大鼠胎脑神经细胞与胶原复合体移植对脑损伤的修复

目的:评价胶原蛋白(Collagen)的细胞相容性;研究胶原蛋白(C)与大鼠胎脑神经细胞(FBN)复合体(C-FBN)脑内移植对脑损伤的修复作用。方法:将大鼠FBN与胶原蛋白联合体外培养,进行光镜、扫描电镜观察。并将体外联合培养3～5d的C-FBN(移植前48h培养液中加入BrdU)移植到大脑皮质损伤模型的大鼠脑损伤部位,术后3,6,10,15及30d光镜、BrdU免疫细胞化学染色(ICC)、透射电镜观察脑组织对移植物的反应、移植细胞生长状态及载体在体内的降解情况等。结果:胶原蛋白对FBN生长无不良影响;脑组织对移植物无明显的免疫排斥反应;胶原蛋白与周围脑组织整合好,有血管长入移植物中;载体内有大量存活神经细胞,而且术后各时段都检出BrdU阳性细胞;移植区有突触形成;胶原蛋白海绵吸收、降解快,可诱导组织再生。结论:胶原具有良好的细胞相容性和组织相容性,是神经组织工程的一种较为理想的生物载体材料;生物材料与胎脑神经细胞联合培养移植是治疗脑损伤较有前途的新方法。     

艾滋病患者细菌性血流感染病原菌分布及耐药情况

  目的  了解艾滋病住院患者细菌血流感染的患病率、病原菌种类及耐药情况。  方法  回顾性收集上海市公共卫生临床中心2015年至2020年血培养分离出细菌的艾滋病患者资料,分析病原菌种类及相应抗菌药物的耐药情况多重耐药的比例。  结果  艾滋病患者中 2015年至2020年间血流感染细菌检出率为4.48%。革兰阳性菌检出128株（59.3%）,83株有耐药报告,对青霉素的耐药率为94%,对红霉素的耐药率为91.4%,未检出利奈唑胺、替加环素、万古霉素、喹奴普汀/达福普汀耐药者,多重耐药率38.6%,39.7%的细菌对5类以上抗菌药耐药。革兰阴性菌检出88株（40.7%）,70株有耐药报告,对氨苄西林的耐药率为81.6%,喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌都有较高的敏感性,多重耐药率14.4%,12.8%的细菌对5类以上抗菌药耐药。  结论   艾滋病合并细菌性血流感染者,革兰阳性菌多重耐药率更高,治疗时可以选择利奈唑胺、替加环素、万古霉素及喹奴普汀/达福普汀。喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌较敏感。     

昆明地区HIV感染者抗病毒治疗前的肾病及影响因素

  Objective  To investigate the prevalence and characteristics of nephropathy in HIV infected patients before antiviral treatment, and to analyze the related factors of nephropathy before antiviral treatment.  Methods  Patients with HIV infection who visited the Third People’ s Hospital of Kunming from June 2019 to March 2021 were recruited and screened by urine analysis, serum creatinine, urine microalbumin-to-creatinine ratios, urinary α1 microglobulin, and renal ultrasound. And all patients were screened by triglyceride, total serum cholesterol, fasting plasma glucose test . Body mass index was measured.Demographic data , medical history of hypertension and diabetes were collected. SPSS17.0 was used for univariate analysis and logistic regression analysis.  Results  The mean age of 468 subjects was 43.42±14.66 years. The male to female ratio was 1.96. The mean body mass index was 21.73±3.76. Body mass index ≥25 accounted for 15% of all the subjects . Some patients smoked daily which accounted for 33.3% of all the subjects. Patients with hypertriglyceridemia, hypertension and diabetes accounted for 24.7%, 10.7%, 7.7% respectively. And 21.8% of patients were taking drugs which were not antiretroviral therapy. The detection rate of kidney disease in total of 468 cases was 20.7%. the CKD-EPI formula was used to calculate and estimate glomerular filtration rate （eGFR）. Patients with eGFR < 60 mL/min/1.73 m2, 60～90 mL/min/1.73 m2, ≥ 90 mL/min/1.73 m2 accounted for 1.1%, 9.6%, 89.3% respectively. The positivity rate of urinary protein was 3.1%, which measured just only by urine analysis. The urinary microalbumin/creatinine ratio （ACR） ≥ 30 mg/gCr were occurred in 24/111 cases （21.6%）. The Urinary α1 microglobulin ≥ 12.5 mg/L were occurred in 71/111 cases （63.9%）. Multivariate analysis indicated the independent effects of the age ≥ 50 years （OR = 2.285, P = 0.002）, body mass index ≥25 （OR = 2.029, P = 0.025）, hypertension （OR = 2.334, P = 0.017）, diabetes （OR = 2.634, P = 0.014）, HIV viral load ≥1×105 copies /mL （OR = 2.296, P = 0.002）, which significantly associated with kidney disease. Female is a protective factor for kidney disease in HIV infected persons before antiviral therapy.   Conclusions  The detection rate of kidney disease is high and mainly abnormal urinary protein in Kunming area.Gender, age, hypertension, diabetes, body mass index and HIV viral load are significantly associated with the kidney disease in HIV patients before antiviral treatment. When screening for kidney disease, it is recommended to fully evaluate the results with urine analysis, serum creatinine, renal ultrasound, urinary microalbumin/creatinine ratio, and urinary α1 microglobulin.     

60岁以上HIV/AIDS病人抗病毒治疗满一年的效果及影响因素

正老年艾滋病病毒(HIV)感染者人数在世界范围内逐渐上升~([1]),中国随着人口老龄化的加速及免费抗病毒治疗(ART)的深入开展,老年患者人数逐渐增多。国内研究显示~([2]),ART能有效延长老年HIV感染者的生存时间,降低死亡率。为了更好地了解老年HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的ART特点及影响因素,对治疗满一年以上的老年HIV/AIDS病人进行疗效观察,了解     

咽部刺营法治疗慢性咽炎60例临床观察

目的:观察咽部刺营法治疗慢性咽炎的临床疗效及对炎症因子IL-2、TNF-α的影响。方法:将120例慢性咽炎患者随机分为2组各60例。治疗组采用咽部刺营法(针刺患处放血)治疗;对照组采用甘桔冰梅片口服治疗。结果:2组IL-2、TNF-α值治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P0.05);2组各项症状体征积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P0.05)。结论:咽部刺营法治疗慢性咽炎有较好的临床疗效。     

HIV/AIDS合并药疹患者实验室资料和预后的相关性研究

目的 了解HIV/AIDS患者发生药疹对内脏系统的影响及导致患者死亡的相关因素.方法 对72例HIV/AIDS合并药疹住院患者进行人口学资料、流行病学资料、实验室检查及疾病转归情况研究.结果 HIV/AIDS合并药疹患者病死率为6.9％,均死于感染,CD4＋T淋巴细胞数＜200 cells/μl者病死率为10.6％,病毒载量高于1×102 copies/ml者病死率为10.2％.55.3％患者天冬氨酸氨基转移酶升高,54.1％患者丙氨酸氨基转移酶升高,22.2％患者总胆红素升高,4.2％肾功能损伤,9.1％患者白蛋白减低,白蛋白降低患者病死率为16.1％,50.0％白细胞总数减少,45.9％中性粒细胞减少,33.3％淋巴细胞减低,低淋巴细胞病死率为12.5％,红细胞减少患者病死率10.3％,低血红蛋白病死率为16.4％.结论 感染是HIV/AIDS合并药疹患者的主要死亡原因,低CD4＋T淋巴细胞、高病毒载量、低蛋白血症、低淋巴细胞、低红细胞及低血红蛋白提示患者预后不良.     

倍他乐克治疗不稳定心绞痛的护理体会

目的观察倍他乐克在不稳定心绞痛中的治疗作用及护理。方法选择不同类型的不稳定心绞痛病人120例,治疗组与对照组各60例。在常规应用扩血管药物和抑制血小板药物的同时,治疗组加用倍他乐克,缓慢增加剂量,4w后通过症状改善、心电图和血压的监测评估疗效。结果治疗组症状改善的总有效率达95%,心电图改善的总有效率达90%,对照组症状和心电图改善的总有效率分别为80%和75%,治疗组疗效显著优于对照组(P<0.05)。结论在常规抗心绞痛治疗基础上加用倍他乐克,可有效控制和治疗不稳定心绞痛。     

金属对金属人工髋关节的磨损预测

目的发展复杂动态载荷与瞬态运动条件下的球面共型接触硬对硬人工髋关节的磨损预测模型,并用于典型的金属对金属人工髋关节在复杂三维生理运动条件下的磨损预测研究。方法建立有限元模型用于接触力学问题求解,采用固定-跟踪法(fixed-tracked method)完成具有三维欧拉运动的人工髋关节双侧界面动态磨损几何再现及相应的接触与磨损问题模拟的数值交换。结果磨损预测表明,磨损导致金属对金属人工髋关节接触界面几何由球面向非球面过渡,接触区域随磨损周期而增大,接触压力变化趋于平缓、最大接触压力逐渐减小。结论本研究所发展的三维复杂动态、具有双侧界面几何磨损变化的人工髋关节磨损预测模型,能够很好地进行金属对金属髋关节磨损数值预测模拟实验,为认识人工髋关节磨损机理提供了新的方法。