人类免疫缺陷病毒感染/艾滋病合并肺结核患者与无HIV感染肺结核患者分枝杆菌药敏结果对比分析

目的回顾性分析肺结核患者(PTB)与人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)合并PTB患者的分枝杆菌药敏和菌株鉴定结果,期望为HIV感染/AIDS合并PTB患者早期有效抗结核治疗提供数据参考。方法搜集重庆市公共卫生医疗救治中心结核科和感染科2013年1月1日至2013年12月31日期间1708例无HIV感染PTB患者和106例HIV感染/AIDS合并PTB患者临床资料,统计分枝杆菌药敏试验和菌株鉴定的结果,分析耐药特征,采用卡方检验,以P0.05为差异具有统计学意义。结果无HIV感染PTB组与HIV感染/AIDS合并PTB组的总耐药率、初治耐药率、复治耐药率差异均有显著统计学意义(P均0.01);HIV感染合并PTB组耐药率12.5%(2/16)与AIDS合并PTB组耐药率24.4%(22/90)差异无显著统计学意义(P0.05)。结论该中心收治的痰结核培养阳性患者中,HIV感染/AIDS合并PTB患者耐药趋势远低于PTB患者,HIV感染合并PTB组耐药状况与AIDS合并PTB组大体一致。     

获得性免疫缺陷综合征常见机会性感染的诊治(二)——分枝杆菌

结核分枝杆菌感染一、流行病学结核分枝杆菌(MTB)感染是我国获得性免疫缺陷综合征(AIDS)患者最为常见的机会感染之一,全球近4000万人类免疫缺陷病毒(HIV)感染或AIDS患者中约有36%合并     

合并HIV/AIDS肺结核患者单纯抗结核治疗的近期疗效分析

艾滋病（AIDS）患者和HIV（人类免疫缺陷病毒）感染者逐渐增多，艾滋病患者中有1／3同时感染结核分枝杆菌，且两病相互影响，互为因果。结核病加重艾滋病病毒感染者的病程发展，缩短了他们的寿命，1／3的艾滋病死于结核病。因此，加强对艾滋病机会性感染特别是结核病的治疗，是控制艾滋病的发展、改善预后的有效手段之一。本文对32例合并HIV／AIDS肺结核患者进行抗结核治疗观察，现将结果报告如下。     

合并HIV/AIDS肺结核患者单纯抗结核治疗的近期疗效分析

艾滋病（AIDS）患者和HIV（人类免疫缺陷病毒）感染者逐渐增多,艾滋病患者中有1/3同时感染结核分枝杆菌,且两病相互影响,互为因果^[1]。结核病加重艾滋病病毒感染者的病程发展,缩短了他们的寿命,1/3的艾滋病死于结核病^[2]。因此,加强对艾滋病机会性感染特别是结核病的治疗,是控制艾滋病的发展、改善预后的有效手段之一。本文对32例合并HIV/AIDS肺结核患者进行抗结核治疗观察,现将结果报告如下。     

肺结核与艾滋病

目的 了解结核病院人类免疫缺陷病毒(HIV)/结核分枝杆菌(MTB)双重感染发病情况及发现病例的临床表现?治疗对策?方法 对1995年2月～1999年2月3707例住院结核病患者常规检测HIV抗体?结果 3707例中HIV(+)4例,阳性率108‰?男3例,女1例?平均年龄295岁,占21～40岁年龄组的314‰?4例中血源性感染1例,异性间感染2例,另1例血源性?异性间感染难以确定?4例均可诊断为艾滋病(AIDS)?结论 对具有HIV感染危险因素的结核患者,特别是中青年,应常规进行HIV抗体检测,对HIV/MTB双重感染患者抗结核治疗时应特别注意药物副反应?在抗痨同时并用中西药抗AIDS治疗,结核病取得较好近期疗效?     

肺结核与艾滋病(附四例报告)

目的 了解结核病院人类免疫缺陷病毒(HIV)/结核分枝杆菌(MTB)双重感染发病情况及发现病例的临床表现?治疗对策?方法 对1995年2月～1999年2月3707例住院结核病患者常规检测HIV抗体?结果 3707例中HIV(+)4例,阳性率108‰?男3例,女1例?平均年龄295岁,占21～40岁年龄组的314‰?4例中血源性感染1例,异性间感染2例,另1例血源性?异性间感染难以确定?4例均可诊断为艾滋病(AIDS)?结论 对具有HIV感染危险因素的结核患者,特别是中青年,应常规进行HIV抗体检测,对HIV/MTB双重感染患者抗结核治疗时应特别注意药物副反应?在抗痨同时并用中西药抗AIDS治疗,结核病取得较好近期疗效?     

结核病与艾滋病病毒感染的相互影响

目前,全球感染艾滋病(AIDS)病毒(人免疫缺陷病毒,HIV)人数估计>3 600万人,而全球60亿人口中,有约1/3感染了结核分枝杆菌(MTB)。结核病(TB)不仅直接威胁人类健康,同时又“助纣为虐”,使得目前全球AIDS和TB双重感染的病例逐年增加。所以在21世纪,人类必须正视TB合并HIV/AIDS     

艾滋病合并肺结核12例临床分析

人类免疫缺陷病毒（HIV）感染,特别是艾滋病（AIDS）比其他因素更能促使患者感染结核分枝杆菌（MTB）^[1]或引起结核病（TB）的复燃,增加社区内MTB传播的风险^[2],且耐多药结核菌株极易在AIDS/HIV人群中传播而造成耐多药结核病的爆发流行^[3]。HIV感染与结核可相互促进病变的进展、恶化,并迅速导致患者死亡。为了解湖北省随州市HIV/AIDS患者的结核患病的情况,2005年1—3月,我们对当地的HIV/AIDS患者进行了结核筛查,发现并治疗艾滋病合并肺结核（AIDS/TB）患者12例,现将结果报告如下。     

T细胞斑点试验在老年性HIV/AIDS中的临床诊断价值

目的探讨T细胞斑点试验(T-spot.TB)检测在老年性人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者中的临床诊断价值。方法选择感染科及结核病科住院的老年HIV/AIDS患者作为研究对象,合并结核病者41例(试验组),未合并结核者56例(对照组)。对两组患者进行T-spot.TB检测,分析其对老年性HIV/AIDS合并结核病的诊断价值。结果试验组35例(85.25%)T-spot.TB检测阳性;而对照组T-spot.TB检测阳性5例,阳性率8.93%,两组差异有统计学意义(χ~2=20.08,P0.05)。T-spot.TB对老年HIV/AIDS患者合并结核病的灵敏度为86.9%,特异度为91.1%,阳性预测值为87.5%,阴性预测值为89.5%。结论 T-spot.TB试验可用于诊断老年HIV/AIDS患者是否合并结核病,具有较高的灵敏度和特异度。     

艾滋病合并结核性脑膜炎的治疗与护理

目前,我国艾滋病（acpuired immunedeficiency syndrome,AIDS）患者和人类免疫缺陷病毒（HIV）感染者日益增多。结核性脑膜炎（结脑）是由于结核分枝杆菌侵入蛛网膜下腔进而累及脑实质和脑血管的病变,是重症结核病。大约有1／3的艾滋病患者同时感染了结核分枝杆菌。而HIV感染后,机体对结核菌的杀伤力显著下降,结核菌得以快速生长繁殖而发病,两病互相影响。我院2005年1月至2008年5月,收治10例艾滋病合并结脑患者,现将治疗过程中的护理体会总结如下。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.