The 481st case: fever, rash, and cough / 中华内科杂志

Talaromyces Marneffei infection is rarely reported in patients with chronic active Epstein-Barr virus (EBV) infection. We reported an old man with chronic fever, pleomorphic rash, cough, EBV viraemia, and secondary hemophagocytic syndrome. Repeated histological biopsy and culture of skin lesions revealed Talaromyces Marneffei. This patient was diagnosed as chronic active EBV infection, and Talaromyces Marneffei infection. After treated with glucocorticoid steroids and anti-fungal therapy, the patient finally recovered. EBV infection is usually seen in immune compromised patients, who are susceptible to opportunistic pathogens rarely as Talaromyces Marneffei in this case.

Listeria monocytogenes meningitis in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective To summarize the clinical characteristics of SLE patients complicated with Listeria monocytogenes meningitis (LMM).Methods The clinical manifestations,systemic involvements,laboratory tests,cerebrospinal fluid (CSF) examinations,treatment and prognosis of SLE inpatients combined with LMM in Peking Union Medical College Hospital during Janurary 2000 to December 2015 were retrospectively analyzed.Results Eight SLE patients with LMM accounted for 0.14％ of the 5 675 hospitalized SLE patients.Seven were female and 1 was male,with the mean age of (35±16) year.Headache (7/8) was the most common neurological symptom followed by positive meningeal irritation sign (5/8),unconsciousness (3/8) and nausea or vomiting (2/8).Increased intracranial pressure was found in 7 cases and 4 of them were even higher than 330 mmH2O.CSF protein elevated in 6 cases and CSF glucose decreased in 6 cases.LMM often occurred in inactive or mild active SLE with the average SLE disease activity index (SLEDAI) score of 4.7±1.5.Systemic manifestations included hematologic changes (6/8),rashes (4/8),renal involvement (4/8) and arthritis (3/8),etc.Treated by autibiotics such as penicillin and medications for SLE,7 patients achieved clinical improvements,1 patient died.Conclusion LMM is one of the opportunistic infections in SLE patients and tends to occur in inactive lupus cases.There are unspecific clinical and laboratory features and CSF changes which maybe overlap and mix up with systemic manifestations of SLE.That's why it is necessary to take continuous cultures of CSF.Early identification and appropriate treatment lead to prognostic improvement of these patients.

An antiretroviral regimen containing 6 months of stavudine followed by long-term zidovudine for first-line HIV therapy is optimal in resource-limited settings: a prospective, multicenter study in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.</p><p><b>METHODS</b>This prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.</p><p><b>RESULTS</b>In terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.</p><p><b>CONCLUSION</b>AZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.</p>

A clinical analysis of AIDS-related non-Hodgkin lymphoma in 5 patients and review of literature / 中华内科杂志

Objective To analyze the clinical characteristics of AIDS-related non-Hodgkin lymphoma(ARL)and review relative literature for the diagnosis and treatment of ARL.Method The clinical data of ARL patients admitted to Peking Union Medical College Hospital from April 2009 to April 2011 were retrospectively analyzed.Results Five male ARL patients aged 32 to 65 years old were included in this retrospective study.Among them,two patients were found to be HIV-positive for the first time,three were on regular highly active anti-retroviral therapy(HAART)for 7-8 months before the emergence of lymphoma-related symptoms.CD4+ T cell count was(69-232)× 106/L at presentation.Two patients firstly presented with sore throat and throat ulcer,one with cervical nodules,one with pelvic mass,one with fever and edema in right thigh.Through pathological analysis,four patients had B cell-originated lymphoma,with one Burkitt lymphoma and three diffuse large B cell lymphomas; one patient had T-cell lymphoma.Four patients were treated with chemotherapy,with one complete remission,one relapse,one non-response,and one death.One patient had radiotherapy only and had progressed disease.Bone marrow suppression and gastrointestinal disturbance were the main adverse effects of chemotherapy.Conclusions Lymphoma should be considered in any HIV-infected patients presented with unexplainable adenopathy,recurrent sore throat or throat ulcer,or fever of unknown origin.Biopsy should be rigorously carried out.Appropriate chemotherapy,together with HAART,may improve the prognosis greatly.

The impact of highly active antiretroviral therapy on bone mineral density in human immunodeficiency virus infected patients / 中华内科杂志

Objective To evaluate the influence of highly active antiretroviral therapy ( HAART) on bone mineral density ( BMD ) of human immunodeficiency virus ( HIV) infected patients and correlating clinical factors. Methods The clinical data from 2007 to 2008 were analyzed, including 50 patients treated with HAART (named treated group) ,12 HIV-infected antiretroviral-naive patients (named untreated group) and 20 healthy people (named control group).Lumbar, femoral neck, femur, femoral greater trochanter and whole body BMD were measured by dual energy X-ray absorptiometry.The data were respectively analyzed.Results There were 19 (38.0% ) patients with osteopenia and 1(2.0% ) patient with osteoporosis in the treated group.There were 6(50.0% ) patients with osteopenia and 2 (16.7% ) patient with osteoporosis in the untreated group.There were 5(25.0% ) patients with osteopenia, no one with osteoporosis in the control group.The prevalence of osteopenia/osteoporosis was statistically higher in the untreated group than that in the control group (P = 0.02).The BMD of femur, femoral neck and greater trochanter [(0.97±0.14) , (0.91 ±0.13 ) , (0.76 ±0.12) g/cm2] in the HIV-infected group (including the treated and untreated group) were significantly lower than that in the control group [(1.04±.12) , (0.98±.14) , (0.84±0.11) g/cm2 ,P <0.05].There were no significantly differences in the BMD between the untreated group and the treated group.In the treated group, osteopenia/osteoporosis correlated with body weight less than 60 kg (r=0.074,P =0.004) and the viral load before HAART(r=5.103,P =0.021).Conclusions The prevalence of osteopenia and osteoporosis in antiretroviral-naive HIV-infected patients is higher.The BMD of HIV-infected patients are reduced compared with the healthy people.The BMD is similar among HIVinfected patients irrespective of antiretroviral treatment Body weight less than 60 kg and the viral load before HAART are the risk factors of osteopenia/osteoporosis for the HIV-infected antiretroviral patients.

Preliminary study of the cultivation and growth characteristics of human salivary gland epithelial cells / 实用口腔医学杂志

Objective:To establish a culture method of human salivary gland epithelial cells and to study their growth characteristics in vitro.Methods:Tissue explant technic was employed to culture human salivary gland epithelial cells in serum free medium (SFM),1∶1 DMEM/F12 and 1∶1 DMEM/F12 containing 25 ml/L fetal boven serum (FBS) respectively.The morphology of the cultured cells was observed by phase contract microscope.The cell growth was studied by cell counting.The cells were identified by HE staining,PAS staining and SP staining.Results:Growth of human salivary gland epithelial cells was observed in primary culture in the three kinds of medium in all 10 cases. The cultured cells were epidermoid, positive for cytokeratin, negative for Vimentin and positive for PAS staining. The cells in SFM could be subcultured for five passages,while only for one passage in the other two kinds of medium.Conclusion:SFM is superior to serum free 1∶1 DMEM/F12 or 1∶1 DMEM/F12 containing 25 ml/L FBS for the culture of human salivary gland epithelial cells.

Docetaxel inhibites the proliferation of adenoid cystic carcinoma SACC-83 cells of salivary gland / 实用口腔医学杂志

Objective:To study the effects of Docetaxel o n the proliferation of adenoid cystic carcinoma SACC-83 cells of salivary gland. Methods:The inhibitory effects of Docetaxel on the proliferatio n of SACC-83 cells were investigated with cell counting, soft agar clonogenic a ssay, and flow cytometry. Results:With the exposure time of 24, 48 or 72 h the IC 30(nmol/L) of Docetaxel was 1.39,1.26 and 0.47, the I C 50(nmol/L) 13.02, 3.34 and 1.26 respectively; the relative antitumor acti vity (RAA) of the drug against SACC-83 cells was 330, 1 289 and 3 426 respectiv ely. After the cells had been treated for 72 h, the percentages of G 1, S and G 2 phase cells in the cell cycle in the control group were 73.8,19.8 and 6.4, in IC 30 group 65.0, 29.5 and 5.5, in IC 50 group 57.6,42.4 and 0, res pectively. The clonogenesity (%) in control, IC 30 and IC 50 groups we re 36.0?0.5,8.3?2.5 and 0.5?0.3 respectively. Conclusion:Doc etaxel may inhibit the proliferation of SACC-83 cells in a dose and time depend ent way.

The effects of 17 beta-estradiol on the proliferation and metastasis of salivary mucoepidermoid carcinoma M_3SP_4 cells / 实用口腔医学杂志

Objective:To study the effects of 17 beta-estradiol (E2) on the proliferation and metastasis potential of salivary gland mucoepidermoid carcinoma M_3SP_4 cells. Methods:The effects of E2 on the potential of proliferation and metastasis of M_3SP_4 cells were investigated by cell counting, MTT assay, clonegenetic assay, in vivo tumour growth and metastasis assay in nude mice.The expression of VEGF,c-erbB-2,Ki-67 and P16 in M_3SP_4 cells was examined by immunohistochemistry assay. Results:E2 increased the proliferation of M_3SP_4 cells at 10~-10-10~-5 mol/L. E2 at 10~-7 mol/L showed the strongest effects.After treatment with E2 at 10~-7 mol/L,the population doubling time of M_3SP_4 cells decreased by 10.8%,clonegenecity increased by 225%, VEGF,c-erbB-2 and Ki-67 expression increased,P16 decreased.In the in vivo assay,the tumour growth increased by 65% and metastasis increased by 609% in nude mice treated with E2 at 0.005 2 mg/d. Conclusion:E2 may stimulate the proliferation and metastasis potential of M_3SP_4 cells.

The influence of unilateral occlusal contact condition on the central biting electromyography activity of masseter and temporalis-anterior muscles / 实用口腔医学杂志

0.05).During unilateral contact maximal biting EMG activity of the temporalis-anterior muscle on the bitting-side was higher than that on the disoccluded side(P0.05).Conclusion: Vertical distance occlusion contact may affect the EMG activity of temporalis-anterior muscle but not on that of masseter muscle during the central biting.