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Objective To explore the outcome and its influencing factors of the Multi - drug resistant tuberculosis(MDR -TB)patients with community management,and to provide the scientific basis for the further implementation of the community management of MDR - TB patients. Methods Retrospective study was conducted on MDR - TB patients diagnosed and treated with MDR - TB from January 2009 to June 2012 and the patientsˊ willingness and influence factors of outcome in community management were analyzed. Results 220 MDR - TB patients were under community management and the cute rate was 65. 91% . The cure rate of patients with degree in college or above ,occupation for workers,new type of patients,patients with no adverse reactions during drug injection therapy was relatively high. The cure rate of the patients who injected in home(86. 67% )was higher than who injected in community(68. 15% )and others (54. 84% ). The cure rate of the patients whose injection distance from home ≤5 km(67. 74% )was higher than whose injection distance from home ﹥ 5 km(36. 36% ). The cure rate of the patients with community doctor/ nurse follow - up management(70. 39% )was higher than those who without community doctor/ nurse follow - up management(55. 88% ). Through the analysis of needs for the community management,the results showed that 65. 91% of the patients were willing to accept the injection in the community,and 94. 09% patients chose medication at home. Conclusion The cute rate of MDR - TB patients should be improved in community management . In the future ,we should pay more attention to the patientsˊ needs in the development of community management for MDR - TB patients according to the actual situation,and to further strengthen the psychological support and community care for MDR - TB patients.
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<p><b>BACKGROUND</b>Screening on multidrug-resistant tuberculosis (MDR-TB) has been limited to the serious TB subpopulations excluding the new TB patients. This study aimed to examine MDR-TB burden among the new TB patients.</p><p><b>METHODS</b>We conducted a study in Zhejiang Province during 2009-2013 to screen for MDR-TB patients among the low MDR-TB risk patients and five subpopulations of high MDR-TB risk patients. The number, prevalence, and trend of MDR-TB were compared while the logistic regression model was used to examine risk factors related to MDR-TB.</p><p><b>RESULTS</b>A total of 200 and 791 MDR-TB cases were, respectively, identified from the 9830 new TB cases and 2372 high-risk suspects who took MDR-TB screening from 2009 to 2013. The MDR-TB rates went down in both of the new TB patients and five MDR-TB high-risk groups over the study time, but the percentage of MDR-TB patients identified from the new TB patients in all diagnosed MDR-TB cases kept stable from 28.3% in 2011 to 27.0% in 2012 to 26.0% in 2013.</p><p><b>CONCLUSIONS</b>The study indicated that MDR-TB burden among new TB patients was high, thus screening for MDR-TB among the new TB patients should be recommended in China as well as in the similar situation worldwide.</p>
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Objective To analyze the basic characteristics of the therapy discontinued patients with multi -drug resistant pulmonary tuberculosis (MDR -TB)and to find the causes of therapy discontinuing.Methods Using case -control study method,a questionnaire survey was conducted to analyze the causes of MDR -TB in the treatment of interruption,and to compare the characteristics with the treatment completed patients,and to analyze the risk factors of discontinued therapy among MDR -TB patients.Results The study included 45 cases of therapy discontinued MDR -TB patients,and 45 cases of MDR -TB patients who had completed the treatment as the control.Multivariate logistic regression analysis results showed that patients with over 65 years old(OR =8.69,95% CI =1.12,67.57),leak medication or drug withdrawal experience (OR =53.18,95% CI =5.90,479.27),were the risk factors of discontinued therapy(P <0.05).Patients with hospitalization for over 15 days was the protective factors for discontinued therpy(OR =0.09,95% CI =0.01,0.58), (P <0.05).Conclusion advanced age≥65 years old,low income,leak medication or drug withdrawal experience short hospitalization periods were related to the risk of MDR -TB patients therapy discontinuing.were the key targets for patient management in the future.
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Objective To monitor the drug resistance of tuberculosis in Zhejiang Province and to provide scientific evidence for the control of drug resistant tuberculosis.Methods Thirty counties in Zhejiang Province were selected as sample during July 1,2013 and June 30 2014,and smear positive cases were selected to be monitored during study period. Results The rate of drug resistance was 30.88%,and the rate of multi drug resistance was 5.02%.The rate of the extensively drug -resistant tuberculosis was 0.32%.Among initial treatment cases,the rate of drug resistance was 29.22%,higher than 2008,and the rate of multi drug resistance was 3.21%.Among retreatment cases,the rate of drug resistance was 45.74%,and the rate of multi drug resistance was 21.28%.All kinds of monitored drugs were found resistance phenomenon.The drug resistant rate of SM was highest (15.28%),and aminoglycosides (2.35%)were relatively low.Conclusion The status of retreatment TB drug resistance suggested that we had reduced acquired TB drug resistance through implementation of DOTS strategy and standard short course chemotherapy treatment in Zhejiang Province. But it is still not optimistic to control TB drug resistance,and the status of initial treatment TB resistant suggested that resistant strains spread had not been effectively controlled in Zhejiang Province.So we should strengthen the early detection of drug resistant among TB patients,and to further improve the standard of conventional TB treatment.
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<p><b>OBJECTIVE</b>To explore association of miR-149 and miR-605 polymorphisms with other risk factors of lung cancer susceptibility among Chinese population.</p><p><b>METHODS</b>Two hundred and forty-four patients with lung cancer and 243 cancer-free controls matched by age and sex were enrolled from 2002 to 2008. Peripheral venous blood samples were collected from all subjects. Single nucleotide polymorphisms (SNPs) of miR-149 and miR-605 were genotyped by PCR-RFLP. Multiple-variable logistic regression model was used to assess the association of SNPs and cancer related risk factors for lung cancer.</p><p><b>RESULT</b>There was not significant association of SNPs of miR-149 and miR-605 with lung cancer. A marginal significance was observed while the males with at least one G allele of miR-605 had higher risk of lung cancer (OR=1.5, 95% CI:1.0-2.3) than those with AA genotype. Increased frequency of smoking was associated with lung cancer risk. Compared with no-smoker, the subjects with <20 and >20 cigarettes/day had higher risk of lung cancer: OR (95%CI)=1.7(1.0-3.0) for <20 cigarettes, OR (95%CI)=4.2(2.3-7.6) for >20 cigarettes. There was no interaction between two genes and smoking on lung cancer.</p><p><b>CONCLUSION</b>miR-149 polymorphisms may not affect lung cancer susceptibility. miR-605 gene mutant might be increase the risk of lung cancer among males. Cigarette smoking increased a risk of lung cancer, but there were not interactive effects between two gene and smoking on lung cancer.</p>
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Aged , Female , Humans , Male , Middle Aged , Asian People , Genetic Predisposition to Disease , Genotype , Logistic Models , Lung Neoplasms , Genetics , MicroRNAs , Genetics , Polymorphism, Single Nucleotide , Risk Factors , SmokingABSTRACT
<p><b>OBJECTIVE</b>To investigate mRNA expression of caspase apoptosis pathway genes in colorectal cancer, polyps and normal mucosa.</p><p><b>METHODS</b>Nineteen patients with colorectal cancer, 86 patients with polyps and 10 normal controls were enrolled from 2008 to 2010. Fluorescence quantitative RT-PCR was performed to detect the mRNA expression of caspase apoptosis pathway genes (caspase-2,-3,-6,-7,-8,-9 and -10) in colorectal cancer, polyps and normal mucosa.</p><p><b>RESULT</b>There were no statistically significant differences of demographic characteristics between patients with colorectal cancer, patients with polyps and normal controls. Compared with normal control group, the mRNA expression of all selected genes except for caspase-3 were lower; however, the P values did not reach statistic significance. Highly positive correlations were observed between mRNA expression of all selected genes except caspase-9.</p><p><b>CONCLUSION</b>There are no significant changes in mRNA expression levels of caspase apoptosis pathway genes from normal mucosa to polyps to cancer. The mRNA expressions of most caspase pathway genes are highly correlated with each other.</p>