目的 探究艾滋病(AIDS)合并马尔尼菲青霉病(PSM)的感染率，以及常规实验室检查结果和5种抗真菌药物对马尔尼菲青霉菌(PM)的体外抗菌活性。 方法 2006年1月-2009年11月间确诊AIDS患者326例，从其血液、骨髓培养出65株PM，检测该65例患者的血常规、肝功能和肾功能，并对20株酵母相PM进行体外药敏进行分析。 结果 AIDS合并PSM的感染率为19.94%；外周血常规：WBClt;4.0×109/L者48例，HBlt;100 g/L者51例，PLTlt;100×109/L者46例。肝功能检查：ALTgt;40 U/L者49，ASTgt;40 U/L者51例，GGTgt;60 U/L者44例，ALPgt;150 U/L者36例，ALBlt;35 g/L者53例，A/G倒置者50例。肾功能检查：BUNgt;7.2 mmol/L者9例，Crgt;150 μmol/L者4例。20株酵母相PM对5-氟胞嘧啶(5FC)、两性霉素B(AMB)、氟康唑(FCA)、伊曲康唑(ITR)、伏立康唑(VRC)的敏感率分别为75%、90%、80%、90%、90%。 结论 AIDS合并PSM感染率较高；患者感染后外周血WBC、HB、PLT通常低于正常人，肝功能多表现异常，肾功能的改变较少；对PM的治疗以AMB、ITR、VRC为首选。
【摘要】 目的 掌握德昌县艾滋病流行趋势，为制订防控措施提供准确依据。 方法 利用描述流行病学方法分析德昌县1995年以来艾滋病疫情资料。 结果 自1995年德昌县报告首例艾滋病感染者至2011年8月共报告艾滋病感染者/患者262例，年均报告发病率18.95/10万，2008年-2010年报告发病率呈快速增长趋势；男性年均发病率26.57/10万，女性11.05/10万，差异有统计学意义（χ2=43.94，P=0.002），男女性别比为2.49︰1；年龄分布以20~45岁和55~75岁高发为特征，两个年龄段合计占病例报告总数93.49%；农民、不详2项职业的艾滋病病例数占全部病例的82.4%，职业高峰明显；异性传播及注射毒品是德昌县艾滋病的主要传播途径，分别占病例总数的64.89%、32.82%。异性传播中有29例为夫妻间家庭式感染病例，另外还有3例为母婴传播病例。 结论 德昌县艾滋病疫情快速增长，形势严峻，须加强艾滋病防治知识宣传，提高全民预防艾滋病的意识；各部门互相合作，对娱乐场所进行监管；加强对流动人口的管理；进一步完善咨询检测网络，提高艾滋病的发现率，以有效控制艾滋病的蔓延。【Abstract】 Objective To understand the epidemiological trend of acquired immune deficiency syndrome (AIDS) in Dechang County so as to provide a scientific base for prevention and control of AIDS. Methods Descriptive epidemiological analysis was conducted on the AIDS epidemic data in Dechang county. Results From 1995 when the first case of HIV infection was confirmed to August 2011, a total of 262 cases of HIV/AIDS were reported with a total infection rate of 18.95/100 000. From 2008 to 2010, the reported infections showed rapid growth. The annual infection rate of male was 26.57/100 000 and female 11.05/100 000 with a significant difference (χ2＝43.94, P＝0.002). The ratio of male to female infections was 2.49∶1. Most of the AIDS cases were young adults aged between 20 and 45 years and old people aged between 55 and 75 years old who occupied 93.49% of the total infectious cases. The number of reported AIDS cases of farmer and unknown occupations accounted for 82.4% and there was an obvious occupations peak. Most patients in the county were infected by heterosexual sexual contact and injecting drugs, which accounted for 64.89% and 32.82% of the total respectively. The AIDS cases of 29 infected couples and 3 mother-to-child transmission. Conclusions AIDS epidemic growth is rapid in Dechang county with the situation being quite grim. We should enhance the AIDS prevention propaganda in the publicity, to raise national awareness of AIDS prevention. The related departments should cooperate to regulate the illegal entertainment and strengthen the management of migrant workers. The counseling and testing network should be improved so as to raise the detection rate and control the spread of AIDS.
Objective To investigate the feasibility and methods of surgical treatment for HIV/AIDS patients with otolaryngology diseases. Methods From January 2016 to February 2017, nineteen patients with HIV/AIDS who underwent otolaryngology surgery were included in this study. The demographic data of patients, including age, gender, course of disease, CD4+ T lymphocyte count before operation and disease type were collected and the clinical treatment methods were summarized. The curative effect was analyzed retrospectively. Results The operations of all the 19 patients were successful without occupational exposure among medical staff. One patient with papillary squamous cell carcinoma did not received further treatment. The other 18 patients recovered well and their life quality was significantly improved. Conclusions If HIV/AIDS patients with otolaryngological diseases are examined preoperatively and have no surgical contraindications, the operation shloud be performed by controlling the surgical indications strictly. The life quality of the patients may be improved and the patients’ life may be prolonged after the surgery.
Objective To investigate the level and influencing factors of perceived HIV stigma and discrimination among people living with HIV/AIDS (PLWHA). Methods By using convenience sampling method, 123 patients were recruited from the department of infectious diseases in a tertiary hospital in Chengdu from April to May in 2017. Berger HIV stigma scale was used to measure the level of perceived HIV stigma. Results The mean score of Berger HIV stigma scale was 113.72±17.890, which revealed a middle to upper level. Among the four subscales, the score of disclosure concerns (3.07±0.462) was the highest, while the score of negative self-image (2.70±0.494) was the lowest. Multiple regression analysis showed that gender and self-perceived health status were the influencing factors of perceived HIV stigma. Conclusions The level of perceived HIV stigma among PLWHA is from middle to upper level. Female gender and poor self-perceived health status are associated with a higher level of perceived HIV stigma. Individualized interventions are required in order to reduce the level of HIV stigma.
ObjectiveTo investigate the ultrasonic changes of liver during various immune periods with different number of CD4+ T lymphocytes in HIV/AIDS patients with chronic viral hepatitis. MethodsThe clinical data of 100 patients with chronic viral hepatitis diagnosed between January 2010 and December 2012 were selected. Among them, 50 simple chronic viral hepatitis patients were designated as the control group, and the other 50 HIV/AIDS patients with chronic viral hepatitis were regarded as the experimental group. Ultrasonographic observation was applied on patients of the experimental group according to different immune period based on the number of CD4+ T lymphocytes. Indexes observed included liver size, the edge of liver, capsule of liver and hepatic parenchymal echo. The cross-check analysis was employed between observed results and clinical laboratory results. ResultsAbnormal changes of the experimental group were shown on the ultrasound observation of liver in different CD4+ T lymphocyte count immune periods, including enlargement of the liver, slightly blunt liver margin, slightly thick capsule, dense and uniform, slightly rough and not so uniform, or rough and not uniform hepatic parenchymal echo. There was no significant difference in ultrasonic changes of liver between the two groups when the CD4+ T cell number was over 300/mm3. However, the difference was significant when the CD4+ T cell number was below 100/mm3. ConclusionLiver abnormalities become more obvious as CD4+ T cell count decreases in HIV/AIDS patients with chronic viral hepatitis. Comprehensive considerations of various liver ultrasound indicators are helpful in clinical evaluation of HIV/AIDS patients with chronic viral hepatitis.
Acquired Immunodeficiency Syndrome (AIDS) is a severe infectious disease induced by human immuno deficiency virus (HIV). Laboratory testing plays an important role in the diagnosis of HIV/AIDS. In general, laboratory testing includes detection of virus antibodies and antigens, virus RNA, immune cells (CD4+, CD8+) and anti-HIV drug resistance. During the past twenty years, great progress has been made in laboratory testing. As research on HIV/AIDS has advanced and biotechnology has developed rapidly, different methods of testing have been discovered. In recent years, the application of molecular biotechnology and immunology has led to important advances for epidemiological surveys, clinical diagnosis and treatment of HIV. The existence of a testing method with high sensitivity and specificity is not only helpful for early diagnosis and prediction, monitoring and evaluation of therapeutic efficacy, but can also reduce the risk of false-negative results. HIV laboratory testing is now developing towards a simple, rapid, sensitive, accurate and automatic way of diagnosing this condition.
【摘要】 目的 探讨综合性医院内获得性免疫缺陷综合征（acquired immune deficiency syndrome，AIDS）患者的肺部表现及其特征。 方法 回顾性分析2006年2月－2009年12月收治的58例AIDS患者肺部病变的临床资料。 结果 58例患者中男47例，女11例，男女比例为4.27∶1；年龄6~78岁，平均43岁，其中lt;50岁者36例，占62.1%，gt;50岁22例，占37.9%。肺部表现是AIDS患者入住综合性医院的常见临床表现，居各种临床表现的首位（占55.2%）。主要有弥漫性肺部疾病和肺结核，分别是21例（36.2%）和23例（39.7%），收治的主要科室是呼吸内科38例（65.5%）和传染科12例（20.7%）；常见的临床症状有发热、咳嗽、活动后气促或呼吸困难；其肺部影像学表现多样，有毛玻璃样变、弥漫性结节影、斑片影、肺内块影或肺内空洞、纤维条索影或伴胸水；其常见伴随症状有口腔溃疡真菌、腹泻或其他消化道症状，及其皮疹、贫血、神经系统症状等；同时也有部分患者合并乙型肝炎病毒/丙型肝炎病毒/梅毒等混合感染。 结论 AIDS的肺部病变是综合性医院住院AIDS患者的主要表现，提高呼吸科医师对AIDS患者肺部表现的认识将有利于AIDS的临床防治。【Abstract】 Objective To investigate the clinical characteristics of acquired immune deficiency syndrome (AIDS) with pulmonary diseases in comprehensive hospitals. Methods The clinical data of 58 cases of AIDS with pulmonary diseases admitted in our hospital from 2006 to 2009 were analysed retrospectively. Results Among the patients, there were 47 males and 11 females, and the proportion of the number of males to females was 4.27∶1. Their age ranged from 6 to 78 years old, averaging at 43. Thirty-six patients (62.07%) were under 50 years old; and there were 22 patients (37.93%) aged 50 or above. The pulmonary expression was common in AIDS patients admitted into comprehensive hospitals, occupying the first place in various clinical manifestatiosn (55.24%). Pulmonary expressions of AIDS were mainly diffuse pulmonary diseases and pulmonary tuberculosis, which had 21 (36.21%) and 23 (39.66%) cases respectively. Chief treating departments were Department of Respiratory Medicine (65.52%) and Department of Infective Diseases (20.69%). Its common symptoms included fever, cough, shortness of breath after activities or dyspnea; Its pulmonary image had various manifestations including ground-glass opacity (GGO), diffuse nodal shadow, spot and thin piece shadow, pulmonary chunk shadow or cavity, fibre twigs shadow or/and hydrothorax; Its common combined symptoms included oral cavity ulcer fungus infection, diarrhoea or other digestive tract symptoms, and erythra, anemia, and nervus system symptoms, etc. There were still some other cases of combined viral hepatitis type B, type C, or syphilis. Conclusion Pulmonary diseases of AIDS are the main expressions of patients with AIDS in comprehensive hospitals. It will be beneficial to clinical prophylaxis and treatment of AIDS to heighten the knowledge of respiratory physicians on pulmonary expressions of patients with AIDS.