Table of Content

10 January 2002, Volume 24 Issue 1

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The estimation of required funds for implementing national tuberculosis control programme

WANG Li-xia′,YANG Hua-lin,ZHANG Dong-ying,et al.

. 2002, 24(1):  5-8. 

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Objective To provide the base for the estimation of required funds for National Tuberculosis Control Programme implementation.Methods The funds were estimated based on the implementation Results for World Bank Loan Tuberculosis Control Project and some relative materials.Results Costs of diagnosis,treatment and management for a initial smear-positive case and retreatment smear-positive were estimated to be $318 and $458 respectively.The supervision fee in prefecture and provincial units was estimated to be $4440×number of counties and $3525×1/3 number of counties respectively.2?027?600 smear-positive pulmonary tuberculosis cases will be detected and treated,autonomous regions and municipalties from 2001 to 2005.$1335.79 million will be needed.Average TB control cost for 1 smear positive case will be $659.Conclusion The method will act as a scientific base for estimating required funds for National Tuberculosis Control Programme implementation.

Clinical analysis of 69 cases with endobronchial tuberculosis

DU Yun-ze¹,WANG Shu-chuan,DONG Zhi-yun.

. 2002, 24(1):  9-11. 

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Objective To find out the clinical features of endobronchial tuberculosis and approaches to its early diagnosis.Methods Clinical symptoms,chest X-ray/CT scans and fiberoptic bronchoscopic (FB) findings of 69 cases with endobronchial tuberculosis were analyzed.Results Main symptoms were as follows:68 had cough,44 had expectoration with sputum,50 had light fever after noon,49 had night sweat,48 had asthenia,18 had breathlessness,13 had blood-stained sputum.Chest X-ray and CT demonstrated:42 cases showed uneveness and irregular narrowing of the inner bronchial wall,26 cases showed obstructive pneumonia,25 cases showed atelectasis,14 cases showed pulmonary cavity,11 cases showed hilar lymphadenovarix.Positive sputum smear and culture for acid-fast bacilli (AFB) were 43.5% and 36.2%,respectively.Staining for AFB was 55.1% positive in bronchial washings and diagnosis was confirmed by bronchoscopic biopsy specimens in 56.7%.Bronchoscopic Results showed exduative lesions in 40.6% of the cases,granulomatous in 13.0%,ulcerative lesions in 29.0% and cicatricial lesions in 26.1%.Positive ratio of found AFB for the four subtypes were 71.4%,77.8%,100% and 55.6%,respectively.Conclusion We should select patients by chest X-ray when they have clinical manifestation as described above and CT were examed for the observed lesions.Bronchoscopic was done when the patients were suspected.When endobronchial tuberculosis couldn’t be confirmed by pathology and bacteriology,the follow-up bronchoscopic biopsy,brushing examination and anti-tuberculosis treatment should be repeatedly preformed until the diagnosis was confirmed by the follow observation.

Mechanical ventilation tactics in treatment of tuberculous respiratory failure

ZHANG Yao-ting,QIU Yao-ling,WU Yan-hua,et al.

. 2002, 24(1):  12-13. 

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Objective To explore the mechanical ventilation tactics in treatment of tuberculous respiratory failure.Methods The lung-protective mechanical ventilation was given to 52 cases of tuberculous respiratory failure,to observe the therapeutic effect and complication.Results Forty nine cases of respiratory failure were cured without apparent complication,three cases died.Cure rate was 94.2%.Conclusion Lung-protective mechanical ventilation is safe.The curative effect is dramatic.

Surgical treatment on drug-resistant pulmonary tuberculosis retreatment cases

XUE Hao-yu,WEI Li,WU Xiao-ming,et al.

. 2002, 24(1):  14-15. 

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Objective To study its effect and method of the surgical treatment on drug-resistant pulmonary-tuberculosis retreatment cases(DRPTRC).Methods 96 cases surgical treated were analysed.Results For those cases who were effective to the ofloxacin (OFLX) regimen and received surgical treatment at the same time,93.8% of them were sputum persistent negative conversed and had no relapse in the two follow-up years.5.2% of them were sputum negative conversed during their treatment after surgery.And 1.0% of them were sputum persistent positive.Conclusion It is an effective cure method for DRPTRC that they were chemically treated with OFLX regimen and were surgically removed their focus at the same time.

A study on the treatment of multi-drug resistant pulmonary tuberculosis with bronchofiberscope and catheter intervention after basified local environment

ZHANG Rui-e,ZHANG Qi,Li Hong-wu,et al.

. 2002, 24(1):  16-18. 

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Objective To study the efficacy of brochofiberscope and catheter intervention combined with chemotherapy in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB).Methods 44 cases were treated by injecting amikacin,ofloxacin and isoniazid,after cleaning up exudation and bacifing local environment with NaHCO 3 through brochofiberscope and catheter combined with chemotherapy,while 30 controls were treated by chemotherapy only.Results By the end of 9 months,the sputum tubercle bacillus conversion rate,radiagraphical improvement rate and cavity closing rate were 93.2%?90.9% and 40.5% respectively in the treated groups,while all these indications were higher than control group 60%?56.7% and 16.1% (P＜0.01,P＜0.05).No complications and obvious adverse reactions were observed.Conclusion Brochofiberscope and catheter intervention combined with chemotherapy is safe and more effective than simple chemotherapy in the treatment of MDR-TB.

Clinical application of CT examining in the spondylocace disease

CHE Feng-yi,LIU Shu-qing,YUN Lai-biao.

. 2002, 24(1):  19-20. 

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Objective To evaluate the diagnostic value of CT in the spondylocace disease.Methods Comparing 80 cases by X-ray,CT and operation of spondylocace disease.Results The accuracy of CT diagnosis was better than X-ray:it increases 27.5% in the wound of the spongyboue of vertebral body, 18.2% in the wound of interbral discs,38.6% sequestra,29.2% abscess,62.5% pressed spinal cord and the average increased accuracy is 35.2%.Conclusion CT examining can provide an accurate diagosis,especially it plays a very important role in the early diagnosis,the operation indication,approaches and aimnessly clearing away the pathological changes.

Comparision of two different methods for lung biopsy

YANG Shu-ling¹,XIA Dong,HE Ming,et al.

. 2002, 24(1):  21-23. 

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Objective To increase the positive rate of diagnosis by comparing with two different Methods for lung biopsy.Methods 293 cases were not be positively diagnosed by radiographs、sputum、cytdogy、bacteriology and fiberbronchoscopy from 1988 to 2000.These cases were examined by two different Methods of lung biopsy.Results Lung biopsy through skin conducted by X-ray、CT and B somascope was used in 148 cases and the positive rate is 87.8%;145 cases were examined by fiberbronchoscopy,with 79.3% positive rate.The frequency of complications was respectively 23.6% and 21.4%.Conclusion Different Methods of lung biopsy have different Results and diferent clinical meanings.Lung biopsy conducted by CT has the most accurate rate of diagnosis.

The relativity of the diagnostic chance and prognostic of maternal pulmonary tuberculosis

LEI Su-ying,PAN Ying.

. 2002, 24(1):  24-25. 

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Objective To evaluate the relativity of the diagnostic chance and clinical classify and prognostic of maternal pulmonary tuberculosis.Methods 48 cases with definite maternal pulmonary tuberculosis were analyzed retrospectively.They were assigned to two groups:pregnant group and postpartum group.Results The incidence of the hematogenous pulmonary tuberculosis 55.6% (15/27)?the incorporate incidence of cerebral tuberculosis 44.4% (12/27) of postpartum group were significantly higher than pregnant group,9.5% (2/21) and 0 (0/21) P＜0.005;and the mortality of postpartum group 18.5% (5/27) were significantly higher than pregnant group 0 (0/21),P＜0.05.Conclusion Diagnose and treat in gestation can reduce the incidence and mortality of heavy tuberculosis among maternal pulmonary tuberculosis.

The clinic analysis of different aspirating large quantity pleural effusion ways

WEI Chang-chun,LIU Yan-yan,DONG Qiu-lan,et al.

. 2002, 24(1):  26-28. 

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Objective To find a best safety complete aspirating large quantity pleural effusion way.Methods Dividing the studying object into rapidly complete group,slowly complete group and conventional group by aspirating speed and quantity.Analysing clinic effect and thorax pressure by statistics on three groups.Studying the medicine incentive of re-expansion pulmonary edema.Results Slowly complete aspirating large quantity pleural effusion way was the best way in clinic effect (P＜0.01).The thorax pressure was common among these different ways (P＞0.05).The aspirating speed was one of the most important incentive of re-expansion pulmonary edema (P＜0.01).Conclusion Slowly complete aspirating large quantity pleural effusion way was the best way in clinic effect and it could also prevent re-expansion pulmonary edema.

Clinical analysis of 248 cases of endobronchial tuberculosis

GAO Tong-jun, LI Fang, CHEN Xi-chen.

. 2002, 24(1):  29-31. 

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Objectives To explore the clinical characteristic and diagnostic therapeutic measures for endobronchial tuberculosis.Method 248 cases of endobronchial tuberculosis admitted from 1993 to 2000 were analyzed based on clinical, photographic and bronchoscopic data.Results The age group of 15～34 female patients occupied 69.2% of the total and was significantly higher than other groups. The bronchial lesions located on left side were much more than on right side. The diagnosis was confirmed by photographic, bronchoscopic and laboratory examination in 234 cases. The diagnosis was confirmed by pathological examination of resected lung in 14 cases. All the cases were under standard anti-tuberculosis chemotherapy;72 cases were also treated with aerosol treatment and 26 cases were also treated by intra-bronchial injection. The overall effective rate was 84.6%. Conclusion Bronchscopic examination was the most important procedure for the diagnosis of endobronchial tuberculosis. Beside the standard chemotherapy of anti-tuberculosis drugs, combined treatment of aerosol and intra-bronchial injection were very useful for relieving clinic symptoms, reducing or eliminating the stricture of bronchus. Surgical operation on time was indicated on patients with un-reversible stricture of bronchus, atelectasis and serious insufficiency of pulmonary functions.

Evaluation of the influence factors on strategy of DOTS in the tuberculosis control

XU Dong-ying,YANG Ying-zhou,LUO Yu-xi,et al.

. 2002, 24(1):  32-34. 

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Objective To analyze the influence of various factors on strategy of DOTS in the tuberculosis control.Methods Using Canonical Correlation Analysis to study the impact of various factors on case-finding and treatment.Results Of all the factors of DOTS strategy,the average of appropriate mo- ney is the factor wich has the largest influence on implement,followed by other two factors,the transfering rate of convergence case-management and average points of supervise network.Conclusion Paying great attention to the action of government in tuberculosis control is very important.

The analysis on situation of convergence case-management of suspicious TB cases of Zhengzhou

LIU Li¹,CHEN Yu,LIU Qiu-zhen.

. 2002, 24(1):  35-36. 

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Objective To study the fact of TB patients transferring rate and to find effective Methods to improve the transferring rate successfully.Methods To investigate the relative date of TB patients in 13 hospitals.Results The situation of convergence case-management of Tbis imbalame.There are non-transferring and transferring unsuccessfully phonomona in some hospitals.Conclusion Effective Methods should be taken to decreases non-transferring rate and to improve the transferring rate of TB patients.

Analysis on the therapeutical effect of Maozhaocao Capsule on cervical lymphonodus tuberculosis

XU Rui-lan.

. 2002, 24(1):  54-56. 

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Objective To analyse the therapeutical effect of Maozhaocao Capsule on cervical lymphonodus tuberculosis.Methods 204 cases were divided randomly into control group(HRZS) and treatment group (Maozhaocao capsule and HRZS).Results More cases were cured in treatment group.Cases in treatment group recovered sooner than the ones in control group.Conclusion It could short therapeutical course and improve therapeutical effect by applying Maozhaocao Capsule and antituberculous drugs on cervical lymphonodus tuberculosis without drug side-effect.