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Objective: To evaluate the reliability of thiophen-2-carboxylic acid hydrazine (TCH) test for identification of Mycobacterium bovis (M. bovis)., Methods: A total of 4069 clinically isolated strains were identified by P-Nitrobenzoic acid medium (500 mg/L) and TCH medium (5 mg/L). Mycobacterium tuberculosis (M. tuberculosis) complex strains susceptible to 5 mg/L TCH were further tested for susceptibility to 2 mg/L TCH. Spacer oligonucleotide typing (spoligotyping) and multi-loci PCR were also performed to identify TCH susceptible strains., Results: Among the 4069 isolated strains there were 3929 strains belonging to M. tuberculosis complex (MTBC) of which 245 were susceptible to 5 mg/L TCH. Of these 245 strains, 20 were also susceptible to 2 mg/L TCH, while only 1 strain was identified to be M. bovis by both spoligotyping and multi-loci PCR., Conclusion: TCH susceptibility test (either 5 mg/L or 2 mg/L) is not a reliable method for identification of M. bovis.

Objective: To study the effects of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangiomas (CCH)., Methods: It was a retrospective cases series study. One hundred and fourteen cases (114 eyes) in out-patient department were enrolled in the study with 80 male cases and 34 female cases. The age ranged from 16 to 71 yrs with an average at 44 years. Single eye was affected in all cases. Indirect ophthalmoscope, fundus fluorescein angiography (FFA), ultrasound (B) were used for the examination. Treatment was delivered via slit lamp by using an 810 nm diode laser (Irises) with spots or composed spots (larger tumor) covering the whole tumor. If the tumor was located or partly located in the fovea, laser spot should be avoided in the fovea and papillo-macular bundle. The laser power should be lesser (light gray color) in parafovea area. Routine laser spot (gray-white color) was used in perifovea area. A width of 200 µm out of disk border should not be placed by laser spot in paradisk tumor cases., Results: The visual acuity (VA) ≥ 0.5 of pre-and post-treatment was 17 eyes (14.9%) and 27 eyes (23.7%), respectively. Pre-treatment, the retinal detachment extended in the inferior part in 27 cases (23.7%) except on the tumor surface. The tumor was located at macular area in 67 cases (58.8%), around the disc in 35 cases (30.7%), at the temporal arcuate in 12 cases (10.5%). In our cases, VA maintenance with fluid absorption was noted in 76 cases (66.7%) after the treatment. VA improvement with fluid absorption in 28 case (24.6%). Both VA maintenance and improvement (rate of efficiency) with fluid absorption were 91.2%. Fluid non-absorption or VA decline was regarded as unsuccessful in 10 cases (8.8%). The average thickness of 32 cases tumor pre- and post-treatment was (3.90 ± 1.15) mm and (2.41 ± 1.30) mm. Twenty seven cases were followed up for ≥ 1 year (mean 22.8 months) with rate of efficiency at 81.5%. The complications (9 eyes, 7.9%) contained minor macular hemorrhage in 2 eyes, macular pucker in 3 eyes, macular edema and cystoid macular edema in 2 eyes, retinal branch occlusion in 1 eye, and arcuate scotoma in 1 eye., Conclusions: The treatment of TTT on CCH, whether the tumor located around-disc or in foveal area with exudative fluid could get successful in the majority of cases. TTT is one of the treatments worth doing owing to fewer complications, less expenses and easy-doing with definite and persistent effect.

Objective: To report the clinical features of occult macular dystrophy (OMD)., Methods: It was a retrospective case series study. 9 cases (14 eyes) with 3 males, 6 females, mean age 36 (7 to 53) years, were examined with vision acuity, fundus ophthalmoscope, fundus fluorescein angiography (FFA), electroretinogram (ERG), visual evoked potential (VEP), multifocal electroretinogram (mfERG) and optical coherence tomography (OCT). In mf ERG, the amplitude density and implicit time of P1 ring1 and ring2 of the affected eyes were compared with the normal control eyes. The correlation between the implicit time & amplitude density of P1 ring1 & ring2 of the affected eyes and visual acuity were examined., Results: 9 eyes VA were 0.05 to 0.2, 4 eyes were 0.3 to 0.6 and 1 eye it was ≥0.7. All of the 9 cases possessed their unique clinical features, including progressive visual decline, normal fundus, FFA, and F-ERG. Macular function impairment was showed only by mfERG. In mfERG, the results of comparison between the affected eyes and normal control eyes were as follows:On implicit time of P1 ring1, average figure of the affected eye group was (27.67±1.07) ms, the control group was (26.28±1.88) ms. The parameters were significant difference between 2 groups (t=-2.308, P<0.05). On ring1 amplitude density, average figure of the affected eye group was (42.71±15.48) nv/deg2, average figure of the control group was (66.79±14.87) nv/deg2, there was also a significant difference between two groups (t=5.259, P<0.05). On implicit time of ring2, average figure of the affected eye group was (27.80±1.20) ms, average figure of the control group was (26.91±0.82) ms, the results from the 2 groups showed significant difference (t=-2.275, P<0.05). On ring2 amplitude density, average figure of the affected eye group was (24.99±8.49) nv/deg2, average figure of the control group was (39.20±6.47) nv/deg2, there was significant difference between two groups (t=4.943, P<0.05). No correlation was found between the implicit time (r=-0.329, -0.369) & amplitude density (r=0.053, 0.057) of P1 ring1 & ring2 of the affected eyes and visual acuity (P>0.05)., Conclusions: The major signs of OMD are visual acuity decline with normal fundus, FFA and F-ERG, macular function impairment manifested only by mfERG. It's probably a type of cone dystrophy.

Objective: To evaluate the mycobacterium efficacy of linezolid to Mycobacterium tuberculosis bacilli and Non-tuberculous mycobacteria (NTM) in vitro, and to analyze the interaction between linezolid and other anti-TB drugs in vitro., Methods: The minimum inhibition concentrations (MICs) of 121 Mycobacterium tuberculosis clinical isolates and 30 non tuberculosis Mycobacteria isolates and the corresponding standard strains to linezolid were tested by Microplate Alamar Blue assay (MABA). The interactions between linezolid and rifampicin, isoniazid, streptomycin, ethambutol, kanamycin, ofloxacin, and rifabutin were also tested in vitro by fractional inhibitory concentration index (FICI) method., Results: 94.2% (114/121) of the Mycobacterium tuberculosis isolates were inhibited by linezolid at concentrations ≤ 1 mg/L. There was no statistical difference in the MIC values of sensitive strains, MDR strains, and drug resistant strains other than MDR (χ(2) = 0.481, P > 0.05). Only Mycobacterium kansasii was totally sensitive to linezolid among the 5 tested NTM strains. In vitro drug combination testing displayed overall non-association between linezolid and 7 other anti-TB drugs among 8 clinical isolates and H(37) Rv., Conclusions: Linezolid showed great mycobacterium efficacy to Mycobacterium tuberculosis clinical isolates in vitro, regardless of the strains' drug resistant parameters. This study also showed non-association of the interactions between linezolid and 7 other anti-TB drugs in vitro.

Objective: To study the positive rate of smear and culture in different sputa from smear-positive patients with tuberculosis, and to discuss the criteria of sputum selection for smear and culture., Methods: The results of smear and culture of sputum samples from 3813 cases during tuberculosis drug-resistance baseline survey in 2007 were retrospectively analyzed. The positive rates of smear and culture of spot sputum, night sputum and morning sputum were compared, and the culture positive rate of sputum samples with 1-2 acid fast bacilli (AFB)/300 fields was summarized. The χ(2) test was used for comparison., Results: The smear positive rate of spot sputum, night sputum, and morning sputum was 75.2% (2868/3813), 87.9% (3350/3813), and 89.4% (3408/3813) respectively. The percentage of cases which were positive for all the 3 sputum samples was 64.5% (2460/3813), while that for 2 samples and 1 sample was 23.4% (893/3813) and 12.1% (460/3813) respectively. The cumulative smear positive rate of spot sputum plus morning sputum reached 96.9% (3695/3813) of the rate combined from the 3 sputum samples. The culture positive rate of spot sputum, night sputum, and morning sputum was 97.8% (1654/1691), 96.7% (3006/3107) and 97.2% (2473/2543) respectively. For the smear positive cases, the positive rate of 2 sputum culture increased only 1.7% - 2.8% compared with that of 1 sputum culture. The culture positive rate of samples with a smear result of 1 - 2 AFB/300 fields was 90% (98/109)., Conclusions: When spot sputum and morning sputum are collected for the diagnosis, the number needed for smear can be decreased from 3 to 2. For smear-positive cases, if sputum is selected for culture according to the smear result, the number needed for culture can be decreased from 2 to 1. A smear result of 1 - 2 AFB/300 fields is of considerable diagnostic value for tuberculosis.

Objective: To explore the spectrum and clinical features of causes for chronic cough., Methods: A total of 103 patients with at least 8 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of China-Japan Friendship Hospital Department of Respiratory Diseases between Oct 2005 to Feb 2009. The causes were investigated using a well established protocol according to The Chinese Respiratory Society guidelines for management of cough. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestations, examination findings and a positive response to therapy. The results were compared with those reported in Guangzhou before., Results: The cause of chronic cough was defined in 95.1% of the patients, of which 83 patients (83.5%) with a single cause, 32 (13.6%) with 2 causes, and 3 (2.9%) with 3 causes. The most important causes of cough were: cough variant asthma (CVA) (n = 41, 33.3%), rhinitis and/or sinusitis (n = 30, 24.4%), gastroesophageal reflux (GERC) (n = 25, 20.3%), medicine related (n = 7, 5.7%), eosinophilic bronchitis (EB) (n = 6, 4.9%), atopic (n = 4, 3.3%), and idiopathic (n = 6, 4.9%). Other causes included pulmonary interstitial fibrosis (n = 2, 1.6%), left heart insufficiency (n = 1, 0.8%) and bronchiectasis (n = 1, 0.8%). There was more nocturnal cough in CVA (80.9%, 36/41) than in other causes (chi2 = 19.81, P<0.01). In CVA, 63.4% (26/41) was complicated with atopic rhinitis, 68.3% (28/41) showed seasonal variations, and 67.8% (19/28) aggravated in the autumn. GERC manifested more day coughs, with 56.0% (14/25) cough associated with taking food and 68.0% (17/25) with reflux symptoms. There was more productive cough in rhinitis and/or sinusitis (73.3% (22/30) ,chi2 = 24.99, P<0.01). The percentages of CVA and GERC were significantly higher than those reported in Guangzhou (chi2 value were 9.52 and 4.56 respectively, P<0.01), but those of EB and atopic cough were significantly lower (p values were 17.61 and 7.86 respectively, P<0.01)., Conclusions: The most common causes of chronic cough in our study were CVA, rhinitis and/or sinusitis, GERC, medicine related cough, EB and atopic cough, which were different from previous reports in other cities such as Guangzhou. The spectrum and clinical features of causes for chronic cough are important in the diagnostic procedure of chronic cough.

Objective: To assess the clinical features and management of choroidal metastasis., Methods: Fundus examination was performed in 49 patients (66 eyes) with choroidal metastasis. Fundus fluorescein angiography (FFA) was performed in 44 cases, combined with indocyanine green angiography (ICGA) examination in 12 cases. B-scan ultrasound examination was performed in 8 cases. Transpupillary thermotherapy (TTT) was performed in 24 eyes, combined with photo-dynamic therapy in one eye. Plaque radio-therapy was used in one eye. The parameters of treatment for TTT were 1.2 - 3 mm spot size, 450 - 1000 mV, 60 s; 2 sessions of TTT in 2 eyes and 3 sessions in 3 eyes., Results: Fourteen cases were male and 35 cases were female. Both eyes were affected in 17 cases (34.7%). Age ranged from 23 - 74 years old with an average of 47 years. The visual acuity was 0.05 or less in 13 eyes; 0.06 - 0.2 in 22 eyes and 0.3 or more in 31 eyes. Primary tumours were found in 40 cases (81.6%) (surgical excision in 25 cases), consisting of breast carcinoma in 16 cases (32.7%), lung carcinoma in 14 cases (28.6%), hepatoma and cholangiocarcinoma in 3 cases, colon and stomach carcinomas in 3 cases, gynecologic appendix carcinoma (including 1 case of ovarian mucous cyst adenocarcinoma) in 2 cases, nasopharyngeal adenocarcinoma in 1 case, vertebra tumor in 1 case, undetected in 5 cases (10.2%) and under detection in 4 cases (8.2%). The fundus had 1 lesion in 58 eyes (58/66 = 87.8%), 2 lesions in 4 eyes (4/66 = 6.0%), 3 or more lesions in 2 eyes (including 7 lesions in 1 eye). According to the location and development status of the lesions, they could be divided into solitary type, 39 eyes (39/66 = 59.1%); diffuse type, 19 eyes (19/66 = 28.8%); and early type, 8 eyes (8/66 = 12.1%). FFA examination: early stage lesions showed hypofluorescence and later stage lesions showed moderate to strong hyperfluorescence. In 8 cases of solitary lesions, the size of the lesion measured by B-scan averaged 11.5 mm x 10.5 mm x 3.6 mm with the maximal height at 4.9 mm. The tumor became flattened and vision remained stable at 3 months after plaque radiotherapy in 1 case. Three cases were followed-up for 2, 3, and 4 months after TTT treatment. The lesions remained stable with vision unchanged or slightly decreased., Conclusions: The choroidal metastasis has specific clinical features. The classification of metastatic lesions into solitary, diffuse and early types is helpful for the evaluation of the disease process. The primary tumor can be found in 80% of cases. The most common primary cancer is breast carcinoma, followed by lung carcinoma. These two cancers account for 75% of primary tumors. In solitary type and early type lesions, TTT combines with systemic treatment could result in regression of lesions, saving of vision and improvement of the life quality.

Objective: To investigate the clinical features of choroidal neovascularization (CNV) in different classifications., Methods: In this retrospective case series, 393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology, location, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings., Results: The relative frequency of various causes in CNV was as follows: there were 153 cases (49.04%) from age-related macular degeneration (AMD) , 94 cases (30.13%) from idiopathic CNV, 37 cases (11.86%) from pathologic myopia, 15 cases (4.81%) from inflammatory disorders, 7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV), 3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor, respectively. The majority cases from AMD was male (64.71%), whereas most from pathologic myopia, idiopathic CNV and inflammatory disorders were female (78.38%, 73.40%, 73.33%). The age range of the cases from AMD was 49-95 years (68.73 +/- 8.31), and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86 +/- 6.45), and 84.04% of them were between 20 and 40 years old. The sex (chi2 = 57.17, P<0.05) and age (F=172.57, P< 0.05) had significant difference in each etiological group. FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic. CNV in 91.67% from pathologic myopia, 76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic. In each group, most of the CNV was subfoveal type (58.00%-100.00%), followed by juxtafoveal type (0%-35.00%). In the ICGA of 54 eyes with AMD, 11 eyes (20.37%) were occult CNV (plaque, spot and mixed CNV), 17 eyes (31.48%) were CNV fibrosis. CNV was active in most cases. The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%, respectively, no lesions were noted in 1 eye (1.85%) in ICGA., Conclusions: The clinical characteristics and frequency of various types of CNV are different due to different causes. Classification of CNV based on its etiology, FFA and ICGA findings, location, and activity in detail is important for the diagnosis, treatment and prognosis judgment in CNV.

Unlabelled: OBJECTIVE; To make a comparative study of the clinical characteristics and risk factors of nonischemic central retinal vein occlusion (CRVO) between patients younger and older than the age of 40., Methods: It was a retrospective case series. Retrospective data analysis (including best corrected visual acuity, color fundus photograph and fundus fluorescein angiography, etc. ) was conducted in patients with nonischemic central retinal vein occlusion who were followed-up for 6 months or longer., Results: The data of 148 cases (151 eyes) were analyzed. The follow-up time was 6 months to 15 years, averaged 17 months. Among them, 39 patients (40 eyes) aged 40 years or younger, their age ranged from 15 to 40 years, averaged 27 years old. There were 20 cases of male patients (20 eyes) and accounted for 51% of total cases. The rest of the patients were above the age of 40 years old. Their age ranged from 41 to 76 years, averaged 57 years old. Male patients (53 cases, 54 eyes) accounted for 49% of total cases. In the younger patients, only 2 of them had a history of hypertension, no other systemic illness was found. In the older patients, more than 40% of them had a history of systemic illness, including hypertension and diabetes mellitus. Initial visual acuity showed no statistically significant difference between these two groups (Pearson, chi2 =0. 087, P = 0.769). There was a significant difference in final visual acuity between these two groups (Pearson, chi2 = 4.692, P = 0.047). Final visual acuity was 20/60 or better in 18 cases (45%) in the younger group, but only 25 cases (23%) in the older group. Final visual acuity was 20/200 or less in 67% of cases in the older group, while 35% in the younger group. Complications occurred more frequently in the older group. The difference of complication rate in these two groups was statistically significant (Pearson, chi = 8.763, P = 0.006). Final vision was statistically correlated with age, initial visual acuity and complications, but not with sex or systemic illness. CONCLUSIONS Systemic illness is a risk factor for the occurrence of CRVO in the older group, but not in the younger group. It does not affect the final visual acuity. Complications occurs less common in the younger group. Although final visual acuity was better in the younger group, but still 35% of them was 20/200 or less. Most of the patients in the older group have severe visual impairment. Active treatment should be given to both groups.

Objective: To study the consistency of the color fundus photography and fluorescein angiography for grading the diabetic retinopathy., Methods: It was a retrospective case series. The agreement study was conducted in a series of diabetic patients, who were excluded from the mild non-proliferative diabetic retinopathy (NPDR) and the severe proliferative diabetic retinopathy (PDR). Ninety-nine cases (188 eyes) met the selected criteria Five 50 degrees non-stereoscopic photography for each eye were taken in all cases before FFA was performed. The diabetic retinopathy was graded from the fundus photography and FFA images according to international diabetic retinopathy disease severity scale. The kappa value was calculated according to the grading outcomes from the fundus photography and FFA images to estimate the agreement of the grading outcomes., Results: The fundus photography showed 59 moderate NPDR (31.4%), 76 severe NPDR (40.4%) and 53 PDR eyes (28.2%) respectively, FFA showed 50 moderate NPDR (26.6%), 72 severe NPDR (38.3%) and 66 PDR (35.1%) respectively. The agreement for the grading of DR by the fundus photography and FFA was substantial (K = 0.601). In the evaluation whether it was necessary to implement PRP (more serious than NPDR and PDR), there was higher agreement between them (K = 0.652)., Conclusions: Five 50 degrees photography can provides the support of the application of PRP for diabetic patients, FFA may be earlier and relatively accuracy in the diagnose of diabetic retinopathy.

Objective: To explore the clinical characteristic, visual prognosis and related factors of nonischemic central vein occlusion., Methods: Retrospective data analysis (including visual acuity, color fundus photography and fundus fluorescein angiography) was conducted in patients with nonischemic CRVO who were followed-up for 3 years or longer., Results: The data of 35 cases (37 eyes) were analyzed. The follow-up time was 3 - 15 years, averaged 4.5 years. Age of those patients ranged from 18 to 76 years, averaged 56 years. Thirty cases (32 eyes) were over 40 years old. Two cases had chronic angle closure glaucoma. At the final visit, visual acuity improved in only 2 eyes (5%), remained the same in 11 eyes (30%), and decreased in 24 eyes (65%). Twenty-eight eyes (75%) had a final visual acuity of 20/200 or less. Nine eyes (24%) transformed to the ischemic type, among which neovascular glaucoma occurred in 5 eyes. Macular complications were the major causes of serious visual impairment. The patients with chronic angle closure glaucoma and partial optic nerve atrophy had relatively good final visual acuity., Conclusions: Nonischemic CRVO can cause severe visual impairment. Macular complications are the major causes of vision loss. Partial optic nerve atrophy may have a protective effect on visual acuity in CRVO.

Objective: To observe clinical features of Retinitis pigmentosa with retinal vascular occlusion and its prognosis., Methods: To analyze the clinical Data in 18 cases retrospectively using fundus examination, fundus fluorescein angiography, indocyanine green angiography, electroretinogram, visually evoked potential etc. Gene screening was performed in 3 cases., Results: the major clinical manifestations of the disease were optic atrophy, vascular attenuation to obliteration, widespread retinal pigment epithelium atrophy with depigmentation and/or fine pigment spots, total or nearly total a and b wave were extinct in the examination of electroretinogram. All this manifestations were compatible with that of typical Retinitis Pigmentosa (tapeto-retinal dystrophy). It also had its unique features, such as total or nearly total vascular obliteration, marked optic atrophy in later stage, and choroidal vessels abnormal. Gene mutation was not found in gene encoding area of RHO gene of No: 3 chromosome and of RLBPI gene of No: 15 chromosome. vision loss in this kind retinitis pigmentosa is much faster than that of typical retinitis pigmentosa., Conclusion: Retinitis pigmentosa with retinal vascular occlusion may belonged to a kind of tapeto-retinal dystrophy, vascular progressive obliteration was probably its associated disease.

Objective: To evaluate the clinical value of stereotactic radiosurgery (SRS) for uveal melanoma., Methods: From Jan, 1996 to March, 2004, 16 patients with uveal melanoma were treated with SRS, two by one session (35 Gy, 25 Gy) and fourteen by fractionated SRS (30-55 Gy/2-4F/4-16D). The follow-up period ranged from 3 to 100 months (median: 66 months)., Results: All 16 patients were still alive though all were blind in the diseased eye during recent follow-up. Local control rate was 93.4%, 5-year survival rate of 13 patients who have been followed for more than 5 years, was 100% (13/13). However, 7 patients received eyeball enucleation due to corneal ulcer (n = 2), suspicion for uncontrolled tumor (n = 2) and secondary glaucoma (n = 3). One patient developed distant metastasis, though still alive., Conclusion: Fractionated radiosurgery is safe and effective for uveal melanoma. It is indicated for lesions of limited size (longest diameter < 20 mm, depth < 15 mm) located in the posterior pole or behind the equator at the back of the eyeball.

Objective: To study the characteristics of katG, inhA, ahpC, kasA, and oxyR gene mutations in isoniazid-resistant clinical isolates of Mycobacterium tuberculosis., Methods: A total of 101 isoniazid-resistant and 43 susceptible strains of Mycobacterium tuberculosis were analyzed by PCR and sequence analysis of their katG, inhA, ahpC, kasA, and oxyR genes., Results: (1) Sequencing of katG from 101 INH-resistant strains showed point mutations, small deletions or insertions in 81 isolates (80.2%), but no complete deletions were identified. The mutations at 16 position were found for the first time. Point mutations at position 315 were found in the genomes of 38.6% (39/101) of isoniazid-resistant strains. Low level isoniazid resistant strains (1 microg/ml) had higher mutation frequency at 315-Ser than high level isoniazid resistant strains (10 microg/ml; chi(2) = 9.31, P < 0.05). Mutations at position 463 were detected in 58 (57.4%) isoniazid-resistant strains. Arg463leu was also present in 23 of 43 susceptible strains. (2) Mutations in inhA genes were identified in 5 isoniazid-resistant isolates (4.9%). None of the susceptible strains contained any mutation in inhA genes. (3) Only 3 isolates in the 101 (2.97%) isoniazid-resistant clinical isolates had mutations in ahpC genes. No mutations were identified in the ahpC genes in 43 isoniazid-susceptible isolates. (4) Mutations in kasA genes were present in 17 of 101 (16.8%) isoniazid-resistant isolates. However, G312S was also present in 3 of 43 susceptible strains. (5) None of the isoniazid-resistant strains and susceptible isolates contained oxyR gene mutation. (6) Taken together, 91 of 101 (90%) isoniazid-resistant strains had mutations in katG, inhA, ahpC, and kasA genes which were associated with drug resistance., Conclusion: These studies provide further evidence supporting the association between katG, inhA, ahpC, and kasA gene mutations and INH resistance in Mycobacterium tuberculosis, while other mechanisms of INH resistant may exist.

Objective: To study the bactericidal effect of rifapentine and its cross-resistance with rifampin for Mycobacterium tuberculosis and to determine the critical concentration of rifapentine for laboratory drug susceptibility test and therefore to provide the laboratory data for using rifapentine in the treatment of tuberculosis, particularly rifampin resistant tuberculosis., Methods: We detected the minimal inhibitory concentrations (MICs) of rifampin and rifapentine to H(37) Rv and isolated strains of rifampin susceptible and resistant Mycobacterium tuberculosis by using Middlebrook 7H9, Sauton and Lowenstein-Jensen media., Results: The MICs of rifampin were > or = 0.32 microg/ml for 80% of the 19 rifampin susceptible strains on Middlebrook 7H9 and the MICs of rifapentine ranged from 0.02 microg/ml to 0.32 microg/ml for most of the strains (84%). The MICs of rifapentine were 2 - 4 times lower than those of rifampin to H(37) Rv and most clinical isolates. The rifapentine susceptible isolates were mostly separated from resistant strains at MICs 5-10 microg/ml., Conclusions: Our results demonstrate the cross resistance of rifampin and rifapentine and the stronger bactericidal potency of rifapentine than rifampin. Some rifampin resistant strains still show susceptibility to rifapentine, which suggests rifapentine may be effective in the treatment of rifampin resistant tuberculosis. Our results also determined a critical resistant concentration of rifapentine for routine drug susceptibility test.

Objective: To rapidly identify drug-resistant Mycobacterium tuberculosis using phenotypic and genotypic methods and to evaluate the clinical significance of rapid phenotypic susceptibility test by phage amplified biologically assay (PhaB)., Methods: PhaB, DNA sequencing and polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) were performed on the 91 rifampicin (RFP)-resistant strains (including 82 multi-drug resistant Mycobacterium tuberculosis strains), 42 RFP-susceptible strains, 75 ofloxacin (OFLX)-resistant strains and 40 OFLX-susceptible strains at the same time., Results: The results obtained using PhaB assay, DNA sequencing and PCR-SSCP were compared with the absolute concentration method. For RFP susceptibility, the accordance, sensitivity and specificity of PhaB were 93%, 92% and 95% respectively; the accordance, sensitivity and specificity of DNA sequencing were 93%, 90% and 100% respectively; those of PCR-SSCP were 90%, 86% and 100% respectively. For OFLX susceptibility, the accordance, sensitivity and specificity of PhaB assay were 95%, 95% and 95%; those of DNA sequencing were 80%, 71% and 98% respectively; those of PCR-SSCP were 75%, 63% and 98% respectively., Conclusions: PhaB assay is a low-cost, rapid, and sensitive method and shows high accordance with absolute concentration technology. It can give drug susceptibility test results within 48 - 96 h, and is a promising technology in clinical laboratory.

Objective: To study the characteristics of optical coherence tomography (OCT) pictures in pathologic myopia., Methods: 100 cases (195 eyes) of pathologic myopia were examined with OCT. The Age ranges of all the cases was 16-76 years and refraction error was -6.00 - -36.00 diopters., Results: OCT image was normal in 7 eyes (4.3%), the reflectivity band of RPE and chorio-capillaries were uneven and thinning in 147 eyes (90.2%). Full-thickness macular hole was found in 21 eyes (10.8%), of which 10 (5.1%) eyes were associated with retinal detachment; local shallow retinal detachment was found in 24 eyes (12.3%), of which 7 eyes (3.6%) were associated with retinal schisis, 19 eyes (9.7%) with macular choroidal neovascularization (CNV). retinal swelling was often associated with the following diseases: Fuchs spot 9 eyes (4.6%), thick macular hemorrhage 3 eyes, epiretinal macular membrane 18 eyes (9.2%); macular sensory retina thinning in 5 eyes (2.6%)., Conclusion: Compared with fundus examination including slit lamp with pan-retinoscope, OCT showed unique preference for observation of the changes of retinal pigment epithelium (RPE), chorio-capillary layer, diagnosis macular hole and epiretinal macular membrane, discovery of small sensory retinal detachment, schisis and thinning of sensory retina layer etc. OCT can not either discover a piece of thin macular hemorrhage or differentiation between thick macular hemorrhage and pigment spot.

Objective: To test the effectiveness and safety of laser-induced chorioretinal venous anastomosis in the treatment of nonischemic central retinal vein occlusion (CRVO), and also the effectiveness of the preventative measures for complications associated with the treatment., Methods: Laser-induced chorioretinal venous anastomosis was performed on 34 cases, 35 eyes with nonischemic CRVO. During the treatment, preventative measures for complications were taken as follows: (1) Patients with total retinal papillary nonperfusion area of less than 5 DA were selected to receive the treatment. (2) Treatment sites must be at least 3 PD away from the optic disc and 4 PD away from the macula. (3) At most 2 argon laser shots were attempted over each treatment site, to avoid severe laser damage. (4) Scattered argon laser photocoagulation was done over the drainage area of the vein distal to the treatment site, in order to prevent neovascular complications in case distal vein occlusion occur., Results: During the 3 approximately 12 months (average 6 months) follow-up, successful anastomosis formed in 28 eyes out of 35 eyes (80%) with a mean of 2.4 attempts to create an anastomosis in each eye. With successful anastomosis, retinal hemorrhage started to be absorbed gradually 2 weeks after the treatment, and almost entirely absorbed 1 approximately 2 months later. Retinal edema also alleviated. Visual acuity improved in 20 out of 28 eyes (71%), and remained unchanged in the rest of the patients with successful anastomosis. In comparison with the natural course of the disease, our treatment has improved both the visual prognosis and the retinal damage caused by the disease. No serious complications occurred in these patients with successful anastomosis. Anastomosis failed to form in 7 cases (7 eyes), among which, 2 eyes developed serious neovascular complications., Conclusions: CRVA treatment is effective in the treatment of non-ischaemic CRVO. With proper preventative measures for complications associated with the treatment, the safety of the treatment can be increased prominently, but serious neovascular complications was not entirely prevented.