Table of Content

10 December 2017, Volume 39 Issue 12

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The introduction of the measuring instruments for caregiver burden of tuberculosis patients

ZHANG Man-hui, YAO Hong-yan, LIU Jian-jun

Chinese Journal of Antituberculosis. 2017, 39(12):  1268-1272.  doi:10.3969/j.issn.1000-6621.2017.12.003

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Caregiver burden refers to the emotional, social, financial, physical and mental adverse effects that caregivers perceive when caring for patients. Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis infection, which remains a major public health burden in China. Therefore, it is of great practical significance to study the caregiver burden of tuberculosis patients. We elaborated the necessity of this study, the status quo of the caregiver burden of tuberculosis patients and its available measuring instruments, and analyzed the requirement of the measuring tools, thus providing a basis for evaluating the present situation of TB-patients caregiver burden and scheduling intervention methods, so as to provide a reference for further researches.

Treatment and care of pulmonary tuberculosis with diabetes mellitus

KANG Ying-ying, CHENG Zhi-feng

Chinese Journal of Antituberculosis. 2017, 39(12):  1273-1277.  doi:10.3969/j.issn.1000-6621.2017.12.004

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Pulmonary tuberculosis (PTB) and diabetes mellitus (DM) are common chronic diseases that ser-iously endanger human life and health. Diabetes is an independent risk factor for tuberculosis, while tuberculosis can increase the metabolic disorders of diabetic patients, and easily lead to a variety of acute and chronic complications of diabetes. The coexistence of the two has become a major clinical problem, bringing new challenges and problems to the disease diagnosis and treatment. Therefore, we should further understand diabetes and tuberculosis and the relationship of the two in order to achieve better effectiveness in the treatment, and improve the cure rate of tuberculosis with diabetes.

Association between serum levels of interleukin-12, Chemokine cytokines ligand 1 and occurrence of Type 2 diabetes mellitus complicated with pulmonary tuberculosis

CHEN Hai-jun, LI Yu-ze, LIU Yu-qin, CHEN Xiang-li, YU Tian-jia, LYU He, JIANG Hui, LI Dian-zhong

Chinese Journal of Antituberculosis. 2017, 39(12):  1278-1281.  doi:10.3969/j.issn.1000-6621.2017.12.005

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Objective To investigate the relationship between serum levels of interleukin-12 (IL-12), Chemokine cytokines ligand 1 (CCL1) and type 2 diabetes mellitus complicated with tuberculosis (T2DM-PTB). Methods From September 2014 to June 2015 in the Infectious Hospital of Heilongjiang Province, 40 cases of T2DM-PTB patients (group T2DM-PTB), 40 cases of T2DM patients (group T2DM), and 40 healthy people (control group) were selected as the research objects. The demographic characteristics of the subjects were collected. In addition, 3 to 4 ml venous blood was collected in the early morning. The serum levels of IL-12 and CCL1 were mea-sured by enzyme-linked immunosorbent assay and compared among groups. Results The serum concentrations of IL-12 in the control group, T2DM group and T2DM-PTB group were (9.87±2.75) μg/L, (11.25±1.99) μg/L and (13.33±3.67) μg/L, respectively. The difference among the three groups was significant (F=4.46, P<0.01). The serum levels of CCL1 in the control group, T2DM group and T2DM-PTB group were (158.03±29.21) μg/L, (245.02±33.04) μg/L and (381.60±29.99) μg/L, respectively. The difference among the three groups was significant (F=267.90, P<0.01). The serum levels of IL-12 and CCL1 in the T2DM and T2DM-PTB groups were significantly higher than that in the healthy control group, and the serum levels of IL-12 and CCL1 in the T2DM-PTB group was significantly higher compared with the T2DM group (P<0.05). Conclusion The serum levels of IL-12 and CCL1 in patients with T2DM-PTB were significantly increased, suggesting their roles in the pathogenesis of T2DM-PTB.

Dietary nutritional status of patients with type 2 diabetes mellitus and those complicated with pulmonary tuberculosis

LYU He^*, LI Yu-ze, YAN Ya-geng, WANG Ting, HOU Shao-ying, DONG Feng-li

Chinese Journal of Antituberculosis. 2017, 39(12):  1282-1285.  doi:10.3969/j.issn.1000-6621.2017.12.006

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Objective In order to study the dietary nutritional status of patients with type 2 diabetes mellitus (T2DM) and those complicated with pulmonary tuberculosis (T2DM-PTB),and to analyze the differences in dietary nutrient intake. Methods Using simplified Food Frequency Questionnaire (FFQ) method, a dietary survey was conducted in patients with T2DM (n=140) in the Department of Endocrinology, the First Affiliated Hospital of Harbin Medical University, and patients with T2DM-PTB (n=140) who were hospitalized in the Heilongjiang Province Infectious Disease Prevention and Treatment Hospital from January 2017 to July 2017. Results Energy intakes per day was (8444.5±1507.1) kJ in patients with T2DM and (6424.9±2032.2) kJ in patients with T2DM-PTB, respectively (t=6.93, P=0.000). The intake of protein was (81.9±9.9) g and (57.3±18.5) g, respectively (t=9.78, P=0.000). The intake of fat was (63.2±35.7) g and (51.7±27.7) g, respectively (t=2.12, P=0.036). Carbohydrate intake was (280.5±33.3) g and (210.3±40.3) g, respectively (t=11.23, P=0.000). The iron intake was (24.5±4.7) mg and (15.9±3.9) mg, respectively (t=11.80, P=0.000). The intake of zinc was (11.8±1.7) mg and (8.3±2.1) mg, respectively (t=10.93, P=0.000). The selenium intake was (40.5±7.1) mg and (36.6±14.0) mg, respectively (t=2.07, P=0.041). Calcium intake was (518.3±121.2) mg and (393.4±127.9) mg, respectively (t=5.93, P=0.000). Intake of vitamin A was (428.0±172.9) μg retinol equivalent (μg RE) and (346.8±145.5) μg RE, respectively (t=3.01, P=0.003). The intake of vitamin D was (1.9±0.9) μg and (3.8±4.5) μg, respectively (t=-3.19, P=0.001). The intake of vitamin E was (25.7±17.1) mg and (18.7±12.5) mg, respectively (t=2.75, P=0.007). The intake of vitamin B1 was (1.2±0.2) mg and (0.8±0.2) mg, respectively (t=10.92, P=0.005). The intake of vitamin B2 was (0.9±0.1) mg and (0.7±0.3) mg, respectively (t=7.07, P=0.000). The intake of vitamin B6 was (0.4±0.2) mg and (0.2±0.1) mg, respectively (t=8.28, P=0.000). Conclusion The dietary nutritional status of T2DM-PTB patients was worse than that of T2DM patients. Both T2DM-PTB and T2DM patients should increase the intake of foods rich in vitamins and trace elements.

Risk factors of respiratory failure in type 2 diabetes mellitus patients complicated with pulmonary tuberculosis

WANG Xiao-wei, LUO Bao-jian, ZHANG Nan, LIU Qiu-yue, KANG Wan-li, LI Qi, CHEN Xiao-you

Chinese Journal of Antituberculosis. 2017, 39(12):  1286-1290.  doi:10.3969/j.issn.1000-6621.2017.12.007

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Objective To analyze the risk factors of respiratory failure in patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis, so as to provide reference for clinical treatment. Methods A total of 200 cases of pulmonary tuberculosis cases in Beijing Chest Hospital from January 2012 to December 2015 were retrospectively investigated and divided into two groups. Group A: 100 cases of type 2 diabetes mellitus patients complicated with pulmonary tuberculosis, with respiratory failure; group B: 100 cases of type 2 diabetes mellitus patients complicated with pulmonary tuberculosis, without respiratory failure. The clinical data of all patients was collected. Logistic regression analysis was used to screen risk factors. Results The clinical data of group A and group B was analyzed by single factor analysis. Significant statistical difference was found in age (χ²=18.588,P=0.000),number of affected lung fields (χ²=11.808,P=0.001),tuberculous cavity (χ²=16.330,P=0.000), hemoptysis (χ²=8.753,P=0.003), glucocorticoids (χ²=10.485,P=0.001), long-term use of antibiotics (χ²=4.750,P=0.029),tuberculosis course (χ²=9.469,P=0.009), ketoacidosis (χ²=8.414,P=0.004), and body mass index (χ²=14.474,P=0.001). Multivariable analysis of these factors further revealed that age (Wald χ²=15.527,P=0.000,OR=4.055 (95%CI:2.021-8.136)), number of affected lung fields (Wald χ²=11.938,P=0.001,OR=3.689 (95%CI:1.759-7.735)), tuberculous cavity (Wald χ²=4.844,P=0.028,OR=0.463 (95%CI:0.233-0.919)), glucocorticoids (Wald χ²=7.374,P=0.007,OR=4.765 (95%CI:1.544-14.707)),and ketoacidosis (Wald χ²=6.077,P=0.014,OR=4.859 (95%CI:1.383-17.079)), the Results had a significant statistical difference. Conclusion The results indicated that age, number of affected lung fields, tuberculous cavity, glucocorticoids application and ketoacidosis were important risk factors that led to respiratory failure in type 2 diabetes mellitus patients complicated with pulmonary tuberculosis.

Association of ToII-like receptor 4 gene polymorphism with diabetic lower extremity vascular disease in patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis

LI Yu-ze^*, HOU Shao-ying, CHEN Xiang-li, ZHANG Jie, CHU Guang-yan, LIU Yu-qin, LI Dian-zhong

Chinese Journal of Antituberculosis. 2017, 39(12):  1291-1296.  doi:10.3969/j.issn.1000-6621.2017.12.008

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Objective To investigate the relationship between TLR₄ gene polymorphism and LEAD in patients with T2DM-PTB. Methods We recruited 87 cases with T2DM-PTB patients complicated with LEAD and 68 cases with T2DM-PTB from Infectious Hospital of Heilongjiang Province between September 2013 and June 2015. The basic information of both T2DM-PTB patients complicated with LEAD and T2DM-PTB patients were collected. Meanwhile, peripheral blood was collected in order to undergo gene polymorphism analysis. DNA was extracted by genomic DNA extraction kits and genotyping was accomplished by using Real-time PCR (Taqman probe method). Three TLR₄ gene loci (rs 7873784, rs1927911, rs1927914) were tested. Results Allele distribution of TLR₄ gene SNPs locus in the observation group and the control group: The G allele of rs7873784 were 91.38% (159/174) and 91.18% (124/136) in the two groups, and the C allele were 8.62% (15/174) and 8.82% (12/136) in the two groups, respectively. There was no significant difference between the two groups (χ²=0.00,P=0.950); The T allele of rs1927911 in two groups were 59.20% (103/174) and 61.76% (84/136), respectively, and the C allele were 40.80% (71/174) and 38.24% (52/136), respectively. There was no significant difference between the two groups (χ²=0.21,P=0.646); The T allele of rs1927914 in two groups were 59.77% (104/174) and 64.71% (88/136), respectively, and the C allele were 40.23% (70/174) and 35.29% (48/136), respectively. There was no significant difference between the two groups (χ²=0.79,P=0.374). Genotype distribution of TLR₄ gene SNP locus in the observation group and the control group: The GG genotypes of rs7873784 were 82.76% (72/87) and 82.35% (56/68) in two group, and the GC genotype of the two groups were 17.24% (15/87) and 17.65% (12/68), respectively. The difference between the two groups was not statistically significant (χ²=0.00,P=0.947). The TT genotypes of rs1927911 were 32.18% (28/87) and 35.30% (24/68) in two groups, the CT genotype of the two groups were 54.02% (47/87) and 52.94% (36/68), and the CC genotype of the two groups were 13.80% (12/87), 11.76% (8/68), respectively. The difference between the two groups was not statistically significant (χ²=0.24,P=0.887). The TT genotypes of rs1927914 were 33.33% (29/87) and 42.65% (29/68) in two groups, the CT genotypes of two groups were 52.87% (46/87) and 44.12% (30/68), and the CC genotypes of two groups were 13.80% (12/87), 13.23% (9/68), respectively. The difference between the two groups was not statistically significant (χ²=1.49,P=0.475). Rs7873784 gene locus of TLR₄: compared with wild homozygous genotype GG, the adjusted OR value of GC genotype was 0.90 (95%CI:0.39-2.06, P=0.80). Rs1927911 gene locus of TLR₄: compared with wild homozygous genotype TT, the adjusted OR values of CT genotype and CC genotype were 1.00 (95%CI:0.51-1.97, P=1.00) and 1.29 (95%CI:0.46-3.66, P=0.63), respectively. Rs1927914 gene locus of TLR₄: compared with wild homozygous genotype TT, the adjusted OR values of CT genotype and CC genotype were 1.27 (95%CI:0.64-2.51, P=0.49) and 1.24 (95%CI:0.47-3.27, P=0.67), respectively. There was no significant difference between the 3 genotypes at different loci (P>0.05). Conclusion The polymorphisms of rs7873784, rs1927911 and rs1927914 in TLR₄ gene are not associated with LEAD in T2DM-PTB patients.

Clinical analysis of 26 cases of pulmonary cryptococcosis misdiagnosed as pulmonary tuberculosis in the first consultation

YANG Cheng-qing, DU Rong-hui, CAO Tan-ze, ZHOU Meng, MEI Chun-lin

Chinese Journal of Antituberculosis. 2017, 39(12):  1297-1302.  doi:10.3969/j.issn.1000-6621.2017.12.009

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Objective To raise the awareness of pulmonary cryptococcosis (PC) among tuberculosis specia-lists. Methods From January 2014 to May 2017, there were 26 cases of PC misdiagnosed and referred to Wuhan Pulmonary Hospital (Wuhan Institute for Tuberculosis Control). The clinical features,laboratory examinations,chest CT images and treatment of these 26 cases PC were retrospectively analyzed. Results The patients consisted of 18 (69.2%) males and 8 (30.8%) females,with a mean age of (49.9?3.9) years (range,22 to 77). Eleven (42.3%) cases presented with CT image abnormality, but with no clinical symptoms and 15 (57.7%) cases presented with a mild cough, chest tightness or chest pain. White blood cell counts were normal except for 2 cases. Twenty cases were confirmed as PC by pathology,and 6 cases were confirmed as PC through cryptococcal capsular antigen test positive, and the fact that they were cured with antifungal therapy. A total of 16 cases were tested with serum cryptococcal capsular antigen, with a positive rate of 100.0%. Chest CT showed that unilateral lung involvement in 18 cases, and bilateral lung involvement in 8 cases. Only 2 cases were with both upper and lower lung involvement. The common CT imaging features of the PC included peri-pheral pulmonary distribution was 88.5% (23/26), and the existence of pulmonary nodule was 88.5% (23/26), including 69.2% (18/26) with multiple nodule,halo sign 80.8% (21/26) and pleural thickening 84.6% (22/26). Rare imaging signs were solitary nodules 19.2% (5/26), masses 15.4% (4/26), and consolidation 15.4% (4/26). No lymph node enlargement and pleural effusion were found in all cases. All patients were clinically cured with fluconazole. Conclusion The clinical symptoms of PC were mild and more common in middle-aged and older males. The imaging of PC was mostly in unilateral and single part involvement, with more peripheral pulmonary distribution and the imaging features were the multiple nodules with the halo sign and the pleural thickening. High specificity of the diagnosis of PC was found by a cryptococcal capsular antigen test. After treatment with antifungal therapy, the prognosis of PC is good.

Diagnostic value of high-sensitivity ELISA in active tuberculosis through detecting the secretion protein MPB64

ZHAO Bing^*, HOU Ping, HUANG Jing, HE Wen-cong, OU Xi-chao, LIU Dong-xin, ZHAO Yan-lin

Chinese Journal of Antituberculosis. 2017, 39(12):  1303-1308.  doi:10.3969/j.issn.1000-6621.2017.12.010

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Objective The aim of this study was to evaluate the value of high-sensitivity-ELISA test (HI-ELISA) in detecting Mycobacterium tuberculosis (MTB) in sputum, which is based on detecting the secretory protein MPB64. Methods Ninety-seven stored sputum specimens from suspected tuberculosis patients were subjected to cultivation in BACTEC MGIT 960 tubes, Xpert MTB/RIF test and HI-ELISA test, respectively, the results of HI-ELISA test and 960-liquid-culture test were compared to evaluate the diagnostic efficacy of HI-ELISA method. Results Among the 97 sputum specimens collected in this study, the positive rates of detecting MTB of 960-liquid-culture method and HI-ELISA method were 36.08% (35/97) and 32.99% (32/97) respectively. When compared with liquid-culture, the sensitivity of HI-ELISA was 88.57% (31/35), the specificity of HI-ELISA was 98.39% (61/62) and the overall coincidence rate was 94.85% (92/97). Of the 66 positives putum specimens using Xpert MTB/RIF, the positive rate of 960-liquid-culture method and HI-ELISA method in detecting MTB were 51.51% (34/66) and 48.48% (32/66), respectively; furthermore, compared with 960-liquid-culture,the sensitivity of HI-ELISA was 91.18% (31/34), the specificity was 96.88% (31/32) and the coincidence rate was 93.93% (62/66). Among the 31 negative sample stested by Xpert MTB/RIF, MTB was detected in only one sample by 960-liquid-culture method but HI-ELISA method failed to detect it, however, in the other 30 sputum samples, the results of HI-ELISA method were entirely consistent with the results of 960-liquid-culture method and the coincidence rate was 96.77% (30/31). Conclusion HI-ELISA assay was able to detecting viable MTB with high sensitivity and specificity, it was of high evaluate in diagnosis and treatment of active tuberculosis.

Clinical significance of using the simultaneous amplification and testing method (SAT) in the early diagnosis of suspected pulmonary tuberculosis

JIANG Wan-hang, WEI An-na, PANG Hui-min, TAN Shou-yong

Chinese Journal of Antituberculosis. 2017, 39(12):  1309-1312.  doi:10.3969/j.issn.1000-6621.2017.12.011

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Objective To investigate the clinical significance of using the simultaneous amplification and testing method (SAT) in the early diagnosis of suspected pulmonary tuberculosis. Methods Three hundred and thirty-eight cases with respiratory disease (including 242 cases with suspected pulmonary tuberculosis and 96 cases with non-tubercular and other lung diseases) admitted in Guangzhou Chest Hospital from July to December 2015 were recruited in the study. Sputum samples were submitted for testing for SAT, smear, culture and strain identification. The number of cases of infection with Mycobacterium tuberculosis, and non-tuberculosis mycobacteria were determined. The coincidence rate of SAT and MTB culture, SAT and strain identification were calculated, and the sensitivity and specificity of SAT in the detection of suspected pulmonary tuberculosis was determined. Results Of the 242 cases with suspected pulmonary tuberculosis, 233 cases were sputum culture positive, 222 cases were infected with Mycobacterium tuberculosis, and 11 cases with non-tubercular mycobacteria, 96 cases with non-tubercular and other lung diseases were sputum culture negative. In the MTB group, 192 cases were SAT positive, and the coincidence rate of SAT and strain identification was 86.5% (192/222). In the NTM group, no case (0/11) were SAT positive, and the coincidence rate of SAT and strain identification was 100.0% (11/11). Of the 96 cases with non-tubercular and other lung diseases, 2 cases were SAT positive (2.1%, 2/96), and the coincidence rate of SAT with MTB culture and strain identification was 97.9% (94/96). The sensitivity of SAT in the diagnosis of suspected pulmonary tuberculosis was 86.5% (192/222), and the specificity was 97.9% (94/96). Conclusion The use of the SAT assay has important clinical significance for the early diagnosis of suspected pulmonary tuberculosis.

Knowledge attitude belief and practice in health education after spinal tuberculosis

YU Xing-yan, BI Na, LIU Ning, YU Mei, ZHANG Yan-hui, CHEN Jia-yi

Chinese Journal of Antituberculosis. 2017, 39(12):  1313-1317.  doi:10.3969/j.issn.1000-6621.2017.12.012

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Objective To explore the effectiveness of KAP (knowledge, attitude, belief, and practice) on the health education to patients with spinal tuberculosis. Methods Four hundred and thirty eight patients with spinal tuberculosis treated in People’s Liberation Army (PLA) 309 Hospital spinal surgery department from May to October 2016 who signed the informed consent form and joined the research voluntarily, excluding other non-spinal diseases and those patients with grade A, B by nerve function Frankel grade. The patients treated from May to July were enrolled in the control group, and those treated from August to October were enrolled in the intervention group. The control group received routine nursing care, and the intervention group received the same nursing care as the control group, but also added knowledge evaluation of spinal tuberculosis, and took a series of methods to enhance the beliefs of patients and their families, and required the patients and relatives to record daily nursing behavior. According to the record, the responsible leader continuously improved the nursing content. The activities of daily living (ADL) scores, the treatment compliance and the satisfaction of the nursing service at the time of discharge were compared between two groups at the time of discharge, 3 months and 6 months after discharge. Results At 6 months after discharge in the intervention group and the control group ADL scores were 90.12±4.02 and 88.13±6.78 respectively, with a significant difference between two groups (t=-2.87. P=0.00).Dietary compliance between two groups at the time of discharge and 3 months of discharge showed significant differences (10.59±0.78 vs 10.88±0.81, t=2.13, P=0.03; 9.08±0.23 vs 10.26±0.91, t=3.89, P=0.02). The scores of medication, dietary and exercise in the intervention group were significantly higher than the control group at 6 months after discharge (7.98±0.21 vs 8.05±0.31, t=2.22, P=0.04; 8.59±0.82 vs 10.14±0.61, t=2.01, P=0.00; 9.22±0.53 vs 10.98±0.78, t=3.51, P=0.01). The total satisfaction scores of nursing service at discharge were 96.77±7.52 and 85.68±8.77 among the intervention and control groups, with a significant difference (t=6.51, P=0.00). Conclusion KAP nursing mode can improve the activities of daily living and treatment compliance of patients with spinal tuberculosis after operation。 In the meantime, it also improved the satisfaction of the nursing service. The application of KAP health education can improve the patient’s health attitude and health behaviors, which will accele-rate the recovery of the patients.

A study on epidemiological characteristics of pulmonary tuberculosis in Yi and non Yi districts in Sichuan Province from 2006 to 2015

LI Jing, LI Ting, LU Jia, LI Yun-kui, XIA Yong, HE Jin-ge

Chinese Journal of Antituberculosis. 2017, 39(12):  1318-1323.  doi:10.3969/j.issn.1000-6621.2017.12.013

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Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) between Mabian Autonomous County and Muchuan County which located in Yi and non Yi districts in Sichuan Pro-vince during 2006-2015. Methods There were 1733 and 1131 registered PTB patients in Mabian Yi Autonomous County and Muchuan County in the ‘National TB Reporting Information Management System’ during 2006-2015, respectively. A descriptive statistics analysis was conducted to analyze the epidemiological distribution characteristics of age, gender, ethnic, and regional of PTB patients in the two counties. Results The average registration rate of PTB was 83.78/100 000 (1733/2 068 456) in Mabian Yi Autonomous County from 2006 to 2015, and 43.84/100 000 (1131/2 579 967) in Muchuan County. The registration rate of PTB patients declined obviously from 65.04/100 000 (167/256 758) in 2006 to 12.52/100 000 (32/255 650) in 2015 in Muchuan County (χ²_{trend=125.15, P<0.05). The registration rate of PTB was 96.71/100 000 (181/187 157) in Mabian Yi Autonomous County in 2006 and 98.86/100 000 (213/215 449) in 2015 with little change in the past 10 years. The average registration rate of male PTB patients was 109.19/100 000 (1170/1 071 486) in Mabian Yi Autonomous County, which was higher than that of female patients (56.47/100 000 (563/996 970)); the difference was statistically significant (χ²=171.48, P<0.05). The average registration rate of male PTB patients was 66.76/100 000 (915/1 370 503) in Muchuan County, which was higher compared with female patients (17.86/100 000 (216/1 209 464)); the difference was statistically significant (χ²=350.73, P<0.05). The registration incidence peak appeared in 30- young adults which accounted for 27.52% (477/1733) in Mabian Yi Autonomous County from 2006 to 2015, while a peak appeared in the 40- older group in Muchuan County which accounted for 19.98% (226/1131). During 2006-2015, the Yi nationality patients accounted for 84.25% (1460/1733), which was more than Han nationality (15.52% (269/1733)) in Mabian Yi Autonomous County, while Han nationality patients accounted for 99.56% (1126/1131) in Muchuan County; the difference was statistically significant (χ²=341.30 and 8785.64, respectively, P<0.05). The number of registered PTB in rural accounted for 96.19% (1667/1733), which was higher than that in urban (3.81% (66/1733)) Mabian Yi Autonomous County, and the registered patients in rural accounted for 78.87% (892/1131), which was higher than that in urban (21.13%(239/1131)) Muchuan County from 2006 to 2015, (χ²=324.75 and 22.77, respectively, P<0.05). Conclusion The epidemic situation of PTB in Yi district is serious. The Yi people, young and middle-aged men and the peasants should be regarded as high-risk groups in the two counties, and these persons will be the focus of the work of TB prevention and control.}

Investigation of the satisfaction and acceptance of mobile supervision mode among pulmonary tuberculosis patients in Shandong

SUN Xiao-ying, CHENG Jun, CHU Lei, BIAN Xue-feng, LUO Bin, JING Rui

Chinese Journal of Antituberculosis. 2017, 39(12):  1324-1329.  doi:10.3969/j.issn.1000-6621.2017.12.014

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Objective The research is to study the degree of satisfaction and acceptance of the mobile supervision mode among the patients who are suffering from pulmonary tuberculosis and to explore the appropriate population in some areas within Shandong Province in order to provide evidence for further promotion. Methods Ten cities in Shandong were selected by simple random sampling as study locations. Finally, 910 TB patients were interviewed face to face who were diagnosed from 10 counties of Yantai,Linyin,Tai’an, Liaocheng, Zibo, Zaozhuang, Jining, Heze, Dezhou and Binzhou in all 10 cities during April 1st, 2012 to March 31st, 2013. 910 valid questionnaires were collected and the effective rate was 100.0% (910/910). EpiData 3.1 was used to set up the databases,and SPSS 18.0 for descriptive and χ² test analysis,with P<0.05 as significant difference. Results TB patients had higher level satisfaction with this mode, the proportion of very satisfied to satisfied was 31.8% (289/910) to 41.2% (375/910) respectively. 32.8% (298/910) of TB patients completely accepted and 42.9% (390/910) of patients comparatively accepted “according to mobile reminders to take medicine on time”. The satisfactory rate in 18-49 years age group was 35.9% (207/577), higher than 24.7% (82/333) of over 50 yeas age group (χ²＝4.60,P<0.05). The rate in high school education was 41.5% (83/200), higher than 13.8% (11/80) of illiteracy education (χ²＝16.45,P<0.05). The rate in other professions was 38.6% (169/438), higher than 23.1% (95/364) of migrant workers (χ²＝6.94,P<0.05). The rate of overall acceptance in high school education and above was 41.0% (82/200), higher than 17.5% (14/80) of illiteracy education (χ²＝4.15,P<0.05). The rate in other professions was 38.1% (167/438), higher than 26.9% (98/364) of agriculture laborers (χ²＝4.51,P<0.05). Conclusion Most pulmonary tuberculosis patients can accept and are satisfied with mobile supervision mode. This mode is worth promoting. Additional training and guidance should be given to the elderly, low education level and low-income patients.

Analysis of Authors in Chinese Journal of Antituberculosis from 2003 to 2015

WANG Jia, YAO Hong-yan, SUN Jin-fang, LIU Jian-jun, WANG Qian

Chinese Journal of Antituberculosis. 2017, 39(12):  1330-1336.  doi:10.3969/j.issn.1000-6621.2017.12.015

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Objective To analyze the features of authors in Chinese Journal of Antituberculosis from 2003 to 2015. Methods A total of 2639 papers including 11 852 authors published in Chinese Journal of Antituberculosis from 2003 to 2015 were selected and analyzed in terms of bibliomertic parameters for authors’ features. The core authors were calculated according to the Terrace formula: M=0.749(N_max)^1/2. Results There were 170 core authors accounting for 9.27% (170/1834) of all first authors. Among them, 28 were members of editorial board of Chinese Journal of Antituberculosis, accounting for only 36.84% (28/76) of the eighth editorial committee of the journal. There were six provinces including Beijing, Guangdong, Shanghai, Shandong, Zhejiang and Hubei pro-vinces published more than 100 articles in journal. The authors from the hospital and TB dispensary accounted for 44.79% (1182/2639) and 39.22% (1035/2639), respectively. The authors of per article were 4.49 persons. Among 2639 articles, the author’s cooperation rate was 91.06% (2403/2639) and the unit cooperation rate was 30.77% (812/2639). Conclusion The core authors in Chinese Journal of Antituberculosis are stable. The authors distribute unevenly in different regions. The submission activity in the members of editorial board should be improved.

Analysis of the Chinese Journal of Antituberculosis questionnaire from readers and authors

GUO Meng, FAN Yong-de, LI Jing-wen, WANG Ran, MENG Li, YANG Ying, XUE Ai-hua

Chinese Journal of Antituberculosis. 2017, 39(12):  1337-1342.  doi:10.3969/j.issn.1000-6621.2017.12.016

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Objective We analyzed the Chinese Journal of Antituberculosis questionnaire from readers and authors, in order to understand their needs and provide reference for the improvement of journal work. Methods The Chinese Journal of Antituberculosis Editorial Department designed the questionnaire in April 2016, which was issued at the second joint of tuberculosis and imaging diagnosis and interventional treatment of lung diseases, the fourth session of the forum of bone and joint tuberculosis clinical diagnosis and treatment and standardized workshops, and the Chinese Antituberculosis Association 2016 National Academic Conference on the prevention of tuberculosis. A total of 425 questionnaires were collected at the 3 meeting, of which 397 were valid questionnaires (effective rate was 93.41%). Results Of the 397 questionnaires, 221 (55.67%) respondents had submitted to the journal or were intend to submit. Subscription was mainly through their institutions, accounting for 70.03% (278/397); the main way of reading was browsing the table of contents first and then choosing the interest articles, accounting for 71.28% (283/397); About the column, “expert forum” and “original article” were the most popular ones, accoun-ting for 51.13% (203/397) and 52.90% (210/397), respectively; most contributing authors submitted a draft once year (42.32%, 168/397), the main aim of submitting was to contribute promotion (38.29%, 152/397), and the ratio of respondents who identity with the influence of the Chinese Journal of Antituberculosis in similar journals was high (35.52%, 141/397); for the periodical annual symposium sponsored view, 90.43% (359/397) of respondents were supported; Most respondents (88.66%, 352/397) concerned about the thematic focus and were willing to submit their articles. Conclusion The Chinese Journal of Antituberculosis is quite influential in all participants. Most of them actively respond to the related work, and focus on the development of this periodical.

Recent research progress of the nucleotide-binding oligomerization domain-like receptor immune response to Mycobacterium tuberculosis infection

ZHANG Yu-qing, ZHANG Xu-xia, LIU Yi, LI Chuan-you

Chinese Journal of Antituberculosis. 2017, 39(12):  1343-1347.  doi:10.3969/j.issn.1000-6621.2017.12.017

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Mycobacterium tuberculosis (MTB) is the main pathogenic bacteria of Tuberculosis (TB). The immune responses of the host play an important role in the process of tuberculosis pathogenesis, which mainly work dependent on pattern recognition receptors (PPRs). Nucleotide-binding oligomerization domain-like receptor (NLR) is one of the important PPRs, which plays a vital role in the infection and pathogenesis of MTB. More than 20 types of NLR have been discovered hitherto. NLR primarily responses to intracellular bacteria and viruses, as well as the products released or degraded from these microorganisms. NLR functions in the process of recognition and elimination of pathogens by innate immune system in the early infection of MTB, as well as initiating adaptive immune response, secreting cytokines and inducing inflammation and autophagy. In recent years, the study of NLR has got new progress. In this paper, the immune response to MTB infection mediated by NLR and its relationship with the TB pathogenesis were analyzed comprehensively, so as to provide new clues for the study of interaction between MTB and host cells.

Progress in diagnosis and treatment of brucellosis spondylitis

CAI Xiao-yu, Maierdan稭aimaiti, Yakefu稟bulizi

Chinese Journal of Antituberculosis. 2017, 39(12):  1348-1352.  doi:10.3969/j.issn.1000-6621.2017.12.018

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Brucellar spondylitis (BS) occurs when Brucella attacks the vertebral column and causes inflammation in the intervertebral disc or vertebral body. Early diagnosis can be conducted by imaging, laboratory and clinical manifestations. It is mainly needed to be distinguished from spinal tuberculosis when diagnosis. BS should be controlled by combined, full-dose and full-course medical therapy. If the outcomes of medication and conservative treatment are not satisfactory and the patient is in conformity with the operation indications, operations via anterior, posterior or combined approach should be chosen according to the patient’s condition. During the operation, the lesion should be completely removed and the internal fixation device should be used to increase the stability of the spine, which is benefit to improve symptoms and prevent recurrence of the disease. The surgical procedures should be strictly planed with the indications for surgery when the surgeon chooses minimally invasive surgery for BS. At present, although the diagnosis and treatment of BS has made great progress, it is still necessary to study in depth and formulate standardized standards of diagnosis and treatment.

Diagnosis and treatment analysis of one case of penicilliosis marneffei misdiagnosed as tuberculosis

LIU Xiao-yu, SHENG Jian, JIANG Yu-hui, DAI Xi-yong, LEI Mei, CHEN Jun, YUAN Bao-dong

Chinese Journal of Antituberculosis. 2017, 39(12):  1353-1358.  doi:10.3969/j.issn.1000-6621.2017.12.019

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Penicilliosis marneffei (PSM) mainly occurs in immunocompromised people especially in patients of HIV infection.The clinical symptoms and signs of PSM are lack of specificity. Penicillium marneffei (PM) is critical for the culture condition and the positive rate is low. It’s easy to be misdiagnosed as tuberculosis. One case of penicilliosis marneffei without HIV infection in our hospital who had a disseminated lesion and was misdiagnosed as tuberculosis at beginning.was discussed from clinical feature to treatment.

Drug susceptibility analysis of 355 Mycobacterium tuberculosis

Xierzati·bulikemu, WANG Xiao-ping, Kamuranni·uotebula

Chinese Journal of Antituberculosis. 2017, 39(12):  1359-1361.  doi:10.3969/j.issn.1000-6621.2017.12.020

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To understand and analyze the drug resistance situation of first-line and second-line anti-tuberculosis (anti-TB) drugs in Yili Kazak Autonomous Prefecture of Xinjiang Uygur Autonomous Region (Yili Prefecture) in order to provide the basis for formulating reasonable treatment plans. The authors had cultured samples from 355 cases of sputum smear-positive patients admitted to the four counties (cities) in Yili Prefecture with acid-modified Roche culture method. PNB and TCH were used as identification medium to carry out the preliminary identification of mycobacteria. The positive strains were screened with 11 commonly used first-line and second-line anti-TB drugs for drug susceptibility testing. It showed that the total resistance rate to first-line anti-tuberculosis drugs was 35.77% (127/355), the total resistance rate to second-line anti-tuberculosis drugs was 7.89% (28/355); the resistance rate among newly diagnosed patients was 26.50% (75/283), the rate of resistance among the repeatedly treated patients was 72.22% (52/72). Resistance situation in Yili Prefecture is relatively serious, which deserves great attention.

Epidemiological characteristics of pulmonary tuberculosis in Shennongjia, Hubei during 2011-2015

CHEN Zi-bai, CHEN Chen, LI Guo-ying, ZHOU Yi-de, WANG Li, XIANG Yu-hua, DU de-yun

Chinese Journal of Antituberculosis. 2017, 39(12):  1362-1366.  doi:10.3969/j.issn.1000-6621.2017.12.021

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To analyze the epidemiological characteristics and regularity of pulmonary tuberculosis (TB) in Shennongjia, Hubei from 2011 to 2015, and to provide evidence for further prevention and control of tuberculosis. The results showed that there were 271 pulmonary TB cases reported in Shennongjia during 2011-2015, resulting an average annual reported incidence of 68.25/100 000 (271/396 070). The incidence was 74.92/100 000 in 2011, 69.16/100 000 in 2012, 69.06/100 000 in 2013, 63.09/100 000 in 2014 and 64.91/100 000 in 2015 respectively. Among the 271 patients, the most frequent time of onset was in March (12.18% (33/271)), while the lowest incidence was observed in May (4.06% (11/271)). Of the patients, 71.22% (193/271) were males, and 28.78% (78/271) were females, yielding a male: female ratio of 2.47:1. The difference in gender was statistically significant (χ²＝41.36, P<0.01). Among the 271 patients, the majority were aged 35- and 45- years, accounting for 38.01% (103/271). Farmers accounted for 61.25% (166/271). Therefore, prevention and treatment of pulmonary TB in Shennongjia should continue to strictly implement modern TB control strategy and to consolidate the “Trinity” TB prevention and control system. Furthermore, the work should focus on rural areas and farmers.

Analysis of referral and tracing of tuberculosis patients in non tuberculosis control institutions in Xinjiang during 2009-2015

Ayinuer·ohmat^*, LUY Jiang-hua, LI Yue-hua, XUE Feng, YAO Li-dan, WANG Jing

Chinese Journal of Antituberculosis. 2017, 39(12):  1367-1370.  doi:10.3969/j.issn.1000-6621.2017.12.022

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This article analyzed the referral, tracking and arrival of 299 338 registered tuberculosis patients in Xinjiang during 2009-2015 in non TB control institutions (herein after referred to as “non TB institutions”). The results showed that the referral rate, tracing arrival rate and overall arrival rate of pulmonary tuberculosis cases and suspected pulmonary tuberculosis patients reported by non-TB institutions in Xinjiang increased year by year. The rates were 18.40% (6332/34 411), 6.47% (12 482/22 103) and 60.68% (20 881/34 411) respectively in 2009, 27.74% (6058/21 838), 59.61% (8666/14 538) and 72.74% (5885/21 838) in 2010, 28.49% (6598/23 161), 70.11% (11 245/16 038) and 78.75% (18 239/23 161) in 2011, 36.48% (8800/24 125), 76.95% (11 527/14 979) and 85.29% (20 576/24 125) in 2012, 41.65% (10 282/24 685), 77.39% (10 845/14 013) and 86.75% (21 413/24 685) in 2013, 39.50% (14 334/36 326), 77.90% (16 716/21 459) and 86.60% (31 459/36 326) in 2014, 43.88% (20 181/45 986), 85.52% (20 709/24 214) and 90.05% (41 409/45 986) in 2015. The diagnosis accuracy rates of the arrival patients with active pulmonary tuberculosis as well as smear positive pulmonary tuberculosis declined. They were respectively 35.47% (7406/20 881) and 17.12% (3574/20 881) in 2009, 57.41% (9119/15 885) and 24.25% (3852/15 885) in 2010, 56.62% (10 327/18 239) and 21.74% (3966/18 239) in 2011, 41.75% (8591/20 576) and 15.59% (3207/20 576) in 2012, 43.53% (9322/21 413) and 12.88% (2757/21 413) in 2013, 36.21% (11 390/31 459) and 10.98% (3454/314 590 in 2014, 35.17% (4562/41 409) and 11.29% (4676/41 409) in 2015. The contribution rates of non TB institutions for the detection of activity pulmonary tuberculosis patients as well as smear positive pulmonary tuberculosis increased. They were 31.18% (7406/23 749) and 29.42% (3574/12 150) in 2009, 36.19% (9119/25 201) and 33.75% (3852/11 412) in 2010, 44.92% (10 327/22 989) and 42.23% (3966/9329) in 2011, 30.24% (8591/28 409) and 28.76% (3207/11 150) in 2012, 30.72% (9322/30 346) and 32.60% (257/8456) in 2013, 36.88% (11 390/30 880) and 43.49% (3454/7942) in 2014, 35.58% (14 562/32 666) and 61.06% (4676/7658) in 2015. Therefore, there is still room for improvement for the arrival rate of tuberculosis patient, and the tracing arrival rate and overall arrival rate maintain at a higher level in Xinjiang from 2009 to 2015.

Epidemiological survey and analysis of tuberculosis at a college in Chongqing

DUAN Wei-xia, LIU Ying, WANG Qing-ya, ZHANG Wen, PANG Yan, CHEN Wei, HU Dai-yu, WU Cheng-guo

Chinese Journal of Antituberculosis. 2017, 39(12):  1371-1374.  doi:10.3969/j.issn.1000-6621.2017.12.023

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Data of tuberculosis (TB) which outbreak at a college of Chongqing during September and December of 2016, were collected through epidemiological study, case investigation, TB screening for contacts, environment and TB work survey, and were analyzed using SPSS 16.0. The total 33 pulmonary TB students including two aggregated cases and 28 sporadic cases. Most cases were smear negative, 90.9% (30/33) were found by screening and the pulmonary TB detection rate was 0.30%. Furthermore, 84.8% (28/33) cases had no suspected TB symptoms, 51.5% (17/33) cases had pulmonary TB contact history and 30.3% (10/33) cases often went to Internet cafes. The pulmonary TB detection rates in grade 2014, 2015 and 2016 were 0.48% (9/1868), 0.47% (16/3382) and 0.19% (8/4213), respectively. The pulmonary TB detection rates in grade 2014 and grade 2016 were significantly different (χ²=4.78, P=0.029), and so did grade 2015 and grade 2016 2015(χ²=3.96, P=0.047). However, no significant difference was found between grade 2014 and 2015 (χ²=0.00, P=0.965). Overall, the TB burden is high in the college, TB prevention and control work should be further strengthened.