26例艾滋病合并巨细胞病毒性视网膜炎的护理

目的探讨艾滋病（AIDS）合并巨细胞病毒性视网膜炎的护理方法。方法回顾性总结26例AIDS合并巨细胞病毒性视网膜炎患者的护理资料。结果 17例患者得到及时治疗未出现视力损害,9例患者出现不同程度的视力下降,其中2例出现单眼失明。结论密切观察患者病情变化,做到早发现、早治疗,加上行之有效的护理方法 ,有助于有效控制病情。     

艾滋病合并慢性乙型肝炎患者视网膜病变的临床分析

目的：研究AIDS合并CHB患者的视网膜病变的临床特征及治疗效果。方法对65例AIDS合并CHB患者进行间接检眼镜检查,总结其视网膜病变的眼部症状、眼底情况、CD4+ T淋巴细胞水平、治疗及转归等情况。结果患者视网膜病变主要表现为视网膜棉絮斑（29例）、出血（12例）、血管异常（6例）、巨细胞病毒性视网膜炎（CMVR）（16例）和全葡萄膜炎（2例）。发生视网膜病变患者的CD4+T细胞计数多小于200细胞/μl（61例,93.8%）;且随着CD4+T细胞计数的下降,眼部病变的发生率随之上升（P ＜0.05）。经治疗后,棉絮斑及出血均在3个月内消退,但可出现新病灶;CMVR患者的治疗有效率是81.3%（13例）,但有4例患者在停药3～4周内复发。结论 AIDS合并CHB患者的视网膜病变主要表现为棉絮斑、出血、血管异常和巨细胞病毒性视网膜炎,多见于CD4+ T细胞计数较低者,且发病率随着CD4+ T细胞计数降低而增加。AIDS合并CHB患者应常规行眼科检查,以期早期诊断和早期治疗视网膜病变。     

获得性免疫缺陷综合征患者合并巨细胞病毒性视网膜炎的诊治

目的 探讨AIDS患者巨细胞病毒性视网膜炎的临床特征及转归.方法 观察21例(31眼)AIDS合并巨细胞病毒性视网膜炎的临床表现,随访2～18个月,对其临床特征和实验室资料进行分析.结果 9眼视网膜病变为早期后极部血管旁白色棉絮斑伴出血;22眼为沿血管分布的视网膜大片黄白色病损及颗粒伴出血,晚期血管狭窄、闭塞.7眼并发视神经乳头水肿.本组患者CD4+ T细胞计数平均为(27.05±28.15)/μL,经实时定量PCR检测发现,19例CMV阳性.更昔洛韦治疗有效,6例(8眼)治愈,8例(12眼)好转,31眼的治愈、好转率为64.5%(20/31),7例(11眼)无好转,其中6例患者随访期间死于各种机会感染.结论 巨细胞病毒性视网膜炎眼部病变特征为早期后极部血管旁白色棉絮斑伴出血,进展期为沿血管分布的视网膜大片黄白色病损和灰白颗粒伴出血.CD4+ T细胞计数＜50/μL是巨细胞病毒性视网膜炎发病的危险因素.     

获得性免疫缺陷综合征患者高效抗逆转录病毒治疗的相关肝毒性

高效抗逆转录病毒治疗(HAART)能有效地抑制HIV复制,并重建机体的免疫功能,大大降低获得性免疫缺陷综合征(AIDS)相关疾病的发病率与病死率.研究表明,HAART治疗后的肝功能损伤已经成为AIDS治疗后的最常见并发症之一,也是患者死亡及中断治疗的重要原因 [1-2].     

粒细胞集落刺激因子可以提高艾滋病患者的存活率

美国约翰·霍普金斯大学的Jabs博士等最近报道,采用粒细胞集落刺激因子(Filgrastim)治疗,可以使艾滋病(AIDS)相关巨细胞病毒(CMV)视网膜炎患者的病死率降低56%。不过,导致这种存活受益的原因似乎与细菌感染的下降无关。Jabs博士等指出,在高效抗逆转录病毒治疗(HAART)问世前,嗜中性粒细胞减少症在AIDS患者中较为常见。由于嗜     

20例AIDS合并巨细胞病毒脑炎的临床分析

目的探讨AIDS并发巨细胞病毒脑炎的临床特点、诊治及转归。方法回顾性分析北京地坛医院2012年1月—2015年1月明确诊断为AIDS并发巨细胞病毒脑炎的20例患者临床资料,分析其临床表现特点、脑脊液检测结果及诊治过程。结果 20例患者均处于AIDS晚期的严重免疫缺陷状态,临床表现不典型,多有智力下降、头痛、意识障碍以及神经功能受损表现,影像学检查无显著特异性,疗效较差。结论巨细胞病毒脑炎临床表现缺乏特异性,须尽早确诊治疗以降低病死率。     

艾滋病的免疫重建炎性综合征

20世纪90年代开始应用的高效联合抗逆转录病毒治疗(HAART)使HIV／AIDS的临床治疗获得突破性进展。HAART能够有效抑制HIV复制，重建HIV／AIDS患者的免疫功能，显著降低AIDS相关疾病的发病率和病死率。但随着HAART的应用却发现部分HIV／AIDS患者在开始HAART后，尽管血浆HIV载量及CD；T淋巴细胞计数两项指标均有改善，临床症状却出现恶化甚至死亡。     

免疫正常患者巨细胞病毒食管炎1例报道并文献复习

巨细胞病毒食管炎通常发病于有免疫缺陷的患者,国内对于免疫力正常并患有巨细胞病毒食管炎的病例尚未见报道。现报道1例并进行相关文献复习,总结免疫力正常巨细胞病毒食管炎患者的临床表现、内镜下特点、诊断及治疗方法。     

AIDS并发巨细胞病毒性视网膜炎

目的探讨艾滋病(AIDS)并发巨细胞病毒(CMV)性视网膜炎的临床特点和治疗转归.方法观察分析北京协和医院确诊为AIDS并发CMV视网膜炎的5例患者的临床和实验室资料、治疗转归.结果 5例CMV视网膜炎患者的9只眼均经眼底散瞳检查确诊.全部患者均为AIDS晚期患者,CD+4T淋巴细胞计数3～36/mm3,在确诊CMV视网膜炎时均已合并其它机会性感染.平均年龄29.2±5.1岁.临床症状有视物模糊、视力下降等.眼底检查有典型的视网膜血管炎,表现为沿血管分布的黄白色病损、黄白色颗粒及视网膜出血,但玻璃体透明或轻微混浊.4例接受更昔洛韦(GCV)治疗的患者病情均得到控制,眼底病变消退,但其中1例视力丧失(失明)无法恢复;1例患者未特殊治疗死于多种机会感染.结论中国CMV视网膜炎的表现和国外文献报道的类似,多发生于晚期AIDS患者,不及时治疗将导致视力丧失,早期诊治非常重要.建议对于CD+4 T细胞计数<50/mm3以及存在眼外CMV感染的AIDS患者,应常规作眼底检查;反之,对于拟诊CMV视网膜炎的所有患者,均应常规筛查血清HIV抗体.     

高效抗逆转录病毒治疗与抗结核治疗的联合应用策略

结核分枝杆菌感染是人类免疫缺陷病毒感染／艾滋病（HIV／AIDS）患者最常见的机会感染之一,也是AIDS患者死亡的重要原因,证据表明对HIV／AIDS合并结核病（TB）患者,联合应用高效抗反转录病毒治疗（HAART）与抗结核（ATB）治疗能改善预后。     

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.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.