【摘要】 目的 評價高效抗逆轉錄病毒療法（highly active antiretroviral therapy，HAART）對艾滋病患者的療效，并觀察其耐藥情況。 方法 2008年11月，對23例接受免費HAART治療1~3年的艾滋病患者的HIV-RNA病毒載量、HIV-1耐藥、CD4+T淋巴細胞絕對計數、常規生化檢測結果進行分析。 結果 23例艾滋病患者在HAART治療1~3年后有6例（26.1%）患者HIV-RNA載量在水平線以下，17例（73.9%）HIV-RNA載量未達到檢測線以下。5例患者（21.7%）的HIV-1發生了耐藥，服藥依從性良好的患者僅9例（39.1%）。 結論 HAART對艾滋病患者的療效較差、耐藥率高、服藥依從性差。【Abstract】 Objective To evaluate the efficacy of highly active antiretroviral therapy (HAART) in treating HIV, and observe the resistance of HAART in AIDS patients. Methods Twenty-three HIV patients receiving free HAART for one to three years were investigated. The plasma viral load, drug resistance to HIV-1, CD4+ T cell count were tested and routine laboratory examinations were performed in our study. Results After one to fhnee-year HAART treatment, HIV viral load of six patients (26.1%) declined to the undetectable level, while the viral load of 17 patients (73.9%) kept at a high level. Resistance to HIV-1 occurred in five cases (21.7%). Only nine patients (39.1%) had good treatment compliance. Conclusion HAART has a poor therapeutic effect on patients with HIV/AIDS with a high rate of drug resistance and poor treatment compliance.
A certain degree of varus alignment is physiological in the native knee, and alignment strategies such as kinematic and functional alignment permit residual postoperative varus. However, identical total varus angles may result from varying combinations of femoral and tibial varus, whose biomechanical implications for implant loading and ligament stress remain unclear. This study aims to investigate the biomechanical effects of different femoral–tibial varus configurations in total knee arthroplasty (TKA). Using combined geometric modeling and finite element analysis, TKA models with different varus combinations were constructed to evaluate changes in limb moment arms, polyethylene insert stress, and ligament forces during static knee flexion (0°–90°). Results demonstrated that a higher proportion of femoral varus, under equivalent total varus and flexion angles, led to reduced maximum polyethylene stress and decreased tension in the medial collateral ligament (MCL) and anterolateral ligament complex (ALL). Knee flexion angle had a more significant impact on polyethylene stress than varus: stress increased by approximately 2.48 times at 90° flexion compared to 0°, whereas 12° varus increased stress by only approximately 14%. The ALL experienced the greatest tensile load during flexion, indicating a key stabilizing role. In conclusion, optimizing the combination of femoral and tibial varus may help redistribute loads and improve implant longevity. This study reveals, from a biomechanical perspective, how different varus configurations affect stress distribution in the prosthesis and surrounding soft tissues, suggesting that intraoperative osteotomy strategies should comprehensively consider the combined alignment of the femur and tibia.