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NMDA受体在hiv相关认知功能障碍发病机制及治疗靶点中的作用

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中风与神经疾病杂志 2015年第1期32卷 91-93页

作者：李珊陈恩德周燕广西医科大学药学院广西南宁530021

人类免疫缺陷病毒（hiv）相关认知功能障碍（hiv-associated neurocognitive disorders,HAND）在艾滋病（AIDS）患者中的发生率为30%~50%[1]。疾病的症状轻重不一,临床上可根据患者神经学和行为学功能表现以及结合神经心理测试结果[2],... 详细信息

人类免疫缺陷病毒（hiv）相关认知功能障碍（hiv-associated neurocognitive disorders,HAND）在艾滋病（AIDS）患者中的发生率为30%~50%[1]。疾病的症状轻重不一,临床上可根据患者神经学和行为学功能表现以及结合神经心理测试结果[2],将该病分为无症状性神经认知损害（ANI）、轻度神经认知紊乱（MND）和hiv相关痴呆症（HAD）。

关键词： NMDA受体 hiv相关神经认知神经心理测试细胞生长行为学突触前膜谷氨酸受体痴呆症神经学

hiv相关认知功能障碍的疾病负担:全脑成像测定研究

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世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 40-41页

作者： Ragin A.B. Storey P. Cohen B.A. 李宏建 Department of Radiolo gy 676 N. St. Clair 1400 Chicago IL 60611 United States Dr.

Objective: To study whole-brain MR measures derived from diffusion tensor i maging and magnetization transfer imaging(MTI) for the in vivo assessment of cum ulative neuropathologic changes in hiv and to evaluate the quantitative imaging strategies with respect to cognitive status measures including the severity of d ementia and the degree of impairment in specific cognitive domains including att ention, memory, constructional abilities, and motor speed. Methods: Quantitative whole-brain measurements, including fractional anisotropy (FA), apparent diff usion coefficient (ADC), and magnetization transfer ratio (MTR), were derived fr om histograms and compared in hiv and control participants. Relationships betwee n the MR and cognitive status measures were examined. Results: Wholebrain FA and MTR were reduced in patients with hiv and correlated with dementia severity. Wh ole-brain MTR and ADC were correlated with psychomotor deficits. Evaluation of relationships between the studied MR measures indicated a correlation between A DC and MTR; FA was not correlated with either ADC or MTR. Conclusions: Findings from this investigation support the use of quantitative whole-brain MR measure s for evaluation of disease burden in hiv. Reductions in whole-brain fractiona l anisotropy and magnetization transfer ratio (MTR) distinguished hiv and contro l subjects, and these measures were associated with dementia severity. Relations hips were identified between whole-brain MTR and apparent diffusion coefficien t and psychomotor deficits. Combining these quantitative strategies in neuroimag ing examinations may provide more comprehensive information concerning ongoing c hanges in the brains of hiv patients.

关键词： hiv相关脑成像磁化转移率磁化传递成像精神运动性神经病理学构建能力表观弥散系数弥散张量成像认知范围

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hiv相关毛囊综合征患者临床症状自发改善

世界核心医学期刊文摘（皮肤病学分册） 2005年第2期1卷 31-32页

作者： Blasdale C. Turner R.J. Leonard N. 马慧群 Department of Dermatology Royal Victoria Infirmary Queen Victoria Road Newcastle upon Tyne NE1 4LP United Kingdom

Since 1991 infrequent reports have described a distinctive triad of nodulocystic acne, striking follicular spines and an eruption resembling pityriasis rubra pilaris (PRP) in hiv-positive patients. It has been suggested that this may represent a subtype of PRP, or alternatively that it should be viewed as a unique hiv-associated follicular occlusion triad. Clinical manifestations may be severe, and in several cases have been ultimately fatal, with death occurring due to complications of cutaneous sepsis. We describe a case demonstrating severe conglobate acne, follicular keratotic spines and histologically confirmed PRP in association with hiv infection. Clinical features and treatment modalities of previously reported cases are reviewed. Despite refusing all topical and systemic treatment our patient showed spontaneous remission of skin signs after 2 years.

关键词： hiv相关临床症状囊肿性痤疮聚合性痤疮毛发红糠疹角化性脓毒症外用药物皮肤症状非典型性

hiv病毒蛋白在hiv相关神经损伤中的作用

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北京医学 2015年第12期37卷 1180-1182页

作者：刘志英李威陈德喜吴昊首都医科大学附属北京佑安医院感染科 100069

hiv相关的神经认知损害（hiv-associated neurocognitive disorder,HAND）是由hiv-1病毒引起的神经系统病变,可出现注意力不集中,记忆障碍,手部运动缓慢,共济失调,大小便失禁,感情淡漠,以及步履艰难等症状,严重影响患者工作、生活和社... 详细信息

hiv相关的神经认知损害（hiv-associated neurocognitive disorder,HAND）是由hiv-1病毒引起的神经系统病变,可出现注意力不集中,记忆障碍,手部运动缓慢,共济失调,大小便失禁,感情淡漠,以及步履艰难等症状,严重影响患者工作、生活和社会活动,30%以上的hiv感染者可罹患HAND。

关键词：病毒蛋白 hiv病毒 hiv相关记忆障碍神经损伤神经认知大小便失禁共济失调中枢神经元神经系统病变

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淋巴水肿性hiv相关的Kaposi肉瘤

世界核心医学期刊文摘（皮肤病学分册） 2006年第11期2卷 15-16页

作者： Ramdial P.K. Chetty R. Singh B. 董平 Department of Anatomical Pathology Laboratory BuildingInkosi Albert Luthuli Central Hospital 800 Bellair Road Mayville 4058 KwaZulu Natal South Africa

Background: Advanced Kaposi’s sarcoma is frequently associated with chronic lymphedema (cLO). The histopatho- logical features of lymphedematous hiv-associated KS (KS) are poorly documented and the co-existence of fibroma-like nodules in lymphedematous KS is under-recognized. The aims of this study were to assess the clinicopathological spectrum and diagnostic difficulties associated with lymphedematous KS and to highlight the clinicopathological profile of fibroma-like nodules. In addition, the pathogenesis of fibroma-like nodules and cLO is revisited. Materials and methods: Prospective 17-month clinicopathological study of all biopsies from patients with lymphedematous KS. Results: Seventy-four biopsies, the majority from the lower limbs, from 41 patients were evaluated. Nineteen, 14, five and three patients had one, two, three or four biopsies each, respectively. In 14 biopsies, there was poor clinicopathological correlation of KS stage. Exclusive lesional KS (patch, plaque, nodule or lymphangioma-like) was identified in 29 biopsies; 23 and eight biopsies demonstrated KS or fibroma-like morphology and the adjacent dermis demonstrated cLO. There was variable intratumoral and peritumoral venous compression and lymphatic dilatation. Fourteen biopsies demonstrated cLO exclusively. Smaller fibroma-like nodules lacked KS spindle cells, whereas> 5mm nodules demonstrated focal KS spindle cell proliferation and aggregation on extensive sectioning. The subcutis of 42 biopsies demonstrated variable fibrosis, hemosiderin deposits, lymphocytes, plasma cells, KS, interstitial granular material and pools of lymph fluid. Subcutaneous abscesses were identified in six biopsies. All biopsies had variable epidermal features of cLO. Conclusions: cLO influences clinicopathological correlation of KS stage and may also mask the presence of KS and the co-existence of subcutaneous abscesses. Smaller fibroma-like nodules are hypothesized to be a manifestation of cLO that have the potential to acquire the characteristics of KS. Lymphatic

关键词：淋巴水肿 hiv相关 Kaposi 病理活检含铁血黄素梭形细胞皮下脓肿肉芽肿样静脉阻塞纤

重视MRI新技术在hiv相关脑痴呆的临床研究及应用

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临床放射学杂志 2014年第12期33卷 1802-1802页

作者：李宏军首都医科大学附属北京佑安医院放射科 100069

自1981年首次报道人类免疫缺陷病毒-1（human immunodeficiency virus-1,hiv-1）特异性感染辅助性T淋巴细胞,破坏免疫系统,造成以机会性感染和恶性肿瘤为主要临床表现的获得性免疫缺陷综合征（acquired immune deficiency syndrome,AIDS... 详细信息

自1981年首次报道人类免疫缺陷病毒-1（human immunodeficiency virus-1,hiv-1）特异性感染辅助性T淋巴细胞,破坏免疫系统,造成以机会性感染和恶性肿瘤为主要临床表现的获得性免疫缺陷综合征（acquired immune deficiency syndrome,AIDS,简称艾滋病）。近期世界卫生组织发布最新hiv/AIDS进展报告,全球约有3400万人携带hiv;截至2014年7月31日,中国疾病预防控制中心统计我国现存活hiv感染者/AIDS患者共483801例,其中hiv感染者293239例，AIDS患者190562例。

关键词：机会性感染特异性感染进展报告 hiv相关 MRI antiretroviral 鸡尾酒疗法多模态神经认知早期诊断

ColoPlus:基于牛初乳的一种可以缓解hiv相关性腹泻的新产品

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世界核心医学期刊文摘（胃肠病学分册） 2006年第12期2卷 59-59页

作者： Florén C.-H. Chinenye S. Elfstrand L. 沙焕臣 Department of Internal Medicine Lund University HospitalSE-22185 LundSweden Dr.

Objective.hiv-associated diarrhoea occurs in nearly all patients with acquired immunodeficiency syndrome(AIDS) in the developing countries.Diarrhoea is caused by the hiv-related immune dysfunction and is pivotal in the decrease of the helper T-cell(CD4+) population.Enteric pathogens in hiv-associated diarrhoea are,for example,Cryptosporidium,Amoeba and Campylobacter species.Bovine colostrum is the first milk the suckling calf receives from the cow.It is rich in immunoglobulins,growth factors,antibacterial peptides and nutrients.It supplies the calf with a passive immunity before its own active immunity is established.ColoPlus is a product based on bovine colostrum and is designed for slow passage through the gastrointestinal tract,as well as having a high nutritional value.The aim of the study was to investigate whether ColoPlus given orally can influence the severe diarrhoea associated with hiv infection.Material and methods.The study was carried out at Braithwaite Memorial Specialist Hospital,Port Harcourt,Nigeria.Thirty patients with hiv-associated diarrhoea were included in the study.The patients were treated with ColoPlus for 4 weeks in an open-labelled non-randomized study,after an observational period of one week.After a post-treatment period of another two weeks,treatment with anti-hiv drugs was started,if deemed appropriate.The effects on the frequency of stool evacuations per day,on body-weight,fatigue,haemoglobin levels and CD4+ counts before(week 1) and after treatment with ColoPlus(week 7) were measured.Results.There was a dramatic decrease in stool evacuations per day from 7.0± 2.7 to 1.3± 0.5(± SD) ,a substantial decrease in self-estimated fatigue of 81%,an increase in body-weight of 7.3 kg per patient and an increase in CD4+ count by 125%.Conclusion.ColoPlus may be an important alternative or additional treatment in hiv-associated diarrhoea.

关键词：牛初乳 ColoPlus hiv相关弯曲杆菌属细胞计数主动免疫生长因子免疫球蛋白血红蛋白

加巴喷丁治疗疼痛性hiv相关感觉神经病的安慰剂对照试验

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世界核心医学期刊文摘（神经病学分册） 2005年第4期1卷 35-35页

作者： Hahn K. Arendt G. Braun J.S. 江山 Department of Neurology Charité Campus Mitte Schumannstr. 20/21 D- 10117 Berlin Germany Dr

Background: Painful hiv- associated sensory neuropathies (hiv- SN) are a common complication of hiv infection. The pathogenesis is unknown and the treatment very limited. Gabapentin (GBP) is effective in painful diabetic neuropathy and postherpetic neuralgia and its effectiveness on painful hiv- SN has been reported anecdotally. Design: Multicenter, prospective, randomised, double- blind, placebo- controlled study. Methods: Patients were followed for a 1- week screening, a 4- week double- blind and a 2- week open treatment phase. GBP was initiated at 400 mg/d, titrated over 2 weeks to 1200 mg/d, and then either maintained at this level or - if not beneficial - titrated to 2400 mg/d. After 4 weeks the medication was unblinded and the patient had the choice to begin, to maintain or to increase GBP to 3600 mg/d. The primary outcome measure was an improvement in median pain on the Visual Analogue Scale (VAS) from the screening week compared to the 4th treatment week. A secondary efficacy measure was the median sleep score (VAS). Results: 15 patients received GBP and 11 placebo. In each group one patient dropped out during the double- blind phase. Median pain (GBP 5.1; placebo 4.7) and sleep score (GBP 4.5; placebo 5.6) did not differ between both groups at baseline. In the GBP- group there was a significant decrease of the pain to 2.85 (- 44.1 % ) as well as of the sleep VAS to 2.3 (- 48.9 % ). No significant decrease in the pain (median VAS = 3.3, - 29.8 % ) as well as in the sleep score (median VAS = 4.95, - 11.6% ) was observed in the placebo- group. GBP was generally well tolerated. The most frequent side effect was somnolence reported in 80 % of GBP- treated patients. Conclusions: GBP was more effective than placebo in reducing pain and sleep interference in patients with hiv- SN.

关键词： hiv相关疼痛性加巴喷丁安慰剂对照维持剂量睡眠障碍视觉模拟发病机制