获得性免疫缺陷综合征研究进展

获得性免疫缺陷综合征是一种由人免疫缺陷病毒引起的、严重损害人体免疫系统的疾病。该病有明显的地域聚集性;以30～39岁的男性占绝大多数;主要通过精液和血液传播。临床上主要表现为机会性感染和恶性肿瘤,病情的轻重取决于细胞免疫功能的丧失程度。AIDS的诊断主要依据监测标准和临床病毒学检测。目前对该病尚无特效的治疗方法,重点在于加强宣传教育,增进人们对其传播途径及一般预防措施的认识。     

获得性免疫缺陷综合征抗病毒治疗及预防的研究进展

获得性免疫缺陷综合征(AIDS)是人免疫缺陷病毒(HIV)引起的全球流行的传染性疾病。近40年来,全球感染HIV患者数量不断增加,大部分患者因AIDS相关疾病死亡。抗反转录病毒治疗(ART)是最有效的治疗AIDS的方法,由于HIV细胞潜伏库的存在,ART不能彻底清除HIV,但能有效抑制HIV复制,改善预后,提高患者生存质量,减少HIV传播。随着抗病毒治疗药物的不断更新、治疗时机提前、治疗方案的优化,AIDS治疗及预防有了巨大进展,使AIDS成为一种可控制的慢性传染性疾病。     

获得性免疫缺陷综合征合并中耳感染的临床观察

目的 :探讨获得性免疫缺陷综合征 (AIDS)合并中耳感染的临床特点。方法 :回顾分析在坦桑尼亚姆希比利大学医学院医疗中心工作期间收治的 2 0例AIDS合并中耳感染患者的临床资料。结果 :AIDS合并中耳感染患者服中药和全身用抗生素 ,局部用抗生素滴耳 ,Ⅱ期患者的症状暂时可得到缓解 ;Ⅲ～Ⅳ期患者中 ,2例死于颅内感染 ,1例死于肺结核 ,余者均进行性加重。结论 :AIDS合并中耳感染的患者发病急 ,病程短 ,发病后症状严重 ,伴有多脏器感染。虽有严重感染 ,但WBC不升高者 ,需查HIV。     

获得性免疫缺陷综合征的临床隔离与消毒

我科自1993年至1998年底共收治了9例AIDS，总结形成了一套保高、消毒的具体措施，体会如下．lAIDS的临床同＊根据AIDS的传播途径和病人抵抗力，我们对AIDS加强了“血液一体液”隔离和“保护性”隔离措施．l．l生活用品及医疗用品单独使用．限制AIDs病人与结核病、水痤、带状克疹等感染性疾病患者接触．对有呼吸道感染的病人，应限制活动范围，外出接受检查应找回军．对合并机会性感染、有出血或开放性引流饬口，严重腹泻或大便失禁、昏迷惑不能合作。”剧烈咳世略疾、病危有特护需求和有某些。。理或社会需要考，应做到单间隔离．l…     

治疗获得性免疫缺陷综合征的中药研究

总结了近年来抗人类免疫缺陷病毒 (HIV)的中药活性成分及复方制剂的研究进展情况 ,说明中药在治疗获得性免疫缺陷综合征 (AIDS)方面有着非常广阔的前景     

获得性免疫缺陷综合征的眼部并发症

获得性免疫缺陷综合征(AIDS)是由人免疫缺陷病毒(HIV)感染引起,导致被感染者免疫功能部分或完全丧失,CD4+细胞数目减少,继而发生机会性感染、肿瘤等各种表现的慢性进行性疾病。其眼部并发症多发生在眼后段,包括HIV/AIDS视网膜炎、机会性感染、罕见肿瘤和神经眼科疾病。目前广泛应用高效抗逆转录病毒疗法(HAART)及更昔洛韦治疗AIDS及其眼部并发症取得了很大进展。现本文对4种眼部主要并发症进行综述。     

适配子介导转运在肿瘤靶向治疗中的研究进展

适配子是生物分子的单链寡核苷酸配体,通过指数富集的配体系统进化技术从人工合成的单链随机寡核苷酸文库中筛选获得。本文从连接方式、治疗靶点、疗效、优缺点多个方面对适配子介导转运在靶向肿瘤化疗、核酸治疗、光动力疗法和光热疗法中的研究进展进行概述。指出以适配体靶向肿瘤的递送系统在肿瘤相关靶向治疗中发展迅速,但仍面临许多挑战。筛选更多靶点的高亲和力适配子,改进适配子与其他治疗药物的结合模式,改善药物的药代动力学是目前工作的重点。     

核酸适配子及其筛选进展

随着对单链DNA/RNA的不断研究,人们发现这些单链的寡核苷酸序列具有特殊的三维结构,能高亲和力和高特异性地结合各类靶标.根据单链DNA/RNA的这一性质.人们应用指数富集配体的系统进化技术在体外进行数轮筛选和扩增到特异性高、亲和性强的寡核苷酸序列,即核酸适配子,也称为适配子.基于适配子的化学结构和特点.稳定性的不断提高和筛选的方法不断改进,适配子被广泛运用于早期临床诊断和治疗等生物医学研究领域,并不断取得进展.本文就适配子技术及其筛选进展作一综述.     

癌胚抗原特异性寡核苷酸适配子的体外筛选及其意义

目的:通过体外筛选获得癌胚抗原(CEA)特异性适配子,为高表达CEA肿瘤的靶向奠定基础。方法:构建长度为81 bp的随机ssDNA文库,体外筛选、富集CEA特异性适配子,通过配体介导的靶蛋白纯化实验检测经筛选的适配子与纯化蛋白结合;提取LS174T细胞总蛋白,免疫共沉淀检测经筛选的适配子与细胞总蛋白的结合。结果:经体外7轮筛选富集及筛选条件的优化,配体介导的靶标分离实验证实了筛选出的适配子与纯化CEA蛋白的结合;免疫沉淀及Westem blot证实了其识别并特异性结合天然状态的CEA。结论:经过体外7轮筛选,证实了所获得的CEA适配子可特异性地与纯化CEA和天然状态的CEA蛋白结合,为后续高表达的CEA肿瘤的靶向诊断和治疗奠定了初步的实验基础。     

获得性免疫缺陷综合征患者抗病毒治疗后耐药基因变异分析

3例人类免疫缺陷病毒（HIV）-1阳性患者。采集血浆，设计针对HIV-1全长蛋白酶基因和部分逆转录酶基因（40-250aa）引物，RT—PCR法扩增模板RNA，PCR产物序列测定后，用HIVdb软件进行HIV-1耐药突变相关位点的分析；流式细胞术检测患者外周血CD4^＋／CD8^＋T淋巴细胞数，核酸序列扩增实验（NASBA）进行外周血病毒负荷的测定。     

淋巴结结构及其结构改变与获得性免疫缺陷综合征发病机制的关系

免疫器官是免疫细胞再生、分化的重要场所,淋巴结（lymph nodes,LNs）作为外周免疫器官,其正常结构对于维持自身内环境稳定和免疫细胞的生存、发育、增生是非常重要的.近来,国外有研究发现胶原纤维在淋巴组织中T细胞区域（T cell zone,TZ）的沉积可能是导致HIV感染者外周血和淋巴组织中CD4^＋ T细胞减少的又一重要机制.该文拟根据近年研究进展,阐述LNs正常组织结构对CD4^＋ T细胞存活、发育和运输的影响及其结构改变与获得性免疫缺陷综合征（AIDS）发病机制的关系,以期对目前AIDS发病机制和临床治疗的研究有所裨益.     

艾滋病伴发皮肤损害的皮肤病理学分析

目的 探讨伴发皮肤损害的HIV/AIDS患者的皮肤病理类型及其特点,为艾滋病的诊断和治疗提供依据。方法 无菌条件取伴有皮肤损害的HIV/AIDS患者的皮肤组织进行病理学检查,通过HE、抗酸、过碘酸雪夫（PAS）和淀粉酶消化后过碘酸雪夫(D-PAS）染色,光学显微镜下观察形态学,描述组织病理特点,并对病理结果进行统计学分析。结果 82例HIV/AIDS患者的皮肤组织病理学检查表现为感染性皮肤病32例（占39.02%）,炎症性皮肤病36例（占43.90％),皮肤肿瘤14例(占17.07%)。其中马尔尼菲篮状菌病14例,银屑病10例,湿疹9例,卡波西肉瘤12例。马尔尼菲篮状菌随着CD4⁺T淋巴细胞计数的减少,感染率升高（P=0.003）。结论 HIV/AIDS患者皮肤损害的原因感染性主要为马尔尼菲篮状菌感染,且多数发生在CD4⁺T淋巴细胞计数低下的患者,炎症性主要为银屑病,最常见的皮肤肿瘤为卡波西肉瘤,临床上需要加强对HIV/AIDS患者伴发各种皮肤病的诊断和治疗。     

北京大学生艾滋病相关知识、态度、行为的变化特点及影响因素

目的：探究不同年份大学生艾滋病相关知识、态度、行为及其影响因素的变化情况,为今后开展针对性健康教育提供参考。方法：分别于2006年和2016年在北京市采用分层整群抽样方法选取大学生进行问卷调查,调查人数分别为1 800人和3 001人。调查问卷内容包括人口学特征、艾滋病相关知识、艾滋病相关态度、性行为及相关高危行为情况、安全套使用意向、艾滋病健康教育情况。 结果：与2006年相比较,2016年大学生艾滋病知识平均分有所下降 ［(12.78±1.95) vs. (11.90±2.56), t=12.91, P<0.05］,各题知晓率均有所下降。除安全套使用信念外,2016年大学生艾滋病相关态度和自我效能得分均低于2006年。与2006年相比,2016年有过性行为的大学生中,金钱（物品）交易性行为的发生率有所上升［6.53% (16/245) vs. 17.65% (33/187), χ2=13.003, P<0.001］,同性性行为的发生率有所上升［4.13% (10/242) vs. 15.43% (29/188), χ2=16.356, P<0.001］。与2006年相比,2016年接触色情信息的主要途径由书籍变为网络（41.15%）。2016年大学生安全套使用意向的影响因素为男性(OR=0.713)、安全套购买自我效能(OR=0.876)、大学前未接受过性教育(OR=0.752)、安全套使用自我效能(OR=1.135)、安全套使用信念(OR=1.775)以及对艾滋病患者的态度(OR=1.136)。结论：大学生艾滋病相关知识、态度、行为已发生改变,艾滋病健康教育应在当前大学生特点上深入开展,注重培养大学生正确的性观念和性责任,加强大学生自我保护意识。     

Ocular manifestations in 321 male consecutive cases of human immunodeficiency virus infection/acquired immunodeficiency syndrome at an HIV-referral centre

Background

Most studies on the ocular manifestations of human immunodeficiency virus (HIV) infection are on cases of acquired immunodeficiency syndrome (AIDS), not including asymptomatic carriers of HIV. With this background, we proceeded to study all the HIV-infected individuals attending our centre, with the aim:a. To study the ocular manifestations of HIV.b. To correlate those manifestations with the CD4+ T-lymphocyte counts.c. To compare our findings with other studies.

Method

A cross-sectional study involving a detailed ocular examination of 321 cases of HIV/AIDS was done. Automated perimetry, digital fundus photography and fundus fluorescein angiography were done for relevant cases. The last 125 cases were subjected to Schirmer''s test and tear film break-up time.

Results

We studied 321 male HIV cases (642 eyes), with a mean age of 36.78 years, mean CD4+ count of 276.54 cells/μL, 78.82% of them being on anti-retroviral therapy. Ocular manifestations were seen in 87 out of 321 cases, 72.41% of them being asymptomatic carriers of HIV. The ocular findings seen were conjunctival microvasculopathy, molluscum contagio-sum, dry eye, neuro-ophthalmic manifestations, anterior uveitis, posterior uveitis, and HIV retinopathy, only the last three of which had a significant association with CD4+ counts. The overall prevalence of ocular lesions also had a significant association with CD4+ counts.

Conclusion

Ocular manifestations are common in asymptomatic carriers of HIV. Anterior uveitis, posterior uveitis and HIV retinopathy have a significant association with CD4+ counts and are reliable indicators of low CD4+ count.     

Ocular manifestations in 321 male consecutive cases of human immunodeficiency virus infection/acquired immunodeficiency syndrome at an HIV-referral centre

Background

Most studies on the ocular manifestations of human immunodeficiency virus (HIV) infection are on cases of acquired immunodeficiency syndrome (AIDS), not including asymptomatic carriers of HIV. With this background, we proceeded to study all the HIV-infected individuals attending our centre, with the aim:a. To study the ocular manifestations of HIV.b. To correlate those manifestations with the CD4+ T-lymphocyte counts.c. To compare our findings with other studies.

Method

A cross-sectional study involving a detailed ocular examination of 321 cases of HIV/AIDS was done. Automated perimetry, digital fundus photography and fundus fluorescein angiography were done for relevant cases. The last 125 cases were subjected to Schirmer's test and tear film break-up time.

Results

We studied 321 male HIV cases (642 eyes), with a mean age of 36.78 years, mean CD4+ count of 276.54 cells/μL, 78.82% of them being on anti-retroviral therapy. Ocular manifestations were seen in 87 out of 321 cases, 72.41% of them being asymptomatic carriers of HIV. The ocular findings seen were conjunctival microvasculopathy, molluscum contagio-sum, dry eye, neuro-ophthalmic manifestations, anterior uveitis, posterior uveitis, and HIV retinopathy, only the last three of which had a significant association with CD4+ counts. The overall prevalence of ocular lesions also had a significant association with CD4+ counts.

Conclusion

Ocular manifestations are common in asymptomatic carriers of HIV. Anterior uveitis, posterior uveitis and HIV retinopathy have a significant association with CD4+ counts and are reliable indicators of low CD4+ count.     

Pneumonia in the acquired immune deficiency syndrome

To data there have been 130 cases of the acquired immune deficiency syndrome (AIDS) in Britain. AIDS is though to be caused by the retrovirus human T cell lymphotropic virus III/lymphadenopathy associated virus (HTLV-III/LAV). The presenting feature of AIDS may be and acute pneumonic illness with cough, breathlessness, and fever. Nearly always, however, there is a preceding history of several months' ill health characterized by loss of weight, intermittent of prolonged fever, and malaise. The organism most commonly responsible for AIDS related pneumonia is the multiflagellate protozoa Pneumocystis carinii. Pneumonia caused by this organism is usually associated with an insidious but progressive dry cough and increasing breathlessness. Other organisms associated with AIDS related pneumonia in the US include Mycobacterium avium intracellulare and cytomegalovirus. In patients suspected of having AIDS the diagnosis may not be possible until an opportunistic organism has been identified. P carinii may be identified morphologically only in stained specimens of bronchoalveolar lavage or of alveolar tissue obtained by transbronchial, percutaneous needle, or open lung biopsy. Clinicians disagree as to whether agressive investigation is really necessary. Most will probably choose the most likely pathogen on clinical and radiological grounds and treat accordingly, reserving transbronchial biopsy and bronchoalveolar lavage for patients who fail to respond. The initial choice of antibiotics is likely to be difficult since many patients may have multiple infecting organisms. Conventional pneumonia should be treated with oxygen, physiotherapy, and broad spectrum antibiotics. The mortality from a 1st attack of P carinni pneumonia is about 1/3.     

1990—2019年中国人类免疫缺陷病毒/获得性免疫缺陷综合征流行趋势及疾病负担

目的 分析1990—2019年中国人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)疾病流行现状、负担及危险因素变化趋势,预测2020—2030年HIV/AIDS发病和死亡情况。方法 探讨1990—2019年中国HIV/AIDS疾病的流行现状,通过Joinpoint回归拟合其发病率和疾病负担变化趋势。采用集成嵌套拉普拉斯近似(INLA)的贝叶斯年龄-时期-队列分析(BAPC)方法预测2020—2030年HIV/AIDS发病和死亡趋势。结果 1990—2019年中国男性HIV/AIDS标化发病率、标化死亡率高于女性,15～19岁、20～24岁标化发病率总体呈增长趋势,75～79岁标化发病率变化幅度最大。1990—2019年中国HIV/AIDS标化发病率、标化伤残调整寿命年(DALYs)率均呈上升趋势,差异具有统计学意义(P均<0.001);归因于危险性行为的标化DALYs率最高。BAPC预测结果显示,2020—2030年中国男性HIV/AIDS标化死亡率呈上升趋势。结论 中国青少年HIV/AIDS发病风险持续增加,老年群体死亡风险也不容忽视;HIV/AIDS疾病负担呈上升趋...     

Immune reconstitution of acquired immune deficiency syndrome

Acquired immune deficiency syndrome （AIDS） is a chronic infectious disease,which the patients are infected with human immunodeficiency virus （HIV）.HIV damages the human＇s immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy （HAART） can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.