Feasibility of programmed death-1 monoclonal antibody treatment for patients with acquired immunodeficiency syndrome complicated with malignant tumor / 中华传染病杂志

Objective:To investigate the feasibility, efficacy and adverse reactions of programmed death-1(PD-1) inhibitors in patients with acquired immunodeficiency syndrome (AIDS) complicated with malignant tumor.Methods:From September 2020 to August 2021, patients with AIDS complicated with malignant tumor in Zhongnan Hospital of Wuhan University were enrolled. Data including basic information, laboratory test results, CD4 + T cell count, human immunodeficiency virus (HIV) viral load were collected. Patients were continuously administered intravenously PD-1 monoclonal antibody until disease progression or intolerant toxicity reaction occurred. Adverse reactions during treatment were recorded.And treatment outcomes were assessed once every 12 weeks after treatment. HIV viral load was measured after treatment once a week for four consecutive times, then once four weeks for two consecutive times, and then once every 12 weeks. Results:Ten patients were included in the study, including seven males and three females, three cases of Hodgkin′s lymphoma, two cases of cervical cancer and hepatocellular carcinoma respectively, one case of non-Hodgkin′s lymphoma, non-small cell lung cancer and anal cancer respectively. There were four patients with CD4 + T cell count of 100 to 200 cells/μL and two patients with CD4 + T cell count lower than 100 cells/μL. All patients had completed at least three cycles of treatment with PD-1 monoclonal antibody, HIV viral load remained lower than 20 copies /mL. Three cases achieved complete response and three cases achieved partial response. Adverse reactions were cutaneous capillary endothelial proliferation (CCEP) (seven cases), major bleeding (three cases), and hearing impairment (one case). Conclusions:PD-1 inhibitor has no adverse effect on the continuous suppression of HIV viral load and has an effect on tumor control, so it is a viable choice in AIDS patients complicated with tumor. However, due to its considerable adverse reactions, multidisciplinary cooperation is needed to reduce the risk of complications and deal with serious complications.

Impact of Rehabilitation on Exercise Capacity, Cardiopulmonary Function and Quality of Life in Chronic Heart Failure Patients / 中国循环杂志

Objective: To evaluate the impact of rehabilitation on exercise capacity, cardiopulmonary function and quality of life (QoL) in patients with chronic heart failure (CHF). Methods: A total of 96 CHF patients with NYHA Ⅱ-Ⅲ and left ventricular ejection fraction (LVEF)<40% were enrolled. Based on routine drug therapy, the patients were randomly assigned into 2 groups: Control group, n=50 and Rehabilitation group, n=46, the patients performed treadmill exercise, the training intensity was tailored by (50-80) % of peak oxygen uptake (peak VO2) of baseline cardiopulmonary exercise test (CPET) at (25-40) min/session, 3 sessions/week for 12 weeks. The peak VO2, VE/VCO2 slop, anaerobic threshold (VO2 AT), maximum workload and maximum exercise time were measured by CPET; left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), cardiac index (CI) and LVEF were examined by echocardiography; 6 min walking distance (6MWD) and plasma NT-proBNP level were recorded; QoL was assessed by Minnesota living with heart failure questionnaire (MLWHFQ). The above indexes were compared within Rehabilitation group and between 2 groups. Results: In Rehabilitation group, compared to baseline condition, the following indexes were increased by 12 weeks training: peak VO2 (19.8±2.7) ml/min?kg vs (17.4±2.1) ml/min?kg, VO2 AT (11.6±2.5) ml/min?kg vs (9.5±1.8) ml/min?kg, maximum workload (120±20) w vs (102±21) w, maximum exercise time (8.2±1.7) min vs (6.4±1.5) min, CI (2.2±0.5) L/(min?m2) vs (1.9±0.4) L/(min?m2), LVEF (42±5) % vs (35±4) % and 6MWD (406±58) m vs (345±79) m, all P<0.05; while the following parameters were decreased: VE/VCO2 slop (31.7±4.6) vs (34.2±5.8), LAD (38.6±5.5) mm vs (41.5±3.6) mm, LVEDD (58.4±6.3) mm vs (62.9±5.4) mm, NT-proBNP (235±69) ng/ml vs (387±57) ng/ml and MLWHFQ (30.8±12.0) vs (42.3±8.5), all P<0.05. The above indexes were different between Control group and Rehabilitation group, all P<0.05. Conclusion: Rehabilitation may safely and effectively improve cardiopulmonary function and quality of life in CHF patients.

Effects of SNPs at newly identified lipids loci on blood lipid levels and risk of coronary heart disease in Chinese Han population: A case control study / 华中科技大学学报（医学）（英德文版）

Associations between "lipid-related" candidate genes, blood lipid concentrations and coronary artery disease (CHD) risk are not clear. We aimed to investigate the effect of three newly identified lipids loci from genome-wide association studies on CHD and blood lipid levels in Chinese Han population. The genotypes of SNPs at three newly identified lipid loci and blood lipids concentrations were examined in 1360 CHD patients and 1360 age- and sex-frequency matched controls from an unrelated Chinese Han population. Allele T of rs16996148 occurred less frequently in CHD patients with the odds ratio (OR) being 0.64 (95% CI 0.50 to 0.81), after adjusting for conventional risk factors and was associated with a 33% decreased CHD risk (P<0.01) comparing with the major allele G. Individuals with GT genotype had the lowest CHD risk. No associations were found between the polymorphisms of other two loci with CHD risk and all three SNPs had no effect on lipid profile in this population. SNP rs16996148 on chromosome 19p13 is significantly associated with lower risk for CHD in Chinese Han population. However, it remains unresolved why these lipid-related loci had significantly less effects than the correspondingly expected effects on blood lipids levels in this population.

A survey of children with HIV/AIDS in highly epidemic villages of AIDS / 中华儿科杂志

<p><b>OBJECTIVE</b>To estimate prevalence of HIV/AIDS among children and the transmission routes in a highly endemic villages of AIDS.</p><p><b>METHODS</b>Totally 208 high-risk women of child bearing age and 159 of their children aged 0 - 14 years were investigated. Their medical histories of blood donation or transfusion were collected, blood samples were taken and sera were separated for HIV test. Enzyme-linked immunosorbent assay (ELISA) and Western blot assay were performed for HIV antibody. The Nested-polymerase chain reaction (PCR) assay amplifying gag gene p17 was performed on samples of children aged less than 18 months.</p><p><b>RESULTS</b>Thirty-seven HIV infected cases were found among 159 children aged 0 - 14 years of whom 33 were infected by mother-to-child transmission (89.2%, 33/37), 3 by blood transfusion (8.1%, 3/37) and one by iatrogenic route (2.7%, 1/37). Sixty seven mothers who were seropositive for HIV and their 86 children who were born after 1992 were investigated, 33 cases of them were infected with HIV. The rate of vertical transmission was 38.4% (33/86). The HIV vertical transmission rate among mothers with AIDS (68.8%, 22/32) was significantly greater than that among mothers with asymptomatic HIV infection (20.4%, 11/54, P < 0.05). The number of children infected with HIV through vertical transmission increased from 1993 to 2001. Among 37 children infected with HIV, 12 cases developed AIDS and 4 of them died, of whom 2 cases died from tuberculosis. The morbidity of AIDS was 27.3% (9/33). Ninety three point nine percent (31/33) of infected mothers didn't know their HIV seropositive status before pregnancy and delivery. Of 8 pregnant women infected with HIV, one had aggravation of AIDS, 2 miscarried, 2 terminated their pregnancy and 3 continued their pregnancy.</p><p><b>CONCLUSION</b>Mother-to-child transmission of HIV was the major route of HIV/AIDS transmission to the children. The main reason leading to HIV infection in children was the lack of prenatal HIV counseling and testing for the high-risk women of childbearing age and lake of interventions. The countermeasures must be taken to control the further transmission of AIDS in order to protect the health of women and children in the highly endemic areas of AIDS.</p>

The investigation of mother-to-child transmission of Type-1 Human Immunodeficiency Virus / 中华传染病杂志

Objective To investigate mother-to-child transmission of HIV-1 and the factors that affect transmission. Methods 136 children who were born to HIV positive mothers in a high HIV prevalence region were interviewed and blood samples were examined for anti-HIV anti-HGV and HIV RNA or HIV DNA. Results Among 136 children who were born to HIV positive mothers, 50 were infected with HIV. The MTCT rate was 36.8% (50/136). Thirty eight DNA fragments of HIV-1 gag gene P17 obtained from HIV-1 seropositive mothers were amplified by PCR from uncultured peripheral blood mononuclear cells (PBMCs). Sequence analyses showed that all of them were HIV-1 B subtype. The HIV vertical transmission rate among mothers with AIDS (67.4%, 31/46) was significantly greater than among those with HIV alone (21.1%, 19/90), P