Table of Content

10 March 2001, Volume 23 Issue 3

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The molecular epidemiology of Mycobacterium tuberculosis in Beijing

ZHANG Li-xing,DING Bei-chuan,TU De-hua,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  141-147. 

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Objective Typing of Mycobacterium tuberculosis strains and epidemiological studies in Beijing.Methods (1)To detect and analyze the restriction fragment length polymorphism (RFLP) of M.tuberculosis isolated from 128 new patients with pulmonary tuberculosis by using standardized method.(2)A sociodemographical and epidemiological questionnaire investigated all patients selected in this study.(3)The relationship of genotype of M.tuberculosis and their epidemiology were analyzed.Results (1)128 M.tuberculosis detected were belonged in 3 groups, according to their homology of IS6110 fingerprinting.The strains in A and B groups were called as “Beijing genotype strains” because these strains had high homology, and they had a high percentage (103/128,80.5%) in all strains detected.Strains in group C, called as “non-Beijing genotype strains”,had lower homology and only 19.5% in all strains detected.(2)The polymorphism of the strains isolated from the younger patients (<40) were different significantly compared with the strains isolated from those elder patients (>40).The selectivity predominance of “Beijing genotype” was not due to BCG vaccine widely.(3)The polymorphism of the strains detected were not correlated significantly to past TB contracted history of the patients investigated,living in urban or rural area of Beijing and the drug-resistance of the strains.Conclusion Fingerprinting analysis of M.tuberculosis can be a useful tool for the study of modern epidemiology of tuberculosis.

A cohort analysis of smear-positive pulmonary tuberculosis for 1736 cases of throughout

CHEN Zi-jin,GOU Yong,XIANG Jing,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  148-150. 

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Objective To evaluate new-registered smear-positive pulmonary tuberculosis cases with throughout.To analyse the effects of TB control.Methods 1736 cases of new-registered smear-positive were studied, with a cohort analysis.Results New-registered smear-positive pulmonary tuberculosis mostly occurrs in young and middle-age farmers living in the remote and high mountains.The discovery was delayed.The cure rate was increased every year.The uncured rate within past 5 years was decreased.Conclusion To strictly implement DOTS is the major measures for controlling the infectious source of pulmonary tuberculosis.

The trend of drug resistance for in-patient pulmonary tuberculosis

LI Shu-yuan,ZHAO Dong-mei,SUN Yu-li.

Chinese Journal of Antituberculosis. 2001, 23(3):  151-152. 

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Objective To analyse and evaluate the trend of antituberculosis drugs resistance for in-patient pulmonary tuberculosis for a better job of tuberculosis control.Methods To collect in-patient cases in different years, i.e.1980～1981,1990～1991,1997～1998.The trend of drug resistance was analysed.Results The prevalence of primary drug resistance was 24.6%,35.1% and 38.3% respectively in three periods.The prevalence of primary MDR-TB drug resistance was 3.5%,6.1% and 12.3% respectively.The prevalence of acquired drug resistance was 81.0%,65.8% and 74.4% respectively.The prevalence of acquired MDR-TB drug resistance was 11.5%,16.6% and 34.9% respectively.The perevalence of primary and acquired MDR-TB drug resistance was increasing but the prevalance of acquired drug resistance was almost steadily decreasing.Conclusion The key of controlling drug resistance is to implement NTP,to standardize chemotherapy regimens,to implement DOTS,and to improve the evaluation work of drug resistance.

The analysis of polluted bacteria in the sputum growing medium used for BACTEC which from 43 patients of pulmonary department

WANG Yi-wei.

Chinese Journal of Antituberculosis. 2001, 23(3):  153-154. 

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Objective To investigate the characteristics of the distribution of polluting bacteria in the sputum growing medium used for BACTEC which from pulmonary department patients,so we can do much better in controlling pollution and reduce the pollution ratio.Methods There were 650 sputum samples by means of BACTEC which were from pulmonary department patients between Oct.97 and Jan.99.To evaluate the polluted sputum samples in these 650 samples in normal way of bacterial culture and analyse the results.Results In the 650 samples,43 cases were polluted,total pullotion rate was 6.6%(43/650).To evaluate in normal way of bacterial culture,the 43 polluted samples and got 12 kinds of strain.There were 2～3 kinds of strain from every one of 4 samples.So 48 strain were got.Mainly of B.subticis and M.agilis.16(33.3%) and 9(18.8%) respectively.The other were 6(12.5%) strains of S.aureus;3(6.2%) strains of C.albicans and 14(29.2%) strains of gram-negative bacilli.The gram-negative bacilli can be divided into 7 kinds of bacterias.Conclusion (1)Laboratory pollution is the main pollution source.Non-bacteria operation must be strictly controlled.(2)The gram-negative bacilli,S.aureus and C.albicans were 47% (23/48).This may be related to the pulmonary infection and pathogenic bacteria in the mouth and pharynx [1].We suggest to increase the control of the pulmonary inflammation in clinic.

The clinical analysis of childhood tuberculous pleurisy (A report of 22 cases)

ZHANG Qing,XIAO He-ping.

Chinese Journal of Antituberculosis. 2001, 23(3):  155-157. 

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Objective To summarige the characteristics of tuberculous pleurisy in children induce for reducing misdiagnosis and evaluating the treatment methods.Methods 22 cases of tuberculous pleurisy in children from 1993 to 1999 were reviewed and analyzed.For comparison we chose 40 cases of tuberculous pleurisy in adults during the corresponding period.Results Anorexic,fever and cough were more than associated diseases;The incidence of medical hepatitis was low;PPD test and chest CT examination could assist in diagnosis.Conclusion A better Results of treatment can be achieved by mastering the characteristics of tuberculous pleurisy in children,comprehensive analysis,early diagnosis and regular therapy.

The detection of infection of human immunodeficiency virus in patients pulmonary tuberculosis

FENG Die-yi,CHEN Zhi-cheng,CHEN Xiao-bin,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  158-160. 

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Objective To study HIV infection and occurrence of AIDS in patients with tuberculosis by HIV detection.Methods Primary screening of HIV antibody assay was carried out in 2151 patients with pulmonary tuberculosis by ELISA.The positive cases were sent to the Center Laboratory of HIV in Guangdong epidemic-prevention station for verification.Results There were 7 positive cases of HIV with 5 males and 2 females in 2151 patients with pulmonary tuberculosis,with the positive rate 3.25‰.In the 7 positive cases of HIV,3 were infected by intravenous drug injection and 4 by heterosexual behavior.Conclusion Routine HIV antibody assay in patients with tuberculosis with high-risk behaviors and venereal diseases,especially in young and middle-age patients,was helpful for early diagnosis and treatment of AIDS and preventing the spread of the two diseases.

A case-control study for pulmonary tuberculosis in the servicemen of Jinan Command

LI Zi-jian, LIU Yuan-dong, JIN Xiao-hong, et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  161-163. 

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Objective To study the risk factors for pulmonary tuberculosis(PTB) in the servicemen of armed forces. Methods The study included 162 cases of PTB. Each case was pair matched with one control for sex, post and age. Data was analyzed with conditional logistic regression with SAS software. Odd Ratios(ORs) were calculated for the relevant factors. Results Single-varible analysis showed that labor intensity, body mass index(BMI), Bacillus Calmette Guerin(BCG) vaccination scar, housing, history of exposure to PTB, native place and charactor associated with the incidence of PTB, with ORs of 5.12, 0.37, 0.42, 0.51, 1.82 0.57 and 1.63 respectively(P<0.05). All of the factors except for charactor entered the final regression model. Conclusion It is suggested that we should perfect inoculation of BCG and take corresponding measures according to risk factors. So we can control the epidemic situation of PTB.

Implementation and research of bringing tuberculosis control into line with the Primary Health Care in Xinmi city

WANG Li,JIN Hong-jian,XIAO Yan, et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  164-165. 

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Objective Do feasibility study of bringing Tuberculosis Control into line with the Primary Health Care. Methods The indexes of ‘Primary Health Care’ were increased from 13 items to 14 items, 10 points increased, and to guantify the Tuberculosis Control indexes for convenient operation. Results (1)The new-smear registered rate increased 57.4% compared to the previous period; (2)The transferred case were 59% of the new-smear registered ones; (3)The rate of new-smear cases cured was increased 15.6% compared to the prior; (4)The rate of losing was reduced 65%; (5)The annual mortality reduction rate was 13.9%, it is low level in the country. Conclusion Tuberculosis Control into line with Primary Health Care is the effective way of promoting Tuberculosis control and reducing the epidemic situation.

The influence of the pulmonary tuberculosis on the grade-uplifting rate and mortality of silicosis in Yibin

ZHENG Ming-de.

Chinese Journal of Antituberculosis. 2001, 23(3):  166-167. 

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Objective To evaluate the influence of pulmonary tuberculosis on the grade-uplifting rate, average uplifting time and the death rate of silicosis complicated with pulmonary tuberculosis. Methods Data of 315 cases of silicosis diagnosed by the Yibin Occapational Disease Department from 1973～1998 were studied、 analyzed and summed up. Results The grade-uplifting rate of Ⅰ is 32.1%, while that of Ⅰ+T is 56.3%(P<0.01); the average grade-uplifting time of Ⅰ is 5.8Y, while that of Ⅰ+T is 4.3Y (P<0.05); the death rate of Ⅰ is 27.5%, While that of Ⅰ+T is 66.7%(P<0.01); the grade-uplifting rate of Ⅱ is 19.6%, while that of Ⅱ+T is 41.2%(P<0.01); the average grade-uplifting time of Ⅱ is 4.9Y,while that of Ⅱ+T is 3.4Y( P<0.05);the death rate of Ⅱ is 51.1%, while that of Ⅱ+T is 54.6%(P>0.05). Conclusion All this shows that silicosis complicated with pulmonary tuberculosis increases the grade-uplifting rate, shortens the averge grade-uplifting time and increases the death rate.

Study on immunochromatographic test for detection of tuberculous pleurisy

LE Jun,LIANG Li,HE Guo-jun.

Chinese Journal of Antituberculosis. 2001, 23(3):  168-169. 

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Objective To assess the clinical value of a rapid immunochromatographic test (ICT) for the diagnosis of tuberculous pleurisy. Methods Mycobacterium tuberculosis antibody in the pleural effusions was determined by a rapid immunochromatographic test (ICT), including 42 cases of tuberculous pleurisy and 29 cases of maligant pleural effusions. Results The overall sensitivity and specificity were 61.9%,96.3% respectively. Conclusion ICT is a valuable aid in clinical diagnosis for tuberculous pleurisy.

The analysis of tuberculosis control project in Zhejiang

SUN Song-wen, LI Qun, HE Tie-niu, et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  170-173. 

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Objective To analyse the implementing effects of tuberculosis control project in the past 6 years. Methods According to the program rules, the accurate information was from the normal report system which had been built cooperating with the site supervision. Results In the past 6 years, the program was carried out in 48.3% counties of Zhejiang Province, with a population of 51.5%. 15263 infectious patients were diagnosed, 91.9% of smear-positive patients were cured in the cohout analysis(94.1% was cured from initially treatment and 80.4% was cured from retreatment). Conclusion Remarkable Results have been achieved after 6 years’ practice of the program of Ministry of Health. The target of high discovery and curing rate has been realiged,which will further promote the tuberculosis control work in Zhejiang.

Value of three kinds of tuberculosis antibodies in diagnosis of three common tuberculous diseases

YAN Shi-ming,YANG Jia-dao,YU Guan-cheng,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  174-177. 

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Objective To study the value of three kinds of tuberculous antibodies in diagnosis of pulmonary tuberculosis,tuberculous meningitis and tuberculous pleurisy. Methods Select ICT-TB card,TB-DOT produced by Austrilia and homemade ELISA to detect tuberculous antibodies of 220 patients with pulmlonary tuberculosis,56 tuberculous miningitis,36 tuberculous pleurisy had been observed comparatively with 48 cases of non-tuberculosis lung diesase(serum),17 cases of non-tuberculosis meningitis brain disease(CSF),18 patients with pleurisy except tuberculosis(pleurorrhea),30 healthy individuals(serum). Results The sensitivity was 50.7%,52.7%,58.7%,there was no significant difference (P>0.05) in Results detected by three kinds. The specificity was 97.3%,93.2%,79.7%,there was no singnificant difference (P>0.05). The sensitivity of ICT-TB card in serum of pulmonary tuberculosis,tuberculous meningitis and tuberculous pleurisy was 57.2%, 46.4%,30.6%,TB-DOT was 60.0%,44.6%,33.3%,ELISA was 68.2%,42.9%,38.9%. There was significant difference (P<0.005,P<0.05). To compare the sensitivity of three kinds to detect three kinds of body fluid with each other,the serum was highest (57.2%～68.2%), CSF was second(51.8%～55.4%),the pleurorrhea was third (31.6%～50.0%). Conclusion The specificity of ICT-TB card and TB-DOT is higher but the sensitivity is lower. On the contrary,the sensitivity of ELISA is higher and the specificity is lower. But in fact,the value in clinical is similar. To detect tuberculous antibodies in diagnosis of pulmonary tuberculosis is more valuable than in tuberculous meningitis and tuberculous pleurisy.

An analysis on the therapeutic effect of 3SHRZ/3HRZE/12HRE and 3SHRZ/9HRE on coal worker’s pneumoconiosis-tuberculosis

CHEN An-qi,CHENG Zhen,HAN Su-min.

Chinese Journal of Antituberculosis. 2001, 23(3):  178-180. 

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Objective To probe into the better retreatment scheme for the coal worker’s pneumoconiosis-tuberculosis treatment. Methods Analyse the therapeutic effect and the anti-tuberculosis treatment in the case in which 194 3SHRZ/3HRZE/12HRE and 73 3SHRZ/9HRE were applied on these patients who had been discharged from hospital. Results After 6 months treatment,both of these 2 treatment schemes were obviously different in the sputum tubercle bacillus negative convertion-rate on all kinds of the coal worker’s pneumoconisis-tuberculosis(P<0.05); and so were they on the redution-rate of chest X-ray after the course of treatment (P<0.05). Conclusion The 6-month strengthened period-the scheme of the 3SHRZ/3HRZE/12HRE applied on the reteatment of the coal worker’s pneumoconiosis-tuberculosis case,and the course of treatment was as long as 18 months. The therapeutic effect was quite satisfactory,so it is not appropriate to apply the 12-month scheme.

Primary drug resistance of Mycobacterium tuberculosis in Zhengzhou(1992～1996)

CHEN Yu,LIU Li,WU Hong-jun,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  181-183. 

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Objective To illustrate the primary drug resistance of M.tuberculosis in ZhengZhou,during 1992～1996. Methods Absolute concentration method was used for the detection of drug sensitivity of 6 antituberculosis agents. Results The rate of total primary drug resistance and resistance to rifampin decreased from 41.5%,19.5% in 1992 to 29.6%,11.1% in 1996,respectively. Conclusion The primary drug resistance of M.tuberculosis and to rifampin decreased in Zhengzhou,1992～1996.

Clinical observation of intrapleural injection of Mycobacterium vaccae vaccine for patients with malignant pleural effusion

LU Shui-hua,WANG Zi-ran,WANG Han-xiang,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  184-186. 

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Objective To determine the effects of intrapleural injection of Mycobacterium vaccae vaccine for patients with lung cancer and pleural effusion. Methods 40 patients with lung cancer and malignant pleural effusion were divided into study group and control group at random pair.Mycobacterium vaccae vaccine 1000μg were injected into the pleural cavity once weekly for 2～3 weeks for the control group. Results 90%(18/20) of the study group achieved partial relief and 60%(12/20) had complete relief. Both of which were significant higher than those of the control group(P<0.05),while 55%(11/20) of the control group achieved partial relief and 20%(4/20) had complete relief,after 1yr follow-up,the relapse rat of pleural effusion of the study group was 5%(1/18),and the control group was 46%(5/11),P<0.05. Conclusion As adjunct to chemotherapy,Mycobacterium vaccae vaccine is helpful for patients with lung cancer and malignant pleural effusion.

Analysis of prevalence on the elderly pulmonary tuberculosis in Zhongshan

CUI Lan-ying,CHEN Yu-hua,TANG Tian-lan.

Chinese Journal of Antituberculosis. 2001, 23(3):  187-188. 

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Objective To explore prevalence of the elderly pulmonary tuberculosis in Zhongshan. Methods Analysis on the sputum smears and chest X-ray films. Results The prevalence of elderly pulmonary TB in Zhongshan is 24.2%,the smear-positive rate is 79.5%. Conclusion Must pay attention to the controls over the elderly pulmonary TB.

The analysis of the origin of the tubercular patients in the program of tuberculosis control in Longyan city of Fujian

HU Zhi-quan,YUAN Hong-bin,RAO Pei-lin,et al.

Chinese Journal of Antituberculosis. 2001, 23(3):  189-190. 

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Objective The essay analyses the conditions of the program of tuberculosis control and the origin of the tubercular patients in 1999 in Longyan of Fujian province.Methods According to the origin of the tubercular patients in the program of tuberculosis control in 1999,we angalysed the case-finding work of tuberculosis.Results 573 smear-positive patients are under the program of our management,71.4 percent of which have previously been examined in general hospitals.Also,It’s found that the rate of the Initial cases were higher than that of the patient voluntarily to be examined in the Antituberculosis institute (P<0.01).Conclusion This fact illustrates that the tuberculosis patients are majorly detected in the general hospitals and it is a necessary and long-term work to set up the clinics for the tuberculosis in antituberculosis institute.