Objective To assess the effect of early antiretroviral therapy on acquired immune deficiency syndrome in Butuo County, Liangshan Autonomous Prefecture. Methods A total of 1 037 patients who underwent antiretroviral therapy between January 1st 2012 and December 31st 2013 in Butuo Coungty were divided into 2 groups. The early treatment group (with CD4+ lymphocyte count >350 /mm3) was group A (n=459) and delayed treatment group (with CD4+ lymphocyte count≤350 /mm3) was group B. After 18-month treatment, the treatment retention rate, clinical effect and the side effects of medication in two groups were observed and analyzed. Results After 18 months, there were 297 (64.7%) and 320 (55.4%) patients who were persisting in treatment in group A and B, respectively; while the mortality was 6.1% (28/459) and 14.4% (83/578), respectively in group A and B. The differences were significant (P<0.001). The rate of virological suppression in group A and B was 64.0% (190/297) and 63.8% (204/320) respectively without any significant difference (P>0.05). Compared with baseline CD4+ T lymphocyte counts, the growth rate of CD4+ T lymphocyte count in group A and B was 5.7% and 37.5%, respectively; the difference was significant (P<0.001) Conclusions Early treatment for acquired immune deficiency syndrome in Butuo County, Liangshan Autonomous Prefecture is effective, however, its growth rate of CD4+ T lymphocyte count is lower than that of delayed treatment. Early treatment doesn’t cause the increasement of the risk of common adverse reactions of medication, and it can reduce the mortality.
ObjectivesTo systematically review the methods of pharmacoeconomic evaluation model for hepatitis C therapies and to identify shortcomings of the existing modeling research by comparing the model structure, hypothesis and methodological differences, and to provide suggestions for the construction of high-quality hepatitis C pharmacoeconomic evaluation models.MethodsPubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect relevant literatures on the pharmacoeconomic evaluation models for hepatitis C therapies from August 2014 to August 2019. Two reviewers independently screened literature, extracted data, and evaluated the quality of the included studies. Then, the data related to the model structure, methods, and assumptions were compared and summarized.ResultsMost of the 46 studies that finally included used similar modeling methods. Ignoring different modeling elements would cause overestimation or underestimation of the value of hepatitis C therapies. Model structure of all studies were similar and key parameters were from the same source. Forty-five studies measured the cost of drugs and medical cost of health status. All studies used quality-adjusted life years as the outcome and reported incremental cost-effectiveness ratio. Thirty studies conducted one-way sensitivity analysis and probability sensitivity analysis.ConclusionsThe included studies share similar methodological designs and have high quality in general. However, there are some differences and deficiencies in research perspective, model types, model assumptions and model verification. Future pharmacoeconomic evaluation model of hepatitis C therapies should report the results of the whole society, establish dynamic model to consider the impact of transmission, make half-cycle correction for long periods, consider the recurrence after cure, model liver transplantation, and verify the model.
ObjectiveTo summarize progress of 25-hydroxycholesterol (25-OHC), 27-hydroxycholesterol(27-OHC), and 7α,25-hydroxycholesterol (7α,25-OHC) three oxidized cholesterols in inflammation and immunology and to provide evidence for related basic researches and diseases treatments.MethodThe relevant literatures about these three important oxidized cholesterols in the inflammation and immunology in recent years were reviewed.ResultsThe 25-OHC and 27-OHC could exert the antiviral effects by interfering with various viruses invading the host via various mechanisms. Moreover, the 25-OHC and 27-OHC also played the important regulatory roles in a variety of inflammatory processes and inflammatory diseases. The 7α,25-OHC played the important role in a variety of inflammatory processes by acting on the inflammatory and immune cell membrane receptor G-protein coupled receptor 183 (also known as Epstein-Barr virus-inducible receptor 2).Conclusion25-OHC, 27-OHC and 7α,25-OHC play an important roles in occurrence and development of various inflammatory and immune responses and diseases of inflammatory and immune by acting on a variety of nuclear receptors and membrane receptors.
【摘要】 目的 研究纳米银体外抗H3N2流感病毒的作用，并初步探索其作用机制。 方法 在H3N2流感病毒吸附细胞后加入纳米银和吸附前用纳米银预处理犬肾细胞（MDCK），在体外用细胞病变效应（cytopathic effect，CPE）观察法和3-（4，5-二甲基-2-噻唑）-2，5-二苯基溴化四唑（3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide，MTT）测值法，分析纳米银对H3N2流感病毒感染MDCK细胞的预防作用、直接灭活作用以及对流感病毒子代病毒体生成的抑制作用，运用RT-PCR法研究纳米银对H3N2流感病毒HA基因复制的干扰作用。 结果 纳米银能明显杀伤H3N2流感病毒，50、25 μg/mL的纳米银溶液与H3N2流感病毒充分作用2 h后感染MDCK细胞，细胞存活率分别为94.38%和92.17%，纳米银能有效抑制流感病毒对MDCK细胞的侵入和侵入后病毒的继续增殖，25 μg/mL纳米银溶液通过上述两种方式处理细胞，细胞存活率分别为85.39%和83.28%，与病毒对照组相比，差异均有统计学意义（Plt;0.001）；400、200 μg/mL纳米银溶液分别与流感病毒H3N2充分混合作用15、30、60、120 min后，病毒液的HA基因均未能成功扩增，纯病毒液和溶剂对照组在1 700 bp处均出现明显条带。 结论 通过3种不同的给药方式，纳米银在体外均能明显抑制流感病毒对细胞的感染，纳米银抑制流感病毒的机制可能是通过干扰H3N2流感病毒和吸附、穿入和基因的复制，从而抑制子代病毒体的生成。【Abstract】 Objective To explore the anti-viral effects of silver-nanoparticles (silver-nps) on H3N2 influenza virus in vitro and to evaluate its mechanism. Methods Silver-nps was added to canine kidney cells (MDCK) before and after the cells was adsorpted by H3N2 influenza virus. Cytopathic effect (CPE) assay and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay were used to analyze the preventive effect, directly off deactivation, and the inhibit formation of progeny virions of silver-nps on H3N2 viruses. The interference of HA gene replication was observed by the RT-PCR assay. Results The survival rate of MDCK cells was 94.38% and 92.17% after 50 and 25 μg/mL silver-nps were mixed with 100 TCID50 H3N2 virus in 2 hours, and the survival rate of MDCK cells was 85.39% and 83.28% before and after the cells was adsorpted by H3N2 influenza virus when 25 μg/mL silver-nps was added to the cells (all compared to virus control, Plt;0.001), which showed that silver-nps could inactivate H3N2 virus, prevente them invasing to the cells and reproducting when H3N2 entered the cell remarkedly. The HA gene was not amplified successfully when 50 and 25 μg/mL silver-nps were mixed with 100TCID50 H3N2 virus in 15, 30, 60, and 120 minutes later, but both pure virus solution and solvent control group appeared a significant bright band in the 1 700 bp area. Conclusion Under three different administration modes, silver-nps has an obvious effect against H3N2 in vitro, which could interfere the HA gene replication and inhibit the formation of H3N2 progeny virions.
ObjectiveTo systematically review the efficacy and safety of traditional Chinese medicine (TCM) and antiviral antibody therapy in the treatment of COVID-19. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and SinoMED databases were electronically searched to collect randomized controlled trials (RCTs) on efficacy and safety of traditional Chinese medicine and antiviral antibody therapies for COVID-19 from inception to June 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 14.0 software. ResultsA total of 44 RCTs were included. The results of network meta-analysis showed that, for mortality rate, the rank of cumulative probability was: TCM+ standard care (SC) (100%)>convalescent plasma (CP)+SC (42%)>SC (8%). In terms of hospital stay time, the rank of cumulative probability was: TCM+SC (95.5%)>SC (31.4%)>CP+SC (23.2%). In terms of time to viral clearance, the rank of cumulative probability was: TCM+SC (97.4%)>SC (37.4%)>CP+SC (15.2%). In the aspect of mechanical ventilation rate, the rank of cumulative probability was: TCM+SC (98.9%)>CP+SC (42.9%)>SC (8.3%). In the aspect of adverse reactions/events, the rank of cumulative probability was: TCM+SC (99.9%)>SC (47.9%)>CP+SC (2.2%). ConclusionThe current evidence shows that TCM combined with SC is the most effective treatment in reducing mortality, shortening hospitalization time and viral negative conversion time, reducing mechanical ventilation rate, and the incidence of adverse reactions/events is low. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.
目的:分析艾滋病患者抗病毒治疗后的临床疗效,比较不同基线CD4+T淋巴细胞计数增长情况。方法:纳入51例符合治疗标准的初治患者,采用国家标准抗病毒治疗一线方案和卫生部统一提供的免费药物,通过对服药后半月、1月、3月、6月、12月的时段进行临床评估和实验室检查,并比较不同基线CD4+T淋巴细胞计数水平治疗后的增长情况。结果:治疗12月后,各方案组疗效无差异,不同基线CD4+T淋巴细胞计数的增长有显著差异。毒副反应为肝损伤、过敏性皮疹,消化道反应为主。结论:HAART可显著的抑制体内HIV病毒的复制,重建机体的免疫功能,缓解患者病情,有利于存活期的延长。严重的毒副作用发生较少。
Objective To analyze the clinical characteristics of adverse drug reaction (ADR) caused by 3 kinds of coronavirus disease 2019 drugs, and provide a reference for clinical safe medication. MethodsA total of 33 patients with coronavirus disease 2019 admitted to Xiangtan Central Hospital from January 20 to March 5, 2020 were selected as the research objects. The clinical data of patients with ADR during the antiviral process were analyzed retrospectively. The patients’ gender, age, type of medication, combination medication, organs or systems involved, and clinical manifestations were summarized and analyzed. Results A total of 33 patients were enrolled. A total of 21 cases of ADR were reported. The incidence of ADR is higher in patients older than 60 years (80.0%). The most common clinical manifestations are digestive tract symptoms (66.7%). The incidence of ADR is highest in the combination of lopinavir/ritonavir+arbidol+ribavirin (100.0%), followed by the combination of lopinavir/ritonavir+arbidol (85.7%). Abidol and ribavirin each caused 1 case of severe ADR. Conclusion For patients with coronavirus disease 2019, the combination of two or more antiviral drugs should be avoided, and pharmaceutical monitoring should be strengthened for elderly, severe/critical and allergic patients.
ObjectiveTo investigate the psychological status of patients with chronic hepatitis B during the anti-virus treatment. MethodThe questionnaires of 150 outpatients with chronic hepatitis B treated between May 2013 and May 2014 were collected. And the date was properly processed. ResultsAll the patients were suffering from different degrees of worries, and the top 3 rates of worries were:the recurrence after stop using drugs (88.00%), the side effects of long-term medication (78.00%) and discrimination from people seeing the package of drugs (69.33%). ConclusionsPatients with chronic hepatitis B are in different degrees of psychological hazard during the treatment of anti-virus; further nursing work in psychological counseling and health education are needed to eliminate the hidden trouble, as to enhance the curative effect.