Table of Content

10 April 2001, Volume 23 Issue 4

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An operational control research of two different case-management methods for new smear-positive pulmonary tuberculosis cases

WANG Xue jing,et al.

. 2001, 23(4):  215-218. 

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Objective To seek an effective case management Methods to be used in villages,especially in remote and poor areas of our country.Methods To select new smear positive pulmonary TB cases in 20 counties of Hebei province and to divide them into two groups,namely standardized self administrative treatment and directly observed treatment.All of selected patients were treated with initial smear positive short course regimen:2H₃R₃Z₃E₃(S₃)/4H₃R₃,and observed the outcomes and the situation of interrupted treatment under two different case management methods.Results By the end of treatment,the sputum conversion rate of the patients under standardized self administrative treatment and directly observed treatment was 97.1% and 98.5% respectively and the interrupted treatment rate was 0.2% and 0.12% respectively.Conclusion The same effectiveness can be gained between standardized self administrative treatment and directly observed treatment.

Analysis on one year implementation effect of fujian province WHO/WPRO TB control project

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

. 2001, 23(4):  219-221. 

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Objective Initial success had been achieved in WHO/WPRO TB control project which was carried out in the four counties of Fujian province a year ago.Methods In accordance with the organization and technical standards set by the project “the scheme put into effect”,DOTS strategy recommended by WHO was carried out.Results the project was put into practice in the four counties with a coverage of the population 1604000 and an investment of special fund 75000. During the first year of practice, the new registered rate of the new smear positive cases reached 20.45/100000. The cure rate of initial treatment smear positive pulmonary Tuberculosis reached 97.2%. Conclusion The project had achieved the anticipated goal. As a result the five elements had been well carried out and the new registered rate of new smear positive cases was more than 20/100000.The cure rate of initial treatment smear positive cases was higher than 90%.

Study on MICs’ distribution of three kinds of fluoroquinlone against Mycobacterium tuberculosis

ZHANG Xu xia,WANG Su min,GAO Wei wei.

. 2001, 23(4):  222-224. 

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Objective To explore the MICs’ distribution of ofloxacin,levofloxacin and ciprofloxacin against clinical isolate of Mycobacterium tuberculosis in vitro strains.Methods The MICs of these drugs were determined by equivalent dilution method.Results Of 21 clinical isolates of M.tuberculosis not previously exposed,and of 15 clinical isolates previously exposed within 4 weeks to these drugs,the MICs of 20 (95.2%) and 13(86.7%) respectively were closed to that of Mycobacterium tuberculosis H₃₇Rv’s,of 16 isolates of M.tuberculosis previously exposed beyond 4 weeks,MICs of 15 isolates (93.7%) were higher than that of H₃₇Rv.Conclusion If the three drugs were treated patients with tuberculosis for a long time,the MICs of M.Tuberculosis of these drugs might be increased.

Analysis for diagnostic delay of new smear positive patients

HOU Shuang yi,XIAO Ai qing,LI Guo ming,et al.

. 2001, 23(4):  225-227. 

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Objective To investigate the diagnostic delays of newly smear positive cases in Hubei.Meth ods Consulting the history of new smear positive cases in 6 counties.Results To collected 108 cases in 6 counties/cities.The average time of patient delay,doctor delay and total delay was 4.6 weeks,6.4 weeks and 8.7 weeks,respectively.The initial symptoms of delayed patients were cough (88.9%),expectoration (78.7%) and hypodynamia (37.0%),etc.The main delayed reasons were paying no attention to symptoms (58.7%),economic difficulties (34.8%).Only 10.2% of patients had sputum smear results.Other patients were only diagnosed by X ray examination.Conclusion The main reason of patient delay was that patients did not care for their own health,the main reason of doctor delay was that doctors paid more attention to X rays examination than sputum inspection.

Clinical observation of chemotherapeutic effect in 124 cases of pneumoconiosis tuberculosis

YU Zhong ying,LIU Yao song,LU Cai gang,et al.

. 2001, 23(4):  228-230. 

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Objective To assess the therapeutic efficacy of chemotherapy with varied course on culture positive pneumoconio tuberculosis cases.Methods To observe the therapeutic effect in 124 patients with culture positive pneumoconio tuberculosis in 10 years.According to chemotherapy duration,patients were divided into 12 month group (3HRZS/9HRE),18 month group (3HRZS/6HRZ/9HRE) and 24 month group (3HRZS/6HRZ/12HRE).All patients who completed the therapy were followed up for 5 years.Evaluating the therapeutic effect depended on sputum bacteriological conversion.Results Sputum negative conversion rates of 3 groups at the end chemotherapy were all 99.2%,and their recurrent rates in follow up period were 17.4%,3.8%,and 1.4% respectively.Conclusion 12 month regimen is suitable for phrase Ⅰ～Ⅱ pneumoconio tuberculosis,24 month regimen is suitable for phrase Ⅲ pneumoconio tuberculosis.

Analysis of the relationship between the drug-resistance and the short-course chemotherapy effect in 228 pulmonary tuberculosis patients

HAN Yong xing,YAO Qiang,YU Ding,et al.

. 2001, 23(4):  231-232. 

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Objective To analyze the relationship between the drug resistance and the short course chemotherapy effect in 228 new smear positive pulmonary tuberculosis patients.Methods The treatment regimens of 228 cases were short course intermittent chemotherapy,and all cases had been done the susceptibility tests with absolute concentration method.Results After complete the 6 months treatment course,the rate of failure in 33 drug resistant cases was 12.1%. (1)In R resistant cases and drug sensitive cases,the rate of failure was respectively 40% (2/5) and 2.6%(5/195).There were significantly difference (P＜0.05).(2)In the other drug resistant cases (except R resistant cases),the rate of failure was 7.1%,and it was no significantly difference from drug sensitive cases (P＞0.05).The check in 2 years showed that the positive conversion rate was 3.5% in drug resistant cases,and 1.1% in drug sensitive cases.Conclusion It is reasonable and effective to cure drug sensitive cases and drug resistant cases (except R) with the short course intermittent chemotherapy.

Analysis in surgical treatment for 38 cases of unilateral destroyed lung

WANG Jia li, HAN Dian hui, WANG Xiao-ming.

. 2001, 23(4):  233-234. 

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Objective To study the experience of surgical treatment for unilateral destroyed lung.Methods From 1982 to 1998 we performed pleuropneumonectomy to treat 38 cases of unilateral destroyed lung.Results The quantity of operative hemorrhage was 800ml to 7?200ml,over 1?000ml was in 27(71.0%),over 3?000ml was in 13(34.2%). There was a cure rate of 97.4%, a mortality of 2.6%, and an incidence of postoperative complication of 7.9%. Conclusion Pleuropneumonectomy on these cases was very difficult. The main difficulty was dissection of the lung and handling of the hilum. There was loss of a great deal of blood. the incidence of postoperative complication was high. It should be strict to handle the operative indication. Circulation monitoring at operation and meticulous operative procedure were most important. Prevention of intrathoracic infection was of significance.

Study on the value of transbronchial needle aspiration in bronchial tuberculosis diagnosis

TIAN Jing lun,ZHANG Fu yun.

. 2001, 23(4):  235-237. 

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Objective To explore the value of transbronchial needle aspiration (TBNA) in diagnosing the bronchial tuberculosis.Methods TBNA biopsy was performed in 36 cases of patients with the bronchial tuberculosis (BT),the Results were compared with those of brushing and operational specimens for cytological examination.Results The Results showed the correct diagnosis rate was 83.3% (30/36) for TBNA,44.4% (16/36) for brushing and 55.6% (10/18) for operational specimens and cytological examination.Of 21 cases BT,the early diagnosis was 90.5% (19/21) for TBNA and 28.6% (6/21) for brushing.There was significantlly different in them (P＜0.005 ).Conclusion TBNA could help enhance the correct diagnosis rate in BT,especially for the old patients.

Rapid detection of rifampicin susceptibility of Mycobacterium tuberculosis by bioluminescence based on film

FU Zhi jun,et al.

. 2001, 23(4):  238-240. 

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Objective To develop a rapid method for determining rifampicin susceptibility of Mycobacterium tuberculosis by luminescence based on Polaroid T677 film.Methods The recombinant mycobacteriophage which can express luciferase during it propagated in related bacteria was used to detect the vitality of M.tuberculosis in liquid medium containing rifampicin and luminescence was recorded by an Polaroid T677 film.The susceptibility of 43 strains of tuberculosis mycobacterium to rifampicin was determined by luminescent photography of Polaroid T 677 film.Results Compared with method of L-J slant,the sensitivity and specificity of bioluminescent photography were 95.7% and 90% respectively.The optimal bacteria concentration for luminescence detection was 10⁷～10⁸ CFU/ml bacteria;the optimal reaction time for rifampicin reaction was 48 hours;and the optimal rifampicin concentration for drug susceptibility test is 1mg/ml.The detection time was within 72 hours and can be detected by naked eyes.Conclusion Luminescent photography assay was a rapid,simple,sensitive and selective method for detection rifampicin susceptibility of Mycobacterium tuberculosis strains.

Study of the mushroom biphasic culture’s application on the tuberculosis culture

SHEN Jian wei, YUAN Wei, LI Ping, et al.

. 2001, 23(4):  241-244. 

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Objective On the base of mushroom extract, processed a new kind of biphasic culture for tuberculosis’s culture.Methods H₃₇R_v basic test and 351 clinical samples were cultured on both acid Lowenstein-Jensen culture medium and mushroom biphasic culture.Results It shows that the total positive result is 172(49%). Among them, the mushroom biphasic culture’s positive result is 166(47.2%), the acid Lowenstein-Jensen culture medium is 144(41.0%), and the positive rate (of the total positive result) is 96.5% and 83.7%. For the more, the primary grow time on the mushroom biphasic culture is much shorter. Conclusion All shows that mushroom biphasic culture, which is processed conveniently and cheaply, has good practical value in many basic hospitals and tuberculosis hospitals.

Detection of DNA of Mycobacterium tuberculosis in cerebrospinal fluid by Amplisensor-PCR

LIAO Jin liang, TAN Yao ju, CHEN Zhi cheng, et al.

. 2001, 23(4):  245-247. 

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Objective To study the diagnostic value in patients with tuberculous meningitis of the detection of DNA of Mycobacterium tuberculosis in cerebrospinal fluid by Amplisensor-PCR.Methods The DNA of Mycobacterium tuberculosis in cerebrospinal fluid in 117 patients with tuberculous meningitis and 36 patients with non-tuberculous menigitis was detected by Amplisensor-PCR. The result was compared with the data detected by PCR, smear and culture.Results The positive rate of Amplisensor-PCR, smear and culture were respectively 57.3%, 1.7%and 6.7%; The sensitivity of Amplsensor-PCR was significantly high than that of smear and culture.(P＜0.001). Conclusion The lower limit of Amplisensor-PCR may be calculated and the value of primitive target DNA be covered through the standard curve. The Amplisensor-PCR had high specificity and sensitivity and diagnostic value to tuberculous meningitis.

Features of experimental tuberculosis in Wistar rats

CHEN Hong,et al.

. 2001, 23(4):  248-249. 

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Objective To observe the features of experimental tuberculosis in Wistar rats.Methods Wistar rats were intravenously injected with H₃₇R_v.They were sacrificed six weeks later to observe pathomorphology changes in lung,liver,and spleen tissues.We also did Mycobacterium tuberculosis culture of lung tissues.Results There are typical tubercle lesions in the lung tissues of experimental rats but not in liver,and spleen tissues,and 100% of the positive controls were infected.Conclusion Wistar rats can be infected by Mycobacterium tuberculosis and can be used as animal model of experimental tuberculosis.