Objective To explore the factors affecting the duration of secondary prophylaxis for penicilliosis marneffei in patients with acquired immunodeflciency syndrome (AIDS).Methods A retrospective analysis was conducted.The study included 92 adult patients with AIDS and penicilliosis mameffei which were confirmed at the Guangxi Centers for Disease Control and Prevention/Medecins Sans Frontieres clinic.The patients were divided into two groups based on the counts of CD4+ T cells at the time of discontinuation of secondary prophylaxis with itraconazole.The patients with a CD4+ lymphocyte count ＞ or =200 × 106 cells/L at the discontinuation of secondary prophylaxis were assigned to Group Ⅰ,and those with a CD4+ lymphocyte count ranging from 100 × 106 to 200 × 106 cells/L to Group Ⅱ.The treatment duration and clinical outcome were compared between the two groups,and factors which might affect the duration of secondary prophylaxis,including organ involvement,complications,antifungal regimen,antiviral treatment timing,and so on,were assessed.The SPSS 13.0 ~ftware package was used for statistical analysis.Results All the 92 patients received highly active antiretroviral therapy (HAART).No significant difference was observed in the sex ratio,age,follow up duration,number of organs involved,occurrence of complications,composition and duration of antifungal treatment regimens between the two groups (all P ＞ 0.05).The duration of secondary prophylaxis was significantly shorter in Group Ⅱ than in Group Ⅰ (8.13 ± 5.13 vs.12.44 ± 9.51 months,P＜0.05).The commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis were associated with a longer duration of secondary prophylaxis,and the influence degree of these factors decreased in order,whereas the commencement of HAART before the treatment of penicilliosis was associated with a shorter secondary prophylaxis (P ＜ 0.05).Conclusions For AIDS/PSM patients receiving HAART,secondary prophylaxis could be discontinued 3 to 6 months after the CD4 +lymphocyte count restores to 100 × 106 cells/L or more.The duration of secondary prophylaxis may be extended by the commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis,but shortened by the commencement of HAART before the treatment of penicilliosis.

Objective To investigate the correlation between levels of erythrocyte natrium(EN),magnesium(EM),adenosine triphosphate enzyme(Na + K + ATPase,Ca 2+ Mg 2+ ATPase) activity versus urine natrium(UN),urine endogenous digitalis like substances(UEDLS) change in patients with acute cerebral infarction(ACI) Methods 35 patients with ACI were measured in UEDLS,the changes of UN,erythrocyte membrane ATPase activity,and levels EN,EM,and compared with the normal controls Results Levels of UN,UEDLS,EN were significantly elevated( P

Cultivation of Medical Humanism Spirit has special value in the teaching of psychiatry,but which was ignored in the teaching. This paper explored the way to integrate humanistic spirit education into the teaching process of psychiatry.

Objective To evaluate the clinical effects of combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization in the treatment of primary hepatic carcinoma. Methods 80 patients with primary hepatic carcinoma were randomly divided into a control group, treated by transcatheter hepatic arterial chemoembolization, and a treatment group, additionally treated by Fuyuan Huoxue decoction on the basis of the control group. By observing the change of gross tumor volume、tumor markers、clinical symptoms、Karnofsky Performance Status(KPS) score、quality of life and so on,compare the clinical effects and quality of life between the two groups. Results The effective rate of solid tumor was 47.50%and 35%in the treatment and the control group respectively, with no significant difference(χ2=-1.229, P>0.05);The total effect rate was 87.50%and 32.50%in the treatment and the control group respectively, with significant difference(χ2=-5.633, P<0.05);The rate of patients merged with portal vein tumor thrombus whose cancer embolus narrowed more than 1/2 after the treatment was 78.95%and 33.33%in the treatment and the control group respectively, with significant difference(χ2=7.836, P<0.05);The rate of alpha fetoprotein(AFP) decreasing or turning negative was 78.95%and 37.83%after the treatment in the treatment and the control group respectively, with significant difference(χ2=-3.857, P<0.05);Both groups have improvement in Karnofsky Performance Status(KPS) score after the treatment, the ratios was 80% and 72.50% in the treatment and the control group respectively, with no significant difference(χ2=-1.203, P>0.05);The accumulated scores change of quality of life(QOL) has asignificant difference(χ2=-3.025, P<0.05) between the two groups after the treatment. Conclusion The combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization can alleviate the clinical symptoms, improve treatment effects and quality of life of patients with primary hepatic carcinoma.

Monoclonal antibody-targeted therapy has been a hot spot in current clinical cancer treatment. As current antibody drugs have large molecule sizes leading to poor tissue penetration, and high dosage in clinical application leading to high cost, to overcome the problems, the development of new antibody drugs with miniaturization and high potency has become a new trend. In recent years, the conjugates of monoclonal antibodies and cytotoxins, called antibody-drug conjugates (ADCs), have entered the arsenal of anti-cancer drugs, becoming a new format of antibody drugs and attracting extensive attentions. The ADC molecule usually consists of antibody, linker and effector molecule. According to different effector molecules, ADCs can be divided into three categories as chemo-conjugates, immunotoxins and radio-conjugates. When ADC molecules are internalized into cancer cells, cytotoxins will be released by chemical, enzyme degradation or by action of lysosomal proteases, then kill targeted cells by inhibiting protein synthesis, depolymerizing microtubules or breaking double-strand DNA. Recently, two ADC drugs have been approved by the US FDA and more ADC drug candidates are in clinical phase II or III trials which show significantly clinical effects and attracting much attention and competition of pharmaceutical enterprises. In this review, antibody conjugates in the past and present will be summarized and the future development trends and challenges of this type of antibody drugs will be discussed.

Human epidermal growth factor receptor 2 (HER2) belongs to the transmembrane glycoprotein receptor family. Overexpression of HER2 could directly lead to tumorigenesis and metastasis. This phenomenon could be observed in the breast cancer, ovarian cancer, gastric cancer, lung cancer and prostate cancer. Compared with the conventional chemotherapy, the targeted treatment of antibody is more specific and has lower side effects. This review describes the current status of monotherapy and combination therapies of anti-HER2 antibodies, trastuzumab and pertuzumab, with chemotherapeutic drugs. The development trends of new formats of anti-HER2 antibody drugs such as bispecific antibody, immunotoxin are also discussed.

Objective To study the relationship between Nogo-B and transforming growth factor-β1 (TGF-β1)/Smad2 signaling pathway in mice models of hepatic fibrosis.Methods Twenty four healthy male ICR mice were divided into two groups,with 6 in the control group and 18 in the model group.Mice in the model group were further divided into three subgroups according to different time points:subgroups of 4,8 and 12 weeks,with 6 mice in each subgroup.Hepatic fibrosis of mice was induced by subcutaneous injection of carbon tetrachloride (CCl4).The histopathologic changes of the liver were observed by optical microscope using hematoxylin-eosin and Masson trichrome stainings of the liver tissues.Expressions of Nogo-B,Smad2 and TGF-β1 mRNA and proteins in liver were detected by reverse transcription-polymerase chain reaction (RT-PCR),Western blot and immunohistochemistry assays,respectively.Means among groups were compared by univariate analysis of variance.Results The hepatic fibrosis models were successfully induced by CCl4 injection.The expressions of two subtypes of Nogo-B,Nogo-B1 and Nogo-B2 mRNA in normal livers were 0.140±0.050 and 0.104±0.023,but both significantly increased in the livers of mice in the 12 week model subgroup (1.054±0.040 and 0.500±0.057,F=431.41 and 135.46,respectively; both P＜0.01).The Nogo-B protein was mainly expressed in nonparenchymal cells of the liver,and was hardly expressed in hepatocytes.Linear correlation analysis showed that the expressions of Nogo-B mRNA and proteins were positively correlated with Smad2 and TGF-β1 mRNA and proteins (all P＜0.01),which were considered to participate in the signaling pathway of hepatic fibrosis.Conclusion Nogo-B might play a role in the development and progression of hepatic fibrosis by participating in TGF-β1/Smad2 signaling pathway.

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Objective To evaluate the treatment effect of acute liver failure(ALF) by xeno-transplantation of co-microencapsulated Sertoli cells and hepatocytes and the intraperitoneal immune privilege effects of Sertoli cells on hepatocytes. Methods ALF rats were induced by intraperitoneal injection of D-galactosamine and, thereafter, were treated with physical saline, free hepatocytes, microencapsulated hepatocytes, or co-microencapsulated Sertoli cells and hepatocytes (CMSH), respectively. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) were detected in rats' blood samples from various groups. Expression of Smac/Diablo and caspase-3 were determined by reverse transcription-polymerase chain reaction (RT-PCR). Fifteen rats in each group were used for survival rate analysis. The intraperitoneal microencapsules were observed and lymphocytes in ascites were counted. The data were analyzed by multi-factor or single factor analysis of variance and the comparison between groups was done by t test. Results In CMSH treatment group, ALT level decreased to (533.7 ± 76.5) U/L, AST level decreased to (381.2 5± 46.7) U/L after 48 h. TBil level reduced to (7.36 ± 2.18) μmol/L after 72 h. Albumin level increased to (28.4±2.5) g/L after 48 h. All these values were significantly different from those in other groups (F=10.7,6.5,12.2,8.4;P＜0.05). The expression levels of Smae/Diablo and caspase-3 mRNA at 48 h and 72 h were lower in CMSH group than in other groups (F=3.7,4.8,3.6,4.2; P＜0.05). Survival rates in microencapsulated hepatocytes group and CMSH group were similar while both of them were higher than other groups. Microencapsules neither in microencapsulated hepatocytes group nor in CMSH group were adhered to intraperitoneal mucosa. Lymphocyte counts in ascites of CMSH group were lower than those in microencapsulated hepatocytes group (t= 4.21, P＜0. 05). Conclusions Intraperitoneal transplantation with CMSH is a promising approach for ALF treatment. Furthermore, Sertoli cells can help reduce lymphocytes' aggregation caused by encapsulated hepatocytes in ascites.

Objective To evaluate the anatomic localization and size of acute necrotic myocardium in the ischemic-reperfused rat hearts using 99m TC-Glucarate and microSPECT/CT.Methods The ischemic-reperfused ( IR) rat heart models were established by ligating left anterior descending coronary artery for 60 min.99mTC-Glucarate was intravenously injected into the rats 24 hours after IR operations .Images were acquired 30 min after administration of 99m TC-Glucarate using microSPECT/CT. Anatomic localization and size of acute necrotic myocardium were analyzed with microSPECT/CT imaging , and these results were compared to those determined by triphenyltetrazolium chloride ( TTC ) staining.Results The microSPECT/CT images showed hot spot accumulations of 99mTC-Glucarate in IR hearts (the heart-to-liver ratio was 1.90 ±0.33), not in controls (P <0.05).The anatomic localization of 99mTC-Glucarate-labeled necrotic myocardium were in correspondence with TTC staining results .The hot spot size was related significantly to necrotic myocardial size determined by TTC staining ( R2 =0.964 ) .Conclusions The localization and size of acute necrotic myocardium can be assessed by non-invasive microSPECT/CT imaging with99m Tc-Glucarate.