淋巴结活检术在HIV/AIDS合并颈部淋巴结核诊断中的应用

目的探讨HIV/AIDS合并颈部淋巴结核的临床特点以及淋巴结活检术在HIV/AIDS合并颈部淋巴结核诊断中的应用价值。方法回顾性分析168例颈部淋巴结肿大的艾μ病患者的淋巴结活检组织切片、临床资料、影像资料、T淋巴细胞亚群、切口分泌物细菌涂片及培养。结果经外科手术获得的168例标本,经病理诊断102例淋巴结结核,其中CD4+P<100个/μL组淋巴结核阳性率较其他组别增高(χ2=5.44,<0.05)。168例患者共发生切口感染4例,窦道形成2例,切口分泌物以结核杆菌为主。所有患者均无食管、气管损伤等重大并发症。结论淋巴结活检术是确诊HIV/AIDS合并颈部淋巴结核的主要方法。     

Developing Elastic Tissue: An Electron Microscopic Study

Electron microscopic identification of elastic tissue in normal and disease states has been uncertain due to the lack of a specific electron-dense stain. Recently we introduced a silver porphyrin electron microscopic stain (silver tetraphenylporphine sulfonate) for the identification of adult elastic tissue. This stain has now been employed to study the development of elastic tissue with the aim that new and old elastica can be differentiated at the electron microscopic level. Present observations showed that developing elastica consisted of two distinct morphologic components. Each portion exhibited different staining properties with the silver porphyrin and lead citrate. One component was fibrous and the other amorphous. The fibrous component stained with lead citrate while the amorphous stained with the silver porphyrin. The fibrous component was the first to appear; the amorphous portion appeared later in development and was formed within the fibrous matrix. Mature elastic tissue was devoid of the fibrous component. Based upon the morphologic appearance and staining properties, one can now differentiate between newly formed elastic tissue and the existing one in various disease states.     

艾滋病与咨询

1　艾滋病流行概况艾滋病 (ＡＩＤＳ)是人类免疫缺陷病毒 (ＨＩＶ )引起的、通过性、血液和围产期母婴三种途径传播的传染病。根据联合国艾滋病规划署 (ＵＮＡＩＤＳ)和世界卫生组织 (ＷＨＯ) 1999年 12月公布的数据 ,自艾滋病流行以来 ,全世界累计已有 1880万人死于艾滋病 ,目前存活的艾滋病毒感染者和艾滋病人估计为 3430万[1] 。艾滋病已成为世界上仅次于心脏病、脑卒中和急性下呼吸道感染的第四个主要死因 ,是造成死亡最多的传染病 ,它已成为发展中国家主要的疾病负担[2 ] 。艾滋病流行对社会、经济和人口方面的毁灭性冲击是独一无二的[…     

HIV/AIDS患者外周血T淋巴细胞亚群的研究

目的 通过对HIV/AIDS患者外周血T淋巴细胞亚群进行分析,探讨初始、记忆和效应T细胞各亚群的变化情况及其与疾病进展的关系.方法 应用流式细胞仪检测15例正常人,79例HIV/AIDS患者CD4<200组17例、200≤CD4≤500组45例和CD4>500组17例.外周血淋巴细胞中T细胞各亚群绝对数及百分比.结果随着疾病进展,CD4+ 初始细胞(Naive)计数和比例均逐渐减少(P<0.001);CD4+中枢性记忆T细胞(Tcm)计数逐渐降低(P<0.001),但百分比逐渐升高(P=0.002);CD4+效应记忆性T细胞(TEMA)百分比上升(P<0.001);CD8+Naive细胞计数及百分比均逐渐下降(P<0.05);CD8+ TCM、TEM和终末分化的效应性记忆T细胞(TEMRA)的计数及百分比,各组间差异均无统计学意义(P>0.05).结论 HIV感染者外周血T淋巴细胞亚群发生显著变化,幼稚型T淋巴细胞数目逐渐减少,功能型T淋巴细胞数目增加.本研究有助于对HIV致病机制的研究及疾病进展的监测.     

Hyperplastic lymphoid tissue in HIV/AIDS: an electron microscopic study

The purpose of this study was to characterize the ultrastructure of lymphoid tissue from HIV/AIDS patients and to evaluate it as a reservoir and source of HIV. HIV has been demonstrated in lymph nodes and tonsils and adenoids, by immunohistochemistry (IHC), in situ hybridization (ISH), and transmission electron microscopy (TEM), to be associated with germinal center (GC) follicular dendritic cells (FDC). The presence of HIV in the larger gastrointestinal tract-associated lymphoid tissue (GALT) has been much less studied. Whether FDC themselves are productively infected by HIV in any of the lymphoid sites is controversial. Lymph nodes, tonsils, and gastrointestinal biopsies were fixed in neutral buffered glutaraldehyde and prepared for TEM. Mature HIV particles were abundant in GC of hyperplastic lymph nodes, tonsils, and the GALT. They were enmeshed within an electron-dense matrix associated with an all-encompassing branching FDC network of processes. HIV particles were seen budding from both FDC and lymphocytes. The greatest numbers of particles were seen in hyperplastic lymphoid tissue from untreated individuals and in lymph nodes co-infected with opportunistic organisms, such as Mycobacterium avium complex. In addition to HIV, unidentifiable "particles" of varying sizes, possibly including other viruses, were regularly seen in association with FDC. Ultrastructural study graphically demonstrated the abundance of HIV particles associated with the complex FDC network of hyperplastic lymph nodes, tonsils, and GALT. HIV was shown to productively infect FDC, as well as lymphocytes.     

Lipid profile in HIV/AIDS patients in Nigeria

Introduction

Alterations of serum lipid profiles have been reported widely among Human Immuno deficiency Virus (HIV) positive patients on Highly Active Anti Retroviral Therapy (HAART). However, there are few data on serum lipid profile among treatment naïve HIV positive patients in our environment.

Objectives

To describe the pattern of lipid profile among treatment naïve HIV positive patients and changes following HAART initiation.

Methods

One hundred and thirty HIV positive patients seen in HIV center in an urban area in Nigeria and 44 matched individuals were recruited. Data were collected on socio demographic characters, baseline lipid profiles and CD4 count. Values of lipid parameters were retrieved after 12 months on HAART.

Results

The mean Low density lipoprotein(LDL) was 2.26+ 0.9 mmol/l among the test group compared with 0.96+0.39mmol/L among the control, p value=0.000. The mean High density lipoprotein (HDL) was also significantly lower, 0.8+0.6mmol/L reaching a dyslipidemic level, in the HIV positive group than the control, p value = 0.00. Tuberculosis/HIV co infected patients had a significantly elevated mean LDL, p=0.002.

Conclusion

Abnormality of serum lipid is common among treatment naïve HIV patients seen in Nigeria. The NNRTI regimen is associated with elevation of HDL and some stabilization of TC and TG.     

Pediatric AIDS/HIV Infection: An Emerging Challenge to Pediatric Psychology

The number of pediatric AIDS cases are increasing. This disease,with its social and political ramifications, as well as itsbiological consequences, presents a number of unique issuesfor psychologists. Some of the areas that present opportunitiesand problems for psychologists are briefly identified. Theseareas include prevention, clinical issues, public education,research, neu-ropsychological effects, psychoneuroimmunologicalissues, and ethical concerns. Current epidemiological projectionsand future directions for research are also discussed.     

An integral care telemedicine system for HIV/AIDS patients

OBJECTIVE: In this article we will describe a new approach to improve the quality of care of chronic HIV/AIDS patients, combining the integral care approach with a telemedicine system. METHODS: Following the integral care approach, we included the patient in a multidisciplinary care team, covering the whole process of care with a telemedicine system that allows the patient to improve his/her self-care and to be remotely followed-up by the healthcare professionals. RESULTS: This challenge has been met by the creation of the "VIHrtual Hospital" project. Its main goal is the definition, development, clinical routine installation and evaluation of a telemedicine service that complements standard care with a telecare follow-up for treating stable HIV infected patients, in a chronic stage of their disease, and study if that improves the quality of assistance and the expense per patient compared to the conventional control (without telemedicine service) that patients usually have. Although the study is not yet finished, in the discussion the main benefits and drawbacks of this telemedicine system are described. CONCLUSIONS: The main conclusion of the article is that a new home telecare model for chronic HIV/AIDS patients has been created and has been implemented through the "VIHrtual Hospital" in the Clinic Hospital in Barcelona (Spain). The architecture of this web-based system fulfills the demanding security and integration requirements of the IT department of the hospital. An easy-to-use graphical interface for both patients and professionals has also been developed. The low costs of the system allow us to cover a wide range of patients and promising results are being obtained regarding the use of telemedicine systems for improving the follow-up care of chronic HIV/AIDS patients and for creating a new care model for this disease.     

HIV/AIDS患者特异性细胞毒性T细胞功能的研究

目的 了解中国HIV／AIDS患者HIV特异性细胞毒性T细胞(CTL)功能。方法 将覆盖HIV-1 P15、P17和P24 Gag全长的94个重叠多肽作为抗原，用IFN-γ ELISPOT方法检测HIV／AIDS患者HIV-1特异性CTL功能。结果 HIV-1抗原多肽P17-15、P17-16、P24-7、P17-8，P24-28最易被HIV／AIDS患者特异性CTL识别。HIV感染者识别HIV-1多肽的数量和强度均高于AIDS患者。结论 我国HTV／AIDS患者体内存在识别不同HIV-1 Gag多肽的特异性CTL，且HIV特异性CTL功能与疾病进展相关。     

CALCITONIN-PRODUCING INSULINOMA: An Immunohistochemical and Electron Microscopic Study

A pancreatic endocrine tumor measuring 1.5×1.0×1.0 cm in a 67-year-old man with recurrent hypoglycemic attacks was examined by immunohistochemistry and electron microscopy. The tumor cells were relatively uniform, and almost all of them were immunoreactive to Insulin. A few calcitoninpositive cells could be identified scattering in tumor cell strands, and the content of calcitonin in the tumor was 85 ng/g wet tissue. Coexistence of insulin and calcitonin in tumor cells was demonstrated by using adjacent semithin sections of the Epon-embedded material. Electron microscopically, the tumor consisted of a single type of cells with secretory granules identical to B-cell granules in the normal counterpart.     

An Electron Microscopic Study of Hepatic Angiomyolipoma

Three cases of hepatic angiomyolipoma, each composed of an intimate mixture of numerous abnormal blood vessels and various-sized fat, spindle and/or epithelioid cells, are presented along with the findings of an electron microscopic study. The spindle cells were confirmed to be smooth muscle by immunohistochemical staining for des-min and by their ultrastructural characteristics. The mature fat cells, smooth muscle cells, immature short spindle cells apparently intermediate or transitional between the former two cell types, and the epithelioid cells were observed adjacent to the endothelial cells. Ultra-structurally, the epithelioid cells were characterized by unusual cytoplasmic organelles such as myofilaments having focal densities and dense attachments, numerous large electron-dense bodies, and a large number of glycogen particles and lipid droplets. Therefore, it is considered that the immature short spindle and epithelioid cells in hepatic angiomyolipoma might be primitive mesenchymal cells having an ability to differentiate toward both smooth muscle and fat cells. Acta Pathol Jpn 39 : 743-749, 1989.     

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Background

Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent.

Objective

To review the current and emerging challenges facing pediatric HIV care in sub-Saharan Africa; and proffer solutions that could help in tackling these challenges.

Method

A Medline literature search of recent publications was performed to identify articles on “pediatric HIV”, “HIV and children”, “HIV and infants”, “HIV and adolescents” in sub-Saharan Africa.

Result

There are a number of challenges and emerging complex issues facing children infected and affected by HIV in sub-Saharan Africa. These include late presentation, limited access to pediatric HIV services, delayed diagnosis, infant feeding choices, malnutrition, limited and complex drug regimen, disclosure, treatment failure and reproductive health concerns. A holistic cost effective preventive, diagnostic and treatment strategies are required in order to eliminate pediatric HIV in SSA.

Conclusion

HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa.     

Mycoplasmas infection in male HIV/AIDS patients in Jiangsu,China

Mycoplasmas are widely distributed among animals, plants, and human. The four species namely, Mycoplasmas genitalium(Mg), Mycoplasmas fermentans(Mf), Mycoplasmas pentrans(Mpe), Mycoplasmas pirum(Mpi) are also called AIDS-associated mycoplasmas due to their involvement in the development and outcome of AIDS. To investigate the infection prevalence of Mg, Mf, Mpe and Mpi among male HIV/AIDS patients in Jiangsu Province and to analyze the relationship between pathogenic mycoplasmas and cellular immune function of them. First void urine and venous blood samples were collected and epidemiology questionnaires were administered after informed consent. Nested PCR was performed to determine the infection of Mg, Mf, Mpe and Mpi while ELISA assay was applied to detect interleukin-2(IL-2), interferon-γ(IFN-γ) and tumor necrosis factor-α(TNF-α). SAS 9.0 software was applied to analyze the data. A total of 713 HIV/AIDS patients were recruited in this study. The overall infection rates of Mg, Mf, Mpe and Mpi are 27.9%, 9.7%, 1.0% and 18.4% respectively. Generally, the infection rates of Mg(χ² = 10.311, P = 0.006) and Mpi were declined as the CD4+ cell counts increased, while Mf infection was higher in CD4+ T cell>350/μl group. The levels of cytokines are different with the variance of mycoplasmas infection. Mycoplasma infection among male HIV/AIDS patients is associated with changes in cellular immune response (cytokines). However, the affect of mycoplasmas on the immune function is complex, further studies are still required to elucidate whether mycoplasmas interact with HIV by interfering host immune system.     

HIV/AIDS: 30 years of progress and future challenges

Acquired immune deficiency syndrome (AIDS) was first described 30 years ago in a report from the US Centers for Disease Control. Two years later the causative virus was identified and afterwards named the human immunodeficiency virus (HIV). This article reviews the progress made in the three decades since the recognition of AIDS and the discovery of HIV, with respect to the virus, the infected cell, and the host, as well as directions for future studies.     

Opacification of Artificial Intraocular Lens: An Electron Microscopic Study

This paper describes the usefulness of electron microscopy in the investigation of the cause of opacification of an intraocular artificial lens (IOL), which affected both the anterior and posterior surfaces of the IOL. The explanted lenses were remarkably similar and were uniformly opaque, with "reticulated" surfaces under dissecting and ordinary light microscopes. TEM showed that the surfaces of the explanted lenses were irregular, and there was a layer of electron-dense granular deposits that extended to a depth of approximately 5 &#119 m into the lens substance. SEM showed a "cerebriform" lens surface with elevated areas alternating with depressed crevices, which corresponded nicely to the TEM appearance. Energy-dispersive x-ray analysis showed that the deposit was composed of calcium, oxygen, and phosphorus, which was later shown to be calcium hydroxyapatite by x-ray diffraction study. Electron microscopy has proven to be an essential tool in the investigation of the cause of this mysterious outbreak of opacification of the surfaces of the artificial lenses. Apart from directly visualizing the lens surfaces in a 2- and 3-dimensional manner, it also provides information on the elemental composition of the deposit. Such findings enable the clinicians and manufacturer to search for the underlying pathogenesis of the abnormal calcium hydroxyapatite crystals deposit.     

Myonecrosis Induced by Rattlesnake Venom: An Electron Microscopic Study

The myonecrotic effect of rattlesnake (Crotalus viridis viridis) venom on mouse skeletal muscle was studied. The biceps femoris muscle was examined with the electron microscope after one-fourth the LD₅₀ of the crude venom was injected into the gracilis and semimembranosus muscles. Focal areas of myonecrosis were abundant. Injured fibers contained dilated sarcoplasmic reticulum, disoriented, coagulated myofilamentous components and condensed, rounded and enlarged mitochondria. The external lamina and sarcolemma remained intact in many fibers. Hemorrhage was apparent in the endomysial connective tissue, and hemolysis was discernible. In areas where the erythrocytes were tightly packed between the muscle fibers, there was disruption of the external lamina and sarcolemma. Degeneration of the fibers in these areas was pronounced. These findings correlate well with the breakdown of muscle fibers by various methods described in the literature. Myonecrosis induced by snake venom may serve as a useful model for studying muscle necrosis because of its rapid onset and relative ease of induction.     

中国HIV+/AIDS患者神经心理学初步研究

目的:探讨中国HIV+/AIDS 患者神经心理功能特点及情绪状态。方法:选取年龄、性别和受教育年限方面均匹配的28例HIM+和23例HIV-被试。对被试进行包含七个认知领域(如词语流畅、抽象/执行功能、信息处理速度、工作记忆、学习、延迟回忆和运动功能)的神经心理成套测验,共18个分测验。同时选用贝克抑郁问卷(BDI)让患者进行情绪自评。结果:单个测验粗分比较,HIV+/AIDS 被试比HIV-被试在范畴流畅测验、词语发音流畅测验、连线测验A、颜色连线测验Ⅱ及霍普金斯词语学习测验显著较差(P<0.05)。基于美国常模校正的标准分(T 分)显示,HIV+/AIDS 被试比HIV-被试在整套测验、词语流畅、抽象/执行功能和学习领域神经心理操作显著较差(P<0.05)。中国HIV-被试的平均T 分与美国常模50相近,总的平均T 分为48,各认知领域的平均T 分范围46-51。BDI 自评分提示中国HIV+/AIDS 被试比HIV-被试显示出更严重的抑郁情绪(P<0.001),且与躯体状况无关。HIV+/AIDS 被试BDI 得分与总的平均T 分无显著相关(r=0.22,p=0.27)。结论: 1.本研究所选用的神经心理成套测验有较为理想的跨文化效能。2.中国HIV/AIDS 被试在词语流畅、抽象/执行功能、学习认知领域和总的神经心理功能上比HIV--试显著较差,抑郁情绪更为严重,但抑郁情绪与HIV 造成的各领域认知功能损害无显著相关,提示HIV 可能对大脑的认知功能有一定影响。     

中国东北地区未经抗病毒治疗的HIV/AIDS患者HIV毒株的耐药基因变异研究

目的　研究我国东北地区未接受抗逆转录病毒治疗的HIV AIDS患者HIV毒株的逆转录酶和蛋白酶耐药变异情况 ,为开展大规模临床抗病毒药物治疗提供本底数据。方法　RT PCR和套式PCR扩增HIVpol区基因 ,双脱氧法测定逆转录酶和蛋白酶基因序列 ,与国际耐药数据库比对辨别耐药变异。结果　 (1) 5 3例患者毒株亚型分析结果 :B′亚型 4 7例 ,B′ C亚型 4例 ,A、B亚型各 1例 ;(2 )未发现逆转录酶和蛋白酶原发耐药变异存在 ,但发现存在逆转录酶抑制剂继发变异 :M4 1L(1.9% )、I6 3M (1.9% )、L74I (1.9% )、S6 8G (1.9% )、V75L (3.8% )、V10 6I (1.9% )、I135L T (5 .7% )、V179D (7.5 % )和V189I (1.9% ) ,无症状感染者RT继发耐药变异出现率为 11.8% ,而艾滋病患者为5 2 .6 % (P <0 .0 1)。存在大量蛋白酶耐药继发变异V77I (88.7% )、L6 3P (86 .8% )、E35D (81% )、A71V(2 4 .5 % )、R4 1K (15 .1% )、L10I (9.4 % )、R5 7K (9.4 % )、D6 0E (9.4 % )、N37D (5 .7% )、G16E (3.8% )、I15V (1.9% )、M36I (1.9% )、K5 5R (1.9% )和L89M (1.9% )。未发现明显的亚型特异性耐药变异。结论　在中国东北地区未接受抗逆转录病毒治疗的HIV AIDS患者中未发现毒株逆转录酶和蛋白酶耐药原发变异 ,但大量继发耐药变异的存在提     

HIV-1 Tat-Based Vaccines: An Overview and Perspectives in the Field of HIV/AIDS Vaccine Development

The HIV epidemic continues to represent one of the major problems worldwide, particularly in the Asia and Sub-Saharan regions of the world, with social and economical devastating effects. Although antiretroviral drugs have had a dramatically beneficial impact on HIV-infected individuals that have access to treatment, it has had a negligible impact on the global epidemic. Hence, the inexorable spreading of the HIV pandemic and the increasing deaths from AIDS, especially in developing countries, underscore the urgency for an effective vaccine against HIV/AIDS. However, the generation of such a vaccine has turned out to be extremely challenging. Here we provide an overview on the rationale for the use of non-structural HIV proteins, such as the Tat protein, alone or in combination with other HIV early and late structural HIV antigens, as novel, promising preventative and therapeutic HIV/AIDS vaccine strategies.