Table of Content

10 February 2003, Volume 25 Issue 2

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Clinical value of fluorogenic probe hybridzation assay for detecting Mycobacterium tuberculosis in clinical specimens

LI Guo li,ZHAO Ming,Wang Wei,et al.

. 2003, 25(2):  65-67. 

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Objective To evaluate the clinical value of PCR-fluorogenic probe hybridzation assay (TaqMan assay) for detecting Mycobacterium tuberculosis in clinical specimens.Methods The sputum specimens of 133 patients with pulmonary tuberculosis and 53 patients with respiratory system diseases other than tuberculosis were tested by bacteriology(smear and culture)and TaqMan assay.Results The sensitivities of bacteriology and TaqMan assay for detecting Mycobacterium tuberculosis in sputum specimens of patients with pulmonary tuberculosis were 36.1% and 61.7% respectively.The specificity of TaqMan assay in tested clincal specimens was 96.2%.Conclusion The TaqMan assay performed in a hermetially sealed tube is simple,rapid ,anticontaminative, sensitive and specific. It is one of the effective Methods for the diagnosis of pulmonary tuberculosis.

Clinical evaluate the diagnostic value of tuberculosis for detection of M.tuberculosis PCR,culture and microscopy assay

XIAO Ai qing,HOU Shuang yi,LI Guo ming,et al.

. 2003, 25(2):  68-70. 

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Objective To study the clinical effect of M.tuberculosis examination by PCR,culture and microscopy assay.Methods 1?217 specimens of the clinical suspicious tuberculosis cases were compared with 3 kinds of Methods (PCR,culture and microscopy) in diagnosis of tuberculosis.Results The positive rate of PCR?culture and smear by the different clinical specimens were 88.7%,43.4%,26.5% respectively.Conclusion By means of analyze of comparation with 3 kinds of methods,PCR is the fast and its positive examiniatorial rate is the highest.For diagnosis of tuberculosis,it is one of important Methods in detection of M.tuberculosis.

Observation of the pharmacokinetics of three antituberculous drugs in the serum of pulmonary tuberculosis patients with or without diabetes of different age groups

GAO Wei wei,DUAN Lian shan,HUANG Xue rui,et al.

. 2003, 25(2):  71-74. 

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Objective To observe the pharmacokinetics of INH,RFP and OFLX in the serum of pulmonary tuberculosis patients with diabetes to provide references in choosing clinical therapeutic regimens.Methods 17 adult tuberculosis patients were randomly divided into two groups.The observe group,9 cases (pulmonary tuberculosis patients with diabetes);the control group,8 cases (non diabetes tuberculosis patients).They took INH 0.4,RFP 0.6,OFLX 0.6 orally.The concentrations of the three antituberculous drugs in the serum were measured by HPLC (high performance liquid chromatography).The data were calculated with software 3p87.Results There was significant difference in the T max of INH only ( P< 0.05).There was no significant difference between the two groups in the other pharmacokinetic parametres such as t _1/2 (h),C _max (μg/ml),AUC(μg/(ml·h)) of INH ( P> 0.05).There was no significant difference between the two groups in the t _1/2 (h),t _max (h),C _max (μg/ml),AUC(μg/ml· 1) of RFP( P > 0.05). There were significant differences between the two groups in the t _1/2 (h),T _max (h),C _max (μg/ml),AUC(μg/(ml·h)) of OFLX.Conclusion 1.INH and RFP,were not affected by the factors of diabetes,age and sex.2.OFLX,was affected by the factors of diabetes or age.

The diagnostic value and significance of the HRCT scan in tracheo brochial tuberculosis

WANG Zi bin,YANG Ji sheng,YANG Chuan bin,et al.

. 2003, 25(2):  75-77. 

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Objective To assess the significance of high resolution computed lomography (HRCT) scan in the diagnosis of the tracheobronchial tuberculosis.Methods The HRCT findings of 32 cases with tracheobronchi tuberculosis were analyzed,and observing the formal changes of the wall and cavity in tracheobronchial and the pathological changes in the lungs.Results The diagnosis rate with the changes in the tracheobronchial wall was 73.9%,of which the slight thickened of the tube wall was 54.4% and obviously was 19.8%,the changes in the cavity was 67.4%,of which the narrowing <50% was 41.3%,>50% was 19.6% and obliteration was 6.5%,meanwhile it were observed that the enlarged lyphnode around the tracheobronchi and mediastinum was 7 cases,mucus embolism in the tube was 12 cases,local enlargement of the tube was 5 cases,lobular emphysema was 18 cases and tuberculosis focus in the lung was 39 cases.Conclusion The HRCT scan was of clinical significance in observing the pathological changes of tracheobronchi and evaluating the relationship between the lung focus and tracheobronchi lesions,prepare doing the FB examining for the weak patients and evalute the prognosis of the patients.

Clinical analysis of 64 cases with pulmonary tuberculosis complicated by Candida Albicans Infection

JIN Guan fu,LIN Ming gui,CHEN Hong bin,et al.

. 2003, 25(2):  78-79. 

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Objective To study the clinical feature and treatment of pulmonary tuberculosis complicated by Candida albicans infection.Methods To review and analyze of the 64 cases of pulmonary tuberculosis complicated by Candida albicans infection in our department in recent 5 years.Results The major clinical feature of pulmonary tuberculosis complicated by Candida albicans infection were:long history of tuberculosis,usually occurred in older patients and the patients with infiltrative pulmonary tuberculosis and chronic fibrocvaitative pulmonary tuberculosis;Extensive lesions and many cavities in lungs;Most of them had the evident causes of fungus infection.Their diagnoses depend on the examination of pathogenic organisms.Conclusion The number of patients with pulmonary tuberculosis complicated by Candida albians infection is increasing.Understanding of the clinical feature can improve the level of recognition.

Analysis of causes for 17 patients with pulmonary bronchogenic cyst (PBC) being long-term misdiagnosed as pulmonary tuberculosis (TB)

SUN Yi fen, HU Ying,HU Pei an.

. 2003, 25(2):  80-82. 

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Objective To improve the ability to differentiate the two diseases through the analysis of causes for PBC being long-term misdiagnosed as pulmanory tuberculosis (TB). Methods Retrospective analysis of 17 cases which are verified through surgical pathology as PBC which bad been long-term misdiagnosed as pulmonary TB.Results PBC being long-term misdiagnosed as pulmonary TB to PBC being treated by operation the same time is 43.6%(17/39). Main symtoms: cough, sputum, hemorrhage, thoracic pain, low fever and tired. Chest X-ray shows variedly, globular of 10 cases, the part with satellite focus and calcification, cavity or melting, etc. Big uneven density flat of 5 cases, unilatery damaged lung of 1 case, interlobe fluid of 1 case. Of all patients sputum for tuberculous bacterium is negative. Sputum, hemorrhage and fever repeatly occur through regularly anti-tuberculosis treatment of 11 cases (64.7%) uneffective of 6 cases (35.5%). Conclusion Causes of misdiagnosis are the lack of knowledge about atypical PBC. PBC should be considered in patients with negative sputum for tuberculous bacterium but clinical symptoms resembling pulmonary TB and after treated by regularly anti-tuberculosis repeatly occuring or effective.

Study on therapeutic effects of tuberculous pleural effusion by using drainage in the method of intravenous guttate

JING Qiu sheng ¹,LI Cai ping,LIAN Zhan.

. 2003, 25(2):  83-85. 

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Objective Study on therapeutic effects of tuberculous pleural effusion by using drainage in the method of intravenous guttate. Methods By different therapeutic Methods 217 tuberculous pleural effsuion was divided into drainage in the method of intravenous guttate group(53 cases)?thoracentesis group(107cases) and conservative management groups(57 cases), statistic analyze times of centesis,duration,effusion quantity and pleural incrassation of three groups. Results Pleural incrassation of drainage in the method of intravenous guttate group was less than other two groups, the times of centesis was less than thoracentesis group, but duration is more,the first effusion quantity of drainage in the method of intravenous guttate group was more than thoracentesis groups, and none occures complication. Conclusion Drainage in the method of intravenous guttate used to treat tuberculous pleural effusion cxcels thoracentesis and conservative management.

Diagnostic value of fiberoptic bronchoscopy in diffuse pulmonary diseases

WU Yin,KONG Wen qin.

. 2003, 25(2):  86-88. 

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Objective To evalute the diagnosis value of fiberoptic bronchoscopy(FB) in diffuse pulmonary diseases(DPD). Methods In the period of 1993～1999, 86 patients with DPD, who were negative sputum smears for tubercle bacilli and pathological examination for tumor, were received bronchoscopy, transbronchial biopsy, brushing and bronchoalveodar lavage(BAL). Results The overall positive rate of FB in DPD was 87.2%, 51 of 86 (59.4%) cases had lesions by immediate bronchoscopy identification, positive rate of transbronchial biopsy, brushing and BAL was 69.2% ,55.6% and 30.8%. Among 38 patients with lung cancer, the positive rates of bronchial neoplasm, lung biopsy were as high as 100% and 84.2%. On the other hand, the positive rates of BAL was only 27.3%. Among 25 patients with tuberculosis, The overall positive rate of biopsy was 85.7%, while positive rate of tubercle bacilli brushing and culture was only 16.2%. The shows that the positive rate of transbronchial lung biopsy was not increased with the number of biopsies. Conclusions Bronchoscopy, especially with biopsy ,is a safe, simple method which has a high diagnostic rate and less complications.

The clinical relation of tuberculosis and fever of cause to be unknown (analysis of 136 cases)

WANG Gai ¹,CAO Qing shan,GUO Yuepeng.Department of Tuberculosis,

. 2003, 25(2):  89-91. 

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Objective To explore the relationship of the fever of cause to be unknown (FOU) with the tuberculosis (TB). Methods To analyse of 258 cases of FOU from January 1980 to July 2000.Results 57.7% of FOU was diagnosed for TB,The clinical manifestations inTB group were different from that of the non-TB group significantly (P<0.005). Conclusion The important cause of the FOU is TB. The time of using anti-TB treatment in patients with suspect TB should be more than 2～2.5 months.

Clinical analysis of 45 cases with tuberculous multiple serosltis

LU Qing.

. 2003, 25(2):  92-94. 

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Objective To explore the clinical characteristics of tuberculous multiple serositis (TMS),and to improve the diagnostic and therapeutic level.Methods Retrospective analysis of 45 cases of TMS with reviewing of clinical data.Results (1)Middle aged and young patients under 40 years old were most commonly seen.(2)Fever,oppressed feeling and abdominal distension were the most frequent clinical symptoms.(3)The total cases were complicated with pleursy,and the unilateral pleurisy complicated ascites were common.(4)Nearly half of the patients showed hematogenous disseminated type of pulmonary TB who had hydrops occurred simultaneously in 3 cavities.(5)The clinical efficacy of chemotherapy with rifampicin (RFP) containing regime yielded satisfactory clinical efficacy.High age,complicated with pericarditis,and with hypoalbuminemia were the therapeutic effects related factors.Conclusion To those febrile accompanied with oppressed feeling and abdominal distension middle age and young patients,the physicians should pay attention to the investigation of chest film and Bultrasonogram,so as to rule out the TMS;To those confirmed diagnosed with serous cavity hydrops patients,the other serous cavities should also be investigated with concerning tests;the other serous cavities of hematogenous disseminated TB patients should also be checked as well.Early diagnosis and treated with RFP contaiving regime may yielded the satisfactory results.

Stuffing operation with muscle segment in treating chronic empyema

LI Wei,GAO Zhi gang,ZHOU Feng.

. 2003, 25(2):  95-96. 

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Objective To probe the experience of surgical operation in chronic empyema.Methods 8 cases with chronic empyema were treated by stuffing operation with muscle segment.Results 6 cases were cured.1 case was failed.1 case had a relapse.Conclusion Stuffing operation with muscle segments is an effective method in treating chronic empyema. This method possess characteristic that chest shape isn’t changed or only slightly changed.Thoracoplasly should be supplemented if the pus cavity of chronic empyema can’t be all stuffed with these muscle segments.

Epidemiological surverllance for pulmonary tuberculosis cases in Yuexiu county of Guangzhou during 1995～2000

CHEN Qi chen.

. 2003, 25(2):  97-99. 

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Objective To research on the epidemiological trend of the TB in Yuexiu county during six years.Methods The epidemiological specificity of registered TB cases during 1995～2000 were analyzed.Results The year registered rate and year point registered rate were decreased 19.8% and 40.0%. The new discovered and re appeared case show in old man trend.The pulmonary tuberculosis dead danger was declining. Conclusion The TB situation was of Yuexiu county effectually controlled ,the incidence and prevalence and deadth of pulmonary tuberculosis show in old man trend.

Knowledge on Tuberculosis control among county level general hospital staff

BAI Li-qiong ¹,XIAO Shui yuan,ZHOU Xiang heng, et al.

. 2003, 25(2):  100-103. 

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Objective To ascertain the knowledge on tuberculosis control among county level general hospital staff. Methods Health workers in departments of respiratory disease,infectious diseases,radiology and laboratory from 10 hospitals at the county level were asked to answer a pre-tested questionnaire consisting of 9 multiple-choice questions assessing the knowledge of tuberculosis control in Hu’nan Province by random sampling. Results Total 254 medical workers were involved in the study. The response rate was 97.3%(254/261). Only 36 respondents (14.2%) know rather well about tuberculosis control with the correct answer rate of 100%. Mean knowledge score among 254 respondents was 6.58±1.56 (1 point for each item, 9 items altogether). The knowledge levels were significant differences in gander,professional title,specialty of the medical workers and the knowledge score was correlated with training they received.Conclusion This study demonstrated that the knowledge on tuberculosis control is meager among medical workers in the county level general hospitals. It is an urgent task to train health workers in general hospitals with modern knowledge of tuberculosis control and management.

Clinical Analysis of pulmonary tuberculosis in 43 cases cause by-depending strains

ZHONG Ming,ZHONG Min,LOU Le-shan,et al.

. 2003, 25(2):  104-106. 

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Objective To evaluate the clinical feature of pulmonary tuberculosis by rifampin-depending strains,the produce cause and avoid countermove. Methods The pulmonary tuberculosis by rifampin-depending strains were analyzed retrospectively.Results It was 60.5% (26/43) and 20.9%(9/43) in the age of 22～39 and 40～59 years group respectively,the percent rates was 88.4% (38/43) in the cases of focus scope ≥3 field of lungs:88.4%(38/43), caseation and vacuolation:58.1%(25/43),and the multidrug resistance was 88.4(38/43).The chemotherapy of 5 patients,all of primary treatment and multidrug resistance,was entire failure,and the failure rates of chemotherapy was 52.6%(20/38) in the 38 cases with relapsing patients.The abusing rate of rifampin was 76.3% in this group researched.Conclusion (1)It is main clinical feature that the patients possesses severe condition,multidrug resistance and bad prognosis.(2)That is major reason possible to abuse the drugs of rifampins.(3)To establish the method for rapid detection of drug resistance is the key to prevent producing rifampin depending strains.

Analysis of the effect of tuberculosis control in Hainan province(1992～2001)

LIN Yong ¹,LU Wei-ping.

. 2003, 25(2):  107-109. 

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Objective To analyze the current situation and experience of tuberculosis control in Hainan province.Methods To analyze the current tuberculosis epidemic situation,tuberculosis control strategy implementation situation and the effectiveness of tuberculosis control strategy based on the quarterly reports from every counties and some relative materials. Results The modern tuberculosis control strategy had been introduced to Hannan province in 1992. From 1992 to 2000, there were 192077 tuberculosis suspects had been examined. Among of them, 48?670 suspects received sputum examination, the rate was 25.3%. 31?822 active tuberculosis cases had been detected and registered. 22,946 were smear positive cases. The smear positive case rate increased from 12.8/100?000 in 1992 to 48.4/100?000 in 2000. Till to December 2001, there were 21?625 smear positive cases had been cured. The cure rate was 94.2%. Conclusion The tuberculosis epidemic situation was serious.Tuberculosis control had achieved significant achievements during near 10 years since modern tuberculosis control strategy have been introduced and implemented.Hproved that the strategy was the most effective measure to control tuberculosis epidemic process.

Implementation and evaluation of trberculosis control for citywide population in Shenzhen city

YANG Ying zhou,TAN Wei guo,LUO Yu xi.

. 2003, 25(2):  110-112. 

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Objective To study the mode of tuberculosis control in Shenzhen city evaluate effect of implement and discuss implement of tuberculosis control among citywide population.Methods To implement tuberculosis control strategy to detect and cure infectious sources drastically.Results 8?483 smear positive cases were registered.Cure rate was 96.3%.Resident prevalence of smear positive tuberculosis was reduced 55.9% and non-resident prevalence of smear positive tuberculosis was reduced 38.6% from 1991 to 2000.Conclusion It is essential,feasible and scientific to implement tuberculosis control strategy in citywide population.