[Ultrasonographic assessment of diaphragm function in long-term mechanical ventilation patients].

Objective: To evaluate the condition of the diaphragm in patients with long-term mechanical ventilation using ultrasound technology and to analyze its relationship with ventilation time and muscle atrophy in order to clarify the reasons for diaphragm dysfunction in long-term mechanical ventilation patients. Methods: Patients admitted to the respiratory department at the Chinese PLA General Hospital between June 2018 and April 2019 with mechanical ventilation were included in this study. The enrolled patients were divided into a short-term mechanical ventilation group (7 days ≤ ventilation time<1 month) and a long-term mechanical ventilation group (mechanical ventilation time ≥ 1 month). The diaphragmatic excursion, inspiratory time, contraction rate, E-T index, diaphragm thickness, diaphragm thickness fraction (DTF), and tibialis anterior thickness were compared between the two groups. The correlation between ventilation time and diaphragm thickness was analyzed in all patients. Results: The mean diaphragm thickness and DTF were significantly lower in the long-term mechanical ventilation group than in the short-term mechanical ventilation group [(0.13±0.036) vs (0.17±0.05) cm and (0.22±0.045) vs (0.27±0.075)](all P<0.05). However, there was no significant difference in diaphragmatic excursion, inspiratory time, contraction rate, E-T index or tibialis anterior thickness between the two groups (all P>0.05). There was a significant linear correlation between ventilation time and diaphragm thickness (P<0.01). Tibialis anterior thickness was not significantly correlated with ventilation time (P>0.05). Conclusion: Diaphragm thickness and function were significantly reduced in patients with long-term mechanical ventilation, which was correlated with the duration of ventilation. Nutritional status was not the main factor affecting diaphragm thickness.

[A report on 8 seronegative converted HIV/AIDS patients with traditional Chinese medicine].

OBJECTIVE: For the first time, serum anti-HIV antibody negative conversion was being reported. METHODS: Eight confirmed HIV/AIDS patients (AC1, ARC 6, AIDS 1) were treated with TCM recipes (802, 806, 809, 810, Shengmaiyin, ZY-1), recheck the serum antibody and immunological function and intranuclear HIV-DNA was investigated with PCR amplifying assay and were long-term followed-up. RESULTS: After medication for 87-463 days, seronegative conversion occurred, PCR assay revealed that 5 cases were PCR(+), 2 of them(-), 1 turned seropositive again in the early stage. Observed continuously for 11-49 months, the "serum negative and intranuclear positive" state maintained. These patients belonged to immunosilent HIV-infection. The immunological function of all seronegative converted patients were good. CONCLUSIONS: AIDS is a reversible disease. Using medicinal herbs to enhance the immune function will facilitate the appearance of seronegative conversion, which has not been reported before. If it could be further confirmed, its mechanism elucidated, this may greatly strengthen the confidence of the patients.