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辨证论治艾滋病

王文奎,王峰,王 岭

《中国工程科学》 2007年 第9卷 第8期   页码 30-34

摘要：

艾滋病是一种获得性免疫缺陷综合征，中医学的观点则是正气严重不足。正气依靠精神的支撑，而精神来源于饮食气味及其精微物质 ，精微物质的转化主要靠脏腑功能的正常运化。脏腑功能活动是生命运动的根本。五脏各有所主，各司其职，并且相互和合与平衡，只有当五 脏功能旺盛，并且相互和合时，人体的生命力才会强大，机体“正气”充足，才会有免疫力。在五脏之中，肝、脾、肾三脏功能要保持平衡， 其他各脏功能才会自然趋向平衡与协调，人体才会健康长寿，这就是“三维守恒”法则。

关键词： 艾滋病     正气亏损     辨证论治     五脏功能     三维守恒    

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Co-infection of HIV and parasites in China: Results from an epidemiological survey in rural areas of Fuyang city, Anhui province, China

Li-Guang TIAN MPH, Jia-Xu CHEN PhD, Yu-Chun CAI BM, Jian GUO MPH, Xiao-Mei TONG, Qin LIU DVM, Xiao-Nong ZHOU PhD, Tian-Ping WANG PhD, Xiao-Mei YIN, Wei-Duo WU, Li ZHOU, Feng-Feng WANG, Zhen-Li WANG MSc, Guo-Jin CHENG, Peter STEINMANN PhD, Lan-Hua LI MSc,

《医学前沿（英文）》 2010年 第4卷 第2期   页码 192-198 doi: 10.1007/s11684-010-0039-0

摘要： The aim of this study was to investigate epidemiological characteristics of co-infection of HIV and intestinal parasites in a HIV/AIDS highly endemic area in China. A cross-sectional survey was carried out in two villages where HIV/AIDS prevalence in residents was over 1%. Stool samples of all residents in the two targeted villages were examined for the presence of intestinal parasites. Blood examination was performed for the HIV infection detection and anemia test. A questionnaire survey was carried out in all residents participating in the study. A total of 769 individuals were enrolled in the investigation, 720 of whom were involved in stool examination of intestinal parasites. The infection rates of parasites in the residents of the targeted villages were as follows: 0.56% for , 4.03% for Hookworm, 0.28% for , 0.42% for , 21.39% for , 3.89% for , 1.67% for spp., 4.44% for spp., and no infection for . The overall infection rate of intestinal worms was 4.72%, intestinal parasite infection rate was 24.31%, the anemia prevalence rate was 34.68%, the co-infection rate of HIV and intestinal helminthes 2.17%, the co-infection rate of HIV and intestinal protozoa 28.26%, of which the co-infection rates of HIV and , and HIV and spp. were 19.57% and 13.04%, respectively. A significant difference of spp. infection rate was found between HIV-positive group (13.04%) and HIV-negative group (4.70%) (<0.05). Higher prevalence of anemia (34.68%) occurred in the study villages, particularly in children (>50%) and women (>39%). It was concluded that the infection rate of intestinal protozoa in the residents was higher than that of intestinal helminthes in the local setting, and a same pattern appeared in the co-infection rate of HIV and parasites. An interesting finding is that the infection rate of spp. among the HIV-positives was significantly higher than that in the HIV-negatives, and children and women had higher anemia prevalence.

关键词： human immunodeficiency virus (HIV)     acquired immunodeficiency syndrome (AIDS)     co-infection     intestinal parasites     helminthes     protozoa     China    

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Study on factors affecting TB/HIV co-infection in four counties of China

Shi-Ming CHENG MD, Yu-Ji LAI MS, Er-Yong LIU MS, Lin ZHOU MD, Xue-Jing WANG MS, Qiu-Lan CHEN MS, Dong-Ming LI MS, Ning WANG MD,

《医学前沿（英文）》 2010年 第4卷 第2期   页码 185-191 doi: 10.1007/s11684-010-0040-7

摘要： The factors affecting case detection of tuberculosis (TB)/human immunodeficiency virus (HIV) co-infection cases were explored in order to provide evidence-based formulation of a TB/HIV co-infection control strategy in China. Four counties with different modes of HIV transmission and varying cooperation mechanisms between TB and HIV institutions were selected. HIV test among TB patients and TB examination among people living with HIV/acquired immunodeficiency syndrome (AIDS) were conducted. Patients also completed questionnaires on potential factors affecting TB/HIV co-infection. The results showed that 19 (1.7%) were HIV-positive among 1089 cases of people living with active TB who received HIV testing. Conversely, there were 126 (10%) cases of active TB among 1255 cases of people living with HIV/AIDS. Among the newly discovered 145 cases of TB/HIV co-infection, AIDS institutions found 86.9% of these co-infections and 14.1% came from TB institutes. In different registration categories, there were 31 (21.4%) cases of smear positive TB, 104 (71.7%) cases of smear negative TB, and extrapulmonary cases accounted for 10 (6.9%). Gender, occupation, marital status, ethnic group, education, HIV transmission route, CD4 level, and type of TB susceptible symptoms had significant effects on whether HIV/AIDS patients were co-infected with TB disease (<0.01). Sex, age, ethnic group, occupation, and type of tuberculosis had no significant influence on whether TB patients had HIV infection. AIDS institutions could find more TB/HIV co-infection patients in comparison with TB institutions, particularly in patients with smear negative pulmonary tuberculosis and extrapulmonary tuberculosis. Therefore, a cooperation mechanism should be built up between TB and HIV control systems, and routine TB checks should be conducted for HIV/AIDS patients. In areas where sex or drug use is the major transmission mode of HIV infection, antiretroviral therapy should be expanded, treatment adherence should be improved and patients’ immunity level should be increased in order to decrease TB incidence. Cough and expectoration of more than two weeks, bloody sputum, and recurrent fevers could be revealing symptoms in TB screening of HIV/AIDS patients.

关键词： tuberculosis/acquired immunodeficiency syndrome     dual infection     prevention and control     case detection     impact factors    

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Immunological and virological characteristics of human immunodeficiency virus type 1 superinfection:

null

《医学前沿（英文）》 2017年 第11卷 第4期   页码 480-489 doi: 10.1007/s11684-017-0594-8

摘要：

Superinfection is frequently detected among individuals infected by human immunodeficiency virus type I (HIV-1). Superinfection occurs at similar frequencies at acute and chronic infection stages but less frequently than primary infection. This observation indicates that the immune responses elicited by natural HIV-1 infection may play a role in curb of superinfection; however, these responses are not sufficiently strong to completely prevent superinfection. Thus, a successful HIV-1 vaccine likely needs to induce more potent and broader immune responses than those elicited by primary infection. On the other hand, potent and broad neutralization responses are more often detected after superinfection than during monoinfection. This suggests that broadly neutralizing antibodies are more likely induced by sequential immunization of multiple different immunogens than with only one form of envelope glycoprotein immunogens. Understanding why the protection from superinfection by immunity induced by primary infection is insufficient and if superinfection can lead to cross-reactive immune responses will be highly informative for HIV-1 vaccine design.

关键词： human immunodeficiency virus type I     superinfection     incidence     immune response    

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Targeting apoptosis to manage acquired resistance to third generation EGFR inhibitors

《医学前沿（英文）》 2022年 第16卷 第5期   页码 701-713 doi: 10.1007/s11684-022-0951-0

摘要： A significant clinical challenge in lung cancer treatment is management of the inevitable acquired resistance to third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs), such as osimertinib, which have shown remarkable success in the treatment of advanced NSCLC with EGFR activating mutations, in order to achieve maximal response duration or treatment remission. Apoptosis is a major type of programmed cell death tightly associated with cancer development and treatment. Evasion of apoptosis is considered a key hallmark of cancer and acquisition of apoptosis resistance is accordingly a key mechanism of drug acquired resistance in cancer therapy. It has been clearly shown that effective induction of apoptosis is a key mechanism for third generation EGFR-TKIs, particularly osimertinib, to exert their therapeutic efficacies and the development of resistance to apoptosis is tightly associated with the emergence of acquired resistance. Hence, restoration of cell sensitivity to undergo apoptosis using various means promises an effective strategy for the management of acquired resistance to third generation EGFR-TKIs.

关键词： acquired resistance     EGFR inhibitor     apoptosis     lung cancer    

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Practices, challenges, and opportunities: HIV/AIDS treatment with traditional Chinese medicine in China

Jian Wang, Wen Zou

《医学前沿（英文）》 2011年 第5卷 第2期   页码 123-126 doi: 10.1007/s11684-011-0124-z

摘要： Traditional Chinese medicine (TCM) has become widely used in the treatment of acquired immune deficiency syndrome (AIDS) in China in recent years. In this article, we summarize the recent major developments in human immunodeficiency virus/AIDS (HIV/AIDS) treatment with TCM. The use of TCM is associated with preventing or alleviating HIV-related symptoms, reducing treatment side effects, and improving the quality of life. The potential beneficial effects of TCM should be confirmed through extensive and rigorous trials.

关键词： HIV/AIDS     traditional Chinese medicine    

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中医论治艾滋病

王文奎

《中国工程科学》 2004年 第6卷 第1期   页码 44-47

摘要：

严重的细胞免疫功能缺陷是艾滋病发生的内因，获得性的病毒是外因，外因只有通过内因才能致病。而细胞免疫缺陷的根本，全在于生养细胞的条件与环境。一切条件全靠人体的脏腑功能运动来创造，只有宏观而整体的调控人体的脏腑功能运动，才能化生人体所需要的一切物质。有了物质才能化生精神，有了物质和精神才能保障细胞的免疫功能，才能战胜并消灭各种病毒，才能恢复人体的身心健康，增强人体的免疫功能，保障人体的生命运动正常进行。

关键词： 中医论治     辨证     艾滋病    

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lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired

《医学前沿（英文）》 2022年 第16卷 第3期   页码 389-402 doi: 10.1007/s11684-021-0856-3

摘要： Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2=0.033; P=0.018), followed by acute kidney injury (AKI; R2=0.032; P=0.011) and plasma MIP-1β level (R2=0.027; P=0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients’ lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

关键词： severe community-acquired pneumonia     lung microbiota     clinical improvements     7-category ordinal scale     Prevotellaceae    

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bone marrow transplantation in patients with severe aplastic anemia-II that progressed from non-severe acquired

《医学前沿（英文）》 2021年 第15卷 第5期   页码 718-727 doi: 10.1007/s11684-020-0807-4

摘要： Severe aplastic anemia II (SAA-II) progresses from non-severe aplastic anemia (NSAA). The unavailability of efficacious treatment has prompted the need for haploidentical bone marrow transplantation (haplo-BMT) in patients lacking a human leukocyte antigen (HLA)-matched donor. This study aimed to investigate the efficacy of haplo-BMT for patients with SAA-II. Twenty-two patients were included and followed up, and FLU/BU/CY/ATG was used as conditioning regimen. Among these patients, 21 were successfully engrafted, 19 of whom survived after haplo-BMT. Four patients experienced grade II–IV aGvHD, including two with grade III–IV aGvHD. Six patients experienced chronic GvHD, among whom four were mild and two were moderate. Twelve patients experienced infections during BMT. One was diagnosed with post-transplant lymphoproliferative disorder and one with probable EBV disease, and both recovered after rituximab infusion. Haplo-BMT achieved 3-year overall survival and disease-free survival rate of 86.4%±0.73% after a median follow-up of 42 months, indicating its effectiveness as a salvage therapy. These promising outcomes may support haplo-BMT as an alternative treatment strategy for patients with SAA-II lacking HLA-matched donors.

关键词： severe aplastic anemia     non-severe acquired aplastic anemia     haploidentical bone marrow transplantation     outcomes    

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Analysis of antibiotic usage for viral community-acquired pneumonia in adults

Rongmeng Jiang, Bing Han, Chang Dou, Fei Zhou, Bin Cao, Xingwang Li

《医学前沿（英文）》 2021年 第15卷 第1期   页码 139-143 doi: 10.1007/s11684-019-0736-2

摘要： The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.

关键词： adult     antibiotic     viral pneumonia    

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An 84-month observational study of the changes in CD4 T-lymphocyte cell count of 110 HIV/AIDS patients

null

《医学前沿（英文）》 2014年 第8卷 第3期   页码 362-367 doi: 10.1007/s11684-014-0363-x

摘要：

This study aimed to evaluate the therapeutic effect of traditional Chinese medicine (TCM) by observing the changes in CD4 T-lymphocyte cell count of 110 cases with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) treated continuously with TCM for 84 months. Information of 110 HIV/AIDS patients from 19 provinces and cities treated with TCM from 2004 to 2013 was collected. Changes in the indexes of CD4 counts (≤200, 201–350, 351–500 and>500 cells/mm3) at five time points (0, 12, 36, 60 and 84 months) and different treatments [TCM and TCM plus antiretroviral therapy (ART)] were compared. Repeated measures test indicated no interaction between group and time (P>0.05). Degrees of increasing and decreasing CD4 count of the two groups at four different frames were statistically significant compared with the baseline. The CD4 count between the two groups was not statistically significant. For CD4 count of≤200 cells/mm3, the mean CD4 count changes were 21 and 28 cells/mm3 per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 201–350 cells/mm3, the mean CD4 count changes were 6 and 25 cells/mm3 per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 351–500 cells/mm3, the mean CD4 count changes were -13 and -7 cells/mm3 per year for the TCM group and TCM plus ART group, respectively. For CD4 count of>500 cells/mm3, the mean CD4 count changes were -34 and -17 cells/mm3 per year for the TCM group and TCM plus ART group, respectively. Long-term use of TCM could maintain or slow the pace of declining CD4 counts in patients with HIV/AIDS, and may achieve lasting effectiveness.

关键词： AIDS     HIV     CD4     traditional Chinese medicine     linear models    

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Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational

《医学前沿（英文）》 2022年 第16卷 第4期   页码 651-658 doi: 10.1007/s11684-021-0859-0

摘要： To present the clinical characteristics and the misdiagnosis rate of acute coronary syndrome manifested primarily as throat discomfort, we conducted a multicentric and retrospective study in the cardiology and otorhinolaryngology departments. Records of patients with primary complaint of throat discomfort, absence of chest pain at onset, and an ultimate diagnosis of acute coronary syndrome, as well as patients with pharyngitis (as controls) were collected from May 2015 to April 2016. The patients’ main manifestations were compared. Logistic regression results showed that chest tightness, dyspnea, perspiring, and exertional throat symptoms were significantly associated with acute coronary syndrome, with odds ratios of 8.3 (95% CI 2.2−31.5), 10.9 (95% CI 1.8−66.9), 25.4 (95% CI 3.6−179.9), and 81.2 (95% CI 13.0−506.7). A total of 25 (56.82%) out of 44 acute coronary syndrome patients, who were first admitted to the otorhinolaryngology department, were misdiagnosed, with a 12% (3/25) mortality rate. Throat discomfort can be the principal manifestation of acute coronary syndrome. Such patients exhibit high misdiagnosis and mortality rates. Exertional throat symptoms, chest tightness, perspiring, and dyspnea were important indicators of acute coronary syndrome in patients whose main complaint was throat discomfort. The awareness of this condition will result in prompt diagnosis and reduce morbidity and mortality.

关键词： acute coronary syndrome (ACS)     throat discomfort (TD)     throat pain     cardiology departments     non-cardiologic physicians    

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Diagnosis and management of acquired thrombotic thrombocytopenic purpura in southeast China: a single

null

《医学前沿（英文）》 2016年 第10卷 第4期   页码 430-436 doi: 10.1007/s11684-016-0492-5

摘要：

Acquired thrombotic thrombocytopenic purpura (TTP) is a rare life-threatening thrombotic microangiopathy. This study aimed to provide a profile of the diagnosis and management of patients with acquired TTP collected in 10 years in a single center in southeast China. A total of 60 patients diagnosed with acute acquired TTP from March 2005 to August 2015 were enrolled. Among the 60 patients, 52 patients presented with their first episodes, and eight patients had two or more episodes. The median age at presentation was 49 (range, 17 to 78) years with a female predominance (male:female ratio, 1:1.60). ADAMTS 13 activity were analyzed in 43 patients, among whom 33 (76.7%) patients had a baseline level of<5%. Mortality was 30%. Plasma exchange (PEX) was performed in 62 of 69 (89.9%) episodes. Corticosteroids were administered in 54 of 69 (78.3%) episodes. Other immunosuppressants (e.g., vincristine, cyclosporine, and cyclosporin) were used in 7 of 69 (10.1%) episodes. Rituximab was documented in 4 patients with refractory/relapsed TTP for 5 episodes, showing encouraging results. In conclusion, the diagnosis of TTP depended on a comprehensive analysis of clinical data. Plasma ADAMTS13 activity assay helped confirm a diagnosis. PEX was the mainstay of the therapy, and rituximab can be used in relapsed/refractory disease.

关键词： thrombotic thrombocytopenic purpura     ADAMTS 13     plasma exchange    

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Aneurysmal dilatation of the aortic sinuses of Valsalva — beyond Marfan syndrome: a single centre experience

null

《医学前沿（英文）》 2014年 第8卷 第4期   页码 419-426 doi: 10.1007/s11684-014-0383-6

摘要：

Aneurysmal dilatation of the aortic sinuses of Valsalva has been most extensively documented in the setting of aortopathies, particularly Marfan syndrome. On the other hand, there is limited data in the literature about congenital sinus of Valsalva aneurysms outside this context. For the purpose of this review, we carried out a literature search on aneurysmal dilatation of the sinuses of Valsalva in Marfan syndrome, and compared this with congenital sinus of Valsalva aneurysms, also including data from a case series from our institution. In conclusion, there are differences in management of aortic dilatation in Marfan syndrome and congenital sinus of Valsalva aneurysms. Though less well-recognised, congenital aneurysms are often associated with significant morbidity and mortality and timely intervention is necessary.

关键词： sinus of Valsalva aneurysms     Marfan syndrome     aortic dissection    

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Lung transplantation for bronchiolitis obliterans syndrome after allogenic hematopoietic stem cell transplantation

null

《医学前沿（英文）》 2018年 第12卷 第2期   页码 224-228 doi: 10.1007/s11684-017-0538-3

摘要：

Bronchiolitis obliterans syndrome (BOS) after hematopoietic stem cell transplantation (HSCT) is a major cause of morbidity and mortality with limited treatment options. Lung transplantation (LTX) has been rarely reported as a treatment option for selected HSCT recipients with this problem. In the present study, we reported six patients who underwent LTX due to BOS after HSCT (two females, four males) from January 2012 to December 2014 in our center. The median time from HSCT to diagnosis of BOS was 2.5 years (ranging from 1 to 5 years). At a median time of 4 years (ranging from 2 to 5 years) after diagnosis of BOS, four patients received bilateral sequential LTX, and two patients received single LTX. One of the recipients suffered from mild acute rejection after LTX, another suffered from primary lung graft dysfunction on post-operation day 2, and three experienced fungal infections. The median time for follow-up after LTX was 19.5 months (ranging from 12 to 39 months). At present, all patients are alive with good functional capacity and no relapse of BOS and hematologic malignancy conditions. Patients who received bilateral LTX have better pulmonary functions than patients who received single LTX.

关键词： bronchiolitis obliterans syndrome (BOS)     hematopoietic stem cell transplantation (HSCT)     lung transplantation (LTX)    

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标题 作者 时间 类型 操作

辨证论治艾滋病

王文奎,王峰,王 岭

期刊论文

Co-infection of HIV and parasites in China: Results from an epidemiological survey in rural areas of Fuyang city, Anhui province, China

Li-Guang TIAN MPH, Jia-Xu CHEN PhD, Yu-Chun CAI BM, Jian GUO MPH, Xiao-Mei TONG, Qin LIU DVM, Xiao-Nong ZHOU PhD, Tian-Ping WANG PhD, Xiao-Mei YIN, Wei-Duo WU, Li ZHOU, Feng-Feng WANG, Zhen-Li WANG MSc, Guo-Jin CHENG, Peter STEINMANN PhD, Lan-Hua LI MSc,

期刊论文

Study on factors affecting TB/HIV co-infection in four counties of China

Shi-Ming CHENG MD, Yu-Ji LAI MS, Er-Yong LIU MS, Lin ZHOU MD, Xue-Jing WANG MS, Qiu-Lan CHEN MS, Dong-Ming LI MS, Ning WANG MD,

期刊论文

Immunological and virological characteristics of human immunodeficiency virus type 1 superinfection:

null

期刊论文

Targeting apoptosis to manage acquired resistance to third generation EGFR inhibitors

期刊论文

Practices, challenges, and opportunities: HIV/AIDS treatment with traditional Chinese medicine in China

Jian Wang, Wen Zou

期刊论文

中医论治艾滋病

王文奎

期刊论文

lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired

期刊论文

bone marrow transplantation in patients with severe aplastic anemia-II that progressed from non-severe acquired

期刊论文

Analysis of antibiotic usage for viral community-acquired pneumonia in adults

Rongmeng Jiang, Bing Han, Chang Dou, Fei Zhou, Bin Cao, Xingwang Li

期刊论文

An 84-month observational study of the changes in CD4 T-lymphocyte cell count of 110 HIV/AIDS patients

null

期刊论文

Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational

期刊论文

Diagnosis and management of acquired thrombotic thrombocytopenic purpura in southeast China: a single

null

期刊论文

Aneurysmal dilatation of the aortic sinuses of Valsalva — beyond Marfan syndrome: a single centre experience

null

期刊论文

Lung transplantation for bronchiolitis obliterans syndrome after allogenic hematopoietic stem cell transplantation

null

期刊论文