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

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.

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.

Objectives To investigate etiology, clinical characteristics and outcome in children with epilepsia partialis continua (EPC). Methods Sixty-three pediatric patients with EPC were retrospectively analysed. The patients aged (5.53±3.65) years old, with brain CT scans or MRIs after diagnosis, basic laboratory tests, cerebrospinal lfuid analysis and electroencephalog-raphy. The average follow-up time was (22.19±21.19) months (6-72 months). Results The median duration of EPC was 11 days (1-180 days). The causes of EPC were inlfammatory and immune-mediation (36 cases, 57.14%, Rasmussen’s encephalitis included), metabolic disorders (8 cases, 12.70%), brain structure abnormalities (5 cases, 7.94%), vascular malformation (5 cases, 7.94%), dual causes (3 cases, 4.76%), post brain surgery (2 cases, 3.17%) and cryptogenic pathogenesis (4 cases, 6.35%). Neurological dysfunc-tions were observed in 44 cases (69.84%). Age, routine cerebrospinal lfuid abnormalities, the presence of inlfammation and im-mune mediated, EPC long duration, involving the right upper extremity were the risk factors of poor prognosis. Conclusions The most common causes of childhood EPC are inlfammation and immune-mediated central nervous system diseases. Patients with early age of onset, a great tendency of longer duration of EPC and cerebrospinal lfuid abnormalities, involving the right upper ex-tremity have a poor prognosis.

Objective To investigate the effect of dietary fiber on carbohydrate metabolism of healthy volunteers after the intake of corn starch meal. Methods Totally 12 healthy volunteers aged (25. 8 ± 5. 3) years were enrolled in this study, and they were equally randomly divided into two groups (group A and group B). This was an open, randomized, cross-over, and two-period study, and each period lasted for one day. In period 1, the subjects in group A received fiber-free corn starch and group B received high-fiber corn starch (containing 16 g dietary fiber). In period 2, the two groups are crossed. There was a one-week wash-out time between the two study days. On the study day, breath samples of fasting and 0. 5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0,7. 0, 8. 0 hours post meal were collected to measure13 CO2. Results The delta over baseline at 0. 5, 1.5, 2. 0,2. 5, 3. 0, 4. 0 hour after test meal in fiber free group and in high fiber group were 0. 79, 2. 03, 2. 57, 2. 86,3. 02, 3. 18 and 0. 16, 1. 33, 1.77, 2. 10, 2. 34, 2.42, respectively (the P value was 0. 014, 0. 014, 0. 011,0.018, 0. 036, and 0.020, respectively). Peak concentration of delta over baseline of fiber free group and high fiber group was 3.18 and 2. 56 respectively, there was no significant difference between two groups (P > 0. 05) ,peak time of the group at 4. 0 hour and 3. 5 hour respectively, showed significant difference (P = 0. 032). The cumulative percentage dose recovered 0. 5-6. 0 hours after test meal in fiber-free group and in high-fiber group were 0.41, 1.46, 3.15, 5.50, 8.28, 11.30, 14.42, 17. 62, 23. 65, 28. 78 and 0. 09, 0. 55, 1.61, 3.22,5.23,7.53, 10.09, 12.68, 17.60, 22.27 respectively (the P value was 0.014, 0.018, 0.018, 0.014, 0.013,0.014, 0.018, 0.020, 0.025, and 0.044, respectively). However, there was no significant difference 6.0 hours after meal (P > 0. 05 ). Conclusion The dietary fiber used in this study can delay the absorption of carbohydrate 6. 0 hours within intake without influencing its total absorption amount.

Objective To investigate the efficacy of Ganju Bingmei Pill combined with voice therapy in the treatment of vocal nodules .Methods A total of 72 patients with vocal nodules and 60 health people in our hospital were included .Patients were randomly divided into two groups :Group A (36 cases) with Ganju Bingmei Pill thera‐py ,group B (36 cases) with Ganju Bingmei Pill combined with voice therapy .Taking method of Ganju Bingmei Pill was three times a day ,2 tablets every time ,two weeks as one course of treatment with a total of four courses .Voice therapy in Group B was two weeks for one course with a total of four courses .The results were evaluated by voice handicap index ,voice acoustic analysis and laryngostroboscopy .Vocal nodules disappear or significantly reduce indi‐cated that the treatment was effective .Statistical analysis was performed using t - test and chi - square test .Results In group A ,the scores of T ,F ,P ,E were reduced compared with before treatment (P < 0 .05) ,however ,com‐pared with normal control group ,the score of F ,E ,T were still higher than those of normal group (P < 0 .05) .In group B ,the score of T ,F ,P ,E were reduced compared with before treatment (P< 0 .05) ,and compared with normal control group ,the score of F ,P ,E ,T were close to normal(P> 0 .05) .The VHI score in group B were significantly lower than those of in group A (P < 0 .05) .In Group A compared with before treatment ,jitter ,shimmer ,NHR were lower ,F0 was higher(P < 0 .05) ,however ,compared with the group of normal control ,F0 ,jitter ,shimmer , NHR were still statistically significant (P < 0 .05) .In group B with before treatment jitter ,shimmer ,NHR were lower ,F0 was higher (P< 0 .05) ,and jitter ,shimmer were already close to normal(P> 0 .05) .The F0 of group B after treatment was higher than group A ,jitter and shimmer were lower than group A after treatment (P< 0 .05) . After treatment ,there were 28 cases of group A (77 .78% )of patients with vocal nodules disappear or significantly reduce .There were 35 cases of group B(97 .22% ) of patients with vocal nodules disappear or significantly reduce , the effective rate between group A and group B was statistically significant (P< 0 .05) .Conclusion Ganju Bingmei Pill therapy and Ganju Bingmei Pill therapy combined with voice therapy all have curative effect for the treatment of vocal nodules however ,Ganju Bingmei Pill therapy combined with voice therapy is more efficient .

Objective To study the effect of interleukin 2(IL-2)of clinical dose range,on the proliferation of human peripheral blood T cells,with special emphasis on the number and functional phenotype of γδT cells.Methods Human peripheral blood mononuelear cells(PBMCs)were isolated by density gradient centrifugation and cultured for 2 weeks at different IL-2 concentrations.Ratio and phenotype of different T cell subpopulations before and after in vitro expansion were explored by immunofluorescence staining.Cell number was estimated by trypan blue staining and cell counting.Results Within the four functional phenotypes of Vδ1 as well as Vδ2 γδT cells,CD27~+cells(including CD27~+CD45RA~+and CD27~+CD45RA~-subsets)expressed lymphoid tissue homing receptor CCR7,whereas CD27~-cells(including CD27~-CD45RA~+and CD27~-CD45RA~-subsets)had the peripheral tissue homing potential.All the studied γδT functional subsets showed the expression of activity related receptors,and the ability of a rapid production of various amount of cytotoxicity related effectors following mitogen stimulation.Although IL-2 at high concentration suppressed the proliferation of CD4 T cells,it may promote the proliferation of γδT cells.The proliferated γδT cells were mainly CD27~-CD45RA~-effector cells.Conclusion IL-2 of the clinical dose range may promote proliferation of human peripheral blood γδT cells,which might have important biological significance in IL-2 based anti-tumor therapy.

ObjectiveTo identify the association of HLA-DQA1*0302 and DQB1*0303 alleles with vitiligo in Uygur nationality in Xinjiang Uygur Autonomous Region. MethodsPolymerase chain reaction with sequence-specific primers(PCR-SSP) was performed to analyze the distribution of HLA-DQA1*0302 and HLA-DQB1*0303 alleles among 300 patients with vitiligo and 300 normal human controls of Uygur nationality in Xinjiang region. ResultsA significant increase was observed in the frequency of HLA-DQA1*0302 and -DQB1*0303 alleles in patients with vitiligo compared with the controls(20.5％ vs. 13.83％, 30.17％ vs. 13.33％, both P ＜ 0.01 ). Increased frequency of HLA-DQA1*0302 and -DQB1*0303 alleles was also seen in patients with adult vitiligo (onset age ＞ 12 years) and those with childhood vitiligo (onset age ≤≤ 12 years) ascompared with the normal controls(both P ＜ 0.01). The frequency of DQB1*0303 allele was higher in both patients with and without family history of vitiligo than in the normal controls(both P ＜ 0.01), while that of DQA 1*0302 was higher in only patients without family history (P ＜ 0.01 ). No significant difference was observed in the frequency of HLA-DQA 1*0302 or HLA-DQB1*0303 between patients with adult vitiligo and those with childhood vitiligo or between patients with and without family history(all P ＞ 0.05). Conclusions HLADQA 1*0302 and DQB 1*0303 alleles may be associated with vitiligo in Uygur nationality in Xinjiang region,and there seems to be genetic heterogeneity between patients with adult and childhood vitiligo and between vitiligo patients with and without family history.