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 assess the left ventricular longitudinal shrinkage function in liver cirrhosis patients with two-dimensional speckle tracking imaging (2D-STI). Methods Echocardiography and Doppler echocardiography were performed in 34 patients with liver cirrhosis and 35 healthy subjects of corresponding ages. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ventricle; then the left ventricular diameter, left atrium diameter, the peak filling velocity of E wave and A wave, E/A ratio, EF and FS were measured. The peak systolic strain of left ventricular segment was measured with two-dimensional strain software. Results Compared with healthy subjects, left ventricular diameter, left atrium diameter, EF and FS of liver cirrhosis patients were not statistically different (P>0.05), but the E/A ratio was lower (P<0.05). The peak systolic strain of most left ventricular segment in liver cirrhosis reduced significantly (P<0.05), except that of base segment of posterior wall, anterior wall, inferior wall, anterior and posterior interventricular septum, as well as middle segment of posterior interventricular septum. Conclusion The heart shape, systolic and diastole function of liver cirrhosis are abnormal. 2D-STI can early and accurately evaluate the systolic function of liver cirrhosis.

Objective Probe the value and the operation risk for HIV/AIDS patients with surgical compli-cations. Methods Investigated 27 HIV-infected patients(male 26, female 1, age 27-74 years) were investi-gated. All patients had pre-operative detection of immune function, standardized surgical procedures, careful surgical process to reduce the operation damage, continuous infusion of coagulation factors for haemophilia during operation, conventional application of antibiotics to prevent infection and prompt treatment of compli-cations. Results No incision infected in 8 cases of class one incision, 1 incision infected in 6 cases of class two incision, 3 cases were not healed in 30 days after operation in 13 cases of class three incision. One case died of severe sepsis 12 days after operation, the others discharged with recovery or improvement. Conclu-sion Suitable operation and treatment method may obtain curative effect for HIV-infected patients.

Objective: To investigate the surgical techniques for establishing the rat model of orthotopic liver transplantation.Methods: On the basis of the double-cuff technique of Kamada,we improved the techniques for the separation and perfusion of the donor liver,the shearing and anastomosis of the superior and inferior caval veins,and the anastomosis of the bile duct.Results: Of the 40 rats that underwent orthotopic liver transplantation,80% survived longer than 24 hours and 70% over 7 days.Conclusion: With extreme patience and carefulness,the operator can successfully establish the rat model of orthotopic liver transplantation by shortening the anhepatic phase with skillful surgical techniques.

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.

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 assess the preferential expressions of peripheral blood T cell receptor beta chain variable region (TRBV) subfamilies in patients with psoriasis vulgaris(PV), and to estimate their role in the pathogenesis of psoriasis. Methods Thirty-three upstream primers were designed to target the human functional TRBV genes, downstream primers to target the common T cell receptor beta constant (TRBC) gene,with T cell receptor alpha constant (TRAC) gene as the internal reference. Total RNA was extracted from the peripheral blood T cells of 10 health human controls and 10 patients with PV, and transcribed into cDNA.Then, TRBV genes were amplified by real-time fluorescence quantitative PCR (RFQ-PCR) and the fluorescence intensity of each samples was detected. The expression levels of TRBV genes in the control group were used to calculate the cut-off values (mean expression levels of TRBV subfamilies in the 10 normal controls + 3 standard deviations). When the expression level of a TRBV subfamily from patients with PV was equal to or higher than the cut-off value, it was considered as the preferentially expressed TRBV subfamily. Results The threshold cycle (Ct) value varied from 21 to 24 for TRAC gene. The difference in the Ct value between TRBV subfamily genes and TRAC gene in patients with PV was 2.98 for TRBV2 gene, 3.24 for TRBV5-7 gene, 2.52 for TRBV6-6/6-9 gene, 2.04 for TRBV 12 gene, 3.56 for TRBV 24 gene, and 4.12 for TRBV 29 gene, and the expression levels of these subfamily genes were significantly higher than those in the normal controls (all P ＜ 0.05). According to the above standard, TRBV6-6/6-9, TRBV12 and TRBV29 were considered to be preferentially expressed subfamilies. Conclusions There is a preferential expression of TRBV gene subfamilies in peripheral blood of patients with psoriasis vulgaris, which may play a vital role in the abnormal T cell-mediated immune responses in psoriasis.

Objective:To explore the mechanism,clinical features,and prognosis of trigemino-cardiac reflex (TCR) during skull base operations.Methods:A retrospective analysis was performed on 291 patients with skull base disease from Jan.2009 to Oct.2015 in Peking University First Hospital.By reviewing the patients' operative data and anaesthetic electrical record,and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures,clinical features,influence factors,and prognosis.TCR was defined as a drop in mean arterial blood pressure (MABP) and the heart rate (HR) of more than 20％ to the baseline values before the stimulus and coinciding with the manipulation of the trigeminal nerve.Results:In all the 291 patients receiving skull base surgery,9 patients suffering TCR for 19 times during the operation were found.These 9 cases included three acoustice schwannomas,one trigeminal schwannoma,one petroclival meningioma,one epidermoid cyst in cerebellopontine angle,one cavernous sinus cavernous hemangioma,one pituitary adenoma,and one trigeminal neuralgia.The trigger of TCR was related to manipulation,retraction,and stimulation of the trunk or branches of trigeminal nerve.The baseline heart rate was 62-119/min [mean (79.4 ± 14.6) /min] and dropped about 29.0％-66.4％ (mean 44.3％) to 22-60/min [mean (44.2 ±9.6) /min] after TCR.The baseline mean arterial blood pressure was 75-103 mmHg [mean (87.5 ±7.8) mmHg] and dropped about 23.4％-47.2％ (mean 37.3 ％) to 45-67 mmHg [mean (54.9 ± 6.3) mmHg] after TCR.During the 19 times of TCR,heart rate and blood pressure could return to baseline in a short time while stopping manipulation (8 times),using atropine (8 times,dose 0.5-1.0 mg,mean 0.69 mg),using ephedrine hydrochloride (one time,15 mg),using epinephrine (one time,1 mg),and using dopamine (one time,2 mg).TCR also could be triggered again by a second stimulation.There was no relative cardiologic complication or neurological deficit in the postoperative 24 hours.Conclusion:TCR is a short neural reflex with a drop in blood pressure and heart rate coinciding with the manipulation of the trigeminal nerve in skull base surgery.Correct recognition,intensive observation,and essential management of TCR will lead to a good prognosis.

Objective To investigate the problem of adverse effects in common AIDS patients and AIDS patients with tuberculosis after highly active antiretroviral therapy (HAART). Methods The case group was composed of 106 patients with both AIDS and tuberculosis. The control group was composed of 134 common AIDS patients. The rates of adverse effects and the increase of CD4 + T cell count in those groups after first year HAART were observed and compared. Results The rates of adverse effects in the case group was 36. 8% ,which was more than that in the control group (26. 9%), but the difference was not significantly different(x2 =2.715, P =0. 099). The count of CD4+ T cell in most of the patients was increased after HAART (P ＜ 0. 01). The increase of CD4 + T cell count in the case group [(147.2 ±137.6)/μl] was higher that in the control group[(142. 1 ± 127. 0)/μl after six months HAART vs. (166. 5±133. 1)/μl in case group], and it was lower than that in control group after nine months HAART [(172.7±107.5)/μl], however the difference was not significant(P ＞0.05). Conclusions HAARTcould reconstruct the immunition of AIDS patients. The increase of CD4 + T cell count did not show significant difference between common AIDS patients and AIDS patients with tuberculosis after HAART. AIDS patients with tuberculosis might not increase the risk of development of adverse effects during HAART.

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.