Table of Content

10 January 2001, Volume 23 Issue 1

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Study on drug resistance surveillance of tuberculosis in Guangdong province

ZHONG Qiu,QIAN Min,LI Jian wei,et al.

. 2001, 23(1):  5-8. 

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Objective According to the guidelines of WHO/IUATLD proposed a global drug resistance surveillance of tuberculosis project,to set up a system for surveillance of drug resistance of pulmonary tuberculosis.to obtain the result on initianl and acquired drug resistance rate of pulmonary tuberculosis in Guangdong province of China.Methods 40 centres were radomly selected,39 cases of the smear positive of pulmonary tuberculosis were intook continuously in each centre.all samples were isolated and cultured.the identification and in each centre.all samples were isolated and cultured.the identification and susceptibility test were done for the strians of culture positive.Results The frequency of initial drug resistance was 18%,acquired drug resistance was 33.7%.Conclusion The result proved that drug resistance rate is higher(18%)in Guangdong province.National TB Control Program should be strengthen.

M.vaccae influence the mRNA expression of IFN-γ and IL-4 in tuberculosis mice

CHEN Zheng,ZHANG Li qun,MA Wei lu.

. 2001, 23(1):  9-11. 

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Objective To investigate the anti tuberculosis protection immunological mechanism of M.Vaccae in terms of gene level.Methods BALB/C mice were randomly divided into three groups:group of tuberculosis model(A);group that challenged with H₃₇Rv by their tail veins and immunized by M.Vaccae(B)and group of control mice(N).All mice were killed after four weeks infected.with pathological slices stained with HE,using lungs of mice and spleen of mice and make RT-PCR detect the mRNA expression of IFN-γ and IL-4 were evaluated.Results The mRNA expression of IFN-γ were detected in group A,B and N,but group B was the strongest among them.Only group A can detect the mRNAA expression of IL-4.The lung lesions of group B was milder and less than the group A.Conclusion M.Vaccae can improve the anti tuberculosis protection by prompting the mRNA expression of IFN-γ and inhibiting that of IL-4.

The evaluation of tuberculosis supervising county before and after implementing the tuberculosis control program in Sichuan province

FENG Shu fan,WU Jian lin,XIONG Guo ping,et al.

. 2001, 23(1):  12-14. 

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Objective Exploring the tuberculosis continuous development and providing the evidence for drafting the tuberculosis control strategy.Methods To analyse the tuberculosis control work of six tuberoulosis supervising county before and after implementing the program in our province.Results With the tuberculosis control program,the rate of new smear positive case finding increased 2.7 times,and the treatment coverage rate increased 3.1 times.Conclusion Only if could implementing the correct policies of control and having sufficient expense,the tuberculosis control work could continue to be development.

Clinical observation of 59 cases with outbreak dermatic infection caused by M.fortuitum

LIU Tan ye,WANG Lin,CHEN Jin bo,et al.

. 2001, 23(1):  15-18. 

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Objective To study the characteristics of the dermatic outbreak infection caused by M.fortuitum.Methods Analyzing the clinical characteristics and therapeutic outcome of 59 cases with dermatic infection of M.fortuitum,who were admitted from January to December 1999 and confirmed by bacteriology,pathology and ultrasonic B.Results The average age of 59 cases is 32.3 years old,the ratio of male to female is 1:5.6;and average length of illness is 55±30.5 days.The 59 cases have 76 lesions92.2% of the lesions are located in the buttocks.39 case are confirmed by bacteriology accounting for 66.1% and 12 cases out of the 20 negative cases checked by bacteriology are later found positive by pathology.The total 51 positive cases account for 86.4%.All the cases are treated with the antibiotics which the bacteria are sensitive to and the antituberculotic chemotherapy which can generate cooperative effect.The cases indicated of surgery will be treated accordingly.All the cases are discharged cured.The six month follow up has seen no relapse.Conclusion The infection is caused by M.fortuitum.The therapeutic outcome is satisfactory.

Tuberculosis Surveillance in Wuhan Iron and Steel (Group) Co (WISCO)

HUANG Qiao rong,ZHANG Ning,GAO Guei ying,et al.

. 2001, 23(1):  19-21. 

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Objective To analyse the implementing effects of tuberculosis Surveillance in WISCO.MethodsAccording to the monitoring and statistical data analyses the registered rate and therapeutic effect of pulmonary tuberculosis from 1980 to 1997.Results The registered rate and newly registered rate of active pulmonary tuberculosis decreased 72.0% and 11.1% respectively.The sputum smear positive rate increased 15.2%.The mortality of pulmonary tuberculosis was decreased 80.0%.and the curative rate increased from 92.9% to 97.3%.The average therapeutic duration was shortened 24.8 months.The rate of chronic excretory case decreased 44.1%.Conclusion The tuberculosis surveillance is satisfied in controlling epidemic situation in WISCO.

Analysis of misdiagnosis of 7 patients with pulmonary sclerosing hemangioma(PSH)

SUN Yi fen,HU Pei an.

. 2001, 23(1):  22-23. 

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Objective To get more knowledge about PSH through the analysis of the misdiagnosis. Methods Retrospective analysis of 7 cases which are verified through surgical pathology as PSH.Results Male to female ration is 1：6,average age is 52.3,and misdiagnosis rate is 100%.Chest X ray shows an isolated,round or near round,even density,smooth brim,and tubercle like shadow without calcification and lymphadenectasis in the hilus of lung or mediastium in most cases.Serum CEA>10μg/L of 3 cases,the acid fast bacilli are detected on sputum smear of 1 case.Conclusion Causes of misdiagnosis are lack of knowledge about PSH and liable to be influenced by the age and the laboratory examinations.PSH should be considered in female patients with isolated focus in lung roentgenograms.

Effect of body position on gas exchange in patients with unilateral pleural effusio

HU Ke,JIANG Yan,TU Chu yun,et al.

. 2001, 23(1):  24-26. 

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Objective To evaluate the effect of body position(right and left lateral decubitus positions)on arterial oxygen tension(PaO₂)and the relationship between this postural effect on gas exchange and lung function.Methods Self control design,significance test and linear correlation analysis were used.Results In 53 patients with unilateral pleural effusions,the mean PaO₂ obtained in lateral decubitus position with the normal lung down(PaO₂-N) was higher than that obtained in lateral decubitus position with the effusion down (PaO₂-E).There was a significant difference in the values of mean PaO₂ between the two positions(P<0.001).The values of mean PaO₂-N and PaO₂-E were 79.9±13.8mmHg and 67.8±15.3mmHg respectively.The differences in PaO₂ ranged from 2.3 to 26.4mmHg (mean 12.1±6.9mmHg), PaO₂-N was higher than PaO₂-E in 40 of 53 patients and lower in 13 patients.Conclusion Postural change took effect on gas exchange in these patients.Although gas exchange was improved in most patients in the lateral decubitus position with normal side down,no consistent relationship was found.The difference in PaO₂ between two laterals decubitus position was not correlated with the patients’pulmonary function such as F-EV₁ and FVC.

Therapeutic effects of containing DPC or PAS regimens on multi-drug resistant pulmonary tuberculosis

ZHAO Yi hong,ZHANG Zhen xian,DU Ying.

. 2001, 23(1):  27-29. 

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Objective To understand the therapeutic effects of containing DPC or PAS regimens on MDR pulmonary tuberculosis.Methods 39 cases of MDR pulm.tuberculosis are selected and divided randomly in DPC group and P group respectively.Results After complete the treatment course,the sputum negative conversion rate of above two groups was 95% and 93% respectively.The X Ray resolving rate were 86% equally.The relapse rate following 2 years follow-up were 5% and 8%.All above Results of two groups were no significant difference(P>0.05),but the occurence rate of gastrointestinal adverse reaction and phlebitis of group DPC was much lower than those of the P group(P< 0.05).Conclusion The antituberculosis regimen of DPC or PAS with K、O、TH and Z reparatively is an effective and safe approach for treating the multi drug resistant pulm.tuberculosis,especially the 2 KOTHZ DPC/6 10 OTHZ DPC regimen is cheap cost,less adverse reaction and easy to accept,therefore it is worth recommending.

Obervation of the effect on liver function in pulmonay tuberculosis with positive HBVM treated by antituberculotic combination

CHEN Si cang,CHEN Hong qi.

. 2001, 23(1):  30-32. 

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Objective To observe the effect on liver function in pulmonary tuberculosis with positive HBVM treated by antituberculotic combination.Methods Compare the damage to the liver function of the HBVM positive or negative tuberculosis patient before and after taking the antituberculotic combination.Results The damage to the liver function of the HBVM positive tuberculosis patient is much higher than negative tuberculosis patient(P<0.01 ),and the damage to the “Model-Ⅰ”and “Model Ⅱ”patient varies little(P>0.05 ).But the damage to the liver function of “Model-Ⅰ+Ⅱ”patients is higher than that of “Model Ⅲ”(P<0.05 ).Conclusion The antituberculotic combination will damage the liver function of HBVM positive tuberculosis patients and negative tuberculosis patients,“Model-Ⅰ”and “Model Ⅱ”patients are easily affected.The combination drug must be taken carefully and comprehesive prevention measures must be taken ahead.

Surgical operation in the treatment of 32 cases of pulmonary tuberculosis with cavitation

CHEN Jing yu,ZHU Da wei,ZHENG Ming feng.

. 2001, 23(1):  33-34. 

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Objective To discuss the indication,method and status of surgical operation in the treatment of pulmonary cavitary tuberculosis.Methods 32 operated cases of pulmonary tuberculosis have been reviewed.Results The operation effect was satisfied.The cure rate is 96.9%.Conclusion The surgical treatment is the effective method in destroying the infectius origin,resolving the failure of re treatment of pulmonary cavitary tuberculosis and the serious complications.

Surgical treatment of long standing mycobacteria positive pulmonary tuberculosis

XIONG Han peng,XIE He xiang,WANG Wu ming.

. 2001, 23(1):  35-37. 

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Objective To evaluate the protective significance,the operative indication and appropriate times of thoracis surgical treatment of long standing bacteriological positive pulm.tuberculosis.Methods Sixty-three patients with cavities or destroyed lungs who had failed antituberculosis chemotherapy,received either lung resection or auxiliary thracoplasty were retrospectively analyzed.Results Sputum negative conversion was found in fif-ty-nine patients:The negative conversion rate was 93.7%.Four cases had surgical complication and no surgical death occured.Conclusion Surgical operation is the effective procedure in treating long term bacteriological positive tuberculosis patients with cavities and destroyed lungs.The postoperative antituberculosis chemotherapy should be continued for at least 1year.

Surgical treatment of multidrug resistance pulmonary tuberculosis

SONG Yan zheng,YANG Rui,HE Yi,et al.

. 2001, 23(1):  38-40. 

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Objective To discuss the operation indication for pulmonary tuberculosis with drug resistance.Methods Reviewing 7 000 cases of pulmonary tuberculosis in which 36 cases with drug resistance that have been operated in our hospital from 1990～1997.Results The cure rate of 36 cases of pulmonary tuberculosis with drug resistance is 94%,sputum negative conversion rate is 84%,and the incidence rate of complication is 13%.Conclusion It is feasible for some patients who have 2～3 kinds of drug resistance to receive surgical treatment.It can improve the cure rate of drug resistance pulmonary tuberculosis but the complication rate of patients who have at lease 4 kinds of drug resistance is high,so that more prudent indication criteria should be considered.

Analysis on case finding of tuberculosis control project in Taian city

LI Jian zhi,LI Rong xin,BI Yan ju,et al.

. 2001, 23(1):  41-43. 

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Objective To analyse the work on case finding status of tuberculosis control project conducted in Taian city from 1993 to 1998.Methods According to the project handbook and quarter reports from 1993 to 1998,we analysed the case finding work of tuberculosis.Results 7351 cases of active tuberculosis patients were found in Taian city from 1993 to 1998,among which 5147 sputum smear patiens were positive and that was 2.2 times as many as the total number of 6 years putting altogether before the control project conducted.Among the new sputum smear positive tuberculosis patients,66.5% were from 15 to 54 years old and most femele were from 15 to 34 years old.Conclusion The new register rate of sputum smear positive raised year by year,but the rate is lower than the average rate of 12 project provinces of our country from 1992 to 1995.

Comparison of treatment result between supervised by health personnel and supervised by household member for pulmonary tuberculosis patients

YING Jin zhi,FANG Chun yong,HU Chun sheng.

. 2001, 23(1):  44-45. 

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Objective To observe the treatment result between supervised by health personnel and supervised by household member for pulmonary tuberculosis patients.Methods There were 123 new smear positive cases whose treatment supervised by health personnel and 128 new smear positive cases whose treatment supervised by household member,and both treatment regimens were 2HREZ/4H₃R ₃.Results The cure rate for treatment supervised by health personnel was 93.5% and that for treatment supervised by household member was 98.4% .Conclusion The treatment Results for two kinds of supervision Methods are both good,and at present,the treatment supervised by household member is more suitable for rural area.

Current situation and analysis of tuberculosis control in Hechi district,Guangxi autonomous region

PENG Chao kun

. 2001, 23(1):  46-48. 

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Objective To reflect the current situation of tuberculsis control in Hechi district.Methods To analyse the annual report report of tuberculosis epidemic and tuberculosis registration during 1996～1998 in Hechi district.Results The number of tuberculosis cases discovered in every year were only 10% of the estimated number of tuberculosis cases.The new cases registration rate,registration rate of smear positive pulmonary tuberculosis,sputum examination rate were 20/10⁵,0.7/10⁵ and 15% respectively.The cure rate of smear positive patients was very low.Conclusion Antituberculosis organs are not perfect,poorly financed,fail in convergence cse management are main causes which influence the effectiveness of tuberculosis control in Hechi district.

The observing about homemade tuberculin purified protein derivative’s stablity

ZHANG Ya zhen,FU Qiu ru,YU Su juan,et al.

. 2001, 23(1):  49-51. 

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Objective To evaluate the stablity of homemade PPD.Methods Prepare 1506 babies immuned from BCG.Use PPD in useful life as contrast of four groups of PPD which is stored in four condition:2～8℃ in refrigeratory;60℃ keeped as long as 30 minutes then 2～8℃ in refrigeratory;36℃in the constant temperature box;room temprature.Test the 4 kinds of PPD on both arms of the babies,and watch them for three years to find out how much that different temprature affects PPD’s sensitivity.Results Noting the positive ratio and induration pattern of the delayed allergic reaction on the babies with the test PPD then compare them to te PPD which in useful life.The result comes out:the group of in 2～8℃ refrigeration is normal (P>0.05) but other three groups show remarkable different (P<0.01).Conclusion Homemade PPD owns steady quality and nice safety,if stored in 2～8℃ condition PPD suseful life can be delay to 3 years considerable.

The relatonship between the examine results of acid-fast basillus of the sputum collected in different time in 2936 specimens

WANG Jin,HUANG Ting lin.

. 2001, 23(1):  52-53. 

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Objective To evaluate the influence of the sputum collected in different time on the determination of acid fast bacillus.Methods The sputum specimens were dyed with the Ziehl Neelsen anti acid dyeing method,and observed with the microscope.The positive rate and the distributing of various sputum time are studied.Results The positive rate of 2946 sputum specimens varies evidently in the morning,at night,or any time.The distributing of 462 smear positive in the morning,at night,or any time have great importance.Conclusion The sputum collected in different time has a great influence on the positive rate of acid fast bacillus.The determination of morning sputum should be emphasized.