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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.
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Objective In order to discuss the practicability and risk analysis of deep venous catheter in AIDS patients.Methods 112 patients who needed to keep the intravenous route between October in 2010 and February in 2012 in Yunnan AIDS care center were implemented deep venous catheter.Results Right Subclavian vein catheter 101 cases,right internal jugular vein catheter 10 cases,right femoral vein catheter in 1.Wound happened in 5 cases,catheter heterotopia 1 case.Conclusion Deep venous catheter in patients with HIV/AIDS clinical diagnosis and treatment work could not only relieve the patients' pain because of repeated puncture,reduce the nursing workload,ensure the smooth progress of the clinical diagnosis and treatment,but also the more important is to reduce the occupational exposure risk of medical staff.
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Objective: This work aimed to investigate the relationships of the serum levels of IL-17 and TGF-β with the carcinogenesis and progression of colorectal cancer (CRC), as well as the clinical significance of these serum levels. Methods: Data of 30 healthy subjects, 59 patients with simple CRC and 44 CRC patients with postoperative (post-op) metastasis were recruited in this study. The patients were respectively divided into group A (30 healthy subjects as the control group), group B (59 CRC patients without distant metastasis after surgery), and group C (44 CRC patients with post-op metastasis). The patients in each group had a mean age of 53.8 ± 20.8, 62.0 ± 11.8, and 64.0 ± 15.7 years, respectively. All patients were confirmed by pathological diagnosis. The serum levels of IL-17 and TGF-β were measured by enzyme-linked immunosorbent assay. All quantitative data were analyzed using SPSS 13.0. Results: The IL-17 serum level was significantly higher in groups B and C than in group A. The preoperative (pre-op) serum level of IL-17 was significantly higher than the post-op serum level in group B (P0.05). However, the TGF-β serum level in group C was significantly higher than that in groups A and B (P<0.05). No significant correlation was observed in the serum level IL-17 or TGF-β between colon and rectum cancers in groups B and C. Conclusion: The serum level of IL-17 is significantly correlated with that of CRC. The serum level IL-17 increases with the aggravation of CRC and increased tumor burden. A strong correlation exists between the serum level of TGF-β and metastasis of CRC. Cytokine IL-17 and TGF-β may play an important role in the progression and metastasis of CRC.
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ObjectiveTo evaluate the effect of N-acetylcysteine (NAC) on alleviating hepatorenal damage caused by combined chemotherapy using cisplatin-based regiments in elderly patients. MethodsAll 40 elderly patients with malignant tumors were randomly divided into AB and BA group in cross-over pattern. In AB group, combination of chemotherapy and NAC was administrated for 10 days first, and then combination of chemotherapy, carnine and vitamin C was given for 10 days. In BA group, combination of chemotherapy, earnine and vitamin C was administrated for 10 days first, and then combination of chemotherapy and NAC was given for 10 days, a cycle was 21 days. The hepatorenal damage degree was observed and the curative effect of NAC on hepatorenal damage was evaluated. ResultsThere were no differences in the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and serum creatinine(Cr) between pre chemotherapy and post chemotherapy in A cycle[(25.32±5.23) U/L vs. (29.18±5.43) U/L,(29.21±6.51)U/L vs. (32.37±7. 13)U/L, (89.87±19.56)Mmol/L vs. (95.22±20. 60)μmol/L,all P>0. 05] . In B cycle, the levels of ALT,AST and Cr were (56.76±5.53) U/L, (48.83±6.64)U/L and (137.33±21.16)μmol/L post chemotherapy, respectively, which were evidently higher than pre chemotherapy[(26.19 ± 5.51) U/L, (29.95±6.56) U/L and (88.66±18.27)μmol/L,respectively] (all P<0.01) . ConclusionsNAC has better preventive and therapeutic effects on hepatorenal damage caused by the chemotherapeutic drugs in elderly patients with malignant cancer.