Chinese Journal of Antituberculosis

Enhance imaging diagnosis level of tuberculosis

MA Hong-xia, GUO You-min

Chinese Journal of Antituberculosis. 2012, 34(04): 205-206.

Abstract ( 1538 )

PDF (783KB) ( 647 )

Save

References | Related Articles | Metrics

The value of CT appearances of interstitial changes in secondary pulmonary tuberculosis

WU Jian-lin，SHEN Jing，XU Kai，ZHANG Qing，LU Xi-wei

Chinese Journal of Antituberculosis. 2012, 34(04): 207-211.

Abstract ( 3096 )

PDF (1472KB) ( 1997 )

Save

References | Related Articles | Metrics

Objective To explore the CT characteristics of interstitial changes in patients with secondary pulmonary tuberculosis and analyze the value of CT manifestations to evaluate the effects of anti-tuberculosis therapy. Methods Forty-three patients who were diagnosed as tuberculosis by clinical or pathology were enrolled into our study (male: 23, female: 20; age: 19-54 years old, average age （29±11.4）years old). All the cases showed interstitial changes on CT imaging. Twenty-nine cases were testified by sputum smear, and the other cases were testified by sputum culture, bronchoscopy, biopsy or clinical follow-up. All the cases underwent CT scans before and after anti-tuberculosis therapy. Double-blind method was used to analyze the dynamic changes and outcomes of CT appearances. Results The most common location of this kind of tuberculosis was in the bilaterally upper pulmonary lobes (30/43), mostly distributed in segments, in the form of a small lesion or large fusion lesion. The CT appearances of interstitial changes were mainly intra-lobular reticular reticulation (43/43, 100.0%), micro-nodule (43/43, 100.0%), tree-in-bud (33/43, 76.7%), ground-glass opacity (27/43, 62.8%), thickening of inter-lobular septa (23/43, 53.5%) and thickening of the airway wall (24/43, 55.8%). The most cases showed clear boundary between the interstitial lesion and the normal lung tissue. The interstitial appearances improved after the anti-tuberculosis treatment, and more than 93% of the later four signs disappeared after the consolidation phase therapy (6 months). Conclusion It was a special kind of secondary tuberculosis which mainly manifested interstitial changes. The CT image could show us clear characteristics, and was helpful in detecting tuberculosis in the early phase, and evaluating the outcomes after therapy.

Multislice spiral CT diagnosis of adrenal tuberculosis

Taxifulati·Awuti，Gulina·Azhati，LIU Wen-ya

Chinese Journal of Antituberculosis. 2012, 34(04): 212-215.

Abstract ( 2935 )

PDF (1605KB) ( 599 )

Save

References | Related Articles | Metrics

Objective To explore the multi-slice spiral CT (MSCT) features of adrenal tuberculosis in order to improve the CT diagnosis level. Methods The MSCT findings of 13 patients with adrenal tuberculosis were retrospectively analyzed. Results Patients characteristics: 13 patients, 8 male and 5 femal; age range from 20 to 58 years; mean age 42 years. The CT findings: bilateral adrenal tuberculosis in 12 patients, unilateral in 1 case; mass-like increase of adrenal in 10 cases, mild or moderate increase in 3 cases with intact contours; adrenal glands enlargement with uniform density in 1 case, non-uniform enlargement in 12 cases; peripheral enhancement in 11 cases. After treatment, CT scan showed that the size of bilateral adrenal glands in 1 case shrunk or returned to normal and the low-density disappeared. Nine patients received anti-TB treatment before and after surgery. Enlargement of adrenal glands and the uneven density of the flat circular mass were the features of 9 early adrenal tuberculosis cases with peripheral enhancement and marked enhancement of its internal lines and clear edge. Advanced adrenal tuberculosis of 4 cases showed atrophy of glands and calcification. Eight patients had extra-adrenal tuberculosis, including lung(4 cases), urinary (2 cases), spinal tuberculosis(1 cases) and involement with pulmonary, left kidney, and spinal (1 case). Conclusion The MSCT findings of adrenal tuberculosis are typical. If the adrenal changes present in patients with multi-organ tuberculosis should be considered the diagnosis of adrenal tuberculosis which will provide a guidence for treatment and efficacy evaluation in clinical.

Value of plain CT scan for diagnosis of tuberculous peritonitis

WANG Kong-lin，MA Hong-xia，ZHANG Xiao-ping，ZHANG Zhe，JIAO Wei，CHEN ZHONG Yuan-long，QI Ying-cheng，GUO You-min

Chinese Journal of Antituberculosis. 2012, 34(04): 216-219.

Abstract ( 2814 )

PDF (1683KB) ( 947 )

Save

References | Related Articles | Metrics

Objective To explore features of the plain CT scan in patients with tuberculous peritonitis. Methods Forty-six tuberculous peritonitis patients with data of abdominal plain CT scan were retrospectively reviewed，including 6 cases proven by postoperation pathology, 2 cases diagnosed by abdominal puncture, 4 cases confirmed by laparoscopy, and 34 cases identified by experimental treatment.The CT features of tuberculous peritonitis involved in parietal peritoneun, peritonealcavity，greater omentum, mesentery, and retroperitoneal space were observed. Results The main features in the plain abdominal CT scan of tuberculous peritonitis appeared as follows：①Thickened parietal peritoneum in 33 cases (71.7%)，including smooth in 27 and irregular in 6；②Ascites in 31 cases (67.4%)，of which 20 cases revealed a small amount of effusion；③Thickened greater omentum in 26 cases (47.8%)，including smear like shape in 22 and caked sign in 2；④Mesenteric thickening in 32 cases (69.6%)with concurrent small nodular shadows in 9 cases；⑤Enlarged lymph nodes in 16 cases (34.8%)；⑥Bowel wall thickening in 1 case. Conclusion The main plain CT scan features of tuberculous peritonitis may appear as a small quantity ascites，smooth thickening and enhanced parietal peritoneum，thickened greater omentum with smear shadows，involvement of mesentery and enlargement of lymph nodes.The plain CT scan can provide important information for the diagnosis of tuberculous peritonitis.

Analysis on CT imaging features in 56 cases with tuberculous peritonitis

LV Yan, ZHAO Ze-gang, ZHOU Zhen, XIE Ru-ming, ZHOU Xin-hua

Chinese Journal of Antituberculosis. 2012, 34(04): 220-223.

Abstract ( 4104 )

PDF (1086KB) ( 874 )

Save

References | Related Articles | Metrics

Objective To investigate the CT imaging features of tuberculous peritonitis and dynamic changes. Methods We retrospectively analyzed the CT imaging findings of 56 cases who confirmed by pathology, clinical and laboratory findings including ascites, peritoneal involvement (parietal peritoneum,omentum and mesentery), and lymphadenopathy. All of 56 patients underwent CT plain and enhanced scan collecting dynamic CT images during the treatment. Results Forty-five cases presented with ascites including 1 case with large, 44 cases with medium and small amount, 38 with encapsulated effusion, which CT values was greater than 20 HU in 34 cases. Parietal peritoneum was thickened in 46 cases including uniform thickness in 17 cases, flat mound-like bulge or peritoneal tuberculosis tumor in 29 cases with peripheral enhancement, liver capsule or liver involved in 15 cases. Omentum thickening was seen in 35 cases, including nodular thickening in 34 and omental cake in 1 which presented with mild heterogeneousness on enhanced scan. Mesenteric thickening was seen in 41 cases expressing as nodules and linear, stellate-shaped high density, and intestinal loop adhesions. There were lymph node enlargement in 19 cases, calcification in 5 cases. The lymph nodes showed the appearance of a low attenuation center with ring contrast enhancement and honeycomb enhancement. Seventeen cases of complete dynamic CT images showed that peritoneal fluid absorption was fastest, followed by slower absorption of omentum and mesentery disease, peritoneal tuberculosis tumor shrunk slowest. Conclusion The CT diagnosis of tuberculous peritonitis is a comprehensive variety of signs, a small amount of ascites with peritoneal, omental and mesenteric thickening and adhesion is the most common imaging findings. Dynamic CT images in clinical can evaluate the efficacy.

The anti-tuberculosis activity of metal complexes of fusaric acid and their effect on gene expressions of M.tuberculosis

WANG Juan, HUANG Yu-hong, CHEN Yi, LI Yan, PENG Yi, PAN Jia-hui, WANG Jun, LIN Yong-cheng, LAI Xiao-min

Chinese Journal of Antituberculosis. 2012, 34(04): 224-228.

Abstract ( 2459 )

PDF (759KB) ( 724 )

Save

References | Related Articles | Metrics

Objective To observe in vitro antituberculosis activity of copper ion complex and cadmium ion complex of fusaric acid, and their effects on the gene expressions of M.tuberculosis (Mtb) H37Rv. Methods The anti-tuberculosis activities of copper ion complex and cadmium ion complex of fusaric acid were determined for three times by Kind-Bauer method, and their minimum inhibitory concentrations (MICs) were detected twice by the absolute concentration method.The differences of the gene expressions of Mtb H37Rv between the compound group and non-compound control group were measured twice with DNA chips. Results The antibacterial diameters of cadmium complex and cupric complex of fusaric acid on the BCG plates were (30.0±0.8) mm and (30.4±0.6) mm, respectively. The MIC of cupric complex of fusaric acid on Mtb H37Rv was 10 μg/ml. The MIC of cadmium complex of fusaric acid on multi-drug-resistant Mtb was 7.5 μg/ml, which was lower than that of streptomycin (S, MIC=25 μg/ml) and rifampicin (RFP,MIC=25 μg/ml). The MIC of cupric complex of fusaric acid on Mtb clinical isolate（No.0907961，resistant to S and EMB) was 10 μg/ml, which was lower than that of S (MIC=20 μg/ml); and the MIC of cadmium complex of fusaric acid was 5 μg/ml, which was lower than that of S (MIC=20 μg/ml) and EMB (MIC=6.4 μg/ml). Of 3875 genes tested by the DNA array, 23 genes (10 known functional genes) were significantly different in copper ion complex group, and 28 genes (11 known functional genes) in cadmium ion complex group compared with the control groups. The functions of these differential genes were involved in nucleotide, lipid, energy, coenzyme, amino acid metabolism, DNA replication, transcription, translation, post-translational modification, biosynthesis of cell membranes etc. Conclusion Metal complexes of fusaric acid appeared considerable in vitro anti-tuberculosis activity, especially inhibitory activities of the compounds on some drug-resistant Mtb strains appeared higher than that of the first-line agents.Therefore, they could be used as anti-tuberculosis lead compounds. The genes with differential expressions showed by the DNA chip provide a valuable foundation for further study on their antibacterial mechanism.

Analysis of the resources of laboratories of TB control system in Gansu province

MU Tao-jun，SI Hong-yan，LI Qing，MA Ling，GU Ji-xiu，LIANG Qi-jun

Chinese Journal of Antituberculosis. 2012, 34(04): 229-232.

Abstract ( 1709 )

PDF (628KB) ( 627 )

Save

References | Related Articles | Metrics

Objective To make recommendations for improvement through understanding the resources of laboratories of TB control system in Gansu province. Methods The information of 100 laboratories, including 1 in provincial level, 14 in prefecture level and 85 in county level was collected. Statistics was made on the quantity of staff members, age, education, technical title and professional composition. Meantime, the laboratory equipment and the present work were also analyzed. Descriptive analysis was used to explain the general characteristics of these indicators listed above. Results The education of 33.1 %(43/130) laboratory technicians is technical secondary school or lower；13.1%(17/130) major in neither medicine nor laboratory；The part-time technician accounted for 19.2%(25/130), 14 prefecture laboratories could not carry out drug sensitivity test on a routine basis, 76 laboratories lack of biological safety cabinets and 65 lack of the incubator. Conclusion Both the human resource and the equipment in TB laboratories need to be strengthened.

Clinical diagnosis and differential diagnosis of secondary pulmonary tuberculosis and adult mycoplasma pneumonia

WANG Wei，CHEN Hong-bing，LI Jing，WANG Bo

Chinese Journal of Antituberculosis. 2012, 34(04): 233-236.

Abstract ( 2344 )

PDF (634KB) ( 1286 )

Save

References | Related Articles | Metrics

Objective To compare the clinical data of secondary pulmonary tuberculosis and adult mycoplasmal pneumonia and to lay foundation for the differential diagnosis for the 2 diseases. Methods Sixty-seven cases and 32 cases of the 2 diseases were collected in our hospital from 2008 to 2010, and the clinical performance, X-ray information, laboratory examination and therapy of the patients were retrospectively analyzed. Results （1）The course of most adult mycoplasmal pneumonia patients was usually shoter（87.5%，28/32）than secondary pulmonary tuberculosis patients（7.5%，5/67）（χ²=62.3898，P<0.01）, and symptoms of respiration［runny nose（68.8%，22/32），headache（28.1%，9/32），sore throat（50.0%，16/32）］ were more common than those of patients with secondary pulmonary tuberculosis（3.0%（2/67），6.0%（4/67）,4.5%（3/67））（χ²=51.1830，χ²=9.2565，χ²=30.8682，All P<0.01）. The sign of rale was found more in mycoplasmal pneumonia patients （53.1%，17/32）than that in secondary pulmonary tuberculosis patients（13.4%，9/67）（χ²=17.6145，P<0.01）. （2）The most common CT finding of adult mycoplasmal pneumonia were ground glass opacity and consolidation（71.9%，23/32），with none of secondary pulmonary tuberculosis patients（χ²=62.7398，P<0.01）.Most of the ground glass opacity and consolidation showed tendency of lobular distribution and involving the lower lobes（70.0%，14/20）in patients with mycoplasmal pneumonia, while secondary pulmonary tuberculosis patients was 34.2%（13/38）（χ²=9.5139，P<0.01）. In some patients with mycoplasmal pneumonia, the focus was wandering（9.4%，3/32）, while secondary pulmonary tuberculosis patients was not found （χ²=5.9103，P<0.05）.The lesions was absorbed after treatment with azithromycin or erythrocin in 4 weeks（53.1%，17/32）in mycoplasmal pneumonia, but that could not be seen in secondary pulmonary tuberculosis patients （χ²=42.8718，P<0.01）. （3）Serum cold agglutination test and antibody of mycoplasma pneumoniae were different between adult mycoplasma pneumonia secondary pulmonary tuberculosis（71.9%（23/32） vs. 0，χ²=62.8571，P<0.01; 81.3%（26/32）vs 1.5%（1/67），χ²=67.5228，P<0.01）. Conclusion It is helpful to identify the diagnosis between secondary pulmonary tuberculosis and adult mycoplasma pneumonia if taking medical history carefully, noticing focus characters on imaging, given empirical treatment and multiple serology and bacteriology examination.

Evaluation of the effectiveness of tuberculosis control project among the floating population

ZHANG Dan, PANG Xue-wen, WANG Xu, CHEN Shi-qiang, QI Wei, LI Jing-xin, LI Shang-lun

Chinese Journal of Antituberculosis. 2012, 34(04): 237-240.

Abstract ( 1867 )

PDF (632KB) ( 817 )

Save

References | Related Articles | Metrics

Objective To assess the effectiveness of floating population TB project for improving the tuberculosis control work in the project covered area. Methods The information related to policy and funding, TB case referral and tracing, treatment and management, health education were analyzed in 7 project covered districts(counties). SPSS13.0 software is used for statistical analysis. Results After the project implementation, the DOTS coverage reached 100.0%, the referral in place rate increased from 15.88%（3511/22 106） to 52.01%（9698/18 646）（χ²=6025，P<0.01）, the tracing in place rate rose from 19.38%（2519/12 999）to 36.54%（4284/11 724）（χ²=910.3，P<0.01）, the cure rate of smear-positive pulmonary TB rose from 51.11%（918/1796） to 72.71%（946/1301）（χ²=146.9，P<0.01）. Conclusion The floating population tuberculosis control project play a positive role in tuberculosis case treatment and management.

Clinic and curative effect analysis on 112 cases with strong reactions of lymph node caused by neonatal BCG vaccination

WU Wen-qing，LI Bo，NI Xin-lan，AN Yan-sheng

Chinese Journal of Antituberculosis. 2012, 34(04): 241-244.

Abstract ( 2215 )

PDF (637KB) ( 1017 )

Save

References | Related Articles | Metrics

Objective To analyze the clinical signs and evaluate the efficacy of local treatment for the strong reactions of 112 cases axillary lymph nodes caused by neonatal BCG vaccination. Methods The 112 cases of confirmed cases were given different local treatments including local fomentation, lesion needle aspiration, complete debridement and drainage with antituberculous drugs and the efficacy of the treatments were evaluated. Results 1)The dictionary 112 cases were classified to 4 types: 13 cases presented with the proliferation scleroma, 41 cases with cheese necrosis, 47 cases with abscess rupture, and 11 cases with proliferation cheese necrosis which did not healed after surgery in other hospitals. 2)Needle aspiration specimens or pus were taken from 58 cases for acid-fast bacilli smear and culture examination at the first presentation，in which 18 cases were smear positive, 22 cases were culture positive. Among the 22 cases, 20 cases were mycobacterium bovis through the strain identification. 3) 13 cases with proliferation scleroma were given local fomentation 2-4 times a day. B-ultrasound after 4-8 weeks showed that nodular in 5 cases shrunk and liquid was seen in 8 cases. Cheese necrosis in 49(41+8) cases were given local needle aspiration, and then 10-20 mg(0.2-0.4 ml) INH were injected into the nodule once a week，combining with heating. The wound of 96 (47+49) cases with abscess rupture healed after 4-10 weeks, an average of 8 weeks through debridement, wound drainage, which were given isoniazid once a week. 7 cases from other hospitals whose wound did not heal after surgery were given drainage with isoniazid once a week, the wound healed after 4-12 weeks, on an average of 8 weeks. 4)After 6 month follow-up，there were no relapse cases occurred. Conclusion Abnormal reactions of the ipsilateral axillary lymph nodes would occur in a small number of infants and young children after neonatal BCG vaccination，most will eventually form a cold abscess and ulcerate. Local treatment have little trauma, less lesion, low risk and high cure rate than surgical resection, and it should be widely used in the future.

The value of LTB-S classification in surgical indication for multidrug-resistant tuberculosis

SONG Yan-zheng，WANG Xu，LU Shui-hua，XIAO He-ping

Chinese Journal of Antituberculosis. 2012, 34(04): 245-247.

Abstract ( 1923 )

PDF (627KB) ( 693 )

Save

References | Related Articles | Metrics

Objective To explore the value of LTB-S classification in surgical indication for multidrug-resistant tuberculosis, looking for a judging system of the optimal operation time in patients with multidrug-resistant tuberculosis to reduce the complications and medical costs. Methods We set up a simple practical LTB-S judgment system for surgery of multidrug-resistant tuberculosis based on《Clinical technology operating specifications(tuberculosis section)》 written by Chinese Medical Association Tuberculosis Branch.Patients were divided into class Ⅰ, Ⅱ, Ⅲ which definited absolute sugery indication, relative indication and contraindication, respectively. Twenty-seven cases with pulmonary tuberculosis who has been underwent surgery were randomly chosen for this confirmatory analysis. Results Of 27 patients, 8 patients belonged to class Ⅰ, 17 class Ⅱ, and 2 class Ⅲ in those who complied with the LTB-S class Ⅰ had no complications,the patients which complied with the LTB-S class Ⅱ and Ⅲ have much more complications which incidence were 2 patients(100% in class Ⅲ), respectively. Conclusion LTB-S judging system is helpful for the judgment of operative indications for multidrug-resistant tuberculosis,it is very practical on clinical and suitable for TB physicians learning and understanding.

Clinical research advances on pulmonary tuberculosis in immunocompromised patients

Chinese Journal of Antituberculosis. 2012, 34(04): 248-251.

Abstract ( 1806 )

PDF (2125KB) ( 941 )

Save

References | Related Articles | Metrics

The image findings of tuberculosis combining with aspergillosis infection

Chinese Journal of Antituberculosis. 2012, 34(04): 251-253.

Abstract ( 3330 )

PDF (982KB) ( 1043 )

Save

References | Related Articles | Metrics

Advances in research for the role of tumor necrosis factor-α in anti-TB immunity

Chinese Journal of Antituberculosis. 2012, 34(04): 254-258.

Abstract ( 2010 )

PDF (664KB) ( 675 )

Save

References | Related Articles | Metrics

Table of Content