病毒载量基线和治疗依从性对CD4细胞计数≥200个/μL HIV感染者生存率的影响

HAART能持续抑制血浆HIVRNA，降低HIV感染者发病率和死亡率。最近有研究发现血浆HIVRNA基线水平≥100000copies／mL与病人高死亡率有关，但并不清楚二者之间的关联是否可以通过病人治疗依从性差解释。关于血浆高滴度HIVRNA和CD4^＋细胞计数／〉200个/μL病人的最佳治疗策略并不确定。本研究旨在评价病毒载量基线对CD4^＋细胞计数≥200个／μL HIV感染者生存率的影响。作者根据血浆HIVRNA、CD4^＋细胞计数和依从性水平将首次抗病毒病人分层，用Kaplan—Meier和回归Cox法分析死亡率。     

皮肤软组织感染病人与血浆脂多糖

为观察血浆中LPS在软组织感染时的变化及其临床意义，对47例不同类型软组织感染病人进行了血浆LPS动态监测，结果显示：局限感染组与重症感染组病人血浆LPS水平明显高于对照组（P＜0．001），且随治疗的有效而其水平下降。结论：血浆LPS水平动态监测可作为皮肤感染病人病情和预后、临床治疗指导的指标．     

阿托伐他汀对急性冠脉综合征患者血浆纤维蛋白原和C反应蛋白的影响

目的：观察阿托伐他汀治疗对于急性冠脉综合征患者血浆纤维蛋白原和c反应蛋白的影响。方法：本试验采用前瞻性开放性病例对照研究，将84例急性冠脉综合征患者随机分为2组：A组（41例）采用常规治疗；B组（43例）在常规药物治疗基础上，加用阿托伐他汀（20mg／d）治疗，在治疗前以及治疗2个月后检测患者血浆纤维蛋白原及超敏C反应蛋白水平。结果：常规治疗对血浆纤维蛋白原和超敏c反应蛋白水平无明显影响；阿托伐他汀不但能降低血浆纤维蛋白原水平，还显著降低c反应蛋白水平。结论：阿托伐他汀改善急性冠脉综合征患者血液流变学，并具有抗炎作用，对于抑制心肌缺血的进展具有良好作用。     

反复呼吸道感染患儿血浆维生素A测定及意义

目的：分析反复呼吸道感染与患儿血浆维生素A水平的相关性。方法：选取80例反复呼吸道感染无现症感染患儿为A组，80例健康儿童为B组，80例急性呼吸道感染患儿为C组，测定三组儿童血浆维生素A水平及边缘性维生素A缺乏率，测定A组及B组儿童外周血T细胞亚群和免疫球蛋白。结果：维生素A水平A组为（0.26±0.04）mg/L，B组为（0.31±0.05）mg/L，C组为（0.28±0.03）mg/L，A组、C组低于B组，差异均有统计学意义（P<0.05），A组和C组差异无统计学意义（P>0.05）。边缘性维生素A缺乏A组有60例（75.0%），B组有28例（35.0%），C组有42例（52.5%），A组、C组边缘性维生素A缺乏率高于B组，差异均有统计学意义（P<0.05）。A组患儿血清IgA、IgG、IgM水平均低于B组，差异有统计学意义（P<0.05）。A组CD3+绝对数、CD4+的绝对数、CD4+/CD8+均低于B组，差异均有统计学意义（P<0.05）；A组CD8+绝对数大于B组，差异有统计学意义（P<0.05）。结论：维生素A水平低下可能是反复呼吸道感染的重要原因之一，而呼吸道感染可加重维生素A缺乏。     

新疆奎屯地区110例妇女性传播疾病感染状况调查

目的：了解新疆奎屯地区近年来农村妇女性病感染状况。方法：随机对110例普通农村妇女进行性传播疾病（STD）感染状况调查，包括解脲支原体（UU）、人型支原体（MH）、衣原体（CT）、淋球菌（NG）、酶毒快速血浆反应素试验（RPR）及艾滋病病毒（HIV）检测。结果：UU阳性率为30％，CT阳性率为21．8％，MH阳性率为5．45％，NG阳性率为5．45％，29（26．3％）人有2种或3种病原体感染合并存在。在宫颈炎和／或附件炎病人（59例）中，CT、UU或CT、UU合并阳性率达59％，显著高于正常组；所有人血HIV检测阴性，RPR试验1例阳性。结论：应加强在一般妇女人群中STD的筛选和治疗。     

不同孕周进行抗病毒治疗对HIV感染母婴阻断效果的影响

目的 探讨在不同孕周对人类免疫缺陷病毒（HIV）阳性产妇实施抗病毒治疗对母婴阻断疗效的影响。方法选择2018年5月—2021年10月赣州市第五人民医院分娩的HIV感染孕妇90例为研究对象,以不同孕周将其均分为A、B、C 3组,每组各30例。A组为孕早期孕妇,B组为孕中期孕妇,C组为孕晚期孕妇,均给予抗病毒治疗。统计3组新生儿结局、产妇并发症与新生儿HIV感染发生率。结果 A组新生儿不良结局总发生率显著低于C组（P<0.05）;A组孕妇并发症发生率显著低于C组;A组新生儿HIV感染率显著低于C组（P<0.05）。结论 临床应尽早予以HIV感染孕妇抗病毒治疗,可有效降低新生儿不良结局与产妇产后并发症发生率,降低新生儿感染HIV的风险,对改善母婴结局有积极意义。     

急性下壁心肌梗死时前壁导联ST段压低的临床意义

随着选择性冠状动脉造影术的开展，冠心病、急性心肌梗死（AMI）的诊断、治疗水平发生了质的变化，解决了临床上的许多疑难问题。多年来临床发现在急性下壁心肌梗死急性期，部分病人心电图（ECG）除了在心肌梗死相应导联（Ⅱ、Ⅲ、avF）可见ST段抬高外，同时发现前壁导联（V1－4）ST段水平压低。以往多认为其变化为梗死区域的镜像改变，但随着选择性冠状动脉造影的开展，发现上述ECG变化并非安全能由镜像改变来解释。我们对1997年1月至1998年4月入院的34例ECG诊断为急性下壁心肌梗死的病人进行选择性冠状动脉造影检查，对该现象作进一步探讨。     

HIV、HCV复合感染患者HAART治疗后CD4＋细胞计数和HCV RNA变化的研究

目的了解河南省某县HIV感染者HIV、HCV复合感染状况以及高效抗逆转录病毒治疗（HAART）后CD4＋细胞计数和HCV RNA的变化。方法测定HIV感染者HCV—IgG、CD4＋细胞计数、血浆HIV和HCV病毒栽量。采用单因素方差分析比较应用HAART后CIM＋细胞计数和HCV RNA的变化。结果228名HIV感染者中，HCV—IgG阳性率88、6％（202／228）。在HAART超过6个月且HCV—IgG阳性的病人中，HIV RNA阴性（B组）的CD4＋细胞计数显著高于HIV RNA阳性的患者（A组）（P=0．020）；而两组的HCV RNA病毒栽量差异无统计学意义（P=0．749）。结论河南地区HIV、HCV复合感染在血液传播的HIV感染者中普遍存在。经HAART治疗的患者随着血浆HIV RNA转阴，CD4＋细胞计数显著升高，但血浆中HCV RNA的含量无显著变化。     

株洲市艾滋病病人两年治疗效果观察

株洲市自1998年发现首例HIV感染者以来，现已死亡2例艾滋病病人（均未使用药物治疗者）；但本市仍属低HIV感染地区。为提高艾滋病病人生活质量，我们按统一治疗方案对7例现症病人开展抗病毒治疗，现报道如下：     

自拟益气活血养营汤对急性蛋白质营养不良防治疗效的研究

目的：探讨自拟益气活血养营汤对急性蛋白质营养不良患者血浆白蛋白和 C －反应蛋白的影响。方法：通过对急性蛋白质营养不良患者100例入院时、治疗（包括术后）时、治疗一周时血浆白蛋白、C －反应蛋白指标统计，在常规西医治疗的基础上，随机分为常规对照组和治疗组，治疗一周后，观察益气活血养营汤对血浆白蛋白和 C －反应蛋白的影响。结果：两组临床疗效比较，治疗组明显优于对照组（P ＜0.05）；白蛋白，C －反应蛋白治疗组一周后与治疗时比较差异有显著性（P ＜0.05），对照组改善不明显（P ＞0.05）。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.