BACKGROUND Advanced glycation end products(AGEs)are diabetic metabolic toxic products that cannot be ignored.Nε-(carboxymethyl)lysine(CML),a component of AGEs,could increase macrophage lipid uptake,promote foam cell ...BACKGROUND Advanced glycation end products(AGEs)are diabetic metabolic toxic products that cannot be ignored.Nε-(carboxymethyl)lysine(CML),a component of AGEs,could increase macrophage lipid uptake,promote foam cell formation,and thereby accelerate atherosclerosis.The receptor for AGEs(RAGE)and cluster of differentiation 36(CD36)were the receptors of CML.However,it is still unknown whether RAGE and CD36 play key roles in CML-promoted lipid uptake.AIM Our study aimed to explore the role of RAGE and CD36 in CML-induced macrophage lipid uptake.METHODS In this study,we examined the effect of CML on lipid uptake by Raw264.7 macrophages.After adding 10 mmol/L CML,the lipid accumulation in macrophages was confirmed by oil red O staining.Expression changes of CD36 and RAGE were detected with immunoblotting and quantitative real-time polymerase chain reaction.The interaction between CML with CD36 and RAGE was verified by immunoprecipitation.We synthesized a novel N-succinimidyl-4-18Ffluorobenzoate-CML radioactive probe.Radioactive receptor-ligand binding assays were performed to test the binding affinity between CML with CD36 and RAGE.The effects of blocking CD36 or RAGE on CML-promoting lipid uptake were also detected.RESULTS The study revealed that CML significantly promoted lipid uptake by macrophages.Immunoprecipitation and radioactive receptor-ligand binding assays indicated that CML could specifically bind to both CD36 and RAGE.CML had a higher affinity for CD36 than RAGE.ARG82,ASN71,and THR70 were the potential interacting amino acids that CD36 binds to CML Anti-CD36 and anti-RAGE could block the uptake of CML by macrophages.The lipid uptake promotion effect of CML was significantly attenuated after blocking CD36 or RAGE.CONCLUSION Our results suggest that the binding of CML with CD36 and RAGE promotes macrophage lipid uptake.展开更多
According to the characteristics of comprehensive mechanized heading face, established the mathematical model of single-phase air flow with κ-ε two equations model, and have established κ-ε-θ-κp mathematic model...According to the characteristics of comprehensive mechanized heading face, established the mathematical model of single-phase air flow with κ-ε two equations model, and have established κ-ε-θ-κp mathematic model to solve two-phase flow of gas and particles in dust space with eulerian-eulerian method and eulerian-lagrangian method. Numerical solution of gas-particle two-phase flow was put forward based on collocated grid SIMPLE algorithm. Moreover, numerical simulation of dust concentration in fully mechanized caving face was carded out by using Fluent software. Finally, when in forced-exhaust ventilation circumstance, drawer type fan drum have less dust absorption, and most of dust spread to the other site; the dust concentration is inversely proportional to the distance from tunneling head, and the dust concentration has already diffused to decrease below 102 mg/m3 at the position ofx=12 m. Dust are more focused on relative side（in the range about y from 0 to 2 meter） of roadway space of press-ventilated fan drum, especially between tunneling place and drawer type fan drum; the roadway with road header have a higher dust concentration. These conclusions provide reliable theory basis for the dust prevention in comprehensive mechanized heading face.展开更多
Objective:To evaluate the efficacy and safety of protective lung ventilation strategy combined with lung recruitment maneuver (RM) in the treatment patients with acute respiratory distress syndrome (ARDS).Methods:Tota...Objective:To evaluate the efficacy and safety of protective lung ventilation strategy combined with lung recruitment maneuver (RM) in the treatment patients with acute respiratory distress syndrome (ARDS).Methods:Totally 74 patients with ARDS admitted to the Department of Intensive Care Unit, Changshu Second People's Hospital in Jiangsu Province between September 2010 and June 2013 were selected and randomly divided into lung recruitment group and non-lung recruitment group, and the initial ventilation solution for both groups was synchronized intermittent mandatory ventilation (SIMV). For RM, SIMV mode (pressure control and pressure support) was adopted. Positive end expiratory pressure (PEEP) was increased by 5 cm H2O every time and maintained for 40-50 s before entering the next increasing period, and the peak airway pressure was kept below 45 cm H2O. After PEEP reached the maximum value, it was gradually reduced by 5 cm H2O every time and finally maintained at 15 cm H2O for 10 min.Results:A total of 74 patients with mean age of (49.0±18.6) years old were enrolled, 36 patients were enrolled in lung recruitment maneuver (RM) group and 38 patients were enrolled into non-lung recruitment maneuver (non-RM) group. 44 were male and accounted for 59.5% of all the patients. For the indicators such as PEEP, pressure support (PS), plateau airway pressure (Pplat), peak airway pressure (Ppeak), vital capacity (VC) and fraction of inspired oxygen (FiO2), no statistical differences in the indicators were found between the RM group and non-RM group on D1, D3 and D7 (P>0.05), except that only FiO2 of RM group on D7 was significantly lower than that of non-RM group (47.2±10.0) vs. (52.2±10.5),P<0.05]. For the indicators of blood gas analysis, including pH, arterial oxygen pressure (PaO2), arterial carbon dioxide pressure (PaCO2) and oxygenation index (PaO2/FiO2), PaO2 and PaO2/FiO2 of RM group were significantly higher than those of non-RM group on D7, and the values were [(90.2±16.1) mmHg vs. (76.4±11.3) mmHg,P<0.05] and [(196.5±40.7) mmHg vs. (151.7±37.3) mmHg,P<0.05] respectively. There was no statistical difference in heart rate (HR), cardiac index (CI), central venous pressure (CVP) or mean arterial pressure (MAP) between RM group and non-RM group on D1, D3 and D7 (P>0.05). 28-day mortality, ICU mortality and in-hospital mortality were 25% vs. 28.9%, 25% vs. 26.3% and 36.1% vs. 39.5% respectively between RM group and non-RM group (allP>0.05).Conclusion:Protective lung ventilation strategy combined with lung recruitment maneuver can improve the indicators such as PaO2, FiO2 and PaO2/FiO2 on D7, but failed to improve the final outcomes such as 28-day mortality, ICU mortality and in-hospital mortality.展开更多
AIM:To evaluate the serum levels of endozepine-4,their relation with ammonia serum levels,the grading of coma and the severity of cirrhosis,in patients with hepatic coma. METHODS:In this study we included 20 subjects ...AIM:To evaluate the serum levels of endozepine-4,their relation with ammonia serum levels,the grading of coma and the severity of cirrhosis,in patients with hepatic coma. METHODS:In this study we included 20 subjects with Hepatic coma,20 subjects with minimal hepatic encephalopathy(MHE) and 20 subjects control. All subjects underwent blood analysis,Child Pugh and Model for End- stage liver disease(MELD) assessment,endozepine-4 analysis. RESULTS:Subjects with hepatic coma showed significant difference in endozepine-4(P < 0.001) and NH3 levels(P < 0.001) compared both to MHE and controls patients. Between NH3 and endozepine-4 we observed a significant correlation(P = 0.009; Pearson correlation 0.570). There was a significant correlation between endozepine-4 and MELD(P = 0.017; Pearsoncorrelation = 0.529). In our study blood ammonia concentration was noted to be raised in patients with hepatic coma,with the highest ammonia levels being found in those who were comatose. We also found a high correlation between endozepine-4 and ammonia(P < 0.001). In patients with grade Ⅳ hepatic coma,endozepine levels were significantly higher compared to other groups. CONCLUSION:This study suggests that an increased level of endozepine in subjects with higher levels of MELD was observed. In conclusion,data concerning involvement of the GABA-ergic system in HE coma could be explained by stage-specific alterations.展开更多
Expiratory flow limitation(EFL), that is the inability of expiratory flow to increase in spite of an increase of the driving pressure, is a common and unrecognized occurrence during mechanical ventilation in a variety...Expiratory flow limitation(EFL), that is the inability of expiratory flow to increase in spite of an increase of the driving pressure, is a common and unrecognized occurrence during mechanical ventilation in a variety of intensive care unit conditions. Recent evidence suggests that the presence of EFL is associated with an increase in mortality, at least in acute respiratory distress syndrome(ARDS) patients, and in pulmonary complications in patients undergoing surgery. EFL is a major cause of intrinsic positive end-expiratory pressure(PEEPi), which in ARDS patients is heterogeneously distributed, with a consequent increase of ventilation/perfusion mismatch and reduction of arterial oxygenation. Airway collapse is frequently concomitant to the presence of EFL.When airways close and reopen during tidal ventilation, abnormally high stresses are generated that can damage the bronchiolar epithelium and uncouple small airways from the alveolar septa, possibly generating the small airways abnormalities detected at autopsy in ARDS. Finally, the high stresses and airway distortion generated downstream the choke points may contribute to parenchymal injury, but this possibility is still unproven. PEEP application can abolish EFL, decrease PEEPi heterogeneity, and limit recruitment/derecruitment.Whether increasing PEEP up to EFL disappearance is a useful criterion for PEEP titration can only be determined by future studies.展开更多
Objectives: There is no data in the current medical literature on efficacy or accuracy of transcutaneous (tcPCO2) monitoring during jet ventilation for cardiac ablation. The use of tcPCO2 during cardiac ablation proce...Objectives: There is no data in the current medical literature on efficacy or accuracy of transcutaneous (tcPCO2) monitoring during jet ventilation for cardiac ablation. The use of tcPCO2 during cardiac ablation procedures offers the opportunity to compare end-tidal and transcutaneous methods of CO2 measurement before and after the use of the jet ventilation. Comparison of these measurements with arterial blood gas CO2 levels allows evaluation of the accuracy of the tcPCO2 technique for use during jet ventilation. Design: Observational study;patients served as their own controls. Setting: Cardiac electrophysiology laboratory. Participants: 15 adult patients (9 M), ASA III-IV, aged 26 to 82 years (median 66 years) undergoing radiofrequency ablation for atrial fibrillation. Interventions: Jet ventilation (JV) versus conventional ventilation. Measurements and Main Results: Paired measurements of end-tidal CO2 (EtCO2) and transcutaneous CO2 (tcPCO2) were recorded during periods of conventional ventilation. Paired measurements of arterial blood CO2 (PaCO2) levels and tcPCO2 were recorded during JV. ABG samples were drawn at the anesthesiologist’s discretion to assess the patient’s respiratory status. The level of agreement between the three methods was compared using the Bland Altman plot. We found that tcPCO2 values consistently provided a close approximation to PaCO2 levels. The mean difference between tcPCO2 and EtCO2 values in baseline and post-JV was on the order of 3 - 5 mmHg, with standard deviation of 4 - 6 mmHg. This is well within the range of variability that is accepted in clinical practice. Conclusions: These preliminary results suggest that tcPCO2 provides an acceptable estimate of CO2 concentration in arterial blood during JV, as well as prior to and following JV.展开更多
Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63...Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.展开更多
基金Supported by The National Natural Science Foundation of China,No.82070455Natural Science Foundation of Jiangsu Province,No.BK20201225Medical Innovation Team Project of Jiangsu Province,No.CXTDA2017010。
文摘BACKGROUND Advanced glycation end products(AGEs)are diabetic metabolic toxic products that cannot be ignored.Nε-(carboxymethyl)lysine(CML),a component of AGEs,could increase macrophage lipid uptake,promote foam cell formation,and thereby accelerate atherosclerosis.The receptor for AGEs(RAGE)and cluster of differentiation 36(CD36)were the receptors of CML.However,it is still unknown whether RAGE and CD36 play key roles in CML-promoted lipid uptake.AIM Our study aimed to explore the role of RAGE and CD36 in CML-induced macrophage lipid uptake.METHODS In this study,we examined the effect of CML on lipid uptake by Raw264.7 macrophages.After adding 10 mmol/L CML,the lipid accumulation in macrophages was confirmed by oil red O staining.Expression changes of CD36 and RAGE were detected with immunoblotting and quantitative real-time polymerase chain reaction.The interaction between CML with CD36 and RAGE was verified by immunoprecipitation.We synthesized a novel N-succinimidyl-4-18Ffluorobenzoate-CML radioactive probe.Radioactive receptor-ligand binding assays were performed to test the binding affinity between CML with CD36 and RAGE.The effects of blocking CD36 or RAGE on CML-promoting lipid uptake were also detected.RESULTS The study revealed that CML significantly promoted lipid uptake by macrophages.Immunoprecipitation and radioactive receptor-ligand binding assays indicated that CML could specifically bind to both CD36 and RAGE.CML had a higher affinity for CD36 than RAGE.ARG82,ASN71,and THR70 were the potential interacting amino acids that CD36 binds to CML Anti-CD36 and anti-RAGE could block the uptake of CML by macrophages.The lipid uptake promotion effect of CML was significantly attenuated after blocking CD36 or RAGE.CONCLUSION Our results suggest that the binding of CML with CD36 and RAGE promotes macrophage lipid uptake.
基金Supported by the National Natural Science Foundation of China （51074100） the National Natural Science Foundation of Shan dong province （ZR2OIOEM016）
文摘According to the characteristics of comprehensive mechanized heading face, established the mathematical model of single-phase air flow with κ-ε two equations model, and have established κ-ε-θ-κp mathematic model to solve two-phase flow of gas and particles in dust space with eulerian-eulerian method and eulerian-lagrangian method. Numerical solution of gas-particle two-phase flow was put forward based on collocated grid SIMPLE algorithm. Moreover, numerical simulation of dust concentration in fully mechanized caving face was carded out by using Fluent software. Finally, when in forced-exhaust ventilation circumstance, drawer type fan drum have less dust absorption, and most of dust spread to the other site; the dust concentration is inversely proportional to the distance from tunneling head, and the dust concentration has already diffused to decrease below 102 mg/m3 at the position ofx=12 m. Dust are more focused on relative side（in the range about y from 0 to 2 meter） of roadway space of press-ventilated fan drum, especially between tunneling place and drawer type fan drum; the roadway with road header have a higher dust concentration. These conclusions provide reliable theory basis for the dust prevention in comprehensive mechanized heading face.
文摘Objective:To evaluate the efficacy and safety of protective lung ventilation strategy combined with lung recruitment maneuver (RM) in the treatment patients with acute respiratory distress syndrome (ARDS).Methods:Totally 74 patients with ARDS admitted to the Department of Intensive Care Unit, Changshu Second People's Hospital in Jiangsu Province between September 2010 and June 2013 were selected and randomly divided into lung recruitment group and non-lung recruitment group, and the initial ventilation solution for both groups was synchronized intermittent mandatory ventilation (SIMV). For RM, SIMV mode (pressure control and pressure support) was adopted. Positive end expiratory pressure (PEEP) was increased by 5 cm H2O every time and maintained for 40-50 s before entering the next increasing period, and the peak airway pressure was kept below 45 cm H2O. After PEEP reached the maximum value, it was gradually reduced by 5 cm H2O every time and finally maintained at 15 cm H2O for 10 min.Results:A total of 74 patients with mean age of (49.0±18.6) years old were enrolled, 36 patients were enrolled in lung recruitment maneuver (RM) group and 38 patients were enrolled into non-lung recruitment maneuver (non-RM) group. 44 were male and accounted for 59.5% of all the patients. For the indicators such as PEEP, pressure support (PS), plateau airway pressure (Pplat), peak airway pressure (Ppeak), vital capacity (VC) and fraction of inspired oxygen (FiO2), no statistical differences in the indicators were found between the RM group and non-RM group on D1, D3 and D7 (P>0.05), except that only FiO2 of RM group on D7 was significantly lower than that of non-RM group (47.2±10.0) vs. (52.2±10.5),P<0.05]. For the indicators of blood gas analysis, including pH, arterial oxygen pressure (PaO2), arterial carbon dioxide pressure (PaCO2) and oxygenation index (PaO2/FiO2), PaO2 and PaO2/FiO2 of RM group were significantly higher than those of non-RM group on D7, and the values were [(90.2±16.1) mmHg vs. (76.4±11.3) mmHg,P<0.05] and [(196.5±40.7) mmHg vs. (151.7±37.3) mmHg,P<0.05] respectively. There was no statistical difference in heart rate (HR), cardiac index (CI), central venous pressure (CVP) or mean arterial pressure (MAP) between RM group and non-RM group on D1, D3 and D7 (P>0.05). 28-day mortality, ICU mortality and in-hospital mortality were 25% vs. 28.9%, 25% vs. 26.3% and 36.1% vs. 39.5% respectively between RM group and non-RM group (allP>0.05).Conclusion:Protective lung ventilation strategy combined with lung recruitment maneuver can improve the indicators such as PaO2, FiO2 and PaO2/FiO2 on D7, but failed to improve the final outcomes such as 28-day mortality, ICU mortality and in-hospital mortality.
文摘AIM:To evaluate the serum levels of endozepine-4,their relation with ammonia serum levels,the grading of coma and the severity of cirrhosis,in patients with hepatic coma. METHODS:In this study we included 20 subjects with Hepatic coma,20 subjects with minimal hepatic encephalopathy(MHE) and 20 subjects control. All subjects underwent blood analysis,Child Pugh and Model for End- stage liver disease(MELD) assessment,endozepine-4 analysis. RESULTS:Subjects with hepatic coma showed significant difference in endozepine-4(P < 0.001) and NH3 levels(P < 0.001) compared both to MHE and controls patients. Between NH3 and endozepine-4 we observed a significant correlation(P = 0.009; Pearson correlation 0.570). There was a significant correlation between endozepine-4 and MELD(P = 0.017; Pearsoncorrelation = 0.529). In our study blood ammonia concentration was noted to be raised in patients with hepatic coma,with the highest ammonia levels being found in those who were comatose. We also found a high correlation between endozepine-4 and ammonia(P < 0.001). In patients with grade Ⅳ hepatic coma,endozepine levels were significantly higher compared to other groups. CONCLUSION:This study suggests that an increased level of endozepine in subjects with higher levels of MELD was observed. In conclusion,data concerning involvement of the GABA-ergic system in HE coma could be explained by stage-specific alterations.
文摘Expiratory flow limitation(EFL), that is the inability of expiratory flow to increase in spite of an increase of the driving pressure, is a common and unrecognized occurrence during mechanical ventilation in a variety of intensive care unit conditions. Recent evidence suggests that the presence of EFL is associated with an increase in mortality, at least in acute respiratory distress syndrome(ARDS) patients, and in pulmonary complications in patients undergoing surgery. EFL is a major cause of intrinsic positive end-expiratory pressure(PEEPi), which in ARDS patients is heterogeneously distributed, with a consequent increase of ventilation/perfusion mismatch and reduction of arterial oxygenation. Airway collapse is frequently concomitant to the presence of EFL.When airways close and reopen during tidal ventilation, abnormally high stresses are generated that can damage the bronchiolar epithelium and uncouple small airways from the alveolar septa, possibly generating the small airways abnormalities detected at autopsy in ARDS. Finally, the high stresses and airway distortion generated downstream the choke points may contribute to parenchymal injury, but this possibility is still unproven. PEEP application can abolish EFL, decrease PEEPi heterogeneity, and limit recruitment/derecruitment.Whether increasing PEEP up to EFL disappearance is a useful criterion for PEEP titration can only be determined by future studies.
文摘Objectives: There is no data in the current medical literature on efficacy or accuracy of transcutaneous (tcPCO2) monitoring during jet ventilation for cardiac ablation. The use of tcPCO2 during cardiac ablation procedures offers the opportunity to compare end-tidal and transcutaneous methods of CO2 measurement before and after the use of the jet ventilation. Comparison of these measurements with arterial blood gas CO2 levels allows evaluation of the accuracy of the tcPCO2 technique for use during jet ventilation. Design: Observational study;patients served as their own controls. Setting: Cardiac electrophysiology laboratory. Participants: 15 adult patients (9 M), ASA III-IV, aged 26 to 82 years (median 66 years) undergoing radiofrequency ablation for atrial fibrillation. Interventions: Jet ventilation (JV) versus conventional ventilation. Measurements and Main Results: Paired measurements of end-tidal CO2 (EtCO2) and transcutaneous CO2 (tcPCO2) were recorded during periods of conventional ventilation. Paired measurements of arterial blood CO2 (PaCO2) levels and tcPCO2 were recorded during JV. ABG samples were drawn at the anesthesiologist’s discretion to assess the patient’s respiratory status. The level of agreement between the three methods was compared using the Bland Altman plot. We found that tcPCO2 values consistently provided a close approximation to PaCO2 levels. The mean difference between tcPCO2 and EtCO2 values in baseline and post-JV was on the order of 3 - 5 mmHg, with standard deviation of 4 - 6 mmHg. This is well within the range of variability that is accepted in clinical practice. Conclusions: These preliminary results suggest that tcPCO2 provides an acceptable estimate of CO2 concentration in arterial blood during JV, as well as prior to and following JV.
文摘Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.
