Table of Content

10 June 2006, Volume 28 Issue 6

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Analysis on the survey of smearpositive pulmonary tuberculosis with diabetes mellitus in Henan,China

Wang Guobin,Wang Guojie,Zhen Xinan,et al.

. 2006, 28(6):  339-344. 

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Objective To study the epidemic status,clinical and X-ray radiographic manifestation,anti-TB drug resistance and treatment outcome of smearpositive pulmonary tuberculosis(SMPTB) with diabetes mellitus(DM) in Henan and provide evidence for clinical practice and public health practice. Methods This study was conducted together with the second antiTB drug resistance surveillance in Henan;Blood glucose test was taken in all SMPTB patients before anti-TB therapy(taking 75 grams of glucose orally and testing the level of blood sugar by drawing venous blood 2 hours later).Xray chest radiographs of the patients were read by the group consisting of TB specialists. Results Among the 902 SMPTB patients,12.6% patients were with DM and 14.9% patients were with impaired glucose tolerance(IGT),together accounting for 27.5%.The rates of DM and IGT among SMPTB patients aged at 40 or above were significantly higher than those among the SMPTB patients aged below 40(P<0.05).Anti-TB drug resistant rate among SMPTB patients with DM were 45.6%,which was significantly higher than that among SMPTB patients with normal level of blood glucose or IGT(35.2%,32.8%)(P<0.05).The frequency of lung lesions confined to mid or lower lung fields among SMPTB patients with DM or IGT was significantly higher than those among the SMPTB patients with normal level of blood glucose(P<0.05).The frequencies of effusive focus(93%),cheesy focus(87.7%) and pleural effusion(14.0%) were much higher among SMPTB with DM than those with normal level of blood glucose.The frequency of cavity was high among SMPTB with DM(95.9%).The negative conversion rate at the end of intensive phrase and cure rate among SMPTB patients with DM or IGT was 77.4% and 86.3% respectively,which were significantly lower than that among the SMPTB patients with normal level of blood glucose(88.1%,91.7%)(P<0.05). Conclusion The prevalence of DM and IGT among SMPTB patients is higher than that among general population.SMPTB patients with DM have special Xray radiographic manifestation which helps case detection,diagnosis and treatment.The awareness of abnormal level of blood glucose is low among SMPTB patients with DM and IGT.Anti-TB drug resistant rate among retreated SMPTB patients with DM or IGT is higher,which influence the sputum conversion and treatment outcome.It should be paid high attention that DM and IGT tampered TB treatment.

Analysis of human resource situation about TB control in Zhejiang

Chen Songhua,Liu Beidou,Wang Xiaomeng,et al.

. 2006, 28(6):  345-347. 

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Objective To understand the human resource situation about TB control in Zhejiang at both prefecture and county levels. Methods The latest data obtained by questionnaire were analyzed after classification by dynamic series and χ² test. Results The structure of professional title and academic background had statistical significance at both levels.The level of skills of the TB staff was high.However,the total number of TB staff in Zhejiang were not enough to meet the demands of TB control and the setup of the position was not balanced. Conclusion In order to meet the demands of TB control in the future,more staff should be recruited at the both prefecture and county levels in Zhejiang.

Analysis of DOTS strategy implementation in rural and mountainous area in Fujian province

Lin Yongming,Chen Qiuyang,Liu Xiaoyun,et al.

. 2006, 28(6):  348-350. 

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Objective To evaluate DOTS strategy implementation in rural and mountainous area in Fujian province. Methods A combined qualitative and quantitative methodology was used.Questionnaire survey was conducted to TB patients and in-depth interview was carried out among relevant persons and TB patients.The topics of the in-depth interview included case detection,treatment and management,TB control policies issued by relevant departments.The evaluation was conducted from three aspects which were governmental commitment to TB control,the process of care detection and the implementation of case supervision and management. Results The governmental commitment to TB control implemented well in the three selected counties.53.3% patients selected the village clinic/private clinic as the first time of health care seeking and only 6.9% patients selected TB dispensary in the first health care seeking.26.4% patients delayed in seeking diagnosis while 59.9% patients experienced the delay in diagnosis confirmation.94.9% of smear positive patients were visited by doctors during the treatment,but 72.9% of smear positive cases believed that it was not necessary to be observed by doctors in drug taking.And only 47.3% patients were directly observed the treatment by health care workers. Conclusion The governmental commitment could ensure the implantation of TB control.TB suspects and patients should be informed to visit TB dispensary for diagnosis.The effectiveness of referral should be improved and the delay in diagnosis confirmation should be reduced.Directly observed treatment is the key point in DOTS strategy,thus the training to the township and village doctors should be enhanced to improve their awareness of TB and at the same time medical ethical policies adapted to the situation in rural area should be developed.

The character of drug-induced liver injury caused by anti-tuberculosis drugs in the geriatric tuberculosis patients

Liu Kun,Huang Dongsheng,Huang Guangxiong,et al.

. 2006, 28(6):  351-353. 

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Objective To study the characteristics of drug-induced liver injury caused by anti-tuberculosis drugs in the geriatric tuberculosis patients Method The frequency of drug-induced liver injury during the treatment with anti-tuberculosis drugs was calculated in the test group and control group.The frequency,the degree,the cause,the appearance of drug-induced liver injury caused by anti-tuberculosis drugs and the difference of clinic symptom between the two groups were compared.The software SPSS11.0 was used to deal with the data,and there is significant difference if P<0.05.The clinical symptom,the frequency and the cases whose ALT was? Result over 200U and with jaundice in the test group were more than those in the control group, and the cases whose ALT was between 120～200U were less than the control group (P<0.05),and the difference between the two groups was significant.The data from the two groups showed that the drug-induced liver injury was mostly caused by Rifampicin,the fastigium of drug-induced liver injury appeared after 2～4 weeks.There was no difference in the proportion of the three anti-tuberculosis drugs which caused the liver injury,the appearance and the appearing time of drug-induced liver injury between the two groups. Conclusion The frequency of liver injury is higher and degree of liver injury is more serious in the geriatric tuberculosis patients.

Analysis of the financial burden of pulmonary tuberculosis patients under different management model in Zhejiang province

Xia Shichang,Wang Xiaomeng,Chen Songhua.

. 2006, 28(6):  354-358. 

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Objective To analyze the financial burden of pulmonary tuberculosis patients under different management model. Methods Randomized stratified clustered sampling method was used to select 419 tuberculosis pulmonary cases in 16 sample counties,and questionnaire was used to collect data of the patients under different management models.Economic evaluation method was used to analyze the financial burden of pulmonary tuberculosis patients. Results The average financial burden of pulmonary tuberculosis patients was 3842 yuan.Under three different management modes the financial burden were 3319 yuan,4031 yuan and 4271 yuan respectively.There was no significant difference among the different management models.However,there was significant difference in different areas under three different management odels(F=3.8,P<0.05). The ratio of disease expenditure to the net income of the patient was 94.1%,the ratios of disease expenditure to the net income of the patient’s family was 64.8%.The proportion of expenditure of hospitalization listed as the biggest expenditure in the financial burden of pulmonary tuberculosis patients was 22.4%.Among the three management models,expenditure of hospitalization was the biggest expenditure in the financial burden of pulmonary tuberculosis patients,followed by the expenditure on drugs to protect liver function.The average financial burden of pulmonary tuberculosis patients treated in general hospital was higher than it in center for disease control and prevention(F=7.5,P<0.05).The free supplies provided by government accounted for 17.2% among the financial burden averagely and the patients paid,83.0% of the financial burden themselves. Conclusions The financial burden of pulmonary tuberculosis patients was high. In order to reduce the financial burden of pulmonary tuberculosis patients,the government should increase the input to TB control and meanwhile strictly control the rate of hospitalization,the expenditure of hospitalization and expenditure on the assistant durg.

The study of effect mass recommendation of suspects on tuberculosis control

Wang Lin¹,Ma Shiwen,Jin Hongjian.

. 2006, 28(6):  359-361. 

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Objective To assess the feasibility and impact of mass recommendation for case detection so as to develop standard working procedure for case detection through mass recommendation of suspects. Method Following the 7 criteria as clue to detect TB suspects,new smearpositive TB cases were detected through mass recommendation of indoor investigation by village doctors,fluoroscopy screening in township hospitals and diagnosis in city TB dispensary. Result During the three months of the study 166 active TB cases was detected by mass recommendation out of the total city population of 755 944,including 86 smear positive cases.The screening rate of suspects with cough,cough with sputum or cough with blood was highest to 13%,and the rate for new smear positive TB patients was 7.6%. Conclusion The approach of mass recommendation through indoor investigation by village doctors,fluoroscopy screening in township hospitals and diagnosis in city TB dispensary is not only an effective method to increase case detection but also an effective approach for health promotion activities.

Analysis on sputum examination for tuberculosis in general hospital

Zhou Liping,Xiong Changfu,Zhang Xianfeng,et al.

. 2006, 28(6):  362-364. 

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Objective To analyze the sputum examination of TB suspects in outpatient department in general hospital,and explore the measures to increase case-finding of smear-positive TB in general hospitals. Method Data from case register in the outpatient department,sputum examination register,referral register in general hospital and TB dispensary and data from supervision to general hospital and quality control of sputum examination were collected and evaluated. Result 11,303 TB suspects were registered in 40 general hospitals where the FIDELIS(Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project has been implemented for one year,and among them 859 were smearpositive pulmonary tuberculosis(SPTB 15.6%).(2,094) cases referred to TB dispensary were smear-negative TB or without sputum examination. 1,685 cases had sputum examination,and 804 were smear positive TB(47.7%).Among them,551 were from the 1,026 cases without sputum examinations in general hospital(the smearpositive rate was 53.7%) and 253 were from the 659 smear negative TB who were checked by general hospital(the smear-positive rate was 38.4%). 25,238 TB suspects had sputum examinations in TB dispensaries,the smearpositive rate was 55.7% which was significantly different from the rate in general hospitals(P<0.05). Conclusion Many TB suspects seek medical service in general hospital at the first time.However,the case detection is not standardized in general hospital.Thus, it is efficient approach to improve case detection by setting up sputum examination sites in general hospitals,enhancing administration interventions,strengthening the system of cooperation and coordination between TB dispensary and general hospital,and the internal coordination of the general hospital,integrating the sputum examination into the routine examination items in general hospital,and strengthening the quality control,training and retraining the relevant technicians.

The clinical anlaysis on 97 patients with active pulmonary tuberculosis associated endobronchial tuberculosis

Tian Rong,Feng Li,Liu Qiangui,et al.

. 2006, 28(6):  365-369. 

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Objective To explore the clinical features of the patients with active pulmonary tuberculosis associated endobronchial tuberculosis(EBTB). Methods Clinical data on 97 active pulmonary tuberculosis cases associated EBTB were analyzed retrospectively. Results Cough(82.5%),sputum production(80.4%),fever(45.4%) and the different degree of haemoptysis or blood stained sputum(23.7%) were the most common chief complaints.The most common roentgenographic findings were atelactasis/detelectasis(44.2%) and parenchymal infiltration and/or consolidation(37.9%),and bronchial stenosis or obstruction,bronchiectasis,bronchial dissemination,bronchial air sign,mediastinal lymphadenitis and lymph nodes calcification were also demonstrated in chest CT.Sputum smear/culture of acid-fast bacilli positive rate was 63.9%.It was 83.3% in the patients with muti-lobar/segmental parenchymal infiltration and/or consolidation of Chest CT.Bronchoscopic Results showed the lesions were more likely to be seen in the main and lobe bronchi.Multi-trachea/bronchi were involved(81.4%) and several subtype forms of bronchoscopic finding co-existed.The positive rate of bronchoscopic brushing smear for acid-fast baccili and biopsy was 55.9% and 69.4%,respectively.Only 18 patients received interventional bronchoscopic treatments.6 patients with bronchial stenosis/obstruction and atelactasis received the treatments of fiberoptic broncoscopic balloon dilation.As a result,stenosis was alleviated in 5 patients. Conclusions Symptoms were non-specific in the patients with active pulmonary tuberculosis associated EBTB.Chest CT was very useful in evaluating bronchial lesions such as stenosis or obstruction and the change of mediastinal lymph nodes. Bronchoscopy was still an important method to diagnose active pulmonary tuberculosis associated EBTB.Bronchoscopic findings showed that leision occurred on Multi-trachea/bronchi and overlapping subtype forms existed.Bronchial stenosis can be improved effectively by balloon dilation techniques.

Increase case detection of TB through intensive referral of TB suspects by village doctors to county TB dispensary

Xiong Changfu,Zhou Liping,Zhang Xianfeng,et al.

. 2006, 28(6):  370-372. 

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Objective To explore the new approach to increase case detection of pulmonary tuberculosis(TB). Methods 30 counties whose case registration rates were lower than the average in Hubei province in 2003 were selected in this project.Patients with TB symptoms were inquired and referred by trained village doctors to county dispensaries, designated township health centers or general hospitals for free sputum examination.At the same time,TB patients and suspects notified by general hospitals were traced by TB staff via phone call,letter,etc.if they were defaulted during the referring. Results From Nov 2004 to Oct 2005,12 091 new smear positive TB cases were detected in the 30 counties.The new smear positive registration rate increased from 36.21/100,000 to 49.94/100 000(χ²=101.7,P<0.0001) and the case detection rate under DOTS reached 86.0%.Among 43 464 suspects registered with TB symptoms in 30 counties,15 363(35.3%) patients were referred by village doctors,in which 3 870 were new smear positive TB cases,accounting for 32.0% of the total.The follow-up rate was 70.9%,and arrival rate of the traced cases was only 33.1%. Conclusion It is an effective way to increase case detection through intensive referral of patients with TB symptoms by village doctors to TB dispensary with some incentives to patients and village doctors.

The impact of different health promotion activities on case finding of pulmonary tuberculosis

Zhang Huimin,Zhang Lianying,Chen Haifeng,et.al.

. 2006, 28(6):  373-375. 

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Objective To evaluate the impact of different health promotion activities on case finding of pulmonary tuberculosis. Method Different health promotion activities were carried out in 45 counties from Jan 2004 to Dec 2004,which included flyers/posters,TV or radio program,wall painting,governmental notice,bulletin board and local drama. Results From Jan 2004 to Dec 2004,the rate of TB suspects seeking medical service and the registration rate of smear positive TB were significantly higher than those in the same duration in the last year in 45 counties and those in other area in the same duration(P<0.05).Analyzing the information source of the patients seeking healthcare service and the implementation of health promotion activities,the logistic regression analysis showed that wall painting,TV,bulletin board and governmental notice were most effective Methods that contributed to case detection.The impact from wall painting was statistically significant(P=0.01)? Conclusion The implementation of health promotion activities can increase the rate of TB suspects seeking medical service and case detection rate of smear positive tuberculosis.Wall painting,TV program and bulletin board are most effective approaches.

Analysis on prevention and control project of tuberculosis casefinding in Baoji City

Zhang Yaning,Zhang Kejian,Chang Xiaojie

. 2006, 28(6):  376-378. 

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Objective To evaluate the status of tuberculosis(TB) case-finding in the three years since the TB control project was implemented in Baoji City. Method The indicators of case detection in quarterly report and monthly report from 2002 to 2004 in Baoji City were analyzed and evaluated. Results From 2002 to 2004,6,120 active TB cases were found in Baoji City and among them 2,340 were smear positive,which were 2.6 times(6,120/2,394) and 6.1 times(2,340/381) of the total for the three years before the implementation of the TB project respectively.The registration rate of new smear positive increased yearly(5.9/100000,21.3/100000,35.9/100000). Conclusion After implementing of the project for three years,the level of case-finding has been increased year after year.

Analysis on causes and outcomes of irregular treatment of 333 pulmonary tuberculosis patients

Li Xiangqun,Mei Jian,Xia Zhen.

. 2006, 28(6):  379-381. 

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Objective To find out the causes and outcomes of irregular treatment of pulmonary tuberculosis cases,and to discuss the Methods to improve the compliance and increased cure rate. Methods The sex and age of 333 pulmonary tuberculosis cases with irregular treatment during 2001 to 2003 in Shanghai were compared and the causes of irregular treatment were analyzed. Result The male pulmonary tuberculosis cases of irregular treatment are higher than female cases(χ²=12.5,P<0.001).The causes of irregular treatment mainly include adverse drug effects(64.3%) and noncooperation(26.7%).The cure rate of new smear positive cases was slightly higher than retreatment smear positive cases.(χ²=0.077,P>0.05). Conclusion To reduce the irregular treatment and increase cure rate,the reasonable treatment regimen should be used,supervision and management to the priority cases(male,old,smear positive) should be strengthened and the adverse drug effects should be managed properly.

A clinical observation on treatment effect of rifapentine for rifampin resistant pulmonary tuberculosis

Wang Qingfeng,Gao Mengqiu,Ma Liping,et al.

. 2006, 28(6):  382-384. 

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ObjectiveTo evaluate the role of Rifapentine for patients with Rifampin resistant pulmonary tuberculosis via observing treatment effect of Rifapentine with increased dosage for Rifampin resistant pulmonary tuberculosis. Method One hundred and one cases were enrolled according to the result of drug susceptibility.The treatment group was divided into group 1 with low concentration Rifampin resistance and group 2 with high concentration Rifampin resistance.The regimen for both group 1 and group 2 included rifapentine.The control was the high concentration Rifampin resistant group,but the regimen for this group excluded Rifapentine.The treatment effect was observed at the 3rd month and 18th month after treatment. Result Sputum negative conversion rate,focus absorption,cavity closure of group 1 were better than those of group 2 and control group.The difference was statistically significant.However,sputum negative conversion rate,focus absorption,cavity closure of group 2 were better than those of the control,but the difference was not statistically significant. Conclusions Rifapentine is a preferred drug for treatment in patients with Rifampin resistant pulmonary tuberculosis,especially for patients with low concentration Rifampin resistant pulmonary tuberculosis.However,it is controversial whether Rifapentine should be taken for patients with high concentration Rifampin resistant pulmonary tuberculosis.

Observation of supplementary treatment effect of Yifeizhike capsule in treating re-treatment pulmonary tuberculosis patients

Chen Zunjie,Huang Yuefan,Zheng Shufang,et al.

. 2006, 28(6):  385-387. 

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Objective To observe the supplementary treatment effect of Yifeizhike capsule in treating re-treatment pulmonary tuberculosis(TB) patients. Methods Two hundred and Seventy-eight retreatment TB patients hospitalized from January 2001 to June 2004 were randomly divided into therapy group(140 cases) and control group(138 cases). The therapy group received chemical therapy and Yifeizhike capsule for 6months,while control group received chemical therapy only.The two groups received the same chemotherapy. Results At the end of 6 months,the sputum conversion rate was 82.8%(116/140) in therapy group and 63.0%(87/138) in control group(P<0.01);focus absorption rate in the chext X-ray film was 88.6%(124/140) in therapy group and 71.0%(98/138) in control group(P<0.01);the cavity close rate 70.8%(68/96) in therapy group and 53.9%(49/91) in control group(P<0.05).There was no obvious side effect in the two groups. Conclusion The supplementary treatment effect of Yifeizhike capsule is effective in treating re-treatment TB patients as a supplementary treatment,meanwhile there is no obvious side effect.The drug can be considered to be used in clinical practice.

Expression and significance of heat shock protein 70 in pulmonary tuberculosis patients

Li Quan,Zhang Yanlin,Zhang Hewu.

. 2006, 28(6):  388-389. 

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ObjectiveTo determine the expression and significance of heat shock protein 70(HSP70) in pulmonary tuberculosis(TB) and explore the relationship between HSP70 with TB. Methods The method of sandwich ELISA was used to detect the expression of HSP70 in the blood plasma from 32 pulmonary TB patients which was compared with 25 stable pulmonary TB patients and 25 healthy controls. Results The expression of HSP70 in the blood plasma in active pulmonary TB patients,stable pulmonary TB patients and healthy controls was(7.5±1.3) ng/ml,(5.5±1.7)ng/ml and(5.3±0.8)ng/ml respectively.Active pulmonary TB patients had higher level of HSP70 expression in blood plasma compared with healthy controls and stable pulmonary TB patients(P<0.01).There was no significant difference between stable pulmonary TB patients and healthy controls(P>0.05). Conclusions There is over-expression of HSP70 in active pulmonary TB patients and it could be took as one of the diagnosis marks of active pulmonary TB.

Analysis of drug resistance of Mycobacterium tuberculosis in hospitalized tuberculosis cases from 1992 to 2004

Liu Xiang,Chen Hafeng,Lv Cuihuan,et al.

. 2006, 28(6):  390-392. 

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Objective To analyze the drug resistance of Mycobacterium tuberculosis in 1992,1996,2000 and 2004 respectively. Method Absolute concentration method was carried out for Mycobacterium drug sensitivity in 8 anti-tuberculosis drugs. Results The rate of drug resistance to all drugs were 59.6%,76.3%,70.5% and 50.8% respectively;the rate of initial resistance were 51.9%,79.9%,70.4% and 40.4% respectively;acquired resistance rate were 76.8%,67.5%,70.8% and 77.2%.The rate of drug resistance to INH,RFP and SM were higher than that to other drugs,the rate of drug resistance to SR,HR,SHR,SRE,SHRE combination were higher. Conclusion The Results show that the drug resistance of mycobacterium is rather serious in hospitalized patients,and more attention should be paid to management and treatment for the tuberculosis patients.

Results analysis on questionnaire about pulmonary tuberculosis for doctors in department of respiratory medicine in general hospitals

He Quanying,Tan Xingyu.

. 2006, 28(6):  393-394. 

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Objective To discover the knowledge level about the pulmonary tuberculosis of doctors in department of respiratory medicine in general hospitals in China. Methods Questionnaire survey was conducted among the respiratory doctors attending the national advanced course of new progress in respiratory medicine in 2005. Results Totally 165 valid answer sheets were received.The average score was 54.3,and the pass rate was 28.8%.The average score of 52 doctors from the hospitals of the third grade was 57.3±11.5,and the pass rate was 57.7%.The average score of 104 doctors from the hospitals of the second grade was 53.1±11.2,and the pass rate was 37.6%.The average score and the pass rate of the doctors from the hospitals of the third grade were higher than those from the hospitals of the second grade(P<0.05). The average score of 72 doctors whose positions are associate professors or above was 56.0±10.9,and their pass rate was 42.5%.The average score of the doctors with the positions lower than associate professor was 52.4±11.7,and their pass rate was 31.9%.There were no significant differences of the average score and the pass rate between the two groups(P>0.05). Conclusions The questionnaire survey showed that the respiratory doctors in general hospitals,especially those in the second grade gnernal hospitals did not have clinic and management knowledge about pulmonary tuberculosis.It was not fitting to the severe tuberculosis epidemic and the responsibility of the respiratory doctors in general hospitals in China.

The application of catheter dilatation in the serious bronchostenosis

Jing Qiusheng¹,Li Caiping,Xu Nianliang,et al.

. 2006, 28(6):  395-397. 

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Objective To investigate the value of the application of the catheter dilatation in the serious bronchuostenosis. Methods Fifteen cases of serious bronchostenosis were selected by branchofiberoscopy.The dilatation catheter used was produced by ENDO-FLEX Gmbh.Germany.The type was Fr.5/3.After catheter dilatation,stenosis bronchus was infused with isoniazid(100 mg),amikacin(100 mg),dexamethasone(2 mg).The changes of bronchial lumen and X-ray chest photography after every dilatation was dynamically observed with branchofiberoscopy. Results After catheter dilatation,douche and drug infusion,the temperature of 3 cases with high fever has come down.,2 cases with atelectasis was recovered,1 case with repeated hemoptysis was recovered.After 8 weeks,8 out of 15 cases still maintained the bronchial lumen diameter above Fr.5,the bronchial lumen of 6 cases was completely obturated.1 case repeatedly attacked.Pulmonary tuberculosis focus and obstructive infection focus were improved in 15 cases.The cavity was absorbed in 3 cases.Lab examinations showed that 12 cases were converted negative in both sputum smear examination and rapid culture.After 12 weeks,8 out of 15 cases still maintained the bronchial lumen diameter above Fr.5,the bronchial lumen of 7 cases was completely obturated.The cavity was absorbed in 5 cases.1 case did not change,1 case had atelectasis in the top left part of the lung. Conclusion Catheter dilatation could distend the diameter of stenosis bronchial lumen from less than 1mm to more than 3mm,eliminate the pus,pump out the pus from the deep lumen by means of catheter and branchofiberoscope,and infuse anti-tuberculosis drugs.It could alleviate the clinical symptoms and make more chance of dilatation with saccule.

A methodological research on the way to reduce the pollution in Mycobacterium culture

Wu Longzhang,Huang Jieling,Xie Minna,et al.

. 2006, 28(6):  398-400. 

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Objective To reduce the pollution in mycobacterium culture and increase mycobacterium detective rate. Methods Culture was made to the polluted specimens to determine the distribution of polluted microorganism species in a certain period,and predominant bacterial species were analysed.Accoding to different species of predominant bacterium,different predisposal ways(acid pretreated agent or increasing the concentration of sodium hydroxide) were employed to pretreat samples before mycobacterium culture.This methodological improvement was compared with normal predisposal methods. Results Pretreating sample with 5% sulfuric acid when it was predominantly polluted by gram negative intestinal bacterium or with high density sodium hydroxide when it was predominantly polluted by gram positive bacterium(including yeastlike bacterium) may decrease pollution risk from 6.5% to 2.4%. Conclusion Selectively applying predisposal Methods according to different species of predominant polluted microorganism in a certain period may effectively reduce mycobacterium mycobacterium culture.

The analysis of the change of T subset cells and adhesion molecules in the pleural effusion of the patients with tuberculous pleurisy

Yin Hongyun,Xiao Heping,Shi Xiang,et al.

. 2006, 28(6):  401-403. 

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ObjectiveTo retrospectively study the local pleural immune and inflammatory responses of patients with tuberculous pleurisy. Methods Collecting the samples of blood and pleural effusion from 35 cases with tuberculous pleurisy,we determined different T cells number marked CD3,CD4,CD8 and ICAM-1,2,3,VCAM-1 above samples through flow cytometer,and compared the rate of T subtypes in blood with pleural effusion. Results There was a significant increase at rate of T cells marked CD3,CD4 and CD4/CD8 in pleural effusion compared with it in blood,while there was a significant decrease of T cell marked CD8,and there were no differences at the rate of T cells marked ICAM-1,2,3,VCAM-1.There was no change at those rates of T subset cells in patients with different interval duration from start of symptom to admission checks. Conclusion CD4 cells were main immune responding T cells.There was no variation in T cell expressing adhesion molecules.

The different influence of BCG vaccination to the treatment effect of rats with tuberculosis and to the peripheral blood T lymphocyte subset at different period

Lei Jianping,Peng Yan,Xiong Guoliang,et al.

. 2006, 28(6):  404-407. 

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Objective To investigate the different influence of BCG vaccination to the antituberculosis treatment and to the peripheral blood T lymphocyte subset at different period. Methods 80 SD rats with PPD skin-test negative were randomly divided into 4 groups: group 1 started BCG at the same time that the treatment started,group 2 started BCG after the treatment started for 1 month,group 3 was the control group,group 4 was to judge the effect of the model.Every rat was injected a dose of 108 CFU mycobacterium tuberculosis(Mtb) at beginning of the observation.At the end of the(1st) month,the rats of the group 4 were killed to conduct pathological and tuberculosis bacterial examinations,while the rats of group 1,2 and 3 were given anti-tuberculosis chemotherapy.Group 1 was given BCG vaccination at the beginning of anti-tuberculosis chemotherapy,group 2 was given BCG vaccination after anti-tuberculosis chemotherapy stared for one month Mortality of each group was measured.CD3⁺,CD4⁺,CD8⁺ and DP T lymphocytes in peripheral blood of rats were measured at the beginning and the end of(1st)、(2nd)、(3rd) and(5th) month of experiment.Absolute value of peripheral blood lymphocyte of the rats in group 1,2 and 3 were examined at the(2nd) month and the(5th) month of experiment. Results (1) Within 1 month of the injection of Mtb,2 rats died in group 1,3 and 4 and 1 rat died in group 2.Mortality after 4-month of antituberculosis chemotherapy: group 1 was 22.2%(4/18) which was higher than that of group 2(0/19,P<0.05).Mortality of group 3 was 5.6%(1/18).(2) The value of CD4/CD8 decreased and the level of CD8⁺ cell increased(P<0.05 or(P<0.05 or p<0.01)..(3)In group1,the percentage of T cell(CD3⁺) and CD4⁺ decreased,while the lymphocyte absolute value and the percentage of CD8⁺,DP T cell increased((P<0.05 or P<0.01);after the treatment for 2 months,the level of CD3⁺,CD4⁺ T lymphocytes was at normal level while CD8⁺ and DP T cell were still maintained at high level.(4) In group 2,the level of CD8⁺ and DP T cell went up statistically significant,but the change of CD3⁺,CD4⁺ T lymphocytes was not statistically significant,P>0.05. Conclusion The sum of lymphocyte increased significantly while the percentage of T cell among the sum of lymphocyte decreased significantly is an important immunity character in the group that started BCG at the same time of antituberculosis chemotherapy and the mortality increased after the(1st) month.DP T cell is the protective immune relation cell against tuberculosis.Immunotherapy with BCG should start after q month of anti-tuberculosis chemotherapy.

The clinical value of measuring HBVDNA for pulmonary tuberculosis patients with HBVM positive

Xiong Guojiang,Xiong Guoliang,Xiong Hanpeng.

. 2006, 28(6):  408-410. 

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Objective To explore the liver injury due to the anti-TB treatment among the HBVDNA,HBVM positive TB. Methods Pulmonary tuberculosis patients with HBVM(Hepatitis B virus Marker) positive and HBVDNA positive were recruited in experimental group A,those with HBVM positive but HBVDNA negative were recruited in experimental group B,those with HBVM negative were recruited as control group C,The prevalence rate of liver injury and withdrawal of anti-tuberculosis drugs and the relationship between HBVDNA level and those rates were observed. Results The prevalent rate of liver injury was statistically different in any of the two groups(P<0.01);the rate of withdrawal of group A was higher than other two groups(P<0.01),while Group B and group C did not have the difference on the withdrawal(P>0.05);there were no relationship between HBVDNA level and the prevalent rates of liver injury and withdrawal(P>0.05) in group A. Conclusion Attention should be paid to the liver injury of the pulmonary tuberculosis with HBVM positive and HBVDNA Those with HBVDNA negative could been treated by short-course chemotherapy.Despite the HBVDNA level,those with HBVDNA positive should been careful treated by shortcourse chemotherapy.