Table of Content

20 June 2010, Volume 32 Issue 6

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expression of aquaporin-1 on the pleura of rat model with tuberculous pleural

Du Hongchun,Xie Canmao，He Qiao,Li Fangzhi,Deng Xiaohua

Chinese Journal of Antituberculosis. 2010, 32(6):  7-11. 

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Objective To investigate whether the expression of aquaporin-1(AQP-1) on the pleura is related with tuberculous pleural effusion in a rat model.  Methods Forty-eight Wistar rats were randomly and equally divided into tuberculous pleural effusion (days 1, 3, and 5) and control groups.The rats in tuberculous pleural effusion groups were injected into pleural cavities with 2 ml(9×10⁶ CFU) of Mycobacterium tuberculosis strain H37Rv,and the rats in control group were injected with 2 ml of saline. The visceral and parietal pleural tissues were taken and processed for detecting the level of AQP-1 by real-time PCR (RT-PCR), Western blot, and immunohistochemistry.  Results The rats in tuberculous pleural effusion group(days 5) showed bilateral pleural effusions. The peak amount of pleural fluid occurred on day 3 (4.4±1.2 ml). The level of AQP-1 mRNA and protein were significantly increased in both the parietal and visceral pleura from the rats in the tuberculous pleural effusion groups as compared with the control group (P<0.05).  Conclusion s The expression of AQP-1 was increased on the pleura of rats with tuberculosis. These Results suggest AQP-1 is likely involved in the formation of tuberculous pleural effusions.

effect of the improved minimum inhibitory concentration test on detection of drug-resistantMycobacterium tuberculo

Zhang Jianyuan,Zhao Yanlin,Sun Zhaogang,Jiang Guanglu,Li Yan,Wang Sumin,Liu Yi,Nie Lihui,Gao Tiejie,Zhang Zhiguo,Ren Weicong,Li Chuanyou

Chinese Journal of Antituberculosis. 2010, 32(6):  16-20. 

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Objective To develop an improved minimum inhibitory concentration (IMIC) test to detect drug-resistantMycobacterium tuberculosisclinical isolates.  Methods 135 clinical isolates detected the drug susceptibility using traditional proportional method were retested and verified their sensitivity to isoniazid (INH), rifampin (RFP), ethambutol (EMB), streptomycin (SM) and ofloxacin (OFLX) by IMIC test.  Results In the tubes with same drug concentration, 68.89% of 135 clinical isolates with 1×10⁷/ml bacterium number inoculated got the same Results as those with 1×10⁵/ml bacterium number inoculated, and 31.1% was inconsistent. 14.8% (20/135) of the isolates (including 1 RFP-resistant, 3 INH-resistant, 3 OFLX-resistant，5 EMB-resistant and 8 SM-resistant strains) were judged the Results from negative to positive. Conclusion s The improved minimum inhibitory concentration test could increase positive detectable rate of drug-resistantMycobacterium tuberculosis , and find more potential drug-resistant TB patients.

 Identification of Beijing genotype of Mycobacterium tuberculosis using multiplex PCR

Zhao Defu,Xie Tong,Ju Hanfang,Mu Cheng,Zhao Hui

Chinese Journal of Antituberculosis. 2010, 32(6):  21-23. 

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Objective To develop a new method to identify the Beijing genotype strains ofMycobacterium tuberculosis(MTB), and to analyze the spread and characteristics of Beijing family among the population.  Methods 112 MTB isolates were identified as Beijing genotype and non-Beijing genotype by Spoligotyping and multiplex PCR.  Results Of 112 MTB strains, 107 isolates were determined as Beijing genotype. Multiplex PCR could identify all of the Beijing stains with 100% sensitivity and specificity. Conclusion s Compared with Spoligotyping, multiplex PCR could rapidly differentiate Beijing and non-Beijing stains, it is simple, cost-effective and suitable for monitoring the spread of Beijing family strains on a large scale.

Clone and expression of CFP10-ESAT6 fusion protein and CFP32 protein of Mycobacterium and their antigenicity

Chinese Journal of Antituberculosis. 2010, 32(6):  22-15. 

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Objective To clone and express recombinant CFP10-ESAT6 fusion protein and CFP32 protein ofMycobacterium , and analyze their antigenicity.  Methods The cfp10-esat6 fusion gene fromMycobacterium tuberculosisstrain H37Rv was amplified by PCR. DNA fragment encoding CFP32 fromMycobacterium bovisBacillus Calmette-Guerin（BCG） was obtained by PCR. After cloning and sequence analysis, the cfp10-esat6 fusion gene and cfp32 gene were subcloned into expression vector pQE-30 and pET-23a(+), respectively. The recombinant proteins were expressed inE.coliBL21, purified by affinity chromatography, and analyzed by SDS-PAGE. Their antigenicities were analyzed by Western blot and indirect ELISA.  Results Recombinant expression plasmid pQE30-cfp10-esat6 and pET-cfp32 were constructed. The recombinant CFP10-ESAT6 fusion protein and CFP32 protein were expressed inE.coliBL21 and were purified by affinity chromatography. The purified CFP10-ESAT6 and CFP32 proteins were used to detect the antibodies against tuberculosis, their sensitivities were 85.7% and 71.4%, respectively, their specificities were all 100%.  Conclusion s Recombinant CFP10-ESAT6 fusion protein and CFP32 protein with good antigenicity were successfully obtained.

Analysis on situation and pattern of drug resistance tuberculosis in suspected multi-drug resistance patients in Shenzhen

Xu Li,Yang Yingzhou,Li Mingzhen，Wu Qingfang,Zhuang Yuhua,Guan Hongyun

Chinese Journal of Antituberculosis. 2010, 32(6):  24-28. 

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Objective To investigate the distribution characteristics and pattern of DR-TB in different types of suspected pulmonary MDR-TB patients and provide scientific evidence for MDR-TB control in Shenzhen. Methods All suspected MDR-TB found during October 2006 to April 2009 were investigated. Sputum smear, culture, bacterial identification and drug susceptibility test were performed for diagnosis of MDR-TB. Statistical analysis was made for the incidence rate of DR-TB and MDR-TB in different types of pulmonary MDR-TB patients. Results 406 isolated strains ofMycobacterium tuberculosiswere tested for drug susceptibility, 36.2% of them were diagnosed as MDR-TB; MDR-TB accounted for 45.1% and 33.2% respectively in 82 cases of initial and 310 cases of retreatment suspected MDR-TB cases. In the category of retreatment failure, the proportion of MDR-TB is the highest of 66.7%. Among 147 cases of MDR-TB, initial treatment, retreatment and new patients accounted for 28.6%, 70.1% and 1.3% respectively. Of the 77 cases of other DR-TB, initial and retreatment PTB accounts for 22.1% and 77.9% respectively. The MDR-TB and DR-TB proportion are both high in two categories under initial treatment group. MDR-TB constituted the highest portion in retreatment failure category under retreatment group. In MDR-TB cases, the highest frequency is resistance to HRS and HRES in initial treatment group and HR and HRES in retreatment group. For other DR-TB patients, the majority is single drug resistance with highest frequency in H and R resistance.  Conclusion s Retreatment group was the major category for MDR-TB occurrence, however, there are also high MDR-TB incidence in those with smear positive Results after 3 months treatment and those with initial treatment failure(in fact, these are already retreatment cases). Drug resistance is serious in both new and retreatment group. And other DR-TB is high risk population for MDR-TB.

Analysis of present situation of township sputum collecting centers in Shandong province

Geng Cheng,Li Renzhong

Chinese Journal of Antituberculosis. 2010, 32(6):  29-32. 

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Objective To analyze the present situation of Township Sputum Collecting Centers in Shandong Province and make recommendations. Methods According to geographical features, multi-stage stratified sampling method was adopted, eight counties enrolled as investigation site for in-depth analysis. A combination of interview and questionnaire survey was used. Leaders of health bureau and village hospitals were interviewed and work of township sputum collecting centers and basic situation of suspected TB patients were investigated. Results In2006, Shandong set up a total of 497 Township Sputum Collecting Centers. 824 cases of smear positive TB patients were found in these centers, and the contribution rate is 3.3%. In the eight sampled counties, a total of 2880 cases of TB patients were found, among which 38 were found by Township Sputum Collecting Centers, the contribution rate is 1.3%. As for the operation work of Township Sputum Collecting Centers, except for very few counties, most of centers observe the requirement of national TB program. 38% of suspected TB patients did not check sputum in village hospitals.  Conclusion s In Shandong province, setting up Township Sputum Collecting Centers is feasible, and it does make a contribution in smear-positive TB patients’ case finding. However, the positive rate is low and laboratory conditions are poor, and doctors have a low consciousness of smear check and work is imbalanced between centers. Therefore, current centers should be optimized according to the present situations. And leadership and financial commitment should be increased, and training of laboratory staff and doctors be strengthened in order to improve the efficiency of sputum collecting centers.

Epidemiological analysis of pulmonary tuberculosis form 2005 to 2008 in Shengli oil field

Xu Weiwei,Cheng Shiming,Huang Fei

Chinese Journal of Antituberculosis. 2010, 32(6):  33-36. 

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Objective To analyze the characteristic of reported pulmonary tuberculosis (PTB) in Shengli oil field, in order to provide scientific evidence for PTB control strategy. Methods Reported cases of PTB from disease reporting system from 2005 to 2008 were analyzed; Time, community, occupation, gender, age, and classification of disease and treatment outcome distribution of reported incidents were acquired.  Results From 2005 to 2008, the average reporting incidence was 29.86/100000, with the highest in Shengnan community of 72.93/100000; the number of incident cases were less reported from every November to the next year’s February, but it reached the peak from March to June, which accounted for 39.07% of the whole; the ratio between the male and female was 1.98∶1, the number of cases with age between 20 and 40 accounted for 40.81%; workers accounted for 41.78% which was highest in terms of occupation distribution. The major component of patients were type Ⅲ tuberculosis, and treatment success rate was 95.93%～97.97%.  Conclusion s The reporting incidence varied between communities, and high in elderly and workers. Therefore, local TB control management network should be established, and TB control and prevention should be strengthened, and health education should be extensively carried out, and public awareness should be raised. Focus population and areas should be strengthened in order to protection of labor productivity.

Analysis of treatment compliance and its impact factors of smear-positive pulmonary tuberculosis patients in 3 mountainous counties of Ningxia

Wang Xiaolin，Yang Xuwen

Chinese Journal of Antituberculosis. 2010, 32(6):  37-39. 

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Objective To analysis the treatment compliance and its influential factors of the smear-positive pulmonary TB patients in Mountainous area of Ningxia, in order to provide science evidence for patients’ management. Methods A stratified cluster random sampling method was adopted, and households’ face to face questionnaire survey and personal interviews were conducted. Results Medication compliance, re-examination compliance reached 96.2%, 89.4% respectively. Adverse drug response, distance from home to TB institutions are the main factors affecting compliance. Conclusion s Adequate health education could increase the patients’ compliance. The mode of drug formulations and medication should be further improved. Government could provide appropriate transportation expenses and accommodation costs and liver function test fee to poor patients in order to avoid low compliance caused by economic difficulties.

Study on self-treatment management mode of smear negative patients under guidance of first diagnosis responsibility by county level TB doctors

Liu Yali,Jing Kuanhe,Zhang Shun,Liu Ya,Hu Daiyu

Chinese Journal of Antituberculosis. 2010, 32(6):  40-42. 

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Objective To explore the influence of implementing the management mode of first visit responsibility in county tuberculosis (TB) dispensary doctors on treatment adherence of smear-negative tuberculoses patients.  Methods Patients in the study group received outpatients, handbook and telephone guidance provided by county TB doctors during the whole treatment course. Whereas, the control group patients received whole course management provided by family members.  Result 91% of the patients in study group completed six months anti-TB treatment on a regular and continuous basis, while 78% in control group. For the correct understanding of critical behavior during the treatment, like sputum checking time, treatment duration and drug medication, the study group was higher than the control group. Conclusion Treatment management implemented by county TB dispensary doctors to smear negative pulmonary tuberculosis patients is a feasible management mode and suitable for patients’psychology.

Progress of tuberculosis control work from 2001 to 2008 in Ji’an prefecture

WANG Li-He, XIAO Ai-E, LIU Gao-Jiao, DENG Wen-Sheng, WEI Bi-Hai

Chinese Journal of Antituberculosis. 2010, 32(6):  44-48. 

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Objective To analyze the implementation of modern TB strategies (DOTS) from 2001 to 2008 in Ji’an prefecture and summarize the experience and constraints in order to put forward the measures for improvement. Methods This study adopts the NTP uniform monitoring and evaluation forms and indicators, DOTS implementation related data was collected and analyzed. Result DOTS coverage increased from 37% in 2003 to 100% in 2005. From 2001 to 2008, a total of 26522 cases of pulmonary tuberculosis patients were detected, treated and managed. The registration rate of smear positive cases was raised by year. Patients’ referral in place rate was 63.1%, tracking in place rate was 75.4%, and the cure rate of smear positive patients was 91.89%. From 2005 to 2008, the notification rate of TB decreased from 135.97/100000 to 101.4/100000 and there has a significant decline in the past three years.  Conclusion s The implementation of TB control strategies had prominent effect in Ji’an, and played an important role in fulfilling the NTP goals. In the future, there is a need to further consolidate the sustainable development mechanism, strengthen the capacity building of human resources, and increase the public awareness of TB prevention knowledge.

Rifampicin-induced acute renal failure 8 patients with pulmonary tuberculosis and analysis in literature review

Han Junfeng，Li Li，Wu Qi

Chinese Journal of Antituberculosis. 2010, 32(6):  44-56. 

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Objective To explore the cause and feature of acute renal failure induced by Rifampicin(RFP) during the treatment of pulmonary tuberculosis.  Method A retrospective analysis was conducted on age, administration, treatment and prognosis in 8 patients with pulmonary tuberculosis complicated with acute renal failure induced by RFP during therapy in the past 5 years  Result The elderly patients were in the majority(6/8）.Six patients with pulmonary tuberculosis had previous experience of drug with RFP. All patients were given the regular anti-tuberculosis therapeutic regimenincluding RFP, and then suffered from acute renal failure in 1 month.  Conclusion We must pay more attention to the renal function among patients who have been treated with RFP, especially the elderly and the patients who rececived RFP in the past.

Information management promotes TB prevention and control work of TB designated hospitals

Zhou Ying,Mei Jian,Pan Xiufang

Chinese Journal of Antituberculosis. 2010, 32(6):  49-53. 

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Objective To explore the information management mode of TB designated hospitals in district level in order to improve the work efficiency and quality. Methods Information management system was developed by computer and network techniques; comparison was made between before and after development of this system.  Results This information management strengthened the priority measures of prevention and control work, Simplified workflow、shortened patients’ waiting time，increased medical admissions capacity, reduced the number of staff members and improved work efficiency. The cure rate of new smear positive patients registered in 2007—2008 increased, the proportion of patients with timely smear examination also raised, and the proportion of patient loss reduced. All of these indicate the quality improvement of TB control work.  Conclusion sInformation management is an effective way to improve the quality and efficiency of work; especially to improve work quality of TB control in district level.