Behavior and toxicity assessment of copper nanoparticles in aquatic environment: A case study on red swamp crayfish.

With the wide use of copper nanoparticles (CuNPs) in various industrial and commercial applications, they inevitably enter the aquatic environment. However, their behavior in the aquatic environment and potential toxicity to aquatic organisms remain little known. In this study, we investigated the behavior of CuNPs in freshwater, as well as the toxicity and bioaccumulation of CuNPs and copper sulfate (CuSO4), used as a positive control for copper ions toxicity, in red swamp crayfish (Procambarus clarkii). The results showed that CuNPs released copper ions into freshwater and aggregated rapidly in freshwater, and their release of copper ions and aggregation slowed down at a higher concentration of CuNPs. The calculated 72-h LC50 values for crayfish were 1.18 and 0.54 mg/L for CuNPs and CuSO4, respectively. Cu accumulation in the gill and hepatopancreas from CuSO4 treatments was significantly higher than that from CuNPs, and the highest Cu bioaccumulation level in crayfish was found in the gill, followed by hepatopancreas and muscle with the exposure of copper. The activities of the antioxidative enzymes in the crayfish significantly decreased after exposure to CuNPs for 48 h, compared to the control (without CuNPs or CuSO4). Histological examination revealed that there was no significant alteration of hepatopancreas in the crayfish exposed to CuNPs. Meanwhile, the growth of crayfish was not significantly inhibited by CuNPs. These results suggested that CuNPs exposure can induce oxidative stress in the crayfish, gill is the main tissue for their accumulation, and their toxicity is mainly caused by the released copper ions.

[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.

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.

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.

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.

Effect of treatment course of comprehensive intervention with Traditional Chinese Medicine on mortality of acquired immunodeficiency syndrome patients treated with combined antiretroviral therapy.

OBJECTIVE: To investigate the effect of a treatment course of comprehensive intervention with Traditional Chinese Medicine (TCM) on the mortality of patients with acquired immunodeficiency syndrome (AIDS) treated with combined antiretroviral therapy (cART). METHODS: AIDS patients who had taken cART in a national TCM human immunodeficiency virus treatment trial program (NTCMTP) before 2009 were enrolled in this study and followed for 36 months from November 2009. Patients enrolled in the NTCMTP in 2004 were taken as the first group, those enrolled in 2006 as the second group, and those enrolled in 2009 as the third group. Cumulative survival rates were calculated by the life table method. Survival curves for subgroups were compared by the log-rank test. Hazard ratios were calculated with a Cox proportional hazards model. RESULTS: A total of 1443 AIDS patients were followed for 3 years (4198 person-years). During this period, 91 (6.3%) patients died and 13 (0.9%) were lost to follow-up. The total mortality rate was 2.17/ 100 person-years. The mortality rate of patients enrolled in the NTCMTP in 2004 was 1.49/100 person- years, which was lower than that of patients enrolled in 2006 (2.23/100 person-years) and 2009 (3.48/100 person-years). After adjusting for other factors, a shorter time of treatment with TCM, male sex, older age, lower CD4 + T-cell counts, and long-term treatment with cART were risk factors of mortality. CONCLUSION: Long-term treatment with TCM decreased the mortality risk of AIDS patients. Factors such as being male, older age, CD4 + T-cell counts, and time of treatment with TCM and cART were correlated with mortality.

Survival of AIDS patients treated with traditional chinese medicine in rural central china: a retrospective cohort study, 2004-2012.

This study aimed to explore the survival of AIDS patients treated with traditional Chinese medicine (TCM) in addition to combined antiretroviral therapy (cART) and of AIDS patients treated with cART. Data of patients taking cART between 30 October 2003 and 30 October 2004 in the National TCM HIV Treatment Trial Program area were retrospectively analyzed, with follow-up from 30 October 2004 to 30 October 2012. The log-rank test was used to compare survival between the two groups. A Cox proportional hazards model was used to determine hazard ratios to identify prognostic factors. The study included 521 patients in the TCM + cART group followed up for 3548 person-years and 375 patients in the cART group followed up for 2523 person-years. Mortality rates were 3.2/100 person-years and 4.2/100 person-years in the TCM + cART and cART groups, respectively. The difference in survival was significant. After adjusting for explanatory variables, the mortality rate of AIDS patients in the cART group was 1.7 times higher than in the TCM + cART group. Male sex, older age, little education, and lower CD4 cell count were risk factors for mortality. TCM intervention in addition to cART could increase survival of AIDS patients.

Traditional Chinese medicine could increase the survival of people living with HIV in rural central China: a retrospective cohort study, 2004-2012.

A retrospective cohort study was conducted to explore the effectiveness of Traditional Chinese Medicine (TCM) in treating people living with HIV (PLHIV) by comparing the survival of PLHIV treated with TCM and without TCM. To identify prognostic factors that affect the survival of PLHIV, patients who enrolled in the national TCM HIV treatment trial program (NTCMTP) in October 2004 and PLHIV in the same region who did not enroll in the NTCMTP were compared. Participants were followed up to October 2012. Survival time was estimated through the Kaplan-Meier method, and hazard ratios to identify prognostic factors were computed through Cox proportional hazard models. A total of 3,229 PLHIV (1,442 in the TCM therapy group and 1,787 in the non-TCM therapy group) were followed up for 21,876 person-years. In this time period, 751 (23.3%) died and 209 (6.5%) were lost to follow-up, for an overall mortality rate of 3.43/100 person-years. In the TCM therapy group, 287 (19.0%) died and 139 (9.7%) were lost to follow-up, and in the non-TCM therapy group, 464 (26.0%) PLHIV died and 70 (3.9%) were lost to follow-up. The mortality rate in the TCM therapy group was 2.97/100 person-years, which was lower than the rate of 3.79/100 person-years in the non-TCM therapy group. The 8-year cumulative survival in the TCM therapy group was 78.5%, lower than the 74.0% survival in the non-TCM therapy group. After adjusting for other factors, risk factors of death included male gender, older age, less education, taking combined antiretroviral therapy (cART) at enrollment, not taking cART at follow-up, and lower CD4 + T cell counts. Our retrospective cohort study indicates that TCM increased the survival and lengthened the lifetime of PLHIV in Henan Province of China. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results.

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.

[Correction of maxillofacial expansive deformities resulted from cystic lesions of the mandible by suction drainage].

OBJECTIVE: To prospectively investigate the effectiveness of suction drainage for correction of maxillofacial deformities caused by cystic lesions of the mandible. METHODS: Suction drainage was performed in 21 cases with large cystic lesions of the mandible which had expanded facial contour. Clinical and radiological examinations of these patients were carried out regularly. The volume of the cavity was measured during treatment. The expansion indexes on axial CT image and area of the cyst on a panoramic radiograph were measured preoperatively and postoperatively. The curettage via intraoral incision was completed until the extent of disease significantly shrunk. RESULTS: After a mean duration of suction drainage of 5.1 months, the volume and the size on the panoramic radiographic of the cystic lesions were reduced by an average of 84% and 63% respectively. The expansion indexes were reduced notably during treatment. Computerized tomography of the mandible showed that the contour of expanded mandible was restored greatly and notable new bone was formed in the area of cortex perforation. CONCLUSIONS: Suction drainage is a useful treatment modality for the primary management of giant cystic lesion of the mandible, and can fast correct maxillofacial deformities caused by bony expansion and perforation in the area of cystic lesions.

[Marsupialization or decompression of the cystic lesions of the jaws].

Marsupialization or decompression of the cystic lesions of the jaws is the technique that relieves the pressure within the cyst and causes some decrease in size of the lesion, so that subsequent enucleation or curettage could be performed more simply and with less risk to adjacent vital structures. A permanent tooth in the dentigerous cyst in preadolescents often erupts successfully after marsupialization and resolution of the cyst. Large odontogenic keratocyst or unicystic ameloblastoma is marsupialized initially and then enucleated at a later stage, reducing the possibility of pathological fracture of the mandible or the need for jaw resection. However, it should be kept in mind that a few of odontogenic keratocysts or unicystic ameloblastomas still may recur after this two-stage procedure and multi-cystic amelobalstoma has a high recurrence rate and a potential to infiltrate into the surrounding tissues.