【Abstract】 Objective To detect the expression of lung resistance protein (LRP) and investigate its significance in pancreatic carcinoma cell lines (SW1990, PCT-2, PCT-3, PCT-4, Aspc-1, Capan-1, Mia-PaCa-2 and Panc-1). Methods Reverse transcription PCR (RT-PCR) and immunocytochemistry (ICC) were carried out to investigate the expression of LRP. Results LRP mRNA was absent in PCT-2 cell line by RT-PCR. Mild to moderate expression level was found in other pancreatic carcinoma cell lines. PCT-4, Aspc-1 and Panc-1 presented the highest LRP mRNA expression level, in contrast, SW1990, PCT-3, Capan-1 and Mia-PaCa-2 showed moderate LRP mRNA expression. The median value was 0.56±0.33. LRP was further validated by ICC. Absent to weak protein expression of LRP was found in PCT-2 and PCT-3. Overexpressed LRP was present in SW1990, Capan-1 and Aspc-1, furthermore, the highest expression of LRP was found in Panc-1, Mia-PaCa-2 and PCT-4 cell lines. Conclusion All these data showed that LRP might play an important role in multidrug resistance of pancreatic carcinoma.
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 review the surgical treatment progress in repair and reconstruction of acquired auricle defects. Methods The related literature concerning the surgical methods and techniques for acquired auricle defects was reviewed and summarized. Results In order to attain an aesthetic ear with a clear structure, the location, size, and condition of surrounding skin must be taken into account when planning excision and repair. The application of tissue engineering and digital technology for acquired auricle defects can achieve a satisfactory effectiveness. Conclusion The surgical programs for acquired auricular defects have been constantly improved in recent years, and the emerging medical technologies also play a promoting role in the process, which providing a great deal of reference for obtaining structurally clear and stereoscopic auricle.
【摘要】 目的 研究人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合症(AIDS)患者CD4+T淋巴细胞数变化(ΔCD4+T)和外周血淋巴细胞总数变化(ΔTLC)的相关性。探讨用ΔTLC预测ΔCD4+T在监测HIV/AIDS患者疾病进展以及高效抗逆转录病毒治疗(HAART)疗效的价值。 方法 回顾性分析2005〖CD3/5〗2008年确诊的91例HIV/AIDS患者的临床资料。 结果 ΔTLC与ΔCD4+T呈直线正相关(r=0809,Plt;001),好于TLC与CD4+T的相关性(r=0712,Plt;001)。分别用ΔTLC 170、330、630、910个/μL细胞预测ΔCD4+T 50、100、200、300个/μL细胞时具有较好的预测价值,各项评价指标符合率基本达到90%以上,显著高于相同时间下用TLC预测CD4+T计数的价值。 结论 应用ΔTLC预测ΔCD4+T,可比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。【Abstract 】Objective To assess the utility of total lymphocyte count (TLC) changes (ΔTLC) in place of TLC to predict the development of HIV/AIDS. To investigate the monitoring value of ΔCD4+T on progress of HIV/AIDS and HAART which predicted by ΔTLC. Methods Clinical data of 91 patiens with HIV/AIDS diagnosed from 2005 to 2009 were retrospectively analyzed. Results A linear correlation was found between the value of ΔTLC and the value of CD4+T changes(ΔCD4+T)(r=0809,Plt;001),which was better than the correlation between TLC and CD4+T (r=0712,Plt;001).Using ΔTLC as 170,330,630,910 cells/μL,respectively for forecasting ΔCD4+T as 50,100,200,300 cells/μL,respectively,had a better predictive value with the area under ROC curve near to 09,significantly higher than using TLC for predicting CD4+T counts. Conclusion ΔTLC is more accurate than TLC to reflect the development of HIV/AIDS.
ObjectivesTo investigate the epidemiological and clinical characteristics of first diagnosed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in a general hospital, so as to improve early recognition and diagnosis of HIV/AIDS.MethodsWe retrospectively analyzed the data of HIV/AIDS patients who were diagnosed for the first time and had medical records in West China Hospital of Sichuan University from January 2015 to December 2016. Epidemiological information, clinical characteristics and opportunistic infection of these patients were analyzed.ResultsThe 1 036 HIV/AIDS patients were mainly from other regions of Sichuan Province except Chengdu. The overall ratio of male to female was 3.26∶1, and the ages of the patients were mainly between 15 and 59 years old (83.20%). In the occupational distribution, household or unemployed accounted for the largest proportion (36.39%). In terms of education level, junior high school accounted for the largest proportion (27.70%). Among marital status, married accounted for the largest proportion (52.41%). Among ethnic groups, the Han nationality accounted for the largest proportion (87.64%). The main infection route was sexual transmission (82.05%), of which heterosexual transmission accounted for 65.64% and homosexual transmission accounted for 16.41%. The clinical departments of confirmed patients had a wide range of sources, the top five of which were General Outpatient Clinic, Infection Center, Department of Emergency, Department of Dermatology & Venerology and Department of Neurology. Of the patients, 66.99% reported asymptomatic, and 33.01% had one or more symptoms. The most common symptoms were systemic symptoms such as fever, fatigue and lymphadenopathy, as well as clinical manifestations of respiratory system, nervous system and gastrointestinal system. The clinical stage of HIV/AIDS patients were mainly asymptomatic phase and AIDS phase, accounting for 98.65%. Among the HIV/AIDS patients, there were obviously more medical patients than surgical patients. The most common symptoms of the medical patients were fever, cough and expectoration, headache, fatigue and abdominal pain. The main symptoms of the surgical patients were headache, abdominal pain and lymphadenopathy. Compared with the surgical HIV/AIDS patients, the medical patients were younger (Z=−2.647, P=0.008), and the platelet counts (t=−2.110, P=0.036) and CD4+ T lymphocyte counts (Z=−4.639, P<0.001) were lower, the differences were statistically significant. Compared with the homosexually transmitted HIV/AIDS patients, the heterosexually transmitted patients were older (t=25.477, P<0.001), and had lower CD4+ T lymphocyte counts (Z=−2.779, P=0.005). And in males, the red blood cell count and hemoglobin content were lower. There were 214 patients (20.66%) with opportunistic infections, and 50 patients (4.83%) with tumors.ConclusionsHIV/AIDS patients in this general hospital come from different clinic departments, and were mainly Han nationality and married men. Sexual transmission is the main transmission route. Common clinical presentations of HIV/AIDS include fever, fatigue, cough and expectoration, headache, abdominal pain and lymphadenopathy. The diagnosis and treatment of HIV/AIDS patients combined with opportunistic infections and tumors need more attention.
Objective To investigate the AIDS knowledge and sexual behavior of middle school students in the key areas of HIV/AIDS epidemic in Liangshan, Sichuan Province in 2015 and 2020, so as to understand the epidemic trend and acquire possible references for future prevention. Methods A survey on AIDS knowledge and sexual behavior of middle school students was conducted in 2015 and 2020 in the key areas of HIV/AIDS epidemic in Liangshan, Sichuan Province, respectively. The prevalences of HIV/AIDS knowledge and sexual behavior were analyzed. Results The rate of AIDS education was increasing, which was 75.4% in 2015 and 89.3% in 2020, respectively. However, the awareness rate of AIDS remained low, which was 44.4% in 2015 and 53.3% in 2020, respectively. The reported rate of sexual behavior decreased, which was 12.8% in 2015 and 1.6% in 2020, respectively. The condom usage rates were still low, with 47.4% and 55.8%, respectively in 2015 and 2020. Conclusions The AIDS publicity and education work in Liangshan is effective, and the awareness rate of AIDS, the rate of sexual behavior and the usage rate of condom are improving well. However, the slow increase in the awareness rate of AIDS and the usage rate of condom require further in-depth analysis aiming at the specification of this area so that effective scientific measures can be carried out to prevent the HIV/AIDS diffusion.
Objective To observe the fundus characteristics of acquired immune deficiency syndrome (AIDS) with human immunodeficiency virus (HIV) retinopathy. Methods Eighty eyes of 52 AIDS patients with HIV retinopathy were enrolled in this study. The patients included 42 males (67 eyes) and 10 females (13 eyes). The patients ages ranged from 16 to 78 years, with a mean age of (43plusmn;12) years. All patients' visual acuity, intraocular pressure, slit-lamp microscopy and mydriatic indirect ophthalmoscopy, fundus color photography and CD4+ T cell count was documented. Experienced ocular fundus doctors carried out fundus examinations. Retinopathy characteristics were recorded. Seventeen patients (24 eyes) were followed for a period between two days to two years, with a median of 125 days. We failed to follow up the remaining 35 patients (56 eyes) due to death or moving away. Results Among 52 patients (80 eyes), 28 patients (56 eyes, 70.0%) had bilateral HIV retinopathy and 24 patients (24 eyes, 30.0%) had unilateral HIV retinopathy. Cotton-wool spots (CWS), mostly located close to temporal peripapillary vessels, were found in 46 patients (72 eyes, 90.0%). Six patients (eight eyes, 10.0%) were found to have flaming or spotting hemorrhage located in posterior pole. Among 72 eyes with CWS, 57 eyes were found to have CWS only and 15 eyes were found to also have retinal hemorrhage, mostly located near CWS. Among 24 eyes of 17 followed-up patients, three eyes of three patients were found with no significant changes during the less than two week follow-up. In 18 eyes of 11 patients, CWS or hemorrhage disappeared after one to three months without treatment and in five eyes new CWS or hemorrhage were found in other parts of the posterior pole. Three eyes of three patients initially considered as lint plaque-like lesions were eventually detected with CMVR as lesions during one to five months follow-up. Conclusion CWS are the most common ocular lesions in HIV retinopathy.
ObjectivesTo evaluate the effects of short message service (SMS) intervention for improving antiretroviral treatment adherence in HIV patients by meta-analysis.MethodsDatabases including PubMed, EMbase, CINAHL, Web of Science, ScienceDirect, The Cochrane Library, CNKI, WanFang Data, VIP and CBM were searched electronically from January 2000 to December 2018 to collect randomized controlled trials (RCTs) on the efficacy of SMS intervention on HIV patients. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs with 2 411 patients were included. The meta-analysis showed that SMS intervention could improve significantly treatment adherence of HIV patients (RR=1.11, 95%CI 1.03 to 1.20, P<0.01). The subgroup analysis showed that weekly texting had an effect on treatment adherence (RR=1.15, 95%CI 1.00 to 1.33, P<0.05); personal sending (RR=1.17, 95%CI 0.99 to 1.38, P=0.06) and daily sending (RR=1.02, 95%CI 0.83 to 1.26, P=0.84) of SMS had no statistical significance on treatment adherence; the intervention duration of 6 months (RR=1.11, 95%CI 1.00 to 1.23, P=0.05) could improve the treatment adherence, while the intervention duration of 12 months (RR=1.07, 95%CI 0.98 to 1.17, P=0.13) had no statistical difference on treatment adherence; there was no statistical difference in CD4+ cell count before and after treatment (WMD=4.18, 95%CI −39.33 to 47.69, P=0.85).ConclusionsBy comparing SMS intervention with routine nursing, sending SMS weekly for 6 months to remind HIV patients to take medicine can improve treatment adherence. Due to the limitation of quantity and quality of the included studies, the above conclusions are required to be assessed by more high-quality studies.
ObjectiveTo investigate the clinical manifestations of acquired immunodeficiency syndrome(AIDS) patients with initial-stage cytomegalovirus (CMV) retinitis (CMVR).MethodsRetrospective case series study. From July 2017 to November 2019, 21 patients with 22 eyes of AIDS combined with CMVR in the initial stage of AIDS and CMVR diagnosed in the eye examination in the study. Among them, there were 19 males with 19 eyes and 2 females with 3 eyes; the average age was 34.3±9.6 years. The average CD4+ T lymphocyte count of patients was 26.1±23.2/μl. Routine fundus screening revealed 17 cases, and the contralateral eye disease was found in 4 cases. There were 13 cases of CMVR in both eyes (61.9%, 13/21). Among them, both eyes were in the initial stage of CMVR, and the contralateral eyes were in the early stage of CMVR in 12 cases. The contralateral eye included 2 cases of human immunodeficiency virus-related retinal microangiopathy, 1 case of optic disc edema, and 5 cases of no obvious abnormality on fundus examination. All patients underwent slit lamp microscopy and ultra-wide-angle fundus photography examination. At the same time, 18 eyes underwent optical coherence tomography (OCT). Blood CMV-DNA detection was performed in 17 cases within 1 week before the first diagnosis; aqueous CMV-DNA detection was performed in 7 eyes within 1 week after the first diagnosis. Within 1 week after the fundus examination, 8 eyes of 8 cases and 8 eyes of 7 cases were received and not received systemic anti-CMV treatment; the treatment status was unknown in 6 cases and 6 eyes. After treatment, 18 eyes of 17 cases were followed up. The follow-up time was 0.5-28 months.ResultsThere were no obvious abnormalities in the anterior segment examination of all the affected eyes; the vitreous body was transparent. The fundus lesions were less than 1 optic disc diameter (DD), and they were white granular, clustered, with blurred edges. Among them, there were granular satellite lesions around the lesion in 18 eyes (81.8%, 18/22). The lesions were located in 19 eyes (86.4%, 19/22) in zone 2, 1 eye in zone 1 and 2 (4.5%, 1/22), and 2 eyes in zone 3 (9.1%, 2/22). In 18 eyes that underwent OCT examination, 12 eyes failed to obtain image data because the lesion was not in the conventional scanning range; the other 6 eyes showed the inner or full retina thickened or atrophy depression, structural destruction, accompanied by local vitreous punctate strong reflection. Among the 17 patients who underwent blood CMV-DNA testing, 1 (5.9%, 1/17) and 16 (94.1%, 16/17) cases were CMV-DNA negative and positive, respectively. The 7 eyes that underwent the CMV-DNA test of aqueous humor were all negative. Among the 18 eyes who were followed up, the lesions did not expand, and gradually subsided and absorbed in 4 eyes (22.2%, 4/18); the varying degrees of lesion enlargement in 14 eyes (77.8%, 14/18).ConclusionThe patients with AIDS and CMVR at the initial stage have no obvious ocular symptoms; the fundus shows white granular lesions less than 1 DD with blurred edges.
Abstract： Objective To explore the optimal timing and treatment of acquired Lutembacher’s syndrome. Methods Sixteen acquired Lutembacher’s syndrome patients were studied retrospectively based on records collected between January 2000 and December 2009 in Beijing Anzhen Hospital. There were 9 males and 7 females at age of （39.45±10.23）years. All of them underwent endotracheal intubation, intravenous general anesthesia, and cardiopulmonary bypass. All patients were operated on through a median sternotomy incision into the chest, the right atrium, atrial septal defect to expand with mitral valve replacement and atrial septal defect repair. Postoperative mortality and perioperative complications were observed. During follow-up, periprosthetic leakage was observed using echocardiography, along with the level of residual atrial septal shunt, ventricular size, pulmonary artery pressure changes, and improvement in cardiac function. Results Two of the 16 patients（12.5%）died, one of renal failure, and one of respiratory failure. One patient required extracorporeal membrane oxygenation for 3 days, one required continuous renal replacement therapy for 11 days because of acute renal failure, and one experienced respiratory failure and used a respiratory machine for 23 days. All three of those patients recovered. Fourteen patients were followed up for between six months and five years, and the follow-up rate was 100%. The left ventricular end-diastolic diameter was （42.1±5.7） mm, as measured by echocardiography six months post-operation. There was no detectable periprosthetic leakage or residual shunt. The ejection fraction was （67.4%±6.7%）, and estimation of pulmonary artery pressure was （23.4±5.4） mm Hg. Twelve patients were class Ⅱ（ New York Heart Association） and two patients were class Ⅲ. Conclusion Acquired Lutembacher’s syndrome should be treated promptly if patients’ left ventricular end stage diastolic volume index is good enough to ensure they can tolerate surgery. Extracorporeal membrane oxygenation （ECMO）should be used early in patients who are anticipated to be difficult to withdraw from extracorporeal circulation perioperatively.