Cryo-EM structures for the Mycobacterium tuberculosis iron-loaded siderophore transporter IrtAB

The adenosine 5'-triphosphate (ATP)-binding cassette (ABC) transporter, IrtAB, plays a vital role in the replication and viability of Mycobacterium tuberculosis (Mtb), where its function is to import iron-loaded siderophores. Unusually, it adopts the canonical type IV exporter fold. Herein, we report the structure of unliganded Mtb IrtAB and its structure in complex with ATP, ADP, or ATP analogue (AMP-PNP) at resolutions ranging from 2.8 to 3.5 Å. The structure of IrtAB bound ATP-Mg2+ shows a "head-to-tail" dimer of nucleotide-binding domains (NBDs), a closed amphipathic cavity within the transmembrane domains (TMDs), and a metal ion liganded to three histidine residues of IrtA in the cavity. Cryo-electron microscopy (Cryo-EM) structures and ATP hydrolysis assays show that the NBD of IrtA has a higher affinity for nucleotides and increased ATPase activity compared with IrtB. Moreover, the metal ion located in the TM region of IrtA is critical for the stabilization of the conformation of IrtAB during the transport cycle. This study provides a structural basis to explain the ATP-driven conformational changes that occur in IrtAB.

High-throughput screening of SARS-CoV-2 main and papain-like protease inhibitors

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (Mpro) and papain like protease (PLpro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851Mpro inhibitors and 205 PLpro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both Mpro and PLpro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of Mpro inhibitors and over 20% of PLpro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 Mpro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.

Exploration of the online and offline mixed teaching mode of Medical Imaging / 中华医学教育探索杂志

Based on the online course of Medical Imaging, the online and offline mixed teaching mode is an important reform against the traditional teaching mode. Combining the teaching reform experience of Chongqing Medical University, this paper introduces the resource construction of the online teaching platform of Medical Imaging, the construction of the online and offline mixed teaching mode (including the overall reconstruction design of the online and offline teaching content, and the organic integration of the online and offline teaching content before, during and after class), the details of teaching implementation (taking ischemic cerebral infarction as an example), the teaching efficiency, the existing problems and related improvement measures. The preliminary practice shows that it has great significance in enhancing the teaching quality since it can break through time and space constraints, expand teaching space, effectively stimulate students' learning autonomy, enhance their practical skills, increase the communication and interaction between teachers and students, and improve the teaching effect.

Strategic Exploration of Targeted Therapy for BRAF Non-V600E Mutant Lung Cancer / 中国肺癌杂志

BACKGROUND@#Dabrafenib+Trametinib/Dabrafenib targeted therapy has been approved for V-RAF murine sarcoma viral oncogene homolog B1 with amino acid substitution for valine at position 600 (BRAF V600E) in lung cancer patients, however, the targeted therapy strategy for lung cancer patients with BRAF non-V600E mutations has not been determined yet. This study intends to explore the efficacy of targeted therapy for BRAF non-V600E mutant lung cancer, and provide a reference for clinical treatment.@*METHODS@#Computer search of PubMed, Cochrane Library, Embase, Web of Science, Clinicaltrials.gov, CBM, CNKI, Wanfang database. Collect the relevant literature relevant on the targeted therapy of BRAF non-V600E mutant lung cancer, and conduct a descriptive analysis of the included literature.@*RESULTS@#There were 10 articles that met the inclusion criteria, including 3 cohort studies and 7 case reports. 18 patients with BRAF non-V600E mutant lung cancer were ineffective to vermurafenib; 1 patient obtained partial response (PR) after applying vermurafenib, 5 patients did not respond to BRAF inhibitors; 9 patients showed a potential clinical benefit rate of 34% after monotherapy with trametinib; 7 patients have different degrees of benefit from dabrafenib and trametinib on progression-free survival (PFS); 1 patient is effective to sorafenib.@*CONCLUSIONS@#At present, there is no standard treatment specification for BRAF non-V600E mutation targeted therapy. The challenge lies in the heterogeneous mutation of BRAF gene. Different mutation types respond differently to targeted therapy. In addtion, real-world research evidence is scarce, so it is necessary to carry out further large-sample high-quality research to provide reference for clinical practice.

The effect of hyperlipidemia on perioperative outcomes of rectal cancer patients / 中华老年医学杂志

Objective:To examine the influence of hyperlipidemia on perioperative outcomes of rectal cancer patients.Methods:From June 2016 to June 2019, 86 patients who had received laparotomy or laparoscopic radical resection of rectal cancer at the Department of General Surgery of Nanjing Jiangbei People's Hospital were selected as research subjects.Preoperative blood lipids were measured.Based on lipid levels, patients were divided into the hyperlipidemia group(46 cases)and the normal blood lipid group(40 cases). Operative time, intraoperative blood loss, postoperative recovery outcomes, incidence of anastomotic fistula, and incidences of incision fat liquefaction and incision infections were compared between the two groups.SPSS21.0 was used for data analysis.Results:Compared with the normal lipid group, the operative time of the hyperlipidemia group was significantly longer and the amount of intraoperative blood loss was higher in the hyperlipidemia group, and the differences were statistically significant.Compared with the normal lipid group, the hyperlipidemia group showed a longer time to first postoperative flatus and to first postoperative oral intake, delayed drainage tube removal and ambulation, and longer hospital stays, with statistically significant differences.There were 17 cases of postoperative complications in the hyperlipidemia group(37.0%)and 4 cases in the normal lipid group(10.0%), and the difference was statistically significant( χ2=7.027, P=0.008). Conclusions:Hyperlipidemia has adverse effects on surgical outcomes and postoperative recovery for rectal cancer patients.

High-throughput screening identifies established drugs as SARS-CoV-2 PLpro inhibitors

A new coronavirus (SARS-CoV-2) has been identified as the etiologic agent for the COVID-19 outbreak. Currently, effective treatment options remain very limited for this disease; therefore, there is an urgent need to identify new anti-COVID-19 agents. In this study, we screened over 6,000 compounds that included approved drugs, drug candidates in clinical trials, and pharmacologically active compounds to identify leads that target the SARS-CoV-2 papain-like protease (PLpro). Together with main protease (M

Cryo-EM snapshots of mycobacterial arabinosyltransferase complex EmbB-AcpM

Inhibition of Mycobacterium tuberculosis (Mtb) cell wall assembly is an established strategy for anti-TB chemotherapy. Arabinosyltransferase EmbB, which catalyzes the transfer of arabinose from the donor decaprenyl-phosphate-arabinose (DPA) to its arabinosyl acceptor is an essential enzyme for Mtb cell wall synthesis. Analysis of drug resistance mutations suggests that EmbB is the main target of the front-line anti-TB drug, ethambutol. Herein, we report the cryo-EM structures of Mycobacterium smegmatis EmbB in its "resting state" and DPA-bound "active state". EmbB is a fifteen-transmembrane-spanning protein, assembled as a dimer. Each protomer has an associated acyl-carrier-protein (AcpM) on their cytoplasmic surface. Conformational changes upon DPA binding indicate an asymmetric movement within the EmbB dimer during catalysis. Functional studies have identified critical residues in substrate recognition and catalysis, and demonstrated that ethambutol inhibits transferase activity of EmbB by competing with DPA. The structures represent the first step directed towards a rational approach for anti-TB drug discovery.

Cryo-EM snapshots of mycobacterial arabinosyltransferase complex EmbB-AcpM

Inhibition of Mycobacterium tuberculosis (Mtb) cell wall assembly is an established strategy for anti-TB chemotherapy. Arabinosyltransferase EmbB, which catalyzes the transfer of arabinose from the donor decaprenyl-phosphate-arabinose (DPA) to its arabinosyl acceptor is an essential enzyme for Mtb cell wall synthesis. Analysis of drug resistance mutations suggests that EmbB is the main target of the front-line anti-TB drug, ethambutol. Herein, we report the cryo-EM structures of Mycobacterium smegmatis EmbB in its "resting state" and DPA-bound "active state". EmbB is a fifteen-transmembrane-spanning protein, assembled as a dimer. Each protomer has an associated acyl-carrier-protein (AcpM) on their cytoplasmic surface. Conformational changes upon DPA binding indicate an asymmetric movement within the EmbB dimer during catalysis. Functional studies have identified critical residues in substrate recognition and catalysis, and demonstrated that ethambutol inhibits transferase activity of EmbB by competing with DPA. The structures represent the first step directed towards a rational approach for anti-TB drug discovery.

Clinical significance of neutrophil-to-lymphocyte ratio in assessing response to cardiac resynchronization therapy in elderly patients / 中华老年医学杂志

Objective To investigate the clinical significance of neutrophil-to-lymphocyte ratio (NLR)in assessing response to cardiac resynchronization therapy(CRT)in elderly patients.Methods Clinical data of 105 elderly patients with chronic heart failure(CHF)who had received CRT at our hospital from January 2006 to January 2017 were retrospectively analyzed,and patients were divided into a no-response group(n=42)and a response group(n=63)according to CRT outcomes after 6 months.General clinical data were compared between the two groups.Factors influencing response to CRT were analyzed by logistic regression model analysis.The receiver-operating characteristic(ROC)curve was used to assess the predictive value of NLR in response to CRT.Results Compared with the response group,the no-response group had increased baseline levels of initial QRS width,serum creatinine(Scr) and uric acid(UA)(P ＜0.05).There was no significant difference in left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter (LVESD),the New York Heart Association (NYHA) functional classification,neutrophil count,lymphocyte count and NLR between the two groups before CRT(P＞0.05).After 6 months of CRT,the LVEDD,NYHA functional class,neutrophil count and NLR were higher,and LVEF and lymphocyte count were lower in the no-response group than in the response group(P ＜0.05).The difference in NLR between 6 months after CRT and before CRT(△NLR)was higher in the no-response group than in the response group(P ＜0.05).Multi-factor Cox regression analysis showed that NLR (OR =1.895,95％CI:1.538～5.284,P =0.031)and △NLR(OR =2.579,95％CI:2.110～8.329,P =0.005) were independent risk factors for CRT (HR =1.590,95 ％ CI:1.215 ～ 2.146,P =0.013).ROC curve analysis showed that ROCAUC of △NLR in the no-response group was 0.891,95％CI:0.832～0.937,which was higher than that at 6 months after CRT(0.813,95 ％ CI:0.765～0.864)(Z=2.712,P＜0.05).Conclusions The increase in NLR after CRT may be an early sign for noresponse to CRT,and dynamic monitoring of NLR should be promoted to assess the prognosis of patients undergoing CRT.

Effect of endocrine gland-derived vascular endothelial growth factor on the proliferation and apoptosis of pancreatic cancer cells / 中华肝胆外科杂志

Objective To investigate the effect of endocrine gland-derived vascular endothelial growth factor(EG-VEGF) on the proliferation and apoptosis of pancreatic cancer cells and on the regulation of PI3K/AKT signaling pathway.Methords The expression of EG-VEGF and its receptor-VEGFR-2 in pancreatic cancer tissues and adjacent normal tissues was detected by PCR.The effect of EG-VEGF on proliferation of human pancreatic cancer cells was detected by MTT assay.The effect of EG-VEGF on the apoptosis of human pancreatic cancer cells was detected by flow cytometry.Western lot was used to detect the changes of related proteins expression in PI3K/AKT signaling pathway after EG-VEGF treatment.Results The expression (3.08±0.30,2.17±0.16 respectively) of EG-VEGF and VEGFR-2 in pancreatic cancer tissues was significantly higher than those (1.55±0.73,0.54±0.34 respectively) in adjacent tissues (both P＜ 0.05).MTT and flow cytometry data showed that EG-VEGF could promote the proliferation of pancreatic cancer cells and inhibit cell apoptosis.Western blot showed that EG-VEGF promoted AKT phosphorylation and activated PI3K/AKT signaling pathway.Conclusion EG-VEGF is highly expressed in pancreatic cancer tissue,and can activate PI3K/AKT signaling pathway to promote cell proliferation and inhibit cell apoptosis.

Effect of a noise-optimized virtual monoenergetic reconstruction technique on dual-energy CT for image quality of inflammatory bowel disease / 中南大学学报(医学版)

To assess the value of noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique on objective and subjective image quality in patients with inflammatory bowel disease (IBD) undergoing abdominal dual-energy computed tomography (DECT).
 Methods: Datasets from 32 patients (22 men, 10 women) with IBD, who underwent abdominal DECT, were reconstructed by using the standard linearly blended (M_0.6), traditional monoenergetic (VMI) and VMI+ algorithms in 10-keV intervals from 40-100 keV. Attenuation in IBD lesions was measured to perform objective evaluation using signal-to-noise (SNR) and contrast-to-noise ratios (CNR). Subjective evaluation was performed by 3 independent blinded radiologists using 5-point Likert scales. The overall image quality, image sharpness, lesion delineation, and image noise were analyzed. 
 Results: Mean SNR and CNR peaked at 40 keV VMI+ series (SNR 8.28±2.34, CNR 5.10±2.10) and they were significantly higher than those in linearly blended (SNR 5.82±1.44, CNR 1.53±0.86) and all VMI series (all P<0.01). Subjective image parameter was the highest for the 50 keV VMI+ series regarding overall image quality (mean 4.80, all P<0.01). The highest image sharpness scores were observed at 40 and 50 keV VMI+ reconstructions (mean 4.14 and 4.25, respectively; P=0.415). VMI+ series at 40 keV provided the highest lesion delineation (mean 4.52, all P<0.01). Image noise was low at the 100 keV VMI+ and VMI series (mean 4.58 and 4.40, respectively; P≥0.11).
 Conclusion: Low-keV VMI+ reconstructions improves SNR, CNR, and subjective image quality significantly in patients with IBD.

Study on improving the standardized training resident radiologists' comprehensive ability in medi-cal teaching and research based on PACS retrospective case report presentation / 中华医学教育探索杂志

Picture archiving and communication system (PACS) was used to perform archiving and retrospective cases report presentation in resident radiologist standardized training, and the current conven-tional article reviewing case report presentation form was compared. The results showed the scores of quiz and questionnaire of using archiving and retrospective cases report based on PACS were higher than using the current conventional form (P<0.05). This type of case report presentation can improve overall capability of resident radiologist standardized training including imaging diagnose,research and educational skill.

Correlation between marrow edema and related MRI and clinical manifestations in patients with knee osteoarthritis / 实用放射学杂志

Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.

The advance of detection technology of HIV self-testing / 中华预防医学杂志

At present, China's AIDS testing increased rapidly, but there are still many people living with HIV do not recognize their status, thus postponing the antiviral treatment time. HIV self-testing (HST) is an effective method to expand the testing, not only simple operation, easy to get a result, effectively protect the detection privacy, expand the selection of testers, suit to the entire population, but also the premise and basis of other AIDS comprehensive prevention measures, all over the world are promoting it. Because the HST has controversies in the window period, price and before and after controversial, and our country is in the initial stage of HST, so it is not to develop related policies, but more and more countries are in accordance with their own situations are modified or developed to allow to use rapid detection of AIDS policy to regulate the field. This paper analyzed and summarized the advantage and influence factors of HST promotion, HST believes that in the long term, the advantages outweigh the disadvantages, we need to formulate relevant policies, and improve the sensitivity of the kit, shorten the window period of time, production and promotion of operation standard of video, specification and testing the operating practices, preventing and reporting the possible social harm, investigation and understanding of the needs of the people of the crowd, to maximize the advantages of HST, find more infection, so as to curb the epidemic of AIDS.

Drug resistance mutations and its associated factors among 579 HIV/AIDS patients experiencing failure of antiretroviral therapy in Jiangsu Province, China / 中华预防医学杂志

Objective@#To understand the incidence and related factors of HIV-1 drug resistance among HIV/AIDS patients experiencing treatment failure in Jiangsu province, China.@*Methods@#The HIV/AIDS integrated prevention and control data information management system of China were used to collect the basic data of patients, blood specimens were collected from patients who had antiretroviral therapy (ART) failure with ≥12 months and older than 18 years in 2016 in Jiangsu, excluding cases with missing information, 713 cases were enrolled in this study. HIV-1 RNA was extracted, and then pol gene region was amplified and sequenced. The obtain sequences were submitted to Stanford University HIV Drug Resistance Database to interpret and analyse HIV-1 drug resistance and sub-types. Multivariate logistic regression model was used to explore the related factors of drug resistance.@*Results@#A total of 579 subjects were amplified successfully, male accounted for 85.66% (496 cases), and the median age was 39 years old. The main route of infection was sexual transmission (553 cases, 95.51%). A total of 331 patients with drug resistance gene mutation were detected, drug resistance mutation rate was 57.18%. Compared with patients with baseline CD4+T cell count >500 cells/μl, patients with CD4+T cell count in 201-500 cells/mm3 and ≤200 cells/μl had a higher incidence of genetic drug resistance, the odds ratio was 3.33 and 6.87, respectively. Compared with patients with treatment less than 24 months, patients treated for 25-48 months had a higher incidence of drug resistance, the odds ratio was 1.88. Compared with patients infected by CRF07_BC strains, patients infected by CRF01_AE strains were associated with higher incidence of drug resistance, the odds ratio was 2.22 and 3.32, respectively. Protease inhibitor (PI) resistance mutations, nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) were found in 3.80%, 33.16% and 53.37% of patients, respectively. 31.95% of patients harbored NRTI and NNRTI resistance mutations simultaneously. M184V/I and K103N/Q were the highest frequency of NRTI and NNRTI resistance mutation, the prevalence of M184V/I and K103N/Q were 28.15% and 22.28%, respectively.@*Conclusion@#The status of HIV-1 drug resistance mutations are complex and diverse among patients experiencing failure of ART in Jiangsu. Patients with lower baseline CD4+T cell count, longer treatment time and HIV-1 CRF01_AE and B strains infection were associated with higher incidence of drug resistance mutation.

Structural basis of Zika virus helicase in recognizing its substrates

The recent explosive outbreak of Zika virus (ZIKV) infection has been reported in South and Central America and the Caribbean. Neonatal microcephaly associated with ZIKV infection has already caused a public health emergency of international concern. No specific vaccines or drugs are currently available to treat ZIKV infection. The ZIKV helicase, which plays a pivotal role in viral RNA replication, is an attractive target for therapy. We determined the crystal structures of ZIKV helicase-ATP-Mn(2+) and ZIKV helicase-RNA. This is the first structure of any flavivirus helicase bound to ATP. Comparisons with related flavivirus helicases have shown that although the critical P-loop in the active site has variable conformations among different species, it adopts an identical mode to recognize ATP/Mn(2+). The structure of ZIKV helicase-RNA has revealed that upon RNA binding, rotations of the motor domains can cause significant conformational changes. Strikingly, although ZIKV and dengue virus (DENV) apo-helicases share conserved residues for RNA binding, their different manners of motor domain rotations result in distinct individual modes for RNA recognition. It suggests that flavivirus helicases could have evolved a conserved engine to convert chemical energy from nucleoside triphosphate to mechanical energy for RNA unwinding, but different motor domain rotations result in variable RNA recognition modes to adapt to individual viral replication.

Clinical Research of Acupuncture at Stellate Ganglion for Treatment of Post-stroke Shoulder-hand Syndrome / 广州中医药大学学报

Objective To compare the difference of the clinical efficacy on post-stroke shoulder-hand syndrome treated by acupuncture at stellate ganglion and by conventional acupuncture. Methods Ninety cases of post-stroke shoulder-hand syndrome ( at stageⅠ or stageⅡ) were randomized into treatment group and control group, 45 cases in each group. Both groups received basic rehabilitation training. Additionally, the treatment group received acupuncture at the bilateral stellate ganglions of the neck, with reducing acupuncture by rotating the needles. The control group received the conventional acupuncture on Jiquan ( HT 1) , Chize ( LU 5) , Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), with reducing acupuncture by lifting and thrusting the needle on Jiquan ( HT 1) and Chize ( LU 5) , and with mild reinforcing and reducong acupuncture on the other acupoints. The treatment for both groups was given once every day, and 14 times in total. The total syndrome scores, visual analogue scale (VAS) scores, modified Fugl-Meyer Assessment of motor function scale (FMA) scores, and modified Barthel index (MBI) were observed to evaluate the changes of symptoms, pain and motor function of the upper limbs, and activity of daily life before and after treatment in the two groups. The clinical efficacy was also compared between the two groups. Results The total syndrome scores, VAS scores, FMA scores and the modified Barthel index were improved apparently after treatment in the two groups (all P<0.01), and the improvement in the treatment group as more obvious (all P<0.01) . The total effective rate was 93.33% (42/45) in the treatment group, which was better than 73.33% (33/45) in the control group ( P<0.05) . During the treatment, patients of both groups had good compliance, and all completed the trial. No obvious adverse reaction was found in the two groups. Conclusion Acupuncture at stellate ganglion is effective and safe for the treatment of post-stroke shoulder-hand syndrome, and it has higher efficiency than the conventional acupuncture.

Observations on the Efficacy of Electroacupuncture at Huatuo Jiaji Points in Treating Motor Dysfunction in Stroke Patients During the Flaccid Paralysis Stage / 上海针灸杂志

[Ab]stract] Objective To investigate, according to core myodynamic theory, the clinical efficacy of electroacupuncture at Huatuo jiaji points in treating motor dysfunction in stroke patients during the flaccid paralysis stage.Methods Sixty stroke patients in the stage of flaccid paralysis were randomly allocated to treatment and control groups, 30 cases each. The control group received basic treatment and conventional acupuncture and the treatment group, electroacupuncture at Huatuo jiaji points in addition. The simplified Fugl-Meyer assessment (FMA) score and the Modified Barthel Index (MBI) score were counted before and after treatment and the clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the FMA score and the MBI score in the two groups (P<0.05). There were statistically significant post-treatment differences in the FMA score and the MBI score between the treatment and control groups (P<0.05). The total efficacy rate was 96.7% in the treatment group and 86.7% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Electroacupuncture at Huatuo jiaji points has a promoting effect on the rehabilitation of limb function in the flaccid paralysis stage of stroke.

Analysis of the five-year effectiveness of highly active antiretroviral therapy among 200 HIV/AIDS patients in Jiangsu province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the five-year effectiveness of the people living with HIV/AIDS who initially received highly active antiretroviral therapy (HAART) in Jiangsu province.</p><p><b>METHODS</b>HIV/AIDS initially received HAART from 1 Jan 2005 to 31 May 2014 in Jiangsu province with the CD4(+)T cell count tested in baseline, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after treatment initiation were selected. According to their retrospectively collected baseline and follow-up data, statistical analysis was performed using SPSS 16.0 software to analyze the variation of CD4(+)T counts and its impact factors in different times after treatment initiation.</p><p><b>RESULTS</b>A total of 200 patients were included. A total of 134 patients were men, and 66 were women, the ratio of male to female was 2.03: 1; mean age was (39.7 ± 10.3) years old; 69.0% (138/200) of the patients married; 53.0% (106/200) as the most were infected with HIV through heterosexual transmission, and followed by men who have sex with men (MSM) (25.5%, 51/200); taken together as 78.5% (157/200).58.5% (117/200) were treated in the CDC. The mean (95%CI) baseline CD4(+)T cell count of cases was 106.9 (93.3-120.5) cells/µl; the CD4(+)T count tested in 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after treatment initiation were 107.3, 152.9, 221.6, 260.0, 281.3 and 316.4 cells/µl more than baseline respectively; the CD4(+)T count after treatment initiation has increased over time (F = 201.06, P < 0.01) . The mean(95%CI) CD4(+)T count tested in 5 years after treatment initiation can increase to 540.7(445.4-635.9) cells/µl with a baseline CD4(+)T count more than 200 cells/µl, but in the subgroups with a baseline CD4(+)T count less than or equal to 50 cells/µl, 51-100 cells/µl, 101-150 cells/µl and 151-200 cells/µl, it only can reach to 431.4 (375.9-487.0), 400.0 (339.9-460.2), 380.3 (330.6-430.0) and 412.1 (369.3-454.8) cells/µl respectively. The mean (95%CI) CD4(+)T count tested in 5 years after treatment initiation with 1 baseline symptom categories can increase to 449.2 (392.2-506.2) cells/µl, while 409.1(317.8-500.5)cells/µl in the subgroup with baseline symptom categories more than or equal to 2. The CD4(+)T after treatment increased slowly associated with a lower baseline CD4(+)T count level and more baseline symptom categories (F values were 3.96 and 2.35, P < 0.01).</p><p><b>CONCLUSION</b>It has a remarkable effectiveness for HIV/AIDS treatment in Jiangsu province. The patients with a baseline CD4(+)T count more than 200 counts/µl have a better immune function recovery.</p>

Relationship of the phosphodiesterase 4D gene rs153031 polymorphism and the susceptibility of unstable angina pectoris / 重庆医学

Objective To investigate the association between the phosphodiesterase 4D(PDE4D) gene rs153031 polymorphism and the susceptibility of unstable angina pectoris(UAP) in Chinese Han population of Changwu region .Methods The PDE4D gene rs153031 polymorphism was genotyped by Taqman probe in 172 UAP patients(UAP group) ,as well as in gender-and-age-matched 220 subjects without coronary heart disease(CHD)(control group) .Results In this crowd ,there was PDE4D gene rs153031 poly-morphism in patients with UAP and in subjects without CHD .Compared with control group ,frequencies of GG ,GA ,AA genotypes and G allele of rs153031 in UAP group showed no statistical differences (P> 0 .05) .Conclusion In Chinese Han population of Changwu region ,PDE4D gene rs153031 polymorphism shows no association with the susceptibility of UAP .