Objective To evaluate the 3-year outcomes of the Medecins Sans Frontieres/Guangxi Center for Disease Control and Provention comprehensive and free of charge HIV/AIDS treatment and care project.Methods We present a detailed retrospective analysis of treatment outcomes of 432 cases who received highly active antiretroviral therapy (HAART)from December 2003 to December 2006.Results Among the adult patients who received HAART,the mortality rate was 6.5%and only 12(2.8%)patients were lost to follow up.The mean CD+4 T cell count increase was 147 cells/μl and 246 cells/μl for patients receiving HAART for 9-15 and 21-27 months respectively.An adherence assessment conducted during March to December 2006 indicated that 95.9%of the study cases reached an adherence of 95%or more of the prescribed medications.Among the 30 children patients who received HAART,4(13.3%)cases died and the mean CD4+T cell increase after 9-15 and 21-27 months of HAART was 673cells/μl and 658 cells/μlrespectively.148 of the adult patients starting HAART were current or ex-intravenous drug users(IDU)and showed global death rate and lost to follow-up rate comparable to those of non-IDU patients(Log rank test,P=0.91).Conclusions Good mid-term therapeutic outcomes with combination antiretroviral therapy have been achieved in this project.Total free of charge care and treatment and intensive patient support/counseling are crucial to program success.

Objective To discuss the variation range and the indication of soluble serum Fas (sFas) in aplastic anemia (AA) patients.Methods The level of sFas receptor in 38 AA patients was assayed by ELISA,with 30 cases as controls.Results The level of sFas receptor in AA patients was apparently lower than those of the control group (P

OBJECTIVE:To provide reference for strengthening the management of drug off-label dosage in hospital. METH-ODS:PDCA cycle management was conducted to investigate the current situation of off-label dosage of Alprostadil injection (Li-po-PGE1)in endocrinology department of our hospital before Jul. 2012 in the Plan stage,identify problems,find reasons and devel-op intervention objectives and measures;after intervention in Do stage,medical advices were checked periodically in Check stage, and the data in the same stage of 2013 were spot-checked in Astage stage,intervention effect was analyzed and interventional pro-cess was standardized. RESULTS:Totally 943 medical advices,including 126 cases/times were analyzed before PDCA intervention and according to the data of cases,medical advices and drug usage amount,the incidences of off-label dosage were 39.68%, 31.50% and 47.90%,respectively;after a cycle of PDCA intervention,totally 414 medical advices,including 73 cases were ana-lyzed and the incidences of off-label dosage were 0. The prescribed daily dose(PDD)was decreased from 13.15 μg to the predeter-mined range(10.00 μg)with decrease rate of 23.95%;the drug use density(DUD)was decreased from 59.82 to 20.07 with de-crease rate of 66.45%. There were significant differences in among the incidence of off-label dosage,PDD and DUD of Lipo-PGE1 (P<0.05). It reached the expected targets. CONCLUSIONS:Because of its well-organized ideas on work and continuous improve-ment methods of circulation,PDCA cycle management provides a workable avenue to manage drug off-label dosage uses in hospital.

BACKGROUND: Belladonna drugs have been widely used in clinic in our country to improve microcirculation, or as a herbal anesthetic drug. However,there are few reports regarding the animal experiments on belladonna alkaloid against morphine addiction further OBJECTIVE: To observe the effects of belladonna alkaloid combined with morphine on morphine(Mor)-addicted mice so as to provide an experimental basis for development of belladonna to morphine addiction.DESIGN: A completely randomized-controlled study based on the experimental animals.SETTING: Laboratory of physiology of a medical college.MATERIALS: The study was performed at the Laboratory of Physiology of Medical Department of Hebei Engineering College from June 2004 to August 2004. Fifty 2-month old male healthy Kunming mice of clean grade with a body mass of(20±2) g were obtained from Experimental Animal Centre of Hebei Medical University.METHODS: According to evaluation index of dependence in Morphine-addicted animals, we chose pain threshold and naloxone-urged jumping response as items to observe. Fifty mice were randomly divided into 5 groups with 10 mice each, which were the control group (saline), the morphine group, the scopolamine(Sco)group, the anisodamine(Ani), atropine(Atr)group. The corresponding drugs or saline was administered by intraperitoneal (I. P.) injection once a day for 7 days. The pain threshold at 1 hour after I. P. Injection of drugs was observed from day 1 to day 7 by hot-plate method. Mice were given I.p. Injection of naloxone (Nal, 5 mg/kg ) 6hours after the last injection. The jumping times within 30 minutes were observed to evaluate the ,formation of the Morphine addiction.Nal-urged mice.RESULTS: The pain threshold of the mice in Morphine group was decreased significantly, and the jumping times and jumping rate were obviously increased compared with that of the control group( P ＜ 0.05 or P ＜ 0.01).The co-administration of Sco-Mor mixtures for 7 days significantly increased the pain threshold of Mor-dependent mice( P ＜ 0.01) and markedly decreased the jumping times and the jumping rate( P ＜ 0. 05) . Atr-Mor and Ani-Mor had a weak effect on the elevation of the pain threshold of Mor-dependent mice, but had strong effects on the decrease of the jumping times and the jumping rate( P ＜ 0. 01 ).CONCLUSION: Belladonna alkaloids all could antagonize Mor-dependence in mice at different degrees, which provide an important experimental evidence to develop belladonna drugs for preventing opium addiction.

Objective To construct a lentiviral vector carrying rat sirt1 gene and observe the expression of sirt1 in retinal ganglion cell (RGC) of rat.Methods Rat sirt1 cDNA was inserted into pLV5 vector.After identification by sequencing analysis and PCR,the recombinant sirt1expressinglentivirus vector was packaged by cotransfecting 293T cells with packaged plasmid.Then pLV5-sirt1 was used to infect the cultured Sprague-Dawley rat RGC cell in vitro.The expressions of sirt1 protein and mRNA in infected rat RGC were detected by quantitative real-time PCR and Western blot.Results The sirt1 expression vector pLV5 was successful constructed and sequence was proved to be correct.The expression of sirt1 protein and mRNA in RGC was significantly increased than that in cells infected with control lentiviruses (P ＜ 0.05).Conclusion We have successful constructed a sirt1 expression lentivirus vector pLV5-sirt1 and it can increase the expression of sirt1 protein and mRNA in the rat retinal ganglion cells.

Objectives To investigate the effect of matrine (MAT) on adriamycin (ADR) induced podocyte injury in vitro and explore the function of the mammalian target of rapamycin (mTOR) protein signaling pathway during the intervention. Methods ADR (1μmol/L) was used to induce the model of podocyte injury and then the podocytes were intervened by 10, 20 and 40μg/ml MAT for 24 hours. The viability and apoptosis rate of podocytes, mRNA and protein expressions of desmin and mTOR were detected. The effect of different concentrations of MAT on ADR-induced podocytes was analyzed. Results Com-pared with the control group, declined viability of podocytes (P<0.001), increased percentage of apoptotic podocytes (P<0.001), and increased expression of damage marker desmin (P=0.002) were observed in ADR group. In ADR group, after intervention with MAT of 10-40μg/ml, increased viability of podocytes (P<0.05), decreased percentage of apoptotic podocytes (P<0.05), and decreased expression of damage marker Desmin were found (P<0.05). The protein expression of mTOR and phosphorylation state of mTOR (p-mTOR) decreased in ADR induced-podocytes (P<0.05), and after intervention with MAT of 10-40μg/ml, the expression of mTOR and p-mTOR increased (P<0.05). The expression of mTOR downstream target protein s6k1 and 4EBP1 mRNA decreased in ADR group (P=0.071), while increased after intervention with MAT of 10-40μg/ml (P<0.05). Conclusions 10-40μg/ml MAT have protective effects on ADR-induced podocytes in vitro. The protection mechanism may be related to mTOR signaling pathway.

Objective: To investigate the clinical relevant factors associated with transfusion associated necrotizing enterocolitis (TANEC) in order to reduce the incidence of neonatal necrotizing enterocolitis (NEC). Methods: The clinical data of neonates admitted to the First Hospital of Lanzhou University and received blood transfusion therapy from January 2017 to June 2018 were collected, including perinatal factors, basic conditions of children, and comorbidities.According to the occurrence or absence of NEC within 48 hours after transfusion, the patients were divided into TANEC group and no-TANEC group.The clinical data of the two groups were compared. Results: Univariate analysis showed that there were statistical differences (P<0.05) in the mode of delivery, gestational age, birth weight, neonatal sepsis, patent ductus arteriosus(PDA), neonatal respiratory distress syndrome (NRDS), and anemia.The logistic multivariate analysis revealed that gestational age(P<0.05, OR=0.772, 95%CI: 0.684-0.871), the birth weight(P<0.05, OR=0.236, 95%CI: 0.079-0.711)were protect fators of TANEC, the degree of anemia(mode 1: P<0.05, OR=3.129, 95%CI: 1.003-9.756; mode 2: P<0.05, OR=3.449, 95%CI: 1.024-11.609)and sepsis (mode 1: P<0.05, OR=6.327, 95%CI: 1.732-23.720; mode 2: P<0.05, OR=8.154, 95%CI: 2.122-31.336)were significant risk fators for TANEC. Conclusion The factors leading to the occurrence of TANEC are various.When transfused, the greater the gestational age, the higher the birth weight, the lower the risk of developing NEC.The more severe the combination of neonatal sepsis and anemia, the higher the risk of developing TANEC.Clinically, comprehensive measures should be taken to prevent neonatal anemia.According to the specific conditions of the children and the degree of anemia, a reasonable clinical strategy should be formulated to avoid blood transfusion to reduce the incidence of TANEC and improve the prognosis of the children.

Objective:To evaluate the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of one hundred VLBWI, hospitalized from July, 2016 to June, 2019, were studied retrospectively.The infants were divided into two groups according to whether they received blood transfusion.The general information, incidence of diseases and treatment measures were compared between two groups.The risk factors influencing the blood transfusion were analyzed.Results:Of the one hundred VLBWI, sixty-nine cases needed blood transfusion.The first time of blood transfusion ranged from one to four weeks after birth, and average number of transfusions was 6 times.Maternal anemia during pregnancy, birth weight, gestational age, hemoglobin and hematocrit at birth, volume of blood taking within two weeks after birth, duration of hospitalization, duration of paraenteral nutrition, delivery method, need for intubation and neonatal respiratory distress syndrome, apnea, bronchopulmonary dysplasia, patent ductus arteriosus showed significant differences between the two groups( P<0.05). Logistic regression analysis revealed that lower gestation( OR=0.386, 95% CI 0.212-0.704, P=0.002), longer duration of hospital stay( OR=2.177, 95% CI 1.170-4.049, P=0.014), prolonged parenteral nutrition( OR=1.195, 95% CI 1.083-1.319, P<0.001), greater volume of blood taking within two weeks after birth ( OR=1.269, 95% CI 1.083-1.487, P=0.003)and cesarean delivery( OR=5.513, 95% CI 1.056-28.770, P=0.043) were associated with increasing risk of blood transfusion in VLBWI. Conclusion:The gestational age, length of hospital stay, blood intake within two weeks after birth, duration of paraenteral nutrition and delivery method all affected the risk of blood transfusion to varying degrees.

OBJECTIVETo explore the role of mitochondrial DNA 5178 C/A (Mt5178) polymorphism of NADH-dehydrogenase subunit 2 (ND2) gene in type-2 diabetes mellitus (T2DM) among ethnic Han Chinese through a case-control study.

METHODSThe Mt5178C/A polymorphism was determined by sequencing 1103 T2DM patients and 791 healthy controls. Logistic regression analysis was conducted to estimate odds ratios (OR) and 95% confidence intervals (CI). To confirm the results, a meta-analysis was conducted based on published literature on the association of Mt5178 variant with T2DM.

RESULTSNo significant association was found between the Mt5178C/A variant and T2DM either by our study or the meta-analysis which included eight published studies. Nevertheless, it was found that the T2DM patients with 5178C genotype were at a higher risk for nephropathy complication (OR=1.49, 95%CI: 1.005-2.197, P<0.05) and at significantly lower risk for hypertension complication (OR=0.744, 95%CI: 0.556-0.996, P<0.05) compared with those carrying a 5178A genotype.

CONCLUSIONNo association was found between the Mt5178C/A polymorphism of mitochondrial ND2 gene with the increased risk of T2DM. However, the polymorphism may affect the development of nephropathy and hypertension complications among T2DM patients.

Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; DNA, Mitochondrial ; chemistry ; genetics ; Diabetes Complications ; blood ; genetics ; Diabetes Mellitus, Type 2 ; blood ; complications ; genetics ; Diabetic Nephropathies ; blood ; genetics ; Fasting ; blood ; Female ; Humans ; Hypertension ; blood ; complications ; genetics ; Male ; Meta-Analysis as Topic ; Middle Aged ; Odds Ratio ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Triglycerides ; blood