Table of Content

10 May 2009, Volume 31 Issue 5

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Evaluation on management and treatment of MDR-TB patients in Shenzhen

Tan Weiguo¹, Deng Weizhong¹, Zhao Meigui², Guan Hongyun¹,Yang Yingzhou¹

. 2009, 31(5):  256-258. 

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Objective To evaluate the diagnosis, treatment and management of MDR-TB cases in Shenzhen city and to provide scientific evidence for MDR-TB control and prevention. MethodsGovernment provided special fund. The quality of the TB laboratory was guaranteed. The supply of the first-line and second-line anti-tuberculosis drugs was ensured. Patients treated under DOT were supplied with free first-line and second-line anti-tuberculosis drugs, treatment surveillance and DOT management. Patients treated under whole course management were provided free treatment surveillance. ResultsOne handred and eleven MDR-TB cases were treated from 2003 to 2006. Side-effect rate was 60.4%, treatment success rate was 59.5%, default rate was 18.9% and failure rate was 11.7%. 48 of all were treated under DOT, 33of whom were cured. The cured rate was 70.8%. Sixty-three of all were treated under whole course management, 22 of whom were cured. The cured rate was only 34.9%. ConclusionsDOTS-plus strategy should be implemented increasingly in all population, so that to control the spread of DR-TB.

The evaluation of tuberculosis control network of Chaoyang district in Beijing

Zhang Shihuai

. 2009, 31(5):  259-263. 

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Objective To evaluate the effect of tuberculosis (TB) control network which was composed of Chaoyang TB dispensary, community TB center and community TB supervisor in the field of TB control. MethodsThe data of all active pulmonary TB patients who were registered from the year 2002 to 2007 in Chaoyang district were analyzed. Some indexes of non-network period (2002—2004) versus network period (2005—2007) were compared, which included the cases finding, patients’ management under DOTS, and the treatment outcomes of the smear positive TB patient. Results1. The number of registered patients increased from 789 to 1332, with 533 cases (67.6%) increased. About 40% patients in network period were found by the TB dispensary. 2. The management rate of smear positive TB patient rose from 63.0% to 92.0%. 3. The treatment success rate of resident smear positive TB patients increased from 83.3% to 92.4%, while that of the smear positive TB patients in immigrant increased from 65.5% to 80.7%. 4. In network period, there was no significant difference in the treatment success rate of the smear positive TB patient between community TB center and Chaoyang TB dispensary. ConclusionsBased on the enhanced government commitment, establishment of the tuberculosis control network was an important measure to solve the problems and improve the quality of TB control of Chaoyang district.

Survey on knowledge, attitude, practice and influence factor of community patients with tuberculosis

Jin Yu

. 2009, 31(5):  264-266. 

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Objective Through the investigation on the knowledge, attitude and practice (KAP) of community patients with tuberculosis (TB) and analysis of the related influence factors, to provide basic data for the TB control and prevention. MethodsThe TB patients with treatment record in community health center in Huishi township were selected randomly and interviewed face to face by doctors who were trained for this investigation. The data were analyzed by non-parameter test, univariate and multivariate logistic regression. ResultsThe pass rate of total KAP of TB was 53.6%, with 59.8%, 62.9% and 52.6% for knowledge, attitude and practice respectively; the multivariate logistic regression analysis indicated that the score of knowledge was related to the age and education level of the interviewee; the score of attitude correlated to the score of knowledge; the score of attitude and of practice were related to the extent of family member care. The main sources of TB knowledge acquired by the patients were the medical institute (67.7%) and television (58.6%). ConclusionsThis baseline investigation indicated that the KAP score of TB cases were low, which shows that it is necessary to carry out the health promotion activities focusing on comprehensive control according to the patients’ health requirements. The key intervened population should be those who have gained lower education, manual workers and those who had family history of TB.

Investigation on the awareness status and influence factors of key message on TB among Minhang residents,Shanghai

Cheng Yuping, Tang Lihong, Yan Huiqin, Zhang Jinlan

. 2009, 31(5):  267-272. 

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Objective To explore the awareness status of key message on tuberculosis (TB) among Minhang residents, Shanghai, and to provide scientific evidence for strengthening TB health education. MethodsA multistage stratified systematic random sampling method was applied. Around 1200 permanent residents at age of 12 to 65 in 6 communities and 2 townships of Minhang were selected and interviewed with questionnaire. 1174 valid questionnaires were received (548 males and 626 females).ResultsThe awareness rates of key message among surveyed people was 54.3%, Among the eight key message, the highest awareness rate was 89.2%, while the lowest one was only 12.7%.The main influence factors varied among the key message, there were more influence factors for the key message 4 and 5. Through logistic regression, household registration, education level, marriage status and occupations were found to be associated with the key message 4; Age and education level were found to be associated with the key message 5. ConclusionsIt is essential to strengthen the health promotion on TB key message to the public with emphasis on key locations and important population in order to prevent tuberculosis prevalence and transmission.

Distribution of Nontuberculous Mycobacteria in Shandong province

Jing Hui, Wang Yan,Li Xinxin, Yu Chunbao, Deng Yunfeng, Wang Haiying

. 2009, 31(5):  273-276. 

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Objective To know the distribution of Nontuberculous Mycobacteria (NTM) in Shandong province. Methods2625 strains isolated between 2004 and 2007 in Shandong were identified as M. tuberculosis complex and NTM by conventional method, NTM species identification were performed by 16SrDNA sequence analysis. ResultsOf 2625 clinical isolates, 39 strains were identified as NTM by conventional method; whereas only 36 strains were identified as NTM, 2 strains were M. tuberculosis complex and 1 strain was Nocardia farcinica by 16S rDNA sequencing. Of 36 NTM strains,M. intracellulare had 29 strains (80.6%), M. kansasii and M. fortuitum had 2 strains respectively, M. gordonae, M.scrofulaceum and M. chelonae complex had 1 strain respectively. The prevalence rate of NTM was 1.4% among mycobacteria culture-positive patients in Shandong province. ConclusionsMost of NTM isolates in Shandong are M. intracellulare.

Study on anti-oncogene hypermethylation in bronchial lavages fluid for the diagnosis of primary lung cancer

Duan Hongfei, Fu Yu, Li Qi,Lai Baitang,Wang Hui,Yue Wentao,Zhang Hongtao,Wang Xiaojue,Ma Yu

. 2009, 31(5):  277-283. 

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Objective To evaluate the value of anti-oncogene hypermethylation in bronchial lavages fluid （BLAF） for the diagnosis of primary lung cancer. MethodsSeventy-eight patients with lung tumors (containing 51 patients with lung cancer and 27 patients with benign pulmonary lesions) from Beijing Tuberculosis and Thoracic Tumor Research Institute were selected. DNAs from supernate and cell in bronchial lavages were extracted, quantified, and detected promoter hypermethylation of three target genes, including p16, MGMT and RASSF1A. Using final clinical diagnosis as control, the sensitivity and specificity of promoter hypermethylation in the diagnosis of lung cancer were analyzed. ResultsDNA concentrations from supernate of bronchial lavages had not significant difference among central lung cancer, peripheral lung cancer and pulmonary benign lesions group. The sensitivity and specificity of anti-oncogene hypermethylation from the bronchial lavages cells for the diagnosis of central lung cancer were 85.2% and 81.5% respectively; for peripheral lung cancer were 54.2% and 81.5%, respectively. Combining with the detection of bronchial lavages supernates, the sensitivity and specificity for the diagnosis of central lung cancer were 88.9% and 70.4% respectively, for peripheral lung cancer were 75.0% and 70.4% respectively.ConclusionsHypermethylation of anti-oncogene might be an useful marker for the diagnosis of lung cancer.

Analysis on the effect of external quality assessment of the pulmonary tuberculosis sputum examination in Sanmenxia from 2004 to 2007

Zhou Hong, Zhang Yizhen

. 2009, 31(5):  284-286. 

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Objective To discuss the function of external quality assessment (EQA) in the sputum examination. Methods4133 sputum smears selected for EQA from 2004 to 2007 were analyzed. ResultsThrough carrying out EQA, the qualification rate of sputum slides increased from 71.2% in 2004 to 90.7% in 2007,the positive coincidence rate rose from 95.9% in 2004 to 98.7% in 2007, and the negative coincidence rate rose from 97.8% in 2004 to 99.5% in 2007. ConclusionsEQA is an essential guarantee for improving the quality of the sputum smear examination.

The stability and anti-mycobacterium activity of peptide derivative N22

Gu Hao, Xu Jiajia, Wang Heyao

. 2009, 31(5):  287-290. 

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Objective To study the stability and anti-microbial activity in vitro of a new polypeptide-peptide derivative N22. MethodsThe content change of the peptide derivative N22 and isoniazid(INH) in the neutral solution from 0 to 6 days at 37℃ was analyzed by HPLC. The anti-bacterial activity in vitro was detected by the 2-fold dilution assay and the AlamarBlue assay. ResultsThe Results of HPLC showed that peptide derivative N22 was more unstable than INH in the media. In vitro experiments, the peptide derivative N22 can inhibit M. tuberculosis better than INH, its minimum inhibitory concentration(MIC) was 50μg/ml. It had also the effect against E.coli, and the MIC for E.coli was 130μg/ml. ConclusionsThe peptide derivative N22 had better effect against M. tuberculosis and E.coli.

A study on the correlation between serum cytokines level and lung fibrosis in pulmonary tuberculosis

Zhang Qing, Xiao Heping, Su Chunxia, Li Qiuhong

. 2009, 31(5):  291-294. 

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Objective To evaluate the correlation between six serum cytokines and lung fibrosis, and damaged degree of lung function. MethodsSerum cytokines, lung function and chest high-resolution computed tomography(HRCT) in 133 patients with pulmonary tuberculosis were detected. According to the result of lung function, all cases were divided into normal group (47cases), mild grade restrictive decrease group (36cases), moderate restrictive decrease group (25cases) and severe restrictive decrease group (25cases). The fibrosis extent was defined by score system of HRCT. ResultsAmong 4 lung function groups, the H value of serum cytokines IL-1, IL-2, IL-5, IL-6, IFN-Υ,TNF-αwere 101.282, 96.454, 0.990, 0.538,102.300, 97.715 respectively, with statistically significant differences of IL-1, IL-2, IFN-Υ, TNF-α among the 4 groups(P=0.000). Total HRCT scores ranged from 1 to15. Significant positive correlations were observed between HRCT score and IL-1, and TNF-α(R=0.757 P=0.000，R=0.972 P=0.000), whereas negative correlations were found in IL-2 and IFN-Υ(R=-0.738 P=0.000，R=-0.750 P=0.000). There was no correlation between HRCT score and IL-5, IL-6 (R=0.102 P=0.241，R=0.048 P=0.584). 133 patients were divided into low score (99cases) group and high score (34cases) group according to HRCT score. The difference of mean between IL and TNF-αwas significant by statistics(P=0.000). A correlation matrix for the different cytokines was evaluated one against another. Similar changes were observed between IL-1 and TNF-α; IL-5 and IL-6; IL-2 and IFN-Υ. However, opposite changes were observed between IL-1 and IL-2; IL-1and IFN-Υ; IL-2and TNF-α.ConclusionsThere is a significant correlation between serum cytokines and lung function, and lung fibrosis. IL-1 and TNF-αshow the strongest correlation with them.

Diagnostic value of multi-slice helical computed tomography in pleural tuberculoma

Zhao Zhiqing¹, Luo Dilin¹, Tan Yongliang¹, Hou Yu¹, Xu Chaoxuan¹, Yang Maohong¹, Wu Dong¹，Huang Chunyuan¹，Zheng Keguo²

. 2009, 31(5):  295-296. 

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Objective To investigate the diagnostic value of multi-slice helical CT(MSCT) in pleural tuberculoma, and to improve the understanding of this disease. MethodsWe analyzed retrospectively the MSCT and post-processing film features in 13 pleural tuberculoma diagnosed by clinic or surgical pathology. ResultsSingle pleural tuberculoma were seen in 10 cases and multiple pleural tuberculomas in 3 cases. The CT scan showed papillary nodules in 5 cases, round or elliptic nodules in 6 cases and irregular nodules in 2 cases.The lesion density was homogeneous in most cases, and calcifications or necrosis in a few cases, and the lesion margin was smooth. No or slight enhancement of the tuberculoma can be seen on contrast CT. The adjacent pleura can be seen thickening, adhesion and calcification. There were 9 cases accompanied with hydrothorax, 10 cases with pulmonary tuberculosis and 7 cases with enlarged and calcified mediastinal nodals. The MSCT post-processing images showed the features of pleural tuberculoma completely, intuitionistically and stereoscopically. ConclusionsThe MSCT post-processing technique could make up for the lack of axial CT scan. It is high valuable to improve the diagnosis accuracy of pleural tuberculoma.

Analysis on 59 patients with pulmonary tuberculosis complicated with corticosteroids

Liang Jianqin, Wang Jinhe, Wang Wei, Zhang Guangyu, Wang Ansheng, Chen Zhi,Feng Shisheng, Wang Ruilan

. 2009, 31(5):  298-300. 

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Objective To analyze the clinical characteristics of pulmonary tuberculosis complicated with corticosteroids.MethodsWe analyzed retrospectively 59 hospitalized patients with pulmonary tuberculosis complicated with corticosteroids treated in hospital during 2001—2006.ResultsAll patients received treatment for twelve months. The effective rate was 78.3%, 5 patients died of multi-drug resistant tuberculosis (MDR-TB), 8 patients had no response; Among patients with extensive lesions in Chest X-ray, lesion decreased in 49 cases, cavities shrunk in 12 cases, and sputum smear converted to negative in 17 cases. ConclusionsThe prevention of pulmonary tuberculosis complicated with corticosteroids should be awared, with following-up for chest X-ray and sputum smear performed periodicitily. Good therapeutic efficacy can be seen when treatment given in time.