Penicillium marneffei chylous ascites in acquired immune deficiency syndrome:A case report

Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.

Human immunodeficiency virus/acquired immune deficiency syndrome: Using drug from mathematical perceptive

Entry of acquired immune deficiency syndrome virus into the host immune cell involves the participation of various components of host and viral cell unit. These components may be categorized as attachment of the viral surface envelope protein subunit, gp120, to the CD4+ receptor and chemokine coreceptors, CCR5 and CXCR4, present on T cell surface. The viral fusion protein, gp41, the second cleaved subunit of Env undergoes reconfiguration and the membrane fusion reaction itself. Since the CD4+ T cell population is actively involved; the ultimate outcome of human immunodeficiency virus infection is total collapse of the host immune system. Mathematical modeling of the stages in viral membrane protein-host cell receptor-coreceptor interaction and the effect of antibody vaccine on the viral entry into the susceptible host cell has been carried out using as impulsive differential equations. We have studied the effect of antibody vaccination and determined analytically the threshold value of drug dosage and dosing interval for optimum levels of infection. We have also investigated the effect of perfect adherence of drug dose on the immune cell count in extreme cases and observed that systematic drug dosage of the immune cells leads to longer and improved lives.

Effects of Zhenren Yangzang Decoction Combined with Modified Shenling Baizhu Powder on Immune Function and Intestinal Microecology of Diarrhea Patients with Deficiency and Cold Syndrome

OBJECTIVE: To observe the effects of Zhenren Yangzang Decoction combined with modified Shenling Baizhu Powder on the immune function and intestinal microecology of diarrhea patients with deficiency and cold syndrome. METHODS: A total of 60 diarrhea patients with deficiency and cold syndrome were randomly divided into observation group and control group, with 30 cases in each group. The control group was treated with conventional western medicine. The observation group was given the treatment of Zhenren Yangzang Decoction combined with modified Shenling Baizhu Powder on the basis of the same treatment for 4 weeks. The clinical symptoms, fecal flora and immunoglobulin content of the 2 groups were observed and the clinical efficacy was evaluated. RESULTS: After treatment, the symptoms scores of fecal diarrhea, aversion to cold, cold limbs, loss of appetite, cold and painful waist and knee, abdominal fullness, abdominal distension and abdominal pain, and intestinal bacilli contents were significantly decreased(P < 0.05). The contents of lactobacillus, bifidus bacilli, IgG, IgM and IgA were significantly increased(P < 0.05), and the improvement of the above indexes in the observation group was significantly better than that in the control group(P < 0.05). The total effective rate after treatment in the observation group was 93.3%, which was significantly higher than 73.3% of the control group(P < 0.05). CONCLUSION: The treatment of diarrhea patients with deficiency and cold syndrome with Zhenren Yangzang Decoction and modified Shenling Baizhu Powder can effectively improve the intestinal micro-ecological environment, improve the immune function of patients and promote the rapid recovery of patients.

Bilateral Central Retinal Vein Occlusions Combined with Artery Occlusions in A Patient with Acquired Immune Deficiency Syndrome

Purpose: This is the first report of a bilateral nonischemic central retinal vein occlusionscombined with artery occlusions in a patient with acquired immune deficiency syndrome(AIDS). Methods: Case report. Results: A 22-year-old Chinese(male) with a positive human immunodeficiency virus(HIV) infection developed bilateral nonischemic central retinal vein occlusions combinedwith artery occlusions and severe vision loss. The manifestations of the fundus andfluorescein angiography were similar in both eyes.Conclusion: This case report provides the evidences that central retinal vein and arteryocclusions are probably part of the spectrum of AIDS vascular diseases.

Analysis on Characteristics of Typical Syndromes of Acquired Immune Deficiency Syndrome Based on the Feature Selection Method

Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.

Investigation of perceived stigma among people living with human immunodeficiency virus/ acquired immune deficiency syndrome in Henan Province, China

Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.

Improvement in human immunodeficiency virus-1/acquired immune deficiency syndrome patients' well-being following administration of “Phyto V7”

AIM:To corroborate the capacity of Phyto V7,a complex of phytochemicals,to improve the physical well-being of human immunodeficiency virus-1(HIV-1) infected and acquired immune deficiency syndrome(AIDS) patients not undergoing antiretroviral treatment.METHODS:Two hundred and thirty nine HIV-1 seropositive male and female voluntary inmates were recruited through the Uruguay National Program of AIDS.The study participants received for 90 consecutive days every eight hours two tablets(760 mg/each) of Phyto V7,containing a mix of the following phytochemicals:flavonols(Kaempferol,Quercetin),flavones(Apigenin,Luteolin),hydroxycinnamic acids(ferrulic acid),carotenoids(Lutein,Lycopene,Beta carotene) and organosulfur compounds,all from vegetal origin.The participants did not receive any antiretroviral treatment during the study.At days 0,30,60 and 90(± 2 d) the participants were evaluated for body mass index(BMI),tolerance to Phyto V7 and Index of Quality of Life based on the Karfnosky scale.ANOVA,Tukey Post-test,χ2 test and Wilcoxon Signed Rank test were used to analyze the effect of treatment.RESULTS:One hundred and nighty nine study participants finished the study.Already after 30 d of Phyto V7 consumption,the weight,BMI and Karnofsky score statistically significantly improved(P < 0.001),and continued to improve until the end of the study.The mean weight gain per participant during the 90 d wasof 1.21 kg(approximately 2% of body weight).The overall increase in the mean Karnofsky score after 90 d was 14.08%.The lower the BMI and Karnofsky score of the participants were at the beginning of the study,the more notorious was the improvement over time.For example,the mean increment of Index of Quality of Life,among the participants with an initial Karnofsky score of 5 or below(n = 33) from day 0 to day 90,was of 35.67%(0.476 ± 0.044 vs 0.645 ± 0.09; P < 0.001).The tolerability to Phyto V7 was very good and no adverse reactions were recorded or reported.CONCLUSION:Administration of the Phyto V7 can be an important tool to improve the well-being of HIV-1 seropositive individuals and AIDS patients,not undergoing antiretroviral treatment.

Vanishing bile duct syndrome in human immunodeficiency virus: Nevirapine hepatotoxicity revisited

Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.

The default mode network is affected in the early stage of simian immunodeficiency virus infection:a longitudinal study

Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis

AIM: To evaluate the association between the levels of homocysteine(Hcy), folate, vitamin B12 in human immunodeficiency virus(HIV)-infected patients who were treated with antiretroviral therapy(ART) or not treated with ART.METHODS: The Pub Med and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes(1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and;(2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevM an(version 5.2) was employed for data synthesis.RESULTS: A total of 12 studies were included in outcome 1(1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy(2.05 μmol/L; 95% CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations(-2.74 ng/m L; 95%CI:-5.18 to-0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis(1167 participants; 404 HIVinfected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to nonART HIV subjects(4.13 μmol/L; 95%CI: 1.34 to 6.92, P < 0.01).CONCLUSION: This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection.

Twenty years of human immunodeficiency virus care at the Mayo Clinic:Past,present and future

The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings.

Unified-Planning,Graded-Administration,and Centralized-Controlling:A Management Modality for Treating Acquired Immune Deficiency Syndrome with Chinese Medicine in Henan Province of China

Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome （HIV/AIDS）. Chinese medicine （CM） has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded- administration, and centralized-controlling （UGC）. The UGC modality has one primary concept （patient-centered medicine from CM theory）, four basic foundations （classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV）, six important relationships （the ＂three uniformities and three combinations,＂ and the six relationships therein guide the treatment of AIDS with CM）, and four key sections （management, operation, records, and evaluation）. In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.

A New Cultivation-Evolution Technology of Accident Immune Function for a Petrochemical Enterprise

For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating to immune deficiency syndrome and by referring to immunity genetic algorithm and relevant concepts applied in medicine science. Accident-immunity system for highly hazardous petrochemical enterprise, which is made up of its productive system＇s Safety Organ and Safety Organization, is typically an evolution-cultivation progress for immune function, The new B immune cell is generated after several layers＇ screening, clone expanding, receptor editing, organizing in immune system of work accident in petrochemical enterprise. There is a B immune cell with high appetency and a manipulative function chain for accident-immunity. Taking the antigen of accidents in industry as the target function and the immune antibody as the solution, the authors carried out a computation diagram for prediction of appetency between the antigen and antibody.

Cutaneous leishmaniasis in an indigenous infant with Down’s syndrome: A case report

Rationale: Leishmaniasis, caused by the protozoan Leishmania and transmitted by sandflies, is endemic to the tropical and subtropical areas of Brazil. It is one of the neglected tropical diseases in the world. Patient concerns: A 20-month-old indigenous infant with severe malnutrition and Down’s syndrome presented with a facial ulcer for 5 months. Diagnosis: Giemsa staining of scraped ulcer tissues indicated the presence of the amastigote form of Leishmania sp., and positive Montenegro’s intradermal test helped in diagnosing the condition as cutaneous leishmaniasis. Interventions: The child was hospitalized and received intravenous treatment for cutaneous leishmaniasis(1 mg/kg/day of amphotericin B). Outcomes: The condition was cured with amphotericin B(1 mg/kg/day for 14 d). Lessons: Because of infanticide practices in indigenous cultures, indigenous infants with Down’s syndrome rarely survive. Thus, no similar case has been reported in the literature.

Meeting Minutes of International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome with Chinese Medicine

The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome （AIDS） with Chinese Medicine （CM） was held in Beijing International Hotel from October 16 to 17, 2010. It was cosponsored by Guang＇anmen Hospital, China Academy of Chinese Medical Sciences （CACMS）, and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.

Health related quality of life:is it another comprehensive evaluation indicator of Chinese medicine on acquired immune deficiency syndrome treatment?

Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease,hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions.Being a multi-angle,multi-level,and diversified complex intervention,roles of Chinese medicine(CM) in AIDS treatment have been recognized and accepted by more and more patients,and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS.In this article,the authors analyze the definition and measurement of HRQOL,measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS,and give some reasonable advices for the usage of the scale of HRQOL.The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality,reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.

Clinical characteristics and T-lymphocyte subsets in 48 acquired immune deficiency syndrome patients with cytomegalovirus infections

Objective To investigate the clinical features and Tlymphocytes subsets in patients with acquired immunedeficiency syndrome ( AIDS ) and cytomegalovirus(CMV) infection. Methods A total of 48 hospitalizedpatients with human immunodeficiency virus (HIV)-1 /AIDS and CMV infections were recruited at Peking UnionMedical College Hospital from Jan 2010 to Aug 2017.Their clinical features and immune function were retrospectivelyanalyzed. Patients with only HIV/AIDS inprevious study were recruited as controls. Results All 48patients were at C3 stage, including 36 men and12 women. Five of them were younger than 30 years old,33 cases within 31 - 50 years old,and 10 cases olderthan 50 years old.

基于气络学说运用芪归通络口服液联合艾灸治疗气虚血瘀型慢性疲劳综合征的临床观察

【目的】观察基于气络学说,运用芪归通络口服液(广东省第二中医院院内制剂,由黄芪、当归、三七、赤芍、牛膝、鸡血藤、丹参、地龙等中药组成)联合艾灸治疗气虚血瘀型慢性疲劳综合征(chronic fatigue syndrome,CFS)的临床疗效。【方法】采用回顾性研究方法,根据治疗方法的不同将60例气虚血瘀型CFS患者分为观察组和对照组,每组各30例。对照组给予艾条温和灸神阙穴治疗,观察组在对照组的基础上联合芪归通络口服液治疗,疗程为4周。观察2组患者治疗前后中医证候积分、疲劳量表-14(FS-14)评分、血清免疫球蛋白IgA、IgM、IgG含量及皮质醇(COR)水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗4周后,观察组的总有效率为96.67%(29/30),对照组为80.00%(24/30),组间比较,观察组的临床疗效明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的中医证候积分、FS-14评分均较治疗前明显降低(P<0.01),且观察组对中医证候积分、FS-14评分的降低作用均明显优于对照组(P<0.01)。(3)实验室指标方面,治疗后,2组患者血清IgA、IgG水平以及观察组血清IgM、COR水平均较治疗前明显升高(P<0.01),且观察组对血清IgA、IgM、IgG及COR水平的升高作用均明显优于对照组(P<0.05或P<0.01)。(4)安全性方面,治疗过程中,2组患者均未发生明显不良反应。【结论】基于中医气络学说,以正虚络阻为CFS核心病机,运用补虚通络法,采用芪归通络口服液联合艾灸治疗气虚血瘀型CFS患者疗效确切,能明显缓解患者的临床症状,提高患者的免疫力水平,调节患者的神经-内分泌-免疫(NEI)网络。

血清α1-抗胰蛋白酶、血管紧张素-Ⅱ与获得性免疫缺陷综合征患者预后的关系

目的探讨血清α1-抗胰蛋白酶(α1-AT)、血管紧张素-Ⅱ(Ang-Ⅱ)与获得性免疫缺陷综合征(AIDS)患者预后的关系。方法将该院2019年5月至2022年5月收治的97例首诊AIDS患者纳入研究作为研究组,另选取同期于该院进行体检的健康者97例作为对照组。根据病历收集患者临床资料。对纳入研究者进行α1-AT、Ang-Ⅱ水平检测,并进行分组比较。对纳入研究的AIDS患者进行为期1年的随访,观察患者预后情况,并比较不同预后患者的α1-AT、Ang-Ⅱ水平。采用单因素及多因素Logistic回归分析影响AIDS患者预后的因素。用受试者工作特征(ROC)曲线分析α1-AT、Ang-Ⅱ水平对患者预后的预测效能。结果研究组血清α1-AT和Ang-Ⅱ水平高于对照组(P<0.05)。AIDS患者1年内的预后不良发生率为23.71%(23/97)。预后不良患者血清α1-AT和Ang-Ⅱ水平高于预后良好患者(P<0.05)。单因素分析显示,预后不良患者C反应蛋白(CRP)水平、淋巴细胞计数水平、合并淋巴瘤者所占比例均高于预后良好患者,清蛋白(ALB)水平低于预后良好患者(P<0.05)。多因素Logistic回归分析显示,合并淋巴瘤(OR=2.087)、高α1-AT水平(OR=2.611)、高Ang-Ⅱ水平(OR=2.138)是影响患者预后的独立危险因素(P<0.05)。ROC曲线分析显示,α1-AT预测AIDS患者预后的曲线下面积(AUC)为0.778,Ang-Ⅱ预测的AUC为0.798,α1-AT联合Ang-Ⅱ预测的AUC为0.918。结论α1-AT和Ang-Ⅱ在AIDS患者血清中水平异常升高,而且与患者预后有关,是影响患者预后的独立危险因素。α1-AT和Ang-Ⅱ联合检测可有效预测患者预后。