间日疟对HIV感染者/AIDS患者CD4淋巴细胞凋亡率的影响

目的观察急性间日疟对HIV感染者CD4淋巴细胞凋亡(百分)率的影响,探讨疟疾疗法治疗HIV感染的部分机理.方法 12例HIV-1感染者(CD4细胞计数基线水平范围为1217×106/L～15×106/L)接受疟疾疗法(治疗性急性间日疟)治疗,用流式细胞仪碘化丙啶染色法检测CD4细胞凋亡率.另选20例年龄相配的HIV阴性志愿者作为对照组.结果 CD4细胞凋亡率在疟疾期显著升高,但在终止疟疾后迅速下降至低于疟疾疗法前的基线水平(HIV感染者/AIDS患者组的CD4细胞凋亡率在疟疾疗法前显著高于HIV阴性对照组,但在终止疟疾后两组无显著性差异).结论疟疾疗法治疗HIV感染的部分机理是减少CD4细胞的凋亡.     

HIV阳性患者感染急性间日疟的细胞因子反应

目的　探讨疟疾疗法 (治疗性急性间日疟 )治疗HIV感染的部分机制。方法　 12例HIV 1感染者 (CD4细胞水平为 12 17～ 15× 10 6/L)接受疟疾疗法 ,按CD4细胞水平高低编号和分组 :例 1～ 12为总组 (TG) ,例 1～ 5 (CD4>5 0 0× 10 6/L)为第一亚组 (SG1) ,例 6～ 10 (CD4为 499～ 2 0 0× 10 6/L)为第二亚组 (SG2 ) ,例 11～ 12 (CD4<2 0 0× 10 6/L)不列入亚组作统计学分析。用ELISA法检测血浆细胞因子和细胞因子活性标记物。结果　从总体 (TG组 )上看 ,在疟疾期 ,血浆TNF α、sTNF RII、sIL 2R、新喋呤 (NPT)和 β 2微球蛋白 (β2M ,只有部分患者检测 )均显著升高 ,SG2组显著高于SG1组。但终止疟疾后这些因子迅速降至疟疾感染前的基线水平。在所有患者中IFN γ均检测不到。结论　疟疾疗法治疗HIV感染的部分机制是激发患者体内产生多种细胞因子 ,使已经失去平衡的免疫系统得到一次调整 ,达到一种新的免疫平衡。     

成人HIV/AIDS合并肺结核患者的临床表现和影像学分析

肺结核是获得性免疫缺陷综合征(acquiredimmunedeficiencysyndrome,AIDS)最常见的肺部机遇性感染疾病之一,是引起艾滋病患者死亡的重要原因。临床表现、影像学特征、对药物治疗的反应及预后均与一般肺结核表现有所不同,病变过程可发生在人体免疫缺陷病毒携带者或艾滋病患者(HIV/AIDS)的任何时期,往往是HIV/AIDS患者的早期症状,肺部影像表现多种多样,给影像诊断和鉴别诊断带来较大的困难。我们作为中国援助博茨瓦纳医疗队队员于1999～2 0 0 2年在玛丽娜公主医院工作,期间收集到资料完整的成人HIV/AIDS合并肺结核患者199例,对其临床…     

宾阳县基本消灭疟疾后的监测结果与分析

宾阳县曾是间日疟与恶性疟混合流行区 ,2 0世纪 60年代居民血检疟原虫率为 4.61 % (862 / 1 8698) ,其中间日疟占 5 4.87% ,恶性疟占 44.2 0 % ,混合感染占 0 .93 %。经过 40余年的反复查治 ,于 90年代初期发热病人和居民血检疟原虫率已降至 0 .0 0 2 % (3 / 1 2 3 749) ,1 993年经自治区卫生厅组织考核达到卫生部颁布的《基本消灭疟疾标准》,现将基本消灭疟疾后的 1 994年至 2 0 0 1年疟疾监测结果分析如下。1　方法主要是县级卫生单位和乡 (镇 )卫生院以及村卫生所的防疫人员 ,通过主动和被动侦察 ,随时对当地居民临床初诊为疟疾、疑似疟…     

疟疾引起贫血的原因

本文报道采用铬~(51) 、铁~(59) 及补体的测定来阐明在疟疾病人中引起贫血的原因。患者均系热带病医院住院病人,其中恶性疟5例;间日疟2例;卵形疟1例。所有病人均用氯喹治疗。当病人无发烧和血片中疟原虫消失时进行研究。除一例间日疟外所有患者均有相当程度的贫血,恶性疟患者恢复期贫血较急性期更为严重。     

在委内瑞拉急性疟疾病人中检出HTLV-Ⅲ/LAV抗体

疟疾可引起类似于获得性免疫缺陷综合征(AIDS)的免疫抑制,如严重的淋巴细胞减少、T_4淋巴细胞亚群消失和 B 细胞激活等。作者对急性疟疾病人进行了检查,以了解有无 HTLV-Ⅲ/LAV(人类嗜淋巴细胞Ⅲ型病毒/淋巴结病相关病毒)感染的迹象。作者以 HTLV-Ⅲ/LAV 感染的细胞或病毒作为抗原,用酶联免疫吸附试验、间接免疫荧光试验、免疫印迹技术(Western blot)和放射免疫沉淀试验等方法,检测了委内瑞拉的12例急性间日疟病人和12例恶性疟病人血清中的 HTLV-Ⅲ/LAV 抗体。受检期间病人不使用抗疟药,病人均非 AIDS 高危人群,也无AIDS 相关的疾病。结果 12例恶性疟疾病人中有3例(25%)     

抗病毒治疗并发严重不良反应后更换洛匹那韦/利托那韦片的疗效观察

目的:评估获得性免疫缺陷综合征(AIDS)患者抗病毒治疗后并发严重不良反应,更换洛匹那韦/利托那韦片(LPV/r)的疗效。方法:回顾性分析8例AIDS患者接受三联抗病毒治疗后并发严重不良反应,人类免疫缺陷病毒(HIV)RNA已降至     

盐城市疟疾流行态势及防控对策探讨

目的掌握盐城市疟疾发病特征和流行态势,为疟疾防治决策提供科学依据。方法采用回顾性调查方法,收集1993-2011年全市疟疾确诊病例流行病学资料,分析疟疾病例发病的流行病学特征和流行态势。结果1993-2011年盐城市9个县(市、区)疟疾发病总人数为134例,其中本地间日疟18例,输入性间日疟59例,输入性恶性疟56例,输入性三日疟1例,分别占总病例数的13.43%、44.03%、41.79%和0.75%。19年全市疟疾总发病率为0.03/10万～0.29/10万,本地疟疾发病率为0～0.06/10万,呈低度流行态势,2006年以后全市未发现本地感染疟疾病例。2007-2011年发现境外输入性恶性疟病例56例,并呈逐年上升趋势,同时发现境外输入性三日疟1例。病人发病至就诊时间的间隔中位数为1 d,当天就诊的占58.96%,村卫生室为主要首诊医院,占44.06%;病人发病至血检、确诊和治疗时间间隔中位数均为4 d。结论盐城市本地疟疾发病已趋于逐步消除态势,境外输入性恶性疟明显增加,加强输入病例监测和防控是当前工作的重点。     

人免疫缺陷病毒携带者和艾滋病患者血清IFN-γ、IL-10和免疫球蛋白的检测及其临床意义

目的　探讨IFN γ和IL 10在人免疫缺陷病毒 (HIV )感染中的意义。方法　利用双抗体夹心ELISA法检测 3 0例HIV携带者、16例艾滋病 (AIDS)患者血清IFN γ和IL 10水平 ,采用透射比浊法检测血清IgG、IgA和IgM水平 ,选择 2 3名健康人作对照组。 结果　AIDS患者IFN γ水平为 (4 .5± 2 .7)pg/ml,对照组为 (8.2± 4.1) pg/ml,AIDS患者明显低于对照组 (P <0 .0 5 ) ,HIV携带者、AIDS患者血清中IL 10水平明显高于对照组 [(12 .4± 7.4) pg/ml ,(2 8.1± 11.2 ) pg/mlVs(6.9± 3 .8)pg/ml ,P <0 .0 1] ,且AIDS组高于HIV携带组 (P <0 .0 1)。HIV携带者和AIDS患者血清中免疫球蛋白水平均高于对照组。结论　HIV携带者存在Th1型免疫应答缺陷 ,Th2型免疫应答与感染慢性化及疾病持续发展有关。     

疟疾疗法治疗HIV感染的适应症

目的探讨疟疾疗法治疗HIV感染的适应症.方法按美国疾病控制中心(CDC)1993年修订的分类标准选择12例HIV-1感染者接受疟疾疗法治疗,其中5例诊断为CDCⅠ类(CD4细胞计数≥500×106/L),5例CDCⅡ类(CD4细胞计数200～499×106/L),2例CDCⅢ类(CD4细胞计数＜200×106/L).用流式细胞仪法检测CD4细胞计数和百分率,bDNA法检测病毒载量.分别于治疗前第1次和第2次、第1次疟疾发热、第5次发热、第10次发热、终止疟疾后第10天、1个月、3个月、6个月、12个月、18个月和24个月采集血标本做检测.结果病毒载量在所有CDCⅠ类和Ⅱ类患者于疟疾期均升高,在大部分Ⅰ类和所有Ⅱ类患者于终止疟疾后回降到治疗前基线水平;2例CDCⅢ类患者经疟疾疗法治疗后病毒载量升高.治疗后3～24个月期间,Ⅰ类患者CD4计数均降低,CD4百分率3例降低,2例升高;Ⅱ类患者CD4计数3例升高,2例维持稳定,CD4百分率4例升高,1例维持稳定;2例Ⅲ类患者CD4计数和百分率维持相对稳定不变.结论疟疾疗法可能对CDCⅡ类HIV感染者有疗效.应该选CDCⅡ类患者做Ⅱ期(设对照组)临床试验,以进一步验证其疗效.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.