Prolonged hepatitis A infection in an HIV-1 seropositive patient

Hepatitis A virus (HAV) is a worldwide disease; in most cases, it causes an acute self-limited illness that does not lead to a chronic state. The course of HAV viremia in a homosexual male with human immunodeficiency virus type 1 (HIV-1) and the correlation between HIV and HAV viral load, alanine aminotranferase (ALT) level, and CD4(+) lymphocyte count were investigated during the course of the infection. HAV RNA was detected quantitatively up to 256 days after clinical onset. To our knowledge, this specific case is the first report of a prolonged infection with hepatitis A in a male with HIV-1. The ALT levels decreased gradually; however, 286 days after clinical onset of hepatitis, ALT levels were three times higher than normal values. HIV viral load was not affected by the infection with HAV and CD4(+) cell count was stable during the course of the co-infection. The duration and the high-titer viremia of hepatitis A virus in an immunodeficient patient constitute a serious risk of the spread of hepatitis A within this population. As inactivated HAV vaccine is safe in HIV-positive subjects, it would be wise to establish a strategy of preventive vaccination in this high-risk group.     

高龄产妇并发妊娠期高血压疾病对围生期结局的影响

目的探讨孕高龄产妇并发妊娠期高血压疾病对围生期结局的影响。方法对43例35岁或以上的妊娠期高血压疾病孕妇（观察组）进行了回顾性分析并与同期分娩的35岁以下的妊娠期高血压疾病孕妇238例（对照组）作对照分析。结果观察组子痫前期、子痫的发生率与对照组比较差异有非常显著性（P〈0.01）;观察组胎盘早剥、HELLP综合征、妊娠高血压心脏病等严重并发症的发生率与对照组比较无显著性差异（P〉0.05）;观察组早产、胎儿生长受限、围产儿死亡的发生率比对照组高,差异有显著性（P〈0.05）;新生儿窒息、胎儿窘迫的发生率两组比较,差异无显著性（P〉0.05）,观察组剖宫产率较对照组明显增加,两组间差异有显著性（P〈0.05）。结论高龄产妇并发妊娠期高血压疾病病情重,对母儿危害大,恰当的围产期管理并适时终止妊娠是治疗成功的关键。     

Elektronenmikroskopische Befunde an inneren Organen bei Morbus Fabry

Zusammenfassung Es werden elektronenmikroskopische Beobachtungen zur Lokalisation und zur Feinstruktur der Glykolipideinschlüsse in verschiedenen inneren Organen bei Morbus Fabry berichtet. Die intrazellulÄren und extrazellulÄren Einschlüsse bestehen aus vielschichtig lamellÄren Membransystemen in konzentrischer und exzentrischer sowie in stapeiförmiger paralleler Anordnung. Diese lamellÄre Anordnung ist charakteristisch für flüssigkristalline Phasen von Phospholipid-Wasser-Systemen. Erstmalig werden ultrastrukturelle Befunde an den inneren Organen einer erkrankten Frau mitgeteilt. Demzufolge lassen sich bei heterozygoten Frauen gleiche Glykolipidablagerungen wie bei homozygoten MÄnnern nachweisen. Die Beziehung der Glykolipideinschlüsse zu den Lysosomen wird erörtert.

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Electron microscopic observations in internal organs in morbus fabry

Summary Electron microscopic findings are reported on the localization and fine structure of glycolipid inclusions in different organs (heart, kidney, lymph nodes, arterial blood vessels, pancreas) in Fabry's disease in a female. The intracellular and extracellular inclusions were made up of multilamellar membraneous systems in concentric, excentric, and parallel arrangement. This fine structure is characteristic of liquid-crystalline phases of phospholipid-water systems.The same type of inclusions are found in the internal organs of heterozygotic women as in homozygotic men. The relationship between the glycolipid inclusions and the lysosomes is discussed.

Herrn Prof. Dr. F. Bolck, Direktor des Pathologischen Instituts der Friedrich-Schiller-UniversitÄt Jena, zum 60. Geburtstag gewidmet.     

Comparison of assays to detect cytomegalovirus shedding in the semen of HIV-infected men

We sought to determine the optimal assays for cytomegalovirus (CMV) shedding in semen. Over a 2-month period, 149 HIV-1-infected men who have sex with men each provided up to three semen specimens. Specimens were tested for CMV by culture, rapid assay (shell vial) and polymerase chain reaction (PCR). By culture, 30% of seminal plasma and 28% of seminal cell specimens grew CMV. By rapid assay, results were 38 and 33%, respectively. By PCR, 56% of seminal cell specimens demonstrated CMV: 20% in a single semen specimen; 33% in two specimens; and 34% in all three specimens. Overall, 69% of men had CMV detected by PCR in at least one seminal cell specimen. By quantitative PCR, 14% had ten, 14% had 100, 16% had 1000, and 12% had 10 000 copies in 6.25 μl of semen analyzed. Adjusting for initial CD4+ cell count, men with CMV shedding demonstrated by PCR at the first visit were approximately four times as likely to shed CMV at a subsequent visit (RR 4.28, CI: 2.30–7.95). CMV shedding was associated with decreased CD4+ cell counts in peripheral blood (P=0.05). It is concluded that the PCR assay provided the greatest sensitivity among the three detection methods.     

Effects of aerobic exercise conditioning at intensities corresponding to lactate threshold in the elderly

Summary In this study we attempted to determine the effects of exercise training at the intensity corresponding to lactate threshold (Th_la ^–) on various health-related variables in sedentary but apparently healthy elderly subjects. Six men and five women volunteers [mean age 68.9 (SD 3.4) years] performed supervised endurance-type training on stationary cycle ergometers for 30 min and recreational activities for 30 min, 3 days a week for 12 weeks. Four men and four women served as the control group [68.8 (SD 4.4) years]. As a result of the training programme, statistically significant increases in maximal oxygen consumption (10%), oxygen consumption at Th_la ^–(18%), distance covered in 12-min walk, side step, and leg extensor power were found in the training group, while no changes occurred in the control group. The changes in serum cholesterol and triglyceride concentrations from the pre- to post-training period were statistically significant. High-density lipoprotein cholesterol remained unchanged, and low-density lipoprotein cholesterol tended to decrease following the training programme. These data would indicate that exercise training at the intensity corresponding to Th_la ^–may have favourable effects on overall physical fitness and some serum lipid variables in older individuals.     

男性CHD患者血清T和LP（a）测定的临床价值

目的：探讨血清睾酮（T）和脂蛋白（a）[Lipoprotein（a）,LP（a）]测定对男性冠心病患者的诊疗价值。方法：对102例疑似冠心病（CHD）的男性患者进行冠状动脉造影检查,根据造影结果分为（CHD）病组和非（CHD）组,分别采用放射免疫分析和免疫透射比浊法进行血清T和LP（a）的测定,并对结果进行分析。结果：男性CHD患者血清T水平明显低于非CHD组（P〈0.01）,而血清LP（a）水平则显著高于非CHD组,两者之间呈负相关。结论：检测血清T和LP（a）对男性CHD患者的辅助诊断、疗效观察和预后判断具有重要价值。     

农村老年人心理健康状况的调查分析

随着经济的发展和社会的进步 ,人口老龄化已经成为当今世界人口发展的一种必然趋势。因此 ,老龄问题日益受到关注。研究老年人的心理健康状况及其影响因素对如何提高老年人的生活质量具有重要的指导意义。国内已有一些学者对老年人的心理健康状况进行了研究[1- 7] ,但研究的对象主要是城市老年人 ,关于农村老年人的心理健康状况的研究极少。因此 ,本文想就这一问题作些探讨。1　对象与方法1.1　对象在湖州市所辖三县三区各抽取 9个行政村 ,每个行政村随机抽取 13～ 14个年龄在 6 0岁以上 (包括 6 0岁 )的老年农民进行调查 ,其中有 16人资料…     

输精管绝育者的精子免疫反应及其与冠心病的关系——707例精子循环抗体的测定

本文报告707例精子自身抗体的研究结果。其中健康男性输精管绝育者278例,未绝育者231例;男性冠心病人输精管绝育者87例,未绝育者111例。明胶凝集试验(GAT)、试管玻片凝集试验(TSAT)和精子制动试验(SIT)检测结果表明:精子抗体在手术后6月内就已产生,并持续20年以上。曾作输精管绝育术的健康男性和冠心病人二组比较,抗体的阳性率和滴度皆无差异显著性。没有证据表明输精管绝育术后的精子免疫反应会增加冠心病的发病率。     

我国正常生育力男子精浆的微量元素研究

本文报告测试了68例正常生育力成年男子精浆中的锌、铜,铁等微量元素和镁,测试结果如下:锌130±5.64μg/ml,铜1.84±0.158μg/ml,铁0.801±0.104μg/ml,镁103.86±10.01μg/ml。所测得的数值均在正常范围内。在正常范围内的精液,精浆中的锌、镁含量与精液质量(精子密度和活动力)之间无显著差异。但铜的含量与精子活动度关系密切,含量高则活动度差,反之则活动度好。铁的含量与精子密度关系也十分密切,含量高时精子密度也高。     

泸州市473例新报告50岁及以上男性艾滋病患者性途径感染原因分析

目的调查泸州市中老年男性艾滋病疫情高发的原因,为制订有针对性的干预策略提供依据。方法采用整群抽样的方法,2019年对473例新报告的泸州市50岁及以上中老年男性艾滋病感染者/病人展开性伴、安全套使用及商业性行为等主要内容的问卷调查,采用卡方检验进行差异性分析,检验水准α=0.05。结果分别有81.6%、62.8%和10.1%的人有商业性行为、固定性伴/配偶和临时性伴,除固定性伴比例随年龄增长呈下降趋势(χ²_趋势=6.934,P=0.008)外,其余性伴类型没有统计学差异。与不同性伴发生性关系,近1年从未使用安全套比例均超过90%。无配偶(35.8%)、配偶不在身边(30.8%)、诱惑/好玩(22.4%)是寻找商业性伴的前3位原因;性交易对象以本地为主,本乡镇占56.0%。固定场所(46.3%)和接头拉客(43.7%)是最主要的寻找商业性伴方式。多数性交易价格低于50元,年龄越大,<50元的占比越大(50岁~59岁、60岁~69岁、≥70岁分别为52.1%、78.0%和80.0%),差异有统计学意义(χ²=22.061,P<0.001)。结论中老年男性通过寻找商业性伴满足其性需求,交易价格偏低。该群体存在多性伴行为、基本不使用安全套行为等现象,是其艾滋病疫情快速增长的重要原因。