This study is to evaluate the HAART pharmacodynamics with dolutegravir as the "anchor" in vitro. A nucleoside reverse transcriptase inhibitors (NRTIs) resistant recombinant virus model (VSVG/HIV-1(RT-D67N,K70R,T215F)) and an integrase inhibitors (INIs) resistant recombinant virus model (VSVG/HIV-1(IN-G140S,QI48H)) were constructed and established. The anti-viral pharmacodynamics was evaluated with drug combinations including two NRTIs along with one INI or one NNRTI. The results showed that the combination with an INI gave a stronger synergism on wild type HIV-1 replication comparing to that with an NNRTI. Comparing the two INIs as the "anchor" for HAART, DTG exhibited an equivalent CI to that of RAL on wild type HIV-1 replication; but a greater synergy than RAL on INI-resistant HIV-1 replication. Besides of the pharmacodynamics results of DTG-based drug combination, the results may contribute to clinical antiviral therapy.
Antiretroviral Therapy, Highly Active ; Cells, Cultured ; Drug Resistance, Viral ; HIV Integrase Inhibitors ; pharmacology ; HIV-1 ; drug effects ; physiology ; Heterocyclic Compounds, 3-Ring ; pharmacology ; Humans ; Virus Replication ; drug effects

The incidence of severe acute pancreatitis in children is lower.But it has abrupt onset and atypical symptoms.The fatality rate is relatively high.This paper will review the progress on the diagnosis and treatment of severe acute pancreatitis.

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .

Adult ; Blood Cell Count ; Control Groups ; Female ; Humans ; Male ; Physicians ; Radiography, Interventional

Objective To investigate the effect of fluoride on expression of Runx2 mRNA and protein in bone tissue of rats. Methods Fourteen SD rats were randomly divided into two groups: control group(tap water with fluoride ＜ 0.06 mg/L), and fluorosis group(fluoride 50 mg/L in water). After 4 moths, expressions of both mRNA and protein of Runx2 in rat bone tissue were determined by RT-PCR and Western blotting. Results The results showed that the expression of Runx2 mRNA and protein in fluoride-treated bone tissue were 2.287 ± 0.261 and 0.929 ± 0.229, respectively, both of which were significantly higher than those of control group(0.995 ± 0.123,0.317 ± 0.068, t = 11.85,6.78, P ＜ 0.05). Conclusions Fluoride can increase the expression of Runx2 mRNA and protein in bone tissue of rats, and Runx2 may be involved in the pathogenesis of bone injury caused by fluoride.

Objective To observe the clinical efficacy of wheat-sized moxibustion in treating epigastric pain due to deficient cold of spleen and stomach. Method Fifty-six patients were randomized into a treatment group and a control group, 28 cases in each group. The treatment group was intervened by wheat-sized moxibustion; the control group was by orally taking Omeprazole enteric-coated tablets. For both groups, 7 treatment sessions were taken as a course, and the therapeutic efficacies were evaluated after 2 courses. Result There were significant differences in comparing the total effective rate, pain score, and relapse rate between the two groups (P<0.05). Conclusion It can be confirmed that wheat-sized moxibustion is effective in treating epigastric pain due to deficient cold of spleen and stomach, and it can effectively lower the relapse rate and significantly reduce the sufferings brought by the recurred symptoms.

Objective To report immune-reconstruction in two patients with acute radiation sickness due to 60Co radiation accident after stem cell transplantation.Methods Patient “A” and “B” were diagnosed as intestinal form of acute radiation sickness(ARS)and extremely severe degree bone marrow form of ARS,respectively.Peripheral blood stem cell transplantation was successfully performed in these two patients.During their whole disease course,absolute lymphcyte count,neutrophil leukocyte count,T-lymphocyte subsets,natural killer(NK),and immunoglobulin were sequentially determined.Results Immunoglobulin was decreased after irradiation without any recovery tendency after the transplantation.After irradiation,absolute lymphcyte count decreased rapidly,but recovered partially after the transplantation(maintained at 0.5?109/L).Neutrophilic leukocyte count rose rapidly to normal after the transplantation.NK was lowered obviously after irradiation,and it rapidly recovered to normal level after the transplantation,and maintained at a level higher than normal.After irradiation,the proportion of CD4/CD8 showed a transient rise,followed by an abrupt lowering.After the transplantation,it showed a tendency of elevation,but it did not recover to normal.Conclusions The tendency of lowering of immunoglobulin,lymphocyte count,NK cell count,and CD4/CD8 ratio indicate that there is a rapid deterioration of both cellular and humoral immunity after irradiation.Following the homogeneic peripheral blood transplantation,neutrophil count and NK cell count showed a rapid recovery,lymphocyte count and CD4/CD8 ratio also showed a tendency of slow elevation,but there is no sign of recovery of immunoglobulin.The results indicate that there is a faster recovery of cellular immunity.

Objective To investigate the significance of HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness. Methods Patient “A” from Shandong province suffered from a 60 Co radiation accident with a dose of 20-25Gy, and was diagnosed as intestinal form of acute radiation sickness. On the 3rd day after irradiation, total environmental protection (TEP), antibiotics treatment and emergency HLA zygosity with his elder sister were done, and HLA haploidentical peripheral blood stem cell transplantation was performed with a preconditioning regimen of “CTX+ATG+Flu”. The regimen for protecting from GVHD was “CsA/FK506+MMF+CD25+MSC”. Results WBC began to increase on the 17th day after treatment, and WBC recovered to 5.1?109/L on the 19th day, platelet to over 30?109/L, and RCT to normal. Bone marrow image showed hematopoietic recovery of the three cell lineages. Continuously detection of the implantation ratio of donor's cells by STR-PCR, sexual chromosome analysis and HLA zygosity showed stable complete donor-derived chimera. No GVHD was observed. On the 19th days after treatment, chest X-ray films and CT suggested that a mixed bacterial and fungous infection existed in the patient's lungs. The severest skin damage occurred on the 25th day which occupied 14% of whole body surface. The functions of lung, kidney and heart were damaged sequentially. The patient died of multiple organ failure (MOF) 33 days after admission. Conclusion It is the first time to report a successful HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness in China. A successful transplantation might be a key for prolonging the survival period of such a patient.

Objective To report the diagnosis and treatment of an extremely severe bone marrow form of acute radiation sickness complicated with disseminated Trichosporon Asahii in Jining,Shandong province, China.Methods An extremely severe bone marrow form of acute radiation sickness was transfered to our hospital 3 days after the accident on October 24,2004.The patient was performed allogeneic stem cell transplantion from his brother and soon acquired hematogenesis recovery, however, refractory disseminated Trichosporonosis(mainly lung) then occured in the patient.after the hemato-reconstitusion,and gradually aggravate.Result Strong support treatment and high dosage combination of drug therapy were used to combat fungi ,the accumulative dose of Ampghotec (amphotericin B) was 2965mg, the accumulative dose of itraconazole was 4000mg, and the accumulative dose of Caspofungin(concidas) was 3020mg. The refractory disseminated Trichosporon Asahii was once partially controlled, but the radiation injury and infection were still becoming worse even after many kinds of antiinfection drugs, the patient then died of multiple organ failure on d75 after the accident. Conclution The combination of Ampghotec with Caspofungin and Itraconazole in the treatment of disseminated Trichosporon Asahii was effective, no related toxicity occured, which has not been reported before. However, with continuously injury of radiation, we couldn’t cure the Trichosporonosis thoroughly, and the patient finally died of multiple organs failure related with radiation and infection.According to the clinical treatment of the patient, we also acquired the experience that when we resolve the hematogenesis, to promote the immunologic reconstitution and the tissue damage repair, control the whole body radiation damage and infection will be the key point for this kind of patient to survive.

Objective To observe the changes of serum high-sensitivity C-reactive protein (hs-CRP) in 2 patients diagnosed as acute radiation sickness, and to evaluate its clinical significance. Methods Two victims from Shandong province, China were accidentally received a 60 Co irradiation from a dropped 60 Co source in 2004. They were exposed to more than 20Gy (patient A) and 9Gy (patient B) of X-ray irradiation respectively. The patient A was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS), and patient B was diagnosed as having developed intestinal form of ARS. The two patients successfully got HLA-haploidentical (patient A) and HLA-identical (patient B) peripheral blood stem cell transplantation, and their hematopoiesis recovered, but they cached serious bacterial infection in whole clinical course. Hs-CRP was quantitatively detected by automatically immunoturbidimetric assay. Result The serum level of hs-CRP in the two patients elevated quickly when they suffered from serious bacterial infection, and declined markedly when the infection was controlled effectively. The serum level of hs-CRP also increased slightly when the patients suffered from severe damage on organs or skin function. There existed 3 peak values of hs-CRP level in patient A when kept in the hospital, with a highest value of 188.8mg/L; there existed 4 peak values of hs-CRP level in patient B when kept in the hospital, with the highest value of 377.2mg/L. Conclusion The present results suggested that hs-CRP may be a good indicator to acute radiation sickness complicated with serious bacterial infection, for the hs-CRP levels may fluctuate following the bacterial infection and effectively controlling.