浙江省中医院艾滋病(浙江共用吸管感染艾滋)

时间2023-11-21 13:31:28发布小蚂蚁分类医疗保健浏览48

导读：一、浙江中医院违规操作致5名患者被感染艾滋,你怎么看舞茸β-葡聚糖对HIV（艾滋病）病人的效果Effects of Maitake(Grifola frondosa gulcan in HIV-infected patients【摘要翻译】...

一、浙江中医院违规操作致5名患者被感染艾滋,你怎么看

舞茸β-葡聚糖对HIV（艾滋病）病人的效果

Effects of Maitake(Grifola frondosa) gulcan in HIV-infected patients

【摘要翻译】

为评估一种从舞茸中提取的β-葡聚糖MD-Fraction（舞茸D-fraction）对艾滋病（HIV）感染病人的效果，进行了长期的实验。参与实验的HIV感染者被跟踪监测CD4+细胞计数，病毒载量，艾滋病感染症状，继发病状况，以及健康状态。20位患者的CD4+细胞计数增加到原来的1.4-1.8倍，8位患者降低到原来的0.8-0.5倍。9位病人的病毒载量增加，10位降低。尽管如此，85%的受试者对于HIV引起的症状和继发病的感觉变好，这表明舞茸D-fraction对于艾滋病HIV患者具有积极的影响。

关键词：抗HIV活性，CD4+细胞，舞茸，IL-2，MD-Fraction

注：CD4+细胞是人体免疫系统中的一种重要免疫细胞，由于艾滋病病毒攻击对象是CD4+细胞，所以其检测结果对艾滋病治疗效果的判断和对患者免疫功能的判断有重要作用。

【论文原文】

Effects of Maitake(Grifola frondosa) gulcan in HIV-infected patients

Hiroaki Nanba1)*, Noriko Kodama1), Douglas Schar 2) and Denise Turner 2)

1)Department of Microbial Chemistry, Kobe Pharmaceutical University, 4-19-1,

Motoyamakita-machi, Higashinada-ku, kobe 658-8558, Japan

2)Herbal Clinical Research, 140 Columbia Road, London E2 7RG, U.K.

The effects of MD-Fraction, aβ-glucan extracted from Maitake mushroom(Grifola frondosa)，on the health status of individuals suffering from HIV infection were evaluated in a long-term trial. The HIV status of the 35 respondents who participated in the study was followed by monitoring CD4+ cell counts, viral load measure, sympotoms of HIV infection, status of secondary disease, and sense of well-being. Twenty patients reported to increase in CD4+ cell counts to 1.4-1.8 times, and 8 patients reported a decrease to 0.8-0.5 times. Viral load was reported to increase in 9 patients and decrease in 10 patients. However, 85% of respondents reported an increased sense of well-being with regard to various symptoms and secondary diseases caused by HIV. These results suggest that Maitake D-Fraction had a positive impact in HIV patients.

Key Words:anti-HIV activity; CD4+ cell; Grifola frondosa(Maitake); IL-2; MD-Fraction

Acquired immune deficiency syndrome(AIDS) is caused by HIV infection, which attacks helper T cells(CD4+ cells) and decreases the body’s immunity. In 1991, we studied the effect of a Grifola frondosa S.F. Gray(Maitake) extract, named MD-Fraction on HIV, which is believed to be a cause of AIDS. Sulfated MD-Fraction was found to prevent HIV from killing helper T(CD4+) cells: almost 100% of CD4+ cells survived challenge by HIV at concentrations of sulfated MD-Fraction of around 1 pg/ml, and the results were presented in an abstract paper at the 8th International AIDS conference in Amsterdam in July 1992. National Institute of Health and National Cancer Institute in U.S.A. also confirmed the anti-HIV activity of the sulfated form of MD-Fraction. NCI doctors have recognized that the sulfated MD-Fraction is the most effective among all anti-HIV polysaccharides known to date and is as powerful as the drug azidothymidine(AZT). However, the sulfated MD-Fraction has the strong side-effect of toxicity to cells in vivo. On the other hand, we have reported that aβ1,6-glucan having aβ 1,3-branched chain(named MD-Fraction) can enhance immunocompent cell activities(Hishida et al., 1988; Nanba et al., 1987; Nanba et al., 1993).In this paper, we report that Maitake appears to work on several levels in HIV conditions, by(a) direct inhibition of the human immunodeficiency virus(HIV),(b) stimulation of the body’s own natural defense system against HIV, and(c) making the body less vulnerable to opportunistic disease.

Materials and Methods：

Preparation of Maitake tablets Tablets containing 250 mg of dried Maitake powder(φ200μm) and 5 mg of vitamin C were prepared with a tabloid machine.Preparation of MD-Fraction Dried Maitake powder(500 g) was autclaved with 3,000 ml of distilled water at 120℃for 60 min, and the water-soluble layer obtained was saturated with the same volume of ethanol at 4℃for 12 h. After removal of floating material, this ethanol solution was saturated to 80% with ethanol and stored at 4℃for 10 h. The pellet obtained by centrifugation at 5,000×g for 20 min was suspended in a small volume of distilled water and protein was removed by passage through a DEAE-cellulofine column(4×80cm). Finally 1 g of purified MD-Fraction was prepared.

Detection of virions The HIV genome is known to have nine genes, three expressing structural protein and six expressing regulating protein. Anti-HIV-Env antibody was produced in blood from 10 wk to 12 yr after HIV infection. The coagulation test of antigen was performed with HIV-Env antibody collected from blood. Viral loads were counted in 50-μl portions of patients’ serum.Detection of interleukin-2(IL-2) Production of IL-2 in blood was detected with IL-2 ELISA Kit Intertest-2X(Genzyme Co. U.S.A.)Counting of CD4+ cells and CD8+ cells CD4+ cells were counted by flow cytometric analysis after treatment of 10μl of blood with CD4+- monoclonal antibody(Cytovax Biotechologies Inc.) The count of CD8+ cells was obtained by subtracting the CD4+ cell count from the total count of T cells determined by flow cytometric analysis.

Administration of Maitake A supply of Maitake was given to each HIV carrier at a dose level of 6 g of tablets or 20mg of purified MD-Fraction together with 4 g of tablets per day for 360d.

Results：

The main focus in monitoring the progress of HIV disease is CD4+ cells(helper T cells). The normal range of CD4+ cell count is 500-1,200 cells/10μl of blood. A level of 200-500 cells indicates that some damage has occured. Below 200 cells, the individual is highly susceptible to secondary diseases. An elevated viral load indicates an increased risk of damage to CD4+ cells. The significance of these activities in regard to HIV infection relates to the immune system. Both IL-2 and interferon are activated by the immune system response to infection by viral disease. After administration of Maitake tablets for 12 mo to 35 respondents(24 in England and 11 in U.S.A.), 20 responders reported an increase in CD4+ cell counts and 8 reported a decrease, as shown in Table 1. Nine respondents reported an increase in viral load, 10 reported a decrease and 2 patients reported static, Typical individual results were as follows.

Patient A The initial CD4+ count of 90 cells rose as high as 460 cells(average CD4+ count: 355) in the study period, but viral load was undetected throughout. Previous symptoms were Kaposi’s sarcoma, pneumocystis carinii pneumonia, and allergic conjunctivitis, all of which resolved and remained controlled during study period. The patient consistently reported feeling very well and energy levels much improved.Patient B The initial CD4+ count of 400 cells rose to 620 cells after the treatment. The viral load of 15,200 copies/ml in CD4+ cells decreased to 5,000 copies/ml. IL-2 production was also increased 3.1 times by Maitake treatment. Previous symptoms were Kaposi’s sarcoma, verrucae, anal warts, anal herpes, diarrhea, chest infections, and fatigue. Following the study period, when the patient received 6 g of Maitake tablets together with 20mg of MD-Fraction per day, Kaposi’s sarcoma became static, verrucae and anal warts were resolved, and other symptoms became intermittent.

Patient C The initial CD4+ count of 510 cells showed little change at 500 cells after the study, but the viral load of 60,000 copies/ml in CD4+ cell decreased to 1,000 copies/ml. The patient had day and night sweats, bouts of colds, mucous membrane irritation and fatigue as previous symptoms, but after the course of Maitake all symptoms were resolved. In particular, a direct effect on the sweats was observed.Patient D The initial CD4+ count of 425 rose to 680 counts(average 513.3) during the study. The viral load of 20,000 copies/ml increased to 93,000 copies/ml, but skin, oral, and gastric Candida, catarrh, irritable bowel, and aching muscles as previous symptoms were all improved by Maitake.Patient E The initial CD4+ count of 17 cells decreased to 7 cells during the study, while the viral load of 55,000 copies/ml increased to 62,000 copies/ml. AIDS, oral Candida, and wasting disease as previous symptoms persisted despite the treatment with Maitake. The CD4+ cell counts and HIV viral loads of other patients who received Maitake for 1 yr are shown in Tables 2 and 3. It is known that long infection period of HIV makes seriously symptoms and secondary disease. Therefore, as shown in Tables 4 and 5, we examined that these symptoms and diseases were improved by Maitake treatment. Symptoms depends on HIV infection, such as weight loss, hair loss, night sweat, fever, dry cough and leg pain, were improved by Maitake almost in 50% of patients(as Table 4), also secondary diseases, such as toxoplasmosis, cryptococcosis, herps, kaposi’s sarcoma and mycopathy, were cured in 40-50% of patients. Table 6 indicates that the percentage of patients reporting changes in symptoms and sense of well-being following treatment.

Discussion：

The MD-Fraction exhibited an enhancing effect on CD4+ cells, the target cells of HIV, upon oral administration in animals(Hishida et al., 1988). Even though it was a non-controlled trial, this clinical study indicated that MD-Fraction and Maitake powder were effective in patients with breast cancer, lung cancer, or liver cancer. These human tests suggest that the active ingredients of Maitake have significant healing and preventative potential in HIV-responders by stimulating the immune system. The present study indicates that when MD-Fraction and Maitake enhanced the activities of immuno-competent cells such as macrophages, cytotoxic T cells(CD8+) or helper T cell(CD4+), the HIV in CD4+ cells was directly killed or its multiplication was suppressed. However, even if these cellular activities were increased by MD-Fraction, HIV in CD4+ cells of AIDS patients did not decrease. All of the results shown here indicate that there is evidence to support a more structured investigation in to the potential benefits of Maitake and MD-Fraction in the treatment of HIV infection. The results also indicate that this trial study needs to be done on a larger scales, as many questions remain unanswered.

Literature cited：

Hishida I., Nanba H. And Kuroda H. 1988. Anti-tumor activity exhibited by oral administeredextract from fruit body of Grifola frondosa(Maitake). Chem. Pharm. Bull. 36:1819-1827.

Nanba H., Hamaguchi A. and Kuroda H. 1987. The chemical structure of an anti-tumorpolysaccharide in fruit bodies of Grifola frondosa(Maitake). Chem. Pharm. Bull. 35:1162-1168.

Nanba H. and George S. R. 1993. Effects of Maitake(Grifola frondosa) for HIV-positive orfibroid tumor patients. 113th Congr. Pharmaceutical Society of Japan, Osaka, Japan, March29-31, p.212.

Nanba H.1993. Anti-tumor activity of orally administered D-Fraction from Maitake mushroomGrifola frondosa. J Naturopath. Med. 4: 10-15.

二、国家卫计委彻查“浙江中医院艾滋感染”事件是怎么回事

2月3日、12日，李斌先后主持召开专题会议，指出医疗安全关系群众生命健康，容不得半点麻痹疏忽。要本着对人民健康高度负责的态度，高度重视事件处置工作，加强对当地的指导和督促，组织专家细化诊疗方案，尽最大努力减少伤害。对负有责任的单位和人员绝不姑息，依法依规严肃处理和问责。并要求举一反三，正视问题，进一步加强全国医疗机构内部管理，严密制度，狠抓落实，严格规范操作。

具体情况：

国家卫生计生委高度重视浙江省中医院医源性艾滋病病毒感染事件。接报后，国家卫生计生委主任李斌等负责同志立即批示责成当地了解情况，查清原因，对患者迅速进行检测，及时采取应急预防措施，全力进行阻断和诊治，对责任人依法依规严肃处理。

专家认为，事件发生的主要原因是个别医疗机构及医务人员医疗安全意识缺失，医院感染防控管理制度不健全、制度规范落实不力，没有严格遵守技术规范和标准化操作规程开展诊疗工作。应当进一步落实医疗机构主体责任，完善管理机制，加强安全隐患排查，加大全员培训教育力度，切实保障患者健康权益。同时，国家卫生计生委办公厅和国家中医药局办公室分别向全国印发了《关于进一步加强医疗安全管理和风险防范工作的通知》。

2月7日，国家卫生计生委召开由全国各省、市、县三级卫生计生委相关工作负责同志和全国二级以上医院院长参加的视频会议进行部署。要求各级卫生计生行政部门和医疗机构切实提高医疗安全意识，深刻汲取教训，落实医疗安全质量主体责任，加强制度建设，突出管理重点，进一步加强医疗安全管理和风险防范工作。各级卫生计生行政部门和办医主体要切实履行监管职责，建立医疗安全责任追究机制，加大监管工作力度。同时，开展医疗安全专项整顿活动，针对质量、安全和服务中存在的突出问题和薄弱环节，全面整顿质量安全风险并持续改进，切实保障人民群众健康。

三、杭州艾滋病检查去什么地方

很多医院都能检查的

首推的当然是三甲医院了。

省人民医院：上塘路158号。三甲综合性医院，特色科室：心内科、骨科、泌尿科、普外科等。

省立同德医院：古翠路234号。中西医结合三甲综合性医院，特色科室：骨伤科、精神科、中医骨伤等。

浙江医院：灵隐路12号。三甲综合性医院。特色科室：老年医学、危重病医学、中医骨质疏松重点专科、颈椎病推拿专科、中西医结合重症感染专科、呼吸内科、消化内科等。

省肿瘤医院：半山桥广济路38号。三甲肿瘤专科医院。全国率先开展放射治疗、外科治疗、化学药物治疗质量控制和质量保证。

省中医院：邮电路54号。三甲综合性中医医院，特色科室：妇科、儿科、肾病科、肿瘤科、针灸科等。

浙医一院：庆春路79号。三甲综合性医院，特色科室：传染病学科、心胸外科、肝移植中心、骨髓移植中心、肾病中心、肛肠外科等。

浙医二院：解放路88号。三甲综合性医院，特色科室：心脏中心、脑外科中心、骨科中心、眼科、联合抗过敏中心、急诊中心等。

邵逸夫医院：庆春东路3号。三甲综合性医院，特色科室：内分泌科、神经内科、妇产科（生殖医学）、牙科、泌尿外科、骨科等。

省儿保：竹竿巷57号。三甲综合性儿童医院，特色科室：新生儿专业、小儿消化科、小儿心胸外科、儿童保健专业等。

省妇保：学士路1号。三甲专科医院，特色科室：妇科、围产医学、生殖内分泌科等。

省口腔医院：延安路395号。三甲专科医院，特色科室：整畸科、种植科、颌面外科、口腔修复科等。

市一医院：浣纱路261号。三甲综合性医院，特色科室：消化内科（内镜）、心血管内科、眼科、妇科、肾脏内科、血液内科。

市二医院：温州路126号。三甲综合性医院，特色科室：耳鼻咽喉科、心血管内科、颅脑外科。

市红会医院：环城东路208号。三甲综合性医院，中西医结合特色科室：风湿免疫肾病科、传染病学（结核病）、老年病科、消化内科、疼痛专科等。

市六医院：文晖路201号。三甲专科医院，特色科室：中西医结合肝病治疗重点学科、感染病治疗重点扶持学科、乙肝阳性孕妇母婴阻断重点专科。

市七医院：西溪路536号。三甲专科医院，特色科室：精神病学（行为医学）、心理科、精神科。

市中医院：体育场路453号。三甲综合性医院，特色科室：肾脏内科、中医妇科、推拿科、急腹症科、内分泌科、蛇伤专科、中西结合乳腺病专科。

四、杭州哪个医院可以检查艾滋病