Table of Content

10 May 2003, Volume 25 Issue 5

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Analysis on the results of the adding two approaches for increasing case-finding for smear positive cases in the 4th nationwide TB survey

WANG Li-xia,DUANMU Hong-jin,DU Xin,et al.

. 2003, 25(5):  279-281. 

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Objective To evaluate the effect of the adding two approaches for increasing case finding for smear positive cases in the 4th Nationwide TB Survey.Methods To analye the examine Results of the actual investigation population.Results The 4th TB survey detected more 11.8% smear positive cases for the adding two approaches.44.7% attributed to the approach of TB symptomatic received smear examination directly,17% attributed to the approach of the adding the 3rd sputum specimens for examination.Among the adding detected smear positive cases,83% was TB symptomatic and 17% was non TB symptomatic.Conclusion TB symptomatic is the major objects for case finding.

Evaluation of the present situation of pulmonary tuberculosis Case-finding in Guangdong province

LI Jian-wei,ZHONG Qiu,HUANG Gui-qing,et al.

. 2003, 25(5):  282-285. 

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Objective To evaluate case-finding of pulmonary tuberculosis in Guangdong province.Methods To retrospectively analyse the quarterly report of the tuberculosis control project in 1992-2001 and the Results of case-finding in the survey for tuberculosis in 2000 in Gunagdong.Results The consulted rate of suspects was from 6.6/10 ⁴ in 1992 up to 17.2/10 ⁴ in 2001. The registration rate of pulmonary tuberculosis with smear positive was from 7.9/10 ⁵ in 1992 up to 38.8/10 ⁵ in 2001. There exist linear correlation between the consulted rate and the notification rate.Of smear positive cases, 47.1% and 88.5% was new smear positive cases in 1992 and in 2001 respectively. Conclusion The level of case-finding was improved in Guangdong province during 1992-2001. And Low consulted rate was the factor that restricts the level of case-finding.

Analysis of effect in pulmonary tuberculosis with DOTS implemented

FU Yan-yong.

. 2003, 25(5):  286-288. 

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Objective To estimate the curative effect of pulmonary TB criminals with DOTS conducted at prison.Methods At Tian Jin Prison Bureau,369 cases pulmonary TB criminals were made diagnosis and conducted Directly Observed Treatment Short-Course(DOTS) by Tian Jin Tuberculosis Control Center in 2002,anthor observed and analysed prognosis of state of illness after course of treatment was over.Results The cure rate of initial smear-positive pulmonary TB criminals was 93.8%,The cure rate of retreated smear-positive cases was 69.2%;The regulating taking drugs rate of smear-positive cases was 92.7%;The regulating taking drugs rate of smear-negative cases was 90.1%.The smear-positive cases was 14.9% in all made diagnosis pulmonary TB criminals;It was 7.1% pulmonary TB criminals treat were to stop because they were set free.Conclusions There was a good effect for pulmonary TB criminals with DOTS.

The study on the model of detection for pulmonary tuberculosis cases in Shenzhen city

YANG Ying-zhou, TAN Wei-guo,WU Qing-fang.

. 2003, 25(5):  289-291. 

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Objective To study the model of detection of pulmonary tuberculosis cases in Shenzhen city .Methods TB dispensary cooperated with hospitals through administrative intervention to improve capacity of case detection.Results 92.9% of pulmonary tuberculosis cases registered was through clinical consultation during 1996-2001.71.5% of them were transferred by hospital.The availability rate in TB dispensary of transferred TB suspects from hospital was 97.7% in the city.More than 71.9% of TB suspects made clinical consultation in TB were transferred from hospitals .The rate of smear positive case was 34.9/10 5 and the case holding rate was 67.0% in 2001.Conclusion A higher case holding rate have been achieved through adopting the model of detection for pulmonary tuberculosis in the city.

Investigation on social support situation of pulmonary tuberculosis patients

YANG Lin,JIANG Yi-geng,LI Zheng,et al.

. 2003, 25(5):  292-294. 

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Objective To conduct an investigation on social support situations of the pulmonary tuberculosis patients for providing evidences on psychological intervention according to their special characteristics during the treatment.Methods Questionnaires of social support rating scale (SSRS) were used for investigation 132 pulmonary tuberculosis patients and the subjects in control group.Results The SSRS result showed that the scores on subjective,Objective and total social support of patients were much lower than that of control group (P<0.01).The scores of subjective support of the smear-positive tuberculosis cases was much lower than that of the smear-negative cases (P<0.05);The scores subjective support and Objective support of the single were lower than that of the married ( P<0.01).Conclusion The above Results showed that the social support of pulmonary tuberculosis cases was low and the psychosocial intervention is needed along with the treatment on tuberculosis.

Analysis on misdiagnosis and over-diagnosis situations of the new-registered pulmonary tuberculosis patients from 1998 to 1999 in Shanghai

LI Yong-xiang,SHEN Xin,MEI Jian,et al.

. 2003, 25(5):  295-298. 

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Objective To analyze the condition of misdiagnosis (over-diagnosis) in the new-registered pulmonary tuberculosis in Shanghai and to find the ways for reducing misdiagnosis.Methods All the new-registered tuberculosis (TB) cases that were withdrawn because of being misdiagnosed from 1998 to 1999 in Shanghai were included in the analysis.The indicators like kinds of diseases misdiagnosed,the distribution of hospital provided misdiagnosis,the duration of delay for diagnosis and the time for anti-tuberculosis treatment,and the impact on tuberculosis control.Results The total misdiagnosing rate was 4.2%.The first three diseases be misdiagnosis were lung cancer,pneumonia and pulmonary parasite.The misdiagnosis rates in general hospitals,municipal tuberculosis hospital and district (county) tuberculosis hospital was 4.5%,4.0%,4.2%,respectively.The doctor-delay was 74.1 days for misdiagnosis as TB and then is diagnosis as other diseases.Conclusion Accurate diagnosis is an important premise for finding and curing pulmonary tuberculosis patients,especially for the smear negative patients.It is necessary to develop gold standard to diagnose smear negative tuberculosis.It is essential that to establish and perfect the regular meeting on tuberculosis prevention and chemotherapy.For the difficult and complicated cases,doctors of several departments should provide final diagnosis.

A evaluation on control influence of the initial drug-resistant towards new pulmonary tuberculosis patients with smear-positive

LUO Ping,TU De-hua,HE Xiao-xin,et al.

. 2003, 25(5):  299-301. 

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Objective To study the therapentic effect of short-course chemotherapy on various types of initial drug-resistant pulmonary tuberculosis patients,and to evaluate the impact of the initial drug-resistant on the TB control.Methods To review 334 new pulmonary tuberculosis cases with initial drug-resistance tested 1996-2001 in Beijing.All the 334 patients could be classified into four groups,groupⅠ:sensitive pulmonary tuberculosis patients;groupⅡ:resistant to 1-3 of INH,SM,EB;groupⅢ:RFP resistant or SE resistant;groupⅣ: multidrug-resistant (MDR-TB);and based on the treatment failure rate of each group,we calculated weighted failure rate for Beijing,Zhejiang,Henan districts.Results The treatment failure rate of groupⅡ (4.26%) was identical with that of groupⅠ (1.04%),and the treatment failure rate of groupⅢ,groupⅣ were different from that of groupⅠ (11.11%,30.00% versus 1.04%) statistically. Initial drug-resistance increased the failure rate by 0.83,1.76,5.92 percent respectively in Beijing,Zhejiang,Henan districts.Conclusions The influence of the initial drug-resistance on the treatment outcome mainly depended on the RFP resistant level,particularly multidrug-resistant level;The influence of that on local district depended on the height of RFP initial resistant, particularly that of multidrug-resistant.

The cohort analysis of new smear positive pulmonary tuberculosis in Li Nationality collective residential regions of Hainan province

LIN Feng,LUO Xing-xiong.

. 2003, 25(5):  302-304. 

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Objective To evaluate the treatment outcome of new smear-positive pulmonary tuberculosis cases under DOTS management in Li Nationality collective residential regions in Hainan,1992-2001.Methods To analyze and evaluate case-finding,registering,treatment management and outcome of new-smear positive pulmonary tuberculosis cases in 1992-2001.Results There were 5073 new smear positive pulmonary tuberculosis cases were detected in the Li Nationality collective residential regions.Among whom Han and Li Nationality were 1604 and 3433 respectively.The cure rate of Han and Li Nationality was 97.1% and 95.9% accordingly.The average cure rate was 96.3%.Conclusions There is significant improvement on controlling tuberculosis situation in Li Nationality counties (cities) for government commitment,availability of the funds,the setup and completion of the three-level tuberculosis control network and the steadfast implementing of the DOTS.

The change and significance of pulmonary function in patients with severe acute respiretory syndrome (SARS)

WANG Wei,ZHOU Yi,CHEN Hong-bing,et al.

. 2003, 25(5):  305-307. 

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Objective To observe the change of pulmonary function in patients with severe acute respiretory syndrome (SARS) in convalescence and evaluate the effect for pulmonary function in patients with SARS.Methods There were 10 patients in SARS group and 13 persons in control group, VC,FVC,FEV1.0%,V25%～50%,RV and DLCO were determined.Results The Results showed that VC,FVC and DLCO in patients with SARS were significantly lower than those in controls.Conclusion Pulmonary function in patients with SARS was damaged.Restrictive ventilation disturbance and diffusion disturbance may be characteristic manifast. Examined the pulmonary function of patients with SARS, may realize status of pulmonary function in patients in time.

Clinical analysis of 33 SARS death cases

XU Yu-hua,LU Qing,YANG Shu-ling,et al.

. 2003, 25(5):  308-310. 

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Objective To summarize the possible clinical factors related to the death of SARS through the clinical analysis of 33 probable SARS cases.Methods To analyse the factors such as age,symptom,classification,stage,serum enzyme level,blood gas analysis result,X-ray change extension,basic diseases,etc,according to “The Criteria for Clinical Diagnosis of SARS" issued by the Ministry of Health.Results Of the 33 cases,28 were over 50 years old (84.9%),all with fever over 38℃ lasting for more than 3 days.All 33 cases were clinically classified as serious and very serious cases,in the utmost stage of the disease,28 cases showed abnormal ALT (84.9%) and 25 cases (75.8%) with abnormal cardio enzyme.Blood gas analysis showed partial pressure of oxygen lower than 70 mmHg in 30 cases (90.9%).21 cases with X-ray shadows over 4 lung fields (63.6%) and 31 cases with companying basic diseases such as diabetes (93.9%).Conclusion The age,basic diseases,treatment starting time,serum enzyme level,partial pressure of oxygen and the extension of X-ray shadow were the possible factors related to the death of SARS.So the comprehensive treatment proved to be essential in reducing the fatality rate of SARS cases.

Research on the project of treating tuberculous pleurisy

WANG Xiu-zhen,SUN Yong-juan,SHI Jun-shi.

. 2003, 25(5):  311-313. 

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Objective To explore the project to treat tuberculous pleurisy.Methods Ninety preliminary treating cases of tuberculous pleurisy were divided into group A,group B and group C at random:group A using 2HLZS/4HL as the routine treating project,group B boostering other drugs dose while decreasing hormone gradually,group C using 2HLZS/4HL and ofloxacin was applied during the intensifying period.After the treatment for six months,the symptoms and the effects were examined.Results The three groups have stastitic difference in the symptoms.Pleurorrhea absorption and defervesce.Conclusion The project using ofloxacin while boostering other drug dose but decreasing hormone gradually has the best curative effect.

The clinical analysis of 230 cases with tuberculous pleurisy

LI Yue-mei,REN Yu-lin.

. 2003, 25(5):  314-315. 

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Objective The characteristics of tuberculous pleurisy were concluded and evluate the treatment methods.Methods 230 cases of tuberculous pleurisy from January 1996 to December 2000 in hospital were reviewed and analyzed.Results Young and middle age occupy majority in the 230 patients and most patients have serious typical tuberculous symptoms.PPD test has not specificity.230 patients all have carried out active anti-tuberculous therapy and aspiration for pleural effusion.But patient’s delay (duration from onset to consultation),rational chemotherapy were associated with the prognosis of patients.Results of treatment for the 230 patients were respectively recovered 88 (38.3%),pleural thickening 97(42.2%),pleural effusion be separated 45(19.5%).Conclusion A better Results of treatment can be achieved by mastering the characteristics of tuberculous pleurisy,comprehensive analysis,early diagnosis and regular therapy.

Clinic analysis on cases of acquired immunodeficiency syndrome with tuberculosis

WANG Wei-hua ¹,ZHAO Heng-min,ZHANG He-wu.

. 2003, 25(5):  316-317. 

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Objective To determine the clinical characters of acquired immunodeficiency syndrome (AIDS) complicated with tuberculosis cases.Methods 11 AIDS complicated with tuberculosis cases from 1998 to 2002 were analyzed.Results (1)Transmission route:8 cases (73%) were infected by transfusion.(2)Clinical type:6 cases (54.6%) were diagnosed as AIDS complicated with pulmonary tuberculosis.Among those 6 cases,3 cases were infiltrating pulmonary tuberculosis,1 case was primary pulmonary tuberculosis,2 cases were disseminated tuberculosis.5 cases (45.4%) were diagnosed as AIDS complicated with extra-pulmonary tuberculosis.Among of those 5 cases,2 cases were tubercular pericardial effusion,2 cases were tuberculous meningitis and 1 case was tubercular pleural effusion case.5 cases (45.4%) were with multi-infections.(3)PPD test:The Results of 1∶2000 PPD tests were negative of 11 cases.(4)Treatment:Clinical manifestations were found improved obviously in 7 cases that received treatment with anti-tuberculosis and anti-retrovirus treatments.Among 3 patients that received anti-tuberculosis treatment only,Clinical manifestations were found improved obviously in 1 case,2 cases died.1 case without any treatment died after 6 months.Conclusion The most cases were infected from transfusion.Among AIDS complicated with tuberculosis,circulating disseminated tuberculosis and extra-pulmonary tuberculosis were common and usually combined with other various opportunistic infection,clinical manifestations were complex.There was no meaning of PPD test for diagnose AIDS with tuberculosis.The combined anti-tuberculosis and anti-retrovirus treatments were efficient to cases of AIDS with tuberculosis.

Effect of antituberculosis drugs on liver functions of the tuberculosis patient complicated with both hepatitis B and hepatitis C virus infectious

MENG Zhi-hao.

. 2003, 25(5):  318-320. 

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Objective To study the effects of anti-trberculosis drugs on liver functions of the tuberculosis patients complicated with hepatitis B virus(HBV)and hepatitis C virus(HCV)infectious.Methods Both groups of the tuberculosis patients complicated with HBV and HCV,and group of Tuberculosis patient without HBV and HCV complicated infectious were treated with an identical regimen of chemotherapy of anti-tuberculosis.The liver functions of patients in both groups were observed and compared during the courses of anti-trberculosis therapy.Results The liver injury rate in the group with complicated HBV and HCV was(50.0%)significantly higher than that in the patients without HBV and HCV complicated infectious(7.7%)(P<0.01),and the time of liver injury occurred and time for liver function to restore were also significantly different(P<0.05,P<0.01).However,The injury degree was not significantly different(P>0.05).Conclusion The incidence of liver injury of the tuberculosis patients complicated with both HBV and HCV is high,early occurred,and restore slow.During the anti-tuberculosis therapy ,but the injury degree maybe mild .It is necessary,however,to monitor liver function for those patients in a short period.

The study on rapid culture detection in the standard strains of acid-fast mycobacterium using fluorescent growth indicator tube

WU Xiao-yuan,LIU Zheng-hua,SHI Xu-dong.

. 2003, 25(5):  321-324. 

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Objective To approach the adaptability of the culture system of a rapid fluorescent growth indicator tube,using various strains of acid-fast mycobacterium.Methods The standard strains of all species were puantitatively inoculated in the rapid fluorescent growth indicator tube(RFGIT),which has been developed by our lab,and pair matching compared with Mycobacterial Growth Indicator Tube system(MGIT,Becton Dickinson,MD)and Lowenstein-Jensen(L-J)solid media.The gradient dilutions of Mycobacterium tuberculosis H₃₇ Rv were inoculated both RFGIT and MGIT or L-J media in pairs,the Results were recorded and compared.Results The average detection time of 19 species standard culture is 4.68±2.48 days for RFGIT and 5.39±2.89 days for MGIT.The detected times of eight strains in RFGIT are significantly early than MGIT.The different dilutions of H₃₇ Rv assay in RFGIT shows a earlier detecting 1～5 days than MGIT,average 3.2 days, and 11～31 days early than L-J media,average 19.1 days. Conclusion The detecting time of RFGIT are earlier than L-J media in all standard strains and different dilutions of H₃₇ Rv.RFGIT appears more early than MGIT in some standard strains. Our Results showed RFGIT is a useful,safe,economical and rapid culture system.

Accelerated diagnosis of smear-negative pulmonary tuberculosis with bacteria proliferation accompanied PCR(BPAP)

WU Wei,PAN Yu-xuan,TIAN Miao,et al.

. 2003, 25(5):  325-328. 

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Objective To develop a new method for detecting smear-negative sputum from patients with pulmonary tuberculosis,for the objectives of rapidly detection and determine viable bacillus.Methods By using a new method,called bacteria proliferation accompanied PCR(BPAP),which combine culture with Middlebrook 7H12 semi-liquid media and PCR,46 specimens were detected.Their Southern-blot Results were analyzed by Gel-Pro Analyzer software.Results (1)For smear-negative specimens,to the 7th day,the sensitivity of BPAP was 86.2%;To 4 weeks,BPAP reached its highest sensitivity.It needed a shorter time to the detection of M.tuberculosis for BPAB than culture(P<0.01);And it had a higher sensitivity for BPAP than common PCR(P<0.05).(2)Out of 46 specimens ,there were 29 specimens(63.0%)that Southern-blot IOD ratio between the 7th day and the Oth day>1 zero;And for those specimens got their positive BPAP Results within 7 days,62.1% were supported by the positive 7H12 semi-liquid cultuer results.Conclusion BPAP is not common PCR.Through 7 days’ bacteria proliferation,there is a significant increase in the sensitivity.And for the support and determination of viable organisms by culture and Southern-blot IOD ratio.BPAP helps to get a more accurate clinical diagnosis.