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Objective To monitor the drug resistance of tuberculosis in Zhejiang Province and to provide scientific evidence for the control of drug resistant tuberculosis.Methods Thirty counties in Zhejiang Province were selected as sample during July 1,2013 and June 30 2014,and smear positive cases were selected to be monitored during study period. Results The rate of drug resistance was 30.88%,and the rate of multi drug resistance was 5.02%.The rate of the extensively drug -resistant tuberculosis was 0.32%.Among initial treatment cases,the rate of drug resistance was 29.22%,higher than 2008,and the rate of multi drug resistance was 3.21%.Among retreatment cases,the rate of drug resistance was 45.74%,and the rate of multi drug resistance was 21.28%.All kinds of monitored drugs were found resistance phenomenon.The drug resistant rate of SM was highest (15.28%),and aminoglycosides (2.35%)were relatively low.Conclusion The status of retreatment TB drug resistance suggested that we had reduced acquired TB drug resistance through implementation of DOTS strategy and standard short course chemotherapy treatment in Zhejiang Province. But it is still not optimistic to control TB drug resistance,and the status of initial treatment TB resistant suggested that resistant strains spread had not been effectively controlled in Zhejiang Province.So we should strengthen the early detection of drug resistant among TB patients,and to further improve the standard of conventional TB treatment.
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Objective To know the application of MPB64 antigen detection of immune colloidal gold method for identification of Mycobacterium.Methods Taking the PCR amplified sequencing method as the 'gold standard',a total of 418 clinical isolated mycobacterium tuberculosis and 2 standard strains were tested by immune colloidal gold method,and was compared with the traditional method of PNB/TCH.Results Compared with sequencing method,the coincidence rate of immune colloidal gold method and PNB/TCH identification test was 95. 93%and 87. 08%respectively.The sensitivity, specificity,positive predictive value (PPV ) and negative predictive value (NPV ) of immune colloidal gold method identification were 88. 41%,99. 64%,99. 19% and 94. 58%respectively.It costs MPB64 immune colloidal gold method 15 minutes to carry out the results,less than 28 days of the traditional method,as well as 3 days of sequencing method. Conclusion Compared with PNB/TCH method,MPB64 immune antigen colloidal gold method has higher specificity and sensitivity,and could be applied in identification of Mycobacterium.
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Objective To comprehend the anatomical image data related to the keyhole microsurgery operation approaches in patients with saddle lesions.Methods Fifteen healthy volunteers and 10 patients with intracranial aneurysm were selected in the experiment and 16-slice spiral CT, CT angiography (CTA) and 3D-reconstruction were performed on them. The anatomitical distance and angle were measured through the ways from supraorbital keyhole approach, frontolateral keyhole approach, pterional keyhole approach, and subtemporal keyhole approach to the anterior/posterior clinoid process, the anterior communicating artery and the bifurcation of internal carotid. Results Of the distances between keyhole centre and anterior/posterior clinoid process, the shortest one was the way from subtemporal keyhole approach (4.98±0.54 em; 5.35±0.65 cm) and the longest one was the way from supraorbital keyhole approach (6.44±0.36 cm; 37.68±1.06 cm). Of the angles between the skull sagittal plane and the operation plane from keyhole centre to anterior/posterior clinoid process, the way from subtemporal keyhole approach was better than the way from frontolateral keyhole approach. Of the angles between skull transverse plane and the operation plane from keyhole centre to anterior/posterior clinoid process, that of subtemporal keyhole approach was better than pterional keyhole approach. Distances between keyhole centre and bifurcation of intemal carotid ordered as follows: the way from frontolateral keyhole approach, that from supraorbital keyhole approach, that from subtemporal keyhole approach and that from pterional keyhole approach. Of the angles between cranial sagittal plane and the operation plane from keyhole centre to the anterior communicating artery or the bifurcation of ipsilateral internal carotid,the way of frontolateral keyhole approach was better than that of supraorbital keyhole approach.Conclusion CT and CTA 3D-reconstruction, by demonstrating the distances and angles of each approach,play a significant role in choosing the right keyhole operation approach in different saddle lesions.