Objective To explore the change and the spectra of opportunistic infections in AIDS patients after antiretroviral treatment in He′nan province.Methods Inpatients of post treatment with disease in accordance with the criteria were selected from the Sixth People′s Hospital of Zhengzhou.A retrospective study was carried out, including the content such as gender,age,infection route,treatment time,the date of complication,and CD4+T lympho-cyte counts when the patient with complications.Disease were divided into four group:opportunistic infections,adverse drug reactions,tumor,cardio-cerebrovascular disease and diabetes mellitus.Statistic case number and incidence of every kinds of the disease in the different stages of HAART.Results (1)1 001 cases of patients were involved in the result analysis.People of 41-60 years old,the peasants and peasant workers,accounted for 57.4%and 78.9%.The infection route was mainly through blood transmission and blood collection, accounting for 83.45%.Most of the patients come from Zhumadian, Xuchang, Zhoukou, Nanyang, which were high -incidence area in He′nan.( 2 ) In 1 001 patients of post treatment, the rate of opportunistic infections was 58.4%, while adverse drug reactions was 30.5%.Bacterial pneumonia,extrapulmonary tuberculosis,oral cavity fungal infection and tuberculosis were common in opportunistic infections of patients of post treatment.The main adverse reactions were allergic dermatitis,liver injury and myelosuppression.The liver cancer case was the highest ( 8/29 ) .( 3 ) 1 001 cases were divided into 6 groups according to different count of treatment time,during 3 months of treatment,the incidence rate of opportunistic infec-tions and adverse drug reactions was the highest,accounted for 75.2% and 41.6%.After 5 years of treatment,the incidence rate of cardio-cerebrovascular disease and diabetes mellitus was 6.39%.With the prolonging of HAART time,incidence of opportunistic infections and adverse drug reactions remarkably reduced,but the occurence rate car-dio-cerebrovascular disease and diabetes mellitus increased.Conclusion In AIDS patients after HAART in He′nan at present,opportunistic infections and adverse drug reactions are main diseases and used to occur during three months after HAART.Attention will be focused on tumor, cardio -cerebrovascular disease and diabetes mellitus in AIDS patients of long-term survival.

Objectivestudy the influence of nursing intervention on the anxiety among patients with hyperplasia of mammary glands. Methods Divided 200 patients with hyperplasia of mammary glands into the experimental group and the control group, there were 100 cases in the each group. The nursing intervention was used in the experimental group before the examination and the routine nursing cares were used in the control group. Using the HAMA scale to evaluated the anxiety of the two groups. Results The anxiety in the experimental group was significant better than that of in the control group,P

Objective To study the inhibitory effect of arsenic trioxide(AS2O3)on the tumor growth of breast cancer line MDA-MB-435s implanted subcutaneously in nude mice and its mechanism.Methods BALB/C-nu/nu nude mice were subcutaneously injected with MDA-MB-435s breast cancer cells that are ER-positive,and treated with intraperitoneal injection of AS2O3 and DDP in different concentrations.The implanted tumor was weighed,and tumor inhibition rates were calculated.The expression of PTEN and Caspase-7 induced by AS2 03 were examined by immunohistochemical method.Results The growth of implanted tumor was markedly inhibited with DDP,low dose and high dose AS2O3,and the inhibitory rates were 48.68%,32.80%,66.67%respectively.The immunohisto chemical staining showed that the number of PTEN and Caspase-7 protein increased markedly(P＜0.05).Conclu sions AS2O3 inhibits the growth of human breast cancer cell implanted tumor.The molecular mechanism of AS2O3 on induction of apoptosis of breast cancer cells may be throush increasing the expression of PrrEN and Caspase-7(P ＜0.05).

Objective:To analyze the clinical characteristics of primary acute myeloid leukemia (AML) (non-M3 type) in children suffering from different levels of platelet count(PLT).Methods:In the Tumor Hospital of Zhengzhou University from January 2014 to December 2018, laboratory and clinical data of 247 de novo primary AML pediatric patients were retrospectively reviewed.According to the PLT before treatment, patients were divided into very low platelet group (VLG), low platelet group (LG) and non-lowing platelet group (NLG), with<50×10 9/L, ≥50×10 9/L but <125×10 9/L and ≥125×10 9/L as the boundaries.All patients were followed up until June 30, 2019.Meanwhile, the follow-up data was obtained by consulting medical records or by telephone.SPSS 17.0 software was applied for data analysis. Results:In general clinical features, a different group of hemoglobin (Hb) content, fusion gene AML- ETO and clinical risk stratification were statistically significant in different PLT groups ( χ2=11.270, 12.115 and 12.848, respectively, all P<0.05). However, the differences of other indicators in different groups of PLT were not statistically significant (all P>0.05). There were no statistically significant differences in terms of 3-year disease-free survival(DFS) rate (59.3%, 36.3%, 50.4%) among the 3 groups (all P>0.05). The median total survival(OS)time(40.5 months)and 3-year OS rate(41.0%) of NLG patients were significantly higher than those of VLG(23.1 months, 30.1%)and LG(14.1 months, 18.2%)patients, with statistically significant differences( χ2=7.798 and 6.553, respectively, all P<0.05). The univariate analysis of gender, white blood cell(WBC), Hb, PLT, lactic dehydrogenase(LDH), FLT3-ITD, NPM1, DNMT3A, CEPBA, C-KIT, AML-ETO, molecular genetic prognosis, complete remission(CR), and hemopoietic stem cell transplantation(HSCT) displayed that DNMT3A mutation was an adverse factor that affects patients′ OS ( χ2 =5.834, P<0.05), and the positive factors that influences OS were non-reducing PLT before treatment, and obtaining CR and subsequent HSCT ( χ2=7.798, 79.168, and 31.337, respectively, all P<0.05). Multi-factor analysis revealed that the independent protective factors that affect patients′ OS were the non-reducing PLT before treatment, and obtaining CR and subsequent HSCT( Wald=42.760, 15.918, and 10.183, respectively, all P<0.05). Conclusions:Before treatment, non-reducing PLT is a protective factor for primary childhood AML patients, and the prognosis is satisfying.

Objective To evaluate the efficacy and tolerance of antiretroviral therapy (ART)regimen containing lopinavir/ritonavir (LPV/r) as a second-line regimen.Methods Data of acquired immunodeficiency syndrome (AIDS) patients who have received the first-line therapy for over a year and changed to the second-line antiviral therapy regimen containing LPV/r for more than one year were collected retrospectively from the database of free antiviral therapy in Henan Province from January 1,2009 to December 31,2013.Based on the viral load inhibition status after the alteration of the regimen,the patients were assigned to virology failure with first-line therapy group,and successful viral inhibition but poor immunological reconstruction with first-line therapy group.The variation trend of CD4+ T lymphocyte counts of the two groups in 6,12,24 months after changed to the second-line regimen of LPV/r,the virology inhibition rates between 6 and 12 months,12 and 24 months,and occurrence of adverse events were analyzed.Quantitative data were analyzed by rank sum test,and qualitative data were analyzed by chi-square test.Results A total of 4 113 patients were divided into two groups,including the first-line therapy failure group (n=3 802) and poor immunological reconstruction group (n=311).At 6,12 and 24 months after the alteration of the regimen,the CD4+ T lymphocyte counts increased gradually (all P＜0.01).Between 6 and 12 months after the first-line therapy failure group changed to the secondline regimen,viral inhibition rate was 61.65％(1 408/2 284),while that 12 and 24 months was 68.91％(2 044/2 966).The incidences of adverse reaction of the two groups were 21.88％ (832/3 802) and 22.19％(69/311),respectively,which were not significantly different (x2 =0.015,P=0.901).Condusion The ART regimen containing LPV/r still has good viral inhibition effect and immunological reconstruction effect for AIDS patients who failed the initial therapy with poor immunological reconstruction.

Objective:To study the clinical characteristics of odontogenic cutaneous fistula.Methods:6 cases of odontogenic cutane-ous fistula were represented and the reports of 60 cases of the lesion were reviewed.Results:The fistula was mainly located in cheek, chin,para-nasal part,sub-mandibular area and the lower border of the mandible,and respectively corresponding to mandibular third molar,mandibular incisor,maxillary canine,mandibular first and second molar,the corresponding teeth were mainly in mandible (71 .2%).In middle and old aged patients the lesion usually in para-nasal or mandible area,In younger patients the lesion mostly loca-ted in cheek or sub-mandibular area.After root canal therapy for the teeth with apical periodontitis or extraction of none-curable teeth,the odontogenic cutaneous sinus tract disappeared.Conclusion:Proper treatment of focal teeth can cure the odontogenic cutaneous fistulas.

Objective To explore TCM syndrome and treatment regular for AIDS dementia complex (ADC). Methods Through literature retrieval, the review of medical records and clinical investigation, expert questionnaires survey was carried out. Results The recovery rate of complete questionnaires in the 1st survey was 88.89%. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the concept, clinical features, diagnostic criteria, syndrome differentiation and treatment of insufficiency of kidney essence, nursing, period of treatment and curative effect standard were more than others, CV<0.076. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the etiology and pathogenesis, syndrome differentiation and treatment of deficiency of heart and liver yin were smaller, and CV was within 0.168–0.234. The recovery rate of complete questionnaires in the 2nd survey was 96.00%. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the etiology and pathogenesis, syndrome differentiation and treatment of deficiency of kidney and liver were more than the 1st survey, and CV was within 0.065–0.106, which was smaller than the 1st survey. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of syndrome differentiation and treatment of deficiency of kidney and liver were smaller, and CV was 0.156. The weight coefficient of the 1st and 2nd survey were within 0.072–0.087, 0.071–0.089. The questionnaire reliability of the 1st and 2nd survey were 0.916 and 0.886 respectively. The half reliability of the 1st and 2nd survey were 0.81 and 0.79 respectively. Conclusion TCM syndrome and treatment regular for ADC is preliminarily formed.

AIM:To observe the Toll-like receptor 9 (TLR9) activation in microglia BV-2 cells after oxygen-glucose deprivation and reoxygenation ( OGDR) , and its effects on neuronal apoptosis.METHODS:The BV-2 cell super-natants were collected after the corresponding treatment and added to mouse primary cortical neurons after OGDR for 4 h, followed by normal culture for 24 h.The cells were divided into normal BV-2 group, NC-siRNA group, TLR9-siRNA group, OGDR group, OGDR+NC-siRNA group, OGDR+TLR9-siRNA group and control group (without adding BV-2 cell supernatant) .The changes of the neuronal morphology were observed under an inverted phase-contrast microscope, and the neuronal apoptosis was detected by TUNEL.The protein expression of cleaved caspase-3 was detected by Western blot-ting.RESULTS:After OGDR, the axon turned thin, twisted and broken, and neuronal swelling, decrease in refraction and vacuolar degeneration were observed.The green-stained apoptotic bodies in the neurons in all groups were positive. Compared with control group, the caspase-3 protein levels in other groups were increased.Compared with the normal BV-2 group, the caspase-3 protein in OGDR group and TLR9-siRNA group was increased.Compared with OGDR+TLR9-siRNA group, the caspase-3 protein in TLR9-siRNA group and OGDR group was decreased.CONCLUSION: After OGDR, TLR9 activation in BV-2 cells induces neuronal apoptosis with the increase in caspase-3 protein level.Inhibition of TLR9 expression reduces neuronal damage.

Objective To evaluate the virological and immune responses of Lopinavir/Ritonavir (LPV/r) based second-line regimen in elderly acquired immunodeficiency syndrome (AIDS) patients who failed first line regimens.Methods This was a retrospective cohort study.Elderly patients (≥50 years) who switched to LPV/r-based second-line antiretroviral therapy with human immuno-deficiency virus (HIV) RNA >1 000 copies/mL after more than 1 year of first-line treatment were recruited from Zhengzhou No.6 People Hospital from January 2010 to December 2011.The virological and immunological data during 60-month treatment were collected.Multivariate logistic regression was used to explore the risk factors associated with virological failure or immunological failure of 60-month second-line therapy.Results Totally 256 patients were enrolled with 109 male and 147 female.89.5% were plasma donator.The median age at the time of switching to LPV/r based second-line regimen was 61 years old.Twelve out of the 256 cases were detected for genotypic drug resistance and ten of them were resistant to drugs.No resistance to protease inhibitor (PI) was found.After switching to LPV/r based second-line regimen, HIV viral suppression (HIV RNA≤400 copies/mL) rates at 12, 24, 36, 48, 60 months were 69.5%, 78.4%, 79.0%, 79.7%, and 83.2%, respectively.The CD4+ T cell counts were (313±135) /mL at 12 months, (377±151) /mL at 24 months, (396±155) /mL at 36 months, (389±163) /mL at 48 months and (412±147) /mL at 60 months, which were all significantly higher than that at the initiation of therapy ([243±146] /mL,t=19.092,18.598,12.843,8.516 and 12.980, respectively;all P<0.05).After switching to LPV/r based second-line regimen for 60 months, 43 patients occurred virological failure and 48 patients occurred immunological failure.Multivariate logistic regression showed that poor adherence (OR=48.5, 95% CI: 15.9-98.4, P<0.01) and ART drug toxicity (OR=4.5, 95% CI: 2.6-11.3, P<0.01) were the main factors associated with virological failure at 60 months.Poor adherence (OR=15.1,95% CI: 6.89-33.3, P<0.01), CD4≤100 /mL at the time of switching therapy (OR=10.5,95% CI: 5.1-21.7, P<0.01), concomitant medications (OR=3.6,95% CI:1.6-4.1,P<0.01) were main factors associated with immunological failure at 60 months.Conclusions Elderly patients (≥50 years) who failed first line regimen should switch to LPV/r contained regimen as early as possible.Adherence education should be strengthened, drug toxicity as well as complications of treatment should be managed in time and concomitant medications should be reduced.