Study on the efficacy evaluation of real-time fluorescence assay of RNA isothermal amplification in the treatment of patients with positive pulmonary tuberculosis / 天津医药

@#Objective To investigate the value of real-time fluorescence detection technique of RNA (SAT) constantamplification in monitoring the effect of chemotherapy on patients with sputum positive pulmonary tuberculosis. Methods Sixty-two patients were selected, who were clinically diagnosed as the first-time retreatment for sputum smear-positive pulmonary tuberculosis and were hospitalized in our department from June 2015 to December 2016. After two-month standard anti-tuberculosis treatment, sputum samples were detected by Peng’s vessel acid-fast staining, BACTEC MGIT- 960 culture and strain identification, SAT detection. The BACTEC MGIT-960 culture and strain identification were used as gold standards, the value of SAT during the monitoring the therapeutic effect of the anti-tuberculosis drugs was assessed. Results After the treatment, 49 cases out of 62 showed positive results in mycobacterium tuberculosis culture test, among them 42 patients were diagnosed as human type mycobacterium tuberculosis, 7 patients were diagnosed as nontuberculous mycobacteria infection, and 13 cases showed negative results in mycobacterium tuberculosis culture. Thirty-two cases showed positive results in sputum Peng’s vessel acid-fast staining test, and 30 cases showed negative results. Forty-one cases showed positive results in SAT test and 21 cases showed negative results in SAT. SAT results were well concordant with sputum culture results (Kappa value=0.964), and the sensitivity, the specificity, the positive predictive value and the negative predictive value of SAT were 97.62%, 100%, 100% and 95.24% respectively. Peng’s vessel acid-fast staining results were badly concordant with MGIT-960 culture results (Kappa value=0.086), and the sensitivity, the specificity, the positive predictive value and the negative predictive value of Peng’s vessel acid-fast staining were 54.76%, 55.00%, 71.88% and 36.67% respectively. Conclusion SAT results can be used as good indices during the monitoring therapeutic effects of drugs used for the first-time retreatment in patients with sputum smear-positive pulmonary tuberculosis, which is worth promoting.

Clinical value of bronchoscopy in dignosis of bacteriological negative pulmonary tuberculosis / 中国基层医药

Objective To explore the diagnostic value of bronchoscopy combined materials drawn in multiply methods in patients with bacteriological negative pulmonary tuberculosis.Methods The clinical data of 74 patients with pulmonary tuberculosis were retrospectively analyzed.All the patients had sputum acid-fast staining more than three times,25 patients were sputum bacteriological positive and 49 patients were bacteriological negative or had no sputum.Bronchoscopy was performd in 28 cases,including biopsy examining,brush examining,bronchoalveolar lavage fluid(BALF) smear and sputum spear acid-fast stain test.Results In 28 patients undergoing examination,microscopic abnormalities were found in 14 cases,taken 50.0％.15 cases performed lesion biopsy or transbronchiallung biopsy(TBLB) were diagnosed tuberculosis,taken 53.6％.Brush acid-fast staining was positive in 7 cases,taken 25.0％.BALF smear postive in 10 cases,taken 35.7％.And phlegm test after bronchoscope positive in 6 cases,taken 21.4％.Combined multiply index,23 cases finally diagnosed as pulmonary tuberculosis,taken 82.1％.Conclusion Bronchoscopy with materials drawn in multiply methods has a high value in diagnosing bacteriological negative pulmonary tuberculosis,we should take advantage of it as soon as possible.

Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar / Spirometrics alterations in patients with pulmonary tuberculosis sequelae

El pulmón con secuela de tuberculosis es un diagnóstico frecuente de limitación en la función pulmonar que requiere estudio. Objetivo: Determinar las alteraciones espirométricas más frecuentes en pacientes con secuela de tuberculosis pulmonar que requirieron hospitalización, grado de severidad y la respuesta a broncodilatadores. Material y Métodos: Se realizó un estudio descriptivo transversal retrospectivo con revisión de los informes de espirometría realizadas durante el año 2007 en la Unidad de Función Pulmonar del Servicio de Neumología del Hospital Nacional Dos de Mayo. Resultados: Se revisaron 104 espirometrías. El promedio de edad fue 51,2 años. El motivo de hospitalización fue broncorrea infectada en 75%, disnea en 74,04% y hemoptisis en 30,77%. La CVF, VEF1, VEF1%CVF, CVIF% y FEF25-27%, en promedio fue 109%; 72,9%, 57%, 59,7% y 31,4%, respectivamente. Se obtuvo patrón de normalidad ventilatoria en 16,35%; obstructivo en 79,81% y no-obstructivo (restrictivo) en 13,46%. En los pacientes con patrón obstructivo, la presencia de reversibilidad total a los broncodilatadores se obtuvo en 28,92%. Se encontró una correlación negativa (p<0,05) entre disnea y CIVF. Conclusiones: El patrón obstructivo sin reversibilidad a broncodilatadores fue la alteración espirométrica más frecuente encontrada en pacientes con secuela de tuberculosis pulmonar. Existe una relación inversa la disnea y la CI.

The sequelae tuberculosis lung is a frequent diagnosis with lung function limitation that might have a study. Objective: To determine the spirometry pattern in the hospitalized patients and get theirs severity and bronchodilator answer. Material and Methods: It´s a descriptive, transversal retrospective study; we reviewed 104 spirometries. Results: The average age was 51,2. The reason to hospitalize was infectious bronchorrea in 75%, dispnea in 74.04% and hemoptysis in 30.77%. The FVC was 109%; FEV1 72.9%; FEV1%FVC 57%; CVIF% 59.7%; FEF25-27%, 31.4%. The spirometric results were normal in 16.35%; obstructive in 79.81% and non-obstructive (restrictive) in 13.46%. There was bronchodilator answer in 28.92% of the obstructive pattern. There was an inverse correlation (p<0.05) between dispnea and CIVF. Conclusions: The obstructive spirometry pattern without bronchodilator answer was the most frequent spirometric pattern in patient with sequelae tuberculosis lung. There is an inverse relation between dispnea and inspiratory capacity.

The expression of cell cycle regulators in tuberculosis with lung carcinoma / 中国基层医药

Objective To explore the role of cell cycle regulators in tuberculosis with lung carcinoma.Methods p53,MDM_2,p21~ ras and p21~ WAF1 proteins were detected by LsAB immunohistochemical technique in 69 cases of tuberculosis with lung carcinoma.Results As compared with primary tuberculosis with lung carcinoma,the expression rate p53 or MDM_2 protein in relapsing NPC was similar(78% to 80%,84% to 83%),and the expression rate of p21~ ras and p21~ WAF1 protein in relapsing NPC was obviously descended(73% to 93%,52% to 84%);The high-expression rate of p53 protein in relapsing NPC was similar(42% to 51%),the high-expression rate of MDM_2 protein in relapsing NPC was obviously risen(57% to 32%),and the high-expression rate of p21~ ras and p21~ WAF1 protein in relapsing NPC was obviously descended(16% to 65%,17% to 46%).Among of them,the significant rise of MDM_2 protein expression level in relapsing NPC mainly occurred in the patients of group 2 which relapsing-interval was shorter than 34 months(P

Evaluation of Thoracoscopy-assisted Mini-incision in Surgical Treatment of Lung Tuberculosis / 中国微创外科杂志

Objective To evaluate the role of thoracoscopy-assisted mini-incision in surgical treatment of lung tuberculosis.Methods From 1999 to 2004,pulmonary lobectomy was performed with thoracoscopy-assisted mini-incision(5-7 cm) on 42 patients with lung tuberculosis(right superior lobectomy in 16,right middle lobectomy in 4,right inferior lobectomy in 4,left superior lobectomy in 10,left lingular lobectomy in 4,and left inferior lobectomy in 4).Results None of the patients were converted to open surgery.The mean operation time was 105 min(35-170 min);blood loss ranged 100-800 ml(mean,150 ml).In the patients,thoracic drainage lasted for 1-5 d(mean,2.8 d) after the operation,and the hospital stay was 4-11 d(mean,6.7 d).During a 2-to 13-month follow-up(mean,8.2),no patient showed positive sputum,bronchopleural fistula,or diffusion of tuberculosis.Conclusions Since thoracoscopy-assisted mini-incision is assosiated with minimal tissue injury,few blood loss,quick postoperative recovery,short hospital stay,and few complications after the surgical treatment of lung tuberculosis,it is worth being widely used.For surgeons,it is important to remember the indications for the procedure.

X-ray and CT Features of Pulmonary Tuberculosis in Elder:An Analysis of 200 Cases / 实用放射学杂志

Objective To analyse the imaging characteristics of pulmonary tuberculosis(TB) in elder in order to improve its diagnostic accuracy.Methods Radiological and CT fndings of pulmonary tuberculosis in 200 old patients were analysed retrospectively.Results The types of TB in 200 patients were:type Ⅱin 13 cases(6.5%),type Ⅲ in 163 cases (81.5%),accompanied with the pleuritis in 44 cases(22%) and type Ⅳ in 24 cases (12%).The mainly imaging findings included:old lesions in 85 cases(42.5%),exudative and/or multiplicative lesions in 81 cases (40.5%),caseous pneumonia in 47 cases(23.5%),cavitive lesions in 127 cases(63.5%),tuberculoma in 12 cases(6%),miliary nodules in 13 cases(6.5%),TB pleuritis in 68 cases(34%) and enlargement of lymph nodes in 57 cases (28.5%).Conclusion TB in elder is of characteristics of atypical location and unstable morphology.

Clinical Study on Antituberculotics Combined with Chinese Drug Feilaoning for Treatment of 34 Cases of Pulmonary Tuberculosis of Return Treatment / 中医杂志

Objective:To study and assess therapeutic effect of Fei Laoning in accessory treatment of pulmonary tuberculosis of retu treatment.Methods:67 cases of return treatment with positive tuberculomyces were randomly divided into a treatment group of 3 cases and a control group of 33 cases.They were all treated by the program,3Pa(H)L2VZ(TH)E(Ak)/6Pa(H)L2V,wit Feilaoning added to the treatment group for 3 months.Results:One,three and six months after treatment,the returning negativ rates for the bacterium in phlegm were 61.8%,94.1%,97.1%and 30.3%.75.8%,78.8%;the absorption rates of foci wer 73.5%,94.1%, 97.1% and 36.4%,75.8%,81.8% in the treatment group and the control group,respectively,with significan differences between the two groups(P

Analysis on misdiagosis of atypical CR,DR,and CT appearances of pulmonary tuberculosis / 重庆医科大学学报

Objective: To investigate the atypical CR,DR,and CT appearances of pulmonary tuberculosis and to analyse the causes of misdiagnosis.Methods: CR or DR of Chest PA & LAT and CT of Chest Routine Scan were performed in 30 cases of pulmonary tuberculosis,CT Enhanced Scan performed in 8.All of the cases were confirmed by clinical results or pathology.Results: The CR,DR,and CT findings were classified into 4 types:1) nodule or mass type(n=15):the edge was smooth(n=7)and ill-defined(n=4)and lobular(n=5);2)patchy consolidation type(n=8):this appeared irregular with homogeneous density and ill-defined edge;3)atelectasis type(n=5):this showed stenosis or occlusion of the lobar or segmental bronchus with the collapsed lung;4)solid changing type with gas & liquid sign of Mid & lower-lung(n=2):this expressed 2~3 gas & liquids sign inside.Conclusion: The episode of pulmonary tuberculosis presents a new tendency of the increasing incidence in the elderly.CR,DR,and CT findings are variable.Thus,a comprehensive analysis of all imaging features is necessary to avoid misdiagosis.