Table of Content

15 June 2018, Volume 7 Issue 2

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Expert Note

Current status of diagnosis and treatment of tuberculosis complicated with rheumatic diseases

Guo-fang DENG,Liang. FU

Journal of Tuberculosis and Lung Health. 2018, 7(2):  88-90.  doi:10.3969/j.issn.2095-3755.2018.02.002

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Rheumatic diseases are a heterogeneous group of conditions characterized by being autoimmune, indicating dysfunction or compromise of the patients’ immune system which is often further impaired by the use of hormones and immunosuppressants, leading to high susceptibility to tuberculosis infection. So it is necessary to raise awareness of rheumatic diseases and tuberculosis co-morbidity, the burden of which can be significantly reduced by conducting reasonable screening, diagnosis and treatment, getting a lower incidence and a higher cure rate.

Expert Forum

Characteristics and requirements of tuberculosis infection control in new era

Wei-min ZHANG,Fei ZHAO,Tian-lun HE,Dong-mei HU,Hong GENG,Feng-lin LIU,Jing-min QIN,Guang-xue. HE

Journal of Tuberculosis and Lung Health. 2018, 7(2):  91-94.  doi:10.3969/j.issn.2095-3755.2018.02.003

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TB prevention and control is still facing a severe situation in China. Under such a background, there are lots of new features and requirements for tuberculosis (TB) infection control in the new era in China. The TB epidemic continues to decline nationwide. However, the epidemic is still high in some areas and special populations. The problems of multi-drug resistant (MDR) TB and TB patients living in poverty are constantly highlighted, which have made the difficulties in controlling the transmission of TB. TB infection control work is still weak and lack of awareness; the investment on research and development of new product and new technology related to TB infection control is insufficient and the application expansion is lagging behind, which cannot meet people’s increa-singly refined and diversified needs on TB prevention and control, as well as on maintaining their health. Therefore, TB infection control program and policy should be formulated according to the specific situation and the TB infection control problems in different areas and facilities, so as to take different measures in response to diverse needs in light of different situations, to improve the ability of TB infection control work, to strengthen implementation of the measures, to accelerate innovation and transformation of new products and new technologies, to enhance the per-tinence and effectiveness of education and awareness by using of new media platforms, and to eliminate the risk of TB transmission.

Original Articles

The significance of chest X-ray follow-ups for contacts in disposition of the outbreak of clustered tuberculosis in a school setting

Bo LI,Shu-juan ZHAO,Chun LI,Feng HONG,Zhi-dong GAO,Yan XU,Hai-lun. ZHENG

Journal of Tuberculosis and Lung Health. 2018, 7(2):  95-99.  doi:10.3969/j.issn.2095-3755.2018.02.004

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Objective To analyze the epidemic of clustered tuberculosis (TB) in a school setting, and to explore the significance of chest X-ray follow-ups in the disposition of TB epidemic outbreak. Methods A total of 21 patients with active TB were found in a vocational training school in Daxing District, Beijing from March 17th to April 17th 2016, which was an epidemic of clustered TB outbreak. After the outbreak, 3490 teachers and students received tuberculin (PPD) skin test and chest X-ray screening, and then 3 sputum smears and 2 sputum mycobac-terium culture examinations were performed on each of the 65 cases who appeared to have abnormal chest X-ray results, 39 cases were diagnosed with TB; 313 cases with strongly PPD positive reactions were treated with preventive chemotherapy. The first chest X-ray follow-up was made for the school teachers and students (except for the confirmed patients with active pulmonary TB) 3 months after the disease outbreak. Thereafter 3 chest X-ray follow-ups were carried out and the intervals were 3, 6 and 8 months respectively. Chest radiographs of newly diagnosed patients were printed out during each follow-up and compared with their previous chest imaging data so as to observe whether there were any changes or omissions in the lung lesions, and the relevant records were made. SPSS 18.0 software was used for data analysis,the comparison of count data rate was done by χ² test and P<0.05 was regarded as statistically significant. Results A total of 162 cases with active TB were found in the outbreak. The detection rate was 1.7% (60/3490) when the epidemic occurred, and the detection rates of the 4 follow-ups were 1.6% (50/3031), 0.7% (19/2650), 0.8% (15/1860) and 0.2% (2/1134) respectively. The detection rate in the first follow-up (1.6%) was significantly higher than that of the other 3 follow-ups (that was 0.7%, 0.8% and 0.2%) (χ²=23.73, P<0.05). Seventeen cases were delayed to be detected in the 4 follow-ups, of which 15 cases were found in the first follow-up, while 1 case was found in the second and third follow-up respectively, no delayed cases were found in the fourth follow-up. So the detection rates of the delayed cases in the 4 follow-ups were 30.0% (15/50), 5.3% (1/19), 6.7% (1/15) and 0.0% respectively, and the detection rate of the delayed cases in the first follow-up was significantly higher than the other 3 follow-ups (χ²=7.89,P<0.05). Conclusion It is able to detect the new cases and omissive cases timely in the follow-ups after the outbreak of tuberculosis, especially 3 months after the outbreak, which is effective for the control of tuberculosis epidemic in a school setting.

Application value of PDCA circulation in tuberculosis infection control

Zhi-fen PAN,Jin-qi LU,Jian-ping QIAN

Journal of Tuberculosis and Lung Health. 2018, 7(2):  100-103.  doi:10.3969/j.issn.2095-3755.2018.02.005

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Objective To evaluate the application value of management circulation of Plan-Do-Check-Action(PDCA for short) in tuberculosis infection control.Methods A total of 10979 patients with pulmonary tuberculosis patients including 53 patients treated with mechanical ventilation admitted in the first hospital of Jiaxing city, Zhejiang province were collected in this study during January 2010 to December 2017. 2501 patients with pulmonary tuberculosis admitted during from January 2010 to December 2012 were managed by traditional management methods and 8478 patients with pulmonary tuberculosis admitted during from January 2013 to December 2017 were managed by PDCA. The data of nosocomial tuberculosis infection were compared with these two management methods among clinical medical staff during the period. A survey on the satisfaction degree was conducted between 24 medical staff from the period of traditional management methods and 27 medical staff from the period of PDCA administration.Results There were 10 clinical medical staff infected with tuberculosis among the control group of 1174 average annual clinical medical staff during the three years from January 2010 to December 2012. However, there were no staff infected with tuberculosis among the research group of 1513 average annual clinical medical staff after improving sputum management by using PDCA during these five years from January 2013 to December 2017. The difference of nosocomial tuberculosis infection was statistically significant (χ ²=10.64, P<0.01). The satisfaction degree of medical staff in traditional management period was 91.92±1.69 and that in PDCA method was 97.07±1.92. The difference was statistically significant (t=10.12, P=0.000). Conclusion PDCA management can reduce the incidence of tuberculosis infection among clinical medical staff in hospital and improve the satisfaction of clinical medical staff on infection control measures.

Analysis on referral and tracing of suspected tuberculosis patients in Feixi from 2014 to 2017

Tian-xiang ZHAO,Hong. CAO

Journal of Tuberculosis and Lung Health. 2018, 7(2):  104-108.  doi:10.3969/j.issn.2095-3755.2018.02.006

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Objective To analyze the referral and tracing of suspected tuberculosis patients in non-tuberculosis (TB) and TB control agencies in Feixi, Anhui, and to provide reference for further strengthening TB control and prevention.Methods The information of 2875 suspected TB cases reported by non-TB control agencies in 2014 to 2017 was collected. With the date to implement “the trinity”, December 15, 2015 was set as the point of division, the suspected TB patients were divided into two groups, which included 1690 suspected TB cases reported in January 2014 to December 14, 2015 was traditional group, and 1185 suspected TB patients reported in December 15, 2015 to December 2017 were included in the improving group. Excel 2007 and SPSS 16.0 software were used to analyze the referral, tracing, arrival, diagnosis and patient registration. Chi-square test was applied to compare the count data between the two groups, and the difference was statistically significant with P<0.05.Results From 2014 to 2017, there were totally 2705 suspected TB cases who were reported and should be referred by non-TB control agencies in Feixi arrived, with an overall arrival rate of 94.1% (2705/2875). Among them, the overall arrival rate of patients in the traditional group was 93.3% (1576/1690), and that of the improved group was 95.3% (1129/1185). The difference between the two groups was statistically significant (χ ²=5.11, P=0.024). 1424 cases were diagnosed as TB, which accounted for 52.6% (1424/2705) of the arrival patients. The rates of patients diagnosed with active TB in the traditional group and the improved group were 50.9% (802/1576) and 55.1% (622/1129), respectively, with statistically significant difference between the two groups (χ ²=4.67, P=0.031). There were 1049 cases arrived after referral, and the referral arrival rate was 36.5% (1049/2875), the rates of traditional group and improvement group were 27.3% (461/1690) and 49.6% (588/1185), and have statistical significance (χ ²=150.04, P=0.000). There were 1630 cases arrived after tracing, and the tracing arrival rate was 90.6% (1630/1800). The tracking arrival rates of the traditional group and the improved group were 90.6% (1096/1210) and 90.5% (534/590) respectively, and there was no statistically significant difference (χ ²=0.00, P=0.962). From 2014 to 2017, 1424 patients out of 2875 patients who were reported by non-TB control institutions were diagnosed as pulmonary TB cases, which accounted for 82.4% (1424/1729) of the patients registered in TB control institutions in the same period, and the proportions in the traditional group and improving group were 88.9% (802/902) and 75.2% (622/827), with statistical significance (χ ²=55.75, P=0.000).Conclusion Reporting suspected TB patients by non-TB control institutions is an important way to find TB cases, the suspected TB patients detection and diagnosed after arrival can be further improved by the Implementation of “trinity” TB control mode.

Analysis of the influence of sputum sample quality on diagnostic outcome in 564 cases of pulmonary tuberculosis

Xin-yu YANG,Bo LI,Yan-feng ZHAO,Nen-han WANG,Jie ZHANG,Jun-li YI,Li-li TIAN,Yi-xuan REN,Rui-fang FAN,Wen-juan ZHAO,Hao CHEN,Shuang-shuang CHEN,Xiao-wei DAI,Bei-chuan. DING

Journal of Tuberculosis and Lung Health. 2018, 7(2):  109-113.  doi:10.3969/j.issn.2095-3755.2018.02.007

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Objective To analyze the influence of the quality of sputum samples collected from patients with newly diagnosed pulmonary tuberculosis on the results of bacteriological examinations, to provide a reference for clinical diagnosis and guidance on the importance of collecting good quality sputum samples.Methods A retrospective investigation was conducted on 564 sputum samples obtained from patients newly diagnosed with pulmonary tuberculosis at the Beijing Research Institute for Tuberculosis Control between January 2016 and December 2017. AFB smears and mycobacterium culture (including solid culture and liquid culture) were performed. The positive rate and positive grade of different qualities of sputum samples, and the positive rate obtained with different culture methods were analyzed using SPSS 17.0. Chi-square tests were used for comparing counting data. P<0.05 was considered statistically significant.Results Three sputum samples were collected for AFB examination per newly diagnosed tuberculosis case, and two sputum samples were simultaneously used for mycobacterial culture. A total of 1692 sputum samples were collected from 564 patients, 67.3% (1138/1692) of which passed quality grading. 242 cases (42.9%, 242/564) of pulmonary tuberculosis were confirmed. In 311 cases (55.1%, 311/564), all three sputum samples were of sufficient quality. Positive rates obtained for smears, solid culture, and liquid culture for sputum samples considered to be of sufficient quality were 21.1% (240/1138), 37.4% (258/690), and 68.0% (68/100), respectively, while that for sputum samples of poorer quality were 3.4% (19/554), 16.2% (49/302) and 27.8% (10/36), respectively. The differences in positive rates between sputum samples of good quality and those of poorer quality were statistically significant in all the tests used (χ ² values were 89.64, 44.04, and 17.51, respectively; Ps<0.001). Conclusion The rate of good quality sputum samples obtained from newly diagnosed pulmonary tuberculosis patients is relatively low. The rate of detection of Mycobacteria in good quality sputum samples is significantly higher than that in poorer quality sputum samples. It is thus very important to improve the quality of sputum samples collected.

Clinical efficacy analysis of Qingfei Qulao Pill in the treatment of patients with relapsed pulmonary tuberculosis

Li-hua ZHENG,Jing-lai YU,Peng SUN,Hong-qing LI,Dong CHEN,Ying-jie YU,Sha NI,Ming XU,Yan CHENG,Chun-guang MA,Chun-yu ZHAO,Na YANG,Gui-jiao LI,Juan. LI

Journal of Tuberculosis and Lung Health. 2018, 7(2):  114-119.  doi:10.3969/j.issn.2095-3755.2018.02.008

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Objective To analyze the clinical efficacy of Qingfei Qulao Pill in treating relapsed pulmonary tuberculosis (PTB).Methods From January to June 2017, relapsed bacterial positive PTB patients in the Tuberculosis Hospital of Jilin Province were randomly selected according to their different treatment methods: 60 cases who received chemical drugs (2H-R-E-Z-S/6H-R-E) combined with Qingfei Qulao Pill were selected as the observation group, while 60 cases who received chemical drugs were selected as the control group. The improvement of clinical symptoms, clinical efficacy, bacterial negative conversion rate, and chest X-ray findings in the two groups were compared.Results All patients in both group completed 8 months of treatment. After treatment, the improvement of clinical symptoms such as fatigue and night sweat in the observation group (the incidences were 10.0% (6/60) and 8.3% (5/60), respectively) were better than that in the control group (75.0% (45/60) and 61.7% (37/60), respectively); the differences were statistically significant (χ ² values were 51.87 and 37.51; P values were <0.001 and <0.001, respectively). The rate of sputum negative conversion was higher in the observation group (88.3%, 53/60) compared with the control group (76.7%, 46/60), but the difference was not statistically significant (χ ²=2.83, P=0.093). The observation group showed higher treatment efficacy than the control group (88.3% (53/60) vs 76.7% (46/60)), the difference was not statistically significant (Z=-1.71, P=0.088). The findings of Chest X-ray examination showed that the lesions and cavities were significantly absorbed in 43 cases and absorbed in 12 cases in the observation group, yielding an absorbing rate of 91.7% (55/60). The rate was obviously higher than that of the control group (78.3% (47/60); lesions and cavities were significantly absorbed in 26 cases and absorbed in 21 cases); the difference was statistically significant (Z=-3.20, P=0.001). Conclusion Qingfei Qulao Pill can be used as the adjuvant treatment for relapsed PTB, having a good effect on the improvement of clinical symptoms and induction of lesions and cavities absorption.

Influence of ipratropium bromide combined with N-acety-L-cysteine in patients with chronic obstructive pulmonary disease in stable phase

Shu-gui. LI

Journal of Tuberculosis and Lung Health. 2018, 7(2):  120-122.  doi:10.3969/j.issn.2095-3755.2018.02.009

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Objective To study the efficacy of ipratropium bromide combined with N-acety-L-cysteine in patients with chronic obstructive pulmonary disease (COPD) in stable phase, and to analyze the effect of the treatment strategy on serum transforming growth factor beta (TGF-β) and matrix metalloproteinase 9 (MMP-9) levels.Methods A total of 90 COPD patients in Third Hospitals of Anshan from January 2015 to June 2017 were selected. The subjects were divided into the observation group (45 cases) and the control group (45 cases) by draw method. Patients in the control group were treated with ipratropium bromide, whereas patients in the observation group were treated with ipratropium bromide combined with N-acety-L-cysteine. The clinical efficacy, improvement in pulmonary respiratory function, and serum MMP-9 and TGF-β levels were compared between the two groups.Results The effective rate of the observation group (95.6%, 43/45) was higher than that of the control group (71.1%, 32/45), and the difference was statistically significant (χ ²=9.68, P=0.002). After treatment, the forced expiratory volume in one second (FEV₁; (1.87± 0.51)L), forced vital capacity (FVC; (1.75±0.32)L) and FEV₁/FVC ((63.94±5.20)%) of the observation group were better than the control group ((1.62±0.42)L, (1.39±0.16)L, (55.86±6.42)%). The differences were statistically significant (t=2.68, 7.40, 6.71, all P<0.01). After treatment, the serum TGF-β ((82.98±7.36) ng/L) and MMP-9 ((86.25±6.98)μg/L) levels in the observation group were higher than those of the control group ((93.03±7.91) ng/L, (96.75±8.73)μg/L). The difference were statistically significant (t=5.89, 6.13, all P<0.01). Conclusion Ipratropium bromide combined with N-acety-L-cysteine has significant efficacy in the treatment of COPD in stable phase. It can reduce the levels of TGF-β and MMP-9.

Analysis of pyrazinamide resistance in multidrug-resistant Mycobacterium tuberculosis in Fujian province

Yin-fa ZHOU,Shan-ying ZHANG,Shu-zhen WEI,Yong-ming LIN,Yong ZHAO,Jian LIN,Shu-fang. LIN

Journal of Tuberculosis and Lung Health. 2018, 7(2):  123-127.  doi:10.3969/j.issn.2095-3755.2018.02.010

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Objective To analyze the pyrazinamide (PZA) resistance in multidrug-resistant Mycobacterium tuberculosis (MDR-TB) clinical isolates in Fujian province.Methods A total of 119 MDR-TB clinical isolates and the basic information of MDR-TB patients were collected during the antituberculosis drug resistance surveillance in Fujian Center for Disease Control and Prevention from 2008 to 2010. The average age of the patients was (45.8±15.3) years, of which 76.5% (91/119) were male, 30.3% (36/119) were floating population, 55.5% (66/119) were peasants, and 53.8% (64/119) were patients with primary school education or below. Using the standard strain H37Rv as the control, the BACTEC ^TM MGIT 960 ^TM system (MGIT 960) and the proportional method recommended by the WHO were used to perform the drug susceptibility test of PZA and other antituberculosis drugs on strains in the L-J solid medium. The descriptive analysis of data was performed by SPSS 17.0, and the Chi square test was used on enumeration data. P<0.05 was considered statistically significant. Results Of these 119 MDR-TB clinical isolates, 44 were detected resistant to PZA (37.0%). Among the MDR-TB patients with different demographic characteristics, the PZA resistance rate of patients with primary school education or below (26.6%, 17/64) was lower than those with above primary school education (49.1%, 27/55) (χ ²=6.44, P=0.011). The PZA resistance rates in patients with ethambutol, streptomycin, ofloxacin, levofloxacin and moxifloxacin resistance was 48.6% (36/74), 44.9% (31/69), 62.5% (20/32), 63.3% (19/30), and 71.4% (10/14), respectively; which was significantly higher than that of sensitive patients (17.8% (8/45), 26.0% (13/50), 27.6% (24/87), 28.1% (25/89), and 32.4% (34/105))(χ ²=11.44, P=0.001; χ ²=4.46, P=0.035; χ ²=12.24, P<0.001; χ ²=11.96, P=0.001; χ ²=8.08, P=0.004). Conclusion We should pay more attention to the PZA susceptibility test to provide timely and effective treatment to the patients in the prevention and treatment of multidrug-resistant tuberculosis in Fujian province.

Analysis the drug resisitant of Mycobacterium tuberculosis isolates in Longyan, 2015-2017

Jian-li ZHENG,Zi-xian DU,Yong-ming LIN,Tu-rong. LI

Journal of Tuberculosis and Lung Health. 2018, 7(2):  128-132.  doi:10.3969/j.issn.2095-3755.2018.02.011

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Objective To analyze the drug resisitant of Mycobacterium tuberculosis (MTB) isolates in Longyan from 2015 to 2017, and provide the scientific evidence for TB control and prevention.Methods A total of 837 consecutive cases of smear positive pulmonary tuberculosis. Registered in Longyan Center for Disease Control and Prevention were collected from June 1, 2015 to December 31, 2017,including 698 new cases and 139 retreatment cases. Another 289 new cases of smear negative pulmonary tuberculosis (including newly treated patients) were collected in 2017, according to the new TB control model of tiered medical and comprehensive control service. Then the sputum samples from the 1126 TB patients were collected for culture. Of the 671 sputums (59.6%) were cultured positive, and the strains from cultures were identified and tested for drug susceptibility. Finally analyzing the data by Chi square test,trend chi square test and Fisher exact test in software SPSS 18.0, and the boundary of test was defined as 0.05.Results A total of 651 strains (97.0%) were identified as Mycobacterium tuberculosis complex and 20 were non-tuberculous mycobacteria. The culture positive rate of new and retreatment cases showed an increasing trend year by year, from 24.5% (137/559) to 86.5% (301/348) and from 27.2% (25/92) to 90.3% (56/62), respectively( {\chi }_{\mathrm{trend}}^2 =360.41,71.23;Ps=0.000). The results of drug sensitivity tests to the 9 antituberculosis drugs show that the total resistance rate was 22.0% (143/651), and the rate of multidrug resistance was 6.5% (42/651). The difference of mono-drug resistance rate between the new cases (12.2%,72/592) and retreatment cases(8.5%,5/59) was nonsignificance. The rate of total resistance (20.3%,120/592), poly-drug resistance (3.0%,18/592) and multi-drug resistance (5.1%,30/592) in new cases were significantly lower than those of retreatment cases (39.0% (23/59), 10.2% (6/59), 20.3% (12/59))(χ ²=10.96,P=0.001;χ ²=7.68,P=0.006;χ ²=20.73,P=0.000). The drugs with higher resistance rate are respectively S (3.7%,24/651), Ofx (3.1%,20/651), H (2.2%(14/651)), R (1.4%,9/651) and Cm (1.1%,7/651). Conclusion The drug resistance profile was diverse among each county in Longyan, and also different from the whole country and Fujian province. Therefore, the implementation of drug resistant test should be reinforced and improved in Longyan.

Analysis on the diagnostic values of different detection methods for pulmonary tuberculosis

Bao-jiang WEN,Dong-jun CHEN,Zhi-yong LIANG,Xiao-dong. DENG

Journal of Tuberculosis and Lung Health. 2018, 7(2):  133-136.  doi:10.3969/j.issn.2095-3755.2018.02.012

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Objective To evaluate the diagnostic values of different detection methods for pulmonary tuberculosis (PTB).Methods From January to December of 2017, a total of 149 patients with PTB who were admitted to the Qingyuan Center for Chronic Disease Control, Guangdong Province were selected in the PTB group, and 96 patients with other pulmonary disease were selected in the non-PTB group. The clinical data of all study subjects were collected. The T-SPOT.TB, tuberculin skin test (TST), sputum smear microscopy, sputum culture, and GeneXpert MTB/RIF were performed. The diagnostic efficacies of these methods were evaluated comprehensively.Results 65.8% (98/149) of the patients in the PTB group had a disease course of ≥30 days, which was higher than 52.1% (50/96) of the patients in the non-PTB group. The difference was statistically significant (χ²=4.57, P=0.032). Among the tested methods, sputum etiological examinations had the best specificity. The specificities of sputum smear microscopy, sputum culture, and GeneXpert MTB/RIF were 100.0% (96/96), 100.0% (96/96), and 96.9% (93/96), respectively. As to the comparison in the sensitivity, T-SPOT.TB had the highest sensitivity of 86.6% (129/149). The rank of Youden index of each detection method, from high to low, was TST+T-SPOT.TB (0.58), GeneXpert MTB/RIF (0.54), T-SPOT.TB (0.48), sputum culture (0.38), TST (0.27), and smear smear microscopy (0.24).ConclusionThe sputum etiological examinations are still the gold standard for the diagnosis of PTB. The combination of multiple test methods can help the clinical diagnosis of smear-negative PTB.

Analysis of the volunteer recruitment and publicity of tuberculosis prevention and control in Heilongjiang from 2013 to 2017

Bi-bo ZHANG,Lei WANG,Xin. WANG

Journal of Tuberculosis and Lung Health. 2018, 7(2):  137-141.  doi:10.3969/j.issn.2095-3755.2018.02.013

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Objective To understand and analyze the situation of tuberculosis (TB) control volunteers and their activities in Heilongjiang, so as to provide reference for better organizing volunteers and carrying out activities in future.Methods The basic information of volunteers and the activities carried out from 2013 to 2017 in Heilongjiang were collected from the “Annual Reports on Volunteer’s Activities” of the “Report of millions of volunteers tuberculosis control knowledge dissemination plan” reported by TB control institutions of 13 prefectures (cities) and 106 counties (districts). The personnel composition, publicity methods, and coverage of the volunteers who participated in the TB control activities in our province were analyzed. Excel was used to input data. Chi-square test for trend was applied to analyze all kinds of count data of volunteers within five years. The difference was considered as statistical significance if P<0.05.Results There were a total of 65 382 TB control volunteers participated in activities in 2013-2017, and the number of volunteer recruited was increasing year by year, 7374 in 2013, 9254 in 2014, 12 144 in 2015, 16568 in 2016, and 20042 in 2017. These volunteers were mainly young people aged 18 to 50 (62.74%, 41020/65382), female (57.62%, 37673/65382), Han people (96.76%, 63265/65382), urban dwellers (79.60%, 52044/65382), people with an education background of university or above (43.50%, 28443/65382). For the occupations of volunteers, students (29.78%, 19472/65382) and medical personnel (22.80%, 14905/65382) accounted more than others, while unemployed people (3.96%, 2592/65382) was the least. The differences of the distributions of gender, age, nationality, region, occupation, and education level in 2013-2017 were statistically significant ( {\chi }_{\mathrm{trend}}^2 values were 227.14, 452.39, 629.18, 1812.90, 2758.34 and 3431.39 respectively, all P values were 0.000). The most activities were on field publicity (57.98%, 20446/35267), followed by online publicity (19.29%, 6804/35267). The scale of publicity activities less than 30 persons accounted for 45.03% (15964/35450), 30 to 100 persons accounted for 31.26% (11081/35450). The differences of the distributions of publicity methods and scale of activities in 2013-2017 were statistically significant ( {\chi }_{\mathrm{trend}}^2 values were 6395.67 and 3112.02 respectively, all P values were 0.000). Conclusion The volunteers recruitment and activities carried out in Heilongjiang have achieved good results from 2013 to 2017, while it needs to be further improved in many aspects.

Study on effects of thanksgiving intervention on the improvement in negative emotion and quality of life of patients with chronic obstructive pulmonary disease

Wei FU,You-ling HUANG,Bing. LI

Journal of Tuberculosis and Lung Health. 2018, 7(2):  142-145.  doi:10.3969/j.issn.2095-3755.2018.02.014

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Objective To discuss the effects of thanksgiving intervention on the negative emotion and quality of life of the patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 patients with COPD admitted from January 2016 to June 2016 were selected as the study subjects. Among them, the 54 patients admitted from January 2016 to March 2016 were in the control group, while the 54 patients admitted from April 2016 to June 2016 were in the observation group. After approval of the Ethics Committee of our hospital, patients in the control group were given the routine nursing care, while patients in the observation group received the thanksgiving intervention in addition to the routine nursing care. The negative emotion and the quality of life of the patients in the two groups were evaluated before the thanksgiving intervention and before discharge from the hospital in the stable period.Results After the thanksgiving intervention, the score of Self-Rating Anxiety Scale (SAS) of the patients in the observation group was (37.46±5.49), which was lower than that in the control group (45.38±6.45); the difference was statistically significant (t=-6.38, P<0.01). The score of Self-Rating Depression Scale (SDS) in the observation group was (40.45±5.48), which was lower than that in the control group (46.19±5.45); the difference was statistically significant (t=-4.09, P<0.01). As for the SF-36 score in the observation group after intervention, the scores of overall health, physiologic function, physiologic role, somatic pain, action capacity, social function, emotional function and emotional health of the patients were (77.01±10.80), (83.48±10.87),(82.92±9.18),(76.54±9.45),(76.03±12.25),(84.26±7.39),(78.52±9.13)and(76.24±6.10),which were higher compared with the control group (68.46±7.18),(75.65±9.31),(75.48±7.89),(71.09±5.97),(67.63±7.27),(72.07±7.56),(70.96±8.23)and(69.04±6.16); the differences were statistically significant (t values were 4.85, 4.02, 4.52, 3.58, 4.34, 8.49, 4.52 and 6.11, respectively; P values were all <0.01).Conclusion The thanksgiving intervention to the patients with COPD could effectively relive their negative emotion and improve their quality of life.

Short Articles

Clinical efficacy of local drug administration by bronchfiberscope combined with chemotherapy in the treatment of multi-drug resistant pulmonary tuberculosis

Su-hua. MENG

Journal of Tuberculosis and Lung Health. 2018, 7(2):  146-148.  doi:10.3969/j.issn.2095-3755.2018.02.015

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Ninety cases of multidrug-resistant pulmonary tuberculosis admitted from May 2015 to July 2016 at Qianshan Hospital of Anshan City, Liaoning Province were selected in this study. The subjects were divided into control group and observation group by random number table method (45 cases in each group). After approval by the Ethics Committee, subjects in the control group was treated with chemotherapy alone, whereas those in the observation group received local drug administration by bronchfiberscope combined with chemotherapy. The clinical efficacy of the two groups was compared. The overall effective rate was 68.89% (31/45) in the observation group and 44.44% (20/45) in the control group; the difference was statistically significant (χ ²=5.48, P=0.019). The overall rate of improvement in lesions was 84.44% (38/45) in the observation group and 48.89% (22/45) in the control group; the difference was statistically significant (χ ²=12.80, P=0.000). The overall rate of improvement in cavitation absorption was 81.08% (30/37) in the observation group, compared with 54.29% (19/35) of the control group; the difference was statistically significant (χ ²=8.60, P=0.003). Nine months after the treatment, the rate of sputum negative conversion in the observation group was 91.11% (41/45), which was higher than 46.67% (21/45) of the control group; the difference was statistically significant (χ ²=20.74, P=0.000). The improvement rate was 75.56% (34/45) in the observation group and 44.44% (20/45) in the control group; the difference was statistically significant (χ ²=9.07, P=0.003). No serious adverse reactions occurred in the two groups during treatment. In conclusion, the clinical efficacy of local drug administration by bronchfiberscope combined with chemo-therapy in the treatment of multi-drug resistant pulmonary tuberculosis is superior to chemotherapy alone.

Investigation of social support level and analysis of influencing factors in 121 patients with pulmonary

GAO Chun-mei tuberculosis,Yu-xiao MA,Feng-ju QIN,Xu-sheng GAO,Qing WANG,Lei. ZHANG

Journal of Tuberculosis and Lung Health. 2018, 7(2):  149-152.  doi:10.3969/j.issn.2095-3755.2018.02.016

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One hundred and twenty-one patients with pulmonary tuberculosis (TB), who were admitted to stay at Shandong Chest Hospital from February 2016 to January 2018, were enrolled into this study. Xiao Shui-yuan’s Social Support Rate Score (SSRS) was used to evaluate the factors relate to the enrolled patients, such as age, sex, education level, residence, course of disease, family function, average annual income and major caregivers. The scores of objective support and subjective support, support utilization, and social support were analyzed. The results showed that the average score of subjective support in 121 patients with pulmonary TB was (14.48±4.13) scores, and the average score of objective support was (8.83±2.47) scores, the score of utilization of support was (7.03±2.75) scores, and the total score was (30.36±6.00) scores. The multiple linear regression method was used to analyze the main factors affecting the level of social support, the results showed that the main factors affecting the level of social support were family function (t=-3.28, P=0.001), educational level (t=3.28, P=0.001) and age (t=-4.59, P<0.001), of which the determination coefficient was R ²=0.22. Medical staff should take variously effective interventions to improve the social support situation of TB patients and promote their physical and mental health development.