Table of Content

10 June 2005, Volume 27 Issue 6

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Investigation of the membrane permeability of Mycobacterium abscessus

Sha Wei¹,Weng Xinhua,Xiao Heping,et al.

. 2005, 27(6):  353-357. 

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Objective To study the membrane permeability of Mycobacterium abscessus. Methods（0.05%） Tween-80 was added to the liquid culture which contains RFP of 1/5 MIC concentration to increase the cell membrane permeability.The growth of Mycobacterium abscessus strains that had different MIC to RFP were evaluated by measuring the optical density（OD） of the growing culture at 450nm.The ultrastucture of cell wall was oberseved by electron microscopy. Results OD₄₅₀ of Mycobacterium abscessus clinical drug-resistant strains in the culture that contained both RFP and Tween-80 was significantly smaller than that in the culture contain RFP only（P<0.05）.While for clinical drug-sensitive strain and Mycobacterium tuberculosis drug-resistant strain,there is no significant difference between the OD₄₅₀ in this two kinds of culture.There seem to be a thin layer of deep-dyed structure in the cell wall of resistant strains,while the cell wall was more homogeneous in susceptible strain. Conclusions Mycobacterium abscessus has lower cell membrane permeability.These Results can partly explain the reason of Mycobacterium abscessus resistant to RFP.

Observation on curative effect of positive bacteria pulmonary tuberculosis treated with chemotherapy and vaccae

Li Yuelong,Jiao Qing hui,Men Wenruo,et al.

. 2005, 27(6):  358-359. 

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Objective To evaluate the clinical curative effect of bacteriological positive pulmonary tuberculosis. Methods 169 primary and 90 re-treated bacteriological positive pulmonary tuberculosis cases were divided into groups A,B,C and D randomy.Group A(85 cases) and group B(84 cases) were treated with 2HRZS(E)/4HR;Group C(45 Cases) and group D(45 cases) were treated with 3HRZA(E)/6HR.Vaccae was added in Group A and Group C.Then observe the foci absorption and the sputum negative conversion. Results At the end of 3 months of treatment,the sputum negative conversion rate of groups A,B,C and D was 80.0%,65.5%,71.1% and 62.2% respectively.At the end of treatment,the sputum negative conversion rate of groups A,B,C and D was 97.6%,84.5%,95.6%and 77.8%;the foci absorption rate to groups A、B、C、D Was separately 90.6%,75.0%,82.2%and 60.0% respectively;Cavity close up rate was 85.9%,64.3%,77.8% and 57.7% respectively. Conclusion Vaccae can improve the sputum negative conversion rate,accelerate the foci absorption and improve the vitality of immune cells.It is a good immunity injection to be recommended for expansion usage.

Study on the reasons of the smear positive result at the end of 2th months of treatment of new smear positive pulmonary tuberculosis patients in Guangzhou

Liu Guobiao,Zhang Lihao,He Xia,et al.

. 2005, 27(6):  360-363. 

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Objective To study on the reasons of the smear positive result at the end of 2th months of treatment of new smear positive pulmonary tuberculosis patients of Tuberculosis Control Project in Guangzhou,and to provide the reference evidences for improvement of treatment. Methods 231 new smear positive pulmonary tuberculosis patients in the initial stage of the project,were divided into smear negative groups and smear positive groups according to the Results of sputum test at the end of 2th months of treatment,and the clinical data of the two groups had been analysed retrospectively. Results By univariate analysis,patient delay,focus scope≥2 pulmonary field,with cavities in lungs,with diabetes,sputum smear≥2+ were significantly different between the negative and the positive groups(P<0.001,Logistic regression analysis showed that factors significantly contributed to the smear positive at the end of 2nd months of treatment were patient delay,with cavities in lungs,with diabetes. Conclusion The health education need to be enhanced on tuberculosis control,and it is important to pay great attention to the patients with cavities in lungs,or with the diabetes.

Study on the clinical diagnosis treatment of untypical tuberculosis meningitis

Yan Shiming,Han Lijun,Li Jin,et al.

. 2005, 27(6):  364-366. 

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Objective To study the clinical diagnosis and treatment of untypical tuberculosis meningitis(TBM). Method To analysis the clinical characteristics and the diagnosis basis on the 68 untypical TBM casesrespectively.3HS(E)RZ/9HRZ treatment regimen were adapted,DXM were used as well as to lower the head pressure. Results Sixty-eight cases were divided into two categories.Among them,67 cases are alive,one died,and no sequel left.Furthermore,64 cases have been followed up for over 2 years. Conclusions Diagnosis of untypical TBM can be based on the basis of following manifestations:(1)Manifestations of active pulmonary tuberculosis.(2)Changes of untypical cerebrospinal fluid(CSF) or/and manifestations of untypical TBM.(3)The experiment antituberculotic therapy is effect.(4)Non-TBM diseases can be excepted.(5)PPD antibody in CSF is positive,ADA in CSF is high.(6)Images of head CT and MRI accord with TB changes.(7)Tuberculotical mycobacterium can be found in CSF.If there are 3 items in the anterior 6 or possesses the 7th items alone,the untypical TBM can be determined,and to adapt HS(E)RZ that four drugs are union as a twelve month chemical therapy will be safe and effective.

Clinical value of tuberculosis protein chip in diagnosis of pulmonary tuberculosis

Guo Guangyun,Chen Gong,Guo lingyun,et al.

. 2005, 27(6):  367-369. 

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Objective To study the diagnostic value of tuberculosis protein chip,acid-fast smear and tuberculin purified protein derivative(PPD) in pulmonary tuberculosis. Methods 45 patients with active pulmonary tuberculosis,30 patients with respiratory system diseases other than tuberculosis as control were tested by tuberculosis protein chips,acid-fast smear and PPD,respectively.The Results were compared with each other. Results The examination sensitivitives of tuberculosis protein chip,PPD and acid-fast smear were 66.7%,44.4%,22.2% respectively,and the specificity was 93.3%,84.6%,100 %.The detection rate of combined method was obviously higher than that of the single test,and the positive rates increased by 88.9%.But he specificity remain 80%. Conclusion Tuberculosis protein chip may be used To test Mycobacterium tuberculosis quickly and accurately.The combination had an increased detection rate in detecting pulmonary tuberculosis and remain a higher specificity.

Research on treatment efficacy of the patients with drug resistance in the project for drug resistance surveillance in Guangdong and Zhejiang provinces

Wang Sumin,Wang Xuejing,Zhao Xinping,et al.

. 2005, 27(6):  370-373. 

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Objective To probe into the drug resistance situation in the initial and acquired drug resistance PTB(pulmonary tuberculosis),and therapeutic efficacy on their complement of standard short course chemotherpy.To provide the reference to supervision and treatment for them. Method The objeets of this study were TB cases who have been taken in the project for drug resistance surveillance and completed the full course of treatment in Guangdong and Zhejiang provinces.The proportion method for drug susceptibility was used in this study.The drug resistance condition and treatment effection of the 225 patients who have completed the standard short-course chemotherapy were analysed. Results Of the 149 initials drug resistance patients,87 were single drug resistance patients,and 62 were multi-drug resistance patients.Of the 76 acquired drug resistance patients,38 were single drug resistance patients,and 38 were multi-drug resistance patients.The cure rate of initials single drug resistance patients was 94.3%;The cure rate of multi-drug resistance patients was 88.7%;The cure rate of single-drug resistance and multi-drug resistance for the acquired patients were 92.1% and 63.2% respectively. Conclusion The result shows that the short course chemotherapy could achieve good Results for single drug resistance patients.But it is not satisfied for multi-drug resistance patients,especially for the acquired ones.The treatment outcome should be evaluated with chest X-Ray,tubercle bacillus culture,and so on.The national PTB drug-resistance baseline survey should be organized all around the country,and the mechanism of drug-resistance TB should be paid more attentions,especially the treatment regiment of the multi-drug resistance PTB.

Analysis on the correlated factors of delay in tuberculosis diagnosis and treatment in Fujian province

Chen Qiuyang,Zheng Jinfeng,Wu Nengjian.

. 2005, 27(6):  374-379. 

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Objective To provide the scientific basis to improve case detection rate through evaluation on the correlated factors of delay in tuberculosis diagnosis and treatment with tuberculosis social assessment. Methods Quantitative and qualitative combined analysis in three counties were adopted.Cases,suspects and community residents were investigated. Results 26.4% of cases delayed to diagnosis in these counties.The major reasons were,54.4% of cases realized it is light of their situation,33.3%of cases were poor.Agedness and without knowledge of tuberculosis control institute and the policies of free diagnosis and treatment were the main factors.59.9% of cases delayed to be confirmed tuberculosis.Too many times for diagnosis before firm diagnosis was main factor.96.3% of cases were firm diagnosed took treatment within one week. Conclusions in order to reduce delay in tuberculosis diagnosis and treatment it is essential to strengthen health education in county to improve its cover rate,train the doctors on tuberculosis technique in village level,and pay attention to elcler and women.

The analysis on secondaryfungal infection of pulmonary tuberculosis cases

Guo Xinmei,Rong Xuedong,Ma Xiuli,et al.

. 2005, 27(6):  380-382. 

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Objective To study the risk factors,clinical character and means of diagnosis and treatment of secondary fungal infection of pulmonary tuberculosis cases. Method The information of 74 cases of fungi infection confirmed by culture and identification in 5 hospitals,Shandong province from January 2002 to September 2004 were collected and analysed. Results The distribution of fungi in 74 cases were Candida albicans(70.3%),Glabrata(12.2%),、C.tropicalis(6.8%)and candida krusei (4.1 %).Drug resistance rates of Amphotericin B,Fluorocytosine,Fluconazole,Itraconazole,Ketoconazole were mensurated by ROSCO paper disk diffusion.The antifungal susceptibility to Candida albicails was better and the resistance rates of candida krusei was higher. Conclusion It is common that fungal infection occurredin pulmonary tubetchlosis cases.Standardized application of antibiotic and hormone should be strengthened to reduce the rate of fungal infection and their resistance rates,which will be contribute to tuberculosis control and reduce death rate.

Clinical analysis of pathogenic bacteria from 82 cases with severe pulmonary tuberculosis complicated with lower respiratory tract infection

Deng Guofang,Liu Yang,Sun Lizhen.

. 2005, 27(6):  383-385. 

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Objective To investigate the characteristics of the distribution and drugresistance of pathogenic bacteria in lower respiratory tract of severe pulmonary tuberculosis cases. Method The positive culture from protected specimen brush viabranchofibroscope from 82 cases with severe pulmonary tuberculosis were perfomed for gemspecies identification and drug sensitivity test in vitro. Results Total 98 pathogenicbacteria strains were found in PSB bacterial culture of 82 patients.There were 55 strainsof Gram-negative bacilli(56.1%);20 strains(20.4%) were Gram-positive Cocci;23 strains(23.5%) were fungi. Conclusion The primary pathogenic bacteria were Gram-negative bacilliin lower respiratory tract of the patients with severe pulmonary tuberculosis,and the fungi infection was distinctly rising.It might be related to immunod eficiency,antibiotic abuseand reasonless antituberculosis treatment.

Investigation on the awareness of tuberculosis in Zhejiang province

Liu Beidou,Li Qun,Xu Xuqing,et al.

. 2005, 27(6):  385-388. 

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Objective To determine the current of awareness on tuberculosis(TB) among varying groups in Zhejiang province. Method Eleven cities and 17 countries were seleded with multistage cluster random sampling There were 28 sites totally in Zhejiang.Investigative clusters in each site were selected subsequently.A question survey was made among these groups. Results 1740 people were enrolled from 28 Sites.The percentage of male and female was 51.3%、48.7% respectively.TB awareness was lower in those below 15-year-old and over 55-year-old.Statistics showed that the sources of TB knowledge were significantly different among varying groups.The awareness rate on TB symptomatic with cough and expectoration and/or haemoptysis,clinical consultation to a TB institute once the people have TB symptoms,regular drug taking is the key of cure 86.5%、77.8% and 94.8% respectively.The overall awareness rate of all three above were 67.0%.The awareness was higher in those cities than that of people in the villages(P<0.05) Conclusion There were gaps to achieve the target of national tuberculosis programme in Zhejiang,even TB healthe education project gained great progress.it is very important to strengthen TB health promotion further.

The observation of the effect of the treatment of multi?drug resistant pulmonary tuberculosis with M Vaccae

Yao Hengbo,Shang Haozhen,Guo Lei,et al.

. 2005, 27(6):  389-392. 

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Objective To evaluate the assistant value of Vaccae on treatment of multi-durg resistance pulmonary tuberculosis. Method Sixty cases with multi-durg resistance pulmonary tuberculosis were divided randomly into the treatment group and the control group.The cases in 2 groups were treated by the same chemotherapy regimen with 3PaL₂AkZThV/15PaL₂ZThV.in the same time.The treatment group cases were injected vaccae （22.5μg） every 15-day in the first three month,then observe the change of the market absorption,sputum conversion,symptom improvement,immune function in the two groups after the treatment. Results There was significant difference on the rates of sputum smear negative conversion.In the two groups,they were 56.6% and 26.6% at the end of 3 months,93.3% and 73.3%at the end of 18 months respectively,there were obvious difference of CD4,CD4/CD8 focus absorption and closure rates of cavities at the end of 9 months between the treatment group and control group. Conclusion Vaccae is helpful to the immune function,sputum negative conversion and the absorption of focus,it has a adjustment treatment of multi-drug cases.

The clinical analysis on 53 cases with intracranial tuberculoma

Kong Zhongshun,Bu Jianling,Du Yadong,et al.

. 2005, 27(6):  393-395. 

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Objective To investigate the clinical features of intracranial tuberculoma and its therapeutic effect of antituberculosis drugs. Method A total of 53 cases with intracranial tuberculoma were reviewed.All of them were received 18～24 months anti-tuberculosis chemotherapy and followed-up for 6 to 24 months after of treatment completion. Results MRI in detection of intracranial tuberculomas was superior to CT.The misdiagnostic rate was 77.4%,the death rate was 5.7% and the cure rate 84.9% in 53 cases.None of them relapsed during follow up. Conclusion The intracranial tuberculoma should be recognized at the early stage.The therapeutic Results and its prognosis are excellent when anti-tuberculosis chemotherapy is given in the early phase of disease.

Analysis on treatment outcomes for smear-positive pulmonary tuberculosis of immigrants in Wenzhou

Zhao Xiaochun,Yu Xiaohua.

. 2005, 27(6):  396-398. 

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Objective To evaluate the effect of tuberculosis control of the floating population from other place in Wenzhou city and to provide the scientific evidence for policy makers of tuberculosis control program. Method To provide free diagnosis and treatment for pulmonary tuberculous patients of the floating population from outside of wenzhou.And carry out the DOTS management for the patients. Results There were 208 smear-positive pulmonary tuberculosis cases registered.The cure rate of initial treatment cases with smear-positive was 85.0% and the rate of re-treatment cases with smear-positive was 75.0%.the treatment outcome was close to the outcome of the patient of the residents,which was about 85.6%,and was apparently higher than the average cure rate of the floating population,which was only 61.5% in Zhejiang province.The treatment was proved to be as effective as that of the patient of the resident. Conclusion With strengthened efforts on management of tuberculosis cases of the floating population from other place,treatment outcome could be achieved quite effective.DOTS strategy was expanded in Wenzhou city gradually.