Table of Content

10 February 1999, Volume 21 Issue 2

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Analysis on the rechecking of previous treatment history(PTH) of tuberculosis drug resistnce surveillance(DRS)in Henan

Peng Yili,Wang Guobin,Xing Jin,et al.

Chinese Journal of Antituberculosis. 1999, 21(2):  64-66. 

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Objective To recheck the accuracy of PT H of cases enrolled in WHO DRS in Henan and to evaluate the role of PTH rechecki ng and its influent factors.Method Doctors from 30 DRS counties were trained and 1?080 cas es without PTH in the first inquiry were rechecked.Survey was conducted by arous ing and recalling of PTH,and unified forms were filled.Cases rechecked by provin cial level randomly.Results The rechecking agreement rate is 95.7% between the prov incial and county level.Out of which,cases with and without PTH is 84.4% and 100 % respectively,42.7% cases without PTH in the first inquiry recalled their PTH.T he rate with PTH of drug resistant cases is 62.0%,and it is 31.7% for drug sensi tive cases.Cases with PTH because of non_tuberculosis infectious diseases were more than those because of tuberculosis(1.17∶1).Out of cases with PTH more than one month,drug resistant group is more than drug sensitive group(37.2% and 16.8 %,respectively)and TB group is more than non_TB infectious disease group(82.0% a nd 35.9% respectively).In TB group,INH and RFP were mainly used,and in non_TB gr oup,SM and RFP were mainly used.Conclusion PTH rechecking is an effective quality control meth od for DRS.It will make DRS results more accurate.During PTH inquiring,guideline ,content,method should be unified,technicians should be trained.This work can be done accompanied with regular supervision.Results which got by trained doctors, are reliable.TB drugs were used for non_TB infection should not be ignored.PTH<1 month will be classified as new case in WHO DRS guideline.This criterion is not scientific.It will affect accuracy of initial drug resistance rate.

Analysis on the implementing effects of tuberculosis control strategies in Zhejiang province

Li Qun,Sun Songwen,Yao Qiang.

Chinese Journal of Antituberculosis. 1999, 21(2):  67-68. 

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Objective To analyse on the implementing effects of TB control strategies in Zhejiang province. Method According to the annual report,to analyse the register rate and therapeutic effect of patients with tuberculosis. Result The register rate and cure rate have been improved year by year.The newly registered rate of smear positive cases in 1997 is 2.3 times than that in 1994.The cure rate among new smear positive cases was about 89.1% in 1997. Conclusion The tuberculosis control policies is satisfactory in controling the infectious sources.

Analysis on therapeutic result of pulmonary tuberculosis cases in the anti tuberculosis and non tuberculosis organs

Rao Zhengyuan,Cao Hui.

Chinese Journal of Antituberculosis. 1999, 21(2):  69-71. 

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Objective Analysis the treated effect and expense of pulmonary tuberculosis between Anti tuberculosis and Non tuberculosis organs.Method Random sampling survey 268 cases in six counties.To analyse their treatment and expense situation in diffrent organs.Result The patient cure rate in the Anti tuberculosis organs is higher than Non tuberculosis organs,and the treated expense in the Anti Tuberculosis organs is less than in the Non tuberculosis organs.Conclusion Strength the tuberculosis united management,patient must be treated in the Anti tuberculosis organs.

Effect evaluation of new smear positive patients with pulmonary tuberculosis that received short course chemotherarapy in general hospitals

Jiang Changsan,Shi Qiwen.

Chinese Journal of Antituberculosis. 1999, 21(2):  72-74. 

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Objective To evaluate the effects of short course chemotherapy implemented by general hospitals on new smear positive patients with pulmonary tuberculosis.Method Investigations were carried out in 6 general hospitals and results were compared with those of the World Bank Loaned Tuberculosis Control Project.Result It showed that,in general hospitals,only 63 8%(136/213) of the new smear positive patients with pulmonary tuberculosis completed the full curse of chemotherapy with a total cure rate of 54 0%,and only 115 out of the 136 patients were cured with a cure rate of 84 6%,which was significantly lower( P <0 01)than that (98 8%) achieved by the World Bank Loaned Tuberculosis Control Project in the same period in the district.Conclusion General hospitals are not suited for DOTS implementation,and on the other hand,tuberculos is control institutions should spare no efforts in TB patients finding in order to strengthen the management and supervision.

Retreated smear positive pulmonary tuberculosis during the period 1993 1997:Analysis of 270 cases

Yan Shujun,

Chinese Journal of Antituberculosis. 1999, 21(2):  75-77. 

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Objective To analyse the 270 cases of retreated smear positive pulmonary tuberculosis during the period 1993 1997 in order to provide references basis for tuberculosis control.Method To collect all registered new and retreated smear positive pulmonary tuberculosis cases since the World Bank Tuberculosis Control Project had been carried out in Shunde city of Guangdong province.We analysed the items of case finding,the ratio of initially treated and retreated smear positive patients and others. Result All the registered cases were detected by clinical consultation of symptom.The general hospital were the main mode of detection(63.7%).The trend of ratio of initially treated and retreated smear positive patients was decreased year by year (1∶1.6 in 1993 and 1∶0.3 in 1997).The most of retreated cases were related to them who had been treated in general hospital.Conclusion It is an effective way to manage TB patients under TB Control Center for reducing the retreated smear positive pulmonary tuberculosis.

Investigation for the recognition of the knowledge of the tuberculosis control in the members of the county clinics

Li Shouxuan.

Chinese Journal of Antituberculosis. 1999, 21(2):  78-80. 

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Objective To investigate the condition about the mordern knowledge about the tuberculosis control and the effect of the education of tuberculosis.Method We tested the members of the county clinics before and after the course of education.These include TB case finding,diagnosis and chemotherapy.Results The results shown the correction rate of answer was 75 2% and 71 7% about new case report and migration for diagnosis respectively before education.The correction rate about clinical manifestation,sputum examine and diagnosis criteria was 83 5%,42 5% and 40 8% respectively before education.The correction rate of answer about anti tuberculosis drugs,therapy,chemotherapy principle,short chemotherapy regimens,treatment duration,cure criteria was 58%,14 4%,20 8%,9 2%,17% and 24 3% respectively before education.The investigation after education found the 90% medical members of the county clinics had been driven the mordern knowledge of the tuberculosis control.Conclusion This result suggested the mordern knowledge about tuberculosis control in members of county clinics was so poor.Therefore it is necessary to systemic educate the medical members of the county clinics.The spending of the education is small but the effect is excellent.

Analysis of correspondence rate between pathological and clinical diagnosis of 542 tuberculous cases

Yang Hongjun,Ding Yanqing.

Chinese Journal of Antituberculosis. 1999, 21(2):  81-83. 

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Objective To explore correspondence rate between pathological and clinical diagnosis of tuberculosis.Methods The pathological biopsy samples with tuberculosis in period 1986 to 1996 were reviewed.Results The correspondence rate of span 1991～1996 was not significant as compared with that of span 1986～1990.The correspondence rate of tuberculosis of bone and joint was the highest with the lowest correspondence rate of pharyngolaryngeal tuberculosis( P <0 01).With age growing,the correspondence rate decreased accordingly.Conclusion Enough attention should be paid to the clinical diagnosis of tuberculosis.

The changing tendency of blood gas of patients with tuberculous hydrothorax before and after thoracentesis

Li Xiangrong,Xi Jianing,Wu Xiulan,et al.

Chinese Journal of Antituberculosis. 1999, 21(2):  84-86. 

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Objective To evaluate the changing tendency of patients with tuberculous hydrothorax before and after thoracentesis.Method Testing the blood gas and P(A-a)O₂ from 40 patients with tuberculous hydrothorax before and after thoracentesis.Result PaO₂ and PaCO₂ decreased,P(A a)O₂ increased before thoracentesis.PaO₂ increased,P(A-a)O₂ reduced,PaCO₂ unsignificantly changed after thoracentesis.Conclusion Tuberculous hydrothorax could cause hypoxemia and chronic respiratory alkalosis.Thoracentesis could improve the hypoxemia.

Observation of therapeutic effects of ciprofloxacin on multidrug resistant pulmonary tuberculosis patients

Tang Shenjie,Pan Jinfeng,Huang Cailiu, et al.

Chinese Journal of Antituberculosis. 1999, 21(2):  87-88. 

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Objective To evaluate the effect of chemotherapy with ciprofloxacin on multidrug resistant pulmonary tuberculosis(MDR PTB).Method 51 cases with MDR PTB were allocated at random to two groups.26 cases were treated with the regimen of 6 CHETHT/6CHETHT.25 cases were treated with the regimen of 6HETHT/6HTHT.Result At the end of treatment,the rates of sputum negative conversion in the treatment group(76.9%) were higher than that in the control group(28.0%)( P<0.01).During three year follow up,the bacteriological relapase rates were found to be 10.0% in treatment group and 57.1% in control group.Comparing the two groups,there was an obvious difference( P<0 05).Conclusion CPFX was an effective drugs in treating patients with MDR PTB.

Dianostic value of fiberoptic bronchoscopy for the lower lung field tuberculosis with sputum smear negative

Xia Dong,Xu yuhua,Chen Xuelin,

Chinese Journal of Antituberculosis. 1999, 21(2):  89-90. 

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Object To evaluate the value of fiberoptic bronchoscopy to the lower lung field tuberculosis with sputum smear negative.Method 26 cases with lower lung field shadow and sputum smear negative were chosen for bronchoscopy.Results Major finding detected by fiberoptic bronchoscopy were:tuberculous granuloma;mucosae congestion and edema;bronchiole stomatal stenosis.TBLB was performed in 12 cases.Tuberculous granuloma was found in 8 cases with the positive rate of 66 7%.M.tuberculosis bacterium was found in 5 cases(19.2%,5/26)by brush smear or BALF.The general positive diagnosis rate was 84.6%.Conclusion Fiberoptic bronchoscopy plays an important role in the diagnosis of lower lung field tuberculosis.

Significance of detecting interferon (IFN) gamma and tumour necross factor(TNF) alpha concentrations in pleural effusion in the diagnosis of tuberculous pleurisy

Wang Jingping,Liu Dongyang,Gu Shuxiang,et al.

Chinese Journal of Antituberculosis. 1999, 21(2):  91-93. 

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Objective To eveluate the concentration of inferon(IFN) gamma and tumour necrosis factor(TNF) alpha in pleural effision in the diagnosis of tuberculous pleurisy.Method IFN γ and TNF α of serum and pleural effusion in 41 patients with tuberculous pleurisy,40 patients with malignant pleurisy and 41 healthy individuals serum were detected by ELISA method.Result The concentration of IFN γ and TNF α were much higher in tuberculous pleurisy(427.3±56.8?184.7±64.7),than malignant pleurisy(45.6±20.3,50.5±18.7) P<0.01.The serum concertration of them were low in two groups( P >0.05).The sensitivity,specificity,accuracy of IFN γ in the diagnosis of tuberculosis pleurisy were 100.0%,97.5%,98.8%,respectively.Similarly,those of TNF α for the diagnosis were 87.8%,90.0%,88.9%,respectively.Conclusion Our results indicate that simultaneous measurement of IFN γ and TNF α in pleural effusion might be helpful for the diagnosis of tuberculous pleurisy.

The necessity of optimized one tube nested PCR in clinical samples of the patients with tuberculosis

Xing Qing,Ding Beichuan.

Chinese Journal of Antituberculosis. 1999, 21(2):  94-96. 

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Objective In order to have a better understanding of the effects of reacted conditions to PCR results.Method By adjusted the quantities of templates,concentrations of outer primers and outer cycles in one tube nested PCR.We randomly selected the positive and negative samples confirmed by clinical bacteriology and detected samples by PCR.Result (1)It is affected to the PCR results by the quantities of templates and outer cycles in one tube nested PCR.It was pointed out that it was important for the optimized condition of PCR in different laboratories.(2)By using the optimized PCR condition to detect the clinical sputum samples,the PCR results had a high correlation with the positive bacteriological samples(more than 90%).The PCR positive rate was 53% for the negative patients confirmed by bacteriology,and it could be repeated.Conclusion Optimized PCR condition was necessary when PCR as a clinical tool.

Study on diagnosis value of analyzing CYFRA21.1 and CEA in benign and malignant pleural effusion

Zong Xiaofu Liu Yunxia,Wang Guangxian.

Chinese Journal of Antituberculosis. 1999, 21(2):  97-99. 

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Objective To discuss the role of tumour marker in differentiating malignant pleural effusion from benign ones.Method Pleural and serum levels of cytokeratin 19 fragment(CYFRA21.1)and carcinoembryonic antigen(CEA)were determined in 108 patients with pleural effusions(68 malignant and 40 tuberculous).Result Pleural and serum CYFRA21.1 and CEA levels were significantly higher in the cancer group than that in the tuberculous group.In the cancer group,CYFRA21.1 levels in pleural fluid did not differ significantly from that in the serum.CYFRA21.1 levels showed some false positive reaction in the pleural fluid of the patients with tuberculous effusions.Conclusion Combining the CEA test with CYFRA21.1 analysis appears to be very useful in differentiating malignant pleural effusion from the benign ones.

The studies on CPB's application in sputum specimens to preserving viability of M.tuberculosis.

Zhang Li,Peng Yili,Yang Litao,et al.

Chinese Journal of Antituberculosis. 1999, 21(2):  100-102. 

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Objective To study the impact of store temperature,time and wash method of sputum specimens contained CPB on the separate ratio of M.tuberculosis.Method The sputum specimens contained CPB were collected and stored in different temperature,time and prepared with two wash methods,to observe and compare the separate ratio of M.tuberculosis.Result The sputum samples contained CPB are steady if stored at beyond 18℃,compare with the condition under 18℃.The positive ratio exists marked difference( P<0.05).If the samples are saved for 1～3 weeks,the positive ratio is relatively higher,and saved for over 4 weeks,the postive ratio declines boviously.There exist marked difference( P<0.05)compared with one week.Conclusion The positive ratio of M.tuberculosis of the samples contained CPB is related to the sample reseving temperature and period.