【Objective】 To analyze the distribution of unexpected antibodies in tumor patients retrospectively and explore the clinical significance. 【Methods】 Unexpected antibody screening was performed on inpatients with blood preparation and blood transfusion in our hospital from January 2004 to December 2022, with 1 176 cases tested positive, and the types of unexpected antibodies and distribution characteristics were statistically analyzed. 【Results】 Unexpected antibodies were screened in 1 176 cases, with the positive rate at 1.05% (1 176/111 483). The unexpected antibodies were mainly anti-E 16.33%(192/1 176), anti-M 7.99% (94/1 176), anti-Mur 5.70% (67/1 176) and anti-Le^a 4.76% (56/1 176). Among the 1 176 cases, gastrointestinal tumors accounted for 27.99% (329/1 176), gynecological tumors accounted for 24.84% (292/1 176), respiratory tumors accounted for 16.67% (196/1 176) . 【Conclusion】 The influencing factors of unexpected antibodies in tumor patients were disease type, blood transfusion history and blood type. Therefore, it is necessary for clinical departments to carry out unexpected antibody screening and perform Rh blood type matched transfusion for tumor patients to avoid alloantibody production.

Objective By analysis the differences of technical specifications among National Health Commission of the People’s Republic of China, Centers for Disease Control and Prevention (CDC) and European Network of Infectious Disease (EUNID)domestic and foreign, to provide a reference for the construction of high-level isolation units (HLIUs) in China.

Cryptococcal meningitis is a common and refractory central nervous system infection,with high rates of mortality and disability.The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion.Based on the current situation of cryptococcal meningitis in China,the management of cryptococcal meningitis includes 6 aspects:introduction,microorganism identification,clinical manifestations and diagnosis,principles of antifungal therapy,treatment of refractory and recurrent meningitis,treatment of intracranial hypertension.There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis.This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines.The importance of early diagnosis,combined long-term antifungal therapy,control of intracranial hypertension are emphasized.

Objective To describe the disease spectrum,morbidity,mortality and prognostic factors of acquired immune deficiency syndrome (AIDS) patients complicated with central nervous system (CNS) infections.Methods The data of 4 426 AIDS patients from February 2013 to February 2017 in Chongqing public health medical center were collected,among which 499 cases had CNS infection.The morbidity and mortality of CNS infections were calculated.Association between different CNS infections and CD4+T cell counts was analyzed.Prognostic factors for the outcome of hospitalization were also studied.Mann-Whitney U test was used for continuous variables.Univariate and multivariate analyses were performed by logistic regression analysis.Results The morbidity of CNS infections in AIDS patients was 11.27％ (499/4 426).The most prevalent CNS infections were tuberculous meningitis (4.50％),cryptococcal meningitis (3.25 ％) and CNS infections with unknown etiology (1.11 ％).The mortality rate was 18.84％ (94/499),among which tuberculous meningitis accounted for 35 cases (17.59％),cryptococcal meningitis 23 cases (15.79％) and CNS infections with unknown etiology 19 cases (38.76％).The average CD4-T cell count level in those who died were significantly lower than that in those who survived (Z=2.51,P =0.001).Visual impairment,nuchal rigidity,positive pathologic reflexes,consciousness disturbance,CD4+T cell counts＜50 cells/μL and HIV RNA≥5 lg copies/mL at baseline were independent prognostic factors for mortality.Conclusions The morbidity and mortality of CNS infections are high among AIDS patients in Chongqing,and those patients with severe immunosuppression are usually affected.Older age,consciousness disturtance and severe immunosuppression are three independent risk factors for mortality.

Objective To explore the mortality and prognostic factors of cryptococcal meningitis (CM) in patients with acquired immunodeficiency syndrome (AIDS).Methods We collected the clinical data of all the 203 AIDS patients complicated with CM who had been treated between December 2010 and March 2017 in Chongqing Public Health Medical Center.They were followed up by telephone periodically after hospital discharge and their survival or death was recorded.Their overall mortality rate,survival curves and prognostic factors were then analyzed.Results Of the 203 cases included in this study,92.6％ had CD4+ T cell counts ≤100 cells/μL,50.3％ HIV RNA＞5 lg copies/mL,and 64.5％ intracranial pressure ≥250 mmH2O.Their mortality during hospital stay was 9.9％(20/203),mortality during follow-up 16.2％ (24/148) and overall mortality 26.1％.Their survival rate declined rapidly during the first 2 weeks after disease onset,and their accumulated mortality was close to 25.0％ at week 10 but stabilized thereafter.The patients aged between 18 and 44 years had a significantly lower risk of death than those of other age groups,showing that age was an independent protective prognostic factor (AOR=0.228,P=0.036,95％CI:0.057～0.910).Consciousness disorder was an independent risk factor for death (AOR=7.001,P=0.035,95％ CI:1.143～42.882).Conclusions AIDS patients complicated with CM may face a high mortality and death may mostly occur within the first 3 months after disease onset.Those with a younger age may have relatively better prognosis.Consciousness disorder is a risk factor of death.

Objective To study the effects about rhizoma drynariae poly (lactic-co-glycolic acid) (DR-PLGA) /Calcium phosphate cement (CPC) composite scaffold on treating rabbit femoral bone defect.Methods Eight Newzealand rabbits were randomly divided into experiment group(n =4) and control group (n =4).The preparation of rabbit femoral bone defect model,separately implanted DR-PLGA/CPC scaffold and PLGA/CPC scaffold.After 4,8 weeks,we took out the materials,observed with X-ray,gross anatomy,histology observation to evaluate the osteogenetic activity,the effect of accelerating the healing of bone defect.Resuits At the 4th week and 8th week after implantation,the effect of promoting fracture healing and osteogenic activity of the experiment group were greater than those in the control group.Conclusions DR-PLGA combined with CPC could induce new bone formation,promote the healing of rabbit femoral defect.

AIM:To evaluate the expression level of CXC chemokine receptor 7 (CXCR7) in atherosclerotic apolipoprotein E-deficient ( ApoE-/-) mice induced by high-fat diet ( HFD) and the effects of atorvastatin on it .METH-ODS:ApoE-/-male mice (8-week-old) were used and were randomly divided into 3 groups following 1-week normal ro-dent diet:normal diet control (NDC) group , HFD group and HFD+statins (HFD+Sat) group.HE staining and oil red O staining were used to observe the atherosclerotic lesion burdens in the aortas .The expression of CXCR7 on the aortas was detected by Western blot and immunohistochemistry .The expression of Akt and endothelial nitric oxide synthase ( eNOS) in the aorta was determined by Western blot .RESULTS: Few lesions were found in the aortas in NDC group .Apparent atherosclerotic plaque burdens were seen in HFD group and HFD +Sat group, while the atherosclerotic plaque burdens in HFD+Sat group were notably reduced compared with HFD group .The protein levels of CXCR7, eNOS and Akt in aorta in HFD group and HFD+Sat group were significantly decreased compared with NDC group , while those in HFD+Sat group were increased compared with HFD group .The protein level of p-eNOS in the aorta and the concentration of NO in the plas-ma in HFD group were decreased compared with NDC group and HFD +Sat group.CONCLUSION: In ApoE-/-mice, HFD increases the lipid level and promotes the development of atherosclerosis by downregulating the expression of CXCR 7, Akt and eNOS.Atorvastatin reverses the above effect of hypercholesterolemia on the expression of CXCR 7, Akt and eNOS, thus playing the role in treating atherosclerosis .

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use

Objective To investigate the impact of CD4+ CD25+ FOXP3+ regulatory T(Treg) cells on tumor recurrence in liver transplantation for hepatocellular carcinoma (HCC). Methods Im-munohistochemistry and flow cytometry were used for analysis of the frequency of Treg. Meanwhile,it was compared with that of non-cancer liver transplantation patients. Results The frequency of CD4+CD25+ FOXP3+ regulatory T cells in the blood of HCC liver transplantation was (10. 15 ±1. 00) % , which was significantly higher than that in the normal control group (3. 20±1. 18) %. Cir-culating CD4+ CD25+ FOXP3+ Treg frequency was increased significantly and correlated with the tumor recurrence in the HCC patients. An abundant accumulation of Treg concurrent with significant-ly reduced infiltration of CD8+T cells was found in tumor regions. Conclusion Increased CD4+ D25+FoxP3+ Treg may impair the effectors function of CD8+ T cells, promote the tumor recurrence and re-present a therapeutic target for HCC liver transplantation.