基于ZM-ⅢC智能型脉象仪的HIV/AIDS患者脉象分析

目的探讨云南省HIV/AIDS患者脉象分布特点,分析脉象与性别、艾滋病分期、CD4+T淋巴细胞计数之间的关系。方法 2005年7月-2007年7月共收集云南省HIV/AIDS患者857例,用ZM-ⅢC智能型脉象仪收集脉象信息,并对其进行统计、分析。结果云南省857例HIV/AIDS患者中结代脉的检出率最高,为110例。性别不同,脉象不同,男性以脉力中、脉势正常、节律不齐检出率最高,女性以脉力无力、脉势低平虚、节律不齐检出率最高。艾滋病分期不同,脉象亦不同,艾滋病相关综合征期以脉位浮、脉力无力、脉势低平虚、脉率平为主,艾滋病期以脉位中、脉力无力、脉势低平虚、脉率平为主,HIV感染期以脉位中、脉力无力、脉势低平虚、脉率平为主。CD4+T淋巴细胞计数≤100/mm3时,脉率数检出率最高;CD4+T淋巴细胞计数100/mm3时,脉率平检出率最高。结论云南省857例HIV/AIDS患者以结代脉为主要脉象,伴吸毒患者脉象表现更为复杂。ZM-ⅢC智能型脉象仪所测脉象结果能够反映艾滋病发展阶段,可为临床诊治艾滋病提供参考。     

HAART疗法治疗虚性体质HIV/AIDS患者临床观察

目的:观察高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)对虚性体质HIV/AIDS患者的临床疗效。方法:收集并分析2014年8月—2016年5月南通大学附属南通第三医院传染科门诊及病房诊治的HIV/AIDS患者病例资料,比较HAART治疗后不同体质患者CD4+T淋巴细胞及其亚群变化情况。结果:治疗前气虚质与实性体质患者比较,CD4+T淋巴细胞及Th1、Th17、Th22所占CD4+T淋巴细胞百分较低,Th2、Treg占CD4+T淋巴细胞百分比较高,差异均有统计学意义(P0.05);治疗前气虚质与其他虚性体质患者比较,CD4+T淋巴细胞更为低下(P0.05),而CD4+T细胞亚群无显著性差异(P0.05);HAART治疗1 a后所有虚性体质患者CD4+T淋巴细胞、Th1、Th17、Th22较治疗前有不同程度升高,同时Th2、Treg出现不同程度下降(P0.05);气虚质与其他虚性体质比较,Th1升高值、Th2降低值、Th17升高值、Treg降低值和Th22升高值存在统计学差异(P0.05),而CD4+T淋巴细胞升高值无统计学差异(P0.05);气虚质部分患者给予中医调整体质,HAART治疗1 a后,调整体质患者Th17占CD4+T淋巴细胞比率明显高于未调整体质患者,Treg占CD4+T淋巴细胞比率则明显低于未调整体质患者(P0.05)。HARRT治疗1 a后虚性体质患者除2例气虚质未转阴外,其余均转为阴性。结论:中医体质影响着HIV/AIDS病情进展,不同体质患者对HAART治疗反应性各异,中药调整体质可提高HAART治疗反应性。     

中药配合艾灸治疗HIV/AIDS的临床研究

目的:观察中医辨证论治配合艾灸对HIV/AIDS患者免疫功能的影响.方法:对经CDC确认的HIV/AIDS患者20例,辨证给予口服中药汤剂,同时配合艾灸治疗,疗程24个月,观察患者CD4+T淋巴细胞计数的变化.结果:疗前患者CD4+T淋巴细胞计数为(408.65±162.54) mm-3,治疗后12个月、24个月分别为(462.10±220.07) mm-3 (p≥0.05)和(522.85±260.50)mm-3(P＜0.05),CD4 +T淋巴细胞计数有所增加,疗后24个月时CD4计数显著增加.结论:中医辨证论治配合艾灸对HIV/AIDS患者的免疫功能有一定稳定和恢复作用,应进一步深入研究.     

总淋巴细胞计数对河南省6～18岁HIV/AIDS患者CD4+ T计数的预测作用

目的:探讨总淋巴细胞计数(TLC)作为CD4+T淋巴细胞(CD4+T)计数替代标志物对儿童及青少年HIV/AIDS患者细胞免疫功能的预测作用。方法:采用回顾性队列研究方法,分析266例6～18岁HIV/AIDS患者抗病毒治疗(HAART)前后TLC和CD4+T计数的相关性;通过受试者工作特征曲线判断TLC代替CD4+T<350mm-3计数的预测价值和最佳分界值。结果:HAART前、6个月和12个月时,TLC和CD4+T计数均呈正相关关系(rS分别为0.791、0.625和0.680,P<0.001)。HAART前用TLC<2600mm-3预测CD4+T<350mm-3具有较高的价值,灵敏度和特异度分别为83.56%和79.31%;HAART6个月及12个月时,用TLC预测CD4+T<350mm-3的最佳预测阈值均为2400mm-3,灵敏度分别为76.40%和71.03%,特异度分别为72.38%和82.39%。结论:TLC是CD4+T计数较好的替代标志物,可用于监测儿童及青少年HIV/AIDS患者HAART疗效。     

320例经血感染HIV/AIDS中医证型分布与CD_4~+ T淋巴细胞计数、病毒载量关系的探讨

目的通过回顾性总结分析320例经血感染的HIV/AIDS患者临床资料,探讨中医证型分布与CD+4T淋巴细胞计数、病毒载量的关系。方法收集中医四诊信息和中医证型资料,并检测CD+4T淋巴细胞计数、病毒载量。并比较不同CD4+T淋巴细胞计数分段、病毒载量分段与中医证型的关系。结果320例经血感染的HIV/AIDS患者CD+4T淋巴细胞计数分布与证型有相关性,CD4+T淋巴细胞计数在200/μL以下时,以气虚血瘀、邪毒壅滞型和脾肾亏虚、湿邪阻滞型多见;CD4+T淋巴细胞计数在201~350/μL之间时,以气虚血瘀、邪毒壅滞型,气阴两虚、肺肾不足型和脾肾亏虚、湿邪阻滞型多见;CD+4T淋巴细胞计数大于350/μL,以气血两亏型和气虚血瘀、邪毒壅滞型多见。分析病毒载量与证型的关系发现,VL(HIV血浆病毒载量)500 copies/mL时,气虚血瘀、邪毒壅滞型最多;其次依次为,气阴两虚、肺肾不足型和气血两亏型;500 copies/mLVL104copies/mL时,以气血两亏型最多,其次为痰热内扰型,以及肝郁气滞火旺型和气虚血瘀、邪毒壅滞型,104copies/mLVL105copies/mL,以气血两亏型为主。结论经血感染的HIV/AIDS患者中医证型分布有一定的规律,CD+4T淋巴细胞计数与中医辨证证型密切相关。     

用流式细胞仪研究HIV/AIDS患者HAART的治疗效果

目的:对接受高效联合抗逆转录病毒治疗(HAART)的HIV/AIDS患者,治疗前后淋巴细胞亚群检测结果进行分析并结合临床情况对其重要性进行了评价。方法:应用流式细胞仪(FCM)检测60例HIV/AIDS患者开始HAART治疗前后的外周血CD4+、CD8+淋巴细胞,治疗观察时间6个月,结合临床情况进行分析。结果:结果60例CD4计数平均增加133个/μl;CD4/CD8比值平均增加0.06。提示绝大多数HIV/AIDS患者对HAART治疗效果是敏感的,HAART能够有效促进免疫重建,减轻症状,延长生命,数据显示治疗时患者CD4+淋巴细胞计数在100或以上者,抗病毒治疗的成功率高些。结论:治疗要抓住有利时机,尽可能早治疗,促进和加快免疫重建,尤其对老年人更应选择有利时机早治疗。     

HIV/AIDS患者治疗前后CD4~+、CD8~+细胞水平检测结果分析

目的了解HIV/AIDS患者高效逆转录抗病毒(HAART)治疗前后CD4+、CD8+细胞计数水平变化情况。方法利用流式细胞分析技术对随机选取在本院住院治疗的177例HIV/AIDS患者进行治疗前后CD4+、CD8+检测,观察其治疗前后CD4+、CD8+细胞计数水平的变化。结果经过6个月的HAART治疗后,在选取的177例HIV/AIDS患者中,CD4+、CD8+细胞计数均较抗病毒治疗前有上升的趋势,治疗前后细胞计数比较差异具有非常显著统计学意义(P<均0.01)。结论 HIV/AIDS患者在持续HAART治疗后,CD4+、CD8+细胞计数将会提升到一定的水平,其可更好地提高HIV/AIDS患者的免疫力,在延长患者生命中具有重要的现实意义。     

中医药配合HAART对HIV/AIDS患者CD4+T细胞及病毒载量影响的研究

目的:观察中医药配合HAART对HIV/AIDS患者CD4+T细胞及病毒载量的影响。方法:将180例HIV/AIDS患者随机分成2组,治疗组予以芩花解毒胶囊,艾可清颗粒以及HAART治疗,对照组予以HAART治疗,分别于治疗前后检测患者CD4+T细胞、病毒载量变化以及安全性指标。结果:治疗前后CD4+T细胞绝对计数治疗组与对照组比较均能显著提高(P0.05),治疗组与对照组CD4+T细胞计数与CD4+T细胞上升幅度无显著性差异(P0.05)。安全性方面治疗组并未出现血常规、肝功能以及肾功能,相反,血常规和肝肾功能方面有改善的趋势。结论:艾可清颗粒与芩花解毒胶囊没有影响HAART的免疫学疗效,同时可以改善HIV/AIDS患者血常规、肝肾功能方面的问题以及尿黄、盗汗和便秘等症状。     

AIDS患者和HIV感染者T淋巴细胞亚群的变化及其临床意义

目的: 应用流式细胞仪(Flowcytometer, FCM)检测AIDS患者和HIV感染者外周血T淋巴细胞亚群的表达和绝对计数情况。方法:应用流式细胞仪三色荧光标记和绝对计数法检测 50例正常健康成人, 12例AIDS患者, 18例HIV感染者的外周血CD3+、CD4+、CD8+的表达及绝对数量。结果:AIDS患者和HIV感染者的CD4+淋巴细胞明显比正常人低,特别是AIDS患者CD4+淋巴细胞数低于 200个 /mm3,CD8+淋巴细胞显著增高,CD4+ /CD8+比值倒置。结论:用FCM检测AIDS患者和HIV感染者的免疫状况,可作为评价AIDS病程进展的重要指标。     

HIV/AIDS患者长期高效抗逆转录病毒治疗后眼底动脉硬化发生及影响因素分析

目的探讨HIV/AIDS患者长期高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后眼底动脉硬化情况及影响因素。方法收集2020年1月—2022年6月南宁市第四人民医院收治的203例HIV/AIDS患者HAART前后临床基本资料和眼底检查资料,评估患者眼底动脉硬化发生情况,并对其影响因素进行分析。结果203例HIV/AIDS患者出现眼底动脉硬化159例,发生率为78.33%,其中Ⅰ级33例(20.75%)、Ⅱ级87例(54.72%)、Ⅲ级28例(17.61%)、Ⅳ级11例(6.92%);HAART前,眼底动脉硬化组及正常组患者CD4^(+)T淋巴细胞计数、CD8^(+)T淋巴细胞计数、病毒载量、白细胞计数、血小板计数、血红蛋白、血肌酐、血尿素氮、三酰甘油、总胆固醇、空腹血糖、谷丙转氨酶、谷草转氨酶及血清总胆红素两组间比较差异无统计学意义(P>0.05);在HAART 6个月后,动脉硬化组CD8^(+)T淋巴细胞计数、甘油三酯、空腹血糖值显著高于正常组,两者比较差异有统计学意义(P<0.05);在HAART 6个月后CD4^(+)、CD8^(+)淋巴细胞计数分层比较中,动脉硬化组CD4^(+)淋巴细胞计数(CD4^(+))<200个/μL患者比例显著高于正常组患者,CD4^(+)淋巴细胞计数CD4^(+)≥500个/μL患者比例显著低于正常组患者;而CD8^(+)淋巴细胞计数CD8^(+)≥800个/μL患者比例显著大于正常组(P均<0.05)。二元Logistic回归分析结果显示,机会性感染、HIV病程、HAART后CD4^(+)T、CD8^(+)T淋巴细胞计数及三酰甘油是影响HIV/AIDS患者发生眼底动脉硬化独立危险因素(P<0.05)。结论HIV/AIDS患者眼底动脉硬化发生率高,>4年HIV病程、合并机会性感染、HAART 6个月后较低的CD4^(+)T淋巴细胞计数,较高的CD8^(+)T淋巴细胞计数和三酰甘油值是患者发生眼底动脉硬化的独立危险因素。应对此类人群在HAART前后均需进行眼底筛查,针对心血管疾病风险,制定HAART方案,并在治疗过程中加强心血管疾病风险管理改善患者结局。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.