贵州省艾滋病防治工作的思考

自1981年美国发现首例艾滋病(AIDS)后,艾滋病以惊人的速度迅速在全球100多个国家和地区广泛流行,截止2006年底,全球感染人数已达3 950万人,其中230万是15岁以下的儿童,当年新感染者430万人,艾滋病的流行已经成为影响人类社会和经济发展的重要难题.     

艾滋病实验诊断进展

联合国艾滋病规划署和世界卫生组织联合发布报告指出,2006年全球艾滋病病毒携带者人数为3950万,2006年新增艾滋病感染者430万,其中40%为15～24岁的年轻人,2006年全球有290万人死于艾滋病。卫生部通报我国艾滋病的流行现状,截至2006年10月31日,     

艾滋病护理

艾滋病既获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)是由人类免疫缺陷病毒(human inmunodeficiency virus,HIV)引起的一种严重传染病[1].自1981年在美国发现首批艾滋病患者以来,该病的流行呈逐年上升趋势,目前全球HIV感染者人数是4 390多万,而我国的感染者人数约为84万.     

艾滋病医源性传播及防护

艾滋病(AIDS)是人类免疫缺陷病毒引起的一种获得性免疫缺陷综合征,自美国首次发现艾滋病20余年来,已在全球范围造成了流行,在我国AIDS流行趋势十分严峻,截止到2005年6月底,全国累计报告艾滋病病毒(HIV)感染者为126 808例,感染人数年增长率约30%～40%.据专家预测,如果不采取积极有效的措施,到2010年,我国HIV感染者有可能达到1 000万人.随着HIV感染者的增多,医务人员和患者在医疗环境中感染HIV的危险性增加.我院自2002年7月～2009年8月共收治AIDS患者41例,其中男34例,女7例,年龄21～73岁.随着这类患者的日益增多,加强AIDS院内控制与防护已刻不容缓.     

HIV化学治疗的最新进展

全球流行的人类免疫缺陷性病毒（HIV）感染／艾滋病似乎没有消退的迹象。2002年为止，全世界尚存活的感染HIV的人数已由500万上升至4200万，由于大多数感染者生活在发展中国家，按流行病学趋势预测，到2010年，感染人数将达到1亿。在发达1日家，新感染的人数虽然在增加，但增长速度很低。使用抗逆转录病毒药物的患者，已出现对治疗药物耐药的病毒株。     

结核病的防治

1 结核病的流行情况 早在1993年4月联合国世界卫生组织曾宣告,结核病是全球性的一个突出问题,已处于紧急状态。目前全人类已有三分之一感染了结核菌,其中的三分之二在亚洲,每年约有300万人死亡,已是成人死亡的最主要的传染病。到2005年全球死于结核病的人数将上升到400万,感染人数也将超过20亿,肺结核病大有再次席卷全球之势。尤应注意的是已有510万艾滋病病毒感染者又感染上结核的动向。我国1990年第三次全国结核病流行病学调查结果表明形势严峻,全国的感染者有3.3亿,活动性肺结核600     

疫苗与传染病

疫苗是人类在医学领域里所取得的最伟大成就之一。在疫苗出现之前，人类在与传染病的搏斗中丧失了无数的生命。印度历史上曾先后发生7次霍乱大流行，共导致3800多万人死亡。鼠疫曾发生3次世界性大流行，其中6世纪发生的首次大流行持续半个世纪并波及到所有欧洲国家，导致约1亿人死亡。据不完全统计，1918—1919年的“西班牙流感”共导致全球约5000万人死亡。传染病是人类的头号敌人，一旦暴发常会使整个城市或国家遭受毁灭性的打击，累计死亡人数远远高于在历次战争中死亡人数的总和。     

我国避孕套市场存在的问题与思考

据联合国艾滋病规划署和世界卫生组织发表的（2007年全球艾滋病流行最新报告》估计,2007年全球共有3320万艾滋病毒感染者,新感染艾滋病的人数为250万。《中国艾滋病防治联合评估报告》指出,到2007年10月底我国累计报告艾滋病病毒感染者和艾滋病患者223501例,其中艾滋病患者62838例。死亡报道22205例。避孕套作为计划生育、性病、艾滋病防治工作的重要工具．其产品质量直接关系到公众的身体健康和安全．越来越受到政府有关部门的重视。     

亚洲最大高压氧舱群落户重庆

本刊讯 卫生部马晓伟副部长在日前举行的“2003年预防艾滋慈善晚宴”上介绍了艾滋病在中国的流行形势,他指出,目前我国艾滋病流行形势十分严峻,自1996年以来,已进入快速增长期。2002年6月,艾滋病感染人数估计超过100万,如不采取有效措施,到2010年,艾滋病感染人数将可能突破1000万,其结果必将给     

抗艾滋病药物新的载药释药系统（续一）

联合国艾滋病规划署发布的<2008年全球艾滋病疫情报告>指出,2007年全球新增艾滋病毒(HIV)感染者有270万例,因艾滋病死亡的人数为200万例,全球目前仍存活的艾滋患者和感染者有3 320万例,每天新增HIV感染者7 500例.艾滋病对世界任何一个地方来说都还远未过去,在全球范围内已构成对公众健康的严重挑战.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.