Dural infolding during C1-2 myelography

Inward buckling of the dura at C1-2 may occasionally occur with hyperextension of the neck and can result in a difficult or unsuccessful puncture when the posterior lateral C1-2 approach is used for cervical myelography. In this circumstance, placement of the head in a neutral or slightly flexed position may widen the posterior subarachnoid space and facilitate the needle puncture.     

实施现代结核病控制策略对传染性肺结核患者发现与治疗效果的影响

目的：分析实施DOTS策略对传染性肺结核病例发现与治疗效果的影响。方法：通过对1995—2000年分批实施的卫生部加强与促进结核病控制项目、WHO西太区结核病控制项目及福建省结核病控制项目资料进行分析。结果涂阳病例新登记率由1995年的6．3／10万提高到2000年的19．0／10万，涂片阳性占活动性病例比例由21．5％提高到37．4％，新发涂阳病例治愈率由80．7％提高到89．2％，病例丢失率由7．3％下降到2．7％，治疗失败率由6．9％下降到1．4％。流动人口传染性肺结核病例治愈率仅59．7％。结论：实施DOTS策略，重视流动人口结核病治疗管理，提高涂阳病例发现率、治愈率，减少病例丢失和治疗失败，有效控制结核病。     

龙岩市1995～2000年涂阳肺结核病人随访研究

目的：分析福建省龙岩市结核病控制五年效果。为结核病控制可持续发展提供技术政策依据。方法：收集并分析1995年-2000年福建省龙岩市肺结核月报表和年报表及有关资料，采用队列分析方法对登记治疗管理的初，复治涂阳肺结核病人进行分析。结果：1995年-2000年涂阳肺结核病人发现率从4.9/10万上升到22.7/10万；初治涂阳治愈率从63.4%上升到95.8%；复治涂阳病人治愈率从50%上升到85.6%。结论：涂阳肺结核病人的高发现率和高治愈率是因为1999年开始实施结核病归口管理和DOTS策略，应以持续发燕尾服。     

涂阳肺结核病人发现程序的探讨

目的　探索高发现、操作简便、成本低的病人发现程序。方法 山东省2000年结核病流行病学抽样调查资料。结果 在1715例同时胸透和痰涂片检查的可疑肺结核症状者中,发现涂阳肺结核病人51例,其中胸透诊断正常者15例。结论 对可疑肺结核症状者必须全部查痰。     

Antiretroviral therapy in prevention of HIV and TB: update on current research efforts

There is considerable scientific evidence supporting the use of antiretroviral therapy (ART) in prevention of human immunodeficiency virus (HIV) and tuberculosis (TB) infections. The complex nature of the HIV and TB prevention responses, resource constraints, remaining questions about cost and feasibility, and the need to use a solid evidence base to make policy decisions, and the implementation challenges to translating trial data to operational settings require a well-organised and coordinated response to research in this area. To this end, we aimed to catalogue the ongoing and planned research activities that evaluate the impact of ART plus other interventions on HIV- and/or TB-related morbidity, mortality, risk behaviour, HIV incidence and transmission. Using a limited search methodology, 50 projects were identified examining ART as prevention, representing 5 regions and 52 countries with a global distribution. There are 24 randomised controlled clinical trials with at least 12 large randomised individual or community cluster trials in resource-constrained settings that are in the planning or early implementation stages. There is considerable heterogeneity between studies in terms of methodology, interventions and geographical location. While the identified studies will undoubtedly advance our understanding of the efficacy and effectiveness of ART for prevention, some key questions may remain unanswered or only partially answered. The large number and wide variety of research projects emphasise the importance of this research issue and clearly demonstrate the potential for synergies, partnerships and coordination across funding agencies.     

A proposal for applying molecular markers as an aid to identifying potential cases of imported tuberculosis in immigrants

In recent years, the percentage of tuberculosis (TB) cases in immigrants in Spain has increased markedly. In this context, discrimination between cases with potentially imported TB and cases likely to have acquired it by recent transmission after arrival is a basic issue. In this study, we evaluated molecular markers to obtain information on the geographic origin of Mycobacterium tuberculosis (MTB) strains and to determine whether they could help to identify imported TB cases. We analyzed the pks15/1 gene, spoligotype, and MIRU locus 24 in 168 MTB isolates from immigrants of 32 nationalities and from a selection of autochthonous cases. In non-Asian immigrants we could not detect major differences with the autochthonous cases. For the Asian cases, we found some specific features for these markers. pks15/1 was intact in 69% of the Asian patients, but this gene had a 7-bp deletion in all non-Asian and Spanish (non-Beijing) cases. The spoligotype-defined lineages EAI and CAS, and the allele with two repetitions in MIRU locus 24 was found exclusively among Asian immigrants. The analysis of certain bacterial molecular markers could help to discriminate between potentially imported TB cases and those more probably acquired in the host country.     

中国结核病控制-日本援助项目安徽省实施性研究

目的　了解我省项目工作的现状及项目工作对我省结防工作的影响。方法　根据 2 0 0 2～ 2 0 0 3年《中国结核病控制工作季报表》和《结核病人登记调查表》 ,分析项目病人的发现、治疗等情况。结果　 2 0 0 3年项目地区肺结核、涂阳肺结核登记率分别为 5 3 .4/10万、2 0 .0 /10万 ,分别高于非项目地区 44 .7%、10 0 % ;2 0 0 2年项目地区涂阳肺结核病人治愈率 78.5 % ,明显高于非项目地区。结论　项目工作取得了显著成果 ,为我省其它地区实施项目工作提供了经验 ,为我省结核病控制工作的可持续发展打下了基础。