95% confidence interval, 95% CI, 1.3 - 1.9), and the overall under-register rate to TBIMS was 9.6% (95% CI, 8.9-10.3). The various underreport and under-register rates were displayed in different stratifications of background TB disease burden, HF level, HF category, and data source of the medical record in HF among prefectures of the province. The intraclass correlation coefficient (ICC) was 0.57 for the underreporting null MLM, indicating the facility-level cluster effect contributes a great share of variation in total variance. The two-level logistic MLM showed the data source of medical records in HF, diagnostic category of TB, and type of TB were associated with underreporting by adjusting other factors (p < 0.05). The ICC for under-register was 0.42, and the HF level, HF category, data source of medical records in HF, diagnostic category of TB and type of TB were associated with under-register by adjusting other factors (p < 0.05). CONCLUSION: The inventory study depicted incomplete TB reporting and registering to NNDRS and TBIMS in southwestern China. It implied that surveillance quality improvement would help advance the TB prevention and control strategy.

pH-Responsive Fluorescent Metal-Organic Framework as a Functional Nanofiller for Smart Coatings.

A zirconium-based UiO-type UiO-66-(OH)2 metal-organic framework@carbon dot composite (Zr-MOF@CD) is synthesized through a facile solvent-free thermal method. The Zr-MOF@CD exhibits pH-responsive fluorescence behavior, which emits blue fluorescence for pH < 9 at an emission wavelength of 470 nm. At pH > 9, the fluorescence color turns from blue to yellow, with the emission behavior at 535 nm. Zr-MOF@CDs can serve as functional nanofillers in the epoxy coating for the fabrication of a smart coating, which can realize coating damage warning and metal corrosion reporting. The blue fluorescence can be observed in the area of coating damage with just a minor scratch. Once the scratch is severe enough to expose the metal substrate, the cathodic reaction of oxygen reduction in the corrosion galvanic cell causes an increased pH, where the emission of yellow fluorescence can be identified. The stable fluorescence response is free from the influence of concentration, time, temperature, and the interfering substance. Zr-MOF@CDs can also serve as nanocontainers for loading with the corrosion inhibitor and realizing the repairing of metal corrosion. The development of the smart coating with dual functions of autonomous reporting and repairing holds great potential to improve the lifetime of metals in various industrial applications.

Integrated MOF-74 Coatings on Magnesium for Corrosion Control, Cytocompatibility, and Antibacterial Properties.

Biodegradable Mg and its alloys can degrade safely in vivo without toxicity. The major bottleneck inhibiting their clinical use is the high corrosion rate, which leads to the loss of mechanical integrity prematurely and bad biocompatibility. One ideal strategy is the modification with anticorrosive and bioactive coatings. Numerous metal-organic framework (MOF) membranes show satisfactory anticorrosion performance and biocompatibility. In this study, MOF-74 membranes are prepared on an NH4TiOF3 (NTiF) layer-modified Mg matrix, fabricating integrated bilayer coatings (MOF-74/NTiF) for corrosion control, cytocompatibility, and antibacterial properties. The inner NTiF layer serves as the primary protection for the Mg matrix and a stable surface for the growth of MOF-74 membranes. The outer MOF-74 membranes further enhance corrosion protection, whose crystals and thicknesses can be adjusted for different protective effects. Owing to superhydrophilic, micro-nanostructural, and nontoxic decomposition products, MOF-74 membranes significantly promote cell adhesion and proliferation, showing excellent cytocompatibility. Utilizing the decomposition of MOF-74 to generate the products of Zn2+ and 2,5-dihydroxyterephthalic acid can effectively inhibit Escherichia coli and Staphylococcus aureus, displaying highly efficient antibacterial properties. The research may shed valuable strategies for MOF-based functional coatings in the applications of biomedicine fields.

Positive rates of interferon-γ release assay and tuberculin skin test in detection of latent tuberculosis infection: A systematic review and meta-analysis of 200,000 head-to-head comparative tests.

OBJECTIVE: To compare the positive rates of IGRA and TST in detection of LTBI. METHODS: We searched PubMed, Embase, and the Cochrane Library on March 12, 2022. A random-effects model was used to calculate pooled results. RESULTS: We included 458 head-to-head studies. Compared with immunocompetent controls, TST positive rate in immunosuppressed population decreased more than IGRA positive rate (OR 0.36 [95% CI: 0.31 to 0.41] versus 0.53 [0.46 to 0.61]). In immunocompetent BCG-vaccinated individuals, IGRA positive rate in low-TB burden areas was significantly lower than TST positive rate, but the difference was decreased in high-TB burden areas (OR 0.75 [0.60 to 0.94]). Additionally, IGRA positive rate was equal to that of TST in the elderly (OR 0.98 [0.66 to 1.46]). CONCLUSION: TST is more susceptible to immunosuppression than IGRA. The effect of BCG on TST might be weakened in high-TB burden areas, and TST response waned in the elderly. REVIEW REGISTRATION: PROSPERO CRD42020180163.

The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018.

BACKGROUND: Tuberculosis (TB) makes a big challenge to public health, especially in high TB burden counties of China and Greater Mekong Subregion (GMS). The aim of this study was to identify the spatial-temporal dynamic process and high-risk region of notified pulmonary tuberculosis (PTB), sputum smear-positive tuberculosis (SSP-TB) and sputum smear-negative tuberculosis (SSN-TB) cases in Yunnan, the south-western of China between years of 2005 to 2018. Meanwhile, to evaluate the similarity of prevalence pattern for TB among GMS. METHODS: Data for notified PTB were extracted from the China Information System for Disease Control and Prevention (CISDCP) correspond to population information in 129 counties of Yunnan between 2005 to 2018. Seasonally adjusted time series defined the trend cycle and seasonality of PTB prevalence. Kulldorff's space-time scan statistics was applied to identify temporal, spatial and spatial-temporal PTB prevalence clusters at county-level of Yunnan. Pearson correlation coefficient and hierarchical clustering were applied to define the similarity of TB prevalence among borders with GMS. RESULT: There were a total of 381,855 notified PTB cases in Yunnan, and the average prevalence was 59.1 per 100,000 population between 2005 to 2018. A declined long-term trend with seasonality of a peak in spring and a trough in winter for PTB was observed. Spatial-temporal scan statistics detected the significant clusters of PTB prevalence, the most likely cluster concentrated in the northeastern angle of Yunnan between 2011 to 2015 (RR = 2.6, P < 0.01), though the most recent cluster for PTB and spatial cluster for SSP-TB was in borders with GMS. There were six potential TB prevalence patterns among GMS. CONCLUSION: This study detected aggregated time interval and regions for PTB, SSP-TB, and SSN-TB at county-level of Yunnan province. Similarity prevalence pattern was found in borders and GMS. The localized prevention strategy should focus on cross-boundary transmission and SSN-TB control.

Copper(II)-coated Fe3O4 nanoparticles as an efficient enzyme mimic for colorimetric detection of hydrogen peroxide.

The authors describe the preparation of Cu(II)-coated Fe3O4) nanoparticles (NPs) that possess excellent peroxidase-like activity. The NPs were formed by chelation between Cu(II) ions and the oxygen functional groups of sodium ligninsulfonate. The morphology and structure of the NPs were characterized by scanning electron microscopy, transmission electron microscopy, X-ray powder diffraction, X-ray photoelectron spectroscopy, and Fourier transform infrared spectroscopy. The NPs have an average diameter of 220 nm. They are shown to be viable peroxidase mimics that can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine by hydrogen peroxide to produce a blue coloration. The findings were used to design a colorimetric assay that has a linear response in the 2.5 to 100 µM H2O2 concentration range and a 0.2 µM detection limit. The assay excels by its selectivity, high sensitivity, good selectivity, portability and cost efficiency. Graphical abstract Fe3O4-Cu2+ nanoparticles with excellent peroxidase-like activity were successfully prepared via a facile strategy, and then used to design a facile as well as sensitive colorimetric H2O2 sensor. The linear range and the detection limit were 2.5~100 µM and 0.212 µM.

Trends and Projection of the Incidence of Active Pulmonary Tuberculosis in Southwestern China: Age-Period-Cohort Analysis.

BACKGROUND: The control of pulmonary tuberculosis (PTB) is critical for achieving the vision of World Health Organization's End TB goal. OBJECTIVE: This study analyzes the temporal trends in PTB incidence associated with age, period, and birth cohorts from 2006 to 2020 in Yunnan, China; projects the PTB burden till 2030; and explores the drivers of PTB incidence. METHODS: The aggregated PTB incidence rates between 2005 and 2020 were obtained from the National Notifiable Disease Reporting System. We used the age-period-cohort model to evaluate the age, period, and cohort effects on PTB incidence. We applied the Bayesian age-period-cohort model to project future PTB incidence from 2021 to 2030. We applied the decomposition algorithm to attribute the incidence trends to population aging, population growth, and age-specific changes from 2006 to 2030. RESULTS: From 2006 to 2020, the PTB incidence in Yunnan was relatively stable, although the absolute number showed an increase. The net drift was -1.56% (95% CI -2.41% to -0.70%). An M-shaped bimodal local drift and a longitudinal age curve were observed. The overall local drift was below zero for most age groups except for the age groups of 15-19 years (2.37%, 95% CI -0.28% to 5.09%) and 50-54 years (0.41%, 95% CI -1.78% to 2.64%). The highest risk of PTB incidence was observed in the age group of 65-69 years, and another peak was observed in the age group of 20-24 years. Downward trends were observed for both period and cohort effects, but the cohort effect trends were uneven. A higher risk was observed for the birth cohorts of 1961-1970 (rate ratio [RR]1961-1965=1.10, 95% CI 0.88-1.38; RR1966-1970=1.11, 95% CI 0.92-1.37) and 2001-2010 (RR2001-2005=0.92, 95% CI 0.63-1.34; RR2006-2010=0.84, 95% CI 0.45-1.58) than for the adjacent cohorts. The Bayesian age-period-cohort model projected that PTB incidence will continually increase from 2021 to 2030 and that PTB incidence in 2030 will be 2.28 times higher than that in 2006. The age-specific change was the leading cause for the growing PTB disease burden. CONCLUSIONS: Although there are several levels and measures for PTB control, the disease burden is likely to increase in the future. To bridge the gap of TB-free vision, our study suggests that public health policies be put in place soon, including large-scale active case-finding, priority prevention policies for high-risk older adult and young adult populations, and reduction of possible grandparent-grandchildren transmission patterns.

Constructing N-doping biomass-derived carbon with hierarchically porous architecture to boost fast reaction kinetics for higfh-performance lithium storage.

Active biomass-derived carbons are brought into focus on boosting high-performance lithium storage. However, their low electric conductivity and poor ion diffusion kinetics during the lithium storage reactions remain confusing topics. This study demonstrates a novel and effective strategy of dual system activation process to construct the nitrogen-doped biomass-derived carbon with hierarchically porous architecture (HNBC), which is composed of the three-dimensional porous networks connected by carbon nanorods and the flake-like edges constructed by carbon nanosheets. A large amount of nitrogen doping can improve the conductivity and facilitate the charge transfer during charging/discharging, while the hierarchically porous structure can decrease the diffusion path for lithium-ion transport, enabling fast diffusion and charge-transfer dynamics. The HNBC electrode displays a high lithium-ion storage capacity of above 1392 mAh g-1 at 0.1 A g-1 and superior stability. Moreover, the assembled asymmetric lithium-ion capacitor exhibits excellent cycling stability and delivers a high power density of 225 W kg-1 with an energy density of 186.31 W h kg-1. This dual system activation strategy may inspire the reasonable design of new-generation progressive carbon-based electrodes for high-performance lithium storage devices.

Uncovering the Impact of Control Strategies on the Transmission Pattern of SARS-CoV-2 - Ruili City, Yunnan Province, China, February-March 2022.

Introduction: The implementation of public health and social measures (PHSMs) was an effective option for controlling coronavirus disease 2019 (COVID-19). However, evidence is needed to evaluate these PHSMs' effects on the recently emerged variant Omicron. Methods: This study investigated variant Omicron BA.2's outbreak in Ruili City, Yunnan Province, China. The disease transmission dynamics, spatiotemporal interactions, and transmission networks were analyzed to illustrate the effect of PHSM strategies on Omicron spread. Results: A total of 387 cases were related to the outbreak. The time-varying reproduction number was synchronized with PHSM strategies. Spatiotemporal clustering strength presented heterogeneity and hotspots. Restricted strategies suppressed temporal and spatial relative risk compared with routine and upgraded strategies. The transmission network presented a steeper degree distribution and a heavier tail under upgraded strategies. Phase transformation and distinctive transmission patterns were observed from strategy-stratified subnetworks. Conclusions: The tightened response strategy contained reproduction of the virus, suppressed spatiotemporal clustering, and reshaped the networks of COVID-19 Omicron variant transmission. As such, PHSMs against Omicron are likely to benefit future responses as well.

Dose-response relationship between body mass index and tuberculosis in China: a population-based cohort study.

OBJECTIVES: This study aimed to describe and quantify the relationship between body mass index (BMI) and tuberculosis (TB) incidence. DESIGN: A population-based prospective cohort study. SETTING: Ten randomly selected communities in the southwestern mountainous region of China. PARTICIPANTS: Participants who had resided in study sites before screening for at least 6 months were eligible. Those who refused to participate or were temporary residents (who resided less than 6 months during three waves of screening) were excluded. The present research included 26 022 participants aged over 15 years for analyses. INTERVENTIONS: The cohort study conducted three rounds of TB screening from 2013 to 2015. Face-to-face surveys for participants were carried out. TB symptoms positivity suspects underwent chest X-ray and sputum smear test for diagnosis. PRIMARY OUTCOME MEASURES: The study outcome was the diagnosed active TB in the second and third rounds of screening. RESULTS: During the follow-up of 2.25 years, 43 cases developed TB in 44 574.4 person-years. The negative log-linear relationship between BMI and TB incidence was fitted (adjusted R2 =0.76). Overweight or obese was associated with a lower risk of TB compared with normal weight (adjusted HR (aHR) 0.34, 95% CI 0.14 to 0.82). The inverse log-linear associations between continuous BMI and individual TB risk were evaluated. In subgroup analysis, the risk of TB reduced 78% in overweight or obese women (aHR 0.22, 95% CI 0.05 to 0.97), and a 64% reduction in the elderly (aHR 0.36, 95% CI 0.12 to 1.00) compared with those with normal weight, respectively. CONCLUSIONS: The study provided evidence for a negative association between BMI and TB development in Chinese adults. It suggests the inverse dose-response relationship between BMI and TB incidence, and implies an optimal cut-off point of BMI for screening strategy.

Porous graphene based electrochemical immunosensor using Cu3(BTC)2 metal-organic framework as nonenzymatic label.

An electrochemical immunosensor for highly sensitive detection of cancer biomarkers has been developed based on the combination of a sensing platform of polydopamine modified porous graphene and a nonenzymatic label of metal-organic framework (MOF) conjugated secondary antibody. This approach achieves a wide range of linear response from 0.1 to 10 ng/mL, low detection limit of 0.025 ng/mL (at a signal to noise ratio of 3), good reproducibility and selectivity for the detection of prostate specific antigen (PSA) as a model analyte. The high performance of the immunosensor is attributed to the high surface area from porous graphene and the strong adhesion of polydopamine, allowing a high load of the primary antibody of PSA, as well as the highly electrocatalytic activity of the Cu3(BTC)2 (BTC = benzene-1,3,5-tricarboxylic acid) MOF toward H2O2 to provide greatly amplified sensitivity. In this respect, the MOF-based nonenzymatic label shows promising application for the point-of-care detection of different cancer biomarkers in clinical diagnostics.

Microstructure and Corrosion of Cast Magnesium Alloy ZK60 in NaCl Solution.

In this work, the effects of the microstructure and phase constitution of cast magnesium alloy ZK60 (Mg-5.8Zn-0.57Zr, element concentration in wt.%) on the corrosion behavior in aqueous NaCl (0.1 mol dm-3) were investigated by weight-loss measurements, hydrogen evolution tests, and electrochemical techniques. The alloy was found to be composed of α-Mg matrix, with large second-phase particles of MgZn2 deposited along grain boundaries and a Zr-rich region in the central area of the grains. The large second-phase particles and the Zr-rich regions were more stable than the Mg matrix, resulting in a strong micro-galvanic effect. A filiform corrosion was found. It originated from the second-phase particles in the grain boundary regions in the early corrosion period. The filaments gradually occupied most areas of the alloy surface, and the general corrosion rate decreased significantly. Corrosion pits were developed under filaments. The pit growth rate decreased over time; however, it was about eight times larger than the general corrosion rate. A schematic model is presented to illustrate the corrosion mechanism.

Correction to: Role of community-based active case finding in screening tuberculosis in Yunnan province of China.

In the original publication of this article [1] we noticed the Fig. 4 was incorrect. The correct Fig. 4 is as below.

Role of community-based active case finding in screening tuberculosis in Yunnan province of China.

BACKGROUND: The barriers to access diagnosis and receive treatment, in addition to insufficient case identification and reporting, lead to tuberculosis (TB) spreads in communities, especially among hard-to-reach populations. This study evaluated a community-based active case finding (ACF) strategy for the detection of tuberculosis cases among high-risk groups and general population in China between 2013 and 2015. METHODS: This retrospective cohort study conducted an ACF in ten communities of Dongchuan County, located in northeast Yunnan Province between 2013 and 2015; and compared to 136 communities that had passive case finding (PCF). The algorithm for ACF was: 1) screen for TB symptoms among community enrolled residents by home visits, 2) those with positive symptoms along with defined high-risk groups underwent chest X-ray (CXR), followed by sputum microscopy confirmation. TB incidence proportion and the number needed to screen (NNS) to detect one case were calculated to evaluate the ACF strategy compared to PCF, chi-square test was applied to compare the incidence proportion of TB cases' demography and the characteristics for detected cases under different strategies. Thereafter, the incidence rate ratio (IRR) and multiple Fisher's exact test were applied to compare the incidence proportion between general population and high-risk groups. Patient and diagnostic delays for ACF and PCF were compared by Wilcoxon rank sum test. RESULTS: A total of 97 521 enrolled residents were visited with the ACF cumulatively, 12.3% were defined as high-risk groups or had TB symptoms. Sixty-six new TB patients were detected by ACF. There was no significant difference between the cumulative TB incidence proportion for ACF (67.7/100000 population) and the prevalence for PCF (62.6/100000 population) during 2013 to 2015, though the incidence proportion in ACF communities decreased after three rounds active screening, concurrent with the remained stable prevalence in PCF communities. The cumulative NNS were 34, 39 and 29 in HIV/AIDS infected individuals, people with positive TB symptoms and history of previous TB, respectively, compared to 1478 in the general population. The median patient delay under ACF was 1 day (Interquartile range, IQR: 0-27) compared to PCF with 30 days (IQR: 14-61). CONCLUSIONS: This study confirmed that massive ACF was not effective in general population in a moderate TB prevalence setting. The priority should be the definition and targeting of high-risk groups in the community before the screening process is launched. The shorter time interval of ACF between TB symptoms onset and linkage to healthcare service may decrease the risk of TB community transmission. Furthermore, integrated ACF strategy in the National Project of Basic Public Health Service may have long term public health impact.

Construction of Metal-Organic Framework/Conductive Polymer Hybrid for All-Solid-State Fabric Supercapacitor.

Metal-organic frameworks (MOFs) hold promising potential in energy storage but are limited by poor conductivity. In this work, a metal-organic framework/polypyrrole hybrid is constructed by a facile one-pot electrodeposition method in the presence of dopamine. An all-solid-state fabric supercapacitor based on this hybrid demonstrates excellent electrochemical energy-storage performance, which achieves a specific capacitance of 10 mF cm-1 (206 mF cm-2), a power density of 132 µW cm-1 (2102 µW cm-2), and an energy density of 0.8 µWh cm-1 (12.8 µWh cm-2). The stable cycling life and excellent mechanical flexibility over a wide range of working temperature are also achieved, which maintains a capacitance retention of 89% over 10 000 charging/discharging cycles, a capacitance decrease of only 4% after 1000 frizzy (360° bending) cycles, and no obvious capacitance loss under 100 repeated heating (100 °C)/cooling (-15 °C) cycles. This fibrous supercapacitor displays promising potential in wearable textile electronics as it can be easily woven into common cotton cloth. Our strategy may shed some valuable light on the construction of MOF-based hybrids for flexible energy-storage electronics.

Five-year recurrence rate of tuberculosis and its influencing factors among successfully treated patients in Yunnan Province / 预防医学

Objeetive@#To understand the recurrence of tuberculosis patients in Yunnan Province and its influencing factors,so as to provide scientific basis for the prevention and control of tuberculosis.@*Methods@#Through the tuberculosis management information system, the data of successful treatment of tuberculosis cases in Yunnan Province in 2013 and the data of recurrent tuberculosis cases in Yunnan Province in 2014-2018 were collected. The recurrence rate,recurrence proportion and recurrence time of tuberculosis were analyzed, and the influencing factors of tuberculosis recurrence were analyzed by Cox multi factor proportional risk model. @*Results @#A total of 9787 cases of tuberculosis were investigated. 385 cases recurred in 5 years, accounting for 3.94%. The recurrence rate was 0.73/100 person years. The recurrence interval [M （QR）] was 35.12 （28.57） months. The following are the risk factors for pulmonary tuberculosis recurrence：male（HR=1.297,95%CI：1.031~1.631）,secondary tuberculosis(HR=2.000,95%CI：1.088~3.676) in the 40-59 age group（HR=1.618,95%CI：1.036-2.528）, the retreatment（HR=1.566,95%CI：1.040-2.356）,positive of sputum culture（HR=4.048,95%CI：1.795-9.129）and sputum?smear positive（HR=1.569,95%CI：1.266-1.945）, cavitary pulmonary tuberculosis（ HR=1.382,95%CI：1.112-1.716）.@*Conclusion@#The recurrence rate of tuberculosis is low in Yunnnan province, and the risk of pulmonary tuberculosis recurrence is high in male, in the 40-59 age group,retreatment,positive of sputum culture only and sputum smear positive,patients with cavitary tuberculosis.