Table of Content

10 June 2001, Volume 23 Issue 6

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Rapid detecting of the genomic mutations of the multidrug-resistant Mycobacterium tuberculosis by polymerase chain reaction-single strand conformational polymorphism

HUANG Si yi,QIU Wang long,PAN Zhi ling,et al.

. 2001, 23(6):  341-343. 

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Objective RpoB、KatG、rpsL genes mutation analysis of INH、RFP、SM resistance in isolates of M.tuberculosis (MTB) were undertaken by PCR single strand conformation poylymorphism (SSCP),and to evaluating the value of diagnosing resistance of MTB.Methods Detecting of INH、RFP、SM resistance in 32 isolates strains of MTB and drug susceptivity in 25 isolates strains of MTB by PCR SSCP.Results Among 32 multidrug resistant isolates strains of MTB,28、19、23 isolates had very different rpoB、KatG、rpsL gene mutation pattern of PCR SSCP compared with that of the reference strain (H ₃₇ Rv),and drug susceptivity in 25 isolates had the same PCR SSCP pattern.Compared with drug sensitive test,sensitivity to detecting rpoB、KatG、rpsL genes by PCR SSCP was 87.5%,59.3%,71.9% respectively,and specificity was 100%.Conclusion PCR SSCP is a sensitive and specific method for rapid detecting rpoB、KatG、rpsL genes mutations of MTB,and useful in rapid detecting the multidrug resistant MTB.

Study on the PCR-ECL method for rapid detecting Mycobacterium tuberculosis

WANG Hong jun,ZHOU Yi kai,WANG Jia ling,et al.

. 2001, 23(6):  344-347. 

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Objective Establishing a rapid PCR-ECL method of high sensitivity and high specificity for detecting M.tuberculosis .Methods The 419bp fragment existed in gene coding for Pab in M.tuberculosis and M.bovis was used as target.The sequence of the primer was 5′-ACCACCGAGCGGTTCGCCTGA-3′,5′-GATCT-GCGGGTCGTCCCAGGT-3′.The PCR system was optimized to select the proper concentration of primer,dNTPs and MgCl₂ and the annealing temperature and the cycle number to get high sensitivity and specificity.The polymerization production of 419bp fragment was purified and was used as probe.The probe was labeled by HRP with direct enzyme labeling methed.After polymerization the product was denatured and dotted on the nitrocellulose membrane,the DNA was detected using enhanced HRP luminol-H₂O₂-chemiluminescence system in the molecular hybridization test.Imitative specimen was made by suspending different concentration of M.tuberculosis with sputum of healthy person. M.tuberculosis was incubated with Lowenstein Jensen culture media at 37℃ for 2 weeks.The incubation was killed by being suspended in 70% alcohol for 15 minutes.Guanidinium thiocyanate silicar method was used to purify chromosomal DNA of M.tuberculosis of imitative specimen.Results The concentration of primer was selected as 0.3μmol/L,that of dNTP was 150μmol/L,that of Mgcl₂ was 3.5mmol/L the annealing temperature was 69-70℃,the cycle number was 35.In the standard strains of M.tuberculosis, M.bovis, BCG, M.avium, M.intracellulare, M.godonae, M.ulcerans, M.smegmatis, M.phlei, M.vaccae, M.gilvum and 13 clinical separated strains,the PCR Results of M.tuberculosis ,M.bovis,BCG were positive.The sensitivity of PCR system was 5fg purified chromosomal DNA,which was about the DNA of 1 M.tuberculosis cell.The sensitivity of ECL was 0.5pg DNA.Less than 10 M.tuberculosis cells could be detected with the imitative specimen.Conclusion A rapid PCR-ECL method for detecting M.tuberculosis was established.The detection could be finished in one and half days.

The diagnostic value of Anti-PPD-IgG in serum and pleural effusion for tuberculous pleural effusion

DENG Nian qiang.

. 2001, 23(6):  348-350. 

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Objective To ascertain the diagnostic of anti-PPD-IgG in serum and pleural effusion for the tuberculous pleural effusion.Methods Anti-PPD-IgG in serum and pleural effusion were obtained from 58 tuberculous pleural effusion cases detected by using enzyme linked immunosor bent assay (ELISA) while comparing with the positive rate of pleural biopsy and Mycobacterium tuberculosis in pleural effusion of these cases.42 cases of non tuberculous pleural effusion wewre randomly selected as control.Results The positive rate of Anti-PPD-IgG in serum (82.8%) and pleural effusion (96.6%) in tuberculous pleural effusion group were higher than that of pleural biopsy (56.9%, P<0.005 ) and Mycobacterium tuberculosis in pleural effusion (0%, P<0.005 ) and also higher than those of Anti-PPD-IgG in serum (11.9%, P<0.005 ) and pleural effusion (21.4%, P<0.005 ) of the control group,which with statistical significance.The sensitivity,specificity and accuracy of Anti-PPD-IgG in serum and pleural effusion to diagnose the tuberculous pleural effusion were 82.8%,88.1%,85.0% and 96.6%,78.6%,89.0% respectively.Conclusion The Results suggested that detection of Anti-PPD-IgG in serum and pleural effusion by ELISA method was useful for diagnosis of tuberculous pleural effusion.

Surveillance of the quality of neonatal BCG vaccination in Beijing

LI Bo,WU Shao qin,TU De hua.

. 2001, 23(6):  351-353. 

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Objective To evaluate the quality of neonatal BCG vaccination in Beijing in the recent ten years.Methods To conduct a yearly analysis for the filed data of local neonatal BCG vaccination from 1991 to 2000.Results Six indications such as the BCG vaccination rate,the vaccination rate within one month after birth,the PPD positive rate after 12 weeks’ BCG vaccination and the rate of BCG scar,the mean value of diameter of the induration in tuberculin skin test and that of the BCG scar varied very little in the recent ten years in the whole city.There were no significant difference in BCG vaccination rate in the three areas of urban,suburban and rural,which were all above 97%.Meanwhile,the other two indications such as the PPD positive rate after 12 weeks’ BCG vaccination and the mean value of diameter of the induration in tuberculin skin test in rural area were also very similar to urban and suburban areas.Conclusion The quality of neonatal BCG vaccination in Beijing was good and all indications in relation to surveillance were stable in the recent ten years.

Analysis of the effect of three tuberculosis control programmes in Yancheng

HUAHG Lian zhang,YIN Wei,XING Ya.

. 2001, 23(6):  354-356. 

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Objective To evaluate the effect of three five-year tuberculosis control programmes in Yancheng city.Methods To analyze case finding,treatment effect,investment and returns during the time when three five-year tuberculosis control programmes were carried out.Results The ratio of the new smear positive to the active pulmonary tuberculosis new register was from 19.4% of the seventh five-year program elevated to 31.3% of the ninth’s,the cure rate of the new smear positive was from 84.1% to 93.4%,the average annual reduction rate of the smear positive was 3.7%.Conclusion Government commitment,expenditceve investment and popularizing the modern strategy for tuberculosis control were the key measures to realize the Objective of the tuberculosis control program.

Analysis of the epidemic situation of tuberculosis in the Hani nationality of Honghe prefecture,Yunnan province

BAI Qing fen.

. 2001, 23(6):  357-359. 

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Objective To explore the tuberculosis prevalance about the Hani nationality poputation of Yunnan province.Methods To conduct The PPD test and examine the BCG inocualation ecar on the children from aged 3months to 15 years old.To take the chest X-ray film on those with strongly prositive reaction of PPD test.The sputum examination for acid fast bacillus were performed for all cases who had the suspect tuberculosis symptoms.Results 23 cases with active tuberculosis were found in this investigation. The detect rate was 5.7%. 3 cases were smear positive and the prevalence of smear positive was 746.27/105.25 cases were foune to be strongly positive reaction of PPD test,it’s rate showed 14%.Conclusion The state of tuberculosis prevalence in Honghe prefecture,Yunnan province in very critical.

A study on the effects and affect factors of tuberculosis control in temporary residents of Shenzhen

HUANG Qi lie,CHEN Wei,ZHANG Xing shu

. 2001, 23(6):  360-363. 

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Objective To study the effects and affecting factors of tuberculosis control in temporary residents of urban district,Shenzhen.Methods To do social and economical investigation to every patient with pulmonary tuberculosis. To analyse the statistics of initially consulting register, county tuberculosis register and treating cards of management. Results There were 540000 temporary residents in Luohu district in 1998,1.8 times more than the local population.The temporary residents without temporary identification were defined floating population.The registered rate of pulmonary tuberculosis in temporary residents was 109.21/100000, distinctly higher than that of the local population. The cure rate of pulmonary tuberculosis in temporary residents was 68.9%, evidently lower than the local population (93%). Especially the cure rate of pulmonary tuberculosis in floating population was only 35%. Conclusion The work of 81.1% floating population was heavy and the working hour was long,their wages were low,33.7% pulmonary tuberculosis patients had social medical insurance.Therefore lose rate was 27.5%, most of them prolonged to be diagnosed.The authors suggested that strenghened the propagation power and giving the regional tuberculosis control programme to floating population for free will be benefit in crontrolling the regional tuberculosis.

Evaluation of quality and effect of DOTS implemented in a mountainous area for 10 years in Pinggu conuty,Beijing

QI Li you.

. 2001, 23(6):  364-365. 

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Objective To evaluate the quality of DOTS conducted for 10 years and to compare the effect of implementing by medical personnel and nonmedical personnel in Pinggu County.Methods Retrospectively ana lysed the status of 76 new smear positive pulmonary TB cases with completed treatment course.interviewed the patients,family numbers and village doctors,and checked the medical records,registered cards,chest X-ray film and sputum status at meantime.Results 76 cases conducted DOTS,69(90.8%) of them conducted DOTS by medical personnel and its cure rate was 100%;and the cure rate conducted DOTS by nonmedical personnel was 81.8%. Conclusion The quality and effect of DOTS conducted by medical personnel were the best.The quality and effect of DOTS conducted by nonmedical personnel and non conducted DOT were poor,and their Results were similar.

The analysis of the situation of newly registered cases of pulmonary tuberculosis in primary and middle school students in Funing county,1985～2000

GAO Wei hua.

. 2001, 23(6):  366-368. 

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Objective To grasp the situation of pulmonary tuberculosis prevailing in students and to reduce its rate.Methods To strengthen the convergence case management of TB in the whole county,intensitied the monitoring of epidemic situation in primary and middle school students.Results In the fifteen years from 1985 to 2000,there were 448 cases of newly registered TB in the primary and middle school students of whole county.The proportion of boy students to girl students is 1：0.7.Student with whose sputum smear positive were 24.3%.The average incidence of which was 3.8/10 millions every year.Conclusion The incidence of TB in primary and middle school students was lower than the average level of whole county,and there is a downward trend in the rate per year.The rate of girls was lower than that of boys,but the positive rate of sputum examination is not high.

Analysis of tuberculosis cases from 1995 to 1998 in Karamay

LIU Yan,LI Jing tin,LIU Yong gang,et al.

. 2001, 23(6):  369-371. 

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Objective To evaluate the effect of tuberculosis control project loaned by World Bank in Karamay.Methods To analyse the registration situation and the treatment effect of the tuberculosis patients accofding to tuberculosis registration report from 1995 to 1998 in Karamay.Results The new smear-positive registeration rates remarkably declined from 1995 to 1998.The tuberculosis cases of floating population in creased.The cases of minority mationalities also raised year by year and of the end of 1998,they accounted for 63.5% of the total cases.Conclusion Satisfactory Results have been achieved of tuberculosis control project by World Bank loan in Karamay.

The analysis on situation of convergence case-management of TB cases in Weihai

ZHANG Cheng cui,LIU Xiao yun,LIU Xin rong,et al.

. 2001, 23(6):  372-373. 

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Objective To control the suspect TB patients and the condition of transferring TB patients. Take some measures to enhancing the case finding level of TB patients and the effect of convergence case management.Methods To do the statistical analyses of the case data from the general hospitals in 8 years.Results The transferring rate of TB patients in general hospitals has enhance year after year.Conclusion Take some effective administrative measures,enhancing the transferring rate of TB patients is the key of convengence cases.

Clinical manifestation and diagnosis of localized lower lobe tuberculosis in adults

CANG Long-qing,CANG Yan,TANG Sheng jie.

. 2001, 23(6):  374-375. 

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Objective Investigate the clinical manifestation of localized lower lobe tuberculosis in adults and improve diagnostic capacity.Methods To analyse the clinical characteristics of 42 patients with localized lower lobe tuberculosis.Results Clinical manifestation of most patients was atypical and covered by concomitant diseases.Most cases had increased bronchovascular shadows and blurred margins in chest X-ray examination,with small patchy and maculas shadows,with rare mixed foci and pulmonary cavity.Conclusion Localized lower lobe tuberculosis in adults was easily mis diagnosed for its atypical clinical manifestation and X-ray feature.Diagnosis at early stage depends on sputum examination for tubercle bacilli and fibrobronchoscope examination.

Intrapleural urokinase in the treaatment of loculated pleural effusions

ZHANG Xin gao,LIU Dong yuan,LI Su ying,et al.

. 2001, 23(6):  376-378. 

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Objective To explore the role of intrapeural injection of urokinase for patients with loculated pleural effusions.Methods 67 patients with loculated pleural effusions were dirided into 3 groups randomly,urokinase or chymotrypsin plus NS 100ml were injected 100000～200000U/time respictively into the pleural cavity of 25 and 22 patients with loculated pleural effusions,while NS 100ml was injected into the pleural cavity of 20 patients,as the control group.Results After urokinase or chymotrypsin has been used to dissolve the loculi,the therapeutic effects of UK group were better than chymotrypsin group (P<0.05).As comparing the drainage volumes of fluid,UK group was significantly better than chymotrypsin group (P<0.01),NS was no useless to separated loculi and drainage vulumes of fluid.Conclusion Intrapleural injection of UK or chymotrypsin was the effective and safe method for the treatment of loculated pleural effusions.

The clinical observation of the present duration of anti TB-IgG in the cured tuberculosis patients

ZHAO Yi hong,HUANG Run tang,CAO Song,et al.

. 2001, 23(6):  379-381. 

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Objective To observe the present duration of the anti TB-IgG in the serum in cured tuberculosis patients.Methods The anti TB-IgG in the serum in cured tuberculosis patients had been tested by ELISA in which PPD acts as the coated antigen every three months for 18 months.Results The number of positive patients decreased gradully.The decreasing rate was the greatest from 109 patients in the 9th month (63.0%) to 21 patients in the 12th month (12.1%).The number of positive patients in the 12th month was much more than that of healthy control (P< 0.05).The number of positive patients in the 15th month was 11(6.4%) and no significant difference from the health control (P> 0.05).Conclusion The present duration of anti TB-IgG in the cured pulmonary tuberculosis patients was about 12 months to 15 months.On the chronic fibrotic caritary tuberculosis patients,before the treatment its focus scope was wide,after cured,the present duration of the patients with the proliferativeform as the major focus was longer.