Clinical comprehensive evaluation of recombinant Mycobacterium tuberculosis fusion protein / 中国药房

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

Prediction and analysis of T-cell and B-cell epitopes of Mycobacterium tuberculosis Rv2657c protein / 实用医学杂志

Objective To predict the epitopes of Mycobacterium tuberculosis Rv2657c protein, to understand its immunogenicity Methods The T?cell and B?cell epitopes of Mycobacterium tuberculosis Rv2657c protein were predicted by DNAStar software package. The homology of Rv2657c amino acid sequence with the human protein sequences was prepared using Blast method, then the CTL epitopes were predicted using SYFPEITHI supermotif method, BIMAS quantitative motif method and NetCTL prediction method, and the Th epitopes were predicted by RANKPEP and SYFPEITHI supermotif prediction method. Results The prediction using DNAStar software package showed that Rv2657c protein had 5 B?cell epitopes and 6 T?cell epitopes. The protein had 6 CTL epitopes and there were 38 Th epitopes. Conclusion Rv2657c protein has both B?cell epitopes and T?cell epitopes. It may be a candidate target antigen for the studies of vaccine and diagnosis of tuberculosis.

A case of arthritis, fever, and hemophagocytic syndrome / 中华风湿病学杂志

Objective To explore the diagnostic and differential diagnostic points of patients with rheumatoid arthritis (RA) complicated with fever.Methods Full clinical analysis was performed for a 62-year old patient with RA and fever.Results Hemophagocytes were found in bone marrows smear.Significantly increased ferritin level (74 299 ng/ml),decreased hemoglobin (67 g/L) and platelet (33×109/L),decreased fibrinogen,increased serum soluble CD25 (sCD25),positive cytomegalovirus (CMV) DNA,positive CMV-PP65 antigen,were found by laboratory examination.Decreased activity of NK cells was detected by flow cytometry.Positron emission computed tomography (PET-CT) revealed splenomegaly and pulmonary inflammations.The clinical conditions were recovered with the treatment of corticosteroid,VP16,cyclosporine,anti-CMV virus therapy.Ferritin level was significantly decreased and platelet was normal.The patient was diagnosed as hemophagocytic syndrome associated with CMV infection.Conclusion The possibility of hemophagocytic syndrome should be considered in RA patients presented with fever.

Treating refractory tuberculous hydropertcardium by ultrasonography guided drainage tube beneath xiphoid / 中华超声影像学杂志

Objective To evaluate the effectiveness of real time ultrasound guided drainage tube placing under xiphoid. Methods Fifty-one eases of hydropericardium were refractory to traditional therapy.They were used the systemic chemotherapy regime composed of amikacin, levofloxaein aminosalicylate beside other one or two anti-tuberculosis drug never used before, placing drainage tube beneath xiphoid for periodic draining and infusing regime of isoniazide rifampine and dexamthasone. The average course was 3 months.Results All the 51 cases underwent a successful pericardium puncture without any complications. The rainage tubes were placed for 21 to 60 days with mean of (32 ± 3) days; drainage volume range from 1700 to 3800 ml,mean was (2400 ± 55)ml. All the patient showed clinical improvement, complete absorption of hydroperieardium, no constrictive periearditis occurred. Conclusions Ultrasound guided pericardium puncture and drainage tube placing is safe without hurting myoeardium. Indwelled tube this way facilitate sustained eomplete drainage lavage and drug infusing, and its effectiveness is reproducible.

Low mechanical index contrast-enhanced sonographic findings of hepatic tuberculosis / 中华超声影像学杂志

Objective To investigate the appearance and characteristics of hepatic tuberculosis lesions on low mechanical index contrast-enhanced ultrasound. Methods Eight patients with hepatic tuberculosis lesions were studied with conventional ultrasound and contrast-enhanced ultrasound. Lesions,distribution.size,echogenieity,blood flow,enhancement phase,enhancement patterns and intensity were studied. ResuIts Fifteen lesions were found in eight patients. On conventional ultrasound,mean size of the lesions was(21.7±10.7)mm×(30.3±22.4)mm,and 66.7%(10/15)lesions located under liver capdule,and 33.3%(5/15)were in hepatic parenchyma.All lesions were hypoechoic except the largest one (50 mm x 102 mm)which demonstrated heterogeneous.Doppler signals were not demonstrated in all 15 lesions.After administration of SonoVue,satisfied image data were obtained in 13 lesions for aterial phase,and 15 lesions for portal venous phase and parenchyma phase.84.6%(11/13)of the lesions demonstrated hyperenhancing on aterial phase,mean enhancing start time was(8.6±1.6)s,ranging from 5 s to 10 s.and mean enhancing end time was(25.6±2.8)s,ranging from 20 s to 29 s. Of 13 lesions,6 lesions demonstrated circle periphery hyper-enchanCement,5 lesions demonstrated whole hyper-enchancement,and 2 lesions appeared hypoenhancement on arterial phase. All lesions demonstrated either hypoenhancing or non-enhancement on portal venous phase and parenchyma phase. Conclusions Low mechanical index contrast-enhanced ultrasound can reveal the blood flow status of hepatic tuberculous lesions and will facilitate the diagnosis of hepatic tuberculosis.

Relationship of inflammatory factors in blood serum and immune status of patients with active pulmonary tuberculosis / 第三军医大学学报

Objective To investigate the changes of inflammatory factors in the blood serum and their relationship with the immune status of patients with active pulmonary tuberculosis(TB).Methods A total of 97 cases of pulmonary tuberculosis were included from Feb 2003 to Oct 2005,57 of active TB,40 in resting period.Another 41 healthy people were used as normal control.ELISA and APAAP method were used to detect the level of TNF-?, IL-1,IL-6 and the changes of CD_(4),CD_(8)and CD_(4)/CD_(8).Results The levels of IL-1,IL-6,TNF-? were(15.3?1.3),(80.5?7.3) and(77.2?9.8) ng/ml in the normal controls,(33.7?3.6),(293.6?30.5) and(190.7?25.2) in the patients of active TB,and(18.2?2.1),(130.7?14.5),(87.5?10.2) ng/ml in the patients at resting period,which were highest in the patients of active TB.The ratio of CD_(4)and CD_(4)/CD_(8) was(32.3?2.9)% and(0.83?0.17) in the patients of active TB,lower than(48.2?4.4)% and(0.83?0.17) of normal controls.Conclusion The increase of inflammatory factors and decrease of immune activity were the clinical characteristic of patients with active pulmonary tuberculosis,which are of inverse relationship.

Activity of Pyrazinamide Gel Against Mycobacterium Tuberculosis in Vitro and Eva luation of Its Security / 中国药房

OBJECTIVE:To observe the activity of Pyrazinamide gel against Mycob ac terium tuberculosis in vitro and its security in bronchial interventional therap y METHODS:The MIC and MBC of Pyrazinamide and Pyrazinamide gel were measured b y handwork method and instrument method and secuity of Pyrazinamide gel was asse ssed by bronchial interventional therapy in rabbits RESULTS:The MICs of pyrazi namide gel to M tuberculosis H37 RV,M bovis and M phlei were 1mg/L,1mg/L,1 0mg/L,the MBCs of Pyrazinamide gel to M tuberculosis H37RV,M bovis and M ph lei were 10mg/L,10mg/L,40mg/L respectively;the MIC and MBC of Pyrazinamide gel and those of Pyrazinamide had no significant differences;the animal security ex periment was negative CONCLUSION:These results suggest that Pyrazinamide gel a nd Pyrazinamide have the same efficacy against M tuberculosis,because carbomer dose not affect the activity of Pyrazinamide against M tuberculosis;Pyrazinami de gel which contains carbomer is safe in bronchial interventional therapy

OBSERVATION OF CURATIVE EFFECT IN THE NEAR FUTURE OF 124 CASES WITH MULTI DRUG RESISTANT PULMONARY TUBERCULOSIS / 解放军医学杂志

The curative effect on 124 cases with multi drug resistant pulmonary tuberculosis from January 1996 to June 1999 was reported.All the cases, with an average history of 5.84 years, were recurrent ones. They included 78 cases of infultative pulmonary tuberculosis,46 cases of chronic fibrocavitative pulmonary tuberculosis. Sputum of all the cases was cultured for Mycobacterium hominis tuberculosis with Kuang`s culture medium and drug susceptibility test was done. As a result, the drug resistant rate to 2 drugs, 3 drugs,4 drugs, 5 drugs and more were 20.16%,25.0%,20.9%,33.72% respectively.The authors added 1～2 kinds of anti TB drugs never used before in each case to KOP (Kanamycin, Ofloxacin, Sodium Aminosalicylate),with a mean 3.3 months treating course. The sputum negative conversion rate was 66.9%,foci absorption rate was 72.6%, cavity close up 50.0% . There wasn′t any serious adverse effect encounted. It suggest that KOP synergetic bacteriocidal to Mycobacterium tuberculosis either inside or outside cells, with fewer side effect, is a good regimen for multi drug tuberculosis treatment.

CLINICAL OBSERVATION ON 60 CASES OF PULMONARY TUBERCULOSIS WITH SPUTUM M. TUBERCULOSIS NEGATIVE AND L-FORM OF M. TUBERCULOSIS POSITIVE / 解放军医学杂志

To study the clinical feature of pulmonary tuberculosis with sputum M. tuberculosis negative and L form of M. tuberculosis positive, the sputum of 204 patients with pulmonary tuberculosis with negative smear and culture results was cultured for L form of M. tuberculosis. A comparative study of major clinical manifestations, X ray, and therapeutic effect was carried out in 60 cases of L form positive and 144 cases of L form negative pulmonary tuberculosis. The detection rate of L form positive in patients with pulmonary tuberculosis was 29 4%. The incidence of caseous lesion and cavitation in the L form positive patients was higher than those with L form negative, and the incidence of focal absorption was higher in L form negative patients than those with L form positive. The existence of L form of M. tuberculosis suggested activity of the tuberculous lesion. The treatment of pulmonary tuberculosis must be persisted with a reasonable regimen with whole therapeutic period until L form of M. tuberculosis is eliminated from sputum.