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Objective To investigate the clinical features and prognosis factors of acquired immunodeficiency syndrome(AIDS)patients complicated with cryptococcal meningitis(CM).Methods Retrospective analyses were performed on clinical features,laboratory data,treatment status and related prognosis factors in 8 1 AIDS patients with CM admitted to the Department of Infectious Diseases,Beijing You'an Hospital,Capital Medical University from January 2010 to December 2017.The t test,rank sum test and x2 test were employed to analyze the data.Results of the 81 AIDS patients with CM,71 cases were infected with human immunodeficiency virus(HIV)by sexual transmission(87.7％).The most common clinical symptoms were fever in 60(74.1％),headache in 72(88.9％),and nausea and vomiting in 56(69.1％),Cerebrospinal fluid(CSF)examination results show that 60 cases(74.1％)had elevated opening pressure,the white blood cell count was 17.0(6.0,44.5)×106/L,monocyte count was 9.0(3.0,29.5)×106/L,the level of chloride was(117.26±5.61)mmol/L,of glucose was 2.89(2.05,3.41)mmol/L,of protein was 0.32(0.21,0.65)g/L,ink staining positive rate was 84.0％(68/81),fungal culture positive rate was 59.3％(48/81).The positive rate of serum cryptococcal antigen was 96.3％(78/81),and CSF cryptococcal antigen positive rate was 93.8％(76/81).The clinical efficacies were not significant different among different treatment regimens(x2=1.479,P=0.533).After treatment,60 patients survived and 21 died,with an overall mortality rate of 25.9％.Univariate analysis showed that consciousness disorder and CSF opening pressure were significantly higher in the death group than those in the survival group(x2=22.365,t=0.317,respectively,both P＜0.05),while serum albumin(Alb)and CD4+T lymphocyte counts were significantly lower in the death group than those in the survival group(t=7.975,Z=-3.073,respectively,both P＜0.05).Multivariate logistic regression analysis showed that consciousness disorder and Alb were independent factors influencing the clinical outcome of AIDS patients with CM.Consciousness disorder was related with poor outcome(odd ratio(OR)=26.704,P=0.011,95％confidence interval(CI)2.115-337.247),and higher Alb was related with good outcome(OR=0.671,P=0.005,95％CI0.507-0.888).The area under the receiver operating characteristic curve of serum Alb for predicting poor outcomes of AIDS patients with CM was 0.932(95％CI0.859-0.998,P＜0.01).By using 31.7 g/L as cut-off value,the sensitivity was 95％and the specificity was 8 1％for predicting poor outcome.Conclusions AIDS complicated with CM has a high mortality rate,and its clinical features are lack of specificity.Consciousness disorder and Alb are independent prognosis factors.
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Objective@#To investigate the clinical features and prognosis factors of acquired immunodeficiency syndrome (AIDS) patients complicated with cryptococcal meningitis (CM).@*Methods@#Retrospective analyses were performed on clinical features, laboratory data, treatment status and related prognosis factors in 81 AIDS patients with CM admitted to the Department of Infectious Diseases, Beijing You′an Hospital, Capital Medical University from January 2010 to December 2017. The t test, rank sum test and χ2 test were employed to analyze the data.@*Results@#Of the 81 AIDS patients with CM, 71 cases were infected with human immunodeficiency virus (HIV) by sexual transmission (87.7%). The most common clinical symptoms were fever in 60 (74.1%), headache in 72 (88.9%), and nausea and vomiting in 56 (69.1%). Cerebrospinal fluid (CSF) examination results show that 60 cases (74.1%) had elevated opening pressure, the white blood cell count was 17.0 (6.0, 44.5)×106/L, monocyte count was 9.0 (3.0, 29.5)×106/L, the level of chloride was (117.26±5.61) mmol/L, of glucose was 2.89 (2.05, 3.41) mmol/L, of protein was 0.32 (0.21, 0.65) g/L, ink staining positive rate was 84.0% (68/81), fungal culture positive rate was 59.3% (48/81). The positive rate of serum cryptococcal antigen was 96.3% (78/81), and CSF cryptococcal antigen positive rate was 93.8% (76/81). The clinical efficacies were not significant different among different treatment regimens (χ2=1.479, P=0.533). After treatment, 60 patients survived and 21 died, with an overall mortality rate of 25.9%. Univariate analysis showed that consciousness disorder and CSF opening pressure were significantly higher in the death group than those in the survival group (χ2=22.365, t=0.317, respectively, both P<0.05), while serum albumin (Alb) and CD4+ T lymphocyte counts were significantly lower in the death group than those in the survival group (t=7.975, Z=-3.073, respectively, both P<0.05). Multivariate logistic regression analysis showed that consciousness disorder and Alb were independent factors influencing the clinical outcome of AIDS patients with CM. Consciousness disorder was related with poor outcome (odd ratio (OR)=26.704, P=0.011, 95% confidence interval (CI) 2.115-337.247), and higher Alb was related with good outcome (OR=0.671, P=0.005, 95%CI 0.507-0.888). The area under the receiver operating characteristic curve of serum Alb for predicting poor outcomes of AIDS patients with CM was 0.932 (95% CI 0.859-0.998, P<0.01). By using 31.7 g/L as cut-off value, the sensitivity was 95% and the specificity was 81% for predicting poor outcome.@*Conclusions@#AIDS complicated with CM has a high mortality rate, and its clinical features are lack of specificity. Consciousness disorder and Alb are independent prognosis factors.
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Combined with the five Zang Yin-Yang theory, to discuss the spinal marrow and cerebral Yin Yang state. As the internal organs, we believe that the spinal marrow and cerebral are substantial Yin and functional Yang. Further we can diagnose and treat the cerebral and spinal marrow injury related diseases. In the clinical therapy of acute and chronic cerebral and spinal marrow diseases, we should maintain the substantial Yin by avoiding injury, preventing spinal degeneration and maintaining the blood supply; and we should adjusting the functional Yang by nourishing the blood and promoting blood circulation, calming the liver to stop the wind, keep Yin and Weiqi in balance, tonifying the spleen and kidney etc. From the author's experience ,the patient with acute cerebral and spinal marrow injury diseases should be treated by regulating lung, liver, spleen and kidney to remove the wet water and purge the fire;the patient with chronic cerebral and spinal marrow injury diseases should be treated by regulating heart, liver, spleen and kidney to enhance Yang and nourish Yin.
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Objective:To study the improving effect of curcumin on cardiac function and its influence on myocardial collagen concentration in rats with myocardial infarction (MI).Methods:A total of 60 healthy adult male SD rats were randomly divided into sham operation group (n=10,survived rats n=9)and operation group [n=50,left an-terior descending artery was ligated,they were randomly divided into following four groups,on 28 d the treatment and survived rats in every group were:myocardial infarction (MI)group (n=9),control group (received intraper-itoneal injection of mixed solution,n= 10)and curcumin group (received intraperitoneal injection of curcumin, 100mg·kg-1 · d-1 n= 12)].After four weeks,M-mode echocardiography was used to measure left ventricular shortening fraction (LVFS),left ventricular ejection fraction (LVEF)and heart rate (HR).Masson staining was used to detect the myocardial fibrosis alteration after MI.Immunohistochemistry was used to measure expressions of myocardial collagen type Ⅰ and Ⅲ,and ratio of collagen Ⅰ/Ⅲ.Results:Compared with MI group and control group,after four weeks,there were significant rise in LVFS [(17.23±1.97)%,(19.34±0.83)% vs.(26.70± 1.15)%]and LVEF [(42.08±5.50)%,(41.63± 1.81)% vs.(56.76±2.49)%],significant reductions in HR [(433.16±20.05)beats/min,(433.04±24.17)beats/min vs.(403.96±7.08)beats/min],concentrations of myo-cardial collagen Ⅰ and Ⅲ,and ratio of collagen Ⅰ/Ⅲ [(13.5±0.9),(13.9±1.0)vs.(10.3±1.6)]in curcumin group,P <0.01 all.Masson staining indicated that acute myocardial infarction can cause significant left ventricular interstitial fibrosis.Conclusion:Curcumin could significantly improve cardiac function and inhibit myocardial fibro-sis level in rats with acute myocardial infarction.
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Objective:To investigate effect of curcumin on serum gelatinases level in patients with unstable angina pectoris (UAP). Methods:A total of 80 UAP patients admitted from January 2010 to September 2010 were enrolled and randomly divided into curcumin treatment group (n=40) and routine treatment control group (n=40). Serum levels of gelatinases [contain matrix metalloproteinase (MMP)-2 and -9] of the two groups were measured before and 30d after treatment.Results: Compared with before treatment , after treatment, serum levels of gelatinases significantly decreased [MMP-2:(52.64±6.77)ng/ml vs.(32.65±1.67)ng/ml,MMP-9:(56.75±7.34)ng/ml vs.(35±1.88)ng/ml]in curcumin treatment group (P<0.01), and they were significantly lower than those of routine treatment control group[MMP-2:(32.65±1.67)ng/ml vs.(37.78±2.76)ng/ml,MMP9:(35±1.88)ng/ml vs.(40.23±1.95)ng/ml]],P<0.05. Conclusion:Curcumin could decrease serum levels of gelatinases in patients with unstable angina pectoris, and possesses effect stabilizing coronary artery plaque.
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Objective: To investigate effect of curcumin on serum gelatinases levels in patients with unstable angina pectoris（UAP）. Methods： A total of 80 UAP patients admitted from January 2010 to September 2010 were enrolled and randomly divided into curcumin treatment group (n=40) and routine treatment control group (n=40). Serum levels of gelatinases [contain matrix metalloproteinase（MMP）-2 and -9) of the two groups were measured before and 30d after treatment. Results：Compared with before treatment , after treatment, serum gelatinases levels significantly decreased [MMP-2：（52.64±6.77）ng/ml vs. （32.65±1.67）ng/ml，MMP-9：（56.75±7.34）ng/ml vs.（35±1.88）ng/ml ] (P<0.01) in curcumin treatment group (P<0.01), and they were significantly lower than those of routine treatment control group [MMP-2：（32.65±1.67）ng/ml vs.（37.78±2.76）ng/ml，MMP-9：（35±1.88）ng/ml vs.（40.23±1.95）ng/ml ] , P<0.05 all. Conclusion：Curcumin could decrease serum levels of gelatinases in patients with unstable angina pectoris, and possesses effect of stabilization coronary artery plaque.