Objective To summarize the experience of establishing the stable rat model of chronic allograft nephropathy. Methods We used Fisher rats as donors and Lewis rats as recipients.After the left kidney of the donor perfused in situ under hypothermic condition, the left renal vein,abdominal aorta and bladder flap of the donor was anastomosed with the left renal vein, renal artery and bladder of the recipient, respectively. The recipients were given cyclosporin oral solution 10 mg/kg every day by gavage for 10 days after transplantation. The blood and urine samples were collected 1 month, 2 months and 4 months after transplantation and renal function and total urine protein were examined. The pathological changes of the renal allograft were observed 2 and 4 months after transplantation. Results Forty-five rats received operation and achievement ratio was 85%. The renal transplantations were finished in 120 ± 20 min. The Scr, BUN, Cycs and total urine protein demonstrated a significant increase one month after transplantation. On the second and fourth month,with the exception of urine protein continued to increase, the other indicators did not change significantly. Two months after transplantation renal pathology demonstrated light to moderate interstitial fibrosis, infiltration of lymphocytes and plasma cells. At 4th month the renal allografts showed extensive interstitial fibrosis, a large number of infiltrating interstitial cells, thickening,hardening, occlusion of glomerular basement membrane, and renal tubular atrophy that were consistent with pathological changes of chronic allograft nephropathy. Conclusion Through adequate surgical training and improvement, and specification for rat nephrectomy, transplantation surgery,and postoperative management in every detail, the model with high success rate and stability can be achieved.

OBJECTIVETo analyze the survival time and its related factors among AIDS patients in Liangshan prefecture of Sichuan province from 1995 to 2012.

METHODSA retrospective cohort study was conducted to analyze the information of 5 263 AIDS patients. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Kaplan-Meier and Cox proportion hazard regression model were used to identify the factors related to survival time.

RESULTSAmong 5 273 AIDS patients, 819 (15.6%)died of AIDS related diseases; 2 782(52.9%) received antiretroviral therapy. The average survival time was 126.7 (117.1-136.2) months, and the survival rate in 1, 5, 10, 15 years were 95.4%, 78.8%, 54.2%, and 31.8% respectively. Univariate analysis showed a significant difference in survival time of age diagnosed as AIDS patients, nationality, transmission route, AIDS phase, CD4(+)T cell counts in the last testing, receiving antiretroviral therapy or not. Multivariate Cox regression showed age diagnosed AIDS below 50 years old ( < 15 years old:HR = 0.141, 95%CI:0.036-0.551;15-49 years old:HR = 0.343, 95%CI:0.241-0.489), HIV infection diagnosed phase (HR = 0.554, 95%CI:0.432-0.709), CD4(+)T cell counts last testing ≥ 350/µl (HR = 0.347, 95%CI:0.274-0.439) reduced the risk of dying of AIDS related diseases among AIDS patients. The patients having not received antiretroviral therapy had a higher risk of death(HR = 3.478, 95%CI:2.943-4.112) compared to those who received antiretroviral therapy.

CONCLUSIONSurvival time of AIDS patients was possibly mainly influenced by the age of diagnosed as AIDS patients, AIDS phase, CD4(+)T cell counts and whether or not received antiretroviral therapy. The early initiation of antiretroviral therapy could extend the survival time.

Acquired Immunodeficiency Syndrome ; mortality ; China ; epidemiology ; Cohort Studies ; HIV Infections ; Humans ; Proportional Hazards Models ; Retrospective Studies ; Survival Analysis ; Survival Rate

Objective:To investigate the efficacy of phenolamine in the treatment of sepsis-induced myocardial dysfunction and its effect on cardiac function, myocardial injury index, and hemodynamics in patients.Methods:The clinical data of 79 patients with sepsis-induced myocardial dysfunction who received treatment in Huangshi Central Hospital, Edong Healthcare Group from February 2017 to February 2020 were retrospectively analyzed. These patients were divided into a control group (without phenolamine treatment, n = 41) and an observation group (with phenolamine treatment, n = 38) according to whether they received phenolamine treatment or not. Clinical efficacy, cardiac function, myocardial injury index, and hemodynamic index pre- and post-treatment were compared between the two groups. Results:There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Intensive care unit length of stay and mechanical ventilation duration in the observation group were (9.33 ± 3.52) days and 83.00 (28.50, 138.00) hours, which were significantly shorter than (12.17 ± 4.15) days and 111.00 (47.50, 169.00) hours in the control group ( t = 3.26, Z = -2.27, both P < 0.05). The response rate in the observation group was significantly higher than that in the control group [81.58% (31/38) vs. 60.98% (25/41), χ2 = 4.05, P < 0.05]. After 7 days of treatment, the left ventricular ejection fraction in each group was significantly increased, and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in each group were significantly decreased compared with before treatment (all P < 0.05). After 7 days of treatment, the left ventricular ejection fraction in the observation group was significantly higher than that in the control group ( t = 3.29, P < 0.05), and left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower than those in the control group ( t = 5.94, 11.21, both P < 0.05). N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in each group were significantly decreased with time (both P < 0.05). At 24 and 72 hours and 7 days after treatment, N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in the observation group were significantly lower than those in the control group (both P < 0.05). After 7 days of treatment, heart rate in each group decreased significantly compared with that before treatment (both P < 0.05), mean arterial pressure, cardiac index, and stroke output index in each group increased significantly compared with those before treatment (all P < 0.05). After 7 days of treatment, heart rate in the observation group was significantly lower than that in the control group ( t = 4.90, P < 0.05), and mean arterial pressure, cardiac index, and stroke output index in the observation group were significantly higher than those in the control group ( t = 4.37, 3.23, 6.01, all P < 0.05). Conclusion:Phentolamine can improve hemodynamics, reduce myocardial injury and improve cardiac function in patients with sepsis-induced myocardial dysfunction.

OBJECTIVETo analyze the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) in Liangshan prefecture during 2004-2012.

METHODSA retrospective cohort study was conducted to analyze the information of AIDS patients who initially received ART. Data on patients was collected from the Chinese AIDS Antiretroviral Therapy DATAFax Information System. Life table was applied to calculate the survival proportion, and Cox proportion hazard regression model was used to identify impact factors that were related to the time of survival.

RESULTSAmong 5 525 AIDS patients who initially received ART, the median age was (34.5± 9.0) year old, with 73.9% being males, 65.8% were infected through injecting drug use, time from HIV tested HIV positive to starting ART was (23.0±20.1) months. 287 cases died of AIDS related diseases, and their median time of receiving ART was (12.7±10.6) months, and 32.8% of them died within the first 6 months of treatment. Cumulative survival rates of the patients who had received ART in 1, 2, 3, 4, 5 years were 97%, 93%, 89%, 88%, 84%, respectively. Results from multivariate Cox regression showed that female patients who received ART were at a lower risk to the death of AIDS related diseases(HR = 0.556, 95%CI:0.367-0.872), when compared to the males. Patients infected with HIV through injecting drug use were at a higher risk to death (HR = 1.569, 95% CI:1.061-2.321) when compared to those who were infected through heterosexual transmission. Patients with baseline CD4(+) T cells counts at <50 cells/mm(3) (HR = 11.996, 95% CI: 6.714-21.435) or 50-200 cells/mm(3) (HR = 2.481, 95%CI:1.620-3.798) were at a higher risk to death than those with CD4(+)T cell counts ≥350 cells/mm(3). Patients without pulmonary tuberculosis were at a lower risk to death(HR = 0.511, 95% CI:0.330-0.791)when compared to those with pulmonary tuberculosis a year before starting the treatment.

CONCLUSIONAntiretroviral treatment could prolong the survival time of AIDS patients and with a better rate on survival. Programs on follow-up and CD4(+)T cell counts for AIDS patients should be conducted regularly, as well as timely initiated the antiretroviral therapy.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-HIV Agents ; CD4 Lymphocyte Count ; Cohort Studies ; Female ; Humans ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk ; Survival Analysis ; Survival Rate ; Young Adult