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Objective:To test the HIV virus nucleic acid using immunoblot method (Western blotting, WB) and to follow-up with the negative and indeterminate samples in the Dujiangyan area, compare the WB and nucleic acid results before and after followed-up, and try to reduce the WB band′s false-negatives and false-positives.Methods:The 286 suspected HIV infection samples in the Dujiangyan region from January to October 2021 were confirmed by WB, the HIV virus load were tested for the samples that were WB negative and WB indeterminate, those patients were followed-up with epidemiological history and viral load results, and the results before and after tracking were compared.Results:In the 286 samples of suspected HIV infection included in this study, we reported 213 (74.48%) WB positive, 37 WB negative (12.94%), and 36 WB indeterminate (12.58%); 10 of 37 WB negative samples were followed-up; 18 of 36 WB indeterminate samples were followed-up. Among the followed-up WB negative and indeterminate samples, 17 of them had virus nucleic acid detection prior to the follow-up, and all of them turned positive after following-up. The others with no previous virus nucleic acid detection were confirmed to be negative.Conclusions:Among the followed-up samples, 2 samples were false-negative in WB negative results, and 3 were false-positive in WB indeterminate results. The viral nucleic acid must be tested and followed-up in WB negative and indeterminate samples.
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OBJECTIVE:To provide reference for rational drug use in elderly patients with depression. METHODS:A total of 96 elderly outpatients and inpatients with depression were selected from 39 mental health institutions of Hebei province during Jul. 2nd to 9th,2012. The drug use were surveyed by using self-made questionnaires on the basis of prescriptions/medical orders. The results of investigation were analyzed statistically. RESULTS:In this study,96 questionnaires were distributed and all were collect-ed with effective recovery rate of 100%. Among 96 respondents,95 elderly patients used a new type of antidepressants,mainly by selective serotonin reuptake inhibitors(SSRIs),accounting for 75.0% of the total. The top 5 drugs in the list of use frequency were sertraline(23 cases,24.0%,daily dose:25-200 mg),paroxetine(22 cases,22.9%,daily dose:20-60 mg),escitalopram(20 cas-es,20.8%,daily dose:5-40 mg),venlafaxine (13 cases,13.5%,daily dose:75-300 mg),mirtazapine (12 cases,12.5%,daily dose:8-30 mg). Among all respondents,22 patients (22.9%) were treated with mono-antidepressant and the other 74 patients (77.1%) were treated with drug combination therapy among which 47 cases were treated with two antidepressant drugs,22 were treated with three drugs,4 were treated with four drugs and 1 was treated with five drugs. 6 cases combined with mood stabilizers, 21 cases with antipsychotic,50 cases with benzodiazepine(6 of them combined with two benzodiazepine),2 cases with other hyp-notic drugs,14 cases with anxiolytic drugs and 2 cases with anticholinergic drugs. CONCLUSIONS:The drug use of elderly pa-tients with depression in mental health institutions of Hebei province basically in line with current trends. However,there are still the phenomenon of irrational drug use as drug dose meets or exceeds the prescribed maximum dose;many varieties are used in combination therapy;route of administration is improper.
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Objective To explore the clinical effect and toxicity of daunorubicin combined with cytarabine (DA regimen) and idarubicin combined with cytarabine (IA regimen) for the treatment of patients with acute myeloid leukemia (AML) as induction chemotherapy. Methods The clinical data of 84 newly diagnosed AML patients (except M3) treated with DA or IA regimen were analyzed retrospectively. DA regimen group included 32 patients (17 males and 15 females with median age of 46 years), while IA regimen group included 52 patients (29 males and 23 females with media age of 49 years). Efficacy index was complete remission (CR), total efficiency and adverse reactions after one course of chemotherapy rate. Results In DA regimen group,the CR rate was 65.6 %(21/32), and the total efficiency rate was 75.0 %(24/32), while in IA regimen group, the CR rate was 71.2 %(31/52), and the total efficiency rate was 80.8 %(42/52), respectively, but, the differences of media survival and 5-year survival rate were not statistically significant (16.8 months vs. 24.9 months, 26 % vs. 44 %, both P>0.05). The main side effect in the two groups included hematologic (bone marrow suppression) and non-hematologic adverse reactions, with no significant difference between the two groups (all P>0.05). Conclusion For newly diagnosed AML patients, remission rate and total efficiency of DA regimen are same as IA regimen after one course treatment, and adverse events between the two regimens do not differ significantly.
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Objective To observe the curative effects and toxicity of low-dose bortezomib plus thalidomide and chemotherapy in treatment of multiple myeloma. Methods 35 patients with initial, refractory or relapsed MM received at least two cycles of treatment with bortezomib at 1.1 mg/m2 intravenously on days 0,3, 7, and 10, and by daily oral thalidomide escalated from 50mg to 150 mg and chemotherapy. The chemotherapy regimens included MP, VAD and AD regimen which was chosen according to the status of patients. Results After a median follow-up of 20 months, the overall response rate was 82.8 %, complete remission (CR)48.6 %, very good partial remission (VEPR) 17.1%, and partial remission 17.1%. The 3-year PFS and OS were 60.92 % and 72.41% separately. ORR and OS were same in initial and refractory or relapsed MM patients. Grade 3 or 4 adverse events including debility (3/35), nausing and vomiting (8/35), constipation (4/35), peripheral sensory neuropathy (3/35), neutropenia (10/35) and thrombocytopenia (12 %) were observed.Conclusion The regimen of low-dose bortezomib plus thalidomide and chemotherapy is a highly effective and safety regimen for MM patients. The maintenane therapy with thalidomide may prolong PFS.
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Objective To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary nodal peripheral T-cell lymphoma(PTCL). Methods Clinical records, therapy responses as well as prognostic factors of 19 PTCL patients were analyzed. Results The median age of the 19 patients was Ⅲ-Ⅳ, 84.2 % (16/19) with B symptoms, 84.2 % (16/19) with extranodal involvement, 57.9 % (11/19) with bone marrow involvement. After treatment, the complete remission (CR) rate was 36.8 % (7/19). The 2-year overall survival (OS) rate of all patients was 47.2 % and the 2-year progression free survival (PFS) rate was 25 %. The number of sites of extranodal involvement (EN)≥2, ECOG≥2, IPI＞2 and elevated β2-MG were poor prognostic factors. Conclusion Primary nodal PTCL is a heterogeneous group of aggressive T-cell lymphoma with poor chemotherapy results. Multifactors indicate negative prognosis.
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Objective To explore the acquired deficiencies of vitamin K-dependent coagulation factors in etiology, clinical characteristics and treatment. Methods Retrospective analysis was performed on the data of etiology, clinical manifestations of 45 patients with acquired deficiencies of vitamin K-dependent coagulation factor. All patients were treated with Vitamin K1 10 -40 mg/d, i. v. , for three months. Some patients with severe blooding were additionally treated with fresh freezing plasma or prothromibin complex. Prothrombin time(PT) and activated partial thromboplastic time(APTT) were measured using Stago automatic blood coagulation analyzer before and after treatment. Ⅱ , Ⅶ, Ⅸ and Ⅹ were measured in some patients. Results Among the 45 cases, no certain cause was found in 19 cases (42.2%), anticoagulant rodenticides poison was a common cause ( 11 cases,42.3% ). The main presentations was hemorrhage, the most common bleeding sites were mucosa (77.8%) (35/45)and hematuria (46.7%) ( 21/45 ). After vitamin K1 treatment, PT and APTT had shortened remarkably from ( 110.35 ± 35.36 ) s,(98.91 ±48.98)s to (13.48 ±2. 17)s,(33.25 ±6.95)s,respectively(t=19.10 and 6.19,Ps ＜0.01)and the activities of factor Ⅱ、Ⅶ、Ⅸ、Ⅹ had rapidly increased from ( 17.48 ± 10.93 ) %, ( 10.23 ± 5.68 )%, ( 11.98 ±4.69)%,(12.93±7.48)% to (70. 12 ±21.31)%,(92.76 ±29. 15)%,(88.64 ±40. 21)%,(63.97 ±20.11)%(t=12.13,14.43,13.27and9. 74,respectively,Ps＜0. 01).Conclusions The histories of patients with acquired deficiencies of vitamin K-dependent coagulation factors are usually hiding, therefore it is easily misdiagnosed. It is worth of detecting PT and APTT in diagnosis and monitoring. Using vitamin K1 10 -40 mg/d is effective and safety.