Effect of Didang Xianxiong Decoction on Cardiac Myocardial Microvascular Endothelial Cell Injury Induced by High Glucose / 中国实验方剂学杂志

ObjectiveThis study was designed to observe the effect of Didang Xianxiong decoction on the cardiac myocardial microvascular endothelial cells （CMECs） injury， and to explore its related mechanism based on the CMECs model induced by high glucose. MethodRat primary myocardial cells were cultured in vitro and 33 mmol·L-1 glucose was added for modeling. After modeling， the rats were randomly divided into model group （final glucose concentration： 33 mmol·L-1）， normal group， Didang Xianxiong decoction low dose group （glucose + 5% Didang Xianxiong decoction containing serum）， Didang Xianxiong decoction medium dose group （glucose+10% Didang Xianxiong decoction containing serum）， Didang Xianxiong decoction high dose group （glucose+20% Didang Xianxiong decoction containing serum） and alagebrium chloride （ALT-711） group （glucose+10% ALT-711 containing serum）. The influence of drug-containing serum on the proliferation of CMECs was detected by MTT tetrazolium salt colorimetric assay. The relative mRNA expression of c-Jun was detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The protein expression of phosphorylated Janus kinase 1 （p-JAK1）， phosphorylated signal transducer and activator of transcription 1 （p-STAT1） and transforming growth factor-β1 （TGF-β1） was determined by Western blot. ResultCompared with the conditions in normal group， the mRNA expression of c-Jun and protein expression of p-JAK1， p-STAT1 and TGF-β1 were up-regulated in model group （P<0.01）. Compared with model group， all treatment groups had decreased mRNA expression of c-Jun （P<0.01）. Didang Xianxiong decoction medium and high dose groups and ALT-711 group showed reduced protein expression of p-JAK1 and p-STAT1 （P<0.05， P<0.01）， while there was no significant change in Didang Xianxiong decoction low dose group. TGF-β1 protein expression was lowered in all treatment groups （P<0.05， P<0.01）， and the decrease was more significant in Didang Xianxiong decoction medium and high dose groups than Didang Xianxiong decoction low dose group. ConclusionDidang Xianxiong decoction can protect CMECs with high glucose-induced injury， and the mechanism may be related to reducing the activity of JAK/STAT signaling pathway in cells.

Catheter Removal Planning Based on Phased Evaluation for Severe Traumatic Brain Injury: A Case Report / 中国康复理论与实践

Objective:To introduce a phased evaluation for severe traumatic brain injury in clinical nursing, to promote catheter removal planning. Methods:A case of severe traumatic brain injury in our hospital in October, 2018 was reviewed. Results:This case accepted a phased evaluation about consciousness, condition of tracheotomy and extubation, bladder safety capacity and residual urine volume, and the rehabilitation nursing targeted to the results. After 54 days of treatment and care, all the catheters were removed in a planned way. Conclusion:The phased evaluation for severe traumatic brain injury may promote the planning of catheter removal, prevent repeated tube placement, and facilitate the recovery of patients.

Dermatofibrosarcoma Protuberans: a Systematic Evaluation and Meta-analysis of Efficacy of Postoperative Radiotherapy / 中华放射肿瘤学杂志

Objective:To evaluate the efficacy of postoperative radiotherapy (PRT) for dermatofibrosarcoma protuberans (DFSP).Methods:A systematic review and meta-analysis of articles published before February 23, 2019 were conducted. A total of 655 studies were retrieved consisting of 195 DFSP patients. Among them, 50 cases were assigned into the PRT group and 145 cases in the surgery alone (SA) group. The recurrence rate was statistically compared between two group.Results:Meta-analysis showed that the recurrence rate in the PRT group was significantly lower than that in the SA group (8% vs. 24.1%, OR=0.28, P=0.010). The recurrence rate of patients with positive margins in the PRT group was significantly lower compared with that in the SA group (8% vs. 61.5%, P=0.002). The recurrence rate of patients with negative margins in the PRT group had a decreasing trend than that in the SA group (6% vs. 21.6%, P=0.205). Conclusions:The recurrence rate of surgery combined with PRT is lower than that of SA. The recurrence rate of patients with positive margins is higher than that of those with negative margins. For patients with positive margins, PRT can decrease the recurrence rate. The recurrence rate trends to decline in patients with negative margins after receiving PRT.

Brucella orchitis: A retrospective study of 69 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics, clinical manifestations, diagnosis, and treatment of Brucella orchitis, so as to provide reliable evidence for the prevention and treatment of the disease.</p><p><b>METHODS</b>We conducted retrospective statistical analyses on the medical records of 48 outpatients and 21 inpatients with Brucella orchitis.</p><p><b>RESULTS</b>Brucella orchitis was diagnosed in 6.67% of the male patients with brucellosis (69/1 034). The disease exhibited typical epidemiological features, with a higher incidence rate among those in frequent contact with sheep and elderly people, in the period from April to July, and in the areas with sheep husbandry. All the Brucella orchitis patients had such local symptoms as testicular pain and swelling, more frequently involving both testes, and other most common symptoms included fever, chills, sweating, and painful joints. Based on IIEF-5, 45 of the patients suffered from severe erectile dysfunction, with their reproductive function temporarily affected in the course of the disease. Misdiagnosis easily occurred in the early stage of the disease. Therapeutic options mainly included doxycycline hydrochloride and rifampicin, administered orally or intravenously, which could effect a cure, though relapse might occur in some cases.</p><p><b>CONCLUSION</b>Bru- cella orchitis has distinct epidemiological characteristics, with clinical manifestations of testicular pain and swelling. Though a transient disease, it affects the reproductive function of the patient before cured. It can be treated by combined oral and intravenous medication, with painkillers or ice bags for testicular pain and swelling.</p>

A probe into the education management modes for master degree programs of professional clinical medical education / 中华医学教育探索杂志

The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.

Progress on Correlation between the Expression of CDK5 and Brain Injury Time / 法医学杂志

Cyclin-dependent kinase 5 (CDK5) is a member of cyclin-dependent kinase family, which does not directly regulate cell cycle. Through phosphorylation of target protein, CDK5 plays an irreplaceable role in the development, reparation and degeneration of neurons. Brain injury refers to the organic injury of brain tissue caused by external force hit on the head. Owing to the stress and repair system activated by our body itself after injury, various proteins and enzymes of the brain tissues are changed quantitatively, which can be used as indicators for estimating the time of injury. This review summarizes the progress on the distribution, the activity mechanism and the physiological effects of CDK5 after brain injury and its corresponding potential served as a marker for brain injury determination.

Expression of p35 and p25 after Focal Cerebral Contusion in Rat / 法医学杂志

OBJECTIVE@#To study the expression of p35 and p25 in rat after focal cerebral contusion and to provide experimental data for estimating brain injury time.@*METHODS@#Fifty adult male SD rats were randomly divided into 0 h, 6 h, 12 h, 24 h, 3 d, 5 d, 7 d, 10 d after focal cerebral contusion, control and sham-operated groups (5 rats each group). The focal cerebral contusion rat model was established. The expression of p35 and p25 protein of the damage peripheral zone in brain were detected by HE staining, immunohistochemistry and Western blotting at different injury time.@*RESULTS@#A large number of p35 protein and a small amount of p25 protein were expressed in control group and sham-operated group. After focal cerebral contusion, p35 presented unimodal change with time and p25 presented bimodal changes with time.@*CONCLUSION@#Expression of p35 and p25 showed different regularity with good time correlation, which could help to estimate the brain injury time.

Pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation on recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

To discuss the effective method of decreasing the postoperative recurrence rate of recurrent pterygium. ●METHODS:Totally 126 cases (126 eyes) with recurrent pterygium were randomly divided into A group (56 cases) and B group ( 70 cases ). Group A was treated by pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation, group B was treated by amniotic membrane transplantation. The followed-up time after surgery was 6-24mo. ●RESULTS:ln group A, postoperative 5-7d (average 5. 62± 1. 38d), cornea epithelium was repaired. ln group B, postoperative 7- 10d ( average 7. 38 ± 1. 12d), the corneal wound was healed. There was statistical significant difference between two groups (t = 4. 307,P ●CONCLUSlON: lt is suggested that pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation is effective in the treatment of recurrent pterygium.

P-VEP games aided combined treatment of amblyopia in children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game. METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games. RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Application of On-line SPE-HPLC System in Pharmacokinetic Study of Highly Active Anti-Cancer Compound TEB-415 / 分析化学

An on-line solid phase extraction-high performance liquid chromatography ( SPE-HPLC ) system was applied in the plasma pharmacokinetic study of highly active anti-cancer compound tyrosine kinase inhibitors (TEB-415) in mouse. The on-line SPE-HPLC method associated with Ultimate3000 system which was applied to the determination of the blood drug level of TEB-415 in mouse plasma. C18 column ( Venusil MP, 150 mm × 4. 6 mm, 5μm) was used as analytical column and the mobile phase consisted of acetonitrile-5 mmol/L monopotassium phosphate buffer ( pH 3 . 5 ) at a flow rate of 1 . 0 mL/min was used as the isocratic elution. An MF Ph-1 column (10 mm×4 mm, 5 μm) was used as on-line SPE column, and water and water-acetonitrile were used as the washing solvent and elution solvent respectively. The detection wavelength was set at 262 nm. The pharmacokinetic parameters were calculated by WinNonlin 5. 2 software. The linear range of the calibration curve was between 100 and 20000 μg/L, and the limit of qualification was 20 μg/L. The extraction recovery was between 90 . 5% and 94 . 6%. The RSD of intra-day and inter-day precision was less than 3. 5%. The accuracy of short-term stability, freeze-thaw stability and long-term stability were between 91. 49% and 101. 96%. After oral medication, the mean peak time (Tmax) of TEB-415 in mice was 5. 29 h, and the mean maximum concentration ( Cmax) was 3403μg/L. The area under the curve ( AUC) of TEB-415 was 24600 μg/L·h. This drug's mean half-life was 3. 84 h, and its mean retention time (MRT) was 6. 56 h. These parameters suggested that TEB-415 had appropriate rate of absorption and elimination with preferable bioavailability.

Serum HBV DNA level at week 12 is superior to viral response at week 24 in predicting long-term treatment outcome of telbivudine for chronic hepatitis B patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Telbivudine, one of the five nucleos(t)ide antiviral drugs, was reported to be superior to lamivudine in a better biochemical, virological, and histological response for treatment-naive patients in the GLOBE trial. The aim of this study was to determine the antiviral potency, viral resistance, and the signifcance of early response for long-term telbivudine treatment.</p><p><b>METHODS</b>We recruited 161 patients of chronic hepatitis B (CHB) on telbivudine between January 2009 and September 2011 in Macau, China. The serum hepatitis B virus DNA levels, hepatitis B e antigen (HBeAg) seroconversion, alanine aminotransferase (ALT) normalization, and viral resistance were analyzed.</p><p><b>RESULTS</b>The median age and follow-up duration were 48 years and 16.9 months. All patients were followed up for at least 6 months, while data were collected for 132, 120, 95, and 53 patients at 12, 24, 48, and 96 weeks respectively. The cumulative HBeAg seroconversion rate was 20.8% and only three patients (1.9%) presented with telbivudine low level resistance. The ALT normalization rates were 76.9% at 48 weeks and 77.6% at 96 weeks. Undetectable HBV DNA was achieved by 1.8%, 31.6%, 60%, and 74.1% in HBeAg positive patients and 29.3%, 60.3%, 84%, and 84.6% in HBeAg negative patients at each time point. Week 12 HBV DNA level < 1000 copies/ml (< 200 IU/ml) was a better predictor of viral suppression at 2-year follow-up (P = 0.001, OR = 27.00) than undetectable HBV DNA level at week 24 (P = 0.120, OR = 4.81).</p><p><b>CONCLUSIONS</b>Two-year telbivudine treatment yielded high rates of viral suppression and ALT normalization. Serum HBV DNA level at week 12 is a superior predictor for long-term viral suppression.</p>

Steady-state pharmacokinetics of zidovudine in Chinese HIV-infected patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The pharmacokinetics of zidovudine (AZT) are possibly influenced by weight, age, sex, liver and renal functions, severity of disease, and ethnicity. Currently, little information is available on the steady-state pharmacokinetics of AZT in Chinese HIV-infected patients. The current study aimed to characterize the steady-state pharmacokinetics of AZT in a Chinese set-up.</p><p><b>METHODS</b>Eleven Chinese HIV-infected patients were involved in the steady-state pharmacokinetic study. In total, 300 mg of AZT, as a part of combination therapy, was given to patients, and serial blood samples were collected for 12 hours. The samples were measured by a high-performance liquid chromatography (HPLC) assay, and the results were analyzed by both the non-compartment model and the one-compartment model.</p><p><b>RESULTS</b>The C(max) of AZT in Chinese patients was higher than that in non-Asian patients. The half-life of AZT, analyzed by the non-compartment model (P = 0.02), in male patients ((1.02 ± 0.22) hours) was shorter than that of AZT in female patients ((1.55 ± 0.29) hours). The AZT clearance, analyzed by the one-compartment model (P = 0.045), in male patients ((262.60 ± 28.13) L/h) was higher than that in female patients ((195.85 ± 60.51) L/h).</p><p><b>CONCLUSION</b>The present study provides valuable information for the clinical practice of AZT-based highly active antiretroviral therapy in a Chinese set-up.</p>

Homer protein expression after focal brain contusion in rats / 法医学杂志

OBJECTIVE@#To investigate Homer protein expression after focal brain contusion and explore the relationship between expression and injury time.@*METHODS@#Focal brain contusion in rats was established and Homer protein expression in brain at different injury intervals after contusion was detected by immunohistochemistry and Western blotting.@*RESULTS@#A small amount of Homer positive expression cells were detected in control group, sham operated group and experimental group (0.5 h after contusion). The amount of Homer positive expression cells increased after 3 h and reached peak 12 h after contusion. The amount of positive cells continued to decrease 1 d after contusion and to the base level 7 d after contusion. Homer protein expression based on immunohistochemistry and Western blotting had statistical difference among adjacent groups.@*CONCLUSION@#Expression of Homer protein near the focal contusion area shows time dependence after brain contusion in rats.

Outcome analysis of screening on high arsenic water source in Jingzhou City, Hubei Province / 中国地方病学杂志

Objective To survey the arsenic content of drinking water in Jingzhou City, to provide basis for prevention and control of endemic arsenic disease. Methods According to historical data, the .arsenic content of water was detected in 357 villages from 6 counties of Jianglin, Songzi, Gongan, Shishou, Jianli, Honghushi in Jinzhou City in 2007 and 2008, The past have been found to have high arsenic water villages, villages known to have high concentration of arsenic were put into census. Villages not found to have high-arsenic wells were sampled 10 percent of the whole water resources at five directions of east, west, south, north and the center. Using sampling investigation, water arsenic was determined by half -quantitative fast reagent kit. All samples of water with arsenic exceeding the standard were re-determined using silver diethyl dithiocarbamate using silver diethyl dithiocarbamate colorimetric mothod. Survey on the disease was carried out in the villages with arsenic exeeeding the standard. Results All 6074 water samples was inspected. Arsenic in 210 samples outnumbered 0.05 mg/L, 51 natural villages were high arsenic areas;The maximum level of arsenic content in drinking water was 0.7 mg/L 3.2% (152/4784) of the wells no deeper that 30 meters and 4.9%(58/1184) between 30 to 100 m had arsenic exceeding the standard The water arsenic content was normal when the wells was deeper that 100 m. The abnormal percentages of water arsenic was related with the depth of wells with a significant difference(χ2 = 12.29,P < 0.01). Medical examination 84 064 residents in 51 villages having high arsenic water 31 neighboring villages was made, No Patients was found suffering from endemic arsenic poisoning. Conclusions High arsenic source has been found in Jingzhou City ,but no endemic arsenic poisoning patient in Jingzhou City. It is suggested that necessary preventive measures should be taken in high arsenic area, low-arsenic water should be spotted or high arsenic water improved. Moreover, wells should be drilled for more than 100 meters or more in depth.

Impact of baseline CD4(+) T cell counts on the efficacy of nevirapine-based highly active antiretroviral therapy in Chinese HIV/AIDS patients: a prospective, multicentric study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>CD4(+) T cell counts have been used as the indicator of human immunodeficiency virus type 1 (HIV-1) disease progression and thereby to determine when to start highly active antiretroviral therapy (HAART). Whether and how the baseline CD4(+) T cell count affects the immunological and viral responses or adverse reactions to nevirapine (NVP)-containing HAART in Chinese HIV-1 infected adults remain to be characterized.</p><p><b>METHODS</b>One hundred and ninety-eight HIV-seropositive antiretroviral therapy (ART)-naive subjects were enrolled into a prospective study from 2005 to 2007. Data were analyzed by groups based on baseline CD4(+) T cell counts either between 100 - 200 cells/microl or 201 - 350 cells/microl. Viral responses, immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 52, 68, 84, 100.</p><p><b>RESULTS</b>Eighty-six and 112 subjects ranged their CD4(+) T cell counts 100 - 200 cells/microl and 201 - 350 cells/microl, respectively. The pre-HAART viral load in CD4 201 - 350 cells/microl group was significantly lower than that in CD4 100 - 200 cells/microl group (P = 0.000). After treatment, no significant differences were observed between these two groups either in the plasma viral load (pVL) or in the viral response rate calculated as the percentage of pVL less than 50 copies/ml or less than 400 copies/ml. The CD4(+) T cell counts were statistically higher in the 201 - 350 group during the entire follow-ups (P < 0.01) though CD4(+) T cell count increases were similar in these two groups. After 100-week treatment, the median of CD4(+) T cell counts were increased to 331 cells/microl for CD4 100 - 200 cells/microl group and to 462 cells/microl for CD4 201 - 350 cells/microl group. Only a slightly higher incidence of nausea was observed in CD4 201 - 350 cells/microl group (P = 0.05) among all adverse reactions, including rash and liver function abnormality.</p><p><b>CONCLUSIONS</b>The pVLs and viral response rates are unlikely to be associated with the baseline CD4(+) T cell counts. Initiating HAART in Chinese HIV-1 infected patients with higher baseline CD4(+) T cell counts could result in higher total CD4(+) T cell counts thereby achieve a better immune recovery. These results support current guidelines to start HAART at a threshold of 350 cells/microl.</p>

Clinical analysis of otogenic intracranial complications / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and treatment protocols of otogenic intracranial complications in Peking Union Medical College Hospital.</p><p><b>METHODS</b>Retrospective study of 14 patients (10 males and 4 females, aged between 12 - 62 years, mean age 32.1 years) hospitalized from 1982 - 2006. Twelve cases were otitis media (OM) with cholesteatoma, the other 2 cases were non-cholesteatomatous OM. All the otogenic intracranial complications located at the same sides as otologic disorders. Brain abscess was the most common type of otogenic complications and Proteus was the most common microorganism detected. Suppurative ear discharge, headache, high fever and nausea with vomiting were the most common clinical manifestations with very high incidences. All the patients received combined protocols of mastoid surgeries and antibiotics treatment.</p><p><b>RESULTS</b>All the 14 patients recovered clinically. For patients discharged before 1987, there were 4 patients followed up for 22.5 - 24.4 years with a mean time of 23.8 without recurrence, 1 patient died of cardiovascular disease 19.2 years later after discharge, 4 patients lost follow-up. For the 5 patients discharged after 1997, brain abscess recurred in one patient with pseudo-recovery after 24 days and he fully recovered after re-hospitalization and treatment. All the five patients were followed up for 1.5 years to 10.6 years with a mean time of 6.5 years without recurrence.</p><p><b>CONCLUSIONS</b>Youngsters and males seemed to be more vulnerable. Brain abscess was the most common intracranial complication and Proteus was the most common pyogenic microorganism. Combination of mastoid surgery and antibiotics were essential for effectively controlling the intracranial complications and improving the recovery. CT and MRI were essential for correct diagnosis bedtimes and MRI seemed to have a better performance.</p>

Assignment of CCR7 gene to chicken chromosome 27 by radiation hybrid panel mapping / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The protein encoded by CC chemokine receptor 7 (CCR7) is a member of the G protein-coupled receptor family. This receptor was identified as a gene induced by the Epstein-Barr virus (EBV), and is thought to be a mediator of EBV effects on B lymphocytes. This receptor is expressed in various lymphoid tissues and activates B and T lymphocytes. It has been shown to control the migration of memory T cells to inflamed tissues, as well as stimulate dendritic cell maturation. To map the CCR7 gene in chicken chromosome, a 6 000 rads chicken-hamster radiation hybrid panel (ChickRH6) was used. PCR of samples from ChickRH6 revealed that the location of CCR7 gene is linked to the maker SEQ0347 (6 cR away) with LOD score of 16.6 and that the marker SEQ0347 is located on chromosome 27 at 27 cR of RH (radiation hydrid) map. We compared the corresponding human mRNA sequence with the predicted coding sequence of chicken CCR7 gene, and found that the assembled contig shared a high percentage of similarity with that of the human gene.

Total parathyroidectomy combined with partial auto-transplantation for the treatment of secondary hyperparathyroidism / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Drug treatment for secondary hyperparathyroidism caused by chronic renal failure may be available at the early stage of the disease, but it is not as effective for serious patients. The aim of the study was to evaluate the effect of total parathyroidectomy combined with forearm autotransplantation in the uremic patients with secondary hyperparathyroidism.</p><p><b>METHODS</b>From September 1999 through September 2006, parathroidectomy and autotransplantation was performed in 20 patients. The coherence between the results of preoperative parathyroid ultrasonography and surgical exploration were compared. The serum calcium concentration and intact parathyroid hormone (iPTH) were monitored preoperatively, intraoperatively, and postoperatively.</p><p><b>RESULTS</b>A total of 71 hyperplastic parathyroid glands were resected in the 20 patients. The accordance rate of parathyroid localization between B-ultrasonography and intraoperative exploration was 94.4%. The average iPTH value was (110.90 +/- 67.42) ng/L, (433.80 +/- 243.72) ng/L, (48.80 +/- 42.69) ng/L, (229.04 +/- 172.68) ng/L and (232.39 +/- 224.05) ng/L at day 1, 2, 3, 7, 30 after operation respectively. The clinical symptoms were ameliorated and the levels of serum calcium concentration were controlled within the normal range after operation. Recurrent secondary hyperparathyroidism had happened in 1 case, 4 years postoperatively because of the development of autograft hyperplasia, and in another case 2 years postoperatively due to remnant of neck parathyroid glands. The clinical symptoms were all alleviated after re-operation. No surgical complication had occurred in any of the patients.</p><p><b>CONCLUSIONS</b>The total parathyroidectomy with forearm autotransplantation is feasible, safe, and effective for patients with secondary hyperparathyroidism in the short term. The long-term effects should be further investigated.</p>

Clinical characteristics of 143 Chinese HIV/AIDS patients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in China.</p><p><b>METHODS</b>Totally 143 HIV/AIDS patients who were first diagnosed in Peking Union Medical College Hospital form January 1988 to April 2006 were enrolled in this study. Clinical characteristics were retrospectively analyzed.</p><p><b>RESULTS</b>Among 143 HIV/ AIDS patients, 57 patients had no clinical symptoms and were confirmed by routine examinations; 86 patients had clinical symptoms, including fever (n = 50), weight loss (n = 18), and discomforts involving respiratory system (n = 34), gastrointestinal system (n = 16), and derma and mucosa (n = 17). Opportunistic infections (OIs) such as pneumocystis jiroveci pneumonia (PCP) (n = 27), oropharyngeal candidiasis (n = 16), tuberculosis (n = 15) , and cytomegalovirus (CMV) infection (n = 9) were also observed in patients whose CD4 + T cell counts were less than 200/mm3. Most CMV infection and cryptococcal meningitis occurred in patients whose CD4 + T cell counts were less than 100/mm3. CD4 + T cell count was negatively correlated with plasma viral load (r = -0.420, P = 0.001).</p><p><b>CONCLUSIONS</b>Fever, dyspnea, and weight loss are the most common symptoms in the patients of this study. The respiratory system, gastrointestinal system, derma and mucosa are the most commonly affected areas by OIs, and PCP is the most common OI. The occurrence of OIs corelates with CD4 + T cell count.</p>

Clinical outcomes and immune reconstitution in 103 advanced AIDS patients undergoing 12-month highly active antiretroviral therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Highly active antiretroviral therapy (HAART) produces profound suppression of HIV replication, substantial increase in CD4(+) T cells, and partial reconstitution of the immune system. However, the numbers of subjects were small in previous Chinese studies. This study evaluated the efficacy and side effects of HAART in Chinese advanced AIDS patients.</p><p><b>METHODS</b>One hundred and three antiretroviral drug naive AIDS patients were enrolled in this study and were divided into two groups by their baseline CD4(+) count: < 100 cells/microl or > or = 100 cells/microl. Clinical, virological and immunological outcomes were monitored at baseline and at 1, 3, 6, 9 and 12 months during the course of treatment with HAART.</p><p><b>RESULTS</b>One patient died and another was lost from the follow-up. For the remaining 101 HIV/AIDS patients at the 12th month during the HAART, the plasma viral load (VL) was reduced to (3.2 +/- 0.7) lg copies/ml, the CD4(+) count increased to (168 +/- 51) cells/microl [among which the naive phenotype (CD45RA(+)CD62L(+)) increased to (49 +/- 27) cells/microl and the memory phenotype (CD45RA(-)) increased to (119 +/- 55) cells/microl], and the percentage of CD4(+)CD28(+) cells increased. At the same time, there was a significant reduction of CD8(+) T cell activation. In the 69 patients with the baseline CD4(+) count < 100 cells/microl, 37 had a VL < 50 copies/ml; while in the 34 patients with the baseline CD4(+) count > or = 100 cells/microl, 25 had a VL < 50 copies/ml, the difference between the two groups was statistically significant. The CD4(+) T cell count showed a two-phase increase during HAART and a significant positive correlation was shown between the change of CD4(+) count and plasma VL. Over 12 months of HAART, 10 patients had gastrointestinal side effects, 13 peripheral neuritis, 7 hepatic lesions, 8 hematological side effects, 8 skin rashes, 10 lipodystrophy and 1 renal calculus.</p><p><b>CONCLUSIONS</b>Immune reconstitution as well as the significantly improved clinical outcomes is observed in Chinese advanced AIDS patients after HAART. Side effects are common during HAART and require clinical attention.</p>