(1) Background: The objective of this study was to investigate the prevalence of genetic diversity and drug resistance mutations among people living with HIV (PLWH) attending clinics in Beijing. (2) Methods: A retrospective analysis was conducted on PLWH admitted to the Fifth Medical Center of People’s Liberation Army (PLA) General Hospital between 1 March 2013 and 31 July 2020. The participants were analyzed for pretreatment drug resistance (PDR) and acquired drug resistance (ADR). Nested polymerase chain reaction (PCR) was utilized to amplify the pol gene from plasma RNA samples obtained from the participants. Genotypic and HIV drug resistance were determined using the Stanford University HIV Drug Resistance Database. Univariate and multifactorial logistic analyses were used to assess the risk factors for PDR. (3) Results: The overall prevalence rates of PDR and ADR were 12.9% and 27.8%, respectively. Individuals treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) exhibited the highest prevalence of mutations. Specific mutation sites, such as V179D for NNRTIs and M184V and K65R for nucleoside reverse transcriptase inhibitors (NRTIs), were identified as prevalent mutations. Individuals treated with efavirenz (EFV) and nevirapine (NVP) were found to be susceptible to developing resistance. The multifactorial regression analyses indicated that the factors of circulating recombination form (CRF) genotype CRF07-BC and a high viral load were associated with an increased risk of PDR. CRF01-AE and CRF07-BC were the most prevalent HIV genotypes in our study. (4) Conclusions: The distribution of HIV genotypes in Beijing is complex. There is a need for baseline screening for HIV drug resistance among ART-naive individuals, as well as timely testing for drug resistance among ART-experienced individuals.

聚乙二醇干扰素(PEG－IFN)联合利巴韦林(RBV)的方案和直接抗病毒药物(DAA)是目前临床较为常见丙型病毒性肝炎治疗方案。本文对两种治疗方案的不良反应及护理干预进行综述,旨在引起医护人员和患者对不良反应的关注及再认识,为医护人员提供全维度的护理干预措施提供参考。

目的 探索赴高原执行任务的医务人员的不同应对方式、心理弹性和焦虑抑郁之间的关系以及心理弹性的中介效应.方法 使用一般调查问卷、简易应对方式问卷(SCSQ)、心理弹性量表(CD-RISC)、医院焦虑抑郁量表(HADS)对2021年9-11月某医院赴高原执行任务的113名医务人员进行问卷调查.结果 (1)经分析,性别、学历和收入在焦虑水平上;婚姻状态、收入水平在抑郁水平上;学历和收入在应对方式上;婚姻状态和收入在心理弹性得分上比较差异有统计学意义(均P＜0.05).(2)应对方式与心理弹性之间呈正相关(r=0.390,P＜0.01),与焦虑抑郁之间呈正相关(r=0.371,P＜0.01);心理弹性与焦虑抑郁之间呈正相关(r=0.206,P＜0.05).其中,焦虑与消极呈正相关(r=0.550,P＜0.01),与积极、力量、坚韧呈负相关(r=-0.221,0.257,-0.221;均P＜0.05);抑郁与积极、乐观、力量、坚韧呈正相关(r=0.425,0.560,0.696,0.694;均P＜0.01).验证心理弹性在应对方式与焦虑抑郁之间存在中介效应(P=o.001,R2=0.142).其中,心理弹性在积极应对与抑郁水平存在完全中介效应;力量与坚韧在积极应对与焦虑水平存在部分中介效应.结论 初人高原工作的医务人员存在焦虑、抑郁状态,应对方式、心理弹性与焦虑抑郁之间有相关性,心理弹性在应对方式与焦虑抑郁之间存在中介效应.

Objective:To discuss the impact and practicability of pluralistic management when puerpera with hepatitis B virus (HBV) in hospital.Methods:By review researching and convenient sampling, two groups of puerpera with HBV were studied comparatively by the index of the time of breast milk, the breastfeeding rate and the satisfaction rate in hospital.The control group (411 cases, January to December, 2017) carried on the normal regulations nursing and the observation group (411 cases, January to October, 2018) carried on the pluralistic management in the Obstetrics and Gynecology Department of the Fifth Medical Center of PLA General Hospital.Results:The rate of the starting time of milk secretion (<24, 24-48, 49-72, >72 h) was 29.4%(121/411), 36.0%(148/411), 24.6%(101/411), 1.0%(41/411) in the observation group, and 13.6%(56/411), 21.7%(89/411), 33.3%(137/411), 31.4%(129/411) in the control group. The differences between the two groups were significant ( χ2 value was 7.66-57.43, all P<0.01). Postpartum hospital stay in 3 days and 6 days, the breastfeeding rate and average rate was 90.4%(198/219), 95.3%(183/192), 92.7%(381/411) in the observation group, and 79.0%(180/228), 84.2%(154/183), 81.3%(334/411) in the control group, the differences between the two groups were significant ( χ2 value was 11.13, 12.7, 23.61, all P<0.01). The total satisfaction rate in hospital was 99.5%(409/411) in the observation group, and 91.2%(375/411) in the control group, the difference between the two groups was significant ( χ2 value was 31.93, P<0.01). Conclusions:Pluralistic management can raise the rate of breastfeeding of puerpera with HBV and the satisfaction of puerpera with HBV and her family.

目的 探索并完善接诊2019冠状病毒病期间发热门诊人员配置及排班方法,为发热门诊安全、有效完成接诊排查工作奠定基础.方法 针对发热门诊护士配置特点、工作性质、接诊情况,对排班方案随时调整,不同阶段分别采取了2h轮班单人、4h轮班双人、高峰时段4h轮班3人的排班模式.结果 排班模式的合理化调整,保证了接诊新型冠状病毒肺炎患者期间发热门诊工作的顺利开展和方案的有效实施,且保证了护士在体力、耐受力能承受的情况下安全完成各项工作,未发生任何职业暴露.结论 在人员有限但疫情不可控的情况下,合理的人员配置及排班模式,是圆满完成各项工作,保证人员安全的基础.

The aim of this study was to observe the effect of Rehmannia glutinosa oligosaccharide (RGO) on differentiation of bone marrow mesenchymal stem cells (MSCs) into cardiomyocytelike cells. Rat MSCs were isolated, treated, and grouped as follows: RGO treatment group, 5-azacytidine (5-aza) treatment group, RGO + 5-aza treatment group, and control group. Following a four-week induction period, cardiac troponin I (cTnI) levels in MSCs were quantified by chemiluminescence, and the levels of myocardial enzymes creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB) were measured using a dry chemistry analyzer. The cTnI-and connexin 43 (Cx43)-positive MSC population was identified by immunofluorescence, and expression levels of cTnI and Cx43 were analyzed by western blots. Following induction, cTnI, CK, and CK-MB levels were significantly higher in the RGO + 5-aza group as compared with the RGO and 5-aza groups (P < 0.05). In addition, fluorescence intensity of cTnI and Cx43 was higher in the RGO + 5-aza group as compared with the RGO and 5-aza groups. No cTnI- or Cx43-positive cells were detected in the control group. Western blot analysis further confirmed that cTnI and Cx43 were not expressed in the control group, while cTnI and Cx43 was higher in the RGO + 5-aza group than in the RGO and 5-aza groups. These results suggest that MSCs can be induced by RGO to differentiate into cardiomyocyte-like cells in vitro, and that RGO in combination with 5-aza enhance differentiation of MSCs.

Objective To explore the correlation between multiple cardiovascular risk factors and the coronary angiographic features in patients with acute coronary syndrome(ACS).Methods A tolal of 644 patients with ACS were selected according to inclusion criteria.The extent and severity of angiographic coronary artery disease(CAD) were expressed by the number of diseased vessels.The risk factors included age,gender,smoking status,type-2 diabetes mellitus,hypertension,increased body mass index,dyslipidemia,increased blood uric acid level,etc.Analyses were achieved by univariate and multivariate analysis.Results(1) The number of diseased vessels increased with increasing age,hypertension,the level of blood sugar,urea and uric acid and blood sugar CV.(2) Logistic regression analysis showed that age was a prominent independent risk factor for three-vessel coronary artery lesions(RR = 1.43, 95%CI 1.208,1.462,P = 0.001).Age was the most important risk factor in men,whereas hypertension was the most important risk factor in women.Conclusion(1) Age is the most prominent risk factor for the the number of diseased vessels in ACS patients,but it is an incontrollable risk factor,so it is very important to control other risk factors in the intervention and prevention of CAD.(2) The distribution and severity of risk factors vary in different genders,therefore the treatment of risk factors should be different.

Objective To investigate the effects of Rehmannia glutinosa oligosaccharides (RGOs)on electrophysiological characteristics of skeletal myoblasts in the light of their outward potassium current (Ito). Methods Skeletal myoblasts (SMs) and cardiomyocytes were isolated using a modified enzymatic dissociation method from SD rats. Whole cell patch clamp technique was used to record Ito of cardiomyocytes and SMs,and study the difference in Ito between SMs and cardiomyocytes after intervention with 0.625g·L-1 RGOs. Results Ito of both cardiomyocytes and SMs was activated from -40mV. Ito density from -30mV to 30mV in the SMs of RGOs treated group was (7.3±0.7)pA/pF to (65.3±2.3) pA/pF(n=5),respectively,which were significantly greater than cardiomyocyte group(0.9±0.1)pA/pF to (28.8±0.9) pA/pF (n=5) and SMs group(4.5±0.5)pA/pF to (23.7±2.0) pA/pF (n=5). Conclusion RGOs could elevate Ito current density of SMs and affect the electrophysiological characteristics in transplanted SMs. It could provide a new strategy for promoting the safety of SMs transplantation.

1 病例摘要 患者关系,72岁,已婚.主因"劳力后心悸、气短40年,加重伴少尿、下肢浮肿2年,黑便1个月"于2006年12月22日入院.

[Objective] To study the clinical and coronary angiographic features in patients with non-ST segment elevation acute coronary syndromes(NSTEACS) and type 2 diabetes mellitus(T2DM).[Methods] 720 patients with NSTEACS were divided into two groups: A group with T2DM and B group without T2DM and their coronary angiographic features were analyzed. [Results] Compared with B group,A group had higher body mass index(BMI),more histories of hypertriglyceridemia and coronary heart disease(CHD),more heart failure events and increased left ventricular end diastolic and systolic diameter and decreased left ventricular ejection fraction(LVEF).The levels of serum triglyceride,glucose and glucose coefficient variation(CV) and the incidence of triple vessel disease and left main artery of coronary artery were higher than those of the B group.[Conclusion] The patients with NSTEACS and T2DM have more severe lesions of coronary arteries,left ventricular dysfunction and metabolism disorder.

异舒吉是硝酸异山梨酯注射液,我们应用该药与低分子肝素钙、葛根素注射液(布瑞宁)合用对不稳定型心绞痛(Unstable angina,UA)患者进行治疗,效果比较满意,报道如下.

人体的脂肪细胞不仅是储能细胞,也能分泌许多信号蛋白和细胞因子,如C-反应蛋白、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6、血管内皮生长因子、血管紧张素原、纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor,PAI-1)、脂联素(adiponectin)等,具有广泛的生物活性.其中脂联素在机体代谢过程中具有许多重要作用,并与多种疾病有关,已有研究报道显示脂联素水平与冠心病的发生和发展呈负相关,低脂联素血症是冠心病的独立危险因素.另外高血压、糖尿病,脂代谢紊乱也是冠心病的主要危险因素.因此脂联素与冠心病及其危险因素关系的相关研究是目前的热点之一.