ObjectiveTo investigate the efficacy and safety of simplified diagnosis and treatment strategies and regimens in the treatment of patients with human immunodeficiency virus （HIV）/hepatitis C virus （HCV） co-infection. MethodsThis multicenter prospective real-world study was conducted among 198 patients with HIV/HCV co-infection who received hepatitis C treatment in 10 designated primary hospitals for hepatitis C in Yuxi， China from July 2023 to June 2024， and according to whether genotype detection was performed， they were divided into genotype detection group with 122 patients and non-genotype detection group with 76 patients. The patients were observed in terms of sustained virologic response at 12 weeks （SVR12）， safety， and liver biochemical parameters. Propensity score matching was used to match the two cohorts， using caliper matching （caliper value = 0.02） at a ratio of 1∶1. The independent-samples t test or the Wilcoxon signed-rank test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. ResultsAmong the 122 patients in the genotype detection group， 63.11% （77/122） had genotype 3， while the non-genotype detection group had 76 patients； both groups achieved an SVR12 rate of 100%. From baseline to 12 weeks after treatment， both groups had a significant increase in the serum level of albumin， significant reductions in the serum levels of total bilirubin， alanine aminotransferase， aspartate aminotransferase， and alpha-fetoprotein， and a significant reduction in FibroScan value （all P<0.05）. A total of 54 patients （27.27%） experienced at least one adverse reaction， and anemia was the most common adverse reaction （38 patients， 19.19%）， with an incidence rate of 50.00% （33/66） in patients with liver cirrhosis. HIV viral load remained <50 IU/mL before and after treatment， and there was no significant change in CD4⁺ T lymphocyte count after treatment （Z=-0.969， P=0.202）. Compared with the genotype detection group， the non-genotype detection group had a significantly shorter time from positive HCV RNA testing to treatment initiation （4±2 days vs 19±4 days， t=5.321， P<0.05） and significantly lower testing costs （618±97 yuan vs 789±129 yuan， t=3.661， P<0.05）. ConclusionFor patients with HIV/HCV co-infection， the simplified diagnosis and treatment strategies can achieve a relatively high SVR12 rate， improve biochemical indicators， and effectively reduce time cost and economic burden， with a favorable safety profile.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Endogenous bioactive small molecules are characterized by low molecular weight,high biological activity,low immunogenicity,and rapid synthesis and metabolism,play a pivotal role in maintaining vascular homeostasis.Vascular calcification(VC)is a abnormal deposition of calcium and phosphorus in the vessel wall.Endogenous bioactive small molecules such as cardiovascular bioactive peptides,adipokines and gaseous molecules participate in the process of VC through various mechanisms.This review summarises the advances in relationship between endogenous bioactive small molecules and the occurrence,development,and related mechanisms of VC.

Endogenous bioactive small molecules are characterized by low molecular weight,high biological activity,low immunogenicity,and rapid synthesis and metabolism,play a pivotal role in maintaining vascular homeostasis.Vascular calcification(VC)is a abnormal deposition of calcium and phosphorus in the vessel wall.Endogenous bioactive small molecules such as cardiovascular bioactive peptides,adipokines and gaseous molecules participate in the process of VC through various mechanisms.This review summarises the advances in relationship between endogenous bioactive small molecules and the occurrence,development,and related mechanisms of VC.

Objective To cultivate and breed laboratory cats in conventional laboratory animal facilities,collect background data on laboratory cats,and compare them with purchased domestic cats to assess the feasibility of breeding laboratory cats.Methods Indigenous cat breeds were introduced for reproduction and population expansion under conventional laboratory environment,with recording of kitten survival rates and growth curves.Indicators of 20 laboratory cats of F1 generation(half male and half female),including complete blood count,blood biochemistry,organ mass,organ coefficient,heart rate,and blood pressure,were detected and comparisons between sexes were made.Blood pressure values and sensitivity to histamine of these cats were measured using depressor substance detection method in the Pharmacopoeia of the People's Republic of China-Four Parts:2020,and were compared with the data from 173 concurrently purchased domestic cats.Results Laboratory cats adapted well to the environment of conventional laboratory facilities,with a survival rate of 77.08％of kittens at 8 weeks of age.Red blood cell count,hemoglobin content,mean corpuscular hemoglobin concentration,and hematocrit in male laboratory cats were significantly higher than those in females(P＜0.01),while the mean corpuscular volume in males was significantly lower than that in females(P＜0.01).The levels of serum alanine aminotransferase,total bilirubin,creatinine,triacylglycerol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol in male laboratory cats were significantly higher than those in females(P＜0.05 or P＜0.01),while cholesterol,globulin,total protein,and the albumin-globulin ratio were significantly lower in males(P＜0.01).The liver coefficient in male laboratory cats was significantly lower than that in female cats(P＜0.05),while the kidney coefficient was significantly higher(P＜0.05).The spleen-brain and kidney-brain ratios were significantly higher in males compared to females(P＜0.05 or P＜0.01).No significant differences were found in heart rate,systolic pressure,diastolic pressure,mean blood pressure,or sensitivity to histamine between male and female laboratory cats(P＞0.05).Compared to laboratory cats,purchased domestic cats had significantly higher heart rate,systolic pressure,and mean blood pressure(P＜0.01),and the magnitude of blood pressure changes induced by medium and high doses of histamine was significantly reduced(P＜0.05 or P＜0.01).Conclusion It is feasible to breed laboratory cats in conventional laboratory animal facilities.The accuracy of experimental results can be improved by using laboratory cats with clear and standardized background data.

Objective:To evaluate the safety and effectiveness of the accurate puncture during sacral neuromodulation (SNM) guided with 3D printing navigation template based on reconstruction techniques using fusing sacral CT and MRI images.Methods:Totally 42 patients operated with SNM were selected in Renji Hospital, School of Medicine, Shanghai Jiaotong University from July 2016 to August 2017. The patients were randomly divided into control group ( n=22) and experimental group ( n=20) using random number table. The conventional cross-positioning technique under X-ray was used for puncture during SNM in the control group. While in the experimental group, the sacral CT and MRI images were fused for reconstruction and design of the navigation template, printed by 3D technique for the puncture in SNM. The times of punctures, the average time for puncture operation, the time of intraoperative testing of the stimulator device, the minimum onset voltage of the stimulator, the X-ray radiation dose, postoperative curative effect (rate of secondary transformation) and the incidence rate of complications were compared between the two methods using independent-simple t test or χ 2 test. Results:Compared to control group, fewer times of punctures, shorter time needed for puncture operation, shorter time of intraoperative testing of the stimulator, smaller radiation dose and minimum effective voltage were found in the experimental group ( P<0.05). There were 15 and 16 patients who completed the secondary transformation in the control group and experimental group, and there was no significant difference between the two groups (χ2=0.757, P=0.384). There were 3 cases of complications in the control group, including 2 cases of infection and 1 case of bleeding, while no complications in the experimental group. Conclusions:CT and MRI images fusion reconstruction-guided 3D printing navigation template can help perform accurate and safe punctures in SNM. Compared to conventional puncture positioned under X-ray, it can effectively improve the puncture efficiency, and reduce the radiation dose in the operation.

Objective:To investigate the clinical features, diagnosis and treatment of lymphoplasmacytic lymphoma (LPL) with biclonal M protein.Methods:The clinical data of one LPL patient with biclonal M protein at Yancheng First People's Hospital in January 2018 was retrospectively analyzed, and relevant literature was reviewed.Results:The patient was an elderly woman with clinical manifestations of lymphadenopathy, kidney damage, anemia, and bone destruction. The diagnosis was confirmed based on lymph node biopsy, immunofixation electrophoresis, bone marrow cytology, and genetic mutation testing (MYD88 L265P mutation-positive). Partial remission was achieved after 4 courses of treatment with bortezomib-based regimen.Conclusions:Clinically, LPL with biclonal M protein shows one characteristic of M protein, and the immunoglobulin IgM and IgA biclonal LPL is even rarer. The treatment scheme based on bortezomib has a certain therapeutic effect.

Objective: To investigate the factors associated with CD4⁺ /CD8⁺ T lymphocyte ratio normalization in acquired immunodeficiency syndrome (AIDS) patients after antiretroviral therapy (ART). Methods: The data of 1 188 human immunodeficiency virus (HIV)/AIDS patients from the national ART reporting system in Yuxi City, Yunnan Province between January 1, 2006 and December 31, 2016 were retrospectively collected and analyzed. The rate of CD4⁺ /CD8⁺ T lymphocyte ratio normalization after ART was calculated by lifetable. Cox proportional hazard models were used to analyze the factors associated with CD4⁺ /CD8⁺ T lymphocyte normalization in AIDS patients after ART. The Wilcoxon rank sum test was used for comparison between groups. Results: The follow-up time was 3.8 (1.0-10.8) years. CD4⁺ /CD8⁺ T lymphocyte ratio normalization was documented in 95 patients with the rate of 1.89 per 100 person-years (95% confidence interval(CI) 1.52-2.27) after ART. The average time from ART to CD4⁺ /CD8⁺ T lymphocyte ratio normalized was 9.4 years. The cumulative normalization rate was 0.02 for the first year, 0.06 for the third year, 0.11 for the fifth year, 0.19 for the seventh year and 0.37 for the ninth year. By Cox proportional hazard models, the probability of CD4⁺ /CD8⁺ T lymphocyte ratio normalization in patients infected HIV by heterosexual contacts was 3.709 (95%CI 1.781-7.726) times higher than those by intravenous injection. The probability of CD4⁺ /CD8⁺ T lymphocyte ratio normalization in patients with baseline CD4⁺ T lymphocytes of 350-499 and more than 500 cell/μL groups were 2.792 (95%CI 1.196-6.519) and 3.832 (95%CI 1.648-8.913) times higher than those with baseline CD4⁺ T lymphocytes less than 200 cell/μL, respectively. The probability of normalization after ART in patients with higher baseline CD4⁺ /CD8⁺ T lymphocyte ratio was higher than those with baseline CD4⁺ /CD8⁺ T lymphocyte ratio≤ 0.20 (hazard ratio>1, all P<0.01). Conclusion The CD4⁺ /CD8⁺ T lymphocyte ratio normalization in AIDS patients after ART is associated with baseline CD4⁺ T lymphocyte counts, baseline CD4⁺ /CD8⁺ T lymphocyte ratio and HIV transmission mode.

Objective To analyze the results of serum makers of transfusion-related infectious diseases in Hubei Province and the surrounding areas,in order to understand the patient′s infection status,thereby avoi-ding or reducing medical disputes,and providing reference data for the prevention and treatment of transfu-sion-related infectious diseases,especially AIDS and syphilis.Methods 60 570 pretransfusion patients from 2011 to 2016 in Hubei Province and surrounding areas were selected as the study group.Meanwhile,19 800 pretransfusion patients from 2001 to 2003 in Hubei Province and surrounding areas were selected as control group.Chemiluminescence detection was used to examine human immunodeficiency virus (HIV),hepatitis B virus (HBV),hepatitis C virus (HCV) and treponema pallidum (TP) serum markers.Different period pre-transfusion patients′infection status,route of transmission and distribution characteristics of transfusion-re-lated infectious diseases were compared.Results In the study group,44 cases (0.07%) were HIV positive, and there was no statistical difference compare with the control group (P>0.05);1 091 cases were TP posi-tive (1.80%),7 607 cases were positive for HBV (12.56%),and 1 062 cases were HCV positive(1.75%), and there were statistically significant differences compared with the control group (P<0.05).In addition, there were 8 cases of HIV and TP double infection,10 cases of HIV and HBV double infection,4 cases of HIV and HCV double infection;3 cases of HIV,T P and HBV triple infection,4 cases of HIV,T P and HCV triple infection,1 case of HIV and HBV,HCV triple infection in the study group;and compared with the control group,it showed an increasing trend (P<0.05).Conclusion The status of transfusion-related infectious dis-eases in Hubei Province and surrounding areas is still severe.Some patients have been infected with HIV,TP, HBV or HCV before hospitalization,and a few have even had double or triple infection.Clinic should further strengthen the prevention and control of transfusion-related infectious diseases,especially for HIV and TP, and reduce the spread of transfusion-related infectious diseases in the general population.

Medical history and physical examinations were performed to assess the clinical manifestations and growth of one patient with familial hypocalciuric hypercalcemia(FHH). Clinical data, including histories of his parents and 3 maternal relatives were collected. Serum parathyroid hormone(PTH), calcium, phosphorus, 24-hour urinary calcium, and 24-hour urinary calcium to creatinine ratio(UCCR)were measured or calculated. Meanwhile, after peripheral blood samples were collected and genomic DNA was extracted, the whole exome sequencing to detect gene mutations of the proband was performed. Further family screenings were also performed by Sanger sequencing to assess the relationship between genotype and phenotype. The results showed that the proband with motor developmental delays had severe hypercalcemia(4.20 mmol/L), while his mother without clinical symptoms had a higher blood calcium within the normal range(2.57 mmol/L). However, their urinary calcium levels were both low(UCCR< 0.01). The C→T heterozygous missense mutation was found by exome sequencing at nucleotide 1243 within exon 4 of calcium sensing receptor(CaSR)gene in the proband, which caused a substitution of Arginine to Tryptophan(R415W). Sanger sequencing confirmed the same mutation in his mother. There was no mutation in other family members. (Chin J Endocrinol Metab, 2018, 34: 583-586)