Tsutsugamushi disease is an acute infectious rickettsial disease caused by the intracellular parasite Orientia tsutsugamushi. Due to its variety of clinical signs, this disease is often misdiagnosed. This article examines a total of 4 patients who visited our clinics with fever and sore throat. 3 of them had body temperature of 39.5 Celsius degrees when admitted. The characteristic black eschar occurred on 4 of them. Lymphadenopathy occurred on 2 of them. Cough occurred on 1 of them. Lab tests showed that 3 of them had Leukocytosis, 1 of them had increased bronchovascular markings, and 3 of them had Weil-Felix test positive. After admission, all patients, who were confirmed of diagnosis of tsutsugamushi disease instead of tonsillitis, received the comprehensive treatment and cured afterwards.
Diagnostic Errors ; Humans ; Orientia tsutsugamushi ; Pharyngitis ; etiology ; Scrub Typhus ; complications ; diagnosis ; Tonsillitis ; diagnosis

The quality of traditional Chinese medicines (TCMs) has been mainly evaluated based on chemical ingredients, yet recently more attentions have been paid on biological ingredients, especially for pill-based preparations. It is a key approach to establish a fast, accurate and systematic method of biological ingredient analysis for realization of modernization, industrialization and internationalization of TCMs. The biological ingredient analysis of TCM preparations could be abstracted as the identification of multiple species from a biological mixture. The metagenomic approach based on high-throughput-sequencing (HTS) and big-data-mining has been considered as one of the most effective methods for multiple species analysis of a biological mixture, which would also be helpful for the analysis of biological ingredients in TCMs. Simultaneous identification of diverse species, including the prescribed species, adulterants, toxic species, protected species and even the biological impurities introduced through production process, could be achieved by selecting appropriate DNA biomarkers, as well as applying large-scale sequence comparison and data mining. By this approach, it is prospective to offer an evaluation basis for the effectiveness, safety and legality of TCM preparations.
Biological Products ; chemistry ; Data Mining ; High-Throughput Nucleotide Sequencing ; Medicine, Chinese Traditional ; Metagenomics ; methods

Objective:To explore the influential factors of cognitive change among Chinese oldest-old.Method: Three waves of data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)were analyzed with a two-level repeated measures model.Results:In baseline,the male had a higher mean MMSE score than the female(27.0?3.7/24.4?5.6,P

Objective To investigate the expression of CD158b in NK cells after allogeneic kidney transplantation.Methods In 62 patients with allogeneic kidney transplantation, blood samples were collected on the day before operation, first, 7th day after operation, the moment the graft (reco)-(vered) and the acute rejection occurred. The expression of CD158b was detected in peripheral blood NK cells. The ratio of CD3~-CD16/56~+CD158b~+ was measured.Results There were 38 patients without acute rejection during the whole transplantation period. The ratio of CD3~-CD16/56~+ cells and CD3~-CD16/56~+CD158b~+ cells were stable before and after the transplantation. Twenty-four patients experienced acute rejection post-transplantation. The ratio of CD3~-CD16/56~+ cells was increased significantly after acute rejection, the ratio of CD3~-CD16/56~+CD158b~+ cells decreased significantly, and the percentage of CD3~-CD16/56~+CD158b~+ cells of total NK cells decreased significantly.Conclusion There are not too much factors interfering with the expression of CD158b in NK cells, and the ratio of CD3~-CD16/56~+CD158b~+ cells had already decreased significantly before the clinical diagnosis of (acute) rejection. Monitoring of CD158b in NK cells is more accurate and sensitive for the evaluation of immune state.

The quality of traditional Chinese medicines (TCMs) has been mainly evaluated based on chemical ingredients, yet recently more attentions have been paid on biological ingredients, especially for pill-based preparations. It is a key approach to establish a fast, accurate and systematic method of biological ingredient analysis for realization of modernization, industrialization and internationalization of TCMs. The biological ingredient analysis of TCM preparations could be abstracted as the identification of multiple species from a biological mixture. The metagenomic approach based on high-throughput-sequencing (HTS) and big-data-mining has been considered as one of the most effective methods for multiple species analysis of a biological mixture, which would also be helpful for the analysis of biological ingredients in TCMs. Simultaneous identification of diverse species, including the prescribed species, adulterants, toxic species, protected species and even the biological impurities introduced through production process, could be achieved by selecting appropriate DNA biomarkers, as well as applying large-scale sequence comparison and data mining. By this approach, it is prospective to offer an evaluation basis for the effectiveness, safety and legality of TCM preparations.

Abstract: Objective　To monitor and analyze the avian influenza virus contamination in the environment outside the poultry-related places in Guangxi, and to assess the risk of human infection with avian influenza viruses, so as to provide a scientific basis for the prevention and control of avian influenza in Guangxi. Methods　From 2021 to 2022, environmental samples from 5 kinds of poultry-related sites were collected monthly in 14 cities of Guangxi. The real-time fluorescent quantitative RT-PCR method was used to detect the nucleic acids of generic influenza A viruses, and H5, H7, and H9 subtypes of avian influenza virus. The detection results of avian influenza virus in the environment of the poultry-related sites in Guangxi were collected for retrospective analysis. SPSS 22.0 was used for data analysis, and the chi-square test was used to compare the rates. Results　From 2021 to 2022, a total of 5 960 environmental samples were collected in 14 cities, of which 3 918 were positive for influenza A virus nucleic acid, with a positive rate of 65.74%; Among the positive samples, 281 were positive for H5 subtype (7.17%), 2 508 were positive for H9 subtype (64.01%), 552 were positive for H5+H9 subtype (14.09%), 577 were positive for type A but not H5/H7/H9 (14.73%), and no subtype H7 was detected. The positive rate of influenza A in poultry-related environment samples was higher throughout the year in Guangxi; except for Wuzhou, which had a similar number of H5, H9, and A non-H5/H7/H9 subtypes, the H9 subtype was predominantly detected in other cities. There was significant variability in positive rates among different regions, with the highest being in Hezhou City (90.32%, 653/723) and the lowest in Yulin City (28.96%, 75/259). The positive rate of different specimen types ranged from 50.32% to 74.94%. There were statistically significant differences in the positive rates of samples from different types of samples (χ2=163.08, P<0.001), different months (χ2=172.69, P<0.001), different regions (χ2=498.86, P<0.001), different monitoring sites (χ2=370.01, P<0.001). Conclusions　There is severe contamination of avian influenza virus in the poultry-related environment in Guangxi, predominantly with the H9 and H5 subtypes. Therefore, the relevant authorities in Guangxi should strengthen the monitoring, management, and disinfection of poultry-related premises.

OBJECTIVETo compare the tissue engineered cartilage constructed with chondrocytes derived from auricular and articular cartilage.

METHODSChondrocytes were isolated from porcine auricular and articular cartilage, and BMSCs were obtained from bone marrow aspirate and cultured. Each kind of chondrocytes were resuspended alone or mixed with BMSCs at a ratio of 1:1, and seeded onto PGA/PLA scaffolds to construct tissue engineered cartilage (n = 4). The constructs were cultured for 8 weeks in vitro and then subcutaneously implanted into nude mice for 6 weeks. The differences between chondrocytes monoculture from articular and auricular cartilage or between each of them co-cultured with BMSCs were evaluated by gross view, measurement of thickness and wet weight, histological examinations including H&E, Safranin O, type II collagen, and Ponceau's & Victoria blue staining, and gene expression analysis of cartilage related genes.

RESULTSNo obvious differences were found histologically among the complexes constructed in vitro 8 weeks except for few elastic fibers secreted in the auricular chondrocytes + BMSCs co-culture group. Neo-cartilage is thicker in the groups of articular chondrocytes (38. 1% than the group of auricular chondrocytes, P < 0.05) and articular chondrocytes + BMSCs co-culture (19.3% than the group of auricular chondrocytes + BMSCs, P < 0.05). However, after 6 weeks in vivo the elastic fibers were found positive in the complexes constructed by auricular chondrocytes, and its staining was even stronger and more homogenous in the group of auricular chondrocytes + BMSCs co-culture. The tissues generated by articular chondrocytes alone and co-cultured with BMSCs both formed the characteristic features of three-layer structure of hyaline cartilage and ossified in vivo with significant up-regulation of COL10A1 and MMP-13. To summarize, auricular chondrocytes formed the elastic cartilage while articular chondrocytes formed the hyaline cartilage during the development of tissue engineered cartilage either by monoculture or the co-culture with BMSCs.

CONCLUSIONSThe chondrogenic response of chondrocytes from different cartilage origins demonstrates that an initial chondrocyte and cartilage type recapitulates the same in later tissue-engineered development.

Animals ; Bone Marrow Cells ; cytology ; Cartilage, Articular ; cytology ; Cells, Cultured ; Chondrocytes ; Coculture Techniques ; Ear Auricle ; cytology ; Mesenchymal Stromal Cells ; cytology ; Mice, Nude ; Swine ; Tissue Engineering ; methods ; Tissue Scaffolds

Adolescent ; Adult ; Child ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Sunburn ; Young Adult

Objective To prepare taxol TPP-PEG-PE nanomicelles and study its in vitro release behavior, mitochondrial targeting and pro-apoptosis of A549 lung cancer cells. Methods The taxol TPP-PEG-PE nanomicelles were prepared by membrane hydration method. Based on the drug loading, encapsulation efficiency and particle size, the preparation parameters of taxol TPP-PEG-PE nanomicelles were optimized. The preferred nano-drug delivery system was then characterized. The drug delivery system was evaluated by in vitro drug release, mitochondrial targeting, lung cancer cell toxicity, and apoptosis assay. Results The diameter of taxol TPP-PEG-PE nanomicelles was (18.7 ± 0.8) nm, Zeta potential was (13.4 ± 0.5) mV, and the results of TEM electron microscopy showed that the taxol TPP-PEG-PE nanomicelles were regular spheres of uniform size. Mitochondrial targeting experiments showed that TPP-PEG-PE nanomicelles can promote drug accumulation in mitochondrial sites. Lung cancer cytotoxicity assay showed that taxol TPP-PEG-PE nanomicelles had good anti-apoptotic effect, and Hoechst staining suggested that a large number of morphological changes were observated in apoptotic lung cancer cells. Taxol TPP-PEG-PE nanomicelles could significantly increase the pro- apoptotic Caspase-3 activity and reduce the expression of anti-apoptotic protein Bcl-2 and c-IAP1. They were all significantly superior to that of taxol-PEG-PE nanomicelles and taxol group (P < 0.01). Conclusion The taxol TPP-PEG-PE nanomicelles had good mitochondrial targeting of lung cancer cells and promoted the apoptosis of lung cancer cells. It was a potential and efficient drug delivery system for lung cancer cell mitochondria.

Objective:To evaluate the short-term prognostic value of model for end-stage liver disease (MELD) combined with high density lipoprotein-cholesterol (HDL-C) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:From December 2015 to December 2018, 182 patients with HBV-ACLF who were treated in Henan Provincial People′s Hospital were included. Prognosis and clinical data including HDL-C, total bilirubin, international standardized ratio (INR), creatinine of patients within 24 hours after admission were collected and analyzed retrospectively.The values of MELD were calculated. The binary logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients.The receiver operator characteristic curve (ROC) and MedCalc 15.2 software were used to assess the predictive value of MELD, HDL-C and MELD-HDL-C model for prognosis. Kaplan-Meier survival curve was performed to analyze the prognosis of patients in different groups.Results:Sixty patients were divided into the death group and 122 patients were divided into the survival group according to the prognosis during hospitalization and 90 days after discharge. The MELD score of patients in the survival group was 21(19, 24), which was significantly lower than that in the death group (29(25, 34)), and the HDL-C value of patients in the survival group was significantly higher than that in the death group (0.3 (0.1, 0.6) mmol/L vs 0.2(0.1, 0.5) mmol/L). The differences were both statistically significant ( Z=-6.290 and -4.087, respectively, both P<0.01). Multivariate logistic regression analysis showed that MELD score and HDL-C value were the independent risk factors for 90-day mortality in patients with HBV-ACLF(odds ratio ( OR)=1.432, 95% confidence interval ( CI)1.271-1.613; OR=0.584, 95% CI 0.487-0.700, respectively; both P<0.01). Areas under the ROC of MELD, HDL-C and MELD-HDL-C scoring models were 0.775, 0.782 and 0.878, respectively. MELD-HDL-C scoring model was superior to both MELD and HDL-C , and the differences were both statistically significant ( Z=3.944 and 3.104, respectively, both P<0.01). When the MELD-HDL-C Youden′s index was set at 0.72, the optimal threshold was 24.69. Patients with MELD-HDL-C score≥24.69 had lower survival rate than patients with MELD-HDL-C score<24.69, and the difference was statistically significant ( χ2=142.900, P<0.01). Conclusion:MELD, HDL-C and MELD-HDL-C scoring systems could predict the short-term prognosis in patients with HBV-ACLF, and the predictive value of MELD-HDL-C has the superiority.