简介:目的:报道1例马尔尼菲青霉败血症。方法患者男性,39岁,主因“发热伴淋巴结肿大1个月”就诊。进行骨髓瑞士染色、血液接种于有氧及厌氧培养瓶、沙氏培养基培养等检查,并对培养物进行形态学及rDNA序列鉴定。结果骨髓涂片见细胞内分隔孢子,3种培养方法均见真菌生长。沙氏培养基上菌落为丝状菌,表面为黄绿色粉末状,背面为红色;脑心浸汁培养基为酵母样菌落,37℃培养受限制。经DNA序列分析,与马尔尼菲青霉相似性在100℅,鉴定为马尔尼菲青霉。患者诊断为艾滋病并马尔尼菲青霉败血症,立即给予氟康唑治疗,转入传染病医院后因极度衰弱死亡。结论败血症可作为马尔尼菲青霉病首发症状,临床应予以重视;患者血液极具传染性,应注意隔离;对于有冶游史的不明原因发热患者,注意考虑本病可能,必要时行血液培养及HIV检测。
简介:目的探讨艾滋病合并马尔尼菲青霉病的流行病学、临床特点、早期确诊方法及治疗方案。方法对2007年1月-2008年12月我院收治的256例艾滋病合并马尔尼菲青霉病患者的临床资料进行回顾性分析。结果1404例艾滋病患者中合并马尔尼菲青霉病者共256例,发生率为18.2%,患者以发热、消瘦、贫血、咳嗽、咳痰、皮疹、淋巴结肿大为主要表现,外周血CD4+T淋巴细胞平均值为19×10^6/L,患者往往还合并其他多种机会性感染,以口腔念珠菌病、耶氏肺孢子菌肺炎、结核病等多见。两性霉素B治疗组临床疗效优于氟康唑治疗组,伴有皮疹者和无皮疹者病死率差异有统计学意义(P〈0.001)。结论马尔尼菲青霉病是广西艾滋病患者常见的机会性感染之一,主要发生于CD4+T淋巴细胞〈50×10^6/L的患者。血培养是早期确诊马尔尼菲青霉病的最有效方法,治疗上首选两性霉素B。
简介:目的观察两性霉素B联合氟胞嘧啶与伏立康唑治疗艾滋病合并隐球菌性脑膜炎的疗效和安全性,探讨艾滋病合并隐球菌性脑膜炎的新型治疗策略。方法采用回顾性病例对照研究,20例艾滋病合并隐球菌脑膜炎分别接受三联治疗(两性霉素B+氟胞嘧啶+伏立康唑,n=10)和传统的两联治疗(两性霉素B+氟胞嘧啶,n=10),比较两种治疗方案在降低脑脊液中隐球菌计数的幅度以及临床症状缓解、病死率等方面的差异以及不良反应发生情况。结果治疗2周后,三联治疗患者脑脊液中隐球菌计数下降率明显高于两联治疗患者(下降率分别为0.743和0.408,P=0.009),三联治疗患者头痛明显减轻或消失的时间短于两联治疗者(分别为12d和20d,P=0.009),两组在2周、4周、8周及12周时的病死率均无统计学差异。两种治疗方案的不良反应发生率相当。结论两性霉素B联合氟胞嘧啶与伏立康唑能有效降低脑脊液中隐球菌计数,可作为艾滋病合并隐球菌脑膜炎诱导期的治疗选择。
简介:FewerthanonemillionHIVinfectedindividualsarecurrentlyreceivinganti-retroviraltherapy.ThelimitationsofsuchtreatmenthaveunderscoredtheneedtodevelopmoreeffectivestrategiestocontrolthespreadandpathogenesisofHIV.Typically,naturallyoccurringprotectiveimmuneresponsesprovidetheparadigmforsuchdevelopment.ItisnowclearhoweverthatHIVcanutilisethemillieuofanactivatedimmunesystemtoitsownreplicativeadvantage.Mobilisationoftheimmuneresponse,intendedtothwartofHIVcontributestolackofimmunecontrolandthedevelopmentofprogressivediseaseinthemajorityofinfected,untreatedindividuals.FurtherdelineationoftheintimateinteractionsbetweentheHIVandtheimmunesystemwillbecriticalandrecentadvancesinthisdirectionarediscussed.
简介:ProteomicshasbeenwidelyusedinthelastfewyearstolookfornewbiomarkersanddecipherthemechanismofHIV-hostinteraction.Herein,wereviewtherecentdevelopmentsofHIV/AIDSproteomicresearch,includingthesamplesusedinHIV/AIDSrelatedresearch,thetechnologiesusedforproteomicstudy,thediagnosisbiomarkersofHIV-associateddiseaseespeciallyHIV-associatedneurocognitiveimpairment,themechanismsofHIV-hostinteraction,HIV-associateddementia,substanceabuse,andsoon.Intheendofthisreview,wealsogivesomeprospectsaboutthelimitationandfutureimprovementofHIV/AIDSproteomicresearch.
简介:SmallinterferingRNA(siRNA)andmicroRNA(miRNA)aresmallRNAsof18-25nucleotides(nt)inlengththatplayimportantrolesinregulatinggeneexpression.TheyareincorporatedintoanRNA-inducedsilencingcomplex(RISC)andserveasguidesforsilencingtheircorrespondingtargetmRNAsbasedoncomplementarybase-pairing.ThepromiseofgenesilencinghasledmanyresearcherstoconsidersiRNAasananti-viraltool.However,inlong-termsettings,manyvirusesappeartoescapefromthistherapeuticalstrategy.Anexampleofthismaybeseeninthecaseofhumanimmunodeficiencyvirustype-1(HIV-1)whichisabletoevadeRNAsilencingbyeithermutatingthesiRNAtargetedsequenceorbyencodingforapartialsuppressorofRNAi(RNAinterference).Ontheotherhand,becausemiRNAtargetingdoesnotrequireabsolutecomplementarityofbase-pairing,mutationalescapebyvirusesfrommiRNAspecifiedsilencingmaybemoredifficulttoachieve.Inthisreview,wediscussstratagemsusedbyvariousvirusestoavoidthecells'antiviralsi/mi-RNAdefensesandnotionsofhowvirusesmightcontrolandregulatehostcellgenesbyencodingviralmiRNAs(vmiRNAs).
简介:目的探讨(1,3)-β-D-葡聚糖检测和半乳甘露聚糖抗原检测在侵袭性真菌病诊断中的价值。方法回顾性研究北京大学第一医院2008年1月~2010年7月临床疑诊侵袭性真菌病的住院患者。根据诊断标准确定是否诊断侵袭性真菌病。分析非培养诊断方法血清半乳甘露聚糖(GM试验)和血浆(1,3)-β-D-葡聚糖(G试验)的敏感度和特异度,以及二者联合应用后诊断的敏感度和特异度。结果GM试验灵敏度为70%,特异度为84%;G试验灵敏度为50%,特异度为92%。GM试验和G试验二者联合试验时,其灵敏度和特异度分别为93%和78%。结论GM试验和G试验均对侵袭性真菌病具有诊断价值,二者联合应用使其应用价值进一步提高。
简介:目的了解HIV患者新生隐球菌感染的分子流行病学及其临床特点,为HIV患者新生隐球菌感染的预防和治疗提供依据。方法收集首次分离自HIV患者的新生隐球菌34株,回顾性分析患者一般资料;VITEKMS质谱仪进行菌种鉴定,ATBFungus3测定新生隐球菌对5种抗真菌药物的MIC值;利用PCR对特异性引物扩增,确定变种和交配型;多位点序列分型(MLST)对菌株进行分子遗传学分析。结果34株新生隐球菌绝大部分分离自中年男性,且主要来自脑脊液(73.5%)标本;初次脑脊液压力平均为(27.26±11.52)mmH2O,CD4细胞计数中位数28cells/μL(3~163cells/μL),脑脊液白细胞中位计数32(2~110)×10^6/L,蛋白质定量中位数为362mg/L(160~2730mg/L),葡萄糖含量中位数为2.28mmol/L(1.50~5.98mmol/L);所有菌株对5种抗真菌药均敏感,且所有菌株均为Aα、VNⅠ型;MLST分析共检出3种ST型,ST5(n=32)、ST32(n=1)和ST186(n=1)。结论近两年本地区HIV合并新生隐球菌感染主要以中年男性多见,常规实验室检查缺乏特异性,对临床常用抗真菌药物耐药性不强,ST5是其感染的主要克隆系。
简介:Comparedwithhighinfectionareasoftheworld,thetotalHIVinfectionrateinChinaisrelativelylow.Nonetheless,becauseofChina'svastterritoryandlargepopulation,thepotentialinfectionriskmustbetakenseriously.Inthenextfewyears,needlesharingamonginjectiondruguserswillremainthemostcommonrouteoftransmissionfortheHIV/AIDSepidemicinChina.Unprotectedsexisgraduallybecomingamajorrouteoftransmission.ChinabegantoimplementHAARTin1999accordingtointernationalstandards.Priorto2003,therewereonlyabout150HIV/AIDSpatientsweretreatedwithHAARTinsomeclinicaltrialsandabout100HIV/AIDSpatientsweretreatedbyprivatesources.ResultsofthosetreatmentsarethescientificbasisfordevelopmentofthetherapeuticstrategiesinChina.InMarchof2003,theChinesegovernmentinitiatedChinaCARESprogram.InNovemberof2003,theChineseMinistryofHealthannouncedanationalpolicyoffreeARVtreatmenttoallHIV+ChinesecitizenswhowereinpovertyandrequiredARVtherapy.Therearetotalof19,456HIV/AIDSpatientsreceivedfreeARVdrugstodatein159regionsand441towns.Currentchallengesarehowtofollow-upandevaluatethosepatientsintheclinicalsettings.Thelongerthetherapyispostponed,themoresideeffectsandthehigherprobabilityofdrugresistancearegoingtooccur.Itremainsunclear,therefore,whenHAARTregimenshouldbestartedintheHIV/AIDSpopulationinChina.
简介:<正>Manyvirusesestablishlife-longinfectionsintheirnaturalhostwithfewifanyclinicalmanifestations.Therelationshipbetweenvirusandhostisadynamicprocessinwhichthevirushasevolvedthemeanstocoexistbyreducingitsvisibility,whilethehostimmunesystemattemptstosuppressandeliminateinfectionwithoutdamagetoitself.Wearenowbeginningtounderstandthatvirusescanemployavarietyofstrategiestoevadehostimmuneresponses.TheseincludeescapefromTcellrecognition,resistanceto
简介:Chinesenongovernmentalorganizations(NGOs)haveplayedasignificantroleinthebattleagainstAIDSinthePeople'sRepublicofChina.Thisarticleprovidesabriefoverviewofthestructureoftheseorganizations,aswellasananalysisoftheirprincipleaccomplishments.OfgreatsignificanceinthisanalysisisthefactthatChineseNGOshaveeffectivelydealtwithmanysensitivehealtheducationareasthatgovernmentauthoritieshavefeltreluctanttohandledirectly.Assuch,theyhaveprovidedanindispensablecomponentintheHIV/AIDSpreventionandcontrolcalculusonthemainland.
简介:克隆河南人免疫缺陷病毒(HIV)感染者HIV-1B型株tat基因完整编码框序列,并分析比较其编码产物的序列结构特点.使用重叠PCR技术,从河南省1名HIV-1感染者外周血标本中扩增出tat基因第一和第二外显子并重组为完整的tat基因序列.获得的HIV-1B病毒株tat基因,第一外显子为263bp,第二外显子为214bp.将该基因编码产物与其他HIV-1株Tat蛋白经DNA软件编辑并翻译成蛋白质,使用ClustalX1.81进行多序列对比分析发现,第一外显子编码产物的3个保守区域的氨基酸组成大致相同,只有少数氨基酸存在差异.由于Tat蛋白不同病毒株间有高度保守的Cys富集区、核心区和碱性氨基酸富集区,tat基因的克隆为研究其功能并以其为靶点设计和筛选抗艾滋病的药物奠定了基础.
简介:Internationalnon-governmentalorganizationswereamongthefirstinternationalactorsthatrespondedtotheemergenceofAIDScrisisinChina.Since1994,thenumberofinternationalnon-governmentalorganizationsandcharitablefoundationsworkinginAIDSrelatedissueareasinChinahasgrownsteadilyandsubstantially.Despitetheirorganizationaldifferences,mostofthesenon-governmentalactorspresentthecharacteristicsofindependentmission,localizedpracticeanddiverseworkingfocus.Eventhoughtheyareconstrainedbyfinancialandotherfactorscomparedwithmultilateralandbilateralofficialassistanceagencies,theyhavestillplayedauniqueroleinfightingagainstAIDSinChinaastechnicalexperts,publiceducators,andcivilsocietysupporters.