Table of Content

10 May 2005, Volume 27 Issue 5

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Measurement of messenger RNA in Mycobacterium tuberculosis from sputum as a marker for monitoring the response to chemotherapy

Lu Yu,Gao Mengqiu,Chu Naihui,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  281-284. 

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Objective To study the clinical value of Ag85B mRNA of M.tuberculosis in the sputums as a marker of monitoring the response of patients with pulmonary tuberculosis to chemotherapy.Method The sputums were collected from 15 smear-positive,primary treated patients with pulmonary tuberculosis at 2,4,7,14,30,60 days after receiving a standard short-course chemotherapic regimen,measured Ag85B mRNA of M.tuberculosis using quantitative reverse-transcribed polymerase chain reaction assay.The Results were compared with that using culture method.Results The level of Ag85B mRNA declined rapidly at 2 days after initiation of therapy,which was consistent with viable M.tuberculosis colony counts.Of 15 patients,11,12,and 14 had no detectable mRNA at 7,14,and 30 days after treatment,respectively.None of sputa had detectable mRNA at 60 days after treatment.Conclusion The rapid disappearance of M.tuberculosis Ag85B mRNA from sputum suggests that it might be a good indicator of microbial viability and a useful marker for rapid evaluation of response to chemotherapy.

Research on the mechanism of BCG inducing a protective immunity in mice

Zhang Guolong,Shi Ruiru,Gao Feixu,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  285-288. 

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Objective To investigate the mechanism on BCG inducing protective immunity,and to seek for the component of BCG playing main role on it.Methods We determined the level of IL-12p40,IL-18,and IFN-γ secreted by peritoneal exudate cells(PEC) from the mice in response to the lysates or the culture filtrates of viable or killed M.bovis BCG strain.Results Viable BCG strain could activate macrophage to produce both IL-I 2p40 and IL-18.Their lysate and culture filtrate also showed the activity inducing lL-12p40.In contrast,killed BCG strain and heat-treated filtrate could not induce IL-12p40 and IL-18 pro ductions.However,the lysate of killed BCG strain exerted significant activity inducing IL-12p40.Conclusion It showed that some heat stable factors in the culture supernatant from viable BCG strain contribute to the cyto kine productions.

RpoB gene mutations of rifampin-resistant Mycobacterium tuberculosis in Shandong Province

Wang haiying¹,Liu Zhimin,Xu Yong,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  289-292. 

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Objective To investigate gene mutations in the rifampin(RIF) resistance determining region(RRDR) of rpoB gene in Mycobacterium tuberculosis(MTB) isolates from Shandong Province,China.Method60 RIF-resistant and 75 RIF?susceptible MTB isolates collected from over 30 counties of Shandong Province in 1997,2000,and 2003 were analyzed by direct DNA sequencing.Results Fifty five(91.7%) of 60 RIF-resistant isolates were found missense mutations in RRDR of rpoB gene.The most common mutations occurred at codon 531(60.0%),526(29.1%) and 516(7.3%) respectively.One isolate presented multiple mutations at codons 511,515,518 simultaneously.Only 3(4.0%) of 75 RIF-susceptible isolates showed mutations at codon 533 with one novel mutation type(CTG→ATG).Conclusion The agreement rate between RRDR mutations of rpoB gene and RIF resistance among 135 MTB isolates from Shandong Province is 94.1%(127/135).Mutations at codon 533 were not associated with RIF resistance.

Analysis on the effects of implementation of two rounds of CIDA-WHO tuberculosis control project in Zhejiang Province

Yang Shibo,Li Qun,Miao Ziping.

Chinese Journal of Antituberculosis. 2005, 27(5):  293-295. 

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Objective To evaluate the effects of two rounds of CIDA-WHO tuberculosis control project in the past two years in Zhejiang province. Method To collect and analysis the quarterly reports of the project from every counties and other relevant materials.Results 6 526 smear-positive pulmonary tuberculosis were detected in the firs round of CIDA-WHO project,new notification rate of smear-positive pulmonary tuberculosis cases was 32.15/105,case-detection rate of smear-positive pulmonary tuberculosis patients was 69.9% and the cured rate was 86.8%;8674 smear-positive pulmonary tuberculosis were detected in the second round of CIDA-WHO project,new notification rate of smear-positive pulmonary tuberculosis cases was 34.92/105,case-detection rate of smear-positive pulmonary tuberculosis patients was 75.9%.Conclusion remarkable outcomes have been achieved in two year’s implementation of CIDA-WHO tuberculosis control project in Zhejiang province.The Objective of higher detection and cured rate has been reached.It provide a model of sustainability of tuberculosis control in Zhejiang province.

Systematic review of 20 clinical pathological conference articles on tuberculosis

He Quanying¹,Zou Li.

Chinese Journal of Antituberculosis. 2005, 27(5):  296-301. 

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Objective To explore the causes of tuberculosis misdiagnosis.Method 20 clinical pathological conference(CPC) articles on underdiagnosis of tuberculosis published in Chinese series core journals were searched by means of manual searching.The patient’s characteristics,final pathological diagnosis and the lessons of under-diagnosis were recorded.Results Among 20 cases with tuberculosis,13(65.0%) cases with miliary tuberculosis,8(40.0%) cases were incured by large amount application of glucocorticoids.Conclusion Clinical doctors should have high awareness on tuberculosis in order to reduce underdiagnosis.

The clinical and pathologic analysis of 27 cases malignant lymphoma misdiagnosed as tuberculosis

Zhang Yanlin,Yuan Baodong,Du juan,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  302-304. 

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Objective To study the clinical and pathologic characteristics of malignant lymphoma misdiagnosed as tuberculosis and its misdiagnosed reasons.Method The clinical and pathologic manifestations,X-ray features,diagnosis and treatments of 27 diagnosed malignant lymphoma cases misdiagnosed as tuberculosis from 1996 to 2003 were retrospectively analyzed.Results There were no specific clinical characteristics.The most common symptoms were fever(19/27),cough(8/27) and hemoptysis(1/27),8 cases without of symptoms(29%),the enlargement of the lymph nodes were in found in 22 cases.The X-ray showed as bumpnade lesions(10 cases),diffuse lesions(5 cases),hilar lymphadenopathy(11cases),pleural effusion(10 cases).Confirmed diagnosis was made by pathologic and immunohistochemical examinations through lymph node excision(22cases),bronchoscopy(2cases),or percutaneous needle lung biopsy(3cases).and 7 cases were confirmed as Hodkin’s lymphomas and 20 cases without Hodkin’s lymphomas.The main treatment Methods were radiotherapy and chemotherapy.The treatment outcome was poor.Conclusion There were similarities on clinical and pathologic manifestations,X-ray features between malignant lymphoma and tuberculosis.Misdiagnosis was common.Appropriate invasive biopsy procedures were necessary for early diagnosis.

Social-economic effects of TB control in Ningxia

Wang Xiaolin.

Chinese Journal of Antituberculosis. 2005, 27(5):  305-306. 

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Objective to analyze the cost-effects of TB control project supported by Ningxia-Central government funds.Method The data of case finding,treatment and management in the project supported by central governmental and local special funds between 2001 and 2002 were analyzed.Results 1-968 cases of pulmonary tuberculosis were cured by using central government funds of 0.64 million RMB Yuan and local special funds of 1.0 million RMB Yuan in the past two years.Among of them 19.22 million Yuan were saved.It is estimated that the losses both GDP and income is reduced by 154.67 and 14.568 million RMB Yuan.2952 people were avoided forsuffering from TB. Then the losses avoided both GDP and Income were 270.42 and 254.33 million RMB Yuan respectively.Conclusion Good effects were got in implementation the project by using central government and local special funds in the past two years.Although the investment was low,good social and great economic benefits have been achieved.It was a cost-effective disease control project.

Clinical preliminary results analysis of debridement and fusion with internal fixation in the treatment of thoracic and lumbar spinal tuberculosis

Xu Xiaoxiong,Jia Sharete，Jielile,Zhan Yulin.

Chinese Journal of Antituberculosis. 2005, 27(5):  307-309. 

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Objective To evaluate the clinical Results of debridement and fusion with internal fixation to treat thoracic and lumbar spinal tuberculosis.Method Forty-six cases of thoracic and lumbar spinal tuberculosis cases were treated with combination of debridement,fusion and internal fixation.The fusions of all cases were assessed by Moon method and the recoveries of neurological functions were assessed by Frankel grade before and after surgery.Results All cases were follow-up for 2.5 years in average.Kyphotic deformity was corrected(P<0.01).The cases used internal fixation had a higher recovery rate(98%).Conclusion Internal fixation plays an important role in surgical treatment of spinal tuberculosis by early re-constructional spinal stability,correcting deformity,speeding bony fusion,lessening arrest and early functional practice.

The investigation on drug resistance of hospitalized previously retreated tuberculosis patients during 1996-2001 in our hospital

Ren Laixing,Gui Xuwei,Xia Xiangxin,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  310-312. 

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Objective To investigate the situation of drug resistance of hospitalized previously treated pulmonary tuberculosis patients.Method To analyze and compare the drug resistance of 440 cases of retreated pulmonary tuberculosis from 1385 baterilogical positive pulmonary tuberculosis cases during 1996-2001.Results The total rate of drug resistance in youth group was the highest.The proportion of 2 and above drugs resistance was higher than that of 1 drugresistance.The rate of R resistance in youth group was obviously higher than that in old age group.The rate of HR resistance was the highest in 2 drug resistance group.The total rate of multi-drug resistance was 49.5%,but that in youth group was as high as 73.9%.Conclusion We should pay more attention to the grave situation of drug resistance of the patients with retreated pulmonasy tuberculosis.It is important to take the more measures to reduce the rate of drug resistance.

A Clincal analysis on 47 cases with Mycobacterium abscessus pulmonary disease

Zhang Yuqing,Wu Longzhang,Huang Jieling,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  313-315. 

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Objective To improve the understanding of Mmycobacterium abscessus(M.abscessus)pulmonary disease.Method Retrospective analyze the information of 47cases with M.abscessus pulmonary disease from Jan.1998 to Dec.2001.Results There were 15 cases of M.abscessus pulmonary disease accompanied with pulmonary tuberculosis,whereas the other 32 cases without pulmonary tuberculosis.31 cases were treated with anti-tuberculosis drugs before diagnosis.The main clinical symptoms included cough,expectoration with sputum,hemoptysis.On the chest X-ray,78.7% patients’ disease focuses were distributed over 3 pulmonary fields.59.6%cases in X-ray chest film were seen lesions bilaterally,31.9% in right side and 8.5%in the left.48.9% patients were accompanied with cavities.The resistant rates were high to isoniazid,rifampin,streptomycin,ethambulol,protionamide,pasiniazide and rifapentine,while lower to amikacin,capreomycin,levofloxacin,and clarithromycin relatively.Conclusion M.abscessus pulmonary disease is characterized with long progress,nonspecific symptoms,high resistant rate to anti-tuberculosis drug and unsatisfactory result of therapy.

The clinical evaluation of lipoarabinomannan for diagnosis of tuberculous meningitis

Li Yanggang¹,Yang Kunsheng,Jin Huawen,et,al1.

Chinese Journal of Antituberculosis. 2005, 27(5):  316-318. 

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Objective To evaluate the clinical value of lipoarabinomannan for diagnosis of tuberculous meningitis and to determine the ROC.Method The detection of anti-LAM-antibodies made by dot-immunolgold filtration assay in sera and cerebrospinal fuid(CSF) from patients with tuberculous meningitis and non-tuberculosis.The sera was diluted by 25 times and the CSF by 1,2,4,8,16,32 times.Results The sensitivity and specificity in serum was 96.9% and 58.3% respectively.The two indexes in CSF with the dilution of 1,2,4,8,16,32 times were 93.8%,90.6%,56.3%,37.5%,12.5%,3.1% and 83.3%,95.8%,95.8%, 100%,100%,100%.The best cut-off value was in CSF with dilution 2 times on which the specificity was significant difference compared with that of sera,but there was no significant different on sensitivity.Conclusion The detection of anti-LAM-antibodies in CSF made by dot-immunolgold assay is a useful tool.

Analysis on immunodetection results of 95 active pulmonary tuberculosis cases

Li Yuecui¹,Huang Xiaodong,Tang Shenjie.

Chinese Journal of Antituberculosis. 2005, 27(5):  319-321. 

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Objective To assess the relation between cellular immunity and humoral immunity in active pulmonary tuberculosis patients.Method T lymphocyte subsets and tuberculous antibody were measured in serum of 95 cases of active pulmonary tuberculosis,and PPD tests were done in all patients.Results The positive rates of tuberculous antibody and PPD tests in patients with bacteriological positive pulmonary tuberculosis were higher than those in patients with bacteriological negative pulmonary tuberculosis.There was no significant relation between T lymphocyte subsets and sputum bacteriology.The abnormal rates of T lymphocyte subsets were high when tuberculous antibodys in serum were posiyive.The probability of nomal T lymphocyte subsets in serum were high when the positive rates of PPD tests were enhanced.Conclusion The detection of T lymphocyte subsets in serum in patients with pulmonary tuberculosis can indirectly understand the changes of tuberculous antibody and PPD tests,reflect immune status of organism.

Study on the three different treatment means of tuberculosis pleurisy

Shang Haozhen,Yao Hengbo,Guo Lei,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  322-324. 

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Objective To probe the treatment means of tuberculosis pleural effusion.Method 123 received creating cases of tuberculosis pleurisy were divided into group A,B,and C at random,group A:42 cases put drainage in the thorax and inject Vaccae in it,group B: 45cases put drainage in the thorax only,group C:36cases,carry aspiration for pleural effusion one or two times of a week.Three groups all use 2HRZE/4HR,and group C use Pedisorn 30?mg/d.Results After one month treating,the group A controlling rate is 95.3%,36(85.7%)have remarkable result,4(9.6%) have effective result,2(4.7%) have no effective,have effective result 100% after 6 months;The group B,controlling rate is 91.1%,36(80%)have remarkable result,5(11.1%) have effective result,4(8.9%) have no effective,have effective result 100% after 6 months;Group C: controlling rate is 66.6%,3(8.3%)have remarkable result,21(58.3%)have effective result,12(33.3%) have no effective,have effective result 83.3% after 6 months.Conclusion There have no remarkable difference of inject drug or no when put drainage in the thorax.

The clinical observation on treatment effect of gatifloxacin for the gerontism tuberculosis affiliate lower respiratory infection cases

Zhu Yaojin Xu Long.

Chinese Journal of Antituberculosis. 2005, 27(5):  325-326. 

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Objective To observe the clinical therapeutic effects of Gatifloxacin forthose patients with gerontism tuberculosis affiliate lower respiratory infection.Method A total of 63 cases chosen in a randomized way were divided into two groups: the study group(n=34) and the control group(n=29).The treatment measures were quiescent point Gatifloxacin and Ciprofloxacin with 400?mg does everyday for the study and control groups respectively.The course of treatment was all 7～14 day.Results The effective rate in study group was 85.3% and in the control group was 62.1%.The difference of two groups was significance(P<0.05).The therapeutic effects in study group was better obviously than that in the control group(P<0.05).The bacterialogical negative conversion rate in study group was 78.6% and in the control group was 60.9%.The difference of two groups were not significance(P>0.05).Conclusion The therapeutic effects of Gatifloxacin was perfect for the patients with gerontism tuberculosis affiliate lower respiratory infection and it was significant on clinical application.

Therapeutic effect of compound glycyrrhizin and reductive glutathione on the fourty-eight inpatients suffered from hepatitis resulted from anti-tuberculous drugs

Yang Song,Zhang Yaoting,Yin Jiantuan.

Chinese Journal of Antituberculosis. 2005, 27(5):  327-329. 

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Objective To explore the therapeutic effect of compound glycyrrhizin and reductive glutathione on the hepatitis suffered from anti-tuberculous drugs.Method Prospective study was adopted.Fourty-eight inpatients suffered from hepatitis resulted from antituberculous drugs during Jan,2001 and Dec,2004 were randomly sorted out into treatment group and control group.The former was treated with compound glycyrrhizin and reductive glutathione,but the latter was treated with routine drugs.The effect was analysized byχ² test.Results Most inpatients of hepatitis occurred during the enhanced period.The clinical manifestations were followed as nausea or vomit.Either tiredness,icterus,windy feeling,pain in liver,or augment of liver might be happened in severe cases.Drug hepatitis was often resulted from the secondary pulmonary tuberculosis or extra-pulmonary tuberculosis.The effect at treatment group was markedly excelled than the control.Conclusion Compound glycyrrhizin and reductive glutathione not only were able to alleviate the clinical manifestations of drug hepatitis within one week,but also able toimprove liver function.Compound glycyrrhizin and reductive glutathione were characteristic of both safe and well therapeutic effect on the hepatitis suffered from antituberculous drugs.

Analysis on current situation of tuberculosis control project and initial drug resistance rate of pulmonary tuberculosis in Dongguan city

Peng Jianmei,Yi Lailong,Hu Chunmei,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  330-332. 

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Objective To evaluate the effect of tuberculosis control program carried out in Dongguan city and to determine the initial drug resistance level.Method Drug resistance surveillance(DRS) was implemented in Dongguan according to WHO/IUATLD Guidelines for Surveillance of Drug Resistance in Tuberculosis(1994).The proportional method was used for new smear-positive pulmonary tuberculosis without history of anti-tuberculosis drug use.Results Among 558 cases,the rate of initial resistance was 18.1%.The resistant rate to isoniazid was 9.9% and streptomycin was 11.6%.Those two drugs were the major resistance drugs.The resistant rate to one drug was 50.5% among the patients with resistance results.The treatment outcomes were good not only in new susceptibility cases but also in initial drug resistant cases.Conclusion The result revealed that the drug resistance level in Dongguan was high.Therefore,TB control program should be further strengthened.

A Study on the concentration of ADA、β₂-MG and SAin patients with SARS

Yi Xiaoping,Luo Xiaohong,Zhang Yuanliang,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  333-335. 

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Objective: To determinate the concentration of adenosine deaminase(ADA)、β₂-microglobulin(β₂-MG) and saliva acid(SA) in patients withsevere acute respiratorysyndrome(SARS) and evaluate the immunore-action and degree of damage caused by severe acute respiratory syndrome virus.Method Serumsamples of thepatients with SARS,pulmonary tuberculosis(TB) or normal pneumonia(NP) were collected and the levels ofADA、β₂-MGand SAwere detected separately.Results(1)As to the ADAlevel,SARS group was obviouslylower thanthe TBgroup(P<0.001) while among SARS patients,the result was different withthe total amountof WBChigher or lower than 5.0×109/l in which the higher group has more ADAproduction than the lowergroup.(2)As totheβ₂-MGlevel,SARS group was higher thanthe TBgroup or the NPgroup while it rise withthe age inthe SARS patients.(3)The SAconcentrationinthe SARS group was higher thanthe TB group or theNPgroup while the result was different withthe total amount of WBChigher or lower than 3.0×10⁹/Lin whichthe lower group patients produced more SAthanthe higher group.Discussion: The concentration of ADA、β₂-MGand SAcan be used as a set of parameterto evaluatetheimmunoreactionand degree of damage caused byse-vere acute respiratory syndrome virus.

The analysis on case finding and treatment situation of tuberculosis in the assigned tuberculosis outpatient department in the general hospital

Zhao Zhiying¹,Yang Weina,Zhao Liming,et al.

Chinese Journal of Antituberculosis. 2005, 27(5):  336-338. 

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Objective To investigate and analyze the distribution,clinical characteristic and treatment status in the assigned tuberculosis outpatient department in the general hospital for providing evidences for improving work in its prevention and treatment.Method An analysis was conducted based upon the survey and registration materials from assigned tuberculosis outpatient department of Yuyao city from January,2002 to October,2004.Results Among 1012 cases with symptoms seeking for medical advicedirectly,977 cases transferred from another department of hospital(96.5%).The distribution of the source department referred from showed as followings: internal medicine 65 %,respiratory 11.1 %,stomatology 8 %,emergency 6.9 %,and surgery 5.6 %.478 cases were confirmed and bacteriological positive(47.2 %).Among these,92 cases(9.1 %) had coexistent diabetes and 23 cases(2.3 %) had coexistent pulmonary cancer.869(85.9%) cases completed course of treatment,766 cases cured,80 cases improved.143 cases interrupted their treatments.Among these,62 cases had referred to the local tuberculosis dispensary.39 cases died of severe complications or underling diseases.Conclusion The case finding and treatment in the assigned tuberculosis outpatient department in general hospital was satisfactory,but the number of assigned outpatient department should be increased.The concerned management should be enhanced.