ABSTRACT
Objective@#To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. @*Methods@#The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method.@*Results@#Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%.@*Conclusion@#The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.
ABSTRACT
Objective@#To investigate the epidemiological characteristics of pulmonary tuberculosis ( PTB ) incidence and mortality in Zhejiang Province from 2016 to 2020, so as to provide the evidence for formulating the PTB control strategy.@*Methods@#The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The reported cases and deaths of PTB cases were descriptively analyzed by time, population and regions.@*Results@#A total of 129 985 PTB cases were reported in Zhejiang Province from 2016 to 2020, and the overall reported incidence rate of PTB was 45.81/105, with a tendency toward a decline in the reported incidence ( χ2trend=298.899, P<0.001 ) and an annual decline rate of 3.72%. The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.51%, 47.17%, 46.67% and 4.65%, respectively. A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020, and the reported mortality of PTB was 0.19/105, with a tendency towards a decline ( χ2trend=10.818, P<0.001) and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.83%, 82.97%, 13.37% and 1.83%, respectively. The highest reported incidence ( 92.18/105 ) and mortality ( 1.19/105 ) of PTB was found in patients aged 65 years and older, and farmer was the predominant occupation of PTB cases (60 774 cases, 46.75%) and dead PTB cases ( 345 cases, 63.19% ). In addition, the top three cities with the highest incidence of PTB included Quzhou City ( 66.43/105 ), Jinhua City ( 64.24/105 ) and Lishui City ( 53.91/105 ), and the top three cities with the highest mortality of PTB included Quzhou City ( 0.67/105 ), Lishui City ( 0.27/105 ) and Jiaxing City ( 0.26/105 ).@*Conclusions@#Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020; however, the proportion of positive etiological tests increased. Higher attention should be paid to the elderly aged 65 years and older and and farmers, and active screening and health education are recommended; in addition, PTB control requires to be intensified in highly prevalent regions, including Quzhou City, Jinhua City and Lishui City.
ABSTRACT
Objective Drug-resistant tuberculosis (TB) may be resistant to one or multiple anti-TB drugs.We used generalized estimation equations to analysis the risk factors of drug-resistant TB and provide information for the establishment of a warning model for these non-independent data.Methods The drug susceptibility test and questionnaire survey were performed in sputum positive TB patients from 30 anti TB drug-resistance surveillance sites in Zhejiang province.The generalized estimation model was established by the GENMOD module of SAS,with resistance to 13 kinds of anti-TB drugs as dependent variables and possible influencing factors,such as age,having insurance,HBV infection status,and history of anti-TB drug intake,as independent variables.Results In this study,the probability of drug resistance at baseline level was 20.26％.Age,insurance,whether being co-infected with HBV,and treatment history or treatment withdrawal were statistically significantly correlated with anti-TB drug resistance.The prediction equation was established according to the influence degree of the factors mentioned above on drug resistance.Conclusion The generalized estimation equations can effectively and robustly analyze the correlated binary outcomes,and thus provide more comprehensive information for drug resistance risk factor evaluation and warning model establishment.
ABSTRACT
Objective Drug-resistant tuberculosis (TB) may be resistant to one or multiple anti-TB drugs.We used generalized estimation equations to analysis the risk factors of drug-resistant TB and provide information for the establishment of a warning model for these non-independent data.Methods The drug susceptibility test and questionnaire survey were performed in sputum positive TB patients from 30 anti TB drug-resistance surveillance sites in Zhejiang province.The generalized estimation model was established by the GENMOD module of SAS,with resistance to 13 kinds of anti-TB drugs as dependent variables and possible influencing factors,such as age,having insurance,HBV infection status,and history of anti-TB drug intake,as independent variables.Results In this study,the probability of drug resistance at baseline level was 20.26％.Age,insurance,whether being co-infected with HBV,and treatment history or treatment withdrawal were statistically significantly correlated with anti-TB drug resistance.The prediction equation was established according to the influence degree of the factors mentioned above on drug resistance.Conclusion The generalized estimation equations can effectively and robustly analyze the correlated binary outcomes,and thus provide more comprehensive information for drug resistance risk factor evaluation and warning model establishment.
ABSTRACT
Objective To analyze the epidemic characteristics of tuberculosis (TB) cases in Zhejiang province from 2005 to 2014, and to identify the cluster spots.Methods TB notification data in Zhejiang province from 2005 to 2014 were analyzed at county and district level by using spatial scan statistic analysis method, which was showed on the digital map.Results In zhejiang province from 2005 to 2014, a total of 377 707 cases of patients with tuberculosis were reported.The average annual registration rates of the entire province was 72.61/100 000 (range: 28.85/100 000-182.90/100 000).Spatial analysis identified 14 clusters (RR=1.05-1.62) with statistical significance.Temporal analysis revealed that there were clusters between 2005 and 2009 in terms of the notification data on TB cases (RR=1.27,P=0.001).Spatio-temporal analysis identified 6 clusters (RR=1.19-3.55) with statistical significance.Counties and districts included in the first class cluster were similar by using the two different methods-spatial analysis and spatial-temporal analysis.Conclusions There is a descending trend of TB cases notification rates from western to eastern Zhejiang during the study period.The distribution of the TB case notified is not random at spatial, temporal and spatio-temporal levels.
ABSTRACT
Objective To analyze the spatial distribution characteristics ofmultidrug-resistant (MDR) tuberculosis (TB) cases in Zhejiang province in 2010-2012.Methods Data on MDR-TB cases in Zhejiang province were collected and linked to the digital map at the county and district levels.ArcGIS 10.0 software was used for spatial analysis.Results Results from the spatial autocorrelation analysis showed that spatial aggregation appeared in MDR-TB distribution during 2010-2012 while local Moran's I spatial autocorrelation analysis identified several "high incidence regions" (Wuxing,Deqing,Yuhang,Gongshu,Jianggan,Xiaoshan,Yuecheng,Shaoxing Shengzhou,Changshan,Kecheng),and "low incidence region" (Haishu).Through Getis-Ord General G spatial autocorrelation analysis,18 "positive hotspots" (Wuxing,Nanxun,Deqing,Yuhang,Shangcheng,Xiacheng,Gongshu,Jianggan,Binjiang Xiaoshan Xihu,Haining,Yuecheng,Shaoxing,Zhuji,Shengzhou,Kecheng and Suichang) and 11 "negative hotspots" (Nanhu,Haiyan,Cixi,Dinghai,Zhenhai,Jiangbei,Jiangdong,Beilun,Yinzhou,Fenghua,and Yueqing) were identified.Conclusions Spatial analysis on MDR-TB incidence implied the spatial aggregation in Zhejiang province.Data showed that the hotspots with high population density and human movement were under progressive expansion.
ABSTRACT
Objective To analyze the spatial distribution characteristics ofmultidrug-resistant (MDR) tuberculosis (TB) cases in Zhejiang province in 2010-2012.Methods Data on MDR-TB cases in Zhejiang province were collected and linked to the digital map at the county and district levels.ArcGIS 10.0 software was used for spatial analysis.Results Results from the spatial autocorrelation analysis showed that spatial aggregation appeared in MDR-TB distribution during 2010-2012 while local Moran's I spatial autocorrelation analysis identified several "high incidence regions" (Wuxing,Deqing,Yuhang,Gongshu,Jianggan,Xiaoshan,Yuecheng,Shaoxing Shengzhou,Changshan,Kecheng),and "low incidence region" (Haishu).Through Getis-Ord General G spatial autocorrelation analysis,18 "positive hotspots" (Wuxing,Nanxun,Deqing,Yuhang,Shangcheng,Xiacheng,Gongshu,Jianggan,Binjiang Xiaoshan Xihu,Haining,Yuecheng,Shaoxing,Zhuji,Shengzhou,Kecheng and Suichang) and 11 "negative hotspots" (Nanhu,Haiyan,Cixi,Dinghai,Zhenhai,Jiangbei,Jiangdong,Beilun,Yinzhou,Fenghua,and Yueqing) were identified.Conclusions Spatial analysis on MDR-TB incidence implied the spatial aggregation in Zhejiang province.Data showed that the hotspots with high population density and human movement were under progressive expansion.
ABSTRACT
Objective To identify precipitating factors of a tuberculosis (TB) outbreak in a school and discuss the importance of index case detection on outbreak monitoring,follow up and related control measures.Methods A case survey of the index patient was conducted to evaluate the illness severity and infectious duration of the case.The initial response to this case was surveyed to understand the factors leading to the outbreak.Results A total of 25 TB cases were detected in the outbreak,including 14 cases in one class.The risk of catching TB among the classmates of the index case was 10.74 times higher than that among students in other classes (x2=42.31,P＜0.001).Although the index case had typical TB symptom of cough and expectoration,TB was not diagnosed until pulmonary cavity was detected by chest radiograph one month later.Among 64 close contacts,56 (87.5％) completed TB screening,52 (92.9％) were purified protein derivative positive.No TB cases were detected.Conclusion The factors leading to the outbreak included delayed diagnoses of the index case,no chemoprophylaxis taken by the close contacts; poor surveillance and follow-up for close contacts.
ABSTRACT
Objective To investigate the effects of Pinella's ingredients on the viability of cells, morphology, microstructure, cell cycle and apoptosis in human cervical cancer cell lines. Methods The β-sitosterol and/or total protein of Pinella were incubated at different concentrations with cervical cancer cell line SiHa. The effects of β-sitosterol and/or total protein of Pinella on the viability of cells were tested by MTT assay. The effects of β-sitosterol on morphology, microstructure, cell cycle and apoptosis were studied by phase-contrast microscope, electron microscope and flowcytometry, respectively. Results β-sitosterol could obviously inhibit the viability of SiHa cells in a time-and dose-dependent manner. The total protein of Pinella had no effects on SiHa cells' viability. 20 μmol/L β-sitosterol induced the accumulation of SiHa cells in S phase in the cell cycle. And the percents of apoptosis and necrosis increased. The morphology and microstructure of SiHa cells changed significantly after treated with 20 μmol/L β-sitosterol. Conclusions The total protein of Pinella had little influence on the viability of cervical cancer cells SiHa. The viability of SiHa cells could be suppressed by β-sitosterol. β-sitosterol could induce the accumulation of cells in S phase and the percent of apoptosis and necrosis. The morphology and microstructure changed significantly after treated with β-sitosterol. Therefore, β-sitosterol might be a prospect safe and low toxicity anti-cervical cancer drug.
ABSTRACT
Objective:To investigate the value of ultrasonography in the diagnosis of cystic renal cell carcinoma(CRCC).Methods:To review and analyze 32 cases confirmed by histological examination with the complete data and to sum up their characteristic features of ultrasonographic appearance,and then compared with the results of CT.Results:The sensitivity of ultrasonography in the diagnosis of cystic renal cell carcinoma was 75.00%(24/32),CT was 87.50%(28/32),therefore there was no obvious statistical difference between them.Conclusion:Color Doppler ultrasonography has diagnostic value in cystic renal cell carcinoma.
ABSTRACT
The peripheral blood lymphocytes (PBLs) from 111 cancer patients were isolated and cultured respectively for 23 - 27 days in the medium mainly conditioned by IL-2 and PHA. With ~(125) I-UdR release method, sampling in random way, we examed the cytotoxicities of PBLs and lymphokine-activated-killer (LAK) cells in different culture periods in vitro. The statistic analysis on sufficient data gave the following results: 1. The cytotoxicity against K562 cells increased from 34.78 ?25% of the PBLs to 68.04 ?17.3% of the cells cultured for 8-13 days, afterward, kept about 70% to 23 - 27 days. The constitutional proportion patterns showed that the freshly isolated samples dispersed at a wide range of cytotoxicities (10 - 90%), and that most of the cultured samples ( ~ 85%) concentrated on the range of higher cytotoxicities (50 ~ 95% ) after 8-13 days. 2. The cytotoxicity against Raji cells rose from 8.9 ?8% of the fresh PBLs to 42.1 ?22% of the LAK cells at 8 - 13 days, and maintained about 35% in the following periods. The constitutional proportion patterns of the cytotoxicity against Raji illustrated that all the fresh PBL samples were below 25% of cytotoxicity, and that during the culture, one part of the samples ( ~ 30%) acquired the higher cytotoxicities (50 -90% ), but the other part of the samples ( - 40%) remained at lower cytotoxicities (below 35% ) . The mechanisms behind these phenomena are worth further investigating.