Advantages of Chinese Medicine for Patients with Acquired Immunodeficiency Syndrome in Rural Central China.

OBJECTIVE: To analyze the effect of Chinese medicine (CM) on mortality and quality of life (QOL) of acquired immunodefificiency syndrome (AIDS) patients treated with combined antiretroviral therapy (cART). METHODS: A random sample of AIDS patients enrolled in the National Chinese Medicine Treatment Trial Program (NCMTP) that met the inclusion criteria was included in this study. NCMTP patients were included as the CM+cART group, and those not in the NCMTP were included as the cART group. Survival from September 2004 to September 2012 was analyzed by retrospective cohort study. QOL was analyzed by cross-sectional study. RESULTS: The retrospective cohort study included 528 AIDS patients, 322 in the CM+cART group and 206 in the cART group. After 8 years, the mortality in the CM+cART group was 3.3/100 person-years, which was lower than the cART group of 5.3/100 person-years (P<0.05). The hazard ratio (HR) for mortality in the cART group was 1.6 times that of the CM+cART group by Cox proportional hazard model analysis. After controlling for gender, age, marital status, education, and CD4+ T-cell count, the HR was 1.9 times higher in the cART group compared with the CM+cART group (P<0.05). The cross-sectional study investigated 275 AIDS patients. The mean scores of all QOL domains except spirituality/personal beliefs were higher in the CM+cART group than in the cART group (P<0.05). CONCLUSIONS: For AIDS patients, CM could help to prolong life, decrease mortality, and improve QOL. However, there were limitations in the study, so prospective studies should be carried out to confifirm our primary results.

[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.

Treatment of acquired immunodeficiency syndrome with Chinese medicine in China: opportunity, advancement and challenges.

Chinese medicine (CM) has been used in the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) for 30 years and the demonstrated therapeutic effects of CM, such as reducing plasma HIV viral load, increasing CD4(+)T cell counts, promoting immunity reconstitution, ameliorating symptoms and signs, improving the health related quality of life (HRQOL) and counteracting against the effects of anti-retroviral drugs, were summarized and reviewed in this article. The authors point out that it had been a good opportunity to use CM for the treatment of HIV infection and AIDS in the past and also there are huge challenges ahead for CM research and clinicians to discover more effective CM and its underlying mechanisms for treatment of AIDS.

[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.

[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.

[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.

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.