Table of Content

10 February 2001, Volume 23 Issue 2

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Investigation of infection and onset of tuberculosis in children and youth after termination of BCG vaccination

WANG Hua jin,ZHOU Chang shan,WEI He ping,et al.

. 2001, 23(2):  81-84. 

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Objective To observe the infection and incidence of tuberculosis in children and youth after termination of BCG revaccination.Methods In 1998,PPD testing was conducted on 12 years old students from Fangshan district (BCG revaccination termination group) and Tongzhou district (BCG revaccination not termination group) of Beijing respectively,PPD reactions were measured at 72 hours,chest X ray examinations were performed on those with average diameter≥6mm indurations,acid fast bacillus detection was done for ones found exhibiting lung shadows and so on.Then,calculate tuberculosis infectious rate and morbidity according to PPD reaction intensity and finding of active tuberculosis patients.Results Morbidities of active pulmonary tuberculosis for BCG revaccination termination group and BCG revaccination not termination group were respectively 14.8/10⁵ and 18.6/10⁵ (P＞0.05).Tuberculosis infectious rates:when criterion as diameter ≥15mm 7.9% and 19.6% respectively (P＜0.005),and when criterion as diameter ≥20mm 3.9% and 4.2% respectively (P＞0.05).Therefore,the two indicators used as reflecting tuberculosis infection and onset after BCG revaccination termination were both not higher and even lower than the BCG revaccination group.Conclusion BCG revaccination termination don’t increase tuberculosis infection and initiation in children and adolescents.It can spare a large amount of manpower,material recourses,and financial capacity.

Expression of MPT64 protein of Mycobacterium tuberculosis in Escherichia coli and its purification application.

WU Xue qiong,ZHANG Jun xian,LI Hong min,et al.

. 2001, 23(2):  85-88. 

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Objective To obtain the recombinant MPT64 protein,to study its immunological characteristics,and to evaluate its potential value for serodiagnosis of tuberculosis.Methods The gene coding MPT64 protein inserted into a expression vector pET 15b,and then transferred to E.coli BL21(DE3).The expressed product was purified by metal chelation chromatography,and analyzed its immunogenicity by western blotting.66 human serum was detected the antibodies against M.tuberculosis rMPT64 and PPD antigens by ELISA,and antibodies against M.tuberculosis antigens by tuberculosis one step test.Results Sequencing recombinant plasmid pET 15b MPT64 showed that there was a mutation (CCA→CCG) at codon 83,but its amino acid had no change.The recombinant MPT64 protein existed in inclusion bodies of E.coli ,and amounted to 20～30% of total bacterial proteins.Its molecular weight was about 26 kilodalton.It can produce good immunoreactivity with serum from goats vaccinated with M.tuberculosis by western blotting.The purity of final product was about 80%.10mg of rMPT64 protein per 100ml culture could be obtained.The positive cutoff values were OD₄₉₂ plus 2 standard deviation of 33 negative serum detected by ELISA.Of 33 serum from tuberculosis patients,the specificity and sensitivity of PPD as antigen of ELISA were 94% and 63.7%,That of rMPT64 were 94% and 30.3%,and that of tuberculosis one step test were 88% and 66.7%,respectively.Conclusion The recombinant MPT64 protein could be highly expressed in the form of inclusion bodies in E.coli. It had good antigenic specificity and immunoreactivity,and might be selected as one of serodignostic antigen of tuberculosis.

Clonizine the probe of IS6110 of Mycobacterium tuberculosis

ZHANG Zong de,JIA Hong yan,Ma Yu,et al.

. 2001, 23(2):  89-90. 

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Objective Obtain the clonized IS6110 probe.Methods Clone the 245bp IS6110 PCR product into plasmid pCR2.1.Results Get the E.coli strain containing Objective insert fragment.Conclusion Colonized probe can made comparable Results and easy to use.

Analysis on effects of TB control project loaned by World Bank in Hubei (1992～1998)

LIU Jin lan,XIONG Chang fu,WANG Xiao jing,et al.

. 2001, 23(2):  91-94. 

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Objective Analyze the effects of TB control project in Huebei province (1992～1998). Methods Collect and analyze the project quarterly report and annual report in the period during 1992～1998.Results The coverage rates of counties (cities) and population were 100% and 95% respectively.410 000 cases suspected of pulmonary TB were received at the TB clinics.93.8% of them were implemented DOTS policy.The cure rate for initial treated cases was 95.3% and 91.3% for retreated cases.Conclusion The TB control project loaned by World Bank in Hubei made a great progress during the last seven years,but there was 10.7% of gap compared with our initial goal (finding 126 000 smear positive cases).We must adopt strong measures against TB to speed up the step of TB control.

Evaluation on unbalance and affecting factors conducting the tuberculosis control project loaned by World Bank in Shandong province

TAN Jing lu,WANG Shi chang,HAN Jian ping,et al.

. 2001, 23(2):  95-98. 

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Objective To evaluate on unbalance and its affecting factors of conducting the tuberculosis control project loaned by World Bank in 17 prefectures of Shandong province.Methods To analyse conducting project from 1994 to 1998.Results In 17 prefectures,the average annual new smear positive register rates were 8.9/10⁵ to 29.1/10⁵;the cure rates of new smear positive and retreatment cases were 88.1% to 97.6% and 79.3% to 94.1%,respectively.Conclusion To find out the reasons for unbalance in the aspect of tuberculosis control in all prefectures,facilitate the TB control programme,reduce the difference in tuberculosis control in all prefectures.

Study on tuberculosis control status of floating population in Shenzhen

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

. 2001, 23(2):  99-102. 

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Objective Tuberculosis control among floating population is new focus today,summarize some experience of tuberculosis control among floating population in Shenzhen.Methods The tuberculosis control of floating population had been get into Regional Tuberculosis Control Program (RTP) in Shenzhen since 1993.The tuberculosis cases of floating population had been managed with Directly Observed Treatment,short course chemotherapy (DOTS),as same as the resident cases.Results and Conclusion There were 7 368 floating TB cases registered from 1993 to 1999 in Shenzhen.3 603 of which were new smear positive cases.87.3% of 3 603 were 15～34 age group.All of above cases were managed with DOTS,the cure rate was about 97%.The effect of management and treatment on floating cases were the same as resident cases.The tuberculosis control get into RTP are feasible and effective,which could effectually control the epidemiologic situation of tuberculosis.

The situation and effectiveness of pulmonary tuberculosis convergence case-management in Dalian

LU Xi wei, ZHANG Hong juan, SHEN Jie, et al.

. 2001, 23(2):  103-105. 

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Objective To explore the role of convergence case-management in tuberculosis control.Methods Start the work of convergence case-management according to ‘The Management Methods of Prevent and Treatment Tuberculosis in Dalian’ under administrative intervention. All cases with smear positive were treated by the directly observed chemotherapy.Results The report cards of suspicious pulmonary tuberculosis cases increased from 448 pieces in 1997 to 2533 in 1999. The retain rate declined from 74.0% in 1997 to 2.8% in 1999. In 1997～1999, the proportion of the transfer finding cases in the new smear-positive case was 65.9%, 88.0% and 90.7% respectively. The annual register rate of new smear-positive was markedly increased than that before conduct the work of convergence case management. In 1997～1999, The cure rate of new smear-positive case was 93.9%, 95.3% and 95.0% respectively. Conclusion 1. The level of cases finded is in direct proportion to the convergence case-management. 2.Convergence case-management plays a major role in the new smear-positive case finding. 3.Convergence case-management and DOTS is a useful measure to improve case finding rate and cure rate of new smear positive cases.

The analysis of factors affecting seek medical advice of suspect pulmonary TB cases

YANG Cheng-feng,YANG Shu-wang,LI Ming-chen.

. 2001, 23(2):  106-109. 

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Objective To increase the rate of seeking medical care by suspected TB cases, to achieve the project goal of “high detection rate".Methods Comparison and analysis of various factors affecting patients seeking medical help in various counties/cities.Results The provincial maximum average service radius is 46.7km,rate of seeking medical care is 1.66%;the maximum service radiuses and the rate of seeking medical care by suspected patients for poor counties/cities at national level,that at provinical level and mountainous counties/cities are 60.6km,1.41‰;46.7km,1.48%;and 57.4km,1.55‰,respectively.It is indicated that factors such as economy do not have much influence on medical care seeking behavior with strengthened education and training.Conclusion Comprehensive measures should be taken to improve medica care seeking behavior.Publicity and education on TB should be conducted during project implementation;policies on free or proper reduction in charge for diagnosis and treatment are carried out;more assigned centers or mobile teams should be established and patients placed in assigned hospitals for treatment and control.

Drug resistance observation on pasiniazide for the TB bacteria resistant to INH and PAS

SUN Li,XI Jia ning,KANG Li jun, et al.

. 2001, 23(2):  110-111. 

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Objective To determine the PSNZ drug resistance incidence among INH and PAS-resistant M.tuberculosis.Methods By applying the reformed L-J medium, observe and compare the drug-resistance and drug-susceptibility to PSNZ in 36 INH and PAS resistant-M. tuberculosis, and 149 INH and PAS sensitive M. tuberculosis.Results 44.4% of the 36 INH and PAS resistant-M. tuberculosis are susceptible to PSNZ at the concentration of 1μg/ml; 96% of the 149 INH and PAS sensitive M. tuberculosis are susceptible to PSNZ at the concentration of 1μg/ml.Conclusion PSNZ is still effective to some of the TB bacteria resistant to INH and/or PAS. It is an independent anti-TB drug. It can be used as one of the effective drugs for treat the MDR-TB.

Analysis of the TB prevalence in the She nationality of Fujian province

CHEN Qiu yang,ZHAO Rui ying,CAO Guang nong,et al.

. 2001, 23(2):  112-113. 

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Objective To Investigate the TB prevalence about the Fujian She nationality population.Methods Proceed the investigation according to the 4th National TB Investigative Project.Results In the six investigative places,the active tuberculosis prevalence is 429.0/10⁵,the prevalence of smear positive cases is 237.3/10⁵,the prevalence of culture positive cases is 248.6/10⁵,Which are as 1.8 times,2.5 times and 1.9 times as the prevalence in the seven Fujian investigative places during the same year.There were 11 smear positive cases had known before the investigation,in which we found 21 smear positive cases altogether,but only 3 cases (27.3%,of the 11 cases) had been registered.The percentage of re treatment patients were 52.4%,the children BCG scar rate was 63.9%.Conclusion The state of the TB prevalence in the Fujian She nationality is very serious,and the preventive action is quite backward.

Clinical analysis of 13 cases with tuberclous appendicitis

SHEN Xing hua,WU Jian qian,

. 2001, 23(2):  114-116. 

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Objective To explore the clinical characteristics and treatment of tuberclous appendicitis. Methods The clinical data of 13 tuberclous appendicitis cases confirmed by pathology were analyzed retrospectively, and all cases were treated with antituberculosis drugs. Results All cases were misdiagnosed before operation and were cured with antituberculosis drugs after operation.Conclusion Tuberclous appendicitis is extra pulmonary tuberculosis and is rare, the early diagnosis and timely operation should be performed and treated with anti tuberculosis drugs as soon as possible.

Diagnosis and treatment of thyroid tuberculosis

YING Jing fang,XU Yin.

. 2001, 23(2):  117-119. 

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Objective To summarize the diagnosis and treatment of thyroid tuberculosis.Methods Retrospectively analyze 48 cases with thyroid tuberculosis confirmed by pathology received surgical operation. Results Before the surgical operation, the mojority of cases were misdiagnosed as thyroid adenoma, the minority were misinterpreted as thyroid carcinoma or thyroiditis, and few cases were suspected as thyroid tuberculosis. Performed local excision in 32 cases, unilateral thyroid lobectomy in 6 cases, bilateral subtotal thyroidectomy in 4 cases, isthmectomy in 3 cases and incision & drainage in 3 cases. In addition, also performed neck dissection in 3 cases. All the patients were treated with anti-tuberculosis drugs for 9 to 12 months and were recovered. All the patients were followed up for 1 to 22 years and didn’t recur. Conclusion Cytological examination by fine-needle aspirate biopsy was helpful to diagnosis. The first choice was treatment with anti-tuberculosis drugs. To the diffuse enlargement of the thyroid could perform incision & drainage, and after the operation could irrigate the lesion with anti-tuberculosis drugs.

Influence of administrative intervention on tuberculosis convergence case-management

FENG Wei guo.

. 2001, 23(2):  120-122. 

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Objective To evaluate the effects of administrative intervention on tuberculosis convergence case management.Methods 17 general hospitals were chosen at random from all kinds of hospital in Xiangfan city,and adopeted some measures of administrative intervention and lawful supervision to caryy out tuberculosis convergence case management.Investigated and compared tuberculosis convergence case management situation in general hospitals before and after the measures has been adopted.Results Through the intervention measures,the pulmonary tuberculosis patients transfer and report rate in general hospitals went up from 24.3%,27.0% to 75.3%,87.2% respectively before and after interventien.Conclusion It’s effective to strengthen administrative intervention and lawful supervision for curring out tuberculosis convergence case management in general hospitals.