Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.

Objective To investigate the relationship among the average checking time of biochemistry results ,mental health of biochemistry results checkers and the rate of medical complains .Methods 258 biochemistry results checkers from 17 hospitals of Guangdong were tested by using symptom checklist(SCL‐90) ,biochemistry results checking time questionnaire and medical com‐plaints questionnaire .Results Compared with the national model data ,the mental health levels of biochemistry results checkers were worse relatively .The mental heath did not have gender difference ,however ,female checkers were significant worse than males in horror .The mental heath didn′t have gender difference between secondary and advanced technicians .However ,the junior techni‐cians were significant worse than technicians of other levels in obsession ,somatization ,anxiety ,depression and horror .The average checking time of biochemistry results was correlated with mental health of biochemistry results checkers .The average checking time of biochemistry results had relationship with the rate of medical complains .Conclusion The mental health conditions of biochemis‐try results checkers are bad .No mental health difference exists in gender .The junior technicians′mental heath are significant worse than secondary and advanced technicians .There are some relationships between the average checking time of biochemistry results , mental health of biochemistry results checkers and the rate of medical complains .

Objective To study the direct immunofluorescence method for rapidly detecting influenza A virus antigen and its clinical application .Methods The inpatients with clinically diagnosed acute respiratory tract infection were selected .Two hundred samples were collected and divided into two groups :the winter and spring epidemic seasons children group and the summer and au‐tumn non‐epidemic seasons children group ,100 cases in each group .The US D3 Ultra influenza A virus antigen detection reagent was used .The fluorescence labeled monoclonal antibody was adopted to detect influenza A virus antigen in the patients with cold . Results During the winter and spring seasons of influenza prevalence ,8 cases of 100 detected cases were positive with the positive rate of 8% ;during the summer and autumn seasons of non‐influenza prevalence ,2 cases of 100 cases were positive with positive rate of 2% ,the difference in the positive rate between the two groups had statistical significance(P<0 .05) .Conclusion Applying the direct immunofluorescence method for rapidly detecting influenza A virus antigen is an economical ,efficient ,rapid and specific detec‐tion method ,and can guide clinical rapid diagnosis and rational medication .

ABSTRACT:Objective To investigate the distributional characteristics of anaphylactogens in prurigo nodularis (PN)patients so as to provide clinical basis for selecting the method of allergy test.Methods We divided 262 PN patients into four groups and then used skin-prick (5 4 patients ),skin-patch (5 0 patients ),serum IgE allergen detection (56 patients)and serum IgG allergen detection (102 patients)to analyze anaphylactogen positive rate and their distribution differences in PN.Results For skin-prick test in 54 PN patients,the detection rates of platanus orientalis,artemisia argyi,poplar,dust mite,dirt mite,cod,peanut and tomato were higher than those in the control group (P<0.05 ).For skin-patch test in 50 PN patients,the detection rates of nickel sulfate,flavor compounds,black rubber,and carba mix were higher than those in the control group (P<0.05).For serum IgE test in 5 6 PN patients,the detection rates of house dust,scandent hop,cat/dog hair,bug,penicillium/neurospora and mutton were higher than those in the control group (P<0.05).For serum IgG test in 102 PN ones,the detection rates of crab,shrimp,beef and cod were higher than those in the control group (P<0.05).Conclusion Skin-prick test and serum IgE detection have high application values in PN patients.Serum IgG detection is of certain importance in adjusting PN patients’diet structure while skin-patch test applied in PN needs further exploration.

Objective:To investigate cytokine(TNF-?,IL-1) effect on apoptosis and express of related protein in thyrocytes and the relationship with pathogenesis in Graves' disease(GD).Methods:To test thyroid tissues from 50 patients with GD Fas expression by immunohistochemical method.Thyroid tissues were collected from samples of GD operation and were cultured by primary culture method.Content of sFas in culture medium was tested by ELISA.Fas/sFas mRNA were tested by RT-PCR.Cytokine inducing apoptosis in Graves' disease showes observation group,normal people showes control group.Results:Compare apoptosis culture rate there is significant difference(P

Objective To investigate the resistance of clinical isolates from Yuebei People’s Hospital so as to provide the ref-erence for clinical use of antibiotics.Methods To comprehensively analyze the drug resistance,AST was performed with K-B or MIC method to 2 527 strains of clinical isolates and the data were analyzed by WHONET 5.4 and SPSS19.0 softwares according to the breakpoints of CLSI 2012 standard.Results MRSA accounted for 30.9% in Staphylococcus aureus iso-lates,MRCNS accounted for 76.2% incoagulase negative Staphylococcus isolates ,no detection of vancomycin or linezolid re-sistant strains.The antimicrobial drug resistance of Enterococcus faecium was significantly higher than that of Enterococcus faecalis ,no detection of glycopeptide and linezolid resistant strains in Enterococcus faecalis ,but one linezolid resistant strains and two teicoplanin resistant strains in Enterococcus faecalis .Enterobacteriaceae remain highly sensitive to carbapen-em antibiotics,ESBLs produced strains in Escherichia coli ,Klebsiella pneumoniae were 43.9% and 37.5% respectively,five polymyxin B resistant strains were detected in Pseudomonas aeruginosa ,and 63.7% of MDRO rate in Acinetobacter bau-mannii .Conclusion Drug resistance of clinical pathogenic bacteria remain seriously in hospital,clinical application of antibi-otics should be reasonable based on the result of drug sensitivity.

Objective To investigate the relations between adiponectin(APN) and lipoprotein associated phospholipase A2 (LP‐PLA2) with the development and progress of essential hypertension .Methods 60 patients with essential hypertension were collect‐ed and divided into 3 groups of the hypertension grade 1 ,2 ,3 groups according to the levels of blood pressure ,20 cases in each group .Contemporaneous 20 healthy controls were selected .The peripheral venous blood samples were collected from the cubital vein and the serum levels of APN and LP‐PLA2 were measured by ELISE .The related biochemical indicators were simultaneously detected .Results The serum APN levels in the hypertension grade 1 ,2 ,3 groups were significantly lower than that in the control group ,moreover which in the hypertension grade 3 group was significantly lower than that in the hypertension grade 1 group(P<0 .05);on the contrary ,serum levels of LP‐PLA2 in the hypertension grade 1 ,2 ,3 groups were significantly higher than that in the healthy control group ,moreover which in the hypertension grade 3 group was obviously higher than that in the hypertension grade 1 group(P<0 .05);serum APN was significantly negatively correlated with LP‐PLA2(r= -0 .772 ,P<0 .05) .Conclusion Serum levels of APN and LP‐PLA2 are closely related with the development and progress of essential hypertension .

Objective To evaluate the clinical value of MRA on the abnormal vessels in Moyamoya and cerebral revascularization , and to evaluate PWI in the observation of cerebral hemodynamics before and after cerebral revascularization.Methods Twenty-four patients with Moyamoya disease ascertained by DSA received cerebral revascularization on one side.MRA and PWI were performed for all patients before and after the operation , while DSA was performed after operation in nine patients to compare the images of MRA and DSA by three experienced radiologists.Perfusion parameters in terminal branches of middle cerebral artery ( MCA) on the operative side were compared with those on the contralateral sides and the cerebellum , including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and delay time ( DT) , as well as relative ratio ( values on the operative side/values on the contralateral side , and values on the operative side/values on the cerebellar region ) of perfusion parameters (rCBF, rCBV, rMTT and rDT) were calculated.Comparisons of the data between different groups were performed using paired Student′s t test.Results MRA was similar to DSA in displaying the internal carotid artery , main branches stenosis, Moyamoya vessels, and cerebral revascularization.DSA was better in displaying collateral vessels than MRA, but primary images of MRA provided anatomic and pathologic information of cerebral parenchyma.After the operations , rCBF (1.30 ±0.27) and rCBV (1.26 ±0.21) of MCA perfusion regions on the operative and the contralateral sides were higher than rCBF (0.73 ±0.15) and rCBV (0.98 ±0.12) before the operation significantly (t=-7.19,-6.64,P<0.05).rMTT (1.06 ±0.20) and rDT (1.07 ± 0.18) after the operation were lower than rMTT(1.53 ±0.34)and rDT (1.40 ±0.26) before the operation (t=5.62,5.40,P<0.05) .In MCA perfusion regions on the operative and cerebellar sides , rCBF(1.93 ± 0.34)and rCBV(2.25 ±0.35)were higher than rCBF(0.88 ±0.18)and rCBV(1.16 ±0.22)(t=-3.04,-3.06,P<0.05) before the operation.rMTT (1.13 ±0.29) and rDT (1.29 ±0.12) were lower than rMTT (1.88 ±0.19 ) and rDT ( 3.29 ±0.47 ) before the operation ( t =4.01, 4.72, P <0.05 ).Conclusions MRA is a safe , reliable method to evaluate abnormal vessels and cerebral revascularization after the operation in moyamoya disease.PWI can detect poor cerebral perfusion , and can be used for assessment of the effect of cerebral revascularization.

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Objective To investigate different antigens detected by a novel labelled reagent‐quantum dots(QDs) in the colorectal cancer tissues microarray(TMA) .Methods Depend on QDs streptavidin conjugate(QDs‐SA) combined specially with biotinylation IgG ,immune of luorescent histochemistry was utilized to examine expression of K‐ras ,matrix‐remodeling associated 5(MXRA5) proteins in the colorectal cancer TMA ,where the protein accurate location was observed .Results K‐ras ,matrix‐remodeling associ‐ated 5(MXRA5) proteins were high expressed in colorectal cancer tissue and located accurately in the cell membrane and nucleus of colorectal cancer cells ,respectively .Conclusion QDs exhibit excellent photostability ,broad emission spectrum and long fluorescence lifetime .Modified with streptavidin could accurately detect different protein locations in the colorectal cancer TMA .This is a novel approach for studying targeted imaging of colorectal cancer in vivo and vitro clinical diagnosis .