Background study of HIV-1 drug resistant mutations in treatment-naive patients in liaoning province / 中国医学科学院学报

<p><b>OBJECTIVE</b>To collect background information on drug resistance mutations in treatment-naïve HIV-1 infected individuals in Liaoning Province.</p><p><b>METHODS</b>Samples from 91 antiretroviral therapy-naïve patients were collected. The entire protease gene and 1-290 amino acids of the reverse transcriptase gene were amplified by nested PCR from provirus DNA and sequenced. The results were analyzed with HIVdb-Drug Resistance Algorithm, and genotypic resistance mutations were determined to particular anti-HIV drugs.</p><p><b>RESULTS</b>Totally 91 sequences were obtained, 3 of which displayed M46I mutations in the protease gene. Minor resistance mutation rate to protease inhibitors was 100%, including types of L63P (60.4%), V77I (60.4%), M36I/V (31.9%), A71V/T (22.0%), L10I (8.8%), and K20R (6.6%). Only one sequence carried reverse transcriptase related resistance mutations M184I.</p><p><b>CONCLUSIONS</b>About 4.4% of HIV-1 infected individuals in Liaoning Province carried strains with drug resistance mutations. Most treatment-naïve HIV-1 infected individuals in Liaoning Province were sensitive to the currently available antiviral medicines, but antiviral treatment must be in accordance with the strict procedures to keep better adherence and avoid the prevalence of drug-resistant strains.</p>

Modified laparoscopic exploration of common bile duct:A report of 42 cases / 中国微创外科杂志

Objective To investigate the technique and instrument improvement of laparoscopic choledocholithotomy with T-tube drainage. Methods A total of 42 cases of gall stones complicated with common bile duct stones entered the study. During the operation, we exposed the common bile duct before the removal of the gall bladder, opened the common bile duct by a self-made bile duct scalpel, removed the stones by open instruments laparoscopically, and performed choledochofiberscopic examinations and T-tube drainages. Results All the 42 operations were successfully accomplished without the conversion to open surgery. The operation time (exclusive of that of LC) was 80～180 min (mean, 96 min). All the patients got out of bed and received liquids within 24 hours after the surgery. The postoperative hospital stay was 5～9 days (mean, 6 days). The T-tube was removed 3 weeks after the operation in the absence of residual stones or stenosis of bile duct under T-tube choledochography. Follow-up for 6～48 months (mean, 23 months) in 38 cases found no recurrence of stones or biliary tract symptoms. Conclusions The modified laparoscopic choledocholithotomy with T-tube drainage, which shortens the operation time, is an effective and safe method for the treatment of common bile duct stones.