Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ²=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.
Male ; Humans ; Middle Aged ; Reverse Transcriptase Inhibitors/therapeutic use* ; HIV Infections/drug therapy* ; Drug Resistance, Viral/genetics* ; China/epidemiology* ; Mutation ; HIV-1/genetics* ; Protease Inhibitors/therapeutic use* ; Genotype

Aim To investigate the effect of dietary intake of o)-3 poly unsaturated fatty acids ( u>-3 PUFAs) on the immune function of chronic graft versus host disease (cGVH) lupus model mice.Methods A single intraperitoneal injection of bml2 mice lymphocytes was used to establish a cGVH mouse model.On the day of modeling, 90% cd-3 PUFAs and 97% EPA were given by gavage for 14 days.The immune indexes of mice were evaluated by flow cytometry, and the serum total J J J ∗ IgG levels were measured by ELISA.Results Compared with control group, cGVH group significantly down-regulated Treg subsets, and up-regulated the Tfh , GC B and plasma subsets in the lupus mice.Comparer] with model control group, u>-3 PUFAs could significantly elevate Treg subsets, and decrease TFH, (X] B, and plasma subsets; serum total IgG levels in the 97% EPA group were significantly reduced.Conclusion In the cGVH lupus mouse model, co-3 PUFAs can suppress some immune functions by increasing Treg cells, reducing TFH, GC B, plasma cells and inhibiting the secretion of IgG.Such immunomodulatory effect provides new sights into the development of a potentially novel treatment modality for cGVH.

Clinical data of 43 patients who underwent endoscopic resection for gastrointestinal stromal tumors (GIST) of length ≤1.2 cm at the Digestive Endoscopy Center of the 909th Hospital from January 2016 to December 2018 were retrospectively analyzed. The patients were divided into the endoscopic ligation resection (ELR) group ( n=27) and the endoscopic submucosal excavation (ESE) group ( n=16). The general, perioperative and follow-up data of the two groups were compared. The results showed that there was no significant difference in the general data between the two groups. The operation time was 20.0 (18.0,25.0) min in the ELR group and 27.5 (23.0,37.5) min in the ESE group, showing significant difference ( U=92.5, P=0.001). The en bloc resection rates were 100.0% (27/27) in the ELR group and 81.3% (13/16) in the ESE group, showing significant difference ( P=0.045). The postoperative hospital stays were 3 (2,4) days in the ELR group and 5 (4,6) days in the ESE group, showing significant difference ( U=125.5, P=0.020). There was no significant difference in the intraoperative bleeding rate, intraoperative hemorrhage volume, intraoperative perforation rate, number of hemostatic clips or postoperative complications including hemorrhage, fever and peritonitis between the two groups ( P>0.05). During the follow-up, there was no recurrence or metastasis of GIST in both groups. ELR and ESE can be safe and effective for small GIST ≤1.2 cm in diameter. Compared with the ESE group, the operation time and postoperative hospital stay are shorter with higher en bloc resection rate in the ELR group.

Objective To investigate the effect of electroacupuncture (EA) preconditioning on apoptosis after cerebral ischemia-re-perfusion (I/R). Methods A total of 72 male Sprague-Dawley rats were randomly divided into sham group (n=24), model group (n=24) and EA group (n=24). The rats in latter two groups were occluded the right middle cerebral arteries for two hours and reperfused. EA group was treated with EA at Baihui (GV20) for two weeks before modeling. They were as-sessed with modified Neurological Severity Scores (mNSS) 24 hours after modeling. Then, the cerebral infarct volume was measured with TTC staining, the apoptosis was detected with TUENL assay, and the expression of p53, Bax and Bcl-2 proteins in ischemic penumbra was detected with Western blotting. Results Compared with the model group, the score of mNSS, cerebral infarct volume and the number of TUNEL-posi-tive cells all significantly decreased (P<0.05) in EA group; while the expression of p53 and Bax proteins de-creased (P<0.05), Bcl-2 increased (P<0.05), and Bax/Bcl-2 decreased (P<0.05).Conclusion EA preconditioning can induce tolerance to cerebral I/R injury, which might associate with the inhibition of p53 protein and down-regulation of the Bax/Bcl-2 ratio in ischemic penumbra, to inhibit cerebral cell apoptosis.

The concept of neurovascular units studies the interaction between neural cells and blood vessels, regards the blood-brain barrier as the core,and relates with the neurodegenerative diseases.This paper reviewed the relationship be-tween neurovascular units and neurodegenerative diseases, such as Alzheimer's disease, amyotrophic lateral sclerosis, Huntington's disease,multiple sclerosis,etc.

Exosome is a hot topic in the field of medical research in recent years, which can serve as new carriers for cell-to-cell communication, and show great potential in the diagnosis and treatment of ischemic stroke. microRNA containing in exosomes plays an important role in it. This article reviewed the research progress of exosomes in ischemic stroke on biomarkers, drug carriers, neurovascular remodeling, and treatment.

Objective To investigate the effects of downstaging and neoadjuvant reetal(NAR) score on the prognosis of patients with clinical stage Ⅲ middle-low rectal cancer undergoing preoperative concurrent chemoradiotherapy.Methods From 2006 to 2014,195 patients who were admitted to our hospital and diagnosed with clinical stage Ⅲ middle-low rectal cancer by pelvic magnetic resonance imaging or computed tomography were enrolled.All patients received preoperative radiotherapy with doses of 42-50.4 Gy (median:50 Gy,93.8％ of patients received doses of ≥ 50 Gy) and concurrent chemotherapy with capecitabine ± oxaliplatin.Total mesorectal (R0) excision surgery was performed at 4-15 weeks (median:7 weeks) after concurrent chemoradiotherapy.The effects of downstaging (stage yp0-Ⅱ) and NAR score (calculated based on cT staging and ypT/N staging) on the prognosis were evaluated.The 3-year disease-free survival (DFS) rate was calculated using the Kaplan-Meier method and analyzed by log-rank test.Results In all the patients,the median follow-up time was 44 months (6.7-125.5 months);the 3-year DFS rate was 76.8％.Downstaging after preoperative chemoradiotherapy was a significant prognostic factor for the 3-year DFS (92.2％ vs.56.8％,P=0.000).The median NAR score was 15.0(0-65.0) in all the patients.Patients with NAR scores of ≤ 15.0 had significantly improved 3-year DFS than those with NAR scores of＞15.0(90.1％ vs.57.0％,P=0.001).In patients with downstaging,those with NAR scores of ≤8.4 had significantly improved prognosis compared with those with NAR scores of＞ 8.4(95.1％ vs.87.5％,P=0.022).Conclusions Patients with downstaging after preoperative concurrent chemoradiotherapy for stage c Ⅲ middle-low rectal cancer have satisfactory prognosis.The NAR score is an effective prognostic predictor.

Objective To analyze the safety of atrial septal defect closure using Da Vinci surgical system. Methods Totally 23 atrial septal defect patients hospitalized from July to December 2016 underwent atrioseptopexy by using Da Vinci surgical system. The effect of atrioseptopexy was observed under cardiopulmonary bypass conditions. Results All the patients had the operation completed successfully, with the operating time being (2.8 ±0.5)h, the intraoperative cardiopulmonary bypass time being (35.4±18.4)min, aortic clamping time being (25.9±8.4)min, postoperative mechanical ventilation time being (5.7±1.5)h, amount of thoracic drainage fluid from 50 to 300 ml and postoperative hospital stay being (7 ±5.1)d. The follow-up 1 and 3 months after discharge showed there were no complications and death occurred, and the examinations by chest X-ray film and heart color ultrasound found no abnormality. Conclusion Da Vinci surgical system gains advantages in safety, reliability, patient satisfaction, operative incision and surgical trauma, and thus is worthy promoting clinically.

OBJECTIVETo investigate the effect of ulinastatin, a urinary trypsin inhibitor, on the postoperative liver function in patients who have received bilateral total knee arthroplasty (TKA) under pneumatic tourniquet.

METHODSTotally 40 patients who were scheduled to receive bilateral TKA under thigh tourniquet were randomly assigned into trial group (U group, receiving intravenous ulinastatin) and control group (C group, receiving natural saline). All patients received the same general anesthesia and postoperative analgesia. The plasma concentrations of alanine transaminase (ALT), total bilirubin (TBil), and direct bilirubin (DBil) were recorded and compared preoperatively and 4, 24, 48, and 72 hours after the surgery.

RESULTSThe demographic data were not significantly different between these two groups (P>0.05). The ALT was not significantly changed after the surgery in the C group (P>0.05) but was significantly decreased 48 hours (P=0.002) and 72 hours (P=0.001) after the surgery in the U group. TBil and DBil were significantly increased 48 hours (P=0.012, P=0.000) and 72 hours (P=0.000, P=0.000) after the surgery in C group, while only that at 48 hours (P=0.010, P=0.038) was significantly increased in the U group. ALT 4 hours (P=0.026), 48 hours (P=0.013), 72 hours (P=0.004) after the surgery were significantly lower in the U group than those in C group. TBil at the 72 hours postoperatively in U group was significantly lower than that in C group (P=0.036). DBil was not significantly different between C group and U group at all time points (all P>0.05).

CONCLUSIONThe application of ulinastatin in bilateral TKA can protect postoperative liver function.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase ; blood ; Arthroplasty, Replacement, Knee ; Bilirubin ; blood ; Female ; Glycoproteins ; pharmacology ; Humans ; Liver ; drug effects ; physiopathology ; Male ; Middle Aged ; Postoperative Period ; Young Adult