Table of Content

10 April 2002, Volume 24 Issue 4

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Study on clinical application and correlation of T lymphocyte subgroup and argyrophilic proteins of the nucleolar organizer regions in patients with pulmonary tuberculosis

WU Yin, ZHANG Pei-yuan ,SUN Gui-zhi,et,al.

. 2002, 24(4):  181-184. 

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Objective To explore clinical significance and relationship of T lymphocyte subgroup and argyrophilic protein in the nucleolar organizer regions (AgNORs) in pulmonary tuberculosis patients.Methods 98 patients with pulmonary tuberculosis,39 patients with pneumonia and 41 healthy people were included by analyzing their T lymphocyte subgroup with the alkaline phosphatase-antialkaline phosphatase(APAAP) method and the areas of AgNORs in T cell with a KL Imaging System. 71 patients with pulmonary tuberculosis were observed continually during treatment.Results CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺ ,I.S% of patients with pulmonary,tuberculosis were significantly lower than those of patients with pneumonia and healthy people (P<0.01). When tuberculosis patients’condition was getting better, these two values also were readings going up.Conclusion The Results of T lymphocyte subgroup are in accord with those of AgNORs. These Results show immune function of patients and can be used as reference of guiding treatment.

Clinical significance between T lymphocyte subgroups and prognostic situation in primary smear-positive pulmonary tubculosis patients

SONG Xiao dong,REN Yan wei,ZHANG Hong juan,et al.

. 2002, 24(4):  185-187. 

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Objective To observe significance for variation of T lymphocyte subgroups and prognostic situation in primary smear positive pulmonary tubculosis patients.Methods Observing variation of T lymphocyte subgroups for 79 primary smear positive patients before and after treatment with alkaline phosphatase antialkaline phospatase assay (APAAP),all patients who completed the treatment were followed up for one year for observing the relapse.Results The values of identifying CD₃⁺、CD₄⁺ in primary smear positive patients were significantly lower than those in the healthy group,and CD₈⁺ had no obvious variation.CD₃⁺、CD₄⁺ of the cases with cavities before treatment were lower than those without cavities.After treatment the CD₃⁺、CD₄⁺ values of the patients with cavities were obviously higher than themselves before treatment,CD₈⁺ 、CD₄⁺/CD₈⁺ had no obvious difference.There were five relapse cases within twelve months after the end of treatment.Conclusion There was a definite relationship between variation of T lymphocyte subgroups and the variation of illness and the prognosis.

Value of testing of a variety of antibodies against Mycobacterium tuberculosis and pleural biopsy for diagnosis of tuberculous pleurisy

ZHAO Jian ping,KONG Wen qin,CHANG Zhan ping,et al.

. 2002, 24(4):  188-191. 

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Objective To probe value of testing of a variety of antibodies against Mycobacterium tuberculosis and pleural biopsy in diagnosis of tuberculous pleurisy.Methods 121 cases of tuberculous pleurisy (60 of them had also been with pulmonary tuberculosis) and 44 cases of carcinomatous pleurisy were subject to testing of antibodies (PPD-lgG, LAM-IgG Card, TB Dot Card, ICT-TB Card) against Mycobacterium tuberculosis in both serum and chest fluid, while 72 cases of tuberculous pleurisy were subject to pathological examination of pleural biopsy.Results Positive rates of 4 antibodies in serum was 75.6%, 30.7%,44.7% and 35.1% respectively, while counterparts in carcinomatous pleurisy was 43.2%, 17.1%,11.4% and 2.6% respectively. Positive rates of 4 antibodies in chest fluid was 81.7%,24.0%,27.1% and 22.7%, while counterparts in carcinomatous pleurisy was 51.2%,14.7%, 5.9% and 2.8%. Positive rates registered in both serum and chest fluid were higher than that of in carcinomatous pleurisy, positive rates of those tuberculous pleurisy with pulmonary tuberculosis were higher than that of in simple tuberculous pleurisy. PPD-lgG had the highest sensitivity but had the least specificity (56.8% in serum and 48.8% in chest fluid) and had obvious cross with carcinomatous chest fluid; as for LAM-lgG Card, TB-Dot Card, ICT-TB Card, specificity in serum was 82.9%, 88.6% and 97.4% respectively and specificity in chest fluid was 85.3%, 94.1% and 97.2% repectively, they had higher specificity than PPD-lgG but had lower sensitivity than PPD-lgG. Except for PPD-lgG, positive rates of antibodies in chest fluid were all slightly lower than that of in serum. If two positive rates were combined together as set A: PPD-lgG and TB-Dot Card or set B: PPD-lgG and ICT-TB Card, specificity of diagnosis by positive rates from serum could achieve to 94.3%～100% and specificity of diagnosis by positive rates from chest fluid could achieve to 91.4%～97.2%. Combined positive rate in serum was 36%～42.98% and in chest fluid was 17%～23%, which can be referred to by clinical differential diagnosis. 34 cases of the 72 cases subject to pleural biopsy were positive (47.2%), and the positive rates had close bond with disease course. Those cases whose onset was within 2 months had the highest positive rate of 75.5% (25/34).Conclusion Diagnosis of pathological pleural biopsy values important in diagnosis of tuberculous pleurisy, combined testing of various antibodies has some degree of significance of reference for diagnosis of tuberculous pleurisy.

Animal model of experimental diabetes complicated with tuberculosis

CHEN Hong,LUO Yong ai,ZHOU Bo.

. 2002, 24(4):  192-194. 

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Objective To establish an animal model of diabetes complicated with tuberculosis.Methods Mycobacterium tuberculosis H₃₇ Rv (0.01mg/0.4ml) was injected into Wistar rat with diabetes which was produced by injection of STZ (60mg/kg).Not only blood glucose,index of pulmonary tubercular lesion and count of Mycobacterium tuberculosis in alveolar macrophages were measured,but histopathological changes in lung,liver,spleen and pancreas tissues were also observed.Results In the control group,blood glucose was increased more than 16.65mmol/L,pancreas tissues were injured and typical tuberculosis lesions were found in the lung and spleen.Conclusion It suggested that the animal model of diabetes complicated with tuberculosis was successfully established.

Analysis relation between PPD skin test result and CD₄ cell count in HIV positive patients

LIU Guo hua ¹,WANG Lin, CUI Wei-guo,et al.

. 2002, 24(4):  195-196. 

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Objective The relation between PPD skin test result and CD₄ cell amount was analysed in HIV positive patients.Methods PPD test, CD₄ cell count and MultiSET ^TM Physician examination were applied among people doubted affection by HIV in high-risk region. Results The positive rate of PPD test was 12.5 percent among HIV-seropositive people, 28.2 percent among HIV-seronegative. HIV-seropositive rate dereased with CD₄ cell decreasing. Conclusion The positive rate of PPD test was significantly decreased among HIV-seropositive patients. This was possibly correlative with CD₄ cell decreasing.

Clinical analysis of 164 cases of esophageal tuberculosis

JIANG Yin jiu 1,LUO Yong ai,LI Chao xian,et al.

. 2002, 24(4):  197-199. 

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Objective To improve the recognization and reduce misdiagnosis of esophageal tuberculosis.Methods 164 cases of esophageal tuberculosis published in Chinese language literature including a case from our hospital were summarized and analyised. All diagnosis were established by histology after endoscopic examination or surgical excision.Results There were more females than males(F/M= 1.3∶1) and most of them (81.9%) were below the 45 years old. Almost every one had suffered with dysphagia or chest pain. The sites of lesions were usually middle part of esophagus(69.5%), Only 46 cases(34.3%) were confirmed before surgery by endoscopic examination and most of the others were mistaken as carcinoma (96.6%). Only 151 cases had therapeutic record . All of them were cured after receiving antituberculous therapy and 104 cases of them also receiving thoracotomy.Conclusion Most cases of tuberculosis of esophagus are younger than 45 years old and females were more compared to males. It always occurs at middle part of esophagus and the predorminant symptoms were dysphagia or chest pain. Diagnosis can be difficult even based on endoscopic examination and usually mistaken for carcinoma. Most cases can be successfully treated with antituberculous chemotherapy or combined with surgery.

Significance of detecting P-selectin of pleural effusion in differentiating tuberculous and malignant pleural effusions

ZHAO Yun feng,WANG Ying nian,GAO Dai qing,et al.

. 2002, 24(4):  200-202. 

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Objective To explore the clinical significance of detecting P-selectin of pleural effusions in differentiating tuberculous and malignant diseases.Methods To detect the content of P-selectin in centrifuged supernatant of 48 cases with tuberculous pleural effusions and 50 cases with malignant pleural effusions by ELISA method.Results P-selectin of malignant pleural effusions (18.76±8.45μg/L) was distinctly higher than that of tuberculous pleural effusions (7.43±5.32μg/L) (P<0.01).Conclusion Detecting P-selectin of pleural effusion might be helpful for differentiating tuberculous and malignant diseases.

Analysis on case-finding status in Jiangsu province

XU Wei guo,FAN Ben da,GAO Zhan.

. 2002, 24(4):  203-204. 

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Objective To investigate and analysis case-finding status in Jiangsu province.Meth ods To investigate the patients in Jiangsu province who were detected in the 4th national TB prevalence survey were investigatde useing the society-economy questionaireanser.Results 86 cases with active pulmonary TB, of them 72 cases (80.0%)had TB symptoms, 42 cases (48.3%) had consulted doctors, 29 cases(33.7%)had been diagnosed as pulmonary TB,only 10 cases(11.6%) had been registered.Conclusion Case finding work should be concerned and strengthened.

The effect of city’s hospital in the case-finding of tuberculosis

ZHAO Xiao ¹,LUAN Xiang ming,LI Jie.

. 2002, 24(4):  205-206. 

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Objective To enhance the level of the case finding of tuberculosis.Methods To strengthen the government support fully utilize the human resources medical facilities,set up TB registation centre at epidemic institution preventive station and hospitals in Shizuishan city.Result New case registration rate of smear positive pulmonary.tuberculosis increased from 3.42/10⁵ in 1993 to 17/10⁵ in 2000.Conclusion City general hospitals may develop the important effect on tuberculosis control work.

Tuberculosis surveillance in Zhejiang (1987～2000)

XU Xu qing, CHEN Song hua, LI Qun.

. 2002, 24(4):  207-212. 

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Objective To evaluate the implementing effects of tuberculosis surveillance in Zhejiang province(1987～2000).Methods To collect and analyze the tuberculosis surveillance annual report and other statistical data in the period of 1987～2000.Results In the native residents, the registered rate and newly registered rate of active pulmonary tuberculosis were decreased 71.2% and 13.9% respectively. The newly registered rate of smear positive tuberculosis was increased 32.0%. The mortality of pulmonary tuberculosis was decreased 97.8%. The cure rate was increased from 80.6% to 92.3%, and the impact of infections reduction was increased from 20.5% to 44.8%. But in the temporary residents, the registered rate and newly registered rate of active pulmonary tuberculosis were increased 140.1% and 129.4% respectively. Mostly were males and 20～39 years old. And the cure rate was very low. Conclusion Satisfactory Results have been achieved of tuberculosis control in Zhejiang province but the tuberculosis control in the temporary residents is a problem which should be caused our concern.

The effect observation of initial smear-positive pulmonarytuberculosis cases treated with short-course intermittent unfixed-course chemotherapy regimen

LU Li¹, ZHANG Lian-ying, CAO Ji-ping, et al.

. 2002, 24(4):  213-215. 

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Objective To understand the therapeutic effect and chemotherapy course of intermittent unfixed course regimen with which the initial smear positive pulmonary tuberculosis cases were treated. Methods 440 cases of initial smear positive pulmonary TB cases were selected and divided randomly in the new regimen group and the old regimen group. The TB cases in the new regimen group were treated with the intermittent unfixed course chemotherapy regimen, (2～3)H ₃R₃Z₃S₃(E₃)/(2～6)H₃R₃. The ones in the old regimen group were treated with the 6 month intermittent chemotherapy regimen, 2H₃R₃Z₃S₃(E ₃)/4H₃R₃. Results The sputum conversion rates of the cases in two groups were 98.6% and 98.2% at the end of six months respectively. The relapse rates of one year were 1.5% and 2.0% respectively. There were not significant differences in all indexes between the two groups ( P >0.05). The average course of the new regimen group was 4.8 months. It is 1.2 months shorter than the olds. Conclusion The initial smear positive pulmonary TB cases that were treated with the intermittent unfixed course chemotherapy regimen had achieved the same effects as with the fixed one. The unfixed course method can shorten the course of the fixed course method. It posses the characteristics of less cost of patient’s and the patients are easy to cooperate with the doctor.

Study on forward curative effect of unfixed continuation phase short-course chemotherapy for smear positive untreated pulmonary tuberculosis

CHEN Zhong xi,QIAO Bing hai,TAO Hong wen,et al.

. 2002, 24(4):  216-218. 

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Objective To investigate the forward curative effect of further shortening the chemotherapy on the basis of 6 months chemotherapy regimen.Methods The 2HRZS(E)/ XH ₃R ₃ regimen was used in smear positive untreated pulmonary tuberculosis patients.The treatment was continued till sputum negative conversion maintained for three consecutive months. The quality control was emphasized on each research stage.Result 92 cases in the study group of 95 patients completed their chemotherapy.The sputum negative conversion rate at the end of treatment was 98.9%. 91 cases were 5.1 months on the average.The bacteriological relapse rate in two year follow up was 2.3%.Conclusion The Results indicated similar Results of the bacteriological relapse rate with the short course chemotherapy in our country,which showed a high cure rate.

Analysis on situation of convergence case-management of suspicious TB cases on 61 general hospitals in Fujian

CHEN Qiu yang,LIN Shu fang,ZHAO Rui ying,et al.

. 2002, 24(4):  219-221. 

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Objective To investigate the situation of convergence case management of TB in general hospital,and indentify the existing problems so as to improve the future work and improve the level of tuberculosis finding.Methods Sampling 61 general hospitals and 57 anti tuberculosis institutes to examine the data concerned on convergence case management,to analyse the Results of report,transfer,sputum examination and X ray diagnosis.Results The rates of reporting,transferring and transferring of patients successfully in general hospital were 84.1%,29.2% and 70.3%.The sputum examination rate of initial patients was only 41.8%.The rate of sputum smear positive was 14.7%.These figures in general hospitals were much lower comparing to those in the anti tuberculosis institutes.Conclusion It is important to enhance the administrative intervention to promote tuberculosis convergence case management in general hospitals.

Discussion of the mode of centralized transfer diagnosis of the lung TB patients in Yanbian area

JIN De-fu ¹, HUANG Dian wen, LI Kui dong.

. 2002, 24(4):  222-223. 

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Objective To analyse the result of the lung TB patients’ success rate of transfer diagnosis since the establishment and carrying out of Yanbian Area’s Lung TB centralized transfer diagnosis mode, to discuss the effective Methods of enhancing the transfer diagnosis’ success rate. Methods During the last 8 years, we investigated and evaluated the city, county hospitals, TCM hospitals, central hospitals, large enterprise and institutional units hospitals in the eight cities and counties in Yanbian area.Result 1.After the establishment of the transfer diagnosis system, during the first stage, the transfer diagnosis rate was 48.3%, and the transfer diagnosis success rate was 29.0%. Later, the transfer diagnosis rate was 89.0%, and the transfer diagnosis success rate was 72.4%. 2, During the first stage, the annual average lung TB new patients registration rate was 13.36/10000 people. Later, it reached 17.86/10000. There was a large difference between the indexes for the first stage and later stage of the carrying out of the centralized transfer diagnosis (P<0.01). Conclusion The Yanbian Area’s lung TB patient centralized transfer diagnosis system effectively enhanced the success rate of the lung TB transfer diagnosis, the system is valuable to be popularized.

Clinical analysis of pasiniazid,ofloxacin,capreomycin and prothionamide in weating Multi-drug resistant tuberculosis

JI Bao jun.

. 2002, 24(4):  224-226. 

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Objective To explore the therapeutic effect of multi drug resistant tuberculosis cases treated with 3LiOCTh/3LiOThC ₃/6LiOTh regimen.Methods 54 cases of multi drug resistant tuberculosis were treated with 3LiOCTh/3LiOThC ₃/6LiOTh regimen from 1994 to 1997.The patients were examined with sputum smear and liver funtion very month,X ray in 3,6,12 month.Results When the treatment was completed,the sputum megative conversion rate was 87%.The sputum positive recurrent rate was 12.8% after 24 months follow up.The damage rate to the liver function was 1.9%.Conclu sion It is effective to treating multi frug resistant tuberculosis cases with 3LiOCTh/3LiOThC ₃/6LiOTh regimen.The regimen is less adverse reaction and recommendable.