Steroids in acute respiratory distress syndrome:A panacea or still a puzzle?

Acute respiratory distress syndrome(ARDS)is a unique entity marked by various etiologies and heterogenous pathophysiologies.There remain concerns regarding the efficacy of particular medications for each severity level apart from respiratory support.Among several pharmacotherapies which have been examined in the treatment of ARDS,corticosteroids,in particular,have demonstrated potential for improving the resolution of ARDS.Nevertheless,it is imperative to consider the potential adverse effects of hyperglycemia,susceptibility to hospital-acquired infections,and the development of intensive care unit acquired weakness when administering corticosteroids.Thus far,a multitude of trials spanning several decades have investigated the role of corticosteroids in ARDS.Further stringent trials are necessary to identify particular subgroups before implementing corticosteroids more widely in the treatment of ARDS.This review article provides a concise overview of the most recent evidence regarding the role and impact of corticosteroids in the management of ARDS.

Comparative analysis of cytomegalovirus retinitis and microvascular retinopathy in patients with acquired immunodeficiency syndrome

AIM：To compare the clinical manifestation of cytomegalovirus（CMV）retinitis and microvascular retinopathy（MVR）in patients with acquired immunodeficiency syndrome（AIDS）in China.METHODS：A total of 93 consecutive patients with AIDS,including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed.Highly active antiretroviral therapy（HAART）status was recorded.HIV and CMV immunoassay were also tested.CD4＋T-lymphocyte count and blood CMV-DNA test were performed in all patients.Aqueous humor CMV-DNA test was completed in 39patients.Ophthalmological examinations including best corrected visual acuity（BCVA,by International Standard Vision Chart）,intraocular pressure（IOP）,slit-lamp biomicroscopy,indirect ophthalmoscopy were performed.RESULTS：In MVR group,the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13.Blood CMV-DNA was 0（0,269 000）and 42 patients（80.77%）did not receive HAART.In CMV retinitis group,13 patients（31.71%）had anterior segment abnormality.The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470（0,1 450 000）.Nineteen patients（46.34%）had not received HAART.MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%,respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION：In comparison of CMV,patients with MVR have relatively mild visual function impairment.Careful ophthalmological examination and close follow-up are mandatory,especially for patients who have systemic complications,positive CMV-DNA test and without received HAART.

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.

Drug-induced erythroderma in patients with acquired immunodeficiency syndrome

BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis(SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin(IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.CONCLUSIONS: The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.

Acquired von Willebrand Syndrome

Acquired von Willebrand syndrome (AvWS) is kind of bleeding disorder with laboratory findings similar to those in congenital yon Willebrand disease (vWD).AvWS doesn's have any personal or family history of bleeding, but is associated with certain diseases or abnormal conditions or drugs. Although AvWS is being stated as a rare disease, it has gained more and more attention during the past years. Not because of the severity of the disease, but it is more common than we thought and most patients don' t have a proper diagnosis.

Hepatic portal venous gas due to cryptosporidiosis in a patient with acquired immunodefi ciency syndrome

Although the presence of hepatic portal venous gas (HPVG) on computed tomography (CT) is typically an ominous finding, HPVG may sometimes be less catastrophic. The clinical significance of HPVG is variable, and it depends primarily on the underlying pathol ogy. We report a case of a patient with acquired immunodeficiency syndrome (AIDS) who was found to have HPVG on CT as a presumed result of gastrointestinal cryp tosporidiosis, an association that, to our knowledge, has not been reported. This case illustrates another cause of HPVG that should be considered in patients with AIDS.

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.

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.

Differential Diagnosis and Association of Acquired Immunodeficiency Syndrome and Systemic Erythematous Lupus: A Brief Review

Acquired immunodeficiency syndrome and lupus erythematosus are multisystem diseases that can affect several organs and systems at different stages of disease evolution. Both diseases share common clinical manifestations, which may lead to diagnostic difficulties, especially at the onset of the disease. Another additional challenge is when there is an association of the two pathologies. The objective of this brief review is to describe the clinical manifestations of the diseases and to make considerations regarding the moment of onset of symptoms. Knowledge of these common manifestations and their peculiarities may alert clinicians to possible diagnoses and avoid errors in the evaluation and conduction of these patients.

Forearm compartment syndrome due to acquired hemophilia that required massive blood transfusions after fasciotomy:A case report

BACKGROUND Acquired hemophilia is rare.In some cases,the bleeding in muscle causes compartment syndrome.However,it is not clear whether fasciotomy should be performed for the compartment syndrome caused by acquired hemophilia because of the risk of bleeding and the unknown functional results.CASE SUMMARY A 75-year-old woman was admitted with severe pain of the right forearm with no preceding traumatic event.The right forearm was obviously swollen,and stretch pain was observed.Subcutaneous hematomas were suspected in various parts of the body.Compartment pressure was 110 mmHg on the volar side.Activated partial thromboplastin time(aPTT)was prolonged to 54.9 s.Fasciotomy was performed,and hematoma was observed in the volar compartment.Postoperative laboratory examinations revealed a low level of factor Ⅷ(FⅧ)activity(12.5%)and a high level of FⅧ inhibitor(15.2 bethesda units/mL).Acquired hemophilia A was diagnosed.Though recombinant clotting factors were administered,transfusion of red blood cells reached 46 units(140 mL/unit).Hemostasis was achieved 9 d after fasciotomy.The total cost of the clotting factor concentrates administered reached 28834600 yen.With prednisolone,FⅧ activity and aPTT recovered gradually.Final function of the hand was good in the index finger and excellent in the others.CONCLUSION Fasciotomy resulted in good function of the hand in a case of non-traumatic compartment syndrome caused by acquired hemophilia,but life-threatening bleeding occurred,and the cost of clotting factor treatment was high.Preparation of sufficient blood transfusion,preoperative administration of recombinant activated clotting factor Ⅶ,and prompt fasciotomy could be ideal for such cases.

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.

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.

Salivary gland disease in human immunodeficiency virus/acquired immunodeficiency syndrome: A review

The effect of human immunodeficiency virus(HIV) infection on salivary glands has diagnostic and prognostic significance. HIV-salivary gland disease(HIV-SGD) is comprehensively ascertained amongst the major critical acquired immunodeficiency syndrome(AIDS)-relatedoral manifestation and causes substantial morbidity. Parotid gland swelling due to sicca syndrome, parotid lipomatosis, sialadenitis, diffuse infiltrative lymphocytosis syndrome, benign lymphoepithelial lesions, neoplasms(benign or malignant) of salivary gland, parotid gland inflammation, diminished flow rates of saliva and xerostomia have been documented that also affects the health- associated characteristics of life in subjects infected with HIV. There is a necessity for health care researchers to diagnose it, particularly as it might worsen if left undiagnosed. The precise characteristic of alterations in dynamics of salivary gland structure and functionality with long-standing usage of highly active anti-retroviral therapy still remains unknown. HIV positive children also present with bilateral parotid enlargement and the syndrome state with classical clinical and cytological features of predominated lymphoid hyperplasia. Though various case reports and studies have been extensively published on different aspects of HIV-SGD, it has not been described solely, thus leading to occasional confusion of nomenclature and clinical presentation of HIV-SGD. This article reviews the pathogenesis of HIV-related SGD and its components and various other miscellaneous disorders affecting the salivary glands in HIV/AIDS.

Epidemiological characterization and geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome infection in North African countries

BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To characterize the epidemiological and spatial trends of HIV infection in this region.METHODS A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years(2008-2017)following the PRISMA guidelines.We performed a comprehensive literature search using Medline PubMed,Embase,regional and international databases,and country-level reports with no language restriction.The quality,quantity,and geographic coverage of the data were assessed at both the national and regional levels.We used random-effects methods,spatial variables,and stratified results by demographic factors.Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.RESULTS A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis.There was considerable variability in the prevalence estimates of HIV within the countries of the region.The overall prevalence of HIV ranged from 0.9%[95%confidence interval(CI)0.8-1.27]to 3.8%(95%CI 1.17-6.53).The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals.The dense HIV clustering noted varied from one country to another.At least 13 HIV subtypes and recombinant forms were prevalent in the region.Subtype B was the most common variant,followed by CRF02_AG.CONCLUSION This comprehensive review indicates that HIV infection in North African countries is an increasing threat.Effective national and regional strategies are needed to improve monitoring and control of HIV transmission,with particular emphasis on geographic variability and HIV clustering.

^(99m)Tc-ECD brain SPECT imaging in patients with acquired immunodeficiency syndromes

In order to investigate the changes of regional cerebral blood flow(rCBF) in patients with acquired immunodeficiency syndromes (AIDS), 99mTc-ECDbrain SPECT imaging was performed in 5 patients with AIDS and 16 sex and agematched normal controls, and the rCBF percentages compared to the cerebellum werecalculated using a semi-quantitative processing software. Hypoperfusions in the rightand left frontal, temporal, porietal lobe, basal ganglia and left thalamus were seen in1 patient with dementia. Hypoperfusions in the right and left frontal and temporallobe were seen in 4 asymptomatic patients. The rCBF in the right and left frontal.temporal, porietal lobe, basal ganglia and thalamus, front and pons were decreasedsignificantly in patients with AIDS than those of the control subjects (p ＜0.005). Itis concluded that there exists reduced cortico-subcortical rCBF in AIDS patients.

泉州地区艾滋病患者机会性感染现状及预后Nomogram预测模型的构建

目的通过对泉州地区艾滋病(AIDS)患者机会性感染现状、临床特点及其预后的影响因素分析,为AIDS机会性感染的科学预防和治疗提供一定依据。方法选取2017年1月—2022年1月于福建医科大学附属泉州第一医院确诊并接受住院治疗的172例AIDS合并机会性感染患者作为研究对象,收集患者一般资料和机会性感染情况,采用多变量Cox回归分析确定影响AIDS合并机会性感染患者预后的独立预测因子,将独立预测因素引入R软件,根据各因素回归系数绘制预后Nomogram模型。采用一致性指数(C-index)对该模型的区分度进行标定,利用校准图阐明Nomogram预测的预后与实际预后之间的关系,并采用决策曲线(DCA)对Nomogram模型的临床效用进行验证。结果172例AIDS合并机会性感染患者中,机会性感染共有8种,其中细菌性肺炎占比最高,达54.65%,其次为口腔白斑,占51.74%,肺孢子菌肺炎占43.60%,带状疱疹占28.49%,肺结核占21.51%,感染性腹泻占19.77%,中枢神经系统感染占12.79%,巨细胞病毒感染最低,仅占10.47%。男性明显多于女性,18~39岁人群居多。年龄、感染种数、基因型耐药、CD4+T淋巴细胞水平是AIDS合并机会性感染患者预后的影响因素。校准曲线及DCA显示Nomogram预测模型具有较好的预测能力和临床有效性,且精准区分度较好。结论年龄、感染种数、基因型耐药、CD4+T淋巴细胞水平等因素是影响AIDS合并机会性感染患者预后的主要因子,而构建Nomogram预测模型能发挥较好的临床预测能力和有效性,为临床早识别、早防控提供科学依据。

中医辨证治疗方案对老年社区获得性肺炎出院后患者生存质量和疗效满意度的评价研究

背景社区获得性肺炎(CAP)为常见的感染性疾病之一,尤其在老年患者中,其临床症状不典型,易出现严重并发症,缺乏有效的治疗措施,常预后不良。目的探究中医辨证治疗方案对老年CAP出院(1周内)患者的生存质量及其疗效满意度情况。方法本研究为多中心、随机双盲安慰剂临床研究。选取河南中医药大学第一附属医院、河南省胸科医院、河南省人民医院、郑州市中医院、郑州人民医院5家医院呼吸科2018年4月—2020年1月病房收治的老年CAP出院后患者为研究对象,采用中央随机入组模式将患者分为试验组和对照组。试验组患者经中医辨证后给予相应中药颗粒剂进行治疗,气虚痰湿证给予补肺健脾化痰方,气阴虚痰热证给予益气养阴清肺方。对照组则给予与中药颗粒外观、重量、颜色、气味基本一致的安慰剂。治疗疗程为2个月,随访至治疗开始后6个月。比较两组患者治疗前、治疗1个月、治疗2个月、随访3个月、随访6个月的生存质量[采用中文版生存质量评分量表(SF-36)评价]和疗效满意度[采用肺炎患者疗效满意度问卷(ESQ-CAP)评价]。结果纳入120例患者中,脱落8例,最终纳入符合方案集的病例112例,其中试验组54例、对照组58例。治疗前两组性别、年龄、出院后时间、中医辨证分型、CUBR-65评分、基础疾病比较,差异无统计学意义(P>0.05)。组别对SF-36生理机能领域评分(F组间=5.057,P组间=0.027)、一般健康状况领域评分(F组间=7.286,P组间=0.008)、情感职能领域评分(F组间=6.858,P组间=0.010)主效应显著。组间比较:治疗2个月、随访3个月、随访6个月,试验组SF-36生理机能领域评分高于对照组(P<0.05);治疗1、2个月和随访3、6个月,试验组SF-36一般健康状况领域、情感职能领域评分高于对照组(P<0.05);随访3、6个月,试验组SF-36精神健康领域评分高于对照组(P<0.05)。组别对ESQ-CAP日常生活与能力领域评分(F组间=16.218,P组间<0.001)、方便领域评分(F组间=25.013,P组间<0.001)及ESQ-CAP总分(F组间=13.843,P组间<0.001)主效应显著。治疗2个月和随访3、6个月,试验组ESQ-CAP日常生活与能力领域评分高于对照组(P<0.05)。治疗1、2个月和随访3、6个月,试验组ESQ-CAP方便领域评分及ESQ-CAP总分高于对照组(P<0.05)。随访3个月,试验组ESQ-CAP总体疗效领域评分高于对照组(P<0.05)。结论中医辨证治疗方案对于老年CAP出院后患者的生存质量和疗效满意度具有较好的改善作用。

焦虑、抑郁情绪对艾滋病患者抗病毒治疗免疫学失败的影响及心理干预策略分析

目的分析焦虑、抑郁情绪对艾滋病患者抗病毒治疗免疫学失败的影响,并提出相应的心理干预策略。方法回顾性分析2021年2月至2022年2月北京某医院收治的200例接受抗病毒治疗的艾滋病患者的临床资料,根据抗病毒治疗后的免疫应答情况将其分为成功组和失败组。比较两组的基础资料与治疗前心理状态,统计两组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,采用单因素、多因素Logistic回归分析影响艾滋病患者抗病毒治疗免疫学失败的因素,绘制受试者工作特征(ROC)曲线,分析SAS、SDS评分及二者联合预测艾滋病患者抗病毒治疗免疫学应答失败的临床价值。结果200例艾滋病患者抗病毒治疗后免疫学失败率为21.00%(42/200)。失败组性别、年龄、世界卫生组织临床分期、服药依从性及是否合并焦虑、抑郁与成功组比较,差异具有统计学意义(P<0.05);多因素Logistic回归分析结果显示,性别(男)、年龄(≥60岁)、世界卫生组织临床分期(Ⅲ/Ⅳ期)、服药依从性(不依从)、焦虑和抑郁状态是影响艾滋病患者抗病毒治疗免疫学应答失败的危险因素(OR>1,P<0.05)。失败组SAS、SDS评分高于成功组(P<0.05);ROC曲线结果显示,SAS、SDS评分及二者联合预测艾滋病患者抗病毒治疗免疫学应答失败的曲线下面积分别为0.734、0.724、0.768。结论艾滋病患者抗病毒治疗后仍有部分患者出现免疫学失败,原因多与性别、年龄、世界卫生组织临床分期、服药依从性、焦虑与抑郁情绪相关,且SAS评分联合SDS评分可有效预测艾滋病患者抗病毒治疗免疫学应答的失败。

肺热咳喘方联合常规疗法治疗社区获得性肺炎痰热壅肺证临床研究

目的:观察肺热咳喘方联合常规疗法治疗社区获得性肺炎痰热壅肺证的疗效。方法:选取123例痰热壅肺证社区获得性肺炎患者,按随机数字表法分为对照组60例及联合组63例。对照组采用常规西药治疗,联合组采用肺热咳喘方联合常规西药治疗,2组均治疗2周。观察2组临床疗效、影像学检查结果、不良反应发生情况及临床症状消退时间,比较2组治疗前后中医证候积分、血清C-反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)水平的变化。结果:治疗后,2组中医证候积分主症、次症、总分均较治疗前下降(P<0.05),联合组中医证候积分主症、次症、总分均低于对照组(P<0.05)。治疗后,联合组退热、咳嗽消退、咳痰消退及肺部啰音消退时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CRP、PCT、WBC水平均较治疗前下降(P<0.05),联合组上述3项水平均低于对照组(P<0.05)。治疗后,联合组影像学吸收率为95.24%,对照组为81.67%,2组比较,差异有统计学意义(P<0.05)。联合组临床疗效总有效率为95.24%,对照组为81.67%,2组比较,差异有统计学意义(P<0.05)。联合组不良反应发生率为6.35%,对照组不良反应发生率为8.33%,2组比较,差异无统计学意义(P>0.05)。结论:肺热咳喘方联合现代医学治疗社区获得性肺炎痰热壅肺证能明显缓解症状,降低炎症水平,临床疗效显著,且安全性良好。

广州市某三甲医院人类免疫缺陷病毒感染者用药安全行为风险的“知信行”调查及分析

【目的】了解广州市某三甲医院人类免疫缺陷病毒(HIV)感染者用药安全行为风险的知识掌握情况及相关态度和行为,为艾滋病防治提供科学依据。【方法】以我院就诊的18岁及以上的HIV感染者作为调查对象,采用问卷调查的形式,调查其艾滋病用药安全行为风险的知识、态度、行为情况。【结果】共回收问卷549份,有效问卷503份,有效率为91.6%。503名调查对象艾滋病用药安全行为风险的平均知识评分、态度评分、行为评分为(14.58±8.49)分、(25.21±6.92)分、(47.58±3.33)分;知识、态度、行为得分率分别为36.46%、63.02%、95.16%。不同年龄、教育程度、职业人群的知识评分比较,差异均有统计学意义(P<0.05)。多重线性回归显示教育程度、医保状态对知识评分影响显著(P<0.05);不同教育程度人群的态度评分比较,差异均有统计学意义(P<0.05);不同职业人行为评分比较,差异均有统计学意义(P<0.05);多重线性回归显示年龄、职业、知识得分和态度得分对行为评分影响显著(P<0.05);患者期望获得药师的药学服务,主要形式包括面对面沟通、网络平台咨询和电话咨询。用药知识需求包括药物不良反应知识及应对措施、避免药物相互作用,和漏服药的应对办法并提高依从性的措施。【结论】广州市某三甲医院HIV感染者对艾滋病用药安全行为风险的合理用药意识良好,但用药知识掌握情况有待提高,个别不良习惯,可能会影响服药依从性,导致用药安全隐患。患者对开展艾滋病合理用药相关药学服务的需求迫切。