HIV感染成人和青少年机会性感染的诊断、治疗与预防（十）（17）单纯疱疹病毒感染；（18）水痘带状疱疹病毒感染

人单纯疱疹病毒型1（HSV1）和型2（HSV2）感染常见。在美国血清流行病学，成人HSV1达80％，年龄≥12岁人群HSV2达21．9％。大约95％的HIV1感染者HSV1或HSV2血清学阳性。有效的ART治疗并不影响这些数据。     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（八）（13）组织胞浆菌病；（14）球孢子菌病；（15）曲霉菌病

组织胞浆菌病 1流行病学 组织胞浆菌病由二态性霉菌荚膜组织胞浆菌引起。在美国居住在疾病流行区的AIDS病人（即中西部和波多黎各）及未用ART治疗者的发病率为2％～5％。在疾病非流行区，先前曾在流行区住过的病人最易发生该病。     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（十二）（22）丙型肝炎病毒感染

丙型肝炎病毒病 1 流行病学 丙型肝炎由丙型肝炎病毒（HCV，一种单股RNA病毒）引起。由6个基因型和大约50个亚型。在美国基因型1感染占所有HCV感染的75％。基因型2和3在西欧更为流行。HCV和HIV-1均可通过血液重复经皮暴露而有效传播。研究证实在静脉吸毒HIV-1感染者和血友病者有高的HCV合并感染率（50％～90％）。HCV的其它潜在传播模式包括母-婴（传播率大约为5％，但如果母亲为HIV-1病人则可增加到15％），针刺或性传播。     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（三）（5）结核分支杆菌病

结核分支杆菌病 1流行病学 在美国，结核病的总的发病率在下降，2002年报告的新病例数大约为15 000例。对怀疑或证实为结核的病例，推荐作HIV检测，但未被完全执行。因此，在美国有HIV1感染者，结核的百分率仪是估计。在1999年，在美国大约10％的结核病例有HIV1感染。     

弓形虫宫内感染动物实验与临床研究

应用放射核素＾１２５Ⅰ－弓形虫感染孕１４天小白鼠，动态观察＾１２５Ⅰ－弓形虫分布。结果证实，＾１２５Ⅰ－弓形虫侵入孕鼠血液寄生于日细胞内，分布致脏器组织细胞浆内，少数在核内。孕鼠的单位重量组织的放射量由高到底顺序为肺、脾、肾、心及脑，而胎鼠主头、肝、肺。胎鼠头／躯干放射量为１．３２：５．９５。感染率胎盘为８５．８％，胎鼠为７６．８％（Ｐ〈０．０１）。临床跟踪５２例弓形虫感染孕妇，垂直传染胎儿２４例     

弓形虫感染与先天性弓形虫病

近年来 ,随着围生医学与预防医学的发展 ,妊娠期弓形虫感染引起的胎婴儿先天性异常 ,已受到众多预防及临床工作者的高度重视。它是导致胎儿宫内感染的最重要的生物学因素之一 [1 ,2 ]。弓形虫是一种原虫 ,寄生在除红细胞外的几乎所有有核细胞中 ,可引起人兽共患的弓形虫病 ,尤其在宿主免疫功能低下时 ,可致严重后果 ,是一种重要的机会致病原虫[1 ,3 ] 。弓形虫可寄生在人及 190多种动物体内 ,终宿主是猫。 190 8年法国学者 Nicolle及 Man ccaux在北非的刚地梳趾鼠的肝脾单核细胞中发现弓形虫。 192 3年捷克医生 Jan Ku在布拉格一医院观察…     

关于弓形虫感染的免疫学研究及其在防治中的应用前景

弓形虫是一种广泛寄生在恒温动物有核细胞内的原虫。据国外文献记载，美国人的感染率为三分之一，欧洲高达85％，我国人群弓形虫感染抗体阳性率为5-20％。尽管大多数人呈隐性感染无临床表现，但在AIDS患者，接受骨髓及其他器官移植者，肿瘤患者或免疫力低下者，     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（十一）（19）人疱疹病毒8感染；（20）进展性多灶性脑白质脑病；（21）人乳头瘤病毒感染

人疱疹病毒8疾病 1 流行病学 人疱疹病毒8（HHV-8）是一传播性DNA病毒，在美国血清流行病学为1％-5％。血清流行病学在MSM中较高（不管HIV-1感染怎样），在某些地中海国家更高（10％-20％），在非洲撒哈拉地区为30％-80％。HHV-8与所有类型的卡波齐肉瘤相关（即经典型、流行型、移植相关型和AIDS相关型），与某些肿瘤罕有相关性（即原发性渗出性淋巴瘤和多灶性巨大淋巴结增生病），即使HHV-8的血清转换先于这些肿瘤的发生，其确切发病机制不清楚。     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（十五）（26）类球孢子菌病；（27）等孢子球菌病；（28）恰加斯病

类球孢子菌病 1 流行病学 类球孢子菌病由巴西类球孢子菌引起，该菌为一二形态霉菌，在土壤以菌丝体期存在，而在感染组织为芽生酵母菌。类球孢子菌病是在中南美洲最为流行的霉菌病。易感宿主的感染推测是以菌丝体期的霉菌吸入所致。     

HIV感染成人和青少年机会性感染的诊断、治疗与预防（十四）（24）青霉病；（25）利什曼病

青霉病由二态霉菌Emarneffei（马纳菲青霉菌）引起，并在东南亚（特别是泰国北方和中国南方）流行。在泰国北方，14％的AIDS病人有播散性青霉病的临床表现。国际旅游需要增加对青霉病及其治疗的认识和了解。大多数青霉病病例见于CD4^＋T细胞计数常〈50／μL。如果不给予合适的抗霉菌药的及时治疗，往往伴有较高的病死率。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.