RESUMO
Objective:To discuss the clinical characteristics of the Pneumocystis jirovecii pneumonia (PCP) in the non-HIV-infected blood disease patients, and to analyze its risk factors, treatment methods, prognosis and prevention measures.Methods:A female patient aged 18years old was confirmed as acute myeloid leukemia (AML) , and experienced dyspnea, chest congestion and hypoxaemia during the recovery period of hemogram after chemotherapy.The chest CT showed the bilateral lung diffuse ground glass density images.The patient had a dry cough and the oxygen saturation was gradually decreased to 75％5dafter antibacteriological treatment.A repeat chest CT showed enlarged diffuse ground glass density images on both lungs.Considering about the possibility of PCP, the patient received oral trimethoprim/sulfamethoxazole (TMP/SMX) 1g, once every 6h, in combination with caspofungin.Results:Two days later, the symptoms of the patients were not improved.The patient was transferred to ICU and was diagnosed PCP by bronchoalveolar lavage.The patient was switched to oral TMP/SMX2g, once every 8h, in combination with caspofungin.Meanwhile, the patient received bi-level positive airway pressure ventilation (Bipap) for the increased work of breathing.Five days later, the symptoms of the patients were improved and the Bipap was stopped.The patient got better and discharged 5dlater.The patient continuely received oral TMP/SMX 2g, once every 8hfor 36d.Conclusion:Prevention of PCP should be focused, in the non-HIV-infected blood disease patients receiving chemotherapy.Diagnosis of PCP should be considered in these patients without prevention who once have suspected clinical manifestation of PCP in non-granulocytic phase.Early empirical treatment of PCP and ICU management in the non-HIV-infected blood disease patients with acute respiratory failure are the keys to reduce death and improve the prognosis of PCP.
RESUMO
Objective:To understand the progress in AIDS/HIV research over the last 10 years through a bibliometric approach.Methods:The literatures were searched in Web of Science citation database(1996-2005)using the following terms:"HIV*"or"AIDS"or"human immunodeficiency virus*"or"acquired immune deficiency syndrome".The searching results were analyzed by the Derwent Analytics software concerning the article numbers and the total citations by countries,institutes and authors,and AIDS/HIV magazine distribution,in an effort to discover AIDS/HIV research progress in and outside China in recent years.Results:The annual numbers(about 12000)of AIDS/HIV articles published in Web of Science had little change from 1996 to 2005.The U.S.played a leading role the AIDS/HIV research in the world;China has made a great progress in AIDS/HIV research in the recent years,but still lagging far behind western countries like the U.S.,England, France,Italy,German,etc.The etiology,pathogenesis of AIDS,the HIV coreceptors(CXCR4 and CCRS),and HIV drugs and vaccines were the focuses of AIDS/HIV research in the world in the recent years;meanwhile,the isolation,purification and function of antiviral and antifungal proteins from plants,HIV coreceptors(CXCR4 and CCR5),and APOBEC3G protein were the focuses in China.Conclusion:Due to the worldwide epidemic of AIDS/HIV and the increasing attention from scientists,the prevention and treatment of AIDS/HIV had been a research focus in recent years.The research of AIDS/HIV in China has been progressing rapidly,but still lagging behind its international peers.The research contents and focuses of China are different from the international ones.