2006年正阳县结核病人发现与治疗管理情况分析

目的分析2006年正阳县结核病人发现与治疗管理情况,为上级业务主管部门和政府部门的决策提供科学依据。方法方法根据正阳县疾控中心2006年结核病控制工作上报数据。结果 2006年共登记肺结核病人675例,死亡22例,发病率为88.63/10万,共登记涂阳病人337例,其中新发涂阳病人312例,完成全年任务的111.03%（312/281）,新涂阳病人登记率40.97/10万（312/761556）,涂阳病人平均治愈率88.72%,达到了《结核病防治规划（2001-20100）》的要求,其中初治涂阳治愈率89.42%,复治涂阳治愈率80.00%,二者没有显著的统计学意义（x2=2.05,P〉0.05）。结论实现了《正阳县结核病防治规划（2001-20100）》年度目标,但结核病疫情仍十分严峻,要采取切实可行的现有手段与措施,并且及时探索新的技术与方法,确保新涂阳病人发现工作,提高病人治疗的依从性,进一步提高病人的治愈率。     

我为什么那样害怕结核病?

《心理与健康》编辑部: 我是国家机关的干部,现年48岁。10年前机关为干部进行体检时,和我在一起办公的一位同志被查出有结核病,我因此而发生了恐惧。 开始时,害怕传染结核病,我有意识地回避有结核病的人。只要自己不注意碰到病人的手则马上用自来水冲洗,或用酒精擦。后来,正巧邻居也有人患了结核病,更加重了我的恐惧心理。只要见到     

2006年正阳县结核病人发现与治疗管理情况分析

目的 分析2006年正阳县结核病人发现与治疗管理情况,为上级业务主管部门和政府部门的决策提供科学依据.方法 方法根据正阳县疾控中心2006年结核病控制工作上报数据.结果 2006年共登记肺结核病人675例,死亡22例,发病率为88.63/10万,共登记涂阳病人337例,其中新发涂阳病人312例,完成全年任务的111.03%(312/281),新涂阳病人登记率40.97/10万(312/761556),涂阳病人平均治愈率88.72%,达到了<结核病防治规划(2001-20100)>的要求,其中初治涂阳治愈率89.42%,复治涂阳治愈率80.00%,二者没有显著的统计学意义(x2=2.05,P>0.05).结论 实现了<正阳县结核病防治规划(2001-20100)>年度目标,但结核病疲情仍十分严峻,要采取切实可行的现有手段与措施,并且及时探索新的技术与方法,确保新涂阳病人发现工作,提高病人治疗的依从性,进一步提高病人的治愈率.     

县区级结核病防治机构信息化管理初探

目的探索县区级结核病防治机构信息化管理模式,提高基层结核病控制工作质量。方法运用计算机和网络技术,根据县区级结核病防治机构工作管理流程,研制开发系统管理软件并实际应用。结果县(市、区)级结核病防治管理信息系统软件运行稳定,达到县区级结核病防治机构工作管理要求。结论县区级结核病防治机构信息化管理,可以完全替代并优于传统管理模式,对提高基层结核病控制工作质量意义重大。     

河源市源城区外来人口肺结核流行现状分析

目的了解源城区外来人口结核病疫情现状，探讨外来人口结核病管理的有效对策。方法分析2002—2006年源城区外来人口肺结核病人的发病情况、患病情况及治疗效果等。结果2002—2006年外来人口肺结核就诊和发现人数逐年增多。登记涂阳病人118例．占常住人口涂阳肺结核病人登记的24．7％；男女比例为3．58：1，发病年龄高峰期为20～39岁；体力劳动者、文化程度低者为主要患病人群；涂阳患者治愈率95％，涂阴患者规则治疗率仅66％。结论外来人口结核病人治疗、管理工作已成为河源市结核病控制工作的重点和难点。根据外来人口肺结核发现和患病特点，制定适宜的治疗管理措施，提高病人的发现率和治愈率是达到结核病防治规划目标的关键。     

江汉油田矿区近3年肺结核病人家属结核病防护现状

目的 调查江汉油田矿区肺结核病人家属对结核病防护情况.方法 用自制问卷对近3年收治的113例肺结核病人家属进行了结核病防护相关知识的调查.结果 调查人群对结核防护的知晓率因其年龄、职业和文化程度的不同而异.调查对象在15-49岁年龄组中结核病防护的知晓率与50岁以上年龄组的调查对象相比有一定的差异(p＜0.05),脑力劳动者与体力劳动者,大专或以上文化程度与小学文化程度的调查对象的结核病防护的知晓率有显著性差异(p＜0.01).结论 加强肺结核病人家属的健康教育,应充分考虑目标人群教育的适宜性,特别是对受教育较少、社会地位较低的目标人群,提供个体化健康教育,以提高其结核病防护的知晓率,减少结核病的蔓延.     

泉州市2005-2010年涂阳肺结核病人来源情况分析

目的了解涂阳肺结核病人来源分布情况,为进一步提高涂阳肺结核病人发现水平提供理论依据。方法收集2005-2010年泉州市涂阳肺结核病人的来源资料,对病人的来源情况进行综合分析。结果 2005-2010年泉州市共发现涂阳肺结核病人16976例,其中转诊占64.7%,就诊占34.2%,因症推荐占0.5%,其他途径占0.6%,转诊与就诊已成为结防机构门诊初诊病人的主要来源,占全部涂阳病人的98.9%,转诊途径发现的涂阳病人与其他来源比较差异有统计学意义（χ2=1022.0,P〈0.01）;转诊病人中涂阳病人检出率为30.0%,涂阳检出率明显高于其他3种来源的检出率,差异有统计学意义（χ2=3320.8,P〈0.01）。结论医院转诊已成为泉州市发现涂阳肺结核病人的重要来源。落实结核病归口管理,加强医防合作,提高转诊到位率等是实现结核病防治规划中涂阳病人＂高发现＂目标的有效措施。     

汝南县涂阳肺结核病人发现治疗管理情况分析

目的分析汝南县结核病控制项目(2004～2005年)阶段性效果。方法对2004～2005年项目执行情况中的涂阳肺结核病人治管资料进行汇总分析。结果全县加强了以DOTS策略为主的结核病综合防治措施。涂阳肺结核病人发现和治疗管理水平逐年提高,两年共接诊可疑结核病症状者5842例,治管活动性肺结核患者1428例,其中涂阳肺结核患者652例,新涂阳肺结核患者542例,涂阳肺结核病人治愈率达92.14%。结论汝南县涂阳肺结核病人治管取得满意效果,但存在病人发现水平不均衡,对项目病人督导管理力度不大等问题,应继续扎扎实实地执行DOTS策略,对乡、村两级防痨人员进行结防知识培训,提高正阳县结核病防治工作的整体水平。     

结核病化学疗法的进展

近一二十年来,由于有效抗结核药物问世及结核病化学疗法的不断改进,使结核病防治工作中的作用发生根本性的转变。结核病化疗中较为突出的进展有:药物服用方法由分次服用发展为顿服;治疗方式由每日用药发展为间歇治疗和两阶段治疗;疗程由长程发展为短程化疗等。这些进展在提高结核病化疗的疗效、减少药物不良反应、方便病人     

牛分枝杆菌mpb64基因在Vero细胞中的瞬时表达

牛结核病作为一种严重的人畜共患病已越来越受到人们的重视，尽管大多数国家不提倡用疫苗来预防牛结核病，但由于牛结核病病原体牛分枝杆菌与结核杆菌基因组同源性高达99％以上，因此研制针对牛结核病的DNA疫苗对于牛结核病的预防和开发人结核病新型疫苗无疑具有重要的意义。     

淮南市高校学生结核病知识知晓率调查与分析

目的 了解淮南市高校学生结核病防治知识知晓情况和宣传情况,为下一步的结核病知识宣传提供理论和实践依据。方法 自主设计调查问卷,按照随机、整群抽样的原则进行问卷调查,使用EpiData3.1软件录入数据,SPSS19.0软件进行统计学分析。结果 结核病知识总知晓率50.23%,知晓率与生源地、专业、学历相关（P＜0.05）。未接受过结核病知识宣传的学生为60.91%,55.04%的学生希望宣传者为医务工作者。结论 淮南市高校学生结核病知识知晓率较低,未来需加强普及结核病相关知识,提高知晓率,减小结核病发病率及传染率。     

Materials management with a bar code reader

A materials management system capable of inventory control, accounting and the automatic recording of supplies for a clinical department has been developed for the George Washington University Hospital Department of Anesthesia. This system combines a microprocessor-based computer for data storage and a hand-held bar code reader to record the bar code scan of each item in the inventory. A relational software program with easy-to-use menus and help keys was written. Bar code information stored for each item includes item number, quantity, date and time of issue. Accumulated bar code scans are loaded into the computer by use of a serial port and then used to update current inventory in the computer. Comparison between current inventory and reorder levels by the computer will initiate automatic printing of appropriate purchase orders. Reorder levels are adjusted regularly, by comparing previous year or month usage to current needs; items already on order, items on back order and delivery lag time are also taken into account.     

Proteomic analysis of sputum in patients with active pulmonary tuberculosis

The protein composition of sputum most faithfully reflects the state of the lungs. The aim of this study was to determine whether relative qualitative and quantitative differences in protein expression of sputum could be related to active pulmonary tuberculosis. Sputum samples were collected from 65 patients with active pulmonary tuberculosis and 38 healthy controls. Comprehensive proteomic approaches were used to profile the proteome changes of host sputum in response to Mycobacterium tuberculosis infection using two-dimensional electrophoresis in combination with matrix-assisted laser desorption ionization time-of-flight/time-of-flight mass spectrometry. Mascot software was used to identify proteins from protein databases. Enzyme-linked immunosorbent assay was used to confirm the proteomic results. A total of 62 differentially expressed proteins were identified, among which, 15 proteins were up-regulated and 47 proteins were down-regulated in the tuberculosis sputum compared with the controls. Bacterial protein UqhC was the most increased protein, whereas serum albumin was the most decreased protein in the tuberculosis sputum compared with the controls. The enzyme-linked immunosorbent assay analysis was consistent with proteomic data. Bioinformatics analysis suggested that multiple host cell pathways were involved in the tuberculosis infection processes, including acute phase response, signal transduction, cytoskeleton structure, immune response and so on. In all, for the first time, our results revealed that a number of proteins were differentially expressed during active pulmonary tuberculosis infection. These data will provide valuable clues for further investigation of tuberculosis pathogenesis and biomarkers for detection of active pulmonary tuberculosis infection.     

Evaluating the usefulness of computerized adaptive testing for medical in-course assessment.

PURPOSE: This study investigated the feasibility of converting an existing computer-administered, in-course internal medicine test to an adaptive format. METHOD: A 200-item internal medicine extended matching test was used for this research. Parameters were estimated with commercially available software with responses from 621 examinees. A specially developed simulation program was used to retrospectively estimate the efficiency of the computer-adaptive exam format. RESULTS: It was found that the average test length could be shortened by almost half with measurement precision approximately equal to that of the full 200-item paper-and-pencil test. However, computer-adaptive testing with this item bank provided little advantage for examinees at the upper end of the ability continuum. An examination of classical item statistics and IRT item statistics suggested that adding more difficult items might extend the advantage to this group of examinees. CONCLUSIONS: Medical item banks presently used for incourse assessment might be advantageously employed in adaptive testing. However, it is important to evaluate the match between the items and the measurement objective of the test before implementing this format.     

Identification of a Promiscuous T-Cell Epitope in Mycobacterium tuberculosis Mce Proteins

The characterization of Mycobacterium tuberculosis antigens inducing CD4(+) T-cell responses could critically contribute to the development of subunit vaccines for M. tuberculosis. Here we performed computational analysis by using T-cell epitope prediction software (known as TEPITOPE) to predict promiscuous HLA-DR ligands in the products of the mce genes of M. tuberculosis. The analysis of the proliferative responses of CD4(+) T cells from patients with pulmonary tuberculosis to selected peptides displaying promiscuous binding to HLA-DR in vitro led us to the identification of a peptide that induced proliferation of CD4(+) cells from 50% of the tested subjects. This study demonstrates that a systematic computational approach can be used to identify T-cell epitopes in proteins expressed by an intracellular pathogen.     

Leukocyte migration inhibition in bacillus Calmette-Guérin vaccinated healthy adults and in tuberculosis assayed by a rapid photoelectric procedure

A sensitive photoelectric method was used for reading migrations of human peripheral blood leukocytes from agarose microdroplets. Its rapidity enabled the use of a wide range (12 logs) of in vitro concentrations of antigen. Inhibition of migration of leukocytes (LMI) of healthy subjects having had BCG vaccination in childhood was found to occur in two zones of PPD concentrations, one high, from 10(-1) to 1000 micrograms/ml with a peak at 100 micrograms/ml, and one low, from 10(-8) to 10(-2) micrograms/ml. While three-fifths of subjects showed high zone LMI, in one-fifth it was bizonal and in another fifth observed only in the low zone. In patients with active pulmonary tuberculosis LMI, prior to all treatment, was reduced, absent, or replaced by enhanced migration, particularly in the low zone or in both zones. One and a half to four months after treatment LMI was found to be bizonal, enhanced migration having disappeared. These observations suggest the participation of two cell populations with widely different sensitivity to PPD in LMI in tuberculous and BCG vaccinated subjects and the presence of migration stimulatory lymphokine(s) during active tuberculosis.     

Fluorescent nanoparticle-based indirect immunofluorescence microscopy for detection of Mycobacterium tuberculosis

A method of fluorescent nanoparticle-based indirect immunofluorescence microscopy (FNP-IIFM) was developed for the rapid detection of Mycobacterium tuberculosis. An anti-Mycobacterium tuberculosis antibody was used as primary antibody to recognize Mycobacterium tuberculosis, and then an antibody binding protein (Protein A) labeled with Tris(2,2-bipyridyl)dichlororuthenium(II) hexahydrate (RuBpy)-doped silica nanoparticles was used to generate fluorescent signal for microscopic examination. Prior to the detection, Protein A was immobilized on RuBpy-doped silica nanoparticles with a coverage of approximately 5.1 x 10(2) molecules/nanoparticle. With this method, Mycobacterium tuberculosis in bacterial mixture as well as in spiked sputum was detected. The use of the fluorescent nanoparticles reveals amplified signal intensity and higher photostability than the direct use of conventional fluorescent dye as label. Our preliminary studies have demonstrated the potential application of the FNP-IIFM method for rapid detection of Mycobacterium tuberculosis in clinical samples.     

Measurement of the tissue distribution of immunoperoxidase staining with polyclonal anti-BCG serum in lung granulomata of mice infected with Mycobacterium tuberculosis.

Mice inoculated with Mycobacterium tuberculosis, strain H37Rv were used as a model of human tuberculosis. The microanatomical location of immunoperoxidase staining with a polyclonal anti-BCG serum was within macrophages and appeared granular rather than delineating whole bacilli. Immunoperoxidase staining appears to demonstrate degraded mycobacterial antigens from disrupted organisms and so reflects prior turnover of bacilli. On Ziehl-Neelsen staining, intact or almost intact bacilli are seen and so the extent of this form of staining reflects the current bacillary load. Both methods have limited sensitivity, but with larger mycobacterial loads the area of immunoperoxidase stain measured on a semi-automated image analyser correlated with the numbers of bacilli observed. The immunoperoxidase method will be useful in the evaluation of residual antigen in studying the pathogenesis of experimental murine tuberculosis. In human mycobacterial granulomata, this immunohistochemical technique should provide an alternative method of estimating the extent of bacillary load: this approach may also provide evidence of mycobacterial infection from residual antigen deposits in the tissue when whole bacilli have been successfully cleared.     

Use of magnetic beads for tissue DNA extraction and IS6110 Mycobacterium tuberculosis PCR.

Polymerase chain reaction (PCR) techniques are used increasingly for the diagnosis of Mycobacterium tuberculosis infection and can be used on the DNA obtained from both frozen and formalin fixed, paraffin wax embedded tissues. However, the extraction of DNA by means of the conventional phenol/chloroform method is time consuming and requires the use of potentially dangerous chemical reagents. This paper describes a method based upon the use of magnetic beads for the extraction of M tuberculosis DNA from both routinely formalin fixed, paraffin wax embedded tissues and frozen tissues. Magnetic bead extracted DNA from brain, lymph node, and lung tissues collected from patients with human immunodeficiency virus and tuberculosis was compared with that extracted using the phenol/chloroform method. The magnetic bead extraction procedure requires less than two hours, including the time necessary to dewax the tissue sections. In all cases, the DNA extracted with both methods was amplified successfully by PCR for the M tuberculosis IS6110 sequence. Magnetic bead DNA extraction can be used on both frozen and archival tissues: the method is reliable, simple, sensitive, and rapid; in addition, it does not use hazardous procedures or specialised laboratory equipment and can be used for routine DNA isolation from various human tissues.