Table of Content

10 January 2004, Volume 26 Issue 1

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Clinical trial on the treatment effects of four Fluoroquinolones for retreating multi-drug-resistant pulmonary tuberculosis

Nie Yusheng,Liang Ruiwu,Wen Dongmei,et al.

. 2004, 26(1):  5-9. 

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Objective To compare and evaluate the clinical application value of four fluoroquinolones: Ciprofloxacin（C）, Ofloxacin（O）, Levofloxacin（V）, and Sparfloxacin（S_P）.Methods 168 retreatment multi-drug-resistant pulmonary tuberculosis cases that confirmed bacterilogically were divided into four research groups and one control group randomly.The regimen of the control group was 3HRZEAK/5HL₂ZE/4HL₁E, while C,O,V AND S_P was added to the regimen used in the control group four research groups respectively in the first eight months. The Results of bacteriological examination,X-ray examination and side effects of the drugs were collected and compared at the end of full treatment courses and two years’follow-up.Results The sputum negative conversion rates at the end of full treatment course used C, O, V and S_P were respectively 70.0%, 73.3%, 80.7% and 93.5%.It was 40.0% in the control group. Effect rates of X-ray-examined focus turned out were 86.6%, 86.6%, 90.8% and 90.3%.It was in the control group. Closure rates of cavities were respectively 53.3%, 58.8%, 85.7% and 70.6%, compared to 18.8% of the control group. There were statistical differences on the above 3 indicators of the research groups and the control group （ P <0.01）. Among the research groups the sputum negative conversion rate of bacteria rate of group O was similar to that of group C （ P > 0.05 ）. Group V resembled group S_P （ P >0.05 ）. Group V and group SP dwarfed group C and group O respectively （ P <0.05 ）. There were no significant difference on the effect rates of X-ray examined focus or closure rates of cavities in the research groups （ P >0.05 ）. No adverse reactions were reported during the treatment course. Recurrence rate of sputum bacteria of the five groups after two years’follow-up was 5.0%, 5.0%, 4.0%, and 3.8% respectively and it was 35.7% in the control group. There were significant differences of these indicators of the research groups and the control group （ P <0.05）. There were 1 case in each of the four research groups and 5 cases in the control group whose X-ray focus deteriorated and 6 cases in the control group whose cavities deteriorated. There were significant differences of X-ray Results of all the reaearch groups and the control group （ P <0.05 ）.Conclusion Ciprofloxacin, ofloxacin, levofloxacin and sparfloxacin were respectively added retreatment multi-drug-resistant pulmonary tuberculosis cases and were observered that patients’ the sputum negative conversion rates were increased and recurrent rates were reduced.The Results showed that those drugs were safe and reliable for curing pulmonary tuberculosis cases. Levofloxacin or sparfloxacin is preferable to ciprofloxacin or ofloxacin.

Establishment and evaluation of the prediction model for tuberculosis epidemic trend

He Xiaoxin,Jin Shuigao,Zhang Lixing,et al.

. 2004, 26(1):  10-15. 

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Objective To establish the tuberculosis epidemic situation prediction model.Methods Aiming at the limitations of Aruma tuberculosis model,the tuberculosis epidemiology in china had been translated into a model including series of equations. The evolution of tuberculosis epidemic situation for 1979-2000 in Beijing had been simulated with the new established model.And the simulated data was compared with the actual data.Goodness-of-model fitting has been evaluated.Results The simulated data numbers of registered active tuberculosis patients number, registered sputum positive tuberculosis patients, tuberculous infection rate, and the tuberculosis prevalence from national tuberculosis sampling epidemiological survey were fitted with the acual datas. The Results of sensitivity analysis of the key factors in model indicated that only the proportion of tuberculosis patients managed by the Tuberculosis Control Stations elevated, then the DOTS strategy could affect the epidemic situation significantly.Conclusion The tuberculosis epidemic situation prediction model could reflect the actual tuberculosis evolution exactly, and was fit for tuberculosis control measures evaluation and epidemic situation prediction.

Analysis of Relevance of Pulmonary Tuberculosis to HLA-DR Gene haplotype among Han Nationality of Southern Chinese

Liu Zhihui,Luo Yilu,Tan Yaoju,et al.

. 2004, 26(1):  16-20. 

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Objective To study possible role of HLA-DR gene haplotype in incidence of pulmonary tuberculosis among Han nationality of southern Chinese.Methods Case-control study was implemented and haplotype frequencies(HF) of DR53-DRB1、DR52-DRB1 and DR51-DRB1 were compared and relative risks (RR)were calculated by using PCR-SSP to detect 23 alleles of HLA-DR gene sites of 110 tuberculosis cases and 101 controls who come from Guangdong, Guangxi, Hunan, Hubei,Jiangxi and Fujian.Results Frequency of DR16-DR52 haplotype in pulmonary tuberculosis cases is strikingly higher than that in controls (0.01< P <0.05) and its RR is 3.10.Frequencies of DR1-DR53、DR1-DR52、DR13.3-DR53、DR12-DR53、DR13.3-DR52、 DR7-DR52、DR9-DR52 haplotype in pulmonary tuberculosis cases is remarkably lower than that in controls (for DR1-DR53、DR1-DR52、DR13.3-DR53、DR12-DR53, P <0.01, for DR13.3-DR52、 DR7-DR52、DR9-DR52, 0.01< P <0.05) and their RRs are 0.29、0.26、0.38、0.52、0.25、0.10 and 0.42 respectively.Conclusion DR12-DR53、DR7-DR52、DR9-DR52 haplotype are potential relative to incidence of pulmonary tuberculosis among Han nationality of southern Chinese. However, difference of frequencies of DR16-DR52、DR1-DR53、DR1-DR52、DR13.3-DR53、DR13.3-DR52 haplotype between pulmonary tuberculosis cases and controls may be caused by remarkable differences of gene frequency.

Measuring TB-Ab-IgG,ADA and CEA for differentiation diagnosis value of bening and malignant pleural exudate

Feng Yuejuan,Shao Huajun

. 2004, 26(1):  21-23. 

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Objective To determine the differential diagnosis value of Mycobacterium tuberculosis antibody (TB-Ab-IgG),carcinoembryonic antigen (CEA) and adenosine deaminase (ADA) between benign and malignant pleural exudate.Methods The TB-Ab-IgG measured by DIGFA,ADA activity by the modified Giusti assays and CEA measured by IRMA in 92 cases of pleural exudate were analyzed.Results The positive rates of TB-Ab-IgG of tuberculous,malignant exudate and other group were 81.8%, 12.8% and 1.1% respectively,the specificity was 87.5%;the ADA activity of tuberculous and malignat exudate was (59.6±28.8)U/L and (24.7±11.5)U/L( P <0.01).The CEA levels were (8.7±7.3)ng/ml and (60.2±39.6)ng/ml( P <0.01);While the ADA activity of other group was (44.6±26.5)U/L,Compared with tuberculous exudate ( P >0.05).Conclusion The test of TB-Ab-IgG,ADA and CEA of pleural exudate is of great value of differentiate benign from malignant exudate.

Analysis for DNA fingerprinting of M.tuberculosis strainsin Guangdong province

Zhong Qiu,Qiang Ming,Li Jianwei,etal.

. 2004, 26(1):  24-26. 

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Objective To establish DNA IS6110 fingerprinting patterns of M.tuberculosis strains and to explore distributing characters of the M.tuberculosis of Guangdong province in the molecular epidemiology.Methods The standardize method of M.tuberculosis DNA fingerprinting that is recommended by Van Embden was used for establishing the standard M.tuberculosis strains of Mt14323 and the DNA IS6110 fingerprinting patterns of seventy-four clinical isolates from Guangdong province.The data of fingerprinting patterns we detected were compared with the fingerprinting patterns data of the world by internet. The software of Gel compar 4.1(Applied Maths, Kortrijk, Belgium) were applied to analyze to the fingerprinting patterns of the strains in clustering.Results The DNA IS6110 fingerprinting patterns of Mt14323 standard strains and seventy-four clinical isolates are the same with the reports in the other country. Among 74 clinical isolates, the similar value of DNA IS6110 fingerprinting patterns of 24.3%(18/74) was form 1 to 0.65. And the result of identification showed that all of them are belong to Beijing family. It is more the isolates which have 1 copy and 2 copy (21/74).Conclusion At present, the M.tuberculosis strains of Beijing family has been prevailing in the area of Guangdong province in a certain level.

Surveillance of the quality of neonatal BCG vaccination in Tongling

Surveillance of the quality of neonatal BCG vaccination in Tongling

. 2004, 26(1):  27-29. 

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Objective To determine the Methods and approaches for improving and guaranteeing the quality of neonatal BCG vaccination.Methods The following approaches like perfecting organization and management system,training all personnel of neonatal BCG vaccination,developing perennial outpatient service of surveillance of neonatal BCG vaccination and expanding the area of surveillance were implemented.Results From 1999 to 2001,the rate of neonatal BCG vaccination ,the PPD positive rate after 12 weeks’ BCG vaccination ,the rates of BCG scar,the mean values of diameter of induration in PPD skin test and that of BCG scar all stably reached a set of standard.The problem of vaccination were promptly detected and solved.102 individuals that with the bad quality of vaccination were reccinated.Conclusion Consummating organization and management system,training all personnel,and continuous,dynamic and overall surveillance could improve quality of neonatal BCG vaccination.

The evaluation on the tuberculosis control project in Yantai for 10 years

Xu Jishan,Chi Desi,Cong Shuzhen,et al.

. 2004, 26(1):  30-33. 

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Objective To evaluate the effect of the tuberculosis control project supported by World Bank Loan.Methods Relevant data was collected from the quarterly reports,annual reports and some special surveys from 1992 to 2001.Results From 1992 to 2001,the notification rate of smear positive cases increased from 3.54 to 17.94 per handred thousand.The cure rate of new smear-positive cases increase from 86.36% to 96.91% and the cure rate of retreatment cases rate is from 71.74% to 94.86%.Conclusion Conducting TB control project in Yantai has made great progress during the last ten years.It proved that implementing effective project is feasible.The experience is very useful for sustainabilty of tuberculosis control.

Analyse the effects of the implementation of referring system of pulmonary tuberculosis in Nanning for 6 years

Zhao Yaling

. 2004, 26(1):  34-36. 

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Objective Evaluate the effects of the implementation of referring system of pulmonary tuberculosis in Nanning city for 6 year.Methods Establish the referring system of pulmonary tuberculosis.Regularly checking the diagnosis records and the records of hospitalization and exchange registration in hospitals.And the situation of case managment and outcome of cases in hospitals.Results Since the establishment of the referring system,the case management rate,referring rate and referring success rate increased year by year.The highest rates were in 1999.That were 63.5%,86.2% and 63.1% respectively and then began to fall down.The percentage of cure rates was low.In 1999-2001,The cure rate of smear-positive case were 9.1%?29.1% and 26.5% respectively.Conclusion Although achievement has been made in field on the referring system,many problem still remains.Administrative interventions,monitoring and standardized case management should be strengthened.Units of convergence must be centralized.

Causes and clinical therapies of 240 atelectasis cases

LIU Qian-gui,FNEG Li,WANG Feng-hong

. 2004, 26(1):  37-39. 

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Objective To study the causes of atelectasis and its therapy.Methods Retrospective analysis had been used to study the causes,location and therapy of atelectasis through the review of the 240 atelectasis cases.Results For 240 cases with atelectasis,tuberculosis (60.8%),tumor(16.6%),inflmation(12.1%) were its main causes.Conclusion CT and bronchoscopy were its main examination means.Atelectasis is mostly found in tuberculosis, neoplasms and inflammations, and should be examined with fiberoptic bronchosope to gain bacteriological and pathological evidences; basic therapies should be paid attention: encouraging the patients to cough, percussing the backs, ultrasonic aerosol inhalation, full sputum aspiration and local therapy with fiberoptic bronchoscope.

The analysis of 34 cases with HIV positive and pulmonary tuberculosis

Su Huiyong,Yang Xuewen,Su Jiankang,et al.

. 2004, 26(1):  40-41. 

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Objective To investigate the clinical manifestation and diagnosis of HIV positive cases combined with pulmonary tuberculosis.Methods 117 HIV positive cases were examined by X-ray and other laboratory tests.Results 34 to 117 HIV positive cases had tuberculosis.The rate was 29.1%.The clinical manifestation included fever,cough,emaciation hemoptysis and dyspnea.The X-ray revealed that most pulmonary tuberculosis were Ⅲ type,the positive rate was 61.8%.The pulmonary tuberculosis cases with HIV positive sometimes combinated with other opportunity infections,such as candidiasis,the positiver rate was 37.5%.Conclusion HIV positive cases always are drug injection users.The pulmonary tuberculosis cases which with candidiasis or other opportuni infections should do HIV test.

The analysis of tuberculosis control project of Ministry of Health in inner Mongolia Autonomous Region

Fan Chenxia,Zhen Zhifang,Su Yunkai

. 2004, 26(1):  42-44. 

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Objective The implementing situation of tuberculosis control project of Ministry of Health (MOH) in the past eight years.Methods Data was collected from the routine reporting system established at the beginning of the project.Results In the past eight years,the programe was carried out in 31.7% counties of Inner Mongolia,with a population of 43.4%.13?260 smear-positive patients were diagnosed,93.7% of them were cured (94.7% was cured from initially treatment and 88.3% was cured from retrearment).Conclusion Tuberculosis control work in Inner Mongolia have been proinoted through the implementation of MOH project in the past eight years.

The drug resistance results of 29 strains Mycobacterium fortuitum

Qiu Zhiqiang,Liang Qingfu, Wang Wei, et al.

. 2004, 26(1):  45-47. 

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Objective To determine the drug resistance on Mycobacterium fortuitum .Methods 29 strains M.fortuitum of clinical isolates had been identified by conventional and molecular biological identification Methods were uesed for susceptibility tests to the main anti-tuberculosis drugs.Results The isolates were susceptible to OFLX and LVFX,resisted to all single anti-tuberculosis drug;The Results of malti-drugs susceptibility test showed that the isolates resistant to two or three anti-tuberculosis drugs at the low concentration but susceptible at the high concentrat .Conclusion It will be possible toget higher cure rate,if the clinical cases should been treated with susceptible antibiotics in combination with anti-tuberculosis drugs in synergism.

Clinical ananlysis of 40 cases with SARS among elderly patients

Chen Xuelin,Xu Yuhua,Huang Yongjun,et al.

. 2004, 26(1):  48-49. 

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Objective To determine the clinical characteristics and outcomes of the elderly patients with SARS.Methods Analyzed the data of elderly patients with SARS and compared with that of control group young and ltlt patients the youthful group.The dats was compared between the cured group and died group for analysis the characteristics of outcome of SARS.Results Among the elderly patients with SARS;low or middle fever,basal disease of cardiovascular were seen often（ P <0.01）;high fever,chills,pantalgia/myalgia,diarrhea.hypodynamia were seen rarely（ P <0.05）,PaO₂<50mmHg（ P < 0.01）, diarrhea（ P <0.05）were seen often in the died group.Conclusion In the elderly patients with SARS,low or middle fever is common and combined with less systemic poisoning symptoms.Obviously decline of PaO₂,diarrhea were the most important comtribation factors on for die.

The impaet of HBVM positive to hepatic function and relative countermeasure

Zhu Yuyin,Zheng Chunyu,Ye Chunjuan,et al.

. 2004, 26(1):  50-52. 

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Objective To explore the influence to hepatic function caused by liver virus infection of tuberculosis cases during chemical anti-tuberculosis treatment and relative countermeasure.Methods Retrospective analysis on the clinical data of 1?746 pulomary tuberculosis cases(PTB) There were evidences on liver function damaged of 160 cases .Results 68 cases(38.64%)out of 176 PTB suffered with HBVM positive Were obsenred fo be damaged on their liver function.While 70(4.7%)out of 1490 suffers with HBVM negative.And among 80 cases without HBVM test,there were 22 cases(27.5%)with liver function damaged evidences.There was a significant difference( P <0.01)of liver tunction damaged incidence between HBVM positive and negative PTB cases.Most of the liver function dannaged were observed from 15 to 90 days after receiving treatment.Conclusion The liver virus infection during short-term chemical treatment will influence hepatic function.Testing HBVM and hepatic function is necessary before providing anti-tuberculosis treatment for the PTB cases.It is important to select some drug with minor side effections on liver function for the PTB cases with HBVM positive result.In the meantime,proper liver protection treatment,and closely observation on change of hepatic function should be taken.