Objective To analyze the prevalence and diversity of genotype resistant mutations in 123 HIV/AIDS patients experiencing failure of high antiretroviral therapy (HAART) in Yunnan province.Methods A cross-sectional survey was conducted among 151 HIV/AIDS patients experiencing failure of antiretroviral therapy form January 2011 to January 2012 in Yunnan province.The HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR),the sequences were then submitted to the Stanford University HIV drug resistance database to analyze the prevalence of resistant mutations.The resistant mutations were statistically analyzed by gender,ethnic groups,transmission route and subtype,respectively.The chi-square or fisher's exact test was used for statistical test.Results Of the 151 cases,123 plasma samples were amplified successfully for protease PR (codon 1-99) and reverse transcriptase RT (codon 1-272) fragments.The most common mutation was M184 (72.4％),followed by the mutation at position K103 (47.2％),T215 (26.0％),D67 (15.4％),G190 (34.1％),Y181 (29.3％),K101 (17.1％).The frequency of mutations at position V75,A62 and M230 was higher in male population than that in female population (x2 =7.001,6.975,5.446,P ＜ 0.05).The frequency of variants at position Tl215,K70 and T69 was higher in the Han population than in the other ethnic population(x2 =5.290,4.060,3.860,P＜ 0.05).It was interesting that the variant M41L was rare in the other ethnic groups.The significant difference existed at various transmission routes.Frequencies of variants at position T215 and T69 were significantly higher among people infected HIV-I through sexual contact than the intravenous drug users (x2 =10.431,7.952,P ＜ 0.05).Frequencies of variants at position G190 were significantly higher among the intravenous drug users than the population infected HIV-1 through sexual contact(x2 =6.669,P ＜ 0.05),but the variant M230L never occurred in intravenous drug users.The RT mutations V75,T69,M230 were more frequently occurred in patients infected with CRF01_AE than in patients with subtype B (P＜ 0.05).The mutation L74 was never seen in patients infected with CRFOI_AE (P ＜ 0.05).Conclusions The HIV/AIDS patients with failure of high antiretroviral therapy (HAART) were attributed to HIV-1 genotype resistance mutations.The mutation sites among the HAART failure patients from the regions of Dehong,Gejiu,Wenshan and Yuxi were significant difference accordance among the gender,ethnicith,transmission route and subtype,respectively.

This study demonstrates that nerve growth factor (NGF) plays a protective role in myocardial infarction and early reperfusion by reducing the myocardial cell apoptosis and by improving ventricular remodeling and seeks to assess the effects and mechanisms of NGF on late reperfusion after myocardial infarction. The models of late reperfusion were established by ligating the left main coronary artery and then cutting the suture 2 hours after coronary artery ligation. The rats in NGF treatment group were injected 10 µL Ad-NGF (by constructing the adenovirus vector Ad-NGF containing NGF gene) at four locations around infarction. The rats in adenoviral vector (Adv) group were injected 10 µL adenoviral cector as the NGF group. The late reperfusion group and the sham group were given normal saline as above, and the sham group underwent thracotomy without coronary ligation. On the 3rd, 7th, 14th and 28th day after operation, we investigated the role of NGF on late reperfusion by recording cardiac structure and function with echocardiography, by examining the expression of NGF and VIII factor with immunohistochemical method, and by evaluating the myocardial cell apoptosis with terminal dUTP nick end-labeling method (TUNEL). We found that the NGF group had higher expression of NGF protein (P < 0.01) and lower apoptosis index (AI) (P < 0.01 or P < 0.05) compared to the late reperfusion group and Adv group on all time points. The NGF group had remarkably higher level of neovascularization compared to the late reperfusion group on the 14th day (P < 0.01) and the 28th day (P < 0.05). The NGF group also had higher LVEF and FS levels compared to the late reperfusion group on the 14th day (P = 0.006, P = 0.006) and on the 28th day (P = 0.000, P = 0.000). Whereas the NGF group had lower LVEDD, LVESD (P = 0.038, P = 0.000) and lower LVEDV, LVESV (P = 0.001, P = 0.000) on the 28th day compared to late reperfusion group. In this experiment, the NGF gene carried by adenovirus vector had been transfected and obviously increased the expression of NGF protein in NGF group. NGF may help postpone the myocardial remodeling and improve the heart function by promoting the myocardial neovascularization and inhibiting myocardial apoptosis.
Adenoviridae ; Animals ; Apoptosis ; Disease Models, Animal ; Echocardiography ; Genetic Therapy ; Myocardial Infarction ; therapy ; Myocardium ; pathology ; Myocytes, Cardiac ; cytology ; Nerve Growth Factor ; pharmacology ; Rats ; Reperfusion Injury ; therapy

Objective To investigate the clinico-pathological characteristics of nodular goiter (NG) with lymphocytes infiltration and its relationship with Hashimoto′s disease. Methods Clinical and histologic data were collected and reviewed for 1121 cases of nodular goiter and 55 cases of thyroid adenoma, among which 83 cases had lymphocytes infiltration. These 83 cases of NG with lymphocytes infiltration were observed histologically in detail, followed up and assessed for the correlation of thyroid function to histologic findings. Results The overall incidence of lymphocytic infiltration in non-toxic nodular goiter was 7.4% (83/1121). Most of them were women of middle age. All had lymphocytes infiltration, follicule atrophy and oxiphilic epithelia in the background of nodular goiter. Seventy-six percent underwent cystic degeneration or had fibrous scar. Nineteen percent with lymphocytes infiltration in NG developed post-operative hypothyroidism. Six cases (7%) had high levels of thyroid auto-antibodies. None of the 55 cases of thyroid adenoma had overt lymphocytes infiltration. Conclusion Nodular goiter with lymphocytes infiltration and Hashimoto′s disease shares similar morphology and clinical presentation in some degree. It seems that NG with lymphocytes infiltration is a kind of inflammatory hyperplasia relating to autoimmunity and perhaps the beginning of some cases of Hashimoto′s disease.

Objective To investigate the risk factors for coronary artery lesions (CALs) in children with Kawasaki disease (KD) in Lanzhou. Methods One hundred and seventy-four children with diagnosed KD were divided into CAL group and non-CAL group based on the existence of concurrent CALs. The age, gender, fever duration, intravenous immunoglobulin (IVIG) start time, IVIG dose, C-reactive protein (CRP), serum albumin, erythrocyte sedimentation rate (ESR), platelet (PLT), red blood cell count (RBC), hemoglobin and so on were compared. Results Among the 174 children, 46 children (26.44%) were complicated by CALs and 128 children were not. The differences of average fever duration, IVIG starting time, IVIG dose, PLT, CRP, ESR and RBC were statistically signiifcant (P<0.05). Conclusions When KD children has the fever durations>10 d, start of IVIG af-ter 10 days of fever, increase of PLT, CRP and ESR and decrease of RBC, clinicians should be alert to the risk of concurrent CAL.

ObjectiveTo investigate the imaging characteristics of solitary fibrous tumor(SFT).MethodsThis study included 11 cases with SFT proved by pathological results.The imaging manifestations were retrospectively reviewed and analyzed in comparison with surgical and pathological results. Among them,8 patients underwent CT plain scan (1/8) or enhanced scan (7/8),4 patients underwent MR plain scan (2/4) or enhanced scan (2/4),and only 1 patient underwent both CT and MR scan.Results( 1 )SFT were located in the thoracic cavity(2/11 ),abdominal and pelvis(5/11 ),and somatic soft tissues (4/11 ).The average tumor size was 11.8 cm ( 2.5 to 23.0 cm).Among them,4 tumors were round or ellipse,and 7 tumors were irregular.Eight tumors had well-defined contours,and the others showed illdefined contours.(2)On CT scan,all SFTs showed inhomogeneous density with low density areas.Calcification was seen in I case,and hemorrhagic foci were detected in 2 cases.(3)On MR scan,all SFTs showed intermediate signal intensity on T1 WI.Three tumors were slightly hyperintense and the other was hypointense on T2WI.All of them were rich of vascular signal voids.Three tumors,including 2 tumors with scattered long T1 and T2 signal and 1 tumor in the liver with hyperintense haemorrhage,displayed inhomogeneous mixed signal.One tumor in the orbit showed homogeneous signal.(4)On enhanced scan,9 tumors showed irregular enhancement with multiple circuitous vessels in the arterial phase,and continuous or progressive enhancement with patch non-enhanced areas in the venous phase.( 5 ) Histologically,SFTs were composed of juxtaposed hyper- and hypo-cellular spindle cells,dense collagenous stromas and numerous thin-walled blood vessels with a staghorn configuration.Conclusion The possibility of SFT should be considered when a single soft tissue mass with sharp border,inhomogeneous density is detected,especially with inhomogeneous enhancement maintaining in the venous phase.

OBJECTIVE To investigate the epidemic situation of vertical dissemination of the Escherichia coli(ECO) and Klebsiella pneumoniae(KPN) isolates producing extended-spectrum beta-lactamases in the hospital.METHODS The fingerprints of the isolates were obtained by pulsed-field-gel-electrophoresis(PFGE),and were analyzed with software Quantity One.RESULTS The similarity of 10 isolates and 7 isolates among the 21 ECO(isolates) from ICU was more than 90%,and 100%,respectively;the similarity of 3 KPN isolates was 100%.The similarity of 9 isolates among the 20 ECO(isolates) was more than 90% and the similarity of 4 isolates among the 6 KPN isolates was more than 90% in the neurosurgery ward.The similar coefficients of 3 isolates and 2(isolates)(among) the 10 ECO isolates from the ward for cadre were more than 90% and 100%,(respectively.) The similar(coefficients) of 2 isolates among the 7 ECO isolates from the gastroenterology ward and 2(isolates)(among) the 18 ECO isolates from the respiratory ward were more than 90%.The isolates whose similarity was more than 90% were also found in other wards.CONCLUSIONS There are vertical disseminations of single clone of ESBL-producing organisms in several wards,especially in the ICU.It is necessary to strengthen the management of(infection)-control.

Objective To investigate clinical features and risk factors for recurrent syncope in children with orthostatic intolerance.Methods Patients with orthostatic intolerance and syncope admitted in the Second Hospital of Lanzhou University from January 2014 to June 2015 were retrospectively analyzed by using t test,Chi -square test,and Fisher′s exact probability method.According to frequency of syncope,all cases were divided into 2 groups,the occasio-nal syncope group and the recurrent syncope group.All risk factors including age,gender,body mass index(BMI),in-ducement,the history of motion sickness,family history,syncope -related injuries,performance of head -up tilt table test,and outcomes of head -up tilt table test were studied statistically and compared within 2 different groups.Results A total of 83 cases were enrolled in this study.Among these children,33 cases(39.76%)were assigned as occasio-nal syncope group,in which 17 cases were male and 16 cases were female and the age ranged from 6 to 18 years with the average age of (9.70 ±2.87)years;50 cases(60.24%)were assigned as recurrent syncope group,in which 27 ca-ses were male and 23 cases were female and the age ranged from 6 to 18 years with the average age of (11.24 ±2.83) years.Of all the investigated risk factors,the BMI and the history of motion sickness were significantly different between 2 groups[(18.84 ±3.49)kg/m2 vs (18.16 ±3.68)kg/m2 ,t =4.82,P =0.001;39.39%(13 /33 cases)vs 70.00%(35 /50 cases),χ2 =7.64,P =0.006].No significant difference was found in age distribution(6 -9 years,10 -14 years,15 -18 years)between 2 groups(P =0.428).There were no significant differences in gender (male /female), family history,or syncope -related injuries between 2 groups[17 /16 cases vs 27 /23 cases;3.03%(1 /33 cases)vs 10.00%(5 /50 cases);15.15%(5 /33 cases)vs 20.00%(10 /50 cases),all P >0.05].And no significant difference was found in inducement (prolonged standing,body posture change,emotional stress/emotional stimuli,muggy environ-ment,movement)between 2 groups [78.79% (23 /33 cases)vs 72.00% (36 /50 cases);9.09% (3 /33 cases)vs 14.00%(7 /50 cases);3.03%(1 /33 cases)vs 6.00%(3 /50 cases);12.12% (4 /33 cases)vs 10.00% (5 /50 cases);3.03%(1 /33 cases)and 12.00%(6 /50 cases),all P >0.05].And performances of head -up tilt table test (blurred vision/blacked out,nausea/vomiting,sweating,dizzy/headache,palpation,anhelation /chest tightness,hot, weak)between 2 groups showed no significant differences[18.18%(6 /33 cases)vs 12.00%(6 /50 cases);36.36%(12 /33 cases)vs 50.00%(25 /50 cases);24.24%(8 /33 cases)vs 26.00%(13 /50 cases);51.52%(17 /33 cases) vs 58.00%(29 /50 cases);6.06%(2 /33 cases)vs 16.00%(8 /50 cases);27.27%(9 /33 cases)vs 22.00%(11 /33 cases);33.33%(11 /33 cases)vs 32.00%(16 /50 cases);12.12%(4 /33 cases)vs 16.00%(8 /50 cases),all P >0.05].Also there were no significant differences in outcomes of head -up tilt table test between 2 groups(P =0.589). Conclusions The risk factors for recurrent syncope in children with orthostatic intolerance were low BMI and the his-tory of motion sickness for such children,and more positive and effective clinical intervention can improve the living quality of children with orthostatic intolerance to some extent.

Objective To explore the levels of neuron-speciifc enolase (NSE) of the cerebrospinal lfuid (CSF) in children with convulsion. Methods Ninety children with convulsion were enrolled. According to the frequency of convulsion attack, the children were divided into brief convulsion group 51 cases and prolonged convulsion group 39 cases, further, based on the etiology, the children were divided into viral encephalitis (VE) group, idiopathic epilepsy (EP) group, and febrile convulsion (FS) group. CSF was collected within 24-48 h convulsion attack. Twenty-three children with elective surgery were selected as a control group. CSF was collected before surgery. The NSE level of CSF were measured by ELISA method and compared among groups. Results The NSE levels of CSF in prolonged convulsion group and brief convulsion group were signiifcantly higher than that in control group, while the NES levels of CSF in prolonged convulsion group were signiifcantly higher than that in brief convulsion group (all P<0.05). Among the prolong convulsion group or the brief convulsion group, the VE group had the highest NSE level of CSF, which was signiifcantly higher than EP group and FS group (all P<0.01), and the difference between EP group and FS group was not statistically signiifcant (P>0.05). Conclusions Convulsion contributed to higher NSE levers of CSF, especially in children with prolonged convulsion attack or with VE. The NSE level of CSF can be regarded as an early objective indicator of brain damage after convulsions.

Objective To investigate the value of induction chemotherapy in the treatment of stage N2.3M0 nasopharyngeal carcinoma with plasma Epstein-Barr virus (EBV) DNA＞4000 copies/ml.Methods A retrospective study was performed on clinical data from 210 patients with stage N2-3M0 nasopharyngeal carcinoma and plasma EBV DNA＞4000 copies/ml who were admitted to our hospital from 2009 to 2013.In the 210 patients,101 received induction chemotherapy plus concurrent chemoradiotherapy (NCRT) and 109 concurrent chemoradiotherapy alone (CCRT).The survival rates were calculated by the Kaplan-Meier method.The log-rank test was used for the analysis of survival rates and univariate analysis of the impacts of the changes in the plasma EBV DNA level after induction chemotherapy on the prognosis.Results The 3-year sample size was 154.The NCRT group had significantly higher 3-year disease-free survival (DFS) and distant metastasis-free survival (DMFS) rates than the CCRT group (80.1％ vs.70.6％,P =0.029;87.1％ vs.76.0％,P=O.036),while there was no significant difference in 3-year overall survival (OS) rate between the two groups (88.0％ vs.80.4％,P =0.210).Patients with stage N2 disease in the NCRT group had significantly higher 3-year DFS and DMFS rates than those in the CCRT group (P=O.031,O.014).Patients with stage N3 disease in the NCRT group had significantly higher 3-year OS,DFS,and DMFS rates than those in the CCRT group (P=0.029,0.012,0.019).In all the patients,the 3-year OS and DMFS rates were improved with the increase in the cycle number of induction chemotherapy (P =0.020,0.021).In the NCRT group,patients treated with 2,3,and 4 cycles of induction chemotherapy before radiotherapy had plasma EBV-DNA clearance rates of 51.85％,76.92％,and 88.57％,respectively (P=0.004).Using the complete clearance of plasma EBV-DNA as a predictor of progression,the sensitivity for the above three groups was 62.50％,66.67％ and 75.00 (P=0.910),respectively,and the specificity was 57.89％,90.00％ and 96.77％ (P=0.000),respectively.Conclusions In the treatment of nasopharyngealcarcinoma with plasma EBV DNA ＞ 4 000 copies/m1,induction chemotherapy improves DFS and DMFS inpatients with stage N2-3 M0 disease and OS in patients with stage N3 disease;induction chemotherapy dose not improve recurrence-free survival rate.The prognosis and plasma EBV DNA clearance rate are improved with the increase in the cycle number of induction chemotherapy.Using the complete clearance of plasma EBV DNA as a predictor of progression,the sensitivity and specificity in patients treated with 4 cycles of chemotherapy are superior over those in patients treated with 2 or 3 cycles of chemotherapy.

ObjectiveToinvestigatetheriskfactorsforunfavorableoutcomeinpatientswithminor ischemic stroke. Methods Patients with minor ischemic stroke were enroled prospectively. The modified Rankin Scale ( mRS ) w as used to assess the clinical outcome at day 90 after onset, and mRS 0-2 w as defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group w ere compared. Multivariate logistic regression analysis w as used to identify the independent risk factors for early poor outcome in patients w ith minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enroled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95%CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95%CI 1.177-2.347; P=0.004), limb movement disorder ( OR 2.430, 95%CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95%CI 1.188-7.221;P=0.020), early neurological deterioration ( OR 50.994, 95%CI 17.659-147.258; P<0.001), infarct diameter ( OR 1.279, 95%CI 1.075-1.521; P=0.005), non-responsible vascular stenosis ( OR 2.518, 95%CI 1.145-5.536;P=0.022), and large artery atherosclerotic stroke ( OR 2.010, 95%CI 1.009-4.003; P=0.047) w ere the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated w ith age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided.