1.Effect of Schisanlactone E on Neuroinflammation and Synaptic Damage in APP/PS1 Mice and Their Relationship with Th17/Treg Immune Balance
Wenjing YU ; Miao YANG ; Chunxiang HE ; Jiawei HE ; Zhenyan SONG ; Ping LI ; Shaowu CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):112-123
ObjectiveTo investigate the effect of schisanlactone E in ameliorating neuroinflammation and synaptic injury in APP/PS1 mice and to elucidate whether its mechanism is related to the regulation of helper T cell 17 (Th17)/regulatory T cell (Treg) immune balance. MethodsAPP/PS1 transgenic mice were assigned into model, low- and high-dose (2 mg·kg-1·d-1 and 4 mg·kg-1·d-1, respectively) schisanlactone E, and donepezil (1 mg·kg-1·d-1) groups. C57BL/6J mice were used as the control group. Each group received the corresponding drug by gavage for 30 days. Learning and memory abilities were assessed by the Morris water maze and novel object recognition tests. The percentages of Th17 and Treg cells in the peripheral blood were analyzed by flow cytometry. The mRNA levels of retinoid-related orphan receptor γt (RORγt), interleukin (IL)-17A, forkhead box protein 3 (FoxP3), and IL-4 in the hippocampus were determined by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The synaptic ultrastructure in the hippocampus was observed by transmission electron microscopy. The protein levels of synapsin Ⅰ and postsynaptic density protein 95 (PSD95) in the hippocampus were measured by Western blot. Aβ aggregation and microglial activation in the hippocampus were observed by immunofluorescence staining. The mRNA levels of tumor necrosis factor (TNF)-α, IL-6, and IL-1β in the hippocampus were determined by Real-time PCR. ResultsCompared with the control group, the model group showed prolonged escape latency (P<0.05), decreased time spent in the target quadrant, platform crossings, novel object exploration time, and percentage of novel object contact frequency (P<0.05, P<0.01), increased Aβ aggregation in the hippocampal tissue (P<0.01), an increased proportion of Th17 cells (P<0.05), a decreased proportion of Treg cells (P<0.05), and an increased Th17/Treg ratio (P<0.01) in the peripheral blood. Furthermore, the hippocampal tissue in the model group exhibited upregulated mRNA levels of RORγt and IL-17A (P<0.05, P<0.01), downregulated mRNA levels of FoxP3 and IL-4 (P<0.01), decreased synapses (P<0.05), decreased PSD density, synaptic interface curvature, and active zone length (P<0.05, P<0.01), and increased synaptic cleft width (P<0.05), downregulated protein levels of Synapsin Ⅰ and PSD95 (P<0.01), increased microglial activation (P<0.01), and upregulated mRNA levels of TNF-α, IL-6, and IL-1β (P<0.05). Compared with the model group, the high-dose schisanlactone E group and the donepezil group exhibited shortened escape latency and increased time in the target quadrant and platform crossings (P<0.05, P<0.01). The schisanlactone E groups and the donepezil group showed increased novel object exploration time (P<0.05, P<0.01) and percentage of novel object contact frequency (P<0.05, P<0.01), and reduced hippocampal Aβ aggregation (P<0.05, P<0.01). The schisanlactone E groups showed a decreased proportion of Th17 cells (P<0.05) and an increased proportion of Treg cells (P<0.05) in the peripheral blood, and all treatment groups showed a decreased Th17/Treg ratio (P<0.05, P<0.01). The high-dose schisanlactone E group showed a downregulated mRNA level of RORγt in the hippocampal tissue (P<0.05), and all treatment groups showed a downregulated mRNA level of IL-17A (P<0.05, P<0.01), and upregulated mRNA levels of FoxP3 and IL-4 (P<0.05, P<0.01). The schisanlactone E groups and the donepezil group showed increased synapses, active zone length, synaptic interface curvature, and PSD density, decreased synaptic cleft width (P<0.05, P<0.01), and upregulated protein levels of synapsin Ⅰ and PSD95 (P<0.05, P<0.01). The high-dose schisanlactone E group and the donepezil group showed decreased microglial activation in the hippocampus (P<0.01). The schisanlactone E groups and the donepezil group showed downregulated mRNA levels of TNF-α, IL-6, and IL-1β in the hippocampal tissue (P<0.05, P<0.01). ConclusionSchisanlactone E significantly improves the cognitive function in APP/PS1 mice by regulating the Th17/Treg immune balance, inhibiting neuroinflammation, and ameliorating synaptic injury.
2.Aspirin Curcumin Ester Inhibits High Glucose/Aβ1-42-induced Microglial Inflammatory Response by Regulating Glucose Metabolism Reprogramming
Wenjing YU ; Miao YANG ; Chunxiang HE ; Ze LI ; Jiawei HE ; Ping LI ; Zhenyan SONG ; Shaowu CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):124-137
ObjectiveTo observe the effect of aspirin curcumin ester (CA) on the activation and glucose metabolism reprogramming of the mouse microglia (BV2) model of inflammation induced by high glucose/β-amyloid (Aβ)1-42, and to explore the potential mechanism of CA in reducing neuroinflammatory response in the brain. MethodsThe BV2 activation model was constructed by high glucose combined with Aβ1-42 oligomers. BV2 cells were treated with Aβ1-42 oligomers (10 μmol·L-1) in a high glucose (50 mmol·L-1) environment and allocated into normal, high glucose, Aβ, and high glucose + Aβ groups. The cell morphology of each group was observed under a bright field. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was adopted to assess the mRNA levels of inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) as well as glycolysis-related glucose transporter type 1 (GLUT1), hexokinase 2 (HK2), phospofructokinase-2/fructose-2,6-bisphosphatase 3 (PFKFB3), and pyruvate kinase M2 (PKM2). To reveal the effects of CA on inflammatory response and glucose metabolism in BV2 cells exposed to high glucose/Aβ1-42, this study established the BV2 cell model of inflammatory activation by high glucose and Aβ1-42 oligomer intervention. The cells were allocated into normal, model (50 mmol·L-1 glucose + 10 μmol·L-1 Aβ1-42), CA (10 μmol·L-1), 2DG (0.2 mmol·L-1), and DADA (1 mmol·L-1) groups. Cell counting kit-8 (CCK-8) was used to detect cell survival rate. The cell morphology of each group was observed under a bright field. The expression of inflammatory factors TNF-α, IL-6, and IL-1β and glycolysis-related key enzymes GLUT1, HK2, PFKFB3, and PKM2 at the mRNA level in each group was measured by real-time PCR. The protein levels of GLUT1, HK2, PFKFB3, and PKM2 were determined by Western blot. The glycolysis rate in each group was measured by seahorse. LC-MS was employed to identify the glucose metabolism intermediates. The morphology of mitochondria in cells was observed by electron microscopy. ResultsConstruction of the BV2 cell model: Compared with the normal group, the Aβ group and the high glucose + Aβ group showed more amoeboid-shaped cells and cell aggregation. The high glucose + Aβ group exhibited increased the mRNA levels of TNF-α, IL-1β, and IL-6 (P<0.05, P<0.01), as well as those of key glycolytic enzymes GLUT1, HK2, PFKFB3, and PKM2 (P<0.01). The Aβ group also showed significantly increased mRNA levels of PKM2 and PFKFB3 (P<0.01). Effects of CA on the inflammatory response and glucose metabolism in BV2 cells exposed to high glucose/Aβ1-42: Compared with the normal group, the model group exhibited amoeboid-shaped cells and cell aggregation, upregulated mRNA levels of TNF-α, IL-1β, IL-6, iNOS, GLUT1, HK2, PFKFB3, and PKM2 (P<0.01) and protein levels of GLUT1, HK2, and PFKFB3 (P<0.05, P<0.01), an increased basal glycolysis rate (P<0.01), a decreased compensatory glycolysis rate (P<0.01), increased glycolytic intermediates and reduced TCA cycle intermediates. In addition, the mitochondria in the model group exhibited a decreased number (P<0.05), impaired crista integrity (P<0.01), an increased proportion of vacuolization (P<0.01), and abnormal mitochondrial morphology. Compared with those in the model group, the number of amoeboid-shaped BV2 cells reduced in the CA and 2DG groups, while most BV2 cells in the DADA group became elongated spindle-shaped. All the three treatment groups showed downregulated mRNA levels of TNF-α, IL-1β, IL-6, GLUT1, HK2, PFKFB3, and PKM2 (P<0.05, P<0.01), downregulated protein levels of GLUT1, HK2, and PFKFB3 (P<0.05, P<0.01), and slow compensatory glycolysis and basal glycolysis (P<0.05, P<0.01). Glycolytic intermediates were decreased and TCA cycle intermediates were increased in the CA and 2DG groups. Mitochondrial morphology largely returned to the normal level in all the three treatment groups, with an increase in mitochondrial number (P<0.05), improved crista integrity (P<0.05, P<0.01), and a decreased proportion of vacuolization (P<0.05). ConclusionAβ1-42 oligomers can activate BV2 cells and enhance glycolytic activity in the high glucose environment. CA can reduce the expression of inflammatory factors and inhibit the activation of BV2 cells by regulating the glucose metabolism reprogramming in BV2 cells.
3.Outcomes of patients with HIV-associated Burkitt lymphoma treated with R-DA-EPOCH regimen: A single-center experience in Shanghai, China.
Yueming SHAO ; Zhenyan WANG ; Wei SONG ; Yang TANG ; Tangkai QI ; Li LIU ; Jun CHEN ; Yinzhong SHEN ; Renfang ZHANG
Chinese Medical Journal 2025;138(22):3010-3012
4.The impact of myocardial infarct size dynamics on left ventricular remodeling in STEMI patients after primary percutaneous coronary intervention
Si CHEN ; Xin A ; Yiqing ZHAO ; Zhenyan MA ; Ying ZHANG ; Ke LIU ; Lei FU ; Liping ZHANG ; Yongqiang YANG ; Ping LI ; Jinwen TIAN ; Hongbo ZHANG ; Lei ZHAO ; Geng QIAN
Chinese Journal of Cardiology 2025;53(6):653-660
Objective:To explore the impact of changes of myocardial infarct size on left ventricular adverse remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).Methods:This was a prospective cohort study. The STEMI patients who underwent primary PCI in the First Medical Center of the Chinese People′s Liberation Army General Hospital, Beijing Anzhen Hospital, Hainan Hospital of the Chinese People′s Liberation Army General Hospital and Guangxi Yulin First People Hospital from January 1, 2017 to January 1, 2022 were enrolled. Cardiac magnetic resonance (CMR) was performed to dynamically assess the myocardial infarct size and calculate the rate of infarct size change between the acute phase (5 to 7 days post-primary PCI) and 6-month follow-up. The endpoint was left ventricular adverse remodeling which was defined as an increase of more than 20% in left ventricular end-diastolic volume (LVEDV) assessed by CMR at 6 months after primary PCI compared with LVEDV at 1 week after primary PCI. Based on serial CMR assessments, the patients were divided into left ventricular adverse remodeling group and non-remodeling group. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of infarct size change for left ventricular adverse remodeling, and according to the optimal cutoff value, improved infarct size was defined as a decrease of >20% in the infarct size measured by CMR at 6 months after primary PCI compared with infarct size at 1 week after primary PCI. Multivariate logistic regression analysis was performed to identify the protective factors and risk factors for left ventricular adverse remodeling.Results:A total of 267 patients were enrolled, aged (58±11) years, with 234 males (87.6%). And 73 cases in the left ventricular remodeling group and 194 cases in the non-remodeling group. Infarct size assessed by CMR at 6 months after primary PCI decreased significantly compared with infarct size at 1 week after primary PCI in the left ventricular remodeling group ((23±13)% vs. (27±12)%, P=0.004), the same as in the non-remodeling group ((18±10)% vs. (23±10)%, P<0.001). The area under the ROC curve for the rate of infarct size change in predicting left ventricular remodeling was 0.735 (95% CI 0.670-0.799, P<0.001), a 20% reduction was the optimal cut-off value. Compared to the patients with non-improved infarct size, the incidence of left ventricular adverse remodeling was significantly lower in the patients with improved infarct size (18% (24/133) vs. 37% (49/134), P=0.001). Multivariate logistic regression analysis showed that improvement in IS was a protective factor for left ventricular adverse remodeling ( OR=0.376, 95% CI 0.236-0.721, P=0.002). Conclusion:Patients with STEMI who experience obvious reduction in infarct size after primary PCI have a significantly reduced risk of left ventricular adverse remodeling.
5.Exosome Linc00665 regulates radiotherapy resistance in oral squamous cell carcinoma by regulating T cell immunoreactivity
Huan LI ; Junhong HUANG ; Yating HU ; Yahui LI ; Zihui YANG ; Zhenyan ZHAO ; Xinjie YANG ; Jianhua WEI
Journal of Practical Stomatology 2025;41(6):744-749
Objective:To investigate the function and mechanism of exosome Linc00665 in modulating CD8+T cell immunoreactivity to promote radiotherapy resistance in OSCC.Methods:HOEC,SCC9 and SCC9-RR exosomes were extracted and identified,and the expression of Linc00665 was detected by qRT-PCR in cell lines and exosomes.The expression of TNF-α,IFN-γ,perforin and granzyme B in each treatment group was detected by ELISA(PBS,SCC9 exo,SCC9-RR exo).The killing ability of CD8+T cells against SCC9 cells in each treatment group was detected by CCK-8 assay.The targets of Linc00665 were further bioinformatically ana-lyzed and verified by qRT-PCR and Western blot.The expression of Linc00665,miR-28-5p and PD-1 in CD8+T cells was exogenous-ly regulated,the expression of immunoreactive factors in the supernatants of each treatment group was detected by ELISA(NC,sh-Linc00665,miR-28-5p inhibitor,sh-PD-1),and the killing ability of cells in each group was detected by CCK-8 method.Results:The concentrations of TNF-α,IFN-γ,perforin and granzyme B in the supernatants of cell culture in the SCC9-RR exo/CD8+T group were significantly decreased compared with those in the PBS/CD8+T group and the SCC9 exo/CD8+T group(P<0.05),and the kill-ing ability of the cells in the SCC9-RR exo group was significantly decreased compared with those in the PBS group and the SCC9 exo group(P<0.05),suggesting that SCC9-RR exo could inhibit the tumor killing ability of CD8+T cells.qRT-PCR results suggested that Linc00665 was highly expressed in the SCC9-RR cell line as well as exosome(P<0.05).It was further verified by bioinformat-ics analysis that Linc00665 could regulate PD-1 expression via miR-28-5p,thereby modulating CD8+T cell immunoreactivity to pro-mote OSCC radiotherapy resistance.Conclusion:Exosome Linc00665 regulates CD8+T cell immunoreactivity through miR-28-5p/PD-1 axis to promote OSCC radiotherapy resistance.
6.The impact of myocardial infarct size dynamics on left ventricular remodeling in STEMI patients after primary percutaneous coronary intervention
Si CHEN ; Xin A ; Yiqing ZHAO ; Zhenyan MA ; Ying ZHANG ; Ke LIU ; Lei FU ; Liping ZHANG ; Yongqiang YANG ; Ping LI ; Jinwen TIAN ; Hongbo ZHANG ; Lei ZHAO ; Geng QIAN
Chinese Journal of Cardiology 2025;53(6):653-660
Objective:To explore the impact of changes of myocardial infarct size on left ventricular adverse remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).Methods:This was a prospective cohort study. The STEMI patients who underwent primary PCI in the First Medical Center of the Chinese People′s Liberation Army General Hospital, Beijing Anzhen Hospital, Hainan Hospital of the Chinese People′s Liberation Army General Hospital and Guangxi Yulin First People Hospital from January 1, 2017 to January 1, 2022 were enrolled. Cardiac magnetic resonance (CMR) was performed to dynamically assess the myocardial infarct size and calculate the rate of infarct size change between the acute phase (5 to 7 days post-primary PCI) and 6-month follow-up. The endpoint was left ventricular adverse remodeling which was defined as an increase of more than 20% in left ventricular end-diastolic volume (LVEDV) assessed by CMR at 6 months after primary PCI compared with LVEDV at 1 week after primary PCI. Based on serial CMR assessments, the patients were divided into left ventricular adverse remodeling group and non-remodeling group. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of infarct size change for left ventricular adverse remodeling, and according to the optimal cutoff value, improved infarct size was defined as a decrease of >20% in the infarct size measured by CMR at 6 months after primary PCI compared with infarct size at 1 week after primary PCI. Multivariate logistic regression analysis was performed to identify the protective factors and risk factors for left ventricular adverse remodeling.Results:A total of 267 patients were enrolled, aged (58±11) years, with 234 males (87.6%). And 73 cases in the left ventricular remodeling group and 194 cases in the non-remodeling group. Infarct size assessed by CMR at 6 months after primary PCI decreased significantly compared with infarct size at 1 week after primary PCI in the left ventricular remodeling group ((23±13)% vs. (27±12)%, P=0.004), the same as in the non-remodeling group ((18±10)% vs. (23±10)%, P<0.001). The area under the ROC curve for the rate of infarct size change in predicting left ventricular remodeling was 0.735 (95% CI 0.670-0.799, P<0.001), a 20% reduction was the optimal cut-off value. Compared to the patients with non-improved infarct size, the incidence of left ventricular adverse remodeling was significantly lower in the patients with improved infarct size (18% (24/133) vs. 37% (49/134), P=0.001). Multivariate logistic regression analysis showed that improvement in IS was a protective factor for left ventricular adverse remodeling ( OR=0.376, 95% CI 0.236-0.721, P=0.002). Conclusion:Patients with STEMI who experience obvious reduction in infarct size after primary PCI have a significantly reduced risk of left ventricular adverse remodeling.
7.Exosome Linc00665 regulates radiotherapy resistance in oral squamous cell carcinoma by regulating T cell immunoreactivity
Huan LI ; Junhong HUANG ; Yating HU ; Yahui LI ; Zihui YANG ; Zhenyan ZHAO ; Xinjie YANG ; Jianhua WEI
Journal of Practical Stomatology 2025;41(6):744-749
Objective:To investigate the function and mechanism of exosome Linc00665 in modulating CD8+T cell immunoreactivity to promote radiotherapy resistance in OSCC.Methods:HOEC,SCC9 and SCC9-RR exosomes were extracted and identified,and the expression of Linc00665 was detected by qRT-PCR in cell lines and exosomes.The expression of TNF-α,IFN-γ,perforin and granzyme B in each treatment group was detected by ELISA(PBS,SCC9 exo,SCC9-RR exo).The killing ability of CD8+T cells against SCC9 cells in each treatment group was detected by CCK-8 assay.The targets of Linc00665 were further bioinformatically ana-lyzed and verified by qRT-PCR and Western blot.The expression of Linc00665,miR-28-5p and PD-1 in CD8+T cells was exogenous-ly regulated,the expression of immunoreactive factors in the supernatants of each treatment group was detected by ELISA(NC,sh-Linc00665,miR-28-5p inhibitor,sh-PD-1),and the killing ability of cells in each group was detected by CCK-8 method.Results:The concentrations of TNF-α,IFN-γ,perforin and granzyme B in the supernatants of cell culture in the SCC9-RR exo/CD8+T group were significantly decreased compared with those in the PBS/CD8+T group and the SCC9 exo/CD8+T group(P<0.05),and the kill-ing ability of the cells in the SCC9-RR exo group was significantly decreased compared with those in the PBS group and the SCC9 exo group(P<0.05),suggesting that SCC9-RR exo could inhibit the tumor killing ability of CD8+T cells.qRT-PCR results suggested that Linc00665 was highly expressed in the SCC9-RR cell line as well as exosome(P<0.05).It was further verified by bioinformat-ics analysis that Linc00665 could regulate PD-1 expression via miR-28-5p,thereby modulating CD8+T cell immunoreactivity to pro-mote OSCC radiotherapy resistance.Conclusion:Exosome Linc00665 regulates CD8+T cell immunoreactivity through miR-28-5p/PD-1 axis to promote OSCC radiotherapy resistance.
8.Association of psychological stress with wives’ hypertension across over 10 million Chinese married female population aged 20-49 years
Zhenyan ZHAO ; Jiajing JIA ; Xinyi LYU ; Lihua ZHANG ; Yuanyuan WANG ; Yuan HE ; Zuoqi PENG ; Ya ZHANG ; Hongguang ZHANG ; Qiaomei WANG ; Haiping SHEN ; Yiping ZHANG ; Donghai YAN ; Xu MA ; Ying YANG
Chinese Medical Journal 2024;137(13):1583-1591
Background::Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women.Methods::Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.Results::Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives’ hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively. Conclusion::Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.
9.Clinical efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide and lamivudine/dolutegravir in the treatment-na?ve patients with acquired immunodeficiency syndrome
Jiangrong WANG ; Jianjun SUN ; Junyang YANG ; Renfang ZHANG ; Li LIU ; Jun CHEN ; Yang TANG ; Tangkai QI ; Wei SONG ; Zhenyan WANG ; Yinzhong SHEN
Chinese Journal of Infectious Diseases 2024;42(3):147-153
Objective:To analyze the efficacy and safety of integrase inhibitor-based single-tablet regimens bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and lamivudine/dolutegravir (3TC/DTG) in the treatment-na?ve patients with acquired immunodeficiency syndrome (AIDS).Methods:This study was a retrospective cohort study. The clinical data of treatment-na?ve AIDS patients initiating anti-retroviral therapy (ART) with B/F/TAF or 3TC/DTG and on ART for greater than or equal to 24 weeks from October 2020 to July 2023 in Shanghai Public Health Clinical Center, Fudan University were collected. The baseline human immunodeficiency virus (HIV)-1 RNA, CD4 + T lymphocyte counts at baseline and 12 weeks of treatment, and the rates of virological suppression and virological failure at 24 weeks of treatment, and levels of total cholesterol, serum creatinine, uric acid before and after treatment were compared between the B/F/TAF group and 3TC/DTG group. Independent sample t test, corrected t test, Mann-Whitney U test, Wilcoxon signed rank test, chi-square test were used for statistical analysis. Results:Among 189 treatment-na?ve AIDS patients, 141 cases were in B/F/TAF group and 48 cases in 3TC/DTG group. The HIV-1 RNA level at baseline was 1.77(0.78, 4.52)×10 5 copies/mL in the B/F/TAF group and 0.97(0.24, 2.20)×10 5 copies/mL in the 3TC/DTG group. There was a statistically significant difference between the two groups ( U=2 221.00, P=0.006).There were 77.3%(109/141) patients on B/F/TAF achieved complete virological suppression with no virological failure at week 24, and 85.4%(41/48) on 3TC/DTG achieved complete virological suppression with one (2.1%) virological failure at week 24. At 12 weeks of treatment, 92.2%(130/141) of the patients in the B/F/TAF group and 85.4%(41/48) of the patients in the 3TC/DTG group had an increase in CD4 + T lymphocyte count by more than 30% compared with baseline. The proportion of CD4 + T lymphocyte count increased by more than 100/μL from baseline in the B/F/TAF group was 67.4%(95/141), and that in the 3TC/DTG group was 52.1%(25/48). There were no significant differences between the two groups ( χ2=1.91 and 3.61, respectively, P=0.167 and 0.733).The levels of total cholesterol ( W=2 036.00, t=-5.42, respectively), serum creatinine ( W=1 098.00, 234.00, respectively), uric acid ( W=2 188.00, 299.00, respectively) and the proportion of patients with mild to moderate renal insufficiency ( χ2=22.29, 8.22, respectively) in the B/F/TAF group and 3TC/DTG group after 24 weeks of treatment were significantly higher than those before treatment (all P<0.01). Conclusions:Both B/F/TAF and 3TC/DTG are effective in terms of virological suppression and immunological recovery and have good safety profiles in treatment-na?ve patients with AIDS.
10.Changing trends of the pathogenic spectrum of pulmonary infections in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome from 2017 to 2022
Suyue HUANG ; Hong CHEN ; Wei SONG ; Tangkai QI ; Zhenyan WANG ; Li LIU ; Jianjun SUN ; Yang TANG ; Shuibao XU ; Junyang YANG ; Bihe ZHAO ; Jiangrong WANG ; Jun CHEN ; Renfang ZHANG ; Yinzhong SHEN
Chinese Journal of Infectious Diseases 2024;42(4):225-232
Objective:To analyze the changes of pathogen spectrum of pulmonary infection in human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) patients before and during coronavirus disease 2019 (COVID-19) epidemic.Methods:The clinical data of hospitalized HIV infection/AIDS patients with pulmonary infection confirmed by etiology and/or imaging examinations in the Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University from January 2017 to December 2022 were collected, including the types of pathogens, the peripheral blood CD4 + T lymphocyte counts at admission due to pulmonary infection, and the treatment outcome of the patients at discharge. The changes of pathogen spectrum of pulmonary infection before COVID-19 epidemic (2017 to 2019) and during the epidemic (2020 to 2022) were analyzed, and their effects on adverse treatment outcomes (death during hospitalization or automatic discharge) were analyzed. Statistical analysis was performed using the chi-square test, trend chi-square test or Kruskal-Wallis test. Results:The proportion of patients with pulmonary infection during the epidemic was lower than that before the epidemic, the difference was statistically significant (23.01%(1 061/4 612) vs 28.68%(1 463/5 102), χ2=40.76, P<0.001). From 2017 to 2022, the proportion of hospitalized HIV infection/AIDS patients with pulmonary infection showed a downward trend ( χ2trend=8.81, P<0.001). Among the pathogens causing pulmonary infection from 2017 to 2022, bacteria, mycobacteria, and fungi were the three main pathogenic pathogens, accounting for 48.77%(1 231/2 524), 32.13%(811/2 524), and 14.34%(362/2 524), respectively. The proportion of bacterial infection decreased from 55.02%(805/1 463) before the epidemic to 40.15%(426/1 061) during the epidemic, and the proportion of fungal infection increased from 9.23%(135/1 463) to 21.39%(227/1 061), the differences were both statistically significant ( χ2=54.45 and 74.11, respectively, both P<0.001). There was no significant difference in the proportion of mycobacteria between before and during the epidemic ( P=0.169), but the proportion of Mycobacterium tuberculosis (MTB) infection decreased from 22.01%(322/1 463) before the epidemic to 15.08%(160/1 061) during the epidemic, while the proportion of nontuberculous mycobacterium (NTM) infection increased from 7.11%(104/463) to 11.78%(125/1 061), the differences were both statistically significant ( χ2=19.11 and 16.28, respectively, both P<0.001). There was a significant difference in the pathogen spectrum of pulmonary infection before and during the epidemic ( χ2=128.91, P<0.001). There was a significant difference in the peripheral blood CD4 + T lymphocyte counts of patients with MTB, NTM, Pnenmocystis, Talaromycosis marneffei and Cryptococcus infection ( H=71.92, P<0.001). There were 63.74%(109/171) of Pneumocystis infection and 67.65%(69/102) of Talaromycosis marneffei infection occurred in patients with CD4 + T lymphocyte count<50/μL. Among the patients with pulmonary infection, the proportion of patients with adverse treatment outcomes during the epidemic was higher than that before the epidemic, and the difference was statistically significant (13.29%(141/1 061) vs 10.39%(152/1 463), χ2=5.04, P=0.025). Among the patients with pulmonary infection who developed adverse treatment outcomes, the top three pathogens (from high to low) were bacteria (63.48%(186/293)), mycobacteria (27.65%(81/293)), and fungi (6.83%(20/293)). The proportion of adverse treatment outcomes caused by bacterial infection decreased during the epidemic compared with that of before the epidemic (71.71%(109/152) vs 54.61%(77/141), χ2=9.23, P=0.002), while the proportion of adverse treatment outcomes caused by fungal infection increased (2.63%(4/152) vs 11.35%(16/141), χ2=8.74, P=0.003), and the differences were both statistically significant. The proportion of adverse treatment outcomes caused by mycobacterial infection increased, but without statistically significant (23.03%(35/152) vs 32.62%(46/141), χ2=3.37, P=0.066), among which there was no difference in the proportion of adverse treatment outcomes caused by MTB infection (13.82%(21/152) vs 14.89%(21/141), χ2=0.07, P=0.793), while the proportion of adverse treatment outcomes caused by NTM infection increased (5.92%(9/152) vs 14.89%(21/141), χ2=6.41, P=0.011). There was a significant difference in the pathogen spectrum of pulmonary infection patients with adverse treatment outcomes before and during the epidemic ( χ2=12.22, P=0.007). Conclusions:Among the spectrum of pathogens causing pulmonary infection and adverse treatment outcomes of HIV infection/AIDS patients during the epidemic, compared with that before the epidemic, the proportion of bacterial decreases, while the proportion of fungi increases, and the proportion of mycobacteria remains stable with the proportion of NTM increasing. The proportion of MTB causing pulmonary infection decreases, while the proportion of MTB causing adverse treatment outcomes remains stable.

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