Diagnostic dilemma: treatment outcomes of tuberculosis patients with inconsistent rifampicin susceptibility.

OBJECTIVE: A retrospective clinical trial to evaluate treatment outcomes in adults with smear-positive tuberculosis (TB) and discordant rifampicin (RMP) resistance results. DESIGN: A total of 2156 smear-positive TB patients underwent both conventional and Genechip drug susceptibility testing (DST) for RMP resistance. All 49 patients with discordant results treated with either a first-line or second-line regimen were analysed. RESULTS: Of 30 Type I cases (Genechip-resistant, conventional DST-susceptible) receiving the first-line regimen, 4 had a favourable outcome and 5 failed treatment. The 21 remaining Type I cases were treated with the second-line regimen, of whom 18 had a favourable outcome. Second-line regimen thus resulted in significantly more favourable outcomes than first-line treatment (P = 0.032). Among Type II cases (Genechip-susceptible, conventional DST-resistant), 13/19 received the first-line regimen, and 7 had a favourable outcome. The six Type II cases treated with the second-line regimen all had favourable outcomes. CONCLUSION: Patients with discordant RMP DST results who receive second-line regimens may have a better clinical response than those treated with the first-line regimen. Patients infected with fluoroquinolone-resistant Mycobacterium tuberculosis strains were observed to have a significantly higher treatment failure rate.

Treatment of domestic sewage by a metal membrane bioreactor.

A submerged flat metal MBR (membrane bioreactor) was used to treat synthetic domestic sewage in this study. The experiment was continued for 270 days and ran under two modes as AMBR (aerobic membrane bioreactor) and A/O-MBR (anoxic/aerobic membrane bioreactor) at a permeate flux of 0.4-1 m³/(m² d). PVA (polyvinyl alcohol) gel beads were added to the aeration tank with a volume ratio of 10% at the end of the A/O-MBR mode. The mean COD and TN removal efficiencies achieved 96.69 and 32.12% under the AMBR mode, and those were 92.17 and 72.44% under the A/O-MBR mode, respectively. SND (simultaneous nitrification and denitrification) occurred at high MLSS (mixed liquor suspended solids) concentration. The metal membranes reduced effluent COD during filtration. The system ran stably for 115 days at a permeate flux of 0.8-1 m³/(m² d) without changing membranes under the AMBR mode, but the membrane filterability decreased gradually under high MLSS or A/O-MBR mode, and the addition of PVA worsened the membrane filterability on the contrary. PSD (particle size distribution) and sludge fractions had evident influence on membrane fouling. The main fouling mechanism was cake formation under the AMBR mode, and that was pore blocking under the A/O-MBR mode.

Clinical and experimental effectiveness of Astragali compound in the treatment of chronic viral hepatitis B.

Chinese herbs are widely used in the treatment of chronic viral hepatitis B. The effectiveness of 2 months' treatment with Astragali compound (AC), containing Radix Astragali and adjuvant components, was studied for the treatment of chronic viral hepatitis in 116 patients; 92 patients were given other drugs in regular clinical use for viral hepatitis (controls). The clinical efficacy of AC was significantly better in AC-treated patients than in controls. Negative seroconversions of hepatitis B virus (HBV) antigen e and HBV DNA were also significantly higher in AC-treated patients than in controls. Of eight duck viral hepatitis B models infected with duck hepatitis B virus (DHBV) and treated with AC, three showed negative seroconversion of DHBV DNA and serum DHBV DNA levels significantly decreased after AC administration compared with the controls; DHBV DNA was negative in biopsied liver tissue by in situ hybridization and immunohistochemistry in two ducks treated with AC. Pathological changes were milder in AC-treated ducks than in controls. These results indicate that AC may promote recovery from viral hepatitis and inhibit HBV replication.

[Clinical and experimental studies on effects of chronic hepatitis B treated with astragali composita].

Eighty-seven cases of chronic persistent hepatitis (CPH) and 29 cases of chronic active hepatitis (CAH) were treated with Astragali Composita (AC), the clinical markedly effective rates were 69.0% and 55.2%, the total effective rates were 90.8% and 89.7% respectively; the sero-negative conversion rates of HBeAg and HBV-DNA were 27.7% and 28.0% respectively, they were higher than that of control group (P < 0.05-0.01). Eight ducks infected hepatitis B virus were treated with AC, sero-negative conversion of DHBV-DNA was seen in 3 ducks, DHBV-DNA levels of duck sera were lower after treatment than that before treatment (P < 0.05); mild inflammatory changes in liver tissues were seen in 3 ducks, its pathologic changes were milder than that of control groups; DHBV-DNA in liver tissues of 2 ducks was negative in situhybridization. The results indicated that AC had obvious effects of protecting liver tissues and some effects of inhibiting sera HBV and HBV replication.

[Derivatives of arteannuin B with antileukemia activity].

Arteannuin B (I) was converted to hydroxy lactones (VII, VIII) by a mixture of formic acid and sulfuric acid. Compound VI and Compound VII both showed activity against leukemia P 388 cell in vitro. The rate of growth inhibition were 97.5% and 11.8% for (VI) and 80% and 52.6% for (VII) at the concentration of 10 and 1 micrograms/ml respectively. It seems that the antileukemia activity of 6-membered lactone is higher than that of 5-membered and the methylene group is necessary for the antileukemia activity.