Objective To estimate the clinical features of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection among acquired immune deficiency syndrome (AIDS) patients and the interaction of lamivudine (3TC) contained antiretroviral therapy (ART) with hepatitis virus replication.Methods From 2004 to 2010,199 human immunodeficiency virus (HIV)/HBV coinfected patients admitted to Zhongnan Hospital of Wuhan University were enrolled,including 76 cases of HIV/HBV/HCV triple infection and 123 cases of HIV/HBV dual infection.Hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) were detected routinely.HBV DNA,HCV RNA before and after ART with 3TC and incidence of end-stage-liver-diseases in two groups were compared.Categorical data were analyzed by chi-square test,and measurement data were compared by t test.Results Positive rates of HBV DNA in HIV/HBV and HIV/HBV/HCV coinfection group before treatment were 45.5 ％ (56/123) and 25.0 ％ (19/76),respectively (x2 =8.429,P=0.004).The levels of HBV DNA in the two groups before treatment were (5.61±1.88) lg copy/mL and (4.70±1.84) lg copy/mL,respectively (t=2.589,P=0.003).After ART with 3TC,detectable rate of HBV DNA in HIV/HBV/HCV group decreased to 9.2％ (7/76),which was significantly lower than pretreatment (x2 =6.681,P=0.010),but serum HCV RNA increased significantly from 56.6％ (43/76) pretreatment to 72.4％ (55/76) post-treatment (x2 =4.136,P=0.042).The incidence of end-stage-liver-diseases in HIV/HBV/HCV co-infected group was significantly lower than that of HIV/HBV dual infection group (18.8 per 1000 person years vs 42.1 per 1000 person years; x2 =4.459,P =0.035) during an average of 5.6 years of follow up.Conclusion It is possible that there are interactions between HBV and HCV when the two viruses are co infected.The timing of patient enrollment might be an impact factor on study results.

Objective To observe the effect of different concentrations of realgar on the apoptosis of gastric adenocarcinoma cell Line SGC-7901. Methods MTT assay was conducted to detect the growth inhibition ratio of SGC-7901 cells treated by different concentrations of realgar (0,10,20,50 and 80 μg·mL-1 ). AnnexinⅤ/ Propidium iodide double staining method together with flow cytometry were used to detect the effect of realgar at 0,20,50 and 80 μg·mL-1 on the apoptosis of SGC-7901 cells. Results The growth inhibition ratio of SGC-7901 cells by various concentrations of high-purity realgar (10,20,50 and 80 μg·mL-1 ) was 6. 15% ,7. 54% ,42. 31% and 63. 54% ,respectively,24 h after realgar treatment. At 48 h after the treatment,the growth inhibition ratio rose to 32. 56% ,46. 14% ,64. 51% and 87. 52% ,respectively (P<0. 05). Half inhibitory concentration was 45. 23 μg·mL-1 after 24 h and 15. 34 μg·mL-1 after 48 h. After treated by various concentrations of pure realgar (0,20,50 and 80 μg·mL-1 ) for 24 h,early cell apoptosis rate was (11. 10±2. 10)% ,(15. 31±1. 30)% ,(25. 81 ±2. 68)% and (43. 62 ±8. 51)% ,respectively,significantly different among the four groups (P<0. 05). The late cell apoptosis rate in each group was (1. 84±0. 25)% ,(4. 41±0. 09)% ,(4. 37±0. 14)% and (5. 00±0. 10)% ,respectively (P>0. 05). Conclusion High purity realgar can inhibit the proliferation and induce early apoptosis of gastric adenocarcinoma SGC-7901 cells.

Objective To investigate the requirements of hospitalized patients on humanized nursing in the ward of whole-process humanistic care mode and provide scientific references for continuous improvement of nursing quality.Methods A total of 408 patients from 2 wards of whole-process humanistic care mode.Patients were applied the self-designed questionnaire in combination with interview to understand the patients’ requirements of humanized nursing.Survey was carried out before the inpatients were discharged from the hospital adopting the “Evaluation Table of Patients’ Satisfaction Degree about the Nursing Service” produced and researched by our hospital independently.Results After carrying out the whole-process humanistic care service mode,the inpatients’ overall satisfaction degree and satisfaction rate with humanistic care were respectively 98.2％,97.5％.Conclusions Carrying out the quality care demonstration project and enhancing the concept of humanistic care can promote each other.Carrying out the inpatients’ care needs survey in the ward of whole-process humanistic care mode,integrating humanistic into every aspect of clinical nursing,are the crux of deepening high-quality nursing care as well as a new subject that clinical nurses should confront conscientiously.

Kidney transplantation is a high-cost and high-risk surgery,thus genuine informed consent from the patients and their family members is indispensable both for protecting rights of patients and ensuring medical safety.Guided by related regulations and ethical guidelines,this paper proposes necessary information which should be provided for patients,one example of Informed Consent Form(ICF) composing of information sheet,and consent signature form offered for reference.The proposed ICF applies three accepted requirements for informed consent,i.e.,completely being informed,fully understood and free to make choice.

Objective To find the microorganisms which hydrolyze sugar residues of steroidal saponins at C-3 position and to obtain their glucosyl-derivatives.Methods The enzymes secreted by fermentation of Curvularia lunata((3.438 1)) in the culture medium were employed to transform polyphyllin Ⅴ(compound Ⅰ) and polyphyllin Ⅵ(compound Ⅱ).The products were separated by means of chromatography on C_(18) column and their structures were elucidated on the basis of spectral analyses.Results Compounds Ⅰ and Ⅱ could be transformed by C.lunata((3.438 1)) and the main products were identified as diosgenin-3-O-?-D-glucopyranoside,named trillin(compound Ⅲ) and pennogenin-3-O-?-D-glucopyranoside(compound Ⅳ),respectively.Conclusion The terminal rhamnosyls of polyphyllin Ⅴ and polyphyllin Ⅵ at C-3 position could be hydrolyzed selectively by C.lunata((3.438 1)) for the first time.

Objective:To investigate the epidemic trend and risk change of acquired immunodeficiency syndrome (AIDS) complicated with malignant tumors after combination antiretroviral therapy (cART).Methods:The types of malignant tumors in patients with AIDS at different stages of cART were analyzed among anti-human immunodeficiency virus (HIV)-positive population in Hubei Province screened in National AIDS/HIV prevention and control information system from 1st January, 2004 to 31st December, 2018. The standardized incidence ratios(SIR) of malignant tumors in AIDS patients was analyzed based on the incidence of malignant tumors in the general population in Hubei Province or China in 2013. The changes in risks for development of malignant tumors in AIDS patients at different cART stages from 2004 to 2013 and 2014 to 2018 were compared.Chi-square test was used for statistical analysis.Results:Three hundred and twenty-three out of 22 994 AIDS patients were diagnosed with malignant tumors. Non-Hodgkin lymphoma(NHL) and cervical cancer were most common types in acquired immunodeficiency syndrome-defining cancers (ADC), while liver cancers and lung cancers were the most common types in non-acquired immunodeficiency syndrome-defining cancers (NADC). The overall risk of malignancy in AIDS patients was similar to that in the general population (SIR=1.06, χ2=0.62, P=0.426). However, the risks of Kaposi sarcoma, NHL, Hodgkin lymphoma, cervical cancer, and head and face cancers (excepting nasopharyngeal cancer) in AIDS patients were significantly higher than those in the general population (SIR=834.09, 9.65, 13.33, 5.22 and 2.94, respectively, χ2=11 747.27, 625.54, 56.65, 184.21 and 13.66, respectively, all P<0.01). The risks of lung cancer, colorectal anal cancer, stomach cancer and breast cancer in AIDS patients were significantly lower than those in the general population (SIR=0.33, 0.36, 0.43 and 0.45, respectively, χ2=33.43, 12.84, 9.01 and 7.21, respectively, all P<0.05). The SIR of cervical cancer, liver cancer and colorectal anal cancer from 2014 to 2018 were 4.06, 0.43 and 0.10, respectively, which were significantly lower than those from 2004 to 2013 (7.42, 1.96 and 0.84, respectively). The differences were all statistically significant ( χ2=5.39, 19.52 and 10.86, respectively, all P<0.05). Conclusions:At present, there are no significant differences of the incidences of malignant tumors between AIDS patients and general population, but the tumor types are different. The most common malignant tumors in this region are NHL and cervical cancer, which should be noted that HIV screening among patients with such tumors is conducive to comprehensive treatment to improve the efficacy.

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 explore the epidemiologic features and distribution pattems of hepatitis C virus (HCV) genotype infection among HIV positive former blood donors (FBDs) and transfusion recipients in Hubei province.Methods597 serum samples from HIV-positive patients in Hubei were collected and examined for anti-HCV by enzyme-linked immunosorbent assay ( ELISA ).Reverse transcription nested polymerase chain reaction (RT-nested PCR) amplification and DNA sequencing were used to evaluate the HCV core regions.ResultsThe prevalence rates of HCV in HIV positive FBDs and transfusion recipients were 76.5％ (205/268) and 57.4％ (189/329) respectively.HCV genotypes 1b (92.8％,90/97) and 2a (7.2％,7/97 ) were detected.ConclusionsBlood donation and blood transfusion are the major modes of HIV-HCV co-infection in Hubei province.The prevalence of HCV in HIV positive transfusion recipients is lower than that in HIV positive FBDs.HCV genotypes 1b and 2a are the predominant strains among HIV-positive FBDs and transfusion recipients.

Objective To analyze the incidence,mortality and risk factors of death in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients with combined antiretroviral therapy (cART).Methods A total of 427 HIV/HCV co-infected patients admitted to Zhongnan Hospital of Wuhan University or local disease prevention and control canters from January 2003 to December 2010 were enrolled in the study.The demographic and clinical data of patients were retrospectively studied.Cox progressive regression model was used for data analysis,and Kaplan-Meier method was used to evaluate the effect of end-stage liver diseases on the death.Results of 427 HIV/HCV co-infected patients,53 ( 12.4％ ) died during the follow-up,in which 28 (52.8％) died of liver-related diseases.Male gender ( RR =2.63,P =0.05 ),infection via blood transfusion ( RR =2.15,P =0.04),baseline CD4 + T cells ＜50 cells/μL ( RR =2.83,P =0.02),HIV RNA≥ 104copies/mL at the end of follow-up (RR =2.79,P =0.00 ) and complicated with end-stage liver disease ( RR =7.79,P =0.00) were significantly related to the death.Duration of cART ＞ 5 years is a protective factor for the death ( RR =0.03,P =0.00).Themortality of patients complicated with end-stage liver diseases was 52.7％ ( 29/55 ).Conclusion Liver disease-related death has become the leading cause of death in HIV/HCV co-infected patients,and patients with end-stage liver diseases are of high risk of death.

The paper presented the implementation of the healthcare reform policy and initial success of Xinyu TCM Hospital in its reform pilot work of public hospital reform in Xinyu city ,Jiangxi province. The authors also analyzed problems and causes of the hospital in business development and cost control during the reform ,proposing to carry out TCM development policy ,enhance government investment ,streamline TCM service pricing ,and innovate TCM supporting model. In addition ,they also proposed TCM hospitals to enhance management ,and reform their mechanism to resolve such problems as high operating costs ,and poor talent development and lack of feature disciplines .