Table of Content

10 March 1999, Volume 21 Issue 3

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The economic evahiatkm of tuberculosis control strategy

Gong Youlong, Fang Junyong ,Wu Guiying，et al.

. 1999, 21(3):  111-115. 

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Abstract Objective To assess current tuberculosis control practices in rnral China, this articlc examined the effi-ciency of alternative strategies (internatinal, national and general TB control actions). Method lliree main techniques(CEA,CBA and CUA),as well as MIA and EBD are used in economic evaluation.Six outpatient TB control centers were selected and 600 TB patients( included initial treatment and re-treatment cases) were enrolled in our pilcH study. Results and Conclusion Based on the results,we generally summarized that the IIP is the optimal program design and most efficient tactic of all pulmonary tuberculosis controlling strategies in China. TTie second effective and potential practice is in NTP.Comparing to two recommended tuberculosis ccmtrol projects in OP and NTP, the experiences

Methodology of the burden of disease with smear_positivepulmonary tuberculosis and its infectivity

Xu Qun , Jin Shuigao , Zhang Lixing .

. 1999, 21(3):  116-119. 

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Objective To explore a methodology of the Disability_ Adjusted Life Year( D A L Y) with smear_positivepulmonary tuberculosis and itsinfectivity . Method An assumed cohort of 2.000 cases was set up based on the age_specificincidence of 794 newly registered smear positive casesin Beijing in 1994 . Prognostic trees and model diagrams ofinfectivitywith natural history and D O T Sinterventions were constructed according to the epidemiology evidence . Results The re sultsshow that it would be neglect 29 .6 % of D A L Y S without consideration of the D A L Y caused by its infectivity . Conclusion D O T Sstrategy could not only reduce 92.9 % of D A L Y Srelated to T B patient itself but also 99.9 % of D A L Y Scaused by itsinfectivity.

The study of co m bining the work of tuberculosiscontrol with the rural cooperative medical service

Jiao Xiaolei, Liu Chuanyu , Zhang Yi ,et al.

. 1999, 21(3):  120-122. 

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Objective To carry out the modern tuberculosis controlstrategy with raising funds in many ways . Methods To draw special funds of tuberculosis control from rural cooperative m edical service ,according to themanagement pattern of the Ministry of Health tuberculosis control program me ,organize and carry out the work ofcase finding ,treating and m anaging . Results After one year ,the annual new smear positive cases detection rate was26.9/100.000 ,the average cure rate of new sm ear positive cases was 90.1 % ,in w hich ,90.4 % for initially treatedcases and 87.5 % for retreated cases . Conclusion It sloved the problem of shortage of tuberculosis control funds ,achieved the desired results ,explored a new way for continued advance of the tuberculosis control work .

The present situation and evaluation of the “ Tuberculosis and Lungcancer Case_finding Network”in Xuhui district , Shanghai

He Jianping , Hu Zheng .

. 1999, 21(3):  123-125. 

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Objective To evaluate the effect of tuberculosis and lung cancer case_finding network in Xuhui district , Shanghai. Methods The detecting rate between 1987 and 1997 in tuberculosis and lung cancer case_finding network in Xuhuidistrict and thatin mass X_ray screening ofour clinic have been analyzed and compared . Results In tuberculosis and lung can cer case_finding network ,onlythrough X_ray chestexamination of 7 .2 % ofthe outpatients,the detecting rate oftuberculosisis7 times higherthan that of massscreening ,while the detecting rate oflung canceris 92 times higherthan that of massscreen ing( P< 0 .01) . Conclusion Tuberculosis and lung cancer case_finding network is a good method to detect the patients withtuberculosis and lung cancerin outpatients as early as possible. The method is characterized by high efficiency ,im mense eco nomical benefits and easy check and popularization .

The analysis on the report and ad ministration ofpulm onary T Bdivided into the second class infectious disease

He Xiaoqing , Qian Jie .

. 1999, 21(3):  126-128. 

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Objective To exploration the effective way and manageable procedure of case legal ad ministrationunder the new situation w hich pulm onary T Bdivided into the second classinfectious disease . Method By analysingthe case report of Xishan city ,from 1997 to 1998 . Results It shows that 842 confirmed cases ,only 73 cases(8.7 % ) m et the legal report time .659 cases had sputu m exa mination ,sputu m exa mination rate was 78 .3 % .567case (67 .3 % ) were transfered to special procedures . The rate oftransfer of alltuberculosisin floating population andcity hospitalis relatively low . Conclusion To im prove the quality of T Blegal control and ad ministration ,it needsan effective and regular procedure in diagnosis ,report ,register and transfer .

The analysis about current situation of pum onary tuberculosis of 35 college in Beijing

Xing Fuhua , Liu Yuqing , Xu Daokang ,et al.

. 1999, 21(3):  129-131. 

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Objective To observe currentsituation of tuberculosis of 35 college in Beijing . Method Investiga tion on 111 newly registered cases of students from 1995 to 1997 in Haidian District , Beijing . Result Fro m 1995to 1997 the newly registered tuberculosis rates(1/105) are 30.2 ,27.0 ,29.1 ,stabilize trend in all( P> 0.05) . Thenewly registered rates(1/105) of fresh men 48.1 and senior 50.6 are higher ,w hile newly registered rates of sopho mores 4.0 and juniors 13 6 are lo wer( P< 0.01) . Conclusion College students were a main group for T Bcontrolin Haidian District , Beijing . Based on the analysing result of newly registered cases in fresh men and senior ,suggest ed intensify works to case finding and health education .

Analysis of factors on affecting initial/retreatedcase finding ratio of tuberculosis cases in Hubei province

Hou Shuangyi, Xiao Aiqing , Li Guoming , et al .

. 1999, 21(3):  132-134. 

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Objective Finding out the causing reasons of retreated patients . Methods By looking throughthe history of retreated patient registered in 6 counties/cities from 1996 to 1997 , to find out the causing reasons . Results There are 36 . 3 % and 26 . 0 % produced before the T Bcontrol project loaned by World Bank in 1996and 1997 , respectively . 63 . 7 % and 74 . 0 % after the project . Am ong them , 27 . 7 % , 35 . 5 % and 34 .4 % , 38 . 9 % are caused by mistreatm ent at general hospitals and tow nship hospitalsin 1996 and 1997 respective ly . Conclusion The main reasons as follows : 1 . The action period of the project is very short . Many patientswho have suffered from T Bbefore the project have not been found right away . 2 . General hospitals and townshiphospitals have been retained the patients .

Influencing factors on pleuralthickening in patients with tuberculous pleuritis

Zhang Fengying , Wang Qingfeng , Hu Fanbin .

. 1999, 21(3):  135-136. 

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Objective To investigate the influencing factors on pleuralthickening in patients with tuberculouspleuritis . Method To analyse the clinical materials of 113 hospitalized patients with tuberculous pleuritis retro spectively . Results Factors of patient's delay (duration from onset to consultation) , total nu m ber of the cells ,white blood cell, the content of protein in pleural effusion and aspiration of effusion were associated with the fre quency of pleural thickening . Conclusion 1 . Rational chem otherapy and active aspiration for pleural effusionwere m ostim portant m easuresin the treatment of tuberculous pleuritis . 2 . Patients with tuberculous pleuritis haveto be transfered to the dispensary or hospital specialized to tuberculosis for further treatment.

The nutritive condition survey in cases with sputu m positive relapsing pulm onary tuberculosis

Tan Shouyong , Lin Zhaoyuan .

. 1999, 21(3):  137-139. 

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Objective In order to study the feasibility of the adminicular treatment with nutrition for the patientswith sputumn positive relapsing pulmonary tuberculosis ( R P T B) ,the nutritive condition of the patients with R P T B was re searched . Method Allthe patients who hospitalized from Dec .1994 to Dec.1997 with pulmonary tuberculosis ( P T B) ofspu tumn positive was researched before treating . The data was analysed by multivarian analysis of variance characteristic roots andvectors in the S A Sof statistical package . Results 1 . The nutritive condition in the patients with R P T Bbefore treating wasworse than thatin the patients with primary treatment P T B( P< 0.01) ；2 . The a mounts ofserum albu min andlymphocyteinthe patients with R P T Bafter 2 monthstreating were morethan thatin those whosesputu mn still positive after treating . Con clusion The untritive condition in the patients with R P T B was worse ；and the a mounts of serum albumin and lymphocyteplayed more important role in treating . So the ad minicular treatment with nutrition may be feasible .

Clinical analysis of 33 cases of connective tissue disease co m plicated with infectious pulmonary tuberculosis

Bu Jianling , Gao Weiwei, Liu Hong ,et al .

. 1999, 21(3):  140-141. 

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Objective To analyze the clinical characteristics of connective tissue disease complicated with pulmonarytuberculosis. Method To retrospectively analyze 33 cases of connective tissue diseases complicated with infectious pulmonarytuberculosis treated during 1984 ～1998 . Results 1 .71.4 % ofthe patients had along term treatment with im munodepressiondrugs before onset of pulmonary tuberculosis in 33 cases.2 . The disease were extensive in chest X ray examination ,81.8 %with pulmonary cavities,66.7 % with pulmonary interstitialchanges,69.7 % with pleuralthickening .3 . Pulmonary tuberculosiswere easily misdiagnosed and leakdiagnosed ,prognosis were worse . Conclusion We might look out for occurrence of pul monary T Bin patients with connective tissue disease for early diagnosis ?treatment and favourable prognosis.

Pulmonary tuberculosis and dependence on heroin( Areport of 15 cases)

Wu Meirong , Ni Zhengyi, Xiao Changsheng ,et al.

. 1999, 21(3):  142-143. 

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Objective To observe and study the clinical characteristics of pulm onary tuberculosis cases depend ing on heroin . Methods Analysed the general conditions and clinical characteristics of these patients who weretreated in Wuhan Tuberculosis Hospital and Wuhan 12th Hospital during past 5 years . Results All the cases in cluding 13 male and 2 fem ale accord with the diagnosisstandard of morphine taking .86.7 % ofthem are fro m 26 to38 years old and 60.0 % is new cases . Their conditions are rather serious . They have more co m plications and60.0 % of them have lung damage . The therapeutic com pliance is bad and the failure cure rate is 100.0 % . None ofthe m can insist on the treatment for 6 months and none of the 10 sputu m positive cases converses . Conclusion These cases should be co m pelled to give up drug taking w hen treated with Antituberculosis drugs .

Pathogenic bacteria identify and clinical analysis of 156 caseswith pulm onary tuberculosis in lower respiratory tract

Dong Zhiyun , Yu Sen , Du Yunze ,et al .

. 1999, 21(3):  144-146. 

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Objective To investigate the characteristics of the distribution and drug resistant of pathogenicbacteria in lower respiratory tract of pulmonary tuberculosis cases ,and analyze the clinical manifestation w hen co m plicated with pneu monia . Methods 156 cases with pulmonary tuberculosis were taken for strain identification and sensi tivity test to antibiotic in vitro afterthe result positive of bacteria and fungus culture . Results All of 239 cases for pathogenicbacterialstrains were found in sputums bacterial culture of 156 patients. There were 210 strains of gram negative bacilli(87.9 % ) ；fungus were 21(8.8 % ) ；gram positive cocci were 8(3.3 % ) . The detection of drug sensitive test suggested thatciprofloxacin had the highest susceptibility ,rates was 60.6 % ,and rifampicin had thelowestsusceptibility ,only 4.1 % . Conclu sion The primary pathogenic bacteria were gram negative bacilliin lower respiratory tract of pulmonary tuberculosis patients . This may be related toim munodeficiency ,abuse antibiotic and treated with antituberculosis drugs .

The clinical analysis of 85 elderly cases with tuberculous pleurisy

Cao Wenli .

. 1999, 21(3):  147-149. 

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Objective The characteristics of tuberculous pleurisy in elderly patients were concluded in order to inducemisdiagnosis and evaluate the treatment methods. Methods 85 cases oftuberculous pleurisyin elderly patientsfrom Jan .1995to June 1998 in our hospital were reviewed and analyzed . Results Atypicalsymptoms :no chest pain (69.4 % ) ,no chest de press (65.8 % ) ,no fever (56.5 % ) ； more associated diseases ； Chest C Texamination and pleural biopsy could assistin diagno sis . Conclusion Master the characteristics oftuberculous pleurisy in elderly patients,emphasis must be put on early diagnosisand C Texamination or pleural biopsy wassuggested forthose patients with different diagnosis,reducing misdiagnosis,and reg ular therapy receiving good results of treatment .

The status of surgical operation in the treatm ent of pulm onary tuberculosis

Song Yanzheng , Zhang Xinyan , Wei Li ,et al .

. 1999, 21(3):  150-151. 

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Objective To discuss the indication ,opptunity and the status of surgical operation in the pul monary tuberculosis treatment . Method 7.000 pulm onary tuberculosis and 270 operated patients have been re viewed in our hospital. Result 270 patients with pulmonary tuberculosis have been operated ,the effect was satis fied ,the cure rate was 95 % . Conclusion The surgical treatment is nessesary for a part of pulm onary tuberculosis ,this method can im prove the cure rate of pulmonary tuberculosis .

Detection of specific antibodies for the diagnosis of tuberculosis

Lu Xuedong , Sun Huiping , Zhang Xiaoyan ,et al .

. 1999, 21(3):  152-154. 

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Objective The specific diagnosis for tuberculosis have more problems. To solve these problems , Im munoblots technique have be used . Methods Using Im munoblotstechniquefor detecting antibody that againstspecific antigen( T B S Ag 1) of M.tuberculosis. Results The Sensitivity was 89.5 % in 361 tuberculosis patients and the specificity was95.6 % in 150 nontuberculosis patients and 350 healthy controls . Making a comparison between Im munoblots and Myco Dottechnique . Conclusion Im munoblots technique have a higher positive rates . So suggested that Im munoblots technique for de tecting specificantibody of M.tuberculosis was a usefultoolfor diagnosis of tuberculosis .

Clinical value of detection of M .tuberculosis D N Ain peripheral blood lym phocyte fraction

Lei Jianping , Xiong Guoliang , Fu Hongfan ,et al .

. 1999, 21(3):  155-158. 

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Objective To evaluate the clinical value of detection of M.tuberculosis( M T B) D N Ain peripheral bloodlymphocyte fraction ( P B L F)for identifying patients with active tuberculosis. Method Polymerase chain reaction( P C R)technique was used to am plify 123bp and 245bp D N Afragment of M T Bin lymphocyte fraction separated from peripheralblood and in blood plasma sim ultaneously . The duration needed for elimination of M T B D N Ain P B L Fof patients with ac tive tuberculosis was investigated . Results It was verified again that,patient with active tuberculosis have M T B_ D N Aintheir P B L F,but notin plasma . The sensitivity of detecting M T B_ D N A123bp is 91.3 % (137/150) ,and 245bp is 83.3 %(125/150) . The particularity of detecting M T B_ D N A 123bp is 100 % (50/50) ,and 245bp is 92.0 % (46/50) . In 3month before end of the treatmet course, M T B were not found in sputu m smear in any of 30 initial treated patients withactive tuberculosis ,at same time thelesion in theirlung became steady . The M T B_ D N Ain P B L Fin 4 of 30 initialtreatedpatients became negative on the 6th month oftreatment course ,in 23 of 30 ,on the 9th month ,and in 3 of 30 ,on the 12thmonth . To our surprise ,the M T B_ D N Ain 25 of the 30 patients reverted to be negative within 3 months follow up . The M T B_ D N A123bp in P B L F was negetive in all persons without active tuberculosis but with positive P P Dskin test(includ ing 10 cases who were suffering from other diseases ,30 people whose tuberculosis had been cured for three years , 11healthy persons) . Conclusion Since the presence of M T B_ D N Ain P B L Fin cured patients cannot lase for a long time ,wesuggest that P C Rassay of M T B_ D N Ain P B L Fcould be used to determine active tuberculosis and to monitor the efficacyofthe treatment of tuberculosis.

Exploration on the reform ed m ethod of drug sensitivity test for Mycobacteriu mtuberculosis

Sun Guizhi , Zhang Peiyuan , Kang Lijun ,et al .

. 1999, 21(3):  159-161. 

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Objective To explore the reformation on the m ethod of drug sensitivity test for Mycobacteriu m tu berculosis . Method 50 M . T B was separated from the clinic by the 7 H12 Bliquid mediu m used for B A C T E C. Afterdiluted at different density ,directly vaccinated on the reform ed L珔o wenstein Jensen medium . Com paring with thedrug sensitivity results of B A C T E C,the reform ed drug sensitivity method could be valued . Result 1 . The nu mberof M . T Bin 1 ml 7 H12 Bliquid m ediu m( G I500 ～900)is equal to that of 1 m g wet weight of M . T B(106 ～7) .2 . Thebacteria liquid draw n fro m 7 H12 B liquid medium was directly vaccinated on the traditional L珔o wenstein Jensenmedium . With the drug sensitivity result co mparing with that of B A C T E C,there is no significant difference( P>0.05) . Conclusion The m ethod of B A C T E Cdrug sensitivity testis usually used for only 4 kinds of anti tuberculo sis drugs . The reform ed method could be used for more and remedy the defect of B A C T E C. Com paring with themethod of L珔o wenstein Jensen drug sensitivity test ,the time the new method used was short of 13 to 15 days .

Manifold tests detected and analysed in cerebrospinal fluid of tuberculous menigitis

Gao Weiwei , Wang Shuxia , Zhang Jinfu ,et al .

. 1999, 21(3):  162-164. 

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Objective To analyse the diagnostic value of the cerebrospinal fluid manifold tests in detected ofearly stage tuberculous menigitis of patients . Method Choice had diagnosed of 52 cases with early stage tuberculousmenigitis of patients . C S Fhad sent examinations separately for routine ,bioche mistry , A D A, P C R, B A C T E C,smearand resistance tuberculous antibody . C S Froutine and biochemistry of change were observed after treatment for twomonths . Results P C R and A D A of detection is significance for diagnosis of initial tuberculous menigitis ,besides C S Froutine and bioche mistry . The other tests are without obvious significance for initial diagnosis ,because theirpositive rate is very low . The cell count had recovered at first ,sugar is secondary after treatment for two months . Conclusion The routine ,biochemistry , P C Rand A D Ain C S F of detection is valuable for diagnosis of early stagetuberculous m enigitis .

The evaluation of 5 laboratory detection methods on the diagnosis of tuberculosis

Yan Guorui , La Sheng ming , Yang Jianhua ,et al .

. 1999, 21(3):  165-166. 

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Objective To analyse and co mpare 5 laboratory dectection methods and try evaluate the effect ondiagnosis of tuberculosis . Methods 53 health persous .70 pulm .tuberculosis cases and 30 cases with non tuberculo sis disease were studies and using sputu m sm ear ,culture , Myco Dot test , P C R, E L I S A assay ,all results were co m pared . Results The studies sho wed that smear ,culture , E L I S A had high sensitivity but the specificity are belo w50 % ,and then the P C R assay . Conclusion Myco Dot have high specificity ,simple and convenient ,rapid superiori ty ,this assay may be the m ore valuable auxiliary test on diagnosis of tuberculosis .