ObjectiveTo investigate the distribution of human immunodeficiency virus-1 (HIV-1)subtypes and the relationship with transmission routes in Shenzhen city. MethodsThe epidemiological survey was conducted in 429 subjects with HIV-1 infection.Vein blood was collected and prepared with anticoagulation.Thereafter,the viral nucleic acid was extracted and subsequently amplified for HIV-1 env,gag genes by reverse transcription nested polymerase chain reaction. The viral sequences were analyzed using Mega software and compared with those in HIV database. The HIV-1 subtypes were confirmed and evolutionary tree was established. The gene discrete rate of different subtypes was calculated.ResultsFour hundred qualified samples were identified as CRF01_AE (n=207),CRF07_BC (n=115),CRF08 _BC (n=14),CRF02_AG (n=1),B (n=49) and C(n=14),respectively.CRF01_AE was the predominant subtype that was detected in the subjects with different transmission routes,such as homosexual contact,heterosexual contact,intravenous drug use and hospital-acquired infection. Among these,sexual contact was the most common route.There were nine cases infected with subtype B HIV-1 in 10 case who were blood borne. The gene discrete rate was more significant in subtype B HIV-1 compared to the other subtypes.According to the evolutionary tree analysis,the viruses under the same subtype formed the relatively independent clusters by different transmission routes. But some overlaps were observed as well. Conclusions Tbere are many HIV-1subtypes in HIV-1 infected subjects in Shenzhen, while the recombinant viruses present as the predominant form.Transmission routes are various with sexual contact as the most common route.Every subset distributes unevenly and forms its own characteristic.Overlap can be observed among the gene distribution of different HIV-1 subtypes.

Objective Study of pulmonary hypertension (PAH) during pregnancy has characteristics of the high risk factors for patient death and its clinical characteristics.Methods Death in patients with clinical data was collected from January 2006 to October 2013 in Beijing Anzhen Hospital Affiliated to Capital Medical University treated 8 cases of pregnancy complicated with PAH in hospital. According to the mechanism of PAH patients will be divided into two categories, Idiopathic pulmonary arterial hypertension (IPAH) in 4 cases, 4 cases of secondary PAH [are secondary to congenital heart disease, also known as congenital heart disease associated PAH (CHD-PAH)]. Analyze the clinical features of 8 cases of patients and pregnancy outcome.Results (1) In 8 patients,4 cases were IPAH, none of them with primary diseases, and they were complicated with severe tricuspid regurgitation. 4 cases were CHD-PAH, all with Eisenmenger′s syndrome. 8 patients were not preconception counseling and regular prenatal examination. (2) The pregestational cardiac function of 8 cases was gradeⅠ-Ⅱ, and it was gradeⅢ-Ⅳon admission. The estimation pressure (sPAP) of pulmonary artery systolic by echocardiography was 101 mmHg (1 mmHg=0.133 kPa). In 8 patients, 7 cases were in pregnancy 27 weeks and beyond for treatment since the clinical symptoms increased, 1 case of pregnant 18 weeks for treatment caused by the increased clinical symptoms. (3) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus, its sPAP was 170 mmHg, dead at 12 hours after admission; the remaining 7 cases termination with cesarean section. 4 patients with IPAH were continuous epidural anesthesia, including 1 case for the intraoperative PAH crisis and respiratory and cardiac arrest with general anesthesia, 3 cases of CHD-PAH patients in 1 case with continuous epidural anesthesia, 2 cases of general anesthesia.(4) In 8 patients, 7 cases of median death time were 3 days after delivery, including 4 cases of IPAH patients death for 2.5 days after delivery;the causes of death were PAH crisis and heart failure. Time of death in 4 cases of CHD-PAH, 1 case was dead at 12 hours after admissions, the remaining 3 cases median death time were 13 days after delivery;the death causes for 4 cases of CHD-PAH were PAH crisis and multiple organ failure. (5) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus in gestational week 31 stillbirths occur. 1 case of pregnant 19 weeks had treatment of caesarean operation, the remaining 6 cases respectively at 28-30 weeks of gestation live birth, neonatal survival. (6) Before delivery, 4 cases of IPAH and 3 cases of CHD-PAH patients treated with alprostadil, iloprost, sildenafil, reduction of pulmonary artery pressure treatment, 1 case of CHD-PAH patient was dead after 12 hours in hospital, no drug treatment.Conclusions (1) PAH in patients need for consultation prior to conception, pregnancy must conduct regular prenatal examination, symptoms occur during pregnancy, the cardiac function was significantly decreased, and no improvement of drug treatment should be early terminated the pregnancy. (2) Compared with the pregnant women with CHD-PAH, faster progress and poor prognosis in patients with IPAH disease. (3)The patients during cesarean operation or intrapartumare easy to cause PAH crisis and heart failure or multiple organ failure. Taking active measures to maintain stability of hemodynamics is the key to prevent the occurrence of death of pregnant women with PAH.

AIM: To study the anti-ulcer actions of the clinic experience prescription Shuangpu Powder and to provide experimental basis for further application. METHODS: Four kinds of experimental rodent ulcer models including aqueous extract excitability ulcer in rats,pyloric ligational ulcer in rats,hydrochloric acid-alcohol induced ulcer in rats and indomethacin induced ulcer in mice were used to observe its actions of anti-ulcer of Shuangpu Powder. RESULTS: The results showed that the Shuangpu Powder significantly decreased ulcer formation induced by stress,pylorus ligation,hydrochloric acid-alcohol and indomethacin. CONCLUSION: Shuangpu Powder has obvious anti-ulcer actions.

Objective To analyze the incidence of invasive fungal infection and the risk factor in primary acute leukemia patients.Methods Retrospectively analysis of clinical data from Jan 2007 to Jun 2008 about 80 newly diagnosed patients with acute leukemia primary treated in Peking University People's hospital.Results The incidence of invasive fungal infection is 13.8%,elderly patients、higer WBC counts and longer antibiotics treatment are the risk factor for the fungal infection.Conclusion There are high incidence of invasive fungal infection in induction therapy for primary acute leukemia,the prophylaxis therapy should be consider in high risk patients.

This study aims to investigate the effect of total flavones of Fructus Chorspondiatis (TFFC) on the mRNA and protein expression of collagen type I and III of rat cardiac fibroblasts (CFs) induced by angiotensin II (Ang II), and explore its anti-myocardial fibrosis molecular mechanism. Neonatal rat CFs were prepared from Sprague-Dawley rats (1-3 d after birth). The expression of collagen type I and III mRNA and protein were measured by RT-PCR and Western blotting, respectively. The study showed that stimulation of neonatal rat CFs with 100 nmol.L-1 of Ang II for 72 h resulted in a significant increase of the expression of collagen type I and III mRNA and protein. The changes on the expression level were blocked by TFFC. The results demonstrated that TFFC can inhibit myocardial fibrosis induced by Ang II in rats, which is probably associated with the collagen type I and III mRNA and protein levels up-regulated by Ang II, and TFFC was shown to decrease the expression levels of collagen type I and III mRNA and protein.

Objective To study retrospectively the response and side effects in two groups of patients with untreated multiple myeloma receiving bortezomib-based regimen(VD/VT)and vincristine combined with adriamycin and dexamethasone(VAD).Methods Eighteen patients were enrolled in a group of VD or VT,receving bortezomib 1.0 mh/m2 or 1.3 mg/m2 on days 1,4,8 and 11,along with dexamethasone 20-40 mg on days 1-4(12 cases);or thalidomide 100 mg/d continuously(6 cases). Twenty-four patients treated with VAD entered into a control group,receiving vincristine 0.4 mg/d on days 1- 4,adriamycin 9 mg·m-2·d-1 on days 1-4 and dexamethasone on days 1-4,9-12,17-20,with 28 days as a cycle.Results After bortezomib-based combinations,16 of with 18 patients(88.9%)achieved at least a partial response,including complete response and near complete response in 7 patients(38.9%).Side effects in the VD/VT group were predictable and manageable;they were mainly haematologic, gastrointestinal,and peripheral neuropathic and were more evident during early cycles.The main side reactions in the VAD group were infections.loss of hair and phlebitis.Conclusion Bortezomib-based combinations therapy is an effective and safe induction regimen for newly diagnosed multipli myeloma patients and appears significantly superior to VAD,yielding high response rates even in patients with poor prognostic features.

Objective To evaluate the anatomic localization and size of acute necrotic myocardium in the ischemic-reperfused rat hearts using 99m TC-Glucarate and microSPECT/CT.Methods The ischemic-reperfused ( IR) rat heart models were established by ligating left anterior descending coronary artery for 60 min.99mTC-Glucarate was intravenously injected into the rats 24 hours after IR operations .Images were acquired 30 min after administration of 99m TC-Glucarate using microSPECT/CT. Anatomic localization and size of acute necrotic myocardium were analyzed with microSPECT/CT imaging , and these results were compared to those determined by triphenyltetrazolium chloride ( TTC ) staining.Results The microSPECT/CT images showed hot spot accumulations of 99mTC-Glucarate in IR hearts (the heart-to-liver ratio was 1.90 ±0.33), not in controls (P <0.05).The anatomic localization of 99mTC-Glucarate-labeled necrotic myocardium were in correspondence with TTC staining results .The hot spot size was related significantly to necrotic myocardial size determined by TTC staining ( R2 =0.964 ) .Conclusions The localization and size of acute necrotic myocardium can be assessed by non-invasive microSPECT/CT imaging with99m Tc-Glucarate.

Objective To investigate the role of RhoA /Rho-kinase pathway in rat models of left heart disease-as-sociated pulmonary hypertension ( PH-LHD) .Methods Twenty male SD rats (3-4 week-old, 90-100 g) were randomly divided into two groups (10 rats in each group):the group C ( control group) with sham operation, and group H ( pulmo-nary arterial hypertension) .The rat model of left heart disease-associated pulmonary hypertension was established by supra-coronary aortic banding in the group H, and the sham surgery was applied for the rats in the group C ( The titanium clip was fixed at the mediastinal tissue adjacent to the artery rather than the ascending aorta).On day 60 after the operation, the cardiac functions, including right ventricular systolic pressure and pulmonary artery pressure were evaluated.After that, all rats were sacrificed and treated with cardiopulmonary lavage in vivo until the lung became white.Then the left lung tissues were fixed in 4%paraformaldehyde for pathological observation while the right lung tissues were frozen for mRNA detec-tion.Results Compared with the group C, both ventricular systolic pressure and pulmonary artery pressure in the group H were increased significantly (P<0.01).Pathological data demonstrated that the pulmonary artery walls in H group were much thicker than that in the group C.Moreover, vascular wall hypertrophy index in the group H was increased greatly compared with that in the group C (P<0.01).QPCR data showed that mRNA levels of Rho kinase, RhoA and ET-A R in the group H were up-regulated compared with the group C ( P<0.01) .Conclusions Rat model of left heart disease-asso-ciated pulmonary arterial hypertension can be successfully established by supracoronary aortic banding.Rho-kinase-media-ted pathway may contribute to the pathogenesis and progress of left heart disease-associated pulmonary arterial hypertension.

Objective To study the methods of matching kilovolt CBCT image with planning CT scan. Methods A total of 121 CBCT scans were matched with planning CT scan using a manual and four automatic match methods by four observers in the offline. In the manual match, the live contour was used as a surrogate for image registration. Four automatic match methods, including routine soft?tissue match, routine bone match, automatic liver match and vertebral body match, were performed using image registration sofeware. First, the stability of the sofeware was tested. Then, the reproducibility of the same automatic match method was evaluated by comparing different observers’ match results. After the manual match by four observers, the mean of the match results was used as a standard to compare with others. The differerces was test by McNemar method. Results In the uniform match factors, automatic match result would not change. The reproducibility of routine soft?tissue and bone match are best, automatic vertebral body match is better than automatic liver match. Howerver, the automatic liver match result is the most similar to manual match, the percentages of match result have an absolute error no more than 3 mm in left?right, superior?inferior and anterior?posterior directions are 84?? 3%, 77?? 7% and 92?? 6%. Conclusions Automatic liver match can be used in image?guided radiotherapy for liver cancer, however, it should be performed by experienced oncologist and technologist together in each fraction, after that, the matching result should be adjusted carefully according to live contour.

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