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Objective To evaluate clinical features,therapeutic effects and outcomes of patients with non-human immunodeficiency virus(HIV)-infected cryptococcal meningitis treated with fluconazole or fluconazole and flucytosine.Methods Twenty-four cases of non-HIV-infected cryptococcal meningitis(fluconazole with or without flucytosine as initial therapy)in Huashan Hospital,Fudan University from 1997 to 2007 were retrospectively reviewed.Clinical manifestations,therapeutic effects and outcomes of the patients were collected.Results Fluconazole was administered with median dosage of 400 mg/d,for a median duration of 20.5 days.After fluconazole initial therapy for 2 weeks,16.7% showed partial response,83.3% showed no response,and the overall response rate was 16.7%.After 10 weeks,33.3% showed partial response,29.2% showed complete response,16.7% showed no response,and the overall response rate was 62.5%.Mortality at week 10 was 20.8%.Twenty-two patients who failed to respond to initial therapy were switched to other antifungal drugs(amphotericin B,amphotericin B colloidal dispersion,itraconazole)or other fluconazole containing combined therapy.Eleven out of the 24 patients died during one-year follow-up,8 of whom died of eryptococcal meningitis,and 3 died of other diseases.Conclusions The initial therapy of fluconazole with or without flucytosine is inefficient,and most of the patients need other antifungal drugs because of initial therapy failure.Therefore,fluconazole might not be appropriate for initial therapy in non-HIV-infected cryptococcal meningitis.
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Objective In order to investigate the synaptic plasticity in dentate gyrus after seizures and axonal and dendrtic sprout- ing induced by KA administration. Methods The density of synapses, the curvature forms of synaptic interface were studied under electron microscope. Results 1 .The density of the synapse is decreased obviously 3 days after KA injection, while the density of synapses is increased to control level 7 days after KA injection. 2. Compare with the curvation forms of synaptic interface of control animals and 3days after KA administration animals, the amount of smile synapses is significantly decresed and the amount of frown synapses is significantly increased in the moleculous layer of dentate gyrus 7 days after KA injection. Conclusions 1 .This result demonstrates that the axonal and dendritic sprouting of dentate granule cells is functional. 2. The increase of frown synapse is related to the release of glutamate of sprouting mossy fibers.
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AIM: To investigate the mRNA changes of L-type Ca~(2+) channel ?_(1C) subunit (CaL-?_(1C)) and Na~+-Ca~(2+) exchanger (NCX) in the atria of renovascular hypertensive rats. METHODS: Two-kidney one-clip Goldblatt hypertensive Sprague-Dawley rats were divided into three groups 1 week after operation, HD group was treated with 250 mg/d diltiazem, LD group was treated with 50 mg/d diltiazem, control group (C group) was treated with vehicle. After 4 weeks treatment, semiquantitative RT-PCR was used to estimate the mRNA changes of CaL-?_(1C) and NCX, and GAPDH was used as internal control. RESULTS: Systolic blood pressure in LD group was comparable with C group, and that in HD group was decreased to normal level after diltiazem treatment. In C group, CaL-?_(1C) mRNA level were 2.5, 2.4 and 2.1 times of S, HD and LD group, and NCX mRNA level were 1.9, 1.6 and 2.1 times of S, HD and LD group. There were no significant difference in the mRNA level of CaL-?_(1C) and NCX among S, HD and LD group. CONCLUSION: The mRNA levels of CaL-?_(1C) and NCX are upregulated in the atria of hypertensive rats. Ca~(2+) antagonist inhibits their upregulation independent of blood pressure.