Table of Content

10 February 2000, Volume 22 Issue 2

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Cost-effectiveness of DOTS and non-DOTS strategy for smear-positive pulmonary tuberculosis

XU Qun,JIN Shuigao,ZHANG Lixing.

Chinese Journal of Antituberculosis. 2000, 22(2):  60-62. 

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Objective The study is to evaluate cost effetiveness of DOTS and non-DOTS strategy for smear-positive pulmonary tuberculosis.Methods Cost accouting based on the expenses for drugs,chest X-ray films,sputum smears and cultures for the patients.Effectiveness of intervention was composed of two aspects:direct benefits to the patient treated,and indirect benefits to others though reduced transmission of tuberculosis,and DALY is the index.Results One DALY could be saved with 45.7 yuan by DOTS and 471.4 yuan by non-DOTS.Conclusion DOTS is a good cost-effectiveness stratcgy for TB control.

Controlled clinical study on efficacy of Levofloxacin in treating pulmonary tuberculosis

MA Liping,WANG Qingfeng,Wu Xiaoguang.

Chinese Journal of Antituberculosis. 2000, 22(2):  63-65. 

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Objective To assess antituberculosis efficacy,suitable dose and application perspective of levofloxacin in China.Methods 97 new smear positive pulmonary tuberculosis patients were randomly allocated into treatment group(50 cases,receiving 2HL 2V/4HL 2 regimen)and controls(47 cases,2HL 2Z/4HL 2)for observation.Results The sputum negative conversion rates at the 2nd month in treatment group and the controls were 94.0% and 83.0% respectively,and at the end of chemotheraphy 98.0% and 97.7% Chest radiography showed remarkable improvement.The resolution of pulmonany lesions in the treatment group and the controls accounted for 98.0% and 95.7% respectively,with cavity closure rates of 73.1% in the treatment group and 50.0% in the controls.The drug adverse reaction rates were 13.2% in the treatment group and 7.8% in the controls.Conclusion Levofloxacin is a new effeitive and safety antituberculosis drug.

A study on fully supervised chemotherapy implemented in Tongzhou district,Beijing

ZHOU Changshan,

Chinese Journal of Antituberculosis. 2000, 22(2):  66-68. 

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Objective To study the acceptability of fully supervised chemotherapy for smear-positive pulmonary tuberculosis in Tongzhou district,Beijing.Methods Domiciliary treatment for smear-positive pulmonary tuberculosis was implemented under fully supervised chemotherapy.Net work of health services has been organized at district,community and village three levels and supervised by Tongzhou District Bureau of Health.Results There were 1.648 case of smear-positive pulmonary tuberculosis registered during 1979～1997.The average coverage of DOTS for smear-positive cases was 86.2%,sputum conversion rate after complete the treatment was 95.3% and relapse rate during the 2 years was 3.2%.The prevalence of smear-positive cases decreased from 81/100.000 in 1980 to 2.3/100.000 in 1997 with 97.2% reduction rate.About 130 thousand population prevented from infection of tubercle bacilli.The value of output was created with RMB 6.590 thousand Yuan by protection of labors.Conclusion DOTS for smear-positive cases can be continuously and successfully implemented by network of three-level health service and supervision under administrative sectors.

Diagnosis and treatment of tuberculoma of pleura

DENG Lihong,TIAN Xizhong,ZHANG Haiqing,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  69-71. 

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Objective To study the clinic and X-ray characteristics of tuberculoma of pleura.Methods Analyzed retospectively 31 cases of pleura tuberculoma treated during 1970～1998.Results 1.61.3% of the patients had an explictly exudative pleural effusion history,after treatment effusion absorption and months or years later,a spherical shadow appeared. 2.77.4% chest X-ray had a pleural thichening,cacification and costophrenic angle change.3.45.2% misgnosed as lung cancer,mesothelioma and hamartoma.Conclusion Dignosis of pleural tuberculoma need an integrated history,tangential position X-ray film?CT and fuoroscopy of chest and sufficient antituberculous treatment may avoid operation.

Analysis of 58 cases with community-acquired rapidly growing nontuberculous mycobacteria(RNTM) pulmonary disease

CHU Haiging,LI Huiping,HE Guojun.

Chinese Journal of Antituberculosis. 2000, 22(2):  72-73. 

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Objective To study the clinical characterisitcs of community-acquired rapidly growing nontuberculous mycobacterium(RNTM)pulmonary disease.Methods 58 cases with RNTM pulmonary disease,diagnosed through identification of mycobacterium strains and isolated from 3.901 sputum culture positive cases,were retrospectived from Jan.1986 to Dec.1997.Results According to Runyon classification,there were 38 cases with M.Fortuitumin and 20 cases with M.Chelonae in type Ⅳ,39 cases in male and 17 in female.The main clinical symptoms included cough,expectoration with white mucous sputum,haemoptysis and fever,60.3% cases in X-ray chest film were seen lesions bilaterally,24.1% in left side and 15.5% in the right.The resistant rates were high to isoniazid,streptomycin,ethambutol,sodium paraaminosalicylate and prothionamide,while lower to kanamycin and comparatively.The sputum negative conversion was 31%.Conclusion The RNTM pulmonary disease was characterized by long course,nonspecific symptoms,high resistant rate and unsatisfactory therapeutic efficacy.

Protective effect of captopril on kidney of diabetic patients with pulmonary tuberculosis by aminoglycoside

WANG Ziling,CHAI Manchao,LIU Xin,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  74-75. 

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Objective To investigate the mechanism of captopril's protecting the kidney of diabetic patients with pulm.Tuberculosis(PTB)by aminoglycoside(AG).Methods 85 diabetic cases with PTB were divided into treating group(44 cases,group A) and control group(41 cases,group B),AG were used in both A and B group,Patients in group A took captopril during treatment.Urinary micro-albumin,β 2-m,serum creatinine and creatinine clearance were measured before and after treatment.Results Urinary β 2-m in group A decreased significantly after tretment than that before treatment(P<0.05),the others had no significant change.But urinary microalbumin and β 2-m in Group B increased significantly(P<0.01 and P<0.05),Conclusion Captopril can reduce the amount of urinary albumin and protect the kidney function on cases of diabetics with PTB.

Clinical analysis and investigation of lower respiratory tract infection on in-patients with pulmonary tuberculosis

FENG Li,TIAN Rong,ZHAO Yuping,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  76-78. 

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Objective To find out the clinical occurrence and related risk factor inpatients of tuberculosis with lower respiratory tract infection.Methods Conducting retrospective analysis of pulmonary tuberculosis patients who were discharged from January 1998 to December 1999.Special record forms were filled for every pulmonary TB patients with lower respiratory tract infection.Results The occurrence rate of lower respiratory tract infection in patients of pulmonary tuberculosis was 4.9%.TB patients who were aged,with fibratic cavity,bronchiectasis or atelectasis were more likely to get lower respiratory tract infection.The high risk factors were long hospitalization duration,frequent hospitalization,malnutrition due to serious TB and long term administration of broad spectrum antibiotics.Pseudomonas aeruginosa and Klebsielia pneumoniae were the main pathogenic bacteria for infection and 48.2% of the cases were combined with fungus infection.Conclusion Clinical concern shoud be put to inpatients with pulmonary TB with lower respiratory tract infection.

Survey of infection rate of nontuberculous mycobacteria among adolescent in Henan province(1995-1997)

YAO Yuxia,PENG Yili,MA Liping,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  79-80. 

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Objective To investigate the NTB infection rate among adolescent and its changing tendency in Henan.Methods PPD skin test approved by WHO and commonly used judge standard were applied in this surrey.Results NTB infection rate among adolescont during the three years were 8.1%,5.9% and 3.5% respectively.There are no significant differences in sex and age,the difference was significant among areas.Conclusion NTB infection rate among adolescent in Henan presented decreasing gradually,and lower than the average level of country.

Assessment on management of pulmonary tuberculosis cases in temporary residence population on effect of chemotherapy

CAO Dawei,SU Miya,YANG Yingzhou.

Chinese Journal of Antituberculosis. 2000, 22(2):  81-82. 

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Objective To analyze the influence of strengthening the management of sputum positive TB patients in transient population on chemotherapy effects.Methods To compare the management rate,treatment rate and negative conversion rate of new sputum positive TB patients in transient population in 1997 and 1998 when management measures were improved.Results The management rate in 1998 was increased by 7.3% compared with 1997,treatment rate was increased by 4.4%,sputum negative conversion rate were increased by 17.7% and 5.5% respectively.Conclusion Strengthening the management of pulmonary TB patients in transient population is an effective and practical measure to tuberculosis control.

Clinical observation of intrapleural injection of urokinase for patients with encapsulated tuberculous pleural effusion

HAO Jinzhu,QU Haiyan,ZHANG Chunsheng,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  83-85. 

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Objective To determine the effects of intrapleural injection of urokinase for patients with encapsulated tuberculous pleural effusion.Methods Regular antituberculosis treatment was given to all patients observed.Urokinase and INH were injected 50.000U/day and 300mg/day respectively into the pleural cavity of 21 patients with encapsulated tuberculous pleural effusion for 5 days.While prednisolone of 125mg/day plus INH of 300mg/day were injected into the pleural cavity of 14 patients of the control group.Results 94.3%(19/21)of the 21 cases of the study group achieved complete improvement and another 5.7%(2/21)of the studied cases achieved partial improvement.While in control group,complete improvement occurred only in 35.7%(5/14),partial improvement was seen in 42.9%(6/14) and inefficacy remaind among the other 13.4%(3/14)of the patients.Conclusion For patients with encapsulated tuberculous pleural effusion,regular antituberculosis treatemnt plus urokinase injection into the pleural cavity can increase the drainage,decrease pleural thichening and improve pulmonary function of the patients.

Curative effect of bipheny dicarboxylate and glucurolactone on medicamentous liver lesion

QU Yanwen,YU Shuli.

Chinese Journal of Antituberculosis. 2000, 22(2):  86-87. 

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Objective To evaluate the efficacy of bipheny dicarboxylate and glucurolactone on prevention and treatment of antituberculous drug hepatoxicity.Methods 124 hospitalized HBsAg positive patients with pulmonary tuberculosis were randomized to bipheny dicarboxylate and glucurolactone of control group in addition to 2HRZE/4HR therapy.Results Middle level reversible serum aspartate transaminase elevation (17.0% vs 35.2% P<0.05) occurred more commonly in the 71 patients randomized to the control group. There exists statistically significant difference between the two groups.Meanwhile 116 HBsAg negative patients with pulmonary tuberculosis were observed and only 8.6% of them occurred middle level reversible serum aspartate transaminase elevation during antituberculous therapy.Conclusion Medicamentous liver lesion may occurred more commonly in HBsAg positive patients after antituberculous therapy.bipheny dicarboxylate and glucurolactone can only prevent and cure part of them.Drug anaphylactic reaction may play a role in medicamentous liver lesion.

Anti-tuberculosis antibody test and result analysis

ZHAO Yurong,ZHANG Peiyuan,LI Jinhong.

Chinese Journal of Antituberculosis. 2000, 22(2):  88-90. 

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Objective Discuss the diagnostic value for tuberculosis with combination of three antibody test methods of LAM-IgG,TB-Dot,ICT.Methods Withdraw serum(pleural fluid,ascites,BALF,cerebrospinal fluid),and test TB antibodies simultaneously using LAM-IgG?TB-Dot?ICT methods.Results Bacillus positive pulmonary tuberculosis for the three methods was 45.3%?63.5% and 69.1% positive respectively,with 3 methods all positive 33.1% and any two of the three positive 23.7%,adding up to 56.8%.Bacillus negative pulmonary tuberculosis for the three methods was 24.6%?39.3% and 39.5% positive respectively,with all three positive 15.4% and any two of them positive 18.4%,adding up to 33.8%,significantly different compared with nontuberculosis group.For bacillus positive and negative pulmonary tuberculosis the three methods all failed to produce in 25.3% and 37.0% of both respectively.Conclusion Antituberculosis antibody test especially using 3 methods simutaneouely is one of the major basis for the tuberculosis diagnosis and differential diagnosis.But in some serious pulmonary tuberculosis patients,patients with complications such as diabetes mellitus and old pulmonary tuberculosis patiente the positive rate is low.In addition,the antibody level in tuberculosis serositis is significantly lower than in pulmonary tuberculosis.

Analysis on curative effect of 1500 retreated smear-positive pulmonary tuberculosis cases

FU Caiyun,FU Zhishun.

Chinese Journal of Antituberculosis. 2000, 22(2):  91-92. 

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Objective To analysis the curative factor of retreated smear-positive cases;To explore the effect of retreated chemotherapy regimen with DOTS.Methods To collect medical record of 1.500 cases retreated smear-positive pulmonary tuberculosis during the period 1992～1998 in Hainan province.Results 81.3% chemotherapy regimen is not reasonable.82.0% is not regular treatment or not completed the full course of chemotherapy.By retreated smear-positive regimen,at the end of 2nd and 3rd months sputum smear-negative conversion rate is 91.9% and 95.4%,cure rate is 81.5%.Conclusion Retreated smear-positive is result of the new smear-positive cases with not reasonable treatment.Adopt WHO short coursechemotherapy regimen with DOTS implementation is satisfactory and carry out to use.

Analysis on therapeutic result on 98 cases with tuberculosis of cervical lymph modes and evaluate the treatment model

HUANG Hanping,ZHANG Li,WU Hongbing,et al.

Chinese Journal of Antituberculosis. 2000, 22(2):  93-94. 

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Objective To study the treatment model of tuberculosis of cervical lymph nodes.Methods Analyse the treatment outcome of 98 cases of cervical tuberculous lymphadenopathy and compared between the experimental group and control group.Results The curative rate of experimental group is 95.4% and the control group is 64.5%,the excellent curative effect was obtained in the experimental group.Conclusion The treatment outcome as presented in this article is very good and the treatment model is valuable for clinical practice.