Objective To study the accuracy of improved resistance index (RI) in judging the prognosis in renal allograft with reversed diastolic flow. Methods According to the transplant nephrectomy, patients with reversed diastolic flow in renal allograft were classified into two groups:surgical group (n = 5) and nonsurgical group (n = 19). The differences in improved RI between two groups were compared by using Student's t test. Improved RI was defined as a ratio of peak systolic velocity plus peak diastolic velocity divided by peak systolic velocity. Receiver operating characteristic (ROC) curve was constructed for improved RI to evaluate diagnostic accuracy in judging the prognosis in renal allograft with reversed diastolic flow. Results Improved RI in surgical group ( 1.57 ± 0. 26)was higher than in nonsurgical group (1.22 ± 0. 08) (P＜＜0. 05). Areas under ROC curve for improved RI was 0. 979. An improved RI threshold of 1.31 had 100 % sensitivity, 90 % specificity, 71%positive predictive value, and 100 % negative predictive value for renal allograft with reversed diastolic flow loss as the maximum Youden index was 90 %. Applying this cutoff value to predict the function of renal allograft with reversed diastolic flow recovery, the accuracy was 92 % (maximum) or 83 %(minimum). Conclusion Improved RI can not only serve as a useful noninvasive index to predict renal allograft with reversed diastolic flow loss, but also to predict the function of renal allograft with reversed diastolic flow recovery.

Objective To investigate the value of electroencephalogram(EEG), transcranial Doppler sonography (TCD), somatosensory evoked potentials (SEP) on evaluating brain function in coma patients. Methods The brain function in 72 cases of coma(mild coma 12,moderate coma 17,open eyes coma 4 and severe coma 39 cases) were examined using EEG,SEP ,TCD and scored. Results For the first time of exam, the results of EEG in 25 cases were electrical silence; no blood stream signalthe were found in 28 cases by TCD; the wave of P14 were disappeared in 26 cases by SEP and all of them belonged to severe coma group. For the second time exam, the results of finally EEG in 17 cases were electrical silence. The results of TCD in other 24 cases were surge waves and nail waves spectra eumorphism. Brain function grading: the EEG grade V in 42 cases, grade Ⅳ in 10 cases, grade Ⅲ in 14 cases were affirmed; TCD grade V in 28 cases, grade Ⅳ in 9 cases and SEP grade Ⅲ in 27 cases were affirmed. All the 28 cases of death and the most of 25 cases abandoned treatment for many reasons were belong to severe coma group. Conclusions The more severe of coma, the higher grade of EEG,TCD and SEP, the worse of prognosis. EEG,SEP,TCD testing can provide an objective indicator not only for evaluating brain function of coma patients, but aslo for estimating prognosis.

Objective To explore the value of somatosensory cortex evoked potential(CSEP)monitoring in objective evaluation of spinal cord function and integrity as well as prognostication of neural function after surgery.Methods CSEP monitoring was performed before the operation,during surgical procedure and after the operation in 56 spinal cord surgery patients to observe and analyze latency and amplitude of cortical potential.The significant changes were amplitude reduction≥150%or latency prolongation≥10%.Results There were 71.43%(40/56)true negative finding,both latency and amplitude without abnormal changes during the operation and without new neural functional deficit after operation.There was 0.18%(1/56)false negative finding,latency and amplitude without abnormal changes during surgical procedure,but with new neural functional deficit after operation.There were 26.79%(15/56)true positive findings,where latency transient prolongation<10%and amplitude reduction<50%during surgical procedure were observed.After suspending procedure or changing direction during surgical procedure,the waveform restored or improved.Conclusion CSEP monitoring during surgical procedure could reflect the sensitiveness to distracting,ischemia and injury of spinal cord.A timely intervention might improve the CSEP.CSEP could reflect the function and integrity of spinal cord.CSEP possess an important value in preventing spinal cord injury and evaluating the prognosis of neural function.

BACKGROUND:Studies have confirmed that the active ingredients ofPaeonia lactiflora Pal. have better inhibitory effects onCandida albicans, but its monomer paeoniflorin has not been reported whether it can inhibit Candida albicans biofilm. OBJECTIVE:To observe the effect of paeoniflorin onCandida albicans biofilm in vitro. METHODS:Paeoniflorin solution at different concentrations of 4, 2, 1, 0.5, 0.25 g/L was prepared using RPMI-1640 according to 2-fold dilution method. Chlorhexidine was diluted with RPMI-1640 to different concentrations, including 2%, 1%, 0.5%, 0.25%, 0.125%. We compared the effects of different concentrations of chlorhexidine and paeoniflorin on diameter ofCandida albicans by agar diffusion method. MTT assay was used to detect the effect of different concentrations of chlorhexidine or paeoniflorin on the celladhesion of Candida albicans as wel as their inhibitory effects onCandida albicans biofilms. Confocal laser scanning microscope and LIVE/DEAD BacLight Bacterial Viability Kits were combined to observe the changes ofCandida albicans biofilms under normal or intervention conditions. RESULTS AND CONCLUSION:Both chlorhexidine and paeoniflorin possessed bacteriostatic ability, and their bacteriostatic ring diameters were positively correlated with drug concentrations. Significant differences in the bacteriostatic ring diameter were observed between chlorhexidine and paeoniflorin, except between 2 g/L paeoniflorin and 1%, 2% chlorhexidine. Paeoniflorin at different concentration could inhibit celladhesion of Candida albicans as wel as inhibitCandida albicans biofilm. The inhibition rate was also positively correlated with drug concentrations. Under normal conditions, most of bacteria in the biofilms were alive, and there was a smal amount of dead bacteria after 48 hours. After intervention with paeoniflorin, the proportion of dead bacteria in the biofilms was increasing along with the concentrations of paeoniflorin. Compared with the chlorhexidine, paeoniflorin showed a lower bacteriostatic activity. These findings indicate that paeoniflorin has an obvious inhibitory action in Candida albicans biofilms in vitro.

JB25 and JB26 are new HIV-1 nonnucleoside reverse transcriptase inhibitors, and show potent anti-HIV activities. Sequential passage experiments with wild-type virus were performed to select and identify mutations induced by these two compounds in vitro. For the initial passage, compounds were present at approximately 2-fold IC50 in MT-2 cells. When cytopathic effect (CPE) was observed in more than 75% of the cells, the culture supernatants were collected. For the subsequent passages, fresh MT-2 cells were infected with 1 mL supernatants from the previous passage (regardless of the virus titer) and cultured in the presence of the compounds at concentrations that were increased 2-fold compared with that in the previous passage. This procedure was repeated with increasing concentrations for 12 passages. JB25 had amino acid substitution L100I (TTA-->ATA) at passage 6, and then changed into 100 M (ATA-->ATG) at passage 12, which was rare mutation form and had not been reported. At the same time, Y188C (TAT-->TGT) mutation appeared at passage 10. For JB26, there was a L100I (TTA-->ATA) mutation at passage 10. In a word, JB25 and JB26 showed a low genetic barrier to the development of resistance, and the resistance to JB26 developed slower than JB25. The mutations selected by JB25 and JB26 were mainly associated with codons 188 and 100 of HIV-1 reverse transcriptase.

Objective To evaluate CT characteristics of pulmonary sclerosing hemangioma(PSH) so that to improve the knowledgeof this disease.Methods CT characteristics of PSH pathologically verified were retrospectively analysed.Conventional scan andcontrast-enhanced scan were performed in all the patients.Results 14 lesions were in right lung,while 10 were in left,Diameters of these lesions ranged from 0.8 to 10 cm,and the average diameter was 3.08 cm.3 lesions were located in hilum of lung,while the rest(87.5%)were located in peripheral lung tissue.20 lesions were oval,and 4 were lobulated in morphology.21 lesions were smooth in edge.45.8% of the cases had calcification.All the lesions enhanced obviously on contrast-enhanced scan,and average CT value of(46.62?9.47) HU was increased.The dilated and distorted blood vessels could be detected in 2 large lesions.Conclusion On the basis of general benign tumor features, obvious enhancement and calcification are the characteristics of PSH on CT.

Human Immunodeficiency Virus Type 1 exists in vivo as quasispecies, and one of the genome's characteristics is its diversity. During the antiretroviral therapy, drug resistance is the main obstacle to effective viral prevention. Understanding the molecular evolution process is fundamental to analyze the mechanism of drug resistance and develop a strategy to minimize resistance. Objective: The molecular evolution of drug resistance of one patient who had received reverse transcriptase inhibitors for a long time and had treatment which replaced Nevirapine with Indinavir was analyzed, with the aim of observing the drug resistance evolution pathway. Methods: The patient, XLF, was followed-up for six successive times. The viral populations were amplified and sequenced by single-genome amplification. All the sequences were submitted to the Stanford HIV Drug Resistance Database for the analysis of genotypic drug resistance. Results: 149 entire protease and 171 entire reverse transcriptase sequences were obtained from these samples, and all sequences were identified as subtype B. Before the patient received Indinavir, the viral population only had some polymorphisms in the protease sequences. After the patient began Indinavir treatment, the variants carrying polymorphisms declined while variants carrying the secondary mutation G73S gained the advantage. As therapy was prolonged, G73S was combined with M46I/L90M to form a resistance pattern M46I/G73S/L90M, which then became the dominant population. 97.9% of variants had the M46I/G73S/L90M pattern at XLF6. During the emergence of protease inhibitors resistance, reverse transcriptase inhibitors resistance maintained high levels. Conclusion: Indinavir- resistance evolution was observed by single-genome amplification. During the course of changing the regimen to incorporate Indinavir, the G73S mutation occurred and was combined with M46I/L90M.

AIM: To study the roles and mechanisms of ERKs and intracellular free calcium in cardiomyocyte hypertrophic response induced by endothelin-1(ET-1). METHODS: (1) Neonatal rat cardiomyocyte hypertrophic response was assayed by measuring cell surface area and protein content; (2) ERKs activity was determined by Whatman Paper Filter method; (3) Intracellular free calcium concentration (［Ca2+］i) was measured using Fura-2/AM as a fluorescent indicator. RESULTS: (1) ET-1 could increase total protein production, surface area, ERKs activity and ［Ca2+］i in cultured cardiomyocyte in dose-dependent manner at concentrations ranging from 10-9 to 10-7 mol/L. And this effect could be abolished by BQ123, an antagonist of ETA receptor, partly inhibited by PTX, but not by BQ788, an antagonist of ETB receptor.（2）The activation of ERKs and the increase of ［Ca2+］i induced by ET-1 were obviously inhibited by PD98059, a selective ERKs kinase inhibitor, and nifedipine, a calcium channel blocker, respectively. Both antagonists partially inhibited ET-1-stimulated cardiomyocyte hypertrophic response. (3) Staurosporine, a selective PKC inhibitor, could inhibit ET-1-stimulated cardiomyocyte hypertrophic response and increase of ［Ca2+］i, but not affect the activation of ERKs. CONCLUSION: Cardiomyocyte hypertrophic response induced by ET-1 is mediated by ETA receptor coupled to PTX-sensitive G-protein, which involves at least two signalling pathways: PKC-mediated increase of ［Ca2+］i , and PKC-independent activation of ERKs.

Objective To clarify the serological characteristics and predictive value of HIV antibody indeterminant and to evaluate the efficiency of 3 assays to discriminate HIV antibody indeterminant.Methods Three hundred and ninety-four HIV antibody indeterminant serum samples were collected and the Western blot pattern were analyzed.Ninety-seven HIV antibody indeterminant individuals were followed up,and the development of HIV antibody were observed.The initial serum samples of 67 followed individuals were tested by viral load,line immunoblot assay and ELISA for HIV-1 p24,with the golden standard of follow up,the efficiency of 3 kinds of assay to discriminate HIV antibody indeterminant were evaluated.Results There were 38 patterns among 394 HIV antibody indeterminant,the proportions of env,pol and gag indeterminant were 37.54%,4.04%and 58.37% respectively.Five HIV antibody indeterminant cases were converted to HIV antibody positive among 97 followed individuals,they were all env indeterminant and HIV antibody developed rapidly.HIV viral load was an ideal assay to discriminate HIV antibody indeterminant with best sensitivity.Conclusion The indeterminant of gag were most common,but were unspecific reaction.Env indeterminant were with the greatest predictive value of HIV infection,especially the gp160p24 and gp160.Viral load assay can be applied to discriminate HIV antibody indeterminant.

CRP measurement on automated biochemistry analyzer. The method can be used in clinical diagnosis.