Table of Content

10 March 2005, Volume 27 Issue 3

Previous Issue    Next Issue

Control in university students in Beijing:preventive therapy for tuberculosis-infected persons

Liu Yuqing¹,Tu Dehua, An Yansheng,et al.

. 2005, 27(3):  139-142. 

Abstract ( 1523 )   PDF (2537KB) ( 460 )   Save

References | Related Articles | Metrics

Objective To investigate efficacy of preventive chemotherapy treatment and management of administration for tuberculosis-infected students of university. Methods Members of Red Cross, doctors from hospital of university and district tuberculosis center were combined and shared out the work and help one another, including extensive health promotion PPD testing and management of preventive chemotherapy. Preventive chemotherapy was given to new students with over 15 mm PPD testing reactors based their consent. Placebo-controlled study was adopted and incidence rate was investigated during follow-up 4 years. Rifapentine and isoniazid intermittent regimen was selected twice weekly for 3 months, total 25 times. Results There were 3 713 students enrolled, 1948 and 1765 students of which were selected as treated and placebo groups respectively. Complete treatment rate was 90%. Side effects rate was 3.3% and stopping drug treatment rate 0.98%. There were 5 cases, 64.17/100,000 and 18 cases, 254.96/100,000 occurred in treated and placebo groups during 4 years follow-up respectively. It showed 74.8% protection against subsequent tuberculosis. Conclusion Previntive treatment with Rifapentine and Isoniazid twice weekly for 3 months is effectiveness, safety and feasibility in the students of university.

Analysis on the reasons of 31 pulmonary aspergillosis cases misdiagnosed as tuberculosis

Zhang Hongmei¹, Zhang Haiqing¹, Han Zhirong,et al.

. 2005, 27(3):  143-147. 

Abstract ( 1759 )   PDF (3316KB) ( 429 )   Save

References | Related Articles | Metrics

Objective To analyse the clinic characters and the misdiagnosis reasons of pulmonary aspergillosis patients. Methods An retrospective study was carried out in 31 cases that have been misdiagnosed as tuberculosis(TB) and finally diagnosed aspergillosis by operation. Result There were 20 male patients and 11 female patients, whose age from 17 to 55 years old and average age was 35.8.The duration of illness from 6 months to 20 years, mean duration was 36.8 months. The cardinal symptoms were cough and sputum accounting for 90.3% and haemoptysis accounting for 93.5%. Analysing the images, there were 12 cases with ball or node in X-ray and all were single. There were 17 cases with differently sheet and streaky shadow in X-ray, there were 2 cases with one lung destroyed, there were 18 cases with "new moon"signs accounting for 58%. The pathological changes usually locates in the upper and under lobar and single lung, which are the frequently place that TB happened (accounting for 77%). The sputum test of all cases were negative, by giving normally therapy of anti-TB and anti-inflammation, and the state of illness of all cases were unconspicuous after therapy, including 6 cases that treated with antigungal before operation. Conclusion The misdiagnosis reasons were that the clinic and X-ray exhibitions of TB were similar to that of aspergillosis. The positive of sputum test for aspergillosi was low. With the effect of old TB history, if the state of illness were changed, it easily mistook as TB recurred. If the patient whose chest X-ray has "new noon"signs has repeated cough and sputum and the effect of antituberculosis is not good, we should think of aspergillosi and operated in time on these patients.

Analysis on TB control effects in Wuchang Prison from 1997-2003

Chen Liping , Su Wen, Hu Yongfeng, et al.

. 2005, 27(3):  148-150. 

Abstract ( 1291 )   PDF (1854KB) ( 384 )   Save

References | Related Articles | Metrics

Objective To engage the work of TB control in prison into the overall TB control programme and reduce the local TB epidemic burden. Methods The cohort Results were analysed of 523 TB cases detected in the prisoners from1997-2003. Their treatment were under DOTS. Results During 7 years, the cure rate of new smear?positive cases was 93.3% and 85.7% of retreatment cases in average. Prevalence of smear?positive in prison reduced from 1146.95/100,000 in 1997 to 497.37/100,000 in 2003.Conclusion The achievements of active case finding and implementation DOT in Wuchang Prison of Hubei Province for 7 years were remarkable.

The impact of air-conditions on transmission of M tuberculosis in hospital

Pan Zhifen¹, Yu Shouchang ,Zhang Ruying,et al.

. 2005, 27(3):  151-153. 

Abstract ( 1248 )   PDF (1988KB) ( 385 )   Save

References | Related Articles | Metrics

Objective To explore the impact of air-conditions on transmission of M tuberculosis in hospital. Methods The air-samples in the areas with central air-condition, and independent air-condition and no air-condition were collected and incubated in the Lowenstein-Jensen culture medium separately.The air-samples have been cultivated in 36.5℃ for 28 days.Primary distinguish is devised on the shape of the colony on the Lowenstein-Jensen culture medium and the characteristic of the antacid dyeing means. Finally the M tuberculosis was confirmed by a series of the biochemistry tests. Results The detection rate of M.tuberculosis was 31.1% in the area with central air-condition and 15.6% in the area with independent air-condition and 4.4% in the area without air-condition. There were significant differences of the Results in three areas. Conclusion The air-conditions especially the central air-conditions had definite effect on the transmission of M tuberculosis in hospital, and it should be paid necessary attentions.

The clinical analysis on 54 cases of cavitary pulmonary tuberculosis of initial treatment

Zou Fangchun .

. 2005, 27(3):  154-155. 

Abstract ( 1271 )   PDF (1419KB) ( 329 )   Save

References | Related Articles | Metrics

Objective To explore the clinical features of pulmonary tuberculosis cavities of initial treatment. Methods Fifty-four cases of pulmonary tuberculosis cavities were analyzed retrospectively. Results Among the 54 patients , 49 cases with fever (90.7%), 50 cases with cough (92.6%), 32 cases with weakness and night sweat (59%) , 40 cases with blood count rising (74%), 17 cases (74.1%) were sputum smear positive. The X-ray film showed in 46 cases (85%) with thin-walled ,caseous cavity. Forty cases with lesions over 3 lung fields (74.1%) .At the end of 6 months, cavity curative effect rates were 77.8%(28/36) and 44.4%(8/18) in the patients with the course of diseases of 10～30 d and 30～60 d respectively. Conclusion Major cavitary pulmonary tuberculosis patients of initial treatment had typical clinical appearance. Single, thin-walled,caseous cavity and multiple lung fields involved were common in chest X-ray. Early treatment was of benefit to the closing of cavities.

Analysis on referring TB suspects from health institutions to TB dispensaries

Tang Aiqun , Tang Weiguo ,Yang Yinzhou ,et al.

. 2005, 27(3):  156-159. 

Abstract ( 1167 )   PDF (2494KB) ( 542 )   Save

References | Related Articles | Metrics

Objective To analyze situation of referring TB suspects from health institutions to TB dispensaries and explore the measures for strengthening referring system. Method The data was coming from registers, forms, cards, referring registers and sheets, and monitoring reports to health institutions at different levels in Shenzhen Luohu Distric during 1995-2001. Results The average successful referring rate of tuberculosis suspects was 89.4% during the seven years. The registration rate of smear positive patients was raised from 14.3/100,000 to 30.7/ 100,000 since 1995. 2132 of 5941 referred cases were confirmed as active TB, 83.7% of smear positive cases detected in TB dispensary were referred from health facilities. Conclusion The health facilities, especially hospitals, are importance sources where tuberculosis cases are detected. Case-finding could be improved through strengthening referring system.

Mid-term evaluation on implementation of Ningbo TB Control Programme

Yi Bo, Yang Weina, Zhao Minjie, et al.

. 2005, 27(3):  159-161. 

Abstract ( 1102 )   PDF (1957KB) ( 783 )   Save

References | Related Articles | Metrics

Objective To evaluate the mid-term implementation Results of Ningbo TB Control Programme(2002-2006).Methods To summarize and analyze the implementation data from 2002 to 2004. Results During 2002-2004, (11330) TB suspects made clinical consultation to TB dispensaries.(7909) active TB cases have been detected .The notification rate of positive TB cases was raised from 21.39/10,000 in 2002 to 29.25/10,000 in 2004 . The cure rate of new positive cases reached 90.9%. Conclusion Ningbo gets a satisfactory result in TB control project. But it were uneven between counties and districts. The National Tuberculosis Control Programme should be implemented through strengthening approaches with high quality.

Lung cancer complicated by tuberculosis: a clinical analysis of 54 cases

Chen Zidan, Xiao Heping, Shi Hongzhang , et al.

. 2005, 27(3):  162-164. 

Abstract ( 1338 )   PDF (2052KB) ( 755 )   Save

References | Related Articles | Metrics

Objective To study on clinical diagnosis and treatment of lung cancer complicated by tuberculosis and the relationship of two diseases. Method A total of 54 patients with lung cancer complicated by tuberculosis were analysed retrospectively. Results All the patients’ histopathology types were squarmous cell carcinoma(18), adenoarcinoma(23), adenosquamous carcinoma(3),SCLC(2), unclassified carcinoma(7). Disease stage wasⅠa(2),Ⅰb(1),Ⅱb(6),Ⅲa(10),Ⅲb(10),Ⅳ(21).The type of tuberculosis wasⅠ(1), Ⅲ(43).Seven patients were missed diagnosed carcinoma. Four patients were missed diagnosed tuberculosis. The coexistence of two diseases in the same lobe was 78.1%.Conclusion Lung cancer complicated by tuberculosis is missed diagnosis or misdiagnosis easily. Doctors should pay more attention to it. Its prognosis is very bad . If the two diseases could be treated at the same time, the patients would survival longer. Carcinoma lesion and tuberculosis lesion have tight relationship.

The surgical treatment of 47 pulmonary tuberculosis patients with aspergrilloma

Zhang Aiping,Xu Jianrong,He Zhijian,et,al.

. 2005, 27(3):  165-167. 

Abstract ( 1365 )   PDF (1902KB) ( 460 )   Save

References | Related Articles | Metrics

Object To probe into the relation,diagnosis and treatment of the pulmonary aspergilloma and tuberculosis. Method The data of surgical treatment of 47 pulmonary tuberculosis patients with aspergrilloma were analysed retrospectly. Results 31cases(65.1%) were male patients; 28 cases with more than 5 years histories; 41 cases(87.2% )with serious hemoptysis. Among 47 pulmonary tuberculosis patients with aspergrilloma, 32 cases (68.1%) had confirmed diagnosis before operation. The rate of missed diagnosis is 31.8%. 45 cases( 95.7%)were cured. Two cases(4.2%) died.10 cases have complication of chest infection, pneumonia, bronchi and pleura fistula, pulmonary atelectama, bronchial asthma, respiratory failure, hemorrhagic shock. ConclusionThe pulmonary aspergilloma occurs in the patients with tuberculosis cavitation. The patients still had repeatedly hemoptysis after regular anti-tuberculosis treatment. The rate of missed diagnosis is high. Operation is the best and effective treatment.

Primary pulmonary TB misdiagnosed as pneumonia in children:a report of 33 cases

Zhang Yang.

. 2005, 27(3):  168-171. 

Abstract ( 1476 )   PDF (2526KB) ( 91079 )   Save

References | Related Articles | Metrics

Objective To study misdiagnosed causes of primary TB to pneumonia.Method To analyze the clinical features,the films of chest X-ray,the reaction of tuberculin test in 33 cases,and find the differences between pneumonia and primary TB. Results General tuberculous intoxication symptoms such as subfebrile temperature, sweating ,indigestion, emaciation occurred in the cases. There were no high fever,shaking chills,tachypnea and three depression sign of pneumonia. Chest X-ray showed consolidation in lobar and segmental distribution. But see though the consolidation to get at the X-ray sign of primary TB in 21 cases. The positive result of tuberculin test supported the diagnosis of TB. Conclusion The misdiagnosis was happened, because the different clinical features were as neglected, the signs of chest-ray on primary TB was neglected, the tuberculin testing was not performed.

Short-term and long-term treatment effects of new smear positive tuberculosis cases in Changping District in Beijing

Zhao Fujun, Gao Tiejie.

. 2005, 27(3):  171-173. 

Abstract ( 1201 )   PDF (2060KB) ( 490 )   Save

References | Related Articles | Metrics

Objective To observe the short?term and long?term effects of smear positive pulmonary tuberculosis patients with short?course chemotherapy. Method The 6 months, 1 year, 2 years and 10 years effects of 155 patients in Changping District from 1992 to 1994 were analyzed retrospectively. Results By the end of the treatment, the sputum negative conversion rate and the radiographic improvement rate were 96.8% and 97.0% respectively the follow?up radiograph Results within one year, within two years and within ten years were 97%, 99% and 100% respectively the relapse rate (sputum and radiography) is 0. Conclusion The short?course chemotherapy regimen including SHRZ or HRE is high effective,safe, with low relapse rate and less adverse reaction for new smear positive tuberculosis patients.

Study on increasing the case-detection of pulmonary tuberculosis patients by utilizing the information from internet-based communicable diseases reporting system

Miao ziping,Li Qun,Yang Shibo,et al.

. 2005, 27(3):  174-177. 

Abstract ( 1163 )   PDF (2664KB) ( 357 )   Save

References | Related Articles | Metrics

Objective To explore the possible approaches of increasing case-detection of pulmonary tuberculosis patients. Methods TB data from internet-based communicable diseases reporting system and TB dispensaries was analysed in Zhejiang Province. Results The reported incidence rate from communicable diseases reporting system was higher than that of TB dispensaries, and the reported incidence rate of new smear-positive was lower than the rate in TB dispensaries , the difference was statistically significant (P＜0.01). 63.8% of patients registered and managed in TB dispensaries came from non-TB dispensaries. The proportion of referred cases and suspect cases from hospital reaching the dispensaries was 78.8%. Conclusion The process to overcome the constraints of referring TB cases from hospitals to TB dispensaries could be accelerated by utilizing the information of internet-based communicable diseases reporting system, it is possible to increase case-detection and cure rates further.

Analysis on the epidemic characteristic of tuberculosis relapsed after short-course chemotherapy

Gao Sanyou , Du Changmei , Ma Liping, et al.

. 2005, 27(3):  178-181. 

Abstract ( 1463 )   PDF (2922KB) ( 697 )   Save

References | Related Articles | Metrics

Objective To reveal the epidemiology characteristic and the risk factors in the relapse tuberculosis cases after received short-course chemotherapy. Method To follow-up the cured cases in tuberculosis control project supported by Henan provincial government and to identify the relapse cases within three years. Results The relapse rate with sputum positive tuberculosis in Henan tuberculosis control project was 3.12%, and the relapse rate in cases whose sputum smear converted negative in two months, three months and over three months with chemotherapy were 2.13%, 4.23% and 8.85% respectively (P＜0.01). There was no significant difference among the cases with the quantity eliminated sputum tubercle bacillus. Conclusion It was a risk factor to recur that the time converted negative for tubercle bacillus in sputum of tuberculosis with chemotherapy. The longer time converted sputum smear negative, the higher relapsed rate. But there was no significant difference between male and female. There was no effect-reaction relationship in tubercular bacillus quantity eliminated by tuberculosis case in sputum. It was reasonable and feasible that the cases were followed up for one year after cured with finishing full course chemotherapy . The poverty and elder TB patients with cavity was high risk population to relapse, so it must be stressed to follow up them.

Analysis on registration and management of student cases with tuberculosis in Guangzhou City from 1993 to 2002

Zhou Lin,Chen Qiceng,Li Huifen ,et al.

. 2005, 27(3):  182-185. 

Abstract ( 1188 )   PDF (2376KB) ( 487 )   Save

References | Related Articles | Metrics

Objective To investigate the situation on management and therapy for patients with tuberculosis(TB) among students Guangzhou City. Method TB cases among students registered in Guangzhou Chest Hospital from 1993 to 2002 were collected and analyzed. Results The TB cases among students were 1764, of which students from colleges, middle school and primary school were 777 831 and 156 respectively. The detected manners for the diseases were clinical consultation and healthy examination. Most of them had TB suspicious symptoms such as cough. Majorities of student cases were first treatment (1694,96.0%). The student cases from colleges and middle schools were usually diagnosed as type Ⅲ of the diseases, and those from primitive school were type I of the diseases. The management manners for treating them included DOTS in full course (38.9%), therapy in hospital (15.6%), full-course management (11.6%), self-administrative treatment(0.5%). The overall cure rate was 93.5%. Conclusion It is important that to implement different health promotion strategy for different kind of student patients with TB and provide appropriate therapy managements according to their different diseased features.

Analysis on approaches of diagnosis and treatment of cathether intervention of 246 cases of endobronchial tuberculosis

Shen Jianen ,Gao Chunrong,Zhang Yena, et al.

. 2005, 27(3):  186-188. 

Abstract ( 1282 )   PDF (1918KB) ( 461 )   Save

References | Related Articles | Metrics

Objective To explore the clinical features, approaches of endobronchial tuberculosis at early stage and the effects of cathether intervention treatmemt. Method Clinical symptoms,chest X-ray/CT scans and fiberoptic bronchoscopic(FB) findings and effects of cathether intervention of 246 cases with endobronchial tuberculosis were analyzed.Results Main symptoms were as follows:183 had cough,92 had expectoration with sputum,59 had light fever afternoon,78 had night sweat,84 had asthenia,67 had breathlessness,23 had blood-stained sputum.Chest X-ray and CT demonstrated:96 cases showed the bronchus narrowing,31 cases showed obstructive pneumonia,55 cases showed atelectasis,38 cases showed pulmonary cavity.Sputum smear and culture positive rate was 43.5% and 35.3% respectively. The culture positive rate of bronchial washings was 56.5%. Pathological confirmed TB in bronchoscopic biopsy specimens was 58.4%. Bronchoscpic Results showed exduative lesions in 42.2% of the cases,granulomatous in 10.2%,ulcerative lesions in 18.7% and cicatricial lesions in 17.1%. The sputum conversion rate at the end of 2, 6 months was 90.6% and 100% respectively. Conclusion We should provide chest X-ray and CT examinations for the suspects who have clinical manifestation as described above.Bronchoscopic was done when the patients were suspected. If there is no positive pathological and bacteriological results, anti-tuberculosis treatment could be done for testing the response and further diagnosis. Catheter intervention is reliable and safe method in the treatment of endomembrane pulmonary tuberculosis.