免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。...免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。外感疫毒、药物毒、情志郁毒长期作用于机体,致湿热郁毒横生,毒邪侵袭致机体气血阴阳失调,毒虚交结,既可由虚致实,也可由实致虚。故HIV合并HCV肝损伤为本虚标实之证,正虚为本,湿热郁毒为标。治疗时应以解毒补虚为基本治则。肝损伤急性发病期,应急则治其标,以抗炎护肝为主,重用清热利湿解毒退黄药,应用龙胆泻肝汤、茵陈蒿汤等加减;情志郁毒所致者应用柴胡疏肝散、逍遥散等以疏肝解郁、行气导滞;风阳上扰者应用镇肝熄风汤加减以清肝泻火、镇肝潜阳;应用重剂解毒药物同时需佐少量健脾益气药物以顾护正气,使邪祛而不伤正。肝损伤的慢性发展期或恢复期,应缓则治其本,以扶正固本,调畅气血为治则,应用四君子汤或黄芪汤加减以健脾益气,同时加用疏肝理气药物,使土得木而达。展开更多
Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phle...Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phlebitis.This study was designed to investigate effects of anisodamine on the expressions of vascular endothelial growth factor （VEGF） and intercellular adhesion molecule 1 （ICAM-1） in a rabbit model of infusion phlebitis and to analyze the mechanisms of anisodamine effect on the prevention and treatment of experimental infusion phlebitis.Methods Twenty-four specific pathogen-free male Japanese white rabbits were randomly assigned to the control group,the model group,the magnesium sulfate group and the anisodamine group.The rabbit model of infusion phlebitis,induced by intravenous administration,was established and expressions of VEGF and ICAM-1 were determined and contrasted with the control group treated with normal saline.We evaluated expression by histopathology,immunohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting assay.Results Pathohistological changes of the model group were observed,such as loss of venous endothelial cells,inflammatory cell infiltration,edema and thrombus.The magnesium sulfate group and the anisodamine group showed significant protective effects on vascular congestion,inflammatory cell infiltration,proliferation,swelling of endothelium and perivascular hemorrhage.The model group showed the highest expressions of VEGF and ICAM-1 of the four groups （P〈0.01）.On the contrary,anisodamine alleviated the inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1 compared with the model group （P 〈0.01）.There was no significant difference in the expressions of VEGF and ICAM-1 between the magnesium sulfate group and the anisodamine group （P 〉0.05）.Conclusion Anisodamine alleviates inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1,and shows significant protective effects展开更多
Background Few studies have examined the properties of human immunodeficiency virus type 1 （HIV-1） epitope-specific cytotoxic T lymphocyte （CTL） responses in children. To address this issue, we characterized epito...Background Few studies have examined the properties of human immunodeficiency virus type 1 （HIV-1） epitope-specific cytotoxic T lymphocyte （CTL） responses in children. To address this issue, we characterized epitope-specific CTL responses and analyzed the determinants that may affect CTL responses before and after highly active antiretroviral therapy （HAART） in children with HIV-1 infection. Methods A total of 22 HIV-1-infected children and 23 uninfected healthy children as control were enrolled in the study. Circulating CD4 T cells and HIV-1 RNA load in plasma were routinely measured. Peripheral HIV-l-specific CTL frequency and HIV-1 epitope-specific, interferon-y （IFN-y）-producing T lymphocytes were measured using tetramer staining and enzyme-linked immunospot （ELISPOT） assay, respectively. Circulating dendritic cell （DC） subsets were monitored with FACS analysis. Results More than 80% of the children with HIV-1 infection exhibited a positive HIV-1-epitope-specific CTL response at baseline, but HIV-specific CTLs and IFN-y-producing lymphocytes decreased in patients who responded to HAART in comparison with non-responders and HAART-naive children. The duration of virus suppression resulted from HAART was inversely correlated with CTL frequency. While in HAART-naive children, HIV-l-specific CTL frequency was positively correlated with myeloid DC （mDC） frequency, although the cause and effect relationship between the DCs and CTLs remains unknown. Conclusions HIV-l-epitope-specific CTL responses are dependent on antigenic stimulation. The impaired DC subsets in blood might result in a defect in DC-mediated T cell responses. These findings may provide insight into understanding the factors and related mechanisms that influence the outcome of HIV-1 carriers to HAART or future antiviral therapies.展开更多
Background The pathological abnormalities of the AIDS patients lie in the subcortical regions of the brain, specifically the deep white matter and basal ganglia, while the extent of pathology generally correlates with...Background The pathological abnormalities of the AIDS patients lie in the subcortical regions of the brain, specifically the deep white matter and basal ganglia, while the extent of pathology generally correlates with the severity of cognitive impairments in the white matter and basal ganglia. Brain metabolite changes of these lesions can reflect the pathological abnormalities. The purpose of this study was to assess the value of magnetic resonance spectroscopy （MRS） in the diagnosis of cognitive impairment in AIDS patients.Methods 3.0T MR was used to measure N-acetyl aspartate （NAA）, choline （Cho）, myo-inositol （MI） and creatinine （Cr）in the frontal white matter, basal ganglia and parietal cortex of 21 AIDS patients with dementia complex （ADC）, 19 AIDS patients with neuroasymptomatic （NAS） and 20 seronegative （SN） controls. Then we compared the difference of metabolic rate between AIDS patients and SN groups.Results NAA/Cr （mean=1.2502, SD=0.1600） was significantly decreased and Cho/Cr （mean=1.2028, SD=1.1655） was increased in the frontal white matter in ADC group, while NAA/Cr （mean=1.5334, SD=0.0513） was reduced in NAS group when compared with SN group. NANCr in the basal ganglia was decreased in both ADC and NAS groups （mean=1.2625,SD=0.1615 and mean=1.5278, SD=0.0380, respectively）. Cho/Cr （mean=1. 1631, SD=0.0981） was markedly increased in ADC group. Although NAA/Cr, Cho/Cr and MI/Cr in the parietal cortex had a certain change in both ADC and NAS groups compared with SN group, the differences were not statistically significant.Conclusions The brain metabolite changes of AIDS patients are correlated with cognitive impairments. MRS can be used as a valuable inspection method to assess cognitive impairments in AIDS patients.展开更多
文摘免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。外感疫毒、药物毒、情志郁毒长期作用于机体,致湿热郁毒横生,毒邪侵袭致机体气血阴阳失调,毒虚交结,既可由虚致实,也可由实致虚。故HIV合并HCV肝损伤为本虚标实之证,正虚为本,湿热郁毒为标。治疗时应以解毒补虚为基本治则。肝损伤急性发病期,应急则治其标,以抗炎护肝为主,重用清热利湿解毒退黄药,应用龙胆泻肝汤、茵陈蒿汤等加减;情志郁毒所致者应用柴胡疏肝散、逍遥散等以疏肝解郁、行气导滞;风阳上扰者应用镇肝熄风汤加减以清肝泻火、镇肝潜阳;应用重剂解毒药物同时需佐少量健脾益气药物以顾护正气,使邪祛而不伤正。肝损伤的慢性发展期或恢复期,应缓则治其本,以扶正固本,调畅气血为治则,应用四君子汤或黄芪汤加减以健脾益气,同时加用疏肝理气药物,使土得木而达。
文摘Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phlebitis.This study was designed to investigate effects of anisodamine on the expressions of vascular endothelial growth factor （VEGF） and intercellular adhesion molecule 1 （ICAM-1） in a rabbit model of infusion phlebitis and to analyze the mechanisms of anisodamine effect on the prevention and treatment of experimental infusion phlebitis.Methods Twenty-four specific pathogen-free male Japanese white rabbits were randomly assigned to the control group,the model group,the magnesium sulfate group and the anisodamine group.The rabbit model of infusion phlebitis,induced by intravenous administration,was established and expressions of VEGF and ICAM-1 were determined and contrasted with the control group treated with normal saline.We evaluated expression by histopathology,immunohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting assay.Results Pathohistological changes of the model group were observed,such as loss of venous endothelial cells,inflammatory cell infiltration,edema and thrombus.The magnesium sulfate group and the anisodamine group showed significant protective effects on vascular congestion,inflammatory cell infiltration,proliferation,swelling of endothelium and perivascular hemorrhage.The model group showed the highest expressions of VEGF and ICAM-1 of the four groups （P〈0.01）.On the contrary,anisodamine alleviated the inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1 compared with the model group （P 〈0.01）.There was no significant difference in the expressions of VEGF and ICAM-1 between the magnesium sulfate group and the anisodamine group （P 〉0.05）.Conclusion Anisodamine alleviates inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1,and shows significant protective effects
基金This work was supported by the grants from the National Key Basic Research Program of China (No. 2001CB51003) and the National Natural Science Foundation of China (No. 30228025).
文摘Background Few studies have examined the properties of human immunodeficiency virus type 1 （HIV-1） epitope-specific cytotoxic T lymphocyte （CTL） responses in children. To address this issue, we characterized epitope-specific CTL responses and analyzed the determinants that may affect CTL responses before and after highly active antiretroviral therapy （HAART） in children with HIV-1 infection. Methods A total of 22 HIV-1-infected children and 23 uninfected healthy children as control were enrolled in the study. Circulating CD4 T cells and HIV-1 RNA load in plasma were routinely measured. Peripheral HIV-l-specific CTL frequency and HIV-1 epitope-specific, interferon-y （IFN-y）-producing T lymphocytes were measured using tetramer staining and enzyme-linked immunospot （ELISPOT） assay, respectively. Circulating dendritic cell （DC） subsets were monitored with FACS analysis. Results More than 80% of the children with HIV-1 infection exhibited a positive HIV-1-epitope-specific CTL response at baseline, but HIV-specific CTLs and IFN-y-producing lymphocytes decreased in patients who responded to HAART in comparison with non-responders and HAART-naive children. The duration of virus suppression resulted from HAART was inversely correlated with CTL frequency. While in HAART-naive children, HIV-l-specific CTL frequency was positively correlated with myeloid DC （mDC） frequency, although the cause and effect relationship between the DCs and CTLs remains unknown. Conclusions HIV-l-epitope-specific CTL responses are dependent on antigenic stimulation. The impaired DC subsets in blood might result in a defect in DC-mediated T cell responses. These findings may provide insight into understanding the factors and related mechanisms that influence the outcome of HIV-1 carriers to HAART or future antiviral therapies.
文摘Background The pathological abnormalities of the AIDS patients lie in the subcortical regions of the brain, specifically the deep white matter and basal ganglia, while the extent of pathology generally correlates with the severity of cognitive impairments in the white matter and basal ganglia. Brain metabolite changes of these lesions can reflect the pathological abnormalities. The purpose of this study was to assess the value of magnetic resonance spectroscopy （MRS） in the diagnosis of cognitive impairment in AIDS patients.Methods 3.0T MR was used to measure N-acetyl aspartate （NAA）, choline （Cho）, myo-inositol （MI） and creatinine （Cr）in the frontal white matter, basal ganglia and parietal cortex of 21 AIDS patients with dementia complex （ADC）, 19 AIDS patients with neuroasymptomatic （NAS） and 20 seronegative （SN） controls. Then we compared the difference of metabolic rate between AIDS patients and SN groups.Results NAA/Cr （mean=1.2502, SD=0.1600） was significantly decreased and Cho/Cr （mean=1.2028, SD=1.1655） was increased in the frontal white matter in ADC group, while NAA/Cr （mean=1.5334, SD=0.0513） was reduced in NAS group when compared with SN group. NANCr in the basal ganglia was decreased in both ADC and NAS groups （mean=1.2625,SD=0.1615 and mean=1.5278, SD=0.0380, respectively）. Cho/Cr （mean=1. 1631, SD=0.0981） was markedly increased in ADC group. Although NAA/Cr, Cho/Cr and MI/Cr in the parietal cortex had a certain change in both ADC and NAS groups compared with SN group, the differences were not statistically significant.Conclusions The brain metabolite changes of AIDS patients are correlated with cognitive impairments. MRS can be used as a valuable inspection method to assess cognitive impairments in AIDS patients.
