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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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OBJECTIVE To identify the valid targets and new drugs of ulcerative colitis (UC), a recurrent and intractable inflammatory bowel disease. METHODS and RESULTS In an in vivo mouse model of DSS-induced colitis, HLJ2 decreased weight loss, colon contracture, disease activity index (DAI), colon mucosa damage index (CMDI) and histopathological index (HI). HLJ2 also decreased myelo?peroxidase(MPO) activity and reduced production of the inflammatory cytokines TNF- α, IL- 1β, andIL- 6. HLJ2 improved intestinal mucosa damage induced by dextran sodium sulfate (DSS) and increased the expression of ZO-1 and claudin-1. Fecal 16s rRNA high-throughput sequencing demon?strated a significant improvement in UC intestinal dysbacteriosis in mice treated with HLJ2, including increased abundance of probiotics such as Lachnospiraceae, Prevotellaceae, and Lactobacillaceae. At the same time there was a reduction in the abundance of pathogenic or conditional pathogenic microor?ganisms such as Bacteroidaceae, Porphyromonadaceae, Deferribacteraceae, and Pseudomonadaceae in HLJ2- treated mice compared with untreated mice. CONCLUSION Our results demonstrated that the XBP1 agonist HLJ2 inhibits inflammation, regulates the intestinal flora, and protects the intestinal mucosa. It is thus a potential therapeutic agent for ulcerative colitis.
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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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Objective To explore the risk factors of patients with re -treatment multidrug resistant pulmonary tuberculosis (MDR -TB)and to provide suggestions for intervention.Methods A case -case control study was carried out between patients with or without re -treatment MDR -TB,with a questionnaire interview and multivariate logistic regression analysis to explore the risk factors of re -treatment MDR -TB.Results A total of 172 patients were enrolled in this study including 99 re -treatment MDR -TB patients and 73 re -treatment non -MDR -TB patients(P >0.05).There was no significant difference between case group and control group in gender,age,residence and marital status.The sick time,the anti -tuberculosis treatment time,the number of anti -tuberculosis treatments,the rate of adverse reactions,history of taking isoniazid or rifampicin and the number of treatment interruption were higher in cases than those in control group(P <0.05),while the months of first -treatment were lower than those in control group(P <0.05).The number of anti -tuberculosis treatments(≥3),adverse reactions during treatment,the months of first -treatment were significant risk factors by the multivariable regression model,with the adjusted ORs and 95%CIs of 5.07 (1.89,13.64),4.27 (2.04, 8.94)and 2.35(1.06,5.22),respectively.Conclusion The number of anti -tuberculosis treatments,adverse reactions during treatment,the months of first -treatment were risk factors of patients with re -treatment MDR -TB.
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Objective To investigate patients’negative emotional reactions and its influencing factors when pulmonary tuberculosis (PTB ) was diagnosed, and to provide evidence for health education and intervention. Methods A questionnaire survey was conducted among 440 PTB patients who were treated at the designated clinics of two counties in Zhejiang Province.Twenty patients at one clinic were randomly selected for a semi-structured interview.Results A total of 437 qualified questionnaires were collected and 19 patients were successfully interviewed.When they were told the result of diagnosis,58.58% patients felt worried,29.75% were shocked,20.37% tended to blame themselves,10.98% felt helpless and 35.70%had a sense of shame.In the semi-structured interview,the main reasons for negative emotions told by the patients were disbelieving the fact of getting the disease and misunderstanding TB was incurable.Old people felt more shocked (40.26%),worried (58.44%)and self-blaming (38.96%)about the diagnosis of TB.The divorced and widowed expressed more reactions of worry (95.24%), shock (6 1.09%), self -blame (6 1.09%), helpless (42.86%).Farmers had higher rate of shock (48.89%),worry (70.37%),and self-blame (43.70%).Conclusion Negative emotions or feelings were popular among TB patients when the disease was diagnosed.The elders,divorced or widowed people and farmers need to be attached more importance during the process of health education or intervention.
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Objective To explore the direct medical cost of tuberculosis patients and its components under designated hospital mode,and to provide evidence for configuration optimization of tuberculosis prevention and control funds in Zhejiang Province.Methods A total of 7 counties including Cixi,were selected as study spots,and 50 initially-treated tuberculosis patients who completed treatment from each county were continually enrolled as study objects.Questionnaire survey and outpatient and inpatient medical records survey were carried out for each object.Results Average medical cost of initially-treated tuberculosis patients was 4 086 Yuan (RMB)which was 12.69% of their total yearly family income and 20.17% of patients occurred in debt.Average medical cost in designated hospital was 3 020 Yuan (RMB),of which 78.31% (2 365 Yuan)was used for DOT treatment in outpatient clinic.Examination cost of the outpatient constituted 25.24% (CT cost constituted 8.57%),and non -free medicine constituted 74.76% (hepatic protector medicine cost constituted 41.94%).Conclusion Tuberculosis patients suffered heavy economic burden because of self -paying auxiliary examination and drugs.To adjust existing funds usage of tuberculosis prevention and resource configuration is needed.
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<p><b>OBJECTIVE</b>To optimize extraction and purification methods of acidic polysaccharide from Moerella iridescens (MIAP).</p><p><b>METHODS</b>With alkali extraction process and orthogonal experiment,the time consumption,temperature,pH value of the solution and alcohol concentration during the extraction were optimized. The crude products were deprived of protein,pigment and ion,then were purified with DEAE-cellulose ion-exchange chromatography and verified with Sephadex G-100 and cellulose acetate membrane electrophoresis,and examined with infrared spectrum.</p><p><b>RESULTS</b>The optimized extraction conditions were as follows: extraction time 6 h,extraction temperature 70 degree,the solution pH 8.0 and the concentration of alcohol precipitation 70%. Intuitive features showed that the MIAP was pure white crystalline granular with slight dark brown color. The purification results demonstrated that the target MIAP was eluted and identified as a homogeneous components by DEAE-cellulose ion exchange column,Sephadex G-100 and cellulose acetate membrane electrophoresis. Infrared spectral scanning suggested that MIAP was α-D-type terminated glucopyranose. Intuitive features showed that MIAP was soft and cottony white.</p><p><b>CONCLUSION</b>The extraction process with orthogonal test has been optimized and the acidic polysaccharide from Moerella iridescens is successfully isolated.</p>
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Animals , Bivalvia , Chemistry , Chromatography, DEAE-Cellulose , Methods , PolysaccharidesABSTRACT
<p><b>OBJECTIVE</b>To investigate the status of awareness on tuberculosis (TB) in the public and its impact factors in Zhejiang province.</p><p><b>METHODS</b>A multi-stage sampling was applied. Around 6600 subjects were enrolled for questionnaire survey from December 2010 to January 2011 in Zhejiang province. Survey data were input by EpiData 3.0 software, and the the status of awareness on tuberculosis (TB) in the public and impact factors were analyzed by SPSS 13.0 software package.</p><p><b>RESULTS</b>A total of 6546 subjects were investigated, the response rate was 99.18% (6546/6600), 3306 were male and 3240 were female, the age of subjects was (44.90 ± 12.40) year-old. The total key information awareness rate of TB was 45.66% (14 944/32 730). 65.70% (4301/6546) knowing the transmission route, 33.30% (2180/6546) knowing the symptom of TB, 39.21% (2567/6546) knowing where to go when suspected suffering TB, 38.28% (2506, 6546) knowing national free anti-TB drug supply and examination of infectious TB patients, 51.79% (3390/6546) knowing TB is curable in most case. As for the the key information awareness rate, among senior high school or above, primary high school, primary school or below were 57.19% (3257/5695), 52.07% (6 066/11 650), 36.54% (5 621/15 385), respectively; among birthplace in city, rural areas were 54.70 (1745/3190), 44.68% (13 199/29 540), respectively; Amone male, female were 47.11% (7 788/16 530), 44.17% (7 156/16 200); among different occupations, cadre or staff was highest (59.43%, 1 563/2 630), whereas students was lowest (40.33%, 492/1220); among different age groups, subjects aged beyond 50 years was lowest (39.75%, 5 189/13 055). The total key information awareness rate among above different population groups showed statistically difference (all P values < 0.01).</p><p><b>CONCLUSION</b>Awareness of knowledge for prevention and therapy of tuberculosis in Zhejiang public was insufficient and imbalanced among subjects with different social demographic characteristics.</p>