艾滋病抗病毒治疗药物的合理选择

艾滋病的抗病毒治疗经历了多个发展阶段。最早用于治疗人类免疫缺陷病毒（HIV）感染的抗病毒药物是核苷类逆转录酶抑制剂一叠氮胸苷（zidovudine,AZT）,它对HIV复制起到了一定的抑制作用。但许多感染者在治疗12周后会发生不同程度的耐药,出现病毒载量的反弹。进入20世纪90年代后,非核苷类抗逆转录酶抑制剂和蛋白酶抑制剂得到发展,用于临床的药物种类也增多,开始联合应用两种药物,抗病毒作用加强,同时耐药性的比例也有所减低,但仍然不能维持长期疗效。1996年,美籍华人何大一提出高效抗逆转录病毒疗法（highly active antiretroviral therapy,HAART）,即3种药物联合应用,是艾滋病抗病毒治疗的又一个里程碑。HAART治疗的优点是抗病毒活性进一步提高,使感染者体内病毒载量降低到可以检测的水平以下,明显延缓耐药性的产生,至今仍然是抗HIV的主要手段。     

中国HIV感染者的IL-21水平及其在高效抗反转录病毒治疗中的动态变化

目的:观察在接受抗HIV治疗的中国HIV感染者队列中血白细胞介素21( IL-21)的动态变化.方法:将符合高效抗反转录病毒治疗(HAART)指南标准的25例慢性HIV成年感染者纳入研究,在启动HAART的0,6,12个月时各抽取感染者的20 mL血液.运用流式细胞仪进行CD4+T细胞和CD8+T细胞计数,以RT-PC...     

蛋白酶抑制剂突变的数量和类型可决定病毒学反应

来自于美国的研究人员报道说,通过检测HIV感染者的蛋白酶抑制剂(PI)突变的数量和类型可预测其对抗逆转录病毒药物的病毒学应答。美国食品药品管理局(FDA)的Lisa K．Naeger博士认为,弄清HIV感染者中的抗逆转录病毒抗性是确定接受过抗逆转录病毒治疗的患者下一个最佳治疗方案的关键所在。     

HAART治疗与心理干预对HIV感染者外周血CD4+T细胞凋亡的影响

目的 观察高效抗逆转录病毒疗法(HAART)与心理干预对HIV感染者外周血CD4+T细胞内Ca2+浓度、细胞凋亡率、细胞线粒体膜电位的改变,探讨其对HIV感染者外周血CD4+T细胞凋亡的影响.方法 应用免疫磁珠分离外周血CD4+T细胞,流式细胞术检测细胞内Ca2+浓度,线粒体膜电位,细胞凋亡率.结果 HAART治疗心理...     

HAART使用的HIV感染者口腔真菌菌群特征

［摘要］目的　初步探明昆明地区使用HAART的HIV患者口腔念珠菌等真菌的分布特点．方法　采用黏膜拭子法收集45例用和54例未用HAART的HIV患者口腔标本,进行真菌培养和分离,用梅里埃API 20C AUX酵母菌鉴定试剂盒鉴定菌种,使用SPSS统计软件对结果进行统计分析．结果　未用和用HAART组的HIV患者口腔念珠菌检出率分别为53.3%和20.4%,差异有统计学意义（χ2 = 11.669,P＜0.01）,说明未用HAART组念珠菌检出率明显高于HAART组, 即HAART降低患者口腔念珠菌检出率．在分离到的41株念珠菌,白色念珠菌占78.0%,其次为近平滑和光滑念珠菌各占9.8%,热带念珠菌占2.4%．结论 HAART使用降低了口腔念珠菌检出率,但无症状携带率改变不大．     

白念珠菌分泌性蛋白酶活力与其对氟康唑耐药性之间关系的研究

目的研究白念珠菌分泌性蛋白酶（Sap）活力与其对氟康唑耐药性之间的关系。方法将对氟康唑敏感的白念珠菌培养在含氟康唑浓度逐渐增加的液体培养基中，体外诱导为氟康唑耐药株；运用牛血清白蛋白培养基（BSA）的方法测定了对氟康唑敏感的白念珠菌和对氟康唑耐药的白念珠菌的分泌性蛋白酶活力。结果40株对氟康唑敏感的白念珠菌均在体外被成功的诱导成为对氟康唑耐药的耐药株。耐药株的分泌性蛋白酶活力明显强于敏感株（P〈0．001）。结论白念珠菌Sap活力的增加与其对氟康唑耐药性增加是一致的。     

艾滋病合并痴呆的研究进展

在高效抗逆转录病毒治疗（HAART）用于人免疫缺陷病毒（HIV）感染者以前，艾滋病痴呆综合征（ADC）是艾滋病患者死亡的一个重要原因。但随着对ADC的发病机制的深入研究及HAART在HIV感染者中的广泛运用，ADC的发病率明显下降，预后也有很大的改善。本文就艾滋病痴呆的研究进展进行综述。     

HIV/HCV感染者合并脂肪肝的临床特征及独立预测因素研究

目的 探讨HIV/HCV共同感染者脂肪肝的发生率和独立危险因素分析.方法 选取102例HIV/HCV共同感染者,通过彩超检查是否存在脂肪肝,分析所有患者的性别、感染途径、体质指数(BMI)、高效抗反转录病毒治疗(HAART)方案和持续时间、CD4+T淋巴细胞计数、空腹血糖、血脂、肝肾功能、HCV-RNA定量值和HCV-RNA阳性率,采用Logistic回归分析HIV/HCV共同感染者脂肪肝的独立危险因素.结果 在102例HIV/HCV共同感染者中,21例(20.6%)存在脂肪肝.Logistic回归多变量分析发现脂肪肝的独立危险因素包括:高总胆固醇(TG)血症(OR=1.76,P=0.010)、低高密度脂蛋白(HDL)血症(OR=0.14,P=0.049)和HAART持续时间(OR=1.03,P=0.006);未发现患者的性别、感染途径、BMI、肝肾功能、HAART方案、CD4+T淋巴细胞计数、HCV-RNA定量值和HCV-RNA阳性率与脂肪肝的发生相关.结论 HIV/HCV共同感染者中脂肪肝的发生率为20.6%;高TG血症、低HDL血症和HAART治疗持续时间是脂肪肝发生的独立预测因素.     

HIV感染者获得免疫重建后可停止弓形体病治疗

来自于西班牙巴塞罗那大学临床医院的Jose M．Miro博士及其同事在近期出版的《临床传染病》（CID）杂志上报道说，对高效抗逆转录病毒治疗（HAART）应答的HIV感染者而言，可以不需要进行抗弓形体感染的预防治疗，即在那些HAART疗法显效的HIV感染者中，可以安全地停止弓形体脑炎的初级预防及二级预防措施。     

HIV、HCV复合感染患者HAART治疗后CD4＋细胞计数和HCV RNA变化的研究

目的了解河南省某县HIV感染者HIV、HCV复合感染状况以及高效抗逆转录病毒治疗（HAART）后CD4＋细胞计数和HCV RNA的变化。方法测定HIV感染者HCV—IgG、CD4＋细胞计数、血浆HIV和HCV病毒栽量。采用单因素方差分析比较应用HAART后CIM＋细胞计数和HCV RNA的变化。结果228名HIV感染者中，HCV—IgG阳性率88、6％（202／228）。在HAART超过6个月且HCV—IgG阳性的病人中，HIV RNA阴性（B组）的CD4＋细胞计数显著高于HIV RNA阳性的患者（A组）（P=0．020）；而两组的HCV RNA病毒栽量差异无统计学意义（P=0．749）。结论河南地区HIV、HCV复合感染在血液传播的HIV感染者中普遍存在。经HAART治疗的患者随着血浆HIV RNA转阴，CD4＋细胞计数显著升高，但血浆中HCV RNA的含量无显著变化。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.