简介：ChinahasrecognizedthethreatofHIVtoitspopulationandrespondedwithanationalantiretroviraltreatment(ART)program.However,highARTfailureratesandthespreadofresistancewithinpopulationsareimportantrealitiestoconsiderwhendevelopingandmanagingARTprogramsinChinaandworldwide.Conceptswhichwilldefinetreatmentsuccessandlocalandnationalprogrammaticgoalsare1)accesstoART,2)durabilityofARTatthepatientlevel,3)scalabilityoftreatmentmodalities,andthe4)sustainabilityoftheprogramatthecommunityornationallevel.Inthefaceoflimitedresources,ChinamustalsoconsiderwhentostartARVtherapy,whichagentstouse,whentoswitchthem,andhowtotreathighlyexperiencedpatientswithdrugresistance.TheoptimalARVregimentostartwithischangingfrequentlywiththeintroductionofnewagentsandthepresentationofnewdata.Currently,aregimenincludingtenofovir,emtricitabineorlamivudineandanonnucleosidereversetranscriptaseinhibitorappearstohaveoptimalcharacteristicstotreatHIV/AIDSinChina.However,criticaltoallofthesechoicesistheevaluationofprogramsimplementedtoinsurewidescalesuccess.Chinahaswiselybegunthisprocessofevaluatingtheperformanceoflocalprogramsthroughsystematicmonitoringandevaluationoftreatmentoutcomes.Thiswillallowregimensandprogramsthatworktobeexpanded,andprogramswithhighfailureratestobeeliminated.Intheend,evidencebaseddatasupportingtreatmentstrategieswillallowChinatosuccessfullyconfrontitsAIDSepidemicearlyandpreventitstragicconsequences

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简介：AbstractBackground:After the scale-up of antiretroviral therapy (ART) for HIV infected people, increasing numbers of patients have pretreatment drug resistance (PDR). In this study, the prevalence of PDR was evaluated in adults initiating antiretroviral therapy in China.Methods:Blood samples were obtained from 1943 patients who initiated antiretroviral therapy (ART) in 2017 from 13 provinces or cities in China. Pol sequences were used to analyze drug resistance and construct transmission networks. Logistic regression model was used to estimate the potential factors associated with PDR.Results:In total, 1711 eligible patients (76.0% male; 87.8% aged ≥ 25 years) were included, of which 117 (6.8%) had PDR. The highest rates of PDR were 12.2% in Liangshan Prefecture of Sichuan and 9.3 and 8.9% in Dehong and Lincang Prefecture of Yunnan. A multivariate logistic regression analysis revealed that PDR was significantly higher among intravenous drug users (adjusted Odds Ratio (aOR) = 2.64, 95% CI: 1.57–4.44) and individuals from Liangshan, Dehong, and Lincang (aOR= 2.04, 95% CI: 1.26–3.30). In total, 754 sequences were used to generate 164 transmission networks. Five transmission networks had two or three sequences containing the same mutations, two networks contained subjects from Liangshan, and one network contained subjects from Dehong.Conclusions:Overall, the PDR prevalence was moderate, with a particularly high prevalence in areas with severe HIV epidemics. These results indicate the importance of continuous PDR monitoring in patients initiating antiretroviral therapy.

简介：AbstractObjective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60 years, with a mean age of 38 ± 0.966 years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common non-infective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of <200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

简介：AbstractBackgroundStudies have reported that low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)-infected patients; however, the factors that contribute to HIV-related BMD changes are yet to be fully understood. Due to the application of dual X-ray absorptiometry (DXA) among a select group of hospitals only, the prevalence and risk factors of low BMD in HIV-infected populations have not been intensively investigated in China. Thus, the aim of our study was to investigate the prevalence of and risk factors associated with BMD changes among antiretroviral therapy (ART)-naive HIV-positive patients in China.MethodsThe assessment of the prevalence of and risk factors associated with BMD changes was conducted among 156 ART-naive HIV-infected patients. Demographic and clinical data, as well as results of fasting blood tests were obtained from patients. Further, all patients underwent DXA scans to determine BMD, which was then used to classify patients with osteopenia/osteoporosis. The risk factors of reduced BMD were then evaluated using binary logistic regression.ResultsAmong the 156 ART-naive HIV-infected participants, osteopenia and osteoporosis were diagnosed in 48.7% (76/156) and 4.5% (7/156) of patients, respectively. The lumbar spine was most likely to have reduced BMD (49.4% [77/156]), and the proportion of osteopenia in the left hip (32.7% [51/156]) was higher than in the right hip (24.4% [38/156]). In the lumbar spine, bone loss rate in the L1 section (60.9% [95/156]) was the most significant (L2, 53.2% [83/156]; L3, 45.5% [71/156]; L4, 52.6% [82/156]). Further analysis showed that, compared with the neck (26.9% [42/156] in the left, 18.6% [29/156] in the right) and the interior (15.4% [24/156] in the left, 13.5% [21/156] in the right), the trochanter had the greatest probability of reduced BMD (46.2% [72/156] in the left, 28.8% [45/156] in the right). In the risk factor analysis, low body mass index (BMI: <18.5 kg/m2) was positively associated with reduced BMD (Exp (B) = 39.743, 95 % confidence interval: 3.234-488.399, P = 0.004), and was specifically positively correlated with BMD values at three sites (r = 0.335 at right hip, r = 0.327 at left hip, r = 0.311 at lumbar spine).ConclusionReduced BMD was found in the majority of ART-naive HIV-infected patients and BMI was identified as an additional risk factor for reduced BMD. Our results show that BMD reduction was simultaneously present in the left hip, right hip, and lumbar spine among nearly one fifth of patients. Our work highlights the importance of closely monitoring BMD in ART-naive patients and provides a foundation for the clinical intervention of bone demineralization in them.

简介：基因治疗为癌症的治疗提供一条新途径。编码immunostimulatorycytokines的基因的转移与显著成功被使用了在动物消除癌症。然而，在有这策略的病人的临床的试用限制了功效。因此，基因转移向量系统的改进是必要的。混合病毒的向量，与鼠科的IL-12或记者LacZ基因由SFVreplicon组成，被构造。这混合向量在vitro并且在vivo在HCC显示出表示的特性和高水平。在一个老鼠orthotropic肝肿瘤模型，没有伴随毒性，由有mIL-12基因的混合向量的确定的肿瘤的治疗导致了一项强壮的反肿瘤活动。随后，助手依赖者侵入人体气管粘膜的病菌包含mifepristone(RU486)的向量可诱导的系统被构造为控制并且人的interleukin的肝特定的表示12(hIL-12)(HD-Ad/RUhIL-12)并且鼠标IL-12(mIL-12)(HD-Ad/RUmIL-12)。数据证明hIL-12的高、支撑的浆液层次能被继续RU486的管理达到每12或24h。hIL-12的重复正式就职能被获得在上，至少在HD-Ad/RUhIL-12的单个注射以后的48个星期的一个时期。肝转移与的处理HD-Ad/RUmIL-12，正RU846在所有动物导致了完全的肿瘤回归。然后，不同cytokine基因被插入到有条件的replicative侵入人体气管粘膜的病菌向量(也叫的oncolytic侵入人体气管粘膜的病菌)。在肿瘤房间的侵入人体气管粘膜的病菌的复制将杀死肿瘤房间和版本病毒，它感染包围肿瘤房间。由oncolytic侵入人体气管粘膜的病菌的cytopathic效果和transgene的生物效果的联合将施加强壮的反肿瘤活动。向量的这些新类型可以为癌症基因治疗提供一个有势力和安全工具。

简介：考生进入高三后，紧张的情绪会逐渐加深，每天可以听20-30分钟音乐舒缓一下情绪。

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简介：Inthepastdecade,anincreasedamountofclinically-orientedresearchinvolvingimmunotoxinshasbeenpublished.Immunotoxinsareagroupofartificially-madecytotoxicmoleculestargetingcancercells.Thesemoleculescomposedofatargetingmoiety,suchasaligandoranantibody,linkedtotoxinmoiety,whichisatoxinwitheithertruncatedordeletedcell-bindingdomainthatpreventsitfrombindingtonormalcells.Immunotoxinscanbedividedintotwocategories:chemicallyconjugatedimmunotoxinsandrecombinantones.Theimmunotoxinsofthefirstcategoryhaveshownlimitedefficacyinclinicaltrialsinpatientswithhematologicmalignanciesandsolidtumors.Withinthelastfewyears,single-chainimmunotoxinsprovideenhancedtherapeuticefficacyoverconjugatedformsandresultinimprovedantitumoractivity.Inthisreview,webrieflyillustratethedesignoftheimmunotoxinsandtheirapplicationsinclinicaltrials.Cellular&MolecularImmunology.2005;2(2):106-112.

简介：IntroductionThereisnowanewwaytotreathypercholesterolemia,usingamonoclonalantibody(Evolocumab)thatbindstoandinhibitsPCSKA9.MostphysiciansknowthetermPCSK9buthavenoideawhatPCSK9standsfor(includingme).MypurposeforwritingthiseditorialistoeducatemyselfonwhatPCSK9isandwhatitdoes.MyhopeisthatIcanperhapseducatethosereadingthisdocumentaswell.

简介：Coronaryarterydisease(CAD)istheleadingcauseofdeathworldwide,butbecauseofseveralfactors,oneofwhichisantiplatelettherapy,themortalityrateshavesteadilydeclined.However,womencontinuetoexperiencehigherCADmortalityratesthanmen.Thismaybeexplainedbydifferencesincomorbidities,increasedtimetopresentation,higherbleedingrates,anddifferencesinmanagement.Therearenumerouslandmarktrialsinthefieldofantiplatelettherapy;however,womenareconsistentlyunderrepresentedinthesetrials.Theresultsofthesetrialsrevealthatwomenexperiencethesamebenefitasmenfromantiplatelettherapybutexperiencehigherbleedingrates;thereforebleeding-reductionstrategiesareimperativeinthispatientpopulation.ThisreviewprovidesanoverviewoftheavailableevidenceonCADinwomenanditsimplicationsforantiplateletmedications.

简介：Wehavereviewedthegenetherapyingastrointestinaldiseases^[1].GastriccanceriscommoninChina^(2-20),anditsearlydiagnosisandtreatmentarestilldifficultuptonow^(13-36).Theex-pressionofanexogenousgeneintroducedbygenetherapyintopa-tientswithgliomascanbemonitorednon-invasivelybypositron-emissiontornography^[4].

简介：质子放射疗法在hepatocellular癌(HCC)的治疗看见了一个增加的角色。历史上，外部横梁放射疗法由于毒性的高发生在HCC起了一个很有限的作用到包围正常结构。把放射的高剂量送到肿瘤的能力是在在HCC改进结果的一个关键因素。在光子放射疗法的进展改进了剂量一致并且允许剂量逐步上升到肿瘤。然而，尽管有这些进展，仍然有一个大量正常的肝，在处理期间收到可观的放射剂量。一旦他们进入身体，质子横梁没沿着横梁路径有出口剂量。质子放射疗法的固有的物理属性提供一个方法当避免过多的放射到留下的肝时，经由剂量逐步上升最大化肿瘤控制，因此增加的生物有效性。在这评论，我们在HCC为质子放射疗法讨论物理属性和基本原理。我们也关于为HCC的处理使用质子放射疗法的临床的结果考察最近的文学。

简介：Advancedagebringsahigherincidenceofthrombosis-relateddiseases.Althoughantithrombotictherapysignificantlyreducestheriskofischemicevents,relativelyhigherbleedingratesresultinincreasedmortalityandworseprognosisintheelderly.Thusthebenefitsandharmsofantithromboticdrugsshouldtobecarefullyevaluated.Inthisreview,wesummarizecurrentevidenceandupdatedguidelinesregardingantithrombotictherapyintheagingpopulation.

简介：AbstractIncreasing numbers of targeted drugs are used in hormone receptor (HR)-positive metastatic breast cancer (MBC) to overcome or delay resistance to endocrine therapy. This study will systemically review the progress made in endocrine therapy combined with targeted therapy in the treatment of HR-positive MBC. From the "AI (aromatase inhibitor) era" represented by aromatase inhibitors, we have gradually entered the "post-AI era" represented by fulvestrant. Under the guidance of research on the molecular mechanism of endocrine therapy resistance, the "combination of endocrine therapy and targeted therapy" era is approaching. The development of drugs that target endocrine therapy resistance has concentrated on cyclin-dependent kinase 4/6 inhibitors, histone deacetylase inhibitors, and inhibitors of drug targets in the phosphatidylinositol 3 kinase-protein kinase B-mammalian target of rapamycin (PI3K-AKT-mTOR) pathway, providing new strategies for HR-positive MBC. Exploring biomarkers to guide the more precise use of targeted drugs in endocrine therapy for MBC is the focus of current and future research.

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简介：尽管免疫系统拥有工具对癌症作出回应，它经常没能控制恶意的传播。尽管如此，装备内长的免疫释放强壮的antitumor回答比常规治疗有重要优点。这评论探索一些可得到的选择完成这，在有刺激免疫系统并且授权更强壮的antitumor回答的肿瘤抗原的种痘上集中第一。我们然后比较并且形成对照声发有用淋巴细胞转移的T的采纳治疗的记录得好的药品潜力的种痘的有限临床的成功。最后，我们用与受体一起利用allogeneicT房间全部剧目的房间受体(TCR)基因转移策略为定义MHC/peptide联合在vitro选择了的T加亮新奇途径，作为癌症的抗原特定的基因治疗的一个基础。

简介：AbstractBismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.

简介：ThisarticleprovidesexplanationstohowdistanceexternalQitherapyworksbyquotingvariousrigorouslydesignedcontrolledexperimentsconductedatvariouspartsoftheworld.Italsointroducesanewmethodoftherapy,Informationtherapythatreliesontheentanglementofinformationcarriedbylowhissingsoundplaybackwithmp3playertoentanglewiththeinformationofsubjectsexhibitedbythefacialphotowiththewholesystemplacedinasealedcarton.Preliminaryresultshaveshownhugepotentialforinformationtherapytobeappliedonneurologicalcases,particularlyonautismanddementia.

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