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Objective@#To investigate the characteristics and pathogenic characteristics of acquired immunodeficiency syndrome (AIDS) complicated with severe pneumonia.@*Methods@#The clinical data of patients with AIDS complicated with severe pneumonia who were hospitalized and treated in the First People′s Hospital of Linhai City from January 2016 to January 2018 were collected. The laboratory test results, imaging findings, distribution of pathogens, mixed infections of pathogens, treatment and outcomes were statistically analyzed. The influencing factors of the prognosis were tested by Fisher′s exact test, and Logsitic regression analysis was used for multivariate analysis.@*Results@#Among the 42 patients, the majority were male patients(90.48%), and most of them were 21 to 50 years old(78.57%), and the onset involved multiple systems. The CD4+ T lymphocyte count was less than 200/mm2 (100.0%) in the 42 patients, including 69.05% less than 50/mm2 and 73.81% of patients had albumin levels lower than 25 g/L. Chest CT showed multiple or diffuse distribution of increased density and ground glass opacity. Various strains of microorganisms were successfully isolated from 29 cases (69.05%), a total of 76 strains. The top three of pathogen spectrum were fungi (60.53%, 46/76), Gram negative bacteria (15.79%, 12/76) and Gram positive bacteria (10.53%, 8/76); 92.86% of the patients were infected with 2 or more kinds of pathogenic bacteria. In the 42 patients, 17 cases (40.48%) survived and 25 cases (59.52%) died. Univariate analysis showed that CD4+ T lymphocyte count<50 /mm2, the albumin level<25 g/L and mechanical ventilation were related to the prognosis of the disease. Multivariate Logstic regression analysis showed that the albumin level <25 g/L and mechanical ventilation were independent risk factors affecting the prognosis of the disease.@*Conclusions@#Fungal infection is the most common infection in patients with AIDS complicated with severe pneumonia, and 92.86% of them are accompanied by mixed infections. Low albumin level and mechanical ventilation are important risk factors influencing the prognosis.
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OBJECTIVE:To observe therapeutic efficacy and safety of telbivudine combined with adefovir dipivoxil in long-term treatment of active hepatitis B cirrhosis. METHODS:76 patients with active hepatitis B cirrhosis in our hospital were ran-domly divided into observation group and control group,with 38 cases in each group. Control group was treated with adefovir dip-ivoxil 10 mg,qd;observation group was additionally treated with telbivudine 600 mg,qd,on the basis of control group. Both groups received 2-year consecutive treatment. TBIL,ALB,ALT,AST,rate of HBV-DNA negative conversion and serum virologi-cal index were compared between 2 groups after treatment,and clinical efficacy and ADR were also compared between 2 groups. RESULTS:After treatment,the levels of AST,ALB,ALT and TBIL in observation group were significantly better than the control group,with statistical significance(P<0.05);the rate of HBV-DNA negative conversion,the decreased of serum virus in observa-tion group were significantly higher than control group after 1 and 2 years treatment,with statistical significance(P<0.05). The to-tal effective rate of observation group was significantly higher than that of control group,with statistically significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Telbivudine combined with adefovir dipivoxil can significantly improve the liver function of patients with hepatitis B cirrhosis and have good long-term therapeutic efficacy with high safety.