AIM: To investigate the clinical features of acquired immune deficiency syndrome ( AIDS) patients associated ocular diseases in Urumqi and the relationship between ocular fundus manifestations and CD4+T cell count.
METHODS: The fundus of 93 AIDS patients were examined by indirect ophthalmoscopy. The clinical symptoms and CD4+T cell count of those patients with fundus changes were analyzed.
RESULTS: Thirteen patients were found having fundus changes which occurred in one eye of 4 patients and two eyes of 9 patients, respectively, and the total detection rate was 14. 0%. Seven patients had vision changes, and the main clinical features of retinal lesion were cotton wool spot and hemorrhage of retina. Four patients were diagnosed as retinitis with cytomegalovirus ( CMV ) infection and 9 patients were diagnosed as HIV related retinopathy diseases. Seven patients among 37 patients with CD4+T cell count ≤100cell/μL had fundus changes related AIDS, and the detection rate was 18. 9%; while 6 patients among 56 patients with CD4+T cell count >100cell/μL had fundus changes related AIDS, and the detection rate was 10. 7%. There was statistical difference between the two detection rates (P<0. 05).
CONCLUSION: No specificity was found of those patients with the clinical manifestation of HIV- related retinopathy, and those patients are easy to be missed diagnosis. A number of AIDS patients have fundus changes without any vision changes. Therefore, it is very useful for AIDS patients to be carried out the routine fundus examination for the early diagnosis and treatment.

BACKGROUND:Phytohemagglutinin (PHA) can stimulate the peripheral blood mononuclear cells (PBMCs) into cellcycle, and cause their immune activation, which is a common immune proliferation model. However, the role of non-PBMC ingredient of peripheral blood is unclear, as wel as the expression of endothelial cells related cytokines. OBJECTIVE:To study the effect of whole blood culture and PBMCs alone culture with PHA on the PBMC proliferation and apoptosis, expression of inflammatory cytokine and endothelial cellsecreted cytokine markers. METHODS:Morphological changes of PBMCs separated from normal karyotype human peripheral blood individual y cultured with or without PHA were observed. The PBMCs were col ected by whole blood culture or PBMC separated culture. mRNA was extracted for the fluorescence quantitative RT-PCR, which was applied to detect the cellproliferation, apoptosis, and expression of inflammatory cytokine and endothelial cellsecreted cytokines. The statistic analysis was used for the significance explication. RESULTS AND CONCLUSION:PBMCs alone cultured ere different from those undergoing whole blood culture. The PHA could up-regulate the gene expression of Ki67, proliferating cellnuclear antigen, Caspase 3, interferon-γ, tumor necrosis factor-βand interleukin-6, but down-regulate Protein C. This indicted that PHA could promote the proliferation and apoptosis of PBMCs and up-regulate the expression of inflammatory cytokines, but down-regulate the expression of endothelial cells secreted coagulation cytokines.

Objective To explore the diagnosis and treatment of clinical possible organizing pneumonia.Methods The medical records of 31 patients with clinical probable organizing pneumonia were retrospectively analyzed.The clinical presentation,radiographic results and treatment were collected and analyzed.Results Thirty-one patients with non-response to antibiotics were preliminary diagnosed as organizing pneumonia.By percutaneous lung biopsy or transbronchial lung biopsy the tuberculosis,fungi,suppurative inflammation,lung cancer and other diseases were ruled out in 24 patients,and 7 patients were diagnosed by perfect effect of corticosteroids treatment.Twenty-one patients had typical CT findings.All the patients responded rapidly and completely to the administration of corticosteroids.Six patients relapsed after the reduction or stop of corticosteroid in a follow-up time of 6-25 months.Conclusions Non-response to antibiotics,the typical imaging findings and lung biopsy ruling out other diseases are important for diagnosing organizing pneumonia.Rapid response to administration of corticosteroids may be helpful to the diagnosis.Decreasing the dose of corticosteroid too early may cause recurrence of organizing pneumonia.

Objective To summarize and analyze the effect of hand hygiene(HH)cost on the incidence of health-care-associated infection (HAI),evaluate continuous improvement method,and provide data for hospital manage-ment.Methods The cost of HH project and incidence of HAI in a hospital from January 2013 to June 2014,as well as HH compliance in the first half year of 2014 were investigated.Results Semiannual statistics were performed, the cost of HH project in the first half of 2013,second half of 2013,and first half of 2014 were 283 490,414 232, and 522 345 yuan respectively,compared with the first half of 2013,the cost of HH in the first half of 2014 in-creased by 84.26%;incidence of HAI were 3.13%,3.33%,and 3.03% respectively,difference was significant(χ2=10.37,P <0.001).In the first half of 2014,HH compliance rate increased from 35.00% in January to 59.49% in June.The top three factors that affecting the implementation of HH were busy work,had no time for handwashing;inadequate HH facilities or supplies;inadequate knowledge about HH.Conclusion Increasing the investment of HH products can improve HH compliance and reduce the incidence of HAI.

Objective To explore the diagnosis and treatment of non traumatic chylothorax in non-Hodgkin's lymphoma (NHL) and to understand the differences in diagnosis and treatment between chylothorax and pseudochylothorax. Methods The patient aged 83 years was confrimed as chylothorax and NHL after lymph node biopsy.We reviewed literatures about chylothorax in NHL to analyse the possible mechanism,its diagnosis and treatment. Results The patient was sufferring from unilateral chylothorax diagnosed as true chylothorax by thoracentesis,and progressed to bilateral chylothorax after 1 year.PET/CT examination showed intrathoracic and right cervical lymph nodes enlargement and an increasing metabolic activity.Cervical lymph node biopsy revealed diffuse large B cell type non-Hodgkin's lymphoma.The patient refused any other treatment except the diet therapy and died after 19 months.We searched 19 cases with NHL chylothorax in associated literatures about the treatments including radiotherapy (6/6 improved),chemotherapy (6/11 improved),thoracic duct ligation (I/1 improved),thoracic duct ligation and drug pleurodesis(1/1 improved). Conclusions PET/CT is useful in finding the hidden clues of chylothorax in NHL.There is no standard mangement for NHL chylothorax and the treatment must be individualized. The overall prognosis of NHL chylothorax is similar to that of non-Hodgkin's lymphoma and the patient needs early diagnosis and general treatment in order to prolong the survival time.

Objective To evaluate the titers of EV71 neutralizing antibody in donators' plasma,and to establish a high throughput screening method to screening anti-EV71 positive plasma for the production of EV7l-specific IVIG in practice.Methods The EV71 neutralizing antibody titers in plasma samples and in commercial IVIGs (intravenous immunoglobulins) were evaluated by micro-cytopathic effect neutralization test (MCPENT),and a selecting criteria was determined for screening anti-EV71 positive plasma.Then,a high throughput neutralizing method for screening plasma was established and a comparison with MCPENT was conducted.EV71-specific IVIG was prepared from screened anti-EV71 source plasma,and its neutralizing activity was evaluated in cell model and mouse model.Results The results of MCPENT showed that the titers of EVT1 neutralizing antibody were 1 ∶ 50 or above in 20％ of the source plasma,and reached 1 ∶ 180 after being pooled,approaching to the titer of commercial IVIG.In 480 samples,the coincidence rate between the established high throughput neutralizing method and MCPENT was 88.1％.The quality of prepared EV71-specific IVIG was complied with the national standard,and its neutralizing potency was 16 times of that of IVIG,suggesting EV71-specific IVIG had a significantly improved protecting effect on experimental neonatal mice.Conclusion The screening method and the screening criteria for EV71 specific plasma were successfully established.The established high throughput neutralizing method that was operated easily could be used for plasma screening in the development of EV71-specific IVIG.The prepared EV71-specific IVIG,whose neutralizing potency was significantly improved,showed a markedly protective effect on experimental neonatal mice,suggesting it might be very important for the prevention and treatment of handfoot-and-mouth disease.

Objective To evaluate the clinical effect of splenic internal jugular shunt for Budd Chiari Syndrome (BCS). Methods A retrospective analysis was made on the clinical data of 21 patients of BCS who underwent this operation. Results There was no death in 21 patients receiving this operation, The average post operative reduction of FPP was 0.97Kpa.2 suffered postoperative lung infection . Abdominal incision infection occurred in one patient. Tweenty cases were followed up for one month to forty five months. Lower extremity varicose veins and abdomen wall varicose veins basically disappeared a month postoperatively; ascites vanished completely 3 months postoperatively,and lower limb ulcer healed 6 months postoperatively. Seventeen patients followed by CDFI showed that no thrombus was found in their artificial vessel. Barium meal studies in 12 cases displayed that oesophageal varicose veins had basically disappeared during the follow up period. Conclusions Splenic jugular shunt bridged by artifical vessel is safe,effective and less traumatic for patients with type III and some patients with type II Budd Chiari syndrome. It is currently the best choice for treatment of BCS.

Objective To evaluate the safety,middle or short -term effect and indication of the endovascular treatment for ischemic stroke patients with extracranial carotid stenosis.Methods The clinical datas with percutaneous transluminal angioplasty and stenting for extracranial carotid artery stenosis cases were retrospectively reviewed,from which 106 cases with ischemic stroke in the past were selected for study.And theinformation including operation opportunity,operation experience,serious complications such as cerebral hemorrhage and secondary ischemic stroke were summarized.Their clinical features,methods of treatment and prognosis were analyzed specially.Results The placement of 106 cases with 120 stents was satisfaction.Cerebral hemorrhage occurred in 3 cases while thrombosis fol-lowing stent placement in 2 cases,hypotension and bradycardia in 6 cases,vasospasm in 11 cases,gastrointestinal stress bleeding in 1 case,restenosis occurred in 8 cases and no cerebral infarction occurred after operation.Apart from one case of death cerebral hemorrhage,8 cases of restenosis,the,middle or short -term results of the remaining 97 patients were satisfactory.83 cases were followed up for 3 months to 5years,there were no ischemic attack and cerebral infarction occurred.Conclusion The satisfactory effect and safety are achieved in the therapy of carotid stenosis by percutaneous transluminal angioplasty and stenting.Angioplasty and stenting may improve the cerebral hemodynamics of patients with severe /moderate internal carotid artery stenosis.It is suitable for previous ischemic stroke patients.We must be individualized to more carefully assess these patientsˊsurgical risk,strictly adhere to the indications of surgery,and general measures is the key of preventing the complications during the perioperative period.

0.05)respectively,when the whole radiotherapy was finished,the CR was 53.3% and 25.8%(P

Adult ; Carcinoma, Renal Cell ; secondary ; Female ; Humans ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; Vaginal Neoplasms ; secondary