Journal of Tuberculosis and Lung Disease

To attach importance to the application of information technology to promote tuberculosis prevention and control

Sheng-yuan LIU,Wei-guo TAN,Ya-rui YANG,Hong-yun GUAN,Jun-hao SHAO,Min-min ZHU,Xu-jun GUO,Wei-ye YU

Journal of Tuberculosis and Lung Health. 2018, 7(1): 3-8. doi:10.3969/j.issn.2095-3755.2018.01.002

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The new era of Internet + Medical is emerging, and internet technology is gradually applied in the field of tuberculosis (TB) prevention and control, which provides a solid technical support for TB mobile medical care. A number of studies show that the application of fixed-line video telephony technology, computer equipment network video technology, website platform, public information resource bank, short message service/voice techno-logy, application (APP), global positioning system (GPS), electronic medicine box technology, laboratory information system (LIS), geographic information system (GIS), hospital information system (HIS) and other internet technologies in the field of TB prevention and control plays an active role in realizing the reasonable distribution of medical resources, improving the working efficiency of medical staff and optimizing the diagnosis and treatment of patients. The author teases out the literature report on the application of internet technology in the field of TB prevention and control, and carries on related elaboration, to provide reference for the Internet + TB prevention and control research in China.

Preliminary analysis of survey on mobile phone usage and video supervision willingness of residents in Longhua District of Shenzhen City

Keng LAI,Xin ZHANG,Xiao-ping TAN,Bing-chan ZHOU,Nian-sha ZHANG,Qiu-zi CHEN,Hong-xia FANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 9-14. doi:10.3969/j.issn.2095-3755.2018.01.003

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Objective To analyze the mobile phone usage and video supervision willingness of residents in Longhua District of Shenzhen City.Methods The convenience sampling method was applied to extract 3 sampling sites (including Longhua Center for Chronic Disease control, in-patients Department of Respiratory Medicine in Longhua District Central Hospital and industrial park) in Longhua District of Shenzhen City, and 465 inhabitants (including 134 suspected pulmonary tuberculosis patients, 75 inpatients in the Department of Respiratory Medicine and 256 healthy workers in the industrial park) were taken as survey objects from January to February 2017. Data on demographic characteristics, mobile phone usage, mobile network usage and tuberculosis medication supervision were collected and analyzed.Results A total of 465 questionnaires were issued. Twenty seven questionnaires were excluded due to missing items or errors, and 438 were finally included. The efficiency of the questionnaire was 94.2%. 98.6% (432/438) of the respondents had smartphones, 95.2% (417/438) were able to surf the internet, 93.4% (409/438) applied Wechat, and 75.3% (330/438) kept their phones online at all times. By subgroup analysis by education background, the proportions of capacity of 16G and above, the usage rate of smartphones able to surf the internet and the usage rate of Wechat were 63.2% (115/182), 91.2% (166/182) and 88.5% (161/182) in the group of junior middle school and below, 75.2% (94/125), 97.6% (122/125) and 96.8% (121/125) in the group of high school, and 84.0% (110/131), 98.5% (129/131) and 96.9% (127/131) in the group of college and above, respectively. With the increase in the level of education, the proportions were increasing (the trend $χ trend 2$ were 16.97, 9.50 and 9.75, respectively, and the P values were <0.01, 0.002 and 0.002, respectively). 68.9% (302/438) residents were willing to video medication way (taking multi-day medication and shooting the daily medication video). In terms of medication reminder, 77.4% (339/438) residents were willing to receive a daily medication reminder text by Wechat, and only 69.2% (303/438) residents were willing to accept the telephone alert when they missed daily drug.Conclusion The majority of residents in Longhua District of Shenzhen City have a mobile phone and good mobile network conditions to carry out tuberculosis mobile phone supervision and management and the willingness to choose video supervision is strong. Especially for residents with college education and above, mobile phone usage is more suitable for video supervision. Residents are more likely to choose to receive medication reminders by Wechat rather than to receive missed medication reminders calls.

Influence of pulmonary tuberculosis on the mental health status of student patients themselves and their classmates

Hong-ge GUO,Qing-ye OU

Journal of Tuberculosis and Lung Health. 2018, 7(1): 15-18. doi:10.3969/j.issn.2095-3755.2018.01.004

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Objective To analyze the influence of pulmonary tuberculosis (PTB) on the mental health status of student patients themselves and their classmates so as to provide theoretical basis for health promotion policy and intervention strategies implementing.Methods Newly diagnosed student patients in colleges and middle schools registered by tuberculosis management information system (TBMIS) in Zhuhai from January 1, 2015 to December 31, 2017 were selected as survey objects, as well as their classmates. A questionnaire survey was conducted using Mental Health Diagnostic Test (MHT) Handbook. A total of 4800 questionnaires were issued, and 4351 qualified ones were recovered with effective recovery rate of 90.65%. The qualified questionnaires were filled by 128 students with PTB and 4223 classmates.Results The mental health status of the students with PTB was significantly lower than those without PTB, which was mainly reflected in the sores of following scales: learning anxiety (6.69±2.13 versus 5.77±2.23; t=4.60, P<0.01), interpersonal anxiety (5.74±2.34 versus 5.17±2.71; t=2.35, P=0.018), lonely tendency (4.68±2.84 versus 3.94±1.94; t=4.15, P<0.01), allergy tendency (3.71±2.53 versus 3.15±2.04; t=3.04, P=0.002), physical symptoms (2.88±2.91 versus 2.36±1.68; t=3.34, P<0.01), phobia tendency (3.95±1.93 versus 3.40±1.65; t=3.66, P<0.01) and total score of MHT (34.97±13.97 versus 30.66±11.33; t=4.22, P<0.01). Among students with PTB, we found that: (1) Difference between different gender was significant in mental health status. The male students had better mental health status (the total score of MHT of male students was 32.69±14.83, and the total score of MHT of female students was 37.56±11.03 (t=-2.09, P=0.030); (2) Comparing with college school students, middle school students got higher scores in learning anxiety (7.55±3.12 versus 6.13±2.11; t=-2.92, P<0.05) and impulsion tendency (4.67±2.99 versus 3.41±2.55; t=2.51, P<0.05), but significantly lower scores in interpersonal anxiety (5.19±2.25 versus 6.58±2.80; t=-3.11, P<0.01); (3) Non-remission group students had higher scores of interpersonal anxiety (6.34±2.19 versus 4.81±3.13; t=-3.25, P<0.05), lonely tendency (5.16±2.41 versus 4.08±2.00; t=-2.53, P<0.05), and allergy tendency (4.33±1.98 versus 3.57±2.10; t=-2.07, P<0.05) than remission group students.Conclusion Suffered from PTB has an impact on the mental health status of students in Zhuhai. We must give full attention to the students with PTB, and intervention should be conducted accurately and timely. Furthermore, psychological support and care should be provided.

The analysis on the establishment of health files of pulmonary tuberculosis and suspected patients in Longhua District of Shenzhen City

Yu-bao QIN,Hong-xia FANG,Chang-wei LIU,Zhi-cong CHEN,Xin-feng YAN,Ming-chuan ZHANG,Keng. LAI

Journal of Tuberculosis and Lung Health. 2018, 7(1): 19-22. doi:10.3969/j.issn.2095-3755.2018.01.005

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Objective To analyze the establishment of health files of tuberculosis and suspected patients of floating population in Longhua District of Shenzhen, and to provide the evidence for further exploring the health files of floating population through clinical medical large data platform.Methods A prospective cohort study was used to collect data on the health records of residents of 3222 non-Shenzhen registered tuberculosis and tuberculosis suspected patients in the Shenzhen Longhua Center for Chronic Disease Control from January 1, 2017 to December 31, 2017, in contrast to the health records of residents.Results Among 3222 tuberculosis and tuberculosis suspected patients registered in Shenzhen Longhua Center for Chronic Diseases Control, 43 patients had established health records (accounted for 1.3%), and the other 3179 patients had not established health records (accounted for 98.7%). Among the 1400 patients who lived in Shenzhen less than 1 year, 17 patients had established health records (accounted for 1.2%), and among the 596 patients who lived in Shenzhen between 1-2 years, 13 patients had established health records (accounted for 2.2%). Among the 1226 patients who lived in Shenzhen above 3 years, 13 patients had established health records (accounted for 1.1%). Among the 568 patients with Shenzhen residence card, 9 patients had established health records (accounted for 1.6%). There was no statistical difference between Shenzhen residence time, handling Shenzhen residence permit and whether to establish health records (χ ²=4.10, P=0.129; χ ²=0.33, P=0.576).Conclusion The health files of tuberculosis and suspected patients in Longhua District are low, and there is no association with residence time and residence permit.

A study on mathematical model of comprehensive clinicl diagnosis of tuberculosis based on big data

Bao-jiang WEN,Zheng-hua ZHOU,Zhi-yong LIANG,Jun LI,Wen-pei WEN,Hui-xin. GUO

Journal of Tuberculosis and Lung Health. 2018, 7(1): 23-28. doi:10.3969/j.issn.2095-3755.2018.01.006

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Objective This study on mathematical model of comprehensive clinicl diagnosis of tuberculosis (TB) based on big data is aimed to improve the clinical diagnosis of tuberculosis. Methods A total of 345 patients from the Chronic Disease Prevention and Control Hospital of Qingyuan City between January 2016 and December 2017 were selected using stratified random sampling method.They were divided into TB group (n=198, initial therapy for active TB) and no-TB (n=147, including old TB).Results of X-ray,PPD, WBC, serum albumin, sputum smear, sputum culture, GeneXpert MTB/RIF test and T-SPOT.TB, clinical symptoms and medical history were analyzed using logistic regression model and discriminant analysis.Results After detecting sexual (χ²=6.047,P=0.014;OR (95%CI)=0.410 (0.201-0.834)), TB history (χ²=29.273,P=0.000; OR (95%CI)=0.086 (0.036-0.210)), WBC (χ²=10.266, P=0.001; OR (95%CI)=0.771 (0.657-0.904)), GeneXpert MTB/RIF (χ²=18.633, P=0.000; OR (95%CI)=7.280 (2.956-17.928)), sputum culture (χ²=10.400, P=0.001; OR (95%CI)=10.021 (2.469-40.664)), T-SPOT.TB (χ²=23.669, P=0.000; OR (95%CI)=5.769 (2.848-11.688)), PPD (χ²=6.462, P=0.011; OR (95%CI)=1.503 (1.098-2.057))and weight loss (χ²=7.807, P=0.005; OR (95%CI)=3.335 (1.433-7.761)), it was found that all ORs of GeneXpert MTB/RIF,sputum culture, T-SPOT.TB and weight loss were above 2, which was significantly help to diagnosis of TB. Function model of TB diagnosis is useful, the accuracy in differential diagnosis of no-TB was 83.67% (123/147), and the accuracy in TB diagnosis was 79.29% (157/198). Conclusion Function model of TB diagnosis in this study is of high accuracy in differential diagnosis, it help to clinical diagnosis of TB and could reduce the misdiagnosis rate.

Application value of GeneXpert MTB/RIF in diagnosis of newly active pulmonary tuberculosis and rapid detection of rifampin-resistant

Yang GAO,Qi-sheng SONG,Jie ZHOU,Dong ZHANG,Xin-yuan WANG,Dong-cheng. AN

Journal of Tuberculosis and Lung Health. 2018, 7(1): 29-32. doi:10.3969/j.issn.2095-3755.2018.01.007

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Objective To investigate the application value of GenXpert MTB/RIF (Xpert) in diagnosis of newly active pulmonary tuberculosis (PTB) and rapid detection of rifampin-resistant.Methods The data of 268 clinical diagnosed PTB patients and 102 cases excluded from PTB from June to November 2015 in Dalian Tuberculosis Hospital were collected. Sputum smear, solid culture and Xpert were used to detect sputum samples, and results were compared. Based on clinical diagnosis, the sensitivity and specificity of solid culture and Xpert for PTB detection were compared, as were the results of drug sensitivity test of proportion method and Xpert for rifampin-resis-tant detection. SPSS 21.0 was used for data analysis and χ ² test was used for enumeration data, statistical significance was set at two-tailed P<0.05.Results The positive rates of the three tests were 29.5% (79/268), 43.7% (117/268) and 55.6% (149/268), respectively, the difference was statistically significant (χ ²=37.42, P=0.000). Of the 189 cases of PTB smear negative, the difference of positive rates of culture and Xpert MTB were statistically significant (20.1% (38/189) vs. 37.0% (70/189);χ ²=13.27, P=0.000). Based on clinical diagnosis, the sensitivities of culture and Xpert were 43.7% (117/268) and 55.6% (149/268), and the specificities of them were 99.0% (101/102) and 98.0% (100/102), respectively. There was statistically significant difference between the sensitivity of solid culture and that of Xpert (χ ²=7.64, P=0.006), but no difference was found in specificity (χ ²=0.00, P=1.000). Of the 113 cases of PTB with solid culture +/Xpert +, there were 11 drug-resistant cases confirmed by proportion method but one was sensitive by Xpert, and there was only one drug-resistant case in the left 102 cases confirmed by proportion. There was fine consistence between Xpert and proportion methods to detect rifampin resistant (Kappa=0.899).Conclusion Xpert is convenient, rapid, and of high sensitivity in diagnosis of newly active PTB and is valuable for rapid detect of rifampin-resistant.

Analysis of direct solid culture method for drug sensitivity test using sputum specimens isolated from smear-positive patients with Mycobacterium tuberculosis

Li CHEN,Jian WU,Yu-bao QIN,Lu TANG,Xin SU,Yan. ZHANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 33-36. doi:10.3969/j.issn.2095-3755.2018.01.008

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Objective To investigate the application value of direct solid drug sensitivity test (DST) using sputum specimens from smear-positive pulmonary tuberculosis patients.Methods A total of 389 (from Feb 2010 to Jul 2011) sputum specimens isolated from patients with positive acid-fast tuberculosis were collected. The sputum samples were first used for mycobacterial solid culture and direct DST, and then the solid-culture-positive strains were subjected to conventional proportional susceptibility testing and sodium nitrobenzoate (PNB) medium growth test to differentiate strains. The direct DST was conducted as follows. Based on the specimen traits, 1 to 2 times of 4% NaOH was added to the pre-treatment tube containing sputum specimen, and the screw cap was tightened. The tube was vortexed for 30 seconds until the sputum specimen was liquefied, and then incubated for 15 minutes at room temperature. The pretreated sputum specimens were aspirated with a sterile pipette and evenly inoculated into common acidic Roche medium (control medium for DST), rifampicin (RFP, 40.0μg/ml)-containing acidic Roche medium and isoniazid (INH, 0.2μg/ml)-containing acidic Roche medium (0.1 to 0.15ml per tube). The tubes were incubated at 36℃. The bacterial growth on the culture tube was recorded weekly until the 8th week. On the premise of positive cultures of mycobacteria on the control medium, drug resistance was defined as a percentage of drug resistance of >1% or number of colonies on drug-containing medium >20. The results of direct DST were judged based on the above two drug resistance determination methods. The detection value of DST was analyzed using the proportional method as gold standard.Results Specimens that could not obtain susceptibility test results due to pollution or smear-positive but culture-negative were excluded. As a result, 346 specimens were available for RFP susceptibility test by both the direct method and the proportional method, and 338 specimens were available for INH susceptibility test. When using a resistance percentage of >1% as the definition for drug resistance, the detection rate of RFP resistance by the direct method was 10.4% (36/346), which was lower than that detected by the proportional method (13.9%, 48/346), and the difference was statistically significant (χ ²=24.14, P<0.01). Using the proportional method as the standard, the sensitivity, specificity, and accuracy of the direct solid DST for RFP resistance testing were 75.0% (36/48), 82.9% (247/298), and 81.8% (283/346). No strong consistency between the two methods was shown (Kappa=0.43). For INH resistance, the detection rate by the direct method was 7.1% (24/338), lower than that detected by the proportion method (10.9%, 37/338), and the difference was statistically significant (χ ²=15.29, P<0.01). Taking the proportion method as the standard, the sensitivity, specificity, and accuracy of the direct solid method for INH resistance testing were 64.9% (24/37), 86.0% (259/301), and 83.7% (283/338), respectively. The consistency between the two methods was poor (Kappa=0.39). When using number of colonies on the drug-containing medium more than 20 as the definition for drug resis-tance, the RFP resistance rate tested by the direct method was 10.4% (36/346), which was lower than that of the proportional method. The deference was statistical significance (χ ²=15.87, P<0.01). Using the proportional method as the standard, the sensitivity, specificity, and accuracy of the direct solid DST for RFP resistance testing were 75.0% (36/48), 86.2% (257/298), and 84.7% (293/346), respectively. No strong consistency between the two methods was shown (Kappa=0.49). The INH resistance rate detected by the direct method was 7.1% (24/338), which was lower compared with the proportion method, and the difference was statistically significant (χ ²=9.38, P<0.01). Using the proportional method as the standard, the sensitivity, specificity, and accuracy of the direct solid DST for INH resistance testing were 64.9% (24/37), 88.7% (267/301), and 86.1% (291/338). No strong consistency between the two methods was shown (Kappa=0.43). Conclusion The direct solid DST shows quite different drug resistance results compared with the traditional proportional DST. The clinical diagnosis of drug resistant tuberculosis by direct solid method is not ideal.

The effect of multiplex nursing intervention measures on the breathing exercise of multidrug-resistant tuberculosis patients

Xue-jiao JIANG,Fei REN,You XU,Ling YANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 37-43. doi:10.3969/j.issn.2095-3755.2018.01.009

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Objective To explore the effect of diverse nursing intervention measures on respiratory function exercise of MDR-TB (multidrug-resistant tuberculosis) patients.Methods A total of 123 inpatients with MDR-TB were enrolled in Xi’an Chest Hospital from Oct 2015 to Sep 2017. Fifty four cases of MDR-PTB inpatients from Oct 2015 to Sep 2016 (control group) were educated tuberculosis knowledge by nurses and breathing function exercise during hospitalization. Meanwhile,they were provided health education prescriptions and reminded exercise after discharged from hospital and required rechecking. Sixty nine cases of MDR-PTB inpatients from Oct 2016 to Sep 2017 (observation group) received more comprehensive and effective intervention measures including education in beeper, respiratory function training in video, health education in brochures and bulletin board, multimedia health education symposium (WeChat group, Wechat Official Account) and learning breathing exercise from nurses. One hundred and twenty-three patients were investigated about compliance, methods and knowledge of respiratory function exercise by face-to-face communication after 3 months discharge. SPSS 18.0 software was used for statistics, and counting data were tested by chi square test. P<0.05 was as the significant difference statistically.Results The compliance rate of respiratory function exercise (81.16% (56/69)), mastery rate of respiratory function exercise (84.06% (58/69)), awareness rate of knowledge of disease and respiratory function exercise (81.16% (56/69)), the rate of satisfaction with nursing work (94.20% (65/69)) in observation group were higher than that in the control (53.70% (29/54),51.85% (28/54),64.81% (35/54),81.48% (44/54))(χ ²=10.70,P=0.001;χ ²=14.39,P=0.000;χ ²=4.20,P=0.040;χ ²=4.86,P=0.027, respectively). The reasons for the two groups of patients who did not exercise respiratory function were “it is considered ineffective “(44.74% (17/38)),” no time “(7.89% (3/38)),” method not mastered “(10.53% (4/38)),” cause of disease “(15.79% (6/38)),” unsupervised “(15.79% (6/38))” and “other” (5.26% (2/38)), respectively.Conclusion Diversified nursing intervention can significantly improve the compliance of the MDR-TB patients with respiratory function exercise and the satisfaction to health care work.

Effects of extended nursing on multidrug-resistant tuberculosis patients’ treatment compliance and life quality

Li ZHU,Xiu-lei ZHANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 44-48. doi:10.3969/j.issn.2095-3755.2018.01.010

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Objective To explore the role of extended nursing on multidrug-resistant tuberculosis (MDR-TB) patients’ treatment compliance and life quality.Methods A total of 110 MDR-TB patients who admitted to the Shandong Provincial Chest Hospital from January 2015 to March 2016 were included in this study. According to their admission numbers (odd or even), the patients were divided into routine nursing group (RNG) and extended nursing group (ENG) (55 patients in each group). Patients in the RNG were routinely followed-up, whereas those in the ENG were given extended care after discharge, respectively. The study was approved by the Ethical Committee of Shandong Provincial Chest Hospital. Data on their missed medications, timeliness of clinical revisits, and measurements of life quality (assessed by 4 indicators of the SF-36 health survey scale, including vitality, social functioning, mental health and general health) 6 months after discharge were collected and analyzed.Results During the first 6 months’ treatment after discharge, in the ENG, one case died, one moved and one was lost to follow up, and consequently 52 patients were included in this analysis; in the RNG, two patients were lost to follow up, and eventually 53 patients were included in the analysis. The proportion of participants who had not missed any single dosage was higher in the ENG (84.6%, (44/52) compared to the RNG (58.5%, 31/53). The difference was statistically significant (χ ²=8.13, P=0.004). 94.2% (49/52) ENG participants made their revisits regularly, which was significantly higher compared with RNG (77.4%, 41/53). The difference was statistically significant (χ ²=6.10, P=0.023). The scores of the 4 indicators of SF-36 health survey scale including vitality, social functioning, mental health and general health in the ENG at 3-month time-point ((37.05±1.05), (38.98±1.23), (40.05±1.07) and (51.08±2.08)) and 6-month time-point after discharge ((40.23±1.57), (40.29±2.03), (41.95±1.27) and (53.04±2.09)) were significantly higher than those of the RNG at 3-month time-point ((34.01±1.05), (35.12±1.06), (39.23±2.02) and (43.01±1.08)) and at 6-month time-point ((32.89±2.02), (36.07±1.99), (38.85±1.68) and (45.04±2.17)), and the differences were statistically significant (3-month: t=14.83, 17.24, 2.59, 25.02; P=0.005, 0.005, 0.042, 0.006; 6-month: t=20.76, 10.76, 10.65, 19.24; P=0.007, 0.006, 0.003, 0.006).Conclusion Extended nursing is an effective new tool to improve MDR-TB patients’ treatment compliance and life quality. It is necessary to formulate standard nursing services package in the future.

Evaluation of linear probe technology in the detection of drug resistance in Mycobacterium tuberculosis

Li CHEN,Yu-bao QIN,Jian WU,Lu TANG,Bai-feng LIN,Xue-zhi. ZHANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 49-53. doi:10.3969/j.issn.2095-3755.2018.01.011

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Objective To investigate the effectiveness of the line probe assay GenoType^? MTBDRplus in the detection of drug resistance in Mycobacterium tuberculosis.Methods Three hundred and seventy eight Mycobacterium tuberculosis clinical isolates were tested for resistance to rifampicin (RFP) and isoniazid (INH) using the molecular line probe technique, and drug susceptibility testing (“susceptibility testing”) against RFP and INH was performed using conventional proportional assays. Differences in results obtained between the two methods were compared by Chi-square tests using SPSS 13.0 software, P<0.05 being considered statistically significant. The Kappa consistency test was also applied, Kappa≥0.75 indicating better consistency.Results RFP resistance rates obtained by the linear probe and proportional methods, 12.2% (46/378) and 10.6% (40/378), respectively were not significantly different (χ ²=3.60, P>0.05). The overall consistency rate was 97.4% (368/378), the two methods showing good consistency (Kappa=0.87). INH drug resistance rates, 14.3% (54/378) and 12.2% (46/378), respectively, were not significantly different (χ ²=3.20, P> 0.05). Overall consistent rate was 94.7% (358/378), the two methods showing good consistency (Kappa=0.77). Multidrug resistance rates determined by the two methods, 7.4% (28/378) and 7.9% (30/378), respectively, were not significantly difference (χ ²=0.40, P>0.05). The overall consistency rate was 97.4% (368/378), indicating that the two methods show good consistency (Kappa=0.81). The sensitivity and specificity of the linear probe method for detecting RFP resistance was 95.0% (38/40) and 97.6% (330/338), respectively, while that for detection of INH resistance was 87.0% (40/46) and 95.8% (318/332) respectively. The sensitivity and specificity for detecting MDR was 80.0% (24/30) and 98.9% (344/348), respectively.Conclusion Linear probe technology for detecting the drug resistance status of clinical isolates of M.tuberculosis drug resistance is practicable.

Comparative analysis on treatment effect between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients

Yan MA,Mai-ling HUANG,Jian DU,Wei SHU,Shi-heng XIE,Hong-hong WANG,Shou-yong TAN,Xiang-qun LI,Yan-yong FU,Li-ping MA,Lian-ying ZHANG,Fei-ying LIU,Dai-yu HU,Yan-ling ZHANG,Yu-hong LIU,Liang LI

Journal of Tuberculosis and Lung Health. 2018, 7(1): 54-59. doi:10.3969/j.issn.2095-3755.2018.01.012

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Objective To analyze treatment effect between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients, and provide reference for tuberculosis prevention and control strategy.Methods Two thousand and seventy five patients diagnosed and treated from 8 provinces were enrolled in the study, 282 patients were 65 years old and above,ranging from 65 to 91 years old with an average of (73.6±16.4)years old. 1793 cases were under 65 years old ranging from 15 to 64 years old with an average (38.3±18.6)years old among 2075 patients. Chi-square test and Fisher exact test were used to compare the following variables between aged 65 and above and under aged 65 years with pulmonary tuberculosis patients: adverse reactions (ADR), cavity closure, lesions absorption, sputum-culture results at the end of the 2nd month of treatment, and treatment outcome. A P-value of less than 0.05 is considered statistically significant.Results Sixty five years old and above patients accounted for 13.6% (282/2075), ADR rate, no change and deterioration of lesions among aged 65 and above group was 24.8% (70/282) and 9.9% (20/203) respectively and was higher than under 65 years old group which was 22.0% (390/1793) and 7.8% (111/1419), but the difference was not significant (χ ² value was 0.249 and 0.248,respectively; P-value >0.05);meanwhile no change and deterioration of cavities, sputum-culture rate at the end of the 2nd month of treatment and failure rate among aged 65 and above group were 17.6% (13/74), 20.2% (44/218) and 12.8% (36/282) respectively, was significant higher than under 65 years old non-elderly group which was 8.9% (51/575),14.6% (217/1491) and 7.8% (139/1793)(χ ² value was 0.041, 0.034 and 0.001,respectively; P-value <0.05).Conclusion Treatment effect aged 65 and above group was inferior to those under 65 years old group with higher ADR rate, higher deterioration of lesions and cavities, higher sputum-culture rate at the end of the 2 ^nd month, higher failure and death rate.

The establishment and application evaluation of health management information system for TB patients in Shantou City

Zhuang-hao CHEN,Jian-xiong LIN,Dong-dong PENG,Rui-ming CHEN,Xiao-ying CHEN,Wen-pei WEN

Journal of Tuberculosis and Lung Health. 2018, 7(1): 60-63. doi:10.3969/j.issn.2095-3755.2018.01.013

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Objective To evaluate the implementation effect of the integrated management platform for TB control managers, supervisors and clinicians, and to provide experience sharing for the health management mode of TB patients.Methods Developed and built a health Management Information System for TB patients (MIS). Analyzed the management rate of TB patients before and after using MIS, Using Delphi to analyze the difference including information delivery methods, reliability, timeliness,accuracy of 8 indicators between the before and after using the MIS in JinPin area and ChaoYang area.Results Before and after the application of MIS, the management rates of TB patients in Jinpin area were 80.5% and 90.7% (χ ²=9.66,P<0.05),the management rates of TB patients in Chaoyang area were 87.7% and 92.76% (χ ²=9.40,P<0.05).The difference is statistically significant. after using MIS,the 8 indicators including information delivery, reliability, timeliness, accuracy are all better to before.Conclusion For the work of TB patient`s health management, MIS plays an important flow, supervision and management, gathering team role, effectively improves the management rates of TB patients and the management level.

Effects of conventional therapy combined with oral lactobacillus for elderly patients with acute exacerbation of chronic obstructive pulmonary disease

Shu-gui LI

Journal of Tuberculosis and Lung Health. 2018, 7(1): 64-67. doi:10.3969/j.issn.2095-3755.2018.01.014

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Objective To explore the effects of conventional therapy combined with oral lactobacillus for elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 120 cases of AECOPD patients in third hospitals of Anshan city from May 2015 to August 2017were divided into the observation group (n=60) and the control group (n=60) using digital table method. The control group was treated with conventional therapy,and the observation group was combined with lactobacillus. Pulmonary function index (forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), forced expiratory volume in one second as percentage of predicted value (FEV₁/FVC)), unctional dyspnea grade score, blood routine, incidence of adverse reactions, fatality rate, oxygenation index and time of hospitalization were compared between the two groups.Results The incidence of adverse reactions in the observation group was 3.33% (2/60) and was 6.67% (4/60) in the control group, the difference was not statistically significant (χ ²=0.70, P=0.402). The fatality rates in the observation and control groups were 1.67% (1/60) and 3.33% (2/60) (χ ²=0.34, P=0.559); the FEV₁ of the two groups were (1.89±0.53)L vs. (1.61±0.43)L (t=2.91,P=0.004); the FVC of were (1.79±0.31)L vs. (1.61±0.43)L (t=8.83, P=0.000); the FEV₁/FVC were (64.01±5.18)% vs. (55.89±6.41)% (t=6.76, P=0.000); the unctional dyspnea grade scores were (2.31±1.35) vs. (2.97±1.28) (t=2.41, P=0.018); as to blood routine examination, WBC counts were (7.49±1.98)×10 ⁹/L vs. (9.01±2.72)×10 ⁹/L (t=3.08, P=0.003), neutrophilic granulocytes were (65.87±7.65)% vs. (74.16±11.60)% (t=4.04, P=0.000); Oxygenation indexes were (351.01±65.79) vs. (304.02±82.11) (t=3.06,P=0.003); times of hospitalization were (7.25±2.31)d vs. (9.94±3.52)d; all the above differences were statistically significant (t=4.32,P=0.000). Conclusion The efficacy of Lactobacillus for elderly patients with AECOPD was significant. It helps to restore lung function.

Discussion on the health management mode of tuberculosis patients in the information age

Rui-ming CHEN,Jian-xiong. LIN

Journal of Tuberculosis and Lung Health. 2018, 7(1): 68-70. doi:10.3969/j.issn.2095-3755.2018.01.015

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Tuberculosis (TB) is an ancient disease, but still prevalently at present. The traditional prevention and control methods have not been able to achieve the goal of eliminating TB. In this rapid development of the information age, it is a trend to according to the actual work to form the total network control of TB, using TB control information combined with existing monitoring systems.

Epidemiological features of pulmonary tuberculosis complicated with diabetes mellitus in the District of Longgang, Shenzhen City from 2011 to 2015

Ming SHEN,Min-lu LI,Xiao-qi ZHANG,Wei-guo TAN

Journal of Tuberculosis and Lung Health. 2018, 7(1): 71-73. doi:10.3969/j.issn.2095-3755.2018.01.016

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Data of pulmonary tuberculosis (PTB) patients registered by Infectious Disease Reporting System (IDRS) and Tuberculosis Management Information System (TBMIS) from 2011 to 2015 in the District of Longgang were collected to analyze the epidemiological features of PTB complicated with diabetes mellitus (PTB-DM). The result showed that 3974 PTB cases were registered from 2011 to 2015 in the district of Longgang, among whom 102 (2.57%) cases were identified with PTB-DM. There were 65 male and 37 female PTB-DM patients. Most PTB-DM patients were ≥45 years, accounting for 85.29% (87/102). The majority of PTB-DM patients (92.16%, 94/102) were found by clinical consultation. The proportion of onset of diabetes before the PTB (89.22%, 91/102) was higher than that of the PTB before diabetes (10.78%, 11/102). Therefore, we should strengthen screening PTB-DM, improve the cure rate of PTB, and reduce the spread of tuberculosis.

Application effects evaluation of WeChat-based multi-functional information system for tuberculosis control and management

Jian-ming PENG,Zhi-dong LIU,Qiu ZHONG,Lin-hua LIU,Liang CHEN,Xiao-fen LI,Jian-feng WENG,Bi-wei HUANG,Wen-jie CHEN

Journal of Tuberculosis and Lung Health. 2018, 7(1): 74-76. doi:10.3969/j.issn.2095-3755.2018.01.017

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The related data and information during 2016 and 2017 were collected from the Registration Form of Diagnosed Tuberculosis (TB) Patients in Huizhou City, the National TB Recording & Reporting System of Chinese CDC and the Huizhou City WeChat-based Multi-functional Information System for TB Control and Management (hereinafter referred as the “Information System”). The effects before and after using WeChat-based Information System were compared. In 2016, before the Information System was used, the accuracy rate of the TB suspects’ referral information was 81.0% (4973/6140), but this rate increased to 98.0% (5910/6031) after the Information System was used in 2017, and the difference of the accuracy rate before and after using the Information System was statistically significant (χ ²=51.978, P<0.05); the referral information arrival rate within 1 hour of the TB suspects was 56.0% (3438/6140) before the Information System was used, but the rate was 97.0% (5850/6031) after the Information System was used, and the difference of the information arrival rate before and after using the Information System was statistically significant (χ ²=384.618, P<0.05); before the Information System was used, the tracing rate of TB suspects was 68.0% (41758/6140), however the tracing rate increased to 97.0% (5850/6031) after using the Information System, and there was significant difference (χ ²=171.205, P<0.05); the accuracy rate of the notice letter for TB patients management was 85.0% (2530/2977) before using the Information System, but this rate increased to 99.0% (2640/2667) after using the Information System, and the difference was statistically significant (χ ²=15.674, P<0.05); the arrival rate of the notice letter for TB patients management within 1 hour was 55.0% (1637/2977) before using the Information System, but the arrival rate within 1 hour increased to 98.0% (2614/2667) after the Information System was used, and the difference was statistically significant (χ ²=197.506, P<0.05). The WeChat-based Information System has significant effects on TB suspect referral, TB suspect/patient tracking and TB patient management.

Analysis of clinical treatment outcomes in 18 cases with severe bronchial asthma

Tong ZHANG

Journal of Tuberculosis and Lung Health. 2018, 7(1): 77-78. doi:10.3969/j.issn.2095-3755.2018.01.018

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Eighteen patients with severe bronchial asthma were treated in the Sixth People’s Hospital of Fuxin City during 2012—2014. According to the predisposing factors and clinical manifestations of the attack in those patients, oxygen therapy and drug therapy were adopted to correct their electrolyte disturbances. Finally, 17 cases got cured while 1 case was improved. The author thought that the standardized management to the patients with severe bronchial asthma during the treatment can stabilize the patients’ conditions and make the patients to get better treatment outcomes.

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