Objective To analyse effect of glycyrrhizin on serum levels of platelet derived growth factor ( PDGF ) , interleukin 17 ( IL-17 ) , monocyte chemotactic protein 1 (MCP-1) and serum response factor (SRF) in patients with glioma.Methods 48 patients who were diagnosed with glioma in our hospital were collected.All patients were randomly divided into experimental group and control group,24 cases in each group.All patients were treated with surgery,control group was treated with temozolomid capsule(150 mg/m2 ) orally, one times per day, 28 days for a treatment period of 5 days continuous administration.On the basis of control group, experimental group was treated with compound ammonium glycyrrhetate injection 40 mL, dissolved in 250 mL 5% glucose solution intravenously,one times per day,four weeks was a period of treatment.After two groups were treated two period of treatment,the serum levels of PDGF, IL-17,MCP-1and SRF were detected in all patients.Results After treatment, compared with control group, the serum PDGF level was lower than that of experimental group (P<0.05);the serum IL-17 level was lower than that of experimental group (P<0.05);the serum MCP-1 level was higher than that of experimental group ( P <0.05 );the serum SRF level was lower than that of experimental group ( P <0.05).Conclusion Glycyrrhizin could significantly reduce the serum PDGF, IL-17 and SRF levels,increase MCP-1 levels, have guidance significance for clinic.

Objective To investigate the characteristics of opportunistic infections in acquired immunodeficiency syndrome (AIDS) patients.Methods A comprehensive retrospective chart review study was conducted of 603 AIDS patients with different opportunistic infections in a special hospital authorized for AIDS patients.Results In all 603 patients,327 cases (54.2％) were infected with Pneumocystisjiroveci,251 cases (41.6％) were infected with fungus and 210 cases (34.8％) were infected with mycobacterium.Totally 367 cases (60.9％) had only one pathogen and 236 cases (39.1％) were co-infected with more than one pathogen.A total of 390 cases (64.7％) had a single site of infection with the respiratory tract being most frequently involved (271 cases,69.5％),and 213 cases (35.3％) had more than one infected site.The most common coinfected sites were oropharynx and respiratory tract (111 cases,52.1％).Conclusions AIDS patients are usually coinfected with multiple pathogenic organisms and multi-systems involved.Most of the opportunistic infections can be cured by timely diagnosis and effective treatment to prolong life and improve the quality of life of AIDS patients.

Literature of TCM contains abundant information of Chinese medicine. Traditional Chinese medicine information is characterized by its high degree of knowledge-intensive and complex inter-knowledge, so it is difficult to integrate and share knowledge. TheShanghanlun is one of the Chinese medical classics, and it includes the rules and methods of syndrome differentiation and treatment and it showed good effects in the clinical application. However, it is difficult to master for beginners. As a kind of knowledge organization tool, topic maps can flexibly define the relationship between knowledge, which realizes the visualization of knowledge network, and integrates and shares the distributed knowledge. This paper focused on the current situation of topic maps researches. The topic maps was used to organize the original content ofShanghanlun, construct the concept model of it and explore the specific application of topic maps technology in the field of traditional Chinese medicine.

Objective To investigate the correlation between the human chemokine type 1 chemokine ligand 3 (CCL3L1) and chemokine ligand 4 (CCL4L) gene expression and the immune reconstitution of acquired immunodeficiency syndrome (AIDS) patients after antiretroviral therapy.Methods The gene copy numbers of CCL3L1 and CCL4L were detected by real time polymerase chain reaction in 217 AIDS patients before antiretroviral therapy.And the correlation between CCL3L1 and CCL4L gene copy numbers and the level of CD4+ and CD8+ T lymphocytes were analyzed.The changes of CD4+ and CD8+ T lymphocytes were defined as mean change value per month after 48 months treatment.The change rates of CD4+ and CD8+ T lymphocytes were defined as the logarithm of the ratio of the value after 48 month to that at baseline.Comparison between groups was conducted using analysis of variance.Results The median of gene copy numbers of CCL3L1 and CCL4L were 2 (range:0-8) and 3 (range:0-7),respectively.After antiviral treatment,there were significantly different changes of CD8+ T lymphocyte level (F=3.054,P＜0.05) and change rate of CD4+/CD8+ (F=3.520,P＜0.05) among groups of high (gene copy 4-8),median (gene copy 2-3) and low (gene copy 0-1) CCL3L1 gene copy numbers.The changes of CD8+ T lymphocyte levels (P=0.023) and change rates (P=0.038) in high and low CCL3L1 gene copy groups were both significantly different.There were significant differents changes rate of ratio of CD4+/CD8+ T lymphocyte among high and median (P=0.010),high and low CCL3L1 gene copy numbers (F=4.397,P＜0.05).The significant difference of the change rates of CD4+/CD8+ were found between the gene copy 3 group and gene copy 4-7 group CCL4L (P=0.005) and between the gene copy 4-7 group and gene copy 0-2 group of CCL4L (P=0.030).The change ratio of CD4+/CD8+ T lymphocytes increased with the increase of copy numbers of CCL4L gene.Conclusions The gene expressions of CCL3L1 and CCL4L might be associated with the ability of immune reconstitution of AIDS patients after antiretroviral therapy.

Objective To determine the concentrations of amphotericin B in serum and cerebrospinal fluid from patients with AIDS-associated cryptococcal meningitis.Methods Ten patients with AIDS-associated cryptococcal meningitis were enrolled in the study.Blood samples were collected before drug administrated at the 7th.14th and 21 th day after maintenance dose achieved.Cerebrospinal fluid samples were collected from lumbar puncture or taken before intrathecal drug administration at least one week after maintenance dose achieved.The concentrations of amphoteriein B in blood and cerebrospinal fluid samples were determined using RP-HPLC.Results When maintenance doses varied from 25 to 40 mg/d,the blood steady-state trough concentration range of amphotericin B was 1.34-2.27 ms/L,and that of cerebrospinal fluid was 44.0-9 1.7μg/L.Conclusions The concentrations of amphotericin B in the cerebrospinal fluid would be lower than the desired concentration if amphotericin B administrated only through intravenous or integrated with irregular intrathecal administration.It suggests that higher dosage of intravenous injection and regular intrathecal administration should be applied to achieve the desired concentration.

Objectives Occult HBV infection is defined by positive HBV DNA in individuals with undetectable levels of HBsAg.The objective of this study was to assess the prevalence of occult HBV infection in HIV-infected patients.Methods Serum samples were obtained from 105 HBs Ag-negative HIV patients who were hospitalized and were not giyen anti-virus treatment at Shanghai Public Health Clinical Center.Microparticle enzyme immunoassay(MEIA)was used to detect HBV serologic markers(HBsAg,anti-HBs,HBeAg,anti-Hbe and anti-HBc).EUSA was used to detect HCV antibody.CD4+ T cell count was examined with flow cytometry.Nested PCR was used to amplify surface protein region of HBV.Results 32(30.5%)patients(27 men,5 women)were HBV DNA positive in the 105 HBsAg-negative HIV-infected patients(92 men and 13 women).22 patients(including 5 patients with HBV DNA+)were in 16-30 years group,44 patients(including 15 patients with HBV DNA+)were in 31-49 years group and 39 patients(including 12 patients with HBV DNA+)were in 50-75 years group.5 patients were negative for all HBV serologic markers and 27 patients detected with at least one of anti-HBc.anti.Hbe or anti-HBs.14 patients (29.8%)with HBV DNA+in 47 HIV-infected patients were coinfected with HCV,18 patients(31.0%)were HBV DNA+in 58 HIV-monoinfected patients.The median absolute CD4+T eell count was 145.1cells/μ1(4-623 cells/μ1),26 patients(34.7%)were HBV DNA+in 75 AIDS patients with CD4+T cell＜200 cells/μ1 and 6 patients(20.0%)HBV DNA+in 30 HIV-infected patients with CD4+ T cell＞200cells/μ1.No statistical significant association could be established between the above factors.Conclusions It is found tIlatoccult HBV did occur in HIV-infected patients.No statistical significant association could be established between occult HBV infection and gender,age,HBV serologic markers,coinfected HCV and CD4+T cell count.

Objective To analyze the causes of death for 89 HIV/AIDS patients,and the association of CD4+ T lymphocyte counts with the mortality.Methods Data were collected from 89 deceasedpatients who were admitted to Shanghai Public Health Clinical Center from Jan 1996 to Sep 2007,and wereretrospectively analyzed with t-test.Results Heterosexual,blood transfusion and blood products were themajor transmission routs for 89 deceased HIV/AIDS patients.The primary causes of death varied with different levels of CD4+ T lymphocyte counts.With higher CD4+T lymphocyte counts,patients were more likelyto die from non-AIDS-related opportunistic infections such as upper digestive tract hemorrhage.Serious pulmonary infection induced by various etiologies was the primary cause of death.Co-infections of multiple etiologics were often seen in these death cases.Conclusion Opportunistic infection is the primary cause of death for HIV/AIDS patients.Appropriate therapies should be based on CD4+ T lymphocyte counts and patients' specific conditions to reduce the mortality.

Objectives To investigate the markers of endothelial injury, adipocytokine and thrombotic activity and explore whether there are cardiovascular disease risk factors in antiretroviral-naive HIV patients. Methods Clinical data and venous blood samples were collected from 43 anti-retroviral naive HIV-infected patients during February -October 2009 in our center, and compared with 17 healthy subjects.Plasma leptin, adiponectin, soluble intercellular adhesion molecule-1 ( sICAM-1 ), D-dimer were measured by ELISA. Four markers and cholesterol, triglyceride, fasting plasma glucose were compared between the two groups. The CD4+ T cells and percentages of CD38, HLA-DR on CD8+ T were determined by flow cytometry and plasma HIV copies were detected with bDNA analyzer among HIV-infected participants.Spearman correlations between the significant markers and CD4+ T cells, CD8+ CD38+/CD8+, CD8+ HLA-DR +/CD8+, HIV viral load were examined among HIV-infected participants. Analyses were conducted by using Stata version 7. Results Thirty-eight of the 43 patients were sexually infected by HIV and the median absolute CD4+ T cell count was ( 133 ± 82 ) cells/μl, HIV RNA was (4. 42 ± 0. 66 ) lg copies/ml. HIV-infected patients, compared with healthy subjects, had lower leptin [11.41 (7.91,14. 53 )μg/L vs 55.31( 16. 49,229.65 ) μg/L, P= 0. 0005], adiponectin [1.79 ( 1.40,4. 00 ) mg/L vs 3.36 ( 2. 92,4. 18 ) mg/L,P =0. 003] and higher sICAM-1 [1.71 (1.11,2.40) mg/L vs 0. 69 ( 0. 57, 0. 80 ) mg/L, P = 0. 0000].No significant differences exist in cholesterol, triglyceride, fasting plasma glucose. For HIV-infected participants, sICAM-1 tended to correlate with CD8+ CD38+/CD8+ and HIV viral load ( r= 0.3378, P= 0.0267;r = 0.3904,P = 0.0096). Conclusion Patients with untreated HIV infection have lower leptin, adiponectin and higher sICAM-1 levels and the relationship of these markers to HIV-mediated atherosclerotic risk requires further study.

Objective To analyze the epidemiology and clinical characteristics of acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis (TB) co-infection.Methods A retrospective study was conducted with the clinical data of patients diagnosed with AIDS and TB in Shanghai Public Health Clinical Center during the period from 2011 to 2015.The outcome of the patients were evaluated by outpatient and telephone follow-up.The data were analyzed by descriptive analysis using SPSS 22.0 software package.Results A total of 359 patients with AIDS/TB co-infection were included in this analysis,including 325 males and 34 females,the highest proportion in 30-44 age group.The diagnosis was delayed in about 42.6％ of the patients.The clinical symptoms were mainly fever,cough and weight loss,but hemoptysis uncommon.Both lungs were affected in most cases,with lesions in at least 3 lung fields,but rare pulmonary cavity.T-SPOT.TB test showed lower positive rate.CD4+T lymphocyte count was 50 cells/μL or less in 50.7％ of the patients at their first test.About 43.5％ of the 69 patients with antimicrobial susceptibility data showed resistance to therapy.Majority (93.2％) of the patients with known viral status received antiretroviral treatment.Extra-pulmonary tuberculosis was identified in 282 cases.The complication and opportunistic infection included central nervous system infection,syphilis,hepatitis B virus infection,hepatitis C virus infection,pulmonary infection,and drug-induced liver injury.Of the 333 patients with known outcome,53 died,most (79.2％,42/53) within 6 months.Conclusions The patients with AIDS/TB co-infection showed higher proportion of young people.The CT finding was atypical.The patients showed lower positive rate for T-SPOT TB test and lower CD4+T lymphocyte count at their first test.Most patients had extra-pulmonary tuberculosis and other complications or opportunistic infections.

Objective To evaluate the safety and tolerance of the first-line hiighly active antiretroviral therapy(HAART)regimen in Chinese HIV/AIDS patients.Methods The clinical data and laboratory results were retrospectively reviewed in 95 HIV/AIDS outpatients receiving first-line HAART regimen of zidovudine,lamivudine and efavirenz(or nevirapine)in Public Heahh Clinical Center Affiliated to Fudan University during January 2005 and August 2008.Mixed effects model and X2 test or Fisher test were used to analyze panel data and ratio data respectively.Results Totally 81%(77/95)patients had adverse events in the course of treatment,11.6%(11/95)developed grade 3 or higher adverse effects.Hematological adverse events and hepatotoxity were the most common in term of laboratory events with the total incidence of 46.3%(44/95)and 27.4%(26/95)respectively;8.4%(8/95)and 6.3%(6/95)were grade 3 or higher.In clinical events,30.5%(29/95),37.8%(36/95)and 27.4%(26/95)patients had dermatological,gastrointestinal and neurological adverse events respectively,however,only 1.1%(1/95)experienced grade 3 or higher dermatological adverse events.Conclusion The first line HAART regimen is safe and well tolerated in Chinese HIV/AIDS patients.