Analysis of drug resistance in patients with acquired immunodeficiency syndrome who failed antiviral therapy / 中华传染病杂志

Objective:To investigate the drug resistance of patients with acquired immunodeficiency syndrome (AIDS) who failed antiviral therapy.Methods:A total of 156 AIDS patients with antiviral therapy failure at the Sixth People′s Hospital of Zhengzhou from October 2017 to December 2018 were selected. The human immunodeficiency virus (HIV)-1 ViroSeq? genotyping method was used for the detection of HIV resistance, and Stanford University HIV drug resistance database (http: ∥hivdb.stanford.edu/) was used for testing results comparison.Results:Among the 156 AIDS patients with antiviral therapy failure, 122(78.21%) developed drug resistance. One hundred and six (67.95%) cases were multi-resistant to nucleoside reverse transcriptase inhibitor (NRTI), among which, 104 (66.67%) were resistant to lamivudine, emtricitabine and abacavir. One hundred and eighteen (75.64%) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI), and 118 (75.64%) were multi-resistant to efavirenz and nevirapine. And seven (4.49%) were resistant to protease inhibitor (PI). There were 16 resistant sites for NRTI, with 87 (71.31%) most frequent M184V/I mutations. There were 13 resistant sites for NNRTI, with 49 (40.16%) K103N/R mutations. There were 11 resistant sites for PI, with 49 (40.16%) A71V/T mutations. The antiviral drugs lamivudine and emtricitabine were moderately and highly resistant in 102 (83.61%) cases, efavirenz and nevirapine were moderately and highly resistant in 117 (95.90%) cases. Once drug resistance developed, these drugs were likely to be moderate or high resistance. There were 29 (23.77%), 48 (39.34%), and five (4.10%) cases were resistant to zidovudine, tenofovir and lopinavir/ritonavir, respectively. The resistance barrier of these drugs was relatively high.Conclusion:The incidence of drug resistance in patients with AIDS treatment failure is high, and multi-drug resistance is serious with various sites of drug resistance.

A preliminary grounded theory-based study on the response model of tested nurses by using Self-report Inventory / 中国实用护理杂志

Objective:In order to provide guidance strategies for the establishment and application of self-report inventory in nursing research, we discussed the mental response model regarding tested nurses during its application.Methods:From September to November 2020, based on the grounded theory, we conducted semi-structured interviews for 9 tested nurses, who were from Qilu Hospital of Shandong University and Jinan Central Hospital, and data were analyzed to extract the psychological response topic.Results:A response model for tested nurses, which formed three psychological responses that factored in exam motivation, exam situation and individual will was built.Conclusion:The present study reveals the correlations among exam motivation, exam situation, individual will and psychological responses during the application of self-report inventory on tested nurses, which could provide references for the establishment and application of self-report scale in nursing research.

A single arm clinical study of 86 patients with common type of coronavirus disease 2019 treated by integrated traditional Chinese and Western medicine: multicenter case observation from 7 designated hospitals in Henan Province / 中华危重病急救医学

Objective:To evaluate the clinical effect of integrated traditional Chinese and Western medicine on common type of coronavirus disease 2019 (COVID -19) in Henan Province. Methods:A prospective single arm clinical study was performed. Patients with common type of COVID -19 admitted to seven designated hospitals for COVID -19 in Henan Province from January 25th to February 26th, 2020 were enrolled, and treated with integrated traditional Chinese and Western medicine. The negative transformation of 2019 novel coronavirus (2019 -nCoV) nucleic acid, disease outcome, hospital stay, clinical symptoms and signs scores, and chest imaging performance were observed. Results:Totally 86 cases were included in the analysis, including 48 males (55.8%), aged 43.5 (35.0, 53.3) years old, 24 patients (27.9%) with previous medical history. Fifty-eight patients were primarily diagnosed COVID -19 and 28 patients were transferred. The 2019 -nCoV nucleic acid of 86 cases (100%) turned negative, and the median time of turning negative was 10 (7, 14) days. Eighty-six cases (100%) were discharged from hospital, and none turned into the severe type; the average length of hospital stay was (13.8±5.6) days. The scores of fever, cough, chest tightness, shortness of breath, and fatigue decreased with the treatment time, and the scores of 7 days and 14 days after treatment were significantly lower than those before treatment [fever (points): 0 (0, 0), 0 (0, 0) vs. 1 (0, 1); cough (points): 1 (0, 1), 0 (0, 1) vs. 1 (0, 2); chest tightness (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); shortness of breath (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); fatigue (points): 0 (0, 1), 0 (0, 1) vs. 1 (0, 1); all P < 0.05]. The improvement rate of X ray and CT image was 42.9% (12/28) and 81.0% (64/79), respectively. Conclusions:The treatment with integrated traditional Chinese and Western medicine has good curative effect on common type of COVID -19 in 7 designated hospitals of Henan Province. It can improve the clinical symptoms, promote the absorption of pulmonary inflammation, and to some extent control the progress of disease and shorten the time of turning negative of virus nucleic acid and hospital stay.

Relationship between podocyte gene and steroid resistant nephrotic syndrome / 国际儿科学杂志

Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, serum hypoalbuminemia, edema, hyperlipidemia.Most children can get relief with hormone therapy, but 15%~20% of children with hormone resistance eventually reach to end-stage nephropathy.Genes associated with steroid resistant nephrotic syndrome(SRNS)include NPHS1, NPHS2, CD2AP, TRPC6 encoding the slit diaphragm of podocytes, ACTN4 and INF2 encoding podocyte cytoskeleton proteins, WT1 encoding the nucleus of podocytes, COQ2 and COQ6 encoding mitochondrial proteins of podocytes, LAMB2 encoding glomerular basement membrane proteins.Research have found that one mutation in one of these molecules is enough to cause SRNS, so SRNS is also known as podocyte molecular disease.

Clinicopathological features and research progress of C1q nephropathy / 国际儿科学杂志

C1q nephropathy is a special type of glomerulonephritis, which characterized by massive deposition of C1q on glomerular mesangial.The pathological manifestations of C1q nephropathy are minimal change disease, focal segmental glomerulosclerosis and proliferative glomerulonephritis.C1q nephropathy is prone to hormone dependence or resistance, and the prognosis is not good relatively.The pathogenesis of the disease is not clear.The clinical manifestations are quite different.Glucocorticoid is still the first choice for treatment.Immunosuppressive agents are often used in patients with hormone dependence or resistance.It has been found that the rituximab has good curative effect on C1q nephropathy in recent years.Although the understanding and research on C1q nephropathy is deepening, there is still much controversy about whether to classify C1q nephropathy into a class of independent diseases and the clinical significance of their classification.In this paper, the pathogenesis, pathological histology, clinical characteristics, treatment and prognosis of C1q nephropathy are reviewed in order to have a better understanding of C1q nephropathy.

Clinical characteristics of 71 patients with coronavirus disease 2019 / 中南大学学报(医学版)

OBJECTIVES@#To analyze the clinical characteristics of 71 patients with coronavirus disease 2019 (COVID-19).@*METHODS@#The general data, epidemiological data, laboratory tests, imaging examinations, and treatment of 71 patients with COVID-19 admitted to the Sixth People's Hospital of Zhengzhou from January 19, 2020 to March 3, 2020 were retrospectively analyzed.@*RESULTS@#Of the 71 COVID-19 patients, the ages were 4-84 (41.29±15.21) years, 38 (53.5%) patients were male, 33 (46.5%) were female, and 52 (73.2%) were in 22 clusters. The main clinical manifestations were fever (78.9%), cough (64.8%), and sputum (38.0%). The fever was mainly low and moderate, with 49 patients (69.0%) at 37.3-39.0 ℃. Most of the leukocytes, neutrophils, and lymphocytes were normal, accounting for 47 (66.2%), 51 (71.8%), and 51 (71.8%) patients, respectively; a few of them were decreased, accounting for 21 (29.6%), 16 (22.5%), and 20 (28.2%) patients, respectively. There were 38 (53.5%) and 31 (43.7%) patients with the decreased CD4 and CD8 T cell counts, respectively. There were 41 (57.7%), 38 (53.5%), 32 (45.1%), 26(36.6%), 22 (31.0%), 20 (28.2%), 14 (19.7%), 14 (19.7%), and 9 (12.7%) patients with the increased levels of C-reactive protein, erythrocyte sedimentation rate, procalcitonin, fibrinogen,interleukin 6, lactate dehydrogenase,-dimer,alanine aminotransferase, and aspartate aminotransferase, respectively. Of the 71 patients, the lung was involved in 60 (84.5%) patients, the double lung was involved in 47 (66.2%) patients, and the single lung was involved in 13 (18.3%) patients. The course of the disease was long, and the time from symptom onset to the second severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid negative transformation was (17.22±6.34) days.There were no significant differences in the incubation period (=-0.453, >0.05), the complicates (χ=0.042, >0.05), and the time from symptom onset to diagnosis (=-1.330, >0.05) in patients between the non-severe group and the severe group. The onset age, gender, SARS-CoV-2 nucleic acid negative time, lymphocyte count, -dimer, C-reactive protein, total bilirubin, direct bilirubin, lactate dehydrogenase, calcium ion, CD4 T cell count, CD8 T cell count, calcitonin, procalcitonin, and troponin were significantly different between the severe group and the non-severe group (all <0.05). Among the 71 patients, 4 (5.6%) patients were mild, 59 (83.1%) were normal, and 8 (11.3%) were severe or critical.@*CONCLUSIONS@#The aggregation phenomenon of COVID-19 is obvious. Fever and cough are the main clinical manifestations. White blood cells, neutrophils, and lymphocytes in the most patients in the early onset are normal. Most COVID-19 patients are light and ordinary type, with good prognosis.

AnalysisofgenderdifferencesincoronaryarterydiseaseinpatientswithHIVinfectionbasedonCCTA / 实用放射学杂志

Objective Toanalyzethedifferencesofthecoronaryarterycalciumscore,andtheprevalence,severity,characteristics ofcoronaryarteryplaquesbetweenAIDSinfectedfemaleandmale.Methods 158AIDSpatients(72femalesand86 males)and102 HIVGuninfectedpatients(49femalesand53 males)withsuspectedcoronaryarterydiseaseinourhospitalwereenrolledbetween March2017andFebruary2018.Patientsunderwentcoronarycomputedtomographyangiography (CCTA)bythethirdgenerationdual sourceforceCT.Thedifferencesofcoronaryarteryplaquesbetweengenderswereassessed.Results In HIVGuninfectedpatients,the prevalenceoftotalplaque,mixedplaque,severestenosisandtwoGvesseldiseasewassignificantlyhigherinmalethanfemale(allP＜0.05) andtheprevalenceofnonGcalcifiedplaquewassignificantlylowerinmalethanfemale(allP＜0.05).InAIDSpatients,theprevalence oftotalplaque,calcifiedplaque,severestenosisandCACS＞100wassignificantlyhigherin malethanfemale(allP＜0.05)andthe prevalenceofnonGcalcifiedplaqueandmixedplaquesignificantlywaslowerinmalethanfemale(allP＜0.05).Theprevalenceofthree ormorevesselsdiseasein maleAIDSpatientswassignificantlyhigherthanfemaleAIDSpatients.Conclusion MaleAIDSpatients havehighercoronarycalcifiedscoreandheaviercoronaryatherosclerosisburdens.Inaddition,femaleAIDSpatientshavelesscoronary atherosclerosisburdens,butmixedplaqueseemtobemorefrequently.

Survival analysis and associated factors of acquired immune deficiency syndrome patients under antiretroviral therapy in He'nan Province during 2005 to 2015 / 中华传染病杂志

Objective To study the survival status and the prognostic factors of aquired immune deficiency syndrome (AIDS) patients under the highly active antiretroviral therapy (HAART) in He'nan Province.Methods Survival data of AIDS patients were collected from the National HAART reporting system between 2005 and 2015,and analyzed using SPSS 23.0 software.Results A total of 38 143 AIDS cases were enrolled in this study.The cumulative survival rate of patients under antiretroviral therapy after 1-5 years were 95％,91％,89％,86％ and 85％,respectively.The cumulative death cases were 5 704 and the total mortality was 3.68/100 person years (5 704/155 060 person years).A total of 1 975 cases died within a year with a percentage of 34.62％.Cox proportional hazard regression model analysis indicated that the hazard ratioc (HR [95％CI]) of death in patients with age of 40-49 years,50-59 yrears,60-69 yrears and ≥70 years groups compared to those with age ＜30 years group were 1.49 (1.22-1.80),1.88 (1.55-2.28),2.82 (2.32 3.42) and 4.60 (3.75-5.65),respectively.The HR (95％ CI) of death in patients with CD4 T cell counts ＜50 cells/μL,50-199 cells/μL,200-349 cells/μL groups compared to those of ≥350 cells/μL group were 3.28 (2.98-3.61),2.30 (2.09-2.53) and 1.39 (1.25-1.54),respectively.Male (HR-1.35,95％CI:1.28-1.42) and not switching to second line therapy (HR=4.41,95％CI:4.12-4.73) were the risk factors of death.Compared to sex transmission,blood transmission was the risk factors of death in AIDS patients.Conclusions The initiation of early HAART and timely switching to second line therapy for AIDS patients are key to prolong the survival time and to reduce AIDS related death.

Expression of thioredoxin-2 in human lens epithelial cells with oxidative damage and its significance / 中南大学学报(医学版)

Objective:To explore whether thioredoin-2 (Trx-2) is involved in the development of cataract and to study the effect of Trx-2 on hydrogen peroxide (H2O2)-induced injury in human lens epithelial cells.Methods:A total of 10 volunteers (removing the lens due totraumatism) and 30 patients received phacoemulsification (age more than 60 years) were selected.The expression of Trx-2 protein in lens epithelial cells from cataract patients and volunteers were detected by the immunohistochemical streptavidin-peroxidase (SP) method.SRA01/04 cells were cultured and were divided into six groups according to different treatment:a control group,H2O2-treated groups at 20,50 or 100 μmol/L,a negative control group (transfected with pCMV6 plasmid plus 100 μmol/L H2O2),and a Trx-2 overexpression group (transfected with pCMV6-Trx-2 plasmid plus 100 μmol/L H2O2).Methyl thiazolyltetrazolium (MTT) assay and flow cytometry was performed to measure the cell viability and apoptosis for SRA01/04 cells,respectively.The activities of superoxide dismutase (SOD) and catalase (CAT),the content of glutathione (GSH) and malondialdehyde (MDA) in human lens epithelial cells were measured via chemical chromatometry.Western blot was used to measure the protein levels of Trx-2,B-cell lymphoma 2 protein (Bcl-2),Bcl-2 associated X protein (Bax) and caspase-3.Results:Compared with the volunteers,the expression of Trx-2 was significantly decreased in lens epithelial cells in patients with cataract (P＜0.05).Compared with the control group,the expression of Trx-2 protein in the 20,50 or 100 μmol/L H2O2 groups was decreased (all P＜0.05).Compared with the control group,the cell survival rates were decreased in the 100 μmol/L H2O2 group and the negative control group (both P＜0.05),along with enhanced apoptotic rates,inhibited cellular SOD activities and CAT activities,reduced GSH contents,augmented MDA contents,down-regulated Trx-2 and Bcl-2 expression and up-regulated Bax and caspase-3 expression (all P＜0.05).Compared with the negative control group,the cell survival rate was increased in the Trx-2 overexpression group (P＜0.05),along with suppressed apoptosis,increased SOD activities and CAT activities,elevated GSH contents,decreased MDA content,up-regulated Trx-2 and Bcl-2 expression and down-regulated Bax and caspase-3 expression (P＜0.05).Conclusion:Trx-2 might be involved in the apoptosis of lens epithelial cells in patients with cataract.The overexpression of Trx-2 obviously attenuated H2O2-induced injury of human lens epithelial cells,which might be associated with the inhibition of H2O2-mediated oxidative stress.

Analysis on 10 year survival of HIV/AIDS patients receiving antiretroviral therapy during 2003-2005 in Henan province / 中华流行病学杂志

Objective To understand the survival of HIV/AIDS patients after receiving antiretroviral therapy for 10 year in Henan province and related factors.Methods The database of national integrated management system of HIV/AIDS was used to collect the basic information and follow-up information of HIV/AIDS patients who received antiretroviral therapy between 2003 and 2005 in Henan province.Software SPSS 23.0 was used to analyze the patients' survival and related factors based on the life-table method and Cox proportional hazards model.Results Among the 2 448 HIV/AIDS patients who started antiretroviral therapy during 2003-2005,the men accounted for 53.5％,and women accounted for 46.5％.Up to 70.1％ of the patients were aged 40-59 years and 95.5％ of the patients had blood borne infections.The patients were observed for 10 years after antiviral treatment,and 719 cases died from AIDS related diseases,with a mortality rate of 3.78/100 per year (719/19 010 per year).The cumulative survival rates of patients within 1-year,3 years,5 years and 10 years were 0.94,0.86,0.78,0.69 respectively.Compared with the patients aged ＜40 years,the HRs of the patients aged 40-,50-,60-and ≥ 70 years were 1.417 (95％CI:0.903-2.222),1.834 (95％CI:1.174-2.866),2.422 (95％CI:1.539-3.810) and 3.424 (95％CI:2.053-5.709) respectively.Compared with patients with baseline CD4+T lymphocyte ＞350 unit/ul,the HRs of the patients with CD4+T lymphocyte ＜50 unit/μl,50-199 unit/ul and 200-350 unit/ul were 7.105 (95％CI:5.449-9.264),4.175 (95％ CI:3.249-5.366) and 2.214 (95％ CI:1.691-2.900) respectively.Compared with the women,the HR of the men was 1.480 (95％ CI:1.273-1.172).Compared with the patients who received second line ART therapy,the HR of patients receiving no second line therapy was 11.923 (95％CI:9.410-15.104).Conclusions The cumulative survival rate the HIV/AIDS patients after 10 years of antiretroviral therapy reached 0.69 in Henan.Male,old age,low basic CD4+T lymphocyte count and receiving no second line therapy were the risk factors for long-term survival of AIDS patients.

Analysis on 10 year survival of HIV/AIDS patients receiving antiretroviral therapy during 2003-2005 in Henan province / 中华流行病学杂志

Objective To understand the survival of HIV/AIDS patients after receiving antiretroviral therapy for 10 year in Henan province and related factors.Methods The database of national integrated management system of HIV/AIDS was used to collect the basic information and follow-up information of HIV/AIDS patients who received antiretroviral therapy between 2003 and 2005 in Henan province.Software SPSS 23.0 was used to analyze the patients' survival and related factors based on the life-table method and Cox proportional hazards model.Results Among the 2 448 HIV/AIDS patients who started antiretroviral therapy during 2003-2005,the men accounted for 53.5％,and women accounted for 46.5％.Up to 70.1％ of the patients were aged 40-59 years and 95.5％ of the patients had blood borne infections.The patients were observed for 10 years after antiviral treatment,and 719 cases died from AIDS related diseases,with a mortality rate of 3.78/100 per year (719/19 010 per year).The cumulative survival rates of patients within 1-year,3 years,5 years and 10 years were 0.94,0.86,0.78,0.69 respectively.Compared with the patients aged ＜40 years,the HRs of the patients aged 40-,50-,60-and ≥ 70 years were 1.417 (95％CI:0.903-2.222),1.834 (95％CI:1.174-2.866),2.422 (95％CI:1.539-3.810) and 3.424 (95％CI:2.053-5.709) respectively.Compared with patients with baseline CD4+T lymphocyte ＞350 unit/ul,the HRs of the patients with CD4+T lymphocyte ＜50 unit/μl,50-199 unit/ul and 200-350 unit/ul were 7.105 (95％CI:5.449-9.264),4.175 (95％ CI:3.249-5.366) and 2.214 (95％ CI:1.691-2.900) respectively.Compared with the women,the HR of the men was 1.480 (95％ CI:1.273-1.172).Compared with the patients who received second line ART therapy,the HR of patients receiving no second line therapy was 11.923 (95％CI:9.410-15.104).Conclusions The cumulative survival rate the HIV/AIDS patients after 10 years of antiretroviral therapy reached 0.69 in Henan.Male,old age,low basic CD4+T lymphocyte count and receiving no second line therapy were the risk factors for long-term survival of AIDS patients.

Analysis of AIDS epidemic and clinical features in some part regions of Henan province during 2006-2015 / 中国基层医药

Objective To discuss the epidemiology and clinical characteristics of AIDS in some part of Henan regions.Methods Retrospective analysis was conducted based on the clinical and epidemic information collected from AIDS patients who were treated in the Sixth People's Hospital of Zhengzhou between 2006 and 2015 in He'nan province.Results Between 2006 and 2015,the number of hospitalization increased every year.The average growth rate was 20.31％.The average age of patients was (43.91 ± 13.56) years old.The patients from 40 to 60 years old group occupied 54.06％ of total patients,and 71.12％ of patients were farmers.During 2006 to 2015,the propagation path changed a lot.Before 2008,blood transmission was the major propagation path (72.72％),but after 2013,the major propagation path was sexual activity (59.69％).40.41％ of patients were infected by two or more opportunistic infections.The top five opportunistic infections were bacterial pneumonia (32.68％),tuberculosis (19.29％),fungal infection (18.65％),pneumocystis carinii pneumonia (12.96％),extra pulmonary tuberculosis (7.45％).The death rate was 5.79％.The number of CD4 cells in peripheral blood was closely related to the severity of illness.Conclusion Early anti-virus treatment and opportunistic infection control are key factors to relieve the severity of illness and reduce the death rate.

Study on the Sustained Release of BSA from Chitosan-OREC/BSA Films Coated Mats in Vitro / 现代检验医学杂志

Objective To investigate the sustained release of BSA from chitosan-OREC/BSA films coated mats in vitro.Methods The negatively charged cellulose acetate (CA) fibrous mats were modified with multilayers of the positively charged chitosan or chitosan-OREC intercalated composites and the negatively charged bovine serum albumin (BSA) via electrostatic layer-by-layer (LBL) self-assembly technique.The adsorption and rinsing steps were repeated until the desired number of deposition bilayers was obtained.The in vitro BSA encapsulation and release experiments demonstrated that OREC could affect the degree of protein loading capacity and release ficiency of the LBL films coating.Results In the pH-gradient release assay,only a small amount of BSA was released from the mats in 1 h.As the time increased,the release rate of BSA of all the samples gradually went up to the maximum data within 8 h.For the samples with identical number of bilayers and record time,obvious increasing of the release amount could be seen in pH 7.4,in comparison with pH 1.2.Besides,doubling bilayers film-coated mats generally.Meanwhile,it was slightly distinguishable between 5 and 5.5 as well as 10 and 10.5 bilayers (t=0.651～ 1.324,P＞0.05).Interestingly,it could be seen that protein release of the chitosan-OREC/BSA films coated mats remarkably increased compared with that of chitosan/BSA films coated mats(t=2.264～ 2.305,P＜0.05).Conclusion The release of protein in the initial time could be controlled by adjusting the number of deposition bilayers,the outmost layer and the composition of coating bilayers.

Effect of second-line antiretroviral treatment on human immunodeficiency virus/acquired immune deficiency syndrome in Zhengzhou / 中华传染病杂志

Objective To evaluate the effect of second-line antiretroviral treatment (ART) on human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and provide reference for subsequent HIV/AIDS treatment.Methods Two hundred and twenty-eight HIV/AIDS patients received second-line ART during January 2011 and December 2015 in Zhengzhou were included.Two hundred and forty-eight who received first-line ART during this period were randomly enrolled as control group.CD4+ T cell count and HIV RNA load before and after treatment were compared with x2 test and t test when appropriate.Results There were 228 patients (137 male and 91 female) in the second-line ART group and 248 patients (176 male and 72 female) in the control group.In second-line ART group, CD4+ T cells increased from (274±200)/μL to (476±261)/μL after an average treatment of (39.5±18.8) months.The difference was statistically significant (t=12.91, P0.05).During the treatment, the rates of immunological failure were 9.6% (22/228) in second-line ART group and 12.9% (32/248) in the control group.There was no statistical difference between two groups (x2=1.251, P>0.05).Complete viral inhibition rates were 83.3% (190/228) in second-line ART group and 88.7% (220/248) in control group with no statistical difference (x2=2.881, P>0.05).Conclusions Second-line ART regimen has equivalent treatment efficacy with first-line ART.To achieve a better outcome, second-line ART regimen should be selected as an alternative option when first-line regimen fails.Compliance is the key to guarantee the success of antiviral therapy.

Survival time of HIV/AIDS death cases after antiretroviral therapy and related factors in Henan province, 2003-2015 / 中华流行病学杂志

Objective To analyze and investigate the survival time of dead HIV/AIDS patients after antiretroviral therapy (ART) and related factors in Henan province. Methods The database of national integrated management system of HIV/AIDS was used to collect the information of dead patients who received ART between January 2003 and December 2015. Software SPSS 23.0 was used to analyze the survival time of dead patients and related factors. Result A total of 6267 AIDS patients died after ART and the average survival time was 23.85 months (QR: 6.87-50.46 months). Within 6 months, 7-12 months and 13-24 months after ART, the numbers of dead patients were 1441 (23.00%), 652 (10.40%) and 1052 (16.79%), respectively. The number of dead cases decreased after 24 months of ART. The number of AIDS-related deaths was 5085 (81.1%);and 799 (12.7%) deaths were due to other causes, in which 179 (2.9%) were caused by accidents and 109 (1.7%) were caused by suicides. The differences in annual composition ratio of death causes during 2003-2015 had significance ( χ2=864.27, P<0.01). Twelve months, 36 months, 60 months and 120 months after ART, the survival ratios were 66.59%, 36.62%, 19.24% and 0.64% respectively. Compared with patients infected through blood donation, the HR of the patients infected through sexual transmission was 1.602 (95%CI: 1.483-1.732). Compared with patients with initial level of CD4+T lymphocyte≥350 unit/μl, the HR of patients with initial level of CD4+T lymphocyte<50 unit/μl was 2.320 (95%CI: 2.119-2.539). Compared with patients receiving second line ART, the HR of patients receiving no second line ART was 3.312 (95%CI: 3.083-3.558). Conclusion The AIDS related deaths mainly occurred in the first six months after ART. As the increase of duration of ART,the death rate decreased. Sexual transmission, low initial level of CD4+T lymphocyte and receiving no second line ART were the risk factors for the deaths of HIV/AIDS patients.

Survival time of HIV/AIDS death cases after antiretroviral therapy and related factors in Henan province, 2003-2015 / 中华流行病学杂志

Objective To analyze and investigate the survival time of dead HIV/AIDS patients after antiretroviral therapy (ART) and related factors in Henan province. Methods The database of national integrated management system of HIV/AIDS was used to collect the information of dead patients who received ART between January 2003 and December 2015. Software SPSS 23.0 was used to analyze the survival time of dead patients and related factors. Result A total of 6267 AIDS patients died after ART and the average survival time was 23.85 months (QR: 6.87-50.46 months). Within 6 months, 7-12 months and 13-24 months after ART, the numbers of dead patients were 1441 (23.00%), 652 (10.40%) and 1052 (16.79%), respectively. The number of dead cases decreased after 24 months of ART. The number of AIDS-related deaths was 5085 (81.1%);and 799 (12.7%) deaths were due to other causes, in which 179 (2.9%) were caused by accidents and 109 (1.7%) were caused by suicides. The differences in annual composition ratio of death causes during 2003-2015 had significance ( χ2=864.27, P<0.01). Twelve months, 36 months, 60 months and 120 months after ART, the survival ratios were 66.59%, 36.62%, 19.24% and 0.64% respectively. Compared with patients infected through blood donation, the HR of the patients infected through sexual transmission was 1.602 (95%CI: 1.483-1.732). Compared with patients with initial level of CD4+T lymphocyte≥350 unit/μl, the HR of patients with initial level of CD4+T lymphocyte<50 unit/μl was 2.320 (95%CI: 2.119-2.539). Compared with patients receiving second line ART, the HR of patients receiving no second line ART was 3.312 (95%CI: 3.083-3.558). Conclusion The AIDS related deaths mainly occurred in the first six months after ART. As the increase of duration of ART,the death rate decreased. Sexual transmission, low initial level of CD4+T lymphocyte and receiving no second line ART were the risk factors for the deaths of HIV/AIDS patients.

Evaluation of the virological and immune responses and their impact factors of Lopinavir/Ritonavir based second-line regimen in elderly acquired immunodeficiency syndrome patients who failed first line regimens / 中华传染病杂志

Objective To evaluate the virological and immune responses of Lopinavir/Ritonavir (LPV/r) based second-line regimen in elderly acquired immunodeficiency syndrome (AIDS) patients who failed first line regimens.Methods This was a retrospective cohort study.Elderly patients (≥50 years) who switched to LPV/r-based second-line antiretroviral therapy with human immuno-deficiency virus (HIV) RNA >1 000 copies/mL after more than 1 year of first-line treatment were recruited from Zhengzhou No.6 People Hospital from January 2010 to December 2011.The virological and immunological data during 60-month treatment were collected.Multivariate logistic regression was used to explore the risk factors associated with virological failure or immunological failure of 60-month second-line therapy.Results Totally 256 patients were enrolled with 109 male and 147 female.89.5% were plasma donator.The median age at the time of switching to LPV/r based second-line regimen was 61 years old.Twelve out of the 256 cases were detected for genotypic drug resistance and ten of them were resistant to drugs.No resistance to protease inhibitor (PI) was found.After switching to LPV/r based second-line regimen, HIV viral suppression (HIV RNA≤400 copies/mL) rates at 12, 24, 36, 48, 60 months were 69.5%, 78.4%, 79.0%, 79.7%, and 83.2%, respectively.The CD4+ T cell counts were (313±135) /mL at 12 months, (377±151) /mL at 24 months, (396±155) /mL at 36 months, (389±163) /mL at 48 months and (412±147) /mL at 60 months, which were all significantly higher than that at the initiation of therapy ([243±146] /mL,t=19.092,18.598,12.843,8.516 and 12.980, respectively;all P<0.05).After switching to LPV/r based second-line regimen for 60 months, 43 patients occurred virological failure and 48 patients occurred immunological failure.Multivariate logistic regression showed that poor adherence (OR=48.5, 95% CI: 15.9-98.4, P<0.01) and ART drug toxicity (OR=4.5, 95% CI: 2.6-11.3, P<0.01) were the main factors associated with virological failure at 60 months.Poor adherence (OR=15.1,95% CI: 6.89-33.3, P<0.01), CD4≤100 /mL at the time of switching therapy (OR=10.5,95% CI: 5.1-21.7, P<0.01), concomitant medications (OR=3.6,95% CI:1.6-4.1,P<0.01) were main factors associated with immunological failure at 60 months.Conclusions Elderly patients (≥50 years) who failed first line regimen should switch to LPV/r contained regimen as early as possible.Adherence education should be strengthened, drug toxicity as well as complications of treatment should be managed in time and concomitant medications should be reduced.

Expression of miR-2 2 1 and miR-2 2 2 in Papillary Thyroid Carcinoma Tissues and Its Clinical Significance / 现代检验医学杂志

Objective To explore the expressions of miR-221 and miR-222 in papillary thyroid carcinoma (PTC),and relativi-ties with clinical pathological features.Methods Samples from patients of PCT (43 cases),nodular golter(21 cases),and para-carcinoma thyroid tissues(14 cases),78 cases in total (from 06/2015 to 05/2016,Shaanxi Provincial People’s Hospital) were collected.Real time-PCR tests were carried out,then analyzed in relation to clinical pathology features,and statistical a-nalysis was used to evaluate the results.Results The expressions of miR-221 and miR-222 were significantly higher in PTC (11.54±3.37,10.67±2.45)than in nodular golter (3.21±1.12,2.89±1.23)and normal thyroid tissue (2.02±0.76, 1.98±0.34)(t=3.62,3.25;3.27,3.01,all P0.05),and no differences were found in nodular golter and in normal thyroid tissue (t=0.91, 0.79,P>0.05).Conclusion miR-221 and miR-222 could be considered as a specific molecular marker of PTC,may play an important role in the diagnosis and treatment on PTC.

Effect of hepatitis C virus genotype on antiviral therapy in patients with human immunodeficiency virus/hepatitis C virus coinfection / 中华传染病杂志

Objective To investigate the effect of hepatitis C virus (HCV) genotype on antiviral therapy in patients with human immunodeficiency virus (HIV)/HCV coinfection in Henan province.Methods A total of 129 patients were coinfected with HIV and HCV, among whom, 70 were HCV 1b genotype and 57 HCV 2a genotype.And 131 patients were HIV single infection.Immunological failure rate, virological suppression, CD4+ T lymphocyte counts and liver and renal function after antiretroviral therapy (ART) were compared among the three groups.Flow cytometry was used to count CD4+ T lymphocytes and polymerase chain reaction amplification was used to detect HIV RNA.The liver and renal function were tested by automatic biochemical analysis.Statistical analysis was conducted by χ2 test, analysis of variance and LSD-t method.ResultsImmunological failure rate in HCV 1b group, HCV 2a group and HIV single infection group were 7.14% (5/70), 15.79% (9/57) and 9.92% (13/131), respectively.There was no significant statistical difference among the three groups (χ2=2.59, P>0.05).The CD4+ T lymphocyte counts in three groups were (614±258), (529±245), and (518±243) cells/μL, respectively.The difference was statistically significant (F=3.17, P0.05).The levels of aspartate transaminase, alanine aminotransferase and total bilirubin in HCV 1b group and HCV 2a group were all significantly higher than those in HIV single infection group (F=27.38, 15.22 and 7.33, respectively, all P0.05).Conclusions The main HCV genotypes in patients with HIV/HCV coinfection by blood transmission are HCV 1b and HCV 2a in Henan province.HIV/HCV coinfection does not affect the effect of ART, but could aggravate the liver damage in acquired immune deficiency syndrome patients.

Application of intravascular ultrasound and fractional flow reserve on treatment of coronary intermediate lesion / 重庆医学

Objective To compare the clinical effects of intravascular ultrasound (IVUS) and blood flow reserve fraction (FFR) in guiding the treatment of critical disease of coronary artery.Methods Forty nine patients with coronary artery disease who underwent coronary angiography were divided into IVUS group (n=43) and FFR group (n=51).In IVUS group,such as MLA ＜4 mm2 or coronary artery stenosis was insufficient,but IVUS showed unstable plaque,and we went the PCI treatment;in the FFR group,FFR＜0.75 was regarded as coronary stenting sign.The patients were followed up for 6 months.The incidence of cardiovascular adverse events was compared between the two groups.Results (1)There was no significant difference in general information and coronary angiography between the two groups (P＞ 0.05).(2)The proportion of interventional therapy in IVUS group was higher than that in FFR group (P＜0.01).(3)The incidence of adverse events between the two groups was not statistically significant (P＞0.05).Conclusion IVUS and FFR examination can be used to guide the interventional treatment of critical disease of coronary artery.However,the accuracy of IVUS can not replace the status of blood flow reserve.