五酯胶囊预防抗结核药对肝功能损害疗效观察

目的观察五酯胶囊预防抗结核药物对肝功能损害的疗效。方法86例结核病患者在全程常规抗痨的同时,随机分为五酯胶囊治疗组和常规护肝对照组,6-12个月为一疗程,结束后分别统计并进行比较它们的临床症状、体征和肝功能变化情况。结果观察6-12个月,显示两组有显著性差异(P<0.05)。结论在全程常规抗痨的同时口服五酯胶囊,能有效地预防抗结核药物对肝功能的损害,无反弹现象,未见不良反应,具有较高的临床价值。     

On the 99mTc‐labeling of isoniazid with different 99mTc cores

Recent advances in the chemistry of radiolabeling with ^99mTc such as use of the ^99mTc tricarbonyl and ^99mTc–HYNIC cores have revived interest in ^99mTc‐labeling of small biomolecules and further investigation as potential radiopharmaceuticals. Isoniazid, a drug commonly used for treatment of tuberculosis, has been chosen for the present study. Three distinct strategies were utilized to radiolabel isoniazid with ^99mTc. In the direct labeling protocol, the hydrazino amide functional group of isoniazid was used for ^99mTc‐labeling in the HYNIC sense using tricine and EDDA as co‐ligands. The other strategies of ^99mTc‐labeling involved the derivatization of isoniazid to its N, N‐diacetic acid derivative, which in turn was either used as a tridentate ligand for labeling with the [^99mTc(CO)₃(H₂O)₃]⁺ synthon or directly labeled by the conventional route wherein ^99mTc is in the +3 oxidation state. The complexes prepared in >95% yields were characterized by paper chromatography, thin layer chromatography and HPLC. Comparison of the three approaches showed that maximum specific activity and stability was obtained in the ^99mTc–isoniazid derivative synthesized via the tricarbonyl method. However, in vitro cell‐binding studies indicated that none of the ^99mTc–isoniazid complexes prepared had any appreciable uptake in Mycobacterium tuberculosis. Copyright © 2005 John Wiley & Sons, Ltd.     

寡核苷酸表达谱揭示异烟肼耐药对结核分支杆菌致病性的影响

目的研究结核分支杆菌异烟肼耐药菌株与H37Rv异烟肼敏感菌株感染巨噬细胞后差异表达的基因. 方法利用高密度cDNA芯片检测巨噬细胞U937感染结核分支杆菌异烟肼耐药菌株与H37Rv后的基因表达谱的差异. 结果两者诱导巨噬细胞的差异表达基因有53条,异烟肼耐药菌株比敏感菌株诱导多种趋化因子和细胞免疫增强的细胞因子表达上调和免疫抑制细胞因子IL-10等表达下调. 结论异烟肼耐药对细菌毒力有明显的影响,异烟肼耐药菌株的致病力下降,异烟肼耐药菌株容易被宿主免疫系统清除;结果为耐多药结核病控制提供依据;骨桥接素和巨噬细胞趋化因子等,在抗异烟肼耐药结核分支杆菌感染免疫中的作用值得深入研究.     

2013～2018年安徽省老年肺结核疫情特征分析

目的分析2013～2018年安徽省老年肺结核疫情特征,为制定老年肺结核防治策略提供参考依据。方法采用描述性流行病学研究方法,分析2013～2018年安徽省老年肺结核患者疫情特征。结果 2013～2018年,安徽省活动性肺结核年平均登记率老年人高于全人群(χ~2=55. 061,P <0. 001);涂阳肺结核年平均登记率老年人高于全人群(χ~2=21. 840,P <0. 001),老年复治涂阳占全省复治涂阳的42. 42%(3 379/7 965);老年肺结核男女性别比为3. 32∶1;安徽省所辖16个市以亳州、铜陵、池州老年肺结核年平均登记率最高。结论安徽省老年肺结核疫情高于全人群,男性高于女性,亳州、铜陵、池州老年肺结核疫情重,需加强重点人群和重点地区的结核病防治工作。     

Drop‐offs in the isoniazid preventive therapy cascade among children living with HIV in western Kenya, 2015–2019

IntroductionIsoniazid preventive therapy (IPT) can reduce the risk of tuberculosis (TB) in children living with HIV (CLHIV), but data on the outcomes of the IPT cascade in CLHIV are limited.MethodsWe evaluated the IPT cascade among CLHIV aged <15 years and newly enrolled in HIV care in eight HIV clinics in western Kenya. Medical record data were abstracted from September 2015 through July 2019. We assessed the proportion of CLHIV completing TB symptom screening, IPT eligibility assessment, IPT initiation and completion. TB incidence rate was calculated stratified by IPT initiation and completion status. Risk factors for IPT non‐initiation and non‐completion were assessed using Poisson regression with generalized linear models.ResultsOverall, 856 CLHIV were newly enrolled in HIV care, of whom 98% ([95% CI 97–99]; n = 841) underwent screening for TB symptoms and IPT eligibility. Of these, 13 (2%; 95% CI 1–3) were ineligible due to active TB and 828 (98%; 95% CI 97–99) were eligible. Five hundred and fifty‐nine (68%; 95% CI 64–71) of eligible CLHIV initiated IPT; median time to IPT initiation was 3.6 months (interquartile range [IQR] 0.5–10.2). Overall, 434 (78%; 95% CI 74–81) IPT initiators completed. Attending high‐volume HIV clinics (aRR = 2.82; 95% CI 1.20–6.62) was independently associated with IPT non‐initiation. IPT non‐initiation had a trend of being higher among those enrolled in the period 2017–2019 versus 2015–2016 (aRR = 1.91; 0.98–3.73) and those who were HIV virally non‐suppressed (aRR = 1.90; 95% CI 0.98–3.71). Being enrolled in 2017–2019 versus 2015–2016 (aRR = 1.40; 1.01–1.96) was independently associated with IPT non‐completion. By 24 months after IPT screening, TB incidence was four‐fold higher among eligible CLHIV who never initiated (8.1 per 1000 person years [PY]) compared to CLHIV who completed IPT (2.1 per 1000 PY; rate ratio [RR] = 3.85; 95% CI 1.08–17.15), with a similar trend among CLHIV who initiated but did not complete IPT (8.2/1000 PY; RR = 4.39; 95% CI 0.82–23.56).ConclusionsDespite high screening for eligibility, timely IPT initiation and completion were suboptimal among eligible CLHIV in this programmatic cohort. Targeted programmatic interventions are needed to address these drop‐offs from the IPT cascade by ensuring timely IPT initiation after ruling out active TB and enhancing completion of the 6‐month course to reduce TB in CLHIV.     

氨茶碱针与二羟丙茶碱针治疗支气管哮喘疗效比较

目的观察氨茶碱针与二羟丙茶碱针对照治疗支气管哮喘的效果。方法对100例中老年哮喘患者分别使用氨茶碱针与二羟丙茶碱针治疗1h后疗效及3d后疗效、不良反应进行了观察、比较和统计。结果氨茶碱针对哮喘患者的显效时间比二羟丙茶碱针快,不良反应前者比后者多。结论氨茶碱针治疗支气管哮喘优于二羟丙茶碱针,但不良反应较多。临床应用应权衡利弊。     

外科治疗373例胸壁结核的临床分析

目的总结胸壁结核的诊断及手术治疗。方法回顾性分析我院30年胸壁结核共373例的临床资料。结果胸壁结核是胸壁软组织、肋骨和胸骨结核性感染的总称,早期诊断较困难,针吸活检对诊断帮助较大,手术治疗原则为：彻底清除病灶,消灭残腔,术后加压包扎,防止积液,促进伤口愈合。结论外科手术治疗胸壁结核疗效肯定,治愈率高。     

复方甘草酸苷对抗结核药物性肝损害的疗效观察

目的观察复方甘草酸苷对抗结核化疗而引起的药物性肝损害的疗效。方法87例初治菌阳肺结核患者随机分为观察组和对照组,均应用“2H3R323E3（S3）／4H3R3”方案抗结核化疗,观察组加用复方甘草酸苷,对照组加用肝泰乐。结果观察组在肝功能改善方面优于对照组（P〈0．05）;观察组与对照组总有效率分别89．4％、67．5％、（P〈0．01）。结论复方甘草酸苷可显著降低初治菌阳肺结核患者的抗结核药物性肝损害,减少因抗结核药所致肝损害而造成的不规则化疗。     

CT影像与X线影像对肺结核疗程判定的对比分析

目的探讨CT影像在肺结核疗程中的诊断价值。方法选择继发型肺结核和胸膜炎者127例,在标准疗程结束时做影像检查,根据CT结果延长疗程3个月至1年不等,全疗程结束时作胸片及CT对比。结果X线显示可以结束疗程者,经CT检查病变仍有活动性者65例。结论CT检查对肺结核痊愈期判定明显优于X光片。     

Ag85b-卡介苗重组疫苗的构建及鉴定

目的构建结核分枝杆菌Ag85b-卡介苗重组疫苗,研究其免疫原性及抗结核作用,以期获得结核病预防性和治疗性疫苗。方法通过基因工程重组技术将结核分枝杆菌保护性抗原Ag85b的编码基因与穿梭质粒载体pYUB295重组,通过电穿孔技术导入卡介苗中,应用PCR扩增、PAGE电泳鉴定重组卡介苗。结果通过PCR扩增获得Ag85b基因,与穿梭表达载体pYUB295重组后,通过PCR扩增、限制性内切酶酶切、DNA测序鉴定表明成功地构建了Ag85b基因pYU295重组质粒。将重组质粒通过电穿孔导入卡介苗,重组卡介苗在抗性培养基上生长良好。pYUB295-Ag85b重组卡介苗基因组DNA的PCR扩增以及培养上清液的PAGE电泳表明：Ag85b-卡介苗重组疫苗构建正确,Ag85b蛋白在卡介苗中分泌表达。结论成功构建了Ag85b-卡介苗重组疫苗。