ABSTRACT
Objective:To explore the effect of Xingnao Kaiqiao acupuncture treatment on brain network reorganization for the patients with stroke recovery, and therefore understand the neural mechanism underlying Xingnao Kaiqiao acupuncture treatment.Methods:Prospective case series study. Thirteen acute ischemia stroke patients were recruited from the Department of Neurology, Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine from Aug 2018 to Oct 2019. They were treated with Xingnao Kaiqiao acupuncture once a day for 10 consecutive days in addition to routine treatments, and received clinical assessments before treatment and 14 days after treatment onset. EEG signals were recorded during the first acupuncture treatment, from before inserting the needles (the baseline), during needle retention, to after removal of the needles. The brain network was constructed using phase locking index, and its clustering coefficient (CC), characteristic path length (PL) and small-worldness (S) were analyzed using one-way repeated ANOVA.Results:Compared with the baseline, the CC of delta-band network (sparsity=0.10: t=3.306, P=0.006; 0.12: t=2.909, P=0.013; 0.14: t=2.331, P=0.038) and the PL of delta-band (sparsity=0.12: t=3.236, P=0.007; 0.14: t=2.754, P=0.017, 0.18: t=2.878, P=0.014) and alpha-band (sparsity=0.10: t=2.432, P=0.032) networks were significantly decreased during the needle retention stage. Clinical assessments demonstrated a significant treatment efficacy of Xingnao Kaiqiao acupuncture, and its efficacy which was indicated by improved NIHSS score, was significantly correlated with the CC changes in the delta band network from baseline to needle retention. The correlation was strongest when the network sparsity was 0.12 ( r=0.78, P=0.002). Conclusion:Xingnao Kaiqiao acupuncture can regulate the brain network of stroke patients in real time, and this immediate regulation maybe associated with its treatment effect.
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Objective:To analyze the clinical characteristics of AIDS complicated with plasmablastic lymphoma (PBL).Methods:Clinical data and laboratory test of 7 AIDS patients complicated with PBL admitted to Yunnan Infectious Disease Hospital from January 2016 to October 2022 were retrospectively analyzed.Results:There were 6 male patients and 1 female patient with a median age of 48 years (41-56 years). All patients had oral and maxillofacial involvement, and only 1 case was stage Ⅱ at the initial Ann Arbor stage, while 6 cases were stage Ⅲ or higher. Six patients had systemic symptoms. All patients had a Ki-67 proliferation index greater than 80% and all presented MYC gene rearrangements, and 6 patients were positive for EBER. All patients received DA-EPOCH-based first-line chemotherapy and antiretroviral therapy (ART), Five patients initiated ART at the same time as chemotherapy, and 2 patients initiated ART before chemotherapy. Four patients achieved complete remission after chemotherapy according to PET-CT evaluation, and 3 patients died.Conclusions:Active chemotherapy combined with ART can maximize the therapeutic benefits of AIDS patients with PBL. The introduction of ART in the first chemotherapy cycle can avoid the rapid disease deterioration in the patients.
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Objective:To analyze the clinical characteristics, diagnosis and treatment process, and prognosis of human immunodeficiency virus (HIV) positive patients with systemic lupus erythematosus (SLE).Methods:A retrospective study was used to collect and analyze the clinical characteristics, treatment and prognosis of eight HIV-positive patients with SLE treated in Yunnan Provincial Infectious Diseases Hospital from August 2017 to January 2020.Results:All of the eight patients were diagnosed with SLE after HIV infection. All of the patients were female. CD4 + T lymphocyte counts were >500/μL in four cases, 350 to 499/μL in two cases, and 200 to 349/μL in the remaining two cases. Case 6 presented with butterfly erythema on the face. In Case 1, hemoglobin was 40 g/L and urine occult blood was (+ + ). The hemoglobin of Case 2 was 76 g/L, the platelet count was 2×10 9/L, and the granulocyte count was 0.6×10 9/L. The lung computed tomography (CT) examination of Case 3 showed diffuse exudative lesions in both lungs. The 24 h urinary protein levels of Case 4 and 5 were 2 231.6 mg and 2 761.0 mg, respectively, and urine occult blood were (+ + ). The total bilirubin of Case 4 was 70.0 μmol/L and alanine aminotransferase (ALT) was 49 U/L. The total bilirubin of Case 7 was 129.6 μmol/L and ALT was 56 U/L. The lung CT examination of Case 8 showed moderate to massive pericardial effusion in the pericardium. Seven patients received antiviral therapy and immunotherapy, and their conditions were stable without relapse. Case 1 was refractory SLE complicated with autoimmune hemolytic anemia. After treated with rituximab combined with cyclophosphamide the patient achieved clinical remission. Case 7 was injection drug user and died after giving up treatment. Conclusions:The clinical characteristics of HIV-positive patients with SLE are heterogeneous, and the prognosis is generally good after antiviral therapy and immunotherapy. For patients with refractory SLE complicated with autoimmune hemolytic anemia, clinical remission can also be achieved through active treatment.