Table of Content

10 April 2004, Volume 26 Issue 4

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The effect analysis of the tuberculosis case-finding mode in Zhejiang province

Li Qun,Yang Shibo,Xu Xuqing,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  195-198. 

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Objective To improve the tuberculosis case-finding rate through strengthening the important rules played by the general hospital on tuberculosis control work.Methods To change the traditional tuberculosis control mode and extensively implement the referring case-management system,and to assign the responsibility of the tuberculosis control institution and the general hospital.Results The detection rate for new smear positive cases already increased to 55.7%. New notification rate of smear-positive pulmonary tuberculosis cases increased from 16.37/10⁵ in 2001 to 25.60/10⁵ in 2003. The referred rate increased from 77.8% in 2000 to 95.9% in 2003.Conclusion The referring case-management system effectively increased the case-finding rate and the referring rate in hospital. It’s a key to utilize existing medical care facicities for tuberculosis control.

Analysis of relevance of pulmonary tuberculosis to HLA-DQB1-HLA-DRB1 gene haplotype among Han Nationality of Southern Chinese

Luo Yilu,Liu Zhihui,Xu Yuanhua,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  199-203. 

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Objective To probe possible role of HLA-DQB1-HLA-DRB1 haplotype in incidence of pulmonary tuberculosis among Han nationality of southern Chinese.Methods PCR-SSP was applied to detect 20 alleles of HLA-DRB1 and 8 alleles of HLA-DQB1 gene sites of 110 tuberculosis cases and 101 controls who came from Guangdong,Guangxi,Hunan,Hubei,Jiangxi and Fujian in a case control study.Then DQ2,3(8)-DRB1,DQ3(7)-DRB1,DQ3(8,9)-DRB1,DQ2,3(7,9)-DRB1,DQ2-DRB1,DQ4-DRB1,DQ5-DRB1 and DQ6-DRB1 haplotype frequencies (HF) as well as relative risks (RR) were calculated and compared.Results It was found that frequencies of DQ2,3(8)-DR12.1,DQ3(7)-DR16 haplotype in pulmonary tuberculosis cases were strikingly higher than that in healthy controls (6.10 vs.0.50、4.18 vs.0.99,their RRs were 13.40 and 4.41) and that frequencies of DQ2-DR1,DQ2-DR12,DQ2-DR13.3,DQ3(7)-DR1,DQ3(7)-DR13.3,DQ3(8,9)-DR13.3,DQ2,3(7,9)-DR1,DQ2,3(7,9)-DR13.3,DQ2,3(7,9)-DR13.4,DQ4-DR4 haplotype in pulmonary tuberculosis cases were remarkable lower than that in healthy controls (1.84 vs.5.60,1.37 vs.5.60,4.18 vs.11.00,2.30 vs.9.89,12,62 vs.22.28,5.61 vs.11.56,3.70 vs.14.40,16.88 vs.28.94,5.13 vs.12.12,2.30 vs.6.13),which their RRs were 0.31,0.23,0.34,0.21,0.47,0.44,0.46,0.38 and 0.35 respectively.Conclusion This study suggested that DQ2,3(8)-DR14.1,DQ2-DR12,DQ2,3(7,9)-DR13.4,DQ4-DR4 haplotype is potential relative to incidence of pulmonary tuberculosis of Han nationality of southern Chinese.However,differences of frequencies of DQ3(7)-DR16,DQ2-DR1,DQ2-DR13.3,DQ3(7)-DR1,DQ3(7)-DR13.3,DQ3(8,9)-DR13.3,DQ2,3(7,9)-DR1,DQ2,3(7,9)-DR13.3 haplotype between pulmonary tuberculosis cases and healthy controls may be caused by remarkable differences of gene frequency (GF) of constituted gene.

Fused expression of Mycobacterium tuberculosis CFP-10 and ESAT-6 protein in Ecoli

Li Juan,Wu Xueqiong,Zhang Junxian,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  204-208. 

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Objective To obtain the recombinant CFP10-ESAT6 fused protein of M.tuberculosis .Methods The gene coding CFP-10 and ESAT-6 protein was amplified by polymerase chain reaction (PCR).The gene was inserted into an expression vector pET-28a to get recombinant plasmid.The recombinant plasmid was transformed into E.coli BL21(DE3).The E.coli carrying recombinant plasmid were induced by IPTG.The expressed product was indentified by SDS-PAGE and purified by metal chelation chromatography,and its immunological characteristics were analyzed by Western-blotting and ELISA technology.Results The sequence of CFP-10 and ESAT-6 in recombinant plasmid was consistented to that of Genbank report. The recombinant CFP10-ESAT6 protein was highly expressed in the form of solution in E.coli ,which was confirmed by Western-blotting analysis with monoclonal antibody against 6×His·tag and TB patient serum .ELISA test Results indicated that the purified recombinant protein could distinguish sera from tuberculosis patients and those from healthy people.Conclusion The recombinant CFP10-ESAT6 protein was expressed and purified successfully in the form of solution in E.coli and showed specific immunogenicity.

Interferon-γ level in tuberculous and non-tuberculous inflammatory and malignant pleural effusions

Gao Tongjun,Wang Qingfeng,Li Youcai,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  209-211. 

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Objective To detect interferon-γ level in tuberculous and non-tuberculous inflammatory and malignant pleural effusions,and explore its role for differentiation of diagnosis.Methods To detect interferon-γ level of 51 tuberculous pleurisy cases,30 malignant pleurisy cases and 20 non-tuberculous pleurisy cases by ELISA.Results There was a significant difference of interferon-γ levels different groups.The levels in tuberculous pleurisy group was 58.75±70.89 pg/ml.It is higher than that in other two groups (P<0.01).The levels in group of malignant pleurisy was 54.64±36.67 pg/ml and in the group of non-tuberculous pleurisy was 58.75±47.26 pg/ml.Conclusion The levels of interferon-γ could be an important reference indicator for diagnosis of tuberculous pleurisy.

CT findings of cervical lymph node tuberculosis

He Wei,Xie Ruming,Zhou Xinhua.

Chinese Journal of Antituberculosis. 2004, 26(4):  212-214. 

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Objective To determine and probe the CT imaging feature of cervical tuberculous lymphadenitis and the value for diagnosis.Methods Plain CT and enhanced CT were scan in 45 cervical lymph node tuberculosis patients and 13 metastasis tumor patients verified by pathology.Results In 45 cases,the most involved area of cervical lymph mode tuberculosis was inferior internal jugular (86.1%),middle internal jugular (60%) and posterior triangle lymph modes (42.2%).Based on the configuration,attenuation and surrounding fat planes on CT scan,cervical lymph node tuberculosis were divided into five types.Type 1:homogeneous soft tissue density;Type 2:central low density and peripheral rim enhancement with relative preservation of surrounding fat lanes;Type 3:multilocal central low densities and peripheral rim enhancement with obliteration of surrounding fat planes;Type 4:lager confluent low density with peripheral rim enhancement and loss of lymph node architecture.Type 5:heterogeneous soft tissue density.Among the 45 cases of CTBL,Type 3 was most common type be noted (53.4%),followed by type 4 (44.5%),type1 (28.9%),type5 (11.1%),type2 (6.7%).Conclusion CT can not only well demonstrate the number,location,size and enhancement feature of CTBL but also reflect the pathological feature.It has important value in diagnosis and therapy of CTBL.

The role of fibrinogen concentration of pleural effusion relate with the developing of pleural thickness and adhesion in tuberculous pleurisy

Li Haiming,Zhang Huaru.

Chinese Journal of Antituberculosis. 2004, 26(4):  215-216. 

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Objective To investigate the relationship of concentration of pleural effusion in tuberculous exudative pleurisy with pleural thickness and adhesion.Methods 117 cases of primary tuberculosis pleurisy were divided into 3 groups (A、B、C) from low to high according to the content of fibrinogen concentration of pleural effusion.Pleural thickness were measured and the incidence rates of pleural adhesion were assessed during the course of treatment and after treatment.Results Pleural thickness indicators in the course of treatment:there was difference between group A and group B ( t=2.57,P<0.05 );there was significant difference between group A and group C ( t=7.15,P<0.01 );there was difference between group B and group C( t=2.46,P<0.05 ).The incidence rate of pleural adhesion in the course of treatment:there was no difference between group A and group B (χ²=3.51, P>0.05 );there was significant differencebetween group A and group C(χ²=9.87, P<0.01 );there was difference between group B and group C (χ²=4.51,P<0.05 ).Pleural thickness indicators after treatment:there was no difference between group A and group B ( t=1.45,P>0.05 );there was significant difference between group A and group C ( t=3.46,P<0.01 );there was signifcant difference between group B and group C ( t=2.89,P<0.01 );The incidence rate of Pleural adhesion after treatment:there was no differnce between group A and group B (χ²=0.10,P>0.05);there was difference between group A and group C(χ²= 4.36,P<0.05 );there was significant difference between group B and group C (χ²=7.49,P<0.01 ).Conclusion Pleural thickness and the incidence rate of pleural adhesion were effected by the content of the fibrin in pleural effusion.

Diagnostic value and health economic evaluation of fluorogenic hybridization assay in pulmonary tuberculosis

Fan Lin,Xiao Heping.

Chinese Journal of Antituberculosis. 2004, 26(4):  217-219. 

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Objective To probe the diagnostic value and health economic evaluation of PCR-fluorogenic hybridization assay in pulmonary tuberculosis.Methods To analysis and compare the Results of sputum PCR-fluorogenic hybridization method and sputum fluorogenic smear of 301 cases from May 2002 to November in 2002.Results The sensitivities of sputum fluorogenic hybridization method with,specimen and sputum smear with 1,3 and 6 specimens was 51.9%,49.2%,57.4,61.2% respectively.There was no statistic significance ( P>0.05) of the sensitivities of two methods.The per case cost of test by fluorogenic hybridization method and smear method was 257.47 yuan and 50.17 yuan respectively.Conclusion Fluorogenic hybridization method is rapid and efficient compared with smear examination.But it was expensive.It could not replace the traditional method i.e. smear examination in diagnosing tuberculosis.

A study on the BCG vaccination in temporary resident children in Fengtai district of Beijing

Li Chunju,Wu Zhaoru,Zheng Suhua,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  220-222. 

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Objective In order to determine the situation of BCG vaccination in temporary resident children in Fengtai district.Methods The children who were the second grade class of primary schools were investigated the history of the BCG vaccination,BCG scar,native place and conducted PPD test.Results The rate of BCG vaccination was lower in temporary resident children.Conclusion BCG vaccination in temporary resident children should be strengthened.

Case-finding and treatment management for pulmonary tuberculosis cases in Zhengzhou city

iu Jianmin,Liu Wantong.

Chinese Journal of Antituberculosis. 2004, 26(4):  223-225. 

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Objective To study the case-finding and treatment management for pulmonary tuberculosis cases in Zhengzhou city.Methods To analysis and evaluate the tuberculosis refering situation from general hospitals and the treatment outcome of new-smear positive pulmonary tuberculosis cases in 1996-2002 based cohort analysis.Results The cure rate of new-smear positive pulmonary tuberculosis(87.4%) was increased ( P<0.05).The lose rate(0.6%)was reduced (P<0.01),The success rate of referred TB patients from hospitals was 32.4%.Conclusion The foundation situation of tuberculosis control in Zhengzhou city for was follows:strengthened political intervention,perfecting three-level tuberculosis control network and implementing of the DOTS strictly.

Analysis on effects of World Bank Loaned TB Control Project in Chongqing (1992—2001)

Liu Li,Jing Kuanhe,Du Changting,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  226-229. 

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Objective To analyze the effects of World Bank Loaned TB Control Project in Chongqing since the project was put into action 10 years ago.Methods To collect and analyze the quarterly reports of the project from 40 districts/counties during 1992 to 2001,the data of 2000 tuberculosis epidemiological survey in Chongqing in 2000 and some other relevant materials.Results The project had covered 30.98 million population in 40 districts/counties.The coverage rate was 100%.Over the past ten years,401?342 cases of suspect tuberculosis patients had been examined,among of them 84?471 smear-positive patients were detected and 91?460 tuberculosis cases have been treated free of charge.The cure rate of new smear-positive cases reached 94.8%,and the cure rate of retreated smear-positive cases reached 90.3%.Conclusion The Health V project in Chongqing has made a great progress in the past ten years.A number of pulmonary TB patients have been detected and cured.However,the epidemic situation of TB in Chongqing is still very serious,and further efforts should be made.

Surveillance of drug resistant tuberculosis in Huangshi of China

Ai Yiming,Huang Ling,Li Guoming,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  230-232. 

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Objective To collect the data of initial and acquired drug resistance based the established surveillance system for antituberculous drug resistance according to WHO/IUATLD guidelines,And to evaluate the efficacy of on going tuberculosis control strategies.Methods The study objectives were new detected smear positive pulmonary tuberculosis cases of Huangshi in 1999.Susceptibility tests (proportion method for SM,INH,RFP and EMB) were done in all culture positive specimens.Results 210 patients with pulmonary tuberculosis cases involved in the study.Among of them,200 were culture positive,The culture-positive rate was 95.2% and the culture-negative rate was 3.8%.And the contamination rate was 1.0%.The total drug resistance rate was 18.5%.The initial drug resistance rate was 12.5% and the acquired drug resistance rate was 42.5%.The initial MDR-TB rate was 20%.Conclusion The anti-tuberculosis drug resistant surveillance and quality control system were establisned.The reliable data on the status of anti-tuberculosis drug resistance in Huangshi prefecture were collected.The drug resistance Results provided the evidences for improvement and assessment on TB control measures.

Study on L-form Mycobacterium bacilli in the lesions of osteoarticular tuberculosis cases

Han Fengman,Cheng Hong,Wu Qiqiu,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  233-234. 

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Objective To explore the exist of L-form Mycobacterium bacilli in the lesions of bone and joint tuberculosis.Methods After N-Acetyl-L-Cystein-Sodium Hydroxide (NALC-NaOH) decontamination and Z-N stains,the specimens collected from the lesions were inoculated in L-J culture media,Bactec 460 and L-form broth media for detecting the Mycobacterium bacilli and L-form of Mycobacterium bacilli.Results The L-form of Mycobacterium bacilli were found in the lesions of 11(18.3%) osteoarticular tuberculosis patients.The smear positive rate of smear and L-J culture positive were 9 cases (15%) and 3 cases (5%) respectively.The positive rate of Bactec 460 was 12 cases (20%).Conclusion It is necessary to make L-form Mycobacterium bacilli examination for retreatment tuberculosis patients.

Analysis of the effects of one year implementation of CIDA-WHO tuberculosis control project in Shandong province

Cheng Jun,Geng Hong,Li Renzhong,et al.

Chinese Journal of Antituberculosis. 2004, 26(4):  235-237. 

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Objective To evaluate the effects of CIDA-WHO tuberculosis control project in the past one year in Shandong.Methods To analyze the information of case notification from the quarterly reports and compare with the plan of Shandong CIDA-WHO project.Results 8?712 smear-positive pulmonary tuberculosis were detected in the past one year.The cured rate of 2?335 cases initial treatment of smear-positive pulmonary tuberculosis was 96.5% and the cured rate of 589 cases retreatment of smear-positive pulmonary tuberculosis was 94.9%.Conclusion Remarkable outcomes have been achieved by one year’s practice of CIDA-WHO tuberculosis control project.The aim of higher detection and cure rates has been reached.It provide a good experience for the second round of CIDA-WHO project implementing and a model of sustainability of tuberculosis control in Shandong province.

Application valuation by pleural biopsy under gasgraphy reserved intubation for diagnosis of thoracic disease

Chen Ying,Liu Xin.

Chinese Journal of Antituberculosis. 2004, 26(4):  238-239. 

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Objective To explore the valuation of pleural biopsy under gasgraphy by intubation for thoracic disease.Methods 44 inpatients which were no confirmed diagnosis by biopsy in the position pointed by routine ultrasonic,were placed a reserved catheter through central vein in thoracic cavity.Gas was injected through the catheter after pleural fluid was pumped out from the cavity.Then biopsy were done in the area of thickening pleural,which was pointed by X ray.Results The pathological positive rate of biopsy was 0 in the pleural specimens of the positions pointed by routine ultrasonic of 44 cases.The positive rate of thickening pleural by gasgraphy under X ray was 90.9%,and the pathological rate of biopsy was 97.5%.There were 12 cases with adenocarinoma,5 cases with malignant mesothelioma,22 cases of pulmonary tuberculosis.112 times of biopsy at the same site and different direction was taken,and there was no complication occurred.Conclusion The pleural lesion was easy to be found by gasgraphy through reserved intubation.The Results of biopsy was credibility and the positive rate was high.The method was safe,economical and could be popularized.

Analysis on treatment outcomes for smear-positive pulmonary tuberculosis of immigrants

Ye Yuechang.

Chinese Journal of Antituberculosis. 2004, 26(4):  240-241. 

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Objective To explore the effect of tuberculosis control in immigrants and to provide the scientific evidences for integrating immigrants into regional tuberculosis control program.Methods To provide free diagnosis and treatment for pulmonary tuberculous patients of immigrants.And DOTS was implemented for case management.Results There were 450 smear-positive pulmonary tuberculosis cases registered.The cured rate of initial treatment cases with smear-positive was 90.9% and the rate of retreatment cases with smear-positive was 85%.The treatment outcome is close to the outcome of the patient of the resident.Conclusion With strengthened efforts on management of tuberculosis cases of immigrants,treatment outcome could be achieved the same outcome in the resident.

Analysis on liver damage caused by anti-tuberculosis drugs for new smear positive pulmonary tuberculosis cases in Shantou city from 1998 to 2002

Chen Jiahuai,Xu Zhuopan.

Chinese Journal of Antituberculosis. 2004, 26(4):  242-244. 

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Objective To review problems related to the liver damages of treatment regimens of the tuberculosis control project for ensuring the implementation of the project smoothly.Methods Retrospective analysis had been done for the 282 cases with liver damage symptoms out of the 1?654 smear-positive cases who received the anti-tuberculosis treatment from 1998 to 2002.Results The highest rate of liver damage casued by anti-tuberculosis drugs was occurred in 35-75 year (210 cases,74.5%).Digestive tract symptom and liver function changes that appeared within two months in 90% cases.For the cases with less serious changes,liver-protection treatment was used and no need to stop anti-tuberculosis treament.For the cases who with serious changes,liver-protection treatment was used and the anti-tuberculosis treatment courses (97.5%).Conclusion The side-effect of the anti-tuberculosis can be figured out and countermeasure of prevention and cure be mastered so that the Tuberculosis treatment courses would be successfully completed.Lives of the patients would be saved and medical care disputes can be avoided.