Coronary Artery Disease Manifestations in HIV: What,How, and Why

Understanding why persons with human immunodeficiency virus (HIV) have accelerated atherosclerosis and its sequelae, including coronary artery disease (CAD) and myocardial infarction, is necessary to provide appropriate care to a large and aging population with HIV. In this review, we delineate the diverse pathophysiologies underlying HIV-associated CAD and discuss how these are implicated in the clinical manifestations of CAD among persons with HIV. Several factors contribute to HIV-associated CAD, with chronic inflammation and immune activation likely representing the primary drivers. Increased monocyte activation, inflammation, and hyperlipidemia present in chronic HIV infection also mirror the pathophysiology of plaque rupture. Furthermore, mechanisms central to plaque erosion, such as activation of toll-like receptor 2 and formation of neutrophil extracellular traps, are also abundant in HIV. In addition to inflammation and immune activation in general, persons with HIV have a higher prevalence than uninfected persons of traditional cardiovascular risk factors, including dyslipidemia, hypertension, insulin resistance, and tobacco use. Antiretroviral therapies, although clearly necessary for HIV treatment and survival, have had varied effects on CAD, but newer generation regimens have reduced cardiovascular toxicities. From a clinical standpoint, this mix of risk factors is implicated in earlier CAD among persons with HIV than uninfected persons; whether the distribution and underlying plaque content of CAD for persons with HIV differs considerably from uninfected persons has not been definitively studied. Furthermore, the role of cardiovascular risk estimators in HIV remains unclear, as does the role of traditional and emerging therapies; no trials of CAD therapies powered to detect clinical events have been completed among persons with HIV.     

基于“中医传承辅助平台”软件挖掘年莉教授治疗糖尿病肾病的用药规律

[目的] 采用"中医传承辅助平台"软件，探讨年莉教授治疗糖尿病肾病的用药规律。[方法] 将2016年11月-2019年4月年莉教授治疗糖尿病肾病的中药处方信息输入中医传承辅助平台系统，采用频次分析、组方规律分析方法挖掘、探讨年莉教授治疗糖尿病肾病的临床用药特点。[结果] 对年莉教授治疗糖尿病肾病158首处方进行分析，涉及中药207味，使用频次在前10位的药物分别为白芍、川芎、当归、半夏、刺蒺藜、丹参、泽泻、牛膝、厚朴，白术获得9组药对、3组核心药物组合。[结论] 年莉教授治疗糖尿病肾病经验丰富，高频药物的配伍体现了年莉教授多采用平肝疏肝，补血养阴，活血化瘀的治疗原则。期望能为临床治疗和药物研发提供参考，并为糖尿病肾病在泰国的治疗提供新的理念和借鉴。     

谷参肠安胶囊长期毒性试验

本文报告谷参肠安胶囊大鼠长期毒性试验,结果表明,谷参肠安胶囊对动物的一般状况,体重增长、外周血象、肝肾功能及病理组织学检查等未见明显毒性。     

Heparin effect on ionised calcium concentration

The effect of heparin on plasma ionised calcium was studied by adding it in increasing amounts to whole blood from 10 normal subjects. There was no significant change in ionised calcium from the addition of 1 U/ml but a significant fall of 0.02 mmol/1 when 2 U/ml were added and a progressive further fall with increasing concentrations. Heparin from three different manufacturers produced similar results. The effect of heparinisation in vivo was studied during regular haemodialysis on 10 patients with chronic renal failure. Following intravenous injection of 10000 U of heparin there was a consistent and significant fall averaging 0.03 mmol/l.     

定量RT-PCR法对"苦参"在心肌炎模型中药效学研究

目的用定量RT-PCR法检测“苦参”中抗柯萨奇B病毒有效成份“抗柯注射液”,在Balb/c小鼠病毒性心肌炎模型病毒血症时,对抗“柯萨奇B病毒”的药效。 方法取48只雄性18-22g 8周龄的Balb/c小鼠,随机分成A-H共8组,每组6只。1.各治疗组(A-F组),每只小鼠从腹腔接种0.1ml l04TCID50 CVB3m病毒2h后,每天从尾静脉分别注射抗柯注射液,5、10、15、20、25、30mg/kg,2次/d,连续用药3d。2.病毒组(G组),注射病毒同上法,2h后从尾静脉注入0.3ml无菌生理盐水,2次/d,连续3d。3.空白对照组(H组),腹腔内注射无小牛血清的RPMI-1640培养液,2h后从尾静脉注入0.3ml无菌生理盐水,2次/d,连续3d。 结果 空白组CVB-RNA(-)对接种CVB3m感染后用不同剂量“抗柯注射液”治疗的各小组血液中CVB3m-RNA含量与病毒组相比明显下降,其抑制率(％)与所用抗柯注射液的剂量呈正比,即“抗柯”剂量增加,CVB3m-RNA含量下降的幅度亦增加,每天5-30mg,/kg中的各剂量都有明显抑制病毒增殖的作用。 结论用定量RT-PCR法检测到“抗柯注射液”对Balb/c小鼠病毒性心肌炎病毒血症时效果明显,最小有效剂量为5mg·kg-1·d-1。     

Effect of bronchodilator therapy administered by canister versus jet nebulizer

Bronchodilator efficacy of metaproterenol sulfate aerosol therapy delivered either by canister or jet nebulizer was compared in 25 patients, 13 with severe asthma and 12 with COPD. Treatment was carried out in double-blind crossover fashion on 2 days and consisted of either metaproterenol sulfate solution 15 mg in 2.3 ml administered from a jet nebulizer or three puffs of metered-dose metaproterenol sulfate (total 1.95 mg) inhaled sequentially. FVC and FEV1 were monitored before and after therapy for 2 hr. In 13 asthmatic patients, FEV1 increased from a baseline mean of 0.83 L to 1.57 L at 2 hr after jet nebulizer therapy and increased from 0.84 L to 1.52 L after canister therapy. In 12 patients with COPD, FEV1 increased from 0.58 L to 0.78 L after jet nebulizer therapy and from 0.57 L to 0.76 L after canister therapy. FVC also increased similarly after each form of therapy. The two types of aerosol therapy were equally effective and were without side effects. Canister therapy has the advantage over jet nebulizer therapy by being convenient and cheaper.     

Tonic heart rate level, social class and antisocial behaviour in adolescents

On the basis of previous empirical research it was hypothesised that (a) antisocial behaviour in adolescence would be characterised by lower tonic heart rate levels and (b) any such relationship would be particularly borne out in the higher social classes where the 'social push' towards antisociality may be relatively weaker. These predictions were tested by relating tonic heart rate levels in a sample of 15 year old male schoolchildren to self-report and teacher ratings of antisocial behaviour/undersocialization. An 'antisocial' group was found to have significantly lower heart rate levels than a 'prosocial' group. Several analyses on high and low class groups resulted in a significant low heart rate/antisociality relationship in the high classes only. It was speculated that the heart rate/antisociality relationship may be mediated by somatotype, or alternatively that low levels in high class antisocials may reflect a vagal passive adaptation to mildly aversive events.