Wenshen Jianpi recipe induced immune reconstruction and redistribution of natural killer cell subsets in immunological non-responders of human immunodeficiency virus/acquired immune deficiency syndrome: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of the Wenshen Jianpi recipe (, WJR) on immune reconstruction and natural killer (NK) cells in immunological non-responders (INRs) of people living with human immunodeficiency virus (HIV) (PLWH) and propose new therapeutic strategies for HIV. METHODS: Based on Traditional Chinese Medicine treatment principle "invigorating and warming in the spleen and kidneys", WJR combined with antire-troviral therapy (ART) therapy was performed in a randomized, double-blind, placebo-controlled study of 60 patients with non-responders. The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences. Sixty patients who met the inclusion criteria obtained random numbers (that is the drug number) was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio. CD4+T cell counts and natural killer (NK) cells counts were evaluated at baseline and 12-week, 24-week follow-ups. RESULTS: Four participants received random numbers and did not enter the group due to the patient's own reasons. A total of 56 patients were enrolled, including 28 in the treatment group and 28 in the control group. CD4+T cell counts in the treatment group were significantly increased at week 24 ( = 0.01 < 0.05), which were significantly higher than those in the control group (= 0.01 < 0.05). Although no significant differences were observed between two groups, the CD56briCD16- NK cell counts in the treatment group were significantly increased after duration. and CD56dimCD16+ NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment (= 0.025 < 0.05). As compared with the control group, the treatment group had significantly lower CD56negCD16+ NK cell counts after 24 weeks of treatment (= 0.023 < 0.05). CONCLUSIONS: WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets, notably decreasing CD56negCD16+ NK cell counts in INRs. However, the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs. Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.

Epidemic and clinical characteristics of measles in Northeast China in 2014：an analysis of 1 401 cases / 中华临床感染病杂志

Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .