3TC＋TDF＋LPV／r方案治疗免疫重建不良AIDS病人的临床观察

目的观察核苷类反转录酶抑制剂（NRTI）＋蛋白酶抑制剂（PI）方案,对免疫重建不良的艾滋病（AIDs）病人免疫功能的影响。方法接受一线抗病毒治疗1年以上、病毒载量低于检测下限（〈50拷贝／mL）且免疫学失败的病人,改用NRTI＋PI方案,即用拉米夫定（3TC）、替诺福韦酯（TDF）＋洛匹那韦／利托那韦（LPV／r）治疗12个月,检测治疗期间病人CD＋T淋巴细胞（CD4细胞）数的变化。结果收集的16例病毒载量〈50拷贝／mL且免疫学失败的病人,在接受治疗3、6和12个月后,病人CD。细胞数分别上升至（195±5．63）个／μL（213±4．68）个／μL和（270±4．36）个／μL,显著高于基线（换药时）CD4细胞水平（131±3．65个／μL）（P〈0．01）。结论3TC＋TDF＋LPV／r方案可以促进病毒载量低而免疫功能低下的病人的免疫重建。     

Influence of garlic or its main active component diallyl disulfide on iron bioavailability and toxicity

Garlic is regularly consumed and is known to have diverse biologic activities, particularly due to its antioxidant properties. In this study, we hypothesized that crude garlic can prevent iron-mediated oxidative stress in a rat model of nutritional iron overload, and we used an in vitro model to confirm the results. For the in vivo studies, rats received a basal diet supplemented with or without carbonyl iron (3%) and were fed distilled water or garlic solution (1g/kg body weight) by gavage for 3 weeks. The presence of both garlic and iron led to a 2-fold increase in plasma iron and a 50% increase in liver iron as compared with iron alone. However, garlic did not offer any protection against iron-induced oxidative stress. Duodenal divalent metal transporter-1 mRNA expression was fully repressed by iron and by the combined treatments but was also reduced by garlic alone. To confirm these data, we tested the effect of diallyl disulfide, one of the active components in garlic, in vitro on polarized Caco-2 cells. A 24-hour treatment decreased iron uptake at the apical side of Caco-2 cells but increased the percentage of iron transfer at the basolateral side. This probably resulted from a modest induction of ferroportin mRNA and protein expression. These results suggest that garlic, when given in the presence of iron, enhances iron absorption by increasing ferroportin expression. The presence of garlic in the diet at the dose studied does not seem to protect against iron-mediated oxidative stress.     

比较以蛋白酶抑制剂或非核苷类反转录酶抑制剂为主方案治疗HIV/HCV合并感染患者的安全性

目的探讨以PIs或NNRTIs为主方案治疗HIV/HCV合并感染的患者比较其安全性。为临床治疗药物的选择提供依据。方法 2007~2008年分别在上海、广州等传染病医院的门诊,选择确诊的HIV/HCV合并感染,CD4+T淋巴细胞≤350/mm3的100例患者,随机分为两组(PIs组和NNRTIs组),各50例患者接受1年的治疗,临床观察肝肾功能、代谢等指标。结果治疗前、后两组进行了比较,NNRTIs组天冬酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、甘胆酸(CG)上升(P<0.01),血糖、肌苷上升(P<0.05)。PIs组总胆固醇、载脂蛋白A1、载脂蛋白B、低密度脂蛋白上升(P<0.01)。结论 NNR-TIs比PIs对肝脏、血糖、肌苷的不良反应大。PIs比NNRTIs对血脂的不良反应大。     

以蛋白酶抑制剂或非核苷类逆转录酶抑制剂为主的方案治疗HIV/HCV合并感染患者的临床疗效比较

目的 比较以蛋白酶抑制剂（PIs）或非核甘类逆转录酶抑制剂（NNRTIs）为主的方案治疗HIV/HCV合并感染患者的临床疗效.方法 将CD4＋T淋巴细胞≤350/mm3的100例HIV/HCV合并感染患者随机分为2组,每组各50例,分别接受以PIs或NNRTIs为主的方案治疗,观察CD4＋ T淋巴细胞计数和HIV RNA载量等指标的变化.结果 治疗后两组患者的HIV RNA均下降（P＜0.01）,外周血CD4＋T淋巴细胞计数均有不同程度的升高（P＜0.01）,两组比较差异无显著性（P＞0.05）.结论 以PIs或NNRTIs为主的治疗方案治疗HIV/HCV合并感染者均有效.     

Trends and predictions to 2020 in breast cancer mortality in Europe

ObjectivesWe analyzed trends in mortality from breast cancer in women in 36 European countries and the European Union (EU) over the period 1970–2014, and predicted numbers of deaths and rates to 2020.Materials and methodsWe derived breast cancer death certification data and population figures from the World Health Organization and Eurostat databases. We obtained 2020 estimates using a joinpoint regression model.ResultsOverall, EU breast cancer mortality rates (world standard) declined from 17.9/100,000 in 2002 to 15.2 in 2012. The predicted 2020 rate is 13.4/100,000. The falls were largest in young women (20–49 years, −22% between 2002 and 2012). Within the EU, declines were larger in the United Kingdom (UK) and other northern and western European countries than in most central and eastern Europe. The UK has the second lowest predicted breast cancer mortality rate in 2020 (after Spain), starting from the highest one in 1970. Breast cancer mortality is predicted to rise in Poland, where the predicted 2020 rate is 15.3/100,000. We estimated that about 32,500 breast cancer deaths will be avoided in 2020 in the EU as compared to the peak rate of 1989, and a total of 475,000 breast cancer deaths over the period 1990–2020.ConclusionThe overall favourable breast cancer mortality trends are mainly due to a succession of improvements in the management and treatment of breast cancer, though early diagnosis and screening played a role, too. Improving breast cancer management in central and eastern Europe is a priority.