江苏省HIV感染者和艾滋病患者抗病毒治疗1年后CD4+T淋巴细胞检测结果分析

目的 :了解江苏省首次接受艾滋病免费抗病毒治疗的HIV/AIDS患者治疗1年后CD4+T变化及影响因素。方法 :收集江苏省首次接受抗病毒治疗的基线和治疗随访1年时均有CD4+T细胞检测结果记录的HIV/AIDS患者资料,随访截止时间为2014年5月31日。建立Excel数据库并用SPSS16.0软件进行分析。结果:首次接受抗病毒治疗的基线和随访1年时均有CD4+T检测结果记录的HIV/AIDS共3 290例。81.4%为江苏省籍,男女比例为4.36∶1,平均年龄(39.7±12.1)岁。感染途径主要为性传播。入组时基线CD4+T细胞计数均数为185.81个/μl。治疗1年后的CD4+T细胞均数为312.20个/μl。Logistic回归分析显示,年龄大、基线CD4+T高、在疾控中心治疗和临床Ⅰ期的HIV/AIDS患者,其CD4+T较基线增长值≥100个/μl的比例低。结论:江苏省HIV/AIDS抗病毒治疗对免疫功能恢复效果显著,应继续规范、早期开展抗病毒治疗工作。     

2003～2013年开封市艾滋病抗病毒治疗患者生存分析

目的了解开封市艾滋病患者接受抗病毒治疗后的生存状况及影响生存时间的因素。方法利用国家艾滋病抗病毒治疗信息系统,收集2003年1月至2013年12月在开封市接受艾滋病抗病毒治疗患者的基线和随访信息,采用COX比例风险模型对影响患者抗病毒治疗后生存时间的因素进行分析。结果共纳入3 365例艾滋病患者,其中存活患者2 607例,因艾滋病相关疾病死亡患者758例。研究对象1a~11a的累积生存率从94.22%下降到71.25%。多因素COX回归分析显示影响艾滋病患者生存时间的危险因素是男性(HR=1.308,95CI:1.128~1.517)、开始抗病毒治疗时年龄越大(HR=1.270,95CI:1.126~1.433)、初始治疗采用含DDI的方案(HR=2.342,95CI:1.848~2.969);影响艾滋病患者生存时间的保护因素是教育程度越高(HR=0.602,95CI:0.509~0.712)、基线CD4+T淋巴细胞计数越高(HR=0.543,95CI:0.499~0.591)。结论开封市艾滋病患者接受抗病毒治疗后生存率较高,对符合治疗条件的艾滋病患者尽早开展抗病毒治疗,进一步优化抗病毒治疗方案等延长开封市艾滋病患者生存时间的有效措施。     

211例HIV/AIDS患者抗病毒治疗效果分析

目的:通过随访分析211例抗病毒治疗的艾滋病患者CD4+T淋巴细胞指标,分析治疗效果?方法:对不同时段CD4+T淋巴细胞构成比描述,利用Fisher确切概率法检验?结果:211例在治患者接受抗病毒治疗并随访,在不同时段内,CD4+T细胞计数水平构成比随着治疗时间的延长,高水平CD4+T细胞计数不断增高,而低水平CD4+T细胞计数显著降低,并于后期稳定持续?结论:有效的抗病毒治疗可以增加CD4+T淋巴细胞计数水平,提高患者的免疫水平?     

艾滋病患者抗病毒药物治疗的护理体会

目的探讨和分析艾滋病患者抗病毒药物的治疗效果以及护理体会.方法对在我院2008年8月~2011年8月间住院治疗的40例接受药物治疗的艾滋病患者进行回顾性分析.结果艾滋病患者经过药物治疗后,有37.5%的患者出现了副反应;CD4+T 淋巴细胞绝对计数与基线比较,治疗3,6,9,12,24个月均有增长,不同时间的治疗CD4+T 淋巴细胞变化差异具有统计学意义.结论艾滋病抗病毒治疗对艾滋病患者疗效显著,加强对患者的护理可以提高治疗效果和患者的生存质量.     

萧县艾滋病抗病毒治疗的效果分析

目的 探讨艾滋病抗病毒治疗的效果,为进一步开展有效的抗病毒治疗工作提供依据.方法 选择2003年10月至2008年4月5年抗病毒治疗的病人,统计分析其治疗前后CD4+T淋巴细胞计数、体质量、临床症状体征以及生存状况指标的变化,以评价其治疗效果.结果 艾滋病病人经抗病毒治疗后,CD4+T淋巴细胞计数增加,治疗2～3年后与治疗前基线相比,平均增长150/mm3以上;病人治疗1年后,体质量增加明显,各种机会性感染症状体征发生率由治疗前的94.57%下降到7.61%;病人生存率提高,维持治疗3年和5年生存率分别达到82.46%和61.54%.结论 抗病毒治疗效果显著,艾滋病病人生存状况和生命质量得到明显改善,符合治疗条件的病人应及早进行规范的抗病毒治疗.     

惠州市艾滋病患者抗病毒治疗前后CD4细胞计数变化特征

目的了解惠州市艾滋病抗病毒治疗病人不同基线CD4细胞计数的变化特征,建立健全艾滋病病毒感染者/艾滋病患者CD4+T淋巴细胞监测平台,为取得相关治疗的最大成效比提供数据支持。方法利用国家艾滋病防治信息系统的抗病毒治疗管理基本信息数据库及实验室检测数据,比较惠州市2006~2012年抗病毒治疗病人治疗前后(治疗前、治疗后3个月、6个月、9个月、12个月)CD4细胞数值的变化情况,进行统计学分析。结果经抗病毒治疗3个月以后,106例患者的CD4细胞有不同程度增高,最高378个/uL,平均增加88.74个/uL。同治疗前基线CD4+T淋巴细胞数相比,治疗后3个月、6个月、9个月、12个月时CD4细胞数明显增加,经统计学分析差异均有统计学意义。结论艾滋病病毒感染者/病人接受免费抗病毒治疗以后,CD4细胞计数在不同治疗时间段均逐渐上升,提示患者抵抗力的增强。定期监测CD4细胞计数的变化,有助于治疗医生了解患者的病情发展,选择正确的治疗方案,并观察对治疗的反应。     

湖南省艾滋病病人抗病毒治疗死亡病例分析

目的探讨影响艾滋病抗病毒治疗病人死亡的主要因素,为降低病人死亡率,提高治疗效果提供参考。方法1 346例艾滋病抗病毒治疗病例信息均来自国家艾滋病综合防治信息系统,用SPSS13.0统计软件进行数据处理,对病例进行生存分析,计算病死率[/（100人.年）],分析可能影响病人死亡率的临床和基线CD4计数等因素。结果从2003年到2008年,共有1 346名艾滋病人接受抗病毒治疗,其中死亡221例,死亡病例中艾滋病相关疾病死亡198例,其他原因死亡23例;总病死率为13.6/[（100人.年）],12个月生存率为14.0%,按病死率[/（100人.年）]计算为19.8;接受治疗前94.9%（188/198）的患者出现过1种临床症状,77.3%（153/198）的病例同时具有2种或2种以上临床症状;基线CD4计数（个/mm3）在〈50,50~200,〉200各组间病死患者生存时间差异有统计学意义,P〈0.05;1年以内病死的与生存1年以上的病例基线CD4计数水平差异也有统计学意义,P〈0.01。结论接受抗病毒治疗患者1年以内的生存率变化最大,病死率与开始治疗时的基线CD4细胞计数水平及病人的一般情况密切相关,加强病人的早期发现和及时治疗,构建社会综合支持网络,才能有效地降低病人死亡率,提高治疗效果。     

639例艾滋病患者抗病毒治疗后生存质量及生存时间分析

目的调查接受艾滋病抗病毒治疗患者的生存质量和生存时间,探讨其影响因素。方法收集2005年1月1日—2015年12月31日在惠州市随访并接受艾滋病抗病毒治疗的639例患者信息,采用SF-36量表对患者进行生存质量调查,分析影响患者生存质量及生存时间的因素。结果研究对象的生理机能、社会功能、生理职能、情感职能、精神健康、精力、躯体疼痛、一般健康状况的得分明显低于常模,差异有统计学意义(P0.05)。多因素Logistic回归分析显示个人年收入高是生存质量的保护因素,年龄大、副反应、WHO分期高是生存质量的危险因素。Cox比例风险模型结果显示:以CD4+T淋巴细胞计数≥200个/mm3为参照,CD4+T淋巴细胞计数50个/mm3的患者死于艾滋病相关疾病的风险为5.387(95%CI:1.673~17.483),50个/mm3≤CD4+T淋巴细胞计数200个/mm3的患者的风险为3.607(95%CI:1.201~11.084);出现持续或间断发热患者的风险为2.147(95%CI:1.304~4.042)。结论艾滋病抗病毒治疗患者的生存质量低于一般人群,影响生存质量的因素有年龄、年收入、副反应、WHO分期。结合生存时间分析,尽早开始标准化治疗有利于患者的生存预后。     

福建省艾滋病抗病毒治疗患者生存时间影响因素分析

目的了解福建省艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者接受抗病毒治疗后生存时间的影响因素,为进一步改善患者的生存状况,提高抗病毒治疗工作质量提供参考依据。方法利用国家统一的中国疾病预防控制系统艾滋病综合防治信息系统中福建省治疗数据信息,使用SPSS 15.0进行相关分析。通过筛选,本次研究共纳入1 061例患者,死于AIDS相关疾病66例(6.22%)。结果 Cox比例风险模型分析结果表明,基线CD4+T淋巴细胞计数<200、基线时患者有持续或间断发热影响患者抗病毒治疗后生存时间。结论结合抗病毒治疗生存时间影响因素分析,在疾病早期符合抗病毒治疗标准时尽早开始治疗对患者生存预后有益。     

湖北省黄石市2003—2018年艾滋病抗病毒治疗患者生存分析

目的 研究黄石市艾滋病抗病毒治疗患者生存情况及影响因素。方法 提取艾滋病综合防治信息系统中黄石市2003—2018年进行艾滋病抗病毒治疗的患者信息,通过寿命表法计算患者的累积生存率; Log-Rank检验进行生存时间影响的单因素分析,Cox比例风险模型进行生存时间影响的多因素分析。结果 截至2018年12月,研究对象存活1 159例,平均生存时间为142.50个月,95%CI (139.09~147.94个月)。1~5年累积生存率分别为90.54%、85.76%、82.82%、80.50%、78.87%。全死因死亡253人,平均死亡年龄(62.77±11.46)岁,死于艾滋病相关疾病患者157人,治疗后1年之内死亡162人,全死因患者中位数生存时间为10.00个月(P ₂₅~P ₇₅为3~24个月)。经Cox比例风险模型分析,基线CD4⁺T淋巴细胞计数为351~500个/μL,治疗效果较好(HR =0.20,95%CI 0.09~0.47);年龄越大,生存率越低(HR = 22.57,95%CI 5.89~86.49)。结论 黄石市艾滋病抗病毒治疗患者累积生存率较高,开始治疗年龄、CD4⁺T淋巴细胞计数、WHO临床分期等是艾滋病抗病毒治疗患者生存时间的影响因素。     

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.