Table of Content

10 March 2000, Volume 22 Issue 3

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The effect analysis of tuberculosis control project loaned by World Bank in Dalian

ZOU Xue-mei,ZHAO Qin,ZHANG Hong-juan.

. 2000, 22(3):  113-115. 

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Objective To evaluate the effect of tuberculosis control project loaned by World Bank in Dalian.Methods To analyse the registration and the treatment effect of the tuberculosis patients according to Dalian tuberculosis report.Results The above program had been conducted widespreadly since 1994.Over the past five years,101 779 cases of suspicious tuberculosis patients have been received and diagnosed,in which 4 236 infectious patients (containing 3 217 newly-attacked infectious patients)were found.Just in 1998,the number of newly-attacked infectious patients tripleted that of 1991 prior to this program.And the average cure rate of infectious patients reached to 93.8%.The cure rate showed an uptrend amounting to 96.8% from 88.2%.Conclusion Satisfactory Results have been achieved of tuberculosis disease control project loaned by World Bank loan in Dalian.

The cohort analysis of smear positive cases of pulmonary tuberculosis in Zhuhai special economic zone,1992～1998

LIU Fang-jun,LIU Jun-wei.

. 2000, 22(3):  116-118. 

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Objective To analysis the curative effect of smear positive cases with pulmonary tuberculosis.Methods Cohort analysis were done in newly registered and recurrent smear positive cases with pulmonary tuberculosis in 1992～1998.Results The curative rate of new smear positive cases with pulmonary tuberculosis increased from 73.0% in 1993 to 98.0% in 1998 and the recurrent smear positive cases with pulmonary tuberculosis increased from 65.0% in 1993 to 95.8% in 1998.Meanwhile,the cure rate of new smear positive cases with pulmonary tuberculosis in floating population increased from 73.6% in 1997 to 85.4% in 1998.Conclusion It’s very important to strengthen propaganda and govemment interference and stressing on pulmonary tuberculosis patients’classified management is necessary and efficient.The DOTS measure is very important too.

Research on the organization and the management in case-finding of pulmonary tuberculosis

XIE Hong,FENG Xue-fen,ZENG Qing-zhi,et al.

. 2000, 22(3):  119-121. 

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Objective To explore the significance of strengthening the organization and the management for the case-finding.Methods Strengthened the organization and the management in the government intervene,the case-finding work at general hospitals,the duty of tubculosis control centre and the active case-finding.Results New smear positive cases average detection time was to 22.5 days.Newly registered rate of smear positive cases and the ration of registered among existing bacillus positive were increased to 27.21/100 000 and 33.60%respectively.Conclusion It is obvious that strengthening the organization and the management can increase the efficiency of case-finding.Therefore,it can increase the effect of tuberculosis control.

Study on the situation and effectiveness of pulmonary tuberculosis convergence case management in Xuanwu district,Beijing

HAN Peng-xuan,HAN Jia-ying,KONG Xiang-yun.

. 2000, 22(3):  122-124. 

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Objective To evaluate the pulmonary tuberculosis patients belong to administration situation and effectiveness in the Xuanwu district,Beijing.Methods Establish the system of belong to administration,regular spot check over records of diagnosis and report,hospitalized cases registration and observe situation of failed to report,definite diagnosis,succeeded transfer diagnosis and remaining patients through investigation and check on epidemic situation cards.Results The patients failed to report amounted to 0.4%～2.0%,the succeeded transfer rate were 75.0%～86.1% and the retain rate were 23.3%～10.1%.Conclusion Epidemic situation reports have improved year by year.The rate of the succeeded transfer has raised every year.The rate of the retain cases has declined and 90% of the retain cases were tuberculous pleurisy.

The evaluation of the tuberculosis control effect between the demonstrational county and the other

HUANG Lian-zhang,SUN Kai-you.

. 2000, 22(3):  125-126. 

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Objective To evaluate the effect of the WHO West Pacific Region tuberculosis control demonstration project carried out in Yancheng city.Methods To compare and analyze the TB control datum of the demonstration at counties and the non-demonstrational counties,according to the chief evaluation and assessment of the tuberculosis control model project.Results The annual smear-positive new register rate and the annual new smear-positive new register rate in demonstrational counties are 2.6 times and 2.2 times more than those of the other.The whole therapeutic term cure rate of the new smear-positive case is 7.2 percent higher than that of non-demonstrational counties.The average cure and management expense on every new smear-positive case and the average cure expense on every new smear-positive case are $ 83.5 and $120.4 lower than those of non-demonstrational counties.Conclusion The short-course intermittent chemical therapy and the whole-course direct supervision are not only based on“the low cost,the high effect”but also the key to realize“the high case-finding rate,the high cure rate.”

The study of detecting sputum specimen of patients of pulmonary tuberculosis by rDNA probe

ZHANG Ling-xia,ZHUANG Yu-hui,YANG Hua-wei,et al.

. 2000, 22(3):  127-129. 

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Objective Using rDNA probe detecting mycobacteria to establish a new method detecting clinical specimen.Methods Using special primer b to produce PCR probe labeled with biotin.Specificity and sensitivity of the probe detecting primer b PCR products were studied,the positive rate of this probe detecting clinical specimen were also studied.Results The sensitivity was 100pg/μl,only M.tuberculosis and M.gastri were positive hybridization.The probe hybridized with prime b PCR products of 90 sputum specimen of pulmonary tuberculosis patients,positive rate was 80.2%.Conclusion rDNA probe with PCR was a practical Methods in detecting M.tuberculosis.

Study of HLA-DR.DQ genes associated with tuberculosis of the bone and joint

LIU Zhong-quan,SONG Zhang-xing,HU Xiu-ling,et al.

. 2000, 22(3):  130-133. 

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Objective To study the association with HLA-DR.DQ genes in these people with Tuberculosis of the bone and joint. Susceptible gene was compared Tuberculosis of the bone and joint with pulmonary Tuberculosis. Methods The alleles at the HLA-DR.DQ typing were analyzed by polymerase chain reaction with sequence-specific primers(PCR-SSP)in 86 patients with tuberculosis of the bone and joint,34 patients with pulmonary tuberculosis and 88 healthy controls.Results Compared tuberculosis of the bone and joint with normal people,A significant increased frequency of DRB1*09 and DQB1*0301 was found in tuberculosis of the bone and joint(38.99% vs 8.24% PC<0.0001 RR=8.92;18.27% vs 2.66% PC<0.05 RR=2.21).The freuqency of DRB1*13.2 in tuberculosis of the bone and joint was significantly decreased(4.76% vs 20.50% PC<0.01 RR=0.18).Compared tuberculosis of the bone and joint with pulmonary tuberculosis,A significant increased frequency of DRB1*09 and DQB1*0301 was found in tuberculosis of the bone and joint(38.99% vs 9.2% PC<0.0001;18.15% vs 1.85% PC<0.01).The frequency of DRB1*15 in tuberculosis of the bone and joint was significantly decreased(17.17% vs 36.3% PC<0.01).Conclusion The Results showed that HLA-DRB1*09 and DQB1*0301 were probably susceptible gene in tuberculosis of the bone and joint,HLA-DRB1*13.2 may be a protective gene.It was different for susceptible gene between tuberculosis of the bone and joint and pulmonary tuberculosis.

Rapid technique in detection of rpoB gene mutation in Mycobacterium tuberculosis by PCR-SSCP

YAN Guo-rui, LIU Gou-hua, LIU Chuan-yu

. 2000, 22(3):  134-136. 

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Objective To evaluate rifampin-resistant Mycobacterium tuberculosis by PCR-SSCP technique to detect rpoB gene mutation in Mycobacterium tuberculosis of sputums. Methods Fifty clinical isolates of rifampin-resistant and multidrug resistant Mycobacterium tuberculosis, twelve sensitive strains, Hiirty-five rifampin-resistant strains from sputum specimens of patients with pulmonary tuberculosis, were analyzed by PCR-SSCP technique, with H₃₇Rv reference as control group. Results The characteristics of PCR-SSCP grah in fifty strains of rifampin-resistant were different from H₃₇Rv except for five strains. In comparison with susceptibility testing methods,the sensitivity and specificity were 90% and 100% respectively. Twelve sensitive strains were same as H₃₇Rv. In thirty-five strain from sputum specimens of patients with pulmonary tuberculosis,twenty-one strains of them were positive by PCR. The characteristic of SSCP graph in fifteen of them were different bom H₃₇Rv, and the characteristics of PCR-SSCP graph in twenty-eight of them were different from H₃₇Rv, the positivity was 80%. Ccmdusicm llie PCR-SSCP can easily and rapidly detect rifampin resistance of Mycobacterium tuberculosis,the technigue might be used for rapidly detect Mycobacterium tuberculosis rifampin resistance in clinical specimen directly.

The character of drug resistance of pulmonary tuberculosis cases in Zhejiang

WANG Xiao-meng,LI Qun,HAN Yong-xing,et al.

. 2000, 22(3):  137-139. 

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Objective To evaluate the effect of NTP carried out in Zhejiang province and to find out a set of surveillant system for susceptibility tests.Methods All the cases from 20 clusters had been done susceptibility tests from January to June 1997 with absolute concentration method.Results Among 709 cases,the rate of initial resistance was 18.6%,the resistant rate to one drug was the highest(10.5%);the rae of acquired resistance was 68.5%,the resistant rate to isoniazid and rifampicin was the highest(38.7%).The effects of chemotherapy were good not only in new susceptibility cases but also in new drug resistant cases.The effect of chemotherapy to retreatment of drug resistant cases was worse,the cure rate was 39.5%.Conclusion NTP had not been fully carried out in Zhejiang province in the past.Adopting DOTS and standard Chemotherapy to new smear positive cases will be carried out emphatically in the future.

Preliminary observation of therapeutic effect of the regimen containing augmentin on multidrug resistant pulmonary tuberculosis

CAI Bao-yun,MA Yu,ZHANG Jin-fu,et al.

. 2000, 22(3):  140-141. 

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Objective To explore the mechanism of MDR-TB and treatment regiment using second line antituberculosis drugs,to illustrate the effective mechanism of augmentin.Methods The standard and treatment outcome of MDR-TB designed by Chinese Antituberculosis Association was used to compare the curative effect of treatment regimens using second line antituberculosis drugs containing augmentin(expermental group)and without augmentin(control group) to treat 72 cases with MDR-TB admitted in our hospital in the last 10 years.Results The comparison of treatment outcome of the 72 MDR-TB cases showed that,after 6 months treatment the improving rate of chest X-ray and sputum conversion were more obvious in experimental group than in control group.There is significantly difference between the two groups (P＜0.05) .Conclusion Augmentin is new,effective and safe antituberculosis drug.

Interventional diognosis and treatment of cryptogenic hemopotysis

WANG Ling-pu,GOU Ji-xuan,LIU Huai-jun.

. 2000, 22(3):  142-145. 

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Objective To study the relationship between the image manifestation of bronchial arteriograghy (BAG) and pathologic mechanism,and quest reliable basis for its diagnosis and bleed locating.Methods 1 52 patients with cryptogenic hemoptysis were selected,including following two group:①routine image examinations (including chest plain film,tomogram,computed tomography and bronchialgraphy) were negative.②one lobe or segment showed a few lesions,but they were not the ones for causing hemoptysis proved by BAG,while another lobe or segment had signs of bleeding (17 cases).All these patients were performed by seldnger puncture technique,and catheter was put through aorta into bronchial artery.If bronchial arteriography showed direct or indirect bleeding signs,bronchial arterial embolization (BAE) was performed.2 Another 5 cases with bronchial lesions were selected,which were demonstrated by preoperative image examinations and confirmed through BAG procedures to be bleeding cause and location.They were given surgical operation because BAE were ineffective or there were other lesions.Pathological examination under microscope were conducted on these operation samples,and the correlation between BAG findings and phthologic changes was analyzed.Results For all patients with hemoptysis,their BAG showed different degree of hypervascularity,typically being broomlike or reticulate proliferation and deranging vascular bundles.Serious cases were accompanied by intrapulmonary bleeding focus.Combined the BAG findings with pathological findings from the operation samples of patients with bronchialectasis,both blood vesseles changes were identical.Conclusion 1 Pathological mechanism of cryptogenic hemoptysis is the damage of bronchial artery,which are caused by infection of bronchial artery,therefore blood vessel abnormalities indicated by BAG may provide the basis of diagnosis and bleeding locating for cryptogenic hemoptysis.2 Bronchial arteriography and embolization can integrate diagnosis with therapy,which is safte and effective,and the patients have small injuries.There is practice significance in saving the patients with massive hemoptysis.Bronchial arteriography and embolization can provide a new and effective method for controlling massive hemoptysis.

The study of the tolerability to antituberculous drugs in the senile pulmonany tuberculosis with diabetes

WU Fu-rong,XIAO He-ping.

. 2000, 22(3):  146-147. 

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Objective To study the tolerability and precaution to antituberculous durgs in the senile pulmonary tuberculosis with diabetes.Methods The 96 senile pulmonary tuberculosis patients including 47 cases of diabetes and 49 control cases (without diabetes mellitus) were comparatively analyzed in the side effect incidence of antituberculous drugs.Results The male side effects incidences of antituberculous drugs in both groups were higher than the female.There was no significant correlation between serum level of glucose and the side effects incidence of antituberculous drugs,but the eighth carnial nerve injury incidence in diabetes group was significantly higher than the control group.The comparative analysis of the incidences in different kinds of side effects showed the most common side effect were gastrointestinal reaction and liver injury and the second common side effect was the eighth carnial nerve injury in both groups.Conclusion The dosage of antituberculous drugs in senile pulmonary tuberculosis patients should be lesser and the using of aminoglycosides should be carefully of ceased,especially in the senile patients with diabetes who have high risk of the eighth carnial injury and should be monitored closely.

Short course chemotherapy adding supersonic aerosol combinant for newly diagnosed smear positive pulmonary tuberculosis

XU Jin-yun,SUN Xiu-xia,FENG Jia-he,et al.

. 2000, 22(3):  148-150. 

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Objective To observe the effects of short course chemotherapy adding supersonic aerosol combinant for newly diagnosed smear positive pulmonary tuberculosis.Methods 63 patients were randomly divided into two groups:Control group 33 cases were treated with short course chemotherapy only;Treatment group 30 cases were treated with short course chemotheray adding supersonic aerosol combinant.Results The smear positive time of treatment group was 16.67±10.28(day),the time of coutrol group was 37.5±15.41(day),the difference was statistically significant (t′=6.37,P＜0.001),the side effect for the treatment group was not apt to increase.Conclusion Shortcourse chemotherapy adding supersonic aerosol combinant was useful for pulmonary tuberculosis,and the mothods,can be used widely in clinic.

Effect of regimen of 2H₃R₃Z₃S₃(E₃)/4H₃R₃ on the liver function of the pulmonary tuberculosis patients with positive markers of viral hepatitis B

HAN Dan,ZHANG He-wu.

. 2000, 22(3):  151-153. 

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Objective To investigate the effect of regimen of 2H₃R₃Z₃S₃(E₃)/4H₃R₃ on the liver function of the pulmonary tuberculosis patients accompanied with positive markers of HBsAg,HBeAb,and HBcAb.Methods From December 1994 to December 1998,the liver function of the pulmonary tuberculosis patients with positive markers of HBsAg,HBeAg,and HBcAb (group Ⅰ) who were given the treatment of regimen of 2H₃R₃Z₃S₃(E₃)/4H₃R₃,was retrospectively analyzed.Simultaneously,the Results have been compared with those of negative markers of viral hepatitis patients (group Ⅱ).Results The incidence of liver damage in group Ⅰ was 15.6%,higher than that in the group Ⅱ (12.0%),but no significant difference was found between the two groups (P＞0.05).Conclusion The regimen of 2H₃R₃Z₃S₃(E₃)/4H₃R₃ had a slight damage to the liver function of the pulmonary tuberculosis patients with positive marker of HBsAg,HBeAb,and HBcAb and is worthy spreading.

Clinical analysis of 604 cases on side effects of antituberculous agents

YUAN Hui,XIE Li-juan.

. 2000, 22(3):  154-156. 

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Objective To illustrate the side effects of antituberculous agents.Methods The clinincal data of pulmonary tuberculosis patients during 1990～1998 were analyzed.Results Various side effects resulting from antituberculous agents were confirmed in 604 cases (32.7%),liver injury,acoustic nerve injury,blood system injury,gastrointestinal response of them were primary (82.1%).Stopped treatment rate was 14.6%.77% in side effects occurred within 2 months after administration,but the blood system injury occurred after 3 months.Conclusion The side effects of antituberculous agents were common and extensive in distribution,clinical doctors must think highly of the matter.

A research on effect of anti-germ for Multiresistant M.tuberculosis with antituberculous drugs in combination

MA Hai-zhan,CHEN Zheng.

. 2000, 22(3):  157-160. 

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Objective To explore the role of antituberculous drugs in common use and in combination against Multidrug-resistant Mycobacterium tuberculosis with another antituberculous drugs.Methods To determine MIC and MICs each single drug and in combination to different Multidrug-resistant M.tuberculosis strains,according to FIC formula,count out the synergetic activitives.Results FIC of in combination of INH,RFP,EMB,CAM and INH,RFP,PZA,OFLX are less than 0 5.Conculusion In vitro,constitution of INH,RFP,EMB,CAM and INH,RFP,PZA,OFLX have been confirmed that have synergetic effect to multidrug-resistant M.tuberculosis.

The differential value of several detective methods in features of pleural effusion

LI Kun-lin,ZHOU Xiang-dong.

. 2000, 22(3):  161-163. 

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Objective To determinate the feature of pleural effusions by several detective medthods.Methods Several detective Methods were used to determinate the features of 89 cases of pleural effusions.Results The Results show that the differential value of pleural biopsy is significantly higher than other detective methods.The diagnostic value of the tubercle bacillus DNA polymerase chain reaction (TB DNA PCR) is better in pulmonary tuberculosis,and the diagnostic value is better by detecting peripheral blood than by detecting pleural effusions (P＜0.01)。Conclusion The features of pleural effusions can be differentiated more effectively and exactly by combining the pleural biopsy and TB DNA PCR.

Observation of curative effect of positive bacteria pulmonary tuberculosis treated with chemotherapy and Utilin “S”

ZHANG Guo-cai,HE Hua-ying,FAN Yu-hua.

. 2000, 22(3):  164-165. 

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Objective To Observe and evaluate the curative effect of positive bacteria pulmonary tuberculosis treated with chemotherapy and Utilin “S”.Methods 191 primary and re treated positive bacteria pulmonary tuberculosis cases were separated into groups A、B、C、D at random.Group A(50 cases) and group C (50 cases) were treated with 2H₃R₃Z₃S₃/ 4H₃R₃ and 2H₃R₃Z₃E₃S₃/6H₃R₃E₃ which Utilin “S” is added to.Group B (46 cases) and group D (45 cases) treated with 2H₃R₃Z₃S₃/ 4H₃R₃ and 2H₃R₃Z₃E₃S₃/6H₃R₃E₃ alone.Then observe the foci absorption and the sputum negative conversion.Results At the end of 2 months,the sputum negative conversion rate to groups A、B、C、D was separately 96.0%,78.3%,92.0% and 68.9%.At the end of treatment,the sputum negative conversion rate to groups A、B、C、D was separately 98.0%,87.0%,96.0% and 77.8%;the foci absorption rate to groups A、B、C、D was separately 96.0%,84.8%,92.0% and 73.3%;cavity close up was separately 80.9%,63.2%,76.0% and 60.9%.Conclusion Utilin “S” can improve the sputum negative conversion rate,accelerate the foci absorption and improve the vitality of immune cells.It is a better immunity injection.