Protozoal infection is one of the most important opportunistic infections among patients with acquired immune deficiency syndrome(AIDS). In order to enhance the knowledge of protozoal infections in AIDS, the current status of diagnosis and treatment of toxoplasmic encephalitis, cryptosporidiosis, microsporidiosis and isosporiasis was reviewed in this paper.

T follicular helper cells(Tfh)possess the function to induce efficient B cell maturation in germinal center (GC).However,HIV infection can destroy the structure of lymphoid follicles,and disturb the quantity and function of Tfh,resulting in the dysfunction of B cells.Meanwhile,HIV may remain dormant in the Tfh after invading host and escape the elimination of immunologic system.Consequently,the Tfh turns into the sanctuary of HIV.By the above mentioned mechanism,HIV infection leads to the progressive damage of CD4 + T lymphocytes, hypergammaglobulinemia and the loss of memory B lymphocytes.

The mortality of septic shock has been reported high.Glucosteroid is widely used in patients with septic shock as one of the assistant therapies of septic shock.However the applied patients,the using time,the duration and the dose of glucosteroid remain controversial.Recently it is recommended using small dose in septic shock according to results of large scale clinical trials.We will review the studies of glucosteroid in septic shock in recent years here.

Zika virus disease is a mosquito-borne disease with aedes as a potential viral vector. Besides Zika virus, aedes can also serve as a vector for other viruses such as yellow fever virus and dengue virus.With the impact of globalization and climate changes, many regions in the world are experiencing outbreaks of mosquito-borne diseases in recently years.This paper focuses on the epidemic, prevention and control measures of mosquito-borne infectious diseases such as Zika virus disease and yellow fever which are firstly imported to China.

Objective To review the blood gas analysis of H7N9 flu patients for better understanding the characteristics and prognosis of the emerging disease.Methods A retrospective review was conducted for the 15 H7N9 influenza patients,whose blood gas profile was tested with a Radiometer 80 Blood Gas Analyzerin our hospital.The profile of blood gas analysis was compared between the 12 surviving patients and the 3 deaths in terms of their outcomes.Results The 3 patients who died of H7N9 influenza averaged 83 years old.The partial pressure of oxygen was <8 kPa in 9 of the 12 surviving patients,which meet the diagnostic criteria of type I respiratory failure.Their partial pressure of oxygen all recovered to normal (11 .033 ± 2.335 kPa,reference range 10-14 kPa)on discharge.The pH value of peripheral arterial bloold averaged 7.335 (range 7.39-7.54)on adission for the 3 patients who died of H7N9 influenza.The worst average pH value was 7.233 (range 7.32-7.35), which was significantly different from the values of the surviving patients.Conclusions Elderly patients are susceptible to H7N9 influenza infection and subsequent respiratory failure.Old age was associated with higher mortality.The partial pressure of ox-ygen is not significantly associated with patient outcomes.Appropriate active treatment may recover the blood gas profile to normal regardless of the initial values.If decreasing peripheral arterial bloold pH value is highly suggestive of poor prognosis, comprehensive measures should be taken to keep acid-base balance,including assisted ventilation to correct hypoxemia.

The outbreak of COVID-19 occurred in January 2020, the epidemic is still rampant around the world. The Shanghai Expert Consensus on Comprehensive Treatment and Management of Corona Virus Disease 2019 was issued in early March 2020, which provided the guidance of the standardized treatment and rational medication for COVID-19. The administration of " four agents (glucocorticoids, heparin, high-dose vitamin C, Interferon-κ) and one peptide (thymic peptide)" recommended by the consensus is the key to successfully block and treat critical illness.

Objective To study the mutations of ERG11 gene which encodes P450 lanosterol 14-α demethylase, and to explore the possible role of ERG11 gene in inducing fluconazole resistance in Candida glabrata. Methods ERG11 genes of 9 fluconazole-resistant Candida glabrata isolates and 10 fluconazole-sensitive Candida glabrata isolates were cloned into pUC57-T vector. The open reading frame of ERG11 gene were sequenced by two directional sequencing using universal primers. All sequences were compared with the published sequence. Results Ten kinds of synonymous point mutation were found. Neither missense mutation nor frame-shifting mutation was found. Among the 10 kinds of synonymous point mutation, 5 were found in both fluconazole-resistant and fluconazolesensitive Candida glabrata isolates, and 3 were only found in fluconazole-resistant isolates, 2 were only found in fluconazole-sensitive ones. The majority of the point mutations were located between 1320-2200 base pair of ERG11 gene. Conclusions There are ERG11 gene polymorphisms in clinical strains of Candida glabrata. ERG11 gene mutations are not found to be involved in the development of fluconazole resistance in Candida glabrata.

Objective To assess the epidemiological relatedness on an outbreak of Enterococcus facium sepsis between humans and pigs based on genomic analysis. Methods Two bacterial isolates recovered randomly from the blood of one patient and one pig were analyzed for homogeneities by comparison with 16S rRNA gene sequences in the GeneBank. Moreover, The extracted genomic DNA was digested with the 20 U SamI enzyme respectively, then their interrelationship was performed according to the pulsed field gel electrophoresis. Results Sequences determined from both human and pig isolates were 100% identical and most closely related to E. facium , diverging from the prototype sequence by one nucleotide (99.9% similarity) and displayed indistinguishable pulsed field gel electrophoresis patterns. Conclusions These data demonstrate epidemiological relatedness of the bacterial isolates, and suggest spread of an E. facium -related sepsis outbreak from pigs to humans.

Objective To construct recombinant plasmid with p24 and gp41 gene, express fusion protein in E.coli. Methods To design primer with restriction endonuclease position,and amplify p24 and gp41 by RT-PCR, link both into pMD18-T vector.To choose correct clone with target gene.Then p24 fragment will be cleaved and linked into pMD18-T vector within gp41 gene. Both post-linked gene will be cleaved and linked into pET21a vector. The vector will be transformed into E.coli. And protein is highly effective expressed in E coli. Western blotting proved that the expressed product could react with 6?his antibody. Result Fusion protein p24-gp41 is highly effective expressed in E.coli. Conclusion Fusion protein p24-gp41 is highly effective expressed in E.coli in pET21a vector.

Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.