【摘要】 目的 分析成都市近年一线抗结核药的耐药状况，为耐药结核病预防控制提供依据。 方法 对成都市2007年1月-2009年12月就诊的结核患者，临床分离株培养鉴定为结核分枝杆菌的菌株采用绝对浓度法进行一线抗结核药:链霉素（SM）、异烟肼（INH）、利福平（RF）、乙胺丁醇（EMB）耐药性检测，分析结核分枝杆菌的耐药情况。 结果 1 235例结核患者中，总耐药率和总耐多药率分别为28.83%、14.01%，初始耐药率和获得性耐药率分别为12.82%、61.27%。近3年耐多药率有下降趋势，但获得性耐药率呈逐年上升趋势。 结论 成都市结核耐药状况仍然比较严重，进一步加强耐药结核的监测和控制非常重要。【Abstract】 Objective To analyze the drug resistant treating mycobacterium tuberculosis (MTB) in Chengdu in recent three years, and to provide the evidence for tuberculosis controlling. Methods The patients with MTB diagnosed from January 2007 to December 2009 in Chengdu were enrolled. Absolute concentration method was used to test the drug-resistance of streptomycin (SM), isoniazide (INH), rifampicin (RFP), and ethambutol (EMB). Results The total rate of drug resistance and multi-drug resistance were 28.83% and 14.01% respectively. The rates of initial drug resistance and the acquired drug resistance were 12.88% and 61.27% respectively. Multi-drug resistance rate showed a downward trend, but the rate of acquired drug resistance increased gradually. Conclusion The situation of drug resistance of tuberculosis in Chengdu is still serious, and it′s very important to further monitor and control the drug resistance treating tuberculosis.
ObjectiveTo investigate the epidemiology of tuberculosis in Mianyang city, and investigate its risk factors to provide scientific evidence for tuberculosis prevention and management. MethodsA stratified cluster random sampling method was applied and 184094 residents were recruited in the study. The prevalence of tuberculosis was analyzed by questionnaires, physical examinations, X-ray, and laboratory tests. The risk factors of tuberculosis were analyzed by binary logistic regression method. ResultsOne hundred and seventy-five subjects were diagnosed with active tuberculosis, and the incidence of tuberculosis was 95.06 per thousand. There were 32 smear-positive pulmonary tuberculosis patients, and the incidence was 17.38/100 per thousand. Males, farmers and workers, diabetes, family history of tuberculosis, smoking, drinking were risk factors for tuberculosis. ConclusionsThe prevalence of tuberculosis in Mianyang city is similar with the whole country. Male, farmers and workers, diabetes, family history of tuberculosis, smoking, and drinking maybe the risk factors of tuberculosis.
ObjectiveTo understand basic characteristics and clinical features of tuberculosis in Mianyang, Sichuan, and to investigate the risk factors of two case-finding methods for tuberculosis:"passive finding" and "active screening". MethodsOne-hundred and seventy-five active tuberculosis patients screened by physical examination in 21 villages of Fucheng and Jiangyou from June 2013 to March 2014 were included. Information about basic characteristics and clinical features of tuberculosis was collected using questionnaire, chest X-ray and laboratory examinations. We also applied binary logistic regression to explore the risk factors of finding for tuberculosis. ResultsIn all 175 tuberculosis patients, 41.71% were over 60 years old and 73.71% were farmers. Productive cough over two weeks was the most common symptom, accountting for 58.29%. 19.63% were sputum smear-positive while 70.87% were PPD-positive. Binary logistic regression analysis demonstrated that tuberculosis history significantly influenced the findings for tuberculosis (OR=15.809,95%CI: 6.708~37.258). ConclusionsActive tuberculosis patients screened by physical examination in Mianyang, Sichuan were mainly elderly male over 60 years old and farmers, with single pulmonary symptom as the primary clinical feature. The patients with tuberculosis history may be found by "passive finding".
Objective To evaluate the clinical role of video-assisted mediastinoscopy and its safety and effectiveness in the diagnosis of thoracic disease. Methods We reviewed the clinical data of consecutive 40 patients (25 males and 15 females with an average age of 54.6 years) who received video-assisted mediastinoscopic surgery in our department of thoracic surgery from December 2011 to November 2016, including mediastinal lymph node biopsy in 27 patients, mediastinal primary lesions biopsy in 8, bronchial cystectomy in 3 and esophageal dissection in 2. Results The histological results were positive in 20 patients (73.1%) in mediastinal lymph node biopsy, including granulomatous mediastinitis in 14 and metastasis in 6 (non-small cell lung cancer in 4, Ewing sacoma in 1 and small cell lung cancer in 1) and reactive proliferation in 7 (26.9%). In mediastinal primary lesions biopsy, the accuracy rate of diagnosis was 100.0%. The pathologic results were malignant in all patients, including small cell lung cancer in 5, adenoid cystic carcinoma in 1, squamous carcinoma in 1 and adenocarcinoma in 1. In patients who received the bronchial cystectomy, no recurrence was found during at least 2 years follow-up. There was one patient with severe complication (innominate artery injury). Two patients suffered transient laryngeal recurrent nerve palsy with hoarseness and two patients incision secretion. Conclusion Video-assisted mediastinoscopic surgery is effective and safe and dissection should be careful in granulomatous mediastinitis to avoid the great vessel injures.
Objective To evaluate the effectiveness of using titanium alloy trabecular bone three-dimensional (3D) printed artificial vertebral body in treating cervical ossification of the posterior longitudinal ligament (OPLL). Methods A retrospective analysis was conducted on clinical data from 45 patients with cervical OPLL admitted between September 2019 and August 2021 and meeting the selection criteria. All patients underwent anterior cervical corpectomy and decompression, interbody bone graft fusion, and titanium plate internal fixation. During operation, 21 patients in the study group received titanium alloy trabecular bone 3D printed artificial vertebral bodies, while 24 patients in the control group received titanium cages. There was no significant difference in baseline data such as gender, age, disease duration, affected segments, or preoperative pain visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), vertebral height, and C2-7 Cobb angle (P>0.05). Operation time, intraoperative blood loss, and occurrence of complications were recorded for both groups. Preoperatively and at 3 and 12 months postoperatively, the functionality and symptom relief were assessed using JOA scores, VAS scores, and NDI evaluations. The vertebral height and C2-7 Cobb angle were detected by imaging examinations and the implant subsidence and intervertebral fusion were observed. Results The operation time and incidence of complications were significantly lower in the study group than in the control group (P<0.05), while the difference in intraoperative blood loss between the two groups was not significant (P>0.05). All patients were followed up 12-18 months, with the follow-up time of (14.28±4.34) months in the study group and (15.23±3.54) months in the control group, showing no significant difference (t=0.809, P=0.423). The JOA score, VAS score, and NDI of the two groups improved after operation, and further improved at 12 months compared to 3 months, with significant differences (P<0.05). At each time point, the study group exhibited significantly higher JOA scores and improvement rate compared to the control group (P<0.05); but there was no significantly difference in VAS score and NDI between the two groups (P>0.05). Imaging re-examination showed that the vertebral height and C2-7 Cobb angle of the two groups significantly increased at 3 and 12 months after operation (P<0.05), and there was no significant difference between 3 and 12 months after operation (P>0.05). At each time point, the vertebral height and C2-7 Cobb angle of the study group were significantly higher than those of the control group (P<0.05), and the implant subsidence rate was significantly lower than that of the control group (P<0.05). However, there was no significant difference in intervertebral fusion rate between the two groups (P>0.05). Conclusion Compared to traditional titanium cages, the use of titanium alloy trabecular bone 3D-printed artificial vertebral bodies for treating cervical OPLL results in shorter operative time, fewer postoperative complications, and lower implant subsidence rates, making it superior in vertebral reconstruction.