Table of Content

10 January 2000, Volume 22 Issue 1

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The research of methods to increase case notification rate of new smear positive pulmonary tuberculosis cases

ZHANG Fusheng,WU Zhilei,ZHANG Xiulei,et al.

. 2000, 22(1):  1-4. 

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Objective To improve and increase the rate of case-finding.Methods 6 counties were chosen at random according to the rate of new smear positive pulmonary tuberculosis cases from 3 different level,and adopted some vigorous measures in the counties.We tried our best to educate people to have the knowlege of TB symptoms and made them know the necessity for patients to see TB doctor in time.Then we investigated and compare health people,pulmonary TB patients and inpatients in general hospitals before and after the adopted measeures.Result Through wide propaganda and health education,people get to know much about tuberculosis.More and more people who have tuberculosis symptoms are willing to go to tuberculosis dispensary.The rate of patients going to see TB doctors directly went up from 2.9%to 27.0% before and after interventien.For issued documents on tuberculosis classified management,the pulmonary tuberculosis inpatients in general hospital dropped from 0.30%to 0.14%.During the same period,the rate of failing to report came down from 28.2%to 15.9%.After adopting the measures,the rate of new smear positive pulmonary tuberculosis was 13.45/100 000 in 1995,which raised obviouslly,comparing with 11.94/100 000in 1994 before intervention ( P<0.01) .The new registered smear positive cases increased 30.3%,2 050 comparing with 2 940,before interventien of 4 years(1990~1993)and after interventien of 4 years(1994~1997).Cnclusion It's very important to strengthen propaganda and education.And stressing on pulmonary tuberculosis patients' classified management is necessary and efficient.The general hospital should set up fluoroscopy register.These measures can raise case notification rate of new smear positive pulmonary tuberculosis case effectively.

Pulmonary tuberculosis and AIDS(report of 4 cases)

KONG Wenqin,SUN Li,LIU Xiaohong,et al.

. 2000, 22(1):  5-7. 

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Objective Investigate the situation of combined infection of human immunodeficiency virus(HIV)/mycobacterium tuberculosis(MTB)in tuberculosis hospital and the clinical manifestation and therapy measures of found cases.Methods Routine antibody detection among 3 707 tuberculosis inpatients was conducted between Feb.1995and Feb.1999.Results Among the 3 707cases,there were 4 cases of HIV(+),positive rate was 1.08‰,3 were male and 1 female.Average age was 29.5,accounting for 3.14‰ among the 21～40 age group.Among the four,one was due to hematogenous infection,2 due to heterosexual infection,and 1 not sure for either of the causes.The four might all be diagnosed as having AIDS.Conclusion For tuberculosis patients at risk of HIV infection,especially young and middle-aged,routine HIV antibody detection should be conducted,and adverse reaction should be paid particular attention when conducting antituberculosis therapy for patients of combined infection of HIV/MTB.Concurrent integrated chinese traditional and western medical therapy against AIDS can obtain the better near-term therapeutic effect.

Analyzing the mutations of rpsL gene in Mycobacterium tuberculosis clinical isolates by PCR-RFLP

WU Xueqiong,ZHANG Junxian,ZHUANG Yuhui.

. 2000, 22(1):  8-11. 

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Objective To observe the mutations of rpsL gene in M.tuberculosis streptomycin-resistant isolates,and to develop a new method for detecting drug resistance.Method Analyzing the mutations of rpsL gene codon 43 in M.tuberculosis clinical isolates with PCR-RFLP.Results M.tuberculosis strain H 37 R V was used as a control.The rpsL gene fragments from 13 drug-sensitive strains could be digested by restriction endonuclease MboⅡ.31(83.8%)of 37 streptomycin resistant strains were not restricted by MboⅡ.2 of 12 non-streptomycin-resistant strains hadn't also sites of MboⅡ.Conclusions Most M.tuberculosis streptomycin-resistant strains could be observed the mutations situated at codon 43 of genes encoding the ribosomal S12 protein (rpsL).PCR-RFLP might become a simple,rapid and reliable means of detecting drug resistance in clinical isolates.

Drug-supplying system of the tuberculosis control project of the World Bank loan in China

SU Zhi,LI Qunhui,DAI Yuansheng,

. 2000, 22(1):  12-14. 

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Anti-tuberculosis drug supplying system is one of five factors in the national tuberculosis control programme.In this article,the authors summarize the successful experiences of our country's first drug supplyinhg system in the World Bank loan's tuberculosis project.Systemic introduction on the organization and administration,training and supervision of the project drug supplying system,and also introduces the cooperation and coordination from planing,inviting tenders,procurement,delivering drugs,the steps and methods of designing annual delivering and demanding drug plan and so on.In the end,the authors analyze the uses of the drug supplying system on guaranteeing project's implementing success and find the methods of developing the drug supplying system.

Evaluation of quality control system for sputum smear microscopic examination in tuberculosis diagnosis

LIU Yuhong,HUANG Ziqing,LI Guogang,et al.

. 2000, 22(1):  15-17. 

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Objective To establish and develop a feasible Quality Control(QC)system for sputum smear microscopic examination in China.Method Four times external QC were carried out by way of direct supervision and indirect supervision in plain area or mountain area laboratories within one year.Results and Conclusion The accordance rate of QC between direct and indirect supervision did not show significant difference.The substance of direct supervision is much richer and the cost is much lower than that of direct supervision.Based on the results of the study,we suggest direct supervision is very effective and can not be replaced by other method,especially at the beginning of QC.Local laboratories can combine the two supervision methods according to their own economical and topographic condition,but they must perform direct supervision at least once a year.

Influence of Mycobacterium vaccae on humoral immunity of the PPD positive cases and its significance

JIN Xiaohong,LIU Yuandong,GUO huilan,et al.

. 2000, 22(1):  18-19. 

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Objective To observe the influence of Mycobacterium vaccae on the humoral immunity of the PPD positive case.Methods The serum antibodies to IgG of the PPD positive cases were measured before and after Mycobacterium vaccae being injected(12weeks).The serum antibodies of another group were also measured before and after taking 6 months INH.The OD value of them was compared.Result At the 12 weeks after injecting Mycobacterium vaccae the OD value of IgG is higher than that before ( P<0.01) .The positive rate is from 25%to 80%.While those who taking INH have no change.Conclusion The increasing of IgG after M.vaccae injection shows that it can boost human beings humoral immunity.It may be better to prevent tuberculosis than that of taking medicine.

Studies on the epidemiological situation of tuberculosis by survey the annual risk of tuberculosis infection.

LI Dengxu,YAN Guorui,SONG Huaizhou.

. 2000, 22(1):  20-22. 

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Objective To observe the epidemiological situation of tuberculosis in Henan in recent years.Method Survey the annual risk of tuberculosis infection in 13 years old children from 1995 to 1998 continuously.Results The prevalence of tuberculosis infection in 13 years old children in Henan was 6.0%in 1995,6.3% in 1996,6.5% in 1997,5.9%in 1998.The annual risk of tuberculosis infection was 0.47% in 1995,0.50%in 1996,0.52% in 1997,0.47%in 1998.The risk of tuberculosis infection during 1995～1998 were lower than in 1990.Conclusion The modern TB control programme has been successfully implemented in Henan since 1990,The epidemiological aituation of tuberculosis has been rapidly improved.

Analysis on the acid-base imbalance of 120 cases of serious pulmonary tuberculosis with infection

GAO Guanju,WANG Shuping,ZHENG Yali,et al.

. 2000, 22(1):  23-25. 

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Objective To analysis the acid-base imbalance of serious pulmonary tuberculosis with infection.Method Samples of groin arterial blood from 120 patients were assayed with ABL-505 gas-electrolyte analysis instrument.According to the values of pH,PCO 2 and HCO - 3,acid-base imbalances were classified a simple or mix.Subsequently,based on the values of AG,we judged whether trio acid-base imbalance existed.Results The occurrence of acid-base imbalance were of simple>mix>trio and respiratory acidosis>respiratory alkalosis.Metabolic acidosis had the same occurrence with metabolic alkalosis.The effective treatment of pulmonary infection made it easy to correct the acid-base imbalance. Conclusion With infection occured,the lung tissue of patients with serious pulmonary tuberculosis were destroied more seriously.Ventilation-perfusion and V A/Q A disorders can occur,which resulted in acid-base imbalance.It is the most importance to treat the pulmonary infection and the main methods are correcting acid-base imbalance and disorder of electrolyte.

Clinical value of PCR to pleural biopsy specimen in diagnosis of tuberculous pleuritis

ZHANG Lingli,LIU Yunmei,JI Xian,et al.

. 2000, 22(1):  26-27. 

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Objective To evaluate the value of PCR to pleural biopsy specimen in the diagnosis of tuberculous pleuritis.Methods PCR technique was used to detect M.tuberculosis DNA in pleural biopsy specimen of 65 cases.The results were compared with that of pleural liquid PCR and pleural pathological examination respectively.Results The positive rate was 83.1%by pleural biopsy specimen PCR,63.1% by pleural liquid PCR and 60.0%by pleural pathological examination respectively.This method was more sensitive than the two others.Conclusion PCR detection of pleural biopsy specimen had greater diagnostic value in tuberculous pleuritis.

The clinical study of 28 cases of epididymal tuberculosis

XIE Min,LI Jing,WANG Zengli.

. 2000, 22(1):  28-29. 

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Objective To study the clinical features of epididymal tuberculosis,in order to elevate the level of diagnosis and treatment.Method Twenty eight cases of epididymal tuberculosis derived from patients of our hospital in 1995～1998,were retrospectively studied.Results The most common symptom was painless mass in 82% of the cases.In 28%cases,patients diagnosed with tuberculocele.Only18%cases appeared as an acute or subacute inflammatory duration.Conclusion It is easy to make a correct diagnosis by clinical features,biopsy or regional puncture.If patients treated regularly with antituberculous and regional surgical ectomy,a good prognosis were recieved.

Analysis on situation of pulmonary tuberculosis cases belong to administration survey in Changchun city

ZOU Zhiyan,YANG Guangxu,Yang Jiadao,et al.

. 2000, 22(1):  30-32. 

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Objective In 1998.all kinds of genenal hospital pulmonary tuberculosis patients belong to administration situation was reported in Changchun.Methods Investigate medical unit respirtatory clinic registration,hospitalized cases,X-ray chest film examination registration,epidemic situation report,transfer bill combine with the registration of antituberculosis institute really turn over,epidemic situation card check,no reporters was called fail to report.Results 86 hospital respiratory patients have 343 070 cases,Among them.tuberculosis patients are 828 cases.The rate of examination;transfer diagnosis,turn over,epidamic situation fail to report are 0.24%,60.3%,74.0%,50.9% respectively.Conclusions For the belong to carry out,university and college hospitals is superior of all kinds of general hospital.The military hospital is the worst.Item county is superior to non-item county( P<0.05) .

An epidemiological survey report of tuberculosis of Dingxi prefecture,Gansu province in 1996

LIANG Chengzhi.

. 2000, 22(1):  33-35. 

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Objective To evaluate the effectiveness of the comducting TB control project loaned by World Bank,to find out the epidemic situation,in order to improve the control measures.Method According to"Implementing regulation of national epidemiological sampling survey of tuberculosis in 1990",at 6 points epidemiological sampling survey of tuberculosis was carried out in 3 counties of Dingxi prefecture Gansu province in 1996.Results The prevalence rate of active pulmonary TB was 17.8/100 000,the prevalence rate of smear positive pulmonary TB was 41.0/100 000,the annual reduction rates were 23.4% and 11.3% respectively.Conclusion The control strategies were suitable for Dingxi's situation and its effectivenss was found in this TB control project loaned by World Bank.As long as following the project technique regulation,the goal of the project enables to achieve.

Clinicalanalysison 35caseswithpulmonarytuberculosiscomplicatedinapplyingimmunosuppressant

LIAimin ,GUANXia ,WANGYuwan .

. 2000, 22(1):  36-38. 

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Objective Todelveintotheclinicalcharacteristics ,diagnosisandtreatmentofpulmonarytuber culosiscomplicatedinapplyingimmunosuppressanton 35cases.Methods These 35casesareallclinicalpa tients,applyingimmunosuppressantforalongperiodordiscontinuouslyafter 2～ 2 4monthswhenthepatients arepathogenic.ClinicalsymptomsandX -rayhaven'tgivenobviousshow .Diagnosisusesthemeansofpathol ogyandbacteriology .The 35casesareallregularlyantiphthisic.Results Whenthecoursesoftreatmentsof the 35casesfinished ,therateofsputumbacteriatransferingintonegativereached 85 .7% (2 4 / 2 8) ,chestexam inationbyX -rayshowedthat 4 8.5 % (1 6 / 33)wereabsolutelyabsorbedand 30 .3% (1 0 / 33)werepartlyab sorbed .Afterwithdrawal,inthefollow -upsurvey ,therewerenocasesofrecurrenceinoneyearand 2casesof dyingofprimarydiseasesafter 6months.Conclusion Immunocompromisedhostcomplicatedbypulmonary tuberculosiscanbemadetangibletherapeuticeffectivenessifusingregularantiphthisicwithatleastoneyear courseoftreatment.Inaccordancewiththestateoftheprimarydisease,immunosuppressantcanbeappliedap propriatelyandthatwillnotinfluencetheantiphthisiceffectiveness.