浙江中医院违规操作致5名患者被感染艾滋，你怎么看？
1月26日，浙江中医院一名技术人员违反“一人一管一抛弃”操作规程，在操作中重复使用吸管造成交叉污染，导致部分治疗者感染艾滋病病毒，造成重大医疗事故。经疾控机构检测，确诊5例。目前公安机关已立案侦查。
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, a β-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 a β1,6-glucan having a β 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(φ200 μm) 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 10 μl 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 administered extract 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 or fibroid tumor patients. 113th Congr. Pharmaceutical Society of Japan, Osaka, Japan, March 29-31, p.212.
Nanba H.1993. Anti-tumor activity of orally administered D-Fraction from Maitake mushroom Grifola frondosa. J Naturopath. Med. 4: 10-15.
可是中国医院里面的服务情况，并不是全部都会好转起来，总有极个别的医院依旧在侵害老百姓的利益，甚至侵害老百姓的生命。最近的消息是我感到很难过，因为消息里面说浙江中医院违规操作致5名患者被感染艾滋，这样的事情真的叫人觉得气愤，对于这种医院国家应该彻底的进行清理和查处了。
这件事情的性质十分严重，艾滋病是一种可怕的病症，几乎没有任何的治疗方法，得病的患者会慢慢的失去生命，他们们的人生会在这一次的事件中变得黯淡无光，这些人只是普普通通的老百姓，都有自己的家庭和事业，现在他们的遭遇是很悲剧的，我觉得社会必须给予他们关心和爱护，保证他们的权益。
这家医院因为使用交叉的医疗用品，根本不顾医院患者的身体健康，这才造成现在这样的悲剧发生，医院的领导和医院的工作人员，他们都有基本的医疗知识，更明白这样做的后果，但是为了自己的利益，他们什么事情都可以干出来，如果这样的人不接受最严厉的法律处罚，那么就太不公平了。
国家应该通过这件事情，认真的进行总结，对于这件医疗事故的严重性，必须做出总结。同时国家相关部门要对这家医院的领导和工作人员进行逐步的审查，对于责任人必须要严惩不贷。因为医院的这种行为严重的危害到患者的生命，给社会造成的影响也是巨大的，当事责任人的行为，可以说毫无人性，如果不给严厉的惩罚，那么真是无法向社会大众交代了。
染上艾滋病对于这五名病人来说无异于晴天霹雳，可能他们都可以有光明的未来，可是这样的差错却导致他们一辈子都必须活在艾滋病的阴影下，因为艾滋病目前只能控制，没有办法治愈。
他们没办法结婚生子，包括工作几乎都是不可以进行的，给家庭和家人造成的伤害也是一辈子都无法弥补的。
以前的医疗不发达，很多地方卖血的时候都会多次使用针管，而今这种简陋的操作早就应该废弃了，可是为什么这位医生会多次使用导致五名患者都被感染了呢？要说他是不小心的，我没有办法相信，如果是忘记了，可能会使某一个患者被使用用过的针管，而不是同时五个都这样。而医院又不是他开的，根本就没有必要“节约”针管啊。所以这个案件对于医生的这方面操作还是必须要严查的，找出他到底为什么这样做。
医生这个职业繁忙，我们可以理解，但是真的做不到容忍出错，不是我们心胸不够宽广，而是因为这不是一般的职业，其他职业如果出错误很多是可以补救，如果医生出错了，那么伤害的不是事情，而是人命。生命是每一个人都所珍视的，怎可以儿戏呢？
就拿我个人来说，每年我都要去献两次血，刚开始我爸妈是不太同意的，因为说实在献血也有一定的风险性，万一导致身体虚亏呢？而且更担心是就是献血的时候操作不合理，万一不小心用重复了针管呢？或许我也会遭受到这样恐怖的事情，所以每位医生都请你们要有足够的耐心和足够的细心，选择了这个职业，就请为患者负责吧！
一人一管一抛弃，这样的操作流程，即使是普通人也应该知道吧。到底是什么原因让医院竟然敢一管交叉使用呢？这简直就是谋财害命呀。一管交叉使用的危害，不要是医护人员可以预见，就是平民老百姓也知道这样是不幸的。即使现在不出事，将来一定也会出事的。医院这样完全是草菅人命，不顾他人的死活，只为了这一丁半点的利益，希望有关部分彻查，把相关责任人查办，给这些可怜的患者一点交代。
为今之计，有关部门一定要彻查此事，责令医院整改，把相关责任人不管官位多高一律查办，给患者一个说法，并让医院给患者足够多的补偿，虽然再多的补偿也没用了，但生活总归要继续。医院这种关心人身家性命的地方，真的容不得一丝一毫的杂志。
作为医务工作者，应该具备专业的医疗基本知识。竟然重复使用吸管造成交叉污染，导致了感染，犯下如此低级的错误，让患者受到身心的伤害，严重违背了职业道德素质，实在是不应该发生的。尽管医生每天都在面对着生死的画面，但是更不能懈怠了每一名患者，拿别人的生命开玩笑，一个小小的错误，都是会引发起“人命关天”的大事情，马虎不得的。
在医患关系，如此紧张的时候，各种质疑的声音，经常会有听闻到。我们该拿什么来换取医患之间相互的信任呢？患者把生命，把信任交给了医生，必然应该得到尽心尽力的医治，因为每个人，都充满了对生的渴望，对生活的留恋，对生命的延续，生命的意义就在于此。当医患关系上升为了社会问题，人人都应该关注重视起来，深刻的思考一番。
希望在这次事件发生的背后，相关的部门，应该高度重视并引以为戒。不要让悲剧再次发生，五名患者，关系到了五个家庭的悲剧命运，家人们该有多难受啊，后续还要面对漫长的治疗过程，各种社会舆论的压力，难以想象，愿他们可以坚强的挺过去。