Objective To investigate the risk factors of hypersensitivity induced by compound sulfamethoxazole (Co-SMZ)in patients with human immunodeficiency virus (HIV)infection.Methods A retrospective study was performed in 111 patients with HIV infection receiving prophylactic Co-SMZ at the Department of Infectious Diseases,the Third People′s Hospital of Nantong City,Jiangsu Province from January 2014 to December 2014.Data including age,gender,interval time from diagnosis of HIV infection to hospitalization,history of drug allergy,and the counts of CD3 + T cell,CD4 + T cell,CD8 + T cell and natural killer (NK)cell on the day when the medicine was administrated for the first time were recorded. All the patients were followed up for two months.Student t test was used in data with normal distribution or approximate normal distribution.Rank sum test was used in data with skew distribution.The count materials were examined byχ2 test.Results Among the 111 patients with HIV infection,there were 107 males and 4 females with average age of (45 .7±11 .1)years old.The interval time from taking Co-SMZ to hypersensitivity was (14.0±7.6)d.There were differences in the counts of CD4 + T cell and NK cell between patients with hypersensitivity and without hypersensitivity (both P <0.05).Multivariate analysis showed that NK cell was a risk factor for inducing hypersensitivity (OR=1 .010,95 %CI :1 .005 -1 .017, P =0.001).The area under of receiver operating characteristic curve predicting hypersensitivity induced by Co-SMZ was 0.748 (95 %CI :0.647-0.850,Z =4.701 ,P =0.001).The best predictor was 109.80/μL with sensitivity of 63.2% and specificity of 84.7%.Conclusion In patients with HIV infection,NK cell might be associated with hypersensitivity induced by Co-SMZ.

Objective:To analyze the clinical characteristics of patients with uremic tumoral calcinosis (UTC).Methods:A total of 10 patients with UTC were enrolled in this study, who were admitted in the Department of Nephrology, China-Japan Friendship Hospital and Beijing Chuiyangliu Hospital from March 2013 to February 2019.Results:The average age of 4 male and 6 female patients on regular hemodialysis was (39.90±8.57) years. The average dialysis duration was(5.90±2.57) years. Three patients presented as single lesion of one joint, the other 7 patients as involvement of multiple large joints. Serum calcium was elevated in 2 patients,both over 2.75 mmol/L. Serum hyperphosphatemia was seen in all patients with average level 2.22 (1.94,2.44) mmol/L. Serum intact parathyroid hormone (iPTH) was remarkably increased in 9 patients with average level 1 348.0(854.8,1 800.0) ng/L, while only 1 patient reported slight elevation (92.4 ng/L).High-sensitivity C-reactive protein increased in all 10 patients with average 35.81 (17.60,74.20) mg/L. The imaging findings before treatment suggested that a large number of irregular masses of calcification shadows deposited in the soft tissue adjacent to the joints. The outlines of calcification were clear without significant bone absorption. Nine patients with severe secondary hyperparathyroidism (SHPT) were treated with parathyroidectomy, resulting in lesions diminishing or even disappearing. A total of 32 parathyroid glands were resected, and pathological results showed that 7 parathyroids were diffuse hyperplasia, 11 as diffuse/nodular hyperplasia, the rest 14 as nodular hyperplasia. At least one hyperplastic parathyroid gland was seen in each patient. Only 1 patient received medical therapy yet no obvious improvement was observed.Conclusion:UTC is a rare complication in patients on regular hemodialysis, which is usually associated with severe SHPT. Parathyroid surgery may improve the clinical outcome.

Objective: To explore the changes of the peripheral invariant natural killer T (iNKT) cells in patients with human immunodeficiency virus (HIV) infection. Methods: A total of 101 patients with HIV infection including 52 asymptomatic patients and 49 acquired immunodeficiency syndrome (AIDS) patients were enrolled in the study from June 2016 to July 2017. Flow cytometry was used to detect iNKT cells, CD4⁺ T cells and CD8⁺ T cells, and the relationship among them and HIV RNA was studied. At same time, 12 healthy persons were enrolled as control group. T test or variance analysis, rank sum test, Chi-square test and Fisher exact test were used for statistical analysis. Results: In HIV infected asymptomatic patients, AIDS patients and healthy controls, iNKT cells were 0.135% (0.066%, 0.228%), 0.058% (0.034%, 0.100%) and 0.385% (0.205%, 0.600%), respectively, and the difference was statistical significant (Z=40.113, P<0.01). CD4⁺ T cell counts in the three groups were (340.82±119.26) cells/μL, (72.73±61.84) cells/μL and (555.17±229.43) cells/μL, respectively, and the difference was statistical significant (t=113.79, P<0.01); CD8⁺ T cell counts in the three groups were (842.29±423.68) cells/μL, (540.43±257.85) cells/μL and (875.92±516.45) cells/μL, respectively, and the difference was statistical significant (t=9.423, P<0.01). Ratios of CD4⁺ /CD8⁺ T cells in the three groups were 0.490 (0.240, 0.695), 0.120 (0.030, 0.210) and 0.600 (0.475, 0.895), respectively, and the difference was statistical significant (Z=53.603, P<0.01). iNKT cell counts in patients with or without hepatitis B virus infection, pneumocystis pneumonia, oral mold infection, treponema pallidum, latent tuberculosis or EB virus infection were not significantly different (Z=0.244, 2.325, 2.393, 0.168, 1.183 and 0.454, respectively, all P>0.05). There were correlations between iNKT cells and CD4⁺ T cells, CD4⁺ /CD8⁺ T cells (r=0.513 and 0.261, respectively, both P<0.05), and no relationship was found between iNKT cells and CD8⁺ T cells (r=0.155, P=0.126). In HIV infected asymptomatic patients and AIDS patients, iNKT cells was not associated with HIV RNA (r=-0.113 and -0.111, respectively, both P>0.05). Conclusions The level of peripheral iNKT cells in HIV infected patients decreases with the disease progression. To certain extent, iNKT cells can reflect the severity of immune damaging in HIV infected patients.

Coronavirus disease 2019 (COVID-19) is now a major public health problem worldwide. Infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is extremely strong. The one major target of the virus is the lung, which leads to the deaths of respiratory distress syndrome and multiple organ failure. The kidney is also one of the main organs attacked by viruses, which directly damage the renal tubules through angiotensin converting enzyme-2 and cause cytokine storm, resulting in kidney damage and increasing the risk of death in the patients. Early investigation of risk factors for kidney injury, detection of kidney injury indicators, timely supporting treatment and renal replacement therapy for the existence of kidney injury patients are useful for reducing the mortality rate of COVID-19 patients.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology* ; Humans ; Kidney ; Pandemics ; Pneumonia, Viral/epidemiology* ; SARS-CoV-2