Objective To study the level of clinical diagnosis of pulmonary tuberculosis and implementa-tion of tuberculosis prevention and control policy. Methods Frequencies and percentages of pulmonary tuberculosis, other lung diseases and health among 3315 cases with pulmonary tuberculosis suspicious symptoms ,transferred by non-tuberculosis control institutions during 2010-2015,were calculated and analyzed. Results Among the 3315 suspected cases of pulmonary tuberculosis ,cases of pulmonary tuberculosis ,tuberculosis ,other lung diseases and healthy group were 2068,598 and 649 based on final diagnosis and their percentages were 62.38%,18.04% and 19.58% respectively. As to groups of elder than fifteen years ,the proportion of patients with pulmonary tubercu-losis accounts for 72.62%,61.00%and 48.58% of the total of young group(15~44 years old ),middle age group (45 ~ 64 years old)and elderly group(≥ 65 years old )respectively. Conclusions Compared with pulmonary tuberculosis suspicious symptomscases from tuberculosis control institution during the same period ,the proportion of tuberculosis patients from transferred groups is roughly the same.It indicate high levels of tuberculosis diagnosis and implementation to tuberculosis control policy.

Objective To explore the impact of hypocholesterolemia on pneumonia in pulmonary tubercu-losis.Methods Data of 600 patients who were diagnosed with pulmonary tuberculosis in Guangzhou chest hospital were collected.Of these patients,300 were combined with pneumonia(experimental group)and the other subjects were pulmonary tuberculosis only(control group). Parameters including age,gender,sputum tubercle bacilli state,alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),blood urea ni-trogen(BUN),hemameba(WBC),c-reactive protein(CRP),procalcitonin(PCT),serum albumin(ALB),hemo-globin(HB),total of blood lymphocytes(TLC),and plasma total cholesterol(TC)between the 2 groups were com-pared. The correlation between hypocholesterolemia and the severity of pneumonia estimated with CURB-65 score was analyzed. Results hypoproteinemia,low lymphocyte and(all P < 0.05)were identified as risk factors for pneumonia with univariate logistic regression(all P<0.05).Moreover,hypocholesterolemia was confirmed as inde-pendent risk factor in mulitvariate logistic model(P < 0.05). The TC concentration was negatively correlated with CURB-65 score and significantly different among low-risk(CURB-65 score of 0-1),moderate(CURB-65 score of 2)and high risk(CURB-65 score of 3-5)pneumonia groups(all P < 0.05). Conclusions Hypocholesterolemia was an independent risk factor for pneumonia in pulmonary tuberculosis patients. The decreased level of TC was parallel with the severity of pneumonia.

Objective To analyze the clinical efficacy of pre-extensive drug resistant tuberculosis (pre-XDR-TB), and to explore the feasibility of using the standard multidrug resistant tuberculosis (MDR-TB) therapeutic regimen to treat the patients with pre-MDR-TB. Methods A retrospective analysis was made for 126 cases of the MDR-TB patients who were received the treatment in Guangzhou chest hospital from 2009 to 2013. It was divided into MDR-TB group, pre-XDR-TB group and XDR-TB group according to the drug sensitive test (DST) of quinolone(levofloxacin, moxifloxacin) and aminoglycoside (amikacin). All patients were treated for 6-months with the standard therapeutic regimen including Am(Cm), Lfx(Mfx), Pto, PAS and PZA. Results (1) There were 126 cases of the MDR-TB patients in the study, 31 cases (24.6%) complicate with aminoglycosides-resistance, 69 cases (54.7%) complicate with quinolone-resistance. (2) The negative rate of MDR-TB group, pre-XDR-TB group and XDR-TB group was 82.0%, 55.8% and 29.2% respectively (χ2 = 20.110, P < 0.001). (3)The negative rate of pre-XDR-TB group significantly lower than MDR-TB group (χ2 = 8.146, P = 0.004). The negative rate of pre-XDR-TB group higher than XDR-TB group (χ2= 4.661, P = 0.031). Conclusions The situation of quinolone and aminoglycoside resistance was high in the patients with MDR-TB. We should carry out the detection of quinolone and aminoglycoside resistance in clinical treatment. The clinical efficacy for the patients with pre-XDR-TB was significantly poorer than the patients with MDR-TB using the standard MDR-TB therapeutic regiment treated.

Objective Age and sex of the population with suspected pulmonary tuberculosis (PTB) symptoms in Yuexiu District of Guangzhou were analyzed , to find out the prevalence and important risk factors responsible for tuberculosis in this district. Methods New PTB suspects domiciling in Guangzhou Yuexiu District during 2010-2015 were of interests. Data from Guangzhou Tuberculosis Control Project registration book and biobank of Guangzhou Tuberculosis Translational Medicine Center were applied to analyzed the frequency distribution of age and sex of the population. Results 6 154 cases of PTB suspects were included in this study. As to sex,ratio of male to female was 1.70 and there was no obvious fluctuation from 2010 to 2015. Frequency distribution among PTB suspects under 40 had no difference between male and female , but the ratio of male to female was nearly 1.70 for study objects aged above 40.As to age , there was a minor peak in the age group of 25~ while the greater peak was in the age group of 50~ after the age group of 35~. Conclusion In Yuexiu District of Guangzhou ,male were more likely to be the PTB suspects than female , and the peak age of prevalence was between 50 and 60.

Objective To study the correlation of PAZ with anti-tuberculosis treatment regimen and drug-induced liver injury in tuberculosis patients with HBV-DNA positive in order to provide an optimized treatment regimen. Methods from Jan 2013 to Dec 2014, 199 pulmonary tuberculosis with HBV-DNA positive patients and 103 pulmonary tuberculosis patients without HBV in our hospital were collected. They were assigned as follows:122 cases were anti tuberculosis treatment with antiviral therapy,64 cases were A(HRZE),58 cases were B (HRE). 77 cases were anti tuberculosis treatment but not antiviral therapy , 41 cases were C (HRZE), 36 cases were D(HRE) and 103 patients without HBV were E (HRZE, the contrast group). We had observed the liver injury for 2 months after the treatment. Results 1.Incidence of liver injury was 34.38% in group A , higher than the cases in group B(20.69%,P > 0.05). 2.Incidence of liver injury in group C was apparently higher than in group D (73.17% vs. 30.56%,P < 0.05). 3.Incidence of liver injury in group B was lower than group D (20.69% vs. 30.56%,P > 0.05)4.Incidence of liver injury in group A was lower than group C (34.38% vs. 73.17%,P < 0.05).5. Incidence of liver injury in group A was higher than group E (34.38% vs. 17.48%,P< 0.05)and there was no difference between group B and group E (20.69% vs. 17.48%,P> 0.05). Conclusion Although anti tuberculosis treatment combined with antiviral therapy can be partially reduce the incidence of liver injury and relieve the severity of liver injury in tuberculosis patients infected with HBV , but PZA toxicity to hepatocytes is a major risk factor for liver injury , and we need to change the treatment plan to reduce the occurrence of liver injury.

Objective To analyze the different expressed protein of pleural effusion caused by tuberculosis and to identify proteins associated with tuberculous pleural effusion for building an economic , rapid, and accurate diagnostic method. Methods Two-dimensional gel electrophoresis technology was applied to separate protein in pleural effusion of 20 cases of tuberculous pleurisy ,19 cases of lung cancer patients and 6 cases of transudate. Analysis of isoelectric point, the range of molecular weight, matching rate and grey value of the protein was carried out by the PDQuest8.0 software.Then the electrophoregram was compared to get the distinct protein. Results There were 13 differential protein spots between tuberculous pleural effusion and the transudateand 9 protein spots were highly expressed for two folds, but 4 protein spots poorly expressed for 0.5 folds in pleural effusion caused by tuberculous pleurisy. There were 11 differential protein spots between tuberculous and malignant pleural effusion and 5 protein spots were highly expressed , but 4 protein spots poorly expressed in pleural effusion caused by tuberculous pleurisy , while 2 protein spots were expressed only in the pleural effusion caused by lung cancer. Conclusion Two-dimensional electrophoresis technology is available to acquire an electrophoretogram of pleural effusion caused by tuberculosis , lung cancer and transudate with well resolution and high repetition rate.In addition, there are different protein spots.

Objective To explore the relapse rate of the patients with primary smear-positive pulmonary tu-berculosis and pyrazinamide-resistance. Methods Retrospective analysis was made on the relapse for 150 patients with primary smear-positive pulmonary tuberculosis , who had been diagnosed and completed treatment in Guangzhou Chest Hospital from January 2012 to August 2013 , and had followed up two years. According to the re-sults of drug susceptibility test before treatment, they were divided into pyrazinamide-sensitive (114 cases) and pyrazinamide-resistant (36 cases) groups. Results (1)By the end of the treatment, the recovery rates in the sensi-tive group and resistant group were 98.25%and 88.89%respectively (P=0.044). The rate of the lesions absorption was 99.12%and 94.44%respectively (P=0.143). The rate of the cavity shrinking was 89.01% and 70.37% re-spectively (P = 0.039). The rate of the relapse was 3.57% and 6.25% respectively (P = 0.867) within 2 years fol-low-up in the sensitive group and the resistant group. Conclusions PZA has certain effects on the patients with primary smear-positive pulmonary tuberculosis. Those who are tolerant would have lower incidence for cavity shrink-ing. But the relapse rate for two-year follow-up showed there were not significant differences in two groups.

Objective To establish a diagnostic scoring system for diabetic patients with smear-negative pulmonary tuberculosis , and then to improve the rapidity and accuracy of clinical diagnosis and save medical expenses. Methods A case-control study was applied. 150 diabetic patients with smear-positive pulmonary tuberculosis who on initial treatment were assigned to a study group; 150 patients with lung infection were recruited as a study group. The data on general status, symptoms, chest X-ray manifestation, and laboratory examinations was collected. Univariate logistic regression analysis was used to gain significant indexes for multiple logistic regression analysis. β-coefficients derived from the independent predictors in our logistic regression model was applied to develop a scoring system. Results Toxic symptoms of tuberculosis, cough, upper lung, cavity, multiple lung field , and PPD positive entered into the final multipie logistic regression model , and the scoring system was accordingly established. The patient with a score of more than 11 had higher probability of TB , while those with a score of smaller than 11 were not likely to have TB. Conclusion The scoring system can be used as a predictive tool in diagnosis of diabetes mellitus complicated by smear-negative pulmonary tuberculosis , helping diagnose active tuberculosis rapidly.

Objective To explore the epidemic situation of nontuberculous Mycobacteria in both Yuexiu and Zhuhai districts. Methods Mycobacterium tuberculosis culture and strain identification were conducted in suspected smear-positive tuberculosis patients who had visited our clinics at Yuexiu and Haizhu districts in Guangzhou during the period of 2010 to 2012. Results 2 014 sputum samples were identified as NTM and MTC, 1 630 samples were MTC (80.9%), and 384 samples were NTM (19.1%). The isolated rate for NTM from 2010 to 2012 was 17.6%, 17.1% and 21.2%, respectively. 79 strains of 384 NTM were identified; the rapid-growing mycobacterium was 50.6%, and the slow-growing mycobacterium was 49.4%. Conclusions The sputum-isolated rate of NTM for the suspected tuberculosis patients was 19.1% in Yuexiu and Haizhu districts in Guangzhou. For the smear-positive pulmonary tuberculosis patients who respond to treatment poorly , we should pay attention to NTM lung disease.

Objective To investigate the effects of different liver protective drugs on preventing liver injury induced by anti-tuberculosis drugs. Methods Retrospective analysis was made on 355 patients with primary pulmonary tuberculosis during intensified time. The patients received silibinon and bicyclol to prevent liver injury. 82 patients with TB were treated as control group during the same time. Results The number of patients with liver injury in silibinon group and bicyclol group were 16 cases (14.7%) and 55 cases (22.4%) respectively. The number of control group with liver injury was 9 cases (11.0%) (χ2 = 3.627,P > 0.05). The liver injuries within 4 weeks were mainly counted in. There is no difference between intervention and control groups(χ2 = 0.414,P > 0.05). There is no difference between three groups in liver injury degree (U = 0.288,P> 0.05). Conclusion Without high risk factors, anti-inflammatory and enzyme reduction drugs have no significant protective effects on liver injury caused by anti-tuberculosis drugs.