ABSTRACT
Objective:To observe and preliminarily explore the relationship between the area of active fundus lesions and aqueous cytomegalovirus (CMV)-DNA in patients with acquired immunodeficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR).Methods:A retrospective study. From November 2019 to December 2020, the study population consisted of 22 AIDS patients (31 eyes) with active CMVR at the Beijing Ditan Hospital, Capital Medical University. All the patients were male. The age of the patients was 38.0±8.7 years. In total, 13 patients accepted highly active antiretroviral therapy (HAART). The median duration of treatment was 4 months. There were 9 cases that did not receive HAART. Ultra-wide-angle fundus imaging examination was performed using Optos P200T laser scanning ophthalmoscope. The software was used that comes with the device to measure the area of active lesions. Anterior chamber puncture was performed in all the affected eyes, 100 μl of aqueous humor was extracted, and the CMV-DNA load was quantitatively detected by polymerase chain reaction. At the same time, 19 cases of peripheral blood CD4 +T lymphocytes and CMV-DNA load were tested; 17 cases of the human immunodeficiency virus (HIV)-RNA load were tested. The area of active lesions was used as the independent variable, and the CMV-DNA load of aqueous humor was used as the dependent variable to construct a linear regression function. Results:All eyes were active CMVR, with lesions ranging from 1 to 264 optic disc diameters, with a median of 43 optic disc diameters. Among 31 eyes, 30 eyes (96.8%, 30/31) had a median aqueous CMV-DNA load of 1.3×10 4 copies/ml, and one eye was negative for CMV-DNA in aqueous humor. In 19 patients who underwent peripheral blood CD4 +T lymphocyte detection, the median CD4 +T lymphocytes were 18 cells/μl; 4 cases (21.1%, 4/19) were detected with CMV-DNA load. In the 17 patients who underwent HIV-RNA load testing, the median HIV-RNA load was 4.1×10 4 copies/ml. The results of correlation analysis showed that the amount of CMV-DNA in aqueous humor was significantly correlated with the size of active fundus lesions ( r=0.601, P<0.001), and was correlated with CD4 + T lymphocytes, CMV-DNA load in blood, and HIV-RNA load. There was no significant correlation between the amounts ( r=0.125, 0.202, -0.096; P>0.05). The regression equation was CMV-DNA load in aqueous humor = 3.38 + 0.01 × active lesion area. Conclusion:The amount of CMV-DNA in the aqueous humor is significantly correlated with the area of fundus active lesions, which can reflect the activity of fundus lesions.
ABSTRACT
Objective To observe the image characteristics of OCT in patients of acquired immunodeficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR).Methods Thirty-nine eyes of 26 patients of AIDS with CMVR diagnosed in Department of ophthalmology of Beijing Ditan Hospital Capital Medical University from January 2015 to December 2017 were included in this study.All the patients were males,with the mean age of 33.12± 9.87 years.All the patients underwent the OCT examination by Spectralis HRA+OCT.The locations of scanning were macular,optical papilla and posterior pole of retina with retinitis.Typical images were saved and analyzed.Results The OCT pathological changes of CMVR included increase of retinal thickness and reflex of retina,indiscernible retinal layers,irregularity or absent external limiting membrane and/or ellipsoid zone,hyperreflective spots,vitreous cells.Among 39 eyes,there were 6 eyes with strong point-like reflection in the outer layer of retina around the lesion,31 eyes (79.49％) with strong point-like reflection in the full layer of retina,25 eyes (64.10％) with lesion involved macular area,34 eyes (87.17％) with vitreous cells.Conclusions OCT images of the eyes with AIDS with CMVR were characterized by lesions involving the whole retina.Absent ellipsoid zone or structural changes can be seen in the affected areas and peripheral areas of the lesion.
ABSTRACT
OBJECTIVE To summarize the clinical features of the acquired immunodeficiency syndrome-related Kaposi's sarcoma(AIDS-KS) in head and neck. METHODS The clinical data of 20 inpatients with AIDS-KS in head and neck from June 2009 to September 2016 in Beijing Ditan Hospital were retrospectively analyzed. RESULTS All 20 patients were male, median age 38.50±10.98. One case was Manchu, 1 case was of Uygur, and others were Han nationality. There were 7 cases with homosexuality history, 2 cases with blood transfusion history, and 1 case with prostitution history. Mass in head and face was the first symptom in 10 cases. The head and neck skin and mucosa were involved, including 2 cases with nasal mucosa involvement, 4 cases with auricle skin involvement, 8 cases with oral mucosal involvement, 3 cases with facial skin involvement, 1 case with neck skin involvement, 1 case with eyelid conjunctiva involvement. Four cases had disseminated lesions. When diagnosed, the CD4+T lymphocyte were 52.55±47.87/mm3. The CD4+T were less than 200/mm3 in all of the patients, including CD4+T＜50/mm3 in 15 cases(75％). After treatment with highly active antiretroviral therapy combined with or without chemotherapy, 12 cases were discharged. Eight cases died due to respiratory failure or septic shock or other reasons. CONCLUSION Kaposi's sarcoma of the head and neck might be the first visit of AIDS patients. Some of the patients get partial remission after highly active antiretroviral therapy and the overall prognosis is poor.
ABSTRACT
Objective To develop a method of loop-mediated isothermal amplification(LAMP) to Staphyloccocus aureus rapidly, specifically, sensitively and simply suited for the primary health agency. Methods According to conserved nucleotide of Staphyloccocus aureus and principle of LAMP, we designed a set of LAMP primers and set up an LAMP reaction system. We evaluated the specificity, sensitivity and re-peatability of the method. In addition,we evaluated the linearity between initial template copies 1g value and reaction time (the time when the fluorescent value is 1×10~4). Results The optimal assay showed that it was no cross-reaction with other closely related members of pathogens, and was 10 times more sensitive than PCR. The coefficient of variance between tests was less than 5% ,and the kinetics curves showed a good line-arity between initial template copies lg value and reaction time(r~2=0. 9501). The detection activity could be finished within 1 h with the sensitivity of LAMP was 100% and the specificity was 94.4%, and the accuracy was 96.6%. Conclusion These findings demonstrated that the LAMP had the potential clinical application for detection and differentiation of Staphyloccocus aureus in the public health agency for its sensitive, specific and simple feature.