Table of Content

10 February 2006, Volume 28 Issue 2

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Smear positives detection in family contacts of smear positive cases

Hou Shuangyi,Zhang Xianfeng,Ye Jianjun,et al.

. 2006, 28(2):  71-73. 

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Objective To determine smear positive detection situation in family close contacts of smear positive cases.Methods 36 423 confirmed close contacts of smear positive cases were asked to provide 3 sputum specimens(night,morning and spot sputum) for smear examination.Results The smear positive detection rate was 1.0% in family close contacts of smear positive cases.There was a positive correlation between smear positive detection rate of close contacts and the amount of bacteria discharged by the cases.The smear positive detection rate in ≤15 age group and ≥55 age group of close contacts(1.5% and 2.1% respectively) was higher than other groups.There was significant statistical difference.Conclusions To screen close contacts of smear positive cases by sputum examination could help to increase smear positive case detection rate.Especially for the close contacts of those cases with amount of bacteria discharged more than 2+ and close contacts in ≤15 age group and ≥55 age group,sputum examination screening will help to detect cases as early as possible.

Evaluation on the the short-term effects of chemotherapy for the patients with tuberculosis and diabetes

Zeng Lixiang,Chen Bingxi,Li Yafa,et al.

. 2006, 28(2):  74-76. 

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Objective To evaluate the short-term effects of chemotherapy for the patients with tuberculosis and diabetes,and to evaluate the duration of treatment.Methods The data of 78 patients with tuberculosis and diabetes were collected retrospectively,and therapeutic effects were analyzed.Results At the end of the treatment,the sputum conversion rate of the plasma glucose controlled well group(group I) was 92.3%,while the sputum conversion rate of the group,that the patients suffer tuberculosis not with diabetes,was 94.5%,there was no statistical difference(P>0.05).The sputum conversion rate of the plasma glucose controlled fall group(group II) was 66.7%,there was significant difference in statistics of group I and group II(P<0.05).The foci absorption rate of group I was 89.5%,the foci absorption rate of group II was 52.4%, two groups have a significant difference in statistics(P<0.01).The cavity close up rate of group I was 67.6%,the cavity close up rate of group II was 15.4%,there was significant difference in statistics of two groups(P<0.01).Conclusions If plasma glucose was controlled well,the short-term effects of chemotherapy in the patients who suffered tuberculosis and diabetes is good;if plasma glucose was controlled fall,the effects is worse.The patients whose plasma glucose controlled fall should prolong the treatment;at the end of treatment,whose tuberculosis is activity,also should prolong the treatment.Early diagnosis and treated tuberculosis and diabetes may yield the satisfactory results.

The effect of the interferon-r injected by intramuscular combined with regular anti-tuberculosis regimen used in pulmonary tuberculosis

Wang Lin,Wang Xuezhi,Cheng Qiulan,et al.

. 2006, 28(2):  77-79. 

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Objective To observe the effect that IFN-γ how to interfere the homeostasis of Thl/Th2 used combine with conventional anti-tuberculosis regimen.Methods IFN-γ was used at initial phase of the treatment(2 months)only in intervention group.Both intervention group and control group were all treated with conventional anti-tuberculosis regimen.The lesion extent in lungs,sputum conversion,serum cytokines and IgE were examined.Results At the end of two months and six months of treatment,there was no significantly difference of sputum conversion rate between the two groups.The lung lesion in intervention group diminished more clearly than in control group.It was statistically significant.The laboratory test showed IL-4 decreased and IFN-r elevated significantly in intervention group than control group.But IgE was not correlated with IL-4 completely.Conclusion There was intervention effect of external IFN-γ interfere for the unbalance of Thl-Th2 during the illness of pulmonary tuberculosis,IFN-r can strengthen and advance Thl predominance.

The clinical analysis on 36 tuberculous pericarditis cases

Liu Xin¹,Liu Wei,Zhang Fan,et al.

. 2006, 28(2):  80-82. 

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Objective To improve the diagnostic and therapeutic level through the analysis of the clinical characteristics of tuberculosis pericarditis(TP).Methods Retrospective analysis on the clinical data of 36 cases of TP.Results (1) Youth and adult cases was most common.(2) Fever,chest pain and oppressed feeling were the most frequent clinical symptoms of TP.Abdominal distension and dyspnea were the most frequent clinical symptoms of constrictive tuberculosis pericarditis(CTP).(3) most of TP were complicated with bilateral pleurisy.A few were complicated with other cavity hydrops.(4) Most of pericarditis were hemorrhagic effusion and fibrose effusion was common.ADA detection was significance for diagnosis of effusive tuberculosis pericarditis(ETP) besides pericarditis routine and biochemistry.(5) Echocardiographic(Echo) examination is a sensitive,reliabal and feasible method to detection of pericarditis.Echo combined with CT examination was a highly value in diagnosis of CTP.(6)The clinical efficacy of chemotherapy with rifampicin containing regime yielded satisfactory clinical efficacy.Surgery was the most efficient therapy.Conclusion To those febrile accompanied with chest pain and oppressed feeling youth-prime of life patients,the physician should pay attention to the investigation of chest film,Echo and pericarditis routine,biochemistry,ADA detection to rule out ETP.To those abdominal distention and dyspnea youth-prime of life patients,CT examination is necessary as well to rule out CTP.Early diagnosis and treat with RFP contriving regime may yield the satisfactory results.

The protein-malnutrition and drug-induced hepatitis due to anti-tuberculosis drugs

Tan Shouyong,Lin Zhaoyua,Guan Yuhuan,et al.

. 2006, 28(2):  83-86. 

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Objective To explore the influence of protein-malnutrition to the drug-induced hepatitis due to anti-tuberculosis drugs.Methods 137 patients new pulmonary tuberculosis with protein-malnutrition hospitalized in our department from September 2001 to May 2003 was observed for the their drug-induced hepatitis,who was treated by the first line anti-tuberculosis drugs.And with the same period hosptitalization,811 patients new pulmonary tuberculosis with non-protein-malnutrition were selected as the control group.Results The rate of the drug-induced hepatitis of new pulmonary tuberculosis with protein-malnutrition was higher,during the first month,than that of the control group（22.6%,χ²=4.614,P=0.032,RR=1.5）.And the rate of that was higher than that of the same group,during the second month（χ²=15.191,P=0.001）.The drug-induced hepatitis rate of female with HBsAg（+）occurrence was higher,but there was no significant statistical difference（P<0.05）.There was no relation of age and the scope of tuberculosis focus with the drug-induced hepatitis（P<0.05）.Conclusion The protein-malnutrition tuberculosis patients in the treatment process emergence medicine liver function injures easily,so that we should monitor the clinical treatment for their liver function changes and pay attention to improve their nourishment appearance for reducing the medicine liver function injure.

The clinical effect of chemotherapy combined with Mycobacterium vaccae vaccine on tuberculous pleurisy

Wang Xing,Hao Shijia,Chen Xiangdong,et al.

. 2006, 28(2):  87-89. 

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Objective To evaluate the therapeutic effect of Mycobacterium vaccae（M.vaccae）vaccine on tuberculosis pleurisy.Methods Eighty cases of tuberculosis pleurisy were divided randomly into study group（40 cases） and control group（40 cases）.All of the two groups were treated by chemotherapy with a regimen of 2HALZ/6HL₂ and aspirating pleural effusion.And the study group was given intramuscular injections of M.vaccae vaccine once weekly for three months,the control group took prednisone for 6～8 weeks.Results The rates of pleural thickening were 5% in the study group and 22.5% in the control group.There was significant difference（P＜0.05）.The average times of absorption of pleural effusion were 19.3 days in the study group and 28.3 days in the control group.There was significant difference（P＜0.01）.The relapse rates following 1.5 years follow-up were 0 in the study group and 8.6% in the control group（P＞0.05）.The side effects of M.vaccae vaccine were local in duration（1 case） and slight fever（1 case）,Conclusion M.vaccae vaccine is an effective and safe drug to reduce pleural thickening in treating patients with tuberculous pleurisy.

Study on diagnostic value of detection of adrenomedullinin differentiation malignant pleural effusion from tuberculous pleurai effusion

Lili,Yuhua,Zhang Chunling,et al.

. 2006, 28(2):  90-94. 

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Objective To study the diagnostic value of detection of adrenomedullin(AM) and combineddetection of with CYFRA211,NSE and CEA in differentiating malignant pleural effusion from tuberculosis pleural effusion,comparing with CYFRA211,NSE and CEA,to prove the experimental basis of differential diagnosis of malignant pleural effusion.Method The levels of AM,CYFRA211,NSE and CEA in malignant pleural effusion and tuberculosis pleural effusion were determined by radioimmunoassay(RIA) and the sensitivity,specificity and accuracy for making diagnosis of malignant pleural effusion were compared.Results (1)The level of AM in the malignant pleural effusion(115.05±31.06 pg/ml) are significantly higher than that in the tuberculosis pleural effusion(71.404±10.80 pg/ml).There was markedly statistical significance between them(P<0.01);(2)The sensitivity and accuracy for making diagnosis of malignant pleural effusion of AM were higher than those of CEA and NSE(P<0.05).There was no difference between AM and CYFRA211 in the sensitivity and accuracy(P>0.05).(3)The sensitivity and accuracy of the combined determination containing four tumor markers were 90.4% and 89.4%,were higher than any single tumor markers in diagnosis of malignant pleural effusion(P<0.05).Conclusion (1)AM can be regarded as a laboratory mark of differentiating malignant pleural effusion from tuberculosis pleural effusion;(2)Combined detection of AM,CYFRA211,NSE and CEA can ignificantly improve the sensitivity and the accuracy in diagnosis of malignant pleural effusion;(3)This research shows that AM is closely correlated with malignant pleural effusion,disrupting the binding of AM and its receptor or signal transduction pathways could be a new way to cure malignant pleural effusion.

The study on the second round surveillance of drug resistance in tuberculosis and its trends in Henan,China

Du Changmei¹,Wang Guobin,Xu Jiying,et al.

. 2006, 28(2):  95-100. 

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Objective To determine the drug resistance prevalence in 2001 and its trends from 1996 to 2001 in Henan,as well as to evaluate the implementation of the tuberculosis control program and to provide reference evidence for policy makers of tuberculosis control.Methods 30 centers were randomly selected using clustering sampling method.The intake of patients in every center was successively,that is,all smear positive cases(patients with or without treatment history) in the intake period were enrolled,until the 43 new cases in each center were completed.Sputum smear microscope test was carried out using the Ziehl-Neelsen technique.All smear positive sputum samples were cultured using Loewenstein-Jensen medium,and identification of M.TB of all culture positive strains was carried out using TCH and PNB.Proportion method was used for drug susceptibility tests for the four anti-tuberculosis drugs,isoniazid,rifampicin,streptomycin and ethambutol.Results The total,initial and acquired drug resistance rate are 35.3%,29.8% and 60.8% respectively.And the total,initial and acquired Multi-drug resistance(MDR) rate are 12.9%,7.8% and 36.6% respectively.Compared with the drug resistance prevalence in 1996,the total,initial drug resistance rate,as well as the total and initial MDR rate in 2001 decreased significantly,while the acquired drug resistance rate and its MDR rate did not show significant change.Conclusion The drug resistance prevalence in Henan is still the highest out of the five provinces surveyed in China,and one out of the highest countries in the world,which should be paid much attention.It also suggests that sound tuberculosis control strategies(DOTS) should be carried out in Henan.

The actual states of the convergence tuberculosis cases-management in Guangzhou during 1999—2003

Chen Qichen,Liang Chengshuang,Wu Huiyi.

. 2006, 28(2):  101-102. 

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Objective To determine the states of tuberculosis cases reporting of convergence tuberculosis cases-management since 1999.Methods After all county(district) tuberculosis dispensaries followed up the reported tuberculosis cases,the followed up Results were reported to prefecture tuberculosis dispensaries and the data were consolidated quarterly.Results The average arrival rate was 89.2% during 5 years.The tuberculosis cases confirmation rate among the reported cases was 52.2%.The case holding rate in hospitals was 5.1%.The rate of patients with unclear address and refused to visit tuberculosis dispensaries was 5.7%.Conclusion The situation of the convergence tuberculosis cases-management was good and stable since 1999.It was a important means of the case detection.The problems like holding patients by hospitals,unclear address of patient and patients refuse to visit tuberculosis dispensaries should be solved.

The analysis on the trend of drug resistance of tuberculosis in Huzhou city,Zhejiang

Xu Deshun.Zhng Sichao.YANG Jun-chao.

. 2006, 28(2):  103-105. 

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Objective To determine the dynamic changes and trend of drug resistance of tuberculosis and to evaluate the effect of tuberculosis control program.Methods To cultivate Mycobacterium tuberculosis in the sputa with a positive smear test result of new and re-treat patients with tuberculosis.Drug susceptibility testing was tested in the culture positive strains against four anti-tuberculosis drugs by using the proportional method from 2001 to 2004.Results The rate of total drug resistance was declined from 30.0% in 2001 to 21.8% in 2004.The rate of initial resistance was declined from 23.6% in 2001 to 16.5% in 2004.The rate of acquired resistance was declined from 61.5% in 2001 to 47.2% in 2004.The rate of different drug resistance was declined.Conclusion The rate of initial and total drug resistance was declined.The main reason is due to convergence case-management and the implementation of DOTS strategy.

Ananlysis of the roles and working mode of assigned hospital for tuberculosis control

Pan Hongqiu¹,Yue Shuiyan,Jing Yueming,et al.

. 2006, 28(2):  106-109. 

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Objective To evaluate the effect of working mode of the city assigned general hospital forundertaking the management and treatment of tuberculosis cases.Methods Based on document the responsibility of implementation tuberculosis control strategy(abbreviation DOTS strategy) that original took by the disease control central of Zhenjiang and each lung department of the general hospital was shifted to the new set up department of our hospital "Prevention Tuberculosis Department".Results For 3 years,the referring rate of the tuberculosis patient increased to 90% from 20%.The notification rate of the new smear positive tuberculosis patient raised year by year.The rate of 2001 was 5.57/100,000,2003 was 12.28/100,000.The rate reached to 21.57/100,000 in 2004.It increased 387.2% than that in 2001.The sputum examination rate and positive detection rate increased year by year.In 2001,the average sputum examination rate in urban area was 25%,the smear positive detection rate was 20%.To the end of 2004 the rate came to 100% and 40.1% respectively.The case detection rate of infectious tuberculosis increased to 50% for continuous 3 years.DOTS coverage rate was increased from below 10% before to 95% above.The cure rate of new infectious cases was 90% above;the cure rate of re-treatment cases was 80%.Conclusions The assigned general hospital can undertake the modem tuberculosis control strategy,make the manage and supervise of tuberculosis go well with the treatment,and can play important role in tuberculosis control.

Tuberculosis treatment with government financial support in Pudong New Area,Shanghai

Qu Feng,Cai Fengzhu,Mei Jian,et al.

. 2006, 28(2):  110-112. 

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Objective To analyze on the situation of bacteriological positive pulmonary tuberculosis (PTB)treatment supported by government funds.Methods The total and average free or partly free of charge fee to PTB patients among residents and floating population in Pudong New Area was analyzed from January 2004 to March 2005.Results The average free or partly free of charge fee was 798.81 yuan per patient.The beneficial fee of patients among loating population,permanent resident with medical insurance and permanent resident without medical insurance was 949.15 yuan,661.25 yuan and 843.74 yuan respectively.Retreated patients benefited more than new patients.Conclusion The policy of free or partly free of charge provided some financial support to PTB patients.At the same time,the cost of diagnosis and treatment for tuberculosis in general hospitals should be controlled.