A new approach to prevent HIV transmission: Project Protect intervention for recently infected individuals

Past research suggests that as many as 50% of onward human immunodeficiency virus (HIV) transmissions occur during acute and recent HIV infection. It is clearly important to develop interventions which focus on this highly infectious stage of HIV infection to prevent further transmission in the risk networks of acutely and recently infected individuals. Project Protect tries to find recently and acutely infected individuals and prevents HIV transmission in their risk networks. Participants are recruited by community health outreach workers at community-based HIV testing sites and drug users' community venues, by coupon referrals and through referrals from AIDS clinics. When a network with acute/recent infection is identified, network members are interviewed about their risky behaviors, network information is collected, and blood is drawn for HIV testing. Participants are also educated and given prevention materials (condoms, syringes, educational materials); HIV-infected participants are referred to AIDS clinics and are assisted with access to care. Community alerts about elevated risk of HIV transmission are distributed within the risk networks of recently infected. Overall, 342 people were recruited to the project and screened for acute/recent HIV infection. Only six index cases of recent infection (2.3% of all people screened) were found through primary screening at voluntary counseling and testing (VCT) sites, but six cases of recent infection were found through contact tracing of these recently infected participants (7% of network members who came to the interview). Combining screening at VCT sites and contact tracing the number of recently infected people we located as compared to VCT screening alone. No adverse events were encountered. These first results provide evidence for the theory behind the intervention, i.e., in the risk networks of recently infected people there are other people with recent HIV infection and they can be successfully located without increasing stigma for project participants.     

Spiral-shaped Metallic Implant in the Treatment of Achilles Tendon Ruptures: An Experimental Study on the Achilles Tendon of Sheep

There are 2 main factors contributing to the strength of tendon repair: the tensile strength of the material used in repair and the tendon-holding capacity of the suture configuration. In the current study, we aimed to find a technique with high repair strength by increasing both the tensile strength of the material and the tendon-holding capacity of the configuration. We developed metal implants (models 1 and 2) made from stainless-steel wire with 2 different spiral-shaped configurations. We measured tendon-holding capacities of these alternative implants biomechanically and compared them with frequently used suture techniques, the Bunnell and locking loop, which were achieved with 5 Ticron sutures. Sixty-four sheep Achilles' tendons were used in the study as 16 tendons in each group. Model 2 was more resistant to deformation under loading when compared with model 1. The results demonstrated that model 2 was superior to model 1 and both suture techniques. This study could be accepted as a step for reaching a strong tendon repair technique. It should be emphasized that the technique needs to be improved technically to make it convenient for clinical use.     

Bcl-2和Caspase-9对儿童癫痫持续状态近期预后的预测价值

目的探讨血清B细胞淋巴瘤相关蛋白-2(Bcl-2)和半胱氨酸天冬氨酸蛋白酶-9(Caspase-9)对儿童癫痫持续状态(SE)近期预后的预测价值。 方法选择SE患儿62例为SE组,选择同期体检健康儿童62例为对照组;按照预后将SE患儿分为预后不良组和预后良好组。癫痫持续状态严重程度量表(STESS)评估SE患儿SE严重程度。ELISA检测各组血清Bcl-2和Caspase-9水平。结果SE组Bcl-2和Caspase-9水平高于对照组(P＜0.05)。预后不良组和预后良好组STESS评分、Bcl-2和Caspase-9水平比较,差异有显著性(P＜0.05)。STESS评分、Bcl-2和Caspase-9是影响SE患儿近期预后的独立影响因素(P＜0.05);入院血清Bcl-2和Caspase-9联合检测对SE患者近期预后具有较好的预测效能(P＜0.05)。 结论血清Bcl-2和Caspase-9是SE患儿近期预后的有效预测指标。     

Thymic Function and Output of Recent Thymic Emigrant T Cells During Intracranial Glioma Progression

One of the hallmarks of patients with glioblastoma multiforme (GBM) is profound lymphopenia mostly confined to the T cell lineage. A deficiency in the production of naïve T cells from the thymus could contribute to the lymphopenia seen in GBM patients. In this study we asked whether thymic function and the production of recent thymic emigrant (RTE) T cells from the thymus was influenced by intracranial (i.c.) glioma progression. We found significant thymic involution in animals with progressive i.c. gliomas. Involuted thymi from animals with progressive i.c. T9.F gliomas showed dramatic losses of CD4⁺CD8⁺ (DP) thymocytes. Microscopic analysis complemented those findings by demonstrating a reversal of the typical cortico-medullary structure. Significant increases in apoptosis accompanied the rapid loss of viable thymocytes, which was prevented in part by adrenalectomy, suggesting a dominant role for endogenous glucocorticoids. This thymic involution was also associated with a significant decrease in peripheral RTE T cells, reflecting the diminished thymic function. Finally, we found that CD8⁺ RTE T cells were enriched in progressively growing T9 gliomas, which points to an immunological role for RTE's in anti-glioma immunity. Our findings may shed light on the significance of thymic function for anti-glioma immunity and the response to immunotherapeutic treatment paradigms.     

急性缺血性卒中的神经保护药物研究进展

缺血性脑损伤的病理生理机制包括兴奋性氨基酸的释放、梗死灶周围去极化、炎症反应及神经元凋亡等。几乎对缺血级联反应的所有环节都已进行过神经保护药物的开发和试验。许多神经保护药物在脑缺血动物模型研究中证明有效,但临床试验效果却难以令人满意。本文就目前各类神经保护药治疗脑缺血的临床前期和临床试验的结果与进展作简要的回顾和展望。     

EGFR野生型肺腺癌患者一线化疗方案选择影响因素分析

目的 晚期肺癌一线化疗方案的有效率无明显差异,而在不良反应和药物经济学方面存在明显区别.本研究探讨晚期表皮生长因子受体(epidermal growth factor receptor,EGFR)野生型肺腺癌患者一线化疗方案应用状况并分析其原因.方法 回顾性分析广州医科大学附属第一医院2009-12-01-2014-11-30收治的738例晚期EGFR野生型肺腺癌患者5种不同一线方案应用状况和影响因素,观察其近期疗效和不良反应.结果 临床常用5种不同一线方案的患者例数分别为:吉西他滨含铂双药(GP组)358例,紫杉醇含铂双药(TP组)157例,多西他赛含铂双药(DP组)99例,培美曲塞含铂双药(PP组)93例,长春瑞滨含铂双药(NP组)31例.5组之间疗效差异无统计学意义,仅PP方案的疾病控制率较其他4个方案为优,x2 =4.01,P=0.038.5种方案不良反应:NP方案在3级以上白细胞减少方面明显高于其他方案,x2 =3.33,P=0.042;TP和DP方案在口腔炎、周围神经炎、3级及以上脱发的发生率方面明显高于其他方案,均P＜0.05;GP方案而在血小板减少及谷丙转氨酶升高方面明显高于其他方案,x2=3.21,P=0.043;PP方案在乏力方面明显高于其他方案,x2 =3.93,P=0.041;而5种方案在贫血、恶心、呕吐、腹泻、血肌酐升高和皮疹不良反应发生率差异无统计学意义.5种不同方案过去5年使用比例由高到低分别为,GP 48.51％＞TP 21.27％＞DP 13.41％＞PP12.60％＞NP 4.20％,这与5位制定化疗方案的主任医师对5个不同一线方案的平均评分排序完全一致.方案选择具体原因分析提示不良反应、使用便捷性、经济原因、医保政策4个因素是影响方案选择的主要原因,而疗效因素由于其本身差异并不明显,故并非是影响方案选择的主要原因.NP方案由于其不良反应和使用便捷性评分较低而总评分最低,而GP方案由于各方面均无明显劣势而总评分最高.结论 过去5年晚期EGFR野生型肺腺癌患者常用的5种一线方案使用率顺序依次为GP＞TP＞DP＞NP＞PP.5种方案疗效未见明显差异,并非是影响方案选择的主要原因.方案的选择与制定方案的具体医生推荐有明显相关性,而具体原因主要集中在不良反应、使用便捷性、经济原因和医保政策4个因素.     

大孔吸附树脂分离纯化葛根总黄酮的研究

 目的研究大孔吸附树脂分离纯化葛根总黄酮的工艺，为葛根总黄酮的工业化生产提供实验依据。方法采用D₁₀₁型、D₂₀₁型、AB-8型3种大孔吸附树脂对葛根总黄酮进行吸附纯化，以总黄酮收率、纯度为考察指标综合评价。结果D₁₀₁型、D₂₀₁型、AB 8型大孔吸附树脂吸附3种方法中静态饱和吸附量以干树脂计分别为113.5，133.1和133.9 mg·g^-1；静态脱吸附率分别为75.6%，66.7%，94.2%；以70%的乙醇为洗脱剂洗脱率最高为92.4%；AB-8型吸附树脂饱和吸附洗脱量为82.0 mg·g^-1；稳定性实验中第11个周期总黄酮收率为91.3%，纯度为86.0%。结论3种纯化方法中，以AB-8型树脂综合性能最好，适合于葛根总黄酮的分离纯化。     

宁心红杞胶囊对围绝经期综合征的治疗作用

目的：观察长期服用纯中药制剂宁心红杞胶囊，对围绝经期妇女症状、子宫内膜、性激素水平的影响。方法：绝经未逾5年妇女26例，未绝经妇女14例，持续服用宁心红杞胶囊3个月以上，观察其临床症状、阴道脱落细胞、血清中女性激素含量、阴道流血及子宫内膜厚度等的变化。结果：长期服药后，临床症状好转，阴道脱落细胞伊红指数上升，女性激素稳定在一定水平，无阴道不规则流血现象，子宫内膜增值在正常范围内。结论：纯中药制剂宁心红杞胶囊治疗围绝经期综合征疗效确切且安全、无毒副作用。     

应届毕业医学生心理韧性现状及影响因素分析

目的:调查新冠肺炎疫情下应届毕业医学生的心理韧性现状,并分析其影响因素。方法:采用Conner-Davidson心理韧性量表,对湖北医药学院480名应届毕业医学生采用问卷方式进行调查,分析其影响因素。结果:应届毕业医学生的心理韧性总分为(53.54±11.56)分,处于中等水平。多元线回归分析显示:性别、生源地、家庭结构、职业生涯规划、人生目标是应届毕业生心理韧性的影响因素。结论:应届毕业医学生的心理韧性水平有待提升,学校应高度关注应届毕业医学生的心理韧性状况,针对性地进行干预和指导,避免负性情绪带来的不良影响。