Advantages of Chinese Medicine for Patients with Acquired Immunodeficiency Syndrome in Rural Central China / 中国结合医学杂志

OBJECTIVE@#To analyze the effect of Chinese medicine (CM) on mortality and quality of life (QOL) of acquired immunodefificiency syndrome (AIDS) patients treated with combined antiretroviral therapy (cART).@*METHODS@#A random sample of AIDS patients enrolled in the National Chinese Medicine Treatment Trial Program (NCMTP) that met the inclusion criteria was included in this study. NCMTP patients were included as the CM+cART group, and those not in the NCMTP were included as the cART group. Survival from September 2004 to September 2012 was analyzed by retrospective cohort study. QOL was analyzed by cross-sectional study.@*RESULTS@#The retrospective cohort study included 528 AIDS patients, 322 in the CM+cART group and 206 in the cART group. After 8 years, the mortality in the CM+cART group was 3.3/100 person-years, which was lower than the cART group of 5.3/100 person-years (P<0.05). The hazard ratio (HR) for mortality in the cART group was 1.6 times that of the CM+cART group by Cox proportional hazard model analysis. After controlling for gender, age, marital status, education, and CD4 T-cell count, the HR was 1.9 times higher in the cART group compared with the CM+cART group (P<0.05). The cross-sectional study investigated 275 AIDS patients. The mean scores of all QOL domains except spirituality/personal beliefs were higher in the CM+cART group than in the cART group (P<0.05).@*CONCLUSIONS@#For AIDS patients, CM could help to prolong life, decrease mortality, and improve QOL. However, there were limitations in the study, so prospective studies should be carried out to confifirm our primary results.

Histopathological features of middle cerebral artery and superficial temporal artery from patients with moyamoya disease and enlightenments on clinical treatment / 华中科技大学学报（医学）（英德文版）

The histopathological features of the middle cerebral artery (MCA) and superficial temporal artery (STA) from moyamoya disease (MMD) and their relationships with gender, age, angiography stage were explored. The causes and the clinical significance of vasculopathy of STA were also discussed. The clinical data and specimens of MCA and STA from 30 MMD patients were collected. Twelve samples of MCA and STA from non-MMD patients served as control group. Histopathological examination was then performed by measuring the thickness of intima and media, and statistical analysis was conducted. The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group. There was no significant pathological difference between the hemorrhage group and non-hemorrhage group, and between the males and females in MMD patients. Neither the age nor the digital subtraction angiography (DSA) stage was correlated with the thickness of intima in MCA and STA. MMD is a systemic vascular disease involving both intracranial and extracranial vessels. Preoperative external carotid arteriography, especially super-selective arteriography of the STA, benefits the selection of donor vessel.

Risk Factors of the Mortality among Senile HIV/AIDS Patients Intervened by Comprehensive Intervention of Chinese Medicine and Pharmacy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Chinese medicine and pharmacy (CMP) on the mortality of senile HIV/AIDS patients as adjunctive therapy.</p><p><b>METHODS</b>HIV/AIDS patients of a certain rural area of Hanna Province, who were recruited in national CMP HIV treatment trial program (NTCMTP) in 2004, were enrolled as the CMP treatment group. HIV/AIDS patients in the same village without recruiting in NTCMTP were enrolled as the non-CMP treatment group. Data related to subjects were collected from the database of NTCMTP and National HAART Reporting System. Multiple regression analysis under Cox proportional hazard model was applied to examine the risk factors for death of senile HIV/AIDS patients.</p><p><b>RESULTS</b>A total of 436 HIV/AIDS were enrolled in this study, 204 in the CMP treatment group and 232 in the non-CMP treatment group. There were 70 AIDS-relative deaths in the CMP treatment group, with 8-year mortality rate of 37.74%. There were 111 AIDS-relative deaths in the non-CMP treatment group, with 8-year mortality rate of 48.34%. The 8-year mortality rate was higher in the non-CMP treatment group than in the CMP treatment group (chi2 = 5.136, P < 0.05). Results of univariate Cox proportional hazards regression analysis showed the hazard ratio in the non-CMP treatment group was 1.41 times that of the CMP treatment group (P < 0.05). Result of multivariate Cox proportional hazards regression analysis showed the hazard ratio in the non-CMP treatment group was 1.44 times that of the CMP treatment group (P < 0.05). Besides, gender and marital conditions were significantly associated with death of HIV/AIDS patients.</p><p><b>CONCLUSION</b>CMP treatment was favorable to lower the mortality rate of senile HIV/AIDS patients, and its objective evaluation awaits for further prospective study.</p>

Spinal 5-HT3AR contributes to BmK I-induced inflammatory pain in rats / 生理学报

Subcutaneous injection of BmK I could be adopted to well establish a novel pain model. Moreover, 5-hydroxytryptamine (serotonin, 5-HT) receptor is involved in regulating animal pain-related behaviors. However, the underlying mechanism of 5-HT3R on BmK I-induced pain remains unclear. Animal behavioral testing, RT-PCR and Western blotting were used to yield the following results: first, intraplantar (i.pl.) injection of BmK I (10 μg) induced elevated mRNA and protein levels of 5-HT3AR in bilateral L4-L5 spinal cord; Second, intrathecal (i.t.) injection of ondansetron (a specific antagonist of 5-HT3AR) reduced spontaneous pain responses, attenuated unilateral thermal and bilateral mechanical hypersensitivity elicited by BmK I; Microglia could be activated by BmK I (i.pl.) in both sides of L4-L5 spinal cord, and this effect was reversed by intrathecal pre-treatment with 5-HT3AR antagonist. Meanwhile, the 5-HT3AR in L4-L5 spinal cord was almost co-localized with NeuN (a marker of nerve cell), but not co-expressed with Iba-1 (a marker of microglia). Finally, the expression level of CX3CL1 and CX3CR1 was reduced by intrathecal pre-treatment with ondansetron. Our results indicate that both 5-HT3AR signaling pathway and microglia are activated in the process of induction and maintenance of BmK I-induced pain nociception. Meanwhile, our results suggest that the neuronal 5-HT3AR may communicate with microglia indirectly via CX3CL1 which is involved in regulating the BmK I-induced hyperalgesia and sensitization.

Biomechanical study of compressive strength distribution on the whole spine endplates / 医用生物力学

Objective To study distributions of the compressive strength on the whole spine endplates by measuring the compressive strength at different locations of the whole spine endplates. Methods Indentation tests were performed at 49 locations in 225 bony endplates of intact human vertebrae (C3 S1) from 5 fresh male specimens to record the failure loads. Results (1) For the whole spine endplates, failure loads of the cervical and lumbar spine were found to be higher than those of the thoracic spine (P<0.01).The failure load was first decreased from C3 to C7 before increasing to T1, and then dropping through T7 and rising again from T8, reaching the maximum at L4, and dropping at L5 before increasing again at S1. (2) The failure load at inferior cervical endplates was significantly higher than that at superior endplates except at C5 and T1 (P＜0.05). (3) Within the intervertebral space, the cranial endplates had a higher yield stress than the caudal endplates except at C5/6, T12/L1 and L5/S1. (4) Failure loads were generally increased from the central to peripheral zones (P＜0.05). (5) For different angular points, failure load distributions were found among the endplates (P<0.01). (6) Distributions of the compressive strength on the endplates varied significantly within the whole spine（P<0.01）. It was found that at C3/4, the failure load at posterior was higher than that at anterior, but at C5/6, the failure load at posterior and anterior was balanced. At T1, the failure load was found to be higher at posterior again, until passing through T2 5, and at T6 L3, the failure load at anterior was higher than that at posterior, and balanced between the anterior and posterior again at L4. At L5 S1, the failure load at posterior was higher than that at anterior. Conclusions The strength distributions on the endplates varied significantly at different locations within the whole spine, which was closely correlated with the physiological curve of the spine. The failure load at inferior endplates was higher than that at superior endplates and it was increased from central to peripheral zones. Within the intervertebral space, the compressive strength at cranial endplates was higher than that at caudal endplates.