Table of Content

10 May 2004, Volume 26 Issue 5

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Analysis of therapeutic effect on the individualized regimens for 69 patients with multi-drug resistant pulmonary tuberculosis

Huang Xuerui,Gao Weiwei,Bu Jianling,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  257-260. 

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Objective To observe and analyse the therapeutic effects of individualized regimens for 69 patients with multi drug resistant pulmonary tuberculosis (MDR TB).Methods The patients were divided into 3 groups according to the result of susceptibility test.Three groups were HR resistant group (Group Ⅰ),resistant to 3 drugs including HR (Group Ⅱ) and resistant to 4 or more drugs including HR group (Group Ⅲ).And the patients received individualized regimens for treatment.Sputum negative conversion rates and chest X ray improvement rates were observed.Results The sputum conversion rates and chest X ray improvement rates of 3 groups in the treatment of 6,12 and 24 months:the sputum conversion rates and chest X ray improvement rates in Group Ⅰ were 76.5%,94.1%,94.1,94.1,Group Ⅱ were 60.0%,65.0%,70.0%,80.0% and Group Ⅲ were 46.9%,50.0%,46.9%,56.3% respectively.The rates of Group Ⅰ were higher significantly than that of Group Ⅲ ( P<0.05,P<0.01,P<0.01). There was no difference between Group Ⅰ and Ⅱ/Conclusion Individualized regimens therapeutic effects were associated with the number of resistant drugs and irreversible lesions.Our Results obtained in this study suggested that timely individualized regimens were provided to MDR TB patients based on the susceptibility test is improtant for the treatment.

Analysis on the status of diagnosis and treatment of drug resistant tuberculosis patients in Shenzhen

Tan Weiguo,Yang Yingzhou,Cheng Jinquan,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  261-263. 

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Objective To determine the status of diagnosis and treatment of drug resistant tuberculosis patients in Shenzhen in order to provide evidences for policy makers on TB control.Methods To investigate drug resistant TB patients from city and county level TB dispensaries and infectious disease hospitals on diagnosis,treatment and management situation in 2002-2003.Results 103 drug resistant TB patients had been diagnosed and treated in 2002—2003.The laboratory method selected for diagnosis was different.28.1% of treatment regimens were irrational,direct observed treatment (DOT) was not provided to patients.The cure rate was 34.9%,the failure rate was 30.1%,the default rate was 13.6%.9.7% of cases were not evaluated.Conclusion Epidemical situation of MDR TB is very severer in the city.It is necessary to establish criteria for diagnosis,treatment and management of MDR TB and implement DOTS PLUS tactics to control the prevalence of MDR TB.

Report on the fourth epidemiological survey for tuberculosis in Xinjiang Uygur Autonomous Region

Jin Xin,Fan Xinchun,Yan Huakui,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  264-267. 

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Objective To determine the epidemiological situation of tuberculosis,evaluate the effections of the efforts on tuberculosis control and provide scientific evidences for developing 2001—2010 tuberculosis control programme in Xinjiang.Methods The multi stratified grouping random sampleing and the proportional sampling method was used.The tuberculosis cases were screened by sputum examination,X ray and PPD test.Results The prevalence rate of active,bacteriological positive and smear positive was 463.65/100?000,252.23/100?000 and 159.50/100?000 respectively.It declined 42.7%,23.3% and 33.8% on the baseline of 1990 respectively.The annual reduction rate was 5.4%,2.6% and 4.1% respectively.The mortality of tuberculosis and pulmonary tuberculosis was 38.10/100?000 and 34.64/100?000 respectively.It declined 33.3% and 37.5% on the baseline of 1990 respectively.The prevalence in south part of Xinjiang was higher than that of north part.The prevalence in rural area was higher than that of urban area.The prevalence in minority nationalities was higher than that of Han nationality.Conclusion The tuberculosis epidemiological situation was still serious,The efforts on tuberculosis control should be strengthened.The modern tuberculosis control strategy that focus on infectious cases should be implemented continuously.The minority nationalities and rural areas should be the priority area of tuberculosis,The case management should be strengthened at the same time that increasing case finding for ensuring higher cure rate.

Report on the fourth random survey for the epidemiology of TB in Liaoning province

Shang Yanping,Wang Li,Wang Cui,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  268-270. 

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Objective To evaluate the effect of the implementation of the provincial TB control program (1991—2000) and the World Bank Loaned TB control project (1992-2000) as well as to determine the epidemiology situation of TB in the province.Methods The multi stratified grouping random sampling method and the proportional sampling was used.Results The prevalence of active,smear positive,bacteriological positive pulmonary TB and the TB mortality were 130.8/100000,56.3/100 000, 66.3/ 100 000 and 2.9/100000 respectively.48.1% of the patients had received certain kind of health education about TB.The smear positive patients who had not received the supervised chemotherapy occupied 31.2%.Conclusions The prevalence rate of active pulmonary TB and the mortality declined significantly.The prevalence rate of smear positive and bacteriological positive pulmonary TB decreased,but it declined slowly.The health education about TB and the supervised chemotherapy on TB patients must be strengthened further.

Evaluation results on Sichuan provincial TB Control Programme

Cao Hui,Wu Janlin,Wang Zhaowei,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  271-274. 

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Objective To evalute the implementation situation of TB control programme and to identify the constraints and difficulties for providing the scientific evidences for policy makers.Methods To use the unified method and questionnaire in this evaluation and all the data was collected and input into computer.Results 77.2% of the governments have developed the TB control programme plans.Rates of TB control funds were 48.8%,38.3% and 51.0% in 2001,2002 and 2003 respectively.96.0% of the health administrative sectors have put TB control into the health agenda.47321 infections TB patients have been detected from January 2001 to June 2003.33.8% of case finding target of programme’s 5 year plan (2001-2005) has been reached.Conclusion It is urgent to strengthen the TB control.

The application of the photographic character of tree in bud at pulmonary tuberculosis

Lu Xiwei,Wang Yueming,Zhan Jie.

Chinese Journal of Antituberculosis. 2004, 26(5):  275-276. 

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Objective To analyze the photographic character of tree in bud at pulmonary tuberculosis.Methods To check 216 pulmonary tuberculosis patients with spiral CT and statistic the formation and location of tree in bud at various tuberculosis.Results The rates of tree in bud sign at smear positive and cavity pulmonary tuberculosis were 84.5% and 92.3% respectively.The rate in tuberculoma was 9.1%. The occurrence frequency of tree in bud in cavity pulmonary tuberculosis which located in down lobe was 87.5%.The occurrence rate of opposite lung was 60.3%.Conclusion Tree in bud sign is the character photographic of pulmonary tuberculosis which spread through airway.It shows different formation and distribution during different period of tuberculosis development.

Related factors and clinical characteristics of the MDR-PTB patients who received treatment before

Zhang Tingmei,Luo Kewen,Zhang Xiaojun,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  277-279. 

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Objective To determine the occurrence mechanism clinical characteristics multidrug resistant pulmonary tuberculosis (MDR PTB) who received treatment before.Methods The clinical data of 625 cases with MDR PTB received treatment before in Guiyang pulmonary Hospital from 1992 to 2002 was analyzed.Results 625 cases with MDR PTB received treatment before occupied 30.8% in patients of retreatment bacteriological positive PTB.Young and middle age females occupied majority.The Results of susceptibility test wereas follows:7 cases with drug resistance Results to H.R. (1.1%);125 cases with drug resistance Results to 3 drugs (20.0%);493 cases with drug resistance Results to H.R.S.E.(78.9%);the initinl drug resistance rate was 19.4% and acquired resistance result was 80.6%.There were more patients in rural and town than ones in the city and the cure rate of patients come from rural area was lower than that of patients from urban area.Conclusion The treatment to post MDR PTB is more difficult than to general MDR PTB.Besides economic cultural and regional diffence,medical factor is one of mainly reasons of occurrence rate increasing.The rate of primary resistance in the cases is higher than the rate of national average resistance.The difference in effective rate of treatment in different area is because of there is short of regular treatment manage by specialist.The better effect can be got by the private treatment especially unite the operation treatment.

The analysis of 24 cases suffer from pulmonary tuberculosis related AIDS

Lv Kangyan,Liang Shuxue.

Chinese Journal of Antituberculosis. 2004, 26(5):  280-282. 

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Objective To investigate the clinic feature and the treatment of pulmonary tuberculosis related AIDS.Methods To analyse the 24 cases of pulmonary tuberculosis related AIDS retrospetively.Results The incidence of AIDS with the complication of pulmonary tuberculosis raised from 0.05% in 1998 to 0.73% in 2002.The infection pathways were intravemous injection (77.1%) and sex transmitted (22.9%).Clinical manifestation:fever (91.7%),cough (91.7%),cough with sputum (79.2%),obviously emaciated (79.2%),enlargement of lymphnode (54.7%).The chest X ray indicated that pulmonary tuberculosis were mainly encroachment type (66.7%);50% of cases with the complication of hepatic virus;sputum bacteriological positive rate was 41.7%;Positive rate of PPD test was 16.7%.14 cases treated by anti tuberculosis (3HRZE/9HRE) were cured or completed the course of treatment.The side effects rate was 79.2%.Conclusion AIDS with the complication of pulmonary tuberculosis often with an urgent onset,severe symptoms,low positivie rate of PPD test.The side effects of the treatment of the drugs were too many.We should pay more attention to high risk people of pulmonary tuberculosis with the complication of AIDS in the high AIDS prevalence of area.

Analysis on the impact of tuberculosis to human life

Chen Zhihua,Wang Jun,Xu Jie.

Chinese Journal of Antituberculosis. 2004, 26(5):  283-286. 

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Objective To study the impact of tuberculosis to human life.Methods The data from the database of retrospective research on the reasons of habitants’ death was used and the abridged life table was applied for calculation life expectancy of pulmonary TB.The PYLL,PYLL rate and standardized PYLL rate were calculated range from 1 year to 70 years old.Results (1)The sex ratio of TB mortality rate is 2.43∶1 (male 0.17‰,female 0.07‰).And male mortality rate was more higher than that of female mortality.(2)The TB mortality rate in 70～74 years old classfication was the highest.And the peak of absolute death number was in 55～79 years old group.(3)Life expectancy of TB death causes elimination was 0.25 year (male 0.32,female 0.16).(4)Complete death causes PYLL is 1282858,TB PYLL was 1.14‰ (male 1.41‰,female 0.85‰).Conclusion The impact of tuberculosis to life expectancy and life lost was very small.Although it isn’t the main reason of “premature mortality” now.It is still one of the important disease of the important disease of harming human life.The efforts on tuberculosis control should be strengthened further.

Retrospective analysis on the characteristics of lingular segments and right middle lobe lesions under broncho-scopic and clinical aspects

Sun Li,Xia Jinghong,Mu Guangqin,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  287-290. 

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Objective To explore the characteristics of lesions in lingular bronchus and right middle lobe for providing diagnosis evidences.Methods Retrospective analysis on the clinical,radiological,and bronchoscopic characteristics of the 161 cases with lingular segments lesions and 507 cases with right middle lobe lesions from a total of 5?286 cases examined by fiberoptic bronchoscopy.Results The ratio of the incidence between right middle lobe and lingular segment lesions was 3.1∶1.Out of these cases lingular bronchus with lingular bronchus lesions,the number of lung carcinoma patient was the top one.The lump image with cancer symptom only constitutes 34.4% of all lung cancers.Abnormality in the bronchial wall and bronchial cavity found by the fiberoptic bronchoscopy commonly resulted by lung cancers.Pneumonia occured frequently at right middle lobe.Abnormality in its bronchial all was commonly resulted by pneumonia,and abnormorlity in its bronchial cavity was mostly observed in lung cancer by fiberoptic bronchoscopy.Conclusion The typical signs of lung cancer in lingular segments are undefined by the chest radiography and fiberoptic bronchoscopy.Fiberoptic bronchoscopy examination would play important role in early diagnosis and identification diagnosis for the lingular segments and middle lobe lesions.

The Clinical value of tubercle bacillus culture in lung tuberculoma

Wei Li,Zhu Changgeng,Wang Guobin,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  291-292. 

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Objective To determine the evidence of culture and sensitivity in lung tuberculoma for guiding clinical treatment of lung tuberculoma.Methods Tubercle bacillus culture and sensitivity test were applied in resecting lung tuberculoma.Results The sensitivity rates to Rifampicin,Pyrazinamide,Ethambutol and Streptomycin exceeded 81.4% except Isoniazid.And the sensitivity result was satisfaction to combination of anti tuberculotic.Conclusion It is no need to provide the treatment regimens which treating drug resistant TB and MDR TB for most of the lung tuberculoma patients.The therapeutic regiment with 2HRZS/4HRZ could be used and the outcome of treatment will be satisfaction after operation.

A case-control study on the socioeconomic status of pulmonary tuberculosis patients in Wuhan

Zhou Meilan,Xie Hong,Yao Hongyan,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  293-294. 

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Objective To study the socioeconomic factors related with pulmonary tuberculosis.Methods A case control study was designed and multivariable logistic regression model was applied.85 pulmonary tuberculosis cases were studied by 1∶1 match.Results The single factor conditional logistic regression analysis showed that the monthly average income per family,with job or not,various kinds of medical insurance and source of income were significant risk factors associated with pulmonary tuberculosis (OR=4.000,5.333,8.000,6.000;χ ²=7.200,8.895,5.440,4.880;P <0.05).Future multivariable logistic regression analysis turned out that monthly average income per family and with job or not were the independent risk factors of pulmonary tuberculosis.Conclusion Without job and the low level of family income were the risk factors of pulmonary tuberculosis in Wuhan City.

Study on the method of rapid fluorimetry for primitive identification of species of Mycobacterium

Shi Xudong,Liu Zhenghua,Wu Xiaoyan,et al.

Chinese Journal of Antituberculosis. 2004, 26(5):  295-297. 

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Objective To set up a method of Rapid Fluorimetry for identification of group of Mycobacterium by using the liquid culture medium.Methods Examined the drug susceptibility in vitro of 15 strains standard Mycobacterium and 78 strains Mycobacterium from clinical samples to P Nitro benzoic Acid (PNB) and 2 Thiophene carborylic acid hydrazide (TCH) by the examining tube of radioactive Free and rapid fluorimetry anddetermined the concentration of PNB and TCH in testing of identification of group of Mycobacterium.Results 100μg/ml of PNB can identify Mycobacterium tuberculosis complex and non tuberculosis mycobacterium (NTM),2.5μg/ml TCH can identify mycobacterium tuberculosis and Mycobacterium bovis .The test just took 7～10 days.Conclusion This method is economic,practical and the report time was shorten significantly for identification of group of mycobacterium.The report time of the method was 7～10 days.It was 18～21 days shorter than that of the method of L J (28 days).