Suboptimal immune recovery and associated factors among people living with HIV/AIDS on second-line antiretroviral therapy in central China: A retrospective cohort study.

The introduction and scale-up of antiretroviral therapy (ART) have contributed to significantly improved patients with acquired immune deficiency syndrome (AIDS) quality of life and prolongs their survival. This has occurred by suppressing viral replication and recovering the CD4 cell count. However, some patients do not normalize their CD4 cell count, despite suppression of the viral load (VL). Patients with suboptimal immune recovery (SIR), as defined by a VL < 400 copies/ml with a CD4 cell count of<200 cells/µl, after ART initiation, exhibit severe immune dysfunction and have a higher risk of AIDS and non-AIDS events. In recent years, People living with HIV/AIDS (PLWHA) with first-line ART failure began to gradually switch to second-line ART. This study aimed to examine the prevalence and factors affecting SIR among PLWHA who switch to second-line ART in rural China. A 1-year retrospective cohort study was conducted among PLWHA who switched to second-line ART between January 2009 and December 2018. All patients with a VL < 400 copies/ml after 1 year of second-line ART were included. SIR was defined as a CD4 cell count <200 cells/µl and a VL < 400 copies/ml after 1 year of second-line ART. The data collected from medical records were analyzed by univariate and multivariate analyses. A total of 5294 PLWHA met the inclusion criteria, 24 died, and 1152 were lost to follow-up after 1 year of second-line ART. Among 4118 PLWHA who were followed up, 3039 with a VL < 400 copies/ml had their data analyzed, and the prevalence of SIR was 13.1%. The patients' mean age at recruitment was 47.6 ± 8.1 years and 45.3% were men. A total of 30.7% of patients were HIV-positive for >8 years and 88.2% were receiving ART before starting second-line ART for >3 years. The mean CD4 cell count was 354.8 ± 238.2 cells/µl. A multivariable analysis showed that male sex, single status (unmarried or divorced), and a low CD4 cell count were risk factors for SIR among PLWHA with second-line ART. The prevalence of SIR among PLWHA who switched to second-line ART in this retrospective cohort study is lower than that in most other studies. Several factors associated with SIR include male sex, marital status, and CD4 cell count levels in PLWHA.

An Accurate and Efficient Time Delay Estimation Method of Ultra-High Frequency Signals for Partial Discharge Localization in Substations.

Partial discharge (PD) localization in substations based on the ultra-high frequency (UHF) method can be used to efficiently assess insulation conditions. Localization accuracy is affected by the accuracy of the time delay (TD) estimation, which is critical for PD localization in substations. A review of existing TD estimation methods indicates that there is a need to develop methods that are both accurate and computationally efficient. In this paper, a novel TD estimation method is proposed to improve both accuracy and efficiency. The TD is calculated using an improved cross-correlation algorithm based on full-wavefronts of array UHF signals, which are extracted using the minimum cumulative energy method and zero-crossing points searching methods. The cross-correlation algorithm effectively suppresses the TD error caused by differences between full-wavefronts. To verify the method, a simulated PD source test in a laboratory and a field test in a 220 kV substation were carried out. The results show that the proposed method is accurate even in case of low signal-to-noise ratio, but with greatly improved computational efficiency.

[Breakthrough Point of Chinese Medicine and Pharmacy for HIV/AIDS Prevention and Treatment in the Post-HAART Period].

HIV/AIDS is a severe infectious disease with ineffective drug or method found till now. Highly active antiretroviral therapy (HAART) is a treatment method widely internationalized. Its coverage populations are continually expanding due to its definite clinical effect. AIDS prevented and treated by Chinese medicine and pharmacy has ever been reported. Especially early intervention of Chinese medicine syndrome differentiation based treatment can delay the process of HIV-infected subjects' entry into AIDS in AIDS asymptomatic phase. However, it has great significance of clinical and basic researches in the following 4 aspects: (1) attenuating toxic/adverse reactions of HAART; (2) improving clinical effects of HAART; (3) lowering resistance rate of HAART; and (4) treating common opportunistic infections of AIDS in the post-HAART period.

[Risk Factors of the Mortality among Senile HIV/AIDS Patients Intervened by Comprehensive Intervention of Chinese Medicine and Pharmacy].

OBJECTIVE: To observe the effect of Chinese medicine and pharmacy (CMP) on the mortality of senile HIV/AIDS patients as adjunctive therapy. METHODS: HIV/AIDS patients of a certain rural area of Hanna Province, who were recruited in national CMP HIV treatment trial program (NTCMTP) in 2004, were enrolled as the CMP treatment group. HIV/AIDS patients in the same village without recruiting in NTCMTP were enrolled as the non-CMP treatment group. Data related to subjects were collected from the database of NTCMTP and National HAART Reporting System. Multiple regression analysis under Cox proportional hazard model was applied to examine the risk factors for death of senile HIV/AIDS patients. RESULTS: A total of 436 HIV/AIDS were enrolled in this study, 204 in the CMP treatment group and 232 in the non-CMP treatment group. There were 70 AIDS-relative deaths in the CMP treatment group, with 8-year mortality rate of 37.74%. There were 111 AIDS-relative deaths in the non-CMP treatment group, with 8-year mortality rate of 48.34%. The 8-year mortality rate was higher in the non-CMP treatment group than in the CMP treatment group (chi2 = 5.136, P < 0.05). Results of univariate Cox proportional hazards regression analysis showed the hazard ratio in the non-CMP treatment group was 1.41 times that of the CMP treatment group (P < 0.05). Result of multivariate Cox proportional hazards regression analysis showed the hazard ratio in the non-CMP treatment group was 1.44 times that of the CMP treatment group (P < 0.05). Besides, gender and marital conditions were significantly associated with death of HIV/AIDS patients. CONCLUSION: CMP treatment was favorable to lower the mortality rate of senile HIV/AIDS patients, and its objective evaluation awaits for further prospective study.

Emerging trends of HIV drug resistance in Chinese HIV-infected patients receiving first-line highly active antiretroviral therapy: a systematic review and meta-analysis.

BACKGROUND: Highly active antiretroviral therapy (HAART) has led to a dramatic decrease in AIDS-related morbidity and mortality through sustained suppression of human immunodeficiency virus (HIV) replication and reconstitution of the immune response. Settings like China that experienced rapid HAART rollout and relatively limited drug selection face considerable challenges in controlling HIV drug resistance (DR). METHODS: We conducted a systematic review and meta-analysis to describe trends in emergent HIV DR to first-line HAART among Chinese HIV-infected patients, as reflected in the point prevalence of HIV DR at key points and fixed intervals after treatment initiation, using data from cohort studies and cross-sectional studies respectively. RESULTS: Pooled prevalence of HIV DR from longitudinal cohorts studies was 10.79% (95% confidence interval [CI], 5.85%-19.07%) after 12 months of HAART and 80.58% (95% CI, 76.6%-84.02%) after 72 months of HAART. The HIV DR prevalence from cross-sectional studies was measured in treatment intervals; during the 0-12-month HAART treatment interval, the pooled prevalence of HIV DR was 11.1% (95% CI, 7.49%-16.14%), which increased to 22.92% at 61-72 months (95% CI, 9.45%-45.86%). Stratified analyses showed that patients receiving a didanosine-based regimen had higher HIV DR prevalence than those not taking didanosine (15.82% vs 4.97%). Patients infected through former plasma donation and those receiving AIDS treatment at village clinics had higher HIV DR prevalence than those infected through sexual transmission or treated at a county-level hospital. CONCLUSIONS: Our findings indicate higher prevalence of HIV DR for patients with longer cumulative HAART exposure, highlighting important subgroups for future HIV DR surveillance and control.

Survival of people living with HIV after treatment with traditional Chinese medicine in Henan province of China: a retrospective cohort study.

OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus (PLHIV) after treatment with Traditional Chinese Medicine (TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness ofTCM in treating PLHIV. METHODS: PLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard models. RESULTS: A total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312 (18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years, which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year [95% confidence interval (CI) (94.8-96.8)] and 80.4% at 6 years [95% CI (78.4-82.3)]. Elevated death risks emerged among males, older individuals, and those with lower CD4+ T-cell counts. CONCLUSION: TCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However, retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.

Mortality Risk Factors Among People Living with HIV Receiving Second-line Antiretroviral Therapy in Rural China.

BACKGROUND: Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing. OBJECTIVE: This study aimed to investigate the survival and factors affecting mortality among this group. METHODS: We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55-0.79), > 50 years old (HR, 2.69; 95% CI, 2.03-3.56), single/widowed (HR, 1.26; 95% CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52-0.96), liver injury (HR, 1.58; 95% CI, 1.19-2.10), and CD4+ T cell count <200 cells/µl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/µl (HR, 1.37; 95% CI, 1.03-1.82) were associated with mortality risk. CONCLUSIONS: We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.

Factors associated with fatigue in acquired immunodeficiency syndrome patients with antiretroviral drug adverse reactions: a retrospective study.

OBJECTIVE: To retrospectively study the prevalence of fatigue and factors associated with fatigue among acquired immunodeficiency syndrome (AIDS) patients with antiretroviral drug adverse reactions. METHODS: Data were collected from case report forms (CRFs) for a project funded by the 11th National 5-year Special Science and Technology Program on Major Infectious Diseases. Fatigue was defined by patient self-report. The outcomes were the prevalence of fatigue and the potential risk factors of fatigue. Univariate and multivariate logistic regression analyses were conducted to identify the factors associated with fatigue. RESULTS: Among the 228 subjects, the prevalence of fatigue was 86.8%. In univariate analysis, the significant differences in demographic characteristics between patients with and without fatigue were: gender [OR = 2.29; 95% CI (1.05-4.98)], education level [OR = 0.40; 95% CI (0.18-0.85)], anemia [OR = 3.80; 95% CI (1.27-11.31)], time of HIV diagnosis [OR = 0.29; 95% CI (0.13-0.65)], and route of infection [OR = 0.14; 95% CI (0.06-0.32)]. Abnormal taste and rapid pulse were more commonly seen in patients with fatigue (P < 0.05), while abdominal distension and lumbar soreness were encountered less often in patients with fatigue (P < 0.05). Multivariate analysis showed that the four main factors associated with fatigue were anemia [OR = 3.50; 95% CI (1.01-12.15)], route of infection [OR = 3.40; 95% CI (1.21-9.58); P = 0.02 < 0.05], lumbar soreness [OR = 0.06; 95% CI (0.02-0.18); P = 0.000 < 0.05], and rapid pulse [OR = 10.58; 95% CI (2.16-51.75); P = 0.004 < 0.05]. CONCLUSION: This study demonstrated that fatigue is common (86.8% prevalence) in AIDS patients with antiretroviral drug adverse reactions, and that anemia, route of infection (i.e., non-commercial blood donation) and rapid pulse were risk factors, while lumbar soreness was a protective factor related to fatigue. More attention should be paid to fatigue and more efforts should be made to find ways to prevent, control and eliminate this symptom in AIDS patients with antiretroviral drug adverse reactions.

Reliability and validity of dermatology life quality index: assessment of quality of life in human immunodeficiency virus/acquired immunodeficiency syndrome patients with pruritic papular eruption.

OBJECTIVE: To test the reliability and validity of dermatology life quality index (DLQI) in simplified Chinese language by assessing the quality of life (QoL) in HIV (human immunodeficiency virus)/AIDS (Acquired immunodeficiency syndrome) patients with pruritic papular eruption (PPE). METHODS: A study of simplified-Chinese-version DLQI was carried out in Henan province, China. The reliability and validity were tested by means of statistical method. Data were processed with SPSS 19.0. RESULTS: One hundred and seven subjects participated in the study and 106 (99.07%) finished the questionnaire. Eighteen patients were mildly affected; 62 were moderately affected, 24 were highly affected, and 2 were extremely affected. Reliability analysis showed that the split-half reliability coefficient of questionnaire was 0.556 and the reliability of the full test estimated with Spearman-Brown. correction was 0.7146. The Cronbach alpha was 0.673. According to validity analysis, the correlation between the scores of items and the total scores ranged from 0.208 to 0.529 (P < 0.05). Three factors were abstracted froml0 questions with the principal component analysis and the contribution rate of the 3 common factors was 59.95%. CONCLUSION: The simplified-Chinese-version DIQL is an acceptable and valid scale for HIV/AIDS patients with PPE. It can be used to evaluate the QoL of HIV/AIDS patients with PPE in China.

[Analyzing Chinese medicine syndromes of hematotoxicity reaction induced by highly active antiretroviral therapy].

OBJECTIVE: To investigate the main features of Chinese medicine (CM) syndromes and differences of hematotoxicity reaction induced by highly active antiretroviral therapy. METHODS: The information of CM four diagnostic methods was collected by cross-sectional study. Their syndrome features were summed up and their differences were analyzed. RESULTS: Of the 216 patients, the main syndromes were qi-blood deficiency syndrome (142 cases, accounting for 65.7%) and Pi-Shen yang deficiency syndrome (74 cases, accounting for 34.3%). The score of qi-blood deficiency syndrome was obviously lower than that of Pi-Shen yang deficiency syndrome (P < 0.05). The count of CD4+ T cells was higher in qi-blood deficiency syndrome than in Pi-Shen yang deficiency syndrome. There was no statistical difference in the serum viral load between the two groups (P > 0.05). The quality of life was higher in qi-blood deficiency syndrome than in Pi-Shen yang deficiency syndrome, but with no statistical difference (P > 0.05). CONCLUSIONS: Qi-blood deficiency syndrome and Pi-Shen yang deficiency syndrome were main syndromes of hematotoxicity reaction induced by HAART. The pathogenic condition of qi-blood deficiency syndrome patients was milder. There was no obvious difference in the quality of life, CD4+ T cells, and the viral loads between two syndromes.

Effectors of Hyperlipidemia among HIV/AIDS patients with second-line antiretroviral therapy based on register data.

OBJECTIVE: In this study, we aimed to determine the prevalence and effectors of hyperlipidemia among people living with HIV/AIDS (PLWHA) and taking second-line antiretroviral therapy (ART) using registry data in central China. METHODS: We conducted a cross-sectional study and collected information of PLWHA on second-line ART during 2018 from two medical registries. Hyperlipidemia was defined according to the 2016 Chinese guidelines for the management of dyslipidemia in adults. Univariate and multivariate logistic regression analyses were performed to explore the influencing factors of hyperlipidemia. We calculated odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 2886 PLWHA taking second-line ART were included in this study, and 978 (33.9%) had hyperlipidemia. Female patients, those with hyperglycemia, and patients with CD4+ cell counts >500 cells/µL had a higher prevalence of hyperlipidemia with 37.0%, 49.0%, and 41.3%, respectively. Multivariate analysis showed that CD4+ cell count 350-500 cells/µL (OR=1.72, 95% CI: 1.26-2.38), CD4+ cell count >500 cells/µL (OR=2.49, 95% CI: 1.85-3.38), and FPG >6.2 mmol/L (OR=2.08, 95% CI:1.64-2.65) were risk factors for hyperlipidemia. Male sex (OR=0.72, 95% CI: 0.61-0.85) and Hb <110 g/L (OR=0.59, 95% CI: 0.45-0.76) were protective factors against hyperlipidemia. CONCLUSIONS: PLWHA on second-line ART had a higher prevalence of hyperlipidemia. Gender, CD4+ cell count, FPG, and hemoglobin were influencing factors of hyperlipidemia.

The Prevalence of HIV-infected Patients with Virological Suppression but a CD4+ T-cell Count of ≤ 200 Cells/mm3 after Highly Active Antiretroviral Therapy Initiation: A Meta-analysis.

Highly active antiretroviral therapy (HAART) strongly inhibits HIV replication. However, many patients show suboptimal immune recovery (SIR), as defined by virological suppression (i.e. low viral load) with a CD4+ T-cell count of ≤ 200 cells/mm3, after HAART initiation. Here, we performed a systematic evaluation of the SIR prevalence among HIV-infected patients in cohort studies. We searched PubMed, Cochrane Library, Embase, CNKI, Wanfang database, and Chinese Biomedicine Database for cohort studies about HIV-infected participants whose CD4+ T-cell count was ≤ 200 cells/mm3 but still had virological suppression after HAART initiation. The SIR prevalence from each of those cohort studies was pooled into a random-effect meta-analysis. We obtained two kinds of pooled post-HARRT initiation SIR prevalence: one among participants with virological suppression (11 cohort studies involving 18,672 participants), and the other among all HIV-infected participants (seven cohort studies involving 12,063 participants). The pooled SIR prevalence among HIV-infected patients with virological suppression after HAART initiation was 43% (95% confidence interval [CI], 34-51%) at 6 months post-HAART initiation and 10% (95% CI, 5-18%) at 36 months post-HAART initiation; among all HIV-infected patients after HAART initiation, it was 17% (95% CI, 0-55%) and 5% (95% CI, 2-10%) at 6 and 36 months post-HAART initiation, respectively. The SIR prevalence among HIV-infected patients is high at 6 months post-HAART initiation, but its prevalence gradually reduces over time under continuous HAART. Thus, it is important to follow-up on variations in the CD4+ T-cell count and viral load.

Effects of Chinese Medicine on the Survival of AIDS Patients Administered Second-Line ART in Rural Areas of China: A Retrospective Cohort Study Based on Real-World Data.

OBJECTIVES: Chinese medicine (CM) improves the symptoms of patients with acquired immune deficiency syndrome (AIDS) and prolongs their survival. This real-world study aimed to evaluate the effects of CM on the survival of AIDS patients administered second-line antiretroviral therapy (ART). METHODS: We conducted a retrospective cohort study of the medical records of patients with AIDS who switched to second-line ART between January 2009 and December 2014. Patients were divided into ART and CM + ART groups. Propensity score matching (PSM) was performed to correct for biases between groups. Kaplan-Meier analysis and the log-rank test were used to compare survival rates, and Cox regression models were employed to identify factors significantly associated with survival. RESULTS: The study population (n = 4180) was comprised of the CM + ART group (n = 855) and the ART group (n = 3325). After 1 : 2 PSM, 855 patients in the CM + ART group and 1699 in the ART group were selected for analysis. Patients in the CM + ART group were followed for 4246.8 person-years, and the mortality rate was 2.12/100 person-years. Patients in the ART group were followed for 8381.2 person-years, and the mortality rate was 2.91/100 person-years. Cox regression model analysis revealed that patients in the CM + ART group survived significantly longer than those in the ART group (hazard ratio: 0.73 and 95% confidence interval: 0.57-0.93). Gender, age, symptoms, CD4 cell counts, and viral loads were independently associated with the survival of AIDS patients treated with second-line ART. CONCLUSIONS: CM significantly improved the survival rate of AIDS patients treated with second-line ART.

[Systematic review of public literatures on HIV-1 genetic subtype in China].

OBJECTIVE: To identify the characteristics of HIV-1 and their distributions in the different infective subject of China, and provide base data for prevention and treatment of HIV infection. METHODS: We searched electronic databases such as the Chinese National Knowledge Infrastructure (CNKI), the Wanfang database and the Chinese Science and Technology Journal Full-text Database (VIP). Analysis the distributions of HIV subtype according the data acquired. RESULTS: A total of 62 articles were included with a total of 2091 cases reported. The main subtype epidemic in our country were B(12.4%), B(23.9%), CRF01-AE(30.0%) and CRF-BC(27.2%). There was relationship between the subtypes and the transmission routines. The circulation recombinant forms increased recently in our country. CONCLUSION: The epidemic of HIV subtype in our country was more complicated, and gave more perplex in surveillance, prevention and treatment, meanwhile, it also gave more challenge for the vaccinal manufacture.

[Traditional Chinese medicine syndrome factors of patients with HIV infection or AIDS in China].

OBJECTIVE: To study the characteristics of traditional Chinese medicine (TCM) syndrome factors of patients from different areas of China with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS). METHODS: A cross-sectional investigation study was conducted in Henan, Guangdong and Yunnan Provinces and Xinjiang Uygur Autonomous Region of China from October 2008 to August 2010. Based on literature review and expert opinion, a clinical questionnaire of TCM syndromes was drawn up. This survey was carried out after the investigators were professionally trained. Wenfeng III Auxiliary Diagnosis and Treat System of TCM was used to analyze the frequencies of AIDS patients' signs and symptoms with scores above 70 of syndrome factors respectively. Based on this work, syndrome factors of AIDS were analyzed in different areas. RESULTS: There were 608 HIV/AIDS cases investigated from October 2008 to August 2010 in total; among them, 276 cases were from Henan, 126 cases from Guangdong, 120 cases from Xinjiang and 86 cases from Yunnan. The results of syndrome factor analysis indicated that the syndromes of four provinces were similar. HIV/AIDS patients in the four areas exhibited qi deficiency, blood deficiency, yin deficiency, yang deficiency, dampness, phlegm, qi stagnation and essence deficiency syndromes. Patients in each area also had their own characteristics, such as that the scores of dampness of Guangdong and yin deficiency of Xinjiang were higher than the other syndromes, whereas the scores of Henan Province were higher than the other areas. AIDS patients had higher scores of syndromes than HIV-infected patients. CONCLUSION: HIV/AIDS patients from different areas had similar syndrome elements. The theory of "AIDS toxin injuring primordial qi" can sum up the TCM etiology and pathogenesis of HIV/AIDS.

Effect of intrathecal injection of miRNA-138 on neuropathic pain in rats undergoing partial sciatic nerve ligation and its underlying mechanism.

BACKGROUND: microRNA-138 (miRNA-138) might have a promising therapeutic effect in the Neuropathic pain (NP). We aim to investigate the effects of miRNA-138 on NP and explore its underlying mechanism. METHODS: we performed a partial sciatic nerve ligation (pSNL) surgery in rats to induce pain and inflammation. Rats were administrated by intrathecal injection of lentiviral (LV)-mediated miRNA-138. Mechanical withdrawal threshold (MWT) and paw withdrawal thermal latency (PWTL) were measured to evaluate the pain degree. The expression levels of miRNA-138, toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-α), interleukin-ß (IL-ß), and IL-6 in the spinal cord were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Western blotting was performed to measure the expressions of macrophage inflammatory protein-1 alpha (MIP-1α) and C-C chemokine receptor type 1 (CCR1). Next, the mechanism of miRNA-138 on NP was investigated by intrathecal injection of CCR1 inhibitor or MIP-1α neutralizing antibody. Inflammatory factors, MWT, and PWTL were also measured on day 7. RESULTS: Intrathecal injection of miRNA138 significantly reduced MWT and PWTL. qRT-PCR showed that miRNA138 mimic group significantly reduced the level of TLR4, TNF-α, Il-ß, and IL-6 on day 7. Western blotting showed that the protein expressions of MIP-1α and CCR1 in pSNL + miRNA138 mimic group were significantly decreased on day 7. In addition, the miRNA138 inhibitor inversely increased MWT, PWTL and inflammatory cytokines. Further, the effect of miRNA138 inhibitor all were significantly reversed by CCR1 inhibitor or MIP-1α neutralizing antibody. CONCLUSIONS: Intrathecal injection of miRNA-138 can remarkably alleviate NP in rats with a pSNL, which may be achieved by suppressing the TLR4 and MIP-1α/CCR1 signaling pathways.

Effect of Traditional Chinese Medicine Therapy on the Trend in CD4+ T-Cell Counts among Patients with HIV/AIDS Treated with Antiretroviral Therapy: A Retrospective Cohort Study.

This retrospective cohort study was conducted to explore the effect of traditional Chinese medicine (TCM) therapy on the long-term trends in CD4+ T-cell count among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) who were treated with combined antiretroviral therapy (cART) over a 14-year period. A total of 721 individuals were treated with cART alone (cART group), and 307 individuals were treated with both cART and TCM (TCM + cART group). Among all enrolled patients with HIV/AIDS, 99.5% were farmers, 71.1% had more than 6 years of education, and 96.8% were infected with HIV via a paid blood donation. For those patients with HIV/AIDS who had a baseline CD4+ T-cell count of <350 cells/mL, the CD4+ T-cell count tended to increase to approximately 350 cells/mL more rapidly in the TCM + cART group than in the cART group, but when the baseline CD4+ T-cell count was ≥350 cells/mL, there was no difference between the cART and TCM + cART groups. For other patients with HIV/AIDS who had a baseline CD4+ T-cell count of 350-500 cells/mL, the CD4+ T-cell counts tended to increase slightly, but there was no difference between the two groups. For patients with HIV/AIDS who had a baseline CD4+ T-cell count of ≥500 cells/mL, the CD4+ T-cell counts tended to be maintained at a particular level, with no difference between the two groups. The results show that the effect of TCM on the CD4+ T-cell counts of patients with HIV/AIDS is related to the CD4+ T-cell level at the time of initial treatment. TCM can increase the CD4+ T-cell count among patients with HIV/AIDS who have a baseline CD4+ T-cell count of <350 cells/mL. Sex and age have a slight influence on the therapeutic effect of TCM.

Transformation and apoptosis of NIH/3T3 cells treated with nickel-smelting fumes.

The purpose of this study was to investigate the transformation and apoptosis of NIH/3T3 cells treated with nickel (Ni) smelting fumes. Cytotoxicity of NIH/3T3 cells was detected with a methyl thiazolyl tetrazolium (MTT) colorimetric assay. The cell translation model was established by cell focus translation using two types of Ni-smelting fumes from a Ni smelting plant in China. The transformed focus was determined by soft agar culture assay. The apoptotic characteristics of NIH/3T3 cells treated with Ni-smelting fumes were detected by flow cytometry using Annexin V-FITC and PI as markers. The DNA fragment of apoptosis in NIH/3T3 cells treated with nickel smelting fumes was detected by observing agarose electrophoresis and morphological characteristics of cells under electron microscopy. With increase in exposure time, growth of NIH/3T3 cells was inhibited. The NIH/3T3 cell transformation model was established successfully using two Ni-smelting fumes, and the transformed cells grow in soft agar. No apoptosis peak was detected by flow cytometry. Apoptotic cells characterized by necrosis were observed using electron microscopy. There was no apparent "ladder" observed by DNA fragment analysis. Data indicated that Ni-smelting fumes produced cytotoxicity by mechanisms associated with necrosis but not apoptosis.

[Genetic damage of mammalian cells induced by nickel-refining fumes].

OBJECTIVE: To study the effects of two kinds of nickel-refining fumes on DNA damage of NIH/3T3 cell and the difference. METHODS: NIH/3T3 cells were treated by two kinds of nickel fumes collected from smelting furnace and refining workshop of a nickel-smeltery, and PBS taken the place of nickel-smelting fumes was used as negative control. Several hours later, the cytotoxicity of on NIH/3T3 cells was detected with MTT colorimetric assay, and the DNA damage was also measured by comet assay (single cell gel electrophoresis). RESULT: With the extension of exposure time and increasing of concentration, the living rate of NIH/3T3 cells was decreased; the tail rate, tail extent moment and tail DNA percent of NIH/3T3 cell induced by these two refining fumes were increased. After cells were treated with 100.00 microg/ml of nickel-smelting fume for 48 h, the living rate of NIH/3T3 cells was 24.5% and 26.5% respectively. The tail length of NIH/3T3 cell induced by these two refining fumes was not significant difference. Tail DNA percent of NIH/3T3 cell induced by smelting furnace fume was higher than negative control group (P < 0.05). The tail rate, and tail DNA percent (except 12.5 microg/ml and 50.0 microg/ml treated 2 h group) of NIH/3T3 cell induced by refining workshop fume was higher than negative control group (P < 0.05). CONCLUSION: Nickel-smelting fume could depress the survival rate of NIH/3T3 cells, and induce different degree DNA damage of NIH/3T3 cell.

Prevalence trend and risk factors for anemia among patients with human immunodeficiency virus infection receiving antiretroviral therapy in rural China.

OBJECTIVE: To estimate the prevalence trend and risk factors for anemia in patients with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART) in rural China. METHODS: We conducted cross-sectional studies among the same population in 2010, 2012, and 2014, based on data from standard medical record registers. Factors associated with anemia were evaluated using a logistic regression model. RESULTS: The number of patients with HIV infection included in each cross-sectional study was 1456 in 2010, 1531 in 2012, and 1567 in 2014, and the prevalence of anemia was 44.3%, 34.7%, and 27.6%, respectively. The prevalence of anemia was lower in female patients in 2010 [odds ratio (OR) 0.68; 95% confidence interval (CI) 0.55-0.85]; however, there was no difference by sex in 2012 (OR 0.90; 95% CI 0.72-1.11) and 2014 (OR 1.05; 95% CI 0.84-1.32). Patients with a higher level of education had a lower risk of anemia in 2014 (OR 0.72; 95% CI 0.56-0.92), but there was no difference in 2010 (OR 1.00; 95% CI 0.79-1.25) and 2012 (OR 0.99; 95% CI 0.79-1.24). Patients who had received a longer duration of ART had a higher risk of anemia in 2014 (OR 1.74; 95% CI 1.15-2.64), but there was no difference in 2010 and 2012 (P > 0.05). Patients receiving Traditional Chinese Medicine (TCM) therapy had a lower risk of anemia. CONCLUSION: The prevalence of anemia among patients with HIV infection receiving ART decreased between 2010 and 2014 in Henan Province but was still higher than the prevalence in the general population of China. TCM therapy can potentially decrease the risk of anemia among patients with HIV infection.