Table of Content

10 June 2004, Volume 26 Issue 6

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Impact of immigrants on epidemic of tuberculosis in Beijing

An Yansheng,Zhang Lixing,Tu Dehua.

. 2004, 26(6):  319-323. 

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Objective To determine the impact of immigrants on the epidemic of tuberculosis in Beijing.Methods To analysis th e trends of newly registered active and smear-positive pulmonary tuberculosis c ases in census register and immigration in Beijing.Proportion change of tubercul osis cases in immigration in Beijing was clarified.Results Numb er of newly registered active and smear-positive pulmonary tuberculosis cases d ecreased from 2?347 and 764 in 1993 to 2?205 and 703 in 2002 in Beijing reside nts,which only decreased 6% and 8% respectively during the 10 years.On the contr ary,number of newly registered active and smear-positive pulmonary tuberculosis immigrants of Beijing increased from 242 and 90 cases in 1993 to 1?075 and 304 cases in 2002,which increased by 344.2% and 237.8% respectively.If the number o f active and smear-positive cases in Beijing residents added with the cases in immigrants,the number were 3?279 and 1?007 cases in 2002,which corresponded to the levels of number of active and smear-positive cases in 1989 and 1992 respe ctively.Conclusion The trends of increasing tuberculosis cases in immigrants were gradually impact on epidemic of tuberculosis in Beijing,which should be taken effective control measures.

Analysis on the cost and workload of different diagnostic procedures smear positive for TB cases

Wan Lixia,Dumu Hongjin,Wang Xuejing,et al.

. 2004, 26(6):  324-328. 

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Objective To guide the choosing diagnostic proce du res in routine TB control implementation through analysis on the cost and worklo ad of different diagnostic procedures for smear positive TB cases. Methods Imitated the situation o f one moderate county (with 500,000 population) TB dispensary that adopts 3 diag nostic procedures based on some available research data. Analysis two key indica tors, one is cost and one is workload. Results The workload of smear examination per day is the crucia l indicator for choosing the diagnostic procedure. Conclusion If sputa smear and reading under the microscopy per day by 1 lab staff is less than 25 slides, the best choice is using the procedur e that smear and X-ray film examination will be taken at the same time. Otherwi se, the procedure that using X-ray film as the screen tool should be adopted.

Analysis of the papers received by the journal of Chinese Anti-t uberculosis Association(1998—2002)

Fan Yongde.

. 2004, 26(6):  329-331. 

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Objective To improve the quality of the journal an d expedite the science intercommunion of antituberculosis through analysis manus cripts received by the Journal of Chinese Antituberculosis Association.Methods To check the register of the manuscripts received from 1998 to 2002 and the published journals from 1998 to 2003.The quantity of receiv ed manuscripts and accepted papers and the delay duration for publishing were calculated.Results 2592 manuscripts were received in 5 years ,about 518.4 every year,795 papers were released,the releasing ratio is 30.4%.Th e delay duration for publishing was longer.Conclusion The quant ity of the received manuscripts were enough,but the quality of the papers need t o be improved.The longer delay duration for publishing affected the information sharing timely.

The comparative analysis of demographic characteristics and family disease financial burden of drug-resistant tuberculosis in Zhejiang

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

. 2004, 26(6):  332-335. 

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Objective To study demographic characteristic an d family disease financial burden of drug-resistant and drug-sensitive TB cases in Zhejiang.Methods 15 counties were randomly selected from 30 surveillance counties of “The global drug-resistance surveillance of TB projec t of WHO”.207 cases of drug-resistanct and drug-sensitive TB cases were intake n continuously in each counties.The method of economical evaluation was used to explore the disease financial burden of the patients’ families and demographic c haracteristics.Results There was no significant difference in t he proportions of sex,age,education level,labour force and economical level betw een drug-sensitive and drug-resistant TB cases.The average family financial b urden related with TB was 5972.5 Yuan for drug-resistant TB cases and 4?05 8.0 yuan for drug-se nsitive TB cases.Conclusion Most of drug-resistant and drug-s ensitive TB cases were 26～55 years old,with lower education level and relative poor.And The family financial burden related with TB of drug-resistant TB cases was obviously higher than that of drug-sensitive TB cases.

Study on the adding sites at township level for screening suspects of tuberculosis to increase cases detection in Fuqing county

Chen Qiuyang,Xue Li,Shen Guicheng,et al.

. 2004, 26(6):  336-337. 

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Objective To pilot the adding sites at township le vel for screening suspects of tuberculosis to order to increasing case detection .Methods 6 screening sites are selected in 22 towns.One of them is charge of sputum smear and X-ray examination and the initial examination re sults will be reconfirmed by the county tuberculosis dispensary.Results In 2003,the consultation rate of TB suspects was 1.93%, sputum smear examination rate was 85.8%.The proportion of smear positive cases w as 67.2% and the notification rate of smear positive cases was 40.6/100?000.Tho se indicators were improved 91.1%, 14.4%,60.4% and 20.1% respectively compare d with that in 2002.Conclusion It is feasible that the adding sites at township lev el for screening suspects of tuberculosis and the case detection of smear positi ve cases were increased.

On guard against antituberculosis drugs cause the abnormality of hematological system

Zhu Min,Liu Yadong,Zhao Qian,et al

. 2004, 26(6):  338-340. 

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Objective To evaluate the effects of antitubercu lo sis drugs in hematological system.Methods The clinical data of 115 pulmonary patients with the abnormality in hematological system from Jan.199 6 to Jun.2004,were reviewed retrospectively.Results In 4812 tuberculosis cases,the abnormality in hematol ogical system were 115 (2.4%),aleucocytosis were most common existed (44.4%),th e second were pancytopenia (22.6%) and thrombocytopenia with hypolekocytosis (10.4%).aplastic anemia,HA and SMF were seldom seen.Conclusion Almost all the antituberculosis drugs can cause abno rmality of hematological system.Rifomycins were most common next were aldinamide and isoniazide.It can cause a formed elements to change in blood.A nd cause the abnormality of whole blood,and death in serious patients cause.So it should be on guard against.

Controlled clinical study on efficacy of national fixed-dose compounds in antituberculosis chemotherapy

Chu Naihui,Gao Mengqiu,Ma Liping,et al.

. 2004, 26(6):  341-343. 

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Objective To evaluate the treatment outcome and si de-effects of national fixed-dose compounds (2HRZ/4HR).Methods 81 new bacteriological positive pulmonary tuberculosis patients were divided r andomly into treatment group (42 cases) and control (39 cases) group.Results The sputum negative conversion rates at the 2nd month in the treatment and the control group were 82.5% and 65.7% respectively.And the rates at the end of the chemotherapy were 100.0% and 88.6% respectively.Chest ra diography showed remarkable improvement.The resolution of pulmonary lesions in t he treatment group and the control group accounted for 92.7% and 94.3% respectiv ely.The cavity closure rates were 63.2% in the treatment group and 62.5% in the control group.Two patients defaulted because of hepatic dysfunction in the t re atment group and 4 patients in the control’s.Conclusion Nation al fixed-dose compounds rifater/rifinah show excellent therapeutic efficacy,saf ety and compliance in antituberculous chemotherapy,which could be recommended fo r wider use in tuberculosis control in China.

Image characteristics of pulmonary tuberculosis of diabetes mellitus (Analysis of 45 cases)

Li Zhengmin.

. 2004, 26(6):  344-345. 

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Objective To analyze the image characteristics o f chest of pulmonary tuberculosis associated of diabetes mellitus in order to offe r some basis for the clinical synthetical diagnosis.Methods To review the image characteristics of chest in 45 pati ents with pulmonary tuberculosis and diabetes and analysis the related clinical information.Results The image characteristics of the patients s howed that massive and dense patchy shadow was 68.9%,multiple small cavity patch y shadow was 68.9%,dispersive pieces and small patch shadow was 26.7%,nodosity a nd tumour shoadow was 4.4%.Conclusion To familiar with the varied image characteristics of pulmonary tuberculosis in diabetes,which have important reference value in synt hesis diagnosis or state analysis.

Clinical analysis of pulmonary tuberculosis complicating with severe pneumonia

Zhang Yaoting.

. 2004, 26(6):  346-348. 

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Objective To explore the clinical feature,bacter ia distribution and treatment technology of pulmonary tuberculosis complicating wi th severe pneumonia.Methods The data of thirty five cases of pu lmonary tuberculosis complicating with severe pneumonia diagnosed by bronchoscop e with protected specimens brush (PSB) were analysed retrospectively.Results Clinical feature was high fever,purulent sputum,breathl ess,respiratory failure and high blood cell count.Xanthomonas maltophilia,anaero be and pseudomonas aeruginosa were the main pathogenic bacteria for infection.Th irty one cases were cured,four died,the fatality was 11.4%.Conclusion The clinical manifestation of pulmonary tuberculosis complicating with severe pneumonia was typical,had severely toxic symptoms.Bron choscope with PSB can provide accurate pathogenic diagnosis and guide using anti biotics.The complexing agent of third generation penicillin or cephalosporin and β-lactamase inhibitors and metronidazole were recommended to be used for cont rol of infection.Holding reasonably the indication and tactics of mechanical ve ntilation can increase cure rate.

The clinic analysis on 63 elder pulmonary tuberculosis cases comb ined with diabetes

Jia Shuyan,Qiao Cuijun,Li Hongmei,et al.

. 2004, 26(6):  349-350. 

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Objective To improve the awareness of elder pulm on ary tuberculosis combined with diabetes for detecting and treating at the early stage.Methods To make clinic analysis on 63 pulmonary tuberculosis co mbined with diabetes in 4 years.Results Among the 63 patients,blood sugar leve l of 57 cases had been controlled from 7.9 to 11.1 mmol/L.Among the 57 cases,the tuberculosis focus of 51 cases turned to be absorbed;the somear negative conver sion Results were available in 30,21,6 cases at the end of first,second and thir d months of the treatments.The blood sugar level of 6 cases had not been control led satisfactorily and higher than 11.1 mmol/L.Among the 6 cases,the tuberculosi s focus of only 1 cases turned to be absorbed;the smear negative conversion resu lts were available in 3,3cases at the end of third months and 3-6 months of the treatments.Conclusion To control the blood sugar level from 7.9 to 11.1 mm ol/L through the treatment of diabetes is the key factor to cure elder pulmonary tuberculosis cases combined withdiabetes.

Clinical analysis of Levofloxacin and Netilmicin in treating Mult i-drug resistant tuberculosis

Li Yuelong,Jiao Qinghui,Wang Yawen,et al.

. 2004, 26(6):  351-353. 

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Objective To observe and evaluate the treatment ef fect of the regimen which contains the Levofloxacin (LVFX) and Netilmicin (NTI) for MDR-TB cases.Methods 102 MDR-TB patients were randomly di vided into two groups.52 cases in the observation group (treated with LVFX,NTI,D ,1321Th,PZA).50 cases in the control group (treated with OFLX,D,1321TH,PZA,EMB). The duration of treatment were 12 months.Results All 102 cases completed their treatment courses.The sputum smear negative conversion rate were 86.5% and 56.0% in the observation group (52 cases) and control group (50 cases ).The rate in observation group was significantly higher than that of the control group (P<0.01).Conclusion It is effective to treating mu lti-drug resistant tuberculosis cases with 3DNZThV/9DThV regimen.The regimen is less adverse reaction recommendable.

Study on severe acute respiratory syndrome patients with multiple organ injury

Li Ande,Liu Xiaohong,Wang Jiajie,et al.

. 2004, 26(6):  354-357. 

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Objective To study on multiple organ injury pres en tation and treatment principle of SARS patients.Methods To anal yze the clinical data of 182 SARS patients with multiple organ injury in 429 cas es retrospectively.Results 174(95.6%) of all 182 patients had e xposure to SARS,and the incubation period ranged from 2 to 19 days.The clinical features included fever (99.5%),cough (64.3%),body pain (41.8%),dyspnea (26.9%), diarrhea (26.9%),headache (19.8%).There were differential acute lung injury (ALI ) in 182 cases and differential hepatic lesion in 152 cases and heart injury in 52 cases.Conclusion The morbidity of differential organ injury in SARS patients are different.The highest morbidity was lung injury and it has differential presentation in every stage.Most of cases with hepatic injury with mid level increased transaminase an d it was related to drugs.The injury of heart was directily invasion by SARS-Co V in early stage and it was relating to secondary immune reaction in late stage. The morbidity of kidney injury was the lowest.

X-ray features of SARS cases

Chen Yanxia,Liu Jun sheng,Tang Ming,et al.

. 2004, 26(6):  358-359. 

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Objective To get a better of understanding and diagnosis of SARS in image.Methods X-ray imaging of 52 case of cl inically confirmed of SARS diseases were analyzed retrospectively.Results The main X-ray changes included:(1)Lung markings thick ening,hardening,observed as “withered branch”；(2)Brightness of lung field was d rop,density of lung field increased；(3)Lung markings manifold,observed patchy sh adow to be along with lung markings；(4)Density of interstitial increased,observe d net,small nodes and infiltration shadow in interstitial；(5)Lung segmental or t otal lobar became consolidation.Conclusion X-ray finding of SA RS was varied and changes quickly.Obvious abnormalities were seen on the film wh ich were in sharp contrast with the mild clinical respiratory symptoms.Understan ding X-ray finding of SARS to be helpful of diagnosis,treatment and isolation early.